For true metabolic health, you need to know the state of your glucose metabolism – and sporadic finger pricks won’t give you the full picture. That’s why Dr. Casey Means, a Stanford-trained physician who is the Chief Medical Officer and co-founder of metabolic health company Levels, believes that continuous glucose monitoring (CGM) is the key to reversing the epidemic of metabolic disease. Dr. Means talks with Leanne Vogel of The Keto Diet Podcast all about glucose metabolism and how stress, sleep, and so many other individual factors impact your body. Understanding which factors are the most critical variables in your own glucose equation helps you develop a “metabolic toolbox” for optimal health.
8:52 — Glucose data, minus the pricks
Continuous glucose monitoring (GGM) lets people with diabetes track blood sugar in real time without pricking their finger to dose their insulin.
“Continuous glucose monitors is this fabulous little technology. It’s basically the size of a quarter and you stick it on the back of your arm. It’s a wearable device and it is monitoring your glucose 24 hours a day and sending that information to your smartphone…This was a real game changer for people with diabetes, because as opposed to pricking your finger, you know, one or two or three or four times a day to see how your food impacted your glucose and also to be able to dose insulin properly — you now don’t have to prick your finger. You’ve got this little sensor that’s on the back of the arm all the time that gives you 10 times or more data points per 24 hours automatically in the background.
10:14 — The real-time impact of food
CGM has become popular among non-diabetic health-seekers who want to know how food (and stress, sleep, and a host of other factors) impacts their blood sugar levels.
“People have started to think hey, this is a really interesting technology. Maybe this could actually be used for a wider population — people who are health-seeking and don’t necessarily have a diagnosed metabolic disease. It can be used as this tool that gives this super rapid closed loop feedback on how food is affecting health, and also how other lifestyle factors are affecting metabolism. We know that not only food, but also how much we sleep, how you respond to stress and the exercise we’re doing — all of these things feed into our glucose levels every day.”
17:38 — Too much sugar, too much insulin
Eating too much refined carbohydrates and processed sugar leads the body to overproduce insulin, which reduces the cells’ sensitivity to it. This process is known as insulin resistance.
“Let’s say you’re eating a standard American diet that’s full of refined carbs and processed sugar. Your body is pumping out a ton of insulin and ultimately the cells become resistant to that insulin. There’s so much of this insulin around where you’re going to have to like block some of the signal. And then what happens, to get the same amount of glucose into your cells, you actually have to produce more insulin. So you become hyperinsulinemic. That’s problematic because that insulin has effects all over the body. And when it’s floating around, it can cause lots of different problems….it can create all sorts of symptoms and problems. And there are so many diseases and symptoms that are associated with insulin resistance and metabolic dysfunction.
19:55 — The fat indicator
One clue that your insulin is at a good level: if you’re in ketosis and burning fat.
“Another function of insulin is that it blocks fat oxidation. So insulin is a signal to the body that, Oh, we’ve got tons of glucose around, so we don’t need to burn fat for fuel. So it actually molecularly stops fat from being burned. So if you have a fasting glucose level that is in the normal range, and you’re also definitely making ketones because you’re monitoring your ketones — that’s a good indicator that your insulin is probably pretty good and pretty low because you’re burning fat, you are fat oxidizing.”
20:30 — One data point vs. many
You get a much clearer picture of your glucose metabolism with dozens of measures throughout the day, as opposed to individual, sporadic ones.
“Bottom line, a one-time point measurement doesn’t give you a full picture. When you actually can track it throughout the day and see what’s happening after every meal, that gives you a lot more information. So if you’re pricking your finger after a meal, you might be catching the upswing of your spike. You might be catching the downstream swaying of your glucose spike. You might be catching the peak, but it’s very difficult to know if you’re actually capturing both the peak glucose elevation after a meal.”
21:31 — Gentle, rolling hills
A slow, minimal rise in your blood sugar after eating, with a rapid return to normal, is healthiest.
“The shape of that glucose curve after a meal — lots of research has gone into showing that is really quite predictive of your metabolic health overall. So you want to see essentially a very low peak after a meal, and you want to come down really quickly. That’s ideal. Really gentle, small rolling hills and your glucose curve. You don’t want to see these huge mountains, up and down jagged peaks. And so that’s the type of information that you can get from seeing it with a continuous glucose monitor that you just can’t, unless you’re pricking your finger, you know, 20, 30, 40 times a day.”
22:41 — Fight or flight stress response
In acute moments of stress, blood sugar surges to help you escape from a lion…even if there is no lion.
“Stress and glucose have a fascinating relationship and a history that is really rooted in evolutionary adaptation. So if you think back to the original sources of stress, they were very physical stresses and threats that we had. A common example you always hear about is like being chased by a lion….The body, essentially, was like, ‘Okay, we have some sort of physical challenge we have to overcome. And so we need to have energy for our muscles to work.’ Then the stress hormone cortisol is released. Regardless of whether it’s a physical threat or a psychological stress, regardless of whether you actually need glucose for your muscles or not, we still release cortisol. That’s going to travel to our liver and tell the liver to dump out its stored glucose into the bloodstream to essentially raise the level of the blood glucose very quickly to feed all these muscles for whatever threat is coming, whatever stressor you have to fight. That still happens today.”
30:07 — High spikes, high stakes
Why is high glucose such a big deal? Because it can trigger a host of harmful processes in the body.
“For people who may not be totally aware of why a glucose spike is bad…The first thing, it can generate inflammation. High spikes tell the body again, like with that stress pathway, ‘There’s maybe a threat. Why is there so much glucose in the body?’ And so that can actually trigger inflammation. It can also trigger oxidative stress — too many free radicals in the body and it can trigger glycation, which is the process where sugar is actually just sticking to things in the body, sticking to proteins and cell membranes and other things. And when glucose sticks to things in the body, it can cause dysfunction and how those cellular structures are working.”
33:04 — The biggest offenders
Thanks to CGM, many people are surprised to see that heart-healthy oatmeal actually wreaks havoc on their glucose levels.
“The first basic thing is understanding which food spikes you? Like, what are the biggest offenders? A lot of people have been shocked. We have a lot of customers, and even on our founding team, people who used to eat used to eat oatmeal for breakfast, and they’re like, ‘Oh, it’s heart-healthy.’ And this is like really ideal. And, you know, the package makes it sound awesome. But for many people, rolled oats will send their glucose up into like the 170s, 180s — extremely high, high levels that you probably never want to go to.”
33:42 — Reframe, don’t restrict
Your favorite food ramps up your glucose? There are a handful of strategies to modulate that rise, versus simply removing it from your diet.
