WORD OF THE DAY

Hangry bacteria in your gut microbiome are linked to chronic disease – feeding them what they need could lead to happier cells and a healthier body

Christopher Damman, Associate Professor of Gastroenterology, School of Medicine, University of Washington
Sun, October 1, 2023 

The gut microbiome may play a role in regulating the body's appetite, cognition and immune responses. 

nopparit/iStock via Getty Images Plus

Diet-related chronic diseases have reached a critical juncture in the U.S.

Nearly half the population has prediabetes or diabetes. Over 40% are overweight or obese. One in nine people over the age of 65 has Alzheimer’s disease, the development of which researchers are exploring the potential role of diet. Poor diet is also linked to poor mental health, cardiovascular disease and cancer. It was responsible for nearly 1 in 5 deaths in the U.S. and accounted for over US0 billion in U.S. health care spending in 2016.

Though American waists are getting bigger, research is showing that the gut microbiome – the bacteria living in our digestive tracts – and the energy-producing compartments of cells, the mitochondria, remain hungry for nutrients missing in the American diet.

I am a physician scientist and gastroenterologist who has spent over 20 years studying how food can affect the gut microbiome and whole body health. The ultraprocessed food that makes up an increasing part the American diet has removed vital nutrients from food. Adding those nutrients back may be important for health in part by feeding the microbiome and mitochondria that turn food into fuel.

Your health is what you eat

Research has consistently shown that the Mediterranean diet and other whole food diets are associated with better health and longer lives, and ultraprocessed foods and drinks like soda, chips and fast food, among others, are linked with poor health outcomes such as diabetes, cardiovascular disease, cancer and other diseases.

But improving the diet of an individual, let alone a population, is challenging. Whole foods are sometimes less convenient and less tasty for modern lifestyles and preferences. Furthermore, food processing can be beneficial by preventing spoilage and extending shelf life. Whole grain processing in particular extends shelf life by removing the germ and bran that otherwise rapidly spoil. Long-term storage of affordable calories has helped address food insecurity, a primary challenge in public health.

Much of the public health conversation around diet has focused on what to avoid: added sugars and refined carbs, some fats, salt and additives. But modern food processing, while increasing the concentration of some nutrients, has removed other key nutrients, producing potential long-term health costs. Equally important is what to add back into diets: fibers, phytonutrients, micronutrients, missing fats and fermented foods.

Only 5% of the U.S. population gets sufficient fiber, a prebiotic nutrient linked to metabolic, immune and neurologic health. Americans are likely also deficient in phytonutrients, potassium and certain healthy fats linked to lower rates of cardiovascular disease and cancer.

Fermentation is nature’s version of processing, creating foods with natural preservatives, flavors and vitamins. Recent research suggests fermented foods can improve gut microbiome diversity and dampen systemic inflammation.

Figuring out which bioactive nutrients contribute to disease can help both individuals and institutions develop diets and foods that are personalized to different health conditions, economic constraints and taste preferences. It can also help maximize nutrients in a way that is convenient, affordable and familiar to the modern palate.

Of microbiomes and mitochondria

Understanding how nutrients affect the gut microbiome and mitochondria could help determine which ingredients to add to the diet and which to temper.

In your lower gut, bacteria transform undigested bioactive nutrients into biochemical signals that stimulate gut hormones to slow down digestion. These signals also regulate the immune system, controlling how much of the body’s energy goes toward inflammation and fighting infection, and cognition, influencing appetite and even mood.

The microbiome’s biochemical signals also regulate the growth and function of energy-producing mitochondria across many cell types, including those in fat, muscles, heart and the brain. When these cues are missing in ultraprocessed diets, mitochondria function less well, and their dysregulation has been linked to obesity, diabetes, Alzheimer’s disease, mood disorders and cancer. A better understanding of how diet could improve the function of the microbiome-mitochondria axis could help provide a way to reduce the burden of chronic disease.

The Greek physician Hippocrates, regarded as the father of medicine, supposedly once said “Let food be thy medicine,” and a growing body research suggests that, yes, food can be medicine. I believe that shining a light on the connection between diet, health and the microbiome and mitochondria could help societies reach a bright future in which unhealthy aging isn’t an inevitability of growing older.

This article is republished from The Conversation, a nonprofit news site dedicated to sharing ideas from academic experts. The Conversation is trustworthy news from experts. Try our free newsletters.

It was written by: Christopher Damman, University of Washington.

Read more:

• Microbes in your food can help or hinder your body’s defenses against cancer – how diet influences the conflict between cell ‘cooperators’ and ‘cheaters’

• Which microbes live in your gut? A microbiologist tries at-home test kits to see what they reveal about the microbiome

• Are you a rapid ager? Biological age is a better health indicator than the number of years you’ve lived, but it’s tricky to measure

Christopher Damman is medical and science officer at Supergut and on the scientific advisory board at BCD Biosciences.

America can prevent (and control) Type 2 diabetes. So why aren’t we doing it?

Karen Weintraub and Adrianna Rodriguez, USA TODAY
Updated Sun, October 1, 2023 

LONG READ

Editor's note: Part one of a five-part USA TODAY series revealing why America hasn't solved its long struggle with Type 2 diabetes.

For chef Robin Ray, newly married with young stepchildren, the turning point came when a stabbing chest pain sent her rushing to the emergency room.

For Brian Castrucci, the gravity hit when the ER doc who had treated him for a near-heart attack a few weeks earlier gave him a big bear hug. “I didn’t think you’d make it,” the doctor said.

The crisis unspooled more slowly for James Haynes but started in 2019 when he stepped on a rusty nail and didn’t notice.

He walked on it all day as it pierced the sole of his sneaker and then his foot. By the time he took off his shoe that night, it was bloodied and infected. When he was in the hospital for the next two months, doctors and nurses tried, mostly unsuccessfully, to get the infection and Haynes' blood sugar under control.

The moments were turning points for all three to get serious about addressing their diabetes.

Type 2 diabetes, in which the body can’t properly regulate blood sugar, has become so common it’s almost considered inconsequential. More than 1 in 10 Americans have the disease (though many don't know it) and another nearly 4 in 10 are at risk for it. In total, half of all adults and a quarter of teenagers have diabetes or pre-diabetes.

Its financial costs are astronomical. The country spends more than $300 billion a year to address diabetes, accounting for $1 out of every $4 spent on health care.

