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Nutrition Month Celebration 2006

By Vanessa Martinez,2014-05-20 11:00
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In many instances, the produce of selective food production is used in supplementary feeding. Health and Environment Sanitation, which involves promoting

    Nutrition Month Celebration 2006

    Talking Points

    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

    executives.

    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

    future.

    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

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    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

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    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.

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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 serving

    ? 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

    1 serving

    ? 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

    of water

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    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

    children?

    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.

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    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

    adequate breakfast.

    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

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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

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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

    preparation.

    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

    pipino.

    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

    also recommended.

    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

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    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

    child:

    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

    watching television.

    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

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