#866：Virta Health 的萨米·因基宁——逆转2型糖尿病、划船2750英里，以及从10万多人的代谢健康改善中获得的启示

天哪，萨米。

Damn it, Sami.

我真需要尽可能多的帮助。

I need all the help I can get.

所以当大脑处于接收模式时，你只是在不停地往杯子里倒东西。

So if the brain is in a consumption mode, you're kinda just filling the cup.

我发现那些创造性想法和问题解决能力，往往是在后台默默进行的，但现在却消失了。

And I've noticed the creative thoughts and the problem solving that's happening kind of in a backwards background processing is not happening.

总之，我注意到，听太多有声书和播客，脑子被塞得太满，反而停止了创造。

So, anyways, that's a tactical thing that I've noticed that too much audiobook podcasts kind of filling the brain and it stops creating stuff.

这真的很有趣。

It's very interesting.

至少这是我个人的体会。

That's at least my personal experience.

所以我现在特别留意，在锻炼、散步或者开车的时候，给自己设个界限。

So I'm very conscious of on those moments when I'm, you know, exercising or walking or driving somewhere that there's kinda like a cutoff point.

别再听了。

No more listening.

让大脑自己去运转。

Just let your brain do its thing.

到了星期三，我就感觉脑子里已经有个大致框架了。

And then the Wednesday comes in, it's more like, okay, now I kinda have the framework in my head.

花一个半小时，写写明年的工作重点吧。

Take an hour and a half to, I don't know, write above next year's priorities.

这就是我们即将推出的新产品。

So this is gonna the new product we're gonna launch.

甚至我写的那些团队信件，其实都是在离开书桌的时候，在脑子里先构思好的，等坐下来一写，就

Or even these team letters that I write, I actually write them in my brain when I'm away from the desk, and then when I sit down, it just

这正好引出了我下一个问题。

actually leads into my follow-up question.

我相信不只我一个人好奇，当你做这些锻炼的时候——假设是早上一做就是一个半小时到两小时，真正高强度的训练——肯定有不少想法在脑子里慢慢冒出来。

I can't imagine I'm the only person wondering this, which is when you're doing these workouts, let's just say it's an hour and a half to two hours, the real workouts, right, in the morning, I would imagine quite a lot percolates and comes up.

如果你周一、周二，甚至周六、周日都这么做，等到了周三，要是我没及时用语音录下来，或者在本子上记点简短的提示，我真怕自己记不住这周早些时候冒出的好点子。

And if you're doing that Monday, Tuesday, maybe also Saturday, Sunday, etcetera, by the time you get to Wednesday, if I have not taken some step to maybe verbally record some of that or make short notes in a notebook for cues for later, I would be doubtful that I would be able to recall the good ideas that I had earlier in the week.

你是天生就能记住这些东西，还是锻炼完后会记点速记，留着周三当提醒用？

Do you just have a preternatural inclination to be able to remember all that stuff, or do you take some type of shorthand after the workout so that you can use those then on Wednesday as prompts?

这具体是怎么操作的？

How does that work?

我基本上会给自己发邮件，或者存些笔记。

Essentially, I write emails to myself or store notes.

其实是一回事。

It's the same thing.

一整周下来会积累不少零碎想法，到了周三就能用上。

So there's tidbits along the week, and then I have it for Wednesday.

一半在脑子里，一半写在别处，这样才不会全忘掉。

And then half may be in in the brain and half is is written somewhere so I don't forget it all.

锻炼完你就直接给自己发封邮件，记点东西？

And you just send yourself an email after the workout with some type of note?

是的

Yeah.

对

Mhmm.

没错

Yep.

你周三发给团队或公司的邮件一般会写些什么呢？大概有多长？

What is an example of what you might cover in a team slash company email on a Wednesday, and how long is that?

就像你之前提到的，这是你从一开始就一直坚持的做法。

That is, like you mentioned earlier, one of the things you've repeated since day one.

能举个具体的例子吗？

What would be an example that you can share?

可以是假设的，但大概会写些什么内容？篇幅多长？

Could be hypothetical, but just, like, what might you put into that, and how long is it?

当然。

Absolutely.

嗯，其实有个大概的固定结构。

Well, there's sort of half a standard structure.

比如我们会引用一段患者的话，细节后面再说，但你知道，我们做的就是逆转代谢性疾病，帮助人们通过营养恢复健康。

So there's a quote from, again, we can go into details, but you know, we're in a business of reversing metabolic disease and helping people get healthy with nutrition.

我们对待患者，就像对待真实的普通人一样，已经有几十万人了。

So we treat patients like real humans, hundreds of thousands.

所以这一半内容就是沿用这个现成的结构。

So half of it is this existing structure.

我们会引用一位患者的反馈，总是先用这个来说明我们为什么在这里，也给大家一个正面的激励。

There's a quote from a patient, so we always kind of lead with this is why we're here and here's kind of a positive feedback from a patient.

然后是一些业务数据，比如我们增长了多少，当前的重点是什么，再提醒一下今年的核心目标。

And then there's some business metrics like how much we've grown and what are the priorities and just a reminder of this year's key objectives.

所以这一半就是这些内容。

So half is like that.

而另一半最重要的，是本周的主题。

And then the most important other half is topic of the week.

所以这一周的主题，本质上是我以CEO和创始人的身份写的一篇心得，我想这应该就是你问的吧。

So topic of the week is essentially my as a CEO founder essay, and I think that's what you were asking.

我觉得这些内容大致可以分成两到三类。

I would say they're roughly in two or three categories.

第一类是外部世界发生了什么？

One is what has happened in the external world?

那背后的背景是怎样的？

What's the context there?

这些变化又对我们有什么影响？

And how does that affect us?

举个实际的例子，这个我之前写过不少。

One example, this is a real world example that I've written quite a bit about.

既然我们把营养干预作为核心手段——当然我们的医生也会综合运用各种工具——过去几年里，治疗肥胖和代谢疾病最大的变化之一，就是GLP-1类药物的出现。

Since we use nutrition as the core tool, but obviously our providers use all the tools in the toolkit, one of the things that has really changed in addressing obesity and metabolic disease over the last couple of years is the GLP-one drugs.

也就是大家常说的司美格鲁肽这类药。

So these are the, you know, the Ozempic's of the world.

所以我收到不少来信，都在讨论这些药物可能如何影响我们对患者的照护，以及对我们的业务有什么影响。

And so I've had a number of letters discussing how do these drugs potentially affect how we take care of our patients and what's the impact on our business.

这属于外部因素，以及它如何影响我们的战略。

So that would be sort of externality and how is it affecting our strategy.

这是一个例子。

So that's one example.

另一个类别是给团队成员的职业和个人建议，比如如何在Virta的工作经历中收获最大。

The other category is career and personal advice to our team members, like how to make most out of your experience working at Virta.

围绕这类话题，我们还讨论过个人效率的问题，怎样才能更好地利用时间，我觉得这是第二类。

And around that sort of kind of stuff that we discussed, we've discussed now, like personal productivity and how do you make most out of so that's, I would say, is the second category.

第三类则是内部事务。

And then third is just internal.

发生了什么，这对我们的意义是什么。

This is what happened, this is what it means for us.

说实话，差不多就是这样。

So, honestly, kind of like it.

这是我个人的表达方式，有时候我会说，嘿，已经写了五十多篇了。

It's my personal outlet and sometimes I'm said, Hey, five thirty plus essays.

