March 31, 2020
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Dr. Jason Fung – ‘The Aetiology of Obesity’


論肥胖之成因 卡路里的騙局
【酮好字幕組】(翻譯:曾建璋) 嗯 在我開始這個主題之前 我只想說 首先 謝謝 Jeff 和 Rod
(譯註:美國的Jeffry N. Gerber和澳洲的Rod Tayler醫生) 這是一個很棒的研討會 我今天不會特別談第二型糖尿病 相信我 叫我不提到 是非常困難的 因為我常常面對這樣的病患 跟 Eric 一樣 我也想說
(譯註:美國杜克大學的Eric C. Westman教授) 我們也在診所行醫 專門治療第二型糖尿病 同時也協助改善肥胖問題 如果有任何人對這方面有興趣 歡迎他們來拜訪我 我會很高興在診所和他們聊聊 把知識傳遞出去是很重要的 雖然我和Eric的方法稍微不同 但是 你知道 本質上是相同的 我們都用LCHF和間歇性斷食
(譯註:LCHF 低醣高脂飲食) 但今天我要把重點放在肥胖上面 嗯 雖然和第二型糖尿病非常相關 但關係有點複雜 實際上是不同的 今天要把的重點放在 肥胖的病因學 病因學這個詞是什麼意思呢 是研究造成肥胖的根本原因 這真的是一個非常重要的問題 這問題 常常困擾著我 這個重要的悖論 讓我開始思考這整個問題 這是一個非常重要的悖論 對吧 為什麼會有胖的醫生呢 因為我們總認為 醫生是營養學的專家 對吧 我們知道不是 但我們這麼想 對吧 你同時具備需要的知識 也有能力 怎麼會這樣呢 肥胖只有兩個可能 對吧 要嘛是沒那個能力 不然就是沒有相關知識 要減肥 這是一個非常重要的問題 到底是什麼讓體重上升的呢 什麼造成肥胖 肥胖的病因學是什麼 對吧 那就是我們的問題 因為如果你的答案是錯的 根據那個答案所做的每件事 也跟著錯了 每件事 所有的治療是錯的 所有開的藥是錯的 你對肥胖的認知 都是錯的 而我認為 我們每件事都搞錯了 嗯 太多卡路里了嘛 太明顯了 二年級我們就學到啦 吃太多卡路里造成肥胖 對吧 就是這個概念 卡路里進 卡路里出 一卡就是一卡 對吧 問題在於 我認為 那概念 完全徹底是錯誤的 這就帶我們來到能量守衡的模型 食品公司 如可口可樂 他們喜歡這種 能量平衡的模型 這種天平概念 太多卡路里進 太少卡路里出 他們都引用了熱力學第一定律 對吧 如果你沒聽過 它是這樣 卡路里是不能無中生有的 整個系統的能量是守恆的 你不能無中生有 也不能消滅它 結論呢 要嘛卡路里進 不然就卡路里出 而這論點有兩個大問題 嗯 其中 我們後面會講到 但我們知道這樣的模型 事實上是完全失敗的 而不是只有我這麼說 研究也顯示 這種類似「少吃多運動」的失敗率大約高達99% 所以你保證會失敗 如果你看書 如「肥胖手冊」 Joslin 寫的「糖尿病」 基本上 這本是非常權威的醫學教科書 裡面寫了 限制卡路里攝取 是任何治療肥胖方法的基礎 對吧 減少卡路里 是第一重要的 但裡面又寫 這些方法 其效果都沒有被驗證過 對吧 那意思是說 我告訴你 你必須減少卡路里攝取 但我知道行不通 這不是很好的建議 不幸的是 你到哪都看得到這種建議 美國農業部(USDA) 糖尿病的教科書 任何教科書都是這麼說的 這「卡路里進、卡路里出」理論 有兩個基本上的錯誤 第一個 是我們搞混了根本原因和直接原因的差異 第二呢 我昨天的演講已稍微提到 但我們來複習一下
(譯註:請看影片「治療性斷食以解決兩倉儲問題」 他們視卡路里是單一倉儲
而肥胖其實是兩個倉儲的問題 意思是你吃進的能量 身體有不同的使用方式 你可以燃燒它 也可以存成脂肪 所以 有兩種路徑 而重點在於 你往哪條路徑走 而不是整個系統的能量是多少 我們先來談 直接原因和根本原因的問題 什麼是直接原因呢 直接指的是最接近 當討論肥胖 肥胖的直接原因是吃太多卡路里 對吧 那是最接近肥胖前發生的事件 是造成肥胖的原始原因 叫根本原因 如果你只治療直接原因 通常都是徒勞無功的 如果你治療根本原因 因為那才是真正造成這個疾病的潛在原因 那才是最重要的 嗯 讓我給你些例子 酗酒 你可以說 酗酒是因為 太多酒精進 或太少酒精出 對吧 你知道 那可是最基礎的定律 那是酒精熱力學第一定律 你無法憑空生出酒精 也無法消滅它 所以如果你告訴我這個是錯的 那你就是在說 科學的基礎理論是不存在的 對吧 當然那不是真的 但這爭論方式 和大家討論卡路里是一樣的 對吧 那只是直接原因 不是根本原因 而治療是無效的 如果你說 喔 你是酒鬼 我有個建議給你 少喝點酒 嗯 你會說 這不是個好建議 對吧 那酗酒的根本原因是什麼呢 有許多原因 上癮 家庭因素、壓力過大者 具上癮傾向的個性 所有這些原因 是真正引起酗酒的根本原因 所以你仔細想一下 現在呢 你能真正去治療這疾病 因為你知道根本原因是什麼 對吧 而治療方式 不是叫病人少喝點酒 療法是 互助小組 像匿名戒酒會 家庭支持、社工協助 朋友、教會、宗教 所有這些 都是極為重要的 而你並沒有違反這個 酒精熱力學第一定律 對吧 那太荒謬 那不過是直接原因 你可以用這個來分析飛機失事 對吧 什麼使飛機掉下來 直接原因呢 是因為地球引力太大了 或是上昇力太小 那是基礎的自然定律 對吧 所以 改善方式是把機翼變大 或是把飛機的重量減少 那也是很荒誕的 但一樣的 把機翼做大的建議 你不會說 太扯了 因為你違反了自然定律 對吧 那只是直接原因而已 那不是真的造成的原因 那只是在飛機掉到地上前發生的事 對吧 而根本原因呢 是像人為失誤、天氣因素、機件故障 對吧 所以 政府呢 確保機師受到專業訓練 維修保養、即時天氣預報 那是合乎常理的 因為那是針對根本原因 當你改善根本原因 是有效的 而改善直接原因 是無效的 所以我們可以輕易地用這概念 分析肥胖問題 這是我們對肥胖的認知 太多卡路里造成肥胖 對吧 那是大家在說的 但那只是直接原因 針對那來治療 你會說那就少吃多運動吧 但根本原因是什麼呢 這是熱力學第一定律 但同時也是沒說出口的指責 對吧 這大概是肥胖問題中最不公平事 我們是這麼說的 這是直接原因 而根本原因呢 都是你的錯 就是這個沒說出口的指責 「你放縱自己大吃!」 對吧 「是你的錯」 「你不該吃那個貝果!」 治療的方式呢 意志力 有這就行了 對吧 他們是這麼說的 但這理論模型是錯的 療法只有在這個模型是正確下才有用 有另外一個理論模型是 荷爾蒙引起肥胖 把肥胖視為荷爾蒙失調的問題 一樣地 直接原因還是太多卡路里 但是什麼驅使你 想得到更多卡路里 是胰島素 皮質醇也會 都是荷爾蒙 所以這樣一來 如果你以荷爾蒙的角度來看肥胖 療法不會是意志力 因為 我們國民突然在50年之後喪失意志力 50年前我們意志堅強 那也太誇張 所以療法應該是 降低胰島素 而你就能了解 會了解 為什麼它會成功 所以 記得 在這個荷爾蒙理論模型裡 你並沒有違反任何熱力學定律 並不是說能量可以無中生有 人們總是拿這些 來爭論低醣飲食 人們總是 「什麼?你不相信熱力學第一定律?」 