肥胖带来的多重健康问题（在线收听）

肥胖带来的多重健康问题

For the last 15 years, Plymouth, England has held a symposium on obesity. It’s estimated that more than half the city’s adults are overweight or obese. The rest of Britain is not fairing much better. But what’s happening in the U.K. can also be seen the U.S. and many Western countries and a growing number of developing nations. One obesity expert said it’s a long term problem that is very difficult to solve

过去15年，英国普利茅斯举办过肥胖方面的研讨会，会议估计该市有一半以上的成年人超重或肥胖。英国其他地方的情况并不比普利茅斯更好，但英国所发生的情况也同样可以在美国、很多西方国家和大量的发展中国家看到。一位肥胖专家称这是个很难解决的长期问题。

Professor Jonathan Pinkney said, “No one health issue has the most impact on human health, or engenders more debate about how to tackle it, than obesity.” Pinkney - a professor of Endocrinology and Diabetes – took part in the annual Plymouth Symposium on Obesity, Diabetes and Metabolic Syndrome on May 21st.

乔纳森·平克尼教授说，“没有哪一种健康问题比肥胖更能影响人体健康，也没有哪种问题能比肥胖引发更多有关如何解决的辩论。”平克尼是内分泌学和糖尿病学教授，他参加了5月21日的普利茅斯肥胖、糖尿病和代谢综合征研讨会。

He said obesity is a complex issue that involves more than calorie intake.

他说肥胖是个复杂的问题，不仅涉及卡路里摄入过多。

“I personally feel that this is such a wide field. There are so many issues. There’s politics. There’s biology. There’s everything you can imagine. There’s the food industry. And I think that sometimes we’re all a bit guilty of just maybe concentrating on one of those areas. And you can go to a conference anywhere in the world where they spend days just talking about bariatric surgery or fizzy drinks. So, I think it’s right to talk about everything under one umbrella.”

“我个人认为这个问题涉及范围很广，涉及很多问题，有政治问题，有生物方面的问题，还有一切你能想象的，包括食品行业，只是关注于这些领域中的某个方面会让我们感到内疚的。你可以到世界任何地方的会议上，看到人们花几天的时间，只是在讨论肥胖外科手术或汽水，我想正确的是要讨论各个方面的问题。”

Bariatric surgery restricts how much food a person can eat, sharply reducing caloric intake.

肥胖外科手术会限制人吃下去的食物的量，从而大大减少卡路里的摄取。

The professor gave his definition of obesity as “when body size becomes so huge that it impairs people’s day to day function and quality of life and well-being and personal relationships. Yeah, that’s kind of devastating. That tends to occur at a higher level of body weight.”

这位教授给肥胖下的定义是“体型过大以至影响到日常的功能、生活质量、健康快乐和人际关系，这是很糟糕的，往往会在体重较高时发生。”

However, Pinkney said those not considered technically obese are also at high risk for poor health.

不过，平克尼说，那些并非严重肥胖的人也会面临健康水平差的风险。

“That’s the more important point for the health of the population. You know, all the diabetes and heart attacks and cancers and things. I mean that’s really caused by lower levels of weight gain. As you can see, it’s just the average weight of the population drifting up because we’re just sort of eating the wrong things and not really sufficiently active,” he said.

“对于人口健康来说这是更重要的方面，要知道，所有的糖尿病、心脏病、癌症等疾病，都是由低水平的体重增加引起的。因为我们吃了错误的东西，并且没有多多运动，所以人口的平均重量在上升。”

The Plymouth symposium showed that much is known about the biology of the brain and appetite control. But Pinkney said, as one speaker pointed out, knowledge is not enough.

普利茅斯研讨会表明，我们对大脑和食欲控制方面的生物学了解很多。但平克尼说，正如一位发言者指出的那样，仅仅了解是不够的。

“That is completely overridden by things going on around us in the environment: food advertising – food Industry -- the way that it’s all marketed to everybody, including children. And I think the simple fact of the matter is, you know, our bodies are very smart and beautifully built. But it’s just that the biological systems that would keep us slim are just completely swept away by the pressure from the things going on around us,” he said.

“我们被周围的一切糟蹋了，食品广告、食品业，它们向包括儿童在内的大众所进行营销的方式。我想很简单的事实是，我们的身体非常智能，构造很优美。但那些让我们保持苗条的生理系统完全被我们周围的压力冲垮了。”

And he said it’s difficult to do anything about it whether in Britain, the U.S. or developing countries that have adopted a Western diet heavy in sugar, salt and fat.

他说，无论是在英国、美国或采取了西方高糖、高盐、高脂饮食方式的发展中国家，很难对这一现状做些什么。

“There’s a multinational food industry and there’s huge vested interest in selling a lot of the stuff. I can’t give you a magic word as to how you crack this, but we’ve got exactly the same problem here. And I think you can prescribe all the drugs you want. You can do all the bariatric surgery you could manage to fund, but it’s not going to crack the problem unless you stop the development of the epidemic at source,” said Pinkney.

