肠道微生物组与炎症
Dr. Will: 什么是粪便移植?就是你取一个健康人的粪便,然后把它转移到生病的人体内。举个例子,我有一个病人,她服用了抗生素,这会清除你的肠道菌群,结果变得危及生命。我们的选择是切除结肠,或者给她做粪便移植。所以我给她做了粪便移植。第二天,整个感染问题就解决了。这是一个很好的例子,说明我们的肠道微生物组有多么重要,因为你粪便重量的60%就是你的微生物组。
Original English
Dr. Will: What's a fecal transplant? You take a healthy person's poop and you transfer it into the person who's sick. For example, a patient of mine took an antibiotic which wipes out your gut, which became life-threatening. Our choices were to remove the colon or to give her a fecal transplant. And so, I delivered the fecal transplant to her. By the next day, the entire infectious issue got shut down. So, this is a great example to show how important our gut microbiome is because 60% of the weight of your stool is your microbiome.
Steve: 真的吗?
Original English
Steve: Really?
Dr. Will: 是的。但这没有得到足够的重视,我们需要谈谈这个问题。
Original English
Dr. Will: Yes. but it's not getting enough attention and we need to talk about that.
Steve: 世界著名的胃肠病学家威尔·布尔西维茨博士又回来了。这次他分享了关于肠道微生物组的全新信息,以及粪便如何成为你健康的关键。60%的听众目前正遭受某种肠道问题的困扰,这些问题以微妙的方式表现出来,比如腹胀、疲劳加剧、注意力不集中、睡眠不佳和皮肤问题。所以它在不知不觉中发生,但最终会导致其他健康问题。
Original English
Steve: World-renowned gastroenterologist Dr. Will Bulsiewicz is back. This time he's sharing brand new information regarding the gut microbiome and how poo might actually be the key to your health. 60% of people that listen are currently struggling with some kind of gut problem and it manifests in these subtle ways like bloating, increased fatigue, difficulty concentrating, you don't sleep well at night, skin issues. So it flies under the radar but ultimately leads to other health related problems afterwards.
Steve: 我有很多问题。
Original English
Steve: So I've got so many questions.
Dr. Will: 当然。
Original English
Dr. Will: Totally.
Steve: 引起腹胀的原因是什么?
Original English
Steve: What's the cause of bloating?
Dr. Will: 便秘是首要原因。但是,那些腹胀的人,请不要用吸管喝水,不要喝碳酸饮料,不要嚼口香糖,因为这只会让情况变得更糟。
Original English
Dr. Will: So constipation is the number one cause. But people who are bloated, please don't sip through straws, drink carbonated drinks, chew on gum, because you just make it worse.
Steve: 下一个。作为父母,你做出的决定会对孩子肠道功能产生持久影响吗?
Original English
Steve: Next. Are there decisions that you make as a parent that will have a lasting impact on a kid's gut function?
Dr. Will: 是的。到3岁时,你的微生物组基本上就达到了成年人的大小。但是,抗生素、奶瓶喂养和剖腹产都与对微生物组的影响有关,例如增加过敏性疾病、自身免疫性疾病和代谢性疾病的风险。我将解释原因。
Original English
Dr. Will: Yeah. By 3 years of age, you are basically fully adult-sized in terms of your microbiome. But antibiotics, bottle feeding, and birth by cesarean section are associated with an impact on the microbiome, such as an increased risk of allergic, autoimmune, and metabolic diseases. And I'll explain why.
Steve: 那么,我能修复肠道吗?
Original English
Steve: And then, can I repair the gut?
Dr. Will: 是的,100%。每3到5天,你就会建立一个新的肠道屏障。所以我发现了我们饮食中缺少的四样东西,以及一个可以优化我们微生物组的日常习惯。当你做到这些时,你就会茁壮成长,活得更久,疾病更少。我现在就带你了解所有这些步骤。
Original English
Dr. Will: Yeah, 100%. And every 3 to 5 days, you build a new gut barrier. And so, I've identified four things missing in our diet, as well as a daily routine that can optimize our microbiome. And when you do these, you will thrive and you will live longer and you will have less disease. And I'm going to take you through all of these steps right now.
Steve: 我经常在评论区看到一些信息,说你们有些人没有意识到自己没有订阅。所以,如果你能帮我一个忙,检查一下你是否订阅了这个频道,我将不胜感激。这是任何经常观看这个节目的人都可以做的简单而免费的事情,以帮助我们保持节目按照目前的轨迹继续发展。所以请务必检查你是否已经订阅,非常感谢,因为在某种程度上,你是我们历史的一部分,你和我们一起踏上这段旅程,我为此感谢你。
Original English
Steve: I see messages all the time in the comments section that some of you didn't realize you didn't subscribe. So, if you could do me a favor and double check if you're a subscriber to this channel, that would be tremendously appreciated. It's the simple, it's the free thing that anybody that watches this show frequently can do to help us here to keep everything going in this show in the trajectory it's on. So please do double check if you've subscribed and thank you so much because in a strange way you are you're part of our history and you're on this journey with us and I appreciate you for that. So yeah thank you
炎症是现代健康问题之源
Steve: 威尔博士,在我们开始录制之前,我问了你关于你写的新书,你谈论它的方式非常充满热情。为什么?
Original English
Steve: Dr. Will. Before we started the recording I asked you about this new book that you've written and the way that you spoke about it was incredibly passionate. Why?
Dr. Will: 我真诚地相信,如果人们采纳这本书中的建议并真正遵循它——这是最难的部分——我完全相信它会改变你的生活。那是因为我们都在与同一个问题作斗争。我们以不同的方式表现出来,但有一个共同的问题,那就是炎症。这是我们这个时代的健康故事。它没有得到足够的重视。这本书不仅是为了揭示这一点,更是为了向人们提供他们所需的循证工具,以获得成功并过上抗炎的生活。当你这样做时,你就会茁壮成长,活得更久,疾病更少。
Original English
Dr. Will: I sincerely believe that if people take the advice that's in this book and they actually follow it, which is the hardest part. I'm completely convinced it will transform your life. And that's because we all are struggling with the same problem. We manifest it in different ways, but there's this common issue which is inflammation. And it's the health story of our time. It's not getting enough attention. And this book is not only about shining the light on that. It's about providing people with the evidence-based tools that they need in order to be successful and to live an anti-inflammatory life. And when you do that, you will thrive and you will live longer and you will have less disease.
Steve: 你能像给10岁孩子解释一样,给我解释一下炎症吗?
Original English
Steve: Can you explain inflammation to me like I'm a 10-year-old?
Dr. Will: 史蒂夫,你有一个保护身体的免疫系统。炎症就是我们启动并激活这个免疫系统的时候。有时这是好事,对吧?如果你得了肠胃炎,你希望清除感染,对吧?如果你受伤了,你希望伤口愈合。那时你的免疫系统非常棒,它在为你工作。但我们现在的问题是,我们在不需要的时候启动了免疫系统,而且它24小时、每周7天都保持开启状态。这最终会产生问题,因为它会导致新的问题,新的健康状况。
Original English
Dr. Will: Steve, you have an immune system that protects your body. And inflammation is when we turn that immune system on and we make it active. And sometimes that's a good thing, right? If you had a tummy bug, you want to clear that infection, right? If you hurt yourself, you want to heal that wound. That's when your immune system is really good. It's working for you. But the problem that we have these days is that we're turning on the immune system when we don't need to. And it's staying on 24 hours a day, seven days a week. And that ultimately creates problems because it leads to new issues, new health conditions.
Steve: “炎症”这个词听起来像是某种东西膨胀或肿胀了。
Original English
Steve: The word inflammation sounds like something has inflated or become swollen.
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Dr. Will: 嗯,那是过程的一部分。例如,如果你伤到膝盖,对吧,你的膝盖会发炎,它会变红,会肿胀,会变得触痛,这些都是炎症出现时的典型特征。但我们现在谈论的是慢性低度炎症。这是一个棘手的问题,因为它可以在不知不觉中发生。你可能没有意识到它的存在,你的医生也可能没有意识到它的存在。它以这些微妙的方式表现出来,比如你感到疲劳加剧,注意力不集中,晚上睡不好,醒来时浑身酸痛,或者关节有点痛,或者有皮肤问题,对吧?人们会说:“嗯,我们都有这些问题”,但那就是炎症。炎症正在驱动许多这些问题。所以,人们认识到这一点很重要,你可能会有这些症状。有那么多病人向医生抱怨这些症状,而医生却不知道该怎么办。我认为是时候让我们敞开心扉,认识到炎症这个问题正在驱动这些症状和许多健康状况。最终,我们需要一个计划来解决这个问题。
Original English
Dr. Will: Well, that is a part of the process. For example, if you hurt your knee, right, there will be inflammation in your knee and it will get red, it will get swollen, it will become tender and like those are the typical characteristics of inflammation when it arrives. But what we're talking about is chronic low-grade inflammation. And this is a tricky thing because it can fly below the radar. It can fly below the radar where you don't realize that it's there. Your doctor may not realize that it's there. And it manifests in these subtle ways where it's like you have increased fatigue. You have difficulty concentrating. You don't sleep well at night. You wake up with aches and pains or you have joints that hurt a little bit or you've had skin issues, right? And it's like, well, we all have those problems, but that's inflammation. Inflammation is driving many of those issues. And so, it's important for people to be aware that, you know, you may like these. There's so many patients that go to their doctor complaining of these symptoms. And the doctor's kind of not really sure what to do about that. And I think it's time for us to like open our mind and bring awareness to the possibility that there is this issue inflammation that's driving that problem, the symptoms, the health conditions of which there are many. And ultimately, we need a plan to address that.
Steve: 那么,瘦子也能发炎吗?
Original English
Steve: And is can you be like skinny and in shape and still have inflammation?
Dr. Will: 100%。
Original English
Dr. Will: 100%.
Steve: 所以这不仅仅是体重问题。
Original English
Steve: So it's not just a a weight thing.
Dr. Will: 不,这不仅仅是体重问题,因为如果你想想那些竞技健美运动员,他们外表看起来很棒,但内心却在崩溃。这些人经常遭受消化系统健康问题的困扰。我知道,因为他们会联系我,包括许多看起来很棒但却饱受肠道问题困扰的知名人士,最终他们面临其他健康相关问题的风险。所以关于炎症这一点,就是你的免疫系统一直处于开启状态。它为什么会一直开启呢?我该如何关闭它?
Original English
Dr. Will: No, it's not just a weight thing because if you if you think about, you know, people who are competitive bodybuilders, they look amazing on the outside and they're falling apart on the inside. And these people often suffer with digestive health problems. I know because they reach out to me, including many people that are well-known who look incredible and they're suffering with gut issues and then ultimately they're at risk for other health related problems afterwards. So on this point of inflammation is when your immune system kind of stays on. Why does it stay on and I mean how do I turn it off?
Dr. Will: 嗯,我们必须首先承认,这导致问题的原因是,我们可以打个比方,免疫系统是你的小军队,它们在那里保卫你。当我们激活军队,它们实际上在打仗时,你必须预料到周围区域会受到损害,对吧?就像如果发生战争,当然会有破坏和损害,而且是残酷的。问题是,如果我们激活免疫系统,它周围的区域就是你的身体,对吧?而发生的破坏和毁灭是在你自己的组织、你自己的器官内部。当我研究这本书时,我花了三年时间来理解这个主题。我发现免疫系统和肠道之间存在着不可否认的联系。这种联系成为了一个强大的因素,让你能够理解它为什么会发生以及我们如何修复它。我们有我们的肠道微生物组,在大肠内生活着38万亿个微生物。它们包括细菌、酵母和古菌,这些东西已经在地球上存在了40亿年,可能还有寄生虫。所以,在这个庞大的微生物群落中,它们的存在是有目的的,那就是支持你和你的生理机能。它们的一个关键作用实际上是滋养覆盖你整个肠道的肠道屏障。
Original English
Dr. Will: Well, we have to start with acknowledging that the reason why this causes problems is that it let's like sort of use an analogy of the immune system is your small army and they're there to defend you. And when we activate the army and they're actually going to war, you have to expect that there's going to be damage to the surrounding areas, right? Like if people if if there's a war occurring, of course there's decimation and damage that occurs and it's brutal. And the problem is that if we're activating the immune system, the the areas that are surrounding it, that's your body, right? And the decimation and destruction that's occurring is within your own tissues, within your organs. As I was researching this book, I actually took three years to understand this topic. And what I discovered is a connection between your immune system and your gut that is undeniable. And that connection becomes the powerful factor that allows you to understand why it happens and how we can fix it. We have our gut microbiome and there are 38 trillion microbes that live inside of our large intestine and they include bacteria and yeasts and and archaea which are these things that have been on the planet for 4 billion years and possibly parasites. And so in this entire community of microorganisms, they're there with a purpose and that is to support you and your physiology. One of their key jobs is actually to basically feed the gut barrier that lines your entire intestines.
Steve: 你想用这个给我演示一下吗?
Original English
Steve: Do you want to show me on using this?
Dr. Will: 当然。
Original English
Dr. Will: Sure.
Steve: 这是身体的正确部位吗?
Original English
Steve: Is this a the right part of the body?
Dr. Will: 所以,现在大肠是你的微生物组的家。这38万亿个微生物,这是它们的住所,它们的领地。现在,整个系统,大约20到25英尺长,也就是6到8米,它覆盖着一层单细胞,我们称之为上皮层,那就是你的肠道屏障。它是你身体中一个相当迷人的部分,因为它就像城墙,把坏东西挡在外面,但同时又需要让好东西进来。这些细胞每3到5天更新一次。所以这实际上是一件美好的事情,因为每3到5天你就有机会创造一个新的肠道屏障。所以在这个系统中,生活在你结肠内的微生物,它们的工作就是修复和恢复肠道屏障。当肠道屏障完好无损时,它就会履行保护免疫系统的职责。当肠道屏障开始破裂时,一些东西就会偷偷溜过去,我们称之为肠道通透性增加,但通俗的说法是肠漏。免疫系统会看到并识别那些不应该存在的东西。所以免疫系统就会行动起来,想要清除它们。这基本上意味着它需要被激活并攻击。那就是炎症。
Original English
Dr. Will: So now the large intestine is the home to your microbiome. So these 38 trillion microbes this is their this is their residence. This is their domain where they live. Now this entire system which is like on the order of 20 or 25 feet so like something on the range of 6 to 8 mters it's coated with a single layer of cells which we call the epithelial layer and that is your gut barrier and it's a quite fascinating part of your body because this is like the castle wall and keeps the bad stuff out but simultaneously needs to allow the good stuff in and These cells they turn over every 3 to 5 days. So it's a beautiful thing actually because every 3 to 5 days you have an opportunity to create a brand new gut barrier. So within the system the microbes that live inside your colon their job is to basically repair and restore the gut barrier. And when the gut barrier is intact it's going to do its job of protecting the immune system. And when the gut barrier starts to break down, then things can sneak across which we would refer to as increased intestinal permeability, but the common language is leaky gut. The immune system will see and recognize things that aren't supposed to be there. And so the immune system then steps up and wants to take it out. And that basically means it needs to get activated and attack. And that is inflammation.
Dr. Will: 所以,从微生物开始的这三个系统的崩溃,微生物实际上是你的第一道防线,然后导致肠道屏障的崩溃,这就是当有不应该存在的东西偷偷溜过去时,最终激活免疫系统的原因。反之亦然。对我来说,激动人心的机会就在于此:如果你能治愈肠道微生物,那么肠道微生物就能重新工作,修复和恢复肠道屏障。当你建立一个强大的肠道屏障时,你基本上就是在保护免疫系统。然后你实际看到的是,免疫系统会平静下来,变得更具策略性,更能胜任它的工作。
Original English
Dr. Will: So the breakdown of these three systems that start with the microbes, microbes are actually your first layer of defense and then leading to the breakdown of the gut barrier is what ultimately activates the immune system when we have things that are sneaking across that are not supposed to be there. the reverse can also be true. And that to me is where the exciting opportunity exists is that if you can heal the gut microbes, then the gut microbes can get back to work and do their job of repairing and restoring the gut barrier. And when you create a strong gut barrier, then basically you're protecting the immune system. And then what you see actually is the immune system cools off and it becomes more tactical and capable of doing its job.
Steve: 好的。当我们吃很多不好的东西时,今天我们要谈论的许多东西都会导致这些微生物的崩溃,从而导致肠道屏障恶化,从而导致免疫系统启动,从而导致炎症,而炎症又会损害我们的细胞。免疫系统过度运作会导致什么?你刚才谈到了军队的比喻,军队在打仗,其中一些正在破坏周围的环境。
Original English
Steve: Okay? And when we're eating lots of bad stuff and you know many of the things we're going to talk about today are causing a breakdown in those microbes which is causing the gut barrier to worsen which is causing the immune system to kick in which is causing the inflammation and the inflammation is therefore causing our cells to be damaged. What's the immune system overfunctioning causing? Like you you're talking about the army analogy where there's an army and they're at war and some of them are damaging the surroundings.
Steve: 我的免疫系统一直开启,它是如何破坏我周围环境的?
Original English
Steve: How is it damaging my surroundings? My immune system being on all the time.
Dr. Will: 嗯,所以最终发生的是它引发了这种连锁反应,这会对你的整个身体产生影响,免疫细胞,它不仅仅是几个免疫细胞,它们开始发出信号,我们称这些信号为细胞因子。所以你可以测量这些细胞因子,它们基本上是免疫细胞之间用来寻求帮助的沟通工具。所以当它们被激活时,这些细胞因子就开始释放出来,然后这会导致更多的免疫细胞释放出更多的细胞因子。然后引发这股浪潮,这就是你最终能在你的整个身体中感受到的。它会造成对这些个体组织的损害。所以这取决于我们指的是哪个组织。肝脏中的炎症,我们称之为肝炎,对吧?但同时,我们现在有压倒性的证据表明,大脑中的炎症,我们称之为神经炎症,与情绪障碍有关。所以像重度抑郁症,大脑中的炎症与认知障碍有关,比如阿尔茨海默病、帕金森病。所以,这并不是说所有疾病都与肠道微生物组有关或由其引起。这并不是这个意思。它更多的是说,我们需要明白我们的免疫系统与我们的微生物组如此紧密地连接在一起,以至于你无法将两者分开。而且有证据表明我们可以进行干预。所以无论是抗生素(它会摧毁肠道),还是相反的替代方案,粪便移植,它能迅速恢复肠道活力,恢复肠道结构和生态系统。
Original English
Dr. Will: Well, so what ends up happening is it sets off this sort of chain reaction which can have an effect throughout your entire body where the immune cells, it's not just a couple of immune cells, they start to basically send out signals and these signals we call them cytokines. So you can measure those cytokines and those are basically communication tools that the immune cells are using with each other to basically call for help. So and as they get revved up these cytokines start to go out and then this leads to a cascade of even more immune cells releasing even more cytokines. And so and then kick off this wave and this is what ultimately you can feel throughout your entire body. And it has these consequences of basically causing damage to these individual tissues. So it depends on which tissue we're referring to. Inflammation in the liver we would call hepatitis, right? But at the same time we have overwhelming evidence at this point that inflammation in the brain which we call neuroinflammation has been associated with mood disorders. So like major depression inflammation in the brain has been associated with cognitive disorders like Alzheimer's disease, Parkinson's disease. So, and it's not to claim it's not to claim that all disease literally is related or caused by the gut microbiome. That's not the call. It's more so to say that we need to understand that our immune system is so powerfully connected to our microbiome that you cannot separate the two. And there's evidence to suggest that we can we can manipulate. So whether it be antibiotics which decimate the gut or the alternative the the opposite would be a fecal transplant which rapidly reinvigorates the gut and restores that gut architecture and ecosystem.
粪便移植与疾病治疗
Steve: 什么是粪便移植?
Original English
Steve: What's a fecal transplant?
Dr. Will: 粪便移植就是你取一个健康人的粪便,然后把它转移到生病的人体内。
Original English
Dr. Will: So fecal transplant is where you take a healthy person's poop and you transfer it into the person who's sick.
Steve: 他们在哪里进行移植?
Original English
Steve: And where are they administering it?
Dr. Will: 我职业生涯中一直进行粪便移植的方式是在结肠镜检查期间。
Original English
Dr. Will: The way that I've always done the fecal transplant because I've done many throughout my career is during a colonoscopy.
Steve: 那么,从理论上讲,结肠镜检查是什么?
Original English
Steve: So if in theory colonoscopy what's a colonoscopy?
Dr. Will: 是的。结肠镜检查是一种医疗程序,通常你会处于睡眠状态,当你睡着时,我用一根大约我食指大小的长而柔软的管子,我可以控制它穿过你的整个大肠,大约五到六英尺长。我甚至可以进入小肠的最后一部分,我们称之为末端回肠,它位于腹部的右下方。你进行粪便移植是因为他们患有这种恶性感染,叫做艰难梭菌感染(C. diff),这种感染可能危及生命。你进行粪便移植是因为抗生素不起作用。所以你需要一个替代方案,其理念和目标是恢复肠道生态系统的平衡。
Original English
Dr. Will: Yeah. So colonoscopy is a medical procedure where typically you would be asleep and while you're asleep I take a long flexible tube that is about the size of my index finger and I can pass that with control all the way through the entirety of your large intestine which is about five or six feet long. And I can actually dip into the last part of the small intestine which we call the terminal ileum which is down here in the right the right lower part of the abdomen. You're administering the fecal transplant because they they have this vicious infection called C. diff and again those infections this infection can be life-threatening. And you're administering the fecal transplant because the antibiotics are not working. So you need an alternative where the idea and goal is to restore balance within the gut ecosystem.
