顶级科学家谈抗衰老：避免久坐、坚持运动、生酮饮食与补充维生素

为什么人们不知道缺乏维生素D会使痴呆症风险增加百分之八十？为什么人们不知道缺乏这种矿物质会增加患癌症的长期风险？为什么人们不知道欧米伽-3指数低对死亡率的影响与吸烟一样糟糕？作为一名科学家，我亲眼所见，你衰老过程的70%实际上是由生活方式决定的。而所有这些事情做起来都非常简单。

Why do people not know that vitamin D deficiency can increase dementia risk by eighty percent? Why do people not know that having a lack of this mineral is affecting their long term risk of cancer? Why do people not know that having a low omega-three index is as bad for you in terms of mortality as as smoking. And as a scientist, I've seen firsthand that 70% of the way you're aging is actually due to your lifestyle. And all these things are so easy to do.

举个例子，随着年龄增长，大脑中负责学习和记忆的某些区域每年会萎缩约1%到2%。但好消息是，研究表明参与运动计划的人不仅海马体没有萎缩，反而增长了1%到2%。还有更多发现。有些方法甚至不需要像运动那样费力，比如补充剂。研究反复证明，如果让一个人连续21小时睡眠不足，然后摄入25到30克肌酸，不仅能抵消睡眠剥夺带来的认知缺陷，还能让人表现得比充分休息时更好。

So for example, as we age, certain areas of the brain which is involved in learning and memory starts to shrink by about one to 2% per year. The good news is, studies show that people being part of an exercise protocol, not only did they not have their hippocampus shrink, it actually grew by one to 2%. And there's more. There are other things that don't even require as much effort as exercise, like supplements. And it's been shown study after study that if you take someone and you sleep deprive them for twenty one hours and give them twenty five to thirty grams of creatine, not only does it negate cognitive deficits of sleep deprivation, it makes people function better than if they were well rested.

再来说镁元素。研究显示，体内镁含量最高的人群全因死亡率低40%，你体内有300多种酶需要镁来维持短期生存。然而美国有50%的人口镁摄入不足。还有更多方法：桑拿、红光疗法、生酮饮食、蓝莓、电解质补充等等，我们可以详细讨论...

And then there's magnesium. There have been studies showing that people with the highest magnesium levels have a forty percent lower all cause mortality, and over 300 different enzymes in your body need it to help with short term survival. And yet fifty percent of the population in The United States does not have adequate levels of magnesium, and there's still more. There's saunas, red light therapy, ketogenic diets, blueberries, electrolytes, and we can talk about all of

这些。请继续。

them. Please.

好的。我发现当你进入桑拿房时，会发生神奇的变化。所以

Okay. So I've found when you go into the sauna, something happens that's incredible. So

请给我三十秒时间说两件事。首先衷心感谢你们每周收听我们的节目，这对我们所有人来说意义重大。这个梦想我们从未敢想，更没料到能走到今天。其次，我们感觉这才刚刚开始。

Just give me thirty seconds of your time. Two things I wanted to say. The first thing is a huge thank you for listening and tuning into the show week after week. It means the world to all of us and this really is a dream that we absolutely never had and couldn't have imagined getting to this place. But secondly, it's a dream where we feel like we're only just getting started.

如果喜欢我们的节目，请加入24%的固定听众群体，在这个应用上关注我们。我向你们承诺：我会竭尽全力让节目现在和未来都保持高质量。我们会邀请你们想见的嘉宾，继续保留你们喜爱的所有环节。谢谢大家。

And if you enjoy what we do here, please join the 24% of people that listen to this podcast regularly and follow us on this app. Here's a promise I'm gonna make to you. I'm gonna do everything in my power to make this show as good as I can now and into the future. We're gonna deliver the guests that you want me to speak to and we're gonna continue to keep doing all of the things you love about this show. Thank you.

Rhonda Patrick医生，你给我的印象是个相当执着的人。你执着于什么？为什么如此执着？因为从我们之前的交谈中，我能感受到你对今天要讨论的话题充满热情。所以我想知道，是什么驱使你研究这些课题，你想达成什么目标。这些都是我通过经历领悟到的。

Doctor Rhonda Patrick, you strike me as a fairly obsessed person. What is it you're obsessed about and why are you obsessed about it? Because I can see from speaking to you previously how passionate you are about the subjects we're gonna talk about today. And so I was wondering what it is about these subjects that is driving you and what you're trying to accomplish. I've learned through my experience.

所以我拥有

So I have

生物医学博士学位，研究领域涉及衰老、癌症、新陈代谢、营养学、神经科学等多个跨学科方向。几十年的研究让我意识到，许多微小的改变能对我们的健康——也就是所谓的'健康寿命'——产生巨大影响。这本质上意味着终生远离疾病、保持健康、感觉良好。我痴迷于优化这一状态，寻找最佳方案并分享给全世界。

a PhD in biomedical science. I've done research on aging, on cancer, on metabolism, nutrition, neuroscience, a lot of different fields, very cross disciplinary. And I've realized over the decades of doing research that there are many different small changes that can be made that have a really big impact on our health, what's called our health span. So this is essentially being disease free throughout our life, being healthy, feeling good. And I'm sort of obsessed with trying to optimize that and find a protocol to optimize it and then share that information with the world.

有趣的是，在这个信息爆炸的时代，那些能显著改善衰老过程的简单重要方法，大众却仍不知晓。我的使命就是传播这些知识，让人们通过简单改变活得更健康、更舒适。

And it's funny because we live in a time now where we've got access to so much information, overwhelming amount of information. But the reality is, is that simple, important tools that people can do in their life right now to drastically improve the way they age are still not known to the general population. And so my mission is to get that knowledge to people so that they can make these simple changes and live healthier and feel better.

如果他们理解并实际应用这些知识，会对生活产生什么具体影响？

And what will be the impact on their lives if they understand that information and start to implement that information on a real sort of specific practical in a real specific practical sense?

比如人们普遍缺乏的营养素，简单补充维生素D就能降低患病风险和痴呆概率。这不仅能即时提升生活质量，还影响远期情绪状态、抑郁倾向，以及神经退行性疾病如痴呆和阿尔茨海默病的风险。

Well, are things that people are deficient in, for example, that they could simply take a supplement. Vitamin D is a good example. That could affect their disease risk, their dementia risk. I mean, so you're talking about quality of life improvement right now and also later. So it affects mood, it affects depression, and it affects your neurodegenerative disease risk like dementia and Alzheimer's disease.

有些是唾手可得的改善方式，比如填补营养缺口；有些则需要更多努力——这就是运动的价值。如果把运动效果浓缩成药丸，那将是轰动世界的奇迹药物，远胜Ozempic之类，根本不可同日而语。

So there are low hanging fruits, things that are simple that you can just basically fill these gaps. I mean, are things that are also a little more effortful. And this is where exercise comes in, where you put in this effort and it just if you could pill up what exercise does in a pill, I mean, would be biggest blockbuster miracle drug out there. I mean, it'd blow Ozempic out of the water. It'd be, I mean, just no comparison.

所以我认为，这些小事你能做到，它们将有助于缓解抑郁，改善当前情绪，让你立刻感觉更好，给你更多能量，帮助你更专注，更有动力，同时也能降低你长期的疾病风险，这样当你年老时，不会患上痴呆症。这影响着你，也影响着你的家人。因此我认为这非常重要，因为有些简单的事情可以做，而人们却不知道。

So I think that, you know, again, it's these little things that you can do that is going to help with depression, help with mood right now, make you feel better right now, give you more energy, help you be more focused, help you be more motivated, but also affect your long term disease risk so that, you know, when you're older in life, you're not demented. And that affects you. It affects your family. So I think it's just an important it's so important because there are easy things that can be done that people just don't know about.

这其中是否有心理因素，让我们将衰老视为必然，从而不去抗争？因为我们似乎只在生活中那些觉得自己能掌控的事情上才会干涉、抗争并产生动力。我们看到每个人都会变老，看到每个人开始有点驼背，走路吃力，身体逐渐衰弱。因为我过去二三十年目睹了太多这样的现象，我30多岁，刚过30岁，就假设这也会发生在我身上。

Is there a psychological element to this where we kind of see aging as an inevitability so we don't fight it? Because we only seem to interfere with and fight and are motivated by things in life there where we feel like we've got an element of control. And we see we see everybody get old and we see everybody start to, you know, lean over a little bit and struggle to walk and get a little bit more frail. So I think because we've observed that so much over the last couple of decades, I'm 30 years, I'm just over 30 years old. I assume that will happen to me.

我看到我父亲逐渐变老，身材发福，肌肉流失。所以我想，我像父亲，遗传了部分相同的基因，这对我来说是不可避免的。

So I've seen my dad, you know, get older, get a little bit more large, lose his lean muscle. So I think, well, I'm like my dad, I've got some of the same genetics. That's inevitable for me.

基因确实在衰老过程中起作用，但作用很小。事实上，70%甚至更多的衰老方式取决于你的生活方式。想象两位70岁的老人，约翰和罗布。约翰思维敏锐，能把购物袋拎到车上。

So genetics does play a role in the way you age, but it's a small role. In fact, 70% or more of the way you're aging is actually due to your lifestyle. Let's just imagine two 70 year old men, Okay, John and Rob. And John, you know, he's razor sharp. He can carry groceries to his car.

他不会气喘吁吁，感觉健康，走路利索。而罗布则说话忘词，

He doesn't get out of breath. You know, I mean, he's feeling healthy. He is able to he can walk efficiently, right? And then there's Rob. And Rob is forgetting his words.

认知迟钝，走到车旁就上气不接下气，提购物袋非常吃力。基因在这两位老人不同状态中只起了很小的作用。我认为，决定他们衰老差异的最大因素是生活方式，其中很大一部分是运动。我们都知道长辈们常说运动有益健康，

You know, he's not cognitively sharp. He's out of breath just from walking to his car, has a really hard time carrying groceries. Genetics only plays a small role in those two different outcomes for those two men. The biggest, I would say, thing that's dictating the way these two men age is their lifestyle with a huge part of that actually being exercise. And, you know, I know we've all heard it from our mother or grandmother, great grandmother, you know, exercise is good for you.

健康饮食加运动就会更健康。这虽是老生常谈，但事实确实如此——运动影响着从分子层面开始的整个衰老过程。所以不，衰老不仅由基因决定，也并非不可避免。

If you eat healthy and you exercise, you're going to be healthier. And that's like a general statement. But the reality is it is so true that exercise affects everything, down to the molecular level in terms of the way you're aging. So no, it's not just dictated by genetics. And it's not inevitable.

而且有些事情你可以做来显著延缓衰老。

And there are things that you can do to dramatically age better.

那我们来玩个小游戏。假设我听从了你关于健康、长寿和衰老的所有建议——虽然这很难做到，因为知道和践行是两回事。我们把这个人称为史蒂夫A。然后还有个史蒂夫B，他完全反其道而行。

So let's play a little little game here. So imagine that I listened to your advice and the things that you know about health, longevity, aging, and I followed all of them, which is very hard to do because, you know, implementation is is not the same thing as knowledge. So imagine that's person A, that's Steve A. And then there's Steve B. I do the exact opposite.

根据你对科学和预期结果的了解，遵循你建议的史蒂夫A在衰老过程中会如何生活？而史蒂夫B又会面临怎样的结局？虽然这显然是个超级预测性的假设问题，但你认为这两个人的人生轨迹会有多大差异？

Based on what you know about the science and about outcomes and expected outcomes, how would Steve A that followed your advice live his live his life as he ages? And how would Steve B, how would his outcomes be as he ages? Like, what would you if you had to obviously, this is like super you're you're forecasting here and it's hypothetical, but what do you think the variance in these two people's lives would be?

如果讨论极端情况，比如史蒂夫B嗜糖、抽烟酗酒、肥胖又久坐不动，把所有不该做的事都做了...

Well, if you're talking about the extreme ends, like if Steve B was like eating sugar and smoking and drinking and just obese and sedentary, everything that you don't want to.

这其实符合很大一部分人的现状。

Which is like a lot of the population.

那预期寿命可能相差十四年，这很惊人。但不仅是寿命，还包括独立生活能力和认知能力——你会健忘，生活质量将非常糟糕。不仅死得更早，活着时也没有生活质量可言。

I mean, then you're talking like a fourteen year difference in life expectancy, which is pretty big. But not just life expectancy, the way your independence, right, your mind. So you'd be forgetful. I mean, it would just be it would be a terrible quality of life, right? So it's not only are you going to die earlier, you're not you're just not going to live a good quality of life.

而史蒂夫A可能九十多岁还在冲浪，因为坚持锻炼、摄入身体所需营养、睡眠充足、体重正常、远离精制糖等加速衰老的因素。我们可以详细讨论这些要素如何影响衰老速度和疾病风险。有研究显示，病态肥胖者和精瘦者的预期寿命差距可达十四年。

So Steve A might be into his 90s and out surfing, you know, because you've exercised, you've given your body like the right nutrients that it needs, you've gotten good sleep, you're not overweight, you're not eating a lot of refined sugar, all these things that sort of accelerate the aging process. And we can talk about different components of this and how they do affect the way we age and our disease risk. But I mean, there's studies that show even like a fourteen year difference in life expectancy for like someone who's morbidly obese versus lean.

所以史蒂夫A可能在90岁时还在冲浪，而史蒂夫B可能在75岁就面临死亡，而且他的生活质量——健康寿命很可能在40多岁和50多岁时就开始下降。

So Steve A could be out surfing at 90 and Steve B would be potentially dying at 75, but also his quality of life would his health span would diminish probably in his 40s and 50s.

没错。

Right.

因此这实际上是寿命缩短了十四年，但健康寿命可能缩短了三十到四十年。

So it's really a fourteen year reduction in lifespan, but potentially a thirty, forty year reduction in health span.

在生活质量和健康寿命方面，能够保持功能独立，思维敏捷，感觉良好，对吧？还有你的情绪。我是说，所有这些都会受到影响。

In quality of life and health span, being able to be functionally independent, being able to be cognitively sharp, feel good, right? And your mood. I mean, all these things are affected.

你一定有些疯狂的想法吧，因为作为生物医学科学家，你能看到一些即将问世的研究和技术。所以在开始讨论之前，我想知道，关于衰老和长寿的未来，你脑海中有什么重要的想法吗？这些其实很关键，因为正如布莱恩·约翰逊常对我说的，你想活着看到这些突破。

You must be sitting on some some crazy ideas because as a biomedical science, you can kind of see as a biomedical scientist, you can see some of the research and technology that's coming down the pipe. So I'm wondering before we get into the conversation, are there any big ideas about the future of aging and longevity that are in your mind that you think about? They're actually really important to know because as Brian Johnson has often said to me, you want to live to see these breakthroughs.

是的，是的。我对一些基因疗法感到兴奋，能够重新编程我们的细胞使其更年轻。你知道，这是2006年由日本的山中伸弥开创的。他实际上获得了诺贝尔奖。当时他的研究对衰老领域的重要性还不为人所知。

Yes, yes. I am excited about some gene therapies and being able to sort of reprogram our cells to be more youthful. So, you know, this something that was pioneered back in 2006 by Shinya Yamanaka from Japan. And he actually won the Nobel Prize. Why his research was so important for the field of aging wasn't really known at that time.

他所展示的是，你可以取一个老化的细胞，它可以是任何细胞。比如，可以来自一位85岁的帕金森病患者。我们每天都在不断获取皮肤细胞并脱落。你可以取其中一个细胞，向其中添加四种不同的蛋白质。它们被称为转录因子。

What he had shown is that you could take a cell that's old, and it could be any cell. It could be from an 85 year old person with Parkinson's disease, for example. And we're constantly getting skin cells and sloughing them off every day. You can take one of those cells and add four different proteins to them. They're called transcription factors.

本质上，这意味着它们就像是体内众多基因的总指挥，调控基因如何被激活、开启并执行其应有功能，或在需要保持静默时关闭。加入这四种蛋白质后，你就能将一位85岁帕金森病患者的皮肤细胞转化为所谓的胚胎干细胞。这个过程通过清除表观基因组实现——人们都熟悉DNA对吧？而表观基因组就像是位于DNA之上的调控层，决定着基因的表达或沉默状态。

Essentially, all that means is they're kind of like master orchestrators of many different genes in your body and how genes are activated and turned on and doing what they're supposed to, or they're turned off and quiet for the time that they're supposed to be quiet. And you add those four proteins, and you can take that 85 year old cell, skin cell from a person with Parkinson's disease, and you can make it into what's called an embryonic stem cell. And it does that by sort of wiping out what's called epigenome. So, people are familiar with their DNA, right? Well, the epigenome is something that sort of sits on top of your DNA and it regulates how your genes are being expressed or turned on and off, right?

这种技术能让细胞回溯时光，重编程回到年轻态的胚胎干细胞阶段。随后这种胚胎干细胞可以分化成任何类型的体细胞，无论是心肌细胞、肝细胞、脑细胞还是眼球细胞。这就是诱导多能干细胞技术，当年的重大突破为细胞再生治疗奠定了基础。

And it sort of brings it back, reprograms it to this youthful state where it becomes an embryonic stem cell. And then that embryonic stem cell can then form any type of cell in the body. It can form a heart cell or a liver cell or a brain cell or a cell from your eye. And so this is called induced pluripotent stem cells. And this was a breakthrough at the time because it's important for cell regenerative therapies.

假设某位帕金森患者需要治疗——要知道该病症会导致黑质区多巴胺能神经元快速丧失。这些产生多巴胺的神经元不仅关乎动机和认知功能，更对运动控制至关重要。我们的目标就是从患者身上获取衰老的皮肤细胞，将其重编程为多巴胺神经元后回输体内。

Okay, let's say someone does have Parkinson's disease and you want, you know, Parkinson's disease people are losing dopaminergic neurons and they're substantia nigra. So, are dopamine producing neurons. And dopamine is important for motivation and it plays a role in our, you know, cognitive function, but it's also important for movement, right? So people with Parkinson's disease are losing those at a rapid rate and they lose control of their motor capabilities. And so you want to be able to take an old skin cell from someone, reprogram it to become a dopamine neuron, and then inject it into that person, right?

