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.
这个演讲是关于自然界的奇迹的, 而大会的议题是关于对幸福的追求。 我会试图将两者结合在一起, 因为对我来说,康复的确是终极的自然奇迹。 你的身体拥有非凡的自我康复能力, 并且其康复速度之快是人们不曾意识到的, 而这一切只需你简单地停止那些引起问题的行为。 所以,真的,我们在医学上,甚至一般而言在生活中所做的, 是把精力集中在擦地板上的水,却忘记关上水龙头。
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.
我喜欢这项工作,因为它确实给了许多人 新的希望和新的选择,而这些是他们以前所没有的。 并且它让我们不光讨论诸如饮食之类的话题, 还有幸福的本质—— 我们一直讨论追求幸福, 可是当你真正地面对所有的精神传统, 即奥尔德斯·赫胥黎所称的“永恒智慧” 当你超越了将人们割裂开的名义上的、形式上的和仪式上的东西, 其实我们会发现,我们的本质就是幸福的; 平和的,健康的 所以它不是外在的东西——幸福不是你所能获得的东西, 一般而言,健康也不是你所能获得的东西。 而所有这些不同的修行—— 比如,古代的大师、拉比、神父、和尚和尼姑们 所遵循的这些方式,并不只是用来调节压力 或降低血压,或使血管通畅, 尽管这些效果都可以达到。 这是一些可以让我们转变的强大的工具, 其目的是为了使我们的身心平静 以及体验什么是幸福的感觉, 平和的感觉,快乐的感觉, 并且意识到这并非你需要追求并得到的, 而是你本已拥有,却被你后来破环。 我曾跟随一个名为Satchidananda大师的老师学习了多年的瑜伽,
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."
人们会问他,你是什么教派的,印度教(Hindu)吗?他说,不,我是还原(undo)教的。 其关键是找出是什么
(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.
让我们破坏了自身所固有的健康和幸福, 然后让我们天然的康复能力发挥作用。 对我来说,这就是真正的自然奇迹。
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.
所以,在这个背景下,这个更大的背景下, 我们可以讨论饮食,压力调节, 也就是这些精神练习, 适量运动,戒烟,支持小组和团体—— 这些我会在随后更多谈及——以及一些维生素和补充剂。 而它不只是一个饮食计划。 你知道,当大多数人考虑我所推荐的饮食计划时, 他们觉得它太严格了。 想要治病的话,只有这么做, 但如果你只是想健康的话,你还是有一些选择范围的。 它可以使你朝着健康的方向发展, 使你活得更长久,感觉更好, 使你减轻体重等等。 在我们的研究里,我们已做到的是, 用非常昂贵的,高科技的,先进的手段 来证明这些简单的、低科技、低成本的, 以及——在很多方面来说——古代的发明,是多么的强大。
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.
我们最初从心脏病开始研究, 当我在26,27年前开始做这项工作的时候, 当时认为如果你得了心脏病,情况只能变得更遭。 我们所发现的是,在许多病例中,病情并非变得越来越差, 反而能越来越好, 而且其康复速度之快远超出人们想象。
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.
这是一个典型病例,病人当时73岁 他必须要做搭桥手术,但选择参与这项计划; 我们使用量化的动脉造影术来展示动脉阻塞 这是通往心脏的主动脉之一, 你们可以看到此处阻塞。 一年之后,它并不那么阻塞了——而通常情况下它会变得更差。 这些血管阻塞上的微小改变, 使血流有了百分之三百的改善, 使用心脏正电子放射层扫描术,即PET扫描, 蓝色和黑色显示无血流,橘黄和白色显示最大血流。 在不用药,不用手术的情况下,产生了巨大的变化 临床诊断上,他以前连过个马路,都会伴随着剧烈的胸疼; 而在一个月内,像大多数人一样,胸不再疼了, 在一年内,他每天能爬100多层楼。 这样的情况再正常不过了,这也是促使人们 坚持这些改变的部分原因, 因为它极大地改善了人们的生活质量。 总的来说,如果你查看对比组所有病人的所有动脉, 它们在一到五年内,都变得越来越差。 这是心脏病发展的自然规律, 可是它的确又不是必然的,因为我们发现病情可以变得越来越好, 而且比人们曾以为的要快得多。 我们也发现,人们改变得越多,他们变得越好。 这与他们的年龄大小或病情严重程度无关, 主要与他们作了多少改变有关, 年龄最大的病人与年轻的病人改善的程度是相同的。
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.
