Drewnowski Adam
Nutritional Sciences Program and the Center for Public Health Nutrition, School of Public Health, University of Washington, Seattle, WA 98195, USA.
Nestle Nutr Inst Workshop Ser. 2012;73:95-112. doi: 10.1159/000341303. Epub 2012 Oct 29.
Obesity in the United States does not affect all segments of the population equally. It is more prevalent in deprived neighborhoods and among groups with lower education and incomes. Inequitable access to healthy foods is one mechanism by which socioeconomic factors can influence food choice behaviors, overall diet quality, and bodyweight. Having a supermarket in the immediate neighborhood has been linked to better diets and to lower obesity rates. However, the affordability of healthy foods may have more of an impact on food patterns than does distance to the nearest store. Grains, added sugars, and added fats are inexpensive, good-tasting, and convenient. Their consumption has been linked to lower quality diets, lower diet costs, and lower socioeconomic status. By contrast, the recommended healthier diets not only cost more but were consumed by more affluent groups. New techniques of spatial analysis are a promising approach to mapping obesity rates and linking them with measures of socioeconomic status based on diverse social and economic aspects of the built environment. Low residential property values predicted bodyweights of women better than did either education or incomes. Shopping in low-cost supermarkets was another powerful predictor of bodyweight. Bodyweight gain may be best predicted not by any one nutrient, food or beverage but by low diet cost. Higher obesity rates in poor neighborhoods may be the toxic consequence of economic insecurity. Alleviating poverty may be the best, if not the only, way to stop the obesity epidemic.
美国的肥胖问题对不同人群的影响并不相同。在贫困社区以及受教育程度和收入较低的群体中更为普遍。社会经济因素影响食物选择行为、总体饮食质量和体重的一种机制是获取健康食品的机会不平等。附近有超市与更好的饮食和更低的肥胖率有关。然而，健康食品的可承受性对饮食模式的影响可能比与最近商店的距离更大。谷物、添加糖和添加脂肪价格低廉、味道好且方便。它们的消费与较低质量的饮食、较低的饮食成本和较低的社会经济地位有关。相比之下，推荐的更健康饮食不仅成本更高，而且更多为富裕群体所消费。空间分析新技术是一种很有前景的方法，可用于绘制肥胖率地图，并将其与基于建成环境的各种社会和经济方面的社会经济地位指标联系起来。低住宅房产价值比教育或收入更能预测女性的体重。在低成本超市购物是体重的另一个有力预测因素。体重增加可能最好不是由任何一种营养素、食物或饮料来预测，而是由低饮食成本来预测。贫困社区较高的肥胖率可能是经济不安全的有害后果。减轻贫困可能是阻止肥胖流行的最佳方法，如果不是唯一方法的话。
