Isabela Province

Zen Hotel, Santiago City, Isabela November 07, 2019 2018 Expanded National Nutrition Survey

METHODOLOGY Old Survey Design of the NNS Features Description Survey Design One shot (one year) every 5 years Coverage 17 regions, 81 provinces National, Regional, Level of Disaggregation Provincial for some indicators Target Number of Households 60,000 Households and all members of the sampled Target Population households Duration of Data Collection 6.5 Months (one shot) for the reference year Why did we change the design of the NNS?

. Provide Province and HUC Level estimates for local planning of specific and sensitive interventions of our stakeholders

. Provide reliable National Level Estimates annually Why did we change the design of the NNS?

. Adoption of the new Master Sample of the PSA to provide reliable estimations at the Province and HUC Levels Sampling Design of the 2018 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 households z 16 sample replicates are drawn from each domain 2nd stage

Households from 16 replicates (1,536)

Icons used were retrieved from http://www.flaticon.com PSA Board Resolution No. 06 Approving and Adopting the Survey Design of the Expanded National Nutrition Survey What is the Survey Design of the 2018 NNS?

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

Grouping of provinces and HUCs with similar characteristics into replicates

A replicate has at least 5 Test variables provinces and HUCs Number of persons Number of birth registered Number of OFWs 2010 Census of Number of WRA Population and Housing Number of infants Number of children below 5

Number of disabled members Replicated Replicated Sampling Formation of replicates Provinces and HUCs covered in the 2018 ENNS

Cagayan Province Capiz Maguindanao Isabela City

Isabela Province Eastern Samar Butuan City Davao City Nueva Vizcaya Tacloban City Quezon City Davao Occidental

Laguna Mandaue City City of Manila Sultan Kudarat Sorsogon Siquijor City of Caloocan Baguio City Aklan Western Samar City of San Juan Mountain Province

Olongapo City Northern Samar City of Las Piñas Abra

Zambales Iloilo Province City of Makati Oriental Mindoro

Bulacan Iloilo City City of Mandaluyong Cagayan De Oro City City of Taguig Camarines Norte Zamboanga Del Norte Camiguin Level Eligible Response Response Rate (%)

Household 52,285 45,957 87.9

Individuals 196,332 159,926 81.5 Households Individual Province Eligible Response Response Eligible Response Response Rate (%) Rate (%)

Isabela 1,494 1,394 93.3 5,649 4,925 87.2 Province 2018 Expanded National Nutrition Survey

Sociodemographic and Socioeconomic Profiles of Households and Its Individual Members 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 • The wealth index is 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. Wealth Index • The wealth index categorizes the households into 5 wealth quintiles, allowing us to assess how the common health and nutrition indicators differ between the poor and non-poor households. • For the provincial and HUCs estimates, wealth status is classified as poor for the bottom 30% of the income group and the non-poor for the upper 30%. Operational Definition Highest Educational Attainment* • refers to the highest grade/year of formal schooling completed by each member of the household and not the total years attended • Regrouped into: a) none - no grade completed b) elementary level - the stage of formal education concerned with providing the first six years of basic education. c) secondary level** - the stage of formal education following the elementary level concerned primarily with continuing basic education and expanding it to include the learning of employable gainful skills, usually corresponding to four years of high school d) college level*** - the stage of formal education following the secondary education, covering the programs on all courses of study leading to a bachelor degree. e) others - Alternative Learning System, SPED , Arabic Schooling

* Phil. Standard Classification of Education (PSCEd) ** including Post-Secondary Non-Tertiary and Short- Cycle Tertiary Education or Equivalent *** including Master and Doctoral Level Education or Equivalent 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.

• 2012 Philippine Standard Occupational Codes (PSOC) is a statistical classification of the different occupational groups of the working population, including the military work force in the country Sociodemographic Profile • Describes the population groups by: a) age - refers to the exact age of each household member as of his/her last birthday b) sex – categorized the household members of the households as males and females c) civil status – or marital status Operational Definitions Civil status - status of an individual in relation to marriage and classified as: a) single - a person who has never been married b) married - a person who has been united in matrimony with another person of opposite sex through a religious or civil rites. c) separated - a person whose partner has left permanently, with or without legal sanctions. d) widowed - a person who has been married before, whether formally or consensually but his/her partner has died and has not remarried at the time of visit. e) common law/live-in – those who live together consensually with another as husband or wife 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. Operational Definitions Household head • person who generally provides the chief source of income for the household unit • adult person, male or female, who is responsible for the organization and care of the household or who is regarded as such by the members of the household Profile of Households Household Size Sex of Household Members

Mean 4.4

5 members and below 74.9%

Male Female More than 5 25.1% members 48.7% 51.3% Population Groups

Age groups n (%) Women of Reproductive Age 0-23 months 172 4.1 n (%)

24-71 months 464 10.1 48 4.4

72-120 months 553 9.9 122 11.1 >10-19 years 954 18.2

20-59 years 2,310 48.4 975 84.5

60 years and over 472 9.3 Profile of Household Heads Sex Civil Status 100

80 74.0

60

40 Male Female 20 13.5 6.6 83.0% 17.0% 2.8 3.2 0 Single Separated Common Widowed Married Law/Live-in Farmers, Forestry workers, Fishermen 43.4 Laborers and unskilled workers 16.9 Plant and machine operators 12.9 Occupation Craft and related traders workers 9.5 Service Workers 8.2 Officials of the gov't, Corporate executives, managers, supervisors 2.4 Technicians and associate prof 2.0 Professionals 2.0 Clerks 1.2 Not classified elsewhere 1.0 Special Occupations 0.3

0 5 10 15 20 25 30 35 40 45 50

70.0 60.0 50.0 44.4 40.6 Educational 40.0 30.0 Attainment 20.0 13.3 10.0 1.6 0.1 0.0 No education Elementary level At Least At Least Others Secondary Level* College Level**

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

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

“limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways” (Institute of Nutrition, 1990) When recurrent leads to hunger and hunger when prolonged results to malnutrition 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) Percentage of households by food security status: Philippines, 2015 vs. 2018 Percentage of food insecure households : 66.1% vs. 53.9%

100 2015 2018

80

60 46.1 40 33.9 31.9 28.8 21.9

20 12.3 12.3 12.8 Percentage

0 Food Secure Mildly Food Insecure Moderately Food Severely Food Insecure * Insecure *

* Significantly different at 5% level of significance Percentage of households by food insecurity items: Philippines, 2018 Percentage of food insecure households = 53.9%

