OBJECTIVE: This work presents an updated and broad documentation of current practices of blenderized whole food tube feed (BTF) handlers (n=40) in some tertiary (n=8) and specialty (n=2) hospitals in the National Capital Region, Philippines.

STUDY DESIGN: Descriptive study

METHODS: Survey questionnaire and checklists which reflect processes and practices on BTF production were developed and pre-tested. These tools were then administered to 40 respondents from 8 tertiary and 2 specialty hospitals in the National Capital Region, Philippines. Observations were also recorded concerning BTF handling and administration as well as the sanitation of the preparation facility. The study further conducted additional interviews, and on-the-job observations with the same group of respondents in each of the test hospitals to validate survey responses and actual demonstration made in the documentation phase.

RESULTS: Not all of the participating BTF handlers were observed to follow even simple personal and workplace hygienic practices. Moreover, not all BTF handlers had previous exposures to food safety systems training, and all test hospitals have yet to establish hazard analysis critical control point (HACCP) plans for BTF. The absence of accredited raw ingredient suppliers for the majority of the BTF facilities, failure to always wash raw materials prior to preparation, and the use of soft-boiled whole eggs were identified as sources of potential microbiological hazards. Total plate count was established to be as high as log10 7.19 CFU.ml-1. Ninety-three percent of the BTFs had plate counts exceeding the acceptable standard limit.

CONCLUSION: The microbiological quality of the BTFs analyzed was attributed to the observed poor hygienic practices, as well as the inherent microflora of BTF ingredients. Familiarity with good manufacturing practices (GMPs), good hygienic practices (GHPs), and HACCP is recommended to improve the microbiological quality of BTFs. The results of this work may be used as basis for advancing efforts to further improve BTF safety, especially that the country had just recently ratified the Philippine Food Safety Act of 2013.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Enteral Nutrition ; Feeding Methods ; Food Handling ; Hospitals ;

OBJECTIVE: This study has been conducted to determine the prevalence of malnutrition and nutritionally-at-risk community-dwelling older adults in an urban setting through the use of Mini Nutritional Assessment (MNA®).

METHODS: A cross-sectional survey was done among older adults in Barangay Sto. Niño, an urban poor community in Pasay City, Metro Manila to determine the prevalence of malnutrition and older adults using the short and full form of the Mini Nutritional Assessment (MNA®). Anthropometric assessment was done to determine body mass index as well as physical examination to determine presence of nutrient deficiencies.

RESULTS: Using the Asia Pacific cut-off for BMI, it can be noted that 16.5% were classified as underweight. On the other hand, results of the MNA® short form screening showed that less than half (42.6%) of the study respondents have normal nutritional status. Majority of the respondents were either malnourished (14.8%) or at risk of malnutrition (42.6%). Moreover, results of the Full MNA® form showed that almost half of the study respondents were either malnourished (8.2%) or at risk of malnutrition (39.3%). The rest of the study respondents were classified as having normal nutritional status (52.5%).

CONCLUSION: As compared to Body Mass Index, which can only identify prevalence of malnutrition, the MNA®, both short and full form, was not only able to identify malnourished and nutritionally-at-risk older adult as well as provide variables that may screen for possible causes of malnutrition. This is necessary and relevant for timely nutrition intervention for improved nutritional outcome among older adults.

Human ; Male ; Female ; Aged 80 And Over ; Aged (a Person 65 Through 79 Years Of Age) ; Nutrition Assessment ; Malnutrition