不 我們不是這樣說的 傻瓜 我們是說 造成的原因是別種 不是意志力 是胰島素 是胰島素讓你體重上升 對吧 但他們還是不了解 指名道姓也沒用 另一點呢 他們在基本上誤解了這個問題 肥胖是兩個能量儲藏區的問題 意思是指 不單純只是能量進出的問題 不單只是 「誰進、誰出」的問題 因為呢 你可以把身體想做 我今天打算用另一種比喻 想像你自己是個火力發電廠的管理員 每天你得到2000大卡的卡路里 2000噸的煤炭 而你燒2000噸的煤炭 但煤炭不是只能拿來燒 你也可以把部份存起來 存在倉庫裡 所以有兩個去向 而重點在於 能量會去哪邊 並不是總能量 因為 當你減少能量輸入 所以 如果得到的不是2000大卡 2000噸的煤炭 你只領到1500噸的煤炭 所以 我們都預期 你的倉庫存量會降低 這建立在一個前提下 如果你的燃燒量維持不變 那就是我們昨天談到的 根本不是這樣 那是唯一倉庫存量會變少的可能 另外一個可能性呢 當你減少煤炭的輸入 你也減少燃燒的能量 讓輸入輸出達到平衡 再次強調 你並沒有違反任何熱力學定律 而是能量分配的問題 這是個難題 對吧 所以 假設你面臨這個情況 你只領到1500噸的煤炭 所以這陣子呢 你從倉庫中拿些出來用 你燒2000噸的煤炭 但只領到1500噸的煤 所以日復一日 你燒掉的比領到的多 會如何呢 你會把倉庫裡的用光 你的身體會完全停機 你無法產生任何能量 到處都停電 對吧 老闆會說 給我進來 你這蠢蛋 搞什麼東西呀 這樣太瘋狂了吧 你不會真的笨到這麼做吧 合理的做法 就是每天少燒一點能量 對 可能電壓會有點不足 但不會停電 對吧 所以 就是這樣 兩種做法都可以 但哪種是實際發生的呢 其實我們已經研究這個100年了 我們知道到底發生什麼事 這是1917年的研究 他們把卡路里降到1400大卡到2100大卡 以現在的標準來說 並不是真的很低 結果呢 這些是12個年輕男性 他們把卡路里攝取減少約3成 因為他們想知道會如何 結果是 他們的代謝率下降約3成 那蠻聰明的 因為若不這樣 你會用光能量 然後死亡 這個身體並不想死 對吧 這是 Ancel Keys 的著名研究 我們常談論 Ancel Keys 因為另一個原因
(譯註:請看「我們都錯怪了脂肪和膽固醇」) 他對拒服兵役的人做了一個知名的研究 他找不想參加二戰的人 他減少他們攝取的卡路里 大約少3到4成 他事實上一直持續減少卡路里 以讓他們持續減重 每個人都以這研究指出 為什麼你不該斷食 但這不是斷食 事實上 這是限制卡路里的飲食 所以這些人 一天吃1570大卡 所以這不是斷食 不是挨餓 是限制卡路里的飲食 結果呢 結果是他們的代謝率約下降4成 非常合邏輯 你拿到比較少能量 所以你也燃燒比較少能量 你們量測相當多東西 這其實是個相當好的研究 心容積變小、心搏排血量變小、心跳變緩 還有大家都注意到的 他們的體溫降低 炎熱的夏天 他們還蓋著毯子 還有各種神經精神的問題 有人極度渴望食物 有些人瘋了之類的事 其實有點有趣 因為這些人平均一天吃1570大卡 比起一些別的飲食 其實並沒有少很多 但重點在於 當你減少卡路里輸入 輸出也會跟著減少 比較最近的研究也看到 這是 Leibel 醫生非常著名的研究 他的做法 是找體重在一穩定值的病人 然後讓他們待在代謝實驗室量測 他做了兩件事 第一個 他強迫他們飲食過量 所以他們平均多了10%的體重 然後他讓他們回到正常 然後再讓他們減重 他量測他們的所有過程中的代謝率 他發現 如果你強迫這些人飲食過量 而他們體重多了10% 他們的代謝率增加了 每日多燒500大卡 其實身體並不是只會一直變胖 一直變胖 一直變胖 每個人總說 你吃更多卡路里 你就會變胖 不 你的身體其實試著要把多的燒光 每日多燒500大卡 那同一群人 你讓他們體重回到起始值會如何 他們的基礎代謝率回到跟之前一樣 然後當他們減重 他們開始燒較少能量 他們減少代謝率 大概少了300大卡 所以 這完全合情合理 如果你收到很多煤炭 你只是一直往倉庫擺 到最後放不下了 你就把炭堆到你老闆辦公室 對吧 你老闆會怎麼做呢 他會把你炒了 對吧 他會說 你怎麼那麼笨呀 身體沒有那麼笨 它會把這些多的都燒光 因為它不想要多的 那正是實際發生的事 所以這兩倉儲問題 你得看路徑走哪邊 這是我們的希望 你減去一些體重 你知道你的代謝率會下降 但也許你長期維持在這個體重 身體會開始習慣在這個新體重 那是我們的希望 很不幸地 實際上不是這樣子 所以我們來看長期的研究 他們維持減掉的體重長達一年 可看到的是 代謝率每日還是少400大卡 並沒有升回去 所以代謝率無限期地 在低檔狀態 所以 看起來 這就是你試著降低卡路里會發生的事 那就是為什麼限制卡路里是行不通的 對吧 我們之前就知道它行不通 因為我們都試過 現在知道為什麼了 另外一件事 其他的荷爾蒙變化 當你開始減少卡路里 你的荷爾蒙分泌開始改變 飽足賀爾蒙和飢餓荷爾蒙 這是2011年發表的 也就是5年前 這研究讓受試者減重 然後長期維持那個體重 並量測他們的荷爾蒙 一年後 我們看看發生什麼事 一樣的 我們的希望是 當你”習慣”了這個新體重 你的身體會開始適應並調整 但沒有 所以 Ghrelin 是所謂的飢餓荷爾蒙 就是讓你覺得餓的荷爾蒙 所以即使是在一年後 在第62周時 減重的一年後
(譯註:空心三角型) 你的 Ghrelin 還是比之前高很多 Peptide YY 是飽足荷爾蒙 讓你覺得飽 所以若較低 代表你會覺得較餓 也一樣 即使是在一年後 你的飽足荷爾蒙 也是比正常低 所以最終就是 你感覺很飢餓 因為你減重後 身體並沒適應 你只是減少卡路里 並沒對付胰島素 所以你比較餓 再次 我總覺得這是醫學上最不公平的事了 因為你覺得飢餓 所以你吃多點 你渴望吃多點 不是因為你是扶不起的阿斗 對吧 而是因為你的荷爾蒙讓你覺得飢餓 而你又燒比較少熱量 所以當你復胖到之前體重 每個人都會想 「你沒遵循飲食方式」 「因為你沒意志力」 醫學最不公平的一件事 因為我們知道 那是因為代謝率下降 而你的飢餓荷爾蒙上升 而這全部始於 對於肥胖完全錯誤的認知 所以不是意志不堅 對吧 你不是無法堅持 不 是你的荷爾蒙讓你覺得餓 你也不是懶惰所以不運動 你每天少燃燒 500大卡 不是因為你不願意 所以沒在運動 是你的荷爾蒙 是你的基礎代謝率下降 我們知道是這樣的 所以你回頭看這個限制卡路里的模型 我們總是在用的 太多卡路里 是你個人選擇 其實不是真的 全是因為代謝上的適應 包括減少消耗能量值 及增加飢餓感 這是我昨天提過的參考資料 我們知道這會發生 因為這個美國婦女健康關懷的超大規模的研究 針對5萬名女性 所以她們起始於 每天燒1788大卡 7年後追踨 是1445大卡 每天總燃燒能量相較起始值 少了361大卡 日復一日 而他給她們更多蔬菜、水果、纖維質之類的 如果你看 那個能量 他們的飲食 他們用的是50%的碳水飲食 所以他們從44.5% 升到52.7%
(譯註:圖表右下角) 而你看脂肪部份 從38.8%到29.8% 太好了 完美 低卡路里、低脂飲食 對吧 愛死它了 唉 結果呢 無效 這些人應該要每年減36磅 在接近十年的觀察中 幾乎一磅也沒減 一磅也沒有 他們總共應該減掉210磅的脂肪 他們一點也沒減 一點也沒 甚至不到 這是1公斤 所以大概差異不到4分之1磅 所以也許是早上在馬桶上比較順暢造成的 對吧 是的 這行不通 所以我們已經知道這麼久了 我們卻不停地告訴人們 「減少卡路里」 「減少卡路里」 「多運動」 我們知道那行不通 我可以直接告訴你 這是個殘忍的騙局 真的是個殘忍的騙局 因為我們把責任都怪這些人 但其實責任在我們 我們給的建議實在太爛 所以你減少卡路里攝取 你減了些體重 你的身體察覺 你體重變輕了 所以降低代謝率、增加飢餓感 然後你就復胖了 但因為你的意志力堅強 你加碼 你開始吃更少卡路里 對吧 我們都經歷過 所以你減了一點點 但問題在於 你的身體再次調整 降低代謝率 增加飢餓感 你再次復胖 持續不斷 直到你再也受不了 因為你覺得不舒服 而體重一直回來 那是個殘忍的騙局 而 更有甚者 每個人都認為 「對 就是那傢伙」 「照著減肥餐吃很困難嗎?」 這是對人最不公平、最殘忍的事了 終極的證據其實不在這些大型研究 最終極的證據就是我們自己 對吧 我可以給你看數據 但老實說 誰沒試過這種飲食 我的估計是90%的北美民眾都曾經試過類似這種飲食 在他們人生某些時刻 但沒效 對吧 事實如此 這就是問題 問題在於 你必須知道能量去哪 而問題癥結就在胰島素 因為就是它告訴身體能量如何移動 對吧 胰島素 告訴身體屯積脂肪 那是它的例行工作 當你進食 胰島素上升 而你開始存脂肪 你沒有違反任何熱力學定律 所以我們可以看到 如果你以「肥胖是荷爾蒙問題」的角度來看 如果你真的了解肥胖的病因學 問題還是太多卡路里 那是直接原因 不是根本原因 根本原因是胰島素 如果那是根本原因 把「少吃多運動」丟了吧 就像「少喝點酒」對酗酒者來說 那是不可能成功的 根本的治療是降低胰島素 現在 你了解了 現在你可以設計合理的療法 所以 胰島素使你變胖的證據在哪呢 有很多各種協會的研究 但這些協會的研究的問題在於 它並沒有告訴你任何事 你需要的是因果關係的研究 要這麼做 你必需給予受試者東西 如胰島素 這是糖尿病控制與合併症相關性試驗