Worried about food 50.3 49.7 Yes No Unable to eat preferred food 47.5 52.5 Ate just a few kinds of food 43.2 56.8 Ate food they really do not want to eat 37.8 62.2 Ate a smaller meal 33.8 66.2 Ate a fewer meals in a day 19.1 80.9 Had no food of any kind in the household 7.7 92.3 Experienced going to sleep hungry 7.3 92.7 Experienced going a whole day and night without eating 3.3 96.7

0 20 40 60 80 100 % Percentage of households by food security status by wealth status, household size and sex of household head: Philippines, 2018

Food Secure Food Insecure 100 90 82.0 84.1 80 70 62.1 60 53.9 55.7 49.6 50.4 51.8 48.2 50 46.1 44.3 37.9 40 30

Percentage 18.0 20 15.9 10 0 PHILIPPINES Wealth Quintile (Bottom Wealth Quintile (Upper 1-5 members More than 5 members Male Female 20%) 80%) Wealth Status Household Size Sex of Household Head Food Security Status Isabela, 2018 Percentage of households by food security status: Isabela, 2018

100 Philippines 100 Isabela

80 80

60 60 46.1 % 40 % 28.8 40

20 12.3 12.8 20

0 0 Food Secure Mildly Food Moderately Food Severely Food Food Secure Mildly Food Moderately Food Severely Food Insecure Insecure Insecure Insecure Insecure Insecure

90% Confidence Interval 90% Confidence Interval LL 44.1 11.7 27.1 11.2 LL 47.6 8.8 22.4 11.6 UL 48.0 12.9 30.5 14.4 UL 54.6 12.4 27.5 15.3 * p<0.10 Percentage of households by food insecurity items: Isabela, 2018 Percentage of food insecure households = 48.9%

Worried about food 42.8 57.2 Yes No Unable to eat preferred food 43.7 56.3 Ate just a few kinds of food 39.4 Ate food they really do not want to eat 33.6 66.4 Ate a smaller meal 30.7 69.3 Ate a fewer meals in a day 16.7 83.3 Had no food of any kind in the household 7.7 Experienced going to sleep hungry 7.7 Experienced going a whole day and night without eating 3.0 97.0

0 20 40 60 80 100 % Percentage of households by food security status by wealth status, household size and sex of household head: Isabela, 2018

Food Secure Food Insecure 100 90 80 72.6 70 61.2 60 52.3 51.7 51.1 48.9 47.7 48.3 51.1 48.9 49.5 50.5 50 38.8 40

30 27.4 Percentage 20 10 0 Isabela Poor* Non-poor 1-5 members More than 5 members Male Female

Wealth Status Household Size Sex of Household Head

* p<0.10 Nutritional Status of Filipino Preschool-Age Children in Isabela Province

Prevalence of malnutrition among children under five (0-59 months) in the Philippines and Isabela Province: ENNS, 2018 Philippines Isabela Province

50 50

40 40 30.3 28.8 30 30 23.2

19.1 (%) Prevalence 20 20

Prevalence (%) Prevalence 7.6 10 5.6 4.0 10 3.1 0 0 Underweight Stunting Wasting Overweight-for-Height Underweight Stunting Wasting Overweight-for-Height 90% CI Underweight Stunting Wasting Overweight- 90% Underweight Stunting Wasting Overweight- for-Height CI for-Height Lower 17.7 28.2 5.2 3.6 Lower 19.6 24.7 5.3 2.2 Limit Limit Upper 20.5 32.4 6.1 4.3 Upper 26.9 32.9 9.8 4.0 Limit Limit Prevalence of malnutrition among children under five (0-59 months) by sex and wealth status: Isabela Province ENNS, 2018

60 Underweight 60 Stunting

50 50

40 40 38.4 32.7 30 28.8 29.3 28.6 23.2 24.5 30 22.2 22.6 18.1

20 20

Prevalence (%) Prevalence Prevalence (%) Prevalence 10 10

0 0 All Male Female Poor Non-Poor * All Male Female Poor * Non-Poor

* significantly different at 10% level of significance Prevalence of malnutrition among children under five (0-59 months) by sex and wealth status: Isabela Province ENNS, 2018

20 Wasting 20 Overweight-for-Height

10 10

7.6 7.5 7.9 8.0 8.0 Prevalence (%) Prevalence Prevalence (%) Prevalence 3.9 4.4 3.1 2.2 1.0 0 0 All Male Female Poor Non-Poor All Male Female Poor * Non-Poor

* significantly different at 10% level of significance in preschool-age children Prevalence of anemia among preschool-age children 6 mos to 5 years old (6-71 months) in Isabela Province: ENNS, 2018

30

20 18.6 18.6 19.1

14.3 Prevalence (%) Prevalence 10

0 Philippines Isabela Province Male Female 90% CI Philippines Isabela Province Male Female Lower 12.8 13.3 7.9 11.0 Limit Upper 15.9 23.9 29.4 27.2 Limit PREVALENCE OF IDD AND VAD

• Urinary iodine excretion and the determination of IDD is not covered among preschool-age 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 0-23 months old, by breastfeeding practices

100 Philippines 100 Isabela Province

80 80 69.2 72.0 61.6 57.6 54.9 60 60 50.6 38.8

40 33.1 40

Proportions (%) Proportions Proportions (%) Proportions 20 20

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

90% CI 90% CI

Lower Limit 65.2 51.2 45.4 29.3 Lower Limit 54.8 42.5 56.9 23.0 Upper Limit 73.1 58.5 55.9 37.0 Upper Limit 68.5 72.8 87.0 54.5 * significantly different at 10% level of significance 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 meeting Minimum both the minimum dietary diversity and the Acceptable minimum meal frequency to ensure both Diet: dietary and nutrient adequacy. Proportion of children 6-23 months, by complementary feeding practices 100 Philippines 100 Isabela Province 89.0 89.2

80 80

60 60

40

40 (%) Proportions Proportions (%) Proportions 23.0 22.9 20 14.8 20 13.4

0 0 Minimum Dietary Minimum Meal Minimum Acceptable Minimum Dietary Minimum Meal Minimum Acceptable Diversity Frequency Diet Diversity Frequency Diet

