20 Minutes About Metabolic Fitness – 20 Minute Fitness Episode #198
Episode introduction
Will that personal pizza make or break you? Maybe not within a single day. But over time, those small dietary choices add up. In America, it’s resulted in an epidemic of unprecedented proportions. Josh Clemente, Co-Founder of metabolic health company Levels, believes that everyone can improve their fitness and optimize their performance through improved lifestyle choices. Josh joined Martin Kessler on the 20 Minute Fitness podcast by Shape to explain how metabolism works and the role of diet and exercise in building metabolic fitness. Josh also shares easy adaptations to make to your lifestyle to reduce illness, while still enjoying all of life’s indulgences.
Show Notes
Key Takeaways
2:32 – Sugar is vital for energy but too much and there will be consequences
The body metabolizes sugar and other food into energy for our cells to power physical and mental activity. But consuming too much glucose disturbs the delicate hormonal balance.
“Glucose itself, it’s sugar essentially. And this is a molecule that is the primary energy molecule in the human body. So that metabolism functionality that we talked about is driven primarily off of glucose, sugar, and fat. And so when you’re consuming sugar, it releases into the bloodstream. This is actually just typically happening with carbohydrates as well. They break down into sugars that enter the bloodstream. And so this triggers a cascade of hormonal processes and those tell your body how to appropriate that glucose into the cells for their use. This can drive things like weight gain. It can be for muscle expenditure, for energy that you’re using for mechanical loads. It can be used for cognitive function in the brain. But when those levels get too high, you actually have an inflammatory situation because glucose is a very reactive molecule. It produces what are called free radicals, inflammatory cytokines, TNF, alpha. These different molecules or byproducts of glucose reactions that actually are very inflammatory and can cause breakdown of tissues and skin glycation, which currently leads to browning of the skin and wrinkles and all of these sort of byproducts that ultimately are not good for us. And so there’s a fine balance and glucose is meant to be kept in tight control.”
5:41 – Metabolic fitness is vial for stabilizing energy and hunger pangs
The body needs a certain amount of energy to function. Metabolic fitness is providing the right amount of energy which can be used to fuel the body’s needs. Too much fuel in the form of sugar, and the body overreacts and comes crashing down.
“Metabolic fitness is what underlies physical fitness and mental fitness. Because energy is being used in all of the cells at all times, we need to have energy available. So it’s not the case that we want to minimize glucose levels, but we do need to provide the appropriate amount of the fuel molecules so that our bodies can turn them into energy in the appropriate way. And so it’s like you have a dynamic system where we’re this chemistry set. Where everything is run by chemicals that are released in response to other chemicals. And so if you sort of just dump in one chemical in large proportion, other chemicals have to be dumped in large proportion to accommodate that. And so this is the glucose coming into your bloodstream, causing a huge increase, and then insulin has to be released to flood the bloodstream to take care of that, to try and push it into the cells. And in many cases it overcompensates. And then you have hormones that tell you we’re actually going too low. Now all the sugar is out of our blood. We need more. And so that releases hunger hormones that cause you to feel this wave of hunger because of the overcompensation, you can start to feel tiredness because insulin is storing all that energy, you’ve now got low energy, start to feel that wave of fatigue. So it’s this dynamic system.”
Audiogram link: https://share.descript.com/view/ZztXV0fBDzo
Audiogram embed code: <iframe src=”https://share.descript.com/embed/ZztXV0fBDzo” width=”640″ height=”360″ frameborder=”0″ allowfullscreen></iframe>
7:32 – 28 days to metabolic fitness with Levels Health
The Levels program involves four weeks of wearing a CGM to understand how current choices are affecting metabolic fitness and then making small adaptations and improvements.
“So the program that we built is a 28-day experience where you receive 28 days worth of clinical grade continuous glucose sensors. So these sensors are worn on the arm. They have a little filament that measures electrochemically the amount of glucose in your skin, and that sensor has a life associated with it. So each one last 14 days. Wear two of these over the course of a month and throughout that you connect into the Levels ecosystems. This app scores and reports daily, weekly, and monthly reports that allow you to observe, interact with your glucose responses to specific choices and then optimize. So bring together all of the educational material that you’ve learned over the course of the month about yourself and how you respond to your own choices and shoot for metabolic trends and patterns that are optimal for your goals. And so that’s the way it plays out. We sort of break it down into four weeks where week one, you just observe, this is sort of like the baseline, see how you’re responding to the choices you already are making daily. And then in the second and third weeks we encourage some sort of exploration.”
Audiogram link: https://share.descript.com/view/niA4ZUM6m4E
Audiogram embed code: <iframe src=”https://share.descript.com/embed/niA4ZUM6m4E” width=”640″ height=”360″ frameborder=”0″ allowfullscreen></
iframe>
9:14 – Lifestyle choices can improve or ruin your health
The four areas in life that impact glucose levels are diet, exercise, sleep and stress. Monitoring how these affect blood sugar will lead to better choices and optimal metabolic fitness.
“Our program currently is oriented around the big ones, which are diet and exercise. So you can log those directly into the app. We have Apple Health integrations. We’re working on Google Fit so that we can import directly and passively your workouts into the ecosystem. And then longer term we’re working on some of the exciting stuff that has to do with stress and sleep, because these are very big or very large vectors of dysregulation for people. So stress is a very profound hammer on the system that people don’t really realize. A stressful meeting or a lack of sleep for example, can induce short-term insulin resistance that can really defeat your goals in the longer term. And so seeing how these choices, how your sleep data is affecting you, and starting to string together comparisons using our comparison features our zone scores to help people understand five hours of sleep versus nine hours. You’re gonna have a completely different day in terms of processing your dietary choices.”
10:21 – The tool for people who want to know themselves better
People want to optimize their physical and mental performance. Metabolic fitness is the key to unlocking potential, according to Josh. Levels is creating the technology so anyone can understand their body and optimize.
“Levels is for anyone who wants to know themselves better. So anyone who wants to understand their bodies and how their lifestyle is affecting them and their long-term goals, these are kind of the health seekers, the health optimizers long-term. Those are the early adopters, people who already as soon as they know about the product, they say I’ve been waiting for that. People are waiting for a way to really understand how their choices are affecting them immediately rather than days, weeks, months in the future. So we’re starting off in this kind of premium space where very similar to other hardware and software players. And you can think about Peloton or these other areas where you’re using a really elegant user experience plus hardware plus software, obviously the comparison with other wearables like WHOOP and Oura. And ultimately we’re going to be bringing this down into the mainstream and moving into a space where metabolic health is the thing people think about prior to thinking about achieving physical fitness or achieving mental fitness. You want people to start to realize that you’ve got to optimize the terrain that you’re standing on before you can start to build a solid structure. And that’s the way we want to think about metabolic fitness.”
