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Katrina Sarazawa
Sea Cucumber Products: Sea Cucumber Products: Appetizer for Feeding Program to Undernourished Children of Saint Gregory Primary School,
Narvacan, Ilocos Sur
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Table of Contents
Abstract 2
Introduction 3
Objectives 4
Review of Related Literature 4
Methodology 8
Results and Discussion 9
Conclusion 10
Recommendation 10
References 11
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Sea Cucumber Products: Appetizer for Feeding
Program to Undernourished Children
of Saint Gregory Primary School,
Narvacan, Ilocos Sur
Katrina S. Sarazawa
Ilocos Sur Polytechnic State College
ABSTRACT
Three sea cucumber appetizer products formulated, evaluated and analyzed were utilized as food
intervention given to underweight school children aged to 7 to 9 years at St. Gregory Primary School for the
school year 2012-2013. Feeding underweight school children with sea cucumber products as appetizer
significantly improves their weight gain, sea cucumber products have potential to improve Vitamin A level,
and have a brighter prospect of developing foods made from sea cucumber to combat Vitamin A deficiency
in the populations at risk. To determine the effect of sea cucumber appetizers on the growth and
development of underweight school children’s body mass index, further studies be conducted on other age
groups of children not considered in the study.
Keywords: Sea cucumber appetizer, feeding intervention, nutritional status, appetizer, underweight
school children
Instructor I
Email: [email protected]
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INTRODUCTION
Micronutrient deficiencies are widespread and have far greater impacts on health,
productivity and mental capacity than previously realized. Worldwide, about 852 million people are
classified as undernourished by the Food and Agricultural Organization. However, another 2.5
times as many people suffer from micronutrient deficiencies known as “hidden hunger”. The
vulnerable segments appear to get enough to eat at least in terms of calories but are lacking in
micro-nutrients such as vitamins and minerals (Butt et al., 2007).
Four million Filipino children are malnourished and the number is expected to grow if
households are forced to cut down on food due to high inflation as reported by the Food and
Nutrition Research Institute (FNRI, 2008). The forms of malnutrition vary from Protein-Energy
Malnutrition (PEM), Vitamin A Deficiency (VAD), Iron Deficiency Anemia (IDA) and Iodine
deficiency Disorder (IDD).
In particular, vitamin A, iron and iodine deficiencies are considered as major while the
prevalence of zinc and folate deficiencies are thought to be minor deficiencies (Van-den Briel et al.,
2007). Vitamin A controls various important metabolic processes and its deficiency results in
impairment of immune modulating mechanism like mucus secreting epithelium is replaced by
keratinized epithelium thus decreasing immunity. Vitamin A level significantly affects
immunoglobulin like IgG and IgM. Furthermore, total proteins, albumin and retinol binding proteins
showed a significant correlation with retinol. Vitamin A deficiency (VAD) contributes towards several
health disparities like xerophthalmia, night blindness and some others while its excess causes
hypervitaminosis. FNRI (2008) revealed that the prevalence of malnutrition is highest in the
Autonomous Region of Muslim Mindanao, the Zamboanga Peninsula, Southern Tagalog, Southern
Mindanao, and Eastern Visayas regions, where up to one-third of children under the age of 10 are
either underweight or short for their age.
Moreover, the report of FNRI (2008) showed that the number of underweight children (0-5
years old) was 3.67 million while among 6 to 10 year old children, the prevalence of underweight
was 32.9 percent equivalent to 3.07 million children.
Previous studies found that interventions which seek to alter single factors in the environment, such
as food intake could bring significant improvement in children’s development or chances of survival.
With this in mind, this study aims to develop healthy appetizers with the use of sea cucumber as
extender and saluyot as vitamin A enhancer.
