1.Effects of micronutrient powder and complementary food blend on growth and micronutrient status of Filipino rural children: a randomised controlled trial
Eva A Goyena ; Corazon VC Barba ; Ma. Theresa M Talavera ; Merlyne M Paunlagui ; Agnes C Rola ; Nancy A Tandang
Malaysian Journal of Nutrition 2018;24(4):475-492
Introduction: This study aimed to evaluate the effects of micronutrient powders (MNP) containing 15 versus nine nutrients, with or without complementary food blend (BigMo), on the nutritional status of rural young children in the Philippines.
Methods: The study was conducted for 6 months among 126 rural children aged 6-17 months in four villages selected by cluster randomisation. Children were randomised into four groups: VitaMix with 15 micronutrients plus Bigas Mongo (BigMo) (n=31); VitaMix without BigMo (n=31); Micronutrient Growth Mix (MGM) with nine micronutrients plus BigMo (n=29); and MGM without BigMo (n=31). Blood samples were collected at baseline and endline to determine haemoglobin, ferritin, retinol, and zinc concentrations. Intervention compliance, weight, length, and dietary intakes were collected every month. One-way ANOVA was used to compare changes in the mean estimates across groups. McNemar and Pearson’s x2 tests were used to compare changes in the proportion estimates within groups and across groups, respectively.
Results: Both VitaMix and MGM with or without BigMo improved haemoglobin concentrations and reduced anaemia (Hb<11g/dL). However, only VitaMix and MGM combined with BigMo had effects in reducing moderate anaemia (Hb<10g/dL), compared to groups without BigMo. Only MGM+BigMo group demonstrated significant reduction in the prevalence of moderate non-iron deficiency anaemia (IDA) (Hb<10g/dL and ferritin>12ug/L). A significant increase in the length-for-age z-scores was noted in the MGM with and without BigMo groups.
Conclusion: Daily supplementation of MGM with nine micronutrients combined with complementary food blend may have a greater potential than MNP with 15 micronutrients in improving the nutritional status of young children.
2.Factors influencing malnutrition in Filipino elderly
Nancy A. Tandang ; Reanne Len C. Arlan ; Gerard C. Navarro
Malaysian Journal of Nutrition 2020;26(No.3):317-322
Introduction: The elderly population is susceptible to malnutrition due to the
physiological and functional changes caused by ageing. Hence, to prevent the
degenerative nutritional conditions of the elderly and improve their quality of life,
this study aimed to determine the influencing factors of malnutrition among Filipino
elderly. Methods: Anthropometric component data from the 8th National Nutrition
Survey (NNS) were utilised along with the nutritional status of Filipino elderly,
based on body mass index as the dependent variable and variables from the clinical
and health, dietary, and socioeconomic components of NNS as explanatory factors.
Multinomial logistic regression analysis was then performed in fitting models.
Results: High magnitude and severity of malnutrition were observed among
Filipino elderly – 20.2% were underweight and 24.8% were overweight. Significant
influencing factors in estimating an elderly’s odds of being underweight were the
elderly’s age group, presence of hypertension, presence of anaemia, and adequacy of
vitamin A intake. Whereas, significant influencing factors in estimating an elderly’s
odds of being overweight/obese included highest educational attainment, presence
of anaemia, hypertension, diabetes, and dyslipidaemia. Conclusion: Knowing
the influencing factors may help the elderly become more aware and conscious of
their health, as well as to promote nutrient intakes to prevent malnutrition that
can worsen their health conditions. Additionally, concerned institutions in the
country could use the findings of this study as one of the bases in strengthening
their approach and implementation or even provide relevant and timely policies and
programmes that address malnutrition in the elderly of this country.
3.Maternal characteristics and weight-for-length status of young children aged 0-23 months in the Philippines.
Alea Paula V. HINOJOSA ; Nancy A. TANDANG ; Divine Grace C. DOMINGO
Acta Medica Philippina 2022;56(10):5-15
Introduction. Malnutrition in the forms of wasting and overweight among children ages 0 to 23 months is a continuing public health concern in the Philippines. Childhood malnutrition has lifelong consequences. For young children aged 0-23 months, maternal influences play a significant role in the realization of optimal nutritional status.
Objective. This study aimed to identify maternal characteristics that may influence the nutritional status of children aged 0-23 months.
Methods. This study utilized data from the 2015 Updating Survey from Department of Science and Technology-Food and Nutrition Research Institute. The association of maternal characteristics with the nutritional status of a child was determined using the Rao-Scott Chi-squared test statistic. Multinomial logistic regression was used to model a child's nutritional status using weight-for-length as an indicator.
