Do you ever feel like your energy is on a roller coaster? One second you feel ready to run a marathon or concentrate on a project, and the next you’re ready for a nap? If so, it could be due to unhealthy glucose levels and metabolic dysfunction – a silent epidemic that’s sneaking up on millions of Americans. Josh Clemente struggled to diagnose glucose as his own energy problem. Once he did, he founded Levels Health in order to bring clarity to anyone who wants it. As a guest on Product Market Misfits, Josh chatted with host Dan Hightower on how we can break unhealthy patterns and shift the country’s health bell curve for the better.
03:54 – The key to maximizing healthspan
When there is a hormonal balance there are no reactive byproducts being produced that negatively affect the internal systems. Maintaining steady glucose is absolutely critical to this because it is extremely reactive and can create some nasty byproducts.
“Glucose is absolutely critical for the human body to function. However, it’s also an extremely reactive molecule. So in the presence of oxygen, you can create some pretty nasty byproducts, if glucose levels are too high. And the contrast is that if glucose levels get too low, the brain and other tissues that really need that energy start to shut down very quickly. So there’s a tight bound that glucose levels have to be maintained within, in order for us to run effectively…When the human body is running at proper insight, its proper ranges and everything is nicely controlled, you have hormonal balance. You don’t have a lot of runaway systems. You don’t have a lot of those reactive byproducts being produced. And that’s when the body’s at its peak potential and you can really maximize health span. But when things go poorly in one way or the other without a feedback loop to the person, this is when you start to have a chronic lifestyle.”
06:50 – Harnessing diet superpowers
A study done on mice showed that eating a fat-focused diet gave them the superhuman power of living five times longer in a deadly environment than the mice on a sugar-focused diet.
“Oxygen is a very reactive molecule. When astronauts or divers are exposed to high-pressure oxygen environments, because of that increased reactivity, you basically destroy tissue in the brain very quickly and you can have seizures and you can effectively die very quickly. And I was designing an oxygen system at SpaceX at that time. So this was a very interesting area of focus for me. So I read this paper and essentially it showed that for rodents, feeding these rodents a ketogenic diet can extend their lifespan in the high-pressure action environment by five times. And so that kind of blew me away. It’s like, wait, they’re just basically eating a fat-focused diet rather than a sugar-focused diet. And this is giving them the superhuman power of living five times longer in a deadly environment. And that was the first wake-up call for me that diet can have legitimate physiological benefits.”
09:18 – Breaking unhealthy patterns
When Josh saw the blood sugar spikes that were causing his midday crashes and fatigue, it set him on the path to creating Levels to bring glucose-monitoring technology to everyone.
“My blood sugar control was completely broken. I was all over the place, the highest highs, and I was spending up to two hours over 160 milligrams per deciliter, and then crashing back down to hypoglycemic lows and the time separation between a meal that I would eat and that crash that I would experience that I felt as shakiness and hunger and irritability was about two hours. And so it’s pretty hard to connect those dots when you don’t have that feedback loop. And so that realization, seeing the patterns on this device, suddenly just woke me out of my stupor…That whole process of realization by consequently using that same data to define a new diet, a new approach to a lifestyle that helped my blood sugar stays rock solid and experiencing then the benefits of that, like not superhuman energy, but just controlled energy. The pattern was now fixed. I wasn’t having the highest highs, but nor was I having the lowest lows. And that whole process just drilled home for me that this is by default a technology that millions and millions of people could benefit from. It’s also ready for prime time. It is a consumer product wrapped up in medical packaging. That’s kind of the core moment where I said, this is what I want to do. I want to bring this to other people.”
12:11 – The hormonal roller coaster effect
Current diet and lifestyle trends are causing people to be stuck in a loop of blood sugar spikes and crashes. With Levels, they will get closed-loop data, helping them make the right decisions.
“Closed-loop is where every decision you make is influenced by all of the prior decisions you’ve made because you are measuring the output of that choice. The way this translates into a product is seeing the effect of your decision immediately after the decision allows you to have context for what that did. Now today in modern society, we develop our lifestyles based on either no data or the bathroom scale, which takes weeks or months to adjust, or the yearly checkup at the doctor, which has absolutely no functionality for picking what to eat for lunch, right? So you sit, you get your printout of blood panel results, and there’s a bunch of numbers on there. How do you know what to eat for lunch? Those two things are just too disconnected in order to be useful. With Levels, you have Chinese chicken, and then 15 minutes later, your blood sugars on a rocket ship ride to lunar orbit. And then, 40 minutes after that, you’re getting the shaky crashing and you’re hungry again. And that’s the hormonal roller coaster effect.”
14:41 – Why ice cream is a pretty balanced meal
Ice cream has a ton of sugar, fat, and protein. For some people, it can cause a lower blood sugar spike than Chinese chicken.
“Ice cream is, all things considered, a pretty balanced meal. It’s got a ton of sugar, a ton of fat, a ton of protein. But those things tend to actually, in combination, manage a blood sugar release. So fat tends to slow down the digestion pathway. You go from that rocket ship ride to a slower, more controlled increase. Now whether or not that’s necessarily healthy for that person, hard to say. But the data is clear that super-high elevations in blood sugar are extremely inflammatory. So you do not want your blood sugar to go very high. You said you went to 210 on Chinese chicken. The American Diabetes Association says that normal people would rarely exceed 140 milligrams per deciliter. And I think there is a lack of data that is driving that statement. It’s true that people should not exceed 140, but I think it’s happening all the time. And people just don’t have any feedback on it and we’re not measuring the non-diabetic blood sugar space is just completely untapped.”
16:06 – Why Levels is shifting the bell curve to the left
The health curve is based on the average American, who is already unhealthy. Levels is shifting the curve to the left by advocating for more research into those who are healthy to establish better baseline numbers.