And its personal tolls are even worse: heart attacks, amputations, blindness, kidney disease, double the risk of premature death. It also causes what’s known as “diabetes distress,” the daily burdens and emotional toll of living with and managing a chronic ailment that can lead to regular dips in energy, foggy thinking and depression, and a sense of isolation.

The most frustrating aspect of Type 2 diabetes, experts say, is that it has long been largely preventable and controllable.

“We have made tremendous gains in understanding diabetes,” said Dr. Donald Berwick, a pediatrician and former administrator of the Centers for Medicare & Medicaid Services. “The best diabetes care can make a very big difference. You can’t say we don’t know what to do.”
The Diabetes Dilemma

Type 2 diabetes rates continue to climb, despite well-known treatments and prevention approaches. To better understand why, USA TODAY's health team traveled across the country, talking to researchers, clinicians and patients. They found people with diabetes often must fend for themselves against systemic barriers and a difficult disease.

And yet, diagnosed rates of Type 2 diabetes have soared over the past 25 years, and especially over the past dozen – particularly among working-age adults like Ray, Castrucci and Haynes.

Roughly 40% of people who died early in the coronavirus pandemic had Type 2 diabetes, a rate four times higher than people without the disease. Even when elevated blood sugar levels are below the threshold for type 2 diabetes, the risk for heart disease jumps 30% to 50% compared with people with normal blood sugar levels. (Type 1 diabetes, which accounts for 5% to 10% of diabetes, is caused by the immune system and is unrelated to diet or lifestyle.)

America’s failure to address Type 2 diabetes highlights larger problems with our food and medical systems, Berwick and other experts said.

A soda costs less than a bottle of water, a double cheeseburger and fries less than a carton of blueberries. Patients wait months for medical appointments only to see the back of a white coat for the short time they’re allotted. Treating disease costs society far more than preventing it but typically provides more profit for insurance companies, hospitals and the pharmaceutical industry.

The USA TODAY Health team spoke with scores of health care providers, researchers, community leaders and patients for this five-part series to understand why Type 2 diabetes continues to worsen in America despite known solutions.

The answer isn't simple. It involves systemic problems facing everyone in society, not just those with diabetes: a food system designed to sell products; a medical system in which cutting off a leg is less expensive than saving it; the high cost of healthy living and the fact that breaking habits takes a lot more than just personal willpower.

This first story looks at what it takes for people to cope with or overcome the disease.

Then, we explore one community in a David vs. Goliath battle against a food system that fails to prioritize people's health.

More in series: Diabetes runs deep in rural Mississippi. Locals have taken to growing their own solutions.

We next travel to Colorado, which has the lowest level of diabetes in the nation. Yet even in this state, where hiking trails and gorgeous views abound, economic and other disparities make it easier for some people to avoid diabetes than others.

More in series: A diabetes disparity: Why Colorado's healthy lifestyle brand isn't shared by all

It's tough to manage a chronic illness in the face of high medical costs, scattered care and caregiver frustration and burnout, so we highlight that next.

More in series: The steep cost of Type 2: When diabetes dragged her down, she chose to fight

Finally, we explore solutions, addressing why it will take a combination of education, medication, medical devices and improved food access to solve this national problem.

More in series: Solutions exist to end the Type 2 diabetes dilemma but too few get the help they need

The system is fixable, said Dr. Dariush Mozaffarian, a cardiologist and professor at the Tufts University School of Medicine in Boston.

But it will take "sensible action" from across many sectors, including health care, science, nutrition, business, public health and politics to change the financial and other incentives that drive so many Americans toward sickness instead of health.

"If we do it all, we could fix a lot of this in 10 years," said Mozaffarian, who serves on the President’s Council on Sports, Fitness, and Nutrition. "If we do it incrementally or don't do it at all, we're all going to be toast in 50 years from diet-related illnesses and a depleted environment."
Personal and structural

There’s no question personal responsibility plays a role in fighting diabetes.

Haynes, Ray and Castrucci radically changed their lifestyles and sought help after their come-to-Jesus experiences. They’ve reduced their dependence on daily medication and hope to have saved themselves the horrors of more amputations, blindness and dialysis. They’ve extended their lives and improved the quality of that time.

But like many medical problems, the challenges of diabetes go well beyond individual responsibility and blame.

“There are structural issues that we have to start paying attention to and addressing,” said Dr. Shivani Agarwal, an endocrinologist who specializes in research and treating young adults with diabetes at Montefiore Medical Center and Albert Einstein College of Medicine in New York. Agarwal recently led a series of studies in the journal The Lancet that looked at diabetes rates around the world.

Poverty, the studies showed, was a major driver of diabetes, along with racism and unequal access to healthy food and high-quality medical care.


Personal stories illustrate how these structural issues play out in the lives of so many Americans.

Ray, 45, director of culinary operations at HOSCO/North Sarah Food Hub in St. Louis, got weight-loss surgery and then put her culinary expertise to good use.

Castrucci, 49, who runs a public health nonprofit outside Washington, D.C., used his advantages provided by his work, salary and insurance to “buy” himself better health.

“I’m healthy because of privilege – not diet, not exercise, not determination,” he said.

Haynes, 58, a former truck driver and maintenance technician in Gulfport, Mississippi, has fewer material assets, but his attitude and the advantages he does have explain why he's still around, despite all he has been through.

“It’s going to be all right after a while, as long as I keep this spirit,” he said.
Changing the recipe

Ray’s love for food began when she was 8 years old, watching Julia Child on TV. During family gatherings, she would run around taking everyone’s dinner order. Then she’d scurry back to the kitchen with a notepad full of scribbles.

Throughout her life, she made fried chicken, pork chops, baked mac and cheese, collard greens, and even a whole roasted chicken filled with wild rice and two sticks of butter – everything that made her soul sing.


In her world, food was home. Food was family. Food was love.

But that was some pretty tough love.

In 2002, Ray was diagnosed with Type 2 diabetes. Her father, grandmother, aunts and uncles all had diabetes. She knew what it meant.

“For you to tell me I can’t have ice blue raspberry Kool-Aid was like you shut down my world,” Ray said. “I didn’t want to accept it. So, I ate, because you eat through your emotions.”

