Raising children in the MAHA era: Where have all the healthy kids gone?
There have been massive changes in children’s health—both physical and mental—over the last generation.
在上一代人中，儿童的身体和精神健康发生了巨大变化。
In this episode of No More Sidewalks: Parenting Today , CEO of ParentData and Brown University economist Emily Oster joins host Abby McCloskey to discuss what new factors could be driving these shifts, as well as what can be done at the household and government levels to improve the health of children.
在《不再人行道：今日育儿》的这一集中，ParentData 首席执行官兼布朗大学经济学家艾米丽·奥斯特 (Emily Oster) 与主持人艾比·麦克洛斯基 (Abby McCloskey) 一起讨论哪些新因素可能推动这些转变，以及家庭和政府层面可以采取哪些措施来改善儿童的健康。
Abby M.
艾比·M。
McCloskey is a columnist for Bloomberg Opinion and the Dallas Morning News .
麦克洛斯基是《彭博社观点》和《达拉斯晨报》的专栏作家。
She is a nonresident fellow in Economic Studies at the Brookings Institution.
她是布鲁金斯学会经济研究的非常驻研究员。
She is founder and principal of McCloskey Policy LLC, a research and consulting firm serving business and political leaders across the country.
她是 McCloskey Policy LLC 的创始人兼负责人，该公司是一家为全国各地的商业和政治领导人提供服务的研究和咨询公司。
Emily F.
艾米丽·F。
Oster is the Esposito Family Goldman Sachs University Professor of Economics at Brown University.
奥斯特是布朗大学埃斯波西托家族高盛大学经济学教授。
Her research focuses on health and statistical methods, as well as educational recovery from the COVID-19 pandemic.
她的研究重点是健康和统计方法，以及从 COVID-19 大流行中恢复教育。
Emily is the founder and CEO of ParentData , a data-driven guide to pregnancy, parenting, and beyond.
Emily 是 ParentData 的创始人兼首席执行官，这是一本关于怀孕、育儿等方面的数据驱动指南。
She is also a New York Times best-selling author, whose books include Expecting Better , Cribsheet , The Family Firm, and The Unexpected .
她也是《纽约时报》畅销书作家，其著作包括《期待更好》、《Cribsheet》、《家族企业》和《意外》。
Welcome to No More Sidewalks, where we discuss parenting today.
欢迎来到“不再人行道”，我们今天在这里讨论育儿问题。
I’m Abby McCloskey.
我是艾比·麦克洛斯基。
As a parent the baseline you want for your child is good health, and yet that’s become harder to come by.
作为父母，您希望孩子健康的底线是健康，但这变得越来越难实现。
Things I’m sure my own mother spent approximately two minutes thinking about in her whole life like tap water or microplastics or Tylenol, now live in a never-ending doom scroll for parents.
我确信我自己的母亲在她的一生中花了大约两分钟思考的事情，比如自来水、微塑料或泰诺，现在都生活在父母永无休止的厄运卷轴中。
Prominent social media feeds are filled with stories about pesticides on our fruits and vegetables, the food dyes in our children’s favorite cereal, and cancer-causing chemicals in basically everything.
著名的社交媒体上充斥着关于水果和蔬菜中的杀虫剂、孩子们最喜欢的谷物中的食用色素以及几乎所有东西中的致癌化学物质的故事。
Overnight, it feels like it’s become a full-time job in twenty-first century America for moms and dads to avoid seemingly poisoning our kids starting in pregnancy.
一夜之间，在二十一世纪的美国，避免孩子从怀孕开始就受到毒害似乎成了父母的一项全职工作。
There’s a sense of urgency underlying all of it.
这一切背后都有一种紧迫感。
That’s because kids are objectively less healthy today than they’ve been in previous generations on a large number of core metrics, and this despite never spending more money on healthcare or having more information at our fingertips.
这是因为，在许多核心指标上，今天的孩子客观上不如前几代人健康，尽管我们从来没有在医疗保健上花更多的钱，也没有掌握更多的信息。
Some parents are wondering if the healthcare system itself is the culprit.
一些家长想知道医疗保健系统本身是否是罪魁祸首。
Are vaccines leading to an uptick of autism or autoimmune disorders and early puberty?
疫苗是否会导致自闭症或自身免疫性疾病和青春期提前的增加？
Are kids overmedicalized, over-therapied, overvaxxed?
孩子们是否过度医疗、过度治疗、过度注射疫苗？
Joining us to discuss all of this is Emily Oster.
艾米丽·奥斯特 (Emily Oster) 与我们一起讨论这一切。
Emily is not a physician; she is a distinguished economist at Brown University.
艾米丽不是医生；她是一名医生。她是布朗大学的杰出经济学家。
She is also the founder of the immensely popular website ParentData, which I highly recommend, and a New York Times bestselling author of several books, including Cribsheet .
她还是极受欢迎的网站 ParentData（我强烈推荐）的创始人，也是《纽约时报》畅销书的作者，包括《Cribsheet》。
How many books is it now—five?
现在有多少本书——五本书？
Which in my opinion should be given out right in the maternity ward.
我认为应该在产房里发放。
If you are a parent, Emily is who you want to talk to, and this is the conversation you’ve been waiting for to understand what has changed in children’s health in our country.
如果您是父母，艾米丽就是您想与之交谈的人，这就是您一直在等待的对话，以了解我国儿童健康状况的变化。
Emily, welcome.
艾米丽，欢迎。
Well, I’m so grateful for your friendship, and I know that millions of parents wish that they had you on speed dial as a friend and ask all of the questions that you’re so good at answering, and we’ll talk about a lot of those today.
嗯，我非常感谢你们的友谊，我知道数以百万计的父母希望他们能把你作为朋友加入快速拨号，并询问你擅长回答的所有问题，今天我们将讨论其中的很多问题。
But I think at the base of it is this fear that today’s children are the sickest generation of children in American history.
但我认为，其根源是担心今天的孩子是美国历史上病态最严重的一代。
We stand at a generational turn point.
我们正处于一个世代的转折点。
Our children are the sickest generation in modern history, and decades of failed policies, captured agencies, and profit-driven systems have caused it.
我们的孩子是现代历史上最病态的一代，几十年来失败的政策、被俘的机构和利润驱动的体系造成了这一问题。
Parents across the country demanded change and we are delivering.
全国各地的家长都要求改变，我们正在兑现。
That was the conclusion of the MAHA report, the Make America Healthy Again report last summer.
这是去年夏天 MAHA 报告《让美国再次健康》的结论。
And I just want to start by asking you, is that true?
我只想首先问你，这是真的吗？
I think that’s a complicated question, and there are some dimensions it’s true on and some that it’s not, which is of course how academics start every answer.
我认为这是一个复杂的问题，在某些方面是正确的，在某些方面则不是，这当然是学者们如何开始每个答案的。
But I think there are some things for which that is true.
但我认为有些事情确实如此。
So obesity rates, for example, are higher now than they have ever been.
例如，肥胖率现在比以往任何时候都高。
If you look at metabolic disease, Type 2 diabetes, that was virtually unheard of in kids, you know, 50 years ago, and it is now fairly common.
如果你看看代谢性疾病，即 2 型糖尿病，这在 50 年前在儿童中几乎是闻所未闻的，但现在却相当常见。
So there are some of these kind of chronic disease conditions which certainly have gone up.
因此，某些慢性疾病的发病率肯定有所上升。
There are other places where I think the data’s a bit more nuanced, so something like autism.
我认为还有其他地方的数据更加细致，比如自闭症。
That is diagnosed at much higher rates now than it was in the past, but a huge share, perhaps all, certainly a very large share of that increase is in fact diagnostic, not about differences in actual illness, but more about how we recognize things.
