The Poo Doctor: This Gut Mistake Leads To Cancer. The Cheap Spice That Helps Repair A Damaged Gut!
发布时间 2026-01-01 08:00:06 来源
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. There are choices where 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. Really? Yes, but it's not getting enough attention. And we need to talk about that.
什么是粪便移植？就是把健康人的粪便移植给生病的人。例如，我有一个病人，因为服用了一种抗生素，导致肠道菌群被清除，这对她的生命造成了威胁。面临的选择是切除结肠或进行粪便移植。我给她进行了粪便移植。到第二天，感染的问题就完全消失了。这是一个很好的例子，说明我们的肠道微生物群有多么重要，因为我们粪便重量的60%是由微生物群组成的。真的？是的，但这个问题没有得到足够的重视，我们需要谈论这个问题。
World-renowned gastroenterologist Dr. Will Bolswitch 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.
世界知名的胃肠病专家威尔·博尔斯威奇博士回来了。这次，他分享了关于肠道微生物群的新信息，并指出排便可能是健康的关键。在听众中，有60%的人正在遭受某种肠道问题的困扰。这些问题往往以不明显的方式表现出来，比如腹胀、疲劳感增加、注意力难以集中、晚上睡不好觉、皮肤问题等。这些问题可能不易被察觉，但最终会导致其他健康相关的问题。
So I've got so many questions. Totally. What's the cause of plating? 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. Next, are there decisions that you make as a parent that will have a lasting impact on a dead-scuff function? Yeah, by three years of age, you are basically fully adult-sized in terms of your microbiome. But antibiotics, bottle feeding, and birth bicessarian 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.
所以我有很多问题。没错。腹胀的原因是什么？便秘是主要原因。但是那些容易腹胀的人，千万不要用吸管喝饮料、喝碳酸饮料或者嚼口香糖，这些只会让情况更糟。接下来，作为父母，你所做的哪些决定会对孩子的消化功能产生长期影响？是的，到三岁时，孩子的肠道微生物群基本上就相当于成人的规模。但抗生素、奶瓶喂养和剖腹产都对微生物群有影响，比如增加过敏、自身免疫和代谢疾病的风险。接下来我会解释原因。
And then can I repat the gut? Yeah, 100%. And every three to five 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. 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.
然后，我可以修复肠道吗？是的，完全可以。每隔三到五天，你就能建立一个新的肠壁。所以，我发现我们的饮食中缺少四样东西，还有一个可以优化我们肠道微生物群的日常习惯。当你做到这些时，你会更健康，活得更久，并且得病更少。现在我就带你一步步了解这些步骤。我经常在评论区看到消息，一些人没意识到自己还没有订阅。所以，如果你能帮个忙，确认一下自己是否订阅了这个频道，那我会非常感激。
It's the simple, it's the free thing to anybody that watches the show frequently can do to help us here to keep everything going in the show in the trajectory it's on. So please do double check if you subscribed. And thank you so much, because there's 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. Dr. Will, before we started recording, I asked you about this new book that you've written, and the way that you spoke about it was incredibly passionate. Why?
这是一件简单而免费的事情，任何经常观看我们节目的观众都可以通过订阅来帮助我们，让节目保持在现在的发展轨迹上。所以请务必确认一下您是否已经订阅。非常感谢，因为您以一种特别的方式成为了我们历史的一部分，与我们共同踏上这段旅程。我对此深表感谢。所以，再次感谢您。
在开始录音之前，我问了您关于您新书的问题，您谈论时充满了激情。为什么呢？
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 that we'll 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.
我真诚地相信，如果人们能采纳这本书中的建议并实际遵循它，尽管执行可能是最困难的部分，我完全确信这会改变你的生活。这是因为我们都在与同样的问题斗争。尽管表现形式各不相同，但根本问题是炎症，而这也是我们这个时代的重要健康问题，然而却没有得到足够的关注。这本书不仅仅是为了揭示这一点，更是为了为人们提供基于科学证据的工具，以便他们能成功并过上抗炎的生活。一旦做到这一点，你将会更健康、更长寿、患病更少。
Can you explain information to me a lot? I'm a 10-year-old. 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.
当然可以！让我用简单的中文来解释给你听。
Steve，你身体里有一个免疫系统，它就像一个保护盾，帮助你对抗细菌和病毒入侵。发炎就是当我们把这个免疫系统启动，让它开始工作的时候。有时候，发炎是好事，比如你肚子不舒服的时候，免疫系统可以帮助清除感染；或者当你受伤时，它帮助伤口愈合。在这些情况下，免疫系统对你很有帮助。
但是，现在我们面临的问题是，我们把免疫系统启动的次数太多了，而有时候其实并不需要启动它。结果就是，免疫系统一直在工作，每天24小时不停歇。这样会引发新的问题，比如新的健康状况或疾病。希望这样能帮你理解！
The way inflammation sounds like something has inflated or become swollen. Yeah. 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.
炎症听起来像是某物膨胀或肿胀。这确实是过程的一部分。例如，如果你伤到了膝盖，它会出现炎症，膝盖会变红、肿胀并且变得敏感，这些都是炎症的典型特征。但我们所讨论的是慢性低度炎症。这是一件棘手的事情，因为它可以在不知不觉中出现。你可能意识不到它的存在，医生也可能没发现。它以一些微妙的方式表现出来，比如说增加疲劳、注意力难以集中、晚上睡不好觉、早上醒来时感到疼痛，或者关节有些疼痛，或者有皮肤问题。这些问题我们可能都会有，但它们很多都是由炎症引起的。
And so it's important for people to be aware that, you know, you may, like, there's so many patients that go to their doctor, complaining of these symptoms. And the doctor is 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. And it can be like skinny and in shape and still have inflammation. A hundred percent. So it's not just a weight thing. No, it's not just a weight thing because 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.
因此，让人们意识到这一点非常重要。你知道，有很多病人去看医生，抱怨这些症状。而医生往往不太清楚应该如何处理。我认为是时候让我们开放思维，提高对这一问题的认识了，这个问题就是导致这些症状和许多健康状况的炎症。最终，我们需要一个计划来解决这个问题。即使是瘦削且貌似健康的人，也可能存在炎症这一百是没有问题的。所以，这不仅仅是体重的问题。因为如果你想一想，那些参加健美比赛的人从外表上看起来很棒，但是他们的身体可能已经出了问题。这些人往往会遭受消化健康方面的问题。我知道这一点，因为他们会向我求助，其中包括很多看起来很棒的知名人士。
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? Well, we have to start with acknowledging that the reason why this causes problems is that let's 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. Like if there's a war occurring, of course, there's decimation and damage that occurs, and it's brutal.
他们正在遭受肠道问题的困扰，因此最终有可能面临其他健康相关的问题。在这个炎症的问题上，意味着你的免疫系统一直处于活跃状态。为什么会一直活跃呢？又该如何让它停止呢？我们必须首先认识到，问题的根源在于：可以把免疫系统比作一支小型军队，他们的任务是保护你。当我们激活这支军队，让他们参与战斗时，你要预料到周围区域可能会受到损伤。就像发生战争一样，当然会造成破坏和损失，这是一种残酷的现象。
And the problem is that if we're activating the immune system, the areas that are surrounding it, that's your body. 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 yeast and archaea, which are these things that have been on the planet for four billion years, and possibly parasites.
问题在于，如果我们启动了免疫系统，那么周围的区域就是你的身体。而那些正在发生的大规模破坏和毁灭正是在你自己的组织和器官内。在研究这本书时，我花了三年时间来理解这个话题。我发现你的免疫系统和肠道之间有一种不可否认的联系。这种联系成为了理解为何会发生这种情况以及我们如何解决问题的关键因素。我们有肠道微生物群，它们生活在我们的结肠内，共有38万亿个微生物。这些微生物包括细菌、酵母、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。
And so in this entire community of microorganisms, they're there with the 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. It's gonna show me using this. Sure. This is the right part of the body. Now the large intestine is the home to your microbiome. So these 38 trillion microbes, this is their residence. This is their domain where they live. Now this entire system, which is on the order of 20 or 25 feet, so something on the range of 6 to 8 meters, 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.
在整个微生物群落中，它们的存在是有目的的，而这个目的是支持你和你的生理功能。它们的一项主要工作就是给你整个肠道的肠壁提供营养。现在就让我用这个来展示。这是身体的正确部位。大肠是你的微生物群的家园，这38万亿个微生物就住在这里，这是它们的领地。整个系统大约有20到25英尺长，约6到8米，这个系统覆盖着一层叫做上皮层的细胞，这就是你的肠道屏障。这个部分非常神奇，因为它就像城墙一样，能够阻挡有害物质的侵入。
But simultaneously needs to allow the good stuff in. And these cells, they turn over every three to five days. So it's a beautiful thing actually because every three to five 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 gonna 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 increase in intestinal permeability, but the common language is we could 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.
同时，它也需要允许好的东西进入。而这些细胞每三到五天就会更新。所以这实际上是一件很美妙的事情，因为每三到五天，你都有机会建立一个全新的肠道屏障。在这个系统中，生活在你的结肠内的微生物，它们的工作就是基本上修复和恢复肠道屏障。当肠道屏障完好无损时，它会完成其保护免疫系统的任务。而当肠道屏障开始破裂时，一些物质就可能悄悄通过，这就是我们所说的肠道通透性增加，通俗点说就是肠漏。免疫系统会看到并识别不应该存在的东西，然后免疫系统就会启动，想要排除这些东西。这基本上意味着它需要被激活并进行攻击，而这就是炎症。
So the breakdown of these three systems that start with the microbes, microbes are actually your first layer of defense. And then weeding 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.
这些系统的分解从微生物开始，微生物实际上是你的第一道防线。肠道屏障的崩溃最终会激活免疫系统，因为一些不应存在的物质悄悄穿过了屏障。但反过来也成立，这就是让我感到兴奋的机会所在。如果你能治愈肠道微生物群，那么它们就可以重新工作，完成修复和恢复肠道屏障的任务。当你建立一个强健的肠道屏障时，你基本上就保护了免疫系统。实际上，你会看到免疫系统变得更加冷静，能够更有效地完成它的工作。
Okay. And when we're eating lots of bad stuff and many of the things we're going to talk about today, a 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 ourselves to be damaged. What's the immune system over functioning causing? You're talking about the army analogy where there's an army in their war and some of them are damaging the surroundings. How is it damaging my surroundings, my immune system being on all the time? 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 is not just a couple of immune cells. They start to basically send out signals. And these signals, we call them cytokines.
好的。当我们吃很多不健康的食物时，我们今天要讨论的许多东西会导致肠道微生物的破坏。这种破坏使肠道屏障恶化，引发免疫系统反应，导致炎症。炎症进一步损害我们的身体。那么免疫系统过度反应会带来什么后果呢？你提到了一个军队的比喻，就像军队打仗时有些士兵会损坏周围环境。那么免疫系统持续运作是如何损害我身体的呢？实际上，这会引发一系列连锁反应，影响整个身体。这不仅是一两个免疫细胞的问题，它们基本上开始发送信号，我们称这些信号为细胞因子。
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. Information in the liver, we would call hepatitis, right?
你可以测量这些细胞因子，它们基本上是免疫细胞相互之间用来沟通的工具，以便呼救。当这些细胞因子被激活时，它们会开始传播，这会导致更多的免疫细胞释放出更多的细胞因子，从而引发一系列反应。这种反应在全身都会被感受到，它基本上会对各种组织造成损害。造成损害的具体表现取决于受影响的组织，例如，如果是肝脏受到影响，我们称之为肝炎。
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.
但与此同时，我们现在有大量证据表明大脑中的炎症，也就是我们所说的神经炎症，与情绪障碍有关。比如重度抑郁，大脑中的炎症也与像阿尔茨海默病、帕金森病这样的认知障碍有关。不过，这并不是说所有的疾病都与肠道微生物群有关或由其引起。要表达的是，我们需要理解我们的免疫系统与微生物群是密不可分的，两者之间有着强大的联系。并且有证据表明，我们可以对其进行调节。
So whether it be antibiotics, which decimate the gut or the alternative, the opposite would be a fecal transplant, which rapidly reinvigorates the gut and restores that gut architecture and ecosystem. What's a fecal transplant? So fecal transplant is where you take a healthy person's poop and you transfer it into the person who's sick. And where are they administering it? The way that I've always done the fecal transplant because I've done many throughout my career is during a colonoscopy. So if in theory, I wouldn't say colonoscopy.
无论是抗生素，它们会严重破坏肠道，还是相反的方法——粪便移植，后者可以快速恢复肠道活力并重建肠道结构和生态系统。那么，什么是粪便移植呢？粪便移植就是把健康人的粪便移入患病人的体内。那么这项操作是如何进行的呢？在我的职业生涯中，我多次进行粪便移植，通常是通过结肠镜检查进行的。因此，从理论上讲，我不会说是结肠镜检查。
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 missing the fecal transplant because they have this vicious infection called C-DeF. 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.
好的。结肠镜检查是一种医疗程序，通常情况下你会在睡眠状态中进行。在你睡着的时候，我会用一根和我的食指差不多粗细的长而柔韧的管子，可以完全控制地通过你的整个大肠，大约有五到六英尺长。我还可以进入小肠的最后一部分，我们称之为末端回肠，它位于右下腹部。
你需要进行粪便移植是因为患有一种叫做艰难梭菌（C-DeF）的严重感染。这种感染可能会危及生命，而抗生素治疗无效，因此需要一种替代方案。粪便移植的目的和目标是恢复肠道生态系统的平衡。
Yeah, you're putting good bacteria and not taking bad bacteria. Yeah, not taking old bacteria out, I guess. 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 do well in the space, the forest is washed and it's vibrant again.
是的，你在加入有益菌，而不是引入坏菌。我想，也不是在清除旧菌。你添加的是有益菌。当这样做时，你实际上是在一次性地重新平衡地引入数百种细菌。这就像是一个完整的生态系统移植。就好比我们面对一个状况不佳的森林，然后决定把整个亚马逊雨林移植到这里。现在有了适应这个环境的各种动物，森林就恢复了生机，变得繁茂起来。
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 chronically a great inflammation.
回到我们之前讨论的免疫系统的话题，免疫系统一直处于激活状态的原因是因为我的肠道受到了损伤。免疫系统实际上是在努力修复我的肠道。如果因为我的饮食习惯导致肠道长期处于这种受损状态，那么理论上我会一直处于炎症状态。我认为，现代社会的生活方式正在损害我们的肠道和微生物群，进而引发一系列问题，比如肠道屏障受损。最终，这种情况激活了我们的免疫系统，使其陷入长期的“战争”，导致长期的慢性炎症。
How is cancer associated with this? We talked about 130 different diseases. And in your book, I think it's around page 22, you mentioned, I think it's chemotherapy, while you're making an analogy between how chemotherapy kind of wipes everything out and how poorly kept gut is associated with an increase in cancer likelihoods. 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. 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.
癌症是如何与这个问题关联的呢？我们谈到了130种不同的疾病。在你的书中，大概在第22页，你提到了化疗，你用化疗清除一切的方式打了一个比喻，说明维护不好的肠道与癌症风险增加有关。让我们从这里开始。你的身体每秒会产生380万个细胞。免疫系统负有识别并消除问题细胞的责任。你不可能每秒创造380万个新细胞而其中不出现可能变成癌症的基因异常。因此，免疫系统的责任就是在你人生的每一天里都尽量做到完美，及时清除那些问题细胞，防止它们演变成更大的问题。
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 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. So it turns out that your immune cells have like basically a kill switch. If there was a problem, you could flip it off immediately. And that specific receptor is called PD1. And the tumors, they're so nasty because they produce this protein that basically activates the kill switch.
这是一项不可能的任务。在这段对话中，有一个完整的故事正在展开，讲述了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相联系。这一切真正开始于黑色素瘤的研究。我们早已在黑色素瘤的治疗中使用免疫调控方法。但是，改变的是开始使用被称为免疫疗法的方法，更具体地说，是使用免疫检查点抑制剂。事实证明，你的免疫细胞有一个类似“紧急停止开关”的东西，如果出现问题，可以立刻关闭。而这个特定的受体被称为PD1。而肿瘤非常狡猾，因为它们产生一种蛋白质，能够激活这一停止开关。
It turns off your immune system 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 like restore the microbiome with a fecal transplant?
