重播最多时刻：饮酒是否存在安全量？酒精对身体的影响揭秘！

所以是酒精。

So alcohol.

是的。

Yes.

我的意思是，酒精经历了一段历程。

There's I mean, alcohol's been on a journey.

是的。

Yes.

它在社会对它的看法方面经历了一段变化。

It's been on a journey in terms of society's opinion about it.

嗯。

Mhmm.

你能带我回顾这段历程，告诉我我们现在处于什么阶段吗？

Can you take me on that journey and tell me where we are now?

当我这么说的时候，我指的是社会对酒精健康益处及其本质的看法。

And and in turn when when I'm saying that, I'm talking about society's opinion on its health benefits and what it is.

而且我们现在对酒精的理解也存在误区。

And and then and then also what we're getting wrong now about alcohol.

是的。

Yeah.

对。

Yeah.

所以，酒精的演变历程非常引人入胜。

So, I mean, the journey of alcohol is fascinating.

首先，我认为人们觉得这是相对现代的现象。

So first, I think they think of this as a relatively modern thing.

但考古学家已经发现，早在13000年前的狩猎采集者洞穴中，就有酿造啤酒的设备。

But, you know, archaeologists have discovered, like, beer making equipment in hunter gatherers' cave dwellings from 13,000 years ago.

这太惊人了。

That's wild.

也就是说，13000年前的人们就已经懂得如何酿造啤酒了。

Like, 13,000 of people figuring out how to make beer.

你知道吗，九千年前的中国就是这样。

You know, you look at China nine thousand years ago.

那时候，酒精更多是一种精神上的体验或社交活动。

It was really about, like, a spiritual journey or a social thing.

它从来就不是为了健康。

It was never really about health.

但在某个时候，我们开始把它说成对健康有益的东西。

At some point, we started talking about this as something that is good for your health.

比如，喝红葡萄酒。

Like, drink red wine.

它能改善你的健康。

It's gonna improve your health.

我认为我们在这里犯了错误。

And that's where I think we got wrong.

而原因其实来自于我们对数据的解读方式。

And the reason why was actually from how we were looking at the data.

首先，如果你只看某一种健康状况，确实有一些健康问题在适量饮酒的情况下反而会改善。

So first, if you look at only one health condition, there are some health conditions where a moderate amount of alcohol actually improves your health.

但这也与人们进行研究的方式有关。

But it was also how people were conducting with studies.

在大多数这些研究中，人们会选取一个庞大的群体，数以万计的人，收集他们报告的饮酒量数据。

So in most of those studies, what people do is they take, like, a massive population, tens of thousands of people, where we have some data where they're reporting how much alcohol they used.

然后我们观察这些人随着时间推移的健康风险。

And then we look at health risks over time.

科学家们会把人群分为非饮酒者、轻度饮酒者、中度饮酒者和重度饮酒者几类。

And scientists would lump people into sort of nondrinkers versus light drinkers, moderate drinkers, heavy drinkers.

他们发现，即使是中度饮酒的人，健康状况也比完全不饮酒的人更好。

And what they're finding is that people who are drinking in the even up to the moderate level were actually doing better than the people who weren't drinking at all.

因此，这种‘饮酒有益健康’的观点就由此产生了。

And so that was where that concept that drinking is good for your health came from.

于是人们谈到这种现象时，会用一个‘J形曲线’来形容，意思是中度饮酒者患健康问题的风险实际上更低。

And so people talk about this, like, j shaped curve, meaning that moderate drinkers actually have lower risks of health problems.

而只有当你开始饮用非常高的量时，才会比完全不喝酒的人面临更高的健康风险。

And then it's really only when you start drinking very high levels that you start having more risk of health problems than people who don't drink at all.

他们意识到的问题在于，那些完全不喝酒的人中，很多人不喝酒是因为他们本身由于其他原因已经非常不健康。

What they realize is wrong with that is that in the people who don't drink at all, many of those people are not drinking because they're actually really unhealthy for another reason.

比如，他们可能患有心力衰竭，因此不想喝酒，以免与药物产生相互作用。

Like, they might have heart failure, and they, like, don't wanna drink because they don't want it to mix with their medication.

或者他们可能有酒精使用障碍史，目前正在康复中。

Or they might have had a history of alcohol use disorder, they're actually in recovery.

所以他们已经因酒精造成了一些损伤，因此才选择不喝。

So they've already had some damage from alcohol, and they are not drinking because of that.

因此，当你改变对照组时，实际上会把比较对象从完全不喝酒的人，改为几乎从不喝酒的人。

And so when you change the reference group, you actually make the the sort of group that you compare people to to people who very rarely drink.

