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是的,肥胖是个问题——但更大的问题是食品行业及其贪婪Yes, obesity is a problem – but a greater one is the food industry and its greed

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“我之后的几代人从出生起吃的就是超加工食品。”照片:Alamy/PA‘The generations below me have eaten ultra-processed diets from birth.’ Photograph: Alamy/PA

您的社论《50岁以下人群的癌症》(10月8日)正确地将食品列为罪魁祸首之一。但它所呼吁的对抗应更多地针对导致肥胖的根源,而非肥胖本身。肥胖是中间环节;真正的暴露源是为利润而设计的食品体系。

Your editorial on cancers in under-50s ( 8 October ) rightly names food among the culprits. But the confrontation it calls for should be aimed less at obesity than at what produces it. Obesity is the intermediary; the exposure is a food system engineered for profit.

《柳叶刀》关于超加工食品的系列报道表明,这些产品正在全球范围内取代传统饮食并推动慢性病的发生,并记录了超过200个相互关联的游说集团,通过这些集团,食品行业组织其影响力以阻碍监管。

The Lancet's series on ultra-processed foods showed these products displacing traditional diets worldwide and driving chronic disease, and documented more than 200 interconnected lobby groups through which the industry organises its influence to block regulation.

我于51岁时被诊断出患有结肠癌,幸免于这些统计数据之外;比我年轻的一代自出生起就一直在食用超加工饮食。

I was diagnosed with bowel cancer at 51, narrowly escaping these statistics; the generations below me have eaten ultra-processed diets from birth.

政府知道什么有效:营销限制、警示标签、财政措施、学校和医院远离超加工食品,以及使政策制定免受行业干扰。

Governments know what works: marketing restrictions, warning labels, fiscal measures, schools and hospitals free from ultra-processed food, and policymaking protected from industry interference.

伊维特·库珀应像她的前任最终对待烟草那样,对待那些塑造我们饮食的公司:不视为可协商的伙伴,而应视为需予以监管的行业。肯特·布斯教授,肥胖与预防委员会,世界肥胖联合会早发性癌症的令人担忧的上升凸显了政府干预肥胖问题的紧迫性。当高脂、高盐、高糖的选择始终是最易获得且最实惠的选项时,我们的食品体系就已经破裂。

Yvette Cooper should treat the companies that shaped our diets in the same way that her predecessors eventually treated tobacco: not as partners to consult, but as an industry to regulate. Prof Kent Buse hair, policy and prevention committee, World Obesity Federation The worrying rise in early-onset cancers underlines the urgency of government intervention on obesity. Our food system is broken when high-fat, -salt and -sugar options are consistently the most accessible and affordable.

癌症研究和减肥药物的进步将在管理与饮食相关的疾病中发挥关键作用,但仅靠治疗无法解决公共卫生危机。我们必须首先修复驱动肥胖的食品环境。这要求改变大型食品企业的激励机制——这些企业生产并推销我们日常消费的食品。

Advances in cancer research and weight-loss drugs will play a key role in managing diet-related illness, but treatment alone cannot solve a public health crisis. We must fix the food environment driving obesity in the first place. That requires changing the incentives for large food businesses that make and market the food we eat.

政府提出的健康食品标准堪称迄今为止食品环境改革方面最具雄心的举措,但自该标准公布以来,相关进展却陷入停滞。该标准有望使全国成年人的肥胖率降低约五分之一,儿童肥胖率则有望下降四分之一。目前其他任何措施都远远无法达到这一效果。

The government's proposed healthy food standard sets out the most ambitious action for reforming the food environment to date, but progress has stalled since its announcement. It has the potential to reduce national obesity rates by about one fifth in adults and a quarter in children. Nothing else on the table comes remotely close to that.

首要步骤便是强制要求企业公开健康相关信息,从而杜绝企业自行“打分”的乱象。随后还需为各大食品企业设定明确目标,促使其改善所售食品的健康属性。归根结底,只有让健康食品成为最易获取且价格最亲民的选择,我们才能保护下一代免受可预防的饮食相关疾病之苦。我们绝不能采取“坐等民众患病后再用药治疗”这种消极策略。

The first step is establishing mandatory health reporting so that companies can no longer mark their own homework. Then we need clear targets for major food businesses to improve the health of what they actually sell. Ultimately, we cannot protect future generations from preventable diet-related disease until healthier food is the easiest and most affordable option. We cannot let our strategy be "wait for people to get sick and then put them on the drugs".

雨果·哈珀,Nesta基金会主任在英格兰,癌症已成为2型糖尿病患者的主要死因,代谢风险与癌症问题更是当前健康领域面临的重大威胁。然而,无论是医疗从业者还是400万名2型糖尿病患者本人,对此却知之甚少。

Hugo Harper Director, Nesta Cancer has become the greatest cause of death among people with type 2 diabetes in England and the problem of metabolic risk and cancer is one of the great threats to health. However, this is not known by health professionals or the 4 million patients with this condition.

癌症筛查项目在公众的积极配合下能够发挥显著成效。全科医生及其所在诊所可借助每年一次的糖尿病检查契机,向患者强调癌症预防的重要性。只要资源得到合理调配,癌症筛查项目与基层医疗服务便能携手合作,共同预防癌症。世界癌症研究基金会的最新报告更是凸显了此事的紧迫性——让我们切实加以利用吧。帕万·兰德夫博士,英国癌症研究基金会前全科医生我饶有兴趣地阅读了安娜·鲍登的文章(《国际研究发现:年轻人群体中癌症发病率上升更快》,10月6日)。

文章似乎认为“生活方式的选择”是造成这一现象的主要原因,但我想知道,如今我们究竟有多少选择的余地?

Cancer screening programmes work effectively with informed participation. GPs and their practices can use the annual diabetes check to highlight the cancer prevention. Screening programmes and primary care can work together to prevent cancer, if resources are targeted in the best way. The World Cancer Research Fund report has added urgency – let's use it effectively. Dr Pawan Randev Former Cancer Research UK GP I read with interest Anna Bawden's article ( Cancer rates rising more quickly among younger people, international research finds, 6 October It seems that "lifestyle choices" are largely responsible for this, but I wonder just how much of a choice is open to us nowadays.

我们可以选择少饮酒、不吸烟、多运动、吃得更健康,但健康食品的选择却十分有限。随着产品日益工业化,化学添加剂被大量添加,而我们对环境或农业污染物的控制几乎为零。除此之外,我们还要面对不断上涨的生活成本以及就业困难带来的压力。

We can choose to drink less alcohol, not smoke, exercise more and eat more healthily, but our choice of healthy food is limited, as products become increasingly industrialised with the addition of chemical additives, and we have little or no control over environmental or agricultural pollutants. To all this we might add the stress of the increasing cost of living and difficulty in finding jobs.

我认为,问题或许并不在于生活方式的选择不当,而在于我们缺乏真正的选择。帕特里夏·汉普顿,意大利米兰

I believe it is perhaps not so much a question of poor lifestyle choices, but a lack of lifestyle choices. Patricia Hampton Milan, Italy