In this episode of Momentum with host Steven Borden, former SpaceX and Hyperloop engineer Josh Clemente shares how he ended up founding health-tech company Levels. He discusses how to apply first principles thinking to solve problems, the process of launching a new health product, and the critical role of blood sugar on health, performance, and longevity.
The importance of first principles
Focusing on the immutable facts of a problem will help you get from A to B. It’s a learned skillset that’s honed over time.
Engineering is kind of the science of building things, is an easy way to think about it. And science itself requires that you create a hypothesis and then you try as quickly as possible to invalidate it. So your goal is to constantly be testing, iterating on your assumptions and then improving your experiments. And so for engineering, it’s you apply that science in a way that is different than other primary sciences like physics and in chemistry where you’re trying to map the way the universe works. And this way, you’re trying to get the most efficient solution to the problem you’re trying to solve. So I don’t really like calling it a pure science. But it is based on the fundamentals of the scientific method. And so what I think is the most important thing when trying to solve a problem is to stay grounded in simplicity and elegance. And that is where first principles comes in. The first principles of a problem space are the immutable facts.
Don’t get distracted from core considerations
If you find yourself getting distracted from your goals or problem-solving, find ways to re-center.
A lot of what we do in career and in our day-to-day lives is you brought up nature and nurture. I think it’s the thinking brain, the problem solving brain is complex. And so much of it is emotional and influenced by factors that are outside of our control. So you can easily be distracted from the core considerations of a problem or of your financial strategy or of your really by factors that are outside of your control. And it is a process of repetition to reground the conversation or your daily actions in the first principles of what you’re trying to improve. And that could be as something as simple as a meditation practice, where you have a mantra that is oriented around what you’re trying to work on in your life, what you’re focused on, and it brings you back to center. And so you might get off track and start focusing on the wrong things at some point during the day, and just like, well at the office, you can easily get into a tangential conversation that has nothing to do with the core problem. It could be a total waste of time for everyone involved. But as long as you can recenter, and you have mechanisms built into your life to, yeah, reorient your process and those people involved to get back on square one, that’s okay.
Recognize when your body is telling you something
Josh was physically fit and working on incredible professional projects when he realized that his health was going off a cliff. The problem was, nothing seemed wrong at first glance.
I was approaching the most important project of my life, leading this astronaut life support program or life support team inside of the life support program, I just suddenly became aware of the fact that everything felt different from how I thought it should be. My mood was always poor. My energy levels were tanking consistently. Every single day, I would feel the need to just sit down, close my eyes, go to sleep or lay under my desk and try to hide. And it was a very shocking transition. And it happened slowly. But I suddenly realized that something’s very different about my day-to-day. I was having these episodes that were a little bit hard to describe but certainly symptomatic. I would get itchy skin. I would get shaky. I’d get a cold sweat, like very strange sensations. And so I went to my doctor and I asked him to do a full workup, figure out what’s wrong with me because it seems like I have a terminal illness. Something’s changed. And I feel very unhealthy. And he looked at me and he was like, “You’re fit. You’re fine.”
Glucose monitors aren’t just for diabetics
The pivotal moment in Josh’s personal and entrepreneurial journey was when he realized how helpful a CGM could be for diagnosing health, in diabetics and non-diabetics alike.
I continued to get more interested in this metabolic health stuff and was reading primary literature. And I came across eventually continuous glucose monitors, which are these are devices that developed for the management of diabetes, where you have to sort of intensively manage your glucose levels. And I was like, “Oh, I need one of those. This is what I’m basically replicating. I’m pricking my finger 40, 50 times a day, plotting the results. If I can just wear a sensor that does this for me, great.” Asked my doctor. And he flat out denied me, “Absolutely not. It’s crazy for you to ask for that. You do not need to measure blood sugar unless you are diabetic.” And those were basically verbatim. And so this was like kind of the third insult in this whole cascade of events where I left that office. And I just thought, “That’s my blood sugar data.” This is happening in my body one way or another. It doesn’t matter if it’s good or bad. It’s my body’s data.
Stable blood sugar results in physical health & mental clarity
Josh was already physically fit when he started stabilizing his blood sugar. Where he did see noticeable results was on his cognitive functioning.
I’ve now been wearing CGM basically continuously for three years. When I look back on where I was then and where I am now, the vast majority of the changes are cognitive. So my ability to maintain, I think, perspective, my mood control, and my clarity, my clarity of thought, these are the things that I feel have changed the most for me. And there’s a secondary effect of continuous energy. And this one is a little bit harder to describe because I don’t have those episodes of shakiness and just general symptomatic hypo, which typically are related to meals anymore. And so I say I have more consistent energy.
Health isn’t just about weight
A key takeaway of Josh’s research is that metabolic dysfunction encompasses much more than a number on the bathroom scale.
We’ve always looked at weight. We’ve always sort of said, like, “Metabolic dysfunctions, those are things that overweight people deal with.” And we do not look under the hood and consider the links to depression, the links to anxiety, the links to mental health, and especially the links to dementia. Alzheimer’s today in medical schools is being taught as potentially type-3 diabetes. The relationship there is because the brain becomes insulin resistant during the transition into Alzheimer’s dementia. And that’s well known and accepted. The question is whether it’s causal or a symptom of the Alzheimer’s. But the point is that the brain exhibits the same insulin resistance that the muscle tissue and general tissues of a diabetic, a person who’s experiencing diabetes, those are the same or similar transformations.
What should you eat and why?
Many doctors and dieticians will try to answer this question. But because every individual is unique, the best answer will come from a biowearable like Levels.
Levels is basically what I wish I had when I started this whole journey myself. And specifically, it’s the first tool that can answer the question, “What should I eat and why,” with real time data from your own body. Right now, that data consists primarily of continuous glucose information. So when you try levels, you get a pack of CGM sensors. These are continuous glucose monitoring sensors. You wear one of these patches on the back of your arm continuously for two weeks. And it wirelessly communicates with the level software. And inside the level software, you log your behaviors. These kind of cover the four main levers of lifestyle actions, which are your nutrition choices, your exercise, your sleep, and your stress.
Metabolism is not binary
Health isn’t a light switch that’s flipped on or off. It’s a spectrum, and our place on it is ever-changing.
Our goal is to connect people with the lifestyle choices they can make that can lead towards metabolic awareness, which is understanding how your actions affect your metabolism, and then ultimately metabolic fitness, which we are using this term to encompass the fact that metabolism is not binary. You’re not either healthy or unhealthy metabolically. We’re all on the spectrum. And we can improve our metabolism, our metabolic fitness through focus, effort, repetition, correct decision making. But you need to measure if you want it to improve, right? So that’s the ultimate concept is just by surfacing this information, you can learn from it. And then by improving it iteratively through small micro-optimizations over time, you can get better.
Eat balanced meals and move often
If Josh could summarize his findings and recommendations into one sentence, it would probably be to eat good ratios of food groups and get lots of mild exercise.
