Amanda Fronk on the Gut Microbiome

The gut microbiome is a complex subject. Amanda Fronk’s article “Inside Micropolis” in the Fall 2018 issue of BYU Magazine is a nice distillation of some of the basics. All quotations in this post are from that article, with bullets to separate different passages.

First, just to persuade you of the importance of gut bacteria, consider the effects of transplanting gut bacteria from one creature to another by transplanting poop:

  • Consider this: Five years ago, Chinese researcher Liping Zhao and his team at Shanghai Jiao Tong University caused some mice in their lab to transform from healthy to obese in a matter of weeks, putting on four times the grams as their cage mates on a similar diet. How did they do it? By transplanting bacteria from the gut of a 385-pound, morbidly obese human.

  • … Clostridium difficile is a pathogenic bacteria that causes severe diarrhea and can lead to death. It often occurs after intense courses of antibiotics, which leaves the intestines susceptible to infection. “It’s hard to get rid of. There aren’t good [traditional] treatments,” says Chaston. He calls its cure—a fecal microbiota transplant—“the hallmark of microbiome treatment.” The transplant involves giving “an unhealthy person a healthy person’s poop,” Chaston explains. “We don’t know what’s in it. We just know that they get better.” Some 90 percent of transplant recipients recover, often within mere hours of the transplant.

Here are some theories about how gut bacteria could affect health:

  • Researchers aren’t sure exactly how Enterobacter cloacae B29 or any other bacterium causes obesity, but there are theories. One is that certain bacteria are masterful at squeezing calories from food.

  • Another idea is connected to the endotoxins that some bacteria release into the bloodstream. At high levels, these endotoxins can cause septicemia and often death, but at very low levels, it could lead to chronic inflammation throughout the body. What does that have to do with obesity? “Inflammation affects insulin signaling,” says Bridgewater. “And if insulin response isn’t working right, then people can be storing fuel that they should be burning.”

  • Bacteria also appear to play a part in mental illnesses like anxiety and depression. How can your intestines have anything to do with mental illness? First off, “90 percent of the serotonin in our body is actually made in the gut,” says Bridgewater. Serotonin is one of the key neurotransmitters our body uses to keep us emotionally balanced. And second, the vagus nerve, one of the biggest in the body, runs from the brain to the gut’s 100 million neurons.

The article has some reasonable advice for improving the health of gut microbiomes: let kids eat dirt (literally), eat greens consistently, reduce stress, and be careful in using antibiotics that could kill good gut bacteria. It also has a table listing characteristics of some important types of gut bacteria that I won’t try to retail.

Besides trying to identify antibiotics that kill bad gut bacteria but leave good gut bacteria unharmed, there are bacteria-killing viruses called “phages” that might be able to target bad gut bacteria while sparing good gut bacteria.

Overall, although there is plenty of evidence that the gut microbiome matters a lot, we are only beginning to understand what the gut microbiome does and all the interventions that might improve it. One thing that will make progress slower is that there are a huge number of different types of bacteria that can live in the human gut and the portfolio of different bacteria in given individuals vary enormously. Stay tuned for many more scientific results about the human gut microbiome in the coming years.

For annotated links to other posts on diet and health, see:

The Federalist Papers #27: People Will Get Used to the Federal Government—Alexander Hamilton

In the Federalist Papers #27, Alexander Hamilton argues that the federal government is likely to be acceptable enough to the people that it will seldom need to resort to full-out military force to establish its authority. In hindsight, the US Civil War and the Utah War (see “The Federalist Papers #17: Three Levels of Federal Power”) demonstrated that the federal government did, sometimes, take up war against a part of the United States. Nevertheless, there is a lot of merit to Alexander Hamilton’s arguments. Here is the Federalist Papers #27 in outline form:

  1. Why should the attitude toward the federal government be much different than to a state government? Won’t it depend on the quality of government?

  2. The federal government is likely to be of higher quality than state government because it can draw on a larger talent pool. Also, it is easier for a truly corrupt faction to take control of a smaller unit of government than a larger unit of government.

  3. The federal government is an important guarantor that state governments will follow their own constitutions.

  4. If the federal government interacts directly with all the people, rather than just with the state governments, the people will get used to it through those interactions.

  5. The federal government will be so powerful it will seldom need to actually use force against a part of the United States; the threat of force alone will typically be enough.

  6. People will see state government and federal government as being on par. And the power of state government and federal government will often be employed jointly, further impressing upon people the legitimacy of federal power.

I find the 4th point especially interesting. In 2021, people have one image of the federal government from news reports of decision-making in Washington, and another image from the parts of the federal government they directly interact or watch fictional enactments of: the FBI, the post office, the national parks, the Social Security Administration, the local Federal court, etc. I sense a lot of respect for the majority of those parts of the federal government people directly interact with. (The Internal Revenue Service—IRS—and Immigration and Customs Enforcement—ICE—are exceptions.) One of the more entertaining evidences of the gap between the perception of Washington DC decision-making and the perception of another arm of the federal government has been the signs saying “Government, keep your hands of my Medicare!”

All of this, in practice, increases deference to Federal government authority. We do not, in fact, see the federal government as one monolith (even if we think we do). We get used to the authority of different pieces of the federal government separately.

Despite the times when the federal government has had to take up arms against a part of the US, I think Alexander Hamilton could rightly feel vindicated in the how solid the perception of—and deference to—federal authority is in the United States.

To see how Alexander Hamilton lays out his argument in detail, below is the full text of the Federalist Papers #27, with my outline interspersed as headings in bold italics (and one footnote included where it appears in the text within square brackets).

