如何优化你的大脑与身体功能及健康

吐姆呼吸法已经存在了几个世纪。

Tummo breathing has been around for centuries.

对于熟悉呼吸练习和瑜伽修行的人来说，我承认我刚才描述的这些并不是什么科学上的新发现。

And for those of you that are familiar with breath work and yogurt practices, I acknowledge that nothing I just described is new based on science.

不过，科学解释了这些练习为什么有效。

However, the science informs why those practices work.

顺便说一句，我想强调一下，这个播客的核心目标之一就是去掉那些花哨的术语，不管是瑜伽术语还是科学术语，让普通人也能掌握这些方法。

And just as a little mini editorial, I just want to emphasize as well that one thing that this podcast is really about is trying to remove fancy nomenclature, whether or not it's yogic nomenclature or scientific nomenclature so that people can access protocols.

因为一旦我们用人的名字来命名，或者叫它“吐姆”之类的，我对此没有意见，但这并不能说明练习的具体做法，也不能解释背后的机制。

Because the moment we start naming things after people or calling them Tummo, etcetera, I have no problem with that, but it doesn't inform how the practices are done nor does it inform the underlying mechanisms.

所以在这里，我想教你们的是这些机制。

So here, I'm trying to teach you the mechanisms.

最后一点，最有效的呼吸方式是基于基本机制的：吸气会加快心率，呼气会减慢心率，而二氧化碳和氧气与血液和大脑的关系也有特定的规律。

And as a final point to that, the most powerful form of breathing is the one that takes into account the fundamental mechanisms that inhales increase heart rate, that exhales decrease heart rate, and that carbon dioxide and oxygen relate to the bloodstream and the brain in particular ways.

一旦你理解了这些要素，你就可以自己创造出所谓的呼吸练习了。

Once you understand those components, then you can create your own so called breath work practices.

你可以用最适合自己的方式呼吸，而不是觉得某种方法就是最好的或者适用于所有情况的万能方法，因为事实并非如此。

You can breathe in the ways that best serve you, as opposed to thinking that one protocol is the best or holy protocol for everything, because it's simply not.

最后一点，我想说的是，当你改变呼吸方式时，不管你是排出更多二氧化碳还是吸入更多氧气，你都在从根本上改变你身体内部环境的化学状态。

As a final, final point, I want to say that as you shift the way that you breathe, whether or not you're blowing off more carbon dioxide or bringing in more oxygen, you are fundamentally changing the chemistry of your internal milieu of your body.

而且已经证明，这对你的免疫系统功能、你应对炎症的方式，以及各种可能进入你身体并引发问题或压力状况的东西，都有重要影响。

And that has been shown to have important effects on the way that your immune system functions and the way that you deal with inflammation and all sorts of different sort of things that can enter your body and cause problems or conditions of stress, etcetera.

所以随着节目的进行，我会进一步探讨这个问题，但我想先简单提一下呼吸的另一个纯机械性的方面，我觉得这非常有趣也很重要，它涉及到一个反射，你很快就会非常熟悉，而且在极端压力下它对你很有帮助。

So I will explore that further as the episode goes on, but I want to move on to just touch on one other aspect of breathing that's purely mechanical, which I think is very interesting and important, which relates to a particular reflex that you're going to be very familiar with in a second and that can serve you very well in times of extreme stress.

我说的这个反射叫做赫林-布罗伊尔反射。

The reflex I'm referring to is something called the Hering Breuer Reflex.

我不会详细讲赫林-布罗伊尔反射是怎么运作的，但它跟一类叫做压力感受器的神经元和细胞有关。

I'm not going to go into details about how the Hering-Breuer Reflex works, but it has to do with particular classes of neurons and cells that are called Baroreceptors.

这些基本上就是压力感受器。

Those are basically pressure receptors.

它们感知压力。

They sense pressure.

基本上，赫林-布罗伊尔反射的意思是，当你的肺被充满时，你呼吸的欲望就会减弱。

And basically what the Hering Breuer Reflex is about is that when your lung is inflated, your desire to breathe is reduced.

你现在就可以试试。

So you can try that right now.

你可以深吸一口气，吸得很大很大，然后屏住，好吗？

You can inhale, huge big big thing of air and hold, okay?

相比你呼出所有空气后屏住呼吸，你呼吸的欲望会来得更晚一些。

Your desire to breathe will kick in later than were you to exhale all your air and hold your breath.

当你呼出所有空气并屏住呼吸时，除非你按照我几分钟前描述的那种方法，先有意识地做几次吸气和呼气，否则你会感到空虚。

When you exhale all your air and hold your breath, unless you've done the sort of protocol I described a few minutes ago of doing a bunch of inhales and exhales first in a very deliberate way, you will feel empty.

那些压力感受器会疯狂地发出信号，说这里没有压力。

Those Baroreceptors are going to be firing like crazy saying there's no pressure in here.

这里没有压力。

There's no pressure in here.

我这里什么都没有。

I got nothing in here.

你需要呼吸。

You need to breathe.

你需要呼吸。

You need to breathe.

而且喘气反射会更早出现。

And the gasp reflex will kick in sooner.

这个原理可以应用到各种场合，比如运动时、调节压力时等等。

You can apply that in all sorts of situations related to exercise, related to modulating stress, etcetera.

所以赫林-布鲁尔反射是一个非常强大的反射。

So the Hering Breuer Reflex is a very powerful one.

这就是为什么你在潜入水下之前要深吸一口气，对吧？

This is why you take a big deep breath before you go underwater, right?

你不会把肺里的空气全呼出去再下水。

You're not going to exhale all your air and go underwater.

如果你把肺里的空气全呼出去再下水，你肯定会比肺里充满空气时更早感到需要浮上来呼吸。

If you were to exhale all your air and go underwater, you would absolutely feel the need to come up sooner for a breath of air than had you a full tank, so to speak, full of lungs full of air.

这也是人们教自己在水下感到舒适的方式。

And this is also the way that people teach themselves to feel comfortable underwater.

所以学游泳的时候，你既要学会肺里有气在水下，也要学会肺里没气在水下。

So when you learn how to swim, you learn how to swim both by having air in your lungs while you're underwater and no air in your lungs while you're underwater.

总之，赫林-布鲁尔反射是机械压力影响大脑决策的另一个维度，在这种情况下，就是决定身体要不要呼吸。

In any event, the Hering Breuer Reflex is yet another dimension to the way that mechanical pressure influences your brain's decision making about what to do with your body in this case, whether or not to breathe.

现在我想把话题从呼吸、横膈膜和肺，转到我们内脏里的另一个器官，那就是肠道。

So now I want to shift away from breathing and diaphragm and lungs and move toward another organ within our viscera, which is our gut.

这包括我们的胃、肠道、食道等等。

So this includes our stomach and our intestines, our esophagus, and so forth.

我之前也说过，别人也说过，我们其实就是一系列管子。

Been said before both by me and by others that we are but a series of tubes.

确实如此，信不信由你，你身体里的每个系统都是一根管子。

And indeed that's true, believe it or not, every system in your body is a tube.

你的大脑其实也是一根管子，它连着脊髓，脊髓也是一根管子。

Your brain is actually a tube that connects to your spinal cord, which is also a tube.

你一开始就是个管子。

You started off as a tube.

你就像一根吉事果，你知道那种吉事果吗？如果你不熟悉的话，它们就像管子形状的甜甜圈。

You were like a churro, you know, those churros, I don't know if you're not familiar with churros, they're like donuts that are shaped like a tube.

那基本上就是你在发育早期、受孕后不久的样子。

That's essentially what you look like early in development, not long after conception.

那根吉事果的前端不断生长，但你始终保持着管子内部的中空。

And the front end of that churro grew and grew and grew, but you always maintained a hollow through that tube.

这就是为什么你有所谓的脑室间隙，也就是大脑和脊髓中的空间，贯穿整个大脑和脊髓，脑脊液和其他物质在这个空间里流动。

That's why you have what are called ventricles gaps or a space in your brain and spinal cord that run the length of your brain and spinal cord and fluid, cerebral spinal fluid and other things move through that space.

我们稍后会再回到脑室这个话题。

We're going to return to the ventricles later.

它们非常重要。

Are very, very important.

它们只是充满液体的空间，但作用很大。

They're just space filled with fluid, but they do a lot.

同样，你的消化系统从嘴巴里的管道开始，当然会经过喉咙往下走。

Similarly, your digestive system starts with the tube at your mouth and of course goes down through your throat.

然后你有胃和肠的所有部分，最后从另一端出来。

And then you've got all the elements of the stomach and the intestines, and then it comes out the other end.

所以你不过是一系列不同的管道，你的血管系统也是一系列管道。

So you are but a series of different tubes, your vascular system, a series of other tubes.

所以你的管道，你的消化系统的工作方式，就是向大脑传达沿这条管道机械压力的状态。

So your tubes, the way your digestive system works is to communicate to your brain about the status of the mechanical pressures along this tube.

所以在你胃里、肠里等等，以及管道内不同部位的化学状态，来告诉大脑应该如何控制这条管道。

So within your stomach and your intestines, etcetera, and the chemical status of that tube at various portions within that tube to inform your brain about how your brain should control that tube.

那么我们先从肠道的机械感知说起。

So let's start with the mechanical sensing of your gut.

如果你喝了很多液体，或者吃了很多食物，你的肠道就会填满。

If you drink a lot of fluid or if you eat a lot of food, your gut will fill up.

你的胃会装满食物。

Your stomach will fill up with food.

现在食物在那里开始消化。

Now it gets digested there.

当然，它也会在消化道的其他地方被消化，但一开始是在那里消化的，因为沿着这条管道，有一系列叫做括约肌的东西，基本上就像小拉绳。

It gets digested elsewhere along your digestive tract too, of course, but it starts getting digested there because along this tube, have a series of what are called sphincters, which basically are like little draw pulls.

如果你用过那种带拉绳的洗衣袋，一拉绳子就收紧封口，再一拉又能打开，那就是那种东西。

If you ever had a laundry bag, which has a drawstring on it and you pull it and then it cinches shut and then you can open it again, that's what those are.

那些就是括约肌开口，你的喉咙里有，消化道里一直到末端都有。

Those are sphincter openings and you have them in your throat, you have them along your digestive tract all the way to the end.

食物会进入你的肠道。

Food will enter your gut.

如果食物很多，压力感受器——其中一些是压电感受器——会向大脑中负责进食的区域发送信号，说：别再吃了。

And if there's a lot of that food, pressure receptors, some of which are these piezo receptors will communicate to the areas of your brain that are involved in feeding and will say, don't eat anymore.

你不需要再摄入了。

You don't need to consume anymore.

但人们会绕过这个机制。

Now, people bypass that.

我猜他们有什么热狗大胃王比赛之类的。

These, I guess they have these like hot dog eating competitions.

