肠道专家揭秘：这一肠道错误竟会致癌！廉价香料助你修复受损肠道！

气体是随着粪便一起排出的。

So gas travels with poop.

可能，我不是特指你，史蒂夫，听众们可能会注意到，早上醒来时你会不停地放屁。

May, I don't mean you specifically, Steve, people listening may notice this, that you wake up in the morning and you're farting like crazy.

而且这种放屁会一直持续到你完成早晨的排便为止。

And that farting continues until you actually have your morning bowel movement.

一旦你有了良好、健康的早晨排便，就会感觉踏实，不再放屁了，对吧？

And then once you have your good, healthy morning bowel movement, you feel solid and you're not farting anymore, right?

气体是随着粪便一起排出的。

The gas travels with the poop.

所以，这种情况发生的原因是，首先，你的粪便不仅仅是食物的残渣。

So, and the reason why this happens is because first of all, your poop is not just the leftover remains of your food.

实际上，你的粪便主要由你的肠道菌群组成。

Actually, your poop is predominantly your microbiome.

粪便重量的60%是微生物。

60% of the weight of your stool is microbial.

真的吗？

Really?

是的。

Yes.

你说微生物，是指细菌吗？

When you say microbial, you mean like the bacteria?

细菌。

The bacteria.

60%

60% of

都是。

it is.

我给你举个例子。

Let me give you an example.

如果我把一些可溶性纤维——也就是益生元——加到你的饮料里。

If I took your drink and I added some soluble fiber, which is prebiotic into your drink.

是的。

Yeah.

没有任何渣滓。

There's no grit.

没有任何粗纤维，你甚至感觉不到它的存在。

There's no roughage, you don't even know it's there.

由于我刚才的做法，你明天会排出更大、更健康的粪便。

And you're going to have a bigger, healthier bowel movement tomorrow as a result of what I just did.

为什么？

Why?

因为我喂养了你的微生物，它们变得更强壮，然后繁殖，因为它们繁殖了，所以你的粪便量变大了，对吧？

Because I fed your microbes and they grow stronger and then they multiply and because they multiplied, you have a bigger bowel movement, right?

这就是它的运作方式。

That's the way that that works.

不过别误会，你吃沙拉，也会排出更大的粪便。

Now don't get me wrong, you eat a salad, you're going to end up with a bigger bowel movement as well.

但那部分很大程度上是沙拉中的纤维在滋养这些微生物。

But a big part of that is the fiber within that salad that's feeding these microbes.

它们繁殖、生长，于是你就有了更大的排便。

They multiply, they grow, and you have a big bowel movement.

所以如果那是我的粪便，我手里拿着一块巧克力棒，其中60%是微生物吗？

So if that was my if that was my my stool, my poop, I'm holding a chocolate bar here, 60% of that would be the microbes?

那其中60%是微生物。

60% of that would be the microbes.

是的。

Yes.

所以对于那个人来说，当粪便堵塞、无法通过时，这些微生物就会在那里有无限的时间进行发酵并产生气体。

So for that person, when the poop is in gridlock and it's not moving through, then those microbes are basically sitting there with unlimited time to ferment and produce gas.

好吧。

Okay.

因此，它们接触到的任何东西，都会开始对其进行分解。

So anything they come into contact with, they're just going to start working on it.

所以这不仅仅是纤维的问题。

So it'sand it's not just like a fiber thing.

它们接触到的任何东西，比如蛋白质，都会被发酵并产生气体。

Anything they come into contact with, it could be protein, they will ferment it, they will produce gas.

因此，这是便秘与胀气和腹胀密切相关的重要原因。

So this is a big part of the reason why constipation is so strongly associated with gas and bloating.

当人们食用乳制品之类的食物时，我认为一些对麸质敏感的人往往会放屁增多。

When people eat dairy and things like that, and I think some people that have gluten, they often tend to get a little bit gassy.

是的。

Yeah.

这是便秘吗？

Is that constipation?

胀气和腹胀并不仅仅是便秘的问题。

Gas and bloating is not just a constipation issue.

我认为便秘是这一问题的首要原因，但还有许多其他潜在原因。

I would argue that constipation is the number one cause of that particular issue, but there's many potential causes.

第一个可能是肠道蠕动，也就是便秘。

Number one could be motility, that's constipation.

什么是肠道蠕动？

What's motility?

肠道蠕动是指你的肠道如何运动。

Motility is the way in which your intestines move.

如果肠道运动过快且不规律，就会导致腹泻。

So if the intestines move too fast and out of rhythm, you get diarrhea.

如果肠道运动太慢、迟缓，就会导致便秘。

If the intestines slow down too much, sluggish, you get constipation.

我们希望肠道保持规律，因为当肠道有规律时，就像你的心脏一样，才能发挥最佳状态。

We want the intestines in a rhythm because when they're in a rhythm, just like your heart, that's when they perform their best.

所谓有规律，就是指每天排便时间可预测、稳定。

So in a rhythm basically means predictable, consistent daily bowel movements.

这最终正是我们希望达到的状态，对吧？

That's ultimately where we would love to be, right?

这在某种程度上涉及到了我们之后可以深入探讨的昼夜节律话题。

And that in a way taps into like an entire circadian conversation that we can have later.

你的昼夜节律中有一个非常理想的早晨排便过程。

This is a part of your circadian rhythm is a fantastic morning bowel movement.

motility 只是导致胀气和腹胀的原因之一。

Motility is just one of the causes of gas and bloating.

第二个原因是肠道菌群。

The second is the microbiome.

如果你的肠道菌群受损且功能不佳，就无法正常履行其职责。

If you have a microbiome that's damaged and struggling, it's not going to be able to do its job the way it's supposed to.

而它的一部分职责是处理和分解纤维，因为我们人体缺乏消化纤维的酶。

And part of its job is processing and breaking down fiber because the fiber in our diet, we don't have the enzymes to digest it.

所以纤维会通过肠道，与微生物接触，而这些微生物拥有我们人类所不具备的多达六万种酶。

So it works its way through the intestines, comes into contact with the microbes and the microbes, they have literally 60,000 enzymes that we don't have as humans.

它们协同工作，使纤维不再以纤维形式存在，而是产生短链脂肪酸。

They go to work as teams, Fiber stops being fiber, produces short chain fatty acids.

这就是它应有的运作方式。

This is the way that it's supposed to work.

当你的肠道不健康时，微生物也会虚弱，你让它们干活，它们却无法胜任。

When your gut is not happy, they're weak, the microbes are weak and you're asking them to do work and they can't handle that.

结果就会导致消化不良，这就是胀气和腹胀的原因。

And you end up with sloppy digestion and that's gas and bloating.

第三个因素可能是你的饮食。

The third thing can be your diet.

你刚刚提到了乳制品，其中含有乳糖。

So you just mentioned dairy, which contains lactose.

