15: Continuous Glucose Monitoring & Fighting Chronic Disease With Levels Health on Nutrition Made Simple
Episode introduction
You might look healthy. You might exercise regularly. But there could still be a gaping hole in your health. This was the case for Josh Clemente, who started to feel unwell despite being an advanced CrossFit trainer. Once Josh turned his full attention to the question of his health, he realized the shocking truth – his glucose levels were off, and he was pre-diabetic. This led him on a journey to found Levels, a glucose monitoring service featuring a simple wearable device that provides custom bio-feedback in the quest to help regular individuals better diet decisions. As a guest on the Nutrition Made Simple podcast, Josh explained everything from the afternoon energy slump to the truth about carb-loading.
Show Notes
Key Takeaways
5:22 – The gaping hole in our health
Josh Clemente’s personal health journey made him realize that annual bloodwork isn’t an effective method of managing our health.
“The fascinating thing is just that we have data that we’re using in so many different ways in society, and exactly to your point, the one big gaping hole is our health. You know most people get one dataset maybe like when they get bloodwork done at the doctor’s office per year. And they’re using that. Not only is the doctor using it this way, but the individual is using it this way to project their health, to extrapolate one data point and say, this is how healthy I am. And there’s no other similar situation in society. We have massive data sets on everything from real estate to finance, to I mean name it right, where we have more data about our social trends and social transactions and you know, how many likes we have from than we do about whether or not our daily lunch is causing us to be sick. And you know, I think it’s fundamentally imperative that we change that, and we put people into an empowered position where every day you’re making objective data-driven decisions that are tailored to you.”
7:03 – Custom biofeedback is the key
It’s not about what foods are good and bad, it’s how your body reacts to each food. That’s why it’s important to have continuous monitoring and feedback.
“Two people could eat the same two foods, which were in this case, a banana and a cookie made with wheat flour and they can have equal and opposite blood sugar responses. To say that this flips the table over on an ideal diet is to understate it. It’s truly the case that we really need tailored information about the individual, both in terms of genetics and body composition, but also context. Like the reason that people have such wildly different responses to the same food is not just genetics which was actually shown in the study. It’s also something like how stressed are you? How much body fat do you have on your body? How much lean muscle mass to metabolize the food you’re eating. And so all of that combines into a context and we can now use that real-time data to solve that problem. It doesn’t have to be something be and scary.”
9:12 – Data can help us make better food decisions
Without accurate data feedback, we’re making emotional decisions about food that’s overtime having a compound effect on our health.
“Every day, we’re sitting down and we’re saying I’m going to eat lunch. What am I going to eat and why? And the answer is overwhelmingly based on emotion or based on an internet search or based on something that someone told you at some point that worked for them. And that’s a major problem because as you just said, these decisions, and we make hundreds of them every day, these are our lifestyle choices and they compound together into an outcome. And it’s not overnight. It is truly that we are on a spectrum of health and we’re constantly making trades, we’re balancing our health in one direction or another. And without feedback, it’s very easy to over time make very small, poor decisions that ultimately lead to a very large health consequence.”
15:06 – Why we eat high-calorie meals
Evolution has primed us to crave high-calorie meals through famine and long fasting periods. Now, with an abundance of food, we should be rethinking our urges and food habits.
“Humans historically have been in conditions of famine. We’ve been at – food has been scarce. For the vast majority of evolution, we did not have any agriculture. So we had to hunt and gather and eat whatever was available. We were fasting for long durations of time and calories were scarce. And so we have always craved calories, anything we can get, and the higher the calorie density the better. That’s typically sugar and sources of really rich fats. So those are the things that we love. They taste great. They’re rewarding to eat. And now we’re in a situation where we can produce as much of that as we want for every person on the planet. And that is exactly what we’re doing. And unfortunately, we’ve now exceeded the ability of the human physiology to metabolize that we can literally train wreck ourselves in a single meal and eat more fast-acting carbohydrates than a prehistoric person would come across in literally years, if ever.”
18:38 – People want to be healthy
With feedback and information, people will make better decisions and change to a healthier lifestyle when they see how their choices directly affect their health and quality of life.
“It’s very common in industry circles to think that people don’t want to change. They’re not going to change. It’s an uphill battle. Everyone kind of wants to be unhealthy. And I just certainly disagree at a personal level. And the organization is built on the idea that with better information people will act. We’ve seen this with smoking, as better information that has come around with respect to how smoking can lead directly to lung cancer, we’ve seen precipitous drop-off and involuntary cigarette smoking. And so I think the same thing will happen with nutrition where your husband, for example, sees oh, this is destroying not only my blood sugar control, which has inflammatory effects, but also my sleep, which if I’m not recovering that puts us into an elevated state of stress. We feel terrible the next day, we’re more likely to indulge and repeat the vicious process. He sees that and takes action and decides, No, actually, the reward is not worth the penalty.”
22:59 – Why we crash in the afternoons
We make emotional, irrational correlations for our moods and energy levels, but with accurate data and feedback, we can track why we have these crashes and make better food decisions to avoid them.
“That is the vicious cycle that many people live in, and because they were previously trying to navigate that based on emotion or blind guesses, it doesn’t work super well for most people. And that’s why I’m super optimistic about real-time biometrics being able to just in a very lightweight way, not in a disciplinary sense, but just surfacing that insight and saying yeah, that was actually lunch. You’re experiencing the fallout from lunch, as surprising as that may be. And then you can just test something different and watch and notice the qualitative experience change. For me, when I took those massive spikes and crashes out of my diet, I started to feel so much more consistent. It wasn’t that I had superhuman energy, but I didn’t have those lows, which were what I was trying to solve for.”
