Ep. 292: Control Your Blood Sugar, Control Your Life W/ Josh Clemente of LEVELS

Josh Clemente thought he was healthy. After departing from SpaceX as an engineer, the entrepreneur began to think about how choices throughout his life — from the number of hours he slept to how often he exercises — affected his physical performance. Continuous glucose monitors (CGMs) allowed him the ability to see real-time metrics on how his life choices affected his health, which spurred the creation of Levels, a health and wellness company that he co-founded. In a conversation with Jonathan Levi on the SuperHuman Academy podcast, Josh dives into how his preconceptions of health changed following a CGM, how closed feedback loops can enact real change, and how Levels is bringing lab-quality metrics to everyday people.

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• Connect with Josh Clemente on LinkedIn or Twitter
• Check out SuperHuman Academy
• Connect with Jonathan Levi on LinkedIn or Twitter

08:41 — Becoming fascinated with continuous glucose monitoring

After leaving SpaceX, Josh eventually got his hands on a continuous glucose monitor (CGM), which, for the first time, allowed him to quantify some of his health habits.

“I started to think more broadly and widely about my own choices. What am I doing to optimize? I have this experience where I’m in good physical shape, but I am not feeling that way, I don’t feel healthy by any stretch of the imagination. And that led to a period of experimentation. I left SpaceX to start a different company, which I did for about a year. And during that time, I started to dig into physiology and metabolism deeply, eventually got my hands on a continuous glucose monitor because it was a quantitative data stream that was very closely tied to all of the experiences I was having. So all this energy issue and ultimately found out that I was essentially pre-diabetic or very close to it. Just by chance, just basically due to this interest, I used the CGM and discovered this and that again was a second life-changing moment, which ultimately led to my realization that this is an epidemic-scale problem that can be resolved with better information.”

13:09 — Redefining what it means to be healthy

Just because you look healthy doesn’t mean you are healthy. By using his CGM, Josh realized that he was near pre-diabetic, even though he was living an otherwise “healthy” lifestyle.

“I just did not have any nuance here. I kind of was a carb loader, a calories in, calories out person, and did not think deeply about the role of diet in holistic health. And it was not until this moment when I realized that someone can be physically fit, their BMI can be healthy. You can see your abs and yet you can be pre-diabetic under the skin. And that was another realization just that the physical representation of health is very different from person to person. So all of that coming together brought my attention to the continuous glucose monitor, which I had attempted to get for about a year and a half after I had learned about them. And several physicians had turned me down for a prescription because they just weren’t familiar with the use case. I wasn’t diabetic according to these blood spot tests that we all do — you go in and you get your fasting glucose chapter, your A1C, and that’s how they predict or project your metabolic health. And so I hadn’t broken a threshold yet. So the assumption was that I was healthy. And so it took having the full-time high-resolution information, which is tracking my blood sugar 24/7, in order for me to see all of these periods after meals in particular, my blood sugar was remaining elevated well into the prediabetic, sometimes diabetic state, for hours.”

14:58 — Glucose is the key for holistic health

Glucose levels don’t become a problem — until they do. The downstream negative effects of high glucose levels are plentiful, but rarely paid attention to.

“There are basically three energy substrates that we can use to power our cellular machinery. One is glucose. The other is fat. And then what we call ketones or exogenous ketones is another macronutrient, but they’re basically fat as well. And so you’re basically either burning fat or burning sugar. And oftentimes both now. Glucose — it’s really important that you have it. If you’re too low on glucose, that’s called hypoglycemia and it is acutely dangerous. But where we in society currently are struggling is due to changes in a culture where we have a more sedentary lifestyle and extremely high energy processed food supply. We’re experiencing chronic hyperglycemia, so chronic elevations in glucose. And what that does is, because glucose is a very reactive molecule, we have what’s called ‘cellular glycation’ happening where glucose binds to other proteins in the body and causes damage. When levels of glucose are too high, you cause widespread tissue damage. And this builds up over time.”

18:51 — Working backward toward the root cause of insulin sensitivity

Healthcare is a reactive industry, but companies like Levels and Virta Health are digging into the root causes behind insulin sensitivity and glucose levels.

“We have not fixed the insulin sensitivity issue at the root — we haven’t changed how much sugar we’re dumping in, which requires insulin to dispose of. And so taking a root cause analysis of this problem, you’re absolutely right that sort of exogenous or just insulin increase does not solve in some resistances is only making matters worse. And you have companies and organizations like Virta Health now, who are showing that just with a dietary approach you can get 60% of people off all meds, including those who are diabetic, right? So you can essentially reverse the symptoms of diabetes using strictly diet. And that’s a fascinating and basically a world-changing set of evidence that we’ve kind of been approaching the problem backward for decades now.”

25:39 —  Bringing lab technology to the people

CGMs were once a technology confined to labs and only for those who were experiencing pre-diabetes or diabetes. Now, technology has enabled CGMs, like the ones from Levels, to be on anyone who wants one, increasing the pool of glucose data to a size never seen before.

“So looking at the arc of technology development, continuous glucose monitoring, this tech was only available in the lab. And so in a lab environment, you were measuring basically just people who had glucose dysregulation to the degree of diabetes. And we were not aware of any sort of levels to compare them to we weren’t measuring nondiabetic glucose control. And so now the technology has bridged out from that space due to the microelectronics revolution and improvements in supply. And we now can start to use the tech to understand not just what it does but what does the dysfunctional state look like? What does the functional state look like? What does optimal look like? And so the thing is, is that you need very large datasets and you need to start bringing people from all different populations. Traditionally, metabolism has been measured in small groups of sort of observational cohorts, let’s say a few hundred people. And now what we can do with something like Levels is we can put hundreds of thousands of hours of data on people who do not yet have diagnosed metabolic dysfunction into the system.”