所以他们并不是完全不喝酒，而是只喝非常非常少量的酒。

So it's not that they're not drinkers at all, but they drink, you know, very, very light levels.

这样一来，你就会发现酒精的那些健康益处消失了，尤其是当你综合考虑所有健康状况时。

Then you start to see that those, like, health benefits of alcohol go away, especially if you look across all conditions.

你是说酒精没有任何健康摄入量吗？

Are are you telling me that there's no healthy level of alcohol consumption?

是的。

Yes.

我从不会说喝酒对健康有益。

I would never say drinking alcohol is good for your health.

这并不意味着，在我们所谓的低风险水平下饮酒，不能成为健康生活方式的一部分。

That doesn't mean that drinking at what we call low risk levels can't be a part of a healthy lifestyle.

所以，这只是一个小小的转变，别误以为喝一杯葡萄酒就像锻炼了三十分钟。

So it's a slight slight shift that, like, don't fool yourself into thinking that drinking that glass of wine is like going to exercise for thirty minutes.

它并不是能促进你健康的东西。

Like, it's not something that's gonna promote your health.

我更倾向于把它看作吃甜点、吃培根、晒太阳。

I think of it more like having dessert, eating bacon, going out in the sun.

这些活动都有相应的风险。

There are risks associated with all those activities.

这并不意味着我会说你永远不能做这些事，但你需要了解其中的风险，然后为自己做出选择。

It doesn't mean that I would say you can never do any of that, but you need to understand what the risks are and then make choices for yourself.

所以我看着这杯葡萄酒和这杯啤酒。

So I look at this glass of wine here and this pint of beer.

是的。

Yep.

如果我每天喝一杯这样的酒，量不大，我认为人们通常会想，反正只有一杯。

If I drank one of these a day, not a huge amount, I think what people tend to think is they think, well, it's only one.

对。

Yeah.

所以我的身体会把它代谢掉，不会有任何健康危害。

So my body will just flush it out and there'll be no adverse health consequences.

是的。

Yep.

这是真的吗？

Is that true?

问题是，我们通常认为的一杯酒到底是什么量。

Well, so part of the challenge is what we think of as one drink.

就像你学会重新审视食品的份量一样，你会发现，一份冰淇淋其实只有半勺。

So I think, much like, you know, if you learn to re read the serving size on a food, you realize that, like, oh, a serving of ice cream is like a half a scoop.

而不是一大份圣代冰淇淋。

It's not like a giant ice cream sundae.

酒精也是如此。

The same is true with alcohol.

在英国，低风险饮酒指南中提到的是酒精单位，相当于8克酒精。

So in The UK, the kind of low risk drinking limits talk about units of alcohol, which is the equivalent of eight grams of alcohol.

那么，多少酒含有8克酒精呢？

So how much of a drink has eight grams of alcohol?

要处于低风险类别，你每天的酒精摄入量必须低于14个单位。

And to be in that low risk category, you have to be below 14 units.

问题是，光是看一眼那杯葡萄酒，它的酒精含量就已经有好几个单位了。

The problem is that glass of wine, just eyeballing it, has several units of alcohol.

所以，尽管我们把它当作一杯酒，但实际上，我得猜一下，它可能大约有三单位酒精。

So it is not a even though we think of it as a single drink, it's probably I mean, I have to guess, but it's probably like three units of alcohol.

所以如果我每天喝一杯葡萄酒，就会超过这个限制吗？

So if I have a glass of wine every day, I'll be over that limit then?

你正好处于这个上限。

You'd be right at that limit.

问题是，大多数人不会只喝一杯。

The problem is most people don't drink just one glass.

如果你某天喝了两杯，另一天喝了一杯，又因为参加社交活动而某天喝了三杯，那你实际上已经远远超过了这个限制。

If you, you know, if you have two glasses one day, and then one glass one day, and then three glasses one day because you're at a social function, all of a sudden, you're actually quite a lot over that limit.

所以如果你说这大约是三单位，而且

So if you said that this this is roughly three units, And

你每周可以有十四单位。

you get 14 a week.

你每周可以有十四

You get 14 a

每周。

week.

是的。

Mhmm.

所以三乘七。

So three times seven.

是的。

Mhmm.

二十一。

21.

对。

Yep.

所以是的，如果你喝这种量，就超了。

So yes, you're over if you're drinking that size.

对。

Yep.

好的。

Okay.

所以如果我每天喝一杯葡萄酒，那我就超过了英国的什么饮酒标准？

So if I have this glass of wine every day, then I'd be over The UK limit of?

低风险饮酒。

Lower risk drinking.

低风险饮酒。

Lower risk drinking.

那我就属于中等风险饮酒。

So I'd be medium risk drinking.

