(⽂章第⼀部分的英文来自drperlmutter.com.)

( The First part of this article is taken from drperlmutter.com. )

近些年来，我们听到很多关于饮食如何影响⼼脏病发作⻛险，骨密度， 糖尿病和血糖控制等方面的理论，而最近则是其对⼤脑健康的影响。

Over the years we’ve heard so much information about how diet  affects things like heart attack risk, bone density, diabetes and blood  sugar control, as well as, more recently, the brain. 

我们在过去⼗年中发现，地中海饮食与降低患阿尔茨海默病的⻛险之间似乎存在着关联。但是，我们需要更确切地理解该饮⻝如何影响那些对于⼤脑健康有着预兆性的⽣物标志。这正是最近⼀项题为“地中海饮食、阿尔茨海默病生物标志物和老年脑萎缩”的研究目标。

We’ve known over the past decade that there does appear to be a  relationship between consuming the so-called Mediterranean diet and  lower risk for Alzheimer’s disease. But the question needs to be asked  in terms of actual biomarkers that threaten the brain as to how diet  relates to these harbingers of Alzheimer’s disease. And this was  recently the stated objective of a study entitled Mediterranean Diet,  Alzheimer Disease Biomarkers and Brain Atrophy in Old Age. 

这是⼀项引⼈思考的研究。研究⼈员评估了 512 名平均年龄为69.5岁的⽼年⼈。其中有169 名认知正常，其余有着较⾼的阿尔茨海默病风险，其中53名有患有阿尔茨海默病的亲属，209 名患有主观认知障碍（意思是他们认为自己的认知功能已经达不到正常标准），另有 81 ⼈患有轻度认知障碍，意思是他们的认知功能已被评估为与其年龄不相符。

This is a fascinating study. The researchers evaluated 512 somewhat  elderly individuals with an average age of 69.5 years. In this group  there were 169 cognitively normal participants as well as subjects who  were specifically at higher risk for Alzheimer’s disease including 53  with Alzheimer’s disease relatives, 209 with subjective cognitive  impairment (meaning they felt their cognitive function wasn’t up to  par), and another 81 with mild cognitive impairment, meaning that  their cognitive function was evaluated and proven not to be  appropriate for age. 

参与者的饮食通过食物频率问卷进行了评估，也就是对这些⼈摄⼊的各种食物的调查。这个问卷评估的结果帮助研究⼈员确定他们的饮食与地中 海饮食的类似程度。根据这些信息，计算出所谓的地中海饮食⼀致性分数。

The subjects were assessed by administering what is called a food  frequency questionnaire – basically an inquiry as to the various foods  that these individuals consumed. The results of this evaluation helped  the researchers determine how close their diets were to the so-called  Mediterranean diet. And from this information they calculated what  was called the Mediterranean diet adherence score. 

此外，每个参与者都接受了大脑的 MRI 扫描、广泛的神经心理学评估，并进行了脑脊液的检查（226 个⼈），来测定诸如淀粉样蛋白42/40和磷酸化tau蛋白的⽐率之类的数据。是的，这些都是技术术语，但它们与阿尔茨海默病的风险密切相关。 

In addition, each of the subjects underwent an MRI scan of the brain,  extensive neuropsychological evaluation, and examination of their  cerebral spinal fluid (in 226 individuals) to look at things like the ratio of amyloid beta 42/40 and phosphorylated tau protein. Yes, these are  technical terms, but they do correlate with Alzheimer’s disease risk. 

研究人员的发现⾮常有趣。与那些和地中海饮食差别较⼤的饮食相比，与地中海饮⻝的⼀致性程度越高，大脑内侧颞部（海马体部位，大脑的记忆中心）就有更多灰质、更好的记忆⼒、更少的淀粉样蛋⽩和更少的 tau 蛋白。 

What the researchers found was certainly quite interesting. Higher  adherence to the Mediterranean diet was associated with larger  amounts of gray matter in the medial temporal part of the brain (site of  the hippocampus, the brain’s memory center), better memory, less  amyloid, and less tau protein in comparison to those who were less  involved in the Mediterranean diet.  

更有趣的是，即使研究人员排除了与 APOE-E4 基因相关的因素，这些关系仍然存在。携带APOE-E4基因会增加患阿尔茨海默病的风险，这⼀点非常重要，因为⽆论个体是否携带这种遗传风险标记，地中海饮食似乎都可以降低阿尔茨海默病的风险。

Interestingly, these relationships persisted even when the researchers  corrected for the genetic status of the patient as it relates to the  APOE-E4 allele. The APOE-E4 allele is associated with increased risk  for Alzheimer’s. This is an important point because it means that the  Mediterranean diet seemed to be associated with less Alzheimer’s risk  regardless of whether or not the individuals carried this genetic risk  marker. 

