22. Josh Clemente | Levels (metabolic fitness)
Metabolic dysfunction should be front page news – but hardly anyone is talking about it. Josh Clemente is setting out to change that by shining a light on things like glucose levels, food reactions, and health with his company, Levels Health. Levels was created to provide innovative software to help anyone with an interest in health to gain real-time access to their glucose information. But more than anything, Josh and his team don’t want to sell software. They want to educate and inspire a new generation of healthy Americans. On this episode of The Founder, Josh spoke to host Kallaway about the powerful connection between data and personal accountability.
05:28 – Metabolic fitness as an aspirational goal
Metabolic fitness requires a lot of focus, effort, and repetition – but it is something that people can achieve when they put their mind to it.
“For someone who’s metabolically fit, they’ll produce enough energy when they need it. They’ll be able to tap into the energy stores that are available, whether in their blood or stored on their bodies as fat. And they’ll be able to perform at a high level, no matter what their goals are, day in and day out. This requires a lot of focus, effort, and repetition, which is why we call it metabolic fitness. This isn’t something that you’re born with necessarily. It’s just like physical fitness or martial arts or any practice, mindfulness, et cetera. You have to go in, make choices, learn from them and then improve on those daily, in order to produce an outcome that is beneficial. A lot of us really don’t think about metabolism. And we certainly don’t think about improving daily when it comes to metabolic health. That’s why we’ve introduced metabolic fitness because it’s an aspirational goal that you can work towards daily and have an improvement, both in your quality of life here and now, and also in your long-term quantitative risk of chronic illness.”
07:45 – How data can cause social change
We know every individual has unique reactions to food. When enough people make better decisions based on their personal data, we get social change.
“Even identical twins who share a hundred percent of their DNA can have similar variations in their responses to the same foods. This shows that A) everyone’s an individual, there’s no one-size-fits-all diet, and B) it’s not all genetics. You can’t predict just based on genetic factors. There are other factors like potentially stress environment, body composition, potentially microbiome, all of which are going to affect the way that a person processes their food and turns it into energy. Without this data in real-time, there’s no way of knowing whether you are, for example, a person who responds very negatively to fruit sugar, versus someone who responds negatively to grain sugars, and where all of that resolution lies is in the real-time data. So by empowering the individual at a small level, they make better choices. And then a large level, when many individuals are doing this, you get social change.”
11:48 – Changing the actionability of data with CGM
The goal is not just to have blood sugar data. The goal is to be able to decipher what the data means and use that insight to make better life decisions.
“I started to experiment pricking my finger, read about a continuous glucose monitor, really wanted one. I was turned down by my physician and several others for a prescription. And when I ultimately got one, I found out that I was either pre-diabetic or borderline, depending on who you ask. That really triggered two things for me. It was the realization that, Hey, there’s an accessibility issue, right? So these device manufacturers, they’ve done a great job developing the hardware. It’s really high quality, but getting your hands on it was very challenging just given the regulatory environment and that it’s not commonly used. The actionability of the data is not quite there. You get a raw data stream, but it’s very hard to determine whether the shape of this curve is correct. Should I be changing? When I eat a meal, how high should I go? How long should I stay elevated? Should I have any change at all? There’s all this like detailed nuance there that has never been explored whatsoever. We have a very unexplored world of metabolic function in non-diabetics. And so I think because of the improvements in the technology, it has facilitated the opportunity to start opening up this space and going in on wellness and performance in a way that otherwise wasn’t possible until the last few years.”
14:19 – The shades of gray of metabolic dysfunction
Metabolic dysfunction sets in slowly. The symptoms are often easy to dismiss as due to aging, temporary fatigue, and short term stress. For Josh, it took nearly three years to fix the damage done in close to a decade.
“It is truly shades of gray. As metabolic dysfunction sets in because it happens over such long timescales and so it’s not acute, it’s not super painful initially. It’s very easy to brush it off as a bad night of sleep or just the classic aging, or just shrug it off as like, Oh, this is in my head. That’s what I was doing as the fatigue levels were building over long periods of time. But it wasn’t until it was truly challenging to get to work in time, to get out of bed, to get the energy to make it to that meeting, or to make it to the meeting after lunch without arming myself with half a gallon of coffee, it was like all of a sudden, I kind of had a wake-up call at some point. Where I just said, something’s wrong. This is not just in my head anymore. At one point I was energetic and bouncing off the walls, all day long. And now here three, four years later, I’m feeling like I honestly would rather just curl up under my desk and sleep all day. That happened as a result of all the adjustments that come with professional life. You do push yourself, sleep starts to go out the window. You are aging, which is undoubtedly going to have an impact on your hormonal system, and how your body processes your metabolic function is related to your age. A lot of these factors set in simultaneously. And for me, it took probably a hard-hitting college career and then probably four or five years out in the real world before I stood up and looked around and thought, you know, this is not good. Something wrong is happening here.”
16:59 – Why is this not front-page news?
Rates of diabetes has increased 1,000% since the 1950s – but hardly anyone was talking about it. For the last seven months, Josh and his co-founders have been working to change that.
“The rates of diabetes are increasing, and they’ve increased by over a thousand percent since the 1950s. All of these statistics and I was just like, why are we not talking about this at a daily epidemic scale? Why is this not front-page news everywhere I looked? That process was very slow. It was a lot of research, a lot of turning things over in my head, and self-experimentation, but then once I got serious about bringing on the team and Sam Corcos was on the shortlist for sure. He and I talked and once we teamed up and really put the pedal to the metal things started to happen quickly, certainly not overnight. It’s now been about 13 months that we’ve been running Levels and we’ve only been out of stealth for about seven of those months, but things have been happening at a much faster pace now that we’ve got a real world-class team on it.”
18:23 – The first few iterations of the Levels CGM
Levels is rigorously testing several iterations of CGM to get the best out in the market. Right now, the trial users are buying from a pharmacy with a prescription, and getting data from a very simple platform.
“I like to put several iterations through my own testing before I’m ready to bring in somebody else and have them work on it or try it out. That’s kind of my instinct. And to Sam’s credit, when we started Levels and brought on the founding team, it was like a matter of days before he wanted to sell something and understand if there’s an appetite for this product to exist as we were envisioning it. What we ultimately put together initially was a very prototype-y version of what we have today. There was no app, we put together a partnership with a telehealth physician network. We built a little, very simple platform so that physicians could communicate with our potential customers and determine whether or not a prescription would be good for them. This is all independent from Levels. And then if they determined it was good, they’d write a script for this CGM and we’d have that delivered from a pharmacy. And the person would just use a CGM as exactly as someone with diabetes uses it. They would just text us about it, about their experience, and exchange thoughts, like, Hey, this is cool. I learned this interesting thing because my blood sugar shot up after I ate grapes, which was counterintuitive. I drank some wine last night and my blood sugar crashed, all night long I was hungry and restless and didn’t sleep well. And this morning I’m ravenous. They’re seeing this data and sending us interesting little tidbits and all of this information we could correlate back to research that we had seen.”
28:03 – Does a perfect protein bar exist?
From protein bars to breakfast foods, at Levels people are developing insights across the board on what works for them and what causes a blood sugar spike and crash.
“I’ve tested like every protein bar that’s out there and certainly all the zero carb ones. And the way that the zero carb bar is developed is they take the amount of carbohydrate in there and they subtract out the fiber and then the result is considered the carbohydrate load. As long as you add enough fiber to offset the carbohydrates, they can say that’s zero carb. However, because of the personalization element of metabolism, I respond very negatively to, for example, tapioca fiber in corn fiber. And so certain bars that use tapioca fiber to offset the carbohydrates cause a huge skyrocket for me. And so I’ll be in this pre-diabetic blood sugar range. One bar that does not do this to me is the Perfect Keto bar. They are net-zero carbs, but what they use as a base works super well for me. Being able to just know if I’m on the run if I need to grab something, a Quest bar, a Perfect Keto bar is going to work great for me every time is a huge win. People are developing these insights across the board.”
30:50 – A culture of radical transparency
At an individual and social level, people do not have enough information to make the best choices for themselves. Levels is building a culture of radical transparency where everyone shares the good and the bad through social media, blogs, and podcasts.
“We’re a radically transparent company. If people are interested in what we’re doing and they reach out to us, we’re going to share probably some long-form documents from the inside that we wrote about the problem that you’re asking about or about the specific topic you’re asking about. We’ve kind of embraced this transparency because the problems that we’re trying to solve are actually related to a lack of information across the board. At an individual level, we don’t have enough information to make good decisions day-to-day. And at a social level, we have this really contradictory nutrition environment and a lot of forces and tension that are keeping us all in the dark. Our goal here is truly to reverse the trends of metabolic dysfunction and to do that, we need to educate people on the problems as they exist and share as much information and knowledge base as possible. So I think leaning in really early on just being extremely transparent, both about the business practices and the underlying fundamentals and then also about the concepts that we’re working with. Our blog is a prime example. We leaned in hard on content, very early spending a lot of time at the founder level. My co-founder Casey Means, she’s a Stanford-trained medical doctor and between the various blog posts and her other responsibilities, she’s spending hundreds and hundreds of hours just giving information out.”