Results. A child whose mother was educated was less likely to be wasted. The odds of a child being wasted was observed to increase with underweight mothers, longer duration of lactation and higher wealth quintile. Alternatively, the odds of a child to be overweight is reduced if the mother had formal education, was in late lactation stage, and availed tetanus toxoid vaccine. The likelihood that a child will be overweight increased with higher family wealth quintile and obesity of the mother.
Conclusion. Maternal nutritional status, education, duration of lactation, wealth quintile, and availment of prenatal services were found to be associated with the weight-for-height status of children 0-23 months. Incorporating the identified maternal factors when planning new interventions and policies is recommended to address wasting in young children.
Nutrition Surveys ; Overweight
4.Acceptability of height measuring equipment of different materials among community nutrition and health workers and parents in Laguna Province, Philippines.
Maria Theresa M. TALAVERA ; Normahitta P. GORDONCILLO ; Nancy A. TANDANG ; Divine Grace C. DOMINGO
Acta Medica Philippina 2022;56(3):30-36
OBJECTIVES: This study aimed to determine the acceptability of four height/length boards as measuring equipment, (1) NNC wooden height board (HB), (2) Allen's stick, (3) aluminum-acrylic height board, and (4) stadiometer, from the perspective of the community nutrition and health workers (CNHWs) and mothers/caregivers.
METHODS: The study was conducted in two municipalities in the province of Laguna, Philippines. Respondents were 12 CNHWs and 22 parents/guardians of randomly selected children ages 1-5 years. Focus group discussions were also conducted among CNHWs to determine their perceptions, experiences, and feedback on the use of the equipment. Parents/guardians were interviewed about their views on the acceptability of the equipment.
RESULTS AND CONCLUSION: In the urban area, Allen's stick was most favored by end-users, while in the rural area, the NNC wooden HB was the most acceptable. Meanwhile, guardians preferred the aluminum-acrylic HB in the rural area and Allen's stick in the urban area. It was concluded that the use of height boards to measure the height or length of children was acceptable to both CHNWs and parents. CHNWs preferred the stadiometer for height measurement and Allen's stick for length measurement. In contrast parents/guardians preferred the aluminum-acrylic HB and Allen's stick as these were deemed non-threatening, culturally acceptable, safe, comfortable for the children, and the procedures were easily understood.
Nutritional Status
5.Relationship between maternal characteristics and stunting in children aged 0 to 23 months in the Philippines
Alea Paula V. Hinojosa ; Nancy A. Tandang ; Divine Grace C. Domingo
Malaysian Journal of Nutrition 2021;27(No.3):411-420
Introduction: Stunting is the most prevalent form of child malnutrition worldwide,
and is the best overall indicator of growth. This study aimed to determine the
relationship between maternal characteristics and nutritional status of children
aged 0-23 months based on their length/height-for-age. Method: The study
used data from the 2015 Updating Survey conducted by the Philippines’ Food and
Nutrition Research Institute – Department of Science and Technology. It employed
a stratified multi-stage sampling technique covering all regions in the Philippines.
Mothers (n=5,254) of sampled children 0-23 months were the respondents of the
Maternal Health and Nutrition survey. The length-for-age z-scores (LAZ) of children
and maternal characteristics were analysed. Rao-Scott Chi-square test was used for
association analysis. Logistic regression was performed for model fitting. Results:
A quarter (25.2%) of children aged 0-23 months in the Philippines at the time of
the survey were stunted, with the highest prevalence (36.2%) observed among
12-23 months. Children being stunted or normal in height was associated with
prenatal services, maternal nutritional status, education, and duration of lactation.
Maternal education (OR: 0.39; p=0.012), age-appropriate breastfeeding (OR: 0.63;
p=0.042), and prenatal services like tetanus toxoid vaccination (OR: 0.67; p=0.011)
and ultrasound (OR: 0.71; p=0.025) lowered the likelihood of a child being stunted.
Conclusion: It is recommended to strengthen and intensify service delivery among
pregnant and lactating women because of the implication of maternal factors to the
length-for-age status of children 0-23 months.
6.Effect of a capacity building on the knowledge, attitude, and self-efficacy on nutrition-sensitive agriculture (NSA) of the Local Agriculture Planners in CALABARZON: A non-randomized controlled trial
Kim Leonard G. Dela luna ; Maria Theresa M. Talavera ; Leila S. Africa ; Clarissa B. Juanico ; Nancy A. Tandang ; Marison Felicidad R. Dy
Acta Medica Philippina 2024;58(Early Access 2024):1-12
Background:
Filipino farmers recorded the highest incidence of poverty in the last decade. In addition, a heightened awareness was observed within agriculture and different government agencies to better understand the link between agriculture and nutrition. However, limited studies have been conducted in the Philippines integrating nutritionsensitive agriculture into the Municipal Agricultural Development Plan (MADP).
Objectives:
This study aims to determine the effect of capacity building on the knowledge, attitude, and self-efficacy of municipal agriculturists on Nutrition-Sensitive Agriculture (NSA) in CALABARZON.
