A Comparison of a Healthy Thai Diet and Contemporary Thai Diet on Health Indices in Individuals With Noncommunicable Diseases: A Randomized Controlled Trial

Background: Studies have suggested that dietary patterns emphasizing low-fat, plant-based foods like vegetarian, Mediterranean, and Dietary Approaches to Stop Hypertension (DASH) diets reduce noncommunicable disease risk. Objectives: To compare the effects of a Healthy Thai Diet (HTD) and a Contemporary Thai Diet (CTD) on body mass index (BMI), blood pressure, cholesterol, and glycemia. The HTD is characterized by low-fat, plant-based Thai food that substitutes animal products with plant-based ingredients while maintaining traditional seasonings (eg, fish sauce, shrimp paste, and coconut milk). Methods: Individuals exhibiting at least 1 abnormal health index (BMI, blood pressure, low-density lipoprotein cholesterol [LDL-C], fasting blood sugar [FBS]) or undergoing chronic disease treatment were randomly assigned to the HTD (n = 30) orCTD (n = 32) for 12 weeks. Health indices were measured at baseline and at week 12. Statistical analyses included paired t tests for within-group comparisons and student’s t tests for between-group comparisons. Results: After 12 weeks, the HTD group experienced significant weight loss (-3.03 kg vs 0.43 kg in CTD, P < .01), particularly in participants with BMI greater or equal to 23 kg/m² (-3.99 kg vs 0.04 kg, P < .01). Systolic blood pressure dropped significantly in the HTD (-17.4 mmHg vs -6.3 mmHg in CTD, P = .05), especially in those with initial readings greater or equal to 140 mmHg (-32 mmHg vs -12 mmHg, P = .01). LDL-C decreased notably in the HTD (-34.1 mg/dL vs -12.9 mg/dL in CTD, P < .05). Participants with type 2 diabetes in the HTD were able to reduce or discontinue medications while maintaining stable glycemic control. Significant changes in gut microbial abundance and improvement in estimated glomerular filtration rate (eGFR) (P < .05) were observed in the HTD. Conclusions: These results suggest that the HTD may be a promising dietary intervention for managing obesity, hypertension, dyslipidemia, and type 2 diabetes in Thailand.