它会关闭你的免疫系统。免疫检查点抑制剂的理念就是要把这个开关重新打开。通过打开开关，激活你的免疫系统，让它识别出癌症，然后采取行动。如果有人在接受免疫检查点抑制剂治疗之前使用了抗生素，他们的治疗效果往往不好。这就引发了一个问题：这可能是肠道微生物群的问题。所以研究人员想，如果抗生素有这种负面效果，那么如果我们反其道而行之，用粪便移植来恢复肠道微生物群，会发生什么？
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 with incredible results, like literally twice as many people were beating cancer relative to the expectation. The fascinating thing about that is that it's not just the 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 brain condition. 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.
他们的发现是令人难以置信的结果。目前有多项关于黑色素瘤的研究，其中的一些研究通过粪便移植的方法，将反应良好的病人的肠道菌群移植给即将接受治疗的患者。这样做取得了惊人的效果，比如战胜癌症的人数比预期多了一倍。令人着迷的是，这不仅仅是关于癌症的故事。现在在帕金森病的研究中也有类似发现。帕金森病是一种神经认知障碍，主要影响大脑。然而，研究表明帕金森病可能起始于肠道，实际上是一种肠脑连接的障碍，因为两个部分都涉及其中，而大脑症状只是更严重的一部分。
So for the people who are listening at home, we have a model out and I have just lifted their skull like a headable lector and exposed their brain tissue. And what we want to talk about is the brain gut connection connections between the brain and their intestines. And so we have classically thought of Parkinson's disease as being 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.
对于在家收听的观众来说，我们现在展示了一个模型，我刚刚像汉尼拔·莱克特那样揭开了他们的头骨，露出了他们的大脑组织。我们要讨论的是大脑与肠道的连接。我们传统上认为帕金森病是一个大脑健康问题，但我在这里告诉大家，这个问题是从肠道开始的，并涉及两者之间的连接。因为我见过的所有帕金森病患者都有便秘的情况。所有人都有。而有趣的是，现在已经发现便秘发生在帕金森病之前。但这并不意味着所有便秘的人都会得帕金森病，便秘的人有很多，但只有很小一部分最终会发展成帕金森病。
But it's important to understand that 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. They gave them a poo transplant. 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. Can the average person go and get one? I think we need to talk about that.
重要的是要明白，这种健康状况的表现其实是在进入大脑之前就从消化系统开始的。在这项研究中，他们对患有帕金森病的人进行了粪便移植。研究发现，一年后，这些人在运动问题方面有持久的持续改善。现在有其他针对帕金森病的研究表明，粪便移植不仅对大脑和帕金森症状有益，还能改善我之前提到的便秘问题。那么问题来了，这些粪便移植听起来很棒，普通人能去做吗？我认为我们需要谈谈这个问题。
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 over the monitor. A huge percentage of the population struggle with gut problems.
是的，我们需要谈谈这个问题。因为有一部Netflix的特别节目，让人觉得你应该在家里自己做这件事。千万不要这样做，请不要这样做。首先，我们需要研究并充分了解其中的风险。粪菌移植听起来好像是一个快速简单的解决方案，可以搞定你整个生活的问题。但这与通过生活方式和饮食工具来重建微生物群并获得长期有意义的健康影响是不同的。其实，很多人都在与肠胃问题作斗争。
We asked the direverseo 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 61% of people responding to those three words, bloating discomfort, a regular digestion. Then about 15% of people said that they have IBS, 14, 15% of people said, self-diagnosed 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? Because I'm trying to figure out how I help those 61% of people that.
我们询问了Direverseo的观众，其中大约60%以上的听众表示他们目前正遭遇某种肠胃问题，无论是腹胀、某种不适，或者只是一般的消化问题。在这些人中，61%提到了腹胀、不适和消化不规律的问题。大约有15%的人表示他们有肠易激综合征（IBS）；另外14%到15%的人自我诊断认为他们可能有肠易激综合征。我想问的是，他们提到的这些问题的根源是不是潜在非常不同？还是说主要就是一两个原因？因为我试图找出如何帮助那些61%的人。
Like me have eaten something sometimes and then feel shit 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. Yeah, I mean, this is the same issue that I struggle with. So I write a book with the goal of trying to help as many people as possible knowing that there's no one's has fits all. So ultimately it's about empowering people with the right information and helping them to identify. I 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.
有时候我吃了东西后感觉不太好，不太确定是什么原因，可能有点胀气，消化不太顺畅，但不一定知道是什么导致的，也不知道什么时候会出现。我自己也面临同样的问题。所以我写了一本书，目的是为了帮助尽可能多的人，虽然我知道没有一种方法适合所有人。最终，这本书是为了赋予人们正确的信息，帮助他们识别问题。我在书的作者说明部分写到，每个人都会读到同一本书，但这本书触动你的方式对你来说是独一无二的。你会在其中发现某些东西，会让你觉得这是属于你的时刻，是你的“顿悟时刻”。对于很多人来说，根据统计看平均的美国饮食习惯，这方面其实有很大的改善机会，因此我投入了大量的精力和关注，因为我知道数据所揭示的内容。
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. 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 like we need to shine a light on that. We'll do all of that. On this point about bloating discomfort regular digestion if I have one of those things does that theoretically mean that something is not right. Everyone gets bored of 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. But if it's prolonged 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.
我知道美国需要这方面的关注，但同时，我们也应当讨论一些其他的话题，比如我们现在的生活方式与祖父母辈小时候的生活方式有很大不同。对我来说，更重要的是帮助人们找到对他们来说最重要的那个因素。有些人听到这可能会发现，问题不在于饮食、睡眠或生物钟，而在于创伤，我认为我们需要关注这些问题。我们会做这些。在关于腹胀、不适、消化正常的问题上，如果我有其中之一，理论上这是否意味着有什么不对劲？每个人偶尔都会感到无聊，所以我认为说你永远不应该有任何不适症状是不公平的。但是，如果这些症状持续存在，或者成为慢性健康问题，如果你每天早晨醒来时心想“希望今天会是个好日子，希望我不必处理那个具体的问题”，那么这就需要引起注意。
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 can't tell you that without knowing more about you. What about this issue of people getting gassy like farting a lot. Yeah. Is that typically associated with one particular gut issue or is that again could that be a plethora of issues? So it could be a plethora of issues. 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.
你有一个我们已经知道的问题，然后我们必须解决这个问题。我认为，我们需要在某种程度上采取个性化的方式，但我们可以使用的工具是相同的，所以关键在于我们如何去实施。把问题摆到台面上，这里有你的选择。你选择最适合你的选项，寻找属于你的机会。在不了解你更多的情况下，我无法给出具体建议。
关于这个人们容易胀气的问题，比如经常放屁。是的，这通常是与某种特定的肠道问题有关，还是可能与多种问题有关？它可能与多种问题有关。这是一个常见的问题。如果要我说出一个首要问题的话，那肯定是便秘。 绝对是 100%。现在有很多正在听的人其实有便秘问题，但他们自己并不知道，因为他们每天都排便，他们认为排便的频率就是定义便秘的标准，但事实并非如此。
So constipation is what happens when you're not adequately emptying your bottles and that could be a frequency problem but it could also be that it's a partial poop. Oh okay because I thought constipation was if you just haven't been you can't go you don't get to the toilet and nothing comes out. 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 right. So frequency is not that fuel and end all. It's part of the it's part of the equation right but there's also people who they poop and 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.
便秘指的是你的排便不够彻底，这可能是排便频率的问题，但也可能是每次排便不完全。哦，明白，因为我原以为便秘就是当你完全排不出来，去了厕所也没有结果的情况。你没必要误会，如果你一周没排便，那显然是便秘，这不用多说。但有些人隔天排便一次，那是他们的正常状态，他们感觉良好，没有肠胃不适，也没有便秘问题。这样没问题。排便的频率不是唯一的标准，它只是问题的一部分。同样还有些人，早上上厕所会很费劲，结果却不理想，他们必须非常努力才能排出一点点，之后还是感觉憋着，可能45分钟后又要去一趟。这就是另一个情况。希望你能理解，我很乐于谈论这些，因为这是我的工作。
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 bottles right and 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. Where is the gas coming from and that's why why do people you eat something and then you thought what's going on. 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.
好的，那不是一次新的排便。你可能是在部分排便，可能只排出了20%或25% ，所以一天之中可能会排便三四次，但仍然没有完全排空肠道。这就是一个可能会感到腹胀和便秘却没有意识到的人，因为他们会想：“医生，我一天排便三次，气体从哪里来的？”这就是为什么有些人吃完东西会有肠胃胀气现象。气体是跟随粪便一起的，或许大家早上起来会发现自己一直在放屁，直到进行早上的排便为止。
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 really? Yes. When you say microbial you mean like the bacteria. The bacteria 60% of it. Let me give you an example. If I took your drink and I added some soluble fiber which is pre-botic into your drink.
然后，当你早上排便顺畅健康，你就会感到很踏实，不再放屁，对吧，气体是随着大便一起排出的。之所以会这样，首先是因为你的大便不仅仅是你食物的残渣。实际上，大便的主要成分是你的微生物群。你的粪便重量的60%是微生物。真的吗？是的。当你说微生物时，是指像细菌这样的东西。细菌占了60%。让我给你举个例子。假如我在你的饮料中加入一些可溶性纤维素，这是一种益生元。
Yeah. 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 multiply 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 the grow and you have a big bowel movement. So if that was my, if that was my stool my poop I'm holding a chocolate bar here. 60% of that would be the microbes. 60% of that would be the microbes.
好的。这段话的意思是：是的，没有粗糙或难以下咽的东西，你甚至不会注意到它的存在，而因为我刚才做的事情，你明天会有一次更大更健康的排便。为什么呢？因为我给你的微生物提供了食物，它们变得更强壮，然后繁殖。因为它们繁殖了，所以你会有更大的排便。这就是它的工作原理。当然，不要误会，如果你吃一份沙拉，你也会有一次更大的排便，但这很大程度上是由于沙拉中的纤维在喂养这些微生物，它们繁殖生长，你就会有一次大的排便。如果这是我的大便，我拿的这个巧克力棒，其中60%是微生物。
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. Okay. So anything they come in the contact with they're just going to start working out. So it's not just like a fiber thing anything they come in the 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. When people eat dairy and things like that and I think some people that have gluten they often tend to get a little bit gassy.
好的。对于那个人来说，当排泄物堵在肠道中不能移动时，肠道里的微生物就有充足的时间来发酵并产生气体。因此，任何它们接触到的东西，它们都会开始分解。所以，不仅仅是纤维，任何它们接触到的东西，比如蛋白质，它们都会发酵并产生气体。这就是为什么便秘与胀气和腹胀紧密相关的重要原因之一。当人们吃乳制品等食物时，或者对于一些对麸质敏感的人来说，他们常常会变得有些胀气。
Yeah. Is that constipation? 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. What's motility? 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.
好的。这是便秘吗? 气体和腹胀不仅仅是便秘的问题。我认为便秘是这一问题的首要原因，但也有其他许多可能的原因。第一个可能的原因是肠道蠕动的问题造成的便秘。那什么是蠕动呢？蠕动是指肠道的移动方式。如果肠道移动得太快且节奏不稳，就会导致腹泻；如果肠道移动得过慢并且无力，就会导致便秘。我们希望肠道的运动是有节奏的，因为当肠道像心脏一样有节奏地运动时，就是它们工作得最好的时候。
So an erhythm 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 microbombs. If you have a microbombs that's damaged and struggling it's not going to be able to do its job the way it's supposed to.
所以，"erhythm" 基本上是指每天规律且稳定的排便。这是我们理想的状态，其实这也涉及到我们稍后可以讨论的整个昼夜节律的一部分。作为你昼夜节律的一部分，理想的情况是早晨排便顺畅。肠道蠕动是导致胀气和腹部胀痛的原因之一。另一个原因是肠道菌群。如果你的肠道菌群受损并且工作不顺利，它将无法正常发挥作用。
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 in the 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.
这段话的大意是：我们饮食中的纤维需要被处理和分解，因为我们人体没有可以消化纤维的酶。纤维通过肠道时，会接触到体内的微生物，而这些微生物拥有我们人类所没有的6万种酶。它们合作把纤维转化为短链脂肪酸，这是理想的工作方式。然而，当你的肠道不健康时，微生物也会变得虚弱，而你仍指望它们工作，但它们无法胜任，于是就会导致消化不良，如胀气和腹胀。
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 can 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 pre-botic 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.
第三个因素可能是你的饮食。你刚提到乳制品，它们含有乳糖，而乳糖很容易被发酵，从而产生气体。你还提到麸质。麸质是一种蛋白质，那么它能被发酵吗？技术上是可以的，但实际上发生的不是这个。真正的问题在于，含有麸质的食物，比如小麦、大麦和黑麦，还含有一种叫做果聚糖的碳水化合物。果聚糖对我们的微生物很有好处，它们是益生元。但如果你摄入了非常大量的果聚糖，并且身体不习惯吃这些食物，就可能导致肠胃产气和腹胀。
These days when I was younger if I had if I had pasta as fine if I have pasta these days I'm going to feel it for the next like two two days. Really? Yeah I don't know I didn't even know what's going on but then other people can eat pasta as much as they want it seems. At a curiosity can you go to Italy and eat pasta and be okay or no? Same thing. I haven't really not really tried. And it totally I think when I remove when I have like non gluten bread or non gluten pasta I think I feel much better 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.
这些天，我注意到年轻时吃意大利面还没事，而现在一吃意大利面，可能接下来的两天都会有感觉。真的？是的，我也不知道怎么回事，但其他人似乎可以随便吃意大利面。出于好奇，你去意大利吃意大利面会没事吗？还是一样的。我还真的没尝试过。不过，当我改吃无麸质面包或无麸质意大利面时，感觉会好很多。但我也知道，根据和你这样的人聊天，实际上只有很小一部分人真正对麸质不耐受，但我们都觉得自己多少有点不耐受。
I think it's was the numbers is it like 20% of people think they are or something? So like here in Los Angeles it's like probably 80% of people think that well like almost everyone's gluten free. Yeah right. Which they don't need to be and actually you can cause problems. It can it can cause problems to be gluten free unless you know what adaptations to make.
我想它和数字有关，大概是20%的人认为自己需要这样做？所以在洛杉矶可能有80%的人认为几乎每个人都是无麸质饮食。是的，没错。但实际上他们并不需要这样做，而且如果你不知道如何正确调整，无麸质饮食实际上可能会引发问题。
So what do you when you ask that question about Italy what you getting at? 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 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 field of wheat you harvest okay here are your choices Steve you can wait a couple weeks and let it dry out naturally in the air and store it somewhere or you can spray it with this chemical and it will be dry by tomorrow and then you can ship it up.
那么，当你问关于意大利的问题时，你想了解什么呢？在美国，有一个关于小麦加工的问题，就是他们允许在小麦上喷洒草甘膦，也就是一种叫做“农达”的除草剂。他们这样做主要是为了尽快干燥小麦。想象一下自己是一个农民，你有一片小麦田，可以进行收割。选择有两个，史蒂夫：你可以等几个星期，让小麦自然风干然后储存，或者你可以喷洒这种化学物质，让它在明天之前就干燥，这样你就可以快速运输了。
Yeah 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 Shikamat 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 you know what do you think happens when it comes in the contact with them.
对，那问题是除草剂草甘膦不会标在标签上，你永远不知道它是否被喷洒，除非你买有机产品。如果你买的是有机产品，根据定义他们是不允许喷洒草甘膦的。你永远不会知道它是否存在，草甘膦的问题在于它被批准用于我们的食品系统，前提是认为它是安全的。草甘膦的作用机制是关闭一种叫做莽草酸途径的东西，这会杀死杂草或植物。我们有一个解决办法，这与氨基酸有关，人类可以通过这种方法合成氨基酸，但植物不能，因此植物会死去而我们不会。但问题在于，生活在我们大肠中的微生物没有这样的解决办法，所以那微量的草甘膦，你可能会觉得对我们这样的大人类来说那么小，你觉得它接触到这些微生物时会发生什么呢？
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 the bad bacteria 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 and you think it's that glyphosate yeah they don't do that there.
我们知道草甘膦会干扰微生物群落，它会消耗有益细菌，而那些能够最好地耐受它的细菌往往是引发炎症的有害细菌。这意味着细菌之间的平衡被打破了。虽然这听起来像个小问题，但我听很多人，比如史蒂夫，说他们在美国吃小麦会有问题，但去意大利就没事。你可能会想，这是因为草甘膦的原因，对，意大利不使用这种化学品。
So if I tried I'll try organic pasta tonight and maybe that'll be better yes and then like the alternative choice is how do you do a bread are you okay not all bread my generally I stay away from bread okay do you ever eat sourdough yeah do you do okay with sourdough yeah there we go so here's the here's the second part of this equation put the glyphosate put this aside for a moment let's talk about the fruit hands that we're talking about a moment ago when you ferment your wheat when you ferment your dough you actually reduce the fruit tan content.
