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.
這一節談是大自然的奇功, 而大會主題則是對快樂的追尋。 我試著統而合之, 於我而言, 自我療癒(機能)確是大自然的極至玄奧。 你的身體有卓越的能力展開自療, 而且比過往人們所理解的要快得多, 你只要別再幹那些讓出亂子事的就是。 所以,實際上,我們許多用藥和生活上所做的 都是水龍頭沒關好卻一味拖地, .
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.
我愛幹這事兒,因為它確實給予許多人 他們前所未有的新希望和選擇. 又讓我們可談到 -- 飲食以外 "但快樂非單是... 我們(著實)談的是 尋求快樂"♫ 但當你認真審視所有這些心思 Aldous Huxley 所稱「亙常智慧」 你一旦超越那些將人劃分的稱號、規格和儀式的時候 底裡關係到我們求快樂的本性; 想我們天生想望能得和平, 得健康. 所以它不是一種-快樂不是一件可攫獲的東西 宏觀地來說 健康亦並非可(刻意)求取的東西。 反之,這種種不同的做法, 要明白那些古老印度猶太大師, 教士僧尼 所研發的這些技巧, 並非僅僅為著紓壓, 降血壓、通血管, 即便對這些都有功效。 它們(應該說)是大號的改造模具、 可將我們的身心先安定下來 容許我們體驗甚麼是快樂 平安、喜悅 並瞭解:那並非你可求取; 而是原來固有, 直至後來讓你自己擾亂了的一種東西。 我跟隨一位叫Satchidananda的老師研習瑜伽多年
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."
有人會問(他):「你是印度教徒麼?」他會答:「不,我是個[剃]度教徒」。 它的用意其實是要指明出是什麼讓我們
(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.
擾亂自身內在健康和快樂, 從而讓身體展開自療。 於我這就才是真正的自然奇功。
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.
據此, 我們方可於較廣的義理內 談飲食調節, 談壓力處理, (說明白了)就是這些精神作業, 像適量運動、戒煙、互助群組- 這些我都會再多說點-還有維他命和補品。 可這並非節食. 大多數人提起我建議的飲食時 都看成是個硬餐單. 若是為了扭轉病情,那當然事在必行, 但若你只是想健健康康,那你的選擇可多了。 及至讓你踏上健康之路, 你將可活得更久,感受更好, 你將可減磅輕身..等等。 研究所得, 是我們一直做到的 只是用了極昂貴、先進高科技的的方法, 去證明原來這些簡單、低科技和便宜 調適方法, 其中不少是老掉牙的, 竟有如此强大功效!
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.
我們先來看一下心臟病: 26、27年前,我剛開始做這工作時, 一般認為你一旦得了心臟病,就好不了。 而我們發現的卻是,非但沒惡化 許多案例中, 病情反能好轉, 而且進度比前人所知快得多。
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.
這是一位當時73歲的病人, 分流非做不可了,卻又決定做了這個 我們用量化造影術顯示其動脈窄化, 這是負責引血至心臟的其中一條主動脈, 你們可以看到這部位在窄化。 翌年,它竟沒那麼塞的-通常情況會相反。 這類阻塞的小變 讓血流量有3倍改善, 又以正電子發射計算機斷層做影, 或「PET」掃描出來 藍黑部位表示沒血流量,橙白部位血流量最大。 重大的變化於沒用藥沒動手術的情況亦可發生. 按臨床診斷,他走過馬路都將會引起劇烈胸痛。 可一個月不夠,跟大部分人一樣,沒痛了, 一年不到, 能每天在登階機上爬一百層以上了。 這並不稀奇, 更讓人得以 維持此等改善, 因其於他們生活的品質上造成了那麼重大的差異。 整體上,你們會看到這對比組內全體病人的動脈 都於一年到五年內持續惡化。 此乃心臟疾病的自然歷程, 但實際上又不可說全屬自然,因為我們發現病情亦可以轉好, 且比從前的人想的快得多。 我們亦發現,人們改得越多,就變得越好。 這並非一個他們多老或病多重的官能關係, 而主要是他們作了多少改變, 所以最老的病人亦可以好轉改善, 一如年輕的患者.
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.
數年前我收到這聖誕卡 是兩位參予我們其中一起試驗的病人寄來的. 弟弟86歲,哥哥95。 他們要向我展示他們從前是多柔軟, 翌年,他們寄我這個,我覺得蠻攪笑.。
(Laughter)
(哄笑)
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.
