ARTICLE

Sociodemographic factors
associated with nutrient intake of
women living in urban areas
Cecile Leah T. Bayaga*1, Yasmin Janina A. Serrano1, Marietoni B. Pico1,
Demetria C. Bongga1, and Alonzo A. Gabriel2

1Breastmilk Research Laboratory, Department of Food Science and Nutrition, College of Home
Economics, University of the Philippines, Diliman, Quezon City
2Laboratory of Food Microbiology and Hygiene, Department of Food Science and Nutrition, College of
Home Economics, Diliman, Quezon City

well-nourished woman is able to perform intervention programs as well as in effectively implementing

A satisfactorily domestic and reproductive functions.

In the family, she most often provides order and
discipline to the household. Women also spend
more than half of their lives in reproductive years.
Thus, they deserve special considerations in policies and
intervention programs for food security. This study looked into
existing ones.

KEYWORDS

food security, socio-demographic factors, nutrient intake,

the association between socio-demographic factors (age, parity, pregnancy, lactation, women
household size, frequency of eating outside of home per month
and frequency of meals per day) and nutrient intake of selected
Filipino women living in urban areas. A total of 73 women (28 INTRODUCTION
non-pregnant, 22 pregnant, and 23 lactating), living in Metro
Manila, Philippines participated in the study. Three Worldwide, poor diet quality is a key reason for mortality and
questionnaires (Food Habits Questionnaire, Family disability. This increases the risk for underweight, overweight
Composition Questionnaire, and 24- hour food recall) were used and non-communicable chronic diseases (NCDs) which have
to gather data on the socio-demographic characteristics and been identified as a global priority (Imamura et al. 2015).
usual food intake. The nutrient contents of the recalled food Outcomes of maternal undernutrition may have an impact on
items were computed using the values on the Philippine Food economic productivity of the household and also susceptibility
Composition Table. Backward multiple linear regression to NCDs such as cardiovascular disease and diabetes (Victoria
showed that frequency of meals per day significantly affects et al. 2008; Rothman et al. 2019).
caloric, carbohydrate, protein, and most micronutrient intake of
lactating, and women in general. On the other hand, eating out Women play a major role in the economic productivity of their
affects caloric, carbohydrate, protein, and a few of the families and human reproduction. Majority of women are
micronutrient intake among pregnant women. The findings of involved in production, marketing, processing, preparation, and
the study may provide useful insights for formulating relevant intra-household distribution (Chatterjee 1989). Women also
policies or guidelines on women’s nutrition and food security have essential roles in society as child bearers and caregivers.
There is also an increasing number of female-headed households
worldwide. Women spend approximately half of their lives
bearing, nourishing, and caring for a child, which take a heavy
*Corresponding author toll on their own nutritional well-being during these years
Email Address: [email protected] (Dunnerram and Jeewon 2015).
Date received: September 13, 2019
Date revised: March 17, 2020 Mothers have increased nutrient and energy requirements during
Date accepted: April 7, 2020 pregnancy to support the proper growth and development of the
fetus. A pregnant woman with insufficient energy and nutrient

34 Philippine Science Letters Vol. 13 | No. 01 | 2020

intake is more likely to deliver a low birth weight baby who is
at a higher risk of death or illness throughout infancy. Some
malnourished young children who may survive are likely to
remain shorter than their peers and often are susceptible to
illness in their growing years (Elder and Ransom 2003; Negrato
and Gomes 2013). Hence, relevant studies are needed to guide
interventions focused on alleviating food insecurity to improve
maternal nutrition (Johnson et al. 2018; Ivers and Cullen 2011).
A previous study (Wibowo et al. 2015) concluded that unequal
intra-household food distribution that discriminates against
mother and children increases the risk of dual forms of
malnutrition on these vulnerable household members.

During lactation, the mother needs more energy and nutrients to

produce the needed volume of breast milk, improve breast milk
quality, and maintain maternal nutrient stores (Joshi and
Kulshrestha 2018). Specifically, lactating mothers need
additional 500 kcal, 27 g in protein, 2 mg in iron, 400 µg RE in
Vitamin A, 0.2 mg Vitamin B1, 0.6 mg Vitamin B2, 4 mg
Vitamin B3, and 35 mg Vitamin C daily (PDRI 2015).
Furthermore, according to UNICEF (2013), the Philippines
ranks 5th with the greatest number of low birth weight infants
worldwide. The recent national nutrition survey (2016) of the
Department of Science and Technology, Food and Nutrition
Research Institute (DOST-FNRI) reported that 20.1% of
pregnant women were nutritionally at-risk, while another 11%
of lactating mothers were undernourished. If these trends
continue, the country’s economy will also be compromised
because the children of these vulnerable mothers are the
country’s future work force (Rodriguez 2014). Hence,
identifying factors that may affect the nutrient intake of women
may provide useful information toward efforts to improve the
nutrition of women especially those in their reproductive age.

