最常回放的瞬间：漱口水抵消了运动的好处！内森·布莱恩博士

如果我刚刚听完了你所说的这一切，我想改善我的口腔微生物组，我应该怎么做？

If I've just listened to everything you've just said there, and I want to improve my oral microbiome, what should I be doing?

我认为我们学到的最重要的一点是，你不该做什么。

Well, I think the most important thing we've learned is what you shouldn't be doing.

所以问题不在于我们该做什么，而在于我们不该做什么。

So it's not what should we do, it's what we shouldn't be doing.

第一，我们必须摆脱氟化物。

Number one, we have to get rid of fluoride.

就在上个周末，我在盐湖城参加了一个牙科会议，会上有来自美国国家毒理学计划的人员，该机构负责在存在任何环境毒物暴露风险时，开展毒理学研究以评估风险是否增加。

Just this past weekend I was speaking at a dental conference in Salt Lake City, and there were people there from the National Toxicology Program, which in The US is the organization tasked with, if there's any kind of risk of exposure of a environmental toxicant, they're charged with doing the toxicology studies to see if there's an increased risk.

风险是什么？

What is the risk?

是否存在一个完全没有风险的安全水平？

And is there a safe level that is without risk?

他们报告称，氟化物没有任何益处，只有风险。

And what they report is that fluoride, there's no benefit of fluoride, and it's all risk.

它会降低孩子的智商多达七点。

It lowers IQ in kids by as much as seven points.

它会抑制你的甲状腺功能。

And it shuts down your thyroid function.

它是一种神经毒素。

And it's a neurotoxin.

正如我之前提到的，大多数牙膏都含有氟化物。

And as I mentioned before, most toothpaste has fluoride in it.

如果你看看牙膏背面的说明，至少在美国是这样写的——我不知道其他国家的情况——上面会写着：如果误吞，请立即联系毒物控制中心。

And if you read the back of your toothpaste, it will tell you, at least in The US, I don't know about in other countries, but it says, If you swallow this, call poison control.

因为它是一种毒物。

Because it's a poison.

他们把毒物放进牙膏里。

They're putting poison in toothpaste.

如果你再仔细留意一下，上面还会写着：每次只用豌豆大小的牙膏量。

And then if you also pay attention, it says, only put a pea size amount of toothpaste on your toothbrush.

一颗豌豆大小。

A pea size.

但我认识的每个人都把牙膏挤满整个牙刷毛。

But everybody that I know fills the entire bristle of the toothbrush toothbrush with toothpaste.

所以那是大约十到十五颗，有时甚至二十颗豌豆大小的牙膏量。

So that's about 10 or 15, sometimes 20, pea size amounts of toothpaste.

一颗豌豆大小的牙膏含有约半毫克的氟化物。

And a pea size amount of toothpaste contains about half a milligram of fluoride.

如果你使用的量是豌豆大小的十倍、二十倍，那么你接触的氟化物就达到了五毫克、十毫克。

Now if you're using ten, twenty times more than that pea size, now you're exposed to five milligrams, ten milligrams of fluoride.

而且你甚至不需要吞下去。

And you don't even have to swallow it.

这是一种非常小的分子，分子量为19。

This is a very small molecule, a molecular weight of 19.

因此它能直接通过颊黏膜和口腔被吸收，进入全身循环。

So it's absorbed directly across the buccal mucosa, the oral cavity, and it becomes systemic.

我不再使用它了。

I'm not going to use it anymore.

是的，你不应该用。

No, you shouldn't.

那我应该用什么代替呢？

What should I use instead?

你必须使用不含氟的牙膏。

You have to use a non fluorinated toothpaste.

那像舌刮器这样的东西呢？

And what about things like tongue scrapers?

至于舌刮器，数据再次证明，这是经过时间检验的。

Now, tongue scrapers, the data again, that's time tested.

这是一种古老的实践。

That's an ancient practice.

甚至在我们的研究中，我们也发现，使用舌刮器的人口腔微生物组更多样，口腔健康状况似乎也更好。

And even in our study, we found that people who do tongue scraping have a more diverse oral microbiome, and they seem to have better oral health.

为什么会这样？

Why is this?

我女朋友一直跟我唠叨这事。

My girlfriend's been banging on to me.

她总是对的。

She's always bloody right.

我女朋友过去两年一直跟我唠叨要刮舌苔，但我一直没当回事。

My girlfriend's been banging on to me about tongue scraping for the last two years, and I've kind of just ignored her.

我就只是说，好的，宝贝。

I've just kind of, yeah, babe.

当然了。

Sure.

当她不在浴室时，我就不用她的舌刮器，因为那看起来太奇怪了。

And then when she's not in the bathroom bathroom, I'm not using her tongue scraper because it just looks strange.

根据我对口腔微生物组以及微生物组的整体了解，我在想：我真该把所有细菌都刮掉吗？

For me, based on what I knew about the oral microbiome and the microbiome generally, I'm like, should I be scraping off all my bacteria?

如果你要种花园，你会在未翻耕的土壤上种吗？

Well, if you're going to plant a garden, do you plant a garden on untilled soil?