Steve: 是的,你是在植入好的细菌,而不是取出坏细菌。
Original English
Steve: Yeah. You're putting good bacteria in, not taking bad bacteria. Yeah.
Steve: 我猜不是把所有细菌都取出来。
Original English
Steve: Not taking all bacteria out, I guess.
Dr. Will: 所以你植入好的细菌,当这种情况发生时,你实际上一次性重新植入了数百种可能处于平衡状态且数量适中的物种。所以,这就像一次完整的生态系统移植。就像我们说:“好吧,这里有一片森林状况不佳,我们要把亚马逊森林移植到这个地方。”现在我们有了所有这些在这个地方生长良好的动物,森林又生机勃勃了。所以,回到我们关于免疫系统的观点,免疫系统之所以一直开启,是因为我的肠道受损了,它本质上是在试图修复我的肠道。所以,如果我因为摄入的东西而长期处于肠道受损的状态,那么理论上我就会长期处于炎症状态。从我的角度来看,现代世界和我们的生活方式正在损害我们的肠道,损害我们的微生物组,然后我们正在承受其后果,那就是肠道屏障的破坏,并最终激活我们的免疫系统,陷入这场永无止境的战争,即慢性低度炎症。
Original English
Dr. Will: So you put and you put the good bacteria in and when this happens, you're actually all at once reinstalling potentially hundreds of species in balance in the right amounts. So, it's like an entire ecosystem transplant. It would be like us being like, "Okay, here's this forest that's not doing well. We're going to take the Amazon and we're going to transplant it into the space." And now that we have all these animals that like do well in the space, the forest is washing. It's vibrant again. So, going back to our point about the immune system, the reason why the immune system is staying on is because I have damaged my gut and it's essentially trying to repair my gut. And so if I live in a permanent state of a damaged gut because of what I'm consuming, then I'm going to live in a permanent state theoretically of inflammation. The thesis from my perspective is that the modern world and the way in which we live is damaging our gut, damaging our microbiome, and then we're suffering the consequence of that which is disruption of our gut barrier and ultimately the activation of our immune system in this forever war, which is chronic low-grade inflammation.
肠道健康与癌症及帕金森病
Steve: 癌症是如何与此相关的?你谈到了130种不同的疾病,在你的书里,我想大约在第22页,你提到了化疗,你将化疗如何清除一切与肠道维护不善如何增加癌症可能性进行了类比。
Original English
Steve: How was cancer associated with this? We you talked about 130 different diseases and in your book I think it's around page 22 you mentioned I think it's chemotherapy where you're making an analogy between how chemotherapy kind of wipes everything out and how a poorly kept gut is associated with an increase in cancer likelihoods.
Dr. Will: 让我们从这里开始。你的身体每秒产生380万个细胞。你的免疫系统有责任识别问题所在并将其清除。你不可能产生380万个新细胞而没有任何可能癌变的基因异常,对吧?所以,免疫系统的责任是基本上在你生命中的每一天都完美无缺,并在那些有问题细胞变得更大更好之前将其清除。这是一项不可能完成的任务。现在,在这场对话中,有一个完整的故事正在展开,关于肠道微生物组如何与我们的免疫系统以及我们治疗癌症的方式联系在一起,它最初始于黑色素瘤。我们长期以来一直使用免疫操作来治疗黑色素瘤。但改变的是他们开始使用这些被称为免疫疗法的东西。更具体地说,是免疫检查点抑制剂。
Original English
Dr. Will: Let's start with this. Your body produces 3.8 million cells every second. Your immune system has the responsibility of identifying where there's a problem and taking it out. You can't possibly create 3.8 million new cells and not have some genetic abnormality that could turn into cancer. Right? So, the responsibility of the immune system is to basically be perfect every day of your life and remove those problematic cells before they turn into something bigger and better. It's an impossible task. There's an entire story that's unfolding now in this conversation about how the gut microbiome is connected to our immune system and the way in which we treat cancer and it's it started really in melanoma. We have been using sort of immune manipulations for a very long time to treat melanoma. But what changed is they were using these things called immunotherapy. To be more specific, immune checkpoint inhibitors.
Dr. Will: 事实证明,你的免疫细胞基本上有一个“杀戮开关”。如果出现问题,你可以立即将其关闭。那个特定的受体叫做PD-1。而肿瘤之所以如此恶劣,是因为它们会产生这种蛋白质,基本上会激活这个“杀戮开关”。
Original English
Dr. Will: So it turns out that your immune cells have like basically a kill switch. If there was a problem, you could like flip it off immediately. And that specific receptor is called PD-1. And the tumors, they're so nasty because they produce this protein that basically activates the kill switch,
Steve: 关闭你的免疫系统。
Original English
Steve: turns off your immune system,
Dr. Will: 它关闭你的免疫系统。所以免疫检查点抑制剂的理念是基本上重新打开那个开关。通过打开它,激活你的免疫系统,然后它会苏醒,看到这个癌症,然后说:“好吧,这需要被清除”,然后去攻击它。如果有人在接受免疫检查点抑制剂之前服用了抗生素,他们的情况就不太好。所以这就提出了一个问题:这可能与微生物组有关。所以他们说:“好吧,如果抗生素会这样做,那么如果我们反其道而行之,通过粪便移植来恢复微生物组会发生什么?”他们发现的结果令人难以置信。现在有多个关于黑色素瘤的研究,他们让人们接受来自一个有反应者的粪便移植,然后将其给予即将接受治疗的人。他们就是这样做的,结果令人难以置信,例如,战胜癌症的人数是预期人数的两倍。
Original English
Dr. Will: and it turns off your immune system. So the immune checkpoint inhibitor, the idea is to basically flip that switch back on. And by flipping it on, activate your immune system, which will then wake up, see this cancer, be like, okay, that needs to be taken out, and go after it. If someone received antibiotics before the immune checkpoint inhibitor, they didn't do well. So then it raised the question, maybe this is a microbiome thing. So they said, okay, well, if antibiotics do this, what happens if we move in the opposite direction and basically act like restore the microbiome with a fecal transplant? And what they discovered was incredible results. There's now multiple studies in melanoma where they take people and they give them a fecal transplant from someone who was a responder and give it to the person who's about to go get treated. And that's what they did. And and with incredible results, like literally twice as many people were beating cancer relative to the expectation.
Dr. Will: 令人着迷的是,这不仅仅是一个癌症的故事。现在有关于帕金森病的研究。帕金森病是一种神经认知障碍。所以这基本上意味着它是一种脑部疾病。
Original English
Dr. Will: The fascinating thing about that is that it's not just a cancer story. There's research now in Parkinson's disease. So Parkinson's disease is a neurocognitive disorder. So that means basically it's a it's a brain condition.
Steve: 嗯。
Original English
Steve: Mhm.
Dr. Will: 事实证明,帕金森病可能始于肠道,这实际上是一种肠脑连接障碍,因为两部分都参与其中。它不仅仅是脑部疾病。脑部疾病实际上是更严重的部分。所以对于在家听的人来说,我们有一个模型,我刚刚像汉尼拔·莱克特一样掀开了他们的头骨,露出了他们的大脑组织。我们想谈论的是肠脑连接,大脑和肠道之间的连接。所以我们传统上认为帕金森病是一种脑部健康问题。但我要告诉你,这个问题始于肠道,并涉及两者之间的连接,因为我见过的每一个帕金森病患者,他们都便秘。所有人都这样。有趣的是,他们现在已经表明,便秘发生在帕金森病之前。所以现在这并不意味着对于便秘的人来说,你们很多人都便秘。这并不意味着如果你便秘,你就会患上帕金森病。只有一小部分人会这样,但重要的是要明白,这种健康状况的表现实际上始于消化系统,然后才转移到大脑。所以现在在这项研究中,史蒂夫,他们所做的是,他们找来了这些患有帕金森病的人。他们给他们做了粪便移植。
Original English
Dr. Will: Well, it turns out that Parkinson's probably starts in the gut and this is actually a disorder of the gut-brain connection because both parts are involved. It's not just the brain condition. The brain condition is actually the more severe part. So for the people who are listening at home, we have a model out and I have just lifted their skull like Hannibal Lecter and exposed their brain tissue. And what we want to talk about is the brain-gut connection, the connections between the brain and their intestines. And so we have classically thought of Parkinson's disease as being a brain a brain health problem. But I'm here to tell you that this problem begins down here in the gut and involves the connections between the two because every single person that I've ever seen with Parkinson's disease, they're constipated. All of them. And what's interesting is that they've now shown that the constipation comes before the Parkinson's disease. So now this doesn't mean for people who are constipated, there's a lot of you out there. This doesn't mean that if you're constipated, you're going to develop Parkinson's disease. There's a very small percentage of people, but it's important to understand that the the manifestations of this health condition actually start in the digestive system before they actually transfer up to the brain. And so now in this study, Steve, what they did is they took these people who have Parkinson's disease. They gave them a fecal transplant.
Steve: 他们给他们做了粪便移植。
Original English
Steve: They gave them a poo transplant.
Dr. Will: 他们给他们做了粪便移植。他们发现一年后,他们在运动问题上获得了持久的持续益处。现在还有其他关于帕金森病的研究,显示对大脑和帕金森病症状都有益处,而且对肠道方面,也就是我之前提到的便秘问题也有益处。我的意思是,这引出了一个问题,这些粪便移植听起来很棒。
Original English
Dr. Will: They gave them a poo transplant. And what they found was a year later they had a durable continued benefit in terms of their movement issues. There are now other studies with Parkinson's disease that are showing benefit both for the brain and the symptoms of Parkinson's disease, but also for the gut in terms of that constipation that I was talking about. I mean, it begs the question, these poo transplants sound great.
Steve: 普通人能去做一个吗?
Original English
Steve: Can the average person go and get one?
Dr. Will: 我认为我们需要谈谈这个问题。
Original English
Dr. Will: I think we need to talk about that.
Steve: 是的,我们需要谈谈这个问题,因为Netflix上有一个特别节目,他们把它说得好像你可以在家自己做一样。请不要那样做。请不要那样做。所以,第一,我们需要研究并充分了解风险是什么。粪便移植听起来像是你可以快速轻松地做,然后解决你整个生活的问题,但这与使用生活方式和饮食工具来重建你的微生物组是不同的,后者才能真正给你带来你所寻求的有意义的长期健康影响。
Original English
Steve: Yeah, we need to talk about that because there was a Netflix special where they made it sound like you should just do it at home. Do not do that. Please do not do that. So, number one, we need to study and adequately understand what the risks are. The fecal transplant makes it sound like this is like the quick easy thing that you do and you fix your entire life, but that's not the same as rebuilding your microbiome using the lifestyle and diet tools that actually are going to give you the meaningful health impact that you're searching for over the long term.
Steve: 从长远来看,很大一部分人口都在与肠道问题作斗争。我们问了Diary of a CEO的听众,大约有超过60%的听众表示他们目前正在与某种肠道问题作斗争,无论是腹胀、某种不适,还是一般的消化问题。现在,61%的人对“腹胀、不适、消化不规律”这三个词做出了回应。然后大约15%的人说他们有肠易激综合征(IBS)。大约14-15%的人自我诊断认为他们患有肠易激综合征。我这样想对吗?他们所说的原因可能大相径庭吗?还是只有一两个原因?因为我正在努力弄清楚如何帮助那61%的人,他们像我一样,有时吃东西后会感到腹胀,可能会有点胀气,消化可能会有点奇怪,但又不确定是什么原因以及何时发生。
Original English
Steve: Over the long term, a huge percentage of the population struggle with gut problems. We asked the Diary of a CEO audience and roughly it was over 60% of people that listen said that they're currently struggling with some kind of gut problem whether it's bloating or some kind of discomfort or just digestion issues generally. Now that's 61% of people responding to those three words bloating, discomfort, irregular digestion. Then about 15% of people said that they have IBS. Like 14 15% of people said self diagnose that they think they have irritable bowel syndrome. Am I right in thinking the causes of what they're saying they have are wildly different potentially? Or is it like one or two things? Cause I'm trying to figure out how I help those 61% of people that like me have eat something sometimes and then feel and then not really sure what it is, feel a little bit bloated, might feel a bit gassy, might have strange digestion, but not necessarily sure what's causing it and when.
Dr. Will: 是的,我的意思是,这也是我正在努力解决的问题,对吧?所以我写这本书的目标是尽可能帮助更多的人,同时知道没有“一刀切”的解决方案,对吧?所以最终,它是关于用正确的信息赋能人们,并帮助他们识别问题。我实际上在书的开头作者序中写到了这一点,它基本上是说,你们都会读同一本书,但这本书触动你的方式对你来说将是独一无二的。里面会有些东西让你觉得:“那就是我的时刻。那就是我的‘啊哈’时刻”,对吧?对于许多人来说,仅仅从统计学上看,看看美国人的平均饮食,在饮食方面有巨大的机会。这就是我投入大量精力的地方,因为我只是知道统计数据怎么说。所以,我知道美国需要这个。但同时,也有一些对话涉及到其他话题,你看,我们的生活方式与我们祖父母小时候的生活方式不同。
Original English
Dr. Will: Yeah, I mean this is the same issue that I struggle with, right? So I write a book with the goal of trying to help as many people as possible knowing that you can't there's no one-size-fits-all, right? So ultimately it's about empowering people with the right information and helping them to identify. I literally wrote about this in my author's note right in the front of the book, which is basically to say you're all going to read the same book, but the way in which this book touches you is going to be unique to you. There's going to be something in there that you're going to find that you're like, that's my moment. That's my aha moment, right? And for many people, like just looking statistically, looking at the average American diet, there's a huge opportunity when it comes to diet. And that is where I put a lot of energy and attention because I just I know what the stats say. So, I know America needs this. But at the same time, there's a conversation that gets into other topics that look, the way that we live is different than the way that our grandparents grew up when they were kids.
Steve: 嗯。对我来说,更多的是帮助人们看到对他们来说最重要的事情是什么。有些人听了这个,他们的饮食不是问题,睡眠不是问题,昼夜节律不是问题,而是创伤。我认为这些事情需要我们去关注。我们会做所有这些。关于腹胀、不适、消化不规律,如果我出现其中一种情况,这是否理论上意味着有什么不对劲?
Original English
Steve: Mhm. To me, it's more about like helping people to see like what is that one thing for them. There's some people who are going to be listening to this that it's not their diet, it's not sleep, it's not circadian rhythm, it's trauma. And I think that these are things that need to like we need to shine a light on that. We'll do all of that. On this point about bloating, discomfort, irregular digestion, if I have one of those things, does that theoretically mean that something is not right?
Dr. Will: 每个人都会偶尔腹胀。所以,我认为如果说你永远不应该有任何不良症状,那是不公平的。
Original English
Dr. Will: Everyone gets bloated once in a while. So, I think I think it would be unfair to make it sound like you should never have any adverse symptoms at all.
Steve: 对。
Original English
Steve: Right.
Dr. Will: 但如果它是长期的。
Original English
Dr. Will: But if it's prolonged,
Dr. Will: 但如果它是长期的,如果它是一个慢性健康问题,如果你是那种早上醒来会说:“我希望今天是个好日子。我希望我不用处理那个特定问题”的人,那么你就有问题了,我们已经知道了。然后我们必须努力解决这个问题。我认为我们如何解决这个问题,需要在某种程度上是个性化的。但我们可用的工具仍然是相同的。所以这只是一个问题,就像我们把它摆在桌面上。这是你的选择。你选择哪些最适合你。你的机会在哪里?如果我不了解你更多,我无法告诉你。
Original English
Dr. Will: but if it's prolonged, if it's a chronic health issue, if you're the type of person who you wake up in the morning and you say, "I hope today is going to be a good day. I hope I don't have to deal with that specific issue." You you have a problem like we already know. And then we have to work on that to address that issue. And how we go about that, I think needs to be on some level personalized. But the tools that are at our disposal remain the same. So it's just a matter of like let's put it on the table. Here are your choices. You pick which ones are most applicable to you. Where are the opportunities for you? And I I can't tell you that without knowing more about you.
便秘与胀气
Steve: 那么人们经常放屁,胀气很多的问题呢?
Original English
Steve: What about this issue of people getting gassy like farting a lot?
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Steve: 这通常与某个特定的肠道问题相关,还是又可能是多种问题?
Original English
Steve: Is that typically associated with one particular gut issue or is that again could that be a plethora of issues?
Dr. Will: 所以它可能是多种问题。这是一个常见问题。如果我必须从我的头号问题开始,那肯定是便秘,100%。现在有很多人正在听,他们便秘却不知道,因为他们每天都排便,他们认为排便频率就是定义。这不是真的。所以便秘是指你没有充分排空肠道时发生的情况。这可能是一个频率问题,但也可能是部分排便。
Original English
Dr. Will: So it could be it could be a plethora of issues. This is this is a common problem. If I have to like start with what is my number one thing, it's constipation for sure. 100%. There are so many people who are listening right now that are constipated and they don't even know it because they poop every day and they think that how often they poop is the definition. And that's not true. So constipation is what happens when you're not adequately emptying your bowels. And that could be a frequency problem, but it could also be that it's a partial poop.
Steve: 哦,好的。因为我以为便秘就是你根本排不出来,你去厕所什么也出不来。
Original English
Steve: Oh, okay. Cuz I thought constipation was if you just haven't been you can't go you go to the toilet and nothing comes out.
Dr. Will: 别误会我的意思。如果你一周不排便,我知道你便秘了。我不需要问更多问题。如果你一周不排便,但有些人每隔一天排便。那是他们的常态。他们感觉很好。他们没有任何肠道症状。他们没有便秘问题。我们没事。
Original English
Dr. Will: Look, don't get me wrong. If you if you don't poop for a week, I know you're constipated. I don't need to ask any more questions. If you go a week, but if it's there are people who they poop every other day. That's their normal. They feel fine. They don't have any gut symptoms. They don't have a constipation problem. We're okay.
Steve: 对吧?对。所以频率不是最重要的。
Original English
Steve: Right? Right. So frequency is not the be all and end all.
Dr. Will: 它是等式的一部分,对吧?但也有一些人排便,我想描绘一下这个画面,请原谅我,我谈论粪便感觉很自在。这是我谋生的方式。但他们早上上厕所。他们很挣扎。不满意。他们不得不非常努力才能排出一小块粪便。然后他们觉得还需要继续排。可能45分钟后他们又排便了。好吧,那不是新的粪便。你正在进行部分排便。你可能只排出了20%或25%的粪便。所以,你一天可能排便三、四次。你可能仍然没有完全排空肠道,对吧?所以,这是一个例子,说明一个人可能正在与腹胀和便秘作斗争,却没有意识到,因为他们会说:“医生,我一天排便三次。”
Original English
Dr. Will: It's part of the it's part of the equation, right? But there's also people who they poop and I I want to sort of paint the picture and forgive me like I feel very comfortable talking about poop. This is what I've done for a living. But they they go to the bathroom in the morning. They struggle. It's not satisfying. They had to work really hard to get a little nugget to come out. And then they feel like they still have to go. and maybe 45 minutes later they poop again. Okay, that's not a new poop. You're doing partial poops. You're probably doing a 20 or 25% poop. So, you could poop three, four times during the day. You might not still be fully emptying your bowels, right? And so that so that's an example of a person who can actually be struggling with bloating and constipation and not think because they're like, "Doc, I'm pooping three times a day."
Steve: 那么胀气是从哪里来的呢?为什么人们吃完东西后会大量放屁?发生了什么?
Original English
Steve: Where is the gas coming from in that? Why why do people you eat something and then you fart a lot? What's going on?
Dr. Will: 所以胀气是伴随粪便而来的。你可能会注意到,我不是特指你,史蒂夫,听众可能会注意到,你早上醒来时会疯狂放屁。这种放屁会一直持续到你早上排便。然后一旦你有了良好健康的晨间排便,你就会感觉很踏实,不再放屁了,对吧?胀气是伴随粪便而来的。所以,发生这种情况的原因是,首先,你的粪便不仅仅是你食物的残渣。实际上,你的粪便主要是你的微生物组。你粪便重量的60%是微生物。
Original English
Dr. Will: So gas so gas travels with poop. You may I don't mean you specifically, Steve, people listening may notice this that you wake up in the morning and you're farting like crazy. And that farting continues until you actually have your morning bowel movement. And then once you have your good, healthy morning bowel movement, you feel solid and you're not farting anymore, right? the gas travels with the poop. So, and the reason why this happens is because first of all, your poop is not just the leftover remains of your food. Actually, your poop is predominantly your microbiome. 60% of the weight of your stool is microbial.
Steve: 真的吗?
Original English
Steve: Really?
Dr. Will: 是的。
Original English
Dr. Will: Yes.
Steve: 当你说“微生物”时,你是指细菌吗?
Original English
Steve: When you say microbial, you mean like the bacteria?
Dr. Will: 细菌。
Original English
Dr. Will: The bacteria.
Steve: 60%都是?
Original English
Steve: 60% of it.
Dr. Will: 让我给你举个例子。如果我拿你的饮料,然后我在你的饮料中加入一些可溶性纤维,也就是益生元。
Original English
Dr. Will: Let me give you an example. If I took your drink and I added some soluble fiber, which is prebiotic, into your drink.
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 没有颗粒,没有粗纤维,你甚至不知道它在那里。结果是,你明天会排便更多,更健康。为什么?因为我喂养了你的微生物,它们变得更强壮,然后它们繁殖。因为它们繁殖了,你排便更多了,对吧?这就是它的运作方式。现在,别误会我的意思。你吃沙拉,你也会排便更多,但其中很大一部分是沙拉中的纤维,它滋养了这些微生物。它们繁殖,它们生长,然后你排便更多。
Original English
Dr. Will: There's no grit, there's no roughage, you don't even know it's there. And you're going to have a bigger, healthier bowel movement tomorrow as a result of what I just did. Why? Because I fed your microbes and they grow stronger and then they multiply. And because they multiplied, you have a bigger bowel movement, right? That's the way that that works. Now, don't get me wrong. You eat, you know, a salad, you're going to end up with a bigger bowel movement as well, but a big part of that is the fiber within that salad that's feeding these microbes. They multiply, they grow, and you have a big bowel movement.
