种子油的真相、蛋白质与真正致病之源 | Simon Hill

在本期《海曼医生秀》节目中即将探讨：关于种子油的整个争论。为什么它成了如此令人恐惧的词汇？许多

Coming up on this episode of the Doctor. Hyman Show. This whole debate about seed oils. Why is it such a boogeyman word? Where a lot of

困惑源于西蒙·希尔是一位营养科学家兼物理治疗师。他以用科学破除健康炒作而闻名。他的使命是什么？是帮助你基于证据做出选择，活得更健康长寿。

the confusion comes from is that Simon Hill is a nutrition scientist And physiotherapist. Best known for cutting through wellness hype with science. And his mission? To help you make evidence based choices to live better and longer.

自1900年以来，我们的大豆油消费量增长了一千倍。

Our consumption of soybean oil has increased a thousand fold since 1900.

当我观察慢性疾病的增长时，对我来说最明显的解释并非种子油消费的增加，而是超可口超加工食品消费的上升。目标应该是创造一个环境，让便捷实惠的选择恰好也是健康的选择。食品行业可不想听这个。

When I look at the increase in chronic disease, to me, the most obvious explanation for that is not an increase in the consumption of seed oils. It's an increase in the consumption of hyper palatable ultra processed foods. The goal should be to create an environment where the convenient and affordable option just happens to be the healthy option as well. The food industry doesn't want to hear that.

所以蛋白质成了营养学界的新宠。关于蛋白质我们知道些什么？

And so protein is the latest darling of the nutrition world. And what do we know about protein?

无论采用哪种饮食方式，肌肉体积或力量都没有差异。

You do not see a difference in muscle size or strength. Regardless of the two diets.

我问你关于蛋白质的问题，结果我们聊到了力量训练。我觉得这很重要。

I asked you about protein, we end up talking about strength training. Well I think that's really important.

这是有意为之的。

It's intentional.

给大家总结下核心要点。他们具体该怎么做？该

Summarize the bottom line for people. Like, what should they do? What

吃什么？但真正的问题在于

should they be eating? But what's really the problem is

你可能已经听说过关于Fatty Fifteen的讨论，这款获奖的健康抗衰老补充剂含有C15。我要告诉你的是，Fatty Fifteen背后坚实的科学依据意味着它将持续发挥功效。这对我们所有人来说都是好消息。超过100项研究和47项专利支持C15的健康益处，难怪超过70%的Fatty Fifteen用户在16周内就感受到了效果。我们说的是更好的体检结果、更舒适的关节以及更深沉的睡眠。

There's a good chance you've been hearing the buzz around fatty fifteen, an award winning healthy aging supplement containing c fifteen. I am here to tell you that the robust science behind fatty fifteen's health benefits means that it is here to stay. That's good news for all of us. With over a 100 studies and 47 patents supporting C15's health benefits, it's no wonder why more than seventy percent of fatty fifteen customers report benefits within sixteen weeks. We're talking better lab results, more comfortable joints, and deeper sleep.

Fatty Fifteen是我日常抗衰老计划中至关重要的一部分。如果你想为身体补充所缺的必需脂肪，请访问fatty15.com/hymen，使用优惠码hymen，今天即可享受90天订阅入门套装85折优惠。我们都经历过这种情况：匆忙中饥肠辘辘，唯一的选择却是用转基因玉米、氢化油甚至可能受霉菌污染的肉类制成的超加工零食。还是算了吧。

Fatty fifteen is a crucial part of my daily healthy aging routine. If you want to give your body the essential fat it's missing, head to fatty15.com/hymen and use code hymen for 15% off your ninety day subscription starter kit today. We've all been there. You're on the go starving, and your only options are ultra processed snacks made from GMO corn, hydrogenated oils, and sometimes even mold contaminated meat. No thanks.

这就是为什么我总是随身携带Paleo Valley的100%草饲牛肉棒。这些可不是普通的肉棒。它们采用再生农业美国农场通过轮牧恢复土壤健康的方式饲养的草饲牛肉制成，经过传统发酵工艺——虽然耗时长达四倍，但风味更佳、更易消化且有益肠道健康。不含糖、麸质或味精，只有有机香料和营养丰富的蛋白质。

That's why I always keep Paleo Valley's 100 grass fed beef sticks on hand. These aren't your average meat sticks. They're made from grass fed and finished beef raised on regenerative American farms using rotational grazing to restore soil health. They're fermented old world style, a process that takes four times longer, but delivers better flavor, enhanced digestibility, and supports gut health. No sugar, no gluten, no MSG, just organic spices and nutrient dense protein.

这款牛肉棒有五种美味口味：原味、墨西哥胡椒味、夏令香肠味、蒜香夏令香肠味和照烧味。销量已突破3500万根，显然不止我一个粉丝。无论是旅行、准备午餐盒饭，还是会议间隙需要快速补充蛋白质，Paleo Valley牛肉棒都是你能找到的最洁净、最可持续的零食。立即登录paleovalley.com/hyman，今天下单可享85折优惠。

These sticks come in five delicious flavors, original, jalapeno, summer sausage, garlic summer sausage, and teriyaki. And they've already sold over 35,000,000 sticks. So clearly, I'm not the only fan. Whether you're traveling, packing a lunchbox, or need a quick protein hit between meetings, Paleo Valley's beef sticks are the cleanest, most sustainable snack you can reach for. Try them now at paleovalley.com/hyman and get 15% off your order today.

西蒙，欢迎来到播客节目。很高兴你能来。

Simon, welcome to the podcast. It's so good to have you here.

马克，非常感谢。这次邀约酝酿了一段时间了。能和你同台是我的荣幸。

Mark, thank you very much. It's been a little while coming in. It's a big honor to be with you.

我们之前就聊过这事。对于还不认识西蒙的听众，他是位极其严谨、思想深邃、非意识形态化的营养科学家。这样的人如今可不多见，所以我特别欣赏他。他最初是研究肌肉质量的物理治疗师，对营养学、长寿和衰老机制都有独到见解。

We've been talking about it. Yeah. You know, Simon, for those of you who don't know him, is a very measured, deeply thoughtful, non ideological nutrition scientist. And there aren't very many of those around, which is why I love him. And he also, started his career as a physical therapist studying muscle mass and has a lot to say about nutrition, longevity, how we age.

今天我们虽然要讨论很多话题，但有个热点议题你最近在几个播客里都提到过——关于植物油的大讨论。我个人长期关注这个问题，因为曾经深感困惑。通常当我搞不懂某件事时，就会写本书。

And, you know, one of the things that, know, we're gonna talk about a lot of stuff today, but one of the things that's sort of this hot topic, and you've recently done a couple of podcasts on it, but I want to talk about on the show, is this whole debate about seed oils. And, you know, personally, I've been very focused on this for a long time because I was confused. And I wrote a when I usually am confused about something, write a book.

我注意到你这个习惯了。

I'm saying that. I've observed that.

当时我想深入了解脂肪，因为这个领域存在太多噪音。于是在2016年写了《吃脂肪，变苗条》这本书。核心观点是：我们过去对脂肪的认知全是错的——先是妖魔化饱和脂肪，后来又没能真正理解膳食脂肪的作用。我们被要求低脂饮食，但这真的正确吗？

So I wanted to know more about fat because I was just there was so much noise in the field. And so I wrote a book, 20, I think 16 called Eat Fat, Get Thin. And the idea was, you know, all our thinking about fat was wrong and then we villainized saturated fat and we've not not really well understood the role of fats in our diet. We're supposed to be low fat. Is that really what we should be doing?

正是这场低脂热潮最终引发了一场巨大灾难。于是我梳理了整个历史背景及其背后的科学原理。我特别想弄明白关于欧米伽-6油脂（也就是植物油，或称种子油）的争议。随着MAH运动的兴起，这话题成了众矢之的。但我觉得，等等，你们搞错重点了。

So it was the whole low fat craze that ended up causing a huge catastrophe. And so I sort of mapped out the whole historical context and the science behind it. And I really wanted to understand this whole controversy about omega-six oils, otherwise known as plant oils, otherwise known as seed oils. And with the whole MAH movement, it's become a lightning rod. And I'm like, well, wait a minute, you guys are talking about the wrong thing here.

问题其实在于糖——我们饮食中的糖和淀粉，以及超加工食品。这些才是大量精炼植物油（或称菜籽油）的载体。说到菜籽油我都困惑，是指西兰花油吗？不，其实是辣椒籽、大豆、玉米、油菜籽、红花、葵花籽等制成的油，这些油不仅用于工业食品，历史上也用于烹饪，比如芝麻油在不同文化中的应用。我深入研读了文献，查阅每项研究，分析实验方法试图搞明白。

I mean, sugar. It's the sugar and the starch in our diet and the ultra processed food. And that's a vehicle for carrying a lot of these refined plant oils or vegetable oils, or I don't even know what you mean by vegetable oil because that's, is it broccoli oil? No, it's like chili seeds or beans, soybean oil, corn, canola, safflower, sunflower oil, and all these oils that are used in industrial food, but also have been used, you know, throughout history, sesame oil and cooking and different cultures. And so I really dove into the literature and I read every study and I tried to figure it out and I looked at the methodologies.

我想先和你从宏观层面探讨：为什么这个话题会变得如此敏感？为什么大家都紧抓不放？为什么'种子油'成了妖魔化的代名词？

You know, and I think I'd like to sort of dive in at a high level with you, like, why do you think this becomes such a lightning rod topic? Why has everybody glommed onto it? And and why is it is seed oil such a boogeyman word?

是啊，它有点沦为替罪羊了。

Yeah. It's become a bit of the whipping boy.

没错。

Yeah.

感觉你是想让我背锅啊——开玩笑的。

And yeah, it's I think you're trying to throw me under the bus here. No.

不不不，我们会进行良性对话的。虽然...

No. No. No. We're gonna have a good conversation. Don't know.

我并非全知全能，但我非常渴望深入探讨

I don't have all the answers, but I I very wanna wanna dive into

这个议题。是的。

this. Yeah.

开场白说一句：你是个严谨的科学家。确实。

As I start out, you're a thoughtful scientist. Yeah.

为何这成为了众矢之的，甚至MAHA运动攻击的目标？我想我们都在寻找解释，为何我们的人口如此不健康。内心深处，我们目睹身边人承受着本可避免的痛苦。因此我们热切追寻根源。在这个领域中的你、我和所有人，不仅仅是为了让人们健康，更是在思考：我们为何渴望健康？

Why has this become, a bit of the whipping boy and I guess a target from MAHA movement? I think we're all looking for an explanation to why our population's so unhealthy. And deep down we're experiencing people around us suffering unnecessarily. And so we are passionate about finding a reason for that. You and I and everyone else in this space is really about, it's more than just trying to get people to be healthy, but why do we want to be healthy?

我们追求健康是为了提升生命充实感。本质上，我们在为人们创造更丰盈的人生。归根结底，我们竭力透过科学探寻真相——究竟是什么在增加慢性病风险，导致体脂逐年攀升，诱发代谢性疾病。我认为初衷大抵是好的，但困惑往往源于研究背景的缺失和细节的忽视。

We want to be healthy to increase our life fulfillment. And so we're about increasing fulfillment for people. And at the end of the day, we're all trying our best to look through the science and find out what is it that is increasing our risk of these chronic diseases causing us to increase our body fatness levels over time and driving metabolic disease. So I think the intention piece is generally pretty good. I think that where a lot of the confusion comes from is the context and missing some of the nuance in research.

当我审视过去五七十年来慢性病的增长，最显而易见的解释并非植物油或种子油消费的增加，而是超可口超加工食品摄入的激增。

So when I look at the increase in chronic disease over the last fifty or seventy years, to me the most obvious explanation for that is not an increase in the consumption of vegetable oils or seed oils, it's an increase in the consumption of hyperpalatable ultra processed foods.

我们过去称其为垃圾食品。

We used to call fast food junk food.

快餐

Fast food

垃圾食品。现在它被称为超加工食品。

junk food. Now it's called ultra processed food.

没错。这会驱动能量摄入过剩，造成热量盈余与体重增加。继而引发一系列代谢问题。若再加上久坐不动导致肌肉量与质量下降，简直就是为代谢灾难埋下伏笔。双重打击。

Right. That drives increased energy consumption and calorie surplus and weight gain. And from there you get a whole lot of metabolic consequences. And if you pair that with being sedentary and you lose muscle mass and muscle quality, well, now you're just spelling sort of metabolic disaster. Double whammy.

我们正目睹这种双重打击。简而言之，可归结为：摄入过多热量而运动不足。

The double whammy, and we're seeing that. And put very simply, that that can be distilled into consuming too many calories and not moving enough.

事情没那么简单。

It's not that simple.

确实不简单。有趣的是深入剖析其中细节。但谈到植物油或脂肪整体时，常被忽视的关键背景是：在营养科学中评估某种食物或营养素是否会增加疾病风险、保持中性或降低风险时，必须考量剂量，必须明确比较基准。因为食物选择极少是孤立发生的。

It's not that simple. And I find what's interesting is double clicking on that and looking at all of those details. But when it comes to to say vegetable oils or just fat in general, the context piece that I'm pointing to that I think is often missed is when we're evaluating a food or nutrient in nutrition science to determine is it increasing risk of some disease or is it neutral or reducing risk, We have to consider dose. We have to consider compared to what? Because very infrequently when you make food choices, does it happen in isolation.

通常你在添加某物时需要移除另一些东西。特别是在讨论脂肪这个话题时，我们必须考虑到，因为你提到了饱和脂肪。饱和脂肪是一个统称，但如你所知，它包含许多不同的类型。

You usually remove something when you add something. We have to also consider, particularly in this conversation of fats, because you mentioned saturated fat. Saturated fat is an umbrella term, but as you know, there are many different types of saturated fat.

而且植物油脂或CBD可能也有不同类型。对，种类繁多——

And there may be different types of plant oils or CBD. Right, many types of

植物油脂。所以当我们讨论用完全不饱和脂肪替代饱和脂肪时，具体指哪些饱和脂肪？是指黄油吗？奶酪、酸奶？还是红肉中的饱和脂肪？

plant oils. So when we're talking about, say reducing saturated fats for wholly unsaturated fats, what saturated fats are we talking about? Are we talking about butter? Are we talking about cheese, yogurt? Are we talking about the saturated fats in red meat?

我们说的是硬脂酸吗？这种巧克力或可可中最主要的饱和脂肪，似乎对血脂几乎没有影响。我希望通过这样的描述能让听众明白上下文的重要性。如果过度简化，就可能出现这样的情况：你引用某项研究说减少饱和脂肪没有带来益处，但另一项研究却显示有效，这会让人非常困惑，显得科学结论自相矛盾。

Are we talking about stearic acid, the most predominant saturated fat in chocolate or cacao that really doesn't seem to affect blood lipids. And so I think hopefully I'm painting a picture to the listeners that this context matters. And if you oversimplify it, what can happen is you can point to one study where it's like, oh, reduction saturated fat didn't lead to a favorable outcome, but then this one did. And it starts to get very confusing and it looks like the science all over the place.

确实如此。

It is. Yeah.

正是这种困惑促使我在攻读营养科学硕士学位前重返校园——当时我被这些不断变化的头条研究弄得晕头转向。

And the outcome of that, and I was in this position before I did a master's in nutrition science, what compelled me to go back to university was that I was confused by all of this stuff and the changing headlines.

想想普通人的感受吧。

Imagine how the average person Right.

