There are now 2.1 billion people who are overweight in the world. China and India are number one and two in the world in sheer number of type 2 diabetics. In the Middle East and North Africa, rates of diabetes are rapidly increasing. It is estimated that we could spend $47 trillion over the next 20 years on lifestyle preventable chronic disease — more than the annual GDP of the six largest economies combined.
Obesity and its related diseases are among the greatest threats to economic development. America has created arguably the worst diet in the world and is exporting it to every country on the planet. North Korea and Cuba are the only nations on Earth without Coca Cola.
Given this tsunami of obesity threatening to cripple health care systems, burden economies and damage productivity, nations are exploring innovative strategies to reverse the tide. A few countries in Europe, including some in Scandinavia, have implemented taxes on sugar, soda and junk food. But Mexico has gone much farther and much faster, implementing a broad range of synergistic policies.
Mexico’s President Enrique Pena Nieto has become the leader in innovation and policy change to fight obesity and type 2 diabetes. And none too soon because almost 10 percent of children in Mexico have type 2 diabetes — once called adult onset diabetes.
Here are the interventions Mexico implemented and which we should learn from, however politically unpopular.
1. Taxing soda and junk food
Mexico has implemented a soda (and sugary beverage) tax of one peso per liter. Mexicans drink an average of 43 gallons of soda per person per year. Studies have documented the benefits of a sugar or soda tax but only a few countries have implemented it. Mexico has also levied a tax on junk food. The tax money is used for community interventions for obesity and public health education.
Does the tax mean people buying less soda and junk food? Food companies like Coca Cola have spent tens of millions of dollars fighting tax initiatives. If they believed it would have no impact on their bottom line, then they would not fight it as vigorously.
2. Clearly labeling healthy and unhealthy foods on the front of the package
Current food labeling confounds and confuses most people. Other efforts, including stoplight labeling — green good, yellow caution and red danger, are being explored in other countries. The $1 trillion food industry has profound lobbying power influencing most dietary guidelines and food regulations.
The FDA (Food and Drug Administration) has recently ruled that trans fats are not GRAS (generally recognized as safe) but it will take years to remove it from foods. Currently, even foods containing trans fats can say “zero” trans fat on the front of the label. The food lobby pressured the FDA to allow a food label to say “zero” trans fat if it had less than 0.5 grams of trans fat per serving. Cool Whip, which is water, trans fat and high fructose corn syrup, is marketed as a “zero” trans fat product.
3. Ending sugar and junk food marketing to children
The rationale and data behind this are clear. Over 50 countries have limited junk food marketing to children. America is one of the few that has not. Children cannot tell the difference between commercials and reality until they are eight years old. The average two year old can identify foods by brand name in supermarkets. And the least healthy foods are often very heavily marketed.
4. Providing only healthy foods in schools
No food that promotes disease should be provided in publicly funded institutions. This is an area where governments have significant leverage. In most schools, there are only deep fryers and microwaves serving industrial processed foods. According to a 2005 survey, nearly half of all public elementary schools and about 80 percent of public high schools have contracts with soda manufacturers.
Other countries have tested various policies to attempt to change behavior. Norway levies duties on sugary drinks, sugar and chocolate. Samoa, one of the fattest nations on Earth, has taxed sugary drinks since 1984. And in 2000, Australia implemented a 10 percent tax on soda, candy and white flour bakery products.
France, Spain, Greece and Belgium have implemented successful community-based interventions.
Obesity is a complex social disease that requires both social and political transformation. Personal responsibility is the mantra of the food industry and even many governments. But in the face of the documented addictive nature of sugar and refined and processed foods, willpower is a myth. The responsibility of governments is to protect their citizens and not place profits above public health. We must end this era of privatizing profits but socializing the costs of obesity.
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