运动与营养科学家：经期锻炼的真相！女性对更年期的说法是对的！这4种补充剂为女性提供最佳健康！

所以如果我们能让发力从股四头肌主导的前侧负荷，转变为前后负荷更均衡的状态，这就回到了我们之前讨论的膝盖受力分布问题——男性的受力更偏向线性，而女性的膝盖存在一定角度。

So if we're able to balance it from being front loaded to being more even loaded, it comes down to how we were talking about distribution of forces through the knee with men being more linear and women having an angle.

如果我们能调整这个角度，让腘绳肌和股四头肌（也就是前后侧肌肉）之间的负荷均匀分布，就能把受力往中间拉，从而降低单个接触点承受的压力。

Well, if we're able to take that angle and we can evenly distribute the load between the muscles of the hamstring and the quads, the front and the back, then it pulls the forces more centrally, which reduces the stress of one point of contact.

所以说，

So

如果我们能练强整条后侧链——锻炼臀肌、腘绳肌，做大量的 calf（小腿肌肉的训练，就能把整个身体后侧的力量都练出来。

if we're developing the strength through the whole posterior chain, we're looking at glutes, we're looking at hamstrings, we're doing a lot of calf work, and we can develop that whole posterior part.

它能减少身体被拉向单一方向的概率，还能避免力的对齐出现偏差。

It reduces the incidence of being pulled in one direction and the misalignment of forces.

另一个要点是变向动作，也就是我们所说的侧向移动。

The other is the cutting motion, where we're looking at lateral movement.

很多时候我们观察青少年体育活动的热身环节时会发现，他们的侧向能力发展普遍不足。

So a lot of times when we're looking at warm ups and you're observing on kids' sports, there's not a lot of lateral development.

所以如果想要预防前交叉韧带撕裂，我们必须大量练习爆发性侧向移动，还有单脚跳跃这类动作。

So, if we're looking at prevention of ACL tear, we have to work a lot of the explosive lateral movements, as well as jumping in single leg jumping.

这些在基层层面其实很少做。

And these are things that aren't really done in grassroots.

但随着我们越来越多地进入职业体育领域，很明显我们必须针对具体的损伤机制进行预防。

But as we start to get more into professional sport, it's becoming more and more apparent that we have to do specific mechanism of injury prevention.

所以，他们正在关注这项运动。

So, they're looking at the sport.

我们是一名足球运动员。

We're a football player.

我们面临较高的前交叉韧带损伤风险。

We have a high incidence of ACL potential.

因此，我们必须充分发展我们的后链肌群。

So, we have to really develop our posterior chain.

我们需要提升侧向移动、步伐和跳跃的力量。

We have to work on our power for our lateral movements, our step and our jump.

因此，国际足联在热身计划中加入了这些内容，因为这种风险确实很高。

So, this is part of what FIFA's put in for the warm up because there is such a draw.

就像你刚才说的，本届世界杯有33名女球员遭遇了前交叉韧带撕裂。

And as you were saying, that 33 women in the World Cup tore their ACL.

其中一部分原因是负荷问题。

Part of it is loading.

还有一部分原因可能是她们在参加世界杯前训练过度了。

Part of it is a little bit maybe overtrained before they go into the World Cup.

但绝大多数原因都和肌肉失衡有关，现在我们必须着手解决这个问题。

But a lot of it has to do with this imbalance between the muscles and now having to address it.

科学界过去是不是只把女性视为男性的不同版本？

Did science just look at women as a different version of men?

不好意思，他们是不是一直把女性当作一种

Sorry, did they just look at women as like a

男性的缩小版？

Smaller version of men?

他们当时是这么看的吗？

Is that how they looked?

对，大体上是这样的。

Yeah, for the most part.

因为我上学那会儿，甚至现在的很多教材里都是这个情况。

Because a lot of the stuff when I was going through school, even now textbooks.

几个月前我在华盛顿的地铁里站着的时候，碰到了一个刚入行运动生理学的年轻姑娘，我无意中听到了她的一段对话。

So I was standing in the metro in DC a few months ago, and there was a young girl who has just gotten into exercise physiology, and I overheard a conversation.

她聊到了他们正在做的一些实验，但从头到尾都没提过要做针对女性的专项实验。

And she was talking about some of the experiments that they were doing, but she never talked about, doing women specific.

我们的项目都是只针对男性设计的。

We're doing men specific.

然后我就问她：‘有没有人跟你讲过，从身体受力角度和肌肉形态来说，女性的身体和男性的有哪些区别吗？’

And I asked her, I was like, Has anyone talked to you about how women's bodies are different than men's from angles and muscle morphology?

她就说：‘没有啊，你在说什么呢？’

And she's like, No, what are you talking about?

我就说：‘这都已经是你读运动生理学的第二年了啊。’

I was like, This is the second year in ex phys now.

而且如果你去翻看现在的教材，里面的配图依然是以男性的形象为主的。

And if you look at the textbooks, it's still a representation of men in the textbook with regards to images.

教材里只会用到「他」或者泛指的「他们」。

You have him or they.

从来不会出现专门指代女性的「她」。

You never have her.

教材里可能会挤出很小一块篇幅讲讲女性运动员，但内容通常也只围绕女性运动员的贫血问题，或是运动相关的相对能量缺乏症展开。

They might have a very small section in there about the female athlete, but usually it's about the female athlete and anemia or relative energy deficiency in sport.

从来没有人思考过，我们该如何帮助女性运用自己的身体和生理条件来发挥自身优势。

It's never about how we can empower women to use their bodies and their physiology to their advantage.

而且现在都快2025年了。

And it's, what, almost 2025 now.

会不会是因为大家太不敢探讨男女之间的生理差异了？

Is there any element of people being too scared to talk about differences in physiology amongst men and women?

我觉得不是。

I don't think so.

我的意思是，当我们研究这段历史，观察现代医学的起步阶段时，我总会从历史视角来解释这件事。

I mean, I always explain it from historical perspective when we're looking at the history and when we started seeing the modernization of medicine.

在现代医学发展起来之前，承担照护者角色的一直都是女性。

Prior to the modernization of medicine, it used to be women who were the caretakers.

要是你生病了去求医，就会有人给你用草药方治疗。

If you're thinking about you get sick, you go, and someone has an herbal remedy for you.

但当医学开始专业化，医学教育也变得愈发精细复杂后，女性就被排除在外了。

But when we started medicalizing and becoming more nuanced in the medical education, women were excluded.

所以当我们追溯医学的起源，看看当初参与建立这一领域的都是些什么人时，会发现全都是男性。

So, when we start looking at the origins of medicine and who was in the room, it was men.

再看看科学的起源和学科发展历程，主导的也都是男性。

We start looking at the origins of science and science development, it was men.

因此所有的科学实验以及相关研究，默认都以男性为主体。

So, all the scientific experiments and everything have always been a default to men.

再看看如今的人工智能，它们用来学习的算法，所基于的也都是男性相关的数据。

We look at AI now, and they're learning from algorithms based on male data.

所以即便是现在，医疗保健仍然严重偏向男性视角。

So even now, health care is still heavily male oriented.

因此当我们审视女性为何未被纳入研究，或者为何女性数据被笼统归入男性数据时，这其实就是事物发展的自然轨迹。

So when we start looking at why women haven't been included or why women have been generalized to male data, it's just been the nature of how things have developed.

现在我们意识到了这个问题，并且有更多研究资金投入到女性健康领域，我们开始看到变化。

Now that we're aware of it and now we have more research money coming into women's health, we're starting to see a change.

医疗保健研究中真正引发这一变革的两个决定性时刻之一，是当我们开始看到安必恩及其药物剂量的许多事件，女性在服用安必恩后发生了很多事故和车祸，因为药物在第二天早上仍在她们体内。

And part of the two definitive moments in health care research that really invoked this change, One was when we started seeing a lot of incidences with Ambien and the dosage of medicines, where women were getting into a lot of accidents, car accidents, after they'd taken Ambien because it was still in their system the next morning.

是安必恩吗？

It's Ambien?

是一种助眠药物。

It's a sleep aid.

是处方级的助眠药。

It's a prescription strength sleep aid.

结果大家就会惊呼，哇，这是怎么回事？

So, then people are like, Woah, what's going on here?

哦，一个180磅男性的剂量和一个120磅女性的剂量是一样的。

Oh, the dosage for a one hundred and eighty pound man is the same as one hundred and twenty pound woman.

而且我们也知道，身体成分和新陈代谢存在差异。

And we also know that there's differences in body composition and metabolism.

所以，一个180磅的男性服用这个剂量第二天早上没事，但一个120磅的女性服用同样的剂量第二天早上就无法正常运作。

So, a one hundred and eighty pound man can take this dose and be fine in the morning, but one hundred and twenty pound woman can't take that same dose and be fine in the morning.