24:06 – The sleep-metabolic feedback loop
Food and sleep are interlinked, what you eat affects your quality of sleep and your quality of sleep affects how you metabolize food. It’s important to keep both in balance.
“The sleep connection is bi-directional. The quality of your sleep and the consistency of your sleep affects how your metabolic system functions. So there have been some studies to show how just a single night of short sleep can cause a 40% reduced glucose clearance from the blood after a normal glucose tolerance test. But then also, like you said, that what you eat correspondingly affects how you sleep. And so there’s this crazy feedback loop you can get into where, whether it starts with bad food or bad sleep doesn’t really matter, because ultimately they lead to worse and worse outcomes for both. And I’m really, really looking forward to that combination. We’re bringing sleep data into the Level’s app right now for the first time and starting to make that actionable. But I just cannot wait to be able to connect those dots for people in a way and show them the causal factors that are affecting their sleep.”
27:58 – The truth about carbo-loading
Your liver can turn stored fat and protein into glucose during a hard workout. So you might be able to do hard workouts in a fasted state.
“The stress of the workout is introducing cortisol and adrenaline, which are telling my body we’re in a fight or flight mode here. We need fuel available for the muscles. And so the liver just starts cranking out sugar and releasing it into the bloodstream. Your liver can produce new glucose from protein and fat in your body. So that’s one of the fascinating mechanisms that you see in real-time, in a hard workout where you actually don’t need necessarily to carb load before a hard workout. Your body is going to do everything it needs to not only produce the work, the glucose you’re going to use, but a significant overload. It’s pretty wild to see that happen in real-time.”
31:05 – HIIT and glucose management
HIIT releases high blood sugar in the bloodstream, but also primes your muscles to absorb that blood sugar, and is better in the long term for muscle building and weight loss.
“So many studies have been done to show that high-intensity interval training in particular is directly related to better insulin sensitivity, meaning the body improves its ability to clear glucose from the bloodstream. So that mechanism, although it’s interesting to watch and kind of counter-intuitive, is definitely connected with better outcomes long-term. And like you said, when you’re in that glycogen-depleted phase, you finished that hardcore workout, all of that glycogen has been used. Your body’s been producing new glucose, you’re now in a mode where your muscles are primed to suck in glucose to replenish that glycogen. And so you can kind of indulge a little bit more right after those hard workouts with some carbs and not experience a big blood sugar spike, which really goes to the concepts that we’ve all heard about, but helps to reinforce them.”
32:38 – The future is in real-time monitoring and feedback
This glucose monitoring is just the first step. The future is going to be in adopting this technology in all manner of hormonal monitoring to help us make the best possible decisions.
“I think that we’re just scratching the surface. Just to kind of paint the picture of the future, we’ve demonstrated the potential for what – we’re just starting to demonstrate the potential really for this metric glucose. And I’m really looking forward to, with wider adoption, seeing all the innovation that comes. Right now Levels is focused on the data science and the software, but the potential for the hardware is that with sufficient adoption, the innovation that would drive us towards multiple analytes that are glucose free fatty acids in the blood, insulin cortisol, all these hormones that are driving our experience, the sensations we feel, not to mention the molecules associated with fuel and metabolic health status. And so I think we’re really at the beginning. It feels like an evolutionary step to start using this tech in real-time. But I mean, five years from now, I think it’s going to be effortlessly integrated in a number of ways into both the decisions we make every day. And also our understanding of where we’re heading.”
Episode Transcript
Nicole Aucion: [00:00:00] Welcome back to the Nutrition Made Simple podcast. At Healthy Steps Nutrition, we believe something as fundamental as nutrition, shouldn’t be complicated, which is why we focus on a simple habit based approach when working with clients. I’m your host, Nicole Aucoin, registered dietitian and founder of Healthy Steps Nutrition, CrossFit HSN, and HSN mentoring.
I’m also the author of the Healthy Kids Cookbook, 100% Kid Approved Recipes For The Whole Family. You can find it on Amazon. In this podcast, we will be teaching you how to take one step at a time to becoming the healthiest version of yourself. Today, we are talking all about continuous glucose monitoring with one of the founders of Levels Health.
But before we dive into continuous glucose monitoring, it’s important to understand why you should care about this. Most people have no idea how their body is responding to the food they eat. In fact, the data isn’t widely available until it’s too late and you’re, most of the time diagnosed with diabetes.
Here are the stats. 34.5% of US adults have pre-diabetes based on their fasting A1C, a three month average of your blood sugar. 13% of US adults have diabetes. Diabetes is a condition where pancreas can’t keep up with the work that it needs to do based on the food that you’re eating. Your pancreas secretes something called insulin, which is a hormone that helps you break down glucose.
And if you’re constantly eating sugar and carbohydrates, and your pancreas isn’t able to keep up, you’re going to have high blood sugar. Imagine your pancreas is a car, and you don’t take care of that car. You don’t change the oil. Eventually you are going to have problems and something is going to break. That is diabetes, but the truth is your car didn’t break overnight.
It happened from years of wear and tear, sometimes faster than others. Yes, there is type one diabetes where some people are born with the inability for their pancreas to work. And you’re not going to get around not taking insulin. But type two diabetes, what most people have, all comes from lifestyle choices and the food that we eat.
