Given the social and economic impact of public health conditions at the national and global levels, it is necessary to reflect on the decisions made by consumers at the individual level, their acts of consumption, and, therefore, their consequences.

According to responsible consumption, one of its three spheres belongs to the consumer in his sphere: the individual sphere, located in the center as an essential and cellular part of a whole. This sphere is responsible for and involves the decisions that the individual makes for himself, in something as personal as his health; however, at some point, it also considers the direct or indirect intervention of the family, since it is part of his wellbeing.

"In a more dynamic sense, the individuals that constitute a family are defined as the members of the most fundamental social group, who live together and interact to satisfy their personal and reciprocal needs. (...) the family remains the central or dominant institution that provides for the welfare of its members and is the primary consumer and consumption unit. (Shiffman and Lazar, 2010).

The individual, based on decisions and habits, builds a way of living his or her life, i.e. a lifestyle. Lifestyles are patterns of behavior that have been chosen from the alternatives available to people, according to their capacity to choose and their socio-economic circumstances. In such a way that their behavior will lead them to have a certain quality of life, also defined as a "combination of objective and subjective components, that is, (...) the conditions of a person's life together with the satisfaction they experience".

"Lifestyles include self-care or self-responsible health behaviors, such as physical exercise, nutrition, interpersonal support, and stress management. self-responsibility with health, such as physical exercise, nutrition, interpersonal support, and stress management." (Martinez, 2010). Health, as a condition of the individual, is an important value in the quality of life, and the quality of life and behavior has a relevant impact on the state of health, which is a function of personal decision making, as well as the surrounding circumstances.

Although these decisions focus on the individual sphere, it should not be forgotten that consumption activity is a social activity that responds to certain market canons and that inevitably any consumption decision may benefit or affect a certain sector of suppliers, mainly related to the production and sale of food. In addition, it is important to emphasize that personal decisions in this sphere should seek the least impact on the extraction process, as well as on the transformation process and waste disposal. In conclusion, healthy consumption has an impact on each of the three spheres and the consumer must be aware of this.

Healthy consumption, the healthiest thing to do

Responsible consumption proposes, as a way of assuming the consequences of health-related decisions, that the consumer should consume healthily. However, the individual, in the dynamics of consumption as a natural and routine activity, is not always aware of his habits. "Within the scale of motives of each subject are his or her health motivations. The objective need is the real one, the subjective need is the one that the individual makes conscious and can awaken motivations and trigger health actions". (Rodríguez, 1987; in Martínez, 2010).

The consumer chooses among various alternatives of products and services, from sweets and food to the hiring of medical treatment or a gym, with a certain probability of not knowing the risks, implications, or consequences they may have. However, the decision to accept or reject this or that product or service is purely individual. Consumer decisions involve desires, the unconscious, economic and advertising strategies, and even the desire to belong to a social group. Therefore, consumers must act responsibly in their decisions because the quality of life they are motivated to have will depend on them.

"The self-control of behavior constitutes the most important tool that an individual can have to make changes in his or her lifestyle; but it is fundamentally regulated by motivation, which is one of the factors involved in the regulation of behavior" (Hernández, 1999; in Martínez, 2010). According to the same author, to achieve healthy behaviors, "the motivation [of] self-responsibility for health must be encouraged from an early age to prevent damage, (...) so the opportunities offered by the socio-medical sciences and the different scenarios and leaders of the community must be taken advantage of, (...) with the community and intersectoral participation that, if well oriented, produces in individuals subjective needs for prevention that translate into responsible health behaviors".

Information for healthy consumption

Advertising has an important influence on consumer decisions and reinforces the decision to choose one product or another, even though most of the time it has nothing to do with satisfying a vital need such as health care. Suppliers study and analyze consumer behavior, how they choose, how they pay, how they use and dispose of, where, when, and how often they buy products and services, even how they spend their free time. Consumers are the largest economic group in the world and their decisions will make or break industry, commerce, and service providers. So, satisfying hunger can be very simple when you are aware of it and have full control over it, or a complex process intervened by internal factors such as the way of thinking, feeling, and individual experiences, and external factors such as society, advertising, fashion, and design.

According to Martínez, studying "health motivation emphasizes the importance of analyzing the reasons for the unhealthy behavior of individuals, which makes it possible to design motivational strategies that make it possible to influence people and motivate self-responsibility for health so that events that affect it do not occur, and thus convert subjective health needs into objective ones so that the individual becomes aware of them to be able to influence behavioral changes; hence its importance to carry out health promotion and education actions at the individual and group level in primary care, which translates into better health-related quality of life".

To date, civil and social organizations bring to light information that is not easily exposed by manufacturers, especially in the case of the fight against the obesity epidemic. They address the importance of the influence of marketing and advertising on decision making and, therefore, demand that the authorities legislate these activities more strictly, such as television schedules, the use of fashion characters in toys, accessories, backpacks, shoes, clothing, cleaning products, etcetera.

It is necessary to recognize that sometimes consumers do not take a particular product or service into consideration, or are not aware of its existence until they are exposed to the product (in this case it is called "unsought good") or to the product's marketing message. On the other hand, according to Shiffman and Lazar (2010), "when a person is faced with a choice between making a purchase or not making a purchase, a choice between brand X and brand Y, or the possibility of spending time on activity A or B, that person is in a position to make a decision. If, however, the consumer has no alternatives from which to choose and is forced to make a particular purchase or perform a specific activity, then this case of non-choice constitutes a "Hobson's choice".

