ABOUT THE SPEAKER
Peter Attia - Surgeon
Both a surgeon and a self-experimenter, Peter Attia hopes to ease the diabetes epidemic by challenging what we think we know and improving the scientific rigor in nutrition and obesity research.

Why you should listen

Peter Attia has dedicated his medical career to investigating the relationship between nutrition, obesity and diabetes. A surgeon who developed metabolic syndrome himself despite the fact that he ate well and exercised often, Attia realized that our understanding of these important health issues may not actually be correct. From 2012-2015, he devoted himself to using vigorous scientific inquiry to test both our assumptions and new hypotheses through the Nutrition Science Initiative, the nonprofit he co-founded with journalist Gary Taubes. Now in private practice, Attia writes the blog Eating Academy, which charts his own adventures in nutrition and examines scientific evidence surrounding food, weight loss and disease risk. Overall, he hopes to convince others that sharp increases in the rates of obesity and diabetes -- despite the fact that we are more culturally aware of these problems than ever -- might be a result of people being given the wrong information.

Attia came to this calling through an unusual path. While he was studying mechanical engineering as an undergrad, a personal experience led him to discover his passion for medicine. He enrolled at Stanford Medical School, and went on to a residency in general surgery at Johns Hopkins Hospital and a post-doctoral fellowship at the National Cancer Institute. After his residency, he joined the consulting firm McKinsey & Company, where he worked on healthcare and financial system problems. The most valuable skill he learned along the way: to ask bold questions about medical assumptions. 

More profile about the speaker
Peter Attia | Speaker | TED.com
TEDMED 2013

Peter Attia: Is the obesity crisis hiding a bigger problem?

Peter Attia: Ka waran hadaynu ku khaldanay cudurka macaanka?

Filmed:
4,258,278 views

Dhakhtar dhalinyar isagoo ah Peter Attia wuxuu yaraysanayaa arinka buke macaan qaba oo aad u cayilan, isagoo isku qancinaaya inuu isagu isugu wacnaa in qaliin cad-gooye ah lagu sameeyo. Lakiin sanado kadib ayuu garawysanayaa oo ay ka soo hor baxaysaa xaqiiqo cilmiya isagoo is weydiinaya: Fikirkaynu macaanka ka haysanaa ma saxanyahay? Suurtagal ma tahay in macaanku cayilnaanta sababo ee aanay cakiskeeda ahayn? Wuxuu diirada saarayaa sida mabaa"diideenu inuu hogaamin karto dagaal caafimaad oo seeflaboodnimo ah.
- Surgeon
Both a surgeon and a self-experimenter, Peter Attia hopes to ease the diabetes epidemic by challenging what we think we know and improving the scientific rigor in nutrition and obesity research. Full bio

Double-click the English transcript below to play the video.

