Don’t Have Diabetes? You Should Still Check Your Blood Sugars on Healthy Human Revolution
Episode introduction
Josh Clemente and Dr. Casey Means both had thriving careers – Josh was a SpaceX Lead Life Support Systems Engineer, while Dr. Means was a successful surgeon. When they put their minds to solving metabolic dysfunction, the result was Levels Health. Levels is all about putting the power of continuous glucose monitoring (CGM) into the hands of everyday individuals so that they can track their glucose levels. By helping users embrace an ethos of preventative medicine, Levels hopes to stave off the worst side effects of insulin resistance before they even happen. Today, Josh is co-founder at Levels while Dr. Means is CMO. In this episode of Healthy Human Revolution with Dr. Laurie Marbas, they talk all about their personal experiences with health and diets, the range of ways that glucose affects the body, and how a continuous glucose monitoring device works.
Show Notes
Key Takeaways
2:31 – Josh’s journey from SpaceX to nutrition
Josh worked at SpaceX for six years on life support systems before transitioning to nutrition and founding Levels.
“I was in charge of the pressurized life support systems development for future spacecraft. I was exposed to a lot of conversations about physiology under duress. So in these emergency scenarios, how to keep people performing optimally. And that eventually led to some really interesting research by Dominic D’Agostino who basically exposed that there are these amazing protective effects of a ketogenic state to central nervous system toxicity in a high oxygen environment, which is one of the scenarios that I was actively dealing with. And so this was my very first exposure to the potential power of diet in the health conversation.”
4:00 – Experimenting with food and diet decisions
Josh never really paid attention to diet until learning about Dominic D’Agostino’s research. He started experimenting with different diets to see what he could learn about his personal eating habits and decisions.
“When I sit down for lunch or sit down for dinner, why am I eating what I’m eating? I mean, frankly, like I had no rationale. It was really frustrating for me. And so that kicked off a period of experimentation for me, where I chose to experiment with very different dietary philosophies. I didn’t have any particular one myself at the time. I was going to start and kind of like work my way through, but I also wanted to get quantitative data myself. And that led me to research all of the potential metrics I could measure. I found glucose, which is obviously available for measurement in the world of diabetes therapy. And I thought, you know what, that’s a fascinating molecule to be able to measure, especially in real time, because it is the primary energy molecule. So if I can measure that, that’s going to be at least something that I can sort of work with.”
5:23 –
Josh was eventually able to get a glucose monitoring device and learned some eye-opening information about his blood sugar – which prompted the founding of Levels.
“Eventually I got [a CGM]. And what was fascinating and really started the whole Levels project is my blood sugar was in the pre-diabetic zone about 35% of every day. And my average glucose was over 110 and I was shocked by this. I was waking up at 115, 128 milligrams per deciliter in the morning. And this is something that once I got up and started walking around, I’d actually dip down. And that kind of explains how I guess my fasting glucose checks had been fine, but long story short, it was a real lightbulb moment. This data is important. I had no idea this was going on. My doctor had no idea this was going on. I had an access issue. I wasn’t able to get my hands on the device and then I used the device to sort of get a hold of which specific nutritional elements were causing the issue. And so anyway, about two years later and a lot of research, we’ve got an amazing team and we’re putting that data into the hands of people who maybe don’t need it for a medical rationale quite yet, but luckily, they may never have to because of it.”
7:12 – Metabolic dysfunction traps you in a cycle of sickness
As a trained surgeon, Dr. Casey Means saw firsthand how glucose affects patients’ overall health, especially after surgery.
“I did head and neck surgery for four years. And during my time working with thousands of patients, it’s just so clear that metabolic dysfunction, diabetes, pre-diabetes, and associated conditions – obesity, heart disease, et cetera – they are rampant, and they have a huge impact on surgical outcomes. And so no matter how great your surgery is, how great your sinus surgery is or your ear surgery or the different things that I was doing, if a person is not on the path towards becoming metabolically healthy, they’re going to continue to get sick. They’re going to continue to have morbidity and increased mortality associated with their metabolic dysfunction.”
9:08 – From surgery to functional medicine
Dr. Casey Means transitioned from surgery to functional medicine, which is focused on holistic lifestyle and illness prevention.
“In that practice, a lot of what we’re looking at is sort of what are the underlying drivers of disease and symptoms? What is the biologic dysfunction happening in the cells that for a particular patient is leading to a particular symptom? Depression isn’t all caused by the same thing. Depression could be from hypothyroidism. It could be from vitamin D deficiency. It could be from other factors. So if you don’t actually zero in on what exactly is the root cause of something for a patient, then just throwing a drug at it is unlikely to be super effective. So that’s sort of the root of functional medicine is really zoning in on the precise mechanisms of what’s causing disease and then attacking at that level. And a lot of attacking at that level means modifying the behaviors, the dietary choices, the lifestyle choices that lead to biologic dysfunction.”
11:40 – Preventing diseases
The continuous glucose monitor is a beneficial tool to fight preventable diseases like Type 2 Diabetes.
“These are preventable diseases. And these things don’t happen as an on-off switch. They happen as a spectrum over years from normalcy to full blown, metabolic dysfunction. So it’s not like one day you wake up and all of a sudden you have diabetes. This is something that’s been going on and developing for probably years and years and years. So then if that’s the case, it really became pretty urgent to me, like why wouldn’t we use this type of technology that’s cheap and easily accessible to be used as a biofeedback tool before people get the disease to help them ward off these things? It kind of seemed like a no-brainer to me. And yet it’s still not commonly done yet. But we’re seeing a lot of interest in people wanting access to these tools to get some actual objective data about how what they’re eating is impacting their risk of future disease and how to just stay in a range that’s going to keep them safer in terms of their glucose.”
12:51 – Merging clinical practice and digital health
Digital health is optimal for tracking glucose because there are so many different factors that can impact glucose levels from minute-to-minute.
“So it’s a multivariate input with a single readout and all those inputs are the lifestyle and dietary things that we’re always working with patients on. So it really lends well to a digital health type of thing because it’s difficult to parse out the data from all those inputs, but machine learning and algorithms can really help kind of parse out the drivers of glycemic dysfunction in a way that honestly it’s challenging to do in a 30-minute visit with a patient. So I can’t be with a patient in their kitchen every day beyond their shoulders saying, do this, do that. But having it on your phone and something that’s kind of doing that insight generation intuition building with you, we have already seen to be super powerful in our users.”
16:59 – Health isn’t fixed and can change over time
Many people think metabolic health is a frozen characteristic trait, and assume that they’re either healthy or not healthy.
“What we want to really drive home is that this is metabolic fitness. It’s through focus, repetition, and effort over time you can improve, just like you can improve physical fitness by going to the gym, just like you can improve your mental fitness wellbeing with meditation. So we use those terms very deliberately. And that’s how we’re getting a lot of positive feedback around that from our users.”
