Prof. Emeritus Kraisid Tontisirin Presentation at Karasin Province 2 August 2017

1. Healthy aging Prof. Emeritus Kraisid Tontisirin Presentation at KarasinProvince 2 August 2017

2. Thai’s elderly population* แนวโน้มการเปลี่ยนแปลงในอนาคต Office of the National Statistic of Thailand concluded that Thailand has been an aging society since 2005 (2548) as the elderly population was more than 10.4 % of the total population. It has also been forecasted that Thailand will be an aged society in 2021 (2564) when elderly population will be greater than 20 %. *ที่มา : สำรวจข้อมูลประชากรสูงอายุไทย ปี 2545, 2554 และ 2557 สำนักงานสถิติแห่งชาติ Kraisid Tontisirin, Mahidol University

3. Thai’s elderly population Office of the National Statistic of Thailand concluded that Thailand has been an aging society since 2005 (2548) as the elderly population was more than 10.4 % of the total population. It has also been forecasted that Thailand will be an aged society in 2021 (2564) when elderly population will be greater than 20 %. Kraisid Tontisirin, Mahidol University

4. Dimensions of health Physical Health status Mental Spiritual Social ” Kraisid Tontisirin, Mahidol University

5. Factors influencing health and wellbeing 1.Genetics 2.Nutrition: the link between food and health 3.Physical activity and exercise 4.Mental and spiritual health 5.Avoidances of tobacco, alcoholic beverages and other addictive substances 6.Environment: physical, chemical, biological, economics, social and political Kraisid Tontisirin, Mahidol University

6. Ecological factors for good health Genetics Health status Environment Health behaviors Health services Kraisid Tontisirin, Mahidol University

7. Promotion • Protection • Treatment • Agriculture/ • Food supply/ • Service Nutrition Food Health Nutrition is a link between food and health, regarding the fulfillment of energy, protein and micronutrient requirements and non-nutrients from food in human life course Ultimate Goals Good Nutrition & Well-being for All Kraisid Tontisirin, Mahidol University

8. Major health challenges in Thai • Low birth weight ~ 9 % • Underweight of underfive~ 6% • Stunting of underfive~ 10 % • Overweight & obesity in children10-15 % • Adult overweight &obesity ~40% • Adult with high blood pressure 25-30 % • Diabetes mellitus type2 ~ 7-10 % • Rising trends of cardiovascular diseases (heart and brain attacks) and cancers which are leading causes of dealth • Accidents Nutrition and NCDs High sugar, fat and salt diets Vegetable and fruit consumption less than400 g./person/day Inadequate physical activity and exercise Tobacco and alcoholic consumption Other undesirable health behaviors Kraisid Tontisirin, Mahidol University

9. Improvement of maternal & child nutrition, Thailand Recent trend of nutritional status of under 5* * Source: NHES 2; Holistic Development of Thai Children; NFNS 5; NHES 4; and NHES 5 Kraisid Tontisirin, Mahidol University

10. Courtesy from; NapaphanViriyautsahakul Director of Bureau of Nutrition

11. Kraisid Tontisirin, Mahidol University

12. Anthropometric goals of health promotionaiming for normal weight and height in human life course Kraisid Tontisirin, Mahidol University

13. Goals of community health promotion Family and community well being indicated by normal wt. and ht., B.P, blood sugar, eat adequate vegetables and fruits with low sugar, fat and salt; no tobacco and no/less alcoholic consumption, physical activity and exercise regularly. Cares of NCDs including: Obesity, high B.P., diabetes mellitus and others to be under controlled. Community and setting approaches in health promotion: with full functions and support by health services (Community and Tambon hospitals) and Local Administrative Organizations, and others. Create healthy environment for health promotion: including recreation areas for physical activity, exercise and other social functions Kraisid Tontisirin, Mahidol University

14. Community-based approaches • Is an integrated program implemented at local level (district level and below) • National commitment with sound nutrition improvement strategies and goals • Community actions: basic services, mass mobilization, mutual efforts/actions to reach all people and to prevent malnutrition Kraisid Tontisirin, Mahidol University

15. Community Based Program for Health Promotion Minimum Basic Services (Health, Education, Agricultural Extension) Supportive System • Menu (Activities) • Antenatal care • Growth monitoring/promotion • Nutrition in school • Elderly cares • Cares of NCDs • Food production • Nutrition education • Food sanitation • & safety • Other activities • (Tobacco and alcoholic • consumption control) • Recreation and physical • activities) • Etc. • Training • Funding • Problem Solving • Supervision Facilitators Interface (service providers andcommunity leaders) • Plan/goals • Implementation • Monitoring/evaluation : Community Leaders Family Individual Volunteers (1:10 households) Minimum Indicators of well-being & NCDs 15 Kraisid Tontisirin, Mahidol University

16. Health cares in human life course Antenatal cares Healthy behaviors & life styles Breast and complementary feedings Nutrition and health promotion in school children Growth and development monitoring & promotion Kraisid Tontisirin, Mahidol University

17. 4 ANC visits for all pregnant mothers High risk check up and treatment monitoring wt. gain Food, Nutrition and health education Food supplementation MTV, iron and folate supplementation Two tetanus toxoids Referral system and safe delivery service Menu Activity on ANCs Kraisid Tontisirin, Mahidol University

18. Menu on Growth Monitoring and Promotion (GMP) Growth monitoring (wt.& ht.) and remedial actions • Child growth education and cares • Breastfeeding and complementary feeding • Immunization • Village based complementary food productionfor infants and young children • Health and nutrition education • Cooking and feeding demonstration • Treatment of malnourished child • Referral of severe illness and malnutrition Kraisid Tontisirin, Mahidol University

19. Menu on Nutrition in School • Monitor weight and height regularly and take remedial actions based on growth monitoring • Food services-school lunch and milk programs Food, personal and environmental hygiene Nutrition education • Promotion of physical activity and exercise • Positive school environment for healthy diets • Plan to set up a “Nutri-teacher”post • School gardens Kraisid Tontisirin, Mahidol University

20. Based on Food Nutrition Plan aiming to provide daily 200 ml of milk to children in kindergartens and primary school 200 days/ year The program has been implemented since 1992 along with school lunch program in kindergartens and gradually stepped up to cover 6 grade-students in 2009 School milk program has created demand for local dairy industry School milk program in Thailand Kraisid Tontisirin, Mahidol University

21. Conclusion: Healthy aging 1.With healthy behaviors in human life course 2.Good nutrition: Eat a variety of food emphasis on unpolished rice, fish, egg, low fat milk, vegetables, fruits,legumes and adequate water consumption 3.Adequate physical activity and exercise regularly 4.Good mental health and happiness:compassion, mindfulness, willing to learn, ethic and morality 5.Avoid tobacco, alcoholic and other addictive substances 6.Healthy family, good friends and nice social environment Kraisid Tontisirin, Mahidol University

22. Thanks for your attention