There are different factors that may affect the food and nutrient
intake of a target population. Some of the studies reported the
significant influence of personal, cultural, social, economic, and
socio-demographic factors. A study conducted by Llanaj et al. Figure 1: Markers show the study sites where data were obtained
(2018), assessed the patterns of food intake and eating out of including the cities of Makati, Mandaluyong, and Taguig. The
location of the laboratory where the study was based (Quezon City) is
homes by university students. Another study examined the role also marked.
of the frequency of eating on total energy intake and diet quality
in low-income, racially diverse sample of schoolchildren (Evans
et al. 2015). Associations between eating frequency and energy of the NCR where most of the inhabitants are engaged in
intake, energy density, diet quality and body weight status in nonagricultural jobs. NCR is home to more than 10% of the
American adults was also studied (Zhu and Hollis 2016). In the Philippine population and residents come from all geographic
study of Joshi and Kulshrestha (2018), cultural beliefs, social areas of the country. All three cities have dense concentration
and family influences were the factors considered to affect food of infrastructures such as houses, commercial buildings, roads,
choices of lactating women in Kumaon Region of Uttarakhand bridges, and railways.
in India. The study has shown that majority of the urban- and
rural-based respondents avoided certain food items due to the Study Design
belief that these food items have negative effect on their children, This is a cross-sectional study conducted as a part of a larger
thus causing a decrease in the caloric intake of these lactating semi-longitudinal study that aims to establish the effect of
women. However, there are limited studies on the effect of maternal dietary intake on the microbiological and
socio-demographic factors on the nutrient intake of women physicochemical characteristics of breast milk.
especially in their reproductive years. This present study aimed
to determine the socio-demographic factors that affect the Study Participants
nutrient intake of Filipino women living in urban areas. These Women who (a) were 18-55 years old; (b) apparently healthy,
include age, parity, household size, frequency of eating outside who do not suffer from any acute or chronic diseases; (c) did not
of home every month, and meal frequency per day. use antibiotic within the last 3 months; (d) did not take
medication except for contraceptive pill; and (e) were not on a
MATERIALS AND METHODS restrictive diet or undergoing treatment, were screened as
potential participants. In addition, those who were lactating
Study Sites should be breastfeeding for more than 11 months; while those
The cities of Makati, Mandaluyong, and Taguig in the National who were pregnant should be in their third trimester of
Capital Region (NCR) of the Philippines have been chosen as pregnancy. A total of eighty (80) women were finally invited to
the study sites (Figure 1). These cities were chosen because they participate in the study. The test population who completed the
implement organized nutrition consultation systems which data collection phase consisted of 23 lactating, 22 pregnant, and
allowed for regular home visits and monitoring of participants. 28 women who were neither pregnant nor lactating. There were
All study areas chosen were from urbanized, commercial cities eight mothers who dropped out due to schedule conflicts with

