为什么美国的健康危机是一个激励问题

看看我们当今的食品体系，人们吃的大部分都是超加工的垃圾食品。

You look at our food system today, majority of what people are eating is ultra processed crap.

普通孩子在户外的时间甚至比最高安全级别监狱里的犯人还少，人们每天花在手机上的时间超过八小时。

The average child spent less time outside than, like, a maximum security prison that people are spending eight plus hours on phone.

我们正面临这个国家最严重的问题之一。

We are in the midst of one of the biggest problems in the country.

如果我们不解决这个问题，美国将会面临更严重的问题。

If we don't fix this, like, America is going to have even more serious problems.

我们所处的环境在结构上就难以保持健康，这就是为什么美国的基础健康结果如此不理想

The environment that we exist in is just structurally just hard to be healthy, which is why you see the default health outcomes in The US

太酷了。

being so cool.

为什么不直接让全民基本收入变得超棒呢？

Why not just universal basic goes epic?

为什么这解决不了问题

Why doesn't that solve

这个问题？

the problem?

我认为现在的问题是我们正在给孩子们喂毒药，而且他们全都生病了。

I think now the problem is we're feeding our kids poison, and, like, all of them are sick.

我认为我们的许多问题都源于一个事实，那就是这个国家的大多数人都在生病。

I think many of our problems are downstream of the fact that the majority of the country is just sick.

不管我们是否变得富有或其他什么，如果这个国家的大多数人都生病了，那这一切又有什么意义呢？

No matter if we get rich or whatever, if most of the country is sick, it's kind of like, what is the point?

如果慢性病危机不是医疗问题，而是环境问题呢？

What if the chronic disease crisis isn't a health care problem, but an environmental one?

贾斯汀·马雷斯十五年来一直围绕一个核心理念创办公司：你吃什么、如何运动、在哪里生活，比你吃什么药更重要。

Justin Mares has spent fifteen years building companies around a single idea: that what you eat, how you move, and where you live matter more than the pills you take.

他的曾祖母活到95岁，从没买过有机食品，也没要求过不含种子油。

His great grandmother lived to 95 without ever shopping organic or asking for no seed oils.

她不需要这么做。她成长的环境不会主动让她生病。

She didn't have to She grew up in an environment that wasn't actively making her sick.

如今，美国儿童平均户外活动时间比最高安全级别的囚犯还要少。

Today, the average American child spends less time outside than a maximum security prisoner.

他们70%的饮食是超加工食品，近80%的成年人超重或肥胖，而医疗系统会花费数十万甚至数百万美元来治疗心脏病发作，却不会花钱预防。

70% of their diet is ultra processed food, almost 80% of adults are overweight or obese, and the health care system will pay hundreds of thousands or millions of dollars to manage a heart attack, but nothing to prevent one.

TruMed正试图改变这种算法。

TruMed is trying to change that math.

该公司允许人们使用免税的HSA和FSA账户资金支付生活方式干预措施——健身房会员、优质食品、助眠工具——这些都能治疗、逆转或预防慢性疾病。

The company allows people to spend tax free HSA and FSA dollars on lifestyle interventions gym memberships, better food, sleep aids that treat, reverse, or prevent chronic disease.

这个想法很简单：如果我们想要改善美国的医疗保健，就必须让预防和治疗一样容易获得支付。

The idea is simple: If we're going to fix American health care, we have to make prevention as easy to pay for as treatment.

我与TrueMed的创始人兼首席执行官贾斯汀讨论了为什么20世纪70年代是美国健康的转折点，农作物补贴如何催生了有毒的食品体系，以及为什么肽可能是几十年来医疗保健领域最具颠覆性的事物。

I speak with TrueMed founder and CEO Justin about why the 1970s were the turning point for American health, how crop subsidies created a poisonous food system, and why peptide might be the most disruptive thing to hit health care in decades.

过去几年你一直在努力探索并试图解决我们的食品危机、健康危机和疾病危机。

You've been on a quest for the last few years to uncover and make a dent in solving our food crisis, our health crisis, our disease crisis.

你能否简单追溯一下你是如何开始痴迷于这个问题的？

Why don't you trace your journey a little bit into how you became obsessed with this?

然后我们会谈谈我们正在做的事情。

Then we'll get into what we're up to.

是的。

Yeah.

彼得·蒂尔有一个关于秘密的理念。

Peter Thiel has this idea of a secret.

我觉得这个理念就是：你吃什么、你的生活方式等等所有这些，都会影响你的健康结果，影响你的精力，影响你的感受。

I feel like the idea that what you eat, your lifestyle, all these things, they impact your health outcomes, they impact your energy, they impact how you feel.

我在20岁时偶然发现了这个想法。

I came across that idea when I was 20.

感觉就像发现了一个秘密：如果你查看美国的任何数据，会发现美国的医疗保健结果非常糟糕。

It felt like this secret where if you look at any data in The US, US healthcare outcomes are horrible.

它们很糟糕，而且还在变得更糟。

They're bad, they're getting worse.

肥胖、心脏病，所有这些疾病的发病率基本上都处于历史最高水平，并且还在持续上升。

Obesity, heart disease, all of these conditions are basically at record levels and continue to go up.

随着我开始更多地了解我们的食品系统、环境毒素以及所有这类事情，我越来越确信每个人都在问：我们的肥胖危机到底是怎么回事？

And as I started to read more about our food system, about environmental toxins, about all these sorts of things, I just became more and more convinced that everyone's like, what's going on with our obesity crisis?

为什么我们如此多病？

Why are we so sick?

答案很简单，就是我们生活在一个系统性地制造不健康人群的环境中。

And the answer is just simply that we exist in an environment that systematically outputs unhealthy people.

而这个理念——只需改变你的食物、饮食、锻炼和环境，就能自然而然地带来更好的健康结果——对我来说就像是一个秘密。十五年来我一直相信并投资于这个理念，还据此创办了公司，但普通人至今仍未完全内化理解这一点。

And that this idea that you could just change your food, change your diet, change your exercise, change your environment, and that would lead to much better health outcomes naturally feels to me like this secret that I believed and invested behind and started companies behind for fifteen years that still the average person does not totally fully internalize.

所以我在20岁左右第一次接触到这个想法时，就完全着迷了。

And so I just became obsessed with this idea the first time I came across it when I was 20 or so.

你自己在生活中就刻意逆流而上，努力保持健康，但如今保持健康非常困难。

You yourself have gone out of your way to go against the grain in terms of your own personal life and trying to be healthy, but it's very difficult to be healthy today.

这就像以前人们总是在推特上封杀别人时常说的，嘿，那就自己建一个推特嘛。

It's almost like people used to say when they were canceling people on Twitter all the time, Hey, just build your own Twitter.

