WEBVTT - How Nafta Made Mexicans Fat 0:00:01.920 --> 0:00:07.480 Thank you, Thank you very much. Then President Bill Clinton 0:00:07.680 --> 0:00:10.680 stepped up to a podium to make an announcement. I 0:00:10.760 --> 0:00:14.200 believe we have might a decision now that will permit 0:00:14.320 --> 0:00:17.439 us to create an economic order in the world that 0:00:17.480 --> 0:00:22.320 will promote more growth, more equality, better preservation of the environment, 0:00:22.920 --> 0:00:26.520 and a greater possibility of world peace. That clip is 0:00:26.560 --> 0:00:30.360 from the William J. Clinton Presidential Library, and in it, 0:00:30.720 --> 0:00:35.040 the President signs into law the North American Free Trade Agreement, 0:00:35.280 --> 0:00:37.840 or NAFTA. The goal of that law was to boost 0:00:37.880 --> 0:00:40.680 the U s economy by opening up trade with Canada 0:00:40.800 --> 0:00:45.080 and Mexico. Twenty four years later, trade has grown. For example, 0:00:45.159 --> 0:00:48.640 Mexico now sends almost eleven billion dollars worth of fruit 0:00:48.720 --> 0:00:52.159 and vegetables each year into the US, and farmers in 0:00:52.240 --> 0:00:55.200 states like Iowa make their living by sending korn south. 0:00:55.840 --> 0:00:59.720 But NAFTA also caused something else to expand, a different 0:00:59.800 --> 0:01:03.680 kind of boom. Clinton didn't mention back in After more 0:01:03.720 --> 0:01:07.280 than two decades of America exporting corn, cork, and dairy 0:01:07.319 --> 0:01:21.080 products to Mexico, what's also growing our Mexican waistlines. Welcome 0:01:21.120 --> 0:01:24.960 to benchmark. I'm Scott Landman, economics editor of Bloomberg News 0:01:24.959 --> 0:01:28.760 in Washington on Benchmark. We've discussed before how the Trump 0:01:28.800 --> 0:01:33.000 administration thinks NAFTA is unfair to American workers, but we've 0:01:33.040 --> 0:01:35.280 never really looked at how the trade agreement has changed 0:01:35.400 --> 0:01:39.640 Mexico and its citizens. One big change America has made 0:01:39.720 --> 0:01:44.080 Mexico more opies. A recent study by researchers in the 0:01:44.200 --> 0:01:47.840 US and Europe, posted on the website fox Eu, found 0:01:47.920 --> 0:01:51.840 a direct correlation between declining public health in Mexico and 0:01:52.160 --> 0:01:55.080 the increase in soybean and pork products being shipped there. 0:01:55.520 --> 0:01:59.120 Shelley Hagen, our economy team intern in DC, wrote an 0:01:59.200 --> 0:02:02.200 article about this study, and she's here with us today. Shelly, 0:02:02.320 --> 0:02:05.720 Welcome to Benchmark. Thanks for having me, Scott. So what 0:02:05.760 --> 0:02:09.120 did this paper say, Shelly? A group of economists found 0:02:09.160 --> 0:02:12.200 that Mexico has been importing a large amount of unhealthy 0:02:12.240 --> 0:02:15.640 American food and beverage products, a number that has grown 0:02:15.680 --> 0:02:18.960 since NAFTA went into effect in the ninety nineties. At 0:02:19.000 --> 0:02:22.640 the same time, Mexico's imports of healthy American products like 0:02:22.720 --> 0:02:25.760 fruits and veggies have not grown nearly as fast as 0:02:25.760 --> 0:02:29.680 the unhealthy imports. Well, Mexico has been purchasing more and 0:02:29.760 --> 0:02:33.720 more unhealthy goods from America. Mexico's obesity rates have also 0:02:33.840 --> 0:02:37.440 risen as much as fifteen in twenty years. In fact, 0:02:37.600 --> 0:02:40.919 Mexico now has more overweight and obese people as a 0:02:40.960 --> 0:02:44.480 share of the population than more than thirty major economies, 0:02:44.560 --> 0:02:48.360 including the US. All right, thanks Shelly. Now to discuss 0:02:48.440 --> 0:02:52.080 this change in public health, we're joined by Simone Barkara. 