00:12
I'll never forget that day
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Abidkay ma ilaabayo maalintaas
00:13
back in the spring of 2006.
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Waxay ahayd gugii 2006
00:17
I was a surgical resident
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Waxaan dhakhtar qaliin joogta ah
00:19
at The Johns Hopkins Hospital,
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Ka ahaa Cusbitaalka John Hopkins,
00:21
taking emergency call.
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Waxan helay fariin degdeg ah
00:23
I got paged by the E.R. around 2 in the morning
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Waxan fariintaka ka hellay E.R-ka ''Qolka degdega'' 2dii saqda dhexe.
00:26
to come and see a woman with a diabetic ulcer
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Si aan u imado una arko haweeynay boog macaan
00:28
on her foot.
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ku leh cagta
00:30
I can still remember sort of that smell of rotting flesh
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Weli wan xususan karaa siduu ahaa urtii cadkaa qudhmay
00:34
as I pulled the curtain back to see her.
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markii aan ka qaaday go'a si aan u arko.
00:38
And everybody there agreed this woman was very sick
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Qofkastoo meesha joogay waa arkayay in qoftani ad u xanunsanayso
00:40
and she needed to be in the hospital.
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weyna u baahnayd inay cusbitaalka ku jirto.
00:41
That wasn't being asked.
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Taas lasyma weydiin.
00:43
The question that was being asked of me was a different one,
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Suaasha lay warsaday waxay ahayd mid taas ka duwan,
00:45
which was, did she also need an amputation?
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Taaso ahayd, Ma u baahantahay in lugta laga jaro?
00:49
Now, looking back on that night,
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Hada, markaan dib u eego habenkaas
00:52
I'd love so desperately to believe that I treated that woman
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Waxan aad u jeclaan lahaa inaan aamino inaan kula dhaqmay haweeynadaa
00:57
on that night with the same empathy and compassion
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habeenkas naxariistii iyo dareenkii
01:00
I'd shown the 27-year-old newlywed
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aan tusay 27-jir dhowaan guursatay
01:04
who came to the E.R. three nights earlier
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taasoo timi ER-ka sadex habeenk a hor
01:06
with lower back pain
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iyadoo xumadi ka hayso qaarka danbe
01:08
that turned out to be advanced pancreatic cancer.
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taaso markii danbe cadatay inay tahay Kaankaro baahday.
01:12
In her case, I knew there was nothing I could do
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Gabadhaa arinkeeda, waan ogaa inaanan qaban karin
01:14
that was actually going to save her life.
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wax xaqiiqadii badbaadin kara nolosheeda
01:16
The cancer was too advanced.
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Kaankaradu waxay ahayd mid aad u baahday
01:18
But I was committed to making sure that
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Laakiin waxa iga go'nayd inaan xaqiijiyo
01:21
I could do anything possible to make her stay
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inaan samayn karo wuxuun suurta gal ka dhigi kara inay
01:23
more comfortable. I brought her a warm blanket
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Nefis hesho. Waxaan u keenay buste diiran
01:26
and a cup of a coffee.
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iyo koob buna
01:28
I brought some for her parents.
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Waxan u keenay oo kale qaar qoyskeeda ah
01:31
But more importantly, see, I passed no judgment on her,
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Laakiin ta muhiimka ah bal fiiri hada, wax go'aana kuma ridin gabadhaasa
01:34
because obviously she had done nothing
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sababtoo ah waxba may galabsan
01:36
to bring this on herself.
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ay isugu keento iyadu arintan.
01:38
So why was it that, just a few nights later,
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Hadaba wuxu xal sida yahayba, habeno yar kadib
01:41
as I stood in that same E.R. and determined
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anoo taagan isla qolkaa E.R-ka gawrasadayna
01:44
that my diabetic patient did indeed need an amputation,
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in bukaankayga macaanka qaba uu u bahanyahay in lugta laga jaro
01:47
why did I hold her in such bitter contempt?
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Maxaan ugu hayaa arinka adag dhexidiisa gabadha?
01:51
You see, unlike the woman the night before,
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Waxaad arkaysaa, si ka duwan gabadhii habeenkii hore
01:54
this woman had type 2 diabetes.
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gabadhaan waxay leheed macaanka nooca 2aad
01:56
She was fat.
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Wayna buurneyd
01:58
And we all know that's from eating too much
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Waxaynu dhamaanten ognahay inay tani ka timi cunto layska cuno
01:59
and not exercising enough, right?
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iyo iyadoon jimicsi dheera la samayn, hagaag?
02:02
I mean, how hard can it be?
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Waxan uga jeeda, siday u adagtahay suurtagalnimadaasi
02:04
As I looked down at her in the bed, I thought to myself,
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Markii aan hoos u eego iyadoo sariirta saran, anaa isla hadlay
02:07
if you just tried caring even a little bit,
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Hadii inuun aad isku dayi lahayd inaad inuun taxadartid
02:10
you wouldn't be in this situation at this moment
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kumaad sugnaateen xaaladatan waqtigan isaga ah
02:13
with some doctor you've never met
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adigoo la jooga dhakhtar aanad weligaa hore u arag
02:14
about to amputate your foot.
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kasoo ka shekaynaya inuu lugtada goosto
02:18
Why did I feel justified in judging her?
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Maxan isugula haboonahay inaan go'an ku rido gabadhan?
02:22
I'd like to say I don't know.
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Waxan jecelahay inaan dhaho ma garanayo
02:25
But I actually do.
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Laakiin xaqiiqdii waan garanayaa
02:27
You see, in the hubris of my youth,
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Waad arki kartaa dhalinyaranimada i qaaday
02:29
I thought I had her all figured out.
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Dhibteeda waxa kenay ban iska xisaabsaday
02:32
She ate too much. She got unlucky.
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Cuntaday iska badisay. Nasiib daraa ku dhacday
02:34
She got diabetes. Case closed.
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Macaanbay qaaday. Khalaas.
02:37
Ironically, at that time in my life,
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Si dadban, waqtigas noloshayda kamidka ah
02:39
I was also doing cancer research,
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Waxaan waday baadhitaan-cilmiyeed cudurka kansarka