90% CI 90% CI Lower Limit 21.1 87.6 12.4 Lower Limit 16.5 83.4 8.6 Upper Limit 24.9 90.4 14.4 Upper Limit 29.3 95.0 21.0 Summary • Underweight and stunting were both of “medium” to “high” public health problem • Anemia was a “mild to moderate” public health problem • Isabela Province had lower number of mothers engaged in timely breastfeeding initiation, while higher number practicing exclusive breastfeeding and continued breastfeeding than national estimate. • Complementary feeding is inadequate in energy and nutrient as indicated by low percentage of children meeting the minimum dietary diversity (MDD) and minimum acceptable diet (MAD). Nutritional Status of Filipino School-Age Children Prevalence of malnutrition among school-age children (5 to 10 years old) in the Philippines and Isabela Province: ENNS 2018

Philippines Isabela Province

40 40

30 24.9 24.6 30 21.2 21.4 20 20

11.6 9.7 Prevalence (%) Prevalence 10 7.6 (%) Prevalence 10 7.4

0 0 Underweight Stunting Wasting Overweight & Obese Underweight Stunting Wasting Overweight & Obese 90% Underweight Stunting Wasting Overweight & 90% CI Underweight Stunting Wasting Overweight & CI Obese Obese Lower 23.1 22.8 7.2 10.4 Lower 18.9 18.7 6.0 7.3 Limit Limit Upper 26.8 26.5 7.9 12.9 Upper 23.5 24.1 8.7 12.2 Limit Limit Prevalence of malnutrition among school-age children (5 to 10 years old) by sex and wealth status: Isabela Province ENNS, 2018

60 Underweight 60 Stunting

50 50

40 40 32.3 34.1 30 30 23.6 21.2 21.4 23.0 18.6 19.9 20 15.5 20

Prevalence (%) Prevalence 15.0 Prevalence (%) Prevalence 10 10

0 0 All Male Female Poor * Non-Poor All Male Female Poor * Non-Poor

* significantly different at 10% level of significance Prevalence of malnutrition among school-age children (5 to 10 years old) by sex and wealth status: Isabela Province ENNS, 2018

30 Wasting 30 Overweight & Obese

20 20

13.0 9.7 10.7

10 8.2 10 8.7 Prevalence (%) Prevalence Prevalence (%) Prevalence 7.4 7.2 7.4 6.9 4.3

0 0 All Male Female Poor Non-Poor All Male Female Poor * Non-Poor

* significantly different at 10% level of significance in school-age children Prevalence of anemia among school-age children (6 to 12 years old) in Isabela Province: ENNS, 2018

40

30

20 17.2 16.3 15.4

Prevalence (%) Prevalence 13.5

10

0 Philippines Isabela Province Male Female 90% CI Philippines Isabela Province Male Female Lower 11.8 12.0 12.4 10.9 Limit Upper 15.2 20.6 22.1 19.9 Limit Iodine Status among School-age children in Isabela Province Median UIEº and Percent UIE below 50μg/L among school-age children (6 to 12 years old) in Isabela Province: ENNS, 2018

300 40

250 221 30 200 180

150 20 Median

100 11.5 Percentage (%) Percentage 9.0 10 7.6 6.6 50

0 0 Philippines Isabela Province * Philippines Isabela Province * Male Female 90% CI Philippines Isabela Province 90% Philippines Isabela Male Female CI Province

Lower 177.6 201.5 Lower 10.3 5.5 5.2 3.6 Limit Limit Upper 183.2 240.3 Upper 12.7 9.6 12.8 9.6 Limit Limit ⁰Iodine Intake * significantly different at 10% level of significance <100 μg/L – Insufficient 100-199 μg/L – Adequate 200-299 μg/L – More than Adequate 300 μg/L and up - Excessive Summary • Underweight, stunting, wasting and overweight & obesity prevalence is lower compared to the national results among school-age children but underweight and stunting remains of medium public health concern. • Anemia prevalence is a public health problem with mild to moderate severity. • Iodine intake of school-age children is more than adequate based on median UIE. Nutritional Status of Filipino Adolescents Isabela Province Nutritional Status of Adolescents, >10 to 19 years old: Philippines and Isabela Province, 2018 50 PHILIPPINESPHILIPPINES 50 ISABELA PROVINCE

40 40

30 26.3 30

20 20 17.7

13.1 Prevalence (%) Prevalence 11.3 11.6 (%) Prevalence 9.9 10 10

0 0 Stunting Wasting Overweight and Stunting* Wasting Overweight and Obese Obese

90% LL 24.7 10.5 10.7 90% LL 15.0 7.8 10.8 CI CI UL 28.0 12.1 12.5 UL 20.5 12.0 15.5

* significantly different at 10% level of significance Prevalence of Stunting among Adolescents, >10 to 19 years old by sex and wealth status: Isabela Province, 2018

50

40

30.4 30

20 17.7 17.6 17.9

Prevalence (%) Prevalence 12.0 10

0 All Male Female Poor* Non Poor

* significantly different at 10% level of significance Prevalence of Wasting among Adolescents, >10 to 19 years old by sex and wealth status: Isabela Province, 2018

20

15

11.5 9.9 10.2 10 9.2

8.2 Prevalence (%) Prevalence 5

0 All Male Female Poor Non Poor Prevalence of Overweight and Obese among Adolescents, >10 to 19 years old by sex and wealth status: Isabela Province, 2018

20

16.1

15 13.5 13.1 12.8

10

Prevalence (%) Prevalence 5.7 5

0 All Male Female Poor* Non Poor

* significantly different at 10% level of significance 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: Philippines and Isabela Province, 2018

100

76.3 80 71.1

60

40 Prevalence (%) Prevalence 20

0

Philippines Isabela Province*

90% LL 74.8 69.5 CI UL 77.7 72.7

* significantly different at 10% level of significance Proportion of insufficiently physically active adolescents >10 to 19 years old by sex and wealth status: Isabela Province, 2018

100

80 77.5 71.1 70.4 71.1 64.7

60

40 Prevalence (%) Prevalence

20

0 All Male* Female Poor Non Poor

* significantly different at 10% level of significance Smoking Status of Filipino Adolescents OPERATIONAL DEFINITION SMOKING

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

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

• those who smoke less often than weekly

Reference: World Health Organization Proportion of current smokers among adolescents, >10 to 19 years old: Philippines and Isabela Province, 2018

10

8

6

4.0 4.0

4 Prevalence (%) Prevalence

2

0 Philippines Isabela Province

90% LL 3.7 3.0 CI UL 4.4 5.0 Proportion of current smokers among adolescents, >10 to 19 years old by sex and wealth status: Isabela Province, 2018

