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  • Cristina Sison

Transforming Food Habits to Stay Healthy

Introduction

As the Philippines successfully deals with chronic energy deficiency, it faces the risk of the double burden of malnutrition with the increasing trend in overweight and obesity in all age groups. While wasting, stunting, and underweight among children age 0 to 59 months are slowly declining, more older children age 6 to 10 yrs old, as well as adolescents are becoming overweight.


Overweight has a steady upward trend among children 5 to 10 yrs, 10 to 19 ys, and among adults both men and women belonging in the higher income group, with the highest incidence in the NCR, CALABARZON, and Central Luzon. These regions are highly urbanized with diminishing area for arable land that could be used for crop production. Typical in urban areas is purchasing as a common practice to acquire food, with a narrowing gap between consumption of food at home (FAH) and food away from home (FAFH) (Rufino, 2017) .



What’s happening in these areas?


NCR is the center of the country’s production, and is the location of majority of micro, small and medium enterprises. There are 190,166 business establishment which provides 61.6% of the country’s employment (PSA, 2019).


Similar to NCR, Central Luzon provides employment opportunities through its industrial and trans-shipment hub. It is home to several industrial and economic zones with efficient water, power and telecommunication infrastructure, and port facilities. Areas in Central Luzon popular for tourism are Subic and Clark which underwent significant transformation after the US Naval Bases were removed in the 1990s. Roads to Manila have much improved making access and transport of commuters, goods and services to and from Central Luzon much more efficient (PSA, 2019).


The proximity of the provinces in the CALABARZON region to the capital makes them just as accessible as Central Luzon. Laguna is also known for its international industrial park (LIIP), international research stations and the University of the Philippines Campus. Alongside Batangas, Quezon, and some parts of Cavite, Laguna thrives on tourism, and recreational activities. All these provides employment and has supported the region’s urbanization (National Economic Development Authority, 2015).


Urbanization has had several implications on standard of living. Given the employment opportunities that provides income, which in turn allows individuals better purchasing power for goods and services (i.e. education and recreation), ways and means of accessing food has also been transformed, with higher preference for energy-dense, and saturated fat foods over nutrient rich foods such as fruits and vegetables (The Economist Intelligence Unit, 2017). This transformation is not only within the individual but also involves changes in the environment they belong. The environment, an important component of the food system, can influence eating habits whether for the good of one’s health or otherwise.


Several factors come into play within the food system that may influence access and availability of food, and the impact it may have on society. The eating habits of Filipinos has changed as the Philippines aimed for reversal of the problem of undernutrition and making its citizens more food secure[1] (FNRI, 2013). With the upward trend of overweight and obesity, the country is now facing the double burden of malnutrition, whose consequence is just as costly as the problem of undernutrition. Although the prevalence rate of obesity in the Philippines is quite low at 5%, obesity will have a strong impact on the country’s economy because of the number of cases compared to its ASEAN neighbors. In terms of cost, obesity will take up .063% of the country’s GDP in terms of productivity, and about 0.48% in terms of healthcare cost (The Economist Intelligence Unit, 2017).


Alongside the problem of overnutrition, the Philippines is also dealing the with issues of Non-communicable diseases (NCDs) as a consequence of changing eating habits leading up to overweight and obesity. For the individual, NCDs such as diabetes mellitus, hypertension, and heart disease imposes personal cost incurred from medicines and hospitalization, apart from the loss in productivity and wages. In 2012, as much 181.5 billion pesos or 39% of the total health expenditure in 2012 was spent on NCDs, mostly out of pocket expenses. Cost of NCDs on the country’s economy as estimated by Castillo et al (2015) was 46 billion pesos annually, including 27 billion pesos spent for tobacco related diseases, 1 billion pesos lost in wages, and 18 billion pesos productivity losses due to premature deaths.


While the Filipinos are becoming more food secure, and the country moving towards a progressive economy, there is a looming threat to achieving “strongly-rooted, comfortable, and secure life for all Filipinos (matatag, maginhawa, at panatag na buhay)”[2]. Should Filipinos have “maginhawa and panatag na buhay”, they should also be “matatag”.


The Food system


The term “food system” is generally used in one of three ways (Center for Food Policy, 2019):


• The Food System: the interconnected system of everything and everybody that influences, and is influenced by, the activities involved in bringing food from farm to fork and beyond.