(譯註:Diabetes Control and Complications Trial) 這是第一型糖尿病患者 他們的做法是 其中一組是高胰島素、低血糖 另一組給的胰島素比較少 也因此血糖較高 血糖積極控制組的確有比較低的併發病 但那不是我想問的 對吧 我的問題是 胰島素是否會使你變胖 的確會 所以在研究結束時 也就是第九年 你可以看到接受高劑量胰島素的那組 幾乎3成的人 有嚴重的肥胖問題 我並不是說 不該給他們胰島素 我是說 這是個明確的因果研究 給予他們胰島素 他們就會變胖 你可以看「胰島素劑量」和「體重上升」的相關性 結果 相關性其實非常高 當你給越多胰島素 對吧 這是越來越多胰島素 體重越來越重 身為醫生 這些你早就知道了 因為我們都開過胰島素處方 我們都知道它會導致肥胖 而第二型糖尿病的研究 也是一模一樣 這是英國前瞻性糖尿病研究
(譯註:The UK Prospective Diabetes Study) 這是另一個試驗 也給予病患很多藥物來控制血糖 其中一組給予的藥物比較少 所以血糖控制較差 一樣 那不是我要問的 我的問題是 這些胰島素是否讓你變胖 再次 還是一樣 積極控制組 胰島素較高 就是更多藥物刺激胰島素分泌 體重增加較多 我們不特別看相關性 這些是直接干預的因果關係 另外有個很棒的研究 1993年時做的 他們讓這些第二型糖尿病患者 胰島素劑量從零開始 然後給大量胰島素 給予很多胰島素 他們的血糖值變得很漂亮 他們的做法是 從0開始 一開始不給胰島素 到第6個月 他們一天給予的量高達100單位 他們的血糖 控制得非常好 但體重呢 你可以看到 平穩上升 (譯註:紅線) 93、97、100、102 我們不是強調相關性 而是因果 我們給予胰島素 人們就變胖 這一個測試特別有趣的地方在於 他們實際去看 每個人每天吃的卡路里是多少 而他們吃進的卡路里數字呢 是減少的 大約減少每日300大卡 253000卡
(譯註:也記得太清楚…) 即使他們減少攝取的卡路里 根據卡路里理論 他們應該要減重的 他們卻胖了快20磅 所以 你吃比較少卡路里 卻胖20磅 怎麼了 因為胰島素 胰島素叫你的身體 「存脂肪」「存脂肪」 那是它的工作呀 所以你的身體會降低代謝率 直到你儲存那些脂肪 因為那就是它的工作 所以你可以看到一樣的狀況在 Metformin Metformin 是一種很有趣的藥 它阻斷糖質新生 而不會使胰島素上升太多 用這個藥物的結果呢 你不會得到變胖的結果 你可以看到只用飲食控制的傳統組 和Metformin組 這兩個差異不大 而磺胺尿素類藥物的三組
(譯註:Sulfonylurea) 那是能刺激胰島素分泌的藥 讓你變胖 不是只有注射的胰島素 而是刺激胰島素分泌的藥物也一樣 身為醫生 這不令人訝異 這些磺胺尿素類的藥物 會刺激胰島素分泌
(譯註:Sulfonylurea) 不是因為它是注射的 外生的 而是你刺激你的胰腺分泌 你就會變胖 另一方面 反過來說 如果是胰島素使你變胖 如果你的胰島素下降 你會預期體重應該下降 那正是事實 這個顯示 當你胰島素一直下降 如何呢 你無法留住體重 第一型糖尿病的典型描述 「全身像融化般由尿液排出」 這是很棒的描述 因為你就是失去一切 不管吃什麼 你可以給他們吃任何東西 不管給他們吃任何東西 他們沒有胰島素 沒有儲存脂肪的信號 他們失去所有的體脂而死亡 很不幸 那就是胰島素療法問世前的狀況 有種疾病叫「糖尿病飲食失調」 是一種飲食失調病 第一型糖尿病患者 刻意自己降低胰島素劑量 血糖上升 你知道 可能死於酮酸中毒 有各種問題 為什麼他們要這麼做呢 因為他們想減重 患者知道 我們也知道 當你減少胰島素 體重就會下降 而最近有另一種藥 也顯示一樣的結果 這是SGLT-2 直到最近 才有藥物是降低胰島素的 這個新藥 已核准治療第二型糖尿病患者 實際顯示 可以降低胰島素 它使患者由尿液排出糖份 胰島素因此下降 這兩組 DAPA組 是使用這個新藥的兩組 你可以看到他們的胰島素濃度下降 然後呢 他們體重也下降 讓我著迷的是 這三組DAPA組
(譯註:下面那三條線) 他們全部都反映出 體重下降 真正令我著迷的部份是 看看後面 你長期追蹤這些患者 一年 兩年 到現在已經四年了 他們沒有復胖 對吧 這實在令人驚訝 你可以去看任何飲食的相關研究 人們在大約六個月後開始胖回去 變瘦 我們都見過 復胖呢 並沒有 為什麼呢 因為你把胰島素降低了 對吧 限制卡路里嗎 有人會說 那是因為你尿糖 所以卡路里降低 但限制卡路里飲食無法維持成果 但當你降低胰島素 也就是造成肥胖的根本原因 體重降低 並能長期維持 可是從來沒發生過的 那是真的令我著迷的部份 所以 這是個治療第二型糖尿病的藥物表 有加強胰島素功效的 或是直接注射胰島素 所以有 胰島素、磺胺尿素類藥物、TZD TZD是另一種類型的藥 不是直接升高胰島素 有些藥物不影響胰島素水平的 Metformin 和這些 DPP IV 有些藥物會降低胰島素的 Acarbose 會降一點點 還有這個新藥SGLT-2抑制劑 你也可以看那些天生缺陷的 結果也一樣 升高胰島素的東西 讓你變胖 降低胰島素的東西 讓你變瘦 這是強烈的證據 說明「荷爾蒙引起肥胖」是更加正確的 因為胰島素導致的肥胖現象 導致身體去適應 是種荷爾蒙的效應 你覺得餓 因為你的身體提高了飢餓荷爾蒙 代謝率下降 而不是把能量燒光 就是這整個過程 讓你掉入這個陷阱 你不是因為過量飲食而變胖 你過量飲食是為了變胖 那就是較佮當的問題 是什麼讓你變胖 什麼是肥胖的根本原因 再次強調 就是胰島素 皮質醇也扮演了一定角色 但那下次再談 你不覺得很有趣嗎 我們還以為我們很聰明 都2016年了 如果你回顧歷史 William Banting 他已了解 精緻碳水化合物會讓人們變胖 對吧 現在2016年 其中50年的斷層在討論卡路里 現在我們了解 精緻碳水化合物 提升胰島素 使你肥胖 而這個人 Banting 是在1850年代 早在該死的150年前 他們就知道了 對吧 就像是 「我的天呀!我們沒那麼聰明!」 這就是整個問題 如果你試著以卡路里問題去治療 而且你認為問題出在個人選擇 你就會失敗 如果你了解 這個疾病是和胰島素有關 那你就會了解 為什麼我們的療法是這樣 所以 飲食中是什麼讓胰島素提升最多呢 精緻碳水化合物 糖和精緻澱粉 什麼提升胰島素最少呢 天然油脂 對吧 橄欖油、酪梨、奶油 Marty Kendall 做了一個很棒的表 他查了所有文獻中 任何食物的胰島素指數 他發現 你可以預測吃下該食物 胰島素的反應 公式根據淨碳水化合物 加上蛋白質含量的一半 不過那只解釋了一部份 變異量約50% 不過現在最佳預測是如此 淨碳水化合物 也就是碳水化合物減去纖維質 和蛋白質量的一半 這解釋了 為什麼我們會給這樣的飲食建議 低碳水化合物、適中的蛋白質、大量的天然油脂 這樣的研討會是很棒的 這給了我們新希望 如果我們繼續誤解肥胖的成因 我們就完了 我們無法成功 想治療肥胖問題 沒有一絲成功的可能 然後你得到第二型糖尿病、接著失明、然後洗腎 還有所有這些問題 這些新的認知 給了我們新希望 現在我們可以說 我知道發生什麼事 是你的胰島素 讓我說 我該如何降低你的胰島素 我們可以做這 也可以做那 低醣飲食 比如高纖維食物 喝醋啦 你知道 也可間歇性斷食
(譯註:譯者個人推薦生酮飲食) 有各種不同策略 而你知道這些方法是會成功的 這是最最重要的一件事 你知道 這並不是在譴責之前做錯的 對吧 而是說 這是一個新黎明 只要我們了解是什麼造成肥胖 我們可以治愈它 我們只是需要把訊息傳遞出去 讓大眾認同我們 然後去執行 謝謝大家

