A LIFE-CHANGING EMAIL

一封改變人生的電子郵件

Tom Wood is a detail-oriented person. When I first reached out to him, he replied back from his work email—he runs a consulting firm on the East Coast—with extensive records documenting his multi-decade struggle with diabetes. I could see the fluctuations and overall trends for his blood sugars across a span of many years. His record keeping was impeccable.

Tom Wood 是一個注重細節的人。當我第一次聯繫他時，他回復了他的工作電子郵件——他在東海岸經營著一家諮詢公司——有大量的記錄記錄了他幾十年來與糖尿病作鬥爭的記錄。我可以看到他多年來血糖的波動和總體趨勢。他的記錄無可挑剔。

In conversation, he is similarly thorough. He’s also confident and at ease discussing his health and body—like most of the people I’ve spoken with over the years, he has become accustomed to thinking and talking about his health and what he believes is helpful and not so helpful from the medical system as it is currently designed. His voice when he speaks on the subject is weary but warm. As always, the story is a long one, and there is much to say. When I ask him to tell me his story, he lets out a long breath.

在談話中，他同樣徹底。他也很自信和自在地討論自己的健康和身體——就像多年來與我交談過的大多數人一樣，他已經習慣於思考和談論自己的健康情況，以及他認為醫療系統目前設計的幫助和説明不大。當他談到這個話題時，他的聲音很疲憊，但很溫暖。與往常一樣，這個故事很長，有很多話要說。當我讓他告訴我他的故事時，他長長地吐了一口氣。

“How much time have you got?” he says, laughing.

“你有多少時間？”

He asks where he should start. I answer simply, “The beginning.”

他問他應該從哪裡開始。我簡單地回答說：“開始。

Whenever I ask people to start at “the beginning,” they tend to go back to the same place: not when they were sick or back further to when they were diagnosed, or even further back to when they were healthy. They go back all the way to their childhoods. I don’t have to ask them to. Something in them knows intuitively that the true roots of their stories are there. And no matter what the disease process is, it’s always about the story.

每當我讓人們從 「開始」 開始時，他們往往會回到同一個地方：不是在他們生病的時候，也不是更遠的回到他們被診斷出來的時候，甚至更遠地回到他們健康的時候。他們可以追溯到他們的童年。我不必要求他們這樣做。他們內心的某種東西憑直覺知道他們故事的真正根源就在那裡。無論疾病過程如何，它總是與故事有關。

Tom always thought of himself as a healthy person. It was part of his identity and had been since he was a kid growing up in Ithaca, New York, where in high school he captained the intramural soccer and tennis teams. His father was director of athletics at Ithaca College, and they were always doing something physical together as a family—hiking, biking, being outdoors.

湯姆一直認為自己是一個健康的人。這是他身份的一部分，從他還是個在紐約伊薩卡長大的孩子起就一直如此，高中時他在那裡擔任校內足球隊和網球隊的隊長。他的父親是伊薩卡學院的田徑主任，他們一家人總是一起做一些體力活動——遠足、騎自行車、戶外活動。

He carried that love of activity instilled by his upbringing into his adult years. After he finished college at Cornell, he found an office job that paid well and moved downstate. He married, and not long after that, he and his wife had a son. He ended up running his own company that offered recruiting, staffing, and consulting services. He was well on his way to a happy and successful life. He set his alarm early every morning, drove to the gym in the chilly dark, the pink sunrise just seeping into the sky, to get in a racquetball game before work. He lifted weights, jogged on the treadmill. At lunchtime, he drove to the fast-food restaurant near his office to get a burger, fries, and a Coke.

他將成長過程中灌輸的對活動的熱愛帶到了成年後。在康奈爾大學畢業后，他找到了一份薪水不錯的辦公室工作，搬到了下州。他結婚了，不久之後，他和妻子生了一個兒子。他最終經營了自己的公司，提供招聘、人員配備和諮詢服務。他正在通往幸福和成功的生活。他每天一大早就設置鬧鐘，在寒冷的黑暗中開車去健身房，粉紅色的日出剛剛滲入天空，在上班前參加一場壁球比賽。他舉重，在跑步機上慢跑。午餐時間，他開車去辦公室附近的速食店買了漢堡、薯條和可樂。

He says now, a little ruefully, “I ate more Burger King than anyone alive.”

他現在有點遺憾地說，“我吃的漢堡王比任何活著的人都多。

The years swept by like a river—he was busy at work, his son was growing up too fast. His weight started to go up. Intermittent back pain came and went. He tried some diets, including the Atkins—he’d lose a few pounds, enough to feel slightly encouraged, then gain it back. He wasn’t terribly overweight, but he was heavier than he used to be. He felt his age, and it wore on him.

歲月像河流一樣流逝——他忙於工作，他的兒子長得太快。他的體重開始上升。間歇性背痛來來去去。他嘗試了一些節食法，包括阿特金斯節食法——他減掉了幾磅，足以讓他感到稍微鼓舞，然後又恢復了。他並沒有嚴重超重，但他比以前更重了。他感覺到自己的年齡，這讓他感到疲憊。

Then one Friday afternoon, coming home on the train from a meeting in the city, he started to feel that something wasn’t right. All day, he’d been feeling run-down and out of sorts but had assumed he was just tired. Driving home from the train station, his chest began to well up with pain. A band tightened around his rib cage, and his left arm started to tingle. Recognizing the signs of a heart attack, he turned off his route home and drove himself straight to the hospital.

然後一個星期五的下午，他從城裡開完會坐火車回家，開始覺得有些不對勁。一整天，他都感到疲憊不堪，但以為他只是累了。從火車站開車回家時，他的胸口開始因疼痛而湧出。一條帶子緊緊地纏住了他的胸腔，他的左臂開始發麻。意識到心臟病發作的跡象后，他轉折了回家的路線，直接開車去了醫院。

“They took me right in,” he says, “and stuck one of those beautiful gowns on me. Slapped on an EKG. I was on it for hours.”

“他們直接收留了我，”他說，“然後把其中一件漂亮的禮服穿在我身上。拍了心電圖。我花了好幾個小時。

By 11:00 that night, the doctors had found what they thought was the source of the problem: one of the blood tests had revealed a protein that is released into the bloodstream when the heart muscle is damaged. It was high, about four or five times above what it should have been. So there it was: a cardiac event. They suspected artery blockage.

到那天晚上 11：00，醫生們已經找到了他們認為是問題的根源：其中一項血液檢查顯示，當心肌受損時，一種蛋白質會釋放到血液中。它很高，大約比它應該高出四五倍。所以事情就這樣發生了：心臟事件。他們懷疑動脈阻塞。

A needle catheterization was scheduled for first thing Monday morning. They threaded the catheter through the femoral artery up to his heart. He was awake, under local anesthesia, as they began the procedure. He could see on the screen as the catheter reached his heart and released a squirt of dye into the bloodstream. An x-ray image tracked the dye as it flowed through the arteries of his heart, allowing the doctors to see any areas of narrowing or blockage. Based on his test results, they anticipated significant blockage. But the catheterization results were surprising—he had less than 5 percent blockage, great for a man his age.

週一早上第一件事就是安排穿刺導管插入術。他們將導管穿過股動脈一直延伸到他的心臟。當他們開始手術時，他在局部麻醉下是清醒的。他可以在螢幕上看到導管到達他的心臟，並將一股染料噴射到血液中。X 射線圖像追蹤了流經他心臟動脈的造影劑，使醫生能夠看到任何狹窄或阻塞的區域。根據他的測試結果，他們預計會出現嚴重阻塞。但導管插入術的結果令人驚訝——他的阻塞率不到 5%，對於他這個年齡的人來說已經很好了。

They wheeled him back to his room—and back to the drawing board. It was a nurse who finally walked in with the necessary clue, holding a readout, clearly a little irritated that nobody had figured this out yet.

他們把他推回自己的房間——然後回到繪圖板。一位護士終於帶著必要的線索走了進來，手裡拿著一份讀數，顯然有點生氣，因為還沒有人弄清楚這件事。

“Excuse me!” she said. “Do you realize he’s running a blood sugar of 300?”

“對不起！”“你知道他的血糖是 300 嗎？”

A follow-up blood panel revealed the true culprit: type 2 diabetes.² Tom had insulin resistance. Insulin, a hormone that helps drive glucose from the bloodstream into cells where it can be used for energy, was having difficulty doing its job. This is called insulin resistance, and it is different from type 1 diabetes, where the cells in the pancreas aren’t able to make enough insulin for the body’s needs. In Tom’s case, since the insulin was prevented from doing its job, blood sugar was building up in his system with nowhere to go, causing a number of harmful changes in the structure and function of his heart.

後續的血液檢查揭示了真正的罪魁禍首：2 型糖尿病。²湯姆有胰島素抵抗。胰島素是一種有助於將葡萄糖從血液驅趕到細胞中以用作能量的激素，它難以發揮作用。這稱為胰島素抵抗，它與1型糖尿病不同，在1型糖尿病中，胰腺中的細胞無法產生足夠的胰島素來滿足身體的需要。在湯姆的案例中，由於胰島素無法發揮作用，血糖在他的系統中積聚，無處可去，導致他的心臟結構和功能發生許多有害的變化。

Type 2 diabetes, untreated, leads to heart failure, kidney damage, blindness, stroke, and amputations, among other problems. Ninety-five percent of new cases of diabetes are type 2, and it’s the seventh-leading cause of death each year. The CDC reports that a staggering 20 percent of spending in health care in the United States is on diabetes alone. The day that Tom Wood drove himself to the ER with what he thought was a heart attack, he became one of the 422 million people worldwide known to be suffering from diabetes.³ Experts estimate that eighty million Americans over the age of twenty have prediabetes and report that one in four people have diabetes but don’t know it. And rates have been climbing stratospherically in recent decades, not only in the United States and developed nations but all around the world.⁴

2 型糖尿病如果不治療，會導致心力衰竭、腎損傷、失明、中風和截肢等問題。95% 的糖尿病新病例是 2 型糖尿病，它是每年的第七大死因。疾病預防控制中心報告稱，美國醫療保健支出的 20% 僅在糖尿病上就達到了驚人的 20%。當 Tom Wood 因心臟病發作而開車前往急診室的那天，他成為全球已知 4.22 億糖尿病患者之一。³專家估計，20 歲以上的美國人中有 8000 萬人患有糖尿病前期，並報告說，四分之一的人患有糖尿病但並不知道。近幾十年來，不僅在美國和發達國家，而且在全世界，利率一直在呈平流層攀升。⁴

In practical terms, type 2 diabetes is treated as an incurable illness—thought of as irreversible and progressive. If caught early enough, some doctors will encourage diet changes, exercise, and weight loss to help slow or mitigate the symptoms, but usually only as an afterthought. And misunderstandings about genuine nutrition abound, not only in patients but also in doctors and nutritionists. Our usual approach to this disease (along with most other chronic illnesses that come through our waiting room doors) is to “treat ’em and street ’em”—basically, make an accurate diagnosis, start a medication, and then discharge to home.

實際上，2 型糖尿病被視為一種不治之症——被認為是不可逆的和進行性的。如果發現得足夠早，一些醫生會鼓勵改變飲食、鍛煉和減肥，以幫助減緩或減輕癥狀，但通常只是事後才想到的。對真正營養的誤解比比皆是，不僅在患者中，而且在醫生和營養師中也是如此。我們對這種疾病（以及通過候診室門的大多數其他慢性疾病）的通常方法是“治療他們，然後讓他們上街”——基本上，做出準確的診斷，開始服藥，然後出院回家。

It seemed to Tom that the approach to diabetes hadn’t changed much in the past fifty years. His mother had been diagnosed with diabetes when he was a kid, but she continued to cook the same classic 1950s foods, heavy on carbs and starches. One day, as a teenager, standing in the kitchen, he noticed her lift her shirt to give herself an insulin shot. He realized she’d been doing it for years.

在 Tom 看來，在過去的 50 年裡，治療糖尿病的方法並沒有太大變化。他的母親在他還是個孩子的時候被診斷出患有糖尿病，但她繼續烹飪同樣的 1950 年代經典食物，富含碳水化合物和澱粉。有一天，十幾歲的時候，他站在廚房裡，注意到她掀起襯衫給自己打胰島素針。他意識到她已經這樣做了很多年了。

“The attitude was that taking insulin was just as good as making your own insulin,” he says. “It was basically the same when I was diagnosed.” It’s true that our ability to provide insulin to people with diabetes, starting in 1922, was a game changer for medicine. That year, a fourteen-year-old boy named Leonard Thompson was given the first ever dose of artificial insulin made for human treatment. As a type 1 diabetic in that era, he typically would have been placed on a starvation diet and would have had only months to live. He lived for another thirteen years.

“我們的態度是，服用胰島素和自己製造胰島素一樣好，”他說。“我被診斷出來時基本上是一樣的。”誠然，從1922年開始，我們為糖尿病患者提供胰島素的能力改變了醫學的遊戲規則。那一年，一個名叫倫納德·湯普森 （Leonard Thompson） 的 14 歲男孩接受了有史以來第一劑用於人類治療的人工胰島素。作為那個時代的 1 型糖尿病患者，他通常會被安排進行饑餓飲食，並且只剩下幾個月的生命。他又活了十三年。

The discovery of insulin has saved millions of lives and played its own role in prompting medicine’s search for “magic bullets” that would eradicate disease and suffering. But as a new era opens in medicine, built on both the successes and limitations of the old, we now know more clearly that medications like insulin treat symptoms but not causes. In the case of type 2 diabetes, the insulin resistance remains, even as we treat a patient. Nothing really gets better if the causes aren’t addressed; one is left treading water at best. With diabetes, disease progression often continues, and therefore one often still ends up with a painful and progressive disease course involving damage to multiple organs, physical pain, and a sharply diminished quality of life. If what Tom’s mother experienced was similar to what we often see, what she called “aging” was actually the progression of the diabetes and, perhaps, other illnesses that are often associated.