现在的诊断率比过去高得多，但其中很大一部分，也许是全部，当然很大一部分实际上是诊断性的，不是关于实际疾病的差异，而是更多关于我们如何认识事物。
And it’s more complicated to say that that’s an increase in illness.
说这是疾病的增加就更复杂了。
And then there are some places, and I actually think this is a really important point, where, like, things have gotten much better, okay?
还有一些地方，我实际上认为这是非常重要的一点，比如，事情已经变得更好了，好吗？
So, like, think about lead.
所以，想想铅。
Parents are very worried about lead.
家长们非常担心铅。
Heavy metal exposure.
重金属暴露。
Kids are getting so much lead paint, lead in food.
孩子们摄入大量含铅油漆和食物中的铅。
Every week there’s a thing, it’s like there’s lead in this food or that food.
每周都会发生一件事，就像这种食物或那种食物中含有铅。
Okay.
好的。
Let me just be straight with you.
让我直接告诉你吧。
You and I, Abby, we have so much lead in us, okay?
你和我，艾比，我们身上有太多的铅，好吗？
When we were kids, it was just so much lead.
当我们还是孩子的时候，铅含量非常高。
The threshold for diagnosing a kid and being worried about a kid’s lead level used to be, like, 60.
过去，诊断儿童和担心儿童铅水平的门槛是 60。
And now it’s something like 3.
现在大约是 3。
So over, over time, because we stopped lead in gasoline, we started thinking about this, kids’ lead levels have just come down and down and down.
随着时间的推移，由于我们停止了汽油中的铅含量，我们开始考虑这个问题，孩子们的铅含量一直在下降、下降、下降。
And so, you know, zero lead would be the best, but fundamentally, kids are way better on that dimension than they once were, and there are many other examples of that.
所以，你知道，零铅是最好的，但从根本上来说，孩子们在这方面比以前更好，而且还有很多其他例子。
So I think the picture is more complicated.
所以我认为情况更加复杂。
Certainly not everything has gotten better, but not everything’s gotten worse either.
当然，并不是一切都变得更好，但也不是一切都变得更糟。
Yeah.
是的。
Or think of, like, teenage pregnancy, which would’ve been a big deal in, you know, the ‘90s when you and I were in school.
或者想想，比如青少年怀孕，这在 90 年代你和我还在上学的时候是一件大事。
Right.
正确的。
That’s gotten better.
这已经好多了。
Yeah, we’re not having that, yeah.
是的，我们没有，是的。
Nobody’s getting pregnant.
没有人怀孕。
I mean, teen pregnancy has really, really collapsed in a way that…
我的意思是，青少年怀孕确实以某种方式崩溃了……
yes, in the 1990s, that was all we were concerned about, was constant discussion of teen pregnancy.
是的，在 20 世纪 90 年代，我们所关心的就是关于青少年怀孕的持续讨论。
There were TV shows.
有电视节目。
Totally.
完全。
And I get that it’s a mixed bag.
我知道这是一个鱼龙混杂的情况。
It’s very hard to make a blanket statement like, “This is the sickest generation of kids in American history,” and obviously if you went back even further, that would become an even more ridiculous—
很难做出像“这是美国历史上最病态的一代孩子”这样的笼统声明，显然如果你回溯得更远，那会变得更加荒谬——
Infant mortality rates used to be 50% before the age of five, so that’s gotten better.
五岁之前的婴儿死亡率过去为 50%，现在已经有所改善。
Yeah.
是的。
But I still think as a mom myself, you’re a mother, when I think back to growing up in the ‘80s and ‘90s, I’m not sure we ever had a piece of salmon or an avocado, or there was any talk about eating organic foods.
但我自己仍然认为，作为一个母亲，你就是一个母亲，当我回想起在 80 年代和 90 年代的成长时，我不确定我们是否曾经吃过一块鲑鱼或牛油果，或者是否有人谈论过吃有机食品。
And yet, again, I was a child, so I don’t exactly know if my memory serves me well, but there weren’t these types of chronic conditions and allergens and all of the health problems, obesity rates that we see today, and yet I don’t really remember hardcore organic nutrition being a feature of my childhood.
然而，我还是个孩子，所以我不知道我的记忆是否对我有好处，但没有这些类型的慢性病和过敏原以及我们今天看到的所有健康问题和肥胖率，但我真的不记得核心有机营养是我童年的一个特征。
One of the issues with all of this discussion is it has gotten us focused on sort of too many things rather than the relatively small number of things which I do think are problematic about the way the health environment has changed.
所有这些讨论的问题之一是，它让我们关注太多的事情，而不是我认为对健康环境变化方式存在问题的相对较少的事情。
Probably the most significant of which is the ultra-processed food, high energy density foods.
其中最重要的可能是超加工食品、高能量密度食品。
So the the food environment, while in some ways organic salmon is more available, the thing that is really a lot more available is snacks.
因此，就食品环境而言，虽然在某些方面有机鲑鱼更容易获得，但真正更容易获得的是零食。
So that’s a change.
所以这是一个改变。
That’s a change from you and I growing up.
这是你我成长过程中的改变。
Okay.
好的。
That is a change.
这是一个改变。
Yeah, I mean, our, our ability to process food, like over the course of the last five decades, has really improved.
是的，我的意思是，我们加工食物的能力，就像过去五年一样，确实得到了提高。
We’ve gotten much better at making hyper-palatable, high-energy density foods that you can eat a lot of without feeling full.
我们在制作超美味、高能量密度的食物方面已经做得更好，你可以吃很多而不感到饱。
We just got a lot better at doing that.
我们在这方面做得更好了。
And that means that people are eating a lot more of that, and that means we are seeing an increase in obesity.
这意味着人们吃得更多，这意味着我们看到肥胖率增加。
And many of the kinds of issues that we’re citing in terms of health issues for kids are really about metabolic disease and about sort of increases in obesity rates and then therefore the increase in Type 2 diabetes and other issues that we have typically only seen with older people.
我们在儿童健康问题方面提到的许多问题实际上都与代谢疾病和肥胖率的增加有关，从而导致 2 型糖尿病和其他我们通常只在老年人中看到的问题的增加。
So that, that piece of it, the kind of ultra-processed food piece, I do think is quite different and is something to be concerned about for sure.
因此，我确实认为那块超加工食品是完全不同的，并且肯定是值得关注的。
Are there other big pieces that you feel like have changed in the environment around kids’ health?
您认为儿童健康环境中还有其他重大变化吗？
Well, for me, there is nothing as large as that in terms of just basic health.
嗯，对我来说，就基本健康而言，没有什么比这更重要的了。
There is probably more sedentary behavior relative to the past.
与过去相比，久坐的行为可能更多。
There’s more fun stuff to do inside, and so exercise is important, and people aren’t probably doing as much of that as they should.
里面有更多有趣的事情可以做，所以锻炼很重要，但人们可能没有做他们应该做的那么多。
But those are the two things I think are the biggest changes.
但我认为这两件事是最大的变化。
I don’t know what you’d put on that list.
我不知道你会把什么列入该清单。
Well, I want to kinda dig into the list, because especially on the ultra-processed foods, that is such a core part of the MAHA movement.
嗯，我想深入研究一下这个清单，因为特别是在超加工食品上，这是 MAHA 运动的核心部分。
And I don’t think I’ve ever seen, with the exception of, like, screens and tech in kids, such a dynamic political movement among parents as MAHA.
