Nutrition-and lifestyle-related risk factors due to behavioral and environmental factors, among others, increases the risk of chronic non-communicable diseases as well as premature deaths among Filipino adults. This is according to the 7th National Nutrition Survey conducted in 2008 by the Food and Nutrition Research Institute of the Department of Science and Technology (FNRI-DOST).
Cardiovascular diseases (CVD) including heart attacks and stroke are the main leading causes of deaths among Filipinos in 2009, according to the Department of Health (DOH).
CVD include diseases of the heart and blood vessels which normally develop over time. By definition, CVD occur when the arteries develop atherosclerosis – a process that begins in childhood and involves a gradual build-up inside them called plaque. This plaque contains fat, cholesterol and other substances which can grow large enough to reduce the blood’s flow through an artery. However most of the damage occurs when a plaque ruptures. Plaques that rupture cause blood clots to form which can block blood flow or break off. If this happens and it blocks a blood vessel that feeds either the heart or brain, it causes a heart attack or stroke.
What can Filipinos do to reduce their risk of cardiovascular diseases and stroke?
Much of the burden of cardiovascular diseases, including both heart attacks and stroke, could be eliminated by reducing the prevalence of major risk factors like high blood pressure, high blood cholesterol, diabetes, cigarette smoking, alcohol drinking and physical inactivity, according to Ms. Charmaine A. Duante, Senior Science Research Specialist of FNRI-DOST.
What risk factors can be changed?
Smoking: Smokers have a three- to five-fold greater risk for CVD including stroke than nonsmokers. Thirty-one percent (31.0%) of Filipino adults smoke cigarettes. Differences exist by sex where Filipino men smokers at 53.2 percent are four times higher than women smokers at 12.5 percent. Cigarette smoking is most prevalent among young men 20-29 years of age and women aged 40-49 years old.
Alcohol Drinking: Alcohol intake of approximately 3-4 drinks per day was found to be a risk factor for CVD especially for hypertension, according to studies.
About 27.0 percent of Filipinos are alcohol drinkers. Men drinkers at 57.5 percent are almost five times more than their women counterparts at 9.8 percent.
Overweight and Obesity: “Overweight” is defined as an excess amount of body weight that includes muscle, bone, fat, and water, while “obesity” specifically refers to an excess amount of body fat. Both overweight and obesity are considered independent risk factors as well as co-morbidities of high blood pressure, high blood lipid levels, and the onset of diabetes. Most often, overweight and obesity develop from eating too much and exercising too little.
A person who is either overweight or obese has at least two-fold greater risk for CVD including stroke than a person with normal body weight.
Two in 10 Filipinos are overweight. This is measured using the body mass index (BMI) following the World Health Organization (WHO) criteria of overweight. The BMI is calculated by dividing weight in kilograms by the square of the height in meters (BMI=wt in kg/ht in m2). A person with a BMI equal to or more than 25.0 to 30.0 is considered overweight.
Android obesity or apple-shaped obesity is prevalent particularly among Filipino women. Apple-shaped obesity is six times more common in women than in their men counterparts, affecting 7 out of 10 and 1 out 10, respectively. Android obesity is measured either using waist circumference (WC≥102 cm for men and WC≥88 cm for women) or waist-hip ratio (WHR≥ 1.0 for men and WHR ≥ 0.85 for women) criteria of the WHO.
Obesity among Filipinos increased dramatically in women using both WHR and WC criteria from 1998 to 2008.
Physical Inactivity: About 97.0 percent of Filipinos failed to participate in regular leisure time physical activity. Furthermore, results of the 7th NNS showed physical inactivity at work and travel was found in more than 75.0 percent of Filipinos. Men were more likely to participate than women in leisure and travel-related activities like walking, biking or cycling. In contrast, women were more likely to be active than men in the household activities.
What risk factors can be controlled?
High Blood Pressure: There is about three to four-fold greater risk for CVD including stroke among hypertensive than among non-hypertensive adults.
About three in 10 Filipinos have high blood pressure based on a single visit measurement. Hypertensive men at 29.1 percent are significantly higher than their women counterparts at 22.2 percent. However, about 53.0 percent of women are hypertensive after menopause. In general, blood pressure increases with age. Between 2003 and 2008, hypertension increased significantly among Filipinos from 22.5 percent to 25.3 percent.
Diabetes: The risk for type 2 diabetes or the so-called late-onset diabetes may increase with age, obesity, and physical inactivity. Type 2 diabetes based on high fasting blood sugar (FBS ≥ 126 mg/dL) is more common in adults aged 40-49 years and older. In 2008 alone, more than 3 million Filipinos were estimated to have type-2 diabetes in 2008.
High Cholesterol: About two- to three-fold greater risk for CVD including stroke among those with high total cholesterol (≥240 mg/dL) than those with normal level of total cholesterol (< 200 mg/dL).
About 13 in 100 Filipino women and 7 in 100 Filipino men have high total cholesterol. Likewise, women have significantly higher LDL-cholesterol than men at 125.6 mg/dL and 110.0 mg/dL, respectively. In contrast, men have higher triglyceride than women at 155.0 mg/dL and 129.2 mg/dL, respectively. Men have lower HDL-cholesterol than women at 39.1 mg/dL and 41.1 mg/dL, respectively. At age 50-59 years, the level of total-cholesterol, LDL-cholesterol and triglyceride peaked for men and women. From 2003 to 2008, cholesterol abnormalities significantly increased affecting millions of Filipinos.
Pre-determined factors such as heredity including culture, sex, increasing age are considered unmodifiable factors or cannot be controlled, the FNRI-DOST added.
Predisposing environment including continuous urbanization, cyclical poverty and low level of education among majority of the people as a consequence of poor economic situation of the country, among others, are all major contributors on the pathway to chronic lifestyle diseases among Filipinos, Ms. Duante emphasized further .
For more information on food and nutrition, contact: Dr. Mario V. Capanzana, Director, Food and Nutrition Research Institute, Department of Science and Technology, General Santos Avenue, Bicutan, Taguig City; Tel/Fax Num: 8372934 and 8373164; email: mvc@fnri.dost.gov.ph, mar_v_c@yahoo.com; FNRI-DOST website: http://www.fnri.dost.gov.ph. (FNRI-DOST S & T Media Service: Press Release – EVA ABILLE- GOYENA)
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