我总觉得那些人里面有些看起来特别瘦，但他们其实为了那些比赛会喝大量的水来训练，这其实是非常危险的做法。

I'm always struck by how some of those people are like seem to be rail thin, but they actually train for those competitions by ingesting large volumes of water, actually a very dangerous practice.

喝水太多真的能把自己喝死，而且为了撑大胃，吃太多任何东西都可能致命。

You can actually kill yourself by drinking too much water and you can kill yourself by ingesting too much of anything really to expand your gut.

这不是个好做法，我也不太喜欢那些比赛，但即使你是那种选手，或者你是世界重量级冠军，这些比赛也能说明我现在要讲的东西，那就是当你撑大胃的时候，胃里的神经元，也就是神经细胞，会向脑干发送信号，传到大脑中负责进食的区域。

Not a good practice, not a big fan of those competitions, but even if you're one of those people or you're the world heavyweight champion of them, they are informative toward what I'm talking about now, which is that as you expand the gut, a signal is sent by neurons, literally nerve cells that are in the gut to the brainstem up to the areas of the that are involved in feeding.

我做过一整集关于进食的节目。

I did a whole episode on feeding.

你可以找到关于进食、新陈代谢和饥饿的那一集。

You can find on feeding metabolism and hunger.

如果你想听的话，欢迎去听那一集，然后它会关闭那些驱动你想往嘴里塞更多东西的神经元。

You're welcome to listen to that episode if you like, and it will shut down the neurons that drive the desire to put more stuff in your mouth.

人们有时候会说，嗯，在这个国家，感恩节大餐后经常说，我一口都塞不进去了。

That thing that people say sometimes on, well, in this country frequently after Thanksgiving meal, I can't put another bite in my mouth.

它们真的会抑制你拿起叉子再吃一口的基本肌肉动作。

Literally they shut down some of the basic movements of the musculature to take another fork bite.

我知道听起来很疯狂，但它们确实能控制你的大脑。

I know it sounds crazy, but they can actually control your brain.

所以当你的胃装得太满时，它就会控制你的大脑，让你把食物送进嘴里的这个动作被抑制住。

So your gut is so full that it's controlling your brain such that this action of spooning food towards your mouth is actually inhibited.

这个动作会变得更难，或者更不容易发生。

It's made more difficult or less likely to occur.

这太不可思议了。

It's incredible.

反过来也一样。

The converse is also true.

当这些压力感受器向大脑发出胃是空的信号时，不管你是否真的需要食物，大脑都会收到一个信号说胃空了，然后像弓状核和下丘脑这些区域的神经元就会被激活，促使你产生张嘴吃东西的冲动，尤其是想吃食物。

When these piezo receptors signal to the brain that the gut is empty, independent of your need, your actual need for food, there's a signal that's sent to your brain that says gut is empty and neurons get stimulated in areas like the arcuate nucleus and these areas of the hypothalamus, etcetera, that drive the desire to make this action, to open the mouth and to put stuff in it, in particular food.

所以当你发现自己站在冰箱前，或者几乎疯狂地找各种东西吃的时候，你甚至都没在想自己在吃什么，因为你实在太饿了。

So when you find yourself at the refrigerator or you find yourself almost, you know, manically trying to get food of different kinds, you're not even thinking about what you're eating because you're so hungry.

这部分是因为肠道里没有食物，这个信息传到了大脑，从而驱动了与进食相关的特定固定行为模式。

In part that's because the lack of food in your gut has sent that information to your brain and is driving particular fixed action patterns that are associated with eating.

事实上，孩子们最早学会的事情之一，就是当有东西送到嘴边时张开嘴巴。

In fact, one of the first things children learn how to do is open their mouth when something is presented to it.

然后他们学会怎么用勺子或叉子。

And then they learn how to move a spoon or a fork.

一开始他们不太会。

They're not very good at it.

刚开始弄得乱七八糟，但最后会变得熟练。

First, they get all over the place, but eventually they get good at it.

至少大多数人能学会。

At least most people get good at it.

如果你观察人们吃饭的样子，其实各有各的方式。

If you watch how people eat, it's kind of variable out there.

不管怎样，这纯粹是一种机械性的现象。

In any event, this is a purely mechanical phenomenon.

而这个纯粹的机械现象正在驱动我们的大脑去引导某些行为。

And this purely mechanical phenomenon is driving our brain to drive certain behavior.

你可以通过一种非常特定的方式来更好地感知饱腹感或空腹感。

You can get better at registering sense of fullness or lack of fullness in a very particular way.

有些人对自己胃部的饱胀或空虚程度非常敏感。

Some people have a very keen sense of how full or empty their stomach is.

所以，如果你在过去一到三小时内吃了任何东西，哪怕只是少量食物，实际上值得花上几秒钟，也许十到二十秒，试着集中注意力去感受肠道里的神经元，以及你有多饱。

So if you've eaten anything, even if it's a small volume of food in the last hour to three hours, it's actually a worthwhile practice to take a few moments, maybe ten, twenty seconds, and actually just try and concentrate on sensing the neurons in your gut and how full you are.

比如，我几小时前吃了东西，然后大约半小时前又吃了点零食，现在我的胃既不觉得特别饱，也不觉得特别空。

Like for instance, I ate a few hours ago and then I had a little snack about thirty minutes ago or so, and my gut feels neither terribly full nor terribly empty.

大概，我会说差不多40%吧，好吗？

It's kind of, I would put it kind of like 40%, okay?

所以，只要在餐间、餐后、餐前等不同时间，有意识地关注自己胃部的饱胀或空虚程度，你就能很快培养出对自己饱饿状态的感知。

So by just taking conscious awareness of how full or empty our gut is at various times between meals, after a meal, before a meal, you can very quickly develop a sense of how full or empty you are.

那么，这又会导致什么结果呢？

Now, what's the consequence of that?

这个结果其实挺有意思的。

The consequence of that is actually rather interesting.

研究表明，这样做的好处是，你能更好地控制那些压感受体以及肠胃饱腹或空腹的信号。

It's been shown that the consequence of that is actually that you can better override the signals of these piezo receptors and gut fullness or emptiness.

所以，如果你发现自己吃东西有点强迫性，或者无意识、下意识地吃——应该说，你至少得清醒着才能吃，但就是下意识地发现自己一直在吃，我其实就是在说我自己。

So for those of you that find that you eat kind of a compulsively or non consciously or subconsciously, should say, probably have to be conscious enough to be awake to eat, but subconsciously you just find yourself eating and here I'm describing myself.

我就是那种路过蓝莓就顺手抓一把吃的人。

I'm a drive by blueberry eater.

如果有一碗蓝莓放在那儿，我每次经过都得抓一把塞嘴里。

If there's a bowl of blueberries, every time I walk past it, sort of have to grab a handful of them, pop them in my mouth.

但如果你培养出对肠胃机械压力的感知——虽然这个词不太准确——就是肠胃里的机械感觉，很快你就能学会控制它。

But if you develop this sense of how much mechano pressure, it's not really a word, but how much mechanosensation is in your gut, very quickly you can learn to override that.

你可能会问，为什么我要去控制胃是空的还是饱的呢？

You might ask, why would I want to be able to override whether or not my stomach is empty or my stomach is full?

其实，想做到这一点有很多原因。

Well, there are many reasons to want to do that.

现在很多人对所谓的间歇性断食很感兴趣。

Many people right now are interested in so called intermittent fasting.

他们每24小时会进行12到16小时的断食。

They're doing fasts of anywhere from twelve to sixteen hours every twenty four hour cycle.

其实我自己就是这么做的。

That's actually what my practice is.

我经常这样做。

I do that on a regular basis.

有时候我也会吃早餐，但通常我会把早餐推迟到上午十一点或中午，有时甚至更晚。

Sometimes yeah, eat breakfast, but normally I push breakfast out till about eleven or noon or sometimes a little later.

有些人会进行更长时间的断食，我的同事萨钦·潘达在索尔克生物研究所发表了一些非常出色的数据，刊登在顶级期刊上。

Some people are doing longer fasts and there are really wonderful data published in excellent journals from my colleague Sachin Panda at the Salk Institute of Biological Biological Studies.

当然，其他实验室的研究也表明，间歇性断食对肝脏健康、大脑健康以及其他方面的健康确实有积极的影响。

And of course from other laboratories showing that intermittent fasting can and will have some positive health effects on things like liver health and brain health and other aspects of health.

至于它是否是减肥的最佳饮食方式，这还存在很大争议，但很明显，每24小时安排一段断食时间，或者偶尔进行更长时间的断食，是有益的，因为它能激发所谓的自噬作用，也就是身体清除某些死细胞（即衰老细胞）的能力。

Whether or not it's the best form of dieting for the sake of losing weight, that's very controversial, but it's clear that having a period of fasting every twenty four hours or perhaps even longer from time to time can be beneficial because it stimulates what's called autophagy, the clearing away or the body's ability to eat certain dead cells, called senescent cells.

对很多人来说，断食很难坚持，因为他们觉得自己的胃空的感觉特别明显，总觉得必须得吃点东西。

And for many people, they struggle with fasting because they feel they have a very keen sense of their stomach being empty and they feel as if they have to eat.

而且有点反直觉的是，有些数据表明，如果你能感知到自己的肠道是饱还是空，并且知道这个信息正在告诉大脑要不要吃东西，光是这种意识和理解，就能让人忽略掉那个信号。

And in a kind of counterintuitive way, there's some data that indicate that being able to sense whether or not your gut is full or empty and just the knowledge that that's communicating information to your brain about whether to not to eat or not, just that awareness, that understanding allows them to override the signal.

他们会想，哦，其实我现在并不需要营养。

They think, oh, you know, I'm not actually in need of nutrients right now.

只是我的胃空了，这些压电感受器还有其他一些我待会儿要讲的感受器，在告诉大脑胃是空的。

It's just that my stomach is empty and these piezo receptors and some other ones that I'll tell you about in a moment are signaling to my brain that it's empty.

我其实不需要吃东西。

I don't actually need food.

只是我的大脑在反应，因为我的肠道可以说是瘪了，或者变小了，里面没有食物。

It's just that my brain is reacting to the fact that my gut is deflated, so to speak, or smaller, doesn't have food in it.

所以我们的肠道和大脑之间还有其他交流方式。

So there are other ways that our guts communicate with our brain.

不只是胃在跟大脑说话。

It's not just our stomach talking to our brain.

而且我们的肠道也会跟大脑交流。

It's also our intestines talk to our brain.

利伯尔实验室，那个人叫史蒂文·利伯尔。

The Lieberle's lab, the guy's name is Steven Lieberle's.

