循證減肥-現場演示

29 5 月, 2020


我們為什麼不熱烈歡迎邁克爾·格雷格博士?!

[Applause]

當然,如果有一些安全,簡單,無副作用的肥胖病解決方案,那麼我們現在就知道了吧?我不確定。

研究結果可能需要多達17年的時間才能納入日常臨床實踐。舉一個對我的家庭特別痛苦的例子:心髒病。您知道,幾十年前,迪恩·奧尼什(Dean Ornish)博士及其同事在世界上最負盛名的醫學期刊之一上發表了證據,證明我們的主要死因可能是 倒轉 僅靠飲食和生活方式的改變—幾乎沒有任何改變。即使是現在,成千上萬的美國人繼續不必要地死於數十年前我們所了解的 可逆的 疾病。實際上,我親眼所見。我的祖母由Dean的前任之一Nathan Pritikin用類似的方法治癒了她的晚期心髒病。

因此,如果有效 治愈 我們的頭號殺手,可能會迷失在兔子洞中而被忽視,醫學文獻中還有什麼可以幫助我的患者的,但僅僅是沒有企業預算來推動它的推廣?好吧,我的一生就是要找出答案。這就是為什麼我首先要當醫生的原因,也是我創辦非營利性網站NutritionFacts.org的原因。

網站上的所有內容都是免費的。沒有廣告,沒有企業贊助。這絕對是非商業性的,什麼也不賣。我只是把它當作一種公共服務,作為一種愛的勞動,是為了向祖母致敬。 [Applause] 幾乎每天都有最新的視頻和文章, 循證營養—什麼概念。

好的,科學證明什麼是減肥的最佳方法?如果您需要個人鑑定和前後圖片,那麼您來錯地方了。我對軼事不感興趣;我對證據感興趣。當做出決定自己和家人的健康和福祉至關重要的決定時,實際上只有一個問題: 目前可提供的最佳證據平衡是什麼?

問題在於,即使僅僅堅持經過同行評審的醫學文獻也不夠,因為“錯誤且科學地 [misleading] 即使在科學期刊上,也普遍存在對肥胖症的無力支持的信念。因此,了解真相的唯一方法是深入研究原始文獻並自己閱讀所有原始研究。但是,誰有時間呢?肥胖有超過一百萬篇關於肥胖的科學論文,每天有一百篇新發表。即使是該領域的研究人員,也可能無法跟踪其狹窄領域。但這就是我們在NutritionFacts.org上所做的。我們每年都會整理成千上萬的研究,因此您……不必。非常好!

確實,我們發現了很多隱藏的數據,例如今天,我將講講簡單的香料,例如,經過隨機,雙盲,安慰劑對照試驗證明的結果,可以加速一天便士的減肥,但利潤卻很少潛力,也就不足為奇了,這些研究從未見過。唯一獲利 一世 不過,關心的是您的健康。因此,我從所有書籍,DVD和演講中獲得的收益100%都捐贈給了慈善機構。我只想為您的家人做普蘭蒂金為我的家人所做的事情。

但是,等等,減肥不只是減少飲食和增加運動量嗎?我的意思是,卡路里不是卡路里嗎?那就是食品工業 想要 你想。食品來源播報的一種說法是,一種來源的熱量與其他任何來源的脂肪一樣肥膩,這是一種減輕自己的罪魁禍首的方法。可口可樂本身甚至在廣告上都強調了“一個簡單的常識性事實”。正如哈佛大學營養學系現任和前任主席所說,工業界的這種“中心論點”是:“胡蘿蔔的卡路里消耗量過多與蘇打水的卡路里消耗量沒有區別……”。如果卡路里只是卡路里,那為什麼重要 什麼 我們放入口中?

讓我們探討胡蘿蔔與可口可樂的例子。的確,在嚴格控制的實驗室環境中,240卡路里的胡蘿蔔(10根胡蘿蔔)對熱量平衡的影響與一瓶可樂中的240卡路里相同,但是此比較與 面對 在現實世界中。您可以在不到一分鐘的時間內消耗掉這些液態糖果的卡路里,但是吃240卡路里的胡蘿蔔會使您持續咀嚼兩個半小時以上。 [Laughing] 您的下顎不僅會酸痛,而且240卡路里的胡蘿蔔就像五杯咖啡一樣-您甚至可能無法全部放入。

我們的肚子這麼大。填滿後,胃壁上的拉伸感受器會告訴我們什麼時候吃飽了,但是不同的食物每個胃所含的卡路里量不同。有些食物每杯,每磅,每口的卡路里比其他食物多。這是卡路里密度的概念,即一定量食物中的卡路里數量。 3磅大約是美國人平均每天的飲食量。如您所見,例如,油的卡路里密度很高,也就是說卡路里很高 濃度,很多卡路里堆積在一個狹小的空間中。在盤子上淋上一湯匙油,就下了毛毛雨,增加了一百多卡路里。對於那些相同的卡路里,您可以吃大約兩杯黑莓,例如,低卡路里的食物。因此,這兩餐的卡路里數量相同。您可以喝一小勺油,甚至在胃中感覺不到任何東西,但是吃幾杯漿果可能會開始使您感到不適。這就是為什麼 生化地 卡路里是卡路里,但是吃 相同 不同食物中熱量的多少,可以產生不同的影響。