胰島素的發現挽救了數百萬人的生命，並在推動醫學尋找根除疾病和痛苦的“靈丹妙藥”方面發揮了自己的作用。但是，隨著醫學新時代的開啟，建立在舊時代的成功和局限性之上，我們現在更清楚地知道，像胰島素這樣的藥物可以治療癥狀，但不能治療病因。在 2 型糖尿病的情況下，胰島素抵抗仍然存在，即使我們治療患者也是如此。如果原因沒有得到解決，一切都不會真正變得更好;一個人充其量只能踩水。糖尿病患者的疾病進展通常會持續，因此通常仍會以痛苦和進行性的病程結束，涉及多器官損傷、身體疼痛和生活品質急劇下降。如果湯姆的母親所經歷的與我們經常看到的相似，那麼她所說的“衰老”實際上是糖尿病的進展，也許還有其他經常相關的疾病。

True to form, Tom’s diabetes progressed. He was placed first on metformin, a drug that attempts to convince your body to use insulin more effectively, but when that began to fail, he was switched to regular shots of insulin, which he took before meals, snacks, and bed. In total, he took approximately forty-five units of insulin per day for the next decade. One problem with taking insulin is that it causes weight gain, which worsens insulin resistance, which then causes even higher blood sugars, causing more insulin to be needed. And so the spiral continued; Tom’s weight crept up, he stopped working out, he developed chronic back pain.

一如既往，湯姆的糖尿病病情惡化了。他首先服用了二甲雙胍，這是一種試圖說服您的身體更有效地使用胰島素的藥物，但當這開始失敗時，他被改用定期注射胰島素，他在飯前、零食前和睡覺前服用。在接下來的十年裡，他總共每天服用大約 45 個單位的胰島素。服用胰島素的一個問題是它會導致體重增加，從而加劇胰島素抵抗，然後導致血糖更高，導致需要更多的胰島素。就這樣，螺旋繼續;湯姆的體重悄悄上升，他停止了鍛煉，他患上了慢性背痛。

“I couldn’t walk one hundred feet through a mall,” he says. “I was in bad shape.”

“我無法穿過購物中心 100 英尺，”他說。“我的身體狀況很糟糕。”

Now, we need to understand: Tom was a smart guy. He was an Ivy League grad and president of a company, had long valued exercise, and had many resources available to him. He had prided himself on not only seeing the best endocrinologists but on seeing the best endocrinologists who treated only diabetes. He said that he had seen perhaps twenty to twenty-five doctors total, including at least eight of these highly specialized diabetes experts over a period of fifteen or more years. And, disciplined and numbers-oriented by nature, he had been more rigorous than most about monitoring and treating his blood sugar as directed. Yet in spite of all this, his blood glucose readings were through the roof—the efficacy of the medication he’d been pumping into his body for fifteen years was wearing thin. He developed a cataract in one eye, and his feet went numb: diabetic neuropathy. And he was increasingly at risk for the common comorbidities—the ever-threatening complications that occur in conjunction with diabetes like heart disease, kidney problems, eye damage, even cancer.

現在，我們需要明白：湯姆是個聰明人。他是常春藤盟校的畢業生和一家公司的總裁，長期以來一直重視鍛煉，並且有很多可用的資源。他為自己不僅看到了最好的內分泌學家而感到自豪，而且因為看到了只治療糖尿病的最好的內分泌學家。他說，他總共看過大約 20 到 25 名醫生，其中至少有 8 名是高度專業化的糖尿病專家，時間跨度為 15 年或更長時間。而且，他天生紀律嚴明，注重數位，在監測和按照指示治療血糖方面比大多數人都更加嚴格。然而，儘管如此，他的血糖讀數還是飆升——他 15 年來一直泵入體內的藥物的療效正在逐漸消失。他的一隻眼睛患上了白內障，雙腳麻木了：糖尿病神經病變。他患常見合併症的風險越來越大，這些併發症與糖尿病一起發生的具有威脅性的併發症，如心臟病、腎臟問題、眼睛損傷，甚至癌症。

It was the weekend after Thanksgiving 2014, when an email swooshed into Tom’s in-box. Glancing at it, he immediately saw that it was spam, an advertisement promising to turn his life around. If he signed up today, the message urged, he would receive the secrets of their “special diet,” lose weight, and be off his diabetes medication and showing normal biomarkers within a month! Tom hovered his mouse over the Delete button, but the money-back guarantee caught his eye. He was tired of being sick. He was tired of the continual shots every day, the chronic pain, extra weight, of feeling like each day was a struggle. He read the message again. “Change your diet, change your life! Only $39.95!” The program was four weeks long. It included a promise: if at the end of four weeks he wasn’t nondiabetic and off his medications, he could have his money back.

那是 2014 年感恩節後的週末，一封電子郵件突然進入了 Tom 的收件匣。他瞥了一眼，立刻發現這是垃圾郵件，一則承諾改變他生活的廣告。消息敦促他，如果他今天註冊，他將獲得他們「特殊飲食」的秘密，減肥，並在一個月內停止服用糖尿病藥物並顯示正常的生物標誌物！Tom 將滑鼠懸停在 Delete 按鈕上，但退款保證引起了他的注意。他厭倦了生病。他厭倦了每天連續的注射，慢性疼痛，額外的體重，感覺每一天都很掙扎。他又讀了一遍這條資訊。“改變你的飲食，改變你的生活！只需 39.95 美元！該計劃為期四個星期。它包括一個承諾：如果在四個星期結束時他不是非糖尿病患者並且不再服用藥物，他可以拿回他的錢。

What the hell, he thought. What do I have to lose?

是什麼，他想。我必須失去什麼？

He punched in his credit card number and downloaded the instructions. The meal plan included no meat and no dairy. The list of foods he’d be able to eat—mostly vegetables, fruits, and beans—looked long and full of options at first glance, but Tom was at a loss. A lot of them were things he’d never eaten or things he didn’t know how to prepare. But he was in for forty bucks, and he figured he could do anything for a month.

他輸入了自己的信用卡號並下載了說明。膳食計劃包括不吃肉和奶製品。他能吃的食物清單——主要是蔬菜、水果和豆類——乍一看看起來很長，而且有很多選擇，但湯姆卻不知所措。其中很多是他從未吃過的東西，或者他不知道如何準備的東西。但他要花四十塊錢，他覺得他一個月可以做任何事情。

Four weeks later, Tom had dropped ten pounds. He’d cut his diabetes medications in half. He felt more energetic, lighter on his feet. He wasn’t completely off his insulin, though, as the program had guaranteed. Still a little suspicious of the program and its promises, he called the company. They refunded his money.

四個星期後，湯姆減掉了 10 磅。他把糖尿病藥物減少了一半。他感覺更有活力，腳更輕盈。不過，他並沒有像該計劃所保證的那樣完全停止使用胰島素。他仍然對這個專案及其承諾有些懷疑，於是打電話給公司。他們退還了他的錢。

But he was impressed. In just four weeks, he had eliminated half his medications and dropped weight for the first time in decades, through nothing more than adjusting the ratio of food types he put on his plate at each meal. How could such relatively modest changes in diet and almost no increase in exercise change his body and his blood sugar so drastically?

但他印象深刻。在短短四個星期內，他已經戒掉了一半的藥物，幾十年來第一次減輕了體重，只不過是調整了每餐盤子里的食物種類的比例。如此相對適度的飲食變化和幾乎沒有運動的增加怎麼會如此劇烈地改變他的身體和血糖呢？

He started researching diet and diabetes in depth. He discovered The End of Diabetes by Dr. Joel Fuhrman. Tom and his wife both read the book. For the first time in years, he felt a tingling of energy and hope, the possibility of truly revolutionizing his health and life. He launched into the program with the support of his wife, who joined him in both the diet and the cooking. Initially, it felt like a lot to learn. But in some ways, it was much easier than the calorie counting that is recommended by many doctors and the American Diabetes Association. Dr. Fuhrman focuses simply on making sure people are eating the foods loaded with the highest percentage of vitamins, minerals, and phytochemicals, rather than counting calories or paying attention to food groups. There are lists of “unlimited” foods you can eat anytime, and food is organized into tiers, based on their nutritional density.

他開始深入研究飲食和糖尿病。他發現了喬爾·福爾曼 （Joel Fuhrman） 博士的《糖尿病的終結》。湯姆和他的妻子都讀了這本書。多年來，他第一次感到一股活力和希望，真正徹底改變他的健康和生活的可能性。他在妻子的支援下開始參加該計劃，妻子也加入了他的飲食和烹飪。最初，感覺要學很多東西。但在某些方面，這比許多醫生和美國糖尿病協會推薦的卡路里計算要容易得多。Fuhrman 博士只專注於確保人們吃的食品中維生素、礦物質和植物化學物質含量最高，而不是計算卡路里或關注食物組。有您可以隨時食用的“無限”食物清單，食物根據其營養密度分為多個等級。

What is nutritional density? According to Fuhrman (and, in fact, the World Health Organization), nutritionally dense foods are loaded with vitamins, minerals, and phytochemicals, but low in calories. They are low in sugar and refined carbs, salt, starches, and unhealthy fats. Included are fruit and vegetables, fish, whole grains, nuts, legumes, seeds, and small amounts of chemical-free fish and lean meats. Dr. Fuhrman created ANDI—the Aggregate Nutritional Density Index—to help patients construct a diet that is high in nutrient-dense foods. The index can easily be found online and provides a great visual aid to use for internalizing the concept of nutritional density and begin building your diet around it. It’s hard starting out, when you have to analyze each meal and each choice that you make—you might need to frequently reference the ANDI and do the creative work of learning new recipes and habits. But with use, it does become second nature.

什麼是營養密度？根據 Fuhrman（實際上是世界衛生組織）的說法，營養豐富的食物富含維生素、礦物質和植物化學物質，但熱量低。它們的糖和精製碳水化合物、鹽、澱粉和不健康的脂肪含量低。包括水果和蔬菜、魚、全穀物、堅果、豆類、種子和少量不含化學物質的魚和瘦肉。Fuhrman 博士創建了 ANDI（聚合營養密度指數），以説明患者構建營養豐富的食物飲食。該指數可以很容易地在網上找到，並提供了一個很好的視覺輔助工具，用於內化營養密度的概念並開始圍繞它構建您的飲食。當您必須分析每頓飯和您所做的每個選擇時，開始時很困難——您可能需要經常參考 ANDI 並進行學習新食譜和習慣的創造性工作。但隨著使用，它確實成為第二天性。

The ANDI will probably change as the science of phytochemicals takes off,⁵ but as it currently stands, it’s absolutely a better tool for health and healing than the food pyramid most of us were brought up with. Zoom out, and essentially the nutrition plan boils down to this: eat mostly vegetables. Tom didn’t completely eliminate foods like pasta, bread, meat, and dairy, but he drastically reduced his intake of those foods to less than 5 percent of calories consumed. He essentially turned his diet upside down, making fresh fruits and vegetables the base of his personal food pyramid.

隨著植物化學物質科學的興起，ANDI 可能會發生變化，⁵ 但就目前而言，它絕對是比我們大多數人從小就養育的食物金字塔更好的健康和康復工具。縮小範圍，基本上營養計劃可以歸結為：多吃蔬菜。湯姆並沒有完全消除義大利面、麵包、肉類和乳製品等食物，但他將這些食物的攝入量大幅減少到卡路里消耗的 5% 以下。他基本上顛覆了自己的飲食習慣，將新鮮水果和蔬菜作為他個人食物金字塔的基礎。

It worked. As of this writing, Tom has been completely nondiabetic, without medication, for almost three years. He’s remained on Dr. Fuhrman’s antidiabetic nutritional plan ever since finding it after that trial promo in Thanksgiving 2014. He says he “stuffs himself” with what Dr. Fuhrman calls “nutritarian meals”—a daily menu organized around great-tasting, high-nutrient eating. It mostly consists of beans, green veggies, nuts and seeds, and berries—a lot like the meals I ate in Brazil. “I’m never hungry,” Tom says. “I wouldn’t go back to my old way of eating for anything.”

成功了。在撰寫本文時，湯姆已經完全沒有糖尿病，沒有藥物治療，已經將近三年了。自從 2014 年感恩節的那次試驗促銷後找到 Fuhrman 博士的抗糖尿病營養計劃以來，他就一直在該計劃中。他說他「填滿自己」，吃福爾曼博士所說的“營養餐”——圍繞美味、高營養飲食組織的每日功能表。它主要由豆類、綠色蔬菜、堅果和種子以及漿果組成——很像我在巴西吃的飯菜。“我從不餓，”湯姆說。“我不會回到我吃任何東西的舊方式。”

But does he cheat, every once in a while? Does he have a piece of cake?

但他會偶爾作弊嗎？他有小菜一碟嗎？

“Very rarely, almost never,” he says. “I don’t feel the compulsion to do it. The cravings for the foods I used to eat were gone after the first month.”

“很少，幾乎從來沒有，”他說。我不覺得有這種衝動。第一個月後，我對以前吃的食物的渴望就消失了。

So many of the people I’ve spoken with say their taste buds have come alive again upon changing their diets. They find that the nutritional lifestyle is no longer difficult once you start following it, and the benefits are so tangible and life-changing that nothing could prompt them to return to the old foods. Fruits and vegetables can be prepared in fabulous ways, though most of us start off not realizing how to do this and not realizing it doesn’t need to be costly or time-consuming. In this case, ignorance is decidedly not bliss. Even eating out is fine, once one knows how to recognize what has nutritional density and what does not.

