母亲的疾病对孩子的皮肤有益

The children of women with untreated worm infections while pregnant had fewer cases of eczema, lending further credence to the \”hygiene hypothesis\” that says some immune challenges may have long-term benefits. Cynthia Graber comments

怀孕期间患有蠕虫感染疾病，并未得到治疗的母亲所生的婴儿，很少会得湿疹。这增加了“一些对免疫系统的考验也许会让人长期受益”这个“卫生学假说”的可信度。 Can we be too clean? According to what’s called the hygiene hypothesis, yes. Without being challenged as kids, our immune systems don’t flourish. Scientists think it could be part of the rise of allergies and asthma.

我们真的太干净了吗？根据所谓的卫生学假说，是的。如果不在小孩的时候就经受考验，我们的免疫系统是不会强大起来的。科学家们认为，这可能是过敏类和哮喘类疾病发病率上升的原因之一。 Now a new study supports the hygiene hypothesis: infants in Uganda had a lower chance of developing the skin allergy condition eczema if their moms had helminth worm infections while pregnant. The research is in the journal Pediatric Allergy and Immunology.

现在，一个新的研究支持了这个卫生学假说：乌干达的婴儿很少有机会患上湿疹这种皮肤过敏症，前提是他们母亲在怀孕期间肚子里面有蛔虫。这个研究发表在儿科过敏反应和免疫学杂志上。 A 2005 study showed that the kids of women treated for worm infections had more eczema. Twenty-five hundred pregnant women took part in this follow-up research. Some got one worm-killing drug. Others took a different drug. And a third group received a placebo. One drug nearly doubled the kids’ risk of eczema. The other more than doubled the odds.

一个2005年的研究表明，治疗了蛔虫感染的妈妈们的孩子湿疹的发病率较高。2500名怀孕妇女参加了这项跟踪研究。一些人吃了一种杀虫药。另外一些人吃另外一种杀虫药。第三群人吃的则是安慰剂。吃其中一种杀虫药的妈妈所生的孩子患有湿疹的风险翻倍了。吃另外一种杀虫药的妈妈所生孩子患有湿疹的风险翻倍还要多。 Helminth worm infections can give the mothers symptoms such as mild anemia or stomach pain and vomiting. Although many people have no symptoms at all. The scientists say more research is needed before they would recommend not treating worm infections. But the work lends additional support to the idea that hygiene may be a balancing act rather than a goal.

蛔虫感染能让妈妈们患上一些症状，比如轻度贫血，胃疼，呕吐。但是也有一些人完全没有任何症状。科学家们说，在建议妈妈们不治疗蛔虫感染以前，还必须要做更多的研究。但是这项研究对这样的观念提供了又一支撑，那就是：卫生是平衡手段，而不是目的。

孕期的”友好细菌”可以预防儿童湿疹

Mothers who drink milk containing \’friendly bacteria\’ (probiotics) while pregnant and breastfeeding may reduce their child\’s risk of developing eczema, reports a new study. And if their child does develop eczema, it may be less severe.

最新研究表明，母亲在怀孕和哺乳期间喝含有\”友好细菌\”(益生菌)的牛奶可能减少她们的孩子患湿疹的危险。即使她们的孩子患湿疹，病况也相对较轻。 What do we know already?

那么我们已经知道了什么？ Probiotics are tiny organisms, usually bacteria, which occur naturally in some foods (such as yoghurt) and are added to others (such as milk and soya drinks). They are also available as supplements.

益生菌是一类微生物，通常是自然生长在某些食物中的细菌（如酸奶）和其他饮料（如牛奶和豆制品饮料）。他们也做为食品的添加剂。 Probiotics are often called \’friendly bacteria\’ because they help with digestion and protect against some types of harmful bacteria. Studies also show they may help the immune system to develop and reduce the risk of allergies, which occur when the immune system overreacts to something harmless, like pollen. This has led researchers to wonder whether probiotics might be used to prevent some allergy-related conditions, such as eczema.

益生菌通常被称作“友好的细菌”是因为他们有助于消化并阻止一些有害细菌的侵入。研究显示他们还可能增加人体免疫力和减少那些因为免疫系统对花粉等某些无害生物的过激反应而产生过敏的危险。这导致研究者对是否益生菌可能被用来阻止某些环境过敏感到好奇，如湿疹。 Eczema is a skin condition that makes patches of skin become dry, red and itchy. It is very common, particularly among children. About 16 in 100 children in the UK have eczema.

湿疹是一种皮肤病，它使皮肤产生斑点、变得干燥、鲜红和瘙痒。这是一种非常常见的疾病，尤其对于儿童。在英国大约在100名儿童中就有16个患湿疹。 Some studies have found that children have a lower risk of eczema if they are given probiotics as babies. However, these studies have looked mainly at children who have a family history of eczema and are at high risk, rather than children in general. Also, few studies have explored whether giving mothers probiotics while pregnant or breastfeeding might have a beneficial effect.

