Kosulwat, Public Health Nutrition, Feb 2002 The nutrition and health transitions in Thailand Vongsvat Kosulwat Institute of Nutrition, Mahidol University

Kosulwat, Public Health Nutrition, Feb 2002 Percentage of population by age group and dependency ratios Estimated of population in urban and rural areas

Kosulwat, Public Health Nutrition, Feb 2002 Gross National Product per Capita in US Dollars, Distribution of Occupation (%)

Kosulwat, Public Health Nutrition, Feb 2002 Per capita food consumption g/d Trends in nutrient intake

Kosulwat, Public Health Nutrition, Feb 2002 Prevalence of malnutrition among school children from different socioeconomic classes (Thai reference, 1987) Prevalence of underweight in primary school children in Bangkok public school Prevalence of obesity in primary school children in Bangkok public school Prevalence of obesity in school children ( ) Source: Nutrition Division, Ministry of Public Health 3.6

Kosulwat, Public Health Nutrition, Feb 2002 Cause specific death rate among Thai population,

Kosulwat, Public Health Nutrition, Feb 2002 Morbidity trend

Kosulwat, Public Health Nutrition, Feb 2002 Age standardized prevalence of cardiovascular risk factors for cardiovascular disease (1991 vs 1995) % % Male Female

Kosulwat, Public Health Nutrition, Feb 2002 Nutrition in Transition in Thailand: Challenges for Healthy Thais HEALTHYTHAIS Under-nutrition‘decreasing’ vulnerable vulnerable groups groups PEM, A, PEM, A, I, Fe* I, Fe* Over-nutrition‘increasing’ Food safety & toxicity Acute Acute - poisoning - poisoning Chronic Chronic - cancers - cancers children & children & adults adults Obesity, Obesity, NCD,CVD NCD,CVD

Kosulwat, Public Health Nutrition, Feb 2002 Problems remained and emerging 1. Under-nutrition 1.1 IUGR 1.2 Infant and young child feeding 1.3 Iron deficiency anemia 2. Over-nutrition 2.1 Obesity 2.2 NCDs 3. Food safety 3.1 poisoning &contaminants 3.2 chronic toxicity -- cancers

Kosulwat, Public Health Nutrition, Feb 2002 Challenges ahead to achieve HEALTHY THAIS 1. Thailand decentralization process and important reforms (Health, Education, important reforms (Health, Education, Civil service) and structural adjustment Civil service) and structural adjustment 2. Shifting paradigms 2.1 From ‘Vulnerable groups’ to ‘Life cycle 2.1 From ‘Vulnerable groups’ to ‘Life cycle approach’ approach’ 2.2 From ‘Deficiency diseases’ to ‘human 2.2 From ‘Deficiency diseases’ to ‘human functions and prevention of risks of functions and prevention of risks of diet-related chronic diseases’ diet-related chronic diseases’

Kosulwat, Public Health Nutrition, Feb 2002 Obesity Genetics Behaviors Environments Foods Intake and output Intervention complications Intervention Diagnostic tools Others Suprasongsin, Chittiwat, July 2001