乳糖很容易被发酵产生气体。

Lactose can be easily fermented to produce gas.

你提到了麸质。

You mentioned gluten.

麸质本身是一种蛋白质。

Gluten itself is a protein.

那么，麸质在技术上可以被发酵吗？

So can gluten technically be fermented?

是的，从技术上讲它可能被发酵，但这并不是实际情况。

Yes, it could be technically fermented, but that's not what's going on.

实际情况是，含有麸质的食物，如小麦、大麦和黑麦，同时也含有被称为低聚果糖的碳水化合物。

What's happening is that gluten containing foods, which are wheat, barley and rye, also contain these carbohydrates called fructans.

而低聚果糖实际上对我们的微生物非常有益。

And fructans are actually really good for our microbes.

它们是益生元。

They're prebiotic.

但如果你摄入了大量这类物质，而你又不习惯吃这些食物，就可能引起胀气和腹胀。

But if you consume a very large amount of them and you're not used to eating these foods, it can cause gas and bloating.

现在，我年轻的时候吃意大利面都没事。

These days, when I was younger, if I had pasta, I was fine.

但现在如果我吃意大利面，接下来两天都会感到不适。

If I have pasta these days, I'm going to feel it for the next like two days.

真的吗？

Really?

嗯。

Yeah.

不知道。

Don't know.

我也不清楚发生了什么。

And I don't even know what's going on.

但其他人似乎想吃多少意大利面都可以。

But then other people can eat pasta as much as they want, it seems.

出于好奇，你能去意大利吃意大利面而没事吗？

Out of curiosity, can you go to Italy and eat pasta and be okay or no?

情况一样吗？

Same thing?

我其实没怎么试过。

I haven't really not really tried.

好的。

Okay.

据我个人经验，当我吃无麸质面包或无麸质意大利面时，我觉得舒服多了。

Anecdotally, I think when I remove, when I have like non gluten bread or non gluten pasta, I think I feel much better.

但我很清楚，像你这样的人告诉我，实际上只有极少数人真正对麸质不耐受。

But I'm well aware from speaking to people like yourself that such a small percentage of the population is actually gluten intolerant.

但我们所有人都多多少少觉得自己有这个问题。

But we all kind of think we are to some degree.

我想知道具体数字是多少？

I think it's what's the numbers?

是不是有百分之二十的人觉得自己对麸质不耐受？

Is it like twenty percent of people think they are or something?

比如在这里洛杉矶，可能有百分之八十的人都这么认为。

So like here in Los Angeles, it's like probably eighty percent of people.

觉得好像

Think that Well, like

几乎每个人都吃无麸质食品。

almost everyone's gluten free.

是啊。

Yeah.

对吧？

Right?

但他们其实不需要这样。

Which They don't need to be.

而且实际上，这可能会带来问题。

And actually, it can cause problems.

除非你知道该做哪些调整，否则无麸质饮食可能会引发问题。

It can cause problems to be gluten free unless you know what adaptations to make.

所以当你问意大利的这个问题时，你的意思是？

So when you ask that question about Italy, what are you

想了解什么？

getting at?

在美国，小麦的加工过程中存在一个问题，那就是他们允许用草甘膦（即农达）喷洒小麦。

There's a processing issue in The United States involving wheat, which is that they allow the wheat to be sprayed with glyphosate, which is Roundup.

这是一种除草剂。

It's a weed killer.

他们这样做主要是为了尽快让小麦干燥。

And they do that to basically dry it out as quickly as possible.

想象一下，你是一个农民，有一片小麦田，你收割之后，对吧？

So imagine for a moment that you're a farmer and you have this field of wheat, you harvest it, okay?

这是你的选择，史蒂夫。

Here are your choices, Steve.

你可以等几个星期，让小麦在空气中自然干燥，然后存起来；或者你可以喷上这种化学药剂，明天它就干了，然后你就能运走。

You can wait a couple weeks and let it dry out naturally in the air and store it somewhere or you can spray it with this chemical and it will be dry by tomorrow and then you can ship it up.

是的。

Yeah.

对吧？

Right?

问题是，草甘膦并没有列在标签上。

And the problem is that glyphosate is not on the label.

除非你购买有机产品，否则你根本无从得知它是否被喷洒过。

You would never know whether it's sprayed or not sprayed unless you're buying organic.

如果你购买有机产品，那么根据定义，他们是被禁止喷洒的。

If you buy organic, then by definition, they're not allowed to spray it.

你根本无法知道它是否存在。

You would never know if it's there.

草甘膦的问题在于，它被批准存在于我们的食品系统中，前提是它安全，因为它会关闭一种叫做莽草酸途径的机制，从而杀死杂草或植物。

The thing about glyphosate is that it's been approved to exist in our food system under the assumption of safety because what it does is it shuts down this thing called the Shikamot pathway and that kills weeds or it kills plants.

我们有一个应对方法，这与氨基酸有关。

And we have a workaround and it has to do with basically amino acids.

我们人类可以通过某种方式合成这些氨基酸，但植物不行。

We have a workaround where we can basically create those amino acids as humans, but the plants can't.

所以植物死了，而我们却活了下来。

So the plants die, we live.

但有一个问题，那就是生活在我们大肠内的微生物并没有这种应对机制。

But there's a problem, which is that the microbes that live inside of our large intestine, they don't have the workaround.

所以，你可能会说，对于我们这些大个子人类来说，那点草甘膦微不足道。

So that microscopic amount of glyphosate, you would say, well, us big humans, that's so small.

当它接触到这些微生物时，你觉得会发生什么？

What do you think happens when it comes into contact with them?

我们知道草甘膦会破坏肠道菌群，它会减少有益细菌，而最能耐受它的恰恰是那些致炎细菌。

We know that glyphosate disrupts the microbiome, that it depletes the beneficial bacteria and the ones that tolerate it the best are the inflammatory ones.

有害的细菌。

The bad bacteria.

有害的细菌。

The bad bacteria.

因此，你正在改变菌群的平衡。

So you're shifting the balance.

这看似是个小问题，但我听人们说，史蒂夫，他们去意大利时说：我在美国吃不了小麦。

And this is a small thing, but I hear from people, Steve, that go to Italy, they say, I can't eat wheat in The United States.

然后他们去意大利，就没事了。

And then they go to Italy and they're fine.

你觉得是草甘膦的原因吗？

And you think it's that glyphosate?

是的。

Yeah.

他们在那儿不这么做。

They don't do that there.

所以如果我今晚试试有机意大利面，也许会好一些。

So if I tried I'll try organic pasta tonight and maybe that will be better.

是的。

Yes.

那替代选择呢？面包你怎么处理？

And then like the alternative choice is how do you do with bread?

你还好吗？

Are you okay?

不是所有的面包。

Not all bread.

一般来说，我尽量不吃面包。

My my generally, I stay away from bread.

