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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

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A Nasty, Nafta-Related
Surprise: Mexico’s
Soaring Obesity
Few predicted when Mexico joined the free-trade deal that it would
transform
the country in a way that would saddle millions with diet-related
illnesses.
Leer en español
By ANDREW JACOBS and MATT RICHTEL DEC. 11, 2017

SAN CRISTÓBAL DE LAS CASAS, Mexico — William Ruiz Sánchez spends his days
grilling burgers and slathering fried hot dogs with pepperoni and cheese at his
family’s restaurant. Refrigerators and fire-engine red tables provided by Coca-Cola
feature the company’s logo in exchange for exclusive sale of its drinks.

Though the Ruiz family sometimes eats here, they more often grab dinner at
Domino’s or McDonald’s. For midday snacks, they buy Doritos or Cheetos at Oxxo,
a convenience store chain so ubiquitous here that nutritionists and health care
advocates mockingly refer to the city as San Cristóbal de las Oxxos.

The family’s experience in food service began in the 1960s, when Mr. Ruiz’s
grandmother sold tamales and home-cooked food made with produce from a
nearby farm; those same ingredients sustained her boys with vegetable stews,
beans, tortillas and eggs. Meat was a luxury.

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

Since then, the Ruizes have become both consumers and participants in an
extraordinary transformation of the country’s food system, one that has saddled
them and millions of other Mexicans with diet-related illnesses.

It is a seismic shift that some nutritionists say has an underappreciated cause:


free trade.

Mexico began lifting tariffs and allowing more foreign investment in the 1980s, a
transition to free trade given an exclamation point in 1994, when Mexico, the
United States and Canada enacted the North American Free Trade Agreement.
Opponents in Mexico warned the country would lose its cultural and economic
independence.

But few critics predicted it would transform the Mexican diet and food ecosystem
to increasingly mirror those of the United States. In 1980, 7 percent of Mexicans
were obese, a figure that tripled to 20.3 percent by 2016, according to the Institute
for Health Metrics and Evaluation at the University of Washington. Diabetes is
now Mexico’s top killer, claiming 80,000 lives a year, the World Health
Organization has reported.

For many Mexicans, Nafta promised to make real “the fever dreams of joining
the modern economy,” said Timothy A. Wise, a trade expert at the Small Planet
Institute and Tufts University. “All former rural workers would be in new jobs in
the burgeoning manufacturing industries of the post-Nafta world. That just hasn’t
happened.”

“The only way that Mexico became a ‘first world’ country was in terms of diet.”

The phenomenon is not limited to Mexico. Research shows free trade is among
the key factors that have accelerated the spread of low-nutrient, highly processed
foods from the west, “driving the obesity epidemic in China, India, and other
developing countries worldwide,” according to the T.H. Chan School of Public
Health at Harvard.

But Jaime Zabludovsky Kuper, Mexico’s deputy chief negotiator on the pact,

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

said Nafta didn’t cause obesity. Instead, he said, it lowered food prices and reduced
malnutrition. In 2012, 1.6 percent of Mexican children suffered from severe
malnutrition, a sharp drop from 6.2 percent in 1988, according to government
data.

Mr. Zabludovsky said that Mexicans had long been enticed by American food,
and that high tariffs used to make it expensive, not unavailable. The economy is
now more stable, he said, and Mexicans are living longer — which is partly why
more people are dying from noncommunicable diseases like diabetes and heart
disease. “It’s a symptom of relative prosperity,” he said.

The broader pros and cons of Nafta have come under increasing scrutiny given
President Trump’s threats to dismantle it. Among its chief champions are
American farm and food-retailing interests whose fortunes have benefited
tremendously from the open market. Mexican exports to the United States have
surged, and a more stable economic structure has evolved in Mexico. The country’s
unemployment rate has stayed mostly constant, but average wages have fallen to
$15,311 in 2016 from $16,008 in 1994, according to the Organization for Economic
Cooperation and Development.

Critics of Nafta acknowledge the complex causes of obesity, but argue free
trade intensified the problem by opening Mexico’s largely isolated economy.

In addition to dramatically lowering cross-border tariffs, Nafta let billions of


dollars in direct foreign investment into Mexico, fueled the growth of American
fast food restaurants and convenience stores, and opened the floodgates to cheap
corn, meat, high-fructose corn syrup and processed foods.

The surge in agricultural investment from the north modernized Mexican farming
practices but it also displaced nearly five million people who worked on family
farms. Many migrated to cities, adding to the ranks of those who rely on Western,
processed food.

The top two grocery chains and most of the top food service outlets in Mexico
are American backed or partners with companies like Walmart, Subway and Pizza

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

Hut. Oxxo, the convenience store chain, is owned by Femsa, a Mexican food and
beverage conglomerate that received hundreds of millions of dollars in foreign
investment, helping it grow to 16,000 stores from 400 in 1990.