所以，如果我尝试一下，今晚试试有机意大利面，可能会更好。然后，另一种选择是，面包你习惯怎么做？你还好吗？我通常尽量不吃面包。那你吃过酸面包吗？你吃酸面包感觉好吗？好吧，这就是第二部分的问题了，先把草甘膦放在一边，咱们来谈谈刚才提到的果糖糖苷。当你发酵小麦或面团时，实际上会减少果糖糖苷的含量。
What's fruit tan so these are the the long chain carbohydrates that exist in wheat barley and rice so if it contains gluten it also contains these fruit hands like gluten is not the only thing in wheat right and these fruit hands 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 fruit tan content and actually then you can tolerate it oh okay so you think it might be the fruit tan in the bread that. I have an issue with and sourdough doesn't have fruit tan in it yeah there was there was a study that was in gastronomy of a few years gastronomy 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 contains a very large concentration of gluten and then the third one contained the fruit hands 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 the 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 fruit tan containing bar they were triggered so basically what the 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 fruit tan intolerance these are people who are attending the struggle with these particular parts of that food.
水果糖是什么呢？这些是存在于小麦、大麦和大米中的长链碳水化合物。所以如果它含有麸质，它也会含有这些水果糖。小麦中不仅仅只有麸质。水果糖对你有好处，对你的微生物群也有益，但是如果某人的肠道有些受损，他们可能就会在加工和消化时遇到困难。这也许能解释为什么有些人吃含有麸质的小麦食物会有不适反应，但吃酸面包时却没问题。因为在发酵过程中，酸面包的水果糖含量会降低，从而更容易消化。哦，所以你认为我可能对面包中的水果糖有问题，而酸面包中几乎没有水果糖？
几年前在《胃肠学》—这是我领域中顶级的期刊—上有一项研究，他们让人们带回家一些早餐棒，不是巧克力棒，但也差不多。他们给了人们三种，其中一种是安慰剂棒，没有特别添加成分；另一种含有大量麸质；第三种包含水果糖。我们以安慰剂棒作为标准进行比较。当人们吃含麸质的棒时（他们并没有乳糜泻，但自认为有麸质问题，就像你刚提到的20%的人一样），症状比吃安慰剂棒时还要轻。换句话说，问题并不是麸质。但当他们吃含水果糖的棒时，症状就出现了。基本上，这表明我们将“麸质不耐受”这个概念搞错了，它其实不是麸质不耐受，而是水果糖不耐受。这些人主要是在面对食物中的这些特定成分时遇到了困难。
What foods contain fructane so we barley and rye okay and different there's there's many different types of fruit tans 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 terrible right that's a that can be a fruit tan issue tough amaranth sorghum keenwa these are these are whole grains that don't contain gluten and they also don't contain fructans.
以下是翻译后的内容：
哪些食物含有果聚糖呢？大麦和黑麦中就包含果聚糖，不过它们有很多不同的种类，所以你可能并不是对所有的果聚糖都有反应，只是对其中的一些有反应。像大蒜和洋葱是经典的例子，所以有些人会说自己吃了大蒜后感觉不舒服，那可能就是果聚糖的问题。此外，苋菜、高粱、藜麦这些全谷物不含麸质，也不含果聚糖。
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 his sort of irritated that gut how long does it take to restore and for those microbes to go back 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 this dysbiosis dysbiosis is the word that we use for a damaged gut is it possible to reverse that it's possible to put them into remission so deeply that they don't have a flare is that what the flare it looks like on this little model that I have in front of me 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 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.
将英文翻译成中文并简化，使其更易于阅读：
要修复受损的肠道需要多长时间？这个问题本身很广泛，但一般来说，对于普通人来说，如果肠道受到了刺激，恢复和微生物回归正常大概需要多长时间？这实际上取决于起点，比如说损害的程度有多深，多严重。对于患有溃疡性结肠炎或克罗恩病的人来说，这些是炎症性肠病的形式，他们的肠道菌群失调最为严重。是否有可能逆转这种情况？可以将其缓解到患者不再发作的程度。这里有一个模型展示了大肠，模型中一个区域显得很生疏、溃烂，看上去在流血。如果碰到那个区域，会流出血来，这就像是一个非常脆弱、敏感的区域。如果你有兴趣，可以到YouTube上观看相关的演示。
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 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 why and because it's decided that it's the enemy.
现在关于这些炎症性肠病，史蒂夫，我有一个关于这个主题的有趣研究。在我看来，它们是典型的肠道炎症健康问题。这个问题的发生是因为免疫系统在攻击肠道的微生物组。所以，严格来说，这并不是自身免疫疾病，因为自身免疫是指免疫系统攻击你自己的身体。而在这里，免疫系统并没有攻击你的肠道，而是攻击并排斥你的微生物组。由于这种情况，你的肠道夹在中间。也就是说，免疫系统正在攻击位于大肠管道内的微生物组，并试图消灭它。为什么呢？因为免疫系统认为它是敌人。
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.
免疫系统感到困惑，因为我们出生时几乎没有微生物群，这时的状态是我们最接近于没有任何微生物的时期。在生命的最初三年里，微生物群通过我们的生活经历逐渐建立。到三岁时，微生物群基本上达到了类似成年人的规模。在这段时间里，免疫系统与这些微生物共同学习和成长，两者之间不可否认地存在着一种相互作用。如果在这前三年中，微生物群保持健康，就会导致免疫系统更加健康。
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 do you think is for someone that has like irritable bowel syndrome all crone's disease and they all 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 so lifestyle change or or is it lots of things what's the number one perpetrator okay there's clearly a genetic component okay so we have to we have to be upfront about that but like these are these are things that are not necessary within a person's control entirely because I mean there's no evolutionary reason why this would happen like there's no evolutionary reason why you have severe gut digestion problems no it's not too there's no advantage to it you know.
所以，这里发生了什么呢？免疫系统本应承认你的微生物群是友好的，但它没有这么做，而是决定将你的微生物群视作敌人并进行攻击。那么，对于患有肠易激综合症或克罗恩病的人来说，如果他们在小肠或大肠中有很大的溃疡，这是否通常与他们的生活方式有关？换句话说，生活方式改变能够改善这种情况吗？或者说是由多种因素导致的？这里面显然存在一个遗传因素，这是我们必须明确承认的。但这些问题通常并不完全在个人的控制之下，因为没有进化上的理由说明为何会发生这样的情况。比如说，没有进化上的优势可以解释为什么人会出现严重的肠道消化问题。
And and these things that uh 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 crone's disease and all sort of clitus 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 all sort of clitus and crone's disease cases were increasing by up to 55% and you can get that any age you get that at any age yeah even if I'm healthy right now I could do a set of things that would give me this.
这些事情在许多年前是相当罕见的，实际上在今天的一些第三世界国家中，炎症性肠病并不多见，克罗恩病和溃疡性结肠炎也不常见。如果你去非洲，会发现这些病非常少见。然而，随着国家工业化的进程，这些疾病的发病例增加。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大约55%。这些疾病可以在任何年龄发生，即使我现在很健康，如果做了一些促发因素的事情，也可能得这些病。
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 oh gosh 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 activate in 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.
实际上，回到我们之前关于抗生素的讨论，如果你服用抗生素，那么你在接下来一年内患炎症性肠病的风险就会翻倍。天哪！这就像是一旦抗生素破坏了肠道，没有什么能比它更快地摧毁肠道。抗生素会使肠道的多样性降低，破坏肠道屏障，使用期间会让肠道屏障的功能下降50%，还会激活免疫系统。这点清楚地说明了，如果你服用抗生素，这些炎症性健康问题的风险确实会大幅增加，并且这种现象在成年人和孩子身上都能看到。
You had a patient at view who was called Michelle who took antibiotics and had a life-threatening swelling of her colon this is this is the colon right uh she's with the colonist so the colon is the origin testant okay fun you yeah and so she took an antibiotic and had a life-threatening swelling if they have had a launching testing so she took it in antibiotics she took clindamycin which is a classic skin antibiotic okay 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.
您观察到一位名叫Michelle的病人，她服用了抗生素，导致结肠出现危及生命的肿胀。是的，结肠是这个部位。她服用了抗生素，具体是克林霉素，这是一种常用于皮肤的抗生素。问题在于，克林霉素会严重破坏肠道中的正常菌群，这时有一种叫做艰难梭菌（c-diff）的致病菌可能会大量繁殖，导致结肠感染，并引起整个结肠的炎症。
So this patient Michelle what happened 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 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 um 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 paratinitis right or you can 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's maxed out on antibiotics.
这位患者名叫Michelle，事情是这样的：当时我在值班，收到一条信息，让我马上去一个房间，因为患者病得很严重。她刚从外院转来，我当时在写一份会诊报告，但立刻停下，跑到病房。她正捂着肚子，痛苦地呻吟着，完全不知道自己身在何处。她满头大汗，脸色苍白，生命体征全都不正常——心跳很快，呼吸也很急促。我做了一个小测试，就是轻轻碰了一下她的床，如果一个人有严重的肠道炎症，碰一下床他们就会跳起来，因为这意味着腹膜炎或称为急腹症。结果我轻轻碰了一下床，她就痛得尖叫起来，捂着肚子，完全不清楚自己在哪里或发生了什么，整个人处于极度的谵妄状态，并且她已经用到了最大剂量的抗生素。
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 so I take her down to the operating room and I actually um 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 a scope being achieved 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 five millimeters six millimeters across it's more gentle and it just makes it harder to do but I basically passed the scope through her rectum and all the way through her intestines to get it over here on the right side.
我们的选择是：要么立即为她进行手术切除结肠，要么给她进行粪便移植，希望能保住她的结肠。所以，我带她去了手术室。老实说，我用了一个特殊的技术，这不是我通常会采用的方法，因为她的炎症特别严重。为了通过内窥镜检查，我使用了一种比较小的内窥镜，这是一个更温和的选择。通常的结肠镜就像我的食指那么粗，大约一厘米宽。但是这次我用了一个更小的内窥镜，大约五到六毫米宽。虽然这样做更难，但更温和。我通过她的直肠，将内窥镜一路经过她的肠道，到达右侧。
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 two 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 information washed away.
所以，基本上我的操作就是通过她的整个大肠，然后在那位置给她进行粪便移植。令人惊讶的是，第一，手术进行得非常顺利，到第二天她已经恢复得像个正常人了，能够平躺在床上，与人交谈。手术后的两天，她的状态恢复得太好了，我们可以让她回家。她所面临的严重感染问题，通过恢复肠道微生物群得以解决。恢复微生物群后，艰难梭菌（C. diff）被抑制，免疫系统恢复平衡，各种炎症迹象也随之消退。
So do you have like a fridge full of these fecal matters that you can just tap into and when you need it no but there is a company in Massachusetts that does 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.
所以你有没有一个冰箱装满粪便，可以随时取用呢？实际上并没有，但在马萨诸塞州有一家公司提供这样的服务，大多数医院会使用他们的产品，将其送达医院。不过这方面有一个有趣的新进展：药企首次开始研究如何利用并非直接通过粪便移植的方法操控肠道微生物群的方法。他们目前正在开发一种重建肠道并在脆弱时期保护肠道的新技术。这就是即将出现的新趋势。
You must hear about so many different types of diets and juice cleanses and whatever else that influences and podgusters 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 are absolutely despised because they are misinforming people about how to create healthy gut well I think the thing from my perspective is that trends fluctuate hard yeah right in 2020 it was like the vegan diet wasn't in 2023 it was the carnivore diet you couldn't have more diametrically opposed diets right and and so the problem is that to the person who's at home and they're trying to get this figured out is 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 five 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.
你一定听说过很多不同类型的饮食和果蔬汁清理法，还有其他影响健康的方法，这些通常由影响者和播客推广，但是你特别讨厌，因为你对肠道健康的后果有更深入的理解。那么有哪些主要的饮食或潮流是你特别厌恶的，因为它们误导了人们如何建立健康的肠道呢？我的观点是，潮流变化得非常快。举个例子，在2020年，流行的是素食饮食，而到了2023年，流行的是纯肉饮食。这两种饮食完全对立，对吧？这样的问题是，普通人在家裡想要弄清楚这些趋势的时候，很容易被当前流行的东西吸引，因为这些正是你在社交媒体上经常看到的内容。然而，从我的角度来看，科学在过去五年中并没有发生那么大的变化。我们确实在不断研究进步，但这些只是我们理解上的小变化，而不是剧烈的转变。
So nor has your biology you have the same biology five years ago so this entire concept of like whipping people over the places total bullshit 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 only diet is in balance 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 they 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.
你的生物学特性其实也没有改变，你五年前的生物状态和现在是一样的。所以，我认为对于一些所谓的饮食模式极端化的宣传，完全是胡扯。我想先说，任何敢于为了健康改变饮食的人，我都觉得非常了不起。因为无论你选择什么饮食方式，你都是在努力搞清楚什么对你最好。我只希望人们能变得更好。然而，问题在于，现在有很多极端的饮食建议，左右两派都有，我完全不相信100%吃肉或内脏的饮食是平衡的，也不是长寿的最佳方案。反过来说，我也从来不会支持或推荐仅吃水果的饮食，这完全是疯狂的。我们在干什么呢？我认为，越是极端的饮食，越是偏离了简单的真理，那就是：均衡摄入全面的天然食物。
What about these like juice diets and stuff like that people do people do like a seven day juice diet or more to diet whatever 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 how long does it take to both kill and then create new gut microbes 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 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 three to five days you build a new gut barrier so there's an amazing opportunity that we have to actually see some quick health effects.
关于果汁饮食这类的事情，比如很多人会进行七天或更长时间的果汁饮食来减肥或者改善健康。如果你有肠道问题，去掉那些刺激肠道的东西，简化饮食，可能会让你暂时感觉好一些，并认为自己做了一些有益健康的事情。但总体来说，这样做并没有太大实际效果。至于肠道微生物的更新速度，说起来一个好消息是你的肠道非常有弹性。你今天做出的饮食选择会在明天反映在你的肠道菌群上。这些微生物的“超能力”在于它们繁殖得非常快——繁殖即生育后代，据估计，可能快到每20分钟就能产生新一代。因此，如果我们支持它们所需的营养，健康的变化可以很快出现。你知道吗？每三到五天就会形成一个新的肠道屏障，所以我们有一个很好的机会能看到快速的健康改善效果。
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 I don't think oh god that's going to be awful for the gut 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 so it's I find the interesting that actually like TikTok some of the trends that have come more recently are actually on point so which feels great because I love it when like people are getting excited about stuff that's good like the fiber maxing trend I'm not ahead about one so fiber maxing it feels like 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 TikTok with this fiber maxing trend where people are basically trying to increase their fiber profoundly.
有哪些健康或饮食方面的误区是您特别担心的，人们正在追随或相信这些误区？尤其是，您是否看到某些东西存在问题，认为“哦，天哪，这对肠胃会很糟糕”？坦白说，这不是我特别关注的事情，因为我并没有使用TikTok。不过，我觉得有趣的是，最近在TikTok上出现的一些趋势实际上是有道理的，这让我感到很高兴，因为我喜欢看到人们对有益的事物感到兴奋。比如"fiber maxing"这一趋势，我对此印象深刻。人们在很长一段时间内都没有太多关注纤维，但现在他们开始意识到纤维带来的好处。在TikTok上，这种趋势充分体现出来，很多人都在努力大幅增加他们的纤维摄入量。
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 because if they don't feel well they're gonna bail and then they're gonna think well fiber's not for me and what was this trend it was people trying to just get above that up and above that daily recommended dose of fiber yes I'm eating high fiber foods 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 the ones that got my carbine massive because fiber is feeding the good bacteria fiber is the principal food for the good bacteria and it is the precursor to short-chain fatty acids.