好的。

Okay.

你吃过酸面包吗？

Do you ever eat sourdough?

嗯。

Yeah.

你吃酸面包没问题吗？

Do you do okay with sourdough?

嗯。

Yeah.

这就对了。

There we go.

这是这个等式的第二部分。

So here's the second part of this equation.

先把草甘膦放在一边，暂时不管它。

Put the glyphosate, put that to the side for a moment.

让我们谈谈刚才提到的果聚糖。

Let's talk about the fructans that we were talking about a moment ago.

当你发酵小麦、发酵面团时，实际上会降低果聚糖的含量。

When you ferment your wheat, when you ferment your dough, you actually reduce the fructan content.

什么是果聚糖？

What's fructan?

这些是存在于小麦、大麦和黑麦中的长链碳水化合物。

So these are the long chain carbohydrates that exist in wheat, barley and rye.

所以，只要含有麸质，就也含有这些果聚糖。

So if it contains gluten, it also contains these fructans.

小麦中不止有麸质，这些果聚糖其实对你有益。

Gluten is not the only thing in wheat, And these fructans, again, they're good for you.

它们对你的肠道菌群有益。

They're good for your microbiome.

但那些肠道略有损伤的人很难消化和吸收它们。

But people who have a slightly damaged gut, they struggle to process and digest them.

这可以解释为什么有些人吃了含麸质的食物后会感到不适。

So this would explain why some people, eat wheat containing, gluten containing foods and they struggle.

但他们吃酸面团面包却没问题，因为发酵面包能降低果聚糖含量，从而让你能够耐受。

But they do okay with sourdough because if you ferment the bread, it reduces the fructan content and actually then you can tolerate it.

哦，原来如此。

Oh, okay.

所以你觉得可能是面包里的果聚糖让我有问题，而酸面团面包不含果聚糖？

So you think it might be the fructane in the bread that I have an issue with and sourdough doesn't have fructane in it?

是的。

Yeah.

几年前有一项发表在《胃肠病学》上的研究。

There was there was a study that was in gastroenterology a few years ago.

《胃肠病学》是我领域内的顶级期刊，他们基本上会让人带一堆早餐棒回家。

Gastroenterology is the top journal in my field where basically they they send people home with a bunch of breakfast bars.

好吧，不是巧克力的，但还是算了。

All right, not chocolate but nonetheless.

他们让人带了一堆早餐棒回家，一共三根。

They sent people home with a bunch of breakfast bars, three of them.

其中一根是安慰剂棒，没有添加任何特殊成分。

One of them was a placebo bar, so they didn't add anything special.

其中一根含有非常高浓度的麸质。

One of them contains a very large concentration of gluten.

第三根则含有果聚糖。

And then the third one contained the fructans.

安慰剂是我们对照的标准。

And the placebo is our standard.

我们将以此为基准进行比较。

We're going to compare to that.

当人们食用含麸质的能量棒时，这些人都没有乳糜泻，但他们自己认为有麸质问题，对吧？

When people ate the gluten containing bar, these were, by the way, people that, they did not have celiac disease, they did have gluten problems according to them, right?

这就像你刚才提到的那百分之二十自认为可能有麸质问题的人。

So this is like the twenty percent of people that you mentioned a moment ago who think they might have a gluten problem.

当他们食用含麸质的能量棒时，实际症状比安慰剂组更少。

When they ate the gluten containing bar, they actually had less symptoms than the placebo.

换句话说，麸质并不是问题所在。

So in other words, the gluten is not the problem.

但当他们食用含低聚果糖的能量棒时，症状被引发了。

But when they ate the fructan containing bar, they were triggered.

所以这实际上表明，我们一直以来对‘麸质不耐受’这个概念的理解是错误的。

So basically what this said is that we have been taking this concept of gluten intolerance and we've misnamed it.

这并不是麸质不耐受。

It's not a gluten intolerance.

而是低聚果糖不耐受。

It's a fructane intolerance.

这些人往往在食用这些特定成分时会出现不适。

These are people who are tending to struggle with these particular parts of that food.

哪些食物含有低聚果糖？

What foods contain fructane?

小麦、大麦和黑麦。

Wheat, barley, and rye.

好的。

Okay.

顺便说一下，低聚果糖有很多种类型。

And there's many different types of fructans, by the way.

你可能不会对所有类型都产生反应，可能只对其中一些有反应。

So you may not react to all of them, You may react to just some of them.

但大蒜和洋葱也是典型的例子。

But garlic and onions are also classic.

所以你会听到有人说：我不能吃大蒜。

So you hear people who are like, I can't eat garlic.

我感觉糟透了，对吧？

I feel horrible, right?

这可能是果聚糖的问题。

That can be a fruit tan issue.

藜麦、苋菜、高粱、小米，这些是不含麸质也不含果聚糖的全谷物。

Teff, amaranth, sorghum, quinoa, these are whole grains that don't contain gluten and they also don't contain fructans.

当你对肠道造成损伤后，需要多长时间才能修复？

How long does it take to repair the gut when you have done damage to it?

这个问题是有意问得比较宽泛的。

That's a very broad question intentionally.

但一般来说，对于普通人的肠道受到刺激的情况，需要多长时间才能恢复，那些微生物才能恢复正常？

But generally, for the average person who's done has sort of irritated their gut, how long does it take to restore and for those microbes to go back?

这真的要看情况。

It really depends.

你得先弄清楚，你的起点是什么，对吧？

You have to start with, okay, what's your starting point, right?

损伤有多严重？

Like how deep is the damage?

情况有多糟？

How bad is it?

因为对于患有溃疡性结肠炎或克罗恩病的人来说，这些是炎症性肠病的形式。

Because for the people who have ulcerative colitis or Crohn's disease, those are forms of inflammatory bowel disease.

这些人有着最严重的菌群失调。

Those people have the deepest dysbiosis.

菌群失调是我们用来描述肠道受损的术语。

Dysbiosis is the word that we use for a damaged gut.

有可能逆转吗？

Is it possible to reverse that?

有可能让他们的病情进入深度缓解，不再发作。

It's possible to put them into remission so deeply that they don't have a flare.

我面前这个小模型上的表现，就是发作时的样子吗？

Is that what the flare looks like on this little model that I have in front of me?

是的。

Yes.

回到前面，对于正在收听但不在YouTube上的听众，如果你感兴趣，可以切换到YouTube，但我在这里展示的是结肠的模型。

So going back, for the people who are listening and not on YouTube, you can flip over to YouTube if you're interested, but what I'm showing here is the model of the large intestine.

这个模型包含一个看起来发炎、溃疡、正在出血的小区域。

And the model includes a little area that it looks raw, ulcerated, it's bleeding.

如果你碰到它，就会开始看到血液渗出。

If you were to bump up against it, it's going to start to you'll start to see blood coming out.

