Dean Ornish: Healing through diet

譯者: Pin-hsien Kuo 審譯者: 黃友豪 .

This session is on natural wonders,

這一節談是大自然的奇功，

and the bigger conference is on the pursuit of happiness.

而大會主題則是對快樂的追尋。

I want to try to combine them all,

我試著統而合之，

because to me, healing is really the ultimate natural wonder.

於我而言, 自我療癒(機能)確是大自然的極至玄奧。

Your body has a remarkable capacity to begin healing itself,

你的身體有卓越的能力展開自療，

and much more quickly than people had once realized,

而且比過往人們所理解的要快得多，

if you simply stop doing what's causing the problem.

你只要別再幹那些讓出亂子事的就是。

And so, really, so much of what we do in medicine and life in general

所以，實際上，我們許多用藥和生活上所做的

is focused on mopping up the floor without also turning off the faucet.

都是水龍頭沒關好卻一味拖地, .

我愛幹這事兒，因為它確實給予許多人

I love doing this work,

because it really gives many people new hope and new choices

他們前所未有的新希望和選擇.

that they didn't have before,

and it allows us to talk about things that -- not just diet,

又讓我們可談到 -- 飲食以外

but that happiness is not --

"但快樂非單是...

we're talking about the pursuit of happiness,

我們(著實)談的是 尋求快樂"♫

but when you really look at all the spiritual traditions,

但當你認真審視所有這些心思

Aldous Huxley 所稱「亙常智慧」

what Aldous Huxley called the "perennial wisdom,"

when you get past the names and forms and rituals that divide people,

你一旦超越那些將人劃分的稱號、規格和儀式的時候

it's really about -- our nature is to be happy;

底裡關係到我們求快樂的本性；

our nature is to be peaceful, our nature is to be healthy.

想我們天生想望能得和平, 得健康.

And so happiness is not something you get,

所以它不是一種－快樂不是一件可攫獲的東西

health is generally not something that you get,

宏觀地來說 健康亦並非可(刻意)求取的東西。

but rather, all of these different practices --

反之，這種種不同的做法，

you know, the ancient swamis and rabbis and priests and monks and nuns

要明白那些古老印度猶太大師, 教士僧尼

didn't develop these techniques to just manage stress

所研發的這些技巧, 並非僅僅為著紓壓，

or lower your blood pressure or unclog your arteries,

降血壓、通血管，

even though it can do all those things.

即便對這些都有功效。

They're powerful tools for transformation,

它們(應該說)是大號的改造模具、

for quieting down our mind and bodies

可將我們的身心先安定下來

to allow us to experience what it feels like to be happy,

容許我們體驗甚麼是快樂

to be peaceful, to be joyful

平安、喜悅

and to realize that it's not something that you pursue and get,

並瞭解：那並非你可求取；

but rather, it's something that you have already, until you disturb it.

而是原來固有, 直至後來讓你自己擾亂了的一種東西。

I studied yoga for many years with a teacher named Swami Satchidananda.

我跟隨一位叫Satchidananda的老師研習瑜伽多年

People would say, "What are you, a Hindu?"

有人會問(他)：「你是印度教徒麼？」他會答：「不，我是個[剃]度教徒」。

He'd say, "No, I'm an undo."

(Laughter)

它的用意其實是要指明出是什麼讓我們

It's about identifying

what's causing us to disturb our innate health and happiness

擾亂自身內在健康和快樂，

and then to allow that natural healing to occur.

從而讓身體展開自療。

To me, that's the real natural wonder.

於我這就才是真正的自然奇功。

So, within that larger context,

據此, 我們方可於較廣的義理內

we can talk about diet, stress management --

談飲食調節, 談壓力處理,

which are really these spiritual practices --

(說明白了)就是這些精神作業,

moderate exercise, smoking cessation,

像適量運動、戒煙、互助群組－

support groups and community, which I'll talk more about,

這些我都會再多說點－還有維他命和補品。

and some vitamins and supplements.

可這並非節食.

And it's not a diet.

When people think about the diet I recommend,

大多數人提起我建議的飲食時

they think it's really strict.

都看成是個硬餐單.

For reversing disease, that's what it takes.

若是為了扭轉病情，那當然事在必行,

But if you're just trying to be healthy, you have a spectrum of choices.