36:44 – Shifting the cognitive load to the second brain
Relying on software to keep track of nutrition and give feedback makes the process effortless. This makes it easier to develop information-based choices and develop new habits.
“When the cognitive load is shifted from the individual to the second brain, the software, that’s when we win. Everybody’s trying to make it through busy lives and perform optimally to the best of their abilities. Right now you’re adding this additional layer of having to determine what to eat and when to sleep and how to manage your work schedule so that you’re minimizing stress. And in the future, I think we’re going to be surfacing this proactively like we talked about and just guiding the individual through their life in a very simplistic, straightforward, and elegant fashion so that it’s very effortless. It’s not like you have to do something extraordinarily different. It’s just a matter of picking between whole fruit and a pressed juice. And when you know the difference for yourself with data, it becomes really easy. You just need to connect those dots with software.”
39:10 – A personal accountability partner
GCM is like having a real-time accountability partner full-time that is effortless, intuitive, and elegant to use.
“We are really cracking the code of that real-time accountability partner that you were full time, and that is effortless, intuitive, and elegant to use. We’re moving in that direction. The underlying software and user experience is a key component of our business. We’re spending really just tons of brain cycles from extremely intelligent people who I think are at the top of their game, in the world of data science, research, and software, to make this a reality. To really turn this product from something that people who are already health seekers who already know about CGM want to try, into something that people who have really never given a second thought to wearable devices are wearing every day and are guiding their lifestyles from. I think it’s going to be a paradigm shift.”
41:36 – Challenging the core tenets of health
Levels is challenging long held beliefs with a data-focused, scientific approach. Josh believes the keys to success are boldness, objectivity, honesty, and transparency.
“We’re really challenging a lot of the core tenants across the big spaces, everything from the food supply, through to nutrition advice, through to the way that we approach symptom care and medicine. People who are intrinsically bold, don’t just settle for the way things are, attracted to challenges like the one where we’re currently tackling. The second thing, combining boldness with just objectivity, basically being willing to challenge one’s own beliefs and avoiding dogma at all costs is another one that we select for. People who, despite being firm in their convictions, are always willing to question and change their minds in the face of better evidence. This is a very scientific mindset and you don’t have to be a strict scientist to understand the value there. We’re actually talking about products that affect people’s lives. And if you wouldn’t feel comfortable or if you’re so firmly rooted in your belief system that you can’t take in additional information and modify it going forward, then that’s not the right fit in a role where we are truly talking about affecting behavior change and introducing different outcomes. Boldness and that objectivity and honesty are really key. And the last one is just transparency. So people who are willing to admit when they’ve failed and willing to share the truth at all costs at all times is also key.”
01:04:04 – Creating a value-led business
Personal investment, big thinking, and teamwork are some of the key elements that Josh credits to Levels’ success.
“First, you have to have a personal investment in what you’re working on. You have to care about it. It’s easy for me to say, I know how challenging it is to find a big goal that you care about at a deep level. But I personally feel that that is a requirement. And second thing is, it has to be a big enough problem that other people will want to join you in solving that. So the challenge has to be close to you, personal, and large in the sense that other people would care about it. The third thing is I’m going to lean back on that, on the co-founder conversation, and just say, don’t make the mistake of assuming you can do it alone. If it’s big enough for you to leave whatever else you’re doing and work on it full time, then it’s very likely going to benefit from more people than just yourself. And so lean in on building an exceptional team who is going to embrace what you’re doing and basically be a force multiplier, as I’ve said, towards that vision.”
Kallaway: [00:00] Welcome back to another episode of The Founder, a show that features entrepreneurs and their early stories of ingenuity, struggle, and perseverance to get their companies off the ground. We do our best to capture the uncensored uncovered look behind the curtain, into what founders really face when getting started. I’m your host, Kallaway. Our guest on today’s episode is a rocket scientist and worked at SpaceX for six years, managing the team that designed the life support systems in their space shuttles. Over time, he started to experience extreme levels of fatigue and things like brain fog throughout his day. He would have these huge spikes and crashes of energy, but for someone that worked out consistently and followed the guidelines for what he believed to be healthy practices, it didn’t really seem to add up. After experimenting with glucose monitoring, he realized that he was pre-diabetic, border lining on fully blown diabetic. And the foods that he was eating were having a significant impact on his performance. It was this discovery and struggle to derive actionable insights from his glucose monitoring that led him to start Levels. Today at Levels, this founder and his team are revolutionizing the way people think about their metabolic health. And why is metabolic health so important? Before Levels, an average consumer had no way of understanding how efficiently or inefficiently their body was producing energy. The process that controls how you feel and perform both mentally and physically throughout the day. Levels is enabling you to access and understand that information in real time, so you can start making better diet and lifestyle choices to avoid those peaks and valleys. When you join their program, you’ll receive two 14 day continuous glucose monitors that stay on your arm and measure glucose in your blood all the time. Using the Levels app, you’re able to seamlessly monitor how different foods as well as things like sleep, stress and exercise are impacting your energy and then make adjustments. In the future, Levels will be able to predict and recommend what you should do to optimize your energy, acting almost as a virtual health coach with personalized recommendations based on your specific choices. As of September 2020 when this episode airs, Levels is currently in waitlist only beta mode. However, as a special offer just for our listeners, this founder has given you a way to cut the 31,000 person wait list and get the product as soon as possible. Go to levels.link/thefounderpod to shortcut the line and become a part of the program today. This is an inspiring interview that shines a spotlight on the massive metabolic health crisis we’re facing in this country and a category creating company that’s doing their part to help solve it. I hope you enjoy it as much as I did. Now, introducing the co-founder of Levels, Josh Clemente. Let’s get it. Josh, welcome to the show. Thanks so much for coming on.
Josh Clemente: [03:06] Thanks for having me. I’m stoked.
Kallaway: [03:08] Yeah, we’re pumped to talk about Levels today. So how I like to start these off is before we dive into the origin story and the company makeup, so you just give us a little bit of an anchor point into Levels. For those at home who haven’t heard about it, and don’t know what you do, what’s your mission, vision, product size today?
Josh Clemente: [03:27] Yes, so Levels is working to reverse the trends of metabolic dysfunction globally, using personal health information delivered at the time that we need to make choices every day. So, arming people with information from their own bodies to make better choices as it relates to their daily lifestyle.
And we are a small team, small but fierce. We’re currently at 13 people. We’ve got about 1300 early customers who have gone through our beta program and we’re really starting to see the resonance and the behavior change that we hope our product will introduce, happening in real time. And so we’re getting ready for our full launch here, closer to the holidays.
Kallaway: [04:06] Amazing. Yeah. Pumped to get into it. And for people at home who, you know, metabolic health, metabolic fitness is a phrase that’s not well known, and Levels is kind of owning right now in the space, for people who don’t know what that means, give a little bit of background in terms of, you know, what’s your vision for that? Someone who is metabolically fit, what does that look like?
Josh Clemente: [04:26] Well, metabolism is the way that our bodies take the food and environment, and turn it into energy. So every cell in every tissue in our bodies requires energy in order to operate. And the way that it produces that is from the food, the nutrition we provide it and the environment, sunlight. You know, it produces vitamin D and things like this. And so when metabolism is functional, we’re able to produce the energy we need in the the quantity we need it. And we’re able to function really effectively, physically, mentally, et cetera. Now, when metabolic dysfunction sets in, which is when these energetic processes start to break down, you either have incorrect allocation of energy. So this would be like weight storage, fat storage, for example, or you have cognitive, you know, sort of cognitive confusion, fatigue, physical detriments. You start to see these side effects and symptoms of systems going haywire that may seem completely decoupled from one another, but that ultimately are all tied to the way that our bodies are allocating resources.
And so for someone who’s metabolically fit, they’ll produce enough energy when they need it, they’ll be able to tap into the energy stores that are available, whether in their blood or stored on their bodies as fat. And they’ll be able to perform at a high level, no matter what their goals are, day in and day out.
And this requires a lot of focus, effort and repetition, which is why we call it metabolic fitness. This isn’t something that you’re born with necessarily. It’s just like physical fitness or martial arts or any practice, mindfulness, et cetera. You have to go in, make choices, learn from them and then improve on those daily in order to produce an outcome that is beneficial. Right now, a lot of us really don’t think about metabolism. And we certainly don’t think about improving daily when it comes to metabolic health. So that’s why we’ve introduced metabolic fitness because it’s an aspirational goal that you can work towards daily and have an improvement, both in your quality of life here and now, and also in your long-term quantitative risk of chronic illness.