因为是自体细胞，所以不会产生排斥反应，这曾是当时的核心理念。但十年后，顶尖衰老科学家们发现：与其用四种蛋白质长期培养使其完全转化为干细胞，其实可以采用脉冲式处理——短暂接触即可。

It's their own cell, so they're not going to reject it, right? So that was like the big thought at the time. Fast forward, you know, a decade or so, and a whole handful of brilliant aging scientists have discovered that instead of taking these old cells and putting these four proteins on it to become this sort of stem cell, they can pulse it. Just a quick little pulse.

脉冲是指电击之类的吗？

What is the pulse? Like an electronic shock?

不是。我指的是缩短四种转录因子作用于细胞的重编程时间。这样做是为了避免细胞完全失去原有特性——比如皮肤细胞若经历完整重编程就会变成胚胎干细胞。

No. What I mean is it's just not incubated for as long of a time period. So, it's a shorter time interval that you're putting these four different transcription factors on top of the cell that reprogram it, right? And the reason for the shorter time is that you don't want it to lose its cellular identity. So let's say it was a skin cell.

我们需要的是保持皮肤细胞属性，但将其从85岁状态逆转为1岁状态。这就是部分重编程技术，研究者发现通过我所说的'脉冲'方式——即短期施加重编程因子——就能实现这种精准的年龄逆转。

You want it to stay a skin cell, not become an embryonic stem cell. But you want it to be a skin cell from a one year old, not an 85 year old. So, the way to do that is what's called partial reprogramming. And so, basically, researchers have found that you can just sort of what I call pulse is partial reprogramming. You're kind of putting it on for like a shorter period of time.

然后那个细胞保持其特性，但变得年轻。它清除了所有损伤，那些积累85年的所有问题。这已在啮齿类动物的研究中得到证实，如果加入这四种不同的转录因子并给予小鼠，可以 rejuvenate 许多不同的器官。本质上就是在这些小鼠的不同器官中逆转衰老时钟。显然这还需要转化应用于人类，但我认为这非常令人兴奋，确实相信这是解决衰老和 rejuvenate 我们器官的未来方向。

And then that cell keeps its identity, but it's youthful. It wipes out all the damage, everything that's accumulated over those 85. And this has been shown in animal studies in rodents that if add these four different transcription factors and you give them to mice, you can rejuvenate many of the different organs. So essentially turning back the aging clock in different organs in these mice. Now, this obviously has to be translated to humans, but I think it's super exciting and I do think it's the future in terms of solving aging and rejuvenating our organs.

因此这是让我相当兴奋并密切关注的事情。

And so it's something that I'm pretty excited about and following closely.

它们甚至活得更长了吗？

And are they even living longer?

其中一些研究是在所谓加速衰老的动物身上进行的。是的，在加速衰老背景下它们确实活得更久。问题是，如果只是普通小鼠而非加速衰老模型，它们能否活得更长？这些正是当前正在进行的研究，这类实验目前都在推进中。

Some of these studies were done in animals that are what's called accelerated aging. So, yes, they were living longer in that background of accelerated aging. The question is, you know, can they live longer if it's just a normal mouse that's not like an accelerated aging model? And these are things that are all being done right now. These sorts of studies are in progress.

根据你所知的一切，你认为我们应该从哪里开始这个对话最重要？或许有些基础性的东西，对吧？

Where do you think is the most important place for us to start this conversation based on everything you know? And maybe some of the presumably there's some foundational stuff, right?

确实。我认为重要的起点应该是：我们把衰老视为一种疾病。我认为久坐不动也是一种疾病，这是个很好的切入点。我所说的久坐不动是指缺乏身体活动，完全不参与任何形式的体育锻炼的人。

I do. I think the important place to start would be we're about aging as a disease. And I think being sedentary is a disease. And I think that's a good place to start. What I mean by being sedentary is not physically active, someone who doesn't engage in any type of physical activity.

那么这个范围是怎样的呢？比如有人24小时完全不动，另一端是那些不断跑马拉松做疯狂运动的人。但我们大多数人在这个尺度上处于什么位置？我们的活动量足够吗？

And what is the spectrum there of, you know, someone who doesn't move at all for, you know, twenty four hours a day versus, oh, you've got obviously someone that's constantly running marathons and doing crazy stuff. But where are most of us on that scale? And are we moving enough?

我们大多数人在这方面做得远远不够。如果从全球范围来看，大多数人其实都处于久坐不动的状态，身体活动严重不足。我们整天坐在电脑前、办公桌或小隔间里，实际上很少走动。我把久坐称为一种疾病，因为研究表明它甚至比我们熟知的疾病——如二型糖尿病、心血管疾病，或吸烟等恶习——更能增加早逝风险。久坐对早逝的预测性实际上超过这些疾病。

Most of us are not moving on that enough. And most of us are if you're talking about globally, we're on that sedentary scale where we're just not physically active. We sit at our computer or a desk or a cubicle all day, and we're actually moving around a lot. And I say sedentary ism is a disease because it's actually been shown to increase the risk of early mortality even more than diseases that we know of, like type two diabetes, cardiovascular disease, or even terrible habits like smoking. So being sedentary actually could predict early mortality even more than those diseases.

但让我们退一步看，问题甚至更为严重。有个了不起的研究叫'达拉斯卧床休息研究'，这项研究始于1960年代。

But let's take a step back. It's even bigger than that. There's this amazing study. It's called the Dallas Bed Rest Study. And the study started back in the 1960s.

该研究由可能是世界上最杰出的心血管运动生理学家们完成。本·萨尔廷和贾里德·米切尔参与了这项1960年代的早期研究。他们选取了五名大学生男性，让他们卧床休息三周——是真正意义上的卧床，连上厕所都不能起身，所以都插着导尿管。

And this is done by probably the world's most talented cardiovascular exercise physiologists. And so Ben Saltine, Jared Mitchell were involved in this early study in the 1960s. And what they did was they took five men they were college students and they put them on bed rest. And this is like three weeks of legitimate bed rest. We're talking couldn't get up to go to the bathroom, so they had a catheter in them.

这些人三周完全没有活动。研究者想观察：如果三周不运动，心血管系统会发生什么变化？想想看，现实中很多人因手术、重病或流感等需要卧床三周——这并不罕见。所以这个研究很有现实意义。结果发现，三周后他们的心血管系统彻底崩溃了。

They did not move for three weeks. The researchers wanted to find out what happens to your cardiovascular system if you are not moving around for three weeks. And now if you think about it, there's a lot of people that are undergoing surgery or they have some sort of bad illness, influenza, or something that keeps them bedridden for it's not unusual to be three weeks, to be honest. So it's not completely irrelevant. And what was found is after that three weeks, their cardiovascular system was just tanked.

这些受试者可能是当时被研究得最透彻的个体。测量的最重要指标之一是心肺适能（通常称为最大摄氧量VO2max），即肺部能吸入并输送到肌肉的最大氧气量，这个指标是在极限运动状态下测量的。

And one of the major they were probably some of the most well studied men at the time. And one of the biggest factors that was measured was their cardiorespiratory fitness. This is often called VO2 max. And essentially, it's the maximum amount of oxygen that you can breathe in in your lungs, then breathe that oxygen to your muscles. And it's measured during maximal exercise.

当人进行极限强度运动时，这个数值就代表你的心肺适能水平。我们可以稍后详谈这个，但当时他们的心肺适能严重衰退。需要说明的是，这个研究发生在1960年代。

You're putting in a maximal effort. And that's called your cardiorespiratory fitness. And we can talk a little bit more about that. But the cardiorespiratory fitness tank. And now, I mentioned this was the 1960s.

约三十年后，本·莱文加入了研究——他现在是达拉斯西南医学中心的著名心血管运动生理学家。他们找到了三十年前那五位受试者，重新测量了他们的心肺适能及其他当年检测过的各项参数。

About thirty years later and this is where Ben Levine came into the study. He's at the UT Southwestern in Dallas. He's also very one of the most famous cardiovascular exercise physiologists out there right now. They found these five men from thirty years earlier. And they measured their cardiorespiratory fitness in a variety of other parameters that they had measured at the time.

他们发现，三周的卧床休息对心肺健康的影响比三十年的衰老更严重。本质上，三十年后他们的心肺健康状况并不比卧床三周后更差，这有点令人惊讶，因为你会认为三十年的衰老对心肺健康的影响应该比三周的卧床更严重。

And what they found was that three weeks of bed rest was worse on their cardiorespiratory fitness than thirty years of aging. So essentially, their cardiorespiratory fitness was no worse thirty years later than it was after their three weeks of bed rest, which is kind of amazing because you would think that the thirty years of aging would be worse on your cardiorespiratory fitness than the three weeks of

卧床休息。而且研究对象是同一批人吗？

bed rest. And it's the same individuals?

同一批人。同样的五位男性。在1960年代，经过三周卧床后，他们通过恢复运动和活动，最终让心肺健康重新提升，虽然这花了些时间。但当你观察他们的基线水平，即基础心肺健康状态，并将其与三十年后他们的基础心肺健康对比时，发现并不比卧床三周后的情况更糟。你可能会问，为什么心肺健康下降如此重要？

The same individuals. The same five men. Now, after the three weeks of bed rest, you know, back in the 1960s, they were able to get their cardiorespiratory fitness back up again once they started exercising and moving around, and it took a while. But when you look at their baseline levels, their baseline cardiorespiratory fitness, and you compare it to their cardiorespiratory fitness baseline thirty years later, it wasn't worse than what happened when they compared it to the three weeks of bed rest. And you might go, well, why is that so significant, the cardiorespiratory fitness dropping?

我们知道心肺健康是预测长寿的最佳指标之一。有研究表明，心肺健康水平高的人比水平低的人平均多活五年。这是个相当大的差距。他们死于多种原因（如心血管疾病、癌症、呼吸系统疾病等）的概率基本降低了80%。所以实际上，这意味着预期寿命增加了五年。

We know that cardiorespiratory fitness is one of the best predictors of longevity. So there are studies that have shown that people with a high cardiorespiratory fitness live five years longer than people with a low cardiorespiratory fitness. That's, you know, pretty big difference. They're basically eighty percent less likely to die of many different causes of death, so cardiovascular disease, cancer, respiratory disease, things like that, than people with a low cardiorespiratory fitness. So you're really getting, you know, a five year increased life expectancy.

你某种程度上是在推迟那些与年龄相关的疾病，比如心血管疾病，你知道的，比如癌症，你让它们在生命后期才出现。所以你不会因为这些疾病更早去世。我们确实知道，只要从低心肺适能状态中有所提升——那些心肺适能低下的人通常是久坐不动的。即使你只是从低劣水平提升到勉强正常水平，你的预期寿命就能增加大约两年。这其实并不难做到。

You're sort of pushing and delaying those age related diseases like cardiovascular disease, you know, like cancer, for example, you're pushing them down later in life. So you're not dying from them sooner. And we do know that really just getting anywhere out of that low cardiorespiratory fitness so people with the low cardiorespiratory fitness are people that are sedentary. And if you just move anywhere above that, even if you're going from low bad to like low normal, you're gaining about two years increase in life expectancy. And that's not really that hard to do.

但如果你想想心肺适能，就像现在，仅仅是进行这样的对话，实际上即使是安静地坐着，每分钟每公斤体重也需要消耗约3毫升氧气。把 groceries 搬到车上，每分钟每公斤体重需要消耗约11毫升氧气。随着年龄增长，你就像在走向悬崖，因为你的心肺适能会随年龄下降。确实如此，这是自然规律。

But if you think about cardiorespiratory fitness, like right here, just having this conversation, actually even just sitting quietly, it takes about three milliliters of oxygen per minute per kilogram body weight to do that. To carry groceries to your car, it takes about 11 milliliters of oxygen per minute per body weight per kilogram body weight. And so as you're aging, you're kind of heading towards this cliff, right, because your cardiorespiratory fitness goes down with age. It does. That's what happens naturally.

如果你不注重锻炼心肺适能，如果不保持身体活跃——有些运动比其他运动更能提升心肺适能。如果你不尝试改善它，你就会更快地滑向那个悬崖。然后每件事都会变得极其费力。说几句话就气喘吁吁，搬 groceries 到车上也会上气不接下气。

If you're at the point where you don't work on your cardiorespiratory fitness, if you're not being physically active and there are certain exercises that are better at improving cardiorespiratory fitness than others. If you're not trying to improve it, you're going to be heading towards that cliff faster. And then everything becomes a maximal effort. You're out of breath just talking. You're out of breath carrying groceries to your car.

每件事都需要全力以赴，而你却不想参与其中。这样的生活质量并不好。确实不好，对吧？更糟的是，你的寿命也会因此缩短。所以这里涉及两个方面的问题。

Everything is a maximal effort, and you don't want to be there. That quality of life is not good. It's not good, right? And then on top of that, you're also going to die sooner. So you're talking about two things here.

你既面临着健康寿命的缩减，也面临着整体寿命的减少。

You're talking about decreased health span and decreased lifespan.

所以是的，我们应该多运动。

So yeah, we should be moving more.

没错。问题在于，你能否在不增加风险的情况下提升心肺健康？对吧？比如，你会举重吗？会去跑步吗？

Right. And the question is, well, do you improve your cardio risk free fitness, right? Yeah. I mean, do you lift weights? Do you go for runs?

骑自行车吗？究竟什么方式最能有效提升无风险的心肺健康？这正是过去几十年来许多运动生理学家试图解答的问题。你需要参与所谓的剧烈强度运动——就是那种运动时你根本无法进行交谈的运动，明白吗？

Do you bike? What is it that is really good at improving cardio risk free fitness? And that's the question that a lot of exercise physiologists have answered over the last couple of decades. You want to do and engage in what's called vigorous intensity exercise. So this is the kind of exercise where you're not able to have a conversation when you're engaged in it, right?

这时你的心率会达到最大心率的80%左右，基本无法说话。我认为这种运动可以间歇进行，比如高强度间歇训练。通过这种训练，你会在高强度运动时提升心率，然后在恢复期休息，让心率回落，避免持续极限运动。

So your heart rate is going up to about 80% your max heart rate. You're not able to really talk. And I would say it's something that can be done in intervals. So you can do high intensity interval training. So you have these intervals where you're getting your heart rate up, you're doing vigorous exercise, and then you have recovery periods where you're kind of resting, you're lowering your heart rate, you're not doing that maximal sort of exercise.

我这么说是因为多项研究表明，进行中等强度运动的人——就是那种让你呼吸急促但仍能勉强对话的运动——

And I say this because there have been studies, multiple studies, that have shown people that engage in moderate intensity exercise. So this is the kind of exercise when you can you're breathy, but you can still kind of have somewhat of a conversation while you're

就像爬楼梯机那样运动。

doing Like the StairMaster.

对，就像爬楼梯机。即使每周进行两个半小时这类运动的人——这是遵循体育活动指南的——其中40%的人心肺功能仍无法提升。要我说，我可不想把运动效果寄托在运气上。如果进行这种运动有50%概率无法改善心肺功能，那我肯定选择确定性方案。而确定性方案就是让这些人进行高强度间歇训练，他们就能切实提升心肺功能。

Like the StairMaster. Yeah, exactly. Even people that are engaging in that type of exercise for two and a half hours a week so this is following the physical activity guidelines forty percent of those people can't improve their cardiorespiratory fitness. And it's like, well, I don't know about you, but I don't want it to be a coin toss in terms of if I'm doing that kind of exercise, well, if I have a fifty percent chance of not improving my cardiorespiratory fitness if I'm doing this, I want the sure thing. And the sure thing is you take those people and then you have them engage in high intensity interval training, and they're able to improve their cardiorespiratory fitness.

这是因为你对心血管系统施加了更强的压力，因此产生的适应性变化更大。部分适应性变化包括：你能吸入更多氧气，更有效地将氧气输送到肌肉和其他组织。这就是心肺功能的本质。关键就在于，哪怕每周只进行一两次这样的训练...

And that's because you're putting a stronger stress on your cardiovascular system. And so the adaptations are greater. And part of the adaptations are you're able to bring in more oxygen, carry it to your muscles, carry it to your other tissues better. And so that's your cardiorespiratory fitness. And that's really, I would say, the bottom line here is engaging in even just once or twice a week.

目前研究最充分的训练方案是所谓的'挪威4×4法'。具体是进行较长间隔训练——每次4分钟高强度运动，最好用健身单车或划船机，以你能维持的最高强度持续4分钟。

And I would say that the most well researched protocol for that would be something called the Norwegian four by four. And that is where you're doing a longer interval. It's a four minute interval. And it's best done on either a stationary bike or maybe a rowing machine. And you're going as hard as you can and maintain that intensity for four minutes.

然后转为轻度运动恢复4分钟，让心率回落。如此重复四次，故称4×4。这可能是提升心肺功能最有效的方法之一，当然还有其他方式。

And then you're going to go down to light exercise and recover for four minutes and let your heart rate go down. And you do that four times. So it's a four by four. And that is probably one of the most robust ways to improve cardiorespiratory fitness. But there are other ways.

甚至可以采用1分钟高强度+1分钟休息的模式：用尽全力坚持整整1分钟（非冲刺强度），休息1分钟，重复10次，总耗时20分钟。

Even doing one minute on, one minute off. So you do one minute as hard as you can go again for that entire minute. You're not going all out, but as hard as you can and maintain that for the entire minute. And then you rest a minute and you do that, you know, 10 times. So it's a twenty minute workout.

