February 12, 2021

Friday Forum is an All Hands meeting for the Levels team, where they discuss their progress and traction each week.

https://youtu.be/VTL7lg9HTg4

Transcript

Josh Clemente: We’ve got a quorum here. Looking good. All right. Let’s jump right into it. We have a special guest on, and we will intro Dr. Perlmutter in just a second, but I’m just grateful for him making the time to join us and for being a part of the Levels Research journey and an advisor to us. So diving straight in, February 12th, 2021-

Casey Means: Josh, you’re not at full screen right now. Just FYI.

Josh Clemente: Yeah. So I’m doing the present mode so that I can refresh easily if I need to. Yeah. Okay. So big week. I want to highlight just right off the top, product that you events are always critical to moving us forward. And we had a really important one this week, which was the first contextual Zone Education. So there’s a little screenshot in the middle. I’m going to let David do most of the talking here. But essentially this is delivering information in the moment that somebody may or may not be confused about what they’re seeing. It’s often the first time somebody’s ever seen their biological information in real time. And so when you get a bad zone score for something you thought may be healthy, that can be confusing. And if we don’t provide information in that moment, we’re missing an opportunity.

Josh Clemente: And so the first build of the app that includes that contextual education is live, which is awesome. Thanks everyone that worked on that. The Levels Program has been selected for a 100 person, 12 week trial with the Salesforce wellness team. And this is huge, obviously, but also a really important learning opportunity. So we’re going to be launching this on March 1st, really appreciate everyone’s help in advance with getting that prioritized and scaling the necessary systems to make sure we can keep everyone moving through quickly for that start date. And in particular, Tom, appreciate all the work you did in locking this down. So I’m looking forward to learning a lot and we’re going to win some, we’re going to lose some. I think this is a huge win. And we’re also going to discover ways that we can, I think, scale our potential employee wellness program opportunities.

Josh Clemente: We kicked off a guided nutritionist pilot with both Jessica Dogert and Lauren Sambataro. And they will each be doing small cohorts where they’re working with the Levels participant or Levels member throughout the entire 28 days and helping to provide additional dietary insight recommendations, just contextualizing what people are seeing. And this has been something that’s been really called for by many, many members across the past few months. So it’ll be interesting to see what we learn here and if this is something that we may want to externalize or internalize or what to go forward with.

Josh Clemente: Had a really good week on the universal IRB concept. So there are details and Notion, but essentially working on establishing a concept that will allow us to integrate with hardware inside of a research study that could be the largest of its kind on sub diabetic glucose levels in the general population.

Josh Clemente: Right now we have a tentative study team signed on that includes the Institute of Human and Machine Cognition to University of South Florida, potentially even Stanford. So a lot of exciting conversations. The next steps are converge on something that works for all parties.

Josh Clemente: And then the obvious visuals here are all oriented around this week’s features in print. So we hit the slot machine on this one. We had New York times Jezebel and Men’s Health all launched full print articles the same week, which is just mind blowing to see. Shout out to everyone. This is huge love seeing Stacy’s imagery in print unchanged. I mean, it’s just so awesome that some of the earliest photos that were taken in the apartment of the [Flinners 00:03:39] a year ago are now printed in the March issue of Men’s Health. So huge.

Josh Clemente: Kristen Holmes, who runs performance and research at Whoop, which has a really successful research program is going to be joining Levels research advisory team. I mentioned this last week, but she has agreed to come on and help us sort of go hide and improve our strategy to getting really high throughput in terms of IRB approvals and high gained partnerships. So I’m very excited for that. And then merch kits, which we’re not going to call them swag. It sounds like merch is the high end version of swag. Anyway, merch kits are ready for distribution. We’re going to be iterating on these as well. So look forward to feedback and what we can do next.

Josh Clemente: Had some really good conversations with Anne from 23 and Me. We have Equinox onboarding their tier X, some tier X trainers for a potential pilot with them. And then lastly, we have a really exciting set of athletes that came through, silver medalists across in the Olympics, NFL, continuing to get tons of interest organically through our potential athlete performance optimization route. So not really leaning in, in a serious way I think into sports specifically, but the individual use cases are all pretty awesome. I think that’s the big one. Some good quotes in here. A couple people just really vindicating the long term usability of the product as well on Twitter and through the user feedback.

Josh Clemente: All right, I’m going to hand it over to Casey to intro Dr. Perlmutter.

Casey Means: Thanks Josh. So I am so excited to introduce to the team our special guest of the week, Dr. David Perlmutter. He is the newest member of our medical advisory board. And to say he is a legend is an understatement. He has really been the key thought leader on linking metabolic health to neurologic health and overall health for decades and getting this topic into the mainstream narrative through all of his work.

Casey Means: So a little bit of background on David before I turn it over to him to say a few words. So he is a board certified neurologist. He’s the author of five New York Times bestsellers. Some of my absolute favorite books that actually initially really inspired me to think differently about root cause medicine. These include Brain Maker, Grain Brain, the associated cookbook, and Whole Life Plan. And his newest book, which is written with his son, Austin Perlmutter, a good friend of mine, which is Brainwash, which is just an incredible book about how to really optimize our brain health in the face of a lot of challenges in our modern world, like the digital world and our processed food world. So just incredible, incredible books.

Casey Means: He’s the board of directors of the American College of Nutrition. He’s on the editorial board of the Journal of Alzheimer’s Disease. He hosts the empowering neurologist podcast, Brings on Key, thought leaders in this space on his podcast. Dr. Davidson Clair was on recently. He’s had Dr. Bredeson, Dale Bredeson and just many other incredible people talking about metabolic health and various health conditions.

Casey Means: He has an incredible blog at drperlmutter.com, writes prolifically about metabolic health and wellness and lectures all over the world. Harvard, Columbia, NYU, World Bank at IMF, just all over. And he’s been featured in Oprah, Larry King, 2020 to Today Show. All over the place. So he’s just absolutely incredible. And we have been wanting to bring him on board basically since day one of the company. And we’re just so thrilled that he’s joined us to really take Levels to the next level. And so, David, thank you so, so much for joining the team and for being here. So if you’d like to say a few words, we’d love to introduce you.

