93: Josh Clemente, Founder of Levels Health

In this episode Level’s co-founder Josh Clemente joins Romeen Sheth on the Square One podcast to discuss his early career at SpaceX, biggest problem humans face today and how Levels is changing the way people interact with food and health.

From aerospace life support to Levels

Josh started his career at SpaceX and after designing life support systems for the crew of space craft he found his way to Levels through a desire to understand his own metabolic health.

spent about six years at SpaceX, eventually leading the team that was developing high pressure life support systems. So the breathing apparatus and cabin pressure control systems for the Crew Dragon spacecraft which flew for the first time in 2020. And from there, I moved on to Hyperloop doing some very early stage infrastructure scale engineering and design, some life support specing and things like that. And ultimately, became through my own experience, obsessed with the human physiology and metabolism. This was basically due to my experience kind of burning out through the process of just pushing myself way too hard for way too long and not understanding why the decisions I’m making every day that were leading to poor lifestyle were essentially grounded in nothing. I just became acutely aware of the fact that I don’t have a data stream of any kind or objective information guiding me towards a better lifestyle.

Misconceptions about first principles

First principles are often considered less valuable for complex problems but Josh says thats not the case.

the shortest distance between two points is a straight line. And so when you start to add complexity to the problem you’re trying to solve, you’re deviating from the straight line, which is the connection between the problem you’re trying to solve simply stated and the execution you’re taking. So another way to describe this could be analysis paralysis, avoiding analysis paralysis. So I think when we talk about first principles, you’re absolutely right, it’s overused and underutilized.

I think that the idea is that there is a core problem that you are intending to solve. And oftentimes we get sidetracked by all the complexities and shiny objects attached to that core problem. And we start to solve extraneous details as opposed to the execution that needs to happen, the iterative process of solving the core fundamental physics-driven or chemistry-driven process.

The best example of first principles from Elon Musk

Simplifying concepts also means simplifying the message to explain concepts as you would to a child.

So Elon, when we first got the Falcon 9 version 1.1 into orbit, he stood up and he gave me what I think of as the best example of first principles speaking that I had ever heard. And he said, “Okay, the rocket put the satellite in orbit, but we didn’t recover just like every other rocket history. If we want to survive as a company, we need to be able to reuse rockets. And so what we need to do is we need to land them and reuse them. So in order to land, you need legs. So we’re going to put legs on the rocket and it’s going to land and we’re going to reuse it. And it’s going to just come in backwards and we’re going to fire the engines up to slow it down and it’s going to land on the pad.”

And he literally talked through this like an eight-year-old kid would talk about a simple problem. And that’s key. And I actually think a requirement of first principles thinking is to simplify language as well as simplifying concepts. And ultimately, the way the Falcon 9 rocket lands and is reused is it comes in backwards, it fires its engines, it slows down, spreads out legs and it lands on a landing pad or on a drone ship.

Why there is a no jargon policy at SpaceX

An early decision by SpaceX execs meant acronyms were outlawed to remove artificial barriers to participation.

If you open up a standard aerospace requirements document from the old aerospace or incumbent aerospace. You’re going to see word salad. It’s a lot of placeholder acronyms that mean long names for certain projects and sub-projects beneath them. And all the way down to the part level, the entire vehicle is enshrouded in this essentially cryptography. It’s impossible to know what you’re reading unless you have the key. And to have the key takes decades. You have to become familiar with all these acronyms. So from the earliest, the executives at SpaceX eliminated acronyms as a means towards this end of eliminating jargon. The reason for this is you are building artificial walls against individuals being able to contribute regardless of their capabilities or their demonstrated credentials.

Levels answers the question – What should I eat and why?

Many people currently make health and lifestyle decisions with little or no data. Levels makes it possible to answer questions with your own data.

So Levels is the first biowearable system that answers the question, what should I eat and why? And this is a surprisingly complicated problem. If I were to ask the majority of people, what are you going to sit down and eat lunch today? And why are you going to choose that? Most people give me a blank stare, they then give me something like, “Well, I read this recipe this weekend on the New York Times.” Or, “I saw an Instagram person post this and they said it was really healthy.” Or, “My mom used to make this.” Or, “It just tastes good.” These are all perfectly good answers, but they are not the answers that you need if you’re trying to determine, is this healthy for me? Is this the right decision for me?

The state of the metabolic health epidemic

Levels is tackling a critical problem by increase awareness and education of metabolic health.

a study in 2018 showed that 88% of the United States is metabolically unhealthy by at least one metric. 70% of the United States is overweight or obese. 90 million Americans have pre-type 2 diabetes. 84% of those 90 million don’t know that they have it. So they are unaware that they are trending towards type 2 and 70% of them are expected to convert to full-blown type 2 diabetes within the next 10 years.

Building a closed metabolic feedback system on existing tech

Levels is using existing continuous glucose monitoring technology and adapting it to consumer usage by adding a deep insights layer.

What Levels is doing is essentially building on this incredible technology that is being used for a very important and necessary reason, but building on the use case for it and moving it from strictly therapeutic. So essentially waiting until something has broken to pay attention to it over to a more wellness and general health awareness use case. And so this is essentially trying to get people aware of the implications of the choices they’re making. So we’re building essentially an insights layer on top of the hardware that pulls in raw data, interprets it with machine learning algorithms, scores decisions you’re making, and then feeds that data back to the end user in a timely fashion coupled with educational material. The goal is to close feedback loops in as short a period of time as possible between actions we’re taking, reactions we’re experiencing and then recommendations for alternative actions.

Opening a new market for wearable devices

Wearable devices have typically relied on surface level data but Levels opens up a new frontier by directly measuring chemical responses.

Historically, wearable devices have been, and this is not detrimental in any way, but they’ve been measuring superficial markers that you can measure on your own. So for example, step count, pulse, things like that. And these are useful, especially when contextualized, and companies like Whoop and Oura and Eight Sleep are all taking that raw data on your pulse and your heart rate variability and feeding it back to you in an insightful manner to help create behavior change around the specific lifestyle that you’re trying to improve, or the lifestyle factor you’re trying to improve. Levels goes deeper in that we are below the skin. We’re measuring molecules in the body in real-time. And this is essentially opening a massive new market for closed feedback loops with bio information associated. Rather than waiting for an external factor of some kind, we can now measure chemicals and estimate or directly measure the responsive chemicals that are effectively driving our quality of life and our quantitative risk of long-term breakdown.

Prehistoric man encountered less high energy calories in their life than we can in a single sitting today

As the world has changed we are now faced with problems of abundance and high energy toxicity rather than scarcity and starvation.