但学术界的困惑要少得多。尽管学者和科学家之间存在分歧，他们对90%的重大议题是有共识的。这是因为他们理解背景知识。当你了解背景后，那些看似矛盾的结果就变得可以解释了。既然你似乎想了解我对植物油和种子油的立场，我就再深入说明一下——我的研究发现是...

What I will say is that in academia, there is far less confusion. Although although there is some disagreement among academics and and scientists, they generally agree on 90% of these big, big topics. And that's because they understand the context. And when you understand the context, these conflicting or or seemingly conflicting results become explainable. And if I was to kinda just double click a little bit more because I I feel like you you want to kind of hear my position on vegetable oils and seed oils, what what do I find?

我来解释下我的思考过程。

I'll explain my thought process here.

我想先为观众铺垫下背景。当我开始研究这个问题时，首先思考的是：我们的进化饮食是怎样的？我有个偏见——如果某种食物我们几十万年来都没食用过，或许就该审视它。如果饮食中某成分突然激增，从进化角度和人体需求来看会产生什么影响？

I I would. I just wanna set the context for the audience just first because, you know, when I began to look into this, I was like, okay. Well, what's what's our evolutionary diet? I I have a bias, which is that if we haven't been eating it for hundreds of thousands of years, maybe it's something we should take a look at. If, if some one component of our diet has increased dramatically, what is the effect from an evolutionary point of view and what our needs are?

要知道，1900年我开始研究这个时，心脏病发作极为罕见。如果有人突发心脏病，所有人都会冲过来帮忙。那时我们40%的脂肪摄入来自黄油、奶油、全脂牛奶和鸡蛋，而心脏病几乎闻所未闻。但与此同时，我们开始精炼这些植物油——无论是叫种子油还是植物油。

And you know, when I began to look at this in 1900, heart attacks were super rare. Like if you had a heart attack, everybody would rush in. By that time we were eating 40% of our fats as butter, cream, whole milk, eggs, and heart attacks were almost unknown. And then at the same time we started to refine these vegetable oils. We call them seed oils, whatever you want to call them, plant oils.

后来我们发明了Frisco（氢化植物油），其实就是反式脂肪，这确实成了大问题。自1900年以来，大豆油消费量增长了一千倍。我想不出还有什么东西增长如此迅猛。这对人群健康造成了什么影响？在现有认知框架下该如何解释？所以我最初对此是抱有偏见的。

And we developed Frisco, which was basically hydrogenated plant oils, trans fats, which really was a problem. And then our consumption of soybean oil has increased a thousand fold since 1900. And so I don't think there's something that's increased that much. What's it doing to the population and how do you fit in the context of all the acknowledgement now? So it's like I had an initial bias around it.

七十年代早期有些研究试图解答这些问题，比如明尼苏达冠状动脉实验和悉尼心脏试验——这些都是随机对照试验，在营养学领域很难实施，需要随机分配不同饮食并长期追踪控制。结果发现摄入欧米伽6饮食的人健康状况更差。例如明尼苏达玉米实验中，尽管食用玉米油组比黄油组的胆固醇和LDL降低了30点，但LDL每降低30点，心脏病发作风险反而上升22%。

And there were some studies that were early done in the seventies that tried to answer questions. The Minnesota Coroner Experiment, the Sydney Heart Trial, which were randomized controlled trials, which were really hard to do in nutrition where you, you know, randomize people different diets and you follow them and you control them. And they seem to find that people who had the omega-six diets actually did worse. Like in the Minnesota corn experiment, the ones who had corn oil versus butter, even though their cholesterol dropped, LDL dropped by 30 points. For every 30 drop in cholesterol, of LDL cholesterol, the risk of heart attack went up by twenty two percent.

确实，这有点说不清。

Yeah. But it's kind of murky

因为当你试图

because when you kind

深究时会发现，当时人们认为人造黄油很健康。我小时候就是吃Fleishman玉米人造黄油长大的。他们实验用的玉米油其实就是人造黄油，现在我们知道那玩意儿致命。

of look below the surface, at that time they thought margarine was fine. I grew up on Fleishman's corn margarine when I was a kid. Right. And so the corn oil they used was margarine, which we know is deadly.

没错。那些干预实验...我认同你的观点，直觉上完全同意你的说法。

Yeah. So they like in those interventions because I agree with you. I think I agree with you intuitively what you stated.

但数据本身其实

Yeah. But the data doesn't really

让我困惑的是，这个原本几乎不摄入的食物类别激增后，心血管疾病死亡率也随之上升。这绝对值得质疑和研究，我完全赞同。

make sense to me that as is this increase in this this food group that we didn't consume Yeah. We see an increase in in cardiovascular mortality. Yeah. So that's worth that's that's definitely worth questioning and researching. I agree with you.

这很合理。就像突然发现危险信号必须彻查。那两项1960年代的研究，在当时看来确实设计精妙。

It makes sense. It's like, hang on. That's a red flag. Let's look into that. Those two studies, I think, at a high level, you know, in nineteen sixties were really elegant studies for their time.

至少根据我的发现，存在一些问题，我很乐意详细说明。

There are some issues, at least, from what I found that I'm happy to walk through.

这项研究存在很多问题。

There's a lot of issues for this study.

我很乐意阐述我是如何看待这些问题的，以及为什么我不认为这些证据表明用多不饱和脂肪替代饱和脂肪不会改善心血管风险——从宏观层面来看。比如明尼苏达冠状动脉实验，那是安塞尔·基斯主导的研究，许多人会……

I'm happy to walk through like how I see them and why I don't look at those as evidence that reducing saturated fats for polyunsaturated fats doesn't improve cardiovascular risk, at a high level. So Minnesota Coronary Experiment, and that was an Ancel Keys study who a lot of people will

他们把它埋没了。他们埋没了那项研究。我见过乔·汉布林，他挖掘出数据并重新分析了研究，因为他找到了安塞尔·基斯团队一位原始研究人员的儿子。对方说：‘这从未发表过。虽然由NIH资助，但始终未公开。’

be They buried it. They buried that study. And I I met Joe Hamblin who uncovered the data and actually reanalyzed the study because he found the son of one of the original researchers with Ansel Keyes. And he said, This never was published. It was funded by the NIH, but it was never published.

‘你知道你父亲的数据去哪儿了吗？’他说：‘嗯，在他房子的地下室里。抱歉要麻烦你去取。’于是他重新分析了数据，但这过程确实存在问题。

Do you know what happened to your dad's data? He's like, Yeah, it's in the basement of his house. Sorry to get it. And so he then reanalyze it. But it it was problematic.

是的，这项研究确实存在问题。关于它被埋没还是未完成，存在不同对立观点——75%的受试者似乎在首年就退出了。

Yeah. It was there was there was problems with it. And, I mean, there's some different opposing views on on that, whether it was buried or whether it was incomplete. So seventy five percent of the subjects appear to drop out in the first year. Yeah.

很可能研究团队认为：'样本量严重不足，连发表都成问题，更别说判断是否能得出显著结论，或是否有足够的统计效力检测差异。'

So it may well have been that the research team were like, this is completely underpowered for us to even publish and understand, like, do we have a significant finding here, or do we have enough power to detect the difference?

研究中的‘统计效力’指样本量是否足以验证假设。如果人数不足，就缺乏效力。

Empower in a study means are there enough people in the study to be able to prove a hypothesis one way or the other? And if you don't have enough people, it's not powered enough.

这项研究在精神病院进行——设计其实很巧妙：采用随机双盲法，受试者不知道自己摄入哪种脂肪。食堂供餐时，工作人员会随机提供饱和脂肪或人造黄油制成的食物。但不仅退出率极高，受试者还被允许离院回家数日再返回。

And these this was in the setting of a psychiatric ward. And so the way they had it set up was that, which is really a neat part of this study, was that they were it was randomized. People didn't know what fat they were getting. So when they make the food in the in the kind of cafeteria setting, they can just give it to them without them knowing, and it's either coming from saturated fats or from margarine. And not only was there a huge dropout, but the participants were allowed to go out home, stay at home for multiple days and then come back.

如今回顾这些细节，我们会发现许多控制不足的问题。至于悉尼饮食心脏研究——虽然整体设计不错，但如你所说，干预组使用的人造黄油可能含反式脂肪（1960年代尚未减少食品中的反式脂肪）。但总体而言，其他研究被纳入元分析时（元分析本身不完美，因其质量取决于原始研究），仍能说明问题。

And so there's all these kind of little issues that we look at now and we're like, oh, that probably wasn't controlled enough. And then Sydney Diet Heart Study, without going into too much details, pretty good study, but also, as you said, the intervention group was contained a margarine that we believe probably contained trans fats at the time being in the nineteen sixties. It was before trans fats were really reduced in the food supply. And but what I would say is, overall, there are other studies. When you when you put them into a meta analysis, which is not perfect, right, because meta analysis really depends on the quality of studies going in.

但当你这样做，并观察那些持续时间最长、退出率最低的试验，采用可能不含反式脂肪这一混杂变量的良好干预措施时，确实能看到心血管事件风险的降低。是的，在这些短期随机对照试验中。而我们很可能再也无法进行这类试验了。

But when you do that and when you look at the trials that are longest in duration with the least dropout with a good intervention that's probably doesn't have this confounding variable of trans fats, you do see a a reduction in risk of cardiovascular events Yeah. In these short term kind of RCTs. And we're probably never gonna have those kind of trials again.

所以在人群研究中，你也看到了同样的

So in population studies, you also see the same

然后在人群研究中，你会看到类似的现象。更进一步说，如果你去研究人群数据并关注亚油酸——植物油或种子油中主要的欧米伽6脂肪酸。没错。在美国，约40%的亚油酸单独来自大豆油。当你查看饮食调查（这只是一个起点，它们并不完美，存在缺陷）并量化人们饮食中亚油酸的含量时，与亚麻酸摄入量较高的人群相比，摄入量较低的人群冠心病风险更低。

And then in population studies, you see a similar thing. And then further to that, if you go and look at population studies of and you look at linoleic acid, which is the primary omega six fat in vegetable oils or seed oils. Yep. And about 40% of linoleic acid in America comes from soybean oil alone. And when you look at just dietary surveys, which are a starting point, they're not perfect, they have issues, when you look at that and you sort of you quantify how much linoleic acid are in people's diets, they have lower risk of coronary heart disease compared to people with higher amounts of linolenic acid compared to those with lower.

你还可以更进一步。一些更现代、更全面的观察性研究还包含血液生物标志物检测，比如分析红细胞含量——像Function Health检测那样测量红细胞中亚油酸含量。有些研究甚至检测了脂肪组织中的亚油酸含量。这算是更深入的一步。

You can go a step further. Some of these kind of more modern, more thorough observational studies also have biomarker blood biomarker assays where they look at red blood cell content, like the function health test that looks at how much linoleic acid do you have in your red blood cells. And also some of them have looked at how much linoleic acid you have in adipose tissue. And so that's like a step further.

与其询问人们吃了什么，不如直接进行活体组织检查

Instead of asking people what they ate, you can actually biopsy them

或者

or do

通过血液检测了解他们的饮食。

a blood test and see what they ate.

是的。因为这些脂肪不是人体自身合成的。它们出现在红细胞或脂肪组织中的唯一途径就是摄入。然后你可以观察是否存在更高脂肪储存、更高红细胞亚油酸水平与冠心病风险（或全因死亡率）之间的关联。你会发现，无论是红细胞还是脂肪组织中亚油酸水平较高的人群，冠心病风险和全因死亡率都更低。

Yeah. It's because that fat we don't make. The only way it ends up in your red blood cells or in your fat tissue is from consuming Yeah. And you can then look and see, is there an association between higher fat stores, higher red blood cell linoleic acid, and a risk of of coronary heart disease, for example, or total mortality, dying of anything during whatever the follow-up period was. And you see again here, you see lower risk of coronary heart disease, lower risk of total mortality with higher levels in both red blood cell or adipose tissue.

因此，当你综合所有这些证据并考察机制时——嗯，可能的解释机制是什么？我认为不全是，但很可能与这种油脂带来的低密度脂蛋白胆固醇降低有关。这一点本身也得到孟德尔随机化研究和人群研究的支持，这些研究一致显示较低的低密度脂蛋白胆固醇会降低冠心病风险。这就是我对整个证据链的理解。

And so when you when you look at all of that evidence and then you look at the mechanisms Mhmm. So what is the probably the mechanism that would explain this? And I don't think it's all of it, but it is probably the LDL cholesterol reduction that you get with that that swab. And then that's supported in and of itself through genetic Mendelian randomization studies, population studies, where you consistently see lower LDL cholesterol, reduced risk of coronary heart disease. And so that's how I think about all of that.

话虽如此，我是否认为在这些超加工食品中摄入植物油和种子油是健康的？不。我认为它们导致了过量卡路里摄入。

That said, do I think it's healthy to consume vegetable oils and seed oils within these ultra processed foods? No. I think they're driving an excess of calorie consumption.

如果你厨房里有一瓶油，这没什么好笑的，但当你把它加入超加工食品时就另当别论了。

No kidding if you have a bottle in your kitchen, but not when you stick it in an ultra processed food.

即使是在自家厨房使用，对吧？你觉得每天摄入大量这种油脂健康吗？不。它的热量密度极高。但我认为，家庭烹饪中使用一汤匙植物油炒菜，与在超加工食品或反复油炸中使用它们有本质区别。

And even in your kitchen, right? Do I think it's good to be having tablespoons and tablespoons of this stuff? No. It's super calorie dense. I what I do think though is the consumption of vegetable oil at home, like a tablespoon on vegetables, cooking them, is very different to having them in ultra processed foods or deep frying them and reheating them.

哦，确实。那是最糟糕的。天啊。

Oh, yeah. That's the worst. Oh my god.

是的。所以我们都能认同应该尽量避免这类食品。但家庭烹饪中适量使用植物油——不涉及深度油炸和反复加热——情况就不同了。

Yeah. So I think we can all agree that we need to completely try and avoid those types of foods as much as possible. But it is different to, again, cooking with some vegetable oil in your pan at home where you're not deep frying and reheating.

我认为另一个问题是，就像人们常讨论的工厂化养殖牛肉与生态放牧牛肉的区别——问题不在牛本身，而在饲养方式。油脂也是如此：来源是什么？与什么食物搭配？你因此减少了哪些营养摄入？又增加了哪些？

And I think the other issue is, you know, it's like, it's, you know, often talk about like, you know, calfo meat versus regeneratively raised meat and the differences and the, it's not the cow, it's the house. The same thing is true with the oils. It's like, where they come from, what are you eating them with? What else are you not eating? What are you eating more of?

你减少了哪些摄入？这让我想到更宏观的背景：从必需脂肪酸和脂肪酸代谢的科学角度看，ω-3脂肪酸代谢会产生抗炎物质，而我们现在讨论的ω-6亚油酸（LA）代谢则产生促炎分子。理论上ω-6应具有促炎性，但这完全取决于整体环境。人体既需要抗炎系统也需要炎症系统。

What are you eating less of? And you know, the, the, that sort of reminds me of this, this bigger context is that the science, when you look at the science of essential fatty acids and fatty acid metabolism, omega-3s flow down a pathway that creates all these anti inflammatory compounds in the body. Whereas LA or linoleic acid, which we're talking about the omega-6s, go down a pathway that creates inflammatory molecules. So theoretically, these omega-6s should be inflammatory, but it all depends on context. And everybody needs the anti inflammatory system and inflammatory system.

