This is Lathe

這是Lathe

I've know him and his wife for almost 20 years.

我認識他和他太太 已經快20年了

In fact, about ten years ago

事實上 大約十年前

we started our own company together.

我們一起開了一家公司

In 2009, Lathe was 36 years old

2009年時 Lathe36歲

and weighed 165lbs.

體重約165磅

He pretty much ate the standard American diet,

他吃的是標準美國飲食

exercised regularly,

規律地運動

and was precisely the same weight he was

而且他的體重和高三時一樣

throughout his senior year of high school.

但接著 Lathe得到一個震驚的消息

But then Lathe received some shocking news.

Okay 你是Poland先生

Okay, you're Mister Poland...Uhhh

嗯 沒錯 你得了糖尿病

Ah yes, you have diabetes!

總之

Anyway, with no family history of the disease,

沒有糖尿病的家族病史

and a diet that most nutritionists would consider healthy,

而吃的又是 大部份營養師認定的健康飲食

shouldn't Lathe be the last person with diabetes?

Lathe應該是 最不可能得糖尿病的人吧

How did this happen?

怎麼會這樣呢

Is Lathe an exception to the rule,

難道Lathe是個例外

or part of an emerging trend?

還是這是個新興的趨勢呢

Did this have something to do with his

這跟所謂的「護心飲食」有關嗎

so called "heart-healthy" diet?

而最重要的是 有多少

and most importantly..

嘿 插一下話 我們

(interupts) Hey real quick, do we...

我們要直走 還是在這左轉

do we go straight here, or do we take this left?

嗯 我會在前面左轉

Hmmm, yeah I would take the left up ahead

Okay 沒問題 抱歉 剛說到哪

Okay good, uh sorry! What were you saying?

沒事 我只是在沈思

No worries, I was just thinking.

有多少現今的健康問題

How many of the health problems we are witnessing today

是現代飲食文化導致的呢

are a result of our modern food culture?

那是個好問題

That's a good question.

的確

Definitely!

嘿 你有左轉嗎

Hey did you take that left?

碳水超載：吃到死的文化

♪♪ Up beat electronic music♪♪

隨著醫學的進步

Carb-Loaded: A Culture Dying to Eat

人們應該是前所未有的健康吧

With advances in medicine, it would seem

但是 看起來似乎正好相反

that people should be healthier now then ever before.

大部份的專家都同意 我們有嚴重的問題

However it's starting to appear the opposite is the case.

我們看到各種慢性疾病的大流行

Most experts agree we have a serious problem.

例如 肥胖、糖尿病 心血管疾病、癌症等等

We are seeing an epidemic explosion of chronic diseases

這是個很長的名單

such as obesity, diabetes, heart disease, cancer

我們總是在講肥胖的流行

The list goes on and on.

但我們開始提到大規模 全球性的肥胖

We've talking about epidemic obesity forever.

因為幾乎全世界的人口都被影響

We started talking about pandemic obesity

在美國 人口肥胖的比例很高

because much of the world's population is now effected

而也許慢慢穩定在很胖的水平

In the United States, where rates of obesity are high

我們有高流行率的肥胖 很胖的水平

and maybe stabilizing at that very high level,

當我們覺得趨勢變緩 肥胖率又開始在不同年齡層上升

we really have hyper endemic obesity- a fixed high level.

我們深陷危機 並沒有誇大 的確深陷危機

Once we start feeling like we're plateauing,

看看社會上 你會發現這些疾病發生率激增

it starts to head back up again in different age groups.

包括 心血管疾病、高血壓

We are in a crisis.There's no other way to put it, we are in a crisis.

癌症、阿茲海默症

A look at our society reveals an alarming rise in heart disease,

肥胖、脂肪肝

hypertension, cancer, alzheimer's

當然還有 糖尿病

obesity, fatty liver disease

這是真的嗎 這裡寫

and, of course, diabetes.

糖尿病不止一種

Are you serious? It says here

那是真的

there is more than one kind of diabetes?

糖尿病折磨人類 已經有很長的歷史了

That's true, and diabetes has been plaguing mankind

事實上

for a very long time. In fact,

糖尿病第一次在醫療文獻中被提及

diabetes was first mentioned in medical literature

是差不多2000年前的事了

almost 2,000 years ago.

糖尿病這一詞

The term diabetes was first coined

是二世紀時 由卡帕多細亞的阿萊泰烏斯命名的 (譯註：阿萊泰烏斯是一個醫學作家)

of Aretaeus of Cappadocia

1675年 mellitus 這個詞

in the early second century.

