Mads Tang-Christensen: The brain science of obesity | TED

Transcriber:

翻译人员: Xiaoli sun 校对人员: Thomas Tam

Have you ever wondered why a pair of siblings

你是否有想过为什么一对兄弟姐妹

living in the same house with the same parents,

生活在同一屋檐下，有一样的父母，

with the same food,

吃一样的食物，

sometimes end up in opposite sides of the weight spectrum?

有时他们的体重却会截然不同？

My name is Mads

我叫麦斯，

and for the last 25 years,

在过去的25年里，

I've been studying what we eat, when we eat and how much we eat.

我一直在研究我们吃的是什么， 什么时候吃，以及吃多少的问题。

And probably more importantly,

更重要的是，

I've been studying how each of our unique bodies

我也一直在研究我们每个独特的身体，

responds differently to the same food and the same environment.

在相同环境下对同一种食物的不同反应。

To be more precise, I study obesity.

更准确的说，我研究肥胖问题。

During my training as an MD, PhD,

在我作为医学生與博士培训期间，

I was very fascinated by a series of experiments done by Barry Levin.

我对巴里·莱文所做的一系列实验 感到非常着迷。

He took 100 rats and subjected them to high-fat feeding.

他给一百只老鼠喂高脂肪的食物。

After months of feeding,

经过一个月的喂养，

he ended up with a bell-shaped curve

他最终获得一个有关体型的 权重分布和钟型曲线

and a weight distribution

with some skinny rats and some obese rats

这个结果里包含一些瘦老鼠，一些胖老鼠

和一些肥瘦適中的老鼠。

and some in the middle.

What he then did was to take the skinny rats

接下来，他选出瘦老鼠，

and breed them among themselves,

让他们自己繁殖。

and the heavy rats.

同时，他也让胖老鼠

And he bred those among themselves.

成群一起繁殖。

And after rounds of breeding, he ended up with two distinct populations:

经过几轮繁殖， 他最终得到了两个不同的种群：

a diet-resistant rat

一种不易肥胖的老鼠，

and an obesity-prone rat.

和一种极易肥胖的老鼠。

And here's the really interesting part.

有趣的是，

Then he took the skinny or the obese,

他接着给瘦老鼠和胖老鼠，

and either massively over- or underfed them.

或是过度喂食或者少量喂食。

And their weight would, of course, go up and down

结果老鼠的体重当然会增加或会减少

depending on the dietary regimen.

依照不同的喂食方式。

But it was as if the little bodies would remember the same old weight trajectory.

但是就像这个小小的身体 会记住他们以前的体重一样，

So once the dietary regimen was stopped,

一旦停止喂食方案，

the rats went right back to the initial weight trajectory.

老鼠就会回到他们的初始体重。

It was like as if you could dress up the obese rat

就好像你把一只肥胖的老鼠

in a skinny sheep's clothing.

放进了瘦老鼠的衣服里。

But the obese rat nature was still scratching to get out.

胖老鼠还是会自然的想要挣脱出来。

The same thing applies to humans.

同样的事情放到人类上，

If you take a thousand kids and weigh them,

如果你去选一千个孩子称体重，

their weight will also be distributed in a bell-shaped curve.

他们的体重也会呈现出一个钟型曲线，

Some skinny, some in the middle and some heavy.

有些孩子体型偏瘦， 有些不胖不瘦，又有些偏胖。

We know that some of the skinny kids will remain skinny throughout life,

我们知道有些瘦孩子一生都会保持苗条，

and some of the obese kids will stay obese throughout life.

一些胖孩子一生都有可能会保持肥胖，

You could argue that their weight, to some degree, has been predetermined.

你可以在某种程度上说， 他们的体重已经被预先决定了。

You could also argue that obesity is a disease.

你也可以说肥胖就是一种疾病。

Wait, did I just say that obesity a disease?

等下，我刚刚是不是说肥胖是一种疾病？

Yes.

是的。

There's actually data and science that shows that.

确实有一些数据和科学表明这个观点。

And I've made it my audacious life goal to come up with a solution

我也已经把想出一个可以预防、治疗、

to prevent, treat or even cure obesity.

甚至是治愈肥胖症的办法 大胆地作为我的终生目标。

Let me explain.