听好了，我对园艺一无所知。

Listen, know nothing about gardening.

你找错人了。

Ask for the wrong guy.

所以，也许吧。

So maybe, yes.

自己种点吃的。

Grow my own food.

所以你得翻土。

So you have to till the soil.

你得把土壤打碎，这样种子才能透气，也能打破那层生物膜。

You've got to break up the soil so the seeds actually can be aerated, and you break up that biofilm.

是的，你从舌背后部，几乎到引发干呕的位置，用铜制的刮舌器向前拉，就会看到那些黏腻物被刮出来。

Yeah, you take the back of the dorsal tongue, almost to the point of the gag reflex, and you just pull that, ideally copper, tongue scraper forward, and you're gonna see this goop coming in there.

但这就像翻土一样，它增加了舌背部分微生物组的多样性。

But it's kind like tilling the soil, and it's increasing the diversity of the dorsal part of the tongue, the microbiome.

所以我的女朋友是对的。

So my girlfriend was right.

在这方面，是的。

In that regard, yes.

但我们发现，在那个孩子身上，血压的升高幅度最大。

But what we found was, in that one kid, we saw the greatest increase in blood pressure.

如果你刮舌并使用抗菌漱口水，那是最糟糕的情况。

If you tongue scrape and use antiseptic mouthwash, that's the absolute worst scenario.

有意思。

Interesting.

如果你只是想一想

If you Just think

关于这一点：你刮舌时打开了毛孔，然后又使用漱口水，它很容易深入舌苔的隐窝中，更有效地杀死细菌。

about this: you're tongue scraping, you're opening up the pores, and now you're using mouthwash, it can easily penetrate deep in the crypts of the tongue and more effectively kill the bacteria.

所以你是想先刮舌，然后用不含氟的牙膏刷牙？

So you want to tongue scrape and then use a toothbrush without fluoride toothpaste?

没错。

Absolutely.

而且不要用抗菌漱口水。

And no antiseptic mouth rinse.

好的。

Okay.

那去看牙科清洁师之类的人呢？

And what about going to dental hygienists and things like that?

你觉得这是个明智的做法吗？

Do you think that's an advisable idea?

因为大约每季度我会去看一次牙科清洁师，把所有东西都清理干净。

Because once every quarter or so, I'll go and see a dental hygienist just to get everything cleaned out.

不，我认为这是一种很好的预防性做法，因为你需要关注牙龈组织和牙周组织的健康。

No, I think that's a good proactive practice, because you need to look at the health of the gum tissue and the gingival tissue.

定期清洁牙齿、刮除牙菌斑，并确保牙釉质有良好的矿化，这是很好的。

And a routine clean and scraping the plaque off the teeth and making sure you have good mineralization of the enamel of the tooth is good.

但绝不要让他们给你做含氟漱口。

But never let them do a fluoride rinse on you.

在我们继续之前，关于口腔微生物组及其与一氧化氮的关系，还有其他我需要了解的内容吗？

Is there anything else on this subject of the oral microbiome and its relationship with nitric oxide that I need to be aware of before we move on?

是的，还有研究表明，如果你使用漱口水，就会失去运动的心脏保护益处。

Yeah, there's also data showing that if you use mouthwash, you lose the cardioprotective benefits of exercise.

所以请好好想想。

So think about this.

我们知道，饮食和运动是最好的药物。

We know that diet and exercise is the best medicine.

许多人致力于做到这一点。

And many people aspire to do that.

他们努力去健康饮食。

They go and they try to eat good.

他们避免糖分和甜食的诱惑。

They avoid the temptations of sugars and sweets.

他们每天锻炼，以期延长寿命并改善心血管健康。

They exercise every day to try to increase their longevity and cardiovascular health.

如果你这样做，同时还在使用漱口水，你就再也得不到运动带来的益处了。

If you do that, and you're using mouthwash, you no longer get the benefits from exercise.

而我们已经确认，饮食也无法提供一氧化氮的益处。

And we've already established you don't get the nitric oxide benefits from diet.

因此，每三个美国人中有两个每天早上醒来都会使用漱口水。

So two out of three Americans wake up every morning and use a mouthwash.

而每三个美国人中有两个血压偏高，处于不安全水平。

And two out of three Americans have an unsafe elevation in blood pressure.

那背后的机制是什么？

What's the mechanism there?

这是因为你杀死了部分负责产生一氧化氮的口腔微生物群。

Well, because you're killing the oral microbiome that's partly responsible for production of nitric oxide.

如果没有一氧化氮，血管会收缩，从而导致高血压。

Without nitric oxide, you get constriction of blood vessels, and it leads to high blood pressure.

这太疯狂了。

That's crazy.

我们的激素水平，比如我的睾酮水平，和一氧化氮之间有联系吗？

And is there a link between our hormone levels, things like my testosterone levels, and the nitric oxide?

是的。

Yes.

这是一个双向的过程。

So this is a two way street.

在男性中，睾酮会促进一氧化氮的产生。

So in men, testosterone activates nitric oxide production.

在女性中，雌激素会激活并刺激一氧化氮的产生。

In women, estrogen activates and stimulates nitric oxide production.

