1

Food Safety and Nutrition

in the Philippines

Assistant Secretary Maria-Bernardita T. Flores, CESO IIIExecutive Director, National Nutrition Council, DOH

3

Outline

• Food safety concerns

• Nutrition situation

• Nutrition research agenda

4

Food safety concerns

1. Microbiological contamination

• Staphylococcus aureus in hotdog, noodles, assorted cooked food

• Escerichia coli in assorted cooked food

• Salmonella in noodles and peanut butter

• Molds and yeast in cakes

5

Food safety concerns

2. Presence of food contaminants

• Aflatoxin in peanuts, corn grits

• Presence of foreign matter and filth

• Allergens in hotcake mix

• Histamine in marine products

• Heavy metals in herbal food supplements

6

Food safety concerns

3. Use of non-permissible food additives

• Borax, potassium bromate, sodium cyclamate, food color

• Melamine in milk

7

Food safety concerns

4. Use of food additives beyond allowable limits

• Sodium nitrite, Sodium nitrate, Sulfur dioxide on jelly

8

Actions taken by BFAD

• Continuous assessment of Good Manufacturing Practices (GMP) and Hazard Analysis Critical Control Points (HACCP) to check compliance

• Continuous review and development of food standards

9

Actions taken by BFAD

• Requiring manufacturers to include label warning re: reaction to a certain ingredient

• Issuance of cease and desist orders (CDOs) to violators

10

Food System

11

Mean one–day per capita food consumption, in grams, Philippines, 1978 - 2003

886803869

897 915

0

250

500

750

1000

1978 1982 1987 1993 2003

Gra

ms

Source: National Nutrition Surveys: 1978-2003, FNRI

1275.0

68.0

86.3

91.4

57.1

60.1

99.2

98.3Energy (kcal)

Protein (g)

Iron (g)

Calcium (g)

Retinol Eq. (g)

Thiamin (mg)

Riboflavin

Niacin (mg)

Ascorbic Acid (mg)

1905

56.2

10.1

0.44

455.2

0.88

0.73

20.6

46.5

Mean one–day per capita energy and nutrient adequacy, Philippines, 2003 (FNRI, 6th NNS)

Nutrient Intake % Adequacy

13

Mean one–day per capita food consumption, in grams, Philippines, 1978 - 2003

Food group and subgroup Consumption (gram), raw as purchased

1978 1982 1987 1993 2003

Cereals and cereal product 367 356 345 340 364

Starch roots and tubers 37 42 22 17 19

Sugars and syrups 19 22 24 19 24

Fats and oils 13 14 14 12 18

Fish, meat and poultry 133 154 157 147 185

Eggs 8 9 10 12 13

Milk and milk products 42 44 43 44 49

Dried beans, nuts and seeds 8 10 10 10 10

Vegetables 145 130 111 106 111

Green, leafy, yellow 34 37 29 30 31

Other vegetables 111 93 82 76 80

Fruits 104 102 107 77 54

Vitamin C-rich 30 18 24 21 12

Other fruits 74 84 83 56 42

Miscellaneous 21 32 26 19 39

Total 897 915 869 803 886

Source: National Nutrition Surveys: 1978-2003, FNRI

15

Nutrition SituationUndernutrition Overnutrition

Preschool (0-5 yrs) 24.6 2.0

School-age (6-10 yrs) 22.8 1.6

Adolescents (11-19 yrs)

15.5 3.3

Adults (20 yrs & above) 12.4 23.9

Source: 2003 National Nutrition Survey and 2005 Updating of Nutritional Status of Children, DOST-FNRI

16Source: ACC/SCN (2000). Fourth Report on the World Nutrition Situation. Geneva: ACC/SCN in collaboration with the International Food Policy Research Institute.

