The fact that the western world is facing a health crisis is nothing new. The image of a fat American snarfing down McDonalds is pretty much ubiquitous with, well, the image of an American, and every day there seems to be a new disgusting revelation about liquid meat products or strawberries genetically modified with penguin skin. As the popularity of highly processed convenience foods filled with artificial ingredients and preservatives only grows, so do rates of obesity and all the diseases that come with it. But what many are only just realising is that the health problems of the west have now carried over to the east. What was once so recently a land of rich biodiversity, organic farming and healthy, traditional-style eating is being rapidly transformed into yet another fast food nation, and its citizens are paying the price.
Today, Thailand is ranked the second fattest country in Southeast Asia, according to the World Health Organisation. Meanwhile, Thailand's own Ministry of Public Health reports that the past five years alone have seen obesity rates grow 36 percent for preschool children and 15 percent for school-age children. Among 20-somethings, the obesity rate over the same five-year period increased 36 percent for men and 47 percent for women. As a result, over 20,000 Thais die every year due to being overweight or obese.
Casual observers can attest to the changes, and disturbing anecdotes abound. A shopkeeper in Warorot Market, whose family has been making school uniforms for the past 40 years, says that he notices a marked increase in the size of the uniforms with each year that passes. A friend who rock climbs in Mae On recently told me that the little country store where he always used to buy soup recently stopped selling fresh food altogether, now hawking only pre-packaged items. Just yesterday, I myself witnessed a woman exit a building, hop onto her motorbike, drive half a block, dismount, and enter another building.
"When I arrived in Thailand 27 years ago, a fat Thai was an unusual sight," writes long-term expat Stephen Merchant in a recent CityNews article. "Cars were mainly confined to the capital city of Bangkok and western lifestyle was a mystery to all but the elite few. The large percentage of Thais lived in the country, worked on their farms and didn't earn enough to pay the high prices for luxury goods."
So, what changed? According to a 2002 study by Mahidol University's Institute of Nutrition, it all started back in the 1980s when Thailand's economic structure shifted from agricultural to industrial. Simultaneously, food consumption patterns began to change, with less food being prepared at home, more "ready-to-eat-food" being purchased from stores, and "Thai staples and side dishes…being replaced by diets containing a higher proportion of fats and animal meat." In turn, there came a dramatic increase in obesity, particularly for wealthier urbanites, and since the late 1980s, the leading overall causes of death among Thais are "diet-related chronic degenerative diseases."
Guess what else just so happened to arrive in Thailand in 1985? The country's very first McDonald's (or, as it is called here, McThai). Four years later? The very first 7-Eleven. Coincidence? You be the judge.
Today, there are over 7,210 7-Elevens in Thailand (the third largest number of any country in the world). About 8.3 million people - that's 12 percent of Thailand's entire population - visit the chain every day. McThai has become such a popular place for young people to hang out and study that last year the franchise imposed a one-hour seating limit during peak dining hours.
Trends like this show that fast food and convenience food have already become deeply embedded in Thailand's culture, and worse, that the future of Thai nutrition could be even bleaker than that of the western world. While McDonald's and other fast food franchises in the west are facing increased pressure to shape up, from banning supersize to adding more salads to the menu, Thailand seems to be going the opposite direction. The popular American viral media site Buzzfeed recently posted an article titled "McDonald's New Menu in Thailand is Insane" featuring a list of decidedly unwholesome Thailand-exclusive offerings, including electric blue "berry mayo dip" (apparently created to promote the new Smurfs 2 movie), sickly sweet "McBubble Drink" (ice cream optional), and of course, the ever-popular corn pie. Let's just be glad Buzzfeed hasn't caught the newest offerings from The Pizza Company (cheese stuffed crust cheese pizza topped with an edible bowl of liquid cheese, anyone?).
A Culture of Crap
Most disturbing of all is that things only get worse with each generation; young people are the target consumers for these ridiculous products, with westernised marketing schemes designed to make traditional Thai culture, food and lifestyle seem old-fashioned and uncool. But unlike in Western countries, where fast food is typically the cheapest option available (meaning poor people are often the least healthy), in Thailand a Big Mac costs three times the price of a bowl of soup from the street and five times the price of an entire bag of seasonal mandarin oranges. This creates an interesting disconnect between the makeup of Thai versus Western health problems, but the symptoms remain similar as the problem seeps out of the cities and into the rural communities beyond.
