However, using a recent estimate of average Thai daily energy consumption as kcal per person  , and a 12 oz can of soda as a serve kcal see  , we estimate SSBs contributed 4. It is likely that SSB intake is, if anything, under-reported overall due to the use of this single question.
Self-reported weight is known to be quite accurate in our cohort  , so overall it is unlikely that the relations we observed were exaggerated by measurement error; if anything, the exposure misclassification will have had the opposite effect. There were some minor differences between respondents and non-respondents. We have no direct measure of whether non-response could be related to the outcome of interest i. As well as age there are a number of other covariates which were related to some degree to both non-response and outcome marital status, urbanisation type, location of residence, education, smoking and fried food consumption ; their inclusion in the regression model will have further mitigated the potential for selection bias to affect results materially.
The possibility of residual confounding by other dietary components has to be considered given the limitations in our dietary data and the mild confounding of the unadjusted estimates indicated by our multivariable results. This will of course have been offset at least in part by the exposure misclassification. A final limitation is that cohort members are more educated and somewhat younger than the general Thai population  ; however, associations and trends identified among the cohort are generally consistent over time and may be manifested among the wider Thai population in the near future.
This study derives from a large sample size drawn from diverse economic, social and geographic backgrounds and is similar to the STOU student body from which it is drawn. It is only the second study known to us conducted among an Asian population vulnerable to the effects of weight gain, type 2 diabetes, metabolic syndrome and other diet-related chronic diseases.
Adding to the importance of this study is the growing body of evidence linking SSB consumption directly with these conditions  ,  particularly in vulnerable Asian populations  and among Thais who are comparatively short statured  and more prone to metabolic challenge. The decrease in SSB consumption in the Thai cohort may signal future directions for the Thai population, particularly in light of Thailand's campaign to reduce sugar consumption.
Thailand, which is a model for progressive food and nutrition policy  ,  , has already restricted advertising and sales of sugar products to children. Nevertheless, successful SSB-lowering trials in children and adults elsewhere offer examples for further large scale public health interventions in Thailand; for example combining different approaches to SSB reduction at the Thai province or district level for comparison.
International trials  ,  also illustrate the need for continued public health efforts to maintain reduced SSB consumption and weight over time. Nevertheless, SSBs should not be the only focus of health promotion; their consumption often co-occurs with low physical activity levels and energy-dense diets which are independently associated with weight gain. Indeed not only should reductions be made in the population's energy consumption via diet but environmental changes to increase the populations' use of energy should be encouraged  , . Sugar consumption, particularly in SSBs, is now considered to be a major health threat comparable to smoking  and evidence suggests that removing SSBs from diets will have a positive impact on weight over time.
They increasingly are a target for health promotion because they have no redeeming nutritional benefits and can be eliminated from the diet without ill effects. Within our Thai cohort we will continue to monitor SSB consumption and links with diabetes, metabolic syndrome and dental health and we will increase the precision of our capture of SSBs; we note the desirability of other longitudinal studies doing the same.
Over a half of adults in the US, Canada, Australia and numerous European countries are now overweight or obese, a proportion that has risen sharply in the past. Request PDF on ResearchGate | Weight of modernity: An intergenerational study of the rise of obesity | Over a half of adults in the US, Canada, Australia and.
We also thank Dr Bandit Thinkamrop and his team from Khon Kaen University for guiding us successfully through the complex data processing. The Thai Cohort Study Team contributed to the development of the study and research instrument. No employees of either funder were involved in the any aspect of the research.
It is being developed to help students to prepare for entrance and competitive examination, to enable people to learn and prepare from best practices from all over the world and to facilitate researchers to perform inter-linked exploration from multiple sources. Critical Public Health 19 3 : Reflecting and responding to time barriers for healthy, sustainable living. The analysed group were compared to the 26 members of the initial cohort who did not respond to the follow-up questionnaire to assess the potential for selection bias; details and results are provided below in the limitations section of the Discussion. Peter Jackson. Request this item to view in the Library's reading rooms using your library card.