• A Food System: the food system in a specific locality or context.


• Food Systems: The totality of different types of food system in different localities and contexts (i.e. multiple forms of “a food system”). This idea of multiple food systems acknowledges the huge diversity of food systems at different scales with differing characteristics. For example, industrial systems at a global scale and alternative systems at a local scale.



The Filipino is becoming more food secure allowing them a more diverse diet that may also have contributed to a shift away from their traditional diets.


This change in food habits and eating patterns is largely dictated by the food system. In recent years, studies have shown some alterations in the food system.


Changes in Food System Alters Food Habits and Eating Patterns


Climate Change: climate change and changes in the environment affects the global ecology and quality of life, in particular, use of arable land that may influence migration and population in certain areas (Raiten, 2019).


Effect of Climate and Environmental Change on Agriculture:


1. Fisheries: with the rising water temperatures, and ocean acidification and habitat destruction, rising CO2 affecting the quality and quantity of fish for human consumption. This will drive consumers towards alternative protein food sources such as red meats and possibly processed protein foods.


2. Plants food sources: changing temperatures, floods and droughts, may destroy food crops and increase greenhouse gas emissions, affect yield. Rising atmospheric levels lowers Affects nutritional value of crop specifically grains and pulses where found to have lower concentrations of protein and essential nutrients such as iron and zinc. Elevated CO2 concentration lowered protein concentrations in rice (7.6%), wheat (7.8%) and barley (14.1%). Projections reveal that additional 148 million people will be at risk of protein deficiency by 2050, and further reductions in iron and zinc in grains and legumes.


3. Animal food source: animals reduce their intake by as much 25% to 30% in response to high temperature. This affects quality of livestock used for food by humans. However, animal agriculture produces methane which contributes to 14.5% of world’s anthropogenic GHGE.

4. Biodiversity: CEC affects food yields by loss of pollinators due to loss of their food species, and or timing of available pollination needs of cultivated crops (crop loss, nothing to pollinate). CEC affects soil microbial ecology affects the food system (health component of the food system). CEC increases exposes humans to animal borne pathogens. Changes in diversity in animal and human gut increases susceptibility to infection (in animals) and non-communicable diseases (NCDs) in humans. Causes shifts in dietary patterns due to change in dietary quality or nutrition transitions from traditional dietary patterns.


Trade: Diets, even in the poorest countries, are increasingly affected by the growing global nature of food trade and trade-related industries. Globalization can act to increase resilience by allowing deficits in one region to be met by others but it can also decrease resilience by propagating systemic shocks. But globalization may also have helped to drive the obesity epidemic by making it easier for consumers to make low quality diet choices (Global Panel on Agriculture and Food Systems for Nutrition, 2016). Globalization has also opened doors for investment of multinational fast foods in middle income countries. It has also made processed foods more available in developing countries, making them more accessible and influencing consumption of more processed foods, meats, and dairy thus contributing to the rising incidence of obesity (Kearney, 2010).


Urbanization: improved infrastructure and better transportation encourages multinational supermarkets to invest, making them more accessible to suppliers thus facilitating trade and shift in consumption patterns. Establishments of fast food chains have also become a sign of urbanization. With more sedentary and low physical activity type of employment in urban areas, fast food chains have sieged the need for convenience by the working class5. This combination of sedentary lifestyle and shift to high calorie (usually from convenience foods) ultimately increases the risk of NCDs. The increasing trend of overweight reported in the NNS by the FNRI, was most prominent in three most urbanized regions of the country. The same region was reported by Rufino to have higher rate of food away from home.


Food Prices: There has been an uneven trend in the price of food products with meats and staples becoming more affordable to Filipinos compared to fruits and vegetables. While plant food sources become more expensive, consumers will veer towards cheaper foods such as processed convenience foods and fast foods (Ecker, 2019). With cereals such as maize being used as feeds for livestock, price of pork and beef have not shown drastic increase because cereals have become cheaper due to increased in production. On the other hand, vegetable have become more expensive because of scale of production, its perish-ability as well cost of inputs follow an increasing trend.