10

8 7.6

5.9 6

4.0

4 3.3 Prevalence (%) Prevalence

2 0.4 0 All Male* Female Poor Non Poor

* significantly different at 10% level of significance Drinking Status of Filipino Adolescents OPERATIONAL DEFINITION DRINKING

CURRENT DRINKERS

– those who consumed one or more drinks of any type of alcohol in the year preceding the survey

Reference: World Health Organization Proportion of current drinkers among adolescents, >10 to 19 years old: Philippines and Isabela Province, 2018

50

40

30

18.8

20 16.8 Prevalence (%) Prevalence

10

0 Philippines Isabela Province

90% LL 15.2 16.2 CI UL 18.4 21.3 Prevalence of anemia among adolescents, >13 to 19 years old: Philippines and Isabela Province, 2018 10 8.9 8.1 8

6

4 Prevalence (%) Prevalence 2

0 Philippines Isabela Province LL 7.4 5.3 90% UL 8.8 12.5 CI Significance Mild Mild Prevalence of anemia among adolescents, >13 to 19 years old by sex: Isabela Province, 2018 50

40

30

20

Prevalence (%) Prevalence 12.5

10 8.9 4.7

0 All Male Female Summary • Prevalence of stunting is significantly lower than the national estimate; stunting is more prevalent in poor than non-poor households • Overweight and obese adolescents are more prevalent in non-poor than in poor households • Majority of adolescents were insufficiently physically inactive; prevalence among females is significantly higher than in males • Adolescent current smokers are significantly higher in males than in females • Proportion of adolescent current drinkers in Isabela is higher than the national estimate though not statistically significant • Anemia prevalence is of mild public health concern Nutrition Situation of Women of Reproductive Age Isabela Province

Prevalence of chronic energy deficiency (CED), overweight and obesity among non- pregnant/non-lactating women of reproductive age, 15-49 years old, 2018 PHILIPPINES ISABELA PROVINCE

CED Overweight and Obese CED Overweight and Obese 50 50 40 35.3 40 32.7 30 30 20 20

10 7.8 10 7.6

Prevalence (%) Prevalence Prevalence (%) Prevalence 0 0

90% CI CED Overweight and Obese 90% CI CED Overweight and Obese Lower Limit 7.3 33.7 Lower Limit 6.2 30.3 Upper Limit 8.3 36.9 Upper Limit 9.0 35.2

Proportion of nutritionally-at-risk pregnant women: Philippines and Isabela Province, 2018 50 40 25.0 30 20.1 20 10

0 Proportion (%) Proportion Philippines Isabela Province

90% CI LL 17.5 12.6 UL 22.8 37.5

Prevalence of chronic energy deficiency (CED), overweight and obesity among lactating mothers, 2018 PHILIPPINES ISABELA PROVINCE

CED Overweight and Obese CED Overweight and Obese 50 50 40 40 28.5 30 30 24.6 17.0 20 11.0 20

10 10

Prevalence (%) Prevalence (%) Prevalence 0 0

90% CI CED Overweight and Obese 90% CI CED Overweight and Obese Lower Limit 9.5 26.1 Lower Limit 10.5 18.4 Upper Limit 12.5 30.9 Upper Limit 23.5 30.7

Prevalence of anemia among lactating mothers and non- pregnant/non-lactating women of reproductive age, 15-49 years old: Philippines and Isabela Province, 2018

Non- Preg/Lact Lactating 50 40 30 20 11.6 14.4 15.7 12.6 10

Prevalence (%) Prevalence 0 Philippines Isabela Province

90% CI NPNL Lactating 90% CI NPNL* Lactating Lower Limit 11.0 12.5 Lower Limit 12.5 5.4 Upper Limit 12.3 16.3 Upper Limit 18.9 19.9

* significantly different at 10% level of significance ºMedian UIE and Percent UIE below 50ug/L among non- pregnant/non-lactating women of reproductive age, 15-49 years old: Philippines and Isabela Province, 2018

250 50 40 200 170 182 30 150 20

Median 11.3

100 10 5.9 Percentage (%) Percentage 50 0 Philippines Isabela Province Philippines Isabela Province*

90% LL 167.9 171.2 90% LL 10.7 4.1 CI CI UL 172.1 192.0 UL 12.0 7.7

ºIodine Intake based on median UIE * significantly different at 10% level of significance <100 ug/L – Insufficient 100-199 ug/L – Adequate 200-299 ug/L – More than Adequate 300 ug/L and up - Excessive ºMedian UIE and Percent UIE below 50ug/L among lactating mothers of reproductive age, 15-49 years old: Philippines and Isabela Province, 2018

250 50 200 40 30 21.2 20.2 150 117

103 20 Median

100 10 Percentage (%) Percentage 50 0 Philippines Isabela Province Philippines Isabela Province

90% LL 98.5 89.8 90% LL 19.7 11.4 CI CI UL 106.5 143.9 UL 22.8 29.0

ºIodine Intake based on median UIE <100 ug/L – Insufficient 100-199 ug/L – Adequate 200-299 ug/L – More than Adequate 300 ug/L and up - Excessive SUMMARY • 1 in every 3 non- pregnant/non-lactating women and 1 in every 4 lactating mothers are overweight/obese in Isabela Province.

• Non-pregnant/non-lactating women in Isabela Province have adequate iodine intake however pockets of the population group (5.9%) have UIE level below 50 ug/L.

• Lactating mothers in Isabela Province have adequate iodine intake however pockets of the population group (20.2%) have UIE level below 50 ug/L. Health and Nutritional Status of Filipino Adults Isabela Province Trends in the Prevalence of Chronic Energy Deficiency and Overweight and Obesity among Adults, 20 years old and above: Philippines, 1993-2018 50

40 37.2

31.1 31.1 28.4 30 26.6 24.0 20.2

20 16.6 Prevalence (%) Prevalence

10 13.9 13.2 12.3 11.6 10.0 10.0 10.3 8.0 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

Based on the WHO Body Mass Index (BMI) cut-off points Nutritional Status° of ADULTS, 20-59 years old: Philippines, 2015 and 2018

50 2015 2018 40

30 28.8 24.7

20 Prevalence (%) Prevalence 9.0 9.6 10 6.9 7.2

0 Chronic Energy Deficient Overweight * Obese *

* * significantly different at 5% level of significance

° Based on the WHO Body Mass Index (BMI) cut-off points Nutritional Status of Adults, 20 to 59 years old: Philippines and Isabela Province, 2018

