Filipino adults are living with a dense cluster of cardiometabolic risks.
According to the Department of Science and Technology–Food and Nutrition Research Institute’s (DOST-FNRI) 2021 Expanded National Nutrition Survey (ENNS), 6.5% had high fasting blood sugar, while dyslipidemia was widespread, 8.3% with high total cholesterol, 5.1% high LDL, 15.4% high triglycerides, and 43.9% low HDL.
Moreover, roughly one in five adults had elevated blood pressure (18.9%), with higher rates among men.
Meanwhile, deficiencies rooted in diet quality persist.
Vitamin A deficiency still affected nearly 1 in 6 children aged 6–59 months in 2018–2019 and anemia remained high in vulnerable groups, about 38% of infants 6–11 months and 20% of pregnant women, underscoring that classic micronutrient problems never truly left.
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A Long-Run Drift, a Changing Disease Profile
The trend line that worries public-health researchers is long and steady. Over 1993–2013, the share of Filipino adults with overweight or obesity rose by roughly 0.73 percentage points per year, small on paper but transformative across two decades, signaling a shift toward diabetes, hypertension, and lipid disorders even as anemia and vitamin A deficiency persisted.
Furthermore, newer surveillance shows the gradient has steepened: using Asia-Pacific BMI cut-offs, DOST-FNRI’s 2023 National Nutrition Survey reported that 57.1% of adults 20–59 are now overweight or obese.
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A Tale of Two Burdens
This “double burden” is measurable in both anthropometry and blood tests. According to the 2021 ENNS, cardiometabolic risks are common in adults, even as early-life micronutrient gaps remain entrenched; based on DOST-FNRI’s 2013 biochemical survey, vitamin A deficiency reached 20.4% among children 6–59 months, a level the WHO classifies as a public-health problem.
Moreover, peer-reviewed analyses quantify how these deficits and excesses overlap: a 2021 study in Frontiers in Nutrition found the co-occurrence of overweight/obesity with anemia, vitamin A deficiency, or iodine insufficiency in a meaningful share of Filipino adults.
Globally, the picture tracks broader shifts: a 2024 Lancet analysis from the Global Burden of Disease (GBD) 2021 project reports obesity and high blood sugar among the fastest-rising drivers of poor health, mirroring the Philippines’ profile.
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What Changed in the Filipino Diet?
While genetics and aging play roles, diet and activity patterns dominate the risk story. DOST-FNRI’s most recent food-consumption compendium shows every day diets tilted toward energy-dense staples and processed foods (with rice and pork as major energy contributors), while fruits and vegetables remain low, especially among adolescents and working-age adults.
Furthermore, this pattern sits atop high physical inactivity: ENNS-based estimates synthesized in the 2022 Philippine Report Card on Physical Activity indicate that around 84–85% of adolescents were insufficiently active, amplifying long-term NCD risk.
On lipids, a regional review places the Philippines among countries with very high triglyceride prevalence (~38.7% in some samples), consistent with carbohydrate-heavy diets and rising adiposity; elevated triglycerides and low HDL are tightly linked to insulin resistance and future cardiovascular events.
The Cardiometabolic Turn
By the mid-2010s, WHO had already flagged the shift. In its 2018 NCD Country Profile, the Philippines showed an estimated 19% of adults with raised blood pressure (2015), ~6% with raised blood glucose (2014), 24% current smokers (2015/2016), and 38% physically inactive (2016), a risk mix that feeds cardiovascular disease (CVD).
recently, GBD 2021 analyses underscore that high systolic blood pressure, diet-related risks, and high fasting plasma glucose remain among the top global drivers of death and disability.
On the other hand, the World Heart Federation’s World Heart Observatory notes that the Philippines’ CVD mortality ranks in the higher range compared with other countries, aligning with the country’s risk profile and burden.
Old Problems That Never Left: Anemia and vitamin A
The NCD wave did not wash away classic deficiencies.
According to DOST-FNRI’s 2013 biochemical assessment, anemia was severe among infants 6–11 months (around 40%) and vitamin A deficiency was 20.4% among children 6–59 months; by 2018–2019, vitamin A deficiency remained at about 15–17% in preschoolers and anemia still affected roughly one-fifth of pregnant women and more than one-third of infants.
Global tracking confirms the broader picture. WHO continues to report widespread anemia among women of reproductive age worldwide, reinforcing why these early-life deficits remain a priority even as overweight and diabetes rise.
The Double Burden Inside One Household
When researchers mapped who is affected and where, an uncomfortable truth emerged: the same households coping with overweight, hypertension, or diabetes in adults often have an anemic toddler or a vitamin A-deficient preschooler.
In a nationally representative analysis of the 2013 NNS, more than half of Filipino households (56%) exhibited some form of double burden, with higher odds in families facing food insecurity and limited diet diversity.
Moreover, at the individual level, overweight or obese adults frequently had co-existing micronutrient deficiencies—an under-recognized pairing that can raise cardiometabolic risk while undermining immune and cognitive function.
