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ªï∑’Ë Ú ©∫—∫∑’Ë Ò ¡°√“§¡ - °ÿ¡¿“æ—π∏å ÚııÙ
Journal of Health Science
Vol. 20 No. 1 January - February 2011
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Special Article
∫∑‡√’¬π®“°π“π“™“μ‘ ·≈–§«“¡∑â“∑“¬
μàÕÕπ“§μπ‚¬∫“¬Õ“À“√·≈–‚¿™π“°“√
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‡æ’¬ßæÕ ‡ªìπÀπ÷ßË „πªí®®—¬‡ ’¬Ë ß ”§—≠¢Õß°“√‡°‘¥‚√§μà“ß Ê (‡™àπ ‚√§‡∫“À«“π ·≈–‚√§À—«„®) „πª√–™“°√‰∑¬
°“√‡¢â“„®∂÷ßÕ‘∑∏‘æ≈¢Õßªí®®—¬‡ ’ˬßμàÕ ÿ¢¿“æ·≈–Õ‘∑∏‘æ≈∑’Ë¡’μàÕªí®®—¬‡ ’ˬßπ’È √«¡∂÷ß°“√»÷°…“∫∑‡√’¬π°“√
®—¥°“√ªí≠À“¥â“πÕ“À“√·≈–‚¿™π“¢Õߪ√–‡∑»μà“ß Ê ®–‡ªìπ√“°∞“𠔧—≠∑’˙૬„Àâ°“√æ—≤π“·≈–¥”‡π‘π
π‚¬∫“¬Õ“À“√·≈–‚¿™π“°“√¢Õߪ√–‡∑»‰∑¬‡ªìπ‰ªÕ¬à“ß¡’ª√– ‘∑∏‘¿“æ °“√·≈°‡ª≈’ˬπ·≈–‡√’¬π√Ÿâ®“°
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π“π“™“μ‘√“ß«—≈¡À‘¥≈ª√–®”ªï 2552 √–À«à“ß«—π∑’Ë 29-30 ¡°√“§¡ æ.». 2552 ‰¥â‡ πÕ·π–π‚¬∫“¬‡æ◊ËÕ≈¥
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∑’‰Ë ¡à‡À¡“– ¡∑—ßÈ „π√–¥—∫∫ÿ§§≈ (‡™à𠧫“¡√Ÿ‡â °’¬Ë «°—∫Õ“À“√·≈–‚¿™π“°“√ ·≈–√Ÿª·∫∫°“√¥”‡π‘π™’«μ‘ ) ·≈–
‘Ëß·«¥≈âÕ¡ (‡™àπ ‚√߇√’¬π √â“πÕ“À“√ ·≈– ◊ËÕ‚¶…≥“) §«∫§Ÿà°—π‰ª √«¡∑—È߇æ‘Ë¡§«“¡√à«¡¡◊Õ®“°¿“§√—∞
·≈–‡Õ°™π ·≈–∑ÿ°√–¥—∫™—Èπμ—Èß·μà√–¥—∫™ÿ¡™π ¿Ÿ¡‘¿“§ ª√–‡∑» ·≈–π“π“™“μ‘ Õ¬à“߉√°Áμ“¡ ª√–‡∑»‰∑¬
¬—ߧßμâÕ߇º™‘≠°—∫§«“¡∑â“∑“¬Õ◊Ëπ Ê πÕ°‡Àπ◊Õ®“°ªí≠À“Õ“À“√·≈–‚¿™π“°“√ ‡™àπ °“√æ—≤π“Õߧå°√μ—Èß
·μà√–¥—∫™ÿ¡™π∂÷ß√–¥—∫ª√–‡∑»„Àâ∑”ß“π„π∑‘»∑“߇¥’¬«°—π ‡æ‘¡Ë §«“¡√à«¡¡◊Õ√–À«à“ßÀπ૬ߓπ·≈–¿“§ à«π
°“√ √â“ßÕߧ姫“¡√Ÿâæ◊Èπ∞“π ·≈–°“√ªÑÕß°—πº≈ª√–‚¬™πå∑—∫´âÕ𠇪ìπμâπ
§” ”§—≠:
æƒμ‘°√√¡°“√∫√‘‚¿§∑’ˉ¡à‡À¡“– ¡, ª√– ∫°“√≥宓°π“π“™“μ‘, ªí®®—¬√–¥—∫∫ÿ§§≈·≈–ªí®®—¬ ‘Ëß·«¥≈âÕ¡,