The Ruiz family followed a characteristic narrative, migrating from family


farms to cities and adopting the new American-style diet, not just as consumers but
as middlemen. They buy ingredients for their restaurant, including cheese,
mayonnaise and ground beef, from Sam’s Club, the members-only retail giant
owned by Walmart.

“I like that a lot of their meat comes from American cows,” said Mr. Ruiz, 28.
“It’s softer and fattier than meat from Mexican cows.”

Mr. Ruiz, at 275 pounds, and his older brother, Gabriel, at 300, are notably
overweight. Their parents’ diets have also changed: Two years ago their father
suffered a stroke brought on by hypertension, while their mother has diabetes.

Across the world, trade deals have made food more affordable and accessible.
A major selling point for the World Trade Organization, founded in 1995, was that
it would relax trade barriers so “food is cheaper” — though such deals can also
influence diet for the worse.

In 2007, Samoa, the South Pacific republic, banned the import of turkey tails, a
fatty, fried delicacy that nutritionists say has played an outsized role in the island’s
roughly 30 percent obesity rate. But when Samoa joined the World Trade
Organization in 2012, it was forced to lift its ban on turkey-tail imports.

Nafta’s impact has been far more pervasive. Direct United States investment
into Mexican food and beverage companies soared to $10.2 billion in 2012 from
$2.3 billion before Nafta, and the link to the trade deal is undisputed; the United
States Department of Agriculture states, “Many of these investments were initiated
following implementation of” Nafta.

The stark changes carried the Ruiz family along for the ride.

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

From farm to fast food


During a lull one recent evening at the their restaurant, Dogo Express, the
mother of William and Gabriel, Maricela Sánchez Espino, 62, reminisced about her
childhood. Her parents raised corn, zucchini, mushrooms, pigeons and rabbit, and
the family ate what they grew.

Her husband, Gabriel Ruiz Barbosa, 60, also grew up in rural Mexico. His
father, a farmer and beekeeper, was murdered, and his mother made ends meet
hawking homemade food.

Mr. Barbosa studied agricultural engineering, but Mexico was moving away
from its reliance on small family farms.

Until the mid-1980s, Mexico had been a protectionist, inward-looking


economy but a financial crisis in the early 1980s spurred talk of free trade to
stabilize the country, attract foreign investment and spur growth.

In 1986, Mexico gained entry into the General Agreement on Tariffs and Trade
— the precursor to the World Trade Organization — which lowered tariffs and
relaxed rules on foreign ownership of companies.

To its supporters, Nafta would complete the transition. “It was a change in the
economic model,” said Mr. Zabludovsky, the deputy chief negotiator. “We started
to seek the advantage of the geographical proximity to the United States.”

The agreement removed hurdles to cross-border investment and fully


eliminated Mexican restrictions on foreign majority ownership in Mexican
companies. The United States, Canada and Mexico became an open trading bloc.

Mexican exports of fruits and vegetables to the United States soared;


enormous quantities of the raw ingredients of processed foods flowed in the other
direction.

Last year, more than half the agricultural products exported from Mexico to
the United States were fruits, vegetables and juice, while these foods made up only

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

7 percent of what the United States exported to Mexico, according to the United
States Department of Agriculture.

United States exports to Mexico have been dominated by meat, soybeans and
corn. The average annual value of grains crossing into Mexico jumped to $4.7
billion in 2016 from $897 million before Nafta. Pork and beef exports also surged
during the same period; exports of high-fructose corn syrup jumped to $345
million annually from $5 million.

After Nafta, Mexican farming became more efficient, but also contributed to a
major shift in how the industry was structured. Overall paid employment of farm
workers rose by 2.8 million but there was a displacement of 4.8 million people who
left family farms, according to a study by the Woodrow Wilson Center that has
been cited by some Mexican officials as evidence of Nafta’s imperfections.

Duncan Wood, director of the center’s Mexico Institute, said falling food
prices, coupled with a stagnant economy, have left many Mexicans in a curious
economic position. “People are able to indulge in more processed food, consuming
more calories,” Mr. Wood said, “but not rich enough to have an affluent lifestyle
where they are able to be healthier.”

So went the Ruiz family. As a boy, William Ruiz adored home-cooked meals
like traditional thick stews with squash, carrots, potatoes and green beans. The
family rarely ate out.

But when he was 11, the family moved to Villahermosa, the bustling, heat-
scorched capital of Tabasco where American fast-food joints had become plentiful.
The Ruizes became avid patrons of Domino’s and Burger King. McDonald’s was
their favorite.

William savors the memory of his first Happy Meal — the crispy fries, chicken
nuggets and toys nestled in the box. “It was like having something first-world on
your uncivilized ranch,” he said, “It was beautiful.”

In 2012, after the bar they owned in Tabasco went out of business, the family

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

moved to San Cristóbal and opened Dogo Express.

The sons began to put on considerable weight in their late teens but the elder
Mr. Ruiz was not worried. In fact, it was a point of pride. “We were in a good
financial position so we could offer them foods heavy in protein and also fast food,”
he said. “We’d say to one another, ‘If they’re a little fat, it means they’re well fed.’”

