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糖让你发胖。我知道，这应该每个人都明白，但这篇文章说的不是这个。在过多糖份带来的诸多健康隐患里，我们今天关注⼀个可能是最让⼈担心的东西：
Sugar makes you fat. Ok, everybody knows that, but that’s the thing I am least concerned with in this article. Among the many negative health consequences it could wreak, let’s focus on one in particular, the most worrisome perhaps:
癌细胞靠糖生存。
cancer feeds on sugar.
著名的“ Warburg效应”是以德国⽣物学家Henrich Warburg的名字命名的，他因发现恶性肿瘤细胞利⽤厌氧⽽不是有氧代谢葡萄糖而获得了诺贝尔医学奖。简单点，意思是癌细胞需要糖份来为它供应能量。实际上，通常⽤于检测癌症的PET扫描就是基于这⼀理论之上。患者喝下高葡萄糖的饮料，然后机器去寻找那些消耗⼤量糖份的区域。这些区域很可能就是由癌细胞组成的。
The famous “Warburg Effect” is named after the German biologist Henrich Warburg who won the Nobel prize in medicine for discovering malignant tumor cells metabolize glucose anaerobically rather than aerobically, or, to put it in every day terms, cancer cells largely depend on glucose consumption for its energy. In fact, the PET scan commonly used to detect cancer utilizes this theory by giving the patient a high glucose drink and then look for areas that consume large quantity of sugar. Those areas are mostly likely made up of cancer cells.
我们都知道含糖食品会刺激胰岛素分泌。但不太多⼈知道的是，胰岛素的释放伴随着另⼀种被称为“胰岛素样生长因⼦”（IGF）的分子的释放。 IGF的主要作用是刺激细胞⽣⻓。可以理解，对于已经患有癌症的⼈来说，这绝对不是⼀个好消息。
We all know sugary foods spike your insulin level. What not many people know is that the release of insulin is accompanied by the release of another molecule called Insulinlike Growth Factor, IGF in short. The main role of IGF is to stimulate cell growth. Understandably, this is not good news for people who already have cancer.
更糟糕的是，过量的胰岛素和IGF都会促发体内的慢⾏炎症。在以前的⼀篇⽂章中，我们探讨过慢性炎症是⼏乎所有慢性疾病的根源。
To make it worse, excessive amount of insulin and IGF both promote inflammation in the body. We have talked about what chronic inflammation does in one of our previous articles. It is the root cause of almost all chronic diseases.
在⼀项研究中，44只小白鼠接种了乳腺癌细胞，然后被喂以含不同糖份的⻝物。两个半⽉后，接收高血糖指数饮⻝的24例中有16例死亡，而接收低血糖指数饮食的20例中只有1例死亡。
In one study, 44 mice were inoculated with breast cancer cells and were fed foods containing different amount of sugar. After two and half months,16 of the 24 that were given high glycemic index diet were dead, compared to 1 in 20 who were fed low glycemic index diet.
另⼀项美国和加拿⼤的联合研究的对象是⼀组50岁以下的女性，结果发现，IGF水平最⾼的⼥性患乳腺癌的几率是IGF水平最低⼥性的7倍。其他研究证实了男性前列腺癌和IGF有着同样的关联，但⻛险是9倍。
In another joint American-Canadian study of a group of women under fifty, those with the highest level of IGF were 7 times more likely to develop breast cancer than those with lowest. Other studies confirmed the same findings for prostate cancer in men, but the risk was 9 times greater.
2009年，“妇女健康倡议”研究对美国近十万名绝经后的妇女进⾏了研究，结果发现，⾼糖和⽩⾯粉饮食会增加体内胰岛素⽔平，并增加患乳腺癌的风险。
In 2009, Women’s Health Initiative study, which looked at almost one hundred thousand postmenopausal women in the United States, found a link between increased insulin level in the body from a diet high in sugar and white flour and a higher risk of breast cancer.
所有这些让我不禁怀疑，当前全世界爆炸式的癌症发病是否与糖份的大量摄⼊有关：尤其是精制糖和高果糖玉米糖浆。对于我们的祖先来说，糖是⼀种不经常的享受，并不是⽇常⻝物的⼀部分。直到1700年代中期，糖才被广泛食用。这之后，它在我们饮⻝中的地位稳步上升。现在，21世纪，普通⼈每年⻝⽤的糖量可以达到惊⼈的70公⽄，尤其是在发达国家，各种糖份甚至可以占到⼀个⼈热量摄⼊量的20％。
All this makes me wonder if the exploding cancer epidemic around the world has something to do with the skyrocketing consumption of sugar in the form of added refined sugar and high fructose corn syrup. Sugar was a treat, not a component of everyday food for our ancestors. It is not until the mid 1700s that sugar became widely available and widely consumed. The world then sees its dominance in our diet rising steadily. Now, in 21 century, an average person could consume a shocking 70 KG of sugar a year, especially in developed countries, and it could constitute as high as 20% of one’s caloric intake.
当我刚到美国时，最先引起我注意的⼀件事就是超市里色彩鲜艳，极其诱惑人的甜点区。对于在中国长大的我，没有“餐后甜点”这样⼀个概念。但是这种诱惑太强烈了，让我最终还是忍不住动用了我微薄的学生储蓄，尝尝我没有享受过的美味。我仍然记得我初次尝试时的震惊。那种巨大的甜味让我都没法吃完⼀块蛋糕。从那以后，美国的甜点再也不吸引我了。
When I first arrived in the US, one of the things that first caught my eyes was the bright-colored, extremely enticing dessert section in the grocery store. Growing up in China, I did not have such a concept as “dessert”, but the temptation was so strong, I eventually pulled money out of my meagre student savings to try these treats. I still remember the physical shock I had when I first tried it. The overwhelming sweetness made it difficult for me to finish even one piece of cake. I was never attracted to American desserts after that.