一些研究发现在婴儿时期给予益生菌的儿童患湿疹的危险要小。可是，这些研究并不全面，它主要针对了那些有湿疹家族史的儿童并且这些儿童有更大可能患湿疹。另外，少数研究发现在孕期或哺乳期给予母亲益生菌可能得到有益的结果。 To help fill these gaps, Norwegian researchers have now done a study of 415 pregnant women who were planning to breastfeed their babies. Half of the women drank milk with probiotics from the 36th week of their pregnancy until their baby was 3 months old. The other half drank identical milk that contained no probiotics. The researchers then followed up the women two years later to find out whether their children had eczema.

为了填补这些空白，挪威研究人员对415位打算哺乳的已怀孕妇女进行了研究。一半的妈妈从她们怀孕的第36周到她们的宝宝3个月止喝带有益生菌的牛奶，另一半所喝的奶中则没有益生菌。两年后研究人员对这些妈妈进行跟踪调查是否她们的孩子患过湿疹。 What does the new study say?

我们看看新研究结果说了些什么？ Children born to women who drank the probiotic milk were half as likely to have eczema at age 2 than those whose mothers drank the regular milk. And the children in the probiotics group who did develop eczema had less severe symptoms overall. These results didn\’t change when the researchers factored in other things that might have affected the children\’s risk of having eczema and other allergies, such as whether their mother smoked, whether they were breastfed for only a short time, and whether they started eating food before age 6 months.

那些喝了带有益生菌牛奶的妇女的孩子在两岁前患有湿疹是喝平常牛奶的一半。并且益生菌组的所患有湿疹的症状总体上要比非益生菌组轻。当研究人员把其他可能影响儿童患湿疹和其他过敏因素考虑进去后，如母亲是否吸烟，是否他们仅仅短时间接受哺乳还有是否他们在6个月前开始给予食物等，这个结果并未改变。 Interestingly, the children most likely to benefit from probiotics were those with no family history of eczema or related allergies. This suggests, say the researchers, that widespread use of probiotics by pregnant and breastfeeding women might be worthwhile for curbing rates of childhood eczema.

有趣的是，从益生菌中得益的儿童好像更多地是那些没有湿疹家族史或相关过敏症的家庭。这建议，研究人员说，在孕期和哺乳期的妇女广泛使用益生菌来抑制儿童患湿疹的几率是值得的。 How reliable are the findings?

这个发现有多少可信度？ These findings should be quite reliable as the study was a randomised, double-blind controlled trial. This is the best type of study for finding out whether a treatment works.

因为这个研究是随机的，双重盲目控制的实验，所以这些发现应该是非常可靠的。这是最好的研究方法来验证治疗方式是否有效。 However, one-third of the women dropped out of the study before it finished. This is slightly more than the researchers anticipated, which weakens their results, although not substantially.

可是，三分之一的妇女在研究结束前就退出了。这有点高于研究者们的期望值，这多少减弱了他们的研究结果，虽然不是很多。 Where does the study come from?

研究从何而来？ The study was done by researchers at the Norwegian University of Science and Technology. It was funded by the Norwegian Research Council, Siemens Medical Solutions Diagnostics AS and a research foundation called Nidarosfondet. The study appeared in the British Journal of Dermatology, which is owned by the British Association of Dermatologists.

这项研究是由挪威科技大学的研究人员完成的。它是由挪威研究委员会，西门子医疗诊断协会和一所名叫Nidarosfondet的研究基金会资助。这项研究刊登在由英国皮肤病协会主办的英国皮肤学报。 What does this mean for me?

这对我意味着什么？ This study adds to a growing body of research showing that probiotics may be useful in preventing eczema in young children. You may find this interesting if you are pregnant or have recently had a baby. And the idea of taking probiotics yourself – rather than giving them to your infant – may also appeal to you.

这项研究增加到研究正在生长的身体来显示益生菌可能对幼儿时期防止湿疹很有用。你会发现这很有趣儿，如果你正怀孕或者刚刚有了一个婴儿。并且采取你自己服用益生菌的想法——而不是给你的婴儿——也许对你同样有吸引力。 However, studies have yet to reveal exactly how probiotics might help prevent eczema and which \’friendly bacteria\’ work best. This study used three probiotics that have had positive results in other research: Lactobacillus rhamnosus GG, Lactobacillus acidophilus La-5 and Bifidobacterium animalis subsp. lactis Bb-12.

无论怎样，研究已经正确揭示了益生菌是怎样可能帮助防止湿疹的并且哪个“友好的细菌”起到最好的作用。这项研究用了在其他研究中得到的好结果的三种益生菌：鼠李糖乳酸杆菌（Lactobacillus rhamnosus GG）、嗜酸乳杆菌（Lactobacillus acidophilus) La-5和动物双歧杆菌乳亚种Bb-12。 What should I do now?

我们现在应该做什么呢？ If you\’re pregnant or breastfeeding and interested in taking probiotics, talk to your doctor or midwife. Although these \’friendly bacteria\’ are unlikely to cause serious side effects, it\’s best to check before making any changes to your diet when you\’re pregnant.