23:57 – Not diabetic? You should still track your glucose levels
Everyone can learn a lot through tracking their glucose levels, such as metrics that doctors aren’t routinely talking about or tracking.
“There’s metrics like glycaemic variability, which is not a term that I think most doctors are even familiar with. But it’s a metric that refers to how glucose swings up and down throughout the day. So do you have sort of a low and flat curve, or do you have a very wild up and down roller coaster curve? And that particular metric is very, very important for health outcomes. And in many, many studies and the research has been associated independently of fasting glucose and A1C and oral glucose tolerance test results of predisposition for heart disease, future onset of diabetes, stroke risk, etc. And so these are trends that you can actually see in a non-diabetic lots and lots of spikes. It’s still going to generate some of the same physiology that’s dangerous to health. It’s thought that big swings in glucose can activate processes that lead to oxidative stress, that lead to inflammation, that lead to excessive glycation, so glucose getting stuck on the proteins in the body. So there’s lots of physiologic things that can happen with glucose swings, regardless of whether or not you actually meet the threshold for prediabetes.”
25:44 – Subtle symptoms of glycemia
There are a host of symptoms associated with metabolic dysfunction. Even for people in the non-diabetic range can suffer from issues ranging from anxiety to infertility.
“I think what a lot of people don’t really realize is that there’s a lot of subtler symptoms that are very associated with glucose, even in the nondiabetic range. Some of these are things like anxiety and depression and just fact recall. People who have higher post-meal glucose have more trouble remembering things acutely – it’s pretty fascinating. Things propensity to get acne, to get wrinkles, which has to do with glycation of collagen proteins in the skin. Things like low testosterone, erectile dysfunction, even polycystic ovarian syndrome, which is the leading cause of infertility in the country. This is a condition that is associated with insulin resistance and metabolic dysfunction. And so for all of these conditions – and other things like fatigue, energy, exercise endurance – where your glucose is, even if you’re non-diabetic, could potentially have an impact on just sort of these symptoms that a lot of people don’t associate with glycemia.”
28:57- Mainstream medicine vs. preventative medicine
Mainstream medicine is great at treating disease. But what if you never got so sick that you needed treatment in the first place? With Levels, prevention is the name of the game.
“There’s a whole host of things that you could be dealing with, that you’re struggling with, that don’t quite meet a medical threshold. But you can work towards optimization by balancing your metabolic information, the data that sort of underlies the metabolic processes that are coursing through you. And you may never get to the point where you then have to work on a therapeutic solution because just that qualitative experience that you focused on ended up being so closely connected to long-term metabolic breakdown that you were able to avert and redirect your course.”
38:53 – Empowering individuals with closed-loop control
The Levels ethos is all about putting everyday agency in the hands of consumers. Every person should be able to reach their goals and learn that they can control their own health.
“I think a take home for people from using this is just really this idea of biochemical individuality, and also just empowerment that comes from that. A lot of medicine I think sometimes feels like one size fits all. You go in with a particular symptom and there’s kind of just like one particular treatment or a couple options of treatment. It can sometimes feel a little bit impersonal. And I think that something really positive subconsciously that happens from using this product is realizing how complex you are in terms of your responses to all these different inputs and choices that you’re making every single day, day in and day out. And then layering that with insights and that closed feedback loop, realizing how much agency we actually have over our own health and over this glucose line and the various metrics. Like it’s really in our control.”
Episode Transcript
Josh Clemente: [00:00:00] And what was fascinating and really started the whole Levels project is my blood sugar was in the pre-diabetic zone about 35% of every day. And my average glucose was over a 110. And, uh, I was shocked by this. I was waking up at 115, 128 milligrams per deciliter in the morning. And, uh, this was something that
um, would, you know, once I got up and started walking around, it’d actually dip down and that kind of explains how I, it, I guess my fasting glucose checks had been fine. But long story short, it was a real, you know, again, a light bulb moment. This is, this data is important. Um, I had no idea this was going on.
My doctor had no idea this was going on. I, I had an access issue. I wasn’t able to get my hands on the device and, uh, And then I use the device to sort of, uh, get a hold of which specific nutritional elements were causing the issue. And so anyway, uh, about two years later and a lot of research, we’ve got an amazing team and we’re putting that data into the hands of people who can, uh, maybe don’t need it for a medical rationale quite yet,
but luckily, uh, they may never have to, because of it.
Dr. Laurie Marbas: [00:01:08] On the Healthy Human Revolution podcast, Dr. Laurie Marbas interviews nutrition and lifestyle medicine experts, and extraordinary guests whose informative and inspiring stories will empower you with the knowledge to transform your life and health.
Dr. Laurie Marbas: [00:01:24] All right. Welcome to the podcast. I’m Dr. Laurie Marbas, and today I’m super excited to welcome back an old friend, Dr.
Casey Means, and also we have Josh Clemente from Levels. And this is a really kind of a cool tool. And we’re going to learn all about it and how it may help you discover, you know, the best dietary pattern for you. And what, if you are eating healthy, maybe some foods you should avoid still. So, hi, Casey and Josh, how are you guys?
Dr. Casey Means: [00:01:51] Doing great, Laurie. Thanks so much for having me back on and for having us here today to talk a little bit about Levels.
Dr. Laurie Marbas: [00:01:59] And thank you, Josh, and you know, Josh, this was kind of your concept and your baby, as all entrepreneurs and has a thought and a desire. Can you tell us a little bit about your story and what this is exactly.
Josh Clemente: [00:02:13] Absolutely. Yeah. So my background is not in, uh, nutrition or, uh, medical world. I’m actually an aerospace engineer, um, mechanical in nature. So I, uh, I initially worked at SpaceX for about six years on life support systems. And I was in charge of the pressurized life support systems development for future spacecraft.
And so this is. Uh, you know, I was exposed to a lot of, uh, conversations about physiology, physiology under duress. So in these emergency scenarios, uh, how to keep people performing optimally. And that eventually led to some really interesting research by Dominic D’Agostino, um, who basically exposed that there are these amazing protective effects of a ketogenic state, uh, to central nervous system toxicity, uh, in a high oxygen environment, which is one of the scenarios that I was, uh, actively dealing with.
And so this was my very first exposure to the potential power of diet in, uh, in the health conversation. So I, I’m a CrossFit trainer as well, and have always sort of considered that sort of, you know, you can tell someone’s health based on aesthetics or, you know, as long as you can perform quickly in a 40 yard dash and lift heavy weights, you’re probably healthy.
And so I never really, frankly, paid much attention to diet, myself. And coming across this research was a real, uh, kind of a tire screeching moment because I, it seemed like a superpower that this diet was, you know, dialing on, on these people and, uh, certainly in the test subjects. And so, um, that’s where it all started for me.
It got the wheels turning and I started thinking, you know, this is fascinating. I have actually no data that’s driving my own decisions each day. And so I live in a world of data. I work in a world of data. Uh, finance and, you know, retirement projections and all this stuff that we have data on, but I’ve no rationale that’s driving my daily decisions.
