Nutritional issues and status of older persons of the Philippines: the IUNS, CRONOS and other studies.

The growing proportion of older persons in the Philippine population, with their potential contribution to development efforts as well as special needs for health and social services, presents an emerging demographic concern. The Philippines participated in the IUNS multicenter cross-cultural study of "Food Habits in Later Life" among urban elderly in three different care settings - elderly who lived with their families, those housed in government-operated homes for the aged, and older persons in private institutions. A second study employed the CRONOS protocol to differentiate nutritional and non-nutritional factors that affect the health and nutritional status of the Filipino elderly in urban and rural settings. Findings from the two studies revealed deficiencies in energy and protein intake among older persons. Those cared for by government social workers and care-givers had lowest protein-energy intakes and the highest proportion of underweight. Food habits of the urban elderly, particularly in terms of meal pattern, and use of table salt, sugar and fats were reported in the IUNS study. There was general perception of tiredness and limited social activity, network and support, but over-all self-rating of the elderly's health was good. The CRONOS study found significant association between later life status indicators, as well as between BMI and illness and physical activity scores. The paper included data from the 1993 National Nutrition Survey describing the nutritional situation of the elderly on a national scale: 30% of Filipino adults aged 60 y and over had a BMI <18.5 kg/m2 indicating chronic energy deficiency, 11% were obese with BMI >or=25 kg/m2, 41% were hypertensive and 45% anemic. Caring patterns were reflected in a 1984 four-country ASEAN study on the elderly which included the Philippines. While favorable, as the Filipino elderly generally lived in households where there was at least one adult female, the presence of other household members who likely competed for the time of the carer diminished the quality and adequacy of care for the persons. Further data is needed to update this information. The paper also discussed methodological and programmatic issues regarding improvement of the nutritional assessment of, and nutritional intervention programmes for the elderly.