这本书正在酝酿中。

There's a book in the making.

我们只需要把它上传到ChatTPT，书就能直接出版了。

All we need to do is upload it to ChatTPT, and we have a book ready to be published.

我之前答应过要回一个帖子，现在意识到那问题可能表达得不太准确。

So I promised I would come back to a thread, which I realize is probably a misworded question.

我问的是，为什么别人很难像你这样，对99%普通人觉得必须做的事说不——这跟你提到的叙事有关。

The question I asked was why people have trouble doing what you do, which is saying no to 99% of the things that normals do or feel compelled to do, to your point about the narrative.

我现在觉得，这或许不是个恰当的问题。

And I realize it's perhaps not the right question.

更合适的问题应该是：你会给那些难以说不、或者无法专注在少数几件事上的人什么建议？

The right question might be, what advice would you give to someone who is having trouble saying no or focusing on just a few things?

但我可以再具体一点，因为我觉得，如果我们能更清晰地想象出来，或许就更容易深入探讨了。

But I can make it much more specific because I think the more we can imagine it, perhaps the easier it is to dig into this.

假设你有个刚入职的年轻员工，虽然年纪轻，但能力顶尖，相当于十倍工程师那种。

So let's say that you had a relatively new hire who is on the younger side, but, you know, a 10 x engineer or some equivalent of that.

这个人明显是天才，但还没建立起像你那样的生活节奏和工作架构。

Someone who is clearly a superstar, but who has not established the type of architecture and routine that you have in your life.

你感觉他正朝着 burnout 的方向走，这对他自己可不妙。

And let's just say you sense that they are on the path to burnout, which is gonna be bad for them.

对公司也不好。

It's gonna be bad for the company.

对你们服务的患者更是有害，你得想办法帮他调整方向。

It's gonna be bad for the patients you serve, and you wanna stage an intervention to help them correct course.

我猜你可能真跟人谈过这类话题。

I imagine you may have even had these conversations.

你会怎么跟这样的人沟通或辅导呢？

What might that conversation or coaching look like?

说来有趣，这正是我团队邮件里经常讨论的话题之一，属于那530条里的内容。

Well, funny enough, this has been one of the topics of my team letters, one of the 530.

我会把这分成两部分，我的建议是：

I would separate it into two things, my advice.

第一是这种规划。

One would be this sort of planning.

其实特别简单，真的。

I literally, it would be very simple.

每周日傍晚，花五分钟，趁着新的一周开始前，把下周必须完成的事情列出来，不管是工作还是个人事务，统统写下来，然后直接安排进日历。

Sit down for five minutes on a Sunday evening before the week starts and write down what absolutely completely needs to get done next week, super duper simple, professionally and personally, and schedule it into your calendar.

就是这么直接。

Like, literally.

如果你时间灵活，那就每天早上留出两个小时，专门搞定那两到三件最重要的事。

And if you have the flexibility, then, like, block two hours in the mornings to get those two or three things done.

等这些做完，其他事情再按顺序处理。

And then when life happens or work happens, everything else kinda comes after that.

对我来说，这绝对是最重要的一步。

So that to me would be the number one thing.

到了周一或者周二，不管你是在办公室上班还是远程工作，都别让外界牵着你的鼻子走。

And then I would couple that when Monday comes or Tuesday comes, you know, whether you work in an office, on a remote setting, do not let the universe control your time.

这意味着，绝对要关闭所有通知。

So this means absolutely no notifications.

除非是家里有急事，比如家人突发状况，那种情况可以例外。

Maybe if you have to get text message for, I don't know, family emergence or something.

其他所有干扰都屏蔽掉，给自己留出一片专注的天地，不管是写东西、写代码，还是打十五个陌生电话，都能安心做完。

But like take everything else out and you kind of create that sacred space where you can do that work, whether that's writing or coding or cold calling 15 prospects or whatever that is.

方法其实特别简单，但一到周一、周二，就很容易又被生活推着走。

It's super duper simple, but it's so easy to then sort of again, Monday comes, Tuesday comes, and then the world takes over.

然后你就会惊呼：天哪。

And you're like, oh my god.

都下午四点了。

It's 4PM.

该做的事还没动呢。

I haven't done the thing.

所以我觉得这算是一大类。

So I'd say that would be the one category.

接下来第二类是

And then the second category is

第二类。

the second.

对。

Yeah.

有些听众如果周日花十分钟，把工作和生活上必须完成的事情列出来，可能每类都能列出二十条。

Some people listening, if they were to sit down for ten minutes on Sunday to write down the things that must get done professionally and personally, they might have a list of 20 things in each category.

那我们说的是每类只做一件，还是三件呢？

So are we talking about one thing, three things in each category?

我知道这听起来有点较真，但对很多人来说，这很可能是个关键的失败点。

I know this seems, like, very persnickety, but this seems like a possible failure point for people.

那你有什么建议？

So what is your suggestion there?

大概是一两件事，但这里又引出了另一个话题——你确实需要一套年度思考和规划的框架，比如考虑公司需要什么。

It's probably one or two things, but this, again, we could launch into another part of which is, obviously, you need an architecture of annual thinking, planning, what does the business need, for example.

事实上，我电脑上就有一个纯文本文件。

Like I have in fact, I just have a text file, ASCII file, on on my computer.

我写下了作为CEO现在和二十年后必须记住的四件事。

I was like, here's the four things to remember as a CEO now and twenty years from now.

今年要做的三件事，这周要做的三件事，也都列在里面。

Here's the three things for this year and here's the three things for this week.

我真就靠这么个文本文件，每个星期天都更新一次。

I literally have a text file and I just update it every every Sunday.

还有另一件事，很多人可能觉得我疯了——我给自己定了个十五年规划，纯属偶然定下来的。

And a whole another topic which I'm sure some people think I'm crazy is I have a fifteen year plan for myself, which I kind of accidentally stumbled.

这其实挺有用的，我每年都会更新一次。

It actually could be useful, and I update it every year.

这个话题咱们可以私下聊，或者先做个标记，回头再说它是怎么来的。

And, again, we can we can take that offline or take a bookmark how that came about.

这真的特别有帮助。

It's been incredibly helpful.

而且我要强调的是，有结构反而能带来自由和灵活。

And, again, I want to highlight structure allows spontaneity and flexibility.

但如果你没有这套体系，到了周日晚上，就会纠结：我到底该不该写本书，换份工作，还是先做老板交代的那些事？

But if you don't have that architecture, then obviously on a Sunday evening, it's like, oh, should I write a book or get a new job or just do these projects that my boss was asking.

所以如果没有一个明确的方向，你就像指南针一样，原地打转。

So it's like, if you don't have that north star, you could be kinda spinning like a compass, get around on it.

我刚才打断你了，因为你提到要在日历里把这些事安排出来。

I did take you off track because you were saying block these things out in the calendar.

比如周日，花五到十分钟。

Like, Sunday, five to ten minutes.

如果可能的话，把这些时间块固定在你的日历里。

Block those things out in your calendar if you can.

早上一上班就先留出两个小时。

Two hours first thing in the morning.

别让外界决定你该怎么用时间。

Do not let the universe dictate your how you use your time.

关掉所有通知。

Block out notifications.

然后你刚才说了第二点。

And then you said the second thing.

对。

Yes.

第二个类别。

Second bucket.

这一点可能最重要，因为它关系到你是否会耗尽自己，甚至崩溃。

This is probably the most important as this relates kinda like a burnout and you just kinda you're falling apart.