02:41
immune-based therapies for melanoma, to be specific,
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Daawanyn difaac ku salaysan oo loo hello melanomaha, khaas ahaan'
02:43
and in that world I was actually taught to question everything,
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Hadaba caalamkaas an ku jiray wax kasta su'aal ban saari jiray
02:47
to challenge all assumptions
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si aan ula halgamo dhamaan xaqiiqoyinka
02:49
and hold them to the highest possible scientific standards.
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uguna beego miisaanka cilmiyeed ee ugu sareeya uguna macquulsan
02:53
Yet when it came to a disease like diabetes
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Laakin markay timado cudurka macaanka oo kale ah
02:57
that kills Americans eight times more frequently than melanoma,
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Kaaso dila dadka maraykanka sideed jeer in kabadan melanoma-aha
03:00
I never once questioned the conventional wisdom.
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Weligay ismaan weydiin arintaa laysla wada garanayo
03:04
I actually just assmed the pathologic sequence of events
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Waxan isaga malaynayay uun in dhacdooyinka cudurada la xidhiidha
03:07
was settled science.
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ay ahaayeen cilmi hore u degsanaa
03:09
Three years later, I found out how wrong I was.
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Saddex sano ka dib, ayaan ogaaday sidaan u khaldanaa
03:13
But this time, I was the patient.
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Laakiin waqtigaan, anigaa bukaan ahaa.
03:15
Despite exercising three or four hours every single day,
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Ka sokow anoo saddex ilaa afar saacadood maalin kasta jimicsada
03:19
and following the food pyramid to the letter,
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raacana qorshaha cunto ee ugu suuban
03:22
I'd gained a lot of weight and developed something
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Waxaa kordhay miisankayga, waxana igu dhacay wax
03:24
called metabolic syndrome.
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loogu yeedho" Metobolic syndorome"
03:26
Some of you may have heard of this.
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Qaarkiin inaad maqasheen ba laga yaabaa.
03:28
I had become insulin-resistant.
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Dheecanka isulin-ta ayaan difaac u yeeshay
03:31
You can think of insulin as this master hormone
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Waad filan kartaa in insulin-tu tahay dheecan muhiima
03:34
that controls what our body does with the foods we eat,
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kaasoo maamula sida jidhkeenu u go'aamiyo cuntada aynu cuno.
03:38
whether we burn it or store it.
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hadii aan gubno iyo hadii aan keedinaba
03:40
This is called fuel partitioning in the lingo.
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Tan afka suuqa waxa loogu yeedhaa habaynta shidaalka
03:43
Now failure to produce enough insulin is incompatible with life.
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Habada awood u waayida inaad so sartid insulin waafiya waa nolol seegis
03:46
And insulin resistance, as its name suggests,
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Insulin difaac u yeelashaduna. sida magaceeda ka muuqata
03:49
is when your cells get increasingly resistant
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waa marka unugyadu difaac u yeeshaan
03:51
to the effect of insulin trying to do its job.
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saamaynta insulinta shaqadeeda wadata
03:55
Once you're insulin-resistant,
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markaad insulinta difaac u yeelatid
03:57
you're on your way to getting diabetes,
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Wadadaadi macaanku kugu dhici lahaa bad haysaa
03:58
which is what happens when your pancreas
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Taaso ah waxa dhaca marka ganaacaagu
04:00
can't keep up with the resistance and make enough insulin.
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uu iska hayn kari waayo iska cabinta samayna kari wayo insulin waafiya
04:04
Now your blood sugar levels start to rise,
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Markaa sonkorta dhiigaaga ayaa kacda
04:06
and an entire cascade of pathologic events
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Dhacdooyoin xidhiidha oo xanuuno ah
04:09
sort of spirals out of control that can lead to heart disease,
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ayaa sidii tusbaxii furma kasoo keensada wadna xanuun
04:13
cancer, even Alzheimer's disease,
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kansar, ilaa cudurka Alzheimer
04:16
and amputations, just like that woman a few years earlier.
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iyo weliba jidh goyn, sida arinka gabadha sanado yar ka hor
04:21
With that scare, I got busy changing my diet radically,
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Anoo cabsidaas qaba, waxaan ku mashqulay si aan u bedelka cuntadayda
04:24
adding and subtracting things most of you would find
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anoo ku daraya kana goynaya waxad badankiis u arki kartaan
04:26
almost assuredly shocking.
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wax xaqiiqadii layaableh,
04:29
I did this and lost 40 pounds, weirdly while exercising less.
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Taasan samaayey waxana lumiyay 40 pound anoon aadna u jimicsan
04:33
I, as you can see, I guess I'm not overweight anymore.
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Hadaba sidaa arki kartaanba hada waxan filayaa inan culays xad dhaafa lahayn
04:36
More importantly, I don't have insulin resistance.
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Ta muhiimka ah, difaac uma lihi hada insulint-ta
04:39
But most important, I was left
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Laakiin ta kasii muhiimsan, waxaa isoo baxday
04:41
with these three burning questions that wouldn't go away:
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sadexdan su'aalood ee dab ka kulul ee aan i seegayn
04:44
How did this happen to me if I was supposedly
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Siday taasi iigu dhacday hadii aan sii loogu talla gally
04:47
doing everything right?
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wax kasta u samaynaayay?
04:50
If the conventional wisdom about nutrition had failed me,
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Hadii arinkii laysla wafaqsanaa ee nafaqadu uu socon waayay
04:53
was it possible it was failing someone else?
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suurta gal ma tahay inay qof kalena ka socon weyday?
04:56
And underlying these questions,
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Markaan hoosta ka xariiqay su'aalahaas
04:58
I became almost maniacally obsessed
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Waxaan si waaliya ugu hamuumay
05:02
in trying to understand the real relationship
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inaan isku dayo fahanka xidhiidhka runta ah ee
05:04
between obesity and insulin resistance.
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ka dhexeeya cayilnaanta iyo difaac u yeelashada insulin
05:08
Now, most researchers believe obesity
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Hada, culimada badankeedu waxay aminsanyihin in cayilaantu
05:11
is the cause of insulin resistance.
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ay tahay waxa keena difaac u yeelashada insulin
05:14