Methods:
This study utilized a non-randomized controlled trial design to measure the change in knowledge, attitude, and self-efficacy of the municipal agriculturists on NSA and nutrition sensitivity of the MADP. A total of 57 municipal agriculturists from CALABARZON participated in the capacity building.
Results:
Local agriculture planners' knowledge, attitude, and self-efficacy significantly improved after capacity building. In addition, membership of municipal agriculturists to local nutrition committee was significantly associated with higher scores difference in knowledge and self-efficacy after the training. Meanwhile, the score difference in their attitude was significantly related to the tenure of employment in local agriculture planners.
Conclusion
Capacity building on the NSA can significantly improve local agriculture planners' knowledge, attitude, and self-efficacy. Thus, the government must support programs and initiatives concerning the NSA, like increasing the capacity of local agriculture planners. This will allow them to integrate nutrition-sensitive agriculture concepts positively into their agriculture development plan.
agriculture
;
food security
;
capacity building
7.Environmental enteric dysfunction, soil transmitted helminthiasis and stunting among 36- to 59-month-old children in Quezon Province, Philippines
Angelina R. Bustos ; Carmelita M. Rebancos ; Corazon VC. Barba ; Victorio B. Molina ; Merlyne M. Paunlagui ; Nancy A. Tandang
Malaysian Journal of Nutrition 2021;27(No.2):221-231
Introduction: Environmental enteric dysfunction (EED) is relevant in public health
as it is a potential cause of child stunting. In the Philippines, stunting affects 33.4%
of children in 2015. As of date, no local studies on EED exist. This study primarily
aimed to determine the prevalence of EED, soil transmitted helminthiasis (STH) and
stunting; and their relationships. Methods: A cross-sectional study was conducted
among 120 children aged 36-59 months old in Quezon Province, Philippines. EED
was assessed via glucose hydrogen breath test with a cut-off of >20 ppm over
baseline by 90 minutes suggestive of small intestinal bacterial overgrowth (SIBO), a
biomarker of EED. Kato Katz Technique was used to determine STH. Stunting was
determined using the 2006 World Health Organization Child Growth Standards.
Descriptive and correlation analyses of data were done at 10% level of significance.
The study received approval from the National Ethics Committee of PCHRD-DOST,
Philippines. Results: Data on expired hydrogen level of <20ppm were documented.
The prevalence of STH among children were 38.1% for Ascaris lumbricodes, 15.3%
for Trichuris trichiura, and 1.7% for hookworm infections. A high rate of stunting at
40.0% was observed. There was a significant positive association between stunting
and the presence of Ascaris (p=0.01). Conclusion: There was no case of EED
detected in the study. The severity of stunting was high at 40.0%. Among the STH,
the prevalence of 38.1% children having Ascaris lumbricodes was alarming in terms
of morbidity control. Nutrition interventions including WASH practices and the use
of anthelminthic drugs need to be intensified to address stunting and STH.
8.Motivating and hindering factors affecting muslim mothers' Infant and Young Child Feeding (IYCF) practices in select municipalities of Maguindanao, BARMM, Philippines
Paul Alteo A. Bagabaldo ; Maria Theresa M. Talavera ; Divine Grace C. Domingo ; Angelina R. Bustos ; Leila S. Africa ; Angelina DR. Felix ; Anna Teresa O. Orillo ; Nancy A. Tandang ; Warren TK Lee ; Maria Cecilia F. Pastores
Acta Medica Philippina 2024;58(Early Access 2024):1-11
Objectives:
This study aimed to determine the motivating and hindering factors affecting the Infant and Young Child Feeding (IYCF) practices of Muslim mothers in select municipalities of Maguindanao.
Methods:
A pretested questionnaire was administered through face-to-face interviews conducted among 320 randomly selected Muslim mothers with a child aged 6-23 months.
Results :
Results revealed that prelacteal feeding was practiced by 16.6% of the Muslim mothers, giving mostly plain water. Solid/semi-solid foods were introduced at a mean age of 6.1 ± 1.4 months, with home-cooked lugao (porridge) (55.0%) and commercial baby food (31.3%) as the top foods introduced. The majority of Muslim mothers (82.5%) fed processed foods as complementary food to their children, including instant noodles (85.2%) and canned goods (51.5%).
Conclusion
The results revealed suboptimal practices in prelacteal feeding and the reliance on processed foods among Muslim mothers, with economic factors, availability, and convenience as motivating factors in complementary feeding practices. Challenges such as household duties, low milk output, and financial constraints hinder breastfeeding and nutritious food provision for infants and young children. The study reinforced the necessity for holistic strategies in IYCF promotion among Muslim mothers.
breast feeding, Islam, malnutrition