然后我们看到了新冠和长期新冠的结局，性别差异显现出来：女性更容易出现长期新冠，而男性则更容易死亡。

And then we have COVID and the outcomes of long COVID and the differences between the sexes with regards to women ended up with more long COVID, men ended up dying.

所以在新冠期间，人们开始意识到：这种疾病的结局存在性别差异。

So, then during the COVID time period, people were like, Woah, there's sex differences in the outcomes of this disease.

我们必须认真研究这个问题。

We have to really start looking at that.

有一些缓慢但对社会影响深远的变化，现在人们终于开始意识到：我们必须把女性当作女性来研究。

So, there are slow things that are really impactful on society that now people are starting to step and say, wait, we have to really look at women as women.

我们也必须把男性当作男性来研究。

We have to look at men as men.

那激素会不会对受伤有任何影响呢？

And is there an element of hormones impacting injury at all?

激素确实一直都会产生影响。

There's always an impact of hormones.

当我们把激素、性激素的作用，和目前已有的研究方案放在一起分析时，会发现这些方案完全没有把雌激素、黄体酮，还有一定程度上的睾酮的影响纳入考量。

When we're looking at the overlay of hormones and sex hormones and then the protocols that have been developed, they don't take into account estrogen and progesterone and, to some extent, testosterone.

如果我们聊回激素和受伤的关联：雌激素会让韧带变得更松弛，也就是说当雌激素水平升高时，我们的韧带会比平时更松弛，这也是为什么大家普遍认为排卵期前后人们更容易出现前交叉韧带撕裂的情况。

So, if we're looking at injury and the way that estrogen makes more laxative ligaments, that means that our ligaments become more lax when estrogen comes up, which is why people assume that around ovulation is when people will have more ACL tears.

这是因为我们还发现孕酮会介入，对肌腱产生截然不同的影响，情况没那么简单。

It's not because we also see that progesterone comes in and can have a different effect on the tendons.

但目前现存的大量训练方案与过度训练预防方案，都没有把这个因素纳入考量。

But that isn't accounted for in a lot of the protocols that are out there for training and prevention of overtraining.

过去人们研究雄性与睾酮水平时，普遍认为睾酮含量越高，越有利于肌肉生长与身体恢复。

We see that when we're looking at male and testosterone, the more testosterone, the better for developing muscle and recovery.

但这个结论同样并非绝对正确。

But that's not necessarily true either.

所以，围绕性激素的社会文化观念存在诸多细微差异，而这些差异也会对我们实际采用的指南和训练方案产生影响。

So, there's nuances in the sociocultural idea around sex hormones that also impact on our actual guidelines and protocols.

如果有一名男士和一名女士来找你，都说自己想减重，比如他们说‘我现在体重200磅，想减一些体重’，那你给他们的减重建议会不一样吗？

If a man and a woman came to you and said, I want to lose weight, they said, I'm two hundred pounds, and I'd like to lose some weight, would you give them different advice on what to do?

当然会不一样。

Absolutely.

肯定会给出不同的建议。

Absolutely would.

这归根结底就是我们在社交媒体上总看到的那套‘摄入热量=消耗热量’的说法，对吧？

And it comes down to a lot of We see this on social media all the time, calories in, calories out, right?

而‘摄入热量=消耗热量’这套理论在男性身上效果还不错。

So, when we're looking at calories in, calories out, that idea of that algorithm can work well in men.

原因就出在下丘脑上。

And the reason for that is the hypothalamus.

下丘脑是大脑中控制食欲的区域，它同时也掌管着我们的内分泌系统。

So, if we're looking at the hypothalamus, which is an area in the brain that controls appetite, it also controls our endocrine system.

所以对男性来说，被称为亲吻肽神经元的这类神经元被激活的数量不会那么多。

So, for men, they don't have as many of what we call our kiss peptide neurons activated.

这些神经元负责感知我们摄入的营养物质。

So, this is neurons that are responsible for when we have nutrients coming in.

它们会发出信号。

They fire.

它们的运作逻辑就像：对，好的，我们已经摄入了足够的营养，现在可以配合肌肉生长、消耗体脂了。

They're like, Yeah, Okay, we got enough nutrition coming in that we can now accommodate for developing muscle and losing body fat.

但对女性来说，我们身体里有更多敏感的区域。

For women, we have more areas that are very sensitive.

对什么敏感？

Sensitive to?

对营养密度敏感。

To nutrient density.

我来解释一下，当我们提到摄入4克碳水化合物的时候——假设这些碳水是从果蔬里获取的，不是从超加工食品里来的。

So, when I say this, when we're talking about four grams of carbohydrate that come in And say they're carbohydrate from fruit and veg, not from ultra processed stuff.

这四克碳水化合物对男性和女性的身体会产生不同的影响。

Those four grams of carb will affect the bodies differently between being a man and a woman.

对男性来说，这四克碳水化合物进入体内后，主要会先提升血糖，之后会被储存为肝脏和肌肉的糖原。

For a man, those four grams of carb coming in primarily will go blood sugar and then be stored as liver muscle glycogen.

而对女性来说，它们只会提升血糖。

For women, it's blood sugar.

这些碳水无法被储存，因为女性要想将糖原储存到肌肉和肝脏中，必须先激活肝脏的部分酶，以及骨骼肌自身的部分酶，这些酶会发出信号：对，没问题，我们要把这些能量储存起来。

It doesn't get stored because for women, in order to store muscle and liver glycogen, you have to have an activation of some enzymes from the liver, as well as some enzymes within the skeletal muscle itself to say, Yeah, okay, we want to store this.

我们的身体不会让这些营养循环开来。

We don't want to circulate it.

所以接下来我们就得研究大脑是如何解读这类情况的。

So, then we start looking at how the brain is perceiving that.

如果大脑判断：对，我们可以把这些营养储存起来，毕竟现有肌肉组织充足，血糖水平也能支撑我们完成日常活动、安稳度过这一天，

So, if the brain is saying, Yeah, we can store this because there's still enough muscle tissue around, there's still enough blood glucose that we can keep going and we can survive the day.

但对女性来说，血糖会一直滞留在血液里。

But for women, it sits there, the blood glucose sits there.

当身体开始消耗这些血糖时，下丘脑就会发出信号：好的，后续补充的食物在哪里？我们得维持运转，还得应对身体正在承受的压力呢？

When it starts being used, the hypothalamus is like, Okay, where's the extra food that's coming in so we can keep going and countering the stress that's coming in?

从数据角度分析，要维持基础热量摄入，保障身体正常运转，同时避免内分泌、激素或食欲功能紊乱，对于男性来说，每公斤去脂体重需要摄入15大卡的热量。

And the best way from a numbers perspective to look at it is when we are looking at baseline calorie intake just to exist and not get into any kind of endocrine or hormone dysfunction and appetite dysfunction, for men, it's 15 calories per kilogram of fat free mass.

而女性则需要每公斤去脂体重摄入30大卡。

For women, it's 30.

所以我们会发现，男性在空腹训练这类模式下的适应效果很不错。

So, we start to see men do really well on things like fasted training.

我们发现男性在热量限制的情况下身体状态都很不错，因为男性下丘脑对较低的热量摄入、低碳水摄入，或是高蛋白高脂肪摄入的敏感度没那么高。

We see men do really well on calorie restriction because the hypothalamus is not as sensitive to lower calorie intake or to low carb intake or to high protein and high fat intake.

但对女性而言并非如此，因为女性下丘脑有更多区域会对营养密度产生感应。

But for women, because the hypothalamus has more areas that are sensitive to nutrient density.

这是什么意思呢？

What does that mean?

不好意思，我没太明白。

Sorry.

我甚至不知道下丘脑是什么。

I'm not even sure what the hypothalamus is.

下丘脑是大脑中的一个区域，负责感知。

So, the hypothalamus is an area in the brain, and it's sensing.

你的血液会流经大脑。

So, you have blood that circulates through the brain.

它感知体温，也就是血液有多热。

It senses temperature, how hot your blood is.

就像身体的恒温器一样。

Like the thermostat or something of the body.

是的。

Yeah.

好的。

Okay.

所以，没错，它确实是个恒温器。

So, yeah, it is a thermostat.

它还是人体的食欲控制中枢。

It's the appetite control center.

它负责调控身体对盐、蛋白质以及碳水化合物的反应机制。

It's how your body responds to salt, how your body responds to protein, carbohydrate.

判断我是不是需要摄入更多的营养？

Do I need more?

还是说要减少摄入？

Do I need less?

所以它大体上就相当于人体的控制中心。

So, it's like the control center for the most part.

那对于来咨询的、正在进行空腹训练的女性来说，她们的下丘脑就会发出疑问：等一下，情况不对。

So, for women who come in and they're doing fasted training, the hypothalamus is like, Wait a second.