你会属于我们所说的中等风险饮酒，这与几乎所有类型的癌症都有关联，我想很多人并不知道。

You'd be in what we call moderate risk, which is associated with pretty much every form of cancer, which I think people don't know.

好的。

Okay.

因为我一直好奇为什么癌症发病率在上升。

Because I was wondering why cancer has been increasing.

是的。

Yes.

多种不同类型的癌症一直在增加。

A variety of different forms of cancer have been increasing.

乳腺癌是我们经常听说的在增加的癌症之一。

Breast cancer is one of the ones we always hear about that's increasing.

所以你的意思是，关于低风险或中等风险饮酒与癌症的数据是什么？

So you're saying, what is the data in terms of low or moderate risk of drinking and cancer?

对。

Yeah.

数据显示，情况正在恶化，令人担忧。

So the data is growing and really worrisome.

对于乳腺癌，有一些癌症即使在低风险限量下，风险也开始上升。

So for breast cancer, there's a few cancers that even at low risk limits, you see the risk begin to increase.

所以我们说，甚至不存在一个安全的低风险饮酒量。

So where we would say there's no even low risk amount.

所以乳腺癌和食管癌就是两个例子。

So breast and esophageal cancer are two examples of that.

以乳腺癌为例，如果你饮酒量低于这些低风险标准，在美国就是少于七杯，但美国的一杯是五盎司葡萄酒，实际量更少。

So breast cancer, if you were to drink below those low risk limits, so in The US, that would be fewer than seven drinks, but a drink in The US is five ounces of wine, which is smaller than that.

而在英国则是低于14个单位，也就是说，你喝的这种尺寸的葡萄酒少于七杯。

Or in The UK is below that 14 units, so it would be, you know, fewer than seven of that that size glass of wine.

我们仍然观察到乳腺癌风险有轻微上升。

We still see a slight increase in the risk of breast cancer.

大约增加了百分之五。

It's about a five percent increase.

这意味着你的乳腺癌风险会增加约百分之五。

So that means your risk of breast cancer would increase by about five percent.

但这并不算很大。

Now that's not huge.

所以我觉得百分比增长这种说法，计算起来有点难。

So I think percent increase is kind of hard to do the math on.

但如果你考虑美国的情况，例如，女性一生中患乳腺癌的概率约为13%。

But if you think in The US, for example, the average woman has a thirteen percent likelihood of getting breast cancer in their lifespan.

13%的概率？

Thirteen percent likelihood?

真的吗。

Really.

哇。

Wow.

真的很高。

Really high.

所以增加百分之五，就会让这个概率上升到大约13.6%。

So five percent increase would increase that to like thirteen point six or so.

这意味着，如果这个房间里有九位女性，从概率上讲，其中一位将会患上乳腺癌。

So that means that if there's nine women in this room, one of them is going to get breast cancer probabilistically.

在她们的一生中，是的。

In their life, yep.

天啊。

Damn.

为什么会出现这种情况，而且还在上升？

Why is it and it's increasing.

是的，造成这种现象的原因很可能是环境因素，因为你的基因在这一时期并不会改变。

Yeah, and so the reasons for that are likely environmental because your genes don't change over that time period.

所以，如果我们考虑乳腺癌的风险因素，包括饮酒、肥胖、生育年龄（是否生育），因为这是一种受激素影响很大的癌症。

So the risk factors, if we think about breast cancer, it's alcohol, it's obesity, it's age when you have children or don't have children, because it's a really hormonally driven cancer.

如果你考虑结肠癌，情况也是一样。

Same thing if you think about colon cancer.

这非常可怕，因为我们看到越来越多的年轻人患上这种病。

That's a really scary one, where we're seeing more and more cases in younger people.

其中一些诱因是吃肉。

Some of the drivers of that, eating meat.

加工肉类会增加你患结肠癌的风险。

So processed meats increase your risk of colon cancer.

所以这些非常普通的日常行为。

So these very sort of normal behaviors.

事实上，可能还有其他我们尚未能测量的环境因素，毕竟加速的速度太快了。

There's probably other environmental things, honestly, that we're not yet measuring or able to measure, just given the rate of acceleration.

当我跟我的同事——肿瘤科医生们交谈时，你知道的，像塑料或其他我们还不了解的东西，显然环境中有一些因素在推高这些癌症风险。

When I talk to my colleagues who are oncologists, you know, things like plastics or other things that we don't yet know, there's it's clearly something in the environment that is driving these increased cancer risks.

所以即使在这个层面上，如果我喝酒，那可能就是一单位。

So even at even at this sort of level, if I'm drinking, that might be one unit.

对吧？

Right?

是的。

Yes.

所以那算作一单位。

So would be one unit.