Steve: 所以,如果那是我的粪便,我手里拿着一块巧克力棒。其中60%是微生物。
Original English
Steve: So, if that was my if that was my my store, my poop, I'm holding a chocolate bar here. 60% of that would be the microbes.
Dr. Will: 其中60%是微生物。是的。所以对于那个人来说,当粪便堵塞不动时,那些微生物基本上就坐在那里,有无限的时间进行发酵并产生胀气。
Original English
Dr. Will: 60% of that would be the microbes. Yes. So for that person when the poop is in gridlock and it's not moving through then those microbes are basically sitting there with unlimited time to ferment and produce gas.
Steve: 好的。
Original English
Steve: Okay?
Dr. Will: 所以任何它们接触到的东西,它们都会开始处理。所以这不仅仅是纤维的问题。任何它们接触到的东西,可能是蛋白质,它们都会发酵。它们会产生胀气。所以,这是便秘与胀气和腹胀如此强烈相关的一个重要原因。
Original English
Dr. Will: So anything they come into contact with, they're just going to start working on it. So and it's not just like a fiber thing. Anything they come into contact with, it could be protein, they will ferment it. They will produce gas. So, this is a big part of the reason why constipation is so strongly associated with gas and bloating.
Steve: 当人们吃乳制品之类的东西,我想有些人吃麸质,他们往往会有点胀气。
Original English
Steve: When people eat dairy and things like that, and I think some people that have gluten, they they often tend to get a little bit gassy.
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Steve: 那是便秘吗?
Original English
Steve: Is that constipation?
Dr. Will: 胀气和腹胀不仅仅是便秘问题。我会说便秘是这个特定问题的第一大原因,但有很多潜在的原因。第一可能是肠道蠕动。那就是便秘。
Original English
Dr. Will: Gas and bloating is not just a constipation issue. I would argue that constipation is the number one cause of that particular issue, but there's many potential causes. Number one could be motility. That's constipation.
Steve: 什么是肠道蠕动?
Original English
Steve: What's motility?
Dr. Will: 肠道蠕动是你的肠道运动的方式。所以如果肠道运动过快且失去节律,你就会腹泻。如果肠道运动过慢,迟缓,你就会便秘。我们希望肠道有节律,因为当它们有节律时,就像你的心脏一样,它们才能发挥最佳功能。所以有节律基本上意味着可预测的、一致的每日排便。这最终是我们希望达到的状态,对吧?这在某种程度上也涉及到我们以后可以讨论的整个昼夜节律。这是你昼夜节律的一部分,就是一次美妙的晨间排便。肠道蠕动只是胀气和腹胀的原因之一。第二个是微生物组。如果你的微生物组受损且功能不佳,它就无法正常工作。它的一部分工作是处理和分解纤维。因为我们饮食中的纤维,我们没有酶来消化它。所以,它会穿过肠道,与微生物接触,而微生物拥有我们人类没有的6万种酶。它们以团队形式工作。纤维不再是纤维,而是产生短链脂肪酸。这就是它应该运作的方式。当你的肠道不健康时,微生物就会虚弱,你要求它们工作,但它们无法处理,结果就是消化不良,导致胀气和腹胀。第三个原因可能是你的饮食。你刚才提到了乳制品,它含有乳糖。乳糖很容易发酵产生胀气。你提到了麸质。麸质本身是一种蛋白质。那么麸质在技术上可以发酵吗?是的,它在技术上可以发酵,但这并不是真正发生的事情。发生的事情是,含有麸质的食物,即小麦、大麦和黑麦,也含有这些被称为果聚糖的碳水化合物。果聚糖实际上对我们的微生物非常好。它们是益生元。但是如果你摄入大量的果聚糖,并且你不习惯吃这些食物,它就会引起胀气和腹胀。现在,当我年轻的时候,如果我吃意大利面,我没事。如果我现在吃意大利面,我会在接下来的两三天里都感到不适。
Original English
Dr. Will: Motility is the way in which your intestines move. So if the intestines move too fast and out of rhythm, you get diarrhea. If the intestines slow down too much, sluggish, you get constipation. We want the intestines in a rhythm because when they're in a rhythm, just like your heart, that's when they perform their best. So in a rhythm basically means predictable, consistent daily bowel movements. That's ultimately where we would love to be, right? And that in a way taps into like an entire circadian conversation that we can have later. This is a part of your circadian rhythm is a fantastic morning bowel movement. Motility is just one of the causes of gas and bloating. The second is the microbiome. If you have a microbiome that's damaged and struggling, it's not going to be able to do its job the way it's supposed to. And part of its job is processing and breaking down fiber. Because the fiber in our diet, we don't have the enzymes to digest it. So, it works its way through the intestines, comes into contact with the microbes, and the microbes, they have literally 60,000 enzymes that we don't have as humans. They go to work as teams. Fiber stops being fiber, produces short-chain fatty acids. This is the way that it's supposed to work. When your gut is not happy, they're weak. the microbes are weak and you're asking them to do work and they can't handle that and you end up with sloppy digestion and that's gas and bloating. The third thing can be your diet. So you just mentioned dairy which contains lactose. Lactose can be easily fermented to produce gas. You mentioned gluten. Gluten itself is a protein. So can gluten technically be fermented? Yes, it could be technically fermented, but that's not really the that's not really what's going on. What's happening is that gluten containing foods, which are wheat, barley, and rye, also contain these carbohydrates called fructans. And fructans are actually really good for our microbes. They're prebiotic. But if you consume a very large amount of them and you're not used to eating these foods, it can cause gas and bloating. these days. When I was younger, if I had pasta, I was fine. If I have pasta these days, I'm going to feel it for the next like two two days.
Steve: 真的吗?
Original English
Steve: Really?
Dr. Will: 是的。我不知道。我甚至不知道发生了什么。但其他人似乎想吃多少意大利面就吃多少。
Original English
Dr. Will: Yeah. I don't know. And I don't even know what's going on. But then other people can eat pasta as much as they want, it seems.
Steve: 出于好奇,你去意大利吃意大利面会没事吗?还是也一样?
Original English
Steve: Out of curiosity, can you go to Italy and eat pasta and be okay or no? Same thing.
Dr. Will: 我还没真正尝试过。
Original English
Dr. Will: I haven't really not really tried. Um,
Steve: 凭经验来说,我想当我吃无麸质面包或无麸质意大利面时,我觉得好多了。但我很清楚,与你这样的人交谈后,只有一小部分人真正对麸质不耐受,但我们或多或少都认为自己是。我想数字是多少?是不是有20%的人认为自己是?
Original English
Steve: anecdotally, I think when I remove when I have like non-gluten bread or non-gluten pasta, I I think I'm I feel much better. But I but I'm well aware from speaking to people like yourself that such a small percentage of the population is actually gluten intolerant, but we all kind of think we are to some degree. I think it's was what's the the numbers? Is it like 20% of people think they are or something?
Dr. Will: 所以,在洛杉矶,大约80%的人。
Original English
Dr. Will: So, like here in Los Angeles, it's um like probably 80% of people
Steve: 认为。
Original English
Steve: think that
Dr. Will: 嗯,几乎所有人都吃无麸质食物。是的。对。
Original English
Dr. Will: well like almost everyone's gluten-free. Yeah. Right.
Steve: 哪个?
Original English
Steve: Which
Dr. Will: 他们不需要这样。实际上,无麸质饮食可能会导致问题,除非你知道如何进行调整。
Original English
Dr. Will: they don't need to be. And and actually it can cause problems. It can it can cause problems to be gluten-free unless you know what adaptations to make.
Steve: 那么,当你问意大利那个问题时,你想表达什么?
Original English
Steve: So, what are you when you ask that question about Italy, what are you getting at?
Dr. Will: 美国在小麦加工方面存在一个问题,那就是他们允许小麦被草甘膦喷洒,也就是农达。它是一种除草剂。他们这样做是为了尽快将其干燥。所以,想象一下,你是一个农民,你有一片小麦田。你收割它。好吧,史蒂夫,你有这些选择。你可以等几周让它自然风干,然后储藏起来,或者你可以用这种化学物质喷洒它,它明天就会干,然后你就可以把它切碎。
Original English
Dr. Will: There's a processing issue in the United States involving wheat, which is that they allow the wheat to be sprayed with glyphosate, which is Roundup. It's a weed killer. And you they do that to basically dry it out as quickly as possible. So, imagine for a moment that you're a farmer, and you have this this field of wheat. You harvest it. Okay, here are your choices, Steve. You can wait a couple weeks and let it dry out naturally in the air and and store it somewhere or you can spray it with this chemical and it will be dry by tomorrow and then you can chip it up.
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 对。问题是草甘膦不在标签上。你永远不会知道它是否被喷洒过,除非你购买有机产品。如果你购买有机产品,那么根据定义,他们不允许喷洒它。你永远不会知道它是否存在。关于草甘膦的问题是,它在安全假设下被批准存在于我们的食物系统中,因为它会关闭一种叫做莽草酸途径的东西,这会杀死杂草或植物,而我们有一种变通方法,这与氨基酸有关。我们有一种变通方法,我们人类可以基本上创造这些氨基酸,但植物不能。所以植物死了,我们活着。但有一个问题,那就是生活在我们大肠内的微生物,它们没有这种变通方法。所以那微量的草甘膦,你会说,我们这些大人类,那太少了。是的。但你认为当它与它们接触时会发生什么?我们知道草甘膦会破坏微生物组,它会耗尽有益细菌,而那些最能耐受它的,是致炎的细菌。
Original English
Dr. Will: Right. And the problem is that glyphosate is not on the label. You would never know whether it's sprayed or not sprayed unless you're buying organic. If you buy organic, then by definition they're not allowed to spray it. You would never know if it's there. The the the thing about glyphosate is that it's been approved to exist in our food system under the assumption of safety because what it does is it shuts down this thing called the Schikim pathway and that kills weeds or it kills plants and we have a workaround and it has to do with basically amino acids. We have a workaround where we can basically create those amino acids as humans, but the plants can't. So the plants die, we live. But there's a problem, which is that the microbes that live inside of our large intestine, they don't have the workaround. So that microscopic amount of glyphosate, you would say, well, us big humans, that's so small. Yeah. But what do you think happens when it comes into contact with them? We know that glyphosate disrupts the microbiome, that it depletes the beneficial bacteria, and the ones that tolerate it the best are the inflammatory ones,
Steve: 坏细菌。
Original English
Steve: the bad bacteria.
Dr. Will: 坏细菌。所以,你正在改变平衡。这虽然是一件小事,但我从去过意大利的人那里听说,史蒂夫,他们说:“我在美国不能吃小麦。”然后他们去意大利就没事了。
Original English
Dr. Will: The bad bacteria. So, you're shifting the balance. And this is this is a small thing, but I hear from people, Steve, that go to Italy, they say, "I can't eat wheat in the United States." And then they go to Italy and they're fine.
Steve: 你认为那是草甘膦?
Original English
Steve: And you think it's that glyphosate.
Dr. Will: 是的。他们那里没有。
Original English
Dr. Will: Yeah. They don't do that there.
Steve: 所以如果我今晚尝试有机意大利面。也许会更好。
Original English
Steve: So if I tried I'll try organic pasta tonight and maybe that'll be better.
Dr. Will: 是的。然后,另一种选择是,你吃面包怎么样?你还好吗?
Original English
Dr. Will: Yes. And then like the alternative choice is how do you do with bread? Are you okay?
Steve: 嗯,不是所有面包。我通常不吃面包。
Original English
Steve: Uh not all bread. My my generally I stay away from bread.
Dr. Will: 好的。你吃酵母面包吗?
Original English
Dr. Will: Okay. Do you ever eat sourdough?
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 你吃酵母面包没问题吗?
Original English
Dr. Will: Do you do okay with sourdough?
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 这就对了。所以这是这个等式的第二部分。把草甘膦放在一边。我们来谈谈我们刚才提到的果聚糖。当你发酵小麦,当你发酵面团时,你实际上会降低果聚糖含量。
Original English
Dr. Will: There we go. So here's here's the second part of this equation. Put the glyphosate. Put that to the side for a moment. Let's talk about the fructans that we were talking about a moment ago. When you ferment your wheat, when you ferment your dough, you actually reduce the fructan content.
Steve: 什么是果聚糖?
Original English
Steve: What's fru?
Dr. Will: 所以这些是存在于小麦、大麦和黑麦中的长链碳水化合物。所以如果它含有麸质,它也含有这些果聚糖。麸质不是小麦中唯一的东西,对吧?这些果聚糖,再次强调,它们对你有益。它们对你的微生物组有益。但肠道略有受损的人,他们很难处理和消化它们。所以这可以解释为什么有些人吃含有小麦、含有麸质的食物时会不适,但他们吃酵母面包就没事,因为如果你发酵面包,它会降低果聚糖含量,然后你就能耐受它了。
Original English
Dr. Will: So these are the the long-chain carbohydrates that exist in wheat, barley, and rice. So if it contains gluten, it also contains these fructans. Like gluten is not the only thing in wheat, right? And these fructans, again, they're good for you. They're good for your microbiome. But people who have a slightly damaged gut, they struggle to process and digest them. So this would explain why some people they eat they eat, you know, wheat containing, gluten containing foods and they struggle, but they do okay with sourdough because if you ferment the the bread, it takes it reduces the fructan content and actually then you can tolerate it.
Steve: 哦,好的。所以你认为我可能对面包中的果聚糖有问题,而酵母面包中没有果聚糖。
Original English
Steve: Oh, okay. So you think it might be the fructan in the bread that I have an issue with and sourdough doesn't have fructan in it.
Dr. Will: 是的,几年前在胃肠病学杂志上有一项研究。胃肠病学是我领域内的顶级期刊,他们基本上让人们带着一堆早餐棒回家。好吧,不是巧克力,但无论如何,他们让人们带着一堆早餐棒回家,三根。其中一根是安慰剂棒,所以他们没有添加任何特别的东西。其中一根含有非常高浓度的麸质,然后第三根含有果聚糖。安慰剂是我们的标准,我们将与之比较。当人们吃了含有麸质的棒时,顺便说一下,这些人没有乳糜泻,他们根据自己的说法确实有麸质问题,对吧?所以这就像你刚才提到的20%的人,他们认为自己可能有麸质问题。当他们吃了含有麸质的棒时,他们实际上的症状比安慰剂组少。换句话说,麸质不是问题。但当他们吃了含有果聚糖的棒时,他们被触发了。所以这基本上说明,我们一直把麸质不耐受这个概念搞错了。它不是麸质不耐受,而是果聚糖不耐受。这些人往往难以处理食物中的这些特定部分。哪些食物含有果聚糖?所以,小麦、大麦和黑麦。
Original English
Dr. Will: Yeah, there was there was a study that was in gastroenterology a few years ago. Gastroenterology is the top journal in my field where basically they they sent people home with a bunch of breakfast bars. All right, not chocolate, but nonetheless, they sent people home with a bunch of breakfast bars, three of them. One of them was a placebo bar, so they didn't add anything special. One of them contained a very large concentration of gluten and then the third one contained the fructans. And the placebo is our standard. We're going to compare to that. When people ate the gluten containing bar, and these were, by the way, people that they did not have celiac disease, they did have gluten problems according to them, right? So like this is like the 20% of people that you mentioned a moment ago who think they might have a gluten problem. When they ate the gluten containing bar, they actually had less symptoms than the placebo. So in other words, the gluten is not the problem. But when they ate the fructan containing bar, they were triggered. So basically what this said is that we have been taking this concept of gluten intolerance and we've we've misnamed it. It's not a gluten intolerance, it's a fructan intolerance. These are people who are tending to struggle with these particular parts of that food. What foods contain fructan? So, wheat, barley, and rye,
Steve: 好的。
Original English
Steve: okay?
Dr. Will: 顺便说一下,果聚糖有很多不同的类型。所以,你可能不会对所有类型都产生反应。你可能只对其中一些产生反应。但像大蒜和洋葱也是典型的。所以,你听到有人说:“我不能吃大蒜。我觉得太糟糕了。”对吧?那可能是一个果聚糖问题。苔麸、苋菜、高粱、藜麦。这些都是不含麸质的全谷物,它们也不含果聚糖。
Original English
Dr. Will: And different there's there's many different types of fructans, by the way. So, you may not react to all of them. You may react to just some of them, but like garlic and onions are also classic. So, you hear people who are like, I can't eat garlic. I feel it's horrible. Right? That's a that can be a fructan issue. Teff, amaranth, sorghum, quinoa. These are these are whole grains that don't contain gluten and they also don't contain fructans.
修复受损肠道
Steve: 当肠道受损时,需要多长时间才能修复?这是一个非常宽泛的问题,但通常对于那些肠道受到某种刺激的普通人来说,需要多长时间才能恢复,让那些微生物恢复正常?
Original English
Steve: How long does it take to repair the gut when you have done damage to it? That's a very broad question intentionally, but generally for the average person who's done who sort of irritated their gut, how long does it take to restore and for those microbes to go back?
Dr. Will: 这真的取决于情况。你必须从你的起点开始,对吧?比如损害有多深?有多严重?因为对于患有溃疡性结肠炎或克罗恩病的人来说,这些都是炎症性肠病的形式。这些人有最深的肠道菌群失调。肠道菌群失调是我们用来形容受损肠道的词。有可能逆转吗?
Original English
Dr. Will: It really depends. You have to start with, okay, what's your starting point, right? Like how deep is the damage? How bad is it? Because for the people who have ulcerative colitis or Crohn's disease, those are forms of inflammatory bowel disease. Those people have the deepest dysbiosis. Dysbiosis is the word that we use for a damaged gut. Is it possible to reverse that?
Dr. Will: 嗯,有可能让他们深度缓解,以至于他们不会发作。
Original English
Dr. Will: Um, it's possible to put them into remission so deeply that they don't have a flare.
Steve: 我面前这个小模型上的发作看起来是这样的吗?
Original English
Steve: Is that what the flare looks like on this little model that I have in front of me?
Dr. Will: 是的。所以,对于正在听而不是在YouTube上观看的人来说,如果你有兴趣可以转到YouTube。但我在这里展示的是大肠的模型。模型中包含一个看起来发红、溃烂、出血的小区域。如果你碰它,它就会开始出血。所以,它是一个非常脆弱敏感的区域。现在,史蒂夫,这些炎症性肠病,我有一个关于这个话题的有趣研究。在我看来,它们是典型的肠道炎症性健康状况。发生的情况是免疫系统正在攻击微生物组。所以从技术上讲,它实际上不是自身免疫性疾病,因为自身免疫性疾病是你攻击自己的身体。免疫系统没有攻击你的肠道。免疫系统正在攻击你的微生物组并排斥它。因为这种情况正在发生,你的肠道被困在中间。
Original English
Dr. Will: Yes. So, so going back for the people who are listening and not on YouTube, you can flip over to YouTube if you're interested. But what I'm showing here is the model of the large intestine. And the model includes a little area that it looks raw, ulcerated, it's bleeding. It if you if you were to bump up against it, it's going to start to you'll start to see blood coming out. So, it's like a it's a very vulnerable sensitive area. Now, these inflammatory bowel diseases, Steve, I have an interesting study on this topic. They are to me the classic gut inflammatory health condition. And what's happening is the immune system is attacking the microbiome. So technically, it's not actually autoimmune because autoimmune would be you're attacking your own body. The immune system is not attacking your intestines. The immune system is attacking your microbiome and rejecting it. And because that's happening, your intestines are stuck in the middle.
Steve: 所以这里是免疫系统正在攻击微生物组。它正在攻击大肠管中的微生物组,而免疫系统正试图攻击并杀死它。
Original English
Steve: So this here is the immune system attacking the microbiome. It's attacking the microbiome which is in the tube of the large intestine and the immune system is trying to get at it and kill it.
Steve: 为什么?
Original English
Steve: Why?
Dr. Will: 因为它已经决定它是敌人。所以免疫系统感到困惑,因为我们出生时,出生时并没有多少微生物组。那是我们最接近什么都没有的时候。然后在生命的头三年里,你通过生活经验建立你的微生物组。到三岁时,你的微生物组基本上就达到了成年人的大小。在这段时间里,你的免疫系统正在从这些微生物那里学习并与它们一起学习。所以两者之间存在着不可否认的相互作用,当微生物组在童年时期,在头三年里健康时,就会产生更健康的免疫系统。
Original English
Dr. Will: And because it's decided that it's the enemy. So the immune system is confused because when we're born, we don't have much of a microbiome at birth. It's the closest that we will get to not really having anything. And then during the first three years of life, you build your microbiome through your life experience. And by three years of age, you are basically fully adult-sized in terms of your microbiome. During this time, your immune system is learning from and with those microbes. So, there's this interplay between the two that is undeniable where when the microbiome is healthy during childhood, during those first three years, it results in a healthier immune system.
Steve: 那么这里发生了什么?免疫系统应该承认你的微生物组是友好的,但它没有。它决定你的微生物组是敌人,所以它正在清除它。那么你认为对于患有肠易激综合征或克罗恩病的人,或者他们的小肠或大肠有这些大的溃疡的人来说,通常是因为他们的生活方式改变,还是很多因素?罪魁祸首是什么?
Original English
Steve: So, what's going on here? The immune system is supposed to acknowledge your microbiome as being friendly and it does not. It decides that your microbiome is the enemy and so it's taking it out. So what what what do you think is for someone that has like irritable bowel syndrome or Crohn's disease and they or they you know they have one of these big sort of ulcers in their small or large intestine. Is it because of their lifestyle typically a lifestyle change or or is it lots of things? What's the number one perpetrator?