但若你只是想健健康康，那你的選擇可多了。

及至讓你踏上健康之路，

To the degree that you can move in a healthy direction,

你將可活得更久，感受更好，

you're going to live longer, feel better, lose weight, and so on.

你將可減磅輕身..等等。

And in our studies, what we've been able to do

研究所得, 是我們一直做到的

is to use very expensive, high-tech, state-of-the-art measures

只是用了極昂貴、先進高科技的的方法，

to prove how powerful these very simple and low-tech and low-cost --

去證明原來這些簡單、低科技和便宜

and in many ways, ancient -- interventions can be.

調適方法, 其中不少是老掉牙的, 竟有如此强大功效!

We first began by looking at heart disease.

我們先來看一下心臟病：

When I began doing this work 26 or 27 years ago,

26、27年前，我剛開始做這工作時，

it was thought that once you have heart disease, it can only get worse.

一般認為你一旦得了心臟病，就好不了。

What we found was, instead of getting worse and worse,

而我們發現的卻是，非但沒惡化

in many cases, it could get better and better,

許多案例中, 病情反能好轉，

and much more quickly than people had once realized.

而且進度比前人所知快得多。

This is a representative patient who, at the time, was 73,

這是一位當時73歲的病人，

told he needed to have a bypass, decided to do this instead.

分流非做不可了，卻又決定做了這個

We used quantitative arteriography, showing the narrowing.

我們用量化造影術顯示其動脈窄化,

This is one of the main arteries that feeds the heart,

這是負責引血至心臟的其中一條主動脈，

and you can see the narrowing here.

你們可以看到這部位在窄化。

A year later, it's not as clogged; normally, it goes the other direction.

翌年，它竟沒那麼塞的－通常情況會相反。

These minor changes in blockages

這類阻塞的小變

caused a 300 percent improvement in blood flow,

讓血流量有3倍改善,

and using cardiac positron-emission tomography, or PET, scans --

又以正電子發射計算機斷層做影, 或「PET」掃描出來

blue and black is no blood flow,

藍黑部位表示沒血流量，橙白部位血流量最大。

orange and white is maximal --

huge differences can occur without drugs, without surgery.

重大的變化於沒用藥沒動手術的情況亦可發生.

Clinically, he couldn't walk across the street

按臨床診斷，他走過馬路都將會引起劇烈胸痛。

without getting severe chest pain.

Within a month, like most people, he was pain-free,

可一個月不夠，跟大部分人一樣，沒痛了, 一年不到,

and within a year, climbing more than 100 floors a day on a StairMaster.

能每天在登階機上爬一百層以上了。

This is not unusual,

這並不稀奇, 更讓人得以

and it's part of what enables people to maintain these kinds of changes,

維持此等改善,

because it makes a big difference in their quality of life.

因其於他們生活的品質上造成了那麼重大的差異。

整體上，你們會看到這對比組內全體病人的動脈

If you looked at all the arteries in all the patients,

they got worse and worse from one year to five years in the comparison group.

都於一年到五年內持續惡化。

此乃心臟疾病的自然歷程，

This is the natural history of heart disease.

但實際上又不可說全屬自然，因為我們發現病情亦可以轉好，

But it's really not natural; we found it could get better and better,

and much more quickly than people thought.

且比從前的人想的快得多。

我們亦發現，人們改得越多，就變得越好。

We also found the more people changed, the better they got.

It wasn't a function of how old or sick they were,

這並非一個他們多老或病多重的官能關係，

but of how much they changed.

而主要是他們作了多少改變,

The oldest patients improved as much as the young ones.

所以最老的病人亦可以好轉改善, 一如年輕的患者.

I got this Christmas card a few years ago from patients in one of our programs.

數年前我收到這聖誕卡

是兩位參予我們其中一起試驗的病人寄來的.

The younger brother is 86; the older one is 95.

弟弟86歲，哥哥95。

They wanted to show me how much more flexible they were.

他們要向我展示他們從前是多柔軟,

翌年，他們寄我這個，我覺得蠻攪笑.。

The following year they sent this, which I thought was funny.

(哄笑)

(Laughter)

可說不定呢.

You just never know.

And what we found was that 99 percent of the patients

而我們發現的是百分之99的患者

stopped or reversed the progression of their heart disease.

開始扭轉其心臟病情.

Now, I thought if we just did good science,

我在想 我們若以為只要做好科研

that would change medical practice.

就能將醫療模式改過來 - 就太天真了點。

But that was naive.

