返回首页

PeterAttia_2013P-_肥胖症危是否掩盖了更大的问题_
I'll never forget that day back in the spring of 2006. 我永远忘不了那天 2006年的春天。
I was a surgical resident at The Johns Hopkins Hospital, taking emergency call. 我还是一个外科住院医生 在约翰霍普金斯医院 应对急救电话
surgical:adj.外科的;外科手术的; resident:adj.居住的;住院医师;定居的;n.居民; emergency:n.紧急情况;突发事件;非常时刻;adj.紧急的;备用的;
I got paged by the E.R. around 2 in the morning to come and see a woman with a diabetic ulcer on her foot. 大约凌晨两点左右,我被急诊室叫去 看一位女病人,她得了因糖尿病而引起的 足部溃疡。
diabetic:adj.糖尿病的,患糖尿病的;n.糖尿病患者; ulcer:n.[病理]溃疡;腐烂物;道德败坏;
I can still remember sort of that smell of rotting flesh as I pulled the curtain back to see her. 我至今还能记得当我拉开帘子看到她之后 闻到的那种肉类腐烂的味道。
flesh:n.肉;肉体;v.喂肉给…;发胖;
And everybody there agreed this woman was very sick and she needed to be in the hospital. 显而易见这位女士病得很重 她需要住院治疗。
That wasn't being asked. 这是毫无疑问的。
The question that was being asked of me was a different one, which was, did she also need an amputation ? 但那时我考虑的是另一个问题 那就是,她需要截肢吗？
amputation:n.截肢(术),切断(术);删除,削减;
Now, looking back on that night, 现在,回想起那夜,
I'd love so desperately to believe that I treated that woman on that night with the same empathy and compassion 我很后悔那天夜里面对那位女士时 心中没有带着同样的同情与悲悯
desperately:adv.拼命地;绝望地;不顾一切地;极度地; treated:v.以…态度对待;把…看作;(treat的过去分词和过去式) empathy:n.神入;移情作用;执着; compassion:n.同情;怜悯;
I'd shown the 27-year-old newlywed who came to the E.R. three nights earlier with lower back pain that turned out to be advanced pancreatic cancer . 就像我平时面对其他病人那般 三天前的夜里一位27岁的新娘 因为下背疼痛来看急诊 后来她被诊断为晚期胰腺癌。
newlywed:adj.新婚的;n.新婚夫妇; advanced:adj.先进的; v.前进; (advance的过去式和过去分词形式) pancreatic:adj.胰的;胰腺的; cancer:n.癌症;恶性肿瘤;
In her case, I knew there was nothing I could do that was actually going to save her life. 虽然我知道我对她无能为力 没办法救她。
The cancer was too advanced. 癌症已经是末期了。
But I was committed to making sure that 但我还是尽我所能的
committed:adj.坚信的; v.做出错事; (commit的过去分词和过去式)
I could do anything possible to make her stay more comfortable. I brought her a warm blanket and a cup of a coffee. 做了所有能让她 舒服一点的事情。我帮她找了条毛毯 端了杯咖啡。
I brought some for her parents. 给她父母送咖啡。
But more importantly, see, I passed no judgment on her, because obviously she had done nothing to bring this on herself. 更重要的是,我一点也不觉得这姑娘有错 很明显她对自己的病 一点责任也没有
judgment:n.判断;裁判;判决书;辨别力;
So why was it that, just a few nights later, as I stood in that same E.R. and determined that my diabetic patient did indeed need an amputation, why did I hold her in such bitter contempt ? 但是为什么,仅仅过了几夜 当我站在同一个急救室并且决定 我的这位糖尿病病人需要截肢手术时 为什么我的心中带着蔑视呢？
determined:adj.决定了的:v.决定;(determine的过去分词和过去式) patient:adj.有耐心的,能容忍的;n.病人;患者; bitter:adj.苦的; n.苦味; v.激烈地; v.使变苦; contempt:n.轻视,蔑视;耻辱;
You see, unlike the woman the night before, this woman had type 2 diabetes . 你看,跟那位新娘不一样 这位女士有II型糖尿病
diabetes:n.糖尿病;多尿症;
She was fat. 她很胖。
And we all know that's from eating too much and not exercising enough, right? 而且我们都知道肥胖源自无节制的饮食和缺乏运动,对吧？ 而且我们都知道肥胖源自无节制的饮食和缺乏运动,对吧？
I mean, how hard can it be? 我的意思是,节食和运动很难吗？
As I looked down at her in the bed, I thought to myself, if you just tried caring even a little bit, you wouldn't be in this situation at this moment with some doctor you've never met about to amputate your foot. 我看着她躺在床上,我心说 哪怕你稍微注意一点儿自己的身体 你也绝不会落到这步田地 跟一个即将给你截肢的陌生在一起 跟一个即将给你截肢的陌生在一起
