MEXICO CITY — One recent Sunday afternoon, music blared from a set of huge speakers and filled the streets of Mexico City's leafy Avenida Paseo de la Reforma. A dance instructor in a powder blue suit stood high on a stage before 30 or so people — mostly women dressed in jeans — leading them through a vigorous workout disguised as a dance routine.
Bicyclists snaked through the crowds, maneuvering around the dancers. Some were dressed in race gear; others pedaled leisurely through the streets with family or friends.
Among them was 13-year-old Mariana Colores, in a bright yellow Nike tracksuit with iPod headphones plugged in her ears. Mariana rides with her father and sister. Her mom, a spunky little woman dressed in spandex and T-shirt, comes for the dancing.
"My mom's been coming for a while," Mariana said. "Me, I do this mainly for fun, but to stay healthy, also. But, for many people, this is the way to get them outside doing something."
Mariana is one of thousands who participate in Mexico City's "Muevete y Metete en Cintura" campaign — "Move and Get in Line" — an exercise program aimed at the obesity epidemic in this country of 110 million people.
While the biking and other exercise attract many, physicians and nutritionists lament the fatness of Mexico.
"Anyplace you look in Mexico, there's an obese person," said Dr. Claudia Sanchez-Castillo, an obesity specialist at the Salvador Zubiran National Institute of Medical Sciences and Nutrition in Mexico City.
Mexico has the dubious distinction of the world's second fattest country, behind only the United States.
According to a 2006 study by the National Institute of Public Health, 24 percent of the male population older than 20 and 35 percent of the female population older than 20 is considered obese in Mexico. By comparison, a 2006 study by the U.S. Centers for Disease Control and Prevention found that 31 percent of the male population and 35.3 percent of the female population in the United States is obese.
With obesity comes a hefty price tag of other diseases, particularly diabetes. Often referred to as the rich country's disease, diabetes is now the leading cause of death in Mexico.
"Diabetes, hypertension, these used to be diseases of the rich, and now they are of the poor," said Dr. Abelardo Avila, a malnutrition specialist at the Zubiran institute. "It's the democratization of diseases in Mexico."
As Mexico's battle against obesity and diabetes intensifies, however, the country still faces a longtime enemy: malnutrition.
Experts blame the typical Mexican diet for this double whammy of diseases.
On nearly every corner, Mexicans huddle around street vendors and wait for their five-minute fix: tacos and tortillas stuffed with cheese melted on top of beef or chicken that's cooked in animal fat, or perhaps a pancake drowning in caramel sauce that's doused with rainbow sprinkles.
Wash it down with a cool "refresco" such as Coca-Cola, and have a taste of Mexico's sugar-crazed culture.
"The new generation is what I call the 'ketchup generation,' " said Dr. Hector Bourges, nutrition director at the Zubiran institute.
As the "ketchup generation" tries to satisfy its sweet tooth, the health of rich and poor alike decays.
"It's a fictitious image that malnutrition is improving in Mexico. Not all areas of the country are improving," Avila said, referring to the malnourished population of Mexico's poor southern states. "But, even so, as malnutrition decreases, obesity increases. There's no happy medium."
Even so, the battle against these twin plagues has taken a back seat to what Mexico considers a more pressing public health concern. The drug wars in Mexico's border areas — some 7,000 people are said to have perished in the last year — have grabbed the government's attention.
"Violence is the number one priority right now, and with this, everything gets left behind," Sanchez-Castillo said.
She said she thought that the widespread fear of violence had made people reluctant to leave their homes, and that "there are no safe places to exercise ... and people are afraid to walk around outside alone."
The drug war isn't the only problem.
As the number of Mexican women working outside the home increases, so does the country's reliance on fast food. Street vendors offer their alternative to a famous McDonald's combo: a torta de tamal, referred to as "fried carbs wrapped in carbs," or greasy tacos al pastor.
"There's so many options to eat unhealthy in Mexico, and everything is cooked in animal fat," Sanchez-Castillo said. "People consume more refrescos than water."
Not only do Mexicans prefer the taste of Coca-Cola, she said, it's also much cheaper than bottled water, which they have to buy because the country's running water isn't safe to drink.
According to a report published by the Journal of Nutrition last year, Mexico is the second-largest consumer of soda in the world, having consumed more than 16 billion liters, about 4 billion gallons, in 2005.
"The mothers of poor families in the south see these Coca-Cola ads, and they put the Coca-Cola in babies' bottles in addition to or in place of milk," Avila said.
Many of the poor southern areas have towns made up solely of women, Avila added. The men have left to work in the United States, and the women are left to do the hard labor such as working in the fields.
"At the end of the day, they are tired, and instead of cooking a meal they will just walk up the road to grab quick food for the family," Avila said.
Over the past 40 to 50 years, Mexico has tried a variety of programs to combat its health issues, but there's never been a sustained effort, the doctors said.
"Health programs change in Mexico each time the government changes," Avila said. "For example, in Costa Rica or Chile, there have been continued programs and actions, and 20 years ago they eradicated malnutrition."
Mexican programs do provide free food for kids in poverty or basic food packages, Avila said.
However, "It's a naive vision to think malnutrition will be solved by just giving food away," he said.
(Petri graduated this month from Penn State University. This story was reported from Mexico City for a class in international journalism.)
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