凯文·霍尔博士谈减重的科学与政治

我还要补充的是，同样的标准，受到奥运选手和职业球队的信任。

The same standard, I might add, trusted by Olympians and pro teams.

每颗咀嚼片含有1克纯肌酸一水合物，原料单一，来自德国，经过NSF运动认证，当然不含任何奇怪的人工添加剂。

Each chew delivers one gram of pure creatine monohydrate, single source from Germany, NSF certified for sport, of course, and without any weird artificial stuff.

现在你可以把它们放在任何地方，这消除了粉末和摇杯带来的所有不便。

Now you can keep them anywhere, which removes all the friction that comes with powders and shakers.

请前往 livemomentous.com，使用代码 rich roll，首次订购最高可享35%折扣。

So head over to livemomentous.com and use code rich roll for up to 35% off your first order.

今天我们由Seed赞助播出。

We're brought to you today by seed.

多年来，我邀请了众多肠道微生物专家做客节目，随着我对这一复杂生理层面的了解日益加深，它变得越来越让我着迷。

I have hosted so many microbiome experts on the show over the years, and the more I learn about this very complex aspect of our physiology, the more fascinating it becomes to me.

但有一件事是简单的。

But there is one thing that is simple.

健康的肠道是健康身体和幸福生活的基础。

A happy gut is the foundation for a happy body and a happy life.

而要达到这一点需要用心、需要刻意，需要一个每天促进肠道健康的仪式，对我来说，这个仪式始于种子DSO1。

And to get there requires care, requires intention, it requires a daily gut health promoting ritual that for me begins with seeds DSO1.

两合一的益生菌和益生元配方，含有24种经过临床研究并证实能成功通过消化道的菌株。

Two in one probiotic and prebiotic formulated with 24 strains that are clinically studied and proven to survive the digestive journey.

研究表明，它能将有益肠道细菌增加400%，但它的作用远不止于肠道。

It's been shown to increase good gut bacteria by 400%, but it goes beyond just the gut.

DSO1支持你的整个身体。

TSO-one supports your whole body.

它被设计用于在短短两周内减少腹部胀气和间歇性便秘。

It's formulated to reduce abdominal bloating and intermittent constipation in as little as two weeks.

我可以证实，我的消化、能量水平和整体肠道舒适度都得到了明显改善。

And I can attest to noticing personal improvements in my digestion, in my energy levels and overall gut comfort.

请前往 seed.com/richroll 并使用代码 richroll20，享受DSO1首月20%的折扣。

So go to seed.com/richroll and use the code richroll20 for 20% off your first month of DSO1.

我们现在正逐渐接近你的发现与一些传统观念产生交集的时刻。

This is where we're sort of tiptoeing up to the point where your findings are brushing up against a few pieces of conventional wisdom.

其中之一就是所谓的‘热量摄入与消耗’理论，对吧？

One of which is this idea of calories in calories out, right?

在很长一段时间里，人们普遍认为这一观点是不可动摇的。

And for a very long period of time, this was believed to be basically sacrosanct.

后来它受到了挑战。

Then it was challenged.

而现在，你稍微细化了这一观点，使其不再只是潮流，而是可能在适当的情境下最为合理。

And now you've kind of nuanced it a little bit to bring it back into not vogue but like maybe perhaps it's best in proper context.

是的。

Yeah.

所以我认为，当人们说‘热量摄入与消耗’时，不同的人其实指的是不同的意思。

So I think different people mean different things when they say calories in calories out.

了解我们具体在讨论什么很有帮助。比如，有些人认为，就减脂而言，唯一重要的是热量摄入与热量消耗之间的差值，而我们必须明确我们关心的结果是什么。

And it's helpful to kind of know what are we talking about So when we say for example, there are some folks who say, the only thing that matters, when it comes to body fat loss, so we have to focus on what is the outcome that we're interested in is the discrepancy between calorie intake and calorie expenditure.

这是一个有趣的问题。

And that's an interesting question.

而且，这并不一定成立。

And, and it's not necessarily the case that, that would be so.

换句话说，如果你能改变热量的类型。

In other words, if if you could change the type of calories.

我们所说的食品中的热量，是指氧化三种宏量营养素之一或其混合物——碳水化合物、脂肪和蛋白质——所获得的热量。

So the calories we're talking about in food are the calories that you get from oxidizing one of the three macronutrients or a multiple mixture of macronutrients, carbohydrate, fat, and protein.

而热量消耗可能非常敏感地依赖于你所摄入的营养素组合。

And it could be that calorie expenditure depends very sensitively on what mixture of nutrients you are provided with.

对吧？

Right?

当人们最初研究这个问题时，十九世纪的狗实验非常有趣，他们对狗进行了大量的呼吸测量。

And when people were first studying this, in dogs back in the eight nineteenth century, What they were doing was very interesting experiments where they were doing all these respiratory measurements in dogs.

他们先让狗挨饿，观察它们会损失多少体脂，然后给它们喂糖。

They were starving them at first to see how much body fat they would lose, and then they'd give them back, like, sugar.

狗唯一获得的东西就是糖。

The only thing that the dog gets is sugar.

他们计算了体脂流失减缓了多少。

And they calculate how much did body fat loss slow.

他们给狗喂回脂肪，纯脂肪，纯糖。

They give them back fat, pure fat, pure sugar.

结果发现，要达到同等减缓饥饿狗体脂流失的效果，所需的糖和脂肪的量差异很大。

And it turned out there was very different amounts of fat and sugar that were to require to to equally slow the loss of fat in a starving dog.

这长期以来一直是个谜。

And this was a mystery for a long time.

为什么你需要提供两倍多的糖，才能像脂肪那样减缓体脂流失呢？

Like, why is it you had to give, you know, more than double the amount of sugar to stop fat loss slowing as as fat?

直到一位名叫马克斯·鲁布纳的人开始从热量角度思考问题：糖和脂肪各自含有多少热量？

And it wasn't until, this guy named, Max Rubner, decided to start to think about things in terms of, well, how many calories are in sugar and fat?

结果发现，单位质量的糖所含热量不到脂肪的一半。

And so per unit mass, it turns out that the the sugar has less than half the calories of fat.

结果发现，狗体脂的流失量并不与所喂入的糖或脂肪的克数相匹配。

And it turned out that the loss of body fat in the dog wasn't matching how many grams of sugar or fat you were giving.

结果发现，你摄入的糖或脂肪的热量才是关键差异。

It turned out how many calories of sugar or fat that you were giving made the big difference.

这意味着，就体脂流失而言，热量就是热量。

And the implication was that a calorie is a calorie when it comes to body fat loss.

但这些测量的精确性源自十九世纪。

But the precision of those measurements was back from the nineteenth century.

而且，这也并不必然意味着不可能存在某种精确的碳水化合物与脂肪组合，导致能量消耗发生变化。

And, it also didn't necessarily follow that it couldn't be, that there was some precise combination of carbohydrates and fats that could cause calorie expenditure to vary.

如果这种情况发生，那么你仍然不会违背任何物理定律，但可能会出现这种情况——这正是阿特金斯所声称的。

And if that happened, then you could still not violate any laws of physics, but you could have it so that, and this is what Atkins claimed.

对吧？

Right?

他声称，如果你在饮食中大幅减少碳水化合物，就会获得一种代谢优势，他称之为，本质上是说身体在以脂肪为燃料时效率低下，因此必须消耗更多热量。

He claimed that if you cut carbs enough in the diet, you're you would have a metabolic advantage, he called it, which was essentially saying that the body was inefficient at running on fat and would have to burn more calories as a result.

因此，你可能会遇到这样一种情况：你摄入的热量可能甚至相同或增加。

And so you could have a situation where the number of calories that you're eating, could be maybe even the same or go up.

他称之为高热量饮食法，可以让人永远保持瘦削，依据的是他患者们的轶事报告。

He called it the high calorie way to stay thin forever based on anecdotal reports from his his patients.

比如，我不吃任何碳水化合物，摄入的热量比以前多得多，但体重和体脂仍在持续下降。

Like, I'm I'm not eating any carbs, I'm eating way more calories than I used to and I'm still losing all this weight and body fat.

要让这种说法说得通，唯一的可能是热量消耗增加了。

Well, the only way to make that make sense is to have calorie expenditure go up.

