Ep 13: The connection between Food and Beauty/Wellness with Dr. Casey Means

Beauty starts from the inside out – literally. The foods that we eat and the way that we live our life can impact everything from skin wrinkles to fertility. As a girl, Dr. Casey Means was fascinated by the science of beauty. Today, she is the co-founder of the metabolic health company Levels, which aims to improve healthy habits by tracking blood glucose Levels. As a guest on Beauty Needs Me, Dr. Means chatted with hosts Dunni and Taleah about how we can all harness our genetic blueprint to enhance beauty, equality, and quality of life.

• Check out Levels
• Follow Levels on LinkedIn or Twitter
• Connect with Dr. Casey Means on LinkedIn or Twitter
• Check out Beauty Needs Me
• Connect with Dunni Odumosu on LinkedIn or Instagram
• Connect with Taleah Griffin on LinkedIn or Instagram

2:09 – Why beauty is not skin deep

It was makeup guru Bobbi Brown who introduced Dr. Means to the fact that diet and lifestyle make a big impact on skin and beauty.

“I always thought that beauty was a fun way to be artistic every day and how you present yourself to the world. In Bobbi Brown’s book, which I think was in the late nineties, early 2000’s, she started talking a little bit about how our diet and our lifestyle impact our beauty, our skin, and that was really early on to be talking about some of those things, but it definitely made an impression on me. She was talking about water intake and things like that and vegetables. As time went on, more books came out about how food intake and diet and things like that kind of impact beauty. There was the Clear Skin Prescription came out and things like that. I was really interested in biology and health and was really interested in that in high school and pre-med in college. And so I really loved that sort of more scientific aspect of beauty and health. And then beauty became ultra scientific for me, really more in college. I was at Stanford right after the human genome project wrapped up and personalized genetic companies like 23andMe were starting to come online. And so I started thinking a lot more about how the interaction between genetics and environment affected things like beauty.”

4:07 – How to harness our genetic blueprint for beauty

Food and environment work together with our genetic blueprint in expressing skin health and overall appearance.

“I read this paper about how leucine, which is a branch chain amino acid found in like dairy and beef, and a lot of other animal products, like it actually goes into the cells and it turns on this little protein called a GTPS, which then turns on this genetic pathway called the M-torch genetic pathway. When that’s upregulated, it increases protein synthesis, fat synthesis, and cell division. And when this happens in the skin, especially in the oil glands of the skin, it can result in too much oil production, too much salt proliferation, and can generate acne. And so I was like, oh wow. So by reducing leucine intake, maybe reducing some of these foods that could have a big impact on something like acne. That was just fascinating to me and kind of sparked an initial interest in how our food and how our environment coupled with our genetic blueprint can like work together to really express the health of our skin and these characteristics that we maybe think are inherent, like beauty, but are actually really on some things that can be in flux. And the way our skin health and our appearance are actually very dynamic in terms of how we live and what we expose ourselves to. So since then, I would say I’ve been most interested in the whole beauty thing from like, how can we just harness our genetic blueprints to create the best expression of health in all ways.”

9:48 – Why health care is not deterministic

The genetic code is just one half of the story. Diet and lifestyle can also change how a disease is expressed.

“I got to work at 23andMe when I was in college when they were really, really early. And it was just so empowering thinking, yeah, we have this view of health as like it’s deterministic, we’ve got this genetic code and that’s what we’re going to be. But that’s just one half of the story. That’s just the blueprint. How that blueprint is then expressed, that is health and disease. Even with something like sickle disease, which is like a single point mutation that causes misfolding of the hemoglobin, you can actually have differential severity of the disease. And we know that people who have very stressful situations or are in situations with different oxygen concentrations, like in the air can exacerbate the disease. And so even that is like an environmental exposure that can sort of change how the disease is expressed. There’s almost no aspect of health that I don’t think can be like, the needle can be moved. There’s almost no aspect of health where I don’t think you can have some moving of the needle by changing the environmental exposures. And so that was really how I came to health care and realizing like it’s not deterministic.”

14:04 – Proactive healthcare for the next generation

Diet and lifestyle can create folding patterns in the genes that can be passed on to the next generation along with the genetic code.

“So let’s say you had a very stressful event. It caused some change in the epigenetic three-dimensional folding of the genome. You can actually pass that on to your kids. And so you’re not only passing the genetic code but the folding. And so, I can’t say enough about how we need to be working on early childhood experiences if we want to do anything in terms of moving the needle on health, especially when it comes to populations that are systemically disadvantaged in terms of our healthcare system. We need to be not just thinking about reactionary healthcare, and what do we do once people actually develop the disease, but how are we, how are kids, what is the pregnancy like? What is the first year of life like in terms of nutrition and stress and parental support and all of these things? We’re not thinking about those things. It’s going to be really hard to ever play catch up in our healthcare system on the backend.”

23:16 – Ironing out the wrinkles

Many skin conditions, like wrinkles, are fundamentally rooted in metabolic dysfunction. All of them can be improved by regulating blood sugar levels.

“So many skin conditions are fundamentally rooted in blood sugar dysregulation and metabolic dysfunction. And the ones that I think are most important to be aware of are wrinkles. Huge impact on blood sugar on development of wrinkles, acne directly related to blood sugar. Psoriasis, Acanthosis nigricans, which are like these dark velvety patches that can develop on people’s skin who have insulin resistance. Hidradenitis suppurativa, which is painful pus-like lumps under the skin, and then even skin tags, because insulin is like a pro-growth signal in the body, and people who are insulin resistant have more skin tags. So acne, wrinkles, hush tools, dark patches, all of these things actually can be improved by getting blood sugar under control.”

36:27 – The messed up reality of food economics and race

Food companies push high sugar foods to minorities, especially children, who are already disadvantaged when it comes to healthcare access.

“Basically, if you look at populations like white and Asian populations have the lowest rates of diabetes, even though they’re still extremely high, but in Native American populations and black populations, it’s much, much higher. And we can’t attribute this to genetics because this is something that’s happened over the past 20, 30 years. There’s no strong evidence that there’s some genetic difference in our insulin receptors or something like that between different races. This is almost certainly environmental. And what’s interesting is there’s a lot of messy stuff here. Obviously our health, our system needs a huge amount of work in terms of access to healthcare in our country. There’s a lot of huge problems in terms of how food has even marketed to different populations like food companies, especially processed food companies have been shown that they actually have different spending amongst different racial groups for how they’re targeting and doing ad spend for like high sugar foods, who they’re bringing on to do the advertisements and things like that. And really focusing a lot on children, especially minorities to really push this product. There’s just a lot of really crazy stuff I think with especially the sugar industry, and how it’s differentially impacting different populations.”

40:34 – The North Star goal

The North Star goal of Levels is to reverse the trend of metabolic dysfunction. They are doing this with clinical efficacy and working closely with hardware manufacturers who are making CGMs.

“Our North Star goal at our company is to reverse the trend of metabolic dysfunction. We’re starting with these bio optimizers and the biohackers and the performance athletes who have a very high willingness to pay for this type of device. It’s a multifold strategy, but one of our goals is to pursue intensive clinical research to show that this is effective in terms of getting people’s glucose levels down. Ultimately that may be able to feed into insurance coverage for this for the non-diabetic population. Clinical efficacy is a big part of our strategy for this first year. The second thing is that hardware companies who make these sensors are starting to realize that people are really interested in personalized nutrition and people really are confused about what to eat. They’re confused about nutrition. No one knows whether they should be doing keto or paleo or vegan or whatever. Objective information is like gold in nutrition right now. This is really the only thing we have right now for objective feedback on nutrition. A lot of hardware manufacturers are coming online.”

50:59 – Combating infertility with a proper diet

PCOS, the most common cause of infertility in the US, is a metabolic disease. With CGM, the patient can optimize diet, sleep, lifestyle, and potentially reverse PCOS and the resulting infertility.

“The most common cause of infertility in our country is fundamentally a metabolic disease. When there’s too much insulin in the body it essentially can stimulate the ovaries to produce more male hormones, androgens, and that can create menstrual irregularity, and then that can create infertility. Low-glycemic diets and keto diets have been shown to be really effective for these populations. But there hasn’t been much in terms of studying how adding a CGM, a continuous glucose monitor on to some of those interventions can really empower it because then you can even find your tune, how different foods you’re eating are impacting glucose. So I think that’s going to be a big next wave and opportunity for people with PCOS to just track their glucose. If you can keep glucose low and down you’re moving in the right direction for your underlying core physiology about PCOS. But I think you’ve really nailed it with the fertility thing and just really optimizing all aspects of wellness. I would encourage people to just really double down on the basics and make them daily habits. So getting between seven and eight hours of sleep per night, keeping glucose low, making sure you’re getting tons and tons of antioxidants in your diet through plant-based sources, herbs, spices because those antioxidants are going to reduce the free radicals in the body. These damaging reactive intermediates that can definitely affect things like fertility.”

01:02:33 – Why a lot of athletes are training fasted now

In a fasted state, the fat-burning pathways are activated in the body. This helps keep insulin low and frees the body from dependency on glucose during exercise so that the body can tap into fat reserves.

“What you can do by tracking glucose is if you over time can keep those glucose spikes lower and lower and lower and ultimately keep a flat line, you’re also keeping your insulin from spiking as much. Over time that can make you more insulin sensitive. Then you were living in this more low insulin sensitive state, which means that’s lifting that brake on your fat-burning pathways…And there’s actually a lot of athletes now that are training in a low-carb state. They’re training fasted, and they’re training in a low-carb state because they want to get their bodies in a place where they can always tap into fat for energy. So especially like marathon or ultra-endurance runners, they don’t want to be having to pound gels and glucose strengths and all this stuff throughout a long event, they want to just be able to continue running and not have to be so dependent on exogenous sources of glucose. If they train in this lower insulin, lower glucose state, they become ultra metabolically flexible.”

01:19:43 – How to protect your skin with diet

According to Dr. Means, it’s important to help DNA repair processes with nutrition and lifestyle and include a lot of antioxidants in the diet to buffer the oxidative stress that’s caused by UV damage.