Dr. Will: 好的。显然有遗传因素。
Original English
Dr. Will: Okay. There's clearly a genetic component.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 好的。所以我们必须对此开诚布公。这些事情不一定完全在个人的控制范围之内。
Original English
Dr. Will: Okay. So, we have to we have to be upfront about that. Like these are these are things that are not necessarily within a person's control entirely
Steve: 因为我的意思是,没有进化上的理由会发生这种事。
Original English
Steve: because I mean there's no evolutionary reason why this would happen.
Steve: 比如没有进化上的理由你会出现严重的肠道消化问题。
Original English
Steve: Like there's no evolutionary reason why you'd have severe gut digestion problems.
Dr. Will: 不,它没有任何优势。而且这些发生的事情在多年前是相当罕见的。事实上,在今天的第三世界国家,炎症性肠病并不多。第三世界国家没有很多克罗恩病和溃疡性结肠炎。如果你去非洲,那里很少。但你看到的是,随着国家工业化,病例开始激增。所以在美国,从1970年到2010年的40年间,溃疡性结肠炎和克罗恩病的病例增加了高达55%。
Original English
Dr. Will: No, it's not to there's no advantage to it at all. And and these things that occur, they were quite rare years ago. In fact, in third world countries today, there's not much inflammatory bowel disease. There's not a lot of Crohn's disease and ulcerative colitis in third world countries. If you go to Africa, there's very little. And what then what you see though is as countries industrialize, there's a takeoff and they start ramping up. So within the United States over the course of 40 years from 1970 to 2010, ulcerative colitis and Crohn's disease cases were increasing by up to 55%.
Steve: 而且你可以在任何年龄患上这种病。
Original English
Steve: And you can get that at any age.
Dr. Will: 你可以在任何年龄患上这种病。是的。
Original English
Dr. Will: You can get that at any age. Yeah.
Steve: 所以即使我现在很健康,我也可以做一些事情导致我患上这种病。
Original English
Steve: So even if I'm healthy right now, I could do a set of things that would give me this.
Dr. Will: 是的。事实上,如果你服用抗生素,回到我们关于抗生素的对话,如果你服用抗生素,你在下一年患炎症性肠病的风险就会翻倍。
Original English
Dr. Will: Yes. In fact, if you take So back to our conversation about antibiotics, if you take antibiotics, your risk of developing an inflammatory bowel disease in the next year just doubled.
Steve: 天哪。
Original English
Steve: Oh gosh.
Dr. Will: 如果你用抗生素破坏肠道,抗生素确实会这样做,没有什么能比它更快地摧毁肠道。它会降低肠道多样性,在服用抗生素期间破坏肠道屏障50%,并激活免疫系统。这真的说明了,如果你服用抗生素,患炎症性健康状况的风险确实会上升。我们在成人和儿童中都看到了这一点。
Original English
Dr. Will: If you disrupt the gut with antibiotics, which the antibiotics do, there's nothing that will basically like decimate the gut faster. Reducing gut diversity. disrupting the gut barrier by 50% during a course of antibiotics and activating the immune system. It really speaks to that like if you take antibiotics, these risks of inflammatory health conditions really start to go up. We see this in both adults and kids.
Steve: 你有一个病人叫米歇尔,她服用了抗生素,导致结肠肿胀危及生命。这是结肠,对吧?
Original English
Steve: You had a patient of yours called Michelle who took antibiotics and had a life-threatening swelling of her colon. This is this is the colon, right?
Dr. Will: 嗯。
Original English
Dr. Will: Uh
Steve: 给我看看结肠在哪里。
Original English
Steve: show me where the colon is.
Dr. Will: 所以结肠就是大肠。
Original English
Dr. Will: So the colon is the large intestine.
Steve: 好的,明白了。
Original English
Steve: Okay, fine. Yeah. Yeah.
Dr. Will: 所以她服用了一种抗生素,导致她大肠肿胀危及生命。
Original English
Dr. Will: And so she took an antibiotic and had a life-threatening swelling of the of her large intestine.
Dr. Will: 所以她服用了一种抗生素。她服用了克林霉素,这是一种经典的皮肤抗生素。
Original English
Dr. Will: So she took an antibiotic. She took clindamycin which is a classic skin antibiotic.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 问题是克林霉素会严重清除你的肠道菌群。当这种情况发生时,如果存在这种致病性坏细菌,叫做艰难梭菌(C. diff),它就有可能繁殖,然后你就会感染艰难梭菌,这种感染会导致整个结肠发炎。所以这个病人,米歇尔,发生的事情是,我当时值班,我收到一条短信说:“你现在必须来这个房间。这个病人病得很重。”她刚从外面医院转过来。所以,我当时正在打一份会诊记录。我放下手头的工作,跑过医院,走进房间。她正捂着肚子,呻吟着,她不知道自己在哪里。她浑身是汗,脸色苍白。她的生命体征完全失常。她的心跳加速。她呼吸非常快。我做了一个小测试,就是轻轻地碰了一下她的床,就像那样。如果一个人肠道有严重炎症,你这样做她就会跳起来,因为她有腹膜炎,对吧?或者你可以称之为急腹症。所以仅仅那样碰了一下床,就足以让她尖叫起来,对吧?她捂着肚子,不知道自己在哪里,也不知道发生了什么。她完全神志不清。她已经服用了最大剂量的抗生素。我们的选择是立即送她去手术,切除结肠,或者给她做粪便移植,让她有机会保住结肠。
Original English
Dr. Will: And the problem is that clindamycin wipes out your gut like hard. And when that happens, there's a risk that this pathogenic like bad bacteria called C. diff, if it's in there, it can multiply and then you get this infection, the C. diff infection that causes inflammation of the entire colon. So this patient, Michelle, what happens, I was on call and I get this text and they say, "You got to come to this room right now. This patient is sick." And she had just been transferred in from an outside hospital. So, I was in the middle of typing up a consultation. Drop that, run through the hospital, walk into the room. She's clutch clutching her belly and she's moaning and groaning and she has no clue where she is. She's sweaty. She's pale. Her vital signs are completely out of whack. Her heart is racing. She's breathing really fast. And I did a little test which is that I gently bumped her bed just like that. And if a person has severe inflammation of their intestines, they will jump if you do that because they have peritonitis, right? Or you could call it an acute abdomen. So just by bumping the bed like that was ENOUGH FOR HER TO AND SHE'S SCREAMING, RIGHT? And clutching her belly and she has no clue where she is or what is going on. She's completely delirious. She was maxed out on antibiotics. Our choices were to rush her to surgery, remove the colon, or alternatively to give her a fecal transplant and give her a shot at keeping her colon.
Dr. Will: 所以,我带她去了手术室,我实际上用了一种,我的意思是,我不会用细节来烦你,但我用了一种特殊的、非典型的方法,因为炎症太严重了,无法通过常规内窥镜。所以我用的内窥镜是一个更小的内窥镜,更温和。
Original English
Dr. Will: So, I take her down to the operating room and I actually used a I mean, I won't bore you with the details, but I used a special technique that's atypical for what I would normally do because the inflammation was so severe to pass a scope. So, this scope that I used was a smaller scope to be more gentle.
Steve: 内窥镜是管子吗?
Original English
Steve: A scope being a tube.
Dr. Will: 内窥镜是管子。我提到过,如果你做结肠镜检查,它有我食指那么大。所以大约一厘米宽。但我选择了一个更小的内窥镜,大约5到6毫米宽。它更温和,只是操作起来更困难。但我基本上通过她的直肠,穿过她的肠道,把它送到了右侧。所以这基本上就像我已经完全穿过了她的大肠。在那个位置,我给她做了粪便移植。所以令人惊奇的是,第一,那个手术非常顺利。第二天,她就恢复正常了。她躺在床上,能够进行对话。两天后,她恢复得非常好,我们能够让她回家。所以她面临的整个严重的感染问题,通过恢复她的微生物组得到了解决和纠正。然后当你恢复微生物组时,艰难梭菌基本上被抑制了,免疫系统恢复了平衡。炎症也消退了。
Original English
Dr. Will: A scope is a tube. And I mentioned that if you get a colonoscopy, it's the size of my index finger. So that's like probably about a centimeter across. But I I instead went with a smaller scope that's more like 5 millime 6 millimeters across. It's more gentle and it just makes it harder to do. But I I basically passed the scope through her rectum and all the way through her intestines to get it over here on the right side. So that's basically like I have now passed all the way through her large intestine. And in that location, I delivered the fecal transplant to her. And so the amazing thing is that number one, that procedure went really well. By the next day, she was a normal human being. She was laying in bed. She was able to have a conversation. And after 2 days, she was so normal that we were able to send her home. So the entire severe infectious issue that she was facing got shut down and corrected by restoring her microbiome. And then when you restore the microbiome, the C. diff basically gets suppressed and the immune system falls back into balance. The inflammation washed away.
Steve: 那么你有没有一个装满这些粪便物质的冰箱,需要时就可以取用?
Original English
Steve: So do you have like a like a fridge full of these fecal matters that you can just tap into when when you need it?
Dr. Will: 没有,但在马萨诸塞州有一家公司有。
Original English
Dr. Will: No, but there is a company in in Massachusetts that does.
Dr. Will: 嗯,所以大多数医院都会使用这种方式,他们会基本上把这个送过来。但这实际上很有趣,因为在这个领域有新的发展,药物公司首次正在识别如何使用实际上不是粪便移植但源于这个想法的东西来操纵微生物组。现在他们正在开发一种方法来重建肠道并在脆弱期保护它。所以这是即将出现的新事物。
Original English
Dr. Will: Um, and so and that's what most hospitals use is they'll basically have this sent in. But it's actually kind of interesting because there's there's new development in this space where for the first time drug companies are actually identifying how to manipulate the microbiome using things that are not actually a fecal transplant but sort of derived from the idea. Now what they're developing is a way to rebuild the gut and protect it during this period of vulnerability. So that's the new thing that's coming.
饮食趋势与肠道健康
Steve: 你一定听说过很多不同类型的饮食、果汁排毒以及网红和播客推广的其他东西,你绝对讨厌它们,因为你对它们对肠道的后果有更深入的了解。有哪些你绝对鄙视的最大饮食或趋势,因为它们误导了人们如何创造健康的肠道?
Original English
Steve: You must hear about so many different types of diets and juice cleanses and whatever else that influencers and podcasters promote that you absolutely hate because you have a deeper understanding of the consequences on the gut. What are some of the biggest diets or I don't know these sort of trends that you absolutely despise because they are misinforming people about how to create a healthy gut?
Dr. Will: 嗯,我认为从我的角度来看,趋势波动很大。
Original English
Dr. Will: Well, I think the thing from my perspective is that trends fluctuate hard.
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 对。2020年,纯素饮食很流行。2023年,食肉饮食很流行。你不可能有比这更截然相反的饮食了。
Original English
Dr. Will: Right. In 2020, it was like the vegan diet was in. In 2023, it was the carnivore diet. You couldn't have more diametrically opposed diets.
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 对。所以问题是,对于在家试图弄清楚的人来说,很容易被任何趋势所吸引,因为当你打开社交媒体时,你听到的就是这些,对吧?然而,我坐在这里,过去5年里科学并没有发生那么大的变化。我们正在努力,但这些只是我们对事物理解上的小波动。这不是根本性的。我们不会那样剧烈摇摆,对吧?所以你的生物学也没有。你五年前的生物学是一样的。所以这种把人们搞得团团转的整个概念,从我的角度来看,是完全错误的。我想首先说,任何有勇气为了健康而改变饮食的人,我实际上认为这很了不起,而且你的选择是什么并不重要,因为你只是在努力弄清楚。最终我只是希望人们变得更好。但问题是,有很多饮食建议是疯狂的,而且史蒂夫,它来自两方面。所以,我绝对不相信100%的肉类或内脏饮食是平衡的,或者是长寿的最佳解决方案。但另一方面,像只吃水果的饮食,我也绝不会支持或推荐。那完全是疯了。我们在做什么?所以我认为,这些高度限制性的饮食,你越是限制,我认为你就越是偏离了相当简单的全食物平衡。
Original English
Dr. Will: Right. And and so the problem is that to the person who's at home and they're trying to get this figured out, it's very easy to get sucked into whatever the trend is because that's what you're hearing about when you open up your social media, right? Whereas as I sit here, the science has not changed that dramatically in the last 5 years. We are working on this, but these are small fluctuations in terms of our understanding of things. It's not a radical. We don't whiplash like that, right? So nor has your biology. you have the same biology five years ago. So this entire concept of like whipping people over the place is total from my perspective. I want to start by saying that any person who has the audacity to change their diet in the interest of their health, like I actually I actually think that's incredible and it doesn't matter what your choice is because you're just trying to figure it out. And ultimately I just want people to be better. But the problem is that there's a lot of dietary advice that's insane and it comes on both sides, Steve. So, absolutely, I don't believe that a 100% meat or organ diet is imbalance or the optimal solution for longevity. But on the flip side, like a fruit only diet, I would never support or recommend either. That's completely insane. What are we doing? So I think that like these highly the more restrictive that you get the more that I think you're drifting away from what is quite simple which is whole food in balance.
Steve: 那么这些果汁饮食之类的呢?人们会进行7天的果汁饮食或水饮食之类的。
Original English
Steve: What about these like juice diets and stuff like that? People do people do like a 7-day juice diet or water diet or whatever.
Dr. Will: 所以如果你有肠道问题,并且你移除了刺激肠道的东西,你通常会感觉更好。所以简化你的饮食并做类似的事情,你可以暂时让自己感觉更好,并认为你做了些什么,但一般来说,那并没有真正起到什么作用。
Original English
Dr. Will: So you will you will often feel better if you have gut issues and you take away the stuff that's irritating your gut. And so simplifying your diet and doing something like that, you can make yourself feel better on a temporary basis and think that you did something, generally speaking, that's not really doing much of anything at all.
Steve: 杀死和创造新的肠道微生物需要多长时间?
Original English
Steve: How long does it take to both kill and then create new new gut microbes?
Dr. Will: 嗯,所以它的美妙之处在于你的肠道非常宽容。所以你今天做出的选择,明天就会反映在你的微生物组中。它的美妙之处在于这些微生物的超能力是它们能够如此快速地繁殖。
Original English
Dr. Will: Well, so the beauty of it is that your gut is very forgiving. So the choices that you make today will be reflected in your microbiome by tomorrow. The beauty of it is that these microbes like their superpower is that they are able to procreate so fast.
Steve: 繁殖是指生孩子。所以它们可以非常快地创造新一代,估计可能快到20分钟。所以我们可以利用这一点,因为如果我们真正支持它们所需的东西,改变可以很快到来。而且,你知道,我回到每3到5天。你建立一个新的肠道屏障。所以,我们有一个惊人的机会,可以真正看到一些快速的健康效果。有没有什么大的健康神话或饮食神话是你担心的,人们目前正在遵循或相信的?有没有什么你看着世界,然后想:“天哪,那对肠道来说太糟糕了。”
Original English
Steve: Procreate meaning making babies. So they can make they can create new generations like estimates are potentially as quick as 20 minutes. And so we can use that to our advantage because if we actually support them with what they need, change can come real quick. And you know, I get back to every 3 to 5 days. You build a new gut barrier. So, there's an amazing opportunity that we have to actually see some quick health effects. Are there any big sort of health myths or diet myths that you're concerned about that people are currently following or believe in particular? Is there anything you look out into the world and think, "Oh god, that's going to be awful for the gut."
Dr. Will: 天哪。这不是我特别关注的事情,因为说实话,我不在TikTok上。
Original English
Dr. Will: Oh gosh. It's not something that I pay a ton of attention to because I'm not on TikTok to be honest with you.
Dr. Will: 所以,嗯,我发现有趣的是,实际上TikTok上最近的一些趋势实际上是正确的。
Original English
Dr. Will: So, um it's I find it interesting that actually like Tik Tok some of the trends that have come more recently are actually on point.
Steve: 所以,这感觉很棒,因为我喜欢人们对好的东西感到兴奋。比如纤维最大化的趋势。
Original English
Steve: So, which feels great because I love it when like people are getting excited about stuff that's good. The like the fiber maxing trend.
Steve: 我没有隐瞒他们。所以纤维最大化,感觉就像。
Original English
Steve: I'm not hiding about them. So fiber maxing, it feels like
Dr. Will: 在很长一段时间没有真正谈论纤维之后,人们开始认识到纤维带来的好处。这在TikTok上通过纤维最大化的趋势得到了很好的体现,人们基本上都在努力大幅增加纤维摄入量。但问题是,你必须让你的身体慢慢适应。所以,我认为这个想法是正确的,人们正在努力的方向是正确的,但执行方面,我只是希望人们以一种让他们感觉良好的方式去做。因为如果他们感觉不好,他们就会放弃,然后他们会认为纤维不适合我。
Original English
Dr. Will: after not really talking about fiber for a really long time, people are starting to come around to the benefits that come from fiber. And this was really exemplified on Tik Tok with this fiber maxing trend where people are basically trying to increase their fiber profoundly. So the issue though is that you have to ease your body into it. So, I think the idea is the right idea of where people are trying to go, but the execution, I just want people to do it in a way where they feel okay. Cause if they don't feel well, they're going to bail and then they're going to think, well, fiber is not for me.
Steve: 那么这个趋势是什么?人们试图通过吃高纤维食物来达到并超过每日推荐的纤维摄入量。
Original English
Steve: And what was this trend? It was people trying to just get above their up and above their daily recommended dose of fiber by eating high fiber foods.
Dr. Will: 是的。并且承认,目前在美国95%的人和英国90%的人都缺乏纤维。这会对一个人的肠道微生物组产生什么并发症或影响?
Original English
Dr. Will: Yes. And acknowledging that 95% of people in the United States and 90% of people in the UK are deficient in fiber as we sit here right now. And what complications or implications does that have for one's gut microbiome?
Dr. Will: 巨大的。
Original English
Dr. Will: Massive.
Steve: 因为纤维正在滋养好的细菌。
Original English
Steve: Because fiber is feeding the good bacteria.
Dr. Will: 纤维是好细菌的主要食物。它是短链脂肪酸的前体。所以短链脂肪酸是当纤维与微生物接触时我们产生的。短链脂肪酸是当纤维与肠道微生物组接触时我们产生的东西。
Original English
Dr. Will: Fiber is the principal food for the good bacteria. And it is the precursor to short-chain fatty acids. So the short-chain fatty acids are what we create when fiber comes into contact with microbes. Short-chain fatty acids are the thing we create when fiber comes in contact with the gut microbiome.
Steve: 是的。
Original English
Steve: Yes.
Steve: 细菌。好的。而且短链脂肪酸真的很好。
Original English
Steve: Bacteria. Okay. And the short-chain fatty acids are really good.
Dr. Will: 它们太好了。事实上,在我研究和了解的所有事物中,它们是我遇到过的最具抗炎作用的东西。所以,它们有三种,三种主要的。乙酸盐、丙酸盐和丁酸盐。它们在体内都有自己独特的作用。它们在肠道、微生物、肠道屏障和免疫系统中都有作用。
Original English
Dr. Will: They're so good. In fact, of all of the things that I've studied and learned about, these are the most anti-inflammatory thing that I've ever come across. So, there's three of them, three main ones. Acetate, propionate, and butyrate. They all have their own distinct effects within the body. They have effects right there in the gut, on the microbes, on the gut barrier, on the immune system.
Steve: 这三样你刚才说的东西是在纤维与肠道微生物组接触时产生的吗?
Original English
Steve: And these are produced, these three things you just named are produced when fiber comes in contact with the gut microbiome.
Dr. Will: 是的。所以,如果你是无菌的,如果你没有,如果你出生时没有微生物组。
Original English
Dr. Will: Yeah. So, like if you were sterile, if you didn't have, if you were born without a microbiome
Steve: 嗯,你听说过泡泡男孩吗?
Original English
Steve: um like you ever hear about Bubble Boy?
Dr. Will: 哦,是的。有一部电影或电视剧,对吧?
Original English
Dr. Will: Oh, yeah. There was a film or TV show, wasn't there?
Dr. Will: 是的。那是一部70年代的纪录片,讲的是一个孩子,他出生时患有这种罕见的遗传性免疫疾病。所以他的家人为了保护他,隔离了他,认为如果没有任何坏东西能进入,他就会没事,对吧?所以他生活在一个无菌的泡泡里。所以理论上,如果你是无菌的,你就永远不会得到这些短链脂肪酸的好处。
Original English
Dr. Will: Yeah. It was like a documentary in the 70s of this kid who was he was born with this rare genetic immune disorder. And so his family in order to try to protect him, they isolated him thinking if if no bad stuff can get in, then he would be fine, right? So like he lived in a sterile bubble. So in theory, if you were sterile, you would never get the benefits of these short-chain fatty acids
Steve: 因为你永远不会有细菌。
Original English
Steve: because you'd never have bacteria.
Dr. Will: 因为你没有细菌。
Original English
Dr. Will: Because you don't have bacteria.
Steve: 好的。
Original English
Steve: Okay?
Dr. Will: 所以我们有相反的问题,那就是我们有细菌,但我们不喂养它们。我们不给它们纤维。你不能无中生有。所以你必须给它们纤维,才能让它们从中产生短链脂肪酸。
Original English
Dr. Will: So we have the the opposite of that problem, which is that we have bacteria, but we don't feed them. We don't give them fiber. You can't create something from nothing. So you have to give them the fiber in order to allow them to create the short-chain fatty acids from it.
Steve: 那么这些短链脂肪酸,我肠道里的微生物组。我把纤维放进去,以什么食物的形式是最好的纤维食物?
