健康解密：肠道的奥秘（2024）

Hi, Maya. Nice to meet you.
你现在想讨论一下你的结果吗
So would you like to discuss your results now?
当然 好啊
Sure. Yeah.
我们的研究表明 总的来说 你很健康
What we found in our studies is that overall, you're pretty healthy.
绝对是高于平均水平的
It's definitely above average.
你每周吃的那些蔬菜都没有浪费
All those vegetables you're eating every week have not gone to waste.
太好了
Cool.
要知道 我也一直 在与饮食失调作斗争
You know, I've also struggled with having a disordered relationship with eating.
我在饮食方面一直非常严格
I've always been very, kind of, restrictive in my diet.
玛雅 是的 很多人都和你的想法一样
So, Maya, yeah, many people think like you,
认为每天吃一份健康的羽衣甘蓝沙拉
that just having a really healthy kale salad every day
就能保持身体健康
is going to keep them healthy.
但这不像我们想的那么健康
That's not as healthy as we thought.
你摄入的食物越多样 微生物群就会越丰富
The more diversity you consume, the more rich your microbiome will be,
肠道内也会出现更多种类的细菌
the more species of bacteria that will be present inside your gut.
这样能让你更好地应对过敏和增强体质
And that does allow you to deal with allergies and intolerances better.
对 - 关键不是限制食物
Yeah. - It's not about restricting things.
而是要扩大你的食谱多样性 增加食物种类
It's about enlarging your world of foods that are possible for you to eat.
我觉得有部分问题在于 我对某些事物
Well, I think part of the problem is that I have some kind of, like, mental blocks
会有心理障碍 比如猪肉
for some foods, like pork,
有时候 我的胃对它的反应很差
and occasionally my stomach just reacts really poorly to it.
我能克服这种事情吗
Is that something that I can overcome,
还是我此生都无法再吃培根了
or is it just I'm never gonna eat bacon ever again in my entire life?
别这么说 听起来很可怕
Oh! Don't say that. Sounds horrible.
对 这很痛苦 对吧 - 是的
Yeah. It's a struggle, right? - Yeah.
我们觉得可以缓解那些反应
We do think to alleviate it,
每次只吃少量 微量
introducing these things in very small doses, microdosing,
然后逐渐增加 直至一个能够发挥作用的摄入量
and then building it up over time into large doses can play a role.
试着在你的日常饮食中少量引入它们
Try small amounts, you know, bring them into your diet.
如果你通过几个月的时间慢慢来
And if you do that gradually over months,
你可能会开始恢复 进食更多食物的能力
you might start to regain the ability to eat a much wider range of foods.
不过我很喜欢这个微量薯片的想法
I do really love the idea of microdosing chips, though.
天啊 我现在也是
Oh man. So do I now.
对 太叫人开心了
Yeah. Yay, that's so exciting.
我想到这一点都觉得有点激动 对不起
I'm getting emotional thinking about it. I'm sorry.
但这段路 真的太漫长 太艰难了
But yeah, it's... it's been a really long, hard road.
微量薯片的想法让我非常兴奋
I'm really excited by the idea of microdosing potato chips.
每次只对我的饮食做出一点点改变
You know, just changing my diet a little bit at a time.
这样很有趣
And it's been fun.
有时候我一天会吃三片薯片
I mean, I eat, like, three potato chips a day sometimes,
我不会觉得不舒服
and I don't feel bad.
这让我开始想 我吃的东西是对的
It does make me wonder if I'm eating the right things,
还是我的大脑里发生了化学变化
or is it, something's changing chemically in my brain?
根据这个世界 以及各种数据和统计
According to the world and all these graphs and charts,
因为我的体重和身高 我被归类为了病态肥胖者
because of my height and my weight, I'm considered morbidly obese.
我以前也试过控制体重
I tried to control my weight before.
我去办过昂贵的健身房♥会员卡
I went and got this expensive gym membership.
我试过节食
I've tried diets.
我试过减肥药 但它对我无效
I've tried the weight loss medicine, and it didn't work for me.
一开始我会瘦很多 然后又会复胖
I would lose a lot of weight at first, and then it just comes right back.
我们家有糖尿病史
Diabetes runs in my family.
尽管我现在很健康
So even though I'm healthy now,
但我还是想减肥 趁那些病还没有找上我之前
I wanna lose weight before any of that, you know, onsets in my life.
为了孩子们 我想在这里待得尽量久一点
I wanna be here as long as I can for my kids.
社会让肥胖女性 觉得自己低人一头
Society, you know, makes women feel less than because they're larger,
不求皮包骨头或瘦到55公斤 我只希望更健康一些
and I'm not looking to be skinny or 120 pounds, just more healthy.
不然这辈子都得当"超大码天后"了
I'm just gonna be this plus-size diva till the end.
你可以以积极的心态面对自己的身体
You can be positive in the body that you're in,
但也要注意自己的健康 因为归根结底 你需要健康
but also be conscious of your health because you ultimately need that.
所以对于吃 我的疑问是
So my question about eating is,
有什么东西是你们吃了而我没吃的
what in the world are y'all eating that I'm not eating
你们都减肥成功了 我却没有
that cause y'all to lose weight and not me?