She didn't dwell on the diagnosis and continued with life. Her culinary career took her to Italy, where she learned and fell even more in love with food. She returned to St. Louis, got married and became a mom to her husband’s two children ‒ “beautiful bonus babies,” as she described them. Through the years, she continued to express love through cooking and eating.

In 2015, a stabbing chest pain sent her to the emergency room. Doctors assured Ray she hadn’t had a heart attack, but they warned that her life was on the line. At 5-foot-2, she weighed 334 pounds and had an A1C, a measure of average blood sugar of 11%, well above the 6.5% cutoff to be considered diabetic. Her diabetes – and her diet – were out of control.

“That scared me. … It was gut-wrenching and terrifying,” she said. “I’m fighting against something that’s fighting me back and I did not know how to win.”

She and her primary care doctor decided she would pursue weight loss surgery.

But she also decided to use her culinary prowess to transform her diet. She reconfigured favorite foods, substituting healthier ingredients: Collard greens cooked in smoked fats or ham hocks turned into a kale, turnip and rutabaga recipe flavored with natural chicken broth fat, oils and seasonings.

She fostered her feelings into new recipes and brought them to North Sarah Food Hub, which partnered with Barnes-Jewish Hospital to make packaged, pre-made meals for St. Louis residents with diabetes and limited access to fresh food.

“I had to restructure the food that I put in my mouth. I had to think about what I was eating and how I was eating and how it was going to be good for my body,” she said. “I became excited about food again, and food became a joy.”


It isn’t always easy, of course. Ray admits to an occasional cookie craving. But now she takes the time to think about how her body processes that cookie and whether it’s worthwhile.

She hopes her cooking can help other people make the same transformation she did. Her staff at North Sarah helps her create new recipes for others. She wants to provide nourishment that allows people to avoid illness and medicine.

“Nobody wants to take 55 pills, nobody wants to feel like a patient, but how do you fix that? It’s by our food,” she said. “That should be what we’re teaching our community and our culture and our children. … It’s not always about the macaroni noodle with a smile, it’s about what’s good for your body.”
The price of good health

Castrucci is a third-generation diabetes patient. The lifetime risk of developing Type 2 diabetes if a parent has it is 40%. If both parents have it, the risk jumps to 70%.

He knew he was at risk, but he pushed his luck, he said, by eating poorly during the pandemic and falling out of his exercise routine. With the luxury of working from home, walking to the kitchen and bathroom was often the extent of his daily activity.

On Feb. 14, 2022 – Valentine’s Day – he went to an urgent care clinic, concerned his breathing trouble meant he had bronchitis. His blood pressure measured 210 over 110, well above normal levels that top out at 120 over 80. A chest X-ray showed fluid filling his lungs, leading to congestive heart failure.

The clinic sent him straight to a local emergency room, where he was diagnosed with a blockage of the left descending artery – a clogged artery made worse by diabetes. If he had waited any longer, he would have had a massive heart attack, his doctor later told him.

After his release from the hospital, he went to the drugstore to fill his new prescriptions. The pharmacist told him she couldn’t fill one because it would cost $1,000. He’d have to wait until his insurance approved it. “Please fill it,” he said. She stressed the cost. “Fill it,” he pleaded, putting the charge on his credit card.

Medication helped him lose 70 pounds in three months. When his local drugstore ran out of the weight-loss drug, he easily drove to another pharmacy and then another to find what he needed.

His 100 hours of high-quality cardiac rehabilitation were fully covered by insurance.

"For my midlife crisis, I got healthy," Castrucci said.

He could devote all his energy to getting well because he didn’t have to focus on how to afford his care. “(I) paid almost nothing for the whole episode,” he said, “and never worried about it because I have really good insurance.”

Even so, Castrucci pays out-of-pocket for a cardiologist and an endocrinologist because the best ones near him don’t accept insurance.

Every time he goes to Walgreens to refill his medications, Castrucci said, he sees someone turned away because they can’t afford their prescriptions. When they finally show up in the emergency room, “because they will,” they will cost the system far more, he said.

“Health outcomes are dictated by economics. It’s a whole side of privilege that we don’t always talk about.”

Struggling to heal

The months of hospitalization after the rusty nail was just the beginning of Haynes’ long journey.

By the time he was released, he knew enough about Type 2 diabetes to realize his daily blood sugar levels – typically in the mid-400s – were four times above what he had been told to shoot for.

But nothing he did or ate seemed to make a difference. He had long since traded ribs for salads, beer for water.

His wife, Angela, barely noticed when James started wearing multiple pairs of socks, pouring powder on his feet and buying bigger shoes. His feet tingled a lot, he said, but he was coping with it.

James ended up in the emergency room again, dehydrated and in need of antibiotics. The doctor amputated the baby toe on his right foot, leaving a large open wound.

"We're going to leave this open because we'll probably have to take more,” Angela remembered the doctor saying. “I didn't like that we're not going to try to save anything, we're just going to start cutting.”

James was fading.



His arm muscles shriveled and he lost his Popeye physique. Antibiotics left him looking sickly, his voice so weak Angela could barely hear him. “I felt like I was watching my husband slowly dying,” she said.

Finally, taking her doctor sister’s advice, Angela emailed Dr. Foluso Fakorede’s office to ask for an appointment. She thought it would take months to get James in to see the heart disease specialist, but the office called and asked if they could come the next day.

The Hayneses would end up going back to see Fakorede many times − sometimes twice in one week, driving more than five hours each way from Gulfport north to Cleveland, Mississippi.

“We started looking forward to these visits because there was always hope,” Angela Haynes said, though she felt guilty they were taking up so much of the important doctor’s time.

Fakorede, who is on a personal mission to save people with diabetes from amputations, noticed what other doctors had missed. Haynes had blockages in blood vessels on both legs.

Once he got the blood flowing again, Haynes began to feel better. His flesh returned to its normal color. The wound started healing at last. Walking became easier.

Then disaster struck again.

On July 2, 2022, Haynes caught COVID-19. "Everything went downhill after that," he said.

During his 13-day illness, the bacteria in his foot raged out of control. He ended up back in the hospital and unable to withstand the long drive to Fakorede’s office.

Every week, a surgeon would come to the door of his hospital room and before even stepping all the way in ask Haynes whether he had decided to get his leg amputated.

"This is my leg. I was born with this. And you're walking in like you're cutting a piece of cake," Haynes said.

He was worried about how he’d get around, how he’d be able to work to support his family if he had only one leg. No one took the time to explain why they thought the leg needed to come off or how he’d cope without it, Haynes said.