By far, the biggest two are balanced meals. So making sure that you have essentially equal proportion, protein, fat, and carbohydrate in a meal, and then the exercise. And for the exercise thing, it’s just more movement more often, as opposed to having to do high intensity training for 90 minutes a day. It’s like just walking after every meal is going to have probably a higher gain effect for someone who’s trying to lose weight or is trying to produce metabolic control for health reasons than that high-intensity session. There’s a whole bunch of implications for high intensity workouts that are great for you. But they also induce stress. And if you do them at certain times of day, they can interfere with sleep. And so the sleep interference can ultimately trickle down into the next day. Having poor recovery actually causing elevated cortisol, which causes elevated insulin. There are all trickle-down effects where when people try to fit in the big chunks of aggressive workouts, they’re potentially doing it at the expense of other downstream effects for their lifestyle.
Levels’ goal is metabolic awareness
Josh and the Levels team cannot promise that your life will be transformed, but they can teach you the rules of the health game, and how to play them.
I got a long message just yesterday from someone who lost 20 pounds and changed their blood panels across all of the major risk factors for cardiovascular disease over the course of three months using Levels. Our goal is not to try and make claims that you’ll reverse heart disease or lose major weight. Our goal is to generate metabolic awareness. It’s for you to know the reactions that your body’s experiencing to the actions you’re taking. Because that information, we believe is the fundamental requirement to make lasting behavior change. People have to know. They have to know the rules of the game they’re playing. And they have to know the implications.
Steven Borden: It is good to be back. And there is so much in store with this podcast. I’ve done a bit of housekeeping, a bit of reformulating with the podcast. Got a new camera. Quality’s going to be a little bit better for the video portions. I think, previously, it looked like I was using in early to 2000’s flip phone or like a sidekick. My picture was pretty blurry. So got a new camera feel pretty good about that. And just generally have exciting things in the works starting with this interview today, Josh Clemente. There’s some people that you come across in business, in life, I guess, in podcasting that you just want to see succeed, good people doing good things, and that are actually making a positive impact on the world.
Steven Borden: Josh Clemente is one of those people, just all around good dude. And their company that he’s launched, Levels Health, is fascinating. I don’t want to get too much into this specifics because that’s going to be for the episode. But Josh, as a brief overrun, is a former SpaceX and Hyperloop engineer. So he worked with Elon Musk at two companies that are – innovative is not even enough of a word to describe what they’re doing, but doing exciting things.
Steven Borden: But Josh eventually had an itch to create something that he wanted to see in the world, launched his own company. I won’t tell the story. I’ll let Josh tell the story. But beyond just hearing what Josh is up to and what he’s doing, hearing, how he solves problems and how he approaches anything in life, whether that’s creating something from scratch or solving a very difficult problem by breaking it down into simple components. I think it’s valuable for anyone, which is a huge part of the reason why I wanted to talk with Josh.
Steven Borden: I was fascinated the entire time, and I think you will be too. So enjoy. Hey, man, this is awesome. I appreciate you carving some time out.
Josh Clemente: Definitely man. Thanks for reaching out.
Steven Borden: Super excited. I think you, guys, there were several reasons why I wanted to talk to you. And I think you’ve got three components. You have obviously like the founder business side, which I think is really interesting, probably dig into. You’ve got the health side being like that’s the nature of your guys’ company, which we’ll definitely dig into that. But then, there’s the engineering side, which has always been fascinating to me. The more time that goes by the more, I pay attention to people, listen to people like you talk and Elon, of course, the more I realize there’s such utility in thinking like an engineer and approaching problems the way engineers approach them.
Steven Borden: And I’ve heard you kind of talk about first principles and how you approach and problem solve. And I kind of want to dig into that. Can you lay some context and just describe how you approach problems and the first principles and how you’ve kind of gone about doing that?
Josh Clemente: Yeah, well I think there’s a kind of the fundamentals of what engineering is. So engineering is kind of the science of building things, is an easy way to think about it. And science itself requires that you create a hypothesis and then you try as quickly as possible to invalidate it. So your goal is to constantly be testing, iterating on your assumptions and then improving your experiments.
Josh Clemente: And so for engineering, it’s you apply that science in a way that is different than other primary sciences like physics and in chemistry where you’re trying to map the way the universe works. And this way, you’re trying to get the most efficient solution to the problem you’re trying to solve. So I don’t really like calling it a pure science. But it is based on the fundamentals of the scientific method.
Josh Clemente: And so what I think is the most important thing when trying to solve a problem is to stay grounded in simplicity and elegance. And that is where first principles comes in. The first principles of a problem space are the immutable facts. You are trying to, for a car, you need to be able to transport. Let’s just say a human for that specific implementation of a car. You’re trying to get from point A to point B. And everything else about that problem is extraneous. It’s separate from when you start talking about fuel injection and aerodynamics and interior, accoutrement, that’s all separate from point A to point B. You know what I mean?
Josh Clemente: And so when you’re trying to develop the car, you need to stay grounded on the principles, the physical constraints that prevent you from transporting something from point A to point B, and those are gravity. Those are wind resistance. Those are like the challenges. And that’s where you orient your mind. And so I think it sounds like a lot of fluff. But if you think about it as a tree, first principles are the trunk. And the branches and leaves are the complex and tangential problem that can be solved, but are not necessary to have a tree if that makes sense.
Josh Clemente: It’s kind of like the thing that frustrates me about first principles and why I just talked with someone else on one of their shows about this is that it’s overused and underutilized. People like to use the term. But oftentimes, it’s hard to tell actually whether am I really focusing on first principles. And that’s where simplicity and elegance comes in. It’s like if you can look at the list of requirements for the task or the problem that you’re trying to solve, all of the problems or projects that you’re working on, if you can run a line through one of them and still have a solved problem, you solve everything else.
Josh Clemente: And if that line doesn’t have to happen in order for you to achieve success, it’s not a first-principle solution. I think that’s one way to think about it. So ultimately I’m the type of person who I kind of have this balance of really liking to solve problems and also being like kind of innately lazy. And that goes, it kind of like meshes well with this philosophy where if you cannot solve the problem and still achieve success, great. Do it that way. That is more likely to be closer to the first principal solution.
Steven Borden: Is it an accurate assessment to say because I’ve almost heard it explained like instead of thinking in sort of abstract, you just sort of look and say, “If we were going to pull this off, how would we go about doing it?”
Josh Clemente: Yeah. It’s what is the bare basic fact that has to be true for you to achieve success? I think it’s a good way to think about it, is just if we were to achieve success, what things must be true, not what things could be true. It’s what must be true. And you cannot achieve success without first principles being solved software. You can achieve success solving for first principles, plus a huge number and unlimited number of other things. And so it’s trying to remove that at excess, peel back the layers, and find the core of the problem. And those are the first principles from which you work forward to solve the problem.