他在哈佛医学院经营一个实验室，是个很棒的实验室，在肠道-大脑交流以及其他内脏-大脑交流方面做了非常出色的研究。

He runs a lab at Harvard medical school is terrific lab, does excellent work on gut brain communication and other aspects of viscera brain communication.

他们发现了一类叫做GLP-1R神经元的神经元。

They discovered a category of neurons called the GLP-1R neurons.

这些神经元基本上就在你的脖子那里。

These are neurons that are basically in your neck.

我的意思是，它们是神经系统的一部分，但可以在脖子附近找到。

I mean, they're part of the nervous system, but they can be found near your neck.

这些神经元会伸出细小的线，一直延伸到肠道，甚至深入胃里，但主要是到肠道。

And those neurons send little wires down into the intestines and deep into the stomach, but mostly into the intestines.

它们能感知肠道的拉伸。

And they sense stretch of your intestines.

这真是太神奇了。

So this is pretty wild.

这些神经元能感知你肠道的拉伸程度，以及食物通过肠道的速度，是快还是慢，或者里面有没有东西。

These neurons sense how stretched out your intestines are and how fast things are moving through your intestines, slow or fast, or if there's nothing there.

然后这些神经元还会伸出另一个分支。

And then those neurons send another branch.

它们有一个分支朝一个方向，感知肠道内的情况。

So they have a branch in one direction senses what's going on in your intestines.

另一个分支从颈部向上延伸到大脑，要么触发继续进食的欲望，要么让你停止进食。

And they have another branch that goes up from your neck into your brain to either trigger the desire to eat more or to stop eating.

所以这些神经元真的非常酷，它们基本上是拉伸感受器。

So these are really, really cool neurons and they're basically stretch receptors.

它们看起来很像我们之前讨论过的压电感受器。

They look a lot like the piezo receptors that we talked about before.

所以这些GLP-1R神经元感知的是拉伸，也就是纯粹的机械感知。

So these GLP-1R neurons are sensing stretch, so purely mechanical sensing.

除此之外，利伯勒实验室还发现了能感知营养物质本身的神经元。

And in addition to that, the Lieberle's lab discovered neurons that detect nutrients themselves.

我们之所以需要进食，主要就是为了给身体补充营养。

Now, the main reason why we need to eat is to bring nutrients into our body.

还有另一组神经元。

And there is another set of neurons.

它们叫做GPR65神经元。

Those are called GPR65 neurons.

如果你想知道，其实不用记这个名字，它们在连接方式上跟前面那些神经元是一样的。

If you want to know that you don't have to remember that, that do the same thing in terms of their connections.

它们向下连接到肠道、消化道和胃，但主要是肠道，然后把信息传回大脑，告诉大脑消化道里有没有某些种类的营养物质。

They send connections down into the intestines and into the gut, into the stomach, but mostly into the intestines, and then send that information back up to the brain as to whether or not there are certain kinds of nutrients in our digestive tract.

如果我们要讨论化学信号，那这些神经元才是关键。

Now, these neurons are the ones to pay attention to if we're talking about chemical signaling.

接下来几分钟，我会告诉你怎么理解饥饿感，以及如何调节饥饿感，让你更想吃对的食物。

And then in the next couple of minutes, I'm going to tell you about how you can understand hunger and how to modulate your hunger for the right foods.

实际上，是针对健康食物的。

In fact, for healthy foods.

实现这一点的方法是利用这些GPR65神经元的活动，这些神经元能感知营养物质，明白吗？

The way this is done is by leveraging the activity of these GPR65 neurons, these neurons that sense nutrients, okay?

它们告诉你的大脑你的肠道里有什么。

They're telling your brain what's in your gut and intestines.

还有另一组神经元，是另一个人发现的。

And you have another set of neurons that were discovered by another guy.

他在杜克大学。

He's out at Duke University.

他叫迭戈，抱歉，迭戈，迭戈·博尔赫斯。

His name is Diego, excuse me, Diego, Diego Borges.

他是一位非常出色的科学家。

He's a wonderful scientist.

他拥有营养学学位，同时也拥有神经科学学位。

He has a degree in nutrition, but also in neuroscience.

他发现肠道内壁有一些神经元，这些神经元和GPR65神经元合作，感知三样东西，明白吗？

And he found that there are neurons that line the gut and those neurons in collaboration with these GPR65 neurons are sensing for three things, okay?

我们说是营养物质，那它们具体在找哪些营养物质呢？

So we say nutrients, which nutrients are they looking for?

这些神经元到底在关注什么？

What are these neurons paying attention to?

这些神经元会被脂肪酸激活，特别是omega-3脂肪酸，比如来自肥鱼、鱼油、磷虾、某些动物蛋白，以及动植物来源的物质。

Well, these neurons are activated by the presence of fatty acids in particular omega-three fatty acids, sorts of things that come from fatty fish, fish oil, krill, certain kinds of animal protein, animal and plant substances.

你可以查查哪些食物富含omega-3，这些omega-3会让这些神经元疯狂放电，把信号传到大脑，让你想吃更多这类食物，但事实证明，这种需求是相当合理的。

You can look up what has a lot of omega-3s and those omega-3s make these neurons fire electrically like crazy up to the brain and make you want to eat more of those things, but it turns out in pretty appropriate levels.

这些神经元还会对氨基酸产生反应。

These neurons also respond to amino acids.

当你吃东西时，食物在肠道里被分解，其实分解过程还挺有意思的。

So when you eat a food, it's broken down in the gut, actually the way it's broken down the gut is kind of interesting.

你的肠道基本上会在有食物时，把上面的括约肌收紧，下面的括约肌也收紧。

Your gut basically cinches off a sphincter up top, cinches off a sphincter below it when there's food there.

然后你有一系列平滑肌，它们会翻动食物，并真正地物理分解它。

And then you have a series of smooth muscles that tumble the food and literally physically break it down.

然后当然，酶会进来开始消化食物。

And then of course, enzymes come in and start digesting the food.

我们一会儿会讨论消化以及它是如何传达给大脑的。

And we're going to talk about digestion and how that's communicated to the brain in a moment.

对于有自身免疫问题或消化问题的听众来说，这次对话会非常重要。

And for those of you with any autoimmune issues or digestive issues, this is going be very important conversation.

与此同时，肠道里有这些神经元，当脂肪酸从消化后的食物中浮出，也就是脂肪分子，以及氨基酸来自蛋白质在肠道中被消化时，还有第三种食物成分，糖分来自我们吃的食物。

But meanwhile, there are these neurons in the gut and as these fatty acids float out of the digested food, so literally fat molecules, and as amino acids are coming from the proteins as they're digested in the gut, And as a third food item, sugars are coming from the foods that we eat.

这些神经元会向大脑发出大量信号，说：嘿，不管你在上面做什么，多做一些，好吗？

These neurons will fire a lot to the brain that says, hey, whatever you're doing up there, do more of it, okay?

糖分有点神秘，因为当我说糖分、氨基酸或脂肪酸时，这些与味觉无关。

Now the sugars are a little bit cryptic because when I say sugars, or I say amino acids, or I say fatty acids, this has nothing to do with taste.

实际上，压力感受器实验室和其他实验室做了精彩的实验，表明即使你麻醉口腔，即使你进行灌胃——这其实就是一个花哨的词，基本就是管饲，你把管子放进肠道，直接把食物送到肠道里。

In fact, beautiful experiments have been done by the Baroreceptors lab and by other labs showing that even if you numb the mouth, even if you gavage, which is a really just a, it's a fancy word for basically tube feeding, you put a tube down in the gut, you just deliver the food to the gut.

所以你根本尝不到味道。

So you get no opportunity to taste it.

听起来挺糟糕的。

Sounds pretty awful.

如果你用管饲强制喂食，或者麻醉嘴巴，这些神经元根本不在乎嘴巴。

If you force feed by gavage or you numb the mouth, these neurons don't care about the mouth.

它们只在乎食物带来的营养。

They only care about the nutrients coming from these foods.

然后它们向大脑发出信号：嘿，做那个动作，做那个举起叉子或勺子的动作，做那个喝奶昔的动作，做那个嘴巴这样动、不是说话、而是吞咽的动作。

And then they signal to the brain, Hey, do that thing, do that thing where you lift that object we call a fork or a spoon, do that thing where you drink the milkshake, do that thing where you move your mouth like this, not talking, but do that thing where you swallow.

所以，这就是我们肠道里的营养如何控制我们的。

So that's how the nutrients in our gut control us.

这就是为什么那些有强烈糖瘾或者轻微糖瘾的人，用富含欧米伽-3或氨基酸的食物替代那些含糖食物，可以减轻糖瘾。

And this is why for people that experience extreme sugar cravings or even mild sugar cravings, replacing those foods with foods that have high levels of omega-three or amino acids can reduce sugar cravings.

我之前在某一集里讲过这个，如果你没看到，也没关系。

And I've talked about this on a previous episode, but if you didn't catch it, no big deal.

我现在就告诉你，对很多人来说，解决糖瘾的办法就是摄入少量的一种氨基酸，叫谷氨酰胺，大概一茶匙左右。

I'll tell you right now that for many people, the solution to sugar cravings is to ingest a small amount, maybe a teaspoon or so of an amino acid called glutamine.

如果你的糖瘾特别严重，你甚至可以把谷氨酰胺和全脂奶油混在一起，这样味道其实还挺不错的。

And if you have really extreme sugar cravings, can even mix that glutamine with a full fat cream, which actually makes it taste pretty darn good.

你可以在想吃糖的时候喝一点，或者就喝一两口。

And you drink that anytime you have a sugar craving or just a sip or two of that.

你会发现糖瘾就消失了，因为你基本上是在给肠道和肠道里的那些神经元提供脂肪和氨基酸，这些神经元会向大脑发出信号，让你想要更多。

And what you find is that the sugar cravings disappear because you're basically giving fat and amino acids to those neurons in the gut and in the intestine that signal to the brain that you want more.

这并不会让你对全脂奶油产生失控的食欲。

Now this doesn't give you a kind of runaway hunger for full fat cream.

不过我得说，我高中的时候，出于各种原因，但主要是因为我喜欢那个味道，我在麦片里加了一半一半的奶油，而且我半夜会醒来喝那个，一旦你习惯了高脂肪含量，那玩意儿味道真的挺不错的。不过现在我不这么做了，但重点是，这些神经元其实尝不出味道，它们只认营养素。

Although I will say when I was in high school for various reasons, but mostly because I liked the way it tastes, I was using half and half in my cereal and I was just waking up in the middle of night and drinking half and half and that stuff tastes pretty darn good once you get used to the high fat content, not something I do now, but the point is these neurons don't really know taste, they only know nutrients.

所以如果你有糖瘾，你可以利用这个系统。

And so you can work with that system if you crave sugar.