人的平均胃部可以擴張以容納約四杯食物;因此,舉例來說,一小杯草莓冰淇淋可以使一整天的卡路里攝入量最大化。對於相同的2000卡路里,要從草莓本身中獲得相同的2000卡路里,就必須吃 四十四 杯漿果。那是 十一 飽腹感。就像漿果一樣美味,我不知道我一天是否能飽腹十一次。有些食物只是 不可能 暴飲暴食。它們的卡路里密度如此之低,以至於您在身體上無法吃飽甚至無法維持體重。在實驗室中,卡路里是卡路里,但是在生活中,卡路里遠非如此。

傳統的減肥飲食著重於減少份量,但是我們知道這些“少吃”的方法會使人們感到飢餓和不滿意。一種更有效的方法可能是將重點從限制​​轉移到積極的“吃多了” 增加 攝入健康,低熱量的食物,但是直到您……進行測試後,您才知道。

夏威夷的研究人員嘗試使人們更多地採用傳統的夏威夷飲食,包括他們可以食用的所有植物性食物,無限量的水果,蔬菜,全穀類和豆類。而且,研究對像在短短21天內平均損失了17磅。卡路里攝入量下降了40%,但這並不是因為他們少吃食物。他們在三週內吃了十七磅的東西 更多 食物,每天超過四磅。怎麼可能由於整株植物的食物通常都是熱量稀薄的,因此您可以在不增加體重的情況下充盈自己。他們在三週內吃了十七磅的東西 更多 餐飲。這就是為什麼在我即將開始的書《如何不節食》中,我感到非常興奮的原因, [clears throat],這就是為什麼“低卡路里”是我理想減肥飲食的17種成分之列。

如前所述,美國人似乎平均每天要吃三磅的食物。因此,如果您大部分都堅持使用這些食物,則可以看到如何吃更多的食物並且仍然減輕體重。

一項計劃在下個月發表的里程碑式研究發現,即使加工食品具有相同的卡路里數量,相同的鹽,糖,脂肪,纖維和蛋白質,它們也會導致體重增加,在兩週內增加了2磅;未經加工的食物導致體重減輕,在同一兩週內減少了兩磅。這是他們的加工食品之一……實際上可能比大多數人的飲食更健康。希臘的脫脂酸奶,烤土豆片,無糖減肥檸檬水和火雞三明治的卡路里數量與此相同……未經加工的餐食在人們身上所吃的東西,類似於西南風味的黑豆沙律,鱷梨,堅果……就是卡路里的密度效應。卡路里相同,但食物更多,難怪它滿足了他們的飢餓感。他們在兩週內吃了更多的食物,減輕了四磅的體重。因此,如何減少飲食中的卡路里密度?好吧,快速瀏覽一下這兩個極端應該建議兩種方法:放棄添加的脂肪和添加廢棄的蔬菜。

方法一:秘密地使人們飲食相對低脂,即使他們可以吃任意多的食物,他們每天也傾向於減少體內脂肪。如果您改為給這些人相同的飯菜,但是這次卻偷偷攝取了足夠的額外油脂,使其轉變為高脂飲食,那麼他們每天都會增加體內脂肪。

實際上,在佛蒙特州的一次著名監獄實驗中,瘦弱的囚犯每天要攝取超過一萬卡路里的熱量,以嘗試通過實驗使他們變胖。事實證明這非常困難。大多數人開始討厭早餐,然後不由自主地吐了出來。研究人員了解到,人們故意增加體重是多麼困難-除非您給他們餵很多脂肪。為了使囚犯按常規飲食增加三十磅的體重,每一定身體表面積要消耗約14萬卡路里的熱量。為了僅通過在飲食中添加脂肪而獲得同樣的30磅體重增加,他們所要做的就是給他們額外飼餵40,000卡路里的熱量。當多餘的卡路里以直脂肪的形式出現時,它消耗了多達十萬卡路里 更少 卡路里獲得 相同 重量。卡路里是 卡路里-這取決於 什麼 你吃。在這種情況下,降低脂肪含量可有效彌補100,000卡路里的熱量。這就是為什麼“低添加脂肪”也列在我理想的減肥成分列表中的原因。

但是,有兩個重要的例外。具有“低脂聲稱”的加工食品通常富含糖,以至於它們可以具有與較高脂肪產品相同數量的卡路里。例如,SnackWell的無脂餅乾每磅1,700卡的熱量就相當於丹麥乾酪的卡路里。

低脂法則的另一個例外是蔬菜熱量高 即使是高脂蔬菜,例如一些油膩的西蘭花和大蒜醬,總體上卡路里的密度也較低,這使我們採取了降低卡路里密度的第二種策略:不要偷偷溜走脂肪,而偷偷溜進蔬菜。

對卡路里密度的最大影響不是脂肪,而是水分。由於水增加了重量和體積而不增加卡路里,因此,卡路里最密集的食物和卡路里最密集的飲食往往是乾燥的食物。另一方面,有些蔬菜的水分超過95%,而不僅僅是捲心萵苣。黃瓜,芹菜,蘿蔔,煮熟的納帕白菜,白菜,西葫蘆,西葫蘆,豆芽和筍可以達到95%的水分含量。它們基本上只是蔬菜形式的水。大碗富含水的蔬菜實際上只是一碗被困的水。對卡路里密度的影響是如此之大,以至於食品工業希望採取這種行動。他們認為,他們可以使用納米技術“用自組裝的,充滿水的……納米細胞或納米管來構造類似於芹菜桿的固體加工食品”。沒必要,因為大自然擊敗了您。