50 PHILIPPINES 50 ISABELA PROVINCE

40 40 28.8 30 30 27.1

20 20

9.6 Prevalence (%) Prevalence Prevalence (%) Prevalence 10 6.9 10 6.8 7.4

0 0 Chronic Energy Overweight Obese Chronic Energy Overweight Obese * Deficient Deficient

90% LL 6.6 28.4 9.3 90% LL 5.8 25.5 6.2 CI UL 7.1 29.2 9.9 CI UL 7.8 28.7 8.5

* significantly different at 10% level of significance Chronic Energy Deficiency among Adults, 20-59 years old, by age group, sex, and wealth status: Isabela Province, 2018

20 20 25

20 15 15 11.8 15 10 10

Prevalence (%) Prevalence 10.2 7.4 10 6.8 6.8 6.2 4.6 5 4.0 5 5.5 5

0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male Female Poor * Non-Poor * significantly different at 10% level of significance Overweight among Adults, 20-59 years old, by age group, sex, and wealth status: Isabela Province, 2018

50 50 50

40 40 40 33.4 31.2 28.6 29.4 30 27.1 26.4 30 30 24.9

Prevalence (%) Prevalence 19.5 20 20 20 16.9

10 10 10

0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male Female Poor Non-Poor *

* significantly different at 10% level of significance Obesity among Adults, 20-59 years old, by age group, sex, and wealth status: Isabela Province, 2018

50 50 50

40 40 40

30 30 30 Prevalence (%) Prevalence 20 20 20

9.9 8.0 7.9 8.7 10 7.4 6.3 6.7 10 10 5.0 3.7

0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male Female * Poor Non-Poor * * significantly different at 10% level of significance Trends in the Prevalence of High Waist Circumference (WC)° among Adults, 20 years old and above: Philippines, 2003-2018

40

Male Female 30 23.1 23.5 19.9 19.0 18.5

20 17.0 Prevalence (%) Prevalence 10 3.8 3.9 2.4 3.1 3.2 3.0

0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

° High WC is ≥102 cm (>40in) for males or ≥88 cm (>34in) for females Trends in the Prevalence of High Waist-Hip Ratio (WHR)° among Adults, 20 years old and above: Philippines, 2003-2018 Male Female 80

65.5 62.5 63.2 63.7 57.9 60 54.8 *

40 Prevalence (%) Prevalence

20 12.1 11.1 6.9 8.0 7.1 8.3 * 0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

° High WHR is ≥1.00 for males or ≥0.85 for females Prevalence of High Waist Circumference and High Waist-Hip Ratio among Adults, 20 to 59 years old: Philippines and Isabela Province, 2018

100 PHILIPPINES 100 ISABELA PROVINCE

80 80

60 60

40 35.3 40 Prevalence (%) Prevalence Prevalence (%) Prevalence 30.5

20 13.5 20 9.0

0 0 High Waist Circumference High Waist-Hip Ratio High Waist Circumference High Waist-Hip Ratio * * 90% LL 13.2 34.9 90% LL 7.9 28.7 CI UL 13.8 35.7 CI UL 10.1 32.3

* significantly different at 10% level of significance High Waist Circumference among Adults, 20-59 years old, by age group, sex, and wealth status: Isabela Province, 2018

40 40 40

35 35 35

30 30 30

25 25 25

20 20 20

Prevalence (%) Prevalence 16.7 15 13.7 15 15 10.6 9.0 9.2 10 7.6 10 10 5.9 4.8 5 5 1.8 5 0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male Female * Poor Non-Poor * * significantly different at 10% level of significance Prevalence of Anemia among Adults°, 20-59 years old, by sex, place of residence, and wealth status: Philippines, 2018

15 15 12.7 2013 2018 11.2 10 9.3 10 9.0 8.3 7.6 6.0

5.2 Prevalence (%) Prevalence 5 (%) Prevalence 5

2013 2018 0 0 ALL Male Female Rural Urban

15

9.0 10 8.6 8.5 8.2 7.1

Prevalence (%) Prevalence 5

0 ° excluding pregnant or Poorest Poor Middle Rich Richest lactating women Prevalence of Anemia among Adults°, 20-59 years old: Philippines and Isabela Province, 2018

PHILIPPINES ISABELA PROVINCE 20 20

15.3 15 15 12.2

9.3

10 8.3 10

Prevalence (%) Prevalence Prevalence (%) Prevalence

5 5

0 0 Anemia Anemia * Male Female *

LL 7.7 LL 10.6 90% 90% * significantly different at 10% level of significance CI UL 9.0 CI UL 13.9

° excluding pregnant or lactating women Trend in the Prevalence of Elevated Blood Pressure° among Adults, 20 years old and above: Philippines, 1993-2018

30 25.3 23.9 25 22.0 22.5 22.3 21.0 19.2 20

15 Prevalence Prevalence (%)

10 ° Based on a single-visit blood pressure measurement,

5 systolic blood 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 Elevated Blood Pressure among ADULTS, 20-59 years old, by age group and sex: Philippines, 2015 vs 2018

50 50 2015 2018 2015 2018 40 36.3 40

30.0 28.3 30 30 25.3 20.8 22.2 20.2

Prevalence (%) Prevalence 20 16.9

20 16.7 (%) Prevalence 16.0 12.7 11.7 9.1 10 10 5.5 2015 2018 0 0 Male Female ALL * 20-29 y * 30-39 y * 40-49 y * 50-59 y * * * * significantly different at 5% level of significance Prevalence of Elevated Blood Pressure among Adults, 20 to 59 years old: Philippines and Isabela Province, 2018

20 16.0 15 14.0

10 Prevalence (%) Prevalence 5

0 Philippines Isabela Province * LL 15.6 13.1 90% CI UL 16.4 15.0

* significantly different at 10% level of significance Elevated Blood Pressure among Adults, 20-59 years old, by age group, sex, and wealth status: Isabela Province, 2018

40 40 40

35 35 35

30 30 30

25 23.7 25 25 20.2 20 20 18.2 20

Prevalence (%) Prevalence 15.9 15 14.0 15 15 9.6 10.1 10.3 10 10 10 5.6 5 5 5

0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male * Female Poor Non-poor * * significantly different at 10% level of significance Trend in the Prevalence of High Fasting Blood Sugar among Adults, 20 years old and above: Philippines, 2003-2018 10 High FBS: ≥126 mg/dL 8.2 8 Impaired blood sugar: 110-125 mg/dL 7.9 6 5.6 4.8

