6 Common Vitamin Deficiencies in the Philippines

What did you eat for breakfast today? If you’re Filipino, chances are high that you got most of your calories from white rice. Rice is a staple of the Filipino diet and central to every meal. Unfortunately, it lacks many of the nutrients our bodies need.

A recent study looked at the diet of 1264 working Filipino adults. It included people from a wide array of job sectors, to avoid economic bias. Researchers found deficiencies in every nutrient measured.

Percentage of filipino adults that lack nutrients pie chart infographic

Does this mean you need to give up rice? No. But the human body needs nearly 50 vitamins and minerals. Not getting enough of even one of these nutrients can lead to fatigue, poor health, and an increased risk of disease. To avoid vitamin deficiency, you need a wide variety of healthy foods in your diet.

Let’s investigate some of the common vitamin deficiencies among Filipinos, and some steps you can take for optimum nutrition.

#1. Iron Deficiency and Anemia

Iron is an essential nutrient–and one that 99% of Filipinos aren’t getting enough of. It is involved in several vital functions, like maintaining healthy blood, skin, hair, and nails. Iron deficiency can eventually lead to anemia and heart problems.

Who’s at Risk for Iron Deficiency?

Eating a traditional Filipino diet, pregnancy, menstruation, dialysis, or being over the age of 65 places you at greater risk for both iron deficiency and anemia.

Symptoms of Iron deficiency  

If you have an iron deficiency, you may crave non-food items, such as dirt, ice, and starch. Other early symptoms to watch for include:

  • Fatigue & Weakness
  • Fast heartbeat
  • Shortness of breath
  • Headache
  • Dizziness/ lightheaded
  • Cold hands and feet
  • Brittle nails
  • Poor appetite

Anemia

Iron deficiency can lead to anemia, a condition where your body does not make enough red blood cells. Left untreated, anemia can cause extreme fatigue that interferes with daily tasks. It can also cause an irregular heartbeat, and worsen chronic conditions like diabetes and heart disease.

Several packets of vitamin supplements sit in a stack.
Most iron deficiency can be easily treated with iron supplements.

Best Sources of Iron

The best dietary sources of iron are red meat, organ meat, shellfish, and a Filipino favorite–canned sardines. Plant-based sources of iron include green, leafy vegetables, tofu, and nuts. Cooking in an iron pot will also increase the iron in your food by up to 80%. You can also take iron supplements, but dosage varies widely between men, women, and different age groups. It’s best to consult a doctor. Note that taking (or eating) vitamin C will help improve your iron absorption.

#2 Vitamin C

The typical Filipino diet lacks ascorbic acid, also known as vitamin C. This vitamin plays an important role in immune system function. A vitamin C deficiency can leave you more prone to illness, including serious infections like pneumonia and the flu.

Vitamin C is also a powerful antioxidant. It helps fight off free radicals, the tiny particles that can damage cells, increase inflammation, and possibly speed up the aging process.

Who’s at Risk for Vitamin C deficiency?

Common risk factors are a poor diet, alcoholism, anorexia, smoking, and dialysis.

Symptoms of Vitamin C Deficiency

Symptoms of severe vitamin C deficiency may take years to develop. Some subtle signs to look for include:

  • Dry, scaly, or bumpy skin
  • Slow-healing wounds
  • Easy bruising
  • Bleeding gums and tooth loss
  • Frequent illness
  • Chronic inflammation
One calamansi fruit contains about 10% of the recommended daily amount of vitamin C.

Best Sources of Vitamin C

The body cannot produce vitamin C or store it. That means you need to eat vitamin C-rich foods daily to avoid deficiency. Calamansi is packed with vitamin C, but you need more than a small squeeze to meet your daily requirements. Try a glass of calamansi juice instead. Other Philippine fruits that are high in vitamin C include papaya, mango, pineapple, lychees, and durian. Note that canned fruits have about the same nutritional content as fresh. Vitamin C is also commonly sold as ascorbic acid capsules in the Philippines.

#3 Vitamin D

Vitamin D does more than just keep you from getting rickets. It's a steroid hormone that acts as a building block for bones and supports the health of your immune, brain, and nervous systems. There is some evidence that it may even help prevent certain cancers and heart disease.

Who’s at risk for Vitamin D Deficiency?

Also known as the “sunshine” nutrient, vitamin D is produced when the cholesterol in your skin is exposed to sunlight. You might think Filipinos have a natural advantage, given our proximity to the equator. But darker skin tones actually produce less vitamin D. If you spend long hours indoors, you’re also at risk for a vitamin D deficiency.

Symptoms of Vitamin D Deficiency

The signs of vitamin D deficiency are not obvious. Only a blood test can confirm the condition. But possible symptoms include fatigue, bone pain, muscle cramps, muscle atrophy, and mood changes, including depression.

A woman stretches her arms in the sun.
Sunlight is the best source of vitamin D.

Best Sources of Vitamin D

Regular sunlight is the most effective way to get vitamin D. Ten to thirty minutes of midday sun exposure is optimal. If you have darker skin, you may need a little more. Food sources of vitamin D are limited. You can find moderate amounts of vitamin D in fish and dairy products, with cod liver oil being the most potent. If that doesn’t sound appetizing, you can opt for a vitamin D supplement.