我想我从来没有见过，除了孩子们的屏幕和科技之外，家长中像 MAHA 这样充满活力的政治运动。
And I feel like it’s framed not just that there’s been this uptick in our ability to create highly processed, ultra-processed foods, but that actually there is kind of a conspiracy between big pharma, big food, big government, that it’s actually not this stuff is more available, but somehow it’s almost being forced upon us.
我觉得这不仅是因为我们制造高度加工、超加工食品的能力有所提高，而且实际上大型制药公司、大型食品、大型政府之间存在某种阴谋，实际上并不是这些东西更容易获得，而是不知何故它几乎是被强加给我们的。
And so I’m I’m just curious your sense if if you’re in agreement kind of identifying that this is one of the major issues impacting kids’ health.
所以我只是好奇你的感觉，如果你同意这是影响孩子健康的主要问题之一。
It’s a it’s a change this generation to previous ones.
这是这一代与前一代的变化。
Like, is the attention on this from MAHA, and we can talk more about what MAHA’s specifically doing, a net benefit?
就像，MAHA 对此的关注吗？我们可以更多地讨论 MAHA 具体做什么，净收益吗？
I don’t agree with everything the MAHA movement does.
我不同意 MAHA 运动所做的一切。
I do think this is a net benefit, although I think that maybe some of the motivational understanding is confused.
我确实认为这是一个净收益，尽管我认为也许某些动机理解是混乱的。
Mm-hmm.
嗯嗯。
So some of this from the MAHA movement ends up sounding, as you say, sort of like a conspiracy.
所以，正如你所说，MAHA 运动中的一些最终听起来有点像阴谋。
Like, Big Food and Big Pharma are in cahoots, and Big Food is trying to give your kids diabetes so Big Pharma can sell them a GLP-1.
比如，大型食品公司和大型制药公司串通一气，大型食品公司试图让你的孩子患上糖尿病，这样大型制药公司就可以向他们出售 GLP-1。
I hear this kind of story a lot.
我经常听到这样的故事。
I don’t think it’s as complicated as all that.
我认为事情没有那么复杂。
I think a much simpler understanding is that the people who make food want to sell food.
我认为更简单的理解是，制作食物的人想要出售食物。
That’s their job.
那是他们的工作。
Their job is to make foods that you want to buy so they sell more of them, because that’s what capitalism is.
他们的工作是生产你想买的食物，这样他们就能卖出更多的食物，因为这就是资本主义。
And so they are incentivized to make foods that are delicious and that you want to eat a lot of because that’s how you get people to buy your foods.
因此，他们有动力去制作美味的食物，让你想吃很多，因为这就是让人们购买你的食物的方式。
I don’t think you need anything more complicated than that.
我认为您不需要比这更复杂的东西。
They don’t need to be cahooting with somebody else.
他们不需要与其他人勾结。
It’s enough to say just the market incentives have pushed into a space where a lot of the foods that are produced are kind of hyper-palatable—
足以说，市场激励已经进入了一个领域，生产的许多食品都非常美味——
—high energy density foods that people eat a lot of, just because people like to eat delicious food.
——人们大量食用的高能量密度食物，只是因为人们喜欢吃美味的食物。
And then I think the question is, okay, with that, how can we then understand, you know, what needs to push back in the other direction?
然后我认为问题是，好吧，我们如何才能理解，你知道，什么需要在另一个方向上推回？
And that’s a harder thing, and it’s not so much that I think there’s a conspiracy, it’s just this is something we are fighting against, and it’s a real, it’s a real market incentive.
这是一件更难的事情，我认为这并不是什么阴谋，而是我们正在反对的事情，这是真实的，这是真正的市场激励。
Right.
正确的。
Well, I think where the conspiracy part bleeds over, so to speak, is there’s all sorts of delicious, fun things in a capitalist society that we don’t allow, or we put punitive taxes on, or we regulate against.
好吧，我认为阴谋部分的渗透之处，可以这么说，是在资本主义社会里有各种各样美味、有趣的事情，我们不允许，或者我们征收惩罚性税收，或者我们监管反对。
And so why is it the case that so many more of those things seem to be, you know, if it’s at the root of this health crisis, seem to be getting through in our system, especially considering in other places they have limitations and rules against these types of things?
那么，为什么这么多的事情似乎是，你知道，如果这是这场健康危机的根源，似乎正在我们的系统中得到解决，特别是考虑到在其他地方他们对此类事情有限制和规则？
And I think it would be great to have more of those, but I don’t think that’s so much about, like, I guess maybe I just am a person with no faith in the regulatory environment, but, like, Congress can’t get anything done.
我认为拥有更多这样的东西会很棒，但我不认为这有那么多，比如，我想也许我只是一个对监管环境没有信心的人，但是，比如，国会无法完成任何事情。
The fact that they can’t get, like, regulations on ultra-processed food just strikes me as they don’t seem to be able to do anything.
事实上，他们无法获得有关超加工食品的法规，这一事实让我震惊，因为他们似乎无能为力。
Well, and, and the ultra-processed food thing, which is a nice kind of bundle to put it all up in, because it’s also, it’s the food dyes and the tap water and the pesticides, and it’s like it’s all this stuff that kind of exists in this universe of our kids have never been more chemically exposed.
嗯，还有超加工食品，这是一个很好的组合，可以把它们全部放在一起，因为它也是食品染料、自来水和杀虫剂，就好像我们孩子的这个宇宙中存在的所有这些东西从未像现在这样接触过化学物质。
There’s never been more additives in food than there are right now, and no one seems to be doing anything.
食品中的添加剂从来没有像现在这样多过，而且似乎没有人做任何事情。
Yeah, but again, I think what makes this complicated is a lot of those things you just said, I usually don’t think that we have a lot of evidence that those are—
是的，但同样，我认为让事情变得复杂的是你刚才所说的很多事情，我通常不认为我们有很多证据表明这些是——
—problematic per se.
——本身就有问题。
So this, like, you know, Red Dye 40.
所以这个，就像，你知道的，Red Dye 40。
You know?
你知道吗？
We’ve done experiments with that.
我们已经对此进行了实验。
That itself does not cause kids to have problem.
这本身不会导致孩子出现问题。
Nope.
没有。
It’s not.
它不是。
And similarly, you know, I don’t think microplastics are great.
同样，你知道，我不认为微塑料有什么好处。
Nobody’s saying that we need to have more microplastics.
没有人说我们需要更多的微塑料。
I don’t really want a spoonful of them in my brain, but they’re there just like the lead.
我真的不想让一勺它们进入我的大脑，但它们就像铅一样在那里。
There’s not a credit card…
没有信用卡……
it turns out there’s not that much microplastics in your brain.
事实证明，你的大脑中并没有那么多微塑料。
Those studies are pretty problematic.
这些研究都是有问题的。
there’s not that much in your brain, but there is some microplastic in you, and that’s not great.
你的大脑里没有那么多，但你体内有一些微塑料，这不太好。
On the other hand, the doses that people are exposed to are way, way, way lower than we probably need for for health issues.
另一方面，人们接触到的剂量远低于我们解决健康问题所需的剂量。
So we’re kind of conflating many things together, when in some sense I think there’s a very simple thing, which is just people are eating too many calories.
所以我们有点把很多事情混为一谈，从某种意义上说，我认为有一个非常简单的事情，那就是人们摄入了太多卡路里。
You give people hyper-palatable foods that are high energy density, and they eat a tremendous number of more calories.
你给人们提供高能量密度的美味食物，他们就会摄入更多的卡路里。
That we know from experimental lab-based data, and that is not good, period.
我们从基于实验室的实验数据中得知，这并不好，就这样。
You don’t need any of this other stuff, and then that’s really hard to regulate though, because how are you, like…
你不需要任何其他的东西，但这真的很难监管，因为你怎么样，就像……
what is the thing you’re putting a regulation on?