The world is changing and for a vast number of people, the scarcity scenario is no longer the threat, it’s the abundance scenario. A way to put a point on this as it relates to metabolism is, for the vast majority of human history, human beings have been kind of roving bands looking for their next calories and a lot of fasting, a lot of physical exertion and very, very few opportunities to eat large amounts of sugar. And sugar is a super fuel. It’s like nitromethane for our bodies, the cellular engines in our bodies.

The problem is that we now have the ability, after only 100 years, 200 years of agriculture to essentially short circuit the body in the sense that we’ve been developing agricultural methods for long periods of time, but we’ve now been able to amplify the processes through the industrial revolution to the degree that an individual can sit down and in a single sitting consume more processed food and more high energy calories through carbohydrates and fats than a prehistoric man would’ve had in their entire lifetimes.

Creating an non-intuitive link between body and mind

Josh has experienced an unexpected impact as a result of using Levels consistently: there is now a shorter path between what his body feels and his ability to make a change.

The interesting thing I think about using a device that is measuring molecules in your body is that it immediately creates this short path between the body and mind, and it becomes, I think, a different conversation with oneself where previously it felt very challenging for people to get the motivation to stick to a new set of goals. Like, “I want to get healthy, I want to lose weight. I’m going to avoid this group of foods as per this diet that I found online. And it’s going to take intense motivation to make it through those moments of temptation, but I’m going to do it.” That’s kind of how things have historically been. That conversation has totally changed in a really elegant, and I think for me, a non-intuitive way, when you bring real-time data for the individual into the conversation. So now that person who is saying, “I want to achieve this goal.” They are then getting feedback from their own body with no middle man, with no individual in the middle interpreting it for them and giving it to them in a patronizing way. It’s instead, I do something and my body tells me directly whether or not that fit with my goals.

Learning is driven by shortening the feedback loop

Connecting the reaction to an action in as close to zero minutes as possible speeds the learning process and highlights the importance of Levels focus on real-time metabolic data.

If you want someone to understand whether or not the meals they’re eating each day are affecting them positively or negatively, you can’t tell them two weeks later that that lunch two Wednesdays ago was bad for them. What you need to do is connect the reaction to the action in as close to zero minutes as possible because that’s how learning happens. We experiment, we see some response to our experimentation and that influences behavior change. You touch a hot stove, it hurts, you immediately remember that. And that’s embedded as habit. So that’s what we’re trying to replicate is the, and not to sound negative, this is not about all touching hot stoves. It’s about closing the feedback loop first with a data stream and then making that as short and as tight as possible, because that’s where the habituation of a lesson learned occurs for human beings, especially when it is their own personal data driving that habit change.

Romeen Sheth: We’re going through a renaissance period in consumer health right now. New tech-enabled products are coming out for sleep, telehealth, diet, nutrition and more. This week’s guest took us deep into what optimizing the metabolic function looks like. Seven of the 10 leading causes of death in the US are strongly related to metabolic dysfunction. Metabolic function improves energy, endurance, memory, mood, and cognitive performance. Josh Clemente has brought a biowearable metabolic sensor market to help solve this problem.

Romeen Sheth: Levels is an innovative platform that pairs continuous glucose monitoring with an impressive software suite to provide the wearer with deep insights about their health. In advance to this conversation, Josh’s team sent my wife and I, both the Levels to see how the product works and it was incredible. It provided us actionable health information and helped us understand how specific foods, exercise and timing of day affected our metabolic health. This episode was a ton of fun. Josh has experience at some of the most innovative companies in the world like SpaceX and brought that experience to Levels to build a next generation category winner in healthcare. Welcome, Josh. Thanks so much for joining me.

Josh Clemente: Thanks a lot for having me on. I’m excited to jump into this.

Romeen Sheth: Yeah. Josh excited to have you on the show today. We’re going to dive pretty deep into Levels and the problem you’re solving. But before we do that, you’ve had a really interesting background, working on challenging problems at companies like SpaceX and Hyperloop. Tell us a little bit more about your background and how it led you to founding the company.

Josh Clemente: Yeah. So I’m a mechanical engineer by training. I focused on thermodynamics and heat transfer in college. And essentially, I wasn’t a great student my whole life. I was more so focused on just enjoying building things and specifically vehicles. So anything that moved people from point A to point B ideally at very high speed. That’s the type of thing I was going to be interested in. So that was how I got fascinated by mechanical engineering and originally intended to go work at Tesla, but due to some interesting circumstances around the company, they had just gotten a Department of Energy loan. They had just bought the NUMMI plant in Fremont. They were moving their offices.

Josh Clemente: My internship with them fell through and they recommended I apply to SpaceX instead. And I had never really considered aerospace as a possibility given my aforementioned grades were not the best. But at the time SpaceX was a small scrappy startup without the attention of the big aerospace programs. So I was able to basically present on a vehicle project that I had built in college and convince them that I knew, not only how to design things and analyze them, but also I could build them with my own hands and that’s what they needed.

Josh Clemente: So started out there as my first position and spent about six years at SpaceX, eventually leading the team that was developing high pressure life support systems. So the breathing apparatus and cabin pressure control systems for the Crew Dragon spacecraft which flew for the first time in 2020. And from there, I moved on to Hyperloop doing some very early stage infrastructure scale engineering and design, some life support specing and things like that. And ultimately, became through my own experience, obsessed with the human physiology and metabolism.

Josh Clemente: This was basically due to my experience kind of burning out through the process of just pushing myself way too hard for way too long and not understanding why the decisions I’m making every day that were leading to poor lifestyle were essentially grounded in nothing. I just became acutely aware of the fact that I don’t have a data stream of any kind or objective information guiding me towards a better lifestyle. And that became very frustrating. Basically, once the light was shown in that space, I realized, “Yeah, this is a huge problem. It’s a vacuum in my life where I have nothing guiding my decisions.” It became increasingly frustrating for me and that ultimately led to some self experimentation and the concept and experimentation that became Levels.

Romeen Sheth: Yeah. The experimentation and finding the ground truth not being rooted in anything, I think is especially interesting. We’ll talk about that a lot in today’s conversation, but I think it’s especially interesting because it refers basically to this concept we talk a lot about in tech called first principles. And first principles is interesting because I think it’s one of the most overrated and underrated concepts in tech simultaneously. Overrated because it’s just referred to so often that in some sense it loses its meaning and underrated because if you actually do unlock it, it can be super significant.

