Nutrition Month Celebration 2006
Kumain nang RIGHT,
para maging batang BRIGHT!
1. What is Nutrition Month?
Nutrition Month (NM) is held every July to focus the general public’s attention on ndnutrition along a chosen theme. This year, the country is celebrating the 32
Nutrition Month. The National Nutrition Council and local government units are
mandated to coordinate the celebration of Nutrition Month (Section 7, Presidential
Decree No. 491 or Nutrition Act of the Philippines, 25 June 1974).
2. What is the National Nutrition Council (NNC)?
The NNC is the policy-making and coordinating body on nutrition in the country.
Ten key government organizations comprise the NNC Governing Board that also
includes 3 private sector representatives appointed by the President of the Philippines
for a two-year term. Chaired by the Department of Health (DOH), the NNC member
agencies are the following:
a. Department of Agriculture (DA), Vice-chair b. Department of the Interior and Local Government (DILG), Vice-chair c. Department of Budget and Management (DBM) d. Department of Education (DepEd)
e. Department of Labor and Employment (DOLE) f. Department of Science and Technology (DOST) g. Department of Social Welfare and Development (DSWD) h. Department of Trade and Industry (DTI) i. National Economic and Development Authority (NEDA) Assisting the NNC Governing Board is the NNC Technical Committee, which is
composed of heads of major department agencies and bureaus of the NNC Governing
Board, and appropriate nongovernment organizations (NGOs). The NNC technical
committee facilitates intra- and interagency coordination on nutrition. It also selects
the theme for the celebration, usually for approval of the NNC Governing Board. The
NNC Secretariat on the other hand, executes policies, decisions, and directions set by
the NNC Governing Board. Among others, it coordinates and leads in efforts to make
the Nutrition Month celebration more meaningful. While the Secretariat has a limited
human resource base of only over 100, the NNC network extends down to the
barangay level through interagency local nutrition committees chaired by local chief
3. What is the focus of the 2006 Nutrition Month?
nd Nutrition Month Celebration is - “Kumain nang RIGHT, para The theme for the 32
maging batang BRIGHT.”
This year’s theme focuses on the nutrition of school-age children. It reinforces the
vital role of proper nutrition in creating a bright child. A bright child is the outcome
of fulfilling the child’s basic right to adequate nutrition and care as provided for in the
Philippine Constitution. A bright child is mentally alert, physically healthy and active,
emotionally-secure, socially-competent and capable of all intellectual, psychosocial
and motor abilities expected at the child’s age level. A child who is given the proper
nutrition and health care, good education and love and social support, is mentally,
physically and psychosocially equipped to grow and develop fully, and have a bright
4. Who is the school-age child?
The school-age child or the stage of middle childhood is between 6 to 10 years old
(although it is also referred to as 7-12 years old in some books). During this period,
growth continues but at a slower pace when compared to the preschool years; body
proportion increases, mental capabilities are enhanced; and motor coordination
increases. At the same time, the body builds up body reserves of nutrients in
preparation for adolescence.
At this stage, a child starts to assert his or her individuality, forming a social life
outside the family circle. The child gets busy with school activities, the school
becoming like a second home. The child also becomes less dependent on his or her
parents and caregivers. Thus, at this stage, the school and peers influence what the
child eats. For instance, a child would want to eat the foods his or her circle of friends
prefers to eat. His or her choices of food would be limited to those readily available
in the school.
5. What is the current state of nutrition of school-age children in the Philippines?
Many of the country’s school-age children are undernourished. Results of the latest
national nutrition surveys conducted in 2003 by the Food and Nutrition Research
Institute of the Department of Science and Technology (FNRI-DOST) showed that:
a. 27 in every 100 children 6-10 years old (26.7%) or about 2.5 million children
are underweight for their age
b. 37 in every 100 children 6-10 years old (36.5%) or about 3.4 million children
are stunted or short for their age
c. 37 in every 100 children 6-12 years old (37.4%) are anemic
While these numbers suggest a slight improvement in the nutritional status of school-age children in 2003 compared to 2001 levels (30.2% for underweight-for-age, and 40.8% for stunting), they are still high, speaking of the prevalence of undernutrition in this age group.
On the other hand, while the prevalence of overweight in this age group is low, (1 in every 100 children 6-10 years old (1.3%) or about 120,000), the prevalence rate increased from a “nil” or almost none level to 1.3%. Thus, while overnutrition is not
yet a problem among school children, there should be efforts to prevent an increase in its prevalence in this age group.