FEDERALIST NO. 27

The Same Subject Continued: The Idea of Restraining the Legislative Authority in Regard to the Common Defense Considered

From the New York Packet
Tuesday, December 25, 1787.

Author: Alexander Hamilton

To the People of the State of New York:

1. Why should the attitude toward the federal government be much different than to a state government? Won’t it depend on the quality of government?

IT HAS been urged, in different shapes, that a Constitution of the kind proposed by the convention cannot operate without the aid of a military force to execute its laws. This, however, like most other things that have been alleged on that side, rests on mere general assertion, unsupported by any precise or intelligible designation of the reasons upon which it is founded. As far as I have been able to divine the latent meaning of the objectors, it seems to originate in a presupposition that the people will be disinclined to the exercise of federal authority in any matter of an internal nature. Waiving any exception that might be taken to the inaccuracy or inexplicitness of the distinction between internal and external, let us inquire what ground there is to presuppose that disinclination in the people. Unless we presume at the same time that the powers of the general government will be worse administered than those of the State government, there seems to be no room for the presumption of ill-will, disaffection, or opposition in the people. I believe it may be laid down as a general rule that their confidence in and obedience to a government will commonly be proportioned to the goodness or badness of its administration. It must be admitted that there are exceptions to this rule; but these exceptions depend so entirely on accidental causes, that they cannot be considered as having any relation to the intrinsic merits or demerits of a constitution. These can only be judged of by general principles and maxims.

2. The federal government is likely to be of higher quality than state government because it can draw on a larger talent pool. Also, it is easier for a truly corrupt faction to take control of a smaller unit of government than a larger unit of government.

Various reasons have been suggested, in the course of these papers, to induce a probability that the general government will be better administered than the particular governments; the principal of which reasons are that the extension of the spheres of election will present a greater option, or latitude of choice, to the people; that through the medium of the State legislatures which are select bodies of men, and which are to appoint the members of the national Senate there is reason to expect that this branch will generally be composed with peculiar care and judgment; that these circumstances promise greater knowledge and more extensive information in the national councils, and that they will be less apt to be tainted by the spirit of faction, and more out of the reach of those occasional ill-humors, or temporary prejudices and propensities, which, in smaller societies, frequently contaminate the public councils, beget injustice and oppression of a part of the community, and engender schemes which, though they gratify a momentary inclination or desire, terminate in general distress, dissatisfaction, and disgust. Several additional reasons of considerable force, to fortify that probability, will occur when we come to survey, with a more critical eye, the interior structure of the edifice which we are invited to erect. It will be sufficient here to remark, that until satisfactory reasons can be assigned to justify an opinion, that the federal government is likely to be administered in such a manner as to render it odious or contemptible to the people, there can be no reasonable foundation for the supposition that the laws of the Union will meet with any greater obstruction from them, or will stand in need of any other methods to enforce their execution, than the laws of the particular members.

3. The federal government is an important guarantor that state governments will follow their own constitutions.

The hope of impunity is a strong incitement to sedition; the dread of punishment, a proportionably strong discouragement to it. Will not the government of the Union, which, if possessed of a due degree of power, can call to its aid the collective resources of the whole Confederacy, be more likely to repress the FORMER sentiment and to inspire the LATTER, than that of a single State, which can only command the resources within itself? A turbulent faction in a State may easily suppose itself able to contend with the friends to the government in that State; but it can hardly be so infatuated as to imagine itself a match for the combined efforts of the Union. If this reflection be just, there is less danger of resistance from irregular combinations of individuals to the authority of the Confederacy than to that of a single member.

4. If the federal government interacts directly with all the people, rather than just with the state governments, the people will get used to it through those interactions.

I will, in this place, hazard an observation, which will not be the less just because to some it may appear new; which is, that the more the operations of the national authority are intermingled in the ordinary exercise of government, the more the citizens are accustomed to meet with it in the common occurrences of their political life, the more it is familiarized to their sight and to their feelings, the further it enters into those objects which touch the most sensible chords and put in motion the most active springs of the human heart, the greater will be the probability that it will conciliate the respect and attachment of the community. Man is very much a creature of habit. A thing that rarely strikes his senses will generally have but little influence upon his mind. A government continually at a distance and out of sight can hardly be expected to interest the sensations of the people. The inference is, that the authority of the Union, and the affections of the citizens towards it, will be strengthened, rather than weakened, by its extension to what are called matters of internal concern; and will have less occasion to recur to force, in proportion to the familiarity and comprehensiveness of its agency. The more it circulates through those channls and currents in which the passions of mankind naturally flow, the less will it require the aid of the violent and perilous expedients of compulsion.

5. The federal government will be so powerful it will seldom need to actually use force against a part of the United States; the threat of force alone will typically be enough.

One thing, at all events, must be evident, that a government like the one proposed would bid much fairer to avoid the necessity of using force, than that species of league contend for by most of its opponents; the authority of which should only operate upon the States in their political or collective capacities. It has been shown that in such a Confederacy there can be no sanction for the laws but force; that frequent delinquencies in the members are the natural offspring of the very frame of the government; and that as often as these happen, they can only be redressed, if at all, by war and violence.

6. People will see state government and federal government as being on par. And the power of state government and federal government will often be employed jointly, further impressing upon people the legitimacy of federal power.