咱们现在没有血糖供给了。

We don't have any blood sugar.

我们摄入的碳水化合物根本不足以支撑这类训练的开展。

We don't have enough carbohydrate to actually do this kind of training.

所以我的身体就会出现一些功能紊乱，而且因为没有足够的能量来维持这些肌肉收缩，我会开始下调所有同样需要这类燃料的其他身体系统的运转。

So, what I'm going to do is I'm going to create a little bit of a dysfunction here, and I'm going to start down turning all the other systems that need the same kind of fuel because I don't have enough just to do these muscle contractions.

那也就是说你最终可能会流失肌肉。

So that means you could end up losing muscle.

没错。

Absolutely.

所以如果有女性来找我，说我想减肥，而且我一直在做空腹训练：我起床后先喝一杯黑咖啡，然后去健身房，先做力量训练，再做一些有氧运动。

So if a woman comes to me and is like, I want to lose weight, and I've been doing fasted training, I get up, I have a black coffee, I go to the gym, I do my lifting, I do some of my cardio.

我女朋友现在就是这么做的。

My girlfriend does exactly that.

我还不觉得饿呢，因为我刚在健身房练了高强度的训练。

And then I'm not that hungry because I did a hard workout at the gym.

我可能会先喝一杯蛋白质恢复奶昔，然后一直忍到中午才吃第一顿饭。

I might have a protein recovery shake, and then I'll hold off eating my first meal until noon.

我每次都会跟她们说，那你还去健身房干嘛呢？

I always turn to them and go, well, why did you go to the gym?

因为你实际上所做的只是消耗掉了你的瘦体重。

Because all you've effectively done is burn through your lean mass.

因为你的身体需要摄入一定的燃料。

Because your body needs to have some fuel.

而身体最先消耗的就是瘦体重，因为它是人体内活性很高的组成部分。

And the first thing that goes is lean mass because it's a very active component of the body.

所以，如果你要做力量训练，不妨提前摄入15克蛋白质；如果要做有氧和力量训练，就提前吃15克蛋白质加30克碳水——这个量并不多，它刚好能提升你的血糖，把「有营养物质正在摄入」的信号传递到下丘脑。

So, it will be better for you as a woman to have maybe 15 grams of protein if you're going to do strength or 15 grams of protein with 30 grams of carb, which isn't a lot, before you go do cardio and strength because this is just enough to raise your blood sugar, to circulate to the hypothalamus that, yes, there's some nutrition coming in.

我可以让血糖正常运转起来。

I'm able to get that blood sugar working.

我可以让这些血糖进入肌肉组织。

I'm able to get that blood sugar into the muscle.

我可以激活肌肉里的线粒体，让它们消耗更多的游离脂肪酸。

I'm able to stimulate the mitochondria in the muscle to actually use some more free fatty acids.

我可以向肝脏发出信号，告诉它我完全可以撑过去，并且消耗掉这些游离脂肪酸，而不是把它们储存起来。

I'm able to tell the liver that I can actually get through this and use these free fatty acids instead of storing them.

只需要吃一点点东西，就能对你正在做的运动产生益处。

It only takes a little bit of food to then have benefit for what you're doing.

换作是男性的话，他可以只喝一杯黑咖啡就开始运动。

For a man, if he comes in, I have a black coffee.

他去健身房完成力量训练，或许再做一点有氧运动，之后再补充蛋白质，之后再推迟正餐也完全没问题。

I go to the gym, I do my strength, I might do a little cardio, have my protein afterwards, and then I might delay my meal, I'm like, That's all right.

因为男性的身体恢复窗口更长。

Because you have a longer window for recovery.

下丘脑就不会那么敏感了。

The hypothalamus isn't as sensitive.

你也就不会消耗掉自身的瘦体重了。

You're not burning through a lean mass.

你的身体会产生一定的压力。

You're developing a stress on the body.

我们都知道，运动后补充蛋白质是非常正确的做法，因为这会启动肌肉蛋白合成过程，还能帮你维持状态，直到你吃下正餐。

And we know that it's really good that you had that protein post exercise because that's going to create some muscle protein synthesis and hold you over till you have your meal.

好的。

Okay.

那我试着用给10岁小孩解释的方式跟你说这个吧，我对这个话题的认知水平也就刚好是这个智商水平。

So I'm going to try and explain this to you like I'm a 10 year old, which is the exact level of IQ I have on this subject matter.

对。

Yeah.

所以你大脑里有个下丘脑，它本质上就是个传感器。

So you've got this hypothalamus in the brain, which is basically the sensor.

它在试着调整，确保所有状态都维持在……我突然想不起别人教过我的那个专业术语了。

It's trying to figure out, make sure everything is in I'm trying to think of that big word that someone taught me.

稳态（Homeostasis）。

Homeostasis.

稳态。

Homeostasis.

所有指标都维持在平稳水平。

Everything is level.

对吧？

Right?

对的。

Yeah.

而且女性的下丘脑敏感度更高。

And a woman's hypothalamus is more sensitive.

所以如果我的伴侣起床后去健身房，喝了黑咖啡，在健身房完成了高强度训练——她一直都是这样——那她体内的下丘脑会比一般情况更慌，因为它会判定身体现在正承受压力，接着它就会检查体内有没有足够的血糖水平，但结果会是血糖不足，毕竟她已经好一阵子没吃东西了，没法达到正常的血糖水平。

So if my partner wakes up, goes to the gym, has her black coffee, goes to the gym, does a big workout, she always does, her body, her hypothalamus, is going to panic a little bit more because it's going to assume that there's stress on the body now, and it's going to look around to see if it has sufficient blood glucose levels and it's not going to because she's not had anything for a while, she's not going to have the sufficient blood glucose levels.

所以它就会开始消耗她的瘦肌肉量。

So it's going to start burning her lean muscle mass.

没错。

Exactly.

也就是说，她的情况基本上就是进一步退一步，白忙活了。

Which means that she's she's essentially gonna it's like one step forward, one step back.

对的。

Right.

我把这个说得非常简单易懂了。

Super simplified.

如果是男士，早上喝了黑咖啡去健身房锻炼，他的身体做出的反应是这样的：

For a guy, has his black coffee in the morning, goes to the gym, does the workout, the body looks.

由于男性的下丘脑敏感度更低，它不会要求身体必须维持很高的血糖水平，不会那么在意这件事。

And because the hypothalamus is less sensitive, it's less requiring of there to be higher blood sugar levels, doesn't care as much.

所以身体会

So it's going to

它还会进一步调用我们肝脏和肌肉中储存的糖原。

It can also tap more into our liver and muscle glycogen stores.

所以它就会想，对，行吧。

So it's going to say, yeah, okay.

我们现在还有少量的血糖。

Well, we have a little bit of blood glucose.

但我们还需要再多一点。

We need a little bit more.

所以让我们动用这些储备并提取出来。

So let's tap into the stores and pull them out.

因此，它不太愿意直接动用我的瘦肌肉组织。

So it's less reluctant to go straight for my lean muscle mass.

没错。

Exactly.

好的。

Okay.

它有另一种能量来源。

It has an alternative fuel source.

这很有趣。

That's interesting.

这背后的进化故事是什么？

And what's the evolutionary story of this?

为什么这说得通？

Why does this make sense?

如果我们从部落群居的角度来看，可能会有一些社会学家反驳我说：‘等等，这话说得不完全对。’

When we look tribally, I might get hit by some sociologists who are like, wait, this isn't completely true.

不过也有例外，确实有一些部落不符合这种情况。

But for the exception, there are some tribes that didn't fit into this.

但从生物进化的总体视角来看，过去当我们遭遇热量摄入不足的时期，不得不外出捕猎野兽、寻找食物来源时，女性如果怀孕、或是多了一张要喂养的孩子的嘴，就会陷入非常不利的处境。

But for the general idea from a biological evolutionary standpoint, when we had times of low calorie intake, so we had to go find the beast or we had to go out and find calories, it was at a disadvantage for the woman to be pregnant or to have a baby an extra mouth to feed.

所以在食物匮乏的时期，女性的生殖系统或是内分泌系统就会逐渐进入休眠状态。

So in times of low food intake, the reproductive system or the endocrine system of a woman would wind down.

所以她会出现闭经，也就是月经会暂停一段时间。

So she would become amenorrhea or lose her menstrual cycle for a while.

但这对男性不会产生同样的影响，因为男性需要保持精瘦的体态、变得更强健敏捷——他们得去和野兽搏斗，或是外出寻找食物并带回来。

But it didn't affect men in that same way because they had to lean up and get fitter and faster because they had to go fight the beast, or they had to go find the calories and bring it back.

