Usual Energy and Nutrient Intakes and Food Sources of Filipino Children Aged 6–12 Years from the 2013 National Nutrition Survey

Imelda Angeles-Agdeppa, Liya Dinney, and Mario V. Capanzana

It is important to assess the food intake of children aged 6–12 years in order to possibly link this with other nutrition-specific interventions to address malnutrition [1]. This study evaluated usual energy and nutrient intakes and food sources of school-age children in the Philippines. Data were from the 2013 National Nutrition Survey. A total of 6,565 children 6–12 years old from all sampled 8,592 households were interviewed for first-day 24-h dietary recall. A second-day recall was obtained from a random subsample (50% of the children). Usual energy and nutrient intakes were estimated using the PC-SIDE program [2]. Energy inadequacy was compared with estimated energy requirements considering active physical activity. Macronutrients were evaluated using the acceptable macronutrient distribution ranges. Micronutrient inadequacy was computed using the estimated average requirements (EAR) cutoff point method [3]. 

Results showed that mean energy intake (1,358 kcal) of all children was 24.6% below the estimated energy requirements. Forty-two percent had total fat intake as percentage of total energy below the lower range of acceptable macronutrient distribution ranges (AMDR), and hence most of the energy was provided by carbohydrates (Table 1). About 16% of children had protein intake below the EAR [4]. The mean intakes of total sugar and dietary fiber were 26.8 and 6.9 g/day, respectively (Table 1). 

The prevalence of inadequate total fat intake as percent energy intake was especially high in rural areas (60%). In children from the poorest quintile, a higher proportion did not meet the AMDR for total fat (80%), while 14% of the children from the richest quintile exceeded the AMDR. Furthermore, 36% of children from the poorest quintile exceeded the AMDR for carbohydrates (Table 1). 

The vitamin with the highest prevalence of inadequacy was vitamin C (81%). Nutrient inadequacy for other vitamins was: folate (70%), riboflavin (67%), and vitamin A (63%), vitamin B6 (30%), niacin (13%), and vitamin B12 (9%). The average intakes of vitamins D and E were 2.2 µg/day and 2.6 mg/day, respectively, and these were very low compared with the recommendations [4]. A high prevalence of inadequacy was also observed for calcium (93%), iron (87%), phosphorus (48%), and zinc (38%). Usual intake of sodium, magnesium, and potassium were 848, 130, and 853 mg/day, respectively. The mean intake of sodium exceeded the requirement, while the intake of potassium and magnesium were below the requirement (Table 1). 

Table 1. Mean usual nutrient intake and intake distribution for all children 6–12 years old (n = 6,565)
table1


Table 2. Percentage contributions of the top 10 food groups to selected macro- and micronutrient intakes among Filipino school-age children
table2b

Refined rice is the major source of energy, carbohydrates, and protein providing 53, 67, and 35% of total intake, respectively (Table 2). Rice also contributed a large amount of phosphorous (48%), iron (28%), calcium (20%), thiamine (32%), and riboflavin (17%). Another major contributor of calcium intake was fish and shellfish (21%). The major sources of fats are pork, sausages, and oils. The major source of vitamin C is fortified fruit-based drinks. Dark green leafy vegetables were the major source of vitamin A (34%). Bread was a major source of folate, contributing 17% (Table 2). 

Applying usual intake analysis in Filipino children, this study demonstrated that the intakes of fat and many micronutrients were markedly inadequate as evidenced by a high prevalence of inadequate intakes of fat and most vitamins and minerals. The shortfalls in nutrients can be largely explained by the high intake of refined rice, which is the major source of many key nutrients, while nutrient-dense foods such as milk, fruits, and vegetables played little role in the diet. The results are informative to nutrition policy and education both for parents and health care professionals, and could be used for the development of various public health strategies to improve diet quality and address nutrient shortfalls in the diets of this population.

References

  1. International Food Policy Research Initiative: Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington, International Food Policy Research Institute, 2016, http://www.ifpri.org/publication/ global-nutrition-report-2016-promise-impact-ending-malnutrition-2030.
  2. Nusser SM, Carriquiry AL, Dodd KW, Fuller WA: A semi-parametric transformation approach to estimating usual daily intake distributions. J Am Stat Assoc 1996;91:1440–1449.
  3. Lopez-Olmedo N, Carriquiry AL, Rodriguez-Ramirez S, et al: Usual intake of added sugars and saturated fats is high while dietary fiber is low in the Mexican population. J Nutr 2016;146:1856S–1865S.
  4. Food and Nutrition Research Institute–Department of Science and Technology (FNRI–DOST): Philippine Dietary Reference Intakes (PDRI) 2015. Taguig City, FNRI–DOST, 2015.