那么对于正在收听的数百万听众，如果要给他们制定最低限度的运动方案，具体训练内容应该是怎样的？每周需要安排几次？

So for the several million people that are listening right now, if you had to prescribe them all something to do, and it was the minimum they had to do, tell me what exactly the workout would look like and how frequent it would be on a weekly basis.

我认为最低有效剂量应该是每周一次。如果你想获得增强心肺功能的上限效果，可以采用一分钟运动、一分钟休息的模式。即使像Tabata这样的训练也能带来改善。

I would say the minimum effective dose would be once a week. Okay. And it would probably be the one minute on, one minute off if you want, like, the upper end robust effects of improving cardiorespiratory fitness. You can still improve it with something like a Tabata.

什么是Tabata？

What's a Tabata?

就是进行20秒高强度间歇训练，由于时间较短需要全力冲刺，然后休息10秒。这样20秒运动、10秒休息为一组，重复八次。如果做两轮的话，基本上就是十分钟的锻炼。

Where you're doing a twenty second interval, and you're going more all out because it's shorter time. And then you're recovering for ten seconds. So it's a twenty second on, ten second off. You do that eight times. And if you repeat that twice so it's essentially a ten minute workout.

这种训练同样能提升心肺功能。但我要解释为什么存在最低标准——比如一分钟运动一分钟休息的模式。不过挪威4×4训练法才是黄金标准，因为它不仅能改善心肺功能。

That's also something that can improve cardiorespiratory fitness. But I would say and I'll tell you why there is the minimum, right? So the one minute on, one minute off. But I would say the Norwegian four by four is the gold standard. And that's because it's not only improving cardiorespiratory fitness.

这可能是我见过的关于运动与抗衰老最令人振奋的证据：参与特定运动方案能逆转心脏因衰老产生的结构变化，效果相当于年轻20岁。具体来说，研究中50岁久坐人群——他们不去健身房也没有任何运动习惯，但没有患病，没有二型糖尿病。

This is probably one of the most exciting pieces of evidence I've seen with respect to exercise and aging. And that is that being part of an exercise protocol was shown to reverse the structural changes that occur with age in the heart by twenty years. So what do I mean by that? I mean people that were 50 years old that were sedentary, so they weren't really going to the gym, they weren't engaging in any sort of physical activity, but they didn't have diseases. They didn't have type two diabetes.

他们也没有心血管疾病（虽然我认为久坐本身就是种疾病）。这些健康的中年人参与了达拉斯西南医学中心Ben Levine的研究——

They didn't have cardiovascular disease. I would argue being sedentary is a disease. But putting that aside, they didn't have any diseases, right? And they're 50, so they're midlife. This was again, this was done by Ben Levine out of UT Southwest in Dallas.

研究者让这些50岁受试者进行两年高强度渐进式训练（对照组做拉伸）。训练强度是逐步提升的，毕竟没人能一开始就做挪威4×4。

He took these 50 year olds and put them on a pretty intense exercise routine for two years, or a stretching routine. This was like the control. And this type of exercise routine was progressive. So they started out lighter and sort of worked their way up, right? Like you don't want to just start with a Norwegian four by four.

那些从不锻炼的人，我的意思是，这将会很困难。所以这是一个渐进式的积累过程。但在大约头六个月接近尾声时，这些人每周锻炼约五到六小时。其中包括一到两次挪威4x4训练。

People that never exercise. I mean, that's going to be tough. So it was a progressive sort of building up to that. But towards the ends of about the first six months, these people were exercising about five to six hours a week. And that included one to two sessions of the Norwegian four by four.

这还包括大量中等至剧烈强度的骑行或跑步，以及一些力量训练。他们这样坚持了两年。他们的心脏接受了检查。随着年龄增长，我们的心脏会萎缩并变得僵硬，这是导致心血管疾病的重要因素。

And it also included a lot of they're doing moderate to vigorous intensity cycling or running and some strength training as well. And they did this for two years. Their hearts were looked at. And so as we age, our hearts shrink and they get stiffer. And that plays a role in causing cardiovascular disease.

我是说，这是美国的头号杀手。它还会影响心肺适能，对吧？为什么心脏会随时间变硬？实际上这与长期暴露在高葡萄糖环境中密切相关。当你摄入大量精制糖和精制碳水化合物时，你的系统里就会充满葡萄糖。

I mean, that's the number one killer in The United States. It also affects cardiorespiratory fitness, right? Why does the heart stiffen with time? Well, it has a lot to do with actually being exposed to a lot of glucose. When you're eating a lot of refined sugar and refined carbohydrates, you're having a lot of glucose around in your system.

这会引发一种称为糖化的化学反应。最终产生的糖基化终产物会与心脏内壁和心肌中的胶原蛋白发生反应，导致其硬化。现在心脏就无法很好地应对压力了。它变僵硬了。这就会导致诸如心脏病发作等问题。

This causes a chemical reaction called glycation. So you get these advanced glycation end products that sort of react with your collagen that's lining your heart and your myocardium, and it causes it to stiffen. And so now the heart can't really respond to stress well. It's stiff. And that plays a role in like heart attacks, for example.

因此，运动是清除血管系统中葡萄糖并将其输送到肌肉的最佳方式之一。这就是它的作用之一，有助于防止心脏硬化。基本上，这些50岁的人经过两年锻炼计划后，他们的心脏结构变得更大、更柔软——心脏状态相当于30岁的人。要知道他们原本是50岁，这太不可思议了。

So exercise is one of the best things you can do to move glucose out of your vascular system and get it to your muscles. And so that's one of the things that it does and helps with not causing that stiffening of the heart. And so essentially, these 50 year olds had their heart, the structure, so it was bigger and less stiff After two years of this exercise protocol, it essentially made their hearts look like 30 year olds. And I mentioned they were 50 year olds. I mean, that's amazing.

这简直令人难以置信——你能让一个中年人坚持两年训练计划，就能让他们的心脏年轻二十岁。

That's incredible that you can take someone midlife, put them on a two year training protocol, and reverse the aging of their heart by twenty years.

关于这个挪威4x4训练法，你说服我尝试一下。具体来说，我先热身，然后进行四分钟高强度运动，再休息。这四分钟的运动可以是任何形式，但必须达到我最大 exertion 水平的80%——80%的强度。

So on this Norwegian 4x4, you've convinced me to give it a shot. But specifically, I do that. So it's I do my warm up, and then I do four minutes of hard exercise. I take a break. And the exercise I'm doing in those four minutes can be any number of things, but I just have to get up to 8580% of my exertion levels 80% difficulty.

正如我提到的，这种方式最适合进行心血管类型的锻炼。比如

So the way it works is, as I mentioned, it's best if you're doing a cardiovascular type of exercise. So like

风阻自行车。

The assault bike.

你可以用风阻自行车。对，风阻自行车。也可以用划船机，或者固定自行车。可以跑步吗？

You could do assault bike. Yep, assault bike. You can do a rowing machine. You could do a stationary cycling machine as well. Could I run?

可以。但我认为骑自行车或风阻自行车之类的可能更好。不过跑步也行。关键是你喜欢做什么，在那四分钟里全力以赴并保持住。这不是完全拼尽全力，远非如此，对吧？

You can. But that is it's definitely I think it's better on doing like maybe a bike or a salt bike or something. But you can run. Like whatever it is that you like to do, and you are going as hard as you can for that four minutes and maintain within that four minutes. So it's not an all out, or it's far from all out, right?

但你在运动时基本无法交谈。然后四分钟的恢复期，如果是跑步，就减速到步行。如果是划船机或风阻自行车，就放慢速度。真的放慢，让心率降下来，让肌肉和体能系统得到一定恢复。

But you're not really having a conversation while you're doing it. And then the four minutes of recovery, if you're running, you kind of go down to walking. If you're on the rowing machine or the assault bike, you're just going very slow. You're just really going slow, you're letting your heart rate come down. You're letting your muscles kind of recover your fitness system recover somewhat.

四分钟恢复后，再回到四分钟的高强度。这样重复四次。虽然不容易，但初学者可以不用一开始就特别拼命，在那四分钟里你甚至还能说话，但仍比平时更努力。对于从未进行过高强度训练的人，循序渐进是个好方法，不能一上来就全力冲刺。

And then after that four minute recovery, you go back to the four minutes of like intense again. And you're doing that four times. It's not easy, but you know people can start out, they don't even if you start out with not going super, super hard in those four minutes where you just maybe you can have a conversation, but you're still going hard, harder than you're used to pushing yourself. And I think for people that haven't really engaged in any type of high intensity training before, that's a good idea where you kind of you can't just start doing it right out the gate. You want to kind of work your way up that.

所以在那四分钟里尽量全力以赴，然后恢复，重复四次。随着一周、两周，甚至一两个月后的持续练习，逐步提升强度，直到那四分钟里你达到几乎无法交谈的全力状态。

So doing the four minutes, just try to put in as much effort as you can, right, during those four minutes. And then you do your recovery, and you repeat that four times. But then work your way up as you do it one week, two weeks, you know, a month later, two months later, and really try then to get to that point where during those four minutes you're getting, you know, you're pushing yourself hard where you're not really able to have that conversation.

从生理学角度来说，当我达到85%-90%的用力程度并持续几分钟时，身体内部发生了什么变化？这在用StairMaster锻炼时是不会出现的。

And physiologically, what is going on in my body when I get to that 85, 90% effort range and I stay there for a couple of minutes, that doesn't occur when I'm doing my StairMaster.

我是说，这时候有太多变化在发生了。应该说，有很多不同的生理反应同时——

I mean, so many things are happening. I mean, there's a lot of different, I would say, physiological responses that are

我说这话时你脸上挂着大大的笑容

You've got a big smile on your face when I say

没错。因为这是我最爱讨论的话题之一。这涉及到当你全力运动时，身体需要快速产能对吧？我们大多数细胞（比如肌肉细胞）主要通过线粒体来产生能量。

something. Yes, I do. Because it's one of my favorite things to talk about. And it has to do with when you're pushing yourself really hard, you need to make energy, right? And the way that most of our cells make energy, like our muscles, is by using our mitochondria.

这些微小的细胞器需要氧气才能工作。当你开始高强度运动时，氧气输送速度跟不上需求，但身体又必须产能。于是机体决定不通过线粒体，直接利用葡萄糖快速生成ATP能量分子——虽然效率较低，但能满足即时需求。

These are tiny organelles inside of our cells that produce energy, but they need oxygen to do it. So that's where the oxygen comes into play. When you start to push yourself really hard, you can't get the oxygen to your muscles quick enough, but you need to make the energy. And so your body decides to make energy in the form of ATP without the mitochondria and it uses glucose to do that. And you're not making as many of those ATP energy molecules, but you're still making them and you're making them quick and that's what your body wants to do.

这个无氧代谢过程会产生副产物乳酸。最让我兴奋的是：长期以来乳酸被视为单纯的葡萄糖代谢废物（就是高强度无氧运动时的产物）。顺便说，这时你并非完全处于无氧状态——更像是部分无氧代谢。

And so it's using glucose to do that without the mitochondria, But as a byproduct, it's making something called lactate. And this is what gets me so excited because, you know, for the longest time, lactate was thought to be this just metabolic byproduct of glucose metabolism, you know, where you're when you're pushing yourself really hard, anaerobic. It's called anaerobic. By the way, you're not only anaerobic. You're just somewhat anaerobic.

你的线粒体仍在产能，只是同时存在旁路代谢途径。这不是非黑即白的情况，更像灰色地带。但核心是：你的身体正在制造乳酸。

You're still producing energy with your mitochondria. It's just you're also producing without the mitochondria. It's not like a sort of black and white sort of thing, right? It's little bit gray. But the reality is you're producing something called lactate.

长期以来，人们认为乳酸是有害的，因为它能形成乳酸，导致肌肉灼烧感。这是几十年前的认知。现在，通过加州大学伯克利分校乔治·布鲁克斯的研究，我们知道乳酸本身并不引起灼烧感。不仅如此，它更像是一种被制造出来的神奇分子。这种代谢物——乳酸进入血液循环后，会被心脏、大脑和肝脏消耗利用。

For the longest time, it was thought this lactate, oh, it's just it's bad because it can form lactic acid and that burns forms that burn in your muscles. And this was decades ago. And we now know from the work of George Brooks out of UC Berkeley that lactate itself isn't causing the burn. And not only is it not causing the burn, it's like a miracle molecule that's being made. This metabolite, lactate, gets into your circulation, and it gets consumed by your heart, by your brain, by your liver.

它被用作能量来源，与β-羟基丁酸非常相似——就是人们禁食或进行生酮饮食时经常谈论的那种酮体。实际上它与酮体极其相似，通过相同的转运蛋白运输，并以类似方式作为能量被利用。但更令人兴奋的是，乳酸是肌肉与其他器官（如大脑）沟通的一种方式。

And it's used for energy. It's very much similar to beta hydroxybutyrate, that ketone body that you always hear about people talk about when they're fasting or doing a ketogenic diet. It's actually very similar to that. It gets transported through the same transporter, and it's used like energy very similar to that. But what's more exciting is that lactate is a way for your muscles to communicate with other organs like the brain.

它被称为信号分子。当你的肌肉在说：'我正在非常努力地工作，这真的很艰难。我们必须对这种劳作做出反应，必须适应。'

And it's called the signaling molecule. So, your muscles are going, I'm working really hard. This is really hard. We have to respond to this work. We have to adapt.

于是你的身体就会响应：'好吧，我需要激活所有这些强大的机制，因为我正在如此努力地工作。我必须做出反应才能保持良好状态，对吧？'研究表明，乳酸大量被大脑消耗，并在大脑中激活一种称为脑源性神经营养因子（BDNF）的物质，这就像是大脑的'奇迹生长剂'。

And so your body goes, Okay, I got to like turn on all this awesome stuff that I have because I'm working so hard. I need to respond to that so that like I'm good, right? And so what happens is the lactate, this has been shown, it gets consumed a lot by the brain. And in the brain, activates something called brain drive neurotrophic factor, BDNF. And this is kind of like a miracle grow for your brain.

本质上，它能促进新神经元的生长（这非常神奇，称为神经发生），增强神经元之间的连接，从而改善记忆和认知能力。它还参与所谓的神经可塑性——即大脑适应环境变化的能力。所有这些都源自乳酸的作用。

So essentially, it's able to increase the growth of new neurons, which is amazing. It's called neurogenesis. It increases the connections between neurons, so it improves memory, cognition. And then it's involved in what's called neuroplasticity, so the ability of your brain to adapt to a changing environment. This is all from lactate.

乳酸还能增加去甲肾上腺素（提升专注力）、血清素（改善情绪，让你感觉更好、更有动力）等神经递质。人类研究显示，与进行中低强度运动的人相比，那些高强度锻炼者会产生更多乳酸。已证实高乳酸水平与认知能力评分提升、冲动控制力增强相关——血清素在冲动控制中起着重要作用。

And it also increases neurotransmitters like norepinephrine, so focus and attention, serotonin, your mood, you're feeling better, you're motivated. All these things are happening because of lactate. And there's been studies in humans showing that people that are compared working hard, working out hard, vigorous exercise versus sort of moderate to light exercise, they make more lactate. And that lactate it's been shown that high levels of lactate are correlated with improved cognition scores, improved impulse control. So serotonin plays a role in impulse control.

这样你就能克制冲动行为，对吧？如果你想提高专注力，这非常理想。这一切都令人振奋，因为归根结底，你的肌肉就像小型化学生物制药厂。而让它们生产这些'药物'的方法就是锻炼和挑战它们——通过简单的高强度间歇训练方案就能实现。

So you're able to not just go on your impulse, right? You're able to kind of like which is great if you want more focus and attention, right? So this is all really exciting stuff because it all comes down to just it's like your muscles are these little chemical pharmaceutical factories. And the way to make them make these pharmaceuticals is to work them, to challenge them. And that can be done with an easy high intensity interval training protocol.

挪威4x4的各种训练方式已被证明能增加脑源性神经营养因子。一分钟开、一分钟关的间歇训练法同样被证实通过乳酸途径提升该因子水平。这可以说是高强度运动与中低强度运动之间的显著差异之一。说实话，我认为当前健身指南过分执着于步数统计。

A variety of them at Norwegian 4x4 can increase brain derived neurotrophic factor. That's been shown. The one minute on, minute off protocol also has been shown to increase that, again, through the lactate. So that's one of the big sort of I would say differences between vigorous intensity exercise and more of that moderate intensity or like low intensity exercise. And I honestly think you know I think the guidelines you know everyone's sort of obsessed with steps.

人们总念叨着'我必须完成一万步目标'，戴着各种可穿戴设备。这固然不错，但我认为应该把一万步改为至少十分钟高强度运动。任何能让心率飙升的运动类型，哪怕只做十分钟，效果都会好得多。

I need to get my 10,000 steps in, my 10,000 steps. And they have wearable devices. And I think that's great. But I think we need to change the 10,000 steps to at least ten minutes of vigorous intensity exercise. Like you could do ten minutes of you know, any type of exercise that's really going to get your heart rate up, and it's going to be so much better.

这可能是个很蠢的问题——既然乳酸堪称神奇药物，为什么不能直接饮用？何必进行高强度间歇训练，直接注射乳酸不行吗？

So this is a really dumb question, but it's the question that I had in my mind, which is if lactate is such a miracle drug, why can't I just drink it? Why can't I just get a shot of lactate versus having to go through vigorous interval training?

这个问题很棒，斯蒂芬。已有研究针对脑外伤患者（比如遭受头部创伤的人）进行实验，通过静脉注射乳酸钠。乳酸会立即被大脑吸收，确实能加速康复。这项评估标准叫做格拉斯哥昏迷评分。

It's a great question, Stephen, because there have been studies that have been done looking at, for example, traumatic brain injury patients, so people that have undergone some sort of head trauma. And they've infused sodium lactate through like an IV into their system. And the lactate immediately gets consumed by the brain. And it's been shown to improve their recovery. So it's called the Glasgow score.