Reduced mental capacity

Inadequate food, health, and care

BABYLow birthweight

WOMANMalnourished

PREGNANCYLow weight gain

CHILDStunted

ADOLESCENTStunted

ELDERLYMalnourished

Higher mortality

rateImpaired mental

developmentIncreased risk of

adult chronic disease

Untimely/inadequate complementary

feeding

Frequent infections

Inadequate food, health,

and care

Reduced mental capacity

Inadequate food, health,

and careHigher maternal

mortality

Inadequate food, health,

and care

Inadequate catch-up growth

Inadequate fetal

nutrition

Undernutrition throughout the life cycle

17

Short- and long-term effects of early undernutrition

Early under-nutrition

in utero & childhood

Brain development

Growth & muscle mass

Body composition

Metabolic programming

of glucose, lipids, protein,

hormones/receptors/genes

Cognitive & educational performance

ImmunityWork capacity

DiabetesObesity

Heart diseaseHigh BP CancerStrokeAgeing

Source: Report of the ACC/SCN Commission on Ending Malnutrition by 2020

18

Cause Per 100,000 Population

%

Rate Death

1. Diseases of the heart 79.1 16.5

2. Diseases of the vascular system 63.2 13.2

3. Malignant neoplasms 47.7 9.9

4. Pneumonia 42.7 8.9

5. Accidents 42.4 8.8

6. TB, all forms 36.1 7.5

7. COPD & allied conditions 20.8 4.3

8. Certain conditions originating in the perinatal period

19.8 4.1

9. Diabetes mellitus 14.1 2.9

10. Kidney diseases 10.4 2.2

Ten leading causes of mortality, Philippines, 2000

Source: Philippine Health Statistics, 2000

19

Double burden of malnutrition: unhealthy diets

• High fat, high sugar, refined carbohydrates, processed meat products, low in fruits and vegetables

• Urban dwellers

Higher income groups

• Low in protein, energy, micronutrients

Lower income groups

Underweight child and overweight mother

20

Addressing the double burden of malnutrition

• Address undernutrition with interventions during pre-pregnancy, pregnancy and first 2 years of life

• Prevent NCDs with interventions during pre-pregnancy, pregnancy and infancy along with strategies for increased physical activity and other lifestyle changes

21

22

Updated Medium-Term Philippine Plan of Action for Nutrition, 2008-2010

• Focus on pregnant women and children 0-2 years old

• Population groups & areas highly affected or at-risk to malnutrition

23

Updated Medium-Term Philippine Plan of Action for Nutrition, 2008-2010

• Promotion of healthy lifestyle

– Promote healthy diet

– Smoking cessation

– Increased physical activity

24

MTPPAN Research Agenda

1. Basis for formulating and implementing nutrition policies and programs

2. Development of new products and processing technologies including more nutritious foods and higher-yield crops

3. Ensure safe foods derived from biotechnology

25

1. Determination of the cost-effectiveness of nutrition interventions

2. Testing & modeling of innovative interventions & delivery systems

3. Development of simple tools for nutrition program management at the local level

4. Child-caring practices of poor households with well-nourished children

Nutrition research agenda

26

5. Formative & exploratory research related to complementary feeding, program for school-age children and adolescents

6. Exploratory studies on making nutrition labeling mandatory in the Philippines

7. Development of more nutrient-dense rice varieties; high yielding, high-protein fish varieties commonly consumed by the poor, and low-fat hog varieties

Nutrition research agenda

27

8. Development of complementary food mixes

9. Determination of modes and levels of financing of nutrition programs and projects

10. Assessment of the effectiveness of• Accelerated Hunger-Mitigation Program• School feeding • Other nutrition programs

Nutrition research agenda

28

Key points

• Vigilance is required to ensure safety of our food

29

Key points

• Vigilance is required to ensure safety of our food

• The Philippines is facing a double burden of malnutrition

30

Key points

• Vigilance is required to ensure safety of our food

• The Philippines is facing a double burden of malnutrition.

• Addressing undernutrition and diet-related non-communicable diseases requires interventions to prevent and address maternal and child undernutrition.

31

Key points

• Vigilance is required to ensure the safety of our food.

• The Philippines is facing a double burden of malnutrition.

• Addressing undernutrition and diet-related non-communicable diseases requires interventions to prevent and address maternal and child undernutrition.

• The continuing challenge for scientists is to find ways of overcoming the double burden of malnutrition in an integrated manner.

32