Prevalence (%) Prevalence 4 3.4 4.3

2 2.7

0 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 High Fasting Blood Sugar among ADULTS, 20-59 years old, by age group and sex: Philippines, 2013 vs 2018

20 20 2013 2018 2013 2018 15 15 12.9 10.6 10 8.6 10 6.7 6.3 6.8 6.6 Prevalence (%) Prevalence 4.7 4.7 5.1 Prevalence (%) Prevalence 4.3 5 3.2 5 1.0 1.6 2013 2018 0 0 ALL* 20-29 y 30-39 y 40-49 y 50-59 y Male * Female * * significantly different at 5% level of significance Prevalence of High Fasting Blood Sugar among Adults, 20 to 59 years old: Philippines and Isabela Province, 2018

20

15

10

6.7 6.4 Prevalence (%) Prevalence 5

0 Philippines Isabela Province

LL 6.2 4.7 90% CI UL 7.2 8.2 High Fasting Blood Sugar among Adults, 20-59 years old, by age group and sex: Isabela Province, 2018

30 30

25 25

20 20

15 15 Prevalence (%) Prevalence 11.6

10 7.5 10 8.0 6.4 5.2 5 2.9 3.3 5

0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male Female Smoking Status

Current Smokers 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)

World Health Organization. (2008). WHO STEPS Surveillance Manual. Current Smoking° among Adults, 20 years old and above: Philippines, 1998-2018

40 34.8 32.7 31.0 30 25.4 23.3 20.7

20 Proportion (%) Proportion 10

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) - World Health Organization. (2008). WHO STEPS Surveillance Manual. Current Smoking among ADULTS, 20-59 years old, by age group, sex, and place of residence: Philippines, 2015 vs 2018

60 2015 2018 60 2015 2018

50 50 44.5 41.3 40 40

30 30 25.0 24.0 23.9 22.5 23.4 23.6

21.5 22.0 20.3 20.9 Prevalence (%) Prevalence 20 (%) Prevalence 20

10 10 6.3 5.8 2015 2018 0 0 Male Female ALL * 20-29 y 30-39 y 40-49 y 50-59 y * * significantly different at 5% level of significance Proportion of Current Smokers among Adults, 20 to 59 years old: Philippines and Isabela Province, 2018

30

25 21.5 21.5 20

15 Proportion (%) Proportion 10

5

0 Philippines Isabela Province

LL 20.7 20.2 90% CI UL 22.4 22.8 Current Smoking among Adults, 20-59 years old, by age group, sex, and wealth status: Isabela Province, 2018

50 50 50

40.2 40 40 40

30 30 30 27.6 24.2 21.5 22.8 20.5 19.1

20 18.3 20 20 Proportion (%) Proportion

10 10 10 4.7

0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male * Female Poor * Non-Poor * significantly different at 10% level of significance Smokeless Smoking Status

Current Smokeless Tobacco Use are those persons who currently use at least one 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) World Health Organization. (2008). WHO STEPS Surveillance Manual. Proportion of Current Smokeless Tobacco Users among Adults, 20 to 59 years old: Philippines and Isabela Province, 2018

50

40

30

Proportion (%) Proportion 20

10 7.7 2.3 0 Philippines Isabela Province * LL 90% 2.0 5.9 CI UL 2.7 9.4

* significantly different at 10% level of significance 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 of ABSTAINERS 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 consumption of alcoholic beverages in a single occasion, specifically…

drinking 5 or more standard drinks in a row for men or drinking 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. Binge Drinking° among currently drinking ADULTS, 20-59 years old, in the past 30 days by age group and sex: Philippines, 2018

70 70 64.4 57.1 60 55.7 55.2 54.7 55.6 60

50 50

40 40 31.0

30 30 Proportion (%) Proportion 20 (%) Proportion 20 10 10 0 0 Male Female ALL 20-29 y 30-39 y 40-49 y 50-59 y * ° Drinking 5 or more standard drinks in a row for men * significantly different at 5% level of significance or 4 or more standard drinks in a row for women Proportion of Binge Drinkers among currently drinking Adults, 20-59 years old, in the past 30 days: Philippines and Isabela Province, 2018

80 62.3 60 55.7

40 Proportion (%) Proportion 20

0 Philippines Isabela Province * LL 53.3 59.0 90% CI UL 58.1 65.5

* significantly different at 10% level of significance Proportion of Binge Drinkers among currently drinking Adults, 20-59 years old, in the past 30 days by age group, sex, and wealth status: Isabela Province, 2018

80 80 80 69.5 70.0 70 70 70 66.7 62.3 62.2 58.8 60.7 60 57.3 60 60

50 50 50

40 40 40 Prevalence (%) Prevalence 30 30 30 19.5 20 20 20

10 10 10

0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male * Female Poor Non-Poor * significantly different at 10% level of significance INSUFFICIENT PHYSICAL ACTIVITY

A person not meeting any of the following criteria is considered being physically inactive or insufficiently physically active:

- 75 minutes (3 or more days) of vigorous-intensity physical activity (e.g. running) per week or - 150 minutes (5 or more days) of moderate-intensity physical activity per week (or walking of at least 30 minutes per day) or - an equivalent combination of moderate- and vigorous-intensity physical activity achieving at least 600 Metabolic Equivalents-minutes per week

- World Health Organization. (2010). Global recommendations on physical activity for health. Physical Inactivity° among ADULTS, 20-59 years old, by age group and sex: Philippines, 2015 vs 2018

70 2015 2018 70 2015 2018

60 60 51.6 50 45.0 45.7 50 46.6 40.7 40.6 40.2 40.3 38.9 40 37.3 37.0 37.8 40 32.9

30 30 28.0

Proportion (%) Proportion Proportion (%) Proportion 20 20

10 10 2015 2018 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male Female

° 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 Physically Inactive Adults, 20 to 59 years old: Philippines and Isabela Province, 2018

60

50 40.6 39.2 40

30 Proportion (%) Proportion 20

10

0 Philippines Isabela Province

LL 38.1 36.1 90% CI UL 43.1 42.3 Physical Inactivity° among Adults, 20-59 years old, by age group, sex, and wealth status: Isabela Province, 2018