如果你正在孕期或者哺乳期并且对服用益生菌感兴趣，请告诉你的医生或者助产士。虽然这些“友好细菌”看起来并没有严重的不良影响，在你怀孕期间对日常饮食有任何改变还是确认一下为好。

抗生素很危险，杀益生菌！引起抗生素抗药性

抗生素过量用药会导致细菌的耐药性

《柳叶刀》杂志报告，抗生素对因轻微胸部感染引起的持续咳嗽患者治疗无效。

在12个欧洲国家大约2000病人填写“疾病”日志。

研究发现，病人用抗生素治疗症状的严重程度和持续时间与服用安慰剂治疗的没有什么不同。

但专家警告说，如果怀疑是肺炎，由于控制疾病的严重程度还应使用抗生素。

南安普顿大学教授保罗•利特尔领导了这项研究，他说：“对疑似未患肺炎的患者却使用抗生素阿莫西林治疗呼吸道感染非但不利反而有害。

“按照初级护理处方过量使用抗生素，特别是治疗效果无效的情况下，会导致出现耐药性且有副作用，如腹泻、皮疹和呕吐。

“我们的研究结果表明，患者自己就会恢复好。但抗生素对少数患者会有效，问题是如何找出受益于抗生素的人，仍具挑战性。”

之前的研究是否抗生素对治疗胸部感染有益，症状包括呼吸短促、虚弱、高烧、咳嗽和疲劳，产生了相互矛盾的结果——特别是老年人，胸部感染会进一步导致并发症。

本研究随机分为两组患者，一组接受抗生素治疗，另一组接受安慰剂治疗，一种使用糖片的惰性治疗形式，一天三次一个疗程服用七天。

据研究报道发现两组在严重程度和持续时间上几乎没有差异。据研究对于老年患者也是一样，研究了近三分之一的老年人（那些年龄在60岁或60岁以上的老年人）。

据研究报道，那些服用抗生素的比那些服用安慰剂的所出现的副作用要多，包括恶心、皮疹和腹泻。

耐药性

肺部感染，是病人去看医生的最常见问题之一。

英国肺脏基金会会员尼克•霍普金森博士认为，这项研究有助于全科医生向病人提供抗生素咨询服务。

他说：“一些患者胸部轻微感染就会要求开处方服药——该项研究可以帮助医生们建议患者服用处方抗生素可能不是最佳的治疗方案。

“最轻微的胸部感染会自行解决，不需要抗生素——主要是由病毒引起。那些患有轻微感染的患者如果症状没有改善就停用抗生素。

“这项研究旨在鼓励和支持医生们所做的。”

过量服用抗生素会导致所感染细菌的耐药性。

皇家学院全科医生迈克尔•摩尔博士，也是这项研究的合著作者，他也表示：“重要的是全科医生们清楚地知道，他们应不应该给病人开抗生素，来降低出现细菌区域的耐药性。

“这项研究支持了国家健康和临床研究所所采取的方法的指导方针，患有急性下呼吸道感染、全科医生可以再次保证非疑似肺炎患者，没有抗生素一样会恢复，无论开处方服药与否疾病可能都会持续大约三个星期。”

欧洲国家包括比利时、英国、法国和德国于2007年11月和2010年4月进行了该项研究。

观察了2061名持续咳嗽患者，持续咳嗽超过28天且呼吸系统感染，如疑似支气管炎。

如果由于没有及时治疗，程度较严重的那些患上肺炎的患者排除在该项研究之外。

参与者每天完成病志记录，病情持续时间并评价病情的严重性，症状包括咳嗽、呼吸困难、胸痛、胸闷或流鼻涕。

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儿童食物过敏：元凶何在？

Like any good mother, ever since my son Eden was diagnosed with life-threatening food allergies, I\’ve been trying to find out why. The Hygiene Hypothesis is a popular theory for the increase in food allergies. In 2004, the National Institute of Allergy and Infectious Disease followed the medical records of 835 children from birth to age one, documenting any fever-related episodes. At six to seven years old more than half of the children were evaluated for their sensitivity to common allergens such as dust mites, ragweed and cats. Of the children who didn\’t experience a fever during their first year, 50 percent showed allergic sensitivity. Of those who had one fever, the percentage dropped to 46 percent. But of the children who had two or more fevers only 31 percent showed allergic sensitivity.

如同任何称职的妈妈一样，自从我的儿子艾登被诊断出患有可能危及生命的食物过敏症起，我就一直在苦苦寻找病因。很多人接受“卫生假说”(Hygiene Hypothesis)来解释食物过敏症的增加现象。（译者注：“卫生假说”在医学领域研究哮喘病潜在病因中一直占主流地位。该假说认为，儿童时代的感染及环境因素，如食物、空气的污染导致了哮喘病的过敏体质。）2004年，美国过敏症及传染性疾病研究所对835名儿童从出生开始，到1周岁期间进行了医学跟踪。对任何和发烧有关的事件都予以记录。到6至7岁时，这835名儿童中，过半的人都有各种各样的过敏症，对常见的过敏原如尘螨，豚草和猫等产生过敏。在1周岁内从未发烧过的孩子中，50%患上了过敏症。1周岁内发烧一次的孩子中，有46%的有过敏症。而那些1周岁内曾经历两次或以上发烧的孩子，患上过敏症的仅仅占31%。 So does this mean that children might have fewer allergies if society allows them to get dirtier and sicker? But how much sicker? What about the advances modern medicine has made in eradicating childhood diseases like Polio? And how much dirtier? Do we want our children exposed to more parasites? The Helminthes Hypothesis is nearly identical to the Hygiene Hypothesis but it focuses exclusively on parasites. Helminthes are the worms that live in the human intestinal tract.

