关于排便的那些事儿

所以它通常是棕色的，因为一种叫做粪胆素的东西，它是胆红素的代谢产物。

So it is generally brown because of something called stercobilin, which is a bilirubin metabolite.

实际上它来自你红细胞中的血红素，当红细胞在体内被分解时，含铁的血红素被释放出来，然后代谢成胆红素和其他物质。

So it actually comes from the heme in your red blood cells that gets as red blood cells get broken down in your body, the heme, which is iron containing, gets released and that gets metabolized into bilirubin and other things.

这些会随粪便排出，带有棕褐色。

That comes out in your stool and has a brownish color.

我们稍后会讨论哪些颜色的粪便需要引起警惕。

We'll talk later about maybe what colors of stool are something to be alarmed about.

然后还有气味，那种臭味是存在的。

And then there's the smell, the odor, which is there.

你知道，其中一部分是硫化氢，和臭鸡蛋的味道一样，来自细菌的代谢。

You know, some of that is hydrogen sulfide, the same smell that you get from, rotten eggs, which comes from bacterial metabolism.

但有趣的是，部分气味来自一种叫粪臭素的细菌产物，它赋予了人类粪便特别典型的气味。

But actually a fun fact, part of the smell is a bacterial product called scatol, which gives a particularly characteristic human poop smell.

而且很少有人知道，粪臭素在香水中还挺受欢迎的添加剂，因为极少量使用时，它似乎带有一种花香麝香的味道。

And little known fact, scattole is a somewhat popular additive to perfumes because in very small amounts, it apparently has a bit of a florally musk scent to it.

这又是一个“剂量决定毒性”的例子，来自“健康其实”播客。

And yet another example of the dose makes the poison coming to you from the wellnessactually podcast.

那有点恶心。

That's kinda gross.

说实话，我觉得那挺恶心的。

Actually, I find that gross.

好吧。

Okay.

行。

All right.

所以那将会

So that's gonna

是“便便正能量”。

be poop positive.

哦，你肯定会很积极。

Oh, You're gonna be positive.

好的。

Okay.

行吧。

Fine.

我确实查过了。

I did look it up.

我确实查过了。

I did look it up.

你香水里的粪臭素并不是直接从粪便中提取的。

The scattole that is in your perfume is not harvested directly from poop event.

这让人放心。

That is reassuring.

它是在实验室里合成的。

It's synthesized in a in a lab.

呼。

Phew.

好的。

Okay.

行。

All right.

所以就是这么回事。

So that's what it is.

我觉得在聊到“灵魂之窗”之前，大家最关心的核心问题是：我的排便正常吗？

I think the core question people have before we get to the window for the soul is like, is my poop regular?

而这正是我觉得我们应该聊聊排便的原因之一，因为人们会好奇自己的排便习惯和别人是不是一样，但你根本不知道。

And this is, I think, part of why we should talk about we should talk about poop because people wonder if their pooping is like other people's pooping, and you don't know.

好的。

Okay.

所以有几点要说。

So a few things.

在NHANES的数据里，就是大家最喜欢的那项全美代表性调查，他们问了人们很多问题，包括多久排便一次。

In the NHANES data, everybody's favorite nationally representative survey of Americans, they ask people many things, including how often they poop.

他们有点

And they kind of

你有没有想过，NHANES那些人聚在一起准备下一年的调查时，会是什么样？

most Do you ever wonder about the NHANES people when they're getting together for, like, next year's survey?

然后他们说，好了，各位。

And they're like, alright, guys.

我们之前调查了饮酒情况。

What we did we did alcohol intake.

我们测了血压，然后有人羞怯地举手。

We did blood pressure, and someone like sheepishly raises their raises their hand.

就像，好吧。

It's like, all right.

总之，继续

Anyway, go

说吧。

ahead.

我太喜欢伊恩·海恩斯了。

What does that I love Ian Haines so much.

所以在那份数据里，典型的频率范围大概是每天三次到每周三次，而大多数人每天排便一次。

So so in that data, the sort of typical range is something like three times a day up to three times a week, and the modal person is pooping once a day.

其实我觉得这些数字有点误导性，因为几乎所有人都在这个范围内，包括那些排便有问题的人。

I actually think these numbers are a little bit misleading in the sense that, like, almost everyone is in that range, including people who are having issues with their pooping.

所以频率其实并不是判断你健康还是生病的好指标。

So frequency is actually not a very good discriminator about whether you are sick or you're you're healthy.

比如，如果你每天排便15次，那你可能整天都待在厕所里。

So, like, if you're pooping 15 times a day, you probably are spending all of your time in the bathroom.

这就像是问题的信号。

That's, like, a signal of a problem.

如果你每周排便少于三次，那也可能意味着便秘，但范围其实挺宽的。

If you're pooping less than three times a week, that is also likely a signal of constipation, but there's a pretty wide range.

嗯。

Mhmm.

而且即使在这个范围内，你的消化系统也可能有问题。

And you could be having issues with your digestive system even within that range.

对。

Right.

大多数人，即使有肠易激综合征或炎症性肠病，就是那种很严重的肠胃问题，也还是在这个范围内。

Most people, even with like irritable bowel syndrome or inflammatory bowel disease, you know, like significant GI problems still fall within that range.

所以这个频率其实没什么用。

So it's not actually that helpful.

就像人与人之间的差异很大。

Like there's as much variation between people.

我觉得大家不太聊这个，那我们来聊聊大便的性状吧，因为我们必须得提到布里斯托大便分类法。

What I think people don't talk about well, let's talk about consistency because we have to talk about the Bristol stool.

布里斯托大便分类法。

Bristol stool scale.

这个

The

布里斯托的专家们制定了一个定性量表，用来判断你的大便是什么样子的。

good people at Bristol have created a qualitative scale to judge what your stool looks like.

这个量表从第一型开始，第一型是像小石子一样的硬块，我觉得就像兔子屎那样，一直到第七型，就是完全水状，没有固体。

And it ranges from type one, which is described as separate hard lumps like little pebbles, I think like rabbit poop or something like that, all the way to type seven, which is watery with no solid pieces.

这两种都是不正常的。

Those are both abnormal.

标准推荐的，或者说比较健康的布里斯托大便分类法，是第三型和第四型。

The sort of standard recommended, I don't know, recommended healthy ish Bristol school chart are types three and four.

第三型是表面有裂纹的香肠状，第四型更细，更像蛇，而且光滑柔软。

Type three is described as sausage shaped with cracks on the surface, and type four is thinner and more snake like, plus smooth and soft.