“As opposed to minimizing, restricting, you can start pairing them with other foods that help minimize the glucose spike. So we know that adding fat and protein to carbohydrates typically does lower or blunt glucose spikes. And food order actually makes a big difference on this. So if you put your protein and your fat and your fiber, more roughage-like foods, before you eat your higher carbohydrate foods in a meal, it will also lower the glucose spike. And there’s lots of interesting adjuncts you can add to your meal. Things like cinnamon and vinegar, which are insulin sensitizers, which can keep your glucose spikes lower. So, as opposed to being restrictive — here are all the things we need to cut out of our diet — it’s actually much more about how can we modulate the food to make it more glycemically friendly.”
38:51 — Overtired and over-glucosed
Healthy glucose metabolism has as much to do with sleep as it does with what you eat.
“One of the key mechanisms is that sleep deprivation increases cortisol levels. And like we talked about earlier, cortisol impacts glucose in the blood. It also affects our ghrelin and leptin levels. So ghrelin and leptin are some of the hormones that tell us whether we’re hungry or we’re satiated. And it throws off the balance of ghrelin and leptin, and essentially makes us much more hungry and more likely to overeat and more likely to crave carbohydrates. It also generates inflammation. And inflammation has a very negative relationship with glucose.”
48:09 — No more picking out carrots!
The knowledge GCM affords can be liberating — like Alison, a beta tester, who discovered carrots don’t impact her glucose levels much.
“There were a lot of foods that were like ‘forbidden foods’ on the Keto diet, which she experimented with a lot of them during this month. And I think she was nervous to do that because she’d been so adherent to the diet for three years. And she found that a bunch of these foods actually did nothing to her glucose levels and did not kick her out of ketosis. And so she was actually able to greatly expand her diet. The one that she mentions in the article was carrots. She used to pick out carrots from all her salads when she’d go to a restaurant. And she found that carrots did very, very little to her glucose. And so she was able to put those back in, and a number of other foods as well. For her, it was very freeing.”
54:05 — Turning the tide on metabolic disease
Tools like CGM can empower the 88% of Americans who are metabolically unhealthy to regain control of their glucose and insulin.
“We’re unfortunately in a very metabolically unhealthy state right now in our country. There’s recent research out of UNC that suggests that 88% of Americans are metabolically unhealthy and only 12% of Americans are metabolically healthy. So this is a really uphill battle, but the beauty is that with smart choices, we can actually totally turn the tide on that. And there’s no point on the spectrum of metabolic disease when you can’t move in a better direction. It is not fatalistic or deterministic. We can always move back into a state of more insulin sensitivity and regain that.”
Leanne Vogel: [00:00:00] Hello. This is episode 279 and today we are chatting about continuous glucose monitoring. If you follow me on Instagram @leannevogel and I shared this a little bit on Facebook also at Healthful Pursuit. I wore a continuous glucose monitor for the month of September and a little bit into October. I recorded today’s episode before I put on a continuous glucose monitor. So it was so great to record the episode knowing nothing about how continuous glucose monitoring works. And now listening to the episode, having had 28 days wearing this bad boy, I can tell you that I have so much to share on continuous glucose monitoring.
So before we get to today’s episode, I want to share a little bit of my experience, give you some resources, so if you want to learn more about continuous glucose monitoring and how this relates to your ketogenic diet, you can do that. I really want to make today’s episode as resourceful, as impactful as possible because guys, I thought continuous glucose monitoring was stupid. I’ll say it right now, wearing a monitor on your arm for 28 days where your phone tells you what your glucose is sounds horrible. I was so not down with this plan and now having worn it, after I did this episode, our guest today is Casey and she works over at Levels, which is the monitor that I ended up using and after recording this episode, I was like, “Oh my gosh! I need one.” They sent me one. I used it and now I’m obsessed and I can’t wait to do another 28 days. I’ve learned so much, not only about my body, but it’s also verified so much of the work that I’ve done in the ketogenic space of like, “Yup! I was right on that.” “Yup! This is how this works.” “Yup! This is so cool.” And to watch how by wearing a continuous glucose monitor, you know exactly what your glucose is all of the time. So you can really tell what time of the month. Yes, I said, what time of the month you are more susceptible to having higher glucose than you are at other times of the month, your hormones and everything plays such a huge role.
And it’s been just so fun getting to see when it’s best for me to eat keto, when it’s not, when I am more sensitive or less sensitive to carbohydrates. Oh, it’s so good. So in today’s episode, we’re talking about one-time testing glucose and ketones versus ongoing levels, which is best. What information you’re going to get by wearing a continuous glucose monitor by knowing your glucose all the time. Why testing ketone levels may not be the best way to checking your metabolism. How the metabolism works in relation to insulin glucose and your ketogenetic diet. So by wearing a continuous glucose monitor, this little monitor that sits on your tricep area, and no, it’s not a needle in your arm. I thought that for the first 14 days of wearing my first continuous glucose monitor. And it’s not a needle.
So by wearing this, you start to understand how your metabolism works and you start to understand how resistant you are to insulin. We’re going to be chatting about stress and glucose, our evolutionary adaptation through time, using glucose as a marker for health to create metabolic flexibility long-term. Oh, Jeez! So many things. Food order. This was a big one. When I started combining certain foods, I started learning that my body responds best to certain things. I can actually have quite a few beans and it does nothing to my glucose, does nothing negative to my digestion and actually helps with my bowel movements. And so that has been a game changer for me to add beans to my ketogenic diet. Yes. I said beans. I cannot even believe that I’m saying that I’m eating beans on my ketogenic diet. It’s just all exciting things. If after listening to today’s episode, which is a very, very basic understanding of how continuous glucose monitoring works. If you’re like, “Whoa! I want to find out what happened to Leanne and how her first 28 days where.” I’m going to include three different links in today’s show notes. If you’re not sure where show notes are, you can just go to the Google machine and type in the app that you’re using and then show notes to figure out how to access the show notes of your specific app, because in those show notes, that’s where I put all resources and such for all of our episodes. So in today’s show notes, I’m going to link up to three different videos that I made while wearing my CGM. So I am back on YouTube, sharing keto stuff. Really excited about that. So there are three videos that I’ll link up to in the show notes on that.
And because our guest today is Casey and we’re chatting about the Levels app and the monitor and how it all works. I’m also going to include a link to the Levels CGM monitor and app. So if you go to levels.link/kdp, you’re going to skip the line. I think the line is like 29,000 people that are waiting to get a monitor.