所以问题在于，你需要让身体逐渐适应这种方式。我认为想要提高纤维摄入量是个好主意，但在执行上，我希望人们能用一种让自己感觉舒服的方式来进行。因为如果他们感受不好，他们就可能会放弃，进而认为“纤维不适合我”，把这当成只是一种潮流。事实上，人们是想要达到并超过每日推荐的纤维摄入量。是的，我确实在吃高纤维食物。我们必须承认，目前美国有95%的人和英国有90%的人纤维摄入不足。那么这对我们的身体有着怎样的影响呢？影响是巨大的，因为纤维是益生菌的主要食物，也是短链脂肪酸的前体。
So the short-chain fatty acids are what we create when fiber comes in the contact with microbes short-chain fatty acids are the thing we create when fiber comes in contact with the gut microbiome yes bacteria okay and the short-chain fatty acids are really good they're so good in fact of all 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 and these have produced these three things you just named a produced when fiber comes in contact with the gut microbiome.
所以，短链脂肪酸是当膳食纤维与微生物接触时产生的。具体来说，当纤维与肠道微生物群接触时，就会产生短链脂肪酸，即细菌与纤维的作用。短链脂肪酸非常有益，事实上，在我所研究和学习的所有物质中，它们是我见过的最具抗炎作用的物质。主要有三种短链脂肪酸：乙酸、丙酸和丁酸，它们在体内有不同的作用。它们不仅对肠道中的微生物有影响，还能对肠道屏障和免疫系统产生作用。这三种物质就是当纤维与肠道微生物群接触时产生的。
Yeah so like if you were sterile if you didn't have if you were born without a microbiome like you ever hear about bubble boy oh yeah there's a film what TV show is no 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 them they isolated him thinking 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 because you never have bacteria because you don't have bacteria okay so but we have the opposite of that problem which is that we have bacteria but we don't feed them.
好吧，所以如果你是无菌的，比如说你天生没有微生物群，就像你听说过“泡泡男孩”吗？哦，对，有一部电影，或者是电视节目？不，其实是70年代的一部纪录片。这个孩子得了一种罕见的遗传性免疫疾病，所以他的家人为了保护他，把他隔离开来，认为如果没有坏东西进来，他就会没事。所以他生活在一个无菌的泡泡里。理论上讲，如果你是无菌的，你就永远不会有这些短链脂肪酸的好处，因为你没有细菌。但是，我们面临的是相反的问题，就是我们有细菌，但我们没有给它们提供食物。
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 and these short chain fatty acids so I've got my gut microbiome in my gut here I put fiber in there in the form of what foods are the best foods for fiber okay so what we have here is an entire array of choices 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 okay you want me to give it to you it's not too married isn't no but the turmeric product probably doesn't have very much.
我们没有给他们纤维，无法凭空创造东西，所以你必须通过提供纤维来让他们产生短链脂肪酸。这些短链脂肪酸是在我们的肠道微生物群中形成的。为了帮助这些微生物产生短链脂肪酸，我们需要摄入纤维，那么哪些食物富含纤维呢？实际上，我们有很多选择，而令人欣喜的是，在这两盘食物中，我只有一样可以指出来不含纤维。你能猜到是什么吗？我猜你能行，还是让我直接告诉你吧，不是姜黄，不过姜黄产品可能纤维不多。
Okay no it's the oil because the issue is that this is a hundred percent fat so you by definition cannot have any fiber inside of an oil okay all right it's like sunflower oil so yeah whatever whatever type now you could have polyphenols like extra virgin olive oil has polyphenols that are really good for the microbiome extra virgin olive oils 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 become complicated fruits vegetables whole grains seeds nuts in my gummies they all have fiber meat anything that's not a plant does not have fiber okay so if it goes on the ground as fiber so if it comes if it comes from a plant it has fiber.
好的，不是的，问题在于油，因为油是百分之百的脂肪，所以从定义上来说，油中不能含有任何纤维。比如葵花籽油，不管是哪种油，都不会有纤维。然而，像特级初榨橄榄油这样富含多酚的油非常有益于肠道微生物群。特级初榨橄榄油对肠道微生物群非常好，但它并不含纤维。其他东西都含有纤维。我们有各种不同的植物性食物，优点是它不复杂：水果、蔬菜、全谷物、种子、坚果，这些食物中都含有纤维。而肉类和任何非植物来源的食物都没有纤维。也就是说，只要是植物生长出来的就有纤维，而植物来源的食物就含有纤维。
And then it cools by the way the mushrooms so the mushrooms are technically fungi 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 the 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 in the short-chain fatty acids they produce more good bacteria but also they help my immune system calm down 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 in Michelle.
然后，再从蘑菇开始降温。蘑菇从技术上讲是菌类，但它们与植物性食物具有许多相同的特性，比如纤维和多酚。这些都是我们希望纳入健康饮食的成分。所以，当我吃这些高纤维食物时，它们进入我的肠道，肠道的微生物群会产生一种叫做短链脂肪酸的物质。这些短链脂肪酸不仅能促生有益菌，还能帮助我的免疫系统平静下来。是的，如果你回想一下，我们一开始提到的模型是，你的免疫系统实际上可以被称为防御系统，因为你的肠道微生物是第一道防线。这一点正是被米歇尔服用的抗生素破坏掉的。
The second layer of defense is your gut barrier which is the lining of your gut that protects the immune system 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 in the contact with your microbes right here in the large intestine specifically the right colon is the classic spot and 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.
第二道防线是你的肠道屏障，也就是保护免疫系统的肠道内壁。第三道防线就是实际的免疫系统了，不过我们更希望前两道防线能够解决问题，而不需要动用到免疫系统。好消息是，当你摄入高纤维食物时，这些食物会在大肠中，尤其是在右侧结肠，与微生物接触。微生物会分解这些食物，释放出乙酸、丙酸和丁酸，这三种物质会影响你的微生物群、肠道屏障和免疫系统。
Now over 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 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.
在这三种选择中，我最喜欢的是丁酸盐，因为它对肠道屏障的微生物影响最大。你实际上需要丁酸盐来生成维持肠道内壁完整所需的蛋白质，丁酸盐还直接影响我们的免疫细胞。因此，它们是我见过的最具抗炎效果的物质之一。我们之所以会受到这些炎症的困扰，部分原因可以追溯到我们之前关于慢性炎症健康问题的讨论。你问我这些问题的根源是什么，这与我们生活在一个工业化世界有关，在这里至少有90%到95%的人摄入的纤维量远远不够。当我们将这一点与其他地区进行比较时，会发现有一项有趣的研究，他们研究了意大利、新加坡以及玻利维亚亚马逊和马来西亚的原住民群体的微生物组。
So two indigenous tribes living a you know hunter-gatherer lifestyle against Italy and Singapore and what they discovered is that there is this radical difference in terms of the diversity of the microbiome there's a difference in terms of their ability to produce short-chain fatty acids 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 leaving and it's not just what they eat it's 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.
两个土著部落仍然过着狩猎采集的生活方式，与意大利和新加坡这两个现代国家进行比较，研究发现他们在肠道微生物群的多样性方面存在着显著差异。这影响了他们产生短链脂肪酸的能力，并引发了关于衰老的讨论。随着年龄增长，炎症程度通常会上升，那么这是否不可避免呢？我们是否因为年龄的增长就必须接受更多的炎症问题呢？研究发现，这些部落的人实际上并不是这样。由于他们的生活方式，他们不论年龄大小都受到了炎症的保护。而这种保护不仅仅与饮食有关，他们会在太阳升起时起床，太阳落山时就寝，与部落保持联系，而不是整天盯着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 I guess they're not also drinking alcohol and vaping no which we you know do a lot more in the Western world here we do what impact does that have on the gut microbiome because I don't typically hear people talking about alcohol in the gut microbiome what we know is that it definitely affects the gut barrier I guess it's just where it's where it's where it's where it's where it's where it's where it's where it's some degree if I'm pouring the same as it would be the same as using an alcohol-based mouthwash which which now we don't recommend anymore.
这段话的大意是：关于这个故事有很多内容，不过重点是，在工业化世界里，我们似乎没有摄入足够的这类食物。同时，我猜他们也没有像我们在西方世界那样大量饮酒和吸电子烟。那么，这对肠道微生物群有什么影响呢？因为我很少听到有人谈论酒精对肠道微生物群的影响。我们知道酒精确实会影响肠道屏障。就好像使用含酒精的漱口水一样——而现在已经不再推荐使用这样的漱口水了。
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 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 the 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 in a week 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.
所以，说到酒精，有一项研究实际上改变了我对酒精的看法，因此我现在几乎不怎么喝酒了。很少会在和我妻子共进特别晚餐时喝一两杯。这项研究中的基本做法是，他们给一些人喝了大量的酒精，然后每30分钟检测他们的血液酒精含量，同时也检测血液中的脂多糖含量。脂多糖是来自我们肠道菌群中的炎症细菌的产物，不应该出现在你的血液中。如果它出现在血液中，通常意味着你的肠道屏障不够严密，因为脂多糖能够通过该屏障。问题在于，免疫系统已经被训练成把脂多糖视为敌人，所以它会被激活。
So and this is where inflammation comes from so in this study that he 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 it 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 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 alcohol that's safe to summarize what's going on there the alcohol's 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.
在这项研究中，他让参与者饮用一定量的酒，然后每30分钟追踪一次他们的状况。你会发现，随着血液中的酒精含量上升，体内的脂多糖也在上升。当酒精含量达到峰值时，脂多糖也一样上升。这里出现了一种奇怪的现象：当酒精含量达到峰值后开始下降，然后又小幅回升，脂多糖的变化完全与酒精的变化一致。脂多糖水平直到酒精含量降为零后才恢复正常。
从我的角度来看，这项研究并不是关于只喝一杯酒的研究，虽然我们知道即便是一杯酒也足以扰乱你的睡眠并引发其他健康问题。但这项研究让我意识到，我认为没有任何量的酒精是安全的。总结一下，酒精进入体内后，对肠道产生了一定影响，导致肠道功能失调，而且这种失调会持续一段时间。
Because 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 yeah yeah so basically alcohol was causing leaky gut oh leaky gut 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.
因为我想了解你为什么会看了这个研究后决定绝对不喝酒。其实，主要是因为酒精会导致肠漏。对，就是肠漏。研究表明，酒精会引起肠漏，且肠漏的严重程度与血液中的酒精含量成正比。直到血液中的酒精含量降低到零，肠漏的情况才会恢复正常。也就是说，血液中任何可检测到的酒精含量都可能引发这个问题，从而导致炎症。
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 and it 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.
我们清楚地知道，重度饮酒者的肠道会受到严重破坏，而这是发展为肝硬化和酒精性肝病的一个必经步骤。然而，有些人尽管大量饮酒，却似乎没有患上肝硬化。肝硬化是指肝脏的功能受损，而肝脏位于右上腹部，其主要职能是净化血液。所有从肠道返回心脏的血液，首先会经过肝脏，这样的身体构造很聪明，因为我们不希望有毒血液直接进入心脏，再循环最终流回大脑。因此，肝脏在这过程中起到了保护和防御的作用。
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 we listen to it through comes out the other end okay instead of that it's just the 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 so and there's many causes of cirrhosis cirrhosis comes from inflammation so all soror 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 on the available data it seems that you have to disrupt the gut microbiome in order to get there.
肝硬化的情况是这样的：我们的肝脏本来是柔软而富有弹性的，就像一个海绵，你可以把水龙头的水灌进海绵里，水从一端进去，再从另一端流出来。然而，当一个人患上肝硬化时，肝脏就变得像一块塑料一样坚硬，什么都无法透过。肝硬化有很多种原因，基本上都是由炎症引起的。因此，所有的肝硬化健康问题本质上都是炎症类疾病的一部分，是与炎症相关的130种健康问题之一。在这里，我们特别讨论的是酒精引起的肝硬化。根据现有数据显示，要在肝脏产生这种炎症，必须先扰乱肠道微生物群。
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'd 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 share 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 showing your dream and enter to win a hundred thousand dollars.
许多人正在追求被动收入形式，并建立副业以帮助我们支付账单。而现在，这个机会就摆在我们面前，由我们的赞助商Stan提供的服务，这家公司是我共有人之一。Stan这个平台可以帮助你充分利用自己的财务状况。Stan让你能够为自己工作，使销售数字产品、课程、会员等简单产品变得更可扩展、更易进行。你可以将你的想法转化为收入，并获得支持来发展你正在构建的项目。我们即将推出一个名为"Dare to Dream"的项目，专为那些准备从思考到实践、从计划到实际行动的人而设计。这是关于在头脑中看到梦想，并明确知道如何将其变为现实。加入这个挑战，发布一个展示你梦想的视频，就有机会赢取十万美元奖励。
I've just finished writing my third book I haven't fund up the title yet but I have started walking 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.
我刚刚完成了我的第三本书的写作，目前还没有定下书名，但我已经开始设计一些不同的封面。我是在使用我们的赞助商之一Adobe Express进行这些设计的。我喜欢Adobe Express的原因是，它让我可以非常轻松地关注到细节，比如字体设计、字体类型、颜色以及文字的位置。这些东西对大多数人来说可能看似琐碎，但实际上它们会组合起来，创造出与众不同的效果，使作品更胜一筹。在设计我的封面时，它让我回想起这些年来我学到的许多创意事物，也让我意识到在我周围还有很多有创意的人，他们也许有自己的秘密创意尚未展现。
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.ly slash one better to download adobe express now and make sure you visit the learn tab to discover how you can become one better than the rest.
所以，我在Adobe Express中创建了一个更好的指南，以便将这些技巧带给你。在这个指南中，你会发现来自行业顶尖的专家们的原则，这些原则被转化为快速且简单的实践方法，供你应用。通过它，你可以训练自己像世界上表现最好的团队一样进行创作。只需访问adobe.ly/onebetter来下载Adobe Express，并确保访问“学习”标签，以探索如何比其他人更出色。
There's a orangey looking chemical on the plate over the turmeric people talk about turmeric a lot when they're speaking about inflammation yeah I'm not really sure what the truth is on turmeric and inflammation yeah you have to be a little bit careful because you could easily overdo it 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.
盘子上有一种看起来橙黄色的化学物质，在姜黄粉下面。人们在谈论炎症时经常提到姜黄。不过，我对姜黄和炎症之间的关系是否真的有效果还不是很确定。是的，我们需要稍微注意一下，因为很容易过量使用。因此，我们必须聪明地对待这种问题，我们真正讨论的是如果你每天坚持服用姜黄，对那些有慢性炎症健康问题的人来说，从我的角度看这是很有意义的。
So turmeric is helping inflammation go down somehow it turmeric is helping inflammation to go down because it blocks another one of the cytokines so in the same way we were talking about those walkie talkies and basically pull in the batteries out turmeric helps to accomplish that so there's a specific cytokine 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 okay curcumin is the chemical okay that actually does the thing and it turns out that curcumin is what we call a polyphenol.
所以，姜黄能够帮助减轻炎症。这是因为姜黄能够阻碍某种细胞因子的作用。就像我们之前提到的对讲机一样，把电池拿出去，姜黄就是这样发挥作用的。具体来说，姜黄中的姜黄素对某种细胞因子有这样的效果。你提到的姜黄素，就是存在于姜黄中的植物化学物质。姜黄是根，而姜黄素是化学成分，能够起作用的就是姜黄素。而实际上，姜黄素是一种我们称之为多酚的物质。
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 cursatin and many people have heard of cursatin 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 here in front of me I have a I guess I guess this is a perfect gut day have you seen this.
所以，当我们坐在这里欣赏这五彩缤纷的食物时，我们会发现每一种食物都含有多酚，它决定了食物的颜色，并对肠道产生影响。比如，这里的洋葱含有槲皮素，许多人知道槲皮素对长寿有好处，大蒜也是如此。不同颜色的食物含有不同的多酚，其中95%需要我们肠道的微生物激活。至于姜黄，您需要小心补充剂的用量，因为如果摄入过多，可能会引发问题。在我面前的这些食物展示了一个理想的肠道日，你见过这个吗？
Yeah well I wanted you to explain to me step by step how to have a perfect gut day this 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.
好的，我想让你一步步地给我解释一下如何度过一个理想的肠道健康日。首先，我会为大家定义一下我的方法，这是一种完美的24小时节奏。我们有一个天生的生物节律，生物节律基本上意味着我们的身体以24小时的时钟运作。为什么呢？因为我们跟随太阳进化，太阳升起又落下，这是定义我们和我们整个环境中一切事物的最有力因素之一。所以我们周围的一切也都是跟随太阳进化，并与其相连。大约50%的基因会根据生物节律在一天的特定时间开启或关闭。一天中，超过50%的微生物也随着时间变化来适应我们的身体需求。我们的身体在稳定一致的环境下最为健康。
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 seven in the morning 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 five 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 seven oh five you're going to wake up your microbes you're going to wake up your body with hydration.