所以从进化论的角度来看，当热量或食物摄入不足时，女性的身体会启动机能 conserve（ conserve在这里是保存储备的意思）、逐渐放缓生殖相关的运作，因为身体会误以为饥荒要来了。

So when we're looking from that evolutionary standpoint, in times of low calorie intake or low food intake, a woman's body will start to conserve and wind down because it thinks there's a famine coming.

但男性对这种情况没那么敏感，他们的身体只会觉得：哦，摄入的热量不多了。

But for men, they're not as sensitive and the body's like, Oh, not a lot of calories coming in.

这说明我必须为一场战斗做好准备，所以我得减脂。

That must mean there's a fight that I have to prepare for, so I'm going to lean up.

我要调整我的所有能量系统，以便能利用所有这些替代能量来源，从而获得足够的能量去猎杀野兽、带回热量。

I'm going to address all of my fuel systems so that I can tap into all these alternative fuel systems so that I will have the energy to be able to go and fight the beast to bring the calories back.

因此，当热量供应充足时，我们会看到女性会变得更为紧致。

So, when there's adequate calories available, we see that women will lean up.

她们会变得更加敏锐。

They'll become more acutely aware.

认知功能会提升。

Cognitive function comes up.

碳水化合物非常重要。

Carbohydrates are really important.

因此，我们会看到卵子成熟的过程开始发展。

So, we see that there is a development of egg maturation.

我们的内分泌脉冲也变得更佳。

We have better endocrine pulse.

这意味着我们那些每日都会波动的激素，能够完整地完成一次波动周期并回归基线水平，从而帮助身体建立一个强健的内分泌系统。

So, that means that our hormones that pulse on a daily basis, they actually have their full pulse and return to baseline to encourage the body to have a really robust endocrine system.

甲状腺的功能就是如此。

So, that's thyroid.

我们的月经周期也一样，所有这类生理过程都是这个原理。

That's our menstrual cycle, it's all the things.

但当我们开始限制热量摄入时，所有这些生理机能都会开始衰退。

But when we start pulling the calories back, all that stuff winds down.

那这对禁食意味着什么呢？

So what does that say about fasting?

所以这就是核心争议点，对吧？

So this is the big debate, right?

我们来聊聊禁食，以及它的起源。

So we look at fasting and where it first came out.

情况大概是这样的：有一些肥胖且长期久坐的患者，为了手术需要快速减重，他们会被安排执行禁食类方案来迅速减轻体重，以保障手术能够顺利度过。

And it's like, Okay, we see that obese sedentary individuals who had to lose weight rapidly for surgery, they're put on a fasting type program to lose weight quickly in order to survive surgery.

但遗憾的是，很多时候这类临床研究的结论会被直接套用到健康健身领域，没人先去验证它是否真的可行。

And unfortunately, a lot of those times, we look at clinical research, and it gets transposed over to health and fitness without actually asking if it's viable.

接着我们再看健身群体里的入门人群——就是那些刚开始学习运动、想要运动的人。

So then we look at the lower end of the fitness population, People are just learning to move and wanting to move.

他们会想，我还得减掉更多体脂，这样才能让运动状态更好。

And like, I also want to lose more body fat so that I can move better.

那我开始断食吧。

Oh, I'll start fasting.

而且我们发现，绝食相关的大量推崇论调，其数据来源又都是男性群体。

And when we see a lot of the push on it, it comes from male data again.

所以当我们开始研究女性群体的情况时，就会遇到很多曾和伴侣一起来找我的女性，她们都会说，我实在搞不明白。

So, when we start looking at women, and a lot of women used to come with their partners to see me and say, I don't understand.

我们俩做的空腹训练是完全一样的。

We're both doing the same kind of fasted training.

他不仅练出了线条，身体也越来越健壮。

He's leaning up and getting fitter.

我体重涨了，动作也越来越慢。

I'm putting weight on getting slower.

我当时就说，好的，那我们得把这个情况区分开来看。

I'm like, Okay, well, we have to separate it out.

如果你是女性，也想要为了那些我们常听到的健康益处来禁食——比如保护端粒长度、延长寿命、改善身体代谢调控——那我们可以配合自身的昼夜节律来做，也就是晚餐后就停止进食。

If you're a woman and you want to fast for all the health reasons that we hear about with regards to telomere length, improving longevity, improving our body's metabolic control, Then we work with our circadian rhythm, where we stop eating at dinner.

所以，我们吃完晚饭，在睡觉前的两到三个小时里就不再吃东西了。

So, we have dinner and we don't eat two to three hours before bed.

我们经历了整夜的空腹状态后，你需要在醒来后的半小时内进食，以此平缓醒来时自然出现的皮质醇峰值。

We have the overnight fast, and then you want to have food within a half an hour of waking up to blunt that cortisol peak that's natural upon waking.

而对男性来说，禁食的方式可以灵活多变。

For men, you can have variations of fasting.

你可以尝试间歇性禁食。

You can do intermittent fasting.

也可以尝试战士禁食法，依然能从中获益。

You can do warrior fasting, and you can still have benefit.

但对女性来说，从现有数据来看，如果我们采用战士断食法——也就是断食20小时、仅留4小时的进食窗口期——男性采用这种方法会增强副交感神经的活性，专注力也会提升。

But for women, when we look at the data, and if we were to do a warrior fast, which is a twenty hour fast, four hour eating window, for men, we see more parasympathetic drives, they get that more focus.

他们的血糖控制能力会变得更好。

They have better blood glucose control.

他们的脂肪燃烧速度还会加快。

They get an acceleration of body fat loss.

他们的代谢灵活性会增强，也就是说他们的身体能够自如地切换碳水化合物和脂肪的供能模式。

They become more metabolically flexible, meaning their body is able to transfer between carbohydrate and fat utilization.

但对女性来说，情况并非如此。

For women, it doesn't happen that way.

如果女性采用战士断食法——也就是每天断食20小时，仅在4小时的窗口内进食——她们的血糖控制能力反而会变差。

For women who do a warrior fast, so that's a twenty hour fasting and four hour eating window, they end up with less blood sugar control.

我们的空腹血糖水平会更高。

We have higher resting blood glucose.

身体的脂肪储存量也会增加。

We have more fat storage.

我们的交感神经兴奋性会增强。

We have more sympathetic drives.

这就意味着身体处于压力状态下，你将无法拥有良好的睡眠或是完成很好的恢复。

That means the body's under stress and you're not going to be able to sleep or recover well.

而且我们发现，在执行这种禁食法的四天内，甲状腺功能就会出现衰退。

And we see a downturn of the thyroid within four days of doing this.

所以说，目前那些有关禁食的研究数据，本质上都是以男性的情况为依据，再将结论泛化套用到女性身上的。

So, when we're looking at the data of fasting, again, it's pulling from the men and generalizing to the women.

但当我们真正深入研究、细化分析女性的专属数据后就会发现，目前健康健身领域流行的这类禁食方法并不适合女性。

But when we start really looking and narrowing it down and looking at female specific data, the type of fasting that's out there in the health and fitness world is not appropriate for women.

那你觉得夜间禁食、也就是提前吃晚餐的方式怎么样？

But you would say that the overnight fast, eating dinner at a earlier time

比如六点、七点就吃晚餐。

At six, seven.

也就是傍晚6点吃完晚餐，等早上起床后，比如八点或者九点左右再吃早餐？这样可以吗？

06:00, and then eating breakfast when you wake up at, say, eight in the morning or nine or something?

六点或七点。

Six or seven.

那关于你听说的三天断食来触发自噬的呢？

What about the three day fast you hear about to get into autophagy or whatever it is?

运动对自噬的刺激作用比断食更强。

Exercise is a stronger stimulus for autophagy than fasting.

因此，我们将运动本身视为一种断食状态。

So we look at exercise in itself as a fasting state.

运动过程中会发生什么？

What happens during exercise?

你开始运动时，身体会试图提供能量。

You start exercising, your body is trying to provide fuel.

它会分解脂肪、分解葡萄糖、分解氨基酸。

So, it's breaking down fat, it's breaking down glucose, it's breaking down amino acids.

同时，从恢复的角度来看，它还会在男性和女性体内促进生长激素和睾酮的分泌，从而引发细胞清理，也就是自噬。

It's also creating, in a recovery standpoint, a boost of growth hormone, a boost of testosterone in both men and women that creates the cell cleanup, which is autophagy.

所以如果我们要对比禁食和运动的差异，运动带来的刺激作用更强。

So, if we're looking at the difference between fasting and exercise, exercise is a stronger stress.

我们常听说禁食能带来的那些益于长寿的功效，运动通通都能实现。

All the things that we hear about fasting and longevity, exercise does the same.

运动对长寿的促进作用比禁食更强。

It's a stronger stimulus for it.