“I think that we all should be wearing sunscreen when we’re outside in the direct sun, but I also like to think of sun exposure also from the inside out as well, because ultimately, the reason sun exposure causes problems like skin cancer and aging and all that stuff is that it causes DNA damage from the UV rays. So how do we think about that from the inside out as well? We want to do everything we can with our nutrition and lifestyle to essentially help with DNA repair processes and put as many antioxidants in the body to basically buffer the oxidative stress that’s caused by UV damage. While I definitely think sunscreen is important, even something like skin cancer and sun damage, so much of it is how it’s buffered by your body. Every time I’m eating vegetables, every time I’m eating like a really nutrient-rich plant-based protein, Omega-threes, all that stuff, I know that I’m helping buffer any inevitable sun damage that’s going to happen. So that’s the skin cleaning. I do use some makeup and for me, the most important thing about makeup is that it’s fragrance-free. I check everything on the environmental working group website to make sure that it doesn’t have toxic chemicals.”

Dunni : [00:00]                      Hey, Beauty Needs Me family. I am one of your hosts, Dunni.

Taleah: [00:05]                   And I’m Taleah. And if you’re new to the podcast, Beauty Needs Me is an inclusive beauty podcast where we host honest conversations about beauty skincare, and self-care that cross color, culture and country lines. This episode, we are talking to the amazing Dr. Casey Means. She is a Stanford trained physician, as well as being co-founder and chief medical officer of health company Levels. As we all know, a huge part of maintaining healthy skin is living a healthy lifestyle. You often hear people talk about the importance of water intake for skin health, but the foods we consume and our overall health affect our skin far beyond just drinking gallons of water.

So we are here today to get the scoop from Dr. Casey. Hey, Dr. Casey.

Casey Means: [00:53]    Hi. Thank you so much for having me on.

Dunni: [00:56]                      Sure, welcome to the pod.

Taleah: [00:59]                   Okay. So.

Casey Means: [01:00]    Thank you.

Dunni: [01:00]                   Before we get into Levels, let’s understand a little bit about how wellness was introduced to you as a child, like wellness and beauty. Like what were your initial thoughts about what it meant to be healthy and what beauty was?

Casey Means: [01:18]    Ooh. That is a great question. Man. This is going far back. I want to run to my bookshelf because I actually have a lot of beauty books on there that are very vintage from my childhood. But to be perfectly honest, I really loved makeup and all things beauty and actually studied makeup quite a bit when I was a child. I loved Kevin Aucoin. I don’t know if he’s a makeup artist that you guys are familiar with.

Dunni: [01:41]                      Oh yeah. Absolutely.

Casey Means: [01:42]    These huge coffee table books called Making Faces and Face Forward. He unfortunately died tragically, very young, in I think the early 2000s. But these books were just so artistic and I really, really loved them. I had Bobby Brown, Teenage Beauty and those were some of my favorites and one of the things. So I loved it from the artistic and the creative perspective. And I always thought that beauty was a fun way to sort of be artistic every day and sort of how you present yourself to the world. Bobby Brown’s book, which I think was in the late 90s early 2000s, she started talking a little bit about how our diet and our lifestyle impact our beauty and our skin. And that was really early on to be talking about some of those things, but it definitely made an impression on me. She was talking about water intake and things like that and vegetables. And then, you know, I think as time went on, more books came out about how food intake and diet and things like that kind of impact beauty. There was, the Clear Skin Prescription came out and things like that. So I got, I was really interested in biology and health and was really interested in that in high school and pre-med in college. And so I really loved that sort of more science-y aspect of beauty and health. And then it, you know, beauty became, I think, ultra sciency for me, really more in college. I was at Stanford sort of right after the human genome project wrapped up and personalized genetic companies like 23andMe were starting to come online. And so I started thinking a lot more about how the interaction between genetics and environment affected things like beauty that initially early in life. I thought of beauty much more as like makeup and creams and lotions and things like that. And now thinking like, “Oh, how much of this is actually coming from the interaction between our genes and our environment?” And so I remember learning something really interesting about how leucine, which is a branched-chain amino acid, this is sort of falls under the heading of nutrigenomics, which is something I was really interested in early on in this whole ecosystem of personalized genetics in college, but nutrigenomics helps food compounds affect gene expression. And there was this one example. I read this paper about how leucine, which is a branched-chain amino acid found in dairy and beef, and a lot of other animal products, like it actually goes into the cells and it turns on this little protein called a GTPase which then turns on this genetic pathway called the M torch genetic pathway. And when that’s upregulated, it will make you produce, it increases protein synthesis, fat synthesis and cell division. And when this happens in the skin, especially in the oil glands of the skin, it can result in too much oil production, too much salt proliferation, and can generate acne. And so.

Dunni: [04:43]                      Wow!

Casey Means: [04:43]    Yeah. And so I was like, “Oh, wow!” So by reducing leucine intake, maybe reducing some of these foods that could have a big impact on something like acne. So, that was just fascinating to me and kind of sparked an initial interest in how our food and how our environment coupled with our genetic blueprint can work together to really express health of our skin and these sort of, you know, these characteristics that we maybe think are like inherent, like beauty, but are actually really on some things that can be in flux and the way our skin health and our appearance can be, are actually like kind of very dynamic in terms of how we live and what we expose ourselves to. So, yeah. So since then, I would say I’ve been most interested in the whole beauty thing from like, “How can we just harness our genetic blueprints to kind of just create the best expression of health in all ways?” But of course, going along with that, it’s going to be things like, you know “beauty in our skin” and whatnot. So, ultimately it’s all wrapped up together. So.

Taleah: [05:47]                   Let me also say, I forgot an accolade when I introduced you. You’re also the associate editor of the International Journal of Disease Reversal and Prevention. So we’re literally going to get cured on the inside out today. So this is even more exciting than people think. It’s like we’re fixing acne, we’re fixing diabetes, [crosstalk 00:06:07] like we’re literally going to transform inside out. So.

Casey Means: [06:15]    I just wanted to just say one thing, which is that I think I jumped right into the science there, but I would say to really answer the question, like what is beauty to me and like how that was introduced to me, I will have to give my parents a shout out because they really promoted a message in our family and for me as a child, that beauty was really not about anything related to looks or things like that, but was really about living with integrity, living with joy, you know, sharing your light, sharing your love [ crosstalk 00:06:44] so that’s what was beautiful. And so I’m very grateful for that. And so I think, and that still resonates, it holds true, you know, for me today. You know, what is, when you walk around on the street like, I think the things that jump out as beautiful are the things that are sort of people living their truth, people expressing themselves honestly, and with integrity and being kind and sharing their lights. So, yeah.

Dunni: [07:10]                      Yeah. I love that.

Taleah: [07:12]                   Because like, literally not sucking just kind of makes you more attractive. Like just how when you don’t suck.

Casey Means: [07:18]    Yeah.

Dunni : [07:18]                      You’re a decent human being, right? So, Casey. Oh, wait, first of all, should we call you Casey or Dr. Casey?

Casey Means: [07:25]    Yes! Casey.

Taleah: [07:26]                   I should say Dr. Casey. “I’m a Dr. Casey!”

Dunni: [07:31]                      I know. Give you all your titles. So what, when did you decide you wanted to be a physician?

Casey Means: [07:37]    Ooh, I decided I wanted to be a physician. It kind of was end of high school, early college. I was so fortunate to be at this very weird all girls high school that we did not have school on Wednesdays. And we actually had to get a job on Wednesdays. And so.

Taleah: [07:55]                   Wait a minute. Where was this school?

Casey Means: [07:57]    It was in Northern Virginia. It’s called the Madeira School. It’s, you know, my favorite place on earth. I really adore it. And they wanted to teach you how to be a contributing citizen to society. And so, yeah, so we didn’t have school on Wednesdays and they helped you write resumes and do interviews and essentially get a job. And so sophomore year it was mostly focused on like public service. And then junior year you had to have a job in politics or on Capitol Hill, this was in the DC area. And then senior year, it was kind of like, “What do you want to be when you grow up?” Like, “Get a job in that.” So I got to work in a lab at the National Institutes of Health and it was in Clinical Hematology. And so I was working in this lab that was on sickle cell disease, and studying. So I was working with patients in the morning, I was actually taking blood from patients with sickle cell disease in the morning and the phlebotomy lab. And then we would be doing research on it sort of like later in the afternoon. And so, got to interact one-on-one with a lot of children and patients who had this terrible genetic disease. And that experience was just absolutely transformative to me and the sort of bench to bedside culture of medicine of-

Taleah: [09:04]                   Were any of them? I’m sorry, were any of them white? Because I feel like you never hear about white people developing sickle cells.

Casey Means: [09:12]    Yeah. As far as I remember, I don’t think I interact with any white people, interacted with any white patients with sickle cell disease. Like, you know, as we all know, it’s unfortunately a disease that’s predominantly-

Taleah: [09:23]                   Yeah. It’s always so fascinating to me. Like, what is that? Okay. Sorry. Continue.

Casey Means: [09:28]    Yeah. But so that was just very, very inspiring. And seeing that, yeah, how research and clinical practice could connect to hopefully move the needle on some of these genetic diseases was very interesting to me. And then I went to Stanford and like I mentioned, like it was just like teeming with so much exciting stuff going on with personalized genetics. And I got to work at 23andMe when I was in college, when they were really, really early and, you know, it was just so empowering thinking like, “Yeah!” We sort of have this view of health as like it’s deterministic, we’ve got this genetic code and that’s what we’re going to be. But that’s just one half of the story. Like, that’s just the blueprint. How that blueprint is then expressed, that is health and disease. And, you know, even with something like sickle disease, which is like a single point mutation that causes misfolding of the hemoglobin, like how people- You can actually have differential sort of severity of the disease. And we know that people who have very stressful situations or have different oxygen, like are in situations with different oxygen concentrations, like in air, like it can exacerbate the disease. And so even that is like an environmental exposure that can sort of change how the disease is expressed. And so, there’s almost no aspect of health that I don’t think can be, the needle can be moved. There’s almost no aspect of health where I don’t think you can have some moving of the needle by changing the environmental exposures. And so, yeah, so that was really how I came to health care, and realizing it’s not deterministic. We certainly can be predisposed to huge things based on our genetic code. But how that’s expressed is really where the money is, I think, in medicine and in empowering people to live lives and make choices that can do the best they can with that particular genetic sequence of As, Ts, Cs, and Gs. And then there’s this whole new area of epigenetics, which is not only the genetic code, but how the genes are folded and how the three-dimensional structure of genes, and that we know has a huge impact on, our lifestyles have a huge impact on that. So we know that stress and childhood trauma and things like that, these experiences actually can change the three-dimensional folding of our genes. And that-

Dunni: [11:44]                      Childhood trauma?

