Current Status and Trends in Dietary Energy from Sugar in Thailand: International Comparisons and Ecological Associations with Obesity and Diabetes
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Abstract
OBJECTIVES: To describe and compare temporal trends in dietary energy from sugar, obesity, and diabetes in Thailand and selected regions, contextualize Thailand’s sugar availability in relation to WHO recommendations, and examine the ecological association between obesity and diabetes prevalence.
MATERIALS AND METHODS: This ecological study used national- level secondary data. Dietary energy from sugar and sweeteners (kcal/capita/ day, 2010–2023) was obtained from FAOSTAT Food Balance Sheets, while obesity and diabetes prevalence (%) among adults (2010–2022) were obtained from the WHO Global Health Observatory. Descriptive statistics and indexed trends (2010 = 100) were used to summarize temporal changes for Thailand and comparator regions (Asia, South-East Asia, the Americas, Africa, and Europe). Spearman’s rank correlation coefficient was used to assess the association between annual obesity and diabetes prevalence in Thailand, with statistical significance set at p < 0.05.
RESULTS: From 2010 to 2023, dietary energy from sugar in Thailand declined from 490.6 to 435.4 kcal/capita/day (−11.3%), while Asia (+9.8%) and South-East Asia (+25.3%) showed rising trends. Despite this decline, Thailand’s dietary energy supply from sugar remained more than twice the Asian average and was comparable to that of the Americas, the region with the highest sugar availability among the comparator regions. Meanwhile, obesity prevalence in Thailand rose from 9.1% to 15.3% (+68.1%) and diabetes prevalence rose from 8.7% to 12.3% (+41.4%) between 2010 and 2022. In Thailand, annual obesity and diabetes prevalence were positively correlated (Spearman’s ρ = 1.00, p < 0.001).
CONCLUSION: Although dietary energy from sugar in Thailand declined during 2010–2023, it remained high when considered in relation to WHO recommendations and most comparator regions, while obesity and diabetes prevalence continued to rise. Sugar reduction alone is unlikely to sufficiently curb the burden of diet-related NCDs; future public health efforts should integrate sugar reduction with broader interventions targeting the food environment and lifestyle-related risk factors.
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