This is a video about my own personal experience.

這部影片是關於我個人的經驗。

Now, in case you missed the Med School Insiders video, let's get the terminology straight right from the get-go.

如果你錯過了 Med School Insiders 的影片，讓我們從一開始就把術語搞清楚。

Usually, when people are talking about intermittent fasting, or IF, they're usually actually referring to time restricted feeding.

一般而言，當人們在討論間歇性斷食（又稱 IF）時，他們通常是指限制進食時間（TRF）。

Time restricted feeding is when you only allow yourself to eat during certain hours each and every day.

限制進食時間指的是當你每天都只允許自己在當天特定時間內進食。

I do also do intermittent fasting, which is a, for me, a 48-hour fast once every couple months, and we'll get to that shortly.

我也會進行間歇性斷食，對我來說就是每幾個月一次進行 48 小時的禁食，我們稍後就會討論到。

Now, I am speaking about my own experience.

我現在是以自身經驗來進行分享。

I am not saying whether you should or should not do either IF or TRF.

我並不是在說你是否應該執行 IF 或 TRF。

I am recommending that you speak with your physician first.

我是建議你應該先跟你的醫生諮詢。

Now, I'm all about health optimization.

我完全贊成健康優化。

Ever since I was hospitalized as an 18-year-old for an acute flare of IBD,

自從我 18 歲因為急性腸胃炎（IBD）住院後，

I mean, thankfully I haven't had any hospitalizations since,

我想說的是，我很幸運地從那之後沒有再住過院，

but I just realized how fragile and important health is.

但我當時才意識到健康是多麼脆弱和重要。

I prioritize it because when you don't have your health, nothing else really matters.

我將它視為優先，因為如果你失去了健康，其它一切都不重要了。

So, I've experimented with so many different diets.

我嘗試了很多種不同的飲食法。

I've tried specific carbohydrate diet, I've tried plant-based diet, I've tried gluten-free diet.

我嘗試過特定碳水化合物飲食、植物性飲食、無麩質飲食。

I even experimented with some keto.

我甚至還實驗了生酮飲食。

All for the sake of trying to minimize my symptoms and do what is best for my health, for my gut, just to live a healthy life.

那些都是為了將我的病狀最小化，並且做出對我健康和腸胃最好的事，好過上健康的人生。

Now, what I was doing up until that point was dietary restriction, limiting what I do and do not eat.

我截至那個時間點在做的事都是限制飲食，也就是限制自己吃和不吃哪些東西。

And that's what most people think about when they're thinking about dietary interventions.

而那就是多數人考量飲食干預時所思考的事。

But I hadn't really considered time restriction until 2017.

但我到 2017 年前都沒認真考慮過限制進食時間。

I mean, until that point, I really thought it was just just for people that needed to lose weight.

我是說，在那之前，我真的以為那只適用於需要減重的人。

And, if anything, at that time, I actually wanted to bulk up, you know, hit the gym and put on some mass.

而我在那個時期其實反而想增重，前往健身房然後增加肌肉量。

But, as you've seen on the Med School Insider channel, I started learning about some of the other health benefits of time restricted feeding.

但如同各位在 Med School Insider 頻道所看到的，我開始了解限制進食時間的其它健康益處。

And, more importantly, what actually got me over the... over the edge is realizing that it could help me with my IBD symptoms.

最重要的是，讓我決定放手一試的是，發現到它可以幫助我減緩 IBD 症狀。

Now, granted, over the last several years, I've experimented a lot to figure out what works and what doesn't, so my IBD is, admittedly, extremely well-managed.

當然了，在過去數年間，我做了很多實驗以找出什麼有效、什麼無效，所以我的 IBD 控制得非常好。

But, there are still, occasionally, days where I am symptomatic and I want to minimize those symptoms as much as possible.

但還是會有幾天我會出現症狀的日子，然後我想要盡力將這些症狀最小化。

Now, by restricting the amount of time I ate each day with time restricted feeding, I would have fewer abdominal symptoms and spend less time on the toilet.

透過利用限制進食時間控制我每天吃飯的時間，我的腸胃症狀會減少並花費更少時間跑廁所。

Who would've thought?

誰會想到呢？

Now, when I first decided to try it, I was rotating on orthopedic surgery.

當我初次決定嘗試它時，我正在骨外科輪值。

Even though I was in plastic surgery residency, you still, especially during the first year, you rotate on different services, just like you do in med school.

雖然我是整形外科實習住院醫師，你還是得在不同專業輪值，尤其是第一年，就像在醫學院一樣。

So, I skipped breakfast, and then, by the time I actually get to eat food, it's probably 2 or 3 p.m., because you have cases, often back-to-back.

