This session is on natural wonders, and the bigger conference is on the pursuit of happiness. I want to try to combine them all, because to me, healing is really the ultimate natural wonder. Your body has a remarkable capacity to begin healing itself, and much more quickly than people had once realized, if you simply stop doing what's causing the problem. And so, really, so much of what we do in medicine and life in general is focused on mopping up the floor without also turning off the faucet.
Aceasta este o discutie despre minunile naturii iar conferinta per ansamblu este despre urmarirea fericirii. Vreau sa incerc sa le combin, pentru ca, din punctul meu de vedere vindecarea este cea mai mare minune a naturii. Corpul nostru are o capacitate remarcabila de a incepe procesul de autovindecare mult mai repede decat ne-am dat seama pana acum, prin simpla inlaturare a cauzei problemei. Prea mult din ceea ce facem in medicina si in viata in general e o incercare de a opri inundatia fara a inchide robinetul.
I love doing this work, because it really gives many people new hope and new choices that they didn't have before, and it allows us to talk about things that -- not just diet, but that happiness is not -- we're talking about the pursuit of happiness, but when you really look at all the spiritual traditions, what Aldous Huxley called the "perennial wisdom," when you get past the names and forms and rituals that divide people, it's really about -- our nature is to be happy; our nature is to be peaceful, our nature is to be healthy. And so happiness is not something you get, health is generally not something that you get, but rather, all of these different practices -- you know, the ancient swamis and rabbis and priests and monks and nuns didn't develop these techniques to just manage stress or lower your blood pressure or unclog your arteries, even though it can do all those things. They're powerful tools for transformation, for quieting down our mind and bodies to allow us to experience what it feels like to be happy, to be peaceful, to be joyful and to realize that it's not something that you pursue and get, but rather, it's something that you have already, until you disturb it.
Imi place sa fac munca asta pentru ca le da oamenilor speranta si optiuni noi, si ne da sansa sa vorbim despre - nu doar diete, pentru ca nu asta e fericirea - despre urmarirea fericirii, dar cand ne uitam la traditiile spirituale, la ceea ce Aldous Huxley numea ,,intelepciunea perena'', cand trecem de denumiri si forme si ritualuri care ne despart, totul se reduce la natura noastra de a fi fericiti. natura noastra este de a fi linistiti, de a fi sanatosi. Astfel fericirea nu e un lucru care se obtine, sanatatea nu e un lucru care se obtine. Mai degraba toate aceste practici - stiti, toti maestrii yoghini si rabinii, preotii, calugarii si maicutele nu au dezvoltat aceste tehnici doar pentru a gestiona stresul sau pentru scaderea tensiunii sau curatarea arterelor, cu toate ca au toate aceste efecte. Ele sunt puternice instrumente de transformare, de linistire a mintilor si trupurilor pentru a ne permite sa experimentam ce inseamna fericirea, pacea, bucuria, si sa realizam ca aceastea nu sunt lucruri pe care sa le obtinem, ci mai degraba lucruri care se afla deja in noi si pe care le-am tulburat. Am studiat yoga multi ani cu un maestru - Swami Satchidananda,
I studied yoga for many years with a teacher named Swami Satchidananda. People would say, "What are you, a Hindu?" He'd say, "No, I'm an undo."
iar oamenii il intrebau ,,Esti Hindus (Hindu)?'' , iar el spunea ,,Nu, sunt refacut (undo)''. Pentru ca totul se reduce la a identifica ceea ce
(Laughter)
It's about identifying what's causing us to disturb our innate health and happiness and then to allow that natural healing to occur. To me, that's the real natural wonder.
ne disturba sanatatea si fericirea inascute si apoi la facilita vindecarea naturala. Pentru mine, asta e adevarata minune a naturii.
So, within that larger context, we can talk about diet, stress management -- which are really these spiritual practices -- moderate exercise, smoking cessation, support groups and community, which I'll talk more about, and some vitamins and supplements. And it's not a diet. When people think about the diet I recommend, they think it's really strict. For reversing disease, that's what it takes. But if you're just trying to be healthy, you have a spectrum of choices. To the degree that you can move in a healthy direction, you're going to live longer, feel better, lose weight, and so on. And in our studies, what we've been able to do is to use very expensive, high-tech, state-of-the-art measures to prove how powerful these very simple and low-tech and low-cost -- and in many ways, ancient -- interventions can be.
Deci, in acest context putem discuta despre dieta, stress management, care sunt aceste practici spirituale, exercitii moderate, renuntarea la fumat, grupuri de sprijin si comunitati - despre care voi discuta mai pe larg - si unele vitamine si suplimente. Si nu este o dieta. Stiti, cand majoritatea oamenilor se gandesc la dieta pe care o recomand, au impresia ca e o dieta foarte stricta. Pentru a invinge boala de asta este nevoie, dar daca vrei doar sa te mentii sanatos, ai o gama larga de optiuni. Si in functie de masura in care vei merge in directia unui stil de viata sanatos vei trai mai mult, te vei simti mai bine, vei putea pierde in greutate, s.a.m.d. Si ceea ce am reusit sa facem prin studiile noastre, a fost sa folosim tehnologie foarte scumpa, de ultima ora, pentru a demonstra cat de puternice pot fi aceste simple si ieftine metode stravechi.
