Everyone Kevin Rose here. Welcome back to another episode of the Kevin Rose show before we get into this episode a quick reminder that I publish an email newsletter that comes out every four to six weeks or so. It's really one side of kind of accumulated enough for a newsletter. I publish it. So it's not weekly where I'm trying to like figure out how to cram in stuff just to fill out a newsletter. This is really high quality things things that I'm paying attention to apps and products that I'm checking out sometimes little mini reviews and and some great tips on how to live a
he and Balanced Life you can sign up for that over at my website at kevincaron.com. Now today's episode is all about glucose and Insulin its impact on fat storage energy levels cancer and dementia risk and why that even if you're skinny you should consider tracking glucose levels with A continuous glucose monitor. So today's guest is Josh Clemente founder of levels, which is a startup that uses data and continuous glucose monitors to give people a window into the real-time Health. Josh is a mechanical engineer.
In CrossFit L2 instructor and previously he developed life support systems at SpaceX and actually the most recent launch that we all watched here just a few weeks ago that took those astronauts to the space station and back. He was the one that had developed those life support systems, which just insane and then even previous to that. He was working on another Elon Musk project hyperloop. And so he did that for Virgin hyperloop. So just insanely talented engineer fellow biohacker and someone that really digs,
To the science to figure out what's going on with metabolic syndrome glucose and Insulin, so I'm really excited to have him on the show. Well Josh, thank you so much for coming on the show. I can't wait to dive into all things metabolic Health. It's great to have you
on it's great to be here. I'm super excited to talk and and dig into some of this exciting stuff.
Yeah. It is really exciting. And I feel like there is a certain set of the population out there that are that's really into Health whether it be the bio hackers or kind of the early adopters.
And you know we have been if you track this stuff as I do on Reddit and all over the place. We've been aware of some of these issues and why this is so important for for a few years now, but really curious to get your take on what's going on. Why why do we care about tracking glucose? What is metabolic health? And you know where you think it's going and why you think it's gonna be a big deal in a few
years definitely at the highest level metabolism is the set of cellular mechanisms that our bodies use to
Make energy from our food and environment. So it's it's fundamental to life in order to power any process in any cell in the body, whether muscular or brain we need energy and so that metabolic layer is how we get that energy and where we get that energy is up to us. That's the lifestyle choices. We make and our food breaks down into two primary molecules in the body glucose and fat and the way our body is sort of stored those access them is in
Individual very very different both between the two substrates and between individuals. So ultimately what we're talking about here is the concept of metabolic Fitness which means optimizing these metabolism mechanisms so that you can produce energy effectively access it whether stored in the body or from the food that we consume in an efficient way to power everything that we need from cognitive function to physical fitness while maintaining optimal weight and the
Metabolic characteristics that reduce risk so long term when metabolic dysfunction sets in we start to see things that range from pre Diabetes Type 2 diabetes all the way to Sexual Health dysfunction PCOS, which is the number one cause of infertility mood disorders. Alzheimer's disease is being called type 3 diabetes stroke cardiovascular disease this whole host of problems that we talked about in the social scale, but we don't necessarily focus on the underpinnings, which is chronic lifestyle choices leading to metabolic breakdown.
And what is it that
That changes like I think of you know how I felt when I was a teenager or you know, just I would throw anything into my gut. It doesn't really matter what it was Limitless energy, you know Run play all day crash out and feel amazing the next morning like what what happens between you know, that teenager kind of life and then getting into your I don't know I first started noticing that certain changes here, I'd say probably in my early 30s like what's happening there.
R
yeah, you know, it's a complex and multivariate problem. But what we know is that you can kind of think of this as interest on the deposits we make so we have compounding effects of the choices were making over years and decades which ultimately lead to an outcome. And so every day you may not have an acute symptom especially in the early years teenage years young adulthood after consuming a specific meal or you know, skipping a night of sleep but over time as these become
And habits lead to outcomes we start to sort of experience the again the compounding return on those on those choices and this is essentially hormonal imbalances. So the body is kind of big wet chemistry set is kind of how we should think about. It's not a pristine machine where you know input equals output. Its everything is chemical releases and responding to the other chemicals in the body. And so when we make specific choices, especially around diet nutrition,
And we are causing the body to respond to that in a specific way. Ultimately you start to bias towards a hormonal environment that is you know to some cases adaptive and positive and other cases maladaptive and negative. So this is this is the the hormonal theory of weight gain and disease which has recently come to the Forefront as opposed to older nutritional Concepts like just the calories model of energy exchange and I really subscribe to this because I'm very similar to you when I was younger.
I was a candy addict I was playing sports all the time, but just fueling on pure sugar and I would eat literally anything within grasp at any time day or night, you know, just no concern for a nutritional guidelines of any kind because I was exercising. I consider myself to be super fit and now in you know, the later years I have you know, ultimately the reason I become even interested in metabolism specifically is because I kind of hit this wall of personal fatigue and mental, you know, sort of mood.
Mood swings that related directly to my physical energy and all of this ultimately. I found through accessing my you know, blood sugar information to be driven by choices. I was making so the meals I was eating the Sleep habits the stress management techniques the exercise timing all of this was causing like a really wild instability and not only my glucose levels, but then the hormones that are Downstream of them and I really think this was a compounding effect over like I said two decades of
Of making just frivolous decisions without any real caused me concern
I cash I was in that boat. I was just talking to a friend of mine yesterday. Do you remember pop rocks? Oh, yeah. Well that kid I was talking about that as like we were told I had a drink that I'd open it was like super physically and I just remind me all of a sudden for some reason fact of those Pop Rocks we used to eat and they just like, you know pop in your mouth and I was thinking oh my God that was pure sugar like just pure sugar. It was just like, oh pour the sugar into your mouth and swallow it.
It's crazy and we did that with all kinds of like crap, you know, like those dipsticks to you did with those sticks and you dip it in the sugar fun dips. Yeah, it was so bad
that the Nerds nerds is another one nerds and then nerds ropes, which is like nerds attached to Twizzlers, which he then, you know, just chew on for hours,
right? Yeah, it's crazy. So what I think about the kind of evolution of our knowledge in nutrition in the body,
You know, I think back to just a few years ago and it was like all about okay, super low carb cutting out sugar. Then there's people that are in the camp of vegetarian those people in the camp that are vegan and you know, people are changing their diets and they do feel better when they make these changes, you know, some people are keto now and they feel much better. What do we know? Like what's happening behind the scenes? Why did these changes make people feel better and kind of where do you stand on all those different?
Types of inputs, you know, like what what are your thoughts?
Well, I used to be very calories in calories out person where it really did not matter where the food source was or what it was rather with. The macro nutrient balance was none of that really mattered What mattered was just whether you're getting enough energy to or the appropriate amount of energy for what you're doing and recently especially in the past, you know, since 2015 essentially new technology like real.
I'm biomarker tracking has allowed us a much higher resolution of information about what happens in the body of a person without diagnosed metabolic dysfunction when they eat different foods and so a prime example of this is the recent breakthroughs in the personal understanding of blood sugar response from studies like The weizmann Institute study for 2015, which put continuous glucose monitors on 800 people without diagnosed metabolic dysfunction and demonstrated that two people can eat the exact same two foods and have equal and
Opposite blood sugar responses to them and this implication is massive because what it does is it flips over the concept that there is a one-size-fits-all solution yes or diet and you know the implication of having a blood sugar response that is you know, extremely high to one food and flat to another that somebody else has the opposite of response to implies that there is a hormonal Downstream effect that will be opposite as well. So the amount of insulin that your body releases and the rate of release will be different because the blood sugar, you know, basically your body responds with hormones.
To the amount of glucose in your blood to get it out into the cells for energy production. And if that is a slow and controlled process the insulin release will be slow and controlled. However, if that's a wave, you know, basically a spike in the blood sugar levels your body has to spike insulin to get that taken up into the cells and Insulin spikes ultimately lead to as we know from from long-standing research eventual insulin resistance where we are in a constant state of elevated insulin and ourselves become numb to them. And so that that original implication of like which
Foods, and I personally sensitive to in a glycemic sense. It has very large implications for how my body is responding and storing those those those Foods essentially as either fat or energy using the muscles and the rate of response is that's really important there. So this type of research and there's been additional Trials of gluco types trial and Stanford the King's College studies in the UK, which actually showed that this effect of individuality extends.
