Integrating Food and Nutrition Security in a Middle-Income , Globalized , Food-Exporting Nation : Thailand ’ s Food Policy Challenge
and undernutrition had been almost eliminated . The substantial investments in health services , particularly community and rural health , had paid dividends with infant mortality and low birth weight statistics being drastically reduced ( Florentino & Pedro , 1992 ). Key evidence of Thailand ’ s success is the reduction in the proportion of the population undernourished which has fallen from over 40 % in the 1980s to now be only 7 % ( Food and Agriculture Organisation , 2012 ). The World Bank considers these measures to be among the most successful in the developing world ( Heaver & Kachondham , 2002 ).
However , rapid economic growth has influenced a dramatic health and lifestyle transition in Thailand ; from rural and agricultural to much more urban industrial and commerce centered lifestyles ( Kelly et al ., 2010 ). Traditional Thai diets are considered healthy and protective against chronic diseases being rich in cereals , legumes , and fresh fruit and vegetables with the majority of protein coming from fish ( Seubsman , Dixon , Pangsap , & Banwell , 2009 ; Suvarnakich , 1950 ). However , economic growth , modernization , and industrialization are typically accompanied by an increasing demand for both more convenient foods and more modern foods , a diet where animal fats and protein replaced legumes and cereals , sugar consumption increased and fruit and vegetable consumption decreased ( Kosulwat , 2002 ). Thailand ’ s regular series of nationally representative Food Consumption Surveys reveal that between 2003 and 2009 , the consumption of snack foods , instant foods
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( especially noodles ), soft drinks , and energy drinks have all increased significantly , particularly among Thai teenagers ( Aekplakorn , 2011 ). Although food security is not a problem in the vast majority of Thai households , the changing makeup of diets and the amount of pre-prepared foods being purchased outside the home are concerns to nutritionists ( Kosulwat , 2002 ). This achievement of adequate caloric consumption in a community does not preclude the continuation of malnutrition in terms of micronutrient deficiencies which is possible when consumption of overprocessed foods is prevalent , and fresh food intake is low .
Chronic undernutrition in Thailand has now been replaced by chronic obesity which affects more than 35 % of Thai adults ( Aekplakorn & Mo-Suwan , 2009 ). Cardiovascular diseases , diabetes mellitus , and other diet-related health problems are all increasingly prevalent , replacing poverty-related diseases as the major causes of death and morbidity for Thai people ( Porapakkham et al ., 2010 ; Wilbulpolprasert , 2008 ). However , the picture is more complex than diseases of poverty being replaced by diseases of affluence . As in many developing countries , and a growing number of developed economies , a range of states of nutrition ( under , normal and over nutrition , and micronutrient deficiencies ) coexist ( Doak , Adair , Bentley , Monteiro , & Popkin , 2005 ; Monteiro , Moura , Conde , & Popkin , 2004 ; Winichagoon , 2013 ). These changes in the health status and risk profile of the Thai population are part of a health-risk transition in developing countries .