因此，我们总是认为热量摄入与热量消耗是固定不变的，完全由我们掌控。

So again, we think of calories in calories out as these immutable things that we have total control over.

但实际上，它们彼此相互作用，可能依赖于宏量营养素的分布等因素。

And they're interacting with each other and they may depend on, the macronutrient distributions and things like that.

这些都是完全可以验证的正当问题。

And those are all perfectly legitimate questions to test.

因此，我们长期以来所做的研究就是把人带到代谢病房，让他们全天候、每周七天都和我们住在一起。

And so those were the kinds of studies that we were doing for quite some time was bringing people in, to a metabolic ward where they lived with us twenty four hours a day, seven days a week.

我们会精确控制人们摄入的碳水化合物和脂肪的量，并使用我们所能掌握的最精确方法，测量他们消耗的热量、脂肪氧化量、碳水化合物氧化量以及体脂的变化，以验证鲁布纳在十九世纪对狗提出的观点是否也适用于人类。

And we would manipulate very precisely how much carbs people were eating, how much fat that they were eating, and, measuring with the most precise methods that we had how many calories were being burned, how much, fat oxidation was there, how much carbohydrate oxidation was there, how much was body fat changing, trying to see if what Rubner had suggested back in the nineteenth century was true in dogs was also true in humans.

我们根据我在NIH职业生涯初期开发的一些数学模型设计了这个实验。

And we devised the experiment based on some of the mathematical modeling that I had been, developing when I first started my career at the NIH.

我们做的第一项研究实际上以一种有趣的方式设计，因为我们认为可以证明鲁布纳的理论虽然可能接近正确，但不必完美，可能存在某种情况会观察到差异。

And, the first study that we did was actually designed in a kind of an interesting way because we thought that we could show that Rubner, while maybe close to being right, it doesn't have to be perfect, right, that there could be a situation where you could see a discrepancy.

因此，我们设计了这项研究来验证这一点。

And so we designed this study to test that.

事实上，我们确实观察到了差异，不过这种差异在临床上毫无意义。

And in fact, we did see a discrepancy, clinically meaningless discrepancy by the way.

这在实际减脂方面完全没有任何影响。

It's like absolutely it doesn't make a a bit of difference when it comes to practical considerations for losing body fat.

但我们观察到一个差异：当肥胖人群在不同时间段分别仅从脂肪或仅从碳水化合物中减少30%的热量摄入时，当热量限制来自脂肪时，他们比热量限制来自碳水化合物时多减了一点体脂。

But we saw a discrepancy such that when the same people with obesity, had, a 30% restriction in calories coming only from fat versus in another time the same folks only from carbs, when they reduced the amount of calories coming in from body fat, they lost a tiny bit more body fat than they did when the same people had the same number of calories restricted from carbs.

这表明一卡路里并非完全等同于另一卡路里，但差异如此微小，临床上完全无关紧要。

Suggesting that a calorie wasn't exactly a calorie, but the difference was so miniscule that clinically it's totally meaningless.

但作为一名理论物理学背景的人，我认为即使这类

But as a background in theoretical physics, I think that even these kind

即使这是一个严格的原则，任何偏差都值得深入研究。

of And even principle if is like a hard and fast principle, any deviation at all is worthy of investigation.

没错。

Exactly.

所以这就是为什么我对这个结果感到兴奋。

And so so that's why I was excited by that result.

对吧？

Right?

当我看到那些对立的饮食派别却拿这项研究说事时，我简直震惊了——他们要么说这研究完全有缺陷、毫无价值，要么说低碳水不够低之类的。

And and kinda shocked when I saw, like, these competing diet tribes take that same study and say, oh, it's either completely flawed and worthless and it wasn't low carb enough or whatever.

另一群支持低脂饮食的人则说：

And then another group for pro low fat.

这不正证明了我们一直主张的观点吗？

It's like, you've proved what we've suggested all of.

嗯，这确实是。

Well, this is yeah.

我的意思是，这种现象在每一个阵营中都普遍存在，你知道的，每个饮食教派都是如此。

I mean, this is rampant, you know, in every tribe of Exactly.

每个饮食教派都是这样。

In every diet cult.

但关键是，生理机制极其复杂。

But the point is is that the physiology is incredibly complicated.

甚至身体如何实现这种近乎等效的状态，尽管并不完全相等，也令人惊叹。

And even how the body achieves this near equivalence and even though it's not precisely equivalent is is incredible.

对吧？

Right?

在体内，内分泌系统简直倒过来了，为了调控不同器官之间的能量物质分配，改变激素水平，从而使得在体重变化这个问题上——而这是鲁布纳完全不了解的，对他那些狗的实验来说是个黑箱——大致上成立。

Inside the body, it's like the hormonal system stands on its head in order to manipulate what what the different fuels are shuttling between the different organs, how hormones are changing, just to make it so that it's approximately true that when it comes to body fat changing, something that Rubner had no idea about, it was a black box for his dog experiments.

他不知道胰岛素的存在。

He didn't know about insulin.

他不知道肝脏在做什么，肌肉在做什么，胰腺在做什么。

He didn't know what the liver was doing, what the muscles were doing, what the pancreas was doing.

对生理机制的内部运作一无所知。

No clue about the inner workings of the physiology.

但令人着迷的是，这意味着人类或狗可以在广泛的宏营养素分布下生存。

But it's just so fascinating that the implications of this is that we can survive as humans or dogs on a wide variety of macronutrient distributions.

而在储存或动员身体脂肪中的热量时，那个专门负责储存热量的器官，其功能大致是等价的。

And when it comes to storing or mobilizing calories from our body fat, the professional organ that is there to store calories, it's more or less equivalent.

它不需要完全精确。

And it doesn't have to be perfect.

人类这种生物具有高度的适应性和创造力。

The human animal is highly adaptive and resourceful.

从你刚才所说的，我理解到，一切事情都比你想象的要复杂得多。

What I take from what you just shared is essentially everything is more complicated than you think it is.

是的，热量摄入与消耗确实存在，但比这更微妙。

Yes, calorie in, calorie out, sure, but more nuanced than that.

碳水化合物-胰岛素模型，或者这种整体观点的激素视角。

The carbohydrate insulin model or the hormonal kind of view of this whole thing.

确实，但可能比我们想象的还要复杂。

True, but also more complicated than perhaps we imagine.

然后我认为，除此之外，还有一层复杂性，那就是科学方法本质上是还原论的。

And then I think on top of that, there's the added layer of complexity, which is that the scientific method, by its very nature is reductionist.

将这种营养学上的还原论方法应用到这一切中本身就是有缺陷的，因为仅靠宏量营养素的比例并不能说明全部问题。

And to apply a nutritionally reductionist approach to all of this is flawed in and of itself because just macronutrient ratios aren't telling the whole story.

你需要将其置于整体食物的背景下考虑，比如食物基质本身。

Like you have to contextualize it in the holistic food, like the food matrix itself.

比如这里面有多少纤维，纤维对热量吸收有什么影响，等等。

Like how much fiber is in this and what does fiber do to the uptake of calories, etcetera.

从这里开始，事情就变得非常模糊了。

And this is like, it just gets super murky from there.

然后也许我会想知道，鉴于这一切的极端复杂性，你真的能从中得出结论吗？

And then perhaps I'm interested in like, can you draw conclusions from all of this given like the vast complexity of all of it?

我的意思是，这真的非常困难，对吧？

I mean, it's incredibly hard, right?

我认为，作为科学家，我们必须保持谦逊，清楚地说明我们自认为对某个系统了解多少，哪些方面我们有一定把握，哪些方面才刚刚开始被理解。

And I think that that's, as scientists, we have to be really humble in kind of saying what we think we know about a system and what what things do we have a certain amount of confidence in and what things are just really beginning to be understood.

我想带你回到这一点：这不仅仅是食物的营养复杂性，还有我们所处的食物环境。

And I I wanna take you back to it's not just the nutritional complexity of food, but it's the food environment that we find ourselves in.

对吧？

Right?

所以，回到我们之前讨论过的那些反馈循环，它们阻碍了我们减掉比预期更多的体重，以及在特定环境中维持体重所需的种种努力。

So kinda going back to the comment about these different feedback loops that we talked about that are preventing us from losing more weight than we would like and, and the effort that's involved in keeping weight off in a given environment.