而且我确实认为，我们大多数人，如果不是所有人，都应该尽量限制甚至戒掉简单糖，大多数时候是这样。然后像谷氨酰胺、高omega-3的食物等等，甚至可能想补充鱼油或类似的东西来获取omega-3。

And I do believe that most, if not all of us should be trying to limit, if not eliminate simple sugars as much as possible, most of the time, then things like glutamine, things like high omega-three foods, etcetera, maybe even want to supplement with fish oil or something similar to get omega-3s.

还有其他理由想这么做，也很有益。

There are other reasons for wanting to do that too, can be very beneficial.

我们这里要讲的是内感受。

And here's what we're talking about is interoception.

也就是你感知自己身体内部状态的能力，但这里是通过化学信号，而不是机械信号。

It's your ability to sense your inner real estate, but in this case, by way of chemical signaling, not by way of mechanical signaling.

现在我想谈谈肠道化学的另一个方面，它对大脑和免疫系统都有深远影响。

So now I'd like to talk about another aspect of gut chemistry that has profound effects on the brain, as well as on the immune system.

如果你有自身免疫性疾病，或者你认识有这类疾病的人，那接下来的讨论会非常重要。

And for those of you with autoimmune conditions, or for those of you that know people with autoimmune conditions, this is going to be a very important discussion.

你的肠道需要维持一定的酸碱度。

Your gut needs to maintain a certain level of acidity or alkalinity.

对于没有化学背景的人来说，pH值数字低表示更酸，数字高表示更碱。

For those of you without any chemistry background, basically the low numbers on the pH scale, that means more acidic, the higher the numbers, more alkaline.

所以更碱就是更偏碱性，更酸就是更偏酸性。

So more alkaline means more basic and acidic means acidic.

这跟氢原子的数量以及其他一些因素有关，但你现在不需要担心这些。

And it has to do with number of hydrogen atoms and all this other stuff, but you don't need to worry about that right now.

我们现在不会去测你肠道的pH值，但我们要讨论一下你肠道的pH值。

We're not going to pH your gut right now, but we are going to talk about the pH of your gut.

你的肠道需要比身体其他所有组织更偏酸性，才能正常运作。

Your gut needs to be more acidic than essentially all other tissues of your body in order to function properly.

细菌在碱性环境中容易繁殖。

Bacteria thrive in alkaline conditions.

我觉得这一点很重要，大家需要明白。

I think this is important for people to understand.

人们总是觉得，哦，你应该更碱性，酸性听起来不好。

People are always thinking, oh, you should be more alkaline being acidic.

酸性听起来几乎就像发炎一样。

That almost sounds like being inflamed.

嗯，这确实是个复杂的话题，但我觉得有时候用词确实容易让人困惑。

Well, you know, it's a complicated discussion, but I think the semantics can be confusing sometimes.

你希望你的肠道是酸性的。

You want your gut to be acidic.

你可能会问，那为什么人们要吃抗酸药呢？

You may ask, well, why are people taking antacids?

那些抗酸药是为了特定目的而存在的，主要是对抗胃酸反流，也就是肠道里的东西往上涌到食道，会引起烧心之类的不适。

Well, those antacids are there for a particular purpose to essentially combat acid reflux, which is the sending up of stuff in the gut towards the esophagus, and it can cause heartburn and things of that sort.

抗酸药的作用原理是让肠道上方的括约肌收紧，但它们其实只是处理了症状，而不是根本原因。

And the way that antacids work is they essentially cause the sphincters above the gut to cinch shut, but they really are only dealing with a symptom, not the cause.

所以倒退到大约十年前、二十年前，关于肠道酸度的讨论，在科学和医学文献里跟现在是很不一样的。

So rewind about ten, twenty years ago, the discussion about gut acidity was quite a bit different than it is now in the scientific and medical literature.

实际上，很多年来，早在我现在要说的这个时间之前，人们就一直说保持肠道适当的酸度很重要，但科学界和医学界对此有点嗤之以鼻，觉得，嗯，这到底是怎么回事？

In fact, for many years, long before I'm going to say it here, people have been saying that it's important to maintain proper acidity of the gut, but the science and medical professions sort of looked at that as a kind of a scant like, you know, what's going on there?

我知道确实有证据表明这是真的。

I know that there's any evidence that that's actually true.

有一些人群在开处方，或者我应该说推荐人们服用盐酸，也就是HCl，用这种方式来调节肠道酸度。

There are communities of people that were prescribing, or I should say recommending that people take hydrochloric acid HCl and adjusting gut acidity that way.

这种做法当时是不太被认可的。

And it was kind of frowned upon.

现在再看同行评审的文献，很明显，让肠道更酸一点这种做法，实际上是人们治疗或试图缓解胃酸反流的一种方式。

Now in looking over the peer reviewed literature, it's clear that this business of trying to make the gut a little more acidic is actually one way in which people treat or try and ameliorate acid reflux.

所以这有点反直觉，增加肠道酸度来减少胃酸反流。

So it's kind of counterintuitive, increasing acidity in the gut to try and reduce acid reflux.

我还以为应该吃抗酸药呢。

I thought you're supposed to take antacids.

其实这个领域已经发生了很大的变化。

Well, the field has shifted quite a bit.

所以我们要来看看，把肠道化学环境维持在稍微更酸或更酸的水平是怎么回事，因为事实证明，肠道里有很多东西。

And so we're going to review what it is to maintain the chemistry of the gut at a slightly more acidic level or a more acidic level, I should say, because it turns out that there are a number of things that are in gut.

我就直说了。

I just call it what it is.

胃液听起来有点恶心，但胃液实际上是大脑状态的强大调节器。

It's gastric juice sounds kind of gross, but gastric juices are actually powerful modulators of brain state.

换句话说，要想拥有一个健康的大脑、运作良好的大脑，以及健康运作的身体，你能做的最好的事情之一就是维持正确的肠道化学环境。

Put differently, one of the best things that you can do to have a healthy brain, a well functioning brain and a healthy and well functioning body is to maintain proper gut chemistry.

这基本上就是通过让肠道保持适当的酸碱度来实现的。

And that's basically accomplished by getting the right level of acidity and alkalinity in your gut.

这可不是什么江湖骗术。

Now, this is not quack pseudoscience.

这也不是基于什么排毒疗法之类的东西。

This is not based on cleanses or anything of that sort.

我们要讨论的是发表在像《细胞》这样的顶级期刊上的同行评审数据，这些期刊包括《科学》《自然》《细胞》等三大顶尖期刊。这些数据表明，肠道微生物组与肠道酸碱度有关，而肠道微生物组可以帮助增强自身免疫功能，并改善大脑和身体健康的其他方面。

What we're going to talk about now are peer reviewed data in very high quality journals like the journal Cell, which is one of the three apex journals, Science, Nature, Cell, and journals of that sort that point to the gut microbiome and its relationship to acidity of the gut and how the gut microbiome can help enhance autoimmune function and various other aspects of brain and body health.

在我们身体的所有黏膜组织中，都有所谓的微生物群，这些微小的微生物不是我们自身产生的，而是来自环境或食物，生活在我们的体内。

So within all the mucosal line tissues of our body, we have what are called microbiota, little microorganisms that we didn't make that actually come from our environment or our food and live inside us.

有好的微生物群，也有坏的微生物群。

And there are good microbiota and there are bad microbiota.

我们体内是好微生物群还是坏微生物群，取决于一件事。

Whether or not we have good microbiota or bad microbiota depends on one thing.

而这个关键因素就是黏膜组织的酸碱度。

And that one thing is how acid or alkaline the given mucosal tissue is.

其实我们的鼻子里也有微生物群。

So we actually have a microbiome in our nose.

顺便提一句，因为不说这个我会觉得过意不去——如果你大多数时候都强调用鼻子呼吸，除了说话或吃饭的时候，并且减少用嘴呼吸，尤其是在睡觉时避免用嘴呼吸，你的鼻腔微生物群就会得到改善。

And just as a very brief aside, because I'd be remiss if I didn't say this, if you emphasize nasal breathing most of the time, except when speaking or eating, and if you downplay mouth breathing, meaning you refrain from mouth breathing, especially in sleep, you improve the nasal microbiome.

它抵抗感染的能力会变得更强。

It gets better at fighting off infections.

这是去年发表在《细胞报告》上的一篇优秀论文中展示的。

This was shown in a beautiful paper published in cell reports last year.

而且我要提一下，那篇论文是在人类身上进行的。

And that paper I should mention was performed in humans.

所以你的鼻子里有微生物群，而通过大多数时候用鼻子呼吸——不是所有时候，因为有时候你可能需要因为某种原因用嘴呼吸，比如剧烈运动、吃饭或说话——但通过大多数时候用鼻子呼吸，你就在对抗可能让你生病的颗粒物方面建立了一道额外的免疫防线。

So you've got a microbiome in your nose and by nasal breathing most of the time, not all the time, because there can be times when you need to breathe through your mouth for whatever reason, hard exercise or eating or speaking, but by breathing through your nose, most of the time you are creating an additional layer of immune defense against particles that could get you sick.

而当你用嘴呼吸时，你等于撤掉了一层防线，让自己更容易感染。

Whereas when you mouth breathe, you are taking down a layer of defense and you're putting yourself more at risk of infection.

这就是这篇论文所展示的内容。

This is what this paper shows.

你的肠道里也有微生物组，分布在喉咙、胃和肠道中。

You also have a gut microbiome that is in your throat, in your stomach and in your intestines.

这个肠道微生物组在调节你的情绪和免疫功能方面非常强大。

And that gut microbiome is extremely powerful in regulating your mood and your immune function.

不过，这不是你能直接感知到的东西。

Now, is not something that you can sense directly.

你不会知道什么时候有一堆好的微生物或一堆坏的微生物，因为你不能感觉到它们在体内移动。

You don't know when you have a bunch of good microbiota or a bunch of bad microbiota, because you can feel them moving around in there.

实际上，那会相当糟糕。

Actually, that would be pretty awful.

那会让人感觉非常毛骨悚然。相反，根据你的肠道是否以适当的方式呈碱性或酸性，你的肠道会定植相应的微生物群。

That would be pretty creepy feeling rather that according to whether or not your gut is alkaline or acidic in the appropriate ways, you will populate your gut with the appropriate microbiota.

所以，你希望你的胃保持相当酸性，但消化道的其他部分则会有不同的pH值。

So you want your stomach to be pretty acidic, but other elements of your digestive tract are going to be more pH.

基本上，肠道里有一个梯度，也就是说pH值从低到高变化。

And basically there's a gradient, meaning there's a low to high pH gradient along the gut.

你不需要知道每个具体位置的pH值应该是多少，因为你不会只在一个地方放微生物，而不在另一个地方放。

You don't have to know what the pH should be at any one given point, because you're not going to go and put microbiota at one location and not another.

