播放最多的片段：阿尔茨海默病在症状出现前20年就开始！现在如何保护你的大脑

你遇到过的最有说服力的研究是什么，能证明运动对预防阿尔茨海默症和大脑健康至关重要？

What's the most compelling study you've ever encountered that proves that exercise is central to Alzheimer's prevention and brain health?

当我们看所有数据时，会发现投资回报率最大的是抗阻训练。

When we look at all of the data, we can see that the biggest amount of return on investment is from resistance training.

抗阻训练是指？

Resistance training being?

力量训练。

Strength training.

最有说服力的研究之一可能是SMART试验，他们让一组轻度认知障碍的人每周进行两到三次抗阻训练。

One of the most compelling studies was probably the SMART trial, where they took a group of people with mild cognitive impairment and gave them two to three times per week of resistance training.

他们不仅保持了认知功能，还提高了处理速度，增强了流体智力，并且减缓了灰质的萎缩。

And they not only preserved their cognitive functions, they enhanced their processing speed, they enhanced their fluid intelligence, and they had slowing of the gray matter.

灰质？

The gray matter?

对。

Yeah.

所以你的大脑由灰质和白质组成。

So your brain consists of both gray and white matter.

灰质是位于大脑外层部分的细胞体。

So gray matter are the cell bodies that lives on the outer side, outer portions of your brain.

而白质位于大脑深处。

And the white matter is deep within the brain.

那里是所有有髓神经元所在的地方。

And that's where all of our myelinated neurons live.

随着时间推移，我们可能会在大脑白质中出现小病变。

And over time, we see that we can have little lesions in the white matter of the brain.

所以很多时候，人们会问我，史蒂文，我很害怕。

So a lot of the times, will ask me, Steven, I'm scared.

我母亲患有阿尔茨海默病。

My mother had Alzheimer's disease.

我担心自己也会得这个病。

I'm scared I'm going to get it.

我们之前聊过遗传因素。

And we were talking about genetics before.

还有一个我们没提到的遗传风险因素。

And there's another genetic risk factor that we didn't talk about.

APOE4基因是阿尔茨海默病最强的风险因素之一，但并不意味着你一定会得病。

The APOE4 gene is one of the strongest risk factors of getting Alzheimer's disease, but it is not a foregone conclusion that you're going to get it.

克里斯·海姆斯沃斯就做了检测，他有两个这种基因。

So Chris Hemsworth was tested, and he has two copies of this gene.

你从妈妈那里得到一个，从爸爸那里得到一个。

So you get two copies, one from mom, one from dad.

这个基因叫载脂蛋白E基因。

It's the Apolipoprotein E gene.

它有三种主要变体。

And it comes in three main variants.

分别是APOE2、APOE3和APOE4。

So you've got apo e two, apo e three, and apo e four.

所以我是3/3型携带者。

So I'm a three three carrier.

我做过检测，这是普通人群最常见的类型。

I've been tested, And that's the general population.

他们是3/3型。

They're three three.

所以这不会增加我患病的风险，但也不能保护我。

So it doesn't raise my risk of getting the disease, but it also doesn't protect me.

如果你有一个APOE2基因拷贝，它能保护你免受这种疾病。

If you've got a copy of the APOE two gene, it protects you against the disease.

但如果你有一个APOE4基因拷贝，你的风险会增加2到3倍。

But when you have a copy of the APOE four gene, it raises your risk by two to three times.

如果你有两个拷贝，如果你是男性，风险会增加10倍。

If you have two copies of the gene, it raises your risk by 10 times, if you are a male.

这里有个令人沮丧的事情。

Here's the devastating thing.

如果你是女性，携带一个这种基因，你的风险是男性同等情况的两倍。

If you are a female with one copy of the gene, you are at double the risk than your male counterpart.

所以，女性携带一个APOE4基因，风险大约增加六倍；而携带两个，风险增加十五倍。

So one copy of the APOE4 gene for a female raises your risk by about six fold, whereas two copies raises your risk by 15 fold.

那怎么去检查呢？

And how would one go and get checked?

你可以找医生检查APOE4基因。

You can get the APOE4 gene checked out with your doctor.

就是简单的抽血化验。

It's a simple blood test.

关于力量训练，我听你说过腿部非常重要。

On this point of resistance training, I've heard you talk about how the legs are so important.

腿部要有力。

Having strong legs.

拥有强壮的腿部，是预防阿尔茨海默病最重要的工具。

Having strong legs is by far the most important tool in your toolbox for the prevention of Alzheimer's disease.