Randall Smitham

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88 COMMENTS

  1. richard olson Posted on June 24, 2016 at 3:18 pm

    I appreciate the ammunition.lchf!

    Reply
  2. Marty Kendall Posted on June 24, 2016 at 4:16 pm

    Thanks for the shout out Jason. 🙂 For more info on the insulin index see http://wp.me/p5VAQF-5u on Optimising Nutrition.

    Reply
  3. Richard Mann Posted on June 24, 2016 at 5:31 pm

    throw away the bathroom scale and just use the tape measure on your waist try for 32inches or less.

    Reply
  4. The1RobynHode Posted on June 24, 2016 at 10:43 pm

    Great vid, though from my angle, I think it's pretty focused on food only. I'll challenge your knowledge set with some quantum and chronobio. What about the controllers of insulin like sunlight and electron loss at cytochrome complex I NADH and II FAD. Could it be that a lot of people that develop insulin resistance are also low in Vitamin D? Yep. Is that an indicator of the lack of sunlight on surfaces? Yep. Or if you build a poor H3O2 exclusion zone with water inside of cells (Gerald Pollack's work). Or what if you blast up your cortisol at night and kill off your melatonin under blue-light (artificial lighting) watching TV, checking your cell or going to the gym late. They react to light, don't they. Or electron theft from being in an electromagnetic field for prolonged periods of time. Lotta reasons outside of food to screw over your insulin. The biophysics is playing a large role in people's lives that is requiring them to eat lower carb due to the hits to cytochrome complex I, especially in the winter when sunlight is not too available (and they are avoiding it to boot).

