Existing obesityrelated policy

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Existing obesity-related policy

• Policy formulation to reduce
• sugar consumption among Thai children

2
Sharing topics

• Background
• Policy/ regulation initiated in Thailand
• Lesson learned

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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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National level

• School milk no sugar added
• Sugar consumption recommendation
• lt 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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Ministerial regulation 286 (2005)

• 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

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

• Carbonated drink are available in gt30 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

Thailand
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4.Healthy healthy meeting

• 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

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3. Snack labeling (MR 305)

• Nutrition label on 5 groups of snacks
• Warning limit the amount exercise
• Signposting

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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Local policy to support national level
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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 interventions to 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