Steven Borden: So then, I’m curious because it’s such a tangible strategy. If you pull this out into really any area of life, it’s valuable. And there’s the nature nurture thing. It’s like, “Are you able to think and operate off of first principal’s mindset,” because a lot of it’s maybe because your brain works like that and you’re an engineer by nature. Have you noticed in your career from studying engineering in school to applying it at SpaceX and all that, which we’re going to, that learning and applying it like that, you’re able to pull that, like, it actually built a muscle in you to use that?
Josh Clemente: Absolutely. It’s a learned skill for sure. A lot of what we do in career and in our day-to-day lives is you brought up nature and nurture. I think it’s the thinking brain, the problem solving brain is complex. And so much of it is emotional and influenced by factors that are outside of our control. So you can easily be distracted from the core considerations of a problem or of your financial strategy or of your really by factors that are outside of your control.
Josh Clemente: And it is a process of repetition to reground the conversation or your daily actions in the first principles of what you’re trying to improve. And that could be as something as simple as a meditation practice, where you have a mantra that is oriented around what you’re trying to work on in your life, what you’re focused on, and it brings you back to center. And so you might get off track and start focusing on the wrong things at some point during the day, and just like, well at the office, you can easily get into a tangential conversation that has nothing to do with the core problem. It could be a total waste of time for everyone involved.
Josh Clemente: But as long as you can recenter, and you have mechanisms built into your life to, yeah, reorient your process and those people involved to get back on square one, that’s okay. It’s part of the human condition. And certainly, when you’re surrounded by people who first principle’s thinking is their goal, they try to learn from each other. So constantly trying to pick up new information on how you can refactor your mental models to do better at staying focused on the core task at hand.
Josh Clemente: And it can get to the point certainly where you’re stripping away all the nuance, all the beauty. It can get pathological for some people where they’re just so obsessive about first principles thinking that they lose some humanity, I think, along the way. So there’s definitely balances with anything. But in my life, this has been a learned skill. I certainly did not have this innately. And I learned from people who are better at it than me.
Steven Borden: That’s fascinating to hear because I’m like always obsessed or interested in, like, I would use the word tangible a lot, but tangible strategy, because we always talk about these things that we can do to improve our lives or accomplish the things we want to. But hearing something like that, being a learned skill because it’s a mechanical process, almost, something you can take.
Steven Borden: I’m kind of curious about your background. I know a bit about your background. I did a little research obviously on you. But could you paint a little picture of where you came from and what led to you building or starting levels?
Josh Clemente: Yeah. So I grew up in Virginia. My dad’s an FBI agent. My mom was my teacher. So, I was homeschooled through K through 12. And I was kind of an outdoorsy energetic, probably ADHD kid and really enjoyed building things, especially vehicles. So I liked to hack together four wheelers and go-karts and dirt bikes and stuff. And my dad’s a pretty mechanically-minded person. I think that my mechanical obsession kind of trickled down from him obviously.
Josh Clemente: But I just ended up getting to the point where I didn’t enjoy school. I was decent, but I was not a great student. And I had to figure out what I was going to do with my life. It was time to apply to college. And I essentially made the decision to apply for mechanical engineering because it was the only career path that I was aware of that would allow me to keep doing what I enjoyed, which was building machines.
Josh Clemente: I had learned to weld at, I think, age 11 or 12. And I could make something. It might not look great. But it could certainly do the trick, and it would move fast. And this was mostly again cars and motorcycles and dirt bikes and such. And so that was my thought process, is I never considered finance. I never considered law. I never considered medicine. I have this selfish interest in building machines and enjoying them. And there’s only one way to do it in my career, it seems. And that’s through a mechanical engineering degree.
Josh Clemente: I was always obsessed with airplanes and the super cars and all the upper crust of vehicles for sure. But I hadn’t thought far enough ahead to really be – was not the type person that had intensively planned my life out, I’ll put it that way, mostly because I didn’t think I was a good enough student to be able to really project into the future and make it happen. It just seemed like I was kind of, to some extent, uncertain about what I would do in the future. But I knew that I wanted to do something with my hands and work on machines.
Josh Clemente: And, ultimately, I did quite well in mechanical engineering, mostly because there is an element of it that is building projects. And so my senior design project won best overall in engineering project at my school. And it became my pitch to companies when I was applying for my first jobs. And at that time, during school, I had become completely obsessed with Tesla motors. I had known about it since the founding.
Steven Borden: What year was this at this point?
Josh Clemente: So I graduated college in 2010. And I went to school in 2006. At this point, Tesla was young. When I first went to college, they had the Roadster. They were a long shot from ever producing what they claimed they would produce. But I loved the Roadster. It was such a cool concept that you would have essentially like the Lotus supercar powered by laptop batteries. It was amazing that they had been able to produce this. And it went against the mainstream philosophy at the time, which was that electric vehicles were useless and slow and ugly.
Josh Clemente: And so I was just obsessed with it. And when I read about the larger scale Tesla vision, it was something I wanted to work on. It was something that seemed underdog. And I was very obsessed with Tesla. That’s where I wanted to work. I thought I could pull it off. And I had not thought about spacecraft and rockets and such, just because everyone I knew that was going down that career path was a much better student than I was.
Josh Clemente: And I had not connected the dots of like fabrication. Rockets and spacecraft have to be built as well to my skillset. I kind of assumed that I would have to be the MIT space camp guy in order to get into a JPL or a NASA Ames or any of those other centers. And that’s where it gets kind of interesting is that I did get an internship at Tesla. But it fell through because they moved their offices. And it was just kind of this weird timing situation.
Josh Clemente: And the recruiter recommended that I instead turned my attention to SpaceX because they need people like you. That was really the first time I had heard that. Again, like I said, I’m not one of the best students and this was like a kind of a surprise to me. And I knew that Elon ran SpaceX. I knew what they were up to. But I just didn’t consider myself relevant.
Josh Clemente: And so, yeah, I turned on my attention to that. I was actually selling used cars after I graduated college at CarMax and really putting all of my effort into getting connections to people at SpaceX to drop my name. Ultimately, I got the call. I got hired as a manufacturing engineer at SpaceX. And I spent six years there.
Josh Clemente: And along the way, got an opportunity to lead a high-pressure life support system there for the astronaut program. And that was like the pinnacle of my career at SpaceX. And during the time there, I personally began experimenting with biometrics, biomonitoring specifically blood glucose for myself to try to optimize the way I was feeling every day. And that is kind of how Levels was born, is through my own realization that what I thought of my health and the reality of my health were two completely different things. And the difference was that I wasn’t tracking any data.
Steven Borden: You hear this a lot with founders. And one of the last people I interviewed Ben Jenkins, same type of thing. He was sort of scratching his own itch. He had like a minor thing he wanted to repair in his home and he was scrolling through pages of Google. And it took him forever. Everybody wanted to come out to see the little project and give him a quote for a $200 project. He’s like, “This is dumb. I can create a better platform.”