In late November, he was finally sent home in a wheelchair. But just three weeks later, as he was getting out of the car after wound care, his right leg gave out and he fell to the ground. Back at the hospital, Haynes was told his foot was broken, essentially beyond repair. He agreed to a below-the-knee amputation.

Released right before Christmas, he spent the next three weeks in bed wondering how he’d manage the rest of his life.

Finally, it looked as if his luck might be turning around.

With the leg gone, his diabetes improved. His blood sugar dropped into the 120s or one-teens. His blurry vision cleared up.

During his long hospital stay, he befriended nurses and learned about a program for people who needed prostheses. The man who ran it called early in the year and said he had received a donated leg. If it fit Haynes, he could have it while waiting for insurance to pay for a personalized one. Miraculously, it did.

Haynes spent the next six months teaching himself to walk again. The donor leg was heavy and uncomfortable. He wasn't mobile enough to hold down a job.

One late spring night, picking up dinner at a nearby restaurant, he headed to the bathroom for a pit stop. A sink had been leaking all day and Haynes slipped in the puddle, falling backward.

He's still recovering from the resulting wrist surgery.

He and Angela are living – barely – off her part-time salary as a secretary and a church organist.

Haynes has tried "at least three or four times" to receive government assistance, but they keep losing his paperwork, or not believing he's disabled, though he once checked himself out of the hospital and arrived at an appointment in his wheelchair to prove he didn't have a leg.

Still, he clings to his faith and the positive attitude he has long used to cheer up himself and others. These are his secret weapons against diabetes and everything else life throws his way.

"I try to put a smile on other people's faces," he said. "It keeps my day going."

Contributing: Nada Hassanein

This story is part of a reporting fellowship sponsored by the Association of Health Care Journalists and supported by the Commonwealth Fund.

Contact Karen Weintraub at kweintraub@usatoday.com and Adrianna Rodriguez at adrodriguez@usatoday.com.

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.

This article originally appeared on USA TODAY: If Type 2 diabetes is preventable, why is problem only getting worse?

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Pope suggests blessings for same-sex unions possible in response to 5 conservative cardinals

NICOLE WINFIELD
Updated Mon, October 2, 2023 




 In this Sept. 6, 2018 file photo, Cardinal Raymond Burke applauds during a news conference at the Italian Senate, in Rome. Five conservative cardinals are challenging Pope Francis to affirm Catholic teaching on homosexuality and female ordination. They've asked him to respond ahead of a big Vatican meeting where such hot-button issues are up for debate. The cardinals on Monday published five questions they submitted to Francis, known as “dubia.”

 (AP Photo/Alessandra Tarantino, File)

VATICAN CITY (AP) — Pope Francis has suggested there could be ways to bless same-sex unions, responding to five conservative cardinals who challenged him to affirm church teaching on homosexuality ahead of a big meeting where LGBTQ+ Catholics are on the agenda.

The Vatican on Monday published a letter Francis wrote to the cardinals on July 11 after receiving a list of five questions, or “dubia,” from them a day earlier. In it, Francis suggests that such blessings could be studied if they didn't confuse the blessing with sacramental marriage.

New Ways Ministry, which advocates for LGBTQ+ Catholics, said the letter “significantly advances" efforts to make LGBTQ+ Catholics welcomed in the church and “one big straw towards breaking the camel’s back” in their marginalization.

The Vatican holds that marriage is an indissoluble union between man and woman. As a result, it has long opposed gay marriage. But even Francis has voiced support for civil laws extending legal benefits to same-sex spouses, and Catholic priests in parts of Europe have been blessing same-sex unions without Vatican censure.

Francis’ response to the cardinals, however, marks a reversal from the Vatican’s current official position. In an explanatory note in 2021, the Congregation for the Doctrine of the Faith said flat-out that the church couldn’t bless gay unions because “God cannot bless sin.”

In his new letter, Francis reiterated that matrimony is a union between a man and a woman. But responding to the cardinals’ question about homosexual unions and blessings, he said “pastoral charity” requires patience and understanding and that regardless, priests cannot become judges “who only deny, reject and exclude.”

“For this reason, pastoral prudence must adequately discern whether there are forms of benediction, requested by one or more persons, that do not transmit a mistaken conception of marriage,” he wrote. “Because when a benediction is requested, it is expressing a request for help from God, a plea to be able to live better, a trust in a father who can help us to live better.”

He noted that there are situations that are objectively “not morally acceptable.” But he said the same “pastoral charity” requires that people be treated as sinners who might not be fully at fault for their situations.

Francis added that there is no need for dioceses or bishops conferences to turn such pastoral charity into fixed norms or protocols, saying the issue could be dealt with on a case-by-case basis “because the life of the church runs on channels beyond norms.”

Francis DeBernardo, executive director of New Ways Ministry, welcomed the pope's openness.

""The allowance for pastoral ministers to bless same-gender couples implies that the church does indeed recognize that holy love can exist between same-gender couples, and the love of these couples mirrors the love of God," he said in a statement. “Those recognitions, while not completely what LGBTQ+ Catholics would want, are an enormous advance towards fuller and more comprehensive equality.”

The five cardinals, all of them conservative prelates from Europe, Asia, Africa and the Americas, had challenged Francis to affirm church teaching on gays, women’s ordination, the authority of the pope and other issues in their letter.

They published the material two days before the start of a major three-week synod, or meeting, at the Vatican at which LGBTQ+ Catholics and their place in the church are on the agenda.

The signatories were some of Francis’ most vocal critics, all of them retired and of the more doctrinaire generation of cardinals appointed by St. John Paul II or Pope Benedict XVI.

They were Cardinals Walter Brandmueller of Germany, a former Vatican historian; Raymond Burke of the United States, whom Francis axed as head of the Vatican supreme court; Juan Sandoval of Mexico, the retired archbishop of Guadalajara; Robert Sarah of Guinea, the retired head of the Vatican’s liturgy office; and Joseph Zen, the retired archbishop of Hong Kong.

Brandmueller and Burke were among four signatories of a previous round of “dubia” to Francis in 2016 following his controversial opening to letting divorced and civilly remarried couples receive Communion. Then, the cardinals were concerned that Francis’ position violated church teaching on the indissolubility of marriage. Francis never responded to their questions, and two of their co-signatories subsequently died.

