#51: Using Continuous Glucose Monitoring to Better Understand Metabolic Health | Dr. Casey Means

What’s the true key to maximizing health and energy? According to Stanford-trained surgeon Dr. Casey Means, the answer is glucose. You don’t have to be a diabetic to benefit from paying attention to your glucose levels. In fact, Dr. Means’ company, Levels, is working to bring CGM – continuous glucose monitoring – to everyone. In this episode of The Live Life Longer Show, host Dan Voss interviewed Dr. Casey Means about everything from fasting and chronic illness to how Levels is pioneering a closed-loop feedback system to understand metabolic health.

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2:57 – What is Levels, and why is it important?

Levels is the first program that lets people understand exactly how their food and lifestyle decisions are affecting their health in real time through a glucose monitor, which is a tiny wearable device that goes on the back of the arm with software that provides insights.

“So it’s the first time we’ve had that closed loop biofeedback about nutrition. And I think this is really helpful because notoriously, nutrition’s kind of this open loop system where you make choices in your diet, you make food choices, but you don’t really know exactly how they’re affecting you. You might, you know, weigh yourself the next day and see some change. You might get lab work done six months down the road. But to be able to really link the individual choices you’re making and what’s immediately been happening in your body, that’s been missing. And in terms of behavior change and making positive movement towards your health goals, having that instant feedback can be really useful.”

5:59 – The role of glucose

Glucose is blood sugar, which is our core metabolic substrate and one of the key building blocks of creating energy in the body.

“Let’s say you eat a cookie. That’s going to break down in your digestive tract. You’re gonna absorb the sugar from that food. The blood sugar will rise after that. And then the body will release hormones, in particular insulin, which helps you take that sugar out of the blood and basically put it into yourself so that it can be transformed into a currency of energy that we can use. Namely, a molecule called ATP.”

6:23 – Excess glucose and metabolic issues

Excess glucose is stored in the body as fat. Frequent elevations in blood sugar and insulin spikes can eventually cause insulin resistance.

“The body’s very tightly regulated to keep that blood sugar sort of back to getting back to normal. And what we don’t want to see is that we have, you know, exaggerated, really large glucose spikes from food over and over and over again in the body. Because what that’s doing to the body is making you have to release that insulin over and over and over again in high magnitudes to respond to that glucose. And with excess glucose, it can be stored as fat. And this can kind of create metabolic problems down the road when our blood sugar is elevated frequently.”

10:35 – Why fasting is beneficial for our bodies

Fasting gives our bodies a break from producing insulin because we’re not having glucose spikes caused by food.

“So fasting is basically, from a biochemical perspective, a time when you’re not having glucose spikes, exogenous glucose spikes. Meaning glucose spikes caused by stuff coming into the body and the mouth, which means you’re also giving your body a chance to not have to pump out insulin. That’s just a time when you can actually start working through the energy that you already have in the body. So only when we sort of burned through the stored glucose that we have in the body in the liver does our body start flipping into fat burning mode, and using the fat that we have in the body for energy. And that is really what we want. That’s a state called metabolic flexibility, which is where our body can really bounce back and forth between both using glucose and using fat for energy based on what substrates are available.”

18:13 – Every body is different

Even if two people eat the same food, their bodies can have very different reactions to it.

“It’s actually very individualized. And more recent research over the last several years has actually kind of debunked the glycemic index, because there’s so much biochemical individuality between each person in terms of how they digest food and their insulin sensitivity and their microbiome. And so we might both eat a sweet potato, you and I, and actually have very different glucose elevations in our blood in response to that. And so as a plant-based person, you kind of think like, ‘Oh, if I’m eating like an unrefined, whole food plant-based diet, like everything’s healthy, it’s all good stuff.’ But actually there’s certain foods that for me, cause really pronounced glucose elevations much more than other foods that I like just as much.”

26:57 – Chronic illness and blood sugar dysregulation

Blood sugar dysregulation can cause more issues than just diabetes, which is one of the top 10 leading causes of death in the United States.

“Most of our chronic illnesses in the United States these days are related to blood sugar dysregulation. Nine of the 10 top leading causes of death in the US are in some way related to dysregulated blood sugar. And some of the obvious ones are things like diabetes, which is clearly a disease of overt, you know, blood sugar dysregulation, which is one of the top 10 leading causes of death in the US. But so many of the other conditions, things like stroke and heart disease, and cancer, these are also significantly contributed to by insulin resistance and dysregulated blood sugar. Elevated blood sugar drives cancers. Heart disease and stroke are fundamentally rooted in metabolic dysfunction. And so, it’s not just about diabetes and weight. It’s about all the other conditions that are in some way contributed to by poor metabolic health.”

29:39 – Times have changed

Dietary and lifestyle choices are having a negative impact on people’s health.

“In the 1950s, less than 1% of the population had type two diabetes. And now almost 14% of the population has type two diabetes. So we have 128 million Americans with prediabetes or type two diabetes, most of which is preventable. And this wasn’t even seen 50 or 60 years ago. Some of the conditions that are big killers in the United States like cancer and heart disease and stroke. You know, someone could easily say ‘Yeah, well, life expectancy was like 60 a hundred years ago. So people weren’t even getting old enough to have these conditions.’ So that’s a fair point. But when we think about just 50, 60 years ago, rates of diabetes, life expectancy has not changed that much in the past 50 or 60 years. And so we’re really seeing, I think, a direct contribution from dietary and lifestyle choices.”

31:14 – Our body’s reaction to stress

Our body’s reaction to stress has been an evolutionary response; it responds the same way to physiological stress as it did to physical stress in the past.

“So the body created this really interesting feedback loop where stress hormones like cortisol and catecholamine hormones actually tell the liver to dump that stored glucose that we have, those chains of glucose called glycogen into the bloodstream so that our muscles have ready access to energy, like really quick access to circulating glucose. So that was really useful when most of our stressors were physical threats. But now, most of our stressors in the modern world are not corporeal in nature. They’re mostly psychological. It’s like the ping from our phone and an email and a stressful conversation. And someone honking at us. And yet our body responds to it the exact same way.”

39:26 – Move your body

It’s important to stay moving throughout the day to improve or maintain your metabolic health.

“The more you’re just moving constituently throughout the day, the better it is for your overall metabolic health. And the way I see it as even moving two minutes every half hour, which I think a lot of us don’t do if we’re sitting at a desk all day. It could be hours between when you actually get up and go to the bathroom or have a meal or something. You’re constantly activating those muscle pathways of like taking up glucose, burning glucose, making energy. So you’re kind of keeping your body just like activated to be metabolically active all day, even if it’s just for two minutes here and there.”

40:44 – Glucose, endurance, and athletic performance

Athletes that focus on being metabolically flexible can build more endurance.

“In an event where you need endurance capabilities, when you run out of your stored glucose, which typically happens after about two hours, you either need to eat glucose or you’re gonna not feel good. You’re going to have run out of energy. And that can be that feeling of bonking that people talk about where you’re just like tapped out. On the flip side, if you’re someone who is very metabolically flexible, and when glucose is low, you can just immediately switch into fat burning. These people basically don’t bonk.”

