Will China Get Fat Before It Gets Rich?
中国会未富先胖吗？
The rising wave of obesity around the world and its health and economic costs cannot be ignored—even in China. This is no longer a “western” problem. Today, 62 percent of the world’s obese people are in developing countries.
这波全球范围内愈演愈烈的肥胖浪潮，以及它导致的健康和经济损失，无法被忽视——即便是在中国。这不再只是个“西方的”难题。如今，发展中国家拥有了世界上60%的肥胖症患者。
Global scourge
全球性灾难
More than 2.1 billion people—nearly 30 percent of the global population—are overweight or obese today. That’s nearly two and a half times the number of adults and children who are undernourished. Obesity is responsible for about 5 percent of deaths worldwide. The global economic impact from obesity is roughly $2.0 trillion, or 2.8 percent of global GDP, roughly equivalent to the global impact from smoking or armed violence, war, and terrorism.
目前，有超过21亿人——约占全球人口30%——超重或肥胖。这几乎是营养不良的成人和儿童数量的2.5倍。全世界大概有5%的死亡是由肥胖导致的。肥胖给全球带来的经济负担约为2万亿美元，或者说占全球GDP的2.8%，差不多和吸烟或武装暴力、战争以及恐怖主义造成的全球性影响相当。
A problem for China?
中国面临的问题？
The fact of the matter is that rapid industrialization and urbanization is boosting incomes (Exhibit 1). Higher incomes mean more food and often a more sedentary lifestyle. The risk of obesity rises.
事实的真相是，高速的工业化和城市化进程提高了收入（图1）。更高的收入意味着更多的食物，还常常伴随着坐得更久的生活方式。于是，肥胖的风险上升了。
In China, the prevalence of obesity in cities is three to four times the rate in rural areas, reflecting higher incomes in urban areas and therefore higher levels of nutrition and food consumption and often less active labor. The prevalence of obese and overweight people rose at 1.2 percent a year in Chinese adult males between 1985 and 2004 and 1 percent a year in adult females. ⑴
在中国，城市中肥胖的流行程度是郊区的三到四倍，这反映出市区有更高的收入和因此带来的更高营养水平、食物消费，以及通常更少的体力劳动。1985至2004年间，中国成年男性中，肥胖和超重人群的比例每年增长1.2%，成年女性中则每年增长1%。⑴
Today, the top social cost to China is air pollution, the second is smoking, and obesity ranks only ninth. That ranking could rise very quickly.
如今，对中国来说，社会成本排名最高的是空气污染，其次是吸烟，而肥胖仅仅排在第九，但它的排名可能会快速上升。
Famine and feast
饥荒与盛宴
There is worrying evidence that obesity can entrench itself even more quickly in countries that have experienced food scarcity in the recent past. Take the Micronesian island of Nauru, which, until the mid-20th century, experienced repeated food shortages and starvation. Once food poverty was a thing of the past, the prevalence of obesity and type 2 diabetes soared to among the highest worldwide. In 2010, 94 percent of men and 93 percent of women were overweight, and approximately 71 percent of the population was obese. ⑵
令人担忧的证据是，在晚近历史上曾经历过食物短缺的国家，肥胖都成了根深蒂固的问题。例如密克罗尼西亚地区的瑙鲁岛，在直到20世纪中叶前的历史上，反复经历着食物短缺和饥荒。一旦食物匮乏不再是一个问题，此地肥胖和II型糖尿病的流行程度迅速蹿升，成为全世界该问题最严重的地区之一。2010年，94%的男性和93%的女性超重，大约有71%的肥胖人口。⑵
What needs to be done?
需要做什么？
Without action, almost half of adults in the world will be overweight or obese by 2030. MGI’s recent economic analysis of obesity looked at 74 interventions that are being discussed or piloted somewhere in the world (including restrictions on advertising of high-calorie food and drink, calorie and nutritional labeling, and public-health campaigns); we had sufficient information to compare 44 of these internationally.
若不采取行动，到2030年全世界大约会有一半的成年人超重或肥胖。MGI近期对肥胖的经济分析，观察了曾被讨论或试行的74种干预措施（包括限制高卡路里饮食做广告，用标签标明卡路里和营养成分，以及公共健康活动），其中44种我们有足够信息作出国际比较。
The conclusion was that each single intervention is likely to have only a small impact on its own. Only a systemic, sustained portfolio of anti-obesity initiatives will work——implemented on a large scale. Everyone needs to play their part from government to retailers, consumer-goods companies, restaurants, employers, media organizations, educators, health-care providers, and individuals.
结论是，单独实施时任何种干预措施，可能只有一点点作用。只有大规模地实施系统性的、持续的反肥胖组合措施才会奏效。政府、零售商、消费品公司、餐馆、雇主、媒体机构、教育工作者、医疗保健机构，以及个人，都需要在其中发挥作用。
Individual responsibility for health and fitness is vital, but experience shows it is insufficient on its own. People need help and that means changes to the environment in which they are making choices. Such changes include changing marketing practices, and restructuring cities to make it easier for people to exercise.
在保健问题上，个人责任是关键，但经验显示，仅仅靠它是不足够的。人们需要帮助，这意味着改变他们做决定时的环境。这包括改变营销策略，和把城市建设得让人们更易于锻炼。
Change is cost-effective
改变是划算的
MGI’s initial analysis of obesity in the United Kingdom found that almost all of the 44 interventions are cost-effective. So it is well worth China experimenting with solutions and trying them out—before obesity takes hold and becomes an expensive problem.
MGI最初在英国对肥胖的分析发现，几乎所有44种干预措施都是划算的。所以在肥胖问题变得昂贵且根深蒂固之前，这些解决方案对中国来说都是值得一试的。
⑴ Barry M. Popkin, “Will China’s nutrition transition overwhelm its health care system and slow economic growth?” Health Affairs, volume 27, number 4, 2008.
⑵ Nauru country health information profile 2011, statistical annex, World Health Organization.
翻译：bear
校对：陆嘉宾（@晚上不买白天买不到）
编辑：辉格@whigzhou