有趣的是，我们才刚刚开始理解这一点。

Well, the the funny thing is that and we're only beginning to understand this.

把同一个人转移到一个不同的食物环境中去。

You take that same person and you shift them to a different food environment.

之前需要费力的事情，现在不再费力了。

What was effortful before is no longer effortful.

换句话说，我们调节体重、食欲和能量消耗的那些机制，结果发现它们受到我们所处食物环境的极大影响。

In other words, points that we're regulating our body weight and our appetite and our energy expenditure, those controls that are helping us regulate body, weight turns out to be incredibly influenced by the the food environment that we find ourselves in.

所以，你知道，我一直在做这些研究，我们操纵宏量营养素，观察到一些微小到临床上毫无意义的差异。

So, you know, I was doing these studies where we were manipulating macronutrients and observing these little tiny clinically meaningless differences.

但一旦我们开始进行实验，直接说：‘你想吃多少就吃多少，我们只是改变你接触到的食物。’

But as soon as we started to do experiments where we basically said, look, eat however much you'd like, we're just gonna change the foods that you're exposed to.

现在我们开始看到每天几百卡路里的差异。

Now we are starting to see hundreds of calories a day differences.

当这些被试被要求：想吃多少就吃多少。

And when we're these people are being told, eat as much as you'd like.

不要试图改变你的体重。

Don't be trying to change your weight.

我们测量了很多东西。

We're measuring lots of stuff.

你不知道的是，我们测量了你所有的剩饭剩菜。

What you don't know is we're measuring all your leftovers.

我们会计算你在不同食物环境中实际决定摄入了多少卡路里。

And, we're gonna calculate how many calories you decided to eat in these different food environments.

而且这些研究都是短期的，有很多局限性，食物环境也非常人为。

And they're really short term studies, lots of limitations, very artificial food environments.

但重点是，环境以某种方式与我们的基本生物学相互作用，而我们至今仍未完全理解这种作用，它使得我们所调节的体重点或狭窄的体重范围受到食物环境的极大影响。

But the point is is that the environment is somehow interacting with our fundamental biology in ways that we still don't fully understand and is making it so that whatever point we're regulating or whatever narrow range of body weights that we're regulating is so influenced by the food environment.

关于这一点的神经科学才刚刚开始被揭开。

And the neuroscience of that is only beginning to get unpacked.

这是一个非常有趣的现象：尽管人们并没有试图改变自己摄入的热量或体重，他们却会自发地每天改变数百卡路里的摄入量，自发地增重、增加体脂，或减重、减少体脂，完全不需要任何努力。

It's a really fascinating sort of observation that despite people not trying to change the numbers calories that they're eating and trying to change their body weight, they're spontaneously changing them by hundreds of calories per day, spontaneously gaining weight, gaining body fat, losing weight, losing body fat without any effort whatsoever.

我认为这极其引人入胜。

And I think that's incredibly fascinating.

这也暗示了，或许我们在整个社会层面所看到的平均体重上升和肥胖率增加，正是由于我们的食物环境发生了某种变化。

And it's it's also suggests that maybe that's what we're seeing in society writ large when it comes to the increasing amounts of average body weight and the increasing prevalence of obesity that we're seeing is that something about our food environment has changed.

关于这一点的科学研究，我认为才刚刚开始被解开。

And the science of that is I think still beginning to get unraveled.

是环境的问题，蠢货。

It's the environment, stupid.

你明白我的意思吗？

You know what I mean?

我们可以争论食物金字塔或食物盘子之类的各种东西。

It's like we can argue about the food pyramid or the food plate and like all this sort of stuff.

但从根本上说，你会吃你环境中存在的东西。

But fundamentally it is, you you're gonna eat what is in your environment.

如果你所有工作的核心主题或论点是什么，那就是：这种肥胖流行病，以及慢性生活方式疾病急剧上升，主要是由有毒的食物系统造成的。

And if there is a core kind of theme or thesis to all of your work, it's that, you know, this obesity epidemic, this incredibly precipitous rise in chronic lifestyle ailments are primarily the result of toxic food systems.

这是一个系统性问题。

It's a systemic issue.

所有这些对意志力或意志力失败和个人饮食选择的关注，都必须放在这个背景下理解，才能真正弄清楚发生了什么，并制定出有效的解决方案。

And all of this focus on willpower or the failure of willpower and individual food choices has to be contextualized within that in order to really understand what's going on and craft solutions that are going to be effective.

对。

Right.

是的，我认为这是对的。

Yeah, I think that that's right.

有些人在特定的食物环境中即使面临挑战，也能取得很大成功，部分原因在于他们限制了自己接触的食物种类，或剔除了那些他们认为可能可以接受的食物。

And the degree to which some individuals might have a lot of success even within a given food environment, some of it is by limiting the foods that they're exposed to or limiting the foods that are on their list of things that they are even deeming possibly acceptable.

因此，我将这种做法视为一种局部环境的调整。

So I sort of view that as a pseudo sort of local environment shift in that way.

那些拥有特权、兴趣、精力和动力去进行这种局部环境调整，并能接触到有助于身体体重调节系统向积极方向发展的食物的人，显然会取得最大的成功。

The folks who have, you know, the the privilege and the and the interest and the energy and, the motivation to kind of engage in that sort of local environment shift and have access to, the kinds of foods that are likely to drive the body weight regulatory system in the positive direction, yet clearly they're gonna have the most success.

对于这些个体，有许多角色和充分的理由去参与和支持他们。

And there's lots of roles and lots of good reasons to kind of engage in those with those folks on an individual by individual level.

也有很多人的职业生涯正是建立在这种模式之上，我完全支持这种做法。

And there's lots of people whose careers are made on on that sort of thing, and I completely encourage that.

但我认为，这种观点忽视了一个事实，即在特定环境中，体型的差异有40%到70%是由遗传决定的。

But I think it overlooks the fact that, you know, body size in a given environment is, you know, 40 to 70% heritable.

嗯。

Mhmm.

有些人比其他人更容易受到食物环境变化的基因影响。

And that some of us are more genetically susceptible to shifts in our food environment than others.

在人口层面，我们必须考虑食物环境的全部复杂性。

And at the population level, what we have to account for is the full complexity of that food environment.

所以这不仅仅是食物本身，还包括它们的背景、广告方式、最便宜、最方便、最容易获得的食物，以及我们的技能水平。

So it's not just the foods themselves, it's the context and how they're advertised, what are the most inexpensive, the most convenient, the most readily available foods, What are our skill sets?

我们在社交情境中是如何互动的？

How are we relating to our in our social situations?

我们身边是否有支持我们改变局部环境的人，还是他们会抵制这些改变？

Do we have supportive folks who are gonna support us to make changes in our local environment, or are they gonna resist those changes?

这变得极其复杂。

It gets incredibly complicated.

但在最广泛的层面上，这似乎是对我们所观察到现象最明显的解释。

But at the broadest possible level, it just seems like the most obvious explanation for what we've seen happening.

体型分布的变化，我的意思是，这些变化早在几个世纪前就开始以积极的方式发生了。

The shifts in the body size distribution, I mean, they they happen they started happening, you know, centuries ago in positive ways.

对吧？

Right?

我们观察到体重和身高都在增加，这是由于营养不良造成的。

We saw increasing weight and increasing height where as a result of nutritional deficiencies.

对吧？

Right?

当我们进入二十世纪中期时，情况发生了变化。

Something shifted as we kind of got into the middle of the twentieth century.

而正是从那时起，我们开始看到工业化食品体系的重大转变，所以……

And that's where we get into the major shifts in the industrialized food system and So

我很欣赏你对饮食派系之争持反对态度。

I love the fact that you're very kind of anti diet tribalism.

听好了，你完全可以采用低碳水饮食或高碳水饮食来保持健康并持续减重，我们可以在这些细节上争论，人们也会为此争得面红耳赤。

Like, listen, you can be healthy and sustain weight loss on a low carb diet, on a high carb diet, like we can quibble around the edges there and people can fight and go to loggerheads over all that kind of stuff.

但从根本上说，房间里那头八百磅重的大猩猩就是超加工食品。

But fundamentally the eight hundred pound gorilla in the room is ultra processed foods.

所以当我们谈论食品环境时，这正是潜藏的巨兽，推动着所有这些有害的健康后果。

So when we're talking about food environments, I mean, is the kind of lurking giant that's driving all of these deleterious health outcomes.

