Combating Chile’s exploding obesity rates

SANTIAGO, Chile — Gone are the days when McDonald’s fliers boasting of well-balanced meals of cheeseburgers and French fries landed on Chilean doorsteps. Now there is talk of taxing junk food and putting warnings on fatty foods to combat Chile’s exploding obesity rates.

Needing to finance reconstruction from the February earthquake, Health Minister Jaime Manalich recently suggested an unpopular idea: taxing junk food. Like raising taxes on tobacco, he said, it would bring in revenues and attack a public health problem at the same time.

Sixty-two percent of the Chilean population is overweight or obese. Almost 22 percent of first-grade students are obese and 25 percent of all adults, according to figures from the Health Ministry.

But the reaction from the food industry, restaurants and fast-food joints was swift and unanimous: no one is being forced to eat unhealthy foods, and unlike tobacco, they aren’t addictive. Manalich took a step back.

“The tax would have no effect anyways,” said Nelba Villagran, president of the Nutritionists Association. “It’s impossible to determine what is junk and we would run the risk of being unfair with some industries. Food isn’t intrinsically bad; what’s bad is how it is composed and combined.”

OBESITY IN THE AMERICAS

Mexico City: 31 percent
Santiago, Chile: 26.6 percent
Barquisimeto, Venezuela: 25.1 percent
Lima, Peru: 22.3 percent
Buenos Aires, Argentina: 19.7 percent
Bogota, Colombia: 18 percent
Quito, Ecuador: 16.3 percent

Source: American Journal of Medicine (January 2008)

Many blame the arrival of international fast-food chains and their aggressive advertising for what President Sebastian Pinera called a “rising epidemic” in his State of the Union address. Companies like McDonald’s, Kentucky Fried Chicken, Burger King and Domino’s Pizza, among many others, staked a place in the Chilean market as soon as the 17-year military dictatorship ended in 1990.

However, Chileans' changing eating habits appear to be more of a problem than the proliferation of McDonald's. Along with the fast-food outlets came major supermarkets with a greater variety of cheap processed foods. And higher incomes meant more money to spend.

Hamburgers and pizzas — completely absent from Chilean tables — quickly became routine weekend meals. Babies who were once given fresh fruit and natural juices are now eating yogurts, processed puddings and other high-calorie desserts.

Chileans are eating more pork, meat, roasted chicken, fries, sodas and products high in sugar, while salads and legumes retreat from the dinner table and the price of fish makes it largely prohibitive.

National surveys over the past decade conclude that obesity is greater in low-income groups and twice as frequent among adults with only a high-school education. Daily intake of fruits and vegetables in low-income households is only half of what wealthier families consume.

“Cars, television, domestic appliances and transportation services closer to home are making them more sedentary. Modern life is giving people less time to cook and exercise,” said Dr. Tito Pizarro, head of the food and nutrition department at the Health Ministry.

Health surveys show that about 90 percent of Chileans lead sedentary lives, and in all age and income groups, obesity is more common among women than men.

In March, a bill that would warn consumers of foods high in fat, sugar, sodium or other harmful ingredients through explicit labels passed a major hurdle in Congress. If approved, these items would not be sold, distributed, advertised or promoted in the school system.

Companies would not be able to use toys or gadgets to lure children under 12 into buying unhealthy foods, and schools would have to include nutrition and eating habits in their curricula and require at least six hours a week of physical education.

Another bill introduced in Congress in June 2008 would require schools to have a “healthy food stand” to give students an alternative source of snacks or lunches. That bill has made no progress.

The government set a goal in 2000 of lowering obesity among first-graders from 16 percent to 12 percent by this year. But 10 years later, obesity in 6-year olds has shot up to nearly 22 percent. So what happened?

According to Pizarro, schools are more concerned about preparing students to perform well in national exams than about fomenting physical activity. Meanwhile they continue to sell cookies, chips and sodas. Moreover, he said, “the school environment doesn’t encourage a healthy lifestyle, with school authorities more worried about not having kids running around in order to avoid accidents, and kids using recess time to eat more than to play.”

In May, the Health and Education Ministries announced a plan that would offer economic incentives and equipment to schools that increase physical education to six hours and stop providing or selling junk food to students. However, a similar plan begun in 2006 had virtually no effect on children’s eating habits.

That year, the Health Ministry launched “EGO-Chile,” a national strategy that included publicity campaigns on eating right and exercising as well as a pilot project in 1,000 schools aimed at improving eating habits and increasing exercise among children.

However, a recent University of Chile study found that obesity rates in those schools had risen almost 3 percent, the same amount as national obesity rates.

“EGO-Schools is not enough. People generally know what food is bad for them, but obesity is not going to drop as long as parents keep feeding their children the same awful food and sending them to school with the same snacks high in sugar and saturated fats,” Villagran said. “We’re playing by double standards: even in hospitals and doctors’ waiting rooms you’ll find vending machines that sell only junk food.”