29:56 — The future of continuous glucose monitoring

Right now, Levels is amassing one of the world’s largest glucose data sets. Josh hopes that Levels will soon be able to make data-backed suggestions for users whose glucose levels aren’t optimal.

“We’re building the data set and training the models, but over time, that potential is really limitless in the sense that everyone has their own set of goals and across the metabolic health spectrum. People can use this data stream to improve anything from athletic performance all the way through to weight loss and the avoidance of long-term chronic illness and everywhere in between. Including, like I was saying, the issues like cognitive impairment. You touched briefly on Alzheimer’s being closely related here. In nursing and medical schools, we’re currently teaching that Alzheimer’s disease is Type 3 diabetes. It’s insulin resistance of the brain tissue. And so for people who want to kind of avoid that type of thing, which it runs in my family, this is a key focus for me is maintaining cognitive sharpness. It’s something that is very closely connected to the choices I’m making today. You know, the meals I’m eating today, the activity level that I’m incorporating into my lifestyle, the way I sleep, how much stress I allow myself to build up — all of this matters and it all compounds. And so by bringing in the data set and giving it to you in the context of your choices, you can see which ones are positive and which ones are negative.”

33:50 — The importance of sleep

In addition to diet, exercise, and stress, sleep can affect a person’s glucose levels. Getting less than eight hours of sleep can result in acute insulin resistance and eventual glucose dysregulation.

“Americans are sleeping 25% less on average than 100 years ago. And over that same time period, you know, diabetes has risen from less than 1% to roughly 10% of the population in the United States. And we have strong evidence that poor sleep induces acute insulin resistance, which you talked about earlier, which is then the cause of glucose dysregulation. In a group of people who sleep, I believe, six and a half hours or less per night, they have to use 50% more insulin to achieve the same glucose control than if they sleep a full eight hours. So it’s basically in the short term that insulin resistance has met. It’s a stress-induced response and it’s a short-term pre-diabetes or diabetes almost. That’s something that we all need to think about. Sleep is very, very closely tied to metabolic health. And we read a lot about this with our friends at Eight Sleep who are trying to crack this nut. So we’re working together to introduce data. And so that is a stress response.”

35:04  — How stress can mimic the impact food has on glucose levels

Like sleep, diet, and exercise, stress can affect glucose and insulin levels. Too much stress can cause levels to rise to levels seen by eating certain foods.

“Stress induces these catecholamines and glucocorticoids, like cortisol, which releases and is directly tied to metabolism. In fact, there are dietary factors like caffeine, which also induced the same stress response. So as cortisol comes up, it kind of inhibits the insulin function and you end up with glucose levels that rise. And so you’re exposing yourself to glucose elevations that are tied to all these negative consequences downstream just by being stressed out. And that’s where mindfulness practice can help. That’s where like healthy lifestyle practices, like taking time away from technology, just spending time in conversation, reading — all of this is very helpful and it can now be kind of quantified in a sense when you can put numbers on it. And I’ve sat through meetings that were stressful and my blood sugar has, on its own elevated to 135-140 milligrams per deciliter, which is the upper limit for the American Diabetes Association for how you should respond to a meal. So we’re talking about fasted elevations to know carby meal levels without any calories — I’m just sitting there and this is just caused by stress.”

43:32 — What works for you may not work for me

Josh cites pressed juices and oatmeal as some foods that, while labeled healthy, may cause glucose levels to spike. Having the information through a CGM allows users to experiment with how their body’s chemistry reacts to certain foods.

“Google the healthiest breakfast and I guarantee you oatmeal will be on the top three, no matter what page you look at. It’s heart-healthy grains, right? It’s the breakfast that you should go on if you have heart concerns. Well, about 75% of people who have tested oatmeal in the Levels’ dataset have an extremely high borderline pre-diabetic response to it. And that’s plain cooked with water, no brown sugar, no maple syrup. It’s just causing these elevations for people because, in many cases, it’s a fairly processed grain. It’s cooked to the point of, essentially, very quick disillusion in the digestive system, and you get this like extreme blood sugar response, which is going to induce an insulin response, which is going to cause your blood sugar to come crashing back down and you’re going to be hungry and you’re going to be shaky and you’re gonna be looking for something else two hours later. So all of these little anecdotes stack up to, basically, a different direction in metabolic health. Long-term having the information and course-correcting on the small choices we may be making even when we don’t even like them — we just think they’re healthy for us — is really powerful and it’s completely changed my approach.”

45:59 — The effects a CGM has had on Josh

**Through consistent use of a CGM, Josh has been able to consistently monitor his glucose levels, and by extension, other vitals, like fatigue and wakefulness.

“So throughout the course of the last two years using this technology, not only as a guide but also as accountability, I’ve brought my average glucose down into the low nineties. It’s like 91 right now. And it’s basically 91, plus or minus 10 points, all day every day. And if I choose to indulge, I see the consequences there. I see the numbers and it reinforces my choices. It drives me stronger towards clinging to my decisions. And so that reduction for me, in an average glucose from 115 down to 91, it first of all is going to be very closely tied with insulin sensitivity. And so I’ve seen an improvement in my responses to carbohydrates again when I do choose to indulge, which is indicative of improvements in insulin sensitivity. And then overall it’s just reduced my exposure to the effects of the glycaemic rollercoaster, which induces us all this hormonal cascade downstream. So my fatigue levels much improved. I mean, coffee now after 11 a.m. is just basically an indulgence. If I choose to do it, I do so, but it’s not a requirement the way it used to be.”

50:45 — Creating tight feedback loops to enact change

By having continuous data at our fingertips, we don’t have to wait for something to go wrong, Josh said. With Levels, users can monitor their glucose levels and make in-the-moment changes that could have important downstream benefits.