48:43 – Catch some Z’s

Sleep is a critical to our overall metabolic functioning. Even if you’re doing well with eating and exercising, you will not achieve optimal outcomes if the sleep piece is missing.

“It’s all very hormonal in nature. When you are deprived of sleep, it raises your cortisol, your stress, hormone levels. That’s of course going to have an impact on your glucose levels. It changes your hunger and satiety hormones, ghrelin, and leptin. It makes you more hungry when you’re sleep deprived and you are often looking for energy dense foods. It changes your insulin sensitivity in general, makes insulin levels higher. It changes your growth hormone levels. There’s such a cascade that happens when you don’t get sleep. And it seems like the optimal amount of sleep for metabolic health is between about seven and a half and eight and a half hours of sleep per night.”

53:26 – Longevity is more about health span

Longevity is less about lifespan and more about health span. It should focus more on how healthy we can live during the time that we have.

“Ideally we want our healthspan and our lifespan to be the same. We want to have health and vibrancy until the year, the day that we die. And so that to me is what I’m really focused on. Because you can’t control how long you’re gonna live necessarily. Like anything can happen. But you can control how much health you have in those years. And that’s where I think everything we talked about today and other guests you’ve had is so important. Because investing in these health behaviors relating to diet lifestyle, I think in particular, you know, food, how we stress, how we sleep, how we move – it just unlocks the ability for every single day and every single year to feel better and feel great. And that’s really what we want.”

Dan Voss: [00:00:00] You’re listening to the Live Life Longer Show with Dan Voss, helping people live longer through hormesis like cold exposure, sauna use, breath work, intermittent fasting, and the healing powers of nature. And this week’s episode, my guest is Dr. Casey Means, a Stanford trained physician, chief medical officer, and co-founder of a metabolic health company, Levels, and associate editor of the International Journal Of Disease, Reversal And Prevention.

Her mission is to maximize human potential and reverse the epidemic of preventable chronic disease by empowering individuals with tech enabled tools that can help inform smart, personalized, and sustainable dietary and lifestyle choices. Dr. Means’  perspective has been recently featured in the New York Times, Men’s Health, Forbes, Business Insider, TechCrunch, Entrepreneur Magazine, The Hill, Metabolism Endocrine Today, and many more. She’s an award-winning biomedical researcher with past research positions at the NIH, Stanford School Of Medicine and NYU. Before we get into today’s episode, I’d like to talk about Kion aminos.

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Some other uses of Kion aminos is better sleep, better recovery, muscle maintenance, appetite regulation, fast, clean energy. It can support your fasting efforts and lifestyle, and improve your cognitive performance. To get 15% off your order of Kion aminos, visit GetKion.com, that’s G E T K I O N.com/Dan Voss. It’s D A N V O S S. You can enter my name, Dan Voss. D A N V O S S at checkout, the code Dan Voss, for 15% off your order of Kion aminos, any of their supplements and their delicious coffee. Dr. Casey Means, welcome to the Live Life Longer Show.

Dr. Casey Means: [00:02:41] Thank you so much for having me, Dan.

Dan Voss: [00:02:43] Yeah, I’m really looking forward to our conversation about Levels, about glucose monitoring, nutrition, uh, living a healthier lifestyle. So let’s start with, uh, your company that you’ve co-founded, Levels. Tell us, uh, what is Levels and what does the company do?

Dr. Casey Means: [00:03:02] Yeah. So Levels is first program that lets people understand exactly how their food and lifestyle decisions are affecting their health in real time. So we’ve had, you know, all sorts of ways to understand how our fitness is affecting us in real time with like fitness wearables, and we have sleep data through other wearables, but we’ve never really understood how nutrition affects our health, um, in a really closed loop way.

And so that’s what we do. So what we, what we offer, is we pair a continuous glucose monitor, which is a tiny wearable device that goes on the back of the arm with software that lets you essentially see how each thing that you’re eating and other lifestyle decisions, how they’re affecting your glucose, uh, in real time.

[00:03:43] So it’s the first time we’ve had that, that closed loop biofeedback about nutrition. And I think this is really helpful because notoriously, nutrition’s kind of in this open loop system where you make choices in your diet, you make food choices, but you don’t really know exactly how they’re affecting you.

[00:04:00] You might, you know, weigh yourself the next day and, and see some, some change. You might get lab work done six months down the road but to be able to really link the individual choices you’re making and what’s immediately happening in your body, that’s been missing. And in terms of behavior change and making positive movement towards your health goals, having that instant feedback can be really useful. If you eat,

[00:04:25] for instance, a cookie and you see immediately that your blood sugar goes up much higher than you want it to. Um, but then you eat a piece of fruit and it goes up half that much, you have immediate information about, uh, about what’s sort of happening to your body with these different choices, and can then personalize and optimize, um, and make choices that work best for your, your body.

[00:04:45] So, uh, that’s what Levels does. And, uh, it, it’s, it’s really neat because it’s the first wearable program for a mass market that actually is testing  internal biomarkers. So  almost like a little lab test that’s going on on your arm, uh, 24 hours a day.

[00:05:01] Host: [00:05:01] Wow. That’s super cool. When you say that it, uh, you can like, see, you have a cookie and then see that your glucose went up much higher than you wanted it to.

[00:05:10] Does it provide information on certain levels of specific foods of where, where your glucose should be?

[00:05:17] Dr. Casey Means: [00:05:17] Well, you know, the body really wants our glucose to sort of be in a fairly tight range throughout the entire day. So glucose is essentially blood sugar. This is our core metabolic substrate. It’s one of the key

[00:05:32] sort of building blocks of creating energy in the body. And because energy is fundamental to every single cell working in the entire body, the body has a lot of different systems, hormonally, to really keep blood sugar pretty tight. And when you eat carbohydrates, uh, that’s going to get broken down into sugar in the bloodstream, and the body has a series of events that happen after that, to help you, um, respond to that sugar and get it back down to baseline.

[00:05:58] So. Let’s say you eat a cookie, that’s going to break down in your digestive track. You’re gonna absorb the sugar from that food. The blood sugar will rise after that. And then the body will release hormones, in particular insulin, which helps you take that sugar out of the blood, and basically put it into yourself so that it can be transformed into a currency of energy that we can use,

[00:06:20] namely, a molecule called ATP. And if there’s excess, that will be either stored as sort of glucose, chains of glucose called glycogen, or will be stored as fat in the body. And so the body’s very tightly regulated to keep that blood sugar sort of back to, get it back to normal. And when we, what we, what we don’t want to see is that we have, you know, exaggerated, really large glucose spikes from food over and over and over again in the body, because what that’s doing to the body is making you have to release that insulin over and over and over again in high magnitudes to respond to that glucose.

[00:06:57] And, and with excess glucose, it can be stored as fat. And this can kind of create metabolic problems down the road when our blood sugar is elevated frequently. So let’s say we eat 10 cookies, like a cookie every hour on the hour for the entire waking day. That’s 10 insulin spikes that you’re also going to have to have as well.

[00:07:19] And what happens is when the body sees lots and lots of insulin um, the cells actually become numb to insulin, which is a process called insulin resistance. And this is sort of like a protective mechanism in the body where it’s like, no, we’ve seen way too much glucosetoday, too much insulin. We’re going to stop this process of glucose, getting shoved into the cells.