这一点在我读到一个关于同卵双胞胎的研究时得到了证实，他们的基因完全相同。

And this was made certain to me when I read a study done on identical twins, exact same genetic profile.

研究人员对他们进行了跟踪，做了认知测试和核磁共振。

And they tracked them, and they did cognitive tests and MRIs.

他们跟踪了这些人十年。

And they tracked them over a ten year period.

结果发现，力量更大、腿部力量更强的那个双胞胎，大脑也更大。

And what they found was that the twin who possessed the greatest strength and the most leg power, had a bigger brain.

灰质体积更大。

Larger gray matter volume.

他们保持了认知功能。

They preserved their cognitive functions.

他们在各种认知测试中表现更好。

They, did better on different cognitive tests.

为什么力量训练能增大我的大脑？

Why is resistance training increasing the size of my brain?

抗阻训练对大脑的好处可太多了。

Resistance training does so much for your brain.

首先，我们得想想我们正在进行的这个过程。

The first thing is we have to think about the journey that we're going on.

对吧？

Right?

所以，当你看到所有这些研究时，我想把话说清楚。

So when you look at all of the studies, I wanna make it really clear.

所有研究都表明，要产生抗阻训练对神经的影响，你需要举起大约你单次最大重量的80%。

All of the studies show that in order to produce the neural effects of resistance training, you need to be look lifting at around 80% of your one repetition max.

也就是80%的1RM。

So 80% of one RM.

所以那相当重。

So that's quite heavy.

现在社交媒体上有很多争议。

There is so much controversy on social media right now.

我该举重吗？

Should I lift heavy?

我该举轻的吗？

Should I lift light?

而且单就增肌来说，也就是增加肌肉、肌肉量和肌肉细胞大小，你可以达到那个效果。

And when it comes to hypertrophy alone, so increase in muscles, muscle mass, muscle cell size, You can get there.

男性可以做到。

Men can get there.

女性可以通过举轻重量、高次数来达到，或者通过举大重量、低次数来达到。

Women can get there by lifting light, high reps, or you can get there by lifting heavy and low reps.

这取决于你是谁，以及你有多少时间。

It just depends on who you are and how much time you have.

但具体到大脑，出于几个原因，你应该举重。

But when it comes to the brain specifically, you want to be lifting heavy for several reasons.

第一个是，当我们举重时，当我们真的像这样收缩肌肉时，我们会释放一系列化学物质。

The first one is when we lift heavy, when we literally like, when we contract our muscle like this, we are releasing a whole set of chemicals.

它们叫做肌动蛋白。

They're called myokines.

当它们从肌肉中释放出来，会到达大脑，对我们的认知表现和认知功能有益，还能帮助海马体中新神经元的生长和增殖。

And when they're released from the muscle, they go up to the brain, and they do beneficial things for our cognitive performance, our cognition, and they help with the growth and proliferation of new neurons in the hippocampus.

而海马体是阿尔茨海默病最先受损的部位。

And it's the first thing to go during Alzheimer's disease.

它实际上会萎缩。

It actually shrinks.

它负责存储我们的记忆。

This holds our memory.

这里也是记忆巩固和学习的主要场所，所以短期记忆是这种疾病最先丧失的功能，明白吗？

This is where a lot of our memory consolidation and learning takes place, which is why short term memory is the first thing to go during this disease, Okay?

而且随着年龄增长。

And as we get older.

我们发现，通过结构化和持续的运动，你可以在海马体中生长出新的神经元。

And what we've found is that you can grow new neurons in the hippocampus from structured exercise and consistent exercise.

最大的增长将来自于BDNF，即脑源性神经营养因子。

The biggest growth is going to occur because of BDNF, brain derived neurotropic factor.

这是大脑的一种生长因子，当我们运动时它就会释放出来。

So this is a growth factor for the brain, and it gets released when we exercise.

当我们进行有氧训练、跑步、长距离骑行时，它会大量释放，但进行力量训练时也会释放。

It gets released abundantly when we are doing aerobic training, when we're running, when we're cycling for long distances, but it also gets released when we do resistance training.

现在，关于它有个很棒的事情。

Now here's the beautiful thing about it.

当我们进行力量训练并释放所有这些肌肉因子时，这些肌肉因子是信号分子。

When we do resist resistance training and we're releasing all of these myokines, these myokines are signaling molecules.

它们协同工作。

They work together.

我们有一种叫做鸢尾素的。

So we've got one called irresin.

对吧？

Okay?

