Despite poverty, obesity eats its way into Mexico

The skinny on nation's latest struggle: Waistlines - and health concerns - are growing

02:50 AM CST on Monday, December 8, 2003

By LAURENCE ILIFF / The Dallas Morning News

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MEXICO CITY – The theme of Mexico's Revolution Day parade is physical fitness, but November's event showed that many Mexicans are marching briskly toward the same bad eating habits and weight-related health risks as their northern neighbors.

Bureaucrats wore baggy sweat suits that couldn't hide growing calves. Pompom girls sported spare tires. And some of the wrestlers were clearly bulking up – intentionally or not.

And so it was with the spectators, who munched on tamales, potato chips and imitation pork rinds made from wheat flour and gulped down buckets of sugary soft drinks.

Suddenly, those skinny and often undernourished Mexicans from decades past are nearly as overweight as their U.S. neighbors. Among industrialized countries, Mexico is at the bottom of the list in education and health care, but No. 2 in obesity – right behind the United States and before the United Kingdom.

"People have become sedentary," said Héctor Hernández, 43, a Mexico City office worker who carries a few extra pounds. "They arrive at the office and sit down. They drive rather than walking. You see kids eating hamburgers, stuck inside the house all day. Adults and kids alike are getting fat."

The rapid urbanization of Mexico, which gives more people access to modern conveniences and processed foods, is creating a nation of overweight couch potatoes, experts say.

But what's so surprising about Mexico's growing weight problem is that it comes in a nation where nearly half the 100 million people live in poverty. Observers blame radical changes in eating habits and less physically demanding lifestyles, caused by what some see as the Americanization of Mexico.

The consequences for Mexico's stretched-to-the-limit public health care system are ominous. Already, Mexico ranks among the top 10 nations in the percentage of diabetes cases.

"Clearly, we have to do something in Mexico, in Latin America, to stop this epidemic of obesity," said Juan Rivera Dommarco, head of nutrition investigation at the National Institute of Public Health. "Otherwise we will have 16-year-olds with diabetes, ... our dialysis units will be saturated, and our health system could collapse," he said from his office in Cuernavaca, just south of Mexico City.

Araceli Suverza Fernández, coordinator of the nutrition clinic at Ibero-American University in Mexico City, said that collapse is already happening.

"The problem that the health system is facing right now with the numbers of overweight people with diabetes and cardiovascular ailments is more than it can handle," she said. "This is a crisis."

It is also something of an unexpected one.

Government aid programs designed to reduce an epidemic of malnutrition among rural farmers and Indian groups have slashed child malnutrition by half, according to the Health Ministry. Still, one in five preschool children remains malnourished.

At the same time, the percentage of people considered overweight or obese has nearly doubled, government figures show. The definitions of "overweight" and "obese" are determined by an international scale called the Body Mass Index that measures a person's weight relative to height and assigns a numeric value.

"Even amid the poverty of southern Mexico, we have problems of overweight people and obesity," Mr. Rivera said.

Nationally, about 60 percent of adult women are overweight or obese, said Mr. Rivera, citing the government's National Nutrition Survey that was published in 2001 after two years of investigation.

The survey focused on women and children, but Mr. Rivera said the obesity rate for men is only slightly lower, mostly because some still get the physical benefits of toiling at heavy labor.

Among the lowest socioeconomic classes, the obesity rate for women is only about 5 percentage points lower than the national average, the survey showed.

Figures from a similar survey in 1988 showed that 24 percent of women were considered overweight and just 9 percent obese.

"Poor people are getting fatter because their work now requires less physical demands, which is good for them, but also they are eating processed foods with high levels of fat and refined sugars," Mr. Rivera said.

That recipe is a familiar one to U.S. residents, including Mexican immigrants, in recent years.

According to a recent study by the Organization for Economic Cooperation and Development, which comprises 30 industrialized nations including the United States, Mexico now has the second-highest obesity rate at 24 percent of the population, beating the United Kingdom, at 22 percent.

The group's 2003 Health at a Glance report said that 31 percent of the U.S. population is considered obese.

One phenomenon Mexico has escaped for now is the high prevalence of "morbid obesity" that is much more common in the United States. People who suffer this condition are often several hundred pounds overweight and have trouble sitting in an airplane seat, for example, or in a restaurant booth.

But Mr. Rivera worried that may be next.

Making matters worse, Mexico is not even close to the United States when it comes to health care for the obese. Health expenditures per capita in Mexico are eight times lower than in the United States, the economic group said in its health report.

Mexican officials and nutrition experts put obesity among the nation's most serious health problems – along with smoking, alcohol abuse and cancer.

Obesity has not escaped average Mexicans, some of whom said they are quite aware of their growing stomachs and their increasingly heavy friends and co-workers.

"There are taco stands on almost every corner these days," said Dulce Hernández, 23, a university student whose careful eating habits have kept her from becoming overweight. "People don't have a lot of time to eat, so they eat at places close to work, like taco stands. They are tired at the end of the day, and don't have time to exercise."

The "slow food" of the past – three-hour lunches at home that feature soup, maybe a salad, and a modest main course – is dying out for most Mexicans, said Ms. Suverza, the nutrition expert.

Mexicans also blame the United States and the fast-food culture that has invaded their country in recent decades.

"Transnational companies are selling fast-food products with the help of the media," said Ana Lilia Franco, 37, who is dieting to lose her extra pounds. "Women are also working more and more and can't make meals for their family.

"And, of course, the influence of the United States. We're the country next door, and we want to imitate the way they dress and the way they eat."

In part, that's true, experts said. Portions are getting larger in Mexico and the "super-sizing" is in full swing. In contrast, some U.S. food giants are downsizing their food.

There's hardly a McDonalds to be found in the pueblos of southern Mexico, yet people there are putting on weight almost as rapidly as in the cities.

"Fast food has influenced the situation, but not much," Ms. Suverza said. "The changes in eating habits have been so rapid and so complete that if we look 10 or 15 years back it is unrecognizable."

In every corner of Mexico, one can find both Mexican and foreign processed food products, with white bread surpassing tortillas and fried snack foods replacing fruits and vegetables, even in communities where they are produced in abundance.

An average mom-and-pop store in a typical Mexican neighborhood has a selection of chips and cakes and cookies and chocolates and candied fruit so extensive that there is little room for anything else. Soft drinks dominate every cooler, and Mexico is No. 1 in the per capita consumption of Coca-Cola. Food products come from global companies, like Nestle and PepsiCo, and huge Mexican conglomerates like the giant bread company Bimbo.

Having caught up to the United States in the junk food craze, however, Mexico is slowly coming to realize that it may be time to slim down, experts said.

Diet and fitness products are being sold through nonstop infomercials, diet soft drinks are becoming more popular and some people are even going to the gym.

But just like their American neighbors, many here are still looking for a magic bullet.

"People are much more conscious that they have to change their behavior, and this is a good thing," Ms. Suverza said, "but everybody's looking for an easy remedy."

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