世界饑餓，肥胖流行

在這個(gè)依然沒(méi)有消除饑餓的世界，肥胖卻悄然蔓延，成為又一個(gè)讓人頭疼的全球性流行病。人們通常將肥胖問(wèn)題歸結(jié)于個(gè)人不良的生活方式，但事情的根源也許遠(yuǎn)非如此??

It’s easy to make the assumption that obesity is an individual problem， having more to do with personal health than with social justice. After all， people make their own decisions about what they put on their plates and how much they put in their mouths.

But many people are starting to see not only the public health consequences of the obesity epidemic， but also the broader forces that contribute to it.

And “epidemic” isn’t too strong a word for the growing problem of obesity. The numbers in the U.S. are unsettling1)， with startling increases over the past few decades. But the worst may be yet to come， as billions of people in formerly developing countries are gradually globalized into “fast-food nation” lifestyles.

The transition has already begun. According to a recent U.N. report， more than 1 billion people around the world are overweight. Each year excess weight and obesity cause 2.8 million deaths—65 percent of the world’s population now lives in countries where being overweight kills more people than being underweight. And it’s only going to get worse: According to Olivier De Schutter， the U.N. special rapporteur2) on the right to food， by 2030 as many as 5.1 million people in poor countries will die each year before the age of 60 from unhealthy diets and diet-related diseases such as diabetes3)， 1.3 million more than today.

The definitions of hunger and malnutrition4) are changing， and as a result so are the responses—but perhaps not quickly enough.

In the 1960s and 1970s， the cause of hunger was diagnosed by most officials as primarily a lack of adequate calories， and thus the response was a singular5) focus on increased outputs. But the diagnosis was at best simplistic6)—even decades ago， in a time of extensive famine， hunger was rooted as much in poverty and powerlessness as in a literal shortage of food.

That’s even truer today. The world produces enough food to feed everyone—17 percent more calories per person than 30 years ago， according to the World Hunger Education Service， enough to provide everyone in the world with sufficient nourishment. The main cause of hunger is still poverty (and the economic and political systems that cause poverty)， along with war， racism， and， increasingly， the effects of climate change.

And while undernutrition is still the main hunger issue in the developing world， obesity is more and more being recognized as another form of malnutrition.

While obesity is undeniably7) related to a person’s lifestyle， personal choices around food cannot be separated from the political， social， and economic context. As De Schutter put it， “Our food systems are making people sick ... we must tackle the systemic problems that generate poor nutrition in all its forms.”

Those systemic problems， which result in an overabundance of cheap， over-processed food， include everything from ag policies (such as the promotion， and often subsidizing8)， of soybeans and cereals—especially corn—over fruits and vegetables) to the marketing of unhealthy foods to children and adults. (U.S. companies spent $8.5 billion advertising food， candy， and beverages9)， not even counting alcohol， in 2010.)

Globalization， of course， magnifies it all worldwide—developing countries export high-quality food to rich countries and import refined grains10). Poor families who in the past may have eaten a diet high in fruits and vegetables from local farms now rely mainly on starchy11) staples12) and ingest higher proportions of fats and sugars. As De Schutter put it， “Urbanization， supermarketization， and the global spread of modern lifestyles have shaken up traditional food habits. The result is a public health disaster.” In other words， along with the super-processed food， we’re exporting diabetes and heart disease， and it’s not surprising that the worst effects are on people who are poor， particularly poor women.

The U.N. report named five strategies to move toward a more sustainable approach to nutrition: 1) tax unhealthy products; 2) regulate foods high in saturated13) fats， salt， and sugar; 3) crack down on junk food advertising; 4) overhaul14) misguided agricultural subsidies that make certain ingredients cheaper than others; and 5) support local food production so that consumers have access to healthy， fresh， and nutritious foods. None of those actions will be easy to accomplish in a domestic and international system where profit trumps15) health justice.

The good news is that people are starting to pay attention. There’s a growing recognition that what we put in our bodies isn’t just about ourselves; it has everything to do with our relationships with our communities and our broader world—human and natural. Food connects us， in profound ways we’re only beginning to understand， to the beautiful， fragile， precious web of life.