The plan reported by the convention, by extending the authority of the federal head to the individual citizens of the several States, will enable the government to employ the ordinary magistracy of each, in the execution of its laws. It is easy to perceive that this will tend to destroy, in the common apprehension, all distinction between the sources from which they might proceed; and will give the federal government the same advantage for securing a due obedience to its authority which is enjoyed by the government of each State, in addition to the influence on public opinion which will result from the important consideration of its having power to call to its assistance and support the resources of the whole Union. It merits particular attention in this place, that the laws of the Confederacy, as to the ENUMERATED and LEGITIMATE objects of its jurisdiction, will become the SUPREME LAW of the land; to the observance of which all officers, legislative, executive, and judicial, in each State, will be bound by the sanctity of an oath. Thus the legislatures, courts, and magistrates, of the respective members, will be incorporated into the operations of the national government AS FAR AS ITS JUST AND CONSTITUTIONAL AUTHORITY EXTENDS; and will be rendered auxiliary to the enforcement of its laws.[The sophistry which has been employed to show that this will tend to the destruction of the State governments, will, in its will, in its proper place, be fully detected.] Any man who will pursue, by his own reflections, the consequences of this situation, will perceive that there is good ground to calculate upon a regular and peaceable execution of the laws of the Union, if its powers are administered with a common share of prudence. If we will arbitrarily suppose the contrary, we may deduce any inferences we please from the supposition; for it is certainly possible, by an injudicious exercise of the authorities of the best government that ever was, or ever can be instituted, to provoke and precipitate the people into the wildest excesses. But though the adversaries of the proposed Constitution should presume that the national rulers would be insensible to the motives of public good, or to the obligations of duty, I would still ask them how the interests of ambition, or the views of encroachment, can be promoted by such a conduct?

PUBLIUS.

Links to my other posts on The Federalist Papers so far:

Why Thinking Geometrically and Graphically is Such a Powerful Way to Do Math

I am currently teaching my favorite course: “The Economics of Risk and Time.” I love the challenge of making math that could have been very difficult easier. To do that, I use geometry, graphs and diagrams as much as possible. I not only find trying to use pictures helpful for myself, I recommend it to my students when they are working on problems.

Why are pictures (geometry, graphs and diagrams) so helpful in doing math—at least for those who have developed their skill in using pictures to do math? I think brain science and evolutionary psychology together give a good answer. Because our ancestors a few million years back lived in the trees, there was a great survival advantage to visual processing to see a branch to catch and to see fruit to grab. As a consequence, those of us who remain inherited genes for a large visual processing region in our brains. If you can bring that visual processing region to bear on math problems, you will be bringing a lot more brain-power to bear. That will make you smarter at math.

For me, a big side-benefit of taking a geometric and pictorial approach to math is the enjoyment I get from the images in my head as I consider the math. It is remarkably similar to the enjoyment I get from looking at great visual art, which is a big deal for me, as you can tell from half of my tweets being retweets of great art.

I have links to many other posts on math in my post “Gabriela D'Souza on Failure in Learning Math”

Why Leptin Isn't a Blockbuster Weight-Loss Drug

As I have said before, I want to point all of my readers interested in diet and health to Peter Attia’s podcasts (“The Drive”). Peter and I have similar perspectives, and where we differ, I agree with him rather than myself.

One way in which I can contribute, even given what Peter has done with his podcast is by shining a spotlight on a few key things in the wealth of information Peter and his guests provide.

In #33, Peter’s interview with Rudy Leibel, I was fascinated by their discussion of why Leptin did not turn out to be the blockbuster weight-loss drug that Pharma hoped it would be. There is a mechanistic reason and an evolutionary reason.

Mechanistically, very low levels of leptin make people want to eat more. But above-normal levels of leptin don’t make people want to eat less. (The same is true for rodents, where this was first discovered.)

Evolutionarily, Peter Attia and Rudy Leibel agreed that signaling when an individual has too little body fat is a much more pressing evolutionary problem than signaling when an individual has too much. So it isn’t terribly surprising that leptin is designed to signal when there is too little body fat by low leptin levels and doesn’t do much of anything to signal when there is too much body fat—especially high leptin levels aren’t treated is much of a signal at all.

In order to signal that there is enough body fat, leptin is a hormone for fat cells to call out “I’m here.” As long as the roll call of fat cells is adequate, the body doesn’t do much with even higher leptin levels.

For those rare individuals who have leptin deficiency, administering leptin can indeed cure obesity. But for most people who are overweight or obese, leptin deficiency is not the problem. There are examples of things which can be the cure of a problem even if they have little to do with the cause. (For example, deep negative interest rates can cure aggregate demand problems caused by deleveraging.) Leptin is not one of them: it only cures obesity if lack of leptin is the cause of that obesity.

Update March 16, 2021: Later on in the podcast, there is a hint that leptin might be helpful in maintaining weight loss. The muscles of those who had lost weight seemed to become more metabolically efficient, thereby burning fewer calories. Leptin injections, presumably by creating the illusion to the body of more body fat than was actually there, resulted in less increase in the metabolic efficiency of the muscles.

But even if this is, in fact, helpful in maintaining weight loss, I have wondered if greater metabolic efficiency of healthy cells combined with regular fasting might be an important cancer preventative, since greater metabolic efficiency of healthy cells increases their metabolic advantage over cancer cells, which are typically metabolically handicapped.

For annotated links to other posts on diet and health, see:

There is a section of links on anti-cancer eating that are relevant to the March 16, 2021 update above.

On the Oppression of Women

Melinda Gates’s book The Moment of Lift comes under criticism from Lily Meyer in her NPR blog post “'The Moment Of Lift' Is More Of A Whisper Than A Call To Action” for not being strident enough—and for focusing on other dimensions of women’s empowerment than abortion rights. But I, for one, am glad to have a book that tries to speak to those with a wide range of different political and religious views.