6. What are the consequences of poor nutrition among school-age children? Undernutrition. Undernutrition among children can lead to poor mental and physical
development, high risk to infections, and poor performance in school and ultimately lower levels of productivity in adulthood.
Iron Deficiency Anemia can lead to growth retardation, inattentiveness, decreased
social responsiveness, low levels of concentration, less motivation for intellectually challenging roles and low level of overall intellectual development, leading to lower scores on mental and motor development tests.
Overnutrition and obesity can lead to serious heart problems and diabetes at a young
age which could have serious health, economic, and social implications in adulthood.
7. Why are school-age children undernourished?
Undernutrition among school-age children could be traced to inadequate food intake. Inadequate food intake could be related to poor habits of skipping breakfast and undesirable snacking practices, among others.
Undernutrition could also be caused by frequent infections and diarrhea. Parasitism, usually, due to poor environmental sanitation and personal hygiene practices, is one of the infections that causes undernutrition among children. Parasitism can contribute to bouts of infections and protein-energy malnutrition (PEM) and thus, affects growth and development of the school-age child. Some parasites also interfere or hinder nutrient absorption particularly of iron, ascorbic acid, nitrogen and fat. Thus, parasitism could cause impaired cognitive function, absenteeism, under-enrollment, drop-out, impaired growth and development, abdominal obstruction (roundworm), growth retardation (whipworm), chronic colitis, iron deficiency anemia (whipworm and hookworm), fatigue (hookworm), reduced work capacity (schistosome) and poor learning aptitude.
Undernutrition among school-age children could be traced to undernutrition in the earlier years of life, including the period of gestation in the womb; which in turn could be traced to the nutritional status of the mother during the pre-pregnancy and pregnancy stages (Figure 1). If a mother who has conceived is malnourished and has low weight gain during pregnancy, the fetus in her womb is likely to experience
inadequate nutrition, leading to growth retardation, which would result to low birth weight. A baby with low birth weight who continues to experience inadequate nutrition, usually arising from undesirable infant feeding practices of non-exclusive breastfeeding in the first six months of life, late or too early introduction of complementary foods, and use of low-calorie and low-nutrient density complementary foods, will experience growth retardation and become stunted. Continued inadequacy of food and frequent bouts of infections results to the persistence of malnutrition up to the school-age period.
Figure 1. Intergenerational dynamics of malnutrition
8. What are the energy and nutrient requirements of a school-age child?
The Recommended Energy and Nutrient Intake (RENI) for Filipinos are levels of intake of energy and nutrients which are considered adequate for the maintenance of health and well-being of all healthy persons. Specific RENI levels for school-age children are shown in Table 1.
Table 1. RENI levels for school-age children
Energy/Nutrients 7-9 yrs 10-12 yrs Calories 1,600 2,140 Protein (g) 43 54 Vitamin A (mcg) 400 400 Vitamin C (mg) 35 45 Calcium (mg) 700 1,000 Iron (mg) 11 13 Iodine (mcg) 120 120 Source: FNRI-DOST, 2002
9. How can school-age children meet their RENI levels?
School-age children can achieve RENI levels by eating a variety of foods every day.
A food guide (Table 2) could be used to ensure variety in foods eaten.
Table 2. Daily food guide for school-age children
Recommended amounts Food group 7 – 9 years 10 -11 years
5? - 6 cups, cooked Rice and other similar products 4 – 5 cups
? 1 cup rice, cooked, or
? 4 pcs pan de sal (about 17 g each), or
? 4 slices loaf bread (about 17 g each)
? 1 cup macaroni or spaghetti cooked, or
? 1 pack instant noodles, or
? 1 root crop, small size
Fish/meat/poultry/dried beans/nuts 2 servings 2 servings
? 2 pieces of fish, 55-60 g each or 15 cm
long each, or
? 30 g lean meat or poultry, cooked
(about the size of a match box)
? 1? cups cooked dried beans, preferably
taken at least 3 times a week
Egg ? piece ? piece Whole milk 1 glass 1 glass
1 glass (240 ml) whole milk is equivalent to
4 tablespoons powdered whole milk or ?
cup evaporated milk diluted to with 1 glass
Recommended amounts Food group 7 – 9 years 10 -11 years Vegetables
Green, leafy ? cup cooked ? cup cooked
Other vegetables ? cup cooked ? cup cooked Fruits
Vitamin C-rich 1 medium slice or 1 1 medium slice or 1
slice of a big fruit slice of a big fruit
Other fruits 1 medium slice or 1 1 medium slice or 1
slice of a big fruit slice of a big fruit Fats and oils 6 teaspoons 6 – 8 teaspoons Sugar 5 teaspoons 5 - 6 teaspoons Water and beverages 6 -8 glasses 6 -8 glasses Source: Nutritional Guidelines for Filipinos, DOST-FNRI. Revised Edition 2000.
