Relationship between consumption of high fat, sugar or sodium (HFSS) food and obesity and non-communicable diseases.

The objective of this study was to investigate the relationship between high in fat, sugar or salt consumption, obesity and non-communicable diseases (NCDs) in the population in Thailand, and other associated factors. This study used data from participants age 15 years or older from the 2021 Health Behaviour of Population Survey. The final analytical sample included 74 894 respondents with complete data. Binary logistic regression analysis was used to investigate the relationship between socio-demographic characteristics, unhealthy food, NCDs and obesity. People with obesity had the significant ORs for sugar-sweetened beverages or SSB (OR 1.208; 95% CI 1.159 to 1.259), high-fat foods (OR 1.162; 95% CI 1.120 to 1.207) and snacks (OR 1.048; 95% CI 1.004 to 1.093), but had the significant protective ORs for meat products (OR 0.964; 95% CI 0.930 to 0.999), instant food (OR 0.903; 95% CI 0.865 to 0.942) and fast food (OR 0.871; 95% CI 0.831 to 0.913). People with any NCDs had the significant protective ORs for meat products (p≤0.001), instant food (p≤0.05) and fast food (p≤0.01). People with diabetes tended not to drink SSB while people with heart disease tended not to consume SSB and snacks. The findings suggest a need for prevention and control strategies such as promoting healthy snacking behaviour, modifying food environments and paying specific attention to the population most at risk of obesity and NCDs.

How an agreement with restriction of unhealthy food marketing and sodium taxation influenced high fat, salt or sugar (HFSS) food consumption.

BACKGROUND: Food taxation and food marketing policy are very cost-effectiveness to improve healthy diets among children. The objective of this study was to investigate the socio-demographic characteristics of Thais and attitude towards on policy unhealthy food marketing restriction and sodium taxation which influence high fat, sodium, and sugar (FHSS) food eating. METHODS: The data were obtained from the 2021 Health Behavior of Population Survey, four-stage sampling method of the Thai people, aged 15 years and above, using a offline survey application-assisted face-to-face interview. Logistic Regression were used to analyze the explanatory variables on agreement and HFSS food intake. RESULTS: Almost half (48.4%) of samples disagreed with sodium taxation, and 42.7% of the samples disagreed with food marketing restriction. Most (99.6%) of Thai respondents consumed HFSS food, including sugar sweetened beverages (SSB). Gender, age, education, income, BMI, and health status were associated with agreement with food marketing restriction policy and sodium taxation policy. There is no association between agreement with policy on sodium taxation and food marketing and HFSS food consumption. CONCLUSION: Nearly half of Thais indicated that they disagreed with policy on food marketing restriction and sodium taxation. Therefore, understanding and awareness of the two policies among Thais should be further investigated in order to develop better policy communication for increased public understanding and engagement.

Financial Hardship on Food Security in Ageing Populations.

Objective: This study investigated the prevalence of food security, and the association of food security with financial hardship and socio-demographic characteristics among the ageing population in Thailand. Methods: The study extracted data on 1,197 persons age 60 years or older from a nationally-representative sample survey of Thai households. The food security data were collected using the Food Insecurity Experience Scale (FIES), developed by the Food and Agriculture Organization. Multiple regression analysis was used to investigate the association between financial hardship, socio-demographic characteristics, and food security. Results: Of the total sample, 71% had food security. The least probability of having food security was observed in the respondents who sometimes and often had income problems (p < 0.001), and felt dissatisfied with their financial situation (p < 0.001). The respondents who were female, at oldest-old age, with lower than primary school education and in the Northeast were less likely to have food security. Conclusion: These findings suggest the need for government assistance for those who are experiencing financial hardship to help them manage their finances and food security more effectively, taking into account different socio-demographic characteristics.

Financial satisfaction, food security, and shared meals are foundations of happiness among older persons in Thailand.

The objective of this study was to investigate the association between happiness and food-related behaviours and other potential factors among older persons in Thailand. This was a cross-sectional study with multistage random sampling. In total, 1,197 older (age 60 + years) persons participated in this study. Face-to-face interviews were conducted to obtain information about socio-demographic characteristics, health status, household chores, home gardening, financial situation, family meals, and food security. Descriptive and multivariate regression analyses were performed for data analysis. The analysis found that age, health status, household chores, and home gardening were found to be significantly associated with happiness. Statistically-significant associations of financial situation, family meals, and food insecurity with happiness were also observed. People who were not dissatisfied with their financial situation were happier than people who were unhappy with their financial situation. Older people who ate every meal with a family member(s) were happiest. People who had severe food insecurity were less happy than those with food security. The findings suggest the need for investment priorities on food and nutrition with a long-term policy to ensure financial self-sufficiency and food security among older persons and their family.