Continuous glucose monitoring allows you to see how your body responds to the foods and make adjustments to treat chronic disease. Super interesting. Today’s podcast, I talk to Josh Clemente. He’s one of the founders of Levels Health. We talk about how continuous glucose monitoring has evolved over the years,
what we both have learned from our continuous glucose monitoring experiments, and how sleep, stress, and other factors all go into your blood sugar, and how it is controlled. At the end of this episode, I will share the top three lessons I learned from my personal glucose monitoring experiment. We will get to this episode right after this message.
Do you know someone that’s looking to get healthy this year? We would love for you to share this podcast with them. You never know who could use some words of encouragement. Take a screenshot, post it on social media. And please don’t forget to tag @HealthyStepsNutrition, so your friends can find some more awesome free help.
Don’t forget to subscribe to this episode either. All right. Enjoy this podcast on continuous glucose monitoring with Josh Clemente from Levels Health. Josh Clemente. Welcome to the Nutrition Made Simple podcast. I’m so excited to have you here.
Josh Clemente: [00:03:46] Thanks, Nicole. I’m so excited to be here.
Nicole Aucion: [00:03:48] We are talking about all about chronic disease today and something that is really cool, continuous glucose monitoring.
Josh Clemente: [00:03:57] Yes, the continuous glucose monitoring is near and dear to me. It’s been transformative in my own life. I kind of call myself patient zero for, for the Levels product because, you know, I, I historically have been very interested in physical fitness. Um, Played sports my whole life.
I’ve been a CrossFit trainer for nine years now, although I don’t train that often anymore, it’s just more, more, so I take physical fitness and performance very seriously. But I’ve only recently through continuous glucose monitoring, understood the other sides of what it means to be healthy and specifically the paradigms of nutrition, sleep and stress management.
And, uh, I’m just excited and privileged to be able to work on this project of bringing this crazy tech that was developed for the management of diabetes to, I think the whole new world of wellness and nutrition management.
Nicole Aucion: [00:04:47] It is so fascinating to me because most people have no idea what’s going on, on the inside of their body.
They eat something and it may be, they might realize that they have low energy, like the afternoon crash, but they probably don’t even correlate it to what they eat, let alone, what is actually going on on the inside of your body, what’s happening to your blood sugar, how is your body responding to food?
And essentially that’s what continuous glucose monitoring does. It helps you understand how food that you eat is processed and how your body responds to it. And the cool thing is every person’s a little bit different.
Josh Clemente: [00:05:21] Absolutely. The fascinating thing is just that we have data that we’re using in so many different ways in society. And exactly to your point, the one big gaping hole is
our health. You know, most people get one dataset maybe, like when they get blood work done at the doctor’s office per year. And they’re using that. Not only is the doctor using it this way, but the individual is using it this way, to project their health, to extrapolate one data point and say, this is how healthy I am.
And there’s no other similar situation in society. We have massive data sets on everything from real estate to finance, to, uh, I mean, name it, right, where we have more data about our social trends and social transactions and who, you know, how many likes we have from who than we do about whether or not, uh, our, our daily lunch is
causing us to be sick. And, um, you know, I think it’s fundamentally imperative that we change that. And we put people into an empowered position where every day you’re making objective data-driven decisions that are tailored to you. And you know, this, the singular benefit is that, you know, the, we will be able to, uh, I think give the individual control, but the secondary benefit is that it will be tailored and unique.
And like you just mentioned, there’s so much individuality that we’ve only discovered with this technology. Um, you know, continuous glucose monitors were developed to do what exactly, exactly what they sound like. You know, they, they measure glucose levels in the blood in real time for people who have blood sugar dysregulation,
so typically for people with diabetes. But recent studies in the non-diabetic population have shown that, and then the most interesting one, which I’ll just jump right to the chase on, was done in 2015, which showed that two people could eat the same two foods, which were in this case, a banana and a cookie made with wheat flour, and they can have equal and opposite blood sugar responses.
And, you know, so to say that that flips the table over on like an, uh, an ideal diet is to understate it. It’s like, it’s truly the case that we, we really need tailored information about the individual, both in terms of, uh, I think, probably genetics and body composition, but also context. Like the reason that people have such wildly different, uh, responses to the same food is not just genetics, which, which was actually shown in the study.
It’s, it’s also something like how stressed are you? How much body fat do you have on your body? How much muscle mass, you know, lean muscle mass to metabolize the food you’re eating. And so all of that combines into a context, and we can now use that real-time data to, to solve that problem. It doesn’t have to be something big and scary.
Nicole Aucion: [00:07:52] So, so much information that you just said, and all of it is super interesting, but the truth is there’s 60% of our US population has one chronic disease. 40% has two or more, and it didn’t happen overnight. It’s daily actions, elevated blood sugars consistently, and a ton of other factors that, that play into are you getting sicker or weller,
better every single day. Right? I remember talking to Julie Fusha a couple of weeks ago on a podcast. And we were talking about when you’re diagnosed with something is not when it happened. It’s years of decisions. And if you can proactively understand how your body is handling certain foods, stress, and sleep, how they all impact your overall wellness, you’re going to make informed decisions.
So. I worked in the hospital as a dietician for a long time. Continuous glucose monitors are, were new when I was working there and not widely available. Now they are more widely available to the general public. So you can actually educate yourself. Um, you don’t have to be diabetic and, and I’m sure you can answer this question.
I can answer from experience, but people think Nicole, you have a needle in your arm. Does it hurt, right? Like that’s the first question people ask.