那是一种信使分子。

And that's a messenger molecule.

它的作用是帮助BDNF表达。

So what it does is it actually helps BDNF express itself.

当我们释放这种肌动蛋白时，它会进入大脑，穿过血脑屏障，告诉BDNF表达。

So when we release this myokin, it goes into the brain, crosses the blood brain barrier, and it tells BDNF to express itself.

然后BDNF进入海马体，帮助生长新的神经元。

So then BDNF goes in and it helps grow new neurons in the hippocampus.

但我们还有另一种肌动蛋白。

But then we've got another myokin.

比如IL-6，白细胞介素6。

Let's just take IL-six, interleukin six.

它来自白细胞介素家族。

It comes from the interleukin family.

那是什么？

What is that?

抱歉。

Sorry.

白细胞介素家族是一类促炎细胞因子。

The interleukin family is a class of pro inflammatory cytokines.

比如，当我们处于压力之下，或者感染了细菌或病毒时，这些因子就会释放出来。

So these get released when we are under stress or you've got an infection or a virus, for example.

但当我们运动时，白细胞介素-6的作用取决于其所在部位。

But when we exercise, it depends on where the site is, interleukin six.

它不再作为促炎细胞因子，不再引发炎症，而是作为抗炎细胞因子发挥作用。

Instead of acting as a pro inflammatory cytokine, instead of creating inflammation, it acts as an anti inflammatory cytokine.

所以它进入大脑，降低炎症水平。

So it goes into the brain and it lowers inflammation.

事实上，这是最早被研究的肌因子之一，研究表明白细胞介素-6还负责下调肿瘤细胞的生长。

In fact, this is, one of this was one of the, first ever myokines to be studied, and they showed that interleukin six is also responsible for the downregulation of tumor cell growth.

因此，通过肌因子的作用，运动也是一种有效的抗癌干预手段。

So exercise is a potent anticancer intervention as well, by way of myokines.

要避免癌症相关的副作用和阿尔茨海默病的问题，一个人需要做多少运动？

How much exercise does one need to do to avoid the cancer related side effects, but also the Alzheimer's problem?

嗯，每天只需三十分钟的有氧运动就能抑制十三种癌症，其中最显著的是乳腺癌、结肠癌和前列腺癌。

Well, just thirty minutes a day of aerobic physical activity can down regulate 13 types of cancers, and the most prominent ones being breast cancer, colon cancer, and prostate cancer.

所以这三种研究得最多，你通过肌动蛋白的释放获得抗癌效果。

So these three have been studied most, and you get your anticancer effects from the myokine release.

具体来说，当我们运动时，我们会大量释放一种叫做自然杀伤细胞的东西。

So quite specifically, when we exercise, we're getting a robust release of something called natural killer cells.

当这些自然杀伤细胞进入血浆和血液中，它们会到达肿瘤部位，做它们天生就该做的事。

And when we get these natural killer cells into the plasma and into the bloodstream, they go into the tumor site and they do what they were born to do.

它们会杀死肿瘤。

They kill.

所以它们进入肿瘤部位，开始杀死肿瘤。

So they go into the tumor site and they start to kill the tumor.

这就是运动抗癌效果的来源。

And this is where you get your anticancer effects of it.

但你也可以从抗阻训练的抗炎效果和有氧训练的抗炎效果中获得这些好处。

But you can also get it from the anti inflammatory effects of resistance training, anti inflammatory effects of aerobic training.

所以这些肌肉因子非常强大。

So these myokines are really powerful.

事实上，制药公司花费数十亿美元试图在瓶子里复制这些肌肉因子，但他们做不到。

In fact, pharmaceuticals are spending billions of dollars trying to replicate these myokines in a bottle, and they can't do it.

我希望男性和女性都进行大重量训练，因为你的大脑中有一些区域。

I want both men and women lifting heavy because you've got areas in your brain.

就在这片区域，是你的运动皮层。

Right across here lives your motor cortex.

把你的大脑想象成房地产。

Think of your brain as real estate.

你的大脑中有专门用于大重量训练的“房地产”。

There's real estate in your brain reserved for lifting heavy.

所以每次你举起大重量而不是轻重量时，举起大重量需要更多的神经“房地产”。

So every time you lift a heavy weight as opposed to a lightweight, it takes more neural real estate to lift that heavy weight.

所以你举得越重，神经驱动就越大。

So the heavier you lift, the greater the neural drive.

神经驱动越大，对你的大脑就越好。

The greater the neural drive, the better it is for your brain.