Logically, then, if you want to treat insulin resistance,
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Caqli ahaana, hadaad rabtid inaad dawaysid difaac u yeelashada insulin
05:16
you get people to lose weight, right?
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waa in dadku miisaan lumiyaa, miyaanay ahayn?
05:18
You treat the obesity.
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Waxaad dawaysay cayilnaantii
05:21
But what if we have it backwards?
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Laakiin ka waran hadaynu dhanka kale ka eegno?
05:24
What if obesity isn't the cause of insulin resistance at all?
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Ka waran hadaynay cayilnaantu ahayn sababta difaac u yeelashada insulin?
05:27
In fact, what if it's a symptom of a much deeper problem,
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Ka waran hadii ay calamad u tahay dhibato sii qoto dheer
05:31
the tip of a proverbial iceberg?
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Figta buur barafa oo la garanayo?
05:34
I know it sounds crazy because we're obviously in the midst
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Waan garanayaa inay doqonimo tahay waayo xaqiiqadii badhtankaynu kaga jirnaa
05:36
of an obesity epidemic, but hear me out.
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cayilnaan baahday, laakiin dhegta ii raarici
05:40
What if obesity is a coping mechanism
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Ka waran hadii cayilnaantu tahay qaab la dagalamaya
05:43
for a far more sinister problem going on
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dhibaato kaloo qarsoon oo ka socota
05:46
underneath the cell?
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unuga dhexdiisa si hoose?
05:48
I'm not suggesting that obesity is benign,
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Ma soo jeedinayo in cayilaantu tahay mid aan dhibaato lahayn
05:50
but what I am suggesting is it may be the lesser
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laakin waxaan sheegayaa ma laga yaabaya inay tahay
05:53
of two metabolic evils.
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laba daran ta door roon
05:55
You can think of insulin resistance as the reduced capacity
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Waxaad u malayn kartaa in difaac u yeelashada insulin ay tahay xadi ka dhinmay
05:58
of ourselves to partition fuel,
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nafaheena oo aynu ku meelayn lahayn shidaal
06:00
as I alluded to a moment ago,
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sidaan hore usoo carabaabay
06:03
taking those calories that we take in
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qaadashada kaloriskaa cuntada ah
06:04
and burning some appropriately and storing some appropriately.
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iyo gubida qaarkood si habsami ah iyadoo qaarna kadyinaysa
06:08
When we become insulin-resistant,
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Markaynu difaac u yeelano insulin-ta
06:10
the homeostasis in that balance deviates from this state.
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habkii isu dheelitiranka ayaa xaladiisii ka weecda
06:13
So now, when insulin says to a cell,
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Hadaba markan, marka insulin ku tiraahdo unuga
06:15
I want you to burn more energy
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Waxan rabaa inaad tamar gubtid
06:17
than the cell considers safe, the cell, in effect, says,
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habada markan uu unugu jawaab celin ku dhaho
06:20
"No thanks, I'd actually rather store this energy."
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''Maya mahadsandid, marabo inaan tamar gubo, waan keydinayaa''
06:24
And because fat cells are actually missing most of
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sababtoo ah unugyada duxda ayaa ka maqan
06:26
the complex cellular machinery found in other cells,
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isku dhiska farsamo unugeed ee unugyada kalle leeyihiin
06:29
it's probably the safest place to store it.
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Suurta gal, inay tahay meesha ugu amnisan ee lagu keydin karo
06:31
So for many of us, about 75 million Americans,
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Hadaba badankeena, 75 million oo maraykani
06:36
the appropriate response to insulin resistance
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jawaabta saxda ah ee ay u hayaan difaac u yeelashada insulin
06:40
may actually be to store it as fat, not the reverse,
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inay tahay in loo keydiyo dux ahaan, ka bedelan cagsigeeda
06:45
getting insulin resistance in response to getting fat.
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insulin difaac loo yeeshaa waxaa keena cayilnaan
06:50
This is a really subtle distinction,
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Tani runtii waa arin dul ka xaadis ah
06:52
but the implication could be profound.
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laakiin fahanku intaa wu u ka sii qot dheeryahay
06:56
Consider the following analogy:
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Bal eeg dhacdadaan isku xidhan ee soo socota
06:58
Think of the bruise you get on your shin
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Ka fikir haar kaa gaadhay boqonta
07:01
when you inadvertently bang your leg into the coffee table.
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kadib markii aad lugta gashatay miiskii shaahu saarnaa
07:05
Sure, the bruise hurts like hell, and you almost certainly
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Xaqiiqadii, haartu way ku dhibaysaa, sida iska cadna
07:08
don't like the discolored look, but we all know
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ka helaysid midab bedelkaa kugu dhacay, lakiin sidaynu wada ogsoonahay
07:11
the bruise per se is not the problem.
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haartu ma aha dhibaatada
07:14
In fact, it's the opposite. It's a healthy response to the trauma,
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xaqiiqadii waa taa ka caksigeeda, waa jawaabta caafimaad ee dhibaatada
07:18
all of those immune cells rushing to the site of the injury
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dhamaan unugyda difaaca ee goobta dhawaca kusoo ururay
07:21
to salvage cellular debris and prevent the spread
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rabana inay badaadiyana unugydada kana hortaga faafitaanka
07:24
of infection to elsewhere in the body.
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Infection ku baaha jidhka intiisa kale.
07:26
Now, imagine we thought bruises were the problem,
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Hada ka fikir hadaynu haarta u haysano dhibaatada
07:30
and we evolved a giant medical establishment
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dhex gallona mu'asaso daaweed weyn
07:33
and a culture around treating bruises:
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iyo waxyaaba kallaynu ku dhayayno haaraha
07:36
masking creams, painkillers, you name it,
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ku duugid kareemo, xumad dilayaal, sii wad
07:39
all the while ignoring the fact that people
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Dhamaan iyadoo layska indha-tirayo in dadku weli
07:42
are still banging their shins into coffee tables.
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ay lugta ku jiidanayaan miiskii shaahu saarnaa
07:45
How much better would we be if we treated the cause --
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Intebay ka si wanagsanaan lahayd inakoo sababta abaara--
07:48
telling people to pay attention