是的。

Yeah.

我的理解是，如果再退一步看，超加工食品其实是我们在书中所说的热量过剩的后果。

I mean, the way I sort of see it is even taking one step back, which is you know, ultra processed foods are the consequence of what we call in the book the calorie glut.

自农业出现以来，人类一直努力为人口提供足够的热量。

So ever since the introduction of agriculture, humans have struggled to provide enough calories to feed populations.

当我们转向农业体系时，这可以说是一种魔鬼般的交易：社会人口得以增长，越来越少的人负责生产食物，我们因此有了文明等等。

That has been the kind of devil's bargain that was struck when we moved into agricultural systems is, society populations could grow, less and less people were responsible for producing food and we got civilizations and whatnot.

但与此同时，我们始终面临人口增长超过农业供养能力的威胁。

But at the same time, we were always threatened with population growth exceeding the ability of agriculture to feed populations.

当然，也曾出现过大规模饥荒的时期。

And there was obviously periods of mass starvation.

十八世纪著名的思想家托马斯·马尔萨斯观察到，我们注定会陷入饥荒，因为农业生产力和产量根本不可能跟上他所认为的人口指数级增长。

Thomas Malthus, kind of a very famous eighteenth century thinker basically made this observation that we're basically doomed to starvation because agricultural productivity and yields cannot possibly keep pace with what he saw as exponential growing populations.

但总体上，我们打破了这一趋势。

We bucked that trend for the most part.

是的，我觉得我们差不多已经做到了。

Yeah, I think we have pretty much.

这很有趣。

It's interesting.

这很狡猾，你知道的。

It's crafty, know.

这太惊人了。

It's amazing.

人类想出的解决方案相当巧妙，

It's kind of ingenious, the solutions that humans came up

用来

with to

解决这个问题。

solve this.

这确实令人惊叹。

It is amazing.

我们认为，好吧，这是十八世纪的托马斯·马尔萨斯。

We think that, okay, yeah, that's eighteenth century Thomas Malthus.

你知道，生物学家保罗·埃hrlich即使在1980年代还说，美国将出现大规模饥荒。

It was, you know, biologist Paul Ehrlich in the even in the 1980s was still saying that we would have mass starvation in America.

就在同一时期，我们目睹了肥胖率的急剧上升。

Right around the same time we were exceeding seeing an explosion of obesity prevalence.

你知道，我们在农业产量、农业工业化等方面所取得的成就真是令人惊叹。

And, you know, it's it's amazing what what we've been able to do with agricultural yields and industrialization of farming and whatnot.

但在二十世纪中期，我们基本上投入了所有资源和研究力量，以最大化热量生产，尤其是在美国、加拿大和欧洲等地。

But, we basically put in place, in, you know, the middle part of the twentieth century all of the resources and research to maximize calorie production, especially in places like The US and Canada and Europe.

我们在写这本书时做过一个计算，我觉得挺有意思的。

We did a calculation for the book, which I thought was kind of interesting.

如果你只考虑四种主要粮食作物——大米、玉米、小麦和大豆，然后问一个问题：这些作物每天为每人生产多少卡路里？

If you just take the four commodity crops for food, rice, corn, wheat, and soy, and you ask the question, how many calories per person, per day are produced in those, those few commodity crops?

结果发现，每天每人生产的热量高达15000卡路里。

It turns out to be 15,000 calories per person per day.

所以，哇。

So Wow.

你知道，六倍，你知道，是的。

You know, six fold, you know Yeah.

营养需求是什么。

What the nutritional needs are.

我们一直在寻找方法来消除这些过剩的热量。

And we've been finding ways to kind of get rid of that glut of calories.

对吧？

Right?

大量的大豆和玉米被用于生物燃料生产，还有畜牧业。

A huge chunk of the the soy and the corn goes to biofuel production, right, which for many And animal agriculture.

而畜牧业是另一大组成部分。

And then animal agriculture is the other big chunk of it.

对吧？

Right?

之所以这样能减少这些过剩热量，是因为动物有新陈代谢。

And the reason why that sort of works to get rid of it is because, well, animals have a metabolism.

对吧？

Right?

它们并不会把一卡路里的玉米直接转化成一卡路里的肉。

They just they don't just kind of translate one calorie of corn into one calorie of meat.

对吧？

Right?

它们在生存过程中会浪费掉大量这些热量。

They waste a lot of those calories by living essentially.

所以，动物农业是一个非常低效的过程。

And and so and so it's a very inefficient process, animal agriculture.

所以，是的。

So, yeah.

所以最终，美国实际的食物供应每人每天大约只剩下4000卡路里。

So at the end of the day, you end up with something more like 4,000 calories per person per day in the actual food supply of America.

而且自20世纪70年代以来的这一增长，已经足以解释肥胖问题。

And even that increase since the 1970s is more than enough to explain obesity.

事实证明，在扣除农业、畜牧业、出口和生物燃料生产后，食物供应中增加的热量中有大约三分之二被丢弃了。

Turns out that that about two thirds of the increase in calories in the food supply after accounting for agro animal agriculture and the exports and the and the biofuel production, two thirds of that increase went in the trash.

这是食物浪费。

It was food waste.

是的。

Yeah.

你发现了一个有趣的关联：食物浪费的增加与肥胖率的上升同步发生。

You have this interesting, like correlation between the increase in food waste and the increase in obesity.

对。

Yeah.

我认为这并非偶然。

And I don't think it's an accident.

我的意思是，关键在于我们制造了这种热量过剩，并找到了非常巧妙的方式将其转移出去，无论是通过畜牧业还是生物燃料生产。

I mean, think that the point is that we have produced this calorie glut and come up with very clever clever ways of offloading it both in terms of animal agriculture and biofuel production.

另一部分是超加工食品。

And the other part is ultra processed foods.

对吧？

Right?

它利用食品系统中廉价且高产的原料，创造出令人惊叹的转化方式。

It's taking those cheap high yield inputs to the food system and coming up with incredible ways to transform them.

谁能想到，你可以用玉米制成糖，也就是高果糖玉米糖浆，用于各种产品中？

Who would have thought you could take corn and make basically sugar, high fructose corn syrup for use in products?

通过补贴人为压低其价格，使其广泛可负担、高度可口、高热量、营养匮乏，而且它还具有一些特性，让我们想快速吃掉它。

Subsidizing it to artificially deflate the price of it to make it widely affordable, hyper palatable, highly caloric, nutritionally deficient and also something about it that makes us wanna eat it quickly.

这一点也存在，对吧？

There's that too, right.

所以我们超过了自身的食欲抑制机制。

So that we're ahead of our sort of appetite suppressant impulse.

对。

Right.

我认为很多人说食品行业完全了解这些成分导致我们过量食用的所有机制，但我并不一定认为这是真的。

And I think that there's a lot of people say that the food industry knows all the mechanisms by which these things cause us to over I don't necessarily think that's true.

我的意思是，我确信他们正在努力开发极其美味、在市场上表现良好的产品。

I mean, I'm sure that they're trying to come up with incredibly tasty products that do well in the marketplace.

对吧？

Right?

当他们失败时——很多产品确实会失败——他们会重新设计替代品并再次推出。

And when they fail, and many of them do fail, they basically reengineer a replacement and put it back.

这就像进化。

It's like evolution.

对吧？

Right?

这是市场上最能最大化销量的产品的优胜劣汰。

It's like selection of the fittest products on the marketplace that are maximizing sales.

对吧？

Right?

而且他们

And they're

不是，如果你把Fritos放进塔可钟的卷饼里会怎样？

not What happens if you put Fritos in a Taco Bell burrito?

你知道的？

You know?

而且人们喜欢这样？

And people like that?

没错。

Exactly.

就是说，咱们试试看。

It's like, let's try it out.

你知道的？

You know?

我们这里有

There's we got a

一个小焦点小组。

little focus group.

他们说他们很喜欢，所以决定试试看。

They said that they liked it enough to let's try it out.

是的，这正是我们当前所处的食品环境。

And, yeah, that's that's the food environment that we're experiencing right now.

而且我认为重点是，在农业领域，从始至终都存在这些未被纳入考量的外部性。

And, and I think the point is that both in the agricultural sector, all along the path, have these externalities that are not part of the equation.

