UNIT 8: Introduction to Public Health Best sources:

Nutrition - Dense whole foods that contain sugars

or starches along with fiber
Food
 Anything that we eat that nourishes the Proteins
body  Chains of amino acids linked by peptide
 Solid, semi-solid, or liquid bonds
 Build-up, maintain, and replace tissue
Two important features:  Breakdown into polypeptides and amino
1. Edible acids for absorption
2. Must nourish the body  1g protein gives 4kcal of energy
 Adults should get 10-35% of their
Calorie calories from proteins
 Unit of measurement that counts the
energy contained in food Amino acids:
- 9 essential amino acids (body cannot
Three Functions of Food synthesize them quickly)
1. Social function - Histidine, isoleucine, leucine, lysine,
2. Psychological function methionine, phenylalanine, threonine,
3. Physiological function tryptophan, and valine
- Histidine – very unique (for infants)
Nutrition
 Process of consuming foods, digesting Functions:
and absorbing nutrients  Growth, maintenance, repair of tissues
 Using these nutrients for growth,  Production of enzymens, hormones,
development and maintenance of life antibodies. Haemoglobin
Eating – Digestion – Absorption –  Clotting of the blood
Transportation – Utilized  Provide energy (alternative for
carbohydrates)
Nutrients
 Found in food Special features:
 Responsible in nourishing the body  Animal proteins are better than
vegetable proteins
Macronutrients  Including two or more sources of
 Present in large quantities in food vegetable proteins in each meal helps to
 Required in large amounts by the body improve the quality of proteins and
 Energy-giving nutrients utilization
 Carbohydrates, proteins, fats, oils
Fats
Micronutrients  Chain of fatty acids linked by Esther
 Present in small quantities bonds
 Not produced by the body  Densest source of energy in the diet
 Only receives from food  Absorption of fat-soluble vitamins,
 Vitamins, minerals insulates and cushion organs
 Largest form of energy storage
Carbohydrates  Brain and nervous system development
 Small chains of sugar  Creates hormones
 45%-65% of the diet  1g fat gives 9kcal of energy
 1g carbohydrate gives 45kcal of energy
 Starches, sugar, fiber
Types of Fats

Saturated fats (bad)

- Carbon-carbon single bond
 Meat, milk, cheese, coconut oil
 Too much can raise LDL (bad
cholesterol)

Unsaturated fats (derived from plants/fish)

- Carbon-carbon double bond
 Plant foods: almond, olive oil
 Fish: salmon, tuna
 Good for the heart

Trans fat (bad)

- Type of unsaturated fat Choline – organic, water soluble, not vitamin
- Trans fat acids nor mineral
 Margarine, snack foods, baked
goods
 Hydrogenated or partially
hydrogenated
 Too much can raise LDL and lower
HDL

Vitamins
 Organic nutrients that are essential for
life

Minerals
 Occur as inorganic crystalline salts
 Remain in the body until excreted
 Cannot be changed into anything else
 Cannot be destroyed by heat, air, acid,
or mixing
 Types of malnutrition

Under Nutrition
 PEM
 Micronutrient deficiencies

Over Nutrition
 Overweight
 Obesity
 Health consequences

Co-existences of under and over nutrition

 Double burden of nutrition
Public Health Nutrition (PHN)  Obesity and PEM in the same individual
 Promotion of good health through or in different children, but in the same
nutrition family
 Primary prevention of nutrition related  Obesity and micronutrient deficiencies in
illness in the population the same individual or in different
 Science and art of preventing disease, children, but in the same family
prolonging life and promoting health
through the medium of nutrition Chronic Malnutrition
 Prolong malnutrition
Malnutrition
 Deficiencies, excesses, or imbalances in Acute Malnutrition
a person’s intake of energy and/or  Short term malnutrition
nutrients
 Gravest single threat to global public Major categories of under nutrition
health
 Result of lack or excess of energy or Macronutrient deficiency
nutrients to the body  Lack of essential vitamins and minerals
 Underweight, overweight, obesity
Micronutrient deficiency
Nutritional status  Significant cause of neurodevelopmental
 State of the body in relation to nutrition disorders
 Dietary intake is separate from
nutritional status The Faces of Malnutrition