你们要监管的是什么？
Is it the, like, energy density of the food?
是食物的能量密度吗？
Is it the processing?
是加工的吗？
But a lot of things are processed that are actually fine for you.
但很多事情都经过处理，实际上对你来说很好。
Like, what about whey protein?
比如，乳清蛋白怎么样？
A lot of healthy people eat whey protein.
许多健康人食用乳清蛋白。
Super highly processed food.
超级深加工食品。
What about…
那么……
Okay, we’ll just going down the list.
好的，我们就沿着列表往下看。
What about tap water and fluoride?
自来水和氟化物怎么样？
Is there more fluoride than when you and I were growing up?
现在的氟化物比你我小时候还多吗？
Like, why is that spiking as a concern?
比如，为什么这个问题会激增？
People have always been worried about fluoride.
人们一直对氟化物感到担忧。
It’s like a weird conspiracy theory, like back to Dr. Strangelove.
这就像一个奇怪的阴谋论，就像回到《奇爱博士》一样。
You don’t need to worry about fluoride.
您无需担心氟化物。
The fluoride levels in your tap water are much lower than the level of fluoride that would cause concern, and if we take fluoride out of the tap water, people are gonna have cavities.
自来水中的氟化物含量远低于引起关注的氟化物含量，如果我们从自来水中去除氟化物，人们就会患蛀牙。
Okay, and what about pesticides?
好吧，那么农药呢？
Because I feel like in my kids’ school lunches, and they’re looking around the table, why everyone has organic raspberries and organic strawberries, and they’re coming in, you know, hot at every meal, and there’s just a lot of pressure, like if you don’t buy organic, like, you’re poisoning your kids.
因为我觉得在我孩子们的学校午餐中，他们环顾餐桌，为什么每个人都有有机覆盆子和有机草莓，而且它们每顿饭都是热的，而且压力很大，就像如果你不买有机的，就像你正在毒害你的孩子一样。
But is there also research that shows it’s a lot better to have organic?
但是否也有研究表明有机食品会更好？
And do people need to be having berries all the time?
人们需要一直吃浆果吗？
Kinda what’s going on there?
那里发生了什么事？
There is not any reliable research that organic foods would be better for your children.
没有任何可靠的研究表明有机食品对您的孩子更好。
Certainly very high exposures to pesticides, like you would get in farm workers, can be dangerous, and that is a policy issue of some concern.
当然，大量接触农药（就像农场工人接触到的农药一样）可能是危险的，这是一个令人担忧的政策问题。
But it’s very different than the question of what kind of strawberries go in your kids’ lunch, and the nutrients there are very, very similar.
但这与孩子午餐中吃哪种草莓的问题非常不同，而且其中的营养成分非常非常相似。
Okay.
好的。
Helpful.
有帮助。
What about shifting to the medical system and kind of the role…
转向医疗系统和角色怎么样……
Again, this gets wrapped up in why are kids sicker?
再说一次，这又涉及到为什么孩子会生病？
Maybe there’s a conspiracy to make kids more sick.
也许有一个阴谋让孩子们病得更重。
And this, again, takes a number of different forms.
这同样有多种不同的形式。
Arguably, no one is bigger than the role of vaccines.
可以说，没有人比疫苗的作用更大。
And I think we saw this obviously during COVID, and then with the measles vaccine, and then with the vaccination schedule in general.
我认为我们在新冠疫情期间明显看到了这一点，然后是麻疹疫苗，然后是总体疫苗接种计划。
But how do you respond to the accusation or the hypothesis that a change in the vaccination schedule, again, from when you and I were children, when you look back in the ‘70s, ‘80s, ‘90s to today, is leading to more health problems among kids?
但是，当你回顾 70 年代、80 年代、90 年代直到今天，疫苗接种计划的改变正在导致儿童出现更多健康问题时，你如何回应这样的指控或假设？
There is simply no evidence for that.
根本没有证据证明这一点。
So I think the first thing to say is even the way that question is asked, which is like, how do you prove?
所以我认为首先要说的是这个问题的提出方式，就像，你如何证明？
And this is a lot of how they say, “Well, can you prove that it’s not causing more health issues?” I don’t know what that proof would look like.
他们经常这样说：“好吧，你能证明它不会导致更多的健康问题吗？”我不知道那个证明会是什么样子。
We have many, many, many studies with millions of people showing, for example, no link between vaccines and autism.
例如，我们对数百万人进行了很多很多研究，结果表明疫苗和自闭症之间没有联系。
Proving a negative, there is no infinitely large study.
事实证明，不存在无限大的研究。
You know, what it seems like sometimes what people want is an infinitely large, randomized trial that follows people for 100 years and shows every possible outcome that you could have with every possible different vaccination schedule.
你知道，有时人们想要的是一项无限大的随机试验，对人们进行 100 年的跟踪，并显示每种可能的不同疫苗接种计划可能产生的每种可能的结果。
That would be really nice, though, you have to admit.
不过，你必须承认，那真是太好了。
By the time we get the answer to that, I will be dead, and so it’s not gonna be super helpful.
当我们得到答案时，我已经死了，所以这不会有太大帮助。
All of the evidence we actually have shows that these concerns are not valid.
我们实际拥有的所有证据都表明这些担忧是无效的。
And at the same time, it’s worth saying there’s a reason that we vaccinate people against diseases.
与此同时，值得一提的是，我们为人们接种疫苗来预防疾病是有原因的。
It’s because people used to die of those diseases.
这是因为过去人们死于这些疾病。
And now they’re gonna die of them again if we’re not getting vaccinated, and that seems pretty bad to me.
现在，如果我们不接种疫苗，他们就会再次死于这些疾病，这对我来说似乎很糟糕。
What about spreading them out?
把它们分散开怎么样？
What about just the fact it’s like, you know, I’ve had kids.
事实上，你知道，我已经有了孩子。
I mean, within those first couple months, you’re getting a lot of shots.
我的意思是，在最初的几个月里，你会得到很多镜头。
Okay, so first of all, one thing I want to say is that one of the concerns people raise is, oh, this is a lot of, like, immune challenge at the same time.
好吧，首先，我想说的一件事是，人们提出的担忧之一是，哦，这是同时发生的很多免疫挑战。
Right?
正确的？
Your child has has many orders of magnitude more immune challenge every single day than they get from vaccines.
您的孩子每天面临的免疫挑战比疫苗接种的免疫挑战高出许多数量级。
You’re constantly being exposed to viruses and other shit out in the world that your immune system is fighting.
你经常接触到病毒和其他世界上你的免疫系统正在对抗的东西。
That’s the world.
这就是世界。
Spacing out vaccines is better than not getting them at all.
间隔接种疫苗比根本不接种要好。
But if we encourage people to space out vaccines, they will get many less of them, and the people who will mostly get many less of them are people with a limited exposure to the medical system who are already not well-served by our medical system, and I think that that’s, that’s tricky.
但如果我们鼓励人们间隔接种疫苗，他们接种的疫苗就会少得多，而接种疫苗的人大多是接触医疗系统有限的人，他们已经没有得到我们医疗系统的良好服务，我认为这很棘手。
Or it’s hard to take time off from work to go to the doctor or what have you.
或者很难从工作中抽出时间去看医生之类的。
Exactly.
确切地。
Yeah.
是的。
There’re a lot of moms on Medicaid.
有很多妈妈享受医疗补助。
They don’t have a lot of time away from work.
他们没有很多时间离开工作。
Having them come in five different times for different vaccines rather than having them all at once means lost wages, or you’re just not gonna come back for the third, fourth, and fifth vaccine.
