JSR

Background: The recent rise of the double burden of malnutrition (i.e., the coexistence of underweight and overweight) in the Philippines presents a significant challenge to achieving numerous agreed-upon Sustainable Development Goals (SDGs). To combat the rising trends of both forms of malnutrition, this research assesses whether there are positive nutrition-related impacts from participation in a microlending program, and also seeks to determine whether microlending participants would be receptive to receiving nutrition promotion education as a component of the microlending model. If so, then microlending could serve as an effective information dissemination platform to increase the likelihood that participants will make nutritious food choices as they acquire more disposable income, thereby keeping both malnutrition rates and the subsequent risk of diet-related non-communicable diseases (NCDs) at bay. Methods: Ethnographic fieldwork in 15 distinct urban neighborhoods in Manila, Philippines was conducted between May and August 2017. 24-h diet recalls and semi-structured interviews were utilized (N = 93) to determine whether and how participants’ food procurement decisions and macro- and micronutrient intake shifted throughout their participation in a microlending program.Results: Interview data illustrate that participants’ food procurement options and their sense of self-worth and empowerment increased the longer they were involved in the microlending program. However, the nutritional outcomes are more nuanced; while participants who had been in the program longer showed higher levels of micronutrient intake, they also consumed elevated levels of prestige items high in sugar and/or salt. Given that participants reported high levels of uncertainty surrounding nutritional information, more education is needed to reverse this trend and decrease the risk of malnutrition development and the associated adverse health outcomes. Conclusions: Microlending platforms may be a viable avenue for disseminating nutrition-related information. However, our data indicate that participants may only be receptive to this information after at least two years of participation because, prior to that, participants are too concerned with income generation, housing stability and their family’s education to fully absorb the information.

microlending; double burden of malnutrition; diet-related non communicable diseases; ethnography; 24-h diet recall; Philippines