Outlive
Outlive
1-Page Summary
How do you want to spend the last decade of your life? Do you want to be weak, bedridden, and mentally foggy? Or busy doing whatever brings you joy, flexing the body and mind of someone decades younger? According to author Peter Attia, you can extend the active and fulfilling part of your life by building the right healthy habits—and the earlier you start building these habits, the better chance you have of circumventing mental and physical decline.
你想如何度過你生命的最後十年？你想變得虛弱、臥床不起，還是精神恍惚？還是忙於做任何能帶給你快樂的事情，展現出幾十歲年輕人的身心？根據作者彼得·阿提亞的說法，你可以通過建立正確的健康習慣來延長你生活中積極而充實的部分——你越早開始建立這些習慣，就越有機會避免心理和身體的衰退。
Attia is a medical doctor and surgeon. He’s the creator of Early Medical, an intensive online course on personal wellness and longevity. He also hosts the podcast The Drive, which features conversations with experts on health, longevity, and performance. Attia wrote Outlive to be a practical guidebook that a general audience can use to improve and lengthen their lives.
阿提亞是一名醫生和外科醫生。他是早期醫學的創始人，這是一個關於個人健康和長壽的密集在線課程。他還主持播客《駕駛》，該節目與健康、長壽和表現方面的專家進行對話。阿提亞撰寫了超越生命，旨在成為一本普通讀者可以用來改善和延長生命的實用指南。
We’ll begin this guide by detailing the chronic diseases you must avoid to live a long and active life, and we’ll explain what causes these diseases. Then, we’ll describe the actions you can take to avoid these diseases: We’ll discuss how best to exercise, what to eat, and a few other miscellaneous health tips. In our commentary, we’ll supplement Attia’s explanations of human biology and modern medicine with information from recent research. We’ll also use additional health and fitness tips to paint a broader picture of the current consensus in the complex field of wellness.
我們將從詳細介紹您必須避免的慢性疾病開始這本指南，以便過上長久而活躍的生活，並解釋這些疾病的成因。接著，我們將描述您可以採取的行動來避免這些疾病：我們將討論最佳的運動方式、飲食建議以及其他一些雜項健康提示。在我們的評論中，我們將補充阿提亞對人類生物學和現代醫學的解釋，並提供來自近期研究的信息。我們還將使用額外的健康和健身提示，來描繪當前在複雜的健康領域中的共識。
To Live Better, Avoid Chronic Disease
要過得更好，避免慢性疾病
According to Attia, the key to avoiding physical and mental decline in old age is preventing four specific chronic diseases: heart disease, cancer, neurodegenerative diseases (like Alzheimer’s and dementia), and type 2 diabetes. By chronic, we mean that these diseases progress throughout a person’s life rather than coming and going quickly, like a cold or flu. As you grow older, your chance of contracting these four diseases increases, and they’re responsible for the vast majority of deaths in the elderly. Even if these diseases don’t kill you, they greatly hinder your physical and mental capabilities, reducing your quality of life.
根據阿提亞的說法，避免老年時期身心衰退的關鍵在於預防四種特定的慢性疾病：心臟病、癌症、神經退行性疾病（如阿茲海默症和癡呆症）以及 2 型糖尿病。慢性的意思是這些疾病在一個人的一生中持續進展，而不是像感冒或流感那樣迅速來去。隨著年齡的增長，罹患這四種疾病的機會增加，這些疾病是老年人死亡的主要原因。即使這些疾病不會致命，它們也會大大妨礙你的身體和心理能力，降低你的生活質量。
(Shortform note: In Lifespan, David Sinclair argues that aging doesn’t just make you more likely to suffer from disease; rather, it is the disease, and our four “chronic diseases” are all its symptoms. Thus, he asserts that we can uniformly avert them all by reversing the biological markers of aging itself. For instance, as you age, your body accumulates senescent cells—cells that can no longer function nor be recycled, and which damage the surrounding tissue. Theoretically, destroying these senescent cells will slow down the aging process, thereby warding off all chronic diseases caused by old age and increasing your quality of life.)
（短文註解：在壽命中，大衛·辛克萊主張，衰老不僅使你更容易遭受疾病；相反，它就是疾病，而我們的四種「慢性疾病」都是其症狀。因此，他主張我們可以通過逆轉衰老本身的生物標記來統一避免這些疾病。例如，隨著年齡的增長，你的身體積累衰老細胞——這些細胞無法再正常運作或被回收，並且會損害周圍的組織。理論上，摧毀這些衰老細胞將減緩衰老過程，從而抵禦所有由老年引起的慢性疾病並提高你的生活質量。）
To avoid these diseases, take early preventative action. Although they often appear to strike suddenly, they don’t present crippling physical and mental symptoms until after they’ve slowly progressed for decades inside your body. Attia contends that by fighting these diseases decades before they present themselves, you’ll often be able to avert them entirely.
為了避免這些疾病，請及早採取預防措施。 雖然它們常常看起來突然發作，但在它們在你體內緩慢進展數十年後，才會出現嚴重的身體和心理症狀。阿提亞主張，通過在這些疾病出現之前的數十年內進行抗擊，你通常能夠完全避免它們。
Unfortunately, in our current medical system, doctors and hospitals often use a fee-for-service model—this means that doctors get paid for administering expensive treatment, not for prescribing low-cost preventative measures. They neglect to diagnose patients with these chronic diseases until severe symptoms manifest, at which point it’s much more difficult to stall or reverse their progression. For this reason, you can’t just rely on your doctor to keep you healthy—you must take your health into your own hands and proactively work to prevent these chronic diseases.
不幸的是，在我們目前的醫療系統中，醫生和醫院通常使用按服務收費的模式——這意味著醫生因提供昂貴的治療而獲得報酬，而不是因開處方低成本的預防措施而獲得報酬。他們忽視對這些慢性疾病患者的診斷，直到出現嚴重症狀，此時要延緩或逆轉病情的進展就困難得多。因此，你不能僅僅依賴你的醫生來保持健康——你必須把健康掌握在自己手中，主動努力預防這些慢性疾病。
(Shortform note: When Attia discusses the current medical system, he doesn’t specify which countries’ medical systems he’s referring to. Most countries accommodate at least some fee-for-service medical care, even those with single-payer systems (in which taxpayers fund a single governmental healthcare service). However, the extent to which they rely on this payment model varies widely. For instance, the United States’ private system heavily relies on the fee-for-service model, while the United Kingdom’s single-payer system only uses fee-for-service for a few treatments—for instance, dental care.)
（短文註解：當阿提亞討論當前的醫療系統時，他並未具體說明他所指的是哪個國家的醫療系統。大多數國家至少提供某種按服務收費的醫療護理，即使是那些擁有單一支付者系統的國家（在這種系統中，納稅人資助單一的政府醫療服務）。然而，它們對這種支付模式的依賴程度差異很大。例如，美國的私營系統 在很大程度上依賴於按服務收費的模式，而英國的單一支付者系統 僅在少數幾種治療中使用按服務收費，例如牙科護理。）
Why Health Insurers Neglect Cheap Preventative Measures
為什麼健康保險公司忽視廉價的預防措施Why don’t the entities paying doctors and hospitals push for preventative strategies to avoid disease? In the US, focusing on preventative measures would theoretically spare insurance companies significant expenses in the long run. For instance, paying for a continuous glucose monitor for someone with prediabetes would be much cheaper than paying for a lifetime’s supply of insulin injections or pancreas surgery after that patient has developed extreme type 2 diabetes.
為什麼支付醫生和醫院的實體不推動預防策略以避免疾病？在美國，專注於預防措施理論上可以在長期內為保險公司節省大量開支。例如，為一位有前期糖尿病的人支付持續血糖監測器的費用，將比在該患者發展成極端 2 型糖尿病後支付終身的胰島素注射或胰臟手術要便宜得多。However, in the US, where most people swap health insurance providers multiple times throughout their lives, insurance companies aren’t incentivized to make investments in their patients that will only pay off years down the line. It’s likely that their competitors would profit from such a move. Because of this, the healthcare industry in the US is often more focused on the short-term profits of treatment rather than the long-term savings of preventative care.
然而，在美國，大多數人一生中會多次更換健康保險提供者，保險公司並沒有動力對患者進行投資，因為這些投資只有在多年後才會有回報。競爭對手很可能會從這樣的舉措中獲利。因此，美國的醫療行業往往更專注於治療的短期利潤，而不是預防護理的長期節省。That said, single-payer healthcare systems also struggle with successfully implementing preventative strategies. Getting patients to make life-saving behavioral changes years or decades before their chronic diseases start presenting major symptoms can be challenging.
這樣說來，單一支付者醫療系統 也面臨成功實施預防策略的挑戰。讓患者在慢性疾病出現重大症狀的幾年或幾十年前做出拯救生命的行為改變可能是困難的。
What Causes Chronic Disease?
慢性疾病的原因是什麼？
How, specifically, can you avoid these four chronic diseases? Attia notes that although these diseases cause your body to break down in totally different ways, there’s an incredibly common yet preventable health condition that directly causes all four: metabolic dysfunction. By keeping your metabolism healthy, you can greatly reduce your risk of contracting all four chronic diseases.
