生物与医学2014researchgate.net
抑郁症是一种炎症性疾病：炎症究竟从何而来？
Depression is an inflammatory disease; where does inflammation come from?
入门 · 约 45 分钟读完前置知识：基础免疫学概念、营养学常识
导读
这篇综述文章提出抑郁症可能与慢性炎症有关，并探讨炎症的来源，如饮食（omega-3/omega-6 比例失衡）、压力、肥胖等因素。文章认为 omega-3 脂肪酸等抗炎成分可能有助于缓解抑郁症状，但文中证据主要来自相关性研究而非实验研究。
HN 关注点：HN 读者围绕鱼油补充剂是否有效、文章证据质量是否可靠展开激烈讨论，涉及营养学与循证医学的争议。
HN 评论精选
这几条评论里：支持 1 质疑 1 亲历 2
支持力挺鱼油补充剂，认为 omega-3 是少数确有科学依据的补充剂
Omega-3 脂肪酸（存在于海鲜、坚果、豆类和绿叶蔬菜中）能减轻炎症。鱼油补充剂又得一分——除了已有的大量科学研究支持它是一种'神奇化学物质'（我这么说绝非轻率）。如果你既不常吃富含脂肪的鱼也不服用补充剂，那真是错过了好东西。在补充剂爱好者中，它一直被认为是少数真正有用的补充剂之一，我推荐液体形式。
pvnick查看英文原文
Omega-3 fatty acids, which are important components of many healthy foods, such as seafood, nuts, legumes and leafy green vegetables, act to reduce inflammation Score another point for fish oil supplementation, on top of the already enormous pile of scientific research showing it to be a miracle chemical (and I definitely don't say that lightly) [2]. Seriously, if you aren't getting enough omega 3 fatty acids, either from regularly eating lots of fatty fish or through supplementation, you're seriously missing out on some good stuff. Among supplement enthusiasts, it's consistently declared to be one of the only supplements that's actually useful. I prefer the liquid form [1]. [1] http://www.amazon.com/Now-Foods-Omega-Lemon-Flavor/dp/B001B4NFNS [2] http://examine.com/supplements/Fish+Oil/ Edit: added [2], a well-written examine.com page summarizing fish oil effects
质疑质疑文章证据质量：几乎全是相关性研究，标题夸大，不是专家共识
我啃完了文末那一长串参考文献，但相关性研究不会因为数量多就更有说服力，何况其中大部分发表在中流甚至较差的期刊上。这篇观点文章有些有趣的想法，但几乎没有什么是被实验研究（无论人体还是动物实验）支持的。标题试图给抑郁症找一个'唯一真因'，而大多数抑郁症或炎症专家并不会把抑郁症称为'炎症性疾病'。等有更确凿的治疗证据再说吧，更值得一读的是另一篇由更专业医生写的书评。
tokenadult查看英文原文
It took me a while to slog through that whole long list of references at the end of the end of the article, but correlational study designs don't impress more by being numerous, especially when most of them are published in middling-to-lousy journals. That's what isn't fun about reading about medical issues here on Hacker News: too many of the articles kindly submitted here are of much too low quality to be worthy of our attention. There are some intriguing ideas in this opinion piece, but basically hardly anything there is backed up by experimental studies, not in a human study and not even in an animal study. The title of the article reflects an attempt to come up with a One True Cause of depression that surely is not the one true cause (most doctors who are experts in depression, or in inflammation, do NOT characterize depression as an "inflammatory disease") and then the article goes off the rails from there. Check back when there is better established evidence about treatment. A better read about depression by a more informed physician would be a book review submitted recently to HN[1] that was hardly noticed when it was submitted. [1] http://www.sciencebasedmedicine.org/depression-re-examined-a-new-way-to-look-at-an-old-puzzle/
亲历亲历分享：用 hs-CRP 检测炎症，素食一个月后从高风险降到低风险
可以通过叫 hs-CRP 的血液检查来检测炎症水平。我测了之后惊讶地发现自己处于高风险区间，于是尝试素食不到一个月，复测时已降到低风险区间（当月唯一的生活方式改变）。全素对我难以坚持，现在改为每天只吃一次肉（通常在晚餐），准备再测看效果。我怀疑比起不吃肉，蔬菜摄入增加可能更关键。注意 hs-CRP 并非完美指标，剧烈运动后恢复期或感冒都可能暂时推高数值，所以最好定期检测、积累纵向数据。
Harj查看英文原文
You can check your inflammation levels via a blood test called hs-CRP (http://en.wikipedia.org/wiki/C-reactive_protein). I took it and was surprised to learn I was in the high risk range. I tried a vegetarian diet for just under a month, re-tested and I'd dropped into the low risk range (this was the only lifestyle change I made that month). I found that a full vegetarian diet isn't sustainable for me so now I'm trying out only having meat once a day (usually for dinner) and will re-test to see what result that has. I suspect that the absence of meat may have been less important than the increase in vegetables. The caveat is that hs-CRP isn't a perfect test because your result can be spiked temporarily if e.g. your body is recovering from intense exercise or a cold. That's why I think it's a good test to do more regularly and have longitudinal data for. I've been spending a bunch of time getting more comprehensive blood tests recently. If you've any questions feel free to ping me (harjeet [dot] taggar [at] gmail).
亲历亲历质疑：服用鱼油 14 年后停用无变化，认为补充剂行业是伪科学加营销
最近有研究把 omega-3 摄入与前列腺癌风险升高联系起来。我吃了 14 年鱼油，花了几千美元买 Nordic Naturals，停用时情绪下降让我以为它有好处，但这次停用前后毫无变化。这是压垮我的最后一根稻草——我已经放弃了所有补充剂和复合维生素，因为研究表明它们没有正面效果甚至可能有害。我越读越确信这是有缺陷的科学加营销，健康多样的以植物为主的饮食应该能满足大多数人的需求。
yogi123查看英文原文
Recent articles have tied omega 3 intake to increased risk of prostate cancer. Got a lot of press last year. I took Omega 3 for the last 14 years. Spent thousands buying Nordic Naturals from Whole Foods at $25/bottle. Whenever I'd stop taking it, I felt a decline in mood so thought it had good systemic benefits. When I went off it this time, I felt zero change before or after (haven't taken since last summer). This study was the last straw. I'd already given up supplements and even a daily multivitamin as studies indicate no positive effect and possible harm. Now I take no supplements. The more I read the more I'm convinced it's faulty science and marketing. A healthy, varied diet of mainly plant based foods should provide all that most people need. If you look at links to omega 3 studies on Wikipedia I don't recall there being conclusive positive evidence, but maybe I'm wrong. Couple of links on prostate cancer study and whether it's accurate or not: http://www.cancer.org/cancer/news/omega-3-fatty-acids-linked-to-increase-in-prostate-cancer-risk http://health.heraldtribune.com/2013/08/26/dr-oz-omega-3-cancer-link-pretty-fishy/ http://articles.mercola.com/sites/articles/archive/2013/07/31/omega-3-fats.aspx
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- 2014Hacker News 讨论帖163 分 · 208 评
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