[00:07:39] You know, the Inn is full. And, and that’s a problem because the body will actually push out more insulin from the pancreas where it comes from, to try and just really overcompensate and push that glucose into the cells. And over time, this, this breaks down and glucose will, you can’t compensate enough and glucose will end up rising in the blood.

[00:08:01] And when glucose ends up rising in the blood over time, um, that’s when we start moving down that pathway of metabolic dysfunction towards prediabetes, towards diabetes. And, and so we’re looking at a body that now is just exposed to more glucose in the bloodstream day in and day out than it was intended to.

[00:08:20] And there’s more insulin floating around at all times because the body’s constantly having to push out more. And so, so that’s the pathway we really want to avoid. We want to keep the cells really insulin sensitive. So when we make food choices, that take into account how much those foods are affecting our glucose.

[00:08:37] We can choose foods that don’t have such an exaggerated response on our glucose, that kind of keep us more low and steady. Like, like I said, it’s natural for glucose to rise after a meal with carbohydrates, but we don’t want it to be these sharp peaks and then valleys. We want it to be more gentle, rolling hills that keeps our body, um, more sensitive to insulin,

[00:08:58] keeps our glucose in a better regulated state, and that’s really where we want to be. So it’s really personalized nutrition through the lens of keeping our glucose in a more, um, a more stable and low range. And that can have, you know, aside from the long-term outcomes that we kind of just talked about with insulin resistance and leading towards potentially pre-diabetes and diabetes, it also has a number of benefits just in our current, everyday life.

[00:09:22] When we keep our glucose a bit more stable and in a lower and healthy range throughout the day, it tends to help us have a more stable day overall, just energy, mood, cognitive performance. Um, something interesting that happens when we have a really big glucose spike, is that because the body surges out that insulin and it takes up all that glucose,

[00:09:42] um, sometimes you can actually overshoot and dip below your baseline. Like the body does too good a job sucking the glucose out of the bloodstream and you can overshoot. And that process is called reactive hypoglycemia. And that sometimes is associated with what we feel like a post-meal slump, you know, like after a meal, we kind of get tired.

[00:10:01] Or you might, um, you know, have a hankering for sugar or something. And that is because we’ve sort of overshot in terms of our, our glucose spike. And then we get that dip. And so the more stable we can keep things with glucose, the more we can kind of keep our days and our performance more stable.

[00:10:17] Host: [00:10:17] Sure.

[00:10:17] And, and much of what you just talked about, uh, is that pretty similar to exactly what fasting does, you know, in terms of avoiding those glucose spikes in those insulin spikes, you’re allowing your body to, to have some time to rest and digest.

[00:10:33] Dr. Casey Means: [00:10:33] That’s exactly right. Yeah. So fasting is basically, from a biochemical perspective, a time when you’re not having glucose spikes, exogenous glucose spikes, meaning glucose spikes caused by stuff coming into the body and the mouth.

[00:10:47] Um, which means you’re also giving your body a chance to not have to pump out insulin. Um, that’s just a time when you can actually start working through the energy that you already have in the body. So only when we sort of burn through the stored glucose that we have in the body in the liver, does our body start flipping into fat burning mode and using the fat that we have in the body for energy.

[00:11:13] And that is really what we want. That’s a state called metabolic flexibility, which is where our body can really bounce back and forth between both using glucose and using fat for energy based on what, uh, substrates are available. Um, and living in America, eating the standard American diet, which is composed largely of refined carbohydrates,

[00:11:36] and we eat very frequently, um, we may never be giving our body the opportunity to actually burn through, um, our circulating and stored glucose in a way that we actually get into fat burning. So we ended up making ourselves metabolically inflexible. You can imagine that if you start eating breakfast at 8:00 AM and you sort of snack and eat throughout the day, eat three meals, a few snacks, then maybe wrap up having your last bite of dessert at 11:00 PM,

[00:12:01] you basically kept glucose elevated, um, throughout the entire day and never got into a fat burning state. And what’s interesting about the hormone insulin is that it not only has the effect of letting yourselves take up glucose, but the secondary effect is it’s a blocker on fat burning. So an element is, when insulin is elevated, it’s a block on fat burning in the body.

[00:12:25] So this has implications for people who are trying to lose weight, for instance, because if insulin is elevated, we’re not going to be burning through fat, uh, in the body. So fasting is a really nice opportunity to just give your body all this time to actually work through the stores of energy that we have and get into a fat burning state and really flex those muscles of metabolic flexibility.

[00:12:48] And also give ourselves a time when they’re not being stimulated by insulin. Um, when you, when you do that over time, you can kind of perk up the cells to hearing that signal of insulin more strongly and kind of regain that insulin sensitivity. So, so. You know, fasting has many different meanings. There’s extended fast, either like a full day or a couple of days, but even just time restricted feeding, which is where you just narrow your eating window from,

[00:13:13] let’s say you are someone who normally eats between 8:00 AM and 8:00 PM. That’s a 12 hour feeding window. Narrowing that from 10:00 AM to 6:00 PM, which is an eight hour feeding window that gives your body, uh, four more hours overnight to really utilize the energy that we already have on board. Um, and there’s been some research that’s looked into how time restricted feeding impacts metabolic health.

[00:13:36] Um, one study had people eat the exact same number of calories, either between 8:00 AM and 8:00 PM or 8:00 AM and 2:00 PM. So it was either a six hour feeding window or a 12 hour feeding window. And even though people were eating the exact same amount of calories in both groups, the people in the shorter feeding window had better overall metabolic health parameters,

[00:13:56] um, which indicates that, you know, a calorie is not a calorie. It, when you’re eating those calories actually makes a difference. And, uh, you can imagine in that shorter feeding window group, they had. You know, if they were just eating for six hours, they had 18 hours where they had lower insulin state, lower glucose state, and were able to kind of flex those metabolic flexibility muscles.

[00:14:18] So, yeah,

[00:14:20] Host: [00:14:20] Super interesting. I feel like there’s a few things I want to touch on here to kind of break down maybe some misconceptions that people might have. Um, I’ve been fasting for, for a few years now, most days I practice that time restricted eating that you were talking about where my, my eating window is shortened from what used to be 10 or 12 hour window down to about seven or eight hours each day.

[00:14:41] Um, I think the first misconception for a lot of people is that it’s going to be really hard and that they just can’t do it. Right. They think that I’ve been eating breakfast when I first wake up at seven or 8:00 AM my whole life. And the idea of waiting till 11 or noon is just not feasible or even on the tail end of the day.

[00:14:59] Because it doesn’t have to be in the morning. You could fast in the evening. Um, Either way they think it’s just not feasible. And what I would say to somebody that maybe is concerned about it, or a little nervous about it, or think that they can’t do it is to at least give it a try and just start small, right?

[00:15:15] Like instead of a 10 hour window, move it to nine. And then over time, just keep narrowing that down to the point where like, I don’t even think about it. Like I’m not hungry in the morning anymore. Um, it, it really truly becomes a lot easier the more you do it. So I would say that’s like the first, um, misconception that a lot of people have.

