Over several decades, there has been a dramatic shift in the way the world eats, drinks and moves. Globalisation has contributed to multinational companies spreading ultra-processed foods high in fats, sugar and salt into low- and middle-income countries, displacing healthier traditional diets, and bringing with them an increase in diet-related type 2 diabetes. But there are wise and caring leaders doing something about it.

Since 1980, the prevalence of diabetes has quadrupled. This alarming rise is not an isolated phenomenon – it has been accompanied by an equally dramatic change in diet and physical activity. As people move less and diets become dominated by ultra-processed foods and beverages, diabetes, together with obesity and hypertension – two key risk factors for diabetes – are skyrocketing. Today, diabetes is one of the top ten causes of death globally. There are 537 million adults living with diabetes – that’s 1 in 10 people. This number is predicted to rise to 643 million by 2030 and 784 million by 2045.

While countries have committed to  a globally agreed target to halt the rise in diabetes and obesity by 2025, the diabetes epidemic continues to worsen, and it’s our children in particular who are at significant risk of a sick future. This is especially true of low- and middle-income countries – where over 80% of all deaths from diabetes take place, but this chronic disease is prevalent in every country. Mexico is one of the most worrying cases. About 73% of the Mexican population lives with overweight or obesity - compared to 20% of the population in 1996. Diabetes prevalence has risen in parallel, catapulting the government into action to halt the rise. Many Mexican states are also stepping up to protect their communities with novel initiatives to promote child health.

Bold action in Mexico leads the way

During the summer of 2020, in the southern state of Oaxaca, some Indigenous communities physically blocked roads to trucks delivering processed foods and beverages so that people could return to healthy, traditional diets. Shortly after, the Oaxaca government passed legislation banning the sale of junk food to minors. Tabasco quickly followed suit, and many other states are now preparing to do the same. Mexico’s Federal Senate has also been emboldened, recently passing a nation-wide law that will prohibit junk food from being included in school meals and make it illegal to sell junk food in the vicinity of school facilities. The new law will also proactively support the establishment of healthy food outlets, and other countries, like South Africa, are being urged to introduce similar junk food and drink sale bans in schools to promote healthy school environments which nurture children’s bodies and brains.

These efforts to reign in the junk food industry’s modus operandi is a hard, long-term battle, and implementation of new laws often presents other hurdles, but Mexico has a track record of success in its determination and tenacity when taking bold actions to protect child health, and with patience other jurisdictions are similarly seeing the fruits of their investments NCD prevention. One courageous initiative in particular is producing successes in Mexico and around the world. Over the past decade, more than 50 jurisdictions have introduced taxes on sugary drinks, not only deterring people from buying those harmful products but potentially raising revenue for public health promotion efforts.

*NCD Alliance acknowledges support from Resolve to Save Lives in the production of this video.

Many small wins = big global change

30 countries around the world now require front-of-package labelling for foods high in fats, salt and sugar, with Argentina being the most recent and joining Mexico, Peru, Chile and Uruguay in the region with similar legislations. Front of pack labels are different in every country – for example Chile uses black stop signs, France uses a ranking from A to E, and Australia uses stars – but the effect is the same everywhere: providing consumers with easier to understand information about what is in the food they eat, to help them make healthier choices at the supermarket.

Some countries are also limiting the marketing of unhealthy food products to kids. The United Kingdom, Sweden, South Korea, Taiwan, Chile and Mexico are among those with national policies that limit or prohibit junk food marketing and advertising to protect children. The UK government approved a law that will come into effect in late 2022 banning all TV and online advertising of junk food before 9pm – one of the reasons cited for this powerful new public health measure was that COVID-19 has highlighted the importance of preventing obesity and related disease like type 2 diabetes. Just last month Spain’s Minister of Consumer Affairs announced a ban on advertising of junk food targeting children under 16 years of age, reinforced by Barcelona’s city Mayor introducing city-wide limits on junk food and drink advertisements in public spaces.

Reducing type 2 diabetes and other diet related NCDs requires every country to do more to promote good nutrition and healthy diets for all. The pandemic has been a wake-up call, and shown that investing in NCD prevention simply can’t wait. It’s the constellation of circumstance and courageous leadership that will – must - help us save our children from a sick future. Battling the powerful system forces making us sick may feel like a case of David versus Goliath, but we are seeing more and more leaders stepping up to the challenge, committed to promoting and protecting health for all their people – the biggest question now is – who will be the next leader to turn nutrition commitments into the strongest of actions?

About the author

Lucy Westerman (@lewest) is Policy and Campaigns Manager at NCD Alliance. Lucy leads NCD Alliance’s NCD prevention and health promotion policy activities, particularly focusing on alcohol, nutrition, physical activity, and cross-cutting issues such as the influence of social, commercial and environmental determinants on health.