BUENOS AIRES – María was diagnosed as obese when she was five years old. The doctor warned her parents that if her eating habits didn’t change, the little girl was at risk of diabetes and, later in life, of heart disease.

“Every day after school I would go by the kiosk and get her whatever she wanted,” said María’s mother, who asked that her daughter’s name be changed to protect her identity. “Then, when her father came home after work, he would bring her a bag full of sweets. She would fill herself up with all those snacks and skip dinner. We didn’t realize it was a problem until she was diagnosed.”

María is one of the 350,000 children in Argentina estimated to be suffering from overweight and obesity. At 9.9 percent, the country has the highest rate of childhood obesity in all of Latin America and the Caribbean. And according to government estimates, overweight and obesity are responsible for 44 percent of diabetes cases in the country, 23 percent of ischemic heart disease cases, and 7 to 41 percent of cancer cases.

The gravity of this issue led the Argentine government to announce a comprehensive plan in 2016 to address the growing overweight and obesity rates among the country’s youngest citizens. Taking a comprehensive approach, the government has borrowed program ideas from neighboring countries that range from better nutritional labeling to taxes on sugary beverages and other foods with limited nutritional value.

María’s mother was quick to take advantage of several of the new initiatives. She signed her daughter up for a special nutritional treatment and transferred her to a school in the south of the city. The new school has a “healthy kiosk” – an initiative put forward by the Buenos Aires city government to increase the offering of healthy snacks in schools. Instead of buying sweets and alfajores cookies, María can now choose from a diverse array of healthy snacks, including bananas, apples and dried fruit.

While advocates applaud these efforts, they are pushing the government to go further. They are seeking legislation that would support many of the initiatives outlined in the plan and ensure that if they come into conflict with business interests, for instance, child nutrition is protected.

A Multi-Component Plan

Argentina’s health ministry introduced the National Plan for Healthy Diet and Prevention of Obesity in 2016. The idea, as health minister Adolfo Rubinstein explained at a recent event, was to “to create a multi-component strategy with the different ministries that includes education, awareness and social marketing in order to prevent overweight and obesity.” Children form a special focus of the effort.

Some of the specific policies outlined in the plan include reaching industrywide agreements to reduce sugar and sodium levels in processed foods, promoting healthy diets and more physical activity in schools, training municipalities to create their own healthy food programs and promoting additional research into what is driving the rising obesity rates.

Experts agree this is the right approach, acknowledging that there is no single answer to reducing childhood obesity.

“We can’t attribute the rise of childhood obesity to people’s individual decisions,” said Sebastián Laspiur, a national consultant on noncommunicable diseases for the Pan American Health Organization, the regional office for the Americas of the World Health Organization. “There are a variety of factors that have led to this crisis… The government has realized this and has come up with a substantive and comprehensive plan to address all these facets of the issue.”

Because the plan is still relatively new, a number of its components are still being designed. But some initiatives are well under way. In Buenos Aires, for instance, more than 213,000 students like María already have access to healthy kiosks in their schools.

Another area of particular focus has been an attempt to limit the advertising of unhealthy foods specifically targeted at kids. According to a 2015 study by the InterAmerican Heart Foundation in Argentina, nine out of 10 food advertisements on children’s TV shows in the country featured products with low nutritional value.

In this regard, a commission is currently working on a legislative proposal that would seek to “protect children and teenagers from harmful or negative content that can generate damage in their health.” Experts are drawing on Chile’s example, where the government was successfully able to implement marketing restrictions and packaging redesigns.

“The Chilean food law is a model for the whole region,” said Fabio da Silva Gomes, the regional consultant on nutrition and physical activity for the PAHO. “It doesn’t only require clear front labeling, but it also establishes that unhealthy products can’t be sold in schools or advertised in any outlet.”

Remaining Challenges

There is some concern, though, that the plan is simply that – a plan. And that when its priorities come into conflict with commercial interests, nutrition loses out. Which is why advocates are pushing for a regulatory approach, as with the marketing restrictions, that can add some ballast to the ministerial commitments.

To justify this approach, they point to President Mauricio Macri’s attempt last year to introduce a tax reform that would have, among other things, increased taxes on sugary drinks from an average of 6 percent to 17 percent. But after much objection from the industry, including a threat from Coca-Cola to cancel a billion-dollar investment in Argentina, the proposal was not implemented.

“Today in Argentina we don’t have a comprehensive, clear and evidence-based regulation to prevent childhood obesity,” said Victoria Tiscornia, a researcher at the InterAmerican Heart Foundation. “What we have are isolated policies that are often hindered by the influence of the food industry.”

This lack of a legal framework, she said, is slowing the efforts to implement the reforms that are mapped out in the plan.

The national government isn’t currently looking at introducing overarching legislation to accompany its national plan. Several provinces have proposed laws that would specifically address childhood obesity in recent months, but none of these bills has been approved, yet. They would attempt to codify much of what is in the plan.

Some advocates remain optimistic about the progress the country is making, though, even without legislation.

“We need to see how the plan progresses,” the PAHO’s Laspiur said. “Each one of these policies has its implementation challenges, because they not only involve the health sector, but also different government, legislative and business sectors. But it is very important that the issue has been included in the top spheres of the government’s agenda. It’s a very important step.”