And, in addition to her message that women need to be treated better (the stories about the horrors of child marriage are especially powerful), Melinda Gates has another crucial message that should not be missed: individuals and communities have to be deeply understood in order to be deeply helped. Let me illustrate with a few quotations from The Moment of Lift.

I’ll start with two simple examples of a cultural fact that those from European-derived cultures might not guess: in many cultures, work that requires a lot of brute force and physical strength is women’s work. Here is Hans Rosling’s story:

Hans Rosling once told me [Melinda] a story that helps make the point. He was working with several women in a village in the Congo to test the nutritional value of cassava roots. They were harvesting the roots, marking them with a number, and putting them into baskets to take them down to the pond to soak. They filled three baskets. One woman carried off the first basket, another woman carried the second basket, and Hans carried the third. They walked single file down the path, and a minute later, as they all put down their baskets, one of the women turned around, saw Hans’s basket, and shrieked as if she’d seen a ghost. “How did this get here?!”

“I carried it,” Hans said.

“You can’t carry it!” she shouted. “You’re a man!”

Congolese men don’t carry baskets.

Importantly, in many extremely poor countries, a large share of the farming is done by women, who are hobbled in that endeavor by their cultures:

A landmark 2011 study from the UN’s Food and Agriculture Organization showed that women farmers in developing countries achieve 20–30 percent lower yields than men even though they are just as good at farming. The women underproduce because they do not have the access to the resources and information that men do. If they had the same resources, they would have the same yields.

Melinda tells the story of how a careful program of community discussion and persuasion did more to end genital cutting of young women in one region than coming from a stance of outrage would have done:

Molly Melching has spent her life proving that point. Molly is another one of my teachers. I told you about her earlier. We met in the summer of 2012, and she showed me one of the best approaches I’ve ever seen for challenging long-standing cultural practices.

I joined Molly in a town in Senegal, and we drove out together to a rural area to see the community empowerment program she runs there. As we spent an hour or so on the drive, Molly told me about coming to Senegal as an exchange student to refine her French in the 1970s. She quickly fell in love with the Senegalese people and culture—so much so that she decided to learn the local language, Wolof, as well.

Even while she loved the country, though, she noticed how difficult it was to be a girl there. Many girls in Senegal have their genitals cut very young—usually between 3 and 5 years of age. Many are married very young and are encouraged to have children quickly and often. Outside groups had tried to change these practices, but no one succeeded, and Molly found herself in a position to see why.

She became a translator for development programs, serving as the link between villagers and outsiders who wanted to help. She quickly saw that there was more than a language barrier dividing these two groups. There was an empathy barrier. The outsiders showed little skill in projecting themselves into the lives of the people they wanted to help, and they had little interest in trying to understand why something was being done in a certain way. They didn’t even have the patience to explain to villagers why they thought something should change.

On our drive out, Molly explained to me that the empathy barrier stymies all efforts in development. Agricultural equipment that had been donated was rusting out, health clinics were sitting empty, and customs like female genital cutting and child marriage continued unchanged. Molly told me that people often get outraged by certain practices in developing countries and want to rush in and say, “This is harmful! Stop it!’” But that’s the wrong approach. Outrage can save one girl or two, she told me. Only empathy can change the system.

Also, those being helped often have a different—and because it is their lives, more authoritative—ranking of priorities than those who want to help. The Gates foundation began by wanting to get sex workers in India to use condoms in order to slow the spread of AIDS. Here is the reaction they received:

“We don’t need your help with condoms,” they said, almost laughing. “We’ll teach you about condoms. We need help preventing violence.”

“But that’s not what we do,” our people said. And the sex workers answered, “Well, then you don’t have anything interesting to tell us, because that’s what we need.”

So our team held debates about what to do. Some said, “Either we rethink our approach or we shut this down.” Others said, “No, this is mission creep—we have no expertise in this area, and we shouldn’t get involved.”

Eventually, our team met again with the sex workers and listened intently as they talked about their lives, and the sex workers emphasized two things: One, preventing violence is their first and most urgent concern; two, fear of violence keeps them from using condoms.

Clients would beat up the women if they insisted on condoms. The police would beat them up if they were carrying condoms—because it proved they were sex workers. So to avoid getting beaten up, they wouldn’t carry condoms. Finally we saw the connection between preventing violence and preventing HIV. The sex workers couldn’t address the long-term threat of dying from AIDS unless they could address the near-term threat of being beaten, robbed, and raped.

So instead of saying, “It’s beyond our mandate,” we said, “We want to help protect you from violence. How can we do that?”

They said, “Today or tomorrow, one of us is going to get raped or beaten up by the police. It happens all the time. If we can get a dozen women to come running whenever this happens, the police will stop doing it.” So our team and the sex workers set up a system. If a woman is attacked by the police, she dials a three-digit code, the code rings on a central phone, and twelve to fifteen women come to the police station yelling and shouting. And they come with a pro bono lawyer and a media person. If a dozen women show up shouting, “We want her out now or there’s going to be a story in the news tomorrow!” the police will back down. They will say, “We didn’t know. We’re sorry.”

That was the plan, and that’s what the sex workers did. They set up a speed-dial network, and when it was triggered, the women came running. It worked brilliantly. One sex worker reported that she had been beaten up and raped in a police station a year before. After the new system was in place, she went back to the same police station and the policeman offered her a chair and a cup of tea. Once word of this program got out, sex workers in the next town came and said, “We want to join that violence prevention program, not the HIV thing,” and soon the program spread all over India.

