MANILA, 18 April 2008 (IRIN) - In the Philippines, one out of four children is considered underweight or stunted - telling signs of nutritional problems. But this figure, which translates into four million children under 10 being undernourished, is considered an improvement, according to the country's Food and Nutrition Research Institute (FNRI). In the early 1990s, 30 to 40 percent of the same age group were found to be either underweight, stunted or in a worse physical condition.

With the surge in global food prices, however, these gains are at risk. The Philippines is one of the world's largest importers of rice and food security is one of the major determinants of nutritional status, according to specialists.

On 14 April, the Council for Health and Development, a local NGO, issued a statement calling for genuine agrarian reform to address the food crisis, warning that "it will not be surprising if the Philippines shall take the place of sub-Saharan Africa as first in rank in terms of malnutrition incidence", if proper measures are not put in place. About a third of children under five in sub-Saharan Africa are underweight, according to the UN Food and Agricultural Organization (FAO).

In response to the anticipated food shortages, the Department of Education will expand its school-feeding programme and the government has repeatedly assured Filipinos of stable rice supplies from both foreign and local sources. But with poverty rates also on the rise, these initiatives may not be enough.

Government figures show that the income poverty rate increased to 33 percent in 2006, up from 30 percent in 2003, with the number of "food poor" Filipinos rising from 10.8 million to 12.2 million over the same period.

Interventions

Mario Capanzana, FNRI's director, told IRIN that even if the food crisis is arrested after two or three months, it will have little impact on malnutrition statistics. But if it continues, malnutrition may worsen.

"We need to address the issue of the availability of food," Capanzana said. It was crucial that vulnerable communities had access to cheap food or adequate food assistance from the government or international agencies and NGOs, he added.

Increased malnutrition could be avoided, Capanzana said, with proper interventions. But he stressed that it was not just an issue of increased rice availability; there needed to be increased awareness of what constitutes a proper diet and micronutrients and the use of fortified foods were also a factor.

Some food fortification is widespread, with 97 percent of households consuming fortified food, according to the UN Children's Fund (UNICEF) salt iodisation programme officer, Edward Otico, but often it is not sufficient. For example, 75 percent of households tested in 2005 had iodine in their salt, but, Otico told IRIN, only 44.5 percent have "adequately iodised" salt. This, he said, means that potentially more than half of households do not meet their daily iodine requirements, which affects the mental and physical development of children.

"People commonly look for goitre as a sign of iodine deficiency," Otico explained. "But the silent and widespread consequence of iodine deficiency is limited mental development. If a population is iodine deficient, the intelligence quotient decreases by 13.5 points on average. In the worst cases, iodine-deficient pregnant women can even lose their babies."

Beyond food security

Anaemia - a form of micronutrient malnutrition caused by iron deficiency - is another chronic nutritional problem for infants and young children. At least six out of every 10 babies aged between six months and one year are anaemic, which is hardly surprising since more than 40 percent of pregnant and lactating women suffer from anaemia too, according to FNRI statistics.

Marinus Gotingk, chief of the health and nutrition section of UNICEF Philippines, explained that lack of micronutrients cannot be addressed simply by food availability. "Normal rice does not have iron. We have to fortify rice," he said. Nor did feeding programmes properly address malnutrition, he claimed. "They attract children to school but it doesn't change malnutrition prevalence," he said, adding that proper nutrition is not just essential for school-age children but particularly critical for infants up to two years of age.

Adrienne Constantino, a senior science researcher at FNRI, told IRIN that certain regions or provinces, especially hard-to-reach rural areas, were highly vulnerable to micronutrient malnutrition. "We will conduct a survey this year to identify which provinces have a high incidence of malnutrition, so our efforts are more targeted."

Constantino said malnutrition was a continuing challenge for the country. "We are improving, but not fast enough."

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