12:08 – Building confidence with data
Everybody responds differently to foods based on genetics. The only way to know what works for an individual is to test and measure the data.
“there’s actually no one size fits all solution. And this may be genetic and maybe microbiome and maybe stress or body composition. All of these factors kind of come together to determine how you respond. Point is that if you’re going to go about making choices that you think are healthy, you need this data in order to be able to be confident. And that’s what we’re seeing primarily is people are realizing that the specific dietary choices I’m making can be optimized for me. They’re eliminating things that counterintuitively don’t work for them. They might have been doing things like, for example, eating oatmeal every morning because, Google, it’s typically top three on the healthy breakfast foods. And so people are doing this daily for decades in some cases, put on Levels and realize that’s causing a pre-diabetic blood sugar excursion for me. And ultimately two hours later, I’m crashing back down and feeling extremely low energy and that’s why I’m snacking. And so they remove that and shift to a meal that has maybe a more balanced macronutrient content.”
14:48 – Enjoy eating without ruining your health
With data on how the body responds, it is possible to make small alterations and still enjoy all of life’s indulgences.
“The advice we’ve always heard is eat healthier, workout more. And that’s just blank bland. It doesn’t really make any sense, not anchored to anything specific. But when you eat a meal, something that you enjoy, let’s just say it’s a personal pizza. You eat that meal and then you sit on the couch, you get this blood sugar response. That’s going to trigger all this inflammatory downstream cascade. Your body’s going to store a bunch of that as fat. You’re going to feel terrible. You’re going to be very tired shortly thereafter. Now the next day, go out and eat that same pizza and then go for a walk, just 20-30 minutes walk around the block. Look at the beautiful sights, come back and look at the score two hours later, and your body will completely modify its response to that meal. And that’s really profound for people who maybe don’t want to go the route of completely eliminating everything and living this sort of stoic lifestyle where they have no indulgences. They can now see that there are ways that you can make these micro optimizations that actually have very large effects. The 80/20 rule. Moving a bit more. It sounds like a legend or an old wives tale type thing, but reality is that it has a basis in data now.”
Audiogram link:
https://share.descript.com/view/Y7DgsxkcnXl
Audiogram embed code:
<iframe src=”https://share.descript.com/embed/Y7DgsxkcnXl” width=”640″ height=”360″ frameborder=”0″ allowfullscreen></iframe>
16:16 – We don’t want to strive for what’s normal
The traditional glycaemic index takes an average of individual responses. As data shows that each person responds differently to food, the best way to know what to eat is to monitor your blood glucose and adjust your own diet accordingly.
“The thing about the glycemic index is it takes all this diet diversity, this individuality, and it normalizes it to 100. So let’s say you and I, we eat a slice of bread. I go to 200 milligrams per deciliter, which for those who aren’t familiar, that would be a diabetic level response. I’ve tested this, I know that that’s where I go. And let’s say you go to 110, so you have a much better response. But the way that the glycemic index works is it normalizes both of those compared to glucose, which is a 100 out of 100. So for me, bread would be forced to a 100. And for you, it might be forced to an 84. And then they take the average of all of that. And that’s how they take the glycemic index. But you’ve now blended out all of the individuality….We don’t want to tell people to strive for normal. Normal, unfortunately in the United States, is metabolically dysfunctional. About 12% of US adults are metabolically healthy. And so that means that we need to not just shoot for what the population averages, but for the optimal direction. And so that personal sensation-driven way of feeling our way through diet has been what we’ve been doing forever. Eating our way through life and then looking back and saying, I felt okay or I kind of feel a little tired now that maybe I didn’t get enough sleep last night, or maybe it was my meal.”
19:08 – Starting to recognize reactions in real-time
Josh shares how real time data from a CGM showed how his symptoms of fatigue linked to diet choices.
“The whole background of this company is that I originally had extreme fatigue issues. So my day to day was extremely challenging. And I’m a CrossFit level two trainer. I was working at SpaceX at the time on life support systems. And I’m doing all this work in the world of human performance. And every day I can barely make it through my meetings. Two o’clock in the afternoon I’m literally desperate for a coffee in order to make it to the next one. And these waves of fatigue were so counterintuitive to me. I was not struggling with weight. I didn’t ever have an issue that was obvious to me from the outside. And yet when I ultimately got a continuous glucose monitor, which took me over a year by the way. When I did get one and I put it on just as an experiment, I saw that my blood sugar, I was riding this extreme wave of spikes and crashes all day, every day. My blood sugar would elevate into the pre-diabetic diabetics now because of a meal I’d eat and I would then crash back down. I would feel hungry. I’d feel shaky, I’d feel tired, irritable, and then I’d go and I’d be snacking for another meal. And it would do this all over again. And that realization completely changed my life.”
21:12 – Play the metabolic fitness game for better scores
Levels software gives scores after meals, rating food and exercise choices. These contribute to an overall metabolic fitness score for the day. The higher the scores, the greater the win for metabolic health.
“The key is we want people to understand how a specific choice you make affects you in the following hours as your body responds and metabolizes it. Then also that choices don’t happen in a vacuum. So they affect each other. So I gave that example of eating a pizza and lying on the couch versus going for a walk. So we’ve developed a scoring system which actually zonifies, basically groups choices that affect one another, or actions that affect one another and provides a score for the entire region of time. So that pizza with a nap afterwards versus the pizza with the walk. It will detect that you had exercise and also that meal and group those and score them together. And that way you can superimpose these choices against each other and see all the factors that are at play. So the zone score is really important to help you to understand specifically how groups of decisions can modify one another and you can string choices together to improve the patterns and trends. And then that goes up with our metabolic fitness score, which takes all of the zones throughout a day and provides you with more of an overall grade for how controlled your metabolism has been throughout that 24 hour period.”
24:31 – Diets need to be personal
There is no perfect diet, as everyone responds differently. Instead it’s about finding the best fit for each body.
“I think there’s probably an optimal diet for the individual. For example, Casey Means, one of my co-founders, she’s a medical doctor from Stanford. She’s all plant-based. So she eats a 100% plant-based diet, very, very high in carbohydrates, and she has some of the best metabolic fitness scores of the entire dataset. So not just on the team. And she achieves this through very focused honing of her diet. She uses that data daily to improve her choices when she’s always eating mixed meals and she’s staying very active. And so she’s going to eat a large carbohydrate meal, she’s also going to have tahini or avocado or beans or something that brings in that fat and that fiber and helps the body to maintain a very controlled, measured response. So I would say that right there is a prime example of someone who is eating almost exclusively carbs. And she’s getting protein and fat in there, but it is primarily vegetables that are high in carbohydrate. And yet achieving exceptional metabolic fitness scores. And she has very strong signals of overall metabolic health. So it’s certainly not the case that Levels requires everyone to give up the carbs entirely. It is just that whatever dietary philosophy someone subscribes to, they should be using their own personal data to ground it in how their body truly responds rather than a philosophy at large.”
