world diabetes dayThis November 14, we observed World Diabetes Day with the theme: “Access to Diabetes Care: If Not Now, When?” which aims to promote awareness about Diabetes risks, prevention and treatment and to improve access to Diabetes care around the world. In the Philippines, Diabetes is the 4th leading cause of death as of 2020 with heart disease as the top 1. This could be attributed to many health and environmental factors that can be prevented or addressed.

What is Diabetes?

Diabetes is a disorder in the way the body uses glucose or sugar that cells need for energy. Sugar in the blood is absorbed by the cells through the hormone insulin. When there is not enough insulin, sugar builds up in the blood and may lead to elevated blood sugar which may cause complications when left untreated. There are 2 types of Diabetes:

1. Type 1 Diabetes - The problem is in the pancreas or the organ in the abdomen that normally produces insulin. Autoimmune disorders may target this organ and prevent it from producing insulin.

2. Type 2 Diabetes - An acquired diabetes due to poor diet and lifestyle that causes the body to stop responding to normal or high levels of insulin. This may overwork the pancreas in the long run and may lead to damage that would cause it to produce little to no insulin.

Who is at-risk of developing Diabetes?

acne and dietProclamation No. 110 declares the second week of November of every year as “National Skin Disease Detection and Prevention Week” under the auspices of the Philippine Dermatological Society which aims to educate the public on the importance of self-examination, adequate skin care, early consultation with dermatologists for proper management of skin diseases. This article focuses on the relationship between nutrition and skin health in terms of acne prevention.

Acne is one of the most common skin conditions experienced by adolescents and young adults. They could be in the form of mild few pimples on the face or body or to severe forms with redness and swelling. Acne lesions form when the hair follicles become blocked with skin cells and excess oil (sebum). This usually happens during adolescence when hormonal imbalances may stimulate excess oil production in the face, neck, chest, upper back and upper arms. This excess oil also allows the overgrowth of the bacteria Cutibacterium acnes that causes inflammation - thus the formation of a red or painful pimple.

What Causes Acne?

1. Hormonal changes. Hormonal changes during puberty stimulate excess oil production which may aggravate acne. Women with Polycystic Ovary Syndrome (PCOS) are also prone to acne and even hirsutism or the formation of male like pattern hair in the face, chest and back due to high levels of androgen hormone. If you suspect that you have an underlying medical condition that is causing your acne, consult your doctor.

Filariasis Awareness MonthDavao region was once an endemic area for Lymphatic Filariasis. In 2019, Davao was considered Filariasis free - which is a result of effective prevention, awareness and eradication campaigns which led to this success. This November, NNC Davao in its observance of the Lymphatic Filariasis Awareness Month, is joining the Health Department in continuously promoting awareness and preventive efforts against Lymphatic Filariasis.

Lymphatic Filariasis is also known as elephantiasis which is a parasitic infection by roundworms such as Wuchereria bancrofti and Brugia malayi which are transmitted through mosquitoes. The parasites can be from reservoir hosts such as cats or infected humans which the mosquito ingests when they take a blood meal. The parasites are transmitted to another person through an infected mosquito. Once inside, the parasites develop into mature worms and lodge into the lymphatic system which usually drains excess fluid from the extremities. Once these draining systems are blocked, it causes edema or swelling of the extremities and in chronic cases - severe swelling of the extremities which leads to elephantiasis. Elephantiasis can be disfiguring or debilitating and may affect an individual’s mental health and livelihood. Thus, this condition must be prevented and treated early to prevent these consequences.

Food Fortification

This November 7, we are observing the National Food Fortification Day as mandated by Executive Order 382 which aims to advocate and promote food fortification to address micronutrient deficiency. Food fortification is defined by the Codex Alimentarius as “the addition of one or more essential nutrients to food, whether or not it is normally contained in the food, for the purpose of preventing or correcting a demonstrated deficiency of one or more nutrients in the population or specific population groups. A famous example is Iodized salt which is table salt fortified with Iodine to address Iodine deficiency that causes goiter, cretinism and mental retardation. Salt Iodization is mandated by the ASIN LAW or Republic Act 8172: “An Act Promoting Salt Iodization Nationwide and for other purposes”, signed into law on 20 December 1995.

Feeding Techniques

Do you have a child who is a picky eater or were you once a picky eater as a child? Have you ever forced children to eat food or experienced being forced to eat food? If yes, how do you feel about that certain food item now as an adult? Forced feeding or forced consumption is defined as: “a situation where an individual (parent, caregiver, relative, friend or acquaintance) forced/demanded that you consume a specific substance such as food or beverage against your will”.

In a 2002 study by Batsell et al., the most common “forced” substances are vegetables (49.5 %), red meat (15.9 %) and seafood (7.5 %), fruits (6.5 %), milk, dairy and pasta. One factor that would influence a child to eat is neophobia or the unwillingness to consume a new food item and it would take 10 exposure trials before the child begins to accept the novel food. This could be aggravated by taste dislike and negative social situations such as punishing children if they do not eat the food. On the other hand, parents or caregivers justify their actions by saying “it's good for you”, “try something new”, “avoid wastefulness”, “child was too skinny” which aims to just increase the child’s size instead of improving their overall health. Even though the objective is to teach children to eat new food or vegetables - force feeding with punishment, humiliation or using another food as a reward is an ineffective way of teaching healthy food practices in children because it will cause a negative association with food which can be carried on up to adult life. In the same study, 72% of the respondents reported that they would not willingly eat the target food today as an adult. This could be detrimental if that individual develops rejection of a whole food group such as fruits and vegetables due to negative childhood experiences.

Malaria Awareness MonthThis November, we are observing the 2021 Malaria Awareness Month to continue promoting Malaria awareness, prevention and control with the theme: “Reaching for Zero Malaria”. Malaria is a parasitic disease caused by the genus Plasmodium that attacks human red blood cells leading to anemia in the long term and other complications which can lead to impaired physical and mental growth and development in children and maternal morbidity and mortality in pregnant women. It is transmitted by Anopheles mosquitoes from endemic areas especially during “kaingin” activities in farmlands.

Worldwide, Malaria is considered as the world’s most important tropical parasitic disease. In the Philippines, 2,932 confirmed indigenous Malaria cases and 2 Malaria related deaths were reported as of August 2021. Endemic areas include several areas in Region IV-B, Bataraza and Brooke’s Point in Palawan and Sultan Kudarat as of 2020. Malaria used to be an endemic infectious disease in Marilog and Paquibato districts in Davao city until DOH declared Davao as Malaria-free in 2019. This success was attributed to prevention and intervention programs using “new technologies, use of insecticide-treated nets, early detection malaria suspects; case surveillance and follow up of last cases, and effective treatment”.