但问题是我们的社会已经变得越来越慵懒，大家都觉得运动太难了。

But the problem is we've become a lazy society and people think exercise is too hard.

作为一名运动生理学家，看到有些人连在街上走路都很费劲，真的让我很难过。这都是因为我们太习惯待在温度恒定的房间里，出门就开车、用自动开门器，或是叫优步，根本没必要自己走路。

As an exercise physiologist, it breaks my heart to see people who are struggling to walk down the street because we are so used to being conditioned to a certain temperature in a room, to having a car, automatic opener, or Uber come so we don't have to walk down the road.

我经常会提到21世纪初的那部动画电影《机器人总动员》，里面有个小机器人在人类社会里四处游荡。

And I bring up that movie Wall E from the early 2000s with the little robot who's wandering around society.

电影里所有人都躺在悬浮床上盯着屏幕看，其中有个人被瓦力撞得从床上掉了下来。

And you see all these people on these floating beds watching a screen, and one of the guys gets kicked off by Wall E, accidentally falls down.

他居然都站不起来了。

He can't get up.

然后他环顾四周，疑惑自己为什么站不起来。

And he's looking around going, why can't I get up?

这到底是怎么回事？

What's going on?

这就是如今的社会：人们根本没办法长时间靠自己的力量支撑身体行动，因为这对他们来说太难了。

That's today's society, where people are not able to actually pull their own body weight around for a significant amount of time because it feels too difficult.

反观层出不穷的营养学概念和相关潮流——从断食到肉食饮食，再到早些时候的原始人饮食法，人们尝试过所有这些方法，可一提到运动，我们却只会不断变换运动的形式而已。

Whereas, if we look at all the stuff that comes out with nutrition and all of the trends that come out with nutrition, from fasting to carnivorous diet to the old fashioned paleo, all of these things that people are trying to do, We turn to exercise and we change the modalities of exercise.

我们是在做高强度运动吗？

Are we doing intense exercise?

还是在做低强度运动？

Are we doing low intensity?

我们是在做力量抗阻训练吗？

Are we doing resistance training?

还是在做心肺有氧训练？

Are we doing cardio?

我们到底在做什么？

What are we doing?

所有这些运动方式给身体带来的压力远大于那些疯狂的饮食法，能引发更强的适应性变化。

All of these things in exercise are significantly stronger stress on the body that create more adaptive changes than all these crazy diets.

但人们觉得运动太难了，或者没时间。

But people find exercise too hard or they don't have time.

所以，在那个男人和女人来找你的例子中，你不会建议女性以和男性相同的方式禁食。

So, finally, in that example where that man and woman come to you wouldn't recommend the woman to fast in the same way that you'd recommend a man to fast.

如果他们的目标是减重，你在训练方式上会有什么不同的建议吗？

Is there any differences that you'd recommend in training if their goal was to lose weight?

是的，绝对会。

Yep, absolutely.

当我们考虑女性时，无论年龄如何，因为女性的衰老方式与男性不同。

So when we're looking at regardless of age for women, because we see that women don't age in a linear fashion like men.

所以我们有明确的阶段。

So we have definitive points.

我们有青春期。

We have puberty.

我们有生育期。

We have our reproductive years.

这其中可能不包括怀孕。

We may not have pregnancy in there.

我们有围绝经期。

We have perimenopause.

我们有绝经后。

We have postmenopause.

每一个阶段都有不同的激素水平，会影响我们的训练方式。

Each one of those is a different hormone profile that can affect the way we train.

对于男性来说，你就只管说，唉，到了50多岁后期，睾酮水平就开始下降。

For men, you just go, pooh, and we start to see a decline of testosterone when we get into our late 50s.

所以我们现在讨论的是女性和训练。

So, we're talking about women and training.

如果有个35岁左右的人过来，说‘我想减肥’，那好，就做抗阻训练。

If someone is coming in and they're in their mid-30s and they're like, I want to lose weight, okay, resistance training.

如果有个45岁左右的人过来，那他正处于围绝经期，同样做抗阻训练。

If someone comes in and they're in their mid-40s, then perimenopause, resistance training.

这都不是问题。

Doesn't matter.

抗阻训练是关键，它能调动腹部脂肪、增加瘦体重，还能通过一种名为肌因子的物质，加强骨骼肌与人体储存脂肪之间的交互作用——肌因子是运动时由骨骼肌释放的激素信号。

Resistance training is key for mobilizing abdominal fat and for creating more lean mass and also increasing the amount of crosstalk between their skeletal muscle and our stored fat through little things called myokines, which are hormone signals that are released during exercise and released from the skeletal muscle.

所以如果我们决定，好的，那我们就通过抗阻训练来真正实现身体成分重组，同时我们还要提高蛋白质的摄入量——因为研究表明，如果在开展抗阻训练的同时配合更高的蛋白质摄入，我们就能在12周的周期内完成完整的身体成分重组。

So, if we say, Okay, let's do resistance training to really recomp the body, we also want to increase our protein intake because we see if you're doing resistance training with a higher protein intake, then we have complete recomp over the course of twelve weeks.

这对女性来说是一种非常有力的激励工具，因为一直以来，直到最近，女性都被排斥在力量训练领域之外。

And it's a very powerful motivating tool for women because for the most part, women have been excommunicated from the strength world until recently.

过去社会并不接受女性拥有大量肌肉。

It wasn't kosher for women to have a lot of muscles.

就像我是在90年代长大的，那时候的超模都骨瘦如柴，女性去健身房举铁是不符合当时的主流审美和认知的。

We see, like I grew up in the '90s with the supermodels that were super skinny, and it wasn't kosher for women to be in the gym lifting weights.

但我们见证了这种观念的转变，也开始有越来越多针对女性进行抗阻训练的研究涌现出来。

But we see this evolution change, and so we're starting to see more research come out in women in resistance training.

想要改变身体成分，就必须开展抗阻训练，这一点至关重要。

And it's so imperative for body composition change to invoke that resistance training.

那Ozempic（司美格鲁肽）呢？

What about Ozempic?

Ozempic，确实。

Ozempic, yeah.

所以我觉得这很有趣，因为它对社会产生了如此广泛的影响。

So I find it interesting because of all the impact it's having on society.

而且它确实是一个非常强大的工具。

And it is a very powerful tool.

问题在于，没有人真正被教导如何停用它。

The problem with it is no one is being necessarily taught how to come off it.

所以，如果我们观察Ozempic以及GPL-1的强大功效，会发现它确实能启动一种食欲开关，抑制食欲并减弱渴望。

So, if we look at Ozempic and how powerful the GPL-one is, we see it does invoke an appetite switch where it mutes the appetite, it dampens cravings.

所以大家会看到这种药带来快速减重，但减掉的这些体重里其实包含瘦体重。

So, we see it as rapid weight loss, but that rapid weight loss is lean mass.

这就又回到《机器人总动员》里那个情节了——你会因为缺乏瘦体重，连站起来都做不到。

So, that comes back to the Wall E picture where you can't get up because you don't have lean mass.

很多人根本没有机会学习如何通过科学的力量训练、运动方案以及合理的饮食来配合使用Ozempic期间的减重，顺利停药，我很为这类群体担忧。

I fear for society who doesn't have the opportunity to learn how to come off it through proper strength training, exercise modalities, and nutrition to support the weight loss that comes with Ozempic use.

它绝对是个很棒的工具。

It's absolutely a brilliant tool.

它绝对是个很棒的工具，但我们在行为改变这一步掉链子了。

It's absolutely a brilliant tool, but we're falling on the behavior change.

如果我们能真正教会人们在使用这款工具的同时如何培养出相应的行为习惯，那他们停药后就不用担惊受怕体重反弹了。

If we were to really teach people how to create that behavior change while they're using the tool, then they can come off it and not be afraid of putting weight back on.

好的。

Okay.

那如果有人来找你咨询，你会推荐他们用这个药吗？

So would you recommend it for people that come to see you or ask you for advice?

不会，因为来找我咨询的人大多只是想减掉那10磅的“爱美体重”，也就是为了外形想减的体重。

No, because most of the people that come to see me have those 10 vanity pounds they want to lose.

我称之为爱美体重，是因为这些体重是悄悄涨上来的，你完全可以在日常生活中做些小改变来减掉它们，还能维持住不反弹。

I call them vanity pounds because they're the ones that creep up and you can instigate little changes within the daily life to actually lose them and keep them off.

但对于那些受严重肥胖困扰、已经处于糖尿病前期、还伴有其他健康问题的人来说，运动对他们而言实在太难了——仅仅是从椅子上站起来都会气喘吁吁。这种情况下我们得先帮他们减掉一些体重，之后才能逐步开展适配他们身体状况的运动计划。

For people who are struggling who have severe obesity, they're pre diabetic, they have other medical conditions, and exercise is definitely in the too hard basket because they get breathless just getting up out of their chair, we need to lose some weight first so that we can then implement some of the adaptive changes of exercise.