所以这是一个非常脆弱、敏感的区域。

So it's like a it's a very vulnerable sensitive area.

现在，关于炎症性肠病，史蒂夫，我有一项关于这个话题的有趣研究。

Now, inflammatory bowel diseases, Steve, I have an interesting study on this topic.

在我看来，它们是典型的肠道炎症健康问题。

They are to me the classic gut inflammatory health condition.

而正在发生的是，免疫系统正在攻击微生物组。

And what's happening is the immune system is attacking the microbiome.

所以从技术上讲，这并不属于自身免疫，因为自身免疫是指你的身体攻击自身。

So technically it's not actually autoimmune because autoimmune would be you're attacking your own body.

免疫系统并没有攻击你的肠道。

The immune system is not attacking your intestines.

免疫系统攻击的是你的微生物组，并将其排斥。

The immune system is attacking your microbiome and rejecting it.

由于这种情况的发生，你的肠道被困在了中间。

And because that's happening, your intestines are stuck in the middle.

所以这里就是免疫系统在攻击微生物组。

So this here is the immune system attacking the microbiome.

它在攻击位于大肠管内的微生物组，免疫系统试图接触并杀死它们。

It's attacking the microbiome, which is in the tube of the large intestine, and the immune system is trying to get at it and kill it.

为什么？

Why?

因为它已经认定微生物组是敌人。

And because it's decided that it's the enemy.

因此，免疫系统感到困惑，因为我们在出生时几乎没有微生物组。

So the immune system is confused because when we're born, we don't have much of a microbiome at birth.

这可能是我们最接近‘什么都没有’的状态。

It's the closest that we will get to not really having anything.

而在生命的头三年里，你会通过生活经验建立自己的微生物组。

And then during the first three years of life, you build your microbiome through your life experience.

到三岁时，你的微生物组在数量上基本已达到成人水平。

And by three years of age, you are basically fully adult sized in terms of your microbiome.

在这段时间里，你的免疫系统正在与这些微生物共同学习。

During this time, your immune system is learning from and with those microbes.

因此，这两者之间存在着不可否认的相互作用：当儿童时期、尤其是头三年的微生物组健康时，会带来更健康的免疫系统。

So there's this interplay between the two that is undeniable where when the microbiome is healthy during childhood, during those first three years, it results in a healthier immune system.

那么，这里究竟发生了什么？

So what's going on here?

免疫系统本应承认你的微生物组是友好的，但它并没有。

The immune system is supposed to acknowledge your microbiome as being friendly and it does not.

它认为你的微生物组是敌人，因此正在清除它们。

It decides that your microbiome is the enemy and so it's taking it out.

那么，对于患有肠易激综合征或克罗恩病的人来说，他们的小肠或大肠里有严重的溃疡，这通常是由于生活方式造成的吗？

So what do you think is, for someone that has irritable bowel syndrome or Crohn's disease, they have one of these big ulcers in their small or large intestine, is it because of their lifestyle, typically?

是生活方式改变，还是有很多因素？

Lifestyle change or is it lots of things?

最主要的元凶是什么？

What's the number one perpetrator?

好的。

Okay.

显然有遗传因素。

There's clearly a genetic component.

好的。

Okay.

所以我们必须坦诚面对这一点。

So we have to be upfront about that.

这些事情并不完全在个人的控制范围内。

Like, these are things that are not necessary within a person's control entirely.

因为从进化角度来看，这种情况根本没有理由发生。

Because, I mean, there's no evolutionary reason why this would happen.

比如，你出现严重的肠道消化问题，这在进化上完全没有道理。

Like, there's no evolutionary reason why you'd have severe gut digestion problems.

没错。

No.

这并没有任何优势，而且这些情况在多年前还非常罕见。

It's not doing there's no advantage to it at And and these things that that occur, they were quite rare years ago.

事实上，如今在发展中国家，炎症性肠病并不多见。

In fact, in third world countries today, there's not much inflammatory bowel disease.

在发展中国家，克罗恩病和溃疡性结肠炎并不多见。

There's not a lot of Crohn's disease and ulcerative colitis in third world countries.

如果你去非洲，几乎看不到这种情况。

If you go to Africa, there's very little.

但你看到的是，随着国家工业化，这些疾病的发病率开始急剧上升。

And then what you see though is as countries industrialize, there's a takeoff and they start ramping up.

因此，在美国，从1970年到2010年的四十年间，溃疡性结肠炎和克罗恩病的病例增加了高达55%。

So within The United States, over the course of forty years from 1970 to 2010, ulcerative colitis and Crohn's disease cases were increasing by up to fifty five percent.

这种病在任何年龄都会得吗？

And you can get that at any age?

是的，任何年龄都可能得。

You can get that at any age.

所以，即使我现在很健康，我也可能做一些事情导致自己得这种病？

So even if I'm healthy right now, I could do a set of things that would give me this?

是的。

Yes.

事实上，回到我们之前关于抗生素的讨论。

In fact, if you take So back to our conversation about antibiotics.

如果你使用抗生素，你在接下来一年内患上炎症性肠病的风险会翻倍。

If you take antibiotics, your risk of developing an inflammatory bowel disease in the next year just doubled.

天啊。

Oh gosh.

如果你用抗生素破坏肠道，抗生素确实会这样做，没有什么比这更能迅速摧毁肠道了——它会大幅降低肠道菌群多样性，在抗生素疗程期间使肠道屏障功能下降50%，并激活免疫系统。

If you disrupt the gut with antibiotics, which the antibiotics do, there's nothing that will basically decimate the gut faster, reducing gut diversity, disrupting the gut barrier by 50% during a course of antibiotics, and activating the immune system.

这充分说明，如果你服用抗生素，患炎症性健康问题的风险真的会显著上升。

It really speaks to that, like if you take antibiotics, these risks of inflammatory health conditions really start to go up.

我们在成人和儿童中都观察到了这种现象。

We see this in both adults and kids.

你有一个

You had a

你的病人米歇尔服用抗生素后，出现了结肠严重肿胀，危及生命。

patient of yours called Michelle who took antibiotics and had a life threatening swelling of her colon.

这是结肠，对吧？

This is the colon, right?

给我看看结肠在哪里。

Show me where the colon is.

所以结肠就是大肠。

So the colon is the large intestine.

好的，行，没错。

Okay, fine, yeah.

所以她服用抗生素后，出现了大肠危及生命的肿胀。

And so she took an antibiotic and had a life threatening swelling of her large intestine.

她服用了抗生素。

So she took an antibiotic.

她服用了克林霉素，这是一种典型的皮肤抗生素。

She took clindamycin, which is a classic skin antibiotic.

好的。

Okay.

问题是，克林霉素会严重摧毁你的肠道。

And the problem is that clindamycin wipes out your gut, like hard.