所以这就是我们追求的大便稠度。

So that's what we're looking for consistency wise.

这主要取决于水分的吸收，而水分吸收是在结肠里进行的。

And most of this is driven by water absorption, which happens along the colon.

你的结肠会重新吸收大便里的大量水分，这取决于食物通过肠道的时间。

Your colon reabsorbs a lot of the water from your stool, and it does that based on the transit time of passage.

所以粪便在肠道里待得越久，吸收的水分就越多，就会变得越干、越硬、越结块。

So like the longer stool sits in there, the more water gets sucked up and the drier and harder and lumpier it gets.

我们平时不太聊肠道通过时间。

And we don't talk about transit time.

但肠道通过时间其实挺有意思的，因为个体差异很大。

But transit time is interesting because it varies quite a lot.

正常的通过时间大概在十到七十五小时之间，这个范围其实挺大的。

Something you know, normal transit times are something like ten to seventy five hours, and that's actually a huge I mean, that's a huge range.

这是从吃进嘴里到排出体外的整个过程的时间。

That's mouth to toilet transit time.

从嘴到马桶的通过时间。

Mouth to toilet transit time.

要测这个时间，其实有两种方法。

And you can test mouth to toilet transit time by, there's actually two ways.

一种免费的方法就是吃玉米。

So, so a free way to do it is to eat corn.

大多数人消化不了很多玉米，对吧。

So most people cannot digest, like, lot of corn Mhmm.

玉米粒。

Kernels.

所以如果你吃一个玉米棒子，然后等着看什么时候在粪便里看到玉米粒，那是个很好的指标。

So if you eat a corn on the cob and then you wait to see when you see the corn kernels in your poop, That's a good good metric.

你也可以把粪便染成蓝色。

You can also dye your poop blue.

所以有各种商业的和与糖霜相关的方法来做这个。

So there's different commercial and other frosting related ways to do this.

你可以不小心做到这个。

You can do this accidentally.

你可以

You can

不小心做到这个，那还挺有意思的。

do this accidentally, and that's fun.

这还挺好玩的。

That's, like, a fun activity.

我想，我们能放一段音频吗？

I wanna can we play a a clip?

因为现在这个蓝色便便挑战在Instagram上挺火的。

Because this is getting like the blue poop challenge is an Instagram thing.

让我

Let me

好。

Yeah.

让我放给你听。

Let me play that for you.

你做过蓝色便便测试吗？

Have you done the blue poo test?

这个测试的目的是看你吃的食物在你体内通过的速度有多快。

The purpose of this test is to see how fast the food that you eat goes through you.

所以你做蓝色的松饼，早餐吃两个，然后等着看你的便便多久变蓝。

So you make blue colored muffins, you eat two of them for breakfast, and then you wait to see how long it takes for your poo to turn blue.

这能告诉你你的肠道运输时间。

This will tell you your transit time.

大多数人应该把运输时间控制在14到50小时左右。

Most people should be aiming for between fourteen to fifty ish hours of transit time.

如果你在厕所里看到蓝色便便的时间更长，那可能说明你便秘了，或者你的消化需要调理。

If it takes you longer to see blue poo in the toilet, it might be a sign that you're constipated or that your digestion needs some work.

便秘是导致盆底功能障碍的一个重要因素。

A big contributor to pelvic floor dysfunction is constipation.

优化运输时间是改善肠道健康和消除便秘的一个方面。

And optimizing the transit time is one part of improving your gut health and eliminating constipation.

所以这是你在自己家里就能做的事情。

So this is something you can do in the comforts of your own home.

要加什么样的食用色素呢？

What kind of food coloring to add?

我在网上看到过宝蓝色食用色素。

I've seen online royal blue food coloring.

对吧？

Right?

你想给松饼或者类似的东西染色。

You want to dye like a muffin or something like that.

正常的通过时间，就像你说的，是十到七十五小时之间。

And the normal transit time, as you said, is between ten to seventy five hours.

所以十小时算是比较短的，七十五小时算是比较长的，从吃下蓝色松饼到看到蓝色或者有点绿或者其他异常颜色从另一端排出来。

So ten would be sort of the short end and seventy five would be the long end of time to between eating a blue muffin and seeing some blue or maybe greenish or some abnormal color coming out the other end.

不过话说回来，排便很快并不是什么人生目标。

Now having said that, like, transiting your poop very quickly is not like, a, like, a life goal.

对吧？

Right?

那种想追求排便最大化、达到最佳频率，甚至用泻药让便便快点排出来的想法，其实没必要。

This idea that, like, we are trying to, like, poop max and get our, like, get our optimal frequency and, like, put have a laxative so the poop gets out fast.

所以，这真的不是你需要做的事。

So, like, that's not a thing you need to to do.

所以，如果食物在肠道里停留时间太长，可能会导致便秘，因为水分会被不断吸收掉，这点需要注意。

So very long transit times can be associated with constipation because the water gets pulled out and pulled out, and so that's, like, something to be aware of.

但你不应该去尝试蓝色便便挑战，然后想着怎么让便便尽快排出来。

But, you you shouldn't be trying to take the blue poop challenge and then, like, optimize so the poop comes out as fast as possible.

那样做不仅不健康，而且完全没必要。

That's not that's not just not healthy.

对。

No.

我的意思是，排得太快会导致营养吸收不良。

I mean, too fast would lead to malabsorption.

而且，你知道，你需要消化食物。

And, you know, you wanna digest your food.

这很重要，这是关键。

Like, that's part of that's that's everything.

对吧？

Right?

这就是它的用途。

That's what you're using it for.

你知道，如果你在网上看，人们会说，哦，在十到七十五小时这个正常范围内的转运时间，并没有特别与什么不良结果相关联。

You know, if you read online, people say, Oh, transit time within this normal ten to seventy five hour range has not been sort of associated with any particularly bad outcome.

所以这没什么好担心的。

So it's nothing you need to worry about much.

但当我们深入研究粪便的微生物学，比如里面有哪些不同类型的细菌时，我们发现其实很多差异是由转运时间驱动的。

But when we get into like the microbiology of poop, like the different types of bacteria are in there, what we find is actually a lot of that variation is driven by transit time.

所以我要先把这个放一放，等我们讨论粪便微生物组的时候，再记住转运时间是个因素。

So I'm going to table that for a minute as we talk about the so that when we talk about the fecal microbiome, we can remember that transit time is a thing.

也许了解你的转运时间，是的，它不会给你设定什么人生目标，比如让它变短或变长之类的，但无论如何，从科学和生理的角度来看，这都是个有趣的信息。

And maybe knowing your transit time, maybe, yeah, it doesn't give you any life goal in terms of making it shorter or longer or whatever, but it's nevertheless interesting information from sort of a scientific and physiologic standpoint.