0:02:52.200 --> 0:02:55.600 He's the executive director of the Nutrition and Health Research 0:02:55.639 --> 0:02:59.799 Center at Mexico's National Institute of Public Health, and he's 0:03:00.000 --> 0:03:05.400 spent years studying obesity, diabetes, and cardiovascular disease. He joins 0:03:05.480 --> 0:03:09.840 us from Cuernavaca, Mexico, just outside Mexico City. Dr Barkarra, 0:03:10.000 --> 0:03:13.919 Bien beneito, and welcome to Benchmark. Thank you very much. First, 0:03:14.040 --> 0:03:16.880 just a bit of full disclosure. Dr Barkerra's research has 0:03:16.919 --> 0:03:20.959 been partially funded through an unrestricted grant from Bloomberg Philanthropies, 0:03:21.200 --> 0:03:24.760 which encompasses the charitable activities of Mike Bloomberg, the founder 0:03:24.800 --> 0:03:28.040 and majority owner of Bloomberg LP, which is the parent 0:03:28.120 --> 0:03:32.000 company of this podcast. So let's go back in time 0:03:32.480 --> 0:03:36.240 thirty years ago to the nineteen eighties. Dr Barkerra, what 0:03:36.320 --> 0:03:40.559 did Mexicans eat back then at that time, the consumption 0:03:40.760 --> 0:03:45.600 was mostly of basic foods that were prepared in houses, 0:03:45.880 --> 0:03:51.320 mostly beings, tortilla, and many vegetables that are combined in 0:03:51.360 --> 0:03:57.440 the dishes. Also fruits that are locally produced, and different 0:03:57.520 --> 0:04:01.480 types of water infusions that we called our fascus, some 0:04:01.640 --> 0:04:04.560 of them with some amount of sugar, but not as 0:04:04.640 --> 0:04:08.119 much as a soda. And that has changed a lot 0:04:08.240 --> 0:04:11.920 since then. And how would you describe the general health 0:04:12.040 --> 0:04:16.279 of Mexicans thirty years ago. Well, in the eighties there 0:04:16.440 --> 0:04:20.800 was a very low prevalence of overweight and obesity, maybe 0:04:20.920 --> 0:04:25.680 only about less than thirty percent of the population had 0:04:25.760 --> 0:04:30.000 obviosity all overweight, and right now is seventy percent. So 0:04:30.400 --> 0:04:34.160 we basically are thinking of another country where where over 0:04:34.240 --> 0:04:39.200 city was very uncommon. And how did this change throughout 0:04:39.200 --> 0:04:42.599 the nineteen nineties and the two thousand's. Well, it was 0:04:42.760 --> 0:04:46.600 very interesting to see that in just an eleven year 0:04:46.760 --> 0:04:52.680 periods from night to nineteen nine, the increase, for example, 0:04:52.760 --> 0:04:57.680 in so that consumption was of about four percent. At 0:04:57.680 --> 0:05:01.400 the same time at that moment, the consumption of fruits 0:05:01.400 --> 0:05:06.920 and vegetables decrease, and there was a very important change 0:05:07.080 --> 0:05:11.680 in the patterns of food consumption but also in the 0:05:11.800 --> 0:05:15.039 general food system in the country. How much of a 0:05:15.120 --> 0:05:19.039 problem is obesity in Mexico today? Today, I can say 0:05:19.080 --> 0:05:22.640 that is the most important public health problem. We have 0:05:23.240 --> 0:05:27.039 an alert and epiemiologic alert due to the side rates 0:05:27.080 --> 0:05:31.360 of diabetes and obesity that we are facing. Since maybe 0:05:31.720 --> 0:05:35.719 since two thousand and twelve, we have sevent of all 0:05:35.880 --> 0:05:40.839 adults with overweight and obesity and one out of every 0:05:40.880 --> 0:05:44.840 three children has overweight or obesity. So it's a very 0:05:44.839 --> 0:05:48.760 complex situation. In the case of diabetes, we are one 0:05:48.800 --> 0:05:51.720 of the countries in the world with the highest mortality 0:05:51.800 --> 0:05:57.720 and bordering of this condition, which is mostly related to 0:05:57.760 --> 0:06:01.320 the high rates of ovicity. And what would you say 0:06:01.360 --> 0:06:04.039 are the byproducts of this trend? I mean, how is 0:06:04.080 --> 0:06:08.960 that affecting, say, health services in the country, hospitals, doctors. 