Steven Borden: So anyways, he ended up creating an on-demand home services platform, had a pretty good exit and he attributes part of why he did so well to just like scratching his own itch. It was like something he wanted to see in the world. And I know that that was similar situation for you. Could you kind of talk about what you were feeling and what your physical state while you were at SpaceX? Obviously, you were in really good shape from the outside eye as well, right?
Josh Clemente: Yeah. So I played sports growing up. And I really wanted something to be an outlet for… I also lifted weights a lot and was interested in that. But I wanted an outlet that kind of combined the sports component and the weight lifting component and kept me interested the way sports had while a professional. And that was CrossFit. So I got really interested in CrossFit modalities, became a CrossFit trainer.
Josh Clemente: This is sort of parallel to my time at SpaceX. I was fit. I’ve been fit most of my life. I’ve never had a problem with weight gain. But I’ve also been a calories in, calories out absolutest in the sense that it does not matter the source of the calories. It’s all the same, broccoli and Skittles. It’s just a calorie count. And I had a really insane sweet tooth in college.
Josh Clemente: I would eat M&Ms for dinner. And that’s no exaggeration. I would easily crush a pound or two of those. And so I had gotten to the point where I’m in good shape. I’m working at SpaceX which is an extremely high-paced environment. Everyone’s basically trying to outcompete each other to work the most and to always be present and always be the ones carrying the most load on their backs.
Josh Clemente: It’s a rapid road to burnout, to be honest with you. And I was experiencing it. So as I was approaching the most important project of my life, leading this astronaut life support program or life support team inside of the life support program, I just suddenly became aware of the fact that everything felt different from how I thought it should be. My mood was always poor. My energy levels were tanking consistently. Every single day, I would feel the need to just sit down, close my eyes, go to sleep or lay under my desk and try to hide.
Josh Clemente: And it was a very shocking transition. And it happened slowly. But I suddenly realized that something’s very different about my day to day. I was having these episodes that were a little bit hard to describe but certainly symptomatic. I would get itchy skin. I would get shaky. I’d get a cold sweat, like very strange sensations.
Josh Clemente: And so I went to my doctor and I asked him to do a full workup, figure out what’s wrong with me because it seems like I have a terminal illness. Something’s changed. And I feel very unhealthy. And he looked at me and he was like, “You’re fit. You’re fine.” If you could see some of the people that came in to my office, you’d calm down a little bit.
Josh Clemente: We did a whole blood panel. Nothing really was flagged. And I left the office with the generic feedback, like, “Eat some more fish, try to eat healthy in general, work out more. You’re fine.” I was not satisfied with that. So as I’m working on this astronaut program and learning more about the way that astronauts prepare for orbital missions, they’re constantly tracking all biomarkers that you can easily measure in the modern human.
Josh Clemente: It’s typically through blood panels. So they’re doing blood panels on a basically a weekly basis, depending on who they are, and tracking all the metrics that are associated with long-term risk factors. A lot of exercise, a lot of good eating. But a lot of data. And I was very frustrated by this approach that I took in my life, which is every year or every two years. I get a single PDF print out with some numbers on it.
Josh Clemente: And I get the same generic advice versus people who are at on this elite spectrum who can’t get sick because they’re about to go to space where you don’t have emergency rooms, they’re measuring data continuously. And they’re taking action off of it. And this felt very strange to me how different this was despite the fact that the technology existed.
Josh Clemente: So I started to look around like, “All right. I’m having these burnout issues. I feel terrible,” read about the metabolic systems in the body. And it was pretty familiar with the basics. And I just realized, “Hey, you know? There’s actually an easy way for me to measure something about my metabolism and see if these energy issues and these symptomatic episodes are related to it, and that’s measuring blood sugar.”
Josh Clemente: So I got a finger prick, blood sugar device from Amazon or something, and started obsessively, pricking my fingers and plotting my numbers in Excel. And it was basically useless. I would have a cloud of data in the morning, a cloud of data in the evening. And in between, I’m working or I’m on the run and just didn’t have any information.
Josh Clemente: To make a long story short, I continued to get more interested in this metabolic health stuff and was reading primary literature. And I came across eventually continuous glucose monitors, which are these are devices that developed for the management of diabetes, where you have to sort of intensively manage your glucose levels. And I was like, “Oh, I need one of those. This is what I’m basically replicating. I’m pricking my finger 40, 50 times a day, plotting the results. If I can just wear a sensor that does this for me, great.” Asked my doctor. And he flat out denied me, “Absolutely not. It’s crazy for you to ask for that. You do not need to measure blood sugar unless you are diabetic.”
Josh Clemente: And those were basically verbatim. And so this was like kind of the third insult in this whole cascade of events where I left that office. And I just thought, “That’s my blood sugar data.” This is happening in my body one way or another. It doesn’t matter if it’s good or bad. It’s my body’s data. And why am I asking for access to it instead of providing access to other people? It may be the case that my blood sugar’s perfect. But I don’t know that. And I have no way of confirmation, and there’s nothing inherently negative about me having more information about my body.
Josh Clemente: So I stayed focused, eventually got a CGM. And within about two weeks of data, and this is coincidental, I realized that everything is wrong about my blood sugar. It’s constant. Basically every meal I’m eating is putting me well outside the normal range. This is according to the American Diabetes Association. So I’m exceeding 140, oftentimes to 180 milligrams, per deciliter after every single meal spending long periods of time elevated. And then I’m experiencing these crashes where because I am not diabetic, I still release insulin.
Josh Clemente: My body overcompensates to these large elevations, and my blood sugar plummets. And it’s actually during that drop that I would experience those sort of fatigue waves, where I would feel shaky.
Steven Borden: How low would it go?
Josh Clemente: It would drop into the 60s, and then it would resurface. And it’s really the ride down. While you’re at 60, you can feel it. And for anyone that’s ever bonked on a long endurance run or on a ride, it’s that pit in your stomach, that shakiness, the cold sweat. Those are the exact sensations that I didn’t know were a blood sugar thing earlier. But I now can actually predict my glucose based off of the sensations in my body today, because I’ve connected the data to my sensation in real time this way.
Josh Clemente: So that was a learning experience for me. And being able to see these huge elevations knowing the data, having read many, many papers on the stuff at this point, it was obvious to me. And so I then spent several months just using CGM data to fix the diet that was driving this. So I would remove the meals or reorganize portion sizes, and macronutrient makeup to try to get rid of those huge spikes. And it was very effective.
Josh Clemente: And then, I also started learning things about the different exercise, modalities quality and duration of sleep, how all of this stacked up and affected my blood sugar in ways that you can read in a textbook. But it’s the never going to come up on a Google search. And you’re never going to hear it in a fad diet book. Generally, you’re never going to read about it being relevant for anyone without diabetes in the first place. So, it was basically a nutrition and physiology PhD over the course of a few months.