如何具體避免這四種慢性疾病？阿提亞指出，儘管這些疾病以完全不同的方式使你的身體崩潰，但有一種極為常見且可預防的健康狀況直接導致這四種疾病：代謝功能障礙。 通過保持你的新陳代謝健康，你可以大大降低罹患這四種慢性疾病的風險。
(Shortform note: Metabolic dysfunction isn’t the only cause of chronic disease, but it’s the main cause Attia emphasizes throughout the book. He likely focuses on this condition because it’s one you have a great deal of control over relative to unavoidable risk factors like your genetics.)
(短文註解：代謝功能障礙 並不是慢性疾病的唯一原因，但這是阿提亞在整本書中強調的主要原因。他之所以專注於這種情況，可能是因為相較於不可避免的風險因素如遺傳，這是你可以掌控的許多方面之一。)
Next, we’ll explain what metabolic dysfunction is and what causes it. Then, we’ll detail how metabolic dysfunction leads to all four chronic diseases.
接下來，我們將解釋什麼是代謝功能障礙及其成因。然後，我們將詳細說明代謝功能障礙如何導致所有四種慢性疾病。
Defining Metabolic Dysfunction
定義代謝功能障礙
Attia explains that “metabolism” is the process by which your body converts the food and other nutrients you consume into energy and materials used to build, repair, and maintain your body. However, if you regularly ingest more nutrients than you need—in other words, if you consume too many calories—your body will start storing them in increasingly unhealthy ways.
Attia 解釋說，「新陳代謝」是指你的身體將你攝取的食物和其他營養物質轉換為能量和用於建造、修復和維持身體的材料的過程。然而，如果你經常攝取超過所需的營養物質——換句話說，如果你攝取過多的卡路里——你的身體將開始以越來越不健康的方式儲存它們。
Your body converts much of the food you eat into glucose (also known as blood sugar), a form of energy that’s easily stored, transported, and utilized. If your body doesn’t need to immediately burn that glucose as energy, it can store it in healthy ways: in your muscles and liver as a compound called glycogen, or as subcutaneous fat, the healthy layer of fat found under your skin all over your body. However, Attia warns that once this storage is full, your body begins storing this energy in places where it doesn’t belong; for instance, unhealthy visceral fat. This is abdominal fat that surrounds important internal organs and causes dangerous inflammation (an immune response that can cause pain, swelling, and other symptoms).
你的身體將你所吃的食物大部分轉換為葡萄糖（也稱為血糖），這是一種易於儲存、運輸和利用的能量形式。如果你的身體不需要立即將這些葡萄糖燃燒作為能量，它可以以健康的方式儲存：在你的肌肉和肝臟中以一種叫做糖原的化合物，或作為皮下脂肪，這是遍布全身皮膚下的健康脂肪層。然而，Attia 警告說，一旦這種儲存滿了，你的身體就會開始在不該儲存的地方儲存這些能量; 例如，不健康的內臟脂肪。這是圍繞重要內臟的腹部脂肪，並引起危險的炎症（這是一種可能引起疼痛、腫脹和其他症狀的免疫反應）。
Eventually, after you’ve consumed too many nutrients over an extended time, tiny bits of fat squeeze their way inside muscle cells. Attia explains that this fat weakens your cells’ ability to absorb glucose from the bloodstream and use it as energy. Your pancreas tries to compensate for this damage by increasing production of insulin, the hormone that helps push blood glucose into cells that need it. Unfortunately, if your cells are overloaded with elevated insulin for too long, they become less responsive to insulin and absorb even less glucose—a condition called insulin resistance. Insulin resistance directly causes all four of the chronic diseases we mentioned before.
最終，當你在長時間內攝取過多的營養素後，微小的脂肪會擠進 肌肉細胞內。阿提亞解釋說，這些脂肪削弱了細胞從血液中吸收葡萄糖並將其用作能量的能力。你的胰腺試圖通過增加 胰島素 的產量來補償這種損害，胰島素是幫助將血糖推入需要它的細胞的激素。不幸的是，如果你的細胞長時間過度負荷於高胰島素，它們對胰島素的反應會變得更差，吸收的葡萄糖也會更少——這種情況稱為 胰島素抵抗。 胰島素抵抗直接導致我們之前提到的四種慢性疾病。
The term “metabolic dysfunction” refers to this condition as a whole—insulin resistance is one main component of metabolic dysfunction.
“代謝功能障礙”這個術語指的是整體狀況——胰島素抵抗是代謝功能障礙的主要組成部分之一。
(Shortform note: This kind of metabolic dysfunction (a precursor to type 2 diabetes, as we’ll see) shares many symptoms with type 1 diabetes—for instance, fatigue and persistent hunger. Type 1 diabetes occurs when the pancreas fails to produce sufficient amounts of insulin due to a faulty autoimmune reaction. Insulin resistance is rarer in type 1 diabetics (because it’s not a prerequisite like it is for type 2). However, they can still contract insulin resistance in the same way: by overeating until their body forms intracellular fat inside muscle that blocks insulin signals. The only difference is that they form resistance to insulin injections rather than their body’s own insulin.)
（短文註解：這種代謝功能障礙（作為 2 型糖尿病的前兆，如我們將看到的）與 1 型糖尿病有許多相似的症狀——例如，疲勞和持續的飢餓感。1 型糖尿病發生在胰腺無法產生足夠的胰島素時，這是由於有缺陷的自體免疫反應。在 1 型糖尿病患者中，胰島素抵抗較為罕見（因為這不是像 2 型糖尿病那樣的前提）。然而，他們仍然可以以相同的方式產生胰島素抵抗：通過過量進食，直到他們的身體在肌肉內形成阻礙胰島素信號的細胞內脂肪。唯一的區別是，他們對胰島素注射產生抵抗，而不是對自己身體的胰島素。）
The Problem With Counting Calories
計算卡路里的問題Attia asserts that you begin the process leading to metabolic dysfunction when you consume more calories than your body needs to function. By this logic, the simplest way to improve your metabolism might seem to be counting and reducing how many calories you eat. However, this may not be effective.
阿提亞主張，當你攝取的卡路里超過身體所需的功能時，你就開始了導致新陳代謝功能障礙的過程。根據這一邏輯，改善新陳代謝的最簡單方法似乎是計算並減少你攝取的卡路里。然而，這可能並不有效。Calories are a measurement of how much energy a food contains. However, because your digestive system metabolizes different foods in different ways, two foods that contain the same number of calories can cause your body to absorb vastly different amounts of energy. Consequently, they can cause you to produce different amounts of fat.
卡路里是衡量食物所含能量的單位。然而，由於你的消化系統以不同的方式代謝不同的食物，兩種含有相同卡路里的食物 可能會導致你的身體吸收截然不同的能量。因此，它們可能會使你產生不同量的脂肪。For example: A slice of birthday cake contains about the same number of calories and carbohydrates as a cup of quinoa. But since the cake has been processed and refined, making it easier to digest, your body spends far less energy metabolizing the cake than it does the quinoa. In other words, it doesn’t need to use up glucose and glycogen to digest the cake, so those energy stores remain full. This forces your body to turn more of that excess energy into subcutaneous and visceral fat. The subcutaneous fat is fine, but the visceral fat is dangerous. (Additionally, quinoa contains many more healthy nutrients than a slice of cake, such as fiber, protein, and iron.)
例如：一片生日蛋糕 含有大約相同數量的卡路里和碳水化合物，與 一杯藜麥 相比。但由於蛋糕經過加工和精製，使其更易於消化，你的身體 在代謝蛋糕時消耗的能量遠低於代謝藜麥。換句話說，它不需要消耗葡萄糖和肝醣來消化蛋糕，因此這些能量儲備保持滿足。這迫使你的身體將更多的多餘能量轉化為皮下脂肪和內臟脂肪。皮下脂肪是可以的，但內臟脂肪則是危險的。（此外，藜麥含有比一片蛋糕更多的健康營養素，如纖維、蛋白質和鐵。）Calories can be a helpful tool when tracking them helps you eat less, but they don’t give a very good estimate of how much energy you’re actually retaining in the form of glucose and fat.
卡路里可以是一個有用的工具 當追蹤它們幫助你減少攝取時，但它們並不能很好地估計你實際上以葡萄糖和脂肪的形式保留了多少能量。
How Metabolic Dysfunction Causes Chronic Disease
代謝功能障礙如何導致慢性疾病
How could metabolic dysfunction and insulin resistance cause four wildly different chronic diseases? Let’s examine all four.
代謝功能障礙和胰島素抵抗如何會導致四種截然不同的慢性疾病？讓我們來檢視這四種疾病。
First, extreme metabolic dysfunction is type 2 diabetes. Attia explains that you qualify for a diagnosis of type 2 diabetes when you reach a certain level of chronically elevated blood sugar and insulin resistance.
首先，極端的代謝功能障礙 是 第二型糖尿病。阿提亞解釋說，當你達到某個持續升高的血糖和胰島素抵抗的水平時，你就符合第二型糖尿病的診斷標準。
(Shortform note: Type 1 diabetes presents in the same way as type 2—elevated blood sugar and insulin resistance. The most reliable way to distinguish type 1 diabetes from type 2 is to test your blood for autoantibodies. Autoantibodies show that your immune system is damaging your pancreas, indicating type 1 diabetes.)