这是否说明，如果孩子们生活中不太卫生的环境中，并经常得病的话，患上过敏症的机会就会降低呢？那要得几次病才算？何况现代医学技术的发展已完全能根治不少儿童疾病，如小儿麻痹。还有，怎么才算不太卫生的环境？要让我们的孩子多暴露在有寄生虫的环境中？“蠕虫假说”和“卫生假说”大同小异，只是这一假说单独强调了寄生虫的作用，它们生活在人类的肠胃内。 In the 1980\’s researchers studied Venezuelan Indians and discovered that within those who lived in the rainforest and were also heavily infected with worms only 10 percent had allergies. But among the wealthier Venezuelan Indians who lived in cities and were only lightly infected with worms, 43 percent had allergies. A \”Worm vs. Wealth\” theory is the Yang to the Yin of the Hygiene Hypothesis: Maybe we need more exposure to parasites to balance our reduced exposure to bacteria and viruses. Either way, clean water and food, antibiotics, reduced exposure to parasites, animals, viruses and infectious diseases may have caused our progressive worldwide allergies. But these ideas don\’t offer obvious solutions to parents. A few years ago, a well-known research immunologist injected himself with hookworms and reduced his allergic symptoms (shudder).

在上世纪80年代，人们曾对委内瑞拉的印第安人做过研究。发现那些生活在雨林中，并被各种蠕虫严重感染过的人群中，只有10%有过敏症。但那些富裕的，居住在城市的印第安人，也较少受到各种蠕虫感染，却有43%患有各种过敏症。“蠕虫和富裕”理论是“卫生假说”的阴阳两个方面。也许我们真该多接触点寄生虫，来平衡一下我们越来越少接触细菌和病毒的状况。各种生活方式，如清洁的食物和水，抗生素，减少和寄生虫，动物，病毒和传染病的接触，也许引起了全球范围过敏症的蔓延。也许这些理念还不足以提供父母们对孩子过敏症给出一个明确的解决之道。很多年前，一位知名的免疫学家就曾给自己注射钩虫，来减轻自己的过敏症状。（全身颤栗的症状） While there isn\’t strong evidence suggesting that an allergic child would benefit from exposure to his allergens or, say, from an occasional lick of a New York City subway pole (dramatic shudder), when people ask me why Eden has allergies and I answer, \”Well, most doctors favor the Hygiene Hypothesis,\” their next question predictably involves hand wipes. How to segue towards the less inviting explanation, \”Well, some scientists believe our world is too clean!\” Hmmm? Sure, then I could then launch into a monologue about contaminated water except my own kitchen counter is never without a full pitcher of filtered water with its reassuring \”filter-change-reminder-sticker.\”

同时，并没有有力证据证明，过敏症的孩子多接触过敏源会对缓解病症有利。当人们问起儿子艾登过敏症的原因时，我回答说：“好吧，大部分医生把过敏症的发生归咎于卫生假说。”他们接下来的提问一定和洗手有关。然后会继续解释道，“有些科学家相信，我们生活的世界太过干净了!”接着就听到我一个人滔滔不绝地谈论被污染的水。当然在我家里的厨房里，一直有一大桶的纯净水，上面贴着标签，提醒我何时跟换滤芯。 My friends are open to switching their hand soap to Burt\’s Bees All Natural, but balk at the idea of unfiltered water and unwashed hands. Some parents ask me, \”What about all those pesticides? I only buy organic! Don\’t you?\” Well, no, not always. Neither of my children\’s diet is organically stellar. But I get it. I want to control my children\’s health too. I want to benefit from medical progress while circumventing nature\’s backlash. And the hard truth is if I had let Eden play in the mud like a baby farm animal, he still may have gotten allergies. Medical theories address trends and individuals are complicated by their genetics and the particular circumstances of their lives.

我的朋友很爽快地开始改用天然肥皂洗手了，但对饮用没有过滤的水和不洗手仍心存疑虑。有些父母们问我，“那些杀虫剂可怎么办？我只购买有机食品，你呢？”我不会只买有机食品。我孩子吃的食物没有一样是纯有机食品。当然我明白，我会保证我孩子健康的。我希望从医学进步中受益，而避免和自然对抗。可铁的事实就是，即使我哪天让儿子在泥地里疯玩，他仍会得过敏症。医学理论只能提供一个大的趋势，但每个个体由于基因和生活环境不同，而变得十分复杂。 Other allergy theories abound. The increased pediatric vaccination schedule has been called out as a culprit in causing the increase in food allergies. Perhaps vaccination has led to overstimulation of the immune system? Perhaps the ingredients in vaccinations produce a delayed allergic response? Other voices speak out against our industrial and agricultural practices. Perhaps pesticides, cross breeding and genetic engineering are responsible for our children\’s \”toxic overload.\”

其他关于过敏症成因的理论还有很多。有人认为，现在名目繁多的儿童疫苗接种是引起食物过敏症的祸首。也许他们认为疫苗过度刺激了人体的免疫系统？也许疫苗中的某些成分导致了过敏反应时间延长？有些观点则抨击当今的工业和农业生产方式。也许杀虫剂，杂交育种和基因工程使得我们的孩子吸收“过多的有毒物质”。 Perhaps all those alterations to our food render it unrecognizable to our digestive tract? Every factor from cooking methods, socioeconomic status, gender, exposure to pool chlorine, fetal head size, early exposure to foods, late exposure to foods, country of birth origin has been examined in terms of its contribution to food allergies. While some of those circumstances have proven to be instrumental, none have been proven to be the sole determining factor.