π‚¬∫“¬Õ“À“√·≈–‚¿™π“°“√, §«“¡√à«¡¡◊Õ
∫∑π”
„πªí®®ÿ∫—π ª√–™“°√‰∑¬ªÉ«¬·≈–쓬®“°‚√§‰¡à
μ‘ ¥ μà Õ ‡√◊È Õ √— ß ∑’Ë ‡ °’Ë ¬ «¢â Õ ß°— ∫ °“√¡’ ¿ “«–∑ÿ æ ‚¿™π“°“√
‡æ‘¡Ë ¡“°¢÷πÈ ‡™àπ ‚√§‡∫“À«“π ‚√§À—«„®À≈Õ¥‡≈◊Õ¥ ‚√§
À≈Õ¥‡≈◊Õ¥ ¡Õß ‚√§§«“¡¥—π‚≈À‘μ Ÿß √«¡∂÷ß‚√§
¡–‡√Áß(1) ´÷Ëßªí®®—¬‡ ’ˬß∑’Ë ”§—≠¢Õß‚√§μà“ß Ê ‡À≈à“π’È
‰¥â·°à °“√¡’æƒμ‘°√√¡°“√∫√‘‚¿§∑’Ë ‰¡à‡À¡“– ¡ ‡™àπ °“√
∫√‘‚¿§Õ“À“√∑’¡Ë ’ ¥— à«π¢ÕßÕ“À“√ª√–‡¿∑·ªÑß πÈ”μ“≈
ÛÙı
Lessons Learned from International Experiences and Challenges to Future Food and Nutrition Policy in Thailand
·≈–‰¢¡—π Ÿß °“√∫√‘‚¿§º—°·≈–º≈‰¡â∑’Ë ‰¡à‡æ’¬ßæÕ ·≈–
°“√°‘πÕ“À“√∑’˺à“π°“√·ª√√ŸªÀ√◊Õ∂πÕ¡Õ“À“√ ªí®®—¬
‡ ’¬Ë ߇À≈à“π’°È Õà ªí≠À“μàÕμâπ∑ÿπ∑“ß —ߧ¡ (social asset)
·≈–Õπ“§μ¢Õß™“μ‘ ·≈–ªí≠À“μàÕ —ߧ¡„π¿“æ√«¡„π
¡‘μ‘¢Õß°“√∫√√≈ÿ‡ªÑ“À¡“¬‡™‘ß ÿ¢¿“«– ªí≠À“∑“ß
‡»√…∞°‘® ·≈–°“√æ—≤π“ —ß§¡ ‡ªìπª√“°Ø°“√≥å∑’Ëæ∫
„π‡°◊Õ∫∑ÿ°¡‘μ¢‘ Õߪ√–™“°√‰∑¬ ∑—ßÈ Õ“¬ÿ ‡»√…∞“π– ·≈–
¡‘μ‘¢Õß¿Ÿ¡‘»“ μ√å
·¡â «à “ ªí ® ®ÿ ∫— π ‰¥â ¡’ ° “√®— ¥ ∑”·≈–¥”‡π‘ π °“√
π‚¬∫“¬·≈–¡“μ√°“√‡æ◊Ë Õ ≈¥ªí ® ®— ¬ ‡ ’Ë ¬ ß ”§— ≠ ∑’Ë ‰ ¥â
°≈à“«∂÷ߢâ“ßμâπ ·μà¬ß— ‰¡àª√“°Øª√– ‘∑∏‘¿“æ ª√– ‘∑∏‘º≈
·≈–§«“¡§ÿ¡â §à“¢Õßπ‚¬∫“¬·≈–¡“μ√°“√‡À≈à“π—πÈ ∑—ßÈ π’È
Õ“®‡π◊ËÕß¡“®“°ªí®®—¬‡ ’ˬ߇°’ˬ«¢âÕß°—∫μ—«°”Àπ¥ (determinant) ¡’§«“¡À≈“°À≈“¬·≈– ≈—∫´—∫´âÕπ ∑—Èß
ªí®®—¬„π√–¥—∫ªí®‡®°(2) ·≈–ªí®®—¬‡™‘ß ‘ßË ·«¥≈âÕ¡(3,4) ∑—ßÈ
√–¥—∫§√—«‡√◊Õπ ™ÿ¡™π·≈–æ◊Èπ∑’Ë ª√–‡∑» ·≈–√–¥—∫
π“π“™“μ‘ μ—«Õ¬à“߇™àπ æƒμ‘°√√¡°“√∫√‘‚¿§ æƒμ‘°√√¡
ÿ¢¿“æÕ◊Ëπ Ê √Ÿª·∫∫°“√‡≈’ȬߥŸ Õ‘∑∏‘æ≈¢Õß∫√‘∫∑∑“ß
—ߧ¡ ·≈–π‚¬∫“¬∑“߇»√…∞°‘®·≈– —ߧ¡ ‡™àπ π‚¬∫“¬
