最重播时刻：这种饮食可能改善你的心理健康！——乔治亚·埃德博士

这种生酮饮食，你，你做过一项关于生酮饮食的研究。嗯。这里有这项研究。《生酮饮食治疗难治性精神疾病：对31名住院患者的回顾性分析》。对于可能不了解的人，什么是生酮饮食？

This keto diet, you, you did a study on the ketogenic diet. Mhmm. Got the study here. The ketogenic diet for refractory mental illness, a respect a retrospective analysis of 31 inpatients. What is the ketogenic diet for someone that might not know?

很多人认为或听说过生酮饮食是一种减肥饮食。他们可能认为这是一种流行的减肥饮食。他们认为这是一种极低碳水化合物的饮食。他们可能认为这是一种非常高肉类和乳制品的饮食。但实际上，生酮饮食最初是在1921年创造的，一百多年前，用于稳定患有严重癫痫发作的儿童的大脑化学。

So a lot of people think or they've heard about a ketogenic diet as a weight loss diet. They think of it maybe it's a fad weight loss diet. They think of it as a very, very low carbohydrate diet. They might think of it as a diet that's very high in meat and dairy products. But actually, the ketogenic diet was originally created in 1921, more than one hundred years ago, to stabilize brain chemistry in children with severe seizures.

这远在有效的抗癫痫药物出现之前。所以这些儿童在很多情况下每天会有多次癫痫发作。因此，生酮饮食在当时被设计出来，创造出来，是一种非常严格的生酮饮食版本，尽可能接近禁食，但又不至于让儿童饿死。因为几千年来，人们注意到癫痫患者在禁食时往往会有所改善。但你不能永远禁食。

And this was long before the availability of useful seizure medications. So these were children who were having multiple seizures per day in many cases. And so the ketogenic diet was designed back then, created back then, very strict version of the ketogenic diet to get as close as possible to fasting without starving children to death. Because for millennia, people had noticed that those with epilepsy would often improve if they were fasting. But you can't fast forever.

那么如何接近禁食呢？这是最初的模拟禁食饮食。如何在尽可能接近禁食的同时仍然提供一些营养？这就是生酮饮食的最初目标。它是非常成功的治疗方法。

So how do you get close to fasting? This is the original fasting mimicking diet. How do you get as close to fasting as you can while still providing some nutrition? So that was the original goal of the ketogenic diet. It was very successful procedures.

超过50%的儿童和成人有超过50%的反应率，后来研究表明儿童和成人的反应率超过50%，10%到20%的人在采用生酮饮食后完全不再有癫痫发作。

More than fifty percent of children had more than a fifty percent and adults as well. It's since been shown more than fifty percent response rate in children and adults, and ten percent to twenty percent completely free of seizures following a ketogenic diet.

它是如何作用于大脑的？它对大脑有什么影响？

How is it acting on the brain? What's it doing to the brain?

生酮饮食有很多很多作用。它就像是一种多功能的脑健康工具。其中一点是，因为我们讨论过一些精神疾病的根本原因，这些原因直到最近才成为研究的焦点，包括炎症、氧化应激和胰岛素抵抗。生酮饮食可以减少炎症，减少氧化应激，并减少胰岛素抵抗。它还能改善大脑中化学物质的平衡。

The ketogenic diet does many, many things. It's like a multipurpose tool for brain health. So one thing it does, because we talked about how some of the root causes of mental illnesses, which are only relatively recently focus of research, are inflammation and oxidative stress and insulin resistance. The ketogenic diet reduces inflammation, it reduces oxidative stress, and it reduces insulin resistance. It also improves the balance of chemicals in the brain.

很多人认为精神疾病是大脑化学物质失衡的问题。这些就是他们所说的化学物质。你可能听说过血清素、多巴胺或去甲肾上腺素。还有其他物质，如谷氨酸、GABA。大脑中的许多不同化学物质与心理健康症状有关，甚至在某些情况下是导致这些症状的原因。

So a lot of people think of mental illnesses as problems with chemical imbalances in the brain. And these are the chemicals that they're talking about. You might have heard of serotonin or dopamine or norepinephrine. There are others, glutamate, GABA. Many different chemicals in the brain are associated with or in some cases even very much causing mental health symptoms.