也许我们的消化器官对这些面目全非的食物已无法分辨。人们对很多因素，如烹饪方法，社会经济地位，性别，是否接触过含氯的泳池，胎儿头围大小，进食时间的早晚，出生地和过敏症的关系都进行了检视。其中一些因素已证明确实对过敏症的发生有作用，但至今未找到一种单独成因。 Meanwhile I\’ve listened to many mothers assume the burden of their children\’s allergies by citing their maternal diet. Yet an expecting mother\’s diet hasn\’t been proven to cause their children\’s food allergies. We parents want to know why things happen to our children. We are ready to bear the guilt. Bring it on! You can\’t handle the guilt! I can! When Eden was born he was given antibiotics to clear excess fluid from his lungs. The NICU doctors advised us to permit it. They said it was probably best. Was that it? Did those antibiotics tip Eden\’s first domino?

同时，我也听到很多妈妈们给我罗列她们怀孕期间的饮食，想当然地认为，她们是怀孕期间的饮食引起了孩子现在的过敏症，然而至今没有证据表明，怀孕期间的饮食，和孩子食物过敏症发生有关。我们却满怀负疚感，我也有类似的感情。当儿子艾登出生时，当时观察室的医生建议我允许给他注射抗生素，来清除肺部过多的积液。医生们说这可能是最好的方案。是不是那次注射抗生素引起了他的过敏症？ Ah. But then there is guilt\’s evil twin — blame. In 2008, six years after my first pediatrician insisted that Eden wasn\’t vomiting incessantly and allergically to his milk-based formula, the American Academy of Pediatrics published a report defining Eden as an infant at risk based on our family history of allergies. Under those guidelines my pediatrician would have been obligated to instruct me to use \”an extensively hydrolyzed formula\” without question. (Again, she did not.) When I think about that AAP report many times I swallow a raw and unending frustration. Was that it? Then again, Eden was vaccinated on the recommended schedule while his food allergies were emerging. Was that it?

当然除了负疚感，还有责备。2008年，在我儿子第一个儿科医生坚称，艾登并没有持续性呕吐问题，也没有配方奶过敏症后的第六年，美国儿科学会给我儿子出具了一份报告，报告认为，因为家族都有过敏历史，所以孩子在婴儿期有过敏症的风险。其实当初孩子的大夫就有义务指导我应该给他大量喂食“水解配方奶粉”，这是毫无疑问的。（但是，她还是没有。）儿科学会的报告让我反复思考很久，让我感到无尽的失望。这算怎么回事？而在他过敏症日渐严重时，还按计划接种各种疫苗。这样做对吗？ Maybe allergy parents think we gave our children the wrong food or too many antibiotics. Maybe we wake up in the middle of night wondering if we should have kept them away from the cats or the peanut proteins we leaked through our breast milk. Maybe we did something bad that was supposed to be good for our children. But as the medical community looks for answers, I continue to look for ways to help my son live well — odds I can control.

也许父母们认为给他们的孩子吃错了东西或用了太多的抗生素才会这样。也许我们会半夜惊醒，想到或许应该让孩子不要接触家里的宠物猫；抑或是在母乳喂养中，母亲曾吃过花生，而后花生蛋白进入了母乳；也许我们认为做了一些不利于孩子健康的事，实际上是对孩子有利的？医疗机构也在寻求导致过敏症发生的原因，我也在不断摸索能让儿子更健康的办法，去控制各种不利因素。 Follow Susan Weissman on Twitter: http://www.twitter.com/susanweissman

少少不干不净或许是件好事儿!

有点儿不干净可能是一件好事

一些专家说，人体为保护自身健康，必须学会承受部分细菌存在。

九月九日《健康日新闻》记者丹尼斯·汤普森报导，根据美国疾病控制和预防中心的资料，良好的卫生习惯，使人们免除了无数细菌和病毒的感染，拯救了千百万人的生命。

但严格遵守良好的卫生习惯，越来越多的被受关注，虽然保持卫生是保护健康的宝贵手段，但却给人类造成其他形式的疾病。

Proponents of the \”hygiene hypothesis\” believe that reduced exposure to bacteria, viruses and parasites have impaired the immune system\’s ability to properly respond to environmental challenges.