因此，只要我们的性激素处于最佳水平，并且血管内皮中的酶能够正常产生一氧化氮，这就解释了激素替代疗法的心血管保护作用。

So as long as we have optimal sex hormones, and as long as the enzyme in the lining of the blood vessel can functionally produce nitric oxide, that explains the cardioprotective benefits of hormone replacement therapy.

明白了。

Got you.

所以服用睾酮或雌激素疗法有助于提高我的一氧化氮水平。

So taking testosterone or estrogen therapies helps to increase my nitric oxide levels.

只要酶是功能正常且耦合的，也就是说，我们需要理解这一反应的酶学和生物化学机制，使得当细胞暴露于睾酮时，能够实际产生一氧化氮。

As long as the enzyme is functional and coupled, which means that we to understand the enzymology and the biochemistry of that reaction to where, when it's exposed to testosterone, the cell can actually make nitric oxide in response.

运动也存在双向关系，因为我在你的书中读到，运动能激活并刺激一氧化氮的产生。

And there's a two way relationship as well with exercise then, because I've read in your book that exercise activates and stimulates nitric oxide production.

你刚才还告诉我，要想获得运动的极大益处，首先得有足够的硝酸氧化物，否则你的血管会非常狭窄，导致体内氧气输送减少。

You also just told me that if you want to get the great benefits of exercise, you need nitric oxide in the first place, because else your blood cells are going to be very narrow, less oxygen traveling through you.

但你的运动效果也会变差，嗯，

But you're going do a worse workout as well, Well,

关于这一点。

about it.

还有其他激活物，比如维生素D。

There's other agonists, too, like vitamin D.

大多数美国人缺乏维生素D。

Most Americans are deficient in vitamin D.

睾酮水平低的人会出现勃起功能障碍。

People with low testosterone have erectile dysfunction.

为什么会这样？

And why is that?

因为他们没有刺激一氧化氮的产生，也没有扩张血管，因此出现了勃起功能障碍。

Because they're not stimulating nitric oxide production, and they're not dilating the blood vessels, so they develop ED.

所以，无论是什么原因——无论是维生素D缺乏（它是激活和刺激一氧化氮的因子）、激素水平低、饮食不良，还是久坐不动的生活方式——所有这些都可以归因于一氧化氮生成不足。

So all of this, no matter what it is, whether it's related to vitamin D deficiency, which is activator and stimulator of nitric oxide, it's low hormones, if it's a poor diet, sedentary lifestyle, all of that can be explained by insufficient nitric oxide production.

当我思考食物在促进一氧化氮生成中的作用时，我应该吃些什么来提高并维持一氧化氮的健康水平？

When think about the role that food plays in my nitric oxide production, What should I be eating to increase my nitric oxide levels, to keep them at a healthy level?

我认为这个问题的答案也是一样的。

I think the same answer is for that too.

重要的不是我们应该吃什么，而是我们不应该吃什么。

It's not so much what we should be eating, it's what we should not be eating.

所以

So

我们会一步步讲解。

we'll cover those step by step.

第一，你必须避免糖和高血糖指数的食物。

Number one, you have to avoid sugar and high glycemic index foods.

因为糖是一种毒素，是一种毒物。

Because sugar is a toxin, it's a poison.

让我们想想糖到底是什么。

And let's think about what sugar is.

当我们吃糖或喝含糖饮料时，无论是蔗糖、果糖还是高果糖玉米糖浆，最终在人体内都会导致葡萄糖水平升高。

So when we eat sugar or drink sugar beverages, right, whether it's sucrose, whether it's fructose, whether it's high fructose cornstrip, the end result inside the human is we see an increase in glucose.

因此，血糖升高就是糖尿病。

So elevation in blood sugar, or blood glucose, is diabetes.

对吧？

Right?

现在你可以随时随地买到连续血糖监测仪。

And now there's continuous glucose monitors that you can get anywhere.

每个人都这么做。

And everybody does this.

所以如果你吃了某种食物后血糖升高，就应该避免吃它。

So if you eat something and it causes an increase in your blood sugar, blood glucose, then you should avoid that.

因为葡萄糖，顾名思义，就像胶水。

Because glucose, as the name applies, is glue.

它很黏稠。

It's sticky.

如果你喝了一瓶苏打水，不小心洒在台面上，第二天回来一看，它还是黏糊糊的。

And if you have a soda and you spill it on your countertop, you come back the next day, it's sticky.

身体内部发生的情况就是这样。

That's what happens inside the body.

这种糖会黏附在身体的每一个部位。

That sugar sticks to everything.

它会附着在蛋白质上。

It sticks to proteins.

它会附着在酶上。

It sticks to enzymes.

它会与血红蛋白结合。

It binds to hemoglobin.

而附着在血红蛋白上的糖，我们称之为血红蛋白A1C。

And sugar stuck to hemoglobin is what we call hemoglobin A1C.

那

And what

是

is

什么？

that?

它是衡量长期血糖控制的指标。

It's a marker of long term glucose control.

如果你的糖化血红蛋白A1c高于5.7，你就患有糖尿病。

If you have hemoglobin A1c of greater than 5.7, you're diabetic.