Romeen Sheth: Spacex is also an interesting example because first principles at SpaceX and a few select companies like SpaceX around the world really do mean something differently. What does first principles mean to you? And maybe kind of pair that out with an example from your time at SpaceX or Hyperloop that really illustrated that.

Josh Clemente: It’s actually a surprisingly complicated concept to describe. The way I like to think about it is the shortest distance between two points is a straight line. And so when you start to add complexity to the problem you’re trying to solve, you’re deviating from the straight line, which is the connection between the problem you’re trying to solve simply stated and the execution you’re taking. So another way to describe this could be analysis paralysis, avoiding analysis paralysis. So I think when we talk about first principles, you’re absolutely right, it’s overused and underutilized.

Josh Clemente: And I think that the idea is that there is a core problem that you are intending to solve. And oftentimes we get sidetracked by all the complexities and shiny objects attached to that core problem. And we start to solve extraneous details as opposed to the execution that needs to happen, the iterative process of solving the core fundamental physics-driven or chemistry-driven process. So to say first principles, it says nothing about the hardness of the problem being solved. So a lot of people often thinks, “Oh, that that only works for very simplistic problems like moving a package from here to there.”

Josh Clemente: That’s actually not true. No matter how complex a problem on paper, there are first principles associated with it. These are the basic fundamental physical properties of the challenge you’re solving. So very, very hard problems can be attacked from first principles. It’s a way of organizing one’s approach to bias towards clarity of thought and iterative problem solving while staying on that narrow trajectory. Anyway, a simple concept that, or maybe a simple example that could drive this concept would be, while at SpaceX, every rocket that had ever been developed until 2015 put a satellite or a spacecraft into orbit and then fell back through the atmosphere, broke up, dissolved or burned or were shredded and fell into the ocean and was unrecoverable.

Josh Clemente: And that meant that the aerospace industry was exorbitantly expensive and extremely inefficient. Every time something needed to go to space, it required a new launch vehicle. The exception to this rule was the Space Shuttle, but we’re focusing on booster rockets. So Elon, when we first got the Falcon 9 version 1.1 into orbit, he stood up and he gave me what I think of as the best example of first principles speaking that I had ever heard. And he said, “Okay, the rocket put the satellite in orbit, but we didn’t recover just like every other rocket history. If we want to survive as a company, we need to be able to reuse rockets. And so what we need to do is we need to land them and reuse them. So in order to land, you need legs. So we’re going to put legs on the rocket and it’s going to land and we’re going to reuse it. And it’s going to just come in backwards and we’re going to fire the engines up to slow it down and it’s going to land on the pad.”

Josh Clemente: And he literally talked through this like an eight-year-old kid would talk about a simple problem. And that’s key. And I actually think a requirement of first principles thinking is to simplify language as well as simplifying concepts. And ultimately, the way the Falcon 9 rocket lands and is reused is it comes in backwards, it fires its engines, it slows down, spreads out legs and it lands on a landing pad or on a drone ship.

Josh Clemente: And there had been decades of research that demonstrated through analysis that that was impossible. That hypersonic retropropulsion, which is where an engine is coming in into the windward side of the atmosphere and the engines are exposed to this giant essentially cloud of the atmosphere at high pressure and high speed that it would be impossible for a rocket to survive that, let alone start up again and slow a vehicle down. And so no one had ever tried it. And Elon just did it. And he did it on paying customers vehicles. We attached legs to systems that were already heading up in space and we built, tested it and iterated. And it took a few fiery explosions, but ultimately aerospaces transformed.

Josh Clemente: And so making sure that until you have proven something wrong on the grounds of the physics, there has to be evidence that this can’t be done before you assume that that problem is unsolvable. I think that’s the clearest example, and just being unafraid to make recommendations that might sound stupid to an industry professional, I think is another core requirement.

Romeen Sheth: It’s interesting the way you frame that Josh, because I’m hearing two things from what you’re saying. One is the importance and the concept of first principal thinking, but I’m hearing almost an equivalently important concept, which is the importance of simplicity, simplicity and language and communicate specifically. And I think at SpaceX, and you can correct me if I’m wrong, but I think at SpaceX, SpaceX is known for this, that there’s a rule against jargon or so.

Romeen Sheth: And I found that really interesting. I want you to unpack that concept, especially from the experience of having been at SpaceX. And then we’ll use that to parlay into Levels and implications when you’re solving really difficult problems. Why this need for leaving jargon on the sidelines actually ends up being extremely critical.

Josh Clemente: Definitely. Yeah. So it is true that there’s a no jargon policy at SpaceX. And that one’s a little bit harder to enforce, but the easy one that’s enforced rigorously is the no acronyms policy. So if you open up a standard aerospace requirements document from the old aerospace or incumbent aerospace. You’re going to see word salad. It’s a lot of placeholder acronyms that mean long names for certain projects and sub-projects beneath them. And all the way down to the part level, the entire vehicle is enshrouded in this essentially cryptography.

Josh Clemente: It’s impossible to know what you’re reading unless you have the key. And to have the key takes decades. You have to become familiar with all these acronyms. So from the earliest, the executives at SpaceX eliminated acronyms as a means towards this end of eliminating jargon. The reason for this is you are building artificial walls against individuals being able to contribute regardless of their capabilities or their demonstrated credentials, if that makes sense.

Josh Clemente: So when you insulate credentialism by ensuring that only people with the appropriate credentials will be able to contribute to a conversation, you’re unnecessarily eliminating the tales of the contributors. And so I’ve seen this time and time again at SpaceX and elsewhere, where when you speak in simple terms, not only does it enforce that first principle’s thinking because the conversation is necessarily grounded in the larger concepts that you’re trying to resolve instead of the complex exterior superfluous problems.

Josh Clemente: And secondly, you’re opening it up to anyone. So whether this conversation is immediately going to be contributed to by someone who may have a third-person perspective or an outsider perspective, or maybe is recorded and distributed, and someone could potentially absorb that information more effectively and use it for their own project, I think that ultimately simple communication and the reinforcement of it across organizations is powerful. And I think it is a key… It’s really funny to listen into, and I think engineering conversations out of place like SpaceX, because it is so simplistic. The language, it’s almost a competition to explain like I’m five all the time.

Josh Clemente: And I originally was put off by it and I thought, “Some of these people sound really unintelligent.” And then once you’re kind of initiated into it, you realize, “This is powerful.” You don’t have to impress people with the words that you know and the acronyms you’re familiar with. You can simply put an idea out there that potentially in another forum would be embarrassing or would be a potential for you to be, I think, ostracized or identified as an outsider. And so across the board, I think it evens the playing field and provides opportunity for rapid iteration while maintaining first principles conversation.