“We are in a state where 90 million U.S. adults have pre-diabetes and 90% of them don’t know it. Thirty-five million have Type 2 diabetes, which is entirely preventable and is the number one cause of cardiovascular disease, again associated with Alzheimer’s. All of these things are happening because we don’t have a closed feedback loop. And so at Levels, we are all about behavior change through tight feedback loops. Another thing that [Dr. Kelly Starrett] basically said, a movement practice sets us up to understand what’s going on in real-time so that we can improve it, manage it, ameliorate it. We don’t have to wait until something breaks until we realize what’s going on. That’s exactly what we’re doing here at Levels. It’s by having a metabolic awareness, a data stream to connect action, to a reaction — you’re doing exactly that. You’re understanding what’s happening in real-time. Not, you know, someday in the future when you break through a threshold and realize you’re sick. And this is all about taking the front seat in your own health and saying that I care about physical fitness, mental fitness, but also metabolic fitness. These are all closely coupled and we need data to drive our choices.”

[00:00:00] Narrator: Welcome to the award-winning Superhuman Academy podcast, where we interview extraordinary people to give you the skills and strategies to overcome the impossible. And now, here’s your host, Jonathan Levy.

[00:00:19] Jonathan Levi: Hey, listen up and don’t skip over this, before we get started I want to let you know that I am giving away completely free copies of my latest bestselling book, The Only Skill That Matters. This book is going to teach you how to upgrade your memory, read faster, learn more, and conquer your dreams. And it contains all new content written for 2020. Now again, I am giving away completely free copies of this book. All you need to do is pay shipping and handling. So to pick up your free copy, as a listener of this podcast, visit freelearningbook.com. That’s freelearningbook.com.

Hello, my little super friends and welcome, welcome to episode number 292, which is lovingly handcrafted, thanks to a wonderful review from Dan, The Nutrition Man, who says, “Totally binge-worthy. Five stars. Thank you for doing what you do. I recently found your podcast as I’ve been exploring memory training and personal development during the quarantine. I’ve been listening to a couple of episodes, every day, on two X speed during my morning dog walk and absolutely love the content, with real actionable takeaways. I’ll be purchasing the Super Learner course once I’m able to get back to work. Keep up the outstanding work, and I can’t wait to see how far my brain can take me.” Dan, thank you so much for that wonderful review. Honestly, it is what I do this podcast for. Is knowing the changes and positive impact that I have on all of you. And I really want to wish you total luck and success in finding an awesome job that you absolutely love with your super learner skills. Now, onto today’s episode.

Ladies and gents, today I am joined by Josh Clemente of a new company called Levels. He’s a mechanical engineer and a CrossFit level 2 trainer, and he formerly worked at Space X. Where he led a team to develop life support systems for real-life superhumans, like Bob Bankin and Doug Hurley on their May, 2020 trip to the International Space Station aboard the Dragon Endeavor. And he’s also spent time designing and building hyperloop technology and leading engineering for a company providing vehicle-based rescue systems for emergency response. But we barely talked about any of that stuff today because Josh is also the founder of a really fascinating company that I’ve been following for a while called Levels. Their idea – “Wearables are nice, but they don’t give you real, powerful data about what’s going on in your body.” And Levels is trying to change that by coming out with the first consumer available continuous glucose monitor. You’ve probably heard about the hardcore biohackers out there, like Dave Asprey, like Tim Ferris, wearing these glucose monitors that they need all kinds of connections to get, and all the wonderful things you can learn by wearing a glucose monitor. I wanted to find out what the big deal is with glucose monitors and why Levels feels that this is such an important technology to put it in the hands of consumers. I ended up learning a lot, about what is probably one of the most important molecules in your body, which is glucose. It powers absolutely everything you do. And that’s why you want to make sure that you have just the right, Goldilocks level, layers in your body at all times. I think you’re really going to enjoy this episode with my new super friend, Josh Clemente.

Mr. Josh Clemente, how are you my friend?

[00:03:54] Josh Clemente: I’m fantastic. We’re having excellent weather here on the Jersey Shore and I’m very excited to chat.

[00:04:00] Jonathan Levi: Likewise. I’m really excited to chat with you for a number of reasons, not least because I’ve been really excited to try out the product that you’ve been working on. And I think you’re the first person I’ve ever met from former Space X territory. So really exciting to just dig into your history and learn more about you.

[00:04:21] Josh Clemente: Awesome. Yeah, Space X was definitely a formative experience for me. I would, hopefully not the pinnacle of my career, but definitely an incredible, formative experience. In the sense that it exposed me, not only to the way that an organization of high achievers can pull off some really amazing feats, but also, it was part of the founding story of Levels, which we’re going to talk about here today. I experienced some personal, kind of borderline burnout and fatigue and cognitive dysfunction stuff that was just, really getting to me. And that, ultimately, is what led me to interest in human performance metabolism.

[00:04:55] Jonathan Levi: Take me through the whole story. So you… give me the origin story. I guess is the question that I want to ask is – how did you get into this? What took you to Space X? What took you to leave? I know you’re also an athlete yourself, so take me through the whole story.

[00:05:09] Josh Clemente: Yeah, I have played sports throughout my entire life. I’ve been interested in fitness specifically, for a very long time, and I’m a CrossFit level 2 trainer. I don’t really teach CrossFit that often, but I, at a certain point in my life, took it very seriously. And at the same time, I’m obsessed with technology and machines and systems and figuring out how things work and reverse engineering things to find solutions, particularly elegant ones that are very simple and achieve big goals. And so that’s what led me to Space X. I have a mechanical engineering background with a focus on thermodynamics and I ended up at Space X in 2010. I was there for about 6 years, ultimately leading the pressurized life support system team there, which would develop things like breathing apparatus for astronauts, cabin pressure controls, which would keep the spacecraft at a certain pressure throughout its flight, fire suppression systems, basically anything that requires a pneumatic pressurization and/or breathing apparatus for the crew. And that was a really amazing experience, that vehicle flew in May, actually and it just returned at the beginning of this month from the International Space Station with Bob and Doug. And during my time there the pressures were high, the stakes were high, schedule was always being pushed.