當數十種常見食物因數小時的飽腹感而大打折扣時,最能預測的特徵不是脂肪多少或蛋白質多少,而是多少 它有過。那是食物填充量的第一預測因子。這就是為什麼“富含水的食物”也列在我的名單上的原因。

富含水分的食物(例如蔬菜)在80年代左右以重量佔90%以上的水分位居榜首,其次是大多數新鮮水果。 Starchier蔬菜,全穀類食品和罐頭豆類大多為70年代,這意味著它們的重量佔四分之三:純淨水。通常,當談到富含水分的食物時,大多數全植物性食物都漂浮在頂部,大多數動物性食物落在中間的某個地方,而大多數加工食品則沉入底部。

在一系列著名的實驗中,賓夕法尼亞州立大學的研究人員決定對富含水的蔬菜進行測試。向研究對象提供麵食,並告知他們要吃多少東西。平均而言,他們消耗了約900卡卡路里的麵食。如果您首先給他們一百卡路里的色拉,主要是由生菜,胡蘿蔔,黃瓜,芹菜和櫻桃番茄組成,那麼您會怎麼想?他們會繼續吃相同量的麵食並吃一千卡路里的午餐,加900加100嗎?還是他們會少吃一百卡路里的麵食,從而抵消掉添加的沙拉卡路里?甚至比那更好。他們吃麵食的熱量減少了200多種。多虧了沙拉,進了一百卡路里,出了200卡路里。所以,從本質上講,沙拉有 負100 卡路里。預裝蔬菜可以從一頓飯中有效地減少一百卡路里。這樣可以通過多吃食物來減輕體重。

當然了 類型 沙拉很重要。研究人員重複了實驗,這次添加了脂肪調味料和額外的奶酪絲,使沙拉的卡路里密度增加了三倍。現在,作為第一道菜吃這種沙拉並不能將900卡路里的餐點變成熱量少於800卡路里的餐點。取而代之的是,它變成了一頓四位數卡路里的飯菜。這就像用大蒜麵包預裝比薩餅一樣,您最終可能會獲得更多的卡路里。

那麼,截止點是什麼?預緊力的研究表明,飯前吃大約一杯食物會使以後的攝入量減少約100卡路里;因此,要獲得“負卡路里”的效果,第一道菜每杯必須含有少於一百卡路里的熱量。如您在這張圖表中看到的那樣,其中包括大多數新鮮的水果和蔬菜,但是像晚餐卷這樣的東西是行不通的。

但是,嘿,給人們一個大蘋果,然後再吃同樣的麵食,而不是少消耗兩百卡路里,而是少吃三百卡路里。那麼,一個蘋果有多少卡路里? 這取決於您何時食用。 飯前,一個蘋果可以有效地食用 負200卡

您可以看到第一道菜就是給人蔬菜湯。數百卡路里消失了。一項跟踪人們全天攝入量的研究甚至發現,隨機分配給午餐前蔬菜湯的超重受試者不僅吃了更少的午餐,而且在整個七個小時後的晚餐中也扣除了額外的一百卡路里。因此,下次您坐下來喝一頓健康的湯時,您可以想像每勺湯中都會吸收真正的卡路里。

即使只是喝兩杯 飯前不久使人們減少了飯中約20%的卡路里,減少了100多卡路里。難怪超重的男人和女人在每頓飯前減肥時隨機分配兩杯水,使體重減少了44%。每餐前喝兩杯水,減肥速度加快44%。這就是為什麼我的減肥清單上有所謂的“負熱量預緊力” 助推器:無論其餘時間我吃什麼,我發現的所有東西都可以加速減肥。負卡路里預裝只是意味著開始時每杯含少於一百卡路里的食物開始進餐。那將包括許多水果,蔬菜,湯,色拉,或者簡單地是一大杯水。

我們可以在第一道菜沙拉上放些什麼來進一步減輕體重嗎?在“ Amping AMPK”部分中,我討論了激活一種被稱為“肥胖控制者”的酶的方法。它的發現被認為是過去幾十年來最重要的醫學突破之一。您可以通過運動,禁食和尼古丁來激活這種酶,但是有什麼方法可以使它增加體重,而不會出汗,飢餓或整個因肺癌死亡的可怕死亡?

大藥業遍地開花。畢竟,肥胖者可能“不願進行最少的體育鍛煉”,因此,這表明藥物 模仿 耐力運動是非常可取的。”因此,“開發具有高生物利用度的口服化合物以安全誘導慢性AMPK激活至關重要”,以“長期減輕體重和維持體重……”。但是,由於您已經可以在任何雜貨店購買了這種化合物,因此無需開發這種化合物。叫做醋

當醋(乙酸)被吸收並代謝時,您會獲得天然的AMPK促進作用。以沙拉醬為典型劑量,足以增強減肥效果嗎?醋顯然已被用於治療肥胖症已有數百年曆史,但直到最近才開始……進行測試。

一項關於醋攝入對減少超重男性和女性體內脂肪影響的隨機,雙盲,安慰劑對照試驗。受試者被隨機分入每天喝一或兩湯匙蘋果醋的飲料,或者被開發為與醋飲料味道相同的受控飲料,但是準備了不同種類的酸,因此其中沒有真正的醋。 。三個月後,偽造的醋組實際上增加了體重(超重人群往往會增加體重),而真正的醋組則顯著減少了體內脂肪,這是通過CT掃描確定的。每天加一點醋就能使每天只花幾便士的體重減輕一磅,而他們的飲食卻沒有任何減少。這就是為什麼我21項加速減肥的方法之一,就是每頓飯加兩茶匙醋,或者撒在沙拉上,或者甚至加些檸檬汁加到茶中。