而且很有趣。

And it's fun.

好的。

Okay.

在深入讨论这些之前，我觉得有必要先说说，哪些情况会让你担心自己的大便。

Before we get into all of that, I think it's worth saying, what are the things that would make you worry about your Poop.

比如，如果不是运输时间或频率的问题，那有哪些需要担心的呢？

Like, what are the things to be concerned about if it's not transit times or, or frequency?

一个就是如果有血。

So one is if there is blood.

大便带血的话，一定要给医生打电话。

Blood in the stool always deserves a call to your doctor.

顺便说个有趣的事实，大约百分之四十的严肃跑者有时大便里会有血。

I will say that, fun fact, about forty percent of serious runners have blood in their stool sometimes.

在马拉松这样的高强度运动之后，这种情况非常常见。

It's very, very common after, like, a hard effort after a marathon.

是的。

Yeah.

因为当你长时间高强度运动时，身体基本上会把肠道里能吸收的东西都抽走。

Because when you're working really hard for a long period of time, your body basically pulls, like, everything it can out of the gut.

你的消化系统就完全崩溃了。

Like, your digestion just totally flakes apart.

好的。

Okay.

然后之后就会出现血性腹泻。

And then you have bloody diarrhea after.

而且是鲜红色的血，看起来就是那种你会非常担心的样子。

And it is bright red blood, like, just looks like what you'd be very worried about.

好的。

Okay.

我们能不能做一期节目，讲人类其实不应该跑马拉松？

I can we do an episode on, like, people humans shouldn't run marathons?

这是我的一个大胆观点。

This is I'm gonna I I'm hot take.

第一个跑马拉松的人死了。

The first guy who did it died.

死了。

Died.

对。

Yeah.

是真的。

It's true.

但他当时没有充分补充能量，所以我觉得这值得思考，特别是现在有了新的碳水选择。

But he wasn't he wasn't fueling adequately, so I think that's something to think about what with the new carb options.

不过，这是另一个话题了。

Anyway, different episode.

但确实。

But Yeah.

我得说，即使你是认真的跑者，如果便血，也应该告诉医生，你可以决定接下来怎么做。

I will say even if you are a serious runner, if you are pooping blood, you should tell your doctor about that, you can decide what what to do.

好的。

Okay.

你的大便不应该是黑色的，除非你吃了很多铁剂，那会让它变黑，也不应该是苍白的。

Your poop shouldn't be black unless you are taking a lot of iron, which will turn it black, and it shouldn't be pale.

那可能是胆囊有问题的信号。

That can be a sign of a problem with your gallbladder.

是

Is

这样吗？

that right?

对。

Yeah.

我是说，苍白的大便挺吓人的，可能是胆囊梗阻，希望只是胆总管里的胆结石，但更糟糕的情况可能是癌症堵塞了胆总管，那就不太好了。

I mean, pale poop is pretty scary gallbladder obstruction, which could hopefully be a gallstone in the common bile duct, but more ominously could be a sign of cancer that's obstructing the common bile duct, which we don't love.

所以一定要去检查一下。

So definitely get that checked out.

另一件事就是体重下降和排便习惯的无故改变。

The other thing is just weight loss and unexplained changes in pooping.

这些都是严重问题的潜在症状，你们平时一般不应该在晚上排便。

Those are the those are potential symptoms of a serious issue, and you people generally should not, like, routinely poop at night.

所以半夜偶尔排一次便虽然会发生，但这并不是身体正常的消化节奏。

So in the middle of the night pooping sometimes it happens, but it's not a typical way your body would digest.

如果这成了常态，那就值得打个电话咨询一下了。

And if that's a regular thing, that's also worth a worth a call.

对。

Yeah.

大便这个事儿我们之前聊过，但我觉得排便特别能体现脑肠轴的作用，因为你的社交环境会给你便意。

Poop we talked about this in a prior episode, but I think that pooping is this amazing example of the brain gut axis because your social environment cues you to poop.

就像我们之前说的，很多人平时没感觉想上厕所，一回到家看到舒服的马桶之类的，突然就想去了。

Like we've talked about how for a lot of people, it's like they don't feel like they've got to go and then they get home where it's like, oh, my nice toilet and everything.

然后心里就想着，哦，现在得去一趟了。

And then it's like, oh, now I have to go.

对吧？

Right?

就像你的大脑在告诉你的肠道，该行动了。

Like that's your brain telling your gut, like, let's go.

现在是时候了。

Now's the time.

咖啡也有这个作用。

Coffee does this too.

所以咖啡因显然能刺激结肠，但实际上无咖啡因的咖啡也会让人想上厕所。

So caffeine obviously can stimulate your colon, but actually decaffeinated coffee prompts people to poop as well.

这很可能只是习得性行为，你的大脑和肠道在交流，这也是为什么睡觉时，你的大脑通常知道你不应该在睡梦中排便。

And that's probably just a learned behavior, and your brain talks to your gut, which is why sleeping, you generally like, your brain knows that it's not you shouldn't be pooping in your sleep.

所以如果你有这种情况，去看医生吧。

So if you are, talk to a doctor.

好的。

Okay.

所以这就是你的大便在基本层面上告诉你的，就是你在马桶里能观察到的那些。

So that is what your poop tells you on a basic, like, what you can observe in the toilet.

我觉得关于大便，另外两个大问题是：什么能改变你的大便。

I think the two other big pooping questions for me are what can change your poop.

所以如果你发现自己处于布里斯托大便分类法里不太好的部分，比如兔子屎那一段。

So if you do find yourself in a bad part of the Bristol stool scale, like in the rabbit poop era of your Bristol stool.

你能做些什么来改善呢？

Like, what can you do to fix it?

然后我想聊聊肠道菌群，因为现在这个话题特别火，大家都很感兴趣，都想了解。

And then I wanna talk about the microbiome because it's very hot right now, and people are totally into it, and they wanna they wanna know about it.

所以这两件事我们都会聊。

So we're gonna do both of those things.

但在那之前，我们先休息一下。

But before that, let's take a quick break.

我14岁的时候被绑架了，被囚禁了九个月。

When I was 14 years old, I was kidnapped and held captive for nine months.

我活了下来，并且一生都在探索其他人是如何在那些本该摧毁他们的事情中幸存下来的。

I survived, and I've spent my life exploring how other people survived, survive what should have destroyed them.

我是伊丽莎白·斯玛特，这里是《幸存者档案》。

I'm Elizabeth Smart, and these are the survivor files.