“The problem is that for blood sugar specifically, the normal zone is just the average of people who don’t yet have diabetes. And unfortunately, if you look at the numbers in society, 88% of American adults are metabolically unhealthy. 90 million American adults have pre-diabetes and 90% of those do not know that they have it. And the reason they don’t know is that they have no feedback. And this is from random sampling by the CDC. We have a society that is extremely unhealthy, 70% are overweight or obese. So when you just average the people who haven’t yet been diagnosed, you’re averaging in a huge amount of dysfunction…We need to shift the whole bell curve back to the left, which is what Levels is doing. We’re redefining the ranges, we’re not calling them normal, we’re saying this is what’s optimal and it may be very challenging to stay there. But the point is that every choice you make, you want to be bringing you closer to health, not bringing you further away.”
18:09 – The market is ripe for Levels
People want better information about their health. The market is ripe for a wearable that can help people make personalized decisions about what to eat.
“First off, I think that the space that we’re in is ripe. People want better information about themselves. They don’t necessarily want better information about the whole average population, they just want to know how healthy they are and how they can do better. We’re seeing this with the decentralization of fitness, like Peloton and Tonal and all these companies who are coming to you. It’s no longer a gym thing. You’ve got wearables that give you your heart rate, that tell you how you’re sleeping. This personal health information trend is a fantastic one and where it’s still nascent and still brand new, but it’s certainly the case that people want personalization. They don’t want to get cut and paste information.”
28:01 – It’s all about the user experience
It’s not just about what the hardware can do, it’s about how sophisticated the software is and how it can help the end-user get their desired results.
“You look at companies like Apple, you look at companies like Peloton, Tonal, they have exceptional elegant experiences. People don’t want to make major sacrifices to improve their daily behaviors. You got to fit this into a really hardcore lifestyle. In many cases, people have high-intensity schedules and they don’t have time to figure things out. It became clear to me that although the hardware was not optimized like there’s plenty of room for improvement, it was very good. And where the experience was lacking, was in connecting the dots between that hardware and the end goal, which is specific behavior changes across diet, exercise, sleep, and stress. If you want to compare it to heart rate monitoring, for example, optical heart rate sensors are a commoditized product. They’re not expensive, but what takes an optical heart rate sensor and turns it into a Whoop Strap or an Oura Ring is the implementation. It’s the user experience. It’s how easy and elegant the software is and how much it filters through the noise and gives me the signal basically, and tells me what to do and how.”
40:27 – The work culture at Levels
Levels’ work culture is about creating an atmosphere where the team is excited about the product and feels passionate about the vision and mission of the company.
“So Levels has been remote from the very first days. Sam and I chose to make this a remote company. The things that we’ve learned over the past year have been really amazing. I think the biggest one was making sure you take the additional minute to announce something interesting. So we have, for example, channels where we can share emails like the founding team can just throw emails into Slack from exciting developments. This may be a new employee joining. It may be just a piece of praise that we get from our investor network, but we’re able to just plumb that right into Slack so that everyone else can see it on the fly. And that’s a nice little way of just creating a little buzz or just providing an afternoon boost for people. Beyond that, we have an intentional day. It’s not a day, it’s an event every week called the Friday Forum. On the Friday Forum, we get the whole team together. We go through accomplishments for that week. And we also typically will have special guests.”
Dan Hightower [00:00:00] This is Dan Hightower with Product Market Misfits and we have an amazing guest here today to talk about all things from what it’s like to work at SpaceX to quantified self with a company called Levels which you can find at levelshealth.com. The Levels team has raised around 4 million from some amazing investors including Science Scott Bannister, Matthew Dellavedova, Julia Lipton, Michael Arrington, Loop Ventures, Basecamp Fund, Shrug Capital, Todd Goldberg and Rahul Bora. And previously worked at some amazing companies including Y Combinator Back, Kardash, Google, Hyperloop and SpaceX. Levels tracks your blood glucose in real time so you can maximize your diet and exercise. I’m very excited to welcome Josh Clemente, founder of Levels to Product Market Misfits today. On the personal side, Josh is a mechanical engineer and a CrossFit level two trainer. At SpaceX, he led a team to develop life support systems that sustain astronauts in the May 2020 trip to the International Space Station aboard Dragon Endeavor, which was the first new crew carrying spacecraft since 1980. So I’m incredibly excited to hear how and why Josh made the jump from SpaceX to quantified self.
Josh, great to connect with you man. I’ve used the product for the last like month, super excited about it. Levels has changed my behavior in some ways we can dive into, but before we do, I’d love to hear from you about how you got where you are today.
Josh Clemente [00:01:31] Yeah, great to speak with you as well. And I’m excited to hear that the product is working well. I got here kind of through a circuitous route. I’m an aerospace engineer. I’m a mechanical engineer by training. I spent close to six years at SpaceX, originally working on spacecraft mechanical systems. And then I started working on life support development, pressurized systems, breathing gas, suit oxygen controls, fire suppression controls, things that astronauts will need to visit the space station and beyond. And first vehicle I worked on flew in May of this year with Doug and Bob to the International Space Station. And so I worked on that program and had an amazing time. But after six years at SpaceX, pretty stressful environment, I was basically burning out mentally, physically. My quality of work life balance was non-existent. And my diet, exercise, sleep stress foundations were all just disastrous. And I was feeling some pretty intense fatigue, like just really strong fatigue waves every single day that I’ve gotten to the point of interfering with my ability to function effectively. And so that is the process by which I slowly but surely discovered metabolism, metabolic function, which underlies energetic energy production, and got obsessed with the
Dan Hightower [00:03:03] Can we, can you like break down for us simply the importance of glucose, and then more generally talk about that within the context of how Levels works?