Casey Means: [11:46]    Yeah.

Dunni: [11:46]                      Like physical or emotional?

Casey Means: [11:46]    It can change the- Both. Adverse. [crosstalk]     Basically adverse childhood events of any type can change the folding. Yeah.

Taleah: [11:55]                   Well that explains why black people get sickle-cell. You know, we just have all the trauma, generational trauma. You know, if we’re living in urban environments and it’s like the air is messed up and all of these kinds of things. And then when our genes fold, it’s like- Well, that actually makes a lot of sense.

Dunni: [12:16]                      But there’s also a lot of white people, Hispanic people who have those conditions as well. They may be just. It may not be publicized or they may not be in inner cities, but I’m also thinking of like a lot of white people that are like in the Appalachian region, right? That are in super rural or maybe trailer park areas.

Taleah: [12:36]                   But there are also a lot of white people in America. For black people to be a small subset, and then the majority of sickle-cell it’s like, because our circumstances are vastly different with just this little group of people, where there are a lot of white people and only a little bit, or not as much that have these economic situations that are similar to underrepresented communities.

Casey Means: [13:02]    Yeah.

Taleah: [13:02]                   But thank you Doctor, I’m sorry.

Casey Means: [13:03]    No, no. It’s true. I mean- And sickle cell disease is a tiny, is a little bit different than the folding just because this one, it’s this unique disease in the sense that there is one, we have 3 billion base pairs in our genes, like in our DNA. Like there’s 3 billion individual ACTGs that make up our genetic code and one. One of them is mutated and switched to create sickle cell disease. And that’s heritable, you know, that they can be passed on, unfortunately. And so, but then with this folding, so how that long string of genes is then balled up and sort of like what the body has access to express in that genome that, we know that yeah, like stress, adverse childhood events can change that and can change even what your body can get to in the genome to express. And that’s this whole new field of epigenetics that wasn’t even really to be talking about when I was 15 years ago when I was in college. And what’s especially crazy, is that that folding pattern is heritable as well. So let’s say you had a very stressful event. It caused some sort of change in the epigenetic three-dimensional folding of the genome, you can actually pass that on to your kids. And so you’re not only passing the genetic code, but the folding. And so, I mean, there’s. I couldn’t, can’t say enough about how we need to be working on early childhood experiences if we want to do anything in terms of moving the needle on health, especially when it comes to populations that have just, that are systematically disadvantaged in terms of our healthcare system. Like we need to be not just thinking about reactionary healthcare, and what do we do once people actually develop disease, but how are we, how are kids, you know, what is the pregnancy like? What is the first year of life like, in terms of nutrition and stress and parental support and all of these things? And family leave. And like, we’re not thinking about those things. It’s going to be really hard to ever play catch up in our healthcare system on the backend. So yeah, we need to, anyway it all feeds in [crosstalk 00:15:01]       Yeah.

Taleah: [15:02]                   Do we know what happens? Like. So it’s mutated. And then like, how does that affect a person over their lifetime?

Casey Means: [15:11]    Hmm. In terms of sickle cell disease, or the more the epigenetic side of things?

Taleah: [15:15]                   More of the epigenetics, but like, yeah. Like, are there, does it, you know, like what’s it doing to them once it happens?

Casey Means: [15:26]    Hmm. Well, yeah. It’s. So you can imagine, like let’s say you have an important gene that’s related to like inflammation or immunity or something like that. Like, you know, and I’m just going to come up with an example. Like there’s a gene called NF-kappa B, which is like a master inflammatory gene. And we know that like stressful events can change to bind up and to, for the genome to kind of bind up into a different three-dimensional structure and to sort of have to block the body’s ability to express their own genes, it involves a process called methylation and histone modification. There’s these proteins that are like balls that the DNA will actually wind around. And that process either blocks or opens up different parts of the genome to be expressed. And so you can imagine if some really important gene, like an inflammatory gene or a gene associated with, you know, hormones or cell proliferation, if those are sort of inaccessible or more accessible because of the structural change to the genome that is related to stress or trauma or diet or whatever, that it could definitely change just sort of the long term outcomes of our cell biology. So, yeah, it’s really fascinating.

Taleah: [01:16:37]           Got to watch that.

[16:36]                                     Yeah. I mean, it’s like, how do we make it so that, you know, like fundamentally, you know, we have safe, healthy, nutritious pregnancies for all women in our country, you know? That we have excellent hospital care for everyone, that we create environments in homes that are safe, access to good nutrition, access to quality sleep. You know, we develop coping skills and stress management skills early in our life that we can use throughout the rest of our lives. And we create environments where we can exercise and move. Like if we, how do we get those things down? Like, that’s really, you know, those are kind of the foundational pillars of health, you know?

Dunni: [17:16]                      So it’s true what people say? Like stress can kill you, like you can-

Casey Means: [17:20]    Oh yeah.

Dunni: [01:17:20]              Okay. So now tell us what Levels is, like-

Taleah: [17:26]                   Levels is going to save us all.

Casey Means: [17:27]    Right.

Dunni: [17:28]                      Tell everyone what is Levels, the premise of it, how you got involved with it?

Casey Means: [17:34]    Yeah, absolutely. So Levels is a company that I co-founded and I’m chief medical officer right now, and Levels is, you can kind of think of it as Fitbit for your diet. So right now we don’t have a single tool to track how our nutrition is affecting our health in real time. We have a lot of exercise trackers, you know, we’ve got Apple Watch, we’ve got Fitbit, we’ve got sleep trackers, you know Oura ring, Eight Sleep, Whoop. We have stress trackers even that are testing our heart rate variability, which is an objective marker of stress, like the Oura ring and the Whoop. And we don’t have any, this can tell us just in real time, like, “Okay, this is what’s happening with your exercise, your sleep, your heart rate, your stress,” but nothing that you can put on your body where that says what you just ate is problematic for your health and will cause problems. It’s never existed. But Levels is essentially solving that. And in doing so kind of completing this sort of like modern health stack of tools that we can use to have real time feedback on how our choices are affecting our health. We do this by giving people this wearable sensor that’s called a continuous glucose monitor. And it’s this tiny little quarter size device that you stick on the back of your arm. And it’s traditionally being used as actually a treatment tool for people with type one or type two diabetes. It gives them their blood glucose, sends it straight to their phone every 15 minutes. But we were looking at this technology and said, “You know, this is actually going to be extremely valuable for anyone who wants to understand how food is affecting their health.” Glucose is this critical primary energetic substrate in our body. It is foundational for how our cells run. And ultimately we’re just made up of cells. We’re trillions of cells, this big cell package. And so each of those cells needs to be working properly and be able to process energy properly to function. If that’s not happening, we will not have health. And so, by tracking glucose and learning how to stabilize it and optimize it, we can make it so that each of our cells is essentially processing energy more effectively. And in doing so, it’s really low-hanging fruit for improving all aspects of health. So Levels gives people access to, people who, to this technology, access to this off- I’m sorry, access to the hardware and these wearable devices, which normally people haven’t been able to get access to unless you’re type one or type two diabetic. And then we’ve created software that takes that raw glucose data stream, these every 15 minute glucose time points, and transforms it into information that’s really actionable so you can start to really modulate your diet and lifestyle to stabilize your glucose. And what we want is stable glucose. The average American, unfortunately, is walking around with super ups and downs swings and their glucose all day long. And that’s because we’re eating a lot of refined processed sugar in our country, a lot of refined processed grains. And we are just giving our glucose, like it’s just like running all over the place. And we know that this is actually really, really harmful to health. Over time, as you spike your glucose over and over and over again, what happens is your body releases insulin, which is the hormone that tells your cells to take up glucose. So you spike your glucose, you spike your insulin. And over time as you spike your insulin over and over and over and over again, your cells essentially become numb to it. They’re like, “There’s too much insulin around. We’re going to kind of block it.” And so your body’s like, “Oh gosh, we got to get the glucose into the cells. So we’re going to produce more insulin.” So then you become, you actually end up having too high of insulin. And that creates a lot of problems in the body. You become insulin resistant, your body’s not taking up glucose as well. You’re not allowed, you’re not able to make cellular energy as efficiently, and it’s going to affect every single cell in the body, which is why glucose dysregulation and what I would call more broadly metabolic dysfunction, metabolism being how we process energy in the body, is related to so many different disparate symptoms that seem unrelated, but they’re all tied together by glucose dysregulation. So things as different as the most overt things you can imagine are like diabetes and obesity. These are obviously overt glucose dysregulation. But things like cancer, stroke, heart disease, heart attacks, non-alcoholic fatty liver disease, chronic kidney disease, Alzheimer’s dementia, which is now being called type three diabetes. These are all much increased risk if you have blood sugar dysregulation, because fundamentally wherever that blood sugar dysregulation is showing up, whatever cell type or organ, that’s where you’re going to see a symptom. So they seem different, but they’re all rooted in the same physiology. And then there’s all this sort of other stuff that I really don’t think most people realize is rooted in insulin resistance, glucose dysregulation, metabolic dysfunction, which is things like infertility, like polycystic ovarian syndrome. Our number one leading cause of infertility in our country is essentially insulin resistance of the ovaries. It’s a metabolic disease of the ovaries. Things like erectile dysfunction, the way that blood sugar interacts with the small vessels in the penis causes erectile dysfunction. It blocks the blood flow from getting there. Things like depression anxiety is how this shows up in the brain. It’s not the only cause of depression anxiety, but it’s a huge contributor. And so in chronic fatigue, chronic pain, all of these things are where this, basically the result of where glucose dysregulation, energy mismanagement in the body is showing up. And then where I think it really circles back also to what we’re talking about today is skin health. Like so many skin conditions are fundamentally rooted in blood sugar dysregulation and metabolic dysfunction. And the ones that I think are most important to be aware of is wrinkles. Huge impact on blood sugar, on development of wrinkles. Acne, directly related to blood sugar. Psoriasis. Acanthosis nigricans, which is like these dark velvety patches that can develop on people’s skin who have insulin resistance. Hidradenitis suppurativa, which is painful pus like lumps under the skin. And then even skin tags, because insulin is like a pro growth signal in the body and people who are insulin resistant have more skin tags. So yeah. So acne, wrinkles, you know pustules, like dark patches, all of these things actually can be improved by getting blood sugar under control. And I just, it’s just, you know.