你想要自己的信息，完全可以自己搭建一个。

You want your own information, can just build your own.

同样地，你必须自己构建你的食物体系。

Similarly, you have to build your own food.

完全正确。

Totally.

是的。

Yeah.

在很多方面，我觉得健康曾经只是我们所处环境的自然产物。

In so many ways, I feel like health used to just be an output of the environment that we exist in.

我的曾祖母，她活到了95岁。

My great grandmother, she lived till she was 95.

直到去世那天都非常健康。

Very healthy until the day that she died.

她从不购买有机食品。

And she never shopped organic.

她也从不会在杂货店特意避开或要求不含种子油的食物。

She never avoided and asked for no seed oils at the grocery store.

她从未做过任何我不得不学习、摸索并实践的那些疯狂事情。

She never did any of the insanity that I've kind of had to learn, figure out, and do.

这主要是因为她生活成长的环境并不助长疾病。

That's because primarily she lived and grew up in an environment that was not sickness promoting.

她没有接触过美国存在的四万种新型化合物，也没有吃过那些让人上瘾、感觉糟糕并影响健康的食品。

She was not exposed to 40,000 novel chemical compounds that exist in The US or eating foods that were addictive and made her feel shitty and impacted her health.

因此我认为，我们所处的环境在结构上就难以保持健康，这就是为什么美国的默认健康结果如此糟糕。

And so I think that the environment that we exist in is just structurally just hard to be healthy, which is why you see the default health outcomes in The US being so poor.

阿米什人是怎么避开这个问题的？

How are the Amish exempt from this?

举个例子，他们有什么不同的做法？

Just as an example, what do they do differently?

我的意思是，他们有很多不同的做法。

I mean, they do a lot differently.

你应该去一个阿米什社区看看

As you should go to one

在这些社区中，他们有很多做法都和你我截然不同。

of the communities, there's a lot of things they do very differently than you and I.

但基本上，他们一直食用当地应季种植的食物。

But basically, they're eating food that is grown locally, seasonally, all the time.

他们整天都在户外，亲手劳作。

They're outside all the time, working with their hands.

他们生活在一个紧密联系的社群中。

They're existing in a tight knit community.

阿米什人还拥有许多环境和生活方式上的差异。

And there's a whole host of environmental and lifestyle differences that the Amish have.

所以你可以问，是否必须像阿米什人那样生活才能获得更好的健康状况？

So you can argue, do you have to live like the Amish to have better health outcomes?

但毫无疑问，他们的健康状况要好得多，生活方式也和你我大不相同。

But certainly, they have much better health outcomes, and they live very differently than you or I.

但他们不像我们那样刷手机到深夜，那他们是怎么做到的？

But they're not doom scrolling like us, so how do they make it?

他们似乎可能活得更久。

It's like they might live longer.

他们消息闭塞，

They're uninformed,

我知道。

I know.

他们可能活得更久，但代价是什么？

They might live longer, but at what cost?

那事情是从什么时候开始变得特别糟糕的？

So when did things start to get really bad?

是过去一个世纪里一直单调恶化，还是说存在某个转折点让情况开始升级，发生了什么？

Has it just been monotonically for the last century, or was there sort of a moment where things started to escalate, and what happened?

是的，情况在20世纪70年代开始变得糟糕得多。

Yes, things started to get much worse in the 1970s.

我的观点是，大约就在那个时候，儿童肥胖率开始上升。

My view is that that is around the time when you started to see childhood obesity tick up.

你开始看到肥胖症、心脏病等这类问题开始出现。

You started to see obesity, heart disease, things like this kind of start to move.

在我看来，一个重要的原因是当时存在大量来自股东和其他方面的压力，特别是针对大型食品公司，这些公司如今大多已有150年历史。

And in my view, a big reason for that is there was a lot of shareholder and other pressure, specifically geared towards big food companies, around that time where basically these companies are today 150 years old.

几乎所有大型食品公司都是股东所有的。

Almost every big food company is shareholder owned.

它们并非由CEO们经营、控制或管理的。

They are not run, controlled, or anything by CEOs.

它们基本上就是这些行动迟缓的大公司，市场迫使它们只为每股收益进行优化。

They're basically just these lumbering corporations that the market is just having them optimized for earnings per share.

这意味着过去五十年里，这些公司持续选择用某种仿冒版本替代真正的食材。

What that means is these companies, the last fifty years, have consistently decided to trade a real ingredient for something that's kind of a fake version of that.

它们从草莓转向草莓香精，或者从蔗糖转向高果糖玉米糖浆。

They've moved from strawberries to strawberry flavoring, or they've moved from sugar to high fructose corn syrup.

这种情况持续了五十年后，再看我们现在的食品体系——大多数人吃的都是超加工垃圾食品，既让人上瘾又缺乏营养密度，还充满了环境毒素和化学化合物。人类数百万年进化过程中，我们的身体从未接触过其中许多化合物。

And You roll this out over a fifty year period, and you look at our food system today, and the majority of what people are eating is ultra processed crap that is addictive, is not nutrient dense, and is full of environmental toxins, chemical compounds, things like this that the human body has, in our entire millions of years of evolution, never encountered many of these compounds.

因此我认为这种转变始于七十年代。

And so I think that that shift started in the seventies.

这种影响在代际间不断加剧。

It's compounded generationally.

如今的情况无疑更加恶化——普通孩子在户外的时间甚至比最高安全级别的囚犯还要少。

It certainly doesn't help today that the average child spends less time outside than like a maximum security prisoner.

就像大多数孩子说的，他们饮食中约70%都是超加工食品。

Like most kids say are eating like 70% of their diet is ultra processed foods.

人们每天花八小时以上在手机上。

People are spending eight plus hours on phones.

所有这些因素都在起作用。

Like all these sorts of things are factors.

但我真的认为我们的食品体系在七十年代开始变得特别有害，尤其是在美国，这就是为什么你会看到医疗保健和健康结果开始朝着如此负面的方向发展，尤其是相对于世界其他地区而言。

But I really think that our food system started to become uniquely poisonous in the seventies, and especially in The US, that's why you started to see many health care and health outcomes trend in such a negative direction, especially relative to the rest of the world.

有哪些手段可以在扭转食品系统相关趋势方面取得一些进展？

What are the levers that could make a dent in reversing some of these trends as it relates to the food system?

是的。

Yeah.

从食品体系的角度来看，我认为我们能推动的最大单一杠杆（尽管在政治上极具挑战性）是改革我们的作物补贴制度。

From a food system standpoint, I think the biggest single lever that we could pull, which would be extraordinarily politically challenging to pull, is fixing our crop subsidy system.