该研究的重要结论是，就大脑健康而言，饮食的选择极其重要，特别是 在与阿尔茨海默病的可衡量⻛险标志物各方面，而且，饮食的影响超越了遗传基因所带来的⻛险。阿尔茨海默病⽬前是⼀种没有任何真正有效药物的疾病。

The important conclusion of the study is that dietary choices matter a  whole heck of a lot as it relates to the brain, and as it specifically  relates to measurable risk markers for the development of Alzheimer’s  disease, a disease for which there is no meaningful pharmaceutical  treatment. And further, the impact of diet transcends risk that may be  imparted by a genetic predisposition. 

⽬前尚不清楚地中海饮⻝的哪些成分对大脑有如此大的保护作用，有多种可能的因素，包括摄⼊各种五颜六色的蔬菜、减少糖分，以及食用健康脂肪。所有这些因素，当然也许还有其他的，都可能是这种饮食对健康有益的原因。

While it is not specifically clear what components of the Mediterranean  diet are so protective for the brain, there are multiple attributes to be  considered including the addition of various colorful vegetables,  reduced sugar, and the availability of healthful fat. All these factors,  and certainly others, may be contributing to the health benefits  associated with this dietary approach. 

但最重要的⼀点是，这是表明我们的饮食选择和我们大脑命运之间关系的很好科学验证。

But the overriding point is that this is really good science that  highlights the relationship between our dietary choices and the fate of  our brains.

究竟什么是地中海饮食？ “地中海饮食”⼀词通常是指与地中海接壤的国家共享的饮食方法。但这多少有点误导。与地中海接壤的国家有20多个，其中⼀些国家的饮⻝模式很不相同。1993年这种饮食被首次引入美国，当时“地中海饮食⾦字塔”是由哈佛大学和世界卫⽣组织的研究⼈员以及⼀个名为 Oldways 的⾮营利组织合作开发的。这种饮食基于50年代和60年代克⾥特岛、希腊和意⼤利南部的饮食模式之上。

What is exactly mediterranean diet? The term “mediterranean diet”  usually refers to the diet shared by countries bordering the  mediterranean sea. But this is a little misleading. There are more  than 20 countries bordering the Mediterranean Sea, and some of them  have actually quite different dietary patterns. This diet was first  introduced to US in 1993, when “The Mediterranean Diet Food  Pyramid” was developed by a collaboration of researchers from  Harvard and the World Health Organization along with a non-profit  organization called Oldways. The diet was modeled after the eating  patterns of Crete, Greece, and southern Italy in the 50s and 60s.  

它基本是⼀种主要以素食为基础的饮食，主要包括蔬菜、水果、全谷物、坚果、种子、豆类、和香料。橄榄油是膳食脂肪的主要来源。少量食用乳制品、海鲜和家禽。红肉吃得很少。 

Basically it is a diet that is mostly plant-based, mainly consisting of  vegetables, fruits, whole grains, nuts, seeds, legumes, beans, herbs  and spices. Olive oil is the main source of dietary fat. Dairy, seafood, and poultry are consumed in small amounts. Red meat is consumed  infrequently. 

地中海饮食自问世以来就获得了很多赞誉。但它也并不是没有争议。有些人认为这种饮食对健康的益处与他们的生活方式有很大关系，包括经常的运动和亲密的家庭关系；有些人认为他们经常晒太阳，因此良好的维生素D至关重要；也有些⼈认为他们饮食中的谷物和豆类实际上并不那么健康，但大量的蔬菜和橄榄油弥补了这⼀点。尽管存在着这些分歧，作为⼀种饮食模式它还是有相当多的地方值得我们借鉴。 

Mediterranean diet has received a lot of acclaim ever since it came  out. But it also had its share of controversy. Some people argue that  the health benefit of this diet has a lot to do with their life style  including physical activity and close family ties; some think the fact  that they get a lot of sun exposure, thus good vitamin D is critical;  some think the grains and beans in their diet actually go against their  health, but high levels of vegetable and olive oil make up for that.  Despite these disagreements, this dietary practice has a lot to offer.  

当然，我们⾄少可以肯定：

Of course at least we are sure about this: 

你今天放到嘴里的东西对你多年后的记忆能力密切相关。 

What you put in your mouth now affects how much you can remember  years down the road.