philspen_logo01Philippine Society for Parenteral and Enteral Nutrition (PHILSPEN)

Mission / Vision | Master of Science in Clinical Nutrition| Clinical Nutrition Fellowship Training Program

History of PHILSPEN (Side Story: The role of St. Luke's Medical Center)

The practice of nutrition support started as parenteral nutrition use mainly by the anesthesiologists and surgeons in the 1960’s. Dr. Arvid Wretlind developed both protein and lipid formulations which were used throughout Europe, while Dr. Stanley Dudrick made parenteral nutrition widely practiced in the United States. The specialist who espoused parenteral nutrition practice in Europe was mainly the anesthesiologist while in the United States it was the surgeon.

As the value of nutrition in patient care became recognized worldwide, several specialists came together in Hamburg, Germany to report on their experiences and concerns and the International Society of Parenteral Nutrition (ISPN) was born. The practice became multidisciplinary in nature and the present nutrition support practice and nutrition support team came to be. Two similar societies emerged from this “mother society”, the American Society of Parenteral and Enteral Nutrition (ASPEN) in the U.S. and European Society of Parenteral and Enteral Nutrition (ESPEN) in Europe.

Nutrition support practice came to the Philippines with an “American” flavor when Dr. Antonio Limson and his group spearheaded parenteral nutrition use in the Philippine General Hospital (PGH), while Dr. Renato Reyes did the same in University of Santo Tomas (UST). As the dietitians, nurses, and pharmacists came to be involved several nutrition support teams were organized with the support of several medical nutrition companies in the Philippines. ASTRA was the first to fully push for parenteral nutrition practice workshops, followed by the enteral and/or combined parenteral nutrition workshops and postgraduate courses initiated and coordinated by Mead-Johnson, Nestle, Otsuka, and Abbott. The European influence came in with the involvement of Fresenius Kabi and BBraun.

The Philippine Society of Parenteral and Enteral Nutrition (PHILSPEN) was born in 1995 when the need arose to consolidate all activities related to nutrition support into one effort to promote its use throughout the Philippines. Dr. Bernardino Agustin was one of the key persons who initiated this with the support of ASTRA Philippines, who brokered the initial organizational effort. Dr. Jonathan Asprer was the founding president with Dr. Luisito Llido as the Vice President. The Board members were: Dr. Samuel Ang, Dr. Cenon Cruz, Dr. David Dy, Dr. Antonio Limson, Dr. Fernando Melendres, Dr. Claver Ramos, and Dr. Renato Reyes. Dr. Juliet Sio was the secretary. Shortly the Parenteral and Enteral Nutrition Society of Asia (PENSA) was organized in Chiang Mai, Thailand with Dr. Jonathan Asprer as one of the founding members.

Two of the major aims of the society are: firstly, to enhance every physician’s awareness and knowledge on nutrition support in the Philippines and secondly, to help install a nutrition support team (NST) in every major center in the country. Workshops, invited speakers, and seminars were done starting years 1996 to 2002 and attempts to organize NST’s were done supported by every major medical nutritional company in the Philippines, to no avail. The Total Nutrition Therapy (TNT) program initiated by Abbott Philippines hoped to jumpstart the process in 1999 and nutrition support teams sprouted in major centers in the Philippines, but after a while they just became teams in name not in function.

The organization of a nutrition support program and team in St. Luke’s Medical Center (SLMC) under the encouragement of Dr. Ricardo Fernando was a key movement that helped in the revitalization of the society. The successful partnership of the SLMC group with medical nutritional companies through the TNT program, Aesculap academy, and later the FRANC Asia nutrition course made the nutrition support team and its faculty a key factor in providing the needed people to be involved in the education process on nutrition support. The establishment of the nutrition support fellowship training program in St. Luke’s Medical Center followed by the establishment of the Master of Science in Clinical Nutrition of Philippine Women’s University and St. Luke’s Medical Center further provided the education, research, and faculty base which makes the current PHILSPEN able to flex its muscles as it faces the 21st century. Currently, to further consolidate its multidisciplinary base the society has initiated the establishment of the Philippine Board of Clinical Nutrition (PBCN), which will further provide the necessary credentialing process of the specialists who have trained in, gained recognition, or contributed to the work in clinical nutrition practice (physicians, dietitians, nurses, and pharmacists). The goal of developing real nutrition support teams to be fielded in every major medical center of the Philippines is not far off.

The first PHILSPEN convention was held in Shangri-La EDSA hotel in October 2004 and after this third annual convention, the Philippine nutrition team has the honor of hosting the 12th PENSA congress in 2007. The future holds a lot of promise for the society as it gains more recognition in the Asia Pacific region for its role in the continuing nutrition education program and the development of systems that will further enhance the nutrition support process and make it a reality in every hospital in the region.

The role of St. Luke's Medical Center and more details (Back to Main Topic)

