National evidence on the association between recommended adult diets and access to modern and traditional food retail environments
Sirinya Phulkerd, Sasinee Thapsuwan, Natjera Thongcharoenchupong, Sarunya Sujaritpong, Aphichat Chamratrithirong, Rossarin Soottipong Gray, Umaporn PattaravanichAbstract
Objective:
This study investigated the association between the food environment, along with other factors, and healthy diet in Thailand.
Design:
A cross-sectional national survey in Thailand (August 2022 and November 2023) used face-to-face interviews to collect socio-demographic and economic characteristics, food environment and diet data. The modified Thailand Healthy Eating Index (MTHEI) was used to measure adherence to a recommended diet of the study participants. Descriptive and multiple regression analyses were performed on the data set.
Setting:
Thailand.
Participants:
10 763 adults.
Results:
The average MTHEI score among participants was 61·7 out of 100, indicating a diet that needs improvement. People age 60 years and over ( B = 13·430; p < 0·001), female ( B = 1·344; p < 0·001), secondary-school education ( B = –0·916; p 0·002) and high income ( B = –1·132; p < 0·001) were associated with higher MTHEI scores, when compared with their respective reference groups. People with perceived nearby access to both traditional retail and modern trade retail scored 2·1 points ( p = 0·017) lower than those without such retail nearby. Whenever modern trade is present, the diet score is observed to be lower. Those with perceived nearby access to both fresh/wet market and modern trade retail scored 1·0 points lower ( p = 0·044).
Conclusions:
The findings suggest the need for government intervention to address the perceived influence of the food retail environment in residential areas particularly modern trade retail, promote fresh markets and home gardening to encourage healthy consumption of food and beverages. The government should also dedicate support for vulnerable populations, while simultaneously advancing food literacy programs.