那當然重要，但不足夠。

It's important, but not enough,

因為我們醫生都是收費辦事，

because we doctors do what we get paid to do

我們受訓行醫收取酬勞。

and trained to do what we get paid to do,

故此若保險單給改了，那醫療作業及教育亦會相調整.

so if we change insurance, then we change medical practice and medical education.

(到時)分流和血管修復手術都包在保險內了.

Insurance will cover the bypass and angioplasty

但直至最近, (保險)才照管食療或生活調適費用。

but won't, until recently, cover diet and lifestyle.

So we began, through our nonprofit institute, training hospitals

於是我們開始透過我們的非謀利機構

於全國各地醫院進行培訓,

around the country,

我們發現大部分人可以避免動手術，

and we found that most people could avoid surgery.

And not only was it medically effective, it was also cost-effective.

如此這般, 醫療及成本效益俱佳。

保險公司亦發現

The insurance companies found that they began to save

他們開始從每個(受保)病人省免了三萬元給付。

almost 30,000 dollars a patient,

and Medicare is now in the middle of doing a demonstration project,

而Medicare現正進行一個示範企畫，

paying for 1,800 people to go through the program

他們付費讓1800個人在我們的培訓場地

完成程序.

in the sites we train.

The fortuneteller says, "I give smokers a discount,

占卜師說：「吸菸者打折，

因為沒可說已不多。」而... (哄笑)

because there's not as much to tell."

(Laughter)

我喜歡這圖片，因為它能引起話題讓大家討論

I like this slide,

because it's a chance to talk about what really motivates people to change

究竟什麼會激發變改, 又什麼不會.

and what doesn't.

[對死亡的恐懼]不會,

What doesn't work is fear of dying, and that's what's normally used.

卻常被錯引。

Everybody who smokes knows it's not good for you.

每個抽煙的人都知道那對自己不好，

Still, 30 percent of Americans smoke, 80 percent in some parts of the world.

但美國人抽煙的人仍佔百分之三十.

某些地方是百分之八十。人幹嗎這樣做?

Why do people do it?

Well, because it helps them get through the day.

嗯, 因為(抽煙)幫他們將一天熬過.

這我會再談，但真正的流行病

I'll talk more about this,

but the real epidemic isn't just heart disease or obesity or smoking,

不單是心臟病, 過胖或抽煙，而是孤寂和抑鬱。

it's loneliness and depression.

就如一位女士所說的：「這煙盒裡有我的20個朋友，

One woman said, "I've got 20 friends in this pack of cigarettes.

They're always there for me, and nobody else is.

當人都跑光了，它們總在哪。

You're going to take away my 20 friends? What are you going to give me?"

若將我這20個朋友都拉走，那你們要給我留下什麼?」

他們感到鬱悶或大吃,

Or they eat when they get depressed or use alcohol to numb the pain

或用酒精將痛苦麻醉，

有些工作過勞，有些電視看太多。

or work too hard or watch too much TV.

There are lots of ways we have of avoiding and numbing and bypassing pain,

逃避、麻醉、和迴避痛苦的方法林林總總，

but the point of all of this is to deal with the cause of the problem.

但這一切的重點是要解決問題的起因

The pain is not the problem, it's the symptom.

痛楚只是症狀, 而非問題本身.

And telling people they're going to die is too scary to think about,

而說他們會(因此)死掉更嚇得人不敢想象,

or that they'll get emphysema or a heart attack is too scary,

會得肺氣腫或中風都太可怕了，

所以他們都不願想這些, 不管了。

and they don't want to think about it, so they don't.

The most effective anti-smoking ad was this one.

這是一則最有效的反吸煙廣告:

你該留意到他那吊在嘴角, 垂頭喪氣的煙支，

You'll notice the limp cigarette hanging out of his mouth.

和寫上「無能」兩字的標題 - 是「無能」，而不是「肺氣腫」。

And the headline is "Impotent," it's not "Emphysema."

What was the biggest-selling drug of all time,

幾年前上市後

when it was introduced a few years ago?

就一直大賣是什麼藥？

Viagra, right? Why? Because a lot of guys need it.

偉歌，對？為什麼? 因為很多男人需要它。

It's not like you say, "Joe, I'm having erectile dysfunction. How about you?"

並非說已到了碰面就, 「嘿祖, 我亦不舉了, 你呢?」的地步.

And yet, look at the number of prescriptions that are being sold.