你真正要做的就是创造一个环境，让合适的微生物能够茁壮成长。

What you essentially want to do is create an environment where the proper microbiota can thrive.

因为当你做到这一点时，你会大大减少所谓的炎症细胞因子。

Because when you do that, you greatly decrease what are called inflammatory cytokines.

这些物质由体内的细胞和大脑中的细胞分泌，影响大脑健康、大脑功能以及身体健康。

So these are things that are secreted both by cells within the body and cells within the brain to impact brain health and brain function and bodily health.

它们有特定的名称。

They go by particular names.

比如有一种叫做TNF-α，也就是肿瘤坏死因子α。

So there's something called TNF alpha tumor necrosis factor alpha.

它是促炎的。

It is inflammatory.

水平升高可不是什么好事。

It's not a good thing to have at elevated levels.

还有一种叫白细胞介素六，也就是IL-6的东西，它也会引起炎症，损伤组织，长期偏高可不是什么好事。

You have something called interleukin six, IL-six, also causes inflammation, causes damage to tissues, not a good thing to have for elevated for long periods of time.

然后还有抗炎细胞因子，比如白细胞介素10，它们能减轻炎症。

And then you have anti inflammatory cytokines, things like interleukin 10, which reduce inflammation.

这些细胞因子有成百上千种，有些促进炎症，有些减轻炎症。

And there are hundreds of these, if not thousands of these different cytokines, some of which promote inflammation, some of which reduce inflammation.

要调整这些因子的比例，简单的方法就是调整你的肠道菌群。

The simple way to adjust these things in the proper ratios is to adjust your gut microbiome.

调整菌群最好的方法就是吃某些特定的食物。

The best way to adjust your microbiome is to ingest certain types of foods.

现在这方面的文献已经很丰富了，但最重要的还是我在节目开头提到的那些，就是该吃什么、不该吃什么，这样才能为你的肠道创造最佳条件，进而为你的大脑和身体创造最佳条件。

So there is a beautiful literature on this now, but the most important literature is the one that I referred to at the beginning of this episode, which is what to ingest and what not to ingest in terms of foods in order to create the best conditions in your gut so that you can create the best conditions in your brain and body.

我的同事，斯坦福医学院的贾斯汀·索南伯格做过一项研究。

There was a study done by my colleague, Justin Sonnenberg at Stanford School of Medicine.

贾斯汀其实是我在斯坦福工作的大楼里楼上的邻居。

Justin's actually my upstairs neighbor in the building at Stanford where I work.

他们研究了不同的食物，或者说不同的饮食，如何影响肠道微生物组和炎症标志物。

And they explored how different foods or different diets, I should say, impact the gut microbiome and inflammatory markers.

这是一项很棒的研究，因为它在数百名人类受试者身上进行。

And this is a beautiful study because it was done in hundreds of human patients.

这些其实不是生病的人，我应该说，是来自各种背景、其他方面都很健康的人类受试者。

These actually weren't patients that were sick, I should say human subjects that were otherwise healthy from a huge variety of backgrounds.

所以有男性、女性，有不同种族、不同民族的人，背景非常多样，他们追踪了所有这些。

So you had men, you had women, you had people of different races, different ethnicities, you had a huge range of backgrounds and they tracked all of that.

他们做的是探索两种类型的饮食。

And what they did is they explored two types of diets.

一种是高纤维饮食。

One is a high fiber diet.

膳食纤维通常是不易消化或仅部分消化的碳水化合物。

So dietary fibers are non digestible or only partially digestible carbohydrates typically.

他们把这些和高纤维饮食做了对比，那些饮食除了每天增加几份发酵食品外没有变化，比如酸菜、泡菜，他们还研究了发酵白软干酪，听起来挺恶心的，但谁知道呢，我从来没试过。

And they compared that to diets that were unchanged, except for the inclusion of a few to a few more servings of fermented foods each day, things like sauerkraut, things like kimchi, they even explored sounds pretty disgusting to me, but who knows I've never tried it, which is fermented cottage cheese.

他们发现，在最初几周让参与者吃大量纤维或一两份发酵食品后，他们让这些人逐渐增加纤维或发酵食品的摄入量。

And what they found was that after initial period of a few weeks where they had people either eat a lot of fiber or eat one or two servings of fermented foods, they had those people ramp up their ingestion of either fiber or fermented foods.

所以他们算是慢慢引导他们进入状态。

So they kind of eased them into it.

他们从基线开始，然后逐渐增加到每天摄入四到五份纤维或发酵食品，听起来挺多的，但对于发酵食品来说，就是四到五汤匙的酸菜或泡菜。

So they went baseline, then ramp up to the point where they were ingesting, you know, four or five servings of fiber or of fermented foods per day, which sounds like a lot, but for fermented foods, that would be, you know, four or five tablespoons of sauerkraut or kimchi.

这不算多，不是满满一大盘发酵食品。

It's not quite, it's not like huge platefuls of fermented foods.

然后他们观察了很多指标。

And then they looked at a number of things.

他们观察了蛋白质组，就像基因组一样，但指的是身体里产生的一堆蛋白质。

They looked at the proteome, which is a kind of like looking at the genome, but a bunch of proteins that are made in the body.

他们通过粪便样本和血液样本来做这些检测，这很棒。

And they did this by fecal samples, by stool samples, and they did this by blood draw, which is great.

这确实是这项研究的一大亮点。

It's a real power of this study.

事实上，这是我所知的最全面的研究。

In fact, the most comprehensive study that I'm aware of.

通过长期观察这些不同的组织，持续很多很多周，然后让参与者回到他们进入研究前的饮食，他们能够以因果的方式确定，每天摄入纤维或纤维类食物，与摄入发酵食品相比，如何影响肠道微生物组，以及许多炎症标志物、免疫功能标志物和自身免疫功能的标志物。

By looking at these different tissues across long periods of time, so many, many weeks, and then returning people to the diet that they were on before they went into the study, they were able to establish in a causal way, how ingesting fibers or fibrous foods versus ingesting these fermented foods on a daily basis could impact the gut microbiome and many, many inflammatory markers and many, many markers of immune function and autoimmune function.

这项研究的核心结论是，发酵食品的效果远优于高纤维饮食。

And the takeaway message from this study is that the fermented foods far outperformed the high fiber diet.

实际上，高纤维饮食对某些人有益，但对另一些人则引发了炎症问题。

In fact, the high fiber diet in some people was beneficial and in other people caused issues with inflammation.

这和我从小被教导的，以及我们很多人被教导的，非常不同。

This is very different than what I was taught growing up and what many of us were taught.

有趣的是，他们还观察到，吃高纤维饮食的人体内某些酶的活性增加了，这些酶有助于更好地消化碳水化合物。

Interestingly, they also observed that people that ate the high fiber diet had increases in certain enzymes that lend themselves to better digestion of carbohydrates.

我认为这背后有一个重要的洞见。

And I think there's an important insight to come from this.

现在我们好像生活在极端饮食的时代，人们要么就想当纯肉食者，连蔬菜都不碰。

Nowadays we kind of live in the age of extremes where people seem to either want to be carnivore, like never ingest a vegetable.

我听说他们连胡椒都不让吃，更别说酸菜之类的了，要么就是纯植物饮食、纯素食，基本上就是纯碳水化合物或者纯动物蛋白，非常极端。

I hear they don't even, they're like allowed pepper, but they're not even allowed, you know, sauerkraut or something like very extreme or pure plant based, pure vegan or pure, so essentially pure carbohydrate or pure animal protein, very extreme.

我是杂食动物，我喜欢在不同时间吃各种不同的东西，但确实很极端。

I'm an omnivore, I like to eat a mixture of different things at different times of days, but very extreme.

但这很有意思，因为这些数据表明，摄入高碳水、高纤维的饮食——其实高纤维条件就是这样——确实能让人更好地消化碳水化合物。

But this is interesting because what these data show is that perhaps ingesting a high carbohydrate, high fiber diet, which is really what these, the high fiber condition really was actually makes people better at digesting carbohydrates.

这也许能解释为什么习惯了旧石器饮食或纯肉饮食的人，一吃碳水化合物就会说，哎呀，这个不适合我。

This may explain why people who are used to a kind of more paleo type or carnivore type diet might eat carbohydrates and say, oh, that doesn't work for me.

我感觉不舒服。

I don't feel good.

这也能解释为什么主要吃植物和碳水化合物的人，会尝试吃肉，不管是出于实验、还是因为某种原因，或者走投无路，他们会这么做。

It might also explain why people who predominantly eat plant based foods and carbohydrate foods will try eating meat as an experiment or because they lost a bed or whatever it is and they'll do, or desperation or they'll do that.

然后他们就会说，哎呀，我吃肉感觉不舒服。

And then they'll say, oh, I don't feel good when I eat meat.

你感觉好不好，能不能很好地利用那种食物，以及你对那种食物的渴望程度，可能都是由这些决定的。

How good you feel it seems, how well you can utilize that food and how much of that food you crave may be determined.

事实上，看起来是由你的饮食习惯，也就是你吃的那类食物决定的。

In fact, it appears is determined by your food eating history, the types of food you eat.

我觉得这可能解释了一些分歧，而且希望能弥合这些不同群体之间的鸿沟，他们有的说应该这样，有的说应该那样。

And I think this might explain some of the divide and hopefully might bridge some of the chasm between these different groups that are saying it should be one way or it should be another.

但这项研究的核心是一个更大的信息。

But at the core of the study was the bigger message.

更大的信息是，我们所有人都应该定期、每天摄入两到四份不同种类的发酵食品。

The bigger message is that all of us should be ingesting on a regular basis, daily basis, two to four servings of fermented foods of different kinds.

我这么说是因为炎症标志物下降了，自身免疫紊乱的标志物也下降了，因此肠道的化学环境得到了适当的调整。

And why I say that is because the inflammatory markers went down, the markers of autoimmune disruption went down and the chemistry of the gut therefore was adjusted in the appropriate ways.

这并不是说高纤维不好，或者说纤维不好。

Now it's not to say that high fiber is bad or that fiber is bad.

我不想让大家混淆这一点，尽管这是关于内感受、关于感知自身的讨论，但这是一个潜意识的机制，肠道通过它向包括大脑在内的许多器官传递信息。

I don't want people to confuse this, but even though this is discussion about interoception about sensing the self, this is a subconscious mechanism by which the gut communicates to many, many organs, including the brain.

而且其他研究也证明了，这些研究也发表在高质量的同行评审期刊上，当肠道菌群正确存在，炎症标志物减少时，认知能力会提高，也就是专注力、睡眠质量、抵抗感染和伤口愈合的能力都会增强。

And it's been shown in other studies, also in quality peer reviewed journals, that when the correct gut microbiota are present and these inflammatory markers are reduced, cognition improves, so ability to focus, ability to sleep, ability to ward off infection and wound healing, all enhanced.