它们本无好坏之分，关键在于平衡。除了饱和脂肪摄入锐减和精炼油摄入激增外，另一个重大变化是我们ω-3摄入量的差异。ω-3与ω-6的比例似乎非常重要。综合分析数据会发现，许多缺乏ω-3却摄入过量ω-6的人很可能面临健康风险。

Not that they're good or bad. It's just they have to be in balance. And the other big thing that's changed, aside from our dramatic drop in saturated fat content and our increase in these refined oils, is the difference in our omega-three content. And omega-3s in a six ratios seem to be pretty important. When you look at the data at a high level and analyze it all, it seems as though a lot of people who don't have the omega-3s, if they have a lot of these omega-6s, get into trouble potentially.

若比例维持在2:1、1:1甚至5:1尚可接受，但多数美国人的ω-6与ω-3比例高达20:1。我认为这是另一个重大问题——我们不再食用野生食物，不吃野生鱼类。

Whereas if you have a ratio that's, you know, two to one, one to one, four to one, five to one, that's okay. But most Americans are like 20 to one of the omega-six to omega-3s. And that, I think that's another big issue. We're all not eating wild food. We're not eating wild fish.

我们无法获取ω-3脂肪酸，90%的人都缺乏它。这就构成了一个复杂的健康困局，让人们误认为海狗油有害，但我认为本质上并非如此。

We're not getting omega-three fatty acids. Ninety percent of us are deficient in it. So you've got a really complex matrix of a problem that makes people think sea dogs are bad, but I don't think they necessarily are.

因为你提出的所有数据都表明，关键不在于事实本身，而在于如何解读。我认为ω-3与ω-6的比例本质上是整体饮食质量的代名词——比例越高通常意味着超加工食品摄入越多，正如你所说ω-3摄入不足。实际上我认为问题根源不在于ω-6本身。

Because all of that data that you presented there is that the facts says what you'll come across, it's how you explain those. So for me, I think the omega three to six ratio is generally a proxy of, like, overall diet quality. Usually, the higher that ratio, the more ultra processed foods. And like you said, not getting enough omega threes. I don't actually think it's inherently the omega six that that's causing the issue there.

我这么说是因为有临床试验显示，当人们过量摄入欧米伽6和亚油酸时，测量其产生的下一阶段欧米伽6——花生四烯酸（具有促炎性）的含量，结果发现它并未升高。这表明人体似乎会缓冲并维持其处于相当稳定的状态。但我认为问题在于，若你没有摄入足够的直接DHA和EPA（正如你提到的两条代谢途径共享酶系统）。

And I say that because there are clinical trials where you overfeed people omega sixes and linoleic acid, and you measure the amount of arachidonic acid, which is the next omega-six that produces. Which is inflammatory. Yeah, and it doesn't go up. So the body seems to buffer it and hold it at a pretty steady state. So where I think though that this is an issue is that if you're not consuming enough direct DHA and EPA, right, because these two pathways you mentioned, they share the enzymes.

所以如果大量欧米伽6通过该途径代谢并占用这些酶——

So if you have a whole lot of omega six running through that pathway and using a lot of these enzymes-

就像试图挤过一条狭窄的高速公路。如果某种车辆大量通行，其他类型就难以通过

Like trying to get it through a highway. It's a very narrow highway. If you have a lot of one type of vehicles going through, you can't get another

因此如果你仅摄入植物性欧米伽3（ALA）

type So if you're only consuming like plant based omega threes, ALA

对，来自亚麻籽、奇亚籽那些

Yeah. From flax, chia

你需要依赖其向DHA和EPA的转化。但若饮食中欧米伽6过多，这种转化率会更低。这正是人们出现炎症加剧的原因。所以我完全认同你提出的观点，我们似乎都认为问题核心在于欧米伽3（尤其是直接DHA和EPA）摄入不足。

You rely on the conversion to DHA and EPA. But if you have a lot of omega sixes in the diet, that conversion's even lower. And so this is where I think then people see increased inflammation. So I think I completely agree with you in terms of what you're putting forward there. And it sounds like we agree that a big part of that problem is under consumption of omega threes, particularly the direct DHA and EPA.

是的。要么每周吃两三次高脂鱼类——虽然很多人

Yeah. Whether you go out and eat fatty fish two or three times a week, which a lot

做不到。每周吃三次沙丁鱼？我大概可以。

of people don't. Eating sardines three times a week. I I probably do.

要么服用优质的DHA/EPA补充剂来确保获取足量长链欧米伽3。

Or having a good DHA EPA supplement to make sure that that you're you're getting enough of those long chain omega threes.

归根结底，我们面临这场争议：种子油成了2025年的众矢之的。肯尼迪部长点名批评它们——我认为并不妥当。从最高层面看，你会如何引导人们理解饱和脂肪、这些植物油和欧米伽3油之间的复杂关系？毕竟这是三大类别。

So at the end of the day, we've got this whole controversy. Seed oils are the boogeyman of of 2025. You know, secretary Kennedy's called them out, I think not correctly. At the highest level, how would you kind of guide people on how to understand this complexity between saturated fat, these plant oils, and omega-three oils. Because those are the three buckets.

正如你之前所说，它们并非同质化的。饱和脂肪有多种类型，欧米伽-6脂肪有多种类型，欧米伽-3脂肪也有多种类型。对吧？

And as you said earlier, they're not homogeneous. There's many types of saturated fat. There's many types of omega-six fats. There's many types of omega-three fats. Right?

所以它们并非铁板一块，但重要的是要理解，你所摄入的这些食物构成的整体饮食矩阵和复合体，决定了它们对健康的影响，这正是我们在此讨论的核心。

So they're not like monolithic, but it's important to understand that overall diet matrix and complex that you're eating of these things determines the impact on your health, which is in the name of what we're talking about here.

没错，这是关键。此外还有你的个人基因因素。

Yeah, it's the key. And then also your personal genetics.

哦，那个，哦，那个。是的，这非常正确。这对医生来说很令人谦卑，因为当你听到人们说这些绝对化的论断时，你会想，等等，我见过成千上万的人，同样的东西会让一个人的胆固醇飙升，而另一个人的胆固醇却直线下降。这怎么解释？就是基因差异。

Oh, that, oh, that. Yeah, that's very true. And that's humbling as a doctor because when you hear people say these categorical things and you go, well, wait a minute, I've seen thousands of people and the same thing will cause one person's cholesterol to spike and another person's to drop like a stone. And like, how do you explain that? It's genetics.

是的，是基因差异。而且很多时候变化并非孤立发生。我私下跟你提过，当我增加饮食中的椰子油时，我的低密度脂蛋白胆固醇和载脂蛋白B大幅上升，实际上在最近的功能测试中上升了30%。

Yeah. It's genetics. And it's also again that a lot of the time that the change doesn't occur in a vacuum. So I've mentioned off air to you that when I increase coconut oil in my diet, that I see my LDL cholesterol and APOB go up a lot, 30% in fact, on my latest function test.

那是因为你代谢状况良好。

That's because you're metabolically fit.

而我做的替换是用椰子油取代了原本烹饪用的特级初榨橄榄油，同时还增加了一些椰子酸奶。这种替换导致单不饱和脂肪减少，饱和脂肪增加，特别是椰子食品中的月桂酸。就我个人基因和这种替换而言，低密度脂蛋白胆固醇上升了不少。我总是告诉人们要简化理解：就像你之前提到的，1980年代有低脂饮食建议。

And and the swap that I made was olive oil is the oil that I cook with, the extra virgin olive oil. I was swapping that out and adding in coconut oil and then also some coconut yogurt. And so that swap saw a reduction in monounsaturated fats and an increase in in saturated fats, particularly lauric acid and coconut foods. And so for me personally with my genetics and that swap, LDL cholesterol went up quite a bit. What I always say to people to keep this really simple is that, like you mentioned earlier, in 1980s, there was a low fat recommendation.

我查阅文献后发现，确实有证据表明饱和脂肪会增加冠心病风险。但我认为关于这在杂货店购物和日常备餐时意味着什么，信息传达得不够清晰。结果就出现了低脂热潮，人们认为任何低脂食品都是健康的。而我们实际看到的替换是什么？我们看到饱和脂肪食品——无论是肉类、黄油还是奶油——的摄入减少了。

My review of the literature is that there was evidence that saturated fats were increasing risk of coronary heart disease. But I think the messaging was not clear enough on what that meant at the grocery store and at dinner time when you prepare a meal. And so what ended up happening was this low fat craze where people thought anything that was low fat was healthy. And what was the swap that we really saw? We saw saturated fat foods, which whether it's meat or butter, they eat cream, we saw those being reduced.

但人们没有转而食用富含多不饱和脂肪的肥鱼、坚果种子，甚至豆腐、豆豉这类全食物。嗯。增加的反而是超加工食品，这些食品确实含有很多不饱和脂肪，但还添加了精制糖、大量钠。它们极具诱惑力，让人停不下来，而且——它们还非常容易引发炎症。所以替换的食物很重要。

And instead of people eating fatty fish, which are rich in polyunsaturated fats or nuts and seeds, even tofu or tempeh, these types of foods, whole foods. Mhmm. The increase came from ultra processed foods, which yes have unsaturated fats in them, a lot of them, but they're add added refined sugars, lots of sodium. They're super seductive, hard to put down and drives- They're also very inflammatory. So the swap matters.

如果你要减少饮食中的饱和脂肪，却转而吃那些食品，有相当多有力数据表明你反而会增加患病风险。我想我们已经看到了这种情况。所以你替换成什么食物非常重要。与其把事情复杂化，不如回归到饮食模式本身。为什么地中海式饮食或北欧式饮食模式在文献中...

If you're going to reduce saturated fats in your diet, if you go then and eat those foods, I mean, there's a fair bit of compelling data to say that you're just increasing your risk of disease in doing that. And I think we've seen that. So what you eat instead is really important. And rather than making this too complicated, let's just come back to a dietary pattern. Why does a Mediterranean kind of diet across the literature or a Nordic style dietary pattern

鱼类、橄榄油、坚果和种子。

Fish olive oil and nuts and seeds.

如果你持续关注研究，你想关注哪种疾病？二型糖尿病、心血管疾病、痴呆症。遵循这种饮食方式的人能得到保护。所以我要说的是，参考那些饮食指南，然后明白你可以调整那种饮食方式为低碳水化合物。它可以是中等碳水。

If you look at the research consistently, what disease do you want to look at? Type two diabetes, cardiovascular disease, dementia. People that eat that way are protected. And so what I would say is look at those dietary guidelines and then understand that you can modify that way of eating to be low carb. It can be moderate carb.

也可以是高碳水。哪种方式对你最有效，让你感觉最好，血液指标最佳，这时你的个人遗传因素就发挥作用了。然后你可以灵活调整，因为一个人可能比另一个人能承受地中海饮食中稍多的饱和脂肪。但这确实是起点。对我来说，就是通过检测来了解你的状况。

It can be high carb. What's working best for you leaving you feeling best with the best blood work, which is then where your your personal genetics come into play. And then you can toggle around with it because one person might be able to consume a Mediterranean diet with a bit more saturated fat than the next. But that's really the starting point. And then for me, it's you test so you know where you're at.

去干预。这就是饮食模式。有非常好的证据支持这种饮食方式。重新检测，然后根据你得到的反馈进行必要的调整。

Go and intervene. That's the dietary pattern. There is very good evidence to support that way of eating. Retest, and then tweak it as as needed based on the feedback you're

这是最有价值的数据类型。我们称之为个体数据。因为当我们谈论所有这些研究时，随机对照试验、观察性数据，你知道，它们有点像是妥协的结果。换句话说，就像一场竞相降低标准的比赛，我们实际上不知道你的情况。所以你让一群人按照这些人的方式行事，但你可能与这些人完全不同。

This is the most valuable kind of data. We call it N of one data. Because when you when we're talking about all these studies that we've been chatting about, randomized controlled trials, observational data, you know, they're kind of an aggression to them. In other words, it's like a race to the bottom and we don't actually know what's going on for you. So you're putting a group of people and say, you're going to behave like these people, but you may not be anything like them.

最好的学习方式是与自己对比测试。这就是为什么当你自己做测试，去掉可乐、橄榄油，添加椰子，然后重新检测你的血液功能指标时，你可以看到数字的变化。这就是我鼓励人们做的：测试，不要猜测，把你的身体当作自己的对照组。生殖健康和生育能力很复杂，不仅仅关乎你的激素。

And the best way to learn is test against yourself. That's why when you did your own self test, removing Coke, olive oil and adding coconut, and then retesting your blood work with function, you could see that your numbers change. And that's what I encourage people to do is test, don't guess, and use your body as as its own control group. Reproductive health and fertility is complicated. It's about more than just your hormones.

它还关乎你的营养状况、压力、有毒物质暴露等等。所有这些都起作用。而这些生物标志物往往在问题出现前未被检查。这就是为什么我主动检测关键营养素，包括锌、铁和欧米伽3脂肪酸，重金属如铅和汞，压力标志物如皮质醇和DHEA，以及激素指标如FSH、LH、雌二醇和性激素结合球蛋白，对每一位想要掌控自己生殖健康的患者都如此。这些检测在你去看普通医生时是得不到的。

It's about your nutrient status, a stress, toxic exposures, and lots more. All these play a role. And these biomarkers often go unchecked until things arise. And that's why I proactively test key nutrients, including zinc, iron, and omega three fatty acids, heavy metals such as light and mercury, stress markers like cortisol and DHES, and hormonal indicators like FSH, LH, estradiol, and hormone binding globulin with every single patient who wants to take control of their reproductive health. And those are tests you're not getting when you go to your regular doctor.

这就是我们创建Function的原因。它让你能进行超过160项实验室检测，全面了解你的健康状况。你现在就可以加入，访问functionhealth.com/mark。如果你是前一千名注册的用户，可以使用代码Hyman 100获得100美元的会员折扣。在生殖健康和生育问题上，不要满足于猜测或试错。

And that's why we build Function. It gives you access to over a 160 lab tests so you can get a complete view of your health. You can join now at functionhealth.com/mark. And if you're one of the first thousand people to sign up, you can use the code Hyman 100 to get a $100 off your membership. Don't settle for guesswork or trial and error when it comes to your reproductive health and fertility.

检测、了解并掌控。你不会喝脏水。那为什么要呼吸未过滤的空气？室内空气中可能携带各种看不见的颗粒，如霉菌、过敏原、挥发性有机化合物、烟雾，甚至空气中的细菌和病毒。而我们大多数人整天都在不知不觉中吸入这些。

Test, know, and take control. You wouldn't drink dirty water. So why breathe unfiltered air? Indoor air can carry a wide range of invisible particles like mold, allergens, VOCs, smoke, and even airborne bacteria and viruses. And most of us are breathing it in all day without realizing it.

这就是我在家使用Air Doctor的原因。它不仅仅是普通的空气净化器。它采用超高效HEPA过滤技术，能捕捉超细颗粒，包括许多污染物和过敏原。它还配备智能传感器，监测室内空气质量并自动调整过滤，同时保持静音运行。如果你正面临野火烟雾、季节性过敏，或只是想让家里的空气更放心，这是迈向更健康环境的明智一步。

That's why I use Air Doctor in my home. It's not just any air purifier. It's designed with ultra HEPA filtration to capture ultra fine particles, including many pollutants and allergens. It also features a smart sensor that monitors your indoor air quality and adjust filtration automatically, all while staying whisper quiet. If you're dealing with wildfire smoke, seasonal allergies, or just want to feel more confident about the air in your home, this is a smart step toward a healthier environment.

