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.

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 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%). These processed foods were mostly obtained from sari-sari stores, with TV as the top source of information. More than 80% of the Muslim mothers cited food availability, economic reasons, and convenience in food preparation as the top three motivating factors in the practice of complementary feeding (CF). In addition, almost all the Muslim mothers (~97%) mentioned seeing their children grow healthy as the top reason for improving their food preparation practices, followed by positive feedback from their families. Meanwhile, household duties, low milk output, and a new pregnancy make it difficult to continue breastfeeding, while high complementary food costs, a limited budget, and a lack of food make it difficult to provide complementary food. The preparation of food for infants and young children is hindered by an increased workload and a lack of understanding.

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.

BACKGROUND/OBJECTIVE

Although nutritional assessment tools have been available internationally, local data for their use in foreseeing adverse outcomes among admitted patients are currently unavailable. The primary objective of this study was to determine the association of nutritional status using Short Nutritional Assessment Questionnaire (SNAQ) and malnutrition risk using the MST (Malnutrition Screening Tool) with ICU admission and in-hospital mortality.

This was a prospective-cohort study which included 122 purposively-selected adult participants who were non-intubated, admitted for medical and surgical managements, stayed for at least 24 hours, had no COVID-19 infection, and were not admitted in any critical care unit. The SNAQ and MST questionnaires, which are validated tools and consists of  two to three easy-to-answer questions, were used among the participants and their scores were tallied in order to get their nutritional status and malnutrition risk. Primary endpoints measured were length of hospital stay, incidence of mortality, and ICU admission rate. Comorbidities were taken into account using the Charlson Comorbidity Index.

Categorizing the SNAQ scores showed 33.61% were severely malnourished which was similar when using the MST classification, wherein 34.43% were at risk of malnutrition. None of the participants were admitted to the intensive care unit (ICU). Malnutrition risk and nutritional status was not significantly associated with 30-day in-hospital mortality (p >0.05). On the other hand, results of the Cox proportional hazards showed that SNAQ and MST significantly predicted the hazard of 30-day in-hospital mortality, increasing the hazard of mortality by 2.58 times and 3.67 times, respectively, for every 1-unit increase in SNAQ and MST scores. Similarly, nutritional status using the SNAQ classification indicated the severely malnourished category significantly predicted the hazard of mortality, increasing it by 9.22 times for those who are severely malnourished. Also, malnutrition risk using the MST classification indicated that those who were at risk of malnutrition were 9.80 times at greater hazard of mortality than those who were not at risk of malnutrition.

The MST and SNAQ classification are screening tools for nutritional status (SNAQ) and malnutrition risk (MST) that can be administered at the onset of the patient’s hospital course and have been demonstrated in this study to predict 30-day in-hospital mortality. It is important to note that none of the patients included in this study required intensive care unit admission.

BACKGROUND

There is an increasing population of elderly patients with diabetes. Malnutrition has been associated to higher morbidity and mortality among these patients. Currently, there are limited data on malnutrition and its risk factors among elderly patients with diabetes in the Philippines.

This study determined the prevalence, clinical profile and risk factors associated with malnutrition and identify the association of malnutrition with glycemic status and insulin resistance among elderly patients with diabetes.

This is a cross-sectional study involving 117 elderly patients with diabetes seen at a tertiary hospital in Manila, Philippines. Demographic, anthropometric, and clinical data were collected. Mini-Nutritional Assessment-Short form (MNA-SF), Simple FRAIL questionnaire and Mini-cog assessment were administered. Patients were categorized into normal, at risk for malnutrition, and malnourished using the MNA-SF. Comparative and logistic regression analyses were performed to identify the clinical profile and possible risk factors.

The prevalence of malnutrition was 1.71% with 29.06% at risk for malnutrition. There was no significant difference in demographic, anthropometric and biochemical parameters between the different nutrition statuses. High BMI, central obesity, and increased insulin resistance were observed across all nutrition status. Frail patients had almost five times increased likelihood (OR=4.94, p=0.043) of developing malnutrition. Good glycemic control had two-fold decreased likelihood (OR=0.44, p=0.050) of malnutrition. Insulin resistance was not associated with malnutrition.

Malnutrition is prevalent among elderly patients with diabetes. Frailty and poor glycemic control increased the risk of malnutrition. Therefore, malnutrition screening should be routinely performed among these patients. Diabetes management among elderly patients should include maintaining good glycemic control and preventing frailty and its complications.