Josh Clemente: [00:09:04] What’s interesting is I just love what you touched on there. Just briefly that the compounding effects of our decisions. Like every day, we’re sitting down and we’re saying what, I’m going to eat lunch, what am I going to eat and why?
And the answer is overwhelmingly based on emotion or based on an internet search or based on something that someone told you at some point that worked for them. And that’s a, that’s a major problem because as you just said, these decisions. We make hundreds of them every day. These are our lifestyle choices and they compound together into an outcome.
And it it’s not overnight. It, it is, it is truly that we are on a spectrum of health and we’re constantly making trades, you know, we’re balancing our health in one direction or another. And, um, without feedback, it’s very easy to over time, make very small, poor decisions that ultimately lead to a very large health consequence.
So, um, Really being able to just course correct or see trajectory in real time is just a massive improvement. It’s literally shining a light where we’d previously had none. We’re flying, flying blind. So, you know, the, the tech, the history of continuous glucose monitors is really interesting. I mean, it’s been, it was developed in the lab initially and done in like N of one experiments to, to just see if this could work.
And then eventually, uh, was moved into the very expensive, very advanced therapeutic space where, you know, someone was paying thousands of dollars a month to be able to, in most cases, manage type one diabetes where you have to very accurately, you know, meter insulin and based on glucose levels. Because it’s been such a, it’s been a very tightly
controlled development process in a specific population that, that has kind of led to a very long development process. So it’s been decades really, that this tech has been in some various stage of development. But we’ve seen an explosion in innovation in CGM over the past, like five years where the costs have come down by almost two orders of magnitude.
Um, well in 10 years, have come down by two orders of magnitude. In just five years, it has been an order of magnitude and the availability has gone through the roof, and small improvements in like the micro electronics and our cell phones have contributed to the medical device technology we can use. So Bluetooth, for example, making its way into the continuous glucose monitor and allowing continuous streaming to the phone without scanning or without fingerprints, all of this has been amazing.
And, you know, I think not the least of which is just there, the patch that you wear has become so small and slim and convenient that, you know, you can. I was training for a triathlon with one of these early 2020 pre pre COVID and swimming every single day, uh, you know, long exercises, long, long workouts, like lots of sweat. And the device is just like, it’s there, but I don’t know it’s there.
And the reason is that the, that needle that, that you were touching on is, is actually a very flexible filament. It’s almost like a hair-like implement. And so that flexibility makes it such that it can move with the fascia and the, you know, the tissue and it doesn’t feel really. You can’t feel that, you know, as a sensation in your arm. And it’s really, for that reason, giving you extremely high-quality data, because it is actually interacting with molecules in your, in your, uh, your interstitial fluid, um, without I think sacrificing comfort.
So it’s, it’s those advances that have all happened, you know, fairly recently that I think are making this really plausible to move from the sort of medical therapeutic use case over to general wellness in the general population.
Nicole Aucion: [00:12:28] You literally cannot feel it. You feel a more, what hurt me is taking off the band-aid because it was pulling out the hair on my arm.
The actual needle, needle did not hurt at all. Um, you literally cannot feel it. But the coolest thing is, as you can see, basically every minute, what your body is doing, like right before you eat something, right after, one hour after, two hours after. And when you eat something, your blood sugar should go back to normal.
But a lot of times it doesn’t. And depending on what you eat, it could take much longer. So what you guys have done is put a number system next to how your blood sugar responds. So. I, the first thing I did when I got the Level system, because we, I used it for six weeks and my husband did, and I have an interesting story about him.
Um, but I was like, I’m going to have an Acaii bowl, because everyone thinks Acaii bowls are the best thing since sliced bread. Right? Like everyone’s like, this is healthy. It got a one. My Acaii bowl gota one out of 10. And I don’t know if there’s a zero in the score, but I’m a guessing, like one is, is really low and.
Josh Clemente: [00:13:29] There is a zero, but it’s hard to get.
Nicole Aucion:Nicole Aucion: [00:13:31] And the reason why, because it, it took, my blood sugar skyrocket and it took so long for it to go down. And Acaii itself is actually really good for you. But when you go buy an Acaii bowl in a store, it’s loaded with sugar, and then they add honey, and then they add more sugar with fruit and all this stuff in there.
And it’s just a lot of carbohydrates that, that you’re eating and you don’t even realize. And that’s the. When you look at the core problem of why we have chronic disease issues in theUS, and why we have such a big obesity issues in the, in the US, it’s coming down to, we were not educated on what we eat and we’re tricked every single day by food marketing companies.
Josh Clemente: [00:14:11] A hundred percent.
Um, yeah, I’d like to think of it as we have developed too much power in terms of the, the amount of energy that we can get into a single meal. And we, we are powerless. We don’t have a feedback mechanism built into our system, into our bodies to know that. So, you know, historically, like it’s easy to, to just look at what’s available in the store or look what’s available for, you know, food, takeout options, and assume that that was designed like
by some smart regulating body to be best for us. It’s like, this is the food that’s available in the store, so that must be what’s good for us. It’s very easy for people to just go on autopilot and assume that, but it’s exactly the opposite. The, the path that the food supply has taken is the path of least resistance, which is whatever humans are predisposed to crave,
we will provide that. And humans historically have been in conditions of famine. Like we’ve been at, food has been scarce, like for the vast majority of evolution we did not have any agriculture. So it was like we had to hunt and gather and, you know, eat whatever was available. And we were fasting for long durations of time and calories were scarce.
