中国人能摆脱肥胖吗?
Will Chinese Get Rid of Obesity?
750字
2021-03-03 22:41
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火星译客

Say what you will about the Chinese, but they know how to make wholesale changes, and sometimes those changes are inarguably for the good. As noted in an editorial in The Lancet last week, the life span of the average person in China in 1950 was 40 years; by 2011 it was around 76. (The average life span in the United States in 2011 was 79.)

不管你怎么说中国人,他们的确知道该如何实现大规模变化;有时候,这些变化是无可争辩的好事。正如《柳叶刀》(The Lancet)杂志上周在一篇社论中指出的,1950年,中国人的平均寿命为40岁,而到2011年这一数字已经达到76岁左右(2011年美国人的平均寿命为79岁)。

The causes of this near doubling of life span are no secret: China has developed public health programs that have reduced communicable diseases to a manageable level. This is certainly good news. But it means that people are now dying of noncommunicable diseases, or chronic diseases that are largely preventable. These diseases, most common in wealthier nations, are caused not by malnutrition in the classic sense but by overconsumption of disease-causing foods as well as lack of exercise and environmental dangers.

寿命几乎延长一倍的原因,倒也不是什么秘密:中国开展了把传染病减少到可控水平的公共卫生项目。这当然是个好消息。但它也意味着,人们现在死于很大程度上可以预防的非传染性疾病或慢性疾病。这些疾病在富国最常见,它们不是由传统意义上的营养不良造成的,而是源于过度消耗致病食品,以及缺乏运动和环境危害。

Because things are moving so fast in China, and because that country can learn from the example of the United States and others, perhaps it can pull off a public-health leapfrog and avoid the West’s fate of a rapid and tragic increase in obesity levels and the diseases with which they’re associated.

由于中国办事的速度非常之快,而且可以从美国等国家借鉴经验,我认为它可以在公共卫生领域大大迈进一步,避免走上西方可悲的老路:即肥胖和相关疾病发作率的迅速飙升。

And there’s hope: The authors of the Lancet editorial wrote that Li Bin, China’s new minister of health and family planning, “has the political will, together with the support of international colleagues, to meet the urgent challenge” of these noncommunicable diseases and the problems they pose for China’s future.

希望是有的:《柳叶刀》那篇社论的作者写道,中国新任卫生计生委主任李斌“拥有政治意愿和国际同行的支持,可以去迎接迫在眉睫的挑战”,抗击这些非传染性疾病,以及它们给中国未来发展带来的问题。

In high-income countries, excess weight is the third-leading risk factor in death. The importance of addressing this was brought home again last month with the publication of a new study and editorial, also in The Lancet. The work looked at 22 different cancers in Britain and their association with body mass index (B.M.I.), a simple but more effective measure of obesity than weight alone. The conclusions of the study, which involved a whopping 5.24 million people, were both notable and not entirely unexpected: When adjusted for factors like age and smoking, a higher B.M.I. was associated with a large increase in risk of cancers of the uterus, kidney, gallbladder, and liver, and smaller risk increases for at least six other types of cancer.

在高收入国家,超重是第三大致死风险因素。上个月,同样发表在《柳叶刀》上的一篇新研究和社论,再次清楚展示了这个问题的重要性。该文章在英国研究了22种不同的癌症与身体质量指数(BMI)之间的关联;BMI是测试肥胖的指标,很简单,但比单纯采用重量指标更加有效。这项研究覆盖了524万人之多,其结论值得重视,但也并不是太出人意料:剔除年龄和吸烟因素的影响后,较高的BMI大幅增加了人们患上子宫、肾、胆囊和肝脏癌症的风险,而对于患上其他至少六种癌症,风险也有较小程度的提高。

Most people are aware of the links among obesity, diabetes and heart disease, but cancer is only occasionally discussed. And although that association is not news precisely, there are a couple of aspects of the new study that make it notable. The sheer size and carefulness of the study add credibility to the obesity-cancer link. And by showing that the more obese a person is, the greater the likelihood of his developing certain cancers, it’s powerful.

大多数人都知道肥胖和糖尿病、心脏疾病之间的联系,但对它与癌症的关系很少提到。虽然这种联系算不上什么新闻,但好几项新的研究,让它显得引人注目。本项研究的规模和细致程度,增加了肥胖和癌症关系的可信度。通过显示一个人越是肥胖,他患上某些癌症的可能性就越大,它具备了强大的说服力。

The ways in which obesity makes an individual more prone to cancer are far from well understood. Finding those ways may lead to more successful treatment of cancer, and it’s important and continuing work. But identifying what kind of policy might work to reduce obesity — regulations, taxes, subsidies for nonfattening foods, education about better diets and so on — is, or should be, the primary work of public-health officials, activists and forward-thinking politicians.

肥胖为什么会让一个人更容易患上癌症,这种机制我们还远没能充分理解。研究这些机制,可能会带来更好的癌症疗法,这个工作很重要,而且也在持续进行中。但是,弄清楚什么样的政策可以减少肥胖——法规、税收、为健康食品提供补贴、增进人们对饮食的了解等等——是(或者说应该是)公共健康官员、活动人士和具有前瞻性思维的政治人士的首要工作。

With a staggering 70 percent of our a-dult population overweight or obese, the United States was until recently the world’s leader in this unenviable race. Recently, Mexico (71.3 percent), took our place.  (In China, the combined obesity-overweight rate is hovering at under 30 percent, still frightening.) Yet Mexico, which many Americans and Europeans haughtily consider primitive, was the first major nation in the world to institute significant soda and junk food taxes. That law went into effect early this year, and the results are already positive: Sales of soda are slipping.

美国成人的超重率或肥胖率高达70%,直到最近,美国在这个不讨喜的世界排名中一直位居第一。近来,墨西哥(比率为71.3%)夺取了冠军。(在中国,综合肥胖超重率徘徊在30%左右,也很可怕。)虽然很多美国人和欧洲人傲慢地认为墨西哥是个落后国家,但它却是全球第一个对汽水和垃圾食品课以重税的大国。该法规于今年年初生效,现在已经显示了积极成果:汽水销量正在下滑。

In the 21st century, it is inevitable that nearly every citizen of the world has been and will continue to be affected by the scourge of junk food and liquid candy. Even though intelligent proposals abound, few countries have attempted to curb their marketing or sales. Without limits, the consumption of unhealthy foods will result in higher rates of obesity, and therefore an increase in associated diseases and premature deaths.

在21世纪,全球几乎每一个公民都已经并将继续受到垃圾食物和含糖饮料的影响,这是不可避免的。尽管明智的提议比比皆是,试图遏制市场营销或销售活动的国家却寥寥无几。如果没有限制,那么消耗不健康食品就会导致肥胖率升高,从而导致与之相关的患病率和早逝率升高。

If we know how to diminish needless human suffering and mortality, why would we not? As Mexico has shown, it’s the responsibility of government to protect its population from hyper-processed food.

如果我们知道该如何减少不必要的人类痛苦和死亡,那为什么不行动起来呢?墨西哥的状况已经表明,政府责无旁贷,理应保护公众免遭过度加工食品的侵害。

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