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dadka u sheegna inay ka taxadiraan
07:50
when they walk through the living room --
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markay qolalka fadhiga dhexmarayaan--
07:52
rather than the effect?
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halkaygu aynu saameynta eegi lahayn?
07:55
Getting the cause and the effect right
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Iyadoo laysla hello sababta iyo saamaynta si saxa
07:57
makes all the difference in the world.
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waa waxa farqiga keena aduunkoo dhan
07:59
Getting it wrong, and the pharmaceutical industry
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Markii si kale loo eego, suuqa samaynta daawadu
08:02
can still do very well for its shareholders
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weli si fiican buu saamigiisu u shaqayn karaa
08:05
but nothing improves for the people with bruised shins.
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laakiin waxba uma siyaadayaan dadka lugaha haaraha ku leh
08:09
Cause and effect.
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Sabab iyo Saamayn
08:12
So what I'm suggesting is
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Hadaba waxaan soo jeedinaya waxa weeye
08:14
maybe we have the cause and effect wrong
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laga yaabe inay sabab iyo saamayn khalada tahay
08:16
on obesity and insulin resistance.
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cayilnaanta iyo difaac u yeelashada insulin
08:19
Maybe we should be asking ourselves,
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Laga yaabee inaynu is weydiinayno
08:21
is it possible that insulin resistance causes weight gain
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suurta gal ma tahay in Difaac u yelashada insulin ay sababto miisaan
08:25
and the diseases associated with obesity,
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cudurkuna lug ma la leeyahay cayilnaanta
08:27
at least in most people?
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ugu yaraan dadka oo dhan?
08:28
What if being obese is just a metabolic response
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ka waran hadii cayilnantu ay jawaab jidh ahaneed u tahay
08:31
to something much more threatening,
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dhibaato sii mug weyn
08:34
an underlying epidemic,
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baahsanaan heer aan la ogayn ah
08:36
the one we ought to be worried about?
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Ta ay tahay inaynu ka werwero ah
08:38
Let's look at some suggestive facts.
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Hada aynu eegno xaqiiqooyin wax ina tusinaya
08:40
We know that 30 million obese Americans
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Waxaynu ognahay in 30 million oo Maraykan cayilani
08:42
in the United States don't have insulin resistance.
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oo ku nool wadanka aanay lahayn difaaca insulin
08:45
And by the way, they don't appear to be at any
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sida oo ay tahayna, uma muuqato inay inaba
08:47
greater risk of disease than lean people.
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uga khatar badanyihiin cudurka dadka dhuudhuuban
08:50
Conversely, we know that six million lean people
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Taa cagsigeeda,waxaynu ognahay in 6Milyan oo dad dhuudhuuban ah
08:53
in the United States are insulin-resistant,
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oo dalka maraykanka ku nool inay difaaca insulinta leeyihiin
08:57
and by the way, they appear to be at even greater risk
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sida aawadedna. u muuqda inay uga khatar badan yihiin
09:00
for those metabolic disease I mentioned a moment ago
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cudur jidh cunteedka aan hore usoo sheegay
09:02
than their obese counterparts.
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mar loo eego dhigooda cayilan
09:04
Now I don't know why, but it might be because,
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hada ma garanyo sababta laakiin laga yaabe
09:06
in their case, their cells haven't actually figured out
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inay tahay unugyadooda oo aan gawrasan
09:09
the right thing to do with that excess energy.
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wixii saxda ahaa ee ku qaban lahayeen tamarta dheeriga ah
09:12
So if you can be obese and not have insulin resistance,
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Hadaba hadii aad cayilnan karto difaacna u yelan kartid insulin
09:15
and you can be lean and have it,
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caatana ahaan kartid oo aad yeelan kartid,
09:17
this suggests that obesity may just be a proxy
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Waxay tusaysaa in cayilnaantu noqonkarto lagu khadamaha
09:21
for what's going on.
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waxa socda
09:24
So what if we're fighting the wrong war,
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Ka waran hadaynu dagaalkii khaladka ahaa ku dirirayno
09:27
fighting obesity rather than insulin resistance?
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la dirirayno cayilnaan halkii difaac u yeelashada Insulin
09:31
Even worse, what if blaming the obese
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Kasii darane, ka waran hadaynu hiifayno cayilnaha
09:34
means we're blaming the victims?
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oo micneheedu yahay dhibanahoo la hiifay
09:37
What if some of our fundamental ideas about obesity
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3719
Ka waran hadii fikirka asaasiga ee cayilnaanta aynu ka qabnaa
09:40
are just wrong?
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uu khaldanyahay
09:42
Personally, I can't afford the luxury of arrogance anymore,
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Qof ahaan, uma sii dul yeelan karo guracnantan baas
09:46
let alone the luxury of certainty.
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Xaqiiqadu waa inay gees u baxdaa
09:49
I have my own ideas about what could be at the heart of this,
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2846
Fikirkaygaan ka qabaa ku dhexjirka arinkan
09:52
but I'm wide open to others.
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Laakiin cid kasta waan u furan ahay
09:54
Now, my hypothesis, because everybody always asks me,
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Markan, mala-awaalkayga, sababtoo ah qof kasti wuu weydiiyaa
09:56
is this.
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wuxu yahay
09:58
If you ask yourself, what's a cell trying to protect itself from
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Hadaad isweydiisid, muxu unugu inuu ilaaliyo isku dayaya
10:01
when it becomes insulin resistant,
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marka ay difaac u yeelato insulin
10:03
the answer probably isn't too much food.
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sabatoo malahayga ma aha cunta badan
10:06
It's more likely too much glucose: blood sugar.
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waxay u badantahay glucose farabadan; dhiig macaan
10:09
Now, we know that refined grains and starches
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waxaynu hada ognahay macmaanka la miiray
10:11
elevate your blood sugar in the short run,
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2056
inuu kor qaadi karo macaanka dhiiga waqti kooban
10:14
and there's even reason to believe that sugar
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sababaana jirta lagu aamina karo in sonkortu
10:15
may lead to insulin resistance directly.