我轻轻敲敲桌子，不是为了制造噪音，只是图个吉利——我2000年4月创办了第一家软件公司。

And I'm gonna knock here on on my wood my table, not too hard to create any any noise, but I founded my first software company in April 2000.

所以现在，我们已经来到2026年了。

So now it's with we're here in 2026.

所以这已经是二十六年了，我一直都在打造快速增长的公司，但我还没垮掉。

So that's twenty six years running, building fast growth companies, and I I haven't cracked yet.

不过我要提醒一下，这种事情随时都可能发生，也许今晚就会。

And, again, caveat is it could happen tonight.

所以我总结出了一些经验。

So there's a few things I've learned.

我觉得这些方法特别适合知识工作者，毕竟所有信息都往脑子里涌，很容易压力山大、焦虑不安，最终崩溃。

I think these are applicable to especially any knowledge worker where kinda like everything is just coming to your brain and it's it's very easy to, you know, get stressed and anxious and crack.

我也写过这方面的内容。

And I've written about this as well.

这是我个人用得特别好的一套方法。

Here's my formula that has worked for me very well.

第一，你得照顾好自己的基础代谢健康。

One, you have to take care of your sort of foundational metabolic health.

那到底是什么呢？

That's what is it?

就是睡眠、饮食和运动。

It's sleep, nutrition, exercise.

所以这是第一点。

So that's kind of one.

如果你的身体代谢状态非常差，那在压力下崩溃的可能性会非常高。

If you are metabolically very, very unhealthy, it's very, very likely that you're gonna crack under pressure.

这就是第一点。

So that's one.

第二点是，尤其对于创始人或CEO这类人，但对任何人来说，拥有至少两到三个不同的身份或出口都很有帮助。

Second one is it's very helpful to have, especially for kind of founder CEO types, but for anyone, have at least two or three kind of identities or outlets.

对我来说，一个是父亲和丈夫，一个是CEO，还有一个是想当运动员的人。

For me, it's kind of parent husband, one, CEO, two, and then wannabe athlete.

如果其中一个出了问题，至少还有另外两个方面能让我觉得，嗯，生活还在正轨上。

And so if one's failing, hopefully, at least two, there are the areas, outlets in my life where it's like, oh, it's it's going okay.

顺便说一句，我从来没能同时在三个方面都表现得特别出色。

And by the way, it's never that I'm rocking and winning and ringing the bell in all three at the same time.

这真的很有帮助。

And it's very helpful.

简直像绝地武士的心理技巧一样——天啊，工作真糟心，但至少今天孩子还爱我。

It's it's almost like a Jedi mental trick, like, my god, work sucks, but at least my kids love me today.

拥有这样的出口特别重要，尤其是对年轻创业者来说，但往往他们的情况正好相反。

So having that outlet, and particular founder types, younger ones, it's often the opposite.

他们甚至以‘我只有一件事，愿意为公司拼上性命’为荣。

They're sort of proud of the fact that I only have one thing and I'm ready and willing to die for my company.

一切顺利的时候当然没问题，可一旦遇到第一个挫折，整个局面就全崩了。

Well, that's all well and good when everything's going well, but you have the first kind of speed bump and then everything falls to bar.

所以，这是我想要说的第二点。

So that's the second thing I would say.

第三点是，要有一些公司之外的同龄朋友，能让你彻底放松下来。

Third one is have peers outside of your company that you can kind of let your hair down.

抱歉。

Sorry.

不好意思。

Sorry.

我知道。

That I know.

不好意思。

Sorry.

放松一下，别太紧绷。

Let your hair down and relax.

对我来说，是一群CEO朋友。

For me, it's a group of CEOs.

其他CEO会说，天哪。

Other CEOs was, oh my god.

你能相信吗？这些员工又在抱怨了。

Can you believe can you believe these employees are bitching again?

但你显然不能在公司里这么说。

But you obviously, you can't say that in front of the company.

对我而言，从2008年左右开始，我就一直参加YPO，也就是青年总裁组织。

So having that kind of personally, for me, it's been YPO, the Young President's Organization since, I guess, 2008.

现在对我来说，已经不是‘年轻’总裁了，纯粹是‘老’总裁了，毕竟我年纪也不小了。

So now it's for me it's not anymore the why the young, it's just the old because I'm old enough.

我有这个圈子。

I have that.

再有第四个，我觉得每个人都有自己的方法，但关键是要理解自己的思维是怎么运作的。

And then I I think the last fourth one I would say is everyone has their own tools but just understanding how your mind work.

可能是冥想，也可能是别的方法，但对我来说，这个过程就是慢慢意识到：如果你太执着于自己的想法，它们迟早会拖垮你，你根本没法靠思考把自己从坑里挖出来。

It could be meditation, it could be some other tools, but that's been a process for myself to just realize that if you are just attached to your thoughts, eventually they're gonna get you and you can't really think yourself out of the hole that you've thought yourself into.

所以你得退一步，像旁观者一样看看，天啊。

So unless you can take a step back and kinda, like, observe, like, oh my god.

我的大脑简直有自己的想法。

My brain's having a life of its own.

这大概就是我不愿轻易放下的工具包。

So that's kind of the toolkit I would not to crack.

所以，基础的健康需要有不同的出口和身份，有可以倾诉的同伴，朋友也行，还得学会理解自己的内心，明白大脑其实有自己的节奏。

So foundational health, you know, have different outlets, identities, have peers you can talk, it could be friends as well, and then some sort of understanding and kind of way of taming your mind, if you will, or being able to see that the mind has the life of its own.

这对我的帮助很大。

That's been helpful for me.

我得再说一遍，虽然今晚也可能出问题，但我这么多年从来没碰过任何治疗精神类问题的处方药。

And I will say, again, could happen tonight, but I I haven't touched any prescription drug for anything sort of mind related.

这套方法让我一直撑了过来，整整二十五六年了。

That toolkit has kinda kept me head above the water so far for twenty five, twenty six years.

我有个很突然的问题想问你。

I have a very left turn question for you.

希望不会让你觉得冒犯，我刚才听你说‘敲木头’，但又怕发出声音，就忍住了。

Hopefully, it won't be incredibly offensive, but I was just thinking when you were like, I would knock on wood, but I don't wanna make any noise.

然后你说‘放松一下’，我不是有意冒犯啊。

And then you're like, and let my hair down, you know, no offense.

抱歉。

Sorry.

你真的很礼貌，我只去过一次芬兰。

And and you're very polite, and I've only been to Finland once.

我在那儿散步时，当然也去了必去的桑拿房之类的，这其实跟我自己的经历能联系上。

I was walking around and, of course, went to the obligatory saunas and so on, which I actually can tie into my story.

我在赫尔辛基待了大概两天，心里想着，我曾经住过日本。

But I was walking around, and in the maybe two days that I was in Helsinki, I thought to myself, you know, I lived in Japan.

我会说日语。

I speak Japanese.

我跟15岁时寄宿的那户人家至今还保持着联系，那时候我就觉得，芬兰人就像白人版的日本人。

I'm still close to my host family who I stayed with when I was 15, and I thought, Finnish people feel like white Japanese people.

那正是我当时的感觉。

That was my feeling there.

这跟桑拿有关联，虽然场景不同——但你去日本的话，一切都非常克制、非常有礼。

And the reason it ties into the sauna, different context, but if you go to Japan, everything is very restrained, very polite.

