Dinagat Island 2019 Expanded National Nutrition Survey

EXPANDED NATIONAL NUTRITION SURVEY: 2019 RESULTS

DINAGAT ISLAND 2019 EXPANDED NATIONAL NUTRITION SURVEY

Overview and Methodology

CHARMAINE A. DUANTE Supervising SRS The Department of Science and Technology -Food and Nutrition Research Institute (DOST-FNRI) is the premier Research and Development Institute of the government in food, and nutrition and other S & T services. LEGAL BASIS Executive Order 128 Section 22 The FNRI is mandated to undertake research that defines the citizenry’s nutritional status, with reference particularly to the malnutrition problem, its causes and effects, and identify alternative solutions to them; Executive Order 352 The national nutrition survey is a designated statistical activity that will generate critical data for decision-making of the government and the private sector Designated Statistical Activities

• The National Nutrition Survey (NNS) is a comprehensive survey conducted every five years since 1978 and the latest of which is in 2013.

• In-between the five-year period, the Updating Survey of Nutritional Status of Children and Other Population Groups is conducted every 2 to 3 years to rapidly assess the nutrition situation of Filipinos. HISTORICAL BACKGROUND

1978 1982 1987 1990 1993 1995 1998 1st NNS 2nd NNS 3rd NNS 1st 4th NNS 2nd 5th NNS Updating Updating Survey Survey 2001 2003 2005 2008 2011 2013 2015 2018-2020 3rd 6th NNS 4th 7th NNS 5th 8th NNS 6th Updating Updating Updating Updating Expanded Survey Survey Survey Survey NNS SURVEY COMPONENTS

GOVERNMENT CLINICAL & SOCIO-ECONOMIC PROGRAM ANTHROPOMETRY BIOCHEMICAL DIETARY HEALTH

3 Components in 1978 NNS

9 Components in 2019 ENNS

MATERNAL IYCF FOOD SECURITY SAMPLE SIZE

1978 NNS 2018 ENNS 2,800 Households 45,957 Households 17,667 Individuals 159,926 Individuals METHOD OF DATA COLLECTION METHOD OF DATA COLLECTION RESULTS DISSEMINATION

The Expanded National Nutrition Survey or ENNS Rationale: Generation of National Nutrition Data • There is a need to generate Nutrition and Health Data Annually at the National Level to cover key health and nutrition indicators for monitoring national programs

• To provide official statistics on SDG indicators assigned to FNRI for tracking changes or improvement Rationale: Generation of local level data

• To generate reliable estimates for the province and HUCs to be used by local government units (LGUs) and other stakeholders as basis for their development plan. General Objective:

To provide empirical data on the nutritional and health status of Filipinos for planning nutrition and development programs, and for timely policy decisions at the national and provincial/HUC levels. Specific Objectives:

1. To assess the physical growth and dimensions of children and other population groups using anthropometric indicators;

2. To assess the nutrition biomarkers of children and other population groups (e.g. hemoglobin, serum retinol, urinary iodine excretion, etc.); Specific Objectives: 3. To determine the following: • the prevalence of non-communicable disease risk factors of 10 years old and above • energy and nutrient intake at the household and individual levels; • the magnitude of food insecurity and coping mechanisms among households; Specific Objectives: 3. To determine the following: • the participation of households and individuals in selected health and nutrition related programs; • feeding practices of infants and young children, 0-23 months; • maternal nutrition and health status among mothers with 0-36 month old children and pregnant women; Specific Objectives:

4. To describe the socio-economic and demographic characteristics of the households and individuals;

5. To evaluate association of different risk factors to nutrition and health status. Specific Objectives: 6. To monitor/ track progress of the achievement of the Sustainable Development Goals (SDGs) designated to FNRI as the data source:

SDG 2 (Zero Hunger) SDG 3 (Good Health and Well Being) Baseline Updates Goals/Targets/Indicators Data Source Agency 2015 2018 2019 By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, target 2.1 including infants, to safe, nutritious and sufficient food all year round Updating of Nutritional Status of 31.0 Filipino Children and Other Proportion of households meeting 100% 2.1.1.p1 Population Groups, FNRI-DOST recommended energy intake Expanded National Nutrition Survey, 24.2 FNRI-DOST By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on target 2.2 stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons Updating of Nutritional Status of Prevalence of stunting (height for age <-2 33.4 Filipino Children and Other standard deviation from the median of the Population Groups, FNRI-DOST 2.2.1 World Health Organization (WHO) Child Growth Standards) among children under Expanded National Nutrition Survey, 30.3 28.8 5 years of age FNRI-DOST Baseline Updates Goals/Targets/Indicators Data Source Agency 2015 2018 2019 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting target and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and 2.2 lactating women and older persons

Prevalence of malnutrition (weight for height >+2 or <-2 standard deviation from the median of the WHO Child 2.2.2 Growth Standards) among children under 5 years of age, by type (wasting and overweight)

Prevalence of malnutrition for Updating of Nutritional Status of children under 5 years <-2 SD from 7.1 Filipino Children and Other 2.2.2.1 the median of the WHO CGS Population Groups, FNRI-DOST (wasting) 5.6 5.8 Expanded National Nutrition Survey, FNRI-DOST

Prevalence of malnutrition for Updating of Nutritional Status of children under 5 years >+2 SD from 3.9 Filipino Children and Other the median of the WHO CGS Population Groups, FNRI-DOST 2.2.2.2 (overweight) 4.0 2.9 Expanded National Nutrition Survey, FNRI-DOST Baseline Update Goals/Targets/Indicators Data Source Agency 2013 2018 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and target 2.2 wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons

2.2.s1 Prevalence of micronutrient deficiencies (Vitamin A, Iron)

2.2.s1.1 Vitamin A Deficient 6 months to 5 years old 20.4 National Nutrition Survey, FNRI-DOST

16.9 Expanded National Nutrition Survey, FNRI-DOST

Pregnant 9.0 National Nutrition Survey, FNRI-DOST

3.2 Expanded National Nutrition Survey, FNRI-DOST

Lactating 5.0 National Nutrition Survey, FNRI-DOST

2.3 Expanded National Nutrition Survey, FNRI-DOST

60 years old and up 3.0 National Nutrition Survey, FNRI-DOST

1.1 Expanded National Nutrition Survey, FNRI-DOST Goals/Targets/Indicators Baseline Updates Data Source Agency 2013 2018 2019 target 2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons 2.2.s1.2 Anemia 6 months to 5 13.8 National Nutrition Survey, FNRI-DOST years old 14.3 12.5 Expanded National Nutrition Survey, FNRI-DOST Pregnant 24.6 National Nutrition Survey, FNRI-DOST 26.1 19.9 Expanded National Nutrition Survey, FNRI-DOST Lactating 16.7 National Nutrition Survey, FNRI-DOST 14.4 11.6 Expanded National Nutrition Survey, FNRI-DOST 60 years old 20.8 National Nutrition Survey, FNRI-DOST and up 20.2 16.9 Expanded National Nutrition Survey, FNRI-DOST Baseline Updates Goals/Targets/Indicators Data Source Agency 2015 2018 2019 2.2.s2 Prevalence of exclusively Updating of Nutritional Status of Filipino Children and 48.8 breastfed children 0 to 5 Other Population Groups, FNRI-DOST months old 54.9 57.9 Expanded National Nutrition Survey, FNRI-DOST Baseline Updates Goals/Targets/Indicators Data Source Agency 2015 2018 2019 target Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all 3.a countries, as appropriate. 3.a.1 Age-standardized prevalence of current Updating of Nutritional Status of tobacco use among persons aged 15 22.9 20.6 Filipino Children and Other Population years and older Groups, FNRI-DOST 3.a.s1 Prevalence of current tobacco use Prevalence of current tobacco use of Updating of Nutritional Status of Filipino 10-19.9 years old 5.8 Children and Other Population Groups, NNS, FNRI-DOST Expanded National Nutrition Survey, FNRI- 4.5 3.7 DOST Prevalence of current tobacco use of 20 Updating of Nutritional Status of Filipino years old and over 24.9 Children and Other Population Groups, NNS, FNRI-DOST Expanded National Nutrition Survey, FNRI- 22.3 21.7 DOST What and how are the data collected What and how are the data collected METHOD: Actual data collection

Measurement of physical growth (weight and Anthropometry height) and body composition (mid upper arm, waist and hip circumferences)

Measures the prevalence of underweight, underheight, thinness, overweight and obesity METHOD: Actual data collection

Assesses prevalence of Vitamin A Biochemical Deficiency, Iron Deficiency Anemia and other nutrient deficiencies.