National Center for Biotechnology Information , U. PLoS One. Published online May 7. Adrian V. Hernandez, Editor. Author information Article notes Copyright and License information Disclaimer. Competing Interests: The authors have declared that no competing interests exist. Received Nov 14; Accepted Mar This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
This article has been cited by other articles in PMC. Abstract Introduction Sugar sweetened beverages SSBs are implicated in the rising prevalence of obesity and diet-related chronic diseases worldwide. Conclusion SSB consumption is independently associated with weight gain in the Thai population. Introduction Population weight gain in Thailand, as elsewhere, poses a looming health and social problem.
Exposure assessment The primary exposure under examination was SSB consumption in ; change in its consumption frequency between the two surveys was the secondary study exposure. Outcome assessment Weight gain, rather than BMI, is the outcome measure as it more sensitive to change over a short time period such as the 4 years in this study. Assessment of covariates Self-reported urban or rural residence in and when aged 10—12 years old was used to create four life-course urbanization categories: rural to rural RR , rural to urban RU , urban to rural UR , and urban to urban UU.
Statistical analysis The relationship between weight change and SSB consumption was analysed using multiple linear regression models.
Results Respondents to both surveys were broadly representative of the Thai population on socio-economic, demographic other than age and ethnic characteristics. Open in a separate window. Mean weight gain based on an average of individual weight change calculations. Table 2 Characteristics of those consuming 3 or more SSBs per week and weight change between and Age, location of residence, urbanisation type, education, marital, smoking and drinking status in Figure 1.
SSB consumption in and weight change — Figure 1b compares weights in the two surveys for persons of the same age. Table 3 SSB consumption in and weight change between and , by age and sex. Table 4 SSB consumption in and weight change between and Weight change, kg Model a n mean SD wt. Figure 2. Estimated weight gain by SSB consumption frequency in and Discussion This large, prospective cohort study of Thai adults provides detailed information on patterns of association between drinking SSBs and subsequent weight gain in Asia.
Conclusion Sugar consumption, particularly in SSBs, is now considered to be a major health threat comparable to smoking  and evidence suggests that removing SSBs from diets will have a positive impact on weight over time. References 1. Lancet : — Obesity 15 : — Deerochanawong C, Ferrario A Diabetes management in Thailand: a literature review of the burden, costs, and outcomes. Globalization and Health 9. The Lancet : — J Epidemiol Community Health 63 : — doi: Am J Cin Nutri 84 : — FAO Dietary energy consumption of countries.
Rome: FAO. Wilbulpolprasert S, editor Thailand Health Profile — Hu F Resolved: there is sufficient scientific evidence that decreasing sugar-sweetened beverage consumption will reduce the prevalence of obesity and obesity-related diseases. Obes Rev 14 : — Am J Epidemiol : — Int J Epidemiol 37 : — BMC Res Notes 4 : Lim L, Seubsman S, Sleigh A Validity of self-reported weight, height, and body mass index among university students in Thailand: implications for population studies of obesity in developing countries.
Popul Health Metro 7 : N Engl J Med : — James J, Thomas P, Cavan D, Kerr D Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial.
BMJ : N Engl J Med: — JAMA : — New Engl J Med : — Accessed October Euromonitor Soft Drinks in Thailand: Executive summary. The Nation Health advocacy groups urge Thais to consume less sugar. Am J Clin Nutr 94 : — The Wall Street Journal. January 18 Journal of the Academic of Nutrition and Dietetics : 43— Nam S Zeroing In. Accessed October 13 [ Google Scholar ].
Psychol Methods 7 : — Secular changes and predictors of adult height for male and female members of the Thai Cohort Study born between and J Epidemiol Community Health 66 : 75—80 doi: Nutrients 5 : — Obes Rev. DOI: James W The fundamental drivers of the obesity epidemic. Obesity Rev 9 : 6— Support Center Support Center.
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