When I sit down for lunch or sit down for dinner, why am I eating what I’m eating? I mean, frankly, like I had no rationale, it was really frustrating for me. And so I, uh, you know, that kicked off a period of experimentation for me, where I chose to both, uh, you know, experiment with very different dietary philosophies.
I didn’t have any particular one myself at the time. I was going to start and kind of like work my way through, but I also wanted to get quantitative data myself. And, uh, that led me to research, you know, all of the potential metrics I could measure. I found glucose, um, which is obviously available for measurement in, in the world of diabetes therapy.
And I thought, you know what, that’s, that’s a fascinating molecule to be able to measure, especially in real time, because it is the, it’s like the primary energy molecule. So, um, if I can measure that, that’s going to be at least something that I can sort of work with. Um, so I, I tried to get a device from, from my physician at the time. He kind of turned me down and said, You’re not sick.
You don’t need this. Um, you know, you should, you should calm down. This isn’t something that you need to worry about because I have your, your, your, uh, H, A1C here and you’re fine. And, you know, I was like, well, in systems engineering, you don’t take a single point measurement and extrapolate that to the whole mechanism, right?
You, you know, you kind of like have to get as much data and as high resolution and as real time as possible. So that, I didn’t take that for an answer. I kept trying to fight and find CGM. Eventually I got one. And what was fascinating and really started the whole Levels project is my blood sugar was in the pre-diabetic zone about 35% of every day.
And my average glucose was over 110 and, uh, I was shocked by this. I was waking up at 115, 128 milligrams per deciliter in the morning. And, uh, this is something that um, would, you know, once I got up and started walking around, it’d actually dip down. And that kind of explains how I, I guess my fasting glucose checks had been fine. But long story short, it was a real, you know, again, a light bulb moment.
This is, this data is important. Um, I had no idea this was going on. My doctor had no idea this was going on. I, I had an access issue. I wasn’t able to get my hands on the device and, uh. And then I used the device to sort of, uh, get a hold of which specific nutritional elements were causing the issue. And so anyway, uh, about two years later and a lot of research, we’ve got an amazing team and we’re putting that data into the hands of people who can, uh, maybe don’t need it for a medical rationale quite yet, but luckily, uh, they may never have to because of it.
Dr. Laurie Marbas: [00:06:27] Oh, that’s real. That is fascinating. So how, do you mind if I ask how old you were when you made this sort of relation and started using it?
Josh Clemente: [00:06:35] I was 28.
Dr. Laurie Marbas: [00:06:36] So I think that’s another important element that people don’t understand. They go diabetes in older, you’re literally in your twenties. Like my oldest child is two years younger than you.
So I’m looking at, you know, what type of dietary changes are really important for the, this younger generation. So Casey, tell us how you got involved and what does all this mean to someone who doesn’t have diabetes?
Dr. Casey Means: [00:06:59] Absolutely. Yeah. So I came at this from a slightly different perspective than Josh you know, I was working in healthcare and as we talked about a lot on the last time I was on the podcast with you, you know, I was, I was trained as a surgeon.
I did head and neck surgery for four years. And during my time working with, you know, thousands of patients, it’s just so clear that metabolic dysfunction, diabetes, pre-diabetes and associated conditions, obesity, heart disease, et cetera, they are, they are rampant and they have a huge impact on surgical outcomes.
And so, you know, no matter how great your surgery is, um, you know, how great your sinus surgery is or your ear surgery, or what, the different things that I was doing, you know, if a person is not on the path towards becoming metabolically healthy, they’re going to continue to get sick. They’re going to continue to have morbidity and increased mortality associated with their metabolic dysfunction.
And it’s kind of the elephant in the room of American medicine right now. I mean, we, the numbers are just absolutely staggering to me. And I mean, I don’t need to tell them to you obviously, but, but just for the people listening in case like, people aren’t aware, like, I think it’s worth like reviewing like 30, around 30 million Americans have type two diabetes, about 88 million more have pre-diabetes.
And of people who have pre-diabetes, of which most will go on to develop type two diabetes, 90% of them do not know it. They do not know that they have pre-diabetes. And this sort of speaks to what Josh was talking about. And you know, so that’s just straight up like metabolic glycaemic glucose control dysfunction. But associated conditions like, um, obesity, which is also on the metabolic disease spectrum, you know, 74% of Americans have, are overweight or obese at this point.
That’s, it’s, it’s astronomical. And the thing that is similar about these conditions is that the majority of these cases are preventable with dietary and lifestyle choices. And so it’s very interesting. So. You know, then post-surgery, as I transitioned into a much more, you know, being compelled by a lot of this, these thoughts, um, about how important it was to kind of shift our efforts in medicine towards a more prevention and personalized approach to health,
um, I shifted into functional medicine, um, and sort of a more lifestyle and prevention focused practice. And, you know, in that practice, a lot of what we’re looking at is sort of what are the underlying drivers of disease and symptoms? What is the biologic dysfunction happening in the cells, that for a particular patient is leading to a particular symptom.
So, um, you know, depression isn’t all caused by the same thing. Depression could be from hypothyroidism. It could be from vitamin D deficiency. It could be from, you know, other factors. So if you don’t actually zero in on what exactly is the root cause of something for a patient, then just throwing a drug at it is unlikely to be super effective.
So that’s sort of the root of functional medicine is really zoning in on the precise mechanisms of what’s causing disease, and then attacking at that level. And a lot of attacking at that level means modifying the behaviors, the dietary choices, the lifestyle choices that lead to biologic dysfunction.
So what’s tied up in all of that is behavior change, because ultimately to change lifestyles and diets, it has, there has to be a behavior change element to it. Um, and that the same is very true with, with making an impact on this metabolic crisis and obesity crisis in the, in the US. And so it got me thinking a lot about like, what is involved in successful, uh, behavior change.
And I think something that’s kind of tried and true is, is biofeedback and having access to like real-time data and seeing actual data about yourself, is very effective in helping solidify the reward pathways that help you make good decisions and, um, help stay accountable to various things. And so, um. So the continuous glucose monitor is just this incredible device because it’s currently FDA approved for type one and type two diabetics to be used, essentially, just for people who aren’t aware, it’s a device that’s worn on the arm and it’s a very small low-profile.
And it basically has a tiny little filament that goes under the skin that samples glucose from the fluid around cells, the interstitial fluid, every 15 minutes automatically. And then it will sync to your phone, and basically just tell you, give you a curve throughout the entire day of what’s happening to your glucose.
And so when you eat something, it might go up a certain amount, and you can see and get that biofeedback of how particular um, foods, particular lifestyle habits are impacting your glucose. And so it’s really a cool tool for diabetics, um, type one and type two, because it gives them a lot more insight.