2 broad groups of malnutrition Underweight

Under nutrition  Low weight for age
 Stunting  Most common and easiest to addressed
 Wasting
 Underweight Stunted
 Nutrient deficiencies  Low height for their age
 Reflects chronic under nutrition
Over nutrition  Effects become irreversible by age 5
 Overweight  Affects 3M Filipino children under 5
 Obesity years old
 Diet-related non-communicable
diseases Wasted
 Low weight for height
 Acute under nutrition
 Which of the following describes underweight?
1g fat: ____ of energy – 9kcal – low weight for age

Among the faces of malnutrition in children. Which type of nutrient is the best source of
Which f the following has the possibility for energy – Carbohydrates
reversion to normal by just refeeding them? –
wasted 1g carbohydrate:____ energy of fat – 45kcal

Which of the following is not a goal of public Which of the following vitamin is needed for
health nutrition? – none of the choices production of coagulation factors? – vitamin K

Which of the following does not describe Which of the following is not considered as a
underweight children? – low weight for height macronutrient? – minerals

Which of the following is/are true of cis Which of these is not required on the food
unsaturated fatty acids? label? – Manganese
 There is a carbon to carbon double
bond Which of the following does not describe
 Hydrogen atoms are on the same wasted children? – reflects chronic under
side of the carbon to carbon double nutrition
bond
 Molecule has a bent configuration Which of the following describes stunting? –
low height for age
Which of the following does not describe
malnutrition? – NONE OF THE CHOICES Deficiency of Vitamin C could lead to this
condition – scurvy
Thinner and shorter children could be both
classified as which of the following? – wasted Which of the following mineral is important for
and stunted DNA synthesis? – Zinc

The following are vital for energy metabolism – Which of the following is/are true of trans fatty
I, II, and III (Vitamin B1, Vitamin B2, Vitamin acids?
B3)  Hydrogen atoms are opposite in the
carbon to carbon double bond
This is the appearance of a child with an acute  Molecule has a linear configuration
form of malnutrition – wasted  There is a carbon to carbon double
bond
Which of the following is/are considered co-
enzymes? – Vitamin A, Vitamin K, Vitamin B, Which of the following is true about saturated
Vitamin C fats? – raise LDL

This deposits cholesterol in the body’s tissues This transports cholesterol from the tissues to
especially blood vessels – LDL the liver to be metabolized - HDL

Which of the following does not describe Which of the following is/are true of trans
macronutrients? – consists of unsaturated fats?
phytochemicals and antioxidants  Help lower blood pressure
 Reduce TAG
This is the unit of measurement that counts the
energy contained in food – calorie Deficiency of Vitamin D – Rickets
Pinggang Pinoy addresses the Malnutrition Solving the Philippines’ Double Burden of
problem Malnutrition should be a collaborative effort
on March 20, 2019 between the public and private sectors as it is
not an easy feat. With this, Ajinomoto
The country has been facing the rise on the Philippines Corporation partnered with
number of underweight and overweight government agencies to conduct education
Filipinos for more than 20 years. The World programs to raise awareness and promote the
Health Organization (WHO) defined this practice of Pinggang Pinoy® in malnutrition
phenomenon as the “Double Burden of hotspots, where incidences of Double Burden
Malnutrition” or the “prevalence of both Malnutrition are high. This training was given
undernutrition and overweight in the same to homemakers/mothers who have
community, nation, or region.” malnourished (underweight, stunting, wasting,
overweight and obese) school-aged children.

The pilot run resulted to improvements of the

knowledge & attitudes of households related to
the practice of Pinggang Pinoy® within target
areas. However, behavior changes towards
healthier eating habits remains to be a
challenge. The program uncovered a number
#MalnutritionTraps that some Pinoy
households easily fall into. The following
#MalnutritionTraps provide a picture of how
unhealthy eating habits may lead to Double
Burden of Malnutrition:

Overconsumption of carbohydrates:
Voracious rice eaters can easily fill half of their
plates with rice. Others have pandesal &
noodles as regular meal deprived of other
nutrients derived from a well-balanced meal.