Vol. 13 | No. 01 | 2020 Philippine Science Letters 35

the face-to-face interviews and food recalls administration. All estimates of nutrient intakes to be used for planning and
study participants that were invited to participate were randomly assessing diets for healthy people. They include both
selected from the clients who consulted at the barangay health recommended intakes and tolerable upper intake level as
centers from October to mid-December 2016. reference values. The DRIs include the concept of
Recommended Dietary Allowance (RDA) which reflect the
In addition to the aforementioned inclusion criteria, participants average daily dietary intake level that is sufficient to meet the
recruited belonged to low- to middle- income families. Based on nutrient requirement of nearly all (97 to 98%) healthy
the 2015 Family Income and Expenditure Survey, 37% of the individuals in a group (Institute of Medicine 1998).
country’s population belonged to the lower income class while
26% fall within the lower middle-income class. Considering Statistical Analysis
these facts, the study deemed it appropriate to represent the Descriptive statistics were used to summarize the socio-
majority of individuals belonging to these income classes. The demographic characteristics, food habits, and nutrient intakes of
results generated could then be applicable not just for the target the participants. Backward multiple linear regressions using
participants but also to other urban poor areas. Further, the IBM SPSS ver. 23 were conducted to determine which among
participants included in the study were classified as low- to the socio-demographic factors significantly affected the specific
middle-income class using an arbitrary index set by the research nutrient intake of the participants. The independent socio-
team. Participants were considered to belong to the low-income demographic factors namely, age, parity, household size,
class if their combined utilities bill (electricity and water) was frequency of eating out every month, and frequency of meals per
below Php 2,000.00. Participants with combined utilities bill day were correlated with the values of the participants’ energy,
amounting to or more than Php 2,000.00 were classified as the macronutrients, and micronutrients intake.
middle-class income group.
Ethics Clearance
Dietary Data Collection All participants involved in this study gave a written informed
All data were collected using a face-to-face interview, consent to the protocol which was approved by the Far Eastern
conducted by two trained, registered nutritionist-dietitians. The University-Nicanor Reyes Memorial Foundation (FEU-NRMF)
questionnaires used to gather dietary and socioeconomic data Institutional Ethics Review Committee, Diliman, Quezon City
were the food habits survey, family composition questionnaires, (Reference # FEU-NRMF IERC 2016-0114).
and the 24-hour food recall form. The food habits survey
questionnaire was patterned after survey questionnaires (Moore
2017; Cancer Prevention and Control Research Network 2017) RESULTS
and adopted for use in this study in consultation with two
Nutrition and Food Science experts after pre-testing. This Table 1: Socio-demographic characteristics of selected Filipino
questionnaire aimed to obtain general knowledge on the women
common dietary practices of the participant such as frequency Characteristics All
of meals per day, common food items eaten per day, and number (n=73)
of times she eats out of home. It also included basic socio- Age (years SD) 30.36 7.88
demographic data on age, parity, civil status, and breastfeeding
practice, when applicable. The family composition Household size (mean SD) 5.42 2.51
questionnaire gathered information on the gender, educational
Female : Male ratio 2.79 : 2.62
attainment, and occupation of each household member to
determine the characteristics and size of the participants’ Occupation
households. Housewife 48 (65.75%)
Self-employed 6 (8.22%)
The three 24-hour food recalls were taken on two weekdays and
one weekend and were collected in a span of one month. This Employed (fulltime) 19 (26.03%)
was used to determine the usual food intake of the participants. Civil Status
Before the interview, the respondent was asked if the previous Married 33 (45.21%)
day’s food intake typifies the usual diet. The participants were Cohabitation 37 (50.68%)
asked to identify and quantify (in terms of household servings) Single 3 (4.11%)
all the food items they consumed for the past 24 hours, including No. of children
water or any beverage. To assist participants in estimating the 0 9 (12.33%)
actual portions or amounts consumed, participants were shown 1–3 51 (69.86%)
common household measuring utensils (e.g. cup, tablespoon,
4–6 12 (16.44%)
teaspoon, ruler, and thickness pads).
>6 1 (1.40%)
The calorie and nutrient content of the recalled food items was Parity (years SD) 2.32 1.44
computed using the values on the Philippine Food Composition
Pregnant participants 22 (30.14%)
Table (FCT) published by the Department of Science and
Technology, Food and Nutrition Research Institute (1997). The Lactating participants 23 (31.51%)
edible portions, in grams, of the food and drinks consumed were
determined and these weights were used to calculate the nutrient Non-pregnant and non-lactating 28 (38.36%)
content. The nutrients listed in the FCT are expressed per 100g participants
edible portion. The nutrients computed included carbohydrates,
protein, and fat, and micronutrients (i.e. calcium, phosphorus, Study Population Profile
iron, Vitamins A, B1, B2, B3, and C). The average nutrient Table 1 shows the socio-demographic characteristics of all the
intakes of the participants for the three recalls were then used to participants and per physiological status. The mean age of the
represent the participant’s usual intake. The average values participants was 30.36 years while parity was 2.32 years. All
obtained were then used as bases to calculate the % Philippine participants have an average of 5 household members with
Dietary Reference Intakes (PDRI) met. Dietary Reference comparable numbers of male and female in the household.
Intakes (DRIs) are reference values that are quantitative Majority of the mothers were unemployed (65.75%) while some