David Perlmutter: I’d be happy to. Am I unmuted? Yes.

Casey Means: Yes, you are.

David Perlmutter: Well, thank you, Casey. And one thing I’m very excited about in our podcast is we have this world renowned individual in this area. Casey Means going to appear on the program soon. So we’re all real excited about that.

David Perlmutter: A few things just as an update in my life that I think are going to be relevant because I think they may offer up some avenues that Levels can use moving forward. We’ve decided to take our podcast to the next level. Currently I’m in a studio in Naples where we normally do our podcast recordings, et cetera. We’re moving everything up to a much higher level of quality and looking at various avenues for sharing it across multiple platforms. So I want to let you know that’s happening. And not taking these in any particular order.

David Perlmutter: The next thing I would tell you is I’ve been in very close conversations with Nestle Health Science as of late in a variety of context. One of which has to do with some of the products that they are just bringing out that relate to insulin sensitivity, glucose balance, et cetera. They are keen on partnerships that can both show them in a good light and can also be involved in studies that may demonstrate effectiveness of what they’re doing. And so it just, as we were talking about that earlier, Josh, you were mentioning some of the things going on, there may be some terrific avenues there. I mean, I think when you get to interact with a company like that, the sky’s the limit or there is no limit.

David Perlmutter: The third thing I will say is that interestingly, as Casey mentioned, our most recent book Brainwash deals with how we make decisions. Are they short term, self supportive, or are they more thought through long term and more involved? Not just in what’s best for me, but what is also going to be better for the next person, better for the planet, better for the future me. Long term thinking, which is more of a prefrontal cortex type of decision.

David Perlmutter: What we learned is that there’s a powerful relationship between our ability to make better decisions and levels of inflammation in our bodies. In other words, diet plays a huge role in our decision making. Either we have higher inflammation and are locked into impulsivity and self-centeredness, or with less, read, Western diet in our lives, we’re able to leverage the prefrontal cortex and make better decisions. So, it’s really quite clear that one of the surrogates for inflammation relates to blood sugar, certainly. The literature on longer term measurements of blood sugar, A1C, fructose, et cetera, are very well established surrogates for inflammation. But my point is that I really think that an area that can be explored moving forward deals with decision making. It’s sort of a, forgive the pun, a feed forward process.

David Perlmutter: But the better your decision making, the better will be your decision making. So other words, you make better decisions in terms of lifestyle. IE, based upon your feedback through your CGM and therefore moving forward, your decision making will improve. And the corollary, the feed forward process leading to worse decision making is really quite clear. So with that, as an intro, I think I can take questions or just passively participate in the rest of the meeting or open to whatever.

Casey Means: Thank you so much for that intro, David, and what you about the feed forward mechanism. I think really that is so much of what we’re thinking about in terms of our research program this coming year. And how can we show that when people are able to make these better decisions consistently through using a bio wearable with intelligent software, what can we actually see happening in the body? Metabolic biomarkers, metabolic phenotypes, changing over time. And so it’s really great to hear your perspective on that.

David Perlmutter: Casey, let me make one more point if I could, because I think this is also very … I want to plant this in everyone’s brains moving forward, and you know this, but I think for the rest of us. And that is what I’m working on right now. And what I’m working on right now is a book that deals with uric acid. And I know many of you are familiar with the kind of newly discovered role of uric acid or purported role in metabolic syndrome, insulin resistance, as part of that hypertension, weight gain, certainly, type two diabetes, as if they were different. But really most of the maladies of our common times being mediated by this important intermediate called uric acid. And the powerful role that uric acid plays in mediating, specifically, the obvious detrimental role of elevated fructose in the human diet. It’s a really fascinating story, how this is a genetic mutation that occurred in our ancestral primates about 14 million years ago, where we lost what is called the uricase enzyme over a period of several mutations.

David Perlmutter: That is the enzyme that allows us to break down uric acid. Hence we, as humans, and to a lesser extent other great apes, build up uric acid. It served us in the day of caloric scarcity, food scarcity by allowing us to develop insulin resistance, which was a good thing because it triggered us to make fat. So it selected out that uricase mutation, it’s selected out individuals to retain body fat, which was a survival mechanism. That’s why we carry this mutation. All humans. The point is now, obviously, we live in a time of caloric abundance, fructose overfeeding, et cetera, which is a detrimental manifestation then of this uricase mutation, because now fructose consumption and there are other lead-ins to uric acid, but fructose consumption leads to elevated uric acid, ultimately leads to hypertension directly. We can talk about mechanisms, but also through the mechanism of insulin resistance, we get fatter.

David Perlmutter: So the wish list for what we could measure in the future, I added uric acid because we’re so involved in looking at that. But the book, which will be published spring of 2022, manuscript is due middle of June this year. So on a pretty short timeline. The name of the book is Drop Acid. There you go. So that’ll be the attention grabber. We’ll work on the subtitle that works uric acid into that Notion. But no, it’s not about psychedelics. But the point is, manuscript is mid-June. I would foresee working, possibly working Levels into the manuscript somehow. I think the lead in would be perfect. There’s this whole narrative out there remaining in the world that eat all the fructose you want because it doesn’t affect insulin levels. And if somebody’s going to have an event-

Casey Means: Oh, David you’re muting yourself.

David Perlmutter: But anyway. The narrative is that diabetics can eat fructose because it’s good for them because it doesn’t raise insulin. My gosh. I mean, our mission is to really challenge that silly mentality and to let people know that while it does hasn’t happen within 24 hours in the longer term, fructose is about the most lethal thing you can do as it relates to insulin sensitivity. So anyway. So noodle those ideas and I’ll stand by to hear from probably you Casey, about what you want to do moving forward.

Casey Means: Thank you so much, Dr. Perlmutter. Josh, back to you.

Josh Clemente: Awesome. Yeah. Thanks a ton. And I’m excited about the potential for other analytes, uric acid specifically. And we’ve got a little tidbit about that at the end of this show. So thanks.