那么，我想谈谈的是如何创建一个一致的日常习惯，以优化我们的微生物组。我将为你详细讲解各个步骤。让我们想象一下，太阳升起，现在是早上七点。你自然醒来，并保持这种规律，那么你已经有了一个良好的开始。规律地在固定时间起床是开启一天的绝佳方式。在你醒来的前五分钟，我希望你专注于清醒过来，思考你的一天，以及你将如何面对它。因为到七点零五，你将通过水分补充唤醒你的微生物和身体。
So we're going to opt for water and in a perfect world I would love to add a pre-botic fiber supplement to that water so like our company is called 38 Terra you can add that there or you can add alternative this is the hydration the water turns on your gut turns on your brain turns on your kidneys so no coffee straight away no so pause the coffee start with hydration and we're waking up your gut with the water and also with the pre-botic fiber that's going to feed those microbes in your gut okay so that's at seven oh five and let's pretend that takes you 10 minutes and so now it's seven fifteen 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.
所以我们打算选择喝水。在一个理想的情况下，我希望能够在水中加入一种益生元纤维补充剂。比如说，我们公司的名字叫38 Terra，你可以在水中加入它，也可以选择其他的。这种水分补充会启动你的肠道、大脑和肾脏，所以不要立刻喝咖啡。暂停咖啡，先从补充水分开始，用水唤醒你的肠道，还可以通过益生元纤维来为肠道中的微生物提供养分。好，这在七点五分时进行，假设这花费你10分钟，所以现在是七点十五分。接下来我们要“翻开新的一页”，告诉身体新的一天开始了，而这一刻实际上是最重要的。
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 chiasmatic nucleus the SCN and the SCN is the orchestrator that is the master clock of your circadian rhythm.
如果大家只能记住一件事情，我希望是这件：我将告诉你激活生物钟的两个最强大的杠杆。首先是阳光，或者至少是强光的照射。光线进入我们的眼睛，穿过视网膜，再进入体内，被感知后进入视神经。在视神经的起始处，有个大脑部位称为视交叉上核（SCN），这是我们从左右眼收集信息的第一个地方。SCN就是我们生物钟的主时钟，它帮助协调我们的昼夜节律。
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 that's your SCN your SCN is basically managing all that and there's an entire cascade of things that follows from when you tell the SCN today started.
所以，我会把它想象成上学。当我们还是孩子，上学的时候，大家可能都会带着一块手表，这块手表能大致告诉我们一天中所处的时间。同样地，我们的所有器官、组织，甚至超过一半的微生物，它们都有自己的"手表"，可以感知一天中的时间。但最重要的是课间响起的“铃声”，那才是真正的“中心时钟”，也就是你的SCN（视交叉上核）。它基本上在管理这一切，而当你告诉SCN今天开始的时候，会引发一连串的变化。
So that light exposure is what basically activates the SCN to release cortisol through a series of events that releases cortisol all right cortisol is the morning hormone it is it allows us to get activated it makes protein and energy available to ourselves 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% so we're off to a good start.
暴露在光线下基本上会激活视交叉上核（SCN），通过一系列事件释放皮质醇。皮质醇是一种晨间激素，它帮助我们活跃起来，为身体提供蛋白质和能量，使我们专注。此外，它会在特定时刻抑制我们的免疫系统。在早晨接受光照可以将皮质醇水平提高50%，这是一个良好的开端。
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 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 rock 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 pushups whatever it may be you could do jumping jacks you do yoga right.
我们可以利用的第二个因素是户外活动中的运动。这并不需要进行全面的锻炼，也不是说一定要进行高强度的锻炼，而是轻度的运动。比如在夏天，你可以出去散步，当天气好的时候，你可能会选择在户外活动。然而，当是一月份，天气不太好的时候，则可以使用光疗灯。光疗灯让你可以在室内进行活动，只需要确保光疗灯的亮度达到10,000勒克斯，这样它就可以替代阳光。然后你可以进行任何形式的运动，比如做深蹲、弓步、俯卧撑，或者跳跃运动、瑜伽等。
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 then 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 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 715 until 735 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.
所以在这个时间段，如果你接触到光线并进行运动，运动可以增加大约25%到50%的效果，这是一个综合效果，会给你带来理想的晨间皮质醇峰值。这对于推动你的一整天非常重要，因为这样你会更专注，认知能力得到提升，耐力增强，晚上也能睡得更好。我保证，你会在第一天就注意到这些好处。好的，那你需要做这些大约20分钟左右，从早上7点15分到7点35分进行光照和运动，尽量在户外进行。如果你戴眼镜，顺便说一句，摘下眼镜，不需要直接看太阳。
At 735 we're going to basically come back in and this is a time for us to now have our coffee and also quite time 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 which is 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.
在7点35分时，我们会基本上回到这里，这段时间是我们喝咖啡和放松的时刻。对我来说，我们的日常生活没有足够的时间，生活节奏太快了，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。自律神经系统有两个方面：一个是交感神经，负责让你加速，就像是油门；另一个是副交感神经，负责休息和恢复，就像刹车。
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 745 and that you have breakfast all right so and breakfast is the perfect opportunity to take your supplements okay so what breakfast what supplements okay so your breakfast and 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 you should have breakfast you should definitely have breakfast yeah.
所以，现在你已经完成了户外活动和锻炼，回来后我们希望给你10分钟安静、轻松的时间，这可以是冥想、呼吸锻炼、阅读圣经或者写日记，无论是什么，只要适合你就好。你可以在这10分钟里和咖啡一起享受安静的时光，这样当时钟指向7:45时，你就可以吃早餐了。而且早餐是一个很好的时机来补充你的营养品。那么，吃什么早餐？选择什么营养品？你应该有一个早餐计划，是不是要吃很多东西呢？有没有必要吃早餐呢？你应该吃早餐，早餐是非常重要的。
So 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 745 or at 3 in the afternoon and when you eat it at 745 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 and what kind of foods I would argue that we go high fiber and moderate protein no sugar no sugar no sugar no sugar no sugar right no sugar refined carbohydrates should get left out as much as possible what's a refined carbohydrate can be sour or sugar okay so no no baked goods no ex-benedict so the exception from my perspective would be if you're going if you want to have avocado toast then a sour though colossal prefer not they are delicious but no I prefer not because ultimately what we want is we want we want high fiber and moderate protein.
你的新陈代谢在一天中会发生变化，早晨是新陈代谢最强的时候。这意味着，即使你在早上7:45和下午3点吃完全相同的食物，早上7:45吃会带来更好的血糖控制和血脂控制。这些都是新陈代谢的表现，当它们得到控制时，对身体非常有益。因此，我们要尽量将饮食安排在一天中的较早时段。
至于应该吃什么，我建议选择高纤维和适量蛋白质的食物，并且避免摄入糖分。反复强调，糖分应尽量避免，尤其是精制碳水化合物，比如糖或者甜味的食物。因此，应尽量少吃烘焙食品和班尼迪克蛋。唯一的例外是牛油果吐司，但即便如此，建议选择酸面包时尽量节制，虽然它们很好吃。最终，我们的目标是摄入高纤维和适量蛋白质。
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 your simultaneously giving your gut what it needs from a fiber perspective out 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 because you know a lot a lot of parents I've talked about this quite a few times before but when I was young I'd get a lot of orange juice and I didn't realize the orange juice was just like sugar water yeah is there anything that parents should be thinking about when they're giving kids their breakfast of course and I think that the most important thing is that you need to model for your kids what a healthy breakfast looks like by having it yourself because if you don't do that then there you can't expect them to.
通过这种组合，你会感到很饱，因为你从蛋白质的角度给了身体所需，同时也从纤维素的角度满足了肠道需要。比如，你可以选择燕麦，但由于之前提到的草甘膦，所以燕麦应该选择有机的，而且尽量选择加工程度低的燕麦，我个人不太喜欢即食燕麦。至于给孩子准备早餐时，要注意些什么呢？很多父母都谈论过这个问题。我小时候喝了很多橙汁，却不知道橙汁其实就像糖水一样。那么，父母在给孩子准备早餐时需要考虑些什么呢？当然需要，我认为最重要的是，你自己应该为孩子树立健康早餐的榜样。如果你自己都不这么做，就不能指望他们做到。
So healthy breakfasts my kids I four kids so my kids love avocado toast they love avocado toast you could absolutely do yogurt with berries right you can 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 a hundred percent 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.
我的孩子们非常喜欢吃健康的早餐。我有四个孩子，他们特别喜欢鳄梨吐司。当然，你也可以给他们吃酸奶配浆果，或者是浆果和坚果。这方面有很多不同的选择，例如隔夜燕麦和奇亚籽布丁。这些都是可以尝试的选择。在探讨完美的早晨和日常安排之前，作为父母，你是否会做出一些决定，为你的孩子提供某些食物，从而对他们的免疫和肠道功能产生持久的影响？答案是肯定的。这也引发了关于肠道和免疫系统连接的讨论，这种连接在出生前就开始了，而头三年则尤为关键。
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 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 what about kids taking antibiotics does that have a when you're forming you get microbiome is at a young age does that have a consequential impact a hundred percent 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 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 five years increased risk of allergic diseases increased risk of autoimmune diseases increased risk of metabolic diseases.
让我稍微解释一下，Steve。他们有一些研究是关于怀孕期间妈妈的微生物组的。他们会分析妈妈的大便，能够识别出可能与孩子将来患过敏性疾病相关的模式。另外，还有研究表明，如果妈妈在怀孕期间增加纤维摄入，可以降低孩子将来患过敏性疾病的可能性。那么，小孩使用抗生素呢？在年幼时微生物组正在形成，这会有重大影响吗？当然有，抗生素、奶瓶喂养和剖腹产（顺便说一句，我的孩子都是剖腹产出生的，这不是我们的选择，但确实发生了）这三件事都会影响微生物组和免疫系统。如果你看孩子出生后的前五年，这会增加过敏性疾病、免疫系统疾病以及代谢疾病的风险。
Because in the C section the baby didn't pass through the birth canal the birth canal and the birth canal would have given the baby some of the mother's microbiome yes so and then breastfeeding does the same it gives the baby microbiome breastfeeding gives them access to mom's skin microbiome but also breast milk contains these things called HMOs human milk illegal sac rides it's quite fascinating to consider this we evolved where mom's breast milk contains these things human muclegosecrites 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 pre-botic so these human muclegosecrites in breast milk were basically designed to feed the developing baby microbiome.
因为在剖腹产中，婴儿没有经过产道，而通过产道本可以让婴儿获得一些母亲的微生物群。同样，母乳喂养也能实现这一点，它不仅让婴儿接触到母亲皮肤上的微生物群，而且母乳中还含有一种叫做人乳低聚糖（HMOs）的物质。让人觉得很神奇的是，母乳中的这些物质有超过200种，它们本身对婴儿没有直接的营养价值。那么，为什么会有这些物质呢？因为它们是益生元，这些人乳低聚糖实际上是为了滋养婴儿正在发展的微生物群而设计的。
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 monofiber it's not the same as the 200 plus varieties of human muclegosecrites so there was a study that was done out of Finland where they looked at roughly 1100 kids. and they tracked them for five years and during this time five years they got a microbiome specimen poop specimen from the kid at three 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 bottled.
所以，这也是我们面临一些挑战的原因之一。当你用奶瓶替代母乳喂养时，你可能会在配方奶中添加纤维，但这通常是单一纤维，与母乳中的200多种不同的人类粘液糖分泌物不一样。芬兰进行了一项研究，调查了大约1100名儿童，跟踪了他们五年的时间。在这五年期间，他们在孩子三个月和十二个月大时收集了肠道微生物群样本（大便样本），并观察到有些孩子患上了过敏性疾病，比如湿疹、食物过敏、哮喘、鼻炎、过敏性鼻炎等常见的过敏性疾病。他们发现，有几个因素可以预测哪些孩子到五岁时可能会患上过敏性疾病：第一是在生命的第一年接触抗生素，第二是使用奶瓶喂养。
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 produced short-chain fatty acids and the short-chain fatty acids of that chemical we talked about aliron that that you get from five which produces those three things yes but you to rate but rate acetate and appropriate eight and and in fact when they checked the poop for butyrate levels the butyrate levels were low.
好的，他们在孩子12个月的时候研究了微生物群。需要澄清的是，这些孩子在那个时候还没有发展出过敏性疾病，那是在后来的事情。不过他们在12个月时查看了微生物群，发现有特定的模式可以预测哪些孩子将来会发展出过敏性疾病。缺少的是能产生短链脂肪酸的细菌。短链脂肪酸是我们之前提到的那种化学物质，而这一物质来自某种纤维，并能生成那三种东西：丁酸、乙酸和丙酸。实际上，当他们检测孩子的粪便中的丁酸水平时，发现丁酸水平很低。
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 confused immune system with these allergic diseases so going back to a daily routine yep where I'll be too yes we're at 745 and so you want your high fiber moderate protein as a little shark 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 that's for inflammation so these are for inflammation okay yeah.
所以，这项研究最吸引人的发现就是，你可以通过观察微生物组来预测哪些人以后可能会患上因免疫系统紊乱而引发的过敏性疾病。回到日常生活中，是的，现在是7:45，你应该吃高纤维、适量蛋白质、尽量少糖的早餐。这也是服用早晨补充剂的最佳时间。我推荐基于科学证据的补充剂，包括维生素D、欧米伽-3和姜黄，它们都是针对炎症的。
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 why because basically everything about our microbes and our body and the way that it works thrives on consistency so supplements would be the same.
所以我现在也相信，只要有可能，我们都应该进行检测。有维生素D的检测，也有Omega-3的检测。如果你的体内含量足够，就不需要补充剂，但如果缺乏，补充剂就显得非常重要。因此，我认为补充剂应该按昼夜节律来一致地服用，也就是说，我们每天在同一时间服用早晨的补充剂。为什么这样呢？因为我们的微生物和身体的一切运作都是依赖于一致性的，补充剂也是一样。
And when we do this so it's been 745 we've had our breakfast we've taken our morning supplements 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 of 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 place where you're having that good healthy bowel movement and that's indicative of a gut that's in rhythm and doing well.
当我们这样做之后，现在是7:45，我们吃了早餐，服用了早晨的营养补充品。现在距离我们起床已经过了一个小时，是时候来一次非常好的排便了。这是你所做努力的体现。因为当你早上晒太阳时，这有助于促进排便；当你锻炼时，这也有助于排便；当你喝咖啡时，这同样有助于排便。所有这些不同的事情最终导致你有一次健康的排便。这表明你的肠道状态良好，运行正常。
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 it gets to be lunchtime and it's 12 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 how's that good for my gut and inflammation there so feeling socially bonded to another person 50 percent this is by the way statistics that come from before the pandemic right.
所以这就是你的早晨安排。现在你要去工作，我想回到中午这段时间。当时间到中午12点时，我建议大家和他人一起吃午饭，就像我们现在这样坐在这张桌子旁。因为我们这样做的机会太少了，我们太多时候一边吃饭一边低头玩手机，不停地滑动和翻阅。这样对我的肠道和炎症有什么好处呢？和他人形成社交纽带是非常重要的。这是疫情前的统计数据表明的。
So the pandemic made this worse 50 percent of people in America were lonely before the pandemic even started loneliness is the equipment 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 in your longevity and you're quite clear that you define loneliness as the feeling of disconnection versus being alone right yes.
所以疫情使这一情况更加恶化——在疫情开始之前，美国有50%的人就感到孤独。孤独是一种危险，它对人的寿命影响甚至比很多其他因素更大。研究显示，孤独对健康和寿命的负面影响可以媲美经常吸烟。你所说的孤独明确是指与他人失去联系的感觉，而不是单纯的一个人独处，对吧？
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 bond to other people that's what allowed you to survive and thrive your family was like basically 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 at 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 so this is causing some kind of cortisol issue stress issue that's then impacting the gut microbiome and causing inflammation.