如果你观察一下，美国政府在过去十年间已花费近1000亿美元用于作物补贴。

So if you look, the US government over, I think, the last decade has spent close to $100,000,000,000 on crop subsidies.

这些补贴基本上是在扶持玉米、大豆和小麦的种植，以便美国农民能够种植这些作物。

They're basically subsidizing corn, soy, and wheat so that American farmers can grow corn, soy, and wheat.

因为它有补贴，所以人为地便宜，因此我们大量种植。

Because it's subsidized, it's artificially cheap, so we grow a lot of it.

因为它有补贴，所以人为地便宜。

Because it's subsidized, it's artificially cheap.

所以这些大型食品公司把它用在所有东西里。

And so these big food companies use it in everything.

所以这些大型食品公司基本上花了三十年时间，用高果糖玉米糖浆替代糖，或者用高度加工且会引发炎症、导致肥胖的大豆油替代橄榄油之类的，这在老鼠和人类模型中都有体现。

And so these big food companies have basically gone on like a thirty year journey to replace sugar with high fructose corn syrup, or to replace olive oil or something like that with soybean oil, which is highly processed and inflammatory, causes obesity, and all sorts of like rat and human models.

我认为这种大规模替换——用最深度加工形式的最差成分，取代人类传统食用的食材——是慢性病的根本原因之一。

And I think that this sort of wholesale swapping of let's take the worst ingredients in their most highly processed form and replace them with an ingredient that humans traditionally ate is one of the root causes of chronic disease.

如今，普通美国人近20%的热量摄入来自大豆油。

Today, the average American gets almost 20% of their caloric intake from soybean oil.

这在历史上是反常现象，而且并非因为有人想要大豆油。

This is historically anomalous, and it's not because anyone wants soybean oil.

你可能并不是大豆油或类似产品的大量消费者。

You're probably not a big consumer of soybean oil or anything like this.

这只是因为它人为地便宜，而因为它人为地便宜，所以最终无处不在。

It's just because it's artificially cheap, and because it's artificially cheap, it ends up in everything.

我认为这是我们当今食品体系出问题的核心根源之一。

I think that that is one of the core root causes of what is going wrong in our food system today.

这是美国独有的问题吗？

Is that a uniquely US problem?

是的。

Yeah.

这是一个美国特有的问题。

It's a uniquely US problem.

美国，我们的食品体系相对于欧洲或其他地方，他们的许多国家规模较小。

The US, our food system relative to Europe or something like that, many of their countries are smaller.

他们往往更倾向于本地化的农业食品体系。

They tend to lean much more into a local food agriculture system.

他们的食品体系也没有受到那么多联邦层面的干预。

They also don't have as much of a federal intervention on their food system.

美国在很多方面对玉米、大豆、小麦等作物的补贴，其初衷是好的。

The US, in many ways, this sort of subsidy of corn, soy, wheat, things like that, it had good intent.

很多农作物补贴政策始于80年代的农业法案，当时农民遭遇恶劣天气，收成受到严重影响。

A lot of the crop subsidy stuff started with a farm bill in the '80s where basically farmers were exposed to inclement weather, bad weather that was impacting their crop yields.

美国政府介入并表示：好吧，我们会尽力让这些农民维持经营。

The US government stepped in and was like, okay, we're gonna try and keep these farmers solvent.

我认为初衷是好的，但多年后的今天，我们每年投入数十亿美元的这些农作物补贴正在让美国人生病。

I think that the intent was good, but now here we are, years later, we we have billions a year going towards these crop subsidies that are making Americans sick.

我认为我们过去常说，好吧，我们只需要确保生产足够的热量，确保美国人不会死于饥饿。

I think that we used to say, okay, we just need to make sure that we're growing enough calories and make sure that Americans are not dying of starvation.

他们并不是说，要确保我们的孩子有足够的食物。

They're not like, make sure our kids have enough to eat.

我认为现在的问题是我们在给孩子们喂毒药，他们全都生病了。

I think now the problem is we're feeding our kids poison, and all of them are sick.

为什么不直接全民普及奥赛麦肽呢？

Why not just universal basic Ozempic?

意思是，这难道不能解决问题吗？

Mean, doesn't that solve the problem?

是的。

Yeah.

嗯，我认为有两方面。

Well, so I think there's two things.

第一，我认为GLP-1类药物可能是一项非常有趣的技术。

One, I think that GLP-1s are potentially an incredibly interesting technology.

我认为我们正处于最严重的慢性疾病危机之中，这是国家面临的最大问题之一，如果我们不解决这个问题，二十年后美国将面临更严重的问题。

I think that we are in the midst of the worst chronic disease crisis, one of the biggest problems in the country, and if we don't fix this, America is going to have even more serious problems twenty years from now.

考虑到普通美国人普遍超重，我们看到的肥胖超重率几乎达到百分之八十。

Given that the average American is overweight, we're looking at almost eighty percent obesity overweight rates.

我认为让一大批人使用GLP-1药物来尝试启动他们走向健康的方向是有道理的。

I think that it does make sense to put a bunch of these people on a GLP-one to try and jump start them in a direction where they are moving towards health.

话虽如此，我完全不认为普遍给所有人使用GLP-1药物就一定能解决所有问题。

That said, I don't at all think that giving universal GLP-1s to everyone is necessarily a universal solve.

人类历史上曾有过不少糟糕的先例，总有人声称某项干预措施能解决我们作为一个物种的所有问题。

There's just a very poor history of saying, here is an intervention that is going to solve all of our problems as a species.

我只是认为，奥赛米克（Ozempic）不太可能是那个能包治百病的万能药。

I just think that it is quite unlikely that Ozempic is the one thing that is gonna be a cure all.

举个简单的例子，奥赛米克是如何起效的？

Just to use one example, how does Ozempic work?

基本上，它会降低人的食欲，所以你只是吃得少了。

Basically, it turns down someone's appetite, So you're just eating less.

如果你仍在食用普通美国人如今吃的那些垃圾食品，只是靠着奥塞米克减少了摄入量，那么你几乎肯定会缺乏蛋白质、微量营养素以及其他多种必需物质。如果长期摄入不足或缺乏这些营养素，将会对你的健康产生深远影响。

If you're still eating the same crap that the average American is eating today, but you're on Ozempic and eating less of it, you are almost certainly going to be deficient in protein and micronutrients and a bunch of things that will have long term health implications if you undereat or get exposed to not enough of those nutrients for a very long period of time.

因此我认为，如果我们想要拥有一个健康的国家，就必须从根本上解决食品问题。

So I think we fundamentally have to solve the food issue if we want to have a healthy country.