Kallaway: [06:27] Yeah, I think what’s interesting is the personalization aspect that Levels is driving, and we’ll get into it. But we live in a world where people want templated things, right? Everybody wants a template, “Give me a map that has worked for someone else and let me just execute it and let me be done with it.” And what’s interesting on metabolic fitness in the, you know, what I’ve discovered with it is it’s personalized for everyone. One person can eat an Apple and have a crazily different response than someone else who eats an Apple. And so you really have to dial in your own individual metabolic fitness and health in order to optimize your own performance.
Josh Clemente: [06:59] That’s right. Yeah. The way Levels is going about giving people real time data is we’re taking the primary energy molecule in the human body, glucose, which is sugar. It’s another word for sugar. And we’re providing a data stream that is coming from your body in real time using this amazing technology: continuous glucose monitoring.
And one of the interesting developments that’s come about from the proliferation of this technology is we’ve learned exactly what you just said, which is that there is no one size fits all across the population. There were some studies in Israel, in the UK and at Stanford over the past four or five years that have shown two people can eat the exact same two foods and have equal and opposite blood sugar responses to them. And the UK studies actually followed up on that and showed that even identical twins who share a hundred percent of their DNA can have similar variations in their responses to the same foods. So this shows that A, everyone’s individual. There’s no one size fits all diet. B, it’s not all genetics. So you can’t predict just based off genetic factors.
There are other factors like potentially stress environment, body composition, potentially microbiome. All of which are going to affect the way that a person processes their food and turns it into energy. And so without this data in real time, there’s no way of knowing whether you are, for example, a person who responds very negatively to fruit sugar, versus someone who responds negatively to grain sugars. And where all of that resolution lies is in the real-time data.
So by empowering the individual, at a small level, they make better choices. And then at a large level, when many individuals are doing this, you get social change.
Kallaway: [08:37] And what people, you know, once they go down the rabbit hole and discover Levels, it’s, the product’s essentially a continuous glucose monitor. And what’s interesting is you didn’t invent the continuous glucose monitor. It’s been around for people specifically with diabetes to help them dial in their diet, to react to the condition. Why has it not been commercially available? You know, why has another company not gone down this path to try to make it more commercially available to the market?
Josh Clemente: [09:01] So to your point, the technology was developed for the management of diabetes. And so, diabetes is when the metabolic system is totally broken. And our bodies, which use a hormone called insulin to control blood sugar, it’s basically the lock that opens the key on a cell and lets sugar out of the blood, into the cell to be used for energy. When insulin stops being effective. This is a, either insulin resistance is one case where this happens or in the event of pancreatic failure, for people with type one diabetes, blood sugar levels get very high and a lot of very devastating consequences set in because too much sugar in the blood is a very reactive and toxic scenario. So it’s really important for people with diabetes to have full-time awareness of their blood sugar levels and to either inject insulin in the appropriate amount to control for it, or to make better lifestyle choices if they have type two diabetes. Now, continuous glucose monitoring is actually fairly new to the diabetes community. Traditionally, they’ve had to measure using finger sticks, which means they have to prick their finger, bleed onto the small strip, and then you get a single data point. And it basically just says you’re currently at 88. And you know, where you go, where you’re headed, where you came from, how quickly everything is changing is completely hidden. So CGM was developed to give super high resolution insight into that. Now you can see, “Oh, I was actually super elevated for the past three hours. I’m currently crashing.” Or “I just ate that thing and now my blood sugar is skyrocketing.” And it’s not just the stationary point. It gives us amazing color. It’s really helping people with diabetes to make better choices and live holistically healthy lives. But we’ve now gotten to the point where the technology is so readily available. The demand has increased supply and now prices have come down to the point where accessibility is a real interesting proposition. And so I think what we’re seeing is an inflection point where over time, the medical device manufacturers have just been focused on getting this more available by reducing the size of the electronics by getting all the clinical trials completed, such that you can demonstrate safety and efficacy, get them through the regulatory process. And then basically just put them in the hands of people with diabetes, and that’s been their goal.
Now I personally came across CGM because I was trying to figure out why I was burning out physically and mentally and just feeling extreme waves of fatigue in my day-to-day life. I worked at SpaceX. I was working on life support systems and came across some really interesting research that just showed how strongly the metabolic system is connected to longevity and the breakdown of it is connected to the risk of chronic illness. And I want it to make better choices for myself because I wasn’t using any data in my daily life. So I started to experiment, pricking my finger, read about a continuous glucose monitor, really wanted one. I was turned down by my physician and several others for a prescription. And when I ultimately got one, I found out that I was either pre-diabetic or borderline, depending on who you ask. And so that really triggered two things for me. It was the realization that, A, there’s an accessibility issue, right? So these device manufacturers, they’ve done a great job developing the hardware. It’s really high quality, but getting your hands on it was very challenging just given the regulatory environment and that it’s not commonly used. And then the actionability of the data is not quite there. So, you get a raw data stream, but it’s very hard to determine like, “What, is the shape of this curve correct? Should I be changing? When I eat a meal, how high should I go? How long should I stay elevated? Should I have any change at all?” And so there’s all this detailed nuance there that has never been explored whatsoever. You know, we have a very unexplored world of metabolic function in non-diabetics. And so I think because of this, you know, the improvements in the technology, it has facilitated the opportunity to start opening up this space and, and kind of going in on wellness and performance in a way that otherwise wasn’t possible until the last few years, and certainly wasn’t on the radar of medical device manufacturers. We’re very focused on the world of therapy.
Kallaway: [13:11] I was going to ask you about your background and how you got here. I think you covered a lot of it there. I’m curious, you know, how long at your job at SpaceX were you feeling this way, right? And how progressively bad did it get? I think, you know, that, plus, something people always ask me is you hear about these great businesses on these podcasts and immediately think like, “Oh, it’s like an overnight success.” And almost every founder that comes on, “Yeah, it’s been a long night. It’s been years and years in the making.” So why don’t you detail that process a little bit, the discovery, how long? And then where you guys have come so far.
Josh Clemente: [13:42] I was at SpaceX for about six years and I kind of, you know, it has an environment of extreme competitive effectiveness. You know, everybody wants to be at the top of their game and just working the hardest and pulling off the most impressive feats, so to speak. So it’s a really competitive and fast moving environment. And so for about four years, I was just in the grind, working unbelievable hours and not really taking any time and just kind of living and breathing my work. And so one of the sort of nebulous things about metabolic dysfunction is that it does not have strong side effects immediately. It is truly shades of gray. As metabolic dysfunction sets in, you kind of, because it happens over such long timescales and it’s so, it’s not acute, it’s not super painful initially. It’s very easy to brush it off as a bad night of sleep or just the classic aging, or just kind of shrug it off as like, “Oh, this is in my head.” And so that’s what kind of what I was doing is as the fatigue levels were building over long periods of time, but it wasn’t until it was truly challenging to get to work in time, to get out of bed, to get the energy to make it to that meeting or to make it to the meeting after lunch, without arming myself with half a gallon of coffee. You know, it was like, all of a sudden, I kind of had a wake-up call at some point where I just said, “Something’s wrong. Like this is not just in my head anymore.” You know, I was at one point, I was energetic and bouncing off the walls, like all day long. And now here three, four years later, I’m feeling like, I honestly would rather just curl up under my desk and sleep all day. And so that kind of, I think, happened as a result of all the adjustments that come with professional life. You know, you do push yourself, sleep starts to go out the window. You are aging, which is undoubtedly going to have an impact on your, the hormonal system and how your body processes, you know. Your, basically your metabolic function is related to your age. And so a lot of these factors kind of set in simultaneously. And for me, it took probably, you know, a hard hitting college career. And then probably four or five years out in the real world before I kind of stood up and looked around and thought, “You know, this is not good. Something wrong is happening here.” And so from the moment that I started taking seriously my health and thinking more holistically about wellness to the moment that Levels were started was about three years.
During that time, I started a business with my dad, which is still ongoing, but it’s kind of, I’m no longer involved daily. And then I spent also about a year and a half just buried in research and making the case for why Levels should exist. And I did that almost entirely on my own. It was a process of discovery, a bit of passion, as a personal interest. I was, I had discovered that I had this underlying dysfunction using a technology that I had never heard of up until like six months earlier, and it had completely changed the way I lived my life. And I wanted to know, “Is this something that other people are dealing with? And if so, how many other people?” And what I discovered was absolutely shocking. I mean about 90 million people here in the US have pre-diabetes and 90% of them, according to the CDC, don’t know they have it. 35 million people have type two diabetes, which is entirely preventable. The rates of diabetes are increasing and they’ve increased by over a thousand percent since the 1950s, all of these statistics that I was just like-
Kallaway: [17:08] Staggering.
