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营养健康，特别是生命早期阶段的营养健康对于维持终身健康至关重要。但当今时代下，合理的食物供应条件并不均衡，如何提高大众对营养健康的认知、改善营养供应条件是当前社会面临的重要问题。现《肿瘤瞭望消化时讯》邀请奥克兰理工大学Elaine Rush教授就自己多年的工作经验及心得体会进行分享，以期能为营养健康工作带来更多思考。

《肿瘤瞭望消化时讯》
您长期从事儿童健康、营养、肥胖和慢病预防研究。回顾这些年的工作，哪些健康变化最让您担忧？

Elaine教授

在所有影响健康的各类问题中，最让我忧心的是全球各地普遍存在的食物供应与安全问题，人们难以获取维持健康所需的食物是切实存在的现实困境。特别是当下接连爆发的各类战争与社会动荡，扰乱了全球的物资供应链。此外，贫富差距不断拉大的现状也令人十分担忧。低收入人群没有充足的资金，无法自主选择饮食；同理，儿童无法自主决定吃什么，只能被动接受供给。因此，我认为我们应当采用系统性思路审视全球粮食体系，并明确：获取食物是否应当和获取水资源一样，成为一项基本人权。

The change that's concerns me most for health is food supply and insecurity globally as well as locally. These are real concerns about people being able to source or access the foods that they need to be healthy. And particularly with the wars that have been happening and the unrest disrupting global supplies, I think we've got to really look at what's important. So I'm very concerned at how the gap between the rich and the poor is widening. The poor cannot choose the foods that they eat because they don't have enough money. Similarly, children cannot decide what they eat because they're reliant on the appearance to provide. So I think we've got to take a system's approach and look at the food system globally and decide, is this going to be a basic human right, just like water.

《肿瘤瞭望消化时讯》
如今人们获取健康信息比以往任何时候都更容易，但肥胖和慢病负担仍在增加。您认为为什么仅仅拥有知识往往不足以改变行为？

Elaine教授

如今的医疗体系越来越陷入事后补救的困局，只在疾病发生后被动救治，只有经济条件优渥的人群才能享受到完善的健康保障。公共卫生体系的职能之一就是普及健康知识：开设科普网站、发布基于食物的膳食指导方案。中国、新西兰都出台了相应指南，但这些标准与现实严重脱节。人们明明清楚应当多吃蔬果，可市场根本无法充足供给。即便民众有心践行健康饮食，尤其是为了孩子，但仅靠科普知识也远远不够。我们应当建立配套体系，一方面保障民众能够便捷获取健康食材，另一方面推动各国针对性开展粮食种植，实现本国居民粮食自给自足。

I think the healthcare systems is becoming more and more ambulance at the bottom of the cliff. And it's only those with affluent economic conditions can enjoy comprehensive health protection. One of the things that public health systems do is they put out knowledge：they have a website, they talk about the food based eating guidelines. China has some, New Zealand has some, but they just don't match with the reality. You know that you mean to have lots of vegetables and fruit, but it's just not there in the food supply. So knowledge is not enough, even though people know they want to do it for their children in particular. It just, is it possible there has to be systems put in place where access to food can occur, but also that food is growing purposefully within a country to be able to feed the people that live in that country.

《肿瘤瞭望消化时讯》
您的很多研究聚焦于生命早期健康。为什么儿童时期对于长期健康如此重要？

Elaine教授

先天的营养供给至关重要，随着机体不断分裂、生长，胎儿全程依靠母体供给的营养，才能按正常规律发育。孕期内诸多意外状况时有发生，可能为日后患病或维持健康埋下隐患。到了青春期，人体迎来迅猛的生长高峰，细胞进一步分化，两性特征逐步明显。这一阶段不仅奠定下一代生命的发育基础，也决定个体自身的远期健康。举例来说，倘若骨骼在青少年时期没能打好营养基础，晚年健康便会受影响，患上骨质疏松、摔倒后骨折的风险会显著升高。成长的每一天，营养都不可或缺。

It's so important, the nourishment that is a native. And then as the organism divides and grows, it's reliant on the nutrients that are supplied by the mother to be able to develop over the normal way. In that time, there are so many things that could and often do go wrong. So the development is not as smooth as it might be, and they can lay the path for future disease or future health. And in adolescence, a huge growth spurt and also more differentiation of cells, so that boy becomes man, girl becomes woman, setting up the environment for the next generation and also their own future health. For instance, unless the foundation is laid down for the bones of their time, it's not going to mean well for later in life, more likelihood of osteoporosis and breaking bones when you fall. Every day of growth, nourishment is indispensable.

《肿瘤瞭望消化时讯》
在您研究和参与过的众多健康干预措施中，哪些是真正有效并能够带来长期健康改善的？

Elaine教授

有一项落地于奥克兰南部怀卡托地区的项目成效最为突出，新西兰约三分之一的儿童都生活在这里。2004~2019，我们在当地开展了一项覆盖全学段的校园项目，名为“program Project Energize”。项目配备青年活力专员，每位专员对接8~13所学校并提供帮扶，在校内推行体育活动与健康饮食相关教学课程，并在发放科普宣传册之外，指导教师教授基础运动技能，教授孩子制作健康三明治，同时改造校园环境、搭建校园菜园。这项工作年复一年持续推进、层层巩固，坚持让孩子保持运动、均衡饮食，生活在健康的成长环境中。

The most successful and what I'm most proud of as a project that occurred south of Auckland in the area called the Waiketo, which has brand about a third of New Zealand's children there. And we, from 2,004 to 2,019, propel a through school program——program Project Energize, where energizes who were young people. Their job was to look after eight to 13 schools each and help those schools. Buffett physical activity and healthy eating programs for teaching. The children at that stage of life, but not just giving them pamphlets showing the teachers and how to teach fundamental movement skills, showing the children how to make a healthy sandwich, changing the environment to aid the growing of a school garden. And year after year, this program went on and was reinforced，keeping children with physical activity and eating and a healthy environment.

《肿瘤瞭望消化时讯》
如果只能给年轻人一个建议，帮助他们拥有更健康的未来，您最希望他们养成什么习惯？

Elaine教授

建立多吃蔬果的习惯。蔬果在提供不同的植物营养以及维生素和矿物质的同时，也能滋养肠道，为肠道中的微生物群带来获益。

Establish a habit of eating more fruits and vegetables. They have so many different plant nourishment and as well as vitamins and minerals. But they are things that also feed our gut, and that gives a lot of health to the microbiome in the gate gut. 

专家简介


Elaine Rush 教授

新西兰功绩勋章（MNZM）获得者，博士
新西兰健康研究理事会理事
世界卫生组织和国际原子能机构专家顾问
世界肥胖联盟新西兰代表
长期致力于营养、身体组成、儿童健康及慢性病预防研究，累计发表 300 余篇学术成果
主导参与多项研究项目，包括面向学前及小学阶段儿童的活力成长计划、妊娠糖尿病母亲子代的生长发育与膳食模式研究、太平洋岛民家庭纵向队列研究，以及印度儿童相关研究。同时担任里德特食品卓越研究中心荣誉院士、澳大拉西亚生活方式医学会荣誉院士
长期担任顾问、学术导师，并积极倡导优化膳食结构与粮食体系，以满足全人群的营养需求

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