1. Nutrition and health impact of agriculture and food systems in Thailand
Prof. Kraisid Tontisirin M.D., Ph.D
Senior Advisor , Institute of Nutrition , Mahidol U.
Chairman of the Planning Committee on Strategic Frame work for Food Management (SFFM) in Thailand of the National Food Committee
Presentation at the WFD, Bangkok, 26 November 2013

2. Thailand: Current situation
Has succeeded in reduced
maternal and child malnutrition
since the eighty by mutistakeholder
efforts under the Poverty Alleviation
Plan (PAP)
Currently Thailand is facing with
double burden of malnutrition (DBM),
a coexistence of under and over nutrition, and related non-communicable diseases
(NCDs) 2
Kraisid Tontisirin, Mahidol University

3. 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 nutrient and non-nutrient
requirements from food in human life cycle.
Ultimate Goals
Nutrition well-being for all
Kraisid Tontisirin, Mahidol University 3

4. Poverty Alleviation Plan (PAP)
From 1982 onward
Malnutrition was considered as symptom of poverty
With organization changes for management
of rural development
With 5 basic principles: poor area, basic services, appropriate technology, self-help and community participation
PAP
Fd/Nut.Prog.
PHC BMN indicators
Kraisid Tontisirin, Mahidol University

5. 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

6. Components of a successful community based program
Minimum Basic Services
(Health, Education, Agr. Extension)
Supportive System
Training
Funding
Problem Solving
Supervision
Menus (Activities)
Antenatal Cares (ANC)
Growth Monitoring and Promotion (GMP)
Food production
Food and nutrition education
Food sanitation & safety
School lunch and milk
program since 1992
Other activities
Facilitators
Interface
(service providers and
community leaders)
Plan/goals
Implementation
Monitoring/evaluation
Mobilizers
(1:10 households)
Community Leaders
Family
Individual
Basic Minimum Needs Goals/Indicators
Kraisid Tontisirin, Mahidol University

7. Maternal and child nutrition and health Thailand, 1980-2006
1990
2006
ANC coverage % 35 75 95
Anemia in preg. %
50-75
18.8 10
LBW % 16
<10
PEM (Wt/Age of U 5)% 51 20
Kraisid Tontisirin, Mahidol University

8. Trend of nutritional status of children aged 1-5 years*%
Stunting
Underweight
Overweight&
Obesity
NHES 2; Holistic Development of Thai Children; NFNS 5; NHES 4
*Courtesy from Dr. Umaporn Suthutvaravut

9. Roles of agriculture and food systems
Food production for subsistence economy: for consumption and income
Promote local healthy snacks as food supplement for pregnant mothers
Promote complementary food for infants and young children: at household and community levels
School gardens and school lunch program
Local daily farm for school milk program: a win-win activities
Kraisid Tontisirin, Mahidol University 9

10. National Rural Development Committee
Poverty Alleviation Plan
Provision of basic
services with mass
mobilization:1volunteer
/10 households
Agri.& food production for subsistence econ.,
suppl. food for mothers, complementary food for IYC & dairy farm for sch.
Multi-stakeholder Comm.
Nutrition goals and health
indicators are incorporated
to strategies and actions.
Community based
approaches
Kraisid Tontisirin, Mahidol University

11. Thailand: Current situation
Population 64.6 millions
12th largest exporter of
agriculture and food products
Main food exported products :
e.g. Rice
Processed Chicken
Processed Pineapples
Fishery Products 11
Kraisid Tontisirin, Mahidol University

12. Thailand Is A Food Exporter
-- Kitchen of the World --
Thailand
Export Value of
Food in 2011
27, million US$
and was 34,330 millions $ in 2012 12
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13. Thailand: Current situation Kraisid Tontisirin, Mahidol University
Facing with the double burden of malnutrition (DBM) and food safety issue
Kraisid Tontisirin, Mahidol University