人们走在街上，根本不会跟你对视。

People don't they'll stare you in the eye when you're walking down the street.

在日本，如果老板说咱们得出去喝酒，那到了酒桌上，只要老板说你得喝，你就必须喝。

In Japan, though, if the boss says we need to go out and drink, when you drink, okay, and if the boss says you have to drink, you have to drink.

但出去喝酒的时候，大家完全可以吵吵闹闹，放得开得很。

But you go out, and you can get really loud, and you can get really boisterous.

喝点酒之后，你说些平时不敢说的话，大家心里都明白，第二天全都会当没发生过。

You can you're allowed to say things when you've had some alcohol that basically everyone agrees they're gonna forget the next day like it never happened.

我不能说芬兰也这样，但去桑拿房的时候，我特别惊讶的是，他们居然卖大杯的啤酒，人们直接把啤酒带进桑拿房里。

Now I can't take it that far with Finland, but when I went to the saunas, one thing that I was very surprised by is that they sell huge stein glasses of beer that people bring into the saunas.

我当时就想，原来这就是他们放松的时候啊。

And I was like, oh, this is where they let their hair down.

是这样。

Okay.

我这么说会不会太夸张了？

Am I totally off base?

我不确定你有没有在日本待过，但就我这四十八到七十二小时的体验来说，真的有种恍然大悟的感觉。

I don't know if you've spent time in Japan, but culturally, I felt like in my forty eight or seventy two hours of exposure, I was like, wow.

其实芬兰语本身也有一些音素，和日语的发音挺像的。

This is actually even Finnish itself has some of, like, the phonemes, some of the sounds of Japanese.

这么说听起来我好像有点过度联想了。

I mean, that sounds like I'm really overreaching now.

是我太疯狂了，还是你觉得这两者之间真有点什么联系？

But am I just an insane person, or do you feel like there's there's something possibly there?

我觉得确实有相似之处，而且你对日本文化的了解肯定比我深多了，我只去过东京和几个地方几次。

I think there's similarities, and and you're definitely the connoisseur of a Japanese culture versus me having just been to Tokyo and a few other places a couple of times.

但那种空间感、距离感和礼貌，其实东京表面上看一点距离都没有。

But that kind of space and distance and politeness that people well, actually, there's no distance in Tokyo, obviously.

不过在情感上，芬兰和日本确实有种距离感，这跟我2003年刚来美国、搬到加州时的感觉完全不同。

But sort of emotionally, there there is a kind of distance in Finland and in Japan versus when I came to America 2003, moved to California.

那里每个人好像都贴着你，事事都得喊‘太棒了’。

It's like everyone is on your face and everything's freaking awesome.

对，确实是这样。

And it was yeah.

花了好几年我才反应过来。

It was it took a couple of years to I was like, wait.

等等。

Wait.

等等。

Wait.

等等。

Wait.

别这样啊。

Just come on.

给我点空间吧，也不是什么事都那么棒。

Like, give me space, and everything's not awesome.

所以，也许确实有些相似之处。

So, yeah, maybe there are similarities.

还有，酒精在芬兰，几十年来一直被当作缓解心理压力的手段，但效果其实很有限。

And then, yeah, alcohol, I'm sure, has been a mental health tool, not very effective at that in in Finland for for many, many decades.

但桑拿不一样，首先芬兰有五百五十万人，却有三百多万个桑拿房。

But sauna, I I will I have to well, first of all, there's five and a half million people in in Finland, and there are more than 3,000,000 saunas.

三百多万个桑拿房。

More than 3,000,000 saunas.

这太夸张了。

That's a crazy

所以平均下来，芬兰每一到两个人就共享一个桑拿房。

So on average, you have one to two people per sauna in Finland.

以前芬兰的婴儿甚至是在桑拿房里出生的。

Babies used to be delivered in sauna

真的吗？

Really?

因为在芬兰，桑拿房里的高温环境能杀死有害细菌，特别干净。

In Finland because it's the clean bacteria that's in a heat.

完全无菌。

Sterilized.

又暖和，又干净。

It's warm, sterilized.

里面有温水。

There's warm water.

我觉得我妈妈是在桑拿房里出生的。

I think my mom was delivered in sauna.

不过我要澄清一下，我出生是在医院。

I was in the hospital just to be clear.

桑拿早就不仅仅是文化的一部分了。

So sauna is beyond being part of the culture.

它已经融入了我们的基因。

It's part of the DNA.

从文化上讲，桑拿是个特别的地方——不是简单地放松、低头坐着，而是没人穿制服，没有头衔，没有那些社会地位的象征，比如名表什么的。

And it's culturally it's an amazing place actually not just kind of let loose and your head down, but you don't have your uniform, you don't have your titles, you don't have your whatever socioeconomic signals, symbols, fancy watches.

不管你是家人、朋友，还是邻里，大家在这里都聚在了一起。

And kind of everyone comes together, whether that's family or your friends or your community.

是的，桑拿在芬兰确实是个发生很多事情的地方。

And yes, Sauna is definitely a place where a lot of things happen in Finland.

我们当然可以聊桑拿在文化中的角色，但它远远不止是桑拿里泼冷水那么简单。

And we could talk about saunas and its role in the culture, but it's something way way way beyond cold bombs in sauna.

对。

Yeah.

为什么会这样呢？

Why is that?

为什么桑拿在芬兰这么普遍？

Why is it so prevalent in Finland?

看起来是这样，我相信你也注意到了，比如在迷幻剂研究领域，有个研究被反复分析、不断挖掘数据，就为了从同一个老研究里多产出几篇论文。

Because it seems like and I'm sure you've seen this, but, like, there are certain studies in in the world of psychedelics where it's like they did brain imaging in in one study that they've been slicing over and over again and torturing the data again and again to just produce more and more papers on this one study that was done so long ago.

就好像那140个芬兰人的数据，被拿去桑拿相关的各种研究里反复拆解了上百万次。

It seems like the same group of, like, a 140 FINS has been dissected 5,000,000 times in various announcements around saunas.

但为什么在芬兰这么普遍，其他地方却不是这样？

But why is it so prevalent there versus other places?

我不清楚它的起源。

I don't know the origin story.

对。

Yeah.

希望有位历史学家能帮我核实一下，但 sauna 的确可以追溯到几百年前，那时候它几乎是必需的。

And, hopefully, there's a historian who will check me on this, but it definitely goes back hundreds, let's say, many hundreds of years where it was sort of necessary.

芬兰四季分明，冬天冷得厉害。

So, you know, Finland, four seasons, incredibly cold winters.

所以，冬天的时候， sauna 就是用来取暖的地方。

So sauna was a place to kind of basically heat and warm up in the winter.

它也是用来风干食物的地方。

It was also a place where, you know, you could dehydrate food.

现在当然没必要靠它取暖或晾干食物了，但当初大概就是这么发展起来的。

So it gets kinda how it goes way back when and obviously now, you know, it's not necessary to stay warm and it's not necessary to dry your food.

我觉得，这就是它最初的由来。

But I think that's kinda where it started.

然后最初的 sauna 是建在山体侧面的，你就在石头上面烧木头，等火灭了之后，等烟散尽，石头就能长时间保持高温。

And then initial sound is where it kinda duck into the side of a mountain and then you just you burn wood on top of rocks and then, you know, you extinguish the fire and then you make sure that the smokes goes away and, you know, the rocks stay hot for a long time ago.

