Globally, the Americas are leading the way in the obesity and overweight epidemic, with prevalence at or above 60 percent in most countries. Obesity rates among women are even higher. Blame is often pinned on poor individual consumption choices, but evidence increasingly suggests that trade liberalization may be partly to blame.
In 2009, Anne Marie Thow and Corinna Hawkes conducted a study on behalf of the International Food Policy Research Institute (IFPRI) that found that successive trade liberalization efforts in the region—namely through free-trade agreements with the United States—have facilitated greater availability and consumption of meat, dairy products and processed foods (including snacks) in Central America.
They concluded that trade liberalization policies have exacerbated what is known as the “nutrition transition”—rapid changes in food availability and consumption in developing countries that lead to diets shifting from traditional plant-based and home-cooked foods to meat-derived and processed products. This is accompanied by an epidemiological transition from infectious diseases to chronic, non-communicable diseases such as obesity, diabetes and cardiovascular disease. According to the World Health Organization, these are now the world’s biggest killers.
More evidence of the link between trade and public health has recently emerged in Mexico. An Institute of Agriculture and Trade Policy (IATP) study, published in the June issue of the International Journal of Occupational and Environmental Health, looked at the effects of the North American Free-Trade Agreement (NAFTA) on the country’s food supply. Researchers tracked exports from the U.S. to Mexico from 1980 to 2009 of products associated with shifting diet patterns—such as corn, soybeans, sugar and sweeteners, and animal-derived and consumer products—and studied the resulting effect on the nationwide and per capita consumption of those same items. They found that the Mexican food system had increasingly come to resemble the industrialized food system of the U.S., with consumption patterns shifting dramatically.
Mexico is fast becoming the world’s fattest nation. Between 1988 and 1999, for example, the average national percentage of total food energy from fat increased from 23.5 to 30.3 percent. The country’s rates of obesity and overweight tripled in the last three decades—increasing 12 percent just between 2000 and 2006—and now stand at just under 70 percent, according to an analysis of the latest Mexican National Health and Nutrition Survey.
The IATP study concluded that the U.S. has changed the food supply in Mexico, and in fact exported an obesity epidemic to its southern neighbor. U.S.-produced processed foods are now more readily found in Mexican supermarkets and convenience stores.
Another problem is the inaccessibility to healthier foods. In Guatemala, for example, researchers at the University of Pennsylvania investigated diet change and Coca-Cola consumption of the Tz’utujil Maya and reported that Coca-Cola and other soft drinks are often cheaper to buy than healthier alternatives, including water. With around 76 percent of Guatemala’s Indigenous estimated to live below the poverty line, this poses a serious public health problem. These findings were consistent with earlier research looking at Coca-Cola consumption in Mexico.
Of course, it is not only the trade-induced availability and the cheaper prices that increase the consumption of processed foods and drinks. In a recent paper, Canadian researcher Ronald Labonté and team point to other direct and indirect pathways to poor health such as the growth of select transnational corporations and of global advertising and marketing campaigns.
Nonetheless, trade liberalization has exacerbated and perhaps directly contributed to the problem. Both the IFPRI and IATP studies call on the international community to open the door for policies that would allow countries to steer trade in a pro-health direction.
There are some precedents for a healthier trade agenda. The governments of the Pacific Islands have imposed taxes on imported junk food to tackle rising obesity. “It is a question of creating incentives—[using] trade policy to help make the healthy choice the easy choice,” says Anne Marie Thow, the author of the research.
However, no similar policy has been implemented in a large country like Mexico or the United States. If proposed, the bill would likely face industry opposition. “Businesses largely ignored the South Pacific policies—it is not a worthwhile market for them,” said Barry Popkin who specializes in nutrition transition at the Carolina Population Center at the University of North Carolina at Chapel Hill. “In India, however, when the Minister of Health recommended getting rid of soft drinks, the industry complained like mad,” Popkin continued. “We are talking about two very different worlds.”
Whether the industry complains or not, special provisions within the World Trade Organization do allow for certain concerns to override free-trade imperatives. For example, trade can be restricted due to food safety concerns, and producers and exporters have to meet international sanitary and phytosanitary standards to trade abroad. The right to health is also a concern that can claim such special status.
In the end, changing trade policy will only be one part of the solution. “We have created an environment where a certain type of company succeeds,” said Popkin. A concerted international effort to incentivize production, trade, distribution, and the marketing of more natural and healthier foods will be needed to redirect the nutrition transition toward better health in the Americas.