26:19 – Curing the health epidemic by connecting actions with outcomes
The US is facing alarming rates of disease. These can be reversed when people recognize how choices are impacting their health. Through real-time data, it’s possible to link a lifestyle choice with an immediate response.
“So if you’re using the bathroom scale to determine your health, standing on the scale and waiting till you gain 20 or 30 pounds before you start to think about it, that’s way too long a cycle. You’re not connecting it to specific actions. If you go to a fast food restaurant and you load up on the whole nine yards with soda and french fries and a big meal, you’re going to see a blood sugar response that is extremely detrimental in real time. And this has happened. Many people in our program have seen exactly this and it really reframes the debate in your mind. It’s no longer someone giving you advice to change your behaviors. It’s your body now telling you to change your behaviors because you compare that to a home cooked meal and it’s just night and day. And so I think this is really going to shine some sunlight on these areas of our processed food supply that people rely on in some cases, because they think they can just jump on the treadmill and reverse it. But it’s really not the case. The damage is done in real time.”
27:52 – Build metabolic fitness for fighting illness
By building metabolic fitness, the body is better prepared to combat sickness. Inflammation and blood glucose are closely linked, as one increases the other is likely to increase too. Making better choices will lead to better all round health.
“In the context of extremely high blood sugar, the immune system essentially cannot function. And I don’t wanna get too deep into science because this is certainly not my expertise, but it certainly affects the way your body can respond to pathogens and viruses. So that in combination with the inflammatory response of the body to high glucose means that we should be making choices that improve our immunity particularly right now. And I think the way to do this is hone diet and exercise choices. Take walks after meals. Remove processed foods. Sleep seven to nine hours. Try to bring balance and control into your blood sugar and your metabolism at large. And that will definitely benefit, it seems, COVID outcomes. I believe that Levels is a really good way to get an understanding of how your body is responding to your choices. And by optimizing those, you can potentially set yourself up for ideally a better outcome if you should have to battle Covid.”
Episode Transcript
Martin Kessler (00:02) What’s up everyone and welcome to 20 Minute Fitness. Today is going to be all about metabolic health. Now most of you are probably familiar with diabetes and know about the necessity of glucose monitoring to effectively regulate one’s own blood sugar levels. In recent years, CGMs, short for continuous glucose monitoring has grown ever more popular as they allow for continuous monitoring of glucose levels throughout the day and night without the continuous need of finger pricking.
Martin Kessler (00:27) Yet even for healthy non-diabetic individuals, monitoring blood glucose levels may have its own benefits. A high and re-occurring amount of spikes in glucose levels after meals has been found to be actually both a symptom and factor in developing chronic metabolic diseases and often comes with a variety of negative side effects such as headaches and fatigue. So it’s little surprising that CGMs have found a growing following among biohackers and serious health enthusiasts that have started to monitor their own glycemic response to food, exercise, sleep and much more.
Martin Kessler (00:56) One company that has started to cater to this growing market is the startup company Levels. I’ve been using Levels myself for the past two weeks and on today’s show, I will discuss with Levels Co-founder Josh Clemente, how CGMs can actually help you to improve your own metabolic fitness. I’m Martin Kessler and you’re listening to 20 Minute Fitness. 20 Fitness is proudly powered by ShapeScale, the body scanner that is monitoring your body composition in photorealistic 3D.
Martin Kessler (01:22) Everyone, it’s Martin from 20 Minute Fitness. I’m here in San Francisco and I’m connected to Levels Founder Josh Clemente. Josh, why don’t you introduce yourself?
Josh Clemente (01:30) Hey, Martin, it’s great to be on the show. I appreciate you having me on. I’m Josh, Founder of Levels and I’m interested in bringing metabolic fitness to the mainstream.
Martin Kessler (01:37) Great. And so what does that really mean? What is metabolic health?
Josh Clemente (01:40) Yeah. So metabolism – The easy way to think about metabolism is the set of cellular mechanisms that create energy from our food and environment. So this is how we power the processes in our body. Our cells bring in fuel and they turn it into energy. And so metabolic fitness or metabolic health is when those systems are operating properly and you have optimal energy, weight balance, performance without excess byproducts.
Josh Clemente (01:59) And so the way that we’re doing this is we’re using continuous glucose monitoring hardware, software and analytics to close the loop between actions you take every single day in your daily life and the reactions your body experiences, in particular the blood sugar responses your body experiences. And so this is the Levels thesis is that closing loops between actions and reactions is the way that behavior change becomes easy and obvious.
Martin Kessler (02:20) Right.
Josh Clemente (02:20) So we’re the first metabolic fitness company bringing this to market.
Martin Kessler (02:23) And how do you define an excess byproduct? At what point do you have too much nutrition? Or what is it exactly.
Josh Clemente (02:30) So some of the easy ways to think about this are – Glucose itself, so this is, its sugar essentially, and this is a molecule that is the primary energy molecule in the human body. So that metabolism functionality that we talked about is driven primarily off of glucose, sugar and fat. And so when you’re consuming sugar, it releases into the bloodstream and this is actually just typically happening with carbohydrates, as well.
Martin Kessler (02:53) Right.
Josh Clemente (02:53) They break down into sugars, that enters the bloodstream. And so this triggers a cascade of processes, hormonal processes and those tell your body how to appropriate that glucose into the cells for their use. And this can drive things weight gain. It can be for muscle expenditure for energy that you’re using for mechanical loads. It can be used for cognitive function in the brain.
Josh Clemente (03:11) But when those Levels get too high, you actually have an inflammatory situation because glucose is a very reactive molecule. It produces what are called free radicals, inflammatory cytokines, IL-6, TNF-α – these different molecular byproducts of glucose reactions that actually are very inflammatory and can cause breakdown of tissues and skin glycation, which ultimately leads to browning of the skin and wrinkles and all of these byproducts that ultimately are not good for us. And so there’s a fine balance and glucose is meant to be kept in tight control. And that’s what we mean by byproducts.
Martin Kessler (03:41) Right. And normally, unless you have diabetes, you should not have a resistance to insulin release. Right? So how does that really matter then for everyday users that are non-diabetic?
Josh Clemente (03:52) So being that we have been – Since glucose is the primary energy source for the modern person, we’ve studied the post-disease state of glucose for many decades. So this is called diabetes, typically Type 2 diabetes, which is a lifestyle driven illness that sets in when your body can no longer respond to insulin. You can’t use the glucose in your bloodstream effectively. It gets to really high toxic levels. So we studied that quite a bit.