Taleah: [24:08]                   So let’s talk about some of these, right? So let’s talk about glucose and its relation to wrinkles. I read a blog post that Levels did regarding glycation.

Casey Means: [24:23]    Mhm.

Taleah: [24:24]                   So can you explain to us kind of what that is? And kind of like how glucose leads to wrinkles and then. And then I’m going to circle back to you and tell you something about black people, but you go first.

Casey Means: [24:37]    Ooh. Okay. So the wrinkles story is so fascinating. And, like a quick aside, like I, one of the reasons I got so interested in devoting my career to helping people improve their metabolic function is because I actually started out in surgery. I was a head and neck surgeon for five years. Ear nose and throat surgeon. And a lot of that is cosmetic surgery related to the face. So surgeries for wrinkles, like facelifts and you know, eyelid lifts, and also tons of like Botox and like neuromodulators for wrinkles. So a lot of these procedures are very invasive and very morbid and very painful. And it really got me thinking like, “Is there anything we could do to make, to do something, to essentially get people, prevent people from having to get to this stage?” And you know how it is, like you walk down the street, you could see two women who are 70 and have completely different skin in terms of wrinkles. And part of that is of course going to be genetics, but a lot of that is going to be lifetime exposures to different things. And that’s going to move the needle on sort of the expression of something like wrinkles or skin health. So. But I became pretty fascinated by this because it’s quite well established physiology and I’ll share a little bit about it. So, first of all, what is skin aging? What is wrinkles? So wrinkling happens from essentially the result of a wide variety of like dysfunctions of cellular processes. And this includes thinning of the skin, the reduction of, and like the diminished function of some of our structural proteins in the skin like collagen and elastin and vimentin. These are proteins that keep our skin like turgor good. Also reduced blood flow to the skin. And also as we age, we have decreased cell turnover. So all of those things ultimately will lead to sort of sagging and wrinkling and whatnot, but excess sugar seems to speed up the process of all of these things. And one of the reasons for that is because of glycation. So glycation happens when there’s excess blood sugar in the bloodstream. And sugar gets stuck on things. It essentially just sticks to things around the body like proteins and fats and things like that. And so when a sugar molecule sticks to something, it becomes what’s called an advanced glycation end product, which is abbreviated AGEs, which is perfect. And that alters the ability of a protein to do its normal function. And it can affect proteins all over the body, but the most plentiful protein in the entire body is collagen. So, the skin is the largest.

Dunni: [27:13]                      Really? Oh, duh. That makes sense. Skin is the largest organ. Yeah.

Casey Means: [27:17]    The largest organ in the body. I mean, skin. And skin is, you know, skin is the canary in the coal mine for all aspects of health and wellness because it’s the most visible. And it ultimately is being affected by all the other processes that are going on inside. So it is, you know, the harbinger of dysfunction internally. And so collagen, most plentiful protein in the body, glucose is getting stuck to it via glycation and that totally alters collagen’s function. So collagen, basically it’s a structural protein in the skin. And when it’s glycated, it cross-links, it forms these weird tangles and cross-links, which causes stiffness of the skin, and some of that wrinkling that we see. It also changes. Glucose also changes the molecular charge of collagen, which prevents the protein from interacting normally with cells and proteins around it. And the other thing is that when collagen is glycated, it prevents collagen from being turned over and broken down. And so you don’t get as much as that normal turnover of collagen. So in all these ways, sugar is just stopping collagen from working properly. It also affects other proteins- vimentin, cytokeratin that are all critical for structural support. And there was a study showing that tight glycemic control. So keeping glucose really tight in a narrow range by diet and lifestyle over just four months can reduce the glycated collagen in the skin by 25%. So whether that changes wrinkles, that was not studied in that, but it changes the core physiology.

Taleah: [28:48]                   It’s a correlation. Yeah. Dunni, were you going to say something?

Dunni: [28:51]                      Yeah, first of all, this is fascinating. So because one, I did not realize, because one of my questions was going to be, “Why track glucose levels? Like why that over anything else?” But what I’m hearing from you is that any kind of imbalance in those levels really leads to these metabolic disorders, these different diseases. Like everything comes back to sugar, but why, or I don’t want to say sugar. Glucose. Why? Like why is glucose so impactful? Like what about it?

Casey Means: [29:25]    It’s impactful because it is the easiest source of energy for our cells. So for a cell to function, you need cellular energy, and cellular energy is called ATP. It’s essentially like the little power coin in a video game that lets your, all the different processing in the cells actually happen. You need to produce ATP, and glucose can go into the cell, be processed by the mitochondria, this little part of the cell and spit out ATP. And that’s a really efficient process. And if a cell’s not doing that properly, it’s not going to function properly. And if that’s in the ovary, it might look like infertility. If that’s in the brain, it might look like dementia. If that’s in the heart, it might look like cardiovascular disease. If that’s in the blood vessels, it might look like erectile dysfunction or hypertension. It’s just where it’s-And these things, of course the body is all connected. So if you have a big problem with how you’re managing blood sugar and you become insulin resistant, meaning you’re not taking up glucose efficiently into the cells, you can imagine how it could really affect all aspects. And you know, it doesn’t happen overnight. It’s not like a light switch where one day you’re totally insulin sensitive and the next, you’re not. It’s like decades of marching along this pathway. And so anything we can do early on when we’re young and are kind of fresh in terms of this, you know, that is the time I think, to intervene. Imagine if we can shape a diet and a lifestyle that keeps glucose pretty flat and stable every day, you’re essentially, you’re, it’s not like one day you’re going to wake up with insulin resistance. If you’ve been doing that every day, you are not going to walk into the doctor’s office one day and have a surprise where like, “Oh, by the way, you’re diabetic,” because you’ve been looking, you’ve been watching and you’ve been optimizing. And so it’s really like an incredible insurance policy. And, you know, it’s, you could just, people could just say like, “Well, why not just eat low carb and not eat much sugar and exercise? Like it doesn’t seem like you have to track it.” But what’s really interesting is that one, healthy living strategies, just blanketed statements, don’t seem to really work because we were doing that. Everyone knows to exercise and eat healthy and not eat a ton of sugar, but like 72% of our country is overweight or obese. We have 128 million Americans with diabetes and pre-diabetes. It’s like this, that’s not really working, unfortunately,

Taleah: [31:43]                   Because Snickers are good. Yeah. Like we need to track it in. Yeah.

Casey Means: [31:46]    They’re delicious! Tracking gives you a level of accountability and granularity that’s really helpful. But also there’s such an interesting research like five years ago out of a lab in Israel called the Weisman Institute that showed that actually like all three of us could eat the exact same carbohydrate source. We could all eat a banana and all three of us might have completely different glucose elevations from that banana. And that has to do with lots of different things. Genetics, or how much exercise we’re doing, but also one of the big factors is our microbiome composition. So how your microbiome interacts with the food actually predicts how much your glucose is going to go up. So maybe a banana is like a great option for Taleah, but it’s a terrible option for me, if I’m trying to really like zero in on low glucose. So, there’s actually this interpersonal variability between how two people respond. We could have totally opposite reaction to the same carb source. So it’s hard to give blanket statements about nutrition when we now know that it’s actually super variable person to person.

Taleah: [32:53]                   So I guess what I’m wondering is if there is any research regarding glucose and melanin, because what I see being the issue is that we know that back people have higher levels or higher numbers of diabetes. I don’t know if it’s type one or type two, but just diabetes.

Casey Means: [33:11]    Type two. Yeah.

Taleah: [33:11]                   But then we also know that black don’t crack. So I can see it being really difficult to convince, you know, a generation of black people who grew up on Kool-Aid, whose skin looks like they were just born to monitor their glucose, or to convince them that the glucose that’s going into their body is not only going to give them potentially diabetes, but also it’s going to make, also it’s affecting their skin from the inside, even if they can’t necessarily see it as like acne on the outside because I think with a lot of these kinds of like health things, especially if you have what you would consider like good skin or whatever, is going to be very difficult to say like, “Oh, well, you know Angela Bassett doesn’t monitor her glucose.” Forgive me, Angela. I have no idea what she does. But it’s like, she hasn’t been monitoring her glucose for 60 years and she looks like this. So why should I all of a sudden change what I’m doing?

Dunni: [34:16]                      Yeah. So I was, Casey, real quick. I was going to kind of ask that Taleah, but in a different way, because what struck me was the fact that there’s this, I feel like the messaging is, “Black people eat too much sugar, which is why we get diabetes.” Right? But we’re now seeing that there’s a correlation between that glucose imbalance and wrinkles. Right? Which black people don’t typically get. But then you also said other things such as cancer, such as infertility, such as Alzheimer’s disease. Like these are all things that I have never heard people say are associated with a glucose imbalance. Sugar, maybe more recently because I- I’m sorry, cancer. I feel like I’ve heard that people say that sugar can feed cancer cells, but so, like Taleah’s saying, it’s connected, but I feel like we’re looking at it in two similar ways, maybe not from the exact same lens. Like yeah. How do you convince black people that you’ve got to track your sugar? But then also, how do you also let white people know that their sugar regulation being off is part of some of these skin issues and some of these other health issues?