Josh Clemente: And jumping ahead to the Fourth Fridays, Fireside. This is just a quick aside, but the next chat is February 26th and there’s a link here for your topics submissions. This is a notion. If you want to tackle a specific question, if you have a certain topic that you’d like to dig into with the team, please jump onto the Notion and submit it prior to that next meeting. And we’ll have things to dive into as a team. David, product and eng.

David Flinner: All right. And thanks Dr. Perlmutter. That was fantastic education on uric acid and everything. So excited to have you on board. So as Josh mentioned, the first thing that we pushed out this week was the contextual education in your Zone details page. And so just wanted to highlight. This is not the end result you see here on the screen. This is what we showed last week, but going from concept to actual launch took quite a bit, and a lot on the engineering side, through John, a lot of the foundation work with the insight cards as well.

David Flinner: And then next slide. The last week we worked with Haney and Casey to get together what content do we actually want to be surfacing in the moment when you have a … Like, it’s your first glucose spike or you’re constantly getting bad Zone scores. What’s important for people to know. And so we developed some really simple, excellent content that we’ve been struggling to put into words over the last year on what is a glucose spike? Why is it important? And then how should I think about that going forward, through both the principles of better glucose manage and then some practical tips on food swaps, on things you can do to try instead. We paired that with some of the creative assets that we’ve had from Stacy that we’ve taken at our own photo shoots.

David Flinner: And next slide. You can see this is what we launched yesterday. So Josh, you can play that. So now you have a zone here. A spicy fried chicken sandwich that I got. Now below, you’ll see understanding my score. What does a glucose spike mean? And then a few more of what you can do instead. Aspirational imagery. Clicking on those, you’ll see this is the in-app content that John developed over the last few months on the in-app content framework, where we can start to embed this stuff. And some simple rules that people can read to learn more. Hyperlink out to more details.

David Flinner: We’ll continue to augment this. You can imagine that maybe under each of these principles, there’s a little button that says like, “Add this to my to-do list or add this to my challenges. So I can actually remember it and try it next time.” But for now this is some really practical, good tips that you can get right in the moment that it matters.

David Flinner: Next slide. Yeah. So what’s next for this one? We’ll be monitoring for usefulness. Right now that’s going to be primarily for the customer feedback. So eager to hear how people take this. And then over time … This is built so we can expand it to cover other things. Right now it’s only surfacing for essentially when you get a bad score, but you can imagine, we can expand that broadly to help you get more and more articles. Like, how does this score relate to weight loss or my other goals? So we can have additional content to add there. We can go cover more events, like good scores, or it’s your first low glucose event. We already have cards and content for that. We can pair that here as well.

David Flinner: And then over time, as we get into the more bespoke insights that we’ve been aspiring to get to, we can have that in this area too. So celebrate, like for example, maybe we celebrate an improvement, like, “Hey, what you have in this zone, that meal, plus a walk that was a better score than previously,” with an automatic comparison. Or maybe we paired that with a card with companion data from a third party app. Like maybe we get fasting data from zero and there’s a zero card that shows up there. Or maybe there’s something else from Apple health with all your fitness data that could show up there.

David Flinner: And then as we think towards the nutritionist pilot, dieticians, there’s always so much, our mission is to reverse the metabolic crisis. And a lot of that is accessibility. So we need to get this in the hands of most people. And so we’re focusing on automated insights, but there’s only so much we can do on the automated insight front. So over time we might start to, if the dietician pilots or health coach pilots workout, you can imagine that there’s a world where you see your Levels automated insights, also potentially paired with if you have a personal dietician you’re working with, they could annotate that with a card at the bottom saying like, “Hey, great job, Casey, why don’t you try this instead though, it might be slightly better.” It could augment that very well in this framework. So there’s a lot we can do here looking to the future.

David Flinner: Next slide. And then John’s been working on exploring some explorations with the dashboard V2. So the goal for this has been to not try to solve all the problems that our members have on one screen with our current dashboard, but to have a new simplified qualitative homepage where, at a glance, you can understand how your day’s going and what to do next. And there should always be something that when you open the app, you know where you’re at and what are the things you can do with Levels to meet your goals. So John’s been working on, you can see, it’s hard to see, but in the lower left corner, there’s a new home tab down there. So now there’s two dashboard tabs. That’s just temporary and internal, but it’s a new canvas that we’ll be iterating on. As we explore. He implemented a new, much more performant calendar switcher or like a day switcher.

David Flinner: So what you’re seeing here is, you can ignore the UI, but it’s switching days and the numbers are changing very quickly. And what’s cool about this is that all that data is coming from the back end, even though it’s being presented in the front end. And that smooth liquid experience is going to be really key for people to stay engaged in the app. And we don’t have that right now, especially on Android. If you use our app on Android, it’s very laggy and this new version should solve that. But next for this, we’ll be working on that glanceable card, other presentations of zones and insights. So more to come here.

David Flinner: Last week I mentioned that Gabriel had just pushed out when we started the meeting, our third version of anomaly detection. And you can see here just a one week update on how the changes that we’re … We’re looking at the data and continually changing how we detect important events in the glucose data. And we’re continuing to see gains in the hit rate for our anomaly detection. So the green line going up means that our members are taking action to actually create logs from the things that we’re suggesting they should create logs with. And the blue line is when the member says, “No, this is nothing. Just ignore this.” So it’s nice to see that staying stable while the green line goes up. So great work Gabriel on that one.

Josh Clemente: Love it.

David Flinner: And still in progress, subscriptions is progressing. So that’s really nice and it’s going to be a huge win for opt in for our members. Nothing huge to report there. Next slide. The day score ranking is still underway. So we took a look last week at the … Josh, Mike and I had done a lot of labeling of the data and there were some interesting findings.

David Flinner: So broadly, there was a lot of internal consistency across our rankings, but then when you compare across each of the three of us, there are scenarios where we disagree. So I think she’s going to be preparing another data set. We’re highlighting the cases where we disagree so that we can surface that up for more expert review and say, “Hey, in this tricky scenario, maybe it’s a trade off between three medium spikes versus one giant spike, or one slow and high elevation.” How do we actually begin to tease out what is better or not between some of these details? And this is where I think we could, once we have a smaller set, it would be really good to get the advice of people like Dr. Perlmutter or other people on our board and saying, “Is there a right or wrong answer here, or is potentially this a research opportunity where we can go and see whether one of these is a better or not scenario?”