（短文說明：1 型糖尿病的表現與 2 型糖尿病相同——血糖升高和胰島素抵抗。區分 1 型糖尿病和 2 型糖尿病最可靠的方法是檢測你的血液中的自體抗體。自體抗體顯示你的免疫系統正在損害你的胰臟，這表明是 1 型糖尿病。）
Second, metabolic dysfunction directly increases your risk of cardiovascular disease, Attia states. When your metabolism is dysfunctional, your blood pressure increases, damaging the walls of your blood vessels. This damage increases your risk of harmful cardiovascular incidents by causing plaque to build up along your vessel walls. This may eventually clog your blood vessels or force a clot into the bloodstream, causing a heart attack or stroke.
其次，代謝功能失調直接增加你罹患心血管疾病的風險，Attia 表示。當你的代謝功能失調時，血壓會上升，損害血管壁。這種損害會通過在血管壁上形成斑塊來增加你發生有害心血管事件的風險。這可能最終會堵塞你的血管或將血塊推入血液中，導致心臟病發作或中風。
(Shortform note: Why does metabolic dysfunction raise your blood pressure? The answer isn’t totally clear to researchers yet. That said, one potential reason may be that higher levels of insulin in the bloodstream cause the kidneys to absorb more sodium, rather than allowing your body to excrete it through urine. When your blood retains sodium, it also retains more fluid to keep the ratio balanced, raising your blood pressure—consequently damaging your blood vessel walls and increasing plaque buildup. This is also why people at risk of a heart attack or stroke should consume less dietary sodium.)
（短文註解：為什麼代謝功能障礙會提高你的血壓？目前研究人員尚未完全清楚答案。不過，一個可能的原因是血液中較高的胰島素水平會導致腎臟吸收更多鈉，而不是讓你的身體通過尿液排出它。當你的血液保留鈉時，它也會保留更多液體以保持比例平衡，從而提高你的血壓，進而損害血管壁並增加斑塊積聚。這也是為什麼有心臟病或中風風險的人應該減少膳食鈉的攝取。）
Third, metabolic dysfunction provides the perfect environment for cancer cells to grow. Attia explains that cancer cells consume more glucose than healthy cells do, and they use insulin to absorb these vast amounts of glucose. The more insulin is in your bloodstream, the more fuel is available for cancer cells to grow.
第三，代謝功能障礙為癌細胞的生長提供了完美的環境。 阿提亞解釋說，癌細胞消耗的葡萄糖比健康細胞多，並且它們利用胰島素來吸收這些大量的葡萄糖。血液中胰島素的含量越高，癌細胞生長所需的燃料就越多。
(Shortform note: Common cancer treatments including chemotherapy and steroid medications have the side effect of increasing blood sugar and insulin resistance, providing cancer cells with more fuel while killing them. This is part of the reason that treating cancer is so difficult. This reaction to cancer treatment also often exacerbates existing symptoms of metabolic dysfunction, such as high blood pressure.)
（短文註解：常見的癌症治療方法，包括化療和類固醇藥物，具有增加血糖和胰島素抵抗的副作用，這使癌細胞獲得更多燃料的同時又殺死它們。這是治療癌症如此困難的部分原因。對癌症治療的這種反應也常常加劇現有的代謝功能障礙症狀，例如高血壓。）
Finally, Attia asserts that metabolic dysfunction causes neurodegeneration: chronic damage to your brain. To function properly, the brain needs a lot of energy—typically in the form of glucose—and it depends in part on insulin to get the glucose it needs. In particular, the parts of the brain responsible for memory appear to be more dependent on insulin than other parts. If you trigger insulin resistance in the brain, the memory systems can’t get the energy they need, and neurodegeneration sets in.
最後，Attia 斷言 代謝功能障礙會導致 神經退化：對大腦的持續損害。大腦正常運作需要大量能量—通常以葡萄糖的形式—並且在某種程度上依賴胰島素來獲取所需的葡萄糖。特別是，負責記憶的大腦部分似乎比其他部分更依賴胰島素。如果你在大腦中觸發胰島素抵抗，記憶系統將無法獲得所需的能量，神經退化便會隨之而來。
(Shortform note: Neurodegeneration and metabolic dysfunction are so closely linked that many researchers refer to Alzheimer’s disease as “type 3 diabetes.” However, this classification isn’t officially recognized, and other experts argue that this label overstates the connection between the two conditions. Some research suggests that treating neurodegeneration purely as an insulin problem is ineffective: Alzheimer’s patients treated with insulin for a year suffered just as much cognitive impairment as a control group treated with placebos.)
（簡短說明：神經退行性變和代謝功能障礙之間的聯繫如此緊密，以至於許多研究人員將阿茲海默症稱為“第三型糖尿病”。然而，這一分類並未得到官方認可，其他專家則認為這一標籤誇大了兩種病症之間的聯繫。一些研究表明，將神經退行性變純粹視為胰島素問題的治療是無效的：接受胰島素治療一年的阿茲海默症患者，其認知障礙與接受安慰劑治療的對照組一樣嚴重。）
Now that we’ve explored the chronic diseases you need to prevent if you want to age healthily, let’s discuss Attia’s tips on how to prevent them. We’ll begin with his tips on exercising.
現在我們已經探討了如果想要健康老化需要預防的慢性疾病，讓我們來討論阿提亞關於如何預防這些疾病的建議。我們將從他的運動建議開始。
How Should I Exercise? 我應該如何運動？
Attia contends that consistent exercise is the number one habit you can practice to improve your health. As we’ll see, it significantly increases your lifespan and helps ward off all the major chronic diseases.
Attia 主張 持續運動是你可以練習以改善健康的首要習慣。 正如我們將看到的，它顯著延長你的壽命並有助於抵禦所有主要的慢性疾病。
Attia assumes that one main reason you want to avoid disease is so you can keep doing the things that bring you joy. He outlines a set of exercise guidelines intended to help you reach this goal: to maintain enough physical fitness to do everything active you want to do for as long as possible. If you want to continue playing basketball with your friends through your twilight years, or if you just want to be able to walk your dog and tend your garden, Attia recommends regularly practicing three types of exercise: Zone 2 endurance training, VO2 max sprint training, and muscle-centered strength training. Let’s discuss each of these in turn.
Attia 假設你想避免疾病的主要原因之一是為了能夠繼續做那些帶給你快樂的事情。他概述了一套運動指導方針，旨在幫助你達成這個目標：保持足夠的身體健康，以便能夠盡可能長時間地做你想做的所有活動。如果你想在晚年繼續和朋友打籃球，或者只是想能夠遛狗和照顧花園，Attia 建議定期練習三種運動：區域 2 耐力訓練、VO2 最大衝刺訓練和以肌肉為中心的力量訓練。讓我們逐一討論這些。
(Shortform note: Research supports Attia’s decision to offer an exercise regimen intended to maximize independence in old age. Happiness experts have found that autonomy—the feeling that you’ve chosen to do something rather than being forced to do it—in large part determines how much you enjoy whatever you’re doing. Elderly people who feel like their weak bodies are forcing them into a sedentary life may find themselves unhappy due to lack of autonomy, even if their lives as retirees are full of pleasant activities.)
（短文註解：研究支持阿提亞提供旨在最大化老年獨立性的運動計劃的決定。幸福專家發現自主性——感覺到你是選擇去做某事，而不是被迫去做——在很大程度上決定了你對所做事情的享受程度。感覺自己虛弱的身體迫使他們過著久坐生活的老年人，可能會因缺乏自主性而感到不快，即使他們的退休生活充滿愉快的活動。）
Build Endurance Through Zone 2 Training
透過區域二訓練建立耐力
First, Attia recommends regular “Zone 2” aerobic exercise. Exercise experts describe the intensity of a given exercise using one of five “zones.” Zone 2 is light-to-moderate exercise: pushing yourself just hard enough that it’s slightly uncomfortable to speak.
首先，阿提亞建議定期進行“區域 2”的有氧運動。運動專家使用五個“區域”來描述特定運動的強度。區域 2 是輕度到中度的運動：讓自己努力到稍微不舒服以至於無法輕鬆交談的程度。
(Shortform note: You may encounter a personal trainer or piece of gym equipment that describes exercise intensity in terms of metabolic equivalents, or METs, rather than “zones.” This refers to the amount of energy you exert during a given activity in proportion to the energy you spend at rest. The light-to-moderate exercise Attia prescribes here would have a MET value of six or seven, meaning you expend six or seven times more energy than you would lying down.)
(Shortform note: 你可能會遇到一位私人教練或一件健身器材 以代謝當量或 METs 來描述運動強度，而不是“區域”。這是指你在進行某項活動時所消耗的能量與你靜息時所消耗的能量之比。Attia 在這裡建議的輕度到中度運動的 MET 值為六或七，這意味著你消耗的能量是躺下時的六到七倍。）
Zone 2 exercise is beneficial because it causes your cells to produce more high-quality mitochondria—organelles in your cells that metabolize glucose and fatty acids into energy. The more mitochondria you have and the stronger they are, the more fat and glucose they can burn. This frees up storage space for calories you eat that would otherwise cause metabolic dysfunction.