你可能听说过，这套测试用于评估脑外伤患者的恢复状况。乳酸钠确实能改善评分。市面上有多种可摄入的乳酸制剂，理论上应该有效。但问题是摄入的乳酸会先被肠道消耗。

You may have heard of it, but it's kind of essentially this battery of tests that's done to sort of assess how someone's recovering from traumatic brain injury. The sodium lactate does improve that. So there are you can find out there different types of lactate that you can consume. And theoretically, it should help. But what happens is when you consume the lactate, lactate actually gets used by the gut.

大部分乳酸在进入血液循环前就被肠道细胞吸收了。

So a lot of it's going into the gut cells before it gets into your circulation.

这些鬼东西总有代价。每次想走捷径——比如喝点什么来欺骗身体系统时，总存在人们很少讨论的折损效应。

There's always a trade off with these bloody things. Whenever you try and trick the system or shortcut the system by, like, drinking something, feel like there's a trade off which people don't talk about a lot.

问题是，它对肠道确实有益。事实上，我的一位前同事Mark Chikanaga已经证明，乳酸对肠道上皮细胞非常有益。仔细想想，所有这类有益的益生菌，比如双歧杆菌，它们都在产生乳酸。这些乳酸确实会转化为乳酸盐。这就像一种生理稳态，区别仅在于一个氢原子。

Well, thing is, is that it is good for the gut. In fact, a former colleague of mine, Mark Chikanaga, has shown that lactate is really beneficial for the gut epithelial cells. In fact, if you think about it, all these sort of beneficial probiotic bacteria, like bifidobacterium, for example, they're producing lactic acid. And that lactic acid does get converted into lactate. It's sort of like this physiological homeostasis where you have the difference of just a hydrogen atom.

所以可以说，乳酸和乳酸盐处于这种平衡状态。但本质上，你肠道中的细菌正在制造乳酸盐。它之所以如此有益，是因为它是肠道细胞非常容易利用的能量来源。不过我不想离题太远。是的，总会有权衡，尤其是口服摄入时。

So you're having lactic acid and lactate sort of in this equilibrium, so to speak. But bacteria in your gut are making lactate, essentially. And the reason it's so good is because it is a very easily utilizable source of energy for the gut cells. So not to like go off on a tangent here. Yes, there is always a trade off, especially for doing something orally.

但说到运动，就像我们刚开始讨论运动时提到的，如果你能把运动的效果浓缩成药丸，那意味着太多东西了，对吧？不仅仅是乳酸盐。

But when it comes to exercise, there's like I mentioned when we first started talking about exercise, if you could pill up what exercise does, I mean, it's so many things, right? It's not just the lactate.

是啊。

Yeah.

太多不同的效果，太多不同的适应性变化。我的意思是，那将是奇迹药物。所以你不仅获得乳酸盐，还提升了心肺功能，获得了肌肉反应，促进了肌肉适应。

So many different things, so many different adaptations that occur. Mean, I it would be a miracle drug. So there's you're not just getting the lactate. You're getting the improvement in cardiorespiratory fitness. You're getting the muscular response, The adaptations to your muscle.

你激活了应激反应基因，比如对预防神经退行性疾病至关重要的热休克蛋白。由于运动时产生的炎症，你体内产生了抗氧化剂。运动同时引发了数百种协同效应。你根本无法用药物替代。

You're increasing stress response genes like heat shock proteins that are important for preventing neurodegenerative disease. You're making antioxidants because the inflammation that you're generating while you're exercising. There's hundreds and hundreds of things that are happening all in concert from exercise. And you just can't you can't pill it up.

我还有个很傻的问题：如果乳酸盐和其他物质，甚至像肌酸这些东西对我这么好，为什么我的身体不多制造些呢？

I have another really silly question, which is if lactate and these other things, even like creatine and, you know, all these other things are so good for me, why doesn't my body just make more of it?

我是说，身体确实能合成它。问题是随着年龄增长，所有机能都会变得不那么高效。身体各项功能都不如年轻时那样运转良好。至于肌酸——如果你感兴趣我们稍后可以详谈——你的身体只能合成这么多。

I mean, body does make it. The problem is that as we're aging, everything becomes less efficient. Everything doesn't do what it used to do as well as it did when it was younger. And also in the case of creatine, which we can talk about later if you're interested, then your body only makes so much of it.

为什么不能合成更多？也许我没有提供足够的矿物质或自然合成所需的环境？我也不确定。

Why doesn't it make more? Maybe I'm not giving it the minerals or the environment it needs naturally to make more. I don't know.

你也可以从食物中获取。肉类、禽类和鱼类都含有肌酸。这可能就是身体不再多合成的原因，因为它知道你会通过饮食摄入。所以这是获取肌酸的另一种方式。

You get it from your food, too. Creatine is found in meat, in poultry, in fish. So probably that's why your body doesn't make more of it, because it knows you're going to be getting it from your diet as well. And so that is another way to get creatine.

当

Of

然，对于素食者和纯素食者就是另一回事了，因为他们不吃肉。所以他们基本上只能依赖身体自身合成的量。

course, the vegans and the vegetarians, that's a whole other ballgame because they aren't eating meat. And so they're really essentially only relying on what their body can make.

这个我们稍后一定要讨论。关于大脑健康这点，如果...如果我不想成为那种健忘、说话结巴、认知能力衰退的老年人——我现在32岁，感觉正处于一个关键时刻，现在的决定会对我90岁时的大脑状态、思维清晰度和记忆力产生深远影响。有没有什么我现在能做的事，能对我90岁时的认知表现产生重大影响？

We'll definitely talk about that later. On this point of the brain then, if if I I don't want to be an older person who can't remember things and stutters over my words and falls into cognitive decline, And I'm 32 now, so I feel like I'm in a moment in time where I can really make decisions now that have a really big impact on my 90 year old brain and my ability to think straight and clearly and remember things. Are there things that I can be doing now that will have a profound impact on my cognitive performance at 90?

当然有。具体是哪些呢？首先，让我们先总结下运动这部分，因为我认为这项研究非常深刻——实际上研究对象不是32岁人群，而是60岁左右的老年人。

Yes. And what are those things? Absolutely. Well, first of all, just to kind of wrap up the exercise story, because I think this study is so profound, and in fact, it wasn't done in 32 year olds, it was done in older adults. So we're talking 60 year olds a little bit older.

这些受试者被安排进行为期一年的有氧运动训练计划，强度大约维持在最大心率的70%至75%。虽然不算特别剧烈，但对他们来说已经相当吃力了，对吧？这项研究旨在观察大脑衰老过程。正如我之前提到的，我们的心脏会随着年龄增长而变化——它会逐渐萎缩。

And these individuals were put on a aerobic exercise training program for one year that was more of like a 70 to 75% max heart rate. So it wasn't so vigorous, But it was pretty vigorous for them, right? And the basis of this study was to look at brain aging. As we age I mentioned our heart aging, right? It gets different and shrinks with age.

我们的大脑同样会随年龄萎缩，这种现象称为脑萎缩。特别是从中年（约50岁）开始，大脑中负责学习记忆的海马体等区域，每年会以1%到2%的速度萎缩。

Our brain also shrinks with age. It's called atrophy. And as we age, especially starting in midlife, so around the age of 50, your brain in certain areas of the brain like the hippocampus, which is involved in learning and memory, starts to shrink by about 1% to 2% per year.

我可不想这样。

I don't want that to happen.

我也是。好消息是，在这项研究中，经过一年每周三次、每次约30分钟的有氧训练（其实强度并不算高），相比进行拉伸运动的对照组...

Same. Same. The good news is, in this study, after a year of this sort of aerobic exercise training program, they were doing three times a week, about thirty minutes a day. Really not even that intense. These individuals and then there was a control group that was kind of the stretching.

研究者常用拉伸组作为对照。来看看对照组的情况：他们的海马体确实如预期般萎缩了1%-2%。但训练组不仅没有萎缩，反而增长了1%-2%，这归功于神经发生现象——新神经元生长和脑源性神经营养因子的作用。

They like to use the stretching as the control group. So let's talk about the control group, the stretching group. They did lose about 1% to 2% in terms of the size of the hippocampus. It shrunk 1% to 2% after that year, which is what you would expect normally. However, the group that was training, not only did they not have their hippocampus shrink by 1% to 2%, it actually grew by one to 2%, which comes down to that neurogenesis, that growth of new neurons, the brain drive neurotrophic factor that's able to do that.

即便年届五十，你依然能生长出新神经元，这太不可思议了！我特别推崇这项研究有两个原因：首先证明运动不仅能延缓大脑衰老，还能逆转并促进生长；其次它告诉我们——永远为时不晚。

You're actually able to grow new neurons even when you're in the age of 50, which is amazing. It's incredible. So that study I love because a couple of reasons. One, it shows that it's possible to not only stave off some of the components of brain aging, but to reverse it and increase it, right, through exercise. And number two, I love it because it's never too late.

比如你六十岁开始锻炼仍能受益。虽然我们现在讨论的是三十多岁人群，但观众听众里可能已有五六十岁的人——重点在于任何时候开始都不算迟。同样地，我们谈论保持认知敏锐和预防痴呆也是如此。

Like, you can start this, you know, in your 60s and still have a benefit, right? You're talking about being in your 30s. But, you know, some people watching the show, listening to the show may already be in their 50s or 60s, right? So it's never too late. Likewise, you know, we're talking about being cognitively sharp and not getting dementia.

还有研究表明，比如将女性带入实验室测量她们的心肺适能，那些心肺适能最高的女性在后续随访期间患痴呆症的可能性降低了80%。所以我认为，在脑衰老方面，运动是重要因素之一。但你提出了一个重要问题：我现在能做些什么来影响未来几十年大脑的衰老方式？其实还有其他方法，甚至不需要像运动那么费力。

There's also studies showing that people, like women, that were brought into the lab, they had their cardiorespiratory fitness measured, those women with the highest cardiorespiratory fitness were eighty percent less likely to come down with dementia over the follow-up period of time. So again, I think exercise is one of the big ones when it comes to brain aging. But you asked an important question. You say, what can I be doing now that's going to affect the way my brain ages for the subsequent decades of my life? And there are other things that can also be done that don't even require as much effort as exercise.

运动是黄金标准，因为它不仅能阻止大脑萎缩，还能促使部分脑组织再生，这简直不可思议，对吧？我的意思是，这太令人震惊了。

Exercise is the gold standard because being able to not only stave off atrophy of the brain, but to regrow some of it is incredible, right? I mean, that's just mind blowing.

他们有没有对痴呆症、阿尔茨海默病患者进行运动计划，并监测他们在运动计划中认知能力下降的情况？

Have they ever taken people with dementia, Alzheimer's, and put them on an exercise program and monitored the decline of their cognitive abilities on an exercise program?

有的。不过当患者已经处于病理状态时会更困难，因为病情会像滚雪球般加速恶化。虽然运动有些益处，但预防始终是最佳策略。预防永远是最好的选择。

Yes. I mean, it's it's much harder when you already have someone who is in that pathological state because things just really snowball and accelerate. And there are some benefits. I mean, it's not prevention is always the best. Prevention is always the best.

所以我认为，如果要说有什么核心建议，那就是：让我们现在就尽力而为，避免走到那一步。

And so, you know, I think that if there's any sort of take home here, it's that like, let's try to do what we can now so that we don't get to that point.

在我们讨论更简单的预防认知衰退方法之前，我们是否已经知道痴呆症和阿尔茨海默病的成因？有任何线索吗？因为通过脑部成像，他们能看到这些所谓的脑部斑块。

Before we get into the easier ways of staving off cognitive decline, do we know what causes dementia and Alzheimer's yet? Do we have any ideas? Because we can when they do the brain imaging, they can kind of see these plaques on the brain, they say.

这是多因素导致的，意味着痴呆症和阿尔茨海默病有许多不同诱因。你提到的β淀粉样蛋白斑块，实际上是大脑中本该被清除的淀粉样蛋白异常聚集形成的。当清除机制失效时，这些未被清除的淀粉样蛋白就会开始聚集成团块。

I mean, there's a lot of different it's multifactorial, which means there's a lot of different causes of dementia and Alzheimer's disease. So I would say you mentioned plaques, amyloid beta plaques. What happens is, that's the aggregation of a protein in our brain called amyloid that typically is cleared from our brain. And what happens is this abnormal thing happens where you're not clearing the amyloid. And so it starts to kind of form clumps and aggregates with the amyloid proteins that are not being cleared.

这基本上发生在你的神经元外部，但确切位置是在神经元之间形成突触的地方。它扰乱了神经元之间的突触连接，而突触连接本质上是在形成记忆。当你开始破坏这种连接时，不仅记忆开始消失，神经元本身也开始丧失其存在意义——因为形成记忆本就是神经元的功能之一。当神经元失去功能时，它们就会逐渐死亡。淀粉样蛋白聚集与许多问题相关。

And that essentially is happening outside of your neurons, but it's happening where the synapses are formed between neurons. And so what happens is it kind of disrupts the synaptic connection between neurons, which is essentially forming a memory. And so when you start to disrupt that connection, you lose not only the memories start to go away, but the whole purpose of the neuron is to kind of I mean, one of the purposes is to form a memory. And so you start to like neurons start to die, right, when they start to lose their purpose. Amyloid aggregation is linked to a lot of things.

比如我提到过，这些物质在我们睡眠时会被清除，特别是在深度睡眠阶段（慢波睡眠期）。这时会发生堪称神奇的现象——脑部类淋巴系统被激活。你听说过淋巴系统吧？脑部类淋巴系统本质上是由遍布大脑的网状结构组成的通道网络，脑脊液通过这些通道在大脑中冲刷，清除所有代谢废物。

So for example, I mentioned it being cleared when we sleep, particularly when we're in our deep sleep stage, slow way sleep. That is, something happens that's kind of incredible. It's called activation of the glymphatic system. So you've heard of the lymphatic system. Well, the glymphatic system is essentially this series of like networks and like almost like these like highways and essentially roads and stuff all like throughout the brain where you're squirting the cerebrospinal fluid throughout the brain and it's clearing away all the garbage.

那些未被及时清除的蛋白质等物质，通过这个类淋巴系统被冲刷排出。这个系统在睡眠期间尤为活跃。这就是为什么长期睡眠质量差的人患阿尔茨海默病风险更高——因为他们大脑中的淀粉样斑块不断累积。当然还有其他诱因，比如阿尔茨海默病患者大脑中的葡萄糖代谢会出现紊乱。

Things like proteins that didn't get cleared and it's sort of squirting them out and clearing them out through this glymphatic system. That glymphatic system is activated during sleep. And it's one of the reasons why people that don't get good sleep over the course of decades have a higher risk of Alzheimer's disease is because they're getting these amyloid plaques built up in their brains. But there's other causes as well. So for example, glucose metabolism is disrupted in the brains of Alzheimer's disease.

神经元需要葡萄糖供能。如果葡萄糖无法正常进入大脑，脑部能量代谢就会出现问题。这被认为是阿尔茨海默病的另一个潜在代谢性病因——当你摄入大量精制碳水化合物和糖分却缺乏运动时，不仅全身的葡萄糖代谢会紊乱，大脑的代谢机能也会遭到破坏。

You need glucose. Your neurons need glucose. And so essentially, your brain isn't able to make energy correctly without the glucose getting into your brain. And so that's another sort of metabolic underlying cause of Alzheimer's disease where you're essentially I mean, it's thought to be where you're eating a lot of refined carbohydrates, refined sugars, and you're not exercising. And essentially, you're disrupting the glucose metabolism in the brain as well as the whole body, right?

大脑与身体是相互关联的。此外还有遗传因素，某些人的基因会提高患病风险，因为他们清除淀粉样蛋白和修复损伤的能力较弱。血脑屏障本应负责过滤有毒物质进入大脑，但它会逐渐失效——我认为这是阿尔茨海默病非常早期的征兆之一。

So the brain and body are connected. But there's also genetic causes as well. And some people have genes that can increase the risk of Alzheimer's disease because they're not able to clear amyloid as well, because they're not able to repair damage as well. So the blood brain barrier, which is really important for filtering out toxic things from getting into the brain, it starts to break down. And that's one of the, I would say, early, early signs of Alzheimer's disease is that breakdown of the blood brain barrier.

这种情况常见于携带APOE4基因风险因子的人群。你可能听说过这个基因，它堪称阿尔茨海默病最大的遗传风险因素。约25%人群携带一个该基因副本，患病风险会翻倍；若携带两个副本，风险将激增至十倍。

And that happens in people that have a genetic risk factor called APOE4. You may have heard of this, but this is probably one of the biggest genetic risk factors for Alzheimer's disease. About 25 of the population has one copy of this gene. That increases the risk of Alzheimer's disease by twofold. If you have two copies of it, it increases the risk of Alzheimer's disease by tenfold.

所以翻倍是指增加到200%？

So twofold being two hundred percent?

两倍意味着翻倍。是的，百分之两百。而十倍则意味着百分之一千，对吧？你基本上差不多...我是说，情况相当糟糕。而且，即使你有这些基因，也不意味着你注定会患上阿尔茨海默病。

Twofold being twice as much. Yeah, two hundred percent. And tenfold being one thousand percent, right? You're basically almost I mean, it's pretty bad. And it's not like a it's not your destiny to get the Alzheimer's disease if you have those genes.

你可以通过生活方式来扭转局面。所以，你并非必然会患上阿尔茨海默病。许多不同的生活方式因素，如保证良好睡眠、锻炼身体、避免饮酒、避免吸烟、不超重或肥胖，这些都会影响你患阿尔茨海默病的风险。更重要的是，如果你携带其中一种基因，那么你真的需要意识到这些因素。因为如果你携带ApoE4基因之一，那么你的生活方式比那些不携带这些基因的人更为关键。

You can do things in your lifestyle that can sort of turn the table. So, you're not essentially going to be getting that Alzheimer's disease. And a lot of different lifestyle factors like getting good sleep, like exercising, avoiding alcohol, avoiding smoking, not being overweight, obese, like those affect your Alzheimer's disease risk. More importantly, if you have one of those genes, then you really have to be cognizant of those things. Because if you have one of those ApoE4 genes, then essentially your lifestyle matters even more than people that don't.