可說不定呢. 而我們發現的是百分之99的患者 開始扭轉其心臟病情. 我在想 我們若以為只要做好科研 就能將醫療模式改過來 - 就太天真了點。 那當然重要,但不足夠。 因為我們醫生都是收費辦事, 我們受訓行醫收取酬勞。 故此若保險單給改了,那醫療作業及教育亦會相調整. (到時)分流和血管修復手術都包在保險內了. 但直至最近, (保險)才照管食療或生活調適費用。 於是我們開始透過我們的非謀利機構
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."
於全國各地醫院進行培訓, 我們發現大部分人可以避免動手術, 如此這般, 醫療及成本效益俱佳。 保險公司亦發現 他們開始從每個(受保)病人省免了三萬元給付。 而Medicare現正進行一個示範企畫, 他們付費讓1800個人在我們的培訓場地 完成程序. 占卜師說:「吸菸者打折, 因為沒可說已不多。」而... (哄笑)
(Laughter)
我喜歡這圖片,因為它能引起話題讓大家討論
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.
究竟什麼會激發變改, 又什麼不會. [對死亡的恐懼]不會, 卻常被錯引。
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.
每個抽煙的人都知道那對自己不好, 但美國人抽煙的人仍佔百分之三十. 某些地方是百分之八十。人幹嗎這樣做? 嗯, 因為(抽煙)幫他們將一天熬過. 這我會再談,但真正的流行病 不單是心臟病, 過胖或抽煙,而是孤寂和抑鬱。 就如一位女士所說的:「這煙盒裡有我的20個朋友, 當人都跑光了,它們總在哪。 若將我這20個朋友都拉走,那你們要給我留下什麼?」 他們感到鬱悶或大吃, 或用酒精將痛苦麻醉, 有些工作過勞,有些電視看太多。 逃避、麻醉、和迴避痛苦的方法林林總總, 但這一切的重點是要解決問題的起因 痛楚只是症狀, 而非問題本身. 而說他們會(因此)死掉更嚇得人不敢想象, 會得肺氣腫或中風都太可怕了, 所以他們都不願想這些, 不管了。
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.
這是一則最有效的反吸煙廣告: 你該留意到他那吊在嘴角, 垂頭喪氣的煙支, 和寫上「無能」兩字的標題 - 是「無能」,而不是「肺氣腫」。 幾年前上市後 就一直大賣是什麼藥? 偉歌,對?為什麼? 因為很多男人需要它。 並非說已到了碰面就, 「嘿祖, 我亦不舉了, 你呢?」的地步. 然而,就看藥的銷量吧。 心理效用或有點,主要還是涉及心血管, 尼古丁讓你的血管收縮, 古柯鹼, 高熱量飲食, 情緒壓力亦然。
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.
這在我們的文化裡被公認為顯酷的行為 卻正正是讓許多人累壞的舉措 沒勁兒、消沈以至陽痿,都不好過呢。 但你一旦將行為改變 (戒煙),流進腦袋的血就多點, 腦筋就開了,手腳就靈了, 就像我向你們展示的那樣, 你的心就得到更多血,。 你的性功能亦會得到改善。 且這些都在幾小時內就來了。這是個研究:一餐高熱量飯食後 的一至兩小時, 血流量就會顯著減少,, 這在你們過感恩節時都曾體驗。 一頓大魚大肉後,感覺如何? 你儘會感到懨懨欲睡吧。 而低熱量的一餐,卻讓血流量不減反升。 你們當中不少人帶孩子,都曉得這是你們人生中的一個重大改變。 就是說只要是值得, 人們並不怕作出重大改變,。 吊詭的是你的大變讓你得到大利, 你很快就已變得好多了。 對許多人而言,那些值得作的抉擇。 並非為了活更久,而是為了活更好。
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 --
我想聊一下有關過胖流行症候, 因這確實是個問題。 三分之二的成人過重或過肥, 孩童期至三十歲得糖尿病的, 過往十年共增加了70%。這可不是說笑,是事實。 讓你們看, 這來自美國疾病控制與預防中心。 這不是選票結果,而是過重人口的比例。 若你從85年起看, 到86, 87、88、89、90、91年 你得到一個新類別,是百分之15 到 20 ;92、93、94、95、96、至97年間 又另一個新類別;98、99、2000和2001年間。 在密西西比,過重的人口超過百分之25。 幹嗎會這樣?嗯,這是某種減肥法,效果不錯,
(Laughter)
但是不持久,那正是問題所在。
but it doesn't last, which is the problem.
(笑聲)
(Laughter)
其實如何減肥並沒有什麼神祕;
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.
