#2210 - 卡利·米恩斯与凯西·米恩斯医学博士

塑料制品并不会同样刺激睾酮分泌。

It's not like the plastics are also stimulating testosterone.

所以环境中充斥着这些雌激素。

So you've got these estrogens.

然后我们又被糖分包围，甚至孩子们的校园午餐里也满是糖。

Then we're barreled with sugar and it's literally like it's in our kids school lunches.

糖无处不在。

There's sugar everywhere.

糖分促使儿童内脏脂肪堆积，将雌激素转化为睾酮。

Sugar is driving the visceral fat in kids, is turning estrogen to testosterone.

我们仿佛生活在一个使人女性化的世界里，这会导致女孩青春期提前。

So it's like we live in a world that's basically feminizing us, which for women that's going to make puberty early.

对男性而言，则会使其女性化。

For men, it's going to feminize them, you know.

此外，整个食品体系也在促使内脏脂肪堆积，让我们体内雌激素更为富集。

And then we also have an entire food system that's driving visceral fat to make us more estrogen sort of rich.

这会造成什么影响？

And what is this doing?

我认为这在很多方面正在削弱美国的活力，对吧？

I think in a lot of ways, it's depleting American vigor, right?

就像我们生活在这种难以摆脱的雌激素环境中。

Like we're living in this estrogen stew that's hard to get away from.

我认为我的经验与此相关，从根本上说，之所以发生这种情况，是因为这些研究都是由化工公司和食品公司资助的。

This is where I think my experience ties is that on the foundational level why this is happening, it's because these studies are all funded by the chemical companies, by the food companies.

我们几乎被专家误导了，在慢性病和营养问题上，我们放弃了常识判断。

Like like, we've almost been, I think, misled by the experts when it comes to chronic conditions and when it comes to nutrition to take leaves of our common sense.

难道我们需要等待一项双盲安慰剂对照的人类随机对照研究，才能知道我们大脑中有0.5%是塑料成分是否对当下有利吗？

Like, do we need to wait for a double blind placebo controlled human randomized controlled study to know whether point 5% of our brains being plastic is a good thing right now.

最新数据显示。

It's the recent data showing.

难道我们需要进行一项为期十年的人类随机对照研究，才能确定像草甘膦这种喷洒在我们几乎所有食物和儿童食物上的除草剂——喷洒时需要穿着防护服，并且会杀死所有内部生物——是否有害吗？

Do we need to have a human randomized control ten year study to know whether an herbicide like glyphosate that's being sprayed on almost all of our food and our children's food that people have to wear hazmat suits to spray and kills every single organism inside?

我们是否需要等待一项研究？

Do we need to wait for a study?

就像医疗系统被割裂一样，我们也割裂了这些问题，完全抛弃了常识。

Like like, we've been we've we've just as the medical system is siloed, we've siloed all these questions and just taken leave of our common sense.

野生动物，比如野外的狼群，并不会普遍患上肥胖症、糖尿病或代谢功能障碍。

Like animals in the wild, wolves in the wild are not getting, like, chronic rates of obesity, diabetes, metabolic dysfunction.

我们天生就具备辨别有益事物的本能——知道阳光有益，牛排有益，西兰花有益。

Like, we're born with an innate sense of of knowing what's good for us, of knowing that the sun is good, of knowing that, you know, steak is good, that broccoli is good.

这些食物我们不可能过量食用。

We can't overeat those things.

问题在于我们被哈佛、斯坦福和塔夫茨营养学院的教授们欺骗了，根据我的观察，这些机构本质上就是食品行业和制药行业的公关部门，它们把这一切当作既定事实全盘接受。

The problem is we've been lied to by the professors at Harvard, at Stanford, at Tufts Nutrition School that I believe are essentially, from my experience, PR for the food industry and the pharmaceutical industry that accepts all these things as a given.

塔夫茨营养学院80%的预算来自食品公司。

I mean, Tufts Nutrition School, 80% of their budget is from food companies.

据我们估算，斯坦福医学院50%的预算直接或间接与制药业有关。

You know, by our estimate, 50% of Stanford Medical School's budget comes somehow touches pharma.

从根本上说，在基层、微观层面上，这些行业已经侵蚀了我们信任的机构，并引导我们走向歧途。

So just fundamentally, like, on the on the grassroots, like, micro level, these industries have co opted our institution of trust and led us to be.

你问为什么只有我们在发声？

And you ask why we're the only people speaking out?

因为我们已经让循证医学真正接受了所有这些疾病不断滋生蔓延的事实。

Because because we've made it that evidence based medicine really accepts all this disease growing and happening.

而目前95%的医疗支出都用于疾病发生后的治疗。

And 95% of medical spending right now is on disease once it's happened.

这些支出用于管理病症。

It's on managing conditions.

在我们社会中，没有比美国国立卫生研究院、食品药品监督管理局、哈佛医学院、斯坦福医学院更受信任的机构了。

And there's no higher levels of trust in our society than the NIH, than the FDA, than Harvard Med School, than Stanford Med School.

所以所有这些机构都在强化这种模式。

So all of them are enforcing this.

而真正耐人寻味的是他们关注的重点所在。

And then it's really just interesting where their emphasis is.

比如，我前几天刚读到加州医疗委员会正在检查医生的执照，如果医生开具五份疫苗豁免说明，就会对他们进行审查。

Like, I was just reading the other day that California, the medical board, is checking the licenses of doctors, putting them under review if they write five vaccine exception notes.

如果你在疫苗问题上偏离正统观点，几乎就会面临吊销执照的风险。

You literally are, like, on the verge of losing your license if you even go outside the orthodoxy on vaccines.

但这种程度的重视体现在哪里？

But where is that level of emphasis?

这种程度的关注体现在哪里？

Where is that level of focus?

在儿童代谢健康和儿童营养方面，这种严格程度又在哪里？

Where is that level of rigor around metabolic health for kids, around nutrition for kids?

对吧？

Right?

我认为儿童感染小儿麻痹症确实是大事，但现在有50%的青少年超重或肥胖。

I think it is a big deal, like, of kids getting polio, but, fifty percent of teens are obese or overweight right now.

比如，我们的糖尿病前期发病率正在飙升。

Like, we have prediabetes skyrocketing.

医疗系统确实知道如何集中精力处理某些问题。

Like, the medical system knows how to focus on something.

他们知道如何告诉国会，为了某些事可以不惜一切代价。

They know how to tell congress that there's no cost too high for something.

当涉及药物干预时，我们正在用让国家破产的方式治疗已患病的人群。

Like, when it comes to pharmaceutical interventions, we're bankrupt the country with interventions once people get sick.

我真心认为——这也引出了解决方案——其实这是个关于人们觉醒的乐观故事，为什么我们现在处于生死存亡的紧要关头。

Like like, I truly believe, and this gets to, like, the solutions and how I actually think this is an optimistic story of people waking up, why it's an existential kind of knife's edge we're on right now.

我们可以迅速改变现状。

We can change this really quick.

非常迅速。

It the quick.

问题在于那些从我们的恐惧中获利的利益集团——这本质上是个经济事实陈述——他们从我们的疾病中获利，从我们的抑郁中获利，从我们的不孕不育中获利。他们篡夺了我们信任的机构，篡改了临床指南。

The issue is that interest that profit from us being in fear that just fundamentally is a statement of economic fact, profit from us being sick, profit from us being depressed, profit from us being infertile, They have co opted our institutions of trust, and they've co opted the clinical guidelines.

说真的，当我还是个初级员工时，曾协助可口可乐向美国糖尿病协会输送资金。

Like, literally, when I was a junior employee, I helped Coke funnel money to the American Diabetes Association.

好吗？

Okay?

美国糖尿病协会声称糖尿病患者无需担心糖分摄入。

The American Diabetes Association says that if you have diabetes, you don't need to worry about your sugar intake.

他们说这与饮食无关。

They say it's not tied to food.

对吧？

Right?

美国儿科学会目前建议，若您的孩子12岁且体重超标，无论是轻微还是明显超重，都不应等待饮食干预。

The American Academy of Pediatrics right now is saying that if your child is overweight, slightly overweight, overweight, 12 years old, dietary infringits don't wait.

它明确指出不要观望饮食干预是否有效，直接使用Ozempic。

It says do not wait to see if dietary infringits work Ozempic.

该药物目前正针对六岁儿童进行试验。

It's now being studied on six years old.

美国精神病学协会。

The American Psychiatry Association.