And I personally started to experience this, sort of juxtaposition where I have never struggled with weight. I have always been fit aesthetically, I would say. And I’m a CrossFit trainer and working out all the time and then I’m going into the office and there’s just, it’s black and white. Like, I am experiencing horrible fatigue. I’m drinking buckets of coffee a day. I’m having to grab naps under the desk in between meetings. It’s just this really strange juxtaposition that makes no sense if you consider the sort of traditional thought that physical fitness is overt health. And so, through that experience, I started to be exposed, as I got further into the life support program, to some new science. Specifically, including work by Dominic D’Agostino from the University of South Florida. Which was my first foray into the power of diet to contribute to human performance and wellness.

And this was, specifically a study on rats, but it showed that in a very high pressure environment of pure oxygen, which by the way, it was a scenario that I had to think about on my program. So I was reading the study, and in this scenario if the rats are given a ketogenic diet and they’re in a state of ketosis, they have 5 times, something like 5 times as long without experiencing central nervous system toxicity. So like these convulsions due to all of the extremely high energy and reactive oxygen species that are being produced. And so this is like a super, it’s basically a protective, almost superhuman like ability that these animals experience, just simply by being in a state of ketogenesis. And this was like, I mean for someone like me who had, up until that point, just been strictly calories in, calories out workout hard, and you can eat whenever you want. This literally was a screeching tire moment. It was like, what is going on here? You just eat a different macronutrient ratio and all of a sudden you have the ability to outlive, potentially other organisms who are experiencing the exact same environmental conditions.

And so that moment was transformative for me. I started to think more broadly and widely about my own choices. What am I doing to optimize? I have this experience where I’m in good physical shape, but I am not feeling that way. I don’t feel healthy by any stretch of the imagination. And that led to a period of experimentation. I left Space X to start a different company actually, which I did for about a year. And during that time, I started to dig into physiology and metabolism deeply. Eventually got my hands on a continuous glucose monitor because it was a quantitative data stream that was very closely tied to all of the experiences I was having, so all this energy issue. And ultimately found out that I was, essentially pre-diabetic or very close to it. Just by chance, just basically due to this interest I used the CGM and discovered this. And that, again, was a second life-changing moment, which ultimately led to my realization that this is an epidemic scale problem that can be resolved with better information.

[00:09:03] Jonathan Levi: Fascinating. And just to confirm that I heard you correctly, there was a slight cut on the line, these rats with this superhuman ability, or mice with the superhuman ability, this was the presence of ketones in their diet?

[00:09:15] Josh Clemente: That’s right. So essentially what’s going on is, when you’re in a very high pressure oxygen environment, or not very high pressure, just a pure oxygen environment. Oxygen is a very reactive molecule and so, you have such a high concentrations in the brain tissue that you accelerate the process of the generation of reactive oxygen species, essentially in the brain. And this is my understanding. And again, it’s been some some time since I read this paper. But ultimately, yes. Especially in the presence of other reactive molecules, like glucose. And it seems to be that when ketones are the primary energy molecule, they’re elevated in the brain. These less reactive molecules reduce the chain reactions of oxidation that are happening in the brain. And therefore, extend the time until seizure for these rodents. And that’s the long and short of it. So basically, for those, I’m sure most of your audience is familiar, but ketones are basically a water soluble fat molecule. So it’s a way to get fat to cross the blood-brain barrier and be a fuel source for the brain. Which, typically only glucose can do that and you’ll often times hear people say that like, the brain can only run on glucose. And that is not true because if you have ketones in the blood they can cross that barrier and be used for brain energy as well. It’s just that typically, free fatty acids in the blood can’t cross that barrier.

[00:10:33] Jonathan Levi: Interesting. So this took you down the path of, I guess the transformative moment really, was not just learning about the power of ketones, but also this, “Oh my gosh. I’m this fit guy and I didn’t even know that I was pre-diabetic.”, and that’s what really turned you on to the importance of monitoring and having really solid data.

[00:10:56] Josh Clemente: Right. Yeah, it was it was a few things on that same line, where the sudden realization that physical fitness is not health. And that for a very long time was confusing to me. It was not something I’d ever, throughout sports, our common sports culture today is that you train the way the elite athletes are training. And so an elite athlete who’s out there putting in, basically professional work, in the sense that they’re working out hours a day. They’re constantly loading in energy in order to be able to go out there and put in more reps. They’re fueling in a way that is extremely specific to their need, and we tend to replicate that across society.

So as a high school or college athlete, you look at what someone who’s training for the Tour de France is doing and you replicate that. It’s Oh, if they’re eating a 1000 grams of carbohydrate per day, I should eat a 1000 grams of carbohydrate per day. That’s what healthy people do. Let me drink Gatorades at every moment. Let me take these energy gels. I’m going to carb blown after my workout, so I’m going to make sure my glycogen is replenished by carbo-loading before workouts. And you get into this mode where that kind of carries over into the future. Where if that worked while you were at your fittest, when you’re not at your fittest and you’re at the desk trying to get back in shape, you go back to old habits. And these habits are not, they’re not grounded in any data whatsoever.

