经济学人115:长命百岁,美国胖子！

 　　Health and longevity 1健康与寿命

　　Long live the fat American长命百岁 美国胖子！
　　Obesity 2 may threaten life expectancy 3. Or maybe not
　　肥胖症不知是否会威胁人们的预期寿命
　　Jun 30th 2011 | NEW YORK | from the print edition
　　AMERICA’S obesity epidemic 4 is so called for a reason. Roughly one in three adults is obese 5. In 2008 close to 25m Americans were diabetic, according to a study published on June 25th. Nevertheless, Americans are living longer than ever. In 2007 the average life expectancy at birth was 78 years. This follows decades of progress. The question is whether obesity might change that.
　　在美国，说肥胖症流行有理有据：大约每三个成年人中就有一个是胖子。6月25日出版的一项研究结果表明，2008年，美国有近2500万糖尿病患者。然而，美国人正生活在史上最长寿的时期。2007年，初生婴儿平均预期寿命为78岁，这种进步已经持续数十年。如今的问题是肥胖症也许会改变这种进步的趋势。
　　National progress in life expectancy masks wide local disparities, according to a study published on June 15th and written by researchers at the University of Washington and Imperial College London. Men in Holmes County, Mississippi, for example, have a life expectancy of 65.9 years, the same as men in Pakistan and 15.2 years behind men in Fairfax, Virginia. Gaps between America’s counties have widened since the early 1980s. Most alarming, 702 counties, or 30% of those studied, saw a statistically 6 significant decline in life expectancy for women from 2000 to 2007; 251 counties saw a statistically significant decline for men.
　　一项由华盛顿大学和伦敦皇家学院的研究人员共同执笔，并于6月15日出版的一项研究结果显示，预期寿命所取得的全国性进步掩盖了广泛的地方性差异。例如，密西西比州Holmes县男性预期寿命为65.9岁，与巴基斯坦男性相同，但要比佛吉尼亚州Fairfax 县男性少15.2岁。美国各县之间的差距从1980年代早期开始扩大。最令人担忧的是，有702个县（占研究总数的30%）的女性预期寿命在2000年至2007年间出现了大幅下降，有251个县的男性预期寿命出现大幅下降。
　　America’s advances on the national level, meanwhile, have lagged behind those of other developed countries. A panel at the National Research Council recently took on the task of studying longevity. For American women, a rise in life expectancy of 3.3 years from 1980 to 2007 amounted to just 60% of the gains in other rich countries.
　　同时，美国在国家层面的进展已经落后于其它发达国家。美国国家科研委员会的一个专家组近期“受命”研究“寿命”。从1980年到2007年，美国女性预期寿命增长了3.3岁，只达到其它发达国家增幅的60%。
　　Much can be blamed on mid-century smoking habits. Obesity’s effect, however, is debated. While both Americans and Australians have ballooning bellies 7, Australia’s life expectancy has continued to move up nicely. Researchers at the National Research Council estimated that America’s high rates of obesity accounted for between one-fifth and one-third of its lagging life expectancy relative to other rich countries.
　　20世纪中期的吸烟潮对这一现状难辞其咎，但肥胖症的影响也正在争论之中。尽管美国人和澳大利亚人都是大腹便便，但澳大利亚人的预期寿命一直保持着健康的增长态势。据国家科研委员会的研究人员估计，美国的高肥胖率应为其预期寿命低于其它发达国家承担五分之一至三分之一的责任。
　　It is unclear whether obesity might have a greater impact in future. As medicine continues to advance, the paunchy may lead longer lives. Already, America’s most rotund citizens benefit from bypass surgery and cholesterol 8-lowering statins. The prevalence of high cholesterol and blood pressure among the obese in 1999-2000 was about half what it was in the early 1960s.
　　目前尚不清楚肥胖症未来会否有更深刻的影响。随着医学不断进步，大肚汉们可以多活些年月了。美国最胖的一群人已经受益于心脏搭桥手术和降胆固醇药的他汀。从1999年到2000年，胖人中的高胆固醇和高血压患者大约只占1960年代早期的一半。
　　But medical progress may do only so much. “Obesity is being acquired at such young ages that you wonder what the limits of these technologies will be,” argues Eric Reither of Utah State University. In a paper to be published in the August issue of Health Affairs, Mr Reither, Jay Olshansky of the University of Illinois at Chicago and Yang Yang of the University of North Carolina contend that obesity threatens progress in life expectancy. Predictions based on past patterns of mortality, they say, fail to take account of trends among the young. The early onset 9 of obesity may bring severe health problems, such as kidney failure, by the time today’s children reach adulthood 10.
　　但医学进步也许只能尽职于此了。犹他州立大学的Eric Reither抱怨：“肥胖症患者的过度年轻化使人对这类医学技术的限度产生怀疑。”在《健康事务》8月号上的一篇论文中，Reither、芝加哥伊利诺伊大学的Jay Olshansky以及北卡罗来纳大学杨洋作出了“肥胖症威胁预期寿命增长”的论断。他们指出，那种基于过去的死亡率的预测方式没有考虑到年轻人的变化趋势。过早患上肥胖症可能会在今天的孩子们成年时给他们带来严重的健康问题，如肾衰竭等。
　　James Vaupel, director of Duke University’s Population Research Institute, is sceptical of the argument that obesity may reverse future progress in life expectancy. More worrying, he says, is that rising obesity will lead to higher levels of disability. Mr Olshansky remains 11 wary 12. “We have this hurricane that’s about to sweep across the country,” he insists, “and we can’t see it yet.”
　　Duke大学人口研究院负责人James Vaupel对肥胖症将颠覆未来预期寿命发展进程的观点表示怀疑。他说，更令人担忧的是日益增加的肥胖病人将带来日趋严重的残障病人。Olshansky保持谨慎态度。 “这是一场即将到来的横扫全国的飓风，”他坚称，“只是我们还看不见它。”