Title: "Latin America's urbanization is boosting obesity"
Authors: Barbara Fraser
Reference: The Lancet - Vol. 365, Issue 9476, 11 June 2005, Pages 1995-1996
Link:
http://www.thelancet.com/journals/lancet/article/PIIS0140673605666792/fulltext
Reviewed by: Margarita E. Diaz, MD
Barbara Fraser's recent Lancet article, "Latin America's urbanization is boosting obesity," tells the story of a family physician from a
low-income neighborhood in Lima, Peru, and describes the success of the fast food industry within Latin America's impoverished
population. As in other parts of the world, people are moving from rural to urban areas, getting less exercise and eating a diet with
more fat and sugar and less fruit and vegetables, though Fraser notes that rural diets might not always be healthier nowadays. The
article cites data on obesity in Latin America from Manuel Peña and Jorge Bacalao, who studied women and children from 10 Latin
American countries. The excess weight of mothers and the underweight of newborn children could be the cause of an increased risk of
these children for the metabolic syndrome.
Patricia Aguirre, a nutrition researcher and anthropologist, has analyzed changes in the diet in Argentina, where choices include higher
fat and sugar products at affordable lower costs in comparison with healthier choices of the 1960s. Women are at higher risk of
obesity and malnutrition because they prioritize the nutrition of their husbands and children, and the author says they are more
susceptible to gain weight than men. Aguirre suggests national policies to make healthier nutrition choices affordable. Solutions
relative to taxes, food security and European initiatives to encourage exercise are mentioned.
Comment
Obesity has become an alarming problem for Latin America and also for other developing regions of the world. It is a problem for
males, females and children.
A comprehensive approach to the obesity and nutrition problem is urgently needed, as M. Peña and J. Bacalao described in their
article about women (15 to
49 years) and children. Haiti had the lowest prevalence of obesity ( 2.6 %) and the opposite was seen in Mexico, where more than half
of Mexican-American women presented a BMI > 25 Kg/m2. This is just the tip of the iceberg. Studies of secular trends carried out in
Mexico show the increasing prevalence of obesity and the differences between rural (9.4 % in 1998 in Durango) and urban areas
(21 % in 2000 in Mexico D.F.).
In cross-sectional studies round the world, women have shown in many countries--not all--to present a higher prevalence of obesity
than men, but I do not know of any study that proved gender to be a risk factor for obesity.
Fraser postulates a number of solutions for the obesity problem in Latin America. It is difficult to import recipes for handling lifestyle
changes from different cultures, such as strategies carried out in Europe where access to vegetables, fruit and fish differ, as do
education plans or government priorities. Some countries have implemented campaigns such as Brazil's: "Agita Brazil" to increase
physical activity, while others have not even considered the problem of obesity which is already affecting their population. As the
food industry has its marketers, so should the medical community have theirs in the fight for healthy, practical and affordable food
choices, using successful strategies such as the ones used in the fight against the tobacco industry.
REFERENCES
Peña M., Bacalao J. La Obesidad y sus Tendencias en la Region. Rev. Panam Salud Publica v.10 n. 2, 2001
Martorell R., Kettel Khan L., Hughes M.L., Grummer-Strawn L.M. Obesity in Latin American Women and Children. The J of
Nutrition 1998: 128: 1464-1473.
Guerrero-Romero F, Rodríguez M. Prevalencia de hipertensión arterial y factores asociados en la población rural marginada. Salud
Pública de México 1998; 40:339-346.
Arroyo P, Loria A, Fernandez V, Flegal KM, Kuri P. Prevalence of pre-obesity in urban adult Mexicans in comparison with other
large surveys. Obes Res 2000; 8:179-185.