Healthy Plates, Healthy Hearts: The Pinggang Pinoy Approach to Reducing CVD Risk

By Mariela Angella Oladive

Cardiovascular diseases (CVDs) continue to be a major health concern in the Philippines, driven by risk factors such as high blood pressure, elevated LDL cholesterol, unhealthy diets, and sedentary lifestyles.

In response, the Department of Health (DOH) and medical experts continue to advocate for “Pinggang Pinoy”, a practical food guide designed to promote balanced eating habits while considering Filipino culture and the availability of local produce.

The widespread preference for rich, flavorful dishes high in sodium, cholesterol, and unhealthy fats has contributed to the rising incidence of heart disease. Pinggang Pinoy addresses this by emphasizing portion control and healthier food choices.

Dr. Marie “Bambi” P. Tupas, a medical nutrition specialist at The Medical City (TMC) Iloilo emphasized that preventing cardiovascular diseases starts with proper nutrition.

She highlighted the alarming rise of hypertension, dyslipidemia, and diabetes, which are now increasingly affecting individuals as young as their 20s and 30s.

“In the past, these conditions were typically seen in middle-aged or elderly individuals, but there has been a paradigm shift. Today, we are even diagnosing people as young as 20,” she explained, linking the trend to excessive fast food consumption and inactive lifestyles.

“The widespread availability of fast food across the country has made it a more accessible and convenient option compared to healthier alternatives. As a result, frequent consumption of fast food has contributed to a fast-paced lifestyle and less nutritious eating habits,” she added.

Dr. Tupas noted that even in workplaces where employees are required to undergo medical examinations, many individuals who do not exhibit symptoms still receive unfavorable laboratory results.

25-Year-Old’s Wake-Up Call

One of her patients, a 25-year-old private employee in Iloilo City, shared how a health scare in late 2024 forced her to completely shift her lifestyle.

After experiencing severe headaches, dizziness, and vomiting, she sought medical attention and was diagnosed with borderline hypertension.

“It all started last year when I began experiencing severe headaches. It was All Souls’ Day, I thought it was just exhaustion from my work and extreme heat. But as the pain became unbearable and I started vomiting, I decided to rest. However, the pain persisted,” she recalled in vernacular.

She was then brought to a hospital, where a series of laboratory tests revealed borderline hypertension, a condition where blood pressure levels are elevated but not high enough for a full hypertension diagnosis. If left unmanaged, it can progress to chronic high blood pressure, increasing the risk of heart disease and stroke.

Further tests later uncovered multiple underlying health concerns, which her doctors linked to excessive stress, poor diet, and physical exhaustion from work.

“I used to ignore my health because I felt strong. I consumed a lot of coffee, had no control over what I ate, stayed up late, and overworked myself both physically and mentally. I thought resting alone would be enough to recover,” she admitted.

With Dr. Tupas’ guidance, she adopted healthier eating habits, following the Pinggang Pinoy food plate along with regular exercise and medication.

At the time, she weighed 76 kg, classified as overweight based on her Body Mass Index (BMI), but noted that the recommended changes significantly improved her lifestyle.

“Pinggang Pinoy has really helped me. I was advised to eat more fiber and fewer calories—less rice, more vegetables, and enough protein. Compared to my old eating habits, I’ve actually saved money. It was truly life-changing,” she said.

Although she acknowledged the high medical expenses despite savings on food and shared medical insurance from her company, she viewed it as a worthwhile health investment.

In two months, she lost 10 kg and improved her health.

Dr. Tupas shared that she often recommends Pinggang Pinoy to her patients, describing it as “a more practical and effective way for the public to make informed food choices.”

She noted that, unlike the Mediterranean diet, which follows foreign standards and relies on ingredients that can be difficult to find locally, Pinggang Pinoy is more accessible and suited to the Filipino lifestyle.

She recommended simple dietary modifications that ordinary people can integrate into their daily lives:

• Opting for lean meats during gatherings and avoiding fatty cuts.
• Choosing healthier cooking methods, such as boiling, baking, or broiling instead of frying.
• Reducing soft drink consumption and replacing sodas with water.
• Incorporating more locally sourced ingredients, which are fresher and contain fewer preservatives.

Dr. Tupas highlighted the importance of early intervention.

“Even without symptoms, developing healthy eating habits early can prevent severe complications later on. Small, consistent changes lead to long-term health benefits,” she stated.

Meanwhile, for Sheryl Lyn Lamis, a 25-year-old regular employee in a web development and IT services company, adopting a healthy diet has been beneficial, but she faces challenges with consistency.

Though unsure of her health conditions due to a lack of regular check-ups, she makes an effort to maintain a healthy lifestyle, considering her family’s medical history.