They don’t have to prick their fingers as often, which is painful. This is completely painless. It’s much more data helps build intuition about what to eat and how to live, and also helps them manage their medications. Um, but then the question is, you know, these are preventable diseases. And these things don’t happen as an on-off switch.
They happen as a spectrum over years from normalcy to full blown, metabolic dysfunction. So it’s not like one day you wake up and all of a sudden you have diabetes. This is something that’s been going on and developing for probably years and years and years. So then if that’s the case, it really became
pretty urgent to me, like why wouldn’t we use this type of technology that’s cheap and easily accessible to be used as a biofeedback tool before people get the disease, to help them ward off these things. It kind of seemed like a no brainer to me. Um, and yet it’s still not, it’s certainly not commonly done yet, but we’re seeing a lot of interest in people wanting access to this tools, to get some actual objective data about how, what they’re eating is impacting their
risk of future disease, and how to just like stay in a range that’s going to keep them safer in terms of their glucose. So that’s kind of a, kind of broad overview and it just, um. Working with, uh, you know, my practice very much focuses on this type of stuff with patients individually, but I think that given what’s happening in the entrepreneurial and digital health space, I think this is a perfect opportunity to merge the clinical practice with the, with the digital health.
Um, because especially with a metric like glucose, which is a fascinating metric because we know that so many things go into a glucose level, uh. How much you sleep, how well you sleep, your stress level, what you eat, when you eat, um, and your exercise, all those things feed it, feed in to what your glucose level is going to be.
So it’s a multi-variate input with a single readout, and all those inputs are the lifestyle and dietary things that we’re always working with patients on. So it really lends well to a digital health type of thing, because it’s difficult to parse out the data from all those inputs. But machine learning and, and, um, algorithms can really help kind of parse out the drivers of glycemic dysfunction in a way that honestly, it’s challenging to do in a 30 minute visit with a patient.
So I can’t be with a patient in their kitchen every day, be on their shoulders saying, Do this, do that. But having it on your phone and something that’s kind of doing that insight generation, intuition building with you, we have already seen to be super powerful in our users. Um, and that is why I wanted to shift some of my effort from just clinical practice to supporting a digital health company working on this, because I think the impact could be truly monumental, um, for literally potentially every American, but I mean, definitely the almost a hundred million people who are,
we know have metabolic dysfunction, and probably the many more who are kind of on the early part of that spectrum and don’t know, and are craving help, and want nutrition information, are seeking this out, but it’s just a very difficult landscape to navigate. So that’s a long story, but.
Dr. Laurie Marbas: [00:14:29] Yeah, no, no, people loved the last interview we did because you do such a fabulous job of explanation and bringing things home. So I think there’s a couple of things there that I really like. I like that you’re talking about the habit change and behavior modification. So literally what you’re doing is mindfulness, right? So you’re just bringing awareness of what’s actually going on inside to the forefront.
So it’s just like someone who is smoking and they’re becoming aware and mindful of the smoking habits. And now they’re like, Oh, I’m eating this and look what’s happening. So you can actually have this instantaneous feedback, which is fabulous. So, and that really is you’re, you’re lessening the reward component of the habit loop, which actually is how you dismantle the habits.
So I think that’s fantastic. So now we have these people who are non-diabetic, like you said, this is one in three Americans. I don’t think we understand, a hundred million people. That’s one in every three of you. Yeah. Look around, are pre-diabetic or diabetic. And that’s just one element. So can you talk a little bit about
what your experiences with people who are non-diabetic, what they’re saying, what they’re doing, people who use this, who are just wanting the information. Like, what is the revelation? What’s the behavior changes? Like what is the results that you’re getting by someone who actually participates in your program?
Josh Clemente: [00:15:45] Yeah. Um, it’s so I, I love the word you just used, awareness. We actually have two, two sort of, uh, they’re not slogans, but they’re terms that people can understand. The first one is metabolic awareness. So this is the process of closing the loop between an action you take and your body’s reaction. And a closed loop is where you actually have feedback.
Right. And what we’re operating on in society is an open loop. That’s the worst type of system, is you don’t get any feedback to educate you or to, to make informed decisions going forward. And so once you close that loop, that’s, that’s awareness. Now it’s not optimization. You’re no better than you were a minute ago, but you at least know.
And so now you can make better choices. The next stage is where, where we want to point people, and, uh, that’s what we call metabolic fitness. And so the reason we choose the, that terminology is because oftentimes, we get questions from, from our, um, our users and even people who are interested in what we’re doing, and they say, Well, you know, how will you be able to, how quickly will you be able to tell if I’m healthy. Or, um, I don’t think I’m healthy,
my parents weren’t healthy. It’s sort of like this, the conversation is. Um, as though that it’s a characteristic that is frozen in time, you know. I’m either metabolically healthy or I’m not, I’m either going to get diabetes or I won’t. And so what we, what we want to really drive home is that this is metabolic fitness.
It’s a, through focus, repetition and effort over time, you can improve, just like you can improve physical fitness by going to the gym, just like you can improve your, your mental fitness wellbeing with meditation, meditation. Um, and so we use those terms very deliberately. And that’s how we, you know, we’re getting a lot of positive feedback around that from our users, you know, and in terms of what insights people are gathering.
So the first thing is just an immediate, like sense of being a cyborg. You see like have this data readout now. And it’s like instantly fascinating, even if you have no idea what it means. Um, so that’s where the Levels app comes in. You know, we, we take that data stream, you know, it’s really fascinating and people love to scan it.
They love to check it out, but it’s like, well, what does this mean? What’s a milligram per deciliter that, you know, a lot of people don’t even know there’s sugar in their blood. If you tell them that and they are not going to be clear on what you’re trying to express. And so, you know, it’s, it’s an educational process.
The first part, you know, is all about explaining metabolism 101, these are the things that are happening inside of you. The hormones that are triggered by the energy levels, the glucose levels in your blood. These are the, these are these specific large levers that you can pull on to sort of change those numbers.
Um, like Casey was saying, not just the, not the dietary components alone, but also your exercise level, your stress habits, uh, your sleep habits rather, your stress levels. Um, you know, so people are very quickly seeing, having these light bulb moments where it’s like, Oh man, you know, I had this pre-workout in my, you know, my glucose went over 200, you know, and I felt this crazy sick feeling.
And I called my mom and like I told her, I was feeling horrible. And she said, don’t you have that thing on you should, you should check. Uh, you know, and so, and so, like, that’s, that’s a real situation where people have, um, these sensations, and they only ever had sensations before. And now all of a sudden, you know, you have a data source and it’s telling you,
Hey, this thing is not good, like, or, or it’s telling you that thing is good, you know, and you have, but you have to be able to, to have the data in order to understand that. And so we see a lot of light bulb moments like that, where it’s just, uh, Holy cow, this happened. I can’t wait to tell everybody about it.