[00:15:34] And then the other thing that I see from a lot, a lot of people that, um, are interested in it or have questions about it. They may think that you’re going to be eating less calories by, by doing intermittent fasting or time restricted eating. Um, and that’s just not the case. I’m still eating all the same calories that I was before.

[00:15:51] It’s just in a shorter window, like you said, so. And then the third thing that came to mind, uh, was the standard American diet that I was eating, you know, and, and consuming that, that diet pretty much my whole life. And it was really about a year ago, like right when COVID started that I realized, okay, if I’m going to make a big change in my life, it’s gotta be around my diet.

[00:16:14] Um, and same thing that, you know, like I said, with, with fasting to start off small, you don’t have to change your entire diet overnight. You can make small improvements over time. And I think that was the big thing for me was, was realizing like I don’t have to just like clean, clean slate overnight. I can just make small changes here.

[00:16:34] Um, start by eliminating sugar as much as I can. And then I kind of started eliminating carbs more. And now I’m to the point where my, my diet is pretty much locked in. And it’s not perfect, but, um, it is, you know, based mostly around clean lean meats and, uh, and, and, and veggies, you know, it’s cruciferous vegetables and leafy greens.

[00:16:58] And I just feel so much better now that I’ve been focusing more on my nutrition. So those are kind of my, my two sentence for anyone that’s listening that might be going through the same thing, or, uh, have, have questions around any of those topics.

[00:17:12] Dr. Casey Means: [00:17:12] That’s so great. Um, and I think breaking that down and, you know, breaking down things into, uh, baby steps is really so important, because they didn’t seem like huge, huge changes, but just kind of going piece by piece is, is so important.

[00:17:25] So that’s, that’s a great, that’s a great framework to put it through. And, um, you know, the, the vegetable, well, you mentioned you’re eating mostly clean meats and vegetables. And you know, I think, um, something, I found really interesting wearing a continuous glucose monitor now for almost 18 months, is that I’m mostly plant-based.

[00:17:47] So I, I actually do eat quite a bit of carbohydrates. And, but what I’ve learned is that different carbohydrates, things I might not even expect to spike me or not spike me, you know, I get, I get very surprised sometimes when I look at it on my glucose monitor, um. Because we know that actually, even though we have that concept of like the glycemic index chart, which is like, Oh, this particular food is going to raise your blood sugar this much.

[00:18:13] It’s actually very individualized, and more recent research over the last several years has actually kind of debunked the glycemic index because there’s so much biochemical individuality between each person in terms of how they digest food and their insulin sensitivity and their microbiome. And so we might both eat a sweet potato, you and I, and actually have very, very different glucose elevations in our blood in response to that.

[00:18:38] And, and so as a plant-based person You kind of think like, Oh, if I’m eating like an unrefined, whole food plant-based diet, like everything’s, everything’s healthy, it’s all good stuff. But actually there’s  certain foods that for me, cause really pronounced glucose elevations much more than other foods that I like just as much.

[00:18:56] And so I tend to now avoid those a little bit more. So for me, like grapes and corn and sweet potatoes, they just send my glucose to the roof, whereas many other fruits or root vegetables just don’t. And so for me, it’s been fun to just learn that and kind of just make sure that I’m not overdoing it on those foods, or that I’m pairing them appropriately with other macronutrients so that it actually blunts the glucose spike.

[00:19:21] So we know that adding fat and protein and fiber to carbohydrate-rich meals often will blunt the amount of glucose response that you see in your bloodstream. So if I have a sweet potato, I’m going to put tahini on it and chia seeds and or maybe some beans, um, with, you know, which have both protein and fiber. And just make sure that I’m not just eating it in isolation as what I’d call a naked carbohydrate, where it’s just primarily that food, which has high carb, you know. Blunting it with some other adjuncts is helpful.

[00:19:56] And then there’s other tips that you can, you can use to sort of blunt a glucose response. Adding vinegar and cinnamon to food, actually, those are both foods that are known to be insulin sensitizers. So they’ll make your body even more responsive to the insulin signal. So eating, for instance, a salad with a couple ounces of vinegar before eating something like a sweet potato can minimize the amount of glucose response.

[00:20:19] So there’s, those are, and those are just food adjuncts. There’s also lots you can do with movement, walking after a meal can decrease your glucose response significantly to that meal. And just making sure you’re not eating these things that are big spikers when you’re stressed or sleep deprived,

[00:20:35] because both stress and sleep deprivation can make you have a more pronounced glucose response to food. So it’s been really fun to experiment with that because, um, you know, you just learn a lot of surprises. And unsurprisingly green leafy vegetables are kind of fair game. They don’t do anything at all to my glucose.

[00:20:54] And so it’s kind of like, okay, unlimited on, on these, which we pretty much know to be true, that they’re going to be minimal glycaemic  impact. But, um, but then maybe eating a red pepper. Um, I might see a little bit of a response, not a big one, but like, you know, 15, 20 points on my glucose after a big red pepper.

[00:21:11] And, and so it’s just, yeah, it’s, it’s, it’s fun to kind of personalize that. Um, and there’s a lot of people who are in the keto world, the ketogenic world who, um, have used glucose monitoring and, and sort of figured out how to tailor even keto to them because it’s sort of the flip side, actually, Keto is often very restrictive.

[00:21:30] There’s a lot of foods that are even healthy foods like beans or certain high starch vegetables that are, you’re typically not supposed to eat. And I’ve had a number of people use glucose monitoring and see, Oh, these foods actually don’t change my glucose that much at all. So maybe they are okay for my keto diet. And one person in particular, I’m thinking about, would pick

[00:21:51] carrots out of her salads for years thinking that they were going to cause her to get out of ketosis, but found out that actually they have no impact on our glucose. And so she could eat them pretty freely because for her body, it didn’t cause that much of a response.

[00:22:05] Host: [00:22:05] Yeah, I love the idea of personalization, uh, when it comes to Levels

[00:22:10] and, and what Levels does. Do you think glucose monitoring is the answer or at least a really good solution for people that feel frustrated when it comes to their nutrition. And when I say frustrated, maybe they’ve tried different diets or they’re trying all kinds of different foods, and certain things just don’t seem to stick. And then not to mention,

[00:22:32] there does seem to be at times, some conflicting advice across the field, um, you know, in terms of, of different diets, you know, especially when you have people that are in those specific niches, whether it’s keto or plant-based or paleo, or the number of other different diets. Um, I think a lot of people that I talk to, they,

[00:22:53] they sometimes just get frustrated. They’re like, I’m getting told all this advice. One person’s telling me this is good. And the other person’s telling me it’s bad. Um, so do you see glucose monitoring being a really good way to personalize diet and find what works and what doesn’t work for each person?

[00:23:07] Dr. Casey Means: [00:23:07] I think it’s,  it’s definitely one way to do that. You know, glucose isn’t the panacea for figuring out what the perfect diet is for you, because there’s so many other elements of diet that someone should take an account, into account. For instance, you know, eating refined seed oils, like refined vegetable oils can be a significant source of oxidative stress and free radicals in the body.