Researchers have identified the hygiene hypothesis as a possible cause or exacerbating factor in a number of illnesses and medical problems, said Dr. Graham A.W. Rook, a professor in the department of infection at the Centre for Clinical Microbiology at the University College London. These include:

“卫生假说”的支持者们认为，减少对细菌、病毒和寄生虫的暴露，会损伤免疫系统妥善应对环境挑战的能力。

英国伦敦大学临床学院微生物学中心感染科教授Rook博士说，在某些疾病和医疗问题中，研究人员已经确定“卫生假说”可能导致或加剧疾病的因素。包括下列病患：

· Severe allergic reactions.

· Gastrointestinal disorders, such as inflammatory bowel disease and Crohn\’s disease.

· Autoimmune disorders, such as type 1 diabetes and multiple sclerosis.

\”The evidence for all this is very, very powerful,\” Rook said. \”It\’s very easy to show if you live on a farm or keep a dog, you\’re less likely to have these disorders. If you are the youngest child in a big family, you\’re less likely to have these disorders.\”

•严重的过敏反应。

•胃肠功能紊乱，如炎症性肠道疾病和克罗恩病。

•自身免疫性疾病，如1型糖尿病和多发性硬化症。

“所有这些疾病的证据是非常，非常有力的，”Rook说，“这很容易证明，如果你住在农场或养狗，你就不太可能有这些疾病的，如果你是一个大家庭中最小的孩子，你也不太可能有这些疾病。”

The hygiene hypothesis has its roots in the theory of evolution, he said.

\”The bottom line is organisms that were present in mud, untreated water and feces were with us right from the start of humanity,\” Rook explained. Proponents of the hygiene hypothesis believe that the human body adapted to these organisms and began using them as a means of training the immune system.

\”What has happened over the course of evolution is, because these bugs had to be tolerated, they came to activate the tolerance of the immune system,\” Rook said. \”They are the police force that keeps the immune system from becoming trigger-happy. Basically, the immune system is now attacking things it shouldn\’t be attacking.\”

他说，卫生假说是有进化理论根据的。

Rook博士解释说，“从人类诞生开始，存在于泥土、未经处理的水和粪便中的微生物就伴随我们一起生存。”卫生假说的支持者认为，人体适应这些微生物，并开始利用他们作为训练免疫系统的一种方法。

“在进化过程中，因为人体必须承受这些微生物，以此激活人体免疫系统的承受能力，”Rook说。 “他们是警察部队，抑制免疫系统的快乐扳击。基本上，免疫系统现在反常攻击的对象，它不应该攻击。”

Dr. Mitchell H. Grayson, an associate professor of pediatrics at the Medical College of Wisconsin in Milwaukee, said that the hygiene hypothesis is most strongly linked to an increase in allergic diseases and asthma.

\”It\’s thought to have something to do with the way your immune system develops and is programmed,\” Grayson said. Bacteria in the environment teach an immune response to allergens that is more moderate and less severe. \”In the absence of these bacteria, the immune system is thought to become more prone to allergic disease,\” he said.

威斯康新医学院儿科副教授格雷森博士说，“卫生假说”与过敏性疾病和哮喘的相关性越来越强。

“现在认为卫生假说与我们的免疫系统的发生和完善有关，”格雷森说，环境中的细菌诱导免疫系统对过敏原产生较为温和的和不太严重的反应。 “如果没有这些细菌存在，免疫系统变得更容易出现过敏性疾病，”他说。

Rook said that other researchers have used the hygiene hypothesis to show that parasitic infections can aid in the treatment of such conditions as multiple sclerosis and Crohn\’s disease.

Rook说，其他研究人员利用卫生假说治疗疾病的实践结果表明，寄生虫感染能帮助治疗多发性硬化病和克罗恩病等免疫性疾病。

Argentinean researchers, for instance, have shown that the presence of intestinal parasites can moderate the progression of multiple sclerosis. Follow-up studies indicated that, when people were treated for their parasitic infection, they had a relapse of MS.

A research team at the University of Iowa found similar results related to Crohn\’s disease, showing that intestinal parasites helped regulate the autoimmune reaction that causes the intestinal disorder.

例如，阿根廷研究人员证实，肠道寄生虫可以减缓多发性硬化症的进展。后续研究表明，当寄生虫感染被清除后，多发性硬化症即复发。

美国爱荷华州大学的一个研究小组研究克罗恩病时也获得类似的结论，即肠道寄生虫有助于调节导致肠道疾病的自体免疫反应。

On the flip side, such revelations carry risks. Doctors are concerned that some might use the hygiene hypothesis as an excuse to abandon good hygiene, causing a surge in diseases such as dysentery and cholera.

\”Public health and sanitation has been the single greatest improvement in our life expectancy,\” Grayson said. \”I would not recommend living less cleanly.\”

On the other hand, tolerance of a little dirt here and there won\’t hurt.

但另一面，卫生假说的启示也存在风险。医生们担心某些人以此为借口，放弃良好的卫生习惯，导致痢疾和霍乱等疾病激增。

“公共卫生与健康一直是增加我们预期寿命最大的促进因素，”格雷森说。 “我不会推荐生活可以不那么干净。”

另一方面，经常在某些地方有点儿不干净也不会有什么伤害。

\”If your kids come back from the garden with a little mud on their hands, it\’s not a bad thing,\” Rook said. \”They don\’t necessarily have to wash their hands before picking up a sandwich.\”

“如果你的孩子从花园回来时，手上有点儿泥土，那不是一件坏事，”Rook说。 “他们并非必须洗手后才可拿三明治。”

In general, though, it\’s wise to maintain good overall hygiene, he said, and wait for the scientists to figure all this out. Larger studies are underway to determine the exact mechanism by which bacteria and parasites are causing the immune system to moderate its response, Rook said.