Josh Clemente (04:14) But the thing is that all of us across the metabolic spectrum from healthy to less healthy are all using that glucose. And so there is an optimization function here where because these mechanisms are linear – It’s not like a threshold where you cross over it and then suddenly you’re unhealthy. That’s how we’ve historically thought about it.
Josh Clemente (04:31) We need to think about this as metabolic fitness, meaning the choices we make require focus, effort and repetition to achieve optimization. So it doesn’t matter where you fall on the spectrum of metabolic health. The choices you’re making today are affecting your hormonal cascade, causing qualitative experiences and causing quantifiable, potentially detrimental effects like weight gain, worse performance in exercise, cognitive decline – all of the things that we struggle with in our day-to-day are affected by the choices we’re making that we don’t really connect because we don’t have that closed loop system.
Josh Clemente (05:00) And so now by showing that the person who doesn’t yet have diagnosable metabolic dysfunction can optimize your choices daily, see the data in real time, make better ones and then achieve this metabolic control, where instead of having this roller coaster of spikes and crashes and energy issues and again, weight gain – the roller coaster we all ride day-to-day, that we use our emotions to feel our way through it – you can now have data and you can use that to achieve this state of balance control and lower, flatter, smoother, continual metabolic control.
Martin Kessler (05:31) Right. So what is really the goal then? What would be great metabolic health? Would it be where you don’t have any spikes whatsoever? Is that the goal?
Josh Clemente (05:41) Well, think about metabolic fitness as what underlies physical fitness and mental fitness. So because energy is being used in all of the cells at all times, we need to have energy available.
Martin Kessler (05:51) Right.
Josh Clemente (05:51) So it’s not the case that we want to minimize glucose levels. But we do need to provide the appropriate amount of the fuel molecules so that our bodies can turn them into energy in the appropriate way. And so it’s like –
Josh Clemente (06:03) You have a dynamic system. We’re like this chemistry set where everything is run by chemicals that are released in response to other chemicals. And so if you just dump in one chemical in large proportion, other chemicals have to be dumped in, in large proportion to accommodate that. And so this is the glucose coming into your bloodstream causing a huge increase and then insulin has to be released to flood the bloodstream to take care of that to try and push it into the cells. And in many cases, it overcompensates and then you have hormones that tell you, “Oops! You’re actually going too low now. All the sugar is out of our blood. We need more.” And so that releases hunger hormones that cause you to feel this wave of hunger because of the overcompensation.
Martin Kessler (06:37) Right.
Josh Clemente (06:37) You can start to feel tiredness because insulin, by storing all that energy, you’ve now got low energy, you start to feel that wave of fatigue. So it’s this dynamic system that we’re kicking when you cause too much of an impulse in one direction or the other.
Josh Clemente (06:50) So it’s not that we are going to get rid of all spikes, all increases in our blood sugar, but what we want to shoot for is modifying our behaviors. For example, exerting some energy like walking after meals, the timing of our meals around sleep, for example – exercise, sleep, stress, diet, being the big levers we can pull on – such that we have continuous, smooth, there are no spikes and crashes. And I really mean spikes, not in the sense that you’ll – You will always have fluctuations, that’s just how the human body works, but we want to remove the real kicks to the system that are causing those detrimental downstream effects.
Martin Kessler (07:22) Right. And can you describe a little bit more how the Levels program actually looks like? So you already mentioned that you work with continuous glucose monitoring. But then what does Levels actually do then?
Josh Clemente (07:32) Sure. So the program that we built is a 28-day experience where you receive 28 days worth of clinical grade continuous glucose sensors. The sensors are worn on the arm. They have a little filament that measures electrochemically, the amount of glucose in your skin and that sensor has a life associated with it. So each one last 14 days. You wear two of these over the course of a month and throughout that you connect into the Levels ecosystems.
Josh Clemente (07:54) This is app scores and reports, daily, weekly and monthly reports that allow you to observe, interact with your glucose responses to specific choices and then optimize it. So bring together all of the educational material that you’ve learned over the course of the month about yourself and how you respond to your own choices and shoot for metabolic trends and patterns that are optimal for your goals.
Josh Clemente (08:13) And so that’s the way it plays out. We break it down into four weeks, where Week One, you just observe. This is the baseline, see how you’re responding to the choices you already are making daily. And then in the second and third weeks, we encourage some exploration. So look at the boundary cases, see how you respond to specific choices, experiment with timing and macronutrient content, with vegetables and fats and proteins all in a single meal, without where you split them out individually. Start to see how you personally respond to these choices. And then finally, on the fourth week, you strive for optimization. So bring all of those lessons learned together, make the choices in your diet, sleep, stress and exercise routines that can help you try to achieve that optimal metabolic control. And you can use that going forward.
Josh Clemente (08:54) And also we offer a subscription options for continual use. And this is really useful for accountability, training and just true multi-month optimization if you’d like to continue on an ongoing basis.
Martin Kessler (09:03) Right. And within your app, you can lock exercise, you can lock food and then you can really see how your glucose levels actually respond to those different lifestyle factors. Right?
Josh Clemente (09:14) That’s right. We’re at the early stages as an organization, but our program currently is oriented around the big ones, which are diet and exercise. So you can log this directly into the app, we have Apple Health integrations. We’re working on Google Fit, so that we can import directly and passively your workouts into the ecosystem.
Josh Clemente (09:29) And then longer term, we’re working on some really exciting stuff that have to do with stress and sleep because these are very large factors as well of dysregulation for people. So stress is a very profound kind of a hammer on the system that people don’t really realize. A stressful meeting or a lack of sleep, for example, can induce short term insulin resistance that can really defeat your goals in the longer term. And so seeing how these choices, how your sleep data is affecting you and starting to string together comparisons using our comparison features, our zone scores to help people understand five hours of sleep versus nine hours, you’re going to have a completely different day in terms of processing your dietary choices. And the same goes for walking into a stressful meeting, you may want to do a bit of mindfulness to bring your glucose levels down so you don’t have this major increase and maybe store that as fat. That type of micro optimization.
Martin Kessler (10:14) Right. And who do you actually see as using really that first initial program of the first 28 days? Who is it really for?
Josh Clemente (10:21) Levels is for anyone who wants to know themselves better. So anyone who wants to understand their bodies and how their lifestyle is affecting them and their long term goals. These are the health seekers, the health optimizers. Those are the early adopters, people who already as soon as they know about the product they say, “I’ve been waiting for that.” People are waiting for a way to really understand how their choices are affecting them immediately, rather than days, weeks, months in the future.