Steven Borden: Your story’s interesting to me because a lot of times, you’ll hear some implementation, whether it’s a certain diet, keto diet, vegan diet, whatever. And someone will lose a ton of weight on that with that strategy. And then, their health markers improve. And they’ll point to that strategy and say, “Look, it was the keto diet,” when you look and it’s like, “Well, do you lost 80 pounds?” But maybe I’m mistaken on this, but you’re pretty jacked dude, in good shape. And you didn’t go through a tremendous weight loss deal, did you?
Josh Clemente: No. So I started to experiment with a lot of different tools, lifestyle tools, after my introduction to CGM. Those included caring a lot more about sleep, different exercise modalities including Zone 2 cardio training, which I had never really done before. I’d only done high intensity stuff and fasting. And so I did lose weight. Unfortunately, it was a combination of fat. Like I said, I’ve never had probably over 11 or 12% body fat. It’s just, genetically, I just am not predisposed.
Josh Clemente: I’m predisposed to have a tough time gaining. So during the time of experimenting, I lost a couple pounds of muscle and some body fat as well. But just trying things like ketogenic diets, trying things like intermittent fasting, just learning about these tools and how they affect both my quality of life and also, quantitatively, my blood sugar and the sensations associated around that.
Josh Clemente: So it was a very experimental process. And, yeah, to your point, for me, it was when I look back on three years ago, I’ve now been wearing CGM basically continuously for three years. When I look back on where I was then and where I am now, the vast majority of the changes are cognitive. So my ability to maintain, I think, perspective, my mood control, and my clarity, my clarity of thought, these are the things that I feel have changed the most for me.
Josh Clemente: And there’s a secondary effect of continuous energy. And this one is a little bit harder to describe because I don’t have those episodes of shakiness and just general symptomatic hypo, which typically are related to meals anymore. And so I say I have more consistent energy. I still struggle with all of the things everyone struggles with, getting up early, going to bed on time.
Josh Clemente: But I have fairly consistent energy levels throughout the day. But again, the things that I point to as the most transformational for my life are mood perspective, cognitive clarity. And it’s really interesting because Alzheimer’s and late-age dementia run in my family. And when looking at metabolic health and its long term effects, when dysfunctional, there is a very strong tie to the mental health and mental outcomes for a certain subset of the population.
Josh Clemente: And we’ve always looked at weight. We’ve always sort of said, like, “Metabolic dysfunctions, those are things that overweight people deal with.” And we do not look under the hood and consider the links to depression, the links to anxiety, the links to mental health, and especially the links to dementia.
Josh Clemente: Alzheimer’s today in medical schools is being taught as potentially type-3 diabetes. The relationship there is because the brain becomes insulin resistant during the transition into Alzheimer’s dementia. And that’s well known and accepted. The question is whether it’s causal or a symptom of the Alzheimer’s. But the point is that the brain exhibits the same insulin resistance that the muscle tissue and general tissues of a diabetic, a person who’s experiencing diabetes, those are the same or similar transformations.
Josh Clemente: So those relationships are very closely established. And I think that’s the most interesting thing for me personally, is that although this isn’t something that changed my body composition transformationally, I believe that it has changed certainly my mental experience, like my quality of life as it relates to my mental health and potentially long term outcomes remains to be seen. But I certainly feel better about it.
Steven Borden: That’s why this is so interesting to me, because if you had to make like a short list, a list of five things that people could focus on to optimize even you’re talking about the cognitive side, or just how you feel, and then your longevity in your health, man, I would put blood glucose control right up on that list. And it’s funny how you started to optimize your sleep because you noticed the effect that it had on your blood sugar. And I kind of want to get into levels specifically because you’re the perfect use case or example in really good shape.
Steven Borden: Anyone would look at you, like, your doctor looked at you and said, “Dude, you don’t have diabetes. I’m not going to get you a CGM.” Nobody would look at you and say, “You’re someone who probably has crazy blood glucose swings.” But yet once you actually took a look under the hood, you saw issues. And so can you describe what levels is and how people are using it?
Josh Clemente: Yeah. So Levels is basically what I wish I had when I started this whole journey myself. And specifically, it’s the first tool that can answer the question, “What should I eat and why,” with real time data from your own body. Right now, that data consists primarily of continuous glucose information. So when you try levels, you get a pack of CGM sensors.
Josh Clemente: These are continuous glucose monitoring sensors. You wear one of these patches on the back of your arm continuously for two weeks. And it wirelessly communicates with the level software. And inside the level software, you log your behaviors. These kind of cover the four main levers of lifestyle actions, which are your nutrition choices, your exercise, your sleep, and your stress.
Josh Clemente: And so all of that lifestyle logging is in the context of your continuous blood sugar information. So an example is you sit down for lunch. What are you going to eat? And why? Today, a lot of people are selecting meals based off taste, emotion, something that they read about on the internet, something that was recommended for a friend. It’s never, and I can say that pretty confidently based on an objective data source from their own body or their own health record, and this is where levels comes in, is that you can sit down. You can eat that lunch. And two hours later, you’re going to get a score that is based upon how your body processed it metabolically.
Josh Clemente: So the blood sugar response, you experience, the height of the elevation, the time that you were out of range, the variability. So the instability that happened afterwards, all of these things are kind of nuanced factors that affect your both long-term risk and also your quality of life. Probably, you you’ll feel some of the symptoms associated. We combine all of those into a single score. And so now, you have a score for that meal. And we can surface insights to help you make some adjustments, so we can make recommendations around macronutrient content.
Josh Clemente: Maybe, you ate oatmeal on its own. While oatmeal is actually a processed carbohydrate and it tends to break down very quickly and for many people in the Levels data set, it affects them pretty negatively. So that’s going to mean you have to give up oatmeal. But we can make some recommendations trying something like adding fiber in the form of chia seeds. We’re adding some healthy fats and proteins like almond butter.
Josh Clemente: This can have a very significant effect for individuals that most don’t recognize. They think this is all or nothing. But by introducing the nuance of there’s balance associated with the portions, there’s balance associated with the order of foods, so having a salad before carbohydrates can actually affect the way that the carbohydrates break down.
Josh Clemente: And then the sort of summary of our choices, we can also introduce you to the fact that if you take a walk right after an indulgent meal, you can modify that response dramatically because your posterior chain, the largest muscles in your body are moving, working in real time. They’re pulling the glucose right out of your bloodstream and using it for energy in the moment, as opposed to you sitting on the couch after that meal, and it getting sort of converted into fat while simultaneously causing a sustained elevation in your blood sugar.
Josh Clemente: So all of these nuanced decisions are kind of abstract when you read about them. But when you see your body do a thing after you make a choice, and then you modify your choice and see your body do something completely different, that’s a lesson that is very hard to forget. It’s sort of immediately turns to habit. And so that’s the level system. It’s just connecting in closed feedback loops as short as possible, the actions we take to the reactions, our bodies experience using blood sugar.