It’s like, it’s crazy. And, uh, you know, I’m either never going to do that again, or I’m gonna keep doing that. And then, uh, over time, you know, you, you remove, as people start to understand the large levers I was saying, they start to zero in on more nuances. So it’s like stringing these habits together equals a continual control.
Um, when I, when I sleep poorly, I have a 30% higher baseline the next morning, you know, like these are, these are the types of realizations. And these are for people that, keep in mind who are non-diabetics, like they have never thrown an A1C test. Their fasting glucose is objectively okay. Um, it’s, it’s seeing the dynamic data that is, uh, where, it’s where all the richness is, that’s where everything’s happening.
Um, and so, yeah, that’s just a small example set um, uh, some of the insights. You know, already, we have had people who have found legitimate metabolic dysfunction who had no idea and not just myself. Um, and so we, we are still in a beta phase. We are in development. We don’t have that many customers who have gone through this program.
And so just already seeing people have, who need, you know, more, we’ll say more hands-on therapeutics or some, you know, uh, a more deliberate approach, uh, this early is really, uh, it goes to the mission of the company, which is, um, focused behavior change for metabolic improvement across society. You know, we want to focus on the, on the individual, um, multiply that by by many, many individuals and you will get a social benefit where, uh, we’re all healthier.
Dr. Laurie Marbas: [00:20:34] So this brings me back to a question with Casey. So Casey, you and I both understand as lifestyle medicine physician, functional medicine physician that not all providers or medical professionals are going to understand how to deal with this data, because we’re having physicians make diabetics worse by telling them to eat different things or not to eat.
So what can a individual do, who goes ahead and sees all this aggregate data? And they’re like, Oh, I have some issues. How do you guys provide guidance to who to seek? Or what do you do when you have somebody tells you like, Hey, I don’t know what to do now with this. Like, what is that follow up? And again, closing that loop for making sure they get the care that they require.
Dr. Casey Means: [00:21:16] Yeah, absolutely. So a lot, I would say for the vast majority of people, the feedback loop is pretty closed within the use of the product and the app, just from personal intuition that they’re building by, by seeing this data, you know, every single day, um. And the insights that we can just generate, highlighting, like
this particular meal combination took you out of range, this particular meal combination plus good sleep kept you in range. Um, it’s, that’s what, a lot of that is just taken care of, I think just by people using it and seeing what’s happening to them. Um, and, uh, and then just for the people like Josh was mentioning, who, who have a bit more of sort of clinical clinical, uh, meet the clinical thresholds for metabolic dysfunction,
you know, what’s nice is that we’ve partnered with a, um, telemedicine, uh, physician network who are evaluating, this is a prescription only device. And so this telemedicine, uh, physician network that we have partnered with, um, is, uh, evaluating every Levels customer for a CGM prescription. And if it’s safe for them to have to have one based on a variety of, of things, um, they are sent the, the devices.
And so in the situations that we’ve had, where people have shown, um, that they’re meeting sort of these specials for clinical metabolic dysfunction, we can actually loop them back in with the telemedicine physicians and, and, um, get them kind of set up to make sure there’s followup related to that. Um, you know, and I think, um. Yeah, I would say, I think you’re totally right about like, though that even amongst physicians though, a lot are not really aware about the impact of non-diabetic hyperglycemia and non-diabetic, the impact of glucose, even in a non-diabetic.
I think there’s the, still the conventional wisdom is it’s pretty pervasive that we don’t really need to worry about blood sugar until you meet certain thresholds, like the pre-diabetic threshold or the diabetic threshold. And, um, the way that’s conventionally measured, um, in medicine as you know, but just for the, for the listeners is usually based on either a fasting glucose.
So if a fasting glucose is below a hundred, we consider you normal. Um, if it’s between 100 and 125, you’re pre-diabetic, and if it’s 126 or above you’re diabetic. Or an oral glucose tolerance test, which is where people will drink 50 or 75 grams of a glucose drink, and then have their glucose measured at zero and 60 and 120 minute time points,
and if they meet certain thresholds, um, they’re considered they’re pre-diabetic, diabetic ornormal. But like Josh was saying like these single time points are, are, are challenging, um, because it’s a very dynamic process. And so, um, there are a lot of other metrics that have been studied in the literature,
um, aside from fasting glucose and oral glucose tolerance tests that are very relevant to health. So for instance, there’s metrics like glycaemic variability, which is not a term that I think most doctors are even familiar with. But that refer, it’s a metric that refers to how um, glucose swings up and down throughout the day.
So do you have sort of a low and flat curve, or do you have a very wild up and down rollercoaster curve? And that particular metric is, is very, very important for health outcomes, and in many, many studies and the research has been associated independently of fasting glucose, and, um, A1C and oral glucose tolerance test results
um, of predisposition for heart disease, future onset of diabetes, stroke risk, et cetera. And so these are trends that you can actually see in a non-diabetic, lots and lots of spikes. It’s still going to generate some of the same physiology that’s dangerous, um, to health. And so. Um, it’s, it’s thought that big swings in glucose can activate processes that lead to oxidative stress, um, that lead to inflammation, that lead to excessive glycation,
so glucose getting stuck on the proteins in the body. So there’s lots of physiologic things that can happen with glucose swings, regardless of whether or not you actually meet the threshold, um, for diabetes, so, um, or prediabetes. So, um, you know, there’s, there’s a number of different, um, conditions that have also been studied to show,
had been shown to sort of have a higher risk profile in people who are non-diabetic with increased, um, glycaemic variability. And I think a lot of people are aware of the major diseases associated with glucose. So that would be like diabetes, obesity, heart disease, risk for heart attacks, uh, stroke, dementia.
All of those are pretty well established that if you have metabolic dysfunction, you are at much higher risk for those diseases. But I think what a lot of people don’t really realize is that there’s a lot of subtler symptoms that are very associative with glucose, even in the nondiabetic range. Um, some of these are
things like anxiety and depression, and like just fact recall, um. People who have higher post-meal glucose have more trouble remembering things and acutely. Like it’s, it’s pretty fascinating. Things like, um, propensity to get acne, to get wrinkles, which has to do with glycation of collagen proteins in the skin.
Um, things like low testosterone, erectile dysfunction, um, even polycystic ovarian syndrome, which is the leading cause of infertility in the country, this is a condition that is associated with insulin resistance, um, and metabolic dysfunction. And so for, for all of these conditions, um, and other things like even like fatigue, energy, um, exercise, endurance, where your glucose is, even if you’re non-diabetic, could potentially have an impact on just sort of these sort of like symptoms that, that a lot of people don’t associate with, um, with glycemia.
And so we’re getting some inbound interest from people who have some of these conditions and have read articles, like people who have polycystic ovarian syndrome, and read some article about insulin and glucose. And they talked to their primary care doctor about it. And the doctor has no idea. They just, they’re like, Oh. They would never think about suggesting a CGM to help that person tighten up their glucose control.