实际上，即使在自闭症谱系障碍患者中，以及那些有各种心理问题或精神障碍的人中，改善肠道微生物组似乎对改善大脑症状有显著效果。

In fact, even in autism spectrum disorder, in people that struggle with various mental conditions or disorders of the mind, improving the gut microbiome seems to have powerful effects on improving brain symptoms.

说到自身免疫，有很多我们称之为自身免疫性疾病的病症。

Along the lines of autoimmunity, there are a number of conditions that we call autoimmune conditions.

我们以后会专门做几期节目来讨论这些，但对于患有肠易激综合征、克罗恩病、肠漏、桥本氏甲状腺炎（这是一种免疫系统攻击自身甲状腺的疾病）以及湿疹等皮肤问题的人来说，调整肠道微生物组已被证明对改善所有这些症状有帮助。

And we will do entire episodes about these going forward, but for people with so called irritable bowel syndrome, for people with Crohn's disease, for people with leaky gut, Hashimoto's, which is a kind of an immune system self attack on one's thyroid gland and things like eczema skin conditions, adjusting the gut microbiome has been shown to be useful in positively adjusting the symptoms of all of those.

它能完全治愈这些疾病吗？

Will it fix those conditions entirely?

可能不会，但它能对这些疾病产生显著的积极影响吗？

Probably not, but can it have a significant positive impact on them?

很可能可以。

Probably yes.

在那份清单中，有一点值得提一下，那就是肠漏。

There is one thing that's worth mentioning in that list, which is leaky gut.

什么是肠漏？

What is leaky gut?

这里我们说的是肠道。

Here, we're talking about the guts.

肠漏是什么意思？

What is it to have a leaky gut?

听起来很可怕。

It sounds awful.

听起来像是有什么东西从管子末端漏出来，也许是这样，但肠漏实际上是因为你的肠道不是由单层细胞组成的连续管道。

It sounds like something sort of like leaking out the end of the tube and maybe that too, I don't know, but leaky gut is actually because your gut is not a tube that's continuous one cell.

它实际上由许多细胞组成，这些细胞形成一道屏障，并形成所谓的紧密连接。

It's actually made up of many, many cells and those cells form a barrier and they form what are called tight junctions.

所以，如果你有两个细胞，想用它们做一道篱笆，就把它们绑在一起。

So, if you have two cells and you want to create a fence out of those cells, you bind them together.

身体的做法是通过所谓的紧密连接将它们连接起来。

The way that the body does this is to bind them together with what are called tight junctions.

这些紧密连接蛋白，它们的名字像什么克劳丁之类的。

These are, they go by names like cloudins and things like that.

如果你想查的话。

If you want to look them up.

这些紧密连接形成了一道很好的屏障，就像铁丝网一样，东西过不去，但就像铁丝网一样，只有特定大小的分子才能穿过那些孔。

These tight junctions form a nice barrier, like a cyclone fence that things can't get past, but like a cyclone fence, only molecules of a certain size can go through those holes.

所以你不能把一个足球穿过完整的铁丝网，但你可以，比如说，把一根羽毛穿过那个网。

So you're not going to pass a soccer ball through an intact cyclone fence, but you could pass for instance, a feather through that fence.

所以肠漏就是当肠道内的环境过于碱性，或者肠道菌群失调，也就是说喜欢碱性环境的菌群在那里生存。

So leaky gut is when the conditions in the gut are too alkaline or the gut microbiota are off in the gut, meaning microbiota that like alkaline guts are living there.

而那些紧密连接在那个特定的pH值下无法正常工作，你就在那个网上弄出了小洞。

And those tight junctions can't function at that particular pH and you create little holes in that fence.

然后当你摄入食物时，一些食物真的会从肠道漏出来，进入细胞外空间和血液中。

And then what happens is when you ingest foods, some of those foods literally leak out of the gut and into the extracellular space and into the bloodstream.

因为食物含有蛋白质，而抗体会对蛋白质产生反应，所以在肠漏中最终发生的情况，以及我们在自身免疫性疾病中谈论它的原因，就是你开始对特定的食物蛋白质产生抗体。

And because foods include proteins and antibodies react to proteins, what ends up happening in leaky gut, and the reason we talk about it in autoimmune conditions is that you start developing antibodies to particular food proteins.

然后人们开始觉得自己有食物过敏，确实如此，他们真的会形成特定的食物过敏。

And then people start feeling like they have food allergies and they do, they actually create particular food allergies.

那么，预防肠漏的一个方法就是通过摄入我们之前讨论过的适当食物，以及定期摄入发酵食品，来让肠道环境恢复健康。

Now, one way to prevent leaky gut is to get the rest of the gut situation happy by ingesting the proper foods that we talked about before, ingesting fermented foods on a regular basis.

另一个方法就是我们的老朋友——谷氨酰胺。有一些数据，虽然我得说研究数量有限，显示每天摄入一到三茶匙的谷氨酰胺有助于缓解肠漏。

The other is our old friend, glutamine again, there are some data and I should say it's a limited number of studies showing that ingesting glutamine anywhere from one to three teaspoons per day can help alleviate leaky gut.

目前其机制尚不清楚，无论是调整pH值还是为微生物群创造更有利的环境，但可以肯定的是，补充谷氨酰胺对某些人来说可以改善肠漏的状况。

Now, the mechanism for that still isn't clear whether or not it's adjusting pH or whether or not it's creating more favorable environment for the microbiota, but it is clear that supplementing with glutamine can in some people enhance, or I should say improve conditions of leaky gut.

所以这可能也有用。

So that might be useful as well.

最后要谈的一点是，我们讨论的是肠道中的化学感应及其对健康的影响，这涉及肠道酸度。

And then the final thing about this, want to talk about is we're talking about chemical sensing in the gut and how that impacts well-being is about gut acidity.

我承认，这一点有点争议。

And this I confess is a little bit controversial.

有些人认同这一点，有些人不认同。

Some people are on board this, other people are not.

所以我特别想听听你的看法。

And so I'd love your feedback on this.

如果你同意，请告诉我；如果你不同意，也请告诉我，但请告诉我你不同意的具体原因，比如你的亲身经历或数据。

If you agree, please tell me if you disagree, please tell me, but please tell me why you disagree in particular experience or data.

当然，如果你能给我提供经过同行评审的研究，那就更好了。

Although it's always better if you can point me towards peer reviewed studies.

有一种做法，有些人会采用。

There is a practice that some people embrace.

我不一定建议大家这么做，而且你肯定要先咨询医生，但有些人有食物过敏，或者有情绪问题或自身免疫问题，他们通过服用盐酸片来治疗，有些人推荐这种方法。

I'm not recommending people necessarily do this and you would definitely want to talk to your doctor, but where people have food allergies or they're having mood or autoimmune issues and they treat this, some people recommend treating this through the ingestion of HCl, hydrochloric acid tablets.

盐酸会烧伤你，对吧？

Now hydrochloric acid can burn you, right?

酸会烧伤你。

Acids can burn you.

它们真的能把皮肤融化掉。

They literally can melt away skin.

你真的要非常小心各种酸，盐酸也不例外，但盐酸是以补充剂的形式，也就是胶囊或药片的形式出售的。

You want to be very careful with acids of all kinds truly, but hydrochloric acid is sold as in supplement form in capsule or pill form.

有一种做法是，在吃饭吃到一半的时候，开始服用一到两片盐酸片。

And there is a practice of starting to ingest one or two hydrochloric acid tablets midway through a meal.

然后人们通常会观察，看看这是否能改善他们的消化不良症状，以及它如何影响情绪、整体健康感和内脏的感觉。

And then what people will generally do is examine to see whether or not that improves their symptoms of indigestion, how it relates to mood, how it relates to well-being, how it relates to their sensation of their gut viscera.

通过改变酸度，你也改变了肠道通过我们之前讨论过的机制与大脑沟通的方式。

By changing the acidity, you also change the way that the gut communicates with the brain through the mechanisms we talked about before.

现在有越来越多的人开始采用这种服用盐酸的做法。

And there are a growing number of people embracing these practices of taking HCl.

它通常还会和其他东西一起使用。

It's often combined with other things.

它通常会和一种酶搭配，这种酶就是胃蛋白酶。

It's usually combined with an enzyme and that enzyme is Pepsin.

所以，大多数这类补充剂都是盐酸甜菜碱加胃蛋白酶的形式，虽然它们不是万能药，我当然不想暗示它们是万能药。

So, most of these supplements come in the Betaine HCL Pepsin, and while they're not a cure all, I certainly don't want to suggest that they're a cure all.

很多难以调节肠道酸碱度、难以适当调整肠道菌群的人，在用餐时服用这些甜菜碱盐酸胃蛋白酶片或胶囊后，确实有所改善。

Many people that have a hard time adjusting the pH of their gut and have a hard time adjusting the microbiota of their gut in the appropriate ways have benefited from taking these Betaine HCl Pepsin tablets or capsules during meals.

一般的指导是慢慢来，先从一两片开始，然后找到适合自己的剂量，既不会让胃部有过热的灼烧感，也不会影响消化。

And the general instruction is to start slow to start with one or two, and then to find a level that you're comfortable with that doesn't create an excessive feeling of warmth in the stomach that doesn't throw off your digestion.

所以这需要一点尝试和摸索。

So it takes a little bit of experimentation.

再说一遍，在尝试之前一定要咨询你的医疗保健提供者，但这已经成为自身免疫性疾病患者调理肠道的一种非常普遍的做法，因为通过服用东西来调理肠道是可行的，这也成为各种精神状况患者试图调整情绪和改善健康的一种方式。

Again, definitely talk to your healthcare provider before exploring this, but this has become a very common practice for people with autoimmune disorders and accessing the gut because it is accessible by taking things has also become way in which people with various mental conditions are trying to adjust their mood and adjust their well-being.

顺着这个思路，我想提一下，有研究表明，大量补充益生菌甚至益生元的人，有时会出现脑雾。

Along these lines, I do want to mention that there are studies that show that people that supplement with a lot of probiotics or even prebiotics can sometimes experience brain fog.

这个话题讨论得不多，数据也比较分散，但值得思考。

This isn't discussed a lot and the data are a little all over the place, but it is the worth thinking about.

这里的目标不是尽可能多地制造微生物。

The goal here is not to create as many microbiota as possible.

你真正想要的是微生物的多样性。

What you want is microbiota diversity.

我还想再提一下索南伯格的研究，高纤维饮食会增加某些微生物群，但会限制它们的多样性。

And I should mention this again in reference to the Sonnenberg study, which was what the high fiber diet does is it increases certain microbiota, but it limits their diversity.