David Flinner: Next slide. Offline mode is still in testing. It was ready to launch potentially this week, but we held off a bit more because it’s, well, it’s a super critical feature. If it goes wrong, it could also cause some of those disappearing bug issues. So we’re holding it off for another round of testing. So please do jump in and try out the offline mode so we can pressure test it and make sure that it gets released and makes people happy.

David Flinner: Next slide. And this is a small one, but we fully launched the tap to view full pictures in this latest release.

David Flinner: Next slide. And yeah, this is just a summary of the effort we did this week. A couple things that I didn’t mention that I’ll call out here. Xinlu pushed out some changes that probably no one saw, but it was a code cleanup, which is really good, because it took a lot of backend queries that the app was no longer using. And this is important because as we continue to add features, as we continue to grow, the more complexity we have in the code base, the more it’s going to slow down our velocity and the more it’s going to introduce challenges developing the app going forward. So it’s really good to carve out some time to make sure that things stay as simple as possible in the app. It’ll help us on the front end as well.

David Flinner: And Hao has been working on some population comparison explorations. And this is something that I’ll be partnering with him a bit more in the coming week to identify some of the foundational questions. Is this something that can be … What is particularly useful about showing population comparisons? What if it turns out that 88% of the US population is not metabolically healthy? Do you want to see a distribution of everyone on that? Would it be something to celebrate if you were at the 85th percentile in that sense? Or is it still bad? Do we want to help evoke an emotion that you’re still in a bad state? Or should we celebrate that you’re better than 85% of the US population, but still bad? We don’t really know what the population distribution looks like yet, too. So there’s some foundational stuff to explore. I think that’s it.

Josh Clemente: Awesome. Huge update. Thanks, David. And a lot of exciting stuff in work and launched. So eng team, thank you for continuing to crush this. All right. Miz. Mike D is out this week, so Miz will be taking the weekly feedback.

Michael Mizrahi: Yeah. Sounds good. So on behalf of Mike, completed about nine calls this week, and a shout out to Ben and David for taking a few of those, mostly focused on subscribers, given the growth that we’ve seen there, as well as some detractors mixed in as well. David, on that last note that you mentioned in terms of comparison to population in general, it sounds like a lot of feedback and questions around that. A lot of members are expressing that they just want to be told, one, how they compare to other people for competitive reasons, for motivation, for curiosity. And then a little bit off that, people just want to be told what to do as well. So we’re getting a lot of explicit requests, “Just tell me what to do, and I will do it,” versus the experimentation and the challenges which people have to work to get there. And so seeing some interesting behavior there. We’re also seeing some of that on the support side as well. So interesting to see how we’ll address that. And I think some of these app improvements will go a long way on that, on that front.

Michael Mizrahi: The second big theme that’s coming out here is around logging. As we know, a lot of the logs get used for the catalog and then get used at the month end report. A lot of members don’t realize that the quality of their logs matters for the ultimate results that … Quality in, quality out, let’s say. They don’t necessarily realize that. And so getting the report at the 30 day mark with incomplete photos or incomplete logs can be disappointing. And a lot of folks wish that they knew that sooner. And so some requests around that.

Michael Mizrahi: The other pieces around logging are around scanning, barcode scanning, meal tracking. A lot of people are using other apps, My Fitness Pal, and these other food tracking apps and food logging apps. We continually get requests for those kinds of integrations, so that folks don’t have to log their meals in two places. So that’s a theme that’s come up there.

Michael Mizrahi: Other thing to note, Michael post a weekly feedback from all the calls in Notion tonight and put the link in Slack. So if you haven’t read that in a while, make sure to check it out. It is pretty valuable feedback and very important for us to stay in touch there. Cool. So that’s it for this slide and then onto the next, Josh, we’ll take on the operation slide.

Michael Mizrahi: ID verification updates shipped earlier this week. These are the ones that we previewed last week. So the selfie and the photo ID. Early indications are that this is really, really working. I think we only had a dozen or so, and [inaudible 00:28:19] you can correct me if not … Incorrect consult photos this week, which is a huge decrease improves the customer experience significantly, improves the ops friction significantly, reduces the number of back and forth emails. So it’s a very impactful change. And thanks Hao and David for designing that and implementing that pretty quickly. We’ll continue to keep an eye on it and report back with some more firm numbers, but it’s looking good there.

Michael Mizrahi: Other support topics that we continue to see. Subscriptions are almost by far our largest conversation topics, so the most volume there. Adjustments. So, date changes, address changes, payment changes. A lot of back and forth around there. And then sensor accuracy continues to be one of the primary pieces of feedback that we get from both 28 day members, as well as subscribing members.

Michael Mizrahi: They’re seeing differences between their two sensors. After 14 days on one sensor, they apply the second and notice that it’s not quite calibrated the same exact way as the other. There’s a calibration period that’s unfamiliar. And so we do a lot of replacements on these after a few days, but it generally just causes a lot of questions across the board of accuracy. So overnight lows, switching sensors, low readings, generally, accuracy continues to be just a pretty big part of our conversation load.

Michael Mizrahi: Other than that, our wait list grew 5,000 in this last week. I think the New York Times piece had a lot to do with that as well as some of the other press pieces. So that’s a 5,000 person increase. Active subscribers is at 600. So growing at a steady clip. I shout this out every week and I’m going to shout it out again, huge, huge hat tip to Laurie, to Mercy, to Braden for keeping subscriptions running. This is just an insane amount of manual work to get these filled on time, charged on time, email communicated on time, fill request submitted. And so we’re running a pretty large operation manually, and can’t wait for the product improvements coming there.

Michael Mizrahi: We’re ready for the Salesforce pilot, added that to the forecast and through the next four or so weeks, we have just under a thousand consults scheduled and we’re putting out about four to 500 orders a week. So I think we’re at 400 as of this morning. And disclaimer, this top graph is an incomplete week. We still have three more days left of fulfillment. So we’ll likely come up to the low 500s is expected. I think we’re at 400 this morning. That’s it on the upside.