顺便问一下，我们是否已经更新了食物金字塔指南？也就是说，在国家层面上，我们对应该摄入哪些营养素有了准确的认识吗？

By the way, have we yet updated our food pyramid in the sense that we have an accurate understanding of what we should be getting on a country level in terms of nutrients?

是的。

Yeah.

新的食物金字塔相较旧的指南是一个巨大的进步。

The new food pyramid is a tremendous improvement over the old guidelines.

不仅网站设计得非常吸引人——乔·格比亚在这方面做得非常出色——而且人们终于首次开始提倡‘吃天然食物’。

Not only is the site super sexy, Joe Gebbia did a great job on that, but finally, for the first time, people are saying, Eat whole foods.

多吃蔬菜。

Eat more vegetables.

食用肉类及其他优质蛋白质来源、蔬菜和水果。

Eat meats and other well sourced sources of protein, vegetables, fruits.

令人难以置信的是，直到现在我们才意识到或许不该给孩子们提供15份全谷物，还声称两岁以下幼儿摄入糖分完全没问题。

It's crazy that it took until now to say maybe we shouldn't be giving kids 15 servings of whole grain and saying that sugar is totally fine for kids under two.

过去的指导方针确实建议两岁以下儿童摄入一定量的糖分。

We recommend some amount of sugar for kids under the age of two, which was the past administration guidelines.

因此我认为这是非常积极的进步。

So I think they're a tremendously positive step.

所以对于想要改善饮食的人们来说

And so for people who want to make a

你提到了食品系统的差异和政策建议，那么对于那些想直接采取行动的人呢？

difference in the food system, you mentioned that policy recommendation, what about people who want do something direct?

显然在TruMed之前，你创办了一家骨汤公司。

You obviously before TruMed, you started a bone broth company.

这个领域还有哪些大公司可以建立，或者有哪些可以产生影响的机会？

What are other big companies that could be built in this space or opportunities to make a difference?

是的。

Yeah.

我认为在这个领域存在大量机会，核心问题在于许多生活方式干预措施——比如更健康的饮食、锻炼、服用某些补充剂、如果适合个人情况和风险状况的话使用肽类——所有这些都可以被视为医疗干预。

I think there's a ton of opportunities within the space that I think the core problem is that a bunch of these lifestyle interventions, like eating a healthier diet, exercising, taking certain supplements, taking peptides if that makes sense for your individual person and risk profile, all of these things can be considered healthcare interventions.

然而，如果你看看我们的医疗体系，没有任何部分会将心脏病高风险人群的锻炼视为医疗干预。

Yet, if you look at our healthcare system, nothing in the healthcare system thinks about someone who is at risk of heart disease exercising as a healthcare intervention.

没有任何支付方会为此买单。

No payer pays for it.

也没有人会激励你这样做。

No one incentivizes you to do that.

这有点像医生会说，是的，你应该改善饮食并加强锻炼。

It's just sort of like a doctor is like, yeah, you should clean up your diet and exercise.

所以我认为，对于想要在这个问题上有所作为的人来说，存在着巨大的、巨大的机会。

And so I think that there is a tremendous, tremendous opportunity for people that wanna make a dent on this problem.

弄清楚如何将这类生活方式干预措施纳入医疗保健体系，正是我们在TruMed所做的事情。

Figuring out how to make these sorts of lifestyle interventions part of the healthcare system is what we're doing at TruMed.

并且激励人们真正投资于自己的健康，投资于预防，投资于那些能从慢性病角度带来改变的事情。

And incentivizing people to actually invest in their health, to invest in prevention, to invest in things that move the needle from a chronic disease standpoint.

是的。

Yeah.

那么我们来谈谈TruMed吧。

So let's get to TruMed.

首先，请稍微梳理一下这个想法的脉络——你一直痴迷于这个问题，这个元问题，这一系列问题，那么究竟该从何处着手呢？

First, trace the idea maze a little bit in terms of you've been obsessed with this problem, this meta problem, this series of problems, and It's kind of like, where do you even start?

我相信你已经仔细斟酌过每一个细节了。

I'm sure you picked over every nook and cranny.

你是如何确定这就是机会的，还有哪些其他方面是你可能会考虑的？

How did you settle that, Hey, this was the opportunity, what were maybe some other things you would consider?

是的。

Yeah.

在Kettle and Fire的发展过程中，我们刚推出时，16盎司的骨汤每盒大约16美元。

So, in growing Kettle and Fire, basically, when we launched, it was like $16 a carton for 16 ounces of bone broth.

大家都觉得这个产品不错，但价格确实很高。

And everyone was like, this is good, but this is very expensive.

而现在，九年过去了，我们的产品进入了全国每家杂货店，每盒平均价格约为7美元。购买的人多了很多，但他们仍然觉得这非常昂贵。

And now, nine years in, we're in every grocery store in the country, and the average price per box is like $7 People way more people buy it, but they're also like, this is very expensive.

我大致有过这种体验，然后注意到像好市多和沃尔玛这样的零售商是国内有机产品的两大销售商。

I kind of had that experience and then looked at things like Costco and Walmart are the two largest sellers of organic products in the country.

对我来说，这表明人们愿意投资于对自己有益的产品。

To me, that is a signal that people want to invest in products that are good for them.

他们想购买能让自己变得更好、更健康之类的产品，但只是成本太高了。

They want to buy products that leave them off better, healthier, and the like, but it's just cost prohibitive.

然后如果你观察医疗保健系统，我们存在一种奇怪的现象：如果我面临心血管疾病或心脏病的风险，我基本上可以通过锻炼、健康饮食以及采取各种措施来预防急性心脏病发作之类的情况。

Then if you look at the healthcare system, we have this weird dynamic where if I am at risk of cardiovascular disease or heart disease, I basically can exercise, I can eat well, I can do all of these things that will prevent an acute heart attack or something like that.

这些都是自费项目。

That's all cash pay.

我需要自掏腰包支付。

I'm paying out of pocket.

所有这些事情我都完全是在靠自己完成。

I'm doing all of that kind of stuff totally on my own.

而如果一个人完全不采取这些预防措施，基本上他们会早早患上心脏病，然后医疗系统将花费数十万甚至数百万美元来管理这个人余生的情况。

Whereas if you take someone that doesn't do any of those things, basically they have a heart attack early, and then the healthcare system will pay hundreds of thousands or millions of dollars to manage that person's condition basically for the rest of their lives.

因此我认为，从根本上说，我们需要激励人们投资于预防，投资于利用生活方式干预来对慢性病产生影响。

And so I think that fundamentally, we need to incentivize people to invest in prevention, to invest in leveraging lifestyle interventions that can make a dent on chronic conditions.