但问题是，是什么首先导致了这些化学物质失衡？其中一个原因是炎症和氧化应激。但另一个原因是，如果你以错误的方式喂养大脑，在很多情况下，它将无法可靠地产生能量。如果它不能可靠地产生能量，各种问题就会出现。而且方式相当惊人。具体会出现什么问题取决于你是谁。

But the question is, what's causing those chemical imbalances in the first place? And one of the things that's causing those chemical imbalances is that inflammation and oxidative stress. But another thing is that the brain is, if you're feeding it the wrong way, it will not be able to, in many cases, produce energy reliably. And if it can't produce energy reliably, all kinds of things will go wrong. And in quite spectacular fashion, What actually goes wrong is going to depend on who you are.

这就是我们个体差异的来源。所以如果你和我吃完全相同的糟糕饮食，根据你家族的遗传和你迄今为止的生活方式，你可能会患上阿尔茨海默病。你可能会患上双相情感障碍。你可能会患上2型糖尿病。你可能会患上脂肪肝病。

And that's where our individual differences come in. So if you and I eat exactly the same bad diet, depending on what runs in your family and how you've lived your life to this point, you might develop Alzheimer's disease. You might develop bipolar disorder. You might develop type two diabetes. You might develop fatty liver disease.

我可能会发展出完全不同的病症。我可能患上心血管疾病，可能陷入抑郁，也可能出现注意力缺陷多动障碍。而这正是个体差异所在。

I might develop completely different conditions. I might develop cardiovascular disease. I might develop depression. I might develop ADHD. And that's where the individual differences are.

但所有这些病症本质上都是代谢功能障碍。如果细胞不能正常运作，你就会患上各种身心疾病。具体会得哪种病，某种程度上就像抽签一样随机。但如果你懂得如何让细胞保持最佳状态，就能极大控制患病风险。

But all of these conditions are just metabolic malfunction, really, at the heart of it. That's what's going on. If cells aren't functioning properly, you will develop a disease, physical and mental diseases. And which ones you get, it's really kind of luck of the draw. But you have tremendous control over what you are at risk for if you understand how to help your cells operate at their personal best.

为什么坚持生酮饮食这么难？我在录制前跟你说过，我每年这个时候会坚持八周。这对我的生活产生深远影响——让我思维更专注，

Why is it so hard to stay on the ketogenic diet? I've managed to do it for I was saying to you before we started recording, once a year. Around this time of year, I do it for about eight weeks. And it has a really profound impact on a lot of my life. It helps me feel more focused.

身体成分变化速度远超其他任何饮食或运动方式。我还注意到睡眠质量也有所改善。但你坚持很久了吧？差不多有十年了？

My body composition radically changes faster than any other diet or thing that I've ever tried faster than just exercise alone. I I sleep a little bit better as well, I noticed. But you've been doing it for a long time. You've been doing it for roughly, what, almost ten years?

确切地说十二年了。我同意你的观点，这确实不容易。我自己也并非完美执行，但过去十二年间大部分时间都保持着生酮饮食。

For the better part of I mean, more often than I'll say, I've been following a ketogenic diet for twelve years. And I agree with you. It's not always easy. I'm not perfect about it myself, but I have been on the ketogenic diet the lion's share of the last twelve years.

执行难度是个关键因素。对于那些治疗抵抗性抑郁症患者或深受折磨的人，他们可能觉得比我还困难。

It being hard is an important factor. Yes. Because when you're trying to prescribe it to somebody who has got treatment resistant depression or is really suffering in some way, I imagine they'll find it even harder than I do.