‡°’¬Ë «¢âÕß°—∫‡°…μ√°√√¡ °“√¢π àß °“√«“ߺ—߇¡◊Õß ‘ßË ·«¥≈âÕ¡ °“√»÷°…“ ·≈–°√–∫«π°“√º≈‘μÕ“À“√·≈–
°“√μ≈“¥¢ÕßÕ“À“√ ‡ªìπμâπ ´÷Ëß°“√·°â ‰¢ªí≠À“∑’Ë´—∫´âÕπ¥—ß°≈à“«μâÕßÕ“»—¬√–¬–‡«≈“·≈–§«“¡æ¬“¬“¡
Õ¬à“ßμàÕ‡π◊ËÕß ‚¥¬°“√∑”§«“¡‡¢â“„®∂÷ß ¿“æ·≈–
§«“¡‡™◊ËÕ¡‚¬ß¢Õßªí®®—¬‡À≈à“π’È μ≈Õ¥®πÕ‘∑∏‘æ≈∑’Ë¡’
μàÕªí®®—¬‡ ’Ë¬ß ÿ¢¿“æ®÷ß®–‡ªìπ√“°∞“π∑’Ë ”§—≠„π°“√
®—¥°“√°—∫ªí≠À“¥—ß°≈à“« Õ¬à“߉√°Áμ“¡ ‡ªìπ∑’ˬա√—∫
«à “ ¬— ß ¡’ Õ ß§å § «“¡√Ÿâ æ◊È π ∞“π„πª√–‡¥Á π ¥— ß °≈à “ «„π
ª√–‡∑»‰∑¬®”°—¥Õ¬à“߬‘Ëß
πÕ°‡Àπ◊Õ®“°°“√æ—≤π“π‚¬∫“¬ à߇ √‘¡ ÿ¢¿“æ
∫π∞“π«‘™“°“√ Õߧ姫“¡√Ÿâ∑—Èߥâ“π∑’ˇ°’ˬ«°—∫§«“¡
√ÿπ·√ß·≈–°“√°√–®“¬ (magnitude and distribution)
¢Õߪí≠À“ ªí®®—¬·≈– “‡Àμÿ (determinants and
causes) ¢Õߪí ≠ À“ ·π«∑“ß„π°“√·°â ‰¢ªí ≠ À“
¬ÿ∑∏»“ μ√å„π°“√π”π‚¬∫“¬‰ªªØ‘∫μ— „‘ À⡪’ √– ‘∑∏‘¿“æ
346
·≈–°“√μ‘ ¥ μ“¡ª√–‡¡‘ π º≈π‚¬∫“¬ ≈â « π·≈â « ·μà ¡’
§«“¡ ”§—≠μàÕª√– ‘∑∏‘º≈¢Õßπ‚¬∫“¬∑—Èß ‘Èπ °“√
‡√’ ¬ π√Ÿâ ® “°ª√– ∫°“√≥å „ π°“√®— ¥ °“√°— ∫ ªí ≠ À“„π
√–¥—∫π“π“™“μ‘ ºà“π°“√·≈°‡ª≈’ˬπ·≈–‡√’¬π√Ÿâ®“°
ª√– ∫°“√≥å¢Õß∫ÿ§≈“°√À√◊ÕºŸâ‡™’ˬ«™“≠®“°Àπ૬
ß“πÀ√◊Õª√–‡∑» ®–‡ªìπªí®®—¬‡ √‘¡ª√–°“√ ”§—≠
”À√— ∫ §«“¡ ”‡√Á ® „π°“√®— ¥ °“√°— ∫ ªí ≠ À“ ÿ ¢ ¿“æ
“‡Àμÿ®“°¿“«–‚¿™π“°“√¢Õߪ√–™“°√‰∑¬ ·≈–¬—ß
∂◊Õ‰¥â«à“‡ªìπ°≈‰° ”§—≠„π°“√æ—≤π“»—°¬¿“æ∑“ß«‘™“
°“√¢ÕߺŸâ¡’ à«π‡°’ˬ«¢âÕß„π —ߧ¡‰∑¬ ‚¥¬®”‡ªìπμâÕß
æ—≤π“μàÕ¬Õ¥·≈–¥—¥·ª≈ß ‘Ë߇√’¬π√Ÿâ®“°μà“ߪ√–‡∑»
„Àâ Õ¥§≈â Õ ß°— ∫ ∫√‘ ∫ ∑¢Õߪ√–‡∑»‰∑¬ ·≈–𔉪
ª√–¬ÿ°μå„™âÕ¬à“ß¡’ª√– ‘∑∏‘¿“æ·≈–ª√– ‘∑∏‘º≈μàÕ‰ª
°“√𔇠πÕ·≈–Õ¿‘ª√“¬„πÀ—«¢âÕ°“√ª√–™ÿ¡ ‡√◊ÕË ß
Agricultural policies and climate change: Challenge
and opportunity for future diets and public health(5)
®“°ß“πª√–™ÿ¡π“π“™“μ‘√“ß«—≈¡À‘¥≈ª√–®”ªï æ.».
