Interactions among micronutrient deficiencies and undernutrition in the Philippines

Data gathered from the 1987 National Nutrition Survey in the Philippines provided the opportunity to study the interactions among micronutrient deficiencies and undernutrition in different age groups as a basis for program targeting. A randomly selected subset of 50% of the households (3,200) covered by the national survey served as source of subjects. Results showed that there was a greater proportion of anaemia among the undernourished (as judged by weight -for-age in children and weight-for-height in adults (66.0%) than among the adequately nourished (54.6%) alpha=0.01). However, the observed differences in the proportion of serum vitamin A deficiency and of goitre among the undernourished compared to the adequately nourished were not significant. Also not significant were the observed higher- prevalence of anaemia among subjects with acceptable serum vitamin A levels for both adequately nourished and undernourished, and the higher prevalence of vitamin A deficiency among the non-anaemic. Again there were no significant difference in the prevalence of anaemia among goitrous and non-goitrous subjects, as well as the prevalence of goitre among anaemic and non-anaemic subjects. Neither were there significant differences in the prevalence of vitamin A deficiency among goitrous and non goitrous subjects, but there were significant differences in the prevalence of goitre among vitamin A deficient and non-vitamin A deficient subjects among the 7-14 year olds and among pregnant and lactating women. The study concludes that at the national level there is apparently an interaction between anaemia and protein-energy undernutrition and possibly also between goitre and vitamin A deficiency in the high risk age groups, but not between anaemia on the one hand and goitre and vitamin A deficiency in another, perhaps because of clustering in the latter conditions not found in anaemia and general undernutrition. These findings may be useful in targeting communities with high prevalence of micronutrient deficiencies by using prevalence of underweight and goitre as indicators for high prevalence of anaemia and vitamin A deficiency, respectively.