“On my mother’s side, two relatives had cancer—one passed away, while the other recovered after early intervention. Diabetes is also common, with three of my mother’s siblings affected. On my father’s side, he suffered a stroke and has diabetes, his sister has colon cancer, and both his parents are diabetic. That’s why I try my best to stay healthy, especially since I am overweight,” she shared.

Lamis also admitted struggling with weight management.

“I have a slow metabolism, so I’ve been trying to cut down on rice since junior high school and incorporate more greens into my diet. While the changes aren’t very noticeable, my weight has remained stable, and at times, I even lose around 1–2 kg.”

She noted that preparing her own healthy meals is more budget-friendly, but purchasing pre-cooked healthy food can be quite costly.

The Pinggang Pinoy: A Guide to Healthier Eating

The Pinggang Pinoy is a visual guide developed by the Department of Science and Technology – Food Nutrition Research lnstitute (DOST-FNR|) in collaboration with the DOH, World Health Organization (WHO), and National Nutrition Council (NNC) to help Filipinos make healthier food choices.

It promotes a balanced intake of carbohydrates, proteins, and fats, with an emphasis on fruits and vegetables, making it more practical for Filipino eating habits.

In addition to Pinggang Pinoy, the DOST-FNRI releases an annual Menu Guide Calendar (MGC) that offers recipes tailored for specific dietary needs. The 2024 edition featured 14 nutrient-dense, fiber-rich recipes that limit salt and saturated fat.

Each serving provides 132-353 calories, 11.4-21.6 grams of protein, and minimal cholesterol and sodium, making them ideal for those managing high blood pressure.

This year’s MGC introduces 14 innovative recipes that utilize food surplus like vegetable peels, fruit rinds, and fish bones to enhance nutrition while reducing waste. It also includes food preservation techniques such as fermentation and pickling, along with essential food safety guidelines.

Designed for home cooks, the calendar promotes sustainability by supporting local farmers, cutting food costs, and encouraging mindful eating.

It features a four-week seven-day cycle menu, tips on seasonal produce, and articles on food waste reduction, aiming to inspire healthier and eco-friendly cooking habits.

Managing Cholesterol for a Healthier Heart

“Traditional diets have long prioritized fresh, locally sourced vegetables, fish, and whole grains, which are beneficial for heart health. However, the modern shift toward processed foods high in salt, sugar, and unhealthy fats has adversely affected cholesterol levels and overall well-being,” she said.

She explained that while cholesterol is essential for normal body function, an imbalance can significantly impact heart health. High levels of low-density lipoprotein (LDL), or “bad” cholesterol, can lead to plaque buildup in the arteries (atherosclerosis), causing them to narrow and harden. This restricts blood flow and raises the risk of heart attacks, strokes, and peripheral artery disease. In contrast, high-density lipoprotein (HDL), or “good” cholesterol, helps remove LDL from the bloodstream, lowering cardiovascular risks.

To help manage cholesterol levels, Gayomali recommended following the Pinggang Pinoy dietary guide, which consists of:

• 50% leafy greens
• 25% lean protein sources
• 25% fiber-rich carbohydrates

The approach also aligns with the Philippine Package for Essential Non-Communicable Diseases Interventions (PhilPEN), which includes cholesterol screening as part of its risk assessments.

She underscored that adopting a balanced diet alongside an active lifestyle can help improve heart health and prevent non-communicable diseases (NCDs).

To further address CVDs,  she advocated for strengthened regional governance, multisectoral partnerships, and  efforts to reduce risk factors such as smoking, alcohol consumption, unhealthy diets, and physical inactivity.

Data from Philippine Statistics Authority (PSA) revealed that ischemic heart disease, neoplasms, and cerebrovascular diseases were the top causes of death in the country in the first half of 2024, mirroring the trend from the same period in 2023.  From January to June 2024, ischemic heart disease accounted for 49,577 deaths, representing 19.9% of all deaths nationwide.

In Western Visayas, hypertension, a key risk factor for heart disease, ranked as the third leading cause of morbidity in 2021 and 2023 and was the second leading cause of mortality in 2023, according to DOH Regional Field Health Services Information System (FHSIS).

Healthy Hearts Programme: A Local Initiative with Global Impact

A key initiative in the region is the Healthy Hearts Programme (HHP), launched in partnership with the World Health Organization (WHO) Philippines and supported by Resolve to Save Lives (RTSL). It also integrates Pinggang Pinoy to promote healthier eating.

The program aims to reduce premature deaths from CVDs by:

• Reducing trans fat consumption
• Limiting salt intake
• Developing standardized national guidelines for hypertension screening, diagnosis, and treatment

“The program focuses on good governance and financing, which are crucial for commitment and expansion. For every beating heart, the Healthy Hearts Programme has touched many lives, one community at a time,” said Gayomali.

