健康解密：肠道的奥秘（2024）

Basically, every area in the brain
与进食、与食物有关的区域
that can have something to do with eating, with food,
与恶心或饱腹感有关的区域 全都被激活了
with feeling nauseous or full, like, everything is on.
感觉它觉得很困惑
It's almost like it's confused.
好吧 这种说法感觉不太妙
Okay, I don't like the sound of that.
对我来说 唯一合理的解释是
The only way this made sense for me was
所有区域必须一起协作
if everything has to work together to suppress
才能抑制你的饱腹感
so that you don't feel full,
让你不会 对不断吃进去的食物感到恶心
so that you don't get disgusted by more and more food.
你可以看到你的身体 为了达成目标能够做到何种程度
You can see how far your body goes for what you want,
即使它不得不伤害自己
even if it has to harm itself.
他说:"我知道" 他说:"我已经觉得害怕了"
He said, "I know." He said, "I'm already scared."
他说:"我不知道 我的脑子是否还安好"
He's like, "I don't know if my brain is okay."
但没有什么东西被关掉 或消失 或被破坏了
Yeah, but it's not that something is turned off, or gone, or broken.
它们都还在 它们都是激活状态
It's all there. It's all turned on.
现在可能只是连接线路不同了
It's just wired differently maybe now.
你的大脑仍然处于以为你在比赛
Your brain is still trained to think that you're competing
或正在吃那些高度加工食品的状态
or eating those highly processed foods.
我觉得目前的情况非常复杂
Here I think the situation is very complex.
学习倾听身体的声音
Something that would be interesting to try
会是一种有趣的尝试 - 好
would be to learn to listen to the body. - Yeah.
可以是气味 或者一些非常基本的感知
If it's just a smell, or just sensing very basic things,
有时候只需要学会去感受它们
and just learning to feel it, sometimes.
这会是一段漫长的旅程 相当漫长
It's a long journey. A long one indeed.
他说:"这会是 一段漫长的旅程 是吧"
He said, "This is gonna be a long journey though, right?"
我暴饮暴食 是因为我是大胃王比赛的选手
I overeat because I am a competitive eater.
但普通人有时候也会暴饮暴食
But ordinary people overeat too sometimes.
吃太多的时候 就尝不出味道了
When you eat too much, you don't savor the taste
也不会享受食物的香气
or fully enjoy the smell of the food.
你会忽略身体发出的信♥号♥♥ 比如饱腹感
You ignore your body's signals, like fullness.
这很早就开始了
It starts early.
很多孩子从小到大都会被告知
Many kids are raised telling them,
要把盘子里的东西全部吃光 因为好孩子都会这样做
"Clean your plate. Eat the whole plate 'cause that's what good kids do."
所以我们学会了忽视自己的食欲
So we learn to ignore our appetite,
习惯了只有在进餐时间才进食
but get accustomed to just times where we eat.
我们总是在打电♥话♥
We're on the phone the whole time,
或是对着电脑 只有大脑和屏幕
or on the computer with the brain and screen.
重新连接 更关键的是要倾听自己的身体
Reconnecting, it's really more about just listening to your body.
我希望我能健康长寿
I hope to live a long and healthy life.
早上好
Good morning.
我已经决定要退出大胃王比赛了
I've decided to retire from competitive eating.
过去20年 我一直在做这一行
It's all I have done for the last 20 years.
我会担心 我走的下一步会带来怎样的结果
I am worried about what my next step will bring,
但我也对未来倍感兴奋
but I'm also excited about my future.
我的心情很复杂
I have mixed feelings.
但首先
But first,
我想修复大脑和肠道
I want to fix my brain and my gut.
我们正在积极努力
We're actively working to enhance the number
以增加现有不同微生物群疗法的数量
of different microbiome therapies that are out there.
如果微生物群受损了 我们真能用粪便来修复吗
If your microbiome's damaged, can we actually use poop to fix it?
这是相当珍贵的 比黄金还珍贵
This is very, very valuable, more valuable than gold.
如果医生告诉你 某人的粪便能救你的命 你怎么看
What would you say if a doctor told you someone else's feces could save your life?
粪便微生物移植 简称粪便移植
A Fecal Microbial Transplant, simply called FMT,
是将别人的粪便 植入受感染病人的体内
puts feces from someone else into the body of an infected patient.
他提供了结肠镜检查、灌肠或药物等治疗方法
He offers a treatment through colonoscopy, an enema, or pills.
粪便微生物移植 是美国食品及药物管理局批准的
Fecal microbiome transplant is the first FDA-approved therapy
第一种涉及微生物组的疗法 目前可供临床医生使用
which involves the microbiome that's available to clinicians today.
但它只允许用于一种特定的疾病
However, it's only allowed to be used for one particular type of disease.
艰难梭菌 当细菌使结肠发炎并导致严重腹泻时
C. diff. When bacteria inflames the colon and causes extreme diarrhea.
我们从一个健康的人身上 提取细菌群落
We take the bacterial community from a healthy person,
把它喷到结肠里
just spray it up inside the colon, literally,
以重新繁殖肠道内的细菌
in order to re-poop-ulate, repopulate your gut bacteria inside there.
这种疗法的治愈率高达90%
It's a procedure that has a 90% cure rate.
科学家们现在正试图弄清楚
Scientists are now trying to figure out
此方法对其他数百种精神 或身体上的疾病是否同样有效
if it can treat hundreds of other conditions, mental and physical.