既是也不是。在高碳水环境中坚持低碳饮食确实困难——要面对环境诱惑、社交压力、习惯依赖和成瘾性。

Yes and no. Okay. So it's well, it's definitely there's no question about it that it's hard to eat a low carbohydrate diet in a high carbohydrate world. So there's that. There's the environmental temptations and the social temptations and the habits and the addiction.

糖瘾是真实的生化现象。我从小就有体重问题，尝试过各种饮食方案。但这是最容易长期坚持的——

Sugar addiction is a very real biochemical phenomenon, so there's that. But I mean, been I had a weight issue growing up. Everyone in my family did. And I've been on lots of different diets in my life. This is the easiest one to stay on.

其他饮食法我都没能坚持十二年。因为这种饮食能稳定食欲激素，让细胞在餐间获得能量。血糖不再剧烈波动，连带食欲激素、饱腹激素、压力激素、生殖激素和脑化学物质都趋于平稳。

I can't say about any other diet that I've followed for twelve years. And the reason why is this diet really stabilizes appetite hormones. So your cells are getting energized in between meals. You're not getting those spikes and crashes in glucose, which cause spikes and crashes in appetite hormones, satiety hormones, stress hormones, reproductive hormones, brain chemistry. You're not on that roller coaster anymore.

细胞需求得到满足，人体内部环境保持稳定。虽然不能完全抵御诱惑，但我会这样向食物成瘾患者解释。

So your cells are being satisfied. They're getting the energy needs satisfied in between meals. And everything is quiet and calm on the inside. It doesn't mean you're 100% protected against temptation. So I describe it to my patients with food addiction.

我把生酮状态比作一套盔甲。你知道，剑仍可能伤到你，但你并非完全无防护。至少你有了真正的战斗机会。对于那些从未尝试过生酮饮食或坚持不足六到十二周的人来说，大多数人根本不知道当食欲得到良好控制时，遵循健康饮食计划会变得多么轻松。许多人甚至不用检测酮体水平就能感知自己进入了生酮状态——因为他们可以长时间不进食却完全不会想到食物。

I describe being in ketosis as a suit of armor. You know, the sword can still get you, but you know you're not 100% protected. But you've got a real fighting chance. And for anybody who's never tried a ketogenic diet and been on it for at least, I would say, six to twelve weeks, most people have no idea how much easier it is to follow a healthy eating plan when their appetite is in good control. A lot of people know they've shifted into ketosis without even checking their ketone meter because they can go for so long without eating, without even thinking about food.

他们可以工作到忘记吃午饭。现代人的饮食方式让我们大多数人时刻想着食物。早餐还没吃完就开始盘算午餐吃什么。人们随身携带零食，很多人每天至少要进食六次。

They can work through lunch and not even realize that they've missed a meal. Most people, the way we eat, most of us now, are thinking about food all the time. You haven't even finished breakfast, and you're already thinking, what are going to have for lunch? You're carrying food around with you everywhere you go. You're eating at least six times a day in many cases.

这显然不正常——如果人类真需要每天吃六顿，我们这个物种早该灭绝了。现在的饮食方式不是在滋养和满足我们，反而在制造饥饿感。

This is not I mean, we would never have survived as a species if we needed to eat six times a day. So we're not eating in a way that is nourishing us and satisfying us. We're eating in a way that's making us hungry.

我觉得你说的很符合我的体验，特别是那个过山车的比喻。当我不在生酮状态时，确实感觉自己像坐上了充满诱惑与渴望的过山车。而当我进入生酮并度过最初一两周后，这辆过山车似乎就停下来了。

I find what you've said there to be sort of true in my experience, especially in the context of the rollercoaster analogy. So when I'm not on keys ketosis, I do feel like sometimes I'm in a bit of a rollercoaster of, like, temptation, craving, etcetera. And then when I do ketosis and I get past the first week or two, the the roller coaster seems to stop.

没错。

Right.

我...我下车了。但可能六到八周后，当你忙于工作、旅行或疲惫时，诱惑又会悄悄袭来。只要意志稍有松懈，我就会跌出生酮状态，前功尽弃。我一直有个可能是错误的认知：进入生酮需要几天时间...