Original English
Steve: And these short-chain fatty acids microbiome in my gut here. I put fiber in there in the form of what foods are the best foods for fiber.
Dr. Will: 好的。所以我们这里有各种各样的选择。
Original English
Dr. Will: Okay. So what we have here is an entire array of choices.
Dr. Will: 它的美妙之处在于,在这两盘菜中,我只能发现一样不含纤维的东西。你想猜猜是什么吗?我猜就是它。
Original English
Dr. Will: And the beauty of it is that there's only one thing that I can spot on these two plates that does not contain fiber. Do you want to guess? I guess that it is.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 你想让我告诉你吗?
Original English
Dr. Will: You want me to give it to you?
Steve: 是的。是姜黄吗?
Original English
Steve: It does. Is it the It's not the turmeric, is it?
Dr. Will: 不,但姜黄可能含量不多。
Original English
Dr. Will: No, but the turmeric probably doesn't have very much.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 不,是油,因为问题在于这是100%的脂肪。所以,根据定义,油里面不可能有任何纤维。
Original English
Dr. Will: No, it's the oil because the issue is that this is 100% fat. So, you by definition cannot have any fiber inside of an oil.
Steve: 好的。抱歉。
Original English
Steve: Okay. Sorry.
Dr. Will: 就像葵花籽油、橄榄油。
Original English
Dr. Will: It's like sunflower oil, olive oil.
Dr. Will: 所以,是的,任何类型。现在,它可能含有多酚,比如特级初榨橄榄油含有对微生物组非常有益的多酚。
Original English
Dr. Will: So, yeah, whatever whatever type. Now, it could have polyphenols, like extravirgin olive oil has polyphenols that are really good for the microbiome.
Dr. Will: 特级初榨橄榄油实际上对微生物组非常有益,但它不含纤维。其他所有东西都含有纤维。所以,我们有所有这些不同的植物性食物。它的美妙之处在于它不必很复杂。水果、蔬菜、全谷物、种子、坚果和豆类,它们都含有纤维。
Original English
Dr. Will: Extravirgin olive oil is actually incredibly good for the microbiome, but it doesn't have fiber. Everything else has fiber. So, we have all these different plant-based foods. And the beauty of it is that it doesn't have to be complicated. Fruits, vegetables, whole grains, seeds, nuts, and legumes, they all have fiber.
Steve: 肉类,任何不是植物的东西都不含纤维。
Original English
Steve: Meat, anything that's not a plant does not have fiber.
Dr. Will: 哦,好的。所以,如果它长在地上,它就含有纤维。所以如果它来自植物,它就含有纤维,顺便说一下,这包括蘑菇。所以蘑菇在技术上是真菌。嗯,但它们与植物性食物有很多相同的特征。所以有纤维,有多酚,所有这些我们都希望包含在健康的饮食中。所以如果我吃这些高纤维食物,它们进入我的肠道,微生物组会产生这种叫做短链脂肪酸的东西。而短链脂肪酸,它们会产生更多的好细菌,但它们也帮助我的免疫系统平静下来。
Original English
Dr. Will: Oh, okay. So, if it grows in the ground, it has fiber. So if it comes if it comes from a plant, it has fiber and that includes, by the way, the mushrooms. So the mushrooms are technically fungi. Um, but they share a lot of the same characteristics that the plant-based foods do. So there's fiber, there's polyphenols, all of these things we want to include in a healthful diet. So if I eat these high-fiber foods, they go into my gut, the microbiomes produce this thing called short-chain fatty acids. And the short-chain fatty acids, they produce more good bacteria, but also they help my immune system calm down.
Dr. Will: 是的。所以,如果你想想,让我们回到我们开头提到的模型,那就是你的免疫系统有这三个部分,或者我应该称之为你的防御系统,因为你的肠道微生物是第一道防线,对吧?这就是米歇尔服用抗生素时被破坏的部分。
Original English
Dr. Will: Yes. So, if you think about, let's go back to the model that we led off with, which is that there's these three parts to your immune system or actually your I should call it your defense system because your gut microbes are the first layer of defense, right? That was what was broken down by the antibiotics and Michelle.
Steve: 嗯。第二道防线是你的肠道屏障,它是你肠道的内壁,保护着免疫系统。
Original English
Steve: Mhm. The second layer of defense is your gut barrier, which is the lining of your gut that protects the immune system.
Dr. Will: 然后第三部分是实际的免疫系统本身。我们甚至不希望激活它。我们宁愿让前两部分为我们解决问题。对吧?所以这的美妙之处在于,你吃,你摄入这些高纤维食物。它们在你的大肠中与你的微生物接触。具体来说,右结肠是经典的位置。它们分解它们,并释放出乙酸盐、丙酸盐和丁酸盐。这三样东西会影响你的微生物,影响你的肠道屏障,影响你的免疫系统。现在,在这三者中,我最喜欢的是丁酸盐,因为丁酸盐对微生物和肠道屏障的影响最大。你实际上需要丁酸盐才能产生将你的肠道内壁连接在一起的蛋白质。而且丁酸盐对我们的免疫细胞有直接影响。所以这些再次是我遇到过的最具抗炎作用的东西,这也是我们遭受这些痛苦的部分原因,回到最初关于这些慢性炎症性健康状况的对话,你问我它们从何而来?我们生活在一个工业化世界中,我们95%的人,至少90%的人,都没有摄入我们所需纤维的量。当我们将其与其他地方进行比较时,最近有一项有趣的研究,他们观察了意大利、新加坡以及玻利维亚亚马逊地区的土著部落和马来西亚的土著部落的微生物组。所以是两个过着狩猎采集生活方式的土著部落,与意大利和新加坡进行比较。他们发现微生物组的多样性存在根本性的差异。在他们产生短链脂肪酸的能力方面也存在差异。
Original English
Dr. Will: And then the third part is the actual immune system itself. We don't even want to have to activate that. We'd rather the first two parts take care of it for us. Right? So the beauty of this is that you eat, you consume these high-fiber foods. They come into contact with your microbes right here in the large intestine. Specifically, the right colon is the classic spot. and they they unpack them and they release the acetate, propionate and butyrate. And those three things impact your microbes, impact your gut barrier, impact your immune system. Now, of the three, my favorite is butyrate because it's the butyrate that has the biggest effect on the microbes, on the gut barrier. like you literally need butyrate in order to produce the proteins that hold your gut lining together. Um and the butyrate has a direct effect on our immune cells. So these are again the most anti-inflammatory thing that I've come across and part of why we're suffering with these going back to the original conversation about these chronic inflammatory health conditions and you asked me where do they come from? We live in an industrial world where 95% of us at a minimum 90% of us are not getting even close to the amount of fiber that we need. And when we compare this to other places, so there was an interesting study that came out recently where they looked at the microbiome of people in Italy, Singapore, and then they had native tribal people in the Bolivian Amazon and native tribal people in Malaysia. So two indigenous tribes living a you know hunter gatherer lifestyle. against Italy and Singapore. And what they discovered is that there's this radical difference in terms of the diversity of the microbiome. There's a difference in terms of their their ability to produce short-chain fatty acids.
Dr. Will: 还有一个关于衰老的问题,因为随着我们年龄的增长,炎症会增加。这是不可避免的吗?我们是否被困在一个位置,根据我们的年龄,我们应该只期望会有更多的炎症问题?他们在部落人口中发现,实际上根本不是这样。所以他们无论年龄大小都受到炎症的保护,因为他们的生活方式。但他们生活着,这不仅仅是他们吃什么。他们日出而作,日落而息。他们与部落联系在一起。他们不看Instagram。这个故事还有很多。但重点是,在工业化世界中,我们没有摄入足够多的这类食物。
Original English
Dr. Will: And there's this question that comes up about aging because as we age, inflammation increases. Is that inevitable? Are we stuck in a position where like based upon our age we should just expect that we're going to have more inflammatory issues? What they found in the tribal populations is that actually that's not true at all. So they were protected against inflammation regardless of their age because of their lifestyle. But they were living and it's not just what they eat. It's they they wake up when the sun comes up. They sleep when the sun goes down. They're connected to their tribe. They're not looking at Instagram. Like there's so much to that story. The point being though that in the industrial world like we're not consuming a sufficient amount of these types of foods.
Steve: 我猜他们也不喝酒和吸电子烟。
Original English
Steve: I guess they're not also drinking alcohol and vaping.
Dr. Will: 不。
Original English
Dr. Will: No.
Steve: 我们在西方世界做得更多。
Original English
Steve: Which we, you know, do a lot more in the Western world.
Dr. Will: 是的,我们会的。
Original English
Dr. Will: Yeah, we do.
酒精对肠道微生物组的影响
Steve: 这对肠道微生物组有什么影响?因为我通常没听人们谈论酒精对肠道微生物组的影响。
Original English
Steve: What impact does that have on the gut microbiome? Because I don't typically hear people talking about alcohol in the gut microbiome.
Dr. Will: 我们知道它肯定会影响肠道屏障。
Original English
Dr. Will: What we know is that it definitely affects the gut barrier.
Steve: 我猜如果我喝伏特加,也会在某种程度上清除我的口腔微生物组。
Original English
Steve: I guess total clarity wiping up my my oral microbiome as well to some degree if I'm pouring vodka.
Dr. Will: 这和使用含酒精的漱口水是一样的,对吧?现在我们不再推荐这种做法了。所以,是的,酒精,实际上有一项研究改变了我对酒精的看法。所以我现在几乎不喝酒了。我很少和妻子在特别的晚餐时喝一两杯。在这项研究中,他们基本上给人们喝了大量的酒精,然后每30分钟追踪他们的血液酒精水平,同时测量一种叫做脂多糖的东西。它来自生活在我们微生物组中的炎症细菌。它不应该存在于你的血液中。如果它存在于你的血液中,那通常表明你的肠道屏障不足且虚弱,因为它能够穿透。问题是免疫系统已经被训练识别脂多糖为敌人,所以它会被激活。所以,这就是炎症的来源。所以,在这项研究中,他们让人们喝了几杯酒,然后每30分钟开始追踪。你看到的是,随着血液酒精水平的上升,脂多糖也平行上升。当酒精达到峰值时,脂多糖也达到了峰值。发生了一件奇怪的事情。我无法解释为什么,但酒精水平达到峰值后开始下降,然后实际上又回升了。当这种情况发生时,脂多糖也遵循了完全相同的模式。而且脂多糖直到酒精水平为零才恢复正常。
Original English
Dr. Will: And it would be the same as it would be the same as using an alcohol-based mouthwash, right? Which which now we don't recommend anymore. And so yeah, so alcohol, there was a study actually that changed my mind when it comes to alcohol. So I actually don't drink hardly at all anymore. like very rarely I'll have a glass or two with my wife if we're on a special dinner. And in this study they they basically gave people a significant amount of alcohol and then they tracked every 30 minutes the measure of their blood alcohol level and simultaneously the measure of what's called lipopolysaccharide. So it's it comes from the inflammatory bacteria that live inside of our microbiome. It's not supposed to be in your bloodstream. If it's in your bloodstream, that generally indicates that your gut barrier is insufficient and weak because it's able to get across. And the problem is that the immune system has been trained to identify that lipopolysaccharide as the enemy and so it gets activated. So, and this is where inflammation comes from. So, in this study, they had people have a number of drinks and they start tracking every 30 minutes. And what you saw was that as the blood alcohol level goes up in parallel, the lipopolysaccharide goes up. When the alcohol peaks, so did the lipopolysaccharide. There was this weird thing that happened. I don't I can't explain why, but the alcohol level peaked. It started to come down and then actually bumped back up. And when that happened, the lipopolysaccharide followed the exact same pattern. And the lipopolysaccharide did not return to normal until the alcohol level was zero.
Dr. Will: 所以当我从我的角度看到这个时,需要明确的是,这不是一项关于一杯酒的研究,尽管我们确实知道一杯酒足以扰乱你的睡眠并引起其他健康问题。但当我看到这个时,我看到了足够多的证据,可以说我认为没有任何量的酒精是安全的。
Original English
Dr. Will: So when I saw this from my perspective, to be clear, it wasn't a study of one drink, although we do know that one drink is sufficient to disrupt your sleep and cause other health issues. But when I saw this, I saw enough to say I don't think there's any amount of alcohol that's safe.
Steve: 总结一下那里发生的事情,酒精进入身体。它以某种方式影响肠道,导致肠道功能失调,这种功能失调持续一段时间,因为我试图理解你为什么看了那个后就觉得绝对不能像以前那样喝酒了。
Original English
Steve: To summarize what's going on there, the alcohol is coming into the body. It is impacting the gut in some way which is making the gut go into dysfunction and that dysfunction lasts for a little while cuz I'm trying to understand why you you looked at that and thought do you know what absolutely not I'm not going to drink as much as I was.
Dr. Will: 是的。所以基本上酒精导致了肠漏。
Original English
Dr. Will: Yeah. So basically alcohol was causing leaky gut.
Steve: 哦,肠漏。好的。
Original English
Steve: Oh leaky gut. Okay.
Dr. Will: 是的。所以酒精导致了肠漏。这就是我们在那项研究中看到的。而且肠漏的量与血液中的酒精量成正比,并且肠漏直到酒精水平为零才恢复正常,这告诉我,血液中任何可检测到的酒精量都可能导致这个问题,这会导致炎症,这会导致炎症。我们非常清楚,酗酒者,他们的肠道完全被破坏,这实际上是发展成肝硬化和酒精性肝病的必要步骤。所以有些人似乎可以侥幸逃脱,他们可以大量饮酒,但从未真正患上肝硬化。
Original English
Dr. Will: Yeah. So alcohol was causing leaky gut. That's what that's what we saw in that study. And the fact that the amount of leaky gut was proportional to the amount of alcohol in the blood and that the leaky gut did not return to normal until the alcohol level was zero says to me that any amount of alcohol that's detectable in the bloodstream can create this problem which is going to cause inflammation which is going to cause inflammation. We know with total clarity that people who are heavy drinkers, their gut is totally destroyed and that that's actually a requisite step on the pathway towards developing cirrhosis and alcoholic liver disease. So there are some people who seem to get away with it where they can be a heavy drinker and they never actually get cirrhosis.
Steve: 肝硬化是?
Original English
Steve: And it cirrhosis is
Dr. Will: 肝硬化是,肝脏位于你右侧上腹部,它的作用是解毒你的血液。所有流向肠道的血液,在返回心脏后,第一个到达的地方就是你的肝脏。这实际上是一个聪明的解剖学设置,因为我们不希望有毒血液进入心脏,然后循环并最终回到大脑。所以我们让肝脏来保护和防御它。但肝硬化发生的情况是,肝脏,它柔软而海绵状,想象一个你可以放在水龙头下的海绵。水从一端进去,蜿蜒穿过,从另一端出来。好的?而不是那样,它只是一块塑料,对吧?它很硬。它不让任何东西通过。这就是一个人患上肝硬化时发生的情况。
Original English
Dr. Will: Cirrhosis is the so the liver sits in your right upper abdomen and its job is to detoxify your bloodstream. And all of the blood that goes to your gut, the first place that it goes after your gut as it returns to the heart is your liver. And it's actually a smart setup anatomically because we don't want toxic blood to get access to the heart and then circulate and ultimately get back to the brain. So we allow the liver to protect and defend it. But the cirrhosis what's happening is that basically the liver which is soft and spongy like imagine a sponge that you can put it under a faucet. The water goes in one end, wiggles its way through, comes out the other end. Okay? Instead of that, it's just a piece of plastic, right? It's hard. It's not letting anything through. That's what that's what happens when a person develops cirrhosis.
Dr. Will: 所以,肝硬化有很多原因。肝硬化来自炎症。所以所有肝硬化的健康状况最终都是炎症性健康状况。它们都是与炎症相关的130种健康状况的一部分。但在这个特定情况下,我们谈论的是酒精。我所说的是,根据现有数据,要引起肝脏的炎症,似乎你必须破坏肠道微生物组才能达到目的。
Original English
Dr. Will: So, and there's many causes of cirrhosis. Cirrhosis comes from inflammation. So all cirrhosis health conditions ultimately are inflammatory health conditions. They're all part of the 130 health conditions associated with inflammation. But in this particular setting what we're talking about is alcohol. And what I'm saying is that to create that inflammation in the liver based upon the available data it seems that you have to disrupt the gut microbiome in order to get there.
Steve: 我们很多人都在追求被动收入,并建立副业来帮助我们支付账单。这个机会就在这里,我们的赞助商Stan,一家我共同拥有的公司。它是一个可以帮助你充分利用自己财务状况的平台。Stan让你能够为自己工作。它使销售数字产品、课程、会员资格和更简单的产品变得更具可扩展性,更容易实现。你可以将你的想法转化为收入,并获得支持来发展你正在建设的一切。我们即将推出“敢于梦想”挑战。它适用于那些准备从思考转向建设,从计划转向实际行动的人。它是关于看到你脑海中的梦想,并确切地知道如何将其变为现实。加入挑战。发布一个视频分享你的梦想,并有机会赢得10万美元。
Original English
Steve: So many of us are pursuing passive forms of income and to build side businesses in order to help us cover our bills. And that opportunity is here with our sponsor Stan, a business that I co-own. It is the platform that can help you take full advantage of your own financial situation. Stan enables you to work for yourself. It makes selling digital products, courses, memberships, and more simple products more scalable and easier to do. You can turn your ideas into income and get the support to grow whatever you're building. And we're about to launch Dare to Dream. It's for those who are ready to make the shift from thinking to building, from planning to actually doing the thing. It's about seeing that dream in your head and knowing exactly what it takes to bring it to life. Join the challenge. Post a video sharing your dream and enter to win $100,000.
Steve: 我刚刚写完了我的第三本书。我还没有确定书名,但我已经开始制作一些不同的设计。我一直在使用Adobe Express来做这件事,它是我们的赞助商之一。我喜欢Adobe Express的原因是它让我可以很容易地专注于最微小的细节。字体、字号、颜色、文本位置,这些对大多数人来说可能听起来很琐碎的东西,但实际上它们会结合起来创造出脱颖而出的东西,比其他所有东西都更胜一筹。设计我的封面艺术让我想起了这些年来我学到了多少创意的东西。但它也让我想起了我周围有那么多有创意的人也保守着自己的秘密。所以,我在Adobe Express中创建了“更胜一筹指南”,将这些技巧带给你。在其中,你会找到来自行业中最优秀的人的原则,它们被转化为快速简单的实践,供你应用,这样你就可以训练自己,像世界上表现最好的团队一样进行创作。只需前往adobe.com/1better下载Adobe Express,并务必访问学习标签,了解如何才能比其他人更胜一筹。
Original English
Steve: I've just finished writing my third book. I haven't firmed up the title yet, but I have started mocking up some different designs. And I've been doing this with Adobe Express, which is one of our sponsors. What I love about Adobe Express is that it makes it so easy for me to obsess over the tiniest details. The typography, the font, the color, the text placement, the stuff that might sound petty to most people, but actually compounds to create something that stands out, something that's one better than the rest. And designing my cover art has reminded me of how many creative things I've learned over the year. But it's also reminded me that there are so many creative minds around me that are also sitting on their own secrets. So, I've created the one better guide in Adobe Express to bring those tips to you. And in it, you'll find principles from the very, very best in their industry turned into quick and easy practices for you to apply so you can train yourself to create exactly like the best performing teams in the world do. Just head over to adobe./1better to download Adobe Express now and make sure you visit the learn tab to discover how you can become one better than the rest.
姜黄与多酚
Steve: 那边盘子里有一种橙色的化学物质。姜黄。人们在谈论炎症时经常提到姜黄。
Original English
Steve: There's a orangey looking chemical on the plate over there. Turmeric. People talk about turmeric a lot when they're speaking about inflammation.
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Steve: 我不太确定姜黄和炎症的真相是什么。
Original English
Steve: I'm not really sure what the truth is on turmeric and inflammation.
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Dr. Will: 你必须小心一点,因为你很容易过量。
Original English
Dr. Will: You have to be a little bit careful because you could easily overdo it.
Steve: 哦,真的吗?那么,我们必须聪明地处理,因为我们真正谈论的姜黄是如果你每天持续服用它,这实际上从我的角度来看,对于患有慢性炎症性健康问题的人来说非常有意义。
Original English
Steve: Oh, really? So, well, so we just have to be smart with the way that we approach because the turmeric that we're really talking about is if you were to take it on a consistent daily basis, which actually from my perspective makes a ton of sense for people that have chronic inflammatory health issues.
Steve: 所以姜黄以某种方式帮助炎症消退。
Original English
Steve: So, turmeric is helping inflammation go down somehow.
Dr. Will: 姜黄帮助炎症消退,因为它阻断了另一种细胞因子。所以,就像我们谈论那些对讲机,基本上是取出电池一样,姜黄有助于实现这一点。
Original English
Dr. Will: It turmeric is helping inflammation to go down because it blocks another one of the cytokines. So, in the same way we're talking about those walkie-talkies and basically pulling the batteries out, turmeric helps to accomplish that.
Steve: 所以姜黄对特定的细胞因子有这种作用。你提到了姜黄素。姜黄素是姜黄中发现的植物化学物质。姜黄是根。
Original English
Steve: So, there's a specific cytokine that that turmeric has that effect. And so, it's the you mentioned curcumin. So, curcumin is the phytochemical found in turmeric. Turmeric is the root.
Dr. Will: 好的。
Original English
Dr. Will: Okay.