區域 2 的運動是有益的，因為它使你的細胞產生更多高品質的 線粒體—細胞內的細胞器，將葡萄糖和脂肪酸代謝為能量。你擁有的線粒體越多，且越強大，它們能燃燒的脂肪和葡萄糖就越多。這為你攝取的卡路里釋放出儲存空間，否則這些卡路里會導致代謝功能障礙。
(Shortform note: The idea that Zone 2 endurance exercise is the best way to produce high-quality mitochondria is debated among experts. One study in which the same subjects trained each of their legs differently—one with continuous endurance exercise and the other with shorter, repeated bursts of more intense exercise—found that intense intervals yielded a greater number of mitochondria as well as stronger, more efficient mitochondria. However, another study found a contradictory result, concluding that continuous endurance exercise can increase your mitochondria count when intervals can’t. If you want to avoid metabolic dysfunction, regularly practicing both types of exercise may be your best bet.)
（短文註解：專家們對於區域 2 耐力運動是產生高品質線粒體的最佳方式的觀點存在爭議。一項研究中，同一受試者的雙腿進行了不同的訓練——一條腿進行持續的耐力運動，另一條腿則進行較短的、高強度的間歇運動——發現高強度的間歇產生了更多的線粒體，並且線粒體更強大、更有效率。然而，另一項研究得出了相反的結果，結論是當間歇無法進行時，持續的耐力運動可以增加你的線粒體數量。如果你想避免代謝功能障礙，定期進行這兩種運動可能是你最好的選擇。）
Attia recommends that the average person engage in Zone 2 exercise for at least three hours a week. That said, if you’re recovering from a sedentary lifestyle, Attia notes that two 30-minute sessions per week are enough to drastically reform your health.
Attia 建議一般人每週進行 Zone 2 運動 至少 三小時。不過，如果你正在從久坐的生活方式中恢復，Attia 指出每週兩次 30 分鐘的運動就足以顯著改善你的健康。
(Shortform note: Attia’s recommendation of three hours a week is slightly higher than the 150 minutes (2.5 hours) recommended by the US Department of Health and Human Services. This may be because Zone 2 exercise is slightly less intense than what most experts prescribe—therefore, you’d need to spend longer doing it to reap the same benefits. If this demand—or the lesser demand of two 30-minute sessions a week—feels so daunting that it’s difficult to motivate yourself to do it, experts recommend spreading this exercise time throughout the day so each session feels more manageable. Even short three-minute exercises can add up to substantial health benefits.)
（短文註解：阿提亞建議每週三小時的運動量略高於美國衛生與公共服務部建議的 150 分鐘（2.5 小時）。這可能是因為第二區域的運動強度略低於大多數專家所建議的運動強度——因此，您需要花更長的時間來獲得相同的好處。如果這個需求——或每週兩次 30 分鐘的較低需求——讓您感到如此艱鉅，以至於難以激勵自己去做，專家建議將這段運動時間分散到一天中，這樣每次的運動會感覺更可管理。即使是短短三分鐘的運動也能累積出可觀的健康益處。）
Stretch Your Physical Limits Through VO2 Max Training
透過 VO2 最大訓練挑戰你的身體極限
Second, Attia recommends increasing your VO2 max: the volume of oxygen that your body can effectively transport and utilize to create energy while you’re pushing yourself to your physical limits. This number, more than any other, precisely reflects your overall physical fitness. The higher your VO2 max, the more physical activities you’ll be able to perform and enjoy.
第二，Attia 建議提高你的 VO2 max：你身體能有效運輸和利用來產生能量的氧氣量，當你在挑戰自己的身體極限時。這個數字，比其他任何數字，更精確地反映了你的整體身體健康狀況。你的 VO2 max 越高，你能夠進行和享受的體育活動就越多。
Why do you need a high VO2 max to be physically fit? Attia explains that your cells need oxygen to convert glucose and fats into energy. Exercise increases the demand for oxygen throughout your body, and the more intensely you exercise, the more likely it is that your oxygen demand will exceed your VO2 max. At this point, your cells lose oxygen and must resort to less efficient means of energy generation. You’ll hit your physical limit and won’t be able to complete whatever physical activity you’re trying to do.
為什麼你需要高的 VO2 max 才能保持身體健康？Attia 解釋說，你的細胞需要氧氣來將葡萄糖和脂肪轉化為能量。運動增加了你全身對氧氣的需求，而你運動的強度越大，你的氧氣需求就越有可能超過你的 VO2 max。此時，你的細胞會失去氧氣，必須依賴效率較低的能量產生方式。你將達到身體的極限，無法完成你正在嘗試的任何體育活動。
(Shortform note: Since your cells need oxygen during exercise, you may assume that you should inhale as much oxygen as possible to raise your VO2 max. However, in The Oxygen Advantage, Patrick McKeown argues the opposite: Breathing less is the key to increasing VO2 max. He asserts that your blood needs carbon dioxide to pass oxygen on to the cells that need it. Often, people breathe too heavily while exercising and exhale all their CO2. They then lose the ability to utilize oxygen and become exhausted. Instead, if you habitually breathe less, you can train your body to tolerate more CO2, increasing your VO2 max—thereby helping you accomplish more physical activities as you age.)
(短文註解：由於您的細胞在運動時需要氧氣，您可能會認為應該盡量吸入更多氧氣以提高您的 VO2 max。然而，在 《氧氣優勢》 中，帕特里克·麥基翁提出了相反的觀點：呼吸 更少 是 提高 VO2 max 的關鍵。他主張 您的血液需要二氧化碳才能將氧氣傳遞給需要它的細胞。通常，人們在運動時呼吸過重，並排出所有的 CO2。這樣他們就失去了利用氧氣的能力，變得疲憊。相反，如果您 習慣性地呼吸更少，您可以訓練您的身體耐受更多的 CO2，提高您的 VO2 max——從而幫助您隨著年齡增長而完成更多的體力活動。)
VO2 max declines sharply as you age, so to do all the physical tasks you want to in your elderly years, compensate for this decline by training your VO2 max as much as possible. Attia adds that aside from enabling an active lifestyle, a high VO2 max will reduce your risk of disease—research shows that VO2 max is strongly correlated with a longer lifespan.
VO2 最大值隨著年齡的增長而急劇下降，因此 為了在老年時期完成所有想要的體力活動，盡可能通過訓練你的 VO2 最大值來彌補這一下降。Attia 補充說，除了促進積極的生活方式外，高 VO2 最大值還能降低疾病風險——研究顯示 VO2 最大值與更長的壽命有著強烈的相關性。
(Shortform note: Attia doesn’t specify why a higher VO2 max in old age would reduce your risk of disease. One simple possibility is that more oxygen to your organs results in better overall health. A low VO2 max might slightly reduce the oxygen supply to various organs throughout your body—not enough to cause any easily detectable symptoms, but enough to increase your vulnerability to chronic disease.)
(Shortform note: Attia 並未具體說明為何年長者的 VO2 max 較高會降低罹病風險。一個簡單的可能性是，更多的氧氣供應給你的器官會導致整體健康狀況更佳。低 VO2 max 可能會稍微減少你全身各個器官的氧氣供應——雖然不足以引起任何明顯的症狀，但足以增加你對慢性疾病的脆弱性。)
To improve your VO2 max, Attia recommends a high-intensity interval exercise rhythm: Warm up, then perform four-minute spurts of aerobic exercise at the fastest pace you can steadily maintain for those four minutes. Take four minutes of recovery by exercising at a slow, easy pace. Repeat this sprint-rest cycle four to six times, then cool down. Doing this once a week is enough to gradually raise your VO2 max.
為了提高你的 VO2 最大值，Attia 建議採用高強度間歇運動的節奏：熱身，然後以你能穩定維持的最快速度進行四分鐘的有氧運動。接著以緩慢、輕鬆的速度進行四分鐘的恢復。重複這個衝刺-休息的循環四到六次，然後進行冷卻。每週進行一次就足以逐漸提高你的 VO2 最大值。
(Shortform note: The rhythm Attia describes here is a form of fartlek. Fartlek is Swedish for “speed play,” and it refers to any exercise in which you alternate between timed periods of strenuous activity and slower recovery. Fartlek is different from typical interval exercises, which require you to cover a certain distance with every rep—for instance, running 12 200-meter sprints with recovery in between. If you’re struggling with Attia’s rhythm, you can work your way up to it with a fartlek that includes more recovery time—two-minute spurts of intense activity followed by four minutes of recovery. As long as you’re pushing yourself to your physical limit, you’re raising your VO2 max.)
（Shortform 註解：Attia 在這裡描述的節奏 是一種間歇跑。間歇跑在瑞典語中意為「速度遊戲」，指的是任何在有時間限制的劇烈活動和較慢的恢復之間交替進行的運動。間歇跑與典型的間歇訓練不同，後者要求你在每次重複中覆蓋一定的 距離——例如，進行 12 次 200 米的衝刺，中間有恢復時間。如果你在 Attia 的節奏上感到困難，可以通過包含更多恢復時間的間歇跑來逐步適應——兩分鐘的高強度活動後接著四分鐘的恢復。只要 你在挑戰自己的身體極限，你就能提高你的 VO2 最大值。）
Build Muscle Through Strength Training
透過力量訓練增強肌肉
Finally, Attia recommends building as much muscle as possible. Research shows that the bigger and stronger your muscles are, the longer you’ll live and the healthier you’ll be.