Collection of blood and urine samples METHOD: Actual data collection Assesses the prevalence of elevated blood pressure, Clinical and high fasting blood glucose and dyslipidemia, as well as behavioral risk factors such as smoking, alcohol Health consumption, physical inactivity and unhealthy diet.

Measurement of blood pressure, collection of blood and face-to-face interview METHOD: Actual data collection Determines the quality and quantity of food and nutrient intakes of households and Dietary individual member of the sample households.

One-day food weighing (household) and 24-hour food recall (individual) METHOD: Actual data collection Assesses food security at the Food Security household and individual level as well as coping mechanisms and strategies. Government Assesses household’s and member’s Program participation in selected nutrition and Participation related government programs. Socio-Economic Includes the education and occupation Characteristics of of the household members, their type of housing unit, type of wall, roof and Households/ ownership of different types Face-to-face Individuals appliances. interview METHOD: Actual data collection Updates information on the feeding practices of Infant and Young Child Filipino Children 0-23 months old and other related Feeding factors affecting feeding practices. Determines health and nutrition of mothers with Maternal Health and children 0-3 years old, their health-seeking Nutrition behaviors and care giving practices.

Face-to-face interview Who collects the data Trained professionals:

Nutritionist-dietitians

Medical technologist

Nurses

Other allied health professionals How are the survey results used USES OF SURVEY RESULTS

 Micronutrient Supplementation  Philippine Food Fortification Act of 2000 (R.A. 8976) To address nutrition  Asin Law (R.A. 8172) problems by  Republic Act No. 10351 (Sin Tax Law) crafting policies  School Feeding Law and interventions  The First 1000 days Law  National Policies on Infant and Young Children (A.O.No.2005-0014) USES OF SURVEY RESULTS

 Sustainable Development Goal (SDG) For planning, targeting and implementing  Philippine Development Plan (PDP) nutrition and related intervention  Philippine Plan of Action (PPAN) programs, goals and commitment  The Food Fortification Program Salient Features of NNS and ENNS Features National Nutrition Survey Expanded National Nutrition Survey Survey Design One shot (one year) every 5 Rolling Survey (three years) years Updating Survey One shot every 2.5 years within No need to conduct the 5 Years NNS Sampling Design 2003 Master Sample 2013 New Master Sample Coverage 17 Regions 17 Regions 80 Provinces 117 Domains (81 Provinces, 33 Highly Urbanized Cities, 3 Other Areas) Salient Features of NNS and ENNS

Features National Nutrition Survey Expanded National Nutrition Survey Number of Replicates 4 16 Number of 40,000 – 50,000 180,000 Sample Households Households Sample Households 1,536 average number of sample households per province/HUC 60,000 Sample Households Every Year Level of National National estimates every year Disaggregation Regional Provincial/domain level estimates 2019 Expanded National Nutrition Survey

METHODOLOGY PSA Board Resolution No. 06, Series of 2018 Approving and Adopting the Survey Design of the Expanded National Nutrition Survey What is the Survey Design of the ENNS?

40 Provinces & ROLLING HUCs for 2018 40 Provinces & for HUCs for 2019 SURVEY 37 Provinces & 3YEARS HUCs for 2020 Target households (HHs) per domain is average of 1,536 HHs How did we select the provinces and HUCs to be included in the ENNS?

Grouping of provinces and HUCs with similar characteristics

Formation of Test variables (2010 CPH) Replicates Number of persons ReplicatedReplicated Number of birth registered Sampling Number of OFWs Sampling A replicate has at Number of WRA least 5 provinces or Number of infants Number of children below 5 HUCs Number of disabled members Design Validation

FOOD AND NUTRITION RESEARCH INSTITUTE Department of Science and Technology Provinces and HUCs covered in the 2019 ENNS

NCR CAR City of Malabon Benguet City of Marikina Kalinga City of Parañaque CALABARZON (IV-A) Pateros Quezon Province Region I Rizal Ilocos Norte MIMAROPA (IV-B) Pangasinan Palawan Region II Puerto Princesa City Quirino Marinduque Region III Region V Nueva Ecija Camarines Sur Angeles City Pampanga Provinces and HUCs covered in the 2019 ENNS

Region VI Guimaras Antique Region VII Lapu-Lapu City Cebu Region VIII Southern Leyte Biliran Provinces and HUCs covered in the 2019 ENNS Region IX Zamboanga City Region XII Zamboanga del Sur South Cotabato Zamboanga Sibugay CARAGA

Region X Agusan del Norte Bukidnon Surigao del Sur Lanao del Norte Dinagat Islands Misamis Occidental ARMM Misamis Oriental Basilan

Region XI Lanao del Sur Davao del Norte Davao Oriental Sampling Design of the 2019 ENNS 2013 Master Sample (PSA)

Sampling domains: 2-Stage Cluster Sampling Design 81 provinces st 33 HUCs 1 Stage - PSUs 3 other areas PSU size ranges from (Pateros, Isabela City, Cotabato City) 100 to 400 z households 16 sample replicates are drawn from each domain 2nd stage

Households from 16 replicates (1,536) Households Individuals

Response Response Eligible Response Eligible Response Rate% Rate%

Philippines 52,463 49,042 93.5 209,527 165,586 79.0

Dinagat 761 752 98.8 3,043 2,750 90.4 Islands Sociodemographic and Socioeconomic Profiles of Households and Its Individual Members in Socioeconomic Status

• refers to the social standing or class of an individual or group. It is often measured as a combination of education, income and occupation.

Adapted from APA’s Socioeconomic Status Office publications Operational Definition Wealth Index • a composite measure of a household's cumulative living standard. The wealth index is calculated by principal component analysis using data on household’s ownership of selected assets, materials used for housing construction and types of water access and sanitation facilities.