All the way to identical twins who share a hundred percent of the wow. Yeah.
So it must be microbiome related than yeah. Well, you know, there's a ton of
different underlying variables. It could be genetics plays some role because you can see some genetic overlap in particular the foods that both are sensitive to be could still have that really strong difference between people. So some genetic component some microbiome component seems to be unbelievable
to write sleeps a big one. That's
exactly right. So so
A lot of it I think is context. So it's it's what is your body composition? So body mass will matter adipose tissue amount of muscle muscle on the skeleton and then the amount of sleep and stress that you're experiencing in real time. Like all of that is going to play into how your hormones are responding. And so I really think that it's contextual and even though you will have those like specific permanent, I think sensitivities which might be allergies. They might be genetic. They might be microbiotic you will also have this
Contact stuff which you can't you can manipulate and that is really where I'm most interested is like taking real-time data giving it to the individual and then allowing them to guide their choices with a closed loop feedback system. So you can either improve your sensitivities or guide around them to make sure that you're
optimizing. Yeah. I mean, this just makes so much sense that I like to give the analogy of just you know, any modern car that has you know hundreds of sensors on it. Like my test will tell me my back left tire is down by
You know two percentage points and are and it needs to be and we have no window into what's going in on in the human body in a real-time nature until these continuous glucose monitor started to come out and so it's fasting I feel very fortunate that my my doctor Peter a TIA he put me on a CGM a continuous glucose monitor. I guess it's been like almost 5 years now. Wow, I started wearing one and so we have a ton of data around that but he did so because in most Physicians
Is
it a physical they will never do this? But this is a great first step. I think for a lot of people I'm here to see if you agree but Tia had me do glucose tolerance test. So I would go into the actual office. You know, it's harder these days with covid but you go in you get your blood drawn you figure out what your Baseline glucose levels they are fasting you drink this drink, which is just pure sugar and then you do blood draws. You know, what is it about every half hour? Yeah approximately four essentially for
A couple hours and you can see not only how high did you spike but also the insulin levels during that time period and then how good you are at disa disposing of the glucose. You know, how quickly does it return to Baseline and we found out that this is why he put me on a CGM as we found out. I'm not pre-diabetic. I don't have diabetes, but I'm a horrible disposer of glucose. Like I stay elevated longer than I should. Yeah, and so that was like a little bit of a red flag like we need to pay attention.
To this is something we need to track and I would have to imagine there are a lot of people in a similar situation and the other thing to your earlier point about not all foods being equal and being so different between individuals. It's funny, you know, seven eight years ago. I was paying close attention to the glycemic index and glycemic load of foods. And this is a number that is associated with a food as kind of like a blanket one, you know one size fits all a piece of white bread has this much
Kojima context as much Casey me glowed brown rice has this right? But with a crazy thing is the second I started putting on the CGM. I did all those tests. I'm like, oh I can have brown rice because it has a lower glycemic load, but guess what for me brown rice shoots me up to the roof. I'm like well, how is that possible and it totally makes sense based on what you're saying. It is it is is It's So based on the individual that you will almost have to throw away everything we knew back then or we thought we knew about glycemic load.
Glycemic index. Which would you agree with
that? Absolutely agree across all the points. So the first thing you know, I want to I want to take them one at a time because they're also relevant to where we are today and how we got here. So the physician question, you know, Peter Dia. First of all is like total luminary in the space like really shining a light on the underlying manifestations of metabolic syndrome that go beyond just your standard threshold effect pre diabetes diabetes. Like we have this concept in society that I'm just metabolically healthy or I'm not and not just that's a binary switch. There's no in between and what
he is doing especially like his most recent AMA episode was really fascinating here because it goes into actual case studies of people who are manifesting metabolic dysfunction somewhere on a spectrum, right? So it's not great. It's not a disaster, but they're in the middle and they really have to make some some real serious Lifestyle Changes in order to continue, you know optimizing and remaining healthy longer term because it could very quickly transition into something bad and I'm very similar to you in the sense that I'm just
He actively carb intolerant. It's kind of across the board very small quantities unless I'm extremely careful about fiber content and mixed macro nutrients including protein and good fats. I'm going to stay elevated at a very high level for hours. And so my experience initially will see Jim was very different than yours. Unfortunately. I'm glad to hear that. Dr. T is so so forward-thinking with this. I knew he was but for me my physician when I first became interested,
Stood in continuous glucose monitoring. It was after I had been working at SpaceX on life support systems for about six years and I kind of burned out physically and mentally in some ways but also had realized that this burnout was it seemed to be counterintuitive because I was very physically fit and I'm a CrossFit level 2 trainer and I really care about Fitness, but for some reason my health, or the way that I felt did not reflect the way that I, you know thought of myself in terms of health, and so I went to a doctor
I did a bunch of research on my own and discovered that you met metabolic breakdown and endocrine breakdown is really underlying all energy issues essentially and so I was asking for full blood panels. Like I'd love to get more information here at have something quantitative to drive my choices and I'd like to get access to a CGM and just take some concrete data my doctor kind of laughed at me. It was just
like this is this is for
sick people. Like you're you're underweight. If anything you need to stop worrying about this. This isn't a concern at all like I would know because your A1C would be over.
Nine or something and that's what our need to worry and and the
shocks inflated people real quick. What A1C is just so they
yeah, sorry, sorry. So so anyone see is it's basically measuring the amount of glucose that binds to your red blood cells and so a red blood cell lives for about 90 days on average. And so if you can measure the amount of glucose stuck to a red blood cell, you can kind of approximate the average blood sugar of that individual now the issue here is some people's red blood cells last 90 days some last a hundred and twenty days.
Some last only 75 days. And so it's a very very rough and in accurate calculation of average glucose. Whereas a continuous glucose monitor is measuring your blood sugar full-time and is giving you average glucose, right? You just divide the amount of the your glucose levels over the day and it'll just spit out average glucose. So A1C is a very rough measurement and the way that this physician its standard care approaches. This is they wait until your average blood sugar has exceeded a threat.
Hold of objective disorder before you start monitoring in a more meaningful way or intervening in the problem. There is it takes a very very long time periods of dysfunction for your A1c to break right you imagine it's almost
too late at that point.
Right? It's certainly more complicated. I mean at a minimum, I think it is over to health and some others have shown that you can reverse the symptoms of type 2 diabetes, even when it's traumatic with with diet and focus lifestyle, but why should we wait until that time period why?
not constantly aiming towards optimal and I'm trying to be well ahead of any dysfunction because ultimately, you know, the side effects of metabolic breakdown are devastating, you know, it attacks the nervous system attacks the vasculature and attacks the the arteries of the heart you lose your sense of sight and touch and all of these things start to break down because of exposure to radical activist oxidative species or oxygen species, which are really these reactive byproducts of having elevated glucose in the presence of
oxygen and so we really want to avoid having these elevated situations and it's really not a concept that most Physicians certainly not mainstream medicine is is thinking about and so unfortunately, I did not get access to a CGM for about 14 16 months. And when I did I found out similar to you that I was either borderline pre-diabetic or full-blown pre-diabetic depending on who you ask and this is you know, I didn't have an oral glucose tolerance test. This was just my glycemic response after meals was
Remaining elevated for hours and the pre-diabetic Zone and this is something that did not show up on again my A1C test or on a fasting glucose test. So using that CGM, I was able to start to implement closed-loop decisions. So testing Foods testing sleep and stress and how I was responding to different choices. I was making every day seeing how my blood sugar responded and then implementing permanent habit change.
So the 8th really, I mean, it's sadly it's still extremely difficult to get access to see GM's from a standard physical.
Position I have had several friends that have reached out to their primary care provider and they just say no like bright-eyed. Are they worried or doctors worried of writing a prescription that may come back to bite them in some way. Like, why won't they just more freely right
these you know, it's a really good question and something that I think unfortunately is to some extent due to a culture of litigation and we really put the onus on Physicians to be perfect. And so there's there's a long history of malpractice.