36 Philippine Science Letters Vol. 13 | No. 01 | 2020

were employed full-time (26.03%). Among the participants, Table 2: Food habit characteristics of selected Filipino women
4.11% were single and the rest were living with their partners or Characteristics All
husbands. Majority of the mothers have 1 to 3 children. There (n=73)
were twenty-two pregnant mothers in their third trimester Frequency of eating out per month 2.33 1.71
(30.14%) and twenty-three lactating mothers (31.51%) who
participated in the study, while the rest were non-pregnant, non- Meal frequency per day 4.32 1.00
lactating healthy mothers.
Usual cooking method at home
Table 2 shows the result of the food habits questionnaire. All Frying 9 (12.33%)
women, regardless of their physiological status eats out twice a
Sautéing 13 (17.81%)
month and eats an average of 4 meals per day. The usual cooking
method used at home for all women is boiling or stewing. Boiling 51 (69.86%)

Table 3: Energy and nutrient intake of selected Filipino women1

Pregnant Lactating Non-P/L women All
Nutrient

(n = 22) (n = 23) (n = 28) (n=73)

Mean SD
Energy (kcal) 2361.85 596.79b 3160.89 1227.35a 2252.33 867.15b 2577.64 1281.32
Protein (g) 74.35 19.86b 95.24 37.14a 67.20 27.36b 78.40 39.32
Fat (g) 63.77 27.01b 80.31  39.52a 56.23 24.19b 66.27 49.34
Carbohydrates (g) 386.33 108.68b 514.19 196.21a 369.63 157.22b 421.12 209.83
Calcium (mg) 770.76 345.86ab 958.77 649.70a 625.12 395.88b 776.68 693.73
Phosphorus (mg) 1096.64 361.18b 1324.09 568.35a 925.01 403.26b 1105.65 608.02
Iron (mg) 18.62 15.69ab 21.19 10.12a 14.72 6.65b 17.99 17.55
Total Vitamin (RE) (g) 1036.58 1733.35a 1000.86 1418.19a 645.60 560.61a 878.50 2107.87
Thiamin (mg) 1.23 1.23c 1.52 0.80a 0.88 0.37b 1.19 0.87
Riboflavin (mg) 1.78 1.44a 1.76 1.01a 0.99 0.43b 1.48 1.56
Niacin (mg) 20.47 5.43a 24.37 13.43a 22.17 23.86a 22.42 18.35
Ascorbic acid(mg) 67.01 64.59a 79.70 146.22a 65.09 65.43a 70.29 151.98
1
Values are means of 3 24-hour food recalls.
abc
Values in the same row bearing different letters are significantly different at p < 0.05

Nutrient Intakes of the Study Population Table 4: Actual energy and nutrient intake of selected women as
Table 3 shows the actual nutrient intake of the participants. percentage of Philippine Dietary Reference Intakes (%PDRI)
Based on the 2015 Philippine Dietary Reference Intakes (PDRI) Pregnant Lactating Non-P/L
(FNRI-DOST 2015), the lactating participants were able to meet Nutrient (n = 22) (n = 23) women
the recommended intakes except for Vitamin C and iron (Table (n = 28)
4). For the pregnant participants, their intakes of protein, %PDRI
calcium, iron, and Vitamin C intakes failed to meet 100% of
Energy 105.87 130.08 116.70
their recommended intakes based on the 2015 PDRI. Non-
pregnant, non-lactating participants were also able to meet the Protein 85.46 107.01 108.39
recommended intakes except for iron. Comparing the nutrient Calcium 96.25 127.84 83.35
intakes of the three groups, the table also shows significantly
Phosphorus 156.57 189.14 132.14
different caloric, protein, fat, carbohydrates, calcium,
phosphorus, thiamin, and riboflavin intakes, with the lactating Iron 49.00 70.63 52.57
participants having higher nutrient intakes in terms of Total Vitamin A 115.18 100.09 107.60
kilocalories and macronutrients compared to the non-lactating Thiamin 87.86 116.92 80.00
participants. Generally, all participants were able to meet their
recommended nutrient intake except for iron, which was only at Riboflavin 98.89 103.53 90.00
about 50% of the recommended intake. Niacin 113.72 135.39 158.36

