Olivia Affuso: 3 ways community creates a healthy life | TED

Transcriber:

譯者: Lilian Chiu 審譯者: Helen Chang

透過改變生活習慣來減重

並長期維持健康的體重

並非易事。

Making lifestyle changes to not only lose weight

問問嘗試過的人就知道了。

but to maintain a healthy weight long-term is hard.

以我媽媽為例。

她七十七歲，

Ask anyone who has ever tried.

很努力想維持體重，

來把血糖控制好，

So let's consider my mom, for instance.

而過去三十年都很難做到。

She is 77 years old

要知道，要控制好好血糖，就得維持

and has struggled to maintain her weight

in order to achieve good blood sugar control

飲食、運動，

over the past 30 years.

和胰島素注射之間的精確平衡。

You see, good blood sugar control requires maintaining a delicate balance

所以，去年，新冠肺炎疫情的初期，

between diet, exercise and insulin injections.

我媽媽搬來跟我住，

因此改變了她平時的飲食攝取，

So early in the COVID-19 pandemic last year,

從為老年人提供的餐

my mom came to stay with me,

改成更健康的家常菜。

which led to a change in her usual dietary intake,

這怎麼可能會出問題呢？

away from meals provided to the elderly

嗯，才過了一夜，她的血糖 就降低到危險的程度，

to more healthful, home-cooked meals.

且她會語無倫次，幾乎失去意識。

What could possibly go wrong?

Well, overnight, her blood sugar dropped dangerously low,

想像一下，拿著像是給馬用的 超粗針頭幫你母親注射升糖素，

and she was incoherent and nearly unconscious.

以提高她的血糖，

直到她能夠靠自己吸收熱量。

Imagine having to inject your mom

with a giant horse needle of glucagon to boost her blood sugar

我很怕她會出事，

或者怕我得在疫情期間打電話尋求

until she could take in calories on her own.

緊急醫療協助。

I was terrified that she would not be OK

很幸運，她對緊急注射有反應，

or that I might need to call for emergency medical treatment

且能夠消耗足夠的熱量， 讓血糖重新上升。

during the pandemic.

Luckily, she responded to the emergency injection

但，當然，這就造成了高血糖，

and was able to consume enough calories to bring her blood sugar back up.

導致她需要更多胰島素，

胰島素是一種會儲存脂肪的荷爾蒙，

But of course, this led to a high blood sugar,

但能讓她的血糖回到正常範圍。

and she needed even more insulin,

雖然要和她的醫生一起努力

which is a fat-storing hormone,

才能在她的飲食、運動， 和胰島素療法之間找到平衡，

to get her blood sugar to a normal range.

Although it took a coordinated effort with her doctor

但我很高興要我母親 一起做好社交距離。

to find balance between her diet, exercise and insulin regimen,

且她也減掉了一些體重，

不過，她有時會抱怨 我的舉止就像食物警察一樣。

I was happy to be social-distancing with my mom.

And she was able to lose some weight,

無論如何，我都感恩 在封城期間和她在一起，

even though she sometimes complained that I was acting like the food police.

她是最支持我的粉絲， 也是我持續跑步的動力。

我們組成了兩人村落。

Nonetheless, I was grateful to have my biggest fan

每天她都會問我，

and run-streak motivator with me during the lockdown.

你去跑了沒？

白天我在工作時， 以及每晚近十點去跑步時，

We became a village of two.

Each day she would ask me,

她都會騎她的健身腳踏車。

"Did you go run yet?"

那是很艱辛的一年， 這還算說得好聽，

You see, she would ride her stationary bike

while I was working during the day

但至少這安排讓我們

and running at almost 10pm each night.

能一起創造出健康、 相互支持的環境。

It was a tough year, to say the least,

but at least this arrangement allowed us

所以，問題是，我們通常都把 體重控制視為是個人的挑戰。

to create a healthy and supportive environment together.

當然，某種程度上的確如此。

So the problem is,

但我們知道，我們生活、學習、 工作，及玩樂時所處的環境

we often think of weight control as an individual challenge.