我只记得耳边有个低沉、挑衅的声音在说：闭嘴。

I just remember this low, taunting voice next to my ear saying, shut up.

什么都别说。

Don't say anything.

每周，我都会和那些经历过难以想象的事情的幸存者在一起。

Every week, I'm with survivors who lived through the unthinkable.

我知道如果他醒了，毫无疑问，他会伤害我。

I knew if he woke up, without a doubt, he was going to hurt me.

我开始觉得床尾有人，然后我就开始尖叫。

I started feeling that there was someone at the end of my bed, and I just started screaming.

他们被绑架、被跟踪、被控制，几乎被噤声。

They are abducted, stalked, controlled, and nearly silenced.

但这些故事讲的不是她们失去了什么。

But these aren't stories about what's taken from them.

而是她们如何拼尽全力活下来。

They're stories about what it takes to make it out alive.

欢迎在iHeartRadio应用、Apple Podcasts或任何你收听播客的平台，收听伊丽莎白·斯马特的《幸存者档案》。

Listen to the survivor files with Elizabeth Smart on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

在新播客《Solita》中，我们分享女性独自旅行时那些真实又混乱的经历。

On the new podcast, Solita, we share the messy reality of traveling alone as a woman.

我可以等四个小时坐下一班公交，或者接受这个陌生男人骑摩托载我一程。

I can wait four hours for the next bus, or this random dude is offering me a ride on his motorcycle.

我选了第二个选项。

I chose option b.

我是朱莉·皮涅罗，我独自旅行，因为那是一个我不用先征求任何人同意就能说“好”的难得空间。

I'm Julie Pinheiro, and I travel by myself because it's a rare space where I can say yes without asking anyone else first.

我的使命是重新定义“solita”这个词，把同情变成无限可能。

I'm on a mission to reclaim the word solita, trading the pity for possibility.

每次我想一个人待着，却总能遇到人，他们就说，你对我们笑了。

Every time I tried to be alone, I kept meeting people, and they were like, you smiled at us.

这附近很少有人笑。

Not a lot of people smile around here.

正是当你独处时，你才最能接纳真实的世界，而不是那些被灌输的谎言。

It's when you're alone that you're most receptive to the world as it is and not the lies you're sold about it.

这段时间你可以挑战自己的极限，改变想法，或者觉醒成一个全新的自己。

It can be a time where you push your limits, change your mind, or wake up to a new version of yourself.

所以，无论你是独自旅行的老手，还是紧张得不敢预订第一次旅行，我希望你在iHeartRadio应用、Apple Podcasts上收听Solita，

So whether you're a solo travel veteran or you're too nervous to book your first trip, I hope you listen to Solita on the iHeartRadio app, Apple Podcasts,

或者任何你收听播客的平台。

or wherever you get your podcasts.

如果你的书架和你的推荐页对你来说同样重要，那么欢迎回家。

If your bookshelf and your For You page are equally important to your personality, welcome home.

这里是Prose Society，一个每周更新的播客，既是读书俱乐部，又是思想女儿、流行文化狂热者以及任何认为《傲慢与偏见》和《爱情岛》值得同等讨论度的人的群聊。

This is Prose Society, the weekly podcast that's part book club, part group chat for thought daughters, pop culture obsessives, and anyone who thinks Pride and Prejudice and Love Island deserve the same level of discourse.

我是Eli Rallow，每周我们都会把书籍、互联网和大家都聊不停的话题串联起来。

I'm Eli Rallow, and every week, we're connecting the dots between books, the Internet, and the conversations everyone can't stop having.

我得去查查这个故事。

I'm gonna have to look up this story.

我完全迷上了。

I'm obsessed.

我也是，完全着迷了。

I'm obsessed.

从畅销书作家和你最喜欢的书籍推荐达人，到最新的流行文化热点，什么都能聊。

From bestselling authors and your favorite book talk creators to the latest pop culture moments, nothing is off the table.

就像是

It's like

如果你能把一些真实的信息藏在引人入胜的角色里，那就像特洛伊木马一样。

if you can hide some real messages inside compelling characters, and that is a Trojan horse.

无论你是在寻找

Whether you're looking

无论你是想深入探讨文学、聊点有见地的流行文化，还是想找一个爱思考的读者社区，你都来对地方了。

for literary deep dives, smart pop culture conversations, or a community of readers who love to think a little too much, you're in the right place.

在iHeartRadio应用、Apple播客或任何你收听播客的平台，收听《Pro Society》节目。

Listen to pro society on the iHeartRadio app, Apple podcasts, or wherever you get your podcasts.

我们书页间见。

See you between the pages.

好的。

Okay.

我们回来了，我想聊聊“纤维最大化”。

We're back, and I wanna talk about fibermaxxing.

佩里，你在追求纤维最大化吗？

Perry, are you fibermaxxing?

哦，那倒没有。

Oh, so no.

我们已经聊过“蛋白质最大化”了。

We already did protein maxing.

我太专注于蛋白质了，没空想别的。

I'm too focused on protein to focus

对，蛋白质。

on protein.

你得两个都兼顾。

You gotta do both.

你得两个都兼顾。

You gotta do both.

而且你整天吃的那个奶酪粉里，这两样都没有，所以你麻烦大了。

And none of them are in this, like, cheese powder that you eat all the time, so you're in trouble.

我喝了我的——我这儿有吗？

I had my do I have it here?

没有。

No.

我喝了我的蛋白饮，就是那个Oikos的，30克蛋白质的乳清蛋白奶昔，里面一点纤维都没有。

I had my had my protein drink, my, like, Oikos 30 grams of protein whey protein milkshake, which has no fiber.

我其实挺担心我们纤维摄入不足的，毕竟我们一直在追求高蛋白。

I'm actually concerned about our lack of fiber given our protein maxing stuff.

艾米丽，我没有证据证明这是真的，但我就是要这么说，没有证据也敢说。

Emily, I have no evidence that this is true, but I'm going to assert it without evidence.

只有在“健康真相”播客里，你才会听到主持人承认自己完全没证据就下结论。

Only here on the wellnessactually podcast will you hear the host admit that they're asserting something completely without evidence.

但是，我

But I

相信纤维——这个我倒是有一些证据。

believe that fiber I have some evidence for this.

纤维可能是美国人摄入不足最严重的营养素，比任何其他营养素都更达不到推荐量。

Fiber might be the nutrient that Americans are subtherapeutic, like missing the recommended value on more than any other nutrient.

对吧？

Right?