醋研究的好處在於,它們不僅是隨機對照試驗,而且 安慰劑對照試驗。有些研究根本不受控制。女人要求每天午餐前吃一個成熟的番茄,一個月下來,她們損失了約2磅,但沒有對照組,你不知道番茄是否與番茄有任何關係。只要參加一項減肥研究,您就會知道他們將在一個月內再次出現並給您稱重,這可能會使人們以其他方式改變飲食。我的意思是肯定有可能。番茄是95%的水。因此,飯前只有大約15卡路里的熱量可以填滿拳頭大小的胃,這當然是可能的,但是我們需要更好的研究來證明它可以減輕體重。

更有力的研究有對照組。至少,例如,使人們隨機選擇減肥飲食,無論是否喝一到兩杯低鈉蔬菜汁,喝蔬菜汁的人減肥的體重明顯增加。或將人們分成兩組,每天給一半湯匙漿果約兩湯匙,然後四十五天后,枸杞組似乎將腰圍切了兩分半英寸,而對照組則沒有變化。但是,只要您有一個小組做一些特別的事情,您就不會知道安慰劑效應能帶來多少好處。在藥物試驗中,這很容易:您給一半的人實際用藥,另一半給人一模一樣的糖丸安慰劑。兩組都在做相同的事情–服用外觀相同的藥–因此,如果您看到結果有任何差異,我們可以懷疑這是由於實際藥物引起的。但是安慰劑西蘭花會是什麼樣?那就是問題所在。

你不能把白菜塞進膠囊,但是在那裡 一些食物是如此強大,以至於你 可以 實際上將它們放入藥丸中,使其與安慰劑(香料)抗衡。想知道大蒜是否會引起體重減輕嗎?給人們一些大蒜粉,壓製成片劑,而不是安慰劑。和?大蒜起作用,導致六週之內體重和腰圍下降。他們每天大約用半茶匙大蒜粉,花費不到四美分。

四分錢太陡了?一天兩美分怎麼樣?一個 25美分硬幣 每天一茶匙的大蒜粉,約有一百多名超重的男性和女性被隨機分配到每天四分之一茶匙的大蒜粉或安慰劑中,而那些在不知情的情況下服用 兩分錢 在接下來的15周中,每天有價值的大蒜粉會損失約6磅的直身脂肪。

現在,如果您可以揮霍 每天一分錢,有黑孜然。對隨機對照試驗的薈萃分析顯示,減肥功效每天僅四分之一茶匙。不是普通的孜然,這是一種完全不同的香料,被稱為黑孜然。什麼是黑孜然?您顯然沒有讀過聖經。被描述為“奇蹟藥草”,除了減肥外,還有一些隨機對照試驗顯示,每天食用黑孜然可顯著改善膽固醇和甘油三酸酯……可顯著改善血壓……和控制血糖。但是我使用它,只是因為它味道很好-我只是將黑孜然種子放在胡椒研磨機中,像胡椒粉一樣研磨。

在醫學文獻中有1000多篇關於黑孜然的論文,其中一些報告了非同尋常的結果,例如降膽固醇水平與他汀類藥物一樣多,我們為什麼不更多地聽說呢?我們為什麼不在醫學院裡教它呢?大概是因為沒有贏利動機。黑孜然只是一種常見的天然香料。您不會讓股東興奮地出售您無法獲得專利的產品,而該產品每天的費用為3美分。

或者,您可以使用普通小茴香,這是地球上第二受歡迎的香料。那些在三個月的午餐和晚餐中隨機分配到半茶匙的人,又損失了約四磅,腰部多了一英寸,這與被稱為奧利司他的肥胖藥相當。您可能聽說過,這就是“肛門滲漏”藥物,儘管該製藥公司顯然更喜歡“糞便排泄”一詞來描述其引起的直腸分泌物。該製藥公司的網站提供了一些有用的提示,不過,“穿深色褲子和隨身帶上工作的衣服可能是一個聰明的主意。”您知道,以防萬一他們的藥物導致您在工作中胡扯褲子。我想我會堅持小茴香。

卡宴胡椒可以抵消伴隨體重減輕的新陳代謝減慢,並可以加速脂肪燃燒。薑粉!每天僅從四分之一茶匙的生薑中進行的十幾項隨機對照試驗顯示,每天僅降低一個便士的體重,體重就顯著降低。在安慰劑對照試驗中證明是行之有效的,但您可能從未聽說過其中任何一項,因為它們無法獲得足夠的利潤。不要讓我開始。

但是,讓我回到可樂與胡蘿蔔的例子。卡路里不是卡路里,因為喝與喝不一樣。但是,即使您消耗了相同數量的卡路里,咀嚼了數小時以裝滿所有這些胡蘿蔔,卡路里仍可能 仍然 不是卡路里,因為它不是您所吃的東西,而是您吸收的東西。正如曾經吃過玉米的任何人都可以告訴你的那樣,有些蔬菜物質可以直接通過你。卡路里可能仍然是馬桶上盤旋的卡路里,但沖掉的卡路里並不會使它流到臀部。