  • 1980: The Philippine General Hospital Committee on Total Parenteral Nutrition came out with a handbook on TPN. This was headed by Dr. Alfredo Limson
  • 1983: The development of the practice of nutritional support in St. Luke’s Medical Center started with the interest in parenteral nutrition when cases requiring this mode of therapy started to be identified.
  • 1985: The move to produce a TPN protocol for the Department of Surgery in St. Luke’s Medical Center was initiated by Dr. Menandro Siozon. The practice of total parenteral nutrition was integrated in the Department of Surgery.
  • 1986: developments
    • July, Dr. Renato Reyes conducted a seminar on Total Parenteral Nutrition in St. Luke’s.
    • The TPN Team of St. Luke’s Medical Center was formally introduced with Dr. Ricardo Fernando as the Head of the Diet Committee and Dr. Oscar Naidas, the Head of the TPN Team.
  • 1992: developments
    • The TPN protocol of the Department of Surgery was adapted by the TPN Team of St. Luke’s Medical Center through Dr. Luisito Llido who became the head of the TPN Team that same year.
    • (92) The TPN Manual of St. Luke’s Medical Center was formally introduced.
  • 1993: Seminar workshop on TPN was done for the hospital staff at St. Luke’s Medical Center under the guidance of the TPN Team, SLMC.
  • 1995 developments
    • February 3&4, The First Postgraduate Course in Parenteral and Enteral Nutrition was conducted in St. Luke’s Medical Center with the TPN Team, Departments of Surgery, Medicine, Pediatrics, Geriatric Institute and Dietary.
    • The first prevalence of malnutrition survey in a hospital set-up was reported by Fernando, Llido et al. The prevalence of malnutrition was 48%.
  • 1996 developments
    • The Second Post-Graduate Course of Parenteral and Enteral Nutrition was held in St. Luke’s Medical Center.
    • The section on Metabolic Support of the Department of Surgery was organized.
    • A paper on the Report on the Practice of Parenteral Nutrition here in St. Luke’s Medical Center was accomplished (Dr. Martin Villa, resident, Department of Surgery).
    • The Third Postgraduate Course in Parenteral and Enteral Nutrition was conducted at St. Luke’s Medical Center.
  • 1998: The Nutrition Committee was reorganized with new members and the initial plans for the creation of a new Nutrition and Metabolic Support Group was done. Here the plans for the establishment of a training program in nutritional support was initiated.
  • 1999: Total Nutrition Therapy (TNT) workshop initiated in 1999 and continuing to the present – this is a joint project with Abbott International, with St. Luke’s as the lead implementing institution in the Philippines and one of four in the Asia Pacific region.
  • 2000: Nutrition support fellowship training program initiated with Dr. Michael John Encarnacion as the first nutrition support physician and Miss Edelina Navarette as the first nutrition support dietitian. They graduated in 2002 and 2003.
  • 2004: Joint Commission International Accreditation (JCIA) achieved with the Nutrition Support Services playing a key role in the approval process (through the evidence of nutrition screening and assessment data).
  • 2005 developments:
    • Consultants and fellows of the Nutrition Support Services moved to have the first national convention of the Philippine Society of Parenteral and Enteral Nutrition in October 2004 held at EDSA Shangri-La hotel. The second national convention held last October 2005 at the same venue was just concluded.
    • Consultants and fellows of the Nutrition Support Fellowship Training Program have been active in the promotion and education on the value of nutrition support program throughout the whole country with partners in nutrition industry like: Abbott Philippines, Fresenius-Kabi Philippines, Nestle Philippines, B Braun Philippines, Diethelm-Novartis, Otsuka, and other allied industries.
    • Some consultants of the Nutrition Support group have been asked to help other Asian countries in developing nutrition support awareness and training (Total Nutrition Therapy workshops in Thailand, Indonesia, and Malaysia and the FRANC Asia advanced nutrition course in Thailand, Singapore, and the Philippines).
  • 2006 developments:
    • Initiated the setting up of a Master’s Program in Clinical Nutrition with Philippine Women’s University (St. Luke’s is not qualified to set it up alone since it has no Bachelor of Science in Nutrition course). Currently the first batch are about to finish the last trimester and then all will undergo the final residency training program.
    • Two research work in nutrition support are officially published in two (2) international journals in nutrition:
      • Clinical Nutrition journal - Llido LO. The impact of computerization of the nutrition support process on the nutrition support program in a tertiary care hospital in the Philippines: Report for the years 2000-2003 Clin Nutr 2006; 25(1): 91-101.
      • Nutrition international journal - Umali MN, Llido LO, Francisco EM, Sioson M, Gutierrez EC, Navarette EG, Encarnacion MJ. Recommended and actual calorie intakes of intensive care unit patients in a private tertiary care hospital in the Philippines. Nutrition 2006; 22(4): 345-9.
    • Together with the Philippine Society of Parenteral and Enteral Nutrition is setting up the Philippine Board of Clinical Nutrition (PBCN), which will be the specialty accrediting body for all graduates and/or applicants for the following certifications:
      • Physicians – CNSP or Certified Nutrition Support Physician, or Diplomate and/or Fellow in Nutrition Support
      • Dietitians – CNSD or Certified Nutrition Support Dietitian
      • Nurse – CNSN or Certified Nutrition Support Nurse
      • Pharmacist – CNSPh or Certified Nutrition Support Pharmacist
    • The Philippine Board of Clinical Nutrition (PBCN) will be fully organized within September to October 2006.

 Additional information:


The Philippine Society of Parenteral and Enteral Nutrition: In 1995 physicians with interest in improving the nutrition support practice in the hospitals organized the Philippine Society of Parenteral and Enteral Nutrition (PHILSPEN). Two of the major aims of the society are: firstly, to enhance every physician’s awareness and knowledge on nutrition support in the Philippines and secondly, to help install a nutrition support team (NST) in every major center in the country. Workshops, invited speakers, and seminars were done starting years 1996 to 2002 and attempts to organize NST’s were done supported by every major medical nutritional company in the Philippines, to no avail An NST successfully maintained its presence in Veterans Hospital in Quezon City (supported by Mead Johnson Philippines), but when its physician leader left it also fizzled out. A Total Nutrition Therapy (TNT) program initiated by Abbott Philippines hoped to jumpstart the process in 1999 and nutrition support teams sprouted in major centers in the Philippines, but after a while they just became teams in name not in function. The only active NST’S are seen in the Luzon area (see Home page: Challenge) and they comprise 6/83 (7%) of the needed team presence.

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