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Nutrition and health impact of agriculture and food systems in Thailand

Nutrition and health impact of agriculture and food systems in Thailand. Prof. Kraisid Tontisirin M.D., Ph.D. Senior Advisor , Institute of Nutrition , Mahidol U.

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Nutrition and health impact of agriculture and food systems in Thailand

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  1. Nutrition and health impact of agriculture and food systems in Thailand Prof. Kraisid Tontisirin M.D., Ph.D Senior Advisor , Institute of Nutrition , Mahidol U. Chairman of the Planning Committee on Strategic Frame work for Food Management (SFFM) in Thailand of the National Food Committee Presentation at the WFD, Bangkok, 26 November 2013

  2. Thailand: Current situation • Has succeeded in reduced maternal and child malnutrition since the eighty by mutistakeholder efforts under the Poverty Alleviation Plan (PAP) • Currently Thailand is facing with double burden of malnutrition (DBM), a coexistence of under and over nutrition, and related non-communicable diseases (NCDs) 2 Kraisid Tontisirin, Mahidol University

  3. Promotion • Protection • Treatment • Agriculture/ • Food supply/ • Service Nutrition Food Health Nutrition is a link between food and health, regarding the fulfillment of nutrient and non-nutrient requirements from food in human life cycle. Ultimate Goals Nutrition well-being for all Kraisid Tontisirin, Mahidol University

  4. Poverty Alleviation Plan (PAP) • From 1982 onward • Malnutrition was considered as symptom of poverty • With organization changes for management • of rural development • With 5 basic principles: poor area, basic services, appropriate technology, self-help and community participation PAP Fd/Nut.Prog. PHC BMN indicators Kraisid Tontisirin, Mahidol University

  5. 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

  6. Components of a successful community based program Minimum Basic Services (Health, Education, Agr. Extension) • Supportive System • Training • Funding • Problem Solving • Supervision • Menus (Activities) • Antenatal Cares (ANC) • Growth Monitoring and Promotion (GMP) • Food production • Food and nutrition education • Food sanitation & safety • School lunch and milk • program since 1992 • Other activities Facilitators • Interface • (service providers and • community leaders) • Plan/goals • Implementation • Monitoring/evaluation Mobilizers (1:10 households) Community Leaders Family Individual Basic Minimum Needs Goals/Indicators Kraisid Tontisirin, Mahidol University

  7. Maternal and child nutrition andhealth Thailand, 1980-2006 Kraisid Tontisirin, Mahidol University

  8. Trend of nutritional status of children aged 1-5 years* % Stunting Underweight Overweight& Obesity NHES 2; Holistic Development of Thai Children; NFNS 5; NHES 4 *Courtesy from Dr. Umaporn Suthutvaravut

  9. Roles of agriculture and food systems Food production for subsistence economy: for consumption and income Promote local healthy snacks as food supplement for pregnant mothers Promote complementary food for infants and young children: at household and community levels School gardens and school lunch program Local daily farm for school milk program: a win-win activities Kraisid Tontisirin, Mahidol University

  10. National Rural Development Committee Poverty Alleviation Plan Provision of basic services with mass mobilization:1volunteer /10 households Agri.& food production for subsistence econ., suppl. food for mothers, complementary food for IYC & dairy farm for sch. Multi-stakeholder Comm. Nutrition goals and health indicators are incorporated to strategies and actions. Community based approaches Kraisid Tontisirin, Mahidol University

  11. Thailand: Current situation • Population 64.6 millions • 12th largest exporter of agriculture and food products • Main food exported products : e.g. Rice Processed Chicken Processed Pineapples Fishery Products 11 Kraisid Tontisirin, Mahidol University

  12. Thailand Thailand Is A Food Exporter -- Kitchen of the World -- Export Value of Food in 2011 27,809.47 million US$ and was 34,330 millions $ in 2012 12 Kraisid Tontisirin, Mahidol University

  13. Thailand: Current situation Facing with the double burden of malnutrition (DBM) and food safety issue Kraisid Tontisirin, Mahidol University

