1.Effectiveness of customized training programs on knowledge, attitudes, and practices (KAP) related to antimicrobial resistance (AMR) among food handlers in the greater Manila area, Philippines: A quasi-experimental study.
Geraldine B. Dayrit ; Kathyleen S. Nogrado ; Regine O. Mendiola ; John Robert Carabeo Medina ; Fresthel Monica M. Climacosa
Acta Medica Philippina 2026;60(5):80-91
BACKGROUND AND OBJECTIVES
Antimicrobial resistance (AMR) constitutes an escalating global public health menace, intensified by the excessive utilization of antibiotics in human healthcare and agriculture. In the Philippines, the extensive misuse of antimicrobials in food production, especially in chicken, swine, aquaculture, and agriculture exacerbate AMR, presenting considerable threats to public health. Since the transmission of AMR is closely linked to food safety, food handlers play a critical role in mitigating its spread. This study evaluates the knowledge, attitude, and practices (KAP) of food handlers in the Greater Manila Area concerning AMR and the utilization of antimicrobials.
METHODSThis quasi-experimental study involved developing and implementing a customized training program based on pre-training KAP questionnaires, featuring specialized training materials for fruits and vegetables sellers, meat handlers, seafood vendors, and street food vendors. The training, conducted in partnership with government entities and industry specialists, emphasized AMR awareness, food safety rules, and optimal procedures for reducing AMR hazards.
RESULTSThe results showed statistically significant differences in pre- and post-intervention mean percentage scores in the participants’ knowledge, attitudes, and practices about food handling and AMR. There was also substantial improvement observed across all four occupational groups as post-test scores increased in comparison to their baseline scores.
CONCLUSIONThis study underscores the pivotal role of food handlers in combating AMR and stresses the necessity for a training program that is focused on AMR education within food safety initiatives. The training program should be customized, for example, according to the length of experience of the food handler, to either provide basic food safety measures or to improve and upgrade the acquired baseline knowledge and skills related to food safety. This particular study showed the importance of providing food handlers with essential knowledge and skills on food safety and proper food handling to aid in the mitigation of AMR transmission.
Human ; Food Safety ; Knowledge ; Attitude
2.Micronutrient intake and diet quality of overweight/obese Filipino adults in the National Capital Region, Philippines
Jade Q. Florento ; Kim Leonard G. Dela luna ; Charina A. Javier ; Eldridge B. Ferrer
Acta Medica Philippina 2025;59(10):85-94
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.
METHODSThis 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.
RESULTSMajority 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.
CONCLUSIONFilipino 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
3.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 2025;59(11):18-29
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).
OBJECTIVESThis 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.
METHODSThis 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.
RESULTSLocal 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.
CONCLUSIONCapacity 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.
Human ; Agriculture ; Food Security ; Capacity Building
4.Coping strategies to achieve food security among households with children in an urban poor community in Quezon City during COVID-19
Eryn M. Kiunisala ; Beatrice Ysabel G. Dy ; Ralph Alexander T. Flores ; Ramon Raphael M. Montierro ; Renaeus Arlchristian Rualdo D. Torres ; Kim Leonard G. Dela luna ; Ernani R. Bullecer
Acta Medica Philippina 2025;59(1):48-56
BACKGROUND
In the Philippines, the prevalence of food insecurity increased during the COVID-19 pandemic, affecting the nutritional status of communities nationwide. Urban areas in particular are vulnerable to the harmful effects of food insecurity, and the effects are extended and magnified when it comes to children.
OBJECTIVESThis study aims to evaluate the coping strategies of households with children aged 0-10 years old in an urban poor community in Quezon City. In particular, the study will determine Coping Strategies Index (CSI) scores and the frequency of specific coping strategies used.
METHODSA descriptive cross-sectional study was conducted to assess the coping strategies of 405 households with children in the community during the pandemic. Mothers or caregivers were given a survey inquiring about the sociodemographic data and CSI.
RESULTSSociodemographic profiling showed that the households generally belonged to class D and E (PhP 15,000 and below) income households (73.8%). The majority of the household heads (52.6%) have their highest educational attainment at the high school level. The majority (77.5%) of the households were categorized as having low CSI classification (90%CI: 73.9, 80.8). This could indicate that relief operations conducted in the community may have helped ease their food insecurity. Coping strategies that were most frequently employed by the households were depending on less preferred or more affordable food (74.8%), rationing money for prepared food (69.1%), and purchasing food on credit (58.5%).
CONCLUSIONLow CSI classification was noted, which may be due to increased adaptation to persistent food insecurity and the utilization of coping strategies not indicated in the questionnaire. Common coping strategies used by households include reliance on less favored or less costly food items, rationing resources for prepared food, and food on credit. It is recommended that the results collected be used to target food availability and accessibility interventions in the community.