We first began by looking at heart disease. When I began doing this work 26 or 27 years ago, it was thought that once you have heart disease, it can only get worse. What we found was, instead of getting worse and worse, in many cases, it could get better and better, and much more quickly than people had once realized.
Am inceput cu bolile de inima, iar cand am inceput aceste studii acum 26 sau 27 de ani, se credea ca odata declansata, boala de inima nu se poate decat agrava. Ceea ce am descoperit a fost ca in loc sa devina din ce in ce mai rau, in multe cazuri situatia poate deveni din ce in ce mai buna, mult mai repede decat oamenii realizau pe vremuri.
This is a representative patient who, at the time, was 73, told he needed to have a bypass, decided to do this instead. We used quantitative arteriography, showing the narrowing. This is one of the main arteries that feeds the heart, and you can see the narrowing here. A year later, it's not as clogged; normally, it goes the other direction. These minor changes in blockages caused a 300 percent improvement in blood flow, and using cardiac positron-emission tomography, or PET, scans -- blue and black is no blood flow, orange and white is maximal -- huge differences can occur without drugs, without surgery. Clinically, he couldn't walk across the street without getting severe chest pain. Within a month, like most people, he was pain-free, and within a year, climbing more than 100 floors a day on a StairMaster. This is not unusual, and it's part of what enables people to maintain these kinds of changes, because it makes a big difference in their quality of life. If you looked at all the arteries in all the patients, they got worse and worse from one year to five years in the comparison group. This is the natural history of heart disease. But it's really not natural; we found it could get better and better, and much more quickly than people thought. We also found the more people changed, the better they got. It wasn't a function of how old or sick they were, but of how much they changed. The oldest patients improved as much as the young ones.
Acesta este un pacient reprezentativ care la vremea respectiva avea 73 de ani si desi avea nevoie absoluta de bypass a ales asta in schimb: (am folosit arteriografia cantitativa pentru a arata ingustarea)- aceasta e una din arterele care alimenteaza inima, una din arterele principale - si puteti vedea ingustarea aici. Un an mai tarziu nu mai este la fel de infundata - in mod normal merge in directia opusa. Aceste schimbari minore in ceea ce priveste blocajele au dus la o imbunatatire de 300% a fluxului sanguin, si folosind tomografia pozitronica albastru si negru reprezinta absenta fluxul sanguin, portocaliu si alb fluxul maxim. O diferenta enorma poate fi realizata fara medicamente sau chirurgie. Din punct de vedere clinic, el pur si simplu nu putea trece strada fara dureri severe in piept; intr-o luna nu mai simtea dureri in piept, ca majoritatea oamenilor, iar un an mai tarziu putea sa urce 100 de etaje pe zi pe un aparat de gimnastica. Nu este un lucru neobisnuit, si asta ii face in parte pe oameni sa mentina genul acesta de schimbari, pentru ca le imbunatateste atat de mult calitatea vietii. Per ansamblu, daca ne uitam la arterele tuturor pacientilor, s-au degradat din ce in ce mai tare, intr-unul pana la cinci ani, in grupul de comparatie. Aceasta este istoria naturala a bolilor de inima, dar de fapt ea nu este ,,naturala'' deloc, pentru ca am descoperit ca starea de sanatate se poate imbunatati mult mai repede decat oamenii au realizat pana in acum. Am mai descoperit ca cu cat oamenii fac mai multe schimbari, cu atat mai mult se insanatosesc. Nu e in functie de cat de in varsta sau bolnavi erau, ci in functie de cat de mult si-au schimbat stilul de viata, iar pacientii mai in varsta si-au imbunatatit starea mai mult decat cei tineri.
I got this Christmas card a few years ago from patients in one of our programs. The younger brother is 86; the older one is 95. They wanted to show me how much more flexible they were. The following year they sent this, which I thought was funny.
Am primit aceasta felicitare de Craciun acum cativa ani de la doi din pacientii nostri. Fratele mai mic are 86 de ani, iar celalalt 95. Au vrut sa imi arate cat li se imbunatatise mobilitatea, iar in anul urmator mi-au trimis-o pe aceasta, care mi s-a parut destul de amuzanta.
(Laughter)
(Rasete)
You just never know. And what we found was that 99 percent of the patients stopped or reversed the progression of their heart disease. Now, I thought if we just did good science, that would change medical practice. But that was naive. It's important, but not enough, because we doctors do what we get paid to do and trained to do what we get paid to do, so if we change insurance, then we change medical practice and medical education. Insurance will cover the bypass and angioplasty but won't, until recently, cover diet and lifestyle.