就像蛋白质，我们之前聊过蛋白质的推荐摄入量，其实挺低的，因为那只是维持基本生存的量，而几乎每个美国人都远超这个标准。

Like protein, we talked about protein and the recommended protein intake, which is quite low because it's just the amount you need not to waste away to nothing, like almost every American is getting more than that.

然后我们争论说，他们可能应该摄入更多。

And then we argued that probably they should be getting more.

但即使是推荐的纤维摄入量，也就是每天20到25克，根据NHANES的数据，美国人的平均纤维摄入量是每天17克。

But even the recommended amount of fiber, which is like 20 to 25 grams a day, according to NHANES, the mean US fiber intake is 17 grams a day.

所以，大多数美国人实际上都低于推荐的纤维摄入量。

So, like, most Americans are, like, below actually the recommended fiber intake.

所以我们在纤维最大化这方面做得不好。

So we're bad at this, at fibermaxing.

我其实不觉得这很意外，因为往食物里加纤维并不容易。

I don't find that very surprising, actually, because it's not that easy to add fiber to stuff.

我觉得，我们在加工食品时做的很多事情都是把纤维去掉，而把它加回去并不像用蛋白质做东西那么简单。

Like, most of the things we do in processing food take fiber out of it, just putting it back in is, like, not as easy as just making stuff with protein, I think.

天哪。

Oh my god.

这真是对超加工食品的一个绝妙定义。

What a good definition for ultra processed foods.

虽然不是官方定义，但基本上就是把纤维去掉，让食物更容易吃、更容易消化。

Not the, like, official definition by any stretch, but but, like, taking the fiber out to make everything easier to eat and digest.

对。

Yeah.

高能量密度。

High energy density.

但纤维其实分两种。

But fiber comes actually in two types.

有可溶性和不可溶性纤维，还有可发酵和不可发酵的。

It comes in soluble and insoluble fiber and also fermentable and not.

所以我觉得这就像是一个二乘二的矩阵。

So I guess there's, like, a two by two box of this.

可溶性纤维就像燕麦一样，会形成胶状。

So soluble fiber is like it gels it's like oatmeal.

它会在胃里把东西粘在一起，减缓食物在肠道中的通过速度。

It, like, gels things together in your stomach, and it slows the process of things through your through your gut.

不溶性纤维就像麦麸一样。对。

Insoluble fiber is like, like wheat bran Mhmm.

或者，你知道，任何种类的壳，任何东西的壳。

And or, you know, any kind of, like a husk, any type of husk of things.

那就像是的。

That's like Yeah.

大自然的扫帚。

Nature's broom.

我觉得这就是人们想到的。

Think that's what people think about.

它更像是把所有东西都冲出来，很多时候你会在便便里看到完整形态的这些东西。

More it sort of like flushes it all out, and that's the stuff you see, in whole form in your poop a lot of the time.

对。

Yeah.

这就解释了为什么医生会推荐纤维来治疗便秘和腹泻。

And this explains why doctors will recommend fiber both for constipation and for diarrhea.

而且他们通常不会详细说明他们说的是哪种纤维。

And they'll often not go into detail about like which fiber they're talking about.

但就是那种不溶性纤维，比如纤维素、麦麸之类的，会直接穿过你的身体。

But it's that insoluble fiber, you know, cellulose wheat bran and stuff like that that is just going to transit right through.

这些纤维不会被发酵，也就是说它们不会产生气体，而很多人在摄入纤维时不喜欢这一点。

Those are non fermenting, which means they don't cause gas formation, which a lot of people don't like when they are taking in fiber.

对。

Right.

所以，寻找一种不被发酵的不溶性纤维，既能清理你的肠道，又不会产生太多气体。

So like looking for a non fermentable insoluble fiber is going to clean you out without causing too much gas.

这对便秘有好处。

That's good for constipation.

而一种可溶但不发酵的纤维实际上会减缓肠道蠕动。

A soluble non fermenting fiber is actually going to slow things down.

所以当你大便稀溏，想要让大便成形时，像车前子壳粉就是典型的补充剂，而且不会产生气体。

So when you're having kind of loose stools and you want to bulk up your stools, that's something like psyllium would be a prototypical supplement there that doesn't cause gas.

然后还有各种可发酵的纤维，比如抗性淀粉，还有我们几集前聊过的FODMAP饮食里的那些东西，这些都是很好的纤维来源。

And then we have all the fermentable fibers like like resistant starch and all the things on the FODMAP diet that we talked about a few episodes ago, which are which are good sources of fiber.

但是肠道里的细菌会发酵它们，产生气体，然后你就会放屁，也许这可以成为我们下一期的主题。

But the bacteria in your gut will ferment them and that generates gas and then you have farts, which maybe that can be our next episode.

那就继续吧。

Just like let's keep going.

没问题。

No problem.

放屁是怎么回事？

What's deal with farting?

怎么回事？

What's the deal?

好的纤维来源包括豆类。

Good sources of fiber include beans.

豆类含有大量纤维。

Beans have a lot of fiber.

奇亚籽的纤维含量也很高。

Chia seeds have a lot of fiber.

燕麦片含有不少可溶性纤维。

Oatmeal has a good amount of, of soluble fiber.

所以，获取纤维的方式有很多，但大多来自全谷物、水果和蔬菜。

So, there are a lot of ways to get fiber, but they mostly are in the form of whole foods and fruits and vegetables.

对。

Yeah.

孩子们，你们得多吃水果和蔬菜。

You got to eat your fruits and vegetables, kids.

你知道，关于纤维的好处，除了能让你排便规律之外，还有很多健康宣传。

We you know, you see a lot of health claims about the benefits of fiber beyond like it'll keep you regular.

我觉得这些说法有不少依据。

And I think there's a fair amount of support for this.

我猜艾米丽不会像我这么热衷，但她已经在翻白眼了。

I anticipate Emily is not going to be as gung ho as I am, but she's already rolling her eyes.

好的。

All right.

我有来自多项研究的强有力的观察数据，表明较高的纤维摄入量可以降低心血管疾病和中风的风险，而且我用了因果关系的说法，你肯定会因为这个批评我。

I have strong observational data from multiple studies that Higher fiber intake can reduce the risk of cardiovascular disease and stroke as well as I'm using causal language, which you're going to yell at me for.

较高的纤维摄入量也与较低的结肠癌风险相关。

Higher fiber intake is associated with a lower risk of colon cancer as well.

艾米丽，我预测你会说，嗯，吃很多纤维的人还会做很多其他健康的事情，所以他们长期来看更健康。

Emily, you're going to say, I predict that, well, people who eat a lot of fiber do a lot of other healthy things, and that's why they are healthier in the long

我就是这么打算说的。

That's what I'm going say.

