Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.

This study aimed to develop the Thai school lunch planning program using nutrient profiling (NP). The intention was to create a user-friendly tool that aids teachers in preparing nutritionally balanced school lunch menus. The Thai school lunch planner was developed by gathering 53 popular lunch menus from a school lunch outsourcing company in Bangkok. Menus were grouped into ten categories based on food characteristics and cooking methods. Then, menus were graded according to their energy and 13 nutrients using NP criteria as ‘grade A’ (score >16), ‘grade B’ (scores 12-16), and ‘grade C’ (score <12), and menu category codes were created. Lunch sets were matched across the menu category codes and based on the two formats of school lunch standards. Finally, lunch sets were graded based on energy and 13 nutrient contents using NP criteria, with cut-off macronutrients set at 30% of Thai DRI 2020. Regarding the two formats of school lunch standards, this study found 63 uniquely matched patterns, with the possibility of forming 5,160 lunch sets. Lunch pattern format 1 had 57 patterns and 5,085 menu sets, of which 2,706 menu sets met 30% of the Thai DRI macronutrient requirement. The lunch pattern format 2 could create up to 75 sets from six patterns. Thirty-seven menu sets (49.3%) met the 30% Thai DRI macronutrient requirement. NP could be a valuable alternative for planning school lunch sets to guarantee high-quality and nutritious meals. This technique can be combined with the existing school food menu guidelines. Teachers, with or without basic nutrition knowledge, can find this strategy relatively user-friendly. Even though this technique is suitable for primary schools that serve two side dishes, schools serving one side dish can apply it by increasing the portion of the side dish.

School lunch programs play a critical role in providing essential nutrition to children; however, sourcing ingredients locally remains a challenge for many schools in Thailand. This study aimed to explore the drivers and barriers influencing the integration of local farms, using Chiang Mai as a case study, into the Thai school lunch program. In-depth, semi-structured interviews were conducted with 13 school staff and six local farmers in Saraphi and Hang Dong districts of the Chiang Mai area. Data were initially analyzed thematically to identify key patterns and concepts. These themes were then examined using a SWOT (Strengths, Weaknesses, Opportunities, Threats) framework to categorize internal and external factors influencing local food sourcing. A TOWS (Threats, Opportunities, Weaknesses, Strengths) matrix was used to develop context-specific strategies for enhancing school-farm collaboration. The findings showed that key drivers for school-farm integration included strong community support, local market access, and agricultural education initiatives. Barriers included seasonal variability, inconsistent supply, and strict budgetary constraints. The study provided practical recommendations to enhance the sustainability of school-farm integration, including improved procurement planning, streamlined administrative processes, and the development of supportive policies to facilitate farm-to-school partnerships.

The increasing prevalence of childhood obesity in Thailand highlights the need for effective school-based interventions. This study evaluated the impact of a short-term nutrition education intervention on the nutrition knowledge, attitudes, and behaviors (KAB) of students in grades 4-6 in Chiang Mai, Thailand. A quasi-experimental design was implemented in nine public primary schools, comprising four intervention schools (121 students) and five control schools (153 students). The nine-week intervention integrated animated video modules into Health Education, Mathematics, and English lessons. Data on KAB were collected at baseline and at a three-month follow-up after the intervention and analyzed using mixed-effects linear regression models adjusting for clustering at the school level and for student covariates (sex, ethnicity, and daily allowance). Baseline characteristics were comparable between groups, except for age and ethnicity. Knowledge scores increased modestly in both groups, but the difference in change between groups was not significant (adjusted β = 0.21; 95% CI -0.47 to 0.89; p = 0.55). Attitude scores decreased slightly, and behavior scores remained stable, with no significant intervention effects. The short-term, teacher-facilitated intervention modestly improved nutrition knowledge but did not significantly affect overall KAB or dietary patterns. Longer-term, multi-component strategies involving teachers, parents, and supportive school food environments are required to achieve sustained improvements in children’s dietary behaviors.