因此，你每周的摄入量应少于14单位。

So you that would be fewer than 14 of that.

所以你可以想象，如果你喝双倍的量，那就是一杯像样的葡萄酒了。

So you could see, like, an you know, if you had double that, it would be a decent pour of wine.

为了保持低风险，你一周内不能超过七杯这样的酒。

You could not have more than seven of those in a week to be in low risk.

但即使喝这么多，你的乳腺癌风险也会略微上升。

But even drinking that amount, your risk of breast cancer would go up a little bit.

即使这么点量也会？

Even this amount?

在乳腺癌方面，实际上根本没有安全的酒精摄入量。

There's really sort of no safe amount of alcohol when it comes to breast cancer.

只是乳腺癌吗？

Is it just breast cancer?

这个低风险类别指的是，当这些大型癌症研究将人们划分为低风险、轻度饮酒者、中度或重度饮酒者时。

So that low risk category, so when these big cancer studies categorize people as sort of low risk or light drinkers, moderate or heavy.

而对于几乎每一种癌症，一旦进入中度饮酒类别，我们就开始看到风险上升。

And for pretty much every cancer, once you get to the moderate category, we start seeing increases.

这被称为剂量反应关系。

And there's what we call a dose response relationship.

你喝得越多，患癌的风险就越高。

So the more you drink, the higher your risk of cancer.

只有少数几种癌症的风险即使在极低饮酒量下也会增加，乳腺癌就是其中之一。

There's only a few cancers that the risk seems to increase even at that very low level, and breast cancer is one of those.

食管癌也是其中之一。

And then esophageal cancer is one of those.

因此，有些癌症即使少量饮酒也会增加你的风险。

So there are certain cancers where even a small amount of alcohol will increase your risk.

这会影响男性常见癌症的风险吗？

Does it have an impact on thinking about cancers that are prominent in men?

是的。

Yeah.

结直肠癌，我们在许多年轻男性中都观察到了。

So colon cancer, we're seeing that in a lot of young men.

肝癌，是的，前列腺癌，这显然是男性癌症，我们通常不认为它与酒精有很强的关联，但大多数癌症之所以风险增加，是因为酒精影响癌症风险的方式并不局限于某个特定器官，除了肝脏。

Liver cancer, Yeah, prostate cancer, which is obviously a male cancer, we don't think of as much as being sort of an alcohol sensitive cancer, but most cancers, because the way alcohol impacts your risk of cancer is not really on a specific organ outside of the liver.

它真正影响的是我们的DNA。

It's really about how it changes our DNA.

它涉及炎症和所谓的活性氧物质，这些物质会改变我们的细胞，随着时间推移增加突变并导致癌症的风险。

So it's about inflammation and what are called reactive oxygen species that sort of change our cells and increase the risk over time of the mutations that lead to cancer.

所以，是的，你能详细解释一下吗？

So, yeah, can you drill down on that?

所以如果我是个重度饮酒者，比如说我每天喝两杯葡萄酒，这大概算是，如果我每天喝两杯的话。

So if I if I'm a heavy drinker, so say that I'm drinking let's say I'm drinking two glasses of wine a day consistently, which I guess would cons like, if I was drinking two

这两杯的话，是的，你就属于重度饮酒者了。

of those then glasses, yeah, you'd be in the heavy category.

每天两杯就让我归入了重度饮酒者类别。

So two of those a day puts me in a heavy drinker category.

这

Which

这会让大多数人感到惊讶。

would surprise most people.

对吧？

Right?

对很多人来说，这非常正常。

Like, that, for many people, is very normal.

这确实很常见。

It is very normal.

是的。

Yeah.

我认为年轻人更难理解这一点，因为年轻人喝酒较少。

I think it's some somewhat more difficult for younger people to understand because younger people drink less.

但若我想想比我年长的一代人，每天喝两杯葡萄酒是很正常的。

But if I think about the generation above me, having two glasses of wine a day is quite normal.

下班后、周末，甚至每顿饭都会喝。

After work, on the weekends, with with every meal that you have.

那我会被算作重度饮酒者。

So that would make me a heavy drinker.

而且

And

那么统计数据对我的癌症风险有什么说法？

then what are my what are the stats saying in terms of my cancer risk profile?

是的，不同癌症类型的情况不同，但大致来说，癌症风险会增加约百分之四十。

Yeah, so it varies by cancer, but roughly we're talking like a forty percent increase in cancer, depending on the cancer type.

你喝得越多，风险就越高。

The more you drink, the more that's going to go up.

这些是基于大规模人群的科学研究，并不精确反映你个人的情况。

So, these are scientific studies where it's not precise to you as an individual.

