LETTERS TO THE EDITOR
Consumption of healthy beverages in Mexico*
Dear Editor: The Recomendaciones for the Mexican population on beverage consumption for a healthy life are a step in the right direction in the effort to effectively reduce the increasing consumption of sweetened drinks and sodas, which undoubtedly contributes to epidemics of obesity and chronic diseases. I emphasize effectively because the recommendations go further than to merely describe the terrible invasion of sodas, which, between 1999 and 2006, became the main source of liquid calories for all age groups in all social strata in Mexican society. An unfortunate and less than meritorious commercial success on a global scale.2
The essence of the Recomendaciones, in an attempt to balance theory and practice, could be the following: water is vital and should be the most important source of liquids consumed in a day (52% of the recommended ~2500 ml); if one drinks coffee, it is reasonable to drink up to 3 cups (20%) without sugar; and finally, when it comes to milk, skim or reduced fat milk is preferable (15%). It is easy to say these things, but, without a doubt, we have before us a formidable task. The Recomendaciones... are not only a public service announcement (leaving the responsibility on the shoulders of individuals) but are accompanied by instruments of public policy, three of which deserve special mention.
First: water, which receives major attention in the section "Suggested guidelines". In this section it is suggested that in schools, buildings and public programs drinkable water be available to all. We are faced with a battle that will be won not only with regulations such as prohibitions on the sale of sweetened drinks and sodas in schools but will require bringing water back into the consciousness, convenience, economy and palate of the Mexican population. In many Latin American countries the beverage industry took advantage of the cholera epidemic at the beginning of the 90's and the fear of tap water, to introduce bottled water and sodas with aggressive marketing. Potable tap water lost its standing and fell out of favor. It is now necessary to raise it up and turn it into the irresistible first choice when deciding what to drink. This requires, of course, not only political will and coordination among sectors, but also unquestionably pure water and good marketing.
Water is also a renewable resource which has a life cycle and whose flow is not limitless. It is a public good that requires protection and investment in order to preserve it. Bottled water is not an option for personal or environmental health, and for this reason, many national and local governments have established legislation to limit its use and promote potable tap water. This is occurring in the United States of America, Italy, Denmark, Canada, France, England, and Australia.3
Second: given the nutritional importance of milk, it is imperative to do what others have done without complications and melodrama: to change the relative prices and to make whole milk the same price as skim milk. The same should be done with yoghurt.
Third: the above recommendations rightly chose to include regulatory measures such as taxes ("taxes for each gram of sugar added to beverages...") and incentives for industries and institutions such as schools which adopt these recommendations. Regulations on obligatory labeling, on health claims associated to a product, and on commercial advertising are also crucial factors in this effort. Not necessarily because it is an imperative to use the stick in reality many in the industry agree to change but because establishing rules for everyone makes for a competitive and more efficient market.
Enrique Jacoby MD, MPH
Healthy Eating & Active Living,
WHO, Washington DC.
1. Rivera JA, Muñoz-Hernández O, Rosas-Peralta M, Aguilar-Salinas CA, Popkin BM, Willett WC. Consumo de bebidas para una vida saludable: recomendaciones para la población mexicana. Salud Publica Mex 2008;50:172-194.
2. Barquera S, Hernández-Barrera L, Tolentino ML, Espinosa J, Ng SW, Rivera J, et al. Energy Intake from Bevarages is Increasing among Mexican Adolescents and Adults. J Nutr 2008;138:2454-2461.
3. Gies E. Is water a human right or a commodity? WorldWatch 2009;22(2):22-27.
* Originally published in Spanish in Salud Publica Mex 2009;51(3):177