Josh Clemente (10:43) And so we’re starting off in this premium space. We’re very similar to other hardware and software plays and you can think about Peloton, Mirror or these other areas where you’re using a really elegant user experience plus hardware plus software. Obviously, the comparison with other wearables like Whoop and Oura and ultimately, we’re going to be bringing this down into the into the mainstream and moving into a space where metabolic health is the thing people think about prior to thinking about achieving physical fitness or achieving mental fitness. Right?
Martin Kessler (11:10) Right.
Josh Clemente (11:10) You want people to start to realize that you got to optimize the terrain that you’re standing on before you can start to build a solid structure. And that’s the way we what to think about metabolic fitness.
Martin Kessler (11:20) Can you give us maybe some examples of what have been some of the lessons that some of you have been drawing from those initial couple of weeks program?
Josh Clemente (11:28) Some of the stuff is quite intuitive and others are very counterintuitive. So some of the most profound research that’s been done as a result of continuous glucose monitoring becoming more available, is on non-diabetic people and this research vector is showing the personalization between individuals.
Josh Clemente (11:44) So there was a study in 2015 that took 800 people who did not have diabetes, used continuous glucose monitors on them and showed that two people can eat the exact same two foods and have equal and opposite blood sugar responses. So in this case, it was two people each ate a banana and a cookie made with wheat and one person had a large spike from the banana and was totally flat on the cookie and the other person had the exact opposite response.
Josh Clemente (12:07) And so this shows that there’s actually no one-size-fits-all solution. So individuals – and this may be genetic, it may be microbiome, it may be stress or body composition – all of these factors come together to determine how you respond. The point is, is that if you’re going to go about making choices that you think are healthy, you need this data in order to be able to be confident.
Martin Kessler (12:23) Right.
Josh Clemente (12:24) And that’s what we’re seeing primarily, is people are realizing that the specific dietary choices I’m making can be optimized for me. They’re eliminating things that counterintuitively don’t work for them. They might have been doing things like, for example, eating oatmeal every morning because that’s – Google it, it’s typically top three on the healthy breakfast foods. And so people are doing this daily for decades, in some cases. They put on Levels and realize that that’s causing a pre-diabetic blood sugar excursion for me. And ultimately, two hours later, I’m crashing back down and feeling extremely low energy and that’s when I’m snacking. And so they remove that and shift to a meal that has maybe a more balanced macronutrient content, maybe they’re just adding some almond butter to bring up the fat and protein and balancing out that glucose excursion. Another big one is just moving more. So realizing that taking a walk after an indulgent meal can do a dramatic amount to modify your body’s response to that meal because your muscles are consuming glucose in real time.
Josh Clemente (13:17) And so seeing the effects of walking, balanced meals, experimenting with mixed macronutrients – the whole fat-protein-carbohydrate balance – avoiding processed foods and then playing with the timing. So people are moving their meals away from bedtime in order to allow themselves to come down, stop sending energy to the digestive system and allow themselves to achieve more restful sleep. Seeing the effects of alcohol, for example. It’s all these large scale lessons that are happening at the individual basis every day.
Martin Kessler (13:43) Yeah. I saw that study and I also thought it was really, really fascinating because they have those different charts, different types of foods, you mentioned oatmeal, but also some high glycemic foods like bread, which has a literature GI of 71, but then you see the response. Some people go as low as 20 and some go all the way up to 200, which is crazy high. Right? So it’s something that you can’t know about you unless you’ve actually gone through the testing.
Martin Kessler (14:10) And that’s really what sold me because initially I was a bit skeptic. If you just go by the literature GI, you know okay, you should stay away from anything that’s high glycemic, so no flour, no bread, no pasta, no starchy vegetables like potatoes etc. But we all respond differently to it and it’s, like you said, it also really matters what your lifestyle is like, are you really active? I saw on a private Facebook group, some people went as crazy as doing 30 push ups just before breakfast just so they had a better metabolic response to it, which is fascinating.
Josh Clemente (14:47) Yeah. Exactly. I prefer to go for a walk myself, but it’s interesting because the advice we’ve always heard is eat healthier, workout more. And that’s just blank bland, it doesn’t really make any sense. It’s not anchored to anything specific. But when you eat a meal, something that you enjoy, let’s just say it’s a personal pizza. You eat that meal and then you sit on the couch. You get this blood sugar response that’s going to trigger all this inflammatory downstream cascade. Your body’s going to store a bunch of that as fat. It’s going to be – You’re going to feel terrible. You’re going to be very tired shortly thereafter. Now, the next day, go out and eat that same pizza and then go for a walk, just a 20/30 minute walk around the block, look at the beautiful sights. Come back and look at the score two hours later and your body will completely modify its response to that meal.
Josh Clemente (15:29) And that’s really profound for people who maybe don’t want to go the route of completely eliminating everything and living this stoic lifestyle where they have no indulgences. They can now see that there are ways that you can – Making these micro optimizations actually have a very large effect. It’s the 80/20 rule of moving a bit more. It sounds just like a legend or an old lifestyle type thing, but the reality is that it has a basis in data now.
Josh Clemente (15:54) And to your comment about – I think that some people will take this very extremely and they’ll do 100 pushups before their exercise or whatever. But others they’ll just realize, all I have to do is get up and move around for a few minutes. And this is going to now give them the data that will push them across the motivation boundary to actually go out and make that happen.
Josh Clemente (16:15) And so the studies continue to roll in showing the differences between, like you said, bread response, for example. It’s interesting because we all know that bread is somewhere on the Glycemic Index. But the thing about the Glycemic Index is it takes all this diversity, this individuality and it normalizes it to 100. So let’s say you and I, we each eat a slice of bread. I go to 200 mg/dL, which for those who aren’t familiar, that would be a diabetic blood sugar response. I’ve tested this. I know that that’s where I go. And let’s say you go to 110. So you have a much better response. But the way that the Glycemic Index works is it normalizes both of those to 100 out of 100, or it normalize them up compared to glucose, which, which is a 100 out of 100. And so for me, bread would be forced to a 100 and for you, it might be forced to an 84.
Martin Kessler (16:59) Right.
Josh Clemente (16:59) And then they take the average of all of that and that’s how they take the Glycemic Index. But you’ve now blended out all of the individuality. So now people are using Glycemic Index and saying, “Oh, yeah. It’s high glycemic or medium glycemic. It’s totally fine. I know how to eat based off of this.” But the reality is that they’re an individual not an average and so they’re potentially causing themselves dramatic results or consequences because they’re using these very blunt instruments like Glycemic Index.
Josh Clemente (17:24) And so we hope to be able to bring a large amount of nuance into this conversation to say your personal glycemic index is much different than that population average and that’s perfectly fine. You should eat to your personal glycemic index.