Josh Clemente: [17:08] “Why are we not talking about this at a like a daily epidemic scale? Why is this not front page news everywhere I looked?” Yeah. So that process was very slow. It was a lot of research, a lot of, kind of turning things over in my head and, you know, self experimentation. But then once I kind of got serious about bringing on the team and, you know, Sam Corcos was one of the, he was on the shortlist for sure. He and I talked, and once we kind of teamed up and really put the pedal to the metal, things started to happen quickly. Certainly not overnight. It’s now been, I think about 13 months that we’ve been running Levels and really we’ve only been out of stealth for about seven of those months, but things have been happening at a much faster pace now that we’ve got a real world-class team on it.
Kallaway: [17:49] Yeah. And I’m pumped to get into that as well. One area I want to hit on is around the product. So I love having founders on that take on hardware and software at the same time, because I think it’s compounding challenges, getting them to talk together, you have to have basically two teams running it in parallel. Can you take us through the evolution of the product? Like what was the first iteration that you had right when you came out of stealth, or maybe before, when you had first beta customers to what it is today?
Josh Clemente: [18:14] Yeah. So Sam is, he’s really executional oriented to his credit. You know I’m being, coming from hardware, I like to put several iterations through my own testing before I’m ready to bring in somebody else and have them work on it or try it out, right? That’s kind of my instinct. And to Sam’s credit, you know, when we started Levels and brought on the founding team, it was like a matter of days before he wanted to sell something and get like understand if there’s an appetite for this product to exist as we were envisioning it. And so what we ultimately put together initially was a very prototype B version of what we have today. There was no app, it was- We would, we put together a partnership with a tele-health physician network. And so we arranged, we built a little, a very simple platform so that physicians could communicate with our potential customers and determine whether or not a prescription would be good for them. This is all independent from Levels. And then if they determined it was good, then they’d write a script for this CGM and we’d have that delivered from a pharmacy. And the person would just use a CGM as exactly as someone with diabetes uses it. And they would just text us about it, about their experience and like exchange thoughts like, “Hey, this is cool. I learned this interesting thing cause my blood sugar shot up, after I ate grapes, which was counterintuitive.” “I drank some wine last night and my blood sugar crashed. All night long I was hungry and restless and didn’t sleep well. And this morning I’m ravenous.” And like they’re seeing this data and sending us interesting little tidbits and all of this information we could correlate back to research that we had seen. And so it was relatively well understood by us what was going on, but very misunderstood by the end user. And so we’re starting to formulate like, okay, the data is super interesting. Having that real-time closed loop feedback is powerful. People are indexing on it very quickly, but what’s missing here is closing, you know, sort of the knowledge gap between what’s happening in your body and what you need to do about it. And this is where really large datasets and powerful like machine learning algorithms can identify patterns and surface those as potential for improvement. And so, yeah, we had that extreme prototype concept version of the program and from there essentially that was the, we were actually still in stealth when people were using that. So we put through probably a hundred people on that version. And then in January we launched the website and really kind of came out of stealth mode and released our first app version, which you know, is just looking back now, it’s only seven, eight months ago. My goodness. It’s unrecognizable. Like, I can’t believe that we released that app, but now looking at it, it’s come across, yeah, 400, 500 iterations of the app, and we really have some amazing features built in, I think.
Kallaway: [20:59] Yeah. And that’s a testament to the team for people listening. So I’m in the beta program right now, basically the Levels product. I don’t know if we’ve mentioned it to this granularity yet. Essentially you get two 14 day sensor boxes in the mail. The sensor is a wearable/implantable, I would say. It’s not a needle, or there’s a micro needle, but the actual sensor itself is kind of like a softer thread. You put it on your arm and it stays on your arm continuously, obviously continuous glucose monitor, and there’s a patch that goes over it. And then you download the Levels app and you’re able to diagnose what’s going on with the data. I think being a part of it now, how powerful it is to go from I’m eating things and it’s making me feel a certain way, I have no feedback loop, to just this base iteration is such a huge step change, but it’s so easy to connect the dots with where you’re going. And I think one thing I’d love to have you paint the picture for is in the way I think about it is there’s ways to do this in a reactive way or in a productive way. The reactive way is what we’re doing now, which is you collect the data, look at it afterwards and try to preemptively make better decisions. Proactive, you’ll have AI driven feedback coming in throughout the day, et cetera. Paint that picture because I know you guys on the team have thought through this and it’s really exciting.
Josh Clemente: [22:12] Yeah. So, right now, like you said, we’re in data gathering mode and we already have, despite being in beta still, and we’ve put about, I think 900 people have gone through the program. We already have the largest dataset of non-diabetic glucose information ever put together. And that tells you a lot. It tells you that this isn’t, it’s not just an understudied space, it’s unstudied. There’s so little information about what someone who does not have a diagnosed metabolic dysfunction should be doing. “What is an optimal glucose control?” “What does optimal metabolic control look like for that person?” And so what we’re doing is developing that framework where we’re truly setting the foundation upon which we can build the future optimization criteria for every person at an individual level. And so in the future, we will be able to surface those insights from you, from your own body, back to you so that you can understand specifically what your choices are, what the impact of your choices are on your metabolic health and how you stack up against the population, and where you need to go in order to achieve what direction optimal lies in. If that makes sense. And this starts with continuous glucose monitoring, right? Glucose is a powerful molecule, but it’s only one molecule. And in the future, we will add additional analytes. And you can think of many that are really interesting. Ketones, triglycerides, hormones like cortisol and insulin. All of these are, you know, basically co-factors in your metabolism. Your body is influenced by these and influences how you feel based on these. And so bringing all this together, you know, the individual will have, in real time, recommendations that they can live by every day to know that they’re making confidential choices, heading towards a better future.
And that’s the primary effect. The secondary effect is when you have an individual making better choices that’s great. But when you have many, many individuals doing that daily, not being caught up in fads, not being caught up in internet advice or something that worked for someone else, but actually making choices influenced by their own body’s information, those individuals stack up to social scale change, and that change is primary in the sense that they’re making data-driven decisions. Now it’s also secondary, meaning we start to cut through some of the problems that we’re facing in society that are really challenging to tackle. People making data-driven decisions about what they eat means that misleading advertising and misleading marketing and food no longer works. So now, when a company is advertising to you that a food is healthy or provides a certain benefit, once you have data to the opposite effect, you no longer trust that company and you make better choices around food and you demand better food supply options. And that introduces a really interesting secondary effect where the food supply improves. And when the food supply improves, you also have this, the secondary effect of better food being available at lower socioeconomic levels, right? And so you have this proliferation of basically feedback, forcing feedback loops that are benefiting society at really large scales. When there’s more data at an individual level, the medical industry and you know, doctors who are trying to provide both preventative and healing care have better context on their patient’s health status, right? When they have real-time data going back months or years, the doctor can use that to influence their understanding of this person’s health and provide better strategies for tackling any legitimate acute illnesses, right?
So you have all this interesting secondary effect that spreads out from people just wanting to make better choices daily using their own data. And, you know, in the future, I see health information being much more like financial information. So you’re going to, you’re going to pull out your phone, you’re going to have a real-time insight into how you’re doing. You’ll have a projection into the future and sort of a course that you’re following. You can share that data with an expert who can give you better insights into how to leverage this and, you know, kind of the sum total being we won’t just have sort of retirement plans that we’re pacing towards, you know, 10, 20 years in the future, but we’ll also have a really good idea of whether we’re going to be healthy enough to enjoy that retirement.
Kallaway: [26:34] Yeah. I mean, it’s massively important. I feel like how you feel and how you perform is everything. Like, there is nothing else that matters above that in my mind. And you know, when I think about the stage you’re in around, the next topic I wanted to talk about was around like the consumer profile and the segments that you found. It’s clear that you guys are in kind of early adopter stage where you’ve got people who are super excited about this topic, you know, advanced learning, and they’re the ones who are trying it. But I think it’s hard to not map the benefit of Levels to like a particular use case, as well as like the continuous real-time. So I was listening to a podcast you were on before, and you were talking about the travel example. So someone might be sitting at home, listening to this and say, “Oh, like, I don’t, I’m not a big wearable fan. Like I don’t need all this data,” but you travel all the time. And when you travel, you always feel worse when you travel. Like, why is that? It’s because when you’re not in your routine and you’re grabbing for snacks and other things that are not, your body’s not typically used to it, you don’t understand that’s causing an involuntary glucose response, right? And by using Levels, you can compare different snacks to figure out what works better for you. That’s such a small micro example, but I heard you talk about that on another podcast. And I totally agree.
Josh Clemente: [27:42] Yeah, there’s a huge number of intuitive and counterintuitive lessons learned like in the very early stages. And one of them is, yeah, finding out that certain products don’t work for you that you expected would, and then finding out that other products work super well for you, and realizing that those are your sort of arsenal. Like I’m going to lean on these products anytime I need them. And an example for me is I’ve tested like every protein bar that’s out there and all, you know, certainly all the zero carb ones. And the way that the zero card bar is developed is they take the amount of carbohydrate in there and they subtract out the fiber and then the result is considered the carbohydrate load. And so, as long as you add enough fiber to offset the carbohydrates, they sort of can say that’s zero carb. However, because of the personalization element of metabolism, I respond very negatively to, for example, tapioca fiber and corn fiber. And so, certain bars that use tapioca fiber to offset the carbohydrates cause a huge skyrocket for me. And so I’ll be, you know, in this pre-diabetic blood sugar range. And so one bar that does not do this to me is the perfect keto bar. So these are, they’re net zero carb, but what they use as a base, it works super well for me. And being able to like just know if I’m on the run, if I need to grab something, a Quest Bar, Perfect Keto Bar is going to work great for me every time is a huge win.