80 80 80

70 70 70

60 60 60 49.7 50 47.5 50 50 42.8 39.2 40 36.8 36.0 40 40

Proportion (%) Proportion 35.3 29.7 30 30 27.6 30

20 20 20

10 10 10

0 0 0 ALL 20-29 y 30-39 y 40-49 y 50-59 y Male * Female Poor * Non-Poor * 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. Summary (Adults) Chronic energy deficiency was nearly similar with the Philippine estimate. Overweight was slightly lower than the national estimate while obesity, including android obesity (high WC and WHR) was significantly lower than the national estimate. Anemia was of “mild” public health significance. Raised blood pressure was significantly greater than the national estimate and was more prevalent among male adults and those living in non-poor households. Summary (Adults) High fasting blood sugar was almost the same with the national prevalence. Current smoking in Isabela Province was significantly greater among male adults and those belonging to the poor households. The proportion of current smokeless tobacco users (7.7%) was significantly higher than the national estimate. Binge drinking was significantly higher than the national proportion and was more common among male adults. More male adults and those living in non-poor households were physically inactive. Health and Nutritional Status of Filipino Elderly Isabela Province Nutritional Status of the Elderly, 60 years old and above: Philippines, 2018

50 2015 2018 40

30 24.7 21.3 20

Prevalence (%) Prevalence 17.2 13.4 10 4.8 6.3

0 Chronic Energy Deficient * Overweight * Obese * * significantly different at 5% level of significance Chronic Energy Deficiency among Elderly, 60 years old and above: Philippines and Isabela Province, 2018

30 22.6

20

13.4 Proportion (%) Proportion 10

0 Philippines Isabela Province * LL 90% 12.9 18.8 CI UL 14.0 26.5 * significantly different at 10% level of significance Prevalence of Overweight and Obesity among Elderly, 60 years old and above: Philippines and Isabela Province, 2018

50 PHILIPPINES 50 ISABELA PROVINCE

40 40

30 24.7 30

20 20 17.9 Prevalence (%) Prevalence Prevalence (%) Prevalence 10 6.3 10 3.8 0 0 Overweight Obese Overweight * Obese

90% LL 23.9 5.9 90% LL 14.4 1.4 CI UL 25.5 6.8 CI UL 21.4 6.2

* significantly different at 10% level of significance High Waist Circumference among Elderly MALES, 60 years old and above, by age group and place of residence: Philippines, 2015 vs 2018

10 10 2015 2018 2015 2018 8 8 7.5

6 6 4.8 5.0 4.9 4.7 3.5 4 Prevalence Prevalence (%) 4 3.3 2.9 2.7 2.7 2.1 2 2 0.9 2015 2018 0 0 ALL 60-69 y 70-79 y 80 y & over Rural Urban *

* significantly different at 5% level of significance High Waist Circumference among Elderly FEMALES, 60 years old and above, by age group, and place of residence: Philippines, 2015 vs 2018

40 2015 2018 40 2015 2018 34.5

30 27.9 30 28.2 25.8 24.2 23.8 22.2 21.6 20.0 20.6 20 20

15.8 16.1 Prevalence Prevalence (%)

10 10 2015 2018 0 0 ALL * 60-69 y 70-79 y 80 y & above Rural * Urban * * significantly different at 5% level of significance High Waist-Hip Ratio among Elderly MALES, 60 years old and above, by age group and place of residence: Philippines, 2015 vs 2018

30 30 2015 2018 2015 2018 25 25 21.9

20 20 16.6

15.9 16.4 16.0 Proportion (%) 15 12.8 13.5 15 11.9 11.4 9.5 9.4 10 8.7 10

5 5 2015 2018 0 0 ALL 60-69 y 70-79 y 80y & over Rural Urban High Waist-Hip Ratio among Elderly FEMALES, 60 years old and above, by age group and place of residence: Philippines, 2015 vs 2018

100 100 2015 2018 2015 2018 77.8 80 73.8 80 72.0 69.7 66.5 70.0 64.1 67.2 65.4 59.9 57.9

60 55.6 60 Proportion (%) 40 40

20 20 2015 2018 0 0 ALL * 60-69 y * 70-79 y * 80y & over * Rural * Urban *

* significantly different at 5% level of significance Prevalence of High Waist Circumference and High Waist-Hip Ratio among Elderly, 60 years old and above: Philippines and Isabela Province, 2018

100 PHILIPPINES 100.0 ISABELA PROVINCE

80 80.0 60 47.7 60.0 39.6 40 40.0

17.8 Prevalence (%) Prevalence 20 (%) Prevalence 20.0 10.0

0 0.0 High Waist Circumference High Waist-Hip Ratio High Waist Circumference High Waist-Hip Ratio * *

90% LL 17.1 46.7 90% LL 7.3 35.6 CI UL 18.6 48.6 CI UL 12.8 43.6

* significantly different at 10% level of significance Anemia among Elderly, 60 years old and above, by sex, place of residence, and wealth status: Philippines, 2013 vs 2018

30 2013 2018 30 2018 25 23.0 23.3 25 20.8 21.7 20.2 19.1 18.3 20 17.8 20

15 15 Prevalence (%) Prevalence 10 (%) Prevalence 10

5 5 2013 2018 0 0 ALL Male Female Rural Urban

30 2018 24.1 25 21.1 21.8 16.8 20 17.4

15

Prevalence (%) Prevalence 10

5

0 Poorest Poor Middle Rich Richest Prevalence of Anemia among Elderly, 60 years old and above: Philippines and Isabela Province, 2018

40

30 27.4 20.2

20 Proportion (%) Proportion

10

0 Philippines Isabela Province

LL 17.7 22.4 90% CI UL 22.8 32.4 Percent distribution of UIE values among the Elderly, 60 years old and above: Philippines, 2013 vs 2018

50 2013 2018 Median UIE = 80 μg/L Median UIE = 108 μg/L Prev <50 μg/L = 33.8% Prev <50 μg/L = 23.8% 2013 2018 40

30.4 30 27.6 24.0 23.8

Percentage (%) Percentage 20 18.8 15.0 15.5 12.9 9.6 10 7.8 8.9 5.8

0 <20 μg/L 20-49 μg/L 50-99 μg/L 100-199 μg/L 200-299 μg/L ≥300 μg/L Median UIE° and Percent UIE below 50 μg/L among Elderly, 60 years old and above: Philippines and Isabela Province, 2018