2552 √–À«à“ß«—π∑’Ë 29-30 ¡°√“§¡ æ.». 2552 ®—¥¢÷Èπ
‚¥¬√—∞∫“≈‰∑¬ ¡Ÿ≈π‘∏‘√“ß«—≈¡À‘¥≈ Õߧå°√π“π“™“μ‘∑’Ë
‡°’ˬ«¢âÕß ¡Ÿ≈π‘∏‘ ·≈–Õߧå°√ª√–™“ —ߧ¡ ‡ªìπ°“√
ª√–™ÿ¡· ¥ß§«“¡§‘¥‡ÀÁπ√–¥—∫π“π“™“μ‘∑’Ë®—¥√à«¡°—∫
°“√ª√–°“»√“ß«—≈¡À‘¥≈ª√–®”ªï¥â“π “∏“√≥ ÿ¢·≈–
°“√·æ∑¬å ¡’«—μ∂ÿª√– ߧå‡æ◊ËÕ·∫àߪíπª√– ∫°“√≥å
·≈–¢âÕ¡Ÿ≈π‚¬∫“¬∑’ˇ°’ˬ«¢âÕß°—∫ ÿ¢¿“æ ·≈–‡æ‘Ë¡
§«“¡‡¢â¡·¢ÁßμàÕ§«“¡√—∫º‘¥™Õ∫∑“ß —ߧ¡‡°’ˬ«°—∫°“√
æ—≤π“ ÿ¢¿“æ √à«¡°—∫Õߧå°√√–À«à“ߪ√–‡∑» ‡™àπ
United Nations ¡Ÿ≈π‘∏·‘ ≈–¿“§’∑¡’Ë °’ “√æ—≤π“∑—ßÈ Õߥâ“π
·≈–Õߧå°√ª√–™“ —ߧ¡‚≈° ·≈–°“√ª√–™ÿ¡πÕ°√Õ∫
°—∫ºŸ‡â ™’¬Ë «™“≠√–¥—∫π“π“™“μ‘„πÀ—«¢âÕ Tackling Childhood Obesity ‡¡◊ËÕ«—π∑’Ë 31 ¡°√“§¡ æ.». 2552 ®—¥
¢÷πÈ ‚¥¬ ”π—°ß“πæ—≤π“π‚¬∫“¬ ÿ¢¿“æ√–À«à“ߪ√–‡∑»
°√–∑√«ß “∏“√≥ ÿ¢ ·≈– ”π—°ß“π°Õß∑ÿπ π—∫ πÿπ
°“√ √â“߇ √‘¡ ÿ¢¿“æ ( .) ‰¥â √â“ß‚Õ°“ ∑’Ë¥’·≈–
§ÿâ¡§à“„À⺟⡒ à«π‡°’ˬ«¢âÕß°—∫π‚¬∫“¬„π°“√®—¥°“√°—∫
ªí≠À“¿“«–‚¿™π“°“√ ·≈–°“√ª√—∫ª√ÿß‚¿™π“°“√
Journal of Health Science 2011 Vol. 20 No. 2
∫∑‡√’¬π®“°π“π“™“μ‘ ·≈–§«“¡∑â“∑“¬μàÕÕπ“§μπ‚¬∫“¬Õ“À“√·≈–‚¿™π“°“√¢Õߪ√–‡∑»‰∑¬
·≈– ÿ¢¿“æ¢Õߪ√–™“°√‰∑¬„π√–¬–¬“« ‰¥â∑∫∑«π
∂“π°“√≥åª≠
í À“·≈–°√≥’»°÷ …“®“°μà“ߪ√–‡∑» ·≈–
„™â‡ªìπ·π«∑“ß„π°“√®—¥°“√°—∫ªí≠À“ ·≈–æ—≤π“·≈–
ª√—∫ª√ÿßπ‚¬∫“¬¥â“π‚¿™π“°“√·≈– “∏“√≥ ÿ¢∑’Ë¡’
ª√– ‘∑∏‘¿“æ·≈–„Àâª√– ‘∑∏‘º≈μàÕª√–‡∑»‰∑¬„πÕπ“§μ
°“√‡√’¬π√Ÿâ®“°¢âÕ¡Ÿ≈«‘®—¬·≈–°√≥’»÷°…“
°“√‡√’¬π√Ÿâ®“°°“√∑∫∑«π¢âÕ¡Ÿ≈«‘®—¬
‡√◊ËÕß Global agriculture, food and nutrition(6)
Àπ÷Ëß„πªí®®—¬ ”§—≠∑’Ë àߺ≈μàÕ∑‘»∑“߇°…μ√°√√¡
Õ“À“√ ·≈–‚¿™π“°“√¢Õß‚≈° ‰¥â·°à °“√‡μ‘∫‚μ¢Õß
®”π«πª√–™“°√‚≈°´÷ßË „πªí®®ÿ∫π— ‰¥â‡æ‘¡Ë ¢÷πÈ Õ¬à“ßμàÕ‡π◊ÕË ß
·≈– àߺ≈μàÕ°“√¢¬“¬μ—«¢Õßμ≈“¥Õ“À“√ ´÷Ëß —¡æ—π∏å
°—∫°“√‡æ‘¡Ë ¢÷πÈ ¢Õߪ√‘¡“≥‡ªìπæ≈—ßß“πÕ“À“√®“°‚ª√μ’π
§Õ‡≈ ‡μÕ√Õ≈ ·≈–°√¥‰¢¡—πÕ‘Ë¡μ—« (saturated fat
acid)(7) ‡¡◊ÕË »÷°…“∂÷ß√“§“¢ÕßÕ“À“√„πμ≈“¥‚≈° æ∫«à“
√“§“¢—ÈπμË”¢ÕßÕ“À“√·≈–º≈‘μ¿—≥±å‡°…μ√°√√¡∂Ÿ°
°”À𥂥¬§«“¡μâÕß°“√æ≈—ßß“π¢Õߪ√–™“°√·≈–
√“§“æ≈—ßß“π‡™◊ÈÕ‡æ≈‘ß∑’Ë Ÿß¢÷Èπ ‚¥¬ºŸâ àßÕÕ°·≈–π”‡¢â“
‡°…μ√°√√¡·≈–æ≈—ßß“πμâÕߧ”π÷ß∂÷ߧ«“¡ ¡¥ÿ≈∑“ß
°“√§â“πÈ”¡—π·≈–Õ“À“√¥â«¬‡™àπ°—π ªí®®—¬ ”§—≠Õ’°
ª√–°“√Àπ÷Ëß∑’Ë àߺ≈°√–∑∫μàÕ‡°…μ√°√√¡·≈– ÿ¢¿“æ
¢Õߪ√–™“°√‚≈° §◊Õ °“√‡ª≈’ˬπ·ª≈ß¿Ÿ¡‘Õ“°“» (climate change) ‚¥¬‡©æ“–Õ¬à“߬‘Ëß„πª√–‡∑»°”≈—ß
æ—≤π“ ‡æ√“–‰¥â àߺ≈°√–∑∫Õ¬à“ß√ÿπ·√ßμàÕ ÿ¢¿“æ
·≈–°“√‡°…μ√°√√¡¢Õߪ√–™“°√„πª√–‡∑»‡À≈à“π—Èπ
‡™àπ °“√‡æ‘Ë¡¢÷Èπ¢Õß¿“√–‚√§®“°¿“«–¢“¥ “√Õ“À“√
‚√§∑âÕß√à«ß ‚√§‡°’ˬ«°—∫√–∫∫°“√‰À≈‡«’¬π‚≈À‘μ·≈–
°“√À“¬„® (cardio-respiratory) ·≈–‚√§μ‘¥‡™◊ÈÕ °“√
쓬·≈–‡®Á∫ªÉ«¬∑’‡Ë æ‘¡Ë ¢÷πÈ ®“°√—ß ’§«“¡√âÕπ Õÿ∑°¿—¬ ·≈–