"Young people in the country now see office work as the job they should aspire to along with the lifestyle depicted on TV in commercials with luxury cars, alcoholic drinks, fast food and modern apartments," adds Merchant. "Almost all the older generation in my country village are lean, muscled and fit for their age, signs still apparent of a life of hard work, adequate good food and little overindulgence. In contrast, the younger generation are overweight, under-exercised and suffer alarming tooth decay."
Traditional Asian diets are some of the healthiest in the world, which is what makes the shift to toxic western crap even more tragic. "Traditional Thai food had lots of vegetables, lots of fish, lots of chilli paste and not a lot of red meat," says Dr. Supawan Buranapin, M.D., Assistant Professor of Endocrinology and Nutrition at Chiang Mai University's Faculty of Medicine. "Now, with the popularity of fast food chains, people have access to unhealthy food 24 hours a day. Anywhere and anytime you want to eat, you can. It wasn't like this 20 years ago. Even Thai restaurants are changing their menus to cater to foreigners and more popular, modern tastes."
Dr. Supawan, who also works as a nutritionist for patients at Maharaj Nakorn Hospital, says that more than 80 percent of her obese patients tell her they don't like vegetables. "Their diets are very high in meat. Many of them tell me that some days they don't eat any vegetables at all," she adds.
The result? Diabetes, high blood pressure, sleep apnea, hypertension, heart disease, stroke and even cancer.
To its credit, the Thai government has not let the problem go unnoticed. The Ministry of Public Health regularly issues public service announcements and statistics, and has collaborated with both public and private sectors to implement various health-related endeavours. For example, the Nestle Healthy Thai Kids campaign for schoolchildren, and last year's rather creative call for Thais to lose a collective 1,000 tonnes of body weight in order to make merit during Buddhist Lent. But it's not enough.
Scary Side Effects
"Globally, people are getting sicker quicker, and they're dying slower but earlier deaths," says Dr. John Rogerson, a UK-born Chiang Mai-based scientist, healthcare practitioner and teacher. "As humans, we've already hit our peak curve of longevity, meaning our life expectancy is actually shortening. For the first time ever, our generation will be dying before our grandparents."
Dr. Rogerson has spent the past 20 years studying the efficacy of over 200 different types of traditional and alternative medicines and therapies, from meditation to acupuncture to psychotropic substances. Formerly a professional squash player, he became interested in the field after he got injured and found that his body responded better to things like yoga, massage and natural remedies than mainstream painkillers and muscle relaxants.
"Some complementary therapies work, some don't," he says. "But we must wake up to the fact that medicine is not a fix-all, and our food is not as nutritious as it used to be. Regrettably, drugs like antibiotics (meaning 'anti-life') are overused and becoming ineffectual, plus have adverse side effects. Yes of course medicines have their place, but only when you're chronically sick and your body's defence is incapable of treating it by itself."
According to a World Health Organisation bulletin in 2012, Thailand is particularly guilty of antibiotic mania. "In Thailand, a study in a tertiary care hospital revealed that only 7.9 percent of the upper respiratory tract infections (URIs) in the facility were caused by bacteria," it stated. "Despite this, in Thailand most URIs are treated with antibiotics by hospitals, health centres, drug stores and patients themselves."
The overuse of antibiotics is not only ineffective, but also has a dangerous side effect: over time, it helps create bacteria that becomes more and more difficult to kill. According to the Centre for Disease Control (CDC), this process of antibiotic resistance is "one of the world's most pressing public health problems." At worst, it can lead to the development of unbeatable super viruses that no medicine can combat. Hello, zombie apocalypse.
We Are All Made of Stars
Our inability to see beyond quick fixes and short-term pleasures is doing long-term damage. As humans, we've been around long enough to know that nothing is isolated, and everything is connected. Yet we continue to fall prey to short-sighted thinking and profit-driven marketing gimmicks with no sense of responsibility for our own health.