I I'm I'm off the roller coaster. It's then maybe six, eight weeks later, you're busy, life happens, you're traveling, you're tired. That temptation creeps in. And it just takes that one moment of weakness in my head to then fling me off ketosis and all my effort is gone. And in my head, the way I've always thought about it, and I'm sure this is wrong, but I've thought about it like it takes a couple of days to get into a state of ketosis.

而且过渡期通常会伴随头痛。是的。进入生酮时我会有点不适。嗯。但稳定后就没事了。

And then once you're in and I usually get a headache Yeah. On my way into ketosis. I feel a little bit bad on the way in. Mhmm. And then once I'm in there, it's fine.

所以当我破戒时——我和女友都这么称呼打破生酮——我就会想：天啊，又要经历头痛和五天的适应期才能重新进入状态。这种认知正确吗？

So when I have something that breaks my keto, this is what I refer to me and my girlfriend talk about it when I've broken my keto or whatever, I think, oh my god, I've got to go through another headache and another five days of, you know, getting back into it. What is that correct?

这是非常普遍的体验，因为当你的生理系统从燃烧碳水化合物为主转向燃烧脂肪为主时，身体需要重新调整。人体和大脑本是混合动力引擎，我们永远不会只燃烧脂肪或碳水，而是两者的混合。

It's a very common experience because there are these adjustments that happen inside with your physiology as you're shifting from one operating system to another. When you're shifting from a carbohydrate burning system to a more you're shifting your ratio of your fuel. So the body and the brain are hybrid engines. So we're never burning 100% fat. We're burning a mixture of fat and carbohydrate.

从长期以碳水为主要燃料突然转变为脂肪主导的系统，这个转换过程会让人不适——特别是当破戒原因是摄入了大量精制碳水（比如糖或面粉）时。具体反应取决于摄入量及持续时间。许多人在从糖代谢转为脂肪代谢时会经历所谓的'酮流感'。其实通过补充电解质维持盐分平衡等方法，大部分不适都可以预防。

When you're shifting from a system that's fueled almost entirely by carbohydrate almost all the time to a system where you're burning more fat than carbohydrate, that's uncomfortable for some people shifting back and forth, especially if what they have if the reason why you've, quote, broken your keto is because you've had something that has a lot of refined carbohydrate in it, a lot of sugar or flour in it, for example. So, it depends on what you've eaten and how much and for how long. But many people do experience the so called keto flu when they are shifting from a carbohydrate based system to a fat based metabolism. And some of this can be much of this can be prevented in a couple of different ways. One is with electrolyte supplementation, supplementing electrolytes to keep your salt balance even as you're transitioning.

另一种方法是缓慢过渡到生酮饮食，而非一蹴而就。书中还提供了其他建议，帮助人们更舒适地完成这一转变。但最重要的两点就是补充电解质和循序渐进。因此，在书中我并不建议人们立即开始生酮饮食——比如周一了解，周二就执行——而是用一到两周时间逐步进入酮症状态。书中还提供了一种适度的碳水化合物摄入方案来实现这一点。

And another is by transitioning slowly onto the ketogenic diet rather than all at once. And there other tips in the book about how to do this more comfortably. But those are the two big ones And going slowly. So in the book, I don't recommend that people start on a ketogenic diet just straight away, like learn about it on a Monday, start it on a Tuesday, but ease into ketosis over a week or two. And there's kind of a moderate carbohydrate plan in the book that allows people to do this.

遵循这个方案几周后，血糖和胰岛素水平会逐渐降低。这种方式会舒适得多，对大脑和身体的冲击也小得多。如果同时补充电解质并循序渐进，所谓的'酮流感'症状大多不会出现，即使出现也会非常短暂轻微。所以说，这些电解质变化其实是积极的改变。

So you follow that plan for a couple of weeks to gradually lower those glucose and insulin levels. It's going to be a lot more comfortable. It's going be a lot less of a shock to the brain and body. If you're supplementing electrolytes and going slowly, most of these quote keto flu symptoms will not occur, or they'll be very brief and mild. So again, it's a positive change to have these electrolyte changes.