最後，Attia 建議盡可能多地增肌。研究顯示，你的肌肉越大越強壯，你的壽命就越長，健康狀況也會越好。
One reason for this is that the more muscle mass you have, the easier it is to be metabolically healthy. Attia states that muscle tissue is better at metabolizing glucose than other parts of your body, so the more muscle you have, the easier it is to keep your blood sugar low and stable. Additionally, building muscle increases your capacity to store glucose as glycogen for short-term energy consumption, rather than storing it as potentially harmful fat.
這其中一個原因是 肌肉量越多，代謝健康就越容易。阿提亞指出，肌肉組織在代謝葡萄糖方面比身體的其他部分更有效，因此肌肉越多，保持血糖低且穩定就越容易。此外，增強肌肉能提高你將葡萄糖儲存為肝醣以供短期能量消耗的能力，而不是將其儲存為潛在有害的脂肪。
(Shortform note: Because your muscle mass significantly determines how efficiently you can metabolize and store glucose, gaining muscle can result in major metabolic improvements even if you're still carrying an unhealthy amount of fat. One study of overweight and obese adults found that the third of participants with the most muscle boasted 45% greater insulin sensitivity than the third of participants with the least muscle. This meant that the cells of more muscular participants could more effectively absorb glucose from their blood, warding off chronic disease.)
（短文說明：因為你的肌肉量顯著影響你代謝和儲存葡萄糖的效率，增肌 即使你仍然攜帶不健康的脂肪量，也能帶來重大的代謝改善。一項針對超重和肥胖成人的研究發現，肌肉量最多的三分之一參與者的胰島素敏感性比肌肉量最少的三分之一參與者高出 45%。這意味著肌肉較多的參與者的細胞能更有效地從血液中吸收葡萄糖，從而抵禦慢性疾病。）
Unfortunately, around the time someone turns 65, they begin losing muscle at an alarming rate. Unless you build up above-average muscle mass before this time, your muscle mass will drop low enough during your elderly years to leave you significantly more vulnerable to chronic disease and injury. Attia recommends regular strength training (specifically, weightlifting) to prevent this as much as possible.
不幸的是，當某人接近 65 歲時，他們開始以驚人的速度失去肌肉。除非你在這之前建立起高於平均水平的肌肉量 before，否則在老年時期你的肌肉量會下降到足以讓你更容易受到慢性疾病和傷害的程度。 阿提亞建議定期進行力量訓練（特別是舉重）以儘量防止這種情況發生。
(Shortform note: Although extreme muscle degeneration typically doesn’t happen until you’re 65, experts note that without conscious intervention, you’ll start losing significant muscle by age 30: 3 to 5% of your muscle mass every decade. Thus, starting your strength training early can yield significant benefits long before “old age.”)
（短文註解：雖然極端的肌肉退化通常不會在你 65 歲之前發生，但專家指出如果不進行有意識的干預，你將在 30 歲時開始顯著失去肌肉：每十年損失 3%到 5%的肌肉質量。因此，早早開始力量訓練可以在“老年”之前帶來顯著的好處。）
However, Attia emphasizes that if you perform intense strength training exercises poorly, they can do more harm than good—specifically, if they cause you to badly injure yourself. Train yourself to use the proper form when practicing strength exercises, and use lighter weights until you’ve built up the bodily awareness you need to avoid injury when lifting heavier weights.
然而，Attia 強調 如果你不正確地進行高強度的力量訓練，這些訓練可能會弊大於利——特別是如果它們導致你嚴重受傷。訓練自己在進行力量練習時使用正確的姿勢，並在你建立起避免受傷所需的身體意識之前，使用較輕的重量。
(Shortform note: In The 4-Hour Body, Tim Ferriss contends that most injuries during strength training are caused by imbalances—when one side of your body (or one half of the same muscle group) is much stronger and more developed than the other. If any of your muscles feel imbalanced in this way, make sure to correct it before attempting any full-strength exercises. Additionally, using weights that are too light can sometimes cause you to develop improper form, so ensure that you’re using weights heavy enough to realistically replicate the strain that the full-strength exercise will put on your body.)
（短文註解：在《四小時身體》中，蒂姆·費里斯主張，大多數力量訓練中的受傷是由於不平衡造成的——當你身體的一側（或同一肌肉群的一半）比另一側強壯且發達得多。如果你的任何肌肉感覺不平衡，請確保在嘗試任何全力訓練之前進行矯正。此外，使用過輕的重量有時會導致你發展出不正確的姿勢，因此請確保你使用的重量足夠重，以真實地模擬全力訓練對你身體的壓力。）
What Should I Eat?
In addition to exercising correctly, eating a healthy diet is key to maintaining your physical and mental capabilities in old age. Attia emphasizes that what you should eat depends on your unique body—there’s no diet that’s universally the “healthiest” for everyone. Everyone’s body metabolizes food differently, so the exact same diet might help one person and harm another.
除了正確運動，健康飲食對於維持你在老年時的身體和心理能力至關重要。阿提亞強調，你應該吃什麼取決於你獨特的身體——沒有一種飲食對每個人來說都是“最健康”的。 每個人的身體對食物的代謝方式不同，因此完全相同的飲食可能對一個人有益，而對另一個人則有害。
(Shortform note: Individuals’ widely varying metabolic reactions to the same food have cast doubt on countless widely accepted conclusions from nutritional research. Traditionally, studies have compared an experimental group, who all change their diet in the same way, to a control group whose diet stays the same. However, this setup doesn’t account for differences between the two groups’ metabolisms—even if the groups are randomly selected, they won’t always be identical samples of the population. Instead, some researchers are now running a different kind of study: one in which individual participants stick with one diet for several months, then swap to another. This allows researchers to study the effects of different diets on the same metabolism.)
（短文註解：個體對相同食物的代謝反應差異極大，使無數廣泛接受的營養研究結論受到質疑。傳統上，研究比較一組實驗組，所有成員以相同方式改變飲食，與一組控制組，其飲食保持不變。然而，這種設置並未考慮到兩組之間的代謝差異——即使這些組別是隨機選擇的，它們也不會始終是人口的相同樣本。相反，一些研究人員現在正在進行一種不同類型的研究：讓個別參與者在幾個月內堅持一種飲食，然後再換成另一種。這使研究人員能夠研究不同飲食對相同代謝的影響。）
Although there’s no universally optimal diet, Attia offers broad dietary advice that would improve the health of most people. In modern times, many follow what’s called the Standard American Diet, which is heavy in processed, sugary foods. Consequently, they consume too many calories (which contributes to metabolic dysfunction, as we’ve discussed), yet they still don’t get enough of some key nutrients (especially protein, as we’ll see soon).
雖然沒有普遍最佳的飲食，但阿提亞提供的廣泛飲食建議可以改善大多數人的健康。在現代，許多人遵循所謂的標準美國飲食，這種飲食重加工和含糖食物。因此，他們攝取的卡路里過多（這會導致代謝功能障礙，正如我們所討論的），但仍然沒有攝取足夠的一些關鍵營養素（特別是蛋白質，正如我們將很快看到的）。
(Shortform note: Although experts call it the Standard American Diet (SAD), this unhealthy eating pattern isn’t unique to America. One study found that many European countries, including Sweden, France, and Germany, consume the SAD’s processed foods at a comparable rate to the United States. Additionally, many countries in the Eastern Hemisphere have shifted their diet toward the SAD in recent years. This includes India, where instances of diabetes tripled from 1995 to 2014, and China, where rates of obesity quadrupled between 1995 and 2019.)
(短文註解：雖然 專家稱之為標準美國飲食（SAD），但這種不健康的飲食模式並不僅限於美國。一項研究發現，包括瑞典、法國和德國在內的許多歐洲國家，消耗 SAD 的加工食品 與美國的消耗率相當。此外，許多東半球的國家在近年來 將飲食轉向 SAD。這包括印度，1995 年至 2014 年間糖尿病的案例增加了三倍，以及中國，1995 年至 2019 年間肥胖率增加了四倍。）
As we’ll explore in this section, Attia asserts that most people should do the following:
在本節中，我們將探討阿提亞主張大多數人應該做以下幾點：
- Eat more protein
- Eat fewer carbohydrates 減少碳水化合物的攝取
- Complete their diet with fats
完整他們的飲食以脂肪 - Only fast if they have metabolic dysfunction
只有在他們有代謝功能障礙的情況下才需要禁食
Finally, as a side note, Attia states that as long as your metabolism is relatively healthy, practicing the ideal exercise routine is more important than consuming the ideal diet. Although fixing your diet is essential if you’re suffering from intense insulin resistance, perfecting your diet yields far fewer health benefits than perfecting your exercise routine.
最後，作為附註，Attia 表示，只要你的新陳代謝相對健康，實踐理想的運動計劃比攝取理想的飲食更重要。雖然如果你正在遭受嚴重的胰島素抗性，改善你的飲食是必不可少的，但完善你的飲食所帶來的健康益處遠不如完善你的運動計劃。
(Shortform note: This idea contradicts some common wisdom in the field of health and fitness. Some health experts cite the “80/20 Rule”: If you want to lose weight, you need to retain fewer calories. Avoid 80% of those calories by eating less, and burn the other 20% through exercise. This advice disregards the fact that exercise helps you lose weight primarily by improving your metabolism, not by burning calories.)