所以它不仅仅黏附在血红蛋白上。

So it's not just hemoglobin it sticks to.

它还会黏附在制造一氧化氮的酶上。

It sticks to the enzyme that makes nitric oxide.

在生物化学和酶学中，酶必须能够发生构象变化。

And in biochemistry and enzymology, enzymes have to be able to undergo conformational changes.

它将电子从一个供体转移到受体，这就是生物化学运作的方式。

It transfers electrons from one donor to an acceptor, and that's how biochemistry is done.

但如果糖黏附在那个酶上，就会把它锁定在某种构象中，使其无法正常工作。

But if sugar's stuck to that enzyme, it locks it in some confirmation, and it can't do its job.

例如，它就无法产生一氧化氮。

For instance, it can't make nitric oxide.

因此，糖是一种绝对的毒物，会杀死许多酶并黏附在所有物质上。

So sugar is an absolute poison, and it kills many enzymes and binds to everything.

这会降低一氧化氮的生成吗？

And it lowers nitric oxide production?

是的。

Absolutely.

这就是为什么糖尿病患者心脏病发作、中风和全因死亡率高出十倍的原因。

That's why diabetics have a 10 time higher incidence of heart attack, stroke, all cause mortality.

这就是为什么他们会发展出周围神经病变。

That's why they develop peripheral neuropathy.

这就是为什么他们的伤口难以愈合。

That's why they have non healing wounds.

没有一氧化氮。

There's no nitric oxide.

这就是为什么他们会患上糖尿病视网膜病变、黄斑变性和胰腺炎。

That's why they're developing diabetic retinopathy, macular degeneration, pancreatitis.

我的意思是，所有这些都可以追溯到一氧化氮生成不足，因为糖附着在了酶上。

I mean, all of that can be traced back to a lack of nitric oxide production, because the sugar is stuck to the enzyme.

糖分破坏了口腔微生物组，彻底改变了细菌的生态，完全抑制了一氧化氮的产生。

The sugar destroys the oral microbiome and completely changes the ecology of the bacteria and completely shuts down nitric oxide production.

这有点跑题了。

Just a bit of a tangent there.

你提到这就是他们伤口长期不愈的原因

You mentioned that's why they have open wounds that don't

是的，糖尿病性溃疡。

Yeah, diabetic ulcers.

所以一氧化氮在伤口和疤痕的愈合中起着作用吗？

Okay, so nitric oxide's playing a healing role in wounds and scars?

当然。

Absolutely.

我头上有个疤痕。

So I've got this scar on my head.

我前几天踢足球时弄的。

I was playing football the other day.

有人撞到了我后脑勺，他们当时就晕过去了，被救护车拉走了。

Someone ran into the back of my head, and they they, like, they they passed out and got taken away by an ambulance.

但我后脑勺就留下了这么大一块疤，当时是用胶水缝合的。

But I was just left with this big, like, scar on the back of my head, which I've had, like, glue stitched.

所以我在想。

So I'm wondering.

我在想，如果我

I'm like, if I

涂抹一氧化氮血清，可以促进该部位的血液循环，加速细胞更新，愈合伤口并基本消除疤痕。

apply the nitric oxide serum, it'll stimulate blood flow to that, it'll improve cellular turnover and heal that wound and basically remediate the scar.

那我该怎么操作呢？

And how do I do that?

是用

Is it

是的，你每边按压一次泵。

Yeah, so you take one pump from each side.

所以这一侧按一下泵。

So one pump from this side.

然后翻过来，另一侧也按一下泵。

And turn it around, one pump from the other.

是的。

Yeah.

现在如果你涂抹并混合它们，一旦混合，就会开始生成一氧化氮气体。

And now if you apply that and mix it together, as soon as you mix it together, it starts to generate nitric oxide gas.

然后这种气体会扩散到组织中。

So then that gas will diffuse into that tissue.

它会增加血流，动员干细胞，改善细胞更新，彻底重塑并愈合伤口。

It's going to increase blood flow, and it's going to mobilize stem cells, and it's going to improve cellular turnover and completely remodel that and heal that.

如果那里有感染，它会杀死感染性细菌。

And if it were an infection in there, would kill the infectious bacteria.

好吧，那我们就来试试。

Okay, well, we shall Sacrifice.

我们看看这是否有效。

We shall see if that works.

那么我们回到食物这个话题。

So back on this point of food then.

糖是坏的吗？

So sugar's bad?

糖确实不好，是的。

Sugar's bad, yeah.

你必须戒掉糖。

You've got to eliminate sugar.

我认为严格的生酮饮食或纯素食/素食饮食的好处就在于戒除糖和碳水化合物。

And I think the benefits of a straight ketogenic diet or a straight veganvegetarian diet is just the elimination of sugar and carbs.

但我想回答你的问题，我们应该吃什么呢？

But I think, to answer your question, what should we be eating?

我认为你应该均衡饮食，适量摄入。

I think you've gotta eat a balanced diet in moderation.

美国人吃得过多。

Americans are overfed.

