平均壽命世界上等 但中國人能戰勝肥胖嗎大綱
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.)
不管你怎麼說中國人，他們的確知道該如何實現大規模變化；有時候，這些變化是無可爭辯的好事。正如《柳葉刀》(The Lancet)雜誌上週在一篇社論中指出的，1950年，中國人的平均壽命爲40歲，而到2011年這一數字已經達到76歲左右（2011年美國人的平均壽命爲79歲）。
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.
壽命幾乎延長一倍的原因，倒也不是什麼祕密：中國開展了把傳染病減少到可控水平的公共衛生項目。這當然是個好消息。但它也意味着，人們現在死於很大程度上可以預防的非傳染性疾病或慢性疾病。這些疾病在富國最常見，它們不是由傳統意義上的營養不良造成的，而是源於過度消耗致病食品，以及缺乏運動和環境危害。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.
由於中國辦事的速度非常之快，而且可以從美國等國家借鑑經驗，我認爲它可以在公共衛生領域大大邁進一步，避免走上西方可悲的老路：即肥胖和相關疾病發作率的迅速飆升。
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：《柳葉刀》那篇社論的作者寫道，中國新任衛生計生委主任李斌“擁有政治意願和國際同行的支持，可以去迎接迫在眉睫的挑戰”，抗擊這些非傳染性疾病，以及它們給中國未來發展帶來的問題。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.
在高收入國家，超重是第三大致死風險因素。上個月，同樣發表在《柳葉刀》上的一篇新研究和社論，再次清楚展示了這個問題的重要性。該文章在英國研究了22種不同的癌症與身體質量指數(BMI)之間的關聯；BMI是測試肥胖的指標，很簡單，但比單純採用重量指標更加有效。這項研究覆蓋了524萬人之多，其結論值得重視，但也並不是太出人意料：剔除年齡和吸菸因素的影響後，較高的BMI大幅增加了人們患上子宮、腎、膽囊和肝臟癌症的風險，而對於患上其他至少六種癌症，風險也有較小程度的提高。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.
大多數人都知道肥胖和糖尿病、心臟疾病之間的聯繫，但對它與癌症的關係很少提到。雖然這種聯繫算不上什麼新聞，但好幾項新的研究，讓它顯得引人注目。本項研究的規模和細緻程度，增加了肥胖和癌症關係的可信度。通過顯示一個人越是肥胖，他患上某些癌症的可能性就越大，它具備了強大的說服力。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.
肥胖爲什麼會讓一個人更容易患上癌症，這種機制我們還遠沒能充分理解。研究這些機制，可能會帶來更好的癌症療法，這個工作很重要，而且也在持續進行中。但是，弄清楚什麼樣的政策可以減少肥胖——法規、稅收、爲健康食品提供補貼、增進人們對飲食的瞭解等等——是（或者說應該是）公共健康官員、活動人士和具有前瞻性思維的政治人士的首要工作。With a staggering 70 percent of our adult 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.
美國成人的超重率或肥胖率高達70%，直到最近，美國在這個不討喜的世界排名中一直位居第一。近來，墨西哥（比率爲71.3%）奪取了冠軍。（在中國，綜合肥胖超重率徘徊在30%左右，也很可怕。）雖然很多美國人和歐洲人傲慢地認爲墨西哥是個落後國家，但它卻是全球第一個對汽水和垃圾食品課以重稅的大國。該法規於今年年初生效，現在已經顯示了積極成果：汽水銷量正在下滑。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世紀，全球幾乎每一個公民都已經並將繼續受到垃圾食物和含糖飲料的影響，這是不可避免的。儘管明智的提議比比皆是，試圖遏制市場營銷或銷售活動的國家卻寥寥無幾。如果沒有限制，那麼消耗不健康食品就會導致肥胖率升高，從而導致與之相關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.
如果我們知道該如何減少不必要的人類痛苦和死亡，那爲什麼不行動起來呢？墨西哥的狀況已經表明，政府責無旁貸，理應保護公衆免遭過度加工食品的侵害。China has the potential to apply the lessons learned not only from its own positive experience dealing with communicable disease, but from the tragic mistakes made by so-called developed nations. It has a chance to turn the tide against disease-causing diets before it’s too late. Sadly, we may need its example to wake up to our own problems.
中國不僅可以運用自身控制傳染病的積極經驗，還可以借鑑所謂的發達國家在這個悲慘失誤上的教訓。現在爲時還不晚，中國仍有機會力挽狂瀾，和飲食引起的疾病做鬥爭。可悲的是，我們可能需要中國做出的表率，才能對自己的問題有所醒悟。