UNICEF’s 2024 report on child food poverty helps explain the overlap: about 18% of Filipino under-fives (roughly 2 million children) are in severe child food poverty, consuming only two or fewer food groups a day—cheap calories without nutrients, particularly in low-income settings.
Policies on the Table — What’s Moved and What Hasn’t
Over the past decade, the Philippines has put diet squarely in view.
First, the sweetened-beverage excise under the TRAIN Law (RA 10963) took effect on January 1, 2018, with specific per-liter rates laid out in Bureau of Internal Revenue Revenue Regulations No. 20-2018; evidence from other countries suggests such taxes can raise prices and nudge intake down, especially for sugar-sweetened carbonates.
Second, the country adopted a national policy to eliminate industrially produced trans fats: DOH Administrative Order 2021-0039 and FDA Circular 2021-028 (and 2021-028-A) established a pathway that bans partially hydrogenated oils and set compliance thresholds, targeting full compliance by June 2023, a move aligned with WHO’s REPLACE framework.
Third, food-labeling reforms are in active debate: globally, regulators are moving toward clearer front-of-pack labels; in February 2025, the U.S. FDA formally proposed national FOP nutrition labeling to help consumers compare sodium, saturated fat, and added sugars at a glance, signaling a wider policy shift the Philippines is already discussing.
Experts caution, however, that these measures are necessary but insufficient without investments to make healthy, nutrient-dense foods more available and affordable, especially fresh produce, pulses, fish, eggs, and dairy, plus safe spaces for physical activity and strong primary care for hypertension and diabetes management.
Recent WHO and UNDP “investment case” work emphasizes that four behaviors (tobacco, harmful alcohol use, unhealthy diet, physical inactivity) and key metabolic risks (high blood pressure, glucose, cholesterol, sodium) drive most NCD burden, and that cost-effective “best buys” exist if implemented at scale.
The Rice Question and Beyond
In a rice-centric food culture, it’s tempting to pin diabetes risk on a single staple. Plant breeders at the International Rice Research Institute have pursued lower-glycemic, higher-protein lines to blunt post-meal glucose spikes, useful innovations, to be sure.
Nevertheless, nutrition scholars argue that ultra-processed foods and sugary beverages likely contribute more to excess glycemic load and empty calories than rice alone, which is why policy attention has widened to the full food environment, from reformulation to marketing restrictions and fiscal tools.
Where the Latest Numbers Point
While the 1993–2013 trend documented a steady BMI rise, post-2013 indicators confirm that cardiometabolic risks remain elevated. WHO’s NCD profiles and the GBD 2021 evidence point to persistent raised blood pressure, diet-related risks, physical inactivity, and high fasting glucose, each a powerful contributor to CVD.
On micronutrients, FNRI and partners reiterate that infants and toddlers are highly vulnerable, with anemia peaking around 6–11 months and vitamin A deficiency still significant in preschoolers, conditions that demand sustained surveillance and targeted interventions.
A practical playbook is now well sketched: protect children’s diets early (breastfeeding support; diverse complementary foods; targeted vitamin A and iron in high-risk groups), shift the food environment (build on the soda tax and iTFA ban; address added sugars, sodium, and marketing of ultra-processed foods to children; adopt clearer front-of-pack labels), make healthy foods the default (support horticulture, small fisheries, and cold-chain logistics; scale nutrition-sensitive social protection so families can buy nutrient-rich foods even when prices spike), upgrade primary care (screen and treat hypertension, diabetes, and dyslipidemia with medicine access and lifestyle counseling), and keep measuring (sustain and modernize ENNS biomarkers, diet-quality metrics, and provincial estimates so policy can adjust quickly).
Why Urgency is Justified
Even sub-percentage annual increases compound. Elevated triglycerides and non-HDL cholesterol prime atherosclerosis; high systolic blood pressure strains hearts and brains; and poor-quality calories displace iron, zinc, vitamin A, and folate, undercutting immunity and cognition.
The net effect is more CVD, stroke, type 2 diabetes, and maternal-child malnutrition, which together sap productivity and widen health inequities. That’s exactly what the global burden studies—and the country’s own nutrition surveillance, continue to show.
The Deeper Pattern — and the Path Forward
Look again at that long-run slope from 1993 to 2013: small, steady shifts in diet and activity, spread across millions of people, rewrote a nation’s health story.
The challenge now is to reverse the gradient. make nutrient-dense foods cheaper and more available than empty calories, enforce the trans-fat phase-out, keep sweetened drinks as a periodic indulgence rather than a daily habit, and hard-wire hypertension and diabetes control into primary care.
The good news is that several pieces are already in place: a sweetened-beverage tax, a national iTFA ban, and an ongoing policy conversation about front-of-pack labeling and healthier procurement.
Pair those with stronger surveillance, better food access, and clinic-level risk control, and the country can move from managing the double burden to reducing it. The data argue that diet policy is disease policy, and that the next twenty years can look very different from the last twenty if the Philippines tilts its food environments toward health.
Photo by Charlein Gracia on Unsplash