如果余生只能做一个动作来保护大脑，而且只能选一个，你会选什么？

If you had to do just one exercise for the rest of your life to protect your brain, and you could only pick one, what would it be?

硬拉。

Deadlift.

为什么？

Why?

如果做对了，硬拉几乎能用到你全身的肌肉，比如竖脊肌。

If done correctly, the deadlift can use almost every muscle in your body, erector spinae.

还有臀肌。

You've got the glutes.

还有股四头肌。

You've got the quads.

甚至还有前锯肌。

You've even got serratus anterior.

还有小腿肌肉。

You've got your calf muscles.

这一个动作能带动这么多肌肉。

There is so much compounding in that one lift.

可能跟杠铃深蹲差不多。

It would probably be comparable to a barbell squat as well.

根据世界卫生组织的说法，我们越来越久坐不动了。

According to the World Health Organization, we're getting increasingly more sedentary.

我们动得越来越少，部分原因是科技。

We're moving less and less, in part because of technology.

但还有一项克利夫兰诊所做的有趣研究，他们提到了那些“活跃的久坐者”。

But also, there was this really interesting study done by the Cleveland Clinic where they talk about people who are active sedentary.

说实话，这让我觉得有点针对我。

And this felt a little bit personal, if I'm honest.

报告说2025年的一项重大发现指出了‘活跃久坐’的危险，就是那些每天锻炼三十到六十分钟，但其余十个小时都坐着的人。

It says a major finding in 2025 found a danger of being active sedentary, which is people who exercise for like thirty to sixty minutes but sit for the remaining ten hours a day.

如果你每天坐超过十个小时，即使你达到了每周的锻炼目标，患心血管疾病的风险也会增加，因为长时间坐着会抑制脂蛋白脂肪酶，而这种酶对燃烧脂肪和清除血液中的葡萄糖至关重要。

If you sit for more than ten hours a day, your risk of cardiovascular disease increases even if you meet weekly exercise goals, because prolonged sitting shuts down lipoprotein lipase, an enzyme essential for burning fat and cleaning glucose from the blood.

看到这个真让人烦，因为我觉得说的就是我。

That's annoying to read, because I feel like that's me.

对，而且久坐本身就是一种病。

Yeah, and being sedentary is a disease.

你可以通过每小时做10个徒手深蹲来改变你的人生轨迹。

You can change the trajectory of your life by doing 10 air squats every hour on the hour.

而且有一项研究显示，如果你每小时做10个徒手深蹲，这可以弥补你久坐的生活方式，因为不幸的是，这就是我们现在的生活。

And there was a study that was done on this that showed that if you do 10 air squats every hour, this can compensate for your sedentary lifestyle because, unfortunately, this is the life we're living in.

我们的日常生活变得越来越久坐不动了。

We are becoming more sedentary in our day to day lives.

我们坐得越来越久。

We're sitting more.

我们出门没那么多了。

We're not going out as much.

小孩子都在玩电子游戏。

There's younger kids, on video games.

他们一直在刷手机。

They're scrolling.

有太多事情都和久坐的生活方式有关，这显然，就像你说的，增加了我们患二型糖尿病、心血管疾病等的风险。

There's so much happening that is involving our sedentary lifestyle, is obviously, like you said, increasing our risk of type two diabetes, cardiovascular disease, etcetera.

你可以

You can

做到。

do it.

这个。

This.

这就对了。

There you go.

做10个这样的动作。

10 of those.

如果你做10个这样的动作，就能抵消30分钟快走的好处。

If you do 10 of those, you can outweigh the benefits of a thirty minute power walk.

每小时吗？

Every hour?

对。

Yeah.

持续多少小时？

For how many hours?

8小时。

Eight.

好的。

Okay.

那我可以在手机上设个闹钟吗？

So I could set an alarm on my phone?

每小时。

Every hour.

就站起来，或者每四十五分钟，站起来做个徒手深蹲。

Just get up, or every forty five minutes, up and do an air squat.

这主要是因为，如果你听说吃东西后血糖会大幅飙升，而降低血糖飙升的最佳方法就是做任何形式的运动。

And this is primarily because if you heard that when you eat, you get a massive spike of glucose, And the best way to bring that glucose spike back down is by doing any form of exercise.

你可以，虽然，出去快跑，或者做个徒手深蹲，把血糖水平降回基线。

You can, albeit, go out and go for fast run, do an air squat, bring that glucose level back to baseline.