(Shortform note: 這個想法與健康和健身領域的一些常識相矛盾。一些健康專家 引用“80/20 法則”：如果你想減肥，你需要攝取更少的卡路里。通過少吃來避免 80%的卡路里，並通過運動燃燒另外 20%。這個建議忽略了運動主要是通過改善你的新陳代謝來幫助你減肥，而不是通過燃燒卡路里。)
Most People Should Eat More Protein
大多數人應該攝取更多蛋白質
According to Attia, most people consume far less protein than their body needs for optimal health. The body uses protein for countless essential tasks, converting it into important enzymes, hormones, and muscle mass. (As we’ve discussed, building muscle is necessary to increase health and longevity.)
根據阿提亞的說法，大多數人攝取的蛋白質遠低於身體為了最佳健康所需的量。 身體將蛋白質用於無數重要的任務，將其轉化為重要的酶、激素和肌肉質量。（正如我們所討論的，增強肌肉對於提高健康和壽命是必要的。）
(Shortform note: Because the enzymes and hormones your body creates with protein are so vital to survival, severe protein deficiency, or kwashiorkor, disrupts basic biological processes, causing much more serious problems than diminished muscle mass. Kwashiorkor can result in a weakened immune system, permanently stunted physical and mental development, coma, and death.)
（短文說明：由於您身體所產生的酶和激素與蛋白質息息相關，對生存至關重要，嚴重的蛋白質缺乏症或克瓦希奧科症，會擾亂基本的生物過程，造成比肌肉質量減少更嚴重的問題。克瓦希奧科症可能導致免疫系統削弱、身心發展永久性遲緩、昏迷和死亡。）
Although US government agencies recommend consuming 0.8 grams of protein per kilogram of body weight a day, Attia asserts that most people need at least double that—1.6 grams per kilogram. If you’re active and trying to gain muscle (as almost everyone should be), Attia recommends 2.2 grams per kilogram (or 1 gram per pound of body weight) of protein.
儘管美國政府機構建議每天每公斤體重攝取 0.8 克蛋白質，Attia 主張大多數人需要至少雙倍的量—每公斤 1.6 克。如果你活躍並且想要增肌（幾乎每個人都應該這樣做），Attia 建議每公斤攝取 2.2 克（或每磅體重 1 克）的蛋白質。
Whereas excess calories from glucose are sometimes stored in unhealthy ways, your kidneys will filter out any excess protein and you’ll excrete it through urine. Therefore, it’s very difficult to eat too much protein—3.7 grams per kilogram of body weight will strain your kidneys, but the vast majority of people never come close to consuming that much.
由於多餘的葡萄糖卡路里有時會以不健康的方式儲存，您的腎臟會過濾掉任何多餘的蛋白質，並通過尿液排出。因此， 攝取過多蛋白質是非常困難的——每公斤體重 3.7 克會對您的腎臟造成壓力，但絕大多數人從未接近攝取這麼多。
(Shortform note: It’s rare for people to contract kidney disease by eating too much protein. Rather, two out of every three cases of chronic kidney disease are caused by diabetes and high blood pressure (both signs of metabolic dysfunction). Attia would likely argue that increasing your protein intake will almost always reduce your risk of kidney disease, as building muscle improves your metabolic function.)
（短文註解：人們因攝取過多蛋白質而罹患腎病的情況很少。相反，每三例慢性腎病中就有兩例是由糖尿病和高血壓引起的（這兩者都是代謝功能失調的跡象）。阿提亞可能會主張，增加蛋白質攝取幾乎總是會降低腎病的風險，因為增強肌肉有助於改善你的代謝功能。）
The Risks of Eating Too Much Meat
吃太多肉的風險After hearing Attia’s argument that most people fail to eat enough protein, you may decide to add significantly more meat to your diet. However, excess meat consumption can cause a number of health issues: Both red and white meat are high in saturated fats, which (as we’ll discuss in more detail later) increases some individuals’ risk of heart disease. Additionally, processed meats such as ham, bacon, and sausage are particularly high in sodium, which research indicates may increase your risk of high blood pressure, bowel cancer, and stomach cancer.
在聽到阿提亞的論點，即大多數人未能攝取足夠的蛋白質後，您可能會決定在飲食中顯著增加更多的肉類。然而，過量的肉類消費可能會引發多種健康問題：紅肉和白肉都含有高飽和脂肪，這會（如我們稍後將更詳細討論的）增加某些人患心臟病的風險。此外，像火腿、培根和香腸等加工肉類特別高含量的鈉，研究表明可能增加您患高血壓、腸癌和胃癌的風險。This means that getting the amount of protein you need solely from meat may trigger adverse health effects. For example, if you weigh 170 pounds and want to gain muscle, Attia recommends consuming 170 grams of protein per day. To reach this target by eating nothing but ground beef with taco seasoning for one day, you’d consume over 1.5 pounds of beef containing an unhealthy 41 grams of saturated fat (209% of the FDA recommendation) and 5,800 milligrams of sodium (256% of the FDA recommendation).
這意味著僅從肉類獲取所需的蛋白質可能會引發不良健康影響。例如，如果你體重 170 磅並想增肌，Attia 建議每天攝取 170 克蛋白質。要在一天內僅通過吃加了塔可調味料的絞肉來達到這個目標，你需要攝取超過 1.5 磅的牛肉，這其中含有不健康的 41 克飽和脂肪（209% 的 FDA 建議）和 5,800 毫克鈉（256% 的 FDA 建議）。Instead of increasing your protein intake solely through meat, it would likely be healthier to balance your diet with other protein-rich foods like nuts, beans, and quinoa.
與其僅通過肉類增加蛋白質攝取，將飲食與其他富含蛋白質的食物如堅果、豆類和藜麥平衡，可能會更健康。
Most People Should Eat Fewer Carbs
大多數人應該少吃碳水化合物
Most people consume too many carbohydrates, asserts Attia. Although the body uses carbohydrates as its main source of energy, when you consume too many, they raise blood glucose and trigger the overproduction of insulin. This is because your body converts carbohydrates into glucose more readily than any other food group.
大多數人攝取過多的碳水化合物，阿提亞指出。雖然身體將碳水化合物作為主要的能量來源，但當你攝取過多時，會提高血糖並觸發胰島素的過度產生。這是因為你的身體比起其他食物類別，更容易將碳水化合物轉換為葡萄糖。
That said, Attia notes that carbohydrates in moderation are healthy—and they’re healthier for some people than others. For instance, although it would be atypical, you may find that cutting carbohydrates out of your diet doesn’t help you burn fat or reduce your blood sugar.
這樣說來，Attia 指出適量的碳水化合物是健康的——而對某些人來說，它們比對其他人更健康。例如，雖然這並不常見，但你可能會發現，將碳水化合物從你的飲食中去除並不有助於你燃燒脂肪或降低血糖。
(Shortform note: Carbohydrates are particularly healthy for endurance athletes, who need a high-carb diet to maintain their physical performance. Unlike most people, endurance athletes nearly deplete the glycogen stores in their liver and muscles, the human body’s primary source of short-term energy, on a regular basis. To them, carbohydrates are valuable for the same reason they’re unhealthy for others: The body converts them directly into vast amounts of glucose, which can replenish these glycogen stores. Experts assert that most athletes don’t eat enough carbohydrates—a 175-pound endurance athlete needs upwards of 3,800 calories every day just from carbs to replenish their glycogen.)
（短文說明：碳水化合物對耐力運動員特別健康，他們需要高碳水化合物飲食來維持身體表現。與大多數人不同，耐力運動員幾乎定期耗盡肝臟和肌肉中的糖原儲備，這是人體短期能量的主要來源。對他們來說，碳水化合物的價值正是因為它們對其他人來說不健康：身體將其直接轉化為大量葡萄糖，這可以補充這些糖原儲備。專家指出，大多數運動員攝取的碳水化合物並不夠——一位 175 磅的耐力運動員每天需要超過 3,800 卡路里僅來自碳水化合物來補充他們的糖原。）
The only way to know for sure how your unique metabolism processes carbohydrates is to experiment with your diet until you’ve found one that helps you reach your health goals.
唯一確定你獨特的新陳代謝如何處理碳水化合物的方法，就是通過實驗你的飲食，直到找到一種能幫助你達成健康目標的飲食。
To help you do this, Attia recommends using a continuous glucose monitor (CGM), an implantable device that allows you to stay aware of your blood sugar levels at all times. Spikes in blood glucose after you’ve eaten something high in carbohydrates indicate times when your body will produce extra insulin in response. By observing what quantities of specific foods cause your glucose (and insulin) to spike, you can learn to avoid or reduce your intake of those foods in the future. Over time, this helps you keep your blood glucose low and avoid insulin resistance.
為了幫助你做到這一點，Attia 建議使用持續血糖監測器 (CGM)，這是一種可植入的裝置，讓你隨時了解自己的血糖水平。在你吃了高碳水化合物的食物後，血糖的劇烈上升表明你的身體會產生額外的胰島素作為反應。通過觀察特定食物的攝取量如何導致你的血糖（和胰島素）上升，你可以學會在未來避免或減少這些食物的攝取。隨著時間的推移，這有助於你保持血糖低，並避免胰島素抵抗。
(Shortform note: CGMs are generally slightly less accurate than traditional blood glucose meters, which read blood drawn from your finger. This is because they don’t directly measure blood sugar. Rather, they measure the amount of glucose in your body’s interstitial fluid—the plasma-like liquid that fills your body outside of your blood vessels—and use that to estimate blood glucose. This inaccuracy makes CGMs more suitable for getting a vague sense of what foods are good for your metabolism rather than determining your exact glucose levels for medical purposes (like helping your doctor know how much supplemental insulin to prescribe).)