與我交談過的許多人都說，改變飲食習慣后，他們的味蕾又恢復了活力。他們發現，一旦你開始遵循營養生活方式，它就不再困難，而且好處是如此明顯和改變生活，以至於沒有什麼能促使他們回到舊的食物。水果和蔬菜可以以極好的方式準備，儘管我們大多數人一開始並沒有意識到如何做到這一點，也沒有意識到它不需要昂貴或耗時。在這種情況下，無知絕對不是福。即使外出就餐也很好，只要一個人知道如何識別什麼具有營養密度，什麼沒有。

Notice how Tom uses the language of addiction above: “I don’t feel the compulsion to do it. The cravings … were gone.” This language is important, and people often use similar language when, in retrospect, they talk about the nutritional changes they have made. They say they had felt addicted to refined flours and sugars in general, and it’s these habits that make the transition to food with a higher nutritional density initially difficult. It’s not uncommon for people to experience headaches and other temporary symptoms as the body goes through a detox from years of accumulated toxins.

請注意湯姆是如何使用上面成癮的語言的：“我不覺得有強迫性去做這件事。渴望......都走了。這種語言很重要，人們在回想起來談論他們所做的營養變化時，經常使用類似的語言。他們說，他們總體上對精製麵粉和糖上癮，正是這些習慣使最初難以過渡到營養密度更高的食物。當身體從多年積累的毒素中排毒時，人們出現頭痛和其他暫時癥狀的情況並不少見。

Tom is healthier now than he has ever been. Whereas before he couldn’t walk a hundred feet without doubling over in pain, now he walks three miles each day with no pain at all. Now in his seventies, he is lean, flexible, and without any trace of the diabetes that ravaged his body for more than fifteen years.

湯姆現在比以往任何時候都更健康。以前他不能走一百英尺而不痛得彎腰，而現在他每天走三英里，完全沒有疼痛。現在他已經七十多歲了，身材瘦削，身體靈活，身上沒有絲毫糖尿病的痕跡，這種糖尿病肆虐了他身體超過十五年。

Tom’s doctor, an endocrinologist, has been shocked by his progress. A few years ago, she had him come in for lab tests, nervous that he might be neglecting his illness. She walked into the exam room holding his file, looking at the current lab report, then at the one from the previous year, when he was still taking forty-five units of insulin per day, shaking her head.

湯姆的醫生是一名內分泌學家，他對他的進展感到震驚。幾年前，她讓他來做實驗室檢查，擔心他可能會忽視自己的病情。她拿著他的檔走進檢查室，看了看最新的實驗室報告，然後看了看前一年的報告，當時他每天還在服用 45 個單位的胰島素，搖了搖頭。

“I can’t count how many patients I’ve had in my career,” she said, “but in the past twenty years, I’ve never seen anybody do this.”

“我數不清在我的職業生涯中接待過多少病人，”她說，“但在過去的 20 年裡，我從未見過有人這樣做。

Tom’s story resonated with me. Like Tom, I’d always thought of my diet as generally healthy, other than the junk I ate occasionally while busy at work. But for the most part, I thought of myself as making pretty good choices around food, and I didn’t pay attention to how often I simply ate what was around. And I’ve noticed that other people do the same. As a doctor, I ask what people eat, and often see what is on their hospital trays. The truth is, almost everyone thinks they eat healthy, even though they don’t.

湯姆的故事引起了我的共鳴。和湯姆一樣，我一直認為我的飲食總體上是健康的，除了我在忙於工作時偶爾吃的垃圾食品。但在大多數情況下，我認為自己在食物方面做出了相當不錯的選擇，我沒有注意我只是吃周圍食物的頻率。我注意到其他人也這樣做。作為一名醫生，我會詢問人們吃什麼，並經常看到他們醫院托盤上的東西。事實是，幾乎每個人都認為他們吃得健康，儘管他們並不健康。

Growing up on a farm, with that Amish mentality, we ate all home-cooked meals. We never had takeout or packaged foods. My mother made nearly everything from scratch; she even ground the wheat we grew on the farm to make her own flour for baking bread, pancakes, and muffins. We ate meat at nearly every meal, often three times a day. We also ate a lot of heavy carbs like bread and potatoes. I replicated many of these eating patterns into adulthood, and with college added the chips, cookies, and snacks of modern life. I still held on to the traditional food pyramid, with animal products like meat and dairy occupying large structural stripes holding the pyramid up. The message was, they were essential. The pyramid would collapse without them.

我們在農場長大，帶著那種阿米什人的心態，我們吃的都是家常菜。我們從來沒有外賣或包裝食品。我媽媽幾乎從零開始製作所有東西;她甚至把我們在農場種植的小麥磨碎，製作自己的麵粉，用來烤麵包、煎餅和鬆餅。我們幾乎每頓飯都吃肉，通常一天吃三頓。我們還吃了很多重碳水化合物，比如麵包和土豆。我把許多這樣的飲食模式複製到成年後，隨著大學的到來，我加入了現代生活的薯條、餅乾和零食。我仍然堅持傳統的食物金字塔，肉類和奶製品等動物產品佔據了支撐金字塔的大型結構條紋。傳達的資訊是，他們是必不可少的。沒有他們，金字塔就會坍塌。

Ironically, it was med school more than any other place that encouraged terrible eating habits. We ate what was convenient, fast, and filling. We ate on the go, as an afterthought—fast food, takeout, things out of packages and boxes. In medical school, you take in an immense amount of information. The schedule is relentless, and nutrition was rarely addressed in the curriculum. When it was, we failed to make the larger connections that would have emphasized how important it was to put these lines from the textbook into practice.

具有諷刺意味的是，醫學院比任何其他地方都更鼓勵糟糕的飲食習慣。我們吃了方便、快速和飽腹的食物。我們事後在路上吃東西——速食、外賣、包裝和盒子里的東西。在醫學院，你會吸收大量的資訊。課程安排很緊張，課程中很少涉及營養問題。當它出現時，我們未能建立更大的聯繫，以強調將教科書中的這些臺詞付諸實踐是多麼重要。

My fellow students and I sat together in class, memorizing chemical and neurochemical equations that required certain vitamins and minerals at key points to complete important chemical reactions in the body and brain. But then the professor would blithely say that in Western cultures people receive plenty of nutrition, and we would move on. We got up, walked out, and ate pizza and chips for dinner, in the middle of the night, in between study sessions. On tests, we checked boxes to answer questions about how the absence or presence of certain nutrients in the bloodstream could affect the brain’s ability to produce neurotransmitters like serotonin, dopamine, or acetylcholine. And yet now, when someone comes into a doctor’s office with an issue, most of us don’t think to ask, “What are you eating?” It makes sense that if you put the wrong type of gas into your car, sooner or later, the car is going to have problems. Could our mind and bodies really be any different?

我和我的同學們一起坐在課堂上，記住化學和神經化學方程式，這些方程式在關鍵點需要某些維生素和礦物質才能完成身體和大腦中的重要化學反應。但隨後教授會輕描淡寫地說，在西方文化中，人們會獲得大量的營養，我們就會繼續前進。我們起床走出去，在半夜，在學習課間吃披薩和薯條當晚飯。在測試中，我們勾選了方框以回答有關血液中某些營養素的缺失或存在如何影響大腦產生神經遞質（如血清素、多巴胺或乙醯膽鹼）的能力的問題。然而現在，當有人帶著問題來到醫生辦公室時，我們大多數人都不會想問：“你在吃什麼？如果你把錯誤類型的汽油加進你的車裡，這輛車遲早會出問題，這是有道理的。我們的思想和身體真的會有什麼不同嗎？

After Brazil, and after listening to story after story of those who had experienced healing, I began to realize that I also needed to make some major changes, before I found myself fighting one or more of the many illnesses I was seeing in these cases. I knew that I would have to custom-design a nutritional plan to work for me—like Tom, Claire, Juniper, and so many other people who experienced remarkable recoveries had done. Claire in particular emphasized how individual it must be. On her excellent blog, Living with Pancreatic Cancer, where she chronicles her journey to recovery, Claire tells a story about sharing details of her own diet changes early on in her blogging experience. Shortly after she had launched the blog in an effort to reach out to other sick people who were suffering, a woman wrote to her, asking for more detail on Claire’s diet. She gave it, generously I’m sure—Claire is as generous, open, and giving a person as you can find. The woman replied to say she had gone out and bought all the items Claire listed and would follow in her footsteps exactly. Sometime later, she died.

在巴西之後，在聽了那些經歷過治癒的人的故事后，我開始意識到我也需要做出一些重大改變，然後我發現自己在這些病例中看到的許多疾病中的一種或多種作鬥爭。我知道我必須定製設計一個適合我的營養計劃——就像 Tom、Claire、Juniper 和許多其他經歷過顯著康復的人所做的那樣。Claire 特彆強調它必須具有個人性。在她出色的博客中， 與胰腺癌共存，她記錄了她的康復之旅，克雷爾講述了一個關於在她博客經歷的早期分享自己飲食改變細節的故事。在她推出博客以努力接觸其他正在遭受痛苦的病人后不久，一位女士寫信給她，詢問有關 Claire 飲食的更多細節。她付出了，我敢肯定——Claire 是你所能找到的慷慨、開放和給予的人。這位女士回復說，她已經出去買了克雷爾列出的所有物品，並將完全追隨她的腳步。一段時間后，她去世了。

From then on, Claire has made it a rule not to share the specific menu that she followed after her diagnosis.

從那時起，克雷爾就制定了不分享她在診斷后遵循的特定功能表的規則。

“Obviously what worked for me didn’t work for her,” she writes. “I believe that each of us responds to and needs different things.… I don’t believe there’s any one thing, any silver bullet out there for everyone. We need to find out what works for us individually.”⁶

“顯然，對我有用的方法對她不起作用，”她寫道。“我相信我們每個人都會回應和需要不同的東西......我不相信有任何一件事，任何靈丹妙藥都適合所有人。我們需要找出什麼對我們個人有用。⁶

What she is comfortable sharing is that she eliminated refined flours and sugar, as well as processed foods and additives (food coloring, preservatives, etc.). Unlike some, she left in a moderate amount of organic meat and dairy. Her overarching rule that she used as a touchstone: eat fresh and seasonally.

她樂於分享的是，她消除了精製麵粉和糖，以及加工食品和添加劑（食用色素、防腐劑等）。與其他人不同的是，她留下了適量的有機肉類和奶製品。她以此為試金石的首要規則是：吃新鮮的、要當季的。

There were certainly some common truths emerging from the stories of remission I was collecting, but they were broad strokes, not specific rules. The repeating echoes were: eat fresh, eat plants, eat whole foods, and don’t put refined sugar and flours, or anything processed or artificial, into your body. This lined up with research I was seeing that indicated that cancer cells, just like bacteria and fungi, “feed” and grow avidly on their favorite food—refined sugar in the bloodstream—and that the chemicals and additives present in processed foods can serve as disruptors that let cancer and other diseases get a toehold in your body.

從我收集的緩解故事中，肯定有一些常見的真相，但它們是粗略的筆觸，而不是具體的規則。重複的回應是：吃新鮮的，吃植物，吃全食物，不要將精製糖和麵粉或任何加工或人工的東西放入你的身體。這與我看到的研究表明，癌細胞就像細菌和真菌一樣，以它們最喜歡的食物（血液中的精製糖）為食和狂熱地生長，而加工食品中存在的化學物質和添加劑可以作為干擾物，讓癌症和其他疾病在你的身體中站穩腳跟。

A study with mice at Georgia State University⁷ revealed a disturbing correlation between emulsifiers, a very common additive, and cancer. Emulsifiers like carboxymethylcellulose and polysorbate-80—just to name two—are ubiquitously present in processed foods, in everything from mayonnaise to ice cream. They are added frequently to grocery products to extend the shelf life of these foods and “improve the mouthfeel,” as those in the food science industry are fond of saying. The FDA puts limits of how much of any one emulsifier can go in a product, but many companies dodge this by using different types of emulsifiers—each one a distinct chemical compound. This is technically allowed, but it adds more potential chemical disruptors to the foodstuffs we pull off the shelf and into our baskets. Once in our bodies, the emulsifiers—having ridden in on the processed breads and meats we eat, the salad dressing and sauces, and more—disperse through our digestive tract and unbalance the microbiome—that delicate, flourishing ecosystem in our guts.

佐治亞州立大學⁷ 的一項小鼠研究揭示了乳化劑（一種非常常見的添加劑）與癌症之間存在令人不安的相關性。羧甲基纖維素和聚山梨醇酯-80 等乳化劑（僅舉兩例）普遍存在於加工食品中，從蛋黃醬到霜淇淋，無所不包。它們經常被添加到雜貨產品中，以延長這些食品的保質期並“改善口感”，正如食品科學行業的人喜歡說的那樣。FDA 對任何一種乳化劑在產品中的含量進行了限制，但許多公司通過使用不同類型的乳化劑來規避這一點——每一種乳化劑都是不同的化合物。這在技術上是允許的，但它會為我們從貨架上拿下來並放入籃子的食品中增加更多潛在的化學干擾物。一旦進入我們的身體，乳化劑——進入我們吃的加工麵包和肉類、沙拉醬和醬汁等——就會通過我們的消化道擴散並破壞微生物組的平衡——微生物組是我們腸道中脆弱而繁榮的生態系統。

The Georgia State study and others suggest that by disrupting the microbiome and triggering chronic inflammation, emulsifiers may contribute to weight gain, inflammatory illnesses, autoimmune disorders, and even cancer.

佐治亞州立大學的研究和其他研究表明，通過破壞微生物組並引發慢性炎症，乳化劑可能會導致體重增加、炎症性疾病、自身免疫性疾病，甚至癌症。

It can be hard to imagine how such a tiny, microscopic chemical element in a food product—a tiny portion of the overall item—could be responsible for such a wave of illnesses. But when I think about how regularly I used to consume such products—really at every meal (along with my salad, potatoes, and grilled chicken), it’s not so surprising after all. It’s like a tiny pebble that slips into your boot and rubs your whole heel raw. And this is just one of the many chemical additives that you might encounter in a typical food product that you pull off the shelf at your local grocery store.