Human ; Food Insecurity ; Adaptation, Psychological ; Nutritional Status ; Food Security
5.Causal association between gut microbiota and food allergy: a Mendelian randomization analysis.
Li-Xin HU ; Guo-Zhen FAN ; Hui MA ; Lei LI ; Fang WANG ; Zheng-Hai QU ; Ren-Zheng GUAN
Chinese Journal of Contemporary Pediatrics 2025;27(4):444-450
OBJECTIVES:
To analyze the potential causal relationship between gut microbiota and food allergy (FA) using two-sample Mendelian randomization (MR) methods.
METHODS:
Data from genome-wide association studies on gut microbiota and FA were utilized. MR analysis was conducted employing inverse variance weighting, MR-Egger regression, and weighted median methods to assess the causal relationship between gut microbiota and FA. Cochrane's Q test was used to evaluate heterogeneity of instrumental variables, MR-PRESSO analysis was conducted to test for outliers and pleiotropy, and MR-Egger regression was employed to assess horizontal pleiotropy. The "leave-one-out" method was used to evaluate the impact of removing individual single nucleotide polymorphisms on the causal relationship.
RESULTS:
Inverse variance weighting analysis revealed that the phylum Verrucomicrobia, family Verrucomicrobiaceae, order Verrucomicrobiales, genus Ruminococcaceae UCG013, and genus Akkermansia were negatively associated with FA (P<0.05). Sensitivity analyses confirmed the reliability of the findings, indicating no heterogeneity or pleiotropy present.
CONCLUSIONS
There is a causal relationship between gut microbiota and FA, with Verrucomicrobia, Verrucomicrobiaceae, Verrucomicrobiales, Ruminococcaceae UCG013, and Akkermansia potentially reducing the risk of developing FA. These findings provide potential targets for the treatment and prevention of FA; however, further research is needed to explore the specific mechanisms by which the microbiota influence FA.
Humans
;
Mendelian Randomization Analysis
;
Gastrointestinal Microbiome
;
Food Hypersensitivity/microbiology*
;
Genome-Wide Association Study
;
Polymorphism, Single Nucleotide
6.Effect of interleukin-17 gene polymorphism on susceptibility to cow's milk protein allergy in infants and its association with gut microbiota.
Wen-Ying HAO ; Chun ZHU ; Song LU ; Hong WANG
Chinese Journal of Contemporary Pediatrics 2025;27(6):696-701
OBJECTIVES:
To investigate the effect of interleukin-17 (IL-17) gene polymorphism on the susceptibility to cow's milk protein allergy (CMPA) in infants and its association with gut microbiota.
METHODS:
A prospective study was conducted involving 100 infants diagnosed with CMPA at the Women and Children's Hospital of Ningbo University from January 2022 to October 2024. A total of 100 healthy infants undergoing routine check-ups at the same hospital during the same period was enrolled as the control group. Medical information was obtained through the electronic medical record system. IL-17A (rs2275913) and IL-17F (rs1889570) polymorphisms were detected using polymerase chain reaction-restriction fragment length polymorphism method. Serum IL-17 levels were measured using enzyme-linked immunosorbent assay, and high-throughput sequencing was employed to analyze the relative abundance of Lactobacillus and Bifidobacterium. Multivariate logistic regression analysis was used to explore the influencing factors of CMPA occurrence in infants.
RESULTS:
The proportions of infants with a family history of allergy and those with vitamin D deficiency or insufficiency were significantly higher in the CMPA group compared to those in the control group (P<0.05). The distribution of IL-17F (rs1889570) genotypes showed significant differences between the CMPA and control groups (P<0.05), with the frequency of the A allele being significantly higher in the CMPA group (P<0.05). Multivariate logistic regression analysis revealed that a family history of allergy, vitamin D deficiency or insufficiency, and carrying the IL-17F (rs1889570) AA genotype were independent influencing factors for CMPA in infants (P<0.05). Infants in the CMPA group with the IL-17F (rs1889570) AA genotype had significantly higher serum IL-17 levels compared to those with AG/GG genotypes (P<0.05), while the relative abundance of Lactobacillus and Bifidobacterium was significantly lower (P<0.05).
CONCLUSIONS
IL-17F (rs1889570) gene polymorphism influences susceptibility to CMPA in infants, potentially through mechanisms involving IL-17 expression and the relative abundance of gut probiotics.
Humans
;
Interleukin-17/genetics*
;
Milk Hypersensitivity/microbiology*
;
Female
;
Infant
;
Male
;
Prospective Studies
;
Genetic Predisposition to Disease
;
Gastrointestinal Microbiome
;
Polymorphism, Genetic
;
Milk Proteins/immunology*
7.Role and Mechanism of Hyaluronic Acid-modified Milk Exosomes in Reversing Pemetrexed Resistance in Lung Adenocarcinoma Cells.