Unlike Lily Meyer, I think Melinda’s book uses the quiet statement of horrific facts to powerful effect. The truth about the oppression of women is so stark that it doesn’t have to be shouted if someone is reading the book. And more of the people whose eyes would be opened by reading it are likely to read the book because it isn’t strident.

Miles Confronts a Freedom-of-Speech Issue; The Roots of Anti-Semitism

Teaching Assistant: The student clearly meant no harm, but this post has me worried that significant offense could be taken since it treads on an uber-touchy topic with at least some degree of clumsiness. I wonder if we should hide this one just to make sure no hackles unintentionally get raised. 

Miles: I am torn between the sensibleness of your suggestion and a commitment to freedom of speech. I think I come down on the side of freedom of speech.  How about this for a solution? What if both you and I add in public comments pointing out how to say the content with more grace? Then rather than smushing speech, we are helping teach how to talk about sensitive subjects while giving a minimum of offense consistent with being able to talk about issues. By the way, I assume that this was an MLK day post? Otherwise it is rather distant from economics.

Miles: Whenever writing about hatred of a broad group and its sources, it is important to go the extra mile to make clear, repeatedly, that the hatred is not justified. (I don’t have any problem saying that, without exception, I can’t think of any case when hatred of a broad group *is* justified. That is a view I could defend in detail.)

To me, it seems to me a big fallacy that hatred of groups comes from what they actually did. Hatred of an individual one has dealt with directly may come from what that person actually did, but hatred of large groups almost never does. It comes from the stories that are told about that group.

I agree with Ed Glaeser, who wrote:

“What determines the intensity and objects of hatred? Hatred forms when people believe that out-groups are responsible for past and future crimes, but the reality of past crimes has little to do with the level of hatred. Instead, hatred is the result of an equilibrium where politicians supply stories of past atrocities in order to discredit the opposition and consumers listen to them.”

This is from my post “John Stuart Mill on Being Offended at Other People’s Opinions or Private Conduct.” http://blog.supplysideliberal.com/post/105750762661/john-stuart-mill-on-being-offended-at-other

The example Ed Glaeser gives is that in the South after the civil war, there were many stories of African-American men raping Caucasian women that were meant to stir up hatred against African Americans. But what was the reality? In fact, Caucasian men in that era often raped African-American women with impunity, and certainly had done so while slavery was still supported by law. Rape of Caucasian women by African-American men was quite rare in comparison. So the hatred based on these stories was not based on reality. It was based on the stories that politicians and others propagated–precisely with the aim of making people hate African-Americans for the sake of political gain.

Similarly, for thousands of years, there has been political gain to be had from fomenting hatred of Jewish people. I think it is to this political gain from fomenting hatred of Jewish people that one can turn for the explanation of anti-Semitism. A careful analysis could identify easily exactly why there has been political gain to be had from fostering hatred of Jewish people. To me, that would be the most powerful kind of explanation for anti-Semitism.

Starving Cancer Cells: We Need Metabolic Oncology, Stat!

I write about Thomas Seyfried’s work in “How Fasting Can Starve Cancer Cells, While Leaving Normal Cells Unharmed.” I wanted to also highlight Peter Attia’s podcast interview of Thomas Seyfried.

What is most exciting beyond what I say in “How Fasting Can Starve Cancer Cells, While Leaving Normal Cells Unharmed” is that Thomas Seyfried’s recommendations are, albeit very slowly, making their way into clinical practice, most fully in Turkey.

Here is the summary of what Thomas Seyfried recommends and why. Most cancer cells are metabolically handicapped, typically with quite clear damage to their mitochondria. One can argue about whether the mitochondrial damage came first, leading to inaccurate gene preservation and replication, or whether errant genes came first leading to mitochondrial damage. But whatever the reason cancer cells have mitochondrial damage, it opens the door to metabolic therapies that disadvantage cancer cells relative to normal cells. These metabolic therapies can often be better targeted toward harming cancer cells and leaving normal cells unharmed than the typical chemotherapy.

The technical terms are confusing, but there are two categories of reactions that provide energy to a cell: “fermentation” reactions that don’t need oxygen and “respiration” reactions that do need oxygen. Cancer cells rely heavily (and often almost exclusively) on “fermentation” reactions, even when oxygen is available.

The key “fermentation” reactions take glucose (blood sugar) and glutamine (a common amino acid contained in many proteins and one that the human body itself can make).

Fasting and a ketogenic diet can do a lot to reduce blood sugar and thereby starve cancer cells. Drug treatment can push blood sugar down further and starve cancer cells more. Normal cells don’t need blood sugar since they can live off of ketones.

Pushing glutamine down has to be done by drug treatment, and needs to be done intermittently, since the normal cells need glutamine, too, though not as much as cancer cells do.

Ideally, Thomas Seyfried argues,

  • metabolic treatment should be pursued for a few weeks before surgery in order to shrink the tumor and give it less fuzzy boundaries, making surgery easier and more effective.

  • He argues that radiation can exacerbate cancer and should be avoided.

  • Instead of radiation, he recommends treatment with hyperbaric oxygen at 2.5 times atmospheric pressure, which stresses out cancer cells and cleans up the bad blood vessels feeding the cancer cells, and isn’t too hard on normal cells.

  • Steroids, often used to treat cancer, have the unfortunate effect of raising blood sugar, making more nutrients available for the sugar-hungry cancer cells.

  • Chemotherapy does not directly conflict with metabolic therapy, but can be quite harsh in its side effects.