[00:23:31] But if you drink three tablespoons of canola oil, it’s not going to make your glucose go up, but it’s going to have more of that long-term, um, free radical exposure to the body. So that’s, I’ll just caveat it by saying that. Um, but I think it’s a great entry lens for understanding diet, because especially in the American diet where we are

[00:23:53] so, we lean so heavily on refined carbohydrates, more than ever in human history. The average American is eating 152 pounds of refined sugar per year. Whereas 150 years ago, we were eating like one or two pounds total. So, you know, orders of magnitude more refined sugar. That’s not even a refined carbo. I mean, we’re not even talking about refined grains, which is like a whole another mountain of, of, uh, hundreds and hundreds of pounds of refined grains, which basically turn into sugar pretty quickly.

[00:24:25] So because our diet is so skewed towards refined carbohydrates, um, I think it can be just such a great way to get a leg up on just understanding exactly what’s happening to your body with this really important aspect of diet. And I think, especially because so many people are struggling with weight and frustrated with weight loss, and there’s so many loud voices in the nutrition space saying, You should be vegan, you should be paleo,

[00:24:52] you should be carnivore, um, you should be Keto, that it’s like, Well, what do I do? And pretty much any diet you choose, whether it’s any of those four that I just mentioned, trying to optimize it for keeping your glucose in a lower and healthier range is going to be, is going to make that buy, that diet work best for, for you.

[00:25:15] Um, and so it can kind of personalize any philosophy, diet philosophy that you’re choosing from to make it at least, uh, glycaemic impact as possible. And the other thing is, you know, and just to take that thought one step further. The reason that that’s important, if you’re using one of these diets for weight loss is because when you keep that glycaemic impact low, or you’re keeping that insulin response lower, and that insulin, is that break on fat burning.

[00:25:41] So if you’re vegan and you’re struggling to lose weight, it may be because everything you’re eating on that vegan diet is a big spiker, either insulin or glucose. And so you’re just blocking fat burning. You could transition more to a lower glycemic impact vegan diet, focusing more on the green leafy vegetables, the less starchy, um, vegetables, fewer grains, maybe swapping out your grains for things like cauliflower, broccoli, rice, which are going to have much less glycemic impact.

[00:26:09] And then focusing on high fiber carbohydrates like beans, um, making sure you’re getting tons of low carb fiber, like chia seeds and other seeds. And then getting lots of healthy fats like nuts seeds, avocado, coconut, olives. Yeah, you can really have a very low-glycemic impact vegan diet, but you can also have a vegan diet

[00:26:28] that’s just like pasta, bread, rice, crackers, fruit, high starchy vegetables. Like that’s gonna not probably have a great impact on, uh, on, on your progression towards losing weight, unless you’re really calorie restricting, which no one wants to do and isn’t necessarily healthy. So yeah. So that’s one piece.

[00:26:51] The second piece of why it’s good to orient through for people who are frustrated is that most of our, most of our chronic illnesses in the United States, these days are related to blood sugar dysregulation. We, um, nine of the 10 top leading causes of death in the U S are in some way related to dysregulated blood sugar.

[00:27:10] And some of the obvious ones are things like diabetes, which is clearly a disease of overt, you know, blood sugar dysregulation, which is one of the top 10 leading causes of death in the US. But so many of the other conditions, things like stroke and heart disease and cancer, these are also significantly

[00:27:31] contributed to by insulin resistance and dysregulated blood sugar. Elevated blood sugar drives cancers. Heart disease and stroke are fundamentally rooted in metabolic dysfunction. And so just, it’s not just about diabetes and weight. It’s about all the other conditions that are in some way contributed to by poor metabolic health, by dysregulated blood sugar, and even things we don’t even associate at all with blood sugar, like infertility and erectile dysfunction and depression.

[00:27:59] These things are actually, um, we’re learning more and more that having poor glucose control, having high insulin levels in the body can directly worsen these conditions because of the effects they have on, um, for instance, like erectile dysfunction, um, uh, the impact of, uh, blood sugar dysregulation on vascular flow.

[00:28:21] Um, so that’s, that’s a direct contributor. And with infertility the impact of insulin on our ovaries, insulin actually drives our ovaries to make testosterone, which can lead to infertility. And in the brain, insulin resistance in the brain can cause essentially poor ability of the brain cells to make energy.

[00:28:39] And that can lead to things like depression and anxiety and even things like dementia down the road and, and neurodegeneration. So it’s all so interlinked. And we often see these conditions as like, totally separate entities, but in reality, a lot of them are contributed to by our Western diet and what that does to our blood sugar.

[00:28:57] Um, so for those people out there who are trying to use diet as a tool to increase longevity, improve weight loss, um, aren’t seeing the results they want, it is possible that that is in part because the diets that they’re choosing are actually not keeping their glucose as, as stable as they’d like.

[00:29:14]Host: [00:29:14] Sure.

[00:29:14] And to your point in all of the, of the, the host of health issues that you just discussed have only gotten worse over the decades, right? Especially in the U S as you said, the intake of, of sugar, refined sugar has just skyrocketed. These were issues that probably weren’t seen in our grandparents and great-grandparents time.

[00:29:34] Correct? At least not as much as today.

[00:29:37] Dr. Casey Means: [00:29:37] Yeah, not even close. Um, in the 1950s, 1%, less than 1% of the population had type two diabetes. And now almost 14% of the population has type two diabetes. So we have 128 million Americans with prediabetes or type two diabetes, most of which is preventable. Um, and this wasn’t even seen 50 or 60 years ago.

[00:29:57] Some of the conditions that are big killers in the United States like cancer and heart disease and stroke, you know, someone could easily say, Yeah, well, life expectancy was like 60, um, a hundred years ago. So people weren’t even getting old enough to have these conditions. So that’s a fair, that’s a fair point.

[00:30:14] But when we think about just 50, 60 years ago, rates of diabetes, um, life expectancy has not changed that much in the past 50 or 60 years. And so we’re really seeing, I think, a direct contribution from dietary and lifestyle choices.

[00:30:28] Host: [00:30:28] Yeah. And I feel like I’ve, I’m going to have to look up the sources on this, but I’ve read a few articles recently that for the first time ever, our life expectancy has actually gone down in the last few years.

[00:30:40] Dr. Casey Means: [00:30:40] That’s right.

[00:30:41]Host: [00:30:41] Even though it was going up for a while, now we’re actually going back down.

[00:30:45] So there’s obviously, uh, there’s concern there to be had for sure. Um, you had mentioned briefly that stress and sleep play role in glucose. How is stress and sleep related to glucose?

[00:31:02] Dr. Casey Means: [00:31:02] Yeah.

[00:31:02] Host: [00:31:02] Can you touch on that further?

[00:31:04] Dr. Casey Means: [00:31:04] Yeah. So stress is a really interesting one. So. It’s actually sort of like an evolutionary response that now has become maladaptive.

[00:31:13] So historically if we were in times of stress or in times of threat, um, it’s often because we had a physical threat that we had to respond to. So like we, thinking like, you know, historical ancestral times, like maybe we were being chased by a lion, maybe we had to pack up and move, you know, like. We had to basically use our muscles and move,

[00:31:39] and when we were under stress. So the body created this really interesting feedback loop where stress hormones like cortisol and catecholamine hormones actually, tell the liver to dump that stored glucose that we have, those chains of glucose called glycogen into the bloodstream so that our muscles have ready access to energy, like really quick access to circulating glucose.