Actions being taken against Physicians who I think are trying their best to make the choices best for the patient. But I think one ultimately leads to is a bit of fear of moving into an experimental space or a space that hasn't been rigorously demonstrated to be the ideal standard of care. And so in this exact example, we're using monitoring technology that was developed for the management of diabetes, but using it for a completely different population, which is interested in avoiding long-term dysfunction or
Making optimal choices, it seems like to certain positions and unnecessary risk to have anyone use any medical product that is not designed specifically for their use case and it's an unfortunate thing is something that we're going to change in the coming months and years as people realize that real time information is the thing that's been missing from their daily life, you know, everybody sitting down and making a choice for lunch like what am I going to eat and why and all of us, you know with very few exceptions are doing that based on internet advice something that worked for.
Friend or just taste you know, the way it makes you feel and unfortunately that's skipping all of the under the hood effects like the hormonal, you know implications and then the long-term compounding interest on those choices, which we don't have any feedback loop for we don't know is that a positive choice or a negative Choice until now and once people realize that and you know, there will be a I think I can access to personal health information component of this. So we're starting to see a transition in society to the point where people want their own data to be there's to own it whether
that's data from social media and privacy implications or you know, your own body's health information, you know biological information. We should own that at the individual level and we should be able to you know, reach out and combine forces with an expert or a medical provider that we trust and give them access to that data, but we certainly shouldn't have the opposite situation where there's kind of a gatekeeper scenario where we can't access our own data from our own bodies because of a kind of this this nebulous concept of I don't know litigious or malpractice.
And type type of environment it requires both parties to change their perspectives and you know have a little responsibility.
Do you think this eventually gets to an over-the-counter? It's crazy today that you can actually go into any drug store and buy a standard glucose reader meaning like you prick your finger you put a drop of blood in don't have to have any type of prescription for that. Right and but yet a device that does the same thing, but I get that it's a little bit deeper needle, you know, you got to kind of swallow
Bob with an alcohol think well, I guess you do them both both cases. It just seems silly to me that it's the same thing but one is over the counter how long until we see over the counter continuous glucose
monitors. Well, I'm very optimistic. You know, I think that just given the scale of the of the problem that in the also the optimistic potential outcome, you know, if if the mainstream market up takes this as the bio wearable of the future, I think it's going to be really an amazing outcome. And so there is a lot of incentive pushing in this
Actually, no for amazing new breakthroughs in the technology both an accuracy of availability affordability. And so I think we have we're seeing some great progress in this direction and I do believe it will become over-the-counter soon. And this will eventually be integrated into a wearable that you kind of would think of as your Whooper your or you know, something very minimal and easy to use now in terms of timing I'm going to guess that this is going to happen on a two to five year time frame where we'll see like, you know, a direct over-the-counter solution and you know, I think one thing that
Is a little bit tricky is you know, it's hard to describe. It's hard to determine specifically why the regulation exists, you know, it's arguable that for someone who is managing diabetes currently with with exoticness insulin, you know, this is this is insulin that you have to inject because your pancreas isn't producing it if you're wearing a CGM and you're making those choices based on the data, it's definitely possible that a malfunction in the device could cause a very life-threatening situation for that person if they inject the wrong amount of insulin insulin.
Deadly hormone into into of quantities. So that's a scenario that I understand. There should be some protections and some regulation around but if you look at the much much lower risk population, you know, the people who are not using insulin exogenously are not dosing medication off this but instead they're just choosing whether or not to go to McDonald's or like what what time of right exercise and how much sleep to get this is an extremely low risk scenario and far lower risk than that finger prick device that you just talked about because you know with that device you're actually penetrating into the bloodstream.
You're bleeding out you now have an opening in your fingertip, which is supposed more germs than any other part of any other part of our bodies. Whereas the CGM is a little filament. You know, it's a single Paper it does break the skin but stays in a single location. It's sealed off with a piece of all the way around, you know, and it's a full-time high resolution data Stream So the quality of the information is so much better. So I really think that the the argument in favor of making this readily accessible and available is just very well stated already and will continue to get more obvious.
So if someone does and we'll talk about the ways to kind of get access to your data both in terms of devices and and the finger-picking but let's just say someone does notice. Okay. Well, first of all, what do you consider abnormal? Like if someone is looking at their glucose levels and I guess we can say you could do this without having to have a CGM right? You can go and get a device at your drugstore prick your finger measure pre-meal measure 30 minutes after a meal an hour after.
A meal and and get the same data. It's not going to be in five minute increments like you would with the CGM. But if you just wanted to say listen, I don't have the budget to go and do this but I do have you know, fifty seventy-five dollars to go and play with the test this out and see where I stand on a few meals. Yeah. What ranges are you looking at? Where do you like to fall? What would you consider to be healthy,
you know, we have a pretty significant debt to people like, dr. Atiya and Rhonda Patrick Jason Fang others who are really looking hard at this space and pushing to
Redefine what is what is normal and what is optimal and especially in a world where or specifically in the United States where 88 percent of American adults are metabolically unhealthy 35 Insanity. It's hard to imagine but 35 percent are either diabetic or pre-diabetic, you know, we have 70 percent obesity or overweight in this country and rates of childhood. Obesity are on the rise, non-alcoholic fatty liver disease. It's like all of these terrifying statistics and
then you go and you look at how the sort of normal ranges are developed for blood sugar control and it's basically an average of people who don't yet have diabetes. That's kind of how these ranges have been developed and you realize that's not what I want to talk. I don't want to be in the normal range. I want to be in the optimal range where every day I'm making choices that are improving my long-term Health outcomes. Not just you know fitting somewhere in this the middle of this metabolically unhealthy data set so, you know at our current company
Levels, we're currently taking a really hard look at the research that does exist. And unfortunately, you know, the non-diabetic blood sugar space is unstudied essentially not just understudied. There are very very few, you know trials that were done with continuous glucose monitoring in people without diabetes. However, what does exist there shows that for the lowest risk, so basically the bottom quartile of risk for long-term chronic illness people maintain glucose levels between 70 and a hundred and ten or a hundred.
And 20 milligrams per deciliter for 95% or 99% of the day. And so that's where I really like to aim. I actually personally try to keep my blood sugar below a hundred or a hundred and ten including meals 24/7 and my average. I shoot to keep at between say 85 and 95 milligrams per deciliter. And you know, these are much tighter than the American Diabetes Association normal ranges, and certainly it remains to be seen as we continue to improve both the
The population who is using this so in expanding accessibility and increasing the data set that all these information is derived from we're going to get much better high resolution information on outcomes as a result of like where people are staying in what ranges they're staying in and so I think this is a space of study
you like to stay under 110 after a meal like an hour after a meal.
Yeah full time. I have to keep my CGM data always wonder 110
are yeah. I'm just eating steak like like I do.
You forget like no carbs.
Like what are we talking about here? So, you know, it's I actually do eat a fair number of cards. A lot of it comes in the form of nuts and seeds. So I like cashews and almonds and a lot of almond butter and I also eat very high fiber carbs. So I have this kind of daily. It's almost like a cold cereal type thing. But it's like Greek yogurt week brand flax seeds. Chia seeds protein powder. I like mix this all up and it's really kind of a delicious treat up there blueberries in there, which I have a very positive response to it.
I don't kind of like off the charts and I think that's it's low glycemic fruit with high fiber that just works for me. So I found the foods that I can kind of indulgent and get 80 to 120 grams of carbs a day out of without this just large sort of blood sugar Excursion result. So, you know, this is kind of for me. I it took me some time to find this combination of foods that really works well, but I certainly do not eat like a carnivore and actually don't even eat ketogenic. I have a pretty mixed diet All Things Considered and
and Casey means actually Casey means it is my co-founder at levels and she's a Stanford trained surgeon and then she turned to functional medicine and she's 100% plant-based and fascinatingly despite having a diet that is largely vegetables and largely carbohydrate base. She has some of the best glycemic control, you know of the entire data set that I've seen and so her blood sugar typically stays below a hundred including post-meal and you know, this is like with beans and with you know, a lot of a lot of vegetables at some of which are starchy and
Tons of carbohydrate and so it's really fascinating and certainly there is an individual element, but the beauty of it is with that data. You can find what works for you and just cling to it and you'll actually see so I've seen Improvement in my insulin sensitivity. So the way that I respond to it even a car be your meal that I don't typically indulge in is much better now as a result of kind of retraining my body and probably lowering my insulin background levels
So when you say retraining your body, you know, I obviously diet is a piece of this so I think we've got one big
Takeaway for people at home and that you should figure out whether it be through spot checking or a CGM like what foods are offenders for you and what kind of keeps you in a healthy range. So that's the food component of it. Now when you're talking about what are the things that you can do for your body in terms of exercise, you know Atia talks about Zone to cardio Fitness, like what are your thoughts on on ways to kind of sensitize the muscles and get them so they're doing some lifting as
well.