And so we have always craved calories, anything we can get, and the higher the calorie density, the better. And so that’s, you know, typically sugar and sources of really rich fats. So those are the things that we love. They taste great. They’re rewarding to eat. And now we’re in a situation where we can produce as much of that as we want for every person on the planet.
And that is exactly what we’re doing. And unfortunately, we’ve now exceeded the ability of the human physiology to metabolize that. We can literally train wreck ourselves in a single meal, and eat more fast acting carbohydrates than a prehistoric person would come across in literally years, if ever. And what’s, what’s really interesting is like I said, you know, it’s because of that scarcity situation where we evolved without,
without surplus being available, we don’t have a sensory feedback mechanism. It doesn’t hurt to eat sugar. In fact, it’s extremely desirable and enjoyable. Like we, it’s like a positive reinforcement mechanism, which is really bad when you, when you have so much of it available. So all that to say, um, you know, I think that
when you can replace that, you know, sensory feedback, that pain that you have when you touch a hot stove with data, like if you can just see feedback from your body that says, Look, you’re not feeling pain right now, but what’s happening is not good. Like, this is a, this is a disaster for you. Uh, it can supplement that. You can recognize, Oh wow.
Like that Acaii bowl, despite the fact that it says, you know, healthy and, and fruits and vegetables, or, you know, or what have you, are all natural sugars, um, it’s still overloading my system in a significant way, and maybe I should just eat some Acaii you know, straight and try that instead. And then when you see how much better that is for you, you might, and, and using the Levels features, you know, we’ve developed metrics to help score those things that you touched on, and you can see like the Acaii bowl maybe a one, and maybe, uh, you know, a handful or a bowl of fresh Acaii
may be like a seven or an eight or a nine, even. And you know, you’re getting all those antioxidants and nutrition benefits without kind of detonating your, you know, your glucose, insulin pathways.
Nicole Aucion:Nicole Aucion: [00:17:19] It’s so interesting. And I think you’re right. When you can see what’s happening on the inside of your body, you’re so much more prone to make positive choices.
I, my husband is, was I would say. He really loved his sugar at night, he liked his brownies. He liked his, you know, cookies and it literally took him wearing the monitor, seeing that his blood sugar was elevated all night from the brownies that he was eating. And then he started correlating that with the quality of sleep that he was having and he hasn’t done it since.
And it’s been like, a couple months now. So it’s super interesting to see in, like we’re not perfect. We all have our cravings. And you’re right. Our, our brains are, literally light up when we have sugar and fat together. Like it’s not our fault that we crave more and more because our. psychologically, like we do crave more. Our brains like that.
So it is really interesting when people are educated and understand what’s going on in the inside of their body, how, how their decision-making changes.
Josh Clemente: [00:18:24] Absolutely. You know, it’s the theory of, of the Levels Organization is that fundamentally our thesis is that people don’t want to be unhealthy. And actually that’s like not a very popular position.
It’s very common in, you know, in industry circles to think that, No people don’t want to change. They’re not going to change. Like it’s an uphill battle. Everyone kind of wants to be unhealthy. And I just certainly disagree at a personal level. And the organization is built on the idea that with better information,
people will act, you know, it’s, it is certainly not the case. And we’ve seen this with smoking. As better information has come around, you know, with respect to how smoking can lead to directly to lung cancer, we’ve seen precipitous drop-off in voluntary cigarette smoking. And so I think the same thing will happen with nutrition where, you know, your husband, for example, sees,
Oh, this is like destroying not, not only my, my blood sugar control, which has inflammatory effects, but also my sleep, which, you know, if I’m not recovering that puts us into an elevated state of stress. We feel terrible the next day. We’re more likely to indulge and repeat the, the vicious process. Uh, he sees that and, and takes action and decides like, No, actually, I, I, the reward is not worth the penalty.
And I, again, I’ll point to my own experience. Growing up, you know, like I said, I played a bunch of sports. I was always active, never had a problem with weight gain. And so I really believed that for the longest time that a calorie was a calorie, and whether it came from broccoli or from pure cane sugar, as long as it’s energy and I can use it, you know, and, and, and, uh, burn it on the playing field or in the gym, it doesn’t matter, you know, I can eat anything.
And we now know what the hormonal implications of, you know, certainly sugars, but other foods that that’s not true. And also to go back to my example, like I was living that as a total candy addict. Like I would eat candy for dinner in college. And I kind of carried this through, into my professional life where I was, I was always a dessert guy.
Just really loved the, you know, to reward myself with, with whatever dessert was available every night. And since using the continuous glucose monitor and connecting, um, what ultimately was like some significant physical and mental and mood burnout that I was experiencing when I first started experimenting with CGM, with those decisions and seeing how closely my mood tracked with my blood sugar control or lack thereof.
I haven’t touched candy since. I mean, I’ve had dark chocolate, but it’s been about three years since I’ve had a piece of candy. And it’s, it wasn’t a discipline based decision. It wasn’t something like I suddenly developed massive motivation to just, you know, take on this huge challenge and quit cold turkey.
It was like, No, I was, I was actively harming myself and I didn’t know it until I saw the data. And now I’m just unwilling to do that to myself. Um, so it is pretty amazing.
Nicole Aucion: [00:21:06] Everyone wants to feel well, right? Like you don’t want to be in a bad mood. You don’t want to have these energy ups and downs. You want to sleep well.
And so many times we don’t connect the dots to go back to what we ate. And if we started thinking, okay, I’m constantly, I’m having a large sub and chips for lunch. And then I feel like crap in the afternoon. Why is that? Oh, I just need a coffee in the afternoon. And that’s the reason. Well, what if we changed and had a little bit more balanced meals for lunch and just watched, how do we feel in the afternoon?
