健康飲食 就是這麼簡單

Over the past few months, I’ve written a number of times on how nutrition recommendations are seldom supported by science. I’ve argued that what many people are telling you may be inaccurate. In response, many of you have asked me what nutrition recommendations should say.

在過去幾個月裏，我多次在文章中提到，營養建議很少得到科學支持。我的看法是，很多人對你們說的事情可能並不準確。對此，很多人問我有什麼營養建議。

It’s much easier, unfortunately, to tell you what not to do. But here at The Upshot, we don’t avoid the hard questions. So I’m going to put myself on the line. Below are the general rules I live by. They’re the ones I share with patients, with friends and with family. They’re the ones I support as a pediatrician and a health services researcher. But I acknowledge up front that they may apply only to healthy people without metabolic disorders (me, for instance, as far as I know).

不幸的是，給出不建議的東西，要比給出建議容易的多。但在“結語”專欄(The Upshot)，我們不迴避難題。所以我來斗膽回答一下。以下是我的一般守則。我會把這些守則分享給病患、朋友和家人，作爲一個兒科醫生和衛生服務研究人員，它們是我能夠認可的。不過，我要預先承認，這些守則只適用於沒有代謝障礙的健康人士（比如以我目前所知，我就算是一個）。

These suggestions are also not supported by the scientific weight of rigorous randomized controlled trials, because little in nutrition is. I’ve inserted links to back them up with the available evidence. They are not “laws” and should not be treated as such. No specific nutrients will be demonized, and none will be held up as miracles. But these recommendations make sense to me, and they’ve helped me immensely.

這些建議同樣也沒有通過嚴格的隨機對照試驗進行科學評估，因爲營養學領域很少有這樣的試驗。我插入了鏈接，用現有證據來支持這些建議。這些建議不是“規範”，不應該被當成規範來執行。我不會把具體某個營養物妖魔化，也不會奉某個營養物爲人間奇蹟。但是我覺得這些建議是有道理的，而且對我幫助極大。

Full disclosure: I did not invent most of these. I’ve developed them from reading the work of others, including what may be the most impressive “official” nutritional guidelines, those of Brazil, as well as from earlier suggestions from readers, as in this great NYT interactive graphic. It captures readers’ responses to food rules by Michael Pollan. He is, of course, the promulgator of the well-known advice: “Eat food. Not too much. Mostly plants.”

需要聲明：這些建議大多都不是我提出的，而是我通過閱讀別人的作品得出的，包括一些格外出色的“官方”營養指南，巴西提出的那些，還有較早前讀者提出的建議，比如時報的這份精彩的互動圖文裏列出的。這些是讀者對邁克爾·波倫(Michael Pollan)提出的食物守則的迴應。而波倫就無需多說了，他推廣了一個著名的建議：“進食。不要太多。植物爲主。”

1. Get as much of your nutrition as possible from a variety of completely uNPRocessed foods. These include fruits and vegetables. But they also include meat, fish, poultry and eggs that haven’t been processed. In other words, when buying food at the market, focus on things that have not been been cooked, prepared or altered in any way. Brown rice over white rice. Whole grains over refined grains. You’re far better off eating two apples than drinking the same 27 grams of sugar in an eight-ounce glass of apple juice.

1. 儘可能從各類完全未經加工的食物中獲取營養。這些食物包括水果和蔬菜，也包括未經處理的肉、魚、禽和蛋。換句話說，在市場裏購買食物時，要注意選擇尚未烹調、製備或以任何方式改變過的。糙米代替白米，全穀物代替精加工穀物。同樣是攝入27克糖，吃兩個蘋果要比喝一杯8盎司的蘋果汁好太多。

1b. Eat lightly processed foods less often. You’re not going to make everything yourself. Pasta, for instance, is going to be bought already prepared. You’re not going to grind your own flour or extract your own oil. These are meant to be eaten along with uNPRocessed foods, but try to eat less of them.

1b. 少吃輕加工食品。不可能所有食物都自己做。比如意大利麪會去買已經做好的。你不會自己磨麪粉或提煉食油。這意味着要同時進食輕加工食物與未經加工食物，但要儘量少吃。

1c. Eat heavily processed foods even less often. There’s little high-quality evidence that even the most processed foods are dangerous. But keep your consumption of them to a minimum, because they can make it too easy to stuff in calories. Such foods include bread, chips, cookies and cereals. In epidemiologic studies, heavily processed meats are often associated with worse health outcomes, but that evidence should be taken with a grain of salt (not literally), as I’ve written about before.

1c. 更要少吃重度加工食品。即便是最重度加工的食品，也很少有高質量的證據能夠證實它是危險的。但是你要儘量少吃這些食物，因爲它們容易含高熱量。這類食物包括麪包、薯片、餅乾和穀物。流行病學研究發現，重度加工過的肉類往往與健康狀況惡化有關，但正如我之前所寫，該證據不能盡信。

2. Eat as much home-cooked food as possible, which should be prepared according to Rule 1. Eating at home allows you to avoid processed ingredients more easily. It allows you full control over what you eat, and allows you to choose the flavors you prefer. You’re much less likely to stuff yourself silly if you eat home-cooked food. I’m not saying this is easy. Behavioral change takes repetition and practice. It also, unfortunately, takes time.

2. 儘量在家吃，烹飪料理也應遵循守則1。在家裏吃飯能讓你更容易避開加工食材，全權控制自己所吃的東西，選擇自己喜歡的口味。如果是吃自家制食物，你就不會那麼稀裏糊塗地填飽肚子。我知道這做起來並不容易。改變行爲需要重複和實踐。不幸的是還需要很多時間。

3. Use salt and fats, including butter and oil, as needed in food preparation. Things like salt and fat aren’t the enemy. They are often necessary in the preparation of tasty, satisfying food. The key here is moderation. Use what you need. Seasoning is often what makes vegetables taste good. Don’t be afraid of them, but don’t go crazy with them either.