那就是最原始的形式。

And that was the original.

到现在还有人用这种 sauna。

It's called people still have that kind of sauna today.

这种叫烟熏 sauna。

It's called smoke sauna.

本质上，你没法把烟排出去，只能靠开门通风。

Essentially, you don't have a way to get the smoke out other than open the door.

没有那种烟直接从烟囱排走的壁炉结构。

So there's no fireplace where the smoke just goes through a chimney.

所以这种叫烟熏 sauna，是一种特别的 sauna 体验。

So that's called smoke sauna, and it's a special sauna experience.

显然，加热它要花更多时间，也要等它安全了才能进去，毕竟谁也不想在有烟的时候进去。

And, obviously, it takes much more time to heat it and make it safe and because you don't wanna go there when where there's smoke.

但我觉得这大概就是它的由来了。

But I think that's kind of the history.

后来也不知怎么的，就慢慢变成了一种文化，现在芬兰人盖房子，没有桑拿房是根本不敢想的。

And then somehow, I'm missing the link how it became sort of like a culture, but now nobody will build a house without a sauna.

说真的，他们先考虑要不要放桑拿房，再看有没有地方装洗手间。

Like, literally, there's first is worth a sauna, and then let's figure out if there's space for a bathroom.

这在芬兰就是标准的顺序。

Like, that's kind of the order in Finland.

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我去过一家公共桑拿房。

I went to this public sauna.

挺高档的，里面有个词。

It's pretty fancy, and there's a word.

你大概能猜出那是什么词。

You could probably tell me what it is.

就是那种什么的。

It's like or something

就是那样。

like that.

对。

Yeah.

就是这样。

There we go.

这就对了。

There we go.

所以，这就是往石头上泼水的动作吧。

So this is what the act of throwing water on the stones.

是指这个动作吗？

Is that what that refers to?

还是指它发出的声音？

Or the sound that it makes?

我不知道那个地方名字的具体含义，但我之所以提起，是因为我从来没经历过这么多不同类型的桑拿，他们还有一个烟熏桑拿房。

I don't know what the name of the actual location means, but the reason I bring it up is they had I have never experienced so many varieties of sauna, and they had a smoke sauna room.

进之前我看了一下选项清单，心里就想，嗯，明白了。

And in my mind, looking at the menu of options before going in, I'm like, okay.

我懂了。

I get it.

这房间很热。

It's a hot room.

能有多大差别呢？

How different could it be?

但身体的感受、那种深入骨髓的体验，却完全不同。

But the experiences and the feeling in the body and the way it penetrates your being is very different.

我特别惊讶，因为在美国家里我泡过不少干蒸桑拿，也试过蒸汽房，但真没想到桑拿还能有这么丰富的体验层次。

I was shocked because I've spent so much time in dry saunas in The US, and I expect and I've also done steam rooms and so on, but I did not expect there to be such a broad palette of experience in saunas.

是的。

Yeah.

确实太棒了。

Definitely was amazing.

对。

Yeah.

没错。

Yeah.

所以我觉得爱斯基摩人有几十个词形容雪，因为他们能分辨每一种细微差别和细节。

So I guess Eskimos have dozen or so words for snow because they know every nuance and, you know, kind of detail.

芬兰人也是，他们对桑拿相关的各种事物有几十个词，根本没法直接翻译。

And and Finns have dozens of words for different things around sauna that you can't even translate.

‘Lowly’可能是最重要的一个词。

Lowly is probably the most important.

你评判一个桑拿房好不好，主要看‘Lowly’怎么样。

You judge the sauna and its quality based on Lulu.

‘Lowly’就是你把水泼到炉子里的石头上，蒸汽升起来之后的那个感觉。

And Lulu is essentially it's after you throw water into the rocks, the fireplace, the rocks, and then the steam comes up.

不是蒸汽本身。

It's not the steam.

也不是温度。

It's not the heat.

更像是蒸汽的‘魂’——它怎么飘过来，落在你身上的那种触感。

It's the, I guess you could say, the spirit of the steam, but how it feels, how it lands.

我跟你说，这事儿有上百万种不同的情况。

And let me tell you, there's a million different variations how it happens.

是不是太烫了？

Is it too hot?

是不是太刺人了？

Is it too kind of sharp?

是不是够柔和？

Is it soft?

会不会在空气中久久不散？

Does it sort of linger around?

它打在你身上的感觉怎么样？

And how does it feel on your body?

这些都叫Lulu。

That is Lulu.

你判断音质的好坏，全看Lulu。

And you judge the quality of the sound based on a Lulu.

这背后其实有一整套学问，就像空间大小该怎么把握一样。

And there's a whole science to it, kinda like how big is the space.

比如在木桶桑拿里要把Lulu调到位就特别难，顺便说一句，我家就有个木桶桑拿，问题是空间太小了。

Like barrel saunas are very to get the LoLu right in a barrel sauna, which by the way I have at my house, is very very hard because it's too small.

壁炉这边又升不了温，你本来应该坐在壁炉上方一点的位置。

The fireplace you can't get high enough, and you should be sitting kind of above the fireplace.

所以啊，如果你只会一个词，那就是Lulu，想让芬兰人对你刮目相看，就去桑拿房说一句：这Lulu太棒了。

So, yeah, Lulu is if you know one word, Lulu, and you wanna impress Fins, you go to a salon and say, what a fantastic Lulu.

我真想给芬兰旅游局发个邮件，让他们赞助这一期节目。

I feel like I need to reach out to the Finnish tourism board to sponsor this episode.

吸引更多人来芬兰。

Get people headed over to, Finland.

我真的很享受这次体验。

I really enjoyed it.

行程虽然很短，但希望以后还能有机会再去。

It was a very short trip, but hopefully, I'll have a chance to get back.

咱们聊聊代谢健康吧，毕竟维塔这个话题肯定能展开说说。

Let's talk about metabolic health because certainly, Virta, we can talk about Virta.

这次对话的起因，其实是因为我们来回发了海量的短信。

And a part of the impetus for this conversation was tons and tons of text messages back and forth.

有些内容肯定不能公开讨论，毕竟涉及内部数据什么的，但我曾经跟多米尼克·达戈斯蒂诺聊过，长期听节目的朋友应该知道他，他专门研究新型外源性酮体补充剂之类的。

Some of them, I'm sure we can't talk about publicly necessarily because it's internal data or whatever, but I would have, say, a conversation with Dominic D'Agostino, who some long term listeners will know, synthesizes novel exogenous, meaning supplemental ketones and so on.

举个例子吧，我自己的经历里有个挺困惑的问题：我明明已经进入生酮状态了——虽然这么说有点不严谨，但简单讲就是吃高脂肪饮食，或者通过禁食，让自己感觉大脑切换到了用酮体供能的状态。

And I was, for instance, I'll give one example, facing bit of an enigma in my own experience, which was I've gone into ketosis, and I know that's a very kind of sloppy way of putting it, but let's just say getting into ketosis, so eating a predominantly fat based diet or even doing it through fasting, getting to a point where I feel like my brain has switched over to ketones.

我跟多米尼克抱怨说，我的监测设备显示我根本没在生酮状态。

And I was lamenting to Dom, Dominic, that my devices were telling me I was not in ketosis.

对吧？

Right?