你可以通过检测来确定自己是否携带这些基因吗？

And you can do a test to figure out if you have those genes?

是的，是的。市面上有多种基因检测服务可供选择。几乎所有市场上的服务，比如AncestryDNA，都能检测。具体取决于你所在地区以及可用的服务，现在市面上有很多选择，它们都能检测这些基因。

Yes. Yes. There's a variety of genetic testing services that can be done. Pretty much all the ones that are out there on the market, know, AncestryDNA. I mean, on where you live and what there's so many out there right now I'm will test for

如果我发现自己携带两个这种基因，我会非常恐慌。

mortified if I found out I had two of those genes.

携带两个这种基因的情况较为少见。我之前提到25%的人群携带这种基因，通常是指携带一个等位基因。如果你携带其中一个基因，饮酒会显著增加患阿尔茨海默病的风险。我认为，如果你担心痴呆症和阿尔茨海默病，对于携带APOE4基因的人来说，没有安全的饮酒量。另一个因素是接触性运动和创伤性脑损伤。

Two of them is less common. When I mentioned the twenty five percent of the population having it, it's usually one allele. Alcohol essentially can really increase the risk of Alzheimer's disease if you have one of those genes. And I think that there's really no safe amount of alcohol that can be consumed for people that have APOE4 if you're concerned about dementia and Alzheimer's disease. The other thing is contact sports and traumatic brain injury.

携带一个或两个ApoE4基因的人，如果他们遭遇创伤性脑损伤（TBI），比如在打美式橄榄球、踢足球、参加综合格斗或拳击等运动中受伤，那么他们患阿尔茨海默病的风险会飙升到十倍。因为携带这些基因的人修复损伤的能力较差，这会影响到他们大脑修复损伤的能力。因此，这也是一个非常重要的考虑因素。

People that have any one or two of the ApoE4 genes, if they have that, then if they get a TBI, like if they're playing American football or they're playing soccer or MMA or boxing, whatever, then you talk about going up to a tenfold risk for Alzheimer's disease when you get an injury. Because people with those genes don't repair damage as well. So it affects their brain's ability to repair damage. And so that's also really important to consider.

那么回到我们可以做的简单事情来随着年龄增长提升认知能力，这些比剧烈的高强度间歇训练更简单的方法。

So moving back then to the simple things that we can do to improve our cognitive performance as we age, the things that are simpler than doing the vigorous HIIT training.

实际上有不少方法。首先也是我最喜欢的一个就是简单的复合维生素。我之所以喜欢这个，是因为大约十年前发表了一项大型研究，刊登在《内科学年鉴》上，标题叫《适可而止》。

There's actually quite a few. And first and foremost, the one I love the most is a simple multivitamin. And the reason I love this is because I don't know, was about ten years ago there was a huge study that was published. And it was published in the Annals of Internal Medicine. And it was called Enough is Enough.

复合维生素不仅无用，甚至有害。该研究综合了多项研究，声称复合维生素不过是昂贵的尿液，实际上毫无作用。甚至服用复合维生素可能增加患病风险。那项研究糟糕透了。

Multivitamins are not only useless, they're harmful. And it was essentially looking at a variety of studies and arguing that multivitamins are expensive urine. You're just not really doing anything. And in fact, if you take a multivitamin, you might even be increasing the risk of disease. That study was terrible.

十年前我对其进行了逐条剖析和拆解。但十年后的今天，三项大型临床试验已完成。这些随机对照试验让老年人服用普通复合维生素（如善存银片）或安慰剂，持续数年。

And ten I, years ago, went and just broke it down and pulled it apart piece by piece. But here we are ten years later. Three large clinical trials have been done. These are randomized controlled trials where older adults were given either a multivitamin, and this was just your standard run of the mill multivitamin Centrum Silver, or they were given a placebo. And they were given this for a couple of years.

三项不同研究均表明：复合维生素能提升认知能力、加快信息处理速度、改善情景记忆（即对经历和事件的记忆）。其改善效果显著，相当于使情景记忆衰老延缓五年。就这么简单的复合维生素。为何这很重要？

And what three different studies showed was that a multivitamin improved cognition, improved processing speed, it improved what's called episodic memory. So the kind of memory where you're remembering experiences and you can recall events, things like that. And not only did it improve it, it improved it so much that it was equivalent to reducing the aging of the episodic memory by five years. So a simple multivitamin. And why is that important?

因为复合维生素含多种我们从饮食中摄取不足的维生素和矿物质，这些对代谢、神经递质传导、减轻氧化应激损伤等都至关重要。一粒简单的复合维生素——还有什么比这更简单的？关键是这是随机对照试验，证明的是因果关系，而非仅是关联性。

Because multivitamins have a variety of these vitamins and minerals that we're not getting from our diet that are important for everything, for metabolism, for the way our neurotransmitters are firing, for reducing damage that's causing oxidative stress, right? So a simple multivitamin, how much easier can it be than taking a simple multivitamin? And the fact of the matter is that we're talking about a randomized controlled trial. This is showing cause, right? This isn't just an association.

这证明持续数年服用复合维生素比安慰剂更能改善认知。我认为这非常了不起，也是我喜欢的例证之一。但深入研究某些营养素——要知道我最初是科学家出身，其实是化学背景。当我刚进入生物学领域时，就在衰老实验室研究衰老机制。

This is showing that you took a multivitamin for a couple of years and improved your cognition more than a placebo. So I think that's pretty incredible, and it's one of the examples that I like. But diving deeper into some of the nutrients, this is an area you know, I started out as a scientist. I started out as a chemist, actually. But when I first got into biology, I was working in an aging lab and studying aging.

这让我非常感兴趣，因为我实际上可以通过自己的实验，亲手操控这些微小的蠕虫。它们叫做秀丽隐杆线虫。当时它们的全基因组已被测序，那是在2000年代初。它们有许多与人类相似的基因。

It was very interesting to me because I essentially, with my own experiments, with my own two hands, could manipulate these tiny little worms. They're called C. Elegans. Their whole genome was sequenced at the time, and this was in the early 2000s. They have a lot of genes that are similar to humans.

这被称为同源性。其中一个基因涉及胰岛素信号通路和IGF-1通路。胰岛素信号会在葡萄糖作用下被激活。我们现在摄入大量糖分，对吧？而我可以通过基因手段降低这些线虫的胰岛素信号传导。

It's called homology. One of the genes is the insulin signaling pathway and the IGF-one pathway. So insulin signaling would be something that's activated with glucose. We are eating a lot of sugar, right? And I could take these worms and I could genetically decrease their insulin signaling.

打个比方来说，这就相当于我们不会摄入那么多糖分，对吧？我们不会过度激活那条通路。我能在这种寿命约15天的蠕虫身上实现这点，并将其寿命延长至30天。相当于让它们的寿命几乎延长了100%，明白吗？

So it kind of if you think about a parallel to that, that would be, Okay, we're not going to be eating as much sugar, right? We're not going to be activating that pathway so much. And I could do that in this worm that has a life expectancy of about fifteen days. And I can extend its life expectancy to thirty days, right? So you're increasing its life expectancy by pretty much 100%, right?

不仅如此，它们不仅活得更久，还更健康、更有活力。这是肉眼可见的——它们四处活动，完全是充满活力的线虫。二十多岁的我对此非常兴奋，因为这极具现实意义：我们拥有这个基因，而且知道影响它的生活方式因素。

Well, not only did they you know, live longer, they were healthier and youthful. And you could see that visually. They're moving around, and they were just youthful worms. And so I was very excited about this, you know, in my 20s because I was like, wow, this is very relevant. We have this gene, and we know lifestyle factors that affect it, right?

糖分。所以我得出的结论是：生活方式至关重要。当然遗传学也很重要，或许未来某天我们能降低胰岛素信号。但我关注的是当下，而非未来科技。

Sugar. So the take home for me was lifestyle matters. Yeah, genetics. Maybe that'll be something one day where we're decreasing the insulin signal. But I was looking for the now, not the future technology.

于是对我来说，当下的启示就是：我可不想持续激活自己的胰岛素信号通路。看看这些降低信号传导的线虫发生了什么——它们既充满活力又延长寿命，这太神奇了。出于好奇，我开始研究饮食和生活方式，并查阅相关文献。

And so the now to me was, wow, I don't want to be constantly activating my insulin signaling pathway. Look what happens to these worms if you reduce it. I mean, it's amazing. They're youthful, and they live longer. And so I started to kind of get into diet and lifestyle sort of just out of curiosity and sort of reading in the literature.

后来我发现了导师布鲁斯·艾姆斯博士的一些研究，他证明缺乏某些营养素（比如叶酸）会导致问题。叶酸存在于羽衣甘蓝等深色绿叶菜中。如果减少叶酸摄入造成缺乏，本质上会导致DNA双链断裂，效果就像遭受电离辐射。这个实验已经验证了这点。

And I came across some studies from my mentor, Doctor. Bruce Ames, where he was showing that not getting enough nutrients like for example folate. Folate is found in dark leafy greens like kale. You know folate if you decrease folate and make someone deficient in it, it essentially causes double stranded breaks in your DNA that essentially is like being under ionizing radiation. And that experiment was done.

比如你可以用一只老鼠做实验，在它的食物中减少叶酸含量，再让另一只老鼠接受电离辐射机的照射。结果发现两者DNA中的双链断裂数量——这些断裂会引发癌症、加速衰老、影响细胞功能——竟然相同。这简直令人震惊：饮食中缺乏某种营养素的效果，竟等同于站在电离辐射机下。没人愿意暴露在电离辐射中，却少有人意识到日常饮食也能造成同等伤害。

Like you could take a mouse, make it like put low folate in the mouse's food, and then take another mouse and put it under an ionizing radiation machine. And the amount of double stranded breaks in their DNA which cause cancer, which accelerate aging, which affect how your cells are functioning. It was the same. So it was like, wow, not having a certain nutrient in your diet was standing under an irradiating machine, ionizing radiation. No one's going to want to stand under an ionizing radiation machine, but no one's thinking about how your diet can do the same thing.

这让我深入研究了布鲁斯的成果。科学界无人不晓布鲁斯·埃姆斯博士，他发明的埃姆斯致癌物检测法，本质上是种低成本鉴定物质致癌性的方法。

And that was kind of I got into a lot of Bruce's research at the time. So Bruce, he anyone in the science field knows Doctor. Bruce Ames. He actually came up with the Ames carcinogen test. And that essentially was a way of cheaply looking at and identifying whether something's a carcinogen.

随着研究深入，他发现营养问题——比如叶酸缺乏本质上就是致癌因素，就像电离辐射一样。后来他将研究扩展到镁和B族维生素等其他营养素。但对我而言，关键启示在于：这些微量营养素和维生素矿物质对我们衰老过程和健康的影响程度，竟堪比我们担忧的电离辐射等有毒物质，而人们却从未从这个角度思考过。

And he got into sort of nutrition as he started to figure things like folate basically being lack of folate being a carcinogen essentially, right? Like ionizing radiation is a carcinogen. And then he started to go on to other nutrients as well like magnesium and B vitamins. But I think for me, the moment was micronutrients and these vitamins and minerals are affecting the way we age, are affecting our health on a similar level as these toxic things that we're worried about, like ionizing radiation. And nobody's thinking about it like that.

举个实例：你提到预防痴呆症，维生素D的作用远超普通维生素——它能转化为类固醇激素。这种激素会进入细胞核作用于DNA，像开关般激活或抑制基因表达。

So I'll give you an example. Vitamin D, you talked about dementia, what's going to help prevent dementia. Vitamin D is it's actually more than a vitamin. Vitamin D gets converted into a steroid hormone. So a steroid hormone essentially what it does is it goes into the nucleus of a cell where all your DNA is and it's activating genes and deactivating them.

它直接影响基因组。事实上人类超过5%的基因都受维生素D调控。这为何重要？因为全美70%的人口...

It's affecting your genome. And it's actually over five percent of your genome is being affected by vitamin D. Why is that important? Because seventy percent of The U. S.

都存在维生素D不足的问题。原因在于维生素D3需通过皮肤接受阳光中UVB辐射合成。现代人长期室内活动，皮肤难以生成足量D3，而这种物质最终会转化为调节全身功能的类固醇激素。即便外出，还有诸多干扰因素——任何阻挡UVB辐射的物质都会抑制D3合成，比如防晒霜。

Population has insufficient levels of vitamin D. The reason for that is because vitamin D3 is actually made in the skin from UVB radiation from the sun. And so if you're not outside, then you're not really making a lot of vitamin D3 in your skin. And vitamin D3 then gets converted into this steroid hormone that regulates everything, right? And so, you know, modern day society, you know, we're inside all the time.

我们整日伏案工作，很少接触阳光。就算外出，影响维生素D合成的因素也很多——任何阻隔UVB辐射的物质都会妨碍身体制造D3，比如防晒霜对吧？

We're working. We're not outside. And even if you were outside, there's so many other factors that affect it. So anything that blocks out UVB radiation blocks out the availability of your body to make vitamin D3. So sunscreen, right?

这是个重要因素。黑色素，这种较深的色素就像天然防晒霜。然后是纬度，取决于你居住的地方。所以，一年中有相当长的时间，如果你住在更北的纬度地区，比如英格兰、威尔士、芝加哥或瑞典，UVB辐射甚至连续几个月都无法到达大气层。再加上防晒霜或黑色素的作用，简直就是场灾难，对吧？

That's a big one. Melanin, the darker pigmentation that acts as a natural sunscreen. And then latitude, depending on where you live also. So, you know, a good number of months out of the year, if you're in a more northern latitude like England, like Wales, like Chicago or Sweden, UVB radiation is not even hitting the atmosphere for several months out of the year. Combine that with sunscreen or melanin, and you got like this disaster, right?

事实上，芝加哥大学有项研究调查了非裔美国人和白种人在这方面的能力

In fact, there was a study out of the University of Chicago that looked at African Americans and Caucasians their ability

与白人相比。

from white people.

没错，正是如此。他们通过UVB辐射合成维生素D3的能力。

Yeah, exactly. Their ability to make vitamin D3 from UVB radiation.

从阳光中获取。

From the sun.

是的。正如我提到的，黑色素是天然防晒霜。非洲裔、南美裔或东南亚裔人群，也就是通常更靠近赤道的人，体内黑色素更多。这是防止被太阳紫外线灼伤的适应性特征。芝加哥大学的这项研究发现，非裔美国人需要在阳光下停留的时间是白种人的6到10倍，才能合成等量的维生素D3。

Yeah. And as I mentioned, melanin is a natural sunscreen. And people that are either from African origin or South American or Southeast Asian, right, people that are closer to the Equator usually have more melanin. It's an adaptation to prevent you from burning from the UV rays of the sun. Well, this University of Chicago study found that, you know, people that are African American had to stay in the sun six to 10 times longer than people with fair skin, the Caucasians, to make the same amount of vitamin D3.

因此，以你为例，你的黑色素含量稍高些。就像

And so as a consequence, if you take someone who, like yourself, well, you've got a little bit more melanin. Like

混血。A

mixed. A

有一点。对，你的黑色素稍微多些。但假设有个人，比如

little bit. Yeah, you've got a little bit more melanin. But let's say you take someone who, you know, has a

像我妈妈。她是尼日利亚人。

Like my mom. She's Nigerian.

好的。你妈妈来自尼日利亚。假设她搬到芝加哥。对吧？

Okay. Your mom from yeah. Nigerian. And let's say your mom moves to Chicago. Right?

呃，她搬去了该死的英国。

Well, she's moved to bloody England.

或者她搬去了英国。对，没错。那从维生素D的角度来看就是在制造灾难，因为你不仅一年中有好几个月无法合成它——我忘了具体几个月，大概四五个月吧——那时连UVB辐射都到不了大气层，而且你还有天然防晒屏障。

Or she moved to England. Right. Exactly. Then you're talking about a recipe for disaster in terms of vitamin D because you're not only not making it several months out of the year. I forgot how many months out of the year, maybe four or five or something like that, where the UVB radiation is not even hitting the atmosphere, but you have this natural sunscreen.

这会导致什么症状？

What's the consequences of that in terms of symptoms?

嗯，这不像那种急性症状，你照镜子时能立刻察觉并意识到问题。

Well, it's not like an acute thing where you kind of just look in the mirror and you're like

那么从因果关系来看，具体是什么导致的呢？

What is the causation then in terms of?

对，对。是这样的，我之所以这么说，是因为人们总会联想到——比如缺乏维生素C会得坏血病，照镜子就能看到牙龈溃烂，对吧？这种情况很容易识别。但维生素D缺乏或不足则更为隐匿。

Right, right. Yeah. So, the reason I say this is because people always think of like, well, I'm not getting enough vitamin C, and I have scurvy, and you can look in the mirror and your gums are falling apart, right? It's easy to identify this. Vitamin D deficiency or insufficiency is more insidious.

这种损害是随时间累积的，初期不太明显。可能只是感觉嗜睡或精力不足，却找不到确切原因。当然，严重维生素D不足确实会导致佝偻病、骨骼畸形等急性症状，尤其在幼年时期。但我们现在知道，维生素D缺乏会使痴呆症风险增加80%。

It's kind of this damage that accumulates over time. It's something that isn't quite noticeable. Or maybe feeling like lethargic or you don't have enough energy, things like that, but you don't really know quite why. So vitamin D insufficiency and deficiency, there are acute effects where if it's severe it can cause rickets and like bone malformations and stuff, especially if it's happening early in life. But what we now know is that being deficient or insufficient in vitamin D can increase dementia risk by eighty percent.