Factors Affecting Nutrient Intakes of the Participants Ascorbic acid 95.73 83.89 108.48
Table 5 shows that among all the socio-economic factors
investigated, only the frequency of eating outside of home (X5) per day decreases her fat intake significantly. For the lactating
significantly affected energy, carbohydrate, and protein intake, participants, frequency of meals per day positively affected
while frequency of meals per day (X4) negatively influences fat energy, carbohydrates, and protein intake. Meanwhile,
intake at 95% level of significance for the pregnant participants. household size (X2) had a negative correlation and significantly
This means that the more often a pregnant woman eats outside affected energy, carbohydrate, and protein intake, which means
her home, her energy, carbohydrate, and protein intake also that as the household size increases, there is a significant
increases significantly, while increasing the frequency of meals decrease in the intake of the said nutrients. Non-pregnant, non-

Vol. 13 | No. 01 | 2020 Philippine Science Letters 37

Table 5: Factors influencing energy and macronutrients intake of selected Filipino women
Energy and Pregnant Lactating Non-P/L women All

Nutrients (n=22) (n=23) (n=28) (n=73)

Regression Equation P value Regression P value Regression P value Regression P value

Equation Equation Equation

Kilocalories y = 185.522x5 +1855.883 X5 = y=– X2 = - - y = 349.407x4 X4 =

0.010 364.603x2 0.015, X4 0.003
+675.338x4 = 0.004 +1063.880

+2016.489

Carbohydrates y = 28.725x5 +307.994 X5 = y = – 62.064x2 X2 = - - y = 64.012x4 X4 =

0.033 0.009, X4 0.001
+109.238x4 = 0.003 +143.994

+345.992

Protein y = 6.268x5 X5 = y = – 11.218x2 X2 = - - y = 12.107x4 X4 =

0.009 0.008, X4 0.001
+57.254 +16.896x4 = 0.012, +25.946

+5.755x5 X5 =
0.043
+63.830

Fat y = - 11.641x4 +112.977 X4 = - - y=- X1 = y = – 1.090x1 X1 =

0.067 1.067x1 0.056 0.021
+93.941 +99.173

x1 = age; x2 = household size; x3 = parity; x4 = frequency of eating in a day; x5 = frequency of eating out of home in a month

lactating participants’ caloric and macronutrient intakes, on the frequency of eating out of home also significantly increases
other hand, were not significantly affected by the identified Vitamins A, B1, and C.
socio-demographic factors. Considering all the participants as a
group, results showed that frequency of meals per day
significantly affects energy, carbohydrates and protein intake DISCUSSION
positively, while fat is negatively affected by age (X1).
The results of the present study showed that there were
In Table 6, the effect of the identified socio-demographic factors significant differences among the intakes of pregnant, lactating,
on the minerals namely Calcium, Phosphorus and Iron are and non-pregnant women. These can be attributed to different
shown. For the pregnant participants, age significantly increases factors that affect their diet such as knowledge, culture, beliefs,
Calcium intake, while frequency of eating outside of home socio-economic, and demographic factors. For this study, the
significantly increases both Calcium and Phosphorus intake. researchers focused on the socio-economic and demographic
Similarly, among the lactating participants, frequency of eating factors and the effect on the intakes of women of different
outside of home had a positive and significant (p< 0.05) effect physiological state. The participants were relatively
on the Calcium, Phosphorus and Iron intake, while household homogenous in terms of knowledge, culture, and beliefs as they
size had negative and significant (p< 0.05) effect on the intake all were from the low-to-medium income class, residing in
of these minerals. For the non-pregnant, non-lactating group, similar urban areas, and other characteristics stated in Tables 1
frequency of eating out is the sole factor with a positive and 2. In a study conducted by Shahid et al (2011), most
significant (p< 0.05) effect specifically on the Calcium intake. pregnant women are knowledgeable that they need more food
Considering all participants as a group, frequency of eating out during pregnancy, however, most pregnant women also have
is the only factor with a positive significant (p< 0.05) effect on food restrictions that they follow which leads to having limited
both Calcium and Phosphorus intake. food intake. According to Gluckman (2014), cultural beliefs and
practices often influence dietary intake of women during
Table 7 shows the effect of the identified socio-demographic pregnancy up to lactation. In a study conducted by Chakona and
factors on the vitamins (A, B1, B2, B3, and C) intake of the Shackleton (2019) 37% of the pregnant women who participated
participants. For the pregnant participants, frequency of eating in their study reported one or more food practices shaped by
out significantly increases both Vitamins B1 and B3 at p< 0.05. local cultural taboos or beliefs. Another study noted that
Comparably, for the lactating participants, frequency of eating different levels of household wealth index and the changing
out significantly increases Vitamins B1, B3 and C intake. Also, seasons, affect nutrient intakes (Cheng et al. 2009). A similar
frequency of meals per day significantly increases Vitamins A, study also found out that factors significantly related to healthy
B2 and B3 intake of lactating participants. In addition to the two nutritional practices included above primary school education
factors, household size has a positive significant (p< 0.05) effect and being in the 5th quintile of income level (Oh H-K et al.
on the intake of Vitamin B3. On the other hand, no socio- 2019). A study in Northwestern Ethiopia conducted by Nana
demographic factors identified in the study significantly affected and Zema (2018) showed that the husband’s income, ownership
the nutrient intake of non-pregnant, non-lactating participants. of radio, history of disease, and dietary knowledge have
Considering all participants, age was found to significantly significant association with dietary practices of pregnant women.
increase Vitamins B1 and B2 intake, frequency of meals per day, Additionally, a study by Acharya et al. (2018) observed that
significantly increase Vitamin B1, B2 and B3 intake, while women in the underserved population, which is similar to the
participants in this study, have poor knowledge and have strong