那你觉得女性和男性都应该在运动结束后立刻进食吗？还是说男女在这方面存在什么差异？

And do you think women should be eating immediately after they exercise, and men, or is there a variance there at all?

这其中存在个体差异，因为当我们观察所说的代谢回落至基线水平时，也就是你的整个身体恢复到静息状态的过程，

There is a variance because when we look at what we call metabolism coming back down to baseline, so that's your overall body coming back down to its resting state.

女性的这个过程会在运动结束后的30到40分钟内完成，

For women, it happens within thirty to forty minutes after exercise.

男性则需要2到18小时，具体时长取决于运动强度，

For men, it's two to eighteen hours, depending on the intensity.

因此，从这点来看，如果我们想要最大化身体的抗阻训练效果和肌肉合成能力，就需要给身体补充一些食物。

So, in that, we see that if we want to maximize our body's resistance training and muscle building capacity, we need to give it some food.

我们需要给身体补充足量的优质蛋白质。

We need to give it some really good hit of protein.

对于处于生育年龄的女性，建议在运动结束后45分钟内摄入35克蛋白质。

For women who are in their reproductive years, we see 35 grams of protein post exercise within forty five minutes.

这个量就能启动肌肉蛋白合成的过程，促进肌肉生长。

We'll tip the muscle into muscle protein synthesis.

而男性只需要20克蛋白质，而且可以在运动结束后2小时、4小时或是任意时间段摄入都可以。

For men, it's 20 grams, and it can be two, four, whatever hours later.

当我们要让肌肉糖原恢复到正常水平时，女性运动后所需补充的碳水化合物并不多，而男性需要补充更多，因为他们运动时会消耗更多体内储备的糖原。

When we're looking at returning our muscle glycogen back to normal, we don't need as much carbohydrate post exercise as a woman as men need more because they tap more into their stores.

所以女性运动后补剂的黄金窗口期大约在运动结束后45分钟左右，但男性的这个窗口期要宽泛得多。

So the window of opportunity for women post exercise is around that forty five minute mark, but for men, it's open a lot wider.

那生酮饮食对女性来说怎么样呢？

What about the keto diet for women?

无论对男性还是女性，我都反对生酮饮食。

I am anti keto for both sexes.

我这么说是因为肠道微生物群实在是太重要了。

And I say this because when we look at the gut microbiome, that is so important.

随着我们越来越多地定居在城市中，食物链里的食物种类越来越少，我们也观察到肠道微生物的多样性正在下降。

We see a decrease in diversity as we become more and more city dwelling and we are having less and less of variety in our food chain.

我们必须好好养护肠道微生物群。

We have to take care of the gut microbiome.

而生酮饮食伴随的高脂肪摄入，会大幅降低肠道微生物群的多样性，进而削弱身体合成维生素、产生血清素的能力，也会破坏肠道和大脑之间的这种信息交流机制。

If we look at the ketogenic diet and the high fat intake that comes with it, it significantly decreases that gut microbiome diversity, which reduces the body's ability to synthesize vitamins, to produce serotonin, to have this conversation between the gut and the brain.

而且对女性来说，我们天生就具备代谢灵活性，因为我们生来就拥有更多耐力型肌纤维，所以完全没有必要尝试生酮饮食。

And for women, we're already metabolically flexible by the nature of being born with more of those endurant fibers that there's no reason to try to do a ketogenic diet.

那我能不能不吃益生元之类的补剂，只靠多吃蔬菜水果这类食物来补充呢？

Can I not take a prebiotic or something or just eat more fruits and veggies and stuff?

如果你平时吃很多果蔬的话，

So, if you're eating a lot of fruit and veggies

不好意思，我口误了，不是水果，是蔬菜。

Sorry, not fruit, veggies.

不对的。

No.

如果你吃很多富含纤维的水果和蔬菜，那才是我们提升肠道菌群多样性的正确方式。

If you're eating a lot of fibrous fruit and veg, then that's how we increase the diversity.

吃益生菌补剂只会作用于小肠上段，而且这种补剂本身也有点靠不住——市面上所有益生菌产品都仅由两到三家公司代工生产，也就是企业对企业的供货模式。

Taking a probiotic pill just affects the upper intestines, but even that is a little bit suspect because there's only two to three companies that are making all the probiotics that are B2B, so that means business to business.

而且我们并不清楚补充益生菌的长期影响，甚至有可能因为某些益生菌过量增殖，再次引发肠道菌群失调。

And we don't really know the long term outcome, and we can have the overgrowth of some probiotics that, again, can cause some dysbiosis.

那如果我执行生酮饮食的话，还能保护我的肠道微生物组吗？

Could I be on the keto diet and still protect my gut microbiome?

根据我目前了解的情况，我觉得做不到。

I don't think so, not from what I've seen.

我之前一直以为肠道微生物组主要靠植物性食物来维持啊。

Because I thought the gut microbiome was predominantly about plants.

确实是这样，但你也需要从多种不同来源摄取蛋白质。

It is, but you also need some protein that comes from a wide variety of different sources.

真正的生酮饮食中，脂肪摄入量占总摄入热量的70%到80%。

The amount of fat that is taken in through a true ketogenic diet is 70% to 80% of your total intake coming from fat.

这会导致主要依靠脂肪酸生存的细菌过度繁殖，同时会抑制那些依赖我们摄入的高纤维果蔬的有益菌——因为你在生酮饮食期间根本无法摄入足够维持菌群多样性所需的膳食纤维。

And then that will cause the overgrowth of the bacteria that relies primarily on fatty acids, which down regulates all the good bacteria that relies on our fibrous fruit and veg because you're not going to be able to consume as much fiber as you need on a ketogenic diet to really invoke this diversity.

如果想要促进菌群多样性，你一周需要摄入30种不同的植物类食物。

If we're thinking about invoking diversity, you want 30 different plants across the week.

而在生酮饮食模式下，你根本没法摄入足够多的这类食物来构建这样的菌群多样性。

And on a ketogenic diet, you're just not capable of being able to eat as much to create that diversity.

这种微生物多样性对女性而言至关重要，原因在于我们体内有部分肠道菌群负责调节性激素的代谢过程。

And the reason why it's really important for women to have that diversity is because we have some gut bugs that are responsible for our sex hormone metabolism.

比如说我们熟知的雌激素和黄体酮。

So, we think about estrogen, progesterone.

很多人会觉得，对，这些激素是由卵巢和肾上腺释放出来，然后作用于我们的靶组织的。

People think, Oh, yeah, well, it's released from the ovaries and the adrenals, and it goes and hits our target tissues.

但我们体内还有一个“二次循环”的机制：肝脏会摄取这些性激素，让它们与性激素结合球蛋白结合，再通过胆汁送入肠道，随后这些肠道菌群会对它们进行解离处理，也就是拆解开来，最后这些激素会重新回到血液循环中继续发挥作用。

But we have this thing called a second pass, where our sex hormones will be taken up by the liver, bound by sex hormone binding globulin, shot into the intestines through bile, unconjugated or unpacked by these little gut bugs, and then shot back out into circulation to work.

如果肠道微生物群的多样性较低，我们体内就缺少那些能帮助性激素重新激活、让性激素发挥最佳作用的菌群。

If we have a lower diversity of the gut microbiome, we don't have those bugs that will help with our sex hormone reactivation and the ability for the sex hormones to work optimally.

那桑拿浴和冷水浴这类项目呢？

What about things like saunas and cold plunges?

这两类项目对男性和女性的作用存在区别或是差异吗？

Is there a difference, a variance there between men and women?

当然有区别。

Absolutely.

那咱们来说说冰浴，现在这个可火了，对吧？

So, if we're looking at cold plunge, and it's all the rage, right?

大家都在说，咱们去泡冰水吧。

We're saying, Let's get into ice water.

说它能激发强烈的副交感神经反应。

It's going to invoke this massive parasympathetic response.

还说泡完之后思维会更清晰，专注力也会提升。

I'm going to have lots of cognition and focus.

它会产生一种激素反应，帮助改善我的血糖水平。

Going to create a hormonal response that improves my blood glucose.

它还会激发大量自噬作用，还能产生和禁食一样的诸多益处。

It's going to invoke a lot of autophagy and all the things that we see with fasting as well.

它还能带来一种极强的掌控感，不过这都是从男性群体的研究数据里得出的结论。

And it gives me this incredible sense of being in control, male data.

那我们再看看泡冰浴的女性群体的情况。

We look at women who are in ice bath.

水太冷了，根本没法触发这些反应。

It's too cold to invoke those responses.

