Obesity 1 The global obesity pandemic: shaped by global drivers and local environments
Obesity 1 The global obesity pandemic: shaped by global drivers and local environments
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DOI：
10.1016/s0140-6736(11)60813-1
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发表时间：
2011-08-01
期刊：
影响因子：
168.9
通讯作者：
Gortmaker, Steven L.
中科院分区：
文献类型：
--
作者：
Swinburn, Boyd A.;Sacks, Gary;Gortmaker, Steven L.
几乎所有国家的肥胖症同时增加，似乎主要是由全球食品体系的变化驱动的，全球食品体系生产的加工食品比以往任何时候都多，价格合理，市场有效。这种被动的过度消耗能源导致肥胖是基于消费增长的市场经济的可预测结果。全球食物系统驱动因素与当地环境因素相互作用，造成不同人群之间肥胖患病率的巨大差异。在种群中，环境和个体因素（包括基因组成）之间的相互作用解释了个体之间体型的差异。然而，即使存在这种个体差异，这种流行病在亚群中也有可预测的模式。在低收入国家，肥胖主要影响富裕城市环境中的中年人（特别是妇女）;而在高收入国家，肥胖影响男女和所有年龄段，但在弱势群体中比例更高。与其他可预防的死亡和残疾的主要原因不同，如烟草使用，伤害和传染病，没有典型的人群中肥胖流行病已被公共卫生措施逆转。这种缺失增加了采取创造证据的政策行动的紧迫性，优先考虑减少供应方驱动因素。
The simultaneous increases in obesity in almost all countries seem to be driven mainly by changes in the global food system, which is producing more processed, affordable, and effectively marketed food than ever before. This passive overconsumption of energy leading to obesity is a predictable outcome of market economies predicated on consumption-based growth. The global food system drivers interact with local environmental factors to create a wide variation in obesity prevalence between populations. Within populations, the interactions between environmental and individual factors, including genetic makeup, explain variability in body size between individuals. However, even with this individual variation, the epidemic has predictable patterns in subpopulations. In low-income countries, obesity mostly affects middle-aged adults (especially women) from wealthy, urban environments; whereas in high-income countries it affects both sexes and all ages, but is disproportionately greater in disadvantaged groups. Unlike other major causes of preventable death and disability, such as tobacco use, injuries, and infectious diseases, there are no exemplar populations in which the obesity epidemic has been reversed by public health measures. This absence increases the urgency for evidence-creating policy action, with a priority on reduction of the supply-side drivers.