Ultra-Processed Foods, Nutritional Inequalities, and Structural Food Systems: A Literature Review Toward Health Equity
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Abstract
Over the past two decades, Thailand has experienced a significant rise in obesity and non-communicable diseases (NCDs), particularly among low-income populations. This trend has paralleled the growing consumption of ultra-processed foods (UPFs), which are affordable, highly accessible, and energy-dense yet nutritionally poor. Traditional nutrition education targeting individual behavior has proven insufficient in addressing the broader structural factors embedded within the food system, urban economy, and commercial food marketing. This review article aims to analyze and synthesize academic perspectives on the structural role of UPFs in shaping dietary behaviors, nutritional disparities, and health inequities in Thailand. The study employs key conceptual frameworks, including the Social Determinants of Health (SDH), the Obesogenic Environment, and the Nutrition Equity Framework, to examine the systemic factors influencing food choices. The article concludes with policy recommendations to reform the food system toward greater equity and sustainable health outcomes for all population groups.
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Articles published are copyright of the Journal of Home Economics Technology and Innovation. Rajamangala University of Technology Thanyaburi The statements contained in each article in this academic journal are the personal opinions of each author and are not related to Rajamangala University of Technology Thanyaburi and other faculty members at the university in any way Responsibility for all elements of each article belongs to each author. If there is any mistake Each author is solely responsible for his or her own articles.
References
กรมอนามัย. (2566). รายงานสถานการณ์สุขภาพคนไทย ปี 2566. กรุงเทพฯ: กระทรวงสาธารณสุข.
จิราพร เลิศวิริยะ. (2565). โภชนาการป้องกันโรค: ทางรอดของระบบสุขภาพไทย. วารสารโภชนาการชุมชน, 11(2), 14–20.
ทองศิริ, พิชญา, ชลิตา ภูวดล, และสุวรรณา จันทรา. (2565). ความเหลื่อมล้ำด้านโภชนาการในผู้สูงอายุไทย: กรณีศึกษาภาวะทุพโภชนาการคู่. วารสารโภชนาการและการส่งเสริมสุขภาพ, 14(1), 55–69.
บุญรักษ์, นพดล. (2567). การวิจารณ์แนวทางลดอ้วนของรัฐไทย: การมองภาวะอ้วนในเชิงโครงสร้าง. วารสารวิจัยสุขภาพและสังคม, 8(1), 55–70.
ภาณุวัฒน์ ประเสริฐศรี. (2565). อาหารแปรรูปกับพฤติกรรมผู้บริโภคไทยในยุคโควิด-19. รายงานสถานการณ์โภชนาการในประเทศไทย. กรุงเทพฯ: กรมอนามัย.
ปิยะดา พรเสริมสุข. (2566). พฤติกรรมการบริโภคอาหารแปรรูป: ปรากฏการณ์และผลกระทบในยุคเร่งรีบ. วารสารโภชนาการชุมชน, 13(1), 21–35.
สำนักงานกองทุนสนับสนุนการสร้างเสริมสุขภาพ. (2566). รายงานสถานการณ์สุขภาพเด็กและเยาวชน ปี 2566. กรุงเทพฯ: สำนักงานกองทุนสนับสนุนการสร้างเสริมสุขภาพ.
สำนักงานกองทุนสนับสนุนการสร้างเสริมสุขภาพ. (2566). รายงานสถานการณ์สุขภาพคนไทย ปี 2566. กรุงเทพฯ: สำนักงานกองทุนสนับสนุนการสร้างเสริมสุขภาพ.
Adhikari, R., Paudel, P., & Upadhaya, M. (2012). Nutrition transition in low and middle-income countries: A case study of South and Southeast Asia. Asia Pacific Journal of Clinical Nutrition, 21(4), 531–539.
Backholer, K., Gupta, A., Zorbas, C., Bennett, R., Huse, O., Chung, A., ... & Peeters, A. (2021). Differential exposure to, and potential impact of, unhealthy advertising to children and adolescents by socioeconomic position: A systematic review. Obesity Reviews, 22(3), e13144. https://doi.org/10.1111/obr.13144
Baker, P., Machado, P., Santos, T., Sievert, K., Backholer, K., & Martins, A. (2018). Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obesity Reviews, 19(1), 1–17. https://doi.org/10.1111/obr.12764
Baker, P., Machado, P., Santos, T., Sievert, K., Backholer, K., Hadjikakou, M., & Lawrence, M. (2020). Ultra-processed foods and the nutrition transition: Global, regional and national trends, food systems transformations and political economy drivers. Obesity Reviews, 21(12), e13126.https://doi.org/10.1111/obr.13126
Buse, K., & Hawkes, C. (2020). Power, politics, and the framing of obesity: A global analysis. Health Policy and Planning, 35(3), 286–295.