当这种情况发生时，就存在一种风险，即一种名为C的致病性有害细菌。

And when that happens, there's a risk that this pathogenic like bad bacteria called C.

如果它在里面，就会繁殖，导致这种感染，也就是C.

Diff, if it's in there, it can multiply and then you get this infection, the C.

这种C.感染会引起整个结肠的炎症。

Diff infection that causes inflammation of the entire colon.

所以这位名叫米歇尔的患者，当时发生了什么？我正在值班，收到一条短信，他们说：‘你得马上来这个房间。’

So this patient, Michelle, what happened, I was on call and I get this text and they say, You got to come to this room right now.

这位病人情况很危急。

This patient is sick.

她刚从一家外院转来。

And she had just been transferred in from an outside hospital.

我当时正在写会诊记录，立刻放下手头工作，冲进医院，走进房间，她正抱着肚子，呻吟不止，完全不知道自己在哪里。

So I was in the middle of typing up a consultation, drop that, run through the hospital, walk into the room, she's clutching her belly and she's moaning and groaning and she has no clue where she is.

她满身冷汗，脸色苍白，生命体征完全紊乱。

She's sweaty, she's pale, her vital signs are completely out of whack.

她心跳加速，呼吸急促。

Her heart is racing, she's breathing really fast.

我做了一个小测试，就是轻轻碰了一下她的床。

And I did a little test, which is that I gently bumped her bed just like that.

如果一个人的肠道有严重炎症，你这样做时他们会跳起来，因为他们患有腹膜炎，对吧？

And if a person has severe inflammation of their intestines, they will jump if you do that because they have peritonitis, right?

或者你可以称之为急性腹症。

Or you could call it an acute abdomen.

所以，仅仅这样轻轻碰一下床，就足以让她尖叫起来，对吧？

So just by bumping the bed like that was enough for her to, and she's screaming, right?

她紧紧抱着肚子，完全不知道自己身在何处，发生了什么。

And clutching her belly and she has no clue where she is or what is going on.

她完全处于谵妄状态。

She's completely delirious.

她当时已经用到了最大剂量的抗生素。

She was maxed out on antibiotics.

我们的选择是立即送她去手术，切除结肠，或者 alternatively 给她做粪菌移植，给她一个保留结肠的机会。

Our choices were to rush her to surgery, remove the colon, or alternatively to give her a fecal transplant and give her a shot at keeping her colon.

于是我带她去了手术室，实际上，我用了一种特殊的技术——我不细说了，但因为炎症太严重，我用了不同于平常的方法来插入内窥镜。

So I take her down to the Operating Room and I actually, use a, I mean, I won't bore you with the details, but I used a special technique that's atypical for what I would normally do because the inflammation was so severe to pass a scope.

所以我用的是更小的内窥镜，以减少刺激。

So the scope that I used was a smaller scope to be more gentle.

内窥镜就是一根管子。

A scope being a tube.

内窥镜就是一根管子。

A scope is a tube.

我提到过，如果你做结肠镜检查，它的直径大约和我的食指一样粗。

And I mentioned that if you get a colonoscopy, it's the size of my index finger.

所以那大概有一厘米宽。

So that's like probably about a centimeter across.

但我选择了一种更小的内窥镜，直径大约只有五到六毫米。

But I instead went with a smaller scope that's more like five millimeters, six millimeters across.

它更温和，但操作起来更困难。

It's more gentle and it just makes it harder to do.

但我基本上是将内窥镜从她的直肠插入，一路通过她的肠道，到达右侧部位。

But I basically passed the scope through her rectum and all the way through her intestines to get it over here on the right side.

所以，实际上我已经完全通过了她的结肠。

So it's basically like I have now passed all the way through her large intestine.

在那个位置，我为她进行了粪菌移植。

And in that location, I delivered the fecal transplant to her.

令人惊叹的是，第一，这个手术进行得非常顺利。

And so the amazing thing is that number one, that procedure went really well.

到了第二天，她就恢复成了一个正常人。

By the next day, she was a normal human being.

她躺在床上。

She was laying in bed.

她能够进行对话。

She was able to have a conversation.

两天后，她已经完全恢复正常，我们可以让她回家了。

And after two days, she was so normal that we were able to send her home.

因此，她所面临的严重感染问题通过恢复其微生物组得到了彻底控制和纠正。

So the entire severe infectious issue that she was facing got shut down and corrected by restoring her microbiome.

当你恢复微生物组后，艰难梭菌就会被抑制，免疫系统恢复平衡，炎症也随之消退。

And then when you restore the microbiome, the C.

艰难梭菌基本上会被抑制，免疫系统恢复平衡，炎症被清除。

Diff basically gets suppressed and the immune system falls back into balance, the inflammation washed away.

所以你们会像冰箱里存满这些粪便物质，需要时随时取用吗？

So do you have like a fridge full of these fecal matters that you can just tap into when you need it?

不会，但马萨诸塞州有一家公司专门做这个。

No, but there is a company in Massachusetts that does.

大多数医院都是通过这种方式使用，他们会直接接收这种产品。

And that's what most hospitals use is they'll basically have this sent in.

但实际上这很有趣，因为这个领域出现了新进展：首次有公司开始研究如何利用非粪便移植但源于该理念的物质来调控微生物组。

It's But actually kind of interesting because there's new development in this space where for the first time, companies are actually identifying how to manipulate the microbiome using things that are not actually a fecal transplant, but sort of derived from the idea.

现在他们正在开发一种方法，以在这一脆弱时期重建肠道并保护它。

Now what they're developing is a way to rebuild the gut and protect it during this period of vulnerability.

所以这就是正在兴起的新趋势。

So that's the new thing that's coming.

你一定听过无数种饮食法、果汁排毒和其他由网红和播客博主推崇的潮流，你简直讨厌透了，因为你更清楚它们对肠道造成的后果。

You must hear about so many different types of diets and juice cleanses and whatever else that influencers and podcasters promote that you absolutely hate because you have a deeper understanding of the consequences on the gut.

有哪些饮食法或这些潮流是你最反感的？因为它们误导了人们关于如何打造健康肠道的认知？

What are some of the biggest diets or, I don't know, these sort of trends that you absolutely despise because they are misinforming people about how to create a healthy gut?

从我的角度来看，潮流变化非常剧烈。

Well, I think the thing from my perspective is that trends fluctuate hard.

是的。

Yeah.

对吧？

Right?

2020年的时候，素食饮食正流行。

In 2020, it was like the vegan diet was in.

到了2023年，生酮肉食饮食就火了。

In 2023, it was the carnivore diet.

你不可能找到两个更截然相反的饮食方式了。问题是，对于在家试图弄清楚这一切的人来说，很容易被任何流行趋势吸引，因为当你打开社交媒体时，听到的都是这些内容，对吧？

You couldn't have more diametrically opposed diets, And so the problem is that to the person who's at home and they're trying to get this figured out, it's very easy to get sucked into whatever the trend is because that's what you're hearing about when you open up your social media, right?