Operational Definitions

Household

• an aggregate of persons, generally but not necessarily bound by ties of kinship, who sleep in the same housing unit and have a common arrangement for the preparation and consumption of food. Profile of Households Household Size Sex 5 members and below 68.9%

More than 5 members 48.7 % 51.3 % 31.1% Male Age groups

3.8% 10.8% 42.1% 72-120 months 20-59 years

10.8% 19.5% 12.9% 24-71 months >10-19 years 60 years and over Women of Reproductive Age

Lactating Non-Pregnant Pregnant Women/ Mothers Women Non-Lactating Mothers 2.2 % 8.4% 89.4%

Adults 2.1% 9.9% 88.0%

Teenage 2.2% 1.7% 96.1 % Ethnicity

0.1 % Indigenous People

Operational Definitions

Household head • adult person, male or female, who is responsible for the organization and care of the household Profile of Household Heads Sex

Male Female 80.2% 19.8 % Profile of Household Heads Highest Educational Attainment 60 54.6

40 32.7 30

20 10.5 10 1.9 0.3 0 No education Elementary level Secondary level* College level** Others

* including Post-Secondary Non-Tertiary and Short- Cycle Tertiary Education or Equivalent ** including Master and Doctoral Level Education or Equivalent Profile of Household Heads

70 63.4 60 Civil Status 50

20 14.6 13.6 10 5.1 3.5 0 0 0 Single Married Widowed Divorced Separated Annulled Common-Law/ Live-in Operational Definition

Occupation • refers to the type of work a person does to earn his living with work/business only in the past 6 months. Profile of Household Heads Occupation

Farmers, Forestry Workers and Fishermen 43.1 Elementary Occupation: Laborers and Unskilled Workers 16.1 Craft and Related Trades Workers 13.9 Plant and Machine Operators and Assemblers 9.7 Service Workers and Shop and Market Sales Workers 6.1 Officials of Government and Special Interest Organizations, Corporate… 4.2 Professional 3.5 Technicians and Associate Professionals 1.8 Clerks 1.4 Special Occupations (AFP personnel) 0.2 Not Classified 0.2 0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0 50.0 Food Security Status of Households in Dinagat Islands Food Security

exists when all people at all times have physical and economic access to sufficient, safe, and nutritious food that meets their dietary needs and food preferences for an active and healthy life (World Food Summit, 1996) Food Insecurity

the state in which people are at risk or actually suffering from inadequate consumption to meet nutritional requirements as a result of the physical unavailability of food, their lack of social or economic access to adequate food, and/or inadequate food utilization (Global Forum on Food Security, FAO) METHODOLOGY

Questionnaire  Household Food Insecurity Access Scale (HFIAS)

 nine-item questionnaire  based on the respondent’s perception over food situations, resources or supply  self-reported experience in the past month Household Food Insecurity Access Scale (HFIAS) 30-day recall period

Frequency Situation(s) experienced in the past month Never Rarely Sometimes Often 1-2x 3-10x >10x 1. Worry about food 2. Unable to eat preferred foods 3. Eat just a few kinds of foods 4. Eat foods they really do not want to eat 5. Eat smaller meal 6. Eat fewer meals in a day 7. No food of any kind in the household 8. Go to sleep hungry 9. Go a whole day and night without eating Mildly Food Moderately Food Severely Food Legend: Food Secure Insecure Insecure Insecure Percentage of households by food security status: Philippines and Dinagat Islands, 2019 Philippines Dinagat Islands 80 73.0 64.1 * 60 40 35.9 27.0*

20 Percentage (%) Percentage 0 Food Secure Food Insecure 90% LL 31.6 23.2 59.5 68.8 CI UL 40.5 31.2 68.4 76.8

* significantly different at 10% level of significance Distribution of households by food security status: Philippines and Dinagat Islands, 2019 Philippines Dinagat Islands 50 38.9 40 35.9 * 33.3 30 27.0 24.6* 17.2 20 13.6 9.5

10 Percentage (%) 0 Food Secure Mildly Food Insecure Moderately Food Insecure Severely Food Insecure

90% LL 31.6 23.2 16.7 20.7 30.5 34.0 11.5 6.8 CI UL 40.5 31.2 17.7 29.1 36.2 44.0 16.0 13.0 * significantly different at 10% level of significance Percentage of households by food insecurity items: Dinagat Islands, 2019 Percentage of food insecure households = 73.0%

Worried about food 70.0 Unable to eat preferred food 69.2 Ate just a few kinds of food 61.2 Ate food they really do not want to eat 53.2 Ate a smaller meal 41.9 Ate a fewer meals in a day 10.6 Experienced going to sleep hungry 5.8 Had no food of any kind in the household 5.4 Experienced going a whole day and night… 1.7 0 20 40 60 80 Percentage (%) Percentage of food insecure households by wealth status, and sex of household head in : Dinagat Islands, 2019

Wealth Status * Household Head

89.1% 66.6% 74.3% 66.6% Poor Non-Poor Male Female

90% LL 81.7 61.3 90% LL 69.5 51.7 CI UL 93.8 71.5 CI UL 78.6 78.8

* significantly different at 10% level of significance Percentage of food insecure households by household size : Dinagat Islands, 2019

Household Size

71.4% 76.2% 1-5 members More than 5 members

90% LL 65.8 70.4 CI UL 76.5 81.2 Food Insecurity Experience Scale (FIES)

Experience-based food insecurity scale that rely on self-reported information regarding food related behaviors in the face of limited access to food.

The items on the scale are based on well-grounded empirical research regarding the experience of hunger and poor food access, and are intended to be answered according to respondents’ own perspectives regarding the adequacy of their food consumption.

Reflects chronic food insecurity with 12-month recall period Prevalence of chronic food insecurity* based on FIES: Philippines and Dinagat Islands, 2019

Philippines Dinagat Islands 60 50 48.0 39.1 40 30 20

10 5.1 4.8 Prevalence (%) Prevalence 0 Moderately Food Insecure Severely Food Insecure

*Moderately and severely food insecure households for the past 12 months Summary

Seven out of 10 (73.0%) households in Dinagat Islands experienced acute food insecurity.

Food insecurity was evident in households with poor wealth status. Summary

Five out of 10 (52.8%) households in Dinagat Islands experienced chronic food insecurity. Nutritional Status of Filipino Preschool Children in Dinagat Islands Magnitude and Severity Cut-off points (WHO, 1995) Cut-off points used in determining magnitude and severity of underweight, stunted, and wasted among children under 5 years old

50 >40% >30% VERY HIGH 40 VERY HIGH 30-39% HIGH 30 >15% 20-29% 20-29% CRITICAL HIGH MEDIUM 20 10-19% Prevalence (%) Prevalence MEDIUM 10-14% SERIOUS 10 <10% <20% 5-9% POOR LOW LOW <5% ACCEPTABLE 0 Underweight Stunting Wasting Prevalence of malnutrition among children under five (0-59 months) in the Philippines and Dinagat Islands: ENNS, 2019

50 Philippines Dinagat Islands 40

28.8 30 25.5 22.2 19.0

20 Prevalence Prevalence (%) 10 5.8 3.6 2.9 1.5 0 Underweight Stunting Wasting Overweight-for-Height

90% LL 18.0 18.1 26.3 20.9 5.0 2.1 2.3 0.4 CI UL 20.0 26.9 31.4 30.7 6.6 6.3 3.8 5.0 Prevalence of underweight among children under five (0-59 months) by sex and wealth status: Dinagat Islands ENNS, 2019

Underweight = 22.2% SEX WEALTH STATUS * Boy Girl Poor Non-Poor

24.5% 19.9% 34.6% 16.4%

90% LL 19.3 14.2 90% LL 25.5 12.5 CI UL 30.6 27.2 CI UL 44.9 21.2

* significantly different at 10% level of significance Prevalence of stunting among children under five (0-59 months) by sex and wealth status: Dinagat Islands ENNS, 2019 Stunting = 25.5% SEX WEALTH STATUS * Boy Girl Poor Non-Poor

29.2% 21.7% 37.9% 19.6%

90% LL 24.6 15.4 90% LL 31.6 13.7 CI UL 34.3 29.7 CI UL 44.6 27.2

* significantly different at 10% level of significance Prevalence of wasting among children under five (0-59 months) by sex and wealth status: Dinagat Islands ENNS, 2019 Wasting = 3.6%

SEX WEALTH STATUS Boy Girl Poor Non-Poor

4.9% 2.3% 5.8% 2.6%

90% LL 2.9 0.9 90% LL 2.2 1.3 CI UL 8.4 6.0 CI UL 14.4 5.1 Prevalence of overweight-for-height among children under five (0-59 months) by sex and wealth status: Dinagat Islands ENNS, 2019 Overweight-for-Height = 1.5%

SEX WEALTH STATUS Boy Girl Poor Non-Poor

1.2% 1.8% 0.0% 2.2%

90% LL 0.2 0.3 90% LL 0.0 0.6 CI UL 6.6 9.6 CI UL 0.0 7.0 in preschool children Prevalence of anemia among preschool children 6 months to 5 years old (6-71 months) in the Philippines and Dinagat Islands: ENNS, 2019

20 12.5

10 7.6 Prevalence (%) Prevalence 0 90% CI PhilippinesPhilippines DinagatDinagat IslandsIslands Lower Limit 11.4 3.3 Upper Limit 13.7 16.6 Significance Mild Mild Iodine Status and Vitamin A Deficiency • Urinary iodine excretion and the determination of iodine status is not covered among preschool children.