作为医生 当我们向病人解释
As a physician, when we try to explain to our patients
他们减肥为什么会这么困难时
why they're having such a hard time losing weight,
我们会倾向于责怪那个人 责怪病人
we have a tendency of blaming the individuals, blaming the patients.
几十年来 人们一直在按照我们的建议行事
The population has been doing what we were recommending for many decades,
然而肥胖的蔓延并未减缓或逆转
yet the obesity epidemic has not slowed down or reversed.
"节食"这个词非常令人困惑
The word "diet" is really confusing.
低脂肪和低碳水化合物
Low-fat versus low-carb.
大多数人的理解是 这是我要在一段时间内
Most people understand it to be really a sprint that I'm gonna do
进行的减肥冲刺
for some period of time to lose weight,
然后我可以恢复以前那种
and then I can go back to my previous patterns
想吃什么就吃什么的模式
of eating whatever I want to eat.
但节食其实是要 永远地改变你的生活方式
But a diet, it's really about changing your lifestyle for life.
节食无效的另一个原因是 他们把注意力集中在了错误的地方
Another reason why diets don't work is that they really focus on the wrong thing.
从这个意义上说 他们实际上可能误导了我们
And in that sense, they actually could be misdirecting us.
当我们把这些卡路里标签 印在盒子上时 我们会想
When we put these calorie labels on boxes,
"好的 如果我们吃同样的食物
we think, "Okay, this is the amount of energy
那么我们大家都会摄取这么多能量"
that we will all extract if we ate that same food."
但事实并非如此
But of course, that is not true.
如果你把同一个苹果 给三个不同的人
If you would give an identical apple to three different people,
这三个人 会对这同一个苹果产生不同的反应
each of these individuals would show a different response to the same apple.
你知道我不能吃这个的吧
You know I can't eat this, right?
他们会以不同的方式处理它
They will each process it in a different way.
他们会从中摄取到不同的营养物质
They will each extract different nutrients from it.
他们会摄取到总量各异的能量
They will each extract different amounts of energies.
你一辈子都在想:"好吧 就是卡路里
You go your whole life thinking, "Okay, it's calories."
我和你可以吃一样的东西
"Me and you can eat the same thing,
而我们俩最终也会得到相同的结果"
and we should both have the same results, ultimately,"
但事实并非如此
and that's just not what it is.
所以与其去称量那个苹果
So, rather than measuring the apple,
不如去测量吃苹果的人
one needs to start measuring the people who eat the apple.
现在我们关注的是
Now we focus on blood glucose levels
你吃完饭后两小时内的血糖水平
in the two hours after you eat a meal
因为我们知道你餐后的血糖水平
because we understand that your blood sugar levels after a meal
与体重的减少和增加是直接相关的
are directly connected to weight loss and weight gain,
另外也与多种疾病的发生有关
and also to the development of multiple diseases.
很好
Good, good, good.
来点奶油芝士
Some cream cheese.
我今天早上应该查一下我的血糖水平
I ought to check my sugar levels this morning.
尤其是吃了那个之后
Especially after that.
看我有没有打败你
Let's see if I beat you.
天啊 你升得好快
Oh my God, you're going up really fast.
这次绝对打败你了 - 是啊
Definitely beat you this time. Yeah.
贝果对我会有这种效果
Bagels have that effect on me.
我还好
That's okay for me.
杰夫·戈登领导的一项研究
One of the seminal works in the field of microbiome
是微生物群领域的一项开创性成果 他挑选了一对同卵双胞胎
was a study led by Jeff Gordon in which he took identical twins,
其中一个肥胖 另一个精瘦
but one twin was obese, and the other was lean,
他将肥胖双胞胎 和精瘦双胞胎的肠道细菌
and he transplanted the gut bacteria from the obese twin
移植到小鼠身上
and the lean twin into mice.
与获取了精瘦双胞胎细菌的小鼠相比
The mice that received the bacteria from the obese twin
获取了肥胖双胞胎细菌的小鼠
gained more weight on the same food as compared to mice
在摄入相同食物的情况下 体重增加得更多
who received the bacteria of the lean twin.
这帮助我们理解了
And that's helping us to understand
为什么有些人 减肥会更加困难
why some people experience more difficulty losing weight.
对一些人来说 你会瘦掉 又复胖
For some people, you lose weight, put on weight,
瘦掉 又复胖更多 瘦掉 变得更胖
lose weight, put on more weight, lose weight, put on even more weight,
如此循环往复
and it keeps going up.
我们认为微生物群正是其中的关键
We think the microbiome is key to that.
你可能需要节食 9到12个月才能重构生态系统
You may have to go on a diet for 9 to 12 months to reshape the ecosystem,
以防止当你再次开始吃汉堡时
to prevent the weight from coming back with a vengeance
体重反弹
when you start eating a hamburger again.
利用我们从每个人身上 收集到的微生物群数据
Using the microbiome data that we collected from individuals,
我们得以开始预测 哪些食物最适合各个人
we can start to predict which foods are the best for each person.
至少就血糖水平而言是这样
At least as far as blood sugar levels go.
生蚝 太好了
Oysters, that's good.
不能吃茄子三明治 真糟糕
Can't have eggplant sandwiches, that's bad.
对于像我这样的人来说 强迫症是一个问题
For somebody like me where obsession is an issue...
计分不一定对我有帮助
...having scores is not necessarily helpful for me.
我们应该把热狗加进去