And people kind of are developing these insights across the board. It’s the same for breakfast. You know, a lot of people assume, like they do the Google search. “I hear through the grapevine, like oatmeal is the healthiest breakfast you can eat. It’s high in fiber, it’s heart-healthy.” Well about 75% of people that have tested oatmeal in the Levels database have a very abnormal blood sugar response to it, super high elevations, and then they come crashing back down. And the interesting thing about that as it relates to health is that a lot of these people are eating oatmeal because they were told to, or because they’re trying to do something healthier for themselves. But cardiovascular disease is very closely correlated with glycemic variability. So oscillation spikes and crashes in blood sugar is directly related to cardiovascular disease. It’s an inflammatory indicator and it leads to kind of damage to the arterial walls. And so somebody who’s doing this every day to try to benefit themselves and improve heart health may actually be doing exactly the opposite and working against their goals. And they may not even enjoy eating oatmeal in the morning. Maybe they’d rather have, you know, avocado toast or a handful of berries or something. And seeing that data is something that’s really unlocked a lot of freedom, a lot of food freedom for people who have gone through this program because they can now realize like, “Oh, I just don’t have to do that routine I never loved anyway. And I can eat this other thing and feel, you know, super confident.” Right?
Kallaway: [30:22] So [inaudible] for those people.
Josh Clemente: [30:23] Exactly.
Kallaway: [30:24] One thing I like to talk about on this show on every episode I ask about marketing and growth. So I always ask for like outside the box tactics that have worked for you. Obviously you’re in the early stages, but you guys have built an email list of over 28,000 people or a wait list that the people can’t wait to get the product. You know, I know podcasts is a huge strategy for you guys for good reason. This is a perfect forum for you to explain. What are some other things that you’ve tried that you saw kind of interesting response from consumers?
Josh Clemente: [30:50] We’re a radically transparent company. If people are interested in what we’re doing and they reach out to us, we’re going to share probably some long form documents from the inside that we wrote about the problem that you’re asking about or about the specific topic you’re asking about. And we’ve kind of embraced this transparency because the problems that we’re trying to solve are actually related to a lack of information across the board. At an individual level, we don’t have enough information to make good decisions day to day. And at a social level, we have this really contradictory nutrition environment and a lot of forces intention that are keeping us all in the dark. And so our goal here is truly to reverse the trends of metabolic dysfunction, and to do that, we need to educate people on the problems as they exist and share as much information and knowledge base as possible. So I think leaning in really early on just being extremely transparent, both about the business practices and the underlying fundamentals, and then also about the concepts that we’re working with. You know, our blog is a prime example. We leaned in hard on content very early, spending a lot of time at the founder level. You know, my co-founder Casey Means, she’s a Stanford trained medical doctor, and you know, between the various blog posts and her other responsibilities, she’s spending hundreds and hundreds of hours just giving information out, you know? And I think early on, we didn’t even really have a way to capture effectively, like people’s email addresses on the blog. We were really just giving away information for free, but people would spend long periods of time. I mean, like four to six minutes on specific blog posts. This is when we really didn’t have a brand of any kind. We were just like unknown, but people were seeing this information and realizing that this made so much sense and it’s resonating, and they’re spending a lot of time on it. And then they would actually go to the homepage and they would put their email in and jump on the wait list. And so, even though we weren’t super sophisticated on the systems and our website was not ideal early on, I think the quality of what we were putting out into the world spoke for itself early on. And so we’re continuing to double and triple down on that and just sharing information willfully and openly and kind of embracing that transparency throughout the organization, I think is really resonating. People are, everyone from customers through to investors, I think I’ve seen that and has realized that it’s a little bit different than what you’re used to.
Kallaway: [33:09] I like the sound of competitive landscape. You mentioned it already, you know, you guys are kind of blazing the trail in this space, but when I think of like an average consumer, there’s probably only a certain amount of their wallet that’s allocated towards like wearables, you know, elevating fitness. So when you look at companies like Whoop and Oura ring and you know, all of these wearable companies that definitely aren’t continuous glucose monitors, but are complimentary, do you view them as just that complimentary and you think there’s room for everybody or at some point? Is there going to be a competing factor for wallet share there?
Josh Clemente: [33:42] Yeah, you know, first of all, I love Whoop, Eight Sleep, Oura, all the companies out there that are trying to connect people with their own data in real time. I view us all strictly working together to elevate our awareness of the things that are, you know, basically holding us back at a social scale. And so in a personal sense, like very big fans and complementary and in a truly mechanistic sense, what they’re working on at those companies is elevating some physiologic markers of stress and exercise performance and sleep quality. And all of those, a continuous glucose monitor cannot measure it. It breaks through the skin. It’s an interstitial device, meaning there is a filament, as we talked about earlier, that is measuring molecules in the skin. So it’s a fundamentally different device concept. So it’s different hardware platform. And so the interesting thing is that there’s extreme compatibility and information share potential here. You know, we’re referring it, referring to it as the modern health stack, which is you have sleep data, you have real-time exercise data and recovery data, and you have metabolic data. And these two things, these things are all different pillars of holistic health and wellness. And so, you know, when you’re looking at, for example, your Eight Sleep data and seeing how your quality of sleep was affected, right? And then trying to tie that back to factors is where Levels steps in, right? So Levels can provide you with insight on, “Okay. That alcohol that you drank last night at 6:00 PM, that influenced a long-term, you know, blood sugar dip.” And as you were about to go to sleep, you indulged in some late night snacking, the alcohol continued to be metabolized through the night, your Eight Sleep data’s showing you that your body temperature was elevated by one to three degrees all night long. You were restless, tossing and turning. You woke up the next morning and your Levels data shows your blood sugar has been low all night and oscillating. This morning, you’re ravenously hungry. And if you didn’t have that Levels data, you might go out to brunch and indulge aggressively. But the problem is because you slept so poorly, you’re acutely insulin resistant. So this is a stress response that we’re well aware of where your body responds to stress by basically inhibiting the effects of insulin. And so you’re at a worst position in terms of being able to metabolize a large lunch after a restless night of sleep and just a little bit of alcohol that you had the night before. And so being able to connect all of those dots in real time for someone is a collaborative effort. Like we need these different data factors. And so, I strongly believe that we’re all working towards the same goal, which is to make everybody healthier at the individual level, by giving them their data in an actionable way. And so, yeah, right now, always working together and in the future, I think, there’s going to be strong collaboration across these platforms.
Kallaway: [36:27] Definitely. Yeah, that was a setup. I love all of those companies and I feel like it’ll get really interesting when everything’s integrated. Like you’ve got those integrated with your Phillips hue lights in your house, and it can tell when you’re, you know, when something, when you’re stressed and it’ll dim the lights, like once everything’s connected, it’ll be super powerful.
Josh Clemente: [36:43] Absolutely. When the cognitive load is shifted from the individual to the second brain, the software, that’s when we win, right? That’s when, you just have to, you know, everybody’s trying to make it through busy lives and perform optimally to the best of their abilities. But right now you’re adding this additional layer of having to determine what to eat and when to sleep and how to, you know, how to manage your, sort of your work schedule so that you’re minimizing stress. And in the future, I think we’re going to be surfacing this proactively like we talked about and just guiding the individual through their life in a very simplistic, straightforward, and elegant fashion, so that it’s very effortless. You know, it’s not like you have to do something extraordinarily different. It’s just a matter of like picking between a whole fruit and a pressed juice. And when you know the difference for yourself with data, it becomes really easy. You just need to connect those dots with software.
Kallaway: [37:30] I think that’s a great segue to kind of like scale and the future vision. So I love asking founders to kind of manifest. In five years, what do you want Levels to be when it grows up? Like how do we take Levels from what it is today to my parents or your parents, you know, using this month over month?