0:06:09.040 --> 0:06:12.480 How would you describe that well? Is very complicated. Is 0:06:12.800 --> 0:06:17.400 a challenge because obesity is associated with more than faulting 0:06:17.520 --> 0:06:21.400 causes of death, and so it goes from diabetes to 0:06:21.720 --> 0:06:26.560 the vascular disease and cancer. And these chronic conditions are 0:06:26.680 --> 0:06:31.320 very expensive because they cannot be solved with antibiotic with 0:06:31.440 --> 0:06:37.880 a single treatment. These conditions require life treatments and complications 0:06:37.920 --> 0:06:42.200 are very expensive and cause a lot of incapacity. So 0:06:42.880 --> 0:06:49.880 these these conditions affect productivity. So, for example, the diabetes 0:06:50.000 --> 0:06:53.400 is the main cause of blindness in the country, also 0:06:53.520 --> 0:06:58.840 also of amputations, and also of renal failure and dialysis, 0:06:58.839 --> 0:07:02.600 and this kind of treat meants are so expensive that 0:07:02.680 --> 0:07:06.479 there is no enough budget in the system to to 0:07:06.560 --> 0:07:10.560 be able to treat all the patients with this problem. 0:07:10.680 --> 0:07:14.560 So so definitely the only option is to try to 0:07:15.040 --> 0:07:19.920 walk very fat on preventing and controlling these conditions through 0:07:20.200 --> 0:07:23.640 reducing the rates of obesity. Why do you think Mexicans 0:07:23.920 --> 0:07:27.160 have become more obese than many other countries that are 0:07:27.240 --> 0:07:30.880 more developed and have higher incomes. Well, I think it's 0:07:30.880 --> 0:07:34.760 a combination of factors, but one of the most important 0:07:34.960 --> 0:07:41.200 is a very rapid transition to a model of industrialized food, 0:07:41.640 --> 0:07:47.720 which is a phenomenon called accorporation, and without controlling the 0:07:48.040 --> 0:07:53.960 new environment. So the population transition very quickly from drinking 0:07:54.320 --> 0:07:58.640 aguas frisk ass and and traditional food basic food prepar 0:07:58.720 --> 0:08:03.120 at home to ultra processful that is bought in a 0:08:03.200 --> 0:08:07.000 supermarket that has a lot of ingredients that our own 0:08:07.040 --> 0:08:13.440 healthy such as sugar, salt, and fat, and without knowing 0:08:13.600 --> 0:08:19.600 really the relation of diet to these chronic conditions which 0:08:19.680 --> 0:08:24.000 were not really prevalent in the country. So you can 0:08:24.200 --> 0:08:28.160 still now see many populations in impoor areas of the country, 0:08:28.160 --> 0:08:31.520 such as the South, where people have diabetes for the 0:08:31.560 --> 0:08:35.440 first time in their families. So first generation and is 0:08:35.720 --> 0:08:39.960 very complicated. They don't understand why they felt thirsty, and 0:08:40.040 --> 0:08:42.480 they sometimes they don't know that that they have to 0:08:42.480 --> 0:08:46.960 stop drinking soda. There are many communities where soda has 0:08:47.080 --> 0:08:53.160 become part of local ritual traditions. So it is becoming 0:08:53.320 --> 0:08:58.319 very complicated to try to implement measures or policies to 0:08:58.400 --> 0:09:02.960 decrease this unhalth new habits in the population. And would 0:09:03.000 --> 0:09:05.040 you say that obesity is more of an issue in 0:09:05.120 --> 0:09:09.360 cities or in rural areas or both. Well, obviosity is 0:09:09.520 --> 0:09:13.000 more prevalent in the cities right now in Mexico, But 0:09:13.360 --> 0:09:18.200 when you mentioned the speed of increase, rural areas are 0:09:18.280 --> 0:09:23.280 now having a higher speed of increasing the prevalence of obesity. 