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Existing obesity-related policy. P olicy formulation to reduce sugar consumption among Thai children. Background Policy/ regulation initiated in Thailand Lesson learned. S haring topics. Population nutrient goals a.

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Existing obesity related policy l.jpg

Existing obesity-related policy

Policy formulation to reduce

sugar consumption among Thai children


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Background

Policy/ regulation initiated in Thailand

Lesson learned

Sharing topics


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Population nutrient goalsa

Source: Diet, nutrition, and the prevention of chronic diseases. Report of a WHO Study Group. Geneva, World Health Organization, 1990 (WHO Technical Report Series, No. 797).


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In the beginning…

  • Thais sugar consumption

    • 21-30 kgs./head/year

    • 18 teaspoons/day or 432 g/day

    • WHO recommendation: 240 g/day


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In the beginning…

pediatricians

2003

nutritionists

Media advocator

dentists

control sweet tooth habit and

excessive sugar consumption


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Strategy

Research

Policy movements

Social change


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Research

  • Thais’ sugar consumption survey

  • Sugar consumption and illnesses

    • Tooth decays

    • Obesity

    • Type II Diabetes


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Policy Movements

International level

National level

Local level


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International level

  • CODEX

    • Reducing sugar in baby food

    • Supported by Norway, Indonesia  the International Baby Food Action Network (IBFAN), the International Lactation Consultants Association (ILCA) and  the International Association of Consumer Food Organizations (IACFO).


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Proposal

  • "foods for infants and young children are very crucial contributing to their immediate and long term health. Since, a high intake of sugars  enhances the development of sweet taste  preference and dental caries in children, and provides excessive energy intake which may contribute to childhood obesity, therefore, the sugars intake in cereal-based foods should be limited.”


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Sweet enough

National level

  • School milk: no sugar added

  • Sugar consumption recommendation

    • < 6 teaspoons/day

  • No sugar added food for infants ( MR # 286)

    • baby milk powder (6 months – 2 years old formula)

  • Food labeling

    • Food labeling on certain food items (chips, biscuits)

    • Simplified food label (signposting)

  • Fizzy drinks ban in schools

  • Healthy meeting


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40-87% of 0-3 year old children was fed by sweet milk (2002)

More than half of powder milk available in domestic market was sugar-added (2002)

Policy evaluation(2007): consumption of sweet milk decrease to 19%

Ministerial regulation # 286 (2005)

Thailand


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Carbonated drink are available in >30% of primary schools

Children who study in schools with carbonated drink, consume 5-7 times more

Sugar 32-48 gm per can

pH ~ 2.9

2. No carbonated drinks in schools(2007-2008)

Thailand


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Snack during the coffee break was ~ 200-300 kcal

Advocate for low calories coffee break

Department of Health & 23 partners accepted the policy

Supporting and evaluation

4.Healthy healthy meeting


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Nutrition label on 5 groups of snacks

Warning: limit the amount & exercise

Signposting

3. Snack labeling (MR # 305)

Thailand

Fat

10 gm

Sodium

140 mg

energy

370 kcal

sugar

2 gm


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Local level

Fizzy drinks ban in schools

Fruit from farm to table

No sugar day

No candy distribution

in the funeral

Saving for traveling

Sugar reduction in canteen



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Social change

Media advocacy

Social marketing

Entertainment education


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Social marketing

Slogan: Life is sweet enough with less sugar!

Cartoon characters: Noynoi


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Entertainment education

Kids TV program: Hedhansa

Muppets

Future TV program

Hello Noynoi

Songs


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Impacts

  • 6 teaspoons = standard sugar consumption per day

  • More sugar free and sweetener substitute products

  • 1 kg. less sugar consumption per head per year.

  • Sugar industry struggles


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Policy interventionsto promote healthy food consumption

1. Restriction on supply of high caloric foods

2. Product labeling

3. Restriction for advertising

4. Price controls


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Lesson learned

  • Information / Evidence based data

    • International understanding

    • National / local evidence based data

  • Start with feasible and high impact option

  • Common risk factors

  • Multidisciplinary approach to bring in different strengths

  • Combination of knowledge, social movement and policy advocacy

  • Consistent and regularly communicate to the public and policy makers

Thailand


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