指的是甜如蜜

In 1675, the word "Meletus"

由Thomas Willis加上的

(which means "sweet like honey")

那是當他發現病患的尿液是甜的

was added by Thomas Willis

他到底是怎麼發現的呢

after discovering the urine of his patients

100年後

was sweet.

糖尿病患的尿液及血液中 證實有過量的糖 的確是甜的

How would he even figure that out?

人們的血液或尿液怎麼會變甜呢

(Slurping sound)

要知道為什麼 我們必須認識一個重要角色

100 years later, and the presence of excess sugar in a diabetic's

胰臟

urine and blood was confirmed. Hence the sweetness.

胰臟是內分泌系統的一部份

What could possibly cause a person's blood or urine to be sweet?

負責生產重要的酵素及荷爾蒙 幫助我們消化食物

To find out, we will need to meet an important character,

其生產的胰島素 能夠調節體內的葡萄糖

the pancreas

或說是血糖濃度

The pancreas is part of the endocrine system

一個健康的胰臟

and produces important enzymes and hormones

可以生產這些酵素和荷爾蒙

that help us break down foods.

在合適的時候

This includes insulin which regulates the body's glucose

生產合適的量

or "sugar level"

來幫助我們消化吃進肚子的食物

A healthy pancreas

當一個人得了第一型糖尿病

is able to produce these enzymes and hormones,

胰臟受到自體細胞的攻擊

at the right time

則無法生產胰島素

in the right quantities,

來將血液中的糖份降低

in order to properly digest the food we eat.

而第二型糖尿病

When a person has Type 1 diabetes,

由於頻繁及大量的胰島素釋放

the pancreas is being attacked by the body's own cells,

受體細胞對胰島素的敏感度下降

and can no longer produce insulin

這個「胰島素阻抗」現象 造成較少的糖份自血液中移除

to remove sugar from the blood stream.

悲慘的是

In the case of Type 2 diabetes,

世界上 有超過3.6億的人們

due to the volume and frequency of insulin being released,

發現自己有這個狀況

receptor cells become less sensitive to the insulin

不分哪型糖尿病的話

this "insulin resistance" results in less sugar

糖尿病在美國 十大死因排名第七

being removed from the blood. Sadly, over

而在全世界 排名第八

360 Million people worldwide find themselves

你也許會覺得驚訝

in this situation.

在社會最年輕族群中 肥胖比例越來越高

Regardless of the specific type,

自2000年起

overall diabetes is the 7th leading cause of death in the U.S.

糖尿病前期及糖尿病的兒童

and the 8th leading cause of death worldwide.

人數幾乎增為三倍

You may be surprised to learn that obesity rates are growing faster

兩歲到五歲的兒童最為嚴重

in the youngest members of our society. Since the year 2000,

更詳細分析 發現甚至嬰兒也加入肥胖這流行

pre-diabetes and diabetes cases in children have nearly tripled.

我們的孩子在過去三十年 肥胖比例增加至三倍

Two to five year olds lead this frightening trend.

現在每3個兒童就有1個 有體重問題 過重或是肥胖

A closer look reveals there's even an epidemic of obese infants.

疾病管制署提到

We have tripled obesity rates in the last 30 years in our children

2000年出生的兒童

There are one in three children now with a weight issue,

白人 每3個裡的1個

either overweight or obese.

非裔及拉丁裔美國人 每2個裡的1個

The Centers for Disease Control have said that of the children born

在他們有生之年會得到糖尿病

in the year 2000, one out of every three Caucasians, and one out of every

疾管署更進一步指出

two African Americans and Hispanics are going to get diabetes

2000年出生的這一代 將會是美國歷史上第一代

in their lifetime. They've gone further to say that this is the same

平均壽命低於他們父母那一輩 都怪我們餵他們的食物

generation that will be the first in our countries history to die at a

曾經這個病是年過65才容易得到的 以前是老年人才會得糖尿病

younger age than their parents because of what we feed them.

而如今 這個年輕化的趨勢令人害怕

This used to be a disease that was past 65, it was old people that

當8歲的兒童得到第二型糖尿病

had diabetes, and so this shift in the age group is

主要是肥胖引起的

what's very frightening.

合理推測在10年後 他們18歲時 他們會有心血管疾病

When 8 year olds are getting adult onset diabetes,

他們會開始在急診室出現

due largely to epidemic obesity,

再這樣下去 不久的將來這就會成真

stands to reason that 10 years later

長完青春痘 就得心絞痛的那天就快來了

by the time they turn 18, they will have coronary disease.

這聽起來是無法想像的

They'll start turning up in our emergency rooms.