对吧？

Right?

精神病学标准指出，如果你的孩子有点抑郁，应立即使用SSRI类药物进行干预。

The psychiatrist that the standard of care, if your child is a little sad, SSRI, immediate intervention.

对吧？

Right?

过去五年里，高中生使用SSRI类药物的比例翻了一番。

SSRI rates have doubled among high schoolers in the past five years.

对吧？

Right?

如果你的孩子有点多动，这就是标准治疗方案。

If your child's a little fidgety, the standard of care.

对吧？

Right?

他们不问孩子是否缺乏日照，不问是否久坐不动，不问是否被强迫食用超加工食品——这些足以让任何生物发狂，而我们却让孩子承受着这些。

It's not asking whether they're in the sunlight, not asking if they're too sedentary, not asking if they're being forced fed ultra processed food, which would make any animal crazy if we subject them to what kids are subjected to.

对此没有讨论的余地。

No discussion with that.

这根本不在临床指南里。

It's just not in the clinical guidelines.

所以像凯西这样优秀的医生进入医疗体系——我们就像吸引聪明人的磁铁。

So these doctors, these good people like Casey, go into the medical system where I we're we're this magnet for smart people.

我们以正确的理由吸引他们加入。

We get them in for the right reasons.

赚钱有更轻松的方式。

There's easier ways to make money.

但他们进来后，就被单一技能束缚住了。

But they come in, and they get saddled with one skill.

他们背负着巨额债务，然后意识到这是个被操纵的体系。

They get saddled with a bunch of debt, and then they're realizing this is a rigged system.

极少数人——不幸的是——像凯西这样有勇气选择退出。

Some people, few people, unfortunately, had the courage like Casey to drop out.

我当时觉得她是个白痴。

I thought she was an idiot.

我当时就想，你在干什么呢？

I was like, what are you doing?

你知道的，我们当时有点被洗脑了，觉得就该走传统路线。

I was you know, we were kind of brainwashed to do the traditional system.

我简直不敢相信。

I couldn't believe it.

我们有一年都没联系。

We didn't talk for a year.

但人们很难理解你可以放弃这一切，因为社会给人们贴上了这些资历标签。

But it just is hard for people to understand that you can walk away from this because our society stamps these credentials on people.

比如，还有什么比当斯坦福医学院院长更好的呢？

Like, what's better than being the dean of Stanford med school?

现任斯坦福医学院院长和凯西是同一个专业，都是做头颈外科的。

The dean of Stanford med school right now was Casey's same specialty, head and neck surgery.

在医学领域晋升的方式就是专精，你专注于面部那几英寸的区域。

And the way you rise up in medicine as you do specialty, you focus on, you know, a couple inches of the face.

然后他又在更狭窄的身体部位进行专科进修。

And then he focused on a fellowship on an even narrower part of the body.

这就是你晋升的路径。

Like, that's how you rise up.

你把情况都分割开了。

You've siloed the situation.

任何未被分割的领域都被认为不科学，被视为古怪离奇。

Anything that's not siloed is considered not scientific, is considered wack wacky.

他们称我们为...那个...‘玄学派’，就因为我们谈论这些营养学。

We they've called us the, what, what, the woo woo caucus, talking about these nutrition.

医疗体系强化了这种割裂的视角——糖尿病、心脏病、抑郁症、肾病、癌症，它们全被看作独立的问题。

The medical system enforces this siloed view where diabetes, heart disease, depression, kidney disease, cancer, they're all separate things.

如果你患有这些病症，你要看五位互不沟通的专科医生。

If you have those conditions, you're seeing five separate doctors not they're not speaking to each other.

这非常有利可图，也非常成问题。

That's very profitable, very problematic.

所以解决方案真正在于改变临床指南——如何评估疾病及如何进行干预——使其遵循科学依据，即这些都是代谢性疾病。

So the solution is is is truly just having the clinical guidelines of how diseases are assessed and how they're intervened changed to following the science, which is these are metabolic conditions.

美国90%的医疗预算都用于管理可预防和可逆转的生活方式疾病。

90% of The US medical budget is tied to managing preventable and reversible lifestyle conditions.

如果我们让享受医疗补助的人，不是给他们开他汀类药物、注射奥兹匹克或SSRIs——要知道低收入人群正因医疗补助而破产，1.3万亿美元啊。

If we had people on Medicaid, instead of jamming with the statins, jamming them with Ozempic, jamming them with SSRIs, you know, lower income people were going bankrupt from Medicaid, $1,300,000,000,000.

这个数字还在增长。

It's growing.

它在预算中的占比甚至超过了国防预算。

It's bigger part of the budget than defense budget.

如果我们真的思考如何用这笔钱来促进繁荣、激励运动、鼓励这些人选择更健康的食物，我们的国家将焕然一新。

If we literally just ask how do we have that money to spur thriving, to incentivize exercise, to incentivize healthier food for these folks, we'd be a transformed country.

道理就这么简单，但这需要道德勇气。

It's it's literally that simple, but it it takes that moral courage.

这需要美国人真正站出来说，不。

It takes Americans actually saying, no.

我要反对美国国立卫生研究院。

I am gonna go against the NIH.

我要提出质疑。

I am gonna ask questions.

但我们当然遭遇了激烈抵制，记得吗，大概是什么时候？

But we of course, we have violent just reading, you know, back would what?

是2022年吗？

Was it 2022?

当时美国所有公共卫生官员都把你当作头号敌人，就因为你谈论阳光、食物和健康饮食。

Like, every single public health official in America said you were, like, the enemy number one for talking about sunlight and talking about food and talking about healthy eating.

新冠是一种代谢性疾病。

COVID was a metabolic condition.

新冠是一种食源性疾病。

COVID was a foodborne illness.

就是说，如果你的代谢健康，你基本上不会死于新冠，这一点相当明显。

Like, if you were metabolically healthy, you did not die of COVID, like pretty demonstrably.

而你曾是头号威胁。

And you were threat number one.

是啊。

Yeah.

请继续。

Go ahead.

嗯。

Yeah.

对。

Yeah.

不。

No.

我觉得卡莉提到的这点也很关键，我认为这也是为什么——幸好现在有很多医生站出来发声，我对这些医生以及其他医疗人员——包括执业护士、骨科医生、脊椎治疗师、护理师等——充满感激，他们勇敢发声却因此遭受很多非议。

I think I think that Callie's getting into something also that I I think is part of reason that why I mean, there are a lot of fortunately, are a lot of doctors speaking out right now, and I have so much, like, gratitude for all the other, not only doctors, but, like, NPs, DOs, chiropractors, nurse practitioners, these amazing people who are speaking up and getting a lot of shit for it.

但这非常具有部落性。

But this is very tribal.

我认为当你思考这个问题时很困难，这是一种不打破公约、不违背规范的本能。

I think that when you think about and it's hard, this is a primal instinct to not break out of the pact and to not go against what the norm is.

所以在很多方面，我们当前面临的问题将归结于：我们是否有足够的勇气推动人类文明回归正轨。

So I think in a lot of ways what we're dealing with here is going to come down to how courageous are we willing to be to move humanity back.

而这里的人类文明，很大程度上也包含地球的健康，因为它们是相互关联的。

And by humanity, very much also the Earth's health because they're interconnected.

它们本就是一体同源的。

They're one and the same.

我们是否有勇气为此挺身而出？

How courageous are we going to be to stand up for that?

还是眼睁睁看着一切从指缝中溜走？

Or are we going to let things slip through our fingers?

说到部落性——我在医学院时有个惊人发现：斯坦福大学曾在我就读期间获得辉瑞300万美元的课程改革资助。

And I think the tribe, when I was in medical school, it's amazing because of the interest and the fact that, you know, Stanford got a $3,000,000 grant from Pfizer while I was there to revamp the curriculum.

而制定临床指南的美国糖尿病协会正从可口可乐和吉百利公司获得数百万美元的资金。

And the fact that the American Diabetes Association that makes clinical guidelines is getting millions of dollars from Coke and Cadbury.

美国糖尿病协会还从美赞臣（生产配方奶粉）、雅培营养（生产配方奶粉）以及生产流感疫苗的疫苗公司那里获得数百万美元。

And the American Diabetes Association is getting millions of dollars from Mead Johnson that makes formula and Abbott Nutrition that makes formula and vaccine companies that make flu vaccines.