So by getting the monitor with Levels – Normally you have to get a prescription, a doctor’s prescription, for getting this monitor, but Levels does everything for you. You just fill out all the paperwork and then your 28 days of monitors come to your house and then you wear them for 28 days. You get to use the app. It’s super informative. So I’m just going to put that in the show notes because I know that I’m going to get messages like, “But how do I get this thing? This is so cool.” And you’re right. It is pretty much the coolest thing I’ve experienced all year, which I guess is saying not a lot because 2020, Oh man! Trash fire, whatever. This is really, really exciting stuff. I can’t wait to share it with you.
So I guess I should introduce our guest today. Her name is Casey Means. She’s an MD and Stanford trained physician, Chief Medical Officer and Co-founder of metabolic health company Levels and associate editor of the International Journal of Disease Reversal and Prevention. Her mission is to maximize human potential and reverse the epidemic of preventable chronic diseases by empowering individuals with tech enabled tools that can inform smart, personalized and sustainable dietary and lifestyle choices. Dr. Means’ perspective has been recently featured in Forbes, Entrepreneur Magazine, The Hill, Metabolism Endocrine Today, Endocrine Web, Well + Good and Dr. Michael Greger’s, author of How Not to Die, video series. She is an award-winning biomedical researcher with past research positions at the NIH, Stanford School of Medicine and NYU. Oh man! Casey’s so brilliant. Whether you’re interested in continuous glucose monitoring or not, this episode will blow your mind. It definitely has mine. It put me on a totally different trajectory. Really had me re-inspired and sharing keto information as it relates to hormones. Casey’s just so smart and today’s episode was such a treat. I’m so excited to share it with you today and if you have questions about today’s content, you can go to healthfulpursuit.com/contact and ask me. You can also catch up on previous podcast episodes and notes from today’s show by going to ketodietpodcast.com. Okay, let’s do this thing.
Hey! I’m Leanne Vogel and you’re listening to the Keto Diet Podcast. I’ve put together a free 21-page guide on achieving weight loss on your keto diet if nothing is working, as a little thank you for being here today. Grab your free guide at ketoforwomen.com to get the steps you need to overcome the hurdles standing in your way.
Casey, how is it going?
Dr. Casey Means: [00:07:41] Great. How are you, Leanne?
Leanne Vogel: [00:07:42] I’m so good. I’m so good. I’m so happy to have you on the show today.
Dr. Casey Means: [00:07:47] I am so thrilled to be here. Thank you so much for having me on.
Leanne Vogel: [00:07:50] Yeah. So we already have been chatting for 12 minutes and figured I better press record because this conversation is so good. And that’s what I love about having really awesome guests that are just so open and knowledgeable and wonderful to come on the show. And today I really want to focus on continuous glucose monitoring and what this means. It might be a new concept for a lot of our listeners because as keto folk, we’re generally geared toward ketone monitoring as opposed to glucose. Everyone just forgets about glucose. So I’d love to just pick your brain on everything glucose, metabolism. Are you game?
Dr. Casey Means: [00:08:29] I love it. Let’s do it.
Leanne Vogel: [00:08:32] So I guess I should start off because we’re probably going to be saying CGM, CGM a lot. Can you tell me what is continuous glucose monitoring?
Dr. Casey Means: [00:08:40] Sure, absolutely. Continuous glucose monitors is this fabulous little technology. It’s basically like the size of a quarter and you stick it on the back of your arm. It’s a wearable device and it is monitoring your glucose 24 hours a day and sending that information to your smartphone so you can track your glucose essentially in real time and get this really granular data stream about how all aspects of diet and lifestyle are affecting your glucose levels.
So this is a technology that was – It’s been around for probably over a decade and it was – It is initially and currently FDA approved for the management of Type 1 and Type 2 diabetes. So this was a real game changer for people with diabetes, because as opposed to just pricking your finger one or two or three or four times a day to see how your food impacted your glucose and also to be able to dose insulin properly. You now don’t have to prick your finger. You’ve got this little sensor that’s on the back of the arm all the time and is giving you 10 times or more data points per 24 hours just automatically in the background. So total, total game changer and I think a lot of people are really interested in having more objective information about what to eat and what foods are good for them personally.
And so many people have started to think, hey, this is a really interesting technology. Maybe this could actually be used for a wider population, people who are health-seeking and don’t necessarily have a diagnosed metabolic disease. And the use of this tool that can actually really give this super rapid closed loop feedback on how food is affecting health and also how other lifestyle factors are affecting metabolism so we know that not only food, but also how much we sleep, how you respond to stress and the exercise we’re doing. All of these things feed into our glucose levels every day. So it’s a really neat way to track how all these different lifestyle variables are affecting your health. And the cool thing about glucose is that it changes super rapidly in the bloodstream. So it’s not really, it’s not a lagging indicator of what you’re doing. You can eat a handful of grapes and see your glucose shoot up in 15 minutes. It can be starting to go up really fast. So for the first time, we can actually say that this specific food had this specific impact on my health.
And I think people are really craving that type of objective information about their diet because there’s a lot of loud voices in the nutrition space and there’s a lot of confusion about what’s the right way to go. So objective data really cuts through a lot of that noise.
And I guess one other thing I’ll add is that, the other really interesting thing is that people respond very differently to the same carbohydrate source. So there’s actually tons of biochemical individuality between how people respond to the same carbohydrate load. And you and I could both eat a banana and have completely different glucose responses. I could go up five points and you could go up 50 points and that means that it’s having a very different physiologic effect. For one of us it’s creating a much more elevated insulin rise and potentially blocking fat oxidation. For the other it might be generating very little insulin rise and so it might be able to allow someone to stay in a ketogenic state if they eat that.
So having that granularity into how a particular food source is actually affecting your glucose levels is very helpful. And that understanding of that biochemical individuality and how people respond very differently to the same carb source, it goes against that standardized glycemic index scale that we have been shown for years and really moved it to this direction of, hey, maybe we actually each have a glycemic index for ourselves, for each food and we need to figure that out for ourselves individually.
So that’s what CGM can do, continuous glucose monitoring. And so it’s moving from this initial population as a treatment device to really being more of a wearable that allows people to have this, to finally be able to answer that question, how is this food affecting my health?
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You just shared so much. It makes me totally want to try this. I’m so bummed that I don’t have it yet. So how does this differ – You just shared so so much and I want to break it down into pieces. How does this differ from testing glucose once a day? Oftentimes, especially in the keto space, people will test their glucose perhaps, I don’t know, after a meal or before bed, perhaps they’re more geared toward ketone levels, I bet you at least 70% of the women that just heard your beautiful introduction to CGM are like, yeah, but ketone levels are more important for me because I’m on a ketogenic diet. Can we break that down a little bit further into testing specifically and the differences that you’ve seen, perhaps in people that you’ve interacted with that are using CGM versus ones that used to do ketone levels?