BACKGROUND

High-risk areas in the Philippines still experience a high prevalence of undernutrition. The efforts of the governments are not enough to reach those who are in need; hence, the presence of Civil Society Organizations (CSOs) is crucial. One CSO has implemented health and nutrition technical programs to increase the number of well-fed children in four selected areas in the Philippines.

This study aims to shed light on the differences in the nutritional status of the children when they are characterized according to their sociodemographic and economic covariates.

An analytical cross-sectional design was used to survey 692 households, including 764 children aged 0–5 years old. Descriptive analysis and the Chi-Square test of difference were used to answer the objectives.

The study results show that no significant differences were observed when the nutritional status of the children was characterized according to the sociodemographic of the caregiver, food consumption score (FCS) and food security status, water, hygiene and sanitation (WASH) practices, and economic indicators, except weight-for-height and marital status of caregivers, and weight-for-age and livelihood and economic support received by their caregivers (P = 0.02).

The majority of children, regardless of their nutritional status, share the same experience and resources in terms of sociodemographics of caregivers, FCS and food security status, WASH practices, and economic indicators. CSO can boost the impact of their health and nutrition interventions by harmonizing their efforts with government programs, leading to better-targeted and more efficient outcomes.

Background and Objectives: Malnutrition is a serious public health problem in developing countries, including Indonesia. Based on RISKESDAS 2018, the prevalence of stunting aged 13-15 years in Takalar Regency is 24.83%. This study aimed to assess the prevalence of stunting and the determinants of stunting in adolescent girls aged 13-15 years in the South Galesong District, Takalar Regency. Methods: This is a cross-sectional study using purposive sampling method that included 247 adolescent girls in selected junior high schools. Data collection used questionnaires and anthropometric measurements. An anthropometric measurement was converted to the indices of nutritional status using World Health Organization Anthro Plus software. Results: The prevalence of stunting was 25.1%. Bivariate analysis showed determinant factors related significantly to stunting were energy intake (p<0.001), protein intake (p<0.001), iron intake (p<0.005), and zinc intake (p<0.001). Multivariate analysis showed determinant factors related significantly to stunting were zinc intake (p<0.001, OR=7.993), protein intake (p<0.05, OR=2.248), and knowledge level (p<0.05, OR=2.032). Conclusion The occurrence of stunting is related to the quality and quantity of food and the level of adolescent knowledge about balanced nutrition. It is necessary to hold educational programs and interventions on improving nutrition initiated by stakeholders and the department of health, in this case, the health center is needed to reduce stunting rates, especially among adolescents.
Malnutrition ; Growth Disorders ; Adolescent

Background: Severe acute malnutrition (SAM) in children under five years remains a major global health concern. It carries a burden to the overall health of a child, contributes to mortality, and adds financial strain to the family and the hospital. The Philippine Integrated Management of Acute Malnutrition was established to address acute malnutrition in Filipino children. Objective: This study aimed to determine the factors affecting survival of patients admitted at Bicol Regional Training and Teaching Hospital (BRTTH) In-patient Therapeutic Care (ITC). Methods: This is a retrospective cohort study design utilizing survival analysis. Accrual period was from January 1, 2018 to December 31, 2018. Follow-up ended on March 31, 2019. There were 154 admissions and excluded 17 missing charts. Survival analysis was done utilizing STATA 14. Results: The prevalence of SAM requiring ITC admission was 3.0 percent. Majority belonged to 6-59 months of age (63%), with equal predilection for both sexes (1:1) and 71% came from the home province, Albay. Most of patients’ caretakers had middle educational attainment. Sixty-eight percent (68%) were new patients, 16% readmitted, 15% transferred from the Out-patient Therapeutic Care (OTC) and <1% relapsed. The top three most common complications and co-morbidities include: pneumonia, low electrolytes, and fever. Sixty-three percent (63%) of patients at the ITC had a desirable treatment outcome, of which, 8% were cured and 55% transferred to OTC. Undesirable outcomes accounted for 37% of the cases which included non-cured, defaulter, and died at 12%, 8%, and 17%, respectively. The risk of dying was higher in SAM patients with parents having middle and low educational attainment as compared to those with high educational attainment (2-5 folds to 100-200 folds). SAM patients presenting with hypovolemic shock were likely to die by 1.5-19 times (1.5-19x) as compared to those without. SAM patients with malignancy were more likely to die 4-44 folds as compared to patients without malignancy. Conclusion and Recommendations Educational attainment of parents, malignancy, and hypovolemic shock were significant predictors of mortality. We recommend prompt intervention by educating families, strengthen policies targeting socio-economic determinants, capacitate medical staff, refine current clinical practice guidelines and treatment pathways to reduce the number of children who die from severe acute malnutrition.
Severe Acute Malnutrition ; Survival Analysis