Income: while increase in income has led to a shift in a more diverse diet and better access to health care, it has also paved the away from traditional diets to carbohydrate dense food, as well as a higher meat and fat intake. Globally, in particular true for low, middle income countries (LMICs) such as the Philippines, positive growth in terms of GDP was observed to correlate with increase in annual calorie and animal food source per capita (Ecker, 2019).


Trends in food purchasing among Filipino consumers


Vegetables are a hassle


The Food and Nutrition Research Institute’s NNS has consistently showed over time increased consumption of fats and oils, meat and meat products, poultry, milk and milk products, and miscellaneous food items (FNRI, 2008) (FNRI, 2013). In 2003, Pedro et al reported that processed meat products represented nearly 30 percent of meat intake of Filipinos. This may be attributed to increased consumption of fast food.


While consumption of meats and fats and oils is an indication of improved dietary quality due to improvement in income, consumption of green leafy and yellow vegetables has remained the same since 1987 while intake of other vegetables increased by only 4 g (Pedro). The Philippines ranks 94th out of 160 countries in terms of vegetable consumption. Neighboring countries such as Taiwan, Vietnam, and even China, consume twice as much as the Philippines[3].


Barriers to fruit and vegetable consumption among Filipino Adolescents (Gonzales, 2016):


1. Lack of availability in school canteens and cafeteria

2. Lack of availability in the home

3. Preference over other snack items (chips, candy, pastries, soda, and high fat and high sugar food items)

4. Cost (too expensive)

5. Aversion for taste

6. Perishable (easily spoiled)

7. Preparation time (chopping and slicing, cooking time)

Col. Sanders, the clown, and the bumblee


In 2000, there were 2000 national and multinational fast food chains operating in the Philippines with 60 million regular patrons. At that time, the total population of the Philippines was 75.33 million[4]. Respondents in a survey conducted with college level students in Dagupan, Panggasinan indicated that introduction to fast food was as early as the age of 5 yrs old. The Philippines is in the verge of “Jollibesity” epidemic, driven by quick service and western style nutritional regiments (Matejowsky, 2009).


Features of fast food chains according to T. Matejowsky:


1. Fast food companies are not required to provide nutritional information therefore, consumers are not aware of the nutritional qualities. According to T. Matejowsky, 38.8% of Filipino subjects in the study perceive fast food as “good for you” with 43.8% consider fast food as neither good nor bad. Only 6% perceive fast food as “bad for you”.

2. Aggressive marketing and indigenization of corporate fast food standardized menu and service format to accommodate local taste and preferences (far reaching influence).

3. Multinational fast food brands as an indicator of social status, material affluence, modern taste.

4. American style fast food was perceived as superior quality since it was “scientifically” designed (i.e. kitchen technology, pre-cooked ready-made servings, while traditional cooking style appear to be quaint)


Respondents from the Dagupan survey claimed the following advantages of fast food:


• Scientifically standardized preparation over traditional cuisine

• Because of scientifically developed, more consideration for hygiene and safety

• Marketing and advertising


Over all, food service has become more lucrative because Filipinos tend to eat out or prefer food away from home more than they did a generation ago. The Nielsen Shopper Trends Report reveals a 13% decline in monthly grocery spending of Filipino respondents in 2014 compared to 2012. From a monthly spending of P5,400 in 2012, Filipino shoppers only spent P4,700 on average in 2014 (Gavilan, 2014). This trend in grocery shopping implies that Filipinos are not preparing their food at home as much, thus, eating less at home. Because convenience has become a top priority when it comes to meals and food in general, it has become easier to eat at a fast food or at a restaurant that might offer something similar to home cooked food at a low cost without the hassle of preparation. However, restaurants are offering bigger portion sizes that almost replicates the supersize meals in the US. A consumer may hesitate to leave left over food and decide to consume whole dish to avoid wastage and to get their money’s worth. Thirty years ago, Saisaki started the trend of buffet service of Japanese cuisine offering “eat all you can” sushi and sashimi at a fixed price. Other restaurants followed the trend, offering Filipino and western cuisine that included mostly pork and beef dishes, as well as unlimited offerings of rice. Even vegetable dishes would have some pork or meat added to it. Considering that sushi nor sashimi would not pass as a “real meal” for Filipinos, unlimited rice and a buffet of pork and beef dishes would be more enticing. However, an “eat all you can” type of service of a typical Filipino dish (rice and meat) is a diversion from a “normal” or a recommended portion size.