所以，当你独自一人时，你不得不思考我们从何而来。我们天性中是有着部落特性的。几百万年来，人类以狩猎采集的生活方式存在于部落中，那时候没有金钱，人与人之间的关系就是财富的衡量标准，这也是让人们得以生存和发展的方式。家庭就像是一种财富的象征，家人越多，意味着越富有，因为大家会互相合作支持、照顾。而更广泛的部落并不是只有300人，像现在社交媒体上的数十万人这样的庞大群体，是像一个由多个家庭组成的大家庭，我们身处其中，共同面对困难。例如，如果你我在同一个部落中，如果有人攻击我们，我知道你会挺身而出保护我，我也同样会保护你。然而，这种现代社会的广泛社交导致了一些问题，比如高水平的皮质醇引发的压力问题，这进一步影响了肠道微生物群，导致了炎症。
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 that is correct so ultimately that is a manifestation of the brain gut connection okay we have it 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 we sleep worse as well I was reading about some stuff around when people feel lonely they go into self-preservation which is kind of like I guess the analogy would be if you drifted off from your tribe yeah you'd have to be a bit more alert you'd have to be honest you'd have to be wait you know you couldn't sleep for eight hours in peace because you're you're in danger now yeah you don't have that sort of insulating factor of a group of people.
如果我们想折磨一个人，最简单的方法就是让他们独自隔离。这实际上是一种折磨。我们是如此社交的生物，需要与他人互动。而被隔离会引发皮质醇反应，这会导致炎症。这就是大脑-肠连接的体现。我们天生需要与他人建立联系，当这种需求得不到满足时，会给我们带来很大的压力，因为我们会感到脆弱和不安全，我们的睡眠质量也会变差。我读到一些资料提到，当人们感到孤独时，他们会进入自我保护状态，这有点像如果你背离了你的部落，你就需要更加警觉，更加诚实，无法安然入眠八小时，因为你感到处于危险之中，没有了群体带来的安全感。
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 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 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 okay so we socialize at lunch we have to know with other people yes so I want people to socialize and launch to address this epidemic of loneliness that I think is highly problematic and not and not to be underrated because again it's like smoking a pack of cigarettes.
思考一下，有一种名为斯德哥尔摩综合症的情况，这的确很有趣。斯德哥尔摩综合症是在你被绑架的情境下发生的。在这种情况下，作为被绑架者，你可以选择拒绝你的绑架者，或者寻找他们身上的优点并与他们建立联系。实际上，这是一种生存机制。在被绑架的情况下，人们往往会与绑架者建立联系，并对他们产生同情。我们认为这是一种防御机制，因为我们作为社会性生物，需要社交，而不是孤独地被囚禁。我们在午餐时也会与他人社交。我希望大家在午餐时间多与人交流，以应对孤独流行的问题。我认为孤独问题非常严重，不应被低估，因为它对健康的影响犹如每天抽一包香烟。
So let's imagine that we have a nice lunch time that 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 get things done so this reinforces our circadian rhythm when we take a walk and we get outside a second time.
让我们想象一下，我们有一个美好的午餐时间，而不是匆忙的10分钟，而是包含交流的45分钟。到了结束时，我建议大家在返回工作之前，到户外走一走。这样做有两个好处。我们之前谈到了早晨阳光和运动的好处，现在回到这个话题，但这次有些不同。通过到户外走动，我们接触到不同的阳光。这些阳光的类型略有不同，更有可能在一天的后半部分提升我们的血清素水平。而血清素有助于提升我们的心情，增强注意力，帮助我们完成事情。当我们第二次走到户外时，这也有助于强化我们的生物钟。
Also the exercise a 10 minute walk just 10 minutes of simple walking is enough to get 30 to 40 percent 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 eat too much and you don't feel well force yourself to take a walk as opposed to laying on the couch all right so 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 I'm a big matcha believer this is 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.
还有运动，一个10分钟的步行就足够了。简单的步行10分钟就能让你的血糖控制提高30%到40%，因为活动腿部的大肌肉可以帮助降低血液中的血糖。所以，信息就是，如果你吃得太多而感觉不舒服，与其躺在沙发上，不如强迫自己去散步。此外，户外散步还能激活肠道，帮助肠道进入节奏，从而减少饭后的腹胀。之后，你走15分钟，回到工作中，我鼓励大家喝一杯抹茶绿茶。我对抹茶非常推崇，因为在所有种类的茶中，它的多酚含量最高，对肠道微生物群有益，同时还能给下午带来提神的效果。
Okay let's accelerate to four o'clock I saw you um I think it was in your book that I read this yeah in your book it talks about how the gap between sort of three and six is the optimal time to exercise that's right yeah so three and six p.m the reason for that has to do with our core body temperature so our temperature cools off at night our body temperature of 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 three to six p.m I fought a tact on page 159 of your book where you said my one request is that you do not have a heavy exercise late in the evening as this activates the parrots sorry the sympathetic never system and can negatively affect your ability to quickly fall asleep yeah well I always were going to last night it was like bloody god I love until midnight oh no that's like quite typical though because I don't know I just just when I get my time how's your sleep last night okay but I mean there's like a series of issues took place two hours so okay fair enough to do like a series of like my other issues the time I ate was bad and the time I went to the gym was bad and so it was was it was was was was a mess yeah well ideally two hours before bedtime okay 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 but vigorous exercises a different story okay 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 okay three to six p.m.
好的，让我们加速到四点。嗯，我是在你的书里读到的，我记得你提到三点到六点这段时间是锻炼的最佳时间。是的，没错，三点到六点。原因跟我们的核心体温有关。我们的体温在晚上会下降，而白天则开始上升。顺便说一下，早晨锻炼有助于加速这种上升过程，但三点到六点是我们的体温高峰。我在你书的第159页看到你说过，我唯一的建议是不要在晚上进行剧烈运动，因为这会激活交感神经系统，从而影响你快速入睡的能力。嗯，我昨晚一直忙到半夜，真是够烦人的。不过这也挺正常的，因为我通常只有晚上才有时间。你昨晚睡得怎么样？还行吧，不过确实发生了一些问题。吃饭的时间不对，去健身房的时间也不对，结果一团糟。理想情况下，最好在睡前至少两小时停止锻炼，尤其是剧烈运动。轻微运动还好，但剧烈运动就不一样了。好的，从运动表现的角度来说，三点到六点是最佳时间，尤其是如果你想举重的话，下午三点到六点是最好的。
So let's imagine that we go and we get we smash a workout at four o'clock right and so I'm going to give us an hour to smash that wonderful workout and then now it's five and it's the perfect time for dinner I want to point something out real quick I we had breakfasts around eight and we had lunch around noon and we had dinner around five we've spaced things out by about four hours and that's actually the perfect time from from the perspective of your digestive rhythm 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 okay so it's ideal to give a four 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 feel about your gut to fall into a rhythm.
好，让我们设想一下，我们在下午四点进行了一次高强度锻炼。我计划一个小时来完成这次精彩的锻炼，所以现在是五点钟，这正是吃晚饭的最佳时机。我要快速指出一点，我们在八点左右吃早餐，中午吃午餐，五点吃晚餐，我们在每餐之间间隔了大约四个小时。从消化节奏的角度来看，这是理想的时间间隔。
在肠道中有一个概念，很多人可能没有听过，叫做迁移性运动复合波。这个过程在两餐之间发生，基本上就像是肠道在清理和重新组织自己，但如果在这期间吃东西，会打乱这个过程。所以，在两餐之间保持四个小时的间隔是理想的做法。如果这样做，你会发现消化方面的感觉改善，因为你的肠道会进入一个规律的节奏。
All right so we have our dinner it's five o'clock we're moving into the evening and now it's going to be seven o'clock at night and let's imagine I know this time of year the sun is going down much earlier than this in most places but imagine that it's seven 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 percent melatonin is the sleepy time hormone so in the morning it's cortisol and in the evening it's melatonin and it's interesting 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 will 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.
好的，我们现在已经吃完晚餐，时间是五点钟。天色渐晚，晚上七点钟就要到了。尽管这个季节在大多数地方太阳下山的时间要早得多，但我们可以想象现在是七点钟。当太阳下山时，你应该开始调暗家里的灯光，减少个人的光照，因为家里的普通灯光会减少30%的褪黑激素。褪黑激素是一种让人感到困倦的激素。早上，我们的身体主要依赖皮质醇，晚上则是褪黑激素。很有趣的是，早上我们进行锻炼和接受光照，不仅是为了增强皮质醇的峰值，同时也会增加我们的血清素。血清素是一种让我们感到快乐的激素，帮助我们保持专注。而血清素实际上是褪黑激素的前体。因此，当你在早晨进行光照和锻炼时，你实际上是在为14小时后的良好睡眠做准备。
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 eight o'clock if our bedtime is going to be 10 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 eight o'clock 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 830 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 830 to 9 somewhere in that range.
为了保护体内褪黑激素在天黑时开始分泌，我们需要在家中调暗灯光。在晚上8点左右，我们要特别注意，如果我们计划在10点睡觉的话——对某些人来说可能太早了，那就请见谅，但我认为保持一致的就寝时间是好的——那么在晚上8点左右，我们就要开始减少使用电子设备，或者佩戴防蓝光眼镜。防蓝光眼镜可以帮助保护我们免受蓝光影响。大约在8点半时，可以吃晚间补充剂。早上我们已经摄入了维生素D、Omega-3和姜黄素，现在我们需要摄入锌和镁。如果你服用褪黑激素，这大概也是合适的时间，或者如果你有其他帮助睡眠的补充剂，也可以在大约8点半到9点之间服用。
So because it's going to take about 60 to 90 minutes to really kick in around 9 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 to intentionally activate our parasympathetic nervous system and get like relaxed before bedtime so that at 930 we basically are preparing for bedtime and that might mean a hot shower like actually like he 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 o'clock we want to go to bed and 10 o'clock like it could be whatever time but I would argue that we should be consistent it could be 1030 it could be 11 whatever time you choose adapt to it but the point from my perspective it's not so much 10 is the magic number it's more so that 10 is the magic number if you always do 10 1030 is the magic number if you always do 1030 consistency is key.
因此，因为这个过程大约需要60到90分钟，所以我们计划在晚上9点左右开始进行晚间仪式。在早晨我们有安静的时间，晚上也应该有一个安静的时间，以有意地激活我们的副交感神经系统，并在睡前放松下来。这样到了晚上9点半左右，我们就可以开始准备睡觉。这可能意味着洗个热水澡，实际上晚上洗热水澡或去桑拿是很好的，因为其实这些可以降低你内核的温度，或许听起来不可思议，但这正是我们想要的效果。我们需要一个凉爽的房间，一个黑暗的房间，这会帮助我们更好地入睡。因为我们希望在晚上10点上床睡觉。选择具体时间，可能是10点半，或者是11点，关键是要保持一致。不一定10点是神奇的时间，而是如果你总是选择10点，那么10点就是神奇的时间；如果你总是选择10点半，那么10点半就是神奇的时间。保持一致性才是关键。
And you would recommend three meals a day I think that you could do three meals I think the way that we structured this is that if you were done eating at 6 o'clock at night and then you're having breakfast around 8 you have a 14 hour fast do you think that fasting window matters that specific number 14 or in general just like generally generally having sort of a big intermittent fasting window where you have an eaten for 16 hours whatever it might be I think that there's so I think that 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 so when you when you particularly eating late at night I got 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 if that's 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.
我建议一天吃三餐。这样的话，如果你晚上6点就不再进食，然后早上8点吃早餐，这样你就有了14小时的禁食期。你觉得这个禁食时间的重要性是在于这个具体的14小时，还是说一般地有一个比较长的间歇性禁食时间，比如16小时？其实，我认为时间限制饮食的价值有两个部分。首先，我们给消化道一个休息的时间，尤其是在晚上吃东西的时间从根本上讲是可以有不同看法的。但从我的角度来看，唯一不能妥协的是晚上的进食。比如，有时候我们可能会很忙，但如果你晚上吃得太晚，会对代谢产生不同的影响，而且这种影响会延续到第二天，并对你的睡眠产生影响。
Yeah 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 people will be saying yes but I'm hungry and I think part of the reason that the hungry from what you've explained is probably because they didn't have breakfast yeah they like started eating later that's what typically what I find is if I have breakfast I'm typically not hungry later might yeah yeah I think that I think the breakfast helps to sort of set the tone for the rest of the day and then 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.
是这样的，我们真的非常希望尽量选择较早的晚餐时间，然后尽可能早结束一天的饮食。很多人可能会说“但是我饿了”，我认为部分原因可能是他们没有吃早餐。正如你解释的，他们可能是开始吃得比较晚。我的经验是，如果我吃了早餐，通常就不会那么容易饿。我认为早餐有助于为一天定下基调。有两个时间限制饮食的好处：第一是让肠道得到休息，超过12小时对肠道有好处。第二点是，这种方式帮助我们在用餐时间上保持更一致的作息。这整个关于生物钟的讨论可以用一个词来概括，那就是：一致性。
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 CD or pants do you fast ever do you try and like long fast long fast or just sort of most time restricted eating sounds I do I do time restricted eating all the time in fact I most days like I first of all I'm imperfect 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 yeah because 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 same so but on the we're getting today today I did yeah today I had my breakfast because I wanted to be on my game but on the weekend 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.
如果你每天都在相同的时间进食，你会感受到消化方面的明显差异，我向你保证。因此，时间限制性进食的优势在于，它让你关注自己什么时候吃晚餐，什么时候吃早餐，从而可以更加有规律地饮食，而不是随意乱吃喝。你有没有尝试过禁食呢？你会试着进行长时间禁食，还是大多数时候只是做到时间限制性进食？我自己一直都在进行时间限制性进食。事实上，在大多数日子里，我并不完美，这意味着我并不总是完美地遵循我给出的建议。例如，我大多数日子都不吃早餐，因为我的日程很满。我起床后完成早晨的日常，喝了咖啡后就马上开始工作。今天是个例外，今天我吃了早餐，因为我想保持最佳状态。但在周末，我会吃早餐，我发现这样真的不同。比如，我在吃了早餐后，白天就不那么容易感到饥饿，这帮助我保持了能量的平衡。
So yeah I sometimes I do one meal a day last month I told you about a challenge that I'd sat our internal flight tech team flight tech team is our innovation team internally here I toss them we're seeing how much time they could unlock for the company by creating something that will help us fill to new AI tools to see which ones were worth pursuing and I thought that our sponsor five of 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 five of 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 prioritises 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 trialing and testing new AI systems instead of shifting through lots of noise my team flight X has been able to focus from developing even more AI tools once that really moved the needle in our business thanks to the talent on five of pro.
所以，是的，我有时候会在一天内只吃一顿饭。上个月，我告诉过你们一个我给内部飞行技术团队设定的挑战。飞行技术团队是我们公司内部的创新团队。我向他们提出挑战，看看他们能通过创建一些有助于我们筛选新AI工具的东西来为公司节省多少时间，以确定哪些工具值得追求。我认为我们的赞助商Five of Pro平台上可能有能够快速帮助我们构建这个项目的人才。所以，我与我们的创新总监Isaac进行了交流。在过去的一个月里，我的团队Flight X和来自Five of Pro的经过筛选的AI专家一起合作进行这个项目。在我团队的帮助下，我们成功创建了一种全新的工具，该工具可以自动扫描、评分和优先排序不同的新兴AI工具。它的影响力非常大，仅仅几周的时间，这个工具已经为我们节省了大量用于试验新AI系统的时间，让我们不必再在大量噪音中筛选。我的团队Flight X能够专注于开发更多真正能对我们的业务产生重大影响的AI工具，这都是得益于Five of Pro的人才。
So if you've got a complex problem and you need help solving it make sure you check out five of pro at fivea dot com slash diary 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 guest 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 addition 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.
如果你有一个复杂的问题需要帮助解决，记得去访问fivea.com/diary，查看关于五大专家的信息。在当今的世界中，我们尤其需要连接，这正是为什么我们创建了这些对话卡片。在这个节目中，当我和我的嘉宾一起坐下进行深入而私密的对话时，总会发生一件非凡的事情：在节目结束时，我们彼此感到深深的联系。每次我采访的嘉宾都会为下一个嘉宾留下一个问题，我们将这些问题变成了对话卡，并添加了“变化”卡片，让你的对话更加有趣。此外，在对话卡的旅程中，还有更多的意外惊喜。这是我们全新的添加，而且首次在卡片包中加入了这张金卡，上面有我独家的提问。不过，我只在第一批对话卡中放入金卡，所以赶紧在有限的时间内去购买你自己的对话卡，确保你能得到限量版的金卡。请访问下方描述中的链接。
One of the things you we touched on briefly at the beginning was this concept that trauma is linked to gut function powerful in what way we're 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 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 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 the kids if they were young enough they wouldn't remember.