I hope that many doctors listen to this podcast so that metabolic cancer therapies will begin to become more available. As I mentioned in “How Fasting Can Starve Cancer Cells, While Leaving Normal Cells Unharmed,” there are many clinical trial investigating types of metabolic cancer therapies, though there aren’t yet clinical trials of exactly what Thomas Seyfried recommends. The idea that it is unethical not to do surgery, radiation and chemotherapy right away stands in the way of trying out metabolic therapy as the primary approach. Two cases seem especially favorable for trying out metabolic therapy as the primary approach:

  • cancers that have been almost certain death sentences even when treated with surgery, radiation and chemotherapy and

  • cancers detected very early or quite slow growing, so that an acceptable option of “watchful waiting” can be traded in for metabolic therapy.

In the interview, Peter Attia identifies that Thomas Seyfried, while excellent on the science, is not the ideal advocate for this extremely promising but also quite radical new approach to cancer. The cause of metabolic oncology (cancer medicine) could really use additional talented advocates with the right credentials.

I find Thomas Seyfried’s basic argument quite convincing. It could make a big difference to how many people die of cancer if borne out. It deserves a real chance to prove itself.

For annotated links to other posts on diet and health, see:

The Federalist Papers #26: Some Part of the Government Must Be Able to Authorize an Army Whenever Necessary, after Being Forced to Fully Debate the Issue—Alexander Hamilton

In the Federalist Papers #26, Alexander Hamilton argues there is little precedent for limiting a legislature’s authority to raise an army whenever it sees a necessity to do that. There is indeed good precedent for not allowing the executive to authorize an army; that is very different from not allowing the legislature to authorize an army whenever necessary.

Alexander Hamilton also goes a bit overboard in arguing for the constitutional provision that the legislature must reauthorize funding for an army at least every two years as a protection against an army designed to overthrow the legitimate order of government. Here is the passage where Alexander Hamilton makes a claim that does not ring true with modern experience:

It has been said that the provision which limits the appropriation of money for the support of an army to the period of two years would be unavailing, because the Executive, when once possessed of a force large enough to awe the people into submission, would find resources in that very force sufficient to enable him to dispense with supplies from the acts of the legislature. But the question again recurs, upon what pretense could he be put in possession of a force of that magnitude in time of peace?

Even if the US had a period with no active wars, it would have a large military given all the potential dangers in the world and the vast responsibilities it has taken upon itself in the world. And unless the US military were much smaller than it is now, it could easily “awe the people into submission.” The key safeguard of our constitutional order now is not a small miliitary, but inculcating in the members of our military a loyalty to the US Constitution above their loyalty to their commander in chief. (I also talk about this in “The Federalist Papers #22 C: Pillars of Democracy—The Judicial System, Military Loyal to the Constitution, and Police Loyal to the Constitution.”)

Here is the full text of the Federalist Papers #26:

FEDERALIST NO. 26

The Idea of Restraining the Legislative Authority in Regard to the Common Defense Considered

For the Independent Journal.

Author: Alexander Hamilton

To the People of the State of New York:

IT WAS a thing hardly to be expected that in a popular revolution the minds of men should stop at that happy mean which marks the salutary boundary between POWER and PRIVILEGE, and combines the energy of government with the security of private rights. A failure in this delicate and important point is the great source of the inconveniences we experience, and if we are not cautious to avoid a repetition of the error, in our future attempts to rectify and ameliorate our system, we may travel from one chimerical project to another; we may try change after change; but we shall never be likely to make any material change for the better.

The idea of restraining the legislative authority, in the means of providing for the national defense, is one of those refinements which owe their origin to a zeal for liberty more ardent than enlightened. We have seen, however, that it has not had thus far an extensive prevalency; that even in this country, where it made its first appearance, Pennsylvania and North Carolina are the only two States by which it has been in any degree patronized; and that all the others have refused to give it the least countenance; wisely judging that confidence must be placed somewhere; that the necessity of doing it, is implied in the very act of delegating power; and that it is better to hazard the abuse of that confidence than to embarrass the government and endanger the public safety by impolitic restrictions on the legislative authority. The opponents of the proposed Constitution combat, in this respect, the general decision of America; and instead of being taught by experience the propriety of correcting any extremes into which we may have heretofore run, they appear disposed to conduct us into others still more dangerous, and more extravagant. As if the tone of government had been found too high, or too rigid, the doctrines they teach are calculated to induce us to depress or to relax it, by expedients which, upon other occasions, have been condemned or forborne. It may be affirmed without the imputation of invective, that if the principles they inculcate, on various points, could so far obtain as to become the popular creed, they would utterly unfit the people of this country for any species of government whatever. But a danger of this kind is not to be apprehended. The citizens of America have too much discernment to be argued into anarchy. And I am much mistaken, if experience has not wrought a deep and solemn conviction in the public mind, that greater energy of government is essential to the welfare and prosperity of the community.

It may not be amiss in this place concisely to remark the origin and progress of the idea, which aims at the exclusion of military establishments in time of peace. Though in speculative minds it may arise from a contemplation of the nature and tendency of such institutions, fortified by the events that have happened in other ages and countries, yet as a national sentiment, it must be traced to those habits of thinking which we derive from the nation from whom the inhabitants of these States have in general sprung.

In England, for a long time after the Norman Conquest, the authority of the monarch was almost unlimited. Inroads were gradually made upon the prerogative, in favor of liberty, first by the barons, and afterwards by the people, till the greatest part of its most formidable pretensions became extinct. But it was not till the revolution in 1688, which elevated the Prince of Orange to the throne of Great Britain, that English liberty was completely triumphant. As incident to the undefined power of making war, an acknowledged prerogative of the crown, Charles II. had, by his own authority, kept on foot in time of peace a body of 5,000 regular troops. And this number James II. increased to 30,000; who were paid out of his civil list. At the revolution, to abolish the exercise of so dangerous an authority, it became an article of the Bill of Rights then framed, that "the raising or keeping a standing army within the kingdom in time of peace, UNLESS WITH THE CONSENT OF PARLIAMENT, was against law."