Nu se stie niciodata... Ceea ce am observat a fost ca in cazul a 99% din pacienti boala de inima a inceput sa regreseze. Si m-am gandit ca daca as fi facut totul dupa o stiinta riguroasa asta ar fi schimbat practica medicala pentru totdeauna, dar am fost putin naiv. E important, dar nu e de ajuns. Pentru ca noi doctorii facem ceea ce suntem platiti sa facem, si suntem invatati sa facem ceea ce suntem platiti sa facem, deci daca schimbam asigurarile atunci vom schimba practica si educatia medicala. Asigurarea acopera bypass-ul, acopera angioplastia. Dar nu acoperea, pana de curand, dieta si stilul de viata. Asa ca am inceput, printr-o organizatie nonprofit,
So we began, through our nonprofit institute, training hospitals around the country, and we found that most people could avoid surgery. And not only was it medically effective, it was also cost-effective. The insurance companies found that they began to save almost 30,000 dollars a patient, and Medicare is now in the middle of doing a demonstration project, paying for 1,800 people to go through the program in the sites we train. The fortuneteller says, "I give smokers a discount, because there's not as much to tell."
sa invatam spitalele de-a lungul tarii, si am descoperit ca majoritatea oamenilor ar fi putut evita operatia, fiind un lucru eficace nu numai din punct de vedere medical, dar si eficient ca cost. Iar companiile de asigurare au realizat ca incepusera sa economiseasca 30.000 de dolari de pacient, si astfel Medicare este acum pe cale de a realiza un proiect demo prin care platesc pentru 1.800 de oameni inrolati in program in locurile in care noi il implementam. O ghicitoare spunea ,,Le fac reducere fumatorilor pentru ca nu prea am ce sa le spun''. Si (rasete)
(Laughter)
imi place acest slide pentru ca e o oportunitate de a discuta
I like this slide, because it's a chance to talk about what really motivates people to change and what doesn't. What doesn't work is fear of dying, and that's what's normally used.
despre ceea ce ii motiveaza pe oameni sa se schimbe si ceea ce nu ii motiveaza. Si ce NU functioneaza este frica de moarte, si totusi asta se foloseste in mod curent.
Everybody who smokes knows it's not good for you. Still, 30 percent of Americans smoke, 80 percent in some parts of the world. Why do people do it? Well, because it helps them get through the day. I'll talk more about this, but the real epidemic isn't just heart disease or obesity or smoking, it's loneliness and depression. One woman said, "I've got 20 friends in this pack of cigarettes. They're always there for me, and nobody else is. You're going to take away my 20 friends? What are you going to give me?" Or they eat when they get depressed or use alcohol to numb the pain or work too hard or watch too much TV. There are lots of ways we have of avoiding and numbing and bypassing pain, but the point of all of this is to deal with the cause of the problem. The pain is not the problem, it's the symptom. And telling people they're going to die is too scary to think about, or that they'll get emphysema or a heart attack is too scary, and they don't want to think about it, so they don't.
Stiti, toti cei care fumeaza stiu ca nu e bine pentru ei, si totusi 30% din americani fumeaza, iar in alte parti din lume chiar 80%. De ce fumeaza totusi? Pai, pentru ca ii ajuta de-a lungul zilei. Si voi vorbi mai mult despre asta, dar adevarata epidemie nu consta doar in bolile de inima sau obezitate sau fumat, ci in singuratate si depresie. Si cum spunea o doamna, ,,Am 20 de prieteni in acest pachet de tigari, si sunt mereu alaturi de mine atunci cand nimeni nu mai e. Daca imi luati cei 20 de prieteni, ce imi dati in schimb?'' Fie mananca cand sunt deprimati, fie se folosesc de alcool ca sa amorteasca durerea, fie lucreaza prea mult sau se uita prea mult la televizor. Toate acestea sunt metode la indemana pentru a evita sau atenua durerea, dar ideea este sa infrunti cauza problemei, iar durerea nu este problema, ci doar simptomul. Iar cand le spui oamenilor ca vor muri este prea infricosator ca sa se gandeasca - sau ca vor face emfizem sau vor avea un atac de inima - asa ca nu vor sa se gandeasca la asta si nici nu o fac.
The most effective anti-smoking ad was this one. You'll notice the limp cigarette hanging out of his mouth. And the headline is "Impotent," it's not "Emphysema." What was the biggest-selling drug of all time, when it was introduced a few years ago? Viagra, right? Why? Because a lot of guys need it. It's not like you say, "Joe, I'm having erectile dysfunction. How about you?" And yet, look at the number of prescriptions that are being sold. It's not so much psychological, it's vascular, and nicotine makes your arteries constrict. So does cocaine, so does a high-fat diet, so does emotional stress.