几年前,我收到了一张圣诞卡, 是曾参加过我们研究项目的其中两位病人发来的。 他们兄弟俩,弟弟86岁,哥哥95岁; 他们想向我展示他们的身体比以前更加灵活。 第二年他们寄给了我这个,我觉得很有趣。
(Laughter)
(笑声)
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.
你真的想不到。 我们发现有百分之九十九的病人, 他们的心脏病病情开始逆转。 你知道,我原以为,如果我们科研工作做得好, 就会改善医疗,但这个想法有点天真。 这虽重要,但不足够。 因为我们医生就应该做我们的本职工作, 我们参加培训来做我们的本职工作, 所以如果我们改变了保险,那就会改变医疗行业和医学教育。 保险覆盖了搭桥手术和血管再成型手术的费用。 到目前为止,饮食和生活方式还没有被纳入保险范围。 所以,我们通过我们的非赢利性协会,
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."
开始在全国范围内为医院做培训, 并且我们发现大多数人都可以避免动手术, 这不仅在医学上是有效的,而且更经济。 并且保险公司发现 他们可以在每个病人身上可以节省差不多3万美元, 医保现在正在进行一项展示计划, 他们为1800人付费 让他们实地参加我们的项目。 算命的会说,“我给吸烟者打个折扣, 因为没什么好说的“。而且——(笑声)
(Laughter)
我喜欢这张,因为它让我们有机会谈谈
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.
什么是真正推动人们做出改变的,什么是没用的。 不起作用的是对死亡的恐惧, 而这是我们常常使用的方式。
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.
你知道,每个吸烟者都知道吸烟有害, 而仍有百分之30的美国人吸烟, 在世界上某些地区甚至高达百分之80。人们为什么明知故犯呢? 嗯,因为吸烟可以打发无聊的时光。 关于这点我稍后会多谈一些,但真正流行的 并非只是心脏病、肥胖或吸烟,而是孤独和抑郁。 如同一个女人曾说的,”这包烟里有我20个朋友, 没有人会像它们那样随叫随到。 你要夺走了我这20个朋友的话,你给我什么来代替它们?” 或者他们抑郁的时候大吃, 或者他们用酒精麻木疼痛, 或者他们沉迷于工作或电视。 我们有许多可以消除、减轻和避免疼痛的方法, 但这一切的关键在于如何应对问题的起因, 疼痛不是问题本身,而是问题的症状。 告诉烟民他们会因此死亡,对他们来说恐怖得不可想象 告诉他们会得肺气肿或心脏病也是太可怕了, 他们不想去想这个问题,于是他们就不去想。
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.
这是一个最有效的反吸烟广告。 注意他嘴上叼着的那个软软的香烟, 和“阳痿”这个词,其标题是“阳痿”,而不是肺气肿。 前几年刚刚问世就成为有史以来 最畅销的药物是什么? 伟哥,对吧?为什么?因为许多人需要它。 你肯定不会随便跟人说,嗨,老兄,我阳痿了,你呢? 但是,看看有多少人开了伟哥的药方吧。 它治疗的不是心理问题,而是血管的问题 尼古丁让你的血管收缩。 可卡因,高脂肪食物,紧张的情绪也有相同效果
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.