That's a huge one. I think that given the way that muscle can so muscle is a specific type of tissue in the body that can actually use glucose even without insulin. And so however, it can only do that in a low insulin environment and so specifically adding more muscle to your body will improve the amount of tissue that can consume glucose without having to increase amount the amount of insulin. So it's definitely something I would encourage adding some strength training and building some muscle but then also
Pleading your glycogen using the blood sugar stores that are both on your body. And in your bloodstream is a really big one and then exercising in proximity to meals. This is like if there's any take home, this is the one I would I would advise is I've personally seen with my CGM data taking a walk after a meal especially an indulgent meal with a lot of carbohydrates can completely change the blood sugar response that you'll see or the blood sugar Excursion that you'll see
what I wanted to I could click like dive into that a little bit. I'm curious because I've heard mixed things on this and that
at some people say it has to be a pretty intense walk of the people say just you know, a stroll around the block, you know, you have Tim Ferriss has the world that we're doing this a long time ago that we're doing air squats in the bathroom in between between the courses and of meal like we're do you have to be what is your heart rate have to get up to like, what's your take on that?
Yeah. Well, that's a that's a really good question. I personally actually see the best results from a brisk walk now not we're not.
He's walking or anything, but my heart rate when I'm moving at a comfortable Pace walking will be around a hundred or a hundred and five beats per minute. And and so I'll if I eat a meal that I know is like pretty rich re actually this is now just a habit. I like to walk after every meal. I'll do a 15 to 20 minute walk at a Brisk pace. And again, nothing strenuous. I'm not breaking a sweat but the fact that we're using the largest muscles in our body during that time when that when the carbohydrates be beaten are breaking down into glucose and flooding into the bloodstream your muscles can pull those
Directly in as opposed to waiting for the insulin signal to store that glucose as either glycogen or fat depending on how how much energy or how much storage capacity you have in glycogen. So for people especially people who want to avoid weight gain, this is a really easy and honestly a really nice Habit to implement, you know, because we can all serve to we can all benefit from walking a bit more and just getting up and doing it right after meal and seeing in the data how positive that changes versus eating the exact same meal without a walk. It's really powerful.
People and so I actually see yeah, I see great results without having to go too strenuous and I think nobody should really worry too much about having to do air squats or push-ups or anything in between meals that doesn't seem super practical. So I would just encourage generally try and get up and walk and as quickly as possible after a big meal and you'll feel you'll feel really good walk to and from restaurants you
doing 15 20 minutes 30 minutes. Like what do you what's the
recommended 16 to 15 to 20 is kind of the sweet spot for me. Obviously the longer the better, you know, I think in general like
if you can do 30 or 40 minutes and feel feel happy about it, you know, by all means I would encourage it it definitely, you know, I've seen dramatic Improvement in post-meal response, especially on those nights that you want to kind of indulge a little bit
more and what about sauna usage because I do that post dinner sometimes, you know, it's not getting your money. Well, I mean your heart rate does go up so I can get my heart rate up to about 115 to or so. Yeah for if I do a 20-minute
Hundred and eighty-five degrees sauna. Wow, do you think there's benefits there as well?
I believe there are I'm not a super expert on the sauna stuff, but I personally might Family actually install this on a recently at our family home. And so when I go back I definitely use that often and I've seen some interesting results in the in blood sugar data often times. It will might my glucose to actually
increase a lot of that has to do with the the actual sensor heating
up exactly. Yeah, the the resistive sensor elements are likely being affected there. So I don't have really good data in terms of
has control on whether or not sauna is is actively disposing of glucose from the bloodstream or not. But you know, I could certainly see if your if your body is being stressed by the heat you could release cortisol and other stress hormones, which could be causing, you know, lower glucose disposal which you'll also see this effect. If you're doing high intensity exercise like above 90% of heart rate. A lot of people see actually a flooding of the bloodstream with glucose as your body tries to respond to this sort of fight or flight scenario and
And just give you as much energy as possible. So there's this kind of this threshold effect and for me and so on. I haven't yet seen like a glucose disposal effect, but for others, they have described this. It's really interesting that the difference is there too.
Yeah. I have to I haven't looked at that I have to do a pizza night in the give this a funeral. Yeah. Definitely have a cheat day.
Yeah. No, it's um, well these types of things are so fascinating because that finding the hacks and learning about like the first of all understanding exactly we touched on the glycemic index a while back.
But just seeing whether or not there's any real sort of content there for the individual. I think it's really educational a lot of people lean. So heavily on the glycemic index and then you test brown rice versus white rice and you realize this is exactly the same and the result of that for many people. It's just the glycemic index is an average and it's normalized to 100 against against pure glucose. And so everyone's Peak response to a food is forced into into like this normalized rating scale against pure.
Which removes all the individual out individuality and so it's perfectly possible for one person to have a blood sugar response of let's say a hundred and ten milligrams per deciliter to brown rice and then another person to have a blood sugar response of 250 milligrams per deciliter to brown rice. And as long as they also responded proportionally to glucose, that's the they consider it they like force it to its kind of described a like force it down into normalization to on a scale of 100. And so all of that Nuance is lost and when we look at just the glycemic index we're looking at income.
Pleat information and it restricts out the personalization. So having the data so that you can understand like is eating brown rice after every workout in order to quote-unquote replenish glycogen the best move for me or am I completely overdoing it spending two hours in the pre-diabetic blood sugar range then having an insulin crash and then feeling sluggish and wanting more food and go into the ice cream cabinet, you know, or whatever and and this is the type of thing that we're all happy that's happening too many people in the background and they have no context for it. They don't understand because they don't have the closed loop feedback. So it's just so powerful to be able to see this stuff happening.
Real time. Yeah, absolutely. What are your thoughts on unsleep? I noticed that for me if I get less than say seven hours or just a bad night's sleep. You know, you have a couple glasses of wine and you're tossing and turning a little bit and hot at night. Yeah, I wake up and I would say 10 to 15 points higher sometimes on my glucose depending on on my sleep. It's I do you see sleeping a big big factor here as well.
I see the exact same thing and I'm actually embarrassingly I'm currently cruising about 15 to 20 percent higher on my Baseline blood sugar today. I took a red-eye yesterday and didn't get much sleep. And and so I'm playing catch up on my sleep in my glucose response the same exact way. I will see this this basically my Baseline blood sugar without any calories is increased and then also it seems like I have this acute insulin resistance where any food that I eat that has some carbohydrates in it. My response will be much worse for the for honestly for up.
Like several days until I'm able to restore that sleep debt. And so sleep hygiene. I think is huge. Everyone can see the difference in their data for the most part between a five-hour night of sleep and a nine-hour night asleep. Yeah, and and like, you know, we're working with people like the folks over at eight sleep who pulled really good sleep data combining that with blood sugar data and you know, there's a really interesting pilot potential here for us to demonstrate exactly how metabolic control is affected by Sleep control and vice versa. You know, these are essentially inextricably linked,
you know, I've seen those
date sleep mattresses, right? They do I've yet to try one. Do you have you checked out that you'd think it's pretty high fidelity
data. I think it's really good data and most interesting. It's the movement because it's underneath the body the full body and also because it step it has temperature data to which is really fascinating and something that's kind of missed by most of the Sleep wearables low or a does a really drop point temperature as well. But it's really cool. I think to have that high resolution data to show specifically how your body temperature is responding and
For the most part the most interesting thing to me is how much alcohol is involved here. I think a lot of people kind of, you know think that as a nightcap you having a glass of wine or a beer before bed is going to help them sleep and then when you see the data, especially from people like eight sleep who can show it in such high resolution that no, in fact, that's like raising your body temperature by 123 degrees all through the night and you're tossing and turning and you spend much less time in deep Sleep. It is really fascinating and then there's also the Metabolic Effect of having of alcohol consumption, which
Counter-intuitively for most people actually reduces blood sugar and I think there's a lot of hormonal response there. Where as your blood sugar reduces hormones are released that increase hunger and reduce the Tidy and so people will often when having drinks not only is their sleep effective but also their feeling about an increased appetite for carbohydrates and Indulgence and how many times have people had drinks one night slept terribly woken up with acute insulin resistance gone to a big crunch because they're really hungry. We all judge and you know now the effects are like
Twice or three times worse than they had to be?