Josh Clemente: Awesome. Thank you, Miz. All right, Ben.

Ben Grynol: Okay. For growth, so we’ve got $10.6 in cash in the bank. Same as last week. Month is trending pretty well. We’re at $193,000 of recognized revenue. So we are about a third of the way through the month and already two thirds of the way almost to our goal of $300,000. So a month should be looking pretty good.

Ben Grynol: Next slide, please. Weekly revenue. So we are at $76,000 of cash generated that’s unrecognized revenue.

Ben Grynol: Next slide, please. These are the fun ones. So data and analytics. Had a pretty big push with Ben Greenfield. So Feb six, I think that was last Saturday, the podcast episode dropped with Josh. Feb ninth, Ben did an IG post that that was unexpected and then there’s also a blog post that went out. And so what we saw is that there are 160 partner code uses since Feb six up until last night. And that’s $63,000 of revenue generated, unrecognized revenue, which is pretty significant given that we can see how some of these affiliates really impact our growth as a channel.

Ben Grynol: Wanted to highlight LinkedIn. So about a month ago, we started posting on LinkedIn and the goal was to just get a cadence started. We weren’t using it as a platform or a channel for bringing awareness to what we’re doing. And what we’ve seen is our follower account has grown by 30%. So it grew by about 250 people over the past 30 days. We went from zero impressions to 12,000 impressions. So again, it’s still much lower than platforms like Twitter, but it is a trend in the right direction. Engagement rate. So 5% as a reference point, a good engagement rate on LinkedIn is about 0.5%. So we’re 10X in engagement rate, which shows that people really like seeing what we put out and what we’re doing.

Ben Grynol: Page views, 8,600, almost 8,700 page views is pretty significant. Unique visitors. What that means is that we have a lot of people that keep coming back to our page. And if you start to dig to it, what people are looking for is job views. So even though we’re not posting jobs on LinkedIn, that’s a pretty big channel or a big funnel of people who are interested to see when we do have roles as we start to build out the team.

Ben Grynol: Next slide, please. Growth updates. So in Notion, there’s a snippets library inspired by Sam himself. So I think we can all get value if we can dump some of our favorite superhuman snippets in there. As far as forecasting, worked on a super scrappy growth forecast related to partnership initiatives. So the goal being that every time we know there’s a Kelly Leveck podcast or an IG post coming out, we can say, “Hey, our target is X. And the actual that we realize is Y.” The point of it is to give the ops team a heads up so we’re not getting these major inflections in growth that are unexpected.

Ben Grynol: As far as assets go, we’ve got proposed updates to the website that we are working through and we’ll get those going soon enough. And then lastly is the branded podcast. So we had a new drop today, and that is it for growth.

Josh Clemente: Awesome. Thank you, Ben. Moving right along. Mercy.

Mercy Clemente: So this week we broke 20,000 followers on Instagram. So that is huge and very exciting. That’s just over, I think that’s 1400 followers in a week. Ben Greenfield posted stories and an actual post on his page for Levels. So I’m sure that brought over a good amount of followers. And then I’m just sharing a couple interesting user generated pieces of content that were really exciting and inspiring to see.

Mercy Clemente: Next slide. Twitter. We were still over 10,000 growing. I think we grew 400 followers in the past week. So that’s nice that that’s picking up. Twitter information, it’s always really interesting. So the one I like, I always like seeing the great comparison. So this one person on the left said they didn’t believe the hype around the grapes and how much it spiked until they tried it. And they were very surprised and alarmed. Yeah. So just that’s it on social.

Josh Clemente: Cool. Thank you. All right, Tom.

Tom Griffin: All right. Main update here. As Ben mentioned, is Ben Greenfield Fitness that dropped. Calling this one out again. I mean, Ben is a real legend in the space. One of the earliest CGM influencers out there alongside people like Tim Ferris, Peter [inaudible 00:35:29], Dave Aspray. So definitely recommend giving this one a listen.

Tom Griffin: Casey is back, as we all know, and she booked a ton of podcasts. These are just a subset that are listed here. These are all tier one shows that are upcoming that we’re really excited about. Bulletproof will be dropping at the end of the month. And then very excited of course, about Dr. Perlmutter’s interview with Casey. Kelly LeVeque, a16z, BOSSBABE. Those dates there are all recording dates. So we’ll update those when we have more clarity around when they’re going to be dropped.

Tom Griffin: Next slide. All right, playing around with slide formatting here. This is a slider version of it going forward. That’s going to consolidate all upcoming media or influencer promos. So this could be a social post from an affiliate, a podcast interview that’s including a skip the line link, podcast advertisement. So last week, again, Ben Greenfield, and then upcoming the next four weeks. This is what we’re looking at. I’m going to call out Kelly Leveque is doing an IG takeover. Shout out to Stacy. This was all her idea and pitched it to Kelly. Kelly said yes. And so this is going to be huge. So thank you, Stacy. This is awesome.

Tom Griffin: And then another interesting experiment will be a Bulletproof Back Catalog ad. So this is pretty interesting. Every single Bulletproof podcast episode that has aired in the past, for the month of March, will be playing a Levels ad on it. So if you were to listen to any Bulletproof episode, whether it’s three months ago or two years ago, there’ll be a Levels ad playing on it for the entire month. So this will be really interesting to see what type of conversions it generates.

Tom Griffin: Next slide. All right. Some additional partnerships updates. I’ll probably do a dedicated slide on the Salesforce pilot next week, but we’re moving forward and it starts on March 1st. I think they evaluated like eight to 10 vendors and we were one of three that were selected. So it was inevitable that we were going to be picked, which is really great. Equinox. We got eight tier X trainers being onboarded, which is the initial wave of that pilot. The Barwis video, we will present next week. Ali Spagnola released a new YouTube video, doing comparisons around exercise post meal, which is really cool. And then a number of great VIPs, including former Bachelor and NFL player, Jesse Palmer, Kim Glass. Kim is amazing. I worked with her at Halo, excited to get her more involved at Levels. And then probably biggest athlete we’ve had, Mitch Trubisky. He is a starting NFL quarterback, as well as Donovan Peoples-Jones who’s a star rookie in the NFL. That’s it.