人們很容易認(rèn)為，肥胖是個(gè)人的問(wèn)題，主要與個(gè)人健康有關(guān)，與社會(huì)正義沒(méi)什么瓜葛。畢竟，自己盤(pán)子里放什么食物、嘴巴里塞多少東西都是由自己決定的。

然而，現(xiàn)在很多人開(kāi)始看到肥胖流行病給大眾健康帶來(lái)的影響。不僅如此，人們還發(fā)現(xiàn)，導(dǎo)致肥胖流行病的因素比人們以為的更廣泛。

對(duì)于日益嚴(yán)峻的肥胖問(wèn)題，用“流行病”這個(gè)詞來(lái)形容并不為過(guò)。美國(guó)肥胖人群的數(shù)字令人擔(dān)憂，在過(guò)去幾十年里，這一數(shù)字增長(zhǎng)驚人。然而，最糟糕的局面也許還沒(méi)到來(lái)，因?yàn)樵冗€屬于發(fā)展中國(guó)家的數(shù)十億人在全球化浪潮中也逐漸過(guò)上了“快餐國(guó)度”的生活方式。

這一轉(zhuǎn)變已經(jīng)拉開(kāi)帷幕。據(jù)聯(lián)合國(guó)近期的一項(xiàng)報(bào)告統(tǒng)計(jì)，全世界超重的人口數(shù)量已超過(guò)十億。每年有280萬(wàn)人死于超重和肥胖，目前全世界65%的人生活在超重問(wèn)題嚴(yán)重的國(guó)家——在這些國(guó)家，體重超標(biāo)造成的死亡率比體重不足要高。而且，這種態(tài)勢(shì)只會(huì)繼續(xù)惡化：聯(lián)合國(guó)食物權(quán)特別報(bào)告員奧利維爾·德舒特稱，到2030年，貧困國(guó)家每年將有510萬(wàn)人在60歲之前就死于不健康飲食或與飲食相關(guān)的疾病(比如糖尿病)，比現(xiàn)在增加130萬(wàn)人。

對(duì)饑餓與營(yíng)養(yǎng)失調(diào)的定義正在發(fā)生改變，因此，人類的應(yīng)對(duì)措施也在做出相應(yīng)調(diào)整——只是調(diào)整得還不夠迅速。

在20世紀(jì)60與70年代，大多數(shù)官方人士判定，饑餓產(chǎn)生的主要原因是缺乏足夠的卡路里，于是出臺(tái)了與此對(duì)應(yīng)的舉措——單純關(guān)注食品產(chǎn)量的提高。但即便是以最樂(lè)觀的態(tài)度來(lái)看，這樣的判斷也是把問(wèn)題簡(jiǎn)單化了——即使是在幾十年前饑荒蔓延發(fā)生的時(shí)期，饑餓產(chǎn)生的根源也不完全在于食物不足，貧窮和無(wú)能為力與食物不足一樣，也是饑餓產(chǎn)生的根源。

今天來(lái)看，情況更是如此。目前全世界生產(chǎn)的食物足夠養(yǎng)活所有人了。據(jù)世界饑餓教育組織統(tǒng)計(jì)，現(xiàn)在人均占有的卡路里比30年前增加了17%，足夠?yàn)槭澜绲拿總€(gè)人提供充分的營(yíng)養(yǎng)了。但如今，導(dǎo)致饑餓產(chǎn)生的主要原因仍然是貧窮(以及造成貧窮的經(jīng)濟(jì)與政治體制)。此外，造成饑餓的原因還包括戰(zhàn)爭(zhēng)、種族主義以及日益突出的氣候變化的影響。

盡管發(fā)展中國(guó)家的饑餓問(wèn)題仍主要表現(xiàn)為營(yíng)養(yǎng)不良問(wèn)題，但人們也越來(lái)越意識(shí)到，肥胖是營(yíng)養(yǎng)失調(diào)的另一種表現(xiàn)。

不可否認(rèn)，肥胖與個(gè)人的生活方式息息相關(guān)，但個(gè)人對(duì)食物的選擇與其所處的政治、社會(huì)和經(jīng)濟(jì)環(huán)境是分不開(kāi)的。正如德舒特所說(shuō)：“讓人們生病的是我們的食品體制……我們必須解決這些導(dǎo)致各類營(yíng)養(yǎng)失調(diào)癥狀出現(xiàn)的體制問(wèn)題?！?/p>