Martin Kessler (17:37) And at what point do you actually know that, I don’t know, you have high blood sugar or let’s say hyperglycemia, where it’s to the point where you really feel fatigued? In my case, for example, I had, during the test phase, a pizza and my glycemic index went to over 150 something and I felt really tired afterwards. And then another time, though, I had some ice cream and it went up to 140 and I did not feel actually tired. So I was wondering at what point do I really have my limits? At what point is it really, really too much?
Josh Clemente (18:09) Yeah. So there’s a lot of research on the specific detriments, and of course, as we study this space more and more, we’re going to better understand what optimal looks like. We don’t want to tell people to strive for normal. Normal, unfortunately, in the United States is metabolically dysfunctional. About 12% of US adults are metabolically healthy. And so that means that we need to not just shoot for what the population averages but for, again, the optimal direction. And so that personal sensation driven way of feeling our way through diet has been what we’ve been, we’ve been doing this forever, is eating our way through life and then looking back and saying, “I felt okay,” or “I kind of feel a little tired now maybe that was I didn’t get enough sleep last night or maybe it was my meal.”
Josh Clemente (18:49) Now, you have some data that drives that and because there’s so much nuance – the ice cream. Ice cream is an interesting one because it’s essentially a mixed meal. So it has a lot of protein, a lot of fat and a lot of carbohydrates. There’s a ton of energy in that meal.
Martin Kessler (19:01) And that also matters. Right? What is really the combination? Do you have some protein with your carbs? Or are you just eating pure sugar?
Josh Clemente (19:08) Yeah. So the thing is, is that may have a more prolonged response in your system, where you elevate because there is quite a bit of sugar in there and the fat can affect your response there. So you may elevate and stay elevated for longer versus a meal like oatmeal for me, where I see a very sharp spike and then an immediate crash and my body just instantaneously responds to that. And that crash is where I feel that intense fatigue.
Josh Clemente (19:31) And so the whole background of this company is that I originally had extreme fatigue issues. So my day-to-day was extremely challenging and I’m a CrossFit L2 trainer. I was working at SpaceX at the time on life support systems and I’m doing all this work in the in the world of human performance and every day I can barely make it through my meetings. Two o’clock in the afternoon, I’m literally desperate for a coffee in order to make it to the next one. And these waves of fatigue were so counterintuitive to me. I was not struggling with weight. I didn’t ever have an issue that was obvious to me from the outside. And yet when I ultimately got a continuous glucose monitor, which took me over a year, by the way. When I did get one and I put it on just as an experiment, I saw that my blood sugar – I was riding this extreme wave of spikes and crashes all day, every day. My blood sugar would elevate into the pre-diabetic or diabetic zone because of a meal I’d eaten. I would then crash back down. I would feel hungry. I would feel shaky. I’d feel tired, irritable and then I’d go and I’d be snacking for another meal and it would do this all over again.
Martin Kessler (20:27) Right.
Josh Clemente (20:27) And that realization completely changed my life. It led to Levels but it also led to me personally renovating my approach to lifestyle and understanding that these choices we make individually, there’s not a lot of symptoms associated with them in real time. It’s what you experience two hours later that you completely decouple from that dietary choice. You’re like, “Oh, this is different. That was two hours ago.” Well, it’s actually you’re still riding that wave that was a consequence of the meal.
Josh Clemente (20:52) And so I think a lot of it is personal, but there is certainly an optimal range to shoot for. And as we continue to grow our dataset and dig into it deeper and deeper, we’re going to be able to provide some really strong individual recommendations through the app ecosystem.
Martin Kessler (21:06) Right. And every day that you have been logging your metabolic response, you also get a score from Levels. Right?
Josh Clemente (21:12) That’s right. Yeah. We have a couple of scores that we’re developing and the key is we want people to understand a) how a specific choice you make affects you in the following hours as your body responds and metabolizes it. Then also, that choices don’t happen in a vacuum. So they affect each other. So I gave that example of eating a pizza and lying on the couch versus going for a walk. So we’ve developed a scoring system, which actually zonifies or basically groups choices that affect one another or actions that affect one another and provides a score for the entire region of time, if that makes sense. So that pizza with a nap afterwards versus the pizza with a walk, it will detect that you had exercise and also the meal and group those and score them together. And that way you can superimpose these choices against each other and see all the factors that are at play.
Josh Clemente (21:58) So the zone score is really important to help you to understand specifically how groups of decisions can modify one another and you can string choices together to improve the patterns and trends. And then that goes up with our metabolic fitness score, which takes all of the zones throughout a day and provides you with more of an overall grade for how you have, how controlled your metabolism has been throughout that 24-hour period.
Josh Clemente (22:19) This is the one with the metabolic fitness score, where you want to string together a series of positive zones and individual choices and then that will improve your metabolic fitness score for the day. And then you string together multiple days of a streak of metabolic control and shoot for 100% on the metabolic fitness score. It kind of gamifies the experience, but it really is anchored in specific choices and low-hanging fruit, the small decisions you make every day. And so it’s driving people to start thinking about this in grade scale terms as opposed to these clinical mg/dL type terms.
Martin Kessler (22:50) So what types of choices does one have to make to score a metabolic score of 80 to 100?
Josh Clemente (22:55) It really depends on the individual and in most cases where depending on how your body is responding to the choices you’re making, certain people will have to do different things. And ultimately, what the score is looking at is these complex micro variables of how your body or what a glucose curve actually means. So there are things like variability, which is the number of spikes and crashes in a period of time. There’s the target range, so we of course, want to stay inside of a certain threshold where the body is most comfortable. So anytime outside of that range is working against your score. And the amount of times, the area under the curve, works against you. The rate of change of the peak that you achieve – All of these analytical little variables of how your body’s responding come together to drive that score.
Josh Clemente (23:43) And so what I personally choose to do, is I strive for very low variability. So I want to minimize the number of peaks and crashes in my day, so a very spiky chart that’s associated with a lot of inflammation, a lot of cardiovascular outcomes. It’s something that I think is a newer vector. We’ve always studied fasting glucose and average glucose, but now that you have real-time data, you can see the variability. So I would personally choose to shoot for fewer spikes, lower spikes. And then I really try and stay within the target range 100% of the time.
Josh Clemente (24:15) So if you can achieve that, those two things, minimal variability, making choices that provide a smooth and controlled response rather than a spiky sharp one. That’s how you get up into the higher ranges for the metabolic fitness score.
Martin Kessler (24:25) And is something like that actually achievable with a diet that is not low carb?
Josh Clemente (24:30) Yes. You know what? One of the fascinating things is, and again, there’s so much personal variability. It’s hard for me to be able to say that every person can achieve great scores with every type of diet. I’m not entirely sure where that falls. I think there’s probably an optimal diet for the individual.