对吧？

Right?

所有为实现这种工业化农业而造成的环境破坏，所有动物农业带来的问题——无论是从道德角度，还是从产生的粪便、甲烷排放以及气候变化来看——

All of the environmental damage that was done to kind of do this industrial agriculture, all of the, the problems with the animal agriculture just from a moral perspective as well as, you know, the the manure that's produced and and and and and the methane that's produced and climate change and

还有土壤的退化。

And the depletion of the soil.

因此，食物中的营养成分比以前少了。

So the nutrients that end up in the food are less than they once were.

是的。

Yeah.

我的意思是，关于这一点的重要性，可能还存在一些争论。

I mean, some debate about that I think about how important that is.

但我认为确实有案例已经证明了这一点。

But I think that there are certainly cases where that's been shown.

另一个巨大的外部性是医疗成本，对吧？

The other big externality has been health care costs, right?

我的意思是，我们正经历着与饮食相关的慢性疾病急剧增加，这几乎正在拖垮医疗保险、医疗补助和整个医疗体系。

I mean, the fact that, we are experiencing this dramatic increase in diet related chronic disease that is essentially bankrupting Medicare, Medicaid, and the health sector.

而认为这一整个过程解决了马尔萨斯问题，也就是我们实际上已经解决了马尔萨斯问题。

And to think that this entire process of you know, solving Malthus' which is essentially we've solved Malthus' problem.

对吧？

Right?

我们必须做点什么来改变这种状况，不仅是为了应对健康危机，也是因为我们未来不久将面临一百亿人口，这解决了马尔萨斯问题，因为人口预计不会再增长了。

And we have to do something to kind of change this, not just for the health crisis, but the fact that we're gonna have 10,000,000,000 people on the planet in, you know, not too far distant future, that solves Malthus' problem because the population is no longer expected to increase.

我们需要对食品系统做些什么，才能既确保热量的分配，又让这些热量对我们和地球真正健康？

What do we have to do to the food system to both ensure that we have distribution of calories and that those calories are actually healthy for us and the planet.

这是未来几十年农业、营养学和食品科学面临的重大挑战。

That's the grand challenge of agriculture and nutrition and food science for the next several decades.

我们需要在这个背景下思考这个问题。

And we need to think about it in this context.

从某种意义上说，肥胖和饮食相关的慢性疾病就像是副现象，对吧？

In some sense, like the obesity and diet related chronic diseases are like the epiphenomenon, right?

它们之所以发生，是因为我们在农业系统中过早地大量投入了这些热量。

Like they're the thing that happened because we front loaded all those calories in the agricultural system.

现在我们必须找到一种方法，避开这个问题。

And now we've got to figure out a way to kind of steer past that.

幸运的是，一些疗法正进入市场，可以帮助那些在基因上最易受食品环境变化影响的人群。

Fortunately, we have some therapies that are entering the market that can help the folks who are most genetically susceptible to those changes in the food environment.

但我们也不能只停留在这一点上，还要进一步思考：当我们需要为一百亿人提供健康、公平分配且对地球可持续的饮食时，我们最终希望达到什么样的状态？

But we've got to think past that as well and look to see where do we want to end up when we have to feed 10,000,000,000 people a healthy diet that's equitably distributed as well as sustainable for the planet.

今天的节目由Broca赞助。

Today's episode is brought to you by Broca.

说来有趣。

You know, it's funny.

我们通常不会把眼镜视为运动装备，直到它开始妨碍我们。

We don't often think of eyewear as performance gear until it starts to get in the way.

如果你像我一样，一生都受视力问题困扰，那么对运动员来说，这确实是个现实问题，却缺乏真正的解决方案。

And if you're like me, somebody who has contended with eyesight impairment my entire life, it's a very real thing without a real solution for athletes.

我没法告诉你，有多少次在跑步途中，我不得不不断把眼镜推回鼻梁上，因为看不清路面上的树根和石头而绊倒，或者眼镜起雾了。

I cannot tell you how many times I've been mid run constantly shoving my glasses back up my nose, tripping on roots and rocks because I couldn't see them or my glasses had fogged up.

那在骑自行车时呢？那种危险显然更加严重。

Or what about out on a bike where the treachery is obviously far more intense?

因此，ROKA对我来说简直是救星。

Well, is why ROKA has been a godsend for me.

ROKA从运动性能的角度来设计处方眼镜，但并未牺牲时尚感。

Approaching prescription eyewear from a performance perspective first but not at the cost of fashion, should say.

帮助像我这样的人，以及各种运动员，包括环法自行车手和铁人三项冠军，让他们都能使用日常款眼镜，这非常重要。

Helping not only people like me, but all kinds of athletes, including Tour de France cyclists and Ironman champions with everyday frames is important.

他们的秘诀在于专有的仿生 Gecko 技术，专利的鼻托和镜腿垫，越出汗抓得越牢。

Their secret is their proprietary gecko technology, patented nose and temple pads that grip even more securely when you sweat.

不会滑落，不会分心，而且轻得不可思议。

No slipping, no distractions, and they're insanely lightweight.

大多数镜框重量还不到一支铅笔，即使配了处方镜片，也超级轻盈。

Most frames weigh less than a pencil, super light, even with prescription lenses.

除了功能，其工艺水平也达到了极致。

Beyond the function, the craftsmanship is next level.

锐利的光学性能、坚固的结构，以及真正美观且能跟上你步伐的设计。

Razor sharp optics, durable construction, and a design that actually is beautiful and keeps up with you.

戴上它，感受差异，无拘无束地佩戴。

So put them on, feel the difference, and wear without limits.

在 roka.com 使用优惠码 rich roll，立享订单 20% 折扣。

Unlock 20% off your order with the code rich roll at roka.com.

那就是 roka.com。

That's roka.com.

本节目由 BetterHelp 赞助。

The show is sponsored by BetterHelp.

假期会引发很多情绪。

The holidays bring up a lot.

好的一面是，我们有各种家庭传统、期待，以及代代相传的食谱。

On the good side, we've got all these family traditions, anticipation, recipes passed down for generations.

对很多人来说，这真的很美好。

We've And for a lot of people, that's really beautiful.

但对许多人来说，这一年中的这个时候却有些复杂，比如那些反复出现的糟糕家庭行为模式，当那个你早就知道会说奇怪话的叔叔终于开口时的尴尬，社交信号被误解，你懂我的意思吧。

But for many others, this time of year is a little bit complicated, like not so great family patterns of behavior that flare up, the awkwardness when that uncle says the weird thing that you knew he was going to eventually, social cues get misinterpreted, you know what I mean.

并非所有传统都对我们有益。

Not all traditions serve us.

有些只是我们继承下来、却不再符合我们当下身份的东西。

Some are just things we inherited that don't really fit who we are anymore.

我希望你们能考虑一下，也许今年是时候重新定义这一切了，创造真正对你有意义的新传统，无论是从头开始，还是放下那些历来无效、从未起作用的习惯。

And I'd like you to consider that perhaps this might be the year to rewrite all of that, to create new traditions that actually mean something to you, whether that's starting fresh or letting go of these things that historically don't work and never have.

十二月接受心理咨询是实现这一目标的绝佳方式，帮助你梳理这一时期的种种复杂情绪，带着清晰的心态告别这一年，从容应对而非仅仅勉强熬过混乱。

Therapy during December is a pretty great way to do just that, to process all of the complexity of this time of year, to close the year with clarity, and to navigate it successfully instead of just trying to survive the chaos.

而这就是BetterHelp真正能为你提供帮助的地方。

And this is where BetterHelp can really be of service to you.

BetterHelp已为全球超过500万人提供服务，拥有超过3万名持证治疗师，基于超过170万条客户评价，平均评分为5分中的4.9分。

BetterHelp has served over 5,000,000 people worldwide with more than 30,000 licensed therapists with an average rating of 4.9 out of five based on over 1,700,000 client reviews.

所以，今年十二月，开启一个新传统——好好照顾你自己。

So this December, start a new tradition, taking care of you.

现在，你们所有听众都可以在betterhelp.com/richroll享受10%的折扣。

And right now, all of you guys, our listeners, get 10% off at betterhelp.com/richroll.

那就是betterhelp.com/richroll。

That's better,help,.com/richroll.

我的意思是，从这里开始，一切分道扬镳了。

I mean, here's where everything bifurcates.