Romeen Sheth: So let’s talk about Levels because rapid iteration is especially an important part of the company and the product. The product is awesome. My wife has been using it. We were talking a little bit about it before we started the discussion. But before jumping into the product specifically, Josh, just give our listeners a better understanding of what Levels is as a company. Systematically what you’re trying to solve and what’s the scale of the problem at hand?

Josh Clemente: Yeah. So Levels is the first biowearable system that answers the question, what should I eat and why? And this is a surprisingly complicated problem. If I were to ask the majority of people, what are you going to sit down and eat lunch today? And why are you going to choose that? Most people give me a blank stare, they then give me something like, “Well, I read this recipe this weekend on the New York Times.” Or, “I saw an Instagram person post this and they said it was really healthy.” Or, “My mom used to make this.” Or, “It just tastes good.” These are all perfectly good answers, but they are not the answers that you need if you’re trying to determine, is this healthy for me? Is this the right decision for me?

Josh Clemente: And so what we are doing is using real-time data from wearable devices. The first one is a continuous glucose monitor. Glucose is the sugar molecule that most of us are powering every cell in our bodies with. So we are monitoring this data in real-time and then analyzing it in the Level software to provide insightful closed feedback loops. So essentially showing you the reactions to the actions you’re taking every day and helping surface opportunities for better choices, whether those are nutrition-based, exercise-based, sleep or stress management based, helping to surface us those opportunities for little micro optimizations.

Josh Clemente: So the reason we’re solving this, or working on this problem is that it’s a silent epidemic. And the scale of it is beyond most people’s perception. So the metabolic health crisis extends to… Well, the current state, and I’ll just throw some statistics out here to try and drive it home, but a study in 2018 showed that 88% of the United States is metabolically unhealthy by at least one metric. 70% of the United States is overweight or obese. 90 million Americans have pre-type 2 diabetes. 84% of those 90 million don’t know that they have it. So they are unaware that they are trending towards type 2 and 70% of them are expected to convert to full-blown type 2 diabetes within the next 10 years.

Josh Clemente: So this problem is continuing to move earlier and earlier in life and younger and younger people are being affected all the way down to the ages of five and below. So there are pediatric endocrinology experts who are highlighting these cases where children have type 2 diabetes, which is an adult onset, or historically has been considered to be an adult onset due to chronic lifestyle decisions. All of this to say that the metabolic crisis, and we can get into what metabolism is specifically in just a minute, but the crisis is so bad and it’s actually, it’s getting worse at an increasing rate.

Josh Clemente: So globally the world is getting less healthy at an increasing rate. As countries become more developed, they become a bit more sedentary typically as information jobs take hold, the food supply becomes more processed in order to allow for preservation and distribution. And so you have these two, I think, rapidly coupling lifestyle factors that lead to increasing rates of this disorder. And so Levels is attempting to attack this problem, not by solving the world’s problems with a single policy or a single diet, but rather by decentralizing it and giving each individual the information they need to make better choices in the moment. Multiply that by enough people and you have resolved the same social scale problem, or at least that’s how we see it.

Romeen Sheth: And so outside of this scale of the problem, why metabolism and glucose specifically? Why are those the elements you decided to focus on and how do we think about those two elements specifically when we’re thinking about health systems?

Josh Clemente: So metabolism, essentially that is defined as the set of processes that our cells use to generate energy from our food and our environment. So sunlight, other environmental factors like that. And then of course the molecules in our food. So when you think about that, it’s actually a really critical process that we oftentimes clearly ignore. So your brain, your muscles, everything in your body is consisting of living tissue, the cells of which require energy to continue to survive and certainly require energy in order to function optimally.

Josh Clemente: When the metabolic systems start to dysfunction or experience dysfunction, the effect are pretty widespread. You can imagine the number of systems in the human body, all of which consist of different cells. If a certain number of them, or a large majority of them begin to malfunction due to the effects of a poor metabolic set of processes, you’ll start to see this show up in a number of ways. And we call these a whole bunch of different things. Some of the metabolic effects that we are seeing at scale in society are not just type 2 diabetes, which we all commonly think about, cardiovascular disease, stroke, cancer, PCOS which is the leading cause of infertility in the United States. Sexual dysfunction.

Josh Clemente: All of these have deep metabolic roots. Alzheimer’s disease, which is one of the top 10 causes of death in the United States today is being called type 3 diabetes because of the insulin resistance in the brain that actually drives that late-onset dementia. So all of these things are kind of called certain names and they are approached with different symptom care, but they come down to a single concept, which is the metabolic system, the way that our bodies break down the foods we provide and are then able to allocate those resources towards energy production.

Josh Clemente: When those systems start to fail, we see these side effects, and that’s why we’ve chosen to target metabolism specifically and glucose exclusively for now. I can give some specifics on glucose in just a second, but suffice to say that glucose is the number one analyte that our bodies are currently generating energy off of. And the dysfunction of glucose is closest related to all of the aforementioned metabolic disorders. So it’s the earliest target, it’s not the only target, but it’s the earliest one that we want to get people thinking about and start optimizing for.

Romeen Sheth: And so how does the product work? There’s a hardware component. There’s a software component. Talk about how you’re attacking the problem.

Josh Clemente: So historically, the people that are most interested in managing glucose are people who have an active diagnosis of diabetes. And this could be type 1 diabetes, which is typically an autoimmune disorder, or it could be type 2 diabetes, which is considered to be a chronic lifestyle related onset. In both cases, the glucose and the insulin, which is a hormone that manages glucose, the glucose insulin feedback loop is broken and blood sugar levels start to get really out of control. This has a ton of detrimental effects across the body, and it’s really important for people who have diabetes to be able to measure and manage in real-time their blood sugar levels.

Josh Clemente: For this reason a technology was developed over the past few decades called the continuous glucose monitor. And this device is a little patch and it has a small filament on it. And that filament is a little flexible, sort of fishing string type thing. And that sits in the skin, a few millimeters below the skin surface, and it’s directly measuring molecules of glucose in the blood, or really it’s what’s known as the interstitial fluid, which is kind of a filtered subset of the blood. And by measuring those molecules directly and streaming the data to the smartphone, people with diabetes were able to immediately take control continuously of their blood sugar care, as opposed to historically pricking their fingers, bleeding on a strip and measuring a single point in time.