(短文說明：持續血糖監測儀（CGMs）通常是 略微不如傳統血糖計準確，後者是從你的手指抽取血液來測量血糖。這是因為它們並不直接測量血糖。相反，它們測量你體內的 間質液 中的葡萄糖量——這種類似血漿的液體填充在你的血管外——並用來估算血糖。這種不準確性使得 CGMs 更適合用來大致了解哪些食物對你的新陳代謝有益，而不是用於醫療目的（例如幫助你的醫生知道應該開多少補充胰島素）。)
Complete Your Diet With Fats
用脂肪完善您的飲食
When you reduce your consumption of carbohydrates and eat the necessary amount of protein, the rest of your diet will primarily be made of fats. This is perfectly healthy, according to Attia.
當你減少碳水化合物的攝取並攝取必要的蛋白質時，你飲食的其餘部分將主要由脂肪組成。根據阿提亞的說法，這是完全健康的。
Generally speaking, foods high in monounsaturated fats (like olive oil) are healthier than foods high in polyunsaturated fats (like nuts and fish) or foods high in saturated fats (like beef and butter). Attia estimates based on anecdotal evidence that one-third to one-half of people react badly to a diet heavy in saturated fats—it causes them to produce significantly more LDLs and other unhealthy forms of cholesterol, increasing their likelihood of heart disease. That said, for those whose bodies can process it well, saturated fat is perfectly healthy to eat.
一般來說，富含單元不飽和脂肪的食物（如橄欖油）比富含多元不飽和脂肪的食物（如堅果和魚）或富含飽和脂肪的食物（如牛肉和奶油）更健康。阿提亞根據經驗證據估計，三分之一到一半的人對富含飽和脂肪的飲食反應不佳——這會使他們產生顯著更多的低密度脂蛋白和其他不健康的膽固醇形式，增加心臟病的可能性。不過，對於那些能夠良好處理飽和脂肪的人來說，食用飽和脂肪是完全健康的。
(Shortform note: According to Michael Pollan in In Defense of Food, the main reason people believe that dietary fat is so unhealthy is that lobbyists pressured government agencies into popularizing this idea. In 1977, a US Senate committee reported that eating too much red meat and dairy caused heart disease; however, pushback from the meat and dairy industries caused them to retract their findings and instead blame the saturated fats and cholesterol contained in those foods. This allowed corporations to market “healthier” low-fat processed foods like margarine, which ended up also causing heart disease.)
（短文註解：根據邁克爾·波倫在《食物的辯護》中的說法，人們認為飲食脂肪如此不健康的主要原因是遊說者施壓政府機構使這一觀點流行。1977 年，美國參議院委員會報告指出，過量食用紅肉和乳製品會導致心臟病；然而，來自肉類和乳製品行業的反對聲音使他們撤回了這一發現，並將責任轉嫁到這些食物中所含的飽和脂肪和膽固醇上。這使得企業能夠推廣“更健康”的低脂加工食品，如人造黃油，最終也導致了心臟病的發生。）
The Drawbacks of “Healthy” Fats and the Benefits of “Unhealthy” Fats
“健康”脂肪的缺點與“不健康”脂肪的好處Because saturated fats are the only fats with a chance of increasing your risk of heart disease, you may assume that a diet of low saturated fats and high poly- and monounsaturated fats would be ideal for anyone. (One such diet would be the Mediterranean diet, heavy in fish and fatty oils and light on red meat and dairy products like butter.) However, this may not be the case—especially for the one-third to one-half of the population that can process saturated fats just fine.
因為飽和脂肪是唯一有可能增加心臟病風險的脂肪，您可能會認為低飽和脂肪和高多元不飽和脂肪及單元不飽和脂肪的飲食對任何人來說都是理想的。（這樣的飲食就是地中海飲食，重視魚類和脂肪油，輕視紅肉和像黃油這樣的乳製品。）然而，情況可能並非如此——尤其是對於三分之一到一半能夠很好地處理飽和脂肪的人口。Monounsaturated and polyunsaturated fats have some potential drawbacks. Olive oil, a great source of monounsaturated fat, is surprisingly calorically dense. Just one tablespoon of olive oil contains 120 calories. Similarly, nuts like pine nuts and walnuts (which contain polyunsaturated fats) are lightweight but dense with calories. If you’re not careful, the caloric density of these foods may sneak up on you, causing you to gain weight.
單元不飽和脂肪和多元不飽和脂肪有一些潛在的缺點。橄欖油是單元不飽和脂肪的極佳來源，卻意外地熱量密集。僅僅一湯匙橄欖油 含有 120 卡路里。同樣，像松子和核桃這樣的堅果（含有 多元不飽和脂肪）是 輕巧但熱量密集 的。如果你不小心，這些食物的熱量密度 可能會悄悄地增加你的體重。Furthermore, increasing your intake of certain types of saturated fat may yield unexpected health benefits. For instance, the saturated fats caproic, caprylic, and capric acid (known collectively as Medium Chain Triglycerides, or MCTs) have been shown to help your body burn calories, decrease insulin resistance, and prevent seizures. These benefits are potent enough that these saturated fats are sold as dietary supplements.
此外，增加您對某些類型的飽和脂肪的攝取可能會帶來意想不到的健康益處。例如，飽和脂肪的癸酸、辛酸和癸酸（統稱為中鏈三酸甘油脂，或 MCTs）已被證明有助於您的身體燃燒卡路里、降低胰島素抵抗，並防止癲癇發作。這些益處的效力足以使這些飽和脂肪作為膳食補充劑出售。
Fasting Is Sometimes Good for You (But Usually Bad)
禁食有時對你有好處（但通常不好）
Attia notes that in recent years, fasting—restricting your calorie intake for fixed periods of time—has become an incredibly popular health trend. But is it good or bad for you?
阿提亞指出，近年來，禁食——在固定時間內限制卡路里攝入——已成為一種非常受歡迎的健康趨勢。但這對你來說是好還是壞呢？
Fasting is exactly what some people need. If you find fasting easier than trying to follow strict dietary rules, it can help you reduce your calorie intake to a healthy level. Additionally, within three days of fasting, you’ll trigger starvation ketosis—your body burns fat stores to keep you from feeling hungry, and your cells recycle stray waste materials into functional parts in a process called autophagy.
禁食正是某些人所需要的。 如果你發現禁食比遵循嚴格的飲食規則更容易，它可以幫助你將卡路里攝入量減少到健康水平。此外，在禁食三天內，你將觸發 飢餓酮症——你的身體燃燒脂肪儲備以防止你感到飢餓，而你的細胞則在一個稱為 自噬 的過程中回收多餘的廢物材料並轉化為功能性部件。
However, Attia argues that in many cases, fasting can be detrimental to your health. It’s nearly impossible to eat enough protein to support your body during a fast, so you’re likely to lose muscle (which is very unhealthy, as we’ve discussed). For most people, this is too great of a sacrifice to make: Only fast if you have metabolic dysfunction and desperately need to burn fat to avoid chronic disease.
然而，Attia 認為在許多情況下，禁食可能對健康有害。在禁食期間，幾乎不可能攝取足夠的蛋白質來支持身體，因此你很可能會失去肌肉（這是非常不健康的，正如我們所討論的）。對於大多數人來說，這是一個過大的犧牲：只有在你有代謝功能障礙並迫切需要燃燒脂肪以避免慢性疾病時，才應該禁食。
Counterargument: Fasting Is Healthy for Everyone
反駁：禁食對每個人都是健康的In The Obesity Code, Jason Fung takes a much stronger pro-fasting stance than Attia, arguing that fasting is essential to reverse insulin resistance. Fung asserts that if you’re metabolically unhealthy, your body believes it needs more food than is healthy, sending signals that make it incredibly difficult to stick to a healthy diet:
在《肥胖法則》中，傑森·方的禁食立場比阿提亞更為強烈，他主張禁食對逆轉胰島素抵抗至關重要。方指出，如果你在代謝上不健康，你的身體會認為需要比健康更多的食物，發送信號使得堅持健康飲食變得極其困難：
Your metabolism slows, burning less energy and storing more glucose as fat.
你的新陳代謝減慢，燃燒的能量減少，將更多的葡萄糖儲存為脂肪。You produce less leptin, the hormone that makes you feel full and satisfied after eating.
你產生的瘦素較少，這種荷爾蒙讓你在吃完後感到飽足和滿足。You produce more ghrelin, a hormone that makes you feel hungrier.
你產生更多的生長激素，這是一種讓你感到更餓的荷爾蒙。This creates a vicious cycle in which you crave and eat more food, raising your insulin and further disrupting your hormones.
這會形成一個惡性循環，使你渴望並攝取更多食物，提升你的胰島素並進一步擾亂你的荷爾蒙。According to Fung, fasting is the key to escaping this cycle, as triggering ketosis significantly lowers your insulin levels. This is arguably the reason some people find fasting much easier than sticking to a strict diet (which may explain why fasting is popular). It’s not just that its rules are easier to follow, as Attia claims—it also resets your hunger hormones to reduce feelings of craving. Fung recommends regularly fasting for 24 to 36 hours at a time, and he notes that your insulin levels will fall after just 24 hours. He also argues that you can trigger ketosis in two to three days, rather than the three days Attia contends.