很難想像食品中如此微小的化學元素（整個專案的一小部分）是如何導致如此一波疾病的。但是，當我想到我過去經常食用這些產品時——真的在每頓飯（以及我的沙拉、土豆和烤雞）中，這畢竟並不那麼令人驚訝。它就像一顆小鵝卵石，滑進你的靴子里，生生地摩擦你的整個腳跟。這隻是您在當地雜貨店貨架上購買的典型食品中可能遇到的眾多化學添加劑之一。

I saw how these broad guidelines on basing my diet around fresh, green, whole foods could serve as a template for me as I developed an individual diet that satisfied me and turned food into a daily medicine for my body—while noting they ran completely contrary to the way that most of us are taught to eat. For evidence, I didn’t need to look much further than the most comprehensive study of nutrition ever conducted.

我看到了這些以新鮮、綠色、全食物為基礎的飲食的廣泛指導方針如何作為我的範本，因為我開發了一種讓我滿意的個人飲食，並將食物變成了我身體的日常藥物——同時注意到它們與我們大多數人被教導的飲食方式完全相反。為了證明這一點，我只需要看有史以來最全面的營養學研究就行了。

LESSONS FROM A CANCER-RESISTANT COUNTRY

來自抗癌國家的經驗教訓

Around the time that Tom Wood was graduating from Cornell—about to embark on his career and unaware of how his diet might alter the function of his cells—a new professor arrived and joined the Division of Nutritional Sciences right there at the very same university. T. Colin Campbell had been teaching and researching nutrition and biochemistry at Virginia Tech for the previous ten years and was rapidly developing an interest in the link between diet and disease. This wasn’t something that was being talked about at the time, but mounting evidence had Campbell convinced that it was a dangerously understudied subject. He was fresh from an experience in the Philippines, working on childhood malnutrition, and what he found had already changed the course of his career.

大約在湯姆·伍德 （Tom Wood） 從康奈爾大學畢業時——即將開始他的職業生涯，並且不知道他的飲食會如何改變他的細胞功能——一位新教授來了，並加入了同一所大學的營養科學系。T. Colin Campbell 在過去十年中一直在佛吉尼亞理工大學教授和研究營養學和生物化學，並迅速對飲食與疾病之間的聯繫產生了興趣。這在當時並不是人們談論的事情，但越來越多的證據讓坎貝爾相信，這是一個危險的未被充分研究的話題。他剛從菲律賓的經歷中恢復過來，致力於研究兒童營養不良，他的發現已經改變了他的職業生涯。

While there, he’d stumbled, almost accidentally, on a link between the consumption of animal protein and cancer. While working with families across the country to combat the effects of a devastating epidemic of malnutrition, he’d discovered that Filipino children were dying of liver cancer at an alarming rate. Usually, liver cancer doesn’t occur until much later in adulthood, yet many Filipino children were succumbing by the age of ten. Campbell and his colleagues were initially able to trace this phenomenon to a contaminant in the nation’s supply of peanut butter: aflatoxin, a highly toxic carcinogen produced by a type of fungi that grows on peanuts under certain conditions. Aflatoxin, according to Campbell, is “the most potent liver carcinogen known.”⁸

在那裡，他幾乎是偶然地發現了動物蛋白消費與癌症之間的聯繫。在與全國各地的家庭合作對抗營養不良這一毀滅性流行病的影響時，他發現菲律賓兒童死於肝癌的速度令人震驚。通常，肝癌要到成年後期才會發生，但許多菲律賓兒童在10歲時就去世了。Campbell 和他的同事最初能夠將這種現象追溯到美國花生醬供應中的一種污染物：黃麴黴毒素，這是一種劇毒的致癌物，由一種在特定條件下生長在花生上的真菌產生。根據坎貝爾的說法，黃麴黴毒素是「已知最有效的肝臟致癌物」。。⁸

This seemed to explain the problem, but there was a confounding detail. By a vast margin, the children developing liver cancer were from the wealthiest communities, while the ones from poorer areas seemed to escape it completely—even though both groups regularly consumed the contaminated peanut products.

這似乎解釋了問題，但有一個令人困惑的細節。患肝癌的兒童來自最富裕的社區，而來自較貧困地區的兒童似乎完全逃脫了肝癌——儘管這兩個群體都經常食用受污染的花生產品。

Campbell was finally able to home in on one major lifestyle difference: the wealthier children ate diets rich in meat and dairy, similar to a Western diet. The less privileged, unable to afford such foods, did not. It suggested a link between the consumption of animal protein—meat and dairy, long the staples of the Western diet—and cancer, which Campbell wasn’t quite prepared to believe. He’d been operating off a long-held belief in the scientific community that it was protein deficiency that opened the door to cancer and other diseases. But then Campbell happened across a new study out of India, published in an obscure medical journal. In the study, two groups of laboratory rats had been exposed to the aflatoxin that he’d found in the Filipino peanut butter to predispose them to developing liver cancer. One group was then given a diet high in casein—a naturally occurring protein in mammalian milk—while the other received very little. Every animal in the first group developed cancer or precursor lesions that would become cancer. In the second group, zero.

坎貝爾終於能夠意識到一個主要的生活方式差異：較富裕的孩子吃富含肉類和奶製品的飲食，類似於西方飲食。那些買不起這種食物的弱勢群體沒有。它表明動物蛋白（肉類和奶製品，長期以來一直是西方飲食的主食）的消費與癌症之間存在聯繫，坎貝爾並不完全願意相信這一點。他一直基於科學界長期以來的信念進行操作，即是蛋白質缺乏為癌症和其他疾病打開了大門。但後來坎貝爾偶然發現了印度的一項新研究，該研究發表在一本不起眼的醫學雜誌上。在這項研究中，兩組實驗室大鼠暴露於他在菲律賓花生醬中發現的黃麴黴毒素，使它們容易患上肝癌。然後，一組飲食中酪蛋白含量高（哺乳動物乳汁中天然存在的蛋白質），而另一組則接受很少的飲食。第一組中的每隻動物都患上了癌症或會變成癌症的前體病變。在第二組中，為零。

“It was not a trivial difference,” Campbell writes of the obscure experiment that changed the course of his career, “it was 100% vs. 0%.”⁹

“這不是一個微不足道的差異，”坎貝爾在談到改變他職業生涯進程的晦澀實驗時寫道，“它是 100% 對 0%。⁹

Still, Campbell was not completely convinced. Perhaps the researchers had somehow transposed the two groups? Returning home, he carefully ran his own version of the study and obtained identical results.¹⁰

儘管如此，坎貝爾並不完全相信。也許研究人員以某種方式將這兩組人換了位？回到家后，他仔細地進行了自己版本的研究，並得到了相同的結果。¹⁰

After that, Campbell fixed his sights on the link between diet and disease. In 1980, a senior researcher with China’s centers for disease control named Dr. Junshi Chen visited him in his office at Cornell to discuss the possibility of doing a very small study on the link between the mineral selenium and cancer. But as they talked, the very small study quickly began to blossom into something much larger.

在那之後，坎貝爾將目光投向了飲食與疾病之間的聯繫。1980年，中國疾病預防控制中心一位名叫 Junshi Chen 博士的高級研究員在康奈爾大學的辦公室拜訪了他，討論對礦物硒與癌症之間的聯繫進行一項非常小的研究的可能性。但隨著他們的交談，這個非常小的研究很快就開始發展成更大的東西。

The profile of China at that time was unique, and it was ideal for research. First of all, it was an enormous country. The population would reach about 1.2 billion in that decade, representing a third of the globe’s total inhabitants. Second, there was very little geographical mobility—97 percent of the populace had been born in the same county where they currently lived. From a research standpoint, this was paradise: a huge, homogenous population where nearly everyone lived where they were born. This dramatically limits confounding variables and other potential influences. And third, food production and consumption were highly localized. As opposed to a place like the United States or other Western countries, where goods were rapidly transported and meals looked pretty much alike from one coast to the other, meals in China were highly distinctive and determined by geography. This perfect storm of factors led Banoo Parpia, chief coordinator of the project, to call the China of the mid-1980s “a vast human laboratory.”¹¹

當時的中國概況很獨特，非常適合進行研究。首先，這是一個幅員遼闊的國家。在那十年中，人口將達到約12億，佔全球總居民的三分之一。其次，地理流動性非常小——97% 的人口出生在他們目前居住的同一縣。從研究的角度來看，這裏簡直就是天堂：人口眾多，幾乎每個人都生活在他們的出生地。這極大地限制了混雜變數和其他潛在影響。第三，食品生產和消費高度當地語系化。與美國或其他西方國家這樣的地方不同，那裡的貨物運輸迅速，從東西海岸到東西海岸的飯菜看起來幾乎相似，而中國的飯菜則非常獨特，並受地理因素決定。這場完美的因素風暴導致該專案的首席協調員 Banoo Parpia 將 1980 年代中期的中國稱為“一個巨大的人類實驗室”。¹¹

There was an additional factor that made China a potential treasure trove of information about the origins of disease. About five years earlier, as the Chinese premier Zhou Enlai lay dying of cancer, he initiated a massive nationwide survey of 880 million people—98 percent of the population—to collect data on death rates for twelve different kinds of cancer. The landmark survey was called the most ambitious biomedical research project ever achieved. It resulted in a color-coded atlas revealing where certain types of cancer were prominent and also where they were nearly nonexistent. It revealed that counties with the highest rates of some cancers had rates that were more than one hundred times greater than those counties with the lowest rates. While intense politics and huge amounts of research and public interest are generated by small differences in cancer rates between different areas of the United States, this study revealed that some parts of China had cancer rates one hundred times (10,000 percent) lower than others.

還有一個因素使中國成為有關疾病起源的潛在資訊寶庫。大約五年前，當中國總理周恩來因癌症奄奄一息時，他發起了一項對 8.8 億人（占人口的 98%）的大規模全國調查，以收集 12 種不同癌症的死亡率數據。這項具有里程碑意義的調查被稱為有史以來最雄心勃勃的生物醫學研究專案。它產生了一個顏色編碼的圖譜，揭示了某些類型的癌症在哪裡很突出，也在哪裡幾乎不存在。它揭示了某些癌症發病率最高的縣的發病率是發病率最低的縣的一百倍以上。雖然美國不同地區之間癌症發病率的微小差異引起了激烈的政治和大量的研究和公眾興趣，但這項研究表明，中國某些地區的癌症發病率比其他地區低一百倍 （10,000%）。

The wide variations could not be explained away by genetics. China at the time was highly ethnically homogenous—87 percent of the population in the study were of the same ethnic group. This meant that the cancer triggers were not due to genes—they were due to environment. Disease was not destiny; it was within our control.

這種巨大的差異無法用遺傳學來解釋。當時的中國是高度種族同質化的——研究中87%的人口屬於同一種族。這意味著癌症的觸發因素不是由基因引起的，而是由於環境造成的。疾病不是命運;它在我們的控制範圍內。

This was the landscape that T. Colin Campbell, Junshi Chen, and their team of researchers walked into in 1983. Two decades later, they had gathered irreplaceable information on disease mortality for more than four dozen different diseases, ranging from various types of cancers to heart disease and infectious diseases. They compiled data on 367 variables and compared each variable to every other. They administered blood tests and surveys on 6,500 adults, took urine samples and measured everything families ate over a three-day period, and analyzed food samples from marketplaces around the country.

這就是 T. Colin Campbell、Junshi Chen 和他們的研究團隊在 1983 年走進的風景。二十年後，他們收集了四十多種不同疾病的疾病死亡率的不可替代的資訊，從各種類型的癌症到心臟病和傳染病。他們彙編了 367 個變數的數據，並將每個變數與其他變數進行了比較。他們對 6,500 名成年人進行了血液檢測和調查，採集了尿液樣本並測量了家庭在三天內吃的所有食物，並分析了來自全國各地市場的食品樣本。

When the project concluded, they’d found more than eight thousand statistically significant associations between lifestyle, diet, and disease variables. They had completed a study that was unmatched in size, quality, comprehensiveness, and uniqueness. The New York Times crowned it “the Grand Prix of epidemiology.”

當項目結束時，他們發現生活方式、飲食和疾病變數之間存在8000多種具有統計學意義的關聯。他們完成了一項在規模、品質、全面性和獨特性方面無與倫比的研究。《紐約時報》稱其為「流行病學大獎」。。

It proved without a doubt that the Western diet—which has now been exported to most corners of the globe—is a disease-creating diet, one that makes the soil ripe for the most deadly diseases in the world. Remember, this research was conducted in counties where people were genetically similar and where people across generations lived and ate in the same way every day. Comparisons of death rates were made between the dietary preferences of different counties, and the conclusion was that the people who lived in counties with a high consumption of animal products suffered considerably higher death rates from typical Western diseases like heart disease, diabetes, and a range of cancers compared to those counties who consumed more plant-based foods.

它毫無疑問地證明，西方飲食——現在已經出口到全球大部分角落——是一種造成疾病的飲食，一種使世界上最致命的疾病成熟的土壤的飲食。請記住，這項研究是在人們基因相似的縣進行的，並且幾代人每天都以相同的方式生活和飲食。對不同縣的飲食偏好進行了死亡率比較，結論是，與那些消費更多植物性食物的縣相比，生活在動物產品消費量高的縣的人患心臟病、糖尿病和一系列癌症等典型西方疾病的死亡率要高得多。

The study also proved, however, that individual nutrients matter less than the overall diet. Occasionally eating a bit of dairy or meat didn’t seem to increase disease risk in the Chinese population, but they truly did eat only a very small amount. Mere ounces of pork to flavor a soup, for example, or a tablespoon of yogurt as a sauce base. On the flipside, simply adding a “good” nutrient to one’s diet did not elicit any disease-preventing benefits. In other words, the researchers concluded that taking fish oil supplements or vitamins won’t help you build health and prevent disease if your diet is based in refined carbohydrates, animal proteins, or processed foods, as many of ours are, through habit or necessity—the hectic churn of modern life that often leaves us opening a box instead of preparing a mélange of seasonal vegetables.