那邊 纖維 如果您增加人們的纖維攝入量,甚至達到建議的水平 最低 每天的纖維攝入量開始減少,因為它們的每日熱量攝入量減少了約10%。為什麼更多的纖維意味著更少的卡路里?首先,它增加了體積而不增加卡路里。例如,冷榨蘋果汁基本上就是蘋果減去纖維。您可以在幾秒鐘內攪拌一瓶果汁,但是要獲得相同數量的卡路里,您將不得不吃大約五杯蘋果片。這就是纖維的作用,但不僅僅是卡路里密度的事情。

想像接下來會發生什麼:一旦蘋果汁從胃中溢出到腸中,蘋果汁就會迅速被吸收,使血糖升高,而被咀嚼的蘋果片團塊中夾帶的糖會在吸收過程中被吸收得更慢。你的腸子。營養素只有在與腸壁和腸壁物理接觸時才能被吸收。纖維永遠不會被吸收;因此,它可以作為載體來稀釋甚至消除卡路里的另一端。纖維不僅會捕獲糖分。它也起脂肪和澱粉阻滯劑的作用。

那些接受標準美式飲食的人每天通過浪費浪費掉大約5%的卡路里,但是使用高纖維飲食的人則可以使卡路里增加一倍。不是您吃的東西,而是您吸收的東西;因此,您可以通過吃完全相同數量的卡路里來減少高纖維飲食的重量,這僅僅是因為其中一些卡路里被困住,衝到馬桶裡並且永遠不會進入系統。

而且不僅僅是高纖維食物中的卡路里 他們自己 可用的較少。高纖維食物會全盤捕獲卡路里。因此,在高纖維飲食中吃Twinkie,會吸收更少的Twinkie卡路里。就像您在吃很多富含纖維的食物時看到的所有卡路里標籤都會立即打折一樣,這就是為什麼它將它列入我的清單了。

在我關於其他阻脂食品的部分中,首先要按照醫生的命令“吃掉類囊體”。類囊體到底是什麼?只是近乎 所有已知的生活-而且,我們呼吸的氧氣也不算大。類固醇是進行光合作用的地方,是植物將光轉化為食物的過程。類囊體是生命的偉大綠色引擎,是由富含葉綠素的膜濃縮在植物葉片中的微觀囊狀結構。

例如,當我們吃類囊體時,當我們咬進菠菜的葉子時,這些綠色的葉子膜不會立即被消化。他們在我們的腸子裡持續了幾個小時,這就是他們發揮魔力的時候。類囊體膜與脂肪酶結合。脂肪酶是人體消化脂肪的酶。因此,您結合酶-減慢脂肪吸收。

如果最終吸收了所有脂肪,那麼有什麼好處?位置,位置,位置。有一種現象稱為迴旋制動。迴腸是小腸排入結腸之前的最後部分。當檢測到未消化的卡路里 在您的腸子深處,您的身體認為“我必須從莖到尾都吃飽了”,並通過降低食慾來製止進食。這可以通過實驗證明。如果您在人的喉嚨下插入一個9英尺長的管子並滴入任何卡路里(脂肪,糖或蛋白質),就可以啟動迴腸制動。讓他們坐下來吃一頓飯,與安慰劑組相比,安慰劑組只從管子裡噴了些水,所以人們少吃一百多卡路里。您只是不覺得餓。他們感到飽,吃得少得多。這就是迴旋制動的作用。

然後,這可以轉化為體重減輕。將飲食超重的婦女隨機分配到“綠色植物膜”上(換句話說,就是秘密地給她們滑一些粉狀的菠菜),她們會增強抑制食慾的激素,減少了對甜食的需求。是的,的確,菠菜可以減少您對巧克力的渴望。和繁榮,加速減肥。全部歸功於吃了綠色,實際的綠色本身,葉中富含葉綠素的膜。

現在,研究人員僅使用菠菜粉就可以製造出令人信服的安慰劑,但是您可以讓許多類囊體吃大約半杯煮熟的蔬菜,這是我建議人們每天在我的“每日十二點”清單中吃兩次的東西。最健康的事情我鼓勵人們適應他們的日常生活。

在化學工業協會的期刊中,一組食品技術人員認為,鑑於它們具有脂肪阻斷的優點,“類囊體膜可以作為一種有希望的新的食慾降低食慾成分摻入功能性食品中”,或者您也可以將它們加入其中。大自然的意圖。

哪個綠色最多?您可以通過查看它們來判斷。因為類固醇是葉綠素所在的位置,所以葉子越綠,效果越強。因此,去尋找可以找到的最深綠色的綠色;我在那家商店買的是lacinato(又稱恐龍)羽衣甘藍。

現在,如果您把蔬菜過長地煮熟……您知道它們是如何變成單調的橄欖褐色的……這是類囊體在物理上會降解,但是在蒸或沸騰的水中變白十五秒鐘左右,您就會知道綠色得到了甚至更亮的綠色,這實際上意味著增強了脂肪阻滯能力。因此,您可以用自己的兩隻眼睛通過果嶺來評估雜貨店,廚房中類囊體的活動。

儘管類囊體最終被分解,但是纖維使它一直向下進入我們的結腸。雖然是 技術上 誠然 我們 不能消化纖維,這僅適用於我們中實際上是人類的部分。我們體內的大多數細胞是細菌。我們的腸道菌群重達我們的腎臟之一,其代謝活性與肝臟一樣高,被稱為“被遺忘的器官”,它是一種在微生物可訪問的微生物(微生物群可訪問的碳水化合物)上運行的器官。因此,當您看到我寫“吃很多大MAC”時,我不想讓任何人誤解。 MAC只是益生元的別稱,我們的腸道菌群所吃的東西就是纖維。再有那根纖維。