所以,在我们的文化中,我们认为那些很酷的行为, 恰恰会让许多人感到疲惫, 昏昏沉沉,抑郁和阳痿,这些后果就不太好玩了。 但当你改变了那些行为,你的大脑就会获得更多的血液, 你的头脑更加清楚,你变得更有活力, 你的心脏会获得更多的血液,正如我之前展示给你们看的那样。 你的性能力也会改善。 这些变化在几个小时内就会发生。这是一项研究——吃了一份高脂肪食物之后, 在一到两小时内,人的血流量显著减少, 其实你们在感恩节都有过这样的经历。 当你吃了一顿油腻的大餐后,你感觉怎样? 之后你会感觉有些困。 吃了一份低脂肪食物之后,人的血流量并不会降低,甚至会升高。 大多数人都知道,孩子对生活方式而言是个很大的改变, 所以如果值得的话,人们是有勇气在生活方式上作出大的改变的。 有点矛盾的说法是,当你做出很大的改变时,你会得到很大的益处, 而你感觉变好的速度如此之快。 对许多人来说,作出那些选择是值得的, 不是为了活得更长,而是活得更好。
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 --
我想略谈下肥胖症的流行, 因为它的确是个问题。 三分之二的成人超重或肥胖, 儿童和30岁成人的糖尿病发病率 在过去十年上升了70%。这不是玩笑,这是真的。 你们可以看,这是来自美国疾病控制与预防中心的数据。 这些不是选举反馈,这些是超重人群的比例。 如果你看85,86,87,88,89,90,91年—— 你得到一个新的组别,百分之15到20;92,93,94,95,96,97年—— 你得到一个新的组别;98,99,2000和2001。 密西西比州,超过百分之25的人超重。 为什么会这样。嗯,这是一个看起来有效的减肥方法……
(Laughter)
但它没有持续性,这就成问题了。
but it doesn't last, which is the problem.
(笑声)
(Laughter)
现在,减肥是没有什么秘密的;
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.
要么你通过运动来燃烧卡路里,要么你减少卡路里的摄入。 一个减少卡路里摄入的方式是少吃食物, 因此不管你吃什么,少吃就能减肥, 或者限制摄入食物的种类也行。 但问题是,你会感到饿,因此很难坚持下去。 另外一种方法是改变食物的种类。 每克脂肪含有9卡路里热量, 而蛋白质和碳水化合物只有4卡路里。 所以,当你少吃脂肪时,你就会减少卡路里摄入而不必减少食物总体摄入。 所以你可以吃同样数量的食物,但你可以摄取较少的卡路里, 这是因为你吃的食物所含的卡路里较低。 我们的饱足感与食物的数量有关,与食物的种类无关。
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 --
你知道,我不喜欢谈论阿特金斯食谱(食肉减肥法),但每天都会有人问我这个问题, 那我想花几分钟来谈下这个话题。 你们听到的问题是 美国人已经知道需要少吃脂肪, 从脂肪中摄取的卡路里所占的百分比已经下降, 美国人却比以前更胖,所以脂肪并不是让你肥胖的因素。 这说对了一半。实际上,美国人摄取的脂肪比以前任何时候都多, 而碳水化合物更多。所以虽然从脂肪中摄取的卡路里占总数的百分比下降, 但其实际摄入数量却更高了,所以我们的目标是两者都要减少。 阿特金斯博士在去世之前和我曾多次辩论, 我们都同意美国人吃了太多的单一碳水化合物, 即“不好的碳水化合物”,诸如——
(Laughter)
(笑声)
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.
——糖,白面,白米,酒精等,吃了这些你就祸不单行了: 一是由于缺乏纤维,你摄取的这些卡路里并不能喂饱你, 二是这些食物的消化速度如此之快,会导致你的血糖水平升高。 你的胰腺会分泌胰岛素使血糖降低,这很好。 但胰岛素会加快卡路里向脂肪的转化 因此,我们的目标不是要吃炸猪皮,熏肉和香肠—— 这些不是健康的食物—— 而是用所谓“好的碳水化合物”来代替“不好的碳水化合物”。 “好的碳水化合物”包括如天然食品,或未经提炼的碳水化合物: 水果,蔬菜,全麦面粉,糙米,这些食物在天然状态下,是富含纤维的。 在你摄取太多卡路里之前,这些纤维就会使你饱足, 而且会使你的消化速度变慢,血糖就不会过快地升高 你也获得了这些能预防疾病的成分。
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."