\”We need to figure out how to replace what is good from the microbiological environment while maintaining the advances of good hygiene so we can get the best of both worlds,\” Rook said.

说，还要等待科学家研究出更明确的结论。正在进行更大规模的研究，以确定细菌和寄生虫诱发免疫系统调适免疫反应的确切机制。

Rook说：“我们需要弄清楚如何保持良好的卫生优势，又同时承受一个什么样的微生物环境，使我们可以得到两全其美。”

有机牛肉及乳制品不含激素和抗生素吗？

 

是的，多数是不含的。在有机食品规程中，包含抗生素和生长激素的合成兽药多数被禁用。另外，有机肉类和乳制品生产商必须仅使用有机饲料饲喂，而且必须避免其被抗生素和激素污染。如果动物生病，生产商要给它们提供治疗使其恢复健康。不过，治疗中一旦使用了抗生素，就不允许给肉类、牛奶或奶酪贴上有机食品标签。

这些规程是美国农业部有机食品生产法的一个重要组成部分。在非有机肉类和乳制品产业中，激素（尤其是雌激素）被广泛用于促进生长及增加产量。而且，抗生素（常以粉末形式添加到饲料中）作为常规防病措施被用在所有动物身上。

联邦有机食品规程禁止在有资质的有机肉类和乳制品中使用多数含抗生素和激素的合成兽药，这对保障产品的整体质量大有助益。当然，牛自身也有激素（包括雌激素），所以即使是有机肉类及乳制品中也会有一些激素残留（这方面还未见相关研究），不过在合格的有机食品中这些激素应该是很微量的。另外，合格的有机肉类和乳制品中应该是没有抗生素残留的，这通常会出现在非有机食品中。

实用小建议：如果你想减少对肉类和乳制品中激素和抗生素的接触，有资质的有机食品是你的最好选择。吃动物脂（从天然饲养、牧地放养的动物中提取，不含激素，不含抗生素等）.

http://www.whfoods.com/genpage.php?tname=faq&dbid=48

食用肉中的药物、毒素和金属元素

当美国农业部（USDA）的总监察办公室就这个部门的“国家畜牧业残留物检验规划”发布了一份糟糕而令人不安的报告后，华盛顿在周五再次抛出了不少坏消息。包括我们每日食用的肉类中的药物残留、毒物和重金属元素在内，美国牛肉产品在安全方面还存在不少漏洞。

即使用上了联邦政府文件中最为枯燥无味的标题：“审计报告24602-08-KC”，这也是一个令人反胃的冰冷信息。而且每个在饮食方面生冷不忌的美国人都应该花点时间来读一读。

“在我们审查的基础之上，发现这项国家畜牧业残留物检验规划未能完成监察食物供给中有害残留物的任务，”农业部监察办公室如此写道。此项审计报告指出美国农业部食品安全检验处（FSIS），连同食品药监局和环境保护局，“没能建立起针对许多危险物质的检验门槛（比如重金属铜元素以及二噁英），结果导致含有此类物质的肉类在市场上流通。”

更糟的是，联邦政府并未试图召回这些肉类食品，“即使经过检查证实其中含有过量的兽用药物成分，”审计报告中说明。

上周，我曾写了一些文章，表达我对奥巴马治下食品药监局继续实施布什时代提出的允许畜牧业将牛肉产品加入饲料这一规范（这有可能导致疯牛病的传播）的失望之情，主要包括：在小牛幼仔饲料中添加牛血，将潲水加入牛饲料，以及在肉用牛饲料中加入鸡粪——这种饲料中包含有禽类饲料的残渣，其中可能包括一些牛肉的副产品。

而且我们现在了解到美国的一些牛肉产品中含有重金属毒物，比如铜元素、砷元素，以及类似氟尼辛、盘尼西林和伊弗霉素的抗生素，还有许多农药残留——这些都是在集中型动物饲养经营（CAFOs）中所使用的，或者换个更为人所熟知的名字，工厂化农场。

以下发现读起来仿佛出自厄普顿·辛克莱尔百年前讲述肉类加工业可怖工作条件以及漠不关心的政府的著作《屠场》（The Jungle，揭露美国芝加哥肉类加工业的黑幕，更多信息看这里——译注）：