Dr. Casey Means: [00:15:24] Yeah. Absolutely. So I think the first question of, what’s the difference between a one-time point measurement, pricking your finger once per day and maybe getting a fasting glucose or checking after a meal versus checking, getting this continuous data stream? I think the easiest place to start is with the fasting glucose.
So a lot of people are checking their glucose first thing in the morning, people who don’t have a diagnosis of diabetes to just make sure that they’re still in the normal range and see if it’s bouncing around much. And that can be very, very helpful. But the thing about fasting glucose, which is your glucose first thing in the morning after not having consumed any calories for eight hours prior, is that, that metric actually, it can stay fairly stable even if you are moving in the wrong direction on the metabolic spectrum. And the reason for that is because of insulin. Right now, our diagnostic criteria, one of the main things we use to put people in the category of whether they’re normal, pre-diabetic or diabetic is fasting glucose. If your fasting glucose is less than 100 mg/dL, when you go to the doctor and get your finger pricked, then you’re considered quote unquote “normal”. If you’re between 100 and 125, you’re considered pre-diabetic and if you’re 126 mg/dL or above, you’re considered diabetic.
But what’s interesting is that – So just to back up and do a little bit of metabolism 101. So each time you elevate your glucose in your blood, you are going to also cause your pancreas to release insulin. And the reason you do that is because insulin floats around in the bloodstream and it’s a hormone that can bind to cells and basically tell the cells to take up that glucose. So you have a glucose spike, then you have an insulin spike, and then that allows the glucose to be shuttled into the cells. And when you do that over and over again, because let’s say you’re eating a standard American diet that’s full of refined carbs and processed sugar, your body is pumping out a ton of insulin and ultimately the cells become resistant to that insulin. They’re like, there’s so much of this insulin around we are going to have to block some of the signal. And then what happens is to get the same amount of glucose into your cells, you actually have to produce more insulin. So what happens is you become hyperinsulinemic and that’s problematic because that insulin has effects all over the body and when it’s floating around, it can cause lots of different problems. And insulin resistance basically means that your cells aren’t doing a good job of getting this substrate into them to create cellular energy. And when that happens in different parts of the body, it can create all sorts of symptoms and problems. And there are so many diseases and symptoms that are associated with insulin resistance and metabolic dysfunction. And basically where that showing up in the body, it can look like anything. If you’re insulin resistant in the brain, it can look like dementia or fatigue or chronic pain. If it is insulin resistance in the ovaries, it can look like polycystic ovarian syndrome and infertility. If it’s insulin resistance in the skin, it can look like your oil glands, sebaceous gland hyperplasia and acne. It’s basically like where it shows up. If it’s insulin resistance in the liver, it can look like non-alcoholic fatty liver disease. So having that high insulin essentially can keep your glucose almost like looking the same, but you’re producing tons more insulin to keep that glucose the same.
So getting back to fasting glucose. Let’s say your fasting glucose is 80. You could be someone whose fasting glucose is 80 and your insulin is really low, or you could be someone whose fasting glucose is 80, but your insulin is super high to keep it at that level. So insulin is actually probably much more effective as an early marker of people who have some problem with their metabolism, because it’s going to rise and you’re going to be hyperinsulinemic far before that fasting glucose actually starts to rise. Once it starts rising closer to 100 or into the 100 to 125 range of pre-diabetes, that means that your insulin has been high and you’ve been insulin resistance for a long time. So in a lot of ways, long story short, fasting insulin, isn’t a very granular way to tell if you’re metabolically healthy. Certainly if it’s really high, you know you have a problem, but there are going to be years when it’s looking pretty normal and there still could be a problem.
The nice thing about doing it with ketone monitoring is that another function of insulin is that it blocks fat oxidation. So insulin is a signal to the body that, oh, we’ve got tons of glucose around, so we don’t need to burn fat for fuel. So it actually molecularly stops fat from being burned. So if you have a fasting glucose level that is in the normal range and you’re also definitely making ketones because you’re monitoring your ketones. That’s a good indicator that your insulin is probably pretty good and pretty low because you’re burning fat. You are fat oxidizing. So it’s really nice to actually pair those two together, but that’s just a little overview there.
So bottom line is a one-time point measurement doesn’t it give you a full picture. When you actually can track it throughout the day and see what’s happening after every meal, that gives you a lot more information. So if you’re pricking your finger after a meal, you might be catching the upswing of your glucose spike. You might be catching the downswing of your glucose spike. You might be catching the peak. But it’s very difficult to know if you’re actually capturing both the peak glucose elevation after a meal and also how long you’re staying elevated. People who are more insulin resistant, people who are starting to go down the path of metabolic dysfunction. Their glucose is going to stay elevated for longer after a meal. They’re going to probably have a higher spike, stay elevated for longer. And so you can actually see all that granularity when you have this every 15 minute time point. And you can essentially build a little graph of the whole glucose spike and really, really have a clear picture of how you’re responding. And that’s important. And the shape of that glucose curve after a meal – Lots of research has gone into showing that is really quite predictive of your metabolic health overall. So you want to see essentially a very low peak after a meal and you want to come down really quickly. That’s ideal, staying really gentle small rolling hills in your glucose curve. You don’t want to see these huge mountains up and down jagged peaks. And so that’s the type of information that you can get from seeing it with a continuous glucose monitor that you just can’t, unless you’re pricking your finger 20, 30, 40 times a day.
Leanne Vogel: [00:21:20] It would cost so much money to do and guaranteed you’d forget.
Dr. Casey Means: [00:21:26] Yeah.
Leanne Vogel: [00:21:27] So you mentioned after every meal, I’m guessing before, during, after activity. You mentioned stress. What other things have you noticed by using CGM where you’re like, “Whoa! That’s incredible!” I’m wondering, after meditation, would you see something because you’re not stressed? I have all these questions about what happened? What have you seen?
