【卫报】你想了解的关于抗癌饮食的全部丨第11期

While there is no magic diet that will cure or prevent cancer, intervention in a patient's diet will help them maintain an acceptable quality of life - as long as that intervention comes from a medically qualified professional with no vested interests. Which brings us to the case of Australian blogger Belle Gibson, who is facing legal action for "unconscionable conduct" after promoting a book in which she talked of curing herself of multiple cancers by eating the right things. The publisher, Penguin, paid more than A$264,000 (£160,000) for the book and Gibson also made more than A$420,000 from app sales before it emerged that she had never had cancer. Her claims to have donated over A$300,000 to charities also turned out to be false.

尽管世界上是没有任何一种神奇的食物能够预防或是治愈癌症，但是调节病人的饮食能够帮助他们维持一个可接受的生活状态——只要这种“调节”是来自专业而无既得利益的医师。这引出澳大利亚博主贝尔吉布森的例子，她正因“不正当指导”而面临法律诉讼。在其出版的书中，她谈到自己通过摄入正确的食物，治愈了存在于自身的多种癌症。出版商企鹅图书已为此书投入了二十六万四千澳元（折合十六万英镑），而吉布森还通过在应用上售书获利超过四十二万澳元，随后人们才发现她从未患过癌症。她先前自称向慈善机构捐出三十万澳元的事情同样被证明是假的。

• legal action：法律诉讼

• Unconscionable：a. 不合理的

In contrast, a recipe book for cancer patients experiencing weight loss from University College, Cork, and one for patients with swallowing difficulties from Breakthrough Cancer Research have been developed by dieticians and are available free of charge.

与此相反，一本来自爱尔兰科克大学关于癌症患者亲历减肥的食谱书籍，与另一本，关于突破癌症研究基金会中的吞咽困难的患者通过营养师的指导而好转的书籍，都是可以免费获取的。

• Recipe：n. 食谱；[临床] 处方；秘诀；烹饪法

• Dietician：n. 营养师

• 注：Breakthrough Cancer Research：爱尔兰突破癌症研究基金会，对爱尔兰关于癌症治疗与康复的研究进行资金资助。

What is an oncology dietician?

肿瘤学营养学家是做什么的？

Oncology dieticians provide expert, evidence-based advice to cancer patients to help maintain their strength, wellbeing and quality of life. They can, for example, develop plans using fluids or tube feeding to help maintain weight and muscle mass. They also address side effects of treatment that affect a patient's ability to eat. Qualifying as an oncology dietician involves a four-year undergraduate degree in human nutrition and dietetics, with a hospital placement. Alternatively, people with a related science degree can obtain a postgraduate qualification in dietetics, followed by at least three years of post-qualification hospital work.

肿瘤学营养学家能够给癌症患者提供专业且基于临床实证的建议，以帮助患者们保持他们的精力、安乐以及生活质量。例如，他们能制定流体和胃管喂食的计划来帮助维持患者的体重与肌力。他们也提出了治疗的副作用，即影响到病人的自主进食能力。要想获得肿瘤学营养专家的资格，需要通过为期四年的人类营养学专业的本科学习，而且还应是医院的在职医生；同时，拥有相关理学学士学位，可以获得成为营养学研究生的资格，攻读此学位期间，须完成至少三年的临床进修。

• Fluid：n. 流体；液体

• tube feeding：n. 胃管喂食

• side effect：n. 副作用

• Alternatively：ad. 二者择其一地，非此即彼地

Ruth Kilcawley and Fiona Roulston are oncology dieticians. Frustratingly, says Kilcawley, much of the misinformation about diet and cancer her patients receive comes from well-intentioned loved ones, while Roulston's patients often get information online. "If you enter 'nutrition and cancer' into Google, you get over 123m results. With so much conflicting information, it makes it so confusing and overwhelming for cancer patients at an already stressful time."

露丝克尔劳雷和菲奥娜鲁尔斯顿都是肿瘤学营养专家。克尔劳雷沮丧地说道，她的病人们从关心他们的好心人那里了解到了很多饮食与癌症之间错误的信息，而鲁尔斯顿的病人们则是经常在网上搜索。“如果你在谷歌的搜索栏中输入‘营养学与癌症’，你会得到超过一亿两千三百万条结果。如此大量的矛盾信息会让病人在已经杯弓蛇影、草木皆兵的时期变得更混乱、更头疼。”

What about a vegan diet?