¿“«–·Àâß·≈âß ·≈–¿“√–∑’ˇæ‘Ë¡¢÷Èπ„π°“√∫√‘°“√ ÿ¢¿“æ
¢Õߪ√–™“°√ °“√ª≈àÕ¬°ä“´‡√◊Õπ°√–®° (greenhouse
gases) ∂◊Õ‡ªìπªí®®—¬ ”§—≠μàÕ°“√‡ª≈’¬Ë π·ª≈ß¿Ÿ¡Õ‘ “°“»
·≈–‡°…μ√°√√¡ (‚¥¬‡©æ“–Õ¬à“߬‘ßË °“√∑”ª»ÿ μ— «å) ∂◊Õ
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«“√ “√«‘™“°“√ “∏“√≥ ÿ¢ ÚııÙ ªï∑’Ë Ú ©∫—∫∑’Ë Ú
ªí≠À“°“√‡ª≈’ˬπ·ª≈ß¿Ÿ¡‘Õ“°“»®–≈¥≈ßÀ“°ªí®®—¬∑’Ë
‡°‘¥®“°‡°…μ√°√√¡∂Ÿ°·°â ‰¢‰¥â(7)
Addressing malnutrition in all its forms(8)
¿“«–∑ÿæ‚¿™π“°“√ (malnutrition) ‡ªìπÀπ÷Ëß„π
ªí≠À“ ÿ¢¿“æ∑’Ë ”§—≠¢Õߪ√–™“°√‚≈° ‚¥¬‡©æ“–
Õ¬à“߬‘Ëߪí≠À“°“√¢“¥∏“μÿ‡À≈Á°·≈–«‘μ“¡‘π‡Õ ‚¥¬æ∫
¡“°„πª√–™“°√¿Ÿ¡‘¿“§‡Õ‡™’¬·≈–·Õø√‘°“(9) ·¡â®–‰¥â
¡’ § «“¡æ¬“¬“¡„π°“√æ— ≤ π“π‚¬∫“¬·≈–‚§√ß°“√
¥â“π “∏“√≥ ÿ¢·≈–‚¿™π“°“√‡æ◊ËÕ≈¥ªí≠À“¿“«–∑ÿæ‚¿™π“°“√π’È ·μà°≈—∫¡’°≈ÿࡇªÑ“À¡“¬‡ªìπª√–™“°√∑’Ë¡’
∂“π¿“懻√…∞ —ߧ¡μË”·≈–¡’πÈ”Àπ—°μ—«μË”‡∑à“π—πÈ √«¡
∂÷ßÕ“À“√∑’Ë·®°®à“¬„Àâ·°àª√–™“°√‡æ◊ËÕ≈¥¿“«–∑ÿæ‚¿™π“°“√Õ¬Ÿà „π√Ÿª„Àâæ≈—ßß“π·≈–‚ª√μ’π Ÿß·μà ‰¡à ¡’
∏“μÿÕ“À“√∑’Ë®”‡ªìπμàÕ√à“ß°“¬Õ¬à“߇撬ßæÕ ®÷߇ªìπ
π‚¬∫“¬·≈–‚§√ß°“√∑’Ë ‡ πâ π °“√‡æ‘Ë ¡ πÈ” Àπ— ° ¢Õß
ª√–™“°√·μà ‰¡à‡πâπ°“√‡æ‘Ë¡ à«π Ÿß À“°ª√–™“°√‰¥â
√— ∫ Õ“À“√∑’Ë „ Àâ æ ≈— ß ß“π Ÿ ß ¡“°‡°‘ 𠉪‚¥¬‡©æ“–
ª√–™“°√„π°≈ÿà¡∑’Ë¡’°“√À¬ÿ¥¬—Èß°“√‡®√‘≠‡μ‘∫‚μÀ√◊Õ
·§√–·°√Áπ ®– àߺ≈„Àâª√–™“°√¡’§«“¡‡ ’ˬßμàÕ‚√§
Õâ«π‡æ‘Ë¡¡“°¢÷Èπ ¥—ßπ—Èπ§«√æ‘®“√≥“°“√ π—∫ πÿπ
¬ÿ∑∏»“ μ√å°“√®—¥°“√ªí≠À“¿“«–∑ÿæ‚¿™π“°“√„π∑ÿ°
√Ÿª·∫∫∑’ˇ°’ˬ«¢âÕßÕ¬à“ß∂’Ë∂â«π ‰¥â·°à ªí≠À“¿“«–
‚¿™π“°“√μË” (‡™àπ ¢“¥«‘μ“¡‘π‡Õ ∏“μÿ‡À≈Á° ∏“μÿ ß— °– ’
∏“μÿ‰Õ‚Õ¥’π ∏“μÿ‚ø‡≈∑ ·≈–«‘μ“¡‘π∫’ 12) °“√¥”‡π‘π
°“√¥â “π‚¿™π“°“√‡æ◊ËÕ ÿ¢¿“æμ≈Õ¥™à«ß™’«‘μ (life
course approach) ¿“√–®“°‚√§‡√◊ÈÕ√—ß∑’ˇ°’ˬ«¢âÕß°—∫
¿“«–‚¿™π“°“√ ·≈–°“√ªÑÕß°—πμ—Èß·μà™à«ßÕ“¬ÿ∑’ˇ√‘Ë¡¡’
§«“¡ “¡“√∂„π°“√∑”°‘®°√√¡≈¥≈ß πÕ°®“°π’È °“√
º ¡º “πß“π»÷°…“«‘®¬— ‡°’¬Ë «°—∫¿“«–∑ÿæ‚¿™π“°“√¢Õß
United Nations Õߧå°√·∫∫ bilateral agency ·≈–
multilateral agency Õߧå°√‡Õ°™π (NGO) ·≈–
Õߧå°√ª√–™“ —ߧ¡‡¢â“¥â«¬°—π ®–™à«¬°”Àπ¥·π«∑“ß
°“√ªÑÕß°—π·≈–§«∫§ÿ¡¿“«–∑ÿæ‚¿™π“°“√„π∑ÿ°√Ÿª
·∫∫‰¥âÕ’°∑“ßÀπ÷Ëߥ⫬(8,10)
°“√æ— ≤ π“π‚¬∫“¬‡æ◊Ë Õ ®— ¥ °“√ªí ≠ À“‚√§Õâ « π:
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Lessons Learned from International Experiences and Challenges to Future Food and Nutrition Policy in Thailand
∑∫∑«π∫∑‡√’¬π®“°μà“ߪ√–‡∑»(11)
ªí®®—¬∑“ß ÿ¢¿“æ∑’Ë ”§—≠®“° “‡Àμÿ‚√§Õâ«π·≈–
‚√§‰¡àμ‘¥μàÕ„π√–¥—∫∫ÿ§§≈·≈– ‘Ëß·«¥≈âÕ¡ ‰¥â·°à Õ“¬ÿ
‡æ» ªí®®—¬‚πâ¡π”Õ◊Ëπ Ê (constitutional factors) ªí®®—¬