而且随机试验的数据实际上并没有支持这些关于结肠癌的说法。

And randomized trial data has actually not supported some of these colon cancer claims.

那是个很难做的试验，因为我们说的是二十年的纤维摄入量。

That's a very hard trial to do because we're talking about fiber intake for twenty years.

同意。

Agree.

我同意。

I agree.

这个问题很难回答，我觉得我对这些文献的部分不满在于，你们的人会说，哦，这些证据太强了，因为我们有《柳叶刀》的论文，涉及一亿三千五百万人年。

This is a hard question to answer, and I think part of my issue with this literature is your people say, oh, this is such a strong set of things because, you know, we have this Lancet paper, and it's a 135,000,000 person years.

但问题是，当你增加数据时，如果所有数据都有同样的偏差，你并没有解决因果关系和相关性混淆的问题。

But the thing is that when you add data, but it has all of the same biases, you haven't fixed your causal versus correlation problem.

你只是让相关性变得更精确了。

You've just made your correlations more precise.

我们非常清楚，更多的纤维摄入与良好的健康结果相关，但这和说它是因果关系是完全不同的，我不认为因果证据特别好。

We have a very it's very, very clear that more fiber is associated with good health outcomes, but that is very different from saying that it is a causal link, and I don't think the causal evidence there is especially good.

我们不需要在每一集都重新讨论我的看法，虽然我们可以，也应该——

And we don't need to revisit my feelings on this in every episode, Although, we could we should be

这让我感觉像回家一样，对吧。

able use It makes me feel like I'm coming home to, you know Right.

一个温暖舒适的沙发。

A nice a nice warm sofa.

这一篇甚至都没有做孟德尔随机化研究。

There's not even any Mendelian randomization in this one.

所以，你懂吧？

So know?

嗯，如果有的话，我就会用客服那种语气了。

Well, if there was, I would use call center language.

真扫兴。

Bummer.

就是为了气你。

Just to really piss

气死你。

you off.

关于纤维，我最后想说的是，你确实需要水分来让纤维在排便时发挥作用，但水分再多也不会更有帮助。

The last thing I wanted to say about fiber is that you actually do need hydration to make your poop work with your fiber, but more hydration isn't more helpful.

所以纤维的效果就像，你一旦加了它，排便就会变好。

So fiber tends to be like when you add it, your poop gets better.

你需要喝够水才能正常排便，因为大便在结肠里移动的时候，会吸收水分。

You need to be adequately hydrated to appropriately poop because as your poop moves through your colon, it, like, pulls water out.

如果你水喝得不够，身体会优先把水分用于其他功能，然后你的大便就会变得又干又硬，像那种一颗颗的兔子屎。

And if you don't have enough water, it will, like, prioritize pulling the water out for other bodily functions and then leave your poop all dry and bristle type one rabbit pellets.

但是光一个劲儿地喝水，喝得比需要的还多，也不会让你的大便变好。

But just drinking and drinking and drinking and drinking and being, like, way more hydrated than you need to be is not gonna make your poop nice.

我也不知道。

I don't know.

好的。

Alright.

把我的水瓶拿过来。

Get my water bottle with me.

好的。

Alright.

等等。

Wait.

我还想再说两件关于怎么好好排便的事。

I wanna say two more things about how you poop how people poop good.

哦，对。

Oh, yeah.

对。

Yeah.

对。

Yeah.

除了纤维。

Besides fiber.

不止是纤维。

There's more than fiber.

不止是纤维。

There's more than fiber.

其中一个是蹲凳。

One thing is the Squatty Potty.

你有那个蹲坑凳吗？

Do you have a Squatty Potty?

没有。

No.

我没有。

I don't.

而且

And

天哪。

Oh my god.

你居然没有，你怎么回事？

You're missing what is wrong with you?

我知道。

I know.

嗯，我之前不知道那些数据，后来做了研究。

Well, I I didn't know the data, and then I did the research.

现在我就觉得，我也不太清楚。

And now I'm like, I don't know.

Squatty Potty 就是

Squatty Potty is

很棒。

great.

所以Squatty Potty就是放在下面的一个东西。

So the Squatty Potty is just a thing that you put under.

它就像一块，像塑料凳子，你把它放在马桶周围，然后把脚踩上去，它会改变你的姿势。

It's like a piece of it's like a plastic stool, and you put it around the your toilet, and you put your feet up on it, and it changes, like, your posture.

基本上就是把你的膝盖抬高，让你的结肠，怎么说呢，更直一些之类的。

It basically puts your knees up, and it makes your, your your colon, like, I don't know, straighter or whatever.

对。

Mhmm.

它更像是模拟蹲着的姿势，那是人们有马桶之前排便的方式。

It's more mimicking a, like, squatting posture, which is the way people pooped before we got toilets.

而且实际上有随机对照试验的数据，就是随机交叉设计的那种，让参与者用两种方式排便。结果发现，用这种方式，感觉排空干净的程度提高了大约三倍，而且用力屏气的情况也大大减少了。

And there's randomized data actually, randomized crossover data where they have people poop in both in both ways, And this improves the sense of complete emptying by, like, three times, and it reduces the straining by a lot.

而且这个东西很便宜，效果却很明显。

And this is very cheap, and the effect sizes are big.

我真的真的觉得你应该买一个。

And I really, really think that you should get one.

你有吗？

Do you have one?

当然有。

Absolutely.

我们有好几个。

We have multiple.

我所有的马桶上都放了。

I have them on, like, all of my toilets.

我又不傻。

I'm not an idiot.

是的。

Yes.

我是个笨蛋。

I'm an idiot.

我想把这个记下来。

I want to file this.

好，那行。

So Okay.

我在网上看到一些疯狂的东西，好吧，这有点恶心。

So I was seeing some crazy stuff online of Okay, this is gross.

但有人说，如果你真的在追求完美排便，你根本不需要擦。

But people being like, If you're really poop maxing, you shouldn't have to wipe.

对吧？

Okay?

首先，这很恶心。

And that's gross, first of all.

那太恶心了。

That's gross.

那

That's

太恶心了。

gross.

但其中一个论点是，动物都不擦屁股。

But one of the arguments is, like, animals don't wipe.

这倒是真的。

And that is that is true.

也不一定。我以前有只猫，它不擦，屁股上总是沾着屎。

It's not Well, used have this cat that didn't wipe, and it always had poop all over its butt.

所以，我就不想掺和这事儿了。

So, like, I'm just, like, not getting into this.