0:09:23.360 --> 0:09:27.560 That means that rural areas are very quickly catching up 0:09:27.640 --> 0:09:30.760 with the high prevalence of obbicity that we are watching 0:09:30.760 --> 0:09:35.520 in the cities. Simon, over the last twenty years or 0:09:35.520 --> 0:09:37.840 So did it ever cross your mind that it was 0:09:38.040 --> 0:09:42.120 NAFTA that was helped playing a role in delivering these 0:09:42.240 --> 0:09:46.840 kinds of foods that were boosting obesity in Mexico. Yes, yes, 0:09:46.880 --> 0:09:52.120 because we saw very interesting effect effects in food prices 0:09:52.120 --> 0:09:56.120 after NaSTA. For example, Mexico is a big publisher of sugar, 0:09:56.559 --> 0:10:01.800 but with NAFTA we started to have also high cone 0:10:01.880 --> 0:10:06.200 fructose competing in the market. That and and the high 0:10:06.200 --> 0:10:10.120 fructose is subsidized empowered by the United States, so it's 0:10:10.280 --> 0:10:14.359 really low priced. So to try to maintain the production 0:10:14.760 --> 0:10:18.080 and the workers of sugar, the government in Mexico also 0:10:18.200 --> 0:10:22.440 started some sort of support and subsidies to sugar. So 0:10:22.640 --> 0:10:26.480 the net balance of nat time in this example was 0:10:26.559 --> 0:10:29.600 that in a very short period of time we had 0:10:29.720 --> 0:10:35.720 very inexpensive sugar, and that was an incentive for producers 0:10:35.760 --> 0:10:39.320 of many kinds of ultra process foods of adding sugar, 0:10:39.400 --> 0:10:43.280 which everybody likes, and it's an inexpensive way to make 0:10:43.800 --> 0:10:46.880 to add something to a food. So this was one 0:10:46.880 --> 0:10:50.520 of the very important changes. The other change that was 0:10:51.040 --> 0:10:57.160 impressive was the amount of supermarkets in Mexico just after NATA. 0:10:58.120 --> 0:11:01.400 I could say that most of the football chases now 0:11:01.520 --> 0:11:06.400 are done in supermarkets sometimes are the big change with 0:11:06.480 --> 0:11:09.320 the same names as in the US. And there used 0:11:09.360 --> 0:11:11.640 to be shopping in most people. Would you used to 0:11:11.679 --> 0:11:15.400 shop at, say, smaller markets. Is that is that fair? Yes? Yes, 0:11:15.440 --> 0:11:19.160 they used to shop in small markets of locally produced 0:11:19.240 --> 0:11:24.520 foods for example, that there was always as the bakeries 0:11:24.559 --> 0:11:28.560 in Europe, we have the tortillas the cornery shop in 0:11:28.600 --> 0:11:33.720 which there was a tortilla small little factor in in 0:11:33.720 --> 0:11:37.160 in every town. And now the tortillas are in solved 0:11:37.440 --> 0:11:41.679 in the supermarket also and it's the same the same 0:11:41.760 --> 0:11:45.640 kind of preparation of flower for for all of them, 0:11:45.640 --> 0:11:49.440 and it's an industrialized process. So is the food system 0:11:49.520 --> 0:11:53.839 has changed a lot in only twenty two third years now. 0:11:53.840 --> 0:11:56.880 There have also been some efforts to attack this problem, 0:11:56.920 --> 0:12:00.920 to restrict the consumption of the kinds of foods that 0:12:00.960 --> 0:12:04.680 are making people a beast. There's a soda tax and 0:12:04.679 --> 0:12:07.640 and also I believe a junk food tax. Are these 0:12:07.679 --> 0:12:11.240 taxes working? Have they had any effect on obesity? Yes? 0:12:11.440 --> 0:12:15.920 We we definitely have evidence that these taxes are working. 