Josh Clemente: Awesome. Thank you. All right, press update.

Casey Means: Awesome. So just a few dedicated slides to our press this week, since we had our biggest week yet for press with three big print features. So first just a little debrief of the New York Times article. So this was pretty incredible. Very, very favorable article. What was some key points about it, what I think were so special about it, it was about personalized nutrition, but it really emphasized metabolic dysfunction as an epidemic. It also emphasized biochemical individuality. It mentioned in detail, the Weissman Institute paper from cell personalized nutrition by prediction of glycemic responses. Really focused in on that point that everyone’s different and you need to test.

Casey Means: The journalist, Anahad O’Connor. He did a trial of Levels and learned a ton. It was pretty cool. He talked about, “I’m a published author about nutrition.” He’s written a book about nutrition. He’s a senior editor for the well section, and he was like, “I didn’t think I was going to learn anything.” And then spends the article talking about everything he learned. So helped him identify foods that he had no idea where spiking his blood sugar. Chickpeas, vinegar, and better alternatives, and reinforced the value of exercise. He also, in detail, described our process of consultation and fulfillment very favorably.

Casey Means: He ended the entire article with a quote, talking about the metabolic health epidemic. It was a quote from an academic researcher and how CGM is poised to potentially help mitigate that crisis. So overall, really incredible, and just huge kudos to the team and to Anahad O’Connor for just really putting together, I think, a really powerful article. And also just a shout out to JTPR, our PR company, because they really facilitated this connection and had incredible communication and are just doing … They are incredible.

Casey Means: So next we had this four page Men’s Health feature that was part of the future of fitness. This was also extremely positive. Bill Griffin, the author, tried Levels for a few months. He found huge value. He names Levels as the best for optimizing metabolic health. And his focus in the article was on personalized nutrition, athletic optimization, rapid improvements. He saw really big improvements in his numbers over the course of the time he used it. And he talked also about the metabolic health crisis.

Casey Means: So what’s so cool about this and the New York Times article is these authors really grocked the concept that there’s such a dual nature to metabolic health. We’ve got the epidemic and the chronic disease aspect of it, the 128 million Americans with diabetes and prediabetes, but then also the implications for current and performance and things like personalized nutrition, energy athletics. So, just really kudos to them for capturing the angles of what we’re doing.

Casey Means: Next slide. We also just had this beautiful feature in Jezebel. I think the art is just incredible. Huge kudos to Stacy for just this gorgeous photography. It’s so great to see it on display. Again, very favorable article. The author tried the product. We had a great conversation and she got a ton of value out of it. So congratulations to the team. This was a really exciting week and big thanks to JTPR.

Josh Clemente: Awesome. Thank you, Casey. Haney.

Mike Haney: Yeah. So three articles since we last talked. Does vinegar really lower blood sugar is a fun one. We’ll be looking at more of these, these kind of health hacks that go around and really trying to dig into the science of it. And then the healthy candy was sort of our nod to Valentine’s day. Thank you to those of you who tested. If anybody continues to test candy, let us know. We can always update those screenshots. If anybody needs candy, I have a cupboard that is way too full of it right now, and I’m happy to send some out.

Mike Haney: And then a really nice member story this week. This is when it came in through social, the folks that emailed Mercy and said, “Oh my God, we’re dancing with joy here over how much the numbers have improved.” A really lovely couple from Arizona that work together to bring Scott’s numbers down. If anybody notices a disconnect, his name is not actually Scott Anson. He requested a alias.

Mike Haney: And one little thing that came up this week over email that that Sam initiated was the fact that our mission, as we have been stating it, we’re on a mission to reverse the trend of metobolic dysfunction is a little wordy. Dysfunction is maybe hard for folks to wrap their head around. And so we played with some other ways to talk about it. We’re talking about using metabolic health as the phrase that we really try to get into the zeitgeist. I think that tags very well on what Casey was just talking about in those articles. And so after consulting my editor wife and coming up with about seven different words for this, I looked at something Ben had wrote, and he had the perfect phrase in there, which is solve the metabolic health crisis. So anywhere where we’ve got the mission right now, across Notion, we’ve just changed this wording slightly to, we’re on a mission to solve the metabolic health crisis. If anybody has thoughts about that, happy to keep exploring it, but I think it’s a really nice, succinct way to describe what we’re doing.

Josh Clemente: Love it.

Mike Haney: Next slide. And then just from my stat of the week that I always like to share. This is a new one we’re tracking, which is blog to wait list sign up. This is our current conversion metric, I finally figured out in Google analytics, how to track this. It’s been going up a little bit each week. But so this week, this is anybody who’s gone to the wait list from a blog article. So this is really just trying to capture like, does the content that we have spur people to go sign up. And I think this will be a really fun one to watch moving forward. That’s all for me.

Josh Clemente: All right. Thank you. I’m going to do five second research update. So no major updates. We covered this on the first page. The IRB is moving forward. We have great interests from IHMC and USF, potentially even Stanford. This is in the ballpark now for us to move forward. And then the Allison Hull pilot is moving quickly. Signups are in, kits have been shipped out. Thanks to the ops team for making that happen.

Josh Clemente: Grove City College, signups begin imminently. For both, we need to put together a dashboard that de-identify … Well, in one, it has to de-identify to the study team who the participants are per their data. And the other is single blinded, so everyone can get the data straight to the study team. So will be cool to start seeing some results pouring in and to close the IRB study concept.

Josh Clemente: All right, we are to the individual contributions. So let’s start with 10 seconds each, something we’re excited about. Personal encouraged. Tom, over to you.

Tom Griffin: Oh boy. All right. Doing a pivot here. It’s just so cool and super surreal to have Dr. Perlmutter on the Friday Forum. I know I’ve mentioned this in the past, but I somewhat randomly met James Murphy like six years ago. He gave me Grain Brain and book indirectly led me to like pivot my career and go into consumer health and science space. So yeah, really cool. And on a weekly basis, I’m just amazed at the community we’re building and so grateful to be a part of it.

Josh Clemente: Awesome. Thank you. Ben.