The 3 o’clock habit


Adair and Popkin (2005) study showed that similar to the US, youth from the Cebu Longitudinal Health Study (CLNHS) consumed about 40% of their daily calories, and most of their snack from food prepared away from home. Snacks were 18% of their daily calories and came in the form of baked rolls, soft drinks from small stores while meals were purchased from street vendors or cafeterias, usually comprised of fried food, rice and vegetables (Adair, 2005).


According to a Neilsen report in 2014[5], Filipinos rely on their snacks as source of nutrition. Respondent in the Dagupan study consumed fast food for merienda in the afternoon, a common practice among Filipinos. In the CLNH follow up study, youth subject consumed more snacks than their counterparts in other countries such as China but more similar with the US (Adair, 2005). But the type of food consumed may differ and may not necessarily fast food.


Softdrink is a common accompaniment of a typical merienda or snack and is part of the daily liquid consumption. Softdrink intake among children and adolescent has increased and has shown positive association with higher BMI. While children and adolescents are taking in more softdrinks, they are also drinking less milk (FNRI, 2012).


From wet market to supermarket


The traditional/historical format of food retail (Romo, Digal, & Reardon, 2015):


1. Wet market:


· 📷stalls of fruits and vegetables, usually in an open area or under one roof.

· temporary set up (called a talipapa) or permanent (called a palengke).

· stand-alone or appended to a wholesale market. It may

· operate daily at fixed hours in urban areas, or weekly on particular days.

· may include fish, meat, or poultry depending on the region, city, or neighborhood.

· prices are open to bargaining

· shopping is vendor-administered, not self-service.

2. Sari-sari stores:


· the “mom and pop” stores in traditional retail systems in other countries.

· typically from tiny to small/ medium scale, single-owner, often run by a husband and wife and perhaps a family member or employee

· typically from tiny to small/ medium scale, single-owner, often run by a husband and wife and perhaps a family member or employee (fast-moving consumer goods such as detergents) or wet goods (produce, poultry, or meat)

· may deliver to homes, and may offer credit to some of their regular clientele (suki), areas provide credit only to a few select clients (Minten, Reardon, & Satrudhar, 2010).


3. Push carts or “kariton” or “manlalako”:


· typically have a perishable product, such as fresh produce or dairy products in limited assortment

· deliver to homes or station at a particular point and sell at certain hours (e.g. along the street high volume of pedestrians)

· a small cluster of push carts sell different specialties


4. Medium-sized stand-alone shops or traditional groceries:


· Another form of traditional retail usually located in residential neighborhood or other more accessible location. It has more to offer than a sari-sari store of a mom and pop shop but majority of its goods for sale would be packaged and processed foods. It also does not serve as the main source of food supplies but its set up is a smaller version of a supermarket.


In addition to the food retail described above, the weekend farmer’s market is another rich source of fresh goods. It is a “trendier” version of the wet market, usually located in more gentrified, if not, posh neighborhoods where young, health conscious professionals reside or hang out. Stall are located out doors, and vendors may or may not sell on a regular basis since space is dependent on availability. Farmer’s markets are also known for locally sourced fresh produce or locally produced dry goods.


Definition of modern food retail shop:

1. Self-service

2. Large is size or floor area (e.g. supermarket or hypermarket or warehouse store)

3. Selection of food items can be broad (SM hypermart), or it can be narrow such as a 7/11 (convenience store)

4. Assumed to have modernized procurement system, direct purchase from producers or suppliers with sophisticated inventory management practices (e.g. Walmart inventory system – see The World is Flat).

5. Different environment with air conditioning, electronic check out counters allows use of credit cards, and packaging.

6. “Cash and Carry” system combines both retail and wholesale


Distribution of cost of modern food retails such as the supermarket is described by Romo, Digal and Reardon as one third coming from the farm or source, one third for processing, and another one third in the retail segment which adds to the actual cost of food. Where and how the Filipino consumer acquires their food may influence their food choices. For example, food sold in a “sari-sari” store may be limited to packaged and processed foods, while the wet market may allow wider selection of fresh produce.


