Forman Lecture: Simón Barquera on tackling obesity and noncommunicable diseases in Mexico

The global prevalence of overweight and obesity has nearly tripled since 1975, and these conditions now affect more than 340 million children and adolescents ages 5-19 and nearly 39 million children under 5. These conditions are linked to rising rates of noncommunicable diseases such as diabetes and cardiovascular disease. This has become a serious public health problem in in low- and middle-income countries, as rising poverty and inequity, urbanization, and climate and humanitarian crises limit access to healthy diets, especially for the poorest and most marginalized.

But policy responses have emerged that help reduce consumption of unhealthy foods and limit health problems—these include sales taxes on sugary drinks and warning labels on the packaging of highly processed foods. Facing an alarming increase in sugar consumption, Mexico was among the earliest countries to impose a tax on sugary sodas—amounting to about 10%—in 2014.

Simón Barquera has spent his career studying nutrition issues in Mexico, leading research efforts into connections between consumption of sweetened beverages and junk food, overweight and obesity, and public health—and developing policy responses. Barquera, Director of the Center for Research in Nutrition and Health of the National Institute of Public Health in Mexico and President-elect of the World Obesity Federation, explored the lessons of Mexico’s experience, and his own, in the 33rd Annual Martin J. Forman Memorial Lecture November 21 at IFPRI headquarters.

The annual lecture series, hosted by IFPRI since 2002, commemorates Martin J. Forman, who headed the Office of Nutrition at the U.S. Agency for International Development (USAID) for more than 20 years and made a significant impact on international nutrition.

Barquera shared a moment from early in his career that helped inspire his passion for improving nutrition in Mexico. His research team found a very high and previously undocumented intake of soft drinks among Mexicans. They explored this as a possible driver of increased rates of noncommunicable diseases, documenting a corresponding rise in diabetes mortality.

Around the beginning of the 2000s, Barquera said, research and food policy work on nutrition in Mexico focused mostly on challenges such as undernutrition, micronutrient deficiencies, and child stunting. Little research there had examined links between food and noncommunicable diseases. But alarming new trends were emerging.

“In the 1990’s we started to have a transformation of our food systems that increased the prevalence of noncommunicable chronic diseases. Right now, more than 70% of our mortality is due to noncommunicable chronic diseases, over 140,000 deaths every year, and more than 40,000 of those deaths are attributable to sugar sweetened beverage consumption.”

Policymakers started asking what could be done about this problem. Mexico’s tax on sugar-sweetened beverages—which raises the price of drinks and thus helps depress sales and overall sugar consumption—was proposed in 2003 and finally approved in 2014. Barquera pointed that out that finally getting a soda tax implemented in Mexico—despite strong opposition from the food industry—was aided by the fact that the Mexican government was keen to expand its tax base to help its fiscal outlook, whereas other regulations to curb sugar intake have been more difficult to implement.  

In studies conducted in 2014 and 2015, Barquera said, “we documented a sustained reduction in consumption of about five liters per capita per year. After we published these papers, more than 30 countries around the world implemented soda taxes too, so I think this was one of our big wins.”

After a 2007 conference on childhood obesity, Barquera and colleagues proposed another way to limit consumption of unhealthy foods: Adding a warning label to the front of prepackaged processed food items high in sugar, fat, and salt. This policy was implemented in 2020. Based on Chilean food warning labels, the Mexican system uses black octagons that say, “excess of sugar, excess of fat, excess of sodium.”

They also designed related policies barring any product with a warning label from using cartoon characters to advertise to children and ceasing sales in schools. While some companies have tried to use clever packaging and logo placement to get around these marketing regulations, others have reformulated their recipes to include significantly less sugar to comply with warning labels.

Barquera concluded by thanking many students and young researchers who made this research possible. The event concluded with an engaging Q&A session with participants in the room and online.

Prior to the lecture, speakers paid tribute to Dr. Forman. “Martin J. Forman was instrumental in putting into motion so much of what we think about today when we think about the world of global nutrition,” said Purnima Menon, Senior Director of Food and Nutrition Policy at CGIAR and IFPRI: "In a changing world of nutrition challenges, this lecture is a testament to the wide-ranging efforts and continued evolution of evidence needed to solve one of the biggest global challenges.”

Johan Swinnen, IFPRI Director General and CGIAR Managing Director of Systems Transformation, reminded the audience of Forman’s critical role in establishing the United Nations Subcommittee on Nutrition in 1977 as well as other important micronutrient initiatives. “Dr. Forman did revolutionary work in bringing attention to a multisectoral approach to nutrition, one that includes agriculture, education, and health ... We hope to honor Dr. Forman’s legacy by progressing the global dialogue on solutions to the triple burden of malnutrition.”

Dr. Forman’s son Kenan Forman and Kellie Stewart, Chief, of the Nutrition and Environmental Health Division at the U.S. Agency for International Development (USAID), also welcomed the audience and thanked IFPRI and USAID for continuous support for the lecture series. “As we honor Dr. Forman’s legacy, one of our focus areas is to continue to build the next generation of global nutrition leaders,” Stewart said, highlighting the Martin J. Forman nutrition fellowship created for USAID’s mission-based foreign service nutrition specialists.

Jennifer Johnson is a Communications Specialist with IFPRI's Communications and Public Affairs Unit.

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