Steven Borden: And Levels is the software platform that links with the CGM, right? The app on [crosstalk 00:33:50].
Josh Clemente: Right. Exactly. Levels is the software component. We have a program where you can sign up and get access to CGM through a partner, Telehealth Physician Network. That’s something that we offer as a service. But primarily, Levels is a data science company. We’re a behavior change company.
Josh Clemente: Our goal is to connect people with the lifestyle choices they can make that can lead towards metabolic awareness, which is understanding how your actions affect your metabolism, and then ultimately metabolic fitness, which we are using this term to encompass the fact that metabolism is not binary. You’re not either healthy or unhealthy metabolically. We’re all on the spectrum. And we can improve our metabolism, our metabolic fitness through focus, effort, repetition, correct decision making.
Josh Clemente: But you need to measure if you want it to improve, right? So that’s the ultimate concept is just by surfacing this information, you can learn from it. And then by improving it iteratively through small micro-optimizations over time, you can get better.
Steven Borden: I like that you guys, you’re putting everyone on the stand because, like you mentioned, the calories in, calories out was kind of your old mentality. Thermodynamics are real. Energy balance is a real thing in terms of weight loss and weight gain. But there’s a lot more that’s happening under the hood. And people that are maintaining a healthy body weight, and maybe even in a net calorie deficit can still be metabolically all over the place.
Josh Clemente: Absolutely. Yeah. This is one of the tricky parts of the conversation today is that it seems like we’re pitting the hormonal theory group against the calories theory group. And both of these things are true. Calories are a unit of energy. It’s an imperfect science. We aren’t a bomb incinerator. We can’t turn that food into a perfect unit of energy. That’s going to depend on our digestive efficiency and a whole bunch of other things.
Josh Clemente: But it is a unit of energy. And certainly, thermodynamically, it is true that if you intake energy than you expend, you will gain weight. That said, the way that our bodies process the foods that we eat is different and unique. A pound of lean ground beef and a pound of pasta have two completely different impacts on the hormonal implications for our bodies. So fats have nearly zero insulin effect in the body. Carbohydrates have a very significant insulin effect. And certain proteins, especially processed proteins, like whey protein powder also have insulin effects.
Josh Clemente: And insulin, it’s like a master hormone in our metabolism. It drives downstream processes from fat storage to fat oxidation. So basically, it both drives fat storage. It drives glycogen replenishment. But it also blocks fat oxidation. So when your insulin levels are high, you’re going to be locked in your body with no ability to tap into your adipose tissue. And so some people who are experiencing high-insulin levels continuously, they may be in a caloric deficit.
Josh Clemente: But if their insulin levels are high, they cannot burn fat. And that’s something that is really confusing and is where I want to shine the light, is that it is not always the case that just short duration calorie deficits will allow someone to start to shed their weight as easily as someone else. It really is under the hood hormonal implications. And that’s driven by what they’re eating in between meals… or I’m sorry, what they’re eating at meal intervals.
Steven Borden: I know there’s some research to point to people have different glucose responses to different foods. I know you’ve mentioned the banana and cookie, I think, was the example. But in your guys’ data set that you guys have collected or looked at, have you found that to be similar as well?
Josh Clemente: Yeah. I mean to give some anecdotal… Actually, I’ll quickly give that banana cookie example. One of the landmark trials was this Weitzman Institute study in 2015. So, they took 800 people without diabetes, and they gave them continuous glucose monitors. And then, they had them eat these standardized meals, a whole variety of them.
Josh Clemente: And they were able to show that two people can eat the exact same two foods at different times and have equal and opposite blood sugar responses. So in this case, it was a banana, and it was a cookie made with wheat flour. We don’t have enough data from that study to know all of the other downstream implications. Did they have opposite insulin responses? Those are the big questions that remain to be answered that we at Levels are looking to study, with our research program, is to continue to fill in the blanks and push that science forward.
Josh Clemente: Anecdotally, we’ve replicated this many, many times. And eventually, we’re going to be able to publish a lot more. We want to make sure that we have statistical significance. But an example would be a few weeks ago, the whole Levels team did a quick challenge where everyone drank two Coca-Colas, full sugar at separate times.
Josh Clemente: On day one, we drank the Coke and sat on the couch, did absolutely nothing, tried not to expend any energy. On day two, drank the Coke and went for a walk 30 or 40 minutes of just casual strolling. And the goal was to show how different those two events are for our bodies, how the walk can modify the area under the curve, basically, of your blood sugar elevation.
Josh Clemente: And the results are amazing. It’s just completely different. Totally awesome. But what we also showed is the difference between in that sedentary mode, drinking a Coca-Cola across our team was so different. And one of the interesting ones is one of the engineers on our team, he’s built about like me, maybe slightly less muscle mass actually. But lean doesn’t really gain weight about my height and our difference in terms of our postprandial response to that Coke was mine was twice as great in elevation.
Josh Clemente: The departure from baseline, I increased by 80 points. He increased by 40 points. That is the example right there. So that postprandial glucose elevation is very different. And it has very different implications. This is well established. The degree to which your blood sugar excursion increases is directly correlated with long-term outcomes, risk of chronic illness, heart disease, including diabetes, and now increasingly dementia.
Josh Clemente: You would not look at us and assume that we would have different responses. It’s not like this is someone who was hyperinsulinemic, had a lot of weight on their body, different genders. This is pretty similar, well controlled, both fit. Neither of us are smokers. And yet, we’re having dramatically different responses to the exact same standardized input.
Josh Clemente: And so there’s a lot more research that needs to be done on the factors there. But the effect is present, and we see it constantly. And it’s always surprising to me the in-group differences. So, look at the same sort of demographic profile. You’re still going to find differences. And there have been studies on the predict trials in the UK, which have shown the same effect among identical twins. So two people who share a 100% of their DNA can have vastly different blood sugar responses to the same inputs. So it’s still a mystery exactly what’s happening. I think it’s context. It’s the hormones in our bodies. It’s microbiome, so on, and so forth. But we need to tease these out and help people make choices that will optimize for them.
Steven Borden: That’s so interesting that you and your engineer, and what you’re saying potentially is that if you guys redid this trial with a different food, maybe equivalent carbohydrates, there’s a chance that you may handle it better than him, like the complete reverse scenario, which I think is interesting.
Josh Clemente: For sure. That’s one that would be beautiful to be able to… I don’t think we’ve seen that in the literature yet that they will switch. Well, I’m sorry. The Weitzman trial did show that. I don’t think we at Levels have replicated that degree of variability where we eat the banana and the cookie and have equal and opposite for those two foods. We do need to do more digging there.
Josh Clemente: But I think the most interesting thing is that what we all need to be optimizing for is ourselves. So it’s really fascinating anecdotally to know that I have a much worse response than the other person on my team. But it’s actually most interesting for me to know how I respond to different foods and select for those that optimize my blood sugar control. And those may be directly opposite of someone else, or they may have overlap.