Individual decisions and collective decisions - the solution

Given the public health panorama and its social and economic impact, over the last few decades, the design of comprehensive public policies has been considered that take into account both the individual's living conditions and his or her personal decisions, whose impact on society will be beneficial, pause and counteract the consequences. Thus, international organizations propose multifactorial solutions to multifactorial problems.

With the adoption of the United Nations Guidelines for Consumer Protection at the international level, the importance of protection against health risks is recognized, and they serve as a guide for the development of national legislation in this area. They were later updated to consider the importance of environmental sustainability; years later the United Nations reaffirmed and expanded the Guidelines, "recognizing that consumers often face imbalances in terms of economic capacity, level of education and bargaining power; and (...) that consumers should have the right of access to products that are not dangerous, as well as the importance of promoting fair, equitable and sustainable economic and social development...".

For its part, the World Health Organization, in its 1992-1993 World Health Assembly report, reported on health threats, including "the spread of malnutrition"; by 2002, it reported a considerable increase in non-communicable diseases, attributed to demographic changes and lifestyles, particularly those related to unhealthy diets and lack of physical activity. In 2004, the 57th Assembly proposed the "Global Strategy on Diet, Physical Activity and Health".

The Strategy promotes real challenges, such as the prevention of noncommunicable diseases, the most important of which are cardiovascular diseases, type 2 diabetes, and certain types of cancer, as they contribute substantially to the burden of morbidity, mortality, and disability, since the highest percentage of deaths from these diseases are recorded in developing countries and, on average, young people are the most affected.

The key point to note is the risk factors that give rise to these diseases: arterial hypertension, hypercholesterolemia, low fruit and vegetable intake, excess weight or obesity, lack of physical activity, and tobacco consumption. Not to mention dental caries and osteoporosis, which are widespread causes of morbidity (WHO, 57th World Health Assembly). Diseases that can be prevented at source, with a change in consumer behavior habits and, therefore, better decision making.

In Mexico, in response to the protection of health as a constitutional mandate, public policies have also been implemented to modify individual and collective consumption habits. In the search for solutions to counteract obesity, one of the most relevant actions in Mexico is the National Agreement for Food Health, Strategy against Overweight and Obesity (ANSA), in which the federal government called on the food industry, represented by business organizations, as well as social and economic actors, to design, implement and evaluate joint policies and programs to contribute to the solution of overweight and obesity, due to the statistics presented by the National Nutrition Survey.

The purpose of the Agreement is to "contribute to the sustainability of national development by reversing the epidemic of chronic non-communicable diseases (...) with actions aimed especially at minors, at an individual, community and national level, to improve the supply and access to food and beverages favorable to health, as well as the promotion of the practice of constant physical activity throughout the different stages of life". The vision is for Mexicans to improve their food and beverage consumption behavior and increase their physical activity to slow the increase in overweight and obesity.

Based on scientific evidence, priority objectives were adopted that consider the participation of the individual as well as government authorities, the social, industrial and restaurant sectors, and thus develop, "(...) to implement and strengthen a national multisectoral policy and action programs to modify the social and commercial environment, to facilitate and enable the development of healthy behaviors in the population that will allow them to modify their eating habits and physical activity to achieve better health".

The Agreement thus recognizes the importance of consumer decisions in the individual and collective context (authorities and society as a whole), due to the impact they have on themselves, others, the economy, and the environment. Likewise, the "General Guidelines for the sale or distribution of food and beverages in establishments for school consumption in basic education schools" were published in the Official Gazette of the Federation on August 23, 2010, an inter-secretariat work (Ministries of Public Education and Health) to develop competencies in the individual and favor the correct diet of children and adolescents in the school environment.

Thus, through various public policies, the State has promoted the modification of consumption habits, seeking to make consumers aware of their consumption decisions, so that they can opt for an adequate diet. Furthermore, public policies in this area seek to provide consumers with more information so that they do not consume for aesthetics or accessibility alone, but rather so that they are aware of the consequences of the product on their health.

Conclusions

Neoliberal policies and the opening of markets to trade and foreign investment create the ideal environment for the distribution of unhealthy products by multinational companies. Consequently, the population is affected by an obesogenic environment in which changes in the type of food, price, availability, and marketing of unhealthy products are constant in their consumption habits, generating diseases such as obesity and overweight. Consumerism in the consumer society has generated health problems in individuals, mainly derived from their consumption habits.

However, it should be emphasized that consumption should only be the means to satisfy basic needs such as food, thirst, shelter, and above all health, thus achieving biological survival but in a responsible way. education for responsible consumption will bring greater benefits to both the individual and the society to which he/she belongs because when choosing an option he/she will be aware of the consequences that may result in his/her health, thus opting for a quality of life with greater well-being and more productive. Healthy habits such as a correct diet, drinking more plain water, being more physically active, informing oneself before making a choice, and discerning between what is healthy and what is not.

The main advantage of responsible consumption are the benefits generated by a consumer who assumes the consequences of consumption in the individual, social and environmental spheres. Thus, when a consumer makes a healthy consumption, within the scheme of responsible consumption, has an impact on the social sphere and particularly a very positive result on the environment by making the most of natural resources and avoiding any type of waste.

Source: Profeco