Steve: 姜黄素是化学物质。
Original English
Steve: Curcumin is the chemical,
Dr. Will: 好的。
Original English
Dr. Will: okay,
Dr. Will: 它实际上起作用。事实证明,姜黄素就是我们所说的多酚。所以多酚,当我们坐在这里看着这些美丽的色彩时,每一种食物都含有定义其颜色并影响肠道的多酚。比如这里的洋葱会含有槲皮素,很多人都听说过槲皮素对长寿有益。大蒜也是如此。所以不同颜色的食物含有不同的多酚,其中95%需要我们的肠道微生物才能被激活。所以对于姜黄,你只需要小心补充剂,因为如果你过量,如果你服用太多,那可能会产生问题。
Original English
Dr. Will: that actually does the thing. And it turns out that curcumin is what we call a polyphenol. So polyphenols, as we sit here and we look at this beautiful array of all these colors, every single one of these foods contains polyphenols that define the color and that impact the gut. Like the onion here would have quercetin and many people have heard of quercetin as being beneficial for longevity. Same would be true for the garlic. So there's different polyphenols for different colored foods and 95% of them require our gut microbes in order to be activated. So with turmeric, you just need to be careful with supplements because if you overdo it, if you take too much, that could create an issue, though.
完美肠道日作息
Steve: 我面前有一个,我想这是一个完美的肠道日。你见过这个吗?
Original English
Steve: Here in front of me, I have a I guess I guess this is a perfect gut day. Have you seen this?
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Steve: 我想让你一步一步地给我解释如何拥有一个完美的肠道日。
Original English
Steve: I wanted you to explain to me step by step how to have a perfect gut day.
Dr. Will: 好的。所以,我将为人们定义我如何处理完美的24小时节律。我们有一个先天的昼夜节律。昼夜节律基本上意味着我们的身体按照24小时的时钟运作。为什么?因为我们是随着太阳进化的。太阳升起又落下。这是定义我们人类和我们整个环境中所有事物最强大的因素之一。对吧?所以我们周围的一切也随着太阳进化并与之相连。大约50%的基因根据我们的昼夜节律在一天中的特定时间开启或关闭。超过50%的微生物在一天中起伏,以适应时刻。我们的身体在一致性中茁壮成长。所以,我想谈论的是我们如何创造一个一致的日常作息,可以优化我们的微生物组。我将带你了解所有不同的步骤。让我们想象太阳升起,早上7点。
Original English
Dr. Will: Nice. All right. So, I'm going to I'm going to define for people the way that I would approach the perfect 24-hour rhythm. We have an innate circadian rhythm. Circadian rhythm basically means that our body functions on a 24-hour clock. Why? Because we evolved with the sun. The sun goes up and it comes down. And that is one of the most powerful things that defines everything that exists both for us as humans and in our entire environment. Right? So everything around us also evolved with the sun and is connected to it. Around 50% of our genes are turned off or on at specific times of day based upon our circadian rhythm. More than 50% of our microbes rise and fall during the course of our day to meet the moment. Our body thrives on consistency. So, what I want to talk about is how do we create a consistent daily routine that can optimize our microbiome. And I'm going to take you through all the different all the different steps. Let's imagine that the sun comes up and it's 7 in the morning.
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 好的。你自然醒来,并且你始终如一,你就有一个很好的开始。起床时间的一致性是开始你美好一天的绝佳方式。我希望你在一天开始的头5分钟内,首先专注于醒来,思考你的一天以及你将如何处理它。因为从7:05开始,你将通过补水唤醒你的微生物,唤醒你的身体。所以,我们将选择水。在一个完美的世界里,我希望在水中添加益生元纤维补充剂。所以,比如我们的公司叫做38 Terra。你可以添加那个,或者你可以添加替代品。这是补水。水会启动你的肠道,启动你的大脑,启动你的肾脏。
Original English
Dr. Will: All right. and you naturally wake up and you are consistent about it, you're off to a great start. Consistency with the time that you wake up is a fantastic way to start your day. And what I want you to do in the first 5 minutes of your day is I want you to initially just focus on waking up and thinking about your day and how you're going to approach it. Because starting at 7:05, you're going to wake up your microbes. You're going to wake up your body with hydration. So, we're going to opt for water. And in a perfect world, I would love to add a prebiotic fiber supplement to that water. So, like our company is called 38 Terra. You could add that there or you can add an alternative. This is the hydration. The water turns on your gut, turns on your brain, turns on your kidneys.
Steve: 所以不是直接喝咖啡。
Original English
Steve: So, not coffee straight away.
Dr. Will: 不。所以,暂停咖啡。从补水开始。我们用水和益生元纤维唤醒你的肠道,益生元纤维会滋养你肠道中的微生物。好的。所以那是7:05。让我们假设这花了你10分钟。所以现在是7:15,我们基本上要拨动开关,告诉你的身体是时候开始了,我们正在开始新的一天。这实际上是最强大的时刻。所以如果每个人只记住一件事,我希望是这个,因为我给了你激活昼夜节律的两个最强大的杠杆。第一,阳光,或者至少是明亮的光线照射。所以发生的情况是光线穿过我们的眼睛,击中眼后部的视网膜,进入身体检测到这一点,然后进入视神经。在你可以从左眼和右眼收集信息的第一点,坐落着你大脑的这个部分,叫做视交叉上核(SCN)。SCN是协调者。它是你昼夜节律的主时钟。所以,我会把它想象成学校。当我们还是孩子去上学时,我们可能都戴着手表。那块手表给了我们一天中大致的时间概念。你所有的器官,你所有的组织,超过一半的微生物,它们都有自己的手表。它们对一天中的时间有感觉。但最终最重要的是课间响起的闹钟。那是中央时钟。
Original English
Dr. Will: No. So, pause the coffee. Start with hydration. And we're waking up your gut with the water and also with the prebiotic fiber that's going to feed those microbes in your gut. Okay. So, that's at 7:05. And let's pretend that takes you 10 minutes. And so now it's 7:15 and we're going to basically flip the switch to tell your body it's time to go that we're starting a new day. And this is actually the most powerful moment. So if there's only one thing that everyone takes away, I want it to be this because I'm giving you the two most powerful levers in terms of activating your circadian rhythm. Number one, sunlight or at a minimum bright light exposure. So what happens is that light passes through our our eye and hits the retina in the back of the eye, enters into the body detects this and it enters into the optic nerve. And right at the very first spot where you could collect information from both your left eye and your right eye sits this part of your brain called the supra kaismatic nucleus, the SCN. And the SCN is the orchestrator. That is the master clock of your circadian rhythm. So like I would think about it like school. So when we were kids and we went to school, we might have all been wearing a watch. And that watch gives us a general idea of where we are in our day. All your organs, all your tissues, more than half your microbes, they have their watch. They have a feel for where they are in the day. But it's the alarm that goes off between classes that ultimately is what matters the most. That's the central clock.
Steve: 那是你的SCN。你的SCN基本上管理着所有这些。当你告诉SCN今天开始了,就会发生一系列的事情。
Original English
Steve: That's your SCN. Your SCN is basically managing all of that. And there's an entire cascade of things that follows from when you tell the SCN today started.
Dr. Will: 所以光照基本上激活了SCN,通过一系列事件释放皮质醇。好的。皮质醇是早晨的荷尔蒙。它让我们被激活。它为我们的细胞提供蛋白质和能量。它让我们专注。它实际上抑制了我们的免疫系统。在那一刻,你需要更多的皮质醇。通过获得早晨的光照,你可以将其提高50%。
Original English
Dr. Will: So that light exposure is what basically activates the SCN to release cortisol through a through a series of events. It releases cortisol. All right. Cortisol is the morning hormone. It is it it allows us to get activated. It makes protein and and energy available to our cells. It makes us focused. It actually suppresses our immune system. In that moment, you want more cortisol. And by getting morning light exposure, you can bump it by 50%.
Steve: 所以,我们开了一个好头。我们可以利用的第二个杠杆是户外运动。你不需要做全面的锻炼。我不是说你一天中最剧烈的运动。我说的是轻度运动。但如果你只是活动身体,对吧,在夏天,你可能会出去散步,对吧?天气好的时候。当是1月份,天气不那么热的时候,你可能实际上会有一个光照盒。光照盒让你可以在室内。你只需要确保它是10,000勒克斯,这就是你想要的。所以光照盒是太阳的替代品。然后你可以做任何形式的运动。你可以做深蹲,你可以做弓步,俯卧撑,任何你可能想做的。你可以做开合跳。
Original English
Steve: So, we're off to a good start. The second lever that we can pull with our outdoor time is exercise. You don't need to do like a full scale workout. I'm not talking about the most vigorous exercise of your day. I'm talking about light exercise. But if you just move your body, right, which during the summertime, what you would do is like you might go outside and you might have a ruck fest and you take a walk, right? When the weather is good. And when it's January and the weather isn't so hot, you might actually have a light box. The light box allows you to stay inside. You just got to make sure it's 10,000 lux is what you're looking for. So the light box is the substitute for the sun. And then you could do any form of exercise. You could do squats, you could do lunges, push-ups, whatever it may be. You could do jumping jacks,
Steve: 做瑜伽。
Original English
Steve: do yoga.
Dr. Will: 对吧?所以在这段时间里,如果你获得光照并进行运动,运动可以再增加25%到50%。这是一种复合效应,会给你带来最终的早晨皮质醇峰值。这对于推动你的一天至关重要,因为通过获得这个,你会更加专注。你将能够从认知角度做更多事情,比如你的耐力会增强。嗯,你今晚也会睡得更好,而且你会在第一天就注意到这一点。我向你保证。所以,好的。所以,你将这样做大约20分钟。所以从7:15到7:35,你将进行光照和运动。好的?理想情况下,尽可能多地进行户外光照。顺便说一下,如果你戴眼镜,请摘下眼镜。你不必直视太阳。在7:35,我们基本上要回到室内,现在是喝咖啡和安静的时间。
Original English
Dr. Will: Right? So during this period of time, if you get light exposure and you exercise, the exercise can add another 25 to 50%. This is a compounding effect that's going to give you the ultimate morning cortisol peak. And this is essential to propel your day because by getting this, you will be more focused. You will be able to do more from a cognitive perspective like your endurance will be enhanced. Um, you also will sleep better tonight and you will you will notice this on day one. I promise you. So, all right. So, and you're going to do that for about 20 minutes. So, from 7:15 until 7:35, you're going to be doing your light and exercise. Okay? Ideally, outdoor light whenever possible. If you wear glasses, by the way, take off your glasses. You don't have to look directly at the sun. At 7:35, we're going to basically come back in and this is a time for us to now have our coffee and also quiet time.
Dr. Will: 所以,对我来说,我们一天中没有足够的时间。一天节奏太快了,对吧?我们需要有意识地创造机会来激活我们的副交感神经系统。
Original English
Dr. Will: So, like to me, we don't have enough time in our day. The day is so fast-paced, right? We need to be intentional about creating opportunities to like activate our parasympathetic nervous system
Steve: 哪个是?
Original English
Steve: which is
Dr. Will: 所以我们的自主神经系统有两面。自主神经系统就像你无法完全控制它一样。它只是在运行。一面是交感神经系统。交感神经系统是让你快速行动的部分。这就像你的加速器。好的?另一面是你的副交感神经系统,它是你的刹车。它是你的休息和恢复。所以,现在你已经完成了户外活动和锻炼,你回到室内,我们想给你10分钟的安静、低调的交感神经系统时间。所以,那可以是冥想、呼吸练习、读圣经、写日记,对吧?任何适合你的。所以,你用咖啡做这些10分钟,这就到了7:45。现在你吃早餐。好的。所以,早餐是服用补充剂的绝佳机会。
Original English
Dr. Will: so there's two sides to our autonomic nervous system. Autonomic is just like you have like you you can't totally control it. It's just going one side is sympathetic. Sympathetic is the part that gets you going fast. Like this is your accelerator. All right? And the other side is your parasympathetic which is your break. It's your rest and recovery. So, now that you've done your outdoor time and your exercise, you come in and we want to give you 10 minutes of just like quiet, low-key, sympathetic time. So, that could be meditation, breath work, could be reading your Bible, could be journaling, right? Whatever it is that works for you. So, you do that with your coffee for 10 minutes and that brings us to 7:45. And now you have breakfast. All right. So, and breakfast is the perfect opportunity to take your supplements.
Steve: 好的。那么什么早餐?什么补充剂?
Original English
Steve: Okay. So, what breakfast? What supplements?
Dr. Will: 好的。所以你的早餐和。
Original English
Dr. Will: Okay. So, your breakfast and
Steve: 我的早餐策略是什么?我需要吃很多食物吗?我需要吃早餐吗?我为什么需要吃早餐?
Original English
Steve: what is my breakfast strategy? Am I going for a lot of food? Do I need to have breakfast? Why do I need to have breakfast?
Dr. Will: 你应该吃早餐。你绝对应该吃早餐。是的。所以,你的新陈代谢在一天中会发生变化。你最强的新陈代谢是在早上第一件事。所以这意味着你可以在7:45或下午3:00吃完全相同的食物。当你早上7:45吃时,你会得到更好的血糖控制。你会得到更好的血脂控制。所以这些都是我们新陈代谢的表现。当它们得到控制时,这对我们的身体实际上非常好。所以只要有可能,我们都希望把食物转移到一天中的早些时候。
Original English
Dr. Will: You should have breakfast. You should definitely have breakfast. Yeah. So, um your metabolism changes during the course of the day. your strongest metabolism is first thing in the morning. And so what that means is that you could literally eat the exact same food at 7:45 or at 3:00 in the afternoon. And when you eat it at 7:45, you will get better blood sugar control. You will get better blood fat control. So those are those are manifestations of our metabolism. And when they're under control, that's actually really good for our body. So whenever possible, we want to shift our food towards earlier in the day.
Steve: 那么什么样的食物?
Original English
Steve: And what kind of foods?
Dr. Will: 我会说我们应该选择高纤维和适量蛋白质。
Original English
Dr. Will: I would argue that we go high fiber and moderate protein.
Steve: 低糖。
Original English
Steve: Low sugar.
Dr. Will: 无糖。是的。低糖或无糖,对吧?
Original English
Dr. Will: No sugar. Yeah. Low low sugar, right?
Steve: 低糖或无糖。
Original English
Steve: Low or no sugar.
Dr. Will: 精制碳水化合物应尽可能避免。
Original English
Dr. Will: Refined carbohydrates should get left out as much as possible.
Steve: 什么是精制碳水化合物?给我举个例子。
Original English
Steve: What's a refined carbohydrate? Give me
Dr. Will: 面粉或糖。
Original English
Dr. Will: flour or sugar.
Steve: 好的。所以没有。
Original English
Steve: Okay. So no
Dr. Will: 没有烘焙食品。
Original English
Dr. Will: no baked goods,
Dr. Will: 没有班尼迪克蛋。嗯,所以从我的角度来看,例外情况是如果你想吃牛油果吐司,那就选择酵母面包。
Original English
Dr. Will: no eggs benedict. Uh, so the exception from my perspective would be if you're going if you want to have avocado toast than a sourdough.
Steve: 太棒了。
Original English
Steve: Awesome.
Dr. Will: 最好不要。它们很好吃。
Original English
Dr. Will: Prefer not. They're delicious.
Dr. Will: 但不,我更喜欢不吃,因为最终我们想要的是高纤维和适量蛋白质。通过这种组合,可以最大限度地满足饱腹感。所以你会感到饱足。你从蛋白质角度给了身体所需。同时,你从纤维角度给了肠道所需。
Original English
Dr. Will: But no, I prefer not because ultimately what we want is we want we want high fiber and moderate protein. And by doing that combination, it's maximum satiation. So you're going to feel full. You're giving your body what it needs from a protein perspective. and you're simultaneously giving your gut what it needs from a fiber perspective.
Steve: 燕麦。
Original English
Steve: Oats.
Dr. Will: 所以,我的意思是,你可以吃燕麦,出于我们之前讨论草甘膦的原因,燕麦应该是有机的。如果你要吃它们,就尽可能少加工。所以,比如我不太喜欢速溶燕麦。那么对于孩子呢?如果我给我的孩子做早餐,我应该特别考虑什么吗?因为你知道很多父母,我之前谈过很多次,但我小时候会喝很多橙汁,我没有意识到橙汁就像糖水一样。
Original English
Dr. Will: So, I mean, you could do oats do for the reasons that we were discussing glyphosate earlier, the oats should be organic. And if you were to do them, do them as minimally processed. So, like I don't really love instant oats. What about for kids? If I'm, you know, giving my kids a breakfast, should I be thinking about anything in particular? cuz you know a lot of a lot of parents um I've talked about this quite a few times before but when I was younger I'd get a lot of orange juice and I didn't realize that orange juice was just like sugar water.
Steve: 是的。
Original English
Steve: Yeah.
Steve: 父母在给孩子做早餐时应该考虑什么吗?
Original English
Steve: Is there anything that parents should be thinking about when they're giving kids their breakfasts?
Dr. Will: 当然。嗯,我认为最重要的是你需要为你的孩子树立一个健康早餐的榜样。
Original English
Dr. Will: Of course. Um and I think that the most important thing is that you need to model for your kids what a healthy breakfast looks like
Steve: 通过自己吃。
Original English
Steve: by having it yourself.
Dr. Will: 通过自己吃。
Original English
Dr. Will: By eating it yourself
Steve: 因为如果你不这样做,你就不能指望他们这样做。
Original English
Steve: because if you don't do that then they're you can't expect them to.
Dr. Will: 所以,嗯,健康早餐。我的孩子们,我有四个孩子,所以我的孩子们喜欢牛油果吐司。他们喜欢牛油果吐司。嗯,你绝对可以吃酸奶加浆果,对吧?你可以吃浆果和坚果。在这方面有很多不同的选择。所以,隔夜燕麦、奇亚籽布丁,这些都是你可以做的不同选择。关于孩子这一点,在我们继续我们的完美早晨和日常作息之前,作为父母,你做出的决定,给你的孩子某些东西,会对他们的免疫和肠道功能产生持久影响吗?
Original English
Dr. Will: So, um, healthy breakfast. My kids, I have four kids, so my kids love avocado toast. They love avocado toast. Um, you could absolutely do yogurt with berries, right? You could do berries and nuts. There's a lot of different choices in that regard. So, overnight oats, chia pudding, these are different choices that you could do for sure. On this point of kids, before we carry on with our perfect morning and day routine, are there decisions that you make as a parent to give your kids certain things that will have a lasting impact on their immune and gut function?
Dr. Will: 100%。是的。我认为这开启了一个关于我们的肠道和免疫系统之间联系从何开始的讨论。它从出生前就开始了。头三年至关重要。所以,史蒂夫,让我稍微解释一下。他们有研究观察母亲在怀孕期间的微生物组。好的?所以,比如母亲排便,他们分析她的粪便,他们能够基本上识别出与孩子以后患过敏性疾病相关的模式。
Original English
Dr. Will: 100%. Yes. And the I think it opens up a discussion about where the connection between our gut and immune system starts. It starts before birth. The first three years are critical. So, let me unpack that just a little bit, Steve. They have studies where they look at mom's microbiome during pregnancy. All right? So, like mom poops, they analyze her poop and they're able to basically identify patterns that are associated with the kid developing allergic diseases later on.
Steve: 哦,好的。他们也有研究表明,怀孕期间增加纤维摄入量的母亲,也能降低孩子以后患过敏性疾病的可能性。
Original English
Steve: Oh, okay. They also have studies where moms who increase their fiber intake during pregnancy reduce the likelihood of their kids developing allergic diseases later on as well.
Steve: 那么孩子服用抗生素呢?在幼年时期形成肠道微生物组时,这会产生什么后果性影响吗?
Original English
Steve: What about kids taking antibiotics? Does that have a when you're forming your gut microbiome at a young age? Does that have a consequential impact?
Dr. Will: 100%。抗生素、奶瓶喂养和剖腹产。顺便说一下,我的所有孩子都是剖腹产出生的。这不是我们想要的,但它发生了。但这三件事都与对微生物组和免疫系统的影响有关。如果你观察头5年,过敏性疾病的风险增加,自身免疫性疾病的风险增加,代谢性疾病的风险增加。
Original English
Dr. Will: 100%. Antibiotics, bottle feeding and birth by cesarean section. And by the way, all of my kids were born by C-section. It's not what we wanted, but it's what happened. But those three things are associated with an impact on the microbiome and the immune system. And if you look downstream over the course of the first 5 years, increased risk of allergic diseases, increased risk of autoimmune diseases, increased risk of metabolic diseases.
Steve: 因为剖腹产,婴儿没有通过产道。
Original English
Steve: because in a C-section, it the baby didn't pass through the birth canal.
Dr. Will: 产道。
Original English
Dr. Will: The birth canal.
Steve: 产道会给婴儿一些母亲的微生物组。
Original English
Steve: The birth canal would have given the baby some of the mother's microbiome.
Dr. Will: 是的。
Original English
Dr. Will: Yes. So,
Steve: 然后母乳喂养也一样。它给婴儿微生物组。
Original English
Steve: and then breastfeeding does the same. It gives the baby microbiome.
Dr. Will: 母乳喂养让他们接触到母亲的皮肤微生物组。
Original English
Dr. Will: Breastfeeding gives them access to mom's skin microbiome.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 但母乳也含有这些叫做人乳寡糖(HMOs)的东西。考虑一下这相当迷人。我们进化到母亲的母乳含有这些东西,人乳寡糖。有200多种。它们对孩子没有直接的营养价值。那么我们为什么会有它们呢?因为它们是益生元。所以母乳中的这些人乳寡糖基本上是为了滋养发育中的婴儿微生物组而设计的。
Original English
Dr. Will: But also breast milk contains these things called HMOs, human milk oligosaccharides. It's quite fascinating to consider this. We evolved where mom's breast milk contains these things, human milk oligosaccharides. There's over 200 varieties. They have no nutritional value to the child directly. So why do we why do we have them? Because they're prebiotic. So these human milk oligosaccharides in breast milk were basically designed to feed the developing baby microbiome.