这就是我审视创办Kettle and Fire之后想要创立什么公司时所持的视角。

That was kind of the lens through which I was looking at what's the company that I want to start after Kettle and Fire.

当我遇见医生时。

When I met Doctor.

马克·海曼，他基本上是一位功能医学医生，也是Function的联合创始人，他提到自己正在为一些患者做的事情是：对于前来就诊的患者，他会推荐生活方式干预措施，并为他们开具一种叫做医疗必要性证明信的文件。这基本上是一封IRS认可的信函，针对某些特定人群，当某种生活方式干预措施符合他们正在治疗、逆转或预防的病症时，他们可以凭这封信使用免税的HSA和FSA账户资金来支付助眠产品、健康饮食、补充剂、运动等项目。

Mark Hyman, who is basically, he's a functional medicine doctor, co founder of Function, he mentioned that something he was doing with a bunch of his patients was for patients that would come in, he would recommend lifestyle interventions, and he would write them something called a letter of medical necessity, which is basically a letter that the IRS has said for certain people where an intervention like a lifestyle intervention matches a condition someone's working to treat, reverse, or prevent, they can get that letter and use tax free HSA, FSA dollars on sleep aids, healthy, better diet, supplements, exercise, things like that.

所以当马克·海曼告诉我们这个想法时，我觉得这真是个非常有意思的事情。

And so when Mark Hyman told us about that idea, I was like, this is a really interesting thing.

我们基本上可以尝试建立一套基础设施，让符合条件的普通人能够获得这样的LMN证明，并利用HIMSS、Rowe等公司过去几年搭建的远程医疗系统。

We could basically try and build infrastructure that allows the average person to get one of these LMNs if they qualify, and use the telemedicine rails that HIMSS, Rowe, and other companies have spent the last several years building.

但不同于开具奥兹匹克或睾酮替代疗法处方，我们实际上可以开具食物干预、运动等处方。

But rather than prescribing Ozempic or prescribing TRT, we can actually prescribe food interventions, exercise, things like that.

所以这大致就是最初的想法和起点。

So that was kind of the idea and where it started from.

我还考虑了很多其他事情，比如想过开一家杂货店，想过创办一家人寿保险公司，积极帮助人们延长寿命并进行生活方式干预。

I looked at a whole host of other things, like thought about starting a grocery store, thought about starting a life insurance company that would be aggressive in terms of helping you live longer and making lifestyle interventions.

但最终觉得这类事情有潜力在未来几年内将数千亿美元引导至生活方式干预领域。

But ultimately felt like this was the type of thing that had the potential to direct hundreds of billions of dollars towards lifestyle interventions over the next couple years.

因此感觉这是件正确的事情。

And so it felt like it was the right thing to do.

是的，大家都知道我们需要从慢性治疗更多地转向预防性护理，这

Yeah, everyone knows we need to shift more from chronic to preventive care, this

基本上是一种

is basically a way to

从经济上激励人们这样做的途径。

financially incentivize people to do that.

没错。

Exactly.

是的，

Yeah,

没错。

exactly.

你的一个观点是，许多问题的根源在于我们的基因与环境之间存在不匹配。

One of your ideas is that the root cause of a lot of issues is this mismatch between our genes and our environment.

你能不能再详细阐述一下这个观点？

Why don't you flesh that out a little bit more?

是的。

Yeah.

所以，如果你观察一下，想想动物园里的动物。

So, if you look, think of an animal in the zoo.

野外的动物，除了少数例外，它们可能会摔断腿、感染疾病等等，但当动物生活在适合其物种的环境中时，它们往往是健康的。

An animal in the wild, with few exceptions, they can break their leg, get an infection, whatever, but when an animal exists in a species appropriate environment, that animal tends to be healthy.

环境的健康与动物的健康之间存在着天然的匹配关系。

There's a natural match between the health of the environment and the health of an animal.

当你把动物从自然栖息地带走，放进动物园之类的地方时，圈养动物会表现出各种疾病，而这些疾病是它们在野外的同类根本不会得的。

When you take an animal away from its natural habitat and put it in the zoo or something like that, zoo animals exhibit all of these diseases that their counterparts in the wild just don't get.

它们会出现奇怪的抽搐症状。

They have weird ticks.

它们会变得抑郁。

They get depressed.

在一些著名案例中，动物甚至会出现自杀行为，这完全是野外见不到的现象。

In some notable cases, animals have even killed themselves, which is just something you don't see in the wild.

它们会变得肥胖，还会出现各种问题。

And they get obese, they get all sorts of things.

所以我的观点，也是我认为非常正确的，就是动物的健康基本上是其环境健康状况的反映。

And so my take, and what I think is very true, is that the health of an animal is basically a reflection of the health of an animal's environment.

如果动物所处的环境不利于健康，比如处于干旱季节或食物匮乏，那动物就会变瘦并死亡。

If an animal is existing in an environment that is not health promoting, like you're in a season of drought or there's not a lot of food, that animal gets skinny and dies.

你基本上可以看出那只动物所处的环境并不利于健康。

You basically can kind of see that animal is not existing in an environment that's health promoting.

我认为在过去一百年左右的时间里，我们人类基本上已经看到，我们构建了一个环境，这个环境没有考虑、没有支持、也没有思考对人类健康而言什么是正确的事情。

I think that over the last hundred years or so, we basically as humans have seen that we've built an environment that is not considering or not underwriting, not thinking about what is the right thing to do for human health.

比如我们如何促进人类健康与繁荣发展？

Like how do we promote human health and flourishing?

所以我认为，很多时候当我们思考健康时，我们关注的是你个人发生了什么，埃里克，比如这种特定状况，而不是去思考你所处的环境——那个导致你每天走不到8000步、整天抱着手机、饮食糟糕的环境。

And so I think that so often when we think about health, we think about what is going on with you, Eric, with this specific condition, as opposed to thinking about what is the environment that you exist in that leads to you not getting 8,000 steps a day, that leads to you spending all day on your phone, That leads to you eating a terrible diet.

不，其实不是说你。

No, not you actually.

所以我认为这是一个人们思考不足的重要理念：如何塑造你的环境，使其自然促进健康，而不是必须靠自律去做那些大多数人——包括我自己在内——坦白说都失败的事情。

So I think that that is an important idea that people don't think about enough, is just how do you shape your environment so that it's naturally health promoting, as opposed to having to discipline yourself and doing all the stuff that most people frankly fail at, myself included.

推特上有个百万美元奖金竞赛，看谁能写出最好的文章，所以人们都在做点击诱饵内容，有个人发的是‘如何在一天内改变人生’、‘如何在一小时内改变人生’这类帖子。

There's this Twitter competition for a million dollars for who gets the best article, there's this so people are doing clickbait stuff, and there's one guy who's How to change your life in a day, how to change your life in an hour, these kinds of posts.

