Obesity in Latin America

Globally in the last century rates of obesity have grown exponentially due to dietary and lifestyle changes. While epidemiologists initially most feared the worsening epidemic in high income countries, recent years have shown that some of the areas most at risk of obesity and associated diseases are in the global south. In particular, countries such as Mexico, Chile, Argentina, and Costa Rica have risen to have some of the highest rates of obesity globally (Kain, 2002). Latin America has the potential to become one of the regions most affected by the epidemic, as the population rapidly transitions from undernourished to overnourished. Latin America’s increased rates of obesity due to the lack of healthy affordable options and increased access to processed foods will soon result in catastrophic consequences for the region’s health if left unaddressed.

Many studies have investigated the root causes and risk factors for obesity across Latin America. In Mexico, many have blamed the NAFTA trade agreement with the United States and Canada for increasing the consumption of fat, sugary, salty, and processed foods (Jacobs & Richtel, 2017). In fact, the consumption of caloric beverages in Mexico doubled from 1996, two years after NAFTAs enactment, to 2002 (Popkin et. al., 2012). Yet despite this increased availability of fast caloric foods imported from the United States, few Mexicans have gained access to healthier options. Regionally across Latin America, Kain (2002) found that as a country undergoes economic development and increases its national income, consumption of saturated fats increases drastically, while the consumption of fibrous foods such as vegetables remains stagnant. In recent years across Latin America, consumption of healthy legumes has declined (Popkin & et. al., 2012). In the case of Mexico, previous staples such as eggs, beans and tortillas have been replaced by foreign high fat foods such as hamburgers, hot dogs and pizza (Jacobs & Richtel, 2017). In general, fresh markets are being replaced by supermarkets, and multinational chains such as Walmart (Popkin & et. al., 2012). As regional expert Duncan Wood explained, “People are able to indulge in more processed food, consuming more calories, but not rich enough to have an affluent lifestyle where they are able to eat healthier” (Jacobs & Richtel, 2017). In fact, obesity is strongly tied to socioeconomic status. In Latin America, higher-income, educated individuals are less likely to be obese (Kain, 2002). Additionally, women, indigenous individuals, afro-descendants, and rural communities are disproportionately plagued with obesity, likely due to genetic and environmental differences (UN News, 2018; Uauy, 2001). Therefore, in general individuals with less access to healthcare and other resources are more likely to be obese, making the conditions associated with obesity even more threatening.

Obesity is linked to many non-communicable conditions, such as hypertension, heart disease and diabetes. Incidence rates for stroke, cancer, and diabetes have all been predicted to increase substantially by 2030 in Cuba, Colombia and Uruguay, as rates of obesity steadily rise (Webber, 2012). Interestingly, Latin American countries with more European descendants are at a higher risk of increases in cardiovascular diseases, compared to countries with larger indigenous populations (Webber, 2012). These discrepancies are likely a result of genetic differences affecting the manifestation of different conditions within the individual. When comparing across the region, Miranda (2013) found that Chile shows the highest prevalence of hypertension, Puerto Rico the highest prevalence of diabetes, and the Peruvian population was at the lowest risk of complications of obesity. However, generally across the region, given current obesity rates, we can expect to see increases in cardiovascular disease, diabetes, hypertension, cancer, and stroke. While many of these negative health outcomes have been linked with obesity internationally, some researchers have observed regional variations between the United States and Latin America when considering consequences of obesity (Miranda, 2013). Despite the higher prevalences of obesity and high total cholesterol in the United States, Latin America has a higher prevalence of low HDL cholesterol, which increases the risk of stroke (Miranda, 2013). These results demonstrate that obesity manifests differently in different populations, and the impact it will have as the epidemic grows will vary both regionally and nationally.

