Title: Dietary risk factors of physical growth of Filipino school-aged children

Summary

Adequate nutrition during childhood is essential to promote child growth and development.
The study evaluated the relationship of habitual nutrient intake and protein adequacy to the
prevalence of child malnutrition. Data were derived from a nationally representative sample of
children aged 6–12 years. Two nonconsecutive day 24-h dietary recalls (24hR) were collected to
estimate the individual food intake. PC-SIDE version 1.0 software (Software for Intake
Distribution Estimation) was used to estimate the habitual intake of key nutrients accounting
for between- and within-person differences in dietary intake. The 2007 WHO Protein
Digestibility Corrected Amino Acid Score (PDCAAS) method was used to measure the protein
quality or the utilizable protein intake. The nutritional status of the participants is reflected in
the weight-for-age, height-for-age, and body mass index (BMI)-for-age z-scores using the WHO
Growth Reference Standard (WHO, 2007).

Undernourished school-aged children were found to have high protein inadequacy. Higher
consumption of grains and cereal products, meat, and high-quality protein foods was
associated with a lower risk of stunting. Higher intake of milk and milk products, grains and
cereal products, high-quality protein foods, calcium, riboflavin, and vitamin C was associated
with a lower risk of underweight. Higher consumption of grains and cereal products, riboflavin,
thiamine, and fiber was associated with a lower risk of wasting. On the contrary, higher
consumption of meat, milk and milk products, grains and cereal products, high-quality protein
foods, and vitamin C was associated with a higher risk of obesity. Furthermore, linear growth of
children was found to be associated with high-quality protein foods, calcium, vitamin B12,
vitamin C, and vitamin D

Conclusion

This study provided important evidence into the dietary factors affecting the physical growth of
children aged 6–12  years. It was found that undernourished children have a high prevalence of
protein inadequacy. Consumption of meat and grains and cereal products, as well as utilizable
protein, was identified as the common possible risk factor for stunting, underweight, wasting,
obesity, and linear growth, while consumption of milk was identified as a common risk factor
for underweight and obesity among schoolchildren aged 6–12 years. Therefore, the study
suggests that nutrition interventions and policies focusing on child malnutrition should improve
the quality of nutrients in foods consumed by children to aid in proper growth and
development. This study suggests more researches on the dietary factors, especially utilizable
protein and physical growth.

Title: Usual Energy and Nutrient Intakes and Food Sources of Filipino Children Aged 6-12
Years from the 2013 National Nutrition Survey

Summary

It is important to assess the food intake of children aged 6–12 years in order to possibly link this
with other nutrition-specific interventions to address malnutrition. This study evaluated usual
energy and nutrient intakes and food sources of school-age children in the Philippines. Data
were from the 2013 National Nutrition Survey. A total of 6,565 children 6–12 years old from all
sampled 8,592 households were interviewed for first-day 24-h dietary recall. A second-day
recall was obtained from a random subsample (50% of the children). Usual energy and nutrient
intakes were estimated using the PC-SIDE program. Energy inadequacy was compared with
estimated energy requirements considering active physical activity. Macronutrients were
evaluated using the acceptable macronutrient distribution ranges. Micronutrient inadequacy
was computed using the estimated average requirements (EAR) cutoff point method.

Results showed that mean energy intake (1,358 kcal) of all children was 24.6% below the
estimated energy requirements. Forty-two percent had total fat intake as percentage of total
energy below the lower range of acceptable macronutrient distribution ranges (AMDR), and
hence most of the energy was provided by carbohydrates (Table 1). About 16% of children had
protein intake below the EAR [4]. The mean intakes of total sugar and dietary fiber were 26.8
and 6.9 g/day, respectively (Table 1).
The prevalence of inadequate total fat intake as percent energy intake was especially high in
rural areas (60%). In children from the poorest quintile, a higher proportion did not meet the
AMDR for total fat (80%), while 14% of the children from the richest quintile exceeded the
AMDR. Furthermore, 36% of children from the poorest quintile exceeded the AMDR for
carbohydrates (Table 1).

The vitamin with the highest prevalence of inadequacy was vitamin C (81%). Nutrient
inadequacy for other vitamins was: folate (70%), riboflavin (67%), and vitamin A (63%), vitamin
B6 (30%), niacin (13%), and vitamin B12 (9%). The average intakes of vitamins D and E were 2.2
µg/day and 2.6 mg/day, respectively, and these were very low compared with the
recommendations [4]. A high prevalence of inadequacy was also observed for calcium (93%),
iron (87%), phosphorus (48%), and zinc (38%). Usual intake of sodium, magnesium, and
potassium were 848, 130, and 853 mg/day, respectively. The mean intake of sodium exceeded
the requirement, while the intake of potassium and magnesium were below the requirement
(Table 1).

