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1 Food Safety and Nutrition in the Philippines Assistant Secretary Maria-Bernardita T. Flores, CESO III Executive Director, National Nutrition Council, DOH Outline • Food safety concerns • Nutrition situation • Nutrition research agenda 3 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 4 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 5 Food safety concerns 3. Use of non-permissible food additives • Borax, potassium bromate, sodium cyclamate, food color • Melamine in milk 6 Food safety concerns 4. Use of food additives beyond allowable limits • Sodium nitrite, Sodium nitrate, Sulfur dioxide on jelly 7 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 8 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 9 Food System 10 Mean one–day per capita food consumption, in grams, Philippines, 1978 - 2003 1000 897 915 886 869 803 Grams 750 500 250 0 1978 1982 1987 1993 Source: National Nutrition Surveys: 1978-2003, FNRI 2003 11 Mean one–day per capita energy and nutrient adequacy, Philippines, 2003 (FNRI, 6th NNS) Nutrient Intake % Adequacy Energy (kcal) 1905 98.3 Protein (g) 56.2 99.2 Iron (g) 10.1 Calcium (g) 0.44 Retinol Eq. (g) 60.1 57.1 91.4 455.2 Thiamin (mg) 0.88 Riboflavin 0.73 Niacin (mg) 20.6 Ascorbic Acid (mg) 46.5 86.3 68.0 75.0 12 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 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 18 133 154 157 147 185 8 9 10 12 13 42 44 43 44 49 8 10 10 10 10 145 130 111 106 111 34 37 29 30 31 111 93 82 76 80 104 102 107 77 54 Vitamin C-rich 30 18 24 21 12 Other fruits 74 84 83 56 42 Miscellaneous 21 32 26 19 39 897 915 869 803 13 886 Cereals and cereal product Fish, meat and poultry Eggs Milk and milk products Dried beans, nuts and seeds Vegetables Green, leafy, yellow Other vegetables Fruits Total Source: National Nutrition Surveys: 1978-2003, FNRI Nutrition Situation Undernutrition Overnutrition Preschool (0-5 yrs) 24.6 2.0 School-age (6-10 yrs) 22.8 1.6 Adolescents (11-19 15.5 3.3 12.4 23.9 yrs) Adults (20 yrs & above) Source: 2003 National Nutrition Survey and 2005 Updating of Nutritional Status of15 Children, DOST-FNRI Undernutrition throughout the life cycle Higher mortality rate ELDERLY Malnourished Impaired mental development Untimely/inadequate complementary feeding BABY Low birthweight Inadequate fetal nutrition Inadequate food, health, and care Increased risk of adult chronic disease Frequent infections Inadequate catch-up growth CHILD Stunted WOMAN Reduced mental capacity Malnourished PREGNANCY Low weight gain Higher maternal mortality Inadequate food, health, and care Inadequate food, health, and care ADOLESCENT Stunted Inadequate food, health, and care Reduced mental capacity 16 Source: ACC/SCN (2000). Fourth Report on the World Nutrition Situation. Geneva: ACC/SCN in collaboration with the International Food Policy Research Institute. Short- and long-term effects of early undernutrition Early undernutrition in utero & childhood Brain development Cognitive & educational performance Growth & muscle mass Body composition Immunity Work capacity Metabolic programming of glucose, lipids, protein, hormones/ receptors/genes Diabetes Obesity Heart disease High BP Cancer Stroke Ageing 17 Source: Report of the ACC/SCN Commission on Ending Malnutrition by 2020 Ten leading causes of mortality, Philippines, 2000 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 10.4 2.2 10. Kidney diseases Source: Philippine Health Statistics, 2000 18 Double burden of malnutrition: unhealthy diets • High fat, high sugar, refined carbohydrates, processed meat products, low in fruits and vegetables • Urban dwellers • Low in protein, energy, micronutrients Higher income groups Lower income groups Underweight child and overweight mother 19 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 20 21 Updated Medium-Term Philippine Plan of Action for Nutrition, 2008-2010 • Focus on pregnant women and children 02 years old • Population groups & areas highly affected or at-risk to malnutrition 22 Updated Medium-Term Philippine Plan of Action for Nutrition, 2008-2010 • Promotion of healthy lifestyle – Promote healthy diet – Smoking cessation – Increased physical activity 23 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 24 Nutrition research agenda 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 25 well-nourished children Nutrition research agenda 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 26 Nutrition research agenda 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 27 Key points • Vigilance is required to ensure safety of our food 28 Key points • Vigilance is required to ensure safety of our food • The Philippines is facing a double burden of malnutrition 29 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. 30 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. 31 32