Sea cucumber is a very versatile and nutritious. Sea cucumbers, informally named as
bêche-de-mer, or gamat, have long been used for food and folk medicine in the communities of
Asia and Middle East. Nutritionally, sea cucumbers have an impressive profile of valuable nutrients
such as Vitamin A, Vitamin B1 (thiamine), Vitamin B2 (riboflavin), Vitamin B3 (niacin), and minerals,
especially calcium, magnesium, iron and zinc. A number of unique biological and pharmacological
activities including anti-angiogenic, anticancer, anticoagulant, anti-hypertension, anti-inflammatory,
antimicrobial, antioxidant, antithrombotic, antitumor and wound healing have been ascribed to
various species of sea cucumbers. Therapeutic properties and medicinal benefits of sea cucumbers
can be linked to the presence of a wide array of bioactives especially triterpene glycosides
(saponins), chondroitin sulfates, glycosaminoglycan (GAGs), sulfated polysaccharides, sterols
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(glycosides and sulfates), phenolics, cerberosides, lectins, peptides, glycoprotein,
glycosphingolipids and essential fatty acids (Bordbar, Anwar and Saari, 2011).
Malnutrition is a great problem in the world and includes both under- and over nutrition.
The major under-nutrition problems are protein-energy malnutrition (PEM) and deficiencies of the
micronutrients vitamin A, iron and iodine. This study deals with two of these micronutrients; vitamin
A and protein-energy malnutrition. It is hoped that the promotion and consumption of foods rich in
nutrients and medicinal properties such as sea cucumber snacks would help augment the nutrition
deficiencies such as VAD and Protein-energy deficiency.
The information attained from this study would assist researchers to understand their role
in development of foods that would contribute in the improvement of health of undernourished
school children. This would hopefully encourage other culinary arts and HM faculty and students to
use the findings of this study as basis in the development of nutritious foods that are effective in
raising the nutritional status of school children.
OBJECTIVES
This study aimed to utilize the result of the sea cucumber products developed in the
implementation of the feeding program for the undernourished school children of the Saint Gregory
Primary School, school year 2013.
Specifically, it tried to:
1. Determine the weight of the school children aged 7 to 9 years old before the implementation
of the feeding program
2. Determine the weight of the school children after the implementation of the feeding
program
3. Compare the weight gain of the primary school children before and after the intervention
4. Determine the significant difference on the weight gain of primary school children before
and after the intervention
REVIEW OF RELATED LITERATURE
Sea cucumber has a high nutritional value due to presence of up to 50 types of essential
nutritional elements, trace elements or micro nutrients and organic compounds. These include a
high content of protein with low fat, iodine, calcium, potassium, zinc, iron, selenium, manganese,
chondroitin sulfate, saponins, vitamins like vitamin A, thiamine, riboflavin, niacin etc. ( Subhuti
Dharmananda, 2010)
From the modern medical viewpoint, sea cucumber is a valuable source of several kinds
of substances that can serve as natural health products, and, perhaps, be developed as drugs.
Since sea cucumber is consumed as a food by a very small segment of the population outside East
Asia, most people do not have access to its beneficial components. Thus, extracts of desired sea
cucumber materials are put into easy-to-consume formats, such as capsules (hard and soft gelatin)
and tablets (Dharmananda, u.d.).
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Vitamin A is fat soluble, found chiefly in animal foods and belongs to subgroup of
compounds known as retinoids. It is found in body in three main forms differing in their oxidation
states; retinol is hydroxyl form, retinal is aldehyde form and retinoic acid is the carboxylic form.
Vitamin A from diet or supplemental administration is stored in Ito (fat storing) cells of the
liver. Retinol is the true form that is readily metabolized in human body and is called as preformed
vitamin A. Its surplus amount is accumulated as retinol esters in the liver tissues. The retinoid
molecule has a cyclic and polar end group with polyene side chain. Retinoids are chromophores
because of the complex conjugated system comprised of alternating C=C double bonds in polyene
side chain (McGuire and Beerman, 2007). All retinoids are derived from a monocyclic parent
compound containing five carbon-carbon double bonds and a functional group at the end of acyclic
portion.