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·≈–™ÿ¡™π ¿“æ°“√∑”ß“π·≈–°“√¥”√ß™’«‘μ (‰¥â·°à
°“√º≈‘ μ Õ“À“√·≈–°“√‡°…μ√ °“√»÷ ° …“ ¿“æ
·«¥≈âÕ¡°“√∑”ß“π °“√«à“ßß“π πÈ”·≈– ÿ¢“¿‘∫“≈ °“√
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—ߧ¡ «—≤π∏√√¡ ·≈– ‘Ëß·«¥≈âÕ¡(12) √«¡∂÷ß™àÕß«à“ß
¢Õߧ«“¡√Ÿâ ´÷Ë ß ¡’ Õ‘ ∑ ∏‘ æ ≈μà Õ °“√§‘ ¥ §â π ·≈–æ— ≤ π“
π‚¬∫“¬ªÑÕß°—π‚√§Õâ«π¥â«¬ ®“°À≈—°∞“π°“√»÷°…“
«‘®—¬ª√– ‘∑∏‘¿“æ¢Õß¡“μ√°“√‚√§Õâ«π„π‡¥Á°(13,14) æ∫
«à“ °“√»÷°…“«‘®—¬ª√– ‘∑∏‘¿“æ¢Õß¡“μ√°“√‚√§Õâ«π
¬—ß¡’®”°—¥ πÕ°®“°π’¬È ß— ‡πâπ∑’¡Ë “μ√°“√°“√‡ª≈’¬Ë π ·ª≈ß
æƒμ‘°√√¡‡ªìπÀ≈—° ·≈–‡ªìπ¡“μ√°“√¢π“¥‡≈Á° ‰¡à¡’
°“√¥”‡π‘π°“√„π√–¥—∫™ÿ¡™πÀ√◊Õ√–¥—∫™“μ‘ ‡πâπ°“√
®—¥°“√°—∫ªí≠À“‚√§Õâ«π (‡™àπ °“√≈¥πÈ”Àπ—°) ¡“°
°«à“°“√ªÑÕß°—π „πÀ≈“¬°“√»÷°…“‡πâπ∑”°“√«‘®—¬„π
‚√߇√’¬π·≈–∑“ߧ≈‘π‘°·μà§√Õ∫§≈ÿ¡°“√¥Ÿ·≈ª∞¡¿Ÿ¡‘
(primary care) ‡æ’¬ß‡≈Á°πâÕ¬ ·≈–¡’¢âÕ·π–π”μàÕ
π‚¬∫“¬§◊Õ °“√ π—∫ πÿπ·π«∑“ߪ√– “𧫓¡√à«¡¡◊Õ√–À«à“ß«‘™“™’æ (multidisciplinary approach) ·≈–
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‰¥â · °à §”·π–𔇰’Ë ¬ «°— ∫ °‘ ® °√√¡∑“ß°“¬·≈–∑“ß
‚¿™π“°“√ Õߧåª√–°Õ∫¬àÕ¬‡°’ˬ«°—∫°“√‡ª≈’ˬπ·ª≈ß
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(sedentary activity) ·≈–‡æ‘Ë¡°“√‡§≈◊ËÕπ‰À«√à“ß°“¬
„π™’«‘μª√–®”«—π (lifestyle physical activity) ‰¡à
‡æ’¬ß°“√‡≈àπ°’Ó‡∑à“π—Èπ ·≈–°“√ π—∫ πÿπ∑“ߥâ“π
—ߧ¡·≈–®‘μ«‘∑¬“ ·≈–§√Õ∫§√—« ®–™à«¬„Àâ°“√¥”‡π‘π
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348
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‡¡◊Õß (urbanisation) °“√§¡π“§¡¢π àß ¥—™π’™’È«—¥
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„°≈âμ—« (downstream) ·≈–ªí®®—¬‡ ’ˬ߄π¿“æ°«â“ß∑’Ë
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Healthy Weight, Healthy Lives 2007-2008 ¢Õß
ª√–‡∑»Õ— ß °ƒ… (16) ´÷Ë ß ‡ªì 𠂧√ß°“√œ∑’Ë ‡ πâ π °“√
Journal of Health Science 2011 Vol. 20 No. 2
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·≈–°“√ π—∫ πÿπ·≈–„À⧔·π–π” à«πμ—« ·≈–‚§√ß°“√
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√‘‡√‘Ë¡μ“¡‚§√ß°“√¢Õß EU „π‚√߇√’¬π¢Õߪ√–‡∑»
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consumer protection strategy(18) ‰¥â∂Ÿ°‡™◊ËÕ¡°—∫
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ª√–‡∑»Õ‘μ“≈’ (20)
‚§√ß°“√ Sustainable, Organic School Meals
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Lessons Learned from International Experiences and Challenges to Future Food and Nutrition Policy in Thailand
