RESUMEN
OBJECTIVE: This study assessed the impacts of the Dekthai Kamsai programme on overweight/obesity, underweight and stunting among male and female primary school students. STUDY DESIGN: A quasi-experiment was conducted in 16 intervention and 19 control schools across Thailand in 2018 and 2019. In total, 896 treated and 1779 control students from grades 1 to 3 were recruited. In intervention schools, a set of multifaceted intervention components were added into school routine practices. Anthropometric outcomes were measured at baseline and at the beginning and end of every school term. METHODS: Propensity score matching with linear and Poisson difference-in-difference analyses were used to adjust for the non-randomisation and to analyse the intervention's effects over time. RESULTS: Compared with controls, the increases in mean BMI-for-age Z-score (BAZ) and the incidence rate of overweight/obesity were lower in the intervention schools at the 3rd, 4th and 8th measurements and the 3rd measurement, respectively. The decrease in mean height-for-age Z-score (HAZ) was lower at the 4th measurement. The decrease in the incidence rate of wasting was lower at the 5th, 7th and 8th measurements. The favourable impacts on BAZ and HAZ were found in both sexes, while the favourable impact on overweight/obesity and unfavourable impact on wasting were found in girls. CONCLUSIONS: This intervention might be effective in reducing BAZ, overweight/obesity, poor height gain, but not wasting. These findings highlight the benefits of a multifaceted school nutrition intervention and a need to incorporate tailor-made interventions for wasting to comprehensively address the double burden of malnutrition.
RESUMEN
OBJECTIVES: We assessed the use of current guideline daily amount (GDA) label and consumers' ability to read GDA, compared with GDA-plus labels (green colour-coded GDA [GGDA], GDA label with text [GDAT] and green colour-coded GDA label with text [GGDAT]) in Thailand. STUDY DESIGN: This is a cross-sectional study. METHODS: We interviewed individuals at 23 major supermarkets across the country in March 2015. We used a mixed multivariate logistic regression model to identify factors associated with the ability to make healthier choices when reading front-of-pack (FoP) labels. RESULTS: Of 1364 participants, only 11% claimed to read the GDA label every time; those who did not read the main reason was that it was not understandable or attractive. In total, 65%, 62%, 61% and 39% were able to read GDAT, GGDAT, GGDA and GDA labels, respectively. When reading GGDA, GDAT and GGDAT labels, participants were 2.91 (95% confidence interval [CI]: 2.45, 3.45), 3.59 (95% CI: 3.01, 4.28) and 3.13 (95% CI: 2.63, 3.72) times more likely to choose healthier food choices compared with having read an ordinary GDA label. Participants who were exposed to food selection guidelines were more likely to make healthier food choices when reading FoP labels with different odds depending on sources of information. Participants who recognized the link between diet and non-communicable diseases were 1.21 (95% CI: 1.02, 1.44) times more likely to choose healthier food choices. No sociodemographic characteristics were significantly statistically associated with the ability to choose healthier food choices when adjusted for diet-related knowledge and FoP formats. CONCLUSIONS: Use and understanding of GDA are still low, mainly because GDA is incomprehensible and unattractive. Interpretive FoP formats tend to be more understandable and need less complementary public campaigns compared with non-interpretive formats.