For the average person, we want to be metabolically flexible. We want to be relying on energy sources that are consistent and that we have available to us. We don’t want to be stuffing exogenous sources of, basically rapid release energy into our bodies. And so that was me. I just did not have any nuance here. I was a carb loader, a calories in, calories out person, and did not think deeply about the role of diet in holistic health. And it was not until this moment when I realized that someone can be physically fit, their BMI can be healthy, you can see your abs, and yet you can be pre-diabetic under the skin. And that was another realization, just that the physical representation of health is very different person to person. So all of that coming together and then having the thing that brought this to my attention be the continuous glucose monitor, which I had attempted to get one for about 2 years. About a year and a half really, after I had learned about them. And several physicians had turned me down for a prescription because they just weren’t familiar with the use case. I wasn’t diabetic according to these blood spot tests that we all do, you go in and you get your fasting glucose checked, your A1C, and that’s how they predict or project your metabolic health. And so I hadn’t broken a threshold yet. So the assumption was that I was healthy. And so it took having the full-time, high resolution information, which is tracking my blood sugar 24/7 , in order for me to see all of these periods. After meals in particular, my blood sugar was remaining elevated well into the prediabetic, sometimes diabetic state for hours. And that was really where the breakdown was happening. It wasn’t in the morning when I was at the doctor’s office getting a fasting glucose check.

[00:13:46] Jonathan Levi: Now, I want to ask you a question, Joshua, which I’m asking it with beginner’s mind. And I’m going to ask you a question that I somewhat know the answer to, but you know the answer much more than me. For someone listening in the audience going, you know what, I’m not diabetic. What is the big deal with glucose? Why does glucose matter so much in my blood?

[00:14:05] Josh Clemente: There’s a variety of reasons. So glucose is a super powerful and impotent molecule. It’s the primary energy source for the average modern person. We talked a little bit about ketones earlier, but there’re basically 3 energy substrates that we can use to power our cellular machinery. One is glucose. The other is fat. And then, we call ketones or exogenous ketones another macronutrient, but they’re basically fat as well. And so you’re basically either burning fat or burning sugar and oftentimes both. Now, glucose is, again, it’s really important that you have it. If you’re too low on glucose, that’s called hypoglycemia and it is acutely dangerous. But where we in society currently are struggling is due to changes in culture, where we have a more sedentary lifestyle and extremely high energy processed food supply, we’re experiencing chronic hyperglycemia. So chronic elevations in glucose. And what that does, is because glucose is a very reactive molecule, basically we have what’s called cellular glycation happening. Where glucose binds to other proteins in the body and causes damage.

When levels of glucose are too high, you cause widespread tissue damage. And this ends up, over time, it doesn’t have any acute sense. You don’t really have symptoms associated with this, but over time it leads to chronic illnesses like, pre-diabetes of course, diabetes, it’s associated with cardiovascular disease, stroke, Alzheimer’s, mood dysfunction, sexual health, PCLS, which is the number one cause of infertility for women. There are all of these downstream effects that are metabolic in nature and always come with glucose dysregulation. And it’s really important, in modern society, that we start to pay attention to glucose control and specifically metabolic control, which includes glucose, as a key foundation for holistic health.

And this is something that is not currently considered. We think about physical health and we think about mental health, but the reality is that below both of them is the cellular machinery that produce energy and that is metabolic health. And yeah, I would say that it’s something that we’ve known about for a very long time, but we have not focused on optimizing, until now.

[00:16:03] Jonathan Levi: Yeah, absolutely. And I’ll add to the list, there is some suspicion that also Alzheimer’s is caused by excessive glucose. And yet, so many different diseases, whether it’s diabetes, whether people lose limbs over glucose and tissue damage, and yet, the medical establishment, their answer to it is – your body’s not responding to insulin, let’s pump you full of more insulin. It’s treating a punctured eardrum by just blasting louder noise. Which unfortunately, is the way that that hearing aids do work. But it’s not actually solving the problem. t’s not making your ear more sensitive and it’s certainly not making your body more insulin sensitive.

[00:16:41] Josh Clemente: Yeah, that’s a really good analogy. We have a state called insulin resistance that sets in. So basically, taking that example of a sedentary individual eating a very high-processed, energy dense, sugar dense diet, they’re constantly elevating their blood sugar levels. And their bodies are releasing insulin to try and get that glucose into the cells to be burned in the cellular machinery, the cellular power plants called mitochondria. And the problem is, if you don’t have high energy needs, if you’re not doing anything active at the time that this blood sugar is elevated, your cells don’t need that much energy so they tap out very quickly. And then your body says, no, we need to get this glucose out, more insulin. So you’re releasing more and more. And this is happening from the pancreas. And then, eventually the cells just say, look, we can’t. There’s nothing we can do with this glucose. And they basically adapt and it’s an adaptive response it seems, but it’s called insulin resistance where the cells just stop responding.

Insulin kind of works like a key in a lock. So it opens up the cell, allows glucose to cross the barrier and get out of the bloodstream. And so, when this insulin resistance sets in, you’re numb to the signals and your body, eventually this, sort of feedback loop breaks and the body enters a state of, basically it has no control anymore over the glucose levels. And no matter how much insulin you release you only get marginal improvement in glucose disposal. Eventually the pancreas seems to, you get a negative feedback loop where the pancreas stops producing insulin. And that’s when true diabetes sets in. Now, along the way, we have not improved. So it went true diabetes sets in, the way we pick up the pieces, we say, “All right, now here’s a syringe full of insulin. Go ahead and start injecting it because your pancreas isn’t producing it.” But again, like you said, we have not fixed the insulin sensitivity issue at the root. We haven’t changed how much sugar we’re dumping in which requires insulin to dispose. And so taking a root cause analysis of this problem, you’re absolutely right, that exogenous or just insulin increase does not solve insulin resistance. It’s only making matters worse.

And you have companies and organizations like Virta Health now, who we are just, absolute total supporters of, who are showing that just with a dietary approach, you can get 60% of people off all meds. Including insulin,  who are diabetic, right. So you can, essentially reverse the symptoms of diabetes using strictly diet. And that’s a fascinating and basically a world changing set of evidence that we’ve been approaching the problem backwards for decades now.

[00:18:58] Jonathan Levi: Absolutely fascinating. Now this isn’t just people who are diabetic. People of all different walks of life and with all different health conditions need to be concerned about their glucose, as far as I understand it.