amputate:vt.截肢;切断;删除;
Why did I feel justified in judging her? 为什么当时我能心安理得的责备她呢？
justified in:有理由;
I'd like to say I don't know. 我希望我不知道原因。
But I actually do. 但是说真的,我知道。
You see, in the hubris of my youth, 你看,我那时年少轻狂
hubris:n.傲慢;狂妄自大;
I thought I had her all figured out. 我自以为是的觉得 她肯定就是我想到那样。
She ate too much. She got unlucky . 她饮食无度,她运气不好
unlucky:adj.不幸的;倒霉的;不吉利的;
She got diabetes. Case closed. 她得了糖尿病,基本就是这个情况。
Ironically , at that time in my life, 讽刺的是,就在那会儿
Ironically:adv.讽刺地;说反话地;
I was also doing cancer research, immune-based therapies for melanoma , to be specific , and in that world I was actually taught to question everything, to challenge all assumptions and hold them to the highest possible scientific standards . 我正在参与癌症的研究 黑色素瘤的细胞免疫力疗法,具体来说 在那个领域里,我被教着去质疑一切 挑战一切固有的理论成果 并且在研究中严格遵守最高的科研准则。
therapies:n.治疗方法(therapy复数形式); melanoma:n.[肿瘤]黑素瘤;胎记瘤; specific:adj.特殊的,特定的;明确的;详细的;[药]具有特效的;n.特性;细节;特效药; assumptions:n.假定;假设;承担;获得;(assumption的复数) scientific:adj.科学的,系统的; standards:n.标准,水平,规格(standard的复数)
Yet when it came to a disease like diabetes that kills Americans eight times more frequently than melanoma, 但当我面对糖尿病 这种致死几率高于黑色素瘤八倍的疾病时候
disease:n.病,[医]疾病;弊病;vt.传染;使…有病; frequently:adv.频繁地,经常地;时常,屡次;
I never once questioned the conventional wisdom . 我从未质疑过传统的理论。
conventional:adj.符合习俗的,传统的;常见的;惯例的; wisdom:n.智慧;明智;才智;学问;
I actually just assumed the pathologic sequence of events was settled science. 我当时真的认为糖尿病的发病机理 早有定论。
assumed:adj.假定的;假设的;v.假定;假设;认为;承担;(assume的过去分词和过去式) pathologic:adj.病理学的;病态的; sequence:n.顺序; v.按顺序排列; settled:adj.稳定的; v.结束; (settle的过去分词和过去式)
Three years later, I found out how wrong I was. 三年以后,我发现我错了。
But this time, I was the patient. 但是这次,我自己成了病人。
Despite exercising three or four hours every single day, and following the food pyramid to the letter, 尽管我每天运动三四个小时 严格遵守健康食谱
Despite:prep.尽管,不管;n.轻视;憎恨;侮辱;
I'd gained a lot of weight and developed something called metabolic syndrome . 我还是体重激增并且得了 代谢综合征。
metabolic:adj.变化的;新陈代谢的; syndrome:n.[临床]综合征;综合症状;并发症状;校验子;并发位;
Some of you may have heard of this. 你们也许有人听说过它。
I had become insulin-resistant . 我的身体对胰岛素产生了抗性。
insulin-resistant:胰岛素抗性;
You can think of insulin as this master hormone that controls what our body does with the foods we eat, whether we burn it or store it. 你们可以把胰岛素想象成一种荷尔蒙 它能控制我们的身体对摄入的食物做出反应 消耗或是储存它们。
hormone:n.[生理]激素,荷尔蒙;
This is called fuel partitioning in the lingo . 在术语中称之为燃料分区。
partitioning:n.分割;分区;v.把…分成部分;隔开(partition的ing形式); lingo:n.行话;术语;隐语;
Now failure to produce enough insulin is incompatible with life. 缺乏足够的胰岛素是很要命的。
incompatible:adj.不相容的;矛盾的;不能同时成立的;n.互不相容的人或事物;
And insulin resistance , as its name suggests, is when your cells get increasingly resistant to the effect of insulin trying to do its job. 胰岛素抵抗,就像字面上意思一样 意味着你的细胞变得越来越不受 胰岛素的指挥正常运作。
resistance:n.电阻;抵抗;阻力;抗力; increasingly:adv.越来越多地;渐增地;
Once you're insulin-resistant, you're on your way to getting diabetes, which is what happens when your pancreas can't keep up with the resistance and make enough insulin. 一旦你出现胰岛素抵抗的情况 你离患糖尿病就不远了 因为胰岛素抵抗的缘故 你无法制造足够的胰岛素。
