健康解密：肠道的奥秘（2024）

How are you? Good, and you?
很好
Good, good.
早上好
Morning.
今天 我的微生物赢了
Today, my microbes win,
所以我们要带走的是巧克力
so it's gonna be the chocolate that we're gonna go with.
我经常会嘴馋
I get cravings a lot.
有时候 唯一听起来不错的东西 就是很生的牛排
Sometimes, literally, the only thing that sounds good is, like, a super rare steak.
我会试着把它抛诸脑后 不理它
I kind of try to just push it into the back of my mind and ignore it,
但更多的时候 我会听从身体的需求
but I'm trying to listen to my body more.
我的身体渴望吃冰淇淋、糖果或汉堡
My body craves ice cream or sweets or hamburgers.
真希望我能吃这个
I really wish I could eat this.
我喜欢吃海鲜 会尽量多地吃海鲜
I love seafood. I try to eat as much seafood as possible.
我以前经常会想吃
I used to crave
蛋糕和咖喱 特别是小时候
cakes and curry when I was little.
我现在已经感受不到进食的快乐了
I don't feel that joy about eating anymore.
消化很可能是 动物进化出的第一种思维方式
Digestion was very much likely the first form of thinking that animals developed.
它的存在是为了 让神经可以判断食物的优劣
It was there so that the nerves could tell the quality of the food,
周围组织的状况 路过的免疫细胞
how the surrounding tissue was doing, the immune cells that were passing by.
有消化系统这些才能顺利进行
And only after that worked really well,
它就像一个 很好的附加元件 上面还有
it was like a nice add-on to also have this brain up there
能协调各种感官的大脑
that can coordinate senses.
嗨 姬米 如果 你想继续的话 我们准备好咯
Hi, Kimmie, we're ready for you if you wanna come on back.
我今天要做核磁共振
I'm going to get my MRI done today.
我有点担心
I'm a little worried.
但我很期待能了解我身体的状况
But I'm looking forward to understanding what's going on in my body.
我还是有点困惑
I'm still a little confused.
我只想弄清楚 我的身体是怎么运作的
I'm just trying to figure out how my body works,
这样 前进的路上 我才能成为更好的自己
so moving forward, I can be a better me.
好了 姬米 你在里面感觉如何
All right, Kimmie. How you doing in there?
很好
Good.
我们会给你放一组幻灯片
We're gonna go ahead and put up a slideshow for you
很多的照片
of a bunch of pictures.
你只需要看就行 就像看电视或电影那样 好吗
And we're just gonna ask you to watch it like you would watch TV or a movie, okay?
好的
Okay.
我们现在看到的是大脑的活动
What we're looking at is activity in the brain.
看看姬米和科比对刺♥激♥的反应 这个案例是食物刺♥激♥
Seeing how Kimmie and Kobi respond to a stimulus. In this case, food cues.
我们有高热量的甜食
We have high-calorie sweet foods,
或高脂肪 高热量的美食
or high-fat, high-calorie savory foods.
在姬米的大脑中观察到的是 当姬米看到食物时
And what we see with Kimmie's brain is that when Kimmie sees food,
她大脑的情感区域就会被激活
the emotional part of her brain gets activated,
但更重要的是
but more importantly,
控制这些情绪反应的能力减弱了
the ability to control these emotional responses are diminished.
而科比的情况绝对要复杂得多
With Kobi's situation, it's definitely more complex.
饥饿是一个复杂的过程
Hunger is a complicated process.
涉及多个系统
There are multiple systems involved.
大脑、肠道微生物群、炎症
The brain, the gut microbiome, inflammation,
还有你的心情、记忆、环境
but also your mood, your memories, your environment.
与饥饿相关的因素很多
There are so many things that are related to hunger,
我们需要考虑全身
and we need to think about the whole body.
医生被分为不同的科室
Doctors are divided up into specialties
他们只专注于一个器官
where they just focus on this one organ,
而忽略了身体的其他部分
and they ignore the entire rest of the body, essentially.
它最小化了我们对万物关联的理解
It's minimizing our understanding of how everything is connected.
微生物群的美妙之处在于它无所不在
The beautiful thing about the microbiome is it's everywhere,
它的影响也无所不在
and its effects are felt everywhere.
我们必须更全面地去考虑
We have to think more holistically.
因此 我真正感兴趣的
And so, one of the things that I'm really interested in
是当我们的肠道和大脑同时出问题时
is when we have co-occurrences of gut problems with brain problems,
而这种情况很常见 在自闭症中
and it's very common.
在自闭症、帕金森氏综合症中都很常见
It's very common in autism, in Parkinson's disease,
在与压力相关的精神疾病中也是如此
but also in stress-related psychiatric illnesses
例如 焦虑和抑郁
like anxiety and depression.
所以 谁先出现的 这一直都是个问题
And so, which came first is always the question.
在过去五年左右的时间里
In the last five or so years,
我们发现某些"类抑郁症样"症状的人
we found that people with certain depression-like symptoms
他们的肠道中缺少
are missing bacteria in their gut
能分泌一种影响大脑化学成分的细菌
that produce chemicals which shape brain chemistry.
