By Maria Elena Catajan
In the vegetable capital of the Philippines, people suffer from unhealthy eating habits.
“It’s alarming that cardiovascular disease is at the top among Cordilleran’s.” Joyce Rillorta, Nurse V, Lifestyle Diseases Program of the DOH CAR said as she explained traditional cuisine contains high fat, salt, and carbohydrates.
Heart Disease in the Cordillera
Records show that heart disease was the second leading cause of death last year, with over 741 people succumbing to the disease (431 males and 310 females). The most common cardiovascular diseases are coronary artery disease, high blood pressure, and cardiac arrest.
Pneumonia was the leading cause of death, with 850 fatalities and cancer ranked third with 588 deaths. Acute myocardial infarction (heart attack) remains a significant health concern, causing 372 deaths, and hypertension caused 333 deaths.
“Cordilleran’s love rice, and many individuals consume large portions of white rice, which contributes to an increase in blood sugar, resulting in diabetes. Also, most Cordilleran’s love to drink Tapuey (fermented rice wine) and other alcoholic beverages during feasts or after work,” Rillorta added.
Ironically, despite the abundance of vegetables in the region, malnutrition and overnutrition are plaguing households.
Obesity in the Highlands
Candice Salingbay, Nurse V under the Nutrition program of the Department of Health – Cordillera Administrative Region (DOH CAR), said that although the region supplies vegetables for the entire country, Cordillerans do not always eat the produce of the highlands.
“In areas with plenty of vegetables, malnutrition can still exist because a person’s nutritional status depends on diet, lifestyle, physical activity, and other health conditions. Despite being the salad bowl of the Philippines, various forms of malnutrition exist here. In the 2023 Food and Nutrition Research Institute of the Department of Science and Technology study, the Cordillera ranked 2nd in obesity in the entire Philippines, with a prevalence of 63.1% among adults between 20–59. This is still a lifestyle choice. The culture of the Cordillera has high meat consumption, with people mostly carnivorous,” Salingbay said.
Based on DOH CAR interviews and observations, vegetable-producing towns sometimes sell 100% of their produce to the market and indulge in other diets.
Salingbay said that although there are no direct studies linking traditional cuisine to obesity, overconsumption of meat over a number of days will contribute to being obese or overweight. “There is a way to honor tradition and be healthy. Let us practice moderation and balance it with vegetables in our diet. Our diet should be moderate, and let us stay active, increase physical activity, allot time to exercise, and consult our health facilities.”
The Cordillera’s Traditional Cuisine
The DOH CAR notes that the typical diet in the highlands contributes to a decline in health, despite being high in fiber, vegetables, and root crops like camote, gabi, sayote, and beans, due to food preparation that contains high salt content.
During special occasions, highland folk practice rituals to celebrate or commemorate milestones from birth to death, and these involve the butchering of animals like pigs, chickens, cows, and even dogs.
Celebrations may last for a few hours or extend to a number of days, depending on the occasion, and involve animal offerings, distribution of food and drink, as well as a series of prayers done by elders and the community.
The most common offering, a live pig, is slaughtered, and slabs of boiled meat, or the revered watwat, are distributed to the community for all to partake.
The meat is commonly dipped in salt and chilies or soy and eaten with white rice, while delicacies like etag and inasinan (salted and smoked pork), fatty meat, and the all-time favorite pinikpikan (chicken killed by beating) coupled with etag have high salt and high uric acid levels, also known as hyperuricemia.
Pinunog, or smoked meat, is common in the region, but in Ifugao, it is made almost like a sausage flavored with onions and garlic. In some areas, pinunog is made of pig’s blood. The way of cooking and smoking differs in each place, dictated by tradition and necessity.
Apayao’s version of pinikpikan, a soup dish consisting of burned chicken mixed with etag, uses native ducks instead of native chicken, which, according to some homegrown cooks, are tastier and give a stronger soupy taste.
Another innovation is dinuguan, or locally known as zinagan, a traditional Kalinga cuisine that the I-Apayaos have also adopted, considering their long-standing connection.
The dish consists of intestines and other pork innards fried until crispy, like chicharon, before being sautéed with garlic, onions, ginger, and pork blood.
In Sagada town in the Mountain Province, etag (salted meat) is processed in three ways: binalag (drying in the sun), masuukan (smoking in the dapuan or pat-yay), and binul-nay (preserved in a jar).
Leading Causes of Death
The DOH underscores that modernization has introduced dietary changes that contribute to hypertension and diabetes, such as canned goods, noodles, and hotdogs, which have become popular due to convenience but contain unhealthy fats and preservatives. The “eat-all-you-can” culture is strongly linked to obesity because of unlimited portions of high-calorie, high-fat food choices, disrupted satiety signals, social influences, and long-term health risks.
In 2023, the provinces of Kalinga, Benguet, and Mountain Province had the highest number of hypertensive cases, while diabetes cases were highest in Benguet and Kalinga in the same year.
Leading Causes of Death in the Cordillera 2019 to 2023
Salingbay recommends changing lifestyle choices and doing all activities in moderation. “For example, with diet, what we need is high fiber, low salt, and low sugar. We need to be more active, as we have a sedentary lifestyle now, where only our brains are working. Every two hours, we need to walk around.”
Nutritionists are available at the DOH or at the rural health units of the barangays for free diet prescriptions, which will guide those who need it to a healthier way of eating with recommendations based on personal lifestyles.
Rillorta recommends an annual checkup and availing of the Kunsulta packages, which include free blood, glucose, cholesterol, and uric acid tests, X-rays, CBC, and stool examinations at the various rural health units.
Health experts are calling for a proactive stance on heart disease with an ACT NOW mantra;
A – Atherosclerotic Cardiovascular Disease (ASCVD) is considered 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.