• Serum retinol and the determination of Vitamin A deficiency (VAD) is in-progress. Infant and Young Child Feeding Practices Breastfeeding Practices Proportion of infants and young children (0 - 23 months old), by breastfeeding practices in the Philippines and Dinagat Islands: ENNS, 2019

100 Philippines 83.9 Dinagat Islands 80 74.0 57.9 58.9 60 54.1 53.8

40 34.2

Percentage Percentage (%) 18.6 20

0 Timely breastfeeding Exclusive breastfeeding Continued breastfeeding Continued breastfeeding initiation at 1 year at 2 years

90% LL 69.8 72.1 52.5 34.2 48.7 29.6 30.8 7.5 CI UL 77.8 91.3 63.2 79.8 59.4 76.3 37.7 39.0 Percentage distribution of exclusively breastfed infants (0-5.9 months) by single age in months: Philippines, 2019

100 Philippines: 57.9% 77.6 80 70.1 63.7 56.2 60 51.1

40 35.1 Percentage (%) Percentage 20

0 0 1 2 3 4 5 Age in Months Complementary Feeding Practices MINIMUM DIETARY DIVERSITY

Proportion of children 6-23 months of age Minimum Dietary who receive foods from 4 or more food Diversity: groups (DDS > 4) of the following 7 food groups:

1. Grains, roots and tubers 3. Legumes and Nuts 6. Vitamin A rich fruits & vegetables

5. Eggs 7. Other fruits & vegetables 2. Dairy Products 4. Flesh Meat Minimum Meal Frequency

Proportion of breastfed and non-breastfed Minimum children 6-23 months who received solid, Meal semi-solid, or soft foods consumed at the Frequency: minimum number of times per day

Defined as: 2x for breastfed infants 6-8 months old 3x for breastfed children 9-23 months old 4x for non-breastfed children 6-23 months old Minimum Acceptable Diet

Proportion of children 6-23 months Minimum meeting both the minimum dietary diversity Acceptable and the minimum meal frequency to Diet: ensure both dietary and nutrient adequacy. Proportion of infants and young children (6 - 23 months old),by complementary feeding practices in the Philippines and Dinagat Islands: ENNS, 2019

100 92.2 98.0 84.4 Philippines 80 76.6 Dinagat Islands

40 20.1 20 15.0 Percentage Percentage (%) 9.9 6.1 0 Timely Introduction to Minimum Dietary Minimum Meal Minimum Acceptable Complementary Foods Diversity Frequency Diet at 6-8 months

90% LL 79.2 48.9 18.4 8.8 90.2 89.1 8.9 2.4 CI UL 88.5 91.8 22.0 24.2 93.8 99.7 11.0 14.7 Summary

About two out of 10 (25.5%) under-five children was stunted.

Two out of 10 (22.2%) under-five children was underweight.

Stunting and Underweight were “medium” and “high” public health problems in the province. Summary

Underweight and stunting prevalence were significantly higher among poor than non-poor households.

Wasting/thinness (3.6%) was assessed as acceptable based on the WHO cut-offs. Summary

One out of 100 (7.6%) children was anemic, and considered a “mild” public health problem. Eight out of ten (83.9%) infants were initiated to breastfeeding within one hour after birth. Six out of ten (58.9%) infants were exclusively breastfed during the first 6 months of life.

A low proportion of young children 6-23 months old met the minimum dietary diversity (15.0%) and acceptable diet (6.1%). Nutritional Status of Filipino School- Age Children in Dinagat Islands Prevalence of malnutrition among school-age children (5 to 10 years old) in the Philippines and Dinagat Islands: ENNS 2019

Philippines Dinagat Islands 27.2 30 26.0 25.2 23.5 20 8.0 9.5 9.1 10 4.5

Prevalence (%) Prevalence 0 Underweight Stunting Wasting Overweight & Obesity*

90% CI Philippines Dinagat Philippines Dinagat Islands Philippines Dinagat Philippines Dinagat Islands Islands Islands Lower Limit 23.7 22.2 21.9 17.4 7.3 5.8 7.2 3.4 Upper Limit 28.3 32.9 28.7 30.9 8.8 15.3 11.5 6.1

* significantly different at 10% level of significance Prevalence of underweight among school-age children (5 to 10 years old) by sex and wealth status in Dinagat Islands: ENNS, 2019

Underweight = 27.2%

SEX WEALTH STATUS

Boys Girls Poor Non-Poor

28.6% 25.7% 34.3% 24.6% 90% LL 22.7 19.8 90% LL 23.5 19.2 CI CI UL 35.5 32.6 UL 46.9 30.8 Prevalence of stunting among school-age children (5 to 10 years old) by sex and wealth status in Dinagat Islands: ENNS, 2019

Stunting = 23.5%

SEX WEALTH STATUS Boys Girls Poor Non-Poor

23.5% 23.6% 30.5% 20.9% 90% LL 15.9 18.6 90% LL 17.9 15.9 CI CI UL 33.2 29.3 UL 46.9 27.0 Prevalence of wasting among school-age children (5 to 10 years old) by sex and wealth status in Dinagat Islands: ENNS, 2019

Wasting = 9.5%

SEX WEALTH STATUS

Boys Girls Poor Non-Poor

11.5% 7.4% 11.5% 8.8% 90% LL 7.0 3.8 90% LL 5.6 5.4 CI CI UL 18.4 13.9 UL 22.2 14.1 Prevalence of overweight and obesity among school-age children (5 to 10 years old) by sex and wealth status in Dinagat Islands: ENNS, 2019

Overweight and obesity = 4.5% SEX WEALTH STATUS * Boys Girls Poor Non-Poor

4.1% 5.0% 0.6% 6.0% 90% LL 2.2 3.1 90% LL 0.1 4.3 CI CI UL 7.5 8.0 UL 3.5 8.3

* significantly different at 10% level of significance in school-age children Prevalence of anemia among school-age children (6 to 12 years old) in the Philippines and Dinagat Islands: ENNS, 2019

20 10.7

10 7.6 Prevalence (%) Prevalence 0 90% CI Philippines Dinagat Islands Lower Limit 8.7 4.4 Upper Limit 13.1 12.7 Significance Mild Mild Iodine Status and Vitamin A Deficiency • Urinary iodine excretion and the determination of iodine status is in-progress among school-age children.

• Serum retinol and the determination of Vitamin A deficiency (VAD) is in-progress. Summary

3 out of 10 school-age children are underweight (27.2%) while 1 out of 10 was wasted (9.5%) 2 out of 10 school- age children in Dinagat Islands are stunted (23.5%)

5 out of 100 school-age children are overweight/obese (4.5%) Summary

There are more underweight, stunted and wasted school- age children in poor households.

