Egger Garry, Dixon John
School of Health and Human Sciences, Southern Cross University, P.O. Box 313, Balgowlah, Lismore, NSW 2093, Australia.
Clinical Obesity Research, Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia.
Biomed Res Int. 2014;2014:731685. doi: 10.1155/2014/731685. Epub 2014 Apr 7.
The obesity epidemic and associated chronic diseases are often attributed to modern lifestyles. The term "lifestyle" however, ignores broader social, economic, and environmental determinants while inadvertently "blaming the victim." Seen more eclectically, lifestyle encompasses distal, medial, and proximal determinants. Hence any analysis of causality should include all these levels. The term "anthropogens," or "…man-made environments, their by-products and/or lifestyles encouraged by these, some of which may be detrimental to human health" provides a monocausal focus for chronic diseases similar to that which the germ theory afforded infectious diseases. Anthropogens have in common an ability to induce a form of chronic, low-level systemic inflammation ("metaflammation"). A review of anthropogens, based on inducers with a metaflammatory association, is conducted here, together with the evidence for each in connection with a number of chronic diseases. This suggests a broader view of lifestyle and a focus on determinants, rather than obesity and lifestyle per se as the specific causes of modern chronic disease. Under such an analysis, obesity is seen more as "a canary in a mineshaft" signaling problems in the broader environment, suggesting that population obesity management should be focused more upstream if chronic diseases are to be better managed.
肥胖流行及相关慢性病常被归咎于现代生活方式。然而，“生活方式”一词忽视了更广泛的社会、经济和环境决定因素，同时不经意间在“指责受害者”。从更综合的角度看，生活方式涵盖了远端、中间和近端决定因素。因此，任何因果关系分析都应包括所有这些层面。“人类活动因素”一词，即“……人为环境、其副产品和/或受这些因素鼓励的生活方式，其中一些可能对人类健康有害”，为慢性病提供了类似于细菌理论为传染病所提供的单因关注点。人类活动因素的共同之处在于能够引发一种慢性、低水平的全身炎症（“元炎症”）。本文基于与元炎症相关的诱导因素对人类活动因素进行综述，并阐述其与多种慢性病相关的证据。这表明应从更广泛的视角看待生活方式，并关注决定因素，而非将肥胖和生活方式本身视为现代慢性病的具体病因。在这种分析下，肥胖更多地被视为“矿井中的金丝雀”，预示着更广泛环境中的问题，这表明如果要更好地管理慢性病，人群肥胖管理应更多地关注上游因素。
