美国国家公共电台 NPR Pork Tacos Topped With Fries: Fuel For Mexico's Diabetes Epidemic

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Global diabetes 1 rates have been increasing dramatically over the past 20 years. In Mexico, 14 percent of adults now suffer from diabetes. It is, in fact, the leading cause of death there, and it's having a huge impact on Mexico's health care system, as NPR's Jason Beaubien reports.

UNIDENTIFIED MAN: (Speaking Spanish).

JASON BEAUBIEN, BYLINE 3: Part of what's driving Mexico's diabetes problem is that it has an abundance of incredibly rich and inexpensive food.

ANAIS MARTINEZ: So this is the deep-fried tamale that I was telling you about.

BEAUBIEN: Anais Martinez is showing me a pyramid of tamales wrapped in corn husks next to a bubbling cauldron of oil.

MARTINEZ: And we are in Merced Market, which is the second-biggest market in the city, Mexico City.

BEAUBIEN: Martinez is a designer in the Mexican capital.

MARTINEZ: I was born here. I grew up here.

BEAUBIEN: She also studied gastronomy 4 here and now moonlights giving street food tours. She's pointing out a bulging 5 tamale sandwich that costs 10 pesos or roughly 50 cents.

MARTINEZ: So, you know, they're just like a corn dough 6 patty mixed with lard, and then they put it inside the corn husk or the banana leaves, steamed and then after they've done all of that, they deep fry it.

BEAUBIEN: And when it comes out of the fryer, they stick it in a white bread bun to make a sandwich.

MARTINEZ: So it's just like carbs and carbs and fat and fat. But yeah, it's actually really good.

BEAUBIEN: Rich, fatty street food like this is available all over Mexico at bus stops, at schools, on street corners and is affordable 7 to the masses. This is part of what's driving Mexico's burgeoning 8 diabetes epidemic 9.

UNIDENTIFIED WOMAN: (Speaking Spanish).

BEAUBIEN: One of the country's top nutritionists says that for roughly two hours a day, Mexicans can afford a diet heavy in carbohydrates 10, sugar and fat that delivers way more than the U.N.'s recommended daily intake 11 of 2,000 calories. A study in 2015 showed Mexico to be the leading consumer of junk food in Latin America. In addition to the rich tacos and kilos of processed food, Mexicans love to wash down their meals with a soda 12 or an agua fresca, a sugary fruit drink ladled out of massive, five-gallon glass jars.

MARTINEZ: It’s not just the actual fruit. It’s fruit, water and lots of sugar because they have to compete with Coca-Cola in everyone’s taste buds.

BEAUBIEN: Until just recently, Mexico was the largest per capita consumer of soda in the world. That dubious 13 distinction now falls to Argentina with the U.S. and Chile not far behind. Excessive body fat is one of the main contributors to the onset 14 of Type 2 diabetes, and obesity 15 rates have been climbing steadily 16 in Mexico. Now the country is one of the most overweight nations in the world, coming in just behind the United States. Mexican health officials are well aware of the problem. Late last year, the health minister declared diabetes to be a public health emergency. It was the first time Mexico has ever made such a declaration that wasn't targeting an infectious disease.

CARLOS AGUILAR SALINAS: This new facility is focusing diabetes and metabolic 17 disorders 18.

BEAUBIEN: At the National Institute of Medical Sciences and Nutrition in Mexico City, Dr. Carlos Aguilar Salinas is walking through a brand-new research and treatment complex for diabetes.

SALINAS: Diabetes is one of the biggest problems in the health system in Mexico. It's the first cause of death. It's the main cost for the health system.

BEAUBIEN: Treating a patient with a severe case of diabetes in Mexico, he says, can cost upwards 19 of $40,000 a year. But the bigger problem, Aguilar says, is that the Mexican health system isn't prepared to treat the sheer number of complex diabetes patients that are showing up in its clinics every day.

SALINAS: The Mexican system, health system, is very efficient to treat infectious disease. However, for chronic 20 disorders, which education, continuous care, it's much more complex than the infectious disease approach.

BEAUBIEN: Recognizing the huge task of treating diabetes, Mexican officials are putting much of their efforts into trying to prevent it. In 2014, the country slapped a controversial five-cents-per-liter tax on soda that started to put a dent 2 in consumption. There were also new rules limiting advertisements for junk food. New public service announcements encourage people to exercise more. And there's a major push to restrict what foods are allowed to be sold in schools. The head of the World Health Organization's office in Mexico City, Dr. Gerry Eijkemans, says Type 2 diabetes didn't used to be much of a problem in the region.

GERRY EIJKEMANS: It used to be a disease of the rich, you know? In Western Europe and in the U.S., it was really the people who had the money who were obese 21 and overweight, and now it’s actually the opposite.

BEAUBIEN: And now, public health officials in Latin America have to pivot 22 to deal with this complex, chronic disease.

EIJKEMANS: In order to prevent an infectious disease, you, you know, eliminate or you reduce the mosquitoes, and you're basically done, you know, not that it's easy, but it's much easier than to change the way society is basically organized and encourages people to consume unhealthy, high-caloric food with lots of fats and sugars.

BEAUBIEN: An article earlier this year in the medical journal The Lancet warned rising levels of increasingly severe obesity mean that worldwide populations are on the brink 23 of a catastrophic epidemic of diabetes. In Latin America, Mexico isn't on the brink of that epidemic. It's already there. Jason Beaubien, NPR News, Mexico City.