[00:19:11] Josh Clemente: Absolutely. Yeah. so the goal of what we’re doing at Levels, is to connect every person across the metabolic fitness spectrum with their own body’s information in real time. And so now, using continuous glucose monitoring technology, you can see the specific responses to choices you’re making. So the actions that you take have reactions in your body, and now you can measure those and quantify them. And the reason this matters is because all of these issues that we talked about, everything from stroke, Alzheimer’s, cardiovascular disease, diabetes, all of these set in over time. They are a compounding return on our choices.

And it’s important that we realize that we’ve been operating, essentially blind. We’ve been operating in what’s called an open loop system where our choices are not affected. They’re not informed by the outcome of choices we’ve made before. We are just making the same decisions over and over again and using emotion or, kind of advice from others to gauge whether or not this is working for us or something very low resolution like the bathroom scale. But when you close the loop between an action and a reaction, you can see in real time, whether that is positively or negatively affecting you. And if you see a negative response, you can imagine, project that negative response out over 10, 20, 30 years. And that’s how you end up with a chronic lifestyle illness like cardiovascular disease or diabetes. Those are the long-term issues that people are trying to avoid. But most of us are focused on the short-term stuff. We’re focused on things like fatigue and weight gain and acne and sexual health. And these are the types of things, that in the very short term, are acutely affected by glucose dysfunction. So you may not be a diabetic, you may not care about diabetes, and that’s totally fine. But what are we struggling with in our day with day to day? It’s likely that those issues, given the state of metabolic health in this country and globally, are connected with metabolic dysregulation. I think I touched on some of the major issues. But I, personally, completely changed my approach to diet and exercise as a result of having horrible fatigue that was driven by this pre-diabetes I knew nothing about. And I was not breaking, I was not type 2 diabetic, I was not wildly overweight. My issue was caused by this metabolic feedback loop being broken. I had a lot of energy in my blood, my body wasn’t using it effectively and that’s why I was experiencing these waves of fatigue. Other people, if you’re eating a high sugar diet, you’re driving up insulin levels, you’re constantly gaining weight. You may even be doing things that you think are ultimately healthy for you. But because of your personal individuality, the way that your body metabolizes those foods, you may be experiencing hyperglycemic responses. Which are going to lead to insulin elevations and then, ultimately more weight gain.

So there’s all of these, kind of broken feedback loops we have in society because we just don’t have data at the moment that we need it. And so, it doesn’t matter where you are, you could be an elite athlete, you could be someone who is struggling to lose 200 pounds. Both people, their cellular machinery is operating on glucose. And so it’s important to have a fuel gauge and to use it and not continue to fly blind.

[00:22:08] Jonathan Levi: All right, let’s take a quick pause and thank this episode’s sponsor BLUblox, blue light blocking glasses. The only blue light blocking company in the world that create evidence backed lenses for filtering blue and green light. They’re Australian lab built lens technology is fitted into the most fashionable frames and they can even make prescription and reading glasses in there optics lab. So whether you want to wear their Sleep+ glasses, that block a 100% of blue and green light. Their Summer Glow mood booster glasses, or even blue light computer glasses that don’t have a yellow tint, BLUblox has you covered. Now, I like to wear the Sleep+ glasses 2 to 3 hours before bed and they really help your sleep. I also like to wear the daytime ones for reducing digital eyestrain, headaches, and lowering stress. Now BLUblox has free and fast worldwide shipping. And if you use code superhuman at checkout, you can get 15% off any pair that you want. Just go to BLUblox.com. That’s B L U B L O X.com and enter code superhuman to save 15%. All right, let’s get back to the episode.

Now, I’ve always assumed that some of this stuff, I think the genius of a lot of companies out there like Oura or Dream, or Apple really, for that matter, is that they take a lot of really complex data, such as heart rate variability, and they make it so that average non-medically trained people can interpret it. I’ve always assumed that blood glucose was one of those things. Where it’s like, oh, it’s very technical, very complex. Was that part of the challenge in building Levels is making the data actionable? I haven’t tried the product yet, I’m really excited to install it on myself tonight, because it came just today in the mail. And thank you for that, by the way.

[00:23:52] Josh Clemente:  Of course.

[00:23:53] Jonathan Levi: How much of that is a challenge? Or is this something that is just, hey, if you’re over 149 something’s not right.

[00:24:02] Josh Clemente:  Yeah, it’s really amazing, the potential for this dataset. But it’s amazing because we’ve got all of this potential but have not tapped any of it really. So looking at the arc of the technology development for continuous glucose monitoring, we’ve started in a place where this tech was only available in the lab. And so in a lab environment, you were measuring, basically just people who had glucose dysregulation to the degree of diabetes. And we were not aware of any sort of levels to compare them to. We weren’t measuring non-diabetic glucose control. And so now, the technology has bridged out from that space, due to the micro-electronics revolution and improvements in supply. And we now can start to use the tech to understand, not just what does the dysfunctional state look like. What does the functional state look like? What does optimal look like? And so, the thing is that you need very large data sets and you need to start bringing people from all different populations. Traditionally metabolism has been measured in small groups of, sort of observational cohort, let’s say a 100 people, a few 100 people. And now, what we can do with something like Levels, is we can put 100s of 1000s of hours of data on people who do not yet have diagnosed metabolic dysfunction into the system. And we can start to understand trends. And we can start to understand, not just a positive and negative acute decision-making, but what is one, sort of type of food tend to do to a population. But we can start to put together what is the optimal metabolic control look like?