Yeah. Absolutely. I mean you're describing a lot of branches for me. Is that is that reason exactly right a curious on on your kind of it? Sounds like we've already got a couple of really great hacks for people looking to get back on track. One thing I had heard about I think I saw a study on it, but I don't know where it's at never read. The study was around the order in which you eat your proteins versus starches. Is that is that just make
leave is there any is a real data there? I'd never look to the study.
They're you know, they're certainly appears to be and so the way the study was conducted as people. They took the study participants and they gave him the exact same meal in different order. So you imagine like there were vegetables protein and fats all in this mixed this mixed macronutrient meal. And so they gave the study participants. I think they started off with, you know, eating the carbohydrates first and then and then eating the protein and then the vegetables and then they switch the order in
Vegetables with fiber furnace and the protein fat and then the carbohydrates last and fascinatingly. There was a huge effect in both blood sugar response and also insulin response which to me was the most interesting thing was that insulins affected by this kid in that you're eating the same number of carbohydrates. So I'm actually looking at the study results right now and the insulin effect was let's see the peak post parade was 1100 P mole per liter with the carbs first and with vegetables first. It was 500 so it
Basically reduced the insulin response by over one-half by just putting the same meal in a different order and glucose response was was improved by about it. Looks like about 25% and so like that's the amazing thing there is likely in effect from digestion. So when you have the fiber upfront it might have kind of a mechanical effect where it like limits the rate that because there's a bunch of fiber in there. It might limit the rate that the sugar breaks down and gets into the bloodstream fat seems to have a
Their effect on constricting the digestive Pathways and and slowing things slowing things down. So taking a blood sugar Spike come turning it into a slow steady increase and I think that's what's going on there. I'm not an expert but I certainly have internalized that study and I always push to put the fiber and vegetables up front in an indulgent yells. Hmm. Yeah, it's really cool that there's data to back it up. It's one of the things that I'm really eager to do some more research on
do you have to do that? Let's say let's take a plate a dinner veggie.
Cheese chicken no sugar. No dessert nothing like that. Does it really because those are low offenders generally write like you're just having like a vinaigrette or something olive oil dressing. Does it really matter at that point? Like are you going to see that big a difference if you if I do salad first or well, this
is a I think we're having the individual data is super powerful because you can kind of make that choice on the Fly, you know, and for and for many meals like the one you just described it's unlikely to have a big individual variation because there's there's
Much, you know sort of rapid-acting carbohydrate in that meal, but for some people they might have a personal response and certainly for meals that you know, you have a strong personal blood sugar response to that's where you can kind of make these these decisions like yeah macronutrient order making sure that you have a nice big salad Advance the vinaigrette vinegars actually apple cider vinegar in particular is also shown to control blood sugar response and then maybe choosing to walk after that meal it specifically and so you can kind of make these context driven decisions because you know, okay.
I'm going to have brown rice tonight where I'm going to have sweet potato with my meal or I'm going to have pasta and I know how to respond to that and I'm going to make sure that I ordered my meal appropriately and also just be a little active afterwards and its really strong habit forming, you know, sir driver when you see that data and you both get that negative reinforcement when you choose not to do these little tweaks and then the positive reinforcement when you do and you see much better scores and data, you know coming from your own body, right? It's like it's your body telling you great work, you know, you did. It's like it's not like a coach or somebody else.
And it's just you and and yourself, you know, it's like a closed loop between you and your body. So I think it's very context-specific and you need to understand and explore before you can start to make those data-driven choices.
And then what about rate of consumption chewing if you see anything there
I don't have any personal Insight on yet. It's something I should probably consider. Now one thing that I do know is this is kind of similar, but let's say juice versus hold fruit, so
So you can kind of assume that like a juice or a smoothie is similar to taking a whole fruit and like chewing it up in advance. Let's just think of it that way. So you've already processed you broken the food the fruit down and then or vegetables down and then you're kind of just drinking them directly rather than having to do all that chewing and so the effect of a whole a whole Fruit versus a smoothie or in particular oppressed use where you've you've squeezed all of the liquid out and strip the fiber away. It's pretty profound. Actually one of the largest blood sugar spikes I ever had was
Is I went to a organic juice cart in New York and strolling up there looking for something tasty and nutritious because I just taken a flight and I picked a drink called health drink, which was Apple celery and carrot and I watch the the lady prepare it and she just like, you know pulled the fruit and vegetables and press them. There was no additives at all. And I drank this is a 16 ounce drink feeling pretty good about myself. My blood sugar was over 200 milligrams
perhaps I was worried about an hour that is
insane. It's wild and
and I mean I can eat an apple and I can eat carrots and I can eat celery at like carrots and celery like don't even move my glucose for the most part and apple will but I won't exceed a hundred ten most likely for a green apple. And so seeing like by stripping out that fiber and just you know condensing this into a glass and chugging it effectively. I had just given myself a straight-up pre-diabetic episode for no reason actually assuming that it was healthier. It was a good choice for me and I think people are doing this all the time unnecessarily and it's
fascinating it is
Depressing, you know, it's funny Josh like my wife writes about food and she did an article one time talking about it. I don't I don't think it was the main piece of the article but there was definitely a big section. They're talking about the dangers of just straight juicing and ripping out all the fiber and you know what it can do to the body and like dozens. If not more of pro juicers got on there and just they are hardcore. I had no idea the pro juicers will like tear you up like that.
They are like they really bought into this idea of that juicing is the ultimate healthy food. And in reality. I mean, I'm the same as you you take anyone throw on a CGM and I would I would say nine times out of 10. You're going to see spikes that are not healthy in any way now, I'm not saying the underlying ingredients and nutrients are bad because of course that's not the case. Right but the sugar and the delivery in the mechanism the fact that it has been all predigested in a way it just
It's not good for you. It's crazy. And you know, I actually have a pretty good hack for this. I will occasionally make a smoothie and kind of like what you mentioned with the Greek yogurt with your your blueberries. And you know, I will take some fruits that I wouldn't normally that I know have been bigger offenders for me and great example is you know, we get this when oranges are in season we'll get some like local. He's like fresh squeezed orange juice and I'll put a quarter cup in a smoothie and I won't see any movement at all. If I were to check that quarter cup straight up without the
Extra fat I would I would be like back in the bad zone. So I still get all of the flavor and some of the vitamin C and some of the great nutrients from the orange but I make sure to pair it properly or well one of two things one. You can probably just eat it orange, which would be much better. Right and it is it is a slower delivery mechanism as well. Right? Because you're not just chugging it. But when I do throw it with that fat, I don't see so it's not to say you can't have these juices. It's just that you got to figure out the delivery mechanism and sometimes throwing in a bunch of fat as I can.
A binder with it. I don't know this right word. But you know what I'm saying like a buffer. Yeah a buffer, right? Exactly. Yeah, that could help
I totally agree. No, it's all context and you know portion control is something that that really does matter. It's not we're not making the argument of calories here. We're not saying like don't overeat we're saying the context and the way that your body has to respond to a rate of increase of your blood sugar is is very specific and very real, you know, it's not this is not a weight gain balance due to calories. It's a it's a question of
Whether you know if some is good is more better always and I don't think that's actually true. You know, it's not if an orange is good. Should we strip out all the pulps that we can pack ten oranges into a glass and Chuck it probably not, you know, there's always limitations and we should find a signal, you know, and I think this is where the people who are really hardcore about any dietary philosophy or missing the boat is that you know, it's perfectly possible that the dietary philosophy that you subscribe to can be consumed in a data-driven way using objective data to optimize
It's not necessarily that no one should ever drink pressed juice, but I would think that someone who really believes in the nutritional qualities of fruits and vegetables should just strive to have meaningful advice for how people can consume them in a way that is going to work for them and reduce their risk while also getting those nutrients and that might be portion control. It might be different ingredients might be timing, you know, only having them right before or right after exercise or what have you but there are certainly, you know limitations to the idea that just drinking press vegetables.
