Behavioral Risk Factors for NCDs among School Children in the National Capital Region (NCR), Philippines
Ma. Socorro Endrina-Ignacio*
Department of Nutrition, College of Public Health,University of the Philippines Manila,
625 P. Gil St., Ermita, Manila 1000 Philippines
The Philippines is experiencing rapid nutrition transition found to be associated with increased rates of non-communicable diseases (NCDs) attributed to “modifiable” risk behaviors i.e., tobacco use, unhealthy diet, insufficient physical activity, and the harmful use of alcohol. NCDs have not spared the young people, especially the urban residents. This cross-sectional study was conducted to establish baseline data on NCD related behavioral risk factors and consumption of ultra-processed foods (UPF) among school children aged 10–17 years old in the Philippine Red Cross’ (PRC) selected pilot schools in Manila and Quezon City (QC), National Capital Region (NCR). It also aims to determine the students’ awareness of the main causes of NCDs, source of information on NCDs, awareness of school policies, and participation in activities on NCD prevention. Qualitative methods using structured and food frequency questionnaires were employed to obtain information from 1665 randomly selected students in the study schools. NCD risk behaviors were noted among the students – with 74% of 31 students already smoking more than 3 sticks of cigarettes daily, 55% of 94 students already drinking alcohol once a month, and only 27–38% of 1665 students engaged in daily physical activity. High proportions of students have consumed fatty foods (83%), sugary foods (75%), and salty foods (57%) in the past 7 days at the time of the interview. NCD information were obtained from TV (90%), social media (78%), and peers (41%). Sixty percent (60%) were aware of NCD related school policies and 32.5% have received NCD related materials. The prevalence of NCD behavioral risk factors warrants a strong partnership between the school and the community to promote healthy diet and lifestyle practices.
Almost half of all deaths in Asia are now attributable to NCDs, accounting for 47% of global burden of disease (WHO 2010). Eighty percent (80%) of NCDs are occurring in low- and middle-income countries (LMICs) – including the Philippines – as a result of economic development that transitioned from traditional foods to affordable ultra-processed food (UPF) products (Monteiro & Cannon 2012) and decreased physical activity and sedentary lifestyles (WHO 2010; Hancock et al. 2011). . . . . read more
AGUAYO-PATRÓN SV, CALDERÓN DE LA BARCA AM. 2017. Old Fashioned vs. Ultra-Processed-Based Current Diets: Possible Implication in the Increased Susceptibility to Type 1 Diabetes and Celiac Disease in Childhood. Foods 6(11): 100 doi: 10.3390/foods6110100.
ALLEN L, WILLIAMS J, TOWNSEND N, MIKKELSEN B, ROBERTS N, FOSTER C, WICKRAMASINGHE K. 2017. Socio-economic status and non-communicable diseases behavioral risk factors in low-income and low-middle-income countries: A systematic review. Retrieved from https://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(17)30058-X.pdf on 13 Apr 2018.
ASFAW A. 2011. Does consumption of processed foods explain disparities in the body weight of individuals? The case of Guatemala. Retrieved from http://microdata.worldbank.org/index.php/citations/2032 on 11 Apr 2018.
BAKER P, FRIEL S. 2014. Processed foods and the nutrition transition: Evidence from Asia. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/obr.12174 on 14 Apr 2018.
BANKMAN J. 2017. Chronic Disease, Changing Diets and Sustainability: The Globalization of Western-style Eating and Its Implications. Brighter Green. Retrieved from http://brightergreen.org/wp-content/ uploads/2017/10/brighter_green_public_ health_paper.pdf on 11 Apr 2018.
BOYLAND EJ, HALFORD JC. 2013. Television advertising and branding: Effects on eating behaviour and food preferences in children. Appetite 62: 236–41. doi: 10.1016/j.appet.2012.01.032.
COLLISON KS, ZAIDI MZ, SUBHANI SN, AL-RUBEAAN K, SHOUKRI M, AL-MOHANNA FA. 2010. Sugar-sweetened carbonated beverage consumption correlates with BMI, waist circumference, and poor dietary choices in school children. BMC Public Health 10: 234.
[DepEd] Department of Education. 2017. Department Circular No. 17, 2017. Retrieved from http://newsinfo.inquirer.net/428511/deped-reminds-canteens-against-selling-junk-food-softdrinks on 12 Jan 2018.
[DepEd] Department of Education. 2015. Circular 0051/2015. Promotion of Healthy Lifestyle in Post-Primary School. Retrieved from https://www.education.ie/en/Circulars-and-Forms/Active-Circulars/Promotion-of-Healthy-Lifestyles-in-Post-Primary-schools.pdf on 12 Jan 2018.