14. Thailand National Food Committee Act of 2008
Education
Food
Security
Food
Quality
Food
Safety
11 related ministries, 30 national agencies, 30 relevant Acts
Ministry of
Defense
Ministry of
Finance
Ministry of
Foreign Affairs
Ministry of Social
Development
and Human Security
Ministry of
Industry
Ministry of
Public Health
Ministry of
Commerce
Ministry of
Interior
Ministry of
Science
Ministry of
Education
Ministry of
Agriculture
The National
Security Council
The National
Economic and Social
Development board
The Consumer
Protection Board
The national Health
committee
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15. Chairman : Prime Minister
The National Food Committee Component
Chairman : Prime Minister
(or designated Deputy-Prime Minister)
Secretary
: FDA, Ministry of Public Health
Co-secretary
: ACFS, Ministry of Agriculture
7 Resource persons in :
-Food Security (2) -Food Safety (1)
-Food Quality (1) -Law (1)
-Economic and Trade (1)
-Food Innovation (1)
Committee members
11 related ministries, 4 executive administrators
Ministry of
Defense
Ministry of
Finance
Ministry of
Foreign Affairs
Ministry of Social
development
and human security
Ministry of
Industry
Ministry of
Public Health
Ministry of
Commerce
Ministry of
Interior
Ministry of
Science
Ministry of
Education
Ministry of
Agriculture and Commodity
The National
Security Council
The National
Economic and Social
Development board
The Consumer
Protection board
The national health
committee
Committee / Sub-Committee 15
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16. The Authority of the National Food Committee
Setting policy, planning strategies, monitoring and assessing
Food Security
Food Safety
Food Quality
Food Education
Advices and provisions of guidance
to the related ministries / authorities
Advices the cabinet in case of food disaster or bioterrorism for action and
land uses
Meeting at least 2 times a year 16
Kraisid Tontisirin, Mahidol University

17. W S O T SWOT Analysis Strength Weakness Threat Opportunity
Fertile food production resources
2. Food contribute significantly to socio-economic and cultural development
3. Thai foods are unique and well accepted internationally
4. Continued improvement in food production and agro-industry
Weakness
1. Complexity in food management
2. Inadequate inputs for small food
producers
3. Degradation and deterioration of land
and water in certain areas
4. Low investment in R&D
5. High logistic cost related to food
6. Weak consumer awareness W S
Threat
1. Agriculture and food production sectors are not popular among
young generation
2. Competition for agriculture production resources for food, feed, fuel,
bioproduct and non- food crop
3. New threats from global warming , plant/ animals diseases
4. Trade competition and barriers
Opportunity
Increasing demand of high quality, safe and nutritious food
2. Global recognition of Thai food and food culture
3. Food is always in demand and more in crisis situations
4. Geographical Location of the country is conductive to trade
5. New innovation and technology in food O T 17
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18. Continuum from Agriculture to Health
Food supply
Food Service
Promotion
Protection
Treatment
Food
Nutrition
Health
Food production
Nutrition orientation
for healthy diet
Food, feed and fuel
and bio-products
Climate changes
Food quality
Food safety
(Consumer and Trade)
Nutrient needs
Dietary intakes
Nutritional wellbeing
Nutrition literacy
Safe from Hazards
Good health
F o o d S e c u r i t y
F o o d a n d N u t r i t i o n E d u c a t i o n
F o o d C u l t u r e 18
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19. Food Chain Approach Good Agricultural Practices Land Use
OUTCOMES
Safe and Nutritious Food
Good Manufacturing
Practices
GOOD PRACTICES
Good Hygienic Practices
Good Agricultural Practices
Plant and Animal Agro- Biodiversity (Genetics)
Plant and Animal Diseases Prevention and Control
BASIC ISSUES
Nutrition For Plant and Animal
Land Use
Water Management 19
Kraisid Tontisirin, Mahidol University

20. for Food Security and Human Well-Being
VISION
Ensuring Quality
and Safe Food Supply
for Food Security and Human Well-Being
OBJECTIVES
Efficient and effective management of food production resources
2. Ensuring high quality, safe and nutritious food produced at household,
community, and industrial levels
3. Promotion of R&D and utilization of knowledge along the food chain
4. Strengthening food management systems (food law, food database, etc.)
5. Ensuring food security in both normal and crisis situation at the household,
community and national levels 20
Kraisid Tontisirin, Mahidol University 20

21. STRATEGIES & MEASURES :
THEMES,
STRATEGIES & MEASURES :
Food Security
10 strategies
41 measures
Food Quality and Safety
6 strategies
33 measures
Food Education
5 strategies
17 measures
Management
3 strategies
12 measures 21
Kraisid Tontisirin, Mahidol University 21