然而，該研究還證明，單個營養素不如整體飲食重要。偶爾吃一點奶製品或肉類似乎不會增加中國人的疾病風險，但他們確實只吃了非常少量的量。例如，只需幾盎司的豬肉來給湯調味，或者用一湯匙優酪乳作為醬汁底料。另一方面，簡單地在飲食中添加 「好 」的營養素並不能產生任何預防疾病的好處。換句話說，研究人員得出結論，如果你的飲食以精製碳水化合物、動物蛋白或加工食品為基礎，那麼服用魚油補充劑或維生素不會説明你建立健康和預防疾病，就像我們中的許多人一樣，由於習慣或必要性——現代生活的忙碌變化經常讓我們打開一個盒子，而不是準備各種時令蔬菜。

At the end of the day, we don’t eat nutrients—we eat foods. Against the reductionist but popular view that some nutrients will prevent or heal certain diseases, Campbell and his fellow researchers concluded that the complex interaction of nutrients in food matters. What’s essential to health and healing is the overall nutritional pattern, rather than eating as usual and then taking a vitamin. The whole is greater than the sum of the parts. And for most of us, this means large, radical changes in the way we eat.

歸根結底，我們不吃營養物質——我們吃食物。與一些營養素可以預防或治癒某些疾病的還原論但流行的觀點相反，坎貝爾和他的同事們得出結論，食物中營養素的複雜相互作用很重要。對健康和康復至關重要的是整體營養模式，而不是像往常一樣吃東西然後服用維生素。整體大於各部分之和。對於我們大多數人來說，這意味著我們的飲食方式將發生巨大而根本的變化。

Campbell himself became vegan by the conclusion of the study and remains so to this day—though he doesn’t use the word to label himself. He doesn’t like the ideological baggage the term comes with and wants the focus to remain simply on the life-sustaining benefits of a plant-based diet. And today, he is diametrically opposed, philosophically, to where he started his career. “I grew up on a dairy farm. I milked cows!” he told an interviewer from The New York Times shortly after former president Bill Clinton revealed that he’d reversed his own heart disease with Campbell’s book. “The early part of my career was focused on protein, protein, protein.” But he’s flipped 180 degrees, and everything—his diet, his beliefs about health, his career—has been changed by the Cornell-China-Oxford Project.

坎貝爾本人在研究結束時成為純素者，並且直到今天仍然如此——儘管他沒有用這個詞來給自己貼標籤。他不喜歡這個詞帶來的意識形態包袱，並希望重點僅僅停留在植物性飲食對維持生命的好處上。而今天，他在哲學上與他開始職業生涯的地方截然相反。“我在奶牛場長大。在前總統比爾·柯林頓（Bill Clinton）透露他已經通過坎貝爾的書逆轉了自己的心臟病后不久，他對《紐約時報》的採訪者說。“我職業生涯的早期專注於蛋白質、蛋白質、蛋白質。”但他已經發生了 180 度大轉彎，他的飲食、他對健康的信念、他的職業——都被康奈爾大學-中國-牛津項目改變了。

He wrote a book about the project, called The China Study, which he published through a relatively obscure small press in Texas in 2005. Nobody expected a book preaching the revolutionary health benefits of eating plants to make much of a splash, but The China Study has now sold over one million copies—making it a runaway bestseller and one of the top-selling books on nutrition of all time. And yet, despite the success of the book and the lauding of the project itself in the scientific community, we have been shockingly slow to absorb this knowledge or to integrate it in any meaningful way into our health-care system. I know only a scattering of physicians and health-care providers who eat healthfully themselves or who teach others how to do the same. What is also astonishing is that this, the largest study on health and nutrition ever completed, seems to be unknown to most physicians and nurses, much less integrated into our practices.

他寫了一本關於這個專案的書，叫《中國研究》（The China Study），2005年通過德克薩斯州一家相對不起眼的小出版社出版。沒有人期望一本宣揚食用植物的革命性健康益處的書會引起轟動，但《中國研究》現在已經售出超過 100 萬冊——使其成為一本失控的暢銷書，也是有史以來最暢銷的營養書籍之一。然而，儘管這本書取得了成功，而且該專案本身在科學界受到了讚揚，但我們在吸收這些知識或以任何有意義的方式將其整合到我們的醫療保健系統方面卻慢得令人震驚。我只知道零星的醫生和醫療保健提供者自己吃得健康，或者教別人如何做同樣的事情。同樣令人驚訝的是，這是有史以來最大的健康和營養研究，大多數醫生和護士似乎都不知道，更不用說融入我們的實踐了。

Why are we pulled toward foods that are bad for us? Why do our appetites tug us toward all the types of foods that the China Study revealed to be harmful? We’ve built an entire culture of food around a way of eating that is not medicinal for us but that instead feeds diseases that can hamper our quality and enjoyment of life (at best), and end our lives early (at worst). The more I uncovered about spontaneous healing, the more signs pointed toward the inherent intelligence of the body and its innate ability to heal. But if our bodies and immune systems are so smart, why don’t we gravitate toward foods that make us healthier, instead of sicker?

為什麼我們被拉向對我們有害的食物？為什麼我們的食慾會吸引我們去吃中國研究顯示的所有類型的有害食物？我們圍繞著一種飲食方式建立了一整套飲食文化，這種飲食方式對我們來說不是藥用的，而是滋生了疾病，這些疾病可以阻礙我們的生活品質和享受（最好的情況），並提前結束我們的生命（最壞的情況）。我對自發癒合的瞭解越多，就越有跡象表明身體的內在智慧及其與生俱來的治癒能力。但是，如果我們的身體和免疫系統如此聰明，為什麼我們不傾向於讓我們更健康而不是更病的食物呢？

WHY AREN’T OUR BODIES SMARTER?

為什麼我們的身體不更聰明呢？

The short answer to this is: they are smart. But to understand the body’s intelligence on nutrition and cravings, you have to go back in time. Really far back.

對此的簡短回答是：他們很聰明。但要瞭解身體對營養和渴望的智慧，你必須回到過去。真的很久遠。

As humans, we’re hardwired to experience cravings and to act on them. Cravings for certain foods, usually ones high in fat, sugar, or salt—those substances that were all too rare when we were just emerging as a species—are triggered by the pleasure centers in our brains. When you follow a craving and eat whatever you’re yearning for, sinking your teeth into a chocolate bar or a crisp slice of bacon, that reward center in your brain goes nuts, dumping dopamine into your bloodstream like a slot machine spewing nickels. And that dopamine, often called the pleasure pathway, hits your bloodstream fast. You feel the impact immediately.

作為人類，我們天生就會體驗到渴望並採取行動。對某些食物的渴望，通常是高脂肪、高糖或高鹽的食物——這些物質在我們剛剛成為一個物種時太罕見了——是由我們大腦中的快樂中心觸發的。當你追隨渴望，吃你渴望的任何東西，把牙齒浸入巧克力棒或一片酥脆的培根中時，你大腦中的獎勵中心就會發瘋，像噴出鎳的老虎機一樣將多巴胺傾倒到你的血液中。而這種多巴胺，通常被稱為快樂通路，會迅速進入你的血液。您會立即感受到影響。

Sugar, one of the hardest food habits to kick (and, if the science of spontaneous healing has anything to say about it, the most necessary to kick), lights up the pleasure pathway the same way that other powerful pleasure stimulants do. Sex lights it up, too, as can less healthy habits like recreational drugs. We like things that release dopamine into the brain and body, whether they are good for us or not. We are driven to repeat them, to hunt them down again and again.

糖是最難戒掉的飲食習慣之一（如果自發療癒的科學有什麼要說的，那就是最必要的戒掉），它像其他強大的快樂興奮劑一樣照亮快樂途徑。性也點亮了它，消遣性藥物等不太健康的習慣也是如此。我們喜歡將多巴胺釋放到大腦和身體中的東西，無論它們是否對我們有益。我們被迫重複它們，一次又一次地追捕它們。

So if a lot of these things that flip on the pleasure switch aren’t good for us, what’s the benefit? Why are we wired this way?

那麼，如果很多這些打開快樂開關的東西對我們沒有好處，那有什麼好處呢？為什麼我們是這樣連接的？

For our early ancestors, where they found their next meal—and what it consisted of—was often the difference between life and death. From an evolutionary perspective, calorically dense foods—fatty, sugary foods, essentially—were not readily available. They were few and far between and hard fought. High-protein foods like meat helped our ancestors develop crucial muscle mass. And sugar, beyond the quick burst of energy it gives you (which burns off quickly), actually has a secondary function that was especially useful to our scrappy ancestors: it helps your body store fat. In a world of scarcity, you need to be able to burn your own body fat for fuel. Sugar, whether in the form of glucose or fructose, activates processes in the body that help you store and hang on to fat for later. Eat it, and you increase your chances for survival. In a study where kids were given a test to see whether they preferred a sweet solution or a salty one, those who preferred the sweet solution tended, upon follow-up years later, to be taller as adults. Our ancestors who sought out and fought for sugar probably had a better chance of passing down their genes … and becoming us.

對於我們的早期祖先來說，他們在哪裡找到下一頓飯——以及它包括什麼——往往是生與死的區別。從進化的角度來看，熱量高的食物——本質上是脂肪、含糖的食物——並不容易獲得。他們人數眾多，相距甚遠，而且打得很艱苦。肉類等高蛋白食物幫助我們的祖先發展了關鍵的肌肉品質。而糖，除了它給你的快速爆發能量（很快就會燃燒掉）之外，實際上還有一個次要功能，對我們好鬥的祖先特別有用：它説明你的身體儲存脂肪。在一個稀缺的世界里，你需要能夠燃燒自己的體內脂肪作為燃料。糖，無論是葡萄糖還是果糖形式，都會啟動體內的過程，幫助您儲存和保留脂肪以備後用。吃了它，你就會增加生存的機會。在一項研究中，孩子們被測試以查看他們更喜歡甜溶液還是鹹溶液，那些喜歡甜溶液的人在幾年後的隨訪中往往比成年人更高。我們尋找糖併為之奮鬥的祖先可能有更好的機會將他們的基因傳承下來......並成為我們。

So because high-sugar, high-fat foods were linked to survival, our bodies rewarded us for acquiring it—adding the squirt of dopamine that underlined how great it was to eat. These types of foods have a physical, mental, and emotional effect on us. They’re soothing. Even just the slightest taste of sugar can give us an energy boost—studies have found that people who had just a taste of a sugary substance performed better on memory and acuity tests. Children are so hardwired to love it that studies found that it was a natural pain reliever—hospitals even used to give it to babies before circumcisions.

因此，由於高糖、高脂肪的食物與生存有關，我們的身體會獎勵我們獲得它——添加多巴胺的噴射，強調吃東西是多麼美味。這些類型的食物對我們的身體、心理和情感都有影響。他們很舒緩。即使是最輕微的糖味也能給我們帶來能量提升——研究發現，只嘗過含糖物質的人在記憶力和敏銳度測試中表現更好。孩子們天生就喜歡它，以至於研究發現它是一種天然的止痛藥——醫院甚至在包皮環切術之前給嬰兒服用。

Cravings are natural and contributed enormously to our survival as a species. But when the pleasure pathway gets trampled too many times—when that dopamine rush becomes a habit and the stimulant-reward cycle goes on over and over again—a craving can rapidly become an addiction, especially when substances that used to be scarce are now bountiful. And in the span of human history, pure sugar has only been as bountiful as it is today for a very short time.¹² Technology has risen around us like a flood, bringing with it an availability of foods at our fingertips that our ancestors might have literally died for. And yet as the world has upgraded, our biological programming has not. As Dr. Peter Diamandis, cofounder of Singularity University, likes to put it, “Humans haven’t had a software upgrade in 200,000 years.”

渴望是自然的，對我們作為一個物種的生存做出了巨大貢獻。但是，當快樂途徑被踐踏太多次時——當多巴胺衝動成為一種習慣，興奮劑-獎勵迴圈一遍又一遍地進行時——渴望會很快變成一種成癮，尤其是當曾經稀缺的物質現在變得豐富時。在人類歷史的跨度中，純糖的豐富程度只在很短的時間內達到今天。¹²技術像洪水一樣在我們周圍崛起，為我們帶來了觸手可及的食物，我們的祖先可能真的為之而死。然而，隨著世界的升級，我們的生物程式設計並沒有。正如奇點大學的聯合創始人彼得·迪亞曼迪斯博士喜歡說的那樣，“人類已經 200,000 年沒有升級過軟體了。

Our bodies and minds aren’t well suited to live in the modern world. What we call hunger is often addiction and may be akin to craving and withdrawal. Researchers have found that sugar can be more addictive than nicotine or even cocaine. It literally produces a high, not unlike a recreational drug.¹³ Certainly, individuals have told me—and from personal experience, I agree—that the true hunger that one experiences after making the transition to whole, natural foods simply feels different and is less associated with craving. A body that is receiving the nutrition it needs simply doesn’t crave in the same way.

我們的身體和思想並不適合生活在現代世界。我們所說的饑餓通常是成癮，可能類似於渴望和退縮。研究人員發現，糖比尼古丁甚至可卡因更容易上癮。它確實會產生一種興奮，就像一種消遣性藥物一樣。¹³當然，有人告訴我——從個人經驗來看，我同意——一個人在過渡到完整的天然食物后所經歷的真正饑餓感只是感覺不同，與渴望的聯繫較小。獲得所需營養的身體根本不以同樣的方式渴望。

We can’t zap ourselves back in time to the Paleolithic era in order to eat to heal. Our needs are different now. We need to find a way to get what we need here and now, even while surrounded by all these foods that are not medicine for our bodies.

我們不能為了吃東西來治癒而把自己帶回到舊石器時代。我們現在的需求不同了。我們需要找到一種方法來獲得我們現在需要的東西，即使被所有這些對我們身體不是藥物的食物所包圍。

WRITING YOUR OWN (FOOD) PRESCRIPTION

編寫自己的（食物）處方

For Pablo Kelly (whom we met at the beginning of this chapter), it started with what he thought was a stroke, incapacitating him as he strolled down a country road. What it led to was writing his own prescription for a radically different diet.