Josh Clemente: [37:47] So right now we’re building the insights framework, which I think is the foundation upon which this future is built. And the insights framework is the first step toward, it’s the incremental step towards that proactive surfacing of information and showing people explicitly where they’re going right, where they’re going wrong and how to improve. And so, you know, one of the reasons that I started this company is I have a familial history of both Alzheimer’s disease and heart disease. And my grandmother is suffering through Alzheimer’s herself right now. And seeing that happen and realizing that my own parents are going to be, you know, at that age sometime soon and realizing that this is something that could easily affect obviously every generation of my family. The realization was very strong. And so it’s strong and personal for me when I realized that Alzheimer’s disease is being called type three diabetes, and the correlations between insulin resistance and metabolic dysfunction and these degenerative diseases like heart disease, like cognitive deterioration are all coming back it seems, in the literature, to insulin resistance and a poor management of our chronic lifestyle choices. So, in order to get to that phase where we are actively helping people make better choices, that in the moment benefit them with a better life experience and are also preventing that long-term suffering and unnecessary outcome, we are really cracking the code of that real time sort of accountability partner that you wear full time and that is effortless, intuitive, and elegant to use. And, you know, we’re moving in that direction. The underlying software and user experiences is a key component of our business. We’re spending really just tons of brain cycles from extremely intelligent people who I think are the at the top of their game, in the world of data science research and software, to make this a reality, to really turn this product from something that people who are already health seekers, who already know about CGM, want to try, into something that people who have really never given a second thought to wearable devices are wearing every day and are guiding their lifestyles from, right? And it’s going to be, I think, a paradigm shift. We’re going to be talking about metabolic dysfunction the way we’re talking about the opioid epidemic and cancer right now in two to five years, and the differences. You know, we’re going to open up this epidemic and really pull the covers off and show people that this is the thing that society needs to fix. This is the number one health crisis in the world, and we absolutely have got to start paying attention. And the tools that Levels are building are going to shine the light, I think, on that. And obviously, you know, we need to continue to attract amazing people to the team and continue to double down on what we’re doing here and kind of stand firm in the face of all the challenges we’re going to face. But ultimately, I think, the future is going to be one where this unnecessary suffering and chronic illness is completely alleviated by just better information at the individual level.
Kallaway: [40:50] Yeah. Couldn’t have segued better to the hiring piece, which people in the show are sick of hearing me say this. I say this every episode, but when I talk about hiring, I think hiring is the most important thing you can do. If you get superstars, they run the ship, they build the rocket, et cetera. So two questions for you on this. The first is, and I know you guys have an amazing team. What characteristics do you look for in the people that you hire that have proven to be consistent across the superstars that you have?
Josh Clemente: [41:18] Well, boldness is a big one. People who are attracted to a challenge like this, which honestly is threatening a lot of entrenched ways of doing things. You know, there’s this concept of the way we do things, which is the unnamed boundaries on how much disruption is allowed. And we’re really challenging a lot of the core tenets across the big spaces. Everything from the food supply, through to nutrition advice, through to the way that we approach symptom care and medicine. And so people who are intrinsically bold and want to, they don’t just settle for the way things are, are attracted to challenges like the one where we’re currently tackling. And the second thing, so combining boldness with just objectivity. Basically being willing to challenge one’s own beliefs and sort of avoiding dogma at all costs is another one that we select for. So you know, people who are, despite being firm in their convictions, always willing to question and change their minds in the face of better evidence. Right? So this is a very scientific mindset and you don’t have to be a strict scientist to understand the value there. You know, we’re actually talking about products that affect people’s lives. And if you wouldn’t feel comfortable, you know, or if you’re so firmly rooted in your belief system that you can’t in additional information and modify it going forward, then you know, that’s not the right fit in a role where we are truly talking about effecting behavior change and introducing different outcomes, right? And so, yeah, boldness and that sort of self, that objectivity and honesty are really key. And the last one is just transparency. So people who are willing to admit when they’ve failed and sort of willing to share the truth at all costs, you know, at all times, is also key. You know, it’s interesting. Like the idea of failure is one that we in society just like completely, we strictly consider it as a negative. And even though there’s a lot of like talk in Silicon Valley and such like, “Oh no, failures are learning opportunity.” Like when the rubber hits the road, are people willing to actually put their hand up and say, “Hey, I’m not able to keep up,” or just be honest about where they are and when they need support? You know, we definitely select for people who just see that as a net benefit, like just understanding that we’re all a team here, we need to be working in unison towards this vision. And so there is no value to drowning on your own because you don’t want to admit that there’s, that you could use some support. Right? So, I think those all kind of favor the same personality type and it’s that version of a superstar that we’re looking definitely.
Kallaway: [44:08] I don’t often see companies with five co-founders. And it may be semantics, right, because you and Sam started in, brought on a team, but the way you guys marketed, there’s five co-founders across the big disciplines. When you think about that compared to the traditional model, like two to three main co-founders who started off, you know, talk through the pros and cons that you’ve seen. I mean, it’s almost all pros, but share the thought process behind that.
Josh Clemente: [44:33] Yeah. I think that when you have an extremely qualified and motivated and aligned person who is willing and able to take the opportunity cost and take on the challenge and become a force multiplier towards the goal that you’re trying to achieve, and the only thing that is holding you back is a title of some kind, it seems nonsensical, right? It’s like, you want as many people who are as early as possible and as exceptional as you can get on your team with you, and they are taking the same risks you are, you know, and they are truly like conjuring this future out of their own efforts day to day. And it’s almost like, you know, when you think about the timescale of the company, that early couple of months, you know, when you’re putting the team together, is really the highest risk. It doesn’t matter if you’re there on day one or day 60, like, or day 600 even. You know, you’re taking essentially the same risk as everyone else. And so that’s kind of the thought process is just we all came in into this from different directions and with different skillsets and different opportunity costs. But we are all extremely motivated by the challenge and unified in our approach to solving the problem. And we work so well together and are complimentary in our skillsets and personalities. And so it was just kind of a, it was never really a question. I think Sam and I, you know, initially were the first two to kind of come together and put an incorporation down, but we really didn’t have the team until we had the other three, you know, and we’re starting to use that to further leverage and demonstrate to potential hires that we, you know, we are a legitimate business with an exceptional set of founders, right? And I think that honestly, having five of us has only been a net benefit. Like there are a lot of questions because it’s non-standard, but I don’t think we thought twice about it. It’s just been like so effortless and so obvious for us that this is a positive thing.
Kallaway: [46:43] I mean, the mentality as you described it, makes a hundred percent sense, right? You want the most amazing people you can get as early as you can get them because it compounds.
Josh Clemente: [46:52] Yeah. It’s like, yeah, that’s what, if that’s what it takes, you know, if you can incentivize people to come aboard as co-founders, like do that. That is what you should do. If you know someone who’s fantastic and you know, you’re like trying to- I was in this position. Like I started a company prior to Levels that was kind of like the same mission, but I was doing it on my own. And it wasn’t until I was able to join forces with the founding team that things really started to happen. Right? Like there was a lot of background research and a lot of white papers and concepts, but I’m talking about like, as soon as that team came together, we started to see this non-linear success happening. And so for anyone who’s like trying to make this decision, like if you trust this person and you feel they hit the criteria for someone that you would want to work with, like bring them on as a co-founder, you will never regret it. You know? And obviously I need to caveat that, like you need to do your due diligence, but just, you know, we did and we’re benefiting from that.
Kallaway: [47:54] Yeah. That’s great advice. If you could teleport back 13 months and tell yourself a couple of things, you know, still expecting to have to go through all the things you went through because that’s why you’re here, what comes to mind that you would tell yourself.
Josh Clemente: [48:07] Well, I’d want to go back probably two years to, you know, I just mentioned, like I had started the precursor company to Levels, and I spent a long time in research and a long time, it bordered on analysis paralysis where I like knew the scale of the opportunity and like the potential for this to improve people’s lives. But the execution approach I took was very like, “Okay, I’ll lay the groundwork by myself. And I’ll like, you know, build this sort of regulatory framework and have the whole concept basically done. And then I could just bring on some people and execute.” And so I spent a long time in that mode and realizing now, just like the conversation we just had, that what I needed is to bring on additional people who could help me lay that groundwork who had the expertise already and just hit the ground running a bit harder and a bit faster. And you know, it’s not entirely like lost time because there was a lot of learning wrapped up in that, but I would just lean even harder into the founding team earlier I think. And just not question the fact that any amazing accomplishment, any startup out there who’s doing big things, and I learned this lesson at SpaceX, is doing them because of a great team. There are very few, probably borderline zero people out there who are doing very large, complex problem solving on their own. For the most part, they are leveraging or working together with an exceptional group. And so yeah, that’s what I would do, is just like move a bit faster. And then, you know, another one, I think there’s also just a little bit of, there’s always the imposter syndrome that I think a lot of people who take on big challenges feel where it’s like, you know, perfect is the enemy of good enough type of thing, but just, I have this intrinsic sense that like, it needs to be better, whatever it is. And actually the best critic that you can get as the customer. And so understanding and getting that person earlier, getting those earlier customers to, you know, to sign up and like offer their feedback on what we’re trying to build even earlier than we did, is like, I think always a good thing.