Francis did respond this time around. The cardinals didn’t publish his reply, but they apparently found it so unsatisfactory that they reformulated their five questions, submitted them to him again and asked him to simply respond with a yes or no. When he didn’t, the cardinals decided to make the texts public and issue a “notification” warning to the faithful.

The Vatican’s doctrine office published his reply to them a few hours later, though it did so without his introduction in which he urged the cardinals to not be afraid of the synod.

Pope Francis open to blessings for same-sex couples, not women priests

Sheri Walsh
Mon, October 2, 2023 

Pope Francis has revealed he is open to Catholic blessings for same-sex couples, as he reaffirmed the Church’s ban on women priests, in answers to critical questions ahead of a major Vatican meeting this week. File Photo by Giuseppe Lami/EPA-EFE


Oct. 2 (UPI) -- Pope Francis has revealed he is open to Catholic blessings for same-sex couples, as he reaffirmed the Church's ban on women priests, in answers to critical questions ahead of a major Vatican meeting this week.

The pope's eight-page reply, released by the Vatican on Monday, shows his responses to five retired conservative Catholic cardinals who have expressed concerns about a number of controversial issues expected to be addressed at the Synod of Bishops, which runs from Oct. 4 to Oct. 29.

While none of the pope's responses were absolute, he did express an openness to blessing some same-sex unions as long as it is done without the sacrament of marriage.

"The Church has a very clear concept on marriage: An exclusive, stable and indissoluble union between a man and a woman, naturally open to begetting children," Francis wrote in the letter dated Sept. 25.

"Only this union is called 'marriage.' Other forms of union are only realized 'in a partial and analogous way,' which is why they cannot strictly be called marriage,'" the pope added.

"Consequently, we cannot become judges who only reject, deny and exclude," Francis said. "Pastoral prudence must adequately discern whether there are forms of blessing, requested by one or several people, that do not transmit a mistaken concept of marriage."

The pope also answered questions about the possibility of women priests in the Catholic Church, replying "no" while "definitively" affirming St. Pope John Paul II's ban in 1994 of "the impossibility of conferring priestly ordination to women."

Francis said John Paul "was in no way denigrating women and conferring supreme power on men," as he offered the possibility of further study.

As Pope Francis faces societal pressure to push boundaries in the church, he argued that culture does not necessarily mean that divine revelation should also be reinterpreted.

"Depends on the meaning you give the word 'reinterpret.' If it is understood as 'interpret better,' the expression is valid," Francis wrote.

"Cultural changes and new historical challenges do not modify revelation, but they can stimulate us to make more explicit some aspects of its overflowing wealth that always offers more."




Pope Francis's Stance on LGBTQ+ People Challenged by Group of Five Cardinals

Donald Padgett
Mon, October 2, 2023 



A group of cardinals has asked Pope Francis to clarify the Catholic Church’s official position on LGBTQ+ inclusion and other issues ahead of an important meeting or synod taking place behind closed doors at the Vatican this month.

The cardinals submitted the five questions or ‘dubia’ ahead of the Synod of Synodality, the weeks-long meeting which will discuss the church’s policies, teachings, and beliefs in a culturally changing world. The questions seek a yes or no response to questions relating to marriage equality and same-sex unions, women in the priesthood, and who is the ultimate worldly authority of the Catholic Church.

The five cardinals who signed the dubia – German Cardinal Walter Brandmüller, 94, American Cardinal Raymond Burke, 75, Chinese Cardinal Zen Ze-Kiun, 90, and Guinean Cardinal Robert Sarah, 78 – explained their intent in a “Notification to Christ’s Faithful” released today. The group said they had earlier asked the Pope for clarification in light of the agenda for the upcoming synod, but that the responses did not provide definitive answers. The group resubmitted the questions in a yes or no format.

“Given the gravity of the matter of the dubia, especially in view of the imminent session of the Synod of Bishops, we judge it our duty to inform you, the faithful, so that you may not be subject to confusion, error, and discouragement but rather may pray for the universal Church and, in particular, the Roman Pontiff, that the Gospel may be taught ever more clearly and followed ever more faithfully,” the cardinals wrote in the notification.

In its second question or dubium, the dubia specifically asks whether “accepting as a ‘possible good’ objectively sinful situations, such as same-sex unions” betrays the “revealed doctrine” of the Church. The fourth dubium asks whether the Church’s ban on women priests is still viable. The final question asks to clarify the limits of forgiveness, including for matters such as sex outside marriage and same-sex sex acts. Current doctrine teaches that both are considered grave sins.

Some have noted the cardinals are composed of individuals who have lost favor or no longer occupy positions of authority within the church. Burke was removed as head of the Vatican supreme courts by Pope Francis, Brandmueller is a former Vatican historian, and the others have retired from various positions.

Pope Francis opens possibility for blessing same-sex unions

KIARA ALFONSECA and PHOEBE NATANSON
Mon, October 2, 2023

Pope Francis opens possibility for blessing same-sex unions

Pope Francis suggested it may be possible to bless same-sex unions in a newly public response to cardinals who questioned the pope's affirmation of the LGBTQ community in the Catholic Church.

In the July letter, which is written in Spanish, he reaffirmed that "the Church has a very clear understanding of marriage: an exclusive, stable, and indissoluble union between a man and a woman, naturally open to procreation," according to the Vatican News.

However, he advocated for "pastoral charity."

"The defense of objective truth is not the only expression of this charity; it also includes kindness, patience, understanding, tenderness and encouragement. Therefore, we cannot be judges who only deny, reject and exclude," he said, according to Vatican News. He added that "pastoral prudence must adequately discern whether there are forms of blessing, requested by one or more persons, that do not convey a mistaken concept of marriage."

New Ways Ministry, an LGBTQ Catholic outreach group, said in a statement that though his statement are not "a full-fledged, ringing endorsement of blessing their unions," it is a significant advancement in the inclusion of LGBTQ Catholics in the Church.

In August, Pope Francis called on the hundreds of thousands gathered before him to yell that the Catholic Church is for "todos, todos, todos" -- everyone, everyone, everyone.

When asked if "todos" included the LGBTQ community, he said that though the Church has its laws, it is still a place for everyone, including the LGBTQ community.

Pope Francis has also criticized laws that criminalize homosexuality.