Cel mai eficient slogan anti-fumat a fost acesta: Observati tigara care ii atarna din gura, iar ,,impotenta'' - titlul este ,,impotenta'' si nu ,,emfizemul''. Care a fost cel mai bine vandut medicament al tuturor timpurilor, introdus acum cativa ani? Viagra, nu? De ce? Pentru ca multi barbati au nevoie de el. Nu e ca si cum poti sa spui: ,,Hei Joe, am o disfunctie erectila. - Tu?'' Si totusi uitati-va la numarul de vanzari. Nu e atat o problema psihologica, cat vasculara, iar nicotina face arterele sa se contracte. La fel si cocaina, la fel si alimentatia bogata in grasimi, la fel stress-ul emotional.
So the very behaviors that we think of as being so sexy in our culture are the very ones that leave so many people feeling tired, lethargic, depressed and impotent. And that's not much fun. But when you change those behaviors, your brain gets more blood, you think more clearly, have more energy, your heart gets more blood, as I've shown you. Your sexual function improves. These things occur within hours. This is a study: a high-fat meal, within one or two hours, blood flow is measurably less. And you've all experienced this at Thanksgiving. When you eat a big fatty meal, how do you feel? You feel kind of sleepy afterwards. On a low-fat meal, the blood flow doesn't go down -- it even goes up. Many of you have kids, and you know that's a big change in your lifestyle. People are not afraid to make big changes in lifestyle if they're worth it. And the paradox is that when you make big changes, you get big benefits, and you feel so much better so quickly. For many people, those are choices worth making -- not to live longer, but to live better.
Deci tocmai actiunile care ni se par atat de ,,sexy'' prin prisma culturii noastre sunt cele care ii fac pe majoritatea sa fie obositi, letargici, deprimati si impotenti, iar asta nu e prea amuzant. Dar cand modifici acest tip de comportament creierul incepe sa primeasca mai mult sange, incepi sa gandesti mai clar, ai mai multa energie, iar inima primeste mai mult sange asa cum v-am aratat. Functia sexuala se imbunatateste. Iar toate aceste apar in cateva ore. Acesta este un studiu - o masa bogata in grasimi - intr-o ora sau doua fluxul sanguin scade, iar cu totii ati experimentat asta de Ziua Recunostintei. Cand luati o masa mare si bogata in grasimi, cum va simtiti? Vi se face somn dupa aceea. In cazul meselor sarace in grasimi fluxul sanguin nu scade, dimpotriva. Multi dintre voi aveti copii si stiti ca asta implica o schimbare majora a stilului de viata, deci oamenii nu se tem sa faca schimbari daca stiu ca merita. Iar paradoxul este ca atunci cand faci schimbari majore, beneficiile sunt majore, si te simti mult mai bine foarte repede. Pentru multi oameni, aceste alegeri merita, nu pentu a trai mai mult, ci pentru a trai mai bine.
I want to talk a little bit about the obesity epidemic, because it really is a problem. Two-thirds of adults are overweight or obese, and diabetes in kids and 30-year-olds has increased 70 percent in the last 10 years. It's no joke, it's real. And just to show you this, this is from the CDC. These are not election returns; these are the percentage of people who are overweight. And if you see from '85 to '86 to '87, '88, '89, '90, '91 -- you get a new category, 15 to 20 percent; '92, '93, '94, '95, '96, '97 -- you get a new category; '98, '99, 2000 and 2001. Mississippi, more than 25 percent of people are overweight. Why is this? Well, this is one way to lose weight that works very well --
Vreau sa va vorbesc putin despre epidemia obezitatii, pentru ca este o adevarata problema. Doua treimi din adulti sunt supraponderali sau obezi, iar diabetul la copii si la cei de pana in 30 de ani a crescut cu 70% in ultimii 10 ani. Nu e o gluma, e adevarat. Si acestea sunt date furnizate de agentia nationala de sanatate. Acestea nu sunt rezultatele alegerilor, ci reprezinta procentul persoanelor supraponderale. Si daca va uitati - din '85 in '86, in '87, '88, '89, '90, '91 avem o noua categorie, 15 - 20%; '92, '93, '94, '95, '96, '97 - o noua categorie; '98, '99, 2000 si 2001. In Mississippi peste 25% din populatie este supraponderala. De ce se intampla asta? Pai... asta este o metoda de a slabi foarte buna,
(Laughter)
dar din pacate nu dureaza, si asta este problema.
but it doesn't last, which is the problem.
(Rasete)
(Laughter)
Nu e nici un mister cum poti slabi -
Now, there's no mystery in how you lose weight; you either burn more calories by exercise or you eat fewer calories. Now, one way to eat fewer calories is to eat less food, which is why you can lose weight on any diet if you eat less food, or if you restrict entire categories of foods. But the problem is, you get hungry, so it's hard to keep it off. The other way is to change the type of food. And fat has nine calories per gram, whereas protein and carbs only have four. So when you eat less fat, you eat fewer calories without having to eat less food. So you can eat the same amount of food, but you're getting fewer calories because the food is less dense in calories. And it's the volume of food that affects satiety, rather than the type.
fie arzi mai multe calorii prin exercitii, fie mananci mai putine calorii. Una dintre alternativele de a manca mai putine calorii este sa mananci mai putina mancare, si de aceea poti slabi prin orice dieta daca mananci mai putin, sau daca renunti la categorii intregi de alimente. Dar problema este ca ti se face foame, si astfel este dificil sa mentii dieta respectiva. Cealalta alternativa este schimbarea tipului de alimentatie. Grasimea are 9 calorii per gram, in timp ce proteinele si carbohidratii doar 4. Deci, daca mananci mai putina grasime reduci numarul de calorii fara a trebui sa mananci mai putin. Poti asadar manca aceeasi cantitate de mancare, dar mai putine calorii datorita alimentelor mai sarace in calorii. Iar satietatea e influentata de volumul de mancare mai degraba dacat de felul ei.