    Reply
  5. Keto Wager Posted on June 25, 2016 at 3:45 pm

    Nailed it! Fantastic lecture Dr. Fung. Game changer for real.

    Reply
  6. Debbie Heine Posted on June 27, 2016 at 3:54 pm

    Dr. Fung is the best!! His explanations are wonderful.

    Reply
  7. joe schmo Posted on July 9, 2016 at 1:27 pm

    "We're not that smart." yeah, what happened is industry to control of everyone's brain and turned us into zombies – "calories in, calories out."

    The world is still full of brain dead zombies.

    Reply
  8. stan cutler Posted on August 24, 2016 at 10:31 pm

    Dr Fung you have just explained the problem of obesity so well-thank you

    Reply
  9. Lrak Schmidt Posted on August 24, 2016 at 10:43 pm

    Big problem – is it insulin or insulin sensitivity? Two sides fo the same coin. What screws up insulin sensitivity? PUFAs –

    We know if we feed lab rats a bunch of PUFA with carbs they get fat – same reason when cows are to be fattened we feed them corn (loaded with Linoleic acid the most common PUFA ).

    We know know that this change of insulin sensitivity happens on the mitochondrial basis –

    More at Hyperlipid..

    Reply
  10. Oleg Unknown Posted on September 2, 2016 at 2:13 am

    Huge number of assumptions/wrong conclusions and oversimplified approach. Typical doctor crap that has very little understanding of human physiology.

    Reply
  11. Zane Sheppo Posted on September 6, 2016 at 10:46 am

    absolutely correct..INSULIN is the cause of hunger

    Reply
  12. Me Meee Posted on September 9, 2016 at 8:25 am

    hahaha he is amazing, greating from Dubai.

    Reply
  13. Michael Toub Posted on November 6, 2016 at 3:19 pm

    Simply the best explanation on this topic EVER! I heard this segment on Latest In Paleo's after-the-bell !!!

    Reply
  14. AZ Moonshine Posted on January 3, 2017 at 5:21 pm

    You want to hear something sad? There is a keto group on Facebook called Optimal Ketogenic Living who bans people for suggesting Dr Fung. If you don't follow THEIR plan, they remove you.

    Reply
  15. Mikael Vitaly Vyacheslav Posted on February 9, 2017 at 3:58 am

    This post is for all you American people who are unhealthy of eating the American toxic diet ..don't die from heart disease or diabetes ! ! I hope my post will help you in a positive way …I am a Vegan but I don't eat anything with white flour , dairy .my diet is very low fat and low carbs , no oils, no avocado no fat; this is the diet I follow ; "Here’s how my intermittent fasting diet works " :..You get up in the morning and drink a glass of water or a cup of coffee or tea. You can use a little creamer or low-calorie sweetener like stevia, and you can take your supplements if they don’t upset your stomach. But do not eat breakfast or drink anything other than coffee, tea or water.

    Do 20–45 minutes of moderate aerobic exercise—walking, jogging, cycling or whatever you enjoy doing.

    After you exercise, get on with your day, but continue fasting until lunch. Drink water, coffee or tea. Don’t worry about being too hungry to make it through the morning. This fasting/exercise combo dampens the appetite, and the caffeine in coffee and tea helps blunt hunger as well.
    At lunchtime, break your fast and eat normally for the rest of the day. Get plenty of lean protein and low-fat, low-glycemic carbohydrates. Be sure you make healthy, sensible food choices. You don’t have to count calories, but you don’t want to pig out at lunch or dinner, either.Twenty minutes Before dinner take two spoons of Apple cider vinegar that will help your body control insulin and lose weight on a low fat and carb diet .

    But What About Breakfast?

    Yes, this intermittent fasting diet goes against the conventional wisdom that breakfast is the most important meal of the day. But the difference here is that I’m suggesting that you wait to “break your fast” around noon, instead of upon arising.

    The caloric reduction that skipping breakfast bestows is huge. As long as you eat normal, healthy meals at lunch and dinner—without making up for the calories you didn’t eat in the morning—you will reduce your caloric intake by about 30 percent. If you do it for six days, it’s the equivalent of a two-day total fast, and one month is similar to fasting for 10 days.

    How the Intermittent Fasting Diet Melts Excess Weight

    The intermittent fasting diet takes advantage of, and expands upon, the 10–12 hours you normally fast while sleeping.

    By morning, your body is beginning to deplete the glycogen in your liver (from the carbohydrates eaten at your evening meal) and is starting to rely more on fat for energy. As your glycogen stores are progressively exhausted, your liver starts converting fat into ketones, which the brain and other tissues use as fuel. This fat-burning state is called ketosis.

    Aerobic exercise while in the intermittent fasting state is a crucial part of the program because it rapidly puts you into ketosis. Overnight fasting is a start, but exercise really kicks things into high gear. The fuel used during the morning walk you’re taking in place of eating breakfast comes from burning fat, which is exactly what you want when you’re trying to lose weight.
    Even better, if you continue fasting after exercising, you will stay in the ketotic state, further reducing fat stores.

    What the Research Says

    The exercise-enhanced intermittent fasting diet has been evaluated in a clinical trial that involved volunteers with an average weight of 199 pounds, BMI of 32.2 (30 and over is considered obese), waist circumference of 42.6 inches, and fasting insulin of 13.2 IU/mL (a level indicative of insulin resistance).

    After 12 weeks, the participants lost an average of nine pounds and an even more impressive 16 pounds of fat (25 percent of their initial fat mass) plus three inches around the waist. Additionally, the group’s fasting insulin fell by one-quarter, into the normal range.
    I advise all my patients with type 2 diabetes to lose weight and reverse their diabetes using my mini-fast with exercise program, or intermittent fasting diet.

    Book
    The Obesity Code: Unlocking the Secrets of Weight Loss – Paperback Book – March 1, 2016
    by Dr. Jason Fung
    https://www.amazon.com/Obesity-Code-Unlocking-Secrets-Weight/dp/1771641258/ref=sr_1_1?ie=UTF8&qid=1486610940&sr=8-1&keywords=obesity+code
    Show less

    Reply
  16. Vincent LAM Posted on March 9, 2017 at 6:35 am

    drink everytime Dr Fung says right

    Reply
  17. Bryan VanDyke Posted on March 9, 2017 at 5:51 pm

    Dr. Fung drinking game. (Have a large glass of water on hand. ) Take a sip Everytime he says "right?". 😉

    Reply
  18. BroccoliQueefed Posted on April 15, 2017 at 5:08 pm

    Another medical industry whore. Drugs shouldn't be the first choice. They are a big part of the problem

    Reply
  19. mnelson2008 Posted on June 4, 2017 at 6:01 am

    I agree with ALL it. Fasting is key. The only real issue then is, it STILL takes willpower to fast. One must STILL not eat for certain periods of time. Yes, the answer is simple: don't eat. Deplete your "freezer." It's the application of this remedy of fasting that is, again, the problem.