然而，就看藥的銷量吧。

心理效用或有點，主要還是涉及心血管，

It's not so much psychological, it's vascular,

and nicotine makes your arteries constrict.

尼古丁讓你的血管收縮，

So does cocaine, so does a high-fat diet, so does emotional stress.

古柯鹼, 高熱量飲食, 情緒壓力亦然。

So the very behaviors that we think of as being so sexy in our culture

這在我們的文化裡被公認為顯酷的行為

are the very ones that leave so many people feeling tired,

卻正正是讓許多人累壞的舉措

lethargic, depressed and impotent.

沒勁兒、消沈以至陽痿，都不好過呢。

And that's not much fun.

But when you change those behaviors, your brain gets more blood,

但你一旦將行為改變 (戒煙)，流進腦袋的血就多點，

腦筋就開了，手腳就靈了，

you think more clearly, have more energy,

就像我向你們展示的那樣, 你的心就得到更多血，。

your heart gets more blood, as I've shown you.

你的性功能亦會得到改善。

Your sexual function improves.

且這些都在幾小時內就來了。這是個研究：一餐高熱量飯食後

These things occur within hours.

This is a study: a high-fat meal,

within one or two hours, blood flow is measurably less.

的一至兩小時, 血流量就會顯著減少,，

And you've all experienced this at Thanksgiving.

這在你們過感恩節時都曾體驗。

一頓大魚大肉後，感覺如何？

When you eat a big fatty meal, how do you feel?

你儘會感到懨懨欲睡吧。

You feel kind of sleepy afterwards.

而低熱量的一餐，卻讓血流量不減反升。

On a low-fat meal, the blood flow doesn't go down -- it even goes up.

你們當中不少人帶孩子，都曉得這是你們人生中的一個重大改變。

Many of you have kids, and you know that's a big change in your lifestyle.

People are not afraid to make big changes in lifestyle

就是說只要是值得, 人們並不怕作出重大改變，。

if they're worth it.

And the paradox is that when you make big changes, you get big benefits,

吊詭的是你的大變讓你得到大利，

你很快就已變得好多了。

and you feel so much better so quickly.

For many people, those are choices worth making --

對許多人而言，那些值得作的抉擇。

not to live longer, but to live better.

並非為了活更久，而是為了活更好。

I want to talk a little bit about the obesity epidemic,

我想聊一下有關過胖流行症候,

because it really is a problem.

因這確實是個問題。

Two-thirds of adults are overweight or obese,

三分之二的成人過重或過肥，

and diabetes in kids and 30-year-olds

孩童期至三十歲得糖尿病的，

has increased 70 percent in the last 10 years.

過往十年共增加了70%。這可不是說笑，是事實。

It's no joke, it's real.

And just to show you this, this is from the CDC.

讓你們看, 這來自美國疾病控制與預防中心。

These are not election returns;

這不是選票結果，而是過重人口的比例。

these are the percentage of people who are overweight.

若你從85年起看, 到86, 87、88、89、90、91年

And if you see from '85 to '86 to '87, '88, '89, '90, '91 --

you get a new category, 15 to 20 percent;

你得到一個新類別，是百分之15 到 20 ；92、93、94、95、96、至97年間

'92, '93, '94, '95, '96, '97 -- you get a new category;

又另一個新類別；98、99、2000和2001年間。

'98, '99, 2000 and 2001.

Mississippi, more than 25 percent of people are overweight.

在密西西比，過重的人口超過百分之25。

Why is this? Well, this is one way to lose weight that works very well --

幹嗎會這樣？嗯，這是某種減肥法，效果不錯，

(Laughter)

但是不持久，那正是問題所在。

but it doesn't last, which is the problem.

（笑聲）

(Laughter)

Now, there's no mystery in how you lose weight;

其實如何減肥並沒有什麼神祕；

you either burn more calories by exercise

要不運動燃燒多點卡路里，要不少吃一點卡路里。

or you eat fewer calories.

Now, one way to eat fewer calories is to eat less food,

少吃點卡路里的一個方式是節食,

which is why you can lose weight on any diet if you eat less food,

就是說你吃什麼都好，吃少點就可以減肥,

又或者完全不吃某類食物。

or if you restrict entire categories of foods.

但問題是，你餓了會很難受.

But the problem is, you get hungry, so it's hard to keep it off.

The other way is to change the type of food.

另一種做法是改食別的.