起作用的并不只是你从食物中清除的东西, 也包括你所增加的可以起预防作用的食物。 正如不是所有的碳水化合物都对你有害,也不是所有脂肪都对你有害。有好的脂肪。 它们是普遍被称为Omega-3脂肪酸。 你可以在诸如鱼油这样的食物中找到它们。 不好的脂肪是诸如反式脂肪酸,经过加工的食物, 及肉类中含有的饱和脂肪。 如果我今天演讲的内容你一点也记不住, 你也要记住每天三克鱼油可以心脏病 和猝死的发生机率降低50到80个百分点。 每天三克就足够了;它们通常是每片一克—— 吃多了没用。 它也会帮助降低患最常见的癌症的机率, 如乳癌,前列腺癌和直肠癌。 那么,阿特金斯食谱的问题在于, 每个人都知道人们可以通过它减肥, 但是你也可以通过安非他命,和芬-芬减肥药来减肥。 我是说,有许多减肥方式对你的健康是有害的。 你想通过对身体健康有益的方式来减肥, 而不是有害的方式。 该减肥法的问题在于只考虑了一半事实, 即美国人吃了太多的单一碳水化合物, 所以如果你少吃一些单一碳水化合物,你就可以减肥。 但吃天然食物和减少脂肪摄入可使你减掉更多的重量 而且你的健康会改善而不是变差。 他说,“我有一些好消息, 你的胆固醇水平维持不变, 可研究结果不同了。“
(Laughter)
(笑声)
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.
那么,使用阿特金斯食谱会使你的心脏发生什么变化呢? 这是一项由同行审定杂志《脉管学》所做的研究, 这是开始的时候,红色是健康的区域,一年之后, 使用类似我所推荐食谱的人,红色的区域更多了, 使用阿特金斯类型食谱的人,红色区域少了,血流减少了。 所以,是的,你可以减肥,但你的心脏就不高兴了。 如今,一项由阿特金斯中心资助的研究发现, 百分之70的人有便秘,百分之65的人有口气, 百分之54的人头痛——这并非健康的饮食方式。 是啊,也许你开始减轻体重了,开始吸引人了, 可是当他们离你太近时,就有问题了。
(Laughter)
(笑声)
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.
更严重的是,现在有案例报道称, 有几个16岁的女孩按阿特金斯食谱饮食了几个星期后, 死于骨病,肾病等等。 这就是你的身体排泄废物的方式,通过你的呼吸, 肠子和汗水。 所以当你遵循这种食谱时,它们会变得很难闻 一个完美的食谱应该是低脂肪,不好的碳水化合物含量低, 好的碳水化合物含量高,以及有足够的好的脂肪。 而且,它会产生一系列反应: 当你沿这个方向进行时,你将会减轻体重, 你将会感觉更好,而且你将会获得健康。
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.
现在,从生态学的角度看,我们也有理由以食物链低端的生物作为食物, 比如为了防止亚马逊森林被过度采伐,或为了生产更多的蛋白质 给世界上40亿每天只用一美元的人们, 还有,你知道,人们有各种各样道德上的考虑。 所以,除了健康上的考虑,我们还有许多使用这种饮食方式的理由。 现在,我们打算发表第一项研究,
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.
它是关于该项目对前列腺癌的影响, 在同Sloane-Kettering癌症中心和旧金山加利福尼亚大学的合作中, 我们选择了90名经取样验证患有前列腺癌的男病人, 这90名病人都因各种原因选择不进行手术,而其原因均与本次研究无关。 于是我们将他们随机分成两组, 然后我们本可以将非干预组的病人 与像乳癌这样的癌症作比较, 但我们不能这样做,因为乳癌患者每个人都要接受治疗。 我们发现,一年后,
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.
改变了生活方式的实验组的病人, 没有一个需要进行治疗, 而6名控制组的病人需要进行手术或化疗。 我们检查他们的PSA值(前列腺特异抗原)——一种衡量前列腺癌的数据, 控制组的人情况变差, 而实验组的情况却变好了, 而且两组差异是非常显著的。
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.
