Thailand's food retail transition: supermarket and fresh market effects on diet quality and health

Purpose - The purpose of this paper is to investigate whether the food retail transition underway in Thailand, a transitional middle-income setting, is associated with increased consumption of processed foods high in fat, salt and energy. Such "problem foods" are important risks for avoidable cardio-vascular disease and diabetes burdens. Design/methodology/approach - The source population were members of the nationwide Thai Cohort Study (TCS) followed since 2005 (n = 87,151) for a study of the health-risk transition. For this report we used a multi-region sub-sample (n = 1,516) of TCS members responding to an additional questionnaire about food environments, shopping patterns and food consumption. By using a TCS sub-sample we gained access to four years (2005-2009) of longitudinal observations on a wide array of variables related to health and wellbeing from an informative group. Findings - Overall 85 per cent of the sample now have access to supermarkets; ten years ago the figure was 47 per cent, and when aged ten years, 5 per cent. Now half the participants regularly visit supermarkets and convenience stores, especially urban dwellers with higher incomes. Frequent shopping at supermarkets and convenience stores associated with consumption of six "problem foods" (soft drinks, snack foods, processed meats, western style bakery items, instant foods and deep fried foods). Frequent fresh market shopping was associated with increased vegetable intake. There was no association between food shopping and body mass index, diabetes or hypertension but supermarket shopping was related to hyperlipidaemia. Research limitations/implications - Modernization of food retailing is changing Thai diets and creating diet-related health risks. Originality/value - The paper addresses a knowledge gap on links between modernizing food retail in Asia and consumption of unhealthy foods, revealing strong linkage in transitional Thailand.