Are exposure to health information and media health literacy associated with fruit and vegetable consumption?

BACKGROUND: Health information promotes a healthy lifestyle; however, media health literacy (MHL) is essential to personal intake, especially fruit and vegetables (F&V). This study aimed to determine how exposure to health information and MHL affect F&V consumption among Thai youth aged 10-14 years. Health behavior at this age can be an important determinant of consumption habits when transitioning into adulthood. METHODS: A stratified two-stage sample survey was conducted to recruit 1,871 youth across regions to be nationally representative. Qualtrics offline survey application was used for data collection face-to-face with all respondents. Multiple linear regression was used to analyze the explanatory variables on fruit consumption and vegetable consumption. RESULTS: This study found that almost 70% of Thai youth were exposed to health-related content via the Internet, and had low analytical skills to process that information. Grade Point Average (GPA), exposure to health information, various media types, frequency of exposure to health information, and MHL influenced the frequency of F&V intake. Health status related to fruit intake, age, place of residence, amount of pocket money, and body mass index (BMI) were associated with F&V consumption. CONCLUSION: Exposure to health information and MHL are associated with F&V intake. Therefore, exposure to health information and MHL should be addressed for policy formulation in Thai schools and the health system.

Life Satisfaction Before and During COVID-19 Pandemic in Thailand.

Objective: To investigate prevalence of life satisfaction in the Thai population before and during the COVID-19 epidemic, and factors associated with life satisfaction during the epidemic. Methods: Multistage sampling was used to draw a sample from the Thai population. A total of 3,115 Thai participants age 15 years or older from a nationally-representative longitudinal survey in 2019 and in 2021 were included in this study. The study applied the Scale with Life Satisfaction (SWLS) instrument to measure life satisfaction among the Thai population before and during the COVID-19 epidemic. Multiple regression analysis was used to investigate the association between life satisfaction and other variables. The follow-up survey response rate for individuals was 44.8%. Results: An average life satisfaction score during the COVID-19 epidemic (in 2021) was 22.4 which decreased from 25.5 before the COVID-19 epidemic (in 2019). More than one-third of the participants (36.5%) reported having less life satisfaction during the epidemic, which was nearly 20 percentage points higher than before the epidemic (17.7%). Controlling for life satisfaction in 2019, the analysis found statistical associations between demographic and economic characteristics and health-related behaviours, and life satisfaction during 2021. People in the older age cohorts (p ≤ 0.001), in a rural area (p ≤ 0.05), having higher education (p ≤ 0.001), still being employed (p ≤ 0.01) and becoming unemployed (p ≤ 0.01) had higher life satisfaction. The possibility of higher life satisfaction was also found in people who maintained good health (p ≤ 0.01), sufficient physical activity (p ≤ 0.001), and fruit and vegetable intake (p ≤ 0.01). People with income loss during the epidemic had lower life satisfaction (p ≤ 0.05). Conclusion: The findings suggest that policies and systems for resilience and social protection are needed for empowering individuals-especially the poor and vulnerable-to cope with crises, and improve health and wellbeing outcomes.

Choosing an effective food classification system for promoting healthy diets in Thailand: a comparative evaluation of three nutrient profiling-based food classification systems (government, WHO, and Healthier Choice Logo) and a food-processing-based food classification system (NOVA).