Under consumption of vegetables

and/fruits: It is common for some to be content
with rice & meat to satisfy their hunger and
skip/take insufficient amount of
vegetables/fruits. Fact is, the variety of colors
found in Glow foods are important sources of
vitamins & minerals to sustain our energy &
keep us from getting sick.

Overconsumption of protein: Typical Filipino

To address this problem, our government “SILOG” meals include double serving of
launched the Pinggang Pinoy® campaign in proteins (e.g. Tapa+Itlog, Tocino+Itlog,
2014. Pinggang Pinoy® is an easy-to- Longanisa+Itlog, Bangus+Itlog). Eating
understand food guide showing proper food different kinds of protein is fine for as long as
group portioning on a per-meal basis. This they are taken in moderation. We must also
reflects the principles of MOderation, VAriety avoid protein dishes served high in fat,
and BAlance (MOVABA) to promote healthier cholesterol and sodium.
eating habits.
To help Filipinos break free from
#MalnutritionTraps, Ajinomoto’s Culinary
Nutrition Team prepared Healthy & Delicious National Nutrition Council and some Laws
Pinggang Pinoy® Recipes, downloadable on Nutrition
through https://bit.ly/2HIsfkj. Busy and budget-
restricted homemakers will also find these Core Values
Pinggang Pinoy® recipes useful because all  Formulate national food and nutrition
are easy-to-do and affordable (P250/day for policies and strategies and serve as the
family of 5). policy, coordinating and advisory body
of food, nutrition and health concerns
For updates about Mag-Pinggang Pinoy®  Coordinating planning, monitoring, and
Tayo!, visit www.ajinomoto.com.ph and evaluation of the national nutritional
facebook.com/CookmunitybyAjinomotoPH program
 Coordinate the hunger mitigation and
malnutrition prevention program to
In Pinggang Pinoy, Glow foods consists how achieve relevant MDGs
many percent of the total recommended  Strengthen competencies and
consumption? – 50% capabilities of stakeholders through
public education, capacity building and
The following Malnutrition traps provide a skills development
picture of how unhealthy eating habits may  Coordinate the release of funds, loans,
lead to double burden of malnutrition: and grants from GO’s and NGOs
 Overconsumption of carbohydrates  Call on any department, bureau, office,
 Under consumption of fruits and agency, and other instrumentalities of
vegetables the government for assistance in the
 Overconsumption of proteins form of personnel, facilities, and
resources as the need arises
What principles are reflected in the Pinggang
Pinoy program of the National Nutrition Composition
Council? – Balance, Moderation, Variety
Governing Board
In Pinggang Pinoy, vegetable foods consists  Secretary of Health, Chairperson
how many percent of the total recommended  Secretary of Agriculture, Vice Chair
consumption? – 33%  Secretary of the Interior and Local
Government, Vice Chair
 Secretary of Budget and Management
In Pinggang Pinoy, fruits consists how many
 Secretary of Education
percent of the total recommended
 Secretary of Labor and Employment
consumption? – 17%
 Secretary of Science and Technology
What is meanth by the “Double burden of  Secretary of Social Welfare and
malnutrition” according to the WHO? – Development
Prevalence of both under nutrition and  Secretary of Trade and Industry
overweight in the same community, nation,  Director General, National Economic
or region and Development Authority

In Pinggang Pinoy, grow foods consists how Secretariat

many percent of the total recommended
consumption? – 17% 3 representatives from the private sector
- Appointed by the president for a two
year term
Vision Statement Philippine Plan of Action for Nutrition 2017-
NNC is the authority in ensuring the nutritional 2022 (goal)
well-being of all Filipinos, recognized locally To improve the nutrition situation of the country
and globally, and led by a team of competent as a contribution to:
and committed public servants  The achievement of AmBisyon Natin
2040 by improving the quality of the
Mission Statement human resource base of the country
To orchestrate efforts of the government,  Reducing inequality in human
private sector, international organizations and development outcomes
stakeholders at all levels in addressing hunger  Reducing the child and maternal
and malnutrition of Filipinos through: mortality
- Policy and program formulation and
coordination Objectives
- Capacity development Outcome Targets
- Promotion of good nutrition  Final outcomes
- Nutrition surveillance Sub-outcome Targets
- Resource generation and mobilization  Intermediate targets
- Advocacy
- Partnership and alliance building Outcome Targets
 Reduce levels of child stunting and
Core Values wasting
 Integrity  Reduce micronutrient deficiencies
 Zeal  No increase in overweight among
 Excellence children
 Sensitivity  Reduce overweight among adolescents
 Transparency and adults