比如资金问题——美国国立卫生研究院刚刚报告了8000起与食品和制药行业存在重大利益冲突的案例。

Like the fact that the money I mean, 8,000 major conflicts of interest were just reported at the NIH with food and pharma.

因此在每个层面，医疗指南一旦偏离，医生就面临诉讼风险。而我们所尊敬的美国国立卫生研究院，也充斥着大量利益冲突，医学院校也在接受这些资金。

So at every level, medical guidelines that if you step out of, you are at risk for litigation as a doctor and the NIH, you know, oh, like, you know, this thing that we all respect, tons of conflicts of interest and the medical schools accepting money.

作为实习生，你加入的这个群体只能听到一种声音。

The tribe that then you become a part of as a trainee is a tribe that only hears one thing.

所以我对医生们怀有深切同情，因为我确实经历过医学院教育，却没能学到那些后来不得不自学的知识——那些真正帮助我和他人建立基础细胞健康、获得真正健康的知识。

And so I have a lot of compassion for doctors because I was I did go through medical school and not learn any of the things that I had to learn after to actually figure out how to help myself and others truly generate foundational cellular health to be healthy.

回顾我自医学院毕业后不得不学习的内容，

Like, I just look back at what I've had to learn since medical school.

你知道，我主要学习了器官特异性生理学、药理学，然后在住院医师期间学会了做手术。

You know, I learned about basically organ specific physiology, pharmacology, and then in residency, I learned how to do surgery.

当然，在整个过程中还学会了如何开账单。

And then, of course, throughout the whole thing, learned how to bill.

但这些终究不是真正奠定细胞健康基础的工具。

Is ultimately those are not the tools that actually generate foundational cellular health.

要知道，美国80%的医学院不要求修读任何营养学课程，一分钟都不需要。

You know, 80% of medical schools in The United States don't require a single nutrition course, not one minute of nutrition.

然而我们90%的医疗支出都与疾病有关。

And yet 90% of our health care costs are tied to diseases.

正在折磨美国人生活的种种问题都与食品和医生息息相关。

The things that are torturing American lives are tied to food and doctors.

这不在我们的工具箱里。

It's not a hammer in our toolbox.

我没有学过。

I didn't learn.

我在斯坦福医学院时不知道，美国农业部膳食指南委员会95%的成员都与食品行业存在利益冲突。

You know, I didn't learn at Stanford Medical School that 95% of the people on the USDA Food Guidelines for America Committee had a conflict of interest with the food industry.

我没学到美国国立卫生研究院存在8000项利益冲突。

I didn't learn that there were 8,000 conflicts of interest at the NIH.

我没学到地球上有80亿吨塑料正在降解成雌激素类似物。

I didn't learn that there are 8,000,000,000 tons of plastic on planet Earth that are degrading into estrogen analogs.

我没学到全球食品供应每年要喷洒60亿磅农药——主要来自中国和德国——这些农药与阿尔茨海默症、痴呆症、癌症、肥胖症、线粒体功能障碍、不孕症、多动症和肝功能紊乱存在强烈关联。

I did not learn that there's 6,000,000,000 pounds of pesticides sprayed on our global food supply every single year, most from China and Germany, and that these are literally tied very strongly to Alzheimer's, dementia, cancer, obesity, mitochondrial dysfunction, infertility, ADHD, liver dysfunction.

我没学到每天只需走7000步就能将肥胖、二型糖尿病、阿尔茨海默症、痴呆甚至胃酸反流风险降低40%到60%。

I didn't learn that, you know, simply taking 7,000 steps per day can slash your risk of obesity, type two diabetes, Alzheimer's, dementia, even gastric reflux by forty to sixty percent.

而美国人平均每天只走3500步。

And the average American is walking 3,500 steps per day.

说真的，我们整个国家都缺乏运动。

Like, we're literally just not moving as a country.

只要每天走7000步——大约45分钟——就能显著降低所有主要慢性病的风险。

And if you just walk a little bit 7,000 steps, which takes like forty five minutes, you slash your risk of every major chronic disease.

我没学到人体需要阳光照射，因为昼夜节律生物学主导着我们的细胞健康。

I didn't learn that we need to be getting sunlight because circadian biology dictates our cellular health.

我们作为昼行性动物，其生物过程在白天和夜晚各有不同。

Like we are diurnal animals that have biologic processes that happen during the day and other biologic processes that happen at night.

而身体判断昼夜的方式，是通过光子是否照射到视网膜和皮肤细胞。

And the way your body knows whether it's day or night is if you get photons hitting your retina and your skin cells.

这对人类健康而言非常基础且至关重要。

Pretty basic, pretty foundational for human health.

这些我都没学过。

Didn't learn anything about it.

没学过任何关于阳光的知识。

Didn't learn anything about sunlight.

没学过任何关于光子的知识。

Didn't learn anything about photons.

没学过任何关于睡眠的知识。

Didn't learn anything about sleep.

要知道，我们现在的平均睡眠时间比100年前少了20%。

You know, we're sleeping 20% less on average than we were 100 ago.

睡眠是一个巨大的风险因素。

And sleep is a huge risk factor.

在实验环境下，你可以让一个年轻健康的人连续五晚睡眠不足，他们就会变成糖尿病前期。

You can in an experimental setting, take a young, healthy person and subject them to sleep deprivation for five nights and they become prediabetic.

而50%的美国人都处于糖尿病前期或患有二型糖尿病，我们的睡眠质量却很差。

Well, fifty percent of Americans are prediabetic and type two diabetic and we're not sleeping well.

而我关于睡眠的知识一分钟都没学过。

And I didn't learn not one minute on sleep.

所有这些事情，还有更多。

So all the things and so many more.

当然，关于营养学的内容一点也没有。

And of course, nothing about nutrition.

你知道，马蒂·马卡里谈到过这个，比如，我确实没学到医疗失误和用药错误是美国第三大死因。

You know, and Marty Makary talks about this, like, I certainly didn't learn that medical error and medication is the third leading cause of death in The United States.

我学到的是病人来了，我需要给他们贴上诊断标签并开药。

I learned that patient comes in and I need to label their diagnosis and give them a pill.

所以当我谈到部落主义时，我对那些感到被困住的医生们充满了同情。

So it's when I when I speak of the tribalism, it's like I have so much compassion for doctors who feel stuck right now.

他们被困在一个破碎的系统中。

They're stuck in a broken system.

他们所属的部落教会了他们特定的认知体系。

The tribe that they're a part of has taught them a certain set of things.

数万亿美元的利益集团刻意让他们通过狭隘的视角学习知识。

There are huge trillions of dollars of interest to make the things that they learn a specific myopic lens.

而串联线索是危险的——一旦偏离指南，就可能面临严厉的诉讼甚至公众嘲笑。

And putting together dots is risky because if you step outside the guidelines, you're at risk for intense litigation and potential ridicule.

我就经常被称作伪科学的另类右派，你知道的，那些神神叨叨的议员。

I mean, I'm called pseudoscientific alt right, you know, woo woo caucus all the time.

这确实令人恐惧。

And so that's scary.

我认为从根本上说，这其实更是个意识与灵性问题——我们需要祈祷获得勇气。

And I think that fundamentally, this is again why it comes down to like this is actually more of a consciousness and spiritual issue because it's like we need to pray for courage.

我们需要每天早晨坐下来，决定我们想要什么样的未来。

We need to sit down every morning and decide what we want for the future.

我们想要什么？

What do we want?

我们都是参与者。

We're all players.

我们都很重要。

We're all important.

我们都需要发出自己的声音。

We all need to use our voices.

保持沉默意味着什么？我们想要怎样的未来？又愿意为此付出什么？

Being complicit, like what future do we want and what are we willing to do for it?

并理清我们的优先事项？

And get our priorities straight?

我们的优先事项是房子、房贷、游艇和正在扼杀我们的舒适生活吗？

Is our priority like our house and our mortgage and our boat and our comfortable life that's killing us?

还是说要提升自我，成为未来和地球的守护者，并做出一些更艰难的选择？

Or is it to elevate, to be stewards of the future and of the planet and to make some harder choices?

我想说的一点是，如果有医生在听，我可能是在对信徒说教，但就像另一边的那个部落，你知道，我认为我们都在促进健康，这很美好，人们真的很健康快乐，而且并不那么困难，也不那么昂贵。

And I think one thing I would just say, if there are doctors listening, I'm probably preaching to the choir here, but like this tribe on the other side, you know, that I think we're all in of like promoting health, like it's beautiful and people are really healthy and happy and it's not that hard and it's not that expensive.