我已与Air Doctor合作，为您带来独家优惠。访问airdoctorpro.com，输入Doctor Hyman，即可节省高达300美元。网址是aird0ct0rpr0.com/drhyman。掌控您的空气，呼吸更顺畅。

And I've partnered with Air Doctor to give you an exclusive offer. Go to airdoctorpro.com, Doctor Hyman, to save up to $300. That's aird0ct0rpr0.com/drhyman. Take control of your air. Breathe better.

活得更健康。

Live healthier.

不过我想强调，这并不意味着指南和所有科学依据没有帮助，因为它们就像指南针。它们为我们指明了一个方向，让我们看到典型的结果是怎样的。嗯。然后怀着谦逊之心去理解，作为个体，我们并不总是代表典型人群。是的。

I would kind of emphasize though that that doesn't mean that the guidelines and all of the science is not helpful because it gives us it's like a compass. It points us into a direction where we see what the typical result is. Mhmm. And then having the humility to understand, well, as an individual, we're not always representative of the typical person. Yeah.

比如，我们在这个分布中处于什么位置？这正是有趣之处。你可以尝试调整，然后考虑其他因素，比如你的目标是什么？仅仅是预防慢性疾病，还是你是一名运动员，试图尽可能增肌？

Like, where do we fall in that distribution? And that's where it gets fun and interesting. You can play around with it and then you can factor in other things like what are your goals? Is it just chronic disease prevention or are you an athlete? You're trying to build as much muscle as possible.

对我来说，这才是这一切的乐趣所在。但在网上，这似乎引发了很多争论。

And to me, that's what makes all this fun. But online, it it seems to cause a lot of arguments.

确实如此。回到欧米茄6的话题，你知道，含有它们的天然食物对你有益。比如坚果、种子和豆类，它们对你有好处，对吧？问题在于当你通过某种科学手段提取它们、浓缩它们，并将它们与其他各种垃圾混合时——这基本上就是我们摄入它们的方式。

It does. And and and beginning back to the omega sixes, you know, whole foods that have them are good for you. Like nuts and seeds and, you know, beans, they're good for you. Right? So it's when you kind of extract them through sort of science projects and concentrate them and and mix them in with all kinds of other junk, which is essentially how we eat them.

我是说，大多数人不会直接把大豆油倒在食物上，但它占我们热量的10%。这是因为所有超加工食品中都含有它，而这些食品占我们热量的60%。所以这才是问题所在，对吧？

I mean, most people are not pouring soybean all over their food, but it's 10% of our calories. It's because it's in all the ultra processed food and that's 60% of our calories. So that's the issue, right?

我能问你一个问题吗？我对你的观点很感兴趣。我认为在肯尼迪政府时期，确实有对种子油的关注。如果你走进当前的食品环境，保留所有快餐和超加工食品，但你能打个响指，把所有那些食品中的种子油都换成黄油或牛油，但它们仍然是高适口性、高钠、高糖的食品——那会是场灾难。

Can I ask you a question? I'm interested in your opinion on this. So I think with the Kennedy administration, there's certainly a focus on seed oils. Do you think if you were to go out to the current food environment, maintain all the fast food, all the ultra processed foods, but you could click your finger and all the seed oils in all those foods was changed to butter or tallow, but they were still hyper palatable, high sodium, high sugar food. Disaster.

这会对健康产生实质性影响吗？

Would it make a difference to, to health? A tangible difference?

甚至可能会让情况变得更糟。原因如下：我认为，当你观察脂肪的影响时，任何一种脂肪——无论是饱和脂肪还是其他脂肪——当你将它们与高淀粉和高糖饮食（这正是美国的饮食现状）一起摄入时，问题就出现了。我们每人每天几乎摄入一磅的糖和淀粉（主要是面粉），这才是问题的根源。最终，无论是饱和脂肪——比如涂在西兰花上的黄油——还是其他脂肪，都会导致问题。

It would probably potentially even make it worse. And here's why. I think, you know, when you look at the impact of fats, any kind of fat, you know, when you have saturated fat or even all inside your fats and you consume them in the context of a high starch and sugar diet, which is what we'd have in America, we, you know, out of almost a pound a day per person of sugar and starch, flour basically, that's what causes the problem. You end up, whether it's saturated fat. So saturated fat, like butter on your broccoli, okay.

面包上涂黄油可不行，对吧？因为碳水化合物含量问题，并非所有碳水化合物都不好，比如西兰花也是碳水化合物，但淀粉类和含糖碳水化合物实际上会加剧这些食物对心血管的伤害。由于它们会升高胰岛素水平，不仅让糖分进入细胞，还让各种能量、游离脂肪酸涌入细胞，尤其是腹部脂肪区域。胰岛素就像打开了闸门，所有物质都涌了进去。

Butter on your bread, not okay. Right? Because the carbohydrate content, and not all carbohydrates are bad because broccoli is carbohydrate, but starchy and sugary carbohydrates actually exacerbate the cardiovascular harm of these foods. And so because you raise insulin and because you're not just letting sugar in your cells, you're letting any kind of energy, free fatty acids, those just pour into your cells, particularly around your belly fat. And it's like the insulin just opens the gate and everything goes in.

所以当你摄入糖和淀粉时，胰岛素水平飙升，此时无论吃下什么脂肪，都会对体重增加、炎症反应等造成双重恶化。我认为指南应明确：只要保证多元不饱和脂肪与饱和脂肪平衡摄入（比如约2:1的比例），就不必限制饱和脂肪。但精制淀粉和糖分必须严格限制。

So when you're eating sugar and starch, you get this high insulin and then whatever fats you're eating, it just becomes doubly bad for weight gain and for inflammation and for everything else. So I think the guidelines should say that we shouldn't have a limit on saturated fat as long as one, we consume a balance of polyunsaturated fats with them. Right? So it should be probably like a two to one ratio of polyunsaturated fats and saturated fats. And it should be really limited when it comes to refined starch and sugars.

因此，如果饮食中淀粉和糖分含量高，就绝不能吃饱和脂肪，否则会引发灾难性后果。

So you can't eat saturated fat if you're eating a diet high in starch and sugar because it creates a disaster.

我对某些短期临床试验很感兴趣，比如那些为期12周、让受试者大量摄入饱和脂肪或多元不饱和脂肪的研究。这些实验基于西方饮食背景，正如你所说并不理想。但值得注意的是，增加饱和脂肪摄入时，肝脏脂肪堆积比增加多元不饱和脂肪更明显——众所周知这往往是脂肪肝和2型糖尿病的前兆。不过肯尼迪政府似乎认为只要杜绝植物油，问题就能解决，我想听听你的看法。

I've been interested by some of these relatively short clinical trials, like twelve week studies looking at feeding people a lot of saturated fat or polyunsaturated fats. And these are in background diets of Western diets. So like you said, they're not amazing. What's But interesting to me is that when you dial up saturated fats, you seem to increase liver fat more than when you dial up polyunsaturated fats, which as we know often precedes this kind of fatty liver disease type two diabetes. But, yeah, I was just interested in in your view of because it seems like the Kennedy administration seems to think that if you eliminate seed oils, the problem goes away.

但我认为如果60%的热量仍来自超加工食品...

But I would argue that if 60% of calories are still coming from ultra processed foods

问题就在于此。

That's the problem.

我们依然面临严重问题。

We still have a problem.

没错。核心问题是超加工食品，无论具体成分是什么。

Yeah. It's like the ultra processed food is the issue, whatever you're eating.

食品工业可不愿听这种话。

The food industry doesn't want to hear that.

当然。但他们不得不面对。就像西奥多·罗斯福说的，要挥舞大棒施压。

No. But they're going they're going to. They're having to. I think, you know, I think, they're it's like, what is that? Teddy Roosevelt, know, is a big stick, you know, thing.

我昨天刚在《华尔街日报》上读到Marty Makary和Mehmet Oz的一篇文章。他们提到，政府可以召集这些企业开会，要求他们改变——把垃圾成分从食品中剔除，去除人工色素等等。这些公司承诺会照做，但如果不履行，政府手握大棒，即监管和立法手段。

I think we're I just read an article by Marty Makary and Mehmet Oz in the Wall Street Journal yesterday. And they were like, look, we've convened, which the government can do. We brought these companies to table and we said, change, get the crap out of your food, get the dyes out, etcetera, etcetera. And they're promising to do it. But if they don't, we've got a big stick, which is, you know, regulation and legislation.

所以要么自愿整改，要么被迫服从。我认为这确实是步好棋，毕竟食品和农业游说集团每年花费数十亿美元操控舆论，会严重阻碍立法进程。我们正处在关键转折点——膳食指南初稿已显现积极变化，开始弱化教条主义，更强调全食物饮食模式，首次明确提出减少超加工食品，这堪称革命性突破。过去指南只能建议'多吃什么'，从不敢说'少吃什么'（除非针对具体成分），否则容易被食品工业钻空子——他们只需调整盐糖脂比例，就能炮制出各种非食物的'弗兰肯食品'。

So you do it or else. And I think that's actually probably a good move because, you know, there's a lot of things that are going to interfere with regulation legislation because there's so many billions of dollars spent on food lobbying, agri lobbying and controlling the narrative. And so I think, I think we're in an interesting moment. I think we're going to have some progress. And I think, you know, I've seen some of the early renditions of the dietary guidelines and I think it's moving in the right direction.

（这种转变）确实惊人。以往指南从不敢直言'减少超加工食品'，现在终于打破禁忌。过去只能建议'增加摄入'，除非针对具体成分才敢说'减少'——因为成分表容易被操纵。如果是盐、糖或脂肪，食品商只需在超加工食品中增减配比，就能创造出各种根本不是食物的怪异产品。

Less dogmatic, more around dietary patterns, around whole foods, around getting rid of the ultra processed foods, which no dietary guidelines has ever said before, which is quite amazing. It's like, you can only say eat more of, you can't say eat less of, unless it's an ingredient because then that's easily manipulated. And if it's salt or sugar or fat, then you can dial up and down in the ultra processed food and just make different styles of Frankenfood that aren't really food.

没错。目前在这个国家保持健康需要极强的自律性和刻意为之。但理想状态应该是打造一个环境——最便捷实惠的选择恰好就是最健康的选择。

Yeah. Because it it seems to me that, like, right now to be healthy in this country, it takes a lot of intentionality and a lot of discipline. Yeah. Right? But the goal should be to create an environment where the convenient and affordable option just happens to be the healthy option as well.

这需要巨大努力，因为现行政策在变相补贴垃圾食品——我们人为压低了其价格。洛克菲勒基金会几年前发布的《食物的真实成本》报告指出：消费者每在收银台支付1美元食品费，社会就要为慢性病和环境退化额外付出3美元代价。

Yeah. That's gonna take that's gonna take a lot of effort because, you know, we subsidize the crap, and that's the problem. We make it artificially treat cheap. And the Rockefeller Foundation came up with a report a few years ago called The True Cost of Food. And they basically say for every dollar we spend on food at the checkout counter, it costs $3 to society in terms of chronic disease and environmental degradation.

所谓'外部性'根本名不副实。食用垃圾食品必然致病——就像我们不喜欢某种药物副作用时称之为'不良反应'，但这其实就是该药物必然产生的效应。

You know, all the, we call externalities. They're not really externalities. If you eat crap, you're going to get sick. It's not, it's not, it's just, we call it side effects if we don't like it in a drug, but it's not a side effect, it's just the effect we don't like. Yeah.

现在真相已无法掩盖。民众已然觉醒，政界各层级——国会议员、参议员、白宫乃至所有机构都在讨论这个议题。

And, and so I think, I think they're, the cat's out of the bag. People are awake now. People are talking about it. Politicians are talking about it. Congressmen, senators, you know, the White House, all the agencies.

目睹这种转变令人震撼。我为此奔走呼号数十年——早在15年前的《血糖解方》中就揭露过'有毒三巨头'（大食品公司、大农业、大药厂）如何合谋损害公众健康、破坏环境。后来在《食物修复》中深入探讨，现在即将推出修订版《食物修复·无删减版》，更新最新动态。不过关于Omega-6的讨论有些被夸大其词了，核心建议很简单：选择全食物来源，避免加工食品中的油脂，保证Omega-3摄入，健康自然水到渠成。

It's kind of stunning to see. I've been working at this for decades and I've been screaming about this forever. I mean, I wrote, you know, fifteen years ago, mostly in my book, The Blood Sugar Solution, about the toxic triad of big food, big ag, and big pharma, and how they're, you know, co opting our health and undermining, you know, the environment and everything you could possibly think of. And I wrote a book called Food Fix about this and I we're coming out with a new version. It's updated called Food Fix Uncensored Okay.

（新书）会提供最新视角。但关于Omega-6的争议有些被过度炒作了。对听众来说，我和Simon讨论的所有科学术语可以归结为：优先选择全食物来源，远离加工食品中的油脂，保持充足Omega-3摄入，这样就能确保健康。

About an updated kind of take on what's happening. But it's this whole omega six thing is sort of, I think, an acetal thing got kind of steamed somehow. And it's, I think a little bit misguided. Think, you know, for people listening that all the science y stuff that Simon and I've been talking about, the bottom line is try to eat your sources from whole foods. Don't get these oils in processed food and have plenty of omega threes and you'll be okay.

对，还要记得做实验室检测。

Yeah. And do your lab work.

然后做你的实验室检查。如果你是

And do your lab work. If you're

对饱和脂肪超级敏感，比其他人更敏感，你做了实验室检查，检查包括ApoB，很多测试不包括这个，但现在你可以得到这个，你可以订购这个。在某些地方，如果它很高，那么对你个人来说，从多不饱和脂肪中减少饱和脂肪可能更有意义。但只有通过测试你才会知道这一点。

super sensitive to saturated fat more than the next person and you get your lab work done and the lab work includes ApoB, which a lot of tests don't, but you now, you can get that, you can order that. In some places, if it's high, then reducing saturated fat from more polyunsaturated fats for you as an individual might be even more meaningful. But only you will know that by doing the testing.

没错。现在有一些公司做脂质遗传学检查。我做了我的，因为我有遗传性脂质紊乱。我的大多数祖父、兄弟、姐妹，我想他们中有九个人都在五十多岁时心脏病发作或做了搭桥手术。而他是个劳动者，所以他实际上做了很多体力活动，每晚饭后都会散步。

That's right. There are now companies that do lipid genetics. I did mine because I have a genetic lipid disorder. I had most of my, grandfathers, brothers, sisters, it looks like I think nine of them all had heart attacks or bypasses in their fifties. And he was a laborer, so he actually did a lot of physical activity and walked every night after dinner.

所以他直到七十多岁才开始得病，但他们都在五十多岁时得病。所以我有一个遗传性脂质紊乱，使我过度吸收胆固醇，你知道，影响我的甘油三酯，影响不同的生物学参数。所以看看你的遗传学也很有趣。好吧，这就是底线。不是那么可怕的怪物，但你知道，我想谈的最后一点是很多人谈论的，就是它们以有害的方式加工的想法。

So he didn't start to get it until he was later in his seventies, but they all are in their fifties. And so I have genetic lipid disorder that makes me hyperabsorb cholesterol, that you know, affects my triglycerides, that affects different biological parameters. So it's interesting to look at your genetics too. And all right, so that's the bottom line. Not so much the boogeyman, but you know, one last point I want to talk about with this is what a lot of people talk about, which is the idea that they're processed in a way that's bad.