Introduction: This study aimed to assess the nutritional quality of food and beverage products in Thailand by comparing four different food classification systems: the nutrient profiling-based food classification systems by the Department of Health (DOH), the WHO South-East Asia Region (WHO SEA), the Healthier Choice Logo (HCL), and the food-processing-based food classification system, NOVA. Methods: This study used secondary data from the Mintel Global New Products Database (N = 17,414). Food subgroups were classified differently based on these four systems. The DOH classified food products into three groups: Group A-healthy pass or meeting standard, Group B-not meeting the standard, and Group C-far below standard. The WHO SEA classified food products into two groups: marketing prohibited products and marketing permitted products. The HCL classified food products into two groups: eligible products for the logo; and ineligible products for the logo. The NOVA classified food products into four groups: unprocessed or minimally processed foods (MP), processed culinary ingredients (PCI), processed foods (P), and ultra-processed foods (UPF). Descriptive statistics (percentage and frequency) were used for analysis. Agreement analysis was conducted using Cohen's kappa statistic between each pair of food classification systems. Results: Of the total sample that could be classified by any of the four classification systems (n = 10,486), the DOH, the WHO SEA and the HCL systems classified products as healthy (Group A, marketing permitted or eligible for HCL logo) at 10.4, 11.1, and 10.9%, respectively. Only 5.6% were classified as minimally processed foods using NOVA and 83.1% were ultra-processed foods (UPFs). Over 50% of products classified as healthy by the nutrient profiling systems were classified as UPF according to the NOVA system. Products that were eligible for the HCL had the highest proportion of UPF products (84.4%), followed by the Group A products (69.2%) and the WHO marketing-permitted products (65.0%). Conclusion: A hybrid food classification approach taking both nutrients and food processing into account is needed to comprehensively assess the nutritional quality of food and beverage products in Thailand.

Implementing population-wide mass media campaigns: Key drivers to meet global recommendations on fruit and vegetable consumption.

While the influence of implementation of mass media and community-based campaigns has been evident elsewhere, this information has been notably absent in Thailand. This study aimed to investigate the association between implementation of mass media campaigns (MMC) and community-based campaigns (CBC) for increased fruit and vegetable (FV) consumption to meet the global recommended level in the Thai population. The sample was obtained from a nationally-representative, longitudinal household survey of the Thai population, Round1 (2018) and Round2 (2019). The study applied a multi-stage sampling design to obtain a sample of persons age 15 years or older. Face-to-face interviews were conducted with 3,010 respondents who successfully participated in both Round1 and Round2 surveys. Information on FV consumption, exposure to Government MMC, ThaiHealth MMC including social marketing (MMSMC) and CBC, and sociodemographic characteristics were collected. Binary logistic regression analysis was used to investigate the association between implementation of those campaigns and increased FV consumption compared to the recommended level. Of the total respondents, only 11.3% had higher FV consumption and also met the minimum requirement. Respondents who lived in rural areas, were farmers, and grew FV at home had the highest probability of increased FV consumption. Exposure to the MMC and CBC was also associated with an increase in FV consumption. Above all, those who had exposure to the MMSMC, who reported either having high level of perception (OR = 1.832, 95% CI 1.259-2.666) or ever heard or seen (OR = 1.770, 95% CI 1.264-2.479) or heard and seen (OR = 1.698, 95% CI 1.131-2.550) campaign information were more likely to have a substantial increase in FV consumption and meeting/exceeding the recommended level than those who were not exposed to these campaigns. Other associated factors include education, occupation and physical activity. Implementation of MMSMC can help the population meet the global recommended level of FV consumption. This study presents its novelty since it was the first to highlight influence of mass media campaigns on increased FV consumption in Asian population. This was also the first study that used data from a population-based longitudinal study. The study suggested that MMC and CBC should also be promoted together with support systems to increase their intensity to a level that can increase population FV consumption to meet the recommended level. Sociodemographic characteristics should be taken into account, and targeted media is needed to effectively reach specific sub-groups of the population.

Influence of healthy lifestyle behaviors on life satisfaction in the aging population of Thailand: a national population-based survey.

