About 50% of Thai schoolchildren suffer from dental health issues, with the worst facing five-year-olds where 70% of their milk teeth are found to be decayed, according to figures from the Sweet Enough Network under the Bureau of Dental Health, the Department of Health.
Equally shocking is a study from Chulalongkorn Memorial Hospital's paediatric endocrinology clinic which found a 27% surge in the number of Thai teens aged from 10-19 who fell prey to diabetes in the past decade or so. Last year's data from the Diabetes Association of Thailand stated that over 4.8 million Thai adults suffered from diabetes and the number is expected to reach 5.3 million over the next 20 years.
Dental health problems and diabetes are among other healthcare conundrums facing Thai youth as a result of excessive sugar consumption. Despite years of campaigns and movements to keep the issue in check, the problems are still persistent. Therefore, to underline the importance of such chronic health concerns, the Thai Health Promotion Foundation together with the Sweet Enough Network recently announced and stressed its support towards the Ministry of Education's announcement, which bans the sale of carbonated beverages and crispy snacks in schools under the Bangkok Metropolitan Administration.
Dental issues and diabetes are on the rise among Thai youth as a consequence of excessive sugar intake. Wichan Charoenkiatpakul
Thailand in fact has other state measures to curb people's excessive sugar consumption. Among them is the new excise tax on drinks with sugar content, which has been implemented in 2017 in an effort to put pressure on manufacturers to cut the amount of sugar they put in their products. The ban on fizzy drink sales in schools has been discussed for years. But do these state measures actually work? Are they really able to cut people's habit of consuming too much sugar?
Lecturer at Mahidol University's Institute of Nutrition Asst Prof Kitti Sranacharoenpong said that although the ban on fizzy drink sales in schools might seem to work well at the beginning, this is in fact a healthcare issue where long-term consequences should be seriously taken into consideration.
"The ban might look effective when it is first implemented because schools feel like they are monitored. But what's more important is the circumstance that will actually take place in the long run," said Asst Prof Kitti, who has been working with the Office of the Basic Education Commission on Thailand's school lunch programme and with neighbouring countries to set up a healthy lunch campaign for their students.
According to Asst Prof Kitti, the prevalence of diet-related illnesses among Thai children has worsened during the past five years, with kids as young as 12 being diagnosed with diabetes and requiring insulin injections. Apart from obesity and diabetes, hypertension in Thai children is on the rise, as well as heart and kidney diseases. Not only do these illnesses cause a strain for the little ones and their family, but it also stresses the national healthcare budget, with funding diverted to treatment and other necessities.
Certain countries have imposed bans on sugary drink sales in schools. Singapore, for one, does not allow the sale of medium-to-high-sugar drinks in schools and on government premises. In 2005, actor and then California Governor Arnold Schwarzenegger signed bills to eliminate the most fattening, sugary foods from public schools. The bills took effect two years later.
But for Asst Prof Kitti, Thailand should learn lessons from these countries where laws have been used to curb sugar consumption among schoolchildren.
"The ban worked at the beginning. In the long run, it didn't," he said.
Based on his experiences working with schools in Japan on dietary habits, he said the Land of the Rising Sun set a good example for Thailand and other countries seeking to make children healthier.
"[Certain] schools in Japan do not allow students to bring money while at the same time they ensure they provide school meals that are large enough to keep children's stomachs full. That way they won't feel the need to buy extra snacks or beverages that could otherwise deteriorate their health," he said.
To solve this public health issue once and for all, Asst Prof Kitti suggested that it all begins with children themselves because, after all, though they are most likely to be lured into the trap of poor eating habits, their behaviours can be changed most easily.
"Admittedly, children are the change agent in the family. Parents will usually not buy stuff that children do not eat. That way, the whole family will practise healthier eating habits."
Schools in Thailand should also change the way they employ nutrition. Sadly, Thai schools, said Asst Prof Kitti, allocate only eight hours per year to nutrition-related lessons, which are taught to students from kindergarten to Grade 6. With such a low number of diet-related classes, the nutritional expert said the country cannot expect Thai kids to grow up healthily and to know what they should or should not eat.
"Academic curricula should be adjusted," he advised. "Apart from allocating more hours for students to study healthy diets, nutrition-related knowledge should be incorporated into other subjects such as maths, English and wherever possible."
The concept of having a "nutrition teacher" in each school should be implemented, Asst Prof Kitti recommended. Instead of assigning administrative teachers to oversee nutrition-related aspects of school meals, a school should have a specific teacher assigned to this particular task -- or at the very least one nutrition teacher per five-10 schools.
"At present, there is no such teacher in Thailand," he commented. "What our country has now is only junior teachers assigned to take care of school meals while they also have other responsibilities. But for schools across Thailand to be able to provide healthy foods for kids, it is paramount to have nutrition teachers. They should attend yearly training that will keep them updated with regard to diet-related knowledge and know-how. Nutrition teachers will also oversee students' height, weight and other health-related issues. With such a role in academic institutes, all food-related aspects will be easily managed and controlled."
While curbing items sold inside schools, mapping should also be carried out around the neighbourhood to find out what kind of food, snacks and beverages are available nearby and if they are healthy for children.
"To fix nutrition-related issues among schoolchildren, everyone must look ahead. Yet legal measures should only be implemented as the final action because whenever a law is used, business operators will certainly find a way to get away with it. And worse, they could respond with stronger reactions."
Wichan Charoenkiatpakul