  14. Thailand National Food Committee Act of 2008 Food Education Food Security Food Quality Food Safety 11 related ministries, 30 national agencies,30 relevant Acts Ministry of Defense Ministry of Finance Ministry of Foreign Affairs Ministry of Social Development and Human Security Ministry of Industry Ministry of Public Health Ministry of Commerce Ministry of Interior Ministry of Science Ministry of Education Ministry of Agriculture The National Security Council The National Economic and Social Development board The Consumer Protection Board The national Health committee Kraisid Tontisirin, Mahidol University

  15. The National Food Committee Component Chairman : Prime Minister (or designated Deputy-Prime Minister) Secretary : FDA, Ministry of Public Health Co-secretary : ACFS, Ministry of Agriculture 7 Resource persons in : -Food Security (2) -Food Safety (1) -Food Quality (1) -Law (1) -Economic and Trade (1) -Food Innovation (1) Committee members 11 related ministries, 4 executive administrators Ministry of Defense Ministry of Finance Ministry of Foreign Affairs Ministry of Social development and human security Ministry of Industry Ministry of Public Health Ministry of Commerce Ministry of Interior Ministry of Science Ministry of Education Ministry of Agriculture and Commodity The National Security Council The National Economic and Social Development board The Consumer Protection board The national health committee Committee / Sub-Committee 15 Kraisid Tontisirin, Mahidol University

  16. The Authority of the National Food Committee Setting policy, planning strategies, monitoring and assessing Meeting at least 2 times a year Advices and provisions of guidance to the related ministries / authorities Advices the cabinet in case of food disaster or bioterrorism for action and land uses 16 Kraisid Tontisirin, Mahidol University

  17. W O SWOT Analysis • Strength • Fertilefood production resources • 2. Food contribute significantly to socio-economic and cultural development • 3. Thai foods are unique and well accepted internationally • 4. Continued improvement in food production and agro-industry Weakness 1. Complexity in food management 2. Inadequate inputs for small food producers 3. Degradation and deterioration of land and water in certain areas 4. Lowinvestment in R&D 5. High logistic cost related to food 6. Weak consumer awareness S Threat 1. Agriculture and food production sectors are not popular among young generation 2. Competition for agriculture production resources for food, feed, fuel, bioproduct and non- food crop 3. New threatsfrom global warming , plant/ animals diseases 4. Trade competition and barriers • Opportunity • Increasing demand of high quality, safe and nutritious food • 2. Global recognition of Thai food and food culture • 3. Food is always in demand and more in crisis situations • 4. Geographical Location of the country is conductive to trade • 5. New innovation and technology in food T 17 Kraisid Tontisirin, Mahidol University

  18. Continuum from Agriculture to Health • Promotion • Protection • Treatment • Agriculture • Food supply • Food Service Nutrition Food Health • Food quality • Food safety • (Consumer and Trade) • Nutrient needs • Dietary intakes • Nutritional wellbeing • Nutrition literacy • Food production • Nutrition orientation • for healthy diet • Food, feed and fuel • and bio-products • Climate changes • Safe from Hazards • Good health F o o d S e c u r i t y F o o d a n d N u t r i t i o n E d u c a t i o n F o o d C u l t u r e 18 Kraisid Tontisirin, Mahidol University

  19. Food Chain Approach OUTCOMES Safe and Nutritious Food Good Manufacturing Practices GOOD PRACTICES Good Hygienic Practices Good Agricultural Practices Plant and Animal Diseases Prevention and Control Plant and Animal Agro- Biodiversity (Genetics) BASIC ISSUES Nutrition For Plant and Animal Land Use Water Management 19 Kraisid Tontisirin, Mahidol University

  20. VISION Ensuring Quality and Safe Food Supply for Food Securityand Human Well-Being OBJECTIVES • Efficient and effective management of food production resources • 2. Ensuring high quality, safe and nutritious food produced at household, • community, and industrial levels • 3. Promotion of R&D and utilization of knowledge along the food chain • 4. Strengthening food management systems (food law, food database, etc.) • 5. Ensuring food security in both normal and crisis situation at the household, • community and national levels 20 Kraisid Tontisirin, Mahidol University