还有个超级火爆的帖子叫‘如何在一分钟内改变人生’，配图是砸碎手机的照片。

There was one that went super viral that was How to change your life in one minute, and it was a photo of smashing the phone.

这个确实很棒。

That's really good.

完全同意。

Totally.

好的。

Okay.

所以，我很好奇了解更多。你提到过这个观点：我们应该像对待国家安全危机一样严肃对待这场健康危机。

So, I'm curious for more You've talked about this idea of, Hey, we should take this health crisis as serious as we take our national security crisis.

我们国家应该有一个类似健康领域的NRA（全国步枪协会）或某种集体努力，因为这是一个市场自身无法解决、事实上还在加剧的问题。

We as a country have something of an NRA for health or something of a collective effort because it's a problem that, hey, the market isn't solving on its own and in fact exacerbates.

你举了一个补贴的例子。

You gave one example the subsidies.

你认为还有哪些最重要的杠杆手段？

What are some of the biggest levers you think?

是的。

Yeah.

我来回答这个问题，但首先要说明我对这个问题的思考框架：假如中国或我们的某个对手部署了一种生物武器，导致我国75%的人口超重或肥胖，45%的儿童超重或肥胖，并且由于所有人都生病了，医疗保健突然成为国家最大的开支。

So I'll answer that, but just to frame how I think about the problem, if, for example, China or one of our adversaries deployed a bioweapon that made 75% of our population obese or overweight, forty five percent of kids obese or overweight, and healthcare the largest cost in the country all of a sudden because everyone was sick.

所有美国人都会义愤填膺，并试图弄清楚如何将这个问题作为生存危机来解决？

Everyone in America would be up in arms and trying to figure out how do we solve this as an existential crisis?

我们在其中取得进展，这是一个国家安全问题。

This is a matter of national security that we make a dent in that.

不管我们是否赢得IRA（通胀削减法案）变得更富有或其他什么，如果国家大部分人都生病了，那还有什么意义呢？

No matter if we win the IRAs get richer or whatever, if most of the country is sick, it's kind of like what is the point?

我们作为一个国家并没有繁荣发展。

We're not thriving as a nation.

我认为我们许多政治问题的根源在于，这个国家的大多数人实际上都处于不健康状态。

I think many of our political problems are downstream of the fact that the majority of the country is just sick.

所以如果我能挥动魔法棒做任何事，我认为改革补贴制度肯定是我会做的一件事。

And so if I was able to wave a magic wand and do anything, I think fixing the subsidies would be one thing for sure that I would do.

其次，我会让我们的医疗系统在预防方面投入更多资源。

Secondly, I would have our healthcare system just invest far more in prevention.

你看看其他那些人均健康成果非常出色的国家。

You look at other countries that have incredible health outcomes on a per capita basis.

新加坡就是一个很好的例子。

Singapore's a good example.

他们基本上有一些人，虽然不是医生，但像是教练之类的角色，会定期与你沟通，尝试引导你做出更好的选择。

They basically have these people that are not quite doctors, but are coaches or something like that, that will check-in with you and try and nudge you towards making better choices.

然后我会采取更强硬的立场，更接近欧洲的做法，特别是在某些环境毒素、化学品监管等方面。

Then I would take a much stronger stance, one much more similar to that that Europe takes, when it comes to certain environmental toxins, chemical regulation, things like that.

在美国，我们基本上采取的做法是，如果一家公司制造或生产一种全新的环境化学品，只要他们按照现行法规告诉我们，这东西被普遍认为是安全的（GRAS），只要他们说这种化学品是安全的，我们就可以将其引入我们的食品系统。

In The US, we basically take the approach that if a company makes or manufactures a totally novel environmental chemical, that as long as they tell us under current regulations, something called GRAS, generally recognized as safe, as long as they tell us, hey, this chemical is safe, we can introduce it into our food system.

这就是你听说过的永久性化学物质等东西如何进入我们的食品系统的，现在基本上遍布全球，因为大约六十年前3M公司发明了它们，然后它们就开始被广泛使用。

This is how you've heard of the forever chemicals and stuff like this got into our food system, and basically are all over the planet now because three m invented them something like sixty years ago, and basically they just started using them.

在欧盟，这些新型化学化合物必须经过一个更类似于当今美国批准药品所需的流程，需要进行多年的安全测试。

In the EU, these novel chemical compounds have to go through something that is much more like what it takes to unleash or get a pharmaceutical approved in The US today, where they have to do many years of safety testing.

它们必须证明不会造成急性危害，并且基本上需要获得批准才能上市。

They have to show that it doesn't cause acute harm, and they basically have to approve it before it's allowed on the market.

最终结果是，美国有六万到八万种化学化合物在欧盟是不被允许使用的。

The end result is we have between sixty and eighty thousand chemical compounds in The US that are not allowed in The EU.

我认为这种监管方式是导致这么多人患病的一个隐藏原因，也是美国人比世界上任何国家都接触更多有毒化合物和新型化学物质的原因之一。

I think that that regulatory approach is one of the hidden reasons why so many people are sick, and I think it's one of the reasons that US Americans are exposed to more toxic compounds and novel chemical compounds than basically any nation in the world.

我认为这是我们慢性病危机中一个被忽视的重要部分，未来几年你会听到更多关于这方面的讨论。

I think that is a big, kind of hidden part of our chronic disease crisis, and it's something you're gonna hear a lot more about in the coming years.

是的。

Yeah.

真有意思。

Fascinating.

我有个大学教授——不知道这说法是否靠谱——但他坚信孟山都公司是邪恶的，不仅是在健康影响方面，他认为他们还涉足各种外国战争，影响我们的外交政策等等。

I had one college professor I have no idea if this is even remotely accurate, but they were convinced that Monsanto was evil, not just in terms of its health impacts, they thought they were getting involved in all sorts of foreign wars and influencing our foreign policy and stuff.

我提这个是想问，这些巨头企业会不会面临竞争者？

I'd just say that to say, could there be competitors to some of these mega play?

甚至会不会有初创企业出现，开始...

Could startups even emerge that would begin to, or

还是说这在结构上就根本不可能？

is it just structurally unsemble?

我认为从结构上来说确实很困难。

I think it's really hard structurally.

我认为这并不意味着它不会发生，而且希望它会。

I think that that doesn't mean that it's not going to happen, and hopefully it will.

但你看到的一个例子是，比如孟山都，农药游说团体以及化学和农业游说团体是美国最强大的之一。

But one of the things that you have seen is with Monsanto, for example, the pesticide lobby and the chemical and ag lobby is one of the strongest in America.