Dr. Casey Means: [00:21:48] It’s such a great question, and yes, the stress thing is super, super fascinating. So stress and glucose have a fascinating relationship and a history that is really rooted in evolutionary adaptation. So if you think back to the original sources of stress. They were very physical stresses and threats that we had and this common example you always hear about is being chased by a lion. That was the stress, the acute stress back in the day. Now our acute stressors are getting text messages and emails and people honking, but back in ancestral times, when you’re thinking about being chased by a lion. So when the body was stressed, the body essentially was like, okay, we have some physical challenge we have to overcome and so we need to have energy for our muscles to work. So the body, when the stress hormone cortisol is released, that hormone, regardless of whether it’s a physical threat or a psychological stress, regardless of whether you actually need glucose for your muscles or not, we still, when we release cortisol, that’s going to travel to our liver and tell the liver to dump out its stored glucose into the bloodstream to essentially raise the level of the blood glucose very quickly to feed all these muscles for whatever threat is coming, whatever stressor you have to fight. And so that still happens today. And so certainly in a lot of my patients and in the customers of the company that I run that is distributing CGMs to healthy individuals for this personalized nutrition use case, we see a lot of people reporting that stressful situations like big meetings with their company, their stressful conversations with people in their family cause a marked glucose elevation.
And there is also some research that breath work can have a really positive impact on those glucose levels and mitigating that. So something that we’re building into our product is going to be being able to track objective measures of stress. So like heart rate variability and help people create these connections between stress that they might not even be aware of, but that shows up in their HRV maybe dipping and building that one-to-one connection between this is what’s happening in your body from a stress perspective and then this is what’s happening to your glucose. And then that can serve as a foundation for people realizing how important it is to adopt these practices, these mind-body practices that have strong evidence to suggest that they really can get your stress down. So the deep breathing and all the different things that we can do to get into more of a parasympathetic nervous system state.
There was a really neat article that I read on the Wim Hof Method blog. I believe that’s where it was and I can send it to you potentially for the show notes, but it was about people doing the Wim Hof breathing method, wearing CGMs, and that had a really strong impact on glucose levels and bringing it down. And I don’t think that’s been supported by peer reviewed literature at this point, but it’s certainly fascinating anecdotal evidence.
So I think it’s both, I think that glucose can be both a really great biofeedback tool for stress, because it can show, it’s another thing to show you whether – If you’re fasted and your blood glucose is going up, it might be a signal that you are stressed and you might not even be realizing it. And then also as a way to see how your mind-body practices are affecting your glucose.
Leanne Vogel: [00:24:54] I love that. I so love that. I would have so much fun doing different breath work and just seeing how it all functions.
You know what I love more than anything in the entire world is helping people. And when I meet a complete stranger and they’re telling me about symptoms that they’re having or symptoms that their dog is having, or their loved one, oftentimes the first thing that comes into my head is, “You should try CBD oil.” And I’m in fact sitting in my car right now. I just drove an hour and a half to a friend’s place to drop off a bottle of Eaton Hemp CBD oil. Their dog’s having a really difficult time with an inflammatory condition. Nobody knows what it is. And I just thought, again, “You need to try CBD oil.” Now CBD oil has massively reduced my symptoms of anxiety. But CBD oil does so much more, including inflammation reduction, improving digestive function, improving sleep quality, reduces acne.
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Among high quality CBD options, Eaton Hemp’s unfiltered, full spectrum CBD oil is an all-organic choice, again, all-organic choice. They’re one of the first unfiltered CBD products to be USDA certified organic. This guarantee is ‘what you see is what you get’. No toxins, no pesticides and a label trickery. Eaton Hemp uses hemp seed oil as a carrier for CBD giving you the full entourage effect, maximum absorption, potency effectiveness, turpines, cannabinoids, aka results, which is all good things. If you’re supplementing, how do I even do this? Now, I personally take a dropper full a day with my dogs up until both our dogs passed away. Lexi was supplementing with 15 mg. She was a 60 pound dog and Pebbles who was a 10 pound dog, did a drop or two a day. Now with our dog, Coconut, who’s developed a little bit of inflammation, I’ve started giving her 10 mg a day and she’s an 80 pound dog. I personally couldn’t even imagine my life without CBD. It extended Lexi’s life by three years, giving us so much more time to spend together. When the vet said it wasn’t even possible.
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For somebody like me who understands the body and understands that if I see peaks, that’s not a good thing and I can adjust, but what do I do with all the data? As a person who’s listening to the show and now they’re seeing these high highs and these low lows and these peaks, not the rolling hills. What do you do? What do I do next?
Dr. Casey Means: [00:28:32] It’s such a good question. Yeah. That’s the key thing. And the really amazing thing about glucose as a biomarker is that it’s so highly actionable and it’s really easy, quote unquote “easy”. We basically know how to turn around our metabolic health and really it’s a question of just identifying where there are opportunities and then learning how to move things in the right direction.
First thing, I think, just for people who may not be totally aware of why a glucose spike is bad. So a glucose spike is essentially, like we said, like a big peak after a meal and you’re most often going to see these after a higher carbohydrate meal, but sometimes things can be very surprising because there are certain carbohydrates that may really affect you that don’t affect another person. So that can be quite enlightening when – We were talking before the episode, we’ve been talking about the example of a sweet potato could send one person through the roof and barely touch another person’s glucose. So the reason you don’t want to have that big, big spike is because hyperglycemia or high glucose can lead to quite a few physiologic processes that are damaging to the body. So the first thing that it can do is it can generate inflammation. So high spikes tell the body again, like with that stress pathway, okay, there’s maybe a threat. Why is there so much glucose in the body? And so that can actually trigger inflammation. It can also trigger oxidative stress. So too many free radicals in the body and it can trigger glycation, which is the process where sugar is actually just sticking to things in the body, sticking to proteins and cell membranes and other things. And when glucose sticks to things in the body, it can cause dysfunction and how those cellular structures are working. So inflammation, oxidative stress and glycation are all mechanistic reasons why you don’t want to have these glucose spikes.
And then the second thing is that it’s going to stimulate the insulin release and over time, repeated insulin surges are going to lead down the path of insulin resistance, which is essentially the pathophysiology of how diabetes and pre-diabetes develop. You become so insulin resistant that your glucose – You cannot compensate. You can’t get enough glucose into the cells and the glucose starts rising in the blood.
And then a third thing is that when you do have a big spike and you have that big insulin release, you can often have what’s called reactive hypoglycemia, which is that insulin essentially soaks all that glucose up into the cells and then you actually dip below what your initial baseline was. You go up and then you shoot down and that reactive hypoglycemia state can be really subjectively troublesome. That can lead to being jittery, feeling anxious, having that post-meal slump situation where you feel an energy decline. And so it all around can throw you out of your flow. So you don’t want to have that skyrocket and then plummet.
So those are some of the reasons why you don’t want to do that. But then the question is, so how do we minimize those spikes? So that’s essentially the foundation of what my company does. We have created software that takes this raw glucose data stream and makes it highly actionable and insight driven so that we do give people the tools to understand their data stream and then take the steps to move it in the right direction. So I’d say one of the biggest ways to keep glucose levels stable is to really understand food in a much more granular level.