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Fatty Acid „πÕ“À“√(19)
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TFAs Ÿß ¢Õß√â“πÕ“À“√®“π¥à«π∑’ˇªìπ∑’Ëπ‘¬¡„πÀ¡Ÿà
ºŸâ∫√‘‚¿§™“«·§π“¥“ ‡™àπ French fries º≈‘μ¿—≥±å ‰°à
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Meal ®“°°“√º≈—°¥—π¢Õß°≈ÿࡪ√–™“ —ߧ¡·≈–π—°∑”
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Journal of Health Science 2011 Vol. 20 No. 2
∫∑‡√’¬π®“°π“π“™“μ‘ ·≈–§«“¡∑â“∑“¬μàÕÕπ“§μπ‚¬∫“¬Õ“À“√·≈–‚¿™π“°“√¢Õߪ√–‡∑»‰∑¬
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Journal of Health Science 2011 Vol. 20 No. 2
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- §«∫§ÿ¡ à«πª√–°Õ∫¢ÕßÕ“À“√
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‚√ß欓∫“≈ „Àâ¡’¡“μ√∞“π„π¥â“π°“√ π—∫ πÿπ·≈– àß
‡ √‘¡°“√‡≈◊Õ°∑“πÕ“À“√ ÿ¢¿“æ
3. π‚¬∫“¬°“√‡ √‘¡ √â“ßæƒμ‘°√√¡°“√∫√‘‚¿§∑’Ë
∂Ÿ°μâÕ߇À¡“– ¡
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4. °“√„™â°√–· ‚≈°‡ªìπμ—«™à«¬¢—∫‡§≈◊ÕË ππ‚¬∫“¬
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5. °“√∑”ß“π√à«¡°—∫ºŸ‡â °’¬Ë «¢âÕß ”§—≠∑ÿ°¿“§ à«π
‚¥¬‡©æ“–Õ¬à“߬‘ËßÕÿμ “À°√√¡Õ“À“√ (multi-sectoral
policies)
6. °“√®—¥∑”π‚¬∫“¬‡°’ˬ«°—∫‚¿™π“°“√¢Õß·¡à
·≈–°“√„Àâπ¡·¡à‡æ’¬ßÕ¬à“߇¥’¬«
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1. °“√ √â“ß«‘ —¬∑—»πå ‡ªÑ“À¡“¬ ·≈–‚§√ß √â“ß
Õߧå°√ √«¡∂÷ß∫∑∫“∑¢ÕߺŸâπ” ∑—Èß„π√–¥—∫™ÿ¡™π ·≈–
ª√–‡∑» „À⇪ìπ‰ª„π∑‘»∑“߇¥’¬«°—π
2. °“√ √â“ߧ«“¡√à«¡¡◊Õ°—∫Àπ૬ߓπ·≈–¿“§
à«π „π¥â“π “∏“√≥ ÿ¢ ‡°…μ√°√√¡ Õÿμ “À°√√¡ ◊ËÕ
«“√ “√«‘™“°“√ “∏“√≥ ÿ¢ ÚııÙ ªï∑’Ë Ú ©∫—∫∑’Ë Ú
·≈–ª√–™“ —¡æ—π∏å ·≈–Õ◊Ëπ Ê ∑’ˇ°’ˬ«¢âÕß
3. °“√ √â“ßß“π«‘®—¬„À⇪ìπ¢âÕ¡Ÿ≈æ◊Èπ∞“πμàÕ°“√
æ—≤π“π‚¬∫“¬ “∏“√≥–
4. °“√≈ß∑ÿ π ‡æ◊Ë Õ √â “ ß»— ° ¬¿“æ¢Õß∫ÿ § §≈“°√
·≈–Õߧå°√„π√–¬–¬“«
5. °“√æ— ≤ π“√–∫∫°“√§«∫§ÿ ¡ ·≈–ª√–‡¡‘ π
π‚¬∫“¬·≈–¡“μ√°“√
6. °“√®—¥°“√ªí≠À“º≈ª√–‚¬™πå∑—∫´âÕπ√–À«à“ß
Àπ૬ߓπ∑’Ë√à«¡¡◊Õ
‡Õ° “√Õâ“ßÕ‘ß
1. §≥–∑”ß“π¿“√–‚√§. √“¬ß“π¿“√–‚√§·≈–°“√∫“¥‡®Á∫®“°
ªí®®—¬‡ ’ˬß∑“ß ÿ¢¿“æ¢Õߪ√–‡∑»‰∑¬ ªï 2547. °√ÿ߇∑æ¡À“π§√: ”π—°ß“πæ—≤π“π‚¬∫“¬ ÿ¢¿“æ√–À«à“ߪ√–‡∑»
”π— ° π‚¬∫“¬·≈–¬ÿ ∑ ∏»“ μ√å ”π— ° ß“πª≈— ¥ °√–∑√«ß
“∏“√≥ ÿ¢; 2550.
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ÛıÛ
Lessons Learned from International Experiences and Challenges to Future Food and Nutrition Policy in Thailand
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Abstract
