BACKGROUND

With childhood overweight and obesity becoming widespread in the Philippines, there is an increased risk of developing non-communicable diseases at a younger age. The school environment, found to be associated with body mass index, offers an avenue to address and prevent school-aged obesity. However, the lack of data on the current school environment poses a barrier to improving these conditions.

This study aimed to describe the physical, political, and sociocultural environment characteristics of primary schools in the Municipality of Pateros (Philippines) that affect nutrition and physical activity of school-aged children. 

Self-administered questionnaires for key school personnel and observational checklists were used to examine available resources, policies, and current practices for obesity prevention in five public schools in a municipality. The role perceptions of all school personnel on childhood obesity prevention were also gathered. Descriptive statistics was used to describe the number and categories of food items, functional spaces and equipment for physical activity, policies and scores of attitude toward obesity prevention. Data were collected in May to June 2019 and were analyzed descriptively.

Majority of the schools serve food items that contain high amounts of saturated fat, sugar, or salt, provide excess calories, and are not recommended to be sold at school canteens based on guidelines by the Department of Education. While all schools have areas and functional equipment for physical activity, students have limited access to these. Policies and guidelines for nutrition were present but sparse for physical activity and obesity prevention. Positive attitude towards childhood obesity prevention was seen across all school personnel respondents.

Participant primary schools are eager to address childhood obesity, however, the physical, political, and sociocultural environments do not seem to enable this. This situation may promote, rather than prevent, overweight and obesity among school children. This points to the need of reorientation and implementation of policies on obesity prevention to the schools as well as developing the skills of both teaching and non-teaching personnel in healthy eating and physical activity to students. School-based healthcare workers like school nurses and doctors would have critical roles in supporting schools in this regard.

OBJECTIVES

This study aims to describe the micronutrient intake and diet quality of overweight and obese Filipino adults in the National Capital Region (NCR). Specifically, it seeks to assess micronutrient inadequacy among these individuals and analyze differences in food intake based on their sociodemographic profiles and lifestyle habits.

This analytical cross-sectional study utilized data from the Expanded National Nutrition Survey (ENNS) conducted in 2018, 2019, and 2021 by the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI). A total of 3,154 overweight and obese subjects were included. ANOVA and Kruskal-Wallis tests were employed to analyze the food groups consumed by these adults.

Majority of overweight and obese adults were found to be inadequate in vitamin A (81.7%), vitamin C (88.4%), thiamin (62.5%), riboflavin (70.7%), iron (69.8%), and calcium (88.7%). Significant differences were observed in the mean intake of various food groups across different age groups, sexes, civil statuses, wealth quintiles, educational attainments, employment statuses, and smoking and drinking statuses.

Filipino adults who are overweight and obese, and residing in urban settings face significant challenges related to micronutrient inadequacy. When their food intake was assessed based on sociodemographic and lifestyle characteristics, it was found that their diets were more calorie-dense than nutrient-dense. To address this issue, it is recommended to encourage a wider variety of nutrient-dense foods among overweight and obese adults.

OBJECTIVE

This study aimed to determine the association between Asia-Pacific classification of body mass index, waist circumference and waist hip ratio and clinical outcomes of COVID-19 moderate & severe patients at the height of the COVID-19 pandemic.

A This study involved adult patients diagnosed with COVID-19. 182 patients were analyzed and divided into 167 moderate and 15 severe COVID-19 patients. Primary outcomes (respiratory decompensation, septic shock, and mortality) of patients were compared among Asia Pacific BMI groups.

Among patients with moderate and severe COVID-19, 7 out of 10 patients were obese. Respiratory decompensation and sepsis were more frequently seen in obese patients. Obesity and waist circumference were significantly associated with the odds of respiratory decompensation (95% CI p=0.010 and p=0.002), however this association was not sustained upon adjustment for confounders. On univariate analysis, waist and hip circumferences were significantly associated with the odds of ICU admission (95% CI, p=.013 and p=.034), however after controlling for confounders, only hip ratio retained significant association. Among patients with severe COVID-19, there was insufficient evidence to support significant variations in distributions of outcomes of interest across Asia-Pacific BMI groups.

Our study emphasized that although respiratory decompensation and sepsis were more frequently seen in obese patients. progression of respiratory decompensation and mortality is not significantly associated with obesity as defined by the Asia Pacific BMI classification, warranting the need for larger prospective studies.

BACKGROUND

With childhood overweight and obesity becoming widespread in the Philippines, there is an increased risk of developing non-communicable diseases at a younger age. The school environment, found to be associated with body mass index, offers an avenue to address and prevent school-aged obesity. However, the lack of data on the current school environment poses a barrier to improving these conditions.

This study aimed to describe the physical, political, and sociocultural environment characteristics of primary schools in the Municipality of Pateros (Philippines) that affect nutrition and physical activity of school-aged children. 

Self-administered questionnaires for key school personnel and observational checklists were used to examine available resources, policies, and current practices for obesity prevention in five public schools in a municipality. The role perceptions of all school personnel on childhood obesity prevention were also gathered. Descriptive statistics was used to describe the number and categories of food items, functional spaces and equipment for physical activity, policies and scores of attitude toward obesity prevention. Data were collected in May to June 2019 and were analyzed descriptively.