So the first basic thing is understanding which foods spike you. What are the biggest offenders? A lot of people have been shocked. We have a lot of customers, and even on our founding team, people who used to eat oatmeal for breakfast, and they’re like, “Oh, it’s heart-healthy and this is really ideal and the package makes it sound awesome.” But for many people, rolled oats will send their glucose up into the 170s, 180s, extremely high, high levels that you probably never want to go to. And so it can just help you realize which foods are very problematic for you. And one of the easiest things you can do is start to really minimize those.
But then the second thing, as opposed to minimizing and restricting, is you can start pairing them with other foods that help minimize the glucose spike. So we know that adding fat and protein to carbohydrates typically does lower or blunt a glucose spike and food order actually makes a big difference on this. So if you put your protein and your fat and your fiber and more roughage foods before you eat your higher carbohydrate foods in a meal, it will also lower the glucose spike. And there’s lots of interesting adjuncts you can add to your meal. Things like cinnamon and vinegar, which are insulin sensitizers, which can keep your glucose spikes lower. So, as opposed to being restrictive, here are all the things we need to cut out of our diet, it’s actually much more about how can we modulate the food to make it more glycemically friendly and that’s just food and food pairing. But there’s also things like food timing. So it’s pretty well established at this point, that eating carbohydrates earlier in the day, between 8:00 AM and 2:00 PM is going to have less of a glycemic and if you eat them late at night, especially after the sun goes down. And part of that has to do with the fact that melatonin, which is released from the pineal gland at night to help you get ready for sleep, that, that has an impact on our insulin signaling. And yeah, so eating the exact same meal at 8:00 PM versus first thing in the morning, will have a very, very different glycemic response.
So that’s a lot of the stuff related to food. Certainly fasting can play a big role. Time restricted feeding and fasting are very advantageous for overall metabolic health and tools that you can use to help build that positive glycemic response.
But then there’s all these other things in your metabolic toolbox that you can try. And the biggest levers would be improving, sleep, improving the stress response and improving exercise essentially quantity. So sleep, stress, and exercise. Those have really big impacts. So if you’re stressed and you eat a certain carbohydrate, you might have a much bigger response than if you are very calm and really practicing mindful eating and eat the same carbohydrate. There’s even been studies looking at diabetic individuals who did mindful eating practices before their meals, and they had significantly different glycemic responses to the same carbohydrates from when they did not do the mindful eating approach before their meal. So that’s something so important for us to think about is how we approach our meals, how we’re feeling when we eat. We got to get back into , that state where we’re calm and relaxed and we’re in this parasympathetic rest and digest state when we eat.
With exercise, really, the moral of the story is, any type works to help metabolic health and glucose spikes. And the more you do it, the better. So resistance training, flexibility and agility training, low grade aerobic exercise, moderate and high intensity interval training aerobic exercise, all have been shown to improve insulin sensitivity and be good for glucose levels. And even something as simple as a 20 minute walk can decrease your glucose levels after a meal. There was one awesome study that I love where they took three groups of people and they basically said, okay, each of these groups is going to walk for 60 minutes a day, but one third of them are going to do 20 minutes of walking before each meal, one group is going to do 20 minutes of walking after each meal and one group is going to walk for two minutes, every 30 minutes throughout the waking day. All three of those groups had lower 24 hour glucose levels than the group that didn’t exercise at all. But the one that had the best glucose levels was actually the group that walked for two minutes every 30 minutes. So it seems like frequency of exercise and just doing it more often even if it’s two minutes of walking, moving those major muscle groups, getting those quads and those hamstrings just moving a little bit, increases our insulin sensitivity, helps with the spikes.
And then the last thing is sleep. So sleep has a massive impact on how much you spike and we’ve seen tons of people who, even in our early customers who will get six hours of sleep compared to their normal eight and see just that their fasting glucose is elevated the next day, their post-meal spikes are elevated the next day. Everything’s off and there has been tons and tons of research in this area about how sleep impacts metabolic health.
There was one study where they took, I believe it was six healthy young men. They deprived them of sleep for four nights. And I think the deprivation was that they got four hours of sleep. So they still slept. They didn’t keep them up constantly, but basically sleep deprived them. And they essentially took these healthy men and put them into a pre-diabetic state. They essentially turned them into pre-diabetics by just depriving their sleep for a very short amount of time. And this was reversible. Once they then put them back into normal sleep conditions, things bounced back very quickly, but it is profound how much sleep deprivation can impact glucose and even going from 7.5 hours a night to 6.5 hours a night. There has been research that showed that that will elevate glucose levels the next day. So it’s very, very important.
And sleep has a really big impact on – They looked at the mechanisms of this and one of the key mechanisms is that sleep deprivation increases cortisol levels. And like we talked about earlier, cortisol impacts glucose in the blood.
It also affects our ghrelin and leptin levels. So ghrelin and leptin are some of the hormones that tell us whether we’re hungry or we’re satiated. And it throws off the balance of ghrelin and leptin, and essentially makes us much more hungry and more likely to overeat and more likely to crave carbohydrates. It also generates inflammation and inflammation has a very negative relationship with glucose. So there’s lots of reasons for that.
So best way to keep these spikes down is to learn about your food, improve sleep, improves stress management, improve exercise. And those are some of the key levers that have been shown in the research and that we’ve basically built into all aspects of our software to help make this data stream as actionable as possible.
So long answer, but those are some of the key things.
Leanne Vogel: [00:38:05] I really hope you’re enjoying today’s episode. I’d love to see where you’re listening from. You can snap a pic and tag me @leannevogel or leave a review for the show on your favorite podcast player. It helps me out tremendously. Okay. Back to the good stuff.
So beautiful. And I was really amazed by the exercise piece of my takeaway, is just move. Whatever you choose, move your body. And I think we spend a lot of (I know that I have) time, energy, money in the past of like, “But I have to do this because this is the best.” And it feels like by continuous glucose monitoring, we’re cutting out a lot of the time, energy, money, the guesswork of trying to live a quote unquote “healthy life” because – I guess where I’m going with this is, you jump on Instagram and somebody says that their program is going to do X, Y, Z for you and so you get it and it doesn’t work and you don’t know why it’s not working or what happened. By having something like this, it feels like there’s a level of liberation from the bio-individual standpoint. Also just understanding what works for my body and why, so that I can develop a program that works for me that’s really easy. Would that be fair to say?