这是因为在体温调节方面，男性和女性的皮肤感知能力存在差异。

And the reason for that is we have differences in our skin sensation between men and women with regards to thermoregulation.

女性的皮下脂肪更多，也就是皮肤下面的脂肪层更厚。

So, women have more subcutaneous fat, so more fat under the skin.

而且我们的血管会率先出现收缩和扩张的反应。

And we tend to vasoconstrict and vasodilate first.

这意味着血管会紧密收缩，然后我们会开始出现一些内部变化。

So, that means that blood vessels will constrict tightly, and then we'll start to have some internal changes.

或者如果我们太热，会先血管扩张，然后通过出汗来产生内部变化。

Or if we're too hot, we'll vasodilate first, and then we'll have internal changes to create sweating.

因此，当我们考虑冷水浸泡时，对于女性来说，收缩过于强烈，成为了一种过大的威胁。

So, when we look at a cold plunge, there's too much constriction, and it becomes too much of a threat to women.

她们的身体对冰水的反应与男性不同。

And their bodies don't have the same response to ice water.

我们发现，15到16摄氏度，大约55华氏度，是女性体验与男性使用冰水相同效果的最佳温度。

We see that 15 to 16 degrees C, or around 55 degrees Fahrenheit, is optimal temperature for women to experience the same effect that men have with ice.

因此，在冷水浸泡的反应上，男女之间存在温度差异。

So there's a sex difference in the temperature to invoke the same response between cold water immersion responses.

在桑拿中，所有人都会有反应。

In the sauna, everyone responds.

而且我们发现，桑拿的适应机制在男女之间又有所不同。

And we see that the adaptation for sauna is different again for men and women.

这是因为对女性而言，身体开始出汗前，高温环境下的血管舒张过程存在差异，核心体温需要更长时间才会上升。

Because for women, with the difference of the vasodilation in the heat before they start sweating, it takes a longer time for core temperature to come up.

因此在激素水平发生变化、血容量产生适应反应之前，女性可以在高温环境中停留更久。

So, women can spend more time in the heat before they start to get changes in their hormone responses and blood volume adaptations.

而男性就不一样了，说到这儿我都有点想笑。

For men, they can go in and I kind of laugh.

我丈夫之前陪我一起进桑拿房，我都坐了十分钟了还没出汗呢。

My husband will come in with me in the sauna, and I'll sit there for ten minutes and not sweating yet.

他（在冷水里）撑不住了，开始浑身发抖。

And he's pouring.

他就说，我得出去了。

He's like, I got to get out.

而我得花二三十分钟才能出现和他一样的反应。

And it takes me twenty or thirty minutes in order to get the same response.

所以当我们研究那些关于适应过程以及 sauna 引发身体变化的研究数据时，会再次发现女性需要更长的时间——无论是单次急性体验的时长，还是连续数周坚持所需要的周期，都要更长，才能获得和男性相当的心血管适应效果。

So when we look at the actual research and data that looks at acclimatization and looks at sauna invoking changes, we see again that women need more time, both longer time for an acute bout and longer time across the weeks in order to get the same cardiovascular adaptations as men.

有意思。

Interesting.

我之前没意识到这一点。

I didn't realize that.

典型的冰浴温度是多少？

A typical ice bath is what temperature?

是零下一度左右吗？

It's minus one or something?

我觉得是零到四摄氏度。

Think it's zero to four degrees C.

哦，原来如此。

Oh, okay.

零到四度。

Zero to four.

明白了。

Okay.

所以你的意思是，女性需要待在接近15摄氏度的环境里才能获得同样的效果。

So you're saying that a woman should be near a 15 for the same benefits.

对。

Mhmm.

没错。

Mhmm.

是的。

Yep.

在我供职的Flight工作室，它隶属于我规模更大的Flight集团，我们一直在探索各种方法，和我们的受众建立更深厚的联结——不管是针对一档新节目、一款产品还是一个项目，都是如此。

At my company, Flight Studio, which is part of my bigger company, Flight Group, we're constantly looking for ways to build deeper connections with our audiences, whether that's a new show, a product, or a project.

这就是我推出对话卡片的原因。

It's why I launched the conversation cards.

我之前就使用过Shopify，它是今天这期播客的赞助商，而且在我们下一场大型发布活动中我还会再次和他们合作，这件事很快就会和大家官宣。

I relied on Shopify before, who's a sponsor of today's podcast, and I'll be using them again for the next big launch, which we'll hear about soon.

我选择和他们合作，是因为搭建一个能触达你们所有人的线上门店实在太方便了，无论你们在世界哪个角落都能收到。

And I use them because of how easy it is to set up an online store that reaches all of you, no matter where you are in the world.

有了Shopify，在线推出产品时通常会遇到的那些难题就全都不复存在了。

With Shopify, the usual pain points of launching products online disappear completely.

无论你的业务规模大小，Shopify都能提供你所需的一切工具，帮你的业务更上一层楼，还能和全球各地的客户建立更好的联系。

No matter the size of your business, Shopify has everything you need to make your business go to the next level and better connect with your customers all over the world.

为了感谢大家收听我的节目，我们为你们准备了专属试用福利，每月仅需1美元。

To say thank you to all of you for listening to my show, we're giving you a trial, which is just $1 a month.

你可以访问shopify.com/bartlett完成注册。

You can sign up by going to shopify.com/bartlett.

网址是shopify.com/bartlett，也可以在下方简介里找到链接。

That's shopify.com/bartlett, or find the link in the description below.

去年新年前夜，我和我的伴侣聊到了肌酸的话题。

One of the conversations I had with my partner last year at New Year's Eve was about creatine.

对。

Yeah.

我之前把一些肌酸放在家里的台面上，当时我们正好在外没在家。

I had had some with me on the counter in our in our home, and we were away from home.

然后我跟她说，哦，你该吃点这个。

And I said to her, I said, oh, you should take some.

结果她回答说，不用了，那不是女生吃的。

And her response was, no, that's not for women.

接着她解释说，她觉得这个东西基本上就是健美运动员才会用的。

And she went on to explain that she felt it was for effectively like bodybuilders.

对。

Yeah.

而且它（肌酸）会让人发胖。

And that it would like put on weight.

我当时就说，不对，不是这么回事。

I was like, don't think that's true.

我说，我播客里有几位嘉宾跟我说过，所有人都应该补充肌酸。

Said, like, some people on my podcast have told me that everyone should be taking it.

对。

Yeah.

于是我们坐在那里搜索了相关信息。

And so we sat there and Googled it.

搜索了几分钟后，她就开始尽快地把肌酸倒进她的饮料里。

And after googling it for a couple of minutes, she was scooping it into her drink as fast as she possibly could.

但这里存在一种普遍的看法。

But there is a prevailing narrative here.

实际上，在你来之前，我问了AI几个关于女性对肌酸看法的问题。

Actually, before you came, I asked AI a couple of questions about women's perceptions on creatine.

嗯。

Mhmm.

最常见的一种看法是，女性认为肌酸会让人长肌肉、增重，而且觉得那是给健美运动员用的。

And the number one thing was women thought that it would gain muscle and gain weight, and they thought it was for bodybuilders.

是的。

Yep.

这正是关于肌酸的主流误解。

That is the prevailing myths around creatine.

人们通常怎么表达这个说法？

And what's the expression people use?

剂量决定毒性。

The poisons in the dose.

所以，这属于肌酸的一部分。

So, that's part of the creatine.

如果我们关注健美人群，以及肌酸如何提升肌肉容量和训练状态。

So, if we're looking at the bodybuilding set and how it increases muscle capacity and training status.

因此，针对健美训练的肌酸摄入量是每天四次，每次五克，搭配一克碳水化合物。

So, if we're using a lot of creatine, the dosing for bodybuilding is five grams four times a day with one gram of carbohydrate.

我们发现肌酸能帮助肌肉与糖原一起储存水分。

And we see that creatine helps store water within the muscle with glycogen.

我们希望这种效果能提升肌肉表现，因为使用肌酸增强训练强度的原理，在于提高肌肉收缩所需的酶的可用量。

And we want that for muscle performance because the idea of being able to train harder with creatine is to enhance the amount of enzymes that are available for muscle contraction.

肌酸是这一缓冲系统的一部分。

Creatine is part of the buffering system of that.

如果我们关注的是女性健康方面的肌酸，剂量只需每天一次，每次三到五克，无需搭配碳水化合物。

If we're looking at creatine for health and for women, the dose is three to five grams only once a day without carbohydrate.

原因是女性体内的肌酸储存量大约只有男性的70%，而且由于生理原因，女性通常摄入的富含肌酸的食物比男性少。

And the reason for that is women have around 70% of the stores that men have, by the nature, for the most part, don't eat as much creatine filled food as men.