那你觉得有氧训练作为预防阿尔茨海默症的措施，你怎么看？

And do you think much about aerobic training as a preventative measure for Alzheimer's?

我热爱有氧训练。

I love aerobic training.

女性在社交媒体上面临一个困境，因为她们接收到的信息太多了。

Women are facing a dilemma on social media because they're being given so much information.

现在有个很大的争议，我到底该不该做二区运动？

There is this huge uproar of should I do zone two exercise or should I not do zone two exercise?

什么是二区运动？

What is zone two exercise?

我们可以把生理状态分成几个区。

So we can think of, physiology in zones.

一区就是我们现在所处的状态。

Zone one is what you and I are in right now.

对。

Mhmm.

对吧？

Right?

二区是下一个级别，通常是指我们以最大心率的60%左右进行锻炼。

Zone two is that next level up, and that's generally when we're looking at exercising at around 60% of our maximum heart rate.

在这个强度下，你可以慢跑，但还能说话，不过会有点喘。

And it's where you can where you're jogging, but you can have a conversation, but where you're huffing and puffing.

当我们运动时，需要产生能量。

When we're exercising, we need to produce energy.

这种能量首先在线粒体中产生。

And that energy firstly starts in the mitochondria.

所以我们需要，所有能量都是这样产生的，我们制造ATP，这样我们才能完成给定的任务。

So we need, all of that energy gets created, we create ATP, and that's how we are able to perform the given task.

一旦我们超出那个区间，进入三区、四区和五区，我们就在线粒体之外的细胞质中产生能量。

As soon as we get out of that zone and we go into zone three, zone four, and zone five, we're producing energy outside of the mitochondria in the cytoplasm.

为了做到这一点，我们通过一种叫做糖酵解的途径快速分解葡萄糖。

And when we're doing that, in order to do that, we're breaking down glucose so fast via a pathway called glycolysis.

其副产品是乳酸。

The byproduct of that is lactate.

然后我们产生乳酸。

And then we produce lactate.

实际上，乳酸是大脑的燃料来源。

And that's actually a fuel source for the brain.

它也是一种肌动蛋白。

It's also a myokine.

所以那就是我们在第三区、第四区、第五区的时候。

So that's when we're in zone three, zone four, zone five.

所以很多女性一直在做第二区训练。

So a lot of women have been doing zone two.

她们一直去健身房。

They've been going to the gym.

她们一直在做第二区训练。

They've been doing zone two.

而我试图推动女性走出第二区，有几个原因。

And I'm trying to push women to get out of zone two for several reasons.

不是因为这对你不好。

Not because it's not good for you.

我认为所有形式的运动都对你有好处。

I think all forms of exercise are good for you.

你动得越多越好。

The more you move, the better.

对吧？

Right?

但咱们说实话。

But let's be really honest.

很多中年人其实都很忙。

A lot of people in midlife are busy.

他们时间不够用。

They're time poor.

男性做二区运动，回报率确实更高。

Men actually get a greater return on investment by doing zone two.

但女性做二区运动，回报率就没那么高。

Women don't get the same return on investment from doing zone two.

所以我一直鼓励女性先练三区、五区，还有四区、五区。

So I'm trying to push women to first work on zone zone three, five, zone four, zone five.

如果她们能坚持做五区运动，每周再做两到三次力量训练。

If they can just do zone five, then do two to three sessions of resistance training a week.

如果还有剩余时间，那就对了。

And if you have time left over, that's right there.

我刚才描述的差不多是四个小时的锻炼。

I've just described around four hours of exercise.

如果还有剩余时间，那就可以进行二区训练。

If you have time left over, then you can work in zone two.

二区训练确实很棒。

Now zone two is great.

如果你要出去长跑，你其实在做很多事情。

If you're going to go out and go for a long run, you're doing many things.

你会分泌大量的BDNF，这是我们需要的。

You are secreting a lot of BDNF, which we need.

它是大脑的生长因子。

It's a growth factor for the brain.

大量血液流入大脑，这也非常好。

You're getting a massive amount of blood that's going into the brain, which is great as well.

它是持续的。

It's sustained.

血液向大脑输送氧气和营养。

Blood delivers oxygen and nutrients to the brain.

你在做很多事情。

You're doing a lot of things.

对吧？

Right?

但你没有做的是对心脏的四个腔室产生全面的影响。

But what you're not doing is having a complete effect on the chambers of your heart.

对我来说，在跑步机上跑五公里和在外面跑五公里，哪个更好？

Is it better for me to do five kilometers on a treadmill or outside?