这会改变你的感受
That changes how you feel.
我们相信 它会导致"类抑郁症样"症状的出现
And it can lead, we believe, to the onset of depression-like symptoms.
当把一个健康人体内的微生物 移植给一只普通小鼠
When you give a normal mouse microbes from a healthy person
然后给它们机会去探索时
and give them the opportunity to explore,
它们会希望能看到明亮的地方 并且通常很有好奇心
they'll want to see bright areas and be generally inquisitive.
如果你把一个 抑郁症患者的微生物给它们
Whereas if you give them the microbes from a depressed individual,
它们就会躲在暗处
they'll huddle into dark areas,
它们还会产生压力、焦虑和抑郁
and they will develop stress, anxiety, and depression.
在他们的肠道和大脑中
There was changes in the chemicals involved in serotonin,
与情绪分子 血清素有关的化学物质发生了变化
the mood molecule, in their gut and in their brain.
当我们在这些小动物体内添加了那些
When we added bacteria into our animals
抑郁症患者所缺少的细菌时
that's often missing in people who are depressed,
它们确实抑制了抑郁反应
it actually dampens down that depression response.
所以它们的抑郁症也许还在 但没那么严重了
So they may still have depression, but they don't feel it as severely.
对 很有道理
Yeah, it makes sense.
当我为比赛训练时
When I'm training for a competition,
我觉得很有进取心
I feel aggressive,
我会不想和其他人说话
and I don't feel like talking to other people.
想到大脑和肠道的关系如此紧密 感觉很可怕
It's scary to think that the brain and gut are so closely related.
这让我对自己的饮食更加谨慎了
It makes me want to be more careful with what I eat.
太酷了
That's really cool.
天啊 你玩得真好
Ah, man. You're doing really well.
作为父亲 我有个患自闭症的儿子 和另一个患多动症的儿子
As a father with a son with autism and another son with ADHD
我们家族还有抑郁症病史
and having depression in my family,
我一直很想知道
I've been very interested in seeing if there's maybe a link
这是否与微生物群的破坏有关
to disruptions in the microbiome.
这塑造了我的研究生涯
And that's shaped my research career.
我一直在研究 哪些细菌可能在其中起了作用
And I've gone after looking at which bacteria might be playing a role.
我们发现在很多自闭症病例中
We found that in many cases of autism,
有些孩子会腹泻或严重便秘
there are children who have diarrhea or severe constipation.
其他的脑部疾病 例如帕金森氏综合症
In other diseases in the brain, like Parkinson's,
我们经常会看到便秘的症状
we often see an onset of constipation,
有时甚至在真正的 脑部疾病出现之前几十年就发生了
sometimes even decades before the actual brain disease manifests.
为了弄清楚这种关联
To understand this connection,
我们提取了某些疾病患者的细菌 例如帕金森氏综合症
we take bacteria from humans with a certain disease like Parkinson's,
然后把它们植入小鼠体内
and put them in mice.
当将缺失的细菌注入小鼠体内时 它们的症状就会有所改善
When we add missing bacteria into the mice, their symptoms improve.
这是很自然的方式
It's a natural thing.
自然地让体内的 生态系统和化学物质重新达到平衡
Just naturally rebalancing that ecosystem and that chemistry inside the body.
因此 我们真正开始认识到
And so, we're really starting to see that the relationship,
要真正解决一些慢性疾病
our study of the body as a whole unit, is essential
那么将我们的身体 作为一个整体来研究是至关重要的
if we're really gonna get a handle on some of these chronic conditions.
很高兴见到你 科比
Well, very nice to meet you, Kobi.
医生 你好
Hi, doctor.
嗨 科比 嗨 玛吉 - 很高兴见到你
Hi, Kobi. Hi, Maggie. Nice to meet you.
我这儿有了一些结果
So I have some results.
我们很高兴地看到
We were excited to see that,
你的细菌看起来 其实很不错
that your bacteria actually looks pretty good.
哇 真意外
Wow. That really surprises me.
所以 尽管大胃王比赛或许有些影响
So even though the competitive eating, you know, may have had an effect,
你吃的是正常的健康料理 日本料理
the fact that you eat a normal healthy diet, Japanese diet,
这一点影响了你的微生物群
it influenced your microbiome.
因为在你的微生物群中的细菌
Because the bacteria in your microbiome
会在进食后的24小时内做出反应
responds, like, within 24 hours of eating.
但说到食欲不振
But when it comes to the loss of appetite,
这可能是多种原因共同导致的
it could be a combination of many things,
比如胃部的伸缩 你的激素
like the actual stomach stretching,
你的激素 某种轻微的炎症
your hormones, some sort of slight inflammation,
或者消化速度等
or also the speed of digestion.
我只是举几个例子 - 好的
Just to name a few things. - Okay.
但另一部分是头
But the other part is the head.
通常我不喜欢 医生告诉人们 问题在你的大脑里
And usually, I am not a fan of doctors telling people it's in your head,
但当我看你的脑部扫描图时 所有区域都在反应
but when I looked at your brain scan, everything was firing.
基本上 大脑中每一个