要不運動燃燒多點卡路里,要不少吃一點卡路里。 少吃點卡路里的一個方式是節食, 就是說你吃什麼都好,吃少點就可以減肥, 又或者完全不吃某類食物。 但問題是,你餓了會很難受. 另一種做法是改食別的. 脂肪每公克含九個卡路里, 而蛋白質和碳水化合物只有四個。 所以脂肪少吃你就少吃進卡路里,犯不著節食。 你可以吃同等份量食物卻同時攝取低卡路里. 因為那些食物卡路里沒那麼高。 再說讓你感飽腹是食物的份量,而非類別。
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 --
我不想多講甚麼[食肉減肥法],但總是天天被問及。 所以我想還是花幾分鐘來說一下。 你們聽到的這迷思是: 「美國人被勸說少吃點脂肪, 於是脂肪卡路里比例低了, 美國人卻比前更肥;換言之,脂肪不致肥。」 這說來只對了一半。事實上,美國人比過往吃更多脂肪, 甚至更多碳水化合物。於是比例是低了點, 實質份量卻是多了。所以目標應該是兩樣都要減掉。 艾京斯博士去世前跟我曾多次辯論, 我們都同意美國人吃得太多單醣食品, 「bad carbs」,像
(Laughter)
(笑聲)
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、白麵粉、白米、酒精。這讓你受到雙重打擊, 你吃下這許多卡路里卻仍不飽,因為其纖維都被先去掉。 再者,它們很快就被吸收,所以會讓你的血糖飈升, 你的胰腺會分泌胰島素試圖將之拉下來,這本來很好。 可胰島素會將卡路里加速轉化成脂肪。 所以,方向不是吃豬皮火腿香腸去 -- 這些都並非健康食品。 但由「bad carbs」換成「good carbs」。 譬如全麥食品、或未加工碳水化合物: 水果、蔬菜、全麥麵粉、糙米-吃天然的東西,它們富含纖維, 而在你攝取太多卡路里前,纖維就給了你飽腹感, 而且可以減緩消化,所以你血糖不會竄高。 因此,你得到了所有的預防疾病的物質。
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."
在飲食中,除了所排除成分有影響, 囊括的成份是否具有預防性也會影響。 就像不是所有種類的碳水化合物都有害;脂肪也一樣,有好的脂肪, 我們通常稱做Omega-3脂肪酸。 這你們可以在,例如,魚油裡找到。 而不好的脂肪就像反式脂肪酸和加工食品 和飽和脂肪,這常見於肉類。 你要是聽完這場演講什麼都不記得,記這個: 一天三克魚油有助於讓你心臟病發作率 以及暴斃率降低50%-80%。 通常一粒膠囊一克 過量只會給你多餘的脂肪而已。 它也有助於減低最常見癌症的機率 像乳癌、前列腺癌和結腸癌。 現在,有關食肉減肥法的問題, 各位多少都認識一些用這個方法減肥成功的人, 但你也可以用安非他命和減肥藥減肥。 我的意思是,減肥有很多方式都對你有害。 要減肥就用有益身心的方式, 而不是用傷害的方式。 而問題出在人們對這方法一知半解, 也就是美國人吃太多單一碳水化合物, 所以如果你少吃單一碳水化合物,就可以減肥。 你要是食用天然和低脂食品,就減更多肥。 而你會更健康,身體不會變差。 他說:「我有好消息, 在你的膽固醇濃度維持不變時, 研究結果卻變了」
(Laughter)
(笑聲)
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.
現在,你的心臟在你採用食肉減肥法時發生什麼事? 起先紅色是好的,一年後 這是從同行評審雜誌裡一個研究引用的,叫做脈管學 一年後,採用我推薦的飲食法的人有更多紅色, 採用食肉減肥法的,紅色變少了。 所以你是減肥了,但你的心臟不開心。 現在其中一個阿特金斯中心贊助的研究 發現70%的人便秘,65%有口臭, 54%患頭痛。這不是健康的飲食。 所以你的體重可能開始下降,也開始吸引人們接近你, 但當他們太靠近你時,問題就來了。
(Laughter)
(笑聲)
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.
更嚴重的是,這些案例報告中現在有16歲的青少女, 採用一星期的食肉減肥法後去世了。 死於骨頭疾病、腎疾等等。 而這就是你身體排泄廢物的方法,透過呼吸, 排便和排汗。 所以你在採用這樣的飲食時,排泄就開始變臭。 所以另一個飲食的選擇是低脂,少碳水化合物, 多攝取有益的碳水化合物和足夠的好脂肪。 然後這又是一個圖列: 你要是往這個方向移去,就能減肥, 你會感覺更好而且更健康。
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.
現在,也有因應社會生態學,而吃食物鏈中較低等的食材的, 不管是亞馬遜的森林砍伐問題或使蛋白質取得性更高, 甚或因為,你知道,四億人每天靠一元美金過活, 更別提,你知道,任何人們在道德上的顧慮。 所以有很多理由去採用這樣的飲食,不單是為了健康著想。 現在,我們就要發表第一份研究,
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.
