How would you describe a malnourished person? Growing up, I only equated malnutrition to lacking nourishment resulting to looking like skin and bones. A malnourished person for me looked gaunt and emaciated. The lack of muscle mass and body fat is evident due to lack of food intake and proper nutrition.

I have been in private practice as a registered nutritionist-dietitian for over two decades now and what I perceived as malnutrition in my younger years is no longer the same. Overnutrition and undernutrition coexist and cannot be ignored nor separated. These are both forms of malnutrition.

Juvy Martillos-Sy, RND, RDN, the chief nutritionist-dietitian for the Philippine Children’s Medical Center (PCMC) and the current Nutritionist-Dietitians’ Association of the Philippines’ ambassador for the American Society for Parenteral Enteral Nutrition Awareness Week Program, explains more on the double burden of malnutrition in the Philippines.

“The Philippines  is having a continuous challenge with the various forms of malnutrition. The recent data in the Philippines indicate a two-fold increase in overweight and obesity among adults, from16.6 percent to 37.2 percent between 1993 to 2018. Parallel to this is the rising prevalence of metabolic syndrome components, including non-communicable diseases e.g. abdominal obesity, hypertension, high fasting blood glucose, and dyslipidemia. Moreover, poor body weight, anemia, and vitamin A deficiency continue to have public health significance.”

According to Sy, both undernutrition and overnutrition coexist. A dual challenge of nutritional status known as the double burden malnutrition that is present especially among children in the low and middle income countries.

“Overweight has been recognized in developed nations, it remains as the unseen malnutrition in developing nations. For other cultures, it is even considered as a sign of good health or a symbol of successful child-rearing. Thus, the issue of malnutrition remains unresolved,” shares Sy.

Nutritional status during childhood is closely related to adult health. In order to improve the quality of life in adulthood, Sy explains that more attention should be paid to childhood health. “Together with other environmental factors and long-term epigenetic mechanisms, early nutrition for pregnant women’s diet, and nutritional status of newborn babies, and young infants influence brain development. The brain benefits from a heart-healthy diet that encourages weight loss and reduces the risks of developing insulin resistance in adulthood.” 

According to Sy, poor nutrition in the first 1,000 days of infancy can have long-term consequences for the following: brain development, wound healing, mental and emotional health, immune function, lifetime risk of obesity, hypertension, diabetes, and other non-communicable or lifestyle-related diseases. It also impacts the socio-economic status as an adult.

“Based on current study, earlier introduction to complementary food was associated with greater food responsiveness and emotional overeating at age 12 and 24 months. We must consider the potential role of early complementary food introduction on children’s appetitive traits and the observed variability in the types, sequence, and combinations of food and beverages introduced,” recommends Sy. 

It is quite clear that if we want to build a healthy nation, we should start getting serious with nourishing pregnant women, infants and children. Don’t wait until adulthood to adapt a proper diet and nutrition. Simply because, when one reaches that stage in the life cycle, the consequences of poor nutrition from conception to early childhood may have already caused some symptoms to arise from preventable medical conditions.

Sy emphasizes on the concerning rise in the number of overweight children due to shifting dietary patterns and lack of physical activity. “Disparities in health and nutritional status during childhood are highly persistent throughout the whole life course of adulthood.”

When asked about the other factors that lead to overnutrition aside from food intake, Sy mentions inadequate education of parents regarding dietary lifestyle, eating habits while watching television or usage of gadgets during meal times, and having no physical engagement such as sports. 

It is vital for the family’s health and wellbeing to know how to incorporate nutrient rich food into their budget and daily meals. It is also important to be physically active individually and as a family. It is recommended that one meal a day should be spent with family. This means having meaningful conversations and having a pleasant dining experience sans distractions like gadgets. It does not only contribute to building healthy relationships and general well-being but also drives us to be more mindful about what and how we eat. Oftentimes, we tend to eat more than what we need when we are distracted because we don’t chew our food properly. We also don’t notice our fullness until we’ve had too much. 

During the Malnutrition Awareness Week last Sept., Sy imparted a message for the Filipino people, “Invest on good health for ourselves by knowing basic information on right nutrition. Eating healthy is possible even if our resources are limited. It can be possible through alternatives that are available. Consult your nearest registered nutritionist-dietitian in the area instead of exploring social media. This  may lead you to wrong nutrition information and treatments, as well as, develop long term disease-related conditions.”

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