0:12:16.559 --> 0:12:21.920 And when we first watch consumption of soada in the 0:12:22.080 --> 0:12:25.080 end of the nineties, there was a very big amount 0:12:25.160 --> 0:12:29.880 of calories coming every day from sugary beverage in all 0:12:30.000 --> 0:12:32.640 age groups. So so it was it was a problem, 0:12:32.640 --> 0:12:37.800 and we started recommending a solar tax seems two and three. 0:12:38.040 --> 0:12:42.640 So after more than dangers, finally the government had a 0:12:42.720 --> 0:12:46.920 window of opportunity to implement the tax, and we sad 0:12:47.440 --> 0:12:51.760 don't different efforts to evaluate the effects in these two 0:12:51.840 --> 0:12:55.280 years which is the period that we have the tax. 0:12:55.360 --> 0:12:58.319 It's a small tax, it's only one the super leader, 0:12:58.480 --> 0:13:04.640 so equivalent to about ten and even though if smaller 0:13:04.679 --> 0:13:10.280 than that what most international agencies recommend, it has been 0:13:10.320 --> 0:13:14.480 able to show reductions in consumption that are of about 0:13:15.120 --> 0:13:18.800 seven to twelve depending on the on the groups. And 0:13:18.960 --> 0:13:21.800 that's a lot that in a country that has one 0:13:22.440 --> 0:13:27.479 and twenty six million inhabitants, having these kind of reductions 0:13:27.600 --> 0:13:33.000 to cap it them represent many tons of sugar that 0:13:33.080 --> 0:13:38.080 are not consumed thanks to this policy. Besides taxes, what 0:13:38.160 --> 0:13:43.439 other policies could help. Well, we are trying very intensively 0:13:43.480 --> 0:13:49.280 to promote some warning levels on food products that are unhealthy, 0:13:49.320 --> 0:13:53.720 particularly so that and ultra process foods that are hiring salt, 0:13:53.800 --> 0:13:59.360 sugar or fat. We have seen that countries like Chili 0:13:59.640 --> 0:14:03.439 that implemented. These kind of warning levels in the foods 0:14:03.600 --> 0:14:09.200 allow the consumers to very quickly identify on healthy foods 0:14:09.280 --> 0:14:12.720 and look for healthier decisions. So I think this is 0:14:13.000 --> 0:14:16.319 one policy that in which we need to work very hard. 0:14:16.400 --> 0:14:20.440 We are trying to to convince the decision makers that 0:14:20.560 --> 0:14:24.440 this is a very powerful tool in a population that 0:14:25.080 --> 0:14:30.760 doesn't know how to interpret these complex labelings with numbers 0:14:30.760 --> 0:14:34.960 and percentages. That it's almost like a cigarette warning labels 0:14:35.000 --> 0:14:39.240 for chunk food right exactly, you're saying this product is 0:14:39.320 --> 0:14:42.520 high or has an excess of sugar, and then the 0:14:42.560 --> 0:14:45.440 consumer can compare this one with one that doesn't have 0:14:45.560 --> 0:14:49.120 this level, and and that that is very helpful in 0:14:49.160 --> 0:14:52.440 the context. And the other policy that cool health a 0:14:52.480 --> 0:14:57.560 lot is controls on marketing. So again in the same 0:14:57.680 --> 0:15:02.160 way as in tobacco, market think is a very powerful 0:15:02.240 --> 0:15:06.720 tool of corporations to increase consumption. And sometimes this marketing 0:15:06.720 --> 0:15:10.920 in foods is directed to children. So we need to 0:15:11.440 --> 0:15:17.200 develop better policies and regulations to protect children from having 0:15:17.280 --> 0:15:20.760 on healthy foods. We are for example, evaluating point of 0:15:20.880 --> 0:15:25.720 purchase and in the supermarkets it is completely directed to 0:15:26.040 --> 0:15:29.640 attract children's and most of the foods that are sold 0:15:30.120 --> 0:15:34.880 have have excess of sugar and other ingredients that are unhealthy. 