[00:31:59] So that was really useful when most of our stressors were physical threats. But now, most of our stressors in the model, modern world are not, you know, corporeal in nature. They’re mostly psychological. It’s like the ping from our phone and an email and a stressful conversation and someone honking at us.

[00:32:18] And yet our body responds to it the exact same way. It releases the same hormones and our body dumps that glucose into the bloodstream. And yet we don’t need it because we’re just sitting at the computer. And, and so, we get these blood sugar elevations that essentially are not being utilized. And so when, if you think about kind of chronic low grade stress in our modern world, like it’s possible that we can be getting these little cortisol surges, like all throughout the day.

[00:32:45] Like every time you have a little stressful moment in your, in your day, um, all those things, I just mentioned, honking, texts, emails, et cetera. It’s like, it could be all day. And so you’re just kind of getting this baseline elevation and I’ve definitely, we’ve definitely seen, um, in our community of people using continuous glucose monitors, that it’s pronounced what you can see.

[00:33:07] So for instance, if someone’s giving like a talk in front of a lot of people, and let’s say they’re fasted, they’ve had no food that day. So it’s not like they’ve eaten something and their glucose is going up, you can have a 30, 40 point rise in your glucose, just from that anticipatory stress of giving a talk.

[00:33:23] That’s a lot, that’s like equivalent to eating a banana. Um, so it’s not just subtle. It can be really, really pronounced. Some people I know who’ve had their highest spike ever from a stressful response, like a fight with a partner, you know, an argument or whatnot, um, where they’re really upset. Uh, so that’s pretty interesting.

[00:33:42] And there’s also on the flip side, there’s some research showing that mindfulness techniques, so like, deep breathing and diaphragmatic breathing can actually lower glucose response. And I imagine that’s through that mechanism of keeping our stress hormones more stable and down. Um, so that’s kind of the stress piece.

[00:34:02]Host: [00:34:02] Before you get into

[00:34:03] sleep,

[00:34:03] because it sounded like you were about to transition over to sleep, I want to touch a little bit more on that. Um, I love talking about the idea of hormesis, right? That those hormetic stressors, there’s a difference between chronic stress, which is what you were describing. And then you kind of went into a little bit with those hormetic stressors of breathwork and I love cold exposure.

[00:34:23] I do cold shower every morning. Can, can that help improve or stabilize, uh, our, our glucose levels is those, those small amounts of like hormetic stressors.

[00:34:36] Dr. Casey Means: [00:34:36] Yeah. So I think that they, I think they can, although there, there’s probably more research that needs to be done with this. So, um, people often who do cold exposure while wearing a glucose monitor will find that their glucose goes up during their cold exposure.

[00:34:56] So they’ll get like a spike from that. And that’s likely from the stress hormones that are surging during that time. Um, But that’s really, I would say falls into that category of like that acute quickly self-resolving stressor, um, that may fall more into the hormetic category. Very different from the 20 times a day, the chronic low grade stress, or kind of just like a little bit activated here and there.

[00:35:23] And it’s just kind of keeping everything like heightened all day. Um, that’s, that’s not what we want. And the other thing about cold exposure or high intensity exercise, for instance, that are sort of like hormetic stressors, high intensity interval training will also often cause glucose to elevate for the same reason, because it’s like such a strenuous activity that it causes the body to release stress hormones.

[00:35:48] And in cold exposure and in high intensity interval training, the body actually might need to use that glucose because you’re shivering during cold exposure, your muscles are actually maybe using that glucose. And same with the high intensity interval training, your body is actually going, there’s a sink for that glucose.

[00:36:05] Like it’s, it’s pumped out into the blood, but then you’re actually using it in some way. And so, um, different, somewhat different physiology. Um, the other interesting thing about high intensity interval training as a stressor is that the muscles have this really unique capability of actually being able to take glucose up without an insulin signal.

[00:36:25] So just contraction of muscle fibers alone can allow glucose to be taken up into the cell. So you, you can avoid that insulin surge that’s required to kind of get glucose up. And so it’s almost like a different physiology of glucose processing. So I think if anything, that’s any stressor, that’s actually using muscles to take up glucose like high interval training and maybe to some extent, cold exposure, just because of like shivering and using muscles, um, in that capacity, is actually sort of like a positive because you’re, the muscle is one of the biggest glucose sinks in the body.

[00:37:03] Um, it’s going to take up that glucose and actually use it. So it’s a way to burn through glucose. So I think of high intensity interval training, even though it is a stressor in a sense, it’s causing stress hormones to be released, what it’s doing is it’s shuttling glucose out of the liver and being used by the muscles.

[00:37:21] So it’s really burning through as opposed to just unloading and then letting it just sort of sit in circulation, and like lead to issues with more like psychological low grade stressors.

[00:37:31] Host: [00:37:31] I love that.

[00:37:32] That’s super cool. That’s, thank you for that clarification. That’s super helpful. So now that we are talking about, um, exercise with the high intensity interval training, how can, how can glucose, uh, you know, tracking, help athletes improve their performance and their endurance?

[00:37:48] Um, and how does exercise overall impact glucose levels?

[00:37:52] Dr. Casey Means: [00:37:52] Yeah. So overall, glucose, um, exercise in any way is positive for our metabolic health, regardless of really what you’re doing. So things that have been well studied are low to moderate intensity working out. So things like a very light jog or a walk,

[00:38:12] over time, very positive for metabolic health. High intensity interval training, also very positive, especially for insulin sensitivity. And then resistance training, lifting, things like that is, is uniquely excellent for metabolic health. So really it’s like, whatever you do, it’s good. Move your body. Um, I think one set of studies that I really enjoyed is where they took different groups of people and put them under different, lower, moderate intensity

[00:38:41] exercise conditions, and then looked at what happened to their glucose levels. And it was, there was kind of some surprising findings. So in one of the studies, they took people and they had them work out basically before each meal, for like 20 minutes, after each meal for 20 minutes or in, um, for two minute chunks, every 30 minutes throughout the day.

[00:39:02] So it’s either like three, three medium sized chunks, or just two minutes, but many, many times throughout the day. And the people who had the best overall glucose levels were the people who just walked for two minutes, every 30 minutes throughout the day. So what that says to me is, again, it’s like the calories it’s like when you do things actually makes a difference.

[00:39:21] Um, and in this study, what it showed was the more consistently you’re doing things throughout the day, the more you’re just moving consistently throughout the day, the better it is for your overall metabolic health. And the way I see it is even moving two minutes, every half hour, which I think a lot of us don’t do,

[00:39:34] if we’re sitting at a desk all day, it could be hours between when you actually get up and go to the bathroom or get, you know, have a meal or something. Um, you’re con constantly activating those muscle pathways of like taking up glucose, burning glucose, making energy. So you’re kind of keeping your body just like activated to be metabolically active all day, even if it’s just for two minutes here and there.

[00:39:55] So, so those studies really say to me, like, just move more, set a timer, every 30 minutes move for two minutes. It does not have to be a lot. It’s walking. It’s, it’s just, it’s simple. So that’s just sort of more for a practical tip. For athletes in particular, there’s so many ways that glucose tracking can be really useful.