然后我想,不考虑组别的话, 病人改变饮食和生活方式的程度,与PSA值变化之间, 是否存在某种联系呢? 果然,我们找到了剂量联系, 正如同我们在心脏病研究中在动脉阻塞上所发现的结果一样。 为了使PSA下降,病人必须要做出非常大的改变。 然后我想,嗯,也许他们只是PSA值改变了,
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.
但并没有影响其肿瘤的生长。 于是我们提取了一些血清样本,送到洛杉矶加利福尼亚大学, 他们把样本加入一排标准的含有正在生长的肿瘤细胞的组织培养液中, 实验组的样本对肿瘤细胞生长的抑制作用是控制组的7倍, 两者的数据分别是百分之70和百分之9. 最后,我想,不考虑组别的话, 是否在病人改变的程度 与抑制肿瘤成长速度上存在联系呢? 结果确实让我非常兴奋, 因为我们再次发现了同样的规律:人们改变得越多, 就越能影响肿瘤的生长。 最后,我们对其中一些病人做了核磁共振成像和核磁共振光谱检测, 这个病人的肿瘤活跃度显示为红色, 你可以清楚地看到,情况要比一年前更好,PSA值也同时下降。 所以,如果在前列腺癌上有效,几乎可以肯定在乳癌上也有效。 而且无论你是否使用常规治疗, 如果你额外做出了这些改变,就可能会帮助减少复发的机率。 我最后想说的是,关于对幸福的追求这个问题而言,
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.
许多研究显示, 孤独和抑郁的人群 其得病与早死的可能要比平常人高许多倍—— 而抑郁是我们文化中另一个真实存在的流行病, 其中部分原因是,如我们前面谈过的,这些人更易吸烟, 更易暴食暴饮,更易成为工作狂等等。 孤独和抑郁的人们, 其得病和早死的机率要比常人高许多倍, 一些研究显示,从三倍到五倍到十倍都有, 这种情况发生的机制我们仍然不能完全了解。 抑郁是可治疗的。我们需要在这方面做些努力。
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.
在另一方面,任何可以增加亲密感的事情都有康复作用。 它可以是性亲密—— 我碰巧想到,康复能量和性能量 只是同一事物的不同体现。 我们所谈论的一些永恒真理——友情,利他主义,热情,义务服务等, 也是所有宗教和文化的一部分, 只要你开始求同存异, 这些事情其实都是符合我们自身利益的, 因为它们把我们从痛苦和疾病中解放出来。 在某种意义上说,这些是我们所做的最自私的事情。
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."
我们来看一个研究。它是由斯坦福大学的David Spiegel完成的。 他把一些患有转移性乳癌的女病人 随机分成两组。 其中一组每星期参加一次一个半小时的支持小组。 支持小组提供一种关怀,关爱的环境, 促使病人卸下情绪上的防御, 跟能够理解她们的小组成员来谈论患有乳癌的感觉多么糟糕, 因为其他组员也在经历同样的病痛。 她们只是每星期见一次,持续了一年。 五年后,参加支持小组的女病人的寿命延长了两倍,你可以看到—— 参加是否支持小组是两组女病人的唯一差异。 这是一项在《柳叶刀》杂志上发表的随机控制研究项目。 其他研究也显示了这种现象。 所以,这些可以产生亲密感的简单的事情的确具有康复作用, 甚至“healing康复”这个词,它的词根是“to make whole使完整”。 瑜伽这个词是来自梵语, 它的意思是“联合,连接,使结合”。 最后一页,我想向你们展示的是,
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.
这位我跟随其学习了多年的大师, 他和我几年前在维吉尼亚大学医学院做了一个 肿瘤学和心脏病学的联合讨论会。 在讨论会的最后,有人说, “嗨,大师,wellness(健康)和illness(疾病)的不同是什么?” 大师起身在白板上写下illness(疾病)这个词, 然后把第一个字母圈出来,又写了wellness(健康)这个词, 把其前两个字母圈出来, 对我来说,这恰好是我们讨论的一个总结: 任何能够产生连接感, 团体感和爱的感觉的东西都是有真实的康复作用的。 做到了这些,我们就可以在不生病的情况下,更圆满地享受我们的生活。
Thank you.
谢谢。
(Applause)