Association for Public Policy Analysis & Management

The food retail environment is changing in Thailand. Since the late 1990s, Western-style supermarkets and convenience stores are quickly replacing traditional wet markets, a revolution that alters the availability of foods, prices, consumer behavior, and dietary patterns. The change from high fiber and cereal diet towards foods high in sugar and fat unfolded over 50 years in industrialized countries, but in Southeast Asia has taken place over 15-20 years. The impact of nutrition transition on public health is thus expected to be more severe in this part of the world. Thailand has been witnessing the rise of widespread non-communicable diseases (NCDs) in recent years while still battling under-nutrition and infectious diseases. Using a sample from the urban population in Bangkok where the supermarket revolution has been most pronounced, this study explores the influence of the different types of grocery store outlets and individuals’ purchasing behavior on their diet quality and weight status.

Methods:

A sample of 513 working individuals in Bangkok completed a survey questionnaire on grocery shopping behavior and received a body composition analysis using bioelectrical impedance method.  Chi-square tests were used to assess the characteristics of shopper groups, characterized as modern, traditional, and mixed shoppers. The impacts of grocery shopping behavior on diet quality and weight status were tested using Ordered Logistic and Ordinary Least Squares (OLS) regressions.

Results:

Traditional market shoppers appear to have lower income than those who shop primarily at modern-format stores and those who shop at both traditional market and modern markets. The mere grocery destination choice did not display significant association with poor dietary behavior although shopping frequency did.  People who shop at supermarkets 3 or more times a week are more likely to consume unhealthy snacks (p = 0.048). People who shop at convenience stores 3 or more times a week are more likely to eat fast food (p = 0.006), consume sugary drinks (p = 0.001), and drink alcohol (p = 0.036). They are also more likely to sit for at least 8 hours a day (p = 0.012). Similar relationships were not found for frequent traditional market shoppers. There is no statistical significance between five obesity measures (body mass index, percent body fat, waist circumference, visceral fat, and waist-hip ratio) and shopping frequency at modern grocery retailers or traditional markets.

Discussion:

The findings from this study suggest that modern grocery retailers are influencing nutrition transition in Bangkok. People who frequent western-format food outlets are more likely to engage in poor dietary and health behavior. Although unhealthful habits have not translated into poor health in terms of weight status, evidence suggests that this is a critical juncture for Thailand to implement policies that would prevent the spread of diet-related non-communicable diseases.

Learning Areas:

Obesity

Food access

Nutrition transition

Learning Objectives:

Describe the nutrition transition process in developing countries

Discuss the relationship between grocery outlets spatial pattern and food access

Identify ecological factors influencing diet quality

Keywords:

Nutrition, Obesity