pancreas:n.[解剖]胰腺; keep up with:赶得上;和…保持联系;
Now your blood sugar levels start to rise, and an entire cascade of pathologic events sort of spirals out of control that can lead to heart disease, cancer, even Alzheimer's disease, and amputations , just like that woman a few years earlier. 你的血糖开始升高 一系列的病例症状 会突然爆发并且可能导致心脏病 癌症,甚至老年痴呆症 或者截肢,就像几年前的那位女士一样。
blood sugar:n.血糖; cascade:n.小瀑布,瀑布状物;串联;vi.像瀑布般大量倾泻下来;vi.像瀑布般悬挂着; spirals:螺旋;盘旋; amputations:n.截肢(术),切断(术);删除,削减;(amputation的复数)
With that scare, I got busy changing my diet radically , adding and subtracting things most of you would find almost assuredly shocking. 我很害怕,我很快改了食谱 做了一些让大家觉得 不可思议的改变。
radically:adv.根本上;彻底地;以激进的方式; subtracting:v.减;减去;(subtract的现在分词) assuredly:adv.确实地;确信地;
I did this and lost 40 pounds, weirdly while exercising less. 得益于新的食谱尽管我锻炼得少了,我还是减掉了40磅
weirdly:adv.古怪地;
I, as you can see , I guess I'm not overweight anymore. 你们可以看到,我现在没有超重
as you can see:正如你所看到的;你是知道的; overweight:adj.超重的;过重的;vt.使负担过重;n.超重;
More importantly, I don't have insulin resistance. 更重要的是,我没有胰岛素抵抗症了
But most important, I was left with these three burning questions that wouldn't go away: 但是最重要的是,我陷入了 三个亟待解决的问题
How did this happen to me if I was supposedly doing everything right? 为什么这件事发生在我身上呢? 我已经尽力做到无懈可击了。
supposedly:adv.据说;据信;据传;
If the conventional wisdom about nutrition had failed me, was it possible it was failing someone else? 如果传统的营养理论在我身上失效了 在其他人身上会怎样呢？
nutrition:n.营养,营养学;营养品;
And underlying these questions, 通过对考虑这些问题
underlying:adj.根本的; v.构成…的基础; (underlie的现在分词)
I became almost maniacally obsessed in trying to understand the real relationship between obesity and insulin resistance. 我着了魔一样的 希望找到肥胖和胰岛素之间 真正的关系。
obsessed:v.使痴迷;使迷恋;使着迷;(obsess的过去式和过去分词) obesity:n.肥大,肥胖;
Now, most researchers believe obesity is the cause of insulin resistance. 现在,主流观点认为 肥胖导致了胰岛素抵抗。
Logically , then, if you want to treat insulin resistance, you get people to lose weight, right? 依逻辑来说,如果你想治疗胰岛素抵抗 你必须减肥,对吧？
Logically:adv.逻辑上;合乎逻辑;
You treat the obesity. 先对付肥胖。
But what if we have it backwards? 但是如果我们反过来想一下？
what if:如果…怎么办?
What if obesity isn't the cause of insulin resistance at all? 假如肥胖并不会导致胰岛素抵抗？
In fact, what if it's a symptom of a much deeper problem, the tip of a proverbial iceberg ? 实际上,假如它只是一个征兆 一个更深层次的问题的冰山一角？
symptom:n.症状;征候;征兆; tip:n.小窍门,小费;v.给…小费;使倾斜; proverbial:adj.谚语的;众所周知的;谚语式的; iceberg:n.[地理]冰山;显露部分;
I know it sounds crazy because we're obviously in the midst of an obesity epidemic , but hear me out. 这听起来很疯狂 因为我们很正身处 一个肥胖症泛滥的时代,不过请耐心听我解释。
midst:n.当中,中间;prep.在…中间(等于amidst); epidemic:n.流行病;蔓延;adj.传染病;流行性的;
What if obesity is a coping mechanism for a far more sinister problem going on underneath the cell? 假如肥胖是身体的某种应对机制 用来对付一个潜藏在细胞深处 更加凶险的问题？
coping:n.墙压顶;v.(成功地)对付,处理;(cope的现在分词) mechanism:n.机制;原理,途径;进程;机械装置;技巧; sinister:adj.阴险的;凶兆的;灾难性的;左边的; underneath:prep.在…的下面;在…的支配下;n.下面;底部;adj.下面的;底层的;
I'm not suggesting that obesity is benign , but what I am suggesting is it may be the lesser of two metabolic evils. 我不认为肥胖是无害的 但是我觉得肥胖在两种新陈代谢疾病中 是比较次要的那个。
benign:adj.良性的;和蔼的,亲切的;吉利的; lesser:adj.较少的;次要的;更小的;adv.较少地;更小地;不及;