BACKGROUND: Understanding the influence of healthy lifestyle behaviors on population-level life satisfaction is few known in the aging population, especially in low- and middle-income countries in Asia. The objective of our study was to analyse the association of lifestyle behaviors with life satisfaction in a nationally-representative sample of older persons in Thailand. METHODS: The sample was obtained from a baseline phase of a nationally-representative, longitudinal survey of the Thai population. The study employed a multistage sampling technique to recruit study participants age 60 years or older from the five geographic regions of Thailand. In this study, 1460 adults age 60 years or older from 3670 households successfully completed face-to-face interviews by trained staff with a structured questionnaire. Information on self-reported life satisfaction, lifestyle behaviors, and sociodemographic characteristics were collected via survey questionnaire. Life satisfaction was assessed using the Scale with Life Satisfaction (SWLS) [1 to 7] response. Binary logistic regression analysis was used in investigating the association between lifestyle behaviors and life satisfaction. RESULTS: The median age of the participants was 68.1 (60-93 years). The overall mean life satisfaction score was 24.2 ± 5.6. Regular physical activity (at least 30 min per day) and sufficient fruit and vegetable (FV) intake (at least 400 g per day) were significantly associated with older people's life satisfaction (p ≤ 0.001 and p ≤ 0.10, respectively) after controlling all sociodemographic variables. Participants who had regular physical activity were 1.7 times as likely to be satisfied as those with less physical activity (95% CI 1.284-2.151). Participants with sufficient daily FV intake were 1.3 times as likely to be satisfied with life as those with insufficient daily FV (95% CI 0.994-1.723). Life satisfaction score also differed significantly by sociodemographic characteristics (sex, age, marital status, educational attainment) and presence of chronic disease. CONCLUSIONS: To improve the life satisfaction of older persons, taking into account sociodemographic characteristics of the population and absence of chronic disease, the need for promotion of healthy lifestyle behaviors, especially regular physical activity and sufficient FV intake, must be recommended.

Linking Fruit and Vegetable Consumption, Food Safety and Health Risk Attitudes and Happiness in Thailand: Evidence from a Population-based Survey.

The purpose of this nationally-representative cross-sectional study was to investigate the association of fruit and vegetable consumption and food safety and health risk attitudes with happiness among Thai people. The study employed a multi-stage sampling design. A total of 6,955 Thai residents age 15 years or older from four geographic regions and Bangkok in Thailand participated in the study. Information on self-reported happiness, daily fruit, and vegetable consumption, sociodemographic characteristics, and risk attitudes were collected via survey questionnaires. Multiple regression analysis was used in investigating the association between risk attitudes, fruit and vegetable consumption, and happiness, adjusting for the covariates sequentially. Risk attitudes and sufficient fruit and vegetable intake were found to be significantly associated with happiness. The positive association between risk attitudes toward health safety, food safety, and happiness were found to be statistically significant. People who had sufficient fruit and vegetable intake had a 0.187 higher happiness score than those who had insufficient fruit and vegetable intake. These findings could be used by policymakers and public health practitioners to design better interventions that can target specific populations with different risk attitudes and improve their psychological well-being via increasing FV consumption.

Characterizing Urban Home Gardening and Associated Factors to Shape Fruit and Vegetable Consumption among Non-Farmers in Thailand.

The purpose of this study was to investigate the association between home gardening and sufficient fruit and vegetable (FV) intake among non-farmers in Thailand, and examine the influence of socio-demographic characteristics and other associated factors on home gardening among non-farmers in urban areas. Data were collected by a cross-sectional survey of a sample of Thai non-farmers (N = 5634). Information on self-reported home gardening, FV intake, health-related behaviors, and socio-demographic characteristics was collected via questionnaire. The findings show that home gardening is significantly associated with sufficient FV intake among non-farmers (p < 0.001). Within the non-farmer group who lived in urban areas, 9% gardened FV at home. Home gardening was significantly associated with socio-demographic characteristics (sex, age and occupation), physical activity, fear of pesticide contamination of FV, and FV safety awareness among the urban non-farmers. Respondents who were female, in the middle-adulthood group, practiced regular physical activity, feared pesticide contamination, and had high awareness of FV safety had the highest probability of gardening at home (p < 0.05, p < 0.001, p < 0.01, p < 0.001 and p < 0.05, respectively). The Thai government should pay more attention to factors that influence urban home gardening by providing support, building local capacity, and implementing effective interventions with the urban population.

Strength and stress: Positive and negative impacts on caregivers for older adults in Thailand.

AIM: To understand the experiences of caregivers with older people living in Thailand, particularly as related to quality of life and stress management. METHOD: In-depth interviews with 17 family caregivers were conducted and then data were thematically analysed. RESULTS: Carers experience not only negative impacts but also positive impacts from caregiving. Negative impacts include emotional stress, financial struggles and worry due to lack of knowledge. Positive impacts include affection from care recipients, good relationships with caregivers before needing care themselves and encouragement from the wider community. Opportunities to show gratitude, build karma (from good deeds) and ideas shaped largely by Buddhist teachings result in positive experiences. Negotiating between the extremes of bliss and suffering and understanding suffering as a part of life may help carers manage their stress. CONCLUSIONS: Temples and centres for older people could be engaged to develop caregiving programs.