根據 Fung 的說法，禁食是逃脫這個循環的關鍵，因為觸發酮症會顯著降低你的胰島素水平。這可以說是為什麼有些人覺得禁食比遵循嚴格飲食容易得多的原因（這也許解釋了為什麼禁食如此受歡迎）。不僅僅是因為其規則更容易遵循，正如 Attia 所說——它還會重置你的饑餓激素，以減少渴望的感覺。Fung 建議定期禁食24 到 36 小時，並指出你的胰島素水平在僅僅 24 小時後就會下降。他還主張你可以在兩到三天內觸發酮症，而不是 Attia 所主張的三天。Unlike Attia, Fung believes that fasting is beneficial for everyone. In an episode of Attia’s podcast The Drive, Fung explains why he doesn’t share Attia’s concerns about muscle loss from reduced protein intake. He contends that, when fasting, the body gets much of the protein it needs through autophagy, recycling excess protein such as loose skin rather than breaking down muscle.
與阿提亞不同，方認為禁食對每個人都有益。在阿提亞的播客節目 The Drive 中，方解釋了 為什麼他不認同阿提亞對於因蛋白質攝取減少而導致肌肉流失的擔憂。他主張，在禁食期間，身體通過自噬獲取所需的大部分蛋白質，回收多餘的蛋白質，例如鬆弛的皮膚，而不是分解肌肉。
How Else Can I Stay Healthy?
我還可以怎麼保持健康？
Alongside exercising and amending your diet, Attia also highlights a couple of other habits that are important to staying healthy: getting enough sleep and taking care of your emotional health.
除了運動和調整飲食，Attia 還強調了幾個對保持健康重要的習慣：獲得足夠的睡眠和照顧你的情緒健康。
Get Plenty of High-Quality Sleep
獲得充足的高品質睡眠
To improve your health and longevity, get more sleep. Attia notes that sufficient sleep gives your brain time to organize its memories, while insufficient sleep results in short-term damage to memory and mental acuity.
為了改善你的健康和壽命，獲得更多的睡眠。 阿提亞指出，充足的睡眠讓你的大腦有時間整理記憶，而不足的睡眠則會對記憶和思維敏捷性造成短期損害。
(Shortform note: You can claim these short-term neurological benefits of sleep with a midday nap. Naps that last 30 minutes or more trigger the process of memory consolidation Attia mentions. Further, studies have found that napping can increase your alertness and cognitive performance for up to three hours after waking.)
（短期備註：您可以通過午睡來獲得這些短期的神經學益處。持續 30 分鐘或更長時間的午睡觸發記憶鞏固的過程，Attia 提到。此外，研究發現，午睡可以在醒來後提高您的警覺性和認知表現，持續長達三小時。）
Additionally, during sleep, your brain cleans away harmful proteins that accumulate between your neurons during the day. If you don’t give your brain time to do this, these proteins will accumulate and cause long-term damage—including neurodegenerative diseases like Alzheimer’s.
此外，在睡眠期間，您的大腦會清除白天在神經元之間積累的有害蛋白質。如果您不給大腦時間來進行這個過程，這些蛋白質將會積累並造成長期損害，包括阿茲海默症等神經退行性疾病。
(Shortform note: A 2019 study sheds more light into what’s happening inside your brain during this protein-cleaning process that wards off neurodegeneration. The slow electric brain waves that occur during deep sleep reduce blood flow to the brain. This blood movement draws more cerebrospinal fluid up into the skull, where it can wash away harmful proteins. Because this interaction is controlled by brain waves, the cerebrospinal fluid can wash proteins out of the brain repeatedly in a wave-like cycle.)
（短文註解：一項 2019 年的研究揭示了在這個清除蛋白質的過程中，您的大腦內部發生了什麼，這個過程可以防止神經退化。深度睡眠期間出現的緩慢電腦波減少了大腦的血流。這種血液流動將更多的腦脊液引入顱內，從而可以沖洗掉有害的蛋白質。由於這種相互作用是由大腦波控制的，腦脊液可以以波浪狀的循環反覆沖洗大腦中的蛋白質。）
Furthermore, multiple studies suggest that poor sleep disrupts your metabolism, making metabolic dysfunction and chronic disease much more likely. Although researchers aren’t totally sure why this is, Attia theorizes that it’s because insufficient sleep puts your body into perpetual fight-or-flight stress. The stress hormone cortisol raises blood pressure and triggers the liver to release glucose into the blood. This can lead to insulin resistance and an increased risk of chronic disease.
此外，多項研究表明 睡眠不足會擾亂你的新陳代謝，使新陳代謝功能障礙和慢性疾病的可能性大大增加。儘管研究人員尚不完全確定原因，Attia 推測這是因為睡眠不足使你的身體處於持續的戰鬥或逃跑壓力中。壓力荷爾蒙皮質醇會提高血壓並促使肝臟釋放葡萄糖進入血液。這可能導致胰島素抵抗和慢性疾病風險增加。
(Shortform note: It’s likely that the stress response is only part of the reason why insufficient sleep causes metabolic dysfunction. In Why We Sleep, Matthew Walker affirms that sleep deprivation floods your system with the hormone cortisol, and he goes on to describe the other hormonal problems caused by lack of sleep: Your body increases production of the hormone ghrelin and reduces leptin, both of which cause you to feel hungrier. This, in addition to the reduced emotional control you have while sleep-deprived, often leads to overeating—which, as we’ve discussed, is one of the primary causes of metabolic dysfunction.)
(短文註解：壓力反應可能只是睡眠不足導致代謝功能障礙的部分原因。在為什麼我們需要睡眠一書中，馬修·沃克確認睡眠剝奪會使你的體內充滿皮質醇這種激素，他接著描述了缺乏睡眠所引起的其他激素問題：你的身體會增加飢餓激素（ghrelin）的產量，並減少飽腹激素（leptin），這兩者都會使你感到更餓。此外，睡眠不足時情緒控制能力的降低，常常導致過度進食——這正如我們所討論的，是代謝功能障礙的主要原因之一。)
Take Care of Your Emotional Health
照顧你的情緒健康
Finally, Attia emphasizes the importance of taking care of your emotional health. Attia recounts his lifelong journey to overcome feelings of rage toward others and himself, both of which had roots in his childhood trauma.
最後，阿提亞強調了照顧情緒健康的重要性。阿提亞回顧了他一生中克服對他人和自己憤怒感的旅程，這些情緒都源於他的童年創傷。
Often, children who go through traumatic incidents (big and small) adopt emotional coping strategies that hurt them in later adulthood—like how Attia learned to feel angry at himself and others to avoid dealing with the shame from his childhood trauma. Attia recommends using psychotherapy as a tool to uncover how you’ve adapted to past traumas and to develop a plan to repair your unique emotional dysfunction. Doing so, he argues, is the surest way to achieve an emotionally fulfilling life.
經常，經歷過創傷事件（無論大小）的孩子會採取情感應對策略，這些策略在他們成年後會對他們造成傷害——就像阿提亞學會對自己和他人感到憤怒，以避免面對他童年創傷帶來的羞恥。阿提亞建議使用心理治療作為工具，揭示你如何適應過去的創傷，並制定計劃來修復你獨特的情感功能障礙。他認為，這樣做是實現情感充實生活的最可靠方法。
Using Internal Family Systems to Resolve Trauma
使用內部家庭系統來解決創傷Attia worked through his childhood trauma in a relatively emotionally detached way—using reason to dissect his past experiences and identify his coping strategies. In contrast, you may prefer the more emotion-driven method of imagining your coping strategies, both healthy and unhealthy, as “subpersonalities” within yourself—a therapy model called Internal Family Systems (IFS). In IFS, each “part” or version of yourself has its own perspective and goals, and they’re all trying to help you in their own ways.
Attia 以相對情感脫離的方式處理他的童年創傷——利用理性來剖析他的過去經歷並識別他的應對策略。相比之下，你可能更喜歡以情感驅動的方式來想像你的應對策略，無論是健康的還是不健康的，作為你內心中的「子人格」——一種稱為內部家庭系統（IFS）的治療模型。在 IFS 中，每個「部分」或自我的版本都有其自己的觀點和目標，它們都在以自己的方式幫助你。One way you could heal your emotional scars with IFS is by asking yourself what each part of yourself is thinking and feeling about the trauma, listening to what that part of you has to say, and formulating a new plan that all parts of you can agree on. For instance, Attia could have asked the rage-filled part of himself why it was so angry at himself and other people, uncovering some of the emotional logic behind his own behavior. Then, he could have used this information to come up with healthier coping strategies that satisfied the angry part of himself. If this process appeals to you, consider looking for an IFS-certified therapist to work with.
一種可以透過 IFS 療癒情感創傷的方法是詢問自己每個部分對於創傷的想法和感受，傾聽那部分的聲音，並制定一個所有部分都能同意的新計劃。例如，Attia 可以詢問他內心充滿憤怒的部分，為什麼對自己和他人如此憤怒，揭示他自己行為背後的一些情感邏輯。然後，他可以利用這些資訊來提出更健康的應對策略，以滿足他內心憤怒的部分。如果這個過程對你有吸引力，考慮尋找一位 IFS 認證的治療師合作。