好吧，你也许会说，我就少吃点糖果，甜点和含糖饮料。但这样够不够呢？
Ok, you may say, I will try to minimize candies and desserts and sugary drinks. But is that enough?
我们可以参照的⼀个很好的指南是血糖指数。它是根据食品提升葡萄糖⽔平的快慢而分配给食品的⼀个值。纯葡萄糖的值为100。你在下面这个链接可以查到近400多种常见⻝品的GI值：
https://www.sohu.com/a/152439704_785691（中⽂）
A good guide to follow is glycemic index, which is a value assigned to foods based on how quickly and slowly it raises the glucose level. Pure glucose has a value of 100. Here is a link to check the GI value of almost 100 common foods:
https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods
可能让你惊讶的会是，白面包的GI值为75。你可能认为全⻨⾯包更健康。是的，从所含矿物质和维生素而⾔，但从提升血糖⽔平方面说，与白面包的差距不远：74. 玉米片的GI值⾮常高，为81。即⻝燕⻨粥：79。中国人最爱的⽶粥：78。煮⼟⾖：78。土豆泥：87。
What may jump out at you is that white flour bread has a value of 75. You may think whole wheat is much healthier. Yes, in terms of minerals and vitamins, but for its ability to raise your blood sugar, it’s not that far behind white bread: 74. Corn flakes have a very high GI value of 81. Instant oat porridge: 79. Rice porridge beloved by Chinese: 78. Boiled potato: 78. Mashed potato: 87.
比血糖指数更有⽤的另⼀个指数是血糖负荷。血糖指数的不足之处在于没有考虑份量，就是说⼀个⼈实际上会吃多少。例如，西瓜的血糖值很高：80。但是西瓜中没有很多碳水化合物，所以你要吃不止一点才会让血糖迅速上升。
Another index that may even be more useful than glycemic index is glycemic load. Glycemic is limited in certain ways because it does not take into consideration the serving size, meaning, how much a person actually eats for a serving. For example, watermelon has a pretty high GI value: 80. But watermelon does not have a lot of carbohydrates in it, so you have to eat a lot of watermelon to have your blood sugar rise that quickly.
计算血糖负荷的公式为：血糖负荷 = 血糖指数 *食物中碳水化合物的含量/ 100
The formula to calculate the glycemic load is:GL = GI * amount of carbohydrates in the food / 100
⽐如，一片全麦面包大约28克，包括⼤约12克的碳⽔化合物。它的血糖负荷值⼤约为9，所以并不是很糟糕。
For example, a slice of whole wheat bread is around 28 grams, including approximately 12 grams of carbs. That gives it a GL value around 9, which is not terribly bad.
所以，同时参考血糖负荷和血糖指数是个不错的主意，尤其是血糖负荷。以下链接可以查到100多种普通食品的GI和GL值：
https://max.book118.com/html/2018/1012/8077135103001126.shtm（中⽂）
So taking GL and GI both into consideration is probably a good idea, especially glycemic load. Here is the link to the GI and GL values of more than 100 common foods:
https://extension.oregonstate.edu/sites/default/fifiles/documents/1/glycemicindex.pdf
通常来说，GI低于55被认为是低血糖指数，而GL低于10被认为是低血糖负荷。我的神经科医⽣建议我的⼤部分饮食来自血糖指数小于35的食物，来保障大脑健康！我感觉这太难了！幸亏他说“大部分”，而没有说“全部”！
Generally speaking, a GI lower than 55 is considered low, and a GL lower than 10 is considered low. My neurologist actually recommends most of my diet come from foods with a GI less than 35, for brain health! I found it really hard to stick to, and I am really happy he said “most”, not“all”！
尽量减少糖份的摄⼊来维持健康的葡萄糖和胰岛素⽔平对⻓期健康⾄关重要。但是这说起来容易做起来难。这⾥分享⼀些我采⽤的策略，希望对你有所帮助：
Minimizing your sugar intake to maintain healthy level of glucose and insulin is important for long term health. But it is easier said than done. Here are some strategies I have utilized and hope you find them helpful:
• 90/10规则。尝试在90％的时间坚持健康饮⻝。剩下的10％：给自己⼀个放松的机会！
• 90/10 rule. Try to stick to your diet 90% of the time. The remaining 10%: give yourself a break!
• 份量很重要。就像我上⾯给出的全麦面包的例⼦⼀样。尽管它血糖指数很高，但只要你不⼀下子吃很多，它完全可以成为健康饮⻝的⼀部分。所以说可以吃，但要控制份量。
• Size matters. Just like the example I gave above about whole wheat bread. Although it has high glycemic index, as long as you don’t go overboard at one sitting, it could be a part of a healthy diet. So eat, but control the size.
• 不要单独吃富含碳⽔化合物的⻝物。和别的东⻄⼀起吃。
• Don’t eat a carb-rich food alone. Eat it with something else.
• 最后吃碳水化合物。吃东⻄的顺序对餐后血糖水平还是很重要的。先吃非碳水化合物食物，最后再吃富含碳水化合物的⻝物。
• Eat your carbs last. Food order matters for your post-meal blood sugar level. Try to eat non-carb foods first, and eat carb-rich food last.
• 最好不要喝果汁。吃完整的水果或者是将整个水果做成果昔。
• Stay away from fruit juice. Eat whole fruits or blend it into smoothie.
