Solving the country’s malnutrition problem by really trying

by Admin-Phmp

Text by Henrylito D. Tacio

Photos by UNICEF

One out of four children, less than five years old, in Mindanao found to be underweight, according to a nutrition survey results presented during the recently concluded Online Technology Forum for Bangsamoro Autonomous Region for Muslim Mindanao (BARMM) by the Department of Science and Technology – Food and Nutrition Research Institute (DOST-FNRI).

“Underweight prevalence generally increased except for Lanao del Sur,” reported Lea B. Landicho, a science research analyst at DOST-FNRI, adding that four out ten, for the same age group, are also stunted.

Underweight is defined as “a condition where children are found to weigh below the standard weight.” Stunting, on the other hand, is based on the height-for-age index or when the height of a child is below the standard for the child’s age.

Stunting reflects chronic undernutrition, according to a DOST press release. It’s a manifestation of past nutritional status wherein there’s a prolonged inadequate intake, recurrence of illness, or improper feeding practices.

“Stunting prevalence generally increased except for Tawi-Tawi,” Landicho said.

Eight out of a hundred children, less than five years of age, are considered wasting or thin. Wasting or thinness is based on weight-for-height for height index, or it is a condition when a child’s weight is below the standard for the child’s height.

“Wasting generally decreased except for Sulu and Tawi-Tawi,” Landicho pointed out.

What is even more alarming is that four out of one hundred are overweight for their height among the less than five years old.

In Northern Mindanao, for instance, a 7.1% prevalence of overweight and obesity has been recorded based on a survey conducted by the regional office of the National Nutrition Council (NNC) in 2018.

Being underweight or overweight and thin or fat are signs of malnutrition. According to the World Health Organization (WHO), malnutrition refers to deficiencies, excesses, or imbalances in a person’s intake of energy and/or nutrients.

“Every day, 95 children in the Philippines die from malnutrition,” says the United Nations Children’s Fund (UNICEF) the Philippines. “Twenty-seven out of 1,000 Filipino children do not get past their fifth birthday. A third of Filipino children are stunted, or short for their age.”

According to Landicho, the first 1,000 days of a child’s life, which begins in pregnancy, is critical because the damage is irreversible if the child does not get proper nutrition during this period.

Despite the critical importance of the first 1,000 days, Filipino infants are not eating well, according to UNICEF. “As a result, they are surviving but not thriving,” the UN agency deplores.

NNC study showed that only a third of babies are exclusively breastfed during the first six months. Around 44% of children aged 6-23 months are not fed fruit and vegetables, and 59% are not fed eggs, dairy products, fish, or meat.

“(These children) are not getting required nutritional intake by consuming from at least five of the seven food groups,” the UNICEF said.

The seven food groups refer to the seven main classes of nutrients that the body needs. These are carbohydrates, proteins, fats, vitamins, minerals, fiber, and water.

“There has been little progress in addressing undernutrition, and overnutrition has emerged as a serious concern,” said UNICEF in its report, Fill the Nutrient Gap. “This growing double burden hinders the country’s potential for social and economic development.”

When one speaks of malnutrition, one cannot fail to mention hunger. One in nine people are hungry, stated the 2020 Global Nutrition Report.  

The latest edition of the State of Food Security and Nutrition in the World has even heightened the problem. “More people are going hungry,” it said. “Tens of millions have joined the ranks of the chronically undernourished over the past five years, and countries around the world continue to struggle with multiple forms of malnutrition.”

“Overcoming hunger and malnutrition in all its forms (including undernutrition, micronutrient deficiencies, overweight and obesity) is about more than securing enough food to survive: what people eat – and especially what children eat – must also be nutritious,” the report said. “Yet a key obstacle is the high cost of nutritious foods and the low affordability of healthy diets for vast numbers of families.”

The report presents evidence that a healthy diet costs far more than US$1.90 a day, the international poverty threshold. It puts the price of even the least expensive healthy diet at five times the price of filling stomachs with starch only.

Nutrient-rich dairy, fruits, vegetables, and protein-rich foods (plant and animal-sourced) are the most expensive food groups globally, the report states.

“Malnutrition is a threat multiplier,” Dr. Cynthia Rozenzweig, author of the food security chapter in the Intergovernmental Panel on Climate Change’s report on land and climate change, told Guardian. “I think it has been ignored that people who are malnourished are likely to have lower immune systems.”

Dr. Venkatesh Mannar, a special adviser on nutrition to the Tata-Cornell Institute for Agriculture and Nutrition, also deplored: “Poor diet and malnutrition is not a matter of personal choice. Most people are not able to do this because of inequality of food systems. They do not have access to a range of healthy food. The interface between the food supply chain and consumer is inequitable.”

Some years back, the Philippines was listed by the UN Food and Agriculture Organization (FAO) as one of the 13 low-income food-deficit countries in Asia (“those that do not have enough food to feed their populations and for the most part lack the financial resources to pay for imports”). 

“In many developing countries, rapid population growth makes it difficult for agricultural production to keep pace with the rising demand for food,” wrote Don Hinrichsen in a report published by Population Reports. “Most developing countries already are cultivating virtually all arable land and are bringing more marginal land under cultivation.”

Jacques Diouf, at the time when he was the director-general of FAO, echoed the same concern. “Population growth continues to outstrip food availability in many countries,” he pointed out during the 1996 World Food Summit in Rome.

Hunger is the world’s “most solvable problem,” declared the UN World Food Program. But in the Philippines, hunger persists across the country. 

“A generation of Filipino children are already hindered from reaching their full potential if they are hungry and deprived of the nutrition they need to learn in school and stay active,” Senator Grace Poe said in a statement. “We must collectively work together to take care of our children and ensure that they are able to take advantage of the opportunities presented to them.” 

More than 2 billion people suffer from hidden hunger globally, and there is a ripple effect that has consequences for the entire population. “Hidden hunger” is caused by a lack of essential vitamins and minerals.

“Even if people have enough calories to eat, they can still suffer from ‘hidden hunger’ if their only food options do not contain the necessary micronutrients,” says Bev Postma, who has 25 years of experience as a policy expert in international food systems, nutrition, and food security.

But there’s good news. The DOST-FNRI has launched a Malnutrition Reduction Program (MRP) which addresses the undernutrition problem among young children in the country. MRP includes the DOST PINOY strategy, a package of interventions involving direct feeding of rice-mongo-based complementary foods for six months to below three years old children, and nutrition education among mothers and caregivers. This program has been on the roll-out in the countryside.

Alexis M. Ortiz, a research specialist at the technology transfer and commercialization section, said that DOST-FNRI has activities and projects focusing on sharing the nutrition status with the end-users so that they’ll be encouraged to take action.

Through MRP, advocacy meetings or forum are initiated among local executives and councils where issues are being tackled and informed about the nutritional status of their areas. In this way, food technologies can be introduced.

Among these food, technologies are complementary food, such as rice-monggo blend crunchies and curls for snacks and ready-to-eat food for infants and young children, and micronutrient growth mix.

According to the press release, the ready-to-cook blend of rice, mung bean, and sesame seeds contains 130 kilo calories (energy) and four grams protein per 30 grams serving portion – enough to meet the 18 % of recommended energy and 28.6 % of recommended protein intake of 6-month to less than 10-month-old children.

In addition, the DOST-FNRI also developed squash supplemented products, such as pancit canton and bakery products with squash, and also the fast-becoming popular enhanced nutribun. 

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