這些體制問(wèn)題導(dǎo)致的結(jié)果是過(guò)度加工的廉價(jià)食品的泛濫。這些問(wèn)題無(wú)所不包，從農(nóng)業(yè)政策(比如對(duì)大豆和谷物——尤其是玉米——所給予的優(yōu)先于水果和蔬菜的大力推廣和經(jīng)常性補(bǔ)貼)，到將不健康食品推銷給兒童和成人的市場(chǎng)營(yíng)銷。(2010年，美國(guó)公司用于食品、糖果和飲料的廣告費(fèi)用高達(dá)85億美元，這里面都還不包括酒類產(chǎn)品的廣告費(fèi)用)。

當(dāng)然，全球化將這一問(wèn)題擴(kuò)散到了全世界——發(fā)展中國(guó)家向富裕國(guó)家出口高質(zhì)量的食物，卻進(jìn)口加工后的細(xì)糧。過(guò)去，貧困家庭的飲食主要以當(dāng)?shù)剞r(nóng)莊出產(chǎn)的水果和蔬菜為主，但現(xiàn)在他們卻主要進(jìn)食淀粉類主食，并攝入了更多的脂肪和糖類。德舒特指出：“城市化、超市化以及席卷全球的現(xiàn)代生活方式顛覆了傳統(tǒng)的飲食習(xí)慣，而這給公眾健康帶來(lái)了災(zāi)難性的后果?！睋Q句話說(shuō)，我們?cè)诔隹谶^(guò)度加工的食品的同時(shí)，也在出口糖尿病和心臟病，這就難怪最大的受害群體是窮人，尤其是貧困的婦女。

為了讓人們獲得營(yíng)養(yǎng)的方式更具可持續(xù)性，聯(lián)合國(guó)報(bào)告提出了五大策略：①對(duì)不健康食品征稅；②控制富含飽和脂肪、高鹽分以及高糖分的食品；③取締垃圾食品廣告；④改革受到誤導(dǎo)的農(nóng)業(yè)補(bǔ)貼政策，這些政策造成某些特定原料的價(jià)格低于其他原料；⑤扶持當(dāng)?shù)厥称飞a(chǎn)，讓消費(fèi)者能夠獲得健康、新鮮、營(yíng)養(yǎng)豐富的食物。但是在現(xiàn)有的國(guó)內(nèi)和國(guó)際體系下，要執(zhí)行以上任何措施都并非易事，在兩大體系中，對(duì)利潤(rùn)的追求往往會(huì)擊敗對(duì)健康公正的追求。

好在人們已開(kāi)始關(guān)注健康問(wèn)題。越來(lái)越多的人開(kāi)始意識(shí)到，吃什么不僅是我們個(gè)人的私事，還與我們生活的社區(qū)以及更為廣闊的世界——人類社會(huì)和自然界——息息相關(guān)。食物以某種深刻的方式把我們與美麗、脆弱而珍貴的生命之網(wǎng)連結(jié)在一起，而對(duì)于這種方式的了解，我們才剛剛起步。

1.unsettling [?n?setl??] adj. 使人不安的

2.U.N. special rapporteur：聯(lián)合國(guó)特別報(bào)告員，接受聯(lián)合國(guó)人權(quán)理事會(huì)的管理，主要通過(guò)特別的程序執(zhí)行人權(quán)理事會(huì)的命令，就人權(quán)問(wèn)題進(jìn)行調(diào)查、監(jiān)督、建議以及報(bào)告等活動(dòng)。

3.diabetes [?da???bi?ti?z] n. 糖尿病

4.malnutrition [?m?lnju??tr??n] n. 營(yíng)養(yǎng)失調(diào)，營(yíng)養(yǎng)不良

5.singular [?s??ɡj?l?(r)] adj. 突出的，特別的

6.simplistic [s?m?pl?st?k] adj. 簡(jiǎn)單化的，把復(fù)雜問(wèn)題搞得簡(jiǎn)單化的

7.undeniably [??nd??na??bli] adv. 不可否認(rèn)地

8.subsidize [?s?bs?da?z] vt. 資助，津貼

9.beverage [?bev?r?d?] n. 飲料

10.refined grain：加工而成的谷類糧食

11.starchy [?stɑ?t?i] adj. 淀粉的，含淀粉的

12.staple [?ste?pl] n. 主食

13.saturated [?s?t??re?t?d] adj. 飽和的

14.overhaul [???v?h??l] vt. 革新

15.trump [tr?mp] vt. 勝過(guò)，打敗，贏