And so we at Levels have spent 1000s of hours pouring over all the research out there on continuous glucose monitoring thus far and we’ve developed some ranges and metabolic models that can rank the choices that you make in a day. And so, we can understand, we can help you to understand how, not just the overall spike, like the level that your glucose achieves after a meal, that matters. But there’s also this thing called glycemic variability, which is the number of peaks and valleys, the spikiness of your graph. And there’s all of these sub-metrics, like the rate of change and the postprandial peak, the time that you stay elevated. Which would be the area under the curve, which is exposure to glycation. All of these sub-metrics that are really hard to divine out, Levels is resolving, through basically processing power. And so we’re building the platform that can take this raw dataset and turn it into a very easy and actionable resource for people to sit down and say, “Okay, what am I going to eat for lunch and why?” And they can have data to drive that choice, that is based on their bodies and also on a very large and rigorous dataset. And the first of it’s kind.

[00:26:32] Jonathan Levi: I have to imagine that’s not easy. And that one of the hardest things I’ve always found, and I’ve tested all the wearables you can possibly name, the hardest thing is actually converting that into actionable changes in people’s lives. It’s, “Okay, great, I’ve got this Oura ring. I know I should exercise more but give me something that’s actually meaningful to me.” You do better with this or you do better if you sleep at 10 o’clock. Tell me a bit about that challenge and how you get that data. I imagine people need to actually say, “Okay, yeah, my blood sugar spiked and it’s because I ate this.” and over time you’re able to tell them not to eat that thing.

[00:27:05] Josh Clemente: That’s right, yeah. So it’s important to have a relevant dataset. We can’t just take specific anecdotes and say, okay, this is good or this is bad for you. We need continual monitoring, and over time, you try the same things repeatedly, in different environments, you can start to divine out the specific vectors, the levers that you can pull on to modify your responses. And we start to see patterns for individuals and patterns across the population. And so right now, at Levels, where we’re in very much data gathering mode still, where we’re building. As of right now, we have the largest non-diabetic blood sugar dataset in history, and we’re continuing to grow that and build more resolute models. But the individual, the way that you use this system is, you’re monitoring your blood sugar and you are taking, sort of notes on your lifestyle. So you’re measuring, not just glucose, but in the context of the choices you’re making.

So you sit down for lunch, you take a quick picture, add some notes, and then you return for a score about 2 hours later. So the system is analyzing your blood sugar response to that choice. And then, let’s say that you sit down and you have a personal pizza or something, and then you go sit on the couch and watch a TV show. So your body will respond in a specific way to that to, to the energy demands of the moment. Try that same personal pizza again, let’s say the next day, except instead of sitting on the couch, you go for a walk around the block, 15, 20 minute walk. Now, because your energy needs are different and you’re mobilizing glucose in real time to your muscles, your body’s going to respond and metabolize that pizza completely differently. And so you will get a different score out of the Levels system, and that helps, over time, to deliver insights to you. So based on how your blood sugar is changing, we can start to deliver recommendations on how to modify, to intervene for optimization, for improvement. Not just a passive system that, again, like you were saying, you’re just recording every day and looking at the recordings. This is truly inducing behavior change, such that people can get to metabolic fitness.

And so that is currently, that’s the roadmap right now. Again, we’re building the dataset and training the models, but over time, the potential is really limitless. In the sense that everyone has their own set of goals, and across the metabolic health spectrum people can use this asset, this data stream to improve. And anything from athletic performance, all the way through to weight-loss and the avoidance of long-term chronic illness. And everywhere in between, including, like I was saying, the issues like cognitive impairment. You touched briefly on Alzheimer’s being closely related here. Yeah, in nursing and medical schools, we’re currently teaching that Alzheimer’s disease is type 3 diabetes. It’s insulin resistance of the brain tissue. And so, for people who want to avoid that type of thing, which it runs in my family, and so this is a key focus for me is, maintaining cognitive sharpness is something that is very closely connected to the choices I’m making today. The meals I’m eating today, the way that I’m, the activity level that I’m incorporating into my lifestyle, the way I sleep, how much stress I allow myself to build up, all of this matters and it all compounds. And so by bringing in the dataset and giving it to you in the context of your choices, you can see which ones are positive, which ones are negative.

[00:30:00] Jonathan Levi: Incredible. Now, what are the things besides food that influence our blood sugar? You now have more data than anyone. So normally I wouldn’t ask that question, but you are literally the person that I could ask. What are the other things that you’re discovering that are surprising you that are influencing people’s blood sugar? I’ve actually heard that meditation and mindfulness can influence one’s blood sugar. So tell me some of these surprising things.

[00:30:20] Josh Clemente: You touched on one of the biggest learnings for me, which is the mindfulness one. But the big 4 are diet, exercise, sleep and stress. These are the ones that you can, very quickly in the Levels program, see the quantitative benefit of. So diet is, obviously, specifically what you choose to eat. And we don’t drive a specific philosophy. We don’t say everyone has to eat low carb or keto or something. In fact, my co-founder, Casey Means, she’s a Stanford trained medical doctor, former surgeon, she’s a 100% plant-based. So she’s vegan. She has a very high carbohydrate diet, relative to the rest of us on the team, and she is consistently in a top, sort of rank of metabolic fitness scores in our system. Like not just in the team, we’re talking about overall, she has some of the best metabolic health. And so, she’s using data to allow herself to have a data-driven diet that fits her philosophy, which is all plant-based, but that is extremely good for her in the long term. And then we have people who are on the other end of the spectrum, ketogenic, carnivore and maintaining similarly high-quality choices. And so diet is a big one, specifically how you choose to eat is up to you. But why you eat should be driven by data.