虽然这些改变都有益，但过渡期有时会让人不适。这并非意味着危险——我们的生理机制本就设计成能在脂肪和碳水化合物这两种能量源之间切换。只是由于长期错误饮食损害了代谢机能，许多人丧失了部分代谢灵活性，无法像从前那样自如切换了。

And all of these things are good, but there is this transition period which can sometimes be uncomfortable. And this is not to say that it's dangerous. Again, it's a very We're designed, Our biology is designed for us to be able to shift back and forth between fat and carbohydrate as fuel sources. But many of us have lost some of our metabolic flexibility because we've done some damage to our metabolic engines by eating the wrong way for too long. So we don't shift as comfortably back and forth as we used to be able to.

我想大多数人甚至不知道生酮饮食包含哪些食物，因为多数节食法限制严苛到让人以为就是折磨自己。关于生酮饮食的可食用食物，你见过哪些重大误解？

I guess most people don't even know what foods are included in a keto diet because most diets are restrictive to the point that people think they just make your life miserable. But what are the sort of big misconceptions you've seen with the foods you're able to eat on a ketogenic diet?

关键在于，生酮饮食的定义是任何能降低胰岛素水平至开启脂肪燃烧、产生血酮的饮食方式。由于核心在于胰岛素，它本质上不是一份食物清单。无论是纯素、素食、杂食还是纯肉食模式，只要懂得如何降低胰岛素水平，都能获得酮症带来的大脑修复益处。

Yeah, so because a ketogenic diet because the definition of a ketogenic diet is any way of eating that lowers insulin levels enough to turn on fat burning and generate ketones in the blood, because it's about insulin, it's really not a food list. So you can it's not about plants and animals. It's not even about fat or carbohydrate. It's about understanding how to lower your insulin levels, which you can do with a vegan dietary pattern, with a vegetarian dietary pattern, with an omnivore dietary pattern, or even with a carnivore dietary pattern. So whatever your dietary preferences are, you can get the benefits, the brain healing benefits of ketosis.

重点不在于吃什么食物，而在于明白什么会升降胰岛素。精制碳水化合物、全食物碳水化合物、蛋白粉等精制蛋白质、全食物蛋白质都会影响胰岛素。而几乎不影响胰岛素的是什么？脂肪。脂肪是代谢最平稳、最安全的宏量营养素。

So it's not about the foods you're eating. It's more about understanding what raises and lowers insulin. The things that raise and lower insulin are refined carbohydrates, whole foods carbohydrates, refined proteins like protein powders, whole food sources of protein, and guess what barely touches insulin at all? Fat. Fat is metabolically the quietest and safest macronutrient you can eat because it barely stimulates insulin.

酮症是一种状态吗？像二进制那样非此即彼？比如现在处于酮症，现在又退出了？

Is ketosis a state? Like, do I is it like a binary state? Like, now I'm in ketosis and now I'm not?

可以这么说。专家普遍认为，当血酮仪检测到β-羟基丁酸值达到0.5毫摩尔/升以上时，就处于酮症状态。血酮仪通过指尖采血测量这种特定酮体含量。

So yes, but there's yes. Let me put it this way, that most experts will agree that in order to be, quote, in ketosis, your level of beta hydroxybutyrate on a blood ketone meter, a blood ketone meter is prick your finger and put a drop of blood on this little test strip. And it will read the amount of a particular ketone in the blood called beta hydroxybutyrate. And it will give you a reading. If that reading is 0.5 millimole or higher, you are in ketosis.

为什么临界值是0.5？因为要达到这个值必须满足三个条件：一是血糖水平下降，二是胰岛素水平下降。

So what does that mean? Why is the cutoff point five? Because three things have to happen for you to get to at least point five. One is your glucose levels have to come down. The second thing is your insulin levels have to come down.