Dr. Casey Means: [00:39:18] I think it’s a really good point and it’s so efficient. It’s a very efficient way of figuring this stuff out, things that people have been trial and erroring with for years when our weight and our subjective feelings are the only things we have to track how nutrition is affecting us. We haven’t had tools to close the loop on whether a food is a good food for us or if it’s potentially problematic from a metabolic function. We get this once yearly fasting glucose check. We step on the scale maybe each morning and see what happened the day before and we may feel a certain way, like fatigued or this or that after a meal, but there’s really been nothing to close that loop. And once you close that loop, it’s yeah, like you said, it’s very, very liberating because it’s, oh, this doesn’t work for me or this works in this context and boom, you’re done. You don’t have to think about it any anymore.
And I think there’s two counterintuitive things about, I think, using technology like this to shape diet that are very intriguing to me. And fundamentally at my core, I’m a hippie functional medicine doctor. Yes, I am super evidence-based and I trained at Stanford and I am on PubMed all day, but fundamentally, very passionate about the fact that the core behavioral fundamentals are how we generate the majority of health, how we move, how we eat, how we sleep, how we stress, how we connect with other individuals, how we feel about our purpose in life and how we connect with the earth. That’s where I’m coming from. and the idea of running and building a digital health tool, I think you could say that, oh, that’s moving people away from some of those core basic fundamentals. But I actually feel like what’s so beautiful about it is that it’s using technology to ultimately get people so in touch with their body awareness. It is a way to rapidly get people to tune into some of the signals in their body that they can then really hear and select out and listen to. And I know even for myself using CGM for a year, I am much more aware now of the internal cues of my body, because now I’ve had this feedback signal that’s highlighted for me and almost confirmed for me some of the things that I feel inside my body. For instance, if I’m fatigued in the afternoon, now I can draw a relationship between the food I ate, some of the lifestyle things I chose to do that day to a spike that I had and then a subjective feeling I had. So that relationship between data, subjective feeling and choices, that trifecta, all of that really entrenches this new level of body awareness.
And that’s been really positive because I think in our world now, with so much access to technology and so much access to refined ultra processed foods that really hijack some of our normal hunger cues and satiety cues in the body, it can be very hard to hear what’s going on inside our body. And I really love how some digital health tools, I think well-designed tools can actually help us get back to that very core state of being in touch with what’s going on, which is really, really, really important for health.
And I think another thing that’s counterintuitive about digital health technologies getting us back to the basics is around this concept that is talked about a lot called orthorexia, which is the idea of being obsessed with wellness and obsessed with nutrition. And I think a lot of people talk about how the Instagram culture is in getting more people obsessed with this. It’s almost going to a pathological level of how much we’re thinking about wellness, but something I love about a tool like this is that, like you said, it can cut through a lot of that noise very quickly.
And I actually think it moves people away from an obsession about food, because you just start to build your metabolic toolbox. You know what works for. You know what things you can lean on to basically help you keep a low and flat glucose level. You learn which foods and food pairings work for you, and then you can move on.
And so I feel like I’ve thought less about food and weight and other things like that than I ever have in my whole life, because I know now what works for me and I do it and things go well and it’s very simple. So I think there’s cool opportunities that are somewhat counterintuitive in the nutrition space with using digital health tools like this, to get us back actually to the basics.
Leanne Vogel: [00:43:12] I love that you mentioned body awareness because if you think of the keto space, something that I’ve always really disliked is the, “La, la, la. Not listening,” part of tracking your macros and calories and you’re like, “I’m hungry, but la, la, la, not listening. I’ve hit my macros.” To be able to have a tool that allows you or encourages you, rather, to not only seek what’s good for you and your body, but also being validated, like you said, Casey, of just, “I felt like this was a thing, but I didn’t really know.” And I have a feeling the more you’re validated, the more you put trust on your own body and start doing the ‘la, la, la, not listening’ to buy this program because it’ll do X,Y,Z and you’re like, “Nah! That’s not going to work for me.” And you know deep down in the core of your being that, yes, this is not going to work for you because you trust your body because it’s being validated through a tool. And I would imagine that over time, you just get more and more and more in touch with your body, as opposed to, with other tools like calorie, macro tracking, where I feel like oftentimes – Now I’m not saying that it’s not always a good tool because we’ve all used on our ketogenic diet, but generally speaking, there’s this, ‘the tool knows best’ when it’s not a bioindividual approach to wellness. It’s just, you need 75% fat. You’re welcome. Here you go. Everyone takes 75% fat, 5% carbs and there’s no wiggle room.
Dr. Casey Means: [00:44:35] Yeah. I think that’s really important. And the thing is that even though the diet itself says, there’s no wiggle room in the macros for it to be effective potentially. What’s interesting about the biochemical individuality piece is that there may actually be much more wiggle room than we realize. And the reason is because a carbohydrate in the gut, essentially, a carbohydrate that went in the mouth does not translate to glucose in the blood. That is a very different process for each person. It can translate to a lot of glucose for one person and very little glucose for another person. And that depends on all these different factors. And a lot of this came out of this research five years ago that was published in the journal Cell, out of the Weizmann Institute in Israel, which was called Personalized Nutrition by Prediction of Glycemic Responses. And they found that the different things that dictated how a particular carbohydrate in the gut translates to glucose level in the blood is dependent on factors like microbiome composition and genetics and recent physical activity and recent sleep quality and baseline metabolic health. And when you factor these in, then you can really predict the glucose response.
And the thing with keto is that it’s not actually about carbohydrates. It’s about glucose in the blood. The carbohydrates themselves are not stimulating insulin. The glucose in the blood is stimulating insulin and insulin is the thing that’s impairing or allowing for fat burning to produce ketones.
So I think moving away from the idea of macros are king to glucose in the blood is king, that is actually what we need to focus on, can help and maybe even liberalize it for a lot of people. We had an early beta tester, Allison Krook who does a lot of writing about keto. She had a life transforming experience on the keto diet and she’s – I think she’s ‘a keto girl’ on Instagram. But she wrote an essay for us after she went through a month of using CGM and the Levels software and what she had learned – She had been following the strict macro based keto diet and she actually found that there were a lot of foods that were quote unquote “forbidden foods” on the keto diet, which for her, she found – She experimented with a lot of them during this month. And I think she was nervous to do that because she’d been so adherent to the diet for three years. And she found that a bunch of these foods actually did nothing to her glucose levels and did not kick her out of ketosis. And so she was actually able to greatly expand her diet. The one that she mentions in the article was carrots. She used to pick out carrots from all her salads when she’d go to a restaurant and she found that carrots did very, very little to her glucose. And so she was able to put those back in and a number of other foods as well. And so for her, it was very freeing and so shifted the thinking from counting carbohydrates to actually counting and looking at what’s happening to the glucose because that’s the core physiology of keto is the glucose and insulin relationship and the ability to fat oxidize.