OBJECTIVE:The study was conducted to determine the validity of Dietary Diversity Score (DDS) as an alternative indicator for nutrient adequacy among older adults in Pasay City, Philippines.
METHODS: An analytic cross sectional study design was used on a representative sample of older adults (n = 82) in all barangays under the Doña Marta Health Center in Pasay City. A 5-stage multiple pass single 24-hour food recall was performed to determine the dietary intake of each respondent. Subject's nutrient intake was obtained using the FCT+Menu Eval software. Nutrient Adequacy Ratio (NAR) was then computed using the ratio of subject's nutrient intake to the Recommended Energy and Nutrient Intakes (RENI) for Filipinos.  The Mean Adequacy Ratio (MAR) was then obtained by computing for the average of the NARs, expressed as a ratio ranging from 0 - 1. Dietary Diversity Score was calculated using the DDS Questionnaire recommended by the FAO Guideline. For the statistical analysis, Pearson's correlation was used to determine the relationship between MAR and DDS. ROC curve analysis was done to determine the most appropriate cut-off points for using DDS among the older adults.
RESULTS: The selected older adults of Pasay City had a mean DDS of 4.15 (0.14) and a mean MAR of 0.64 (0.02). There was a significant and strong correlation between MAR and DDS (r = 0.519; P < 0.0001). When maximizing sensitivity and specificity, the best cut-off points for achieving a MAR equivalent to both 0.5 and 0.7 were between DDS 4 and 5.
CONCLUSION: DDS may be used as an indicator of nutrient adequacy among the randomly selected older adults.

Human ; Adult ; Roc Curve ; Philippines ; Energy Intake ; Diet ; Food ; Surveys And Questionnaires

Objective. This study was conducted to determine the dietary diversity score and its relation to nutritional adequacy among 16-19 year-old adolescents. Methods. Secondary data analyses were undertaken with a representative sample of 16-19 year-old adolescents (n=521) in a university campus in Manila in 2008. Dietary diversity scores (DDS) were calculated. Nutrient adequacy ratio (NAR) is the ratio of subject's nutrient intake to the 2002 Recommended Energy and Nutrient Intakes (RENI) for Filipinos. The mean adequacy ratio (MAR) was calculated as the sum of NARs for all evaluated nutrients divided by the number of nutrients evaluated, expressed as a ratio (range from 0-1). MAR was used as a measure of adequacy of overall diet. Pearson correlation coefficients between DDS and MAR were calculated and also evaluated for sensitivity and specificity, with MAR taken as the ideal standard of adequate intake. Results. The adolescents had a mean DDS of 3.94 (1.21) and a mean MAR of 0.67 (0.18). There was a strong correlation between MAR and DDS (r=0.543; P < 0.0001). A DDS of 4 was shown to be the best indicators for both MAR equivalent to 0.5 and 0.7 since they provided the best sensitivity and specificity. Conclusion. DDS can be used as a simple and quick indicator of the nutritional adequacy of the diets among these group of adolescents. Further investigation of this tool is needed for other population groups i.e., adults and elderly.
Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; DIET ; ADOLESCENT NUTRITIONAL PHYSIOLOGICAL PHENOMENA ; PHYSIOLOGICAL PHENOMENA ; NUTRITIONAL PHYSIOLOGICAL PHENOMENA ; DIET THERAPY

Objective: Rural and urban differences affect food availability, accessibility, and sustainability; thus, it has a great impact on household food security and dietary diversity. The relationship between the human environment and other factors threatens different domains of food systems resulting in food security. The objective of this study is to determine significant differences between the prevalence of household food security and diet diversity between urban and rural communities in Occidental Mindoro. Specifically, to determine the pattern of usual food intake of preschool children between rural and urban communities Methods: This study utilized a comparative, cross-sectional, analytic study design in order to determine the prevalence of each variable of interest in the two study areas. Radimer-Cornell Tool was utilized to assess the food security status of the household while the FAO-Dietary Diversity Score Questionnaire was used to the diversity of diet among PSC. A total of 480 (rural: n=240; urban: n=240) preschool children were recruited to participate in this study. Ratio and proportion using the point and interval estimate were used to determine the prevalence in different areas, meanwhile, chi-square of homogeneity was used to determine significant difference in the two areas under study. Results: Food insecurity in rural communities was found to be at 56.25% (95% CI: 49.97% to 62.53%) while the prevalence in urban communities was 45.83% (95% CI: 39.53% to 52.14%). There was a significant difference in the prevalence of household food insecurity between rural and urban communities (p=0.0224). Meanwhile, the prevalence of less dietary diversity among preschool children in rural communities was 37.08% (95%: 30.97% to 43.19%) and 26.25% (CI: 20.68% to 31.82%) for urban communities. There was a significant difference in prevalence of low dietary diversity score among preschool children between rural and urban communities (p=0.0107). Conclusion There were significant differences in terms of household food insecurity and less diverse diet between two community settings. Higher prevalence in rural areas signifies that there is a need to prioritize these vulnerable communities in terms of hunger mitigation and nutrition programs. A combination of milk-rice-meat-fish was observed in the diet of preschool children for both communities however, higher prevalence of less dietary diversity was detected among rural communities.
Child ; Preschool ; Food Insecurity Diet