I don't like talking about the Atkins diet, but I get asked about it, so thought I'd spend a few minutes on it. The myth that you hear is, Americans have been told to eat less fat, the percent of calories from fat is down, Americans are fatter than ever, therefore fat doesn't make you fat. It's a half-truth. Actually, Americans are eating more fat than ever, and even more carbs. So the percentage is lower, but the actual amount is higher, so the goal is to reduce both. Dr. Atkins and I debated each other many times before he died, and we agreed that Americans eat too many simple carbs, the "bad carbs." And these are things like --
Nu-mi place sa vorbesc de dieta Atkins, dar sunt intrebat despre ea oricum, asa ca m-am gandit sa vorbesc cateva minute despre asta. Mitul pe care il tot auzim este ca americanilor li se spune sa manance mai putina grasime, procentul caloriilor din grasimi scade, iar cum americanii sunt mai grasi decat oricand rezulta ca nu grasimea te ingrasa. E numai pe jumatate adevarat. De fapt americanii mananca mai multe grasimi decat oricand, si chiar mai multi carbohidrati. Si astfel procentajul este mai redus, cantitatea reala este mai mare, si astfel scopul este sa le reducem pe amandoua. Dr. Atkins si cu mine am dezbatut de multe ori inainte sa moara, si am fost de acord ca americanii mananca prea multi carbohidrati simpli, ,,carbohidrati rai'', cum ar fi
(Laughter)
(Rasete)
sugar, white flour, white rice, alcohol. And you get a double whammy: you get all these calories that don't fill you up because you've removed the fiber, and they get absorbed quickly so your blood sugar zooms up. Your pancreas makes insulin to bring it back down, which is good, but insulin accelerates the conversion of calories into fat. So the goal is not to go to pork rinds, bacon and sausages -- these are not health foods -- but to go from "bad carbs" to "good carbs." These are things like whole foods or unrefined carbs. Fruits, vegetables, whole wheat flour, brown rice, in their natural forms, are rich in fiber. The fiber fills you up before you get too many calories and it slows the absorption, so you don't get that rapid rise in blood sugar. And you get all the disease-protective substances.
zaharul, faina alba, orezul alb, alcoolul, iar impactul negativ este dublu: ingerezi toate aceste calorii care nu te satura, pentru ca ai inlaturat fibrele, ele sunt absorbite rapid in sange, iar nivelul zaharului creste instantaneu. Pancreasul secreta insulina pentru a-i cobori nivelul, ceea ce este bine. Dar insulina accelereaza transformarea caloriilor in grasime. Si astfel, ideea este nu sa trecem la carne de porc, sunca si carnati - acestea nu sunt alimente sanatoase - ci sa trecem de la ,,carbohidrati rai'' la ,,carbohidrati buni''. Acestia sunt alimentele integrale sau carbohidratii nerafinati: fructe, legume, faina integrala, orez negru, care in forma lor naturala sunt bogate in fibre. Iar fibrele provoaca satietate inainte de a ingera prea multe calorii si incetinesc absorbtia, astfel incat nu exista o crestere rapida a zaharului in sange. Astfel primim toate substantele care ne apara de boli.
It's not just what you exclude from your diet, but also what you include that's protective. Just as all carbs are not bad for you, all fats are not bad; there are good fats. These are predominantly what are called omega-3 fatty acids. You find them, for example, in fish oil. Bad fats are things like trans-fatty acids in processed food and saturated fats, which we find in meat. If you remember nothing else from this talk: three grams a day of fish oil can reduce the risk of heart attack and sudden death by 50 to 80 percent. Three grams a day. They come in one-gram capsules; more than that just gives you extra fat you don't need. It also helps reduce the risk of the most common cancers, like breast, prostate and colon. The problem with the Atkins diet is, everyone knows people who've lost weight on it, but you can lose weight on amphetamines and fen-phen; there are lots of ways of losing weight that aren't good for you. You want to do it in a way that enhances your health, not one that harms it. The problem is, it's based on this half-truth: Americans eat too many simple carbs, so if you eat fewer, you'll lose weight, and even more weight if you eat whole foods and less fat, and you'll enhance your health rather than harming it. He says, "I've got good news. While your cholesterol level has remained the same, the research findings have changed."