Overweight/obese school- age children are mostly in non-poor households (6.0%)

8 out of 100 school-age children are anemic (7.6%) Nutritional Status of Filipino Adolescents Dinagat Islands Prevalence of Stunting, Wasting, and Overweight and Obesity among Adolescents, >10 to 19 years old in the Philippines and Dinagat Islands: ENNS 2019

Philippines 28.1 30 26.8 20 15.9 11.7 9.8 10 6.1 0 Stunting Wasting Overweight &

Prevalence (%) Prevalence Obesity 90% CI Philippines Dinagat Philippines Dinagat Philippines Dinagat Islands Islands Islands Lower 23.8 22.4 10.6 11.8 8.0 4.2 Limit Upper 30.1 34.6 12.9 21.1 12.0 8.7 Limit Prevalence of stunting among adolescents, >10 to 19 years old by sex and wealth status in Dinagat Islands: ENNS, 2019 Stunting = 28.1%

SEX WEALTH STATUS

Males Females Poor Non-Poor

29.0% 27.1% 32.4% 26.6% 90% LL 21.9 20.6 90 LL 23.6 20.0 CI % U 37.3 34.8 CI UL 42.5 34.3 L Prevalence of wasting among adolescents, >10 to 19 years old by sex and wealth status in Dinagat Islands: ENNS, 2019 Wasting = 15.9% SEX WEALTH STATUS Males Females Poor Non-Poor

19.0% 12.6% 19.1% 14.8% 90% LL 12.7 9.0 90% LL 10.2 11.2 CI CI UL 27.3 17.4 UL 33.0 19.2 Prevalence of overweight and obesity among adolescents, >10 to 19 years old by sex and wealth status in Dinagat Islands: ENNS, 2019 Overweight and obesity = 6.1% SEX WEALTH STATUS * Males Females Poor Non-Poor

4.7% 7.6% 6.6% 5.9% 90% LL 2.8 4.4 90% LL 2.7 3.8 CI CI U 7.8 12.8 UL 15.2 9.0 L

* significantly different at 10% level of significance Prevalence of anemia among adolescents, 13 to 19 years old in the Philippines and Dinagat Islands: ENNS, 2019 40

20 10.2 10 5.8

Prevalence(%) 0 90% CI Philippines Dinagat Islands Lower Limit 5.5 7.2 Upper Limit 6.1 14.2 Significance Mild Mild Prevalence of anemia among adolescents, 13 to 19 years old by sex in Dinagat Islands: ENNS, 2019 40

30 20 14.7 10.2 10 5.4

0 Prevalence Prevalence (%) 90% CI All Male Female Lower Limit 7.2 2.8 9.5 Upper Limit 14.2 10.2 22.1 Significance Mild Mild Mild OPERATIONA L SMOKING DEFINITION

CURRENT SMOKERS

– those who smoked during the survey either on a “daily” basis (at least one cigarette a day) or on a regular/occasional basis (WHO, 2008)

• Occasional smokers are those who do not smoke daily but who smoke at least weekly and

• those who smoke less often than weekly Proportion of current smokers among adolescents, 10 to 19 years old in the Philippines and Dinagat Islands: ENNS, 2019 10 8 6 4 3.4 2.1

2 Proportion Proportion (%) 0 Philippines Dinagat Islands 90% LL 2.9 1.2 CI UL 3.8 3.6 Proportion of current smokers adolescents, 10 to 19 years old by sex and wealth status in Dinagat Islands: ENNS, 2019 Current smokers = 2.1%

SEX * WEALTH STATUS Males Females Poor Non-Poor

3.8% 0.4% 0.6% 2.7% 90% LL 2.2 0.1 90% LL 0.1 1.6 CI CI UL 6.5 2.1 UL 3.3 4.5

* significantly different at 10% level of significance OPERATIONA L CURRENT DRINKING DEFINITION

– those who consumed one or more drinks of any type of alcohol in the year preceding the survey (WHO, 2015) Proportion of current drinkers among adolescents, 10 to 19 years old in the Philippines and Dinagat Islands: ENNS, 2019 25

20 15 13.2 12.0 10

5 Proportion (%) Proportion 0 Philippines Dinagat Islands

90% LL 11.8 10.3 CI UL 14.9 14.0 Proportion of current drinkers among adolescents, 10 to 19 years old by sex and wealth status in Dinagat Islands: ENNS, 2019 Current drinkers = 12.0%

SEX WEALTH STATUS

Females Males Poor Non-Poor

14.4% 9.5% 9.7% 12.9% 90% LL 11.7 6.7 90% LL 6.8 11.0 CI CI UL 17.6 13.2 UL 13.6 15.0 OPERATIONA L BINGE DRINKING DEFINITION

– Refers to excessive consumption of alcoholic beverages, specifically the intake of four or more (for females) or five or more (for males) standard drinks in a row (WHO, 2008) by those who reported drinking alcoholic beverages in the past 30 days Proportion of binge drinkers among currently drinking adolescents, 10 to 19 years old in the Philippines and Dinagat Islands: ENNS, 2019

60 50 42.6 41.0 40 30 20 10

Proportion (%) Proportion 0 Philippines Dinagat Islands 90% LL 37.9 25.3 CI UL 47.4 58.8 OPERATIONAL DEFINITION PHYSICAL ACTIVITY

Insufficiently Physically Active

- Doing less than 60 minutes of moderate- to vigorous-intensity physical activity per day

Reference: World Health Organization (2015) Global Reference List of 100 Care Health Indicators. Geneva 27, Switzerland Proportion of insufficiently physically active adolescents, 10 to 19 years old in the Philippines and Dinagat Islands: ENNS, 2019

100 79.8 80 72.7

Proportion (%) Proportion 20

0 Philippines Dinagat Islands

90% LL 76.6 65.9 CI UL 82.5 78.7 Proportion of insufficiently physically active adolescents 10 to 19 years old by sex and wealth status in Dinagat Islands: ENNS, 2019 Insufficiently physically active = 72.7%

SEX WEALTH STATUS

Males Females Poor Non-Poor

70.1% 75.5% 76.3% 71.4% 90% LL 61.9 67.2 90% LL 65.5 64.3 CI CI UL 77.2 82.3 UL 84.5 77.6 Summary

3 out of 10 adolescents in Dinagat Islands (28.1%) are stunted while 2 out 10 are There are more stunted and wasted (15.9%) wasted adolescents among males and in poor households

6 out of 100 Overweight/obese adolescents adolescents are are mostly in poor households overweight/obese (6.6%) (6.1%) Summary

1 out of 10 adolescents was anemic (10.2%), mostly females (14.7%)

Current smokers are mostly males (3.8%) and in non-poor households (2.7%) Summary

1 out of 10 adolescents was a current drinker (12.0%), mostly males (14.4%)

Majority (72.7%) of adolescents are insufficiently physically active; mostly females (75.5%)

Four out of 10 (41.0%) currently drinking adolescents are engaged in binge drinking. Nutrition Situation of Women of Reproductive Age in Dinagat Islands

Prevalence of chronic energy deficiency (CED), overweight/obesity among non- pregnant/non-lactating women of reproductive age, 15-49 years old: Philippines and Dinagat Islands, 2019

Philippines Dinagat Islands 50 40 35.2 32.1 30 20 10 8.0 8.0

Prevalence Prevalence (%) 0 CED Overweight/ Obese 90% LL 7.4 6.0 34.0 26.9 CI UL 8.7 10.7 36.3 37.8 Dinagat Islands (Non-Pregnant/Non-Lactating Women)

3 out of 10 (32.1%) Overweight/Obese 1 out of 10 (8.0%) Chronic Energy Deficient (CED) Prevalence of anemia among non- pregnant/non-lactating women of reproductive age, 15-49 years old: Philippines and Dinagat Islands, 2019

25 19.1 20 * 15 9.8 10 5

0 Prevalence Prevalence (%) Philippines Dinagat Islands LL 8.9 15.4 90% UL 10.7 23.5 CI Significance Mild Mild * significantly different at 10% level of significance

Proportion of nutritionally-at-risk pregnant women: Philippines and Dinagat Islands, 2018