3. 烹調過程中按需使用鹽和油脂（包括黃油和油）。鹽和油脂這類調味料並不是敵人。在烹調美味而令人滿足的食品過程中，它們往往是必要的。其中的關鍵是適度。蔬菜往往是通過調味才變得好吃的。不要懼怕它們，但也不要過度使用。

4. When you do eat out, try to eat at restaurants that follow the same rules. Ideally, you should eat at restaurants that are creating all of their items from completely uNPRocessed foods. Lots and lots of restaurants do. Follow Rule 1 even while out to dinner. Some processing is going to be fine, but try to keep it to a minimum.

4. 在外面吃飯時，儘量到遵守這些規則的餐廳用餐。在理想的情況下，你應該在只使用未經加工的食材的餐廳吃飯。許多餐廳都符合此條件。即使是出外吃晚餐，亦應該遵從守則1。吃一些加工食材沒有什麼問題，可還是儘量少吃爲妙。

5. Drink mostly water, but some alcohol, coffee and other beverages are fine. As I’ve pointed out before, you can find a study to show that everything either prevents or causes cancer — alcohol and coffee included. But my take is that the preponderance of evidence supports the inclusion of a moderate consumption of most beverages.

5. 以喝水爲主，但偶爾喝一些酒、咖啡或其他飲料亦可。正如我之前所說，任何東西都能找到某個研究證明它要麼有助預防癌症要麼導致癌症——酒和咖啡亦包括在內。但我的觀點是，多數證據支持大部分飲料可適度飲用。

6. Treat all beverages with calories in them as you would alcohol. This includes every drink with calories, including milk. They’re fine in moderation, but keep them to a minimum. You can have them because you like them, but you shouldn’t consume them as if you need them.

6. 像對待酒精一樣對待所有含熱量的飲料。這包括了所有含熱量的飲料，牛奶也在此列。它們可以適度飲用，但應保持在最低限度。你可以因爲喜歡所以飲用，但不應該把它們當作必須攝入的東西。

7. Eat with other people, especially people you care about, as often as possible. This has benefits even outside those of nutrition. It will make you more likely to cook. It will most likely make you eat more slowly. It will also make you happy.

7. 和其他人一起吃飯，特別是你關心的人，而且次數越頻密越好。這甚至有營養以外的益處。這會讓你有更多下廚房的機會，很可能令你吃飯吃得更慢。這能讓你快樂。

I’ve avoided treating any food like the devil. Many nutrition experts do, and it may turn out they’re right, but at this point I think the jury is still out. I’ve therefore tried not to tell you to avoid anything completely. My experience tells me that total abstinence rarely works, although anecdotes exist to support that practice. I think you’ll find that many other diets and recommendations work under these rules. These are much more flexible and, I hope, reasonable than what some might prescribe.

我一向避免視任何飲食如魔鬼。很多營養專家這樣做，而人們最終可能會發現他們是對的，但目前我覺得還沒有蓋棺定論。因此，我一直儘量不說你應該完全避開某個東西。儘管現時傳聞支持相反做法，但經驗告訴我，徹底戒絕很少是有效的。我想你會發現，有很多其他飲食和建議都適用於這些規則之下。它們更具靈活性，我希望相比有些人開出的方法，它們會是更加合理的。

All of these rules are subtly trying to get you to be more conscious of what you’re eating. It’s far too easy these days to consume more than you think you are, or more than you really need, especially when eating out. I’ve found that it’s impossible to tell any one person how much they should be eating. People have varying requirements, and it’s important for all of them to listen to their bodies to know when they should eat, and when they should stop.

所有這些規則都透過微妙的方式，試圖讓你對自己所吃的東西有更多的意識。現如今，你很容易就會攝取超過自己所想、或是自己所需的分量，出外用餐時情況更尤爲嚴重。我發現，要告訴任何一個人該吃多少食物都是不可能的。人們均有不同的需求，而重要的是所有人都該聽從自己的身體，從而瞭解何時進食，何時停止。

One other thing: Don’t judge what others eat. One of my closest friends has been avoiding carbohydrates for months, and has seen remarkable results. Another was a pescatarian — a person whose only meat dishes are fish — for a year and was very happy with that. I, on the other hand, avoid no food groups in particular.

還有一件事：不要妄論他人的飲食。我的一個好朋友已經連續數月不沾碳水化合物，效果非常好。還有一個堅持魚素食——只接受魚肉這一種肉食——已經有一年，感覺良好。而我呢，不避食任何食物種類。

People are very different. Some may have real problems consuming even the smallest amount of carbohydrates. Others may be intolerant of certain foods because of allergies or sensitivities. It will most likely take a bit of experimentation, on an individual level, to find the actual diet within these recommendations that works for you. But the above rules should allow for a wide variety of foods and for remaining healthy. At least, I hope so.

每個人都是不同的。有的哪怕只是攝入一丁點碳水化合物都會有麻煩。有的由於過敏或敏感而不能接受某種食物。每個人往往都需要自己去實驗，在這些建議中找到適合自己的膳食。不過，以上的守則是包容各種食物的，並且是用於保持健康的。至少我是這樣希望的。

I’m curious what readers think of these. I welcome your comments to this column, as well as tweets to me in response.

我對讀者的想法很好奇。歡迎你們評論這篇專欄，也可以發推給我。