I was working as a junior doctor in a busy A&E department.

我當時是一名初級醫生，在繁忙的急診室工作。

A 60-year-old lady came in having had a cardiac arrest, most likely a result of a heart attack.

一位 60 歲的女士因心臟驟停前來就診，很可能是心臟病發作。

The ambulance crew had started resuscitation at the scene and we continued delivering drugs, manual compressions, exactly how we'd all been trained.

救護人員已經在現場開始了搶救，我們繼續給病人用藥、人工按壓，完全按照我們接受的訓練進行。

But despite our best efforts, we ended up calling her death.

但是，儘管我們盡了最大努力，最終還是宣告了她的死亡。

And I remember leaving that resusc bay feeling so frustrated.

我還記得，離開搶救室時，我感到非常沮喪。

This wasn't what I'd been led to believe medicine was about.

我一直以為醫學不是這樣的。

I wanted to save lives, not struggle in vain and succumb to losing patients.

我想拯救生命，而不是徒勞地掙扎和屈服於失去病人。

And when I went home that night, I refreshed my memory on how many heart attacks there are in the UK every year.

當晚回家後，我再次回憶起英國每年有多少起心臟病發作。

There were slightly less then, but now it's over 100,000.

當時數量略少，但現在已超過 10 萬。

One every five minutes.

每五分鐘一個。

And 30,000 cardiac arrests occur in the same way this poor lady presented.

有 3 萬例心臟驟停發生在這位可憐的女士身上。

Out of hospital.

出院。

With less than a 1 in 10 chance that they'll survive.

他們活下來的機率不到十分之一。

So the reality was from the moment the ambulance crew brought her into the department, there wasn't much we could do.

所以現實情況是，從救護車把她送進科室的那一刻起，我們就無能為力了。

At that point, we were reacting to disease that had been untreated, undiagnosed and started long ago.

在這一點上，我們是在對很久以前就已經開始的未治療、未診斷的疾病做出反應。

The first presentation of which was her collapsing to the floor with a heart attack.

她的第一次表現是心臟病發作倒在地上。

But today, I have 15 minutes to save your life.

但今天，我有 15 分鐘的時間來拯救你的生命。

Or more specifically, I have 15 minutes to help prevent the deaths of roughly 50% of the adults in this audience today who will succumb to preventable lifestyle related illnesses like heart disease, stroke and complications of metabolic disease.

或者更具體地說，我有 15 分鐘的時間來幫助防止今天在座的大約 50% 的成年人死於與生活方式有關的可預防疾病，如心臟病、中風和代謝性疾病併發症。

Lifestyle related illnesses that cause millions of deaths worldwide and in this country.

與生活方式相關的疾病在全球和我國造成數百萬人死亡。

My name is Rupi.

我叫魯皮

I'm an NHS doctor and the medicine I'm prescribing today is food.

我是一名國家醫療服務系統的醫生，我今天開的藥是食物。

But as more people understand the power of our diets to help prevent and in some cases treat ill health, the logical question becomes, doctor, what should I be eating?

但是，隨著越來越多的人瞭解到我們的飲食能夠幫助預防和治療某些疾病，合乎邏輯的問題就變成了：醫生，我應該吃什麼？

And if you've looked at the headlines or scrolled through social media, you will notice meat fighting with vegans, paleo fighting with the Diabetes Association, a war of attrition between multiple sides with the losers being the millions of people just trying to figure out how best to look after themselves.

如果你看過頭條新聞或瀏覽過社交媒體，你就會發現肉食主義者與素食主義者之爭、古法飲食主義者與糖尿病協會之爭，這是一場多方之間的消耗戰，而失敗者則是數百萬試圖找出如何更好地照顧自己的人們。

Today I'm going to help you with a different approach because it seems strange to me that you can have some people who decide to eat a plant-based diet and improve their heart symptoms while some swear by low carbohydrate and come off diabetes medications.