[00:40:15] One is the endurance athletes. So these are athletes who need potentially hours worth of energy to do their event. And like we were talking about before, if you’re someone who is metabolically inflexible, meaning that your body’s just been trained to always be using glucose, you rarely give yourself the opportunity to be in a low glucose state where you’re having to burn fat.

[00:40:37] If that’s the body that  you have, because of the way you’ve been eating, in an event where you need endurance capabilities, when you run out of your stored glucose, which typically happens after about two hours, you either need to eat glucose or you’re gonna not feel good. You’re going to have run out of energy.

[00:40:54] And that can be that, that feeling of bonking that people talk about, where you’re just like tapped out. On the flip side, if you’re someone who is very metabolically flexible, and when glucose is low, you can just immediately switch into fat burning. These people, basically don’t bonk. Um, and there’s a training sort of technique,

[00:41:13] that’s, that’s now being used. Things like carb cycling or low carb training. Um, sometimes these athletes are called fat adapted athletes or keto adapted athletes. And what these people are doing is they’re training in a lower carb state. So they’ll maybe do some of their long training runs having fats in the morning or having eating, eaten more fat and protein and less carbohydrates before their training.

[00:41:38] And they ease into that. But over time, your body is essentially forced to start burning fat during your training, during your workout, as you burn through your, your stored glucose. And these are, since these are cellular pathways, the stuff does not happen overnight. You do really have to adapt to be someone who can do this by training in a low insulin state where you’re actually burning fat.

[00:42:03] Um, so there’s some great research from researchers, Jeff Volek and Steve Phinney all about low carb athletics and what that unlocks for endurance potential. And when you look at the blood of these patients, they’ve studied like the blood biomarkers that’s happening during training with people who are either eating a conventional high carb diet,

[00:42:23] or a low carb diet for endurance events. And the low carb people, at the same intensity of working out, are burning significantly more fat than carbohydrates. And the people who are high carb are burning significantly more carbohydrates than fat. So it actually really changes substrate utilization in these athletes.

[00:42:40] And, um, yeah, so it’s kind of an interesting, uh, phenomenon that we’re seeing where yeah.

[00:42:46] Host: [00:42:46] I find it interesting. I have, I’m not currently training for any marathons, but in the past I have, you know, I’ve run a few marathons and I’ve been into running overall and, you know, there’s that whole adage of, you know, have big pasta the night before, you know, carb, load up on carbs.

[00:43:03] I just find it super interesting to hear you say, uh, you know, athletes are training on more of a high protein, high, fat diet. And it makes sense. It makes sense. That’s cool.

[00:43:15] Dr. Casey Means: [00:43:15] Yeah. Yeah. There’s um, one of our very earliest members, Anthony Kunkel, he’s, um, he’s on Instagram and posts a lot about this, but, um, it’s, uh, it’s fun to follow along and kind of see what he’s doing, but he runs entire marathons

[00:43:29] completely fasted. No, no food at all.

[00:43:32] Host: [00:43:32] That’s wild.

[00:43:33] Dr. Casey Means: [00:43:33] I’m not recommending anyone do that, but it’s just to even know that that’s possible is really, really interesting. And, um, some of these athletes think that there’s other benefits as well, related to recovery, because when we burn fat, um, for energy, we’re making ketones, which are basically an another source of energy the body can use. And ketones are thought to be somewhat anti-inflammatory,

[00:44:01] um, and really, really good for the brain to function on. And so I think some of these athletes find that they actually feel like they recover faster when they are more in a ketogenic state during their, their training. Yeah.

[00:44:14] Host: [00:44:14] Super interesting. Yeah. One other point you were talking about with, uh, movement throughout the day.

[00:44:19] I have a. I’ve been doing a pretty good job of that, mostly because I now have a dog and we’re out for walks throughout the whole day. And sometimes they are only two to five minute walks. Um, but we’re going out every couple of hours. Uh, so that’s been super helpful. And then, um, another thing that I’ve recently been doing, this is more of a productivity hack,

[00:44:39] I think it’s called the Pomodoro method where you block, you set a timer and you do like, so. So what I do is I set a timer for 33 minutes. And that’s my chunk of time to get work done, whether it’s answering emails or editing, uh, or whatever project I’m working on. I’m sitting with no distractions for 33 minutes.

[00:44:58] And then when the timer goes off, I set another timer for six minutes, and that’s six minutes of break time. Right? So that’s for me to go to the bathroom for me to stretch, to fill up more water. Um, and that’s when I’ll usually do like a quick little like jumping jacks or some push-ups, just to like get movement in throughout the entire day.

[00:45:15] So that’s kinda, my little hack is the Pomodoro method. 33 minutes of work, six minutes of break. And then you just continue that throughout the day.

[00:45:23] Dr. Casey Means: [00:45:23] That is so awesome and it fits perfectly with this, you know, and just, yeah. Um, it’s also, I know, from what I’ve read about the Pomodoro method, like it’s really good for the brain and for productivity, like you just get, um, you just really time box the distractions and you know, the checking your phone or whatnot, but to throw in some exercise there is just like, that’s perfect.

[00:45:44] That’s

[00:45:44] awesome.

[00:45:44]Host: [00:45:44] Yeah, a hundred percent. Um, I skipped over, we were starting to talk about sleep too, as well. Uh, how sleep is related to glucose. Do you have anything that you’d like to share on sleep?

[00:45:54] Dr. Casey Means: [00:45:54] Yeah,

[00:45:54] I mean the, the, the main takeaway is that sleep is so critical to our overall metabolic functioning, and more than I think we’ve ever anticipated. But it’s just, we’re learning more and more that it’s like, while food is a key driver of our overall metabolic health.

[00:46:12] You, if you’re eating perfectly and exercising well, if you’re totally skimping on sleep, you’re never going to achieve optimal outcomes. Um, it’s just, it’s, it’s, food is necessary, but not sufficient to have good metabolic health. You have to have the sleep part dialed in. And it’s amazing because even just tiny, tiny amounts of loss of sleep can actually change our hormonal

[00:46:37] sort of milieu in our body the next day. So, um, there’s been some studies looking at, um, people who are, what are called short sleepers, which are people who are basically sleeping 6.5 hours a night, which is pretty typical for a lot of Americans. And then long sleepers who were people getting 7.5 to 8.5 hours of sleep at night.

[00:46:56] And those short sleeper people and the long sleeper people had the same, basically glucose levels. Um, and they did a test with these people called an oral glucose tolerance test where you give them this drink that has 75 grams of glucose in it. And you see what happens to their glucose over the next two to three hours, taking blood at, at regular intervals. And both the short sleepers and the long sleepers who are all healthy non-diabetic individuals, had the same glucose elevation sort of response to the glucose load. But the short sleepers had to produce 50% more insulin

[00:47:28] to get that same level. So they were essentially showing insulin resistance. Their body had to produce out a lot more of this hormone to just be able to have the same normal appearing glucose levels. So by the test, by the glucose test, they all looked like the same level of health. But when you look at insulin, they actually had a lot more insulin resistance in the group that was short sleepers.