Josh Clemente[00:03:12] Yeah. So all of our cells, they require energy to function. And the way we use our food and environment to create that energy is called our metabolism. So it’s a very broad definition, but suffice to say that we have an extremely crucial system here that runs on the fuel we provide. And the two primary fuel sources in the modern human diet are glucose, which is a monosaccharide- it’s a sugar. And fat. Consume fat and it is free fatty acid, and then it gets oxidized as a fatty acid oxidation. Whereas with glucose, we don’t really consume glucose, we consume carbohydrates, which break down into different sugars, glucose being the primary one in our blood. And so glucose is absolutely critical for the
What we have in modern society is a situation where over time, we’ve begun to defeat the systems that control glucose within that tight bound. And the runaway symptoms of this, they’re often called by different names, things like PCOS, you’ve got cardiovascular disease, you’ve got stroke, you’ve got type two diabetes, you’ve got mental conditions like dementia and Alzheimer’s, which is now being called type three diabetes. So you have all of these disparate descriptors that essentially define the same thing which is metabolic breakdown and insulin resistance. When you know the human body is running at proper, sort of inside its proper ranges, and everything is nicely controlled, you have hormonal balance, you don’t have a lot of runaway systems, you don’t have a lot of those reactive by products being produced, and that’s when the human body’s at its peak potential. And you can really maximize healthspan. But when things go poorly in one way or the other, without a feedback loop to the person, this is when you start to have chronic lifestyle, unless it’s set in. And the biggest ones here in the United States are the ones I just listed.
Dan Hightower [00:05:16] I’d be curious to hear how you positioned Levels to be a consumer product, not a medical device. And how you might have leveraged the mental side of the importance of glucose as a personal performance optimization.
Josh Clemente [
So I read this paper, and essentially, it showed that for rodents, feeding these rodents a ketogenic diet can extend their lifespan in the high pressure oxygen environment by five times. And so that kind of blew me away. It’s like, wait, they’re just basically eating a fat focused diet rather than a sugar focused diet. And this is giving them the superhuman power of living five times longer in a deadly environment. And that was the first wake up call for me that diet can have legitimate physiological benefits. And so I started to look into nutritional strategies. And eventually, this led down the rabbit hole where I came across glucose tracking, because glucose is the molecule of energy for most humans. I decided, you know what, I now and you know, I can’t ignore the fact that diet matters, and nutrition matters. I wonder where my glucose levels are.
And so I bought this device that’s called a glucometer. You prick your finger, you bleed on this little test strip, and it gives you your blood sugar level at that moment. And I started using this. I was pricking my finger up to 60 times a day, and couldn’t really, it was just kind of a point cloud. I wasn’t, you know, I was plotting the stuff in Microsoft Excel. And it was like, didn’t make much sense to me. It could make heads or tails of it. And then I read about this device called a continuous glucose monitor. And this was developed for people with diabetes, to help them monitor their blood glucose and meter in insulin. So they inject insulin to help manage their glucose levels. And I said, “You know, I need one of those. You know, I’m pricking my finger all day long. That’s the thing I want. I just want the full time high resolution stream.” So I went to my doctor and asked for one because they’re prescription only. They’re from, again, managing diabetes. My physician was like, “No way. You know, you’re super healthy. You don’t, this is for people who are overweight, it’s for people who are sick. You don’t need that.” And so that just kind of like doubled my desire to get one. Yeah, eventually I did. And so it took me about six or eight months, I think, from that visit. And I had several other physicians on telemedicine platforms turn me down. Eventually, I got one.
And within two weeks, I found out that I was pre diabetic. And my blood sugar control was completely broken. I was all over the place, the highest highs, and I was spending up to two hours over 160 milligrams per deciliter, and then crashing back down to hypoglycemic lows. And the separation, the time separation between a meal that I would eat and that crash that I would experience that I felt as shakiness and hunger and irritability was about two hours. And so it’s pretty hard to connect those dots when you don’t have that feedback loop. And so that realization, seeing the patterns on this device suddenly just woke me out of my stupor, you know, everything I was doing. All day long, I was feeding myself foods that were causing massive instability and rollercoasters of glucose, which cause roller coasters of insulin, which cause which affect other hormones like ghrelin and leptin, which are hunger and satiety hormones. And all of the you know, hunger and irritability that we describe in modern society, I was experiencing it, I was now seeing it. And so that whole process of realization. And then by consequently using that same data to define a new diet, a new approach to lifestyle that helped my blood sugar stay rock solid. And experiencing then the benefits of that, like, not superhuman energy, but just controlled energy, the pattern was now fixed. I wasn’t having the highest highs, but nor was I having the lowest lows. And so that whole process just drilled home for me that this is, by default, a technology that millions and millions of people could benefit from. It’s also ready for primetime. It is a consumer product wrapped up in a medical packaging. And so that’s kind of the core moment where I said, you know, “This is what I want to do, I want to bring this to other people.”
Dan Hightower [00:10:44] So v1 was fingerpicking, like 60 times a day, which doesn’t really work for your current solution, right? Because it’s continuous. And when I use it, I’ll see, like I ate some Chinese chicken, which I now call sugar chicken, because my blood glucose went up to like 210 immediately after eating it, which is trash. And saw the actual, like spike and return to normal, and that correlated with how I felt, you know, how you feel after eating a bunch of Chinese chicken. That’s one example. Another is I’m a relatively healthy person. I used to, before Levels, have like a regular Clif Bar in the morning, which I thought was like a pretty decent day, which it turns out it’s not. I’ve replaced Clif Bars now that I saw the spike that it creates with the RX bars. I’m still toying with like which one I really like best. But, I mean, when you’re talking about medical interventions, it’s always like, “Well prove to me the behavior change, and then I’ll invest in your medical intervention startup.” I’m seeing myself every time I go into the convenience store, I look at the Clif Bars, I’m like, “Nah!”