Josh Clemente: So what Levels is doing is essentially building on this incredible technology that is being used for a very important and necessary reason, but building on the use case for it and moving it from strictly therapeutic. So essentially waiting until something has broken to pay attention to it over to a more wellness and general health awareness use case. And so this is essentially trying to get people aware of the implications of the choices they’re making. So we’re building essentially an insights layer on top of the hardware that pulls in raw data, interprets it with machine learning algorithms, scores decisions you’re making, and then feeds that data back to the end user in a timely fashion coupled with educational material.

Josh Clemente: The goal is to close feedback loops in as short a period of time as possible between actions we’re taking, reactions we’re experiencing and then recommendations for alternative actions. And through this, we feel confident that rather than, again, waiting for the system to fail before we start to measure, we instead can manage upfront and allow people to optimize rather than slowly over time diverging into dysfunction.

Romeen Sheth: And let’s dissect the nuance of that measurement because there’s a ton of companies on the market trying to measure some piece of the stack, whether it’s steps, pulse, you name it, sleep cycles. Apple has come out and made a declaration that healthcare is going to be their line in the sand over the next decade. So a lot of folks are thinking about this. A lot of folks have different approaches to it. How is Levels differentiated in this space? At a top level, I think, to a layman or to a nonscientific person, hearing tracking of things sound similar, but there’s clearly differentiation and underlying elements that make this unique. So talk a little bit more about what specifically Levels is measuring and then how it differentiates from other wearables in this space.

Josh Clemente: Yeah. So historically, wearable devices have been, and this is not detrimental in any way, but they’ve been measuring superficial markers that you can measure on your own. So for example, step count pulse, things like that. And these are useful, especially when contextualized. And companies like Whoop and Oura and Eight Sleep are all taking that raw data on your pulse and your heart rate variability and feeding it back to you in an insightful manner to help create behavior change around the specific lifestyle that you’re trying to improve, or the lifestyle factor you’re trying to improve.

Josh Clemente: Levels goes deeper in that we are below the skin. We’re measuring molecules in the body in real-time. And this is essentially opening a massive new market for closed feedback loops with bio information associated. Rather than waiting for an external factor of some kind, we can now measure chemicals and estimate or directly measure the responsive chemicals that are effectively driving our quality of life and our quantitative risk of long-term breakdown. So right now, we’re just measuring glucose, but the roadmap includes a whole number of additional analytes. And I touched on glucose and insulin briefly, but the real driving force behind metabolic dysfunction, although associated with glucose dysregulation is actually that insulin hormone.

Josh Clemente: So when we continually consume and don’t burn through exercise high sugar, highly processed food, we’re spiking our own blood sugar and correspondingly spiking our insulin, which is the hormone necessary to get blood sugar out into the cells. As that process repeats time and time again, day after day, weeks, months, years into the future, eventually our cells seem to lose the responsiveness, the sensitivity to that insulin hormone, and this is known as insulin resistance and it is the underlying cause and effect, I think of the behaviors we’re kind of… Well, it is the effect of the behaviors we’re implementing, but it is the cause of the ultimate breakdown in our tissues and our quality of life.

Josh Clemente: So with time, Levels intends to be able to measure not just glucose, but also these other analytes, thinking insulin, thinking cortisol, thinking other factors associated with inflammation and long-term breakdown. So our intention is to couple all of this with world class data science and insightful behavior change so that we can continually, not just talk about better behavior, but help reinforce the habits that will create it with these individual actionable molecules.

Josh Clemente: So I welcome the attention from the largest and best hardware providers in the world to this space. I think it’s necessary. In my opinion, it is the largest problem-facing society. And it is not necessary that we all fight over the same space. I think we’re going to be able to be complimentary and as a unit advance the state of understanding of how large this problem is and how best to resolve it.

Romeen Sheth: Now let’s talk about how much surface area has been covered in the wearable space. I think one of the things that’s interesting to me Josh is certainly that advancements in technology and the technology layer you were just describing, I think there’s also a social psychology layer that’s evolving as well. So if you think of the majority of human history, the challenge is getting enough resources. Now the challenge in many senses is actually shutting things out, instant delivery, instant taxi, instant connectivity. It’s more and more and more information that comes to you and it creates a whole slew of different issues.

Romeen Sheth: It also creates significant opportunity. In healthcare, it allows us to move more from a reactive model with long feedback loops to a proactive model with faster iteration. I’m curious how you think about where we are psychologically as well as technologically in terms of the backdrop of the context of Levels. And specifically, how you think about how much surface area has been covered in the wearable space. Are we in the first inning, third inning, seventh inning? What are we good at solving right now and where is there still opportunity to run? I know a really big question, but how do you think about that?

Josh Clemente: Well, I really like the first point you touched on there, which is that the world is changing and for a vast number of people, the scarcity scenario is no longer the threat, it’s the abundance scenario. A way to put a point on this as it relates to metabolism is, for the vast majority of human history, human beings have been kind of roving bands looking for their next calories and a lot of fasting, a lot of physical exertion and very, very few opportunities to eat large amounts of sugar. And sugar is a super fuel. It’s like nitromethane for our bodies, the cellular engines in our bodies.

Josh Clemente: The problem is that we now have the ability, after only 100 years, 200 years of agriculture to essentially short circuit the body in the sense that we’ve been developing agricultural methods for long periods of time, but we’ve now been able to amplify the processes through the industrial revolution to the degree that an individual can sit down and in a single sitting consume more processed food and more high energy calories through carbohydrates and fats than a prehistoric man would’ve had in their entire lifetimes.

Josh Clemente: And this is the underlying issue that we’re facing is truly energy toxicity. So one thing I like to think about here is that the challenge is recognizing that that is the reality. Oftentimes people, we don’t have the context of all of human history. We have our lived experience and everyone around us is living the same lives we are, calling Ubers and calling Uber Eats and flying across the country and working out through VR goggles. It’s becoming this kind of increasing, we’re all in lockstep with each other. And we look to our left and our right, and everyone’s doing the same thing. So this must be what’s normal, what’s healthy, what’s everyone else is doing.

Josh Clemente: And we have to challenge all of those preconceptions because ultimately it is what is leading us to a decline in longevity for the first time really in the developing record. In the United States for the last three years, humans are dying earlier than they had previously. So all of this requires, I think a lot of attention, a lot of education. People need to accept that this is the case and we need to then start to focus on the social of components that are driving it. But it also, as you mentioned, it’s a significant opportunity.