我們的好細菌對纖維有什麼作用?我們餵他們,他們餵我們回來。它們製造的短鏈脂肪酸從結腸吸收到我們的血液中,在我們的體內循環,甚至進入我們的大腦。這就像我們的腸道菌群與我們溝通,降低食慾的方式一樣,同時提高了我們燃燒脂肪的速度並促進了新陳代謝。全部歸功於光纖。

看一下這個。將人們放在大腦掃描儀中,向他們展示高熱量的食物(如甜甜圈),大腦中的獎勵中心立即點亮。但是,如果您重複該實驗,而這次又秘密地將纖維來源的短鏈脂肪酸直接輸送到結腸中,則您的報酬中心反應會變得遲鈍,並且受試者報告說高熱量食品似乎開胃少了,隨後就進食了少吃一頓便餐。但是纖維 補品 就像Metamucil不能起作用一樣,這是有道理的,因為它們不可發酵,這意味著我們的腸道細菌無法食用它。 so, yeah, they can improve bowel regularity but can’t be used by our good bacteria to make those compounds that can block our cravings. For that, we have to actually eat real food.

Our good gut bugs are trying to help us, but when we eat a diet deficient in fiber, we are in effect starving our microbial self. Less than 5 percent of Americans reach even the recommended minimum daily adequate intake of fiber, no surprise since the number one sources are beans and whole grains, and 96% of Americans don’t even reach the recommended minimum intake of legumes (which are beans, split peas, chickpeas, and lentils), and 99% don’t reach the recommended daily minimum for whole grains.

Most people don’t even know what fiber is. More than half of Americans surveyed think that steak is a significant source of fiber. However, by definition, fiber is only found in plants. There is zero fiber in meat, eggs, or dairy, and typically little or no fiber in processed junk, and therein lies the problem.

But wouldn’t at least the protein in that steak fill you up? Surprisingly, even a review supported by the meat, dairy, and egg industries acknowledged that protein intake does actually translate into eating less later on, whereas you eat a fiber-rich whole grain for supper, and it can cut your calorie intake more than 12 hours later at lunch the next day! You feel full a hundred calories quicker the following day because, by then, your good gut bugs are feasting on the same bounty and dialing down your appetite.

Today, even our meat could be considered junk food. For more than a century, one of the great goals of animal agriculture has been to increase the carcass fat content of farm animals. Take chicken, for example. A hundred years ago, the USDA determined chicken was about 23 percent protein by weight and less than 2 percent fat. Today, chickens have been genetically manipulated through selective breeding to have about ten times more fat. Chicken Little has become Chicken Big and may be making us bigger too.

Meat consumption in general is associated with weight gain, but poultry appeared to be the worst. Even just an ounce a day—that’s like a single chicken nugget, or like one chicken breast every ten days, was associated with weight gain compared to eating no chicken at all.

You know, it’s funny, when the meat industry funds obesity studies on chicken, they choose for their head-to-head comparison, foods like “cookies and sugar-coated chocolates.” This is a classic drug industry trick to try to make your product look better by comparing it to something worse. (Apparently, just regular chocolate wasn’t enough to make chicken look better.) But what happens when chicken is pitted against a real control, like chicken without the actual chicken? Chicken chickens out.

Both soy-based proteins and Quorn, which is a plant-based meat made from the mushroom kingdom, were found to have stronger satiating qualities than chicken. Feed people a chicken and rice lunch, and four-and-a-half hours later, they eat 18 percent more of a dinner buffet than had they instead been given a chicken-自由 chicken and rice lunch. These findings are consistent with childhood obesity research that found that meat consumption seemed to double the odds of schoolchildren becoming overweight, compared to the consumption of plant-based meat products. Whole-food sources of plant protein such as beans did even better though, associated with cutting in half the odds of becoming overweight. So, that’s why I consider these kinds of plant-based meats more of a useful stepping stone towards a healthier diet, rather than the end-game goal / ideal.

Part of the reason plant-based meats may be less fattening is that they cause less of an insulin spike. A meat-free chicken like Quorn causes up to 41 percent less of an immediate insulin reaction. It turns out animal protein causes almost exactly as much insulin release as pure sugar. Just adding some egg whites to your diet can increase insulin output as much as a 60 percent within four days. And fish may be even worse.

Why would adding tuna to mashed potatoes spike up insulin levels, but adding broccoli instead cut the insulin response by about 40 percent? It’s not the fiber, since giving the same amount of broccoli fiber alone provided no significant benefit. So, why does animal protein make things worse but plant protein makes things better?

Plant proteins tend to be lower in the branched-chain amino acids which are associated with insulin resistance, the cause of type 2 diabetes. You can show this experimentally. Give some vegans branched-chain amino acids, and you can make them as insulin resistant as omnivores. Or, take some omnivores and put them through even a “48-hour vegan diet challenge,” and, within two days, you can see the opposite—significant improvements in metabolic health.