Josh Clemente [00:11:58] Right. Yeah. So I mean, that is the exact, that’s the example right there. And I think the way we describe this at Levels is closed loop feedback, right. So in control system theory, you have open loop systems and closed loop systems. And open loop systems are where you make decisions, you provide a command, and then you don’t measure the effect of that command in order to influence the next command, right? That’s called open loop, you’re just making decisions on the fly. Flying blind, basically. Closed loop is where every decision you make is influenced by all of the prior decisions you’ve made, because you are measuring the output of that choice. And so for the way this translates into a product is seeing the effect of your decision immediately after the decision allows you to have context for what that did. Now, today in modern society, we develop our lifestyles based on either no data, or the bathroom scale, which takes weeks or months to adjust, or the yearly checkup at the doctor, which has absolutely no functionality for picking what to eat for lunch, right? So you sit, you know, you get your printout of blood panel results, and there’s a bunch of numbers on there. How do you know what to eat for lunch? So right? I mean that, those two things are too disconnected in order to be useful. And so with Levels, you know you, like you said, you have Chinese chicken, and then 15 minutes later, your blood sugar’s on a rocket ship ride to lunar orbit, and then you know, 40 minutes after that, you’re getting the shakey crashing and you’re hungry again. And that’s the hormonal roller coaster effect. And so for me, I mean, it’s exactly the same thing. Except it was every single meal. I mean, I seriously felt like, “Oh, man, like, I haven’t done anything right in years.” And some of the worst ones for me and the most shocking were oatmeal, just plain oatmeal was a total disaster for me. And I mean, this is something that’s advertised as heart healthy for everyone. For me, it puts me into a pre diabetic blood sugar zone. And then a really interesting one was pressed juice. So just carrot, celery and green apple juice, pressed right in front of me, there were no additives. I got it from this organic juice cart. And I hit to 210 as well.
Dan Hightower Really?
Josh Clemente It was up there for about an hour. So what was funny is there was a, there was a girl there who saw this happen, I showed her my blood sugar, and she was like, “I skipped the frappuccino to get that pressed juice every morning, and what I want is the frappuccino.” And it’s doing the same thing to you. So, you know, for some people, and again, we can get into this, but there’s a lot of individual variability involved here. And so you know, it’s not the case that what happens to me happens to everyone, but it is important that everybody ground their decisions in their own data.
Dan Hightower [00:14:26] I saw a tweet from someone that said that ice cream is okay for them.
Josh Clemente [00:14:32] You know, ice cream is, all things considered, it’s a pretty balanced meal. It’s got sugar, it’s got a ton of sugar, a ton of fat, a ton of protein, but those things tend to actually, in combination, manage a blood sugar release. So fat tends to slow down the digestion pathway. And so you go from that rocket ship ride to a slower, more controlled increase. Now, whether or not that’s necessarily healthy for that person, hard to say. But you know, the data is clear that super high elevations in blood sugar are extremely inflammatory. So you do not want your blood sugar to go very high. Like, you know, you said you went to town on chicken, Chinese chicken, you know, the American Diabetes Association says that, you know, normal people would rarely exceed 140 milligrams per deciliter. And I think that is a lack of data that is driving that statement. I think it’s true that people should not exceed 140. But I think it’s happening all the time. And people just don’t have any feedback on it. And we’re not measuring, you know. The non diabetic blood sugar space is just completely untapped. Nobody has done high resolution full time data in a meaningful way.
Dan Hightower [00:15:35] That reminds me of, like, the average American Heart Rate data. But, you know, you probably have, I mean gets your heart rate resting is like 50 beats a minute, or 45, or something like that.
Josh Clemente [00:15:48] Yeah, it’s like in the 50s. And 60s, which-
Dan Hightower [00:15:51] Which is diagnosed bradycardia.
Josh Clemente [00:15:53] Right, yeah. Exactly.
Dan Hightower[00:15:55] The average American. But we have data on heart rate, because we’ve been tracking heart rates for-
Josh Clemente [00:16:00] A couple of decades, for sure. And I mean, again, this is like, these, a lot of these ranges are developed by just averaging the population. It’s like on average, this is not good. And the problem is that, for blood sugar specifically, the normal zone is just the average of people who don’t yet have diabetes. And unfortunately, if you look at the numbers in society, 88% of American adults are metabolically unhealthy. 90 million American adults have prediabetes, and 90% of those do not know that they have it. And the reason they don’t know is because they have no feedback. And this is from random sampling by the CDC. And so we have a society that is extremely unhealthy. 70% are overweight or obese. So when you just average the people who haven’t yet been diagnosed, you’re averaging in a huge amount of dysfunction. And so we then have people who are calibrating off of these dysfunctional zones and saying, “Oh, I’m healthy, because I’m inside the normal range.” And in fact, we’re just slowly ratcheting further and further towards the society being entirely diabetic, which is a terrifying thing. It’s really happening right now. And, you know, we need to shift the whole bell curve back to the left, which is what Levels is doing. You know, we’re redefining the ranges that, we’re not calling them normal. We’re saying this is what’s optimal. And it may be very challenging to stay there. But the point is that every choice you make you want it to be kind of bringing you closer to health, not, you know, bringing you further away.
Dan Hightower [00:17:16] Yeah. And I do get that when I use the app, I get that game, like the optimal zone, I want to stay in the optimal zone. And that’s super interesting because you have leveraged that great experience in the app in a really seamless medical experience, which is obviously way better than 60 finger pricks a day. To give a lot of people of the value here. You are, you’re early early days, and you may, you’re like not even publicly launched yet, but your waitlist is over like 32,000 people.
Josh Clemente [00:17:50] I think we’re at 40,000 as of last weekend.
Dan HightowerDan Hightower [00:17:51] 40,000. Yeah, that was like last week when I asked you. Now it’s 40. It’s amazing. How did you create that level of demand?Dan Hightower
Josh Clemente [00:18:00] Well, first off, I think that the space that we’re in is ripe. People want better information about themselves. They don’t necessarily want better information about the whole average population, they just want to know what, “How healthy am I? And how can I do better.” We’re seeing this with the decentralization of fitness like Peloton and Tonal and all these companies where they’re coming to you. It’s no longer a gym thing. You’ve got wearables that give you your heart rate, that tell you how you’re sleeping. That you know this personal health information trend is a fantastic one. And we’re, it’s still nascent, still brand new. But it’s certainly the case that people want personalization, they don’t want to get cut and paste information. And I think we’re hitting this at a prime time when with COVID, for example, there’s very close connections between COVID and metabolic syndrome. So the outcomes for Coronavirus are much worse for people who have pre existing metabolic dysfunction. Combine that with the fact that people know that they’re flying blind, they have this intuition that, you know, they’re using data in every other part of their lives except for their own health. And so when you bring a product out that provides a you know, you’re measuring a molecule in the blood. This is not, you know, it’s not a superficial measurement, like, you know, I can measure my pulse with my finger. And I can measure my step count, you know, by hand, or mentally, but I can’t measure my blood sugar. And now this device provides a very convenient way of doing that full time to a smartphone with a very seamless and elegant user interface.