對於 Pablo Kelly（我們在本章開頭遇到他）來說，它始於他認為是中風的一次，當他漫步在鄉間小路上時，他失去了行動能力。這導致他自己為一種截然不同的飲食開出了處方。

A slim, dark-haired twenty-five-year-old, Pablo had always been pretty healthy. It was an ordinary day; he’d just finished up some work in the garden, put away his gardening tools, brushed the dirt off his knees. He headed out to meet his girlfriend—they had plans. While he was walking, he experienced the strangest sensation. His left leg suddenly went deadweight heavy, dragging behind him. He tried to reach down and touch it, but his left arm wasn’t responding. The entire left side of his body had gone completely numb.

25 歲的 Pablo 身材苗條，黑髮，一直都很健康。這是普通的一天;他剛剛完成了花園裡的一些工作，收起了他的園藝工具，刷掉了膝蓋上的泥土。他出去見他的女朋友——他們有計劃。當他走路時，他體驗到了最奇怪的感覺。他的左腿突然變得沉重起來，拖在身後。他試圖伸手去摸它，但他的左臂沒有反應。他整個身體的左側已經完全麻木了。

At first, it was temporary. A doctor checked him out and suggested it was a severe migraine—a fluke. But it happened again at work, and then again while he was getting dressed for his sister’s wedding, cinching up his tie: his jaw drooped, his hand went numb.

起初，這是暫時的。一位醫生給他檢查了一下，認為這是嚴重的偏頭痛——一種僥倖。但這種情況在工作中再次發生，然後當他為姐姐的婚禮穿衣服時，他又一次系緊了領帶：他的下巴下垂，手麻木了。

An MRI showed the tumor—a golf ball, lodged in his temporal lobe, an area of the brain that helps you process what you hear and see, and also plays a critical role in language, speech, and personality. It’s also part of the memory cortex—essentially, a tape recorder that turns all those sensations into concrete memories and writes them down. A biopsy diagnosed a glioblastoma multiforme, stage IV. The tumor was inoperable, but they offered him chemo and radiation therapy. Not to cure him, of course—just to extend his life. With treatment, his doctors said, he could perhaps get himself a year. The specific type of glioblastoma multiforme he likely had, called anaplastic astrocytoma, might mean that he had only months to live.

MRI 顯示腫瘤——一個高爾夫球，卡在他的顳葉中，顳葉是大腦的一個區域，可以説明你處理你聽到和看到的東西，並且在語言、言語和性格中也起著關鍵作用。它也是記憶皮層的一部分——本質上，它是一個錄音機，將所有這些感覺轉化為具體的記憶並記錄下來。活檢診斷為多形性膠質母細胞瘤，IV 期。腫瘤無法手術，但他們為他提供了化療和放射治療。當然，不是為了治癒他——只是為了延長他的壽命。他的醫生說，通過治療，他也許可以讓自己活一年。他可能患有的特定類型的多形性膠質母細胞瘤，稱為間變性星形細胞瘤，可能意味著他只剩下幾個月的壽命了。

In the radiotherapy room, they trimmed his beard with scissors, laid him down on the table, and draped a warm sheet over his face—it was light, made of mesh. As it cooled, hardening into a mask, Pablo’s treatment team made preparations for his first round of radiotherapy. Radiotherapy is a form of treatment where therapists map out the tumor site and direct a beam of radiation at it to kill the cancer cells. Like all treatments, it comes with its own set of side effects that patients have to weigh against the benefits when they make decisions surrounding possible treatments.

在放射治療室里，他們用剪刀修剪了他的鬍鬚，把他放在桌子上，用一條溫暖的床單蓋在他的臉上——它很輕，由網眼製成。當它冷卻並硬化成面罩時，Pablo 的治療團隊為他的第一輪放療做準備。放射療法是一種治療形式，治療師繪製出腫瘤部位並將輻射束對準其以殺死癌細胞。像所有治療方法一樣，它有自己的一系列副作用，患者在決定可能的治療方法時必須權衡其益處。

Lying on the hard, movable bed, waiting for the radiotherapy machine to be ready, Pablo rapidly scrolled through all the thoughts and questions he’d had about this course of treatment in the weeks leading up to it. He’d been having hesitations about doing chemo and radiotherapy. If there was a chance it would save his life, he’d do it, but that’s not what they were talking about. They were talking only about extending. And yes, of course he wanted more time. There were so many things he wanted to do, including become a father someday. He and his girlfriend had been talking about it, as something to do a little ways down the road. Now it seemed like the pavement had crumbled away, leaving only a chasm in its wake. The future, on the other side of that gulf, was now unreachable. There was no road there.

Pablo 躺在堅硬、可移動的床上，等待放射治療機準備就緒，他快速流覽了他在治療前幾周對這一治療過程的所有想法和問題。他一直在猶豫是否要接受化療和放療。如果有機會救他的命，他會這樣做，但這不是他們談論的。他們只是在談論延長。是的，他當然想要更多的時間。他想做很多事情，包括有朝一日成為父親。他和他的女朋友一直在談論這件事，作為以後要做的事情。現在，人行道似乎已經崩塌，只留下一道裂縫。在那道鴻溝的另一邊，未來現在是遙不可及的。那裡沒有路。

Conversations and thoughts bounced around his head like Ping-Pong balls. He’d read over the side effects of chemo and radiotherapy and had grown more concerned. How is this going to affect me? he’d been asking everyone on his treatment team. Is it going to make me better, or is it going to make me worse? Nobody seemed to have a clear answer. He’d also been researching diet and the potential impact it could have on the trajectory of different types of cancer. He’d read about Patricia Daly, who’d recovered from a type of eye cancer using the ketogenic diet, and he was curious if it could work for him. Maybe it was worth a try? Research seemed to indicate that it could starve tumor cells and bring down inflammation and swelling around the site. But when he asked about it, his doctors brushed off the idea, even advising him against it. “It has no nutritional value,” they told him. “It won’t help you with the chemo and radiation.” But maybe he didn’t want help getting through the chemo and radiation that would only tack a couple of crappy months onto his already short life.

對話和思緒像乒乓球一樣在他的腦海中跳動。他閱讀了化療和放療的副作用，並變得更加擔心。這對我有什麼影響？他一直在詢問他的治療團隊中的每個人。它會讓我變得更好，還是會讓我變得更糟？似乎沒有人有明確的答案。他還一直在研究飲食及其可能對不同類型癌症的軌跡產生的潛在影響。他讀過派特裡夏·戴利 （Patricia Daly） 的故事，她使用生酮飲食從一種眼癌中康復，他很好奇這是否對他有用。也許值得一試？研究似乎表明，它可以使腫瘤細胞饑餓並降低該部位周圍的炎症和腫脹。但當他問起這件事時，他的醫生不理會這個想法，甚至建議他不要這樣做。“它沒有營養價值，”他們告訴他。“它對化療和放療沒有説明。”但也許他不想得到幫助來度過化療和放療，這隻會給他本已短暫的生命帶來幾個月的糟糕生活。

As the mesh on his face lightly hardened against his skin, it hit him: he didn’t want quantity of life. He wanted quality. He wanted to have a life for the time he had left—not come here to lie on this table six days a week for radiation and then have chemo on Sundays.

當他臉上的網眼在他的皮膚上輕輕變硬時，他突然意識到：他不想要大量的生命。他想要的是品質。他想在他剩下的時間里過上好日子——而不是來這裡每週六天躺在這張桌子上接受放療，然後在周日接受化療。

He sat bolt upright and got off the table. The therapists stopped what they were doing and looked at him in surprise.

他坐直了身子，從桌子上下來。治療師停下了他們正在做的事情，驚訝地看著他。

“I’m not going to do this,” he told them, peeling the mesh off. “You can keep the mask.”

“我不會這樣做的，”他對他們說，一邊剝下網眼。“你們可以保留口罩。”

He launched into the ketogenic diet. Most people find the keto diet difficult to adhere to; it’s extremely specific and limiting. But Pablo was determined. He thought of it like quitting smoking, which he’d done a few years before after being a smoker for ten years. Quitting was miserable and hard and almost drove him crazy, but he’d done it. And he knew he could do this.

他開始了生酮飲食。大多數人發現生酮飲食很難堅持;它非常具體和有限。但巴勃羅決心堅定。他認為這就像戒煙一樣，他在吸煙十年後幾年前就這樣做了。放棄是痛苦和艱難的，幾乎讓他發瘋，但他做到了。他知道他可以做到這一點。

He started off with a few days of fasting, a quick way to achieve ketosis—a metabolic state where the body, deprived of glucose (which, as we discussed earlier, cancer cells feed on) begins to break down its own fats. For those first five days, he only broke the fast with small snacks like nuts or leafy greens. Once he achieved ketosis, he switched into the standard ketogenic diet, which allows meats, leafy greens and green vegetables, high-fat dairy like butter, and nuts and seeds. He maintained ketosis for the next three years. Here’s what happened in that time.

他從幾天的禁食開始，這是一種實現酮症的快速方法——一種代謝狀態，身體被剝奪了葡萄糖（正如我們之前討論的，癌細胞以葡萄糖為食）開始分解自己的脂肪。在最初的五天里，他只吃堅果或綠葉蔬菜等小零食來開齋。一旦他達到酮症，他就改用標準的生酮飲食，允許肉類、綠葉蔬菜和綠色蔬菜、黃油等高脂肪乳製品以及堅果和種子。在接下來的三年裡，他一直保持酮症。以下是那段時間發生的事情。

He hit the six- to nine-month mark that his treatment team had estimated he had without chemo or radiation. He did not die. He felt better, not worse. He had quarterly scans at the clinic. He was supposed to go in, get the scan, then come back a few days later to go over the results. But scan after scan showed that the tumor growth had halted completely—a very unusual turn of events for glioblastoma multiforme. He started calling up ahead of time to ask if they could just take a look at the scan and let him know if he needed to come all the way in. Every time it was the same: “It’s stable,” the nurse would say. “No change.” To everyone’s puzzlement, the golf ball remained a golf ball.

他的治療團隊估計他沒有接受化療或放療，他的 6 到 9 個月就達到了這個目標。他沒有死。他感覺好多了，而不是更糟。他在診所每季度進行一次掃描。他本來應該進去做掃描，然後幾天后回來查看結果。但一次又一次的掃描顯示腫瘤生長已經完全停止——對於多形性膠質母細胞瘤來說，這是一個非常不尋常的事件。他開始提前打電話詢問他們是否可以看一下掃描結果，並讓他知道是否需要大老遠進來。每次都是一樣的：『情況穩定，』護士會說。沒有變化。令所有人困惑的是，高爾夫球仍然是高爾夫球。

Two years passed in that way, until Pablo’s surgeon approached him with some news: he wanted to try an operation. Usually, with glioblastoma, surgery has no benefit other than the temporary relief of symptoms. Glioblastoma has long tendrils that reach out into the surrounding brain, and the only way to remove all of the tumor would be to remove too much or all of the brain, which obviously isn’t possible. But the unprecedented two-year stability of his tumor was changing his options.

就這樣過了兩年，直到 Pablo 的外科醫生找到他，告訴他一些消息：他想嘗試手術。通常，對於膠質母細胞瘤，手術除了暫時緩解癥狀外沒有任何好處。膠質母細胞瘤有伸向周圍大腦的長卷須，切除所有腫瘤的唯一方法是切除過多或全部大腦，這顯然是不可能的。但他的腫瘤史無前例的兩年穩定正在改變他的選擇。

Surgeons performed an awake craniotomy on Pablo in the spring of 2017. Pablo lay on his side on an operating table, and the anesthesiologist briefly put him under. Nerve sensors for pain don’t exist in the brain, and for such surgeries, it’s desirable to have the person awake so the surgeon receives as much feedback as possible when poking and cutting into the brain. When they woke him up shortly after, the surgeon had removed a one-inch piece of his skull and set it aside. Disoriented and frightened, Pablo started to cry. But his neuropsychologist, sitting right in front of him in a mask and gown, grabbed his hand.

外科醫生於 2017 年春天對 Pablo 進行了清醒開顱手術。巴勃羅側躺在手術臺上，麻醉師短暫地將他置於手術臺上。大腦中不存在用於疼痛的神經感測器，對於此類手術，最好讓患者保持清醒，以便外科醫生在戳和切入大腦時收到盡可能多的反饋。當他們很快叫醒他時，外科醫生已經從他的頭骨中取出了一塊一英寸的碎片並將其放在一邊。巴勃羅迷失了方向，害怕了，開始哭泣。但是，坐在他面前、戴著口罩和長袍的神經心理學家抓住了他的手。

“Make a fist,” he said. “Squeeze my hand.”

“握緊拳頭，”他說。“捏我的手。”

He began cycling Pablo through a series of questions, showing him images, asking him to name them, periodically taking his hand again and checking his ability to squeeze. Meanwhile, the surgeon sliced into the dura, the protective membrane that surrounds the brain. Using tiny scissors, he made a snip halfway along that slice, making a T-shaped cut. He used the tip of the scissors to fold back the rubbery, translucent flaps of the dura, and there was Pablo’s brain: a pale, healthy pink, mapped with bright red veins and capillaries, slick and alive. Next, he gently parted the delicate, gelatinous lobes of Pablo’s brain to reveal the tumor. It was firm and whitish, irregularly shaped, and it had tendrils like octopus arms that reached deeper into the brain. The brain tissue surrounding it had turned a pale purple, the color of a bruise. The tumor obviously didn’t belong.