你只要走出去看看，就能发现肥胖的流行现象。

All you gotta do is walk around and see the epidemic of obesity.

优质的蛋白质，优质的脂肪，以及极少或没有碳水化合物。

Good high quality protein, good quality fats, and little or no carbs.

事情就是这么简单。

And it's really that simple.

那你为什么写了一本关于甜菜的书呢？

And why did you write a book about beetroots?

甜菜？

Beets?

是的，甜菜在2012年伦敦奥运会上首次引起广泛关注。

Yeah, the beets hit really the airways back in 2012 in the London Olympic Games.

当时有很多数据表明，甜菜汁能提升运动表现。

There was a lot of data coming out at the time of the benefits of beetroot juice on enhancing athletic performance.

而一氧化氮的产生所带来的益处，可以解释运动表现的提升。

And there was a benefit of the nitric oxide being produced that could explain the improvement in athletic performance.

问题是，这些运动员喝下了数升的甜菜汁，导致严重的胃部不适和腹泻。

The problem is, these athletes were drinking liters and liters of beetroot juice and causing a lot of gastric discomfort, causing diarrhea.

他们的尿液和粪便都会变红，许多人误以为这是胃出血或尿道出血。

Their urine and their feces would turn red, and a lot of people misinterpreted that as gastric bleeds or urinary bleeds.

当我开始研究市场上的产品时，大多数甜菜产品，如脱水甜菜粉，根本没有任何一氧化氮的益处。

And then when I started looking at the products on the market, most of the beet products, the desiccated beet powders, provided zero nitric oxide benefit.

它们不含任何硝酸盐，也没有亚硝酸盐。

They didn't contain any nitrate, no nitrite.

我们称它们为‘死甜菜’。

They were just, we called them dead beets.

它们是毫无作用的甜菜产品。

They're a dead beet product.

因此，我想到，如果消费者在市场上寻找甜菜，是因为它们已被证明能提升运动表现，而这种提升依赖于甜菜促进体内一氧化氮生成的能力，那么普通消费者根本不知道该关注什么。

And so I thought if consumers are out there looking for beets because they've been shown to enhance their performance, but that enhancement in performance was dependent upon the beet's ability to improve nitric oxide production in the body, then the non scientists out there wouldn't know what to look for.

他们购买的产品并没有给他们带来任何益处。

They're buying products that aren't providing any benefit to them.

所以多年前，我们会进行随机安慰剂对照临床试验，我们会购买一些你在本地营养品店或药房就能买到的商用甜菜产品，用作临床试验中的安慰剂，因为它们是完美的安慰剂。

And so years ago, we would do randomized placebo controlled clinical trials, and we would take some of these commercial beet products that you can go to your local nutrition store or pharmacy, buy off the shelf, and we would use those as placebos in our clinical trials, because it's the perfect placebo.

因此，我在那本书中试图教育读者：甜菜究竟有什么重要之处？

So what I tried to do in that book is educate, okay, what is it about beets that are so important?

它的作用机制是什么？哪些成分是甜菜中能够促进一氧化氮生成所必需的？

What's the mechanism and what is necessary in those beets that can improve nitric oxide production?

所以，我所做的一切都是为了教育和告知消费者，让他们知道如何对自己的产品、饮食或口腔卫生习惯做出明智、有根据的选择。

So again, everything I do is intended to educate and inform the consumer so that they know how to make informed, educated choices on the products they're taking, or the foods they're eating, or their oral hygienic practices.

我正在找你书中的那一页，但你曾在书中把甜菜描述为饮食史上被最低估的食物。

I'm trying to find the page in your book, but there was a page in your book where you describe beetroot as the most underappreciated food in the history of eating.

是的，那可能是在《战胜逆境》那本书里。

Yeah, that may be in the beat the odds.

我以为是在这本里。

I thought it was in this category.

但如果回到古代，看看洞穴壁画上的象形文字，古代穴居人会在战斗前饮用红色液体，人们以为他们在喝葡萄酒。

But if go back to historical times, and you look at the hieroglyphics on caves, of the ancient cavemen, people thought they were drinking wine, because they would have these red stuff before battle.

但这些古埃及人实际喝的是甜菜汁，以提升战斗前的表现，让他们做好准备、充满能量、改善血液循环。

But what these ancient Egyptians were doing was they were drinking beet juice to improve their performance before they went into battle so that they were ready, they were energized, they improved their circulation.

这就是关于甜菜的历史研究。

So that's the historical study on beets.

显然，这些甜菜生长在没有除草剂、杀虫剂的时代，土壤可能非常肥沃。

And obviously, these were beets grown at a time when there were no herbicides, pesticides, and the soil was probably fertile.

因此，这些甜菜富含营养，很可能含有大量硝酸盐，从而带来这些益处。

So these beets were full of nutrients, probably full of nitrate that provided the benefits of that.

但不幸的是，如今种植的甜菜，至少在美国，营养已经严重流失，就像大多数食物一样。

But unfortunately today, the beets that are grown, at least in America, really are nutrient depleted, just like most of the food.

那么，你会建议人们吃甜菜根吗？

So would you recommend people eat beet roots?

