Michael Greger 醫(yī)生是暢銷(xiāo)書(shū)《How Not to Die》一書(shū)作者,，中文譯本：繁體版書(shū)名為《食療圣經(jīng)》,。簡(jiǎn)體版書(shū)名為《救命》，將于今年5月出版,。

編譯者前言：Michael Greger 醫(yī)生制作了三個(gè)糖尿病系列基礎(chǔ)視頻,，第一個(gè)視頻由于更新為動(dòng)畫(huà)演示版，所以發(fā)布日期比第二個(gè)視頻還要晚,。沒(méi)有看過(guò)第一個(gè)視頻的請(qǐng)補(bǔ)看一下,。

糖尿病系列視頻之一：動(dòng)畫(huà)演示”胰島素抵抗”是如何發(fā)生的。

溢出效應(yīng)將肥胖癥與糖尿病聯(lián)系起來(lái)

The Spillover Effect Links Obesity to Diabetes

摘要：肥胖可能會(huì)導(dǎo)致與吃高脂飲食一樣多的胰島素抵抗,。

游離脂肪酸,，意味著血液中循環(huán)的游離脂肪不會(huì)被包裝成甘油三酯，會(huì)導(dǎo)致炎癥,，有毒的脂肪分解產(chǎn)物和氧化應(yīng)激,，這些脂肪酸會(huì)堵塞胰島素受體通道并導(dǎo)致肌肉中的胰島素抵抗。

Free fatty acids, meaning free fat circulating in the bloodstream not packaged into triglycerides, result in inflammation, toxic fat breakdown products, and oxidative stress, which can gum up the insulin receptor pathways and lead to insulin resistance in our muscles. 

而胰島素抵抗是導(dǎo)致糖尿病前期和2型糖尿病的原因,。

And insulin resistance is what causes prediabetes and type 2 diabetes.

隨著血液中脂肪水平的增高,，人體從血液中清除糖分的能力也隨之降低。 

As the level of fat in the blood rises, the body’s ability to clear sugar from the blood drops. 

血液中的這種破壞性極大的脂肪來(lái)自哪里呢,？ 它來(lái)自我們所吃的脂肪,，以及身體里的脂肪。

Where does this fat in our blood that’s wreaking all this havoc come from? It comes from the fat that we eat, and from the fat that we wear.

我們所擁有的脂肪細(xì)胞數(shù)量在成年期保持不變,。 

The number of fat cells we have stays constant in adulthood. 

這真有趣,；弄清楚這個(gè)的方法是通過(guò)測(cè)量所有核彈試驗(yàn)被捕獲在DNA中的放射性碳的數(shù)量。 

It’s interesting; the way they figured that out is by measuring the amount of radioactive carbon trapped in our DNA from all the nuclear bomb tests.

無(wú)論如何,，大量減肥后,，脂肪細(xì)胞在減脂時(shí)會(huì)縮小，但數(shù)量保持不變,。

Anyway, after massive weight loss, our fat cells shrink as they offload fat, but the number stays the same. 

反過(guò)來(lái),，當(dāng)體重增加時(shí),，當(dāng)我們把越來(lái)越多的脂肪放進(jìn)每個(gè)脂肪細(xì)胞中，脂肪細(xì)胞就會(huì)變大,。 

Conversely, when we gain weight, our fat cells just stretch as we pack more and more fat into each individual fat cell. 

所以當(dāng)我們的腹部，臀部或大腿變大時(shí),，脂肪細(xì)胞不會(huì)增加,；只是在每個(gè)細(xì)胞中增加了更多的脂肪。

So when our belly, butt, or thighs get big, we’re not adding more fat cells; we’re just cramming more fat into each cell. 

到某個(gè)時(shí)候,，脂肪細(xì)胞變得過(guò)于臃腫,，以至于其中的脂肪溢出回到血液中。

At a certain point, our cells become so bloated that they spill fat back into the bloodstream.

這是所謂的溢出效應(yīng)的例證,。

This is an illustration of the so-called spillover effect. 

肥胖的人不僅身體上會(huì)有更多的脂肪,，而且還會(huì)不斷地將脂肪灑入血液中。 

Not only does an obese person have more fat on their body, but they’re constantly spilling that fat into their bloodstream.

這可能是肥胖和糖尿病之間的聯(lián)系,。

So that could be the link between obesity and diabetes. 

脂肪會(huì)從脂肪細(xì)胞中溢出,，并滯留在肌肉細(xì)胞中，導(dǎo)致胰島素抵抗,，進(jìn)而促進(jìn)2型糖尿病發(fā)作,。

Fat is spilling out from our fat cells and gets lodged in our muscle cells, leading to the insulin resistance that promotes the onset of type 2 diabetes.

或者脂肪可以通過(guò)所吃的食物進(jìn)入血液。

Or the fat can enter our bloodstream through our mouth. 

低碳（高脂）飲食中的脂肪會(huì)在兩小時(shí)內(nèi)累積在肌肉中,，與低脂飲食相比,，胰島素敏感性下降。

If you put people on a low-carb diet, fat builds up in their muscles within two hours, compared to a low-fat diet, and insulin sensitivity drops. 

而肌肉中的脂肪越多,，從血液中清除糖的能力就越低,。 

And the more fat in the muscle, the lower the ability to clear sugar from the blood. 

這并不需要幾年的時(shí)間，在吃下高脂肪食物后數(shù)小時(shí),，身體就有使用胰島素的問(wèn)題,。 

It doesn’t take years for this to happen; just hours after fatty foods go into our mouths, our bodies have problems using insulin. 

高脂飲食可以增加血液中的脂肪，而這種增加伴隨著胰島素敏感性的降低,。

A fat-rich diet can increase fat in the blood, and this increase is accompanied by a decrease in insulin sensitivity.

研究清楚地表明,，血液中的脂肪直接抑制了葡萄糖在肌肉中的轉(zhuǎn)運(yùn)和使用，這是血液中85％的葡萄糖清除的原因,。 

Studies clearly demonstrate that fat in the blood directly inhibits glucose transport and usage in our muscles, which is responsible for clearing about 85% of the glucose out of blood. 

這些發(fā)現(xiàn)還表明營(yíng)養(yǎng)的重要作用,，特別是增加脂肪攝取，對(duì)胰島素抵抗的形成所起的重要作用,。

These findings also indicate an important role of nutrition, particularly increased consumption of fat, for the development of insulin resistance.

通常情況下,，血液中任何時(shí)候都只有10到50微摩爾的游離脂肪，但是那些肥胖的人不斷將脂肪潑灑到血液中,。 

Normally we have only 10 to 50 micromoles of free fat floating around in our bloodstream at any one time, but those who are obese are constantly spilling fat out into their bloodstream. 

然而吃下一餐高脂飲食也可以達(dá)到同樣的水平,。

But we can reach those same levels in our blood eating a high-fat diet. 

因此,，一個(gè)吃低碳（高脂）飲食的瘦人，其血液中的脂肪水平可能與肥胖者相同,。 

So a skinny person eating a low carb diet can have the same level of fat in their blood as obese people do. 

同樣,，肥胖就像整天都在吃一些可怕的培根和黃油，肥胖者都會(huì)不斷地將脂肪潑灑到血液中,，不論他們吃的是什么,。

Similarly, being obese is like eating some horrible bacon-and-butter diet all day, because obese persons are constantly spilling fat into their bloodstream no matter what goes in their mouth.