As communities are transformed into cities and become more urbanized, opening opportunities for modernized retail food markets offering quick access, convenience stores such as the 7/11, Alpha Marts, even the Select Shell Shops, will become an important source of food, if not, meals to the Filipino consumer. Neilsen Shopper Trends in 2015 reported that 29% of Filipino shoppers claimed that they visited convenience stores in a period of four weeks, an increase of 8% from 2012. Convenience stores are therefore offering more ready to eat (RTE) meals to cater to convenience and quick access (Neilsen, 2015).


“There’s an App for that”


Convenience is very important to the Filipino consumer especially when it comes to food. The food service business, especially the fast food chains, have catered to this need for convenience by providing home delivery service. Food delivery has advanced through the use of electronic Apps such as “DoorDash”, “Grubhub”, “Food Panda” etc. and allows the consumer to order with just a few taps on a smart phone at any time and from almost any location. Some delivery companies offer free delivery while some charge a minimal fee (Future Works Technologies, n.d.).


Aside from convenience, another attractive feature of food delivery Apps are images of food options from as many as 5000 restaurants, making the Big Mac look life-like, and the Chicken Joy almost within reach. Food delivery Apps links the Filipino consumer even closer to restaurants, and makes access to fast food, even faster.


While access and convenience are the main drivers of the modern day food delivery, it does not necessarily lead to healthy options. Unless the consumer or user of these Apps are conscious about the kind of food they eat, then they would probably be able to make appropriate choices when taking advantage of these services.


It is important to note that these food delivery Apps are only useful for ordering food but it does not serve to provide nutrition information and labels of food from the restaurants they link with.


Going back to basics for better eating habits and good health


Ideally, Filipinos would have better control over their diets if they prepared their own food at home. However, this would require time for menu planning, marketing and preparation or cooking, which have become a luxury especially among the working-class Filipinos. It seems that the only way one is able to go back to the basics of food preparation is to become unemployed, but then they won’t have money to buy food to cook.


A relatively new innovation to address the issue of convenience and accessibility is the meal kit system that is now becoming more popular in the US (Statista, 2019). With the meal kit, consumers may opt for home cooked food with proper nutrition labels. An example of this is the Blue Apron™[6] which allows the consumer to choose a couple of dishes from their menu. Depending on the consumer’s needs, they can choose a number of dishes packaged in a kit to be delivered to their home each week. The kit is composed of just the exact amount of each ingredient,[7]a step by step recipe with images of the raw ingredients, and dry ice to keep the ingredients fresh while in transit. Since all the ingredients are provided, the consumer is free from doing the marketing, and frees them from excessive purchasing of perishables that may lead to food waste. The dishes and recipes are easy to prepare, and on average requires about 20 minutes preparation time, mostly for chopping vegetables and seasoning the proteins. Meats, poultry and seafood are provided in reasonable serving portion and the right cut. However, some consumers are still not pleased with the cutting or chopping of vegetables, and claim that it is “too much work.”


While Filipinos are learning more about food from the farm to table, or even farm to fork, and are creating demand for organic vegetables, these can be expensive and may not be an option for an average consumer, perhaps, not even to farming households. Ironically, households who depend on fisheries and agriculture, are less food secure (FNRI, 2013). For lower income households, the easiest and probably the cheapest way to acquire food is to purchase packaged and processed foods from a “sari-store” such as instant noodles, a can of sardines, or in worst case scenario, soy sauce or fish sauce to go with rice. Therefore, changing food habits for different sectors of society may require different approach and strategies, that should suit the capability of the household.


Other interventions


The Food and Nutrition Research Institute developed a simple nutrition messages to help guide Filipinos to healthy eating and lifestyle. Tools such as the Pinggang Pinoy, Nutritional Guidelines for Filipinos, the Menu Calendar, etc are useful nutrition education tools if they are more accessible and visible to the public just as the big advertising billboards of Jollibee, McDonalds’ and Red Ribbon to name a few along EDSA.


Commuters along EDSA spend as long as two hours in traffic, looking at the same billboard ads for that long! What if they were seeing Pinggang Pinoy, and the list of Nutritional Guidelines for Filipinos instead of the big Ads of fast food chains? That would be enough time to brain wash commuters for better food choices. Luring the Filipino consumer towards healthy practices, especially in terms of food choices, the same way the food service requires money.