我们在开头简要提到的一个概念是，创伤与肠道功能之间的联系，在某种程度上这种联系是非常强大的。我们刚才谈论的是自主神经系统，包括交感神经和副交感神经。我们大多数时候处于交感神经过度活跃的状态，这实际上相当于经常感到威胁：心跳加速、血压升高、更专注。但这样一来，我们的肠道就会受到影响。当我们激活交感神经系统时，肠道的健康常常被牺牲。相反，我们缺乏足够的行动来激活副交感神经系统，这可以在我们放慢生活节奏时实现，比如通过对话、牵手、拥抱、祈祷、写日记、冥想、桑拿等活动来实现。在回答有关创伤的问题时，有研究表明，我不仅自己需要学习理解这个问题，还需要意识到以前我总以为年纪小的孩子不会记得创伤。
And what I've realized is actually this idea of like the body keeps the score is so well said it's so true 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 this this issue of trauma what happens is that it restructures the brain and how your brain functions and it keeps you sort of trapped in that fight with flight state keeps you trapped yeah so there's a part of our brain called the amygdala and the amygdala is what gets activated if you like go to a haunted house you know like if you get scared of something right or like 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.
我发现“身体记住一切”这个说法确实非常正确。我们的身体确实会记录所有经历，即使是两岁之前发生的创伤，由于记忆有限，你可能完全不记得，但这创伤会在成年后表现出来。这一点在那些被收养并经历了不稳定的前两年生活的孩子中已经得到证实，他们在成年后更容易出现健康问题。创伤的问题在于，它会重塑大脑的结构和功能，让你困在“战斗或逃跑”的状态中。大脑中有一个区域叫杏仁核，当你走进鬼屋感到害怕或者半夜听到可怕的声音时，杏仁核就会被激活。对于遭受过创伤的人来说，他们的杏仁核长期处于激活状态。
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 what is the link there is it is it the hormone that's produced when I'm in a stress state that is impacting my immune system which is then having the impact on my gut yes 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 and C.R.H and C.R.H is this that's effectively your sympathetic nervous system getting activated turned on in a person who's had trauma.
如果我生活中发生了一些导致创伤的事情，那么我的神经系统可能会更容易处于一种交感神经系统的状态，这会激活一种激素，从而干扰我的胃肠蠕动及我们提到的胃肠屏障和其他胃肠功能障碍。那么，这之间的联系是什么呢？是因为我处于压力状态时产生的激素影响了我的免疫系统，进而影响了我的肠道吗？是的，这一切都是脑肠连接的体现。发生的情况是，你的大脑有能力释放一种叫做促肾上腺皮质激素释放激素（CRH）的激素，而CRH是在经历过创伤的人身上激活交感神经系统的因素。
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 and so and then it has this lasting effect I was thinking as just speaking about some of my friends that I've had some bad diagnoses recently got a friend that got diagnosed with something very very serious and what I then noticed after that diagnosis they had lots of other health related issues that seemed to be unconnected but the doctors associated with stress yeah and maybe the traumatic news of that one thing has caused this cascade of other issues downstream.
要说明的是，并不是所有不好的事情都算创伤。创伤是那些在你应对能力之外，给你带来持久影响的事情。我在谈到我的一些朋友时，就想到这个。有些朋友最近被诊断出一些严重的疾病，之后我注意到他们出现了许多看似不相关的健康问题，但医生认为这些与压力有关。可能是因为那个创伤性消息引发了后续的其他问题。
Yeah 100% and that's all a manifestation of the brain gut access so the brain gut access 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 C.R.H. corticotropin releasing hormone that hasn't affected throughout the entire body it puts them on edge and the consequence is that that C.R.H. that's like 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 morning it's perfect it's exactly what your body needs what you don't need is you don't need cortisol to still be elevated at 10 o'clock 11 o'clock midnight one in the morning cortisol is the get up and go hormone right now it's disrupting your sleep now it's actually the adversary of your of your circadian rhythm and that's what's happening in these people is that through that the brain gut access they're activating the cortisol and the cortisol then disrupts their gut barrier and leads the inflammation.
好的，当然。我来翻译一下这段话，尽量使其易读：
是的，完全正确，这完全是大脑-肠道轴的表现。大脑-肠道轴指的是大脑和肠道之间的连接和相互交流。在这个背景下，大脑会释放一种激素，叫做促肾上腺皮质激素释放激素（CRH）。这种激素对整个身体都有影响，使全身处于紧张状态。值得注意的是，早上的皮质醇是一种对身体有益的激素。当早上皮质醇水平升高时，这是理想的状态，因为这是人体所需要的。但你不希望皮质醇在晚上10点、11点或半夜1点时还维持在高水平。皮质醇是让你起床和行动的激素。如果它在夜间仍然很高，会干扰你的睡眠，成为影响你昼夜节律的对手。而这种状况在一些人身上发生，他们通过大脑-肠道轴激活了皮质醇，皮质醇最终破坏了肠道屏障并引发炎症。
Where does healing from that trauma start in your view if a patient were to come to you yeah and they were they had loads of complications with their gut yeah but you were able to identify that trauma was playing a row yeah where would you start with with their healing journey the most important thing is the is to and I think this is the the moment that will be most impactful for some of the listeners not all but some the most important thing is to understand that the trauma is the root of the issue because most people the way that we react to trauma it's the part that we don't want to talk about right so we push it into the corner and we pretend that it's not there we're not like we know it's there but we're not going to even look at it and so the solution is to accept and acknowledge that the trauma is the root of the problem because then you need to actually turn towards it and that's under professional that's with professional help so there's different things that you can do different approaches including cognitive behavioral therapy they're all administered by trained health professionals that's not what I do but step one is the acknowledgement and understand if that's the problem.
在您看来，如果有患者因创伤问题找您求助，而他们的肠道又有许多并发症，但您发现创伤是其中一个因素，那么您会如何开始他们的疗愈旅程呢？
最重要的是要理解创伤是问题的根源。这一点对某些听众来说可能会特别有影响，尽管不一定对所有人都是如此。大多数人对待创伤的方式，就是我们不想谈论它。我们把它推到角落里，假装它不存在。我们知道它在那里，但仍刻意不去面对。因此，解决办法就是接受并承认创伤是问题的根源。
接下来，你需要在专业人士的协助下真正去面对它。可以采用多种方法，包括认知行为疗法，这些都需要由经过培训的健康专业人员来实施。虽然这不是我的工作，但第一步就是承认并理解创伤是问题所在。
You remember last time we made lots of different shapes of poop I think we were using was the Bristol stool there we go yeah we have this Bristol stool thing which is the different types of poop that people produce and on this table I think we have a variety of different styles just to remind me once again if I was guessing I would assume that maybe this one is healthy or this one yeah which one is healthy and Jacobar is your so this sweet Jacobar right here is your glorious Bristol 4 Bristol 4 so the Bristol stool scale is seven unique types of poop and you can tell by looking in the toilet bowl we have been told don't look there's nothing to see there but what I'm saying is we discussed this that 60% of the weight of your stool is your microbiome that's the microbiome story right there in the toilet bowl and so the Bristol 4 is the normal bowel movement and it should be it shouldn't be a rectangle but it's soft but formed like a sausage and the word Bristol is coming from this thing called the Bristol stool chart.
你还记得上次我们讨论过各种不同形状的大便吗？我想我们用的是布里斯托大便分类法，对，就是那个。布里斯托大便分类法是用来定义人们产生的不同类型的大便的。我记得在这个表上，我们有各种不同风格的例子。如果让我猜测哪个是健康的大便，我会想到可能是这个。对，就是这个甜美的"Jacob"，它在布里斯托分类中属于4号类型。布里斯托大便分类共有七种类型，通过观察马桶里的大便形状可以判断。我们通常被告知不要看马桶，但其实从中可以看出一些信息。据说60%大便的重量是由肠道微生物组成的，这在大便中就是微生物群的故事。而布里斯托4号是正常的排便形态，应该不是方块，而是像香肠一样柔软成型。"布里斯托"这个名称来源于"布里斯托大便分类表"。
Yeah so the Bristol stool chart actually comes from Bristol in the UK right the city of Bristol where they did a study in the early 90s and what came of that study was the discovery of these seven unique stool types so and four is normal and three many people would consider normal three is just sort of lumpy bumpy like this but and many people would consider that to be normal by type one and two are constipation and types six and six and seven are diarrhea now what's interesting is that the Bristol study was one location in the UK 2000 people actually at Zoe we did a nationwide survey in the UK and we had 140,000 people tell us about their poop so we actually have we're working on publishing the papers that came from this but we have the largest survey on bowel habits that's ever been done in the world and how many people's people's people's healthy well based upon this actually it was interesting because the results were about what you expect there's a disproportionate number of people that are struggling with bowel related issues so it's probably about 40% of people that are struggling with bowel related issues.
是的，布里斯托大便分类法确实起源于英国的布里斯托市。在90年代初，他们进行了一项研究，发现了七种不同类型的大便。其中，类型四是正常的，很多人也认为类型三属于正常，尽管它稍微有些块状。不过，类型一和二表示便秘，而类型六和七表示腹泻。有趣的是，布里斯托研究只是在英国一个地方进行的，涉及2000人。实际上，在我们Zoe公司，我们进行了全国范围的调查，收集了14万人的大便情况。我们正在准备发表相关论文，这是全球范围内关于排便习惯最大规模的调查。根据这项研究，结果显示大约40%的人有排便方面的问题，这表明与预期相符，有相对较多的人在与大便问题作斗争。
Of all the different types of people one could have is there any that I should be most concerned about if you have these like little pellets rabbit pellets that's severe constipation and is that a lack of something a lack of fiber or a lack of fiber for sure okay but sometimes this is stool softening issue too so like for people that have severe constipation fiber is more nuanced than people are willing to discuss on social media everyone makes this sound like the simple solution is just increase your fiber it's not necessarily that simple so sometimes you have to add magnesium magnesium supplements are great with fiber what do they do so they help to draw water into the intestine and that water softens up the stool so if you have the fiber for the form and you have the magnesium to make it soft this is how you get a soft formed bowel movement.
在所有不同类型的人群中，有没有什么是我应该特别关注的，比如如果你有像兔子粪便那样的小颗粒，那就可能是严重便秘的问题。这是否是因为缺乏什么呢？应该缺乏纤维，但有时候这也是一个大便软化的问题。对于那些有严重便秘的人来说，纤维问题比人们在社交媒体上讨论的要复杂得多。大家通常会说简单地增加纤维摄入就可以解决问题，但这并不总是那么简单。有时你还需要添加镁，镁补充剂与纤维搭配效果很好。它们的作用是什么呢？它们有助于将水分引入肠道，而水分会软化粪便。所以如果你有纤维来形成形状，同时有镁来软化大便，就能形成软而成形的排便。
We talked a moment ago about taking a nighttime magnesium supplement okay if your goal is to sleep or to relax magnesium glycinate is a phenomenal choice but if you're constipated that's not going to do anything so don't do that for constipation magnesium oxide is the one that I would typically go with but there's also magnesium sulfate and magnesium citrate those are the choices okay yeah and if you get to a Bristol 7 which is just like diarrhea that's just yeah it's just a liquid you're not in a good place and so obviously that needs to be addressed as well and be aware of what we talked about earlier which is that there are some people who suffer from chronic constipation and then they start having diarrhea and actually that's overflow.
我们刚才谈到关于在晚上服用镁补充剂的问题，如果你的目标是改善睡眠或放松，甘氨酸镁是一个非常好的选择。但如果你有便秘问题，这种镁不会有帮助，所以不要用它治疗便秘。对于便秘，我通常会推荐氧化镁，不过你也可以选择硫酸镁或柠檬酸镁。
另外，如果你发现自己达到布里斯托尔大便分类法中的7级状况，也就是出现类似腹泻的液体便，这说明身体状况不佳，需要及时解决。请注意我们早些时候谈到的一种情况：有些人长期便秘，随后出现腹泻情况，这实际上可能是溢出性腹泻的表现。
Doctor what's the most important thing we haven't talked about as it relates to all that is in your new book that you think we should have talked about I mean we've probably covered tiny tiny tiny fraction of all the things in that but it gives people a flavor is there one other thing that you think is the most important thing that we haven't talked about here's what I really feel compelled to say to be totally honest with you you're holding the book the book is called plant powered plus I don't want people to be intimidated by the title of my book let me explain this I believe that there are many pads to healing there are many different dietary patterns the one that's going to work the best for you is the one that you're actually willing to do right so this book is not about a one size fits all approach nor is it a hundred percent plants that's not what the book is about so instead the conversation and what we haven't discussed is what's missing in our diet that we really need and we've kind of started to touch on this.
医生，我们还有哪些关于您新书的重要内容没有讨论到，您觉得我们应该谈谈的部分？我想我们可能只聊到书中内容的一小部分，但这可以给大家一个概述。有没有什么最重要的事情是我们还没有讨论到的？说实话，我真的很想告诉大家，您手中的这本书叫做《植物赋能+》。我不希望人们被我书的标题吓倒，让我来解释一下。我相信有很多种疗愈的途径，也有许多不同的饮食模式，最适合你的饮食模式是你真正愿意尝试和坚持的。因此，这本书并不是在推荐一种放之四海而皆准的方法，也不是要你百分之百吃植物。这并不是这本书的核心内容。所以，我们应该讨论的是，饮食中有哪些必要的元素是我们缺少的，我们需要关注这些，而我们其实已经开始涉及到这个话题。
I've identified four things and these four things you find in all of the healthy dietary patterns so whether it's Mediterranean pescatarian flexitarian if you do it right you're going to have these four things number one fiber number two polyphenols number three healthy fat so healthy fat is the extra virgin olive oil healthy fat is this avocado right here healthy fat are these seeds and nuts right here okay they all have healthy fat and in whole form you should consume these whole form foods without restriction if you are obese and you're trying to lose weight the problem with any oil not just not just seed oils also including extra virgin olive oil is that this is the highest calorie thing that exists on the entire planet you cannot create something with a higher calorie content than oil.
我找出了四个在所有健康饮食模式中都能找到的元素，无论是地中海饮食、鱼素饮食还是灵活素食饮食，只要做得对，你就会包含这四个元素。第一是纤维，第二是多酚，第三是健康脂肪。健康脂肪包括特级初榨橄榄油、牛油果以及这些种子和坚果，它们都含有健康脂肪。在健康饮食中，你可以不受限制地食用这些完整形式的食物。但如果你是肥胖人士并希望减肥，任何种类的油，包括特级初榨橄榄油，都是问题所在，因为油是世界上热量最高的东西，你无法创造出热量比油更高的食物。
So it's not to your advantage to really focus on oil if anything you should be limiting your oil intake but these healthy fats the monounsaturated fats that you get from nuts from avocado if we had fish like a salmon or shellfish the omega-3s that you get from those things there's tremendous benefit to those healthy fats that was the third one and on the fourth is fermented food okay which is so which we don't actually see we kind of see here we got the pickles all right we got some pickles here um but the thing about fermented food is most of us are not eating fermented food so the average intake of fermented food in the United States is zero and if any maybe once in a while yogurt that's it we have tons of choices that are available to us.
所以，对于油脂来说，过多关注并不是对你有利的。如果有什么的话，你应该限制油的摄入。然而，来自坚果、牛油果的单不饱和脂肪，以及像三文鱼、贝类这样的鱼类所含的欧米伽-3脂肪酸，这些健康脂肪带来的好处是巨大的。这是第三点。而第四点是发酵食品。实际上，我们并不是很常见到发酵食品，但在这里我们有一些泡菜。不过，大多数人并没有食用发酵食品，美国的平均发酵食品摄入量几乎为零，可能偶尔吃一点酸奶而已。实际上，我们有很多选择可供尝试。
And the key that people need to know is a Stanford study done by some of my friends Christopher Gardner and Justin and Erica Sonnenberg and what they showed is that in just eight weeks by adding fermented food to their diet people could increase the diversity of their gut microbiome that means a healthier gut and they lowered inflammation so as the gut gets healthier inflammation goes down and they did that just by adding fermented food so Steve these four things fiber 95% of Americans are deficient polyphenols almost no one is getting the recommended amount of fruits and vegetables healthy fats we're not opting for the types of fats that we're talking about right now I want people to get more omega-3s and more monounsaturated fat and finally fermented food no one's really consuming if you think about your diet this shouldn't be an exercise in more of the thing that you already have this should be an exercise of what is the thing that's missing that we could add that could transform our health because that's the real opportunity so that's what the nutrition program is about.