And fat has nine calories per gram,

脂肪每公克含九個卡路里，

whereas protein and carbs only have four.

而蛋白質和碳水化合物只有四個。

So when you eat less fat, you eat fewer calories without having to eat less food.

所以脂肪少吃你就少吃進卡路里，犯不著節食。

So you can eat the same amount of food,

你可以吃同等份量食物卻同時攝取低卡路里.

but you're getting fewer calories

because the food is less dense in calories.

因為那些食物卡路里沒那麼高。

And it's the volume of food that affects satiety, rather than the type.

再說讓你感飽腹是食物的份量，而非類別。

I don't like talking about the Atkins diet, but I get asked about it,

我不想多講甚麼[食肉減肥法]，但總是天天被問及。

所以我想還是花幾分鐘來說一下。

so thought I'd spend a few minutes on it.

你們聽到的這迷思是:

The myth that you hear is, Americans have been told to eat less fat,

「美國人被勸說少吃點脂肪，

the percent of calories from fat is down,

於是脂肪卡路里比例低了，

Americans are fatter than ever, therefore fat doesn't make you fat.

美國人卻比前更肥；換言之，脂肪不致肥。」

It's a half-truth.

這說來只對了一半。事實上，美國人比過往吃更多脂肪，

Actually, Americans are eating more fat than ever, and even more carbs.

甚至更多碳水化合物。於是比例是低了點，

So the percentage is lower, but the actual amount is higher,

實質份量卻是多了。所以目標應該是兩樣都要減掉。

so the goal is to reduce both.

Dr. Atkins and I debated each other many times before he died,

艾京斯博士去世前跟我曾多次辯論，

and we agreed that Americans eat too many simple carbs, the "bad carbs."

我們都同意美國人吃得太多單醣食品，

「bad carbs」，像

And these are things like --

(Laughter)

（笑聲）

sugar, white flour, white rice, alcohol.

糖、白麵粉、白米、酒精。這讓你受到雙重打擊，

And you get a double whammy:

you get all these calories that don't fill you up

你吃下這許多卡路里卻仍不飽，因為其纖維都被先去掉。

because you've removed the fiber,

再者，它們很快就被吸收，所以會讓你的血糖飈升，

and they get absorbed quickly so your blood sugar zooms up.

你的胰腺會分泌胰島素試圖將之拉下來，這本來很好。

Your pancreas makes insulin to bring it back down, which is good,

可胰島素會將卡路里加速轉化成脂肪。

but insulin accelerates the conversion of calories into fat.

所以，方向不是吃豬皮火腿香腸去 --

So the goal is not to go to pork rinds, bacon and sausages --

這些都並非健康食品。

these are not health foods --

但由「bad carbs」換成「good carbs」。

but to go from "bad carbs" to "good carbs."

譬如全麥食品、或未加工碳水化合物：

These are things like whole foods or unrefined carbs.

水果、蔬菜、全麥麵粉、糙米－吃天然的東西，它們富含纖維，

Fruits, vegetables, whole wheat flour, brown rice,

in their natural forms, are rich in fiber.

The fiber fills you up before you get too many calories

而在你攝取太多卡路里前，纖維就給了你飽腹感，

and it slows the absorption,

而且可以減緩消化，所以你血糖不會竄高。

so you don't get that rapid rise in blood sugar.

And you get all the disease-protective substances.

因此，你得到了所有的預防疾病的物質。

It's not just what you exclude from your diet,

在飲食中，除了所排除成分有影響，

but also what you include that's protective.

囊括的成份是否具有預防性也會影響。

Just as all carbs are not bad for you, all fats are not bad; there are good fats.

就像不是所有種類的碳水化合物都有害；脂肪也一樣，有好的脂肪，

These are predominantly what are called omega-3 fatty acids.

我們通常稱做Omega-3脂肪酸。

You find them, for example, in fish oil.

這你們可以在，例如，魚油裡找到。

Bad fats are things like trans-fatty acids in processed food

而不好的脂肪就像反式脂肪酸和加工食品

and saturated fats, which we find in meat.

和飽和脂肪，這常見於肉類。

If you remember nothing else from this talk:

你要是聽完這場演講什麼都不記得，記這個：

three grams a day of fish oil can reduce the risk of heart attack and sudden death

一天三克魚油有助於讓你心臟病發作率

以及暴斃率降低50%-80%。

by 50 to 80 percent.

Three grams a day.