关于粪便微生物移植 证据确实令人信服
With fecal microbiome transplants, there is really compelling evidence,
但这项科学还在发展
but the science is still developing.
我们仍在研究 它是否对更广泛的人群有益
We're still working on if it actually has benefit in wider populations,
这种疗效是否持久
if the benefit is long-lasting.
它在这儿 就在我们待会要吃的食物旁边
Here it is, next to the food we're gonna eat later.
在健康范围内吗 - 这个不错
Is it in the healthy range? - This is a good one.
我觉得对大多人来说
I think for most people,
做粪便移植是件非常可怕的事情
it would be scary to do a fecal transplant,
尤其要自己动手的话
especially when it's DIY.
我还认为 很多健康人并不明白
I also think that most healthy people don't know what it's like
生活质量很差是种什么感觉
to get to a place where your quality of life is so low.
我觉得我别无选择
I felt like I had no other options.
这就是爱吗
Is this love?
是的 真爱
Yes, true love.
第一次做粪便移植时 我找了我的兄弟作为供体
The first time I did a fecal transplant, I used my brother as a donor.
虽然我的饮食完全没有改变 但我的体重开始渐渐增加了
I slowly started gaining weight, despite not changing my diet at all.
而且我三年来
And I was able to go to the bathroom
第一次 自己上厕所了
for the first time in, like, three years on my own.
但我的粉刺越来越严重
But I started getting worse acne,
而我兄弟有过荷尔蒙痤疮病史
and my brother has a history of hormonal acne.
后来我决定 让我男朋友来当供体
And then I decided to use my boyfriend as a donor.
他没有任何身体健康问题
He has no physical health conditions,
但他有一些心理健康问题
but he does have some mental health issues.
我吃了几个月我男朋友的药
I took my boyfriend's pills for several months.
不长粉刺了
Stopped getting the acne.
但随着时间推移 我注意到
But over time, I noticed
我的抑郁程度 比以往任何时候都更严重
that my depression was worse than it's ever been in my life.
他常有的细菌我都得到了
I got whatever bacteria he normally has,
这加重了我本来就有的抑郁情况
and it exacerbated the depression that I already had.
我再次让我兄弟来当我的供体
I went back to using my brother as a donor.
不到一周 抑郁的症状就完全消失了
Within a week, that depression completely went away.
放进去
Going right in there...
和冰淇淋在一起
with the ice cream.
粪便微生物移植是有风险的
There are risks with FMT.
当你接受粪便微生物移植时 你得到了有益的细菌
When you get an FMT, you get the good bacteria,
但不好的细菌也会相伴而至
but the bad bacteria could also come along for the ride.
如果这就是完美的解决方案 我会很乐意接受
I would love it if this was the perfect solution.
但我认识的 所有肠胃科医生都非常谨慎
But all the gastroenterologists I know are extremely cautious.
我们可能会把 对各种疾病的易感性一同移植
We could transplant the susceptibility to all sorts of diseases.
所以我会跟大家说 不要在自己身上尝试
So I ask people, don't try and experiment on yourself
一些更激进的疗法
with some of these more aggressive therapeutics.
如果粪便移植…
If a fecal transplant would give you back
能够让你恢复饥饿感和饱足感 你会接受吗
your feelings of hunger and fullness, would you do it?
会 如果它能帮我解决我的问题
Yes, if it could help me with my problems,
我是一定会尝试的
I would definitely try it.
我会成为小白鼠
I'll be the guinea pig.
某人的粪便能救你的命
Someone else's feces could save your life.
粪便微生物…
Fecal microbial...
我觉得这也太奇怪了
I thought it was weird as hell,
但这些关于粪便的话题让我明白了
but all this talk about poop just kind of helped me understand
大便是很正常的
that pooping is normal.
它是日常生活 是每个人都会经历的事
It's everyday life. It's something everybody goes through.
所以为何避而不谈呢
So why not talk about it?
我会提起这个话题 一次随意的便便对话
I'll bring it up, and it's just a random poop conversation.
我挂掉电♥话♥以后就想: "刚刚那样奇怪吗"
And when I hang up the phone, I'm like, "Was that weird?"
以前我觉得是的 但现在觉得:"不 这很正常"
Before it was, but now it's like, "No, it's normal."
粪便微生物移植 是一种相当生硬的工具
Fecal microbiome transplants are quite a blunt tool.
我们更倾向于 使用一种有针对性的方法
We prefer to use a targeted approach,
比如精准益生菌 以一种非常具体的方式来改善健康
like a precision probiotic to improve health in a very specific way.
你在商店里买♥♥到的大多数益生菌 都不是真正的肠道益生菌
Most probiotics you can buy in the store aren't really gastrointestinal bugs.
它们并不是为了 能在我们的肠道中存活而设计的
They're not designed to live inside our guts.
它们通常是 与发酵牛奶或奶酪有关的细菌
They're normally bugs that you would find associated with fermented milk or cheeses,
乳酸菌有机体
Lactobacillus organisms.
所以它们不是为了驻留体内而设计的
So they're not really designed to take up residence.
这就像把一株室内植物 扔进了亚马逊丛林
It'd be like taking a houseplant, and throwing it into the Amazon jungle,
然后满怀期待地 希望它会突然生长繁衍