為什麼? Because decreased consumption of branched-chain amino acids improves metabolic health.看一下這個。 Those randomized to restrict their protein intake were averaging literally hundreds more calories a day; so, they should have become fatter right? But no, they actually lost more body fat. Restricting their protein enabled them to eat more calories, while at the same time they lost more weight. More calories, yet a loss in body fat. And this magic “protein restriction”? They were just having people eat the recommended amount of protein. So, maybe they should have just called this group the normal protein group, or the recommended protein group, and the group that was eating more typical American protein levels and suffering because of it, the 過量 蛋白質組。

Given the metabolic harms of excess branched-chain amino acid exposure, leaders in the field have suggested the invention of drugs to block their absorption, to “promote metabolic health and treat diabetes and obesity without reducing caloric intake.” Or, we can just try not to eat so many branched-chain amino acids in the first place. They are found mostly in meat, including chicken and fish, dairy products, and eggs, perhaps explaining why animal protein has been associated with higher diabetes risk, whereas plant protein appears protective. So, defining the “appropriate upper limits” of animal protein intake “may offer a great chance for the prevention of T2D and obesity,” but it need not be all or nothing. Even an intermittent vegan diet has been shown to be beneficial.

If there was one piece of advice that sums up the recommendations in my upcoming book it would be: “Wall Off Your Calories.” Animal cells are encased only in easily digestible membranes, which allows the enzymes in our gut to effortlessly liberate the calories within a steak, for example. Plant cells, on the other hand, have cell walls that are made out of fiber, which present an indigestible physical barrier; so, many of the calories remain trapped. Now, processed plant foods, like fruit juice, sugar, refined grains, even whole grains if they have been powdered into flour have had their cellular structure destroyed, their cell walls cracked open and their calories are free for the taking. But when you eat structurally intact plant foods, chew all you want—you’re still going to end up with calories completely surrounded by fiber, which then blunts the glycemic impact, activates the ileal brake, and delivers sustenance to your friendly flora. So, bottom line, try to make sure as many of your calories as possible—your protein, carbs, and fat—are encased in cell walls, in other words from whole, intact plant foods.

That’s what nature intended to happen. Millions of years before we learned how to sharpen spears and mill grains and boil sugar cane, our entire physiology is presumed to have evolved in the context of eating what the rest of our great ape cousins eat: plants. The Paleolithic period, when we started using tools, only goes back about two million years. We and other great apes have been evolving since back in the Miocene era, more like twenty million years ago. So, for the first 90 percent of our hominoid existence, our bodies evolved on mostly plants. It’s no wonder then that our bodies may thrive best on the diet we were designed to eat. So, maybe we should go back to our roots. [clears throat]

With enough portion control, anyone can lose weight. Lock someone in a closet, and you can force them to lose as much body fat as you want. Chaining someone to a treadmill could probably have a similar effect. But what is the most effective weight-loss regimen that doesn’t involve calorie restriction or exercise—or a felony? I scoured through the medical literature and all the randomized controlled trials and the single most successful strategy to date is a diet of whole plant foods. The single most effective weight loss intervention like that ever published in the peer-reviewed medical literature, a whole food, plant-based diet. That works better than anything else studied to date. And, no wonder given what we just learned about fiber and branched-chain amino acids.

We’ve known for more than forty years that those eating predominantly plant-based diets weigh, on average, about thirty pounds less than the general population, but you don’t know if it’s the diet itself, until you put it to the test.

In 2017, a group of New Zealand researchers published the BROAD study, a twelve-week randomized controlled trial in the poorest region of the country with the highest obesity rates. Overweight individuals were randomized to receive either standard medical care or semi-weekly classes offering advice and encouragement to eat a low-fat diet centered around fruits, vegetables, whole grains, and legumes. And that’s all it was, just empowerment, and information, empowerment with knowledge. No meals were provided, the intervention group was merely informed about the benefits of plant-based living and encouraged to fit it into their own lives at home.

No significant change in the control group, but the plant-based intervention group, even though there were no restrictions on portions and being able to freely eat all the healthy foods they wanted, lost an average of nineteen pounds by the end of the three-month study. Nineteen pounds is a respectable weight loss, but what happened next? At the end of those twelve weeks, class was dismissed, and no more instruction was given.

The researchers were curious to see how much weight the subjects had gained back after being released from the study; so, everyone was invited back at the six-month mark to get re-weighed. The plant-based group had left the three-month study nineteen pounds lighter on average. But, six months later they were only down about…  twenty-seven pounds! They got better. The plant-based group had been feeling so good both physically and mentally… and had been able to come off so many of their medications, that they were sticking to the diet on their own and the weight continued to come off.

What about a year later? Even in studies that last a whole year, where people are coached to stay on a particular diet for the entire years’ time, by the end of the year, any initial weight lost typically tends to creep on back. The BROAD study only lasted three months, yet after it was all over, those who had been randomized to the plant-based group not only lost dozens of pounds, but they kept it off.

They not only achieved greater weight loss at six and twelve months than any other comparable trial—that was months after the study had already ended! A whole food, plant-based diet achieved the greatest weight loss ever recorded compared to any other such intervention published in the scientific literature. You can read the record-breaking study yourself for free, in full, at nature.com/articles/nutd20173 or you can just point your phone camera up at the screen and pick off the QR code.

Any diet that results in reduced calorie intake can result in weight loss. Dropping pounds isn’t so much the issue. The problem is keeping them off. A key difference between plant-based nutrition and more traditional approaches to weight loss is that people are encouraged, on plant-based diets, to eat ad libitum, meaning eat as much as they want. No calorie counting, no portion control—just eating. The strategy is to improve the quality of the food rather than restricting the quantity of the food.