今天，我將用一種不同的方法來幫助你們，因為在我看來，有些人決定吃植物性飲食並改善了心臟症狀，而有些人卻發誓要吃低碳水化合物並停用糖尿病藥物，這在我看來很奇怪。

If these diets are so wildly different, how can they achieve such similar and frankly remarkable outcomes?

如果這些飲食的差異如此之大，那麼它們又怎麼能取得如此相似且令人驚歎的成果呢？

And the reason why is because a lot of the underlying principles are the same.

原因在於，很多基本原則是相同的。

Let's take a visual approach.

讓我們採用直觀的方法。

So I've taken the liberty of excluding diets that restrict yourself to just eating cucumbers or just pure meat.

是以，我冒昧地把那些只吃黃瓜或只吃純肉的飲食排除在外。

Luckily, they're not that popular and they lack an evidence base.

幸運的是，它們並不那麼流行，也缺乏證據基礎。

But when we look at popular diets that have credible studies, paleo, low carbohydrate, Mediterranean, DASH, whole food plant-based, and we map out where the similarities lie, you will notice an abundance of overlapping themes.

但是，當我們看看那些有可靠研究的流行飲食，如古式飲食、低碳水化合物飲食、地中海飲食、DASH飲食、全食物植物性飲食，並找出它們的相似之處時，你會發現其中有大量重疊的主題。

And it's this exercise that reveals the principles behind a lot of them.

而正是這個練習揭示了其中很多原理。

Naturally, as you would imagine, all of them remove excess junk food, processed foods, excess sugar, as well as balancing for energy control.

當然，正如你所想象的那樣，它們都會去除多餘的垃圾食品、加工食品、多餘的糖分，以及平衡能量控制。

I think we can all reason with that.

我想我們都能理解這一點。

But what do they include?

但它們包括什麼呢？

Largely plants, fiber, quality fats, and lots of colors.

主要是植物、纖維、優質脂肪和豐富的色彩。

What do these do?

這些是做什麼用的？

When you eat largely plants, you're ensuring a selection of micronutrients, vitamins, minerals, but also phytochemicals, the thousands of chemicals that we find locked in roots, leaves, and grains.

當你大量食用植物時，你就確保了微量營養素、維生素、礦物質以及植物化學物質的選擇，這些化學物質成千上萬地存在於根、葉和穀物中。

We used to think that the benefits of plants were just because of antioxidants, but it is far more complicated than that.

我們過去認為植物的益處僅僅在於抗氧化劑，但事實遠非如此複雜。

These chemicals can help regenerate our human cells, help signaling between them, as well as changing their function.

這些化學物質可以幫助我們的人體細胞再生，幫助它們之間傳遞信號，並改變它們的功能。

Fiber, from whole grains, beans, legumes, can contain hundreds of different types of fibers, and these feed your microbiota, this incredible population of microbes that nurture your health by releasing nutrients, they digest food for you, they balance inflammation, they feed you.

全穀物、豆類、豆類中的纖維可以包含數百種不同類型的纖維，這些纖維可以餵養你的微生物群，這些不可思議的微生物群通過釋放營養物質來促進你的健康，它們為你消化食物，平衡發炎，餵養你。

Feeding this population with these sorts of foods is critical to maintaining them.

用這些食物餵養這些人對維持他們的生存至關重要。

Fats, essential for your brain health, the precursors to hormones that curse through your bloodstream.

脂肪是大腦健康的必需品，也是血液中荷爾蒙的前體。

Quality fats that you find in nuts and seeds are incredible for benefiting your health and contain a myriad of different fatty acids and colors.

堅果和種子中的優質脂肪對健康大有裨益，它們含有多種不同的脂肪酸和顏色。

Food has the ability to interact with the very core of our existence, our DNA, and alongside other lifestyle factors like stress and sleep, food has the potential to switch genes on and others off.

食物能夠與我們生存的核心--DNA--相互作用，與壓力和睡眠等其他生活方式因素一起，食物有可能開啟基因，關閉其他基因。

This is the exciting field of nutrigenetics, the power of your food to change the expression of your genes to promote health.

