Improved human well-being is one of the modern era’s greatest triumphs. The age of plenty has also led to an unexpected global health crisis: two billion people are either overweight or obese. Developed countries have been especially susceptible to unhealthy weight gain, a trend that could be considered the price of abundance. However, developing countries are now facing a similar crisis.
改善人类健康是现代最伟大的成就之一。富足的时代也带来了意想不到的全球健康危机:20亿人超重或肥胖。发达国家尤其易受不健康体重增加的影响,这种倾向被视为富足的代价。然而,发展中国家现在正面临着相似的危机。
Obesity rates have plateaued in high income countries but are accelerating elsewhere. The combined findings of UNICEF, the World Health Organisation and the World Bank showed that in 2016 Asia was home to half the world’s overweight children. One quarter were in Africa.
肥胖率在高收入国家已趋平稳,但在其他地方仍不断上升。联合国教科文组织、世界卫生组织和世界银行联合调查的结果显示:2016年,全世界的超重儿童有一半在亚洲,1/4在非洲。
Residents of developing nation cities are increasingly susceptible to obesity, particularly amid the megatrends of urbanisation, globalisation, and industrialisation of food supply. According to India’s National Institute of Nutrition, over a quarter of urban-dwelling men and nearly half of women are overweight.
发展中国家的居民越来越容易肥胖,尤其是在城市化、全球化和食品供应工业化的大趋势之下。据印度国家营养局统计,城市居民中,超过1/4男性和将近一半的女性体重超标。
The majority of the world’s future urbanization is projected to occur in developing countries, particularly in Asia and Africa. As rural dwellers move to urban areas, easy access to cheap and convenient processed foods lures them into unhealthy diets.
世界上大部分的未来城市化预计发生在发展中国家,特别是在亚洲和非洲。随着村民涌入城市,容易获得的廉价、方便的加工食品诱使他们形成不健康的饮食方式。
This crisis will test the political resolve of governments that have historically focused on ending hunger. These governments must understand that the factors making cities convenient and productive also make their residents prone to obesity. Intelligent, focused policies are needed to effectively manage this emerging crisis.
对于一度致力于解决饥饿问题的一些国家政府来说,这场危机将会考验其政治决心。这些国家必须明白,那些让城市生活更加便捷和高效的因素也会让居民更易过度肥胖。要解决这场新出现的危机,需要智慧和有针对性的政策。
Urbanites enjoy a variety of culinary options, ranging from aisles of processed goods in supermarkets to scores of short-order street vendors. Additionally, international fast foodchains are flourishing in developing countries. This is shifting dietary habits away from healthier traditional fare and towards fried foods and sugary drinks.
从超市的加工食品到街边快餐,城市居民在吃的方面有多种多样的选择。此外,全球速食产业链也在发展中国家蓬勃发展。这就使人们的饮食习惯从选择传统的健康食物,转变成了油炸食品和含糖饮料。
The health risks of such diets are compounded by the sedentary lifestyles of urban dwellers. The most recent Indian nutrition survey found that city-dwelling men and women work an averageof roughly eight hours a day. Most are engaged in sedentary office jobs. Onlyabout one quarter exercise.
城市居民久坐不动的生活方式和这些饮食习惯一起构成了健康威胁。最近一次的印度营养调查发现,城市居民平均每天工作8个小时,大多数都坐在办公室里工作,其中只有约1/4会锻炼身体。
People’s leisure time is also being monopolised by passive diversions like television, movies, and video games in the growing number of households able to afford such technologies.
对于可以承担起新技术产品支出的人群来说,业余时间正被消极的消遣所占据,例如看电视、看电影、玩电脑游戏。
The alarming implication of these trends is that developing countries may become sick before they get rich. That sickness may, in turn, cripple health systems.
这些趋势中值得注意的影响是,发展中国家未富先病。反过来,这些病痛也可能摧毁国家的健康体系。
The yearly health care costs in Southeast Asia of obesity-related complications like diabetes and cardiovascular disease are already as high as US $10 billion. Obesity among China’s younger generation could cost US $724 billion in medical treatment by 2030. Such diseases are an added burden on countries already struggling to manage primary health care needs.