他開始讓 Pablo 回答一系列問題，給他看圖片，讓他說出名字，不時再次握住他的手，檢查他的擠壓能力。與此同時，外科醫生切開了硬腦膜，即圍繞大腦的保護膜。他用小剪刀在那片片的一半剪了一剪，做了一個 T 形的切口。他用剪刀的尖端把硬腦膜的橡膠狀半透明皮瓣向後摺疊，這就是巴勃羅的大腦：一種蒼白、健康的粉紅色，上面有鮮紅色的靜脈和毛細血管，光滑而有活力。接下來，他輕輕地分開 Pablo 大腦中脆弱的凝膠狀葉，露出腫瘤。它又硬又白，形狀不規則，有像章魚手臂一樣的捲須，可以深入大腦。它周圍的腦組織已經變成了淡紫色，就像瘀傷一樣。那個腫瘤顯然不屬於這個腫瘤。

After hours of painstaking surgery, making microscopic cuts to the membranous edges of the tumor to loosen it from the brain tissue while a nurse dripped saline solution onto the site, the neurosurgeon was able to get 90 percent of it out. They recommended chemo and radiation therapy to shrink the remaining 10 percent. Or, they told him, he could just “keep doing what you’re doing.” Pablo reports that nobody seemed willing to admit that his strict adherence to the ketogenic diet was the factor that had allowed him to stabilize his tumor until he had the opportunity for surgery—but at the same time, they admitted that something unusual was going on. They just kept referring to it vaguely as “whatever it is you’re doing.”

經過數小時的艱苦手術，在腫瘤的膜邊緣進行顯微鏡切割以使其從腦組織中鬆動，同時護士將生理鹽水滴到該部位，神經外科醫生能夠將其取出 90%。他們建議化療和放療來縮小剩餘的 10%。或者，他們告訴他，他可以 「繼續做你正在做的事情」。。巴勃羅報告說，似乎沒有人願意承認他嚴格遵守生酮飲食是使他能夠穩定腫瘤直到有機會進行手術的因素——但與此同時，他們承認正在發生一些不尋常的事情。他們只是一直含糊地將其稱為“無論你在做什麼”。

Pablo kept doing “whatever it was” for the next few months. And at the next scan, the remaining tumor was gone.

在接下來的幾個月里，Pablo 一直在做 「任何它是什麼」。。在下一次掃描時，剩餘的腫瘤已經消失了。

Since then, quarterly scans have continued to come back clean. He remains on the ketogenic diet and plans to stay on it indefinitely. When I asked if he ever planned to go back to eating the way he used to, he was adamant: no.

從那時起，季度掃描結果繼續保持乾淨。他仍然堅持生酮飲食，並計劃無限期地堅持下去。當我問他是否打算回到以前的飲食方式時，他堅決地說：沒有。

“This is my life now,” he says. “Glioblastoma can come back with a vengeance. I’m not going to stop eating the way my body needs me to eat just because I have clear scans now.”

“這就是我現在的生活，”他說。膠質母細胞瘤可能會報復性地捲土重來。我不會僅僅因為我現在有清晰的掃描就停止按照我的身體需要我吃的方式進食。

There’s been a lot of shock and awe at his remission. His acupuncturist had initially been sure he was going to kill himself. “I thought you were crazy,” he said. “I just kept waiting for you to start going downhill. And then at a certain point, I started thinking, ‘Damn, maybe he’s onto something.’”

人們對他的緩解感到非常震驚和敬畏。他的針灸師最初確信他會自殺。“我以為你瘋了，”他說。“我只是一直在等你開始走下坡路。然後在某個時刻，我開始想，『該死的，也許他在做某事。

His girlfriend is pregnant; they’re expecting their first child in a few months. He doesn’t take anything for granted. He knows that illness can come back, even after an unprecedented remission like his. But he’s happy now; he’s living the life he once imagined.

他的女朋友懷孕了;他們期待幾個月後的第一個孩子。他不認為任何事情都是理所當然的。他知道疾病可能會捲土重來，即使在像他這樣前所未有的緩解之後也是如此。但他現在很高興;他過著他曾經想像的生活。

“I don’t think about dying as a problem,” he says. “Everything I aimed for is coming to fruition.”

“我不認為死亡是一個問題，”他說。“我的目標正在實現。”

What are the commonalities between Tom’s, Claire’s, and Pablo’s radical diet changes? Though externally different, the similarities are critical: there is a major focus on nutrient-dense, non-starchy plant-based food, and the elimination of processed foods, chemicals, sugar, and refined carbs. In other ways, they are radically different—each had to “write their own prescription” based on his or her own situation and intuition. As Claire said of developing her post-diagnosis diet, there is no silver bullet. And I have found that to be true; there is no single set of nutrients or toxins I can isolate from cases of spontaneous healing that any one of us can add or subtract from our diets in order to heal. Any book or study that attempts to do so is misleading. As we see all too often, two different studies will come out on the same isolated nutrient with opposite results; and that information goes out to the public in parcels with no real connection, context, or genuine insight.

Tom's、Claire's 和 Pablo 的激進飲食改變之間有什麼共同點？儘管外表不同，但相似之處至關重要：主要關注營養豐富、非澱粉類的植物性食物，並消除加工食品、化學品、糖和精製碳水化合物。在其他方面，他們截然不同——每個人都必須根據自己的情況和直覺“開出自己的處方”。正如克雷爾在談到發展她的診斷后飲食時所說，沒有靈丹妙藥。我發現這是真的;我無法從自發癒合的病例中分離出任何單一的營養素或毒素，我們任何人都可以從飲食中添加或減少來治癒。任何試圖這樣做的書籍或研究都是誤導性的。正如我們經常看到的那樣，對相同的孤立營養素的兩項不同的研究會得出相反的結果;這些資訊以包裹的形式向公眾傳播，沒有真正的聯繫、背景或真正的洞察力。

In 1917, a pediatrician named Sidney Haas discovered a miracle cure for celiac disease, which was ravaging a large number of New York City’s children. He’d been struggling for years to find relief for his young patients’ painful symptoms, including gastrointestinal distress, malnutrition, stunted growth, and even death. The miracle cure was bananas.

1917 年，一位名叫西德尼·哈斯 （Sidney Haas） 的兒科醫生發現了一種治療乳糜瀉的神奇方法，乳糜瀉正在蹂躪著紐約市的大量兒童。多年來，他一直在努力尋找緩解年輕患者痛苦癥狀的方法，包括胃腸道不適、營養不良、生長遲緩，甚至死亡。神奇的治療方法是香蕉。

Haas found that when he fed his patients a diet heavy in bananas, their symptoms rapidly subsided. They gained back weight and began to flourish. He theorized that the banana was a superfood with curative properties, and he wrote a medical paper extolling the effects the banana treatment had on his young patients, including before-and-after photos that showed their growth and amazing transformation.

哈斯發現，當他給病人餵食香蕉含量高的飲食時，他們的癥狀會迅速消退。他們的體重增加了，開始蓬勃發展。他理論上認為香蕉是一種具有治療特性的超級食品，他寫了一篇醫學論文，讚揚香蕉治療對他的年輕患者的影響，包括展示他們成長和驚人轉變的前後照片。

I’m sure their transformations were amazing; their health turned around so suddenly because they were eating so many bananas that they simply weren’t eating bread anymore. Gluten is the toxin for individuals with celiac disease; this simple protein found in wheat flour destroys the cilia of the stomach, making it impossible to absorb nutrients. Dr. Haas had indeed cured his patients, but he misinterpreted his results. They didn’t recover because they were eating bananas, they recovered because they weren’t eating gluten.

我敢肯定他們的轉變是驚人的;他們的健康情況突然好轉，因為他們吃了太多香蕉，以至於他們根本就不再吃麵包了。麩質是乳糜瀉患者的毒素;這種在小麥粉中發現的簡單蛋白質會破壞胃的纖毛，使其無法吸收營養。哈斯醫生確實治癒了他的病人，但他誤解了他的結果。他們沒有恢復是因為他們吃了香蕉，他們恢復了是因為他們沒有吃麩質。

The China Study almost fell prey to a similar misinterpretation of findings: the research team initially found a correlation between heart disease and wheat flour in a particular region of the country and came to the conclusion that wheat flour was bad. But with a little more digging, it turned out that the spike in heart disease they noted wasn’t about what people were eating but what they weren’t. In this northern region, vegetables were scarce, so people subsisted mostly on grains and starches. It wasn’t that eating wheat flour caused heart disease—it was that eating mostly vegetables prevented it.

中國研究幾乎淪為對研究結果的類似誤解的犧牲品：研究小組最初發現該國某個特定地區的心臟病與小麥粉之間存在相關性，並得出結論認為小麥粉是有害的。但經過更多的挖掘，他們發現他們注意到的心臟病激增不是關於人們吃什麼，而是他們沒有吃什麼。在這個北方地區，蔬菜稀缺，因此人們主要靠穀物和澱粉維持生計。並不是吃小麥粉會導致心臟病——而是主要吃蔬菜可以預防心臟病。

When we zoom out to look at the big picture of diet, health, disease, and the possibility of spontaneous healing, what we see is that a radical change in food philosophy is required for many of us to get on the path to health. It’s not about the food pyramid as it is currently constructed; it’s not about calorie counting or adding or taking away a particular food. It’s about nutritional density and understanding what this means.

當我們放大視野來看待飲食、健康、疾病和自發治癒的可能性時，我們看到的是，我們中的許多人需要徹底改變飲食哲學才能走上健康之路。這與目前構建的食物金字塔無關;這與計算卡路里或添加或減少特定食物無關。這與營養密度和理解這意味著什麼有關。

Remember the ANDI Scale? That’s a great starting place. But the thing to understand and internalize is that you want to be increasing your intake of the foods that carry the most vitamins, minerals, and phytochemicals and eliminating empty calories or foods that contain a high proportion of calories and relatively little of what your body genuinely needs to be at its cellular best. And what, exactly, are phytochemicals? They are natural compounds that are found in fruits, vegetables, and whole grains (phyto means plant) and give these foods their color, flavor, and aroma. Although many of them still need to be identified and better understood, what we know so far is that at least some of them are powerful antioxidants and serve to protect plants from disease, insect invasion, and pollution. And they do the same thing for us. They protect our cells from free radicals, thereby keeping our cells healthy and reducing our risk of disease.

還記得 ANDI 量表嗎？這是一個很好的起點。但要理解和內化的是，您希望增加攜帶最多維生素、礦物質和植物化學物質的食物的攝入量，並消除空卡路里或含有高比例卡路里的食物，而您的身體真正需要的卡路里相對較少，以保持細胞最佳狀態。植物化學物質到底是什麼？它們是存在於水果、蔬菜和全穀物（phyto 意思是植物）中的天然化合物，並賦予這些食物顏色、風味和香氣。儘管其中許多仍需要識別和更好地理解，但到目前為止我們所知道的是，它們中至少有一些是強大的抗氧化劑，可以保護植物免受疾病、昆蟲入侵和污染。他們為我們做了同樣的事情。它們保護我們的細胞免受自由基的侵害，從而保持我們的細胞健康並降低我們患病的風險。

As this book went to press, a group of thirty-seven leading experts published their conclusions and recommendations for what they dubbed a “planetary health diet” in The Lancet after three years of poring over the best worldwide evidence regarding nutrition and the environment.¹⁴ Led in part by Walter Willett at Harvard’s School of Public Health and less influenced by the industry groups that have shaped and limited our understanding of nutrition for decades, they drew the same conclusions that I’ve seen with remarkable survivors: far more fruits and vegetables, whole grains, legumes, and nuts, and far less meat, dairy, refined flours, and sugar. They call on developed countries to slash meat consumption by 80 percent, which, for the average American, suggests eating only about one cheeseburger per week.

隨著這本書的出版，一個由 37 位領先專家組成的小組在《柳葉刀》上發表了他們對他們所謂的“地球健康飲食”的結論和建議，經過三年的仔細研究，有關營養和環境的全球最佳證據。¹⁴在哈佛大學公共衛生學院的沃爾特·威利特 （Walter Willett） 的領導下，他們受幾十年來塑造和限制我們對營養理解的行業團體的影響較小，他們得出的結論與我在傑出的倖存者身上看到的結論相同：水果和蔬菜、全穀物、豆類和堅果要多得多，而肉類、乳製品、 精製麵粉和糖。他們呼籲發達國家將肉類消費量減少 80%，對於普通美國人來說，這意味著每周只吃一個左右的芝士漢堡。

This is a level of unparalleled leadership regarding the problems with nutrition, hunger, and obesity that are facing us around the world and presages well the issues facing us as we move into a world with unprecedented opportunities for health and vitality, not only for the privileged but for all people.

對於我們在世界各地面臨的營養、饑餓和肥胖問題，這是一種無與倫比的領導水準，並很好地預示著當我們進入一個擁有前所未有的健康和活力機會的世界時，我們面臨的問題，不僅對特權階層，而且對所有人。

Nutrition is a large, important topic but not the main or exclusive focus of this book, and neither is it for most survivors. I’ll make just four brief but important points here. First, it’s important to understand that unhealthy levels of sugar and salt are hidden in most processed foods, sugar often disguised as corn syrup or under other names. Second, just because something is advertised as “healthy,” as a “health food,” or as containing healthy ingredients doesn’t mean that it is or does. “Whole wheat bread,” for example, is almost always made mostly with enriched flour, which means that it isn’t made from whole wheat. Third, eating is a way of sharing love and community, and food habits are highly linked to traditions. The goal at the end of this process is improved quality of life rather than less. Life, relationships, and food are complex, so being practical is important. Fourth, when making nutritional changes, it’s critical to focus on the nutrition you’re giving your body and being grateful for that, rather than focusing on what you can’t have. This shift of focus is critical for beating the mental game, for building a mind-set that works for you rather than against what you are trying to accomplish. It takes some work to educate yourself and figure out the details of this new path, but there is no substitute for true knowledge and real understanding when it comes to what you are putting into your body.