Chinese Journal of Lung Cancer 2025;28(9):658-666
BACKGROUND:
Lung cancer currently ranks first globally in both incidence and mortality. Pemetrexed (PMX) serves as a first-line treatment for lung adenocarcinoma (LUAD), but the patients often develop drug resistance during therapy. Milk exosome (mEXO) have the advantages of low immunogenicity, high tissue affinity, and low cost, and mEXO itself has anti-tumor effects. Hyaluronan (HA) naturally bind to CD44, a receptor which is highly expressed in LUAD tissues. This study aims to construct hyaluronan-modified milk exosome (HA-mEXO) and preliminarily investigate their molecular mechanisms for reversing PMX resistance through cellular experiments.
METHODS:
Exosomes were extracted from milk using high-speed centrifugation, and HA-mEXO was constructed. PMX-resistant A549 and PC-9 cell lines were treated with mEXO and HA-mEXO, respectively. CCK-8 assays, colony formation assays, Transwell assays, and flow cytometry were performed to evaluate proliferation, colony formation, migration, invasion, and apoptosis phenotypes in the treated resistant cell lines. Finally, transcriptomic sequencing, analysis, and cellular functional recovery experiments were conducted to investigate the mechanism by which HA-mEXO reverses PMX resistance in LUAD cells.
RESULTS:
The expression of CD44 in A549 and PC-9 LUAD drug-resistant cell lines was significantly higher than that in parental cells, and the uptake rate of HA-mEXO by drug-resistant cell lines was significantly higher than that of mEXO. Compared to the mEXO group, HA-mEXO-treated A549 and PC-9 resistant cells exhibited significantly reduced half maximal inhibitory concentration (IC50) values for PMX, markedly diminished clonogenic, migratory, and invasive capabilities, and a significantly increased proportion of apoptotic cells. Western blot analysis revealed that, compared to parental cells, A549 and PC-9 drug-resistant cells exhibited downregulated ZNF516 expression and upregulated ABCC5 expression. Immunofluorescence analysis revealed that HA-mEXO treatment downregulated ABCC5 expression in A549 and PC-9 drug-resistant cells compared to the PBS group, whereas co-treatment with HA-mEXO and ZNF516 knockdown showed no significant change in ABCC5 expression.
CONCLUSIONS
HA-mEXO carrying ZNF516 suppress ABCC5 expression, thereby enhancing the sensitivity of A549 and PC-9 LAUD drug-resistant cells to PMX.
Humans
;
Hyaluronic Acid/chemistry*
;
Drug Resistance, Neoplasm/drug effects*
;
Exosomes/chemistry*
;
Adenocarcinoma of Lung/genetics*
;
Pemetrexed/pharmacology*
;
Animals
;
Lung Neoplasms/pathology*
;
Milk/chemistry*
;
Cell Proliferation/drug effects*
;
Apoptosis/drug effects*
;
Cell Line, Tumor
;
Hyaluronan Receptors/metabolism*
8.Dietary exposure levels to 134Cs, 137Cs, 90Sr, and 239+240Pu in Japan after the Fukushima Daiichi Nuclear Power Plant accident: a duplicate portion study for fiscal years 2012-2014.
Hiroshi TERADA ; Ikuyo IIJIMA ; Sadaaki MIYAKE ; Tomoko OTA ; Ichiro YAMAGUCHI ; Hiroko KODAMA ; Hideo SUGIYAMA
Environmental Health and Preventive Medicine 2025;30():48-48
BACKGROUND:
Since the accident at Fukushima Daiichi Nuclear Power Plant (FDNPP), concerns have arisen in Japan regarding the presence of radionuclides in food. Moreover, exposure levels to 90Sr and Pu isotopes in adults and those to 134Cs+137Cs, 90Sr, and Pu (where Cs, Sr, and Pu are cesium, strontium, and plutonium, respectively) in children have not been examined. Therefore, this study employed a duplicate portion approach to examine dietary exposure levels of radionuclides in adults and children following the FDNPP accident.
METHODS:
The study spanned fiscal years 2012-2014 and was conducted in 10 prefectures: Hokkaido, Iwate, Miyagi, Fukushima, Ibaraki, Saitama, Tokyo, Kanagawa, Osaka, and Kochi. The participants provided portions of their meals for two non-consecutive days and completed questionnaires on the meal items. The activity concentrations of 134Cs, 137Cs, 90Sr, and 239+240Pu, which are targets of standard limits for radionuclides in foods in Japan, were determined according to the Radioactivity Measurement Series. The daily intake was calculated based on the radionuclide activity concentrations in the duplicate portion samples, and the committed effective doses were estimated using dose coefficients for the ingestion of each radionuclide provided by the International Commission on Radiological Protection.
