2017-11-20  Hilda_NYC   |  转藏

奥利弗·克尼克尔(中)与几名俄罗斯宇航员在位于莫斯科的一座隔离设施中。European Space Agency


The salt equation taught to doctors for more than 200 years is not hard to understand.


The body relies on this essential mineral for a variety of functions, including blood pressure and the transmission of nerve impulses. Sodium levels in the blood must be carefully maintained.


If you eat a lot of salt — sodium chloride — you will become thirsty and drink water, diluting your blood enough to maintain the proper concentration of sodium. Ultimately you will excrete much of the excess salt and water in urine.


The theory is intuitive and simple. And it may be completely wrong.

一项研究否定了有关身体如何处理盐分的许多传统认知,并表明高浓度的盐分或许对减肥有帮助。该研究最近通过在《临床调查杂志》(The Journal of Clinical Investigation)上的两篇复杂的论文得到发表。

The research, published recently in two dense papers in The Journal of Clinical Investigation, contradicts much of the conventional wisdom about how the body handles salt and suggests that high levels may play a role in weight loss.


The findings have stunned kidney specialists.

“实在太新奇、太惊人了,”哈佛医学院(Harvard Medical School)医学助理教授梅拉妮·霍尼格(Melanie Hoenig)说。“研究做得十分严谨。”

“This is just very novel and fascinating,” said Dr. Melanie Hoenig, an assistant professor of medicine at Harvard Medical School. “The work was meticulously done.”

匹兹堡大学(University of Pittsburgh)教授詹姆斯·R·约翰斯顿(James R. Johnston)在两篇文章的页边标出了每一个让他意想不到的发现。结果两篇论文都被他涂满了。

Dr. James R. Johnston, a professor at the University of Pittsburgh, marked each unexpected finding in the margins of the two papers. The studies were covered with scribbles by the time he was done.


“Really cool,” he said, although he added that the findings need to be replicated.

这些新发现是科学家延斯·蒂策(Jens Titze)几十年坚持不懈研究的结果,他现在是范德堡大学医学中心(Vanderbilt University Medical Center)和德国埃朗根临床研究跨学科中心(Interdisciplinary Center for Clinical Research in Erlangen)的肾脏专家。

The new studies are the culmination of a decadeslong quest by a determined scientist, Dr. Jens Titze, now a kidney specialist at Vanderbilt University Medical Center and the Interdisciplinary Center for Clinical Research in Erlangen, Germany.


In 1991, as a medical student in Berlin, he took a class on human physiology in extreme environments. The professor who taught the course worked with the European space program and presented data from a simulated 28-day mission in which a crew lived in a small capsule.


The main goal was to learn how the crew members would get along. But the scientists also had collected the astronauts’ urine and other physiological markers.


Titze noticed something puzzling in the crew members’ data: Their urine volumes went up and down in a seven-day cycle. That contradicted all he’d been taught in medical school: There should be no such temporal cycle.


In 1994, the Russian space program decided to do a 135-day simulation of life on the Mir space station. Titze arranged to go to Russia to study urine patterns among the crew members and how these were affected by salt in the diet.


A striking finding emerged: a 28-day rhythm in the amount of sodium the cosmonauts’ bodies retained that was not linked to the amount of urine they produced. And the sodium rhythms were much more pronounced than the urine patterns.


The sodium levels should have been rising and falling with the volume of urine. Although the study wasn’t perfect — the crew members’ sodium intake was not precisely calibrated — Titze was convinced something other than fluid intake was influencing sodium stores in the crew’s bodies.


The conclusion, he realized, “was heresy.”


In 2006, the Russian space program announced two more simulation studies, one lasting 105 days and the other 520 days. Titze saw a chance to figure out whether his anomalous findings were real.


In the shorter simulation, the cosmonauts ate a diet containing 12 grams of salt daily, followed by 9 grams daily, and then a low-salt diet of 6 grams daily, each for a 28-day period. In the longer mission, the cosmonauts also ate an additional cycle of 12 grams of salt daily.

跟我们大多数人一样,这些宇航员也喜欢吃咸的。33岁的德国人奥利弗·克尼克尔(Oliver Knickel)如今是斯图加特一名汽车工程师,当年参加了那个项目。据他回忆,即使是每天提供12克盐的食物对他来说也不够咸。

Like most of us, the cosmonauts liked their salt. Oliver Knickel, 33, a German citizen participating in the program who is now an automotive engineer in Stuttgart, recalled that even the food that supplied 12 grams a day was not salty enough for him.


When the salt level got down to 6 grams, he said, “It didn’t taste good.”


The real shocker came when Titze measured the amount of sodium excreted in the crew’s urine, the volume of their urine, and the amount of sodium in their blood.


The mysterious patterns in urine volume persisted, but everything seemed to proceed according to the textbooks. When the crew ate more salt, they excreted more salt; the amount of sodium in their blood remained constant, and their urine volume increased.


“But then we had a look at fluid intake, and were more than surprised,” he said.


Instead of drinking more, the crew were drinking less in the long run when getting more salt. So where was the excreted water coming from?


“There was only one way to explain this phenomenon,” Titze said. “The body most likely had generated or produced water when salt intake was high.”


To get further insight, Titze began a study of mice in the laboratory. Sure enough, the more salt he added to the animals’ diet, the less water they drank. And he saw why.


The animals were getting water — but not by drinking it. The increased levels of glucocorticoid hormones broke down fat and muscle in their own bodies. This freed up water for the body to use.


But that process requires energy, Titze also found, which is why the mice ate 25 percent more food on a high-salt diet. The hormones also may be a cause of the strange long-term fluctuations in urine volume.


Scientists knew that a starving body will burn its own fat and muscle for sustenance. But the realization that something similar happens on a salty diet has come as a revelation.

哈佛医学院肾病学家马克·泽德尔(Mark Zeidel)撰写了一篇社论,与蒂策的论文一起发表,其中指出人类的做法和骆驼是一样的。骆驼要穿越没水的沙漠,作为替代,它分解驼峰中的脂肪来获得水分。

People do what camels do, noted Dr. Mark Zeidel, a nephrologist at Harvard Medical School who wrote an editorial accompanying Titze’s studies. A camel traveling through the desert that has no water to drink gets water instead by breaking down the fat in its hump.


One of the many implications of this finding is that salt may be involved in weight loss. Generally, scientists have assumed that a high-salt diet encourages a greater intake of fluids, which increases weight.


But if balancing a higher salt intake requires the body to break down tissue, it may also increase energy expenditure.


Still, Titze said he would not advise eating a lot of salt to lose weight. If his results are correct, more salt will make you hungrier in the long run, so you would have to be sure you did not eat more food to make up for the extra calories burned.


And, Titze said, high glucocorticoid levels are linked to such conditions as osteoporosis, muscle loss, Type 2 diabetes and other metabolic problems.


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