You can think of insulin resistance as the reduced capacity of our cells to partition fuel, as I alluded to a moment ago, taking those calories that we take in and burning some appropriately and storing some appropriately. 大家可以把胰岛素抵抗症看作 我们身体燃料箱变小了 就像我刚刚假设的那样 正常情况下我们摄入的热量 会被适量消耗并且适量储存。
capacity:n.能力;容量;资格,地位;生产力; alluded:vi.暗指,转弯抹角地说到;略为提及,顺便提到; calories:n.[物]卡路里(热量单位,calorie的复数); appropriately:adj.适当地;合适地;相称地;
When we become insulin-resistant, the homeostasis in that balance deviates from this state. 当我们得了胰岛素抵抗的时候 这个平衡就会偏离正常情况。
homeostasis:n.[生理]体内平衡;[自]内稳态; deviates:vi.脱离;越轨;vt.使偏离;
So now, when insulin says to a cell, 于是乎,当胰岛素告诉细胞
I want you to burn more energy than the cell considers safe, the cell, in effect, says, "No thanks, I'd actually rather store this energy." 我需要你消耗一些能量,假如 细胞认为消耗太大,那些细胞就会回应到 “不了,我更想把这些能量储存起来。”
And because fat cells are actually missing most of the complex cellular machinery found in other cells, it's probably the safest place to store it. 因为脂肪细胞不同于其它细胞 它没有那么多复杂的结构和组织 所以能量都被储藏在那。
complex:adj.复杂的;合成的;n.复合体;综合设施; cellular:adj.细胞的;多孔的;由细胞组成的;n.移动电话;单元; machinery:n.机械;机器;机构;机械装置;
So for many of us, about 75 million Americans, the appropriate response to insulin resistance may actually be to store it as fat, not the reverse , getting insulin resistance in response to getting fat. 因此对我们中许多人,大约7500万美国人来说 胰岛素抵抗应被视作 肥胖的成因,而非相反的, 将胰岛素抵抗归因于肥胖。
reverse:n.反面; v.颠倒; adj.相反的; in response to:响应;回答;对…有反应;
This is a really subtle distinction , but the implication could be profound . 这虽然是个相当微妙的区别, 但是它的含义却是相当深刻的。
subtle:adj.微妙的;精细的;敏感的;狡猾的;稀薄的; distinction:n.区别;区分;差别;卓越; implication:n.含意;可能的影响(或作用、结果);暗指;(被)牵连; profound:adj.深厚的;意义深远的;渊博的;
Consider the following analogy : 举个例子来说,
analogy:n.类比;类推;类似;
Think of the bruise you get on your shin when you inadvertently bang your leg into the coffee table . 想象一下你小腿上的乌青, 那是你不小心撞上咖啡桌时留下的。
bruise:n.擦伤;挫伤;青肿;v.使受瘀伤;擦伤;受伤; shin:n.胫骨;v.爬;攀;攀;快步走; inadvertently:adj.非故意地,无心地; bang:n.猛敲; v.猛敲; v.正好; coffee table:[家具]咖啡桌;咖啡茶几;
Sure, the bruise hurts like hell, and you almost certainly don't like the discolored look, but we all know the bruise per Se is not the problem. 毫无疑问,这乌青疼得要命。 而且你肯定不喜欢腿上多个斑,但是我们都知道 乌青本身并不是个问题。
discolored:adj.脱色的;污染的;v.使褪色;脱色(discolor的过去分词); per Se:adv.本身;本质上;
In fact, it's the opposite. It's a healthy response to the trauma , all of those immune cells rushing to the site of the injury to salvage cellular debris and prevent the spread of infection to elsewhere in the body. 恰恰相反,这是对外伤的一个正常生理反应。 所有的免疫细胞都会迅速前往受伤的部位 去清理坏死细胞的碎片并且防止 感染扩散到身体其他部位。
trauma:n.[外科]创伤(由心理创伤造成精神上的异常);外伤; immune:adj.免疫的;免于…的,免除的;n.免疫者;免除者; site:n.地点;位置;场所;v.设置;为…选址; injury:n.伤害,损害;受伤处; salvage:n.打捞;海上救助;抢救财货;救难的奖金;v.抢救;海上救助; debris:n.碎片,残骸; infection:n.感染;传染;(身体某部位的)感染;传染病; elsewhere:adv.在别处;到别处;
Now, imagine we thought bruises were the problem, and we evolved a giant medical establishment and a culture around treating bruises: masking creams, painkillers , you name it, all the while ignoring the fact that people are still banging their shins into coffee tabl es. 好了,想象一下如果我们把乌青当作一个问题, 我们发展出了一个庞大的医疗体系 以及文化来对待乌青: 遮蔽霜,止疼药,等等。 而所有这一切都掩盖了一个事实 那就是人们依旧会撞到咖啡桌