38 Philippine Science Letters Vol. 13 | No. 01 | 2020

Table 6: Factors influencing mineral intake of selected Filipino women
Energy and Pregnant Lactating Non-P/L women All
Nutrients (n=22) (n=23) (n=28) (n=73)
Regression P value Regression P value Regression P Regression P value
Equation Equation Equation value Equation
Calcium y = 26.269x1 X1 = 0.049, y=– X2 = 0.037, y= X4 = y = 198.598x4 X4 <
+74.588x5 X5 =0.088 163.911x2 X4 = 0.044, 158.894x4 0.035 -82.830 0.001
–133.570 +253.120x4 X5 = 0.059 –27.483
–102.810x5
+424.376
Phosphorus y = 29.828x1 X1= 0.027, y=– X2 = 0.008, y= X1 = y = 155.785x4 X4 =
+92.015x5 X5=0.038 164.104x2 X4 = 0.010, 58.375x1 0.080 +47.516x5 0.005,
+49.815 +255.799x4 X5 = 0.019 +624.793 +307.879 X5 =
+100.178x5 0.096
+784.812
Iron - - y=– X2 = 0.023, y = 0.986x2 X2 = y = 2.515x4 X4 =
2.513x2 X4 = 0.003, +9.648 0.073 +7.085 0.058
+5.544x4 X5 = 0.076
+1.342x5
+5.845
x1 = age; x2 = household size; x3 = parity; x4 = frequency of eating in a day; x5 = frequency of eating out of home in a month

