Barriers to compliance with the Daily Food Guide for Children among first-grade pupils in a rural area in the Philippine Island of Mindanao

BACKGROUND/OBJECTIVE: To identify and address caregivers' perceived barriers to compliance with dietary guidelines for children. SUBJECTS/METHODS: Information on family socioeconomic status, child's consumption frequency of nine food items, and caregiver's attitudes and behaviors regarding meal preparation were collected through structured interviews with caregivers (70 mothers, four grandmothers and one father) of first-grade children (39 boys and 36 girls) living in five barangays of New Corella, Mindanao Island, Philippines. If the child's intake did not reach the level recommended in the dietary guidelines, the reasons were investigated from the economic, social, cultural and environmental viewpoints. RESULTS: Their diet relied heavily on rice and others. The percentages of children who did not consume each of the food items on a daily basis were 77.3% for eggs; 57.3% for milk; 41.3% for fish/meat/poultry/dried beans/nuts (FMPDBN); 42.7% for fruits; 17.4% for green, leafy and yellow (GLY) vegetables; and 38.5% for other vegetables. The most reported reasons for the infrequent consumption of FMPDBN (87.1%), milk (81.4%) and eggs (36.2%) were 'no money to buy,' that of fruits (59.4%) was 'out of season' and that of GLY (61.5%) and other vegetables (55.2%) was 'child's dislike.' CONCLUSIONS: The expansion of homestead food production and the national feeding program contribute to increased animal food consumption. Nutrition education aimed at overcoming food preferences and increasing the awareness of micronutrient intake are perhaps the most effective means to promote vegetable intake.