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ay toos u keento difaac u yeelashada insulin
10:18
So if you put these physiological processes to work,
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Hadaba hadaad qaabkan maskaxeed ka shaqaysiisid
10:22
I'd hypothesize that it might be our increased intake
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3473
waxaan filayaa in ay suurta gal tahay korodhka qaadashada
10:26
of refined grains, sugars and starches that's driving
220
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2863
macmaanada la miiray ay keenayso
10:29
this epidemic of obesity and diabetes,
221
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baahitaanka cayilnaanta iyo macaanka
10:33
but through insulin resistance,
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iyadoo keenayso difaac u yeelasha insulin
10:35
you see, and not necessarily through just overeating and under-exercising.
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bal eeg, ma aha cunta badsasho iyo ciyaar badsasho toona
10:39
When I lost my 40 pounds a few years ago,
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Markaa lumiyay 40 pound sanad yar ka hor
10:42
I did it simply by restricting those things,
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SI fudud waxaan yareeyay waxyaabahaa
10:44
which admittedly suggests I have a bias
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3456
Tasoo qiraal ahaan keentay inaan dhinac u jeesto
10:48
based on my personal experience.
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anoo ku salleeyay khibaraday shakhsiga ah
10:50
But that doesn't mean my bias is wrong,
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Taasi maaha in dhinac u baydhidaydu ay khalad tahay
10:53
and most important, all of this can be tested scientifically.
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ku darsoo muhiimku waa in wax kasta si cilmi ah loo sugi karo
10:57
But step one is accepting the possibility
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laakiin ta koowaad waa aqbalida suurtagalnimada ah
11:00
that our current beliefs about obesity,
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in fikirkeena hada ee cayilnaanta
11:02
diabetes and insulin resistance could be wrong
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macaanka iyo insulta ku saabsani uu khalad yahay
11:05
and therefore must be tested.
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sidaa awaadeedna waa inay tijaabo galla arinku
11:08
I'm betting my career on this.
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Waan ugu khamaarayaa xirfadayda arinkaas
11:10
Today, I devote all of my time to working on this problem,
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Maanta waxan u huriyaa waqtigaya arintaas
11:15
and I'll go wherever the science takes me.
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Waana aadayaa meelkastoo cilmigu ila gallo
11:18
I've decided that what I can't and won't do anymore
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Waxaan goaansaday waxanan dib u samayn doonin
11:21
is pretend I have the answers when I don't.
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iska dhigida mid jawaabo haysta anoon haysan
11:24
I've been humbled enough by all I don't know.
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4108
In badan waan isla baxay anoon garanayn
11:28
For the past year, I've been fortunate enough
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2157
Laakiin sanadii danbe, waxan nasiib u yeeshay
11:31
to work on this problem with the most amazing team
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3413
inaan arinkan kalla shaqyeeyo kooxda ugu yaabka badan
11:34
of diabetes and obesity researchers in the country,
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3404
ee macaanka iyo cayilnaanta baadha ee dalka
11:37
and the best part is,
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Arinka ugu wanaagsanina wuxu yahay
11:39
just like Abraham Lincoln surrounded himself with a team of rivals,
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Sidii Abraham Lincoln markuu isku gedaamay koox kuwii kasoo horjeeday ah
11:43
we've done the same thing.
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Anagana sidoo kale ayaan sameynay
11:44
We've recruited a team of scientific rivals,
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Waxaynu shaqalaysiinay koox saynisyahano iska horjeeda
11:47
the best and brightest who all have different hypotheses
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Kuwa ugu wanaagsan uguna sareeya lehna fikiro kalla duwan
11:51
for what's at the heart of this epidemic.
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1614
Kala badhka arinka baahay
11:52
Some think it's too many calories consumed.
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2381
Qaarkood sababtu waaa Kalooris fara badan oo la qaatay
11:55
Others think it's too much dietary fat.
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2379
Qaar kale waa cunta dux leh oo fara badan
11:57
Others think it's too many refined grains and starches.
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Qaar kale waa jadhiidha macaanka ah ee la miiray
12:01
But this team of multi-disciplinary,
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Laakiin kooxdan xirfadaha badan
12:03
highly skeptical and exceedingly talented researchers
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baadhayaal xirfad sare lehna ah
12:06
do agree on two things.
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mid bay isku waafaqsanyihiin
12:09
First, this problem is just simply too important
255
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3649
Kow, dhibaatadani si fudud waa mid ay muhiim tahay
12:12
to continue ignoring because we think we know the answer.
256
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2743
inaynu sii wadno is dhaafinteeda waayo waxaynu u haysanaa inaynu ognahay jawaabta
12:15
And two, if we're willing to be wrong,
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2784
Ta labaad, hadaynu rabno inaynu khaldano
12:18
if we're willing to challenge the conventional wisdom
258
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2537
hadaynu rabno inaynu ka hor nimaadno xikmada caalamiga ah
12:20
with the best experiments science can offer,
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3063
Haysanana tijaaboyinka ugu fiican oo saynisku ina siin karo
12:23
we can solve this problem.
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2305
waynu xalin karnaa dhibaatadan
12:26
I know it's tempting to want an answer right now,
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Waan hubaa in hada jawaab la doono loo bahanyahay
12:29
some form of action or policy, some dietary prescription --
262
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nooc siyaada ha noqoto, cunto qorid ha noqoto--
12:33
eat this, not that —
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1729
tan cun, tan ha cunin ha noqoto---
12:35
but if we want to get it right,
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1680
Laakiin hadaynu u baahnahay inaynu saxano
12:37
we're going to have to do much more rigorous science
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Waa inaynu ka shaqaysiinaa cilmiga si xirfad badan
12:39
before we can write that prescription.
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ka hor inta aynaan daawo qorin
12:42
Briefly, to address this, our research program
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2599
Si kooban, si tan looga jawaabo, barnaamijkayagu
12:44
is focused around three meta-themes, or questions.
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wuxu abaarayaa sadex hogood ama su'aalood
12:47
First, how do the various foods we consume
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Kow, sidee baa cuntooyinka kala duwan ee aynu cunaa
12:50