30 25.8 25 22.9 20 15 10 5 0 Percentage (%) Philippines Dinagat Islands

90% LL 20.1 8.7 CI UL 25.9 55.8 Dinagat Islands (Pregnant Women)

3 out of 10 (25.8%) nutritionally-at-risk pregnant women

Prevalence of chronic energy deficiency (CED), overweight/obesity among lactating mothers, 15-49 years old: Philippines and Dinagat Islands, 2019

Philippines Dinagat Islands 50 35.6 40 31.1 30 20 10.4 10 6.5

Prevalence Prevalence (%) 0 CED Overweight/ Obese 90% LL 9.3 2.6 29.1 26.7 CI UL 11.7 15.2 33.1 45.6 Dinagat Islands (Lactating Mothers)

4 out of 10 (35.6%) 1 out of 10 (6.5%) Overweight/Obese Chronic Energy Deficient (CED) Prevalence of anemia among lactating mothers, 15-49 years old: Philippines and Dinagat Islands, 2019

30 25.2 25 * 20 15 11.6 10 5

0 Prevalence Prevalence (%) Philippines Dinagat Islands LL 9.6 14.0 90% UL 13.9 41.1 CI Significance Mild Moderate * significantly different at 10% level of significance Summary

Among non-pregnant/non-lactating women in Dinagat Islands, CED (6.5%) was of ‘low’ public health significance and overnutrition (32.1%) was a more common problem.

Three in every 10 (25.8%) pregnant women were nutritionally-at-risk in Dinagat Islands. Summary

Among lactating mothers in Dinagat Islands, CED (6.5%) was of ‘low’ public health significance and overnutrition (35.6%) was also a more common problem.

Anemia was of ‘mild’ public health significance among non-pregnant/non-lactating women (19.1%); while it was of ‘moderate’ public health concern among lactating mothers (25.2%) in Dinagat Islands. Health and Nutritional Status of Filipino Adults Dinagat Islands World Health Assembly May 2013 adopted the following set of Global NCD Targets Trends in the Prevalence of Chronic Energy Deficiency and Overweight and Obesity among Adults, 20 years old and above: Philippines, 1993-2019 50

40 37.2 36.0 31.1 31.1 26.6 28.4 30 24.0 20.2

20 16.6 Prevalence (%) Prevalence 10 13.9 13.2 12.3 11.6 10.3 10.0 10.0 8.0 8.8 0

Based on the WHO Body Mass Index (BMI) cut-off points Cut-off points used in determining magnitude and severity of underweight (BMI <18.5) among adults 19.0 years old and over (≥228 months), as public health problem (WHO, 1995)

Magnitude and Prevalence Group Severity for Underweight Low 5-9% Medium 10-19% High 20-39% Very High >40% Prevalence of Overweight and Obesity among Adults, 20 years old and above: Philippines, 2013-2019 50 Overweight Obesity 40

28.1 27.5 30 24.3 24.2 24.3

20 9.1 8.5 Prevalence (%) Prevalence 10 6.8 6.9 6.8

0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Prevalence of Chronic Energy Deficiency, Overweight and Obesity among Adults, 20-59 years old: Philippines and Dinagat Islands, 2019

Chronic Energy Overweight Obesity Deficiency Dinagat Dinagat Philippines Philippines Dinagat Philippines Islands Islands Islands

7.4% 6.6% 28.6% 29.9% 9.0% 6.8%

90% LL 6.8 5.2 90% LL 27.4 26.7 90% LL 8.2 5.5 CI UL 8.0 8.3 CI UL 29.8 33.4 CI UL 10.0 8.3 Chronic Energy Deficiency among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 Chronic Energy Deficient = 6.6% Sex Wealth Status

Male Female Poor Non-Poor

5.9% 7.2% 8.9% 5.8%

90% LL 4.3 5.3 90% LL 6.5 4.4 CI UL 8.0 9.7 CI UL 12.0 7.6 Overweight among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 Overweight = 29.9% Sex Wealth Status

Male Female Poor Non-Poor

27.0% 32.7% 24.2% 32.0%

90% LL 22.8 28.7 90% LL 19.7 27.8 CI UL 31.6 37.1 CI UL 29.3 36.4 Obesity among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 Obesity = 6.8% Sex * Wealth Status Male Female Poor Non-Poor

4.9% 8.5% 3.9% 7.7%

90% LL 3.7 6.8 90% LL 2.1 6.3 CI UL 6.4 10.7 CI UL 7.2 9.5 * significantly different at 10% level of significance Prevalence of High Waist Circumference (WC) among Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

High Waist Circumference

100

20 13.4 12.0 Prevalence (%) Prevalence

0 Philippines Dinagat Islands ° High WC is ≥102 cm (>40 inches) for males 90% LL 12.4 9.3 or ≥88 cm (>34 inches) for females CI UL 14.5 15.4 High Waist Circumference among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 High Waist Circumference = 12.0% Sex * Wealth Status Male Female Poor Non-Poor

2.3% 21.2% 8.2% 13.3%

90% LL 1.4 16.5 90% LL 5.0 10.6 CI UL 3.8 26.9 CI UL 13.2 16.6

* significantly different at 10% level of significance Prevalence of High Waist-Hip Ratio (WHR) among Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

High Waist-Hip Ratio

100

40 35.2 32.8

20 Prevalence (%) Prevalence

0 Philippines Dinagat Islands ° High WHR is ≥1.00 for males 90% LL 33.9 30.6 or ≥0.85 for females CI UL 36.6 35.0 High Waist-Hip Ratio among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 High Waist-Hip Ratio = 32.8% Sex * Wealth Status * Male Female Poor Non-Poor

5.1% 58.9% 26.4% 35.0%

90% LL 3.7 54.7 90% LL 21.6 33.2 CI UL 7.0 62.9 CI UL 31.8 36.9 * significantly different at 10% level of significance Prevalence of Anemia among Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

15 9.9 10 7.2

5 Prevalence (%) Prevalence 0 Philippines Dinagat Islands LL 6.3 7.8 90% CI UL 8.2 12.5 Significance Mild Mild Prevalence of Anemia among Adults, 20-59 years old, by sex: Dinagat Islands, 2019

Sex * Male Female

4.1% 15.4%

90% LL 2.4 11.8 CI UL 7.0 19.9 ° excluding pregnant or lactating women

* significantly different at 10% level of significance Trend in the Prevalence of Elevated Blood Pressure° among Adults, 20 years old and above: Philippines, 1993-2019

30 25.3 23.9 25 22.0 22.5 22.3 21.0 19.2 20 17.5

Prevalence Prevalence (%) 10 ° Based on a single-visit blood pressure measurement, systolic blood 5 pressure of 140 mmHg or higher and/or a diastolic pressure of 90 mmHg or higher (JNC VII, 2004) 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Prevalence of Elevated Blood Pressure° among Adults, 20 years old and above: Philippines, 2013-2019

30 23.9 25 22.3 19.2 20 17.5 16.7

Prevalence Prevalence (%) 10

0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Prevalence of Elevated Blood Pressure among Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

15 13.9 9.6 10

5 Prevalence (%) Prevalence

0 Philippines Dinagat Islands * LL 13.1 8.0 90% CI UL 14.7 11.3

* significantly different at 10% level of significance Elevated Blood Pressure among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 Elevated Blood Pressure = 9.6% Sex * Wealth Status Male Female Poor Non-Poor

12.0% 7.6% 6.9% 10.6%

90% LL 9.8 5.6 90% LL 4.9 8.3 CI UL 14.2 9.7 CI UL 8.9 12.9

* significantly different at 10% level of significance Trend in the Prevalence of High Fasting Blood Sugar among Adults, 20 years old and above: Philippines, 2003-2019 10 9.1 High FBS: ≥126 mg/dL 8.2 8 Impaired blood sugar: 110-125 mg/dL 8.2 5.6 7.9 6 4.8

