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Ladda Mo-suwan , MD, FRPedT, MS (Human Nutrition) Department of Pediatrics, Faculty of Medicine, PowerPoint PPT Presentation


Obesity: Magnitude of problem in Thailand. Ladda Mo-suwan , MD, FRPedT, MS (Human Nutrition) Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. Prevalence of adult obesity in Thailand. %.

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Ladda Mo-suwan , MD, FRPedT, MS (Human Nutrition) Department of Pediatrics, Faculty of Medicine,

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Obesity: Magnitude of problem

in Thailand

Ladda Mo-suwan, MD, FRPedT, MS (Human Nutrition)Department of Pediatrics, Faculty of Medicine,

Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand.


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Prevalence of adult obesity in Thailand

%

Waist circ. 15.4% M>90 cm, 36.1% F >80 cm

5th National Food and Nutrition Survey (DOH, MOPH 2003)

Ladda Mo-suwan


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6-14y

6-14y

Nutritional status of school-aged children

%

Whole country

Ladda Mo-suwan


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11

4

9

5

15

4

5

12

4.0

2005: Data from 268 primary schools(47,389 students)in urban settings 

11.7% obesity (local ref) 14.7% overweight and 5.9% obesity (IOTF)

HRN, NHF supported by TRF

3.7

2.1

Obesity

Wasted

Stunted

3.3

Ladda Mo-suwan


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Thailand MICS 2006

Ladda Mo-suwan


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36%

Increasing obesity in the young

Mo-suwan L et al, 2004

Ladda Mo-suwan


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Medical Complications of Obesity

Idiopathic intracranial hypertension

Pulmonary disease

Obstructive sleep apnea 7%

Hypoventilation syndrome

Metabolic syndrome

Impaired glucose tolerance – 33.8%

Diabetes - 2.8%, 10xin 20 y

Dyslipidemia – 50%

Hypertension

Nonalcoholic fatty liver disease

Severe pancreatitis

Gall bladder disease

Gynecologic abnormalities

abnormal menses

polycystic ovarian syndrome

Joint deformities

Skin

Acanthosis nigricans

striae

From www.obesityonline.org


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Association of GPA with BMI status and changes of BMI status

1994 Mean GPA Regression coefficient p

(95% CI)

1994 BMI status

Underweight 2.60 + 0.78 0.06 (-0.12, 0.25) NS

Normal 2.60 + 0.77

Overweight2.37 + 0.71-0.20 (-0.04, -0.37)0.017

Change of BMI status over the two years

Thinner2.68 + 0.74 0.14 (-0.12, 0.0.41)NS

Stable-non overwt 2.59 + 0.77

Stable-overwt2.43 + 0.69 -0.14 (-0.32, 0.04)NS

Becoming overwt2.11 + 0.73 -0.48 (-0.12, -0.84)0.008

MO-suwan L et al. IJO 1999

Ladda Mo-suwan


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Nutrition situation and NRCDs in Thai adults(5th National Food and Nutrition Survey 2003)

Male Female

High LDL-C>130 mg/dl (%)13-33 13-44

LOW HDL-C<40 mg/dl (%) 6-13 18-32

High TG >150 mg/dl (%) 6-46 8-37

Prevalence of DM (%) 6.4 7.3

Prevalence of high BP (%) 23.3 20.9

Kraisid Tontisirin, 2nd TCN 2007


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Weight loss business in 2007 costs 1.8 to 2 billion baht

กันยายน 2550

Source: National Economic and Social Development Board

Ladda Mo-suwan


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Thailand MICS 2006

National target7%

Thailand MICS surveyed40,000 households in 76 provinces and additional 30,000 households in 26 provinces (NSO & Unicef)

Ladda Mo-suwan


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นมแม่กับอาหารเสริม

-- exclusive breast feeding 5% -------

Thailand MICS 2006

Ladda Mo-suwan


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Diet of children age2 y

% freq/week

Animal protein 90+5-7

Liver732

Vegetables 854-6

Fruit855-8

Soft drink 573-5

Instant noodles as snacks851-2

Drinking yoghurt215-7

Source: Prospective Cohort of Thai Children (PCTC), supported by TRF, MOPH,WHO

Ladda Mo-suwan


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Food, nutrition and life style factors(Data from various sources 2003-2005)

  • Sugar consumption in 2006 was 33.2 kg/person/y or 91 g/d or 17.2 % of energy intake from sugar

  • Average sugar intake from snacks and beverage in the preschool children: 40.4 g/d, 35.2% consumed less than 24 g/d (Wongkongkathep et al, 2006)

  • Soft drink beverage intake was 102 bottles/person/y

  • Increasing energy-dense snack consumption particularly in children, 2 packs/person/day

  • Increased alcoholic beverage intake, 81.7 liter/person/y in 2003

  • Only 35.7 % of male and 23.7 % female from 6 years onward exercised regularly (NSO 2002)

Kraisid Tontisirin, 2nd TCN 2007


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Energy dense foods & beverage

  • Snacks contributed 27% of DRI energy, 34% of sodium in preschool children (Chittchang et al, 2004)

  • School aged: Energy dense snacks contributed to 30% of DRI, fried snacks 7%, beverage 9%(Tangwitoon et al, 2006)

  • Expense on snack -- 3.7 billion USD/y equivalent to government budget for education or 15% of total budget(Maya Group, ThaiHealth)

L Mo-suwan


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TV time (h/wk), DTC 2001

50% of preschool children watched TV more than 2 h/d (2006)


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School environment survey

  • School meal survey: 55% provide fruit 3/week  30% lower prevalence of obesity

  • Less than 1% had vending machines selling soft drink  2x higher prevalence of obesity

  • 41% organized extra exercise 3/week  20% lower prevalence

    Source: NHF surveyed 400 schools by sampling the largest school from each constituency all over the country in 2005

Ladda Mo-suwan


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School soft drink and snack policy

Sale in school School-owned(%)(%)

Soft drink free policy

yes(85%)1528

no8034

Snack free policy

yes (58%)4241

no8760

Schools that received financial support from the food/beverage companies had prevalence of obese students 1.5 times higher than those that did not.

NHF survey 2005

Ladda Mo-suwan


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School environment and obesity

  • School milk program: free sweet milk, sweet drinking yoghurt increased risk for becoming obese and remaining obese over the 2 y about three times [OR 2.9, 95% CI 2.00-4.15] and OR 3.4, 95% CI 1.65-6.80, respectively), while non-sweetened milk reduced the risk (OR 0.1, 95% CI 0.04-0.22).

  • the risk was increased in children who were in schools having fried snack sold after hours (OR 10.7, 95% CI 5.37-21.19).

    (Thitiboonsuwan A, Mo-suwan L, Sangsupawanich P, 2006)

Ladda Mo-suwan


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