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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. Prevalence of adult obesity in Thailand. %.

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slide1

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.

slide2

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

slide3

6-14y

6-14y

Nutritional status of school-aged children

%

Whole country

Ladda Mo-suwan

slide4

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

thailand mics 2006
Thailand MICS 2006

Ladda Mo-suwan

increasing obesity in the young

36%

Increasing obesity in the young

Mo-suwan L et al, 2004

Ladda Mo-suwan

medical complications of obesity
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

association of gpa with bmi status and changes of bmi status
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

Overweight 2.37 + 0.71 -0.20 (-0.04, -0.37) 0.017

Change of BMI status over the two years

Thinner 2.68 + 0.74 0.14 (-0.12, 0.0.41) NS

Stable-non overwt 2.59 + 0.77

Stable-overwt 2.43 + 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

nutrition situation and nrcds in thai adults 5 th national food and nutrition survey 2003
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

slide10

Weight loss business in 2007 costs 1.8 to 2 billion baht

กันยายน 2550

Source: National Economic and Social Development Board

Ladda Mo-suwan

slide11

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

slide12

นมแม่กับอาหารเสริม

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

Thailand MICS 2006

Ladda Mo-suwan

slide13

Diet of children age2 y

% freq/week

Animal protein 90+ 5-7

Liver 73 2

Vegetables 85 4-6

Fruit 85 5-8

Soft drink 57 3-5

Instant noodles as snacks 85 1-2

Drinking yoghurt21 5-7

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

Ladda Mo-suwan

food nutrition and life style factors data from various sources 2003 2005
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

energy dense foods beverage
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

slide16

TV time (h/wk), DTC 2001

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

school environment survey
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

school soft drink and snack policy
School soft drink and snack policy

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

Soft drink free policy

yes(85%) 15 28

no 80 34

Snack free policy

yes (58%) 42 41

no 87 60

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

school environment and obesity
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