Nu doar ceea ce eliminam din dieta, ci si ceea ce includem are un efect protector. La fel cum nu toti carbohidratii au efect negativ, nici toate grasimile nu sunt rele. Exista si grasimi bune. Iar acestea sunt cu precadere cele numite acizi Omega-3. Ele pot fi gasite, de exemplu, in uleiul de peste. Iar grasimile rele sunt cele ca acizii grasi trans si alimentele procesate si grasimile saturate, pe care le gasim in carne. Daca nu retineti altceva din aceasta discutie, 3 grame pe zi de ulei de peste pot reduce riscul de atac de inima si moartea subita cu 50 pana la 80%. Trei grame pe zi. Se gasesc in capsule de 1 gram - tot ce e mai mult e grasime in plus de care nu aveti nevoie. Ajuta de asemenea la scaderea riscului de cancer la san, prostata, sau cancer de colon. Problema cu dieta Atkins - toata lumea stie ca poti pierde kilograme astfel - dar acelasi efect il au si amfetaminele si alte medicamente de slabit controversate. Vreau sa spun ca sunt multe feluri in care poti slabi si care nu sunt neaparat sanatoase. Vrem sa slabim intr-un mod prin care sanatatea noastra sa aiba de castigat si nu sa fie afectata. Si problema e ca datorita acestui adevar partial, si anume ca americanii mananca prea multi carbohidrati simpli, avem impresia ca mancand mai putini astfel de carbohidrati automat vom pierde in greutate. Se pierd si mai multe kilograme consumand mancare integrala si mai putina grasime, si in acest fel sanatatea are de beneficiat. El zice: ,,Am vesti bune. In timp ce nivelul dumneavoastra de colesterol a ramas acelasi. rezultatele cercetarilor s-au schimbat.''
(Laughter)
(Rasete)
Now what happens to your heart when you go on an Atkins diet? The red is good; at the beginning and a year later. This is from a study in a peer-reviewed journal called "Angiology." There's more red after a year on a diet like I would recommend, there's less red, less blood flow after a year on an Atkins-type diet. So, yes, you can lose weight, but your heart isn't happy. Now one of the studies funded by the Atkins Center found that 70 percent of the people were constipated, 65 percent had bad breath, 54 percent had headaches -- this is not a healthy way to eat. So you might start to lose weight and start to attract people towards you, but when they get too close, it's going to be a problem.
Acum, ce se intampla cu inima voastra cand treceti pe dieta Atkins? Partea rosie este buna; un an mai tarziu - si asta e dintr-un studiu revizuit de colegii mei intr-un jurnal numit Angiologia - dupa un an e mai mult rosu in dieta pe care eu o recomand, si mai putin rosu, flux sanguin mai scazut, in tipul de dieta Atkins. Asadar da, poti scadea in greutate, dar inima ta nu este tocmai fericita. Unul dintre studiile finantate de Centrul Atkins arata ca 70% din pacienti erau constipati, 65% aveau respiratie urat mirositoare, 54% dureri de cap - acesta nu este un mod sanatos de a manca. In concluzie, ai putea sa slabesti si sa incepi sa devii atragator, dar cand oamenii se apropie de tine vei avea o problema.
(Laughter)
(Rasete)
And more seriously, there are case reports now of 16-year-old girls who died after a few weeks on the Atkins diet, of bone disease, kidney disease, and so on. And that's how your body excretes waste -- through your breath, bowels and perspiration. So when you go on these kinds of diet, they begin to smell bad. An optimal diet is low in fat, low in the bad carbs, high in the good carbs and enough of the good fats. And then, again, it's a spectrum: when you move in this direction, you're going to lose weight, you'll feel better, and you'll gain health.
Si intr-o nota mai serioasa, au fost cazuri de fete de 16 ani care au murit dupa cateva saptamani de dieta Atkins, de boli osoase, de rinichi, etc. Acesta este felul in care corpul excreta deseurile - prin respiratie, intestine si transpiratie. Deci cand treci pe o astfel de dieta incepi sa mirosi urat. De aceea, o dieta optima este saraca in grasimi si carbohidrati rai, bogata in carbohidrati buni si are destule grasimi bune. Din nou, e vorba de un spectru: cand pornesti in directia asta, vei pierde in greutate, te vei simti mai bine si vei deveni mai sanatos.
There are ecological reasons for eating lower on the food chain too, whether it's the deforestation in the Amazon or making more protein available to the four billion people who live on a dollar a day, not to mention whatever ethical concerns people have. So there are lots of reasons for eating this way that go beyond just your health.