If you put people on a diet packed with fruits, vegetables, whole grains, and beans and allow them to eat as much as they want, they end up eating about 50% fewer calories than they might have otherwise. Just as full on half the calories. How can you keep people satisfied cutting more than a thousand calories from their daily diet? By eating more high-bulk, low-calorie-density foods (vegetables, fruits, whole grains, and beans) and fewer calorie-dense foods, like meats, cheeses, sugars, and fats.

But it may not just be the calories-in side of the equation; those eating more plant-based appear to be effectively burning more calories in their sleep. The resting metabolic rate of those eating more plant-based may be 10% higher, or more; a boosted metabolism that can translate into burning off hundreds of extra calories a day more without doing a thing. Eating more plant-based you burn more calories just existing. So, no wonder why those who eat more plant-based tend to be slimmer. Start packing your diet with real foods that grow out of the ground, and the pounds should come off naturally, taking you down towards your ideal weight.

OK, so that’s what I spent the first half of the book doing, laying out the optimum weight-loss diet, “Plant Yourself.” Then I spend the second half of the book on all the tools I unearthed to drive 進一步 剩下的任何頑固的體重減輕體重。

We already learned that a calorie is not necessarily a calorie. A hundred calories of chickpeas has a different impact than a hundred calories of chicken or Chiclets, based on factors like absorption and appetite, but in the second half I go a step further and explore how even the exact same foods eaten differently can have different effects. Even if you eat the same amount, even if you absorb the same amount, a calorie may 仍然 not be a calorie. 不只是 什麼 我們吃,但是如何和何時。

Just to give you a taste, the exact same number of calories at breakfast are significantly less fattening than the same number of calories at dinner.什麼?!那簡直令人難以置信。 Same calories, different weight loss. A diet with a bigger breakfast causes more weight loss than the 相同 晚餐時節食。 So, my recommendation to stop eating after 7 PM is not just because, you know, I’m afraid people are mindlessly snacking on the couch or something. The same snack at night is literally more fattening than eating the exact same snack during the daytime, all thanks to our circadian rhythms, our “Chronobiology.” Something I spend a whole chapter on.

Some of the sleep data is really crazy too. Overweight adults were randomized to eight weeks of either a calorie-restricted diet or the same diet combined with five days a week of just one less hour of sleep a night. Now, they ended up sleeping an hour later on the weekends. So, overall, they just cut three hours of sleep out of their week. Now, surely 3 hours a week of sleep difference is not going to change how much weight they lost, right? And on the scale that was true. But in the normal sleep group, 80 percent of the weight loss was fat, whereas in the group missing just a few hours of sleep, it was the opposite, with 80 percent of the loss being lean body mass. So, you snooze you lose—fat! A few hours of missed sleep seemed to totally flip fat loss on its head, but just looking at the scale you wouldn’t know it.

It’s like when people fast. Stopping eating completely for a week or two can cause more weight loss than just restricting your calories, but paradoxically, it may actually lead to loss of body fat. Wait, how can eating fewer calories lead to less fat loss? Because during fasting your body starts cannibalizing itself and burning your own protein for fuel.

The scale made it look as though they were doing better when they were fasting, but the reality is they were doing worse. They would have lost more body fat if they had kept eating; they would have lost more body fat, eating more calories. Short-term fasting can interfere with body fat loss, not accelerate it, and you see the same thing, with the keto diet.

Body fat loss actually slows down when you switch to a ketogenic diet. Just looking at the bathroom scale, though, the keto diet seems like a smashing success, losing less than a pound a week on a regular diet to boom—three-and-a-half pounds in seven days after switching to keto, but what was happening inside their bodies told a totally different story. On the ketogenic diet, their rate of body fat loss was slowed by more than half; so, most of what they were losing was water, but they were also losing protein, they were also losing lean mass. That may help explain why the leg muscles of CrossFit trainees placed on a ketogenic diet can shrink as much as 8 percent within two months.

Of course, even if keto diets worked, the point of weight loss is not to fit into a skinnier casket. People whose diets even tend to trend that way appear to significantly shorten their lives. On the other hand, even just drifting in the direction of eating more healthy plant foods is associated with living longer。 Those going the other way, though, those who start out more plant-based but then add meat to their diet at least once a week not only appear to double or triple their odds of diabetes, stroke, heart disease, and weight gain, but may also suffer an associated 3.6-year drop in life expectancy. That’s going from no meat to just once-a-week meat or more.

Low-carb diets have been shown to impair artery function and worsen heart disease. Whereas, whole food, plant-based diets have been shown to actually reverse heart disease – that’s what Ornish used. So, what appears to be the most effective weight-loss diet just so happens to be the only diet ever proven to reverse heart disease in the majority of patients. If my grandma didn’t have to die like that, no one’s grandma has to die like that. If that’s all a plant-based diet could do—reverse the number-one killer of men and women—shouldn’t that be kind of the default diet until proven otherwise? And the fact that it can also be so effective in treating, arresting, and reversing other leading killers, like type 2 diabetes and high blood pressure, would seem to make the case for plant-based eating simply overwhelming. Only one diet has ever been shown to do all that: a diet centered around whole plant foods. You don’t have to mortgage your health to lose weight. The single healthiest diet also appears to be the most effective diet for weight loss.

After all, permanent weight loss requires permanent dietary changes—healthier habits just have to become a way of life. And if it’s going to be life-long, you want it to lead to a long life. Thankfully, the single best diet proven for weight loss may just so happen to be the safest, cheapest way to eat, for the longest, healthiest life. Thank you.

[Applause]





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