Philippine Plan of Action for Nutrition 2017- Some related Nutritional Laws
2022
 Integral part of the Philippine Executive Order No. 51 (Milk Code)
Development Plan 2017-2022 “National Code of Marketing of Breastmilk
Substitutes, Breastmilk Supplement and Other
Consistent with: Related Products”
 Duterte Administration 10-point  Aims to contribute to the provision of
economic agenda safe and adequate nutrition for infants
 Health for all agenda of the DOH  By the protection and promotion of
 Developmental pillars of Malasakit, breastfeeding and by ensuring the
Pagbabago, and Kaunlaran proper use of breastmilk supplements
 Vision of Ambisyon Natin 2040 (strongly
rooted and comfortable life) Republic Act 8976: The Philippine Food
 2030 SDGs Fortification Act of 2000
 2025 Global Targets for Maternal, Infant  Food fortification shall be carried out to
and Young Child Nutrition compensate for the inadequacies in
 2014 International Conference on Filipino diet based on present day
Nutrition needs.
 Consists of 12 programs and 46 projects Philippine Food Fortification Program shall
(framework for action) cover:
Of the 12 programs: - All imported or locally processed foods
 8 are nutrition-specific or food products for sale or distribution
 1 is nutrition-sensitive in the Philippines
 3 are enabling support programs - Dietary supplements
Mandatory Food Fortification Which of the following food items are included
Required to add these micronutrients to food in Mandatory Food Fortification?
- Rice + Iron  Cooking oil with Vitamin A
- Refined sugar + Vitamin A  Refine sugar with Vitamin A
- Flour + Vitamin A and iron  Wheat flour with Vitamin A and iron
- Oil + Vitamin A  Rice with iron

Voluntary Food Fortification This is the addition of nutrient to processed

Sangkap Pinoy Seal – awarded by DOH foods or food products at levels above the
139 food products with Sangkap Pinoy Seal natural state. – Fortification
- 17 noodles
- 52 snack foods What is RA 8976? – Food Fortification Law
- 4 supplementary food for infants
- 10 biscuits What is the vision of AmBisyon Natin 2040? –
- 10 breads and cereals By 2040, Filipinos enjoy a strongly rooted,
- 6 sandwich spread comfortable, and secure life
- 9 cheese products
- 3 milk products Which of the following is not a core goal of
- 4 chocolate drinks National Nutrition Council?
- 14 fruit drinks  Coordinating, planning, monitoring,
- 8 meat and fish products and evaluation of the PPAN
- 2 condiments and mixes
What nutrients are included in the Mandatory
RA 8172 (ASIN Law) Food Fortification?
An act for salt ionization nationwide (ASIN)  Iron and Vitamin A
What is salt ionization? What is the main aim of Food Fortification?
- Salt ionization is a worldwide  To combat micronutrient deficiency
sustainable and cost-efficient strategy
intended to address iodine deficiency. What is the Executive Order 51? – The
Iodine is added to natural salt in small Philippine Milk Code
amounts required by the body
This represents the collective long term vision
and aspirations of the Filipino People for
themselves and for the country in the next 25
years? – AmBisyon Natin 2040

Voluntary Fortification of Food is done through

what program? – Sangkap Pinoy

Which of the following is not an aim of the

Philippine Milk code? – recommend
formulations for best breast milk substitute

A certain snack item brand being sold in the

supermarket bears the Sangkap Pinoy Seal.
What does this mean? – The food item is
under Voluntary Food Fortification
Which of the following does not describe
PPAN? –It consists of 46 programs and 72
projects

What is the purpose of iodization of salt

according to ASIN Law? – to fortify food