而当我坐在这里时，过去五年科学并没有发生巨大变化。

Whereas as I sit here, the science has not changed that dramatically in the last five years.

我们正在研究这些，但这些只是我们对事物理解中的细微波动。

We are working on this, but these are small fluctuations in terms of our understanding of things.

这并不是一种激进的、像那样剧烈摇摆的变化，对吧？

It's not a radical We don't whiplash like that, right?

你的生物学也没有改变。

So nor has your biology.

五年前你的生物学和现在是一样的。

You have the same biology five years ago.

因此，从我的角度来看，这种让人来回摇摆的整个概念完全是胡说八道。

So this entire concept of like whipping people over the place is total bullshit from my perspective.

我想先说，任何有勇气为了健康而改变饮食的人，我真的觉得这非常了不起。

I want to start by saying that any person who has the audacity to change their diet in the interest of their health, like I actually think that's incredible.

你的选择是什么并不重要，因为你只是在试图弄清楚而已。

And it doesn't matter what your choice is because you're just trying to figure it out.

最终，我只是希望人们能变得更好。

And ultimately, just want people to be better.

但问题是，有很多饮食建议是荒谬的，而且两边都有。

But the problem is that there's a lot of dietary advice that's insane and it comes on both sides, Steve.

所以，我绝对不认为百分之百的肉类或仅食用内脏的饮食是平衡或长寿的最佳方案。

So absolutely, I don't believe that a 100% meat or organ only diet is in balance or the optimal solution for longevity.

但另一方面，仅吃水果的饮食，我也永远不会支持或推荐。

But on the flip side, like a fruit only diet, I would never support or recommend either.

这完全疯狂。

That's completely insane.

我们到底在做什么？

What are we doing?

所以我认为，越极端、越限制的饮食，就越偏离了简单而本质的东西——即均衡的全食物。

So I think that like these highly the more restrictive that you get, the more that I think you're drifting away from what is quite simple, which is whole food in balance.

那像果汁饮食之类的呢？人们会做那种事吗？

What about these like juice diets and stuff like that people do?

人们会做七天的果汁饮食或水饮食之类的。

People do like a seven day juice diet or water diet or whatever.

如果你有肠道问题，去掉那些刺激肠道的东西，通常你会感觉好一些。

So you will often feel better if you have gut issues and you take away the stuff that's irritating your gut.

所以简化你的饮食，做类似的事情，你可能会暂时感觉更好，并以为自己做了些什么。

And so simplifying your diet and doing something like that, you can make yourself feel better on a temporary basis and think that you did something.

一般来说，这实际上并没有产生多大作用。

Generally speaking, that's not really doing much of anything at all.

杀死并重新培养肠道微生物需要多长时间？

How long does it take to both kill and then create new gut microbes?

好处在于，你的肠道是非常宽容的。

Well, the beauty of it is that your gut is very forgiving.

所以你今天做出的选择，明天就会反映在你的肠道菌群中。

So the choices that you make today will be reflected in your microbiome by tomorrow.

妙就妙在这些微生物有一个超能力，就是它们能非常快速地繁殖。

The beauty of it is that these microbes, like their superpower is that they are able to procreate so fast.

繁殖是什么意思？

Procreate meaning?

生孩子。

Making babies.

所以它们会一代代地繁衍，据估计最快可能只需要二十分钟。

So they create new generations, like estimates are potentially as quick as twenty minutes.

因此，如果我们为它们提供所需的支持，改变就能迅速发生。

And so we can use that to our advantage because if we actually support them with what they need, change can come real quick.

每三到五天，你的肠道屏障就会更新一次。

And I get back to every three to five days, you build a new gut barrier.

所以我们有机会看到非常快速的健康改善效果。

So there's an amazing opportunity that we have to actually see some quick health effects.

有没有哪些大的健康误区或饮食迷思是你担心人们目前仍在遵循或相信的？

Are there any big sort of health myths or diet myths that you're concerned about that people are currently following or believe in particular?

你有没有看过这个世界，然后心想：天啊，这对肠道来说太糟糕了？

Is there anything you look out into the world and think, oh God, that's going to be awful for the gut?

哦天哪。

Oh gosh.

我其实不太关注这些，因为我根本不上TikTok。但有趣的是，最近一些TikTok上的趋势实际上还挺对的。

It's not something that I pay a ton of attention to because I'm not on TikTok to be honest So with I find it interesting that actually like TikTok, some of the trends that have come more recently are actually on point.

这让我很高兴，因为当人们开始对一些有益的事情产生热情时，我就特别开心，比如‘纤维最大化’潮流。

So which feels great because I love it when like people are getting excited about stuff that's good, like the fiber maxing trend.

我还没听说过这个。

I've not heard about them.

纤维最大化，感觉在很长一段时间没人谈论纤维之后，人们终于开始意识到纤维的好处了。

So fiber maxing, it feels like after not really talking about fiber for a really long time, people are starting to come around to the benefits that come from fiber.

TikTok上的‘纤维最大化’潮流就很好地体现了这一点，人们正在努力大幅增加纤维摄入量。

And this was really exemplified on TikTok with this fiber maxing trend where people are basically trying to increase their fiber profoundly.

但问题是，你必须循序渐进地让身体适应。

So the issue though is that you have to ease your body into it.

所以我认为这个方向本身是正确的，人们正朝着这个目标努力，但执行方式上，我只是希望人们能以一种让自己感觉舒适的方式去做。

So I think the idea is the right idea of where people are trying to go, but the execution, I just want people to do it in a way where they feel okay.

因为如果他们感觉不舒服，就会放弃。

Because if they don't feel well, they're going to bail.

然后他们会认为：纤维对我没用。

And then they're going to think, Well, fiber's not for me.

这个趋势具体是什么？

And what was this trend?

就是人们试图通过食用高纤维食物，使摄入量超过每日推荐剂量。

It was people trying to just get above their daily recommended dose of fiber by eating high fiber foods.

是的。

Yes.

并且承认，就在此时此刻，美国95%的人和英国90%的人都是纤维摄入不足的。

And acknowledging that ninety five percent of people in The United States and ninety percent of people in The UK are deficient in fiber as we sit here right now.

这对人们的肠道微生物组会带来哪些并发症或影响？

And what complications or implications does that have for the one's gut microbiome?

巨大。

Massive.

巨大。

Massive.

因为纤维是为有益菌提供营养的。

Because fiber is feeding the good bacteria.

纤维是有益菌的主要食物，也是短链脂肪酸的前体。

Fiber is the principal food for the good bacteria and it is the precursor to short chain fatty acids.

当纤维与微生物接触时，就会产生短链脂肪酸。

So the short chain fatty acids are what we create when fiber comes into contact with microbes.