这让我觉得特别不可思议，因为我研究这个这么多年，对大脑什么时候真正切换到高效运转模式，感觉特别敏锐，就像CPU突然提速了一样。

And I found this implausible because after so many years of experimenting with it, I feel like I have a very good bead on when my cognition clicks over and is actually operating at a much faster kind of CPU capacity.

可每次用Precision Xtra或者Keto Mojo这些设备扎手指测，结果都显示我根本没达到生酮水平。

But my finger pricks with, say, a Precision Xtra device or the Keto Mojo were telling me I was basically not ketosis.

更让人困惑的是，就连那种靠呼吸检测的设备——我记得叫什么酮气检测仪吧，挺原始的——也给我报了阴性结果。

And very confusingly, even with a breath based, I think it's ketone air or something like that, pretty primitive device, but even with that, I was being given a negative.

你给我发了条消息，上面是你过去十天左右的酮体水平变化曲线图，显示数值一直在下降，可你明明越来越擅长燃脂了。

And you sent me a text showing your bar graph over the last 10 or something of measurable ketone levels going down over time even though presumably you're increasingly and increasingly fat adapted.

我当时就想，对啊，萨米确实有这些数据。

And I was like, of course, Sami has this data.

然后你还有一些特别有意思的数据，我以前从来没见过，是关于不同人群在各种条件下——比如是否采用生酮饮食——的对比分析。

And then you have some fascinating, fascinating data I have certainly never seen anywhere else looking at different cohorts with various combinations of things with or without, say, dietary ketosis.

这正是我请你来的原因之一。

That is part of the reason I wanted to have you on.

你对这些事想得特别细，数据分析也特别严谨。

You're just such a meticulous thinker around these things and data cruncher.

不过在深入之前，咱们先明确几个概念吧。

But let's maybe just define some terms before we get into things.

什么叫代谢健康？

What is metabolic health?

也许你可以讲讲自己的经历，因为据我了解，你曾经体脂率降到百分之十以下，但后来检查的生物指标结果显示，你当时已经处于糖尿病前期，这是我记得的。

And maybe you could tell your personal story because my understanding is at some point, yours need a sub 10% body fat, but your report card in terms of biomarkers and so on came back, and you're prediabetic is my recollection.

你可以把我刚才那场TED演讲当作起点，先定义一下什么是代谢健康，再以你个人的经历作为引子展开聊聊。

But perhaps you could take that TED Talk I just gave and use it as a leaping off point for discussing defining metabolic health and then talking about your own personal journey maybe as a starting point.

首先得说明一点，我虽然拿了两个硕士学位，但并不是医生，也不会在网上装医生。

First caveat, which is that I do have two master's degrees, but I'm not a medical doctor and I don't play one on the Internet.

我猜在这次对话里，我们难免会涉及这方面的内容。

And I'm sure in this conversation, we'll kind of go into that area.

所以我得提前说清楚。

So I just want to be clear.

我不会给任何人提供医疗建议，也不是医生，但对你刚才提到的这个话题，我确实有大量实际经验。

I'm I'm not giving medical advice to anyone and I'm not a medical doctor, but obviously have a lot of experience with with the topic that you just asked.

说到个人经历，那就先回溯一下，不用追溯到芬兰的童年，但我的背景确实跟医学无关。

I guess the personal story, so just rewind, not quite all the way back to Finland, but again, my background is not in medical field.

我受过物理学训练，早年还在芬兰的一家核电站工作，那时候核电还挺时髦的，现在看来，核电似乎又重新流行起来了——这正好说明，我的背景是科学与技术，而不是医疗健康领域。

I'm a physicist by training and in fact started my career in a nuclear power plant way back when in Finland when it was still fashionable, and I guess nuclear power plant's coming back to fashion now now now again, which is just to show that, like, my background is in sort of science and technology, not in health care.

不过我这辈子基本都是运动员，练过越野滑雪和冬季两项，来美国后又开始练铁人三项。

However, I've been essentially an athlete all my life, cross country skier, biathlete, came to America, started doing triathlons.

你以前还得滑雪去上学吧？

And Well, you had to ski to school at one point.

没错。

Right?

是的。

Yeah.

听起来挺田园牧歌的。

Sounds very idyllic.

说不定是我爸妈故意惩罚我呢。

Maybe that was a punishment by my parents.

从一年级到六年级，我确实都是滑雪去上学的。

So Nordic skiing to school indeed first grade through sixth.

这可真不简单。

So quite something.

其实很糟糕。

Terrible, actually.

而且练过现代冬季两项也有用，至少能背着步枪，路上遇到熊袭击时好歹能开枪自卫——当然，这事儿可能纯属编的。

And the biathlon came handy, so carrying a rifle so I could shoot the bears when they were attacking along the way, which may or may not be true.

不过呢。

But yeah.

所以这么多年，我一直都是个运动员。

So as a I was an athlete and have been an athlete all those years.

到了美国之后，就开始练铁人三项，也算个水平不错的运动员。

And then after coming to America, started doing tri triathlons and pretty high level athlete.

当然，不是说拿过奥运金牌那种，但作为业余选手，我参加过很多场夏威夷铁人三项赛，大概有七场是世锦赛级别的，还在自己年龄组拿过铁人三项的世界冠军。

Again, not we're not talking about Olympic gold medals, but as an amateur and, you know, many, many Hawaii Ironmans, I think seven of those World Championship races and even won the World Championships in my age group as a triathlete.

大概是2012年吧。

2012, I believe.

我提这些经历，是想说明我过去对代谢健康、慢性病、二型糖尿病和肥胖的看法，说出来有点不好意思——我以前觉得这根本就是胡扯。

And I keep that all as a background context because my view on metabolic health and sort of chronic disease, type two diabetes and obesity was this is very embarrassing to admit was the following, which is: it's ridiculous.

其实很简单。

It's very simple.

大多数人，尤其是美国人都知道该怎么做。

People know exactly what to do, most people, most Americans.

但他们就是不去做。

They just don't do it.

结果就是，到处都是肥胖的人。

And as a result, we have just obese people everywhere.

人人都有前期糖尿病或者二型糖尿病。

Everyone has prediabetes or Type two diabetes.

顺便说一句，美国成年人中超过一半都是这样。

By the way, it's more than fifty percent of American adults.

现在的数据显示，我认为是93%，这是经过同行评审的公开数据——93%的美国成年人在代谢健康方面都有这样或那样的问题。

Now the data is, I think, ninety three percent this is the published peer reviewed number ninety three percent of Americans are metabolically unhealthy in one way or another, American adults.

也就是说，要么血压高，要么血脂异常，要么肥胖，要么得了二型糖尿病或前期糖尿病。

And, you know, that's either you have a high blood pressure or your lipids are off or you're obese or you have type two diabetes or prediabetes.

我那时候虽然有点苛刻，但一直想说：听好了。

And my view, as judgmental as I was, was always, listen.

太荒谬了。

Ridiculous.

你知道该怎么做，可就是不做。

You know what to do, but you're not doing it.

你吃太多了。

You're eating too much.

就是吃太多，又不运动。

You're just eating too much and you're not exercising.

你真是没用。

You loser.

所以我才要交这么多税，因为医疗开支每年高达五万亿美元，其中绝大部分都跟代谢健康问题有关。

And that's why I pay too many taxes because health care is 5,000,000,000,000 a year, of which almost all of it is metabolic health related.

这就是我当时的想法。

So that was my view.

说实话，我真的很惭愧，以前我就是这样想的。

And I'm very, embarrassed to say that's how I was thinking.