And of course, to some extent it is.

會影響我們能不能夠 做出有益健康的行為。

But we know that the environments in which we live, learn,

當我們身邊的環境是我們所謂的

work and play

「致胖環境」時——

affect our ability to engage in healthful behaviors.

換言之，

這個環境會系統性且永久性地 朝向造成肥胖的方向發展——

When the world around us is what we might call

an “obesogenic environment” --

硬要假裝減重或維持健康體重

in other words,

systemically and perpetually geared towards creating obesity --

都是個人的責任

其實並沒有幫助也沒有效益。

acting like weight loss or maintaining a healthy weight

簡單來說，

is a personal responsibility

我不能怪你超重，

is simply not helpful nor effective.

畢竟餐廳和雜貨店，

或至少你負擔得起的 所有餐廳和雜貨店，

To put this in simple terms,

都在低價大量販售高熱量

I can't blame you for being overweight

if restaurants and grocery stores,

加工食品。

or at least all of the ones you can afford,

且，如果沒有好的健康照護 及健身選項可供你選擇，

sell an abundance of high-sugar,

high-calorie processed foods at low prices.

你又還要兼好幾份工作，

And then if you don't have access to good health care and fitness options

你也根本就沒有時間去運動。

這就像把你的手綁在你背後，

and work multiple jobs,

把你推進游泳池，

you don't have time to exercise anyway.

然後對你大吼著叫你游泳。

且，如果你的基因就容易過胖，

That's like tying your hands behind your back,

pushing you into a pool and yelling at you to swim.

依目前能取得的治療方式， 要你長期維持體重

And if you have a genetic propensity towards excessive weight gain,

可能根本就是無法達成的目標。

雖然，若要有正面的健康成效，

long-term weight maintenance may simply be unattainable

個人的健康行為相當重要，

given the current treatments available.

但我們個人所處的環境

Although individual health behaviors

會影響這些行為。

are important for positive health outcomes,

試想一下這樣的狀況：

these behaviors are driven by the context in which we,

如果我們能針對身體 及心理健康，把體制、政策，

as individuals find ourselves.

以及做法都最佳化， 那麼我們能做到多少事？

Imagine what we could do if we optimized systems,

有很多需要改變之處，

policies and practices

但不可能一夕辦到，

for our physical, not to mention mental, health.

比如我們工作時間表、工資、

每個社區中平價健康食物的可得性，

There are a lot of things that need to change,

but that won't happen overnight,

such as our work schedules, wages,

公共空間的設計也要讓 步行、騎自行車，和健行

the availability of healthy, affordable foods in every community

都很安全、可行，且吸引人去使用。

and public spaces that make walking,

而我們這個社會則需要開始 把這些東西視為不僅是奢侈品，

biking and hiking safe, accessible and inviting.

也是高品質、有益健康的 生活所必備的必需品。

As a society,

we need to start thinking about these things as not only luxuries

但同時，

當大家一起督促地方及國家政府

but essentials for a high-quality, healthful life.

認真看待我們的健康 以及促進健康的體制時，

But in the meantime,

while we push collectively for our local

也有一些我們現在就能去做的事，

and national governments to take our health,

靠我們自己，一個社區 一個社區去做的事。

and the systems that facilitate health, seriously,

there are also things we can do right now,

針對動物和人類族群 所做的研究指出，

透過社交網路和社區所提供的連結

on our own, community by community.

We know from research in animal and human populations

與更好的健康和生活品質有關聯。

that connections provided through social networks and communities

所以，在我們改正那些 傷害我們健康的體制之前，

are associated with better health and quality of life.

我們都要努力去緩衝 這些系統造成的負面衝擊。

So until we fix the systems that are harming our health,

研究也指出，如果一個人 生活在有社交凝聚力的社區中，

we can all work to buffer the negative impact of these systems.