bruises:v.(使)出现伤痕; n.碰伤; (bruise的第三人称单数和复数) evolved:v.(使)逐渐形成;进化;进化形成;(evolve的过去分词和过去式) giant:n.巨人;伟人;巨兽;adj.巨大的;特大的 establishment:n.大型组织;企业;旅馆;权威人士;建立; treating:v.以…态度对待;把…看作;处理;讨论;(treat的现在分词) painkillers:n.止痛药(painkiller的复数形式); ignoring:v.忽略,忽视;(ignore的现在分词);
How much better would we be if we treated the cause -- telling people to pay attention when they walk through the living room -- rather than the effect? 如果我们可以从问题的根源入手 告诉人们注意一下 从客厅走过的时候小心咖啡桌 这会比处理撞伤来的有效果的多
living room:n.客厅;起居室;
Getting the cause and the effect right makes all the difference in the world. 正确理解事情的表象和本因 将使这个世界产生巨大的不同。
Getting it wrong, and the pharmaceutical industry can still do very well for its shareholders but nothing improves for the people with bruised shins. 即使治标不治本,制药行业 依旧可以为股东们带来利润, 但是对于受伤的人们来说,这没有任何帮助
pharmaceutical:adj.制药(学)的;n.药物; shareholders:n.[金融]股东,投资者;股民(shareholder的复数); improves:v.改进;改善;(improve的第三人称单数) bruised:v.(使)出现伤痕;撞伤;擦伤;打击;挫伤(bruise的过去分词和过去式)
Cause and effect. 原因及结果。
So what I'm suggesting is maybe we have the cause and effect wrong on obesity and insulin resistance. 所以我想指出的是 在我们讨论肥胖和胰岛素抵抗的问题时把原因和结果弄反了。 在我们讨论肥胖和胰岛素抵抗的问题时把原因和结果弄反了。
Maybe we should be asking ourselves, is it possible that insulin resistance causes weight gain and the diseases associated with obesity, at least in most people? 也许我们需要问问我们自己了, 有没有可能胰岛素抵抗导致了体重增加 以及随肥胖带来的并发症, 至少对于大多数人来说
diseases:n.[医]病(disease的复数);[医]疾病;[植保]病害;疾病种类; associated:adj.有关联的; v.联想; (associate的过去分词和过去式)
What if being obese is just a metabolic response to something much more threatening, an underlying epidemic, the one we ought to be worried about? 有没有可能肥胖只是胰岛抵抗的一个代谢反应 相较于其他更大的威胁, 例如一些相关的疫病, 它们才是我们真正应该去担心的。
obese:adj.肥胖的,过胖的;
Let's look at some suggestive facts. 让我们来看些有暗示性的建议。
suggestive:adj.暗示的;提示的;影射的;
We know that 30 million obese Americans in the United States don't have insulin resistance. 我们知道在美国有3千万肥胖症患者 并未患胰岛素抵抗。
United:adj.联合的; v.联合,团结; (unite的过去分词和过去式)
And by the way , they don't appear to be at any greater risk of disease than lean people. 同时,没有证据显示他们 比非肥胖症患者更容易贻患其他疾病。
by the way:顺便说一下; lean:v.前俯(或后仰):倾斜:adj.肉少的:难以赚钱的:贫乏的:n.瘦肉:
Conversely , we know that six million lean people in the United States are insulin-resistant, and by the way, they appear to be at even greater risk for those metabolic diseases I mentioned a moment ago than their obese counterparts . 恰恰相反,在美国有6百万非肥胖症患者 存在胰岛素抵抗, 而他们却被证实 易患那些我之前提到的糖尿病并发症, 同时几率较肥胖人士来的更高。
Conversely:adv.相反地; counterparts:n.(契约)副本(counterpart的复数);相对物;相对应的人;
Now I don't know why, but it might be because, in their case, their cells haven't actually figured out the right thing to do with that excess energy. 虽然现在我还不知道为什么,但是一个可能的原因是, 对他们而言,他们的细胞无法正确的 对体内多余能量做出反应。
excess:n.超过,超额;过度,过量;无节制;adj.额外的,过量的;附加的;
So if you can be obese and not have insulin resistance, and you can be lean and have it, this suggests that obesity may just be a proxy for what's going on. 你可以是肥胖症患者,却没患胰岛素抵抗, 或者你可以不肥胖,却患有胰岛素抵抗, 这都表明肥胖只不过是一个表征 而胰岛素抗拒才是根源。
proxy:n.代理人;委托书;代用品;
So what if we're fighting the wrong war, fighting obesity rather than insulin resistance? 所以如果我们斗争搞错了对象, 我们一直与肥胖战斗着,而非胰岛素抵抗？
Even worse, what if blaming the obese means we're blaming the victims? 而且更糟的是,如果指责过胖者 其实确是在指责胰岛素抵抗的受害者？