Objective: This study has been conducted to determine the prevalence of nutrition label use and the factors associated with it among adults in selected communities in Los Baños, Laguna. Methods: This is an analytical cross-sectional study, which conducted face-to-face interview using a developed questionnaire, among 440 adults in the top four barangays with highest population in Los Baños, Laguna using twostage sampling design. In the first stage, three puroks were randomly selected in each barangay, while households were selected using systematic sampling in the second stage. An eligible adult in each selected household was invited to participate in the study. Results: Study findings revealed that nutrition label use among adults in the selected communities was 87.73%. Factors found to be associated with nutrition label use were: 1) intention to use nutrition label (OR: 4.37; 95% CI: 1.77–10.82), 2) enough perceived time-spent on shopping (OR: 2.16; 95% CI: 1.17–4.01), and 3) searching for specific information (OR: 4.77; 95% CI: 2.55–8.93). Conclusion These study findings can be used in promoting and increasing nutrition label use in the country and serve as basis for improvement of nutrition labeling policies. Moreover, this study can serve as a reference in the development and strategy-planning of interventions and programs especially in promoting healthy diets.
Prevalence ; Food Labeling

Background and Objective: Food security is achieved when the population at all times has access to safe, sufficient, and nutritious food to sustain a healthy and active life. This study aimed to determine the significant association between household food security and the prevalence of stunting among preschool children in Occidental Mindoro.

Methods: This study utilized a cross- sectional study design and a three-level, multi-stage, stratified random sampling to answer the study objectives. A total of 480 preschool children (n=240 urban; n= 240 rural) were included in the study. The Radimer-Cornell Tool was used to determine the food security status of the household. A validated- constructed questionnaire was used to determine other factors which were controlled in this study. Multiple Logistic Regression was used to determine significant association between the exposure and the outcome variable while controlling the confounding variable simultaneously.

Results: This study revealed that the prevalence of food insecurity in the province was 51.04% (95% CI: 46.55, 55.53) while the prevalence of stunting was 36.04% (95%CI: 31.73, 40.35). Meanwhile, after controlling the confounding effect of household income and low dietary diversity score it was found that the odds of having a stunted child were 23 times higher among food insecure households (OR: 23.00, 95%CI: 12.05, 43.91).

Conclusion: Based on the results of this study, the magnitude of household food insecurity and stunting were
found to be very high in the study areas. There was a significant association between household food security
and stunting among preschool children.

