1. Prof. Emeritus Kraisid Tontisirin
Healthy aging
Prof. Emeritus Kraisid Tontisirin
Presentation at Karasin Province
2 August 2017

2. Thai’s elderly population*
แนวโน้มการเปลี่ยนแปลงในอนาคต
*ที่มา : สำรวจข้อมูลประชากรสูงอายุไทย ปี 2545, 2554 และ 2557 สำนักงานสถิติแห่งชาติ
Office of the National Statistic of Thailand concluded that Thailand has been an aging society since 2005 (2548) as the elderly population was more than 10.4 % of the total population. It has also been forecasted that Thailand will be an aged society in 2021 (2564) when elderly population will be greater than 20 %.
Kraisid Tontisirin, Mahidol University

3. Thai’s elderly population
Office of the National Statistic of Thailand concluded that Thailand has been an aging society since 2005 (2548) as the elderly population was more than 10.4 % of the total population. It has also been forecasted that Thailand will be an aged society in 2021 (2564) when elderly population will be greater than 20 %.
Kraisid Tontisirin, Mahidol University

4. Dimensions of health Physical Health status Mental Spiritual Social ”
Kraisid Tontisirin, Mahidol University

5. Factors influencing health and wellbeing
1. Genetics
2. Nutrition: the link between food and health
3. Physical activity and exercise
4. Mental and spiritual health
5. Avoidances of tobacco, alcoholic beverages and other addictive substances
6. Environment: physical, chemical, biological, economics, social and political
Kraisid Tontisirin, Mahidol University

6. Ecological factors for good health
Genetics
Health status
Environment
Health behaviors
Health services
Kraisid Tontisirin, Mahidol University

7. Good Nutrition & Well-being for All
Agriculture/
Food supply/
Service
Promotion
Protection
Treatment
Food
Nutrition
Health
Nutrition is a link between food and health,
regarding the fulfillment of energy, protein and micronutrient requirements and non-nutrients from food in human life course
Ultimate Goals
Good Nutrition & Well-being for All
Kraisid Tontisirin, Mahidol University

8. Major health challenges in Thai
Low birth weight ~ 9 %
Underweight of underfive ~ 6 %
Stunting of underfive ~ 10 %
Overweight & obesity in children10-15 %
Adult overweight &obesity ~ 40 %
Adult with high blood pressure %
Diabetes mellitus type2 ~ 7-10 %
Rising trends of cardiovascular diseases (heart and brain attacks) and cancers which are leading causes of dealth
Accidents
Nutrition and NCDs
High sugar, fat and salt diets
Vegetable and fruit consumption less than 400 g./person/day
Inadequate physical activity and exercise
Tobacco and alcoholic consumption
Other undesirable health behaviors
Kraisid Tontisirin, Mahidol University

9. Improvement of maternal & child nutrition, Thailand
1980
1990
2006
ANC coverage (%) 35 75 95
Anemia in pregnancy (%)
50-75
18.8
?10
LBW % 16 10
<10
Underweight of under 5 (%) 51 20
Recent trend of nutritional status of
under 5*
* Source: NHES 2; Holistic Development of Thai Children; NFNS 5; NHES 4; and NHES 5
Kraisid Tontisirin, Mahidol University

10. Courtesy from; Napaphan Viriyautsahakul
Director of Bureau of Nutrition

11. Kraisid Tontisirin, Mahidol University

12. for normal weight and height in human life course
Anthropometric goals of health promotion aiming
for normal weight and height in human life course
Age range
Goals/indicators
Newborn infants
- Normal birth weight
kg.
Children underfive
- Underweight
≤ 5 %
- Stunting
- Overweight & obesity
School children
≤ 10% and be ≤ 5 % (after 5 years)
Adolescents and adults
≤ 20% and be ≤ 15 % (after 5 ปี)
Elderly
- Normal BMI
Kraisid Tontisirin, Mahidol University