Majority of the schools serve food items that contain high amounts of saturated fat, sugar, or salt, provide excess calories, and are not recommended to be sold at school canteens based on guidelines by the Department of Education. While all schools have areas and functional equipment for physical activity, students have limited access to these. Policies and guidelines for nutrition were present but sparse for physical activity and obesity prevention. Positive attitude towards childhood obesity prevention was seen across all school personnel respondents.

Participant primary schools are eager to address childhood obesity, however, the physical, political, and sociocultural environments do not seem to enable this. This situation may promote, rather than prevent, overweight and obesity among school children. This points to the need of reorientation and implementation of policies on obesity prevention to the schools as well as developing the skills of both teaching and non-teaching personnel in healthy eating and physical activity to students. School-based healthcare workers like school nurses and doctors would have critical roles in supporting schools in this regard.

Background: This study aimed to determine the differences in glycemic control, metabolic parameters (blood pressure control, triglycerides, LDL, HDL) and the presence of nephropathy and/or retinopathy between obese and overweight versus normal body mass index (BMI) type 2 diabetes mellitus patients (T2DM). Methodology: This is an analytic cross-sectional study of T2DM patients from outpatient clinics at St. Luke’s Medical Center, Quezon City. Available medical records and laboratory tests were reviewed. Data were analyzed and compared between those overweight and obese versus those with normal BMI based on Asia Pacific Guidelines. Results: A total of 248 patients with T2DM were included in the study. More patients who are obese and overweight have uncontrolled diabetes (p = 0.011), low HDL (p = 0.037) and nephropathy (p = 0.027) compared to those with normal BMI. There were no significant difference between overweight and obese patients versus those with normal BMI with regards to BP control, high LDL, high triglycerides and retinopathy. Conclusion T2DM patients who are obese and overweight have a significantly higher prevalence of uncontrolled diabetes, low HDL and nephropathy compared to those with normal BMI.
Diabetes Mellitus ; Overweight

Background: The association of obesity with adverse COVID-19 outcomes is known, but unexplored in younger adults. Objective: To determine the association of obesity [body mass index (BMI) of ≥30] with severe COVID-19 outcomes in younger and older adults. Design: Retrospective cohort study. Participants: 391 patients with COVID-19 (226 younger adults aged 18-60 years, and 165 older adults aged >60 years). Setting: Southern Philippines Medical Center, Davao City, January 2021 to September 2021. Main outcome measures: Severe COVID-19 outcomes (high-flow oxygen administration, ICU admission, mechanical ventilation, death); odds ratio of severe outcomes in patients with BMI of ≥30. Main results: Of 391 patients (median age of 57 years), 286 had a BMI of <30, while 105 had a BMI of ≥30. Univariate regression analysis showed that a BMI of ≥30 was significantly associated with any severe COVID-19 outcomes (OR=2.68; 95% CI 1.68 to 4.27; p<0.001). This remained after adjusting for age, sex, hypertension, diabetes, and cardiovascular disease (adjusted OR=3.19; 95% CI 1.93 to 5.27; p<0.001). A BMI of ≥30 was also significantly associated with any severe outcomes among younger adults (adjusted OR=4.04; 95% CI 2.23 to 7.32; p<0.001), but not among older adults (adjusted OR=1.80; 95% CI 0.70 to 4.64; p=0.227). Conclusion In our study, among all adults, a BMI of ≥30 significantly increased the odds of experiencing any severe COVID-19 outcomes. This association was also observed in the younger adult subgroup, but not in the older adult subgroup.
SARS-CoV-2 ; Body Mass Index ; Immunity ; Critical Care

Objectives: We aimed to study the trend of referrals for precocious puberty during the COVID-19 pandemic compared to pre-COVID years, explore the differences in the demographic and clinical features, and evaluate the contributing factors. Methodology: The cases referred for assessment of PP from 2018-2021 to our endocrine centre were grouped into pre-COVID (2018-2019) and COVID (2020-2021) years. Cases fulfilling the diagnosis of PP included the onset of thelarche <8 years in females and 4 ml testicular volume <9 years in males. The PP was further differentiated as Isolated Thelarche (IST) and Central Precocious Puberty (CPP). Early menarche was defined as menarche <10 years old. Results: There were more referrals for PP and more diagnosed as CPP during the COVID-19 pandemic, predominantly among females. There were more endocrine tests done and more cases received treatment. None of the abnormal magnetic resonance imaging (MRI) pituitary findings required surgical intervention. The body mass index (BMI) was found to be positively associated with the risk of getting CPP with a crude-odd ratio (COR) of 1.8, P <0.001, and early menarche (COR 2.1, P <0.001). Conclusion We found a significant increase in the referrals of PP and diagnosis of CPP during the COVID-19 pandemic. Higher BMI was found to be associated with CPP and early menarche.
Puberty, Precocious ; COVID-19 ; Obesity