但毫无疑问，你喝得越多，风险就越大。

They're based on large populations, but definitely the more you drink, the greater the risk.

那如果我还有其他所谓的合并症呢？

And then if I have other sort of do they call them comorbidities?

是的，没错。

Yeah, exactly.

所以其他疾病，我身体里的其他病症，如果我超重，我的患病概率还会进一步增加。

So other illnesses, other diseases in my body, my probability is going grow further from obese if I'm overweight.

没错，你吸烟。

Exactly, you smoke.

酒精在癌症中的一个主要作用机制是，它会让你更容易受到烟草致癌效应的影响。

So one of the main drivers of alcohol too in cancer is that it actually makes you more susceptible to the cancer causing effects of tobacco.

所以如果你既喝酒又吸烟，你的癌症风险会更高。

So if you drink and smoke, your risk of cancer is going to be even higher.

这是怎么发生的？

How does that work?

据推测，以食管癌为例，在细胞层面，酒精会让你更容易受到烟草中致癌物的影响。

The thought is if you take esophageal cancer at the cellular level, it makes you more susceptible of the carcinogens, which are kind of the cancer causing compounds, and tobacco.

因此，风险并不是简单的相加，而是几乎呈倍数增长，癌症风险大幅上升。

And so rather than just seeing an additive risk, you actually almost get a multiplied risk in terms of the risk of cancer.

所以吸烟和肥胖是另外两个主要因素。

So smoking and then obesity is the other big one.

很多癌症的风险会随着你的体重增加而上升。

So a lot of cancers, your risk goes up if you're if you're, you know, have an increase in your body mass.

那么身体里发生了什么？

What's going on in the body then?

如果我喝酒，这怎么会导致癌症？

If I drink alcohol, how is that leading to cancer?

你刚才稍微提到了一点，但我希望确保自己完全明白其中的连锁反应，以及这最终是如何导致癌症的。

You referenced it slightly there, but I'm trying to I want to make sure I'm clear of my brain as to what the knock on effects are and how that ends up as cancer.

是的。

Yeah.

我的意思是，有多种不同的机制。

I mean, there's lots of different mechanisms.

所以也许我们先从酒精在体内起什么作用说起？

So maybe starting just with what does alcohol do in your body?

你摄入酒精。

So you ingest alcohol.

它的专业名称叫乙醇。

The fancy name for that is ethanol.

它是一种分子，基本上会很快被胃吸收。

It's a molecule, and it basically gets absorbed pretty quickly from your stomach.

因此，喝完酒后大约十分钟内，酒精就会进入你的血液。

And so it hits your bloodstream usually within ten minutes or so of having a drink.

酒精进入血液的量取决于你体内含水量的多少。

How much it hits your bloodstream depends on how much water you have in your body.

酒精不会渗透到脂肪中。

So alcohol doesn't penetrate into your fat.

它只是在你身体的含水部分扩散。

It just kind of diffuses into the water parts of your body.

因此，很多女性在摄入较少酒精时就会比男性更容易醉或产生更强的效果，因为女性的体脂率通常高于男性。

So that's actually why for many women, they will get more sort of drunk or more of an effect from alcohol at a lower level than men because women have more body fat than men.

但这取决于你个人的情况。

But that's gonna depend on you as an individual.

如果你体脂率更高，那么酒精的影响也会不同。

If you have more body fat, you're gonna have a different impact.

酒精进入你的血液。

So alcohol gets in your bloodstream.

酒精能立即穿过我们所说的血脑屏障，因此会立即影响你的大脑。

Alcohol can instantly cross across what we call your blood brain barrier, so it impacts your brain instantly.

这就是为什么许多人最初会感到愉悦：变得放松、更爱社交、焦虑感减轻一些。

And that's where you feel the initially pleasurable effects for many people of feeling a little relaxed, feeling more social, feeling a little bit, you know, less anxiety.

如果你继续饮用，血液中的酒精浓度持续上升，就会开始出现判断力下降。

If you keep drinking and that level keeps going up, then you start having impaired judgment.

你可能会出现运动协调能力下降。

You might have motor lack of motor coordination.

我们都见过这种情况，很多人可能都亲身体验过。

So we've all seen this, many people have probably experienced it.

你知道，你可能会步履蹒跚，无法安全驾驶。

You know, you may be stumbling, not able to drive safely.

如果你继续喝酒，你就不会做出平时清醒时会做的决定。

You're not gonna make the same decisions you would make if you weren't drinking.

如果你继续喝下去，可能会真的失去意识，昏过去，很多人都经历过这种情况。

And then if you keep drinking, then you get you can actually lose consciousness, so pass out, and people have experienced that.