Josh Clemente: We have a micro electronics revolution that has made the cost of processing power and the size and scalability of battery powered components really attainable. And we now have the opportunity to develop like the continuous glucose monitor. And so by taking the tools of abundance that are positive and turning them towards, I think the opportunities for more contextualization of what’s good and what’s bad. So helping to surface the insights that have now retreated from view.

Josh Clemente: I like to use an example. Since we were always on the hunt for our next calorie, our bodies evolved to reward us for any calories we could get in. So there is a natural feedback loop in the form of taste that rewards us instantaneously. We get dopamine hits for finding a sugary meal. There is no evolutionary driver that created a negative feedback loop for food for over consumption really, or for the healthiness of a calorie. It was all about getting as much energy as possible.

Josh Clemente: So now in the abundance society we have to supplement ourselves and I think we can do so through technology. So we can develop those secondary layers of sensory feedback to tell us, “Hey, you may not feel any acute pain, but what you’re doing day after day is actually leading you closer and closer towards a dangerous situation.” So I think that’s where healthcare ultimately is going. And we’re very early. I would say in terms of innings, we’re inning two or three. We’re starting to break this open. We’re seeing the advancement of telehealth and the advancement of machine learning in pattern recognition for cancer detection and for MRI and X-ray results. We’re seeing all of these technologies making their way into healthcare and supplementing the care provider.

Josh Clemente: And I think the next wave is bringing wearable data from the, again, as I mentioned, the superficial layer where we’re counting steps and such to the point where every conversation within healthcare is based on a deep record of data for the individual, not just how their bodies are responding, but the inputs that they’re providing, that the individual is providing themselves day after day. So in the context of Levels, it’s still early. We’re demonstrating that people… This is not something we have to enforce or force on the world. People want this. They want to be healthier. They want to know how to make better choices each day, and specifically how to make personalized choices for themselves.

Josh Clemente: So I think we’re kind of showing that this is a possibility and that people will adapt it if you can make it convenient and intuitive. And I’m looking forward to work hand in hand with the healthcare system in the future to make sure that this is not just something that the individual or health-seeking person uses, but that each person who needs access to this information, that they can get it. And that they can use it to create an intuitive lifestyle for themselves.

Romeen Sheth: Yeah. I think the concept of a holistic view on variables is really interesting. What I mean by that is, we’ve traditionally looked at things, we’ve looked at a variety of variables, but we’ve looked at them in isolated ways. So what’s the food that I ate? What time did I sleep? Et cetera. And I think of the interesting things we’ve observed in using the Levels product has actually been the ability to get granular and understand how the variables interrelate with one another.

Romeen Sheth: So if I eat something at this time and then I exercise after, the combination of how did all those things affect me versus just looking at one variable or the other. I think conceptually for most folks, it’s easy to understand why more data and understanding of data would create better decision making. I’m curious from your layer and your perspective where you’ve seen this horizontally across a lot of different folks, what are some of the more non-intuitive things you guys have a observed in building the product? And then in relation to digesting those non-intuitive things, how have you guys reacted or evolved from that? And what’s the impact been on folks that are using the product?

Josh Clemente: Yeah, it’s a great question. The interesting thing I think about using a device that is measuring molecules in your body is that it immediately creates this short path between the body and mind, and it becomes, I think, a different conversation with oneself where previously it felt very challenging for people to get the motivation to stick to a new set of goals. Like, “I want to get healthy, I want to lose weight. I’m going to avoid this group of foods as per this diet that I found online. And it’s going to take intense motivation to make it through those moments of temptation, but I’m going to do it.” That’s kind of how things have historically been.

Josh Clemente: That conversation has totally changed in a really elegant, and I think for me, a non-intuitive way, when you bring real-time data for the individual into the conversation. So now that person who is saying, “I want to achieve this goal.” They are then getting feedback from their own body with no middle man, with no individual in the middle interpreting it for them and giving it to them in a patronizing way. It’s instead, I do something and my body tells me directly whether or not that fit with my goals.

Josh Clemente: And it ceases to be a discipline or a motivation determination. It’s now, I don’t want to continue doing that thing because my body is not able to I think effectively manage in that environment. And I now have for the first time that feedback layer. And so that’s been the most non-intuitive thing is that this would transform the entire conversation that people are no longer, they’re coming to us and saying, “I had a huge blood sugar elevation from oatmeal this morning. I just want to ignore it.” I don’t believe it.

Josh Clemente: It’s, “I’ve been doing this thing every single day, thinking that it was better for me, because I want to avoid, for example, I want to avoid doing inflammatory things that could potentially lead towards cardiovascular disease. So I’ve been trying to eat a heart-healthy diet and oatmeal, all the labels say heart healthy. But this morning I ate it and my blood sugar was in this crazy elevated range all day and then it came crashing back down and I felt this headache and all of these symptoms that I’ve been experiencing day after day, but I had no idea why. And now I just want to know what to do instead.”

Josh Clemente: It’s like an instantaneous switch flips, and that individual grasps what’s happening, it’s an abstract concept that they’ve now seen, and they’re able to then go and implement something different and they feel great about it because they’re seeing that now positive response to the new action. And the reason that we are taking this personalized approach is because it comes from this layer of research that we’ve recently uncovered with this same technology, which has shown that the individual variability in how people metabolize foods is dramatic.

Josh Clemente: So there is just one study I’ll highlight from 2015, which showed that two people can eat the exact same two foods, and in this example, there was a banana and a cookie made with wheat flour and they can have equal and opposite blood sugar responses. And the implication there is that they’re also potentially having equal and opposite hormonal responses, insulin releases to that meal and all of the downstream effects associated.

Josh Clemente: So that’s really where I think all of this intuitive, non-intuitive stuff comes in where people have assumptions. They’re like, “I feel weird about this whenever this thing, but my friend, she says it works great and she eats it every day and she feels awesome.” So people push themselves through this sort of interoception that they’re experiencing, and they either ignore it or they follow something else. But then one day they try Levels and they realize, “Yeah, I knew it all along. Tapioca flour is putting me through of the roof on my blood sugar and it’s not affecting my friend the same way.” And so you start to see that you can create these sensory feedback or sensory mechanisms where you can identify a qualitative experience you’ve been having and then couple it with a quantitative result from your body.

Josh Clemente: And that’s really empowering for people. These are all the sort of secondary layer effects of what we’re doing that we had not anticipated kind of coming to the surface so quickly, but it’s what most people would feed back to us.

