Popkin Barry M
University of North Carolina, Chapel Hill, NC, USA.
Am J Clin Nutr. 2006 Aug;84(2):289-98. doi: 10.1093/ajcn/84.1.289.
Global energy imbalances and related obesity levels are rapidly increasing. The world is rapidly shifting from a dietary period in which the higher-income countries are dominated by patterns of degenerative diseases (whereas the lower- and middle-income countries are dominated by receding famine) to one in which the world is increasingly being dominated by degenerative diseases. This article documents the high levels of overweight and obesity found across higher- and lower-income countries and the global shift of this burden toward the poor and toward urban and rural populations. Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of animal and partially hydrogenated fats and lower intakes of fiber. Activity patterns at work, at leisure, during travel, and in the home are equally shifting rapidly toward reduced energy expenditure. Large-scale decreases in food prices (eg, beef prices) have increased access to supermarkets, and the urbanization of both urban and rural areas is a key underlying factor. Limited documentation of the extent of the increased effects of the fast food and bottled soft drink industries on this nutrition shift is available, but some examples of the heterogeneity of the underlying changes are presented. The challenge to global health is clear.
全球能量失衡及相关肥胖水平正在迅速上升。世界正迅速从一个饮食阶段转变，在这个阶段中，高收入国家以退行性疾病模式为主导（而低收入和中等收入国家则以饥荒消退为主导），转向一个世界日益被退行性疾病主导的阶段。本文记录了高收入和低收入国家普遍存在的超重和肥胖情况，以及这种负担向贫困人群、城市和农村人口的全球转移。饮食变化似乎普遍转向以摄入更多动物脂肪和部分氢化脂肪、摄入更少纤维为主导的饮食模式。工作、休闲、旅行和家庭中的活动模式也同样迅速转向能量消耗减少。食品价格大幅下降（如牛肉价格）增加了人们进入超市的机会，城乡地区的城市化是一个关键的潜在因素。关于快餐和瓶装软饮料行业对这种营养转变影响加剧程度的文献记载有限，但本文给出了一些潜在变化异质性的例子。对全球健康的挑战显而易见。