Rise of the chains


On a recent Sunday, the Ruiz brothers went to Sam’s Club to stock up for the
restaurant. They like the expansive meat section with marbled beef that is often
cheaper than the sinewy cuts sold by local butchers.

They are in good company. A study published in 2015 found that Mexicans
bought, on average, 1,928 calories of packaged food and beverages a day, 380 more
calories than in the United States and more than people in any other country
tracked by Euromonitor International, a market research firm.

While the causes of obesity are complex — involving genetics, lifestyle changes
and other factors — multiple studies have linked weight gain to consumption of
processed foods high in salt, sugar and fat that are staples of retail giants.

In 1991, as negotiators hammered out Nafta’s details, Walmart made its first
foreign investment by partnering with Mexico’s largest retailer, Cifra.

In 1997, Walmart paid $1.2 billion for a controlling stake in Cifra. Walmart is
now Mexico’s largest food retailer.

Oxxo is second in grocery market share. It is also the largest convenience store
chain, with a 75 percent market share, according to Euromonitor.

Although Oxxo is owned by Femsa, a Mexican company, it has significant


outside investment. In 1993 Coca-Cola purchased one-third of Femsa’s soft-drink
unit for $195 million, not long after PepsiCo had announced it would spend $635
million to expand in Mexico. Then, in 1994, the Canadian brewing company Labatt

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

invested $510 million in Femsa’s beer business.

The money gave Femsa capital to buy down debt, helping it grow.

“Money flowed south. It’s one of the reasons the growth of these foods is so
fast in these countries,” said Corinna Hawkes, director for the Centre for Food
Policy at City University London and an expert on trade policy and nutrition.
“Oxxo is exactly the kind of thing we’re talking about.”

Such products are core to Oxxo’s success. In its 2003 annual report, for example,
Femsa boasted that Oxxo had become “the largest vendor of beer and soft drinks,
as well as telephone cards, cigarettes and bottled water.”

Javier Astaburuaga, Femsa’s chief financial officer for 11 years, dismissed the
role of free trade in the rise of obesity, saying unhealthy eating habits were taking
hold before Nafta. He attributed Oxxo’s growth to its aggressive corporate strategy,
not free trade, though he conceded that outside investment gave the company a
stronger financial footing to grow all its divisions, including Oxxo.

In a twist, the trust that manages money for the Bill & Melinda Gates
Foundation, one of the largest public health philanthropies, is the biggest outside
investor in Coca-Cola Femsa, which is the largest Coke bottler outside the United
States. Critics say the trust’s investment, currently valued around $470 million, is
at odds with the foundation’s mission statement to “help all people lead healthy
productive lives.”

Dr. Wise, from Tufts, said the investment sounded like “a classic paradox —
give with one hand, take with the other.”

A spokesman for the Bill & Melinda Gates Foundation Trust declined to
comment.

In 2012, Dr. Hawkes co-authored a paper on the impact of free trade on


Mexico’s diet. The study, “Exporting Obesity,” found that the increased investment
by United States companies had made soft drinks and processed food more

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

accessible to the average Mexican.

She concluded that, at a minimum, Nafta had sped up Mexico’s dietary


transition and the rise of obesity.

The impact is a variation on what was feared by Zapatista rebels who swept
into San Cristóbal on New Year’s Day 1994, the day Nafta took effect, burning
military barracks and occupying government buildings.

“They said it would be bad,” said Juan González Hernández, 64, a community
leader in San Juan Chamula, a farming community near San Cristóbal, “but we
didn’t believe them.”

These days, he said, diabetes touches most households, and locals seem more
enamored by processed food and soda than the fruits and vegetables that grow all
around them.

“American food and products dominate our lives,” said Mr. González, who is
also diabetic. “Everyone is sad about the changes but, at the same time, we still go
to Sam’s Club and McDonald’s.”

The Ruiz family shared his sentiments.

“I know this stuff is bad for me, but I can’t stop,” Gabriel Ruiz Barbosa said,
glancing at a tray of McDonald’s sundaes his son was carrying into the restaurant.
“My cardiologist says I should look after myself but I’m very stubborn.”

His son drinks Coke compulsively and suffers from high blood pressure and
achy joints. “I’m afraid that one day I’m going to have a heart attack and die,” he
said.

The family has mixed feelings about open trade. Their tenuous prosperity is
built on selling food from the United States, and their diet is both sustenance and
curse.

“Look at us,” the elder Mr. Ruiz said, as he sheepishly polished off the remains

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A Nasty, Nafta-Related Surprise: Mexicoʼs Soaring Obesity - The New York Times 12/11/17, 7'47 PM

of a chocolate sundae. “We’re all educated people but we’re hooked.”

Oscar Lopez contributed reporting from San Cristóbal, and Albinson Linares from
Mexico City.

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