The nutrition and health transition in Thailand

OBJECTIVE: To explore and describe the nutrition and health transition in Thailand in relation to social and economic changes, shifts in food consumption patterns and nutritional problems, as well as morbidity and mortality trends. DESIGN: This report reviews the nutrition and health situation and other related issues by compiling information from various reports and publications from several sources. Yearly statistics and reports from the National Statistical Office were used as well as data from the Food and Agriculture Organization (FAO) and national surveys on the nutrition and health situation of the Thai population. RESULTS: Thailand has undergone social and economic transitions during the past three decades and is approaching the post-demographic transitional period. These are evidenced by an increase in life expectancy at birth of the population, and declines in the total fertility and infant mortality rates. The economic structure has also moved from agricultural to industrial. Industrial growth has surpassed that of the agricultural sector as indicated by a steady rise in the share of the industrial sector in the gross domestic product, which is greater than that of other sectors. At the same time, results from several nation-wide surveys indicate that the food consumption pattern of the population has changed considerably; Thai staples and side dishes are being replaced by diets containing a higher proportion of fats and animal meat. A shift in the proportion of expenditure on food prepared at home and that expended on purchased, ready-to-eat food, in both rural and urban settings, gives another reflection of the change in food consumption of the Thai population. The prevalence of overweight and obesity among children and adolescents has increased dramatically during the past 20 years and is more pronounced in children from private schools and urban communities than in those from public schools or rural areas. Among adults, results from two national surveys in 1991 and 1996 indicated that the problem of overweight and other risk factors for cardiovascular disease have increased significantly. In considering the overall causes of death among the Thai population, the leading causes are diet-related chronic degenerative diseases. Diseases of the circulatory system have become the number one cause of death in Thailand and cancer has ranked as the number three cause of death since the late 1980s. CONCLUSIONS: The rapid changes in food intake and lifestyle patterns in Thailand clearly demonstrate a significant impact on the shifting pattern of disease burden of the population. These changes should be monitored carefully and must be reversed through appropriate behaviour modification and the promotion of appropriate eating practices and physical activities.