Several studies have been conducted on changing food habits to address the problem of obesity and The Economic Intelligence Unit (EIU) identified interventions that target food intake as having the most impact. These interventions include promoting diets with low glycemic index, low fat and low carbohydrate diets, reducing portion sizes, as well as taxing specific food items such as sweetened beverages (The Economist Intelligence Unit, 2017). Combining these diet strategies with promotion of physical activity was also effective.

Incorporating physical activity as part of diet strategy is also an effective intervention for the prevention of obesity.


Conclusion


Filipino consumers have better access to food especially with the country’s growing economy. Urbanization has played a vital role in changing lifestyle of Filipinos, and how they consume food. The changing environment, whether it is brought about by economic progress or climatic events, will dictate access and availability of food. As demand for food away from home increases, what should be accessible and available on the menu must provide proper nourishment to the consumer. Take away foods from non-fast foods do not require nutrition labelling. But it might be helpful to the consumer food service are required to provide nutrition information on their menus. Usually, just knowing the calories and not necessarily the nutrient, can influence a consumer on whether to select a particular food or not.

While nutrition education will play an important role in helping Filipinos make better food choices, professionals in the field of food and nutrition will also have to consider the issues within the environment that is shaping the food system. Restaurants, and fast foods, and other services that offer convenience will make up the food system and influence how food is produced and how it moves within the food chain.

Therefore, addressing eating habits of Filipinos, especially for the prevention of obesity or to solve the issue of hunger and under nutrition, will require collaborative effort from different sectors. It is widely acknowledged that the private sector can play a role in tackling the malnutrition problem. However, the nutrition community is very selective on who they work with, which may sometimes lead to missed opportunities. While big fast food companies are deemed culprits to poor diets, their Corporate Social Responsibility (CSR) may be useful partners in promoting good nutrition. Partnering with the private food corporations by piggy backing in their advertisements can also be used to disseminate information on proper food choices.


Understanding one’s environment, especially the profile of the food chain in a specific location, of an individual or a particular population can help professionals create a strategy in addressing the changing food habits and transforming it into better food selection practices that will lead to good health.


Five Strategies for Great Food Transformation (EAT Lancet Commission)


1. Seek international and national commitment to shift towards a healthy diet

· Increase consumption of fruits and vegetables, nuts, grains, seeds (plant based foods)

· Limit intake of animal source food

Make healthy foods more available, accessible, and affordable, improve food marketing, invest in public health information, sustainability education, implementing food based dietary guidelines, use health care to deliver dietary advise and interventions.

2. Reorient agricultural priorities from producing high quantities to producing healthy food

· Example: biofortification

3. Sustainably intensify food production to increase high quality outputs

· 75% reduction in yield gaps on current croplands

· Radial improvement in fertilizer and water use efficiency

· Recycling of Phosphorous

· Redistribution of global use of nitrogen and phosphorous

· Implement climate mitigation options (e.g. crop and feed management)

· Enhance biodiversity and agricultural systems

4. Strong and coordinated governance of land and oceans

· Implementation of zero expansion policy of new agricultural land into natural ecosystems and species rich forests

· Management policies for restoration and reforestation of degraded lands

· Establish international land use governance mechanism

· “Half Earth” strategy for biodiversity conservation

· Improve management of world’s oceans (e.g. efficient use of fish stock)

5. Halve food losses and waste, in line with UN Sustainable Development Goals (SDG)

· Substantial loss reduction in the production side

· Substantial loss of food waste at consumption side

· Improvement of post harvest infrastructure, transport, processing and packaging

· Increase collaboration along supply chain

· Training and equipping producers

· Educating consumers


Six steps to identify policy actions to achieve healthy diets (Global Panel on Agriculture and Food Systems for Nutrition, 2016)


STEP ONE: Set a clear diet quality objective

What is/are the diet quality gap/s that need to be addressed and who does it affect

STEP TWO: Engage with communities to explore perceptions of causes of the diet gap

What might be responsible for the diet gap from the perspective of the consumer? Availability? Affordability? Appeal? Or factors outside the food system?

STEP THREE: Review the role of food systems

If and what elements of food systems are responsible for the diet gaps from the local to the global level?

STEP FOUR: Identify actions for food systems solutions

What are available options in the food system for addressing the diet gaps?

STEP FIVE: Align actions to create coherence

What further actions are needed to align these options across the food system?