不过，我为什么为这个播客做这些深入调查，我自己也不知道。

One of the things, though so, like, why I do these deep dives for this podcast, I don't know.

这说明我这个人确实有点问题。

It shows that something's deeply wrong with me.

但我稍微研究了一下进化生物学，结果发现我们需要擦屁股的原因之一，是因为我们直立行走。

But I went into a little bit of evolutionary biology, and it turns out that one of the reasons we have to wipe is because we walk erect.

这就像是我们可以在清单上再加一条：因为进化成直立行走，我们解放了双手去使用工具，这确实挺好的。

It's it's like we can add it to the checklist of things that because we evolved to walk erect, which gave us, you know, use of our hands for tools, that was very nice.

也许还能在非洲草原上越过那些高高的草丛看到远处，或者别的什么好处。

And maybe like seeing over some high grasses in the African Savannah or whatever else it was.

但我们却因此注定要忍受一辈子的背痛，一个乱七八糟的产道，高产妇死亡率，还有擦屁股的需求。

We condemned ourselves to like a life of back pain, a birth canal that is all jacked up and high maternal mortality and the need to wipe our poops.

而且显然有证据表明，人类在梅毒出现之前，在纸出现之前，在什么都没有的时候，就已经开始擦屁股了。

And apparently there's evidence that humans have been wiping their poop since like before syphilis, before we had paper, before we had anything.

所以并不是说动物做得对，我们做得不对。

So it's not like that animals are doing something right and we're doing something wrong.

而是我们一开始就不该站起来。

It's we we should never have stood up in the first place.

也许Squatty Potty能稍微纠正一下这个问题。

And maybe the Squatty Potty corrects that just a little bit.

我不太确定Squatty Potty是不是干这个用的。

I'm not really sure that's what the Squatty Potty does.

而且你还是得擦，还是得擦。

And you still have to you still have to wipe.

对。

Yeah.

对。

Yeah.

不。

No.

继续擦吧，各位。

Keep wiping, people.

你继续擦吧。

You keep wiping.

大家，别停止擦屁股。

People, don't stop wiping.

但你有个小马桶。

But you get a tiny potty.

我马桶上装了个那种坐浴盆，真是彻底改变了生活，我得说。

One of those bidet, like, seats on my toilet, which I is a total game changer, I will say.

我超喜欢。

I love it.

好。

Okay.

挺好的。

It's nice.

另外，你不该在厕所里玩手机，因为那会让你坐太久。

The other thing is you should not use your phone on the toilet because it encourages you to sit for too long.

那太疯狂了。

That is insane.

痔疮。

Hemorrhage.

你真是疯了。

You're you're crazy.

我知道这话说起来有点傻，而且我们很多人上厕所时都会用手机，但我不会。

I realize this is a stupid thing to say, and many of us use our phone on the toilet all the time, and I don't.

不过我觉得换个说法就是，有些研究显示，人们用手机时，就是坐得太久了。

But it is I think a different way to say this is there have been some studies associated with that show that people use their phone, you just sit for too long.

所以上厕所时短暂用一下手机没问题。

So using your phone briefly on the toilet is fine.

但如果你只是为了躲开家人，坐在马桶上刷手机，一直坐着不起来，那你应该离开马桶，坐在浴室的其他地方，假装自己还在上厕所，不然你会得痔疮的。

But if you're just, like, sitting and sitting because you're trying to avoid your family and scrolling on your phone on the toilet, you should get off the toilet and sit in a different part of the bathroom and pretend that you're on the toilet because otherwise you're gonna get hemorrhoids.

对。

Yeah.

我我我也看过那个研究，我觉得它说得对。

I I saw that study, and I I I think it's right.

但这真的很难。

But it is very hard.

我得说，如果我忘了带手机，比如把手机落在另一个房间，然后我在厕所里，我会非常抓狂。

I I will say if I, like, forget my phone like, I leave my phone in another room and I'm on the toilet, I am desperate.

我会抓起洗发水瓶，读上面的成分表。

Like, I will grab a shampoo bottle and read the ingredients.

你不能和自己独处。

I You can't be alone with yourself.

这说明了什么，Perry？

What what does that tell us, Perry?

我做不到。

I I cannot do it.

我不能只是安静地坐着，面对自己的想法，或者……

I I can't just sit quietly with my thoughts or

就比如，本该只需要十二秒的时间。

For, like, the twelve seconds that it should take you.

其实，你知道吗，如果你用个蹲凳会不会更好？

Actually, you know what would be better if you get a squatty potty?

那样会更快，你也不会那么无聊了。

It'd be going faster, and then you wouldn't be so bored.

好吧。

Alright.

蹲凳，给我安排上。

Squatty potty hook me up.

好的。

Okay.

所以，膝盖抬高，手机放下，多吃纤维，多喝水，喝点咖啡。

So knees up, phones down, eat your fiber, drink some water, have some coffee.

这些都是实际的东西。

That's like the practical stuff.

但更有趣、更吸引人的部分是微生物组，也就是生活在我们体内的那些令人兴奋的细菌和真菌群，它们对很多事情都非常重要。

But the more, like, fun, sexy piece of this is the is the microbiome and the idea that this exciting constellation of bacteria and fungi that are living in us are really important for a lot of things.

我觉得微生物组前几年特别火，现在感觉有点降温了，好像《经济学人》每期都在讲微生物组，现在感觉没那么热了。

I feel like the microbiome had, like, a big moment, like, a couple years ago, and now I kind of, like, the every episode of the economist had a thing about the microbiome, and I feel like it's, like, died out a little bit.

哦，在医学领域，它还是很受关注的。

Oh, I in the medical side, it's still, like

哦，你们还在深入研究这个。

Oh, you guys are still really into it.

对，是的。

Oh, yeah.

很好。

Great.

太好了。

Excellent.

那这到底是什么？我们为什么要关注它？

So what what what is this, and why are we thinking about it?

为什么我们在意这个？

Why do we care?

好的。

Okay.

大家都知道粪便里有细菌，但其实不止是有细菌那么简单。

So everyone knows there's bacteria in your stool, but, like, it's more than just there's bacteria.

那是一个生态系统。

It is an ecosystem.

你的肠道和结肠里生活着成千上万种不同的细菌。

There are thousands of types of different species of bacteria that live in your gut, that live in your colon.

它们都在互相作用。

They're all interacting with each other.

它们帮你消化食物。

They're digesting food for you.

它们释放的物质会被身体吸收。

They're releasing substances that are absorbed into your body.

没有它们，我们会病得很重。

Without them, we would be very sick.