Casey Means: [35:31]    Oh my gosh. That’s such a great question. And honestly, not one that I have an amazing answer to, to be honest. Like I, that’s a, it’s very, very interesting to think. You know, like you’re saying like this might, wrinkles might not be so much of a predominant issue for the black population, but there still might be underlying blood sugar dysfunction. And that’s a physiology that I, yeah. That I’m not a hundred percent sure of. I think what I would say is, well, a couple things. One, I do think the relationship between race and blood sugar and diet is kind of a very interesting topic. And I just read this great book by Mark Hyman, a physician, called Food Fix, that talks about a lot about the systemic, essentially racial disparities and food and food access and how that’s affecting health outcomes.And, you know, basically, if you look at populations like white and Asian populations have the lowest rates of diabetes, even though they’re still extremely high, but native American populations and black populations it’s much, much higher. And we can’t attribute this to genetics because this is something that’s happened over the past like 20, 30 years. And there’s no strong evidence that there’s some genetic difference in our insulin receptors or something like that between different races. And so this is almost certainly environmental. And what’s interesting. I mean, there’s a lot of messy stuff here. Like obviously our healthcare system needs a huge amount of work in terms of access to healthcare in our country. But also our food system is just so, there’s a lot of huge problems in terms of how food is even marketed to different populations. Like food companies, especially processed food companies have been shown that they actually have different spending amongst different racial groups, for how they’re targeting and doing ad spend for high sugar foods, who they’re bringing on to do the advertisements and things like that. And really focusing a lot on children, especially in minorities to really sort of push this product. And so there’s just a lot of really crazy stuff, I think with, especially the sugar industry and how it’s impacting, differentially impacting different populations. And one thing that it kind of excites me about an idea, like a tool like CGM, is that this essentially cuts through like food marketing. Like let’s say the food industry or the healthcare industry is not going to take the lead on being helpful in moving the needle on things like chronic disease, and blood sugar, if you have a sensor on, if you have the data, you can essentially know exactly how this stuff is affecting you. And it doesn’t matter what the marketing is. It doesn’t matter what people are saying. Like you have your own personal data and you can make your own decisions. So it really cuts through all that extra layer of problematic stuff with our different industries. So I liked that from the empowerment side of things, like you kind of just get to be like, “This is the truth. I don’t really care what these industries are saying. Like, this is what I need to do or whatnot,” That doesn’t, it doesn’t change the issues related to food access and access to healthy, nutritious foods, and you know, food deserts and all of this that we need to radically change in our country. But at least it gives people a little bit more power in the face of really loud, problematic industries.

Dunni: [39:04]                      So with the Levels, so it’s a device. You put-

Taleah: [39:08]                   And to operate?

Taleah: [39:09]                   Yeah. Okay. And you put it on your arm or can it go anywhere? Does it have to go on your arm?

Casey Means: [39:14]    Back to your arm. Yeah.

Dunni: [39:06]                      It has to go on the back of your arm. It’s like the birth control patch.

Taleah: [39:18]                   It’s like a patch.

Dunni: [39:20]                      So everybody’s-

Casey Means: [39:23]    It’s kind of cool and sleek. It’s got like a cool patch on top of it. But yeah.

Dunni: [39:26]                      And then you wear it all day every day or is there, can you take it off at some point? Like what, how does it?

Taleah: [39:32]                   And how much is it? Yeah, because it sounds really fancy and elite and I’m like, “I can’t afford it,” so.

Casey Means: [39:40]    Well. So you wear it for 14 days, you stick it on and it stays on for 14 days and it’s transmitting this data every 15 minutes to your phone and then you just pull it off and you put on a new one. And so two of these sensors would last a month basically. That right now are, we’re prelaunch. We haven’t even launched fully. We’re doing like a closed beta program. And so right now that month of two pieces of hardware, a physician consultation to get access to this product and the prescription, having a sensor shipped to your home and access to the software. That month long sort of package is $399 right now. So it’s a very high price point to start. This price point will become quite a bit lower over time because right now these are prescription only devices and they’re not FDA approved for non-diabetic individuals. So they’re not covered by insurance. But one of our North star goal at our company is to reverse the trend of metabolic dysfunction. You know, we’re starting with these bio optimizers and the biohackers and the performance athletes, who have a very high willingness to pay for this type of device. But our goal is to- Well, it’s a multifold strategy, but one is to pursue intensive clinical research to show that this is effective in terms of getting people’s glucose levels down. And ultimately that may be able to feed into insurance coverage for this, for the non-diabetic population. And then, so clinical efficacy is a big part of our strategy for this first year. The second thing is that hardware companies who make these sensors are starting to realize that people are really interested in personalized nutrition and people really are confused about what to eat. They’re confused about nutrition. No one knows whether they should be doing keto or paleo or vegan or whatever. And so objective information is like gold in nutrition right now. And this is really the only thing we have right now for objective feedback on nutrition. And so a lot of hardware manufacturers are coming online. Right now, there’s only three companies that make CGMs, and there’s many coming down the pipeline in the next few years. And so I think that’s going to really drive prices down as well because there’s going to be a lot more competition in the market. So. But, you know, it would be, one, an investor, not an investor in our company, but sort of a very well-known investor and CEO, Esther Dyson. She just tweeted out the other day. She’s like, “I want to see this, a CGM on the arm of every second grader in America,” because the idea would be that like A, you could get people interested in science and biology and this and that, but also, you know, food marketing to kids is insane. Most other countries regulate. Food marketing to kids, we basically don’t. We can just put anything on the TV and tell kids anything and get them hooked on this stuff. And so to have kids actually seeing what these fruit loops and frosted flakes and blah, blah, blah are doing to their blood sugar could have really lasting impacts long-term for their overall health. So

Taleah: [42:38]                   I mean, what I will say. So. As I kept bringing this back to black people, because I am one of those people who, I do not do government things, like ever since there was that Tuskegee syphilis experiment back in the day, I don’t let the doctors stick no needles in me. I’m not taking your vaccines or doing yo nothing. However, you’ve convinced me. So if you need me to be a test in your beta program, I am willing to be a test because-

Dunni: [43:10]                      You should send an informed consent.

Taleah: [43:12]                   I literally just went hiking in LA and collapsed on the side of a mountain. Okay? As, if you saw me, you would be like, “You look like you in shape.” That would be a lie, it’d be a lie. Okay. I do a little on a treadmill and I have this band recently that I’ve been like doing these dye things, but it’s like, look, this is probably going through some stuff on the inside relating to the glucose, you know? So.

Dunni: [43:39]                      You know what else this reminds me of? So, have you ever heard of Dr. Sabey?

Taleah: [43:47]                   Mhm. Oh not me, you. Yes.

Dunni : [43:47]                      Okay. So it’s Dr. Sabey and I think there’s, is it Brother Paulite? I might.

Taleah: [43:54]                   I don’t know how to say it.

Dunni: [43:55]                      I don’t know how to say it. Okay. So they’re basically, these are like hood doctors that like-

Taleah: [43:58]                   Holistic, if they’re holistic in medicine.

Dunni: [44:00]                      They’re holistic hood doctors. But when I say that, not no, no, no, it’s not. I’m not like throwing shade or try to be detrimental or, I mean, like, or discrediting them. I just mean that like a lot of black people look to them for advice. They follow their tenets, you know, a lot of the work that they’ve talked about. That’s what I mean by that holistic health

Taleah: [44:24]                   Holistic health care.

Dunni: [44:25]                      Okay. Holistic hood healthcare. And so.

Taleah: [44:29]                   We don’t trust the government with our health.

Dunni: [44:31]                      Right. Holistic hood health care and which is fine. But anyway, my point being that, they have been preaching for, or had preached for years about how food, changing our diet, is what’s necessary for black people to be healthy. Like they have preached, they have talked at length about- You’re, right. Yeah. So holistically, right? But have talked at length about how, you know, we should either be eating according to our blood type, which has been huge, like eating according to your blood type. And how, if we’re keeping certain diets, eating certain foods, making sure we’re drinking alkaline water, all of these things, to help ward off cancer and, and you know, diabetes. And there’s always a lot of resistance, I think, to what they’re saying. And people being like, “Oh, okay, whatever, whatever.” But like, as you’re speaking, I just can’t help but be like, “Wow, all of those things!” And I don’t, I haven’t read or watched everything that they’ve put out, but it’s essentially the same premise about what you’re putting into your body is what is directly affecting your health.

Casey Means: [45:44]    Yeah.

Taleah: [45:44]                   And actually, Casey, I think you’re in the middle because I look at traditional medicine and then holistic medicine. And then I know you practice something called functional medicine. And I think that it’s like right in the middle of being like a real ass doctor, but then also on some other shit.

Casey Means: [46:01]    That’s kind of exactly how I see it, like right in the middle. Yeah, because ultimately, you know, these health behaviors and this more holistic living, what I’m interested in is how those choices translate to our biochemical reality. Like how those, how getting good sleep or not getting good sleep translates through hormones and our nervous system to actually create fundamentally different biochemical situations on ourselves. So it’s kind of like this merger between the two worlds. Like we know that poor sleep. You could just say, like someone would just say like, “Oh, get good sleep. It’s important for health.” But like, “Why is it important for health?” It’s important for health because getting one hour or less of sleep a night makes you slightly more insulin resistant, it makes your insulin receptors less prime to pick up insulin. It’ll make your glucose levels higher the next day. It changes your satiety hormone levels of leptin and ghrelin. So those levels, like leptin and ghrelin are two hormones that basically tell you whether you’re hungry or not, and it will completely change the levels and the balance of those hormones making you more hungry if you’re sleep deprived and also more likely to want carb rich foods. It changes your cortisol levels, which are your stress hormone levels. So like, it is a health behavior, but ultimately becomes, it is, that health behavior is molecular information. And so how do you get that to a place where people understand it and then can maybe use some of the, like biomarker tracking or whatnot, to really buy into it and believe it and see how one-to-one that relationship is, because when you can close that loop and make that to one relationship, that’s where I think sustainable behavior change happens. When you buy into it and believe it, you’ll do it. If it’s nebulous and you’re not sure if it’s helping, and it’s a super delayed response between a somewhat difficult action, like getting to bed earlier in any sort of health outcome, it’s much harder to adopt. So it’s all about shortening that time between the action and sort of like the health impact. So, that’s where I think glucose can be helpful. And what’s also crazy is that food is not the only thing that impacts glucose, like I was just mentioning with the insulin. A night of sleep deprivation can make your glucose worse the next day. Stress makes your glucose go up, and sedentary behavior makes your glucose go up. So it’s almost like the centralizing force amongst all these healthy behaviors we’re all trying to do. Sleep more, stress less, exercise more, eat better. It’s like-

Dunni: [48:30]                      It’s wellness. Really. It’s wellness. It’s not just one thing. It’s like, it’s everything, you know, that? And so I also want to touch on infertility, especially as it pertains to women. So I’m in my mid thirties. I haven’t had my first child yet. I know it’s going to happen soon. And, but I’m also very much, you know, I’ve accepted that I’m going to be an older mom. And just according to science, right, have a geriatric pregnancy. But I’m not the only one. The vast majority of women I know, and a lot of my really close friends, we’re all in the same boat. Or maybe some of them have had one child and they’re like, they know that they’re going to still be an older mom because they’re not finished having children. So for me, I think since the beginning of this year, I’ve really been focused on how can I just be healthy overall, right? I did this 21 day plant-based diet in May. It was life changing because I was like, “Wow.” I could really feel the difference in my body. I could, I told Taleah after that I think I had like some sugar or something, I had this full-on breakout. And I was just like, but just to see how when I changed up how I ate, how my body reacted. So I’ve been more so, very conscious now about, “What can I do in terms of, to bring it back to the” you know, having children right? Only thing I can control is being healthy and my body. So what tips would you have for listeners who maybe this is at the forefront of their mind, but you know, they’re not tracking their glucose exactly. But just from your, some of the research that you’ve been involved in and what you know of the glucose. And I guess, what is it? Glucose what?