RESULTS:
Approximately 80 duplicate samples were obtained in each fiscal year, and 242 samples were collected. The highest summed activity concentration of 134Cs and 137Cs was 11 Bq/kg, which was recorded in Date City (child) in 2013; this level was approximately one-ninth of the standard limit for general foods (100 Bq/kg). The committed effective dose from annual ingestion of the sample described above was 74 µSv, approximately 14 times lower than the maximum permissible level of 1 mSv/y. Pu was not detected and the 90Sr activity concentrations were similar to those before the FDNPP accident.
CONCLUSIONS
For the samples examined in the present study, the 134Cs, 137Cs, 90Sr, and 239+240Pu dietary exposure levels were considerably lower than the regulatory levels and may not pose a health risk.
Fukushima Nuclear Accident
;
Cesium Radioisotopes/analysis*
;
Humans
;
Japan
;
Dietary Exposure/statistics & numerical data*
;
Adult
;
Plutonium/analysis*
;
Child
;
Food Contamination, Radioactive/analysis*
;
Strontium Radioisotopes/analysis*
;
Male
;
Female
;
Middle Aged
;
Child, Preschool
;
Radiation Monitoring
;
Young Adult
;
Adolescent
;
Aged
;
Radiation Exposure/analysis*
9.Comparison of energy and nutrient intakes between weekdays and weekends in Japanese preschool children based on meal categories.
Atsuki SAKAI ; Katsushi YOSHITA ; Takako TAKAHASHI ; Tetsuko OKABE ; Ruriko SASAKI ; Hiromi ISHIDA ; Hiromitsu OGATA ; Mitsuhiko HARA ; Yukiko YOSHIOKA ; Miho NOZUE ; Tatsuaki SAKAMOTO ; Sanae ITO ; Nobuko MURAYAMA
Environmental Health and Preventive Medicine 2025;30():71-71
BACKGROUND:
Meals are provided at nursery schools for Japanese preschool children, and this may result in different energy and nutrient intakes on weekdays and weekends. The purpose of this study was to obtain basic information for public nutrition policies in early childhood by examining differences in energy and nutrient intakes of preschool children between weekdays and weekends using meal categories such as breakfast, lunch, dinner, and snacks.
METHODS:
Energy and nutrient intakes were examined in 761 Japanese preschool children (423 boys, 338 girls) aged 3-6 years attending childcare facilities in seven regions in Japan. Data collection was based on non-consecutive four-day dietary records (two weekdays, two weekend days) in 2019 or 2020. Energy and nutrient intake by meal category were compared using a generalized linear mixed model adjusted for demographic factors.
RESULTS:
Total energy intake was significantly higher on weekdays for boys (1,478 vs. 1,415 kcal) and girls (1,349 vs. 1,296 kcal) (both P < 0.001). Weekday lunches had higher protein content and essential micronutrients such as potassium, iron, vitamins, and lower fat, saturated fatty acids, and salt, compared to weekend lunches. Similarly, weekday snacks also had significantly higher nutritional consumption for most nutrients compared to weekend equivalents.
CONCLUSION
These findings suggest that meals at nursery schools, particularly lunch and snacks, result in more desirable nutrient intake in preschool children. On weekdays, children consume meals with higher nutrient density, possibly due to the role of dietitians in menu planning. However, some children still fail to meet the Dietary Reference Intakes for Japanese, indicating a need for improvements in nursery school and home meals. More communication is needed between nursery schools and families, including sharing menus and recipes is essential. The results of this study are of value for development of public health nutrition strategies targeting early childhood.
Humans
;
Child, Preschool
;
Male
;
Japan
;
Female
;
Energy Intake
;
Meals
;
Child
;
Nutrients/analysis*
;
Diet/statistics & numerical data*
;
East Asian People
10.A review of human exposure to PFAS: substantial contribution from seafood.
Environmental Health and Preventive Medicine 2025;30():73-73
Per- and polyfluoroalkyl substances (PFAS) have recently been shown to affect human health at low levels in the blood, according to epidemiological evidence. Consequently, human exposure to these chemicals should be strictly controlled to prevent health risks. This review reports on the potential sources of PFAS using Japan as an example. Tap water has attracted attention as a source of exposure to PFAS. PFAS have also been detected in the air, in household dust, and in consumer products. Furthermore, in the general population, diet is the most common source of exposure, and there is particular concern about human exposure to PFAS accumulated in seafood. Continuous monitoring is important for appropriate management of exposure for both humans and the environment.
Seafood/toxicity*
;
Fluorocarbons/toxicity*
;
Japan
;
Drinking Water/standards*
;
Air Pollutants/toxicity*
;
Humans
;
Dust/analysis*
;
Environmental Exposure/standards*
;
Food Contamination/analysis*
;
Environmental Pollutants/toxicity*
;
Water Pollutants, Chemical/toxicity*


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