Moontower #44


One of my closest friends is a distinguished MD and researcher who hit me up this week to share a very recent review article from the New England Journal of Medicine.

The topic: intermittent fasting.

At this point, everyone has either tried it or made fun of people who won’t shut up about it. You know what those people sound like.

“Breakfast is the most important meal of the day” is the slogan of the American capitalist propaganda machine used to cell more Fruit Loops.

You’ve never felt real biological hunger.

It’s a great way to lose pounds before a show.

Wait that last one was Hansel from Zoolander talking about eating disorders. Kindly ignore him.

By any rate, fasting has surged in popularity in recent years. I have been doing an 18/6 schedule 5x a week for almost 3 years. It’s certainly crossed-over from fad to lifestyle change. My favorite benefit is actually mental. It’s de-cluttering. It means fewer decisions. It means never feeling like you’re supposed to eat something because N hours have passed. But most people who fast are interested in its promise for their health or weight loss.

So what about this review article?

Wikipedia says a review article is where “journals analyze or discuss research previously published by others, rather than reporting new experimental results.” The NEJM review of the studies on intermittent fasting was very positive. A few bullets that stood out to me that confirmed my own reading about IF.

  • Many studies have indicated that several of the benefits of intermittent fasting are dissociated from its effects on weight loss. These benefits include improvements in glucose regulation, blood pressure, and heart rate; the efficacy of endurance training and abdominal fat loss.
  • In humans, intermittent-fasting interventions ameliorate obesity, insulin resistance, dyslipidemia, hypertension, and inflammation. Intermittent fasting seems to confer health benefits to a greater extent than can be attributed just to a reduction in caloric intake.   
  • Repeated exposure to fasting periods results in lasting adaptive responses that confer resistance to subsequent challenges. Cells respond to intermittent fasting by engaging in a coordinated adaptive stress response that leads to increased expression of antioxidant defenses, DNA repair, protein quality control, mitochondrial biogenesis and autophagy, and down-regulation of inflammation. These adaptive responses to fasting and feeding are conserved across taxa.
  • Intermittent-fasting regimens reduce tissue damage and improve functional outcomes of traumatic and ischemic tissue injury in animal models. Preoperative fasting reduces tissue damage and inflammation and improves the outcomes of surgical procedures… Emerging evidence suggests that intermittent fasting may enhance athletic performance and may prove to be a practical approach for reducing the morbidity and mortality associated with traumatic brain and spinal cord injuries in athletes.

Why is this important?

The NEJM is not Men’s Health or Cosmo. It’s the gold standard of medical journals.

My friend writes:

Being published in NEJM is often considered the equivalent of becoming “textbook” in medicine and it’s rare that NEJM would comment on this type of subject.

My Commentary

I’m not qualified to evaluate any medical study. We need to rely on experts for that. This is an uncomfortable truth in a complex world. A world in which people devote their life’s work to incremental findings. For a layperson to understand these tiny advances would be, to borrow a Seinfeld metaphor, like trying to hear the sound of cotton touching felt.

To navigate such a world, we put our energy into curating who we listen to. We have heuristics for doing this as we try to separate reliable sources from charlatans. One of the most useful heuristics is considering incentives. We don’t take Big Tobacco’s scientists at face value.

Supporting intermittent fasting passes the incentives heuristic easily. The work on it is relatively recent and nobody has a commercial incentive to push it (ie food companies) so in a Bayesian sense, it takes less to convince me. Said otherwise, I don’t have to discount some profiteer’s incentives in the findings.

Feels like a rare spot where truth and interests align.
Here’s the link to the NEJM but there’s a paywall. Might need to google around to see if you can backdoor it.

My prior research on fasting

The majority came from a book called Eat.Stop.Eat by Brad Pilon. It also does an extensive literature review and digs into what we know and don’t know about fasting durations, performance in athletes, and lots of interesting studies about Muslim athlete during Ramadan which provides natural experiments in calorie restriction. (Link)

I was also highly impacted by Dr. Peter Attia. You can start with my notes from his interviews.

  • Invest Like the Best Podcast notes (Link)
  • Notes from his livestream with Patrick O’Shaughnessey (Link)

A Simple Diagram to Remember

Attia has a  simple framework for how to manage your diet.

You have 3 levers to pull:

Calorie restriction
Time restriction
Diet restriction

Always pull 1. Often pull 2. Occasionally pull 3.

The Money Angle

There’s a prevailing sense that the markets will revert to some reasonable valuation. That sense is causing a blind spot. This rally is a sign of market efficiency. And that’s bad news for savers and investors. This week I published my first long post.

Markets Will Permanently Reset Higher (My Sacrifice to the Delta Gods) (Link)

  • I make the case that you do not need to invoke the Fed or bubble-talk to rationalize the market’s ever-ascending valuations.
  • I offer some ways to address it, although none of them are comforting, Instead, you may find yourself hoping that my sacrifice to the delta gods does indeed bring some rain.

One of the implications, although not explicitly said of the essay came up in my chat with Nick. The implication that the value of financial capital is declining relative to human capital. Perhaps, it may even be a stealth circuit breaker on inequality growth.

If there is any doubt that the value of financial capital is retreating, just this week, Matt Levine wrote again about dual share classes for tech companies looking to list.He jokes:

Company: We want to go public with dual-class stock.

Bank: Well, as your adviser on how to go public, we should tell you that investors do not like that, and we recommend against it.

Company: Hmm but we really want to have all the votes for ourselves.

