Supplementary Feeding Utilizing Climate-smart Indigenous Vegetables from School Gardens with Iron Fortified Rice Improved Nutritional Status of Schoolchildren
Imelda Angeles-Agdeppa1*, Emilita M. Oro2, Clarita R. Magsadia1,
Maria Christy Jesusa G. Tacugue2, Julian F. Gonsalves2, and Mario V. Capanzana1
1Food and Nutrition Research Institute, Department of Science and Technology, Taguig City, Philippines
2International Institute of Rural Reconstruction, Silang, Cavite, Philippines
*Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.
ABSTRACT
This study evaluated the effectiveness of supplementary feeding in improving weight, vitamin A (VA), and hemoglobin levels of children using vegetables from school gardens and iron fortified rice (IFR). A cluster randomized controlled study using multi-stage sampling involving 6–8 year old underweight (WAZ <–2 SD) and/or anemic (hemoglobin <12 g/dL) schoolchildren in three public schools in Cavite province was conducted. School 1 and School 2 received lunch with standardized one-dish vegetable recipe; however, School 1 and School 2 had IFR (GIFR) and ordinary rice (GOR), respectively. School 3 (SNK) served hot soups or native delicacies as snacks available in the school canteen. Eighty (80) children in each group participated in the feeding every school day, 5 days a week for 120 days. Data on weight, hemoglobin, and serum retinol concentration for vitamin A (VA) levels were collected before and after the study using standard methods. Basal and endpoint mean weight was similar between groups; however, within group mean increment was significantly higher in GIFR and SNK than in GOR (p<0.05). Translating the results to prevalence of underweight at endpoint, the decrease in GOR was significantly higher than the decrease in GIFR and SNK (p<0.05). Basal mean hemoglobin levels were similar between groups; at endpoint, mean increment in GIFR 1 was significantly higher than in GOR. Baseline prevalence of anemia was significantly lower in SNK than in the two schools (p=0.05). At endpoint, only GIFR had a significant decline between time periods (p=0.000). Baseline mean VA was significantly lower in GIFR than in SNK (p=0.027); at endpoint, mean level was significantly higher in GIFR than in SNK (p=0.003). Supplementary feeding is effective in improving the weight of schoolchildren. The model of linking the use of vegetables from school garden had improved VA levels and the use of IFR has increased hemoglobin level.
INTRODUCTION
The Philippine National Nutrition Survey conducted by the Food and Nutrition Research Institute (FNRI) revealed the prevalence of the following among children aged 5–10 years old: underweight (32.0%), stunting (33.6%), and wasting (8.5%) (FNRI–DOST 2011). Anemia prevalence among schoolchildren aged 6–12 years was 20% (FNRI–DOST 2008).
To address undernutrition among schoolchildren, the Philippines had implemented school nutrition programs that included deworming, school feeding, and vegetable gardening. . . . . read more
REFERENCES
Allen LH, Gillespie SR. 2001. What works? A review of the efficacy and effectiveness of nutrition interventions. United Nations. Administrative Committee on Coordination/ Subcommittee on Nutrition, Geneva. Asian Development Bank, Manila, ACC/SCN Nutrition Policy Paper No. 9 ADB Nutrition and Development Series, Geneva 5: 24–25.
Angeles-agdeppa I. 2006. The efficacy of fortified health drink in improving the nutritional and iron status of schoolchildren (effect on weight). DOST–FNRI Annual Report.
Angeles-Agdeppa I, Capanzana MV, Barba CVC, Florentino RF, Takanashi K. 2008. Efficacy of iron-fortified rice in reducing anemia among schoolchildren in the Philippines. Int J Vitam Nutr Res. 78(2): 74–86.
ANGELES-AGDEPPA I, MONVILLE-ORO E, MAGSADIA CR. 2015. Developed recipes using indigenous vegetables. Retrieved from https://schoolnutritionphils.files.wordpress.com/2014/12/recipe-booklet.pdf
BARBA CVC, CABRERA MIZ. 2008. Recommended energy and nutrient intakes for
Filipinos 2002. Asia Pac J Clin Nutr 17(S2): 399–404.
BELOT M, JAMES J. 2011. Healthy School Meals and Educational Outcomes. Journal of Health Economics 30(3): 489–504.
Best C, Neufingerl N, del Rosso JM, Transler C, van den Briel T, Osendarp S. 2011. Can multi-micronutrient food fortification improve the micronutrient status, growth, health, and cognition of schoolchildren? A systematic review. Nutrition Reviews 69: 186–204.
Bundy D, Burbano C, Grosh M, Gelli A, Jukes M, Drake L. 2009. Rethinking school feeding social safety nets, child development, and the education sector. The World Bank, Washington, D.C.
[CIOMS] Council for International Organizations of Medical Sciences. 2002. International Ethical Guidelines for Biochemical Research Involving Human Subjects. WHO: Geneva, Switzerland.
DAWSON-SAUNDERS B, TRAPP RG. 1994. Basic and Clinical Biostatistics. In a Lange Medical Book, 2nd Ed. Appleton & Lange. Prentice Hall International Incorporated: Norwalk, CT, USA.
[DepEd] Department of Education. 2007. Gulayan sa Paaralan – DepEd Order No. 293 S. Retrieved from http://www.deped.gov.ph/sites/default/files/order/2007/do_s2007_293.pdf on 13 Aug 2012.