Are you starting to feel better? And I think when you’re starting to get in tune with how you feel and connecting it to what you eat, you’re much more likely to stick with something because you’re like, Oh, I actually feel better. I want to feel well. Right. You’re, going back to what you were saying.
Like, I truly believe the same thing. Like people want to feel the best that they possibly can. Right.
Josh Clemente: [00:21:59] Totally agree. Yeah. And, and it’s, um, right now it’s a very trial and error process, but the, you know, we’re going from a situation where we were, we were flying blind completely. And it was, it was really a matter of doing exactly what you’re saying, where
let’s say you feel bad at 2:00 PM. You know, you’re just like, Ah, man, I just want to lay down and go to sleep. And then you start thinking like, Well, did I sleep poorly last night? Maybe I did. I kind of stayed up late. I ate that popcorn. Huh. Well, maybe it’s just bad sleep. And then, you know, you completely ignore the fact that you went for a sushi lunch and you had a bunch of, you know, sushi rolls with white rice. And
that, that doesn’t even cross most people’s minds, that it could be, you know, two hours later, you’re experiencing a reactive hypoglycemic event where your body was, had a huge blood sugar spike from the white rice, had to flood your system with insulin to get that out. Overcompensated, your blood sugar is crashing, and now you’re feeling lethargic and low energy, and your mood has dropped out. And to make matters worse, you’re hungry and you want to go get some snacks.
And so that is the vicious cycle that many people live. And because they were previously like trying to navigate that based on emotion or on just blind guesses. um, it, it didn’t, it didn’t work super well or it doesn’t work super well for most people. And, and that’s why, you know, I’m super optimistic about, you know, real-time biometrics, being able to just in like a very lightweight way, not in a disciplinarian sense, but just surfacing that insight and saying,
Yeah, that was actually lunch. Like you’re experiencing the fallout from, from lunch, as surprising as that may be. And then you can just test something different and watch the, watch and notice the qualitative experience change. You know, so for me, when I took those massive spikes and crashes out of my diet, I started to feel so much more consistent.
You know, it wasn’t that I had superhuman energy, but I didn’t have those lows, which were what I was trying to solve for.
Nicole Aucion: [00:23:43] And you sleep better. I noticed tracking my blood sugar for those six weeks that when I ate a little bit more carbohydrates at night, I did not sleep well and I woke up with elevated blood sugar. And I would have never connected those dots as quick as I did
when you have those metrics, those biometrics to look at, at the data.
Josh Clemente: [00:24:03] Yeah. It’s, the sleep connection is I think bi-directional meaning, like, I think that the quality of your sleep and the, the consistency of your sleep affects how, uh, you know, your, your metabolic system functions. So there have been some studies to show, you know, just a single night of short sleep can cause a 40% reduced glucose clearance from the blood after a normal glucose tolerance test.
Um, but then also, like you said, that what you eat correspondingly affects how you sleep. And so there’s this, there’s this crazy feedback loop you can get into where, whether it starts with bad food or bad sleep, doesn’t really matter, because ultimately they lead to worse and worse outcomes for both. And I’m really, really looking forward to the,
that combination. You know, we’re bringing sleep data into the Levels app right now for the first time, and starting to make that actionable. But I just cannot wait to be able to connect those dots for people in a, in a way and show them, you know, the, the causal factors that are affecting their sleep. Because I mean, it really sucks to be trying to chase down bad sleep.
It’s one of the worst, you know, I can’t, I can’t think of a worse thing than just constantly, Oh, wow. That, that could have been that dessert I ate. It’s like a breakthrough.
Nicole Aucion: [00:25:13] I’m excited about what you guys are doing with Levels, because it’s going to give the general population so much more access to understand their bodies in real time.
It’s, it’s a really cool thing that you guys are doing. Um, I’m excited and we’re going to be starting to integrate what you guys do with our nutrition coaching, because it provides dieticians, a whole another level of support you can give to clients. Okay. Your body is reacting this way to the food you eat,
let’s make these specific adjustments and see how, how you feel and how your blood sugar responds to it.
Josh Clemente: [00:25:44] Yeah, and I can’t wait for that to kick off. You know, I think right now the, the Levels program we’re building is certainly tailored towards metabolic awareness. It’s just connecting the, you know, with, with a very short feedback loop, the actions we’re taking and the reactions our bodies experience. And, you know, we have a lot of ground to cover there, but the future
is where, you know, experts like yourself can, can bring this data in, import it into the conversation with the client and have the conversation begin from a position of objective personalized data. So I can only imagine, you know, not, not being a dietician myself, but I can only imagine that that would be significantly beneficial to start off with months of both lifestyle information about, you know, how this person is sleeping, how this person is eating, and then correspondingly how their bodies are responding to it, and be able to, you know, begin there rather than from, from scratch.
Nicole Aucion: [00:26:36] Absolutely. And it’s not saying you have to do it forever, but I do think you should do it for a season to see how your body’s responding to food, get into a good routine. And then, you know, maybe you go back to it or not. Uh, I think it’s, I think it’s really, really cool. Anything that you’re really surprised about wearing the continuous glucose monitoring system yourself for a while?
What were you most surprised about in regards to, we have a lot of CrossFit athletes that watch, listen to this podcast, in regards to exercise and blood sugar.