Dr. Will: 所以,这就是我们遇到一些挑战的原因,当你用奶瓶喂养配方奶粉时,你可能会在里面加入纤维,但这只是一种单一纤维。它与200多种人乳寡糖不同。
Original English
Dr. Will: So and this is part of why we get into some challenges where when you replace it with with the bottle the formula you might put fiber in there but it's like a mono fiber. It's not the same as the 200 plus varieties of human milk oligosaccharides.
Dr. Will: 芬兰有一项研究,他们观察了大约1000名儿童,并追踪了他们5年。在这5年期间,他们在孩子3个月和12个月大时采集了微生物组样本(粪便样本),他们观察了,好的,这些孩子中有一些患上了过敏性疾病,比如湿疹、食物过敏、哮喘、鼻炎、过敏性鼻炎。好的,这些是经典的过敏性疾病。他们发现,有一些因素可以预测谁会在5岁时患上过敏性疾病。第一,在生命的第一年接触抗生素。第二,奶瓶喂养。好的。然后他们观察了12个月时的微生物组。所以,需要明确的是,这些孩子当时还没有患上过敏性疾病。那是在以后才发生的,但他们观察了12个月时的微生物组,他们可以判断谁会在以后患上过敏性疾病,因为存在一种特定的模式。缺少的是产生短链脂肪酸的细菌。
Original English
Dr. Will: So there was a study that was done out of Finland where they looked at roughly,00 kids and they tracked them for 5 years and during this time 5 years they got a microbiome specimen poop specimen from the kid at 3 months and 12 months of age and they looked at okay so some of these kids develop allergic diseases so eczema, food allergies, asthma, rhinitis, allergic rhinitis. All right, those are the classic allergic diseases. And what they found is, okay, there were certain factors that predicted who was going to develop allergic diseases by the age of five. Number one, exposure to antibiotics in the first year of life. Number two, being bottlefed. All right. Then they looked at the microbiome at 12 months. So, and just to be clear, these kids, they they had not developed the allergic disease yet. That comes later, but they looked at the microbiome at 12 months and they could tell who was going to develop the allergic diseases later on because there was a specific pattern. What was missing were the bacteria that produce short-chain fatty acids.
Steve: 短链脂肪酸是我们之前谈到的那种化学物质。
Original English
Steve: And the short-chain fatty acids are that chemical we talked about earlier on that
Steve: 你从纤维中获得的。
Original English
Steve: that you get from fiber
Steve: 它产生那三样东西。是的。
Original English
Steve: which produces those three things. Yes.
Dr. Will: 丁酸盐。
Original English
Dr. Will: But butyrate
Steve: 丁酸盐、乙酸盐和丙酸盐。
Original English
Steve: butyrate, acetate and propionate.
Dr. Will: 而且事实上,当他们检查粪便中的丁酸盐水平时,丁酸盐水平很低。所以本质上,他们在这项研究中发现的非常迷人的是,你可以观察微生物组,并预测谁会在以后患上这些过敏性疾病所导致的困惑免疫系统。
Original English
Dr. Will: And and in in fact when they checked the poop for butyrate levels, the butyrate levels were low. So in essence what they discovered in this study that was quite fascinating is that you can look at the microbiome and predict who will later on go on to develop these confu the confused immune system with these allergic diseases.
Steve: 所以回到我们的日常作息。
Original English
Steve: So going back to our daily routine.
Dr. Will: 是的。
Original English
Dr. Will: Yep.
Steve: 我们到哪儿了?
Original English
Steve: Where are we to?
Dr. Will: 是的。是的,我们到7:45了,你想要高纤维、适量蛋白质、尽可能少的糖的早餐,这是服用早晨补充剂的最佳时间,因为我推荐的循证早晨补充剂是维生素D、Omega-3和姜黄。
Original English
Dr. Will: Yes. Yes, we're at 7:45 and you So, you want your high fiber, moderate protein, as little sugar as possible, breakfast, and this is the perfect time to take your morning supplements because the morning supplements, the ones that I recommend that are evidence-based are vitamin D, omega-3s, and turmeric.
Steve: 那是针对炎症的。
Original English
Steve: That's for inflammation.
Dr. Will: 所以,这些是针对炎症的。
Original English
Dr. Will: So, these are for inflammation.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 是的。所以,现在我还认为只要有可能就应该进行测试。有针对维生素D的测试。有针对Omega-3的测试。如果你有足够的量,你就不需要服用补充剂。但如果你缺乏,那就是补充剂发挥重要作用的地方。所以,我相信补充剂应该以昼夜节律的方式持续服用。所以这意味着我们每天在同一时间服用早晨补充剂。
Original English
Dr. Will: Yeah. So, now I also believe that we should test whenever possible. There's a test for vitamin D. There's a test for omega-3s. If you have enough, you don't need to take the supplement. But if you're deficient, that's where supplements play an important role. So, I believe that that supplements should be taken consistently in a circadian fashion. So, that means that we take our morning supplements at the same time every day.
Steve: 为什么?
Original English
Steve: Why?
Dr. Will: 因为基本上我们所有的微生物和身体以及它的运作方式都在一致性中茁壮成长。所以补充剂也应该如此。
Original English
Dr. Will: Because basically everything about our microbes and our body and the way that it works thrives on consistency. So supplements would be the same.
Steve: 当我们这样做的时候,现在是7:45了。我们吃了早餐。我们服用了早晨的补充剂。现在我们醒来已经一个小时了,是时候进行一次美妙的排便了。那是你所有努力的体现。因为当你获得早晨的光照时,这有助于排便。当你运动时,这有助于排便。当你喝咖啡时,这有助于排便。所有这些不同的事情最终都会导致你进行良好的健康排便。这表明肠道处于节律中,并且运作良好。所以那是你的早晨。现在你要去工作了。我想回到午餐时间。所以到了午餐时间,中午12点,我基本上会建议人们和另一个人一起吃午餐,就像你和我现在坐在这张桌子旁一样。因为我们做得不够,我们太多时候这样拿着手机,一边吃东西一边翻看和滑动。
Original English
Steve: And when we do this, so it's been 7:45. We've had our breakfast. We've taken our morning supplement stack and now it's been an hour since we woke up and it's time for a fantastic bowel movement. And that is the manifestation of all the work that you've done. Because when you get your morning light exposure, that helps to contribute to that bowel movement. When you exercise, that contributes to that bowel movement. When you drink your coffee, that contributes to that bowel movement. All these different things ultimately lead to this to this place where you're having that good healthy bowel movement. And that's indicative of a gut that's in rhythm and doing well. So that's your morning. Now you're going to go to work. And I want to circle back to roughly the lunchtime hour. So you it gets to be lunchtime and it's 12:00 noon and basically I would advocate for people to have lunch with another person like the way that you and I are sitting here at this table right now. So because we don't do that enough like way too much we're on our phone like this and eating at the same time that we're flipping and scrolling.
社交连接与肠道健康
Steve: 那么这对我的肠道和炎症有什么好处呢?所以与另一个人建立社交联系。
Original English
Steve: How is that good for my gut and inflammation though? So feeling socially bonded to another person
Dr. Will: 50%,顺便说一下,这是大流行之前的统计数据,对吧?所以大流行使情况变得更糟。大流行开始之前,美国50%的人感到孤独。孤独会比其他任何事情更快地摧毁你的寿命。孤独已被证明在对健康和寿命的影响方面与经常吸烟不相上下。
Original English
Dr. Will: 50% this is by the way statistics that come from before the pandemic right so the pandemic made this worse 50% of people in America were lonely before the pandemic even started loneliness is the equ loneliness will destroy your longevity faster than just about anything loneliness is has been shown to be on par with smoking cigarettes on a routine basis in terms of the impact that it has on your health and your longevity.
Steve: 你在那里说得很清楚,你将孤独定义为断开连接的感觉,而不是独处。
Original English
Steve: And you're quite clear there that you define loneliness as the feeling of disconnection versus being alone,
Dr. Will: 对吧?是的。
Original English
Dr. Will: right? Yes.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 所以,但独处在那里,你必须思考我们从何而来。所以,我们本质上是部落性的。你必须明白,数百万年来,人类过着在部落中狩猎采集的特定生活方式。没有钱。财富的衡量标准是你与他人的联系。这让你得以生存和发展。你的家庭基本上是衡量财富的标准。家庭越大,你就越富有,因为你们会一起工作,互相支持,互相照顾。但更广泛的部落,它不是300人,更不用说社交媒体上的数十万人。更广泛的部落,就像这个家庭的家庭,我们在一起。如果你和我在同一个部落,如果有人攻击我们,我知道你会站出来保卫我,我也会为你做同样的事情。
Original English
Dr. Will: So, but being alone there, you have to think about where we came from. So, we um are tribal by our nature. Like you have to understand that for millions of years, humans lived the specific lifestyle of being hunter's gatherers in our tribe. There was no money. The currency of wealth was your bonds to other people. That's what allowed you to survive and thrive. Your family was like basically the the measure of wealth. The bigger the family, the more wealthy you were because you would work together to support one another and take care of each other. But then the broader tribe, which is not 300 people, let alone hundreds of thousands on social media. The broader tribe, which was this like family of families, we were in it together. If you and I were in the same tribe, if someone attacked us, I know that you would step up to defend me and I would do the same for you.
Steve: 所以这会导致某种皮质醇问题,压力问题,然后影响肠道微生物组并引起炎症。
Original English
Steve: So this is causing some kind of cortisol issue, stress issue that's then impacting the gut microbiome and causing inflammation.
Dr. Will: 如果我们想折磨一个人,最简单的方法就是让他们单独隔离。那简直是折磨。我们是如此社会化的生物,我们需要那种联系。而这会引起皮质醇反应。那就会引起炎症。
Original English
Dr. Will: If we want to torture a person, like literally the easiest way to do it is to put them in solitary isolation. That's literally torture. We're so social that we need that. And it's the cortisol response that that's going to cause that. That's that then causes inflammation.
Steve: 那是正确的。所以最终那是肠脑连接的表现。
Original English
Steve: That is correct. So ultimately that is a manifestation of the brain-gut connection.
Steve: 好的。我们对人类联系有内在需求,当这种内在需求得不到满足时,我们实际上会感到非常压力,因为我们感到脆弱和不安全。
Original English
Steve: Okay. We have a we have an innate need of human bonding and when that innate need is not met then it's actually quite stressful for us because we feel vulnerable and unsafe.
Steve: 嗯。我们睡眠也更差。我读到一些关于人们感到孤独时会进入自我保护状态的东西,这有点像,我猜,如果你从部落中漂流出去的比喻。
Original English
Steve: Mhm. We sleep worse as well. I was reading about some stuff around um when people feel lonely they go into self-preservation which is kind of like I guess the the analogy would be if you drifted off from your tribe.
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Steve: 你会更加警觉。你会紧张。你会等待,你知道,你不能安睡8小时,因为你现在处于危险之中。
Original English
Steve: You would have to be a bit more alert. You'd have to be on edge. You'd have to be wait you know you couldn't sleep for 8 hours in peace because you you're in danger now. Yeah,
Dr. Will: 你没有那种群体带来的绝缘因素。
Original English
Dr. Will: you don't have that sort of insulating factor of a group of people.
Dr. Will: 思考起来很有趣,比如有一种叫做斯德哥尔摩综合征的状况,斯德哥尔摩综合征是当你劫持一个人质时发生的情况,在这种情况下,你是被劫持的人。你有一个选择。你可以拒绝劫持你的人,或者你可以实际上在他们身上找到好的一面并与他们建立联系。
Original English
Dr. Will: It's it's so interesting to think about like there's a condition called Stockholm syndrome and Stockholm syndrome is what happens if you take a person hostage and in that scenario you're the person who's taken hostage. You have a choice. You can reject the person who's taken you or you can actually find the good in them and bond with them.
Steve: 嗯。
Original English
Steve: Mhm.
Dr. Will: 这实际上是一种生存机制,在这种被劫持的情况下,人们倾向于与劫持者建立联系并同情他们。
Original English
Dr. Will: And it's actually a survival mechanism that within that context of being taken hostage, people have a tendency to bond with their captor and have sympathy for them.
Steve: 那是,我们认为那是一种防御机制,因为我们是如此社会化的生物。我们需要那种东西,而不是独处和被囚禁。
Original English
Steve: And that's and we think that's a defense mechanism because we're so social. We need that as opposed to like being alone and being held captive.
Steve: 好的。所以,我们在午餐时进行社交。我们和别人一起吃晚餐。
Original English
Steve: Okay. So, so we socialize at lunch. We have dinner with other people.
Dr. Will: 是的。所以,我希望人们在午餐时进行社交,以解决这种孤独的流行病,我认为这问题非常严重,不容低估,因为这又像吸一包烟一样。所以,让我们想象我们有一个愉快的午餐时间。我们不是说10分钟。我们说的是45分钟,包括交谈,对吧?然后我们结束。现在,我鼓励人们在回去工作之前,出去散步。这有两个好处。我们之前谈到了早晨阳光的好处以及早晨运动的好处。我们又回到了这一点。但这次情况有点不同。通过外出,你会接触到不同的阳光射线。所以实际上,我们从太阳那里获得的射线类型略有不同,它们更有可能在一天晚些时候提升我们的血清素。而血清素能提升我们的情绪,让我们专注,帮助我们完成任务。所以当我们散步并第二次外出时,这会强化我们的昼夜节律。
Original English
Dr. Will: Yes. So, I want people to socialize at lunch to address this epidemic of loneliness that I think is highly problematic and not and not to be underrated because again, that's like smoking a pack of cigarettes. So, let's imagine that we have a nice lunch time. We're not talking about 10 minutes. We're talking about 45 minutes that includes conversation, right? And we get to the end. And now, what I would encourage people to do before you go back to work is to get outside and take a walk. So, there's two advantages to this. We talked earlier about the benefits of sunlight in the morning and also the benefits of exercise in the morning. We're circling back to that. But things are a little bit different this time. By getting outside, you're getting different rays of sun. So the actually the types of rays that we get from the sun are slightly different and they're more likely to boost our serotonin later in the day. And that serotonin is what lifts our mood, gives us focus, helps us to get to to get things done. So this reinforces our circadian rhythm when we take a walk and we get outside a second time.
Dr. Will: 此外,运动,10分钟的散步,仅仅10分钟的简单散步就足以让你的血糖控制改善30%到40%。因为当你激活腿部的大肌肉时,它有助于将血糖从血液中排出。所以,它的信息是,如果你吃得太多,感觉不舒服,强迫自己去散步。
Original English
Dr. Will: Also, the exercise, a 10-minute walk, just 10 minutes of simple walking is enough to get 30 to 40% improvement in your blood sugar control. Because when you activate the big muscles in your leg, it helps to draw the blood sugar out of your bloodstream. So like it's the messaging there is if you just ate too much and you don't feel well, force yourself to take a walk.
Steve: 嗯。
Original English
Steve: Mhm.
Dr. Will: 而不是躺在沙发上。
Original English
Dr. Will: As opposed to laying on the couch.
Steve: 嗯。
Original English
Steve: Mhm.
Dr. Will: 好的。所以,嗯,户外散步也能激活我们的肠道,帮助我们的肠道进入节律,这能减少饭后的腹胀。好的。然后你这样做15分钟。现在是下午一点。你回去工作。我鼓励人们喝抹茶绿茶。嗯,我是抹茶的忠实信徒。在所有现有的茶中,它的多酚含量最高,对微生物组非常有益。所以,它能给你下午带来很好的提振。好的,让我们加速到下午4点。我看到你,嗯,我想是在你的书里读到的吗?是的。在你的书里提到,下午3点到6点之间是最佳的运动时间。没错。是的。所以下午3点到6点。原因与我们的核心体温有关。所以我们的体温在晚上会下降。我们的体温在晚上会降低,然后在白天早上开始上升。顺便说一下,早晨的运动有助于加速这个过程。但我们的峰值是下午3点到6点。
Original English
Dr. Will: All right. So um and the outdoor walk also activates our gut and helps our gut to get into rhythm and that reduces bloating after a meal. Okay. So, and then you do that for 15 minutes. It's one o'clock. You're back to work. I encourage people to have a matcha green tea. Um, I'm a big matcha believer. This is the of all the teas that exist. It has the highest polyphenol content and it's phenomenal for the microbiome. So, and it gives you a nice boost to your afternoon. Okay, let's accelerate to 4:00. I saw you um I think was it in your book that I read this? Yeah. In your book it talks about how the gap between sort of 3 and 6 is the optimal time to exercise. That's right. Yeah. So 3 and 6 p.m. The reason for that has to do with our core body temperature. So our temperature cools off at night. Our body temperature lowers at night and then during the day it starts to rise in the morning. Exercise by the way in the morning helps to accelerate that. But our peak is 3 to 6 pm.
Steve: 我在你的书的第159页感到被冒犯了,你写道:“我唯一的请求是,你不要在深夜进行剧烈运动,因为这会激活交感神经系统,并可能对你快速入睡的能力产生负面影响。”
Original English
Steve: I felt attacked on page 159 of your book where you said, "My one request is that you do not have heavy exercise late in the evening as this activates the par sorry, the sympathetic nervous system and can negatively affect your ability to quickly fall asleep."
Dr. Will: 是的。你什么时候锻炼?
Original English
Dr. Will: Yeah. What What time are you working out?
Steve: 我的意思是,昨晚大约是晚上11点到午夜。
Original English
Steve: I mean, last night it was like bloody god 11 till midnight.
Dr. Will: 哦,不。
Original English
Dr. Will: Oh no.
Steve: 但那很典型,因为我不知道。我只是,那是我的时间。
Original English
Steve: That's like quite typical though because I don't know. I just It's when I get my time.
Dr. Will: 你昨晚睡得怎么样?
Original English
Dr. Will: How's your sleep last night?
Steve: 感觉很棒。但我的意思是,发生了一系列问题。
Original English
Steve: feel great. But I mean like a series of issues took place.
Dr. Will: 两个小时。所以,好的,公平地说。
Original English
Dr. Will: Two hours. So, okay, fair enough.
Steve: 是的,就像我其他一系列问题。
Original English
Steve: Yeah, like a series of like my other issues.
Steve: 我吃饭的时间不好。
Original English
Steve: The time I ate was bad and
Steve: 我去健身房的时间不好,所以一团糟。
Original English
Steve: the time I went to the gym was bad and so was was a mess.
Dr. Will: 是的。嗯,理想情况下是睡前2小时。
Original English
Dr. Will: Yeah. Well, ideally 2 hours before bedtime.
Steve: 好的。
Original English
Steve: Okay.
Dr. Will: 至少睡前两小时。所以,尤其是剧烈运动。如果是轻度运动,那没什么大不了的。
Original English
Dr. Will: At least two hours before bedtime. So, and like especially when it's vigorous exercise. If it's light exercise, it's not a big deal.
Steve: 但剧烈运动就不同了。
Original English
Steve: But vigorous exercise is a different story.
Dr. Will: 好的。
Original English
Dr. Will: Okay.
Dr. Will: 是的。所以,三点到六点。这更多是从运动表现的角度来看。如果你想举重,那是最好的时间。
Original English
Dr. Will: So, yeah. So, three three to six. This is more from like an exercise performance perspective. Like that's the best time if you want to lift heavy weight,
Steve: 好的。
Original English
Steve: okay?
Dr. Will: 下午3点到6点。所以,让我们想象一下,我们在下午4点去健身,对吧?所以,我将给我们一个小时来完成那次美妙的锻炼,然后现在是5点,是吃晚餐的最佳时间。我想很快指出一点。我们大约在8点吃早餐,大约在中午吃午餐,大约在5点吃晚餐。我们把时间间隔了大约四个小时。这实际上从你的消化节律的角度来看是完美的时间。
Original English
Dr. Will: 3 to 6 p.m. So, let's imagine that we go and we get we smash a workout at 4:00, right? And so, I'm going to give us an hour to smash that wonderful workout and then now is 5:00 and it's the perfect time for dinner. I want to point something out real quick. I we had breakfast around 8 and we had lunch around noon and we had dinner around 5. We've spaced things out by about four hours. And that's actually the perfect time from from the perspective of your digestive rhythm.
Dr. Will: 所以在肠道中有一个概念,很多人可能没有听说过,叫做移行性运动复合体,在两餐之间,你的肠道会做一整套事情,它基本上就像在扫荡和重新组织自己。但如果你吃东西,它就会被打断。
Original English
Dr. Will: So there's this thing this this concept within the the gut that many people haven't heard of called the migrating motor complex where between meals your gut has this entire thing that it does and it basically is like sweeping through and reorganizing itself. But it gets disrupted if you eat.
Steve: 好的?
Original English
Steve: Okay?