让他们分五次来接种不同的疫苗，而不是一次接种所有疫苗，意味着工资损失，或者你就不会回来接种第三种、第四种和第五种疫苗。
Yeah.
是的。
What about the kind of over-medicalizing?
过度医疗怎么办？
And you’ve done a, you did a great piece on this in The Times , but with Tylenol, for example.
你已经在《泰晤士报》上发表了一篇关于这方面的精彩文章，但以泰诺为例。
Like, not only are we giving too many shots, but, you know, we’re passing out kind of Tylenol, and it turns out maybe even during pregnancy, that’s hurting your baby.
就像，我们不仅注射了太多的疫苗，而且，你知道，我们正在服用泰诺，事实证明，即使在怀孕期间，这也会伤害你的宝宝。
I just feel like there’s so many things that become a source of deep fear.
我只是觉得有很多事情成为深深恐惧的根源。
And then when you go underneath to the data and what’s actually happening, it’s small.
然后当你深入了解数据和实际发生的情况时，你会发现它很小。
Which again, is why I think there’s kind of this underlying feeling of, is there a conspiracy or why are, why is everything seeming bigger than it is?
这又是为什么我认为有一种潜在的感觉，是否有阴谋，或者为什么有，为什么一切看起来都比实际更大？
Yeah.
是的。
I mean, I, I think one, one issue that we’re having is that particularly around autism, but also around these more general issues about health
我的意思是，我，我认为我们面临的一个问题是，特别是关于自闭症，但也围绕这些更普遍的健康问题
ADHD, yeah, particularly around neurodivergence of various sorts, people would like an explanation.
注意力缺陷多动症，是的，特别是围绕各种神经分歧，人们想要一个解释。
People do not like the explanation, like, this is a situation with your kid and, you know, we don’t really know why it happened.
人们不喜欢这样的解释，比如，这是你孩子的情况，你知道，我们真的不知道为什么会发生。
They’re looking for something for themselves, for other people.
他们正在为自己、为他人寻找一些东西。
This is, like, a very human need, and many of our policymakers promised an explanation.
这是一种非常人性化的需求，我们的许多政策制定者承诺做出解释。
You know, RFK Jr. came in, said, ‘I’m gonna figure out what causes autism.”
你知道，小 RFK 进来说，‘我要找出导致自闭症的原因。’
And the reality is that the answer, like we’ve changed the diagnostic criterium and, you know, people need a diagnosis to get an IEP, is actually a super boring explanation, even if largely true.
现实是，答案实际上是一个超级无聊的解释，就像我们改变了诊断标准一样，你知道，人们需要诊断才能获得 IEP，即使在很大程度上是正确的。
The evidence pretty strongly suggests something between, you know, 80 and 100% of the increase in diagnosis is a result of a combination of, you know, better universal screening, changes in the way that the sort of things that we count as autism or or ADHD, and some very strong incentives from the public school system towards diagnosis because it unlocks resources.
证据非常有力地表明，80% 到 100% 的诊断增加是以下因素综合作用的结果：更好的普遍筛查、我们对自闭症或多动症的认定方式的改变，以及公立学校系统对诊断的强烈激励，因为它释放了资源。
And I guess even from the parent side, you can have longer test times or, you know, sit at the front of the class or there’s a bunch, so why wouldn’t you pursue it?
我想即使从家长的角度来看，你也可以有更长的测试时间，或者，你知道，坐在班级的前面，或者有很多人，所以你为什么不追求它呢？
In the case of, of ADHD, a lot of kids who in the past would have been just sort of vaguely labeled as, like, this kid’s having a little bit of a hard time sitting still, in our current school environment, which prioritizes sitting still for longer, which has more academic work early on, there’s more of a push for, like, “Well, what’s wrong with your kid?
就注意力缺陷多动症而言，很多孩子在过去会被模糊地贴上这样的标签，比如，这个孩子坐着有点困难，在我们现在的学校环境中，优先考虑长时间坐着不动，早期有更多的学术工作，更多的是推动，比如，“好吧，你的孩子怎么了？
Why can’t they sit still for six hours in a row because they’re five?”
为什么他们不能连续六个小时安静地坐着，因为他们才五岁？”
It’s not that they’re five, it’s that something else is going on.
并不是因为他们才五岁，而是因为发生了其他事情。
I think we’re seeing a lot of those features.
我认为我们已经看到了很多这样的功能。
That’s like what’s really going on, but people don’t want that.
这就像真实发生的事情，但人们不希望这样。
They want an answer, and then you have, okay, it’s Tylenol, and there’s no evidence that Tylenol causes any of these issues in the best data, but there’s also seemingly no punishment for just saying things which turn out not to be true.
他们想要一个答案，然后你就得到了，好吧，这是泰诺，并且没有证据表明泰诺会导致最佳数据中的任何这些问题，但似乎也不会因为只是说出事实证明不真实的事情而受到惩罚。
And just hanging for one more minute on this point before going into kind of the government’s role in it.
在讨论政府在其中的角色之前，请在这一点上再等待一分钟。
So we’re having a more accurate and obviously a higher level of diagnoses of neurodivergent type things.
因此，我们对神经分歧类型的事物有了更准确、显然更高水平的诊断。
Do you think that’s in general been good for kids’ health, or is that creating, again, a bit of a, an arms race towards, well, my child should also be on these things, and all of a sudden we’re kind of tipping over the other side again?
你认为这总体上对孩子们的健康有好处吗？或者这是否又造成了一场军备竞赛，我的孩子也应该接受这些事情，突然间我们又再次翻倒了？
Do you think this has been an improvement relative to having an autistic kid in the 1980s or not?
你认为这与 20 世纪 80 年代的自闭症孩子相比是否有所进步？
I think broadly, yes, but not, you know, and this is, this is a complicated question.
我认为从广义上讲，是的，但不是，你知道，这是一个复杂的问题。
I would say on, on broad terms, yeah.
我想说，从广义上讲，是的。
And I think in particular for many things like autism, there are a set of kids who would not have been diagnosed in the past, students of color, girls who present in a, in a sort of atypical way, but who would really benefit from resources and a different approach, who are now being diagnosed because screening is universal in pediatricians’ offices.
我认为，特别是对于像自闭症这样的许多疾病，有一群孩子在过去不会被诊断出来，有色人种的学生，女孩，他们以一种非典型的方式表现出来，但他们确实会从资源和不同的方法中受益，他们现在正在被诊断，因为筛查在儿科医生办公室是普遍的。
And so I think those things are are good changes.
所以我认为这些都是很好的改变。
I think there are places probably particularly around ADHD where I see more merit to some of the arguments about over-diagnosis, especially when we talk about diagnosis that comes in school environments when kids are younger than their peers, and we’re diagnosing something which in a previous generation might have been seen really as a more age-typical behavior and might have grown out.
我认为在多动症方面，我认为一些关于过度诊断的争论更有道理，特别是当我们谈论在学校环境中进行的诊断时，孩子比同龄人年轻，而我们正在诊断的东西在上一代人中可能被视为更典型的年龄行为，并且可能已经长大了。
And we know that once kids are diagnosed, they they sort of stay with that diagnosis and sometimes with medication that could have otherwise potentially been avoided.
我们知道，一旦孩子们被诊断出来，他们就会坚持这一诊断，有时还会接受本来可以避免的药物治疗。
But it’s very complicated and very individually specific.
但这非常复杂并且非常具体。
Well, this podcast is being put out through Brookings, so I want to make sure we talk about kind of the public policy angles and the government’s role in all of this.