4 3.4

4.3 Prevalence (%) Prevalence 2 2.7

0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 Prevalence of High Fasting Blood Sugar among Adults, 20 years old and above: Philippines, 2013-2019

10 7.9 8.2 8 5.6 6

4 5.6 Prevalence(%) 2

0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Prevalence of High Fasting Blood Sugar among Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

10 7.1 5.6

5 Prevalence (%) Prevalence

0 Philippines Dinagat Islands LL 6.1 4.1 90% CI UL 8.1 7.5 High Fasting Blood Sugar among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 High Fasting Blood Sugar = 5.6% Sex Wealth Status

Male Female Poor Non-Poor

6.2% 5.1% 4.8% 5.9%

90% LL 3.9 2.7 90% LL 2.9 4.2 CI UL 9.7 9.5 CI UL 7.7 8.3 Trend in the smoking status of adults, 20 years old and over: Philippines, 1998-2019 100 Never Smokers Current Smokers Former Smokers

80 63.7 64.7 66.7 59.2 60 54.5 55.0 54.3

34.8 40 32.7 31.0 Proportion (%) 25.4 23.3 20.7 19.9 20

15.5 12.8 10.2 14.7 13.0 14.6 13.5 0 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Sin Tax Executive Law Order 26

Graphic Heath Warnings Law Current Smoking° among Adults, 20 years old and above: Philippines, 1998-2019

40 34.8 Current 32.7 31.0 Smoking 30 25.4 23.3 20.7 19.9 B 17.8 20 A S E Proportion (%) Proportion 10 L I N E 0

° Are those who either smoke on a “daily” basis (at least one cigarette a day) or on a regular/occasional basis (at least weekly or less often than weekly) Proportion of current users of various tobacco and nicotine products among adults currently smoking, 20 years old and over: Philippines, 2013-2019

2013 2015 2018 2019 94.6 95.9 100 90.6 89.5

40 Proportion (%) Proportion 20 10.1 5.0 3.4 4.1 1.0 0.7 0.7 1.2 0.3 0.1 0.1 0.2 0.1 0.2 0.8 0.3 0 Manufactured Hand-rolled Pipes Full of Tobacco Cigars, cheroots, Electronic cigarette Cigarettes Cigarettes cigarillos Proportion of current tobacco users° among adults, 20 years old and over: Philippines, 2013-2019

30 26.4 24.9 22.3 21.7 18.5

20 Proportion (%) Proportion

0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

° Daily and less than daily current tobacco smokers and/or smokeless tobacco users Proportion of Current Smokers among Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

30 25 20.5 20 16.7 15

10 Proportion (%) Proportion 5 0 Philippines Dinagat Islands * LL 19.6 14.5 90% CI UL 21.5 19.2

* significantly different at 10% level of significance ° Are those who either smoke on a “daily” basis (at least one cigarette a day) or on a regular/occasional basis (at least weekly or less often than weekly) - WHO STEPS Surveillance Manual, 2008 Current smoking among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 Current Smoking = 16.7% Sex * Wealth Status * Male Female Poor Non-Poor

35.1% 1.1% 25.3% 13.6%

90% LL 30.7 0.6 90% LL 19.7 11.0 CI UL 39.8 2.0 CI UL 31.8 16.8 * significantly different at 10% level of significance Proportion of Current Smokeless Tobacco Users among Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

10 2.4 0.1

Proportion (%) Proportion 0 Philippines Dinagat Islands * LL 1.6 0.0 90% CI UL 3.6 0.5 * significantly different at 10% level of significance ° Are those who currently use smokeless tobacco products whether on a daily basis or occasionally - Global Tobacco Surveillance System, 2009 Smokeless tobacco product (tobacco and other products are not smoked but consumed by other means --- snuff by keeping in mouth or nose, chewing tobacco, use of betel nut, quid) Alcohol Consumption Status CURRENT Those who consumed 1 or more drinks of any DRINKERS type of alcohol in the year preceding the survey

FORMER Those who did not consume 1 or more drinks DRINKERS during the year preceding the survey

LIFETIME Those who never consumed 1 or more drinks ABSTAINERS of any type of alcohol in their entire lifetime

World Health Organization. (2015). Indicator and Measurement Registry version 1.7. Alcohol consumers, past 12 months World Health Organization. (2015). Global Health Observatory (GHO) Data. Abstainers, past 12 months. BINGE DRINKING or the harmful use of alcohol means excessive drinking of alcoholic beverages in a single occasion, specifically:

drinking 5 or more standard drinks in a row for men or drinking of 4 or more standard drinks in a row for women

among those who reported drinking alcoholic beverages in the past 30 days.

National Institute of Alcohol Abuse and Alcoholism. (2004). NIAAA council approves definition of binge drinking. Trends in the Proportion of Current Drinking and Binge Drinking among currently drinking adults, 20 years old and over: Philippines, 2013-2019 Current Drinking Binge Drinking 80 69.8 69.1 among currently drinking 68.7 66.7 70 63.0 60.8 58.5 58.6 60 56.2 54.9 54.7 52.2 48.2 50 44.9 46.7 42.7 41.1 38.2 40 28.7 29.5 30.4 28.9 30 24.3 24.7

Proportion (%) Proportion 20

0 All Male Female All Male Female 2013 2015 2018 2019 Proportion of Binge Drinking among currently drinking adults, 20 years old and over: Philippines, 2013-2019

60 56.2 54.9 54.7 52.2 50.6 50

30 Proportion (%) 20

0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Proportion of Binge Drinkers among currently drinking Adults, 20-59 years old, in the past 30 days: Philippines and Dinagat Islands, 2019

60 52.9 44.2 40

Proportion (%) Proportion 20

0 Philippines Dinagat Islands LL 49.5 35.9 90% CI UL 56.3 52.7 Binge Drinkers among currently drinking Adults, 20-59 years old, in the past 30 days by sex, and wealth status: Dinagat Islands, 2019

Binge Drinkers = 44.2% Sex * Wealth Status Male Female Poor Non-Poor

50.3 21.9% 54.0% 40.3%

90% LL 41.2 13.9 90% LL 39.4 30.6 CI UL 59.4 32.8 CI UL 67.9 50.8 * significantly different at 10% level of significance Proportion of insufficiently physically active° adults, 20 years old and over: Philippines, 2013-2019

70 60 50 45.5 42.5 42.2 38.8 41.0 40 30

20 Proportion (%) Proportion 10 0 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

° A person not meeting any of the following criteria: . 75 mins of vigorous-intensity physical activity per week (≥ 3 days of vigorous-intensity activity of at least 20 mins per day) OR . 150 mins of moderate-intensity physical activity per week (≥ 5 days of moderate-intensity activity or walking of at least 30 mins per day) OR . an equivalent combination of moderate- and vigorous-intensity physical activity achieving at least 600 MET-minutes per week - World Health Organization (2010). Global recommendations on physical activity for health. Proportion of insufficiently physically active Adults, 20 to 59 years old: Philippines and Dinagat Islands, 2019

60 50 40 37.1 30 21.9 20

Proportion (%) Proportion 10 0 Philippines Dinagat Islands * LL 34.2 18.3 90% CI UL 40.1 25.9 * significantly different at 10% level of significance ° A person not meeting any of the following criteria: . 75 mins of vigorous-intensity physical activity per week (≥ 3 days of vigorous-intensity activity of at least 20 mins per day) OR . 150 mins of moderate-intensity physical activity per week (≥ 5 days of moderate-intensity activity or walking of at least 30 mins per day) OR . an equivalent combination of moderate- and vigorous-intensity physical activity achieving at least 600 MET-minutes per week - World Health Organization (2010). Global recommendations on physical activity for health. Physical Inactivity among Adults, 20-59 years old, by sex, and wealth status: Dinagat Islands, 2019 Physical Inactivity = 21.9% Sex * Wealth Status Male Female Poor Non-Poor

14.7% 28.0% 19.3% 22.8%

90% LL 11.8 22.4 90% LL 14.2 18.8 CI UL 18.3 34.3 CI UL 25.8 27.3 * significantly different at 10% level of significance Summary  Undernutrition and overnutrition were remarkably seen in the province.  CED prevalence (6.6%) was of “low” public health significance.  Android type of obesity (high WC and WHR) was higher among females and those living in non-poor households.