And so to people who are just getting started, I guess that’s where this kind of applies is like, try to be objective and like get to a minimum viable product that you can share with someone sooner than you are comfortable with, because you honestly will never be comfortable. Like I can tell you from experience, you’re always going to want that next feature to roll out. And that next sort of step function improvement. But what you need to know is that you’re on the right track and you will get that, you can’t trust your own barometer, right? You’ve got selection bias. You need to be asking people who are outside of your head, whether you’re heading in the direction that they want you to head in, right? You need to find the person who fits your customer profile and just get them to try it and get their feedback.
Kallaway: [51:01] So a new segment on the show that I’m going to try out is kind of like this wellness corner idea. So, I actually wrote before we had this conversation, I think of health as a stack as well. And I try to layer my, you know, breathing meditation, nutrition, fitness, sleep, everything together. And I find that there’s a compounding effect, as you mentioned. So I’m going to go through a few different categories of wellness, and I’d love you to just share your thoughts on them. You know, what you personally do throughout the day and any products or brands that you can’t live without. So it’s great that you’re the first one doing this because you’re in this world.
Josh Clemente: [51:34] Cool.
Kallaway: [51:34] So the first one is morning routine. How do you typically start your day?
Josh Clemente: [51:38] So I’m just going to be completely honest here and say that I, although I live by routine, I fall out of routine a lot and have to kind of get back on the horse, you know. I’m like everybody else. And right now I’m in the process of getting back to where I want to be, which is I have to start my morning with a workout. It’s something that I know at the deepest level stabilizes me and sets me up mentally and physically to take on the day. And I know that it’s the first thing to get bumped in the evenings if I don’t prioritize it. So, that’s how I have to start. And, well, I wake up and I check my sleep data. And right now I don’t have an Eight Sleep bed unfortunately, you know, kind of like living on the road a little bit right now. And I cannot wait to get one because I’m a hot sleeper. Like I, my body temperature kind of just gets out of control every night. But I do check my Whoop data like first thing in the morning and just look at my recovery score. And I do use it to plan the degree of effort that I’ll do in my workout, you know, shortly thereafter. So I’ll pick between a long run or a shorter run and a higher intensity, like interval training, based on how well recovered I am. And you know, a lot of that data is influenced by my choices the day prior. So that’s my morning. And then I’ll, after my workout, I’ll try and get a few minutes of just relaxation time, reading a book, having coffee and just chilling with my girlfriend or something like that. And making sure that I’m centering myself and bringing the heart rate back down before diving into email or something. That’s super stress inducing.
Kallaway: [53:06] Yeah. If you’ve never tried Wim Hof breathing, I do it for like 10 minutes in the morning. I’ve experimented it with the Levels data and doing that. And the days I did it, I was able to stay in the range, eating the same foods that I ate different days that I spiked way out of.
Josh Clemente: [53:22] Wow. That’s the stress mechanism, like that is fascinating. I’d love to get some more data on like the cortisol response there, but I’ve heard that from multiple people who are using Wim Hof methods. I haven’t yet, but I need to.
Kallaway: [53:33] Yeah, the problem is it’s another 10 minutes in the day in the morning when you don’t have it. But alright, next category, which is perfect for you is nutrition, eating, intermittent fasting, everything that falls into that bucket. So what are your typical habits throughout the day?
Josh Clemente: [53:47] Yeah. So, I like to avoid eating before, say 1:00 PM every day. I will, I’ll try to eat my last meal before 8:00 PM as well. So I’ve got about a seven hour eating window each day. And you know, a lot, this again is consistency. If I’m in a mode where I’m eating my ideal diet, which for me is a high protein, moderate fat, low carbohydrate, also high fiber though. So they’re, I do eat carbohydrates. I’m not like a ketogenic person, but when I’m eating that consistently, I have extremely good control over A, my blood sugar levels are rock solid. And then B, what that introduces is, because I’m controlling my glucose and also controlling the downstream hormones that are influenced by glucose. These are insulin and a whole host of others that respond to insulin. Leptin, ghrelin, which are your hunger and satiety hormones. And so when I am eating this consistent, sort of meal strategy, I do not experience any hunger, any hanger, you know, that like irritability around meals and I never feel deprived. In fact, I feel like fully satiated until I realize that it’s time I’m going to go get my first calories of the day. And that’s like inclusive of workouts. So that is I think the demonstration of metabolic flexibility, it’s where, when you are getting that solid, you know, span of time between your last meal and your next meal, and you can kind of pick your eating window. But when you’re getting that depletion, so your body’s tapping into its stored glycogen and fat overnight, and then you hit a workout, it’s like tapping it even further. And you’re, you know, you’re constantly in a state of replenishment as opposed to being tapped off all the time through these like consistent eating windows that are just scattered throughout. I think you really reach a pattern of control where your body is well adapted to drop into its fat stores and glycogen stores without like all of this discomfort that people typically feel when they skip a meal. So that’s where I feel best. And honestly, when I have a crazy weekend of, you know, just eating whatever I can get my hands on, I’m catching up on sleep or traveling or something like that. Like it really does throw me off for long periods of time. It can be a solid week of just getting back to a normal. And that’s like both my sleep levels and my metabolic control. So I really try and be consistent with diet.
Kallaway: [56:12] Yeah. I was going to double click on that on the weekend stuff. I feel like so many people I know, they do the 14 to 16 hour fast window during the week. They’re fine. And then Saturday, they eat shitty and then they stay up, they drink past 11 midnight 1:00 AM and it just throws you off so much. So I appreciate you reflecting on that as well. Fitness working out was the next one, but you already covered that. Sleep, you covered the hot sleep piece. How many hours do you shoot for, do you try to go to bed at the same time every night?
Josh Clemente: [56:42] Yeah. This one, you know, again, full transparency. My work days have been pretty erratic lately and I’m- So something that I am trying to hold myself accountable on is a structured calendaring and scheduling, and just making sure that I’m rigorous about maintaining holistic wellbeing. And like, you know, the businesses is really important part of my life and I’m on it 24/7 anyway, but if I can just separate myself, you know, from the computer by 9:00 PM at the latest, you know and get a nice taper down towards sleep, I sleep just infinitely better. I mean, it’s not, no comparison. And I typically will not sleep longer than eight hours. So it’s between six and a half and eight hours a night. But the quality of my sleep is entirely dependent on how I prepare for sleep. Right? If I’m, if I’ve gotten my workout in, I’ve been eating well, I stopped eating before, say 8:00 PM, and I’m not like hitting the sheets straight out of email and all worked up from whatever I was thinking about or working on, just prior to slamming the lid.
Kallaway: [57:45] Trying to get strategy. Just fired up.
Josh Clemente: [57:47] Yeah, exactly. I just, I got to got a separate, have conversation, I don’t know, listen to some music, or just relax, walk around outside. You know, get a nice sort of decompression zone before sleep. Like it’s truly, the difference is, know when to end night and day for me.
Kallaway: [58:06] Yeah. That’s something that turning my brain off to like get ready for sleep is something I’m really struggling with lately. And I, you know, it goes in ebbs and flows. It depends on if you’re working on something you’re interested in. Yeah. Right.
Josh Clemente: [58:16] Right. Yeah, exactly. And that’s really good, you know. I’m working on something I’m passionate about at a deep level and it’s really hard to, it sounds like, you know, it’s a problem I like to have, but at the same time, you know, you really do have to be ready to hit it the next day. So got to get that rest in. And that requires you turning down the brain function towards sleep.
Kallaway: [58:39] Yeah. All right. Last one is your content diet. So newsletters, podcasts, micro content you consume daily, or like books that you’ve been reading.
Josh Clemente: [58:50] Yeah, this is a great question. So my co-founder Sam has a really interesting approach to this that I’ve adopted myself. And his approach is like any information that you ingest should take a hundred times longer to produce as it does to consume. And so he doesn’t take in any news, he doesn’t use social media for news. He doesn’t really do any newsletters or anything like that. And the, you know, the primary educational material he uses is conversation and books. And I’ve kind of moved to the same thing. Like I definitely am on social media for business reasons and also to stay up to speed with other people I care about, but I’m doing my absolute best to limit my time there, limit my tangential social media episodes, where you’re like clicking rabbit holes deep into a friend or something.
Kallaway: [59:41] Yeah. The worm hole for 30 minutes.