Josh Clemente: [00:27:03] Um, so I never, I had read about the physiologic effects of intense exercise, and kind of knew about what I, I should have expected to see. But when I first did, I think it was like, it was a CrossFit open workout, like shortly after I got, you know, I was just doing on my own, obviously I wasn’t in the open, but, um, I was, uh. During this workout with my CGM on for the first time and my blood sugar went, it was. So average,
you should, you know, the Levels goal is to stay below 110 milligrams per deciliter, like including meals. Uh, my blood sugar went to over 210, which would be kind of a diabetic blood sugar range, uh, from a fasted CrossFit workout. And it was hyperintense. I was pushing super hard. And what’s happening there is something that I think is profoundly interesting.
It’s it is. It was totally fascinating to me to see what was going on. And, you know, basically the, the stress of the workout is introducing cortisol and adrenaline, which are telling my, my body, you know, we’re in a fight or flight mode here. We need fuel available for the muscles. And so the liver just starts cranking out sugar and releasing it into the blood stream.
And your liver can produce new glucose from protein and fat on your body. So, um, that’s one of the fascinating mechanisms that you see in real time, in a hard workout where like you actually don’t need necessarily to carb load before a hard workout. Your body is going to do everything it needs to not only produce the work, the glucose you’re going to, you’re going to use, but like a significant overload.
And, um, you know, that. It’s pretty wild to see, to see that happen in real time. And then to understand the mechanisms and, and carry that out. Like, I think it touches on a lot of the different stress pieces that we come across in life. But, um, you know, just comparing that, like super-intense 110% output, um, where you see a massive glucose elevation with a, say, two hours of low intensity zone to training on a bike.
Where for me, my blood sugar, just kind of like monotonically decreases. It just continuously like drops. And then it will flatten out where like, basically at the point where my liver is producing enough to keep me level. And those two different regimes of, of exercise, I think being able to see the data has completely changed how I fuel for, for exercise.
Like. Uh, I now know that for a hyperintense workout. When, first of all, I don’t want a lot of food in my, in my stomach anyway, because I just generally would feel nauseous, trying to keep food down when I’m pushing that hard. Um, but I also don’t need it. You know, I, I, unless I’m going to be going that intense for 90 minutes or two hours, I’m not going to deplete my glycogen and there’s no need for me to, you know, carb up.
But for the longer duration rides, like I will potentially need to time, uh, some fueling in order to keep myself from bonking, because I’ve, I’ve also seen that happen where my glucose will just crater, you know, and I’ll hit like 50 or 55 or something mid-ride, and completely lose energy. So, um, you know, we’re in the very early stages of using this for performance, but those lessons learned, just seeing how your body responds is
pretty brilliant to me.
Nicole Aucion:Nicole Aucion: [00:29:59] I can tell you this I’m, can say the same exact thing that you said. I saw the same thing with my CrossFit workouts. My blood sugar would go up in the 200, like low 200 range, consistently doing CrossFit workouts. And it wasn’t because I had a bunch of food before. I usually just have an applesauce on my way
in the morning before I go to the gym. And that’s usually all I have. So it’s not like a 15 gram applesauce is bringing your blood sugar up to 200. It is from the exercise. And it was super interesting. And what was even more interesting, after your blood sugar goes down, but then you eat something and it doesn’t go as high as you think it would after, which is also super interesting.
Josh Clemente: [00:30:39] Exactly. Yeah. And, and I want to clarify, like, it may sound bad that your blood sugar goes to that high during workout, because we’re talking about how glucose spikes are bad and all that stuff, but it’s entirely different physiologically from eating a sugary meal that would do that to you. You know, this is your body taking
stores of fat and protein available and breaking them down, re, recombining into glucose and releasing for your muscles to use. And so many studies have been done to show that high intensity interval training in particular, is directly related to better insulin sensitivity, meaning like the body improves its ability to clear glucose from the bloodstream.
So it’s that mechanism, although it’s interesting to watch and, and kind of counter-intuitive is, it’s definitely connected with better outcomes long-term. And like you said, you know, when you’re in that glycogen depleted phase, so you finished that hardcore workout, all of that glycogen has been used , your body’s been like producing new glucose,
uh you’re, you’re now in a mode where your muscles are like prime to suck in glucose to, to replenish that glycogen. And so you can, you can kind of indulge a little bit more right after those hard workouts with, um, some, some carbs and not experience a big blood sugar spike, which really goes to the, the concepts that we’ve all heard about, but helps to reinforce them.
And like, you know, for on days, when, when I put in a really hard workout and deplete those glycogen reserves, I’m not going to feel super bad about replenishing, knowing that I’ve, and I’m not gonna overdo it. Like I used to really overdo it, eat Pop-Tarts and stuff, but like, and I’ve seen, I can definitely over do it after a hard workout, but now it’s more tailored to,
you know, what I know I can tolerate.
Nicole Aucion: [00:32:10] It goes back to what we’ve been talking about this whole time. When you have the data, you can make more educated decisions on how to properly fuel your body for overall wellness and health and also performance, which is, which is really neat that you guys are going to be helping more pro athletes understand how their bodies are responding to. Any final thoughts with continuous glucose monitoring
before we jump off.
Josh Clemente: [00:32:35] Well, I mean, I think that we’re just scratching the surface, you know, just to kind of paint the picture of the future. Like we’ve demonstrated the potential for, well we’re just starting to demonstrate the potential really for this metric glucose. And I’m, I’m really looking forward to, with, with wider adoption, seeing all the innovation that comes. You know, right now Levels is focused on the data science and the software, but the potential for the hardware is that we could have,
um, with sufficient adoption, we could have the innovation drive us towards multiple analytes that are, you know, glucose, free fatty acids in the blood, um, insulin, cortisol, all these hormones that are driving our experience, you know, the sensations we feel, not to mention the molecules associated with fuel and metabolic health status.