STEP SIX: Leverage actions for sustainability

How can these actions also be leveraged to improve food systems sustainability?


Works Cited


Adair, L. S. (2005). Are Child Eating Patterns Being Transformed Globally. Obesity Research, 1281-1299.


Castillo, E. N. (2015). The Status of Non-Communicable Disease Prevention and Control in the Philippines: A Systematic Review. ACTA MEDICA PHILIPPINA, 19-26.


Center for Food Policy. (2019). Understanding the food system: Why it matters for food policy. London: City, University of London.


Ecker, O. (2019). Reshaping Agriculture to Reduce Obesity. In S. Fan, S. Yosef, & R. Pandya-Lorch (Eds.), Agriculture for Improved Nutrition, Seizing the Momentum (pp. 81-92). Cab International.


FNRI. (2008). 7th National Nutrition Survey. Bicutan: Food Nutrition Research Institute.


FNRI. (2012). 2012 Annual Report. Bicutan: Food and Nutrition Research Institute, Department of Science and Technology.


FNRI. (2013). 8th National Nutrition Survey. Bicutan: Food Nutrition Research Institute.


Gavilan, J. (2014, October 22). Nielsen: More Filipinos choose to dine out than make own meals. Manila, Philippines. Retrieved from https://www.rappler.com/move-ph/issues/hunger/72785-2014-nielsen-shoppers-trend-report


Global Panel on Agriculture and Food Systems for Nutrition. (2016). Food systems and diets: Facing the challenges of the 21st century. UK, London.


Gonzales, J. T. (2016). Consumption Pattern for Fruits and Vegetables of Some Filipino Adolescents in Selected Public Schools in the City of Manila. J Nutr Disorders Ther , 6:202.


https://www.helgilibrary.com/indicators/vegetable-consumption-per-capita/philippines/. (n.d.).


https://www.nielsen.com/ph/en/insights/report/2014/filipino-consumers-love-a-good-snack/# . (n.d.).


Kearney, J. (2010). Food consumption trends and drivers. Phil. Trans. R. Soc. B, 2793–2807.


Matejowsky, T. (2009). Fast Food and Nutritional Perceptions in the Age of "Globesity": Perspectives from the Provincial Philippines . Food and Foodways, 29-49.


Minten, B., Reardon, T., & Satrudhar, R. (2010). Food Prices and Modern Retail: The Case of Delhi. . World Development , 1775-1787.


National Economic Development Authority. (2015). http://calabarzon.neda.gov.ph

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Neilsen. (2015, June 25). https://www.nielsen.com/ph/en/insights/article/2015/convenience-is-key-to-appealing-to-busy-filipinos/. Retrieved from


Pedro, M. B. (n.d.). Dietary changes and their health implications in the Philippines.


PSA. (2019, August). NCR profile. Retrieved from Department of Trade and Industry, Republic of the Philippines : https://dti.gov.ph/regions/ncr/ncr-profile-of-region


Raiten, D. J. (2019). Nutritional Ecology: Understanding the intersection of climate chenge/environmental change, food systems and health. In S. Fan, S. Yosef, & R. Pandya-Lorch (Eds.), Agriculture for Improved Nutrition (pp. 68-80). Boston: Cab International.


Romo, G. D., Digal, L., & Reardon, T. (2015). The Transformation of Food Retail in the Philippines. Asian Journal of Agriculture and Development, 51-84.


Rufino, C. C. (2017, March 2-4). The Pattern of Consumption for Food Away From Home (FAFH) of Filipino Households during the Modern Era. Manila, Philippines.



The Economist Intelligence Unit. (2017). Tackling obesity in ASEAN Prevalence, impact, and guidance on interventions. London: The Economist.

[1] Note: 2013 to 2015 there was a slight decrease in food secure Filipinos, may be attributed to strong calamities in 2013 (earthquake in Bohol, and Yolanda in Leyte and Bohol).


[2] Rational and legal basis of the Philippines Development Plan 2017 to 2022.


[3] https://www.helgilibrary.com/indicators/vegetable-consumption-per-capita/philippines/



[5] (https://www.nielsen.com/ph/en/insights/report/2014/filipino-consumers-love-a-good-snack/# , n.d.)


[6] https://www.blueapron.com/


[7] Blue Apron includes all the ingredients except for cooking oil, salt and pepper.

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