在这个努力推动人类迈向更和谐未来的部落里，每个人都受到欢迎。

And everyone is welcome here in this tribe of trying to move humanity towards more harmonious future.

每个人都受到欢迎。

And everyone is welcome.

这是两党共同的。

It's bipartisan.

就像布里格姆说的，这关乎人类团队，而人类团队自然延伸就是地球团队，因为它们是相互关联的。

It's really about like Brigham was saying, like, this is about Team Humanity and team humanity always by extension will be team planet because they're interconnected.

因此，我认为我们需要摆脱那种更像我们过去的、部落主义的人类自我，真正意识到我们需要勇敢。

And so I think we need to break out of that that sort of like more our past, you know, human selves of tribalism and really realize, like, we need to be brave.

我们需要有勇气。

We need to courageous.

我们需要为生命而战。

We need to fight for life.

而当我们开始这样做时，前景是相当光明美好的。

And and it's pretty, pretty bright and wonderful when we start doing that.

我认为大多数人并不了解食品体系存在的问题，关于农药、关于人们如何在医学院学习营养学这些方面。

I don't think most people were aware of the problems in regards to the food system, in regards to pesticides, pesticides, and and in in in regards to, like, how people learn nutrition in medical school.

我认为他们直到大约五六年前才真正意识到这些问题。

I don't think they were really aware of that until about five or six years ago.

我觉得这些观念开始逐渐渗入主流意识。

I think it started to creep into the zeitgeist.

我想在此之前，人们完全信任医生，后来疫情爆发，人们对医疗系统失去了很多信任。

I think before that, people just put all their faith in doctors, and then I think COVID happened, and people lost a lot of faith in the medical system.

他们对美国国立卫生研究院失去了大量信任。

They lost a lot of faith in the NIH.

他们看到了福奇那些自相矛盾的视频，说什么你不会感染新冠，还有雷切尔·玛多那些鬼话。

They they saw all the contradictory videos of Fauci saying, you know, you're not gonna catch COVID and Rachel Maddow and all that shit.

然后你就会想，天啊。

And you're like, oh my god.

这整个系统都是被收买来促进利润的。

This is all a bought and paid for system to promote profit.

而且

And

是啊。

Yeah.

我想贾马尔稍微提到过这个，但我觉得这非常重要，因为没人意识到——很多听众几年前听我们讲时，会觉得这听起来像阴谋论。

I think I think Jamal talked a little bit about this, but I think it's so important because nobody realizes this is I think a lot of people listening at us years ago, it's just like, this sounds conspiratorial.

然后事实就发生了，对吧？

And it's just like, what actually happened?

有几个关键的历史日期，我认为是蓄意构建了这个体系。

And there's a couple, like, really important dates that happened that are historical that I think, like, set this structure really intentionally.

第一个是1909年的弗莱克斯纳报告。

The first was nineteen o nine, the Flexner Report.

所以实际上，约翰·D·

So literally, John D.

洛克菲勒的私人律师为国会的报告执笔，这份报告基本确立了当今医学教育的标准。

Rockefeller's personal lawyer wrote the report for Congress that basically set the standard that's the standard today for medical education.

其约束性指南中明确写道，整体健康、营养及身体相互关联性的内容都是伪科学。

And it literally says in the binding guidelines that holistic and holistic health and nutrition and anything about interconnectedness of the body is pseudoscience.

报告称我们需要命名病症，然后切除或开药治疗。

It says we need to name the condition and cut it out or prescribe it.

这是哪一年的事？

And what year is this?

1909年。

Nineteen o nine.

所以他们至今仍遵循1909年的建议。

So they're they're still going by the recommendations of nineteen o nine.

我们依然遵循着

We still follow the

弗莱克斯纳报告。

Flexner report.

我是说，这是一项政策，它

Some a policy I mean, and it

这样我们就能获得

that we can get the

政策固然重要，但重新审视弗莱克斯纳报告，并根据1909年以来我们对人体精妙互联性的新认知，更新科学教育标准和医疗指南，才是真正良好的开端——毕竟我们受制于法律框架，再次强调，这并非阴谋论。

policies, but but, like, resending the Flexner report and having updated scientific education and standard of care guidelines based on what we've learned since nineteen o nine about the majesty of the interconnectedness of our body is a really good first start because we're binded under a law to just demonstrably just like, again, not conspiratorial.

约翰·D·

John D.

洛克菲勒的私人律师撰写了这份报告。

Rockefeller's personal lawyer wrote this report.

为什么？

Why?

因为约翰·D·

Because John D.

洛克菲勒是制药工业之父，利用石油副产品生产药品，并作为首批投资者支持约翰斯·霍普金斯大学、芝加哥大学等主要医学院校，开创了现代健康教育体系。

Rockefeller is the father of pharmaceutical industry and created pharmaceuticals from byproducts of oil production and was the first investor into Johns Hopkins and other major medical schools, University of Chicago, and started the modern education program for health.

当时医疗领域存在一些重大问题。

There were some big issues in the health.

那是个蛮荒无序的时代。

This is the Wild West.

但他创立约翰斯·霍普金斯和住院医师培训标准，刻意将疾病分类隔离，然后以顶级制药商身份推广其产品和干预方案。

But he created Johns Hopkins and the standard of residency training as a way to silo diseases very intentionally and then prescribe his products and interventions as the top pharmaceutical maker.

而他创建的医学院本质上就是他的分销体系。

And the medical schools that he created were basically a distribution system to him.

好的。

Okay.

接着到了二战时期。

So you get to World War two.

直到二战前后，大约上世纪五六十年代，我认为你能想到或任何听众能想到的医学奇迹都诞生于那个时期之前。

Up until World War two, around that time, the nineteen fifties, nineteen sixties, I would argue almost any medical miracle you can think of or any listener can think of was created before that time.

要知道，这些都是针对急性情况的处理——急诊手术、消毒程序、抗生素让感染不再致命。

You know, it's all acute situations, emergency surgical procedures, sanitation procedures, antibiotics to make an infection not deadly.

我们能想到的几乎所有医学奇迹，都是针对那些会立即致命的传染病。

Almost every medical miracle we can think of was something that was going to kill you right away, infectious disease.

然后你服药或接受一段有限时间的治疗，之后就可以停药。

And then you take the pill or take the treatment for a finite period of time and you stop it.

或者快速做完手术就康复——这些才是真正的医学奇迹。

Or do the surgery quickly and you're That those are medical miracles.

在二战之前，我们确实取得了许多重大医学进展。

And we had a lot of good things happen up until World War two.

医疗行业在二十世纪五六十年代非常刻意地推出了避孕药。

Very intentionally, the medical industry saw the birth control pill in the late nineteen fifties, nineteen sixties.

避孕药是人类历史上第一种需要长期服用超过数周的药物。

And the birth control pill was the first pill in world history that people took for longer than a couple weeks.

这是史上第一种让人产生‘哦，有意思’想法的药丸。

It was the first pill ever that is like, oh, interesting.

你确实可以让人长期服用一种药物，甚至可能是他们的大半生。

You can actually convince someone to take a pill for years, for almost most of their life.

持续性的收入。

Recurring revenue.

医疗行业非常重视利用这种建立起来的信任。

And there was a huge emphasis of the medical industry to take the trust engendered.

直到1960年，罗伯特·肯尼迪都曾谈到这一点。

Up until 1960, RFK talks about this.

我们过去不在慢性病管理上投入资金。

We didn't spend money on chronic disease management.

所有医疗都是针对急性病症的。

All medicine was acute issues.

慢性疾病，比如糖尿病、肥胖症，这些都不在医生的诊疗范围内。

Chronic disease, you know, diabetes, obesity, that was outside the doctor's office.

他们意识到可以将慢性病医疗化。

They saw that you could medicalize chronic conditions.

如今，90%到95%的医疗支出都用于慢性病治疗。

Today, 95 90 to 95% of spending is on chronic conditions.

那么我们该怎么办呢？

So we what do we do?

上世纪七十年代，萨克勒家族——就是后来制造阿片类药物的那家人的祖辈——他们发明了安定。

We in the nineteen seventies, literally, Sackler family that did you know, that their their grandkids did and kids did the opioids, Their their their forebearers created Valium.

当时美国有30%的女性服用安定，《时代》杂志称其为'妈妈的小帮手'，形容那个时代为'安定国度'。

And thirty percent of women in The United States in the nineteen seventies were on Valium, Time Magazine, Valium Nation, mommy's little helper.