Is always better for you than Alternatives like hole for the other fruits and vegetables. Yes.
I'm curious real quick on the supplemental side, you know, there's there's cinnamon. There's a whole slew of different things that have been reported to help. You know, I don't even know like you always see these on the side of labels like maintain healthy glucose levels. Like what does that even mean? Right. It's like you see that as like a claim on some of these things. What's crap? What works is there anything out there that people can take along with a meal or
No, there's there's crazy drugs like ARCA bows and those are prescription drugs that will bind the glucose and I don't worry about that stuff. I've tried that once and I got to tell you it's kind of amazing. Like I did I ate a whole. Oh my God. I took an arc of us and talk to your doctor any type of medical advice. This is a biohacking like prescribed substance and I took one and I had a pizza afterwards and my glucose didn't spike it
all it was crazy. That's
why but just by
Ends up. I've heard it can cause gim said I was lucky I didn't have that for me. But I'm curious what out there on the supplemental side of you seen any solid data around. Yeah.
This is a really really interesting one and there are a couple like you mentioned cinnamon. We talked about vinegar. There's Berber in which is a I think it's a naturally dry plant product that is has also been studying research environment and these Mega transference. I have a glucose control supplement that includes Berber in that I have, you know, ultimately I have not seen any benefit.
I've taken it a few times. Actually. I took a quite consistently for a few weeks and didn't see any change in both my postprandial like post-meal response for my averages. So having that data, you know, I just feel I'm generally skeptical about supplements overall. Like I don't I don't think it kind of goes to the Press juice example where you have all these multi vitamins supplements where it's like a thousand times your daily value of you know, this or that and I know, you know just probably isn't delivering you a thousand times the Improvement and it might not even be leaving be delivering single-digit Improvement and might have all these side effects.
So I kind of tend not to take them and now the exceptions are vinegar for me. I have I've seen a really amazing difference when I either have like a shot of apple cider vinegar in the morning or add like a vinaigrette to to foods and so I make a lot of sauces in a lot of dressings with vinegar and use them pretty prolifically throughout my my
nutrition. It's the mechanism there. Do we have any sense of what's going
on? I honestly I really do not know what's going on there. I have got to dig into this one. That's been I've been meaning to you sir.
Times there are studies that show this effect specifically with apple cider vinegar and the mechanisms themselves. I'm are unclear to me right now. So unfortunate, I don't have a good answer but I do know that anecdotally and for several other people who on the team we've seen the same effect. So some people actually will preload for similar to how you use a carbo's for the pizza. They'll preload for an indulgent meal bike shooting apple cider vinegar and it seems to have an effect. You know, it's pretty pretty fascinating.
I would love to be a fly on the wall at your office.
Us and what all the facts that are happening, you know, I one thing I will say in this episode that I really appreciated you telling me off before we started hitting record. As you said, I don't want this to be a commercial for my company and that's always appreciate because you never know like when you have guests on you know, it's like, oh is Kevin have them on the show? Because they paid them none of this is the this is page because going to have a conversation about glucose control, but I do want to get into your company because I think you are providing a really valuable service at the
Time awesome tell me about
levels. Yeah, so levels is it is the metabolic Fitness company and we're using continuous glucose monitoring. Well, ultimately real-time access to one's own biological information to help people make better choices to set themselves up for a long lives with metabolic control and specifically that means that right now we're building a metabolic fitness program where you can get access to continuous glucose monitors a prescription consultation with a licensed physician and then the level software which takes this raw data stream allows you to
to log your lifestyle. So your diet exercise sleep and stress and then receive scores that help you make better choices instead of just having this, you know, sort of milligrams per deciliter unit coming at you and having to do all the research on your own. So we surface insights and help you make better choices.
And so it's interesting because you're dealing a bunch of well, we should tell people it's levels health.com to check out the thing that and I have used it. I went through your program. There's a few things. I really like about it one. You don't have to talk to you.
Care physician to get a CGM. So you guys take care of that you get a CGM the second piece. I like is that it's kind of something you do what like once a year so you wear it for a month and then you're done for the year or like how do you think of this? How does this fit into people's
lifestyle? Well, we kind of meet people where they are. So the goal is not to you know, it's twofold one. We don't push any specific dietary philosophy. We touched on this earlier. It's just whatever your choices are. Would however you choose to eat do so grounded in your own data. And then also we
Don't drive a specific monitoring Cadence like we recommend that you do a month. Learn a ton about how you're responding Sora where you are and set a trajectory for how to make better choices for for the future and then check in regularly, you know, so we in some cases it makes sense to do this quarterly and some cases people like to do it for once a year in other cases, you know, something like 10 or 15 percent of people that use our program. They just do it continuously because it's almost like giving up your cell phone when you have the data. It's like I can't ever not have this this is so it like holds me accountable.
Helps me understand contacts and just keeps me on track. And so it's really individualize. It depends on your goals and where you are and where you're heading and we kind of make it flexible and easy for people to do whatever makes the most sense for them both financially and due to their metabolic concerns.
Yeah. I'm excited for you guys because people should know that this is not an expensive program and that's partially because the devices themselves at this point when they're not covered by insurance, which they wouldn't be for this use case are expensive. Like I don't I don't use you guys I used to
for the one month to try it a lot but like because I have you know, obviously Atiya and his team and they're looking at my data. So I I get a CGM through Dexcom and you know, it's not inexpensive. We're talking the kinds of dollars a month for this type of stuff. I would not continue to do it had I not had and continue to have issues where I want to pay attention of this stuff. You know, if I was a just a healthy person that had no issues. I like my wife she doesn't do it because she's like, well, I'm like she's
LinkedIn that I very jealous of her glucose response to swell and vegetables. Yes totally is but I'm curious like when someone signs up, okay. So let's walk me through what they actually get because you get to see GM you put it into your arm. It's on you have an IOS app or I don't know if you have Android to but you have IOS if you have an Android games and then you launch it you see your numbers, but then what do you do with your food and what how do you coach them do?
They interact with someone like how does that work? Yeah. So so
first on the price piece right now, you know, like I said, these are devices that were developed for the therapy and moderation or management of diabetes. And so right now they're quite costly but what we're seeing is strong indications that this is going to the device costs going to come down especially as you know companies like ourselves expand the market and allow supply and demand to do their thing. And so we expect that in the near term. We're gonna be able to get this down to below $100 a month and people will be able to really across the metabolic Health Spectrum.
Our goal is to get this into the mainstream and people that need it the most can have access to it and it's not a financial issue. So cheaper than a gym membership is where our goal is and then as the program rolls out so initially there's this e-commerce like order experience where you fill out a medical history form. We send that over to our partner Physician Network, they review and ensure that the product is right for you and specifically what that means is. We just want to make sure that you shouldn't see your primary care provider first, you know in the event of having diabetes. For example, we want to make sure that you're getting
Getting more intensive care and I think it's
interesting. I never thought about that. So you have people that will sign up for you. They have no clue that they have diabetes Well, yeah
where they do know, they have diabetes and they really want the levels program because it's so more so much more insightful than the standard cg+, right? And so no, we aren't yet ready, you know as as we're developing very rapidly. We want to make sure that the software is really nailed in their platform is kind of buttoned up before we start bringing on therapeutic use cases, so we're not currently with just general.
A wellness. We don't do diabetes management today. So after the physician consultation, which is quite quick and effortless the pharmacy delivers your levels kit and inside there are to see GM's and then we have these performance covers that go over the sensor and help keep it here at especially for active lifestyle and you use the level software. That's your lifestyle Hub. So logging for example, we're very focused on making this a minimal easy elegant experience. So we don't want people to have to enter way there.
