肥胖——生命中不能承受之重

肥胖——生命中不能承受之重

2015年，欧盟和美国的人均预期寿命均出现了轻微的倒退，这是十分反常的。长此以往，我们这一代人甚至可能比上一代人更短寿。我们该怎么面对日益严重的肥胖问题？也许禁烟措施可以给我们一点启发。

测试中可能遇到的词汇和知识：

assemble聚集，集合[ə'sembl]

eureka找到了！有了！[ju'riːkə]

conductor售票员[kən'dʌktə(r)]

hypothesis假设，猜测[haɪ'pɒθəsɪs]

tarring焦油，柏油[tɑː(r)]

lethal致命的，毁灭性的['liːθl]

premature过早的，不按时的['premətʃə(r)]

diabetes糖尿病[ˌdaɪə'biːtiːz]

dietary饭食的，饮食的['daɪətəri]

epidemic传染病，流行病[ˌepɪ'demɪk]

opioid类鸦片['əʊpiːəʊɪd]

How to solve the obesity epidemic（692 words）

By Simon Kuper

How long will we live? Just a year or two ago, it looked as if we forty-somethings would routinely reach 90, while most of our children would hit 100. Our growing bellies hardly seemed to affect our rising lifespans. But now scary news is coming in. Life expectancy in both the EU and the US fell slightly in 2015. The European decline (which went strangely unreported) was the first since Eurostat's data set was assembled in 2002; the US's was the first since 1993. Given that obesity usually kills with a time lag (sometimes of decades), people in obese western countries may soon start “dying younger than earlier generations”, says Professor Alan Dangour, nutrition expert at the London School of Hygiene and Tropical Medicine.

What to do? Doctors or medical researchers cannot solve this problem. It's up to advertising creatives, finance ministers and town planners.

The necessary medical breakthroughs were made long ago. Soon after the second world war, British researchers noticed a mysterious rise in heart attacks. In 1949, a researcher named Jerry Morris looked into rates in different occupations. When the first results came in, on London bus employees, he had a eureka moment. He told me in 2009, months before his death aged 99: “There was a striking difference in the heart-attack rate. The drivers of these double-decker buses had substantially more, age for age, than the conductors.” Morris immediately guessed the reason: drivers sat all day, while conductors climbed stairs. Soon afterwards, data from postal workers confirmed his hypothesis. Postmen who walked or cycled around delivering mail had fewer heart attacks than male telephonists and clerks who worked behind counters. Exercise protected against heart disease. Morris became possibly the first regular jogger on Hampstead Heath. “People thought I was bananas,” he reminisced.

Meanwhile, another British epidemiologist, Richard Doll, was examining the mysterious rise in lung cancer. He suspected it was due to the tarring of roads. But while checking diagnoses of lung cancer, he had his own eureka moment. He noticed that “if someone had been described as a non-smoker, the diagnosis always turned out to be wrong”. In 1950, Doll and Austin Bradford Hill published a paper proving smoking's link with lung cancer. Since then, smoking has turned out to cause many other diseases besides, while exercise has proved a magic bullet for almost everything, including lethal obesity.

Doll and Morris were part of a British golden age that transformed global health. Between the early 1940s and 1953, Oxford researchers helped develop penicillin, Nye Bevan created the National Health Service, and James Watson and Francis Crick discovered the structure of DNA. Probably no modern medical breakthrough matters as much.

We now know how to live longer. A third of American premature deaths could be prevented if people exercised more, ate healthily or didn't smoke, according to the US National Research Council and Institute of Medicine. That's about 867,000 lives a year. Saving just 10 per cent of them could significantly lengthen US lifespans.

In comparison, the country's opioid epidemic and the Republican assault on health insurance matter less. Yes, it's terrible that the US doesn't have universal healthcare. A study in the New England Journal of Medicine estimates that for every 300 to 800 adults who get coverage, about one life a year is saved. But boring old obesity kills far more. In England, too, obesity was an officially certified cause of mortality on one in four death certificates between 1979 and 2006.

Telling people to exercise and eat healthily doesn't work. We have all heard the message, yet 44 per cent of Brits don't even do moderate exercise. Medics need to hand over the issue to advertising agencies and other people who know how to change behaviour.

The long struggle against smoking is the model. What worked were scary messages on cigarette packets, plus taxation. The World Health Organization backs sugar taxes. The key group to reach are the under-18s, because most life-long dietary habits are set by adolescence.

Many people won't like the nanny state interfering in their lifestyles. That's a reasonable view. However, it entails the avoidable and expensive deaths of millions of people.