Casey Means: [50:24]    Regulation.

Dunni: [50:25]                      Regulation. Yeah. How that, but what is the relation to infertility or fertility? Yeah.

Taleah: [50:32]                   Also just a really quick, like just to piggyback off of that, because Levels is not widely available. Like what should we all be doing?

Dunni : [50:40]                      Be doing? Yeah.

Taleah: [50:42]                   Until we can get the program?

Dunni: [50:44]                      Yeah.

Casey Means: [50:45]    Yeah. Well, with the fertility side of things, so the relationship with glucose is really, comes down to this condition PCOS, polycystic ovarian syndrome. So that, which is like I mentioned, the most common cause of infertility in our country and is fundamentally a metabolic disease. And when there’s too much insulin in the body, it essentially can stimulate the ovaries to produce more male hormones, androgens, and that can create menstrual irregularity, and then that can create infertility. So low-glycemic diets and keto diets have been shown to be really effective for these populations, but there hasn’t been much in terms of studying how adding a CGM, a continuous glucose monitor, on to some of those interventions to like really actually sort of make the- You know, adding a CGM to a ketogenic diet or a low-glycemic diet intervention can really sort of empower it because then you can even finer tune how different foods you’re eating are impacting glucose. So I think that’s going to be a big next wave and opportunity for people with PCOS to, yeah, just track their glucose. If you can keep glucose low and down, like, you know, you’re moving in the right direction for your underlying core physiology about PCOS. So, but I think you’ve really nailed it with the fertility thing and just really optimizing all aspects of wellness. Like I would kind of encourage people to just really double down on the basics and make them daily habit. So, you know, getting between seven and eight hours of sleep per night, keeping glucose low, making sure you’re getting tons and tons of antioxidants in your diet through plant-based sources, herbs, spices, because those antioxidants are going to reduce the free radicals in the body. These damaging, reactive, intermediates that can definitely affect things like fertility. So, you know, plants are so powerful in protecting the body from aging and damage. Getting really quality Omega-3s and making sure your fatty acid balance is right on, you know. We have a real low amount of Omega-3, is sort of, if you look at the whole population, like we’re getting way more Omega-6 fats than Omega-3s in our diet. Omega-6s are a type of fat that are much more inflammatory and can cause more problems and Omega-3s are anti-inflammatory. And basically all of the cells in our body are made up of, they’re surrounded by cell membranes, which are fat. Like every single cell in our body is actually surrounded by fat. And the ratio of Omega-3 to Omega-6 is in that fat capsule, has a huge impact on how our cells function, and especially in the brain, which is like mostly made up of tons of fat. And so eating fatty fish, if you’re eating meat like salmon, sardines, anchovies, mackerel, herring, and then plant-based sources like chia, flax, walnuts, and then reducing Omega-6 sources, which is going to be like the refined processed, vegetable oils, like soybean oil, safflower oil. These are fats that are more Omega-6 focused, conventionally raised beef, chicken, eggs.

Dunni : [54:02]                      Chicken?

Casey Means: [54:03]    I know, I know, but, so you’re going to be-

Dunni : [54:05]                      You’re telling us to not eat chicken?

Taleah: [54:07]                   We got to end this interview right now.

Casey Means: [54:10]    You were just raving about your plant based diet.

Dunni : [54:12]                      No, no, but you’re right. No, you’re right. Honestly. And when I did start eating chicken again, I was like-

Taleah: [54:18]                   You didn’t feel good.

Dunni : [54:19]                      I won’t say there was a noticeable difference, but I do crave more plant-based recipe. I will say that for sure.

Casey Means: [54:25]    And I would say like nothing, there is no like. Off the table in terms of nutrition, it’s really about optimizing the context and the ratios. And I would say if you’re going to eat animal protein, really shifting the framing of this is the way I look at food. And I’ve mentioned this a few times before, is like food is molecular information. Food is great. It tastes good. It’s pleasurable, but ultimately it’s molecular information. It is both a signaling molecule for how our cells to function. It is also a building block of our cells. So if you think about it that way, and we’re talking about chicken, you want to choose the best chicken molecular information you possibly can, which means you want to choose a really well raised chicken that’s been free range, has had lots of exercises, eating natural, healthy foods. Grasses, whatever. And not just being bombarded with genetically modified pesticide, covered corn and soy. And the chick, two chickens raised in different environments are going to be different molecular information for your body. One is going to have more Omega-3s. One’s going to have more Omega-6s. One’s going to have more hormones than the other is. One is going to have more saturated fat versus other types of fats. So basically it really comes down to just sourcing this food in the best way possible. And that might mean that it’s three times more expensive. So what does that mean? Eat a third of the chicken per week and replace it with plants, which are so much cheaper. You know an organic zucchini is like 99 cents, whereas to eat a little bit less of it to make the balance sheet work out. But so be it. Like, at least you’re still getting what you love. You’re getting better molecular information. It’s better for the planet. And you’re filling the rest of that, those calories, to fill with like really nutrient dense food. So, certainly not an off the table type of thing, but just thinking about it in that sort of molecular information framework.

Taleah: [56:16]                   Oh, I have one like supplement industry question before we get into some of your personal questions. When I think about stuff like, okay, so like digestion, right? Like does glucose affect digestion because you have supplements? And I don’t even really know if this is even considered a supplement, but think about a woman who was doing flat tummy tea, because so much of our beauty health, it’s like skincare and body. And it’s like, “Oh, I can just drink this diuretic tea.” And you’re like, “Oh, it’s a tea.” Like, it can’t be that, but does glucose also affect kind of, yeah, like our digestion and kind of how our body is responding to food? When I think about things, like me personally, I’m pretty hungry like every two hours, like a baby, like my stomach is like, “Oh, you should eat something.” So when people talk about intermittent fasting, I was like, “You must be kidding because I’m hungry every two hours,” you know? But I also, it takes me, I don’t know, maybe six hours to digest something as basic. Like literally last week I was on the beach, we had a chicken dinner and one of my friends-

Dunni : [57:34]                      You ate chicken?

Taleah: [57:35]                   Girl. It was all they provided.

Dunni : [57:37]                      Casey, did you hear this?

Taleah: [57:39]                   I had to do what I had to do. I am not, I am not a chicken eater.

Dunni : [57:43]                      Okay girl.

Taleah: [57:46]                   It was served like gourmet chicken on the beach. Right? It was gourmet chicken on the beach.

Dunni : [57:50]                      She tried to chicken shame me, but go ahead.

Casey Means: [57:54]    It was like the most common piece of chicken we have ever seen. It grew up in the beach.

Taleah: [58:56]                   It was literally the best chicken from Chick-fil-A, right? From Chick-fil-A. But I have a friend who, like her stomach was still flat after she ate this chicken dinner; I was three months pregnant. And I was like, you know, what is happening? I’m also the same person who fainted on the side of the mountain. So I was like, “There’s definitely something going on with my body when it comes to food,” and like, I’m just wondering if it had anything to do with glucose. It may not. You can tell me, “No.”

Casey Means: [58:32]    Well, there’s two things you said that I totally want to pounce on. So two things that like feel related to me. So one is this, like, after the hike feeling like you were going to faint?

Dunni : [58:41]                      Oh no, I fainted.

Casey Means: [58:43]    Oh, you actually.

Dunni : [58:44]                      On the. I. It was like-

Casey Means: [58:46]    I thought you were okay.

Dunni: [58:47]                       We were all hiking and I was like, “Guys, first of all, I had already done the really difficult part of the hike.” And then my friends are overzealous and one of them had never been to LA, and it was like, “Oh, now let’s do this second small hike.” And I was like, “Totally guys.” And then of course I do not work out like that. And so, as we’re on this incline, I’m like, “Guys, I feel dizzy,” and I just kind of passed out on the side of the twigs. And so one person stayed with me and they gave me water and stuff, and then everyone else just continued while I sat on the path, like a child who needed tender loving care.

Casey Means: [59:23]    Had you had any snacks? Snacks on the hike?

Dunni : [59:26]                      Yeah. I have water and I had those unshelled pistachios

Casey Means: [59:31]    Okay, okay. So this is really interesting. So you mentioned that, and you also mentioned that you’re hungry every two hours, and I think those things are super related. And I actually am so excited to get you into the beta program because I think this is going to be really interesting for you. So this comes down to this question that is this concept that is really interesting called metabolic flexibility. So, I talked a lot about how glucose is one of our primary forms of energy in the body, but we also know fat is a way to get energy in the body as well. And so we have basically about, we have blood glucose in our circulation that’s floating around. We also have glucose stored in our liver and our muscles, which has chains of glucose called glycogen. And we have about two hours worth of energy in the liver and the muscles. And then we have like weeks worth of fat energy in our body. Like even a very lean person has lots and lots of energy stored as fat in the body. However, the glucose is what you’re going to go to first. And then the fat would be more like long term storage. So really intense exercise, you’re going to deplete a lot of your glucose in about two hours. And if you’re metabolically flexible, you’ll just quickly bounce over to start burning fat. And you’re good.