And so the, you know, frankly, it’s been entirely organic. It’s been amazing to watch, but people want to share this stuff with each other. They want to show like this intuitive result like, “I always felt this way and now I have data to back up why I feel this way, you know, after I sleep for five hours, I’m ravenous all day long. Well, now I can see that my blood sugar’s completely erratic after I have that short night of sleep, but when I sleep nine hours, my baseline is 20 points lower and my swings after meals are much more controlled.” Or the counterintuitive thing, you know, “I’ve been having this press juice every single day instead of a frappuccino, and then I get my blood sugar monitor, and I find out that that’s causing a disastrous blood sugar spike and crash. And like, you know, this might be the reason that I haven’t been able to lose the weight that I thought I would lose by going on a press juice diet, you know.” And so it’s those types of things that are reinforcing. It’s positive and negative reinforcement. You know, it’s like it’s demonstrating for you the way your specific body responds to your specific choices. And so all of that just like it combines to provide, you know, in combination with hardware, software, and those magic moments, a lot of really shareable opportunities.
And so we’ve been benefiting on social media, we’ve done essentially negligible marketing. You know, this 40,000 person waitlist, and growing is the effect of people sharing their own stories. And, you know, we do have a lot of people with large followings who have become early adopters, which has been amazing. And so that flywheel effect of people just saying, you know, “It’s not that I can necessarily apply with this person’s learning, because there’s so much personalization involved, I need this product myself, in order to know for sure.”
Dan Hightower [00:21:02] So many products today are subscribing to the waitlist launch approach. Are all waitlists equally valuable? There are different ways of creating a waitlist, how do you balance, you know, building a huge waitlist with creating a waitlist of highly qualified, you know, buyers that are likely to churn down the road?
Josh Clemente [00:21:24] Yeah, it’s a good question. And I mean, it’s something we’re very focused on. At this point, we’re still heavily in development and focused very much on product feedback, and on our early adopters, you know, giving us everything we need to know, whether we’re resonating. And so it’s kind of a time function, you know, the waitlist continues to grow. And there’s definitely feedback effects there where the larger it is, the faster it grows. And so we’re benefiting from that. We’ve been in development for some time. But I would say that I’m very confident in the intent of our waitlist, specifically because we’ve done such little performance marketing, and we are not driving large volumes of people through advertising, where you can simply click a link and join. We have a pretty involved forum that you have to submit in order to sign up on the waitlist, and it’s at the homepage. And again, most of this is coming from organic places like search traffic, podcasts, and from testimonials on Twitter and elsewhere. So people are, you know, we’ve been focused very much on both product development and on explaining the use case here. So podcasts, for example, are a great opportunity for people to hear specifically how metabolism affects their end goals. You know, you might be a person who has a really exceptional handle on physical fitness like I was, but you might be dealing with the cognitive dysfunction that you can’t get a hold of. It’s like, “Why do I feel so mentally fatigued? Why am I having such a problem with recall and memory?” And when you hear on these podcasts, the way that the brain is metabolizing glucose and what happens, the fogginess that sets in and the recall issues that have been demonstrated in the research environment when glucose is not controlled. You start to have this flash, this, you know, light bulb moment. And then you go and you look in our blog, and you read our blog posts about cognitive clarity, and it all starts to come together. And that’s when you sign up for the waitlist. And so I think we have this, you know, it is certainly not an optimized funnel onto our waitlist by any means. Again, we’re very product focused. So when you have a waitlist that builds, and the only information out there is highly educational information, I think that goes to show that this is a very intent audience. You know, we could definitely be doing, we could be kind of amping this thing up by providing single click additions to the waitlist, you know, add your email address and hit enter. But I think that would be doing us a disservice. Right? The way we have it set up right now you have to go through some hoops. And I think that demonstrates that people really do want to get their hands on the product.
Dan Hightower [00:23:41] Yeah, there are three people in my Twitter DMS right now that reached out, in my tweets about the product, and they’re like, “I filled out the form like, but I haven’t heard back like, Can you help me out? Like, how to get the beta or the trial?” That’s when you know, you got something, right?
Josh Clemente [00:24:01] Right. Yeah, I mean, we originally anticipated that everyone who signed up would like go right into the Early Access Program, like there would be a few 100 or a few 1000 people and that we would put them all into the program. But it quickly got to the point where, you know, for the purposes of the invite only program that we’re running right now, the early access, we just can’t do that much volume and still get high quality feedback. And so the, you know, we started to have to like sort of sift through and pull people out of the waitlist and now obviously, it’s just kind of been a runaway effect. And sorry to those three people. We’re going to get to you soon.
Dan Hightower [00:24:36] Good problem to have, sort of.
Josh Clemente [00:24:38] I’m not complaining, and that’s for sure.
Dan Hightower [00:24:41] Yeah, so you could count Levels as my second quantified self device on my body. Play that out five years, how do you want Levels to fit into what will probably become, like this opportunity to have like 20 things attached to your body?