Generally, Vitamin A played influential roles in vision, reproduction, development, bone
metabolisms, immune functions, gene transcription, reducing risk of heart diseases and cancer
disorders. Vitamin A and its derivatives play an integral role in spermatogenesis, reproduction, cell
differentiation, embryogenesis and organogenesis. Moreover, cell differentiation needs adequate
amount of vitamin A and retinoic acid that are considered to be essential in the segregation of white
blood cells.(Jiang, et.al., 2008)
Vitamin A deficiency (VAD) is a major nutritional concern in poor societies, especially in
lower income countries. Its presence as a public health problem is assessed by measuring the
prevalence of deficiency in a population, represented by specific biochemical and clinical indicators
of status. The main underlying cause of VAD as a public health problem is a diet that is chronically
insufficient in vitamin A that can lead to lower body stores and fail to meet physiologic needs (e.g.
support tissue growth, normal metabolism, resistance to infection). Deficiency of sufficient duration
or severity can lead to disorders that are common in Vitamin A deficient populations such as
Xerophthalmia (xeros = dryness; ophthalmia = pertaining to the eye), the leading cause of
preventable childhood blindness, anemia, and weakened host resistance to infection, which can
increase the severity of infectious diseases and risk of death. A poor diet and infection frequently
coexist and interact in populations where VAD is widespread. In such settings, VAD can increase
the severity of infection which, in turn, can reduce intake and accelerate body losses of vitamin A
to exacerbate deficiency. The prevalence and severity of xerophthalmia, anemia and the (less-
measurable) “vicious cycle” between VAD and infection in vulnerable groups (notably young
children and pregnant or lactating mothers) represent the most compelling consequences of VAD
and underlie its significance as a public health problem around the world (WHO, 2009).
Almost all suffering from VAD comes from the poorer socio-economic strata in low-income
countries. Among these, pre-school children who are not breastfed any more are at greatest risk of
VAD. The reasons behind this are that their nutritional demands are high, their consumption of
vitamin A rich foods and the dietary fat required for absorption can be limited, and infections can
deplete their body reserves of vitamin A.
The World Health Organization (WHO) estimates that 190 million preschool children and
19 million pregnant women are vitamin A-deficient globally. Children with vitamin A deficiency are
more likely to suffer from poor health and premature death. Each year, it is estimated that 670,000
children under the age of five die from vitamin A deficiency. Vitamin A deficiency is the number
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one cause of preventable blindness among children in developing countries – as many as 350,000
go blind every year
The poor in the developing world, who live primarily on a diet of starchy staples that lack vital
micronutrients like vitamin A (such as rice), are particularly vulnerable to vitamin A deficiency.
(WHO, 2009).
Asia has one of the highest prevalence of vitamin A deficiency in the world, with the most
clinical cases found there. Vitamin A deficiency is still considered a public-health problem in many
countries of Asia and 33.5% of pre-school children have vitamin A deficiency and affects
approximately 1.7 million chidren (15.2%) aged 6 months to 5 years. Subclinica Vitamin A
deficiency affects one out of every ten pregnant women (WHO, 2009).
Recommended Energy and Nutrient Intake for Filipino Children
The Food and Nutrition Research Institute (FNRI) of the Department of Science and
Technology (DOST), as in the past, led the review and revision of the 1989 Recommended Dietary
Allowances (RDAs) for Filipinos, a vital and essential tool recognized in the nutrition and health
community as the source of information on recommended energy and nutrient intakes for the
maintenance of good health. This set of dietary standards is periodically evaluated and updated to
keep pace with new knowledge on energy and nutrient requirements and metabolism (Barba and
Cabrera, 2008).
The set of updated standards is now called Recommended Energy and Nutrient Intakes
(RENIs), defined as levels of intakes of energy and nutrients which, on the basis of current scientific
knowledge, are considered adequate for the maintenance of good health and well-being of nearly
all healthy Filipinos (Barba and Cabrera, 2008).