Josh Clemente: There are probably a great deal of foods like green vegetables, for example. Nobody’s really having a dramatic response to the carbohydrates and green vegetables, unless you have an allergy. So there’s a lot of overlap. And then, there are these outliers where there seems to be individual variability. And I mean some of it may be ancestral. If we, for example, look in regions of the world where a certain food was eaten, I would not be surprised if we find that there are microbiome trends or just genetic predispositions, to be able to produce the enzymes, to break down that specific strain of fruit or grain sugar. We’re not deep enough in the science yet to be able to answer those questions. But I do expect that we will.
Steven Borden: I like how you’re talking about, ultimately we just need to optimal ourselves. And I hope that everyone, at some point, wears a CGM. But like some blanket statements, like we talked about quick walks, even 10 minutes after eating, being a huge one. Can you kind of go through some things that you’ve found for most people work really well?
Josh Clemente: I think by far, the biggest two are balanced meals. So making sure that you have essentially equal proportion, protein, fat, and carbohydrate in a meal, and then the exercise. And for the exercise thing, it’s just more movement more often, as opposed to having to do high intensity training for 90 minutes a day. It’s like just walking after every meal is going to have probably a higher gain effect for someone who’s trying to lose weight or is trying to produce metabolic control for health reasons than that high-intensity session.
Josh Clemente: There’s a whole bunch of implications for high intensity workouts that are great for you. But they also induce stress. And if you do them at certain times of day, they can interfere with sleep. And so the sleep interference can ultimately trickle down into the next day. Having poor recovery actually causing elevated cortisol, which causes elevated insulin. There are all trickle-down effects where when people try to fit in the big chunks of aggressive workouts, they’re potentially doing it at the expense of other downstream effects for their lifestyle.
Josh Clemente: So I’m pushing people to just start implementing a walk after every meal, focus on balancing that meal with fiber, fat, protein and carbohydrate. And those are the big ones. And then the next big lever is sleep. If you can make simple changes to your sleep routine, pushing for seven, eight hours is ideal, and just limiting the likelihood that you’re disrupting your own sleep.
Josh Clemente: So eating slightly earlier, try to cut off the eating two hours, maybe three hours before going to sleep, that’s huge. I’ve seen a lot of this. I’m looking forward to digging deeper on the direct correlations between this, because we do have meal logs and we do have sleep data and Levels, and we will be looking into this deeply.
Josh Clemente: But it seems to be that while you’re sleeping, if your body’s having to allocate energy to digestion and allocation of the energy molecules that come from digestion, basically, you’re going to have heat production and you’re going to have energy allocation that you otherwise wouldn’t need. And your body could drop into a more restful state, something like that. Digestive processes require energy. That energy has to come from somewhere.
Josh Clemente: Your body’s focusing on things besides rest and repair. And so just trying to push that eating earlier eliminating alcohol later in the day is another big one Get that restful sleep. And then longer term, your body can start to recover and adapt and reduce the stress environment, which ultimately is where metabolism starts to go awry. When things are kind of going off the rails in terms of cortisol, stress and poor recovery for weeks and months on end, it seems to have a dramatic effect on the insulin resistance of the individual.
Steven Borden: Man, I can speak to the sleep portion. Do you use Oura or Whoop or anything like that?
Josh Clemente: Yeah, I use Whoop.
Steven Borden: So eating before bed, I’m sure you’ve noticed, my resting heart rate will be 20, sometimes beats higher than normal. Alcohol obviously does it too. Have you noticed with yourself being that you can track those two things, glucose, just going through your normal life the next day after a poor night of sleep, can you actually see different responses to foods?
Josh Clemente: Totally. What I have yet to be able to really nail down is the multi-day effects. So it seems to me that the most obvious impacts are when I just don’t sleep. So a red-eye flight, I did one of these. It’s been a little while actually due to COVID. But I did a red-eye flight last year, and my blood sugar was 25%. My baseline was 25% elevated the next day. I was just in a heightened state of stress, for sure.
Josh Clemente: I hadn’t slept at all on the plane. I had an active day prior. And that seemed to sustain for multiple days into the future. And I haven’t had one of those really crazy kind of disruptions more recently. But that’s where we need to tease things out is I believe that, as with anything, it’s a spectrum. And so poor sleep over time is going to replicate this effect for people. But certainly, when you’re compromised, let’s say you have a baby, a newborn and you’re just like, “You’re not sleeping,” that will show up in this sort of elevated stress environment and elevated blood sugar on a CGM.
Josh Clemente: But it’s one of those things where, oftentimes, when we are stressed, when we’re sleep deprived, we like to try and comfort ourselves by indulging in food having pizza for dinner, having some ice creams, because I’m tired, I’m crabby, I’m just going to do this. And I think the interesting thing is when you’re aware of this objective data, it helps you to basically sort of compensate. So there’s the four main levers. You’ve got nutrition, exercise, sleep, and stress. If you’re compromised on one of those and you’re aware of it, you can help make up for it on the others.
Josh Clemente: And so that’s what I’m always aware of, is if I sleep poorly, just like with Whoop, it tells you to kind of back off on the strain. I do the same thing with my other lifestyle factors. I’m going to be a little bit more cautious about indulging, about having very carbohydrate intense meals, because I want to try and limit the insulin exposure that I’m confronting and compensate for the poor sleep. It’s very similar. This is all context.
Josh Clemente: All of these things overlap and have implications for each other. So it I think despite the fact that we don’t have real hard quantifiable evidence of one hour of sleep equals 20% worse insulin resistance, that is going to be individual and it’s going to be variable. But we will be able to show the correlations and people are picking up on this in their own data. I’m looking forward to being more prescriptive and helping people know exactly why they’re experiencing a certain change.
Steven Borden: I think everyone that I’ve talked to that’s worn a CGM has said something similar to me, which is, “I’ll never be the same in terms of just modifying behavior.” Have you noticed that with the people, the feedback that you get from people who have used Levels saying like I’m just naturally making better decisions now, once I’ve seen what’s actually happening inside my body?
Josh Clemente: Absolutely. I think one of the most impressive things to me is how quickly we’ve gone from an idea to something that people are providing feedback has changed their life completely. I got a long message just yesterday from someone who lost 20 pounds and changed their blood panels across all of the major risk factors for cardiovascular disease over the course of three months using Levels.
Josh Clemente: Our goal is not to try and make claims that that you’ll reverse heart disease or lose major weight. Our goal is to generate metabolic awareness. It’s for you to know the reactions that your body’s experiencing to the actions you’re taking. Because that information, we believe is the fundamental requirement to make lasting behavior change. People have to know. They have to know the rules of the game they’re playing. And they have to know the implications.
Josh Clemente: It’s really important that we set the playing field for people and that they can understand. They can see all the information that’s relevant in. And once that happens, the rest is easy. The behavior change. Oh, if I know that this is directly impacting my risk of CVD, that’s easy. I’m just going to modify that portion. I’m going to remove that macronutrient.