嗯，这个播客是通过布鲁金斯学会推出的，所以我想确保我们谈论公共政策角度以及政府在所有这一切中的作用。
So Secretary Kennedy, who’s the head of HHS, was on Joe Rogan, I don’t know, some time ago, and he said, this is the quote:
肯尼迪国务卿，也就是美国卫生与公众服务部的负责人，不久前在乔·罗根的节目中，我不知道，他说，这是引述：
So we are taking the 63 million poorest kids in our country, giving them taxpayer-funded diabetes, and and 78% of them end up on Medicaid.
因此，我们为我国 6300 万最贫困的儿童提供纳税人资助的糖尿病治疗，其中 78% 最终接受了医疗补助。
And he was talking about how taxpayer funds are used to subsidize food stamps or SNAP, which actually, like, one in four kids use some level of food stamps, so it’s not just kind of a, a very marginal problem.
他谈论的是如何使用纳税人的资金来补贴食品券或 SNAP，实际上，四分之一的孩子使用一定程度的食品券，所以这不仅仅是一个非常边缘的问题。
What’s your take on that?
您对此有何看法？
Like, are…
就像，是……
again, has the government kind of created the problem that now we’re trying to come back in and solve?
再说一次，政府是否造成了我们现在正试图回来解决的问题？
The government has not created the problem that we are trying to come back in and solve.
政府并没有制造我们试图回来解决的问题。
I think it’s sort of ridiculous to say that availability of food stamps, a program which in the past, you know, fixed like rickets and other, other very significant issues that children had.
我认为说食品券的可用性有点荒谬，这个项目在过去，你知道，像佝偻病和其他非常重要的儿童问题一样得到解决。
I mean, food stamps’ an incredibly important policy program for many people.
我的意思是，食品券对许多人来说是一项极其重要的政策计划。
As you said, it’s like 25% of kids, and in fact, at some point in their life cycle, like, 40% of American households will be on, on SNAP.
正如您所说，大约 25% 的孩子，事实上，在他们生命周期的某个阶段，比如 40% 的美国家庭都会使用 SNAP。
People cycle in and out of it.
人们骑着自行车进出它。
It’s a really, really big and important, and important program.
这是一个非常非常大、非常重要、非常重要的计划。
And there are some places where the government funding of food is very beneficial.
在某些地方，政府对食品的资助是非常有益的。
So for example, for most kids, the healthiest meal, at least in intention, that they will see every day is school lunch.
例如，对于大多数孩子来说，他们每天看到的最健康的膳食（至少在意图上）是学校午餐。
So school lunches, for all the stuff people complain about, school lunches are actually pretty healthy.
所以学校午餐，尽管人们抱怨很多，但学校午餐实际上是相当健康的。
We could do better, but they are, they are a real opportunity and one that, you know, the current administration has, if anything, taken money away from when I think it’s probably a good idea to add resources there.
我们可以做得更好，但它们是，它们是一个真正的机会，你知道，当我认为在那里增加资源可能是一个好主意时，现任政府（如果有的话）拿走了钱。
Interesting.
有趣的。
What about…
那么……
this is a broader healthcare question.
这是一个更广泛的医疗保健问题。
We’ll, we’ll touch on this before going back to a more nuanced one, but it comes up in these discussions because America spends more on healthcare, as you know, per capita than any other country in the world.
在回到更细致的问题之前，我们会先讨论这个问题，但它会在这些讨论中出现，因为正如你所知，美国在医疗保健上的人均支出比世界上任何其他国家都多。
We have, we have worse outcomes.
我们有，我们有更糟糕的结果。
We actually are at one of our highest insured levels we’ve ever been at, like, over 90%.
事实上，我们的保险水平是有史以来最高的之一，大约超过 90%。
You know, we could throw more money at the problem.
你知道，我们可以投入更多的钱来解决这个问题。
We could have universal healthcare coverage, of course, or a public option, but, like, are we kind of out of options for how to improve this from just a traditional healthcare investment angle?
当然，我们可以拥有全民医疗保健覆盖，或者公共选择，但是，我们是否没有选择仅从传统的医疗保健投资角度来改善这一点？
Yeah, I don’t know.
是的，我不知道。
I mean, I am a health economist, but not really that kind.
我的意思是，我是一名健康经济学家，但并不是真正的那样。
You know, look, I think we spend more partly because our population is, is sicker for reasons that have nothing to do with the healthcare system, and partly because we spend a lot on the end of life, and, you know, we spend a lot to extend people’s lives at the end, and there’s different arguments about how good an idea that is or whatever, but we spend a lot there.
你知道，看，我认为我们花费更多，部分是因为我们的人口由于与医疗保健系统无关的原因而病情加重，部分是因为我们在生命的最后花费了很多钱，而且，你知道，我们花了很多钱来延长人们最后的生命，关于这个想法有多好或其他什么的有不同的争论，但我们在那里花了很多钱。
We spend a lot because of the way the paying system works here.
由于这里的支付系统的运作方式，我们花了很多钱。
So there are a lot of things, and the healthcare system is incredibly complicated, and I think reasonable people would say, you know, we just gotta, like, tear it down and start from scratch.
所以有很多事情，医疗保健系统非常复杂，我认为理性的人会说，你知道，我们必须把它拆掉并从头开始。
This system is insane and bizarre.
这个系统既疯狂又奇怪。
But, you know, at the same time, the places that spend less, you also have to wait like 17 years for a knee surgery.
但是，你知道，与此同时，花费较少的地方，你也必须等待17年左右才能进行膝盖手术。
So, it’s, it, like, it’s not free.
所以，它不是免费的。
—right.
-正确的。
Nothing’s free.
没有什么是免费的。
Yeah.
是的。
Speaking of free lunch in economic terms, something that seems to be gaining traction, and I’m thinking here of the New York City mayor, Mamdani, , is the idea of price controls, and what if we actually put price controls on healthy foods, made them cheaper for people to buy?
说到经济方面的免费午餐，似乎越来越受到关注，我想到的是纽约市市长马姆达尼，这是价格控制的想法，如果我们实际上对健康食品进行价格控制，使人们购买它们更便宜，会怎么样？
Economists in general tend to not be very fond of price controls for reasons that, you know, so…
一般来说，经济学家往往不太喜欢价格管制，原因是，你知道，所以……
But could that be an, an unlock for all the families who can’t go out and just, you know, go to Whole Foods and buy organic carrots for every kid’s sack lunch?
但这是否可以为所有无法外出、只能去全食超市为每个孩子的袋装午餐购买有机胡萝卜的家庭提供一种解脱？
Yeah, I mean, I think the the phrase price control makes me very anxious, and economists hate it.
是的，我的意思是，我认为价格管制这个词让我非常焦虑，而经济学家讨厌它。
But I think a a different phrase, which we don’t hate, is subsidies and taxes.
但我认为另一个我们不讨厌的词是补贴和税收。
And I think there is a stronger argument, and in fact one that we just this morning I was reading a paper with the first evidence about.
我认为有一个更有力的论点，事实上，我们今天早上正在阅读一篇带有第一个证据的论文。
So SNAP, typically you are allowed to buy soda on SNAP.
因此，SNAP，通常您可以在 SNAP 上购买苏打水。
But in the current administration, they have allowed a number of states, given them a waiver to basically take soda off the SNAP.
但在本届政府中，他们允许一些州给予豁免，基本上将苏打水从 SNAP 中剔除。
You can’t buy soda with SNAP.
您无法使用 SNAP 购买苏打水。
Which kind of makes sense.
哪一种有道理。
Kind of feels like it makes sense.
有点感觉好像有道理。
Kind of feels like it makes sense, but effectively for an economist, like, it’s not a price control, it’s a tax.