Josh Clemente (24:45) But for example, Casey Means, one of my co-founders, she’s a medical doctor from Stanford, she’s all plant-based. So she eats a 100% plant-based diet very, very high in carbohydrates and she has some of the best metabolic fitness scores of the entire dataset, so not just on the team. And she achieves this through very focused honing of her diet. She uses that data daily to improve her choices and she’s always eating mixed meals and she’s staying very active. And so if she’s going to eat a large carbohydrate filled meal, she’s also going to have tahini or avocado or beans or something that brings in that fat and that fiber and helps the body to maintain a very controlled measured response.
Josh Clemente (25:18) So I would say that that right there is a prime example of someone who is eating almost exclusively carbs and certainly she’s getting protein and fat in there, but it is primarily vegetables which are high in carbohydrate and yet achieving exceptional metabolic fitness scores. And she has very strong signals of overall metabolic health.
Josh Clemente (25:34) So it’s certainly not the case that Levels requires everyone to give up the carbs entirely. It is just that whatever dietary philosophy someone subscribes to, they should be using their own personal data to ground it in how their body truly responds rather than a philosophy at large.
Martin Kessler (25:50) Right. So I guess if somebody was on a diet of fast food and soda, it would be very difficult for them actually to have a good metabolic score.
Josh Clemente (25:57) Yeah. The processed food is one of the quickest ways to get a poor score and that’s where I think Levels is really profoundly useful for society at large. I touched on some of the numbers, but we have a metabolic epidemic in this country. We are, 90 million people are pre-diabetic, 35 million are Type 2 diabetic and all of the downstream consequences, heart disease, etc., are coming from this.
Josh Clemente (26:16) And it’s because the feedback cycles are so long. So if you’re using the bathroom scale to determine what your health, standing on the scale and waiting until you gain 20 or 30 pounds before you start to think about it. That’s way too long a cycle. You’re not connecting it to specific actions. But if you go to a fast food restaurant and you load up on the whole nine yards with soda and french fries and a big meal, you’re going to see a blood sugar response that is extremely detrimental in real time. And this has happened.
Josh Clemente (26:40) Many people in our program have seen exactly this. And it really reframes the debate in your mind. It’s no longer someone giving you advice to change your behaviors. It’s your body now telling you to change your behaviors because you compare that to a home-cooked meal and it’s just night and day.
Josh Clemente (26:54) And so I think this is really going to shine some sunlight on these areas of our processed food supply that people rely on in some cases because they think they can just jump on the treadmill and reverse it. But it’s really not the case. The damage is done in real time.
Martin Kessler (27:05) Right. Actually, speaking of pandemic, there have been quite a few articles in recent weeks that also mentioned Levels. Can you tell me a bit more about how somebody could actually currently benefit of Levels during the current pandemic?
Josh Clemente (27:18) That’s a good question. The pandemic itself, COVID, it certainly – It’s an interesting one because people are asymmetrically experiencing poor outcomes who already have metabolic dysfunction. So, for example, in Mexico, I think 43% of COVID deaths already had existing diabetes and there is definitely a correlation there. And so specifically, metabolic health seems to be tied into the COVID outcome. And so it’s definitely a good idea to try to improve these metabolic markers.
Josh Clemente (27:46) Another thing that blood sugar control specifically is very closely tied to is inflammation and immunity. So in the context of extremely high blood sugar, the immune system essentially cannot function. I don’t want to get too deep into the science because this is certainly not my expertise, but it certainly affects the way your body can respond to pathogens like viruses.
Josh Clemente (28:03) And so that in combination with the inflammatory response of the body to high glucose means that we should be making choices that improve our immunity, particularly right now. And I think the way to do this is hone diet and exercise choices, take walks after meals, remove processed foods, sleep seven to nine hours, try to bring balance and control into your blood sugar and your metabolism at large. And that will definitely benefit, it seems, the COVID outcomes.
Josh Clemente (28:29) So I believe that Levels is a really good way to get an understanding of how your body is responding to your choices and by optimizing those you can potentially set yourself up for, ideally, a better outcome if you should have to battle COVID.
Josh Clemente (28:42) There’s also another interesting factor where – Essentially, any whole body inflammatory sickness can bring on large blood sugar elevations. So it’s basically glucose elevation in response to stress is a normal physiologic response and so it’s a sign of inflammation and it tends to predate symptoms by several days, in many cases. So if someone’s coming down with an illness, they’ll oftentimes see an increase in their blood sugar response as one of the earliest signs.
Josh Clemente (29:07) So this is something we’re thinking quite a bit about right now is digging into, is it possible that glucose could be an early warning indicator in the way that – Right now, I think, companies like Oura and Whoop are doing the same thing with heart rate variability. And this is not to say that Levels is going to be a predictive or diagnostic tool, but it could be an early sign that your body is fighting off some sort of inflammatory attack and that can be very useful for people to know, obviously.
Martin Kessler (29:30) Right. Interesting. So just going back to Levels, where are you currently at? It’s not fully available in the market yet. It’s still in beta. Right?
Josh Clemente (29:38) That’s right. Yeah. We’re running a closed beta right now and that beta has been ongoing for about, we’re about seven months in, and the goal there is to essentially do a small high intensity, very close feedback loop approach to our programming where people use the Levels program, Levels software and just guide us in the direction that they would like product features to develop so we can understand, is behavior change becoming easy and actionable for people?
Josh Clemente (30:00) And so we’ve had about 1000 people go through that beta thus far. A 1000 people have signed up and about 700 have gone through. And we’re starting to get really strong signals that people are understanding their own metabolic situation and they’re making changes as early as Week One, really renovating their lifestyles. And so this is the indicator that we’re looking for. And so we’re starting to spool up for our slow launch and then ultimately, our major launch might be in the fall timeframe.
Martin Kessler (30:25) And what have you learned so far, maybe anything that was unexpected, perhaps?
Josh Clemente (30:29) What’s unexpected is how strong the demand for something like Levels truly is. Given that we were in stealth, prior to January, we now have 23,000 people on our waitlist and we really have done very little, if any, marketing, testing. People are resonating with this in a way that is – I think it’s absolutely a good sign because I truly believe society needs this. But it’s also just very interesting and unexpected how quickly the appetite is expanding where people see another individual using this and learning from their own body in real time and they just desire immediately, “I need to have that. I need to understand. I have this feeling that I’m making choices that maybe aren’t working for me and this is the tool that I really need to know once for all.” People want confidence.