營養是一個大而重要的話題，但不是本書的主要或唯一關注點，對大多數倖存者來說也不是。我在這裡只提出四個簡短但重要的要點。首先，重要的是要瞭解大多數加工食品中隱藏著不健康的糖和鹽水準，糖通常偽裝成玉米糖漿或以其他名稱出現。其次，僅僅因為某樣東西被宣傳為“健康”、“健康食品”或含有健康成分，並不意味著它是或確實如此。例如，“全麥麵包”幾乎總是主要用濃縮麵粉製成，這意味著它不是由全麥製成的。第三，飲食是分享愛和社區的一種方式，飲食習慣與傳統高度相關。這個過程結束時的目標是提高生活品質，而不是減少。生活、人際關係和食物都很複雜，因此務實很重要。第四，在進行營養改變時，關鍵是要關注你給身體的營養併為此心存感激，而不是專注於你不能擁有的東西。這種關注點的轉移對於擊敗心理遊戲、建立適合你而不是與你正在努力完成的目標相悖的心態至關重要。需要一些工作來教育自己並弄清楚這條新道路的細節，但是當涉及到你攝入體內的東西時，真正的知識和真正的理解是無可替代的。

When I look back at the videos from my first trip to Brazil more than fifteen years ago, I see a completely different man in every way. I don’t recognize myself physically. I don’t recognize the conflict and confusion I was clearly feeling about whether spontaneous healing was worth researching. And I have a completely different body. It’s nearly impossible for me to get ill any longer, no matter the degree of exposure.

當我回顧 15 年前我第一次去巴西旅行的視頻時，我在各個方面都看到了一個完全不同的人。我無法從身體上認出自己。我沒有意識到我顯然對自發療病是否值得研究的衝突和困惑。而我有一個完全不同的身體。無論暴露程度如何，我幾乎不可能再生病了。

When I could no longer ignore the lessons from the stories of spontaneous healing I was hearing and seeing, I began making my own gradual changes. For the most part, I dropped sugar; I didn’t realize until I did how addicted I was to it, and the initial steps were difficult. I dropped processed foods, also initially difficult. Forty pounds melted off my frame, without any other lifestyle changes. Even those two simple changes had drastic and immediate effects.

當我無法再忽視我所聽到和看到的自發治癒故事的教訓時，我開始逐漸做出自己的改變。在大多數情況下，我掉了糖;直到我這樣做了，我才意識到我對它有多麼上癮，而且最初的步驟很困難。我放棄了加工食品，最初也很困難。四十磅的體重從我的身體上融化了，沒有任何其他生活方式的改變。即使是這兩個簡單的改變也產生了巨大而直接的效果。

Now when I’m eating, what I think about is nutritional density. Is what I’m putting into my body loaded with nutrients?

現在當我吃東西時，我考慮的是營養密度。我攝入體內的物質是否富含營養？

It’s important to be practical when it comes to food. We all need to eat, and most of us live busy lives in the context of particular relationships and a complex, unique mix of responsibilities, financial resources, and the availability of different kinds of foods and traditions. Whatever path you choose has to work for you. You don’t want to compromise your health just because you’re surrounded by a context that doesn’t support your best possible health.

在食物方面，務實很重要。我們都需要吃飯，我們大多數人都生活在特定關係和複雜、獨特的責任、財務資源以及不同種類的食物和傳統的供應的背景下。無論你選擇什麼道路，都必須適合你。您不想僅僅因為您周圍的環境不支援您的最佳健康情況而損害您的健康。

This is how I do it. It won’t work for everyone because if you’re living in some parts of the world—rural counties, for example—you simply won’t have a Whole Foods down the street. I am usually on the go, so I know where good salad and hot bars with healthy items are with food to go. I mostly eat vegetables, legumes, fish, and nuts, similar to the Mediterranean diet, and have learned over time that knowledgeable people know how to prepare great-tasting versions of these foods. Family dinners usually consist of a great-tasting vegetable recipe, often with a sweet potato or, less often, a piece of fish, and I know the restaurants where healthy versions of the same are available. More and more books are coming out containing hundreds of fabulous, genuinely healthy recipes, illustrating how you can continue eating healthy versions of the foods you love. For example, I love pizza and ice cream and am delighted to see that riced cauliflower and even prepared cauliflower crusts are increasingly available as a substitute for pizza flour and that such indulgences as avocado ice cream can be easily made and stored.

我就是這樣做的。它並不適合所有人，因為如果您生活在世界的某些地區（例如農村縣），那麼您根本不會在街上擁有 Whole Foods。我通常在旅途中，所以我知道哪裡有好的沙拉和帶有健康食品的熱吧，還有食物可以帶走。我主要吃蔬菜、豆類、魚和堅果，類似於地中海飲食，隨著時間的推移，我瞭解到知識淵博的人知道如何準備這些食物的美味版本。家庭聚餐通常包括美味的蔬菜食譜，通常配一個紅薯，或者不太常見的是一塊魚，我知道哪些餐廳提供相同的健康版本。越來越多的書籍問世，其中包含數百種精彩的、真正健康的食譜，說明如何繼續吃自己喜歡的食物的健康版本。例如，我喜歡披薩和霜淇淋，很高興看到花椰菜丁甚至準備好的花椰菜皮越來越多地作為披薩粉的替代品，而且像鱷梨霜淇淋這樣的放縱可以很容易地製作和儲存。

The pattern is: survivors of incurable diseases tend to fill their diets primarily with these nutrient-dense, medicinal foods—the kinds of foods they served in Abadiânia in 2002 and in rural China in 1983; the kinds that Tom Wood and his wife cooked up in their kitchen together after throwing everything in their pantry away. Tom, now in his early seventies, says he feels younger than he did fifteen years ago. And his numbers support that, on many counts, he actually is younger.

模式是：不治之症的倖存者往往主要用這些營養豐富的藥膳來填滿他們的飲食——他們 2002 年在阿巴迪亞尼亞和 1983 年在中國農村供應的那種食物;湯姆伍德和他的妻子把儲藏室里的所有東西都扔掉后，在廚房裡一起煮的那種。湯姆現在已經七十出頭了，他說他覺得自己比十五年前更年輕了。他的數據證明，在許多方面，他實際上更年輕。

“I only have one regret,” Tom says now, “and that is that I didn’t try this sooner. If any doctor had ever suggested to me that I might be able to cure this disease through diet, I absolutely would have done it fifteen years ago.”

“我只有一個遺憾，”湯姆現在說，“那就是我沒有早點嘗試。如果有醫生曾經向我建議我可以通過節食治癒這種疾病，我絕對會在15年前就這樣做。

A CONUNDRUM

一個難題

My deep dive into diet, and the way big changes in nutrition can roll back illness, had been incredibly illuminating. It was clear that for a lot of people, diet changes can be the doorway into radical healing if you can truly shift to a way of eating where food becomes medicine. But here’s the hitch: I kept seeing cases, tossed into the ointment of spontaneous remissions like flies, where the individual made no real diet changes and still experienced a spontaneous healing. Or conversely, there were those who made all the right dietary changes and it didn’t make a dent in their illnesses. I knew diet was often a huge piece, and I wished that I could offer a perfect, nutrient-dense diet that would hand all of us the keys to healing. But it was clear that this was going to be a harder puzzle to solve.

我對飲食的深入研究，以及營養的重大變化可以逆轉疾病的方式，都非常有啟發性。很明顯，對於很多人來說，如果你真的能改變飲食方式，讓食物成為藥物，那麼改變飲食可以成為通往根治的大門。但問題是：我一直看到一些病例，像蒼蠅一樣被扔進自發緩解的藥膏中，個體沒有真正改變飲食，但仍然經歷了自發的癒合。或者反過來說，有些人做出了所有正確的飲食改變，並沒有對他們的疾病產生影響。我知道飲食往往是一個巨大的部分，我希望我能提供一種完美的、營養豐富的飲食，將治癒的鑰匙交給我們所有人。但很明顯，這將是一個更難解決的難題。

I’d read a fascinating case study that shed some light on the problem. It focused on the Rosetan people of Pennsylvania. In the 1960s, health department investigators swooped into the tiny town of Roseto to get to the bottom of why its inhabitants had such radically lower rates of heart disease than surrounding towns. A leading theory was that the tightly knit Italian community had a remarkably healthy diet, one that investigators could learn from. What they found was the exact opposite: the Rosetans smoked cigars, drank wine, fried their meat in lard and butter. Their cholesterol consumption was off the charts. They weren’t eating a “healthy” diet—what they were doing was gathering together around meals, maintaining extraordinarily close family ties. They found joy and community around the sharing and experience of food.¹⁵

我讀過一個引人入勝的案例研究，它對這個問題有所瞭解。它側重於賓夕法尼亞州的羅坦人。在 1960 年代，衛生部門的調查人員突然進入了羅塞托小鎮，以查明為什麼其居民的心臟病發病率比周邊城鎮低得多。一個主要的理論是，緊密聯繫的義大利社區的飲食非常健康，研究人員可以借鑒。他們發現的情況恰恰相反：Rosetans 抽雪茄，喝葡萄酒，用豬油和黃油油炸肉。他們的膽固醇消耗量超乎想像。他們沒有吃“健康”的飲食——他們所做的是聚在一起吃飯，保持非常親密的家庭關係。他們在食物的分享和體驗中找到了樂趣和社區。¹⁵

I’m not suggesting that you can fry all your food in lard, smoke cigars all day, and expect to recover from a serious illness just because you sit down to eat with your spouse or kids. A shift away from toxic, nutritionally empty foods was key for most who experienced remissions. But I couldn’t ignore the evidence: diet wasn’t the whole picture.

我並不是說你可以把所有的食物都用豬油煎炸，整天抽雪茄，僅僅因為你和你的配偶或孩子坐下來吃飯就期望從嚴重的疾病中恢復過來。對於大多數經歷緩解的人來說，擺脫有毒、營養空的食物是關鍵。但我不能忽視證據：飲食並不是全部。

“I’m contacted by a lot of desperate people,” Claire Haser, our pancreatic cancer survivor, once said. “Every one of them asks me, ‘What did you eat? What should I eat?’ We go to diet way too much. We go to what’s easy. Eating different foods, buying different supplements, is so much easier than changing yourself. Eating is the quick fix; it’s the pill we want to take. And I keep telling people, ‘There is no pill for this.’”

“很多絕望的人都聯繫了我，”我們的胰腺癌倖存者克雷爾·哈瑟 （Claire Haser） 曾經說過。“他們每個人都問我，'你吃了什麼？我應該吃什麼呢？我們節食太多了。我們追求簡單。吃不同的食物，購買不同的補充劑，比改變自己要容易得多。吃是快速解決方案;這是我們想要服用的藥丸。我一直告訴人們，『沒有葯可以治療這個。

Changing your diet long term, revitalizing your terrain, and setting the stage for remarkable recovery requires a whole-life overhaul, not just in what you eat but also in how you think about and experience yourself and the world. Change is about love and respect for the body. It’s also about understanding your community. What you eat is a habit, a ritual, and even part of your identity. It’s also a shared experience with the people you live with and love, and it can be extraordinarily difficult to figure out how you fit into those rituals when your needs are different from those around you. When making deep nutritional changes, we should aim to do so in a way that increases the amount of life and love in our lives, from a place of opportunity rather than just fear.

長期改變你的飲食習慣，振興你的地形，併為顯著的恢復奠定基礎，這需要對你的整個生活進行徹底改革，不僅在你的飲食上，而且在你如何思考和體驗自己和世界方面。改變是關於對身體的愛和尊重。這也是關於瞭解您的社區。你吃什麼是一種習慣，一種儀式，甚至是你身份的一部分。這也是與你一起生活和愛的人的共同經歷，當你的需求與周圍的人不同時，要弄清楚你如何適應這些儀式可能會非常困難。在進行深入的營養改變時，我們應該致力於增加我們生活中的生命和愛的數量，從一個機會而不僅僅是恐懼的地方。

Later, in the chapter “Burn Your Boat,” I’ll talk more about where survivors found the inner reserves to make these very challenging shifts in their diets, which then tended to ripple outward through their lives. As we move forward, we’ll see that for many survivors of incurable illness, making diet changes was the “gateway drug” into making the deeper, profounder changes that they believe ultimately led them toward health. Which begs the question: If diet was the first baby step toward radical transformation, what was the next one?

稍後，在「燒毀你的船」一章中，我將更多地討論倖存者在哪裡找到了內在儲備，以便在他們的飲食中做出這些非常具有挑戰性的轉變，然後這些儲備往往會在他們的生活中向外擴散。隨著我們向前邁進，我們將看到，對於許多不治之症的倖存者來說，改變飲食是做出更深入、更深刻改變的「門戶藥物」，他們認為這些改變最終會引導他們走向健康。這就引出了一個問題：如果飲食是邁向根本轉變的第一步，那麼下一步是什麼？

I knew that one of the major things that happened when people switched their diets to a nutrient-rich one was a massive reduction in systemic inflammation. Sugar, for example, can cause a damaging inflammatory reaction throughout the body. The Western diet—the diet most of us in the developed world eat—is particularly inflammatory. The link between inflammation and the immune system is clear, since inflammation is an immune response—outside of an acute “repair” situation, it’s the immune system in overdrive, hurting what it’s meant to help. Survivors of incurable diseases who made radical changes to their diet were certainly benefiting from an anti-inflammatory boost to their immune systems when they did so. So what else were they doing to potentially magnify that effect?

我知道，當人們將飲食轉向營養豐富的飲食時，發生的主要事情之一是全身炎症的大幅減少。例如，糖會引起全身的破壞性炎症反應。西方飲食——我們大多數發達國家的飲食——特別具有煽動性。炎症和免疫系統之間的聯繫是顯而易見的，因為炎症是一種免疫反應——除了急性“修復”情況之外，它是免疫系統超速運轉，損害了它本應提供幫助的東西。對飲食進行根本性改變的不治之症倖存者在這樣做時肯定會受益於免疫系統的抗炎增強。那麼，他們還做了什麼來潛在地放大這種影響呢？