例如，它们是从大豆中用己烷提取的，己烷是一种毒素。它们被喷洒草甘膦（Roundup），被脱臭，被漂白，化学上高度改变，很容易氧化。所以这是一个理论上的原因，它们应该是有害的，但我没有看到足够的数据来证明这一点令人担忧。或者也许我们还没有真正了解它。缺乏证据并不是没有证据。

So they're extracted from soybeans, for example, with hexane, which is a toxin. They're sprayed with glyphosate, Roundup, they're deodorized, they're bleached, and they're chemically highly altered, and they can be easily oxidized. And so this is kind of a theoretical reason they should be bad, but I haven't seen enough data to kind of prove that they that's concerning. Or maybe we haven't actually learned about it yet. The absence of evidence is not the evidence of absence.

对吧？所以

Right? So

确实。但我同意你的观点，我认为所有这些都值得研究。但我要说的是，我们当前的假设应该是什么？我认为食物影响我们体内的无数途径。我们知道这一点。

True. But what so I I agree with you in that I think all of those things are worth looking into. But what I would say is what should our current hypothesis be? And the way that I think about this is the food that we eat affects a myriad of pathways in our body. We know that.

它可能影响血压。可能影响血脂。可能影响氧化应激。可能影响血糖控制，然后还有成千上万我们可能尚未识别的其他途径。对吧？

It could affect blood pressure. It could affect blood lipids. It could affect ox oxidative stress. It could affect blood glucose control, and then thousands of others that we probably haven't even identified. Right?

所以我们可以推测个别机制，比如也许这个被氧化或含有己烷，可能增加某种风险。重要的是食物对所有途径的净效应，所以当你摄入它时，它相互作用的所有不同方式。我们如何衡量这一点？嗯，就是最终的健康结果。当我看到亚油酸种子油消费数据时，再次回到红细胞含量和脂肪组织，组织中亚油酸含量较高的人患心脏病、癌症死亡率和总死亡率的风险较低。

And so we can speculate on individual mechanisms, like maybe this is oxidized or contains hexane and maybe that increases risk of something. What matters is the net effect of that food on all of the pathways, so all the different ways it's interacting when you consume it. And how do we measure that? Well, it's the end health outcome. And when I look at the linoleic acid seed oil consumption data, again, coming back to red blood cell content and also adipose tissue, they have people with higher linoleic acid in their tissue have lower risk of heart disease, cancer mortality, and total mortality.

所以虽然种子油中可能有个别成分是有害的，

So while there could be individual constituents in seed oil that are harmful,

全球的

the the global

净效应似乎是积极的。

The net effect seems to be positive.

是的，看起来就是这样。尽管我尽管我反对，但似乎就是那样。

Yeah. And that's what it seems like. Even despite my despite my protests, it seems like that's

确实。我能说，我我我不仅感同身受，我我理解背后的逻辑，对吧？看看这是如何制造的以及投入了什么。我完全理解这一点。对。

true. And can I just say, I I I not only empathize, I I understand the the logic behind, hey? Look at how this is manufactured and what's what is goes into it. I completely understand that. Right.

我要说的是，挑战我的是审视这些健康结果的数据，特别是在组织层面。我发现这些数据很难反驳。

And all I'm saying is that what challenges me on that is looking at the data of of these health outcomes, particularly at tissue levels. And I find that data really hard to argue with.

是的，确实。

Yeah. That's, yeah.

所以我某种程度上能理解所有观点和看法，并对它们都感同身受。

So I can kind of, I can see all opinions and views and empathize Now with all of them

我想稍微放大另一个大话题，因为，你知道，我们经历了低脂时代。最近我们又经历了生酮和低碳水化合物时代。现在只剩下一种宏量营养素了。有碳水化合物，有脂肪，还有蛋白质。

I want to sort of zoom out another big topic because, you know, we went through the era of low fat. Then recently we've gone through this era of keto and low carb. And there's only one macronutrient left. There's carbs, there's fat, and there's protein.

我们对所有这些都争论不休

And we argue about all

不是吗

of them, aren't

我们，作为一个群体？

we, as a community?

蛋白质如今成了营养界的宠儿。无论走到哪儿，满耳都是‘蛋白质这个，蛋白质那个’——蛋白棒、蛋白奶昔、蛋白条、蛋白...懂吗？感觉突然之间所有东西都被强行添加了蛋白质。这到底是好是坏？

And so protein is the latest darling of the nutrition world. And now everywhere you go, you're like, Protein this, protein that, protein bars, protein shakes, protein sticks, protein You know? And it's like, wow, okay, somehow everybody's sticking protein to everything. Is that good? Is that bad?

关于蛋白质我们了解多少？又该如何看待它？因为现在有种声音说我们应该摄入两倍甚至三倍于RDA建议量的蛋白质。关于植物蛋白是否和动物蛋白同样优质，以及它们对衰老肌肉的影响也存在争议——而这正是你的专业领域。

And what do we know about protein? And, what should we be thinking about it? Because I think, you know, there's a whole conversation going on that we should be eating two or even three times sometimes what is the RDA recommendation for protein. And there's controversy about whether plant protein is as good as animal protein and what that does to muscle as we age. And this is an area of expertise for you.

既然聊完了种子油的话题，现在该深入探讨蛋白质了。

So now we covered the, seed oil thing. Want to kind of get into the protein thing.

嗯。

Yeah.

那就直接切入主题吧。我就喜欢和你讨论这类棘手问题，你从不回避。

And then dive right in. Not scared of difficult subjects, which is why I like talking to you.

是的。后来我意识到这些问题存在内在关联。我职业生涯初期是物理治疗师，很幸运能同时在墨尔本为职业运动员和社区中心服务——后者人群截然不同：经济条件较差，没有私人医保，普遍患有慢性病和腰背疼痛。很快我就注意到，许多超重的慢性腰背疼痛患者同时伴有脂肪肝、糖尿病，且肌肉量不足，这些病症其实密切相关。

Yeah. And and these things are interconnected in some ways, which is what I realized. So I'd I'd begun my career as a physiotherapist, and I was splitting my time up between working was very lucky to get a job working with professional athletes in in Melbourne and Australia, but it was on the provision that I would also work out in a community center, completely different demographic, less affluent, not on private health insurance, a lot of chronic disease, lot of chronic back pain. And it didn't take long for me to notice that a lot of folks with chronic back pain who were also overweight were coming in with fatty liver disease, diabetes, they were under muscled. And these things are very, very related.

是脂肪过剩还是肌肉不足？或者兼而有之？

Is it over fat or under lean or both?

两者都是。现在越来越常见的情况是：营养过剩导致体脂增加，同时伴随肌肉减少症——肌肉尺寸、功能和质量都在下降。

Both. And what we're seeing is increasingly we're seeing both. We're seeing over nutrition and we see increased body fatness coupled with sarcopenia, loss of muscle size and function and quality.

我更倾向说是热量过剩而非营养过剩。因为严格来说，根据各类定义，食物的本质是能支持生物体健康、生长和发育的物质——按这个标准，超加工食品甚至不能算真正的食物。

I would say excess calories, overnutrition because, you know, if you get nutrition, I think of it as food. And I often said this, but if you actually look up the definition of food in various, you know, places, somewhat worded differently. But the essence of it is food is something that supports the health and growth and development of an organism. And by definition, ultra processed food technically isn't actually even food.

所以热量过剩却仍营养不良，只是以另一种形式表现。

So excess calories and still- malnourished just in another way.

没错。而且严重缺乏维生素。

Yeah. And very vitamin deficient.

对。我观察到这些现象是相互关联的。从大约30岁开始，我们看到肌肉质量每年减少约0.5%到1%。到了50岁，这个速度会加快，每年可能流失1%到2%的肌肉质量。也就是说50岁后每十年可能损失10%到14%的肌肉。

Right. So I was observing that these things are interconnected. And what we see is from the age of about 30 onwards, we see a reduction in muscle mass, about half to kind of 1% per year. And then by the age of 50, that can ramp up so you can be losing one to 2% of your muscle mass per year. So you could be losing 10%, 14% of your muscle mass per decade after the age of 50.

50岁后，每年流失的力量比肌肉质量更多——力量和爆发力同样至关重要。这点我们稍后可以再讨论。

From age 50, you're losing more strength per year than you are muscle mass, which is also really important, strength and power. And we can maybe come back to that.

是啊，因为我甚至分不清肌肉质量、力量和爆发力的区别。

Yeah, because I don't even understand the difference between muscle mass and strength and power.

它们确实有关联，但随着年龄增长，你实际流失的力量比例会超过肌肉流失量，而爆发力的流失在评估跌倒风险时尤为关键。这个问题我们稍后再详谈。本质上，如果我们想在整个成年期保持并增加肌肉质量，同时维持其质量和功能，关键在于我们的运动习惯和营养摄入——其中蛋白质尤为重要。就当前社会而言，导致肌肉减少症的主因是什么？虽然蛋白质确实重要...

And there is an association, but you're actually losing, more strength relative to the amount of muscle that you're losing as you age and power, which becomes really, really important when we look at risk of falls. Let's come let's come back to that. Primarily, if we're trying to maintain and build muscle mass throughout our, adult life and maintain the quality and function of that muscle mass, It comes down to the movement that we're doing or not doing and our nutrition, which is where protein becomes really important among other things. If we were to look at our society right now, what is driving a lot of the sarcopenia? I think protein is important to a degree.

目前美国人平均蛋白质摄入量约为每公斤1.2克，还有优化空间。但真正的问题在于久坐的生活方式和缺乏运动刺激。用进废退——当肌肉得不到刺激时，支配肌肉运动的运动神经元会逐渐退化。常被忽视的是，衰老过程中我们不仅流失肌肉量，更在流失肌肉质量。

The average protein intake is at about 1.2 grams per kilogram at the moment in America, which could be a little bit further optimized. But what's really the problem is the sedentary lifestyle and the lack of the stimulus. If you don't use it, you lose it. And unfortunately what happens is when you're not stimulating the muscle, the kind of motor units, the nerves that go into the muscle that innervate them, that allow us to contract to control, they die off. And so something that I think is often not appreciated is that as we're aging, we're not just losing muscle mass, but the quality.

我们正在流失优质肌肉。快肌纤维（II型肌纤维）会逐渐减少——快肌虽然易疲劳，但能快速产生爆发力，比如百米冲刺时...

We're losing quality muscle. And we get a shift from type two kind of fast twitch fibers. And the fast twitch, fast twitch means faster fatigue, but we can we can produce power really quickly, produce force really quickly. A 100 yard dash. Right.

也能快速做出反应。而慢肌纤维更抗疲劳，属于耐力型肌纤维。随着年龄增长，快肌减少而慢肌相对增加，这导致我们爆发力下降，跌倒风险上升。因为当你需要紧急稳住身体时，必须快速产生力量...

And react really quickly. Whereas the slow twitch are more slower to fatigue, more endurance kind of muscle fibers. And as we age, we get this reduction in the fast twitch and relative increase in slow twitch. And that is what leads to us having less power and being more at risk of falls. Because when when you when you fall and you have to catch yourself, you have to produce force really quickly Yeah.

通过膝盖，通过髋部。是的，这非常关键。

Through the knee, through the hip. Yep. And this is this is critical.

它又回来了，就像森林里倒塌的建筑和树木一样轰然倒下。

It comes back And just falling over like a building and the tree in the forest.

没错。

Right.

轰隆一声。懂吗？

Boom. You know?

就像...是的。

Like Yeah.

这才是致命的关键。

That's what kills people.

为了对抗这种现象，马克你看，如果我们观察资深运动员，有些研究表明...

In order for us to combat this, and we see this, Mark, if you look at masters athletes, there's some studies

你是指年长的运动员？

You mean older athletes?

对，就是五六十岁、七十岁甚至八十出头的运动员，他们终生保持运动习惯，能有效减缓肌肉流失。这说明肌肉流失并非正常衰老现象，明白吗？

Older athletes. Right? So athletes that are in their fifties, sixties, seventies, sometimes early eighties that have been physically active throughout their life, they can attenuate a lot of that muscle loss. So this is not just a normal part of aging. Right?

这完全源于久坐不动的生活方式，缺乏应有的运动刺激。

It is from living a sedentary lifestyle and not having that stimulus there.

说来你可能不知道，今年我生了场大病，做了背部手术。长话短说，我背部感染卧床六周，因为本来体脂率就只有12%，直接掉了20磅肌肉。当时我65岁，特别害怕这些肌肉再也练不回来了。

You know, I was, I don't know you know this, but I was sick this year and I had back surgery and long story short, I had an infection in my back. I was in bed for six weeks. I lost 20 pounds of muscle because I didn't have much fat on me to start with. I was about 12% body fat. And I was scared because I was 65 and I didn't know if I could actually gain the weight back.

但我对蛋白质摄入量和质量极为严格，每天在理疗师和教练指导下健身，最终增重了25磅肌肉。65岁的我简直惊呆了，原以为经历这场病后会变得虚弱不堪。这让我意识到，只要给予身体正确的营养输入，即使年长也能——

But being very disciplined about my protein intake, the quality of the protein, and being in the gym every day with a physical therapist and trainer, I gained back 25 pounds of muscle. And I was like, wow, at 65, like I'm sort of shocked because I was like, I'm just going to be a frail old man after this thing. And I was like, if you actually give the right inputs to the body, even when you're older-

身体渴望适应。我们现在明白，社会普遍认为随年龄增长肌肉流失是正常的现象，其实并非如此。是的，我们完全可以干预，而且越早干预效果越好。

It wants to adapt. So what we understand is that the age related muscle loss that we've kind of normalized in society because it's so pervasive and we see it, it's actually not normal. Yeah. And we can we can intervene and we have a lot more say. And the earlier we intervene, the better.

但正如你刚才所说，任何时候开始都不算晚。

But it's also never too late, like you just said.

但你知道吗西蒙，最荒谬的是我作为医生竟从未学过评估肌肉减少症。直到1996年在肯扬牧场工作时，他们有一台DEXA扫描仪。那是我第一次看到身体成分扫描报告，才真正理解内脏脂肪、腹部脂肪与臀部脂肪的区别，以及雄性和雌性脂肪分布差异。当时我就震惊了——这简直是医学界的黑洞。现在有些血液生物标志物衍生计算能辅助诊断肌肉减少症，很有意思。

But you know what's so crazy, Simon, is that I'm a doctor and I never learned how to evaluate sarcopenia. Then I went to work at Kenyon Ranch in 1996 and they had a DEXA machine. And it was the first time I'd seen actually a body composition scan or knew really what it was about or learned about it or understood the difference between visceral fat or belly fat and your butt fat or your android or gynaecoid fat levels. And I was like seeing these things and I'm just sort of like, wow, this is like a black hole in medicine. And there's some interesting now, biological tests like blood work that you can get that helps indicate sarcopenia that are derivative calculations from other biomarkers.

这些检测手段会逐步完善。我们刚引入了Ezra公司的MRI身体成分扫描技术，精确度极高。必须测量肌肉量和体脂率，否则就像蒙眼飞行——根本不知道身体真实状况。

And so those are things that are going be added to function. We just added, Ezra, which is a scanning company, and you can do an MRI body composition, which is extremely accurate. And, and you can find out what's going on. But you've to measure your muscle mass and your body fat because if you don't have a good sense of what that is, you're kind of flying blind.

测量数据后实施科学干预特别激励人心，能看到进步就意味着方向正确。对抗肌肉功能衰退的关键是：第一，抗阻训练；第二，爆发力训练如跳箱、深蹲跳、滑步跳等。还可以加入立定跳远、波比跳（如果能力允许）。年轻时短跑也是极佳的爆发力训练，能有效保护快肌纤维——这至关重要。

And I think it's really motivating to, to measure and then to intervene and see these science based interventions really work, to see the improvement and know that you are moving in the right direction, or if they're not working, to know that you get to iterate and change, what you're doing. But the two most important things there to combat this loss of muscle function and quality is, a, the training we're doing, so having resistance training in place, and also ideally having some type of power training like plyometric, like box jumps or, squat jumps or skater kind of, lateral bounds, that that type of movement. What else can we throw in there? We can throw in kind of broad jumps, burpees, if you can do them. And even if you can run, like, earlier in life, sprinting is a is a great power movement, which will help you maintain, preserve, look after all of those fast switch motor units, which is really important.

