Impact of a School-Based Nutrition Intervention in Preventing Overweight and Obesity in Children in Thailand.

BACKGROUND: This study evaluated the impact of a school-based nutrition program on preventing overweight and obesity in children in Thailand from 2014 to 2019. METHODS: We used difference-in-differences with matched comparison group to evaluate program impact. Treatment schools were categorized into those that participated in phase 1 only, and those that participated in phase 1 and 2. We matched 311 treatment schools in phase 1 only with 1504 comparison schools, and 75 treatment schools in both phases with 216 comparison schools. Administrative data from Thailand Office of Basic Education Commission were used from 2014 (baseline), 2016 (first follow-up), and 2019 (second follow-up). RESULTS: Program resulted in a 0.6-1.1 percentage point reduction in the students' probability of overweight by the end of phase 1, and 1.7 percentage points by the end of phase 2. Impact on obesity was found only for schools participating in both phases (0.4 and 0.9 percentage points by the end of phase 1 and 2, respectively). IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Program continuity and intensity are key to achieve a reduction in overweight and obesity in schoolchildren. CONCLUSIONS: The program was successful in reducing overweight and/or obesity given appropriate level of continuity and intensity.

The economic impacts of COVID-19 lockdown on low-income older people in Thailand.

OBJECTIVES: The aim of this study was to investigate the economic impacts of the COVID-19 lockdown in Thailand on low-income older people concerning their employment, household income and food security. The study also aimed to identify which socioeconomic characteristics of low-income older Thais are at higher risk of being negatively affected and whether they can access state economic relief during the pandemic response in Thailand. METHODS: Economic, health and social well-being questionnaires were completed by low-income older Thais (n = 808) holding a State Welfare Card during the COVID-19 lockdown in 2020. Descriptive analyses and multivariate logistic regressions were utilized in the data analysis. All analyses were performed using Stata 15. RESULTS: This study found that 62% of participants experienced a negative impact on their household income, 35% had a negative impact on employment and 20% had a negative impact on food security. However, the impact level depended upon their vulnerability before the pandemic. The study also reveals that older Thais who experienced a negative impact on household income could access monetary relief schemes from the government during the pandemic. CONCLUSIONS: This study reveals the layers of economic vulnerability among the population of low-income older Thais negatively affected by the 2020 lockdown. Despite the accessible state monetary relief, differential skills with the use of digital technology could create inequitable access to aid measures among older Thais. The findings highlight the need for longitudinal studies to track changes in the economic impacts arising from subsequent waves of COVID-19 on low-income older people.

Understanding the Complexities of Eliminating Trans Fatty Acids: The Case of the Trans Fatty Acid Ban in Thailand.

Trans fatty acids (TFAs) have no known health benefits and are linked to an increased risk of noncommunicable diseases (NCDs). To eliminate TFAs from the food supply, the government of Thailand imposed a ban on partially hydrogenated oils (PHOs) in 2018. This study was aimed at analyzing the government policies and actions to eliminate TFAs in Thailand, focusing on policy content, context, process, and actors. This single-case qualitative study used a documentary review and interviews with 20 key policy actors. The data analysis was guided by thematic analysis based on the policy triangle framework. The results reveal that policy actors-government organizations, academics, civil society organizations, and the food industry-have different roles, interests, and influences with regard to eliminating TFAs in Thailand. Both formal and informal communication among policy actors aided in the policymaking process and the actions that followed. Changing perceptions of TFAs, the low intake of PHOs in Thailand, hype around trans fats, and trade dynamics shaped the government's decision to impose the ban. As a result, the ban was selected to avoid the technical components of TFA elimination. This study suggests that eliminating TFAs in Thailand could be further enhanced by strengthening government actions in terms of enforcement and creating consumer awareness.

Nudge interventions to reduce fish sauce consumption in Thailand.

High sodium consumption is one of the four major risk factors contributing to non-communicable diseases around the world. Thailand has one of the highest rates of sodium consumption, with fish sauce being one of the main sources. The aim of this study was to examine whether changes in the micro-environment factors can affect fish sauce consumption behavior in a university setting in Thailand. We implemented four interventions (with one control) in five canteens across a Thai university. The study design was a Latin square, where the five canteens were randomized over five weeks to implement four interventions plus a control. Our interventions included behavior-oriented, cognitive-oriented, and affective-oriented nudges aimed to reduce the amount of fish sauce people add to their noodles during lunchtime at the university canteens. Results indicate that a simple change in how fish sauce was served can reduce fish sauce consumption. Serving fish sauce in a bowl with a spoon reduced the amount of fish sauce used per noodle bowl by 0.25 grams, compared to the normal condition where fish sauce is served in a bottle. Using a specially-designed spoon with a hole induced a larger reduction of 0.58 grams of fish sauce used per bowl. The other two interventions, cognitive- and affective- oriented nudges, also showed reductions of fish sauce usage, but the differences were not statistically significant. The findings can be used for policy implementation to advocate the use of a smaller sized spoon and a bowl to serve fish sauce instead of a bottle to reduce sodium consumption among Thai people.