“跨国食品行业对出售这些东西有着巨大的既得利益，我不能给你解决这个问题的咒语，我想你能得到所有你想要的药物，能做所有能支付得起的肥胖外科手术，但是除非能在源头上遏制住，否则是解决不了问题的。”

Going to the source means how eating habits are formed. Poor eating habits can be a learned behavior passed down by parents to their children.

从源头上遏制意味着如何形成饮食习惯，糟糕的饮食习惯可能是父母传给子女的一种习得行为。

“I think a lot of things start very early in life. You know, it’s difficult to break the habits of a lifetime, isn’t it? I think we all find that. But I think our health and our prospects for the future are kind of laid down fairly early. And I think that’s not surprising. Big kids often have big parents. I think they learn this at an early stage,” he said.

“我想很多东西是从人生早期就开始的，很难打破一生的习惯，不是吗？我想我们都发现这一点了，我想我们的健康和对未来的憧憬是很早就定好的，这并不让人吃惊，体格大的孩子其父母也体格庞大，我想他们很早就习得了这些。”

Solving the problem, he said, is a lot harder than simply trying to encourage prevention.

他说，解决这一问题比简单地鼓励预防要难得多。

“There isn’t a kind of medical way to prevent the problem. It really does look as if it’s down to politics, policy, marketing, food industry and preventing children from being exposed to all of this. And I think that’s the toughest thing that we face in the world. It’s very, very difficult.”

“并不存在预防这一问题的医学手段，看来它要归因于政治、政策、市场营销、食品行业，要预防孩子接触所有这些东西，我想这是我们在这个世界上遇到的最棘手问题，非常难以解决。”

Professor Pinkney said too many unrefined carbohydrates – sugars – are to blame for much of the obesity epidemic. He said that they don’t satisfy a person’s hunger for long and people eat their next meal sooner.

平克尼教授说，肥胖要归咎于过量摄取未提炼的碳水化合物，比如糖。他说这些东西并不耐饿，所以人们会很快吃下一餐。

“Commercially produced processed food with large amounts of carbohydrate – sweeteners, short acting carbohydrate – and it just sets us up to fail. And I think there are big problems with carbohydrate in the Western diet,” he said.

“商业上制造的加工食品含有大量的碳水化合物、甜味剂，不耐饿的碳水化合物，让我们难以摆脱，我想西方饮食中的碳水化合物存在大问题。”

While it may be difficult to foster better eating habits, Pinkney said there is precedent for large scale behavior change.

尽管很难形成良好的饮食习惯，平克尼说在大规模的行为改变方面已经存在有先例。

“Other things have changed. I mean one really interesting thing, I think, was what’s happened over cigarette smoking. And how people complained about not being able to smoke in pubs and restaurants and have to go outside. But it didn’t take very long for that to translate into clear health benefit. So, you know, maybe you can get these things through in time, little by little,” he said.

“其他方面发生过改变，我是说一件很有趣的事，就是吸烟方面的变化。人们最初抱怨无法在酒馆或餐厅吸烟，只能到外面去吸。但过了不久人们人们就从中得到健康益处，所以是可以一点点地实现改变的。”

Some lessons, he said, can be learned from our hunter-gatherer ancestors.

他说一些教训是可以从我们那从事狩猎采集的祖先那里学到。

“The hunter-gatherers going right back to last Ice Age and before that would have had a diet that was rich in complex, sort of, fiber kind of carbohydrate. There would be protein in it now and again. But it didn’t have all the sugar. So, the diet that is, of course, followed by traditional peoples is radically different.”

“狩猎采集可追溯到冰河时代，当时我们并没有复杂的饮食内容，比如纤维和碳水化合物，可能含有蛋白质，但并没有糖。所以古人所遵循的饮食方式是非常不同的。”

He said studies of indigenous peoples, who returned to their traditional diets, “took a step back from modern health problems.” Pinkney says a combination of prevention methods, medical interventions and political will be needed to stop the obesity epidemic.

他说，对那些回归传统饮食的土著的研究表明，“要从现代健康问题中走出来”。平克尼说，需要预防措施、医学干预和政治意愿等综合手段来阻止肥胖的蔓延。

In the U.S. the Centers for Disease Control and Prevention reported over 35 percent of adults – or nearly 79 million people – are obese. More 17 million children were obese. The annual medical cost of obesity in the U.S. is nearly $200 million.

疾病控制和预防中心报告称美国有35%的成年人肥胖，人数近7900万，还有超过1700万儿童肥胖。美国每年在肥胖方面的医疗开支近2亿美元。