    Reply
  20. Czar Zenana Posted on June 15, 2017 at 8:31 pm

    So explain this: my father was diagnosed with diabetes type-I when he was 30 y.o.
    He started injecting insulin in high doses (100 units a day) because in those days (>45 years ago) it was very hard to keep his sugar levels stable. Due to the high doses he also had to eat a lot and he did eat a lot and very healthy: no sugar, whole wheat bred, low fat, hardly any alcohol etc. but he lost 20% of his body weight right after starting with insulin, like within 1-2 weeks. He fought the rest of his life against low body weight until he died at the age of 70 y.o.
    His brother was diagnosed with diabetes type-II at the age of 60. His brother started injecting insulin but kept on eating sugar. He was always very low weight for his height but didn't gain a gram of weight after starting with insulin.
    My sister was diagnosed with diabetes type-I on the age of 40. Like all of us she was also quite thin. After taking insulin she never gained any weight, nor lost weight.
    So apparently there are people not gaining weight at all when using insulin and some even lose a lot of weight when taking insulin.
    I am not questioning what dr Jason Fung says though, I think he is highly intelligent and by far most people gain weight after taking insulin.

    Reply
  21. MrAutospec Posted on June 17, 2017 at 5:07 pm

    Deserves a Nobel Prize!!!

    Reply
  22. Pascal Aschwanden Posted on June 21, 2017 at 4:46 am

    "No, we're not saying that you idiot." lol.

    Reply
  23. amazing warehouse Posted on July 27, 2017 at 5:53 am

    I'm a 53 year old male. (picture is my wife). I had diabetes II for 7 years and I've been fasting for 2 years now. My weight was from 215 to 168 lbs. My metformin is now down from 5 to 2 tabs a day. My AIC is always between 5.6 and 6.8. I eat non-stop from 6pm to 10pm daily. I eat anything. Sweets and anything and a lot, really a lot. My doctor says she don't like what I'm doing but all my numbers are OK so she said do whatever you're doing. Now I eat 3 meals per day on weekends. I am hooked to this diet and I can't imagine stopping because everyday I look forward to 6pm because I will eat whatever and I don't count how much or what it is. It's a daily feast. I hope someone tries this because it is very enjoyable. I'm loving my diabetes. It made me eat whatever I want.

    Reply
  24. Joseph Ebrada Posted on August 14, 2017 at 3:58 pm

    Great content here. One of the best explanation about IF, obesity and DM. Thank you Dr Fung.

    Reply
  25. Red Pill Vegan Posted on August 24, 2017 at 4:27 am

    Aww…He described the Women's Health Initiative diet, at ~29-30% Fat… as LOW Fat? That's cute.

    Reply
  26. Alter Ego Posted on August 24, 2017 at 7:38 am

    He mocks people for saying that carbs (calories) is the cause of obesity, so to avoid too many calories is to avoid obesity/diabetes. According to him, one must blame insulin, which is the ultimate cause, and not calories, which is only the proximate cause, for causing obesity/diabetes.
    And yet, by the end of the video, he himself is saying it's the refined carbs (the proximate cause) that leads to increased insulin (the ultimate cause). In other words, he has come to the same conclusion as the people he set out to mock, that it is too many refined carbs (calories, the proximate cause) that leads to obesity/diabetes. Bingo!

    Reply
  27. Carroll Hoagland Posted on September 28, 2017 at 1:19 pm

    Thanks Dr. Fung well done, a fan, – but this message is hard to get out – Filed a complaint with my hospital admin to do "No Sugar Zone", i.e. they were first to post No Smoking Zone, but lost – SOC has too much Legal Standing – (50% of staff is obese – "Health Professionals??") the issue is Modern medicine has abandoned “Root Cause” investigations in favor of “Diagnosis and Drugs”, – this is odd as metabolism is a “Response Mechanism” – and we are seeing the results of Medicine by Chemistry, without “Root Cause Analysis” …
    www.70GoingOn100.com the Centenarian Diet, or maybe 128, the Hayflick limit, or if a Ray Kurzweil fan then this is a Moot Point …

    Reply
  28. KenDBerryMD Posted on October 12, 2017 at 10:54 am

    Anyone trying to lose weight, cure their Type 2 Diabetes, or correct Fatty Pancreas, should binge watch Dr Jason Fung.

    Reply
  29. Oscar Zepeda Posted on November 1, 2017 at 6:10 pm

    "Why Are There Fat Dr.'s ???? " Preach Jason !! Preach On !!!!!!!! Jason Fung Is Thee Health Superstar !!!!

    Reply
  30. Francisco Silva Posted on November 19, 2017 at 12:59 am

    Please explain how to fast like time how many hours or how many days a week. I also have enlarged prostate where some say have water of 8.5 PH some say one tea spoon of Baking Soda with water 8.5 PH some say have water with Hydrogen of minimum 1.2 ppm and ORP of -500 (Negative 500). I am confused. Please help as I am from India. I remain seated waiting for passengers for long hours could this be the cause ? now my feet are swollen and I can't put a bedsheet over them as it feels like a big boulder on my toes.

    Reply
  31. Inge Rush Posted on November 21, 2017 at 5:43 pm

    I love the Obesity Code. Have lost 12 lbs in 3 weeks already (much more to go). What struck me is that I am back to what I always deep down knew was the way to lose weight: just don't eat. That's what I used to do, but then I began listening to all the mambo jumbo out there and kept gaining wait. Super easy and effective! I feel great!

    Reply
  32. David Trejo Posted on November 28, 2017 at 10:33 pm

    Wow. Such an eye opener. I was one who lost 175 pounds and gained 50 back this past year. Why? Because my hunger levels were through the roof! I became hungrier than when I was 175 pounds heavier! Here I am. Keto day 4 and seeing a bright future and understanding ahead of me.

    Reply
  33. Fair Human Posted on February 28, 2018 at 10:29 am

    Been listening to Dr Fungs videos for a while and im hooked also read his book the obesity code. This man is spreading the best and most accurate information to cure modern disease.

    Reply
  34. Chase Rock Posted on March 31, 2018 at 10:02 pm

    Very good, except his recommendation to go to church and/or religion to solve alcoholism.

    Reply
  35. Margaret OConnor Posted on May 30, 2018 at 1:04 am

    Dr Fung , you are a genius! I found your book a year ago and as a 73 yr old retired nurse, I followed intermittent fasting and LCHF. 50 lbs later, I do not have to die fat. Wish I could give you a hug! Keep on keeping on and I will try to inspire others! God Bless you!!!!

    Reply
  36. K Toledo Posted on June 1, 2018 at 6:15 pm

    I happened to come across Dr. Fung's advice and information after I wasn't feeling so well and I started noticing all these people who are bloated and waterlogged they looked exactly like me. I knew I had to make a change I don't want all the added diseases symptoms from excess weight. So after having some heart palpitations and excess water in my legs I decided to go for it. I first started with intermittent fasting and then I did a water fast for 3 days and have been juicing for a week. I have lost 12 pounds exactly since the second week of May 2018. I understand it might be water weight none-the-less I lost the 12 lb when nothing else would work. I am exercising and continuing with the intermittent fasting and making sure that I eliminate as many process carbohydrates as possible.. I'm not starving and I feel that as I continue this I will create more mass muscle mass and finally eliminate a lot of the fat. I won't have that puffy exhausted person look

    Reply
  37. Julie Joseph Posted on July 4, 2018 at 1:51 pm

    The best! The best! The best! I have learned so much from this man.

    Reply
  38. niklasjuchem Posted on July 9, 2018 at 10:58 pm

    getting fat game: eat a sugar cube every time he says "right?"

    Reply
  39. Colorsof Avon Posted on July 17, 2018 at 11:50 pm

    He's a genius. Thank you for sharing this.