第三是要消耗掉肝脏中一定量的储存淀粉。我们的肝脏有个不大的碳水化合物储存库，存量不足一日所需——因为作为动物，我们本就被设计成以脂肪储存能量，碳水化合物只是应对短期紧急情况的快速能源。

The third thing is you have to burn off a certain amount of the stored starch in your liver. We have a storage tank for carbohydrate in our liver. It's not very big. It holds less than a day's worth of carbohydrate because really, as animals, we're designed to store energy as fat. Carbohydrates there for quick energy emergencies short term.

脂肪，无论好坏，我们几乎拥有无限储存脂肪的能力。我们可以储存数月甚至更久的脂肪。但我们只能储存极少量的碳水化合物。所以如果你的肝脏储存库满了，身体就不会转向燃烧脂肪，因为它会说，哦，我们还有很多淀粉可以燃烧。让我们从这里开始。

The fat, for better or for worse, we have almost an unlimited capability to store fat. We can store months and months and months worth of fat. But we can only store a very small amount of carbohydrate. So if your storage tank in the liver is full, your body will not switch to fat burning because it says, oh, we've got plenty of starch to burn. Let's start there.

一旦降到某个点，身体就会说，哦，我们快没能量了。现在去燃烧脂肪吧。这时肝脏就会开始分解脂肪，无论是你体内的脂肪还是餐盘中的脂肪，并将其分解成这些酮体。所以这三件事必须发生。一旦发生，你就会在测量仪上看到酮体水平上升。

Once it comes down to a certain point, the body goes, oh, we're running out of energy. Let's go to fat now. And that's when the liver will start breaking fat down, whether it's fat on your body or fat from your plate, and start chopping it up into these ketones. So those three things have to happen. And once that happens, you'll see the ketone levels rise on the meter.

大多数不吃生酮饮食的人，他们的酮体水平要么检测不到，要么是0.2或0.3。如果他们长时间不进食或刚运动完，偶尔可能会浮动到0.5以上。但总的来说，大多数吃典型饮食的人并不处于酮症状态。当你超过0.5时，很多代谢魔法就开始发生，因为身体和大脑中有许多通路在非酮症状态下并不活跃。而这些正是愈合通路、回收维护清理通路和恢复通路。

So most people who are not eating a ketogenic diet are walking around with ketone levels, either undetectable or they're 0.2 or they're 0.3. They might float up into above 0.5 every once in a while if they're not eating for a long time or if they've just exercised. But for the most part, most people eating a typical diet are not in ketosis. And when you get above 0.5, a lot of metabolic magic starts to happen because there are lots of pathways in the body and brain that are not very active unless you're in ketosis. And those are the healing pathways, the recycling and maintenance and cleanup pathways, the recovery pathways.

我们所有人。这是我多年前研究时意识到的一点——不幸或幸运的是，许多有心理健康问题的人发现他们需要长期处于酮症状态才能保持健康。但科学让我相信，我们所有人都需要至少间歇性地处于酮症状态。我们所有人都需要定期花些时间处于酮症状态，否则就无法愈合。这就像一个制造工厂全年无休地运转。

All of us. This is something that I came to appreciate a number of years ago as I've been studying this is that there are many people, unfortunately or fortunately, there are many people who discover with mental health issues that they need to be in ketosis long term in order to be well. But I've become convinced by the science that all of us need to be in ketosis, at least intermittently. All of us need to spend some time in ketosis on a regular basis, or else we can't heal. We'll only be it's like a manufacturing plant where the plant is just running twenty fourseven, twelve months a year.

他们从不花时间更换零件或清理地板。或者，你知道，他们从不做任何维护或修理工作。所以最终一切都会崩溃。

And they never take time to replace the parts or clean up the floor. Or, you know, they never do any maintenance work or repair work. And so eventually everything breaks down.

当你再次提到酮症时，你说的不是生酮饮食。你说的是低水平的葡萄糖和胰岛素

And when you say ketosis again, you're not saying the keto diet. You're saying the low levels of glucose and insulin

没错。

Exactly.