· 从牛肉中检验出的120种物质之中，只有一种是农药。

· 食品药监局并未为许多自牛肉中发现的药物、农药和重金属元素设立“容忍标准”——包括铜元素和砷元素在内，这些添加物可以促进牛只生长及杀灭某种寄生虫。

· 2008年，一船美国牛肉被墨西哥质监局拒绝入境，因为从中检验出超过墨西哥“容忍标准”的铜元素。这种食品在美国境内销售，却没有设定一个相关的容忍标准。

· 这份报告中列出了五种有害物质以及它们的潜在健康威胁，包括：

· 氟尼辛——可能导致便血、消化道糜烂溃疡和肾衰竭。

· 盘尼西林——可能引起致命的过敏反应，严重的神经损害和结肠炎，嘴唇、舌头和面部肿胀，出血和腹泻。

· 砷元素（砒霜）——可能导致良性的皮肤病，恶性皮肤肿瘤、体内恶性肿瘤，血管疾病和高血压。

· 铜元素——可能导致溶血症，黄疸，血脂病变，加速氧化衰老，肾功能障碍甚至死亡。

· 伊弗霉素——导致神经中毒（比如神经系统正常的活动发生病变，最终破坏或者杀死神经细胞及传导和处理大脑信号的关键性细胞）。

· 烹制肉类可以杀死病菌，但并不能消除残留物，甚至加热过程会使之分解“成为对人体更为有害的成分”。

· 超过90%的奶牛和肉用牛中被检测出残留物。奶牛肉通常最后被制成汉堡的夹馅，而肉用牛经常被喂食抗生素，以及那些经过传染病治疗的奶牛所产的无法销售的“坏牛奶”。

· 农业部食品安全检验处（FSIS）并未召回渗入有害残留物的牛肉，“即使他们已经获知这些肉类食品不能通过实验检验。”

· 肉类加工厂在销售含有非法级别药物的牛肉，可能导致“消费者肠胃、神经或皮肤的问题”，而FSIS并没有要求召回。

· FSIS解释说消费者“也许不会因为购买了某一种肉类而受到‘剧烈伤害’，”这让自愿召回都“难以为继”。

· 检测肉类中含有药物的方法“常常是过时且无效的，因为只有食品药监局核准了某种药物后，相关的检测方法才会被核准。”

· 采用新技术十分“困难”，而食品药监局“并不总是乐于或者有能力承担这项工作。”

· 个别工厂累积了总数为211项的违例，而且仍然认为没什么必要将残留物看做一个严重的问题。

· 肉类检测数据由兽体上的标签逐项收集，这是“一个迟缓笨重的系统，而且并不总是可靠的，”但是FSIS的官员未能认识到他们所采用的技术已经过时。

以上都是些坏消息，真正的坏消息。好消息是总监察办提供了14项推荐规范来解决最严重的问题，而且据闻FSIS表示同意。总的来说，他们要求农业部食品安全检验处、环境保护局和食品药监局做到：“1）扩大他们检查对象的范围，2）改进抽样检验有害残留物的方法，3）确定更为有效的方式以通过检测药品残留物的新方法，以及4）合作制定额外残留物的容忍标准。”

在一段激动人心、一扫官僚语调的陈述中，这份审计报告更进一步指出：“由于消费者无法轻易地对抗他们食品中的有害残留物质，进行自我保护，国家残留物检验规划在让含有有害物质的肉类远离餐桌方面尽可能地加强控制就显得特别重要。”

我们只能寄希望于美国农业部部长汤姆·维尔萨克，食品药监局主席玛格丽特·汉堡，环境保护局局长丽萨·杰克逊，奥巴马总统甚至其夫人米歇尔能很快进行一系列商讨并快速有效地贯彻实施这些改变。

我们也能寄希望于在乳制品、猪肉制品、禽类和蛋类制品方面类似针对整个产业的报告能尽快出炉。

说到奥巴马夫人，就像我今早在唐·伊姆斯的节目中说的那样，如果她确实想要保护我们下一代的营养健康，就得比种植一个有机菜园做得更多——她和她丈夫的政府应当承担更大的责任并完成之。

下面是一个适当的建议：在白宫南草坪上放牧一两只奶牛好为第一家庭提供有机、充足的牛奶、奶油、奶酪和酸奶，向他们的素食主义致意。（那么他们又从何得到肉食、牛奶和蛋类呢？）

另一个建议是不再用鸡粪作为奶牛饲料，防止“疯牛病—— 一种通过食物传染而发生率较低的疾病，”审计报告中提到：

FSIS的官员解释说消费某一类感染了疯牛病（牛棉状脑病）的动物制品有可能引入一种会导致新型克雅二氏病的病原体。尽管在美国，疯牛病的发生较在牛奶中渗入化学和药品残留物的情况要少得多，FSIS官员仍将之看做一个严重的问题，并且认为，与残留物引发的长期问题相比，疯牛病是实施召回的正当理由。

换句话说，（疯牛病的）传播是有可能的，只是我们没有经常虑及这个问题。因此，我们将会和这个可怕的问题狭路相逢了。

（本文作者）大卫·卡比是《动物工厂——产业化的猪肉、乳制品和家禽农场对人类和环境的威胁渐渐浮现》一书的作者—由圣马丁出版公司出版。

http://www.huffingtonpost.com/david-kirby/food-safety—-drugs-pois_b_537686.html

Drugs, Poisons and Metals in Our Meat — USDA Needs A Major Overhaul

David Kirby is author of Animal Factory – The Looming Threat of Industrial Pig, Dairy and Poultry Farms to Humans and the Environment – St. Martin’s Press.