[DOH] Department of Health. 2011. Fact Sheet on the Philippines 2011 (Ages 13-15) Global Youth Tobacco Survey (GYTS). Retrieved from http://www.doh.gov.ph/sites/default/files/publications/PhilippineNATIONALGYTS2011FactsheetAges1315.pdf on Jan 2018.
[DOST–FNRI] Department of Science and Technology – Food and Nutrition Research Institute. 2003. 6th National Nutrition Survey. Retrieved from http://www.fnri.dost.gov.ph/index.php/19-nutrition-statistic/42-6th-national-nutrition-survey
[DOST–FNRI] Department of Science and Technology – Food and Nutrition Research Institute. 2013. 8th National Nutrition Survey. Retrieved from http://www.fnri.dost.gov.ph/index.php/nutrition-statistic/19-nutrition-statistic/118-8th-national-nutrition-survey on 10 Dec 2017.
[GLOPAN] Global Panel on Agriculture and Food Systems for Nutrition. 2016. Food systems and diets: Facing the challenges of the 21st century. London, UK. Retrieved from https://glopan.org/sites/default/files/ForesightReport.pdf on 11 Jan 2018.
HANCOCK C, KINGO L, RAYNAUD O. 2011.The private sector, international development and NCDs. Glob Health 7(1): 1–11. doi: 10.1186/1744-8603-7-23.
KEARNEY J. 2010. Food consumption trends and drivers. Philos Trans R Soc Lond B Biol Sci 365(1554): 2793–2807.
LOUZADA ML, BARALDI LG, STEELE EM, MARTINS AP, CANELLA DS, MOUBARAC JC, LEVY RB, CANNOBN G, AGSHIN A, IMAMURA F, MOZAFFARIAN D, MONTEIRO CA. 2015. Consumption of ultra-processed foods and obesity in Brazilian adolescents and adults. Prev Med 81: 9–15.
LUDWIG DS. 2011. Technology, dirt, and the burden of chronic disease. JAMA 305: 1352–53.
Metro Manila. n/d. In: Wikipedia. Retrieved from https://en.wikipedia.org/wiki/Metro_Manila on 11 Apr 2018.
MONTEIRO CA, MOUBARAC JC, CANNON G, NG SW, POPKIN B. 2013. Ultra-processed products are becoming dominant in the global food system. Obes Rev 2: 21–28. doi: 10.1111/obr.12107.
MONTEIRO CA, LEVY RB, CLARO RM, CASTRO IRR, CANNON G. 2011. Increasing consumption of ultra-processed foods and likely impact on human health: evidence from Brazil. Public Health Nutr 14: 5–13.
MONTEIRO CA, CANNON G. 2012. The impact of transnational “big food” companies on the South: A view from Brazil. PLoS Med 9:7. e1001252.
PELTZER K, PENGPID S. 2015. Health Risk Behavior among In-School Adolescents in the Philippines: Trends between 2003, 2007 and 2011, A Cross-Sectional Study. Int J Environ Res Public Health 13(1): 73.
POPKIN BM, ADAIR LS, NG SW. 2012. Now and Then: Global Nutrition Transition and the Pandemic of Obesity in Developing Countries. Nutrition Reviews 70(1): 3–21.
STATISTA. 2018. Retail sales value of frozen processed food in the Philippines from 2014 to 2018 (in million U.S. dollars). Retrieved from https://www.statista.com/statistics/757806/retail-sales-value-of-frozen-processed-food-in-philippines/ on 14 Apr 2018.
STUCKER D, NESTLE M. 2012. Big food, food systems and global health. PLoS Med 9(6): e1001242. https://doi.org/10.1371/journal.pmed.1001242.
[WHO] World Health Organization. 2010. Global status report on non-communicable diseases. Retrieved from http://www.who.int/nmh/publications/ncd_report_full_en.pdf on 11 Dec 2017.
[WHO] World Health Organization. n/d. Physical Activity. Retrieved from http://www.who.int/dietphysicalactivity/pa/en/ on 15 Dec 2017.
[WHO] World Health Organization. 2003. STEPS: A Framework for Surveillance. Retrieved from http://www.who.int/ncd_surveillance/en/steps_framework_dec03.pdf on 12 Dec 2017.
[WHO–WPRO] World Health Organization – Western Pacific Regional Office. 2015. Fact sheet on adolescent health. Retrieved from www.wpro.who.int/mediacentre/factsheets/docs/fs_201202_adolescent _health/en/ on 11 Dec 2017.