所以說，我會不吃早餐，然後當我實際可以吃東西時，大概已經下午兩、三點了，因為病患通常接連不斷。

And then, even between cases, the time is so limited; you need to go check in the next patient, and if you do have time to eat, it's usually just a small snack.

即便是在病患間空檔期，時間也有限，因為你得去探望下一位病患，然後如果你有吃東西的時間，通常只能吃小點心。

So, I'm, like, snacking at 2 or 3 p.m., and then my feeding window closes at 7 or 8 p.m. because, I mean, it's kind of short, but I don't want to eat too late at night.

所以我會在下午兩、三點吃零食，然後我進食的時間會在晚上七、八點結束，那有點短，但我不想要太晚吃東西，

because, these days, I'm sleeping around 10 p.m., waking up at 3 a.m., so I don't want to eat too late.

因為那些日子裡，我通常都在晚上 10 點左右睡覺、凌晨 3 點起床，所以我不想太晚吃東西。

Trying to sleep with a full stomach is just not comfortable for me.

試圖在飽腹的狀態下入睡對我而言很不舒服。

Long story short, I tried this a few times.

長話短說，我嘗試過幾次。

I was losing way too much weight way too quickly because I couldn't fit enough calories in a few hours.

我的體重掉得太多、太快，因為我無法在短短幾小時內攝取足夠的熱量。

So, I just, kind of, gave up on it.

所以我有點放棄了它。

But in early 2019, I decided I'm gonna give it another shot.

但到了 2019 年初，我決定再試一次。

After all, I'm working for myself now, so I do have complete control over my time and when I do and do not eat.

畢竟我當時是自己開業，所以我可以完全掌控自己的時間以及何時可以吃東西。

I started with the standard 16/8 time restricted feeding protocol.

我從一般的 168 斷食規則開始。

Meaning that, for 16 hours, I would not eat, and then I would eat everything in 8 hours, and outside of that, it's only water, nothing else.

這表示我會禁食 16 個小時，然後所吃的一切東西都在 8 小時內發生，在那之外就只喝水。

And that came down to 12 to 8 p.m. every single day; pretty easy.

那最後就變成每天中午 12 點到晚上 8 點，蠻簡單的。

Adherence wasn't a problem; I actually kind of enjoyed it.

堅持不是問題，我其實還蠻享受它的。

I noticed a few things immediately.

我立即注意到幾件事。

First, I was spending less time worrying about food, eating food, prepping food, cleaning in the kitchen, whatever, and that was awesome.

首先，我花費更少時間擔心食物、進食、備料、清理廚房等等的，那很棒。

I do love food; don't get me wrong.

別誤會，我很愛食物。

I love, like, give me some good omakase, I'm in heaven.

我很愛——給我來場廚師發辦就能讓我上天堂。（譯註：omakase 是日式餐廳的一種飲食方式，由主廚全權代替客人挑選食材並製作料理）

But if I could have it my way, I would not eat for 5 days and, hopefully, not feel hunger.

但如果我能夠隨心所欲，我會接連 5 天不進食，希望不會感到飢餓。

And then, on the weekends, just enjoy, you know, a culinary experience with friends and family.

然後在週末時，跟朋友和家人徹底享受飲食饗宴。

So, eating is almost like a chore at times.

所以說，進食有時有點像是個例行公事。

You know, I want to do other things; maybe I want to work on Med School Insiders or build MEM or go cycle or hang out with friends.

我想要做其它事情，或許是參與 Med School Insider 頻道的工作、建制記憶體、騎單車或跟朋友相約。

But food takes a lot of time.

但食物需要大量時間。

Now, second, I experienced pretty immediate improvements in my IBD symptoms.

再者，我的 IBD 症狀幾乎有了立即的改善。

Again, pretty well-managed, but every now and then, maybe I'll eat some Thai food, a little bit spicy, and I pay the price the next day.

我重申，它控制得很好，但我偶爾可能會吃有點辣的泰式料理，隔天就會付出代價。

But with time restricted feeding, my digestive system wasn't working nonstop, right?

但限制進食時間後，我的消化系統就不會不斷運作了，對吧？

I was only eating for a shorter period each day, and therefore, the gastrocolic reflex wasn't always in action.

我每天吃東西的時間更短，因此胃結腸反射不會持續發生。

Third, sometimes it was challenging, but I found that it was rewarding to build the discipline of saying "no" to food and then being mindful of the experience of hunger.

第三，它有時具有挑戰性，但我發現能夠自律地向食物說「不」很有成就感，然後也意識到飢餓的體驗。

Think of it as, like, discipline training or mindfulness practice.

可以把它看作是紀律訓練或是正念練習。

The way I see it, discipline breeds discipline.