0:15:34.920 --> 0:15:37.880 So this is something that which we also need to 0:15:37.920 --> 0:15:41.360 work a lot, and in schools and other sites in 0:15:41.440 --> 0:15:45.800 which children are very frequently, such as public parks, try 0:15:45.880 --> 0:15:49.680 to increase availability of water and to decrease marketing and 0:15:49.720 --> 0:15:54.240 also sale off on healthy products. Dr bark Hera, we 0:15:54.280 --> 0:15:56.480 can't let you go without talking about the big issue, 0:15:56.520 --> 0:16:00.360 loving all over this and trace Manuel Lopez over Doors 0:16:00.400 --> 0:16:04.600 the leading candidate in Mexico's upcoming presidential election, and he 0:16:04.680 --> 0:16:08.080 likes to talk about how NAFTA has driven Mexican farmers 0:16:08.120 --> 0:16:10.560 out of business, just as a side not check out 0:16:10.600 --> 0:16:12.920 our new poll tracker on Bloomberg dot com for the 0:16:12.960 --> 0:16:17.840 Mexican presidential election. Dr Barca, is there any link between 0:16:17.840 --> 0:16:20.880 the loss of local agriculture in Mexico and the rise 0:16:20.920 --> 0:16:26.280 in obesity? My sense is that in general, many of 0:16:26.320 --> 0:16:31.080 the macro egonomic indicators of Mexico have been improving. Even 0:16:31.280 --> 0:16:35.840 talking about health and development, we have been a nation 0:16:35.920 --> 0:16:40.760 that is showing a little bit about average improvement compared 0:16:40.800 --> 0:16:44.720 to other Latin American countries. So it is complex to 0:16:44.760 --> 0:16:49.640 evaluate something such as the food system that has many effects. 0:16:50.120 --> 0:16:54.320 Many experts, for examples from the World Health Organization are 0:16:54.400 --> 0:16:59.800 trying to understand the net benefits of trade, which some 0:17:00.000 --> 0:17:03.840 times are for example, food availability and reduction of on 0:17:03.960 --> 0:17:07.840 their nutrition, and then compare the trade offs such as 0:17:07.880 --> 0:17:12.040 increasing no communical point diseases. This is a challenge and 0:17:12.240 --> 0:17:16.439 we don't have very clear understanding of it, but in 0:17:16.520 --> 0:17:20.480 general I think the main challenge is a challenge that 0:17:20.560 --> 0:17:25.040 can be solved mostly by regulating and helping the food 0:17:25.119 --> 0:17:31.639 environment more than avoiding phrase just as a solution. All right, 0:17:31.720 --> 0:17:34.879 a very diplomatic answer, Dr Barkerra, thank you so much 0:17:34.960 --> 0:17:37.880 for joining us today on Benchmark. Thank you very much. 0:17:38.200 --> 0:17:44.199 Scott Benchmark will be back next week. Until then, you 0:17:44.240 --> 0:17:46.960 can find us on the Bloomberg terminal, Bloomberg dot com, 0:17:47.000 --> 0:17:50.920 our Bloomberg app, and podcast destinations such as Apple, podcast, 0:17:51.119 --> 0:17:54.359 Overcast and Stitcher. Please take time to rate and review 0:17:54.400 --> 0:17:56.800 the show, and you can also find us on Twitter. 0:17:57.119 --> 0:18:00.440 You can follow me at Scott Landman Show le You're 0:18:00.480 --> 0:18:03.840 at at Shelley k Hagen s h E l l 0:18:04.000 --> 0:18:07.440 y k h A g A. N our guest is 0:18:07.480 --> 0:18:10.560 at at s b A r q U E r 0:18:10.640 --> 0:18:13.240 A and as a side note, check out our new 0:18:13.280 --> 0:18:16.840 pull tracker on bloomberg dot com for the Mexican presidential election. 0:18:17.520 --> 0:18:20.720 Benchmark is produced by tofor foreheas the head of Bloomberg 0:18:20.760 --> 0:18:24.480 Podcast is Francesco Levy. Thanks for listening, See you next time.