总觉得别人不健康，都是因为他们自己管不住自己。

Sort of judging people like you're unhealthy for reasons that are 100% in your control.

后来我才真正意识到自己有多片面，不得不低头认错。我明明体脂率只有10%，做过DEXA扫描，每周锻炼十五个小时，铁人三项表现也不错，结果却是前期糖尿病。

And then, I got the moment where I had to eat a lot of humble pie and I discovered that despite, you know, being, yeah, I don't know, 10% body fat, Dexa, whatever, and, you know, exercising fifteen hours a week and performing well as a triathlete, I was pre diabetic.

所有指标都亮红灯了，眼看着就要发展成二型糖尿病。

All the numbers are off and essentially on my way to Type two Diabetes.

我当时就想，糟了。

And I was like, shit.

等等。

Wait.

我可不是那种没毅力的人。

I'm not one of those people with no willpower.

我也不是那种懒惰的人。

I'm not one of those lazy people.

我不是那种所谓的美国中部地区，三百磅，还得用加长安全带的人。

I'm not one of those quote unquote Middle Of America three hundred pounds, you know, seat belt extender.

那种人跟我完全没关系。

Like, that's not me.

真的吗？

Seriously?

这到底是怎么回事？

What's going on here?

那是2012年，差不多是我前公司Trulia上市的时候。

And this was 2012, around the time my previous company, Trulia, went public.

我当时就想，首先我得弄清楚这个问题，如果连我都没法避免代谢出问题，那别人更没戏。

And I was like, well, first, I have to figure this out for myself because if I can't avoid being metabolically unhealthy, nobody can.

你猜怎么着？

Well, guess what?

根本没人能避免。

Like, nobody can.

在美国，现在有这么多人代谢不健康，这已经是普遍现象了。

Like, that is the status quo in America today with so many people metabolically unhealthy.

这让我特别想深入了解，到底是什么在导致代谢健康问题。

And that got me very interested in this whole topic of what is actually driving poor metabolic health.

幸运的是，我遇到了一些了不起的科学家，他们帮我明白了一个根本道理：肥胖、二型糖尿病，还有其他由代谢问题引发的疾病，根本不是个人选择的结果。

And fortunately met with amazing scientists who kind of helped me understand that fundamentally obesity, Type two diabetes, and the other conditions that result from poor metabolic health, it's not a personal choice.

没人会在周一早上醒来，心想：‘我今天就想胖200磅，再得个二型糖尿病。’

People don't wake up on a Monday morning and say, wanna gain 200 pounds and develop type two diabetes.

那听起来挺棒的？

That sounds awesome.

每天往身上扎胰岛素针，扎上十年？那也挺爽？

And sticking an insulin needle to my body for the next ten years every day, awesome.

我可太想参加了。

Sign me up.

不，这根本不是意志力的问题。

No, it's not lack of willpower.

但营养和饮食才是导致代谢健康恶化的主要原因。

However, nutrition and food is the number one driver of poor metabolic health.

如果你懂得如何利用营养，知道怎么通过饮食来改善甚至逆转代谢问题，你就能帮助那些平均体重三百磅的美国中部卡车司机，或者我们沿海地区的人常会责怪的普通人，系统性地靠饮食逆转这种状况。

And if you know how to use nutrition, if you know how to use nutrition to actually improve and reverse your metabolic health, you can take an average, let's just call it three hundred pound, Middle Of America truck driver or average person that we people on the coast often look like, oh it's your fault, And systematically reverse the condition nutritionally.

而这就是我们在Virta Health目前所做到的，已经帮助了超过二十五万患者，并且还在快速增长。

And essentially that's what we've done at Virta Health now with more than quarter million patients and scaling fast.

不过，我先在这里停一下。

But let me just pause there.

先说说一个来自芬兰的北欧滑雪运动员兼物理学家，是怎么会对代谢健康产生兴趣的，然后我们再分几个方向深入聊。

That's kind of the how did a Nordic skier physicist from FINRA get interesting in metabolic health and and then we can take this down to different paths.

我们开始吧。

Let's hop in.

我想先从……

I wanna start with, well,

正如你

as you

你可能会问到饮食的问题。

might expect, question about diet.

我想知道，回过头来看，你以前的饮食到底哪里出了问题。当然，这个问题有点引导性，如果你觉得不合适，完全可以忽略。

I wanna know what looking back, what the problem was with your diet and also this is, course, a leading question, so feel free to discard it if it's not a good question.

高果糖玉米糖浆在美国的代谢功能紊乱中，到底占了多大一份责任？

But how large a role does high fructose corn syrup play broadly in The US in metabolic dysfunction?

对吧？

Right?

如果把高果糖玉米糖浆从市场上彻底拿掉，会有多大影响？

If that just were removed from the market, what impact would that have?

不过咱们先从你个人的回顾说起吧。

But let's begin with just your personal retrospective.

现在回头看，你当时的饮食到底哪里有问题？

Hindsight 2020, what was wrong with your diet?

你每周锻炼十五小时，体脂率大概百分之十，比赛表现也很好，那时候饮食到底哪里不对？

When you were exercising 15 a week, roughly 10% body fat, performing well in competition, What was wrong with your diet?

我最常被问到的问题之一就是：是不是你的基因问题？

Number one question I get like, oh, was it your genetics?

因为你运动量那么大。

Because you were exorcist so much.

基因当然在很多事情上都有影响，但我只想提醒一下，如今大约百分之六十的美国成年人，也就是六成，要么患有二型糖尿病，要么处于前期状态，显然我们的基因库并没有发生改变。

Obviously, genes play a part in everything, but I just wanna remind that given about sixty percent of American adults, six zero, either have type two diabetes or prediabetes today, clearly it's not like our gene pool has changed.

所以，这不可能是基因的问题。

So it can't really be genes.

如果百分之九十三的美国成年人代谢都不健康，那更不可能是我们基因变了。

Or if ninety three percent of American adults are metabolically unhealthy, it's not like our genes have changed.

所以，不是萨米运气差，成了那个基因特别糟糕的孤例。

So no, it's not that Sami was the n equals one fin with very, bad genes.

这种情况正在大量人群中发生。

This is happening to a lot of people.

所以，我想说的第一点就是这个。

So that's, I I would say, one thing.

第一点就在这儿。

The first one is there.

第二点是，人即使身材瘦削，也可能代谢不健康。

The second thing is that it is possible to be skinny and lean and metabolically unhealthy.

有些人，尤其是亚洲背景的人，不一定胖上几十斤，但代谢状况却很差。

Some kind of people of certain background, especially kind of in Asia, it's more common that you don't gain a 100 pounds, but you're very metabolically unhealthy.

你就算运动量再大，消耗了大量热量，也不会明显长胖，但血糖和胰岛素依然偏高，还会出现胰岛素抵抗。

Also, you can out exercise the calories and burn and not gain massive amount fat, but you can still be elevated blood sugar, elevated insulin, and be insulin resistant.

这正是我当年的情况。

And that's basically what I was doing.

这真的非常难。

It's very, very hard.

我可以告诉你，作为运动员的十五年里，我始终处于饥饿状态。

And I can tell you that I was hungry for fifteen years as an athlete.

我总是觉得饿，比实际需要的还要饿。

It's like, I'm always more hungry than I could.

如果我按胃口吃，我肯定会胖起来。

And if I eat to my appetite, I'm gonna gain fat.