BACKGROUND: Chronic illnesses such as Type 2 diabetes mellitus (T2DM) and obesity have been implicated as risk factors in the development of cognitive impairment (CI), but despite this, definite association between the two conditions in increasing cognitive impairment risk is not well defined. OBJECTIVE: This study aims to examine the association between body mass index (BMI) and cognitive impairment (CI) in elderly patients with Type 2 diabetes mellitus. METHODS: This is a cross-sectional study conducted in the outpatient clinics of a private hospital in Manila which included elderly patients with Type 2 diabetes. BMI categories of the subjects were determined using the Asia-Pacific criteria and the Montreal Cognitive Assessment – Philippines (MOCA-P) was administered to subjects who fulfilled the inclusion criteria. Descriptive statistics were used to determine the prevalence of impaired cognition among subjects while risk ratio analysis was used to determine the correlation between BMI and CI. Correlation analysis and linear regression analysis were used to determine the presence of association between cognition (measured by MOCA-P scores) and BMI. For all analysis, a 95% level of significance was used. RESULTS: A total of 109 subjects from the outpatient clinics were included in the study. A high percentage of the study population (90.83%) had CI based on MOCA-P scores. Subjects that belonged to the extremes of BMI- underweight and obese class 2 had higher incidence of CI compared to the other groups. Underweight subjects had 1.103 (95% CI: 1.038 to 1.172) times likelihood of having impaired cognition (p-value 0.0016), while obese 2 subjects had 1.110 (95% CI: 1.040 to 1.184) times likelihood of having impaired cognition (p-value 0.0016). Regression analysis revealed that in subjects with diabetes of less than 10 years, cognition scores were negatively correlated to BMI (p-value 0.0454). Correlation analysis revealed that at the general population level, regardless of the external factors, increasing or decreasing BMI did not have significant effect on cognition scores. CONCLUSION Subjects who belonged to the extremes of BMI-underweight and obese class 2 – had higher incidence of CI compared to the other BMI groups. Among subjects with T2DM duration of less than 10 years, cognition scores tend to be negatively correlated to BMI.
diabetes mellitus, Type 2 ; cognitive impairment ; cognitive dysfunction ; Body Mass Index

Objectives: This study aims to describe the micronutrient intake and diet quality of overweight and obese Filipino adults in the National Capital Region (NCR). Specifically, it seeks to assess micronutrient inadequacy among these individuals and analyze differences in food intake based on their sociodemographic profiles and lifestyle habits. Methods: This analytical cross-sectional study utilized data from the Expanded National Nutrition Survey (ENNS) conducted in 2018, 2019, and 2021 by the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI). A total of 3,154 overweight and obese subjects were included. ANOVA and Kruskal-Wallis tests were employed to analyze the food groups consumed by these adults. Results: Majority of overweight and obese adults were found to be inadequate in vitamin A (81.7%), vitamin C (88.4%), thiamin (62.5%), riboflavin (70.7%), iron (69.8%), and calcium (88.7%). Significant differences were observed in the mean intake of various food groups across different age groups, sexes, civil statuses, wealth quintiles, educational attainments, employment statuses, and smoking and drinking statuses. Conclusion Filipino adults who are overweight and obese, and residing in urban settings face significant challenges related to micronutrient inadequacy. When their food intake was assessed based on sociodemographic and lifestyle characteristics, it was found that their diets were more calorie-dense than nutrient-dense. To address this issue, it is recommended to encourage a wider variety of nutrient-dense foods among overweight and obese adults.
food intake ; eating ; micronutrients ; overweight ; obesity ; nutritional status

Background: Hyperinsulinemia due to insulin resistance is hypothesized to act as a promotor of cancer growth. In addition to the direct effects of hyperinsulinemia on cancer cells, the stimulation of tumor cell growth can also be indirectly mediated through growth factors and receptors such as insulin-like growth factor 1 (IGF-1). Increased cancer risk is also associated with increased adipose tissue, such as in abdominal obesity, due to the higher risk of insulin resistance and hyperinsulinemia. Waist circumference is a parameter that indicates an individual's level of adiposity. In addition, the risk of cancer also increases in the elderly as they age. This study aims to assess the correlation between waist circumference and IGF-1 levels in the elderly population in Bali, Indonesia. Methodology: This study used a cross-sectional analytical design conducted in the Melinggih Village, Gianyar Regency. The study was conducted in September 2023. This study has been approved by the Research Ethics Commission number 2020/UN14.2.2.VII.14/LT/2023. The study population included elderly individuals residing in the Melinggih Village who were willing to participate. Data analysis encompassed descriptive analysis and the Spearman correlation test. Result: A total of 88 subjects participated in the study, consisting of 57 females (64.8%) and 31 males (35.2%). A statistically significant but weak correlation coexists between waist circumference and IGF-1 levels. Conclusion A weak but statistically significant positive correlation was found between waist circumference and IGF-1 levels in the elderly. However, because of the small sample size, another study with a bigger sample size with enough power to investigate this association needs to be done to validate the results of the current study.
Elderly ; Aged ; IGF-1 ; Insulin-Like Growth Factor I ; Waist Circumference