多项研究都证实了这一点。反之亦然——补充维生素D3的人（这就是简单解决方案所在，既然皮肤合成不足，可以通过补充剂获取），其痴呆风险能降低40%。

And that's been shown in multiple studies. The converse is also true. So people that supplement with vitamin D3 and this is where a simple solution comes in, right? So you're not making it from your skin, but you can take a supplement. People that supplement with vitamin D3 have a forty percent reduced risk of dementia.

也就是说，他们避免了非常普遍的维生素D缺乏，而这种规避直接降低了痴呆风险。甚至有研究对痴呆症和阿尔茨海默病患者分组给予维生素D补充剂或安慰剂，结果发现服用维生素D的组别认知功能改善，β淀粉样斑块标志物也减少了——这些指标都被同步监测到了。

So in other words, they're avoiding deficiency, which is very common, and avoiding that deficiency then is reducing their dementia risk. And there's actually even been studies in people with dementia and people with Alzheimer's disease that were giving a vitamin D supplement or a placebo control. And those individuals given the vitamin D supplement had improved cognition. They had, lower markers of amyloid plaques. So those were also measured as well.

所以维生素D的作用非常广泛，它调控着人类蛋白质编码基因组中5%的基因表达。

So vitamin D is doing a lot of things. It's regulating 5% of your protein coding human genome.

如果我想增加患痴呆症的概率，那么我就得远离阳光、避免摄入维生素D、饮酒吸烟、久坐不动，并且睡眠质量极差。

If I want to increase my probability of getting dementia then, I've got to stay out of the sun, I've got to avoid vitamin D, I've got to drink alcohol, smoke, be sedentary, and I've got to sleep really badly.

对，还要大量摄入精制糖。没错，正是如此。

Yes, and eat a lot of refined sugar. Yeah. Yes, yes, exactly.

明白了。

Okay.

正是。现在你可能会问，需要多少维生素D？我指的是缺乏和不足的情况。你确实需要通过血液检测了解自身水平。已有超过30项研究探讨了维生素D水平与全因死亡率的关系。

Exactly. Now, you might go, how much vitamin D, right? I'm talking about deficiency and insufficiency. And you really want to get a blood test to know what your levels are. There have been, I don't know, 30 plus studies that have looked at vitamin D levels and all cause mortality.

全因死亡率即因各种疾病（心血管疾病、呼吸系统疾病、癌症等）导致的死亡。血液中维生素D水平维持在40至60甚至80纳克/毫升的人群，其全因死亡率最低。这些人既非缺乏也非不足——不足通常在30以下，缺乏则是20及以下。

So that would be, again, dying from a variety of different diseases cardiovascular disease, respiratory disease, cancer. And people that have blood levels of vitamin D between forty, sixty, maybe eighty nanograms per milliliter have the lowest all cause mortality. So these people are not deficient, not insufficient. Insufficiency happens at about 30 below that. Deficiency is 20 and below.

多项针对大脑及衰老与维生素D水平的研究表明：血液中维生素D水平每下降10纳克/升，脑损伤（称为白质高信号）就会增加。这本质上是大脑白质的损伤，而白质正是髓鞘所在。

And so, there have been a variety of studies that have looked at, for example, the brain and the aging brain and vitamin D levels. And it's been shown that for every 10 per liter decrease in vitamin D blood levels, there's an increase in brain damage. It's called white matter hyperintensities. It's basically damage to the white matter in your brain. And the white matter in your brain is myelin.

髓鞘负责大脑信息传递，就像电脉冲传导让你能够思考、说话等等。完全正确。

That's how your brain's communicating and like how, you know, electrical impulses are being, you know, moved so that you can think and talk and all that. Exactly.

是的，我今天还没服用过，所以感觉被你说服了。

Yeah, I hadn't had one today, so I feel like you've persuaded me.

大多数缺乏维生素D的人，每天补充约4000国际单位就能将血液水平提升到正常充足值。这一点已在多项研究中得到证实。其实服用维生素D并不困难，它可能是最便宜的补充剂，每片约10美分。

Most people that are deficient can increase their blood levels to a normal sufficient level by about 4,000 of vitamin D per day. So, not and that's been done, that's been shown in multiple studies. Not it's not it's not that hard to take. In fact, vitamin D supplements are probably the cheapest supplement out there. It's like 10¢ per pill.

当你谈到这些时，我真的很惊讶它们含有抗癌成分。查阅研究后发现确实如你所说，根据世界癌症研究基金和PubMed的数据，羽衣甘蓝、西兰花、抱子甘蓝等与降低乳腺癌、前列腺癌、肺癌和结直肠癌风险相关。但大多数人摄入不足，毕竟这些不是最美味的食物。你还提到了糖分，这让我思考目前正在执行的生酮饮食——考虑到我们之前讨论的痴呆症、长寿和衰老等问题，这种饮食是否最优？

When you talked about these, was really surprised to hear that they have cancer preventing chemicals in them. And then I was looking at some of the research and it does say exactly as you said, things like kale, broccoli, brussels sprouts linked to a reduction in breast cancerous prostate, lung, and colorectal cancers according to the World Cancer Research Fund and PubMed. Most of us don't eat enough of this stuff because it's not the tastiest stuff. And you talked about sugar as well. It makes me think about the diet that I'm currently on, which is the ketogenic diet, and whether that is an optimal diet in terms of all of the things we've discussed earlier dementia, longevity, aging.

你对生酮饮食有什么看法？

What is your views on the ketogenic diet?

我认为存在极端生酮饮食（如经典生酮饮食）和改良版低碳水生酮饮食。后者允许摄入含碳水化合物的绿叶蔬菜——虽然含碳但高纤维低升糖指数。实际上食用这些蔬菜仍能保持酮症状态。我对生酮饮食很感兴趣，因为β-羟基丁酸（酮症时产生的主要循环酮体）具有显著益处，类似乳酸的作用。它能进入大脑并成为神经元易利用的能量源。

I think there's the extreme ketogenic diet, like the classical ketogenic diet, and then there's modified sort of low carb ketogenic diets that do allow for I mean there's yes these are leafy greens that are carbohydrate, but they're high in fiber and they're low glycemic index. And so you can actually eat leafy greens on a ketogenic diet and still be in ketosis. So the ketogenic diet is very I'm very interested in it because I do think that beta hydroxybutyrate, which is the key major circulating ketone body that's produced when you're in ketosis, is highly beneficial, much like lactate. It can actually do a lot of what lactate can do. It gets into the brain and it's an easily utilizable source of energy by neurons.

这就是酮体——当你戒断碳水化合物和糖分时身体产生的物质。最终会进入酮症状态，此时身体依靠酮体供能。

These are ketones, which is what your body makes when you abstain from carbohydrates and sugars. Yes. It eventually shifts into ketosis where you're running on you're in ketosis and you're running on ketones.

没错。你指尖采血测量的就是β-羟基丁酸，这是主要的循环酮体测量指标，实际上它还是一种信号分子。

Yes. It's what you're measuring when you're doing your you're measuring your finger prick. It's beta hydroxybutyrate. That's the major circulating one that you're measuring. And that's actually a signaling molecule.

它正在激活大脑中的脑源性神经营养因子。这非常有趣，因为它几乎就像体内持续存在乳酸一样。因此我对生酮饮食特别感兴趣，尤其是对那些反应良好的人群。我的意思是，有些人的甘油三酯和胆固醇会飙升，个体对饮食的反应存在差异。所以最好定期检测各项指标，确保你对生酮饮食反应良好，或者可能需要周期性调整。

It's activating brain derived neurotrophic factor in the brain. And so it's very interesting because it's almost like having lactate in your body but having it constantly. So I'm super interested in a ketogenic diet, particularly for people that respond well. I mean, some people, their triglycerides go really high, their cholesterol goes really high, and there's sort of an, I would say, individual variation in terms of how you respond. And so it's good to always measure everything, right, to make sure that you're responding well to ketogenic diet or to maybe cycle it.

出于对β-羟基丁酸大脑益处的考虑，我也对周期性实施很感兴趣。研究表明，当这种酮体（如β-羟基丁酸）进入大脑后，可以替代葡萄糖作为能量来源。

I've been very interested in cycling it for brain benefits as well because of the beta hydroxybutyrate, where it's just so beneficial for the brain. It's been shown beta hydroxybutyrate so what happens is when you have this ketone, like beta hydroxybutyrate get into the brain, it's able to be used as energy instead of glucose.

我觉得我们应该退一步，为可能从未听说过或理解生酮的听众解释一下。根据我在社交场合的观察，确实有很大比例的人不了解这个概念——普通人竟然不清楚生酮或酮症是什么，这让我非常惊讶。

I feel like we should take a step back and explain what keto is for the for the listener who maybe has never really heard or understood it before. And I know that there's a large proportion of people that don't know what it what it is because I spend a lot of time at dinner parties trying to talk about it. And it's super surprising to me that the average person actually doesn't really know what keto or ketosis is.

这个提议很好。我们可以聊聊酮症。简单来说，在不涉及太多技术细节的情况下，理解酮症的最佳方式是：你的身体主要利用脂肪酸而非葡萄糖供能。虽然仍会消耗少量葡萄糖——比如无线粒体的红细胞就必须依赖葡萄糖。

So I think that's great. Yeah, we can talk about ketosis. Essentially, if we kind of take a thousand mile high view of it without getting so technical, I would say the best way to think about being in ketosis is your body is using fatty acids as energy and not much glucose. You'll still use a little bit of glucose. You need to use glucose because your red blood cells, for example, don't have any mitochondria.

但主要能量来源是从脂肪组织释放的脂肪酸。

They need glucose. But you're mostly using fatty acids as energy that are being produced from they're being released from fat stored in adipose tissue.

就像我肚子上的脂肪。

Which is like my belly.

没错，包括腹部内脏脂肪和皮下脂肪。

Which is like your belly, visceral fat, subcutaneous fat.

这听起来太棒了。我的身体将开始燃烧脂肪而不是葡萄糖，你知道的，那些来自吃面包之类的食物提供的葡萄糖。我要变瘦了。

This sounds great. My body's going to use burn the fat instead of burn, you know, burning glucose, which I've got from eating bread or something. I'm going to get skinny.

人们在生酮饮食中确实会减重。

People do lose weight on a ketogenic diet.

我爸爸减掉了好多体重，简直不可思议，让人震惊。

My dad has lost so much weight. It's ridiculous. It's like shocking.

是通过生酮饮食吗？

On a ketogenic diet?

是啊，太疯狂了。他原本体型很大——容我直言，肚子特别大。前几天他给我发了张截图，坚持生酮饮食几个月后，他体重降到了13英石（约82.5公斤），这是他自青少年时期以来首次达到这个数字。

Yeah, it's crazy. He was quite a big man, if I say so myself, very big belly. And he sent me the screenshot the other day after a couple of months on the ketogenic diet. And he's like thirteen. He's just for the first time ever been thirteen stone since he was in his teens.

他现在只有13英石了。相当于在几个月内减掉了约4到5英石（25-32公斤）的体重，整个人看起来完全不同了。当然，我并不是说要永远坚持这种饮食方式，但生酮饮食的减重速度确实惊人。

He's now thirteen stone. So he's lost what the equivalent of about four or five stone in weight in a couple of months. And he just looks completely different. Now, not, you know, I'm not necessarily saying to stay on that diet forever, but the speed in which one can lose weight on a ketogenic diet is remarkable.

没错。所以你摄入的食物主要是脂肪对吧？这样你不仅消耗体内储存的脂肪，同时也在用更多脂肪作为能量来源，基本上是把脂肪当燃料使用。

Right. And so you're basically the food that you're eating is predominantly fat, right? So you're basically not only using the fat that your body already has stored, but you're also fueling yourself. You're feeding yourself more fat, right? So you're basically using the fat as energy.

通过一系列生化反应，你会产生酮体作为这一过程的副产品。这并不一定仅限于生酮饮食。比如禁食时你也会进入酮症状态，对吧？因为仔细想想，你没有摄入食物，而是依赖身体已有的储备作为能量来源。而你的肝脏中储存的葡萄糖（以糖原形式）是有限的。

And through a whole bunch of biochemical reactions, you produce ketone bodies as a byproduct of that. It doesn't necessarily have to be just ketogenic diet. Like you can when you're fasting you go into ketosis, right? Because if you think about it you're not giving yourself food, Instead, you're relying on what your body already has as a source of energy. And you only have so much glucose stored as glycogen, right, in your liver.

个体差异存在，但通常在不进食约十二小时后，你的糖原储备就会基本耗尽。这时身体会转向脂肪分解（即脂解作用）。因此禁食是进入酮症的另一种方式。剧烈运动同样可以——比如那些进行长时间耐力运动的运动员也会进入酮症，因为他们更快耗尽糖原储备，同时由于运动强度大、持续时间长，他们也在快速消耗所有摄入的能量。

And that I would say after there's individual variation, but after about twelve hours of not giving your body food, you sort of deplete all your glycogen stores. And then so you start to shift to lipolysis, which means the breakdown of fat. So fasting is another way to get into ketosis. Another way would be intense exercise. So like, you know, these endurance athletes that are doing long duration types of exercise also can go into ketosis, right, because they're depleting their glycogen stores much quicker And they're also using all this energy that they've fueled themselves with because it's so intense, right, long duration type of exercise.

当然，这些方式还可以组合使用。比如在进行耐力运动的同时采用生酮饮食，这样能更快进入酮症状态。

And so, and you can combine these things as well, right? You can do endurance exercise with a ketogenic diet, and you really kind of can get into ketosis quicker.

这个过程像开关一样吗？

Is it like a switch?

这涉及所谓的代谢灵活性——即身体能够在燃烧葡萄糖和利用脂肪酸作为能量（同时产生酮体）之间切换。如果你经常进入酮症状态、规律运动、禁食或采用限时进食法（比如在8小时内吃完所有食物，然后16小时禁食），你的身体会更习惯切换到脂肪酸代谢模式。这种代谢灵活性并非人人具备，因为研究表明大多数人实际进食窗口长达15-16小时，远超过12小时，更不用说10或8小时了。

So there is something called metabolic flexibility, which essentially means that your body is able to switch between burning glucose and using glucose as energy, but also using fatty acids as making, you know, as energy and then producing ketones as well. And the more I would say the more if you've done ketosis or if you exercise a lot like frequently or you do any form of fasting or what's called time restricted eating so let's say you eat all your food within an eight hour window and then for sixteen hours you're not eating food your body is used to switching to fatty acid metabolism, using fatty acids as energy. So you're really metabolically flexible. And not everyone's able to do that because most people actually, they think they eat within a twelve hour period, but there's been studies that have been done that have shown that actually they eat more like within a fifteen to sixteen hour period, not even a twelve hour period. Certainly not a ten or eight hour period.

如前所述，平均需要约12小时耗尽糖原储备（剧烈运动可加速这一过程）。当肝脏糖原耗尽时，身体就会转向燃烧脂肪酸，最终进入酮症状态。

So as I mentioned, it takes about twelve hours on average to deplete all your glycogen levels. Now you can accelerate that if you're doing a lot of physical activity. But once you deplete that liver glycogen, that is when you shift into burning fatty acids and then eventually ketosis, right?

关于长寿研究，是否有实验对比过生酮饮食与普通饮食对寿命的影响？比如用人类、小鼠或其他模式生物进行长期追踪？

In terms of longevity, have you ever done any studies where they put someone on the ketogenic diet or like a mouse or a route on a ketogenic diet versus the average diet and then monitored how long they live?

加利福尼亚州诺瓦托巴克衰老研究所的埃里克·维尔登博士曾进行过相关研究。这大约是几年前的事了，他可能早在近十年前就完成了这些研究，大约在2017或2018年发表的。但他确实在啮齿动物中采用生酮饮食进行过部分研究。

There have been studies by Doctor. Eric Verden out of the Buck Institute for Aging in Novato, California. And I mean, this was several years ago. He's done these studies probably almost ten years ago, maybe about 2018 or 2017 these studies were published. But he did do some of these studies with a ketogenic diet in rodents.

这些研究似乎确实延长了寿命，但更重要的是健康寿命，尤其是大脑健康。就像它们的大脑衰老速度明显减缓，阿尔茨海默病的所有病理特征都更少。正如我提到的，我特别对β-羟基丁酸感兴趣。这是多重因素作用的，因为一方面你减少了葡萄糖摄入，对吧？

And it did seem to extend life expectancy, but more importantly, the health span, so particularly in the brain. So it's like their brain had aged much, much better. They had less of the all of the pathological features of Alzheimer's disease. And again, I do think, like I mentioned, I'm super interested in beta hydroxybutyrate in particular. I mean, it's multifactorial because on the one hand you're not eating as much glucose, right?

这本身就很重要，因为葡萄糖可能极具破坏性，特别是当你缺乏运动时。如果你保持运动并摄入适量葡萄糖，它会进入肌肉，不会损伤血管系统。而血管系统与大脑密切相关。当血管开始硬化时，就会影响大脑的血液供应。

And that in and of itself is important because glucose can be so damaging, particularly if you're not physically active. Because if you're physically active and you're eating some amount of glucose, it's going in your muscle. It's not damaging the vascular system. The vascular system is very much related to the brain, right? So when you start to stiffen your blood vessels and stiffen everything, I mean, that's affecting blood flow to the brain.

这会导致高血压，所有这些都会加速大脑衰老。此外还有葡萄糖本身的破坏作用。有研究显示——这非常有趣——即使是血糖水平处于正常值偏高范围的人群（虽然仍在正常范围内）。

It's causing hypertension. That all affects brain aging as well. So I think just and then the damage that the glucose does in and of itself. I mean, there's studies it's really interesting. There's studies showing that people, even on the high end of normal in terms of their blood glucose levels so they're normal, but they're kind of on the high end of normal.