10. What are some of the eating practices of school-age children?
A study conducted by Molano, et al (2003) on the knowledge, attitude and practices
of school children on food and nutrition, showed that school children 10-12 years old
like to eat rice, beef, pork, chicken and vegetables as they believed that these are the
sources of energy to run around or play sports. Most of the children in the study ate
breakfast at home while lunch and dinner were consumed outside the home. Majority
of children had in-between meals or snacks with chips and biscuits as the most
common snack foods.
In the book, “Basic Nutrition for Filipinos”, Dimaano also pointed that school-age children start to eat a wider variety of foods. They also develop more food
preferences. They want to explore more complex dishes than what they have been
used to. The fondness for certain foods is influenced by what is seen on television
through commercials and or endorsements by their TV idol.
11. What are some nutrition- and health-related behavioral concerns of school-age
a. Skipping meals
Breakfast is the meal most often skipped, especially when the child has to be
in school early. In some cases, the child skips lunch and supper because of a
heavy snack immediately before the meal or frequent snacking in between the
main meals. There are cases when the child skips meals especially dinner
because he or she is too tired and too sleepy to eat.
b. High intake of foods that are high in fats and sugar, but low in other nutrients
Another concern affecting children is the intake of foods that are calorie-dense;
i.e. high in fat and sugars, but low in nutrients that may result to dental caries,
hypercholesterolemia, nutrient deficiency and even obesity. The increased
intake of such foods can be attributed to the rising number of fastfoods and
restaurant and frequent intake of softdrinks, chips and similar snack foods.
c. Frequent snacking or snacking too close to the main meal, resulting to loss of
appetite during the main meal
d. Practices that increase the risk of parasitism and water- and food-borne
diseases like diarrhea, gastro-enteritis, hepatitis A.
e. Inactivity due to long hours of watching TV or playing computer games.
Lack of physical activity has been linked to rising number of overweight and
obese people even among children. Because of the advancement of
technology and the conveniences of modern life, children spend fewer hours in
physical activities. Television and computers have been considered as
“comfort or relaxation zones” among children. Spare time and break times are
spent on computer games. Compared to children 10-20 years ago, who played
in their backyards with traditional and physically challenging activities,
children nowadays spend less time for physical activities.
Watching television does not only decrease physical activity for the child but
also impacts on his or her studies, health and personality development.
Though television can teach some good values to children, watching television
could sometimes distract the child and could substitute for a lot of things. One
is physical exercise which is crucial to the physical development of a growing
child. Watching television or playing computer games also replaces
opportunities for social interaction with family and friends. Such interactions
are important since these are opportunities for parents to learn more about
their child and for the child to practice sharing his ideas and feelings with their
peers or family members.
12. What can be done to address these concerns?
a. To prevent skipping of breakfast
Set a sleeping time for the child and encourage the child to observe this
sleeping time so he or she can wake up early and have enough time to eat an
A good breakfast is one that provides about ? of the total energy and nutrient
requirements of the child. A well-balanced breakfast should consist of rice or
bread or other cereals like oatmeal; a protein-rich food like egg or fried fish or
meat; a glass of milk; a vitamin C-rich fruit like papaya or mango, and a
vegetable if possible, e.g. tomato.
Studies have shown that children who eat breakfast perform better in school
and are more active, pay better attention in class and are less likely to have
problems in behavior. Children who eat breakfast are also able to meet their
daily nutritional needs and are able to avoid weight problems.
b. Preparing a nutritious baon
One way to ensure that the child gets the nutrition she/he needs for the day is
ensuring that she/he has a lunch box containing nutritious foods. Just like
breakfast, a packed lunch should provide at least ? of the child’s daily energy
and nutrient needs. Here are some things to consider when preparing for the
school-age child’s lunch box:
1) Think of a variety of foods to be prepared for the school-age child
since he or she becomes more adventurous in his food choices. 2) Include different groups of food and consider color, balance and
moderation when preparing for the child’s lunch. Apart from the rice,
viands should include meat and vegetables plus fruit as side dish. 3) For snacks, an assortment of fruits, biscuits, juices, sandwiches or milk
could be prepared.
4) Prepare easy-to-pack-and-handle dishes like fried chicken, fried fish,
pork adobo, fish/meat omelette, etc.
