Low intake of fruits and vegetables in Thailand : magnitude, disease burden and urban influence
Thailand is now encountering nutrition and epidemiology transitions triggered by economy, demography, globalization and urbanization influences. A rise in chronic non-communicable diseases, coupled with the existing malnutrition problems addresses the recent national concerns. Fruits and vegetables, as healthful food choices, can play an important part in alleviating this situation and preventing those health problems of both under- and overnutrition. This study aimed to demonstrate the current situation of low intake of fruits and vegetables in Thailand, as well as its potential impact that increased fruit and vegetable intake could help save life lost from cardiovascular diseases and selected cancers, and the potential influence of urbanization towards changes in fruit and vegetable consumption. The combined methods of quantitative and qualitative investigations were applied. Thailand's 2006 5th National Nutrition Survey and Thailand's 2007 Burden of Disease Study were key data sources used in the quantitative section. In the qualitative part, focus group interviews approach was applied to investigate in 4 main provinces in different regions of the country, including Bangkok Metropolitan. The findings showed that consumption levels of fruits, vegetables and combined fruits and vegetables in Thailand were remarkably low. Consumption was higher for vegetables than fruits. The differences in intakes were significantly apparent across age groups, areas of residence and geographical regions. The contribution of composite foods is higher to total vegetables (13.9 percent) than total fruits (2.2 percent). In terms of compliance with the dietary guidelines, only 4.3 percent were indicated as sufficient consumers. For the Thais aged 15 years and over, up to 15 percent and 24 percent of the disease burden estimates or about 13,000 and 21,000 deaths annually in Thailand would be potentially preventable if people across the country consumed at either the minimum recommended amounts of 400 g/person/day or up to 600 g/person/day of fruits and vegetables. The population aged 45- to 69-years both males and females would benefit most, especially from ischemic heart disease, the major contributor of the total disease burden. Urbanization was associated to low intake of fruits and vegetables in both Thai men and women. The northern residents showed the greatest consumption of fruits and vegetables. Thai consumers aged 30-59 years had highest consumption. Influential changes in time and economic-driven lifestyles potentially affected these food consumption patterns. Lack of time to preparing meals, seeking more eating-out or ready-to-eat foods, concern of chemical residues and lack of self-awareness and self-discipline suggested food choice preferences. The use of mass media such as advertising may prove useful in influencing consumers through social marketing. Low intake of fruits and vegetable in Thailand is significantly sizable. Effective policies and programs, especially healthy eating messages, are needed to influence healthy consumption behaviours and promote fruit and vegetable intake.
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