Putem folosi si argumente ecologice pentru a ne alimenta cu elemente care se gasesc mai jos in lantul trofic: de la distrugerea padurii amazoniene sau cresterea cantitatii de proteine disponibila, pana la cei 4 miliarde de oameni care traiesc cu 1 dolar pe zi ca sa nu mai vorbim de toate celelalte probleme etice ale omenirii. Asadar, exista o varietate de motive pentru o astfel de alimentatie, care merg dincolo de propria sanatate. Suntem pe cale de a publica primul studiu
Now, we're about to publish the first study looking at the effects of this program on prostate cancer, in collaboration with Sloan Kettering and UCSF. We took 90 men who had biopsy-proven prostate cancer, who had elected, for reasons unrelated to the study, not to have surgery. We could randomly divide them into two groups, and then we could have one group that is a nonintervention control group to compare to, which you can't do with, say, breast cancer, because everyone gets treated.
care analizeaza efectele acestui program asupra cancerului la prostata; impreuna cu Sloane-Kettering (institutie de tratare a cancerului) si Universitatea din Califonia am facut studiul pe 90 de barbati care au fost identificati cu cancer la prostata si care au ales din motive personale sa nu faca operatie. Astfel i-am putut imparti aleatoriu in doua grupuri, si am putut folosi unul din ele ca si grup de control, lucru pe care nu l-am fi putut face in cazul cancerului de san de exemplu, in care toata lumea se trateaza. Ce am descoperit a fost ca dupa un an
We found that after a year, none of the experimental group patients who made these lifestyle changes needed treatment, while six of the control group patients needed surgery or radiation. When we looked at their PSA levels, which is a marker for prostate cancer, they got worse in the control group but got better in the experimental group. And the differences were highly significant.
nici unul dintre pacientii din grupul experimental, care facusera aceste schimbari in stilul de viata, nu avea nevoie de tratament, in timp ce 6 din grupul de control aveau nevoie de chirurgie sau radiatii. Cand am verificat antigenul prostatic specific, un indicator al cancerului de prostata, acesta crescuse in cazul grupului de control si se imbunatatise in cazul grupului experimental, cu o diferenta semnificativa.
I wondered -- was there any relationship between how much people changed their diet and lifestyle, whichever group they were in, and the changes in PSA? And sure enough, we found a dose-response relationship, just like we did in the arterial blockages in our cardiac studies. And in order for the PSA to go down, they had to make big changes.
Mi-am pus intrebarea daca era o legatura intre masura in care pacientii si-au schimbat stilul de viata, in orice grup ar fi fost, si modificarile de antigen. Si cu siguranta am gasit o relatie doza - raspuns, la fel cum am facut-o si in cazul blocajelor arteriale din studiile noastre cardiologice. Si pentru scadearea nivelului de antigen a fost nevoie de schimbari destul de mari. Si m-am gandit atunci ca poate doar nivelul antigenului este afectat,
I then wondered if they're just changing their PSA, but it's not really affecting the tumor growth. So we took some of their blood serum and sent it to UCLA. They added it to a standard line of prostate tumor cells growing in tissue culture, and it inhibited the growth seven times more in the experimental group than in the control group -- 70 versus 9 percent. Finally, I wondered if there's any relationship between how much people changed and how much it inhibited their tumor growth, whichever group they were in. And this really got me excited because again, we found the same pattern: the more people change, the more it affected the growth of their tumors. Finally, we did MRI and MR spectroscopy scans on some of these patients. The tumor activity is shown in red in this patient, and you can see clearly it's better a year later, along with the PSA going down. If it's true for prostate cancer, it'll almost certainly be true for breast cancer. And whether or not you have conventional treatment, in addition, if you make these changes, it may help reduce the risk of recurrence.
nu si cresterea tumorii. Asa ca le-am prelevat ser sanguin, l-am trimis la UCLA (Univ Califonia din Los Angeles) ei l-au adaugat unei linii standard de celule canceroase in cultura tisulara cresterea acestora fiind inhibata de 7 ori mai mult in grupul experimental fata de grupul de control: 70% fata de 9%. Si in cele din urma m-am intrebat daca exista o relatie intre cat de mult pacientii s-au schimbat si masura in care cresterea tumorii a fost inhibata, in cazul ambelor grupuri. Si asta m-a entuzismat din nou pentru ca am descoperit acelasi model: cu cat oamenii fac schimbari mai mari, cu atat cresterea tumorii este afectata. Iar in cele din urma am efectuat scoposcopii pe unii din acesti pacienti, activitatea tumorii fiind evindetiata in rosu la acest pacient - se pote vedea clar o imbunatatire in decurs de un an, odata cu scaderea antigenului. Asadar, daca este valabil pentru cancerul de prostata cu siguranta este valabil si pentru cancerul de san de asemeni. Si fie ca este urmat sau nu tratamentul conventional daca sunt realizate si aceste schimbari poate scadea riscul de revenire. Ultimul lucru despre care vreau sa vorbesc, apropos de partea cu urmarirea fericirii,
The last thing I want to talk about, apropos of the issue of the pursuit of happiness, is that study after study has shown that people who are lonely and depressed -- and depression is the other real epidemic in our culture -- are many times more likely to get sick and die prematurely, in part because, as we talked about, they're more likely to smoke, overeat, drink too much, work too hard, and so on. But also, through mechanisms that we don't fully understand, people who are lonely and depressed are many times -- three to five to ten times in some studies -- more likely to get sick and die prematurely. And depression is treatable. We need to do something about that.