素食餐怎么样？

There isn't currently any strong evidence that eating too much red meat causes cancer. Some studies have shown a weak possibility that red meat may be associated with colorectal cancer in men. But an association is not a cause. There is some evidence that vegan diets may aid weight loss in certain people though this may partly relate to vegans simply being more aware of what, and therefore how much, they eat . However, a healthy diet hinges on avoiding overindulgence and ensuring that we get enough nutrients to meet our essential needs. The few scientific studies on veganism and vegetarianism refer to a lack of data on vegan diets, but some vegan diets have been shown to result in calcium levels that are below minimum dietary regulations. In a small study of men with early-stage prostate cancer, a vegan diet resulted in vitamin D deficiency.

目前还没有关于食用过量的牛肉能够导致癌症的有力证据。一些研究发现，人类结肠直肠癌与食用红肉之间也许有微弱的关联，但“相关”并不是“因果”。期待您的翻译，将您的理解留言在文章下方，关注每日长难句解析。然而，一份健康的食谱关键在于避免过食，同时确保人体得到了足够的养分来满足我们的日常所需。少数关于素食主义和纯素食主义的科学研究指出，素食餐中某些指标无法测量，但一些对某些素食餐的研究得出了钙含量低于人体日常摄入最低标准的结论。在一个针对早期前列腺癌的男性患者的小型研究中发现，正是由于素食，导致的维生素D缺乏。

• associated with：与……有关系

• hinge on：取决于……

• overindulgence：n. 放纵；沉溺；任性

"Unnecessary diet restrictions of food groups are not recommended during cancer treatment," says Roulston. Kilcawley adds: "The negative consequences include accelerating muscle loss. This leads to reduced ability to tolerate treatment, inadequate micronutrient intake (particularly calcium, which may compound bone mineral density issues with some types of chemotherapy), lack of energy, low mood and fatigue."

“在癌症治疗当中，我们不赞成对食物组分进行不必要的限制。”鲁尔斯顿谈到。克尔劳雷随后补充：“其不良后果包括加速的肌肉损失。这会导致对治疗的耐受性降低，微量元素摄入缺乏（特别是钙，这会导致某些种类化疗后骨密度合成出现问题）也会导致精神不振、情绪低落以及疲劳。”

• Inadequate：a. 不充分的，不适当的

• Fatigue：n.疲劳

But surely we all know that sugar is carcinogenic

不过，我们确然知道糖是致癌物质

Eating too much fatty and sugary food is not good for anyone. But the idea that cancer has a sweet tooth and that a patient can "starve" their cancer by cutting all sugars and carbohydrates is a gross oversimplification for a complex disease that behaves differently from patient to patient. It simply isn't the case that cake feeds cancer while eggs feed healthy cells, and cutting carbs completely puts patients at increased risk of malnutrition. A study of more than 1,000 patients across three Irish hospitals found alarming levels of malnutrition amongst cancer patients.

摄入过多的脂肪和糖分对任何人都没有好处。有种观点认为癌细胞嗜甜，所以癌症患者可以切断糖和碳水化合物的供应来饿死癌细胞，要知道癌症是种很复杂的病，不同的患者有不同的情况，这种观点显得过于简单粗糙了。现实完全与“蛋糕养癌症，鸡蛋生健康”是两码事，而且完全切断碳水化合物的供应会进一步使患者面临营养失调的风险。在爱尔兰的三所医院中，一项对超过1000名患者的调查发现，癌症患者的营养失调情况已经处于警戒水平。

• Starve：vt. 使饿死；使挨饿

• a sweet tooth：吃甜食的嗜好

The case study of a 65-year-old woman who recovered from a brain tumour has been used to promote the idea that a low-carb, high-fat "ketogenic diet" is a cure for cancer. However, this patient had also received standard chemotherapy and radiotherapy. Disturbingly, a proponent of this diet, Dr Thomas Seyfried of Boston College, has said it "can replace chemotherapy and radiation for almost all cancers".

一名65岁脑癌女患者康复的个案研究已被用作鼓吹低糖高脂的饮食疗法的工具。然而，这位病人实际上也接受了化学疗法和放射疗法。令人不安地是，来自波士顿学院的托马斯塞弗里德博士也是此类代餐的拥趸，“无论什么癌，”他形容其为，“对几乎所有的癌症患者，此饮食疗法均可替代化学疗法和放射疗法。”

• Tumour：n. 肿瘤，肿块

• Chemotherapy: n. [临床] 化学疗法

• Radiotherapy: n. [特医] 放射疗法

• Disturbingly：ad. 令人不安地

• Proponent：n. n. 支持者；建议者

Nutrition is complex. Patients should seek advice on their individual needs from a qualified professional. No competent professional will ever tell a patient to forgo evidence-based medicine in favour of a diet. 