通常一粒膠囊一克

They come in one-gram capsules;

過量只會給你多餘的脂肪而已。

more than that just gives you extra fat you don't need.

它也有助於減低最常見癌症的機率

It also helps reduce the risk of the most common cancers,

像乳癌、前列腺癌和結腸癌。

like breast, prostate and colon.

現在，有關食肉減肥法的問題，

The problem with the Atkins diet is,

everyone knows people who've lost weight on it,

各位多少都認識一些用這個方法減肥成功的人，

但你也可以用安非他命和減肥藥減肥。

but you can lose weight on amphetamines and fen-phen;

我的意思是，減肥有很多方式都對你有害。

there are lots of ways of losing weight that aren't good for you.

要減肥就用有益身心的方式，

You want to do it in a way that enhances your health,

而不是用傷害的方式。

not one that harms it.

而問題出在人們對這方法一知半解，

The problem is, it's based on this half-truth:

也就是美國人吃太多單一碳水化合物，

Americans eat too many simple carbs,

so if you eat fewer, you'll lose weight,

所以如果你少吃單一碳水化合物，就可以減肥。

and even more weight if you eat whole foods and less fat,

你要是食用天然和低脂食品，就減更多肥。

and you'll enhance your health rather than harming it.

而你會更健康，身體不會變差。

He says, "I've got good news.

他說：「我有好消息，

While your cholesterol level has remained the same,

在你的膽固醇濃度維持不變時，

the research findings have changed."

研究結果卻變了」

(Laughter)

（笑聲）

Now what happens to your heart when you go on an Atkins diet?

現在，你的心臟在你採用食肉減肥法時發生什麼事？

The red is good; at the beginning and a year later.

起先紅色是好的，一年後

This is from a study in a peer-reviewed journal called "Angiology."

這是從同行評審雜誌裡一個研究引用的，叫做脈管學

There's more red after a year on a diet like I would recommend,

一年後，採用我推薦的飲食法的人有更多紅色，

there's less red, less blood flow after a year on an Atkins-type diet.

採用食肉減肥法的，紅色變少了。

So, yes, you can lose weight, but your heart isn't happy.

所以你是減肥了，但你的心臟不開心。

Now one of the studies funded by the Atkins Center

現在其中一個阿特金斯中心贊助的研究

found that 70 percent of the people were constipated,

發現70%的人便秘，65%有口臭，

65 percent had bad breath,

54 percent had headaches --

54%患頭痛。這不是健康的飲食。

this is not a healthy way to eat.

So you might start to lose weight and start to attract people towards you,

所以你的體重可能開始下降，也開始吸引人們接近你，

but when they get too close, it's going to be a problem.

但當他們太靠近你時，問題就來了。

（笑聲）

(Laughter)

And more seriously, there are case reports now of 16-year-old girls

更嚴重的是，這些案例報告中現在有16歲的青少女，

who died after a few weeks on the Atkins diet,

採用一星期的食肉減肥法後去世了。

of bone disease, kidney disease, and so on.

死於骨頭疾病、腎疾等等。

And that's how your body excretes waste --

而這就是你身體排泄廢物的方法，透過呼吸，

through your breath, bowels and perspiration.

排便和排汗。

So when you go on these kinds of diet, they begin to smell bad.

所以你在採用這樣的飲食時，排泄就開始變臭。

An optimal diet is low in fat, low in the bad carbs,

所以另一個飲食的選擇是低脂，少碳水化合物，

high in the good carbs and enough of the good fats.

多攝取有益的碳水化合物和足夠的好脂肪。

And then, again, it's a spectrum:

然後這又是一個圖列：

when you move in this direction, you're going to lose weight,

你要是往這個方向移去，就能減肥，

你會感覺更好而且更健康。

you'll feel better, and you'll gain health.

There are ecological reasons for eating lower on the food chain too,

現在，也有因應社會生態學，而吃食物鏈中較低等的食材的，

whether it's the deforestation in the Amazon

不管是亞馬遜的森林砍伐問題或使蛋白質取得性更高，

or making more protein available

to the four billion people who live on a dollar a day,

甚或因為，你知道，四億人每天靠一元美金過活，

not to mention whatever ethical concerns people have.

更別提，你知道，任何人們在道德上的顧慮。

So there are lots of reasons for eating this way

所以有很多理由去採用這樣的飲食，不單是為了健康著想。

that go beyond just your health.