Bank: Fine, but if you do that it will reduce investor demand and risk lowering the price you get in your IPO.

Company: Do you have any data to demonstrate that? Is there a list of recent IPOs that failed due to dual-class stock?

Bank: No they all pretty much go fine, I mean Snap Inc. was able to sell zero-vote stock in an IPO.

Company: We’ll just do that then.

Bank: Okay but we’re warning you that investors might push back.

Company: But they probably won’t, right?

Bank: Right.

So the cost of capital is not just declining explicitly, but implicitly via the concessions it is asked to make in corporate governance. (In theory, we should actually see this explicitly via a spread between dual shares classes, but I’ll rely on some of the Moontower pm’s to tell me if such spreads reflect a discerning preference for voting rights).

If you read the essay, as always I welcome comments and criticism.

Climb Higher

Steve sent me this Reddit post with a bunch of useful websites. I went through most of them myself. Some are no longer working or otherwise dated but here’s some of my favorites:

  • Midomi : Find a song by humming it
  • A highlighter for webpages
  • Homestyler: Super-slick site for designing a room or house
  • Privnote: Notes that self destruct. You set the timer.
  • BuiltWith: See what tech stack a website is built with
  • Exploding Topics: Discover exploding topics by genre

If you want to see the mother lode of recommended products and tools, check out Chris Sparks’ list. (Link)

I updated my own list this weekend. (Link)

Last Call

  • Are your kids ready to graduate from Kiwi crates? Ari’s buddy started a monthly subscription box for hackers. Unmysteriously named Hackerboxes. (Link)
  • VC firm Lux made this video describing how the arms race in human deception has driven technological progress. This video is really fun to watch and has amazing examples of deception in nature. The narration goes very well with the vid so sound is recommended. (Link)
  • Alexa can now play boardgames with you if you have the physical game. It works for just a few games including Ticket to Ride. I can’t promise it won’t cheat. (Link)
  • This week I discovered the AirBnB of musical instruments. It’s called Fretish. Want to rent someone’s guitar or pedal for the night? Maybe you are looking to record a specific sound. Or maybe you want to audition a new instrument without needing to listen to a 16-yr old chugging through Master of Puppets at your local Guitar Center. I’ve had this exact idea because I want to rent different guitars to try at home. Meanwhile, so many instruments sit around unused. I came across the founder of the company via a Twitter convo. We emailed about the business and what’s in the pipeline so I’m excited about its future. This is a startup I am rooting for. You can find out more from this article. (Link)
  • A guitar collecting dust on the wall is known by Kevin Kwok as an “underutilized fixed asset”. His article goes into the economics of AirBnB, Hipcamp, Uber, food delivery, and bitcoin as an exercise in tapping into excess capacity of idle apartments, personal acreage, cars, kitchen space, and CPU power respectively. I enjoy these articles because it makes these business models feel like strategy boardgames. (Link)

From my actual life 

First, thanks for all the well wishes after last weekend’s plague ripped through our house. Both kids are back to normal and back to raising hell. Max had his follow-up with his regular doctor this week who said he’s seen bad luck like having strep and the flu. But never seen those plus pneumonia. I’ll remember that age 3 was when we discovered Max is Wolverine.

I’ve been under the weather this week so gym time has been exchanged for couch time. Zak and I just beat Untitled Goose Game (Link)It’s available on every platform and it’s just so ridiculous. Wikipedia describes it as a puzzle game where players control a goose who bothers the inhabitants of an English village. That’s pretty much it. You have a mischief list that this goose must fulfill, but requires lots of planning, strategizing and trial and error. It’s full of frumpy, slapstick humor that had Zak and I laughing throughout.

As far as movies, I watched 2 music documentaries featuring the 60s:

Woodstock: 3 Days That Defined A Generation (Link)

Besides the great footage, the documentary showed how Woodstock overcame impossible logistics to materialize. It’s a well-told dramatic story so I won’t ruin it. The film was also a comforting reminder that as crazy as we think times are now, the 1960s took the volume to 11. Vietnam, civil rights, assassinations. A heavy decade.

Echo in the Canyon (Link)

From Wikipedia: “A look at how musical groups such as The Byrds, The Beach Boys, Buffalo Springfield, and The Mamas & the Papas birthed the beginnings of the Laurel Canyon music scene and how the echo of these artists’ creations reverberated across the world.”

It follows Jakob Dylan, Regina Spektor, and Beck as they record classics with the artists like Michelle Phillips, Stephen Stills, and Brian Wilson.

I have a bit of a fetish with the Hollywood Hills which includes Laurel Canyon. It started when I read Helter SkelterEcho may have saved me from reading about 4 books that I found on the music scene in Laurel Canyon during the 60s. In general, I have anemoia for the 1960s and 1970s and especially in California. My Instagram is a shameless parade of old muscle cars, 1970s fashion, and vintage guitars. With some Million Dollar Listing LA mixed in. Total id.

Pumping IronBoogie Nights and the more recently made Once Upon A Time In Hollywood are some of my favorite movies just because the sound and feel of those eras come through. For OUATIH, Tarantino had freeways closed so they could change the billboards. The attention to detail in re-creating Hollywood in the 60s pays off. And it was this nostalgia for an era I never knew that prompted me to read Inherent Vice last year. California-noir-stoner-detective-novel set near the beach in 1970 with the Manson stuff still dominating the public consciousness. Right. Up. My. Alley.

You know too much about me now.

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