饮食方面蛋白质至关重要。正如你所说，关于摄入量、来源优劣的争论很多。接下来就是时机问题——是否需要分时段补充？

And then when it comes to our diet, protein is super important. And as you said, this has been heavily debated. So how much do we need? What source is best? And then I'd say kind of below those two is like, does the timing matter?

过去十年大量研究让我们更有信心拼凑出答案，当然科学需要保持谦逊——我们仍有认知空白。

And over the last ten years, we've had an abundance of research that's helped us, I think, piece this together with much more confidence. Although, you know, in science, we always have to have a degree of humility and understand we don't know everything yet.

确实。

Yeah.

没错。关于蛋白质摄入，我这些年观点也有变化。但现有证据表明，要维持肌肉量和力量，每公斤体重至少需要1.2至1.6克蛋白质。

Yeah. So there still are some things to learn. But overall, when it comes to and I've changed my view on this over the years. But when it comes to the outcomes of muscle mass and strength, it looks like you wanna be consuming at least 1.2 to 1.6 grams of protein per kilogram.

目前，RDA值（即0.8克/公斤体重）是偏低的。你能解释一下这个数值是怎么得出的吗？0.8具体代表什么？

And currently, the the the RDA, which is point 8.8. Is low. And and can you explain how they come up with that? What is point eight?

他们通过氮平衡实验得出这个数据，这些研究是很久以前做的。简单来说，这些研究更多是着眼于蛋白质的基本需求量。

They do these nitrogen balance studies, and they were done a long, long time ago. But I'd say just at a very high level to explain that those studies are more looking at a requirement of protein.

就像预防蛋白质缺乏症那样。

Like preventing protein deficiency.

而不是蛋白质的最优化摄入量。这两者是不同的概念。

Not an optimization of protein. And these are two different things.

所以75岁老人维持健康所需的量，和避免蛋白质营养不良的量是不同的，对吧？后者显然不够...

So how much you need to be a healthy 75 year old versus how much you need so you don't get protein malnutrition, right? Which is not-

没错。我之前提到过，50岁后每年可能流失1-2%的肌肉量。当年那些研究根本没有探讨如何延缓这种流失。

Yeah. So I mentioned before that after the age of 50, you could be losing one or 2% of your muscle mass per year. Yeah. Those studies done back in the day, they were not looking at how do you attenuate that? How do you slow that down?

我想再明确强调：研究表明，如果你想延缓肌肉流失，实际需要的蛋白质摄入量应该略高于0.8的RDA标准值。

Yeah. So I just wanna make that abundantly clear. The research suggests that you need a little bit more protein than than the RDA at point eight if you wanna do that.

相信我，这些年来我尝试过无数补充剂，但只有少数几款是我出行必带的。其中就有Timeline公司的Mitopure，它含有尿石素A——这种强力成分能支持线粒体（细胞中驱动能量、代谢和健康衰老的微型发电站）。我把它加入我的'青春永驻'抗衰老奶昔里。为什么？

Trust me when I say that I've tried a lot of supplements over the years, but there are just a few that I cannot travel without. And one of them is Mitopure by Timeline. It contains Urolithin A, a powerful compound that supports your mitochondria, the tiny power plants in your cells that drive energy, metabolism, and healthy aging. I take it as part of my young forever longevity shake. Why?

因为它能清除老化失调的线粒体，并帮助身体重建更高效的新线粒体。这意味着更好的精力、肌肉功能和大脑健康——这些都会随着年龄增长而衰退。现在Timeline还推出了无糖草莓软糖版本，每天两颗就能达到临床有效剂量。口感很棒，已成为我的每日必备。

Because it helps clear out old dysfunctional mitochondria and helps your body build new, more efficient ones. That means better energy, better muscle function, better brain health, all the things that start to slow down as we age. And now timeline has made it even easier to take with sugar free strawberry gummies. Two a day gives you the full clinically effective dose. They taste great and they're part of my daily routine.

绝不间断。Timeline为我的听众提供专属折扣，访问timeline.com/drhymen即可获取这份身体应得的支持。作为功能医学医生，我深知皮肤状态往往是内在问题的反映，比如炎症、肠道问题或氧化应激。因此我使用并推荐Peak公司的太阳女神抹茶，因为它能从内而外改善肌肤。

No skipping. Timeline is offering my listeners a special discount. Just go to timeline.com/drhymen and give yourselves the support they deserve. As a functional medicine doctor, I know skin health is often a reflection of what's going on inside, like inflammation, gut issues, or oxidative stress. That's why I use and recommend Sun Goddess Matcha from Peak because it works from the inside out.

这不是普通的抹茶。太阳女神抹茶是纯净的有机 ceremonial 级抹茶，富含EGCG——一种对皮肤透亮、肠道健康和炎症反应极有益处的强效抗氧化剂。由于采用整片茶叶研磨制成，一杯相当于饮用十杯普通绿茶。更长的遮荫培育时间增加了茶氨酸和叶绿素含量，有助于带来平静专注的能量，并支持自然排毒。Peak仅选用最高品质原料，确保每一口都带来无与伦比的纯净与安心。

This isn't your average matcha. Sun Goddess Matcha is a clean, organic, ceremonial grade matcha rich in EGCG, one of the most powerful antioxidants for supporting skin clarity, gut health, and inflammation response. Since it's made from whole ground tea leaves, one cup is like drinking 10 cups of regular green tea. It's also shaded longer to increase L theanine and chlorophyll, which help deliver calm, focused energy, and support natural detoxification. Peak only uses the highest quality ingredients, so you get unmatched purity and peace of mind with every sip.

太阳女神抹茶口感顺滑绵密，带有天然的甘甜鲜味。我每天早晨饮用，它已成为我肌肤与健康护理的基础环节。Peak还提供名为'焕肤双星'的强力组合——太阳女神抹茶搭配他们的BT活力饮，可额外提升肌肤效益并提供更深层细胞支持。现在登录peaklife.com/hymen可享终身最高8折优惠，另赠免费搅拌器与玻璃量杯。网址是piquelife.com/hymen。

Sun Goddess Matcha is smooth, creamy, and has a naturally sweet, umami flavor. I drink it every morning, and it's become a foundational part of my skin and wellness routine. Peak also offers a powerful combination called the Radiant Skin Duo, Sun Goddess Matcha paired with their BT fountain drink for added skin benefits and deeper cellular support. Right now, you'll get up to 20% off for life plus a free frother and glass beaker at peaklife.com/hymen. That's piquelife.com/hymen.

可享受九十天无风险试用。说到这个，我发现现在蛋白质补充真是无处不在。昨天我在Equinox健身完，做了组高强度训练后，发现楼下有个小冰沙吧台，他们卖的这种乳清蛋白冰沙添加了各种健康食材。

Try it risk free with their ninety day guarantee. Yeah. I mean, it's interesting is how much protein is out there. Because yesterday I went to work out at Equinox and I did a pretty hard workout. And then I went down and they had a little smoothie bar and they had a whey protein smoothie with all this healthy stuff.

居然含有54克蛋白质。我当时就震惊了——按0.8克/公斤的标准计算，我全天只需67克。所以问题是：像我这样65岁既想保持肌肉又想增肌的老头子，到底该摄入多少？你刚说的范围是1.2到1.6还是...

And it was like 54 grams of protein. And I was like, wow. And then when I do my calculation based on the 0.8, it's, I need 67 for the whole day. So the question is how much should I be really getting at a 65 year old guy that could not just not lose muscle, but actually develop muscle? And you're saying it's somewhere like 1.2 to 1.6 or

有项精彩研究对比了两种情境下蛋白质摄入与力量的关系：一种是抗阻训练者逐步增加蛋白质摄入，另一种是久坐人群增加蛋白质后力量变化。数据显示，没有抗阻训练配合的蛋白质增量...

Yeah, when you look at, there's a beautiful study that looked at strength, and protein intake at two different contexts. So one was looking at as you dial up protein in the context of someone who's doing resistance training. And then the other is if you dial up protein and they're sedentary, what happens to strength? What you see is increasing protein without resistance training.

完全没用。

Doesn't do anything.

基本毫无效果。

Basically does nothing.

就像把汤料倒进锅里却不点火。

It's like putting the ingredients for soup in a pot and not putting on the heat.

没错。考虑到美国约80%-90%人群未达到抗阻训练标准，这个数字其实...

Right. And if you like 80 or 90%, I think of The US population not meeting the resistance training guidelines. So that's like the number

已经算客气了。

one That is generous.

是的，这可能有些慷慨，但这是首要解决的问题。让我们把这点明确下来。

Yeah, that could be generous, but that's like the number one thing to address. Let's make that clear.

你指的是抗阻训练，也就是力量训练。

And you mean resistance, meaning strength training.

对。理想情况下，我认为...你知道关于最佳重复次数范围有很多争论。我个人觉得8到12次是个不错的范围，因为负荷不会太重导致受伤风险增加——那种4次范围的超大负荷需要训练者非常有经验才能避免受伤。而8到12次还能额外给骨骼施加负荷，获得轻重量做30次时得不到的骨密度提升效益。

Yes. And ideally I think it's in the, you know, there's a lot of debate around what's the best rep range. Personally, I think that that eight to 12 rep range is a good rep range because it's not the load's not too heavy where you increase risk of of injury for people where the load's super heavy, in that kind of four rep range where you need to be a much more experienced lifter to avoid injury. Also at the eight to 12, you get the added benefit of loading the skeleton. So you get the bone mineral density benefits that you you don't get as much if you're doing a lightweight and doing 30 reps.

所以我确实倾向于把8到12次作为通用经验法则，特别是对健康老龄化而言。

So I do like the eight to 12 as a general kind of heuristic, particularly for healthy aging.

这意味着做到8到12次力竭，比如第12次时你再也做不动了。

That means eight to 12 to fatigue, where like the twelfth one is like you can't do one more.

没错，这个点很好。所以应该保持在有效范围内如果

Yeah, and that's a great point. So it's, you should be within an effective If

你用5磅重量做12次，那根本不算一组训练。

you're doing 12 reps of a five pound weight, that's not a set.

对。所以有效的8到12次组应该是最后两次接近力竭状态。你在力竭前还能再做两三次。嗯，明白吗？

Yeah. So an effective set of eight to 12 would be that those last two reps are within failure. You're you're you're getting two a couple reps within failure. Mhmm. Right?

就是说如果继续做，你可能只能勉强再做一两次，而且动作会变形。是的。这样理解很准确。从强度等级来说，可以描述为10分制里的8分。

So if you were to continue the set, you would only be able to maybe lift it one or two more times, and you'd be losing form. Yeah. Right. It's a good way of kind of looking at that. And in terms of an intensity, you might describe that as like an eight out of 10.

10分是全力冲刺。但这项研究表明，在抗阻训练和力量提升背景下，当蛋白质摄入增加到1.2克后收益最大。从1.2克提到1.6克就像拧毛巾最后几滴水，提升很有限了。

In terms of intensity of 10 is all out. Right. But in this study, the if you look at the context of resistance training and strength as you dial up protein, most of the benefit is driven once you get to 1.2. There is a little bit further getting going from 1.2 to 1.6 grams. It's kind of like squeezing the last few drops out of the towel.

对吧？所以我们的首要任务是建立规律的抗阻训练计划。理想情况下，你身体的主要肌群每周至少要完成10组有效训练，按照我们刚才描述的最低刺激标准来促进力量和

Right? So in terms of our priorities, number one is have regular resistance training in place. Ideally, each muscle group in your body, the main muscle groups, you're getting at least 10 effective sets in a week in the way that we just described as a minimum kind of stimulus to promote strength and

具体怎么安排？比如一周三次吗？

What are they, like three times a week?

对，你可以轻松分成三次训练。说到肌群划分，简单方法是按动作模式考虑。比如10组推力动作——嗯——包括过头推和水平推，10组拉力动作——嗯——在两个不同平面进行。

Yeah, you could split that easily across three workouts. And when I say muscle groups, a simple way would be thinking of movement patterns. So ten ten kind of pushing Mhmm. Which could be overhead or horizontal pushing, 10 sets of pulling Mhmm. In the two different planes.

没错。下肢训练可以安排10组蹲类动作模式，10组铰链类动作模式——比如硬拉，但分散在一周完成。如果跟着私教分三次训练——对——这样分配，这个训练量足以促进肌肉肥大增长和力量提升。

Yeah. And then, obviously, lower body, you can have, you know, ten ten sets of, like, some type of squatting pattern, 10 sets of some type of hinging pattern Yeah. Like a dead lift, but over a week. And if you split that across three workouts with a personal trainer Yeah. You can split that up, and that's a that's a that's enough volume to promote, muscle hypertrophy growth and also strength.

然后根据你想投入的时间，如果有余力可以增加到每个肌群20组。对。这样会获得额外收益。

And then depending on how much time you want to invest in this, you can build that up to 20 sets per muscle group if you have enough time. Yeah. And you'll get some extra benefits.

有意思的是我问你蛋白质问题，结果我们聊起了力量训练。我觉得这很关键。

Well, I find it interesting that I asked you about protein, we end up talking about string training. I think that's really important.

这是有意为之，因为研究显示——说真的——当前人们的蛋白质摄入量已经足够，只要加上训练刺激就能增肌。对。现在说到蛋白质来源争议，特别是动物蛋白与植物蛋白哪个更具合成代谢作用。这方面我的观点近年有所转变——过去12个月就有两项临床试验：巴西的Hamilton Rochelle团队和Alastair Montaigne与Benjamin Wall团队，他们比较了纯素饮食与杂食饮食（植物蛋白占比100% vs 60%动物蛋白）。

And it's intentional because we spend And so much time talking about honestly, the studies show that existing protein intake is already at a level where people would be building and maintaining a lot of muscle if they just added the stimulus. Yeah. Now we get into, like, the actual protein source, and there's so much debate about around the source of that, particularly animal versus plant protein, which is more anabolic. And this is where my views have changed a little bit over the years and even in the last twelve months. There's been a couple of clinical trials, Hamilton Rochelle out of Brazil and then Alastair Montaigne and his group with Benjamin Wall that have actually looked at comparing omnivorous diets to vegan diets where all of the protein comes from plants.

这些研究很新颖，因为十多年前的研究大多只是在杂食背景下比较豌豆蛋白与乳清蛋白。而这两项10-12周的研究让健康成人进行抗阻训练，蛋白质摄入设定为1.6克/公斤（Montaigne实验约2克/公斤），结果发现在肌肉维度或力量增长上完全没有差异。

And these are novel studies because most of the studies kinda ten, fifteen years ago just looked at the addition of, like, a pea protein versus whey, but in the background of an omnivorous diet, which is not really helping us fully answer this question. So these diets are are interesting because you look at a completely plant based diet where all the protein comes from plants versus an omnivorous diet where about 60% of the protein is from animal. And in these in these two studies, they go for ten and twelve weeks long where they're doing resistance training in healthy adults, and they put the protein intake at 1.6 grams per kilo, or in Alastair Montaigne's it was more about two grams per kilo which is pretty high, you do not see a difference in muscle size or strength gains throughout that ten to twelve week period.