Dunni : [01:00:41]              If you’re me.

Casey Means: [01:00:43]If you’re not metabolically flexible, what can happen is that you have essentially a situation like bonking where you’re just like, “I’m out of energy. I feel faint. I am hungry.” You’re not shifting gears seamlessly into fat burning. And I don’t know if that’s what’s happening with you, but those two examples-

Dunni : [01:00:59]              It’s me all the time.

Taleah: [01:01:00]           Wait, hungry? I was going to say being hungry is bad? Because then I’m like the number oomp, number one hungry person. I did not know that that was-

Casey Means: [01:01:08]Feeling like I need food. Oh my gosh. Like we should be able to go days without food. Like we have the energy stores in our body to go days without food. We don’t actually need to eat. Like people can fast for a week and be fine. But not like-

Taleah: [01:01:24]           Wait. Like modern day people or like Jesus’ time people? Because who has fasted for weeks?

Casey Means: [01:01:29]People, there’s patients undergoing cancer therapies now that are fasting for weeks at a time, just eating water, starving their body, basically of glucose and using fat as an energy source. Cancer cells, preferentially like to use glucose. And so, you know, so that’s been looked at for essentially a lot of liquid tumors like lymphomas and things like that. And with some really good, interesting results. Valter Longo is a scientist who’s working a lot on this stuff. And, but the, so the physiology behind this sort of metabolic flexibility thing is that when glucose is high or if we’ve kind of been eating a lot of grains and high sugar foods and stuff throughout our life, we’ve constantly been doing that little insulin surge, right? And that insulin, aside from getting, its big job is to get glucose to come up into the cells for energy. But its other job is to actually block fat from being oxidized for energy. So when insulin is high, you can really only preferentially use glucose for energy. You can’t tap into those fat stores. And so what you can do by tracking glucose is if you, over time, can keep those glucose spikes lower and lower and lower and ultimately kind of keep a flat line, you’re also keeping your insulin from spiking as much. And over time, that can make you more insulin sensitive. And then you were sort of living in this more low insulin, insulin sensitive state, which means that’s lifting that brake on your fat burning pathways. So that in a situation like that, like you were in, where you had maybe run out of your stored glucose. You were eating pistachios, which didn’t have a carb source in them, that’s just going to be like fat and protein. Your body’s like, “We have no energy,” maybe because insulin may have still been a little bit high in your bloodstream. I don’t obviously don’t know that for sure. But it’s something to think about. And there’s actually a lot of athletes now that are training in a low-carb state they’re training, fasted, and they’re training in a low-carb state because they want to get their bodies in a place where they can always tap into fat for energy. So especially like marathon or ultra endurance runners, they don’t want to be having to pound gels and glucose strengths and all this stuff throughout a long event, they want to just be able to continue running and not have to be so dependent on exogenous sources of glucose. So if they train in this lower insulin, lower glucose state, they become ultra metabolically flexible. If you look in your blood, they’re actually burning way more fat than your average athlete on sort of a standard American diet. And so it kind of creates this endurance freedom, but also can signal to your body that you’re just not hungry because your energy sources are, you’ve got energy coming to yourselves through fat. So, yeah. So it’d be fun, interesting thing to kind of experiment with and like, see if these things don’t happen overnight. They’re pathways that you have to essentially work. And we use this term metabolic fitness, because it’s just like going to the gym, like as you work these fat burning pathways day in and day out by keeping insulin lower and lower, like they’ll work better. And then you can, you know, see if that changes that desire to kind of have to have a food hit every few hours. So does that make sense?

Taleah: [01:04:42]           Love it. Yeah, it also sounds like it’s really going to help my sex life once I get my glucose together, my adrenaline or my endurance, it’s going to be really something.

Casey Means: [01:04:55]I mean, it might help the guy too because you know, glucose and testosterone- super related. And glucose and erectile dysfunction, super tight relationship. So yeah, if guys, I mean, this is like-

Taleah: [01:05:10]           How about skin?

Casey Means: [01:05:10] I’m like, Oh, like, “Why use an acne cream before using glucose tracking?” But I’m like, “Why use Viagra before using glucose tracking?” Like this is, yeah. So.

Dunni: [01:05:20]              So wait, so, okay. We’re talking about erectile dysfunction and-

Casey Means: [01:05:25]Is that what we’re talking about? Erectile- I just keep bringing it back to back.

Dunni : [01:05:27]              So, that’s what I’m trying to clarify. I’m like, what exactly are we saying? Are we saying that they’re going to be able to go more rounds? Are we saying that they’re going to last longer? What exactly is the correlation here?

Taleah: [01:05:42]           At minimum. At minimum, they should be able to get it up. It sounds like. At minimum.

Casey Means: [01:05:48]I’m going to stick with Taleah on this one. When you think about, when you back up and think about what an erection is, it is rushing of blood flow to the penis, which makes it to (? messenge] which essentially means filled with fluid, and that’s all it is. And the sugar basically for so many different reasons can have a huge impact on how narrow or wide blood vessels are. And so anything you can do to get blood vessels to be more flexible, essentially, like it’s, again, it comes down to flexibility. It’s like narrow and then be able to get wide when it needs to be that type of non rigidity essentially. And then for also, to not have blocked physical blockages. So like atherosclerosis, like clogged arteries, clogged blockages, those are often a result of chronic hyperglycemia and what’s called endothelial dysfunction, which is like the blood vessel linings being dysfunctional. And then you can get buildups. And so, yeah, there’s not dynamism in the blood vessels or if there’s physical blockages, both those things can lead to huge problems with erections, and a lot of forward-thinking urologists and family medicine doctors and internal medicine doctors are starting to look at erectile dysfunction essentially as a red flag in young men for probable metabolic disease. So if a man comes in with that type of symptom and like, “Hey, can I maybe get some Viagra? Like what should I do?” In their forties, you know, this is happening earlier and earlier these days, that is like an immediate red flag for like, “Oh, this person, we should do metabolic testing for them.” So, yeah. It’s-

Dunni: [01:07:25]              This is amazing how glucose literally touches every aspect of health. This is amazing.

Taleah: [01:07:33]           I know. And the reason I kept you a little over time.

Dunni: [01:07:35]              I know.

Taleah: [01:07:35]           Dunni, do you have anything else?

Dunni: [01:07:37]              I just want to, I want to ask about your personal diet. Like what do you eat? What are your, yeah. What’s? You said you’re vegan. So how long have you been vegan? What’s a typical day like in terms of breakfast, lunch, dinner, and snacks.

Casey Means: [01:07:53]Ooh. Well, so I’m vegan. I say more specifically I’m whole foods plant-based. So I, vegan is kind of a catch all term for anyone who doesn’t eat animal products, but I think whole food plant-based more characterizes what I’m trying to do with my diet, which essentially eating whole foods as unrefined as possible, and focusing mainly on vegetables, fruits, nuts, seeds, beans, spices and herbs. And so I use a ton of nuts. Nuts and seeds, like they basically are like the workhorse of my replacements for things I used to eat. Like I can turn nuts and seeds into milks. I can turn it into creamy dips. I can turn it into an Alfredo sauce. I can turn it into pesto. Like it’s just, you know, a cheese dip. I made some insane cashew based queso last night. So you can kind of turn them into like anything. And that’s been a real creative, fun joy for me over the past few years. I’ve been doing this for about two years. And then I also did it earlier in my, like when I was in my twenties for a couple of years as well. And really it stems from all the nutrigenomics stuff I was talking about. When I started learning about how compounds in food directly change gene expression and cell biology, I was deep into that world and realized, “Whoa, the things that changed things for the better are often plant compounds and the things that often change things for the worst are often animal compounds.” And I gave that example of leucine, you know, and the mTOR activation, how that leads to acne. And so I’m like, “Okay, well I’d, you know, going to cut out dairy and, you know, reduce my meat. And my horrible chronic acne cleared up in like a month and a half, you know? And so it’s like, “Okay, that’s interesting.” And then learning about plant compounds that like can also be just like, really revolutionize health. So like, you know, in turmeric there’s a compound called curcumin, which turns down our inflammation genes. And, you know, compounds in green tea are like potent antioxidants that buffer oxidative stress. And you learn about these things. I’m like, “Okay, well, it kind of seems like plants are the way to go, and I’m going to try this out because it’s what I’m reading on PubMed and all these scientific papers. I’m going to try it out.” And the more and more I did that, the more my health was just radically changed. I felt ten out of a ten, so good. Just felt elevated and light and full of light. And I was like, “I’m just going to keep doing this.” Like, it was such, it’s nothing dogmatic. It’s nothing, you know, like set in stone, it’s more that like, “This is just what makes me feel most alive and most joyful.”

Dunni: [01:10:32]              Do you eat bread?

Casey Means: [01:10:34] So I don’t tend to eat bread, and this is where CGM has played into it. So I was whole food plant-based for a while. And then I added the CGM layer on top of it when I started Levels. And that actually really refined that diet even more, because what I realized was even within my whole food plant-based diet, there are actually a lot of foods that were still kind of spiking my glucose a lot. So I found that like grapes and corn and definitely bread, and a lot of grains that I thought were whole grain and healthy were like sending me up to 150, or 160.

Dunni: [01:11:03]              All the things I love, oh my god.

Taleah: [01:11:04]           I know. I’m like-

Casey Means: [01:11:05]But it’s not necessarily that you have to eliminate these things. Some of it’s just about how you, what context you put them in. So if you’re going to eat a high carb source, you might want to eat it with a lot of fat and protein. You might want to eat the fat and protein first. Sometimes food timing, how you sequence foods has a big impact on glucose spike, when you eat them in the day. If you eat carbs earlier in the day, they tend to have less glycemic impact than at night. How you, what other things you use, like vinegar tends to blunt glucose spike. Cinnamon is an insulin sensitizer. Exercising after a meal can lower the glucose spike. Eating your favorite carbs after a good night’s sleep will probably have less of a glucose spikes than if you eat it when you’re tired. So it’s not even about, “Don’t eat these things.” It’s how to build the metabolic context to not have collateral damage from the food that you’re eating, and get the best possible nutrition out of it. But for me, grains were like a big, heavy hitter. And I learned all these grain alternatives that I love, like cauliflower rice, broccoli rice, almond flour bread, flax crackers, zoodles instead of pasta, black bean pasta instead of regular pasta. There were so many alternatives that I love that it wasn’t like a huge thing. So I focus a lot on plants, but I also, things that are super important to me in terms of fundamental health is omega-3, is like I talked about. So you did a ton of, I put chia and flax and walnuts on top of like everything I eat. I actually still do take fish oil supplements. So I, you know, I take like three grams of Omega-3 supplements per day because I need, I want those cell membranes in my brain and all over.