有点感觉这是有道理的，但对于经济学家来说，这实际上不是价格管制，而是税收。
It’s just making soda, like, effectively a bit more expensive for people or a bit less accessible, or in some other way making it seem more expensive.
它只是让苏打水对人们来说实际上更贵一些，或者更难获得，或者以其他方式让它看起来更贵。
And the first evidence I think suggested it does reduce soda purchases.
我认为第一个证据表明它确实减少了苏打水的购买量。
That in turn suggests there’s an opportunity for kind of changing up a little bit how people’s diets work, potentially even through something like the SNAP program.
这反过来表明，有机会稍微改变人们的饮食方式，甚至可能通过 SNAP 计划之类的方式改变。
You know, could you mix around the formulary or say, you know, fruits and vegetables are 50%?
你知道，你能混合一下处方集吗？或者说，你知道，水果和蔬菜占 50%？
There’s a lot of stuff you can do, right?
你可以做很多事情，对吗？
There’s there’s other ways to, to manage doing this that are different than price controls, but would effectively make things that you want people to buy cheaper.
还有其他方法可以做到这一点，这些方法与价格控制不同，但可以有效地使你希望人们购买的东西更便宜。
Obviously, it’s easier to see how it could apply in SNAP given the nature of that program, but in presumably that could be a broader type effort, too.
显然，考虑到 SNAP 计划的性质，更容易看出它如何应用于 SNAP，但据推测这也可能是更广泛的类型工作。
Yeah.
是的。
Sure.
当然。
Yeah.
是的。
I mean, you could…
我的意思是，你可以……
Places have tried soda taxes.
有些地方尝试过征收苏打水税。
Soda taxes are like just basic regular soda taxes.
苏打水税就像基本的常规苏打水税一样。
They have a little bit of of an effect.
它们有一点点作用。
Yeah, but would you be concerned about if someone said that, you know, we do cigarette taxes, right, or alcohol taxes.
是的，但是如果有人说，我们征收香烟税，对吧，或者酒精税，你会担心吗？
Like, what if we just have an ultra-processed food tax, right?
就像，如果我们只征收超加工食品税，对吗？
You know, it’s just like, let’s get rid of this problem.
你知道，这就像，让我们摆脱这个问题。
at the base of the thing.
在事物的基础上。
What if just across the board we’re gonna put a sin tax on it, you know, some sort of punitive tax if you buy these things?
如果我们要全面征收罪恶税，你知道，如果你买这些东西的话，会征收某种惩罚性税吗？
Would that excite you or concern you, make you feel little feelings?
这会让你感到兴奋或担心，让你感觉不舒服吗？
I think I would be very worried about how you implement such a tax, because no one can tell you what ultra-processed foods are.
我想我会非常担心你如何实施这样的税收，因为没有人能告诉你什么是超加工食品。
And in fact, in the data, the concern is more energy density than processing.
事实上，在数据中，人们更关心的是能量密度而不是处理能力。
And you’re gonna be putting that policy up against a bunch of very motivated people who make food.
你将把这项政策针对一群非常积极主动的食品生产者。
Right?
正确的？
And so if you say, you get a tax if, you know, more than 11% of your calories are from blah, well, guess how many percent of the calories will be from blah?
所以，如果你说，如果你知道，超过 11% 的卡路里来自废话，你就会被征税，那么，猜猜有多少%的卡路里来自废话？
It’s 10.9.
是10.9。
And so I would be, for my taste, I would be much more comfortable, I think I would be more interested in something that subsidizes the things you do want people to do because I think in some ways it’s much easier to define what we would like people to buy more of, which is vegetables and fruit.
所以，就我的口味而言，我会更舒服，我想我会对那些补贴你希望人们做的事情更感兴趣，因为我认为在某些方面更容易定义我们希望人们购买更多的东西，即蔬菜和水果。
Just say like things that are like whole vegetables or …
只是说像整个蔬菜之类的东西或......
that’s a much easier space to define.
这是一个更容易定义的空间。
What about, like, dairy, eggs, red meat?
乳制品、鸡蛋、红肉等怎么样？
This administration loves red meat.
这届政府喜欢红肉。
The biggest issue is people don’t eat any vegetables and fruit.
最大的问题是人们不吃任何蔬菜和水果。
You look at Americans’ diets, yeah, sure, they could eat more whole milk yogurt or whatever, but the problem is a lot of people in a, like, a two-day food diary have consumed literally no fruits and vegetables.
你看看美国人的饮食，是的，当然，他们可以吃更多的全脂酸奶或其他什么，但问题是很多人在为期两天的饮食日记中几乎没有食用任何水果和蔬菜。
Like, like zero.
就像，就像零。
Zero fruits and vegetables.
零水果和蔬菜。
That’s, that’s not good.
就是这样，这样不好。
Yeah.
是的。
And that is one of the kind of getting to your book, The Family Firm , and how do you make, you know, optimal choices as a family, that is one of the things at the household level you can control.
这就是读你的书《家族企业》的方式之一，你知道，作为一个家庭，你如何做出最佳选择，这是你可以控制的家庭层面的事情之一。
Like, we’ve talked about, you can’t really control the broader pesticide environment as a mom.
就像我们已经讨论过的那样，作为妈妈，你无法真正控制更广泛的农药环境。
You can’t necessarily control microplastics, you know, as a dad.
你知道，作为父亲，你不一定能控制微塑料。
But you can control…
但你可以控制...
So if you’re advising, and this might be common sense stuff, I mean, but we are running a campaign right now, you know, this White House on Eat Real Food, or you have Michelle Obama’s Let’s Move, like it all kinda seems common sense at some level.
所以，如果你提出建议，这可能是常识性的东西，我的意思是，但我们现在正在开展一场运动，你知道，白宫的“吃真正的食物”，或者你有米歇尔·奥巴马的“让我们行动起来”，就像这在某种程度上似乎是常识。
But what principles would you kind of put out there for parents trying to, within their realm of control, have the healthiest kids they can?
但是，对于那些试图在自己的控制范围内养育最健康的孩子的父母，您会提出哪些原则呢？
Try to have more fruits and vegetables.
尝试多吃水果和蔬菜。
Try to give your kids fruits and vegetables when they’re hungry.
尝试在孩子饥饿时给他们吃水果和蔬菜。
That’s the time they’re most likely to try them.
那是他们最有可能尝试的时间。
Just because they say they don’t like it one day doesn’t mean they won’t like it the next day.
仅仅因为他们有一天说他们不喜欢它，并不意味着他们第二天也不会喜欢它。
And so it’s worth, worth it to keep trying those things.
所以继续尝试这些事情是值得的。
And then I think from a policy standpoint, the more we can make it possible for people to, in a kind of, like, accessible way provide this.
然后我认为，从政策的角度来看，我们越能让人们以一种类似的、易于理解的方式提供这一点。
You know, like we have research that says that kids like vegetables better if you have them with dip.
你知道，就像我们的研究表明，孩子们更喜欢蘸着蔬菜吃。
Like, you know those little containers of like carrots and ranch?
就像，你知道那些装胡萝卜和牧场的小容器吗？
For a while, that was, like, the only thing my kids would eat for vegetables, was like these little containers.
有一段时间，我的孩子们唯一吃的蔬菜就是这些小容器。
They had like carrots and ranch.
他们有胡萝卜和牧场。
You would open them, you would put the carrots in the ranch.
你会打开它们，你会把胡萝卜放在牧场里。
That’s so stupid.
那太愚蠢了。
And you’d be like, “Why can’t they just eat carrots?” Well, I don’t know.
你会说，“为什么他们不能只吃胡萝卜呢？”好吧，我不知道。
They’re children.