It is obvious that obesity poses serious health and economic repercussions for Latin America. Should rates continue to increase drastically over the next few decades, it has the potential to cripple public health establishments. Already, experts approximate that each case of diabetes in Mexico costs the government $708 annually, resulting in over 778 million dollars of spending nationally on just one of the many complications of obesity (Perez de Leon, 2011). It is no surprise that many countries have looked for solutions to curve rising rates of obesity. Yet controlling the rise in obesity rates is a daunting task, involving behavioral changes. As Rivera (2004) explains there are few known interventions which have been proven effective. While some have imposed harsh measures, such as the sugar tax in Mexico (Guthrie, 2014), others such as Chile have implemented holistic programs aiming to increase access to healthy foods. Chile for example has enacted preschool education initiatives teaching nutrition and physical activity, and increased food labeling to help consumers identify unhealthy products (Weber, 2012). Colombia creatively launched a program to increase cycling in Bogotá, which has since been named the world’s third most bike-friendly city (Weber, 2012). Other areas of Latin America have focused on increasing attention around obesity. The Caribbean Public Health Agency, for example, declared that non-communicable diseases are a "key public health priority" (Weber, 2012). Yet none of these policies have proven sufficient to substantially reduce or slow growing obesity rates. Creative multi-faceted approaches are needed at a much larger scale to avoid the detrimental impact of obesity and related conditions throughout the region.

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Additional Resources

Pan American Health Organization (PAHO). (2014). Plan of Action for the Prevention of Obesity in Children and Adolescents. Retrieved from https://www.paho.org/hq/dmdocuments/2015/Obesity-Plan-Of-Action-Child-Eng-2015.pdf?ua=1&ua=1.

Pan American Health Organization (PAHO). (2015). Ultra-processed food and drink products in Latin America: Trends, impact on obesity, policy implications. Noncommunicable Diseases and Mental Health. Retrieved from http://iris.paho.org/xmlui/bitstream/handle/123456789/7699/9789275118641_eng.pdf.

References

Guthrie, A. (2016, January 07). Mexican Soda Tax Helps Curb Consumption, Study Shows. The Wall Street Journal. Retrieved from https://www.wsj.com/articles/mexican-soda-tax-helps-curb-consumption-study-shows-1452198709.

Jacobs, A., & Richtel, M. (2017, December 11). A Nasty, Nafta-Related Surprise: Mexico's Soaring Obesity. New York Times. Retrieved from https://www.nytimes.com/2017/12/11/health/obesity-mexico-nafta.html.

Kain, J., Vio, F., & Albala, C. (2002). Obesity trends and determinant factors in Latin America. Cadernos de Saúde Pública. Retrieved from https://www.scielosp.org/scielo.php?pid=S0102-311X2003000700009&script=sci_arttext&tlng=es.

Miranda, J., Herrera, V., Chirinos, J., Gómez, L., Perel, P., Pichardo, R., & Pereira, R. (2013). Major cardiovascular risk factors in Latin America: A comparison with the United States. The Latin American consortium of studies in obesity (laso). Plos One, 8(1).

Perez de Leon, Veronica. (2011, June 13).Cada paciente con diabetes le cuesta 708 dólares al año a México. CNN Mexico. Retrieved from https://web.archive.org/web/20131031110812/http://mexico.cnn.com/salud/2011/06/13/cada-paciente-con-diabetes-le-cuesta-708-dolares-al-ano-a-mexico.

Popkin, B. M., Adair, L. S., & Ng, S. W. (2012). Global nutrition transition and the pandemic of obesity in developing countries. Nutrition reviews, 70(1), 3-21.

Rivera, J., Barquera, S., Gonzalez-Cossio, T., Olaiz, G., Sepulveda, J. (2004). Nutrition Transition in Mexico and in Other Latin American Countries. Nutrition Reviews, 62(7).

Uauy, R., Albala, C., & Kain, J. (2001). Obesity Trends in Latin America: Transiting from Under- to Overweight. The Journal of Nutrition, 131(3).

UN News (2018, November 7). Hunger and obesity in Latin America and the Caribbean compounded by inequality: UN report. UN News.

Webber, L., Kilpi, F., Marsh, T., Rtveladze, K., Brown, M., & McPherson, K. (2012). High rates of obesity and non-communicable diseases predicted across Latin America. Plos One, 7(8).