而发酵食品饮食，或者说定期摄入发酵食品、每天几份的饮食，会增加微生物群的多样性。

And what the fermented food diet does, or I should say the diet that includes regular ingestion of fermented foods, a few servings a day, is it increases microbiota diversity.

微生物群多样性不足在医学界有个专门的名称。

Now lack of microbiota diversity has a name in the medical profession.

叫做菌群失调，而菌群失调是不好的。

It's called dysbiosis and dysbiosis is bad.

菌群失调常见于长期卧床或长期患病的人。

Dysbiosis is what you see when people are spending long periods of time on bed rest or when they've been chronically ill.

所以这里我们还是在说，要在肠道里创造一个积极的环境，要么通过调整酸度，也许你可以试试盐酸甜菜碱和胃蛋白酶那类东西。

And so here again, we're talking about creating a positive environment in the gut, either by adjusting acidity, maybe you explore the Beta and HCl Pepsin thing.

我觉得如果你消化健康，感觉自己和肠道关系良好，肠道也和你关系良好——虽然这话听起来有点傻，因为你就是它，它就是你——那么我认为没有必要去追求这些。

I think if you have healthy digestion, if you feel like you have a good relationship to your gut and it has a good relationship to you and sort of a silly phrase, because it is you and you are it, then I don't think there's any means or any need to pursue this.

但如果你不是这样，那这可能是一条值得探索的路。

But if you don't, that might be one avenue to pursue.

不过，我觉得所有这些里面，最重要的还是关于发酵食品的研究发现。

However, I think primary in all of this is the fermented food findings.

而且这不只是一项研究，是很多很多的研究结果，现在让我们到了一个数据重心非常集中的地方，都在指向一个方向，就是说要定期摄入发酵食品。

And it's not just one study, it's many, many findings that now bring us to a place where a huge center of mass of data are pointing us in the direction of saying ingest fermented foods on a regular basis.

我还想提一下，像肌少症这种随着年龄增长肌肉组织流失的情况，已经被证明可以通过改善肠道微生物群来缓解。

I should also mention that conditions like sarcopenia, which is the loss of muscle tissue as we age has been shown to be offset by improving the gut microbiota.

所以虽然今天的话题是内感受，我们在讲感知，也在讲潜意识感知。

So while today is about interoception, we're talking about sensing, we're also talking about subconscious sensing.

那潜意识感知是什么呢？

What are we talking about subconscious sensing?

我们说的是对身体内部环境的潜意识感知。

We're talking about subconscious sensing of the milieu of the body.

当肠道和身体的内环境处于良好状态时，大脑和免疫系统就能运作得非常好。

When the milieu of the gut and the body is right, then the brain and the immune system function very well.

所以这不是那种你可以坐在那里说，哦，你知道，我感觉我肠道里都是好的微生物，或者，哦不，那些是坏的微生物，这样的事。

And so this isn't something where you can sit back and say, oh, you know, I feel all those good microbiota in my gut or, oh no, those are bad microbiota.

除非你像索南伯格和其他实验室那样，去采集粪便样本和血液样本，然后进行极其详尽的分析，否则你根本得不到那种信息。

You can't do that unless you're going to take fecal samples and blood samples and analyze them with the extreme exhaustive nature that the Sonnenberg and other labs do, you're not going to get that kind of information.

我知道市面上有些公司提供这类服务，我也不想贬低任何一家，但我想强调的是，要想做得准确，真正分析出你产生了哪些细胞因子、哪些没有，你需要检测非常多的指标。

I know there are companies out there that do this and I don't want to knock on any of them, but I do want to emphasize that to do this right, to really analyze which cytokines you're making and which ones you're not, you really need to look at a huge number of them.

这需要大规模的蛋白质组学、基因组学和炎症标志物筛查。

And that requires large scale proteomic and genomic and inflammatory marker screens.

这可不是大多数商业机构能真正提供给普通人，并且让他们能理解的东西。

It's just not the kind of thing that most commercial enterprises can really provide to people in a way that they can interpret.

相反，在这种情况下，你完全可以去找那个真正能帮你把情况往正确方向推动的东西。

Rather, this is a case where you can simply go to the effector to the thing that can actually move the needle in the right direction for you.

很明显，那就是发酵食品，还有就是让胃酸保持在比人们想象中更酸一点的水平。

It's very clear that's fermented foods and that's keeping the stomach slightly more acid than one might think you would want to.

那我们先来说说呕吐吧。

So let's talk about barfing first.

呕吐，也就是俗称的吐，是指你肠道里的东西反向运行，也就是说从胃里往上走，有时候甚至从肠道往上走，虽然听起来很可怕，但有时候确实会通过食道和嘴巴，吐到你面前随便什么表面上。

Barfing AKA vomiting is when the contents of your guts run-in reverse, meaning when they go up from your stomach, sometimes even up from the intestines, even though that sounds horrible, it sometimes happens up out the esophagus and mouth and onto whatever surface happens to be in front of you.

这真是件糟糕的事。

It's a terrible thing.

没人喜欢呕吐，但这是我们生物学中一个非常有趣的现象，因为它揭示了我们的化学和大脑之间一种美丽且绝对基本的关系。

Nobody likes to do it, but it's a very interesting aspect to our biology because it reveals a beautiful and absolutely fundamental relationship between our chemistry and our brain.

你的大脑其实被一道门锁着，而那道门不是你的头骨。

So your brain is actually locked behind a gate and that gate is not your skull.

那道门就是所谓的血脑屏障。

That gate is the so called blood brain barrier.

就像你的肠道有那些上皮紧密连接，我之前提到的那些像栅栏一样阻止东西通过、防止肠漏的东西，你的大脑也有非常非常紧密的连接。

So just like your gut has these epithelial tight junctions, the things I talked about before that provide a fence so things can't get through and get through in leaky gut, your brain has tight junctions that are very, very tight.

绝对基本的一点是，只有某些分子能穿过血脑屏障，而其他分子不能。

It's absolutely fundamental that only certain molecules get across the blood brain barrier and that others don't.

原因是，你几乎所有的神经元，99.9999%的神经元，都不会再生。

And the reason for that is that most all 99.9999% of your neurons do not regenerate.

不管你在新闻里看到什么，尤其是最近关于迷幻药能促进神经再生的说法，那都是错的，因为实际上它们并不会。

Don't care what you've read, especially in the news recently about how psychedelics cause neurogenesis because they don't, it's absolutely wrong.

迷幻药确实会影响大脑的可塑性，但它们跟神经再生没什么关系，至少没有数据支持这一点。

Psychedelics have effects on brain plasticity, but they have nothing to do with neurogenesis, at least no data support it.

但是因为神经元不能再生，所以你也不能损伤现有的神经元，或者说应该尽量避免损伤。

But because you can't make new neurons, you also can't damage the ones you've got, or you shouldn't as much as possible.

这就是为什么你有血脑屏障，也就是所谓的BBB。

And that's why you have a blood brain barrier or a BBB.

所以这个BBB，就是防止物质进入大脑的屏障。

So the BBB as it's called prevents substances from getting to the brain.

不过，就像任何围栏一样，它也不是从头到尾都均匀一致的。

However, like any fence, it is not always uniform along its length.

在这个屏障上有些小地方，化学物质可以偷偷溜进大脑，这设计得挺巧妙的，不过我对这个设计一无所知。

And there are little spots within that fence where chemicals can sneak across to the brain and through a beautiful design, I don't know anything about the design.

我总说，设计阶段没人咨询过我。

As I always say, I wasn't consulted with the design phase.

我不是在说什么智能设计或者别的什么。

I'm not talking about any kind of intelligent design or anything.

这不是本期播客要讨论的话题。

That is not the topic of this podcast.

这不是哲学播客，也不是宗教播客。

This is not a philosophy podcast, nor is it a religion podcast.

这是一个科学播客，但通过某种巧妙的设计，那道屏障上有一些小孔，而紧挨着这些小孔后面有一些神经元，它们能感知血液中的化学成分。

It's a science podcast, but through a beautiful design of some sort, there are little holes in that fence and there are little neurons that sit right behind those holes and those neurons sense what the chemistry of the blood is.

所以我猜你可能没想到，今天关于感知自我的讨论，竟然是感知你自己的血液，但事实就是如此。

So I'm guessing you probably didn't imagine that today's discussion about sensing the self would be sensing your own blood, but you do.

你大脑里有一个很小的区域，虽然小，但非常重要，叫做最后区，英文是P O S T R E M A。

There's a little area of your brain that's little indeed, but is very, very important called area postrema, P O S T R E M A.

最后区是脑干中的一个区域，紧挨着另一个叫做化学感受器触发区的脑区。

An area postrema is an area of the brainstem that sits right next to another brain area called the chemoreceptor trigger zone.

当血液中的成分属于特定类型时，也就是说，当有病原体或者血液过酸时，最后区的神经元和化学感受器触发区（简称CTZ）的神经元，会触发腹壁的一系列运动反射，让你呕吐，明白吗？

And when the contents in your bloodstream are of a particular kind, meaning when there are pathogens or it's too acidic, the neurons in Area Postrema and the neurons in the chemo receptor trigger zone, the CTZ as it's called trigger a bunch of motor reflexes in the abdominal wall that make you barf, okay?

那种想吐的感觉是由脑干中的这些神经元触发的，而这些脑干神经元又是由某些化学物质的存在所触发的。

The feeling that you need to throw up is triggered by these neurons in the brainstem and those neurons in the brainstem are triggered by the presence of certain chemicals.

而那个位置没有血脑屏障的原因，是因为后区必须像交通警察一样守在那里，确保血液里流进来的东西都没问题。

And the reason why you don't have any blood brain barrier at that location is because postrema has to be there like a crossing guard, making sure that everything that's coming through the blood is okay.

哪怕它只察觉到一丝不对劲，就会触发那个呕吐反射。

And if it even senses just the tiniest bit that things are off, it's going to trigger that reflex.

真正有意思的是，后区的神经元不仅对血液的化学成分有反应，还会对我们的意识、我们的想法、我们的信念，甚至某些特定的记忆做出反应。

Now, the really interesting thing is that the neurons in Area Postrema respond to the chemistry of the blood, but they also will respond to our consciousness, to things that we think and things that we believe and even particular memories.

这就是为什么有些人看到呕吐物、看到别人呕吐，甚至看到别人做出要吐的样子，自己也会觉得想吐。

This is why when certain people see vomit or see someone else vomit, or even somebody else heaving as if they're going to vomit, they themselves feel as if they're going to vomit.

我猜现在可能就有几位听众，已经觉得自己有点想吐了。

I'm guessing there are probably even a few of you right now that feel like you might vomit.

你可能会觉得喉咙里开始分泌唾液，这往往是呕吐的前兆。

You might feel salivation in your throat, which is always a precursor to vomiting.