este ca studii peste studii au aratat ca persoanele singure si deprimate - depresia fiind cealalta epidemie reala din cultura noatra - sunt mult mai susceptibile de a se imbolnavi si de a muri prematur in parte pentru ca, asa cum am discutat, sunt mai predispusi fumatului, alimentatiei excesive, muncii excesive, etc. Dar in acelasi timp, datorita unor mecanisme pe care nu le intelegem pe deplin, persoanle singure sunt de un numar de ori - de 3 sau 5 pana la 10 ori conform unor studii - mai susceptibile de a se imbolnavi si a muri prematur. Si depresia se trateaza. Trebuie sa facem in privinta asta.
Now on the other hand, anything that promotes intimacy is healing. It can be sexual intimacy -- I happen to think healing energy and erotic energy are just different forms of the same thing. Friendship, altruism, compassion, service -- all the perennial truths that we talked about that are part of all religion and all cultures, once you stop trying to see the differences -- these are the things that are in our own self-interest, because they free us from our suffering and our disease. And it's, in a sense, the most selfish thing that we can do.
Pe de alta parte, orice are de a face cu intimitatea are proprietati de vindecare. Poate fi vorba de intimitate sexuala - eu personal cred ca energia vindecatoare si energia erotica sunt doar forme diferite ale aceluiasi lucru. Prietenia, altruismul, compasiunea, slujba - toate adevarurile eterne despre care vorbeam, care se regasesc in toate religiile si culturile odata ce incetezi sa cauti diferentele, acestea sunt lucruri care sunt in interesul nostru, pentru ca ne elibereaza de suferinta si de boala. Si intr-un fel asta e cel mai egoist lucru pe care il putem face.
Just to look at one study, done by David Spiegel at Stanford. He took women with metastatic breast cancer, randomly divided them into two groups. One group met for an hour and a half once a week in a support group. It was a nurturing, loving environment, where they were encouraged to let down their emotional defenses and talk about how awful it is to have breast cancer with people who understood because they were going through it too. They met once a week for a year. Five years later, those women lived twice as long. And that was the only difference between the groups. It was a randomized control study published in "The Lancet." Other studies have shown this as well. So these simple things that create intimacy are really healing. Even the word "healing" comes from the root "to make whole." The word "yoga" comes from the Sanskrit, meaning "union," "to yoke, to bring together."
Uitati-va la un singur sutdiu, facut de David Spiegel la Stanford. El al luat un numar de femei avand cancer la san in metastaza, si le-a impartit in doua grupuri. Unul dintre grupuri se intalnea o ora si jumatate pe saptamana intr-un grup de suport. Era un mediu iubitor si plin de grija, in care erau incurajate sa renunte la barierele emotionale si sa discute despre cat de groaznic este sa ai cancer, cu oameni care le intelegeau pentru ca treceau prin acelasi lucru. S-au intalnit o data pe saptamana timp de un an. Cinci ani mai tarziu, aceste femei traisera de doua ori mai mult - si asta a fost singura diferenta intre cele doua grupuri. A fost un studiu pe un grup de control aleatoriu publicat in The Lancet. Alte studii au aratat acelasi lucru. Asadar, aceste lucruri simple care creeaza intimitate au putere de vindecare, si chiar si cuvantul ,,vindecare'' in engleza vine de la ,,a intregi''. ,,Yoga'' vine din sanscrita si inseamna ,,uniune, a impreuna''. Si ultimul slide pe care vreau sa vi-l arat este din nou
The last slide I want to show you is from -- again, this swami that I studied with for so many years. I did a combined oncology and cardiology grand rounds at the University of Virginia medical school a couple years ago. And at the end of it, somebody said, "Hey, Swami, what's the difference between wellness and illness?" So he went up on the board and wrote the word "illness" and circled the first letter, then wrote the word "wellness," and circled the first two letters. To me, it's just shorthand for what we're talking about: that anything that creates a sense of connection and community and love is really healing. And then we can enjoy our lives more fully without getting sick in the process.
legat de maestrul yoga cu care am studiat atatia ani si despre rundele de oncologie si cardiologie pe care le-am facut acum cativa ani la Universitatea Medicala din Virginia. La final, cineva a spus ,,Hei, maestre - care e diferenta intre buna starea fizica si boala?'' Iar el s-a dus la tabla si a scris ,,stare de rau'' - "illness" si a incercuit prima litera (i=eu), si ,,stare de bine'' - "welness" si a incercuit primele doua litere (we=noi). Pentru mine asta e esenta a ceea ce am discutat: orice creeaza o legatura si o comuniune si un sentiment de iubire duce la vindecare. Si in felul acesta ne putem bucura mai intens de vietile noastre fara a ne imbolnavi.
Thank you.
Va multumesc.
(Applause)