Demonstrating that it is possible to attain the ideal, civil society and the Mexican government reached a legislative consensus to remove trans fatty acids from the food supply in Mexico.

Faced with a clear epidemic of chronic diseases, and with health systems under serious pressure and lacking resources, the elimination of industrially-produced trans fats, which are unnecessary, health-harming chemicals that do not provide any benefit, from the diet of Mexicans, is cause for celebration. Above all, because it has been jointly achieved, with the government listening to the voices of a committed civil society, and responding to their calls and demands for the right to health.

After a strong campaign led by Mexican civil society, the country's legislators - Senators in 2021 and Deputies in 2023 - unanimously approved the law for the elimination of industrially-produced trans fatty acids (iTFA) from the Mexican food supply.

As part of that activist civil society, and having accompanied Mexican organisations in their intense advocacy campaign since 2018, we celebrate this great step to guarantee healthier food environments that protect the health of the population. And, in particular, for those of us who are part of the NCD Alliance (NCDA), it has been a clear example of the importance of coordinating global organizations such as ours, with national alliances such as the México Saludhable Coalition, joining efforts to improve population health. The support and collaboration of NCDA together with the commitment and hard work of México Saludhable throughout this process has demonstrated the importance of strengthening these ties to accelerate political processes for the NCD prevention agenda.

A united and coordinated civil society is key to the success of political advocacy strategies. It is essential to integrate the academic community and health organisations so they can support political processes with scientific evidence and work to gain commitment from legislators to put these issues on the agenda, and carry out communication campaigns that generate more support from the general population.

Overcoming differences to promote health

The WHO guidelines for the elimination of trans fatty acids (known as REPLACE) highlight the importance of raising awareness among the population, producers and regulators of the benefits of prohibiting or minimizing the use of iTFA. The Mexican civil society campaign, which began in 2018 in line with the REPLACE initiative, focused on raising awareness of the damage caused to health by these trans fatty acids, which cause 20,000 preventable deaths per year in Mexico.

The campaign, led by Salud Justa and the México SaludHable Coalition, managed to bring scientific evidence with no conflict of interest to the forefront, convince allies and opponents, and generate space for public deliberation to support a parliamentary process that legislators approved. These efforts, in a government-civil society collaboration, helped push through the change in public policy.

In a context of intense political polarization in Mexico, legislators of all parties reflect the triumph of public health on their social networksn in a unanimous message that "we are capable of overcoming differences in the interest of the health of millions of Mexican men and women".

The Mexican legislative ruling defended the decision, determining that high consumption of trans fats increases the risk of death from any cause by 34%; the risk of death from coronary heart disease by 28%, and with a 21% higher probability of coronary heart disease, as well as a 7% increase in deaths from ischemic cerebrovascular disease and a 10% increase from diabetes.

Such a widespread impact on the health of the population is due to the fact that industries add trans fats to everyday products, which are cheap because of their poor quality. They add them to microwave popcorn, to some types of bread and fried foods, to margarine, to the whipped cream of your favorite coffee, to ice cream...

Despite the fact that consumption has been known for over 50 years to damage health, the food industry adds iTFA to products because they extend shelf life, resist temperature changes and are low cost. However, of all the current dietary risk factors for cardiovascular disease, it is the easiest to eliminate, since there are healthy alternatives.

As WHO Director-General Dr Tedros Adhanom Ghebreyesus has warned, trans fats, in addition to having no benefits, "generate enormous costs for health systems."

The campaign for consensus

In 2021, with the Salud Justa team and the México SaludHable Coalition, we established a valuable collaboration with the Senate of the Mexican Republic, specifically with the Health Commission, who were provided with technical advice on the regulation of industrially-produced trans fatty acids. In addition, with the support of Resolve to Save Lives and the NCD Alliance, we organized forums that included key stakeholders from the Mexican Ministry of Health and the Pan American Health Organization regional and Mexican offices.

As a starting point, we built on an analysis of trans fats, based on the National Survey of Health and Nutrition. This analysis highlighted how Mexico was at a competitive disadvantage by not having a ban on partially hydrogenated oils, as in the United States and Canada. An analysis was also carried out on the conversion cost for industries of trans fats elimination.

In parallel, communication objectives were defined: for consumers to choose foods without trans fats, for industries to use raw materials without trans fats and accept their elimination, and for government regulators to overcome traditional objections to the removal of iTFAs from the food supply.

Other countries such as Denmark and the European Union have already passed legislation in this regard; and in the region, Chile, Uruguay, Peru, Brazil and Argentina have acted to eliminate trans fats. In Mexico, the national government, producers, and civil society worked together to reach an agreement and put an end to practices that make the population sick. The approved ruling adds article 216 Bis to the General Health Law and determines that "oils, edible fats, food and non-alcoholic beverages may not contain partially hydrogenated oils", the substance that trans fats are made from. In addition, they may not contain more than two parts of iTFA for every 100 parts of normal fat.

This is a milestone that strengthens civil society and motivates us to continue working through dialogue, with evidence, and with participation towards health that is more equitable, accessible and fair for all people.

The México SaludHable coalition launched its campaign to eliminate industrially-produced trans-fatty acids from the Mexican food supply in 2020, with the support of the NCD Alliance through its partnership with Resolve To Save Lives.

About the authors

Lorena Allemandi (@LorenaAllemandi) is Senior Manager of Capacity Development for the NCD Alliance (@ncdalliance) and is responsible for the Advocacy Institute. She is a recognized NCD prevention activist, with experience in tobacco control and healthy eating policies. She was a researcher at FIC Argentina between 2009-2012, principal investigator of numerous research projects, and author of several scientific publications. She was director of the Healthy Eating Policies Area at FIC Argentina from 2012 to 2020 and consultant to the regional office of the Pan American Health Organization (PAHO), from 2020 to 2022. Since 2021 she has been a consultant at the NCD Alliance working on the issue of iTFA elimination and supporting global and national advocacy work in Mexico and Pakistan, as part of the NCD Alliance partnership with Resolve to Save Lives. Lorena lives in Argentina.

Erick Antonio Ochoa (@eantonioochoa) is currently the director of Salud Justa Mx and co-coordinator of the México Saludhable Coalition (@MxSaludHable). He is the former Director of Initiatives for Tobacco Control of the Inter-American Heart Foundation Mexico (2010 to 2019). He has presented papers on tobacco control policies in Argentina, Colombia, Costa Rica, Panama, Peru and Uruguay. He has also held various positions within the Mexican government. Born in Chiapas, Mexico, Erick has a degree in Political Science from the Universidad Autónoma Metropolitana Iztapalapa and a master's degree in Administration and Public Policy from the Center for Economic Research and Teaching.