你的身体会尽可能快地分解酒精。

Your body is gonna try to break down alcohol as quickly as it's able to.

就像其他任何东西一样，我们希望排出任何异常物质，恢复正常的生理功能。

Like anything, we wanna kinda excrete any abnormality and get back to our normal functioning.

这个过程主要发生在肝脏，这就是为什么肝脏对酒精如此敏感。

And so that process happens mostly in your liver, which is why the liver is so sensitive to alcohol.

因为你的身体把乙醇视为毒素。

Because your body sees ethanol as poison.

是的。

Yes.

我的意思是，我知道你之前提到过这个，医生。

I mean, you know, I know you talked about this, Doctor.

莱姆克，但你的身体总是想要恢复所谓的稳态。

Lemke, but your body always wants to restore what's called homeostasis.

你的身体始终会努力回到它认为的正常状态。

You're always your body's always gonna fight to get back to what it feels its normal is.

因此，乙醇并不应该存在于你的血液中。

And so ethanol is not something that belongs in your bloodstream.

你的身体会尽可能快地将其排出。

Your body's gonna try to excrete it as fast as it can.

然后它会将乙醇转化为一种叫做乙酸盐的物质，你可以通过排尿和呼吸将其排出体外。

And then it converts it into something called acetate, then you can pee that out and breathe that out and get rid of it.

因此，要消除体内的酒精，你必须经历这个过程。

So to eliminate the alcohol in your body, you have to go through this process.

而这个过程的一部分包括一种有毒分子，它会在体内游荡并损伤你的细胞。

And part of that process includes this toxic molecule that's gonna be floating around and causing damage to your cells.

所以，这是酒精导致癌症的一种方式。

So that's one way that alcohol can cause cancer.

另一种则是普遍的炎症。

The other is just general sort of inflammation.

人们可能已经听说过，炎症对身体有害，并会增加患癌风险。

People have probably heard that inflammation is just not good for the body and increases the risk of cancer.

而酒精在被排出体外的过程中会产生大量这种炎症。

And alcohol generates a lot of that inflammation in the process of getting eliminated.

因此，它实际上会改变你的细胞，长期下来可能引发癌症。

And so it can actually change your cells that over time, that can to cancer.

所以我还找到了这张图表，它向那些目前看不到我们所描述内容的人展示了肝病、死亡率以及整体肝病与其他身体部位的加速对比。

So I also found this graph, which shows for anyone that can't see what we're describing at the moment, it shows the acceleration in liver disease, death rates and general liver disease compared to other parts of the body.

是的。

Yep.

身体的其他器官，我认为它显示了。

Other organs in the body, I believe it shows.

是的。

Yep.

酒精对肝脏有什么影响？

What impact does alcohol have on the liver?

我们这里有个小人偶，用来展示人体肝脏的位置在哪里？

And we have our little mannequin here of Where the human is the liver?

对。

Yeah.

好问题。

Great question.

这是我们的小人偶。

So here's, our little mannequin.

为了让大家更好地了解人体结构，我们现在看到的是体内的内部情况。

So just to orient people to the body, so we're looking at the inside of the body.

所以肋骨和皮肤外层都已经被移除了。

So like the ribs are gone, the outside of the skin is gone.

这两个粉红色的器官是肺。

These two pink things are the lungs.

它们大致包裹着心脏。

They kind of encase the heart.

你可以看到心脏在肺后面，泵送着血液。

You can see the heart's behind the lungs pumping your blood.

肝脏是一个棕褐色的器官。

The liver is this brownish organ.

它位于你身体的右侧，就在肋骨下方。

It's on the right side of your body, right under your ribs.

它相当大。

It's quite large.

它

It's

很大。

it's big.

一个了不起的器官。

An amazing organ.

它相当大。

It is quite big.

它处理我们摄入的大部分物质，包括毒素、食物、葡萄糖和酒精。

It processes much of what any kind of toxins that we take in, things that we eat, your glucose, alcohol.

其中90%都是由肝脏代谢的。

90% of it's metabolized by the liver.

因此，肝脏就像是一个清理中心，负责清除体内的代谢废物。

So the liver is sort of the clearinghouse, getting rid of byproducts in your body.

其他器官是肾脏，但肝脏在酒精代谢中起着至关重要的作用。

The other are the kidneys, but the liver plays a huge role, especially in alcohol.

所以它就位于这里。

So it sits right here.

它看起来几乎和一个肺一样大。

It almost looks like it's as big as the lung, as one lung.

是的

Yeah.

对

Yeah.

它

It

是的

is.

是的

Yeah.

真的吗？

Really?

是的

Yeah.

它是一个巨大的器官，而且是一个奇妙的器官。

It's it's a giant organ, and it's an amazing organ.