是啊。

Yeah.

于是我们开始创造各种精神疾病分类。

So we started creating all these psychiatric conditions.

我们开始将心脏病医疗化。

We started medicalizing heart disease.

我们开始将二型糖尿病等疾病医疗化，由制药行业全额资助的学术研究开始宣称二型糖尿病不可逆转、本质是遗传病，心脏病等疾病也是如此，然后开始给患者大量开药。

We started medicalizing all these type two diabetes, started creating academic research totally funded by the pharmaceutical industry saying that type two diabetes isn't reversible, that it's basically genetic, heart disease, all these things, and started pilling them started pilling them.

那么食物发生了什么变化？

Then what happened to food?

慢性病在七八十年代并不是什么大问题。

Chronic disease wasn't that big of a deal in the nineteen seventies, nineteen eighties.

你看看这张图表。

You you look at the graph.

你看看所有慢性病的趋势图。

You look at the graph of all chronic conditions.

在八十年代出现了一个急剧的转折。

There's just a sharp turn in the nineteen eighties.

几乎就在同一年，美国卫生局发布了吸烟有害健康的报告。

It's the literally to almost to the year of the surgeon general report saying smoking wasn't great.

这份报告一出，菲利普莫里斯和雷诺烟草就成了当时全球最大的两家公司。

So the second that report came out, Philip Morris and RJ Reynolds were two of the largest companies in the world.

那时候的顶级企业名单上可没有微软和谷歌。

It wasn't like Microsoft and Google on the top companies list.

就像是烟草公司一样。

It was like cigarette companies.

你知道吗？

You know?

多巴胺是种极好的销售品，这正是现在科技公司在做的。

Dopamine is a really good thing to sell, which which the tech companies do now.

他们动用了资金储备，到1990年时，美国乃至世界历史上规模最大的三笔并购交易，都是烟草公司收购食品公司。

And they used their cash piles, and by 1990, the three largest m and a deals in American history in world history were cigarette companies buying food companies.

于是就有了RJ雷诺收购纳贝斯克。

So you had Nimbusco bought by RJ Reynolds.

卡夫和通用食品被收购——你见过那些图表吗？显示几乎所有食品公司都被少数几家企业掌控的图表？

You had Kraft and US Food buy and you see those graphs of of of all the food companies owned by, like, a couple a couple companies?

那些就是烟草公司的手笔，他们非常刻意地做了两件事。

That was the cigarette companies, and they did two things very, very intentionally.

他们先是掌控了权威机构，宣称超加工食品是健康的；然后又让自家科学家动手脚，使食品本身更具成瘾性。

They took over the institutions of trust to say ultra processed food was healthy, and then they took their scientists and rigged the food itself to make it more addictive.

不是为了毒害孩子，而是为了让它更具成瘾性。

Not to kill kids, but to make it more addictive.

于是就有了那个字面意义上的食物金字塔，宣称超加工食品很棒，金字塔的基础是低脂碳水化合物。

So you had that literal food pyramid which said ultra processed food is great, low fat carbs based the pyramid.

那实际上是烟草行业为了推广他们的成瘾性产品而刻意构建的。

That was constructed literally by the cigarette industry to promote their addictive products.

这种我称之为食品武器化的行为，并不只是某种阴谋论。

And this weaponization of food, as I call it, it's not just like this conspiracy.

毫不夸张地说，菲利普莫里斯和阿切尔丹尼尔斯米德兰这两家烟草公司，当时是美国最大的食品生产商。

Literally, cigarette industry, those two companies, Philip Morris and Archerians, were the two largest food producers in The United States.

在1990年代，美国约50%的食品都是由烟草公司生产的。

Like, 50% of American food were created by cigarette companies in the nineteen nineties.

他们让我们对这些食品上瘾并将其武器化，各种慢性病的发病率随之飙升。

And they have got us addicted and weaponized this food, and all chronic conditions have just shot up.

这是因为由烟草业科学家研发的超加工食品，从根本上劫持了我们的进化生物学机制。

It's because that ultra processed foods literally by tobacco industry scientists hijacks our evolutionary biology.

再说，你不可能吃过量的草饲牛排，但这些由比我们聪明得多的科学家设计的食品，正是他们正在做的。

Again, you can't overeat grass fed steak, but these food with scientists much smarter than any of us, that's what they're doing.

他们正在关闭我们社会的信号系统。

They're they're they're shutting off our society signals.

这种廉价上瘾食品的副产品——我们甚至还没有相关研究——是它们被喷洒了所有这些化学物质。

The byproduct of this cheap addictive food, which we don't even have research for yet, is that it's sprayed with all these chemicals.

在美国允许使用1万种化学物质喷洒，而在欧洲只允许400种。

It's sprayed with 10,000 chemicals that are allowed in The United States when only 400 are allowed in Europe.

所有这些化学物质都是为了让人对食物上瘾、让食物便宜，你知道，为了单一作物种植。

All these chemicals to make the food addictive, to make the food cheap, you know, to do the mono cropping.

这种食物绝对是...我们不需要等待相关研究结果。

And that food is absolutely and we don't need to wait for the research on this.

这些化学物质，这些神经毒素正在摧毁我们自身，以我们尚未完全理解的方式破坏我们的微生物群。

These chemicals, these neurotoxins destroying ourselves, destroying our microbiome in ways we don't fully understand.

所以我想向大家明确一点：这一切的发生，都是非常有意为之的。

So I just want to make clear to everyone, like, this has happened, like, very intentionally.

就像这样，而且这种情况也能很快被逆转。

Like like and it can be undone pretty quickly too.

但我们必须意识到这不是阴谋论。

But we have to realize this isn't a conspiracy.

这是真实存在的腐败，是蓄意为之的。

It's true corruption that that that that happened deliberately.

我想补充几个日期。

I would just add a few more, like, dates.

我认为关于研究有一点很重要，我们几乎是世界上唯一一个将举证责任倒置的国家——我们允许这些化学物质直接进入食品系统。

I like, you know, I think one thing about the research, you know, we're one of the only countries in the world where the burden of proof for harm like we allow these chemicals to just enter our food system.

我们的食品系统中存在一万种化学物质。

We have 10,000 chemicals in our food system.

欧洲只有400种，因为他们必须证明物质安全才能使用。

Europe, only 400 because they have to show that it's safe before they use it.

而我们却可以直接使用这些物质。

We're allowed to use it.

然后，只有在问题出现后，人们才不得不进行研究。

And then and then only, you know, only if there's issues that crop up do people have to do research.

所以，你知道，存在这种荒谬的'公认安全'(GRAS)认定，本质上是企业自行评估他们创造的化学品是否被普遍认为安全。

So, you know, there's this like ridiculous GRAS, generally recognized as safe designation, which is essentially a company self assesses whether the chemical that they are creating is generally recognized as safe.

没有人监督这一过程。

No one's overseeing it.

布里格姆也谈到这一点，就像对FDA的同情。

And Brigham talks about this, like compassion for the FDA.

他们不堪重负。

They're overwhelmed.

有太多事情要处理。

There's a lot of stuff to do.

这有点像囤积者的房子。

It's kind of like a hoarder's house.

我们该从哪里开始呢？

Where do we even start?

比如，我不确定是否该相信这种说法。

Like, I don't necessarily know if I buy that.

我认为这种情况相当糟糕，我们被收买了才会允许所有这些化学品存在。

I think that it's pretty pretty bad and bought off that we have all these chemicals.

但它们基本上只需自我认定为'一般认为安全'，就能进入我们的食品系统。

But they basically just have to self designate if it's generally recognized as safe and then it can go into our food system.

我觉得非常值得思考的一点是——我经常反思——食品化学品和药物之间到底有什么区别？

One thing that I find really interesting is like that I really reflect on a lot is like, what is the difference between a food chemical and a drug?

它们都是科学家在工厂实验室里合成的分子。

They're all just synthetic molecules that are made in factories, in labs by scientists.

你知道区别在哪里吗？

Do you know what the difference is?

在于用途意图。

Intended use.

所以基本上，只要用途是食品，你几乎可以合成任何东西添加到食物中。

So basically, if the intended use is for food, you can synthesize almost anything you want and put it in food.

我们的食品系统中充斥着近万种几乎不受监管的化学物质，这些物质通过收买论文宣称其安全性，导致我们正在被大规模下药和毒害。

We are being mass drugged and poisoned in our food system with 10,000 virtually unregulated chemicals which have bought off papers saying that they are safe.