What if some of our fundamental ideas about obesity are just wrong? 如果我们对于肥胖症的一些基本认识本身 就存在误差？
fundamental:n.基础; adj.十分重大的;
Personally , I can't afford the luxury of arrogance anymore, let alone the luxury of certainty . 就我个人而言,我没有办法继续保持傲慢的态度, 让我把那种过剩的确信感放在一边。
Personally:adv.个人;亲自;本人;就本人而言; afford:v.给予,提供;买得起; luxury:n.奢侈,奢华;奢侈品;享受;adj.奢侈的; arrogance:n.自大;傲慢态度; let alone:更不必说;听任;不打扰; certainty:n.必然;确实;确实的事情;
I have my own ideas about what could be at the heart of this, but I'm wide open to others. 对于这些问题的核心为何,我有我自己的认识, 同时我也愿意将它与其他人分享
Now, my hypothesis , because everybody always asks me, is this. 我的假设是这样的,因为老有人问我 我的假设是这样的,因为老有人问我
hypothesis:n.假设;
If you ask yourself, what's a cell trying to protect itself from when it becomes insulin resistant, the answer probably isn't too much food. 试问,一个细胞到底在畏惧什么 当它处于胰岛素抗拒状态时。 问题的答案可能不是摄入过多的食物。
It's more likely too much glucose : blood sugar. 答案更有可能是摄入过量葡萄糖而导致血糖过高。
glucose:n.葡萄糖;葡糖(等于dextrose);
Now, we know that refined grains and starches elevate your blood sugar in the short run, and there's even reason to believe that sugar may lead to insulin resistance directly . 精制的谷物和淀粉 将在短时间内抬到你的血糖含量, 而且我们有理由相信 糖分将直接导致胰岛素抵抗症。
refined:adj.精制的; v.精炼; grains:n.谷物;颗粒;细粒;少量;一点儿;(grain的复数) starches:n.淀粉质食品;v.给…上浆;使浆硬(starch的单三形式); elevate:vt.提升;举起;振奋情绪等;提升…的职位; directly:adv.直接地;立即;马上;正好地;坦率地;conj.一…就;
So if you put these physiological processes to work, 所以如果把这些生理过程也列入考虑,
physiological:adj.生理学的,生理的; processes:n.过程; v.处理(process的第三人称单数形式);
I'd hypothesize that it might be our increased intake of refined grains, sugars and starches that's driving this epidemic of obesity and diabetes, but through insulin resistance, you see, and not necessarily through just overeating and under-exercising. 我认为是大量的不断摄入 精制谷物,糖类以及淀粉类食物导致了 肥胖症和糖尿病的流行, 但其病因是胰岛素抵抗症 而不是由于暴饮暴食以及缺乏运动。
hypothesize:vt.假设,假定;vi.假设,假定; intake:n.摄取量;通风口;引入口;引入的量; necessarily:adv.必要地;必定地,必然地; overeating:v.吃得过多;过度饱食(overeat的ing形式);
When I lost my 40 pounds a few years ago, 在我几年前减去40磅时,
I did it simply by restricting those things, which admittedly suggests I have a bias based on my personal experience. 我只是简单的限制了精制谷物,糖,和淀粉的摄入, 诚然这也表明我存在一些偏见, 而这些主要源自我的个人经验。
restricting:n.整形,限制;扼流;v.限制(restrict的ing形式); admittedly:adv.公认地;无可否认地;明白地; bias:adv.使有偏见;n.偏见;偏心;偏爱;v.使有偏见;使偏向;adj.斜的;[电]偏动的;
But that doesn't mean my bias is wrong, and most important, all of this can be tested scientifically . 但是这并不意味着我的偏见是错误的, 更重要的是,所有这些偏见都是可以被科学验证的。
scientifically:adv.系统地;合乎科学地;学问上;
But step one is accepting the possibility that our current beliefs about obesity, diabetes and insulin resistance could be wrong and therefore must be tested. 但是第一步就是要接受一种可能性 那就是我们当前关于肥胖症, 糖尿病以及胰岛素抗拒症的理解可能存在偏差 并需要被验证。
I'm betting my career on this. 我把我的事业都赌在了这个可能性上。
betting:n.打赌;赌钱;v.下赌注(于);用…打赌;敢说;(bet的现在分词) career:n.职业;事业;生涯;经历;
Today, I devote all of my time to working on this problem, and I'll go wherever the science takes me. 现在,我把所有的时间花在了这个问题的研究上, 而且我将不会停止知道找到真正的答案。
devote:v.贡献;把…专用于;听任;
I've decided that what I can't and won't do anymore is pretend I have the answers when I don't. 我已经决定有一件事是我不能也不会再做的, 那就是在我不知道答案的时候却假装知道。