或者至少是有穩固社交連結的社區，

Research also shows that individuals living in socially cohesive communities,

這個人的健康成效就會

優於在社交上較孤立的人。

這些社交環境能夠 對抗肥胖相關的行為，

or at least those with strong social connections,

have better health outcomes

並促進安康，

than those who are more socially isolated.

即使是在面對體制 致胖的條件下也一樣。

And these social environments work to combat obesity-related behaviors

我怎麼會知道？

and promote well-being,

我和我的研究團隊一直在研究 社交環境及女性的健康。

even in the face of systemic obesogenic conditions.

我也在觀察我自己認識的女性 採用什麼社會支持策略，

And how do I know?

My research team and I have been studying social environments

以及她們遇到的體重難題。

and women's health.

雖然她們故事能夠闡明

I've also observed the social support strategies

在長期健康行為改變中 尋找方向的生活經驗，

of the women in my own network, and their struggles with weight.

但那和科學之間又有什麼關係？

Although their stories shed light

on the lived experiences of navigating long-term health behavior change,

我在研究中探究了 黑人女性的身體活動行為，

how do they align with the science?

因為，在美國，和白人女性相比，

黑人女性的肥胖普遍程度 高得不成比例，

In my work examining physical activity behaviors among Black women,

這項研究能找出社會背景的哪些面向

for whom the prevalence of obesity is disproportionately higher

有助於她們的成功。

than white women in the United States,

即使在過重但有在活動的女性中，

we have been able to describe aspects of the social context

也有一半以上的人在從事身體活動時

that support their success.

有他人扮演陪伴、

Even among overweight but active women,

增加動機，以及問責的角色。

more than half engaged in physical activity

一位研究對象表示，

「如果我的朋友沒有來嚕我，

with others for companionship,

我幾乎不會去運動。」

motivation and accountability.

另一位研究對象則鼓勵其他女性參與

One participant stated that,

"If my friends did not bug me, I would rarely work out,"

能推促你朝你的身體活動 目標邁進的社團。

while another encouraged other women to get involved with a community

她描述團體就像是 「志同道合的人」。

that will push you towards your physical activity goals.

我們也對身體活動的 社會團體做了研究，

She described the community as “like-minded individuals.”

團體成員認為，友誼、動機、

鼓勵、和問責性

Also in our work with social physical activity groups,

是支持他們長期持續

the members said that friendship, motivation,

做身體活動的最重要因素。

encouragement and accountability were the most important factors

因為我在研究社交網路以及社會支持

for supporting their long-term physical activity success.

如何能強化我們的能力， 讓我們能達成並維持健康目標，

From conducting research on how social networks

同時我也在支助一個 數百名女性的網路，

and social support strengthen our ability to achieve

因此我能告訴各位，我們 所有人都應該思考這三點。

and sustain health goals

and supporting a network of hundreds of women,

第一，

為你自己找到或建立一個 志同道合者的小團體，

I can tell you there are three things that all of us should consider.

來扮演增加動機和問責的角色。

Number one,

可以是個兩人小團體， 就像我媽媽和我，

find or build yourself a tribe of like-minded individuals

或是一群都喜歡 在大自然中走路的人。

for motivation and accountability.

This could be a tribe of two, like my mom and me,

第二，

定訂每個月的健康目標， 並和你的小團體分享。

or a group of individuals who enjoy walking in nature.

只要有一、兩個小改變

Number two,

以及切實的期望就可以了。

create monthly wellness goals and share them with your tribe.

第三，

One or two small changes and realistic expectations will do.

慶祝你的成功。

別只是推促彼此，

也要辦辦派對，有進展 就應該好好鼓勵彼此。

And number three,

celebrate your success.

切記，

要維持健康的體重， 光靠飲食和運動是不夠的。

Don't just push each other,

but throw parties and uplift each other for making progress.

要整個村落的集體力量

Remember, maintaining a healthy weight

才能創造出健康的生活。

takes more than diet and exercise.

謝謝。

It takes the collective power of a village to create a healthy life.

Thank you.