但沒多久前

Should current trends persist into the not too distant future,

八歲就得到第二型糖尿病 同樣是令人驚訝的

the day may well dawn when angina

根據疾病管制署 這情況若持續 到了2050年

is an adolescent right of passage along side acne.

每3個美國人 就有1個是糖尿病

That may sound imponderable,

而幾乎每2個美國人 就有1個是肥胖

but not all that long ago

不是過重

the notion of adult onset diabetes in 8 year olds

是肥胖！

would have been equally outrageous.

美國和歐洲等西方國家

According to the CDC, if this keeps up, by the year 2050

很快地 全世界

1 in 3 Americans will be diabetic

都流行肥胖及糖尿病

and nearly 1 in every 2 Americans will be obese.

而肥胖的流行為糖尿病 增加了更多案例

Not overweight-

而糖尿病本身

OBESE!

對下列疾病是個危險因子 包括 心血管疾病

The U.S. and western civilization

腎衰竭

and soon the entire world,

眼睛病變、失明

have an obesity and diabetes epidemic.

神經受損

The obesity epidemic is fueling the numberof cases

足截肢

that we see who have diabetes.

糖尿病的併發症影響實在很大

Diabetes in itself

糖尿病不止傷害我們的健康

is a risk factor for developing heart disease,

它同時也傷害我們的荷包

kidney failure, eye disease,

因為 每個人 最後都會為糖尿病買單

blindness, nerve damage, foot amputations

2012年

and so the implications of diabetes are tremendous.

美國在糖尿病上的相關支出

Diabetes isn't just hurting our health

估計約達到2450億美元

it's also emptying our pockets because

那比起五年前增加了41%

everyone ends up paying for diabetes.

這數字包含了直接的醫療支出

By 2012, diabetes related costs in the United States,

曠職

reached an estimated 245 billion dollars.

糖尿病相關的失業

That was a 41 percent increase

因病早死造成的國家生產力下降

from just 5 years earlier.

美國醫療保健的花費 每5塊錢就有1塊錢

That number includes direct medical costs,

花在照顧糖尿病患上

absenteeism, diabetes related job loss,

而全世界的花費超過4700億美元

and productivity loss due to premature deaths.

若目前這趨勢持續到這世紀中期

1 out of every 5 dollars spent on health-care in the United States

每3個美國人會有1個是糖尿病

goes to the care of people with diabetes.

而現在 美國的3億人口中

The worldwide cost is over 470 billion dollars.

有約2千7百萬人被診斷出為糖尿病

Should current trends persist to about the middle of this century,

非常嚴重 我們現在就付不起這些醫療費用

1 in 3 Americans will be diabetic. Now right now

3分之1的我們 是超過1億人

out of a population of over 300 million there are about 27 million

我不認為有任何方法 能夠負擔那個費用

diagnosed diabetics in the U.S. That's pretty bad! We're having trouble

我認為我們身處前線

paying the healthcare bills right now. 1 in 3 of us

處境和國安局面對的差不了多少

would be over 100 million people.

我認為我們國家的命運命懸一線

I don't think there is any way to pay that bill.

光只是糖尿病的費用 就是天文數字了

I think we find ourselves on the front lines

而這將會影響

of nothing less than homeland security.

社會醫療健保體系的花費及支出

So I think the fate of the nation hangs in the balance.

除非我們做出改變

The cost of diabetes alone

當糖尿病及肥胖問題 在新聞上搶盡鎂光燈

is astronomically large, and it will impact

許多專家相信它們 屬於一種規模更大、更險惡的流行病

on society's ability to handle healthcare costs

而這流行病的名稱叫做

and expenditures if we don't make change.

代謝症候群

Of course, while diabetes and obesity

患者有的症狀如 高血壓

get most of the attention in the news,

高血糖

many experts believe they are actually parts of a

體脂過高

much larger and more sinister pandemic, and

不正常的膽固醇水平

the name of this pandemic is Metabolic Syndrome.

超過1億2千4百萬美國人

Sufferers have symptoms like high blood pressure, high blood sugar,

患有這種少人報導的病

excess body fat and abnormal cholesterol levels.

估計75%的醫療保健費用

Over 124 million Americans

事實上 花費在 治療這些代謝症候群患者

are sick from this under-reported condition. It is estimated that

整個社會的人口都已經生病了

75 percent of our healthcare dollars are, in fact, spent on the

但他們完全沒有察覺

treatment of people suffering from Metabolic Syndrome. So there is an

常見的偏見是

entire population that is already sick and may not even be aware of it.