I've been humbled enough by all I don't know. 对所有我不知道的事情,我都相当谦虚。
humbled:使...卑下;轻松打败(尤指强大的对手);贬低(humble的过去式和过去分词);
For the past year, I've been fortunate enough to work on this problem with the most amazing team of diabetes and obesity researchers in the country, and the best part is, 在过去一年里,我很幸运 可以和国内最优秀的糖尿病和肥胖症专家团队一起研究 可以和国内最优秀的糖尿病和肥胖症专家团队一起研究 同时最好的事情莫过于,
fortunate:adj.幸运的;交好运的;吉利的;
just like Abraham Lincoln surrounded himself with a team of rivals , we've done the same thing. 就如亚伯拉罕?林肯将自己置身于由对手组成的团队中 我们也做了一样的事情。
rivals:n.对手(rival的复数);[劳经]竞争者;v.竞争(rival的三单形式);
We've recruited a team of scientific rivals, the best and brightest who all have different hypotheses for what's at the heart of this epidemic. 我们找来了另一个科学家团队作为竞争对手, 他们也都是极为优秀的科学家, 但却对这个流行病的核心成因有着不同的假设
recruited:v.招聘,雇佣;招募;(recruit的过去分词和过去式) hypotheses:n.假定;臆测(hypothesis的复数);
Some think it's too many calories consumed . 有一些认为是过量的卡路里摄入
consumed:adj.沉迷…的; v.消耗,耗费; (consume的过去分词和过去式)
Others think it's too much dietary fat. 有一些认为是过量的脂肪摄入
dietary:n.规定的食物;饮食的规定;食谱;adj.饮食的,饭食的,规定食物的;
Others think it's too many refined grains and starches. 也有些人为是过量的精制谷物和淀粉摄入。
But this team of multi-disciplinary , highly skeptical and exceedingly talented researchers do agree on two things. 这个由多学科, 具有高度怀疑精神以及相当聪明的研究者团队 至少同意两件事情。
multi-disciplinary:adj.多学科的; highly:adv.高度地;非常;非常赞许地; skeptical:adj.怀疑的;怀疑论的,不可知论的; exceedingly:adv.非常;极其;极度地;极端;
First, this problem is just simply too important to continue ignoring because we think we know the answer. 其一,这个问题相当重要, 以至于我们不能再假装我们知道答案而对它视而不见。
And two, if we're willing to be wrong, if we're willing to challenge the conventional wisdom with the best experiments science can offer, we can solve this problem. 其次,如果我们愿意去犯错误, 如果我们愿意通过科学实践探究去挑战传统观念 如果我们愿意通过科学实践探究去挑战传统观念 我们终将解决这个问题。
I know it's tempting to want an answer right now, some form of action or policy , some dietary prescription -- eat this, not that — but if we want to get it right, 我知道我们都希望现在就能得到一个答案, 一些可以参照行为方式或者规则,一些饮食菜单 告诉我们该吃什么,不该吃什么, 但是如果我们想找到一个正确的答案,
tempting:adj.吸引人的;诱惑人的;v.引诱;(tempt的现在分词); policy:n.政策,方针;保险单; prescription:n.处方;药方;医生开的药;开处方;
we're going to have to do much more rigorous science before we can write that prescription. 我们就不得不进行严谨的科学尝试, 不然我们是给出真正的答案的。
rigorous:adj.严格的,严厉的;严密的;严酷的;
Briefly , to address this, our research program is focused around three meta-themes, or questions. 简而言之,为了找到这个答案,我们的研究项目 主要围绕着三个方面或者问题展开。
Briefly:adv.简要地;简短地;暂时地;
First, how do the various foods we consume impact our metabolism , hormones and enzymes , and through what nuanced molecular mechanisms ? 首先,我们摄入的各种各样的食物是如何 影响我们的代谢,激素和酶的, 并且这些影响是通过何种细微的分子机制发生的？
impact:n.影响;效果;碰撞;冲击力;v.挤入,压紧;撞击;对…产生影响; metabolism:n.[生理]新陈代谢; hormones:n.[生理]激素;荷尔蒙;性激素;荷尔蒙制剂(hormone的复数); enzymes:n.[生化]酶(enzyme的复数);酶类,酵素; nuanced:adj.微妙的; v.精确细腻地表演; molecular:adj.[化学]分子的;由分子组成的; mechanisms:n.机制;[机]机构(mechanism的复数);机械;[机]机构学;
Second, based on these insights , can people make the necessary changes in their diets in a way that's safe and practical to implement ? 其二,基于这个视角, 人们有没有办法对他们的饮食做出必要的调整, 使它更安全且更易实践
insights:n.洞察力;眼力;深刻见解(insight的复数); practical:adj.实际的;真实的;客观存在的;n.实习课;实践课; implement:v.实施;执行;贯彻;使生效;n.工具;