一方面，我们拥有个人选择。

Because on the one hand, we have personal choice.

我们每天几次决定吃进嘴里的是什么？

What are we deciding to put in our mouths a couple of times a day?

什么对我们来说是可得且负担得起的？

What's available to us and affordable?

我们个人的自主权以及与自身身体的关系有多大的范围？

What is the extent of our personal agency and our relationship with our own bodies?

另一方面，还有公共政策，关乎整体利益，以及我们需要做出哪些系统性改变，才能实现一个健康星球和健康人群的目标，所有这些。

And then there's public policy and what's good for the whole and what are the systemic changes that we need to make for a healthy planet and a healthy populace, all of that.

这是两种不同的讨论。

And those are two sort of different discussions.

我的意思是，它们彼此相互影响。

I mean, they inform each other.

但我认为，在关于健康和应对肥胖流行病的讨论中，这两者常常被混淆和混为一谈。

But I think in the conversation around well-being and addressing the obesity epidemic, these two things get conflated and confused with each other.

也许这正是你与卫生与公共服务部产生分歧的地方，因为这里存在着一种明显的讽刺：你正在发出关于超加工食品的警告。

And perhaps this is where you kind of butt up against HHS here a little bit because there's such a palatable irony here because you're raising the alarm of ultra processed foods.

这正是导致所有问题的根源，而这与RFK Jr.所说的内容以及整个MAHA运动的主张不谋而合，对吧？

Like this is really what's driving all of the problems, which is in parallel with everything that RFK Jr.

所以你可能会想，嘿，你应该是这个运动的盟友。

Is saying and what the whole MAHA movement is about, right?

但你的研究结果并没有完全符合RFK所认定的真相。

So you would think, hey, you're an ally to this movement.

正是在这里，矛盾产生了。

But your research didn't exactly line up with whatever RFK decided was the truth.

你能谈谈这一点吗？

And this is where this conflict arose.

当然可以。

Can you talk a little bit about that?

是的，没问题。

Yeah, sure.

我的意思是，我们甚至可以回溯到上一次选举之前。

I mean, let's go back even before the last election.

对吧？

Right?

在上一次总统选举之前，这本来是一个两党共同关注的问题。

So before the last presidential election, this was a bipartisan issue.

对吧？

Right?

我们还可以再往前看，比如在米歇尔·奥巴马发起‘动起来’运动时，这还不是一个两党共识的问题。

And and and we can go way back when it wasn't a bipartisan issue with Michelle Obama and the Let's Move campaign.

当时这明显是民主党的议题，人们关注改善饮食、应对肥胖问题。

It was clearly a democratic issue, and people were interested in improving our food and our and and, in addressing obesity.

这显然是一个共识。

That was clearly a Yeah.

而那并没有

And that didn't that didn't go

所以还不错。

so well.

没搞好。

Did not go well.

对吧？

Right?

尽管有那么多良好的意图之类，但结果并不理想。

And for all that good intentions and and whatnot, it did not go well.

但当时发生了一些不同的事情。

But there there was something different that was going on.

我觉得很大一部分原因在于关于超加工食品的讨论，因为我们过去也讨论过这些，你知道，要么是糖，要么是饱和脂肪，要么是钠和盐，这些都被视为公共健康的敌人。

I think a lot of it had to do with the the discussion about ultra processed food because we've had these discussions back, you know, it's it's either been sugar or saturated fat or sodium and salt that have all been like public health enemies.

关于这些议题，背后都有大量数据支持，说明少吃盐、少吃饱和脂肪、少吃糖等对人们更有好处。

And they've all had there's a lot of data behind those, kinds of campaigns and why it would be better for people to eat less salt and eat less saturated fat and, and eat less sugar and things like that.

我认为很少有人会反对这些观点，但它们并没有引起足够的公众关注，尤其是在政治层面——比如，我不记得曾经见过参议院听证会，是的。

And I don't think there's many folks who disagree with it, but they didn't really capture enough public attention, especially at the political level that, you know, I don't remember seeing a senate hearing Yeah.

关于添加糖，你知道的。

About, you know, added sugar.

对吧？

Right?

当时被解读为对个人自由的冒犯，也许这正是信息传达的失败之处。

Well, was interpreted at that time and perhaps that was a failure of the messaging as an affront to personal liberty.

就像是政府要告诉你该吃什么。

Like, government's gonna tell you what you should eat.

没错。

Right.

简直岂有此理，居然干涉我的个人选择。

Like, how dare they, you know, kind of intrude upon my personal choice.

没错。

Right.

而不是说：嘿，有一些阴暗的、庞大的企业根本不在乎你的利益，它们在针对你。

As opposed to, hey, there are shadowy, you know, giant corporations who don't have your best interest at heart here and they're out to get you.

或者，当时可能有另一种方式来传达这个信息。

Or, you know, there could have been a different way of And communicating that message at that

我认为，正是‘超加工食品’这个概念带来的一个关键点在于：食物的营养特性、营销方式、我们所经历的整体食品体系，以及自二十世纪中期以来这些方面的变化，都非常重要。

I think possibly that's part of what this idea of ultra processed food has kind of brought to the table has been the fact that all of these things are important about the nutrient properties of the foods that there are and the way that they're marketed and the overall system of food that we're experiencing and how it's changed since, you know, the middle of the twentieth century.

所以，是的，我们当时有像伯尼·桑德斯、科里·布克这样的人。

And so, yeah, we had, like, you know, Bernie Sanders, Cory Booker.

你根本分不清他们对这件事的评论和比尔·卡西迪，甚至罗伯特·F·肯尼迪 Jr. 当时的说法有什么区别。

You couldn't tell their comments about this from Bill Cassidy or even RFK junior at the time.

这就像，我仍然觉得，如果你今天去问科里·布克，他可能会说，嗯，他现在正在度蜜月，对吧？

It was like it was and I still think that if you talk to Cory Booker today, he would probably tell you, well, he's on honeymoon, I guess, right now.

是的。

Yeah.

他现在正在度蜜月。

He's on honeymoon right now.

但不是这样的。

But no.

但这是他非常关心的问题，确实如此。

But this is it was an issue that he cares deeply Exactly.

他长期以来一直在致力于此。

About and has been working on for a very long time.

确实如此。

Exactly.

因此，我认为对于这一系列议题，仍然存在两党支持。

And so I still think that for this particular set of topics, there is bipartisan support.

在当前政府之前，营养科学长期以来一直受到 NIH 的严重资金不足。

And before this current administration, nutrition science has been funded horribly by the NIH for a very long

时期。

period.

所以资金匮乏并不是新情况。

So it's not a new situation that the funding has been anemic.

确实如此。

Exactly.

我认为，我们一直专注于这个，这确实是开展这项工作的充分理由，但长期以来，重点一直放在生物医学项目上，即想办法治疗和治愈疾病。

And we've been focused, I think, you know, this is a good justification for doing this, but there's been a huge focus on the sort of biomedical program of let's figure out how to treat and cure disease.

对吧？

Right?

没人会反对这一点。

No one's gonna argue with that.

对吧？

Right?

每个人都希望能够治愈癌症，用更好的疗法治疗糖尿病等等。

Everyone wants to be able to cure cancer and treat diabetes with better therapies and whatnot.

但营养科学、预防以及疾病流行环境因素方面的关注和资金投入却较少。

But there has been less emphasis and less funding on nutrition science and prevention and the environmental drivers of disease prevalence.

为什么？

Because?

这是个很好的问题。

It's a great question.

是不是大食品游说团体的资金在影响拨款？

Is it is it, you know, is it big food lobby money, that is influencing appropriations?

我不知道。

I don't know.

我真的不知道。

I honestly don't know.

是缺乏政治意愿吗？

Lack of political will?

我的意思是，我们不妨直说吧。

I mean, I would say that there's probably let's let's face it.

人们什么时候会对疾病产生强烈反应呢？

When do people get exercised about, you know, disease?

当他们自己或亲人患上疾病时。

It's when they get a disease or a loved one gets a disease.

对吧？

Right?

他们首先想要的是治愈方法。

And the first thing they want is a cure.

因此，有许多组织和个人在为那些早已由环境因素引发的疾病所造成的后果而大力游说。

So there's a huge amounts of lobbying from organizations and people who have already suffered the consequences of diseases that were put in motion by environmental drivers a long time ago.