所以你实际上可以切除肝脏的百分之八十，它会自行再生。

So you could actually cut out eighty percent of the liver, and it would regrow itself.

就像那些蜥蜴，你把它们的尾巴切掉，它们还能再生出一条新尾巴。

So kinda like, you know, those lizards that you cut off their tail and they regenerate a tail.

肝脏非常神奇。

The liver is fascinating.

这就是为什么我们可以进行活体肝移植。

It's why we can do living liver transplant.

所以我可以取走你一半的肝脏，移植给需要肝脏的人。

So I could take half of your liver and give it to someone who needed a liver.

你依然能正常生活，而他们则能靠你提供的这部分肝脏重获新生。

You would still be able to live, and they would get a second chance at life from that part of your liver.

这是一个非常神奇的、能够再生的器官。

So it's this really cool organ that can regenerate.

但它只能再生到一定程度。

But it can only regenerate up to a point.

一旦你的肝脏中积累了大量瘢痕组织，我们就称之为肝硬化，这时你就达到了一个不可逆转的临界点，肝脏无法再自我修复。

So once you get to a level where you have a lot of scar tissue in your liver, we call that cirrhosis, you sort of reach a point of no return where at that point, the liver can't heal itself.

所以我常这样想，用烘焙来打个比方：你正在做松饼或蛋糕，一边混合所有原料，突然意识到——哦，我忘了加鸡蛋。

So I sort of think of it like, to use a baking analogy, if you're making muffins or a cake, you're going along, you're mixing all your ingredients, and you realize before you put things in the oven, like, oh, I forgot the eggs.

你还可以把鸡蛋加进去，重新搅匀，这样问题不大，还能做成。

You can still add the eggs in and, like, whisk it all together, it's gonna be okay.

但如果松饼已经在烤箱里烘烤了，你才想起忘了加鸡蛋，那就没法再把鸡蛋倒上去，让面糊恢复原状了。

If the muffins are baking in the oven and you forgot the eggs, you can't, like, pour the eggs on top and make the the batter the same.

肝脏的情况也类似，在一定程度内，你其实完全可以修复酒精、肥胖等带来的损伤。

And the liver's sorta like that, that up to a certain degree, you can actually completely repair the effects of things like alcohol or obesity, other things.

但一旦进入瘢痕组织阶段，肝脏就再也无法再生了。

But once you pass that point into scar tissue, the liver can't regenerate anymore.

因此，当你看到这组数据或肝病发病率持续上升时，肝病的主要诱因是肥胖，其次是酒精。

And so when you think about that graph or just the rising rates of liver disease, the main drivers of liver disease are obesity and two is alcohol.

而这两者正是导致肝移植的最主要原因。

And so those are the leading causes of liver transplant.

最令人难过的是，我在医院工作时经常看到这种情况：越来越多的年轻人因肝衰竭入院。

And the thing that is so sad is, I mean, I see this all the time working in the hospital, first of all, we're seeing younger and younger people coming in and liver failure.

二十多岁的人因为酗酒而出现暴发性肝衰竭，最终在医院去世。

So people in their 20s coming in and fulminant liver failure from alcohol and then dying in the hospital.

更糟糕的是，他们往往根本不知道这些行为正在损害他们的健康。

And the terrible thing is that they often didn't even know that this was causing a problem in their health.

等他们被送到医院时，已经病得太重，为时已晚。

And by the time they get to the hospital, they're so sick, it's too late.

但所有这些本都可以通过及早发现而预防，甚至逆转。

And yet all of that could have been prevented or even repaired if it was caught sooner.

因此，我认为我们需要普及这方面的认知：酒精究竟对健康有哪些真正危害？

And so that's where I think this education of understanding, like, what really are the health harms of alcohol?

我们已经将许多场合下的酗酒行为，尤其是年轻人的酗酒，视为完全正常，然而这会带来严重的健康后果。

And that we have normalized binge drinking in many occasions, especially in young people, as being totally normal, and yet there are very serious health consequences.

所以我对肝脏有很多问题想问。

So I've got a bunch of questions around around the liver.

这意味着我的肝脏在出现真正问题之前能承受一些损伤吗？

Does that mean that my liver can take a bit of a beating before there's any real problems?

像我这样的人，根本不喝酒，

Should I you know, someone someone like me, I don't drink alcohol.

也没有做任何太糟糕的事情，

I'm not engaging in anything too bad.

但有时候我会想，是不是可以偶尔来个狂欢周末，然后肝脏就能恢复正常，我也没事。

But sometimes I do wonder if I could have, like, a blowout weekend, and then my liver would just recover to normal again, and I'd be fine.

是的。

Yeah.