[00:47:48] Um, Another interesting study, took a group of young, healthy men and subjected them to four hours of sleep per night for, I think it was six nights. So that’s definitely, definitely depriving sleep. Um, but I can imagine there’s college students out there who are kind of doing this every now and then, like getting four to five hours of sleep for a week or so.

[00:48:09] And in that six days, they basically took these men who were healthy and otherwise in good shape, took them to basically showing pre-diabetic levels of glucose. They essentially turned them into pre-diabetic individuals in that short period of time, just with sleep deprivation.

[00:48:24]Host: [00:48:24] From sleep deprivation. That’s fascinating.

[00:48:27] Dr. Casey Means: [00:48:27] Yeah. And then they gave them unlimited sleep for like the next week and everyone, you know, bounces back and it’s , but it’s, it’s just amazing.

[00:48:35] And so it’s just even so, so yeah, I, I. It’s made me think a lot more deeply about that and it’s, it’s all very hormonal in nature. When you are deprived of sleep, it raises your cortisol, your stress, hormone levels. That’s of course going to have an impact on your glucose levels. Um, it changes your hunger and satiety hormones, ghrelin and leptin.

[00:48:53] It makes you more hungry, uh, when you’re sleep deprived, and you are often looking for energy dense foods. It changes your insulin sensitivity in general, makes insulin levels higher. It changes your growth hormone levels. It’s just, there’s such a cascade that happens when you don’t get sleep. And it seems like the optimal

[00:49:12] amount of sleep for metabolic health is between about seven and a half and eight and a half hours of sleep per night. Interestingly, when you go above that, like nine or above hours of sleep per night, it actually has, your outcomes go down as well. And when you go below that. So it’s a J shaped curve.

[00:49:28] It’s like the lower, your risk is higher, if you have lowest amount of sleep. And then at this perfect little amount, seven and a half to eight and a half hours of sleep, you’re doing really well from a metabolic standpoint and disease risk standpoint. And then as you increase your sleep too much, it can, uh. So you want to get that sweet spot.

[00:49:45] Host: [00:49:45] Yeah. Do you

[00:49:46] have any info? Like why do you think that is if you get more than eight or nine hours, do you have any info on why that might

[00:49:53] be?

[00:49:54]Dr. Casey Means: [00:49:54] I think it’s a couple things. I think one it’s because you know, our circadian rhythms, it’s not just about getting more sleep. It’s about having a cyclical nature to your body and your hormones and patterns that are associated with health.

[00:50:07] And I think when you have a dysregulated sleep in any way, like you’re getting too much or you’re getting too  little, it might be a sign of an underlying, uh, rhythm dysregulation that, that has other outcomes. So, um, yeah, it’s, it’s, it’s just one of those, like more is not better or type of things, it should be on the right pattern.

[00:50:23] Host: [00:50:23] That makes sense.

[00:50:24] Very cool. Before I get to my last question for you here, um, where can people find more about you and Levels? And if there’s anything else that you wanted to maybe share about Levels that we haven’t covered? I’ll I’ll give you the floor now.

[00:50:36] Dr. Casey Means: [00:50:36] Sure.

[00:50:37] Yeah. So, um, So Levels right now we’re in a beta mode.

[00:50:41] So we have not actually opened up to like the full public yet. But for anyone who is interested in learning more about metabolic health or signing up for our waitlist, you can go to LevelsHealth.com and sign up, um, for our wait list and you’ll get access to our newsletter, which is great. We have a bunch of, you know, the top academic MDs, PhDs, writing amazing articles about why the average person should care about metabolic health and why we should care early, and really interesting content.

[00:51:09] Um, we plan to fully launch later this year. So, ideally in 2021, people will be able to sign up for the program. Um, you can follow us on Twitter and Instagram @Levels. And I highly recommend following our Instagram because people are, our beta customers are doing so many interesting experiments and having really interesting insights and they’re posting about it a lot.

[00:51:33] And it’s really fun to kind of just watch how people are using this type of tool to improve their lives. I’m personally @DrCaseysKitchen on Instagram and Twitter. So Dr. Casey’s kitchen and, um. Yeah, and I write about health and nutrition. So.

[00:51:49]Host: [00:51:49] I love that.

[00:51:49] I’ll have all of those linked up in our description, show notes as well.

[00:51:52] Dr. Casey Means: [00:51:52] Awesome.

[00:51:53] Host: [00:51:53] Cool. So this show, the title of the show is The Live Life Longer Show. Of course, I like to talk about longevity. Um, if you had an ideal age that you can live to, if you can choose what age you’re, you’re living to, what age would that be and why is living life longer important to you?

[00:52:09] Dr. Casey Means: [00:52:09] Yeah. So for me, Ooh, I think a number is a, I’m actually going to defer from giving a number.

[00:52:17] Host: [00:52:17] That’s fair.

[00:52:18] Dr. Casey Means: [00:52:18] Because I, for, for many reasons, um. I  lost my mother prematurely in life and, uh, and I, I really

[00:52:27] I think it’s much less about a number than how you’re actually filling your years. Um, despite, um, you know, dying before her time, she’d lived one of the most fullest lives of anyone I’ve ever met. And so I think I really focus now more on like how we add life to our years, than years to our life, even though living a long time would be great.

[00:52:46] But I think it’s kind of like missing the forest for the trees if we’re not really just focused on, on what we’re doing with the years that we, that we have, um,. And seeing someone die earlier than they should have, with zero fear and zero regret and zero sadness is pretty, pretty much will, I think, solidify that for, for anyone.

[00:53:05] And that’s what I was able to witness. So, um, but and what was the second question. What is living? Why would you want to live long?

[00:53:13] Yeah. Why,

[00:53:13] Host: [00:53:13] why is longevity important or to your point, I think you’ve answered it. Why, you know, adding more life into those years is important too.

[00:53:21] Dr. Casey Means: [00:53:21] Yeah. Yeah. So I think. I think longevity, and I imagine you’ve had other guests probably touch on this before, but you know, it’s really, I think

[00:53:31] less about lifespan and more about health span. Um, lifespan is how many years we live, but health span is how health, how, how long we can live healthy. And ideally we want our health span and our lifespan to be the same. We want to have health and vibrancy until the year, the day that we, that we die. And, and so that to me is what I’m really focused on, because you, you can’t control how long you’re gonna live, necessarily.

[00:53:56] Like anything can happen. But you can control how much health you have in those years. And that’s where, like, I think everything we talked about today and, and other guests you’ve had is so important, because investing in these health behaviors, relating to diet lifestyle, I think in particular, you know, food, how we stress, how we sleep, how we move,

[00:54:15] um, it just unlocks the ability for every single day and every single year to feel better and feel great. And, um, and that’s really what we, what we want. So, yeah.

[00:54:24]Host: [00:54:24] I love

[00:54:25] that. Thank you for sharing all of that. That, that was super powerful. Awesome. Well, Dr. Casey, thank you so much for your time. Sharing your expertise is a awesome conversation and I really appreciate you.

[00:54:35] Dr. Casey Means: [00:54:35] Thanks so much, Dan.

[00:54:37]Host: [00:54:37] Thanks. Have a great day.

[00:54:38]Dr. Casey Means: [00:54:38] You too. .