Epidemiological and nutritional transition in Mexico: rapid increase Bellagio Conference in Nutrition Transition Epidemiological and nutritional transition in Mexico: rapid increase of non-communicable chronic diseases and obesity Juan A Rivera, Simón Barquera, Fabricio Campirano, Ismael Campos, Margarita Safdie and Victor Tovar Centro de Investigaciones en Nutrición y Salud Instituto Nacional de Salud Pública (México) August, 2001 Rivera et al., Public Health Nutrition, Feb 2002

Context, objective and sources of information Epidemiological transition in Mexico Retarded variant of the Transition Model Polarization Undernutrition principal concern in past No major efforts to address emerging NCCDs and obesity until recently Objective: Characterize epidemiological and nutritional transition and their determinants in Mexico Sources of information: Mortality registry from 1980-1998, National Nutrition Surveys 1988 and 1999 National Chronic Diseases Survey National Income and Expenditure Surveys 1984-1998

Relative change in age adjusted mortality rate from non-communicable chronic diseases in Mexico (1980 – 1998) % change in age-adjusted mortality Rivera J, Barquera S et al. The epidemiologic and nutrition transition in Mexico: rápid increase of obesity and chronic diseases, Bellagio Conference in Nutrition Transition, Belaggio, Italy 2001

Regions

Overweight and obesity in women 18-49 y (1988-1999) 33.4 vs 59.6 38.1 vs 65.3 29.1 vs 58.6 34.8 vs 59.1 30.5 vs 55.3 * Mexican National Nutrition Surveys I (1988) and II (1999), Health and Nutrition Research Center, Mexican National Institute of Public Health.

Changes in relative contribution of macronutrients to total energy intake in Mexico % 1988 1999 1988 1999 1988 1999 1988 1999 1988 1999 North Central Mexico City South National

Change in quantity of food purchased by food groups relative to 1984 in Mexico (1984-1998) Rivera J, Barquera S et al. The epidemiologic and nutrition transition in Mexico: rápid increase of obesity and chronic diseases, Bellagio Conference in Nutrition Transition, Belaggio, Italy 2001

Change of quantity of sugars purchased relative to 1984 by region in Mexico (1984-1998) Rivera J, Barquera S et al. The epidemiologic and nutrition transition in Mexico: rápid increase of obesity and chronic diseases, Bellagio Conference in Nutrition Transition, Belaggio, Italy 2001

Change relative to 1984 and quantity index of soda purchased by region in Mexico (1984-1998) Rivera J, Barquera S et al. The epidemiologic and nutrition transition in Mexico: rápid increase of obesity and chronic diseases, Bellagio Conference in Nutrition Transition, Belaggio, Italy 2001

What is the Government doing?

Reduction of prevalence of diabetes mellitus (DM) Selected lines of action for emerging problems in the National Program of health Reduction of prevalence of diabetes mellitus (DM) 8.2% of population 20-69 has diabetes: 4.8 millions (only 1.4 diagnosed) Control of CVD and high blood pressure (HBP) Over ¼ of adults have hypertension and ½ of them are not aware Attention to cancer Mortality due to several types of cancer are increasing Reduce addiction to tobacco, alcohol and drugs Use increased substantially in last decades

Common actions to prevention and control of DM, CVD, and HBP Promotion of healthy lifestyles Prevention of obesity Early identification of at risk patients Early diagnosis and control of conditions Mass communications program to promote prevention and treatment Support groups of patients and their families for control of diseases