impact our metabolism, hormones and enzymes,
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2801
u saameeyaan shaqa-jidheedkeena, iyo dheecanadeena
12:53
and through what nuanced molecular mechanisms?
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iyo waxa duwa qaab molukuyeleedka
12:56
Second, based on these insights,
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Ta labaad, waxay ku salaysan tahay aragti,
12:58
can people make the necessary changes in their diets
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dadku ma ku samayn karaan isbedelka loo bahanyahay cuntadooda
13:01
in a way that's safe and practical to implement?
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Qaab hufan oo hadana amaan ah?
13:05
And finally, once we identify what safe
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3009
Ugu danbaynu markaynu ogaano waxa amaanka ah
13:08
and practical changes people can make to their diet,
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Iyo isbedelka ay dadku ku samayn karaan cuntadooda
13:11
how can we move their behavior in that direction
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iyo sida ay uga dhigi karaan dabeecad arinkaas
13:15
so that it becomes more the default
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markaasoo ay noqon karto arin dega
13:17
rather than the exception?
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halkii ay wax mara noqon lahayd
13:19
Just because you know what to do doesn't mean
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2420
Sabatoo ah waxad ogtahay in garashada waxaad qabanaysid anay la micna ahay
13:21
you're always going to do it.
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1509
inaad mar kasta samaynaysid
13:23
Sometimes we have to put cues around people
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Mararka qaar waa inaynu dadka tusnaaa bidhaan
13:25
to make it easier, and believe it or not,
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2303
si ay ugu fududaato, inay aaminaan ama aanay aaminin
13:27
that can be studied scientifically.
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in arintaa si cilmi ah loo baadhi karo.
13:31
I don't know how this journey is going to end,
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2584
Ma garanayo sida geedigani ku dhamaan doono
13:33
but this much seems clear to me, at least:
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4213
laakiin tanaa ii cad aniga, ugu yaraan:
13:38
We can't keep blaming our overweight and diabetic patients
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4996
Ma sii wadi karo canaanta bukaankeena macaanta qaba ama cayilan
13:43
like I did.
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2912
sidaan sameeyay oo kale.
13:45
Most of them actually want to do the right thing,
289
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2279
Badankooda waxay rabaan samaynta waxa saxda ah
13:48
but they have to know what that is,
290
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3369
Laakiin waa inay ogaadaan waxay taasi tahay
13:51
and it's got to work.
291
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3046
kana shaqaysiiyaan
13:54
I dream of a day when our patients can
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Waxaan ku rajo weynahay mar bukaankeenu ay awoodi doonan
13:59
shed their excess pounds
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1735
inay iska daadiyaan culays badan
14:01
and cure themselves of insulin resistance,
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2813
naftooda ka daweyaan difaac u yeelashada insulin
14:03
because as medical professionals,
295
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2730
sababtoo ah xirfadlay caafimaad ahaan
14:06
we've shed our excess mental baggage
296
834642
1970
anagu waxaan iska saarnay xamuulkii maskaxeed
14:08
and cured ourselves of new idea resistance sufficiently
297
836612
3326
nafteenana waxan ku daweeynay difaac fikir oo waafi ah
14:11
to go back to our original ideals:
298
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3090
si aan dib ugu noqono asalkeenii hore
14:15
open minds, the courage to throw out yesterday's ideas
299
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4417
Fur maskaxda, geesinimada tuurista fikirkii shalay
14:19
when they don't appear to be working,
300
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3328
markuu shaqayn waayay
14:22
and the understanding that scientific truth isn't final,
301
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3119
iyo fahanka in xaqiiqada cilmigu aanay dhamaan
14:25
but constantly evolving.
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2748
laakiin si joogto ah ay isu bedelayso
14:28
Staying true to that path will be better for our patients
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3292
Ku sugnaanta wadadaii waxay u wanaagsan tahay bukaankeena
14:31
and better for science.
304
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3248
waxay kaloo u wanaagsan tahay sayniska.
14:35
If obesity is nothing more than a proxy
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2994
Hadii cayilnaantu wax lagu khaldamay mooyay anay wax kale ahayn
14:38
for metabolic illness,
306
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1926
markay cudurka habsamida jidhka noqoto
14:40
what good does it do us to punish those with the proxy?
307
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5297
Maxay micno inoo samaynaysa inu ciqabno dadka lagu khaldamaha la dhinac ah
14:45
Sometimes I think back to that night in the E.R.
308
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4544
Mararka qaar waxaan dib uga fekera habeenka E.R-ka
14:49
seven years ago.
309
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2313
todobo sano ka hor
14:52
I wish I could speak with that woman again.
310
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3624
waan jeclaan lahaa inan haweynadaa mar labad la hadlo
14:55
I'd like to tell her how sorry I am.
311
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3255
waxan rabi lahaaa inan u sheego san uga xumahay
14:59
I'd say, as a doctor, I delivered
312
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2887
Aan dhaho, dhakhtar ahaan, waan bixiyay
15:02
the best clinical care I could,
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3660
daryeelkii caafimaad ee ugu wanaagsana ee an awooday
15:05
but as a human being,
314
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Laakiin insaan ahaan
15:09
I let you down.
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2408
waan ku dayacay
15:11
You didn't need my judgment and my contempt.
316
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4245
umaad baahnayn go'aankayga iyo is qanciskayga
15:16
You needed my empathy and compassion,
317
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4498
waxaad u baahnayd naxariis iyo beer-jileec
15:20
and above all else, you needed a doctor
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1995
Intasoo dhan ka kaallay, waxad u baahnayd dhakhtar
15:22
who was willing to consider
319
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2629
Kaasoo garawsada arinka
15:25
maybe you didn't let the system down.
320
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3064
laga yaabee nidaamkaan ku jiray inaad dayicin adigu
15:28
Maybe the system, of which I was a part,
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3218
laakiin nidaamka ka qaybta ahaa
15:31
was letting you down.
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2439
ayaa ahaa kii ku dayacay
15:34
If you're watching this now,
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Hada hadaad i daawanaysid
15:36
I hope you can forgive me.
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4238
waxaan kaa tuugayaa inaad i cafidid
15:41
(Applause)
325
929112
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Sacab
Translated by Abdikani Hassan
Reviewed by Ahmed Kadiye