The FAO/WHO recommendations which concur with those of the IOM-FNB are adopted
for all population groups, except pregnant and lactating women. The recommended intake level for
adults corresponds to the intake necessary to maintain plasma iodide level above the critical limit
likely to be associated with the onset of goiter. It corresponds to the daily iodine urinary excretion
of 100 µg/L. The recommended energy and nutrient intake (RENI) for children aged 7 to 9 (24 kg
weight) prescribes the following: Energy – 1600 kcal, Protein – 43 g, Vitamin A – 400 µRE, Vitamin
C – 35 mg, Thiamine – 0.7 mg, Riboflavin – 0.7 mg, Niacin- 9, Folate-300 µDFE, Calcium – 700
mg, Iron – 11 mg, Iodine – 120 µg.
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The recommended intake levels for energy and nutrients are summarized in Tables 1 and 2 (FNRI-DOST,
2002).
Table1. Recommended Energy and Nutrient Intakes per day for Filipino Children
Population
Group
Weight
kcal
Energy
Kcal
Protein
g
Vitamin
A
µg RE
Vitamin
C
mg
Thiamin
Mg
Riboflavin
mg
Niacin
mg NE
Folate
µg
DFE
Calcium
mg
Iron
mg
Iodine
µg
Children,
year
1-3 13 1070 28 400 30 0.5 0.5 6 160 500 8 90
4-6 19 1410 38 400 30 0.6 0.6 7 200 550 9 90
7-9 24 1600 43 400 35 0.7 0.7 9 300 700 11 120
Males
10-12 34 2140 54 400 45 0.9 1.0 12 400 1000 13 120
Females
10-12 35 1920 49 400 45 0.9 0.9 12 400 1000 19 120
Table 2. Recommended daily intakes for other minerals and vitamins for Filipino Children
Pop.
Group
Wt
kg
MINERALS
VITAMINS
Magnesium
mg
Phosphorus
mg
Zinc
mg
Selenium
µg
Fluoride
mg
Manganese
mg
D
µg
E*
mg
K
µg
B5 B12
µg
Children
1-3 yrs 13 65 460 4.5 18 0.7 1.2 5 5 13 0.5 0.9
4-6 yrs 19 76 500 5.4 22 1.0 1.5 5 6 19 0.6 1.2
7-9 yrs 24 100 500 5.4 20 1.2 1.7 5 7 24 1.0 1.8
Males
10-12 34 155 1250 6.5 21 1.7 1.9 5 10 34 1.3 2.4
Females
10-12 35 160 1250 6.0 21 1.8 1.6 5 11 35 1.2 2.4
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METHODOLOGY
The subjects of food intervention were 25 underweight primary schoolchildren, 7 to 9 years of age,
enrolled at Saint Gregory Primary School, Bantay Abot, Narvacan, Ilocos Sur for SY 2012-2013. The three
sea cucumber products developed as a result of the descriptive sensory qualities, proximate analysis were
utilized and fed to the subjects as part of their daily meals.
Sea Cucumber Kropeck
Sea Cucumber Dumpling
Sea Cucumber Roll
Figure 1: Three sea cucumber products tested for sensory evaluation and proximate analysis
These children were subjected to physical examination for anthropometric measurements before
and after feeding them with sea cucumber appetizers. The weighing of the primary school children was
conducted during class break. The anthropometric measurement such as weight of the child was measured
using a weighing scale (Uniscale). The standing height of the child was measured using a tape measure
attached to a portable height board.
Permission to conduct this study was secured from the principal/school administrator of the St. Gregory
Primary School in Bantay Abot, Narvacan, Ilocos Sur and asked consent for their pupils to participate.
Thereafter, informed consent to conduct of food intervention was obtained from the parents of the subjects.
A request letter was also forwarded to the District Supervisor for approval. To determine the effect of the
sea cucumber appetizers on the food intake of underweight school children, measurements of the weight
of the school children before and after the food intervention was done to determine if there were changes
or improvement in the weight of the subjects.