他们比血糖水平正常偏低的人出现更多脑萎缩。

They had more brain atrophy than people on the low end of normal.

你说的脑萎缩是指他们的大脑在萎缩。缩小。

By brain atrophy, you mean their brain was Shrinking. Shrinking.

萎缩。顺便说下，主要是海马体——那个负责学习和记忆的脑区。所以葡萄糖本身就会造成损伤并加速衰老过程。但酮症产生的副产品还有另一个非常有趣的作用，就是β-羟基丁酸，这种酮体通过MCT转运蛋白进入大脑后会产生特殊影响。

Shrinking. And it was the hippocampus, by the way, again, that part of the brain that's involved in learning and memory. So the glucose itself has this effect on causing damage and accelerating the aging process. But then there's this other very interesting effect of these chemicals that are made as a byproduct of being in ketosis, and that is the beta hydroxybutyrate, that ketone body gets into the brain. It's transported across the brain through an MCT transporter.

当它进入大脑后，可以被用作能量来源，你的神经元就不需要依赖葡萄糖了。虽然神经元仍能利用葡萄糖供能，但将葡萄糖转化为能量本身需要消耗能量。而使用酮体——β-羟基丁酸时，制造能量所需的能耗更低。因此从能量利用效率来看，使用这种酮体实际上更有利。更妙的是，它还能释放出游离的葡萄糖。

And when it gets into the brain, it can be used as energy and your neurons don't need to use glucose. And it can do that so your neurons can use glucose as energy, but it takes energy to use that glucose to make energy. When you use the ketone, the beta hydroxybutyrate, it takes less energy to make that energy. So it's energetically favorable to actually use that ketone, that beta hydroxybutyrate. On top of that, this is what's so interesting, it frees up glucose.

既然神经元不再消耗这些葡萄糖，这些葡萄糖去了哪里呢？它们被分流到另一个称为磷酸戊糖途径的代谢通路中。

So the neurons aren't using the glucose. Where does the glucose go? Right? Because it's there. Sort of shunts it into this other pathway that's called the pentose phosphate pathway.

我不想用太多技术细节困扰大家，但关键点在于：这个途径能产生谷胱甘肽的前体物质——谷胱甘肽是大脑中最重要的抗氧化剂。日复一日持续增加谷胱甘肽的产量意义重大，因为大脑氧化应激和炎症正是导致脑部衰老与阿尔茨海默病的主要原因。如今我们已经知道神经炎症是致病主因之一。所以大脑中谷胱甘肽越多，就越能有效抵御那些导致大脑衰老的损伤。

I don't want to, you know, burden people with all this technical details, but let's get to the important part of that is that it shunts glucose into this pathway that makes essentially its precursors that make what's called glutathione, the major antioxidant in the brain. And so you're making more glutathione day after day after day. That is huge because oxidation in the brain, inflammation, this is a huge cause of brain aging and Alzheimer's disease dementia. We now know neuroinflammation is one of the major causes of it. And so if you have more glutathione in your brain, you're going to basically sequester that damage that's you know, that's aging the brain essentially.

因此现在葡萄糖不再被用于供能，而是用来制造大脑中的抗氧化剂。这已经很了不起了，但还有更多惊喜。

And so the glucose now is not being used for energy. It's being used to make an antioxidant in the brain. Okay, that's also really cool. And there's more. There's more.

接下来，β-羟基丁酸本身就像乳酸一样是一种信号分子。

Okay, so then the beta hydroxybutyrate itself is a signaling molecule like lactate.

酮体吗？

The ketone?

酮体本身就是一种信号分子，它代表着机体处于轻度应激状态。当你处于生酮状态时——无论是通过运动、禁食还是生酮饮食——身体其实处于应激状态。而机体对此的响应机制是激活一系列增强抗逆性的应激反应，这些反应最终会改善衰老进程。具体来说，β-羟基丁酸能激活脑源性神经营养因子的产生。

The ketone itself is a signaling molecule where it's basically, you know, it's a little bit of a stressed state, right? So when you're in ketosis, it's you're stressing the body. It's either exercise or you're fasting or you're on this ketogenic diet. And so your body again is responding to that stress by making like a bunch of awesome resilient stress response things that are basically going to improve the way you age. And so the ketone beta hydroxybutyrate then activates brain derived neurotrophic factor.

这种对大脑的神奇生长作用，对吧？它参与新生神经元的生长，增强神经元间的连接，还涉及神经可塑性等所有功能。因此你能获得多层次的好处，既避免了葡萄糖造成的损害。

This miracle growth for your brain, right? It's involved in growing new neurons. It's involved in increasing the connection between neurons. It's involved in neuroplasticity, all those things. And so you get this multi level benefit, not having the glucose causing the damage.

现在葡萄糖不仅不再造成伤害，还被用于制造抗氧化剂。再加上酮体这一层面，你实际上是在激活大脑中所有有益通路，从而减缓衰老。

You have basically the glucose now being used, not only is it not causing damage, it's being used to make an antioxidant. And then you have the whole ketone aspect where you're essentially making and activating all these beneficial pathways in the brain that reduces aging.

当我们通过饮品等方式摄入外源性酮体时，体内会发生什么变化？

And what's going on when we take exogenous ketones, external ketones, via a drink or something like that?

没错。本质上你是在给身体直接补充β-羟基丁酸盐酮体——这种通常在酮症状态下由脂肪酸供能时产生的物质。你相当于绕过了身体自身合成途径，直接提供了大量酮体。这对那些难以坚持生酮饮食的人特别有帮助。

Yeah. So what's happening is you're essentially giving your body the beta hydroxybutyrate ketone that it would make normally if you were undergoing ketosis and using fatty acids only as energy. You're giving your body a big boost of it. So you're kind of bypassing the way that your body would make it itself and giving it to your body. And it's great for people that have a hard time with doing a ketogenic diet, for example.

也许他们无法坚持生酮饮食，或者在其他生物指标上反应不佳，这样他们仍能获得大部分益处。不过效果只能持续一到三小时，对吧？

Maybe they just can't stick with it, or maybe they don't respond very well to it in terms of other biomarkers, they're going to get a lot of the benefit. But it's only going to last, you know, one to three hours, right?

是的，直到被代谢排出体外？

Yeah, until it flushes out, right?

直到被消耗殆尽。没错。除了想获得专注力提升的人群——就像你我服用这种外源性酮体补充剂时的体验，它还具有潜在治疗价值。轻度认知衰退患者，比如早期痴呆或阿尔茨海默症患者，在补充这种β-羟基丁酸盐外源性酮体后可能表现更好。虽然相关研究不多，但已有一些个案研究记录了个体使用后的跟踪观察结果。

Until you use it up. Yeah. And so it's in addition to just people that want to get that focus and attention, which is what both you and I have experienced when we've taken these supplements, this exogenous ketone, there's also some potential therapeutic effects. So people that have mild cognitive decline, maybe like the first stages of dementia or Alzheimer's disease, can kind of perk up and perform better when they're given an exogenous ketone, this supplemental ketone, beta hydroxybutyrate. There's not a lot of studies on it, but there's like a few case studies where case studies being like a single person is given it, they're followed and looked at, you know?

这非常有趣。

And it's very interesting.

事实上我知道他们正在针对这一点进行研究，因为过去几周我确实与几家相关公司和该领域的几位科学家交流过。他们提到目前正在进行研究，探讨外源性酮体（即那些酮类饮品或酮类补充剂）是否能修复认知功能。这是否通过你描述的那个过程实现——葡萄糖被导入另一条代谢途径？

I actually know that they're doing studies on exactly that at the moment, because I've spoken to a few of these companies and a few scientists in this field over the last couple of weeks, in fact. And they were saying that we're currently in the process of doing studies to see that if exogenous ketones, which are these ketone drinks or ketone shots, can repair your cognitive faculties. And is that via the process that you described, where glucose is pushed into this other pathway?

是的。我想我知道你说的那项研究，我在临床试验数据库中查阅过。研究观察的是给阿尔茨海默病患者补充外源性β-羟基丁酸盐（一种酮体补充剂）后的效果。确实可以修复损伤，因为这再次激活了脑源性神经营养因子，它能修复损伤、促进神经元新生、缓解脑萎缩，还能增强神经元间的连接。

Yes. So I think I'm aware of the same study because I've looked it up in the clinical trial and what's being looked at after giving this exogenous beta hydroxybutyrate, the supplemental ketone in people with Alzheimer's disease, you can repair damage because, again, you are activating brain derived neurotrophic factor, which can repair damage. It can grow new neurons. It can help with brain atrophy. It can strengthen connection between neurons.

同时葡萄糖被分流到修复途径中，谷胱甘肽通路被激活，这同样有助于损伤修复。我很期待看到这项研究发表。我推测会出现积极效果，这将非常振奋人心——尤其对部分老年人而言，执行生酮饮食确实存在难度，这种饮食方式并不容易坚持。

And then the glucose now is being shunted into that repair pathway, that glutathione is being activated. And that's able to repair damage as well. So I'm excited to see that study published. I would hypothesize that there's going to be beneficial effects and it's going to be pretty exciting, particularly because it is hard for older adults, some older adults, to do a ketogenic diet. It's not the easiest thing to follow.

我的意思是，执行生酮饮食需要很强的自律性。因此这种替代方案——通过补充剂就能在几小时内模拟出生酮饮食的效果——确实令人兴奋，对吧？

I mean, you do have to be pretty disciplined. So this alternative to being able to supplement with something that can sort of, at least for the course of a couple of hours, do what being on a ketogenic diet can do is very exciting, right?

你服用家里的那种酮类补充剂时有什么体验？你说它效果很强劲。

When you took the keto shot that you had at home, what did you experience? You said it was potent, was powerful.

对，就像促智药的效果。我说的促智效果是指那种专注力提升、警觉性增强的感觉，大脑会自动过滤掉那些干扰性的背景杂念——那些突然冒出让你分神的小念头。这样工作效率会明显提高。有段时间我每次录播客前都会喝一剂，不过这东西挺贵的。

Yeah, it was like a nootropic effect where when I mean nootropic effect, it's the kind of effect where you feel focused, your attention, your alertness is enhanced, you're sort of filtering out all the background noise in your brain that sort of those little thoughts that pop in and distract you. And so you're more productive. And that was very noticeable. In fact, there was a time when I was like, before any podcast, I would take a shot of it. And it's kind of expensive.

但现在有很多人正在使用它。我认为相比目前流行的其他益智药物，比如尼古丁——虽然能带来类似效果但副作用明显——这是一个更好的替代品。它不仅提供那种认知增强的‘大脑泵感’，还对延缓大脑衰老有益，对吧？

But it is there's a lot of people that are using it now. And I think a better alternative to some other nootropics that are common right now, like nicotine, for example, which can really have a negative trade off but can do something similar. Whereas this is like not only gives you that sort of cognitive enhancement, that brain pump, it also has like benefits for brain aging, right?

你的超级食物是什么？你肯定有自己的选择。橄榄油已成为我的超级食物之一，我热衷于把它添加到各种食物中，因为大家都说其中的多酚类物质对人体极有益处。你有哪些大多数人可能想不到的、特别钟爱的超级食物？

What are your superfoods? There must be foods of yours. Olive oil has become one of my super foods. Just a food that I love to just put on as many things as I can because everybody tells me about these polyphenols, which are apparently amazing for you. But what are some of the your sort of favorite super foods that you try and consume that most people might not think of?

我们刚才提到了绿叶蔬菜，这应该算其中之一。

So we talked about leafy greens. I guess that's one of them.

确实如此。绿叶蔬菜富含镁元素，而镁是叶绿素分子的核心成分。叶绿素赋予植物绿色，镁对于防止DNA损伤和癌症非常重要。

It is. Leafy greens, they have they're high in magnesium. And magnesium is at the center of a chlorophyll molecule. Chlorophyll give plants a green color. Magnesium is very important for preventing damage to DNA and cancer.

要知道，半数美国人镁摄入不足。这些蔬菜含多种有益化合物，比如叶酸、维生素K等关键微量营养素。我特别喜欢深色绿叶菜，尤其是羽衣甘蓝和西兰花，因为它们含有萝卜硫素的前体物质。

And you know, half The US population doesn't get enough of it. They're high in a lot of different compounds. I mean, they're folate, vitamin K, once you're getting a lot of these micronutrients that are important. So I do like dark leafy greens. I particularly like kale and broccoli because of something called sulforaphane, which is sulforaphane itself is not in them but a precursor.

当你切碎或咀嚼这些植物时，会激活一种酶，将前体物质硫代葡萄糖苷转化为萝卜硫素。这种物质不仅能提升大脑中的谷胱甘肽水平，还能帮助解毒苯、双酚A等污染物。所以我特别推崇十字花科蔬菜中的深色绿叶菜。

When you break the plant or you chew it, it makes sulforaphane. So there's an enzyme that gets activated that converts a precursor in these plants called glucoraphanin into sulforaphane. Sulforaphane also increases glutathione in the brain. It helps detoxify pollutants like benzene, bisphenol A, BPA as well. So, I do like dark leafy greens of the cruciferous family of vegetables.

再次强调，羽衣甘蓝和西兰花都属于十字花科。我也喜欢蓝莓，它是多酚的来源——你提到的橄榄油也含多酚。

Again, would be kale, broccoli. Those are the cruciferous family. I also like blueberries. Blueberries are a source of polyphenols. You mentioned olive oil is a polyphenol.

如果你正在进行生酮饮食，橄榄油简直是完美选择，对吧？因为你需要脂肪。橄榄油的妙处在于它还含有多酚类物质，这些成分不仅有益健康，研究还表明能提升认知能力和记忆力，甚至能降低如ApoB等不良心血管疾病的标志物。所以我喜欢蓝莓，因为每天一杯蓝莓也被证实能改善认知功能。我就是看中这些多酚。

If you're on a ketogenic diet, olive oil is like the great, right? Because you need fat. And olive oil is so great because it also has those polyphenols that are beneficial and have been shown even in studies to improve cognition and memory and lower even markers of bad cardiovascular disease like ApoB, for example, lower that. So blueberries I like because blueberries have also been shown even a cup of blueberries a day has been shown to improve cognition. So I like the polyphenols.

它能增加大脑血流量。我也喜欢三文鱼。我想大多数人都会认为它很健康。我喜欢它是因为富含欧米伽-3脂肪酸，我个人认为摄入足够的欧米伽-3极其重要。我还会额外补充这类营养素，毕竟相关研究非常充分。

It increases blood flow to the brain. I also like salmon. And I think that would be something that most people would think is healthy. I like it because it's high in the omega-three fatty acids, which I'm very, very I think it's very, very important to get enough omega-three fatty acids. I also supplement with them because there's a lot of research out there.

如果你想深入了解，我们可以展开讨论。但超级食物非三文鱼莫属，这种富含脂肪的鱼类含有大量欧米伽-3脂肪酸EPA和DHA——这些成分只存在于海洋生物中，植物性欧米伽-3并不具备。

And if you want to get into that, we can. But the superfood would be the salmon because it is a fatty source of fish that is high in omega-three fatty acids, EPA and DHA, which are found in marine sources, not plant sources of omega-three.

我在研究欧米伽-3时发现它对心理健康和抑郁等有影响，这非常有趣。

I found it really interesting when I was looking at omega-three that it has an impact on mental health and depression and things like that.

确实如此。它能缓解炎症，算是一种抗炎物质。而炎症在抑郁症中扮演重要角色——事实上我们知道，当人体被注射来自肠道细菌的炎症分子（比如脂多糖）时，相比生理盐水对照组，会直接引发抑郁症状。

Yeah, it does. It resolves inflammation. It's sort of an anti inflammatory. And inflammation plays a role in depression, a big role. In fact, we know that people that are injected with inflammatory molecules, like something that's made in our gut from the bacteria in our gut called lipopolysaccharide, if you inject them with that or a placebo control, which is saline, it causes depression.

但如果同时补充欧米伽-3脂肪酸EPA，就能抑制抑郁症状。换句话说，通过注射致炎物质人为引发炎症会导致抑郁，但若给予相同人群抗炎的欧米伽-3脂肪酸，就不会诱发抑郁，这非常神奇。此外还有大量其他证据。欧米伽-3脂肪酸确实至关重要。

But if you give them an omega-three fatty acid supplement, EPA, it blunts the depressive symptoms. So in other words, if you're causing the inflammation by injecting something that causes inflammation in people, it causes depression. But if you give those same people something that blunts that inflammation, omega-three fatty acids, it doesn't cause the depression, which is kind of amazing. And there's a ton of other evidence out there. But omega-three fatty acids are they're so important.

有趣的是哈佛大学有项研究区分了海洋来源——我提到的三文鱼含EPA、DHA，以及植物来源的ALA。我强调海洋来源，因为这些才是真正值得获取的重要成分。

And what's interesting was there's a study out of Harvard that identified the marine source. So I talked about salmon, EPA, DHA, and then there's the plant source, ALA. And I say marine source because it's really those are the important ones that you really want.

来自海洋。

From the ocean.

来自鱼类、海鲜。哈佛大学的这项研究指出，海鲜摄入不足是可预防死亡的六大原因之一，与未控制高血压、吸烟等并列。本质上，从海鲜中获取不足的omega-3脂肪酸对预防早逝至关重要，其重要性堪比高血压或心血管疾病等问题。人们往往忽视了自己饮食中缺乏什么、未能摄取什么。自2009年那项研究发表以来，已有更多研究关注我们血细胞（红细胞）中的omega-3脂肪酸水平。

From fish, seafood. So this Harvard study identified not eating enough seafood as one of the top six preventable causes of death, up there with not having hypertension, not smoking. So essentially, not getting enough omega-three from seafood was so important for preventing early death that it was comparable to people having high blood pressure, having cardiovascular disease for example. And again, it's one of those things where people just don't think about what they're not eating, what they're not getting. And there's so much research that have been done even since that study that was published in like 2009 looking at omega-three fatty acid levels in our blood cells, red blood cells.