News of the Pope’s comments come two days before the start of a major three-week meeting at the Vatican to discuss the state of the Catholic Church and its future. The three-week synod, or meeting, starts at the Vatican on Wednesday, Oct. 4 and will run until Oct. 29.

During this period, more than 450 people from around the world -- cardinals, bishops, clergy, religious and laypeople -- will take part in the worldwide gathering.

The meeting will address some hot-button issues like the role of women in the church and the inclusion of the LGBTQ+ community. A number of advocacy groups are expected to come to Rome and the Vatican to gain attention for their cause throughout the synod. These groups represent issues such as ending clergy abuse, the women's ordination conference and more.

Some Church watchers are calling this Synod on Synodality a historical event, while some conservative church leaders and commentators have speculated that the gathering could cause harm to the Church and undermine Catholic teaching.

The synod will begin with a mass with new cardinals in St. Peter's Square at the Vatican on Wednesday.

LGBTQ advocates applauded the decision.

“Pope Francis' response is both unprecedented and compassionate and continues to urge every Catholic and leader toward acceptance and recognition of LGBTQ people," said Sarah Kate Ellis, GLAAD President and CEO.

New Ways Ministry, an LGBTQ Catholic outreach group, said in a statement that though his statement are not "a full-fledged, ringing endorsement of blessing their unions," it is a significant advancement in the inclusion of LGBTQ Catholics in the Church.

In August, Pope Francis called on the hundreds of thousands gathered before him to yell that the Catholic Church is for "todos, todos, todos" -- everyone, everyone, everyone.

When asked if "todos" included the LGBTQ community, he said that though the Church has its laws, it is still a place for everyone, including the LGBTQ community.

Pope Francis has also criticized laws that criminalize homosexuality.

71% of all Americans support marriage equality for LGBTQ people, which is at an all-time high, according to a Gallup poll -- this includes 41% of weekly churchgoers.

 abcnews.go.com


Pope Francis suggests for first time some people in same-sex unions could be blessed

Barbie Latza Nadeau, CNN
Mon, October 2, 2023 

Filippo Monteforte/AFP/Getty Images/FILE


Pope Francis has suggested for the first time that people in same-sex unions could be blessed by Catholic priests on a “case-by-case” basis, a seeming reversal of previous statements.

The Pope made the suggestion in a letter to his harshest critics within the Catholic ranks, written in response to a letter from five conservative cardinals with formal questions – called a “dubia” (Latin for “doubt”) – which is an official request for a yes or no answer from a sitting pontiff regarding his running of the Church.

The cardinals, Walter Brandmuller, Raymond Leo Burke, Juan Sandoval Iniguez, Robert Sarah and Joseph Zen Ze-kiun, first sent the letter to Pope Francis on July 10. It focused on an upcoming October meeting of bishops, asking what impact it could have on Church’s teaching, and included questions about the Pope’s intention to bless same-sex unions, and whether he intends to open the door to women priests through ordination.

Unsatisfied with the Pope’s initial response, according to a blog post by American Cardinal Raymond Burke, the five cardinals reworded the “dubia” letter and sent it again on August 21, citing “the gravity of the matter,” according to Burke.

The Vatican then released a letter in Spanish dated September 25 signed by Cardinal Victor Manuel Fernández, the Vatican’s new chief of doctrine. The response includes Pope Francis’ answers to the dubia, signed “Francis.”

On the issue of homosexual unions, the pontiff reiterated that the church only recognizes marriage as a union between a man and a woman, but opened the door for blessings of individuals in same-sex unions, the letter shows.

“When you ask for a blessing, you are expressing a request for help from God, a prayer to be able to live better, a trust in a father who can help us live better,” the Pope wrote, adding that a clergy must show “pastoral prudence must adequately discern if there are forms of blessing, requested by one or various people, which do not convey a wrong concept of marriage.”

The Pope’s response appears to contradict his statement in March, when he said the Church could not bless same-sex unions, because they could “not bless sin.”

The latest development appears to be a nod to a decision made by the German Church in March and carried out in August, in which same-sex unions received a Catholic blessing by several priests in the city of Cologne.

On the issue of women’s ordination, the pontiff was clear that he upheld the words of the late Pope John Paul II, who said in 1994 that the (Catholic) Church had “no authority” to ordain women, but said that the issue needed to be studied in order to educate those who doubt it, the letter said.

“If is not understood and the practical consequences of these distinctions are not drawn, it will be difficult to accept that the priesthood is reserved only for men and we will not be able to recognize the rights of women or the need for them to participate, in various ways, in the leadership of the Church,” the Pope added.

On the issue of the impact the upcoming meeting of Catholic bishops may have on the church’s teaching, Pope Francis was vaguer, writing, “Both the hierarchy, and the entire People of God in different ways and at different levels can make their voice heard and feel like part of the Church’s journey. In this sense we can say that yes, synodality, as style and dynamism, is an essential dimension of the life of the Church.”

He also added that attempts to “sacralize or impose a certain synodal methodology that pleases one group, transforming it into a norm and an obligatory path for everyone, because this would only lead to ‘freezing’ the synodal path.”

The upcoming Synod in Rome has been met with skepticism by the conservative corners of the Church who have expressed concern both that women will have a voice, and that the Church’s teaching is not carried out by consensus.

John Allen in Rome contributed reporting

Pope Francis has appointed 21 new cardinals – an expert on medieval Christianity explains what it means for the future of the Catholic Church

Joanne M. Pierce, Professor Emerita of Religious Studies, 

College of the Holy Cross
Mon, October 2, 2023 

New cardinals at St. Peter's Square at the Vatican on Sept. 30, 2023.

AP Photo/Riccardo De LucaMore


On Sept. 30, 2023, Pope Francis swore in 21 clergymen as new members of the College of Cardinals. The College is an important part of the church’s governance structure – each new member takes a formal oath during a ritual ceremony in the presence of present members of the College.

This assembly of cardinals, known as a consistory, is the ninth that Francis has held to create new cardinals since 2013, when he succeeded the retiring Pope Benedict XVI.

The new appointments will take the membership of the College from 221 to 242, including retirees. Francis has ensured that the College includes clergy from around the world and is representative of the diversity within Catholicism.

As a specialist in medieval Christianity, I have studied the complex history of the College of Cardinals. Shaped by past challenges, it is a crucial institution – for its members will elect the next pope and help develop the policies the Catholic Church will follow in the future.