5) When planning baon, include the child in making choices for his lunch
for the school week.
6) To encourage the child to eat vegetables and fruits, offer colorful
variety and serve different types every day. When giving the child his
or her packed lunch, inform him/her what is in the bag and the benefits
from the vegetables and fruit included in his/her lunch box. 7) The child should have clean and safe water as part of the lunch box.
c. For healthy snacking
Emphasize healthy eating even in snack time. Teach the child “how to snack”
instead of “not to snack.” Thus, advise them to eat snacks more than 2 hours
before a regular meal. Ensure too that the amount of snack foods to be eaten
or given should not be more than or equal to the amount to be given during a
main meal. Instead of chips and softdrinks, serve or encourage the child to
choose nutritious snacks like rootcrops, healthy sandwich, boiled banana or
camote or corn, beans, boiled peanuts and fresh fruits. If the child requests for
chips, give him or her such but not too often and choose those with the
Sangkap Pinoy Seal since these are fortified with vitamin A, iron or iodine.
When preparing for snacks for the school-age child as “baon” in school, here
are some other pointers:
1) Like the main meals, planning snacks for the school-age child should
also consider the food guide for school-age children for wise food
choices. Also, include the school-age child in planning his or her
school snacks. Better yet, if time is available, the child can also help in
the preparation of his/her “baon.” In this way, he or she will most
likely to eat his or her “baon” having been part of the planning and
2) Use whole grain breads and low fat dressings for sandwiches. Use a
different filling each day for variation. To increase nutrient value and
fiber, add cut-up veggies such as tomatoes, lettuce or cucumber or
3) As beverage, milk or fresh fruit juices are recommended for the
school-age child’s nutritious “baon”. Explain the disadvantage of
drinking softdrinks to the school-age child and why milk and fresh
fruit juices are better. Other healthy beverages, which could be
prepared for the school child, are milk/fruit/vegetable shakes,
smoothies, sago at gulaman, and buko juice.
d. To prevent parasitism and water- and food-borne diseases
Food safety should be among the important considerations when preparing
food for the school-age child. The child should be constantly reminded on the
importance and need for hand washing before and after eating and after using
the toilet, and of ensuring their personal hygiene. These same practices should
be done by the family member who prepares food for children. Children
should also be reminded constantly to wear slippers. To avoid getting food
and water-borne diseases like hepatitis A, diarrhea, and amoebiasis, advise the
school-age child to buy food only from the school canteen and from places
that are clean. They should be taught on what to look for if they buy street
foods. For instance, if they like to buy fishballs and the like, advise them to
buy only from vendors who serve the fishballs in paper plates or in separate
containers so that there are less chances of dipping and re-dipping of the
fishball; or the food is covered or placed in a container that protects it from
dust, flies, and other contaminants. Deworming at least every six months is
e. To encourage physical activity Child experts recommend that watching television or playing computer games
should be limited to two hours a day and even less or none at all especially on
school nights. Children should be encouraged to do other activities apart from
watching TV. Encourage children to spend their free time by reading, playing
active games as well as educational ones (e.g. scrabble, chess, word games,
bingo, charades, etc).
When children watch television, allow them to choose what they want to
watch but be around to guide them. This way, parents could help the school-
age child understand what they see on the television. Watching television
with the children is also an opportunity to share and discuss ideas.
The following are suggestions to increase physical activity for the school-age
1) Organize family outings that involve physical activities. Examples are
visit to a park, zoo or museum, which includes walking. Outings with
active games are also helpful.
2) After dinner, walk around the community with the family instead of
3) Work together doing housework, which could be fun when all family
members are involved since the school-age child treasures quality time
with their parents.
4) Limit the use of computer or playing of video games to two hours.
5) When the family is watching television, get the kids to dance or move
with the program being watched, especially for shows and programs
that have music or dancing characters.
6) Do some gardening with the children.
7) Parents should also set a good example by limiting their own viewing
time and instead be involved in other physical activities.
13. How do we determine the nutritional status of a school-age child?
The nutritional status of a school-age child is determined by weighing and measuring
the height of the child. The weight and height are then compared with a “standard”
for a given age and gender (Attachment 1) to know if the child is underweight,
overweight, or of normal weight or if the child is stunted or of normal height for age.
14. What should one do when a child is underweight?
An underweight child should be attended to as soon as he/she is assessed to be one so
as not further complicate the poor nutritional status of the child and to prevent
aggravation of any nutrient deficiencies.
Parents should consult a pediatrician and a nutritionist-dietitian for professional help
to correct the child’s malnourished status. As such, parents should take part in the