# 4 Folate (B9)

Folate is an important B vitamin that assists in red blood cell formation and healthy cell growth and function. It is also essential before and during pregnancy to reduce the risk of certain birth defects. Like iron, a severe folate deficiency can cause anemia.

Who’s at Risk for Folate Deficiency?

A diet low in vegetables, fruit, and fortified cereal is the main cause of folate deficiency. Excessive alcohol consumption and certain digestive diseases, like Crohn’s and celiac disease, can also make it harder for your body to absorb folate.

All women of child-bearing age are advised to get enough folate. This is because birth defects caused by folate deficiency can occur very early in pregnancy--before a person even knows they have conceived.

Symptoms of Folate Deficiency?  

Early symptoms of folate deficiency often go unnoticed. They can include premature gray hair, mouth sores, swollen tongue, and fatigue.

Anemia

Most people associate anemia with iron deficiency. But not getting enough folate can also cause you to produce too few blood cells, resulting in anemia. Folate deficiency anemia causes the same host of symptoms: extreme fatigue, irregular heartbeat, and worsening of chronic diseases.

Folate supplements can reduce the risk of birth defects by up to 70%.

Best Sources of Folate

It only takes a couple of weeks to become deficient in folate, so you need to get enough daily. Some foods containing the most folate include fortified foods, beef liver, beans, peas, papaya, avocado, broccoli, and leafy green vegetables. Folate is often taken as a supplement, especially when pregnant or planning a pregnancy.

#5 Calcium Deficiency

Calcium doesn't just give you strong bones and teeth. Although it's important for bone health, its benefits are far more wide-reaching. It helps your heart to beat, sends messages between your brain and muscles, and helps keep your nerves functioning.

Who’s at Risk for Calcium Deficiency?

Almost 95% of Filipinos are missing their daily required amount (RDA) of calcium. Most households don’t consume an adequate amount of milk and dairy products.

Women are also more at risk for calcium deficiency and osteoporosis. With age, a woman's estrogen level drops leading to a loss in bone density.

Symptoms of Calcium Deficiency

Without calcium, your heart muscles, and nerves can’t function. When you don’t eat enough calcium, your body has to take it from your bones to survive. This is why bone loss is one of the most common symptoms of calcium deficiency.

Most Filipino households do not eat enough dairy to meet their Calcium needs.

Best Sources of Calcium

Most of us know which foods deliver the most calcium–dairy products. They just aren’t a part of the traditional Filipino diet. But there are other good calcium sources, such as small fish that are eaten with bones, like dilis and sardines. Alamang, tokwa, and green vegetables like mustasa and malunggay are other foods high in calcium.

You can also take a calcium supplement. Adding magnesium and vitamin D facilitates better absorption. But calcium can interact with many medications, so it’s best to consult a doctor about dosage and timing.

#6 Vitamin B12 (Cobalamin)

Vitamin B12 helps keep the nervous system healthy and supports red blood cell production. B12 deficiency is one of the most common nutritional deficiencies among seniors and can lead to serious health problems, such as neurological disorders and anemia.

Who’s at Risk for Vitamin B12 Deficiency?

If you are 65 and older or eat little meat, you’re more likely to have a B12 deficiency. It’s estimated that 10-15% of the elderly and 80-90% of vegetarians lack B12.

Symptoms of B12 Deficiency

Severe vitamin B12 deficiency can cause symptoms such as tingling in the hands and feet, confused thinking, movement problems, yellow skin, and fatigue.

Meat, fish, and dairy products can help you avoid B12 deficiency.

Best Sources of B12

Organ meat, shellfish, and meat have the highest vitamin B12 content. Eggs and dairy have a small amount. B12 supplements are often used for people who cannot get enough through their diet.

#6 Magnesium

Magnesium helps build protein and is required for both muscle and nerve function, as well as normal heart rhythm. It also keeps our bones strong and helps regulate blood glucose levels.

Magnesium deficiency is associated with several conditions, including type 2 diabetes, metabolic syndrome, heart disease, and osteoporosis.

Who Is at Risk for Magnesium Deficiency?

Deficiency may be caused by disease, drug use, or inadequate magnesium intake in your diet. Kidney problems and Type 2 Diabetes are common culprits.

Symptoms of Magnesium Deficiency

In the long term, magnesium deficiency can lead to serious health conditions, such as high blood pressure, diabetes, osteoporosis, and migraines. Early symptoms may include:

  • loss of appetite
  • nausea
  • fatigue
  • shaking
  • pins and needles
  • muscle spasms
  • hyperexcitability
  • sleepiness
  • Arrhythmia
You can avoid magnesium deficiency with foods like dark chocolate and avocado.

Best Sources of Magnesium

Some magnesium-rich foods you can include in your diet are spinach, nuts, seeds, avocado, tokwa, dark chocolate, and bananas.

How to Diagnose & Treat a Vitamin Deficiency

The symptoms of vitamin deficiency are too general for diagnosis. A blood test is needed to confirm nutrient levels. You can get a lab screening that tests your blood for several common deficiencies or choose a single test. It’s advised that you consult a doctor after, since overdosing yourself with too many vitamins can also harm your health. A doctor can develop a care plan, and ensure the supplements you take are personalized to your body's needs. Eating a balanced diet including the foods listed above can also help keep your body healthy and reduce the risk for disease.

A blood test is needed to confirm a vitamin deficiency.

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