他们正在做的一个重要部分是，比如几个月前，孟山都大力游说，花费了数千万美元推动一项法案，该法案基本上确保没有人能因他们最受欢迎的产品之一——草甘膦——的潜在健康影响而起诉他们。

And a big part of what they're doing is, for example, a couple months ago, Monsanto was lobbying hard, spent tens of millions of dollars to get a writer and a bill that would basically make sure that no one could ever sue them for the potential health impacts of one of their most popular products, glyphosate.

这类事情是这样的，这些公司规模变得庞大。

That sort of thing is like these companies get big.

它们提供大量化学品。

They provide a bunch of chemicals.

特别是孟山都公司，我认为他们做了很多道德上极其可疑的事情。

Monsanto specifically has done a lot of things that I think are incredibly morally dubious.

然后一旦他们规模足够大，一旦这些产品的销售额达到数百亿美元，他们就会把大量资金用于游说，确保自己免受这些随处喷洒的有毒产品造成的任何伤害和健康影响。

Then once they get big enough, once they start selling billions and billions of dollars of these products, they spend a lot of that money on lobbying and making sure that they are immune from any of the harms and health impacts that come from some of these toxic products that they spray everywhere.

草甘膦是美国喷洒量第一的农药，其最大生产商正竭尽全力确保草甘膦——要知道，因接触草甘膦而患癌症或其他疾病的人们已获得140亿美元的损害赔偿。

Glyphosate is the number one pesticide sprayed in The US, and the largest maker of it is spending as much as they possibly can to make sure that glyphosate, which, you know, there's been $14,000,000,000 of damages awarded to people that have gotten cancer or other diseases from glyphosate exposure.

孟山都正尽其所能试图购买农药责任保护和其他保护措施，以规避竞争或逃避其化合物所致疾病的行为和后果。

Monsanto is spending as much as they can to try and, like, buy, basically, pesticide liability shields and other things that shield them from competition and or that shield them from the actions and the consequences of, like, the diseases their compounds have caused.

我认为当这些公司能以这种方式操纵游戏规则时，初创企业想要真正涉足这些领域就会变得非常非常困难。

I think that when when these companies can kind of rig the game in that way, it becomes very, very challenging for a startup to kind of come along and make a real play at some of these things.

是的。

Yeah.

你提到了一个简单的想法，就是开一家杂货店。

You mentioned a grocery store just as a simple idea.

Whole Foods在他们尝试做的事情上还有什么机会没有抓住？

What's the opportunity that Whole Foods hasn't done with what they've tried

去做？

to do?

是的。

Yeah.

Whole Foods真的很棒。

Mean, Whole Foods is amazing.

所以我认为约翰·麦基是彻底的先驱和传奇企业家。

And so I think that John Mackie was a total pioneer and legendary entrepreneur.

我认为超市真正没有做的是——这也是TruMed的核心理念——把食物视为一种医疗干预手段。

I think that the thing that grocery stores have not really done is and this is kind of the thesis for TruMed, is think about food as a healthcare intervention.

在我看来，人们有很大的潜力通过监测自己的生物标志物，让超市或其他机构来帮助改善你的健康。

And to me, I think there's a ton of potential for people to, for example, look at their biomarkers and have a grocery store or some other entity that is responsible for improving your health.

如果越来越多地把食物和超市视为健康干预的一部分，视为对抗慢性病的手段，那么你对超市的看法就会与今天大不相同，而今天超市基本上只是解决供应链问题，然后让人们随意购买。

I think that if you think increasingly about food, grocery as a health intervention, as part of one's healthcare and part of the fight against chronic disease, you would think about a grocery store very differently than today, which is basically just like, let's figure out the sourcing, then people can buy whatever they want.

所以我的想法是，超市完全可以更积极地参与你的健康，比如建议你吃某些食物、追踪你的宏量营养素，这些都能解决很多人的健康问题。

So I think there's My idea was that I think there's a ton of room for a grocery store that is a more active participant in your health, telling you to eat certain things, tracking your macros, all these sorts of things that I think would solve a lot of problems for people.

是的。

Yeah.

那么，如果我们把健康危机完全视为国家首要任务之一，我们还应该做些什么？

So let's talk more about if we fully identified the health crisis as one of our main national priorities, what else we would do?

也许我们可以从一些支柱或主要原则的角度来审视它，并讨论它们目前的进展。

Maybe we could start looking at it in the light of what were some of the pillars or main principles, and maybe talk about where they are so far.

是的。

Yeah.

所以我认为，在整个医疗保健领域、整个食品领域，你都能看到企业对我们食品指南、健康指南以及所有这类事物的控制。

So I think that you have seen across all of healthcare, across all of food, just corporate capture of our food guidelines, of our health guidelines, of all these sorts of things.

上一任FDA专员，他们管理FDA的既定目标，他们的首要目标是打击错误信息。

The previous FDA commissioner, their stated goal with running the FDA, their number one goal was to combat misinformation.

当前的目标是让美国人健康起来。

The current one is to make Americans healthy.

这意味着要进行食品改革，清理我们对化学品的监管方式。

That means grass reform, so cleaning up how we regulate chemicals.

这意味着要改善学校午餐和军队伙食，基本上就是改善我们给孩子们吃的食物。

That means fixing school lunches, fixing military lunches, basically what we feed kids.

80%的学校与汽水公司签有合同。

80% of schools have contracts with soda companies.

这些汽水公司实际上会向学区付费，在学校各处放置这些自动售货机。

These soda companies literally will pay a school district to put these vending machines all over the schools.

这确实能为学校提供资金支持，但也以损害孩子们健康为代价。

It helps fund schools, but it also comes at a cost of getting kids sick.

所以我认为需要整顿学校午餐、军队伙食以及食品指南。

So I think cleaning up school lunches, cleaning up military lunches, cleaning up the food guidelines.

第二件事是改进并简化我们监管药物的方式。

Second thing is improving and streamlining the way that we look at regulating drugs.

让企业能够更快地投入并推出创新疗法，以应对慢性病危机。

Make it faster for companies to lean in and launch innovative therapies that can make a dent on the chronic disease crisis.

并且努力让常识回归我们对健康和饮食的思考方式，尝试在慢性病危机中取得进展。

And just trying to bring common sense back into the way that we think about health, the way that we think about food, and try and make a dent in the chronic disease crisis.

我们讨论的这些成分、食物或像苏打水这样的东西，是否因为如此令人上瘾、危险或诱人而应该被禁止？

Are are some of these ingredients that we're we're discussing or or or foods or or, you know, soda, like, so so addicting or so dangerous or so appeasing that they should be outlawed?