Ben Grynol: Plus one, really excited to have Dr. Perlmutter join our advisory board. Very, very cool. One other hat tip, Miz for putting out that great memo, how Levels meets. Really excited about that and have used it lots. Personal front, been jamming out to Pomplamoose, which is Jack Conte, founder of Patreon’s band. So if you haven’t checked that out, check out YouTube and you can see some of the covers they do. It’s great.

Josh Clemente: Also a good LaCroix flavor. Hao.

Hao Li: Yeah, glad to see. We have more professional in the field to join us. Welcome Perlmutter to our meeting. And personally, I’m doing a little DIY for my house this weekend. So looking forward to put down some vinyl planks.

Josh Clemente: Awesome. Dr. Perlmutter, I’d love to have you join us with just a quick contribution, something you’re excited about.

David Perlmutter: I’m Excited about this. I’m very excited about this. I mean, this plays into what I’ve been talking about for decades. I mean, if you ever get the chance, there’s a CBS morning show where I was interviewed last year, talking about sugar, how important it is and the counter from, I guess her name is Gail on that show, was that they reached out to the sugar industry that said sugar is perfectly fine, eat all you want. So it was really a bit of a challenge for me.

David Perlmutter: One thing I just wanted to float a bubble is, I don’t know what is the experience on Clubhouse for just the CGM discussion in general or more specifically what you guys are doing, what we are doing. But I’ve been doing a fair amount of that as of late. So maybe Casey, we can coordinate something there, get a few other people, maybe there’s several other people in the space that we can coordinate and have a nice talk on Clubhouse. These are kind of influential people and I think it might be some great exposure.

Josh Clemente: That would be awesome. Yeah. We’ve had a few chats on Clubhouse thus far, but I think that would be an awesome one. All right. Thank you, Dr. Perlmutter.

Josh Clemente: I’m excited about a ton of stuff. It was crazy to see all the print this week. My brother, Rodney, being featured in Stacy’s photography in Men’s Health is kind of a thing that I wouldn’t have assumed unless we are in a simulation. But all that to say, huge week, it was crazy to see. And I’m also just super stoked about the industry. I’ve been learning a ton about the technology for biosensors and the potential is massive. We’re getting more attention and more support from the industry leaders like Dr. Perlmutter. And it’s just, it really bodes well, I think, for the future of health and society. And then I’m also excited because my fiance got a job this week. We’re going to be going back to Philadelphia for the rest of the year. And she got a job at the University of Pennsylvania’s hospital, which is a really huge win. So, stoked for that. Casey.

Casey Means: Thank you. So I’m going to have to pivot and my new one I’m excited about is the upcoming Clubhouse with Dr. Perlmutter. So that’ll be great. I did my first Clubhouse this past week and it was really fun. And then we also have one coming up with Vijay from a16z on the 22nd. So excited to explore that platform a little bit. Also really excited about our product content discussions. It feels like we’re really accelerating on those. David’s really taking the lead on that and having Haney on board makes this all really just move so much faster. And it’s just really exciting to see that coming together.

Josh Clemente: Definitely. Sam.

Sam Corcos: Yeah. The thing I’m most excited about is the quality of candidates we’re getting coming inbound. The engineers are really incredible and the lead designers are really world class. So I’m super excited about that.

Josh Clemente: Great. Miz.

Michael Mizrahi: Yeah, I think the speed we’re moving at is pretty awesome. I’m just kind of reflecting on how fast things are going. And there’s a feeling like we’re approaching the starting line, we can see where things really start to launch and all these things, but also just pausing and realizing what we’re building in the moment. So a little bit of that. This is it. This is what we’re building right now. And so it’s cool to see the progress there and feel like things are in a good spot generally, but also on the side.

Michael Mizrahi: And then on the personal end, I mentioned this before, but it came up again this week. I don’t take this work culture for granted. I think it’s really nice that we’ve landed on it and that everyone’s bought into it, and we’re really trying something new here, and it’s working. And so, I’ve shared that memo with a few folks that I’ve worked with in the past and it’s foreign to them. And like, I wish, that’s such a dream. It’s cool that we actually have it. And so really thankful for that.

Josh Clemente: Awesome. Lori.

Laurie: Well, it’s always exciting to hear the updates each week. It’s really exciting. Personally, I’m thinking about Sunday. My husband and I are planning to, if the weather clears up, we’re going to go buy some fruit trees for our backyard and do some more planning and that’ll be nice. I bought him a man crate. The first time I’ve ever experienced that. I don’t know what they are going to be in reality, but maybe he’ll have fun with that. I don’t know. I like Valentine’s day. We plan hours just to spend together, which we don’t usually do. So I’m looking forward to Sunday.

Josh Clemente: Very nice. Enjoy. Stacy.

Stacy: From a work perspective, the press that’s come out this week has just been so exciting to have these big names just speak so highly of their experience with what is a beta product. It’s just thrilling. And then from a personal perspective, one of our favorite things about New England is how much it reminds us of old England. And so we found a couple hundred year old pub in a neighboring town, and we’re going to simulate a little walk through the countryside in our wellies and then go to the pub. So, that should be fun.

Josh Clemente: Awesome. I’m sure we’ll see pictures. Sounds great. Mercy.

Mercy Clemente: I’m really excited about the new order validation process that has saved a huge amount of time. And I’m hoping that it continues to. And also all the press this week. That was really crazy. Personally, my boyfriend and I to go to Florida. So we flew down here last night and we’re here for the weekend. So it’s nice to be in warm weather because it’s snowing and I think 20 degrees back in Virginia.

Josh Clemente: Must be nice. All right. Haney, wrap it up.

Mike Haney: For work side, I’ll just plus one all the press. This being my background and my space, seeing names like the Times and Men’s Health, where my wife worked for a number of years, getting on board to this is just super exciting and seeing how positive those are is great, because I know how cynical journalists can be. So I love that they had a good experience and said really positive things. And on a personal side, speaking of my wife, she just put on her Levels sensor for the first time this week. So it’s been really fun watching her go through the learning and discover new things.