人们需要知道的关键点是，我的一些朋友Christopher Gardner和Justin及Erica Sonnenberg在斯坦福大学进行的一项研究显示，仅仅通过在饮食中添加发酵食品，八周内就可以增加肠道微生物群的多样性，这意味着更健康的肠道，并且炎症也会降低。也就是说，随着肠道的健康程度增加，炎症下降。而他们所做的，仅仅是添加了发酵食品。
Steve，这里有四个关键点：纤维——95%的美国人都缺乏；多酚——几乎没有人摄入推荐量的水果和蔬菜；健康脂肪——我们没有选择我们正在谈论的那类脂肪，我希望大家摄入更多的Omega-3和单不饱和脂肪；最后是发酵食品——几乎没有人在饮食中摄入。
如果你考虑自己的饮食，这不应该是单纯去增加已经有的东西，而应该是寻找那些可以添加的、真正能改变我们健康的元素，因为这才是真正的机会。这就是这个营养计划的核心内容。
When I look at these this photo of you before and after I think this one's probably sort of during medical school was it or just after medical school so I was actually that's in my early 30s on the left yeah and then this photo here which I'll put up on the screen is you at one age yeah about 40 okay well 10 years has passed and you look 10 years younger yeah and you look pretty ripped yeah what changed in your life between these two photos what was different in one's mind knowledge mentality psychology what was different so the the easy answer is I change my diet I change my lifestyle I grew up eating junk food I grew up eating fast food we celebrated that sort of diet and I shifted towards eating the way that I'm describing to you today right I obviously started going to the gym and working out I think everyone should be going to the gym and working out I don't think that's to be underestimated that's an important part of the program that I'm proposing for people right so there's those things but the part that you don't get on the surface that I don't really talk about that much is I also need to heal on the inside.
当我看到这两张你的照片时，一张是你医疗学校期间或刚毕业后的，而另一张是在你40岁时拍摄的。可以清楚地看到，10年过去了，你不仅显得年轻了10岁，而且身材也非常健美。那么，在这两张照片中间，你的生活发生了哪些变化呢？心态、知识、心理上有什么不同呢？
最简单的答案就是我改变了饮食习惯和生活方式。我小时候吃的是垃圾食品和快餐，这样的饮食习惯曾经是我们庆祝的方式。但如今，我已经改变为我今天所描述的饮食方式了。
显然，我开始去健身房锻炼，我认为每个人都应该去健身房锻炼，不能低估锻炼的重要性，这是我提议的计划中的一个重要部分。
除此之外，还有一些在表面上看不到的改变，我不常谈论但是也非常重要的——我也需要在内心深处进行自我疗愈。
So I was in a dark place and I wasn't in a dark place just because of my diet there were issues that existed within our family I had issues with my dad and I needed to resolve those and what happens a few things one literally an angel came into my life that's my wife right she came into my life in 20 and 2012 and she never pushed anything on me but just seeing her and having her as a presence in my life was what I really needed to change myself in terms of my diet in terms of my lifestyle but also to pick up the phone and call my dad who I didn't talk to in 10 years you'd full an out totally phone oh and there's an entire story that goes into that and I have to own my own mistakes because I'm as guilty as anyone for the issues that existed between us but I picked up the phone and I called him and the other thing that happened in my life that really changed everything was the birth of my daughter.
我曾经处于一个非常低谷的状态，这不仅仅是因为我的饮食问题，还有我们家庭中存在的一些问题。我和我父亲有矛盾，我需要解决这些问题。后来，一些事情发生了，一个“天使”进入了我的生活，那就是我的妻子。她在2012年出现在我生命中，她没有强迫我做任何事情，但只是她的出现和陪伴让我意识到我需要在饮食和生活方式上改变自己。同时，她也让我鼓起勇气打电话给我那已经10年没联系的父亲，我们之间的矛盾完全疏远了。而这背后有很多故事，我也必须承认自己的错误，因为在我们之间的问题上我也有责任。最终，我还是拿起了电话，给他打了过去。还有另一件改变我生活的重大事就是我女儿的出生。
So my oldest I four kids my oldest is now 11 and when you hold that child in your hands you're a different person instantly and I can't describe this to a person to someone who's never experienced this but you have a purpose that you didn't have prior to that day you've experienced love that you never understood and the love that I had for my daughter helped me to understand the love that my own dad had for me but I could never accept that and so the complexity of it all is yes I changed my diet my lifestyle yes I started working out but I also needed to forgive my dad for the things that happened when I was a kid and reconnecting with my dad was actually one of the most important and powerful things that happened for me.
所以我有四个孩子，我的大女儿现在已经11岁了。当你第一次抱起自己的孩子时，你会立刻变成一个不一样的人。这种感觉是无法向没经历过的人描述的。有了孩子之后，你会发现自己有了以前没有的目标，同时也体验到了前所未有的爱。我对女儿的爱让我理解了我爸爸对我的爱，尽管我以前从未能接受这种爱。对于我来说，这其中的复杂之处在于，的确，我改变了饮食和生活方式，也开始锻炼身体，但我还需要原谅爸爸在我小时候发生的事情。重新和爸爸建立联系，其实是我人生中最重要、最有力量的事情之一。
He was vacant he was absent or was this no my when I so this is something that chapter eight of my new book to me it's my masterpiece of all the chapters this my third book of all the Chaps over it and it's the one that I'm most proud of by far and if you if people get the audio book they're going to hear it in my voice so there were some things that I needed to talk about and you'll find them in that chapter and basically this story is that our family we went through a really hard time and my parents got divorced and I was seven and I was the oldest of three boys it was not a nice divorce and when it happens you feel like you have to choose it side and from my perspective again you know I was a kid but there was a part of me that said dad you're a man why did you allow this to happen why did you allow this to happen to our family why didn't you fix this and eventually I stopped talking to him and that was around the time that I graduated from college.
他心不在焉，是出了神吗？还是……不，这不是我想要的。这是我新书第八章中的一部分，对我来说，这是所有章节中我最引以为豪的作品。这是我写的第三本书，而这一章是我最为骄傲的。如果你听有声书，你会听到我亲自讲述这个故事。
在那一章中，我谈到了一些我需要分享的事。这基本上是关于我们家庭的一段故事。我们家经历了一段非常困难的时期，我父母离婚了，当时我七岁，是三兄弟中的老大。离婚的过程并不愉快。当这种事情发生时，你会觉得必须站队。作为一个小孩，从我的视角来看，我心里有个声音在问：爸爸，你是个男人，为什么让这种事情发生？为什么让我们的家庭变成这样？你为什么不去解决这个问题？最后，我停止了与他的交流，那是在我大学毕业的那段时间。
So for 10 years I was like I went to medical school at Georgetown I went to Northwestern I was the chief medical resident there I won the highest award in my residency. class I was fully accomplished I was accomplishing everything I was very very sad inside and what was missing was my dad and I needed him there and so having my daughter and feeling the love that I felt instantly for my daughter helped me to understand the love that my dad had for me and ultimately what I realized Steve is that because I think you have to know that's hard to explain in short order is that we had two brothers my dad used to take us camping three boys no one else just him he took us camping all the time he took us to the vacation all the time if there was a sporting event he was always there right but I wasn't able to see that all of that was really an active love and now having kids myself and understanding how hard it is to be a parent and raise these kids the idea of taking three boys camping by yourself is insane to me.
所以，在过去的十年里，我一直有种感觉：我上了乔治城大学的医学院，去了西北大学，还当上了那里首席住院医师，并在实习期间获得了最高奖项。我在事业上取得了所有成就，但是内心却非常非常悲伤，因为我缺少了我父亲的存在，我需要他在我身边。后来我有了女儿，在瞬间感受到对女儿的爱，这让我理解了我父亲对我的爱。最终，我明白了，斯蒂夫，我觉得有些事挺难用简单的话表达清楚。我们有两个兄弟，我父亲经常带我们三兄弟去露营，不带其他人，只是他一个人。他总是带我们去度假，也总是出现在各种体育活动中。我以前没能看到这一切其实都是爱的表现。现在我自己也有了孩子，理解了做父母和养育孩子有多不容易，想到我父亲一个人带三个男孩去露营，简直不可思议。
I now understand how hard my dad was trying and in your book published in um 2020 I believed 2020 you wrote this fan could you read that in your own voice because I was gonna read it but it's very personal you wrote this in the front of the book yeah I lost my dad during the preparation of this book it was sudden and completely unexpected I couldn't wait to share this book with him would have been easy to just send an electric cop electronic copy but I really wanted his first read to be a physical book with the hard cover all the pages and his son's name on the front over the past few months my dad repeatedly told me how proud he was of me he told me that my grandparents John and Helen Bolsoitz would have been so proud of the work I was doing in the name of our family I can't tell you how much it means to me that he said all that it breaks my heart that he's not here anymore I am who I am because of him but I will forever be grateful for the special times that we shared love you dad will always be thinking of you this book is for you.
我现在明白我爸爸付出了多大的努力。在你2020年出版的书中，我记得是在2020年，你写了一段话。你能用自己的声音读出来吗？因为我本来要读的，但这段文字非常私人。你在书的前面写了这段话：
在准备这本书的过程中，我失去了我的父亲。这是突然而完全意想不到的。我迫不及待地想和他分享这本书，本可以简单地发送一个电子版本，但我真的很想他的第一次阅读是实体书，有硬封面、所有的页面，并且封面上有他儿子的名字。过去几个月里，我爸爸多次告诉我，他为我感到骄傲。他告诉我，我的祖父母John和Helen Bolsoitz会为我以家族的名义所做的工作感到自豪。他说的这些对我意味着什么，我无法用语言表达。让我心碎的是他已经不在了。我之所以成为现在的我，都是因为他。我永远感激与他共度的特别时光。爱你，爸爸。我会一直想念你。这本书献给你。
You know we're all susceptible for letting a relationship sour and then losing a lot of time and I think that's why your story is so inspiring because it reminds us that I guess what might as most in the end and sometimes we can lose I don't know decades years because of grudges or because of misunderstandings that I've never been addressed so I mean it's a huge compliment to your wife that she had the way with all to to try and get you guys to reconnect so that you could reform that relationship before he did pass away and I'm a no doubt that he was would be incredibly proud if it's if he was watching it over us now and I had seen what's happened in the in the last five years in your life because it's been incredible actually incredible healing comes in many forms and sometimes it's the changes that we make to our diet and sometimes it's the changes we make in our relationships with other people.
你知道，我们都容易让一段关系变得苦涩，从而失去很多时间。我认为这就是你的故事如此鼓舞人心的原因，因为它提醒我们，什么才是最终最重要的。有时候，我们可能会因为积怨或未曾解决的误会而失去数年甚至数十年的光阴。因此，我想对你妻子表示极大的赞赏，因为她有能力努力让你们重新联系起来，以便在他去世前修复这段关系。我毫不怀疑，如果他现在能看到你们这五年来的变化，他会感到无比自豪。实际上，这种改变是令人难以置信的。治愈有很多种形式，有时候是我们对饮食的改变，有时候是我们在人际关系中的改善。
There's different opportunities you and I talked about like what is the thing for every person that's something different and it's funny how they're both extricably linked because when one gets right with themselves and others they often find it much easier to get control of their diet and their lifestyle and then it all clicks. I highly recommend everybody goes and gets this book it's it's going to be published in the US here on the 13th of January and in the UK and the 15th that's right yeah Tuesday and the US Thursday and the UK. So I'm going to link it below and we just touched on a fraction of it we haven't gone into much of the details but if you ask someone that is struggling with your gut you know one of the 61% or 70% of people that told me ahead of this conversation that you were I highly recommend this book because it's incredibly accessible in the way that it's written but also it's incredibly comprehensive and up to date.
你我讨论过不同的机会，对每个人来说，情况都会有所不同。很有趣的是，这些事情密不可分，因为当一个人能很好地处理自己和与他人的关系时，往往也会更容易控制自己的饮食和生活方式，一切就会变得顺利。我强烈推荐大家去获取这本书，它将在1月13日于美国出版，1月15日在英国出版。是的，没错，美国是在周二，英国是在周四。我会在下面提供链接。我们只讨论了一小部分内容，并没有深入细节。如果你是那些肠道有问题的人之一——根据我在这次谈话之前得到的数据，有61%或70%的人属于这种情况——我强烈推荐你去读这本书，因为它的写作方式非常易读，同时内容也非常全面和最新。
As you said the science on the gut and all of the related gut related sort of issues and symptoms that we have is always evolving so I love having these conversations is almost refreshes and updates to me because every single time I learn something new and I get more of the sort of jigsaw puzzle of my gut health and as it relates to like my brain and my immune system filled in. It's having it's really remarkable how much of a real-world impact these conversations have had on me they don't think people know this enough but they often ask me like which conversations had an impact on you the way that I view it it's almost it is like a jigsaw puzzle and each conversation is adding a piece and I can see since we had that last conversation about poop and the gut and the microbiminal those things there's been radical changes I've made to my life that I've had a radical impact.
正如你所说，关于肠道以及相关问题和症状的科学研究不断发展，所以我很喜欢这些对话，它们几乎像是给我更新信息。每次我都会学到新东西，让关于我肠道健康、以及它与大脑和免疫系统关系的拼图更完整。这些对话对我的现实生活影响非常显著。我觉得大家对此了解不够，很多人常问我哪些对话对我有影响。我认为这就像拼图游戏，每次对话都在补充新的一块。从我们上次关于大便、肠道和肠道微生物群的对话以来，我的生活发生了重大变化，对我的影响很大。
It's like the lights have been turned on and that's a really good example of what this book does when you read it it turns on the lights so highly recommend people go check it out. You are launching a YouTube channel you said yeah I'm launching a I'm launching a YouTube channel it's the gut health MD and that's also my social hashtag or my social handle so you can find me all those locations but my home base is my website the guthealthmd.com and if you come there I highly encourage people to register for my email newsletter because it's a completely free resource basically a sub-stack for free that's designed this is where I love to like really have these conversations with people about hey there's this new study let's talk about it hey there's this thing that I'm seeing let's talk about it right hey this is what I'm doing right now right so it's an opportunity for sharing that goes beyond like the limitations of social.
就像灯被点亮了一样，这本书就有这样的效果。读它的时候，就像灯光被打开了，因此我非常推荐大家去看看这本书。你提到你正在启动一个 YouTube 频道，是的吗？是的，我正在启动一个 YouTube 频道，叫做 "The Gut Health MD"，这也是我的社交媒体标签或用户名，你可以在所有这些地方找到我，但我的主要基地是我的网站 theguthealthmd.com。我非常鼓励大家来这里注册我的电子邮件通讯，这是一个完全免费的资源，基本上就是一个免费的 sub-stack，这里是我喜欢和大家讨论的地方，比如有新的研究时我们可以讨论，还有我现在在做的事情，这样的分享机会超越了社交媒体的限制。
I'll link all of that below everything we've mentioned in the last 30 seconds everyone can check you out. We do have a closing tradition where the last guest leaves a question for the next and the question that has been left for you is what is one thing you could do today to help rectify your life's biggest regret is it that fighty um well I think that the good news this is to me if anything a story of hope and optimism because on many levels I did um so reconnecting with my dad was key but I think that the other piece is when you when you lose a person the way that we lost my dad he's gone right and it happened real fast and I didn't get to say goodbye.
我会在下面附上所有我们在过去30秒中提到的内容，大家都可以查看。我们有一个结束环节的传统，就是让上一位嘉宾给下一位留下一个问题，而给你留下的问题是：你今天可以做哪一件事来弥补你人生中最大的遗憾？我觉得一个好消息是，这对我来说是一个充满希望和乐观的故事，因为在很多方面我确实做到了。与我父亲重新建立联系是关键，但我认为还有一点是，当你以我们失去我父亲那种方式失去一个人时，他就真的离开了。这件事情发生得太快了，我没有机会和他说再见。
I will say it's my faith that allows me to know like not to pretend to know to actually know that these things that I need to say to him that I never actually got a chance to say that I wish I did I'll have a chance to do that and I look forward to the day when I see him again. What would you say I would tell him that uh I hate the fact that it took me so long to figure out that he was a great dad and you know adults may have conflict that's what the divorce was but he was a phenomenal dad and I didn't see that or get that until I had my own kids doctor will thank you yeah.
我会说，是我的信念让我真正明白，而不是假装明白，我知道我有机会对他说那些我从未真正有机会说的话，我希望我能说的那些话。我期待着再次见到他的那天。你想知道我会对他说什么吗？我会告诉他，我讨厌自己花了这么久才明白他是个好父亲。人们成年后可能会有冲突，这就是他们离婚的原因，但他真的是个了不起的父亲，直到我有了自己的孩子之后我才意识到这一点。医生，非常感谢你。