Early church leadership

During the Roman Empire, when Christianity was illegal, Christians would meet secretly. These meetings were often held in private homes called house churches – domestic buildings that were later adapted solely for worship by members of the local Christian community.

It was during this time that leadership of these communities developed into three main orders of ordained clergy: Overseers became bishop, elders became priests, and ministers became deacons.

After the legalization of Christianity in the early fourth century, Christians were free to build large, more elaborate public buildings for worship, which often expanded some of these original house churches. New churches were also built in various sections of Rome, as well as in seven areas surrounding the city — like suburbs – called the suburbicarian churches.

By the sixth century, key members of the clergy staffing many of these Roman and Italian churches, especially the older ones, were referred to as cardinals, from the Latin word referring to a hinge, or a central joint. Leading deacons, senior priests and prominent bishops serving these parishes were all called cardinals.

Papacy as a political prize

Over these later centuries, Christianity also spread more widely north of the Alps, and the numbers of Christian churches and clergy expanded. However, because of ongoing warfare, conquest and political turmoil, Christianity in western Europe entered a more turbulent period. Popes came to exert political as well as spiritual power, leaving the office of the papacy vulnerable to the influence of competing secular powers, as well as powerful local Roman families and foreign rulers.

This became such a problem that in 769, under Pope Stephen III, a council held at one of the central churches in Rome – St. John Lateran – ruled that no layperson could be elected pope or influence the election of anyone to the papacy; only candidates holding the title of cardinal could be elected pope.

This requirement improved the situation for a time, but also contributed to the increasing political power of cardinals, traditionally the popes’ closest advisers.

In the later ninth and 10th centuries, however, the papacy again became a political prize for prominent Roman families and Italian nobility. This period, called the “nadir of the papacy,” produced a series of unworthy popes, including Pope Stephen VI, who put the corpse of his predecessor on trial; and Pope John XII, at 17 the youngest pope ever elected, who spent his papacy in the mid-10th century in drinking, gambling and debauchery.

However, many changes took place during the next two centuries, supported by reform-minded clergy and rulers in what is now France.

Several popes, notably Popes Leo IX and Gregory VII, brought organizational improvements to the bureaucratic structure of the Catholic Church in the 11th and early 12th centuries; many individual cardinals came to direct administrative departments.

In 1059, Pope Nicholas II declared that a pope could only be elected by members of the College of Cardinals, and a special election consistory was mandated in 1179.
Vatican II and other developments

In the following centuries, cardinals in the Catholic Church continued to assume important roles in Rome as curial officers, diplomats – called papal legates – and experts in the Catholic legal system, the canon law. Others served as advisers to rulers in Catholic countries or directed groups of bishops in their local pastoral ministry.

Pope Benedict XV, cardinals and others pray for peace in Europe at St Peter’s (San Pietro) on Feb. 7, 1915, at the Vatican. 

DeAgostini/Getty Images

Several popes made more substantial changes in the number and selection of cardinals in the 20th and 21st centuries. The requirements for a cardinal candidate were narrowed. In 1917, Pope Benedict XV promulgated a universal Code of Canon Law. In it, the office of cardinal was restricted to priests and bishops, and deacons were excluded.

Later, on the eve of the Second Vatican Council, held from from 1962 to 1965, Pope John XXIII declared that all cardinals must be ordained bishops. Subsequently, John Paul II – pope from 1978 until his death in 2005 – dispensed certain exceptional priests, often elderly theologians, from this requirement. The first so honored in 1983 was the French theologian Rev. Henri de Lubac, and the first American, named in 2001, was Rev. Avery Dulles, S. J..

In addition, popes at this time, stressing the universality of the church, added several new cardinals from countries around the world.

A larger College of Cardinals

Partly because of this stress on diversity, the size of the College of Cardinals increased dramatically. During the later medieval period, popes and councils set the maximum number of cardinals who could serve at one time, varying from 20 in the 14th century to 70 in the 16th century. That limit remained in effect until the 20th century, when John XXIII expanded the College to 88 cardinals, which his successor, Pope Paul VI, expanded to 134 – less than half the size of the College today.

The duties expected of individual cardinals have also changed. During his papacy, Paul VI set out rules for the retirement of all bishops and priests, as well as cardinals: All were expected to submit a letter of intent to retire when they reached the age of 75.

He also set another age limit: After reaching the age of 80, cardinals would not be eligible to vote in a papal election, although they kept the title of cardinal for the remainder of their lives. Even before the September 2023 consistory, almost half of the total number of cardinals were over 80, and so were barred from voting in future papal elections.

The College of Cardinals at the Holy Mass, presided over by Pope Francis at the Vatican Basilica, on Aug. 30, 2022.

Grzegorz Galazka/Archivio Grzegorz Galazka/Mondadori Portfolio via Getty Images

Cardinals and the future of the church

During his pontificate, Francis’ selections have continued to shape the composition of the College of Cardinals in several ways.

Many believe that with his appointments, Francis has tried to ensure that his vision of the church’s future will continue after his death; he is 86 years old and in failing health.

Given the fact that the vast majority of cardinals under 80 are Francis appointees, some commentators have noted that the pope has “stacked” the College with cardinals who are inclined to agree with his more liberal focus on inclusivity and social justice issues, rather than Benedict XVI’s stress on doctrinal orthodoxy and traditional values. Francis’ latest round of cardinal appointments have further underscored this tension.

Some more conservative Catholic bishops and cardinals have criticized the pope’s statements and actions as increasingly divergent from Catholic traditional teaching. The late Cardinal George Pell from Australia, who served over a year in prison until his conviction for child sex abuse was overturned in 2020, called Francis’ pontificate a “catastrophe” in an anonymous letter sent to other cardinals in 2022.

Other bishops and cardinals disagree. For example, Cardinal Blase Cupich, archbishop of Chicago, has publically approved of the pope’s determination to “situate the church for its future” by emphasizing a more collaborative approach, and praising Francis’ stress on inclusion rather than division.

Whatever the outcome of the next papal election, members of the College of Cardinals, as bishops in active ministry, diplomats, intellectuals and papal advisers, will have a profound role in shaping that future.

This article is republished from The Conversation, an independent nonprofit news site dedicated to sharing ideas from academic experts. 

It was written by: Joanne M. Pierce, College of the Holy Cross.