Josh Clemente (31:09) And so that’s very inspiring. I think something that ultimately we’re going to be looking back and saying one day, we’re going to treat metabolic dysfunction the way we did the opioid epidemic of the past few years. We’re going to look at it as something that was a, it was a hidden but epidemic scale problem and we’re going to be able to shine some light on it with this and I think people are ready for it. Their appetite is there.
Martin Kessler (31:30) Yeah. One thing that’s, of course, still holding it back is that CGMs have been largely restricted to users that have diabetes. It’s a prescription device that makes it very hard actually to attain for somebody that doesn’t have diabetes. Right?
Josh Clemente (31:43) Yeah. Historically there – So the technology was developed for the management of diabetes and that’s exceptional. People with diabetes need to know their blood sugar’s in real time. It’s a very immediate concern for them to understand that. And now we’re getting to a point where the technology is – The cost has come down and the supply chains have gone up. So it’s becoming much more available.
Josh Clemente (32:00) And so part of what Levels has built is the access pathway. So we have a telehealth partner network and all of our customers receive a telehealth consultation with one of these physicians that are licensed in their states. And so everyone receives a prescription for the use of these medical devices, these clinical grade continuous glucose monitors. So we are leveraging a technology that was originally developed for, again, the management of diabetes, but bringing it into the space of wellness and performance optimization and that accessibility is really a key vector for Levels.
Josh Clemente (32:27) I personally, again, I struggled with fatigue and ultimately found that I was borderline or full blown pre-diabetic. And the key for me was getting my hands on this technology that gave me real time awareness. And that access issue of not already having diabetes was a major blocker. It took me, again, close to a year to figure this out. And that’s a really big problem. And so yeah, solving that access issue is one of our main concerns and then of course, the actionability of the data is the next thing.
Martin Kessler (32:52) And do you think the regulatory environment is going to change anytime in the near term future where you’re not going to be required to have a prescription to use the CGM apparatus?
Josh Clemente (33:00) I’m very optimistic. I see a lot of great trends in the world of both in the telehealth space where we’re seeing some improvements in regulation and availability of telehealth, which I think is a great thing. And then also, just generally, we see technologies working their way from the therapeutic and medical space out into the mainstream, quite often. And I’m very optimistic that in the next two to three years, we’re going to have not just one but many options for a direct-to-consumer continuous glucose option for the hardware. And so at Levels, we’re working with all the next generation manufacturers and really seeing some exciting things that signal nothing but a bright future ahead for this technology.
Martin Kessler (33:33) And hopefully, that’s also going to bring up the scale of the types of devices that are going to be available because right now, unless you have insurance that covers for it, they are still quite expensive.
Josh Clemente (33:41) They are, yeah. It’s one of those things where a technology like this that’s developed for the management of an illness, it requires quite a bit of an efficacy trial effort and so it’s very expensive and the companies, they need to recoup their investment. And that’s what we’re seeing now. But of course, with the mechanisms of supply and demand, as more people uptake this technology and start using it in their daily lives, that’s going to expand. This is going to have great market effects, I think, where the technology will just come down by dramatic orders of magnitude improvement and that will make it more available to all of us and also just improve the quality and consumerization of the technology. So yeah, all good things. The more people that use this, the better it’s going to be in the long term.
Martin Kessler (34:18) Fascinating. And if our listeners want to learn more about a) Levels and b) metabolic health, what would be some good resources to learn more about those?
Josh Clemente (34:26) One of the big things we’re focused on at the company is education and just helping people understand why metabolism is important, why you should care and the best place to do that is levelshealth.com/blog. We write a lot about it and a lot about the specifics of how this can affect cognitive function, weight gain, everything to PCOS and sexual dysfunction. And so I highly recommend going there and starting to read that and then, of course, levelshealth.com. You can sign up for our newsletter and join our waitlist. And then you can follow along on social media @unlocklevels.
Martin Kessler (34:54) And if you want to dive even deeper, is there any book that you would recommend to read?
Josh Clemente (34:57) Absolutely. So there’s really good ones. I think one of my favorites personally is The Diabetes Code and The Obesity Code both by Jason Fung. These are exceptionally good. I think Personalized Medicine by Eric Topol is another great one. Wired To Eat by Robb Wolfe is actually the book that got me very interested in measuring glucose for myself. And so there are quite a few of these books that have started to open up the problem space of the hormonal theory of energy balance, which means glucose and insulin drive many, many processes and detrimental effects and then also how this technology can be used to get a better understanding of your personal relationship to these serious vectors.
Martin Kessler (35:34) Awesome. Yeah. We’ll make sure to, of course, list all of those in our Show Notes. Well, thanks so much for coming on the show, Josh.
Josh Clemente (35:40) I really appreciate it, Martin. It was great conversation.
Martin Kessler (35:42) Well, that was a fascinating conversation with Levels Co-founder Josh Clemente. We’re definitely still at the very early stages of research and technological adoption of CGMs by, at least, the non-diabetic population, I’d say. However, there’s definitely a growing body of research that is pointing towards the benefits of maintaining a lower glycemic variability and overall lower glucose average of less than 100 mg/dL and while many of us may already be following a low carbohydrate diet such as paleo or keto, you will be still in for a surprise here and there about your varying glycemic responses to sometimes supposedly healthy foods, such as steel cut oats, or that cauliflower pizza crust.
Martin Kessler (36:21) In my own case, one of my habits that I have already started to adjust is the amount of berries that I have with my breakfast in the morning, because even though they range in the lower glycemic range than say bananas, mangoes, pineapples, etc., the fructose still metabolizes rather quickly, which easily leads to early morning spikes in my blood glucose beyond 150 mg/dL, which is considered quite high. Now over the next few weeks, I’m still super keen on doing more tests around certain foods and also combinations such as adding more fiber to my meals with say, chia seeds, especially for those meals that are heavy on carbs.
Martin Kessler (36:55) Now, could I imagine ever wearing a CGM long term? Well, yes and no, maybe not all the time, but on and off definitely and because it’s easy to get obsessed about it and they’re still quite expensive. But I would say that definitely a very meaningful tool of discovery and accountability similar to that of tracking your own nutrition for a month or two. You’re set to learn a ton about your current habits, which really empowers you to make meaningful adjustments later.
Martin Kessler (37:19) Hopefully, we will see though, that the cost of CGMs comes down with greater adoption over time, especially among the non-diabetic groups and maybe even doctors and insurances will start prescribing it to risk groups because it can definitely alter their lifestyle choices if they actually know what’s going on.
Martin Kessler (37:36) As always, you will find the full Show Notes with resource links to some of the research we’ve talked about today on 20minute.fitness. And anyways, what are your thoughts regarding glucose monitoring? Let us know on Twitter or Instagram. You can find us @shape20fit and you can also find me personally @kesslerio. I’m Martin Kessler and you are listening to 20 Minute Fitness.