Healthy Canteen, Smart Eating: Thailand’s Road to Healthy Lives
Unhealthy dietary habits, combined with high body mass index and obesity, are significant contributors to the rising burden of non-communicable diseases (NCDs), such as cardiovascular diseases, diabetes, and hypertension.[1] In 2022, an estimated 1.28 billion adults aged 30-79 years were living with hypertension,[2] while 2.5 billion people (aged 18 and older) were overweight, including 890 million classified as obese worldwide.[3] Thailand is no exception to this trend, with surveys by Wichai Ekpalakorn[4,5] indicating an increase in obesity prevalence among Thai working-age individuals (15-59 years) from 34.7% in 2008-2009 to 42.4% in 2019-2020. Similarly, the prevalence of diabetes jumped from 6.9% to 9.5%, and hypertension from 21.4% to 25.4% over the same period. These rising trends largely stem from dietary shifts, including higher consumption of sugary, fatty, and salty foods alongside a decline in fruit and vegetable intake, with Thai people consuming an average of only 3.7 standard portions of fruits and vegetables per day, falling short of the recommended five standard portions.[6]
Guided by the WHO Global Strategy for Food Safety (2022-2030), the Ministry of Public Health declared 2020 the “Year of Food Safety” on January 23. Under the health and nutrition policy of the Department of Health (DOH), the Bureau of Nutrition (BoN) then spearheaded an initiative to transform all the Ministry’s cafeterias into “healthy canteens” – safe, health-conscious cafeterias offering fresh, clean, and nutritious foods in appropriate nutritional quantities. The goal of converting ordinary cafeterias into healthy canteens was to serve as a model for both public and private sectors, promoting healthy eating habits among working-age individuals in all workplaces. The initiative also aimed to encourage the creation of healthy menus to improve overall public health. In collaboration with the Water and Food Sanitation Bureau, the BoN then developed seven criteria for certifying a canteen as a healthy canteen:
Compliance with the 2018 Ministerial Regulations on food hygiene and sanitation standards
At least one healthy menu per vendor
Availability of at least one fresh fruit vendor
Option for reduced sugar in beverages
Signs indicating sodium and sugar contents in condiments
Nutritional labeling for food items
Ongoing nutrition and food sanitation education for vendors and consumers
Additionally, healthy canteens must offer safe, clean, and nutritionally balanced “healthy menus”, which have been in operation since 2007 – long before the healthy canteen policy came into effect in 2020. These menus must not only be free from harmful bacteria, viruses, parasites, chemicals, and toxins, but also adhere to the BoN guidelines.[7] These operational guidelines set specific limits on energy, fat, sugar, sodium, protein, and dietary fiber in each meal and prohibit the use of monosodium glutamate (MSG) during cooking.
The canteen at the DOH was the first to be designated and certified as a healthy canteen in 2020. Later that same year, the campaign expanded to cover all 11 other canteens within the Public Health Ministry, all of which were subsequently certified as healthy canteens.
From 2021 to 2023, the initiative subsequently spread nationwide through public-private partnerships and a combination of online and on-site engagements, supported by Regional Health Centers 1–12, Bangkok Metropolitan Health and Wellness Institute, Local Administrative Organizations, and Provincial Public Health Offices. As a result, the number of certified healthy canteens grew to 81 in 2021, 160 in 2022, and 245 in 2023, as reported by Regional Health Centers.
To enhance the efficiency of the healthy menu certification process, the BoN launched the “Food4Health” application in 2022. This digital platform significantly streamlined various activities, including on-site canteen inspections by audit and inspection officers, the evaluation of recipe composition and nutritional value based on checklists and operational guidelines, data collection from each vendor and submission to the BoN for final assessment, and the issuance and distribution of certificates to food vendors through Regional Health Centers and Provincial Public Health Offices. As a result, the certification approval time was drastically reduced from one month to less than 10 minutes. Food vendors can now apply for healthy menu certification by simply submitting the required documents as attachments. Once approved, the certification remains valid for two years. Additionally, the platform features a location “pin”, making it easier for consumers to identify cafeterias offering healthy menus.
Prior to this digital transformation, however, the healthy canteen certification process also required audit and inspection officers from Regional Health Centers and Provincial Public Health Offices to conduct on-site visits across the country. Between 2020 and 2023, these teams assessed canteens in various regions using a survey, based on aforementioned seven criteria. They provided feedback for necessary improvements, and restaurant operators who successfully met all seven criteria – including the display of nutritional profiles on menus and submission of supporting documents as evidence – became eligible to apply for certification, which remained valid for two years. However, to improve efficiency, the healthy canteen certification process also transitioned fully to online in 2024, with an option to renew certification every two years. This shift not only streamlined the entire procedure, but also enabled officers to complete their tasks more efficiently, dedicate more time to innovative initiatives, and significantly reduce operational costs, such as transportation and meal expenses.
The public-private partnerships continued to expand in 2024 to include government agencies, private organizations, hospitals, prisons, food courts in shopping malls and educational institutions, extending coverage to Bangkok and all 76 provinces. As a result of these efforts, 373 canteens successfully obtained certification as healthy canteens in 2024, achieving 92% of the target goal of 405.
Consuming a variety of healthy foods throughout the life-course not only prevents malnutrition in all its forms, but also a range of NCDs.[8] Additionally, a recent report from the DOH indicates that companies with healthy canteens in Thailand experience fewer employee sick leaves and lower medical expenses,[9] highlighting the significant benefits of adopting healthy cafeteria initiative.
Therefore, despite some challenges, such as budgetary constraints faced by canteen operators in complying with the 2018 Ministerial Regulations on Food Hygiene and Sanitation Standards outlined in criterion 1, the DOH remains committed to expanding the healthy canteen initiative nationwide, aiming to certify 1,000 healthy canteens by 2027. This goal will be accomplished through collaboration with all ministries, private enterprises, and small businesses, leveraging data-driven decision-making process and a combination of both online and on-site health literacy and nutrition education campaigns to encourage Thais to choose safe, clean, and healthy foods, helping protect them from NCDs and improving their quality of life as they age.
References
World Health Organization. Global Status Report on Noncommunicable Diseases. Geneva, Switzerland. 2014.
Wichai Ekpalakorn. Report on the 4th Public Health Survey by Physical Examination. Thai Public Health Survey Office and Health System Research Institute. Bangkok, Thailand. 2008-2009.
Wichai Ekpalakorn. Report on the 6th Public Health Survey by Physical Examination. Thai Public Health Survey Office and Health System Research Institute. Bangkok, Thailand. 2019-2020.
World Health Organization. Diet, nutrition and the prevention of chronic diseases: Report of a Joint WHO/FAO Expert Consultation. WHO Technical Report Series, No. 916. Geneva, Switzerland. 2003.
Bureau of Nutrition, Department of Health, Ministry of Public Health Thailand. Operational Guidelines on Healthy Menus. Bangkok, Thailand. April 2020.
Bureau of Health Promotion, Department of Health, Ministry of Public Health Thailand. Report on the Promotion of Health Among Working-Age People in Business Establishments. Bangkok, Thailand. 2024-2025.