不会，因为根据我们在2015年发表的调查，我们发现，单靠吃甜菜根本无法摄入足够的硝酸盐来提升表现。

No, because, again, through our survey that we published in 2015, we realized that you really can't eat enough beets to get enough nitrate to improve your performance.

另一个需要注意的是，如果你使用漱口水，或者牙膏中含有氟化物，或者你把甜菜粉混入含氟的饮用水中，你就无法从中获得一氧化氮的益处。

And the other caveat is that if you're using mouthwash, you've got fluoride in your toothpaste or fluoride in your drinking water that you're mixing the beet powder in, you're not going get a nitric oxide benefit from it.

我面前有一张图表，是我打印出来的，显示了抗酸药物使用量的上升趋势。

There's a graph in front of me here, which I printed off, which shows the rise in antacid medications.

哦是的，从2004年到现在大约二十年间，我们看到抗酸药的使用量几乎增加了四倍。

Oh yeah, from 2004 to so a twenty year period, we're seeing what is that, almost a quadrupling of the use of antacids.

这是全球范围的数据，还是仅限于美国？

And this is globally, or is this in The US?

我认为这是全球性的数据。

That's worldwide, I believe.

是的，全球范围。

Yeah, worldwide.

现在这才是问题所在。

Now this is the problem.

这些抗酸药到底是什么？

These antacids What is an antacid?

这是一种口服药物，用于抑制胃酸分泌。

So it's a medication that's given orally to suppress stomach acid production.

而且

And

作为一名生物化学家和生理学家，我想不到还有什么比抑制胃酸分泌更具破坏性了。

as a biochemist and physiologist, I can't think of nothing more damaging than to inhibit stomach acid production.

因为胃酸对于将蛋白质分解为氨基酸是必需的，无论你摄入的是动物蛋白还是植物蛋白。

Because stomach acid is required to break down proteins into amino acids, whether you're eating animal protein or plant based protein.

它对于营养吸收也是必需的。

It's required for nutrient absorption.

你需要胃酸来吸收B族维生素。

You need stomach acid to absorb B vitamins.

你需要胃酸来吸收硒、铬、碘、镁和铁。

You need stomach acid to absorb selenium, chromium, iodine, magnesium, iron.

我的意思是，大多数营养素和微量营养素都是在胃腔内被吸收的。

I mean, most nutrients, micronutrients, are absorbed in the lumen of the stomach.

如果胃不产生胃酸，这些营养素就无法被吸收。

And if the stomach is not making stomach acid, then these nutrients are not absorbed.

大多数美国人，百分之七十五的美国人缺乏镁。

And most Americans, seventy five percent of Americans are deficient in magnesium.

百分之九十五的美国人缺乏碘。

Ninety five percent of Americans are deficient in iodine.

我的意思是，这是一个巨大的问题。

I mean, it's a huge problem.

这些是像盖胃平这样的品牌吗？

These are the brands like Gaviscon?

不，这些是像奥美拉唑、普瑞卡西德、耐信这样的药物，处方药包括奥美拉唑、泮托拉唑。

No, these are like the Prilosec, the Prevacid, the Nexium, the prescription medications are omeprazole, pantoprazole.

如今，在美国，我认为甚至是全球范围内，你都不需要医生的处方就能买到这些药。

Today, in The US, I think it's probably worldwide, you don't even need a prescription for these from your physician.

你可以去当地的药店，购买我们所说的质子泵抑制剂，或PPIs。

You can go to your local drugstore and you can buy these what we call proton pump inhibitors, or PPIs.

那Tums呢？

What about Tums?

非处方药。

Over the counter.

所以Tums和小苏打这样的东西是缓冲剂，对吧？

So there's a difference in so Tums and things like baking soda are a buffer, right?

碳酸氢钠或碳酸钙。

Sodium bicarb or calcium carbonate.

它是一种缓冲剂，对吧？

And it's a buffer, right?

所以如果你突然胃酸分泌过多，可以吃一片Tums或者一些缓冲剂、碱性物质来中和胃酸。

So if you have an acute bout of hypersecretion of acid, you can take a Tums or some buffer, some base, alkaline substance, to neutralize the acid.

中和胃酸和抑制胃幽门细胞自然产生胃酸是完全不同的。

Neutralizing acid is completely different than inhibiting its natural production in the pyloric cells of the stomach.

那你知道Gaviscon吗？

So what is the difference between have you heard of Gabiscon before?

是的。

Yes.

对。

Yeah.

那……胃复安和……有什么区别？

What's the difference between

你是指盖胃平吗？

are you like a Gaviscon?

嗯，抗酸药有几类。

Well, there's certain classes of antacids.

我们称之为H2受体阻滞剂。

There's what we call H2 blockers.

还有质子泵抑制剂。

There's proton pump inhibitors.

还有就是那些天然缓冲剂，它们只是中和胃里的酸性环境。

And then there's the natural buffers that are just neutralizing the acid environment in the stomach.

Gaviscon，我正试着回想它属于哪一类。

Gaviscon, I'm trying to think what class that falls under.

我不认为它在美国广泛使用。

I don't think it's widely used here in The US.