Josh Clemente [00:24:54] Yeah, I’ve done a ton of research on the bioengineering possibilities and the electrochemistry that underlies the sensors and the potential for other molecules to be measured. And suffice to say, I’m optimistic. There’s a huge potential here to take this same form factor. So I have on my arm a small disk, I think you might be wearing one as well, and it has a little filament in it. And that filament is measuring directly glucose molecules in the skin cells. So it’s in what’s called the interstitial fluid. So it’s not actually in the bloodstream, it’s in a layer above that. And there are a lot of molecules in that area that can be highly valuable to understand. These are things like lactate, cholesterol levels, free fatty acids, ketones, cortisol, insulin, potentially. Those hormones, those last two hormones are the hardest to measure, but those others are actually fairly straightforward. And so you can imagine a device that has either a variety of filaments, or a single filament with segmented areas on it, that each are measuring a different molecule in the same form factor and all streaming to your smartphone. And that’s super useful information to both drive behavior change, but also to influence the medical community and help people better understand. You know, if you walk into the physician’s office with three years of lactate, ketone, and glucose information, along with nutrition logs, and sleep logs from your Apple Watch, you have a complete picture of that person and how they are functioning in both, not just how they’re functioning right now, but why they are functioning that way as a function of their lifestyle choices over the past three years. And this can completely change the relationship between physicians and patients, because that context is so valuable.
Dan Hightower [00:26:25] Yeah, that’s a huge vision. The product itself is beautiful, the application is a really enjoyable experience. I’d love to dig into that. You come from SpaceX, that’s not a medical community. I know that astronauts have an unbelievable amount of health quantification going on. But as you thought about launching the company, maybe this has to do with how you selected early co-founders, but I’m curious how you thought about bridging the gap into a medical device product, and where you focused your time. You know, you didn’t build a device, you built an incredible experience. And I’d love to hear how you broke all that decision making down.
Josh Clemente [00:27:09] Yeah. Well, first of all, thank you. I’m glad that you see it the way I see it, I think it’s a really delightful experience. And obviously, there’s plenty of ground to cover. But suffice to say, you know, the experience of using a CGM to change my own lifestyle was very positive, but it was lacking in experience. It required a huge amount of research into what was happening and why. And the devices currently today, they come with software that is essentially just the bare bones operating system. You know, the manufacturers of these devices, they’re intent on providing a means of full time measurement for glucose to people with diabetes. And when you have diabetes, it’s an immediate need. You need to know your glucose. And really beyond that, it’s up to the provider you’re working with, to make changes and all of that. So when you’re talking about a new audience, the consumer audience, that immediacy is gone. And that sort of acute problem to be solved is not there. Instead, it’s a much broader concept. It’s like specific goals. And it’s aspirational. And it’s really, you know, in this space of wellness. And the wellness space, you look at companies like Apple with the Apple Watch, you look at companies like Peloton, Tonal, they have exceptional, elegant experiences. People don’t want to make major sacrifices to improve their daily behaviors, right? You got to fit this into a really hardcore lifestyle. In many cases, people have high intensity schedules, and they don’t have time to figure things out. And so it became clear to me that, although the hardware was not optimized, like there’s plenty of room for improvement, it was very good. And where the experience was lacking was in connecting the dots between that hardware and the end goal, which is specific behavior changes across diet, exercise, sleep and stress. And so, you know, if you want to compare it to heart rate monitoring, for example, optical heart rate sensors are a commoditized product. They’re not expensive. But what takes an optical heart rate sensor and turns it into a whoop strap or an aura ring is the implementation, it’s the user experience. It’s how easy and elegant is the software? And how much does it elevate the focus to like, how much does it filter through the noise and give me the signal basically, and tell me what to do and how. And so that’s kind of what we’re trying to do here, is we know that our, the core competency of developing continuous glucose sensors is already managed. That’s, you know, there are great manufacturers, they’re doing amazing things there. They’ve been doing it for decades. Where the opportunity lies is connecting, again, that hardware to the end user and providing an elegant experience wrapped it in. And so that’s where we focused and it really allowed us to do quite a bit very quickly because we were leveraging existing devices. We didn’t have to do that, you know, intensive development process, all the financial, you know, outlay that would that would come with it. And it allowed us to really focus on the beauty of the experience. And so I have to credit my co founder David, he’s got an unbelievable design intuition. He’s our product guy. And he’s done a great job along with our contract design agency of the working assembly. I want to give them a shout out. Together they’ve really put together I think something really beautiful that people can jump into and learn from very quickly.
Dan Hightower [00:30:22] What did you learn at SpaceX that helps you in your day to day at Levels?
Josh Clemente [00:30:27] Yeah. So SpaceX is a, best way to describe it is it’s driven by first principles. So that’s something that you learn and holds very dear. And first principles are basically the, if you think about a tree, you’ve got the trunk and you’ve got all the branches and then you’ve got all the leaves, and so it’s easy to focus on the leaves as the first thing that strikes your eye when you’re looking at a tree. But the leaves are supported by branches, which are supported by the trunk. And the trunk are the bare minimum, the basic principles upon which the other, the sort of outer design details are attached. And so for any problem, there is the core problem to solve. And then there are a ton of peripheral problems that you could get distracted trying to optimize. And so what we did at SpaceX was just like, What are the core problems that need to be solved?” And if you use first principles like physics, you know, what is the physical problem? Gravity is a physical problem. You know, in a lot of cases it’s like, to build a rocket, how much does the aluminum cost for that much, you know, surface area? That’s like, that’s the first principles problem to solve. And from there we can decide, all right, is this thing, is it possible to build for the price target? So it’s very, very simplistic conversation. You know, when you, when you sit in a meeting at SpaceX, and this something I’m really proud of, essentially anyone, no matter what their background is, would understand the conversation. They might, they may not have specific experience with it, but there are no acronyms. There’s no jargon. And it’s all about ensuring that anyone who’s in the conversation, whether a PhD in aeronautics, or astrophysics, or a brand new intern who’s still in, you know, in their bachelor degree, they can all contribute to the conversation in the moment, because that’s the only way to foster out of the box thinking, to open the opportunity up for anyone to contribute if they have a good idea. So, you know, I think that that’s a really powerful lesson. And it shows that, you know, and honestly, we had a lot of people at SpaceX who had very diverse backgrounds. You know, we had people who had geology backgrounds who were designing rocket structures. And so it’s very much an open minded culture where, if you have an entrepreneurial mindset, and you have a motivation, you will learn on the job. And that’s the qualification you need. It’s the demonstration, it’s not a qualification. You don’t need that piece of paper to say that you’re qualified for the position, it’s more so, “Show us what you can do.” And so I think we’re, you know, at Levels, we’re taking a very similar mindset where, “Let’s solve the core problems.” The core problems of metabolic dysfunction are people are completely blind to the effects of their choices. So let’s give them the information, the specific information they need, not a bunch of fluff. And let’s give it to them in a way that is easy to consume. And then let’s ensure that the team is built on, you know, a foundation that believes in science and challenges their own assumptions, and is willing to challenge the assumptions of others to forge, you know, kind of a new market very quickly. And so I hope we’re echoing SpaceX in some way. Certainly, I try to.