So then they kind of are Googling around and they find Levels and, and say, Oh my gosh, I need this. And so we’re, we’re finding, there’s kind of sometimes, not necessarily a full understanding um, I think in the mainstream medical community of why glucose matters even for a non-diabetic. But individuals are figuring it out and kind of coming to us.
I don’t know if it is, is that fair to say Josh, do you think?
Josh Clemente: [00:27:36] Yeah, absolutely. I think what, um, you know, what Levels can do is help supplement. You know, I, I personally am of the opinion that there is, um, the medical community is exceptional at treating disease. And so tasking the medical community also with preventing disease is a tall order.
And so, um, you know, when you have this like massive array of metabolic dysfunction that, uh, with all different, you know, manifesting symptoms and some of them are very subtle, uh. Like what I was complaining about, maybe I had midday fatigue, you know, but I, I certainly didn’t have any sort of, uh, crazy overt symptom.
And so to try and to not be able to personally take, take charge with some sort of data stream or some sort of optimization, uh, criteria was, you know, meant the only alternative was medical alternatives. And so what, what I’m hopeful for is that using performance criteria, you know, just focusing on what people care about in their daily lives,
um, and optimizing around that, is our way of getting ahead of the, the dysfunction. So if you know, whether, if you’re dealing with like, like Casey was saying, that whole host of issues, if you’re dealing with, um, exercise performance issues, fatigue, so, so performance at work, um, you know, sexual performance, like there’s a whole host of things that you could be dealing with that you’re struggling with, that don’t quite meet a medical threshold,
but you can work towards optimization, uh, you know, by, by balancing your metabolic information, the data that sort of underlies the metabolic processes that are coursing through you. And you may never get to the point where you then have to work on a therapeutic solution because, uh, just that like sort of qualitative experience that you focused on ended up being, uh, so, so closely connected to long-term metabolic breakdown that you were able to avert,
uh, and redirect your course. So I think, you know, that’s kind of a tangent to what you were originally asking, which is that whether doctors know what to do with this information. And I guess my, my hope is that, um, we, we don’t quite. Although, I, I, I agree, like we don’t quite know what non-diabetic optimal looks like because there just isn’t that much information on it.
I’m hoping that by, you know, using the data set that we’re building, we will eventually be able to elicit that out, uh, and, and do so in a very low risk population, which is the group who is trying to enhance performance, not necessarily medical outcomes.
Dr. Laurie Marbas: [00:30:01] Hmm. That is really interesting. Well, just speaking to the host of symptoms that Casey is speaking about, right?
I mean, you give people more energy. It’s like giving them money, right? Because you literally give them the opportunity to do more in their life that they want to do. And if you can remove some other nagging symptoms, um, that maybe they don’t think there’s an answer to, because you to go to your doctor, such vague symptoms.
I mean, some of the worst. So some family medicine, some of the worst symptoms for someone to come in is like fatigue. And just like, you know, that does a host of can of worms. So a few questions. So do you deal, list like a medical symptom questionnaire before and after the 28 day cycle? Or like, these are my symptoms.
Because I know whenever I’ve done interventions with patients. And we did a study at a, in a small rural hospital, a resort, we did, that was a lot of really interesting information because people were just like, you know, they were noting fatigue five times , you know, a week, they were noting bloating and headaches, mild headaches, and nothing like severe migraines that would
go send someone to a doctor to take them, but maybe they’re taking aspirin or ibuprofen. And then at the end of it, I mean, there’s huge dramatic decrease when we were working on the nutritional component of that. Anything like that, that you guys are working on.
Josh Clemente: [00:31:20] So as part of the consultation process Casey was describing, um, since these are prescription devices, we do have a fairly comprehensive, uh, medical form,
so, uh, uh, you know, consultation form. And we are, are, although again, we’re a general wellness organization and we’re focused again on performance and, and sort of the general health and wellness, as opposed to the medical side, we do ask people those qualitative questions. And, um, you know, we still, we’re still building our data set.
We’re very early and we want to get to statistical relevance in terms of how many samples we have. Um, but certainly people are describing large scale improvements. We have, we have had examples of, uh, significant weight loss just by tracking glucose levels, just by cutting off the peaks and dips from the, the massive spikes and insulin crashes.
Um, so we’ve had significant weight loss already, and this is like, many people, not, not just a few. And, uh, you know, and then lots of anecdotal stuff. But I, you know, I certainly am optimistic that with these, and to answer your question, yes, we have the surveys throughout. So beginning, midpoints, we have conversations.
Um, we actually do, uh, video calls with all of our, our participants at the beginning and the middle and at the end of the month. And so. Um, that in combination with the, uh, the asynchronous surveys that we do, we get a lot of data, uh, from all of these people. And, um, yeah, we, we haven’t yet compiled sort of an outcomes, uh, document yet, but, uh, it’s, it’s certainly on the agenda and we do plan to, to make, uh, you know, to, to distribute this information.
And we want to share that this is something that people should care about, and it has real tangible value for the person who is not trying to treat a disorder.
Dr. Laurie Marbas: [00:33:02] Now are you also tracking their dietary consumption daily, so you can kind of weed out exactly what foods and as a congregate are causing issues, you know, anything like that?
Josh Clemente: [00:33:14] Yeah. So the, the Levels app itself is the hub for lifestyle tracking. So you track exercise, food, uh, you know, just general notes, like the way that you feel, because occasionally you’ll, you’ll feel this overwhelming urge to get another coffee or take a nap. Um, so, so you, the users actually take pictures of all of their food.
Um, the Levels app places that in context of your CGM data, so on the plot. And it also groups and scores it. So Casey was describing all of those, like sub metrics of a glucose curve. And there are many, there’s like, you know, incremental area under the curve, like variability, average glucose, uh, peak, all this stuff happening.
And so trying to educate someone on how to look at this visual plot of their glucose over time and pull information out of it is not the right approach. So what we do is we’ve developed these composite metrics. They pull in a whole host of factors and then turn them into a single number. And that number will score your meal, or it will score your, uh, you know, your zone.
So all those things that happened in close proximity to each other in time, and so therefore are likely affecting each other. This would be, an example would be, you know, the macronutrient order. So you eat a salad and then you eat another meal or dessert or something like that. That salad is actually going to affect the way that your blood sugar responds to,
to that dessert. And so we, we do the zone grouping and, uh, provide scores for that to help people understand, This is how these different components interact with one another. And then you can do comparisons. You can sort of mix and match and compare one zone to another. And this is just kind of, uh, we, we, we, we have a lot on the agenda for the product itself.
These are a few samples, but yes, the app is the hub, and we track everything that goes into the body or at least everything that we can. And we also pull in information from other wearables so that we can get the, get the highest resolution image that we can of your metabolism and your metabolic condition.
Dr. Laurie Marbas: [00:35:11] That’s
cool. That’s really cool. Especially with the time factor as well and timestamp of meals. And because I think that chronicity is really important. Um, what about kids? Like if you have a parent who’s concerned, is there an age limit for someone who can seek, you know, a CGM, do you reckon, do you have an age limit recommendation or anything like that?