Now, we're about to publish the first study

現在，我們就要發表第一份研究，

looking at the effects of this program on prostate cancer,

看的是這個計畫對前列腺癌的影響，

in collaboration with Sloan Kettering and UCSF.

與我們合作的有solane-kettering癌症中心和舊金山加利福尼亞大學。

We took 90 men who had biopsy-proven prostate cancer,

然後我們選90個得前列腺癌的男人，都用切片檢查法證明過的，

who had elected, for reasons unrelated to the study, not to have surgery.

他們都選擇不要動手術，他們的決定和這個研究無關，

We could randomly divide them into two groups,

所以接著我們可以任意將他們分為兩組

and then we could have one group

然後我們可以將一組

that is a nonintervention control group to compare to,

作為不干涉控制組來做比較

which you can't do with, say, breast cancer,

我們不用乳癌研究，因為每個人都要受治療。

because everyone gets treated.

我們發現的是，一年後

We found that after a year,

none of the experimental group patients who made these lifestyle changes

沒有任何一個實驗組病患

也就是改變生活方式的，需要受治療。

needed treatment,

同時六位控制組病患卻需要動手術或化療。

while six of the control group patients needed surgery or radiation.

我們在看他們的前列腺特異抗原（SPA）程度時，這是量前列腺癌的數據，

When we looked at their PSA levels, which is a marker for prostate cancer,

they got worse in the control group but got better in the experimental group.

在控制組的都惡化了，

但在實驗組的卻好轉了。

And the differences were highly significant.

而這些差別相當顯著。

I wondered -- was there any relationship

接著我想知道，是不是因為

between how much people changed their diet and lifestyle,

人們在他們的飲食和生活方式方面做的改變？

無論他們是哪一組的，或PSA的不同都一樣。

whichever group they were in,

and the changes in PSA?

確定的是，我們發現一個劑量回應關係

And sure enough, we found a dose-response relationship,

就像我們發現，在我們的心臟學研究裡在動脈阻塞上

just like we did in the arterial blockages in our cardiac studies.

為了讓PSA減弱，他們必須做蠻大的改變

And in order for the PSA to go down, they had to make big changes.

我接著想，或許他們只是在改變他們的PSA

I then wondered if they're just changing their PSA,

但這實質上不影響腫瘤成長

but it's not really affecting the tumor growth.

所以我們取一些他們的血清，送到洛杉磯加利福尼亞大學，

So we took some of their blood serum and sent it to UCLA.

他們把它加進前列腺癌細胞的標準線，在組織文化裡長著

They added it to a standard line of prostate tumor cells

growing in tissue culture,

而它遏止了成長達七倍之多

and it inhibited the growth seven times more in the experimental group

在實驗組，比起控制組：百分之70比9

than in the control group -- 70 versus 9 percent.

Finally, I wondered if there's any relationship

最後，我說，我想知道是否關係存在於

between how much people changed

人麼改變多大，和這如何遏止他們的腫瘤成長

and how much it inhibited their tumor growth,

whichever group they were in.

無論他們剛好出現在哪一組

而這真的讓我興奮，因為再次

And this really got me excited because again,

我們找到同樣的模式，人們改變越多

we found the same pattern: the more people change,

the more it affected the growth of their tumors.

這影響到腫瘤成長的程度也越高

Finally, we did MRI and MR spectroscopy scans on some of these patients.

最後，我們對其中的一些病人進行了MRI和MR？掃描

The tumor activity is shown in red in this patient,

而腫瘤的活動顯示在紅色在這個患者

and you can see clearly it's better a year later, along with the PSA going down.

而你可以清楚看見他一年後好轉了，同時PSA下降了

If it's true for prostate cancer,

所以，如果可以應證在前列腺癌上，幾乎確定也可以應證在乳癌上

it'll almost certainly be true for breast cancer.

And whether or not you have conventional treatment,

而且不管你是否用傳統療法

in addition, if you make these changes, it may help reduce the risk of recurrence.

再加上，如果你做這些改變，它可能有助於減少復發的風險

The last thing I want to talk about,

最後一件我想說的事，與追求快樂這個問題息息相關的

apropos of the issue of the pursuit of happiness,

is that study after study has shown

是一個接一個的研究顯示出

that people who are lonely and depressed --

人們如果寂寞又壓抑

and depression is the other real epidemic in our culture --

而壓抑是另一個確切的慢性病在我們的文化

are many times more likely to get sick and die prematurely,

多許多倍更可能生病且早死

in part because, as we talked about, they're more likely to smoke,

一部分因為，像我們剛剛講的，他們更可能抽煙

overeat, drink too much, work too hard, and so on.