22. Theme 1: Food Security Supply & Access Production
Principle : Ensuring a sustainable food security and effective management of food production resources by active stakeholders participation
Natural &
Agricultural
Resources
Supply
& Access
Production
Enhancing Food Access at Household & Communities
Land & Water Mgt/Reforming
Food Production Zoning
Innovation & Technology
Balancing Food,
Feed & Fuel
Capacity Development & Career
Logistics Improvement
Establish Crisis Management Systems
R & D Along the Food Chain
Active Stakeholders Participation 22
Kraisid Tontisirin, Mahidol University

23. Theme 2 : Food Quality and Safety Community Food Production
Principle : Ensuring high quality and safe food to protect consumer health and to facilitate domestic/international trade
Food Standards
Community Food Production
Quality
Safety
Nutrition
Food Industry
Strengthening
- Value Added
- Enhance Production Practices
Strengthening Community Food Processing
(food loss reduction / value added)
Establishment of harmonized standards
Strengthening of food quality and safety assurance systems
Trading & marketing promotion 23
Kraisid Tontisirin, Mahidol University

24. Knowledge Utilization
Theme 3 : Food Education
Principle : R&D and knowledge utilization through engaging stakeholders in sustainable and effective use of food production resources along the food chain and also strengthening desirable consumption behavior for well-being
R&D
Output
Research and Knowledge Development
Knowledge Integration
Best Practice
Knowledge Dissemination
Knowledge Utilization
& Practice
Basic
Knowledge Utilization 24
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25. Theme 4 : System Management
Principle : Effective food management systems along the food chain
to deal with current and emerging issues in food
Organization
Database & Management System
Reorganization & Strengthening
Legal system
Revise and Reform 25
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26. A Cabinet Resolution on “Thailand Food Strategy”
Approved
The Strategic Framework of Food Management
on 25 November 2010
by the Cabinet 26
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27. Implementation of the Strategic Framework of Food Management (SFFM)
Integrated the SFFM in the 11th National Economic & Social Development Plan
2. Each sector implementing the SFFM & reports back to the National Food Committee
Three thematic committees for promotion the implementation on: Food Security, Food Quality
& Safety, and Linking of Food to Nutrition& Health
Kraisid Tontisirin, Mahidol University

28. Supply Service Linking of Food, Nutrition and Health Safety
Safe and Nutritious Food
Surveillance
Safety
Supply
Good Nutrition&
Good Health
Service
Consumption
►Domestic/
Imported Food
- Primary Product
- OTOP
- Industrial
Quality / Diversity
►Restaurant
►Catering
►Mobile Food
Service Facility
►School
►Household
►Market
►Access
►knowledge
►Behavior
- Diet pattern/Sanitary
- Life style /Exercise
Production 28
Information /Standard and Knowledge based
Kraisid Tontisirin, Mahidol University 28

29. Key Issues Linking Food, Nutrition & Health
1. Standards & indicators on nutrition & related disease
2. Food based dietary guidelines (FBDGs)
3. Food, nutrition & dietetic education
4. Promotion for more vegetable & fruit consumption
5. Reduction of sugar, fat & salt in food
6. School food & nutrition program
7. Community based nutrition program
to promote nutrition & health
8. Nutrition & related disease surveillance & survey
9. Food and nutrition management during crisis
Kraisid Tontisirin, Mahidol University

30. : Community Based Program for Food, Nutrition & Health
Minimum Basic Services
(Health, Education, Agricultural Extension)
Supportive System
Menu (Activities)
Antenatal care
Growth monitoring /promotion
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
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31. Kraisid Tontisirin, Mahidol University
Roles of agriculture and food systems beyond the year 2015 for nutrition
Ensuring nutritious and safe food supply of healthy diets through human life course
Be a key partner to prevent DBM and NCDs by supplying adequate fruits & vegetables; low sugar, fat and sodium foods; healthy fats…etc
Care for environment and sustainable development
As a source of income
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32. National Food Committee
Str Framewk for Food Mgt
(SFFM)
Roles of agriculture and food systems:
Ensuring nutritious and safe food supply e.g.fruits
& veg; low sugar, fat & sodium foods; legume & fishes …etc
Caring of environment & sustainable agriculture.
Multi-stakeholder Comm.
SFFM covers: Food
Security, Quality & Safety,
Education & Research,
Management
Linking of food, nutrition &
health implemented at
central & community levels
for nutrition and p/c of NCDs .
Kraisid Tontisirin, Mahidol University