让我来解释一下，

In the early 1980s and 1990s,

在1980年代和1990年代初期，

obesity was considered a potential global problem,

肥胖被认为是潜在的全球问题，

a global problem of a magnitude

一个巨大的全球问题

that led WHO in the end of 1990s

这个问题让世卫组织在1990年代后期

to declare obesity a global pandemic.

宣布肥胖是一个全球大流行病。

And I probably don't have to tell you why.

我可能不需要告诉你为什么。

Higher rates of diabetes, hypertension, cardiovascular disease, even some cancers,

大量的糖尿病，高血压，

心血管疾病，甚至是 一些癌症和骨关节炎，

osteoarthritis and a clear link to mental conditions such as depression.

以及与抑郁等精神状况的明确联系。

So as the number of obese individuals grew,

所以随着肥胖人数的增加，

so did the number of people suffering from these diseases.

受这些疾病困扰的人数也在增加。

Today, more than 50 percent of the US adult population

如今，有超过百分之五十的美国成年人

are living with obesity or overweight.

正处于肥胖和超重的情况。

From a health perspective, that is devastating.

从健康的角度看，这个数据是毁灭性的

But it's not only a US problem.

然而，这并不仅仅是美国的问题，

The obesity surge has made obesity a global health problem.

肥胖潮已经成为了全球的健康问题。

Many inside and outside the medical community

许多医学界内外的机构

believe obesity is not a disease.

相信肥胖并不是疾病。

They believe that obesity is a condition,

他们相信肥胖只是一种状况

a condition brought about by too much eating

一种吃太多和缺少锻炼的状况。

and too little exercise.

As a matter of fact, a lot of people living with obesity think that too.

事实上，很多肥胖的人也同样这么认为。

They believe that their weight is 100 percent their own fault,

他们相信他们的超重 完全都是他们自己的错误，

which can lead to self-blame and low self-esteem,

这样的想法会导致 他们自责并且没有自信

and perhaps even shame or stress eating,

甚至会引起羞愧和压力下暴食，

which is both heartbreaking, as well as counterproductive.

这既令人心碎， 又适得其反。

But where is the scientific proof that obesity is a disease?

但关于肥胖是一种病的科学证明在哪里？

Well, medically speaking, there's many ways to define disease,

从医学上说， 有很多种方式可以定义疾病，

but let me give you just three examples.

但是让我和你说三个例子，

As a process that impairs your functionality

第一，疾病是一个损害你身体的功能

and reduces life expectancy -- obesity, check.

和减少寿命的过程——肥胖，是的！

You can define disease as a process

你可以把疾病定义为

that leaves you more susceptible to other diseases or causes disease.

一个让你有更大的机会 患上别的疾病的过程，

Obesity, check.

肥胖，是的！

Or you can define disease as a genetic impairment

又或者你可以定义疾病为一种遗传缺陷，

that leads to functional impairment,

从而导致身体机能缺陷。

like, for instance, a duplication of genes on chromosomes.

比如说，染色体上基因的重复。

有明确的证据表明，

There is clear evidence

that a single gene mutation can lead to obesity,

单一基因的突变会导致肥胖，

such as, for instance, leptin deficiency and POMC deficiency.

例如瘦素和阿黑皮素原的缺陷。

We also have two-three genes leading to obesity.

我们也有二至三个基因导致肥胖。

And it's my prediction that we, by the year 2030,

我预测在2030年的时候，

will be able to explain most obesity by the genetic makeup of the individual.

我们可以用个体的基因组成 来解释大部分的肥胖问题。

So obesity as a disease by this measure, check.

所以通过这个方法验证， 肥胖确实是一种疾病。

让我说清楚一点，

Let me be clear.

We humans have had the same genes for decades.

我们人类几十年来有着相同的基因，

And just recently, obesity has become a bigger problem.

但是最近，肥胖变成了一个大问题。

How do we then explain that?

我们应该怎么解释呢？

One obvious thing is actually food, especially calorie-rich food,

一个很明显的事实是食物， 尤其是高卡路里的食物，

which is much more readily available.

更唾手可得。

It's relatively easy and also relatively cheap

人们现在更容易也更便宜

to eat your entire daily need of calories by a fast food or big soft drinks.

吃快餐和大饮料作为日常卡路里的摄取。

So genes do play a role,

虽然基因起了作用，

but the environment also plays a huge role.

但是环境也是一个很大的因素。

The overabundance of calories in certain communities

在一些社区里，卡路里过多的食物

is a relatively new thing,

是一项新奇的事物，

and our genes haven't quite adapted yet.