這就是令人興奮的營養基因學領域，即食物改變基因表達以促進健康的力量。

And we know, for the majority of us, it is a diet that consists largely of plants and lots of colors.

我們知道，對於我們大多數人來說，這種飲食主要由植物和豐富的色彩組成。

Many bodies, including the World Health Organization, recognize that eating a prudent diet, consistent with these features, lowers the risk of chronic kidney disease, autoimmune conditions, inflammatory bowel disease, cancer, depression, and many more beyond just obesity and disease.

包括世界衛生組織在內的許多機構都認識到，符合這些特點的合理飲食可以降低患慢性腎病、自身免疫性疾病、炎症性腸病、癌症、抑鬱症等疾病的風險，而不僅僅是肥胖和疾病。

Your plate contains a wealth of information that interacts with your very inner ecosystem in the most powerful way.

你的盤子蘊含著豐富的資訊，這些資訊以最強大的方式與你的內在生態系統相互作用。

And the confusion that surrounds dietary conflict is actually creating an apathy toward motivation and behavior change.

而圍繞著飲食衝突產生的困惑實際上是對動機和行為改變的冷漠。

What we initially assume as conflicting dietary methods are actually adversarial and complementary in many ways.

我們最初認為相互衝突的飲食方法，實際上在很多方面是對立和互補的。

I want to make it clear here that food is not a panacea, it's not a cure-all or a replacement for the many drugs and services that I prescribe as an NHS doctor daily, but it is a huge component of well-being.

我想在這裡明確指出，食物不是萬能藥，不能包治百病，也不能替代我作為國家醫療服務體系醫生每天開出的許多藥物和服務，但食物是健康的重要組成部分。

And it's this conflict that is creating an issue.

正是這種衝突造成了問題。

I would also love to stand here and explain to you what you should be eating and expect you to just do it, in the same way I can prescribe a pill to a patient and ask them to take it three times a day.

我也很樂意站在這裡向你解釋你應該吃什麼，並希望你照著做，就像我可以給病人開藥並要求他們一天吃三次一樣。

But it's not.

但事實並非如此。

I remember around seven years ago, when I started introducing diet into my consultations, I had a 45-year-old man come into my clinic.

我記得大約七年前，當我開始在諮詢中引入飲食時，有一位 45 歲的男士來到我的診所。

His blood work showed that he was on the verge of type 2 diabetes.

他的血液檢查結果顯示，他瀕臨 2 型糖尿病。

And we had a conversation about how diet and lifestyle can prevent the progression to type 2.

我們就如何通過飲食和生活方式預防 2 型糖尿病進行了交流。

He wasn't keen on changing much about his diet that was full of convenience foods.

他並不熱衷於改變自己滿是方便食品的飲食習慣。

But I said, look, let's just start slow.

但我說，聽著，讓我們慢慢來。

Let's just start with one meal.

就從一頓飯開始吧。

And he said, well, I have frosted Wheaties for breakfast.

他說，我早餐吃的是磨砂麥片。

I don't really like that.

我真的不喜歡這樣。

Maybe that.

也許吧

I said, great.

我說，太好了。

Do you like oats?

你喜歡燕麥嗎？

He said, I don't mind porridge.

他說，我不介意喝粥。

Fantastic.

太棒了

Here's a recipe.

這裡有一份食譜。

Make some oats, put some sunflower seeds on it, add some frozen berries.

做一些燕麥，放一些葵花籽，再加一些冷凍漿果。

They're very cheap.

它們非常便宜。

Try that for a couple of weeks.

先試幾個星期。

Come back and let me know how you get on.

回來告訴我你的進展。

I wrote down the ingredients for him.

我給他寫下了配料。

He got up to leave.

他起身離開。

And I thought to myself, wow, Rufy, I think you've really changed this guy's life.

我心想，哇，魯菲，我想你真的改變了這傢伙的生活。

And then as he left through the door, he turned back to me and he said, just one more thing, doctor.

當他從門口離開時，他回頭對我說，還有一件事，醫生。

How do you make oats?

如何製作燕麥？

Nutrition isn't simple for a number of other reasons.