    Reply
  40. Patrick Ryan Posted on July 30, 2018 at 7:44 am

    He is wrong when he says we don't burn muscle for fuel when we fast. Our red blood cells can only use sugar as a fuel and that can only be made from our muscle protein. I don't trust him as this is very basic information indeed.

    Reply
  41. gary samples Posted on August 5, 2018 at 11:08 am

    Thank you so much for the information ! I finally have possession of the keys to good health and weight loss and can turn it on and off at will with a good balanced keto plan and intermittent fasting it’s too easy

    Reply
  42. David Bates Posted on August 10, 2018 at 7:57 am

    I'm scheduled to have a blood test taken soon mainly for my A1C. What other things should be tested with a blood test that my Dr. isn't testing for.

    Reply
  43. The most uninteresting Man in the world Posted on August 11, 2018 at 6:09 pm

    Listening wtf are ll these idiots laughing at? he's not even trying to get a laugh…although his use of idiot is hilarious to me, he says it all the time

    Reply
  44. Johan Liebert Posted on August 24, 2018 at 4:29 am

    Always get a blast on your lectures.
    I'm so grateful to have found you Dr Fung you have given the answers to questions I had for years and have clarify my thoughts thanks again.

    Reply
  45. FreeQuest Posted on August 29, 2018 at 3:54 am

    Wiser than a goldfish in a spacesuit.

    Reply
  46. Sharaf K Posted on September 9, 2018 at 7:51 pm

    I used to watch chris gethin video for my gym schedules .In the video he says the ratio of burning fat will be very less if you have sugar/carbs in thd body so cut off all the sugar first to burn the fat drastically and he was right.Since then i always wanted to know whats so special with cutting off of carbs .After watching Dr. fung's videos now i have the answer 🙂

    Reply
  47. Athanasios M. Posted on September 11, 2018 at 3:57 am

    I started Intermittent Fasting. I rested the whole day. Within the first 20 hours my blood pressure shot up to 171/98. After taking a pill to decrease my BP,, I ate and slept. Next morning felt good and continued fasting. Iexercized moderately. Within 20-21 hours my blood pressure increased again to 152/101 and had to take a pill as well as eating to stop the headache and red eyes. 59 years old, usually elevated blood pressure to 130 plus, sleep 5-6 hours per day. In the morning of the third day, about 11 hours from takind pill and eating, blood pressure at 135/74. Perhaps you could enlighten us with this aspect of fasting? From a small internet search I read that fasting causes an increase in blood pressure to: 1. People with hypertension 2. People who wake up before sunrise. Is this consistant with your model?

    Reply
  48. Antonio de las Nieves Stoner Posted on September 23, 2018 at 1:50 pm

    This is game changer. Thanks Doctor Fung.

    Reply
  49. Marco Ursi Posted on September 28, 2018 at 8:51 am

    Dr Jason Fund should team up with Dr. Robert Lustig..they are great!

    Reply
  50. Greg Richardson Posted on October 11, 2018 at 7:45 am

    if im doing intermittent fasting then should there be a particular calorie number i should aim for? would i still eat in a deflect and lower insulin to lose weight or eat at maintenance lower insulin to lose fat? thanks

    Reply
  51. Christ Follower Posted on October 15, 2018 at 7:35 pm

    If only Politicians had common sense like Dr.Fung. Life isnt rocket Science. Just a little common sense goes a looooong way

    Reply
  52. Ernesto Hernandez Posted on October 23, 2018 at 8:43 pm

    Will fasting bring my sugar to a dangerous low?

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  53. tiglath pileser Posted on October 31, 2018 at 7:20 am

    What are the long term effects of a LCHF diet ?

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  54. Becca L Posted on November 3, 2018 at 5:28 am

    I'm doing the fast now for 19 hours, then I drink and eat food contains sugar, carbs, does that mean all my fasting is no more effective??

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  55. oscar ghimire Posted on November 28, 2018 at 3:26 pm

    Low carb, low fat, plant based diet, Intermittent fasting, fasting, unprocessed foods made me loose 40 pounds in 3 months.I have reversed my diabetes and fatty liver and I feel more energetic and healthy than ever.

    Reply
  56. hitruth Posted on November 30, 2018 at 2:46 am

    Best health advice in years….

    Reply
  57. Mariano Souto Posted on December 1, 2018 at 7:02 pm

    You eat too much because you are hungry because there are homones that make you hungry. Thats why you eat too much calories

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  58. Marcel LeBlanc Posted on December 2, 2018 at 3:27 pm

    Absolutely fantastic. Please loose the “Right, Right, Right”

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  59. Richard George Posted on December 7, 2018 at 10:48 pm

    I have been trying Dr Fung's ideas for 5 weeks now (low carb low sugar / 20-4 Fasting). I am amazed by the effectiveness of Intermittent Fasting, not only have I lost 14 lbs but I was taking 136 units of insulin a day and I am now COMPLETELY OFF insulin and my blood sugars which averaged around 9.5 are now averaging 5.4. Dr Fung I applaud you !!! Thank you for this wonderful change in my life!!!

    Reply
  60. Iain Dennis Posted on December 22, 2018 at 11:21 am

    My Grandmother was a Victorian lady, she knew that bread, biscuits, scones, cake and sweets made you ill and fat – why and when did we forget what she had known all her life?

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  61. spiritual abundence Posted on December 23, 2018 at 5:28 pm

    IF and carb blockers then Yes?

    Reply
  62. Robin Lillian Posted on December 28, 2018 at 6:02 pm

    It is possible to be fat and also have hypoglycemia. People with hypoglycemia can't maintain safe blood sugar levels while fasting half the day.–which is Dr. Fung's treatment to lower insulin. Even people with diabetes (hyperglycemia) can also suffer from periods of seriously low blood sugar, as well. Dangerously low blood sugars can be fatal pretty quickly. The trick is to lower insulin without raising/lowering blood sugars precipitously. So, then what?

    Reply
  63. Katie G Posted on December 31, 2018 at 2:46 pm

    Dr Banting won a Nobel Prize for his medical research in 1923, not 150 years ago! Or was this just exaggeration for emphasis?

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  64. Rayna Cruz Posted on January 5, 2019 at 7:17 pm

    Keep I’m interested

    Reply
  65. MrTobitobitobitobi Posted on January 9, 2019 at 1:05 pm

    ….right?! 🙂

    Jokes aside, great information!

    Reply
  66. Lynn M Posted on January 15, 2019 at 9:21 pm

    I can't thank him enough. My health has totally turned around because of him and his videos and keto.

    Reply
  67. Ru M Posted on January 24, 2019 at 6:29 am

    How do I make sure my glucose doesn’t drop when I’m fasting, IF. I’m diabetic

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  68. Rodney Booth Posted on January 29, 2019 at 7:06 pm

    So true. Been there for 40 years.

