Abstract
Increased intake of saturated fat and refined sugars underlies much of the problem of emerging obesity all over the world. This includes middle-income countries like Thailand, which are subject to successful marketing of Western fast foods especially targeted at adolescents. In this study we explore the socio-cultural influences on fast-food intake for non-metropolitan (rural and urban) adolescents in North East Thailand (Isan). Our questionnaire sample included 634 persons aged 15-19 years who are in and out of formal schooling and who are randomly representing upper, central and lower Isan. All were asked about their knowledge of fast-food health risks and their attitudes towards, and consumption of, fast food and traditional food. As well, we used several focus groups to obtain qualitative data to complement the information derived from the questionnaire. Some three quarters of sampled youth were aware that fast food causes obesity and half knew of the link to heart disease. About half consumed fast food regularly, induced by the appeal of 'modern' lifestyles, social events and marketing, as well as by the convenience, speed and taste. Nearly two-thirds thought that local foods should be more popular and these beliefs were more likely to be found among children from educated and urban families. Local foods already constitute a cultural resistance to fast-food uptake. We propose several methods to boost this resistance and protect the youth of Thailand against fast food and its many adverse health consequences.