我认为，对大脑来说，做少量但强度更高的运动更好。

I would say it's better for you, for the brain, to do a smaller amount of exercise and a higher threshold.

因为我记得我在哪里读到过，在外面跑步对大脑更好，因为它能刺激大脑。

Because I I was I think I read somewhere one time that running outside is better for the brain because it stimulates the brain.

当然，你在户外，周围有很多东西。

Of well, you're outside, so you've got so many things around you.

想象一下你的大脑。

Imagine your brain.

我跟你说过，它拥有黄金地段。

I told you, it's got prime real estate.

大脑的每个部分负责不同的功能。

Every part of the brain is responsible for for a different function.

从你看到的到你听到的，你走出去，能看到很多东西。

From what you see to what you hear, you go outside and you can see so many things.

你有向前行走，这有助于你的动力、积极性和多巴胺。

You've got forward ambulation, so that's going to help you with drive, motivation, dopamine.

但你也同时接收声音和感官刺激。

But then you're also taking in the sounds, the senses.

这能降低炎症。

It down regulates inflammation.

所以这样做你还能得到很多其他的好处。

So you get so many other things from doing that.

是的。

Yes.

但是，在户外走五公里和做二十分钟的高强度有氧运动相比，哪个对大脑更好呢？

But five kilometers outside compared to twenty minutes of high aerobic physical activity, What is better for the brain?

我会说第五区训练对大脑更好。

I would say that the Zone five is better for the brain.

第五区训练对你的心脏腔室也有很多好处。

The Zone five training does a lot for the chambers of your heart as well.

现在，我要拿这个。

Now, I'm going to grab this.

我们这里有一个小模型。

We've got a little model here.

我们可以看到有一个左心室。

And we can see that we have a left chamber.

我们有一个右心室。

We have a right chamber.

实际上，心脏有四个腔室。

We have actually four chambers of the heart.

但心脏里有个东西叫心室。

But we have something in the heart called a ventricle.

我们有左心室和右心室。

We've got a left ventricle, and we've got a right ventricle.

左心室将含氧血液输送到全身。

Now the left ventricle delivers oxygenated blood to the entire body.

有趣的是，左心室就像一个肌肉。

It's really interesting because the chamber of the left ventricle is like a muscle.

它负责将血液泵送到全身。

It's responsible for pumping blood to your entire body.

它首先将血液输送到大脑，这意味着大脑是身体最重要的部分。

It first gives blood to the brain, which means it's the most important part of your body.

在给大脑供血之后，血液会流向身体的其他部分。

After it's done giving blood to the brain, it goes through to the rest of the body.

随着年龄增长，我们的动脉会变硬，对吧？

As we get older, we get stiffening of these arteries, okay?

心脏里所有的动脉都会变硬，我们会出现一种叫做左心室肥厚的情况。

Stiffening of all of the arteries in the heart, and we get something called left ventricular hypertrophy.

也就是说，左心室开始变厚。

So that's when the left ventricle, it starts to get thicker.

当它变厚时，就意味着它不再那么强壮了。

And when it gets thicker, that means that we can't it's not as strong.

它不能再像年轻时那样向身体其他部分泵送那么多血液了。

It can't pump a lot of blood as much as it could when it was younger to the rest of the body.

本·莱文医生。

Ben Levine, Doctor.

本·莱文是一位运动心脏病专家，他做了一项具有里程碑意义的研究，这项研究改变了我对第五区训练的看法。

Ben Levine, he's a sports cardiologist, and he did this landmark study which changed how I thought about zone five training.

他找了一组平时不怎么运动的男性。

He took a group of sedentary males.

平均年龄我记得大概在47到55岁之间，也就是50岁左右，他给他们的心脏做了扫描。

Average age I think it was around 47 to 55, so around 50 years old, and he scanned their hearts.

他做了超声心动图，拍了心脏的照片，用尽一切办法，在我刚开始这个方案的时候，看看他们的心脏是什么样子的。

He did echocardiograms, he took photos of the heart, he did everything he could to see when I was first starting the protocol, what does their heart look like?

然后他让他们每周锻炼大约四个小时。

He then subjected them to around four hours of exercise per week.

而且他还做了对比，每周安排一次力量训练。

And that was stratified against he did one resistance training session a week.

其中一次是高强度运动，心率达到最大心率的90%左右，也就是最大摄氧量对应的心率。

One was high intensity physical activity at around 90% of the maximum heart rate, the VO two max heart rate.

然后在这之间，他还安排了一些长时间的运动。

And then in between, he did some long sessions as well.