在东南亚国家,每年用在诸如糖尿病、心血管疾病的肥胖并发症上的医保开销就已经高达100亿美元。到2030年,在中国的年轻人中,用于治疗过度肥胖的花销可能高达7240亿美元。对于仍在努力满足初步医疗保健需要的国家来说,这类疾病是额外的负担。
Policies related to taxation, urban design, education and awareness and the promotion of localised food systems may help control obesity at a lower cost than eventual medical treatment for an ageing and increasingly overweight population.
制定涉及税收、城市规划、教育、公众意识的政策,推动本土化的食物生产体系,或许能够控制肥胖问题,成本比以后为肥胖老年人治疗更低。
Some governments have already experimented with direct interventions to control obesity, such as taxation on unhealthy foods and drinks. The US pioneered the soda tax movement. Thailand, Brunei, and Singapore have adopted similar measures. South Africa is likely to introduce a sugar tax beginning in April 2018.
一些国家的政府已经试行直接干预控制过度肥胖,如对不健康的食品和饮料征税。美国率先试行苏打税。泰国、文莱、新加坡也已经采取了相似的政策。南非可能会在2018年4月开始加征糖税。
Regulatory approaches have not stopped at taxation – or at sugar. In the United Kingdom, advertising rules prohibit the marketing of foods high in fat, salt and sugar to children younger than 16.
控制措施不止于征税,也不止于糖。在英国,广告条例规定禁止向16岁以下的儿童推销脂肪、盐和糖含量高的食品。
The city of Berkeley in California recognises that taxes alone are not enough to address obesity. Proceeds from the city’s sugar tax are used to support child nutrition and community health programmes. This underscores the importance of education and awareness.
加里福尼亚州伯克利市意识到,征税本身并不足以解决肥胖问题。伯克利市糖税征来的款项都用作支援儿童营养和社区健康项目。
There is also promise in many initiatives. Urban design holds significant power to reshape lifestyle patterns and public health. Improving the attractiveness of public space, the “walkability” of neighbourhoods and the quality of cycling infrastructure can draw residents out of their cars and living rooms.
很多举措也显露希望。例如,城市规划在重塑人们的生活方式和公众健康方面就能发挥重要作用。提高公共区域的吸引力,建造更多可以行走的场地,提升公用基础设施的质量,可以吸引居民打开车门、走出家门。
A recent study of urban neighbourhoods in Shanghai and Hangzhou found that middle-income residents living in less walkable neighbourhoods had significantly higher Body Mass Indices than both richer and poorer residents who lived in walkable neighbourhoods in urban China.
最近在上海和杭州所做的一次调查发现,在中国城市居民中,居住在步行区较少的中等收入人群身体质量指数高于比居住在适宜步行的地区者,无论收入高低。
Finally, healthier lifestyles begin in grocery store aisles. Governments should encourage tighter connections between agricultural production systems, urban grocers and food vendors. Relationships with farmers in areas immediately adjacent to cities, in addition to the promotion of urban gardens, have been popular approaches in the US.
最后,健康生活方式也是从货架开始的。政府应该鼓励农业生产系统、城市食品商和粮食商贩建立更加紧密的联系。与紧邻城市区域内的农场主建立联系,以及兴建城市花园,在美国已经成为颇受大众欢迎的方式。
Such initiatives can also help urban residents better understand the mechanics of food sourcing. This raises awareness about the relationship between natural foods and healthy lifestyles. Even the preservation of culture around traditional foods can promote healthy alternatives.
这些措施也可以帮助城市居民更好地理解食品来源,让大众意识到天然食物和健康生活方式的关系。甚至,保留关于传统食物的文化本身都可以促进人们选择健康的食物。
Combining controls on unhealthy foods with policies that incentivise healthy eating and active lifestyles constitute a promising response to rising obesity rates. Addressing public health is a policy mandate for developing countries from both an economic and social point of view. To quote the recent Global Nutrition Report, addressing obesity is a global imperative for releasing the brakes on development.
把对不健康食物的控制措施和鼓励健康饮食、积极生活方式的政策结合起来,这是对不断提升的肥胖率的一个很好的解决方法。解决公众健康问题对于发展中国家在经济方面和社会方面都是必须采取的政策。引用最近的全球营养报告来说,要想清除发展道路上的阻碍,解决肥胖问题在全球都势在必行。