Piloting Success in Iloilo

In 2021, Phase II of the program was launched in Iloilo’s First District, piloting a local government-led health service model in seven municipalities. The initiative achieved a remarkable 86% blood pressure (BP) control rate, the highest among all HHP-implementing countries.

Encouraged by these results, Phase III (Expansion Phase) began in 2023, extending the program to additional districts in Iloilo, Antique, and Aklan.

By 2024, 42 of Iloilo’s 43 rural health units (RHUs), along with 18 in Antique and 17 in Aklan, joined as expansion sites, significantly improving access to life-saving interventions.

Barangay Health Workers (BHWs) play a vital role in ensuring these services reach underserved populations by conducting risk assessments for adults aged 20 and above.

“They were capacitated to do active risk assessment, which is a tool to primarily assess the absence or presence of risk factors through early detection, prevention, and management.The assessment tool helps detect risk factors early, enabling prevention and management,” Dr. Gayomali explained.

Capacity-building initiatives, educational materials like the NCD flipchart, and the Hypertension e-Registry have strengthened healthcare workers’ ability to provide accurate care.

As of Q3 2024, BP control rates varied across the region:

• Iloilo: 70% controlled, 10.6% uncontrolled, 19.3% unrecorded
• Antique: 67.6% controlled, 23.8% uncontrolled, 8.6% unrecorded
• Aklan: 54.6% controlled, 24.8% uncontrolled, 20.6% unrecorded

Community Impact

In Barangay Ingay, Tubungan, located about an hour and a half from the city, the program has been instrumental in monitoring and managing the health of hypertensive and diabetic individuals as part of the pilot implementing LGUs.

Ma. Luz Asong, Barangay Kagawad Committee on Health and a BHW for 15 years, reported that out of 554 residents aged 20 and above monitored in 2024, 128 have hypertension and 20 have diabetes.

“These individuals undergo monthly assessments to ensure proper assistance and intervention,” she said.

With support from the WHO, they received BP apparatus and NCD flip charts for house-to-house health campaigns. Free maintenance medicine from the municipal pharmacy is also provided to at-risk individuals.

“Aside from monitoring BP, we conduct educational campaigns on the importance of a healthy lifestyle, discouraging smoking, alcohol consumption, and unhealthy eating habits using the chart,” Asong explained.

“We emphasize that maintaining good health starts at home,” she added.

The barangay also launched Proyekto Bantay Presyon, a focused effort to regularly monitor hypertensive patients and Pabasa sa Nutrisyon, which educates parents and pregnant women on proper nutrition for their child.

Barangay Captain Leonardo T. Tamises, now in his second term, stressed the importance of sustaining health programs.

“We fully support our BHWs in their duties and strive to make Barangay Ingay a model for other communities. Our Bantay Presyon initiative is the first in Tubungan, and we hope other barangays will follow,” he said, emphasizing the LGU’s commitment to health initiatives.

To further encourage an active lifestyle, the barangay also organizes weekend Zumba sessions.

Mary Grace Tamises, 55, shared how the program impacted her.

“I never had check-ups before, but in 2019, my brother-in-law encouraged me to get one. That’s when I found out I had hypertension. I started taking maintenance medication, and when the Healthy Hearts Program became available, I availed the free medication, which has been a huge financial help,” she said.

She now follows a strict diet and eats healthier meals to manage her condition.

However, despite the program’s success, challenges remain. Asong noted that many residents are reluctant to undergo regular check-ups, especially those who do not feel any symptoms.

“Some individuals are in denial, dismissing the risk even when their BP readings indicate otherwise,” she said.

To address this, they continue educating residents about the dangers of untreated hypertension and the importance of early intervention.

She urged those who remain hesitant to prioritize their health before it’s too late.

With sustained efforts and strong community participation, Brgy. Ingay remains committed to improving health outcomes and ensuring residents receive the care and support they need.

Barangay Health Workers (BHWs) in Tubungan, Iloilo conduct routine risk assessments to monitor residents’ blood pressure, cholesterol, and heart disease risks.

Call to Action: Take Control of Your Heart Health

While heart disease remains a leading cause of death in the country, the risk can be reduced with awareness and timely action.

A – Atherosclerotic cardiovascular disease (ASCVD) is a top killer in the Philippines

C – Cholesterol is a key risk but can be managed

T – Take action to lower it fast

NOW – The next heart attack or stroke could be worse. Act now to stay protected.

This article is part of the Unblock Your Heart Health Reporting initiative, supported by the Philippine Press Institute and Novartis, to improve health literacy on cardiovascular diseases.

Know your numbers, understand your risks, and consult your doctor—so no Filipino heart is lost too soon. Take control of your heart health today. Visit unblockedmovement.ph for more information.