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Women's voices and votes loom large as pope is set to open a Vatican meeting on church's future

NICOLE WINFIELD and TRISHA THOMAS
Updated Mon, October 2, 2023 






6- Sister Nathalie Becquart, right, poses for a photo as she enters Vatican City, Monday, May 29, 2023. In 2021 Pope Francis appointed Becquart as undersecretary of the Synod of bishops' Organizing Secretariat, a job which by its office entitled her to a vote but which had previously only been held by a man. At previous synods, women were only allowed more marginal roles of observers or experts, literally seated in the last row of the audience hall while the bishops and cardinals took the front rows and voted. In the upcoming synod starting Oct. 4, all participants will be seated together at hierarchically neutral round tables to facilitate discussion. 

(AP Photo/Alessandra Tarantino, File)


VATICAN CITY (AP) — A few years ago, Pope Francis told the head of the main Vatican-backed Catholic women's organization to be “brave” in pushing for change for women in the Catholic Church.

Maria Lia Zervino took his advice and in 2021 wrote Francis a letter, then made it public, saying flat out that the Catholic Church owed a big debt to half of humanity and that women deserved to be at the table where church decisions are made, not as mere “ornaments” but as protagonists.

Francis appears to have taken note, and this week opens a global gathering of Catholic bishops and laypeople discussing the future of the church, where women — their voices and their votes — are taking center stage for the first time.

For Zervino, who worked alongside the former Cardinal Jorge Mario Bergoglio when both held positions in the Argentine bishops' conference, the gathering is a watershed moment for the church and quite possibly the most consequential thing Francis will have undertaken as pope.

“Not only because of these events in October in Rome, but because the church has found a different way of being church,” Zervino said in a recent interview in her Vatican offices. “And for women, this is an extraordinary step forward.”

Women have long complained they are treated as second-class citizens in the church, barred from the priesthood and highest ranks of power yet responsible for the lion’s share of church work — teaching in Catholic schools, running Catholic hospitals and passing the faith down to next generations.

They have long demanded a greater say in church governance, at the very least with voting rights at the periodic synods at the Vatican but also the right to preach at Mass and be ordained as priests. While they have secured some high-profile positions in the Vatican and local churches around the globe, the male hierarchy still runs the show.

This 3-week synod, which begins Wednesday, is putting them more or less on an equal playing field to debate agenda items, including such hot-button issues as women in governance, LGBTQ+ Catholics and priestly celibacy. It's the culmination of an unprecedented two-year canvasing of rank-and-file Catholics about their hopes for the future of the institution.

The potential that this synod, and a second session next year, could lead to real change on previously taboo topics has given hope to many women and progressive Catholics. At the same time, it has sparked alarm from conservatives, some of whom have warned that the process risks opening a “Pandora’s Box” that will split the church.

American Cardinal Raymond Burke, a frequent Francis critic, recently wrote that the synod and its new vision for the church “have become slogans behind which a revolution is at work to change radically the church's self-understanding in accord with a contemporary ideology which denies much of what the church has always taught and practiced.”

The Vatican has hosted synods for decades to discuss particular issues such as the church in Africa or the Amazon, with bishops voting on proposals at the end for the pope to consider in a future document.

This edition is historic because its theme is so broad — it’s essentially how to be a more inclusive and missionary church in the 21st century — and because Francis has allowed women and other laypeople to vote alongside bishops for the first time.

Of the 464 participants, 365 are voting members, and of them only 54 are women. While organizers insist the aim is to reach consensus, not tally votes like a parliament, the voting reform is nevertheless significant, tangible evidence of Francis’ vision of the Catholic Church as being more about its flock than its shepherds.

“I think the church has just come to a point of realization that the church belongs to all of us, to all the baptized,” said Sheila Pires, who works for the South African bishops' conference and is a member of the synod’s communications team.

Women, she said, are leading the charge calling for change.

“I don’t want to use the word revolution,” Pires said in an interview in Johannesburg. But women “want their voices to be heard, not just towards decision-making, but also during decision-making. Women want to be part of that.”

Francis took a first step in responding to those demands in 2021 when he appointed French Sister Nathalie Becquart as undersecretary of the synod’s organizing secretariat, a job which by its office entitled her to a vote but which had previously only been held by a man.

Becquart has in many ways become the face of the synod, traveling the globe during its preparatory phases to try to explain Francis’ idea of a church that welcomes everyone and accompanies them.

“It’s about how could we be men and women together in this society, in this church, with this vision of equality, of dignity, reciprocity, collaboration, partnership,” Becquart said in a June interview.

At previous synods, women were only allowed more marginal roles of observers or experts, literally seated in the last row of the audience hall while the bishops and cardinals took the front rows and voted. This time around, all participants will be seated together at hierarchically neutral round tables to facilitate discussion.

Outside the synod hall, groups advocating for even more women's representation in the church are hosting a series of events, prayer vigils and marches to have their voices heard.

Discerning Deacons, a group pressing for the pope to approve female deacons, as there were in the early church, sent a small delegation and the issue of female deacons is formally on the synod agenda. Other groups pressing for women's ordination to the priesthood are also in Rome, even though the pope has taken the subject of women priests off the table.

“I’m hopeful that there is room in that space for these bold conversations, courageous conversations, and particularly that the voices and experiences of women called to the priesthood are brought to the synod," said Kate McElwee, director of the Women's Ordination Conference.

Zervino’s group, the World Union of Catholic Women’s Organizations, a Vatican-based umbrella organization of 100 Catholic associations, conducted a survey earlier this year of Catholics who participated in the synod consultations. While a few women in North America and Europe called for female priests, there was a broader demand for female deacons and the call is featured in the synod's working document.

Francis listens to Zervino, an Argentine consecrated woman. He recently named her as one of three women to sit on the membership board of the Dicastery for Bishops, the first time in history that women have had a say in vetting the successors of Christ’s Apostles.

Zervino says such small steps like her nomination are crucial and offer the correct way of envisioning the changes that are under way for women in the church, especially given all the expectations that have been placed on the synod.

“For those who think that there's going to be a ‘before the synod and after,' I bet they'll be disillusioned," she says. “But if women are smart enough to realize that we're headed in the right direction, and that these steps are fundamental for the next ones, then I bet we won't be disillusioned.”

___

Associated Press writer Sebabatso Mosamo in Johannesburg contributed to this report.