Dr. Will: 所以理想情况下,两餐之间间隔4小时,如果你这样做,你实际上会注意到你的消化感觉有所不同。因为你让你的肠道进入了节律。好的。所以我们吃晚餐。现在是5点。我们进入傍晚。现在是晚上7点。让我们想象一下,我知道一年中的这个时候,在大多数地方太阳下山比这早得多。嗯,但想象一下现在是7点。看,当太阳下山时,你希望开始调暗家里的灯光。你希望开始减少个人光照。因为光照,仅仅是家里的普通灯光,就可以将你的褪黑素降低30%。褪黑素是睡眠荷尔蒙。所以早上是皮质醇,晚上是褪黑素。这很有趣。
Original English
Dr. Will: So it's ideal to give a 4-hour space between these meals and that if you do that you will actually notice a difference in terms of how you feel with your digestion. So because you've allowed your gut to fall into a rhythm. All right. So we have our dinner. It's 5:00. We're moving into the evening and now it's going to be 7:00 at night. And let's imagine, I know this time of year the sun is going down much earlier than this in most places. Um, but imagine that it's 7 o'clock. Look, when the sun goes down, you want to start to dim the lights in your house. You want to start to reduce your personal light exposure because light exposure, just casual lights within your home can cut your melatonin down by 30%. Melatonin is the sleepy time hormone. So in the morning it's cortisol and in the evening it's melatonin. And it's interesting
Dr. Will: 因为我们早上通过运动和光照所做的一切,不仅旨在增强皮质醇峰值,而且还增加了我们的血清素。血清素,快乐荷尔蒙,让我们保持专注。嗯,血清素实际上是褪黑素的前体。所以,当你投资于早晨的光照、早晨的运动时,你正在为14小时后的优质睡眠做好准备。所以,我们想要保护它。当外面天黑时,褪黑素就会开始上升。所以,我们希望调暗家里的灯光。当我们接近8点时,我们真的要小心。如果我们的就寝时间是10点,请原谅我,如果对某些人来说太早了,但我认为保持一致的就寝时间很好。如果我们的就寝时间是10点,那么到8点,我们就要开始减少使用设备或戴上蓝光阻挡眼镜。蓝光阻挡眼镜可以帮助保护我们。然后大约8:30,服用你的晚间补充剂。所以,我们早晨的补充剂是维生素D、Omega-3和姜黄。现在,我们想服用晚间补充剂,它们是锌和镁。如果你服用褪黑素,那将是服用它的时间。或者如果你服用不同的助眠补充剂,那将是服用它的时间。大约8:30到9点,在这个范围内。所以,因为它大约需要60到90分钟才能真正起效。大约9点,我们希望激活我们的晚间仪式。所以,早上我们有安静时间。晚上我们也应该有安静时间,有意识地激活我们的副交感神经系统,并在睡前放松,这样在9:30,我们基本上是在准备睡觉,那可能意味着洗个热水澡,实际上,晚上洗热水澡或桑拿是完美的,因为信不信由你,它实际上会降低你的核心体温。所以,这正是我们想要的。我们想要一个凉爽的房间。我们想要一个黑暗的房间,这有助于我们睡得更好,因为然后10点我们想上床睡觉,10点,它可以是任何时间。但我会说我们应该保持一致。可以是10:30,可以是11点。无论你选择什么时间,都要适应它。但从我的角度来看,重点不是10点是神奇的数字。更多的是,如果你总是10点睡觉,10点就是神奇的数字。如果你总是10:30睡觉,10:30就是神奇的数字。一致性是关键。
Original English
Dr. Will: because what we did in the morning with both exercise and with light exposure, it was designed not only to enhance that that cortisol peak, but it also increases our serotonin. Serotonin, the happy hormone that keeps us focused. Well, serotonin is actually the precursor to melatonin. So, when you make the investment of morning light, morning exercise, you're setting yourself up for excellent sleep in 14 hours. So, and we want to protect that. Melatonin is going to start to rise when it gets dark outside. And so, we want to dim the lights within our home. And we want to really be cautious as we move towards 8:00. If our bedtime is going to be 10:00, forgive me if that's too early for some people, but I think it's like nice to have a consistent bedtime. If our bedtime is 10, then by 8:00, like we want to be sort of dialing back on our devices or wearing blue light blocking glasses. The blue light blocking glasses can help to protect us. And then roughly 8:30, take your evening supplements. So, we had our morning supplements, which were vitamin D, omega-3s, and turmeric. Now, we want to take our evening supplements, which are zinc, and magnesium. And if you take melatonin, that would be the time to do it. Or if you take a different sleepy time supplement, that would be the time to do it. Roughly 8:30 to 9, somewhere in that range. So, because it's going to take about 60 to 90 minutes to really kick in around nine o'clock, we want to activate our evening ritual. And so, in the morning, we had our quiet time. We should have a quiet time in the evening too to intentionally activate our parasympathetic nervous system and get like relaxed before bedtime so that at 9:30 we basically are preparing for bedtime and that might mean a hot shower like actually like heat at night hot shower sauna is perfect because actually it cools off your inner core temperature believe it or not. So, and that's exactly what we want. We want a cool room. We want a dark room and that will help us to sleep better because then at 10:00 we want to go to bed and 10:00 like it could be whatever time. But I would argue that we should be consistent. It could be 10:30, it could be 11. Whatever time you choose, adapt to it. But the point from my perspective is not so much 10 is the magic number. It's more so that 10 is the magic number if you always do 10. 10:30 is the magic number if you always do 10:30. Consistency is key.
Steve: 你会推荐一日三餐吗?
Original English
Steve: And you would recommend three three meals a day.
Dr. Will: 我认为你可以吃三餐。我认为我们这样安排,如果你晚上6点吃完饭,然后大约8点吃早餐,你就有14小时的禁食。
Original English
Dr. Will: I think that you could do three meals. I think that like the the way that we structured this is that if you were done eating at 6:00 at night and then you're having breakfast around 8, you have a 14-hour fast.
Steve: 你认为禁食窗口重要吗?
Original English
Steve: Do you think that fasting window matters?
Steve: 那个特定的数字14,还是?
Original English
Steve: That specific number 14 or
Steve: 是的,就像一般而言,有一个大的间歇性禁食窗口,你已经16小时没吃东西了,诸如此类。
Original English
Steve: Yeah, just like generally generally having sort of a big intermittent fasting window where you you haven't eaten for 16 hours, whatever it might be.
Dr. Will: 我认为限时进食的价值有两部分。第一部分是我们给肠道一个休息的时间。
Original English
Dr. Will: I think that there's so I think that there there's two parts to the value that we get from time-restricted eating. So the first is we give our gut a time to rest.
Dr. Will: 所以当你特别在深夜进食时,老实说,所有的时间安排都可以讨论。从我的角度来看,唯一完全不可协商的一点是深夜进食。所以我的意思是,别介意,有时我们很忙,对吧?但当你深夜进食时,它在代谢上对你产生不同的影响,然后它会持续到第二天,它会影响你的睡眠。是的。
Original English
Dr. Will: So when you when you particularly eating late at night, like I honestly the timing of it all could be debated. The one spot where it's a total non-negotiable from my perspective is late night eating. So I mean no offense, like sometimes we're busy, right? But when you eat late at night, it hits you different metabolically and then it carries and it lingers into the next day and it will affect your sleep. Yeah.
Steve: 所以,我们真的尽可能地选择早吃晚餐,然后尽可能地在晚上停止进食。
Original English
Steve: So, we really as much as possible want to opt for early dinner time and then shut it down for the evening as much as possible.
Steve: 人们会说:“是的,但我饿了。”
Original English
Steve: People will be saying, "Yes, but I'm hungry."
Dr. Will: 我认为他们饿了的部分原因,根据你的解释,可能是因为他们没有吃早餐。
Original English
Dr. Will: And I think part of the reason that they're hungry from what you've explained is probably because they didn't have breakfast.
Steve: 是的。
Original English
Steve: Yeah.
Steve: 他们喜欢晚点开始吃。这通常是我发现的,如果我吃早餐,我通常晚上不会饿。
Original English
Steve: They like started eating later. That's what typically what I find is if I have breakfast, I I'm typically not hungry late at night.
Dr. Will: 是的。是的。我认为早餐有助于以一种特定的方式为一天定下基调。所以限时进食的两个优点是,你可以让肠道休息,任何超过12小时的禁食对肠道都有益,然后第二部分,我认为被低估的一点是,它有助于我们更一致地安排用餐时间。所以关于昼夜节律的整个对话可以用一个词来概括:一致性。如果你每天都在同一时间吃饭,我向你保证,你会感觉到消化方面的不同。所以限时进食的优点是它让你关注你什么时候吃晚餐?你什么时候吃早餐?然后你最终会更加一致,而不是随心所欲。
Original English
Dr. Will: Yeah. Yeah. I think that I think that breakfast helps to sort of set the tone for the rest of the day in a in a specific way. So the two the two advantages of time-restricted eating are that you get that you get that gut rest which anything over 12 hours is good for the gut and then the second part is I think it just the underrated thing that no one talks about is it helps us to get more consistent with our meal times. So this entire conversation about circadian rhythm can be summarized in one word consistency. If you ate at the same time every single day, you would feel the difference in terms of your digestion. I promise you. And so the advantage of time-restricted eating is it brings attention to what time am I eating dinner? What time am I eating breakfast? And then you end up being a lot more consistent about it as opposed to just flying by the seat of your pants.
Steve: 你禁食过吗?你尝试过。
Original English
Steve: Do you fast ever? Do you try and
Steve: 长期禁食?
Original English
Steve: like long fast?
Steve: 长期禁食还是只是更限时进食?
Original English
Steve: Long fast or just sort of more time-restricted eating self?
Dr. Will: 我会。我一直都在进行限时进食。事实上,我大多数时候,首先,我是不完美的。
Original English
Dr. Will: I do. I do time-restricted eating all the time. In fact, I most days like I uh first of all um I'm imperfect.
Dr. Will: 所以这意味着我不会完美地遵循我给出的所有建议。所以,我大多数时候不吃早餐。
Original English
Dr. Will: And so what that means is I don't perfectly follow all the advice I give. So like I don't eat breakfast most days.
Steve: 是的。
Original English
Steve: Yeah.
Dr. Will: 因为我很努力。所以,我醒来,做我的早晨例行公事,然后喝咖啡,然后就开始工作。
Original English
Dr. Will: Cuz I'm going hard. So like I wake up, I do my morning routine, I get I get to the coffee stage and then I jump into work.
Steve: 我也是。
Original English
Steve: Same.
Dr. Will: 所以但今天。
Original English
Dr. Will: So but on today
Steve: 今天我吃了。是的。是的。今天我吃了早餐,因为我想保持状态。
Original English
Steve: today I did. Yeah. Yeah. Today I had my breakfast because I wanted to be okay on my game.
Dr. Will: 但在周末我吃早餐。我确实注意到了不同。我白天不那么饿,当我吃了那份早餐后,它能保持平衡。嗯,所以是的,我有时一天只吃一顿饭。
Original English
Dr. Will: But on the weekend I I have my breakfast. I noticed the difference actually. like I'm I'm less hungry during the day when I have that breakfast that sort of just keeps it balanced. Um so yeah, I sometimes I do one meal a day.
Steve: 上个月我告诉过你我给我们内部的Flightex团队设定了一个挑战。Flightex团队是我们内部的创新团队。我让他们看看他们能为公司节省多少时间,通过创建一个工具来帮助我们筛选新的AI工具,看看哪些值得追求。我认为我们的赞助商Fiverr Pro平台上可能有这方面的人才,可以帮助我们快速构建这个工具。所以我与我的创新总监艾萨克进行了交谈,在过去的一个月里,我的Flight X团队和一位经过审查的Fiverr Pro人工智能专家一直在合作这个项目。在我的团队的帮助下,我们已经能够创建一个全新的工具,它可以自动扫描、评分和优先排序不同的新兴AI工具。它的影响是巨大的。在几周内,这个工具已经为我们节省了数小时筛选和测试新AI系统的时间。Flight X团队不再需要筛选大量的噪音,而是能够专注于开发更多AI工具,这些工具真正推动了我们业务的发展,这要归功于Fiverr Pro上的人才。所以,如果你有一个复杂的问题需要帮助解决,请务必访问fiverr.com/diary查看Fiverr Pro。
Original English
Steve: Last month I told you about a challenge that I'd set our internal Flightex team. Flightex team is our innovation team internally here. I tked them with seeing how much time they could unlock for the company by creating something that would help us filter new AI tools to see which ones were worth pursuing. And I thought that our sponsor Fiverr Pro might have the talent on their platform to help us build this quickly. So I talked to my director of innovation Isaac and for the last month my team Flight X and a vetted AI specialist from Fiverr Pro have been working together on this project. And with the help of my team, we've been able to create a brand new tool which automatically scans, scores, and prioritizes different emerging AI tools for us. Its impact has been huge. And within a couple of weeks, this tool has already been saving us hours triing and testing new AI systems. Instead of shifting through lots of noise, my team Flight X has been able to focus on developing even more AI tools, ones that really move the needle in our business, thanks to the talent on Fiverr Pro. So, if you've got a complex problem and you need help solving it, make sure you check out Fiverr Pro at fiverr.com/diary.
Steve: 如果我们有什么需要,那就是联系,尤其是在我们今天生活的世界里。这正是我们创建这些对话卡片的原因。因为在这个节目中,当我与我的嘉宾坐在一起进行那些深入而亲密的对话时,这种非凡的事情一次又一次地发生。我们彼此感到深深的联系。在每一集的结尾,我采访的嘉宾都会为下一位嘉宾留下一个问题。我们把它们变成了这些对话卡片。我们还添加了这些转折卡片,让你的对话更有趣。对话卡片还有更多转折。这是全新版本。我首次在卡片组中添加了这张金卡,这是我提出的一个独家问题。但我只在第一批对话卡片中放入金卡。所以赶快购买你的卡片吧,以免限量版金卡售罄。请点击下方描述中的链接。
Original English
Steve: If there's anything we need, it is connection, especially in the world we're living in today. And that is exactly why we created these conversation cards. Because on this show, when I sit here with my guests and have those deep, intimate conversations, this remarkable thing happens time and time again. We feel deeply connected to each other. At the end of every episode, the guest I'm interviewing leaves a question for the next guest. And we've turned them into these conversation cards. And we've added these twist cards to make your conversations even more interesting. And there are so many more twists along the way with the conversation cards. This is the brand new edition. And for the first time ever, I've added to the pack this gold card, which is an exclusive question from me. But I'm only putting the gold cards in the first run of conversation cards. So get yours now before the limited edition gold cards are all gone. Head to the link in the description below.
创伤与肠道功能
Steve: 我们开头简要提到了一个概念,那就是创伤与肠道功能有关。
Original English
Steve: One of the things you we touched on briefly at the beginning was this concept that trauma is linked to gut function.
Dr. Will: 强烈相关。
Original English
Dr. Will: Powerfully.
Steve: 以何种方式?我们刚才谈到了自主神经系统,它是交感神经系统与副交感神经系统的对比。我们生活在交感神经系统过度活跃的状态下,这基本上等同于持续感到威胁,对吧?心率加快,血压升高,更加专注,但随后你的肠道会遭受后果。当我们激活交感神经系统时,肠道就会被牺牲。
Original English
Steve: In what way? We we were talking a moment ago about the autonomic nervous system which is sympathetic versus parasympathetic. We live our lives on sympathetic overdrive which basically is the equivalent of constantly feeling threatened, right? Heart rate heart rate pumping, blood pressure up, more focused, but then you suffer the consequences within your gut. The gut gets sacrificed when we are activating our sympathetic nervous system.
Dr. Will: 我们做得不够,无法做相反的事情,那就是副交感神经系统,当我们放慢速度时会发生什么。交谈、牵手、拥抱、祈祷、写日记、冥想、桑拿,这些都是副交感神经的活动。
Original English
Dr. Will: We don't do enough to do the opposite which is the parasympathetic nervous system which is what happens with when we slow down conversations holding hands hugs prayer journaling meditation sauna that's parasympathetic.
Dr. Will: 好的。所以回到创伤问题,已经表明,这不仅是我自己必须学习的东西,而且我必须看到,我一直认为如果孩子足够小,他们就不会记住。我意识到实际上“身体会记住”这个想法说得太好了。它是如此真实。
Original English
Dr. Will: Okay. So to the trauma question, it's been shown that and this is something that I had to learn not only myself but I had to see that I always thought that kids if they were young enough they wouldn't remember. And what I've realized is actually this idea of like the body keeps the score is so well said. It's so true.
Steve: 身体会记住。你可能在两岁之前经历过创伤。你不可能记住。然而它会在成年后表现出来。这实际上已经在那些被收养的儿童中得到了证实,他们在生命的头两年不稳定。他们以后更容易遭受健康相关问题。
Original English
Steve: The body does keep the score. You can have trauma that occurs before the age of two. There's no way you remember that. And yet it will manifest later on in adults. And this has been shown actually in kids that are adopted and like have an unstable first two years of life. They are more likely to suffer with health related issues later on.
Dr. Will: 这个创伤问题,发生的情况是它重塑了大脑以及你的大脑如何运作。
Original English
Dr. Will: this this issue of trauma what happens is that it restructures the brain and how your brain functions
Steve: 它让你陷入那种战斗或逃跑的状态。
Original English
Steve: and it keeps you sort of trapped in that fight or flight state
Dr. Will: 让你陷入困境。是的。所以,我们大脑中有一个部分叫做杏仁核。
Original English
Dr. Will: keeps you trapped. Yeah. So, there's a part of our brain called the amygdala.
Steve: 杏仁核是当你去鬼屋时会被激活的部分,你知道,如果你被什么东西吓到了。
Original English
Steve: And the amygdala is what gets activated if you like go to a haunted house, you know, like if you get scared of something,
Dr. Will: 对吧?或者像,嗯,深夜,你听到灌木丛里有奇怪的声音,你不确定发生了什么。好的,那就是你的杏仁核被激活了。嗯,对于遭受创伤的人来说,问题是他们的杏仁核一直处于开启状态。所以,如果我的生活中发生了某种形式的创伤,那么我更有可能处于神经系统的交感神经状态,这会激活一种荷尔蒙,然后这种荷尔蒙会扰乱我的肠道蠕动以及我们谈论的所有其他事情,比如肠道屏障和肠道中的其他功能障碍。
Original English
Dr. Will: right? Or like uh it's the middle of the night and you hear something creepy in the bushes and you're not sure what's going on. Okay, so that's the activation of your amygdala. Well, the the issue for people that suffer from trauma is that they live with the amygdala perpetually turned on. So, if something's happened to me in my life that's caused some form of trauma, there's an increased probability that I'm going to be in a more sympathetic state in terms of my nervous system, which is going to activate a hormone, which is then going to disrupt my gut motility and all the other things we talked about, um, like the gut barrier and other dysfunction across the gut.
Steve: 那么这之间的联系是什么?是当我在那种压力状态下产生的那种荷尔蒙影响了我的免疫系统,然后对我的肠道产生了影响吗?
Original English
Steve: What is the link there? Is it is it the hormone that's produced when I'm in that stress state that is impacting my immune system which is then having the impact on my gut?
Dr. Will: 是的。所以这都是肠脑连接的表现。所以发生的情况是你的大脑有能力释放一种荷尔蒙,促肾上腺皮质激素释放激素(CRH)。
Original English
Dr. Will: Yes. So this is all a manifestation of the brain of the brain-gut connection. So the what's happening is that your brain has the ability to release a hormone corticotropin-releasing hormone (CRH).
Steve: CRH就是你的交感神经系统被激活开启了。
Original English
Steve: CRH and CRH is this that's effectively your sympathetic nervous system getting activated turned on.
Dr. Will: 嗯。
Original English
Dr. Will: Mhm.
Dr. Will: 对于经历过创伤的人来说,需要明确的是,并不是所有不好的事情都是创伤,对吧?有些不好的事情可能不是真正的创伤。创伤是那些让你难以忘怀的事情。它是当你遇到一些让你无法应对的事情时。
Original English
Dr. Will: In a person who's had trauma and to be clear like not everything that's bad is trauma, right? It's possible to have things that are bad that are not actual trauma. Trauma is the thing that sticks with you. It's it's when you have something occur that overwhelms your ability to cope with it.
Steve: 然后它会产生这种持久的影响。我正在想,当你说话时,我的一些朋友最近被诊断出了一些不好的疾病。有一个朋友被诊断出非常非常严重的疾病。然后我注意到,在诊断之后,他们出现了许多其他似乎不相关的健康问题。
Original English
Steve: And so and then it has this lasting effect. I was thinking as you're speaking about some of my friends that have had some bad diagnosis recently. Got a friend that got diagnosed with something very very serious. And what I then noticed is after that diagnosis, they had lots of other health related issues that seem to be unconnected.
Steve: 嗯。但医生将其与压力联系起来。
Original English
Steve: Mhm. But the doctors associated with stress.
Dr. Will: 是的。
Original English
Dr. Will: Yeah.
Steve: 也许那个坏消息的创伤导致了其他一系列下游问题。
Original English
Steve: And maybe the traumatic news of that one thing has caused this cascade of other issues downstream.
Dr. Will: 是的。100%。那都是肠脑轴的表现。所以肠脑轴是我们思考大脑如何与肠道连接以及它们如何相互沟通的方式。在这种情况下,大脑释放这种荷尔蒙,CRH,促肾上腺皮质激素释放激素,它对整个身体产生影响。它让他们紧张。
Original English
Dr. Will: Yeah. 100%. And and that's all a manifestation of the of the brain-gut axis. So the brain-gut axis is how we think about the brain being connected to our gut and how they're in communication with one another. And within that context, the brain releases this hormone, the CRH, corticotropin-releasing hormone that has an effect throughout the entire body. It puts them on edge.
Steve: 嗯。
Original English
Steve: Mhm.
Dr. Will: 后果是,那个CRH,它有点微妙,但让我澄清一下皮质醇。皮质醇是早晨的荷尔蒙。当你早上获得那个高峰时,它是完美的。它正是你的身体所需要的。你不需要的是,你不需要皮质醇在晚上10点、11点、午夜、凌晨1点仍然升高。皮质醇是“起床行动”的荷尔蒙。现在它正在扰乱你的睡眠。现在它实际上是你的昼夜节律的敌人。这就是这些人身上发生的事情,通过肠脑轴,他们正在激活皮质醇。然后皮质醇扰乱他们的肠道屏障并导致炎症。
Original English
Dr. Will: And the consequence is that that CRH that's like um so this is a bit nuanced but let me clarify something about cortisol. Cortisol is the morning hormone. When you get that spike in the
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