13. Goals of community health promotion
Family and community well being indicated by normal wt. and ht., B.P, blood sugar, eat adequate vegetables and fruits with low sugar, fat and salt; no tobacco and no/less alcoholic consumption, physical activity and exercise regularly.
Cares of NCDs including: Obesity, high B.P., diabetes mellitus and others to be under controlled.
Community and setting approaches in health promotion: with full functions and support by health services (Community and Tambon hospitals) and Local Administrative Organizations, and others.
Create healthy environment for health promotion: including recreation areas for physical activity, exercise and other social functions
Kraisid Tontisirin, Mahidol University

14. Community-based approaches
Is an integrated program implemented
at local level (district level and below)
National commitment with sound nutrition
improvement strategies and goals
Community actions: basic services, mass
mobilization, mutual efforts/actions to reach
all people and to prevent malnutrition
Kraisid Tontisirin, Mahidol University

15. : Community Based Program for Health Promotion Minimum Basic Services
(Health, Education, Agricultural Extension)
Supportive System
Menu (Activities)
Antenatal care
Growth monitoring /promotion
Nutrition in school
Elderly cares
Cares of NCDs
Food production
Nutrition education
Food sanitation
& safety
Other activities
(Tobacco and alcoholic
consumption control)
Recreation and physical
activities)
Etc.
Training
Funding
Problem Solving
Supervision
Facilitators
Interface
(service providers and community leaders)
Plan/goals
Implementation
Monitoring/evaluation :
Community Leaders
Family
Individual
Volunteers
(1:10 households)
Minimum Indicators
of well-being & NCDs 15
Kraisid Tontisirin, Mahidol University 15

16. Health cares in human life course
Antenatal cares
Healthy behaviors & life styles
Breast and complementary feedings
Nutrition and health promotion in school children
Growth and development monitoring & promotion
Kraisid Tontisirin, Mahidol University

17. Menu Activity on ANCs 4 ANC visits for all pregnant mothers
High risk check up and treatment
monitoring wt. gain
Food, Nutrition and health education
Food supplementation
MTV, iron and folate supplementation
Two tetanus toxoids
Referral system and safe delivery service
Kraisid Tontisirin, Mahidol University

18. Menu on Growth Monitoring and Promotion (GMP)
Growth monitoring (wt.& ht.) and remedial actions
Child growth education and cares
Breastfeeding and complementary feeding
Immunization
Village based complementary food production for infants and young children
Health and nutrition education
Cooking and feeding demonstration
Treatment of malnourished child
Referral of severe illness and malnutrition
Kraisid Tontisirin, Mahidol University

19. Menu on Nutrition in School
Monitor weight and height regularly and take
remedial actions based on growth monitoring
Food services-school lunch and milk programs
Food, personal and environmental hygiene
Nutrition education
Promotion of physical activity and exercise
Positive school environment for healthy diets
Plan to set up a “Nutri-teacher” post
School gardens
Kraisid Tontisirin, Mahidol University

20. School milk program in Thailand
Based on Food Nutrition Plan aiming to provide daily 200 ml of milk to children in kindergartens and primary school 200 days/ year
The program has been implemented since 1992 along with school lunch program in kindergartens and gradually stepped up to cover 6 grade-students in 2009
School milk program has created demand for local dairy industry
Kraisid Tontisirin, Mahidol University

21. Conclusion: Healthy aging
1. With healthy behaviors in human life course
2. Good nutrition: Eat a variety of food emphasis on unpolished rice, fish, egg, low fat milk, vegetables, fruits, legumes and adequate water consumption
3. Adequate physical activity and exercise regularly
4. Good mental health and happiness: compassion, mindfulness, willing to learn, ethic and morality
5. Avoid tobacco, alcoholic and other addictive substances
6. Healthy family, good friends and nice social environment
Kraisid Tontisirin, Mahidol University

22. Thanks for your
attention