Dan Hightower [00:33:14] I mean, I see that you’ve taken almost atomic level, molecular level measurement, and turned it into a beautiful app that’s easy to understand. And you have raised a little bit of money, I’d love to hear the fundraising story. You know, this is such a big idea. I’m so curious, at what point along the journey you raised first money, and what that looked like.
Josh Clemente [00:33:37] So, my co-founder, Sam, is, he’s a multi time founder and just really has a powerful mind in the area of network theory, and certainly has a ton of experience with raising. And this was my first time raising venture money. So, you know, he really helped define the right strategy, because I wasn’t, I did not have the right strategy figured out, you know, in advance. So I had worked on a company prior to Levels called Frontier Biometric. And the goal there was, the same as Levels, but I was taking a very slow growth kind of bootstrapped approach. And it became clear to me that that was not the right approach to maximize the chances of success. And I needed to replicate, you know, that SpaceX environment where you have an absolutely dynamite team working on a massive problem together. It was not something that I was going to pull off on my own. And Sam was one of the first people I thought of. We teamed up very quickly for Levels. And we basically started bringing in money right away. And so we did that on safe notes, mostly in network people that we knew. So this was primarily angels. We had a few small checks from, you know, institutions. And that was a process of essentially just making phone calls. And Sam has very strong network, given his prior startup experience. I had access to some networks. And so together, we were able to bring in sufficient funds, about a million dollars over the course of a few weeks. And we used that to start to build the team out. From there, we kind of kept a safe note open for a few months. And we ended up raising about close to $4 million on safes over the course of eight months. And we’ve since signed term sheets for our seed raise. And that’s currently undisclosed, but the details will definitely be coming out shortly. And we’ll use those funds to go from this beta phase into our first stage of growth. And so yeah, we’ve been nicely capitalized, we’ve definitely benefited from a fantastic network of investors. You know just, we have people from all walks of life, other startup founders, other investors. We’ve got professional athletes like Matthew Dellavedova, just some really great people who support us in making connections. And you know, it’s been really powerful for me to experience this like earliest stage of funding and all of the benefits it can bring.
Dan Hightower [00:35:49] So you went from very little background fundraising to 4 million raised pretty quickly. I’m curious if you have a preferred resource that got you up to speed, or maybe it was just your founder, but perhaps not.
Josh Clemente [00:36:03] Yeah, you know, most of it honestly came from conversations among the founding team. So Sam, again, he has great, great experience with this. Andrew Connor, who is, he runs engineering, my co-founder, he also has quite a bit of investing experience both his own investing, but then also he had a, he worked at a company that was acquired by Google and became Google Voice, so they had raised money as well. And so he had been through this process himself. And so that like really helped influenced me. I also really looked to a few books like Secrets of Santel was helpful to kind of understand the like, the real larger scale institutional investment round. But honestly when it comes to the earliest money in, it’s all about just relationships, it’s about connecting with people. And so, you know, I think that was the biggest surprise to me was that most angels are looking for a fantastic team. You know, they’re really the earliest money in and they have to, they have to feel confidence in the people. And so understanding that, you know, I would just, I think that was the most helpful resource for me was just to see that you have to demonstrate trust and have that pre existing relationship in order to really maximize the pace. You know, it’s hard to get quick money from scratch, you’ve got to know, you know, have some, it’s honestly, like, even loose ties, some loose relationship is better than none for sure, when it comes to those early conversations.
Dan Hightower [00:37:19] So what has been the biggest mistake or two that you’ve made?
Josh Clemente [00:37:24] Let’s see. I, you know, I call this mistake, I really don’t necessarily think things could have been different because it was a very significant lesson learned. But at that time working on this project myself, and essentially trying to define all of the boundary conditions and say, like, “Here’s the whole business plan, here’s every problem that needs solving. I’ve done all the work in advance. Now let’s just like hire some contractors to knock it out.” That process was extremely educational for me, but it did not move the ball forward very far, all things considered. Now, again, I learned just a huge amount about human physiology. I wrote a white paper of those instructive for bringing on the early team. It demonstrated that there was a used case here, like did a bunch of the educational heavy lifting for bringing other people up to speed on why this is something to do. But I could have accelerated that process by nine months, for sure. And, you know, we could be nine months ahead of schedule from today. So, you know, I kind of call that a bit of a regret that I didn’t, you know, I didn’t treat the scope of the mission with the appropriate execution, if that makes sense. Like, it certainly was clear that this required an all star team of data scientists and product designers, and you know, I’m over here, a mechanical engineer working on it solo. So I would have definitely accelerated that process if I did it all over.
Dan Hightower [00:38:43] Okay, wrapping up, secret weapons. I ask you what your secret weapons are for an unfair advantage you work in life. So what is your secret weapon for staying consistent with your exercise, and nutrition? You can’t say Levels.