但这些都是中等强度到高强度的运动，而且持续了两年。

But it was all moderate to rigorous exercise, and that was done over two years.

两年结束后，他发现心脏年轻了二十岁。

At the end of those two years, what he found was that he remodeled the heart by twenty years.

也就是说，他逆转了心脏因年龄带来的影响和缺陷，相当于把五十岁的心脏变成了三十岁的心脏，仅仅通过体育锻炼就做到了。

So he reversed the age related effects and defects of the heart by twenty years, essentially turning the 50 year old hearts into 30 year old hearts, just from physical activity alone.

每周四小时，坚持两年？

Four hours a week for two years?

对，每周四小时，坚持两年。

Four hours a week for two years.

那是什么样的锻炼呢？

And what kind of exercise was it?

他让他们做，比如说，其中一种方案是以最大心率的90%来锻炼。

So he got them to do, like, let's say, for example, one of the one of the protocols was exercising at 90% of your maximum heart rate.

当我们这样做时，通常是为了提高最大摄氧量。

So when we do this, we're generally looking at increasing our VO two max.

你可能听说过最大摄氧量，还有力量，但最大摄氧量是预测全因死亡率的最强指标。

So you've probably heard that v o two max, along with strength, but v o two max is the strongest predictor of all cause mortality.

对吧？

Right?

所以，如果你想提高你的最大摄氧量，并且想获得他那样的心脏变化，你每周只需要做二十分钟的最大摄氧量训练，就能维持你的最大摄氧量，因为从大约三十五岁开始，它每年都会下降。

So if you want to improve your v o two max, and if you wanna get the heart related changes that he did, what you wanna do is you wanna do twenty minutes of v o two max per week just to keep your v o two max because it does decline year on and year out starting at the age of around 35.

我们开始看到最大摄氧量下降。

We start to see a decline in v o two max.

所以如果我们想锻炼最大摄氧量，我们要做的是所谓的挪威四乘四训练。

So if we want to work on our v o two max, we wanna be doing a what we call the Norwegian four by four.

这是提高最大摄氧量的黄金标准。

It's the gold standard of increasing your v o two max.

你要让心率升高到百分之九十到九十五，持续四分钟，然后休息四分钟，重复四次。

So you wanna get your heart rate elevated to 90 to 95% for four minutes on, four minutes off, repeat four times.

那我该怎么做呢？

So how do I do this?

嗯，我实际上每周做两次，因为做得越多越好。

Well, I actually do this twice a week because the more you do, the better.

我是在踏步机上做的。

I do this on a stepper.

我在健身房做这个，把踏步机调到，好像是14档，然后慢慢往上加，在上面坚持四分钟。

I do this at the gym, And I put my stepper onto, I think I'm at like a level 14, and I'm working my way up, and I'm staying on there for four minutes.

然后完全停下来，休息四分钟。

And then I'm having a complete stop and a complete rest for four minutes.

这样重复四次。

And I'm repeating that four times.

对。

Mhmm.

所以在那时候，我不仅让大量血液涌向大脑，这很好。

So what I'm doing in that moment, I'm not just getting a massive shunting of blood to the brain, okay, which is good.

我不仅让大量肌肉因子和外泌体释放到大脑。

I'm not just getting a massive release of myokines and exokines to the brain.

我还在重塑心脏。

I'm also remodeling the heart.

我在抑制肿瘤细胞的生长。

I'm down regulating tumor cell growth.

我在提升我的认知能力。

I'm improving my cognitive performance.

我做的远不止是单纯的运动。

I'm doing so much more than just exercising alone.

所以这就是莱文研究中每周一次的运动，让这些人的心脏逆转了二十年。

So that's once a week in Levine's study that reversed these guys' hearts by twenty years.

是的。

Yep.

你每周做一次。

You do that once a week.

你只需要每周做一次。

You only have to do that once a week.

但他还进行了大约每周两小时、最大心率70%左右的运动，并且还加入了一次力量训练。

But he also did did around 70% of maximum heart rate for around two hours a week, and he also threw in one resistance training session.

所以坚持是关键。

So consistency is key.

我刚刚看了那项研究的一些发现，其中一个令人惊讶的地方是，它表明心脏的逆转有一个生物学上的截止日期。

I'm just looking at some of the findings of that study, and one of the surprising things is it showed that there is a biological exploration date per se for the reversal of the heart.

是的。

Yeah.