我的意思是，这里主要使用的药物是耐信、诺赛和拉唑。

I mean, the main drugs used here are Prilosec, Nexium, Prevacid.

这些是非处方药。

Those are the over the counter.

而主要的处方药是奥美拉唑和泮托拉唑。

And then the main prescription medications are the omeprazole and the pentoprazole.

Gabiscon 是一种常用的抗酸药品牌，其活性成分是氢氧化铝和碳酸镁？

Gabiscon is a commonly used antacid brand, and the active ingredients are aluminium hydroxide and magnesium carbonate?

哦，所以是 Gabiscon。

Oh, so Gabiscon.

首先，它含有铝，绝对应该避免使用。

So number one, it's got aluminum in it, which should absolutely be avoided.

但没错，这看起来就像一个缓冲剂。

But yeah, that just looks like a buffer.

它含有氢氧化铝，这是一种强碱，可以中和胃酸的分泌。

It's got an hydroxide, aluminum hydroxide, which is a strong base, so it's neutralizing the stomach acid production.

但它是一种中和剂，任何含铝的东西你都应该绝对避免。

But it's a neutralizing agent, but anything that contains aluminum you should absolutely avoid.

我今天提过她几次，但我的女朋友是一位呼吸训练师。

I've mentioned her a few times today, but my girlfriend's a breath practitioner.

她经营一家名为barleybreathwork.com的公司，广告。

She runs a business called barleybreathwork.com, ad.

她经常跟我谈到的一个话题是用嘴呼吸。

And one of the things she's talked to me a lot about is mouth breathing.

我知道一氧化氮和我们的呼吸方式之间存在关联，是通过鼻子还是通过嘴巴呼吸？你能给我解释一下这个联系吗？

And I know there's a relationship between nitric oxide and how we choose to breathe, it's Can through our nose or through our you explain to me that link?

当我们谈到存在于血管内壁的酶时，我们刚开始这个部分。

When we talk about the enzyme that's found in the lining of the blood vessels we started this segment.

同样的酶也存在于我们的上皮细胞、上呼吸道和鼻窦中。

That same enzyme is found in our epithelial cells, in our upper airways, in our sinuses.

就像运动可以激活血管内皮细胞中的一氧化氮生成一样，深呼吸和鼻腔呼吸也能激活鼻窦上皮细胞中的这种酶。

So just like exercise can activate nitric oxide production in the lining of the blood vessels, deep breathing, nasal breathing, activates that enzyme in the epithelial cells of our sinuses.

因此，当我们进行鼻腔呼吸时，它会激活酶来产生一氧化氮。

And so when we do nasal breathing, it's activating the enzyme to make nitric oxide.

现在，我们将这种一氧化氮气体输送到细支气管和下呼吸道。

And now we're delivering that nitric oxide gas into the bronchioles, the lower airway.

它能扩张这些细支气管。

It's dilating those bronchioles.

此外，它还能扩张肺动脉。

Moreover, it's dilating the pulmonary arteries.

因此，我们正在改善氧气的摄取和输送，这就是为什么鼻腔呼吸和深呼吸被证明能降低血压的原因。

So now we're improving oxygen uptake, oxygen delivery, and that's why nasal breathing and deep breathing has been shown to lower blood pressure.

这张图是我从谷歌上截取的，相当惊人，它显示了人们对口呼吸这一话题的兴趣正在迅速增长。

This is a pretty crazy graph I took from Google as well, which shows just how interested people are now getting in the subject of mouth breathing.

哦，是的，再回顾一下过去二十年。

Oh yeah, again, going over the past twenty years.

是的，不，我认为有很多人，比如你的女朋友，还有帕特里克·麦克尤恩，你知道的。

Yeah, no, I think there's a lot of people I mean, obviously your girlfriend, there's Patrick McEwen in yeah, know.

他进入

The He into

龙穴。

Dragon's Den.

在《龙穴》中给他提供了投资。

Made him an offer in Dragon's Den.

是的。

Yeah.

这很难。

It's hard.

不，我认为它的益处已经相当明确，而且从机制上我们也能理解它的益处。

No, I think the benefits of that are pretty well, and mechanistically we understand the benefits of it.

所以用嘴呼吸的人不仅绕过了这种天然的一氧化氮生成途径，而且用嘴呼吸会彻底改变口腔微生物组。

So the mouth breathers are not only bypassing this natural nitric oxide production pathway, but when you mouth breathe, it completely changes the microbiome.

因此，你不仅绕过了上呼吸道的一氧化氮生成，还抑制了口腔微生物组产生一氧化氮。

So you're not only bypassing the nitric oxide producing in the upper airway, but you're inhibiting nitric oxide production in the mouth from the microbiome.

因为口腔被完全氧合，导致唾液的pH值发生变化，彻底改变了微生物组，并完全阻断了一氧化氮的生成。

Because you're fully oxygenating the mouth, it's changing the pH of the saliva, and completely changes the microbiome, and completely shuts down nitric oxide production.

很有趣。

Interesting.

很有趣。

Interesting.

所以你必须——我是说，我非常支持用胶带封嘴。

So you have toI mean, I'm a big fan of mouth taping.