A food and intro macronutrients and worry like, you know about ratios and again serving sizes. It's all about effortless and low overhead. And so you just snap a picture and enter a few words about what the food is and that's mostly just so that you can it's for your recall. So then a few hours later after the software has analyzed your blood sugar response to that meal you'll get a score and that's a it's a score out of 10 and that'll surface and you take a look at you know how that meal affected you and then also how any secondary
Choices you made affected you and so an example here would be about walk. So if you chose to have a meal and they get up and take a walk we use Integrations with apple health kit to sense your activity and then we'll surface that as well and show you that you know, for example, you can see comparisons between having a personal pizza and doing nothing and then having a personal pizza and having a walk shortly thereafter and you can see how the difference is in scoring affected you, you know, your metabolic control and then there's all those implications of weight gain and and, you know, just mood and fatigue and all the downstream issues if you have
A big blood sugar response that crash so you can you can put in context the scoring and how your body responded with how you felt and, you know the qualitative experience. So really making a lightweight easy to log interface joining it with real-time data and just surfacing real-time actionable insights.
It's beautiful to your website's beautiful the app looks great. Thank you very much awesome that you're doing this.
Yeah, and you know, then we also we're pushing more into sleep and exercise and stress, you know, helping people surface you
You're having a non exercise related blood sugar angry or sorry Nan meal related X blood sugar increase we can identify if that was exercised or we can Surface insights and and ask, you know, was this a stress-related thing where you may be in a call or a meeting or something that was very stressful. And so helping people connect actions to reactions is what we're all about close very tight feedback loops. A lot of the stuff is, you know, we're in various stages of internal testing versus product release and we're still in beta mode. So we release about 400 iterations of the app since
you are but there are some really exciting things coming down the pipeline with the specifically that incites framework and eventually we'll be able to provide proactive insights and recommend, you know, so this morning I got, you know yesterday when I got off the red-eye flight eventually levels will surface and say you didn't sleep at all last night. Typically your blood sugar is 20% higher and you respond negatively to these Foods may be in here more to these which tend to do better with after a short night of sleep. So this type of very proactive low cognitive load inside is going to really I think be a game changer.
Yeah.
This is this is without a doubt the future. Right like it's early days. And obviously it's going to take a while to accumulate enough data to where you'll be able to automatically have these insights but like, you know five years from now when these see GM's are going to be they're gonna be way less than $99, right? Yeah, and you'll have millions of data points and coupled with all the latest AI advances that we've seen in the last couple months alone. It's just gonna it's gonna be a beautiful thing of like, you know, push notification to my Apple.
Watch hey, we noticed you just had this particular meal like time to get up and go for your walk because you'll have this it predicted outcome. Like it's going to be fantastic.
Yeah, you know, it's it's a future where we can we can use data in our Wellness choices daily for the first time, you know, it's like it's very interesting like most people if you think about how you live your life, you have a lot of data and information you're using to make choices except for when it comes to your health and wellness. And so for the first time I think we'll be able to use Health Data more like we use financial data and in real time.
You pull out your phone see where you are. See the quote unquote deposits and withdrawals and like projections into the future. And and the implication here is you know, you can use an expert to help you guide guide your plan such that you not only are financially secure for retirement, you know some day in the future but also are going to be healthy and well to enjoy it, you know, that's that type of like large-scale Vision that we have to point people in the right direction very early so that they can plan for it and make those daily choices that support it. Yeah.
One thing we didn't cover that II feel like it's just
Just I can't believe I missed this. I would love to come back real quick and just talk about weight gain. Yeah, and and how glucose and Insulin impacts that so why do people put on weight when they have these big spikes? Well, the mechanism there is insulin.
So insulin is a it's an anabolic hormone meaning it is a it's a storage hormone. It tells your body to take what's available and store it. And so insulin is also the hormone that lets blood sugar or tell
To bring blood sugar into the cell and use it for energy and if the cell is basically at its energetic capacity. So let's say in a situation where you're sedentary and you have a lot of blood sugar or a lot of sugar in your blood insulin will release it will tell the cell. Hey, this glucose needs to come out of the bloodstream into the cell use it for energy. The cell does not have high energy needs because you're stationary you're not using your energy and so the the insulin then tells the body to start producing fat and storing it. So they'll turn glucose into triglycerides and store that in the adipose tissue on the
Body, and so this is again. This is the kind of a dose-dependent situation. So if you have a little insulin, this is happening at a small scale. If you have a lot of insulin and a lot of sugar this is happening at a large scale. And so the insulin environment and is influenced by the glucose environment. So a little glucose increase will produce a little bit of insulin for most people a large glucose increase a large response. So it's really important if you're trying to maintain a low insulin environment to allow your body to not store but actually burn your fat stores and your
Gents available. It's really important that you have insight into your blood sugar response that you can approximate your insulin response people. Like dr. Jason Funk who wrote the Obesity code really dig deep on this and it's really elegant picture of how the human body is not this clean machine with an input equals output, but actually the context of your decisions and the way that your body has to respond to them or monali is what's driving your weight balance energy balance, so it's really important and I think we're going to see some amazing impact. Actually. We've run a few trials internally called are wearable challenge.
Which is a partnership with Justin mayor's from perfect keto and Kettle and fire and we gave a bunch of people who are looking to lose a little weight. We gave them access to levels program. And then the goal was just stay inside this blood sugar range 24/7 for 28 days.
What was the range
it was actually the first one was just below a hundred and forty and the second cohort we drop that down to below a hundred twenty and the average weight lost with no dietary restrictions. We didn't say you have to
These Foods or eat the specific number of calories. It's just keep your glucose and range was about nine point eight pounds crazy. Yeah, the 28 30 days. You have 28. Wow.
So the basically what that means you would think like well, okay someone's watching their numbers in real time. So they're probably just they've made some mistakes in the past. So when they're having that lasagna, they're like, okay five less bytes will still keep me within the range or the so they're the kind of is that what they're
doing to some extent? Yeah. Yeah.
There was a variety of approaches. So some people went full keto some people did fasting some people ate the same diet that they were eating but just restricted portions and the net effect is just by lowering the blood sugar response. We're doing that secondary effect of lowering the insulin response and in many cases, especially if they're fasting or ketosis stepping in your body will go into a really low insulin environment and you'll start rapidly oxidizing body fat you have on and I think it's much easier to do that to to access ketosis.
If you are in a low insulin environment to begin with in a low glycemic environment, and this is what we call metabolic flexibility it swear by, you know, encouraging a hormonal environment where the body can easily switch between glucose oxidation of glucose like sugar burning or fat oxidation, which can come from your food or it can come from your body fat. That's that's the concept of metabolic flexibility. So I think we see a lot of that in these these challenges where people are removing the super high kicks to the system the glucose, you know spikes that are influencing a hormonal change and a
big insulin response and when they remove those the entire environment, you know sort of Smooths out and they can more easily switch to burning their body fat.
Gotcha. That makes sense. That's really cool. It's what a great little challenge. I hope you have more of those in the
app. Yeah, we're going to do a quite a bit in this space. I think, you know, I certainly believe the implications for weight loss are tremendous. That's
great. Excellent. Well, how long is the wait if people do want to sign up and become a member because I know you did have a kind of a little bit of a way to get in. Is that
right? Yeah. So right now we have
We are currently doing an invitation-only beta still and we're increasing the volumes there. And and so that that is very much a development process. We're reaching the point where we're really seeing the behavior change and the resonance with the product that we're looking for in order to go to our to our full launch. And so right now join the website on join the wait list on the website. I'd also like to get you a code, you know, if you'd like to share with your listeners so that they can you sign up and pre-order today if they
Like to go that sounds
great. Yeah. So let's do that. I'll get you a code and we can share that and people can get into the Early Access beta program.
Yeah, I'll put that in the show notes for people that are listening over it podcast Kevin rose.com. So people can find it there. Okay, great. Yeah, and we should also mention that I've always liked to do this. There's no affiliation. You guys aren't paying me for this. I can see we I just did I think it's an important topic to talk about and I'm excited to get more people on a healthy path. So that's good.