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ABOUT THE SPEAKER
Peter Attia - Surgeon
Both a surgeon and a self-experimenter, Peter Attia hopes to ease the diabetes epidemic by challenging what we think we know and improving the scientific rigor in nutrition and obesity research.

Why you should listen

Peter Attia has dedicated his medical career to investigating the relationship between nutrition, obesity and diabetes. A surgeon who developed metabolic syndrome himself despite the fact that he ate well and exercised often, Attia realized that our understanding of these important health issues may not actually be correct. From 2012-2015, he devoted himself to using vigorous scientific inquiry to test both our assumptions and new hypotheses through the Nutrition Science Initiative, the nonprofit he co-founded with journalist Gary Taubes. Now in private practice, Attia writes the blog Eating Academy, which charts his own adventures in nutrition and examines scientific evidence surrounding food, weight loss and disease risk. Overall, he hopes to convince others that sharp increases in the rates of obesity and diabetes -- despite the fact that we are more culturally aware of these problems than ever -- might be a result of people being given the wrong information.

Attia came to this calling through an unusual path. While he was studying mechanical engineering as an undergrad, a personal experience led him to discover his passion for medicine. He enrolled at Stanford Medical School, and went on to a residency in general surgery at Johns Hopkins Hospital and a post-doctoral fellowship at the National Cancer Institute. After his residency, he joined the consulting firm McKinsey & Company, where he worked on healthcare and financial system problems. The most valuable skill he learned along the way: to ask bold questions about medical assumptions. 

More profile about the speaker
Peter Attia | Speaker | TED.com