Josh Clemente: [00:35:32] So, um, right now the, the devices are FDA approved only in, now there are a few out there, but the ones that we tend to use are, are approved for ages 18 and over. There, there’s not enough pediatric data, I think quite yet. Um. There are certainly many populations that have not been studied with CGM quite yet.
And I think that, um, it’s really fascinating given that type one is so prevalent in younger populations, that there is, you know, there’s only one device that I’m aware of that has been approved for that pediatric group. And so, um, unfortunately we would be 18 and older at this time, but as you know, there’s a lot of movement on the hardware front.
There, there are many devices that are coming to market and the technology is improving at an amazing rate. So I’m optimistic that, that we’ll have more options soon.
Dr. Laurie Marbas: [00:36:17] That’s really cool. And then, so for as far as the individual who’s listening and they’re like, wow, I really want to do this. Do they just go to your website?
You know, it’s LevelsHealth.com, right? I got that right.
Josh Clemente: [00:36:32] Right.
Dr. Laurie Marbas: [00:36:33] And, um, which has a ton of great blogs too, written by Casey. And what can they do? I mean, because is this all 50 States at this tele-health company can help you. Do you have to do it that way. Can an individual physician prescribe it for a patient, and I mean, like how does that work?
Josh Clemente: [00:36:48] Yeah. Great question. Um, so right now we are still in development. So primarily focused on building this analytics platform that layers onto the CGM. So, you know, you have the hardware, these devices are used for diabetes therapy. Uh, we are uh, layering on a new user experience and a new set of metrics and use cases.
And this is the general wellness performance optimization use case. This is not really been done before. So we have a lot of work to do to build something that is consumerization of glucose, basically. Um, so right now we are not. Uh, we haven’t launched. We have a full launch, uh, that we’re targeting later this year.
Uh, we would encourage everyone to, again, go to LevelsHealth.com, read the blog, sign up for the waitlist. So if you just go to LevelsHealth.com/SignUp, or you’ll see the big button on the main homepage, uh, you can just give us a little bit of info, like your email, and then we’ll keep you in the loop about product details as they, as they come.
And, uh, we have a small number of beta participants slots each month. And we, we kind of very tightly manage this because it’s, uh, as I described, we have basically video calls with the team multiple times. We’re getting a lot of data from them, uh, lots of feedback. It’s, it’s, it’s almost an example of, uh, this person joins the team for a month and they’re, they’re giving us like real time criticism and feedback.
And, uh, this is where the direction of this feature should go. Um, so we do have a few sample or slots per month, but, uh, that’s sort of a. Um, yeah, we, we kind of filter out who, who, what, who meets the demographics that we’re specifically looking for for this, uh, feedback. And, uh, so yeah, if you sign up in the, in the wait list, if you’re interested in the beta slot, we might be able to get you in there, uh. If not, we will be expanding our options very soon,
and we have a lot of things coming up on the horizon.
Dr. Laurie Marbas: [00:38:34] That’s fantastic. And Casey, do you have any else to say too, as far as what your hopes are, visions and things like that as their chief medical officer.
Dr. Casey Means: [00:38:43] Well, I think, you know, one, one hope I have is really sort of, um, I think a take home for people from using this, which is just really this idea of biochemical individuality, and also just empowerment that comes from that.
So I think, um, you know, a lot of medicine, I think sometimes feels like one size fits all. You know, you go in with a particular symptom and there’s kind of just like one particular treatment or a couple options of treatment. It, it can sometimes feel a little bit impersonal. And I think that something really positive subconsciously that happens from like using, from using this product is realizing how complex you are, uh, in terms of your responses to all these different inputs and choices that you’re making
every single day, day in and day out. And then layering that with insights and that closed feedback loop, realizing how much agency we actually have over our own health and over, you know, this line, this glucose line and the various metrics. Like it’s really, is in our control and, and the intention. I mean, I think
people want to be healthy. People want to lose weight. I mean, the wellness industry is booming. People are trying all of these diets, and yet the vast majority of diets fail. You know, over 80% of diets are completely ineffective. And that’s just, it’s very sad because people are making the effort, but it’s not working.
And so the hope would be that this would, um, you know, uh, allow for more accelerated progress in people meeting the goals that they are clearly expressing that they want to meet. Um, and, and so that’s kind of one of my overarching goals. And I think as a functional medicine practitioner, I’ve always, and as someone with a background in personalized genomics, I’ve always looked at people as these like fascinating complex ecosystems that are in constant conversation with the environment.
And I think of food as molecular information, and I think of lifestyle inputs, even stress translates to molecular information, information through our hormones. And so, um, so thinking about that, um, it just, I think it, it subconsciously comes through by using this device and just realizing how much of an interaction between the environment and your body there is.
I think. So currently right now, you know, if someone were to try and just go out there and say like, Well, I don’t know if I need this. Like, I’m just going to eat a low-glycemic diet or something like that. You know, or I’ll use a low-glycemic chart and figure out how to eat for my glucose. That can be partially effective, but
a lot of research has come out recently showing that actually people have very variable responses to the same food. So two people, like me and Josh, could eat the exact same cookie right now and have a completely different, completely different glucose response. And he could eat a banana and a cookie and I could eat a banana, a cookie, and our curves could actually look
opposite. So I could spike on the cookie and be flat on the banana, and he could be the opposite. And that is, like flies in the face of the general concept of low-glycemic eating and a glycemic index chart. And the reason for that is because it’s not like food just goes into this black hole and boom, glucose raises. It’s being processed by the microbiome.
It’s, it is interacting with your, you know, your colon cells. It is being absorbed into your bloodstream. There is a certain level of inflammation in your body at certain times. You have certain genetics. All this stuff. I mean, it’s just so complex. And, and, um, so it’s a very complex interaction between food and the body to yield that glucose response. Even how fast you digest food, how, how fast your GI motility is, all of these things have an impact.
And so, um, so being able to provide some more refinement and granularity, um, into what it means to actually, um, yeah, sort of have low-glycemic living, um, is, is something I’m really, really excited about. Basically modernizing paradigms that we’re still using and recommending like the glycemic index charts, and modernizing them to actually incorporate the most recent research, um, that shows that everyone reacts differently.
So I just think that that whole concept of biochemical individuality is exciting to me. And we now have tools to really show that to people. And I think a result of that can be empowerment and a real renewed sense of personal agency, um, and progress. So.
Dr. Laurie Marbas: [00:42:57] That’s fabulous. Um, a couple of things there, because I interviewed, I know Dr.
David Jenkins, he actually invented the glycaemic index. And it’s really interesting. I’d love for you guys to meet him. And maybe that might be somebody to just get a little interesting feedback. So anyway, that, but also you’re taking out the willpower, right? Because it’s all these diets fail because people are constantly using willpower,
you’re gonna run out of it after half an hour and then they all these things. But what you’re doing is you’re just giving this non, you know, it’s objective data. You’re not going to, you know, it’s not like you’re standing on a scale once a week and going, Oh, I failed again. Because that’s emotional and all this stuff.