看的是這個計畫對前列腺癌的影響, 與我們合作的有solane-kettering癌症中心和舊金山加利福尼亞大學。 然後我們選90個得前列腺癌的男人,都用切片檢查法證明過的, 他們都選擇不要動手術,他們的決定和這個研究無關, 所以接著我們可以任意將他們分為兩組 然後我們可以將一組 作為不干涉控制組來做比較 我們不用乳癌研究,因為每個人都要受治療。 我們發現的是,一年後
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.
沒有任何一個實驗組病患 也就是改變生活方式的,需要受治療。 同時六位控制組病患卻需要動手術或化療。 我們在看他們的前列腺特異抗原(SPA)程度時,這是量前列腺癌的數據, 在控制組的都惡化了, 但在實驗組的卻好轉了。 而這些差別相當顯著。
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.
接著我想知道,是不是因為 人們在他們的飲食和生活方式方面做的改變? 無論他們是哪一組的,或PSA的不同都一樣。 確定的是,我們發現一個劑量回應關係 就像我們發現,在我們的心臟學研究裡在動脈阻塞上 為了讓PSA減弱,他們必須做蠻大的改變 我接著想,或許他們只是在改變他們的PSA
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.
但這實質上不影響腫瘤成長 所以我們取一些他們的血清,送到洛杉磯加利福尼亞大學, 他們把它加進前列腺癌細胞的標準線,在組織文化裡長著 而它遏止了成長達七倍之多 在實驗組,比起控制組:百分之70比9 最後,我說,我想知道是否關係存在於 人麼改變多大,和這如何遏止他們的腫瘤成長 無論他們剛好出現在哪一組 而這真的讓我興奮,因為再次 我們找到同樣的模式,人們改變越多 這影響到腫瘤成長的程度也越高 最後,我們對其中的一些病人進行了MRI和MR?掃描 而腫瘤的活動顯示在紅色在這個患者 而你可以清楚看見他一年後好轉了,同時PSA下降了 所以,如果可以應證在前列腺癌上,幾乎確定也可以應證在乳癌上 而且不管你是否用傳統療法 再加上,如果你做這些改變,它可能有助於減少復發的風險 最後一件我想說的事,與追求快樂這個問題息息相關的
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.
是一個接一個的研究顯示出 人們如果寂寞又壓抑 而壓抑是另一個確切的慢性病在我們的文化 多許多倍更可能生病且早死 一部分因為,像我們剛剛講的,他們更可能抽煙 而且過量進食和飲酒過度和工作過勞等等 但還有,通過機制,我們無法完全了解的 人們若寂寞和壓抑,那比別人多許多倍 三到五到十倍,在某些研究 更可能生病和早死 而壓抑是可治療的。我們需要做出針對它的某些事
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.
現在,另一方面,任何事,若促進親密性,即是治療 它可以是性方面的親密 我剛好想到,治療動能和性愛動能 兩者只是一體兩面 友情、利他型為、同情、服務-全都是經年不變的事實,老生常談的 存在於所有宗教和所有文化中的 一旦你停止試圖看出差異 這些就是為了自我利益 因為他們解放我們自我們的痛苦和我們的疾病 而且它一方面來說是最自私的我們能做得事
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."
就來看看一個研究好了。這是史丹佛的david spiegel做得 他找了有轉移性乳癌的女人 隨意分成兩組 一組見面時間只有一個半小時,一星期一次,與支持小組 那是個培育的,友愛的環境 在那裡他們受鼓勵去放下他們的情緒防衛 並談談得乳癌多麼糟糕 和能了解的人,因為他們也同樣經歷著這一切 他們僅僅見面一星期一次,持續一年 五年後,那些女人活的兩倍長,而你可以看出那些人 這是唯一的不同在兩組之間 那是個隨機控制研究發表在the lancet上 另一個研究顯示同樣的結果 所以這些簡單的事情創造了親密性是真的有療效 而且甚至連療癒這個字都是來自意思是「成全」的字根 瑜伽這個字從梵文來的 意思是「結盟、連接、和一」 而最後一張投影片我要給你們看的是從-我曾-再次,
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.
這個印度教老師,我向他學習了許多年,而我 做了一個結合腫瘤和心臟大查房 在維吉尼亞大學的醫學院,幾年前 而最終,有人說 「嗨,老師,健康和生病有什麼不同?」 他走上講台並寫「生病」這兩個字 然後圈出第一個字母,接著寫出「健康」這兩個字 並圈出前兩個字母 對我來說,這只是我們剛剛所講的一個速記法 也就是任何能創造連結感的 和群體和愛的都是真正的療癒 而我們可以享受我們的生活更加完全,不用在過程中生病
Thank you.
謝謝
(Applause)