  21. THEMES, STRATEGIES & MEASURES : 21 Kraisid Tontisirin, Mahidol University

  22. Theme 1: Food Security Principle :Ensuring a sustainable food security and effective management of food production resources by active stakeholders participation Natural & Agricultural Resources Supply & Access Production • Enhancing Food Access at Household & Communities • Land & Water Mgt/Reforming • Food Production Zoning • Innovation & Technology • Balancing Food, • Feed & Fuel • Logistics Improvement • Capacity Development& Career Establish Crisis Management Systems R & DAlong the Food Chain Active Stakeholders Participation 22 Kraisid Tontisirin, Mahidol University

  23. Theme 2: Food Quality and Safety Principle :Ensuring high quality and safe food to protect consumer health and to facilitate domestic/international trade Food Standards CommunityFood Production • Quality • Safety • Nutrition Food Industry • Strengthening • - Value Added • - Enhance Production Practices • StrengtheningCommunity Food Processing • (food loss reduction/value added) • Establishment of harmonized standards • Strengthening of food quality and safety assurance systems • Trading & marketing promotion 23 Kraisid Tontisirin, Mahidol University

  24. Theme 3: Food Education Principle :R&D and knowledge utilization through engaging stakeholders in sustainable and effective use of food production resources along the food chain and also strengthening desirable consumption behavior for well-being R&D Output • Research and Knowledge Development • Knowledge Integration Best Practice • Knowledge Dissemination • Knowledge Utilization & Practice Basic Knowledge Utilization 24 Kraisid Tontisirin, Mahidol University

  25. Theme 4: System Management Principle : Effective food management systems along the food chain to deal with current and emerging issues in food Organization Database & Management System Reorganization & Strengthening Legal system Revise and Reform 25 Kraisid Tontisirin, Mahidol University

  26. A Cabinet Resolution on “Thailand Food Strategy” Approved The Strategic Framework of Food Management on 25 November 2010 by the Cabinet 26 Kraisid Tontisirin, Mahidol University

  27. Implementation of the Strategic Framework of Food Management (SFFM) • Integrated the SFFM in the 11th National Economic & Social Development Plan 2012-2016 • 2. Each sector implementing the SFFM & reports back to the National Food Committee • Three thematic committees for promotion the implementation on: Food Security, Food Quality • & Safety, and Linking of Food to Nutrition& Health Kraisid Tontisirin, Mahidol University

  28. Linking of Food, Nutrition and Health Safe and Nutritious Food Surveillance Safety Good Nutrition& Good Health Supply Service Consumption Quality / Diversity ►Domestic/ Imported Food - Primary Product - OTOP - Industrial ►Restaurant ►Catering ►Mobile Food Service Facility ►School ►Household ►Market ►Access ►knowledge ►Behavior - Diet pattern/Sanitary -Life style /Exercise Production 28 Information /Standard and Knowledge based Kraisid Tontisirin, Mahidol University

  29. Key Issues Linking Food, Nutrition & Health • 1. Standards & indicators on nutrition& related disease • 2. Food based dietary guidelines (FBDGs) • 3. Food, nutrition & dieteticeducation • 4. Promotion for more vegetable & fruit consumption • 5. Reduction of sugar, fat & salt in food • 6. School food & nutrition program • 7. Community based nutrition program • to promote nutrition & health • 8. Nutrition & related disease surveillance & survey • 9.Food and nutrition management during crisis Kraisid Tontisirin, Mahidol University

  30. Community Based Program for Food, Nutrition & Health Minimum Basic Services (Health, Education, Agricultural Extension) Supportive System • Menu (Activities) • Antenatal care • Growth monitoring/promotion • 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 KraisidTontisirin, Mahidol University

  31. Roles of agriculture and food systems beyond the year 2015 for nutrition Ensuring nutritious and safe food supply of healthy diets through human life course Be a key partner to prevent DBM and NCDs by supplying adequate fruits & vegetables; low sugar, fat and sodium foods; healthy fats…etc Care for environment and sustainable development As a source of income Kraisid Tontisirin, Mahidol University

  32. Str Framewk for Food Mgt (SFFM) National Food Committee • Roles of agriculture and food systems: • Ensuring nutritious and safe food supply e.g.fruits • & veg; low sugar, fat & sodium foods; legume & fishes …etc • Caring of environment & sustainable agriculture. Multi-stakeholder Comm. SFFM covers: Food Security, Quality & Safety, Education & Research, Management Linking of food, nutrition & health implemented at central & community levels for nutrition and p/c of NCDs . Kraisid Tontisirin, Mahidol University