Josh Clemente [00:38:01] Okay, I was gonna say Levels, I’m not going to lie. The accountability there is huge. But without Levels, I would say I really enjoy physical fitness, but I have kind of evolved away from the super high intensity workouts. And I’ve started to realize that movement is what is most critical for people. And you get an 80Dan Hightower20. So 80% of the benefit for 20% of the effort, you get an 80Dan Hightower20 benefit from just doing something. And that doesn’t have to be getting in your car and spending 90 minutes sweating it out on a treadmill at a gym, or lifting heavy weights at the end of the workday. If you just get up and walk around the block two or three times or walk up and down stairs, while on a phone call, you get massive benefit both mentally in the reduction in cortisol, but also I’ve seen this with blood sugar control myself, and so you’re getting physiologic benefit. So my secret weapon is having learned that lesson and knowing that if I can just get 100 pushups in before bed, I’m better off than if I say, “Ah, this is a lost cause.” And I’ll have to work out tomorrow. Anything is better than nothing.
Dan Hightower [00:40:01] Yeah, that’s super hard for me coming out of the military where if you’re not throwing up in a bucket by the end of what they do to you, then it wasn’t a real workout.
Josh Clemente [00:40:10] Right. It’s rampant. I mean, I’ve got two brothers in the military. And I see it from them too. They come home and they’re like, you know, “We’ll do a six mile run and 100 pull ups.” And they’re like, “Alright, let’s go work out now.” Yeah.
Dan Hightower [00:40:24] Okay, so secret weapon for team culture in this now remote world.
Josh Clemente [00:40:29] Yeah. So Levels has been remote from the very first days. So Sam and I chose to make this a remote company. The things that we’ve learned over the past year have been really amazing. I think the biggest one, making sure you take the additional minute to announce something interesting. So we have for example, channels where we can share emails, like the founding team can just throw emails into slack from, you know, exciting developments. And this may be a new employee joining, it may be just a piece of praise that we get from our investor network. But we’re able to just plumb that right into slack so that everyone else can see it on the fly. And that’s a nice little way of just like creating a little bonds or just providing an afternoon boost for people. And beyond that. We have an intentional day. Well, it’s not a day, it’s an event every week called the Friday forum. And on the Friday forum, we get the whole team together. We go through accomplishments for that week. And we also typically will have a special guest. So this will be like Dom D’Agostino or Ben Beckman or Lou for on our research team, or it’ll be like an early adopters, somebody who invested early or somebody who is an earliest customer and will have them join. And we just go through and just like basically, it’s not a hype, you know, it’s not it’s not just like a hype meeting. It’s not some sort of party. It’s just genuinely demonstrating the progress that has been made across all departments for everyone to see. And we do it synchronously. And it takes about an hour. But it’s great. And then everyone has an opportunity to share something personal at the end that happened that week as well. And it’s a really nice way of like rounding out the weekend or the week going into the weekend, and have everyone like, kind of reflecting on, “Wow, like, you know, again, that might have sucked for me, this week might not have been great for me. But we really moved forward, like, unbelievably fast this week.” And it’s just a way to just reflect on that quickly. And together.
Dan Hightower[00:42:05] I like that. Okay, last one general tech stack, and not the actual hardware device, like the software I mean.
Josh Clemente [00:42:12] So I would have to say, Retool. Retool allows you to basically build custom internal tooling for your data set. And we use this, basically, all of our operations systems are built with Retool. And these are simple queries, But we can build dashboards and visibility systems for our operations team and our customer success team to get into the data set in a really meaningful way. And without like building these custom tools. You know, it would be like unbelievably intensive for the engineering team. But instead, this can take a few minutes running a query and, all of the visibility is like essentially no code built in. And so Retool, I think was like, essentially turnkey. It’s been a phenomenal experience. I’m speaking for engineering, but I’m also speaking for operations and logistics, which is you know, kind of what I’ve been working on the past few months here. And it’s been awesome to be able to just turn that system on and use the database to keep things running. So definitely a big plug for them.
Dan Hightower [00:43:08] Well Josh, the floor is yours. Anything you want to say before we wrap up?
Josh Clemente [00:43:11] Well, I really appreciate you bringing me on. I would recommend if anyone wants to learn more about the metabolism side or the specifics of how that breaks down, check out our blog. That’s levelshealth.com and then jump on the waitlist. I promise we’ll send some emails and keep you in the loop.
Dan Hightower [00:43:24] Awesome. Josh, thanks so much for spending time with me today. What you’re doing to change quantified self is truly amazing. Thank you so much for listening. Please subscribe for more amazing conversations with founders like Josh. And you can find them notes from this episode at productmarketmisfits.com. Check out Levels and levelshealth.com and read more about the science at levelshealth.com/blog on Instagram and Twitter at Levels.
Josh’s burn out led him to discover metabolism, metabolic function, which ultimately led to starting Levels.
Levels focus on helping people optimize their own lifestyles so that they can improve metabolic function and maximize their quality of life.
Josh’s burn out led him to discover metabolism, metabolic function, which ultimately led to starting Levels.
There’s a tight bound that glucose levels have to be maintained within in order for us to run effectively.
Glucose is absolutely critical for the human body to function.
Metabolic breakdown and insulin resistance is what’s happening in many of the symptoms of chronic health conditions.
Josh focused on oxygen toxicity on the central nervous system.
Disparity between how Josh looked and how he felt made him research more.
Glucose monitor as a nutritional strategy because diet has legitimate physiological benefits.
Josh saw how data from continuous glucose monitoring can help millions.
Levels closed loop feedback allows you to see the effect of your decision immediately.
The health range we have is dysfunctional zones because it is just averaged off the population.
Personal health information is a new trend. People want personalization.
The shareable opportunities of Levels’ hardware, software and the magic of personalized reinforcement grew the company organically.
Levels has an intent waitlist that really want the product.
The other possibilities of the Levels device will completely benefit both physicians and patients, in the future.
Levels created a design for beautiful experience with existing CGM technology for wellness aspiration.
Levels echo SpaceX by applying first principles.
Levels raised capital from angel investors from the founders’ network.
Relationships are important in early stage of fund raising.
Jeff would have accelerated the process if he had the right team from the very beginning instead of going solo.
Movement is what is most critical for people to stay consistent in health.
Levels have a weekly Friday forum where everyone in the team gets to reflect and gets boosted.
Retool has helped Levels to keep things running.