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Mexico, a World Leader in Obesity

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Today we have a guest post from Dr. Erin Redman on obesity and Sustainability in Mexico.

Mexico is experiencing, simultaneously, significant epidemiological1)This epidemiological transition is characterized by a shift from high infectious disease morbidity and mortality (rates) to an increasing prevalence of non-communicable chronic diseases (NCCD). (disease) and nutritional2)The nutrition transition is the shift from high rates of under-nutrition to predominance of diet-related NCCD associated with obesity. transitions. The nutrition transition, which is marked by changes in activity and dietary patterns, has three major phases:3)For more information on the nutrition transition in Latin America check out this open access article by Rivera et. al (2004) [3]
  1. Receding famine stage: high rates of infant mortality caused by infectious diseases & under-nutrition
  2. Degenerative diseases stage: increased consumption of fats, processed foods, & sugars as well as reduced physical activity leads to increased rates of NCCD
  3. Behavioral change stage: after experiencing the devastating effects of degenerative diseases, behavioral changes in diet and lifestyle occur, including reduced consumption of fats and refined carbohydrates to increased consumption of fruits, vegetables, and fiber
Mexico has clearly entered the degenerative disease phase, as a recent UN Food and Agriculture Organization (FAO) report [4] declared that Mexico's adult obesity rate surpassed that of the United States. Additionally, Mexico has the highest incidence of youth obesity [5] in the world—with more than 28 percent of children between 5 and 9, and 38 percent of youth ages 10 to 19 categorized as either overweight or obese.

Although some regions in the country have many people who are still struggling to attain sufficient calories, in Mexico (where almost half of the population lives in poverty) the burden of obesity, diabetes, and cardiovascular diseases lies mostly on the poor. Abelardo Avila of Mexico's National Nutrition Institute noted that [6],
The same people who are malnourished are the ones who are becoming obese.
The rate at which this shift has occurred is astounding—only 40 years ago the main causes of death were malnutrition and infectious diseases and now Mexico’s biggest killers are heart disease and diabetes.

obesity photo Many scholars suggest that industrial agriculture and increased urbanization are among the leading causes of the growing obesity rates. The low price of processed foods associated with industrial agriculture, combined with the shift in lifestyle associated with urbanization has left Mexico with a public health crisis. Urbanization, along with demanding jobs and longer commutes, have resulted in many Mexicans abandoning their traditional diet (& home cooking) for fast food and processed snacks. Alejandro Calvillo, director of Power of the Consumer, remarks that “Formula milk, instant soups and sugary sodas have replaced breast-feeding, maize, beans and water, and children become addicted to sugar from a very early age. Kids in rural areas of Chiapas and Guerro are malnourished but overweight.” Indeed, Mexicans appear to be addicted to sugar, as they consume more coca-cola per capita than any other country in the world. Research presented at an American Heart Association conference [7] found that sugary drinks accounted for 22,000 deaths in Mexico every year - the highest rate in the world.4)While soda is the focus of most activists' ire, many other popular drinks including those marketed as "healthy" contain loads of sugar as these charts make clear [8].

Implications of Obesity for Achieving Sustainability

Clearly it is a problem that an estimated 73% of young adult women in Mexico are either overweight or obese, but what does that mean for Sustainability? The impact of obesity can be seen in terms of the 3 Pillars of Sustainability.5)Typically described as economy, society, & environment First, economically, the recent FAO report estimated that the cumulative cost of all non-communicable diseases, for which overweight and obesity are leading risk factors, were estimated to be about US$1.4 trillion in 2010. The social cost, in terms of disability-adjusted life years for obesity is very high. The FAO reported that globally, while the social burden due to child and maternal malnutrition has declined almost by half during the last two decades, the social cost due to overweight and obesity has almost doubled.

One of the dietary shifts that has resulted in adverse health effects as well as in unsustainable patterns of consumption is an increased consumption of animal fats. Prominent nutrition scholar, Barry Popkin, wrote that [9]:
the transformation of the grain markets for animal feed leads to the degradation of natural resources, and significant social changes.
The consumption of red meat has been linked to a number of adverse health effects (including cardiovascular disease and Type II Diabetes) and in terms of the environmental impact, the production of meat is incredibly resource intensive—requiring more energy, water, and land than plant-based counterparts (e.g. beans). In addition to the negative environmental impact associated with meat production, industrial agriculture comes with its own set of environmental burdens, including water and air contamination due to increased use of synthetic fertilizers and chemicals. While reduced prices of meats, among other products, due to industrial agriculture has enabled people to diversify their diets, it has also led to numerous unintended consequences with regard to both Sustainability and nutrition.

factory farm photo In addition to producing cheaper meat, industrialized agriculture has also led to cheaper sugar. Clearly soda consumption is an issue for obesity & the environment, particularly in Mexico, with such high levels of soda consumption while most areas lack a formal recycling system6)The chaotic, informal recycling system of Mexico is a current topic of research for us and we'll be sharing preliminary results as we go on this blog. Stay tuned.. Working at a school with a large dentistry program, I can attest to the problems that high soda consumption can create for dental hygiene in addition to the more often discussed early-onset of Type 2 diabetes. However, parents here may often feel it is safer to give their infants soda rather than unsafe drinking water. So in order to tackle this complicated, interconnected problem, we must look at infrastructure, consumer behaviors, food industry practices, government policies (the sugar tax is a start! [10]), and develop solutions at all levels.

Photos by Gaulsstin [11] [12] and Socially Responsible Agricultural Project [13] [14]

Footnotes   [ open access article by Rivera et. al (2004) [3] 4. While soda is the focus of most activists' ire, many other popular drinks including those marketed as "healthy" contain loads of sugar as these charts make clear [8]. 5. Typically described as economy, society, & environment 6. The chaotic, informal recycling system of Mexico is a current topic of research for us and we'll be sharing preliminary results as we go on this blog. Stay tuned.