Growth Disorders ; Child, Preschool

Objective: This study identified the prevalence of Nutrition Facts Panel (NFP) use. It determined the factors associated with NFP use among young adults aged 19-30 years old in the National Capital Region (NCR). Methods: This analytical cross-sectional study collected data using a developed survey questionnaire. It was pretested to 32 respondents and administered online among young adults aged 19 to 30 years old residing in NCR at the time of the study, with a target sample size of 384. Convenience sampling was used to gather study participants. Nominal, ordinal, and interval data were summarized as frequencies and proportions. Mean and standard deviation were computed for ratio and interval data. Multiple logistic regression was used to test for the association to NFP use, reported as odds ratios. Results: Study findings showed that the prevalence of NFP use among the respondents was 50.49% (95% CI: 44.64 – 54.81%). The factors found to be associated to NFP use were: 1) being a primary household food shopper (p-value= 0.029; OR: 1.67; 95% CI: 1.05–2.63), 2) having a special diet (p-value= 0.001; OR: 3.40; 95% CI: 1.62–7.14), 3) using nutritional supplements (p-value= 0.041; OR: 1.51; 95% CI: 1.02–2.25), 4) preparing food at home (p-value= 0.019; OR: 1.64; 95% CI: 1.08–2.49), and 5) engaging in physical activity (p-value< 0.001; OR: 2.05; 95% CI: 1.37–3.06) regularly. Conclusion The findings show the need for improved nutrition education and promotion, especially in the NFP. The study recommended improvement in the study methodology and nutrition education programs. It suggested several research areas and topics to be explored.
Food Labeling ; Diet ; Young Adult

Objective: This study identified the prevalence of Nutrition Facts Panel (NFP) use. It determined the factors associated with NFP use among young adults aged 19-30 years old in the National Capital Region (NCR). Methods: This analytical cross-sectional study collected data using a developed survey questionnaire. It was pretested to 32 respondents and administered online among young adults aged 19 to 30 years old residing in NCR at the time of the study, with a target sample size of 384. Convenience sampling was used to gather study participants. Nominal, ordinal, and interval data were summarized as frequencies and proportions. Mean and standard deviation were computed for ratio and interval data. Multiple logistic regression was used to test for the association to NFP use, reported as odds ratios. Results: Study findings showed that the prevalence of NFP use among the respondents was 50.49% (95% CI: 44.64 – 54.81%). The factors found to be associated to NFP use were: 1) being a primary household food shopper (p-value= 0.029; OR: 1.67; 95% CI: 1.05–2.63), 2) having a special diet (p-value= 0.001; OR: 3.40; 95% CI: 1.62–7.14), 3) using nutritional supplements (p-value= 0.041; OR: 1.51; 95% CI: 1.02–2.25), 4) preparing food at home (p-value= 0.019; OR: 1.64; 95% CI: 1.08–2.49), and 5) engaging in physical activity (p-value< 0.001; OR: 2.05; 95% CI: 1.37–3.06) regularly. Conclusion The findings show the need for improved nutrition education and promotion, especially in the NFP. The study recommended improvement in the study methodology and nutrition education programs. It suggested several research areas and topics to be explored.
Food Labeling ; Diet ; Young Adult

Background: Anemia is the most common medical disorder throughout a woman’s life. Given that anemia during reproductive years impacts future gestational and perinatal health, then any factors possibly associated with the disorder should be studied and ultimately addressed. Objective: This study aimed to determine anemia prevalence and its associated factors (socio-demographic, lifestyle, knowledge, dietary and biochemical) among a select group of women of reproductive age (WRA) living in Tondo, Manila. Methods: This is an analytic cross-sectional study that utilized interviewer-assisted questionnaire and blood extraction to collect data from 166 WRA (18-40 years). Results: Anemia prevalence among the study participants was found to be 9.0%. In terms of associated factors, being anemic was found to be more likely if the WRA has these factors: higher parity, graduated from college; unemployed; living in a low-income household; took iron supplements, and; have low knowledge on iron. On the other hand, increase in age, increase intake of heme iron and non-heme iron food sources, and an increase in blood ferritin concentration were factors that made anemia less likely among WRA. Conclusion Examining these factors provides insight into the multicausal nature of anemia. Thus, prevention and control programs should focus on the contribution and interrelatedness of these factors to address anemia.
Female ; Iron ; Reproduction ; Hemoglobins