Taleah: [01:12:48]           Is there a brand that you use?

Casey Means: [01:12:50]Yes, I use, I’ve really loved Nordic Naturals. Really pure. They filter out, you know, they’re really good about quality and mercury and all that stuff. And so that’s been a game changer for me. And then the third thing would be fiber, like the impact between the microbiome and all aspects of health, including metabolic health, is profound. And so fiber is essentially food for your microbiome. And so I try and get 50 to 75 grams of fiber a day. The average American gets like 12 grams of fiber a day. And like our microbiome make our neurotransmitters that essentially they make like 70% of the neurotransmitters that control our thoughts, our mood, our energy, our emotion, everything. And so I’m like, a lot of what I’m thinking about when I’m preparing a meal is how can I make the bacteria in my gut as happy as humanly possible so that they can then make all the stuff that can make me happy and make me energetic? So I’m like beans, legumes, chia, seeds. Like anything I can do that feeds them. It’s like, it honestly becomes about like, “How can I serve the bacteria?” Like a total weirdo, but you know, it’s like, those are- So antioxidants, plants, try to get, you know, 10 to 12 serving the plants a day. Low-glycemic omega-3s and fiber are probably my four biggest things that I focus on with diet.

Taleah: [01:14:13]           Is there like a book or something that you follow or is it just all in your brain?

Casey Means: [01:14:19]This has been, there are so many authors that have been so influential to me in thinking through a lot of this stuff. And then this is sort of my little conglomeration of all of it and mixes. You know, most plant-based people are going to be super into high, whole grains, and lots of grains and eat as much fruit as you want and all that stuff. And so I’ve added a little bit of a spin with like, “How can we personalize it to make it low-glycemic?” So that’s kind of how I’ve merged my metabolic stuff with the vegan side of things. But some of the favorite authors that I have, like in the nutrition space, would be Sara Gottfried, MD. She wrote The Hormone Cure, The Hormone Reset Diet, Younger Brain Body Diet. She’s a total bad-ass OB GYN. OB GYN who went to functional medicine. Mark Hyman, who wrote The UltraMind Solution. Joel Fuhrman. He’s a plant-based guy, really interesting stuff. David Sinclair wrote Lifespan. I’m just like looking at my bookshelf. Oh, my bookshelf is right here. How To Not Die by Michael Greger is like an incredible book. I love him.

Taleah: [01:15:32]           I think what I’m also hearing is that you’ll be writing the book and then you’ll come back and discuss it with us?

Dunni: [01:15:37]              Oh, I was going to say launch the podcast. Like

Taleah: [01:15:41]           Okay. That’s really what I’m hearing is that yeah.

Dunni: [01:15:43]              Launch this podcast.

Taleah: [01:15:45]           You figured out your own thing. And now you’re going to tell us how to do it.

Dunni: [01:15:47]              And I feel like there’s such a lane here where this discussion just really isn’t being had widely. Certainly not in the circles that I’m in or the things that I’m following. I mean, yes. We talk about eating healthy. We talk about plant-based, but not at this level at all,

Taleah: [01:16:07]           I can’t tell you the last time I’ve heard someone say the word glucose, so.

Dunni: [01:16:13]              I’m going to get that diabetes, which like, everybody just thinks it’s, you know, because we eat right.

Taleah: [01:16:18]           And we’re like, “Okay, so I won’t drink Kool-aide. Fine”

Casey Means: [01:16:22] Right. And there was a recent study out of UNC in 2018 that showed that 88% of Americans are metabolically unhealthy. There are only 12% of people who are essentially fully metabolically healthy. So like the fact that we’re not hearing glucose on billboards, like all over the world, like it’s insane to me. I mean, it’s the lowest, it’s also so actionable. I mean, in a month you can clean things up and have a huge improvement in your- So it’s like it’s actionable, it’s essentially free because you just choose different things because we’re already paying for food anyways, and it underlies so much. So. Yeah. I mean it’s great to chat about it. I appreciate you giving me the forum to do it and discuss it with you guys. It’s really-

Taleah: [01:17:04]           Of course. I mean I’m ready. Y’all know that I’m part of that 88%. So.

Dunni: [01:17:08]              Basically we’re saying that we can fulfill two more beta testing spots for you.

Casey Means: [01:17:15]Yes! You’re in! Let’s get you in. Let’s do it! No, I will follow up. We got to get you in. I would love to hear what you guys learn.

Dunni: [01:17:24]              But, okay. So let’s transition. Let’s talk about your personal beauty. Take us through your skincare routine.

Taleah: [01:17:33]           Well, first of all, do you have time? Because we have kept you. We’re way past time. Dunni just asked you another complicated question.

Casey Means: [01:17:41]It’s honestly, it’s. Yeah, I totally have time. And thank you for asking. It’s actually not that, I like have the worst. I don’t, very do very little for my skin routine right now, so I-

Dunni: [01:17:54]              But you look good. Like this is the diet, honestly, like I’m looking, and I’m just like, “Wow. Okay.”

Taleah: [01:18:00]           Yeah. She’s about to be like, “Yeah so, I haven’t washed my face.”

Casey Means: [01:18:06]Thank you guys. What’s crazy is that if this has been four years ago, I would have had a huge trip of jawline acne all the way down my neck. I had it all throughout my twenties, through my medical residency, through my surgical residency and medical school. It was just crazy. And I had used everything. I had used Doxycycline for three months. I had done Tretinoin, I had done, you know, oh man, like benzoyl peroxide, salicylic acid, everything. And you know, of course nothing worked. And then changing my diet, it was gone in one month. And now the idea of getting it is it feels almost like, I don’t want to say impossible, but like, it just, I know that if I’m on a certain track, it’s not going to happen.

Taleah: [01:18:45]           It’s not going to happen. Wow.

Casey Means: [01:18:46]Whereas it was like just, I did an Instagram post on, like six months ago with the sort of before and after, and looking at it was just really, re-evangelized me. I was like, “Wow, this is. Yeah, I got to stick with this.” But yeah, so my entire beauty routine is I use a cure, red Moroccan clay scrub, which is like an all natural scrub with Rose oil in it. And then I put Jojoba oil on my skin after that. And that’s it for my skincare. And I don’t wash my face in the morning. So I would say like, so that’s really just like the washing and cleaning and moisturizing. I tend to use a sunscreen, but I only use it if I’m going outside. I try not to overuse sunscreen. I also do want to get some exposure, you know, in a safe way, but like, you know, I think that we all should be wearing sunscreen when we’re outside in the direct sun, but I also like to think of sun exposure also from like the inside out as well, because ultimately, you know, sun exposure, the reason it causes problems like skin cancer and aging and all that stuff is because it causes DNA damage from the UV rays. And so how do we think about that from the inside out as well? Well, we want to do everything we can with our nutrition and lifestyle to essentially help with DNA repair processes and create, I put as much antioxidants in the body to basically buffer the oxidative stress that’s caused from UV damage. So while I definitely think sunscreen is important, even something like skin cancer and sun damage, so much of it is how it’s buffered by your body. And so every time I’m eating vegetables, every time I’m eating a really nutrient rich, plant based protein, Omega-3, and all that stuff I know that I’m helping buffer any inevitable sun damage that’s going to happen. And so, yeah, but I do. So that’s the skin cleaning. I do use some makeup and for me, the most important thing about the makeup is that it’s fragrance free. And I check everything on the environmental working group website to make sure that it doesn’t have toxic chemicals. Not sure, have you guys used ewg.org?

Dunni: [01:20:59]              Mhm. We’re all over it.

Taleah: [01:21:00]           Love it. Yeah. Like, so I’m basically trying to do anything that’s rated a one or a two, so like basically has no known harm. But one big thing that I really focus on is not using anything that is scented with any natural or artificial scent, because a lot of those chemical compounds can be endocrine disruptors and can seep in through our skin and cause problems. So, all my shampoos are unscented or only scented with essential oils and that’s a big focus for me. And then in terms of my makeup, products that I love is Beauty. I love Beautycounter. I like Acure. They have some good products and, what are some of the other ones? Oh, Thrive. Thrive makes a mascara that’s like chemicals free. And they also donate to women’s groups, especially women who have been affected by domestic violence with all the purchases of their products. So yeah, so Beautycounter, Thrive, Acure. And I keep it really simple. I use a BB cream, I use some mascara, some eyebrow pencil and you know, sometimes a little bit of blush. I will also mention Ritual To Feel is a non-toxic brand that has really great cream pigment, lipsticks and blushes and things like that. So, yeah. But those are some of my few things. Yeah.

Dunni: [01:22:21]              Nice. Amazing. Nice. Taleah, are we ready for our last question? Anything else?

Taleah: [01:22:28]           We are ready.

Dunni: [01:22:29]              All right. Our last question, Casey, is why does beauty need you?

Casey Means: [01:22:34]Ooh. I think beauty needs me in particular because we are not thinking as much as we should, I think, about how our diet and lifestyle is affecting our expression of beauty. And if I can be a voice that helps people, you know, make some healthier choices, even if it’s for the purpose of improving certain beauty outcomes, I think ultimately making those choices is going to actually affect all aspects of health. And when we achieve elevated health and wellness, whether it shows up in our skin or “beauty” or elsewhere in our body, like that lets us live our fullest lives, helps us show up for our communities in a kind and loving way, helps us have more energy to rock our purpose and really contribute to the world. And so, yeah, by focusing on our own health and wellness principles and our own beauty, I think we can definitely serve others the best. So, yeah.

Dunni: [01:23:36]              Thank you, Casey. Thanks again.

Taleah: [01:23:39]           Thank you.

Casey Means: [01:23:40]Thank you.

Dunni: [01:23:40]              That wraps up our episode. Thanks Beauty Needs Me, family.

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