33. Thailand’s Development Plans Policies and Strategies
Nutrition Situation
Thailand’s Development Plans
Policies and Strategies
Anaemia in preg: 57%;
- B1 deficiency: 23%;
- B2 deficiency: 47%;
- Low serum retinal: 38%;
- Goitre in school children: 29%
- PEM cases
1962
1967
1972
1977
1982
1987
1992
1997
2002
2007
2012
1st NEDP
2nd NEDP
3rd NEDP
4th NESDP
5th NESDP
6th NESDP
7th NESDP
8th NESDP
9th NESDP
10th NESDP
11th NESDP
2017
: Economic Infrastructure, Sectoral Plans
: Improvement of Agriculture, Infrastructure
(Started working in nutrition since 1974)
: + Social Plan + Food and Nutrition Plan (FNP)
+ Primary Health Care (PHC)
PEM (Wt/Age of U 5): > 50%
: + Poverty Alleviation Plan (PAP) + Integrated and implemented PHC
+ FNP and Basic Minimum Needs (BMN) Indicators in rural/urban communities
PEM (Wt/Age of U 5): 30%
Goitre in school children: 19%
Anaemia in preg: 18%
B1 deficiency: < 1%;
- B2 deficiency: < 1%
: School Lunch Program (SLP) + School Milk Program (SMP)
PEM3 (Wt/Age of U 5): 15%
- Anaemia in preg5: 13%;
- Goiter in school children4: 4%
(Worked at FAO, )
Goitre in school children: 1%
- Anaemia in preg: 10%
PEM (Wt/Age of U 5): 9%
UI in preg8 < 150 µg/L: 61%;
- Low serum retinal9: 16%
: National Food Committee Act
: Strategic Framework for Food Management (SFFM)
approved by cabinet
UI in preg < 150 µg/L: 56%
: Integration of the SFFM and the 11th NESDP
UI in preg < 150 µg/L: 43%
: Universal salt iodisation (USI)
PEM (Wt/Age of U 5): 7%
: Promote cooperation and integration of all relevant sectors, academia, business and NGOs to strengthen national food and nutrition security
: Triferidine tablet (iron+folate+iodine)
Figure Milestones of Thailand’s National Social and Economical Development Plan related to food and nutrition
Kraisid Tontisirin, Mahidol University

34. Food Systems in Thailand
Traditional Food Systems
Modern Food Systems
Food supply at household & community level.
Include production for business
in small & medium scales
Use primary food preservation
(e.g. smoking, sun drying, fermentation, salting)
Mass production/ Large scale
Apply scientific knowledge & technology
in food processing
Aware of food quality & safety
Advance in trade information systems
Food Safety Control System
Procurement & distribution Center
Street Food
SME/OTOP
How both systems could contribute for healthy agriculture,
health diets &nutrition, and healthy people and prosperity
Challenge

35. Conclusion 1
Thailand had been successful in alleviation of undernutrition under the National Rural development Committee implementing the Poverty alleviation Plan but currently is hfacing with the Double Burden of Malnutrition (DBM)
Agriculture and food systems are fundamental for ensuring safe and nutritious food supply of fresh and processed foods at household, community, national and global levels.
Kraisid Tontisirin, Mahidol University 35

36. Kraisid Tontisirin, Mahidol University
Conclusion 2
Multiple strategies and actions linking between macro policy and strategies with actions at community level will lead to the success outcomes and impacts on nutrition.
Under the National Food Committee, the Strategic Framework for Food Management (SFFM) had been approved by the Cabinet and has been implementing with aims for food and nutrition security, food quality and safety, and sustainable development.
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37. Kraisid Tontisirin, Mahidol University
Conclusion 3
Ultimate goals of the SFFM in Thailand
are healthy agriculture and food systems, health nutrition, health people and prosperity.
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38. Kraisid Tontisirin, Mahidol University
…THANK YOU… 38
Kraisid Tontisirin, Mahidol University