Josh Clemente: Love it. All right. So jumping ahead, I’m going to, this week, do a quick run through of some stuff I’ve been learning. I know we don’t have much time, so I might do a loom of this if it’s helpful after. But I’m going to dive into some technologies that I’ve been learning about. And specifically, biosensor tech. So aptamers and enzymes is the today’s story.

Josh Clemente: So we’ll start with enzymes. Enzymes are proteins. They basically accelerate reactions and they break down other molecules, typically which are called substrates. And a good example of this is glucose oxidase. This is a small enzyme, pretty stable, all things considered. Most enzymes basically, they will de composed quite quickly in regular environments. This one breaks down glucose into glucolactone and it also produces hydrogen peroxide in the process. And I’ll get to why that’s interesting.

Josh Clemente: But another fun fact is that glucose oxidase is found in large quantities in honey. And this is one of the reasons that honey doesn’t spoil very quickly because the hydrogen peroxide acts as a natural antibiotic. So it tends to attack bacteria.

Josh Clemente: So the way this works is in the CGM systems that you’re all probably wearing right now, a filament, which is coded with the glucose oxidase enzyme is in the body, in the interstitial fluid. Sorry. And glucose and oxygen interact with the enzyme. And the enzyme breaks that down into hydrogen peroxide, which you can see over here. So this molecule hydrogen peroxide breaks off after being reacted with the glucose oxidase. That hydrogen peroxide then gets oxidized further with this metal filament, the electrode. So there’s electricity running through that. And when that hydrogen peroxide molecule oxidizes, it breaks off an oxygen, it breaks off two hydrogen molecules, and then two electrons are produced. And those electrons run up the electrode and they are sensed as an electric current, which is what we are actually measuring as the glucose signal.

Josh Clemente: So this is the way an enzymatic sensor system works. You have a multi chain chemical reaction where some sort of electron is typically sensed. So enzymes, they’ve been identified for a large number of molecules, but they’re dependent on the specific molecule you’re measuring and the reactivity of it. So there are certain molecules that will react with an enzyme that also reacts with other molecules, which means that the specificity is not very high in certain cases. So they’re well described. They’re commonly used. It’s a very old school way of measuring things. And some of the issues are that enzymes are highly unstable and sensitive to temperature and other conditions.

Josh Clemente: So this is where I’m excited is because there’s a new technology based on aptamers. Aptamers are single strands of DNA or RNA. So it’s oligonucleotide is the specific name, but they have a strong binding affinity for just a single molecule. And the way this works is you synthesize, you have a massive library of genetic code and you synthesize single strands of DNA and RNA, and you make this giant cluster of a ton of different varieties. And then into that solution, you add the molecule that you want to measure. So you just dump these little blue circle molecules in there, and then you filter out the molecules that bound to specific DNA strands. And then you repeat this process a bunch of times, and eventually you get the specific DNA sequence or aptamer that binds to your molecule with the highest affinity. So essentially, you just repeat this process until you find out what binds to your molecule best, then you sequence it with a DNA sequencer and then you know how to make that. So you can just repeat it. You can synthesize that specific DNA strand, anytime you want.

Josh Clemente: And in terms of measuring, this is where it gets cool. So in a biosensor, you can take all of these aptamers, which are just single strands, and you can tag them with this little blue dot at the top, which is called a redox reporter. Oops, what did I do? That redox reporter essentially is exchanging. You can see on the side here. It’s exchanging electrons with an electrode, which is in the same thing as the traditional CGM sensor. So it’s constantly exchanging electrons back and forth with this electrode.

Josh Clemente: When the target molecule comes along, that this aptamer likes to attach to, it actually connects with and changes the shapes. So the top picture is when there’s no molecule, the bottom picture is when that molecule gets trapped by the aptamer. And that difference in distance. So the aptamer wraps around the molecule and it brings that redox report or that little blue dot closer to the electrode. And that massively increases the current, the electron exchange, to the filmament.

Josh Clemente: So what you end up with is a very easily measurable signal, and that signal is so sensitive that it can literally measure fractions of an angstrom of difference in the distance between that redox reporter and the filament. So it’s a very, very sensitive and very specific way to measure molecules. Now, the most exciting thing is that an aptamer can be developed for basically any target molecule. So you can measure proteins, hormones, synthetic drugs, lipids, uric acid. You could literally develop an aptamer for nearly any molecule that you can think of. And the specificity’s amazing.

Josh Clemente: So I know we’re running a little over time here, but just to close out, this seems to be the future of biosensors in the sense that you don’t need reactivity, you don’t need to worry about unstable enzymes, and you can potentially develop a sensor that is 10,000 times more likely to bind to the specific molecule you need than any other molecule, even one that’s almost identical to it. So you don’t have the situations where you, for example, eat or drink high … What is it? High-C? Or what is it? Emergen-C. So you drink this thing that you think is good for your immune system. It’s got a ton of vitamin C in it, and your blood sugar goes through the roof.

Josh Clemente: In reality, what’s happening is, that vitamin C is binding to you and breaking down with the enzyme on this CGM sensor. It’s not a real blood sugar elevation. So that happens with the current state of things. It wouldn’t happen with an aptamer. So I’m stoked that we could potentially measure cortisol, triglycerides, caffeine, et cetera, if we can innovate into the aptamer space.

Josh Clemente: So I’ll stop there. Sorry for going over. And we’ll call the meeting here. I’ll share the slides. We’d love to hear if anyone wants more stuff like this, or it’s too abstract.

Sam Corcos: That’s great.

Casey Means: That’s fantastic.

Sam Corcos: [crosstalk 00:58:54] Yeah, more.

Josh Clemente: All right, cool. So yeah, I’ll share the slides. They’re brief, but they’ve also got some cool videos that link out and I’m putting together a state of bio wearables doc in Notion that includes more of this info.

Josh Clemente: Alrighty. So we’re a little over, sorry about that, everyone, but packed week, really appreciate everyone’s contributions. Dr. Perlmutter, if you’re still on, I really appreciate you joining us and saying some exciting and enthusiastic words to help us keep things going. So, all right, everybody. Enjoy your Friday. Enjoy your weekend. Happy Valentine’s day. Talk soon.

Casey Means: Bye.