这被称为omega-3指数。它是衡量长期omega-3摄入的重要指标，因为红细胞在体内循环约120天。因此它能反映你长期的omega-3摄入情况。脂肪酸研究所的Bill Harris博士团队进行了多项相关研究。

This is called the omega-three index. It's really an important marker of our long term omega-three because our red blood cells stay around in our system for like one hundred and twenty days. So it's a long term marker of your omega-three intake. And there's been a variety of studies done from Doctor. Bill Harris out of the Fatty Acid Research Institute.

我是该研究所的副科学家，研究表明那些拥有高omega-3指数的人群

So I'm an associate scientist there showing that people with what's called a high omega-three index

也就是摄入大量omega-3的人。

Which is a lot of omega-three.

大量摄入omega-3的人，其omega-3指数会达到8%或更高——这被视为高水平。相比之下，低omega-3指数为4%或以下。美国人的平均omega-3指数约为5%，处于偏低范围。

A lot of omega-three, their omega-three index would be 8% or higher. That's considered high. Compared to a low omega-three index, that would be 4% or lower. The average omega-three index in The United States is about 5%. So it's on the low range.

拥有高omega-3指数的人群——即大量食用三文鱼等鱼类，和/或补充鱼油、微藻油（另一种海洋omega-3来源）的人——相比低指数人群，预期寿命延长了五年。这个差异相当显著，而你需要做的只是摄入足够海鲜或补充鱼油。但这项研究最引人注目的是，Bill及其同事不仅分析了omega-3指数，还研究了吸烟人群。他们指出：'我们知道吸烟对心脏危害极大。'

People that had the high omega-three index, in other words, they were either eating a lot of fish like salmon and or supplementing with fish oil or microalgae oil, which is another a marine source of these omega-three fatty acids. They had a five year increased life expectancy compared to people with a low omega-three index. Pretty big difference there and all you have to do is essentially either eat enough seafood and or supplement with a fish oil supplement. But what was so fascinating about this study was that Bill and his colleagues not only looked at the omega-three index, they looked at people that also smoked. And they said, Okay, we know smoking is terrible for your heart.

我们知道它会导致早逝、癌症等等，对吧？那么吸烟者及其欧米伽-3指数呢？研究观察了四组人群：吸烟者中欧米伽-3指数较高的群体——这些吸烟者要么在补充剂，要么摄入了大量海鲜。

We know it causes early mortality, cancer, and all that, right? What about people that smoke and their omega-three index? So there was four groups that were looked at. Smokers that have either a high omega-three index. So these smokers were either supplementing or they were eating a lot of seafood.

另一组是欧米伽-3指数较低的吸烟者。研究人员将他们与不吸烟者进行对比，后者同样分为高欧米伽-3指数组和低指数组。这项研究最引人注目的发现是：就死亡率而言，吸烟的危害程度与低欧米伽-3指数相当。因此，高欧米伽-3指数的吸烟者与低指数不吸烟者具有相同的死亡风险——这非常耐人寻味，因为人人都知道要远离吸烟。如果你想缩短寿命、降低生活质量，现在就开始吸烟吧。

And then there were smokers with a low omega-three index. And they compared them to non smokers with a high omega-three index versus a low omega-three index. And what was so fascinating about this study was that smoking was like as bad for you in terms of mortality as having a low omega-three index. So the smokers with a high omega-three index had the same mortality risk as non smokers with a low omega-three index, which is fascinating because everybody knows to avoid smoking. Smoking if you want to take years off your life, if you want to decrease the quality of your life, start smoking right now.

但同样的死亡风险也存在于欧米伽-3指数不高的非吸烟者身上。明白吗？我这么说的时候，有些吸烟者可能会想：太好了，我只要服用鱼油就能获得和低欧米伽-3指数非吸烟者相同的预期寿命。但关键启示在于：对我们这些不吸烟但饮食中欧米伽-3摄入不足的人来说，这种营养缺乏带来的死亡风险堪比吸烟。

But the same mortality risk was found in non smokers who did not have a high omega-three index. Right? Now, I say this, I'll talk about this, and smokers will say, Oh, great. Now all I have to do is take fish oil and I'll have the same life expectancy as a non smoker with, you know, a low omega-three index. But of course, the take home here is that for those of us that are not smoking, but we're not getting enough omega-three from our diet, that's like smoking in terms of mortality risk.

这一点至关重要。我特别强调这个发现，因为它再次清晰地表明：缺乏这些必需营养素会严重危害健康。而补救方法很简单——你可以服用鱼油补充剂，或者增加三文鱼摄入量。比尔团队的研究显示，每日补充1-2克鱼油就能让人从低欧米伽-3指数提升到高指数，这并不难实现。

So super important, and I like talking about this because it really makes it again really clear that not getting these essential nutrients can be very detrimental to our health. And it's easy to fix. You can take a fish oil supplement, you can increase the amount of salmon that you're eating. And there have been studies from Bill's group that have shown people that supplement with between one to two grams of fish oil per day can go from a low omega-three index to a high omega-three index, which is not hard to do.

那么我有两个问题：这些小粒欧米伽胶囊提供的营养和吃三文鱼效果相同吗？以及需要持续服用多久才能从低指数提升到高欧米伽-3指数？

So I guess two questions, which is, is having these little omega capsules the same as eating the salmon in terms of the omega-three that I'm getting? And how long do I have to take these little omega capsules for to move from having a low index to a high omega-three index?

斯蒂文，这两个问题都很棒。本质上这种小胶囊与食用三文鱼不同，原因有几个：首先，当你食用三文鱼等高欧米伽-3鱼类时，其中的欧米伽-3是以甘油三酯形式存在的——即欧米伽-3与甘油骨架结合。

Well, are great questions, Steven. So essentially, this little capsule here is not the same as eating salmon. And there's a few reasons why. So for one, when you're eating a fish that's high in omega-three like salmon, you have this omega-three in what's called triglyceride form. So the omega-three is bound to a glycerol backbone.

这种形态对吸收方式至关重要。某些鱼油补充剂并非如此，它们经过分子蒸馏后以乙醇骨架存在，生物利用度稍逊。但更重要的是，这些鱼油补充剂都是经过提纯的。

And that's really important for the way you absorb it. Some fish oil supplements don't have that. Basically molecular distilled and then they have an ethanol backbone. So it's not quite as bioavailable. But I think more importantly is that these fish oil supplements are purified.

所以你不会摄入汞、微塑料或整鱼中也存在的其他物质。

So you're not getting mercury or microplastics or things that are also found in the whole fish.

这么说这些更好？

So these are better?

很遗憾，我认为是的。长久以来我一直坚持全食物优先的原则，但我们确实面临环境污染问题。鱼类已被重金属污染，也含有微塑料。

Unfortunately, I think so. I do. As much as I think it's better, know, for the longest time I always I was always a whole foods first approach. But we do have this environmental pollution problem And fish have been contaminated with heavy metals. They've been contaminated with microplastics.

我认为三文鱼是汞含量最低的鱼类之一。按每克计算，三文鱼的汞含量远低于剑鱼等鱼类。但不幸的是，如今鱼类中还含有微塑料，这些物质会在食用时进入人体。因此我认为鱼油补充剂是很好的替代选择，既能获取欧米伽-3脂肪酸，又能避免摄入鱼类中的有害物质。

I would say that salmon is one of the lowest fish that has the lowest amount of mercury compared to other fish. So on a per gram basis, you're getting less mercury per gram with salmon than you would be with something like swordfish, for example. But you also have microplastics, unfortunately, that are now in fish. And it is something that enters our body when we eat the fish. And so I do think the fish oil supplements are a good alternative because you're getting those omega-three fatty acids and you're not getting some of the other bad things that are in the fish.

这真有意思。我从未真正意识到欧米伽-3如此重要，尤其是与长寿的关联。我一直只把它当作改善当下脑力活动的营养素。

That's fascinating. I didn't really think of omega-three as being that important, especially as it relates to longevity. I always thought about it as being something that would help my brain work better today, you know, cognitive performance now.

它确实有即时功效，同时也能预防未来的认知衰退。更重要的是对心血管疾病的防治——已有大型随机对照试验证明，让正在接受他汀类标准治疗的心血管疾病患者每日服用4克精制欧米伽-3（EPA），相比安慰剂组能降低25%的心源性死亡或心梗/中风风险。

Well, it does that, And it also helps prevent the cognitive decline later. And also cardiovascular disease, that's a big one. So there have been some really large randomized controlled trials that have actually given people with cardiovascular disease that are on, you know, some sort of standard of care treatment like a statin. And they've given them four grams a day of a purified form of omega-three called EPA versus a placebo. And the people given the omega-three had twenty five percent less cardiovascular related death or events like heart attacks and strokes.

所以它不仅像我们讨论过的全因死亡率那样延长寿命，还能帮助已患心血管疾病的人群降低相关死亡风险。

So it's not only like preventing you know, we talked about all cause mortality in this association where you live longer. It's also helping people that already have cardiovascular disease and reducing their risk of dying from it.

在这次对话开始前，当我问你目前真正让你兴奋的是什么时，你的回答是有几件事，但其中让你容光焕发的，是肌酸。

When I asked you before this conversation started rolling what you're really excited about at the moment, your response to me was there was a few things, but one of them, lit up your face, was creatine.

是的。这很有趣，因为

Yes. And it's funny because

它又让你容光焕发了。

It lit up your face again.

没错。这很有趣，因为肌酸已经存在了，我是说，几十年了。在我印象里它一直是那种健身猛男用的东西。我心想，我又不需要变得大块头。

Yeah. It's it's funny because creatine has been around for, I mean, ever, for decades. And it's always been in my mind, it was like one of those Jim bro things. I'm like, I don't need to be swole. Yeah.

我不需要靠肌酸来变得大块头。这个想法持续了很多很多年。直到过去五年左右，肌酸对大脑的影响真正引起了我的兴趣。任何影响大脑的东西都会让我特别关注。所以这才是最让我对肌酸感到兴奋的原因。

I don't need creatine to get get swole. And, this was the thought for many, many years. And then over the last five years or so, the effects of creatine on the brain started to really get my interest. Anything that affects the brain, I really become interested in. And so that's kind of what did get me the most excited about creatine.

但我也开始进行大量抗阻训练。于是我想，好吧，现在我也成了那些健身人士中的一员。我在练杠铃，做深蹲、硬举之类的动作。

But also I started doing a lot of resistance training. And so I was like, okay, here I am now. I'm like one of those gym guys. I'm doing the barbells. I'm doing the, you know, the squats and the deadlifts and all that.

那为什么不给自己补充些肌酸呢？不过肌酸到底是什么？为什么它很重要？你之前提到过，为什么我们的身体不多合成些这么有益的物质？其实我们确实会合成肌酸。

And so why not give myself some of the creatine? Well, what is creatine, right? Why is it important? You talked about earlier, you know, why doesn't our body just make more of these things that are so beneficial? We do make creatine.

我们每天大约产生——具体我不清楚——肝脏生成1到3克肌酸，大脑也会合成肌酸。这两个是主要合成器官。肌酸会被肌肉等组织消耗，肌肉可能是最贪婪的，因为肌酸以磷酸肌酸形式储存，但本质上是用来制造能量的。因此它能增加肌肉量。结合抗阻训练时，它能增强肌肉力量，因为你能够更快地再生能量。

We make about I don't know, our liver makes about one to three grams a day of creatine, and our brain also makes creatine. And those are the two organs that make it. Creatine gets consumed by other tissues like the muscle is probably the one that's the greediest because creatine is stored as phosphocreatine but it's used to make energy essentially. So it can increase muscle mass. It can increase muscle strength in combination with resistance training because you're able to regenerate and make energy faster.

举个例子，我是在阅读相关研究后对它产生兴趣的：那些补充肌酸并进行抗阻训练的人，能够增加更多瘦体重，获得更大力量。这提升了他们的训练容量——比如任何动作都能多做1-2次重复。而且似乎还能缩短组间恢复时间。

So for example, I became interested in it after reading studies where people that supplemented with creatine that were engaged in resistance training were able to gain more lean body mass. They were able to gain more strength. It was increasing their training volume. So you can do one to two more reps, right, of whatever exercise you're doing. And it seems to decrease the recovery time between those sets as well.

所以你能提升训练容量。而任何增加训练容量的手段，都会连带产生促进适应性变化的效果，比如增加肌肉量或力量。大约一年前我开始补充肌酸，正是为了这个训练目的。我每天服用5克，因为研究显示这个剂量结合抗阻训练对肌肉健康最有益。

So you're able to increase your training volume. Well, anything that's going to increase your training volume is going to then have the downstream effect of increasing the adaptations like increased muscle mass or increased muscle strength. I started supplementing with creatine about a year ago. And I started supplementing with it for that reason, for my training. And I was doing about five grams a day because that was really what was shown to be beneficial for muscle health in combination with resistance training.

重要的是人们要明白：单纯补充肌酸而不进行任何抗阻训练，不会让你长肌肉或变强壮。你必须付出努力，因为肌酸的作用是帮你更快制造能量。而能更快供能意味着你能完成更高强度、更大容量的训练——它本质上是给你的训练程序增压。

And it's important for people to realize that supplementing with creatine by itself without any type of resistance training isn't going to grow your muscle. It's not going to make you stronger. You have to put in the effort because what creatine is doing, it's helping you make the energy quicker, right? And then being able to make that energy quicker means that you're able to then do that exercise better, harder, more of it, right? So it's sort of supercharging your exercise routine.

每天5克的剂量我觉得很完美，就一直坚持。确实注意到训练容量的提升——我能完成更多重复次数。这是一年前的情况。其实我早就知道它对大脑的影响。

And five grams a day was like okay perfect that's what I'm doing. I'm doing five grams a day. And definitely noticed an effect on my training volume where I was doing more reps. So that was like, Okay, a year ago. I had already been aware of the effects on the brain.

我原以为每天5克也能对大脑起效。那么对大脑有什么影响呢？要知道，大脑也是耗能大户，需要大量能量。虽然它能自产肌酸，但研究发现：在压力状态下额外补充肌酸特别有益。

I thought maybe the five grams a day would do that. So what are the effects on the brain? Well, brain also consumes a lot of energy, you know, needs a lot of energy. So it does make its own creatine. But it turns out if you can give your brain more of that creatine, particularly under a period of anything that's causing stress.

比如睡眠不足、情绪心理压力，或者像我这样的高认知负荷——每天学习复杂概念、记忆知识、整合观点并提出新假设。这种高强度学习对脑力要求极高，本质上就是对大脑的一种压力。

So let's say lack of sleep, or let's say emotional psychological stress, or in my case high cognitive load, where you're just every day learning concepts, complex things. You're trying to remember them. You're putting ideas together and coming up with new hypotheses. And you know, you're just you're just you're studying a lot, it's very cognitively demanding. And it's it's a type of stress on your brain.

这就像我的生活，对吧？在这种压力条件下，抑郁是另一种压力。那是对你大脑的压力。或者神经退行性疾病。那也是对你大脑的压力。

That's like my life, right? Under this condition of stress, depression is another one. That's a stress on your brain. Or neurodegenerative disease. That's a stress on your brain.

所以任何类型的压力状况，正是肌酸在大脑中大放异彩的时候。我认为我们所有人中，谁拥有完美的睡眠量，从未有过压力？没有人，对吧？背景中总是存在某种压力。所以那时我就想，好吧，如果你是完美的人，没有压力，每晚睡眠充足，你的大脑会产生足够的肌酸来完成它需要做的事情。

So any kind of stressful condition, that's where creatine shines in the brain. I would argue that all of us, who has the perfect amount of sleep, never has stress? Nobody, right? There's always some sort of stress in the background. So that's when I was like, Okay, so if you're the perfect person, you have no stress, you get the perfect amount of sleep every night, your brain makes enough creatine to kind of do what it needs to do.

我知道我经常处于压力之下。所以我想，好吧，我想我需要一个提升。这时，许多非常有趣的研究从不同实验室涌现出来，有些来自德国，研究了肌酸的剂量以及它如何提高大脑中的肌酸水平。这就是为什么我现在每天补充十克。德国的研究发现，如果你每天补充五克肌酸，你的肌肉会贪婪地消耗它，特别是如果你在锻炼的话。

I know that I'm constantly under stress. So I'm like, Okay, well, think I need a boost. And this is where a lot of very interesting studies have come out of many different labs, some out of Germany that looked at the dose of creatine and how it increases creatine levels in the brain. And this is why I now supplement with ten grams a day. So the study out of Germany found that five grams a day of creatine, if you're supplementing with five grams a day, your muscles are greedily consuming it, particularly if you're working out.

它们需要它。它们需要它。大约每天五克，特别是几个月后，你的肌肉就饱和了，这就够了，对吧？超过这个量的部分会溢出到大脑。所以这项德国研究发现，十克肌酸增加了大脑几个不同区域的肌酸水平。

They want it. They want it. After about five grams a day, especially over a few months, like you're saturating your muscle and that's enough, right? Anything above that kind of spills over to the brain. And so what this German study found was that ten grams of creatine increased creatine levels in several different regions of the brain.

这可能是我认为最令人兴奋的证据，表明每天补充超过五克肌酸实际上在让肌酸进入大脑方面有所作为。现在已经有各种研究关注不同的结果，对吧？所以如果你每天补充十克肌酸，甚至更高，比如二十克肌酸，那会如何影响认知功能？其中一些研究是由Darren Kandau博士进行的。

And that was probably the most exciting, I would say, evidence that supplementing higher than five grams a day was actually doing something in terms of getting creatine into the brain. There have now been a variety of studies that have looked at different outcomes, right? So if you supplement with ten grams of creatine or even go higher than that, like twenty grams of creatine, how does that affect cognitive function, right? And so some of these studies have been done by Doctor. Darren Kandau.