Romeen Sheth: We’ve talked about closed feedback loops a couple times in some of the discussion points we’ve had. I want to take a pause and define that for folks that are listening to make sure we’re on the same page of what that actually means because of the importance of that fundamentally to the Levels system and the Levels product. And I’ll give an example, I think one of the things I was thinking of in preparation for our conversation, Josh, is this concept of how much does real-time measurement actually matter. So I think there’s a perspective on how much it matters from a mindset and behavior change perspective. And I think that’s where we’ve spent the majority of the time with this idea of close feedback loops.

Romeen Sheth: And then there’s a scientific perspective in terms of how much real-time measurement or what the parameter of frequency of measurement and it’s important to its own scientific. So let’s talk about close feedback loops, what that actually specifically means. And maybe we can use the example I just diagrammed out or another example from your mind on how to think through how that affects the scientific side in that, the mindset, the behavior side.

Josh Clemente: Yeah. So I think the concept of closed feedback loops comes from control systems theory. Let’s just say you have a very simple machine that it has a motor on it, and then it has a controller. And that controller, it’s electro-actuated system. That controller can extend it in the armor or retract the arm, let’s say. If the controller doesn’t have a sensor telling it where the arm position is, it can overdrive. So it can be extending the arm all the way and continuing to try to extend it because it doesn’t know where the arm is. It’s an open feedback loop, essentially the extension and retraction of that system doesn’t have feedback to the controller so it doesn’t know where it’s position is and it’s essentially flying blind.

Josh Clemente: So a lot of old school systems are this open feedback loop. And a closed loop system would be where that same system, that same mechanism has a little sensor on it. And it now tells the motor controller exactly where the arm position is. And so every action that the motor takes, every time it extends or retracts, it knows the exact position that the arm moves to and it can then use then to estimate how much further it needs to move in either direction. That’s a very a simplistic one, but cruise control in your car is another one. Old cruise control systems, you can set them at 60 miles an hour and that car will drive itself right into a brick wall.

Josh Clemente: There are newer cruise control systems that use an array of sensors on the car exterior to sense other traffic and to slow itself down, speed itself up, et cetera. And that’s a closed feedback loop where it’s taking into account its surroundings and the inputs that it’s providing, the output that it creates for the machine. Human beings are flying in an open loop system. We are flying blind every day where the actions we take, so the foods we eat do not give us any feedback until, and oftentimes years or decades later. So for most people, this is waiting for the bathroom scale to start climbing to an uncomfortable point or waiting for their doctor to say something like you have a condition.

Josh Clemente: That’s the point where we start to think, “Okay, I need to I think I need to make some changes.” But the problem is because those feedback loops are so long because we’re waiting years for the bathroom scale to change or potentially decades for the doctor to say something, we are not able to identify the specific behaviors that are leading to this negative outcome. So as it relates to Levels, this is where close feedback loops come in and also the real-time nature. So the tightness of the feedback loop really matters. If you want someone to understand whether or not the meals they’re eating each day are affecting them positively or negatively, you can’t tell them two weeks later that that lunch two Wednesdays ago was bad for them.

Josh Clemente: What you need to do is connect the reaction to the action in as close to zero minutes as possible because that’s how learning happens. We experiment, we see some response to our experimentation and that influences behavior change. You touch a hot stove, it hurts, you immediately remember that. And that’s embedded as habit. So that’s what we’re trying to replicate is the, and not to sound negative, this is not about all touching hot stoves. It’s about closing the feedback loop first with a data stream and then making that as short and as tight as possible, because that’s where the habituation of a lesson learned occurs for human beings, especially when it is their own personal data driving that habit change.

Josh Clemente: Again, it’s not someone else’s, we’re not talking about population averages. We’re talking about your body responded in this way just minutes after that meal. And that drives I think a lesson home.

Romeen Sheth: What are the biggest challenges today for the company? Is it behavior change needed in consumers? Is it technology? What are the challenges and how you think about solving them? I think Levels is interesting from the perspective of once you have a discussion like this, or let’s say you do your research and a lot of the consumers by definition that are coming to you are ones that actually want to make behavior shifts or are not feeling great and want to see a change in their personal lives. And so I imagine, maybe to go mass market, it might be a concept of behavior change, education, et cetera.

Romeen Sheth: But at least early adopters are ones that do actively want to make that change. They want the tools and the mechanisms to be provided so they can do it more simplistically. There’s some advances in technology that are made earlier, you alluded to, maybe we’re in the second or third inning and of course there’ll be additional technology improvements to come. How do you think about what the biggest challenges for the company are today and then the roadmap to actually solving them?

Josh Clemente: Yeah. There are a number of interesting challenges we get to approach with this project. And I think the largest ones are, we touched on them briefly earlier, but it is behavior change, but I actually don’t think that that in and of itself is a challenge, it’s kind of a bucket of different challenges. And so there are different people, different perspectives, and we’re all individuals. I think the hardest problem to solve is entrenched social norms. So it’s the consensus that occurs by default when we are all moving together in the same direction without full context. We have one generation’s context, essentially.

Josh Clemente: So our grandparents were living very, very different lives and their grandparents before them were living very different lives. But then once you get far enough back, people were actually all kind of, for many generations into history, living similar lives. And so we’re now moving at such a fast rate of change, but we don’t recognize it. We think, oh, since this is just how it is, how it’s always been. But what I think has to happen is we need to be able to zoom out and provide contextualization of human history and help people recognize that just because we’re all doing it at scale today does not mean that it is good for us.

Josh Clemente: And in fact, we have to challenge many of these things. We have to accept some uncomfortable truths about how we have gotten off, I think off-track a little bit with our lifestyles and then identify those social scale changes that need to be made, touching on things like food supply and the healthcare relationship where most of us are not using our personal data, our biological data in health care decisions or in lifestyle decisions at all throughout our lives.

Josh Clemente: And so we need to fix these problems that exist while simultaneously recognizing that it’s going to take, not just an individual deciding to avoid certain foods, but we need to then make, I think those hard decisions at a social scale to completely in some cases renovate our systems and processes and provide access to alternatives for not just those amongst with the best means, but for everyone. And this is going to be a multi-year, multi-decade process to get to the point where we as a society are 88% metabolically healthy rather than unhealthy.

Josh Clemente: But I think that’s the biggest one is just being willing to accept that in some cases, not all innovation is good and we’ve kind of taken it to an extreme in many areas of our lives. I mean, not very specific, I know, but I think it’s just highlighting that for many of us were complacent because we can look around and feel comforted that everyone’s doing something similarly. And yet, I think when you zoom out, you see that we’re kind of all driving off a cliff simultaneously, which is avoidable.