So it’s an interesting – I wonder if it’s going to be the future of Keto 2.0 and I think how monitoring glucose continuously with ketones could give people an extra level of personalization and potentially liberalization and freedom that they might not have by just following the particular macro recommendations. So I think that’ll be interesting to see how that plays out.
Leanne Vogel: [00:47:44] This is actually really exciting. It’s not every day that I have a guest on the show where I’m like, “Whoa! This is going to change everything.” “Wow! Yeah! Low carbohydrates are not king, glucose in the blood is.” Yes! Yes!
Dr. Casey Means: [00:47:58] Yeah, it’s interesting. And it was just recently that that’s even been figured out that there’s a difference and that it’s different between people. So it’s a really exciting time for this personalized health, personalized nutrition. It’s I think the start of a really exciting time.
Leanne Vogel: [00:48:13] Yeah. Yeah. And back in 2014, when I started keto, I couldn’t even imagine starting keto now with all the tools available, what’s out there, the information that’s out there. When I started keto, there was one other person online talking about it and I made so many mistakes, rookie, rookie mistakes that people don’t even make now because they have resources and they know what they’re doing. So it’s so cool as time goes on and more and more people are interested in taking care of their body and understanding their body and understanding that that program on XYZ website or this or that. The other thing, if they don’t talk about bio-individuality and they don’t embrace that part to our physiology, I don’t know if it’s worth it. And I think it’s so cool that we have these tools that are at our fingertips right now and to be able to get to know our body better.
Dr. Casey Means: [00:49:02] Absolutely. I think it’s so true. I’m vegan and I eat a very high carb diet, but I’m able to stay in mild ketosis almost every day. And I just try and stay between 0.5 and 1.0 on my ketones, not super up there, but that’s on a diet of basically all plants and beans and legumes and all sorts of stuff. And I think that for me, the only reason I can do that is because I know how to eat beans and legumes and fruits in a way that doesn’t spike my glucose levels. And that usually means putting a ton of fat on them and protein and exercising around and all that stuff. But that process has been really, really interesting, and there’s definitely a vegan keto movement out there happening. But yeah, just thinking about how you can really do whatever works. It just happens to be – I’m not dogmatic about plant-based eating, it just really makes my body feel good. But to be able to do it in a way that doesn’t have the collateral damage of glucose spikes is so empowering to me. Because I think there’s probably a lot of plant-based people out there who are unknowingly thinking it’s extremely, extremely healthy, but are having spikes all the time and that might be collateral damage that’s not even realized. So to be able to strike that balance and have the diet that you want that makes your body feel great, whatever that is, but then reduce the collateral damage and be able to stay in a state of metabolic flexibility, I think that that is exciting because not everyone’s going to want to eat the same thing and not everyone should. So to be able to have some freedom there, I think, is good for people in the face of a lot of dogmatic voices in the nutrition space.
Leanne Vogel: [00:50:33] Yes. Yes. Yes. I agree with you. I think this is the most perfect time to end today’s episode because it was just such a great summary. Do you have anything else you want to add to share with our listeners today, Casey?
Dr. Casey Means: [00:50:44] Oh, goodness. I want to thank you so much for having me on the podcast. I appreciate it so much and I love what you’re doing and really spreading the message of good health. And yeah, certainly if people are interested in learning about vegan keto lifestyle, they can follow me on Instagram. I’m at Dr. Casey’s kitchen and then, if people are interested in learning more about CGM and Levels we’re @unlocklevels on Instagram and Twitter. And they can check out our site too, which is levelshealth.com.
But ultimately, we’re, unfortunately, in a very metabolically unhealthy state right now in our country and there’s a recent research out of UNC that suggests that 88% of Americans are metabolically unhealthy and only 12% of Americans are metabolically healthy. So this is a really uphill battle, but the beauty is that with smart choices we can actually totally turn the tide on that.
And there’s no point on the spectrum of metabolic disease where you can’t move in a better direction. It is not fatalistic or deterministic. We can always move back into a state of more insulin sensitivity and regain that. And so it’s a very hopeful and exciting space to work in because while we’re helping people really personalize their nutrition now with CGM and this product, ultimately our goal is to help move the needle and taking that 88% of metabolic dysfunction down to zero.
Yeah. I think it’s a hopeful and exciting time and excited to see how digital health tools will play into this. But thank you so much for having me on. This has been really fun to chat.
Leanne Vogel: [00:52:12] Yeah. Thank you so much for coming on and doing the work that you do. And you’re just so knowledgeable. I learned so much and I really appreciate you coming on the show today to share your brilliance with all of our listeners. So thank you so much for taking the time out to chat with us.
Dr. Casey Means: [00:52:26] Thank you, Leanne.
Leanne Vogel: [00:52:28] Okay. So if you’re not inspired by this whole continuous glucose monitoring thing, I don’t even know what to tell you. Wasn’t that just so good? Don’t you just want one? I know that that’s how I felt after listening to today’s episode. So if you’re like, I need a continuous glucose monitor right this hot minute, you can go to levels.link/kdp to skip the line and get yours. And if you have questions, jump on Instagram and DM me @leannevogel. I would love to answer your questions as it relates to CGM. Also check out those videos in the show notes, where I go through what my experience was and all the struggles that I had at the beginning, mostly mental struggles. I was really worried that this practice was going to be quite triggering for me. And it actually wasn’t. So I just go through all of that and I’m just, I’m so excited to share this content with you, and I hope you really enjoyed it.
Next up on the podcast, Sunday, November 15th, we have episode 280. Jessica Ernst is coming on the show to squash keto myths for avoiding overwhelm. Really excited about that one.
And Wednesday, November 18th episode 281. We have Anya Fernald chatting with us about meat. Okay. We’ve chatted about meat a lot on the show, but I have to say, this is definitely my favorite episode about meat. So if you eat meat, you’ve got to listen to this episode. It’s a good one.
Also, this is really great news. Starting with episode 280, all of our episodes where there is a guest, oftentimes like 99% of the time, it’ll also be on YouTube as a video. So you’ll see the guest and I interacting as a video on YouTube. So you can go to healthfulpursuit.com/video to subscribe to my YouTube channel. And I’ll see you on YouTube next week for the podcast.
And if you want to just keep listening here on this app that you’re listening to, that’s cool too. I just really wanted to add video with our guests because we’re recording it, why don’t we share it? So I will see you on Sunday, November 15th. Have a good one. Bye.
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