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Descriptive statistical tools such as frequency count, mean, range, percentage and standard
deviations were used to present the descriptive variables in terms of sensory characteristics and
acceptability of sea cucumber appetizers as well as the anthropometric measurements of underweight
school children before and after food intervention. T-test was used to determine if there is a significant
difference between the food intake (as measured by weight and height) of school children before and after
the food intervention. This test was used to determine the effect of food intervention on the weight of the
school children. A 5% level of significance was used to determine significant outcome.
RESULT AND DISCUSSION
Table 1 Comparison on the weight gain of primary schoolchildren
before and affter the intervention
Subject Number Weight before intervention (in kg)
Weight after intervention (in kg)
Difference in weight (in kg)
1 16.1 18.7 2.60 2 17.8 19.5 1.70 3 17.7 19.6 1.90 4 19.8 21.2 1.40 5 16.2 17.5 1.30 6 21.4 22.6 1.20 7 23.2 23.1 0.10 8 18.2 20.4 2.20 9 18.8 20.7 1.90 10 16.6 19.3 2.70 11 23.6 24.9 1.30 12 22.6 24.3 1.70 13 22.2 25.3 3.10 14 18.2 19.1 0.90 15 16.3 17.8 1.50 16 17.2 18.6 1.40 17 18.4 19.5 1.10 18 19.0 20.3 1.30 19 19.2 20.6 1.40 20 18.0 19.1 1.10 21 16.7 18.3 1.60 22 18.4 20.9 2.50 23 19.2 20.4 1.20 24 25.8 27.6 1.80 25 25.1 26.8 1.70
Mean 19.43 21.04 1.62
As shown in the table, except for one schoolchild (subject 7), all subjects weighed higher after
feeding them with sea cucumber appetizers (kropeck, dumpling and roll) daily. Only one subject weighed
lower after the intervention by 0.10 kg. The average weight of the subjects before the intervention was
19.43 kg while after the intervention, the average weight increased to 21.04 kg. An average of 1.62 kg
increase was noted among school children who participated in the feeding intervention. Results imply that
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the feeding intervention improved the weight of the participating primary school children after feeding
them with sea cucumber appetizers.
Table 2
T-test on the weights/food intake of primary schoolchildren before and after feeding with sea cucumber appetizers
Mean N SD t-stat P Decision
Before intervention
19.46 25 2.82 2.03*
0.048
Reject Ho
After intervention
21.04 25 2.80
Test statistics showed that significant difference exists in the weight/food intake of primary school
children before and after the food intervention. The computed t-value of 2.03 was significant at five percent
level. Hence, the null hypothesis of no significant difference on the weight gain of children before and after
the food intervention was rejected. This suggests that although there were significant improvements in the
food intake or weights of children after the food intervention. Thus, evidence indicates that substantial
improvements on the weight of the subjects after they were fed with sea cucumber appetizers daily.
As a whole, finding suggest that the food intervention had a significant effect on the weight gain of
participating schoolchildren from St. Gregory Primary School in Bantay Abot, Narvacan, Ilocos Sur.
Feeding underweight schoolchildren with sea cucumber products particularly sea cucumber dumpling, sea
cucumber kropeck and sea cucumber roll significantly improves the weight of children.
CONCLUSION
The food intervention had a significant positive effect on the weight gain of underweight school
children, aged 7 to 9 years. Feeding underweight school children with sea cucumber appetizers daily
improves the weight of children.
RECOMMENDATION
From the findings of the study, feeding underweight school children with sea cucumber products
had potential to improve vitamin A level in vulnerable segments with special reference to underweight
school children, aged 7 to 9 years. This brightens the prospects of developing foods made from sea
cucumber to combat vitamin A deficiency in the populations at risk. Thus, future investigations on the effect
of sea cucumber appetizers on Vitamin A intake and status of underweight school children are
recommended. Future studies may also be conducted on other age groups of children not covered in this
study.
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