Romeen Sheth: The point you just made is really interesting, especially with the statistic of 88%, because one of the things I think about, and I’m sure you think about this all the time, it’s not a core problem necessarily you’re solving in your business or anything that needs to be solved for the business itself to be successful. But I think one of the interesting thought experiments is, let’s say we did solve that problem to a meaningful scale, maybe 88% of folks challenges don’t go away, but let’s say half of even those challenges go away. I get really interested by what are the secondary impacts we start to see as a society.

Romeen Sheth: I mean, again, at a layman’s or at a high level implications for the health care system, implications for productivity, et cetera, et cetera. I’m sure this is something you guys have thought about, especially in founding the company. So paint a little bit of the picture of, if we were to solve this problem, and Levels, won’t be able to be the only one, it’ll take a community of industry of healthcare systems, et cetera, but if these problems were to be solved, how do you guys think about what society and what the world looks like?

Josh Clemente: Yeah, it’s exciting to imagine because, as you touched on the implications of metabolic dysfunction are, they’re massive. Metabolic disorder underlies physical disorder and mental disorder. This is where essentially the systems in our bodies start to break apart. And the immediate effects are that individual experiences, symptoms and side effects and eventually limited independence and over time, potentially even a shorter life span and depending on what it is. And then the secondary effects are how that affects their family, their community, their productivity loss, the financial burdens.

Josh Clemente: And this goes on and on and ripples throughout our economy. And to the point where in 2030, I believe the diabetes, the expected cost of type 2 diabetes alone is going to be over 600 billion to the United States. And it’s a staggeringly massive problem and yet you don’t hear it being discussed that commonly. It’s sort of hidden or secondary to our more immediate conversations around things like the opioid epidemic or cancer, or these other problems that we do discuss, but we don’t talk about ultimately what I think is the elephant in the room.

Josh Clemente: So if we were to be able to achieve our mission, which I’m optimistic that with time and with iteration, we will get to the point where we get back the majority of our health and at least half the population, I would hope should be able to achieve metabolic dysfunction in just the next decade or metabolic function in just the next step decade. In that scenario, you have a situation where people are empowered with their own data in real-time. So they now are making decisions that are not necessarily coached, but I think guided by objective truth. They have information from their bodies guiding their choices. And this will create, I think, a more informed consumer, which is really exciting.

Josh Clemente: You can now imagine much of the problems in our food supply, many of which I think are driven by misleading marketing can’t really exist anymore when you have an empowered consumer, when you have an informed consumer who knows the effects that that specific product has on their bodies. And they demand, not only to avoid that product, but they navigate towards a better one, a healthier option. When that happens at scale, I think you end up with a food supply that naturally corrects itself, the incentives change, and you have producers being incentivized to produce healthy products and distribute those to everyone, which obviously will allow even those who aren’t using a product like Levels will benefit because the pricing will come down due to economies of scale, et cetera.

Josh Clemente: You also have a situation where I think the healthcare conversation can improve dramatically, when people are coming into their first conversation with a primary care provider with years of lifestyle data, and not just those inputs, but their molecular outputs, the biometric data that determines overall health. When that’s where the conversation starts, we’re in a good place. So any healthcare provider I can imagine who is able to take a look at somebody’s historical record and how they’ve been living and how that’s been affecting them for years, in order to determine maybe something that’s going on that is not metabolic in nature, I think we’re in a really good place as a society. We have big data that we’re applying across the entire scope of society’s problems with the exception of what we do every day to maintain health.

Josh Clemente: So I really look at the future as one where health data is used more like financial data. So the individual owns it, they’re constantly staying up to speed on the deposits withdrawals, how the interest is compounding, positively or negatively. And then you can work with an expert to make a plan and project into the future. And I think that this is a really exciting opportunity in the future for people to, not just financially plan for retirement, but then also be confident that they’re going to be healthy enough to enjoy it when they get there type of thing. And so it all comes down to, I think, unlocking the individual’s information to them and then empowering these at scale. And the secondary effects are quite exciting and I think they’ll happen automatically.

Romeen Sheth: Josh, final question as we round out the conversation. And it’s one I ask of every guest, especially high growth founders that we have on the show, and it’s relevant to the space that each of these founders operate in. What’s the one thing you believe about wearables and health that others wouldn’t agree with you on?

Josh Clemente: Well, that’s a good question. I mean, I think that wearables, they’ve been maligned as useless and toys. And I think what I see is actually already, even the Fitbits and the Apple Watches of the world, I think have made a healthier society and a more informed society. I know many people who drive their daily behavior change or decisions off of the rings on their Apple Watch. I believe that those little messages that are subconscious now, but driven to a habitual layer are creating a healthier society. And this has not, I think been identified in research just yet. In fact, there’s plenty of publications that say the opposite that wearables create anxiety and wearables create hypochondria and all of these things.

Josh Clemente: But in my opinion, we aren’t facing a society that is threatened by hypochondria. We aren’t threatened by anxiety. We’re threatened by sedentary lives and the breakdown of our bodies. And so if people are getting up and getting a walk-in to hit 10,000 steps, well, I’ve seen the effects of simple, lightweight exercise on my metabolic function specifically after meals. And I think these little perfectless messages are creating a healthier society micro-optimization, by micro-optimization.

Josh Clemente: And so I personally believe that we’re seeing massive benefit it just hasn’t been recognized yet. And I disagree with a lot of the research, which I feel like has a little bit of an agenda. It seems like there’s a bit of a decision that’s been made that these are gadgets and toys. And I want to push back on that and say that wearable technologies are much more than that. And we’re only scraping the surface, but I see it as the very beginnings of a technology that’s going to change the world in a positive way.

Romeen Sheth: Yeah. I think one of the interesting things, Josh, from this conversation and just our experience with the product has been, hearing you say that you believe we’re in the second and third innings or so, somewhere in that range and actually seeing the impact the product has had on our health just being in that second and third inning. And so it actually makes me super bullish seeing what’s in the future.

Romeen Sheth: I really appreciate you coming on the show today and sharing so many of your insights. Some of these concepts are ones in which, it’s easy for folks to conceptually understand, but I think it requires actually a nice guidepost to get over the cliff to see the impact that it can actually have on your life. So really, thank you for coming on, really appreciated your insights and looking forward to continuing to see how you guys scale the business.

Josh Clemente: Well, thanks again a lot for being such a strong supporter. And I’m glad to hear that just the earliest versions of the product are resonating. I truly believe. Every day I wake up and work on these problems and I’m excited for the future because we’ve taken a baby step, but there’s so much potential to make a significant impact. So happy to be working on it and I appreciate you bringing me on for the conversation.