并且我们的基因也未能适应。

In the history of feast and famine,

历史上的盛宴和饥荒，

genetic selection has prepared us much better for famine,

基因选择为我们更好的适应饥荒

and for good reason.

并且有其理由，

Starvation is bad,

饥荒是不好的。

but you could also argue obesity is bad.

你可以说肥胖也是不好的

And if obesity is a disease,

如果肥胖是疾病，

how do we then prevent, treat or even cure it?

我们应该怎样预防，治疗甚至治愈呢？

I believe that the brain holds the key.

我相信大脑是关键，

I have always been fascinated

我一直相信

with how small electrical signals in discrete parts of the brain

大脑里离散部分的小电子信号

lead to big behavioral changes.

可以导致大的行为改变。

And my study of the brain led me to Glucagon-Like Peptide 1,

我对大脑的研究让我认识到 胰高血糖素样肽 1，

or GLP-1 for short.

或简称 GLP-1。

GLP-1 is a hormone and a signal molecule

GLP-1是一种激素和信号分子

that is produced both in the gut and in the brain.

它可以在肠道和大脑中产生。

The brain speaks to the gut and the gut speaks to the brain.

大脑和肠道相互交流。

Yes, that's right.

是的，

Your belly and your brain are literally connected.

你的大脑和肠道理论上是连在一起的。

Our research led us to see that GLP-1 has an effect on nerve cells

我们的研究使我们看到 GLP-1对神经细胞的影响

sitting in areas that control whether we eat or not.

不管我们是不是在吃的时候。

So, for instance, if we increase the level of GLP-1,

例如，如果我们增加GLP-1的水平，

the body's desire to eat or overeat food gets turned off.

身体里想要吃或者暴食的欲望被关闭了

GLP-1 serves as the full signal in your car's gas tank.

GLP-1就像是你汽车里 油箱的充满信号。

I've spent years and decades mapping the circuitry of GLP-1

我花了几年和几十年 绘制GLP-1的电路图

and how GLP-1 interacts with other signal molecules and hormones.

以及GLP-1如何 与其他分子和激素互动。

All of these things go together and control food intake,

这些事情一起控制食物的摄入，

body weight and the control of eating behavior.

体重和饮食习惯。

And what does that all mean?

这一切意味着什么呢？

Well, today, we have engineered and studied the molecule,

现在我们研究并设计了分子，

so we now have a molecule

这个分子

that can lead to a significant weight loss.

可以对减重有很重要的影响。

Obviously, GLP-1 is not the whole answer.

显然，GLP-1并不是 问题的全部答案。

We and others have discovered numerous hormones

我和其他人已经发现了多种激素

and other signal molecules

和其他信号分子

that are also pivotal for the regulation of food intake and body weight.

可以监管和规范食物的摄入和体重。

And it may end up

所以

that these signal molecules and hormones are even more important than GLP-1.

这些信号分子和激素的作用 甚至会比GLP-1更重要

So ...

所以，

There's plenty for us to do.

我们还有很多的事情要去做。

There's still plenty for us to explore.

还有很多方面还等着我们去探索，

So this is not the end.

所以研究还没有结束，

It's not even the beginning to the end.

这甚至还不是结束的开始。

But perhaps this may be the end to the beginning.

但也许是初阶段结束而已。

We may have a massive weight crisis on the planet today,

在这个星球上， 我们可能会有很大的体重危机，

but the good news is we are on the right path.

但好消息是，我们在正确的轨道上，

We now have solutions for people living with obesity,

我们现在有了针对肥胖人的办法，

and the next steps will be to understand even better

下一步我们需要更好的了解

the problems people living with obesity are facing.

那些有肥胖问题的人面对的是什么。

To understand even better how genes and environment play together.

为了更好地理解 基因和环境如何共同发挥作用。

And understand, finally, how all these things come together

并且理解，这些事情 最后是怎样结合在一起

and determine our body weight.

去决定我们的体重。

Then, and maybe just then,

也许在那个时候，

we will be able to come up with a prevention,

我们能更好的想出预防措施，

a treatment or even a cure

以及治疗甚至是治愈

for people living with obesity,

肥胖人的方法，

like we strive for with any other chronic disease.

就像我们为其他慢性病努力一样。

And this -- this still remains our audacious life’s goal.

这仍然是我们无畏的人生目标。

Thank you.

谢谢。