但就我而言，我观察我的孩子，有时存在解剖学问题，比如气道阻塞，需要通过牙科矫治器甚至手术来纠正。

But for me, and I watch my kids, but sometimes there's anatomical issues where there's obstructive airways and airway obstruction that has to be corrected by dental appliances or sometimes surgery.

但最糟糕的做法就是封住嘴巴，而气道却处于狭窄状态，导致窒息。

But the worst thing you can do is tape your mouth and your airway be constricted and suffocate.

所以在进行嘴部贴布之前，你需要让牙医做一些影像检查，确保你的气道是通畅的，这样当你被迫用鼻子呼吸时，能够真正实现氧气交换。

So before you do mouth taping, you need to get some imaging done from your dentist to make sure that your airway is open to where if you're forced to breathe through your nose, you can actually have oxygen exchange.

除了这些，还有没有其他我应该做的、能提高和改善一氧化氮水平的方法，我们还没提到的？

And is there anything else that I could and should be doing to increase and improve my nitric oxide levels that we haven't talked about yet?

哼唱，有一些特定的频率。

Humming, there are certain frequencies.

我们曾研究过在哼唱时，呼出气体中的一氧化氮含量。

We've done this in looking at nitric oxide coming out of the exhaled breath when you're humming.

因此，某些频率可以激活这种酶，而这取决于鼻窦的容积。

So certain frequencies can activate this enzyme, and it's dependent upon the volume of the nasal sinuses.

所以并不存在一个适用于每个人的固定频率。

So there's not one frequency that would work in every single person.

因为你的气道、口腔和鼻窦的容积，很可能和我的大不相同。

Because the volume of your airways and oral cavity and sinuses was probably much different than mine.

给我举个例子，演示一下。

Give me an example, show me.

如果你只是像冥想时那样发出‘嗡’声，或者简单地哼唱，实际上——如果我这里有气体分析仪，就能检测到我呼出的气体中含有氮氧化物。

Well if you just, ombs, like what you do in meditation, or just simple humming, you could actuallyso if I had my gas phase analyzer here, I could and I could detect nitric oxide coming out of my exhaled breath.

因为频率的作用

Because of the frequency of the

因为特定频率可以激活一氧化氮合酶。

Because of the frequency and activating the nitric oxide synthase enzyme.

但对于老年患者——我们已经证实了这一点，多年前就有研究发表，其他团队也验证过——老年患者的酶无法产生一氧化氮，无论他们是否进行鼻呼吸或哼唱，呼出的气体中都没有一氧化氮。

But if you take older patientsand we've demonstrated this, it was published years ago, and other groups have demonstrated thisolder patients, that their enzyme isn't making nitric oxide, whether they do nasal breathing or whether they do humming, there's no nitric oxide coming out.

所以，这只是一个激活剂和刺激剂，但它的效果取决于产生一氧化氮的酶的功能。

So again, this is an activator and a stimulator, but it's dependent upon the function of the enzyme that makes nitric oxide.

如果你的酶已经失效，那么哼唱、鼻呼吸或运动都不会产生任何一氧化氮。

If your enzyme is broken, humming, nasal breathing, exercise isn't going to produce any nitric oxide.

如果我想提高一氧化氮水平，还有其他需要注意的事项吗？

Is there anything else that I should be aware of if I'm trying to improve my nitric oxide levels?

我认为关键是避免那些会破坏一氧化氮生成的行为。

I think it's doing the things that disrupt it.

去除氟化物，停止使用漱口水，不要再用抗酸药，戒掉糖，任何会导致血糖升高的东西。

Get rid of fluoride, get rid of mouthwash, stop using antacids, stop eating sugar, anything that leads to an elevation in blood sugar.

均衡饮食，适量为宜。

A balanced diet in moderation.

适度的体育锻炼。

Moderate physical exercise.

每天晒二十到三十分钟的太阳。

Twenty, thirty minutes of sunlight a day.

阳光。

Sunlight.

阳光。

Sunlight.

在可见光谱的两端，分别是紫外线和全光谱红外线。

There's certain, at both ends of the visible spectrum, the UV spectrum and the full spectrum infrared.

这些频率和振动同样能刺激一氧化氮的释放。

So those frequencies and vibrations, again, stimulate nitric oxide release.

所以紫外线有足够的能量，可以将与半胱氨酸巯基和蛋白质结合的一氧化氮释放出来。

So the UV has enough energy to where it'll knock nitric oxide bound to a cysteine thiol and protein.

然后紫外线光谱会释放与金属结合的一氧化氮。

And then the UV spectrum will release nitric oxide bound to metals.

所以你的意思是，要到阳光下晒太阳，同时也要用那些红光床之类的设备？

So you mean go out in the sunshine, but also those red light beds and stuff?

是的，红光。

Yeah, the red light.

我有一张红光床。

I a red light bed.

我有一台使用红光的红外线桑拿房，我每天都用。

I have an infrared sauna that uses red lights in it, and I use it every day.

是为了促进一氧化氮的生成吗？

For nitric oxide production?

是的。

Yeah.