Lessons Learned from International Experiences and Challenges to Future Food and
Nutrition Policy in Thailand
Sirinya Phulkerd, Suladda Pongutta, Thaksaphon Thamarangsi, Walaiporn Patcharanarumol
International Health Policy Program Thailand
Journal of Health Science 2011; 20:345-55.
Unhealthy eating habits such as intake of energy dense diets high in fat and inadequate fruit
and vegetable intake were considered to be one of important risk factors which increased the risk of
non-communicable diseases such as diabetes and cardiovascular diseases. Adequate understanding
in health effects attributable to unhealthy dietary behaviours and factors influencing unhealthy diet
behaviours as well as learning from the experiences of countries which have already had dealt with
obstacles to implementing policy in improving unhealthy diet in their populations were essential for
more effective development and implementation of food and nutrition policy in Thailand. The 2009
Prince Mahidol Award International Conference which was held during 29-30 January 2009 brought
along leading public health leaders and stakeholders from around the world to discuss high priority
on global health issues and in particular an issue on diets and public health, including summarizing
findings and proposing concrete solutions. A food and nutrition policy which addressed both individual (such as knowledge about healthy eating behaviours and lifestyles) and environmental factors (such as schools, food stores and restaurants, and media and food advertisement) influencing
unhealthy diet behaviours of Thai people, was strongly recommended. Together, a need for greater
intersectoral collaboration, particularly between the government and private sector, cutting through
different levels of community, region, nation and international was also recommended to help tackle
health and nutrition problems. However, the challenges facing Thai government were, for example,
capacity building from community to national level, to increase intra and inter sectoral collaboration
and to take steps to prevent conflicts of interests.
Key words:
unhealthy eating habits, international experience, individual and environmental factors, food
and nutrition policy, collaboration
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