社會上過重及肥胖的人 是病得最嚴重的人

A common bias is that the overweight

瘦子常錯誤地認為

and obese members of society are the sickest ones.

肥胖是辨識人們健康與否的指標

Incorrectly, thin people might, in fact, think of obesity as a way to

我們看過很多人外表看來很好

identify the sick people around them.

BMI在正常範圍

We see plenty of individuals who look great,

體脂沒有過高

whose body mass index is in the normal range,

而他們其實已身陷麻煩 但卻不自知

who don't have excessive body fat; and yet they're already

因為他們的飲食造成血糖過高 已經改變了體內的蛋白質(酵素)

in trouble, and they don't know it

比如 他們已經開始有脂肪肝 因為吃了太多果糖

because their diets are such

這已經變成道德與品格 那一類的問題了

that they are already changing their proteins

和體重拔河的病人被指稱 「慢性自殺」「懶惰的貪吃鬼」

by having to much sugar in their bloodstream.

因為我們知道有數百萬 所謂的「胖瘦子」

They are already developing fatty liver because they are eating

代謝上 體內已經病了

a lot of fructose for example.

但外表卻看不出來有生病的跡象

This has been turned into a moralistic and character

現在他們說瘦子其實是胖的 即使他們已經夠瘦

type issue, where individuals who struggle with their weight

這真是嚴重

are "killing themselves" and are "lazy gluttons"

事實上 這嚴重地讓我心情低落

because we know there

難道沒有人知道這怎麼發生的嗎

are millions of "skinny fat" people who are

(到)

metabolically sick inside, but do not look

(到底)

characteristically sick on the outside.

(到底怎麼)

Now they are saying skinny people are fat

(到底怎麼發生的？)

even though they are already skinny.

專家們一致認同有許多因素 造成我們現在的健康危機

This IS serious!

對疾病是由飲食造成的人來說

In fact, it's seriously bringing me down.

原因通常是許多因素一起造成的

I mean, does anyone even know how this happened?

而這些通常是很長時間造成的

How did this happen?

一輩子

Experts agree there are many factors

甚至好幾代

that account for our current health crisis.

例如

For people effected by diet related illness,

(份量)

the answer is more than likely a combination of many factors.

我們吃的量是前所未有的多

And these can take place over

不只是餐廳的餐點份量大幅增加

a long period of time.

我們家中自己料理的份量也增加

A lifetime,

我們把大份量的視覺滿足 也帶到家中

and even generations.

我們在外面看到那些 擺滿整盤的食物

For example,

所以回到家 我們也渴望那樣的份量

We're eating more food than ever before.

我們像是重新定義了正常份量

It's not just that fact that our

一大盤的食物

restaurant portions have grown dramatically,

看起來像是一般份量

but our home cooking portions have grown in turn.

在以往

We bring those portions sizes home with our eyeballs.

我們看到那份量會說 「我的老天」

We see what we get on plates elsewhere,

「那足以餵飽一支軍隊！」 「或整個家庭吧！」

and we bring them home to our own personal plates.

現在我們看到只會說

We've sort of defined a new norm with portions

「那是我的晚餐」

where a very large plate of food

如果你研究「最後的晚餐」

looks like a normal amount of food.

我們後來發現

Whereas in the old days,

如果你仔細看 「最後的晚餐」那幅畫

we would have looked at that and said, "Oh my God

這1000年以來

that's enough to feed an army or a whole family!"

食物份量增加了69%

Now we look at that and say,

盤子加大了66%

"That's my dinner"

連麵包也增加了26%

If you take a study of

人們並沒察覺 每過個十年

'The Last Supper'

我們往盤子上越堆越多

we end up finding that if you look

我拜訪住在德國的父母

at just depictions of 'The Last Super'

那是我長大的地方

over the last 1,000 years,

我剛好拿了個盤子在手上

portion sizes have increased

我問我媽

69 percent. Plate size increased 66 percent,

「主餐的餐盤在哪？」

even bread size increased about 26 percent.

「喔，你不是正拿著它嗎？」

People have no idea

「不，那只是開胃菜的小盤」 「我是說主餐用的盤子」

that with just the passing of every decade,

而她回答 「我們25年來都沒換過盤子呀」

we put more and more on our plate.

「那就是主餐用的盤子呀」

I visited my parents in Germany

住在美國超過十年後

where I grew up,

我已習慣這裡的超大份量

and I have a plate in my hand

但要真正了解現在的健康危機

and I asked my mom,

我們必須從頭來了解

"Where are the dinner plates?"

從創造金字塔的時期開始