 Anemia was of “mild” public health significance.  One in every ten adults had elevated blood pressure and significantly higher among males than females. Summary

 Prevalence of high fasting blood sugar was only 5.6%.

 Current smokers (16.7%) were higher among males and those adults from poor households.  Four out of ten currently drinking adults were binge drinkers.

 Two in every ten adults were insufficiently physically active and more common among female adults. Health and Nutritional Status of Filipino Elderly Dinagat Islands Prevalence of Chronic Energy Deficiency, Overweight, and Obesity among Elderly, 60 years & over: Philippines and Dinagat Islands, 2019 Chronic Energy Overweight Obesity Deficiency Dinagat Dinagat Dinagat Philippines Philippines Philippines Islands Islands Islands

15.2% 10.9% 22.7% 21.8% 5.8% 7.1%

90% LL 13.8 8.2 90% LL 21.1 18.4 90% LL 4.8 4.8 CI UL 16.7 14.3 CI UL 24.4 25.7 CI UL 7.1 10.4 * significantly different at 10% level of significance Chronic Energy Deficiency among Elderly, 60 years old and above by sex and wealth status: Dinagat Islands, 2019 Chronic Energy Deficiency = 10.9

SEX WEALTH STATUS Male Female Poor Non-Poor

11.0% 10.8% 11.7% 10.5%

90% LL 7.4 7.8 90% LL 7.1 7.8 CI UL 15.9 14.8 CI UL 18.8 14.0

* significantly different at 10% level of significance Prevalence of Overweight among Elderly, 60 years old and above, by sex and wealth status: Dinagat Islands, 2019 Overweight= 21.8%

SEX WEALTH STATUS Male Female Poor Non-Poor

19.0% 24.3% 17.5% 23.7%

90% LL 15.1 18.9 90% LL 12.4 19.0 CI UL 23.6 30.5 CI UL 24.1 29.2

* significantly different at 10% level of significance Prevalence of Obesity among Elderly, 60 years old and above, by sex and wealth status: Dinagat Islands, 2019 Obese= 7.1%

SEX WEALTH STATUS Male Female Poor Non-Poor

3.9% 9.8% 4.8% 8.1%

90% LL 1.8 6.3 90% LL 2.1 5.1 CI UL 8.3 14.9 CI UL 10.4 12.6 Prevalence of High Waist Circumference and High Waist-Hip Ratio among Elderly, 60 years old and above: Philippines and Dinagat Islands, 2019 Philippines Dinagat Islands

60 50 44.8 38.5 40 30 20 16.7 14.0

10 Prevalence Prevalence (%) 0 High Waist Circumference High Waist-Hip Ratio *

90% LL 14.7 10.7 42.8 34.9 CI UL 18.8 18.2 46.8 42.3 Prevalence of High Waist Circumference among Elderly, 60 years old and above, by sex and wealth status : Dinagat Islands, 2019 High Waist Circumference= 14.0%

SEX * WEALTH STATUS Male Female Poor Non-Poor

1.7% 24.6% 13.9% 14.1%

90% LL 0.7 19.4 90% LL 9.4 10.2 CI UL 4.6 30.7 CI UL 20.1 19.1

* significantly different at 10% level of significance Prevalence of High Waist-Hip Ratio among Elderly, 60 years old and above, by sex and wealth status : Dinagat Islands, 2019

High Waist-Hip Ratio= 38.5%

SEX * WEALTH STATUS * Male Female Poor Non-Poor

8.3% 64.6% 36.9% 39.3%

90% LL 5.4 58.6 90% LL 28.7 35.2 CI UL 12.7 70.2 CI UL 45.8 43.5

* significantly different at 10% level of significance Prevalence of Anemia among Elderly, 60 years old and above: Philippines and Dinagat Islands, 2019

40 29.8 30

20 16.9

10 Proportion (%) Proportion

0 Philippines Dinagat Islands LL 14.6 24.0 90% CI UL 19.6 36.3 Significance Mild Moderate Prevalence of Anemia among Elderly, 60 years old and above, by sex: Dinagat Islands, 2019 Anemia=29.8% SEX Male Female

36.4% 24.4%

90% LL 29.0 17.8 CI UL 44.6 32.3 Significance Moderate Moderate Prevalence of Elevated Blood Pressure and High Fasting Blood Sugar among Elderly, 60 years old and above: Philippines and Dinagat Islands, 2019 50 Philippines Dinagat Islands 40 34.4 30 24.9 20 13.7 8.9 10

Prevalence Prevalence (%) 0 Elevated Blood Pressure High Fasting Blood Sugar 90% LL 32.8 19.1 11.8 5.7 CI UL 36.0 30.7 15.9 13.7 Prevalence of Elevated blood pressure among Elderly, 60 years old and above, by sex and wealth status : Dinagat Islands, 2019 Elevated blood pressure= 24.9%

SEX WEALTH STATUS Male Female Poor Non-Poor

23.4% 26.2% 27.3% 23.8%

90% LL 15.7 19.4 90% LL 19.1 17.7 CI UL 31.1 32.9 CI UL 35.4 29.8 Proportion of High fasting blood sugar among Elderly, 60 years old and above, by sex and wealth status : Dinagat Islands, 2019 High fasting blood sugar = 8.9%

SEX WEALTH STATUS Male Female Poor Non-Poor

11.0% 7.2% 10.8% 8.0%

90% LL 6.6 3.4 90% LL 5.3 4.7 CI UL 17.9 14.8 CI UL 20.9 13.3 Proportion of Current Smokers and Current Smokeless Tobacco Users among Elderly, 60 years old and above: Philippines and Dinagat Islands, 2019

50 Philippines Dinagat Islands

20 16.7

Proportion (%) 10 4.4 3.4 1.1 0 Current Smokers* Current Smokeless Tobacco Users 90% LL 15.3 2.9 2.6 0.4 CI UL 18.2 6.8 4.4 3.1 * significantly different at 10% level of significance Proportion of Current Alcohol Drinkers, Binge Drinkers among current drinkers and Physically Inactive Elderly, 60 years old and above: Philippines and Dinagat Islands, 2019 Philippines Dinagat Islands 70 60 50 46.3 46.7 40 32.4 26.5 26.4 30 20.2

20 Proportion (%) 10 0 Current Alcohol Drinkers* Binge Drinking among current * Physically Inactive * drinkers 90% LL 24.4 17.8 42.2 15.9 43.0 27.3 CI UL 28.7 22.9 50.5 40.5 50.5 37.9 Summary  CED and Overweight was lower while Obesity was higher compared to the national estimates.

 Android obesity (high WC and high WHR) was significantly higher among females.

 Anemia was of “moderate” public health significance.  Two out of ten elderly had elevated blood pressure while one out of ten elderly had high fasting blood glucose.  Current smokers were at 4.4%, current alcohol drinkers were 20.2% while binge drinking among current alcohol drinkers were at 26.4%.  Three out of 10 (32.4%) of the elderly were physically inactive. Department of Science and Technology - Food and Nutrition Research Institute

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