而且心脏在65岁之前都保持着可塑性，也就是自我重塑的能力。

And then the heart retains its plasticity, the ability to remodel itself until the age of 65.

如果这项干预是在65岁之后开始的，心脏已经太僵硬，无法通过物理重塑达到那种二十年的逆转效果。

If this intervention had started after the age of 65, the heart was too stiff to be physically remodeled to get to that twenty year reversal.

对。

Yep.

你必须从中年晚期开始。

You have to start in late middle age.

完全正确。

Exactly.

所以中年是大脑健康和长寿的机会窗口。

So midlife is the window of opportunity for brain health and for longevity.

我没想到你居然能自己重塑心脏。

I didn't realize you could sort of remodel the heart yourself.

这挺有意思的。

That's interesting.

是的。

Yeah.

你可以重塑心脏。

You can remodel the heart.

而且心脏很神奇，你知道吗，因为你看主动脉的情况。

And the heart is amazing, okay, because what you see with the aorta.

对吧？

Right?

主动脉向上走，我们有两根主要的脑部供血血管，就是椎动脉。

So the aorta goes up, and we've got we've got two we've got the main blood supply for the brain exists in the vertebral arteries.

对吧？

Okay?

所以，从心脏出来的主动脉会分出椎动脉，它们为大脑后部和 cerebellum 供血。

So there's branching off of the aorta, comes from the heart, vertebral arteries which supply the posterior part of the brain and the cerebellum with blood.

然后还有颈动脉，左右各一条，从主动脉分出，为大脑的前部和中部供血。

And then you've got the carotid arteries, so one on each side branching off the aorta, which supply the, frontal and middle part of your brain with blood.

大脑是全身血管最丰富的器官。

The brain is the most vascular rich organ in the entire body.

在压力大的时候，比如高血压，也就是血压升高，我们可能会损伤最小的血管，也就是毛细血管。

In times of stress such as hypertension, that is elevated blood pressure, we see that we can actually kill off the tiniest parts of the blood vessels, which are called the capillaries.

你可以看到这里的毛细血管。

You can see the capillaries up here.

它们甚至为血脑屏障供血。

They supply even the blood brain barrier.

所以它们主要给大脑的外层皮质供血。

So they supply mainly the outer cortex of the brain with blood.

当血压升高时，我们大脑里那些微小的毛细血管就开始死亡。

When we have elevated blood pressure, we are starting to kill off those tiny little capillaries of the brain.

这些毛细血管为大脑中的不同神经元提供营养，同时也滋养着血脑屏障。

Those capillaries are feeding different neurons in the brain and also feeding the blood brain barrier.

所以当这些毛细血管破裂时，我们就会失去血液供应和氧气，血脑屏障本身也会崩溃，这很可怕，我们在患有轻度认知障碍的病人身上就能看到这种情况。

So when we get breaking off of these, we lose the blood supply, we lose the oxygenation, we get a breakdown of the blood brain barrier itself, which is scary, and we see that in patients who have got mild cognitive impairment.

你听说过肠漏症，我们可以称之为脑漏。

You've heard of leaky gut, we can call it leaky brain.

如果你有脑漏，最终会发生什么？你的血脑屏障就像这样。

If you have a leaky brain, what happens eventually is so your blood brain barrier sits like this.

明白吗？

Okay?

那里有细胞，比如我们称之为寄生虫的，它们通过紧密连接结合在一起。

And there are cells, and we call them parasites, for example, and they're bound together by tight junctions.

这就是血脑屏障。

That's what the blood brain barrier is.

你可以把血脑屏障想象成夜总会的保安。

It's like a you think of the blood brain barrier as the bouncer of a nightclub.

他们就像这样站在那里，负责决定谁能进谁不能进，有些分子是不让进的。

They are all standing there like this, responsible for who can come in and who can't, and they don't allow some molecules to get in.

但随着时间的推移，当它开始退化、变得渗漏时，他们就开始散开。

But over time, when this starts to degrade and become leaky, they start to spread apart.

一旦散开，所有这些分子就会被动扩散进来，这对大脑非常有害。

And when they do, you can have the passive diffusion of all these molecules coming in, and that's really bad for your brain.

所以我们要通过保持毛细血管的健康来维护血脑屏障的完整性。

So we want to maintain the integrity of the blood brain barrier by maintaining the capillary health.

我们不想让毛细血管死亡。

We don't want the capillaries to die.

它们只有一层细胞那么厚。

They're one cell thick.

任何损伤都可能伤害它们，甚至导致它们死亡。

Any type of damage can damage them and kill them.