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

In the Philippines, the escalating double burden of malnutrition necessitates an exploration of healthcare professionals' nutrition proficiency. This study aims to evaluate the nutrition knowledge, attitudes, and practices of resident physicians, providing insights into areas that may require enhancement in their nutrition-related competencies. This study aims to assess Resident Physician's knowledge, attitude, and practices regarding nutrition. Employing a descriptive, cross-sectional prospective design, the study surveyed resident physicians working at a tertiary government hospital from January 2021 to March 2023. Data collection utilized self-administered questionnaires, incorporating structured and open-ended questions. Data were subjected to descriptive analysis, with frequencies, percentages, and means presented. The Kruskall-Wallis test, chi-square test and Correlation Phi Coefficient were employed for statistical comparisons. This pioneering exploration among 97 resident physicians underscores their strong recognition of fundamental nutritional aspects. Knowledge levels varied from moderate (61.9%) to excellent (32.9%), with a minority having poor knowledge (5.2%). A significant relationship between years of residency and knowledge (p value= 0.01 Kruskall Walis, 0.029 Chi square), along with a strong relationship correlation was observed. The connection between attitude and practice to years of residency was less pronounced. Findings reveal knowledge gaps and potential disparities between attitudes and practices across different year levels, offering insights for tailored educational interventions and future research. The study underscores the imperative for targeted interventions to strengthen nutrition education among resident physicians. It signifies bolstering nutrition education to advance better patient care.

Background: Apart from its role in bone health, recent developments have shown that vitamin D also has anti-inflammatory properties, and therefore may have a role in inflammatory bowel disease (IBD) in children. Objectives: To determine the effect of vitamin D supplementation on the disease activity of pediatric patients with IBD. Design: Random-effects meta-analysis Data Sources: : Studies were searched at Cochrane Library, PubMed, EBSCO Host, ScienceDirect, Google Scholar, and Wiley Online. Review Methods: Experimental studies measuring the effect of vitamin D on the disease activity of pediatric patients with IBD were included. The proportion of disease activity, measured as remission rate or inactivity using Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and the mean and standard deviation of mean serum vitamin D [25(OH)D] level, change in 25(OH)D, and different inflammatory markers [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)] were extracted or estimated and recorded in an abstraction form. Standardized mean difference and odds ratio were used as summary effect measures and estimated using Stata/Multiprocessor. Results: The serum 25(OH)D (SMD = 1.75, z = 2.33, p = 0.001) and change in 25(OH)D (SMD = 3.37, z = 2.34, p = 0.019) was significantly higher among those who received a high dose of vitamin D. However, a significantly high heterogeneity was estimated (I2 >50%). For the disease activity of IBD, the standard mean difference of mean ESR (SMD = –1.10, z = 5.35, p = 0.001) was significantly lower with high-dose vitamin D. The likelihood of remission rate using the Pediatric Crohn’s Disease Activity Index (PCDAI) or Pediatric Ulcerative Colitis Activity Index (PUCAI), and standardized mean difference of CRP were not significantly different among those who received high-dose and low-dose vitamin D. Conclusion Cognizant of the functions of vitamin D in enhancing intestinal flora balance, regulating immunologic response, and improving intestinal mucosal barrier, vitamin D can be recommended as a supplementary treatment for IBD among the pediatric population. Nevertheless, there is still insufficient evidence for the cut-off level of adequate levels of serum 25(OH)D among pediatric patients with IBD, thus necessitating further studies.
Vitamin D Deficiency

Vitamin B12 deficiency has long been known to present with various neurological manifestations, but only rarely presents as movement disorders, especially in adults. We present the case of a 30-year-old vegan male presenting with tremors on both legs when standing which was relieved by vitamin B12 supplementation. To the best of our knowledge, this is the first documented case of slow orthostatic tremor or pseudo-orthostatic tremor caused by vitamin B12 deficiency.
Vitamin B 12 Deficiency ; Vitamin B 12 ; Vegans ; Movement Disorders ; Tremor ; Electromyography