營養並不簡單，原因還有很多。

Food is an emotive subject.

食物是一個情緒化的話題。

It's how we celebrate.

這是我們慶祝的方式。

It's part of our culture, our history.

這是我們文化和歷史的一部分。

Nutritional medicine isn't being talked about by us in medicine because most of the doctors here in this room were not taught about the importance of food at medical school.

我們醫學界不談論營養醫學，是因為在座的大多數醫生在醫學院都沒有接受過關於食物重要性的教育。

Our children are not educated in how to grow or cook as part of their schooling, which is why I have patients that can't make the simplest of dishes like oats.

我們的孩子在學校裡沒有接受過如何種植或烹飪的教育，這就是為什麼我的病人連燕麥這樣最簡單的菜都不會做。

And access to healthy foods depends on where you live.

而能否獲得健康食品取決於您的居住地。

The promotion of unhealthy options target the most vulnerable.

推廣不健康的選擇針對的是最脆弱的群體。

And whilst I can't pretend to help with every aspect of this complicated food environment, I can provide you with some insight into some hope.

雖然我不能假裝在這個複雜的食品環境的方方面面都能提供幫助，但我可以為你們提供一些希望。

There is a movement starting in the UK, and it is starting right here in Bristol.

英國正在掀起一場運動，就在布里斯托爾。

Because your local medical school is one of the first in the country to start teaching future doctors not only the foundations of nutrition, but also how to cook.

因為你們當地的醫學院是全國首批開始教授未來醫生營養學基礎和烹飪方法的學校之一。

In 2018, I brought together a group of nutrition experts and doctors passionate about reforming nutrition education in UK medical schools.

2018 年，我召集了一批熱衷於改革英國醫學院營養教育的營養專家和醫生。

We ran the UK's first culinary medicine course, an intense four weeks of culinary activities with a professional chef, nutrition lectures with a registered dietician, and teaching on how to apply this information within the constraints of an NHS clinic appointment by a GP.

我們開設了英國首個烹飪醫學課程，為期四周的密集課程包括與專業廚師一起進行烹飪活動、與註冊營養師一起進行營養講座，以及教授如何在全科醫生預約的國家醫療服務體系門診時間內應用這些資訊。

This unique, collaborative teaching method took students through the impact of nutrition on mental health, on our guts, on our environment and beyond.

這種獨特的合作式教學方法帶領學生了解營養對心理健康、腸道、環境等方面的影響。

We ran the cooking courses in an NHS GP surgery right here in Bristol with its own fit-for-purpose community kitchen.

我們在布里斯托爾的一家國家醫療服務體系全科醫生診所開設了烹飪課程，該診所擁有自己的社區廚房。

We even had students run their own health promotion clinics, going to families' homes and helping them stock their cupboards with nutritious, affordable ingredients.

我們甚至讓學生自己開設健康促進門診，深入家庭，幫助他們在櫥櫃裡擺放營養豐富、價格實惠的食材。

And arranged by one of your incredible local GPs, we even had medical students cooking for the homeless, talking to them, listening, providing a medicine in its purest sense.

在當地一位出色的全科醫生的安排下，我們甚至請醫科學生為無家可歸者做飯，與他們交談，傾聽他們的心聲，提供最純粹的醫療服務。

This is a career-defining experience that all health professionals should have.

這是所有醫療專業人員都應該擁有的、決定職業生涯的經歷。

It starts a conversation, a real perspective into the grandeur of food beyond just whether something is a carbohydrate or full of vitamins.

它開啟了一場對話，讓人們真正認識到食物的偉大，而不僅僅是某樣東西是碳水化合物還是富含維生素。

All health professionals have a role in nurturing a culture that appreciates the power of food.

所有衛生專業人員都有責任培養一種重視食物力量的文化。

This is how we reverse the tidal wave of lifestyle-related illnesses that threaten to completely expend all NHS resources, unless we get to the root cause of what is causing illness in the first place.