看看孟山都关于非霍奇金淋巴瘤的所有诉讼案件就知道了。

I mean, you look at what happened with all the Monsanto litigation about non Hodgkin's lymphoma.

他们不得不公开所谓的'孟山都文件'。

They had to release this whole thing called the Monsanto papers.

这些解密文件显示他们找人代笔科学论文，声称草甘膦是安全的。

They were declassified where they ghost wrote scientific papers saying that glyphosate is safe.

整个体系腐败不堪——我们的食品系统存在上万种未受监管的化学物质，显然我们正因此病得越来越重。

So there's all this corruption in there where basically we have 10,000 unregulated chemicals in our food system and we're getting sick as hell, obviously.

然后那些循证派人士会说：我们需要十年纵向研究来证明草甘膦导致X、Y、Z疾病。

And then you've got the evidence based people saying, well, we need to have a ten year longitudinal study to show that glyphosate is causing X, Y, Z disease.

显然这种思路是错误的，因为首先是环境中所有毒素的协同作用导致了这些多效性健康问题。

And it's like, obviously that's not the right approach because first of all, it is the synergistic combination of all the toxins that are now in our environment that are leading to all these pleiotropic health issues.

这非常难以研究。

That's very hard to study.

所以我们必须清醒过来，用常识去认清现状，而不是再等十年去做那些会被腐败侵蚀的NIH资助研究。

So we have to get our heads out of our ass and use our common sense and realize what's going on and not wait ten years with these, you know, NIH funded studies that are going to be corrupted.

而且，我认为这只是食品化学物质问题的一个方面。

And, you know, I think so that's just that's just one thing about the food chemicals.

卡尔，我想补充一点，就像其他日期一样，你看看加工食品的兴起，加工食品真正开始流行是在这些企业合并之后。

I just wanted to add to your point, Cal, like some other dates, like you look at the processed food emergence, processed food like really didn't start taking off until these mergers.

可以说它最初只是稍有苗头。

Like it's there was a little bit of a start of it.

超加工食品在二战前根本不存在。

Ultra processed foods did not exist before World War II.

当时我们需要为士兵提供可以运输的耐储存食品等等。

We and, you know, we needed to have shelf stable food for soldiers and things like that that we could ship.

所以最初可能有些好的初衷。

And so there were maybe some good intentions there.

但后来有人看到了其中有利可图的机会。

But then it got there was an opportunity there that got seen.

我们还可以利用女权运动来反对，比如待在厨房就是奴隶的观念。

And we can also, you know, weaponize the feminist movement against, you know, oh, being in the kitchen, you're a slave.

你知道，你的价值不在家庭内部，你需要攀登企业晋升阶梯。

You know, you don't that your values outside the home, you need to climb the corporate ladder.

来，尝尝这些我们最初为士兵准备的方便食品，我们会告诉你这实际上就是你的解放。

Here, have this convenience food that we basically made for soldiers and we're going to tell you that this is actually your liberation.

所以人们自然就不再下厨做饭了。

So of course we got people not cooking.

家庭不再一起用餐了。

Families aren't eating together anymore.

比如，现在孩子们67%的热量摄入来自超加工食品。

Like, you know, kids are eating 67% of children's calories now are ultra processed foods.

这些是指由食品科学家在工厂生产的食品，不仅仅是加工食品，而是最高级别的超加工食品，占热量摄入的67%。

These means foods that come from a factory made by food scientists, not just processed, ultra processed, the highest form of processing 67% of calories.

然后到了1970年代，高果糖玉米糖浆问世，正如卡莉所说，这发生在一些企业合并之前。

Then you go to the 1970s and we have the advent of high fructose corn syrup, which as Callie talks about, this preceded some of the mergers.

高果糖玉米糖浆是一种大规模杀伤性武器，食品科学家利用对冬眠动物（如熊）的了解开发了它——果糖是少数不仅不会产生饱腹感，反而会让人更饥饿的卡路里类型之一。

High fructose corn syrup is a weapon of mass destruction that basically food scientists used an understanding about hibernating animals like bears, who fructose is one of the only types of calories where instead of making you feel satiated, it makes you more hungry.

这是进化形成的，我们早就知道这一点。

And this is evolutionarily and we knew this.

在秋季，当动物准备冬眠并开始食用富含果糖的浆果时，它们需要为冬天囤积大量脂肪。

In the fall, when animals are preparing for hibernation and they start eating fructose rich berries, they need to put on a ton of fat for winter.

因此果糖存在一种正向反馈机制：它会让熊感到饥饿甚至变得暴力，以压倒其他动物，在短时间内获取尽可能多的浆果，从而为冬季堆积三维打印般的脂肪。

And so there's a feed forward mechanism with fructose where it actually gets the bears to be hungry and even violent to outcompete other animals to get as many berries as possible in a short period of time to lay three d print fat for winter.

于是科学家们理解了这个原理后说：'嘿，我们可以制造出比浆果中的果糖浓度高上千倍的液态果糖，分子结构相同但浓度更高。'

So you have the scientists understanding this and say, hey, we can make liquid fructose thousand times more potent than the fructose you'd find in berries, Same molecule, but in higher concentration.

而且我们可以把它添加到所有食品中。

And we can add it to everything.

我们可以把它加进沙拉酱里。

We can add it to salad dressing.

我们还要把它加进番茄酱里。

We're gonna add it to ketchup.

我们要把它加进学生的校园午餐里。

We're gonna add it to children's school lunches.

我们显然会把它加进汽水里，让人们变得贪得无厌。

We're gonna add it obviously to sodas, and we're gonna make people insatiable.

我们要让人们的身体和大脑误以为在为永远不会到来的冬天做准备。

We're gonna make their bodies and their brains think that they're preparing for winter that's never coming.

已有研究表明高果糖玉米糖浆与暴力行为、儿童多动症等种种问题相关。

And there has been research that shows that hyphthros corn syrup is associated with violence, ADHD in kids, all of these different things.

最后我想提一下，快进到1986年——我认为另一个非常重要的年份，当时通过了诉讼法案，规定我们不能起诉疫苗生产商，这就是《疫苗安全法案》。

Just last thing I'll mention, flash forward 1986, I think another very important date, which is the date when the litigation went through that said we couldn't sue vaccine manufacturers and the vaccine safety act.

这在整个历史上都是非常重要的时刻，因为这是国会首次通过立法，规定制药公司不必为不当行为承担诉讼责任。

That's a very important date in the whole history because it is the one of the first times where we were able to pass legislation through Congress that said that pharmaceutical companies could not be sued for wrongdoing.

这一条款至今仍然有效。

And that still is present today.

他们基本上设立了一个微不足道的小基金，人们可以申请无过错疫苗伤害赔偿，但就是不能起诉制药公司。

They basically put together a little paltry little fund that people could apply to get, you know, no fault reimbursements for for vaccine harm, but you cannot sue the company.

于是企业开始获得法律豁免权，免于为不当行为负责，这一趋势随后加速发展。

So you start to get companies being legally immune from wrongdoing, which has then accelerated.

他们现在甚至开始试图将类似的法律保护扩展到农药领域。

And they're now starting to try and push things like that for pesticides as well.

这就是我们为何会陷入当前处境的部分历史原因。

So that's just some of the history of like why we are where we are today.

这并不复杂。

It's not rocket science.

过去五十年间，这一切都已形成制度化和结构化体系。

This has all been very institutionalized and structured, and it's the last fifty years.

只要有正确的领导，我们完全可以扭转这种局面。

Like, we can undo all of this with leadership.

以上简要说明了我们如何走到今天这一步的部分图景。

And so that's just a little bit of the picture of of how we're we are where we are today.

在继续之前，我能就高果糖玉米糖浆补充一点看法吗？

Before can I just say one thing about the fructose corn syrup?

你提到这个我很高兴，因为我原本不知道果葡糖浆有独特的方式让人更上瘾并破坏饱腹感

I'm I'm so glad you brought that up because I didn't know that there was a unique way that it makes it more addictive and and kills your satiety

哦，是的。

Oh, yeah.

或者说增强瘾性，更准确说是破坏饱腹感。

Or increases it or kills it rather.

因为我一直以为糖就是糖，这也是许多反对者常用的论调——他们会说'这都是胡扯'。

Because I'd always thought that sugar was sugar, and this is one of the arguments that a lot of people that are poo pooing all this stuff like, oh, this is nonsense.