我们发现它在很多方面都有用

And we see that we use it for a lot

我们的

of our

快速能量代谢中，比如肠道健康、大脑健康，以及肌肉表现。

fastenergetics, so for our gut health, for our brain health, and then also for muscle performance.

因此，如果让女性每天只服用一次三到五克肌酸，不会像健美人群每天四次、每次五克那样产生相同的副作用。

So, if we're having women take three to five grams once a day, it does not have the same side effects as the bodybuilding set of taking five grams four times a day.

是的，因为标签上写着要一天服用几次。

Yeah, because on the label, it tells me to take it a few times a day.

是的，你没必要那样做。

Yeah, you don't have to.

而且标签上还提到了冲击期的吃法。

And it says about loading.

你看，这些都是健身健美圈的说法，对吧？

So, this is all the bodybuilding stuff, right?

如果你一定要走冲击期流程的话，一般这类方案会持续两周，就是每天分四次、每次吃五克，快速把身体的肌酸储备填满。

So, if you want to load, we see loading protocols over the course of two weeks, and you're starting to really saturate the body with those five grams four times a day.

但对女性来说，每天吃三到五克，用三周时间就能把身体的肌酸储备完全补足了。

But for women, we see that three to five grams will fully saturate the body over the course of three weeks.

所以这就意味着，正如我刚才提到的，它会作用于我们所有的能量代谢相关机能，比如我们的肠道、肠胃。

So that means that all our fastenergetics, like I said, our gut, the intestines.

我们还会关注肠道细胞和黏膜屏障的完整性。

And we're looking at the integrity of the intestinal cells and the mucosal lining.

而且我们发现，女性出现胃肠道不适的概率要更高。

And we see that there is a greater incidence of GI distress in women.

我记得有数据显示，出现胃肠道不适的男女比例大概是1比5，也就是受影响的女性远多于男性。

I think it's something like a five to one ratio of women to men having GI distress running.

这与雌激素有关，也与我们所说的肠道有关。

And it has to do with estrogen, but also has to do with what we call intestines.

因此，我们希望维持黏膜层的完整性，而肌酸对此至关重要。

So, we want to maintain the integrity of the mucosal lining, and creatine is really important for that.

所以，如果我们用每天三到五克的剂量，持续三周来使身体饱和，就能增强这种完整性，从而减少胃肠道不适。

So, if we're looking at saturating the body over three weeks with three to five grams, we improve that integrity so we have less GI distress.

我们还发现，已有随机对照试验研究了肌酸对情绪的影响，特别是针对抑郁和焦虑。

We also see that there have been randomized controlled trials looking at mood, specifically with regards to depression and anxiety.

服用三到五克肌酸的女性，从抑郁发作中恢复的程度，高于仅使用SSRI类药物的女性。

And women who are taking three to five grams of creatine will come out of a depressive episode more so than women who are just using an SSRI.

因此，它对大脑代谢至关重要。

So, it's really important for brain metabolism.

当我们考虑男性整体的加载策略时，这完全是为了提升肌肉表现。

And when we're looking at that whole loading strategy for men, that's all about muscle performance.

这与肠道健康无关。

It's not about gut health.

它和大脑健康无关。

It's not about brain health.

而是和肌肉表现相关。

It's about muscle performance.

我刚查了一些研究，无论对男性还是女性来说，补充肌酸都能增强肌肉力量、增加肌肉量、提升高强度运动表现、促进恢复，还有潜在的认知益处，同时对神经退行性疾病能起到辅助作用。

Just looking at some studies, creatine supplementation for both men and women enhances muscle strength, increases lean muscle mass, improves high intensity exercise performance, improves recovery, has potential cognitive benefits and supports in neurodegenerative diseases.

对的。

Yes.

艾比·史密斯·瑞安是北卡罗来纳大学的一位同事，她在女性肌酸补充领域做了大量研究工作。

So, Abby Smith Ryan is a colleague out of UNC, and she's done a lot of work in creatine for women.

没错，我们确实观察到肌肉机能有所提升，这是因为你为肌肉收缩增加了可用的能量缓冲储备。

And yes, we see that there is an improvement in muscle capacity because you're increasing the amount of buffer that's available for muscle contractions.

但女性所需的冲击期剂量不必和男性的一样。

But it doesn't have to be the same loading dose as men.

不过如果你是为了提升运动表现——比如你想优化一段训练周期、正在进行形体塑造，或是要参加Hyrox这类赛事，需要更强的肌肉机能，那你可以尝试冲击期补充方案。

If you are looking for performance enhancement because you want to improve a training block or you're in physique building or you're going to do something like Hyrox and you need to have greater muscle capacity, you might want to try the loading strategy.

对，你确实会增加水分重量，因为肌肉内部会储存更多水分。

Yes, you will gain water weight because you're also storing more within the muscle.

但对于那些只是追求健康和运动表现提升的普通女性来说，其实没必要采用冲击期的补充方案。

But for the general woman who's looking for health and performance benefits, you don't have to do a loading strategy.

你只需要每天服用3到5克就够了。

You just have to do that three to five grams a day.

给不了解的人解释一下，所谓冲击期补充方案，就是很多肌酸产品的包装盒和标签上会标注，在最初一周或两周内，先服用大剂量的肌酸。

Loading strategy, for anyone that doesn't know, is basically some of the creatine boxes will tell you, the labels will say, the first week or two weeks, whatever, have a huge dosage of it.

之后你就可以把服用量降下来了。

And then thereafter, you can ease down the dosage.

但我觉得那种“所有人在任何情况下都必须这么做”的说法已经被推翻了。

But I think that's been debunked as something that we all need to do in all cases.

还有没有其他你推荐女性服用的补剂？毕竟我们的生活方式和饮食习惯都摆在这儿了。

Are there any other supplements that you recommend women to take based on the way that we live our lives and the food that we eat?

维生素D。

Vitamin D.

那为什么推荐维D呢？

And why?

它有什么作用？

And what does that do?

说起维生素D，尤其是维生素D3的话

So if we're looking at vitamin D, especially vitamin D3

这两者有什么区别？

What's the difference?

维生素D分为维生素D2和维生素D3两种。

So you have vitamin D2 and vitamin D3.

维生素D2更多是储存型的形态。

Vitamin D2 is more of a storage form.

它无法转化为具有生理活性的功能型形态。

It's not converted to being a functional form.

所以如果你服用维生素D3的话，它本身就已经是可发挥作用的功能型形态了。

So if you take D3, it's already a functional form.

所以，这意味着你的身体会吸收并正确使用它。

So, it means your body is going to take it in and use it as it should be.

因此，我们讨论的是维生素D3补充剂。

So, we're looking at a vitamin D3 supplement.

这样我们就能提高体内循环的维生素D3或可用的维生素D水平，它被身体各个系统所利用。

Then we are able to boost circulating levels of vitamin D3 or vitamin D that's usable, and it's used for every system in the body.

现在这尤其重要，因为我来自南半球，刚过完冬天。

And it's really important now, especially I'm coming from the Southern Hemisphere just out of winter.

你身处北半球的高纬度地区，正值冬季，我们无法获得足够的阳光。

You're in the upper parts of the Northern Hemisphere in the middle of winter, and we don't get enough sun.

而且现在，由于对皮肤癌的担忧，人们都会穿好、戴帽、涂防晒霜，导致我们依然晒不到足够的太阳。

And when we're looking at now all the worries for skin cancer, people are slip, slap, slop, sunscreen, hat, clothes, and we don't get enough.

再来看我们的食物供应，富含维生素D的食物并不多。

And then if we're looking at our food supply, there's not a lot of proper vitamin D rich foods.

你只能指望蘑菇或强化乳制品。

You're looking at mushrooms or fortified dairy products.

而且如今这些食物大家都吃得不多。

And those tend not to be consumed a lot nowadays.

所以，如果我们提高摄入的维生素D3含量，提升体内循环的维生素D水平，我们的身体恢复能力会更好，肌肉功能会更强，大脑健康也会得到改善。

So, if we're improving the amount of vitamin D3 that we're taking in and the amount of vitamin D that's circulating, we have better recovery, we have better muscle function, we have better brain health.

几乎身体的每一项机能都能从中受益。

Pretty much every system is affected in a positive way.

那欧米茄-3呢？

Omega-three?

对的。

Yeah.

Omega-3脂肪酸也很有益，尤其当我们进入围绝经期和绝经后期的时候。

Omega-3s are good, especially as we get into peri and post menopause.

我们需要留意炎症会对细胞产生怎样的影响。

We want to look at how inflammation affects the cells.

所以我们会考虑使用富含Omega-3的补充剂，也就是说，我们得关注产品里添加的是哪类Omega-3脂肪酸。

So, we look at using a really omega-three, I guess we're looking at the types of omega-3s that are in there.