在我看來，紀律會養成紀律。

So, if I'm more disciplined in one domain, it can actually help me in other domains as well.

所以說，如果我在一個面向較有紀律，那可以在其它面向給我實際幫助。

And now, when I'm on a plane and they go around offering pretzels or peanuts or cookies or whatever, it's a lot easier for me to be like, "Nah, not interested."

現在，當我在飛機上，空服員提供蝴蝶餅乾、花生米、餅乾等等的，我要說出「不，我沒興趣」要簡單得多了。

Now, I've experimented and changed a few things since last year.

自從去年之後，我已經實驗並改變了幾件事。

One is that my circadian rhythm is very much shifted, so I wake up around 5 or 6 a.m. and I go to sleep around 10 or 11 p.m. on most days.

第一件事是，我的生理時鐘發生了很大的變化，所以我會在早上五、六點左右起床，多數日子會在晚上 10 點或 11 點左右入睡。

And for that reason, I actually shifted my feeding window to start at 11 a.m., and now, I generally try to stop eating by 6 p.m., sometimes even 5.

基於這個原因，我實際上把我的進食時間改訂在上午 11 點開始，並試著在下午 6 點、甚至是 5 點時停止進食。

So, rather than 16/8, I'm doing more of a 17/7 or an 18/6.

所以說，比起 168 斷食，不如說是 177 或是 186 斷食法。

Now, I've also changed what I eat.

我現在也改變了我吃的東西。

I'm normally doing just 2 meals per day and each of those meals is now a lot larger than they were in the past.

我一般一天之會吃兩餐，這兩餐的份量跟過去比起來都大得多。

So, my breakfast⏤haven't changed my breakfast in... in months, and I love it; it's awesome.

我的早餐——我早餐菜單已經好幾個月沒變了，我超愛它，它很美味。

So, I have Dave's Killer Bread.

我會吃 Dave 的招牌美味麵包。

So, 3 pieces of this toast and then avocado, smoked salmon, 3 individual sunny-side-up eggs, and a side salad, usually one of those pre-made kits, and then 2 cups of almond milk.

我會吃三片這種吐司，加上酪梨、燻鮭魚、三顆太陽蛋、沙拉配菜（通常是預製好的），然後兩杯杏仁奶。

In total, it's generally about 1,300 to 1,400 calories and maybe I'll have, like, a banana or some fruit as dessert afterwards as well.

它總共是約 1,300 到 1,400 大卡，然後我之後可能也會吃個香蕉或是一點水果當甜點。

Then, if I get hungry before dinner time, I will sometimes have a smoothie with plant-based protein powder, banana, frozen berries, etc.

然後如果我在晚餐前感到飢餓，我有時會喝個用植物基底蛋白粉、香蕉、冷凍莓果等等製成的果昔。

I generally try to avoid that, though; I'll usually just try to have dinner sooner.

不過我通常會試著避免它，反而試著早點吃晚餐。

And dinner is very varied, but these days, I'm essentially always just cooking for myself; I'm not really eating out.

晚餐的變化性很大，但這些日子，我基本上都是自己下廚，不太外食。

So, it's usually chicken, veggies, and quinoa in various combinations and preparations.

菜單通常是是雞肉、蔬菜和藜麥，搭配各種不同組合和製作方式。

Now, I've also experimented with intermittent fasting in the form of water-only fasts for a couple days once every few months.

我也實驗過每幾個月進行幾天的純水間歇性斷食法。

Now, I do want to get up to 72 hours, not only because it's a challenge, but because you reach some important physiologic benchmarks.

我想要提升到 72 小時，不僅僅因為那是個挑戰，也因為你會達成某種重要的生理標準。

So, for example, you deplete your glycogen, you inhibit mTOR, you activate AMPK.

舉例而言，你會耗盡糖原、抑制雷帕霉素靶蛋白，並激活單磷酸腺苷活化蛋白質激酶。

And then, because your glucose and insulin is at lower levels, you also increase autophagy and then inhibit senescent cells.

然後，因為你體內葡萄糖和胰島素處於較低水平，你也提升細胞自噬然後抑制衰老細胞。

Now, if you're going to do multi-day fasts, you definitely want supervision from a physician because you gotta worry about electrolytes, minerals, things like that.

如果你要進行多天的禁食，必定要獲得醫生的指導，因為你得考慮到電解質、礦物攝取，諸如此類的東西。

Anyway, that is my experience; hope you guys enjoyed it.

總之，這是我的經驗，希望各位喜歡。

Let me know if you've tried TRF or IF down in the comments below.

如果你嘗試過 TRF 或 IF，請在下方評論區告訴我。

Much love, and I will see you guys in that next one.

愛你們，我們下一部影片中見。