糖就是糖。

Sugar is sugar.

是啊。

Yeah.

就像他们认为苹果里的糖和果葡糖浆里的糖没有任何区别。

Like, there's no difference between the sugar and high fructose corn syrup versus the sugar in an apple.

不。

No.

这真的很有趣。

It's it's really interesting.

有两本关于这个主题的精彩书籍。

There's two amazing books on this.

科罗拉多大学的理查德·约翰逊写了《自然希望我们发胖》，而大卫·珀尔马特则写了《降低尿酸》。

Richard Johnson from use use University of Colorado wrote Nature Wants Us to Be Fat, and then David Perlmutter wrote Drop Acid.

这两本书都讨论了一种名为尿酸的分子，它是果糖代谢特有的产物。

Both books are about a molecule called uric acid, which is unique to fructose metabolism.

当果糖在体内代谢时（与葡萄糖不同），会产生尿酸，导致大脑和身体产生氧化应激和线粒体功能障碍——如果线粒体功能受损，就无法将糖分转化为能量，你知道线粒体是细胞的动力源。

So when fructose is metabolized in the body, not like glucose, it creates uric acid, which creates oxidative stress and mitochondrial dysfunction in the brain and the body that if you have mitochondrial dysfunction, you're not going to able to process sugars to energy, you know, mitochondria powerhouse of the cell.

过量的果糖会通过尿酸超载破坏线粒体功能。

So you break the mitochondria with the excess fructose overloading the mitochondria with uric acid.

然后会发生什么？

And then what happens?

你就无法将糖分转化为能量了。

You can't turn sugars to energy.

那你该怎么办呢？

So what do you do?

你把糖分转化为脂肪。

You turn sugars to fat.

于是你开始3D打印脂肪，因为过量的果糖破坏了线粒体。

So you start three d printing fat because you break the mitochondria with excess fructose.

除此之外，当大脑中出现线粒体功能障碍和氧化应激时，可能会引发暴力行为、多动症等问题，使熊变得狂躁，从而尽可能多地获取浆果。

And on top of that, the mitochondrial dysfunction and oxidative stress when happening in the brain is what may inspire the violence and the ADHD and all that stuff to make the bears manic so they get as much berries as possible.

这就是现在美国每个教室里每个孩子身上正在发生的情况。

This is what's happening in every kid in every classroom in America now.

所以这大致简单地解释了正在发生的生物学机制

And so that's kind of some of the biology very simply about about what's happening

关于果糖。

with fructose.

所以苹果可能是个不好的例子，但.

So the the apple is probably a bad example, but, like, cane sugar.

甘蔗糖是以果糖为基础的吗？

Is cane sugar fructose based?

嗯，通常来说，它含有蔗糖，而蔗糖会包含一定比例的葡萄糖和果糖。

Well, it's generally, it's gonna have sucrose, which is gonna have some amount of glucose and fructose.

但关于水果的关键在于，我们体内有400万亿个细胞，我们具备清除尿酸的能力，也有处理生理量果糖的能力。

But this is the thing about fruit is that we have 40,000,000,000,000 cells and we have the ability to clear uric acid and we have the ability to process fructose in a physiologic amount.

如果我们吃的是一个苹果，就永远不会出现尿酸升高和线粒体超负荷的情况。

We're never going to have the uric acid increasing and overloading the mitochondria if we're eating an apple.

问题是当你摄入的果糖量是苹果的二十到三十倍，就像直接往体内倾倒果糖时，就会突然导致体内尿酸激增并引发其他问题。

It's when you're eating twenty, thirty times the fructose that an apple has and you're literally pouring it down that all of a sudden imagine you get this huge rise in uric acid in the body and other things that are happening.

这时身体就会不堪重负。

And that's when it overwhelms.

所以某种程度上说'剂量决定毒性'，因为我们的身体具备排毒能力。

So it's a bit of that dose makes the poison because our body has the ability to excrete toxins.

我们的身体能够应对一些重金属。

Our body has the ability to deal with some heavy metals.

我们的身体或许有能力清除一定量的草甘膦，但我们无法全天24小时不间断地清除所有这些物质叠加起来百倍剂量。

Our body has the ability to probably clear some level of glyphosate, but we can't clear all of it all the time, twenty four hours a day in 100 times the quantity of all these things together.

而那些研究和循证派系，以及这种科学崇拜，他们最爱对此视而不见。

And the research and the evidence based thing and this cult of the science, they love to ignore that.

这种协同效应——对我们细胞资源的压倒性消耗——被刻意忽略了，因为我们总是孤立地研究事物。

The idea of synergistic effects of this of this overwhelming breaking of our cellular resources is just conveniently forgotten because we study things in isolation.

这恰恰是双盲安慰剂对照研究的定义方式。

That's literally the definition of how a double blind placebo controlled study happens.

它只测试单一变量，你懂的，每次只研究一个因素。

It's one variable, you know, and one thing that you're testing.

你没法在

You can't do it on

道理上

sense.

我们生活在有毒的大染缸里。

We live in a toxic stew.

双盲安慰剂对照研究的唯一答案，每位嘉宾上来都这么说，这就是黄金标准。

The only only answer of double blind placebo controlled studies, which every guest comes on is just like, that's just the gold standard.

大家都默认这就是你需要的。

That's just everyone just accepts that that's what you need.

双盲安慰剂对照研究，唯一的答案就是药片，本质上。

A double blind placebo controlled study, the only answer is a pill, like, essentially.

你不能用那种方式测试致幻剂。

You can't test psychedelics on that way.

你无法测试食物。

You can't test food.

你无法测试运动。

You can't test exercise.

你无法对这些进行盲测。

You can't blind those things.

所以任何真正认识到我们生病原因的整体性和相互联系的事物，都无法通过双盲安慰剂对照研究来研究。

And so anything that actually recognizes the the the unison and the interconnectivity of why we're getting sick can't be studied through a double blind placebo controlled study.

实际上FDA就是这样被建立的。

You actually have the FDA that's basically created.

从近期MDMA的审批决定就能看出这一点。

You saw this with the recent MDMA decision.

本质上这个系统被操纵了——通过我们研究事物和审批药物的最高标准途径，唯一能被批准的只有合成药丸。

It's basically rigged that the only thing that can be approved through the, you know, top way we study things and and and and approve drugs is a synthetic pill.

这是唯一能通过双盲安慰剂对照研究的东西。

That that's the only thing that can basically lead to through a double blind placebo controlled study.

就像疫苗的情况，是啊。

It's like with vaccines, it's like, yeah.

我敢打赌单一疫苗不太可能引发自闭症。

I bet that one vaccine probably isn't causing autism.

但那些在18个月前接种的20种疫苗呢？

But what about the the the 20 that they're getting before eighteen months?

我们并没有从协同效应角度来审视这个问题。

Like, we don't look at it in synergistic.

你知道吗？

You know?

所以这是个严重的问题。

And so that's that's a big problem.

这就是科学崇拜的问题所在，我特意说‘科学’是因为科学本身是美好的。

And this is where the cult of the science, and I say the science specifically because science is beautiful.

运用科学方法和这种探索自然世界的方式是一门美妙的艺术。

Using the scientific method and using that way of inquiry into the natural world is a beautiful art.

但把那些经常被收买或篡改的论文武器化——要知道，我们一些核心医学期刊的负责人甚至承认，已发表的研究中50%最终被证明是错误的。

But weaponizing papers that are often bought for or corrupted and you know, the leaders of some of our key medical journals have actually even said that 50% of scientific research that publish ends up being wrong.

所以它们要么被收买、被篡改，要么本身就是错的。

So it's bought for corrupted or wrong.

我们却依赖这些研究。

We rely on this.

有个值得注意的趋势是：如果我们选择串联线索或运用直觉——上帝赋予的直觉，用任何其他方式而非这种特定检验方法看待事物，就会被视为危险分子。

And if one interesting trend that we're seeing in our world is that if we do choose to put dots together or use our intuition, our God given intuition, anything other than this particular way of examining things, you are dangerous.

你很危险。

You are dangerous.

我认为这确实是我们需要质疑的事情。

And I think that that's something we need to really question.

你知道，特别是作为一个女性，我很快就要考虑生孩子了。

You know, I think especially as a woman, like, I'm and thinking about having kids soon.

我在想，哇。

I'm like thinking about like, wow.