无论动物还是植物蛋白都一样。

Regardless of it's animal or plant.

两种饮食没有差别。这确实挑战了蛋白质研究界的固有认知，Stuart Phillips和Alan Aragon等权威学者都因此修正了观点。现在的共识是：只要蛋白质摄入足够（远高于RDA标准），来源并不关键。

Regardless of the two diets. And that I definitely think that challenged a lot of the protein research world, and a lot of the main researchers like Stuart Phillips came out and Alan Aragon changing their views on these things. And really the consensus view from that was that if protein is high enough so not at the RDA point a. That's very low.

是啊。

Yeah.

没错。但如果蛋白质摄入量足够高，达到每公斤1.6克这个水平，那么植物蛋白和动物蛋白在氨基酸构成上的细微差异似乎就不会影响我们所关注的健康结果。是的，我们可以深入研究，在显微镜下观察这些蛋白质的区别，并给出消化率评分等等。但当你实际让人们在高蛋白摄入的情况下食用这些食物，并测量我们关心的结果时，两者并无差异。而这对现在大多数听众来说，他们真正关心的是力量和肌肉增长。

Yeah. But if protein's high enough and you're up at this 1.6 grams per kilogram, then the subtle differences that exist between the amino acid makeup of plant proteins and and animal proteins doesn't seem to affect the health outcomes that we that we care about. So, yes, we can drill down and look under a microscope at the difference between these proteins and come up with a digestibility score and all these things. But when you actually feed people these foods at a high protein intake and measure these outcomes that we care about, there's no difference. And that's what most people listening to this right now, that's what they really care about is the strength and the hypertrophy.

这不是纸面上的氨基酸评分。

It's not an amino acid score on paper.

当我开始研究这个问题时——因为写《永远年轻》这本书时我真正深入探讨过——我查阅了ProDage研究团队的一项大型综述，该研究针对60岁以上人群的蛋白质需求。因为随着年龄增长，会出现所谓的合成代谢抵抗现象，意味着你比20岁时需要更努力才能增肌。这与激素变化等因素有关。他们建议的摄入量是每公斤1.5至2克。

When I started researching this, because when I wrote my book Young Forever, I started really looking at this. And I looked at this one large review by a group called the ProDage Study Group, which looked at protein requirements in people 60. Because when you're older, there's something called anabolic resistance, meaning you have to work harder to actually build muscle than you would have if you were 20. And that has to do with hormonal changes and other factors. And they said the recommendation was 1.5 to two grams per kilo.

他们还指出动物蛋白效果优于植物蛋白，并建议每餐至少摄入25至40克蛋白质才能达到激活肌肉蛋白质合成（即增肌）的阈值。你能谈谈这个吗？因为当我读到这些时，感觉这是一群专业学者的结论，而且看起来是对文献相当全面的综述。

And they also said that the, that animal works better than plant. And they also said that you should have at least twenty five to forty grams per meal in order to hit that threshold of actually activating they're switching on muscles, protein synthesis, or building muscle. Can you speak to that? Because I think, know, when I read it, was like, this seems like a bunch of experts who know what you're talking about, and it seemed like a pretty well done review of the literature.

据我所知只有两项临床试验——我经常密切关注这类数据，所以应该没有其他研究在1.5至2克/公斤的摄入量下比较植物与动物蛋白对肌肉体积和力量的影响——就是我提到的那两项显示无差异的研究。那篇论文的结论可能源自低蛋白饮食情境下的喂养研究：当全天蛋白质总量未达理想水平时，动物蛋白确实表现出优势，可能因其氨基酸构成更具合成代谢效应。这正是可消化必需氨基酸评分（DIAAS）工具的适用场景——该评分体系本就是针对存在粮食安全问题、可能仅靠一两种食物获取全部蛋白质的地区开发的。在蛋白质摄入不足的情况下，特别是单一食物来源时，很难论证植物蛋白与动物蛋白等效或更优。

The only two clinical trials that I'm aware of, and I look at this data all the time pretty closely, so I don't believe there's any others that have looked at comparing plant protein to animal protein at those levels that you just mentioned, 1.5 to two grams, and looking at muscle size and strength are the two studies that I mentioned where they showed no difference. Where I think those conclusions in that paper are probably coming from are that when you look at feeding studies in the context of low protein diets, where total protein across the day is not where we would say is optimal, animal protein does seem to be superior and seems to be more anabolic and probably because of the amino acid makeup. And that's where I think the digestible indispensable amino acid score, the DS kind of scoring profile that's often used, that's where I think that tool was really developed for parts of the world where there is food insecurity and you may be getting all of your protein from, you know, one or two sources of food. And when you're doing that and you're under consuming protein, it's very hard to create an argument that plant protein is equal or superior to animal protein because animal protein has a better amino acid complex if you're under consuming protein, particularly from one food.

这点无可辩驳。但就在今年，著名蛋白质研究者Luke Van Loon发表了一项由牛肉行业资助的研究——按理说他们最希望证明...

That's kind of undeniable. But even as recent as this year, and Luke Van Loon published a study, who's a big protein researcher. And this study was funded by Beef Chekhov. So if anything Yeah. If anything they wanted out of

行业资助的。

funded by the industry.

我不认为这直接意味着研究不可靠。Luke Van Loon的科研工作非常出色。但至少该研究团队的假设原本是动物蛋白应占优——通常这正是行业资助的动机。而他们在存在合成代谢抵抗的老年人群体中发现...

I don't necessarily think that that immediately means this is a bad study. I think Luke Van Loon does incredible studies in science and is a great scientist. But if anything, at least at least the hypothesis from this group was that animal protein should come out superior. And usually that's why the industry would like to support it. What they found, and this was in elderly who, you know, again as you mentioned, there is anabolic resistance.

我们原以为老年人可能最受益于动物蛋白——在健康中年群体中或许看不出差异，但年龄增长后可能显现重要性。这改变了我的部分观点：在蛋白质摄入量为1.1-1.2克/公斤的情况下，他们对活跃的健康老年受试者进行每日肌肉蛋白质合成率检测，发现杂食与纯素饮食无显著差异，这挑战了研究团队的假设。需要承认的局限是：这只是个9-10天的研究。下一步应该像我之前提到的那些10-16周的长期研究那样，实际测量老年人的肌肉体积和功能变化。

So we would think that if anyone is really going to benefit from animal protein over plant protein, maybe you don't see it in healthy middle aged adults, but maybe it becomes more important as you get older. And this is where my view has changed a bit. They had protein intake at 1.1 to 1.2 grams per kilogram, and they were using elderly, healthy adults that were active and looking at daily muscle protein synthesis rates, and no significant difference between an omnivorous diet and a vegan diet, which kind of challenged their group's hypothesis. Now where I'll say the gap is, and we have to acknowledge this, that's a nine to ten day study. The next step is to take elderly and run like the studies I mentioned before that go for ten, twelve weeks, maybe sixteen weeks, and actually measure muscle size and function.

那么看看力量和这些关于能量的要素，我们之前讨论过的那些关注点，确认一下机制层面的发现。因为如果我现在的说法与之前矛盾就太打脸了。肌肉蛋白质合成是一种机制对吧？这是一种机制。而我们在9到10天内没观察到差异。我们真正关心的健康结果的实际影响是什么？净效应如何？

So look at strength and these things that power, these things that we care about that we were talking about earlier, and just confirm that, okay, what we're seeing in terms of a mechanism, because I would be really contradicting myself to what I said earlier. Muscle protein synthesis is a mechanism, right? That's one mechanism. And we see in the nine to ten days no difference. What's the actual effect on health outcome that we care about the net effect?

要评估这点就需要更长期的研究。所以对我来说这是保持开放心态的观察点。可能老年人在每公斤1.1到1.2克蛋白质摄入量时没有差异，也可能存在差异。

And in order to assess that, you need a longer study. So that's a watch this space for me in terms of stay open minded. It could be that there's no difference in elderly at one point one to one point two grams per kilo. It could be that there is.

他们使用的是哪种蛋白质形式？因为考虑到天然食物蛋白质，比如一小块鸡胸肉约120卡路里含30克蛋白质。但要从豆类（如黑豆）获取30克蛋白质，需要约500卡路里。这几乎是...

What was the forms of protein they were using? Because when you think about, you know, whole food protein, right, a little porn chicken breast has got about 120 calories, 30 grams of protein. But to get 30 grams of protein in beans, with like black beans or whatever, that's about 500 calories. So you're having almost, you know, Little five less,

稍微少一点。但这是

little less. But it's

大概三四五倍的样子。这仍然意味着要多摄入很多卡路里。那么为了摄取足够蛋白质，是否会摄入过多热量？如果没有，是否意味着唯一途径就是使用加工过的浓缩植物蛋白？

like like three, three hundred four, five times whatever. It's still, it's a lot more calories. So in order to consume enough protein, are you consuming too many calories? And if you're not, does it mean you the only way you can get there is using concentrated plant proteins that are processed?

我认为很多这类研究中，如果你观察那些摄入中高蛋白的植物基饮食群体，黑豆小扁豆并非主要蛋白质来源。它们更多是作为提供部分蛋白质和碳水化合物的配菜。更高蛋白密度的食物是豆腐、天贝、面筋（适合耐受者）。现在开始流行的微蛋白——其实不算植物基，源自真菌，富含蛋白质、纤维和铁。你会看到更多应用，Alastair Montaigne试验中就使用了大量这种蛋白。

I think a lot of these studies, and I think if you were to go out and look in like a plant based community of people that are eating moderate to high protein, legumes like black beans and lentils are not a go to source of that There are sort of supplementary food on the side that offers some protein and some carbohydrates, but the more protein dense kind of foods would be tofu, tempeh, seitan for people that can tolerate gluten. Microprotein's like a big one that's now starting to become very popular, is they're actually not plant based, it's derived from fungi, and is incredibly rich in protein and fiber and iron. So you'll start to see more of that. That was actually used in the Alastair Montaigne trial. They used a fair bolus of that.

而我提到的Hamilton Rochelle试验中，健康成年人组：杂食组用乳清蛋白补充天然食物，纯素组用大豆分离蛋白补充，但蛋白粉用量相同。

And in the other one, the Hamilton Rochelle trial that I mentioned, the healthy adults, they in the omnivorous group, used whey protein to supplement their whole food. And in the vegan group, they used a soy protein isolate to supplement their food, but the same amount of protein powder.

但他们没有额外添加氨基酸或其他成分到

Not but they didn't add extra amino acids or anything to

大豆蛋白里。他们没有强化亮氨酸等成分，这很有趣，因为理论上可能需要这样做。但数据显示，在1.1-1.2克（短期研究）和1.6克（长期研究）的蛋白质摄入水平下，动物蛋白与植物蛋白的合成代谢潜力没有差异。Alan Aragon几周前在Huberman节目里对此做了精彩解析。

the soy protein. They didn't do any fortification of leucine or anything like that, which is interesting because you might hypothesize that you would need to do that. Yeah. But what you're what we're seeing is that, again, once you're up to 1.1 to 1.2, at least in those short term studies, and then 1.6 in those longer term studies, that at those level that level of protein intake, we're not seeing a difference between the anabolic kind of potential of the animal protein and the plant protein. Alan Aragon actually beautifully walked through this on on a Huberman show, like, a few weeks ago.

哦，真的吗？

Oh, really?

是的，这确实很有挑战性。我理解。说实话，马克，我曾经是个十足的肉食爱好者。

Yeah. And it's challenging. I get it. Like, I Mark, I was one of the biggest meat eaters, honestly. That my French

澳大利亚，所以它

Australia, so it's

基本上我就是那个总组织牛排馆聚餐的人。那曾是我唯一想吃饭的地方。因此我理解这点，因为我认为过去十到十五年间，动物蛋白最有力的论点一直是它对肌肉相关效果更有利。

basically I was the dude who was organizing all the steakhouse dinners. It's the only place I would ever want to eat. And so I understand that because I think the strongest argument for animal protein over the last ten or fifteen years has been that it's better for muscle related outcomes.

因为

Because

老实说，针对慢性疾病的研究往往更支持植物蛋白，对吧？因为你能额外获得增加纤维、植物化学物质和可能更健康的脂肪构成的好处。现在我们处于这样一个境地——我认为很有挑战性——因为社会上有许多人爱吃肉，这没问题，我认为肉类可以是健康饮食的一部分。但作为科学家和追求客观的人，我们也必须对这些研究结果保持开放态度。就像我说的，如果他们进行一项十二周的研究，证明食用动物蛋白的老年人在力量和肌肉增长方面表现更好，我愿意承认错误或改变观点。

to be honest, the research looking at more chronic disease, it tends to favor plant protein, right, because you get the added benefit of increasing fiber and phytochemicals and probably a healthier fat profile. Now we are in this position where I think it is challenging because a lot of our society loves to eat meat and that's fine, I think meat can be part of a healthy diet. But also as scientists and people that want to be objective, have to stay open minded to what these studies are showing us. And like I said, I'm prepared to be wrong or to change my view if they do a twelve week study and show that people eating the animal protein, the elderly, had better strength and hypertrophy?

我见过的所有研究通常都显示相反结果。所以我希望看到这些研究被复现，因为它们很有趣，但这是否与其他所有数据相符？我认为审视任何科学问题时，不能只看单项研究，还要看它如何融入从基础科学到观察数据再到随机试验的整体文献背景。而且要知道这些研究的质量如何？

Those are all the studies I've seen. It typically shows the opposite. And so I would like to see those studies replicated because they're interesting, but then does it comport with all the other data? And I think when you're looking at any kind of scientific question, you've got look at not just one study, but how does it fit in the context of the overall literature from basic science to observational data to randomized trials? And you know, what are the quality of the studies?

研究方法是什么？统计功效如何？这很复杂。即使作为医生或科学家，要弄清这些答案也很困难，甚至可能根本没有能回答这个问题的正确研究。这是另一个问题。

What is the methodology? How are they powered? I mean, complicated. Even as a doctor or a scientist, like it's hard to figure these answers out and we might even have the right studies to answer the question. That's the other problem.

正因如此，那些长期健康结果研究变得极为重要。是的，你提到的那些研究确实存在，但背景饮食是什么？他们是否优化了全天蛋白质摄入量？还是处于低蛋白摄入状态？在后一种情况下，动物蛋白的优势已相当明确。真正让我感兴趣并改变我对蛋白质看法的是分布问题。长期以来...

And that is where though that these, the longer term health outcome studies become really important because, yes, like, the studies that you're referring to, they they exist, but what's the background diet? Are they are they actually optimized their overall protein intake for the day or are they at a low protein intake where I it's pretty established that animal protein is probably gonna be superior in that context. What's really interesting to me that I think also is changing the way I look at at protein is the distribution question. So I think for a long time

你是指全天分布吗？

When you mean it throughout the day?

没错。长期以来人们认为，将25-30克蛋白质分散在全天多餐中无疑是更优策略。但至少目前数据显示——包括我提到的尼古拉斯·伯德的研究——该研究不仅比较了纯素与杂食对肌肉蛋白质合成的影响，还考察了两种分布模式：不均衡与均衡。他们观察了一天五餐的均衡分布，以及早餐10%、午餐30%、晚餐60%的不均衡分布。

Yeah. For a long time, it was thought that, you know, having, you know, 25, 30 grams and spacing it out into all these different meals throughout the day is definitely the superior strategy. And at least what's being borne out in the the data now, and one of those studies that I mentioned there, the Nicholas Byrd study, not only compared it vegan to omnivorous looking at muscle protein synthesis, looked at two different distributions, uneven and even. So they looked at one where they had five meals across a day, even distribution, and then the other was uneven. So they only had 10% of protein at breakfast, 30% at lunch, and 60% at dinner.