我们应该如何看待这个问题呢？

Is it like, how do we think about it?

不。

No.

实际上，我并不认为其中很多东西应该被禁止。

I I actually don't think that many of these things should be outlawed.

比如，我确实认为消费者的选择权非常重要。

Like, I I do actually think that consumer choice is a very important thing.

你明白吗？

You know?

但具体到孩子们，我们是有指导方针的，而且我们本来就不认为应该让孩子们自由选择。

But we have got like, specifically with kids, we have guidelines, and we already don't think that kids should have free choice.

就像我们不让他们喝酒一样。

Like, we don't let them drink.

所以我认为汽水在这个国家还是有它的位置的。

So I think that there is a place for soda in this country.

只是我也认为，如果你想一直喝汽水，我们或许不应该通过补贴高果糖玉米糖浆来变相资助它。

Just also think that if you want to drink soda all the time that probably we shouldn't be subsidizing it by subsidizing high fructose corn syrup.

或许我们不应该让可口可乐公司像过去十五年那样，花费1.4亿美元来影响我们的营养指南。

Probably we should not have Coca Cola spending a $140,000,000 to influence our nutrition guidelines like they have over the last fifteen years.

我认为很多时候大型食品公司和人们会退回到消费者选择这个理念上。

I think that it's things like that where a lot of times the big food companies and people will fall back on this idea of consumer choice.

我觉得这非常重要，但我们现在也正在应对一个极其重要的慢性病危机。

I think it's very important, but we also are currently grappling with an incredibly important chronic disease crisis.

如果我们不付出努力专门解决这个问题，我认为美国在未来十到三十年将处于极其艰难的境地。

If we don't take effort to uniquely address this thing, I think that The US is in an incredibly tough spot ten, twenty, thirty years from now.

我想问问你关于迷幻药的事情。

I want ask you about psychedelics.

这个话题在讨论范围内吗？

Is that in this discourse at all?

这会影响结果吗？

Does that move outcomes?

还是说其实没什么关系？

Or is that not really, basically?

我认为如果你只是看看

I think that if you just look at

数据，迷幻药是一种极其强大的干预手段。

the data, psychedelics are an incredibly powerful intervention.

在许多情况下，氯胺酮辅助疗法比SSRIs效果更好，特别是在治疗非常严重的情况时，比如难治性抑郁症、创伤后应激障碍等等。

Ketamine assisted therapy works better than SSRIs in many cases, especially for treating things that are very intense, like treatment resistant depression, PTSD, things like this.

我认为对于许多患有创伤后应激障碍和严重抑郁症的退伍军人和其他人来说，迷幻药应该成为我们愿意提供给人们的治疗方案菜单的一部分。

I think that for many of our veterans and others that suffer from PTSD and intense depression, psychedelics should be part of a menu of treatments that we are open to giving people.

我认为我们可能对它们的投资严重不足。

Think that we probably vastly under invest in them.

我认为关于它们的疗效等方面有大量非常有前景的研究。

Think that there's a ton of really promising research around their efficacy and things like this.

我认为一个开放性的问题是，普通美国人是否准备好不再将这些视为六十年代在金门公园吸食迷幻药的人群，而是将其视为对那些真正挣扎的人们至关重要的心理健康疗法。

I think it's an open question of how ready the average American is to think about these things not as a group of people dropping acid in Golden Gate Park in the sixties, but as like a vital mental health therapy for people that are really, really struggling.

我非常支持，你知道，再次强调，就是将迷幻药视为另一种可以解决我们国家许多心理健康和抑郁问题的疗法。

I'm very supportive of, know, again, just looking at psychedelics as another therapy that can address the many mental health and depression issues that we have in this country.

如果你仅仅从这个视角来看待它，作为一种副作用极少甚至没有的治疗方法，尤其是在医生监督下进行的情况下，我认为这应该成为我们应对当今许多心理健康危机的一部分。

And if you look at it just as that through that lens, a therapy that has few to no side effects, especially when done with doctor oversight and things like this, I think these should be part of how we treat and address many of the mental health crises that we see today.

还有

Are

还有其他什么重要的

there any other really big levers that you

如果您的首要目标之一是应对心理健康危机，您会重点关注哪些方面？

would focus on if one of your main goals was to target the mental health crisis?

我认为我们严重低估了生理健康的影响及其与心理健康的关联。

I think that we are hugely underestimating the impact of biological health and how that is tied to mental health.

有一些非常有趣的研究采用了功能医学方法，当你走进来说自己抑郁时，

There's some really interesting studies out there around taking a functional medicine approach where you come in and say you're depressed.

而不是进行谈话疗法等统计显示对许多人效果不佳的方式，

And rather than doing talk therapy and things like this, that statistics show sort of don't work very well for many people.

我们只专注于减轻你的炎症和修复肠道健康。

We focus just on reducing your inflammation and fixing your gut.

已有研究表明，仅通过采用功能医学方法，关注睡眠、肠道健康，以及通过饮食和运动降低炎症，这种综合疗法的效果优于单纯的谈话疗法等方法。

And there have been studies that show just by focusing and taking a functional medicine approach, focusing on sleep, focusing on gut health, focusing on lowering your inflammation through diet and exercise, that combination of therapies works better than just talk therapy and things like that.

因此我认为，我们严重低估了我们作为人类生物有机体的程度，我们的心理健康与身体健康是紧密相连的。

So I think that we massively underestimate the degree to which we are human beings, biological organisms, and our mental health is very tightly coupled to physical health.

我认为我们应该大力资助更多所谓代谢精神病学的研究，其核心观点是：许多被归入心理健康范畴的疾病，如癫痫、抑郁症、精神分裂症等，其根源实际上是代谢问题。

Much I think that we should fund much, much more of research along these lines of what's called metabolic psychiatry, which is basically this idea that many diseases that we put in the mental health bucket, things like epilepsy, depression, schizophrenia, many of these things have causes that are actually metabolic in root.

例如，对于精神分裂症或癫痫患者，甚至在许多双相情感障碍病例中，最佳疗法之一就是采用生酮饮食，这在许多情况下能直接解决问题。

For example, one of the best therapies for someone that is schizophrenic or epileptic, or even in many cases bipolar, if you put them on a ketogenic diet, these things will, in many cases, just resolve.

这是我们当前心理健康领域并未真正认可的做法。

That is not a thing that our current mental health world really underwrites.

是的。

Yeah.

没错。

Yeah.

这让我想起曾与丹尼尔·格罗斯的一次对话，当时他说：嘿。

It reminds me of a conversation I once had with Daniel Gross when he he was saying, hey.