cultural beliefs which serves as a barrier in their food and health- mother, and quantity and quality of breast milk. It was found that
seeking behaviors. The study by Acharya et al. (2018) was in this study, the limitations brought about the identified factors
similar to this current study as both observed the limitations in resulted in relatively poor food choices which potentially may
the capacity to provide more nutritionally adequate food to the cause detrimental health consequences. In the current study,
members of the household considering the identified barriers. participants were aware that they need to consume more foods
during pregnancy and lactation as they were told during the
Results of this study also showed that age significantly affects prenatal care in the local health centers, however, there are
fat, Vitamin B1, and Vitamin B2 of women in general. practices influenced by the beliefs of the elderly and more
Meanwhile, frequency of eating outside of home has a experienced mothers such as avoidance of certain food items and
significant effect on Vitamin A, B1, and C intakes, and meal limitation on the intake of specific food items, thus creating
frequency significantly affects a number of nutrients namely narrower spectrum for the food choices of the participants.
carbohydrate, protein, calcium, phosphorus, Vitamin B1 and
Vitamin B3. More than 50% of the calculated nutrients, as listed As for this study, results revealed that household size
in the 1997 Philippine Composition Table (FCT), are affected significantly affects energy, carbohydrate, protein, phosphorus,
by frequency of meals. A study conducted by Zhu and Hollis and iron intake of lactating women; and frequency of eating out
(2016), found that adults with higher eating frequency in the significantly affected protein, calcium, and phosphorus intake.
United States of America had a healthier diet and that there was A study conducted by Hundera et al. (2015) in Ethiopia noted
a positive association between eating frequency and energy that family size, income, and knowledge on foods also showed
intake. This is also supported by findings of a study conducted significant association with the nutritional status of lactating
by Aljuraiban et al. (2015) which showed that American and mothers. Another study by Pelto et al. (2000) explored on the
British men and women aged 40 to 59 years old with lower BMI effect of sociocultural adaptation on the nutritional intake and
levels who, although frequent eaters, tended to have lower characteristics of household members which showed that as part
consumption of dietary energy but higher nutrient-quality foods. of the cultural adaptation developed by people, people have
Similar results were observed in the nutrient intakes of the improved in maximizing ways of acquiring food that are simply
Filipino lactating participants. Energy intake and eight nutrients available to them. Comparable to the current study, the
(i.e. carbohydrates, protein, calcium, phosphorus, iron, Vitamin participants included in the current study belongs to a relatively
A, B2, and B3) were affected by meal frequency. Consuming large household and low-to-medium economic class. The
more food inevitably redounds to an increased caloric intake but capacity of the participants to access more nutritionally adequate
may not ensure sufficient amounts of required nutrients. Eating food is significantly lower as they are staying in highly
more food does not necessarily equate to getting all the needed urbanized area where prices of commodities are significantly
nutrients. In the case of the lactating participants, result suggests higher. A report in 2009 by the Asian Development Bank
that their snacks or meals may have been a source of more reported that poor families are usually the ones with more
nutrients in addition to calories. A study conducted by Kaliwile household members, and the rise in the urban poor is also
et al. (2019), also found that lactating women consumed more apparent in the country. In this regard, the study was able to
varied food items and had higher food intake compared to capture the urban poor community and based on the result of the
pregnant and non-lactating women. On the contrary, according nutrient intake analysis done, people in urban poor communities
to the FAO report (2013), the National Capital Region or Metro have difficulties in acquiring all recommended amounts of
Manila is the 3rd region with the highest number of malnourished nutrients essential for optimum health. Consequently, with the
lactating women. This may be attributed to other contributing higher nutritional requirements of pregnant and lactating women
factors such as cultural beliefs. A study by Alonso (2014) stated due to physiological changes, these women are most likely to be
that as culture dictates, there are more taboos and restrictions for malnourished as there are many barriers in achieving their
pregnant and lactating women which result to poor nutrition. recommended nutrients intake.
Similarly, a study by Ahlqvist and Wirfalt (2000) mentioned that
postpartum diet is greatly affected by different beliefs such as In the case of pregnant participants, the frequency of eating
the hot and cold values, satisfaction of cravings, survival of the meals outside the home significantly affected their energy,
carbohydrate, protein, phosphorus and Vitamins B1 and B3

Vol. 13 | No. 01 | 2020 Philippine Science Letters 39

Table 7: Factors influencing vitamins intake of selected Filipino women
Energy and Pregnant Lactating Non-P/L women All

Nutrients (n=22) (n=23) (n=28) (n=73)

Regression Equation P value Regression P value Regression P value Regression P value

Equation Equation Equation

Vitamin A - - y = 619.668x4 X4 = 0.032 - - y = 170.941x5 X5 = 0.031

–1881.942 +435.133

Vitamin B1 y = 0.125x5 X5 = y = 0.174x5 X5 = 0.014 - - y = – 0.019x1 X1 =

0.029 0.025, X4
+0.891 +1.092 +0.139x4 = 0.049,
X5 = 0.026
+0.083x5 +0.963

Vitamin B2 y = 0.464x4 X4 = 0.023 - - y = – 0.032x1 X1 =

0.039, X4
- 0.393 +0.226x4 +1.479 = 0.066

Vitamin B3 y = 1.854x5 X5 = y = – 3.313x2 X2 = - - y = 4.558x4 X4 = 0.020

0.004 0.028, X4
+15.415 +6.194x4 = 0.012, +2.684

+2.222x5 X5 =
0.035
+8.201

Vitamin C - - y = 27.187x5 X5 = 0.040 - - y = 14.743x5 X5 = 0.013

+12.321 +32.303

x1 = age; x2 = household size; x3 = parity; x4 = frequency of eating in a day; x5 = frequency of eating out of home in a month