Josh Clemente: [59:42] Yeah, exactly. You just get stuck for an hour. And I really have completely unplugged from news media for about two years now. And the benefits are 100% positive. I have, I don’t think I’m uninformed. Like I know what’s going on in the world, but at the same time, most of that’s coming from other people who are acting as my filters. Like they’re raising things that they’d like to talk about that they feel are important. And if I don’t know something about it, I’ll get the quick download from them. And so that’s been amazing and it’s unlocked all this ability to stay up to speed with podcasts, with journals and with books. And you know, right now the majority of my books are focused around, you know, I listen to a lot of stuff by like Jonathan Haidt, who I think is a really awesome author talking about a lot of the mental health issues that are facing society right now. And then I dig really deep into, yeah the science of metabolism. You know, there’s a great book that just came out from Ben Bikman, Why We get Sick, which digs into insulin resistance and lays out the groundwork for essentially what we’re doing here at Levels. And you know, there’s books like Wired To Eat from Robb Wolf that were basically formative in my understanding of why blood sugar control is crucial, and Personalized Medicine from Eric Topol. There’s a lot of really great stuff out there that I’m, you know, consuming at as often and as many times as possible, like some, if people want to dig into the metabolism stuff, besides those others I mentioned, Jason Fung wrote the Obesity Code and the Diabetes Code, which are probably the most elegant representation of the hormonal theory of weight gain I’ve ever heard. And so this is an opposition to the, well it’s not opposition to, it’s just different than the calories in calories out hypothesis. So for people who really want to understand how the body operates, and the body is a chemistry set. It’s not like a perfect machine. I highly recommend those books. And yeah. So I like to dig into stuff that’s like tech, very tech forward, or wellness education, nutrition education. And then, you know, I’m a huge space nerd. So if anything like the deepest I’ll go on quick news or quick media would be Reddit like on the SpaceX forums and just staying up to speed on that stuff.
Kallaway: [01:01:56] Yeah. We’ll get those books linked up in the, on the website and in the show notes. I think, you know, the content diet is so underrated. Like when you’re consuming all that trash, like the social media pop culture stuff, at the subconscious level, for some reason, it like turns off your ability to like deeply think. I don’t know what it is, but I think that’s an unlock that a lot of people that- That and metabolic fitness, like the two things that I think need to be solved and really there’s nothing going on in that space to solve that.
Josh Clemente: [01:02:22]I personally think they’re closely linked. I mean, we, the connections between stress and metabolic dysfunction are amazing. Like I personally been in a podcast recording. I mean, hopefully it’s not happening right now, but in a podcast recording and my blood sugar has shot up to like 145, which is in the abnormal range, without any calories. And that’s just the effect of cortisol. It’s just stress. And yeah. And so you can imagine when somebody is, especially if you’re an anxious person, you know, and if you’re worrying about the world and then like digging in on essentially strictly the down selected most likely to stress you out material that exists, right before trying to sleep, you’re not going to sleep well. Your brain is going to be, you know, frazzled and going haywire. And honestly your metabolic control is going to be affected. And this is like, you’re going to, this is going to induce weight gain. It’s going to induce additional stress because you didn’t sleep well. And that’s going to double, it’s like a vicious cycle. And so I think those types of people in particular should avoid it. And I don’t think I’m an anxious person by nature, but I am 100% less anxious to some extent on the information diet. And I think this is what we need in society. We, it’s got to be like a purging of this. It’s very similar, you know, it’s like we have this processed information diet that we need to get off of and go back to the whole foods of knowledge, which are-
Kallaway: [01:03:38] So true.
Josh Clemente: [01:03:38]Yeah. Just like high quality educational material.
Kallaway: [01:03:41] Yeah. All right. Final two questions for you, and then we’ll get you out of here. These are the traditions for the show that I asked every guest. So I’m pumped on your take on these. So the first one, and a lot of this, you know, bits and pieces in your other answers, but is the startup manifesto. So if you had to write a startup manifesto with five of the most important key lessons or pitfalls to avoid when starting out, what would they be?
Josh Clemente: [01:04:02]First things first, you have to have personal investment in what you’re working on. You have to care about it. And you know, it’s easy for me to say I know how challenging it is to find a big goal that you care about at a deep level, but I personally feel that that is a requirement. And second thing is it has to be a big enough problem that other people will want to join you in solving that. So the challenge has to be close to you, personal and large in the sense that other people would care about it. The third thing is, I’m going to lean back on that, on the co-founder conversation and just say don’t make the mistake of assuming you can do it alone. If it’s big enough for you to leave whatever else you’re doing and work on it full time, then it’s very likely going to benefit from more people than just yourself. And so, lean in on building an exceptional team who is going to embrace what you’re doing and become, you know, basically be a force multiplier, as I’ve said towards that vision. The next one, I would say, you know we’re in a weird world right now, with startups in particular. We’ve had a bunch of unicorn stories that have gone sour overnight. You know, like we all know the names of the businesses. I won’t repeat them here, but just, we hit this point where growth at all costs, and business fundamentals were lost to, you know, lost to the MBA classroom, I think. And now, I think we’re seeing a resurgence of business fundamentals and people actually caring again about balance sheets and about, you know, actually having a customer in a sale that ultimately ends up with a profit margin. And that I think is key right now is like, be realistic about what you’re building and how do you get to a place where this business can be successful independently, like raising money from exceptional VCs and angels is a positive in a bunch of different ways. Like it’s the right thing for many businesses, but remember that what the goal is here, it’s to create value for people and it’s to make lives better and to do it in a way that creates value for the creators of the company, obviously. So, you know, just make sure that you’re, you have a fundamental business plan that can pan out, right? And let me see what the fifth one here is going to be something I learned at SpaceX, which is just the benefits of radical accountability and just like empowering the individual inside the organization, no matter where they are in the organization, to do their best work and to be unconstrained in doing so. It requires a lot of trust, a lot of transparency, but it pays dividends like all the way through the business. Like people begin to step into the role as though they, which they are by the way in a startup, as though they are co-owners of the business, right? And if you really infuse your organization with that mindset of, you know, you’re not- You’re stepping in and there’s going to be puzzle pieces thrown all over the floor. Like find an area that you think you should work on and just like start assembling the puzzle pieces. You need people that are self motivated and not just that are self motivated, but that feel unconstrained to be self motivated and to be accountable and responsible. And that’s how, you know, like you can have, and I’ve seen this before firsthand, you can have exceptional people that are constrained by the organization and that’s a terrible place to be, you know? No one’s happy in that world. So just always like trust your people and you know, we’re still a small company and I just really think that embracing that well into the future as the organization grows is going to be crucial.
Kallaway: [01:07:43] Yeah, totally. That’s a great list that, that last one really hits home with me as well. So thank you for that. And then the second question is a nomination. So this has been a fantastic way for the show to grow. So it’s your turn to nominate another founder that’s either a friend, colleague or mentor of yours that you’d like to see on the show in the future.
Josh Clemente: [01:08:03]You know, I’ve got a, let’s see, a couple, but I’m going to go ahead and say Matteo or Alexandra from Eight Sleep would be a really great episode. I would love to tune into that. So yeah, digging into the sleep and all the data that they’re unlocking with their sleep technology, I think is going to be super beneficial and kind of complimentary to this episode. I hope.
Kallaway: [01:08:26] Cool. Yeah, I’ve been on them for a while, so that would be, that’d be great. But so before we wrap, I just want to acknowledge you for a second. I do this with all my guests, kind of throughout the conversation, you know, what strikes me most. And I think with you, the self-awareness throughout the process has been, you know, as evident. If you listen, and as people listen to your answers, the way you started this on your own, self aware enough to shift. You know, not being afraid to be wrong, not being afraid to change, all the things that are, the DNA that you’ve infused in the company, I think is super powerful. And if anyone takes anything away from this, it would be that. So I just want to thank you for coming on and you know, I’m a huge fan of Levels already and will continue to support in the future.
Josh Clemente: [01:09:10]I really appreciate that. Thank you.
Kallaway: [01:09:12] Before you jump, you want to just plug the Levels website, social and your personal handles as well?
Josh Clemente: [01:09:18]Absolutely. Definitely check out levelshealth.com. I recommend the blog. It’s the place to start if you want to learn about metabolic health, metabolic fitness and why it is relevant to you because it applies to all of us. And hit us up on Twitter and Instagram @unlocklevels. My personal handle is josh.f.clemente. The original Josh Clemente was taken by somebody else, unfortunately. But yeah, reach out to me there. We’re always excited to engage in and share information about what we’re working on. And you know, we’ve got the beta running right now, which it’s invitation only, but please reach out about slots there and we’re trying to fit people in as quickly as possible. And we’re shooting for a full launch, closer to the holidays, of the product.
Host Kallaway: [01:10:00] Awesome. Josh Clemente, founder of Levels, thank you so much for coming on the show.
Josh Clemente: [01:10:05]Thanks a ton for having me.
Kallaway: [01:10:07] Thank you for listening to that episode with Josh Clemente of Levels. If you want to support the show, there’s a couple of quick things you could do that would really help us out. One, subscribe to our show on Apple podcasts, Spotify, or wherever you listen. If you go on Apple podcasts, please leave us a five star rating and a couple sentence positive review on why the show inspired you. These ratings or reviews are super important and they signal to Apple they should put our show in front of other people that might like it. To follow us on Instagram @founderpodcast. Each week, we put out teasers, audio clips and important quotes from the episode. And lastly, check out our website as a mission control for the show. Go to thefounderpod.com. We have a page on there called special offers where we link up all the discount codes from our founders’ companies, as well as the books and resources that they’ve recommended. I hope you enjoyed that episode and are looking forward to the next one. Until then I’m Kallaway, and this is The Founder .