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  69. Solidfreeman Posted on February 3, 2019 at 10:35 pm

    That´s an interesting presentation……. right? 😉

    Reply
  70. Richard Lonzaga Posted on February 13, 2019 at 12:18 pm

    he's off on 1st law of thermodynamics slide….not all calories consumed from food is equal to calories burned during physical activity…..some of the calories are stored in the body which is represented by U (internal energy), thus, the equation is Ein = Eout + U or in other words U (internal energy) = Ein (energy consumed) – Eout (energy burned)…also he can not apply the 1st law of thermodynamics on alcohol because in the 1st place alcohol is metabolized in the body by the liver via the enzyme alcohol dehydrogenase (ADH), therefore it is destroyed and converted to Acetyl-CoA…well too much application of engineering principles to drive a point

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  71. Ponte Vedra Posted on February 15, 2019 at 1:06 am

    Merci unbelievably great!! Thank you from the heart, ana maria

    Reply
  72. Mel Gon Posted on February 17, 2019 at 4:24 am

    Gosh this is so enlightening. I’ve been watching Dr Fung for the last few weeks. I have his Fasting book from the library. This explains so much. I lost 50lbs several years ago (with probably 30 more to go). I did it on Weight Watchers. It’s the first time I’ve ever been successful. Then, I started getting so hungry. I couldn’t figure out why I was so completely in the zone for probably 1 1/2 years and then fell off the wagon. Could not get back on. Then I got pregnant. Now I’m probably 60lbs heavier than that and just can’t figure this out! I’ve tried intermittent fasting and feel great but something always gets me out of the zone again. My whole point in writing is…it’s really interesting to hear Dr Fung say “this isn’t your fault, your not a glutinous pig”. Although I know I’ve made horrible choices, I know that. I know this is partly my fault in a huge way on a certain level. And I’m someone that would always say “I don’t blame my weight on others, I don’t blame it on emotions etc. I just like to eat and eat too much. Period. And don’t have control”. I feel like this kind of video gives me hope to try. It’s hard to lose weight, gain weight and get the courage to start again. You just keep thinking, “I’ll fail again”. Thanks for the video.

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  73. Mel Gon Posted on February 17, 2019 at 4:30 am

    Also, I would love to know what the solution is for type 1 diabetics. I have a friend who is insulin dependent. I would love to point her in a right direction.

    Reply
  74. Sajjad Khan Posted on February 22, 2019 at 9:36 am

    Does waterfasting help crue lipedema??

    Reply
  75. Gjören Posted on March 1, 2019 at 3:16 pm

    I knew that insulin plays a big role in weight changes but I didn't think it plays that much of a role. It's pretty much the only cause (besides cortisol) for any weight gain and overrides the significance of calories completely. I think that's amazing and we need more people like you who look at things deeper and more scientific than just from the surface like you said with the proximate and the ultimate cause. Thanks for sharing this Dr. Fung!

    Reply
  76. Sadrien Posted on March 6, 2019 at 6:48 am

    People aren't that smart because they all have metabolic syndrome from those healthy whole grains, causing reduce brain activity.

    Reply
  77. Anne Fricker Posted on March 15, 2019 at 8:44 pm

    Im feeling very emotional listening to this. I have eaten healthily, walked and exercised, try to stay active all day. I have felt hungry and eaten more than I intended, tried eating regularly to keep blood sugars level but in the last 3 weeks I have tried IF. Oh my goodness! Im not hungry all the time and I have lost weight. This seems to be the missing link in my conundrum. Thank you Dr Fung. Your explanation makes so much sense and to hear someone explain that we are not all gluttonous lazy slobs as so many people think we are just brings tears to my eyes.

    Reply
  78. Jim Trainor Posted on April 15, 2019 at 1:57 pm

    The problem with "calories in – calories out = calories stored" is that other N equations needed to the model the system that the energy is used by are missing. If an energy balance is used for an engineering analysis then the statement of the first law of thermodynamics would be the first of many steps of analysis. It would not be stated, or be useful, without also developing a model of how the system in question behaves in response to the energy flows. The root of the "calories in – calories out" failure is that that additional analysis was always missing. It is still missing, actually. Nowhere will you find the pages of math that would be necessary to fully model the system. What you'd end up with, if you did that full analysis, is a set of differential equations that model flow of energy and actions of metabolism over time. It wouldn't be simple.

    Reply
  79. Maria Rita Dairo Posted on May 11, 2019 at 11:46 pm

    You are a real doctor! Dr Fung is genius….he solve the problem of obesity in a very simple way IF….high fiber diet and so on…You are Gods given gift to humanity….a million thanks…job well done.

    Reply
  80. Christian Cardona Posted on May 12, 2019 at 6:30 am

    Dr Fung needs to be on Joe Rogan’s podcast!

    Reply
  81. Stgfre Posted on May 26, 2019 at 12:29 am

    So insulin makes you gain weight. If that is the case how do you lower your insulin?

    Reply
  82. Swanee Posted on May 26, 2019 at 9:27 pm

    I 3 personally know 3 people who followed his advice, lost weight, got off of metformin, and have really good blood work now. Dr. Fung is the man! Read his books (or listen to them). His series on youtube is excellent.

    Reply
  83. Jim McKay Posted on June 3, 2019 at 2:02 am

    I have been keto over 2.5 years and intermittent fasting about 5 days a week for 2 years. I lost 50 lbs., maintained my new healthy weight, and have not gained anything back. I actually have to force myself to eat some days because hunger is rarely an issue. On the SAD, I was getting hungry every day after 2 hours of not eating anything.
    I am so happy for this new scientific information that has come forth. Thank God that Dr. Jason Fung freely gives this information to others to help them become healthier. It is a very unselfish act that shows how he truly believes in people becoming better for themselves.

    Reply
  84. Jim McKay Posted on June 30, 2019 at 12:21 am

    For anybody that works a physically demanding job, just know that this works with that also. I work very hard most days, and I still can fast 16, 18, 20 hours with no feelings of hunger. Just the other day I did a 22 hour fast and only ate because I had to take a lunch break. I never once lost energy, or even felt the slightest bit weaker because of it. This is actual science and it has changed my life, starting 2 1/2 years ago. I have not once "cheated" as many say they do. I eat mostly meat, with the occasional vegetable or almond. God bless Dr. Fund, Dr. Barry, Dr. Berg, Thomas Delauer (however you spell that last name), for giving us all the free information, unadulterated by big sugar industries. We all need to be healthy, and these guys are some of the cornerstones of the food revolution that is to come.

    Reply
  85. Nino Concepcion Posted on July 10, 2019 at 5:11 am

    14 months ago, I watched this video and it completely changed my world. I was a personal trainer for about 5 years and what I was taught was all wrong. I feel terrible for giving my clients bad advise. I lost 32lbs within the first 3 months and I've hit my body set weight and keep the weight off. I feel good, healthy, high energy, good gut, and have been told that I haven't aged. Thank you Dr. Fung.

    Reply
  86. gdshdsfjhdh X Posted on August 25, 2019 at 9:07 pm

    I was definitely headed towards type 1 diabetes watching Doctor fung watching dr. Fung's videos most definitely saved me from a life of pain and suffering I took his advice and I've already lost 20 lb and Lord my blood glucose and insulin levels just within two weeks I can't believe that this is all for free anyone out there I would take his advice this is a great and good man who who cares about people and if you just listen to him you can change your life some people would charge thousands of dollars for this information and dr. Fung is giving it to you for free so I suggest that you listen to him if you want to stay out of the hospital I used to eat 5 meals a day 500 carbs a day then I saw my neighbor in the hospital with a diabetic stroke he was a vegetable and that was the turning point for me now I do 20 carbs a day or less just in two weeks I've already lost four inches in my waist also on the keto diet thank you dr. Fung

    Reply
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