但他们所要求的并不是去解决那些几十年前就已导致这些问题的其他因素，比如为了我的孙子辈。

And the ask is not, let's fix those other things that have driven this for, you know, my grandchildren.

他们的诉求是：我需要知道，在我的父母或孩子还剩几年生命的时间里，我该做些什么才能找到治愈方法。

The ask is, I wanna know what it is that I'm gonna have to do to get a cure in the few years left that my, you know, parent or my child has this disease.

这是一个非常有力量的信息，能引起人们的共鸣。

That's a very powerful message that resonates with people.

我并不想否定这一点。

And I don't don't wanna take any anything away from that.

当然。

Sure.

它的紧迫性。

The acute nature of it.

但更多人其实一直在想，为什么我会发胖？为什么我就是减不下来？

But but But far more people are walking around thinking, how come I'm getting fat and how come I can't lose weight?

我的意思是，这几乎涵盖了80%甚至更多的人群。

Like, I mean, that is just that's like you're capturing like 80% of the population or probably more.

但公平地说，近年来我们已经为其中几种情况开发出了相当不错的治疗方法。

And to be fair, we've come up with pretty decent treatments in recent years for several of those things.

而且我认为这对那些人来说是好事，但这并不意味着

And I and I think that that's a good thing for those But it doesn't

这并不是针对根本原因的解决方案。

mean root cause, solutions.

它们并不是根本原因的解决方案。

They are not root cause solutions.

没错，就是这样。

That's that's correct.

它们对某些人有效，我不认为我们应该低估这一点。

They are solutions for some people and I don't think we should, minimize that.

就像我说的，它们是我们通往食物系统所需目标的桥梁的一部分。

And like I said, they are part of the bridge that's gonna get us to what we need where we need to go with our food system.

你指的是像减重手术或GLP-1类药物这样的东西吗？

By this you mean like bariatric surgery or GLP-1s?

是的，正是如此。

Yeah, exactly.

这些是针对那些最易受环境变化影响的人群的治疗方法，正是这些环境变化导致了肥胖率的上升及其一系列下游后果。

Like these are treatments for the ones the folks who were most genetically susceptible to the environmental changes that have put in place the increase in obesity prevalence and the downstream, consequences of that.

幸运的是，我们现在有了有效的治疗方法，其中一些已经能够大规模应用，帮助到许多人。

We thankfully now have effective treatments, and some of them can scale at a level that that will help many of those people.

我认为这是件好事。

I think that's a great thing.

但我觉得你指出得很对：我们投入的资金太少了，根本没好好去探究：我们该如何超越现状？这些问题的根源到底是什么？

But I think you're right to point out that funding to figure out what are how are we gonna move past this and what was the cause of these problems in the first place?

这方面的投入一直严重不足。

It's been underfunded.

特别是营养科学一直资金不足。

And nutrition science in particular has been underfunded.

我觉得这很可悲。

And I think it's tragic.

你知道，就连上届政府期间，我也亲身体验过这一点——当我们发表了一篇关于超加工食品的重磅论文，显示当人们暴露在大量超加工食品的环境中时，他们会摄入多得多的热量。

And, you know, I experienced that even in the last administration, what we've what we've, after we had this big paper on ultra processed foods come out showing that when people are exposed to environments with lots of ultra processed foods, they ate many, many more calories.

他们自发地增重并增加体脂。

They spontaneously gained weight and gained body fat.

这个结果令人震惊。

Shocking without that result.

然后将他们转移到极少加工的环境中。

And then shifting them to a minimally processed environment.

这些环境在提供的热量、宏量营养素、血糖负荷、纤维和钠含量上都进行了匹配，但仍然……

Again, these environments were matched for the number of calories that were presented to people, the macronutrients, the glycemic load, and the fiber, and, the sodium, and yet

还有我们尚未了解的营养暗物质

And the nutritional dark matter, which we haven't

甚至都还没人提过。

even talked about.

说说看。

Talk about.

所以他们只是在食物环境发生变化后，自发地只是决定少吃一点。

So they've experienced this change in their food environment spontaneously just, I just decided to eat less.

我并没有刻意做什么，只是轻松地调整了一下。

I'm not trying to do anything, just effortless shifts.

那项研究发表后，获得了比我预期多得多的关注，随后他们想关闭 NIH 的这个团队。

After that study came out and garnered like way more attention than I thought it was going to get, They wanted to close down the unit at the NIH.

这发生在2020年之前。

And this was prior to 2020.

这是在特朗普政府之前。

This was before the Trump administration.

那是2019年。

Was 2019.

是的，是的，是的。

Yeah, yeah, yeah.

就在那篇论文发表的同一年，我们被临床中心的首席执行官告知，他们打算关闭代谢单位。

So the same year that that paper came out, we were told by the CEO of the clinical center that they were gonna close down the metabolic unit.

我记得当时坐在房间里，会后我说：‘我真的不知道，如果这个单位被关闭了，我怎么能有信心继续我们的研究呢？’

I remember sitting in room, and afterwards I said, know, I just I don't see how I can have any confidence that I can continue to do our studies if this unit's closed.

他说：‘是的，你确实不应该对自己能继续下去抱有任何信心。’

And he said, yeah, you shouldn't have any confidence that you could

继续？你当时心里是怎么想的？

continue And to what is your theory of mind there?

我的意思是，推动你行动的动机是什么？

I mean, is the motivating

推动他的动机是，我认为他计划将这个设施用于他认为更合适的用途，关于这一点我们可以争论。

The motivating fact was that I think he had plans for that facility that he thought were better suited, and we can have a debate about that.

而且他在NIH的职位比我高。

And he was in a higher position at the NIH than I was.

而且，是的，我认为有几种理论。

And, yeah, I think that there are several theories.

我觉得他可能想设立一个阿尔茨海默病单元。

I think he wanted to maybe set up an Alzheimer's unit.

我不太确定那些不同的竞争性理论具体是什么。

I'm not exactly sure what the different competing theories were.

但我们本可以就此展开辩论，而实际上这个辩论被压制了。

But we could have a debate about that, but that was the debate was sort of shut down.

我后来得知HHS有一位更高层的人读过我们的论文，于是我说：嘿，我听说您读过我们的论文，我们对此很感兴趣。

I ended up finding out someone at a higher level at HHS who had read our paper and I said, hey, I heard you, read our paper and we're intrigued by it.

可惜我们再也无法弄清楚其中的机制了，因为这个单元就要被关闭了。

Too bad we won't be able to figure out what the mechanisms were because the unit's gonna get closed.

这让我觉得太荒谬了，因为我们的整个慢性生活方式疾病流行病都追溯到了这一点，对吧？

It's outrageous to me because, like, our entire, epidemic of chronic lifestyle illness all tracked back to this, right?

这不仅导致了这些极其糟糕的健康后果，无端地使数百万人致残，而且还是困扰我们医疗体系的根本原因。

And not only is this driving all of these incredibly poor health outcomes and debilitating millions of people unnecessarily, it's at the root of what's ailing our healthcare system.

从经济角度来看，这进而成为了一个国家安全问题——这些是亟需解决的巨大难题，从根本上关系到我们民主体制的存续。

And so from an economic perspective, which then becomes a national security issue, like these are gigantic problems that need to get solved that are important for the kind of the sanctity of our democratic union fundamentally.

这不仅仅是人们生病这么简单。

Like it's more than just people are getting sick.

这就是为什么医疗保健现在如此昂贵、官僚化且如此繁琐的原因。

Like this is why healthcare is so expensive and so bureaucratic and so kind of overwrought right now.

如果我们想解决医疗保健问题，就必须解决它。

And we have to solve it if we want to figure out health care.

我完全同意。

I completely agree.

虽然我们成功地阻止了关闭我们单位的企图，因此在上一次选举前夕，当这个问题在两党间都受到关注时，我感到非常兴奋，对吧？

And so while we were successful at pushing back against that attempt at closing our unit, so that's why in the run up to this last election with the attention that this was receiving on both sides of the aisle, I was super excited, right?

我以为，

I thought,

没想到会来这么一个人，他谈论的正是我研究和关心的内容。

not Here comes a guy and he's he's talking about this stuff that I'm studying and that I care about.