而且過量進食和飲酒過度和工作過勞等等

But also, through mechanisms that we don't fully understand,

但還有，通過機制，我們無法完全了解的

people who are lonely and depressed are many times --

人們若寂寞和壓抑，那比別人多許多倍

three to five to ten times in some studies --

三到五到十倍，在某些研究

more likely to get sick and die prematurely.

更可能生病和早死

And depression is treatable. We need to do something about that.

而壓抑是可治療的。我們需要做出針對它的某些事

Now on the other hand, anything that promotes intimacy is healing.

現在，另一方面，任何事，若促進親密性，即是治療

It can be sexual intimacy --

它可以是性方面的親密

I happen to think healing energy and erotic energy

我剛好想到，治療動能和性愛動能

are just different forms of the same thing.

兩者只是一體兩面

Friendship, altruism, compassion, service --

友情、利他型為、同情、服務－全都是經年不變的事實，老生常談的

all the perennial truths that we talked about

that are part of all religion and all cultures,

存在於所有宗教和所有文化中的

一旦你停止試圖看出差異

once you stop trying to see the differences --

these are the things that are in our own self-interest,

這些就是為了自我利益

because they free us from our suffering and our disease.

因為他們解放我們自我們的痛苦和我們的疾病

And it's, in a sense, the most selfish thing that we can do.

而且它一方面來說是最自私的我們能做得事

Just to look at one study, done by David Spiegel at Stanford.

就來看看一個研究好了。這是史丹佛的david spiegel做得

He took women with metastatic breast cancer,

他找了有轉移性乳癌的女人

randomly divided them into two groups.

隨意分成兩組

One group met for an hour and a half once a week in a support group.

一組見面時間只有一個半小時，一星期一次，與支持小組

It was a nurturing, loving environment,

那是個培育的，友愛的環境

where they were encouraged to let down their emotional defenses

在那裡他們受鼓勵去放下他們的情緒防衛

並談談得乳癌多麼糟糕

and talk about how awful it is to have breast cancer

和能了解的人，因為他們也同樣經歷著這一切

with people who understood because they were going through it too.

他們僅僅見面一星期一次，持續一年

They met once a week for a year.

五年後，那些女人活的兩倍長，而你可以看出那些人

Five years later, those women lived twice as long.

And that was the only difference between the groups.

這是唯一的不同在兩組之間

那是個隨機控制研究發表在the lancet上

It was a randomized control study published in "The Lancet."

另一個研究顯示同樣的結果

Other studies have shown this as well.

So these simple things that create intimacy are really healing.

所以這些簡單的事情創造了親密性是真的有療效

而且甚至連療癒這個字都是來自意思是「成全」的字根

Even the word "healing" comes from the root "to make whole."

瑜伽這個字從梵文來的

The word "yoga" comes from the Sanskrit, meaning "union,"

意思是「結盟、連接、和一」

"to yoke, to bring together."

The last slide I want to show you is from -- again,

而最後一張投影片我要給你們看的是從－我曾－再次，

this swami that I studied with for so many years.

這個印度教老師，我向他學習了許多年，而我

I did a combined oncology and cardiology grand rounds

做了一個結合腫瘤和心臟大查房

at the University of Virginia medical school a couple years ago.

在維吉尼亞大學的醫學院，幾年前

而最終，有人說

And at the end of it, somebody said,

"Hey, Swami, what's the difference between wellness and illness?"

「嗨，老師，健康和生病有什麼不同？」

So he went up on the board and wrote the word "illness"

他走上講台並寫「生病」這兩個字

然後圈出第一個字母，接著寫出「健康」這兩個字

and circled the first letter,

then wrote the word "wellness,"

並圈出前兩個字母

and circled the first two letters.

To me, it's just shorthand for what we're talking about:

對我來說，這只是我們剛剛所講的一個速記法

也就是任何能創造連結感的

that anything that creates a sense of connection and community and love

和群體和愛的都是真正的療癒

is really healing.

And then we can enjoy our lives more fully without getting sick in the process.

而我們可以享受我們的生活更加完全，不用在過程中生病

Thank you.

謝謝

(Applause)