Refined rice is the major source of energy, carbohydrates, and protein providing 53, 67, and
35% of total intake, respectively (Table 2). Rice also contributed a large amount of phosphorous
(48%), iron (28%), calcium (20%), thiamine (32%), and riboflavin (17%). Another major
contributor of calcium intake was fish and shellfish (21%). The major sources of fats are pork,
sausages, and oils. The major source of vitamin C is fortified fruit-based drinks. Dark green leafy
vegetables were the major source of vitamin A (34%). Bread was a major source of folate,
contributing 17% (Table 2).

Conclusion

Applying usual intake analysis in Filipino children, this study demonstrated that the intakes of
fat and many micronutrients were markedly inadequate as evidenced by a high prevalence of
inadequate intakes of fat and most vitamins and minerals. The shortfalls in nutrients can be
largely explained by the high intake of refined rice, which is the major source of many key
nutrients, while nutrient-dense foods such as milk, fruits, and vegetables played little role in the
diet. The results are informative to nutrition policy and education both for parents and health
care professionals, and could be used for the development of various public health strategies to
improve diet quality and address nutrient shortfalls in the diets of this population.

Title: Cases of Undernutrition among Children in a Selected Elementary School

Summary

The study was conducted to assess the factors affecting undernutrition in undernourished
children in a selected elementary school in Laguna. The researchers aimed to determine the
relationship between the causes of undernutrition and the demographic profile of the
respondents. Among the 729 students in the school, 51 children were undernourished,
according to the list given by their nutrition office. The researchers found that most of the
undernourished children were male, and the age where undernutrition occurred most was 5
years of age. The socioeconomic status directly affects the diet and lifestyle of the respondents.
The study was done by the researchers to have better knowledge and understanding of the
occurrence of undernutrition in the said community. This research provided relevant
information and data for further implementation of effective actions to this issue.

CoInclusion

The study conducted in a selected elementary school in Laguna with a reported 51 children
who are undernourished. Most of the undernourished children are aged five. In addition to this,
most of the undernourished children have socioeconomic status of low income but not poor,
wherein the family salary per month was Php 7890- Php 15 780. The study also proves that the
diet varies according to the age of the children. During childhood, children are recommended to
eat fruits and vegetables to prevent consumption of solid fats, excess sugar, and sodium intake
(2015-2020 Dietary Guidelines of Americans). On the other hand, healthy lifestyle and diet
varies according to the socioeconomic status of the family where the child belongs. Low income
but not poor family only have low quality food to eat, since they only have limited budget
(Konttinen et al, 2012). It was also found out that lifestyle especially personal hygiene plays a
role in the nourishment of children. Moreover, diet was also important to maintain the health
and wellness of the children, thus, eating meal three times a day is vital.
Recommendations

The study benefits the nutrition department of the elementary school through the evaluation
whether their feeding program was effective and to raise awareness that undernourishment
have other factors like socioeconomic status, lifestyle, and diet. Second, the study will benefit
the parents because they will be informed about the factor where their children were deficient.
Lastly, the study is beneficial to other institutions and organizations because the study 23 can
be a basis of the prevalence of undernutrition in a certain place and in turn, they can provide
essential vitamins that are needed by children to improve their nutritional status.

References:

Angeles-Agdeppa, I., Nakamura, T., Sugita, M., Toledo, M. B., Sampaga, P. C., & Zamora, J. A. T.
(2022). Dietary risk factors of physical growth of Filipino school-aged children. Food & Nutrition
Research.

Angeles-Agdeppa, I., Dinney, L., & Capanzana, M. V. (2019). Usual Energy and Nutrient Intakes
and Food Sources of Filipino Children Aged 6-12 Years from the 2013 National Nutrition Survey.
In Nurturing a Healthy Generation of Children: Research Gaps and Opportunities (Vol. 91, pp.
111-122). Karger Publishers.

Aranguren, F. C., Gegabalen, R., Lozano, E., Mojica, R. J., Monique, T., Mondares, M. A., &
Quinto, L. Cases of Undernutrition among Children in a Selected Elementary School.