And so I just, like, I think we’re really at the beginning. It feels like an evolutionary step to start using this tech in real time. But I mean, five years from now, I think it’s going to be effortlessly integrated in a number of ways into both the decisions we make every day, and also our understanding of where we’re heading.
You know, it’s like, very, very much, uh, I think going to be similar to financial data where, where we are using it in real time to plan ahead and make sure that, you know. Similar to retirement, like we want to make sure we’re financially secure for retirement. We’ll be able to ensure that we’re going to be healthy enough to enjoy retirement, I think, uh, using this data.
So just looking forward to it.
Nicole Aucion: [00:33:59] Thank you so much for all that you guys are doing. Because I truly think we’re, we’re in a really cool place where people can have access so soon to information that is going to shape their future and set them up for success long-term and, and hopefully get these numbers down.
So we don’t have 60% of the population with chronic disease. And so many people, not even knowing that they have blood sugar issues or they’re putting themselves at risk every single day because of the decisions that they’re making. So thank you for all that you guys are doing. You can find Josh at LevelsHealth.com.
Um, but where else can people find you?
Josh Clemente: [00:34:36] Uh, you can find me on Twitter @JoshuasForrest with two Rs, and then on Instagram at Josh.F.Clemente. Uh, and then I, you know, even more so recommend following along on the Levels accounts @Levels on Twitter and Instagram. And we like to boost, you know, our members, uh, how they’re using the product and what they’re learning.
And also, uh, we, we post articles to the blog and, you know, kind of help surface information about metabolism, metabolic fitness, and, and continuous glucose monitoring.
Nicole Aucion: [00:35:02] You guys do such a good job on your blog, posting educational information for anyone to learn more about continuous glucose monitoring and how to positively impact their health and wellness.
So thank you for all that you guys do. Thanks again for coming on the podcast. If this all sounded super interesting to you. And you’re like, Hey, I want to get Levels. I want to test, um, and go through a continuous glucose monitoring experiment myself. We will put the link in the show notes to get set up with Levels Health..
Josh Clemente: [00:35:34] Thank you very much, Nicole. And, um, for those who do want to participate, you know, we are currently still in development. Uh, so we have a, an invitation only beta, but Nicole has the link to it to have everyone kind of jump ahead of the, the waiting list and participate early if you’d like to. So, uh, thank you in advanced to anyone who does, and looking forward to your feedback.
Nicole Aucion:Nicole Aucion: [00:35:52] Awesome. And you just told me before we started recording, there’s 85,000 people, and it’s the beginning of February, um, that are on that wait list. So you guys have quite, quite a bit of people that, that want access to this, which is really, really cool.
Josh Clemente: [00:36:06] Yeah, that’s right. It’s, uh, it’s very vindicating because I think it just shows that there is, as we touched on in this show, people don’t want to be unhealthy.
They want better information. They want to make educated decisions for themselves and then feel confident. So I think that number helps to demonstrate how true that is.
Nicole Aucion: [00:36:26] I hope you enjoyed that episode on continuous glucose monitoring. It really is an interesting thing that you can do to empower yourself, to make educated decisions. I can tell you from personal experience, I think twice about some things that I’m eating and how I pair foods together based on the things that I’ve learned from monitoring my glucose for over six weeks. As promised here are my three biggest lessons that I learned.
Number one, pairing protein, carbs and fats together really does help stabilize your blood sugar and prevent those quick spikes and quick crashes. It helps you normalize your energy levels. Number two, you mentioned this during the podcast, but eating carbs and sugar at night really affected my blood sugar overnight. And it caused a second spike, and my blood sugar was higher fasting in the morning when I had sugar and carbohydrates at night.
Some people can break down carbohydrates better than others. And I learned that I do not process carbohydrates the best, probably because I don’t eat a ton of carbohydrates at one time. All right. The third thing has to do with alcohol. A glass of wine did not spike up my blood sugar. In fact, Jason and I went out to dinner a few times and I had a glass of wine,
mashed cauliflower, broccoli and some salmon, and my blood sugar didn’t go up at all. It was rated a nine out of 10, that meal, um, based on how my blood sugar responded. Contrary, uh a Mohito on the other hand, spiked it up drastically. How much sugar are you drinking? Do you have sugar sweetened beverages? Or if you’re drinking alcohol,
are you having sugar in the alcohol? I would be mindful of that because it definitely will affect your blood sugar. We talked a little bit about exercise and how it spiked up your blood sugar, but I was fascinated by this. My blood sugar went up the highest, uh, when I was exercising. And it was all
a natural physiological response, um, not because of the food that I ate. If you are interested in jumping the 85,000 people wait lists of Levels Health, you can click the link in the show notes and you can skip the line and start your own continuous glucose monitoring experiment with our link and partnership with Levels Health.
One last thing. If you are thinking now is the time. I need someone to help me with my nutrition. We would love to help you. You can work with a dietician at our Healthy Steps Nutrition HQ location, or find a nutrition coach near you. Click the link in the show notes, or go to HireANutritionCoach.com and find a Healthy Steps Nutrition coach near you.
I hope you enjoyed this episode. Please don’t forget to subscribe so that you don’t miss another episode. We’ll see you back next week.