这些是生活在我们体内的共生体。

These are symbiotes that live within us.

人们经常问，你会听到一些统计数据，比如你的结肠里有多少细菌，比如我有10磅的细菌。

People often ask like, you'll hear statistics like how much bacteria do you have in your colon with like, I have 10 pounds of bacteria.

那不是真的。

That's not true.

你的结肠里有0.2公斤的细菌。

You have 0.2 kilograms worth of bacteria in your colon.

那大约相当于一个苹果的细菌量。

That's about an apple's worth of bacteria.

但这仍然很多，因为细菌非常小。

But that's still a lot because bacteria are very small.

所以大多数微生物组研究的方式是，你取一个粪便样本，在不同的条件下送到实验室。

So the way most microbiome studies work is you take a stool sample that is sent to a lab under varying conditions.

这些研究存在一些问题，而且结果很混乱。

There are some problems with these studies, but and it's mixed up.

实验室会对很多已知的细菌进行DNA测序。

Labs will do DNA sequencing for a bunch of different known bacteria.

每种细菌都有一段对它来说比较独特的短DNA序列。

Every bacteria has a short sequence of DNA that's kind of unique to it.

然后就像这样：如果我们找到了这段DNA序列，就能推断出这种细菌存在于粪便中。

And it's just like, okay, if we find this sequence of DNA, we can therefore infer that this particular bacteria was in the stool.

对几百种甚至上千种不同的细菌都这样做，你就能看到一个人粪便中各种细菌的相对数量。

And you do that for a bunch of different hundreds or even thousands of different bacteria, you can see the relative amounts of bacteria in someone's stool.

基本上每个人都有大约14个属的细菌，或者说相同的14个属，这算是人类粪便微生物组的典型构成。

And basically everyone has about 14 genuses or the same 14 genuses of bacteria that's sort of like the human stool microbiome.

但这大大低估了人与人之间的多样性。

But that vastly underestimates the amount of diversity from person to person.

在一项针对4000人的粪便微生物组研究中，75%，也就是4000人中的3000人，至少有一种细菌类型是其他任何人体内都没有发现的。

So in a study of 4,000 people looking at their stool microbiome, 75%, so 3,000 of those 4,000, had at least one bacteria type that was not found in any other person.

所以很有可能，你的结肠里住着一种细菌，至少在你所在的城镇，没有其他人拥有这种特定的细菌。

So the chances are you have a bacteria living in your colon that at least, you know, in your town, there is no one else who has that particular bacteria.

这听起来挺不错的。

And that seems nice.

我不知道。

I don't know.

这好吗？

That nice?

我觉得我想更了解我自己的细菌，跟它聊聊天，看看它过得怎么样。

I feel like I would want to know my personal bacteria a little bit better and talk to it, see how it's like in life.

所以从这个意义上说，每个人的微生物组都是非常个人化的。

So people's microbiome is in that sense quite person specific.

实际上，甚至一年之后你都能识别出来。

So actually, like, you can identify even a year later.

有研究表明，一年后你基本上可以重新识别出大约百分之八十的人，通过

People have shown, like, you can basically reidentify, like, eighty percent of people a year later by

嗯。

Mhmm.

比如，他们微生物组的各个方面。

Various, like, aspects of their of their microbiome.

话虽如此，实际上每个人的微生物组在个体内部随时间变化也很大。

Having said that, there's actually quite a lot of individual over time variation within an individual in your microbiome.

所以并不是说你一直都有同一种细菌，数量也完全一样。

So it's not like you have one kind and exactly the same number of bacteria all the time.

它会随着你生活的各个方面而变动。

It's moving around with various aspects of your life.

它变动得非常厉害，我觉得人们并没有意识到个体内部的变化有多大。

It's it's moving around a ton, and I don't think people appreciate the amount of within person variation.

比如，很多健康领域的微生物组网红会谈论某些细菌种类，以及像阿克曼菌之类的相对丰度。

So, for example, a lot of the wellness microbiome influencers will talk about certain species of bacteria and the relative abundance of something like acromancy or whatever.

你的阿克曼菌太低了。

Your acromancy is too low.

你需要吃我碰巧在卖的这款补充剂来提高你的阿克曼菌。

You need to take this supplement that I happen to sell to boost your acromancy.

任何一种细菌的浓度，一天之间可能就会相差十倍。

Any individual bacteria might vary in terms of concentration by tenfold between one day and the next day.

所以，说从整体细菌的总和来看，我们能像指纹一样识别出你，和说某个特定的指纹纹路会导致健康问题或疾病，这两件事是完全不同的。

So it's very different saying taking the entire sum of bacteria, we can re identify you from a data set sort of like, Oh, everyone has kind of unique fingerprints than to say, Oh, the particular whorls on your fingerprint are like causing health or disease.

对吧？

Right?

很多人感到惊讶的是，其实并不存在一个标准的微生物组参考。

Like, the fact that many people are surprised at is there is no reference microbiome.

目前还没有一个公认的标准。

There's no good yet.

这就是问题所在。

I mean, this is the thing about it.

没有所谓的正常值。

There's no normal.

就像‘让你的微生物组变得更好’这种说法。

Like, make your microbiome great.

凭什么？

By what?

就是说，我怎么知道它好不好？

Like, what what how would I know if it was great?

那个人是谁？

Who is the guy?

我们想跟谁比，谁的微生物组最好？我是说，我们可能确实知道布莱恩·约翰逊的微生物组是什么样，但那是值得追求的目标吗？

Who are we aspiring to with the best micro like, what is Brian John I mean, we probably do know what Brian Johnson's microbiome is, but, like, is that something to aspire to?

我不知道。

Like, I don't know.

这里没有所谓的“最优”，不像其他一些可以衡量的东西那样。

How it there is no optimal here the way there might be in some other things that we might that we might measure.

对。

Yeah.

微生物，他叫什么来着？

Micro what's his name?

布莱恩·约翰逊的微生物组可能已经乱套了，因为他患有自身免疫性胃炎。

Brian Johnson's microbiome is probably screwed up because he has autoimmune gastritis.

别这么想。

Don't think

我想要。

I want

对。

Yeah.

去做

To do

这些东西变化挺大的。

these things are shifting around a lot.

这是你独有的。

It is unique to you.

主要驱动因素嘛，你知道，人们会告诉你，哦，就是你吃的东西以及你的健康生活方式和行为，它会改变你肠道里的菌群和微生物。

The primary driver I mean, you know, people will tell you, Oh, it's, you know, what you're eating and your health lifestyle behavior is it's going to change your flora and your fauna inside your your gut.