有些人，光是回忆起或者想到像血、呕吐物这样的东西，或者靠想象，就能真的触发呕吐反射。

Some people, the memory of, or the thought of something like blood or vomit, or use your imagination can actually trigger the vomit reflex.

这是因为后区的这些神经元对过去与负面事物互动的经历非常敏感。

And that's because these neurons in Area Postrema are very sensitive to prior experience of interactions with negative things.

所以，实际上，我正说着这话，就感觉我的胃又开始有点抽筋了。

So, and actually, as I'm saying this, feel my gut kind of cramping up again.

我不太容易吐。

I don't vomit very easily.

我不是那种容易吐的人，但也不是从来没吐过。

I'm not one of those nor am I somebody who's never vomited.

现在我们在这儿聊我的呕吐史，但我觉得在这个话题下挺合适的。

And here we are talking about my vomit history, but I think it's appropriate in this context.

极后区的神经元基本上就是为了保护你整个系统的安全。

The neurons of Area Postrema are there basically to keep your whole system safe.

幸好它们存在，因为比如有些人，不幸喝太多酒，结果吐了。

And thank goodness they are because for instance, some people, unfortunately they drink so much alcohol that they throw up.

你有没有想过这是为什么？

Have you ever wondered why that is?

嗯，那是因为酒精本质上是一种毒。

Well, it's because alcohol fundamentally is a poison.

我不是说对于适龄人群来说，喝酒不好。

I'm not saying for age appropriate folks that ingesting alcohol is bad.

这不是评判，但酒精本身在血液中过量时，会触发后区引起呕吐。

This isn't a judgment call, but alcohol itself at excessive levels in the bloodstream triggers postrema to cause vomiting.

所以这是一个例子，说明记忆、情境，以及我们内部状态的化学变化，都在触发非常根深蒂固的行为。

So this is an example whereby memories context, but also just the chemistry of our internal state is triggering behaviors that are very hardwired.

这些行为非常受反射驱动。

They're very reflex driven.

为什么在同样的酒精水平下，有些人比其他人更容易感到恶心呢？

And why would it be that some people get more nauseous than others at a given level?

这跟酒精耐受度有关。

Well, they'll have to do with alcohol tolerance.

有些人有所谓的，你知道，我们说的“铁胃”或者“胃坚强”。

Some people have what's called a, you know, we refer to as a stronger stomach or a stomach of steel.

而有些人，如果感觉不舒服，或者吃了稍微有点不对劲的东西，就很容易吐。

Other people, they throw up very easily if they don't feel well, or if they ingest anything that's just a little bit off.

从纯粹的适应角度来看，把对身体不好的东西吐出来，可能比让它们留在体内、通过消化系统要好，尤其是当这些东西含有脂肪的时候。

From a purely adaptive standpoint, it's probably better to vomit up things that aren't good for you rather than to pass through, have them pass through your system, especially if those things are contained in lipids.

比如说，如果你摄入了脂肪形式的东西，因为细胞——你身体里的每一个细胞都被一层薄薄的脂肪组织包裹着，我们称之为双层膜。

For instance, if you ingest something that's in lipid form because cells, literally every cell in your body is surrounded by a little thin layer of fatty tissue, We call it the bilayer membrane.

那是一层薄膜。

It's a little membrane.

脂肪很容易穿过脂肪。

Fat can move through fat very easily.

所以，你摄入的任何坏东西都可能留在你的体内。

And so any bad stuff you ingest can get stuck in your system.

那我们花点时间聊聊怎么减轻恶心吧，因为恶心、流口水、那种想吐的感觉，在适应性的情况下可能很有用，比如你吃了什么不好的东西，但有些人会因为其他原因感到恶心。

So let's talk for a second about how to reduce nausea because nausea, that salivation, that feeling that you're going to vomit can be very beneficial in an adaptive circumstance, like you've ingested something bad, but some people experience nausea for other reasons.

有一些好办法可以调节恶心，而且这些方法非常有意思。

There are good ways to regulate nausea and the ways they regulate nausea are very interesting.

它们实际上是通过调整延髓最后区这些神经元的活动，或者直接改变血液的化学成分来起作用的。

They actually adjust the activity of these neurons in Area Postrema, or they change the chemistry of the blood directly.

很多人可能之前就听说过这个，但确实有可靠的数据支持。

And many of you have heard this before perhaps, but it turns out that there are good data.

我找到了11项同行评审的研究，都是没有偏见的独立研究。

11 research studies were the ones that I could find peer reviewed research studies with no bias.

这些研究表明，姜能显著减轻恶心感。

So independent studies showing that ginger can cause a notable reduction in nausea.

那要吃多少姜呢？

How much ginger?

一到三克。

One to three grams.

一到三克是多少呢？

What's one to three grams?

嗯，除非你吃的是药片或胶囊，否则得用秤来量。

Well, you have to measure it out on a scale unless you're taking it in pill or capsule form.

吃片剂还是胶囊似乎没什么区别。

It doesn't seem to matter if you take it in pill or capsule form.

所以你之前听说的生姜能缓解恶心，这确实是真的。

So this thing that you've heard before that ginger can reduce nausea indeed is true.

薄荷显然也能做到这一点。

Peppermint apparently can also do that.

有些人可能不会感到意外，大麻也能缓解恶心，因为大麻在不同地方的法律地位不同。

And some of you will not be surprised to learn that cannabis can reduce nausea, not surprised because cannabis, which has different legality in different places.

我理解这一点。

And I understand that.

所以请考虑这一点，大麻中的THC，或者事实证明CBD也能缓解恶心。

So please take that into consideration, cannabis THC and, or it turns out CBD can reduce nausea.

这至少在一项研究中得到了证实。

That's been shown in at least one study.

它可能不是通过改变血液的化学成分，而是通过改变延髓最后区这些神经元的放电阈值来实现的。

And it probably does that not by changing the chemistry of your blood, but by changing the threshold for firing of these neurons in Area Postrema.

有些情况，比如化疗和放疗，以及其他情况下，人们会感到非常恶心。

And there are conditions such as in chemotherapy and radiation therapy and others where people are feeling very nauseous.

我不是建议大家去用大麻，除非他们自己和家人以及医生商量好了，决定应该用。

I'm not recommending people go use cannabis unless they've decided with their selves and their family and their doctor that they should.

但有趣的是关于CBD这一点，我们之后会专门做一期关于THC和CBD的节目。

But what's interesting is this thing about CBD and we'll do a whole episode on THC and CBD.

CBD没有，或者说按理说不应该有THC那种精神活性作用。

CBD doesn't have, or isn't supposed to have these psychoactive properties that THC does.

虽然CBD可能有轻微到明显的抗焦虑效果，但数据显示，或者说应该说是那些传闻报告显示，大麻确实能减轻恶心。

Although CBD can have a mild to major anxiolytic anxiety reducing effect, but it does appear that the data are what the data support, I should say, the anecdotal reports, which are that cannabis can reduce nausea.

所以想少吐一点的话，可以试试姜、薄荷，如果合法且适合你的话，也许还有大麻。

So to barf less ginger, peppermint, and if appropriate and legal for you, possibly cannabis.

接下来我们聊聊发烧。

Now let's talk about fever.

在之前和之后的节目里，我们会讲到体温调节，也就是身体调节温度的能力。

In previous episodes and in future episodes, we deal with thermal regulation, which is the body's ability to regulate its temperature.

我们会聊冷和热，桑拿、冰浴，还有身体表现。

Talk about cold and heat and saunas and ice baths and physical performance.

我们现在不打算深入讲这些，但我保证以后会讲。

We're not going to deal with all that right now, but I promise we will going forward.

今天我只想聊发烧，因为发烧跟内感受直接相关。

Today, I only want to talk about fever because fever directly relates to interoception.

我这么说是什么意思呢？

What do I mean by that?

其实，发烧就是体温升高。

Well, a fever is simply an increase in body temperature.

这种体温升高是由大脑里的神经元触发的。

That increase in body temperature is triggered by neurons in the brain.

而这些大脑神经元是被血液里某些特定物质激活的。

And those neurons in the brain are triggered by the presence of particular things in the bloodstream.

什么样的物质呢？

What sorts of things?

比如毒素、细菌、病毒。

Well, toxins, bacteria, viruses.

当不好的东西进入我们体内时，身体并不知道它是不好的。

When something bad gets in our system, the body doesn't know it's bad.

它只知道这是外来的，以前没见过，或者它出现在了身体不该出现的地方。

It just knows it's foreign and it hasn't seen it before, or that it's in the wrong compartment of the body.

所以之前我们提到过，蛋白质从肠道漏出来跑到别的地方去。

So earlier we were talking about proteins that leak out of the gut and get elsewhere.

你知道，你肯定不希望一块牛排跑到你的二头肌里。

You know, you don't want a piece of steak sitting in your bicep.

那可就糟了。

That would be bad.

你实际上会产生抗体。

You would actually develop antibodies.

你会感染得很严重，但你的身体有这种智慧，它知道这些蛋白质通常不应该出现在这个区域。

You would have a horrible infection, but your body has this intelligence and that intelligence is to know, these proteins are normally not seen in this region.

然后你的身体，或者更准确地说，那里的细胞，会释放一些物质，这些物质会传到大脑，触发体温升高，这样你的身体就能把坏东西或者导致问题的根源给“煮”掉。

And then your body or the cells there, I should say, will release something that then will travel to the brain and will trigger an increase in body temperature so that your body cooks the bad thing or the cause of the bad thing.

这真的是一个很美的适应机制。

It's really a beautiful adaptive mechanism.

我们总觉得发烧很可怕，但发烧其实是为了把体内的坏东西，或者那些跑错地方的东西给‘煮’掉。

We always think fever is so terrible, but fever is there to cook the bad thing that's inside you or that has left the correct compartment inside you and is in the wrong compartment inside you.

发烧机制的美妙之处在于，它和呕吐机制很像。

So what's beautiful about the fever mechanism is that it looks a lot like the barfing mechanism.

基本上，有一组神经元位于脑室附近。

Basically you have a set of neurons that sit near the ventricles.

记得脑室就是你这个‘管子’中间的那个洞——你其实就是一根管子，一系列管子，你的大脑中间有个洞，一直延伸到脊髓前端的底部。

Remember the ventricles is this hole in the tube that is you, the tube that is you, you are a tube, a series of tubes and your brain has a hole down the middle and it extends down to the bottom of your spinal cord at the front.

这个洞就叫脑室。

It's called the ventricles.

它们从所谓的侧脑室开始，还有——不好意思——从第三脑室和侧脑室开始。

They start with what are called the lateral ventricles and the, excuse me, starts with the third and the lateral ventricles.

然后到第四脑室，再到所谓的中央管。

And then it goes to the fourth ventricle and then to what's called the central canal.