As Dr. Rogerson says, "We are the experiment of the modern food industry, and the experiment is failing. It's particularly bad for Asians because it all came here so suddenly. We in the west are more used to processed foods because we have been eating them for 200 years. Asians come from a land of lots of biodiversity and traditional health, making them much more sensitive to the shift."
But that doesn't mean all is lost. Salvation, at least for those who seek it, may lie in a growing counterculture of wellbeing warriors right here in Chiang Mai.
Enter the Wellbeing Warriors
Perhaps one of the first and most inspiring advocates for change is Jon Jandai, the creator of the Pun Pun Centre for Self-Reliance, an organic farm and learning centre with workshops in sustainable farming, seed saving, earthen building and healthy cooking. As he explained in his inspiring TEDx Talk, Jon's unhappy foray into the fast-paced, money-hungry urban lifestyle of Bangkok caused him to return to his Northern Thai farming roots and drastically simplify his life.
"We are taught to disconnect, to rely on money only," he says in his talk. "To be happy, we need to come back, to connect to ourselves, to connect to other people, to connect our mind and body together again."
Pun Pun has become a model and an inspiration for the development of countless more organic farms and learning centres throughout the region, as well as healthy, organic restaurants within the city, including two Pun Pun cafes.
Phromwiharn "O" Bumroongthin was a busy photojournalist living the modern rat race until he met Jon Jandai. He was so moved by Jon's philosophies that he traded in his career for a life of simplicity and health. Now he grows organic produce at his farm and serves it up to hungry vegetarians at his popular Chiang Mai restaurant, ImmAim. His motto? "To eat is a necessity, but to eat intelligently is an art."
Sean Paul Abbott is an American expat who has lived in Northern Thailand for many years. After marrying a local Karen hill tribe woman and joining her community, he was able to see where most of the food in Chiang Mai actually comes from.
"I didn't understand why the farmers make no money and why they are so in debt from loans from the seed and chemical companies or bank," he says. "I didn't want to eat or feed my children any of the produce coming off my neighbour's farm because I could see the heavy use of chemical input."
Abbot's observations inspired him to join the ranks and start Chiang Mai's newest CSA (Community Supported Agriculture), True Vine. Now, Abbott works directly with local farmers to grow healthy, organic produce, which he then personally delivers to his customers in Chiang Mai each week.
These are just a few of the concerned citizens that are fighting the good fight, but the battle lines don't stop at organic farms and health-conscious restaurants. From large-scale government health initiatives to small-scale kombucha brewers, from dedicated yogis to families who still insist on home cooked meals, many Thais and expats alike are looking to step away from the breakneck pace of modern Thailand and back to the healthy simplicity of nearly forgotten times.
Because that's what it seems to be about, in the end. Ultimately, we need to start looking back in order to move forward.
"We need to return to our grandmothers' ways of living," says Dr. Rogerson. "We need to take responsibility for our own health, and for the health of our planet. Otherwise, there is no future."
Dr. John's Top Tips for Healthy Living
Looking for a new year's resolution? Why not start with your health? Here are Dr. John Rogerson's top 10 tips for long-term wellbeing.
1) Eat as many nutrient-rich green veggies (kale, spinach, broccoli, etc.) as possible.
2) Eat only organic, pesticide-free food.
3) Reduce acidic foods like sugar, dairy, gluten and meat.
4) Drink mineral water rather than ozonated water for better hydration.
5) Reduce chemicals in and around your living environment.
6) Turn off electrical appliances, wifi and cell phones whenever possible to reduce electromagnetic stress.
7) Supplement your diet with the probiotics, minerals and vitamins it lacks.
8) Brush and floss your teeth daily. Your mouth is a reservoir for bacteria and a conduit for potential infections, so oral care is very important for overall health.
9) Ground yourself as often as possible. Hug a tree; walk in bare feet on natural ground; enjoy yoga, meditation and massage.
10) Rest. Most people need at least eight hours of sleep each night. Sick people may need up to 12. Your body cannot function properly without proper sleep.