In that kingdom, when the pulse of liberty was at its highest pitch, no security against the danger of standing armies was thought requisite, beyond a prohibition of their being raised or kept up by the mere authority of the executive magistrate. The patriots, who effected that memorable revolution, were too temperate, too wellinformed, to think of any restraint on the legislative discretion. They were aware that a certain number of troops for guards and garrisons were indispensable; that no precise bounds could be set to the national exigencies; that a power equal to every possible contingency must exist somewhere in the government: and that when they referred the exercise of that power to the judgment of the legislature, they had arrived at the ultimate point of precaution which was reconcilable with the safety of the community.

From the same source, the people of America may be said to have derived an hereditary impression of danger to liberty, from standing armies in time of peace. The circumstances of a revolution quickened the public sensibility on every point connected with the security of popular rights, and in some instances raise the warmth of our zeal beyond the degree which consisted with the due temperature of the body politic. The attempts of two of the States to restrict the authority of the legislature in the article of military establishments, are of the number of these instances. The principles which had taught us to be jealous of the power of an hereditary monarch were by an injudicious excess extended to the representatives of the people in their popular assemblies. Even in some of the States, where this error was not adopted, we find unnecessary declarations that standing armies ought not to be kept up, in time of peace, WITHOUT THE CONSENT OF THE LEGISLATURE. I call them unnecessary, because the reason which had introduced a similar provision into the English Bill of Rights is not applicable to any of the State constitutions. The power of raising armies at all, under those constitutions, can by no construction be deemed to reside anywhere else, than in the legislatures themselves; and it was superfluous, if not absurd, to declare that a matter should not be done without the consent of a body, which alone had the power of doing it. Accordingly, in some of these constitutions, and among others, in that of this State of New York, which has been justly celebrated, both in Europe and America, as one of the best of the forms of government established in this country, there is a total silence upon the subject.

It is remarkable, that even in the two States which seem to have meditated an interdiction of military establishments in time of peace, the mode of expression made use of is rather cautionary than prohibitory. It is not said, that standing armies SHALL NOT BE kept up, but that they OUGHT NOT to be kept up, in time of peace. This ambiguity of terms appears to have been the result of a conflict between jealousy and conviction; between the desire of excluding such establishments at all events, and the persuasion that an absolute exclusion would be unwise and unsafe.

Can it be doubted that such a provision, whenever the situation of public affairs was understood to require a departure from it, would be interpreted by the legislature into a mere admonition, and would be made to yield to the necessities or supposed necessities of the State? Let the fact already mentioned, with respect to Pennsylvania, decide. What then (it may be asked) is the use of such a provision, if it cease to operate the moment there is an inclination to disregard it?

Let us examine whether there be any comparison, in point of efficacy, between the provision alluded to and that which is contained in the new Constitution, for restraining the appropriations of money for military purposes to the period of two years. The former, by aiming at too much, is calculated to effect nothing; the latter, by steering clear of an imprudent extreme, and by being perfectly compatible with a proper provision for the exigencies of the nation, will have a salutary and powerful operation.

The legislature of the United States will be OBLIGED, by this provision, once at least in every two years, to deliberate upon the propriety of keeping a military force on foot; to come to a new resolution on the point; and to declare their sense of the matter, by a formal vote in the face of their constituents. They are not AT LIBERTY to vest in the executive department permanent funds for the support of an army, if they were even incautious enough to be willing to repose in it so improper a confidence. As the spirit of party, in different degrees, must be expected to infect all political bodies, there will be, no doubt, persons in the national legislature willing enough to arraign the measures and criminate the views of the majority. The provision for the support of a military force will always be a favorable topic for declamation. As often as the question comes forward, the public attention will be roused and attracted to the subject, by the party in opposition; and if the majority should be really disposed to exceed the proper limits, the community will be warned of the danger, and will have an opportunity of taking measures to guard against it. Independent of parties in the national legislature itself, as often as the period of discussion arrived, the State legislatures, who will always be not only vigilant but suspicious and jealous guardians of the rights of the citizens against encroachments from the federal government, will constantly have their attention awake to the conduct of the national rulers, and will be ready enough, if any thing improper appears, to sound the alarm to the people, and not only to be the VOICE, but, if necessary, the ARM of their discontent.

Schemes to subvert the liberties of a great community REQUIRE TIME to mature them for execution. An army, so large as seriously to menace those liberties, could only be formed by progressive augmentations; which would suppose, not merely a temporary combination between the legislature and executive, but a continued conspiracy for a series of time. Is it probable that such a combination would exist at all? Is it probable that it would be persevered in, and transmitted along through all the successive variations in a representative body, which biennial elections would naturally produce in both houses? Is it presumable, that every man, the instant he took his seat in the national Senate or House of Representatives, would commence a traitor to his constituents and to his country? Can it be supposed that there would not be found one man, discerning enough to detect so atrocious a conspiracy, or bold or honest enough to apprise his constituents of their danger? If such presumptions can fairly be made, there ought at once to be an end of all delegated authority. The people should resolve to recall all the powers they have heretofore parted with out of their own hands, and to divide themselves into as many States as there are counties, in order that they may be able to manage their own concerns in person.