[DepEd] Department of Education. 2012. School-Based Feeding Program (SBFP) – DepEd Order No. 87 S. Retrieved from http://www.deped.gov.ph/sites/default/files/order/2012/DO_s2012_087.pdf on 13 Mar 2013.
DOAK CM, VISSCHER TLS, RENDERS CM, SEIDELL JC. 2006. The prevention of overweight and obesity in children and adolescents: A review of interventions and programmes. Obesity Reviews 7(1): 111–136.
FLODMARK CEM, CLAUDE M, BRITTON M. 2006. Interventions to Prevent Obesity in Children and Adolescents: A Systematic Literature Review. International Journal of Obesity 30(4): 579–589.
[FNRI–DOST] Food and Nutrition Research Institute – Department of Science and Technology. 2008. Philippine nutrition facts & figures 2008: The 7th National Nutrition Survey. FNRI–DOST, Philippines.
[FNRI–DOST] Food and Nutrition Research Institute – Department of Science and Technology. 2011. Philippine nutrition facts & figures 2011: Updating of nutritional status of Filipino children and other population groups. FNRI–DOST, Philippines.
GRIER S, BRYANT C. 2005. Social marketing in public health. Annuv Rev 26: 319–339.
GIBSON RS. 1990. Principles of nutritional assessment. Oxford University Press: New York.
GULEC S, COLLINS J, ANDERSON G. 2014. Mechanistic and regulatory aspects of intestinal iron absorption. Am J Physiol Gastrointerest Liver Physiol 307(4): G397–G409.
Huybregts L, Houngbe F, Salpeteur C, Brown R, Roberfroid D, Ait-Aissa M, Kolsteren P. 2012. The effect of adding ready-to-use supplementary food to a general food distribution on child nutritional status and morbidity: A cluster-randomized controlled trial. PLoS Med 9: 1–10.
Josshi HS, Gupta R, Joshi MC, Vipul M. 2011. Determinants of nutritional status of schoolchildren – A cross sectional study in the western region of Nepal. NJIRM 2: 10–14.
JUKES MCH, DRAKE LJ, BUNDY DAP. 2007. School Health, Nutrition and Education for All: Levelling the Playing Field. UK: CABI.
Kanjilal B, Mazumdar PG, Mukherjee M, Rahman MH. 2010. Nutritional status of children in India: Household socio-economic condition as the contextual determinant. Int J Equity Health 9: 9–19.
Kazianga H, de Walque D, Alderman H. 2009. Educational and health impacts of two school feeding schemes evidence from a randomized trial in rural Burkina Faso. The World Bank Policy Research Working Papers. Retrieved from http://elibrary.worldbank.org/doi/pdf/10.1596/1813-9450-4976 on 30 Jul 2014.
KRISTJANSSON EA, ROBINSON V, PETTICREW M, MACDONALD B, KRASEVEC J, JANZEN L, GREENHALGH T, WELLS G, MACGOWAN J, FARMER A, SHEA BJ, MAYHEW A, TUGWELL P. 2007. School feeding for improving the physical and psychosocial health of disadvantaged elementary school children. Cochrane Database Syst Rev. 2007 Jan 24;(1): CD004676.
KRISTJANSSON EA, GELLI A, WELCH V, GREENHALGH T, LIBERATO S, FRANCIS D, ESPEJO F. 2016. Costs and cost-outcome of school feeding programmes and feeding programmes for young children: Evidence and recommendations. IJED 48: 79–83.
LAZZERINI M, RUBERT L, PANI P. 2013. Specially formulated foods for treating children with moderate acute malnutrition in low- and middle-income countries. Cochrane Library. Retrieved from http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD009584.pub2/epdf on 30 Jul 2014.
MEJÍA LA, CHEW F. 1988. Hematological effect of supplementing anemic children with vitamin A alone and in combination with iron. Am J Clin Nutr 48: 595–600.
[NSCB] National Statistical Coordination Board. 2012. Official Poverty Statistics 2012. Retrieved from http://www.nscb.gov.ph/poverty/ on 13 Aug 2012.
[PNHRS] Philippine National Health Research System. 2011. National Ethical Guidelines for Health Research. Philippine Council for Health Research and Development, Philippines.
[WHO] World Health Organization, United Nations Children’s Fund, Helen Keller International, International Vitamin A Consultative Group. 1982. Control of vitamin A deficiency and xerophthalmia. WHO Technical Series 672: 40.
[WHO] World Health Organization. 1972. Nutritional anemias. WHO: Geneva, Switzerland.
[WHO] World Health Organization. 2001. Iron Deficiency Anemia: Assessment, Prevention and Control: A Guideline for Programme Managers. WHO Document Production Services: Geneva, Switzerland.
[WHO] World Health Organization. 2007. Growth reference for 5–19 years old. Retrieved from http://www.who.int/growthref/who2007_bmi_for_age/en/ on 10 Jun 2012.
[WHO] World Health Organization. 2010. Nutritional landscape information system (NLIS): Country profile indicators interpretation guide. WHO: Geneva, Switzerland.
[WHO] World Health Organization. 2011. Helminth control in school-age children A guide for managers of control programmes. WHO: France.