And finally , once we identify what safe and practical changes people can make to their diet, how can we move their behavior in that direction so that it becomes more the default rather than the exception ? 最终,一旦我们找到既安全、 又能安全应用到饮食中的方法 我们又如何改变他们的习惯, 使之变得更为自然, 而非一种刻意行为？
finally:adv.终于;最终;(用于列举)最后;彻底地; identify:v.识别:鉴定:确认:发现: default:n.违约;拖欠;缺席;缺陷;v.违约;拖欠;缺乏;不履行; exception:n.例外;异议;
Just because you know what to do doesn't mean you're always going to do it. 你知道应该去做什么并不意味着 你可以坚持这么做。
Sometimes we have to put cues around people to make it easier, and believe it or not, that can be studied scientifically. 有时我们不得不给人们一些诱因 使这种坚持变得更简单,不管你信不信 这都可以经过科学研究
cues:n.开端,线索;提示,关键;球杆;诱因(cue的复数形式);
I don't know how this journey is going to end, but this much seems clear to me, at least: 我不知道这个研究最终会将我带向何处, 但是对我而言,至少有一点是可以肯定地:
journey:n.旅行;行程;vi.旅行;
We can't keep blaming our overweight and diabetic patients like I did. 我们不能继续指责肥胖症和糖尿病患者 就像曾经的我那样。
patients:n.接受治疗者,病人;(patient的复数)
Most of them actually want to do the right thing, but they have to know what that is, and it's got to work. 他们中的大部分其实都想做正确的选择, 但前提是他们必须知道到底什么是正确的, 而且它们切实可行。
I dream of a day when our patients can shed their excess pounds and cure themselves of insulin resistance, because as medical professionals , we've shed our excess mental baggage 我们梦想有一天当我们的患者可以 减去多余的重量 治好胰岛素抵抗症, 因为作为医学专家, 我们已经抛开了多余的思想包袱,
shed:v.摆脱;去除;蜕;落;n.工棚;简易房;剪羊毛棚;挤奶棚; professionals:n.[管理]专业人员(professional的复数); baggage:n.行李;[交]辎重(军队的);
and cured ourselves of new idea resistance sufficiently to go back to our original ideals: open minds, the courage to throw out yesterday's ideas when they don't appear to be working, 并完全治好了自己的新观点抵抗症 从而使我们回归我们最初的理想: 开放的思维,抛弃那些不再有效的陈旧观念的勇气 开放的思维,抛弃那些不再有效的陈旧观念的勇气
sufficiently:adv.充分地;足够地; original:n.原件;原作;原物;原型;adj.原始的;最初的;独创的;新颖的; throw out:v.扔掉;伸出;说出;否决;突出;
and the understanding that scientific truth isn't final, but constantly evolving . 相信科学的真理没有终点, 只有不断的进化。
constantly:adv.不断地;时常地; evolving:v.(使)逐渐形成,逐渐演变;进化形成;(evolve的现在分词)
Staying true to that path will be better for our patients and better for science. 忠于这条追求真理的道路对患者和科学来说都是更好的选择 忠于这条追求真理的道路对患者和科学来说都是更好的选择
If obesity is nothing more than a proxy for metabolic illness, what good does it do us to punish those with the proxy? 如果肥胖只是 代谢疾病的一个替罪羊, 那么我们去指责这些替罪羊又有什么好处呢？
Sometimes I think back to that night in the E.R. 我有时会回想到七年前急救室的那个夜晚
seven years ago. 我有时会回想到七年前急救室的那个夜晚
I wish I could speak with that woman again. 我希望我可以再和那位女士聊聊。
I'd like to tell her how sorry I am. 我想向她道歉。
I'd say, as a doctor, I delivered the best clinical care I could, but as a human being, 我想说,作为一个医生,我提供了 我所能提供的最好的治疗, 但是最为一个人,
clinical:adj.临床的;诊所的;
I let you down. 我让你失望了。
You didn't need my judgment and my contempt. 你需要的不是我的判定和我的鄙视。
You needed my empathy and compassion, and above all else, you needed a doctor who was willing to consider maybe you didn't let the system down. 你需要的是我的同情和怜悯, 而且无论如何,你需要的是一个医生 愿意相信 也许你没有辜负我们的医疗系统。
Maybe the system, of which I was a part, was letting you down. 也许是医疗系统,包括我在内的这个医疗系统, 辜负了你。
If you're watching this now, 如果你现在正在看这个演讲,
I hope you can forgive me. 我希望你可以原谅我。
forgive:v.原谅;免除(债务,义务等);
(Applause) （掌声）