  33. Policies and Strategies Nutrition Situation Thailand’s Development Plans 19601 - Anaemia in preg: 57%; - B1 deficiency: 23%; - B2 deficiency: 47%; - Low serum retinal: 38%; - Goitre in school children: 29% - PEM cases : Economic Infrastructure, Sectoral Plans 1962 : Improvement of Agriculture, Infrastructure 1st NEDP 1967 2nd NEDP (Started working in nutrition since 1974) 1972 3rd NEDP : + Social Plan + Food and Nutrition Plan (FNP) + Primary Health Care (PHC) 1977 19812 - PEM (Wt/Age of U 5): > 50% 4th NESDP : + Poverty Alleviation Plan (PAP)+ Integrated and implemented PHC + FNP and Basic Minimum Needs (BMN) Indicators in rural/urban communities 1982 19863 - PEM (Wt/Age of U 5): 30% 5th NESDP 19894 - Goitre in school children: 19% 1987 19915 - Anaemia in preg: 18% 6th NESDP 19956 - B1 deficiency: < 1%; - B2 deficiency: < 1% 1992 : 1992 + School Lunch Program (SLP) + School Milk Program (SMP) 7th NESDP 1996 - PEM3 (Wt/Age of U 5): 15% - Anaemia in preg5: 13%; - Goiter in school children4: 4% 1997 8th NESDP (Worked at FAO, 2000-2006) 2002 20034 - Goitre in school children: 1% • - Anaemia in preg: 10% 9th NESDP 20067 - PEM (Wt/Age of U 5): 9% 2007 2007 - UI in preg8 < 150 µg/L: 61%; - Low serum retinal9: 16% : 2008+ National Food Committee Act : 2010 + Strategic Framework for Food Management (SFFM) approved by cabinet 10th NESDP 2012 20088 - UI in preg < 150 µg/L: 56% : Integration of the SFFM and the 11th NESDP 11th NESDP 20108 - UI in preg < 150 µg/L: 43% : 2011 - Universal salt iodisation (USI) 201210 - PEM (Wt/Age of U 5): 7% 2017 : Promote cooperation and integration of all relevant sectors, academia, business and NGOs to strengthen national food and nutrition security : 2012 - Triferidine tablet (iron+folate+iodine) Kraisid Tontisirin, Mahidol University Figure Milestones of Thailand’s National Social and Economical Development Plan related to food and nutrition

  34. Food Systems in Thailand Modern Food Systems Traditional Food Systems • Food supply at household & community level. • Include production for business • in small & medium scales • Use primary food preservation • (e.g. smoking, sun drying, fermentation, salting) • Mass production/ Large scale • Apply scientific knowledge & technology • in food processing • Aware of food quality & safety • Advance in trade information systems Procurement & distribution Center Food Safety Control System SME/OTOP Street Food Challenge How both systems could contribute for healthy agriculture, health diets &nutrition, and healthy people and prosperity

  35. Conclusion 1 Thailand had been successful in alleviation of undernutrition under the National Rural development Committee implementing the Poverty alleviation Plan but currently is hfacing with the Double Burden of Malnutrition (DBM) Agriculture and food systems are fundamental for ensuring safe and nutritiousfood supply of fresh and processed foods at household, community, national and global levels. Kraisid Tontisirin, Mahidol University

  36. Conclusion 2 Multiple strategies and actionslinking between macro policy and strategies with actions at community level will lead to the success outcomes and impacts on nutrition. Under the National Food Committee, the Strategic Framework for Food Management (SFFM) had been approved by the Cabinet and has been implementing with aims for food and nutrition security, food quality and safety, and sustainable development. Kraisid Tontisirin, Mahidol University

  37. Conclusion 3 Ultimate goals of the SFFM in Thailand are healthy agriculture and food systems, health nutrition, health people and prosperity. Kraisid Tontisirin, Mahidol University

  38. …THANK YOU… 38 Kraisid Tontisirin, Mahidol University

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