60 200

g/L) 50 μ 150 133.0 40 108.0 100 30 23.3

20 14.5 Percentage (%) Percentage

Median UIE ( UIE Median 50 10 0 0 Philippines Isabela Province * Philippines Isabela Province *

LL 105.2 119.7 LL 90% 90% 20.4 10.7 CI CI UL 110.3 146.6 UL 26.3 18.3

* significantly different at 10% level of significance °Iodine Intake based on median UIE <100 μg/L – Insufficient 100-199 μg/L – Adequate 200-299 μg/L – More than adequate 300 μg/L and up – Excessive Elevated Blood Pressure° among the ELDERLY, 60 years old and above, by age group and sex: Philippines, 2015 vs 2018

50 2015 2018 50 2015 2018 41.2 42.7 40.6 40.6 40.8 41.5 40 37.1 36.8 40 36.8 35.0 33.8 33.6

30 30

Prevalence (%) Prevalence 20 20 Prevalence (%) Prevalence

10 10 2015 2018 0 0 Male Female ALL * 60-69 y * 70-79 y * 80y & over * * ° Based on a single-visit blood pressure measurement, systolic blood pressure of * significantly different at 5% level of significance 140 mmHg or higher and/or a diastolic pressure of 90 mmHg or higher - 7th Joint National Committee on detection and treatment of high blood pressure (JNC VII, 2004) High Fasting Blood Sugar among the ELDERLY, 60 years old and above, by age group and sex: Philippines, 2013 vs 2018

20 20 2013 2018 2013 2018 15.3 15 13.8 15 13.8 13.9 12.5 11.8 11.4 11.0 10.6 9.2 10 Prevalence (%) Prevalence 10

6.4

5.9 (%) Prevalence 5 5

2013 2018 0 0 Male Female ALL 60-69 y 70-79 y 80y & above Prevalence of Elevated Blood Pressure and High Fasting Blood Sugar among Elderly, 60 years old and above: Philippines and Isabela Province, 2018

PHILIPPINES ISABELA PROVINCE 50 50

40 35.0 40

30 30 26.5

20 Prevalence (%) Prevalence Prevalence (%) Prevalence 13.8 20 11.7 10 10

0 0 Elevated Blood Pressure High Fasting Blood Sugar Elevated Blood Pressure High Fasting Blood Sugar * 90% LL 33.7 12.2 90% LL 23.8 6.5 CI UL 36.2 15.5 CI UL 29.3 17.0

* significantly different at 10% level of significance Smoking Status

Current Smokers 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)

World Health Organization. (2008). WHO STEPS Surveillance Manual. Current Smoking° among the ELDERLY, 60 years old and above, by age group and sex: Philippines, 2015 vs 2018 50 50 2015 2018 2015 2018 40 40 32.0 30 30 28.2

Proportion (%) Proportion 21.2 19.2 18.8 20 17.0 20

16.3 (%) Proportion 12.6 11.8 9.0 9.4 10 10 7.5 2015 2018

0 0 ALL * 60-69y 70-79 y * 80y & over Male Female ° Are those who either smoke on a “daily” basis (at least one cigarette a day) * significantly different at or on a regular/occasional basis (at least weekly or less often than weekly) 5% level of significance - World Health Organization (2008). WHO STEPS Surveillance Manual. 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 of ABSTAINERS 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. Current Alcohol Drinking among the ELDERLY, 60 years old and above, by age group and sex: Philippines, 2015 vs 2018

70 70 2015 2018 2015 2018 60 60

48.6 50 50 48.5

40 40 33.8

32.2 (%) Proportion Proportion (%) Proportion 30 27.8 28.2 30 21.7 20.4 20 20 15.5 12.0 13.0 10.4 10 10 2015 2018 0 0 Male Female ALL 60-69 y 70-79 y 80y & over INSUFFICIENT PHYSICAL ACTIVITY

A person not meeting any of the following criteria is considered being physically inactive or insufficiently physically active:

- 75 minutes (3 or more days) of vigorous-intensity physical activity (e.g. running) per week or - 150 minutes (5 or more days) of moderate-intensity physical activity per week (or walking of at least 30 minutes per day) or - an equivalent combination of moderate- and vigorous-intensity physical activity achieving at least 600 Metabolic Equivalents-minutes per week

- World Health Organization. (2010). Global recommendations on physical activity for health. Physical Inactivity among the ELDERLY, 60 years old and above, by age group and sex: Philippines, 2015 vs 2018

80 77.6 80 70.6 2015 2018 2015 2018 61.8 59.9 60 56.6 60 55.0 52.6 50.6 45.1 45.4 42.9 44.7 40

40 (%) Proportion Proportion (%) Proportion

20 20 2015 2018 0 0 Male Female ALL 60-69 y 70-79 y 80y & over Proportion of Current Smokers, Current Smokeless Tobacco Users, Current Alcohol Drinkers, and Physically Inactive Elderly, 60 years old and above: Philippines and Isabela Province, 2018

80 PHILIPPINES 80 ISABELA PROVINCE

60 50.6 60 50.6

40

28.2 40 31.2 Proportion (%) Proportion Proportion (%) Proportion 24.9 20 16.3 20 3.6 8.8 0 0 Current Smokers Current Smokeless Current Alcohol Physically Inactive Current Smokers Current Smokeless Current Alcohol Physically Inactive Tobacco Users Drinkers * Tobacco Users Drinkers * 90% LL 15.5 3.2 25.8 48.5 90% LL 21.8 6.2 28.2 46.4 CI UL 17.1 4.0 30.5 52.7 CI UL 27.9 11.5 34.1 54.8

* significantly different at 10% level of significance Summary (Elderly)

 Chronic energy deficiency was significantly higher in Isabela Province compared with the national estimate.  Overweight was significantly lower than the national estimate while obesity was lower than the national prevalence but not significant.  Android obesity (high WC and high WHR) was significantly lower than the Philippine prevalence.  Anemia was of “moderate” public health significance.  Iodine intake in Isabela Province was adequate based on median UIE. Summary (Elderly)

 Elevated blood pressure was significantly lower compared with the Philippine estimate.  High fasting blood sugar was slightly lesser than the national prevalence however, the difference was not significant.  Current smoking was significantly higher in Isabela Province compared with the national estimate.  The proportion of current smokeless tobacco users (8.8%) was significantly higher than the national estimate.  About 3 in every 10 elderly (31.2%) were engaged in current alcohol drinking.  Physical inactivity was similar with the national proportion. Department of Science and Technology - Food and Nutrition Research Institute

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