我的身体有能力构建一个人类，三维打印一个人，为那个人类注入灵魂。

Like, I I have the ability in my body to, like, build a human, three d print a human, pull in a soul to that human.

我不需要同行评审的研究或教科书来告诉我怎么做。

I don't need a peer reviewed study or a textbook to tell me how to do that.

我们的身体、直觉、思维以及体内发生的微妙变化都很重要。

Our body and our intuition and our minds and the subtle things happening inside us are important.

它们是不可思议的。

They are incredible.

我们现在被告知，如果你那样做就不能信任自己，而且你很危险。

We have now been told that like you can't trust it and you are dangerous if you do that.

我认为这就是为什么现在父母们感到非常沮丧的原因之一——虽然我还没为人父母，但你知道Callie是——当我们现在被告知，父母因为运用自己的判断来照顾家庭和孩子就成了敌人，我想这对人们来说肯定是极其令人沮丧的，而这基本上就是我们现在被要求接受的观念。

And I think that's one of the reasons why I think parents are very frustrated right now is because parenting, I'm not a parent yet, but you know, Callie is, but like, you know, when we're being told now that parents are the enemy for using their own judgment about their families and kids, like, I think that's probably it's it's deeply frustrating to people, and that's basically what we're being asked to do.

确实如此。

So yeah.

我想谈谈阿尔茨海默症。

I wanna talk about Alzheimer's.

这是另一个我想讨论的话题，当我们谈到性早熟时。

That was the other thing that I wanna talk about when you when we talked about early puberty.

你提到过阿尔茨海默症的风险正在不断上升。

You you mentioned the escalating risks of Alzheimer's.

阿尔茨海默症是什么时候开始出现的？

When did Alzheimer's become a thing?

因为我读到一篇文章说它是在植物油问世之前就存在的。

Because I was reading this article that was saying that it was before the advent of seed oils.

你几乎很少见到这种情况，甚至可能从未见过。

You very, very, very rarely saw it, if at all.

不。

No.

它像所有其他慢性病一样在爆炸性增长。

It's been exploding like every single other chronic condition.

我简单说一下，这与你刚才提到的凯西的观点有关。

I'll just quickly go to it ties to Casey's point you just made.

2024年是美国历史上阿尔茨海默症、癌症、自身免疫性疾病、心脏病、糖尿病、肾衰竭、自闭症发病率最高的一年。

This year in 2024 is the highest rate in American history of Alzheimer's, cancer, autoimmune conditions, heart disease, diabetes, cancer, kidney disease, autism.

你能想到的每一种慢性疾病都处于历史最高水平，并且随着我们在治疗这些疾病上投入更多资金，其发病率还在加速增长。

Every single chronic disease you can think of is at an all time high growing at an increasing rate as we spend more money to treat those conditions.

所以我认为我们想表达的一个观点是，所有NIH、FDA都在默认接受这种趋势。

So I think what one point we're trying to make is that, you know, all the NIH, all the FDA, it's all on accepting that trend as a given.

他们完全对此撒手不管了。

It's totally washed their hands of it.

那我们如何找到边际药片来稍微改善这种情况，而不是追问原因呢？

And how do we find marginal pills to make this a little bit better, not asking why?

关于阿尔茨海默症的问题，我们想表达的观点是，对于这类慢性疾病，你真正需要问的不是阿尔茨海默症本身。

And that question about Alzheimer's, the point we're trying to make, is that when it comes to chronic conditions, which Alzheimer's is, you have to really not ask the Alzheimer's question.

你必须追问为什么这只是这棵树上的一个分支——肥胖问题。

You have to ask why that's one branch on this tree, obesity.

对吧？

Right?

这棵树。

This tree.

我们讨论过，我认为凯西有一个绝妙的框架。

And we talk about and I think Casey has this amazing framework.

你实际上可以观察五个生物标志物——代谢功能障碍的标志物：高密度脂蛋白、甘油三酯、血糖、血压和腰围。

You can literally look at five biomarkers, the biomarkers of of metabolic dysfunction, HDL, triglycerides, blood sugar, blood pressure, and your waistline.

我不是在开玩笑。

And I'm not joking.

我没有夸张。

I'm not being hyperbolic.

如果我们解雇美国所有慢性病和营养研究领域的研究人员，取消所有相关拨款，并制定政策来优化这五项生物标志物，那么从定义上讲，你就不会患上二型糖尿病。

If we fired every single researcher and every single and canceled every single grant in the US government for all chronic disease research and all nutrition research and created all policy to maximize those five biomarkers in America, you, by definition, don't have type two diabetes.

你几乎百分之百不会得心脏病。

You almost have a zero percent chance of getting heart disease.

你患阿尔茨海默症的几率几乎为零。

You have very close to zero percent chance of getting Alzheimer's.

从定义上说，你根本不会肥胖。

You are not obese by definition.

真的，你可以逐一排查所有折磨美国人的慢性病。

Literally, you go down every single chronic condition that is torturing American life.

如果你是糖尿病患者，你抑郁或自杀的可能性是常人的四倍，因为我们大脑中有细胞，而糖尿病就是细胞失调。

If you're diabetic, you're four times more likely to be depressed or suicidal because there are cells in our head, and diabetes is cellular dysregulation.

所以，说真的，我不是在否定科研工作——我知道有很多深入钻研细节的研究英雄。

So so, like, literally, I'm not like like, on the on the research and the science thing, you know, I think there's great heroes who've been, you know, getting into the weeds on the on the research.

但慢性病与基本生活方式因素息息相关。

But chronic disease is interconnected to basic lifestyle factors.

我认为这是个政治问题。

I think this is a political issue.

说实话，每个美国人都需要思考：这是个需要渐进改良的问题——只需稍好一点的药物干预和稍深入的研究？

Honestly, every American needs to ask, is this an incremental issue where we need slightly better pharmaceutical interventions and slightly better research?

还是需要彻底转变认知——理解人体机能的相互关联，并意识到医学乃至我们对环境的看法都需要根本性变革？

Or is this a radical shift of understanding how our bodies are interconnected and understanding that that needs to be a shift in medicine and frankly how we view the environment?

这个问题我们认为相当紧迫且具有生存意义。

That is a question that we actually think is relatively urgent and relatively existential.

现代社会是令人惊叹的。

Modern society is amazing.

但正如凯西所说，当前形势很严峻。

But as Casey said, this is dark right now.

如果你相信凯西关于慢性病的统计数据，并实际计算医疗支出以GDP两倍速度增长的数学——这已是美国规模最大且增长最快的产业。

Like if you believe what Casey's saying about these statistics about chronic disease and you actually look at the math that we're growing two times with health care spending, the rate of GDP, it's the largest and fastest growing industry in the country.

美国增长最快的产业并非人工智能。

The the fastest growing industry in The United States is not AI.

也不是科技行业。

It's not tech.

而是医疗保健。

It's health care.

随着它的发展，我们却变得更病态、更肥胖、更抑郁、更不育。

And as it grows, we get sicker, fatter, more depressed, more infertile.

这将使国家破产，而且趋势毫无减缓迹象。

It is going to bankrupt the country, and it's not slowing down.

如果你真的相信这点，相信我们需要新范式——是要进行更好的研究，还是该承认现有研究本身就是错误的？

So if you actually believe this, believe we need a new paradigm, is it about getting better research, or is it about actually saying the research is wrong?

将慢性病割裂看待的整个范式就是错误的。

This whole paradigm of seeing chronic disease in silos is wrong.

我相信你可以多谈谈阿尔茨海默症，但它们是相互关联的。

So I'm sure you can talk more about Alzheimer's, but it's interconnected.

是的。

Yeah.

不。

No.

我认为渐进主义与激进变革之间的选择，正是我们需要自问的关键问题。

I think the point about incrementalism versus radical is the question we need to be asking ourselves.

就像，我们并不是...是的。

Like, we're not yeah.

就阿尔茨海默症而言，一个非常有趣的观察角度是：大脑仅占我们体重的2%，却消耗了全身20%的能量。

And so in terms of Alzheimer's, so I think something a really interesting framing is that the brain, you know, it's only 2% of our body weight, but it uses 20% of our body's energy.

关于阿尔茨海默症有个理论认为，是大脑中的斑块导致的。

And there's been this theory with Alzheimer's of like, oh, it's the plaques in the brain.

比如tau蛋白缠结、β淀粉样蛋白沉积等等这些因素。

It's the tau and the tangles and the beta amyloid and all these things.

所以我们曾经认为，好吧。

And so we thought, okay.