If such suppositions could even be reasonably made, still the concealment of the design, for any duration, would be impracticable. It would be announced, by the very circumstance of augmenting the army to so great an extent in time of profound peace. What colorable reason could be assigned, in a country so situated, for such vast augmentations of the military force? It is impossible that the people could be long deceived; and the destruction of the project, and of the projectors, would quickly follow the discovery.

It has been said that the provision which limits the appropriation of money for the support of an army to the period of two years would be unavailing, because the Executive, when once possessed of a force large enough to awe the people into submission, would find resources in that very force sufficient to enable him to dispense with supplies from the acts of the legislature. But the question again recurs, upon what pretense could he be put in possession of a force of that magnitude in time of peace? If we suppose it to have been created in consequence of some domestic insurrection or foreign war, then it becomes a case not within the principles of the objection; for this is levelled against the power of keeping up troops in time of peace. Few persons will be so visionary as seriously to contend that military forces ought not to be raised to quell a rebellion or resist an invasion; and if the defense of the community under such circumstances should make it necessary to have an army so numerous as to hazard its liberty, this is one of those calamaties for which there is neither preventative nor cure. It cannot be provided against by any possible form of government; it might even result from a simple league offensive and defensive, if it should ever be necessary for the confederates or allies to form an army for common defense.

But it is an evil infinitely less likely to attend us in a united than in a disunited state; nay, it may be safely asserted that it is an evil altogether unlikely to attend us in the latter situation. It is not easy to conceive a possibility that dangers so formidable can assail the whole Union, as to demand a force considerable enough to place our liberties in the least jeopardy, especially if we take into our view the aid to be derived from the militia, which ought always to be counted upon as a valuable and powerful auxiliary. But in a state of disunion (as has been fully shown in another place), the contrary of this supposition would become not only probable, but almost unavoidable.

PUBLIUS.

Links to my other posts on The Federalist Papers so far:

Critiquing the Wall Street Journal Editorial Pages on Fiscal Policy

The Wall Street Journal Editorial Board demonstrates a lack of clarity on fiscal policy in its February 12, 2021 op-ed “The Pandemic Spending Hangover.” Consider the following passages from this op-ed. First:

CBO says federal spending reached $6.55 trillion in fiscal 2020, as Congress addressed the damage from Covid-19 and the government shutdowns. That’s about a $2.1 trillion increase in a single year, and understandably so given the uncertainty of the threat as it emerged in the spring. Notably, and in a pleasant surprise, revenue fell a mere 1.2% to $3.42 trillion as the economy held up better than expected. The deficit came in at a staggering $3.13 trillion, or a record 14.9% of GDP.

The Editorial Board expresses surprise that revenue didn’t fall that much. What they don’t mention is that the fiscal stimulus probably had a lot to do with keeping revenue up by keeping GDP from cratering worse than it did.

Second:

Debt held by the public—the kind the government has to pay back—broke above 100% of the economy in fiscal 2020. Even without new Biden spending, CBO says it will reach 102.3% in fiscal 2021.

…

How much debt is too much, and when does it begin to have corrosive economic consequences? No one knows, but one economic benchmark for harm has been 90% of GDP. We’ve never been preoccupied with debt, since the main focus of economic policy should be growth and broad prosperity.

This idea that above 90% of GDP is known to be dangerous is a zombie myth. (I disagree with Paul Krugman on many things, but he has been right in calling this a zombie myth.) This myth comes from Carmen Reinhart and Ken Rogoff’s badly flawed analysis, and hasn’t been updated in the Wall Street Journal Editorial Board’s minds since it came into question. To see how badly flawed, read my two columns coauthored with Yichuan Wang:

I have no doubt that there is some level of the debt-to-GDP ratio that will lead to bad outcomes but the fact that Japan has had a debt-to-GDP ratio of about 200% for some time without being able to get inflation up when they want to get inflation up should give one pause in thinking that a bit above a 100% debt-to-GDP ratio will be highly inflationary in the US.

(I should also mention that the appropriate measure of the debt-to-GDP should be higher, including the debt held by the Fed. Why? When interest rates finally do go back up, the Fed will either have to sell that debt or it will have to pay interest on that debt. Either way, some arm of the government ends up paying interest on that debt held by the Fed. This is an interesting case where the Wall Street Journal Editorial Board doesn’t understand something that would help their argument.)

Another February 12, 2021 op-ed, “Public Employee Unions Are Having a Fine Old Lockdown” by Carol Platt Liebau, makes a different mistake about fiscal policy. It seems to have the idea that it is a good thing for states to cut their spending during a recession. No: it is a bad thing for states to cut their spending during a recession. If the federal government can help them avoid cutting their spending, that is to be applauded. Here is what she says:

As part of his proposed $1.9 trillion relief bill, President Biden wants to send $350 billion in unrestricted cash to state and local governments to fill their budget holes. But while Covid-19 has depressed state tax revenue, the prospect of federal aid has encouraged many of these supposedly blameless states to keep piling on costs.

Much of the rest of Carol Platt Liebau’s op-ed is lamenting paying state employees too much. Suppose we give her the benefit of the doubt on that. In that case, it may be a good idea to use the crisis to cut back on raises for state employees, especially if there is more legal leeway to modify contracts to pay state employees less. But states shouldn’t cut salaries in order to spend less overall in a recession; if they cut salaries in a recession it ought to be in order to spend more on something else during the recession and then less later on. The timing of spending matters.

There is a way for the federal government to encourage states to spend more than they otherwise would during a recession and less later on. I talk about that in this post:

Part of what is going on in is that Carol Platt Liebau is confusing long-run fiscal policy and short-run fiscal policy. The appropriate considerations for these two dimensions of fiscal policy are very, very different.