Small Steps for Big Results For the past 30 years, my colleagues and I at the nonprofit Preventive Medicine Research Institu

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问题                     Small Steps for Big Results
    For the past 30 years, my colleagues and I at the nonprofit Preventive Medicine Research Institute and the School of Medicine at the University of California, San Francisco(UCSF), have conducted research showing how powerful changes in diet and lifestyle can be.

    In our studies, we’ve used the latest high technical measures to prove how powerful these very simple, low-tech and low-cost interventions can be.
    People often think an intervention has to be a new drug, a new laser or something really high-tech and expensive in order to be powerful. They often have a hard time believing that the simple choices that we make in our lives every day — what we eat, how we respond to stress, whether or not we smoke, how much we exercise and the quality of our relationships — can make such a powerful difference in our health, our well-being and even our survival. But they often do.
    It showed that comprehensive lifestyle changes may reverse the progression of coronary heart disease, prostate cancer, diabetes, hypertension, obesity and other chronic conditions. We found that instead of getting worse and worse, most people got better and better, and much more quickly than had once been thought possible.
    Along the way, we identified what really works to motivate people to make and maintain long-term changes in diet and lifestyle. What have we learned from this research and clinical research?
1. You have a wide spectrum of nutrition and lifestyle choices.
    It’s not all or nothing. To the degree you move in a healthful direction on this spectrum. You’re likely to feel better, look better, lose weight and gain health. People have different needs, goals and preferences. The medicine of the future is personalized medicine.
    What matters most is your overall way of eating and living. If you indulge yourself one day, you can eat more healthfully the next. If you’re a couch potato one day, exercise a little more the next. If you don’t have time to meditate for 20 minutes, do it for one minute — the consistency is more important than the duration. Then, you’re less likely to feel restricted. Studies have shown that those who eat the healthiest overall are the ones who allow themselves some indulgences.
    If you’re trying to reverse heart disease or prevent the recurrence of cancer(the "pound of cure"), then you probably need to make much bigger changes in diet and lifestyle than someone who just wants to lose a few pounds and is otherwise healthy(the "ounce of prevention"). If you want to lower your cholesterol(胆固醇)or blood pressure, you can begin by making moderate changes in diet and lifestyle. If that’s enough to achieve your goals, great; if not, then consider making bigger changes.
    For example, most people in this country have elevated cholesterol levels. They are initially advised to follow a diet based on the American Heart Association and National Cholesterol Education Program guidelines. For some, that’s sufficient to lower their cholesterol levels enough, but not for most people. Many are then told, "Sorry, it looks like diet didn’t work for you. " And they are prescribed cholesterol-lowering drugs, which they are told they will need to take for the rest of their lives. In reality, most people can make progressively bigger changes in nutrition and lifestyle to achieve their goals — often without medications.
2. Even more than feeling healthy, most people want to feel free and in control.
    The food police are counterproductive. If I tell people, "Eat mis and don’t eat that," or "Don’t smoke," they immediately want to do the opposite. It’s just human nature, and it goes back to the first dietary intervention that failed — "Don’t eat the apple" — and that was God talking, so we’re not likely to do better than that...
    If you go on a diet and feel constrained, you’re likely to go off it sooner or later. Offering a spectrum of choices is much more effective; then, you feel free. If you see your food choices each day as part of a spectrum, a way of living, then you are more likely to feel empowered.
3. Eating bad food does not make you a bad person.
    The language of behavioral modification often has a moralistic quality that turns off a lot of people(like " cheating" on a diet). It’s a small step from thinking of foods as "good" or "bad" to seeing yourself as a "good person" or a "bad person" if you eat these. The term "patient compliance" has a fascist, creepy quality to it, sounding like one person bending his or her will to another. Food is just food.
4. How you eat is as important as what you eat.
    If I eat mindlessly while watching television, reading or talking with someone else, I can go through an entire meal without tasting the food. The plate is empty, but I didn’t enjoy it; I had all of the calories and none of the pleasure. Instead, if I eat mindfully, paying attention to what I’m eating, smaller portions of food can be exquisitely satisfying. I can meditate on a single piece of dark chocolate.
    Also, when you pay attention to what you’re eating, you notice how different foods affect you, for better and for worse. More healthful foods make you feel good — light, clear, energetic. Less healthful foods make you feel bad — heavy, dull, sluggish. Then, it comes out of your own experience.
5. Joy of living is a much better motivator than fear of dying.
    Trying to scare people into changing doesn’t work very well. Telling someone that they’re likely to have a heart attack if they eat cheeseburgers or may get lung cancer if they don’t quit smoking doesn’t work very well. Efforts to motivate people to change based on fear of getting sick or dying prematurely are generally unsuccessful.
    Why? It’s too scary. We all know we’re going to die one day — the mortality rate is still 100 percent — but who wants to think about it? Even someone who has had a heart attack usually changes for only a few weeks before they go back to their old patterns of living and eating.
    When you change your diet and lifestyle, you feel good and look good. Your brain receives more blood and oxygen, so you think more clearly, have more energy and need less sleep. Your face gets more blood flow, so your skin glows more and wrinkles less. Your heart gets more blood flow, so you have more stamina and can even begin to reverse heart disease.
6. What we do eat is at least as important as what we don’t eat.
    There are at least a thousand substances that have anticancer, anti-heart-disease and anti-aging properties. Fruits, vegetables, whole grains, legumes, soy products and fish are rich in good carbohydrates, good fats, good proteins and other protective substances , leading to feelings of abundance rather than deprivation.
7. It’s important to address the deeper issues that underlie our behaviors.
    Information is not usually enough to motivate lasting changes. If it were, no one would smoke. We need to work at a deeper level. In our studies, I asked people, " Why do you smoke? Overeat? Drink too much? Work too hard? Abuse substances? Watch too much television? These behaviors seem so maladaptive to me. "
    They would reply, " You just don’t get it. These behaviors are very adaptive because they help us get through the day. " As I wrote in an earlier column, loneliness and depression are epidemic in our culture. If we address these deeper issues, then it becomes easier for people to make lasting changes in their behaviors.
How do most people reach their goal of lowering cholesterol in reality according to the passage?

选项 A、By making moderate changes in diet and lifestyle.
B、By making gradually bigger changes in diet and lifestyle.
C、By taking the medications for the rest of their lives.
D、By doing more exercise every day.

答案B

解析 该段最后一句提到,在现实生活中,多数人是通过在饮食和生活方面逐渐做出更大改变而达到他们的目标的,而不是通过服用药物,再根据前面提到的降低胆固醇的例子,因此可知[B]项与文意符合,[A]项与文中的in reality前提不符,[C]与文意不符,[D]项属于生活方面的改变,只是片面细节,不具概括性。
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