作为运动员，我不能这么做。

I can't do that as an athlete.

现在我来回答你的问题。

So now I'm gonna answer your question.

我的样本数是一，但我非常确信，因为我成功改善了这个问题——过去十多年，我每天吃六顿饭，全是高碳水、高升糖指数的食物，几乎不含脂肪。

So my n equals one, I'm absolutely convinced, because I was able to fix and improve it is, I was eating six meals a day of essentially incredibly high carbohydrate and incredibly high glycemic index foods and practically no fat for ten plus years.

所以你不是在吃奶油夹心蛋糕。

So you weren't eating Twinkies.

我们说的是米饭，像白米饭这样的东西，或者具体是指什么？

We're talking about rice, things like white rice, or what are we talking about?

米饭、面包、苹果、能量棒、番茄酱、意大利面。

Rice, bread, apples, granola bars, ketchup, pasta.

你知道的，只要是含葡萄糖的食物，最后都会变成血糖。

You know, anything that has a glucose molecule turns into blood sugar.

当然，如果糖来自苹果，或者食物纤维含量高，吸收速度会非常慢。

And sure, if it's in an apple or if it's lots of fiber, comes very, very slowly.

但如果你每天吃四千大卡，其中三千大卡都是碳水化合物，你算算看。

But if you're eating 4,000 calories a day, of which 3,000 is carbs, do the math.

每天摄入七百五十克甚至更多的碳水化合物。

750 grams of carbs a day or more.

这就等于你一直在往血管里不断灌糖。

And so you're basically trip feeding sugar into your veins constantly.

下午喝杯Jamba果汁，再来一顿轻食，感觉疲惫，我到现在还记得，那简直是我天天的饮食模式。

Jamba juice in the afternoon, second diet, tired, I just remember it was my diet all the time.

二十多岁的时候，身体能扛得住这种过量摄入。

When you're in your twenties, you can overdose.

人们常说，剂量决定毒性，这话没错。

People say dose makes the poison, that's true.

你确实能长期承受这种负担。

You can tolerate for a long time.

但到了三十多岁，你就知道，事情变得特别难了。

But once you get to your thirties, you know, it gets very hard.

所以我一直坚信，问题就出在这里。

So very convinced that that was it.

现在你们已经有不止一个案例了，关于Inferta Health，有哪些让你特别意外的发现？你们的干预方式是怎样的？

What are some of the more surprising things that you have seen with Inferta Health now that you have more than n equals one, and what do the interventions look like?

我们先从你问题的前半部分说起。

Let's start from the front end of your question.

最让你意外的是什么？

What's the most surprising?

最让人没想到的是，我们居然对任何人都有效。

The most surprising is that we've been able to be successful with literally anyone.

我给你举个例子。

And I'll I'll give you one example.

为什么这会让人意外？

And why is that surprising?

就连我原来以为一切全靠意志力，后来才发现，也许别人不像我这样受过良好教育。

Even overcoming my own concept of it's all about willpower, I had this, like but it's like people aren't maybe not as educated as I am.

他们可能生活特别忙。

Maybe they're kind of busy lives.

也许他们的意志力没我这么强，甚至达不到‘意志力奥运选手’的水平。

Maybe they don't have my willpower or kind of the willpower of willpower Olympians.

这一点真的让我很意外。

So that's been one of the most surprising.

我们跟一些美洲原住民部落合作，他们的卡车司机雇主有将近八百人。

We work with Native American tribes, you know, 800 or so large employers as truck drivers.

我们根据一个叫‘区域剥夺指数’的指标分析了结果。

We've analyzed outcomes based on what's called ADI, so Area Deprivation Index.

把全美所有邮政编码按平均收入排名，结果都一模一样。

So you take all ZIP codes in America, and you rank them by average income, and exactly the same outcomes.

我们还看了种族和族裔因素，结果也完全一样。

We looked at race, ethnicities, exactly the same outcomes.

这些案例规模很大，动辄几万、十几万的患者。

And these are like large scale, tens of thousands, 100 thousands of patients.

这一点特别出乎意料：只要解决了生理问题，结果自然就改善了。

So that's one that's been very surprising, which is to say, if you fix the biology, you fix the outcomes.

不是说你连高中都没读完，生活又特别忙，所以得额外给你做点意志力训练。

This isn't, oh, you didn't even go to high school and you have a very busy life, so we need some sort of extra willpower training.

不是这样的。

No.

只要调理好身体，结果自然会变好。

You fix the biology, you fix the body and the outcome.

这是第一点。

So that's number one.

第二点是改善的幅度有多大。

Number two is the magnitude of improvements.

举几个例子，有人得了二型糖尿病，已经十五年了。

So to give you a couple of examples, someone may have had diabetes, Type two diabetes for fifteen years.

他们每天注射一百单位的胰岛素，一天三次，持续了整整十年。

They are on one hundred units of insulin a day, sticking the insulin needle three times a day for ten years.

我们能在六到九个月内逆转这种二型糖尿病的状态，并且长期维持效果。

And we can reverse that kind of state of type two diabetes in six to nine months and then sustain it for long term.

平均减重13%，这是基于意向治疗分析，不是只挑一千个案例里五个成功的来算结果。

13% average body weight loss, and this is kind of like on an intent to treat basis, not 1,000 starred and then you calculate results based on five successful ones.

不，我们要算的是这一千个人的平均结果。

No, you calculate the average results from all the 1,000.

所以是13%的减重。

So thirteen percent.

在我们的临床试验中，一年平均减重大约三十磅，而且能长期保持，大部分减掉的是脂肪，因为我们还做了DEXA扫描。

So in our clinical trial that was about thirty pounds or so average weight loss at one year and sustained, and mostly fat because we did DEXA scans as well.

我想说的第三点是它的广泛影响。

I would say the third one is the broad spectrum effects.

这些成果都有同行评审支持，我们不仅看到血糖下降、二型糖尿病逆转，也不只是减重，还观察到肝病风险最高降低了75%。

Some of these are peer reviewed, so we've been able to show not just blood sugar down and reversing Type two diabetes, not just weight loss, but we've been able to show up to seventy five percent reduction in liver disease.

以前这病叫脂肪肝，后来科学家改名叫肝病，现在叫MASH和MASLD。

It used to be called fatty liver disease, but scientists changed it to liver disease, and so it's called MASH and MASLD.

顺便说一句，现在美国每年在这上面的花费高达一千亿美元。

By the way, it costs $100,000,000,000 a year in America today.

目前只有一种药获得了FDA批准。

There's one FDA approved drug today.

目前只有一种药获得了FDA批准，专门针对MASH。

One FDA approved drug today for MASH.

这属于肝病的一种。

It's one type of liver disease.

每年的费用是四万五千美元。

It costs 45,000 a year.

真的假的？

No kidding.

它去年才上市，是2025年，第一年销售额就达到了数十亿美元。

And it came out to market last year, first time, twenty twenty five, billion dollars in sales.

我们在营养上也能达到类似的效果。

We deliver similar results nutritionally.

我觉得这个是公开的信息。

I think this is public.

这在我们的资料里有提到。

This is in our texts.

有一篇论文刚通过同行评审，针对的是第四期患者。

Paper just accepted through peer review treating stage four.

我记得应该没有第五期了。

There is no stage five, if I'm remembering correctly.

转移性胰腺癌。

Metastatic pancreatic cancer.

对吧？

Right?

这可不是什么好消息。

This is bad news.