他们是孩子。
I don’t know.
我不知道。
It’s reminding me of Dunkaroos.
这让我想起了邓卡鲁斯。
Remember those?
还记得那些吗？
You’d like dunk them into some sort of sauce.
你想把它们浸入某种酱汁中。
So my daughter and I once had, like, a business idea, which was like hummus cups.
所以我和我的女儿曾经有一个商业想法，就像鹰嘴豆泥杯一样。
But you know like those, the things that are like yogurt with granola?
但你知道像酸奶加格兰诺拉麦片这样的东西吗？
Those exist, Emily.
这些是存在的，艾米丽。
You know those exist.
你知道那些存在。
A hummus cup does exist.
鹰嘴豆泥杯确实存在。
No, no. What I, what I want is the hummus cup, but the top is, like, dried vegetable pieces, and you, like, open it like you open a yogurt thing, and you put it and you mix it with the hummus.
不，不。我想要的是鹰嘴豆泥杯，但顶部是干蔬菜片，你就像打开酸奶一样打开它，然后把它与鹰嘴豆泥混合。
Kids love hummus, Abby.
孩子们喜欢鹰嘴豆泥，艾比。
I, I know, but I, I love hum- I don’t like the dried vegetable bits.
我，我知道，但是我，我喜欢嗡嗡声——我不喜欢干蔬菜块。
Okay.
好的。
Well, you’re…
嗯，你是……
Maybe I would have a different thing for you.
也许我会给你一些不同的东西。
Sounds like you’re not buying my product.
听起来你不买我的产品。
Forget it.
忘了它。
Never mind.
没关系。
You gotta workshop that.
你得去练习一下。
Yeah, we gotta workshop it with the, with the daughter.
是的，我们得和女儿一起讨论这个问题。
What would you say, just to close out, what would you say to…
你会说什么，只是为了结束，你会说什么......
I know so many parents who are well-educated, who are sensible people, and there is just a tremendous amount of fear or an ability to get pretty spun up that if you’re not making your own sourdough, and having organic berries, and avoiding medication at all cost, and spacing out a vaccine schedule, and on and on and on, like, your child is gonna be unwell.
我认识很多受过良好教育的父母，他们都是明智的人，如果你不自己做酵母，不吃有机浆果，不惜一切代价避免用药，不间隔疫苗接种时间表，等等，你的孩子会感到不舒服，他们有极大的恐惧或有能力变得非常兴奋。
And I think there’s so much, especially in social media, that, that is pushing that message of like, “You have to optimize this to like the .001 spot to make sure your kid’s gonna be okay.” Like how would you speak into kind of that moment in children’s health we’re in?
我认为有太多的事情，特别是在社交媒体上，正在推动这样的信息，“你必须优化这个以喜欢 0.001 的广告，以确保你的孩子会没事。”就像您会如何谈论我们所处的儿童健康时刻？
I totally hear that concern as a parent, and we all want to do the absolute very best for our kids.
作为父母，我完全听到了这种担忧，我们都想为我们的孩子做最好的事情。
Most of the things that you are worried about do not matter at all, or they matter in a different direction than you think.
大多数你担心的事情根本不重要，或者它们的重要性与你想象的不同。
So getting your kids vaccinated is important so they don’t get the measles.
因此，让您的孩子接种疫苗很重要，这样他们就不会感染麻疹。
Worrying about the fact that they had six Swedish fish at somebody’s birthday party is not a thing you should be worried about.
您不必担心他们在某人的生日聚会上吃了六条瑞典鱼这一事实。
That is not going to matter.
那没关系。
Save your very real worries for the things that do matter, or save your attention for the small number of things like having your kids eat some whole foods and getting some exercise that are actually relevant for, you know, long-term health outcomes instead of these, like, tiny things.
把你真正的担忧放在真正重要的事情上，或者把你的注意力放在少数事情上，比如让你的孩子吃一些天然食品和进行一些锻炼，这些事情实际上与长期健康结果相关，而不是这些小事情。
Yeah.
是的。
That’s good.
那挺好的。
I’ll, yeah, I’ll put that on record for myself to play over again and again.
我会，是的，我会把它记录下来，让自己一遍又一遍地播放。
So just to close this out, this podcast is called No More Sidewalks .
所以为了结束这个话题，这个播客被称为“不再人行道”。
If you were laying sidewalk or track of policy reform to help this generation of kids be healthier than they are now, from a public policy perspective, what new investment guardrails kind of structures would you like to see?
如果你正在铺设人行道或政策改革轨道来帮助这一代孩子比现在更健康，从公共政策的角度来看，你希望看到什么样的新投资护栏结构？
I would put a lot of money into creative approaches to school lunches.
我会投入大量资金用于学校午餐的创意方法。
School lunches are a place where we have kids in a school environment.
学校午餐是我们让孩子们在学校环境中度过的地方。
They’re very susceptible to their peers.
他们很容易受到同龄人的影响。
Right now, the way that the school lunches work, in regulation, they’re very good, but in practice it’s a lot of, like, “Here’s a bag of baby carrots you’re tossing in the trash.”
现在，学校午餐的运作方式，在监管方面，非常好，但在实践中，很多时候，就像，“这是一袋小胡萝卜，你要扔进垃圾桶。”
I want interesting, creative approaches to getting kids to eat better.
我想要有趣、有创意的方法来让孩子们吃得更好。
Yeah.
是的。
Okay.
好的。
I like it.
我喜欢它。
Emily Oster, always a pleasure to get to chat with you.
艾米丽·奥斯特（Emily Oster），很高兴与您聊天。
Thank you so much.
太感谢了。
I’m Abby McCloskey from the Brookings Institution, and this is No More Sidewalks: Parenting Today.
我是来自布鲁金斯学会的艾比·麦克洛斯基，这是《不再人行道：今日育儿》。
This podcast is produced by the Brookings Podcast Network and the Center for Economic Security and Opportunity at to the production team, including Ike Blake, supervising producer; Fred Dews, producer; and Daniel Morales and Teddy Wansink, video editors.
该播客由布鲁金斯播客网络和经济安全与机会中心制作，制作团队包括监制艾克·布莱克（Ike Blake）；弗莱德·杜斯，制片人；丹尼尔·莫拉莱斯 (Daniel Morales) 和泰迪·万辛克 (Teddy Wansink)，视频编辑。
Plus, thanks to Tara Watson, director of the Center for Economic Security and Opportunity, Stephanie Holzbauer and Tyler Hernandez for their support.
另外，还要感谢经济安全与机会中心主任塔拉·沃森 (Tara Watson)、斯蒂芬妮·霍尔兹鲍尔 (Stephanie Holzbauer) 和泰勒·埃尔南德斯 (Tyler Hernandez) 的支持。
Daniel Morales also designed the show artwork.
丹尼尔·莫拉莱斯 (Daniel Morales) 还设计了展览艺术作品。
You can find all episodes of No More Sidewalks wherever you get your podcasts and on the Brookings website.
您可以在任何播客和布鲁金斯网站上找到《不再人行道》的所有剧集。
And finally, find research on family policy and economic security at Brookings dot edu slash CESO.
最后，可以在布鲁金斯学会 dot edulashCESO 找到有关家庭政策和经济安全的研究。
Thanks for listening.
感谢您的聆听。
The Brookings Institution is committed to quality, independence, and impact.
布鲁金斯学会致力于质量、独立性和影响力。
We are supported by a diverse array of funders .
我们得到了众多资助者的支持。
In line with our values and policies , each Brookings publication represents the sole views of its author(s).
根据我们的价值观和政策，布鲁金斯学会的每份出版物均代表其作者的唯一观点。