短链脂肪酸是我们让纤维与肠道微生物组接触时产生的物质。

Short chain fatty acids are the thing we create when fiber comes in contact with the gut microbiome.

是的。

Yes.

细菌。

Bacteria.

好的。

Okay.

短链脂肪酸真的很好吗？

And the short chain fatty acids are really good?

它们非常好。

They're so good.

事实上，在我研究和了解的所有事物中，这些是我所知道的最具抗炎作用的物质。

In fact, of all the things that I've studied and learned about, these are the most anti inflammatory thing that I've ever come across.

主要有三种：乙酸、丙酸和丁酸。

So there's three of them, three main ones: acetate, propionate, and butyrate.

它们在体内各自具有不同的作用。

They all have their own distinct effects within the body.

它们在肠道内、对微生物、对肠道屏障、对免疫系统都有影响。

They have effects right there in the gut, on the microbes, on the gut barrier, on the immune system.

这些你刚才提到的三种物质，是在纤维与肠道微生物组接触时产生的。

And these are produced, these three things you just named are produced when fiber comes in contact with the gut microbiome.

是的。

Yeah.

比如说，如果你是无菌的，如果你生来就没有微生物组，你听说过泡泡男孩吗？

So like if you were sterile, if you didn't have, if you were born without a microbiome, did you ever hear about Bubble Boy?

哦，对，那部电影或电视剧是吧？

Oh yeah, there was a film or TV show, wasn't it?

是的，那是70年代一部关于一个孩子的纪录片，他生来患有一种罕见的遗传性免疫缺陷。

Yeah, it was like a documentary in the 70s of this kid who was born with this rare genetic immune disorder.

为了保护他，他的家人将他隔离起来，认为只要没有坏东西进来，他就会没事，对吧？

And so his family, in order to try to protect him, they isolated him thinking if no bad stuff can get in, then he would be fine, right?

所以他生活在无菌的泡泡里。

So he lived in a sterile bubble.

所以理论上，如果你是无菌的，你就永远无法获得这些短链脂肪酸的好处。

So in theory, if you were sterile, you would never get the benefits of these short chain fatty acids.

因为你根本没有细菌。

Because you never have bacteria.

因为你没有细菌。

Because you don't have bacteria.

好的。

Okay.

但我们面临的是相反的问题：我们有细菌，却不喂养它们。

So, but we have the opposite of that problem, which is that we have bacteria but we don't feed them.

我们不给它们纤维。

We don't give them fiber.

你不能无中生有。

You can't create something from nothing.

所以你必须提供纤维，才能让它们从中产生短链脂肪酸。

So you have to give them the fiber in order to allow them to create the short chain fatty acids from it.

这些短链脂肪酸，我的肠道菌群就在我肠道里。

And these short chain fatty acids so I've got my gut microbiome in my gut here.

我把纤维摄入体内，那么哪些食物是纤维的最佳来源呢？

I put fiber in there in the form of what foods are the best foods for fiber.

好的。

Okay.

所以我们这里有一整套选择。

So what we have here is an entire array of choices.

嗯。

Mhmm.

妙就妙在，我在这两个盘子上只发现了一样不含纤维的食物。

And the beauty of it is that there's only one thing that I can spot on these two plates that does not contain fiber.

你想猜猜看吗？

Do you wanna guess?

我猜是

I guess that it is

你要我告诉你吗？

You wanna give it to you?

有。

Does.

是姜黄吗？不是姜黄，对吧？

Is it the it's not the turmeric, is it?

不是。

No.

但姜黄可能也没有太多。

But the turmeric probably doesn't have very much.

好的。

Okay.

不是。

No.

是油。

It's the oil.

因为问题是，这是一种100%的脂肪。

Because the issue is that this is a 100% fat.

所以，根据定义，油里不可能含有任何纤维。

So you, by definition, cannot have any fiber inside of an oil.

好的。

Okay.

所以

So

像是葵花籽油或者

it's like sunflower oil or

橄榄油。

olive oil.

所以是的。

So yeah.

不管哪种类型。

Whatever whatever type.

现在，你可能会有多酚。

Now, you could have polyphenols.

特级初榨橄榄油含有对肠道菌群非常有益的多酚。

Like extra virgin olive oil has polyphenols that are really good for the microbiome.

特级初榨橄榄油对肠道菌群实际上非常好，但它不含纤维。

Extra virgin olive oil is actually incredibly good for the microbiome, but it doesn't have fiber.

其他所有食物都含有纤维。

Everything else has fiber.

所以我们有这么多不同的植物性食物。

So we have all these different plant based foods.

妙处在于，这并不需要变得复杂。

And the beauty of it is that it doesn't have to become complicated.

水果、蔬菜、全谷物、种子、坚果和豆类，都含有纤维。

Fruits, vegetables, whole grains, seeds, nuts and legumes, they all have fiber.

肉类？

Meat?

任何非植物性食物都不含纤维。

Anything that's not a plant does not have fiber.

哦，明白了。

Oh, okay.

所以，如果它长在地里，

So if it grows in the ground,

它就含有纤维。

it has fiber.

所以，如果它来自植物，它就含有纤维。

So if it comes from a plant, it has fiber.

顺便说一下，这还包括蘑菇。

And that includes, by the way, the mushrooms.

蘑菇在技术上属于真菌，但它们与植物性食物有许多相似的特性。

So the mushrooms are technically fungi, but they share a lot of the same characteristics that the plant based foods do.

所以，这里有纤维，还有多酚。

So there's fiber, there's polyphenols.

我们希望在健康饮食中包含所有这些成分。

All of these things we want to include in a healthful diet.

所以，如果我吃这些高纤维食物，它们进入我的肠道，微生物群会产生一种叫做短链脂肪酸的物质。

So if I eat these high fiber foods, they go into my gut, the microbiomes produce this thing called short chain fatty acids.

而短链脂肪酸不仅能促进更多有益菌的生长，还能帮助我的免疫系统平静下来？

And the short chain fatty acids, they produce more good bacteria, but also they help my immune system calm down?

是的。

Yes.

所以，如果我们回到我们一开始提到的模型，那就是你的免疫系统有三个部分——或者我应该称之为你的防御系统，因为你的肠道微生物是第一道防线，对吧？

So if you think about, let's go back to the model that we led off with, which is that there's these three parts to your immune system, or actually I should call it your defense system because your gut microbes are the first layer of defense, right?

这正是米歇尔体内的抗生素所破坏的部分。

That was what was broken down by the antibiotics in Michelle.

第二道防线是你的肠道屏障，即保护免疫系统的肠道内壁。

The second layer of defense is your gut barrier, which is the lining of your gut that protects the immune system.

第三部分才是真正的免疫系统本身。

And the third part is the actual immune system itself.

我们甚至不希望激活它。

We don't even want to have to activate that.

