Unraveling the nutrition and health situation of adults in geographically isolated and disadvantaged areas (GIDA) and non-GIDA in the Philippines: A comparative study.

Abstract

Background: Geographically Isolated and Disadvantaged Areas (GIDA) are communities physically and socioeconomically separated from mainstream society (non-GIDA) and lack comprehensive nutrition and health assessments. Aim: This study aimed to assess the nutritional and health status and determine the factors associated with chronic energy deficiency (CED) and overweight/obesity among adults, 20-59 years old, residing in GIDA and non-GIDA. Methods: Data of the 20,381 adults collected in the Expanded National Nutrition Survey were analyzed. Multivariate logistic regression analyses were performed to determine the predictors of CED and overweight/obesity. Results: Chronic energy deficiency and current smoking were significantly higher in GIDA, while overweight/obesity, alcohol consumption, elevated blood pressure, and insufficient physical activity were higher in non-GIDA (p < 0.001). Higher odds of CED was associated with food insecurity (adjusted odds ratio [AOR]: 1.5, p < 0.001; AOR: 1.3, p < 0.001) and current smoking (AOR: 1.4, p = 0.001; AOR: 1.3, p < 0.001) in both GIDA and non-GIDA while poor wealth (AOR: 1.5, p < 0.001) only in non-GIDA. Higher odds of overweight/obesity was associated with higher age ≥30 years (AOR: 2.1, p < 0.001; AOR: 1.9, p < 0.001), being female (AOR: 1.7, p < 0.001; AOR: 1.3, p < 0.001), with grade level completed (AOR: 1.7, p = 0.004; AOR: 1.2, p = 0.038), urban residence (AOR: 1.2, p = 0.035; AOR: 1.3, p < 0.001), hypertension (AOR: 2.4, p < 0.001; AOR: 2.3, p < 0.001), and insufficient physical activity (AOR: 1.1, p = 0.020; AOR: 1.1, p = 0.027) in both GIDA and non-GIDA. Conclusions: Malnutrition affects GIDA in almost the same magnitude. The double burden of malnutrition and health inequity in GIDA underscores the greater need for comprehensive policies and stronger programs directed toward underserved areas.