Colchero, M. A., Rivera-Dommarco, J., Popkin, B. M., & Ng, S. W. (2017). In Mexico, evidence of sustained consumer response two years after implementing a sugar-sweetened beverage tax. Health Affairs, 36(3), 564–571. https://doi.org/10.1377/hlthaff.2016.1231
Condon, J., Grahame, E., & Zivkovic, T. (2022). Stigma, shame and weight bias in health communication: Considerations for inclusive public health. Health Promotion International, 37(6), daac061. https://doi.org/10.1093/heapro/daac061
Darmon, N., & Drewnowski, A. (2015). Contribution of food prices and diet cost to socioeconomic disparities in diet quality and health: A systematic review and analysis. Nutrition Reviews, 73(10), 643–660. https://doi.org/10.1093/nutrit/nuv027
FAO. (2022). The State of Food Security and Nutrition in the World 2022. Rome: Food and Agriculture Organization of the United Nations. https://pmc.ncbi.nlm.nih.gov/articles/PMC10472697/
GAIN. (2022). Thailand Food Environment Report 2022. Geneva: Global Alliance for Improved Nutrition.Hare, G. U., Backholer, K., & Peeters, A. (2021). The structural drivers of obesity: International examples and recommendations for change. Obesity Reviews, 22(4), e13119. https://doi.org/10.1111/obr.13119
Kelly, B., Vandevijvere, S., Freeman, B., & Jenkin, G. (2019). New media but same old tricks: Food marketing to children in the digital age. Current Obesity Reports, 8(1), 18–27. https://doi.org/10.1007/s13679-019-0031-1
Kickbusch, I., Allen, L., & Franz, C. (2016). The commercial determinants of health. The Lancet Global Health, 4(12), e895–e896. https://doi.org/10.1016/S2214-109X(16)30217-0
Lang, T., & Heasman, M. (2015). Food wars: The global battle for mouths, minds and markets. Routledge.
Monteiro, C. A., Cannon, G., Moubarac, J. C., Levy, R. B., Louzada, M. L. C., & Jaime, P. C. (2019). The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutrition, 21(1), 5–17. https://doi.org/10.1017/S1368980018000173
Nisbett, N., Davis, P., Yosef, S., & Akhtar, N. (2022). Nutrition equity: A new framework for research, policy, and practice. Global Food Security, 33, 100633. https://doi.org/10.1016/j.gfs.2022.100633
Phulkerd, S., Chamratrithirong, A., & Kessomboon, P. (2023). Consumption trends and health implications of ultra-processed foods in Thailand. Journal of Nutrition and Health Policy, 17(2), 90–105. https://pmc.ncbi.nlm.nih.gov/articles/PMC10472697/
Popkin, B. M., Corvalan, C., & Grummer-Strawn, L. M. (2020). Dynamics of the double burden of malnutrition and the changing nutrition reality. The Lancet, 395(10217), 65–74.
Scrinis, G., & Monteiro, C. A. (2018). Ultra-processed foods and the limits of product reformulation. Public Health Nutrition, 21(1), 247–252. https://doi.org/10.1017/S1368980017001392
Sleigh, A., Srisurapanon, S., & Yodmai, P. (2024). Food environments and urban inequality in Thailand: An ethnographic study. International Journal for Equity in Health, 23(1), 112–124. https://doi.org/10.1186/s12939-024-01122-3
Swinburn, B. A., Kraak, V. I., Rutter, H., Vandevijvere, S., Lobstein, T., Sacks, G., ... & Magnusson, R. (2015). Strengthening of accountability systems to create healthy food environments and reduce global obesity. The Lancet, 385(9986), 2534–2545. https://doi.org/10.1016/S0140-6736(14)61747-5
Taillie, L. S., Reyes, M., Colchero, M. A., Popkin, B. M., & Corvalán, C. (2020). An evaluation of Chile’s Law of Food Labeling and Advertising on sugar-sweetened beverage purchases from 2015 to 2017: A before-and-after study. PLOS Medicine, 17(2), e1003015. https://doi.org/10.1371/journal.pmed.1003015
Thow, A. M., Jones, A., Hawkes, C., Ali, S., & Labonté, R. (2021). Nutrition policy implementation and political economy in middle-income countries: Lessons for Thailand. Global Public Health, 16(10), 1528–1542.
WHO. (2021). Social Determinants of Health and Health Inequities. Geneva: World Health Organization.
World Health Organization. (2023). Social determinants of health. Geneva: World Health Organization.