Josh Clemente: And this is what people are doing. And it’s amazing how early these sorts of anecdotes are coming in, that people are able to use this tool and able to develop lasting change in their lives that have still early, of course, in the process. But we’re hearing some really impressive things from people. And I’m just excited for the direction the product is moving because I think we’re still just scratching the surface.
Steven Borden: Sorry, man. I don’t know if you saw my camera just dropped out on me. I just got kicked out of the interview.
Josh Clemente: Oh really?
Steven Borden: I’m glad you can hear me now.
Josh Clemente: You’re back now. I can see it.
Steven Borden: Okay, cool. Man, I’m just extremely interested in what you guys are doing. And I heard you mention because wearables kind of get this weird, there’s so much data. And sometimes, people don’t know what to do with it. So wearables can get this bad rap. But I heard you mention something like people are not dying from looking at data or getting overwhelmed by data. People are dying from over excess of food, over excess of maybe processed carbohydrates, just not main being metabolically healthy.
Steven Borden: And so I think what you guys are doing is incredible. And I’m just curious to keep watching. I know we’re kind of rounding out on one hour here. But one thing I didn’t get to ask you earlier that I wanted to ask you, was did you always know that you wanted to be a founder and to start something on your own even when you were a kid or once you were at SpaceX or did this sort of come up after having some time in the trenches working at Hyperloop and SpaceX and all that?
Josh Clemente: That’s a good question. I was kind of, I think, predisposed to entrepreneurship early. When I was in high school, I had a contracting license. And I kind of had a little mini-business. I was advertising on Craigslist and doing remodels and flooring installation and stuff like that. And so I had that. I certainly was not an organized business owner at that age. I was just making money.
Josh Clemente: But I definitely had that independence mentality where I wanted to know that I had the most possible control over the direction of my efforts. And I think that’s what it comes down to, is just Levels is much bigger than just me today. But it started from something that I wanted. And I wanted to work on it because I thought it should exist. And that made it really easy to work on.
Josh Clemente: It made it very exciting, and any incremental step towards progress was something that was kind of selfishly rewarding too. And so having that, I think, that sort of thread is present in my from the very beginning of just wanting to be, to some extent, in control of where I spend my time and why. And so the why for Levels is my own experience.
Josh Clemente: It’s being able to replicate what happened in my life, learning more about my body and over the course of three months than I had in my entire life combined, and then being able to actually make improvement. That was something I wanted to share with a lot of people. And the whole team now today is of like mind. They want to be working on something that is meaningful, that’s mission driven, and to be developing a tool that they themselves would use and want their families to use.
Josh Clemente: So I think it’s a piece of both. For me, it’s not just about being a founder. It’s about working on something that is meaningful. And I felt that at SpaceX. I feel that today. And I hope to continue to be able to build a business that people feel called to work on as opposed to just working on something as a founder. That’s I think secondary.
Steven Borden: Last question. You guys, maybe, it was strategic how you named your company Levels. It’s not specific to glucose. I’m assuming down the road maybe you’d want to measure other things. Two-part question, is there anything exciting that you think would be cool to measure in real time/have you thought about, or do you think it’s possible to measure something like hs-CRP in real time?
Josh Clemente: So we’re spending a lot of time thinking it’s not just about if. It’s when and what we will measure. So there is no panacea in biomolecules. All of these things were a chemistry set. There are a lot of chemicals. These chemicals interact with each other and produce chemical reactions. And so we’re aware of that. And we actually want to get ahead of the fact that glucose is not going to make you healthier.
Josh Clemente: Just tracking your glucose is not going to make you out healthier. It’s how you adjust your behaviors and the implications on molecules besides glucose that will improve your glucose responses and potentially other factors. We want to measure the highest leverage, most actionable molecules in your body. And those are likely to be hormones in the long term and probably lipids.
Josh Clemente: So the big molecules of interest certainly include potentially inflammatory molecules, like hs-CRP. There’s a really bright future for real-time biosensing. There’s some technologies that have been developed in the lab, in academic institutions that can basically measure anything you want. They haven’t been commercialized yet. But they use a brilliant technology that does not depend on enzymes and the reactivity of the molecule. But is more like they use specific DNA strands that identify, or have a specificity to bind to the molecule of interest. And you can develop them for almost any molecule.
Josh Clemente: Stanford’s doing some amazing work on this. UCSB is doing some amazing work on this. And so I’m really interested to follow these trends and to leverage them in the best way possible to be able to measure the molecules that are most likely to help people improve their health. One thing Levels will not do is get into measurement for the sake of measurement.
Josh Clemente: There has to be an actionability component that is directly tied and evidence-based to health and illness. And that’s where we will get involved. And we will design an implementation of that molecule that is insightful and I think elegant to use. And that’s when we would roll it out. So we’ll keep it limited and minimal, but high gain.
Steven Borden: Super exciting. Man, I’m rooting for you a ton. And that wraps up our discussion. Something I clearly don’t know how to do in the interview, formally end the interview, I just sort of transition into… I don’t know what I transition into. But it works for me. So I hope you enjoyed the interview. And I hope that everyone gets an opportunity to experience using a CGM using Levels software specifically in the future.
Steven Borden: Even if it’s something that you do for a two-week stint, I think you can learn a ton about your physiology and a ton about how your body responds to certain foods, and more so, just what it behaviors do. I think we talked in this episode about things that pretty much anyone can do to drastically improve their blood sugar control and how your body utilizes or clears sugar from your bloodstream. But it’s just different when you see it.
Steven Borden: I think elevated blood sugar, you can walk around with crazy high blood sugar and not necessarily feel any ramifications. But when you see this number, I think it’ll make you adjust your behavior naturally. And so check out Levels Health. I’ll put the link to their website and the show notes. And I think it’s pretty obvious given the size of my podcast currently. But I’m not getting paid for any of this.
Steven Borden: If there’s something useful that has great utility, I feel like it’s a good thing to share with the world. So it’ll be in the description. But have a great week, everyone. Stay strong. Make the tough choices that are the right ones. And no matter where you are in your life cycle of, I don’t know, self-improvement or whatever you want to call it, whether you feel like you’re super far off from where you want to be, or you’re close, just understand that it is possible to build discipline. It’s possible to build willpower. It’s possible to focus better.
Steven Borden: It’s possible to be mentally tougher. It just takes one step at a time. Make one small change and then make another, and then make another. And then next time you slip or don’t perform the way you wanted to, or have a bad weekend that you feel like sets you back, don’t let that turn into a Monday, Tuesday, Wednesday slip up. But come right back Monday strong, and begin to build that internal discipline that will pay dividends in the future.
Steven Borden: Jordan Shallow, somebody who I’m a big fan of, says, “The little things don’t add up. They multiply.” I’m a big fan of that one. So little things multiply. Have a strong week. Get after it, and I’ll see you on the next one.