但在我们谈到那个时间点之前，你因为写了这本书而差点被解雇，这是真的吗？

And it has But prior to that before we even get there on the timeline though, is it true that you almost got fired for writing this book?

这发生在当前政府上台之前，

Like this is before That the current administration,

确实如此。

is true also.

什么？

What?

什么？

What?

是的。

Yeah.

你只是在NIH研究加工食品和新陈代谢的普通人。

Like you're just a guy at NIH doing research on processed foods and metabolism.

是的。

Yeah.

那是

That's

最大的威胁是什么？

What's the big threat?

嗯，我觉得有几件事，对吧？

Well, think there's a couple of things, right?

有人向我表达了两个主要担忧。

And it was expressed to me that two main concerns.

一个是，我们整章都在讲政策。

One was that we have an entire chapter about policy.

NIH 一直以我们只提供科学依据、不发表意见为傲，对吧？

The NIH has always sort of prided itself as we provide the science, we don't opine Right.

我们不想介入政策决策。

About policy We don't want to get involved in policy decisions.

第二点是，他们指出书中大量内容并非完全驳斥，但确实对许多人的主张提出了质疑，比如不同饮食群体、销售补充剂的人、销售精准营养项目的人，他们不希望遭到这些人的反击

And the second thing that they pointed out was that the other thing we point out is in the book, there's a lot of I wouldn't say it's debunking, but it's a lot of challenging of claims that various folks are making in different spaces like, the different diet communities, the different folks who are selling supplements, who are selling precision nutrition programs, and they didn't want pushback from

我明白了。

I see.

这些人。

These folks.

而且因为你是一名政府雇员，没错。

And because you're a government employee Exactly.

这给他们带来了麻烦。

It's headache creating for them.

是的。

Yeah.

所以我最初说，要不我干脆不写上我的所属单位？

So I initially said, look, what if I just kind of not put my affiliation on there?

但他们不同意，说不行，如果你是这本书的作者，你将受到处分，甚至可能被撤职。

And there was they didn't agree to that and they said, no, if you're an author of the book, you're going to be disciplined and likely removed from your position.

所以我不得不聘请了一位律师，他非常有名，主要代理那些离开国家安全领域后出版书籍的客户。

And so I actually had to hire a lawyer who is well known for, he's well known for, basically representing clients who write write books after they leave the national security space.

他问我：你是不是想泄露什么机密信息？

And he's like, are you trying to like reveal some comp like classified information?

我说：不是。

I'm like, no.

他接着说：我不明白。

And he's like, I don't understand.

这真是你见过的最奇怪的事了。

This is the most bizarre thing you'd ever seen.

总之，他成功让国立卫生研究院同意让我成为这本书的合著者。

Anyway, he was able to kind of, basically get the NIH to ascend to letting me be a co author of this book.

而且通过

And by the

方式，保住你的工作。

way Keep your job.

是的，保住我的工作，对吧？不过我后来还是离职了，没错。

Yeah, keep my job, right, which I've since left, which is Yeah.

这是故事的另一部分，对吧？

Which is the other part of the story, right?

所以，是的，我想重点是，在那件事解决之后，我以为我会继续留在NIH，但新一届政府上台了，而且两党都支持终于加大对饮食相关慢性病和超加工食品问题的研究投入，对此我非常兴奋。

So so yeah, so I guess the the point was is that, you know, after that was resolved, and I thought I would be continuing with the NIH, I and this new administration was coming in and that there was bipartisan support for finally kind of investing in in understanding what's going on and and tackling these issues of diet related chronic disease and ultra processed foods, you know, I I was very excited about this.

事实上，我开始与NIH营养研究办公室的主任合作，我们一直在做艺术研究，嗯。

And in fact, I started working with, the director of the NIH, office for nutrition research about, you know, we've been doing art studies Mhmm.

这些研究规模都很小。

Which are pretty small scale.

它们需要多年才能完成，因为我们一次只能容纳两到三个人。

They take years to complete because we can only house two or three people at at a time.

如果我们能为其他研究人员提供设施，让他们能更舒适地居住，而不是在医院里，一次容纳几十人，那我们就能在几个月内而不是几年内回答美国人民应得的问题。

What if we had facilities for other researchers where we could house people for more comfortably, not in a hospital, and keep dozens of people at a time, get answers to these questions that the American people deserve in a matter of months rather than years.

我们可以不断循环测试不同的假设和研究机制。

And we could cycle through different hypotheses and different mechanisms that we were studying.

我们开始制定如何实现这一目标的计划。

And we started to work on a plan of how how we would do this.

我当时试图联系MAHA领导层的成员，想和他们谈谈这个计划，但他们当时太忙于与社交媒体影响者打交道了。

And and I was trying to contact members of, the the MAHA kind of leadership to talk about this, but they were too busy talking to social media influencers at the time.

但你知道，我们还是在继续推进我们的工作。

But, you know, we're plugging along doing our work.

最终，我希望能够向相关人员展示这个计划。

Eventually, I wanted to be able to kind of present this this sort of plan to folks.

在新政府上台后的过渡期，我们开始发现，某些话题被认为具有足够的政治敏感性，任何涉及结果传播、参加学术会议或新项目的活动，都必须上报至卫生与公共服务部，并由政治任命官员批准。

And, you know, in that transition period, after the new administration took over, we started to see that certain topics were deemed sufficiently politically interesting that any sort of work that would be communicating results, going to conferences, any new programs had to kind of go up to the level of the Department of Health and Human Services and be approved at by a political appointee.

因此，我开始亲身经历这种情况。

And, and so I started to experience this directly.

第一次是在我原定要在彭博慈善基金会年会上，就我们关于超加工食品的一些研究发表演讲时。

The the first occasion was I I was, supposed to give a talk at the Bloomberg Philanthropies annual meeting about some of our work on ultra processed foods.

而那是我自21年前在NIH工作以来，第一次被拒绝在会议上发言。

And, you know, for the first time in that time, twenty one years at the NIH, I was denied the opportunity to give a talk at the conference.

当时还不清楚，这究竟是因为旅行限制所致。

Now it was unclear exactly at the time was this because of travel restrictions.

于是我回到布隆伯格基金会那边，问他们：我能不能远程参加？

And so I went back to the Bloomberg folks and said, could I do this remotely?

他们说：没问题。

Would you mind if I they're like, yeah.

没问题。

No problem.

于是我再次申请远程参与的机会。

So re, requested the ability to do this.

但还是被拒绝了。

Still, denied.

当时我的同事们却都被允许发表演讲，尤其是远程演讲。

This was at a time when my colleagues were being allowed to give talks, especially remote talks.

所以，我们试图展示的这些结果，一定有什么特别之处，才被这样压制。

So there's something special about, the results that we were trying to present that was being, you know, suppressed in this way.

我们感兴趣的问题是：摄入超加工食品是否会像可卡因一样，劫持大脑的奖励系统？

We were interested in the question, do does ingestion of ultra processed foods hijack the brain's reward system in the same way that cocaine does?

我想问题是，成瘾并不一定非要通过这种特定的生物途径发生。

I guess the question is, addiction doesn't necessarily have to occur through this particular biological pathway.

明白吗？

Okay?

是的。

Yes.

像可卡因、甲基苯丙胺，甚至尼古丁这类药物，都会在大脑中引发异常强烈的多巴胺激增，从而导致一系列适应性变化，最终可能引发成瘾。

This has been a common phenomenon in the drugs like cocaine and methamphetamine, even nicotine cause an outsized surge in dopamine in the brain, which leads to a bunch of adaptations, that that can lead to addiction.

在肥胖研究领域，长期以来人们就通过神经影像学研究肥胖者和瘦人的大脑及多巴胺受体，发现肥胖者的大脑看起来更像那些可卡因成瘾者，而不是瘦人。

There's a very long history even in the obesity space of looking at neuroimaging studies of the brains and dopamine receptors, in people with obesity and people who are lean and saying, hey, look, the brains of people with obesity look more like, people who've been addicted to cocaine than the folks who are lean.

因此，这种与可卡因相关的特定神经生物学成瘾机制已经被充分理解。

And so there is this particular neurobiological mechanism of addiction, which is well understood with cocaine.

但当谈到食物成瘾时，这一直只是假说。

But it's always been hypothetical when it comes to food addiction.

所以这就是我们做研究的原因。

And so that's the reason you do research