Yeah. So anyone that would like to contribute
Development process and we'll get you that link. It's going to likely be be in the show notes and and you can participate in what we're building here and help us, you know, sort of guide product features as we as we move towards full launch, which will likely be towards the holiday time.
That's awesome. Will Josh thanks for being on the show. Is there anything else that you want to mention or that we're leaving out? I feel like this was has been a great overview of all things glucose.
Yeah. This has been awesome. I really appreciate like keeping it tactical and helping sort of surface the insights. That's ultimately what the company is. All about is is making metabolic well,
Reversing the trends of metabolic dysfunction in this country and abroad and we just want people to understand that this is in your control and and metabolic Fitness is focused effort and repetition to improve your metabolic health and it's not a binary situation. You may put on a device for the first time and be a little bit uncomfortable with what you see but you have full, you know, sort of autonomy to make the changes that that improve that well into the future. So we love to share this information. I highly recommend anyone checking out our blog at levels health.com /blog. We publish a ton of
Research and just kind of bringing that research down to the approachable level where you can see how it affects you in your daily life. So and please do this high back on that.
I've read some of those articles they're fantastic and I think that the other thing to just reiterate at the very end of this is that a lot of people when they see my CGM over the years they've said well, why do you care so much about glucose like and I think that it's easy just to think. Oh, it's just people that care about diabetes but in reality, you know, obesity so many different
Types of cancers linked to that outside of diabetes, you know cognitive health and Alzheimer xand, like there's just so many different processes that hang there are connected here that are much more serious than just, you know, someone that is has basic diabetes, you know, like you want to do have we listed them all off or what? Do you be your main ones there that people should be should know about well,
you know to kind of start off like the the implications of metabolic controller are kind of thing.
Very all the way from just the daily quality of life, you know, like you had mentioned the cognitive, you know, overload the fatigue levels that I was experiencing due to just this roller coaster ride of blood sugar and Insulin crashes. I was I was on and then yeah, there are these chronic lifestyle in this is like pre Diabetes Type 2 diabetes Alzheimer's was being called type 3 diabetes today stroke cardiovascular disease sexual health is one of the first implicate comorbidities of metabolic dysfunction mood disorders.
PCOS which is the number one cause of infertility in women today in the United States and then all the way down to like skin glycation, which causes wrinkles and acne. You know, this is also been proven in research to be connected to glucose dysregulation. And so, you know add into the mix weight gain and and then just you know, sort of the entire picture comes clear that this is something that you it's not for sick people. It's actually for anyone who wants to pursue Health each day and make better choices influence by their own knowledge of their
And so that's what levels is really really doing is changing this stigma where you should only concern yourself with blood sugar if you're already sick, right? It's actually quite the opposite. You should concern yourself with blood sugar so you don't become sick and I'll and also so you can optimize your performance, you know, it's being used by athletes right now to improve fueling choices before they go out and try to break records. So yeah, it's we're all using metabolism every day and it's certainly a tool that will be used well into the future as people look to improve and optimize.
It rather than just wait until it's broken. Yeah. Well
the last question I promise I just keep coming up with them as I'm so pleased to be on so we can we can talk about this as I don't have anyone to bounce these ideas off of during covid. So I have noticed that for me, you know, you mentioned that range, you know going into the 70s if you can get there, you know, and that's often times for me. And I don't know if I'm going to get there in any given day. I might be in the 80s somewhere obviously, but but not not 70s is a little bit harder one of the things.
Have noticed without a doubt that gets me back to really healthy levels is when I fast if I can do a 18 hour fast, I'm almost certainly in the 70s by the end of the ATR fast. Have you noticed fasting to be a great kind of way to rebalance and get back down to two decent levels.
Absolutely. Yeah. It's fasting I think is an amazing mechanism because without the external pressure of external food and macronutrients.
You're throwing your body and removing that digestion and also what those break down into glucose cetera your body can start to clear out the insulin levels, you know that so the high insulin background you might be experiencing and then start to access your stored glycogen. So that's your stored sugar. It'll it'll consume that and then it will switch over into ketosis and start using your adipose tissue. That's your fat tissue on your body and that process of reducing the insulin environment and then reducing the fuel storage.
Levels in your body even without you know, it's not like you have to go be super active while you're fasting. It's just this is going to happen. Even if you're stationary about 18 hours of fasting will put most people into fasted ketosis. So I think this is, you know, certainly something that people should ramp into, you know, don't try and go and do a 72-hour fast if you've never done it before it so no leap
brutal and potentially dangerous to you know, people are always good. I always tell people if they could I get a lot of fast and questions obviously with starting 0 and a lot of people will say like, how do I get started?
- I did this crazy fast and I know know if you're going to do anything outside of like, you know, a 13 to 16 hour fast like baby steps. Number one and number two talk to your physician to make sure you don't have any underlying health conditions that would prevent you from doing something like this because it can it can be
dangerous totally. Yeah. It's um, and you know that also points another point, you know talking about like getting as low as possible the glucose down to the 70s. I think that overall we want to reduce our area under the curve so our exposure to hide because levels but there is actually a
Found where it's not that it's not favorable to get lower in this is this is all the way back to the Press juice conversation where like, you know, if lower is better than the lowest must be the best. Well, that's all right. So
that logos levels that is not fun.
Right? You know we've also so I like to do I'm doing more endurance training and so bonking is the is the point where you run completely out of sugar, you know, if you're in a glucose oxidation state and you just hit a wall and your energy drops out from under you and for you know, that's like not actually the dangerous.
Ation, the dangerous scenario is when you know for someone who has diabetes, for example, having a blood sugar get critically low can lead to seizure and ultimately death. And so your body needs glucose. We have to have it. Now. The interesting thing is that your liver can produce the amount of glucose you need even when you're fasting so you'll see this especially with CGM data as you fast. It's not like your blood sugar continuously ramps down down down lower and lower to towards zero. It's actually going to ramp down and it's going to sort of pass it towed towards this level where your liver is producing it from
Your fat stores
you protein and just keeping you sort of rock solid and flat all day long and it's really beautiful to actually see that that system is well controlled and you don't need to rely on dietary sources for for blood sugar. But again, like it won't be near zero and no one should ever strive to get towards
Zero. Have you ever seen an issue where I've run in this to few times? And were you it's mostly those brunch days where you kind of like go over the top you do something car because you had, you know, some drinks or whatever you spiked up again and
Then your body releases so much insulin that you actually drop into a low-level. Yeah. It's like the worst feeling
ever worst. Yeah. It's like your stomach is dropping. I get a little cold sweat I get shaky O'Shea actually. Yeah, this is exactly what I was experiencing when I was describing like my fatigue level. So I was having these roller coasters are like super high elevations after these big carbonyls and then my body would just flooded my system with insulin and I would experience that that reactive hypoglycemic event. Where am I my blood sugar? We're just plummet suddenly and I would feel just
This intense like just shaking his fatigue. I have to sit down and I would be desperate to grab either another coffee or more food. You know, it's more food anything
you can do to get it back up.
Yeah, exactly. And once you see the dates like, oh I can just completely cut this out by just avoiding that thing that caused the
whole roller coaster in the first place, right?
Yeah. And so once you maintain those low control glucose levels, we can data-driven diet decisions. You'll notice just a total absence of that reactive hypoglycemia just for me in particular does not happen without the the big spikes.
Yeah.
Yeah same now that I've really started to keep it within a tighter window. It's it's I don't ever get those unless I go crazy and then I know why you know see
exactly yeah, at least you know, you have the
data exactly. Well Josh. Thank you so much for being on the show. This is so much great information will get a lot of detailed show notes on the website and that codes that people what does that allow them to just jump the line and kind of be next on the beta.
Yeah, you sign up for the for the beta. Yep. And you know, we have we're moving as quick as we can on delivering beta I think the delivery dates right now will be
Late September early October, but we'll get you into that Early Access program. You can help us develop the product. Awesome.
Well, thanks Josh. Thanks for being
on Kevin. Thank you so much. This is really exciting. And I'm glad to be able to be on the show.
All right that is it for this episode. If you enjoyed it head on over to podcast Kevin rose.com. You get all the show notes. They're all the links to things that we talked about. And then also you can sign up for my newsletter comes out every four to six weeks. I think you'll enjoy it. Thanks so much be well.