在血液中。这可以通过卡路里限制实现，可能还有禁食，我想你也可以通过其他饮食方式达到，比如地中海饮食，如果以正确的剂量实施，对吧？

In the blood. And that can be achieved by calorie restriction, potentially fasting, I guess you could achieve it, and other diets like the Mediterranean diet if administered in the right sort of doses, right?

我们应该稍后再谈地中海饮食。但你问题的前半部分很重要，因为正如你所说，酮症可以通过多种不同方式实现。如果你饮食得当——这本来是我们的进化遗产，我们的祖先，尤其是史前祖先，他们很久以前无法获得大量精制碳水化合物。他们吃的是全食物中的碳水化合物、水果和淀粉类根茎蔬菜，对吧？甚至谷物和豆类也是相对较新的碳水化合物来源。

Well, we should come back to the Mediterranean diet a minute. But the first part of your question is important because ketosis is as you said, you can get into ketosis a variety of different ways. If you're eating properly and this would have been our evolutionary heritage, our ancestors, especially our prehistoric ancestors they didn't have access to these lots and lots of refined carbohydrates a long time ago. They were eating carbohydrates from whole foods, fruits and starchy root vegetables, right? And so even grains and beans are very, very relatively much newer sources of carbohydrate.

让我们想想水果和蔬菜。但我们只能猜测他们的饮食方式。我们没有确凿证据。但想想看，如果你的饮食方式能让胰岛素水平在夜间自然下降，如果你吃的是所谓的均衡饮食，包含所需的一切，不会导致血糖和胰岛素剧烈飙升，而且你不是一天吃六顿或整天进食，你的胰岛素水平自然会在夜间下降。

So let's think about fruits and vegetables. But they would have been we can only guess looking at their diets. We don't have proof of this. But think about it. If you're eating in a way where your insulin levels are allowed to come down overnight, If you're eating a balanced diet, so to speak, but it's got everything it needs in it, and it's not giving you exaggerated spikes in your glucose and exaggerated spikes in your insulin, and you're not eating six times a day or all day long, your insulin levels will naturally come down overnight.

这将使你进入一种疗愈模式。因此我相信，如果人们掌握了关于健康饮食应是什么样子的正确信息，在许多情况下，尤其是如果你更年轻、热爱运动或尚未积累大量代谢损伤时，你可能甚至不需要在白天减少碳水化合物摄入。你可能只需要注意所摄入碳水化合物的种类和频率。例如，众所周知，遵循常规饮食的儿童中，许多人在次日早晨会处于酮症状态。

And that will allow you to go into a healing mode. So I believe that if people have the right information about what a healthy diet is supposed to look like, they may not even need to, in many cases, especially if you're younger or athletic or don't have a lot of metabolic damage already. You may not need to lower your carbohydrate intake during the day. You might just need to be careful about what kinds of carbohydrate you eat and how often. So, for example, it's known that in children who are eating a regular diet, many of them wake up the next morning in ketosis.

随着年龄增长，他们的代谢健康程度远优于我们。因此他们的代谢灵活性更强。这些儿童并未采用生酮饮食，只是保持常规饮食。他们夜间睡眠时未进食任何食物。

They're metabolically much healthier than we are as we get older. So they're much more metabolically flexible. So now they didn't go on a ketogenic diet. They were eating a regular diet. They slept overnight, didn't eat anything.

次日早晨，他们就进入了酮症状态。并非所有儿童都如此，但足够多的案例证实这是可能的。对大多数成年人而言，即使完全禁食，至少也需要数天才能进入酮症。因此对多数人来说，禁食至少需要两到三天才能达到酮症状态，而有些人甚至需要整整一周。

The next morning, they're in ketosis. That's not true for all children, but it's true for enough children that we know it's possible. Most adults, it takes them several days at least to get into ketosis, even if they're not eating anything at all. So fasting can take two to three days at a minimum for most people to get into ketosis. But some people, it can take a whole week.

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