我们更希望前两道防线替我们处理好一切，对吧？

We'd rather the first two parts take care of it for us, right?

所以，这种机制的美妙之处在于，你摄入的高纤维食物会进入大肠，特别是右结肠这个经典区域，与你的微生物接触。

So the beauty of this is that you consume these high fiber foods, they come into contact with your microbes right here in the large intestine, specifically the right colon is the classic spot.

微生物会分解这些食物，释放出乙酸、丙酸和丁酸。

And they unpack them and they release the acetate, propionate, and butyrate.

这三种物质会影响你的微生物、肠道屏障和免疫系统。

And those three things impact your microbes, impact your gut barrier, impact your immune system.

在三者之中，我最喜欢的是丁酸，因为丁酸对微生物和肠道屏障的影响最大。

Now of the three, my favorite is butyrate because it's the butyrate that has the biggest effect on the microbes on the gut barrier.

你实际上需要丁酸来产生将肠道内壁细胞紧密结合的蛋白质。

Like you literally need butyrate in order to produce the proteins that hold your gut lining together.

丁酸对我们的免疫细胞有直接作用。

The butyrate has a direct effect on our immune cells.

因此，这些物质是我所知道的最具抗炎效果的物质。

So these are, again, the most anti inflammatory thing that I've come across.

而我们之所以遭受这些疾病，回到我们最初关于慢性炎症性健康问题的讨论，你问我它们从何而来？

And part of why we're suffering with these, going back to the original conversation about these chronic inflammatory health conditions and you asked me, where do they come from?

我们生活在一个工业化的世界里，至少有百分之九十的人摄入的纤维远远不足。

We live in an industrial world where ninety five percent of us, at a minimum ninety percent of us, are not getting even close to the amount of fiber that we need.

当我们与其他地区比较时，最近有一项有趣的研究考察了意大利、新加坡人的微生物组，以及生活在玻利维亚亚马逊和马来西亚的原住民部落人群。

And when we compare this to other places so there was an interesting study that came out recently where they looked at the microbiome of people in Italy, Singapore, and then they had native tribal people in the Bolivian Amazon and native tribal people in Malaysia.

两个过着狩猎采集生活方式的土著部落，与意大利和新加坡进行对比。

So two indigenous tribes living a hunter gatherer lifestyle against Italy and Singapore.

他们发现，微生物组的多样性存在巨大差异。

And what they discovered is that there is this radical difference in terms of the diversity of the microbiome.

在产生短链脂肪酸的能力上也存在差异。

There's a difference in terms of, their ability to produce short chain fatty acids.

关于衰老，人们提出了一个问题：随着年龄增长，炎症会加剧。

And there's this question that comes up about aging because as we age, inflammation increases.

这是不可避免的吗？

Is that inevitable?

我们是否注定因年龄增长而只能接受炎症问题越来越多？

Are we stuck in a position where based upon our age, we should just expect that we're going to have more inflammatory issues?

他们在部落人群中发现，事实根本不是这样。

What they found in the tribal populations is that actually that's not true at all.

因此，由于他们的生活方式，他们无论年龄多大都能抵御炎症。

So they were protected against inflammation regardless of their age because of their lifestyle.

但他们的生活方式不仅仅是饮食，他们日出而作，日落而息，与部落紧密相连，不会刷Instagram。

But they were living and it's not just what they eat, it's they wake up when the sun comes up, they sleep when the sun goes down, they're connected to their tribe, they're not looking at Instagram.

这个故事包含的内容太多了。

Like, there's so much to that story.

但关键在于，在工业社会中，我们并没有摄入足够数量的这类食物。

The point being though that in the industrial world, like we're not consuming a sufficient amount of these types of foods.

我猜他们也不喝酒和抽电子烟。

I guess they're not also drinking alcohol and vaping.

没错。

No.

而我们在西方世界却大量做这些事。

Which we do a lot more in the Western world.

是的，我们确实会。

Yeah, we do.

这对肠道微生物组有什么影响？

What impact does that have on the gut microbiome?

因为我通常听不到人们谈论酒精对

Because I don't typically hear people talking about alcohol in

肠道微生物组的影响。

the gut microbiome.

我们知道，它确实会影响肠道屏障。

What we know is that it definitely affects the gut barrier.

我想，如果我喝伏特加，也会在一定程度上破坏我的口腔微生物组。

I guess also wiping up my oral microbiome as well to some degree if I'm pouring vodka

倒进去的话，是不是和使用含酒精的漱口水一样？

And in it would be the same as using an alcohol based mouthwash, right?

而我们现在不再推荐使用这类产品了。

Which now we don't recommend anymore.

所以，是的，关于酒精，确实有一项研究改变了我对酒精的看法。

And so, yeah, so alcohol, there was a study actually that changed my mind when it comes to alcohol.

因此，我现在几乎根本不喝酒了。

So I actually don't drink hardly at all anymore.

只有在极少数情况下，比如和妻子共进特别的晚餐时，我才会喝一两杯。

Like very rarely I'll have a glass or two with my wife if we're on a special dinner.

在这项研究中，研究人员给受试者摄入了大量酒精，然后每三十分钟测量一次他们的血液酒精浓度，同时测量一种叫做脂多糖的物质水平。

And in the study, they basically gave people a significant amount of alcohol and then they tracked every thirty minutes the measure of their blood alcohol level and simultaneously the measure of what's called lipopolysaccharide.

它来自我们微生物组内存在的炎症性细菌。

So it comes from the inflammatory bacteria that live inside of our microbiome.

它本不该出现在你的血液中。

It's not supposed to be in your bloodstream.

如果它出现在血液中，通常表明你的肠道屏障不够健全、过于脆弱，以至于它能够穿透过去。

If it's in your bloodstream, that generally indicates that your gut barrier is insufficient and weak because it's able to get across.

问题是，免疫系统已经学会将这种脂多糖识别为敌人。

And the problem is that the immune system has been trained to identify that lipopolysaccharide as the enemy.

因此它被激活了。

And so it gets activated.

而这就是炎症的来源。

So, and this is where inflammation comes from.

在这项研究中，参与者饮用了若干杯酒，研究人员每三十分钟进行一次追踪。

So in this study, they had people have a number of drinks and they start tracking every thirty minutes.

你看到的是，随着血液中酒精浓度的上升，脂多糖水平也同步上升。

And what you saw was that as the blood alcohol level goes up in parallel, the lipopolysaccharide goes up.

当酒精浓度达到峰值时，脂多糖水平也达到了峰值。

When the alcohol peaks, so did the lipopolysaccharide.

发生了一件奇怪的事情。

There was this weird thing that happened.

我不清楚原因，但酒精浓度确实达到了峰值。

I can't explain why, but the alcohol level peaked.

之后它开始下降，但随后又回升了一次。

It started to come down and then actually it bumped back up.