他们这样做的原因在于，这往往反映了美国的蛋白质摄入情况。因此他们关注的是：动物蛋白与植物蛋白是否存在差异？但或许这种差异只有在不均衡分布时才会显现。然而他们并未发现这种差异。事实上，无论是跨组比较还是同组内部比较，即使在蛋白质摄入不均衡的情况下，每日肌肉蛋白质合成率也没有差异。

And the reason they did that is that that tends to reflect protein intake in America. And so they were interested in, okay, there a difference between animal and plant? But also, maybe there is a difference, you only see it in an uneven distribution. And they didn't see it. And in fact, across both groups, even comparing to the same group, there was no difference in daily muscle protein synthesis rates even in an uneven distribution.

所以我认为，如果真要深究细节，蛋白质的分配方式或许有些影响，但远不及你摄入的蛋白质总量重要。

And so I think if you were to get really into the weeds, distribution might matter, but it matters far less than the total amount of protein that you eat in

我的理解是，这对未适应力量训练的人影响更大。如果你的肌肉已经处于激活状态，并且你习惯了力量训练和增肌，那么蛋白质的分配时间就不那么重要。但如果不适应，分配方式就更关键。这个说法正确吗？

a day. My understanding was that it mattered more for those who are not adapted to strength training. So if you, if your muscles are already sort of kind of on and you're used to strength training and used to building muscle, that it doesn't matter as much when you distribute your protein. But if you're not, it matters more. Is that, is that true?

我还没见过相关研究，不过这很有趣。如果有相关论文请发给我看看。

I haven't seen that, but I mean, it's interesting. I'd love to read about it if I sent me a study.

这是部分蛋白质代谢研究的内容，但确实很吸引人。好的，那么我们基本上需要比RDA（推荐膳食摄入量）更多的蛋白质——尤其是随着年龄增长。RDA只是避免蛋白质缺乏的标准，而这其实不是大问题。第二，你可以通过植物蛋白达标，但需要某种浓缩的补充蛋白质，这正是我担心的。比如你不需要乳清蛋白，如果摄入动物性食物就能获取足够蛋白质。

That was some of the protege work, but it was fascinating. Okay. So so we need basically more protein, especially as we age than the RDA, which is how much you need to not become protein deficient, which is not really a big problem. Two, you know, you can get there with plant proteins, but you need to have some type of supplementary protein that's concentrated because that that's what worries me. Like you can get you don't have to have whey protein if you're eating animals, right, in order to get enough protein.

但你是否必须食用加工豌豆蛋白或大豆蛋白（可能带来其他影响）才能获取足量蛋白质？还是通过食用豆类、谷物、坚果和种子就能满足需求？

But do you have to eat a processed pea protein or a processed soy protein, which may have other consequences to get the adequate amount of protein? Or can you get it by eating beans and grains and nuts and seeds?

如果摄入足够量的豆腐、天贝、面筋、真菌蛋白等新型植物基或真菌基蛋白是可以的。但我要说，很多杂食者确实在补充乳清蛋白，这很普遍。我认为即使是乳清蛋白或豌豆蛋白，只要通过NSF认证、有第三方检测、重金属和违禁物质检测合格、标签成分真实，就不失为合理选择。

You can get it if you were eating enough tofu and tempeh and seitan and and mycoprotein and these kind of some of these more novel types of of plant based or or fungi based, protein. But I would say, I think a lot of people that are eating an omnivorous diet are definitely supplementing with a whey protein. I think it's pretty common. And I don't necessarily think it's a bad it's a bad choice even if it's a whey protein or a pea protein. If Particularly now if it's like NSF certified, know that there's third party testing, it's tested for heavy metal contaminants, it's tested for banned substances and what they say is in it on the label is actually in it.

如果能通过这类审核找到合格的蛋白质产品，对需要增加蛋白质摄入的人（尤其是食欲减退的老年人）会非常便利。我不想吓阻人们使用蛋白粉补充饮食，但它应该像我们之前讨论的那样——作为膳食的补充而非替代。

I think if you can go through that kind of process and find a protein that ticks those boxes, it can be a very convenient way for someone to increase their protein intake, particularly as people are aging, often their appetite goes down. So I don't want I don't wanna necessarily scare people from supplementing their diet with protein powder, but I think it needs to be it's it's complementing and supplementing a diet like we spoke about before.

嗯，是的。

Mhmm. Yeah. Yeah.

对吧？如果你吃的是超加工食品...（停顿）那很糟糕。如果还特意购买高蛋白超加工食品...在我看来这根本算不上优化。

Right? If you're eating a an ultra processed style diet Really good. That's bad. And you're going out of your way to buy high protein ultra processed foods Yeah. That's that's to me, that's not optimization.

尽管主要是蛋白棒，但看着它们就会想，哦，那简直是最垃圾的加工食品。我记得我以前绝不会吃那种东西。

Even it's mostly protein bars, look at them and go, oh, that's like the most processed crap. I remember I would never eat that.

说实话，回到我之前提到的椰子话题。嗯。我现在正在为马拉松训练。其中一个——我不知道用‘后果’这个词是否准确——但现实情况是我必须大幅增加卡路里摄入来支撑训练。所以我做的一个改变就是添加了这种椰子酸奶。

And to and to be honest, back to the coconut thing that I mentioned earlier. Mhmm. So I'm training for a marathon right now. And and one of the the I don't know if consequences is the right word, but one of the realities of that is I have to increase my calorie consumption by quite a bit in order to fuel my training. And so one of those, the changes that I made was to add this coconut yogurt.

而这原因正显示出我们如何都可能沦为高蛋白宣传的受害者。

And the reason, and this shows like how all of us can be kind of fall victim to the high protein messaging.

是啊。是啊。是啊。

Yeah. Yeah. Yeah.

当时我选择了一款高蛋白椰子酸奶。嗯。我完全没意识到在获取那8克蛋白质的同时，伴随着椰子油烹饪，摄入了多少饱和脂肪。所以对我来说，那不是增加蛋白质含量的最佳方式。

The the reason was I I chose a a high protein coconut yogurt. Mhmm. And I just didn't that and and then cooking with coconut oil, I didn't realize how much saturated fats were coming along for the ride in that coconut yogurt with the eight grams of protein. And so for me, that was not an optimal way to increase my protein content.

这很有趣。记得二十年前参加功能医学研究所会议时，有个讲座让我印象深刻。那是美国国立卫生研究院一位研究大豆的学者做的。因为当时我们都认为大豆有害，含有雌激素。

It's interesting. You know, I remember hearing a lecture when I went to the Institute for Functional Medicine conferences twenty years ago, it really stuck with me. And it was a researcher from the NIH who was studying soy. Because you know, we were, soy is bad. It's like estrogen.

说什么会导致乳房发育啦，可能致癌啦。如果你问大多数治疗乳腺癌的肿瘤医生，他们会建议患者不要吃豆制品——这简直是我听过最蠢的建议。他们会说‘吃冰淇淋可以，但别碰豆制品’。事实并非如此。

It's going to give you breasts and blah, blah, blah. And it maybe cause cancer. And if you talk to most oncologists who take care of people with breast cancer, they tell people not to eat soy foods, which is the stupidest thing I've ever heard. They say, Eat ice cream, but don't eat soy foods. It's not actually like that.

大豆更像是一种调节剂，能温和调控激素而非刺激它。但那位研究者指出，在动物模型中使用分离大豆蛋白（就是那些蛋白质研究中用的）与完整豆制品相比，对癌症的影响截然不同。基本上，作为大豆油副产品的分离大豆蛋白算是废料，被制成各种大豆蛋白粉、蛋白棒之类。而这种水解大豆蛋白在化学结构上与天然大豆蛋白不同，动物实验中与某些癌症结果相关。

There's more like a regulator, like a sort of modulates hormone, not stimulates it. But what he said was really interesting, was when they studied in animal models, giving isolated soy protein, which is what, or it was done in these protein studies, versus whole soy foods, they have profoundly different effects, particularly on cancer. And that the basically soybean protein that's comes from, you know, as a byproduct of making soybean oil, is kind of a waste product. And it's turned into these soy protein shakes or soy protein bars or soy protein whatever. And that that hydrolyzed soy protein is chemically different than soy protein and linked to these cancer outcomes in animal models.

所以这让我有点担心。

So that makes me a little worried about that.

确实。你没必要摄入分离大豆蛋白。乳清蛋白其实也是乳制品工业的副产品，两者在这方面很相似。

Yeah. You don't have to consume, soy protein isolate. Whey protein's also a bit of a waste product as well from the dairy industry. So they're kind of similar in that.

凝乳和乳清，就像小玛菲特小姐的故事。酸奶是凝乳，而乳清就是那些小液体。不过

Curds and whey, it's like Little Miss Muffet. The yogurt is the curd and the whey is the little liquid on But

你并不需要摄入大豆分离蛋白。还有其他形式的植物性蛋白质。关于大豆与癌症的关系，目前的指南确实没有建议人们为避免癌症或癌症患者远离大豆食品，但他们确实指出——我认为这对人们很重要——不要服用大豆异黄酮补充剂，这些补充剂在网络上相当流行。那种高度浓缩的大剂量异黄酮，目前没有证据支持推荐给人们，而且对癌症患者可能有害。

you don't have to consume soy protein isolate. There are other forms of plant based proteins. And I think on the soy kind of cancer relationship, I mean, guidelines now certainly are not telling people to avoid soy foods for preventing cancer or whether they have cancer, but they do say, and I think this is important for people to know, not to take soy isoflavones supplements, which have become relatively popular. You'll find them all over the internet. So having that very isolated high dose of isoflavones, there is no evidence right now to recommend that for people, and it could be deleterious for someone who has cancer.

所以我认为这一点值得区分。但大豆全食品本身，我们看到与癌症风险至少是中性的或正面的关系。如果你看某些亚洲队列研究，在那些摄入最多全大豆食品的地区，乳腺癌风险较低。但我想说的是，如果你不想摄入大豆分离蛋白，现在有这么多其他选择。是的。

So I think that's worth kind of, differentiating. But soy whole foods themselves, we see a neutral or a positive relationship for at least for risk of cancer. And if you look at certain Asian cohort studies, they have a lower risk of breast cancer in the parts of the world where they consume the most whole soy foods. But But I guess the point being there is like, if you don't want to consume a soy protein isolate, there's all these other options now. Yeah.

回过头来看，它是否经过NSF认证，第三方测试，找一个成分不多的好产品。

And come back to like, is it NSF certified, third party tested, and just find a find a good one that doesn't have a lot of ingredients.

是的。太有趣了。你知道，这次对话真是太棒了。我想，听这个的人都能感觉到，科学真的很难驾驭，即使对我们这些毕生致力于此并力求诚实的人来说也是如此，因为它不断变化，营养学总有妖魔化的对象和宠儿。现在，海狗被妖魔化，而蛋白质是宠儿。

Yeah. Fascinating. Well, you know, this has been such an incredible conversation. I think, you know, you can tell from the listening to this that the science is really hard to navigate through, even for people who spend their lives like you and I trying to think about it and be honest about it because it's constantly shifting and there's always a boogeyman in nutrition and there's always the darling of nutrition. And right now, sea dogs are the boogeyman and protein is the darling.

我想我们讲得挺清楚了。希望听完后你能明白底线是什么。也许你可以为大家总结一下底线。他们应该怎么做？应该吃什么？

I mean, I cover, I think we cover those pretty well. Mean, hopefully you understand after listening to this, what, is the bottom line. So maybe you kind of summarize the bottom line for people. Like, what should they do? What should they be eating?

如果你想，听完这个播客后回家，在脂肪和蛋白质方面做对自己正确的事，你会告诉人们什么？

And if you want to, you know, go home and after listening to this podcast, you know, do the right thing for you when it comes to fats and protein, what would you tell people?

我真心建议从地中海饮食模式开始，甚至北欧饮食，比如丹麦的饮食指南。这些饮食模式的重点是全食物。

I would honestly start looking at the Mediterranean dietary pattern or even the Nordic diet, like the Danish dietary guidelines. These are dietary patterns where the focus is on whole foods.

A

A

鲱鱼。是的。相比标准美国饮食，这些饮食中超加工食品更少，纤维更多，富含欧米伽3的脂肪鱼也更多。

herring. Yeah. There there there is a compared to a standard American diet, there's less ultra processed foods. There's more fiber. There's more omega threes, fatty fish.

更强调深色绿叶蔬菜的摄入。如果要吃谷物，就选全谷物。坚果和种子也是重点。这样你就有了基础框架。就像我之前说的，你可以根据需求调整。

There's more emphasis on dark leafy greens. And if you're going to consume grains, whole grains Yeah. Nuts and seeds. And from there, now you have a basis. And like I said earlier, you you can you can tweak that to suit your needs.

你是运动员想高碳水，还是想走低碳水高脂肪路线？但脂肪来源要偏向富含脂肪的鱼类、牛油果、夏威夷果、坚果种子和橄榄油，这样能获取大量单不饱和与多不饱和脂肪。这和网上某些动物性饮食方案有所不同。在此基础上要注意蛋白质摄入。建议花一周记录饮食——这是个好方法，因为很多人根本不清楚食物中的蛋白质量——看看实际摄入情况。

Are you an athlete and wanna go higher carb, or do you wanna go more down the low carb direction and go higher fat? But the bias for the fats there is gonna be from fatty fish and avocado and macadamias and nuts and seeds and olive oil, So you're gonna have a lot of these monounsaturated and polyunsaturated fats. It's a little bit different to how you might see a an animal based diet online sometimes now. Within the context of that, be protein aware. You might want to, for a week, just log your food, which I don't think is a bad exercise because a lot of people are not really sure how much protein is in their food at all, and just see where you land.

在这个框架下，你是否达到每公斤体重至少1.2克蛋白质？能做到这点就满足了很多要求。有时我们容易钻牛角尖导致裹足不前，所以我建议先从这里入手，把这些基础打好。

Are you at at least 1.2 grams per kilogram within that context of that theme? And if you're doing that, you're ticking a lot of boxes. And I think sometimes we can go into all these rabbit holes and people get paralyzed and make no change. So I would say start there. Get all of that in play.

这不像迈克尔·波伦说的'吃食物，别太多，以植物为主'那么简单。

It's not like Michael Pollan, eat food, not too much, mostly plants.

但这个方法有效。关键是...

But it works. And here's the thing.

只吃真正的食物。

Only eating real food.

真正的食物。但马克，只有长期坚持且不追求完美才有效。如果苛求完美只坚持几周，对降低慢性病风险毫无帮助。所以要对自己宽容些，对吧？

Real food. But Mark, it only works if we are consistent with it and imperfect. If we try and get this thing perfect, and we go and do it for a couple of weeks, that's not going to make a dent in our chronic disease risk. So have some grace for yourself. Right?

尽量落实这些原则，找到让你当下感觉良好的方式。同时实现你的各项目标。配合抗阻训练来补充完善。

Try and get as much of that into play as possible. Find a way that leaves you feeling good today. Mhmm. And you're achieving whatever goals it is you have. Supplement it, complement it with resistance training.

我们还没谈到其他训练形式，比如增强式爆发力训练、有氧运动等。要把健康的其他方面也纳入生活，比如良好的人际关系。

We didn't even get into the other forms, but the plyometric kind of power work, aerobic training, get all the other aspects of, you know, health in play, like good relationships.

是啊，都是很基本的东西。

Yeah. Pretty basic stuff.