這就是我們如何扭轉與生活方式有關的疾病浪潮，除非我們首先找到導致疾病的根本原因，否則這些疾病很可能會耗盡國家醫療服務體系的所有資源。

And many, many studies point toward diet as the contributing factor.

很多很多研究都指出，飲食是誘因。

Today, we need to ask ourselves if we dare to think as radically as we have done in the past.

今天，我們需要捫心自問，我們是否敢於像過去那樣激進地思考問題。

This is not radical.

這並不激進。

This is the norm in almost 50% of American medical schools, but we will make that the norm here in the UK as more medical schools wake up to the need for nutrition training in medicine.

這是近 50% 的美國醫學院的常規做法，但隨著越來越多的醫學院意識到醫學營養培訓的必要性，我們將使這一做法成為英國的常規做法。

But, if we are serious about building the healthiest population possible, we need to Where chronic disease is a rarity, type 2 diabetes is uncommon.

但是，如果我們真的要打造最健康的人口，我們就必須知道，慢性病是罕見的，2 型糖尿病也不常見。

Heart disease affects the minority of people.

心臟病影響著少數人。

If we are serious about giving everybody access to the best possible protection from disease, then we need to start reforming our food systems and our food environment.

如果我們真的想讓每個人都能得到最好的保護，遠離疾病，那麼我們就必須開始改革我們的食品系統和食品環境。

Making food as medicine not a cute or quirky concept, but the norm.

讓食物成為藥物不再是一個可愛或古怪的概念，而是一種常態。

Elevating nutritional medicine into a recognisable, mainstream concept in the pursuit of a proactive, healthier population.

將營養醫學提升為一個可識別的主流概念，追求積極主動、更健康的人群。

Affiliating all GP surgeries up and down the country with community kitchens and investing far much more research into nutrition.

將全國上下所有的全科醫生診所與社區廚房聯繫起來，並加大對營養學的研究投入。

I've talked a bit about how food can prevent disease.

關於食物如何預防疾病，我已經談了一些。

I've talked to you a bit about how complicated this food environment is and our little ways of mitigating that.

我已經跟你們說過食品環境的複雜性，以及我們緩解這種複雜性的小方法。

And I want to end this talk in the same way I end my clinical consultations, with some simple, tangible advice.

我想用我結束臨床諮詢的方式來結束這次談話，給大家一些簡單而實際的建議。

As I promised, I'd help you prevent disease.

正如我所承諾的，我會幫你預防疾病。

Just one more.

還有一個

Every time you look at a plate of food or you sit down to eat, just ask yourself, can you add just one more?

每當你看著一盤食物或坐下來吃飯時，就問問自己，還能再加一樣嗎？

Can you eat just one more colourful vegetable, portion of nuts or seeds or fruit at every meal time?

你能在每餐多吃一種彩色蔬菜、一份堅果或種子或水果嗎？

Just one more.

還有一個

If you're having a curry, can you add some spinach to it?

如果您想吃咖喱，能不能加點菠菜？

If you're eating an omelette, can you serve it with some green beans?

如果你在吃煎蛋卷，能不能配點青豆？

And even if you're enjoying a delicious Cornish pasty, can you serve that with a side of butternut squash mash?

即使您正在享用美味的康沃爾麵餅，您能配上南瓜泥嗎？

It's these collections of small additions to what our diets lack every day, every week, every year, that have the potential for much larger downstream effects.

正是我們每天、每週、每年飲食中缺乏的這些小添加物，才有可能產生更大的下游影響。

The opportunity of having the biggest impact on your health is actually in your hands.

對健康產生最大影響的機會其實就掌握在你的手中。

It's not with a blockbuster drug.

不是用大片藥物。

It's not with a new pioneering surgical technique.

這不是因為有了新的開創性外科技術。

It is with the simplest solution.

這是最簡單的解決辦法。

It's how we feed ourselves.

我們就是這樣養活自己的。

And I'm hopeful we can generate a food-focused approach to health in our communities instead of reacting to disease in our emergency departments.

我希望我們能在社區中形成一種以食物為中心的健康方法，而不是在急診室裡對疾病作出反應。

Thank you.

謝謝。