营养学是复杂的。患者应该就自己本身的情况去寻求专业医师的建议。只有没有医师资格证的人才会让患者放弃循证医学选择纯饮食疗法。

• Forgo：vt. 放弃；停止；对…断念

• evidence-based medicine: 循证医学

• 注：循证医学（EBM：Evidence-based medicine），意为"遵循证据的医学"，又称实证医学，港台地区也译为证据医学。其核心思想是医疗决策（即病人的处理，治疗指南和医疗政策的制定等）应在现有的最好的临床研究依据基础上作出，同时也重视结合个人的临床经验。

What about supplements and superfoods?

什么是营养品和超级食品？

Anything that alters how your body works is a drug, even if it's "natural". Supplements not recommended by a dietician can interact with other drugs, including anti-cancer therapies, and make them less effective. The Memorial Sloan Kettering Cancer Centre urges patients to stop taking any herbal supplements before starting treatment and lists some of the dangerous effects such "natural remedies" can have. The term "superfoods" is simply part of a marketing strategy, not based on science.

任何能改变你的身体机能的东西都属于药物，即使是“天然”的东西也不例外。不被膳食学家推荐的增补品可能会和其他药物（包括抗癌药物）相互作用，降低药物疗效。纪念斯隆-凯特琳癌症中心呼吁病人在治疗开始之前停止服用任何草本增补品，并列举出这种“自然疗法”可能带来的危险。所谓的“超级食品”只不过是一种市场营销手段，根本没有科学依据。

• 注：纪念斯隆-凯特琳癌症中心：世界上历史最悠久、规模最大的私立癌症中心，是美国最好的癌症中心之一

• marketing strategy：行销策略；市场战略

"There is huge manipulation of people's emotions going on when someone tries a fad diet, hoping against hope it will cure them, and then subsequently fails because it is restrictive, unpalatable, or the patient is simply too ill," says Kilcawley. "They risk blaming their own failure in keeping to the diet on any progression of disease, which is excessively cruel of those promoting diets without sufficient evidence that the diet if kept to would be effective. I see this a lot."

“当一些人在尝试一种流行的代餐时，另一些人们的心中就会有一种强烈的愿望想要试试，并且指望这些代餐能够治愈他们，后来因为种种原因——限制太多、太难吃或者是病人实在是病入膏肓了而导致愿望落空，”克尔劳雷说道，“他们将失败归咎于他们自己没有在病情发展的每一个阶段持之以恒地吃代餐，这对于过分地相信并依靠这种只有铺天盖地的宣传，却没有任何证据证明其是否有效的代餐患者实为残忍。这种例子我见多了。”

• Manipulation：n. 操纵；操作

• Unpalatable：a. 难吃；讨人厌的

 Further information: Cancer Research UK , Macmillan and the Irish Cancer Society are all reliable sources for advice and support.

补充信息：英国癌症研究中心,麦克米伦出版社和爱尔兰癌症协会都是提供可靠的癌症建议和支持的信息来源。

注：此处的“Macmillan”应指的是“Macmillan Cancer Support”

注：关于food groups食物分组一共分为五类：

1.奶制品。奶制品是钙的绝佳来源，钙元素能够强壮骨骼、促进生长。没有别的日常食品能够像奶制品这样含有如此丰富的钙元素了。

2.水果。水果富含维他命、矿物质、纤维素以及多种植物营养素（它是植物中的营养代表），它能够让你的身体保持健康。

3.粮食（谷物）。我们应该选择全麦（或者纤维素高的）面包、粗粮、面条等。细粮产品（比如蛋糕和饼干）含有大量的糖、脂肪和钠元素。

4.肉制品以及家禽、鱼类、蛋类、豆腐、坚果以及种子。我们的身体利用我们每天食用的蛋白质来合成一些特殊的化学元素，比如血红蛋白和肾上腺素。蛋白质能够组成、维持、修复我们的机体，肌肉和各种组织（例如我们的心脏）就是蛋白质构成的。

5.蔬菜以及豆科植物。我们日常生活中的每一餐都应该多吃蔬菜，蔬菜和水果一样，富含维他命、矿物质、纤维素以及多种植物营养素，多吃蔬菜瓜果能让我们的身体保持健康，更加强壮，而且能让人变得更加营养均衡、纤细苗条，再也不用担心肥胖的问题啦。

翻译丨妖精、寻水鱼

审核丨sunny

编辑丨火柴