I think this is really good because you’re just giving, they’re taking the emotion out of it. You’re getting real-time feedback and giving people that, like you said, empowering them to make better decisions. So I think that’s fabulous. So thank you. What does Josh have to say, I love this.
Josh Clemente: [00:43:50] Well, I kind of give a little backstory on me.
And again, I was not a big diet person. I, I never needed a diet for weight loss. I know I’m lucky in that sense, but, um, so I didn’t really pay attention to it. And, um, you know, recently you had, uh, Judd Brewer on and he, he was, I was listening to that episode and he said, addiction is continuing to do something despite adverse consequences.
And that really stuck with me because I had a candy addiction, but I did not have the adverse consequence of gaining weight nor was I diabetic at the time. And so the adverse consequences were unclear to me. I had, there was a filter between me and the adverse consequence, which is my blood, my blood sugar was probably through the roof and I just had no idea.
And this is what led over time to the degradation of my glycemic control. Without the feedback loop, I didn’t know that. So I didn’t meet his criteria for addiction, unfortunately. I, I think I did in some times, because I was really the face. But, uh, you know, once I got a CGM on, my family will, will tell I have triggers out of my life.
I’ve just, it just ended. It’s not a, it wasn’t a big, a big fanfare. It was just, I didn’t need it anymore because I had better information. And so I wasn’t willing to be the addict who is making that choice despite now my, uh, my awareness of the adverse consequences. We’ve seen this with multiple people.
It’s not just me. People have taken something that has been a staple in their diet. They have tried the program, seeing what the glucose response is, test it multiple times in different VR environments. And if they continued to see this large glycaemic spike or this sustained elevation, they just cut it out.
And that’s something that you just don’t see typically with, um, with other dietary approaches, which are sort of advice-based or sort of average-based, this is a specific individual data point about you. And I think that’s, what’s, what’s really cutting through for people.
Dr. Laurie Marbas: [00:45:40] That’s fascinating.
Dr. Casey Means: [00:45:41] I would just add one thing to that is that, you know, it doesn’t necessarily also mean that people have to cut something out.
I would say for sugar and for candy, I fully promote cutting that out. A single gram of refined sugar ever, um, for, for life. Uh, so, um, but, you know, a lot of what I think our algorithms and our, our, our app is trying to show is that it’s, it’s just because you have a big glucose spike with one particular individual input, because it is a multi-variate complex system of what leads to a glucose spike,
you actually may be able to modify the way that you’re doing that in order to have a better outcome. So for instance, it’s well-established in the literature that eating earlier in the day, one food is going to cause a lower glycemic response in general than eating that late at night. But the con, there’s complex physiology we have, but part of it has to do with interaction between melatonin and insulin secretion in the pancreas.
And melatonin’s released at night and may cause a little bit of sort of transient insulin resistance. Um, and so. So, you know, if, if you have a favorite food that gets you a little bit high on your glucose, try eating it for breakfast instead of at 10:00 PM at night, um, or, you know, incorporate high intensity interval training for, you know, to sort of improve, um, you know, uh, insulin sensitivity,
uh, if you’re going to keep eating certain foods in your diet. So there’s ways to mix and match things to kind of just help get you under better control. I think food combinations is also one that is fascinating. I mean, this would be really impossible to figure out without data, which is that adding certain macronutrients to others can really blunt a glucose response.
And so. You know, I think I talked about this a lot on the last time I was on your podcast, but like I’m a bean fanatics. I’m a fiber fanatic. I talk about fiber all day. Yeah. I want people, all my patients to get 50 grams of fiber a day or more, and, you know, but some of these foods are higher carb.
And if I eat beans completely alone, I don’t have a huge glucose response because they have tons of fiber, but it definitely is a little bump. But when I pair that with tahini and nuts or a nut butter or cook it with something like that, and sort of more of a dish with a lot of extra vegetables, low-glycemic greens, things like that,
I have a totally different glucose response to it. It’s blunted. And so, um, so there’s all this research that has shown this in isolation. If you add fat or protein to a carbohydrate, you’re gonna have less of like glycaemic spike. If you eat earlier in the day, if you do intermittent fasting, if you exercise all, these things can affect
that response. And so really that learning how to pair those things together in an intuitive way, um, to just, yeah, to keep that glucose curve lower and flatter and, and ultimately, you know, improve your, your health and wellness now, and hopefully prevent stuff down the road. So, um, yeah, so that intuition building and mixing and matching lifestyle stuff is, is I think really fun and exciting.
And yeah, it’s enjoyable for people to experiment with their body that way.
Josh Clemente: [00:48:32] Uh, I think I’m sorry.
Dr. Laurie Marbas: [00:48:35] Go ahead. Go ahead, please.
Josh Clemente: [00:48:36] No, it’s a, it’s a major direction for the product, you know, bringing. Right now there there’s, uh, quite a bit of, um, sort of experimentation that’s part of our program, but there are all of these themes, like what Casey’s touching on with the macronutrient mixing or the meal timing.
These are themes that are very robust, and they’re, they’ve been studied. We, we’ve already seen them in our dataset. And so incorporating that into actionable insights that our software can deliver is going to be the, you know, that’s the big focus of, of what we’re doing here. You know, it’s not just about passively logging,
it’s also about pointing out, which, you know, it may not be clear to the initial user, but pointing out that these connections and the modification to your, your glucose, that corresponds with them are important. Focus here, try this, uh, and, and compare, you know. And so helping people understand that this, uh, you know, this whole having a salad before dinner, actually has real tactical benefit.
Like you may be able to, to blunt that, that desserts, like. So, um, yeah, there’s, there’s a lot, a lot on the horizon in terms of like turning those into software and making them replicable.
Dr. Laurie Marbas: [00:49:41] Absolutely. That’s fantastic. Well, thank you both so much for kind of enlightening us at the opportunity that we might have in the near future of, you know, becoming more intuitive with our eating and understanding what we’re doing individually biochemically and the dietary patterns
that will be very helpful for us. So I appreciate you both.
Dr. Casey Means: [00:49:59] Thank you so much, Laurie. It’s so fun to chat with you and really such a pleasure to see you. Thank you.
Dr. Laurie Marbas: [00:50:05] Thank you Josh.
Josh Clemente: [00:50:05] Thank you so much. It was great meeting and I really enjoyed the conversation. I hope to come back on when we’re ready to launch.
Dr. Laurie Marbas: [00:50:10] Oh, I’ll be waiting.
That’s on and can guest here.. I can’t wait to be able to refer people to you guys. So thanks again.
Dr. Casey Means: [00:50:18] Bye.
Josh Clemente: [00:50:19] Thank you very much.