我的意思是，首先，每个人都不一样。

I mean, so first, every person is different.

一次狂欢周末，你可能没什么事。

One blowout weekend, you probably would be fine.

任何人可能都会没事。

Anyone would probably be fine.

问题是，一个狂欢周末可能会导致多个狂欢周末。

The challenge is one blowout weekend then leads to, like, multiple blowout weekends.

随着时间推移，这实际上会加速对肝脏的损伤。

And then over time, that can actually accelerate the damage to your liver.

向上

The up

你之前说我的肝脏是可以再生的。

You said that my my liver regenerates, though.

所以我以为这东西会自己恢复到正常状态。

So I'm thinking this thing will just pop back to normal again.

只要你还没进入纤维化阶段。

As long as you haven't gotten to that scarring phase.

一旦你走得太过遥远，即使你戒酒了，肝脏也无法恢复了。

So once you get too far down that path, even if you were to stop drinking, your liver won't recover.

困难的是，我们还不完全清楚为什么有些人这么年轻就会发生这种情况。

The hard thing is that that we don't totally understand who and why that happened so young too.

因此，这是一个正在进行的研究，因为有些人喝了六十年酒，但他们的肝脏并没有出现纤维化迹象。

So this is an active investigation because there are people who've been drinking for sixty years, and their livers don't show signs of scarring.

而我们却看到一些25岁的年轻人前来就诊，最终在医院去世。

And then we're seeing these young people at 25 who come in and die in the hospital.

因此，存在一些个人因素，你无法预知这些因素会影响你患上肝炎和肝纤维化的风险。

And so there are individual factors that you don't have any way of knowing that are going to impact your risk of developing liver inflammation and scar tissue.

因此，预防这种情况最安全的方法是避免以我们已知会导致伤害的极高剂量饮酒。

And so the safest way to prevent that is to not drink in these really high ways that we know are going to lead to harm.

另一种方法是寻求医疗帮助，因为我们通常通过血液检查发现这些问题，也可以进行超声检查。

The other way is to get medical care, because often we do detect these things through blood tests and we can do ultrasounds.

当我们发现早期阶段时，首先发生的是肝脏中出现脂肪沉积。

And when we see those early phases so what happens first is you actually get fat deposition in your liver.

这是第一步。

That's the first step.

然后我们会看到脂肪肝中的炎症。

And then we see inflammation in fatty liver.

如果你不停止导致这些变化的因素，随着时间推移，我们会看到纤维化的发生，也就是疤痕组织。

And if you don't stop the thing that's driving those changes, over time, we see the development of what's called fibrosis, which is like scar tissue.

然后这些疤痕组织会越来越严重，最终导致肝脏停止运作，要么死亡，要么需要肝移植。

And then that scar tissue gets more and more advanced to the point that your liver stops functioning and you either die or you need a liver transplant.

除了酒精之外，还有哪些活动会给肝脏带来巨大压力，而我们可能没有意识到？

What activities outside of alcohol cause great stress on our liver that we might not see as obvious?

是的。

Yeah.

肥胖就是其中之一。

So obesity.

饮食也会。

Food does.

是的，饮食。

Yeah, food.

你的肝脏在葡萄糖代谢中起着非常重要的作用。

So your liver is very involved in glucose metabolism.

因此，我们的饮食和体重会影响肝脏健康。

So our diet and our body weight impact our liver health.

还有其他药物，比如对乙酰氨基酚或泰诺，这是一种非常常见的非处方止痛药，超过一定剂量可能会导致严重的肝损伤。

And the other medications, so acetaminophen or Tylenol, which is a very common over the counter pain reliever, above a certain threshold can cause serious liver damage.

因此，有时我们会遇到这样的情况：有人没有意识到自己的感冒药和正在服用的泰诺都含有这种成分，然后又大量饮酒。

So sometimes we'll see cases where someone didn't realize that their cold medicine plus the Tylenol they were taking both had that ingredient, and then they go out and drink heavily.

这种组合效应可能会导致肝损伤。

And that kind of combination effect can cause liver damage.

你觉得这个问题可能有点奇怪、有点不清楚，但多少酒精会导致肝损伤呢？

How much do you think this might be a bit of a strange a bit of an an unclear question, but how much alcohol is gonna cause liver damage?

所以，这因人而异。

So, again, it varies person to person.

对于肝损伤来说，通常是中等至较高剂量才会造成损害。

For liver damage, it does tend to be the moderate to higher amounts that cause damage.

有一点是，你知道，像这种大规模的酗酒暴饮，可能比长期保持中等饮酒量的危害更大。

One thing is that, you know, that having these big surges, like these massive binge episodes, is probably more harmful than drinking, like, at a moderate level for a long period of time.