抗擊兒童肥胖的鬥爭猶如溫水煮蛙

“NANNY”, “tyrant”—these were among the charges hurled at Michael Bloomberg, New York’s mayor, when he proposed a ban on big fizzy-drink bottles last May. The billionaire shrugged and pushed forward. However even Mr Bloomberg must heed a court order. The American Beverage Association, which represents Coca-Cola and other soda companies, has sued. Mr Bloomberg’s ban is due to start on March 12th, but a judge may intervene.

去年五月，紐約市長邁克爾﹒布隆伯格提出要全面取締大瓶汽水的銷售後，“奶媽”“暴君”——人們對市長的指責接踵而至，甚囂塵上。然而這位億萬富翁卻不以爲然，執意要將禁令進行到底。作爲可口可樂等一衆汽水公司的利益代表人，美國飲料協會將布隆伯格告上了法庭，面對法庭指令，市長不可掉以輕心。他的禁令將於3月12日生效，不過法院屆時可能會進行干預。

Three years after Michelle Obama launched her Let’s Move! campaign, the fight against childhood obesity faces a tactical problem. Recent years have seen dipping obesity rates in a few places, including New York, Mississippi and Philadelphia. But 17% of American children are still obese. The question is how to speed up progress. Further bans look increasingly unlikely.

距離美國第一夫人米歇爾﹒奧巴馬發起“動起來！”運動已過去三年，如今應對兒童肥胖的鬥爭卻陷入了策略上的泥淖。近些年，包括紐約，密西西比和費城在內的許多地區，肥胖率都在直線下降。但仍有17%的美國兒童過於肥胖。問題在於如何推動減肥運動的發展。頒佈禁令的做法顯得愈發不可靠。

Voluntary programmes remain politically much easier. Mrs Obama has exhorted firms to take action. Many companies have. On March 6th the Partnership for a Healthier America, a business group, published a report praising its members for putting more grocers in poor areas and healthier foods at restaurants. Sixteen food and beverage companies have promised to slash a combined 1.5 trillion calories from their products by 2015. Their first progress report is due in June. The long-term effect of these efforts may be slim. For example, even if the food and drink firms keep their promise, they would cut just 14 calories from the average American’s daily diet.

志願項目依舊能獲得政策上的支持。米歇爾敦促各企業採取行動。許多公司也積極響應，身體力行。3月6號，在集團企業“健康美國夥伴”發佈的報告中，就對其下屬公司在貧困地區增設雜貨店，爲餐廳提供健康食品的舉措予以讚揚。16家食品和飲料公司承諾在2015年前減少全部產品1.5萬億的卡路里值。它們的進度報告將於六月出爐。然而，所有的努力都禁不起長遠的推敲。例如，即使食品和飲料公司遵守諾言，美國人均日常飲食的熱量也只能降低14卡路里。

Regulations might bring bigger change, but recent years suggest that such rules will come slowly, if at all. Congress did pass a law requiring healthier school lunches, though its effects are limited. Other attempts at national regulation have stalled. Four federal agencies studied voluntary guidelines to limit junk-food advertisements to children. Under pressure from Congress, the agencies dropped the effort. Obamacare requires that all restaurants and cinemas post the number of calories in their foods. The Food and Drug Administration proposed a rule for menus in 2011, but has yet to finalise the regulation.

立法是較爲行之有效的辦法，但近幾年的實踐表明，規定的制定週期十分漫長。國會也確實出臺過要求學校改善伙食質量的相關法律，然而收效卻微乎其微。其他試圖制定全國法規的努力均以失敗告終。四所聯邦政府機構通過對支援項目指導方針的研究，提出限制垃圾食品廣告播放時間的構想，但迫於國會壓力，不得不半途而廢。奧巴馬醫改計劃要求所有的餐廳和影院都必須在提供的食品上標註卡路里含量。儘管2011年的時候，食品和藥品管理局提出制定一項有關菜單的法規，但至今都沒能如願以償。

Cities and states are more likely to act than Congress (hardly a high bar), but they face their own challenges. Last year the beverage lobby spent more than $2.8m to defeat a soda tax in the small city of Richmond, California. Even Mr Bloomberg, the anti-obesity crusade’s most fervent warrior, can only do so much.

比起國會（並非障礙），城市和各州更願意改變，但是挑戰無處不在。去年，位於加利福尼亞州的小城裏士滿欲向蘇打汽水徵稅，當地支持飲料業的遊說團體斥資280萬將其扼殺在襁褓之中。即便是反肥胖運動最忠誠的鬥士——博隆伯格市長也黔驢技窮。

He and his health commissioner, Thomas Farley, have already improved school lunches, installed bike lanes and paid for revolting posters that show soda turning to fat. Their efforts seem to be working. From 2003 to 2011 obesity rates among poor four-year-olds dropped from 20% to 17% (see chart). Obesity rates in older children dropped 5.5% from 2006 to 2011, though mostly among richer ones.

他和他的衛生專員，托馬斯﹒法利，改善了學校的伙食，增添了自行車道並且製作了令人厭惡的海報以展示汽水如何轉變爲脂肪。他們的努力卓有成效。從2003年至2011年，4歲貧困兒童的肥胖率由20%降至17%（見圖表）。大齡兒童的肥胖率也在2006年至2011年間降低了5.5%，儘管以富裕家庭爲主。

Mr Bloomberg wants to do more. But New York state rebuffed his bid for a statewide soda tax. Federal regulators rejected his attempt to ban the purchase of soda with food stamps. Now his size limit may be scrapped in court. Other cities are watching closely. If it can fail in New York, it will fail anywhere.

布隆伯格志在千里。他希望在全州範圍內徵收汽水稅，卻遭到了紐約州政府的反對。他試圖禁止貧困者用政府發放的食物券購買汽水，卻遭到了聯邦監管機構的拒絕。法院現在很可能否決他禁售大瓶汽水的決議。其他城市對此熱切關注。因爲成也紐約，敗也紐約。