intake. This may be attributed to the established cravings of the to low-income women will help ensure a healthy pregnancy and
mothers during their first trimester that continued throughout their newborns.
pregnancy. There are theories claiming that cravings are the
body’s way of telling the mother that she may be lacking in a CONCLUSION
certain nutrient (Bouchez 2008). In this present study, only
energy, carbohydrates, protein, phosphorus, Vitamin B1, and B3 Results of this study showed that some socio-demographic
were affected by frequency of eating. According to the 8th factors (e.g. household size, frequency of meals) were
National Nutrition Survey (DOST-FNRI 2013), 1 in every 4 significantly associated with the nutrient intake of urban living,
pregnant women is still nutritionally-at-risk. Other factors that low-to-medium income Filipino women. Frequency of meals per
can be considered to affect the nutrient intake of women are day significantly affected calorie, carbohydrate, protein, and
culture and beliefs. The study by Ogechi and Hamdalat (2017) some micronutrient intake of all women regardless of
in Nigeria, showed that 82.2% of their respondents prohibit physiological status. The other factors considered (i.e. frequency
intake of certain food items during pregnancy. Other significant of eating out, age, parity) did not show a consistent trend.
factors included husband’s income, ownership of radio, history Further studies are needed to verify this. The influence of
of disease and dietary knowledge, based on a study done in cultural beliefs and practices and family income on nutrient
Ethiopia (Nana and Zema 2018). intake of women especially during pregnancy and lactation
merits future studies, specifically in the country as this may
In consideration of the results of the study, it is recommended adversely affect consumption of needed nutrients during the
that during screening of pregnant and/or lactating women for critical period of gestation. Participants that were included in the
nutrition intervention at the barangay health centers, information study belong to urban poor community and it was observed that
about questions on the frequency of meals throughout the day there were several limitations in their access to nutritionally
and probably household size be included, in addition to the usual adequate foods. One of the hindrances noted was the
iron status and anthropometric measures, for a more holistic disproportion in the income of the household to the prices of
assessment of the possible influences on the client’s nutrition. It commodities. As most of the household have only one working
is also recommended that Registered Nutritionist-Dietitians person who sustains the finances of the household, the earnings
(RNDs) at the health centers automatically recommend the were not enough to accommodate the needs of the household
inclusion of one snack, whenever possible to the usual four especially with the large number of household members and the
meals of majority of the patients since the results show that there increased needs of pregnant and lactating women. Another
is a higher chance of meeting the recommended nutrient intake hindrance observed was that the effect of the social environment
with more frequent meal consumption. It is also best to provide on the women’s food consumption. The participants were easily
the mothers needed nutrition counseling about making good influenced by the people who they see as superior regarding the
food choices, to get maximum nutrients from the available food matter of pregnancy and lactation, and as result, there were
choices given their limited food budget, moderation in eating various recommendations from their environment which leads
high caloric snacks, and balancing their meals to meet their to having fewer food options. A study which focuses on the
recommended nutrient intakes. In addition to nutrient cultural beliefs and practices on food intake of pregnant and
supplements, providing supplementary feeding or food subsidy lactating women may provide useful insights on their potential

40 Philippine Science Letters Vol. 13 | No. 01 | 2020

effect on their nutrition and health of mothers and their infants Bouchez C. Pregnancy cravings: when you gotta have it. 2008.
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Dev Stud 1985; 12(4):107-122.
This work was funded by the: (1) UP Emerging Interdisciplinary
Research (EIDR-C08-007.1); (2) UP System Enhanced Creative Cheng Y, Dibley MJ, Zhang X, Zeng L, Yan H. (2009).
Work and Research Grant (ECWRG 2016-2-082); (3) Philippine Assessment of dietary intake among pregnant women in a
Council for Health Research and Development-Department of rural area of western China. BMC Public Health 2009; 9:222.
Science and Technology; and (4) Commission on Higher
Education. The authors wish to thank Jethro Ian G. Belano, and Dunneram Y and Jeewon R. Healthy diet and nutrition education
Joelean Zephanie E. Escote for assisting in the data collection program among women of reproductive age: a necessity of
and the Nutrition Offices of Makati City, Mandaluyong City and multilevel strategies or community responsibility. Health
Taguig City for their full support and assistance to the research Promot Perspect 2015; 5(2):116-127.
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The authors whose names are listed above certify that they have
NO affiliations and relationships with any organization or entity Food and Agriculture Organization. Country nutrition paper:
with any financial interest or non-financial interest in the subject inputs from the food and agriculture sector. 2013. Retrieved
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