Sleep is a really powerful one. Americans are sleeping 25% less on average than a 100 years ago. And over that same time period, diabetes has risen from less than 1% to roughly 10% of the population in the United States. And we have strong evidence that poor sleep induces acute insulin resistance, which you talked about earlier on, which is then the cause of glucose dysregulation. I think that there are some studies that show, for a group that sleeps, I need to get this right, so in a group of sleep of people who sleep, I believe 6 ½ hours or less per night, they have to use 50% more insulin to achieve the same glucose control than if they sleep a full 8 hours. So it’s basically a short term like, yeah, that insulin resistance is a stress induced response. And it’s like a short-term pre-diabetes or diabetes almost. And that’s something that we all need to think about. Like, sleep is very closely tied to metabolic health. And we read a lot about this with our friends at Eight Sleep who are trying to crack this nut. So we’re working together to interpret data. And so that is a stress response. And of course, that means that stress, broadly speaking, is a very large lever. The way that we allow ourselves to accumulate stress throughout the day, whether that’s meetings, stressful meetings, whether it’s dealing with our children. And, of course in times of COVID, it’s easy to tune into the TV and just allow our stress levels to just rise unmitigated. But that stress induces these catecholamines, glucocorticoids like cortisol, which releases and is directly tied to metabolism. In fact, there are dietary factors like caffeine, which also induce the same stress response. So as cortisol comes up, it inhibits the insulin function, and you end up with glucose levels that rise. And so you’re exposing yourself to glucose elevations that are tied to all these negative consequences downstream, just by being stressed out. And that’s where a mindfulness practice can help. That’s where, like healthy lifestyle practices, like taking time away from technology, just spending time in conversation, reading, all of this is very helpful and it can now be, quantified in a sense, when you can put numbers on it.

And, I’ve sat through meetings that were stressful and my blood sugar has, on its own elevated to 130-140 milligrams per deciliter, which is the upper limit for the American Diabetes Association for how you should respond to a meal. So we’re talking about fasted elevations to carby meal levels without any calories. I’m just sitting there and this is just caused by stress. And then let’s see, so that was, what did we cover there? Diet, sleep, stress, and then exercise.

One of the most profound things that people learn almost immediately, is taking a quick walk, just like getting up and moving around after a very heavy meal, completely changes your body’s response to it. This is not, it sounds like an urban legend or kind of old folklore, but the way that your body responds to a meal is heavily induced or heavily influenced by the energy demands of the moment. So whether your body chooses to store that as fat or keep it available as energy is determined by whether or not you need energy at that moment. And your muscles are very large in your legs and getting up and just moving around, it doesn’t have to be high intensity, will completely change the way that you respond to meals. And I use this all the time. If I want to indulge a little bit, I will do it and then I’m gonna get up and I’m gonna go for a walk. And I can look at that score and experience satisfaction after that by knowing that I maintain blood sugar control and still was able to enjoy something I really like, in terms of a snack or a dessert.

And those are the big 4 and people are learning these lessons. It’s always been told, eat healthier, move more, and now you have data to drive those choices and help you, specifically identify which ones are best.

[00:34:50] Jonathan Levi: Absolutely fascinating. So what are some of the things that you’ve changed? And how have you changed your diet? Personally, how have you changed the levels of stress that you’re taking on? I’m very curious about where the rubber has met the road for you and where you are now versus where you were back when you were at Space X and you realized that fitness is not health.

[00:35:10] Josh Clemente: Well, for me, I’m on a constant journey here and learning every day. And one of the most, I would say one of the biggest learnings for me, was just the independence from dietary dogma and understanding that every, diets typically don’t work because they’re grounded in this concept of one size fits all. And so I’m going to give a little bit more background for getting to my own specifics, but this new wave of continuous glucose monitoring technology has, it’s been studied a little bit in the lab. And so in 2015, or rather in the research environment. So in 2015, a landmark study came out from the Weitzman Institute in Israel, and they put CGMs on 800 healthy people and they were able to see, which this is the first time it’s ever been shown, that 2 people can eat the same 2 foods and have an equal and opposite blood sugar response. This kind of threw the traditional idea, one size fits all, or glycaemic index eating, kind of out the window. And it basically said that, if I eat a banana and a cookie and one other person eats a banana and a cookie, I can have a huge blood sugar spike on the banana and be totally flat on the cookie and that the other person can have the exact opposite of those responses. So whether or not I’m the banana person or the cookie person dictates how I should structure my diet. And it’s not necessarily that I should just eat cookies all day, it’s that whether I have a sensitivity to fruit sugar versus grain sugars is what’s going on there. And it could be influenced by body composition, stress, genetics, microbiome. There’s a whole bunch of factors. But the point is, just having that information determines whether or not we can make choices that are tailored for us. Having that idea backed by evidence in my own life has opened up a huge amount of flexibility for me.

The, kind of the biggest lessons I’ve learned, are I am a very carb sensitive person. I’m like the banana and cookie person. I spike on both. And so I’ve introduced, a sort of, I’m not keto, but I would say I’m a protein heavy, so high protein, moderate fat, low carb eater, generally. And I stick to things like green leafy vegetables, a lot of fish and meat and avocados. And I try to eat a lot of healthier nuts and seeds and I will also practice a lot of intermittent fasting and I will structure my meals around my exercise schedule. So if I’m going to be very active for a week, I will eat bigger meals and I’ll eat them more liberally than I otherwise would. Whereas, if I’m on the road and I know I’m going to be taking red eyes and flying a lot and sleeping poorly, I’ll tighten things up and I’ll avoid foods that I know, with evidence, have negative responses for me. And some of these examples, especially on the road would be, like I’ve tested all these different brands. So when you’re on the run, you’re in the airport, you’re stopping by Hudson News and you’re just going to grab a bar or something to eat.

I’ve tested every single bar, like protein bar that is on sale today. And the difference between two 0 carb bars, I’ll give an example, Think Thin versus Perfect Keto, is profound. For me, the Think Then bars cause a pre-diabetic blood sugar response and Perfect Keto, it doesn’t even look like I consumed anything. So I’ve now found that I can tailor, I can find foods that I can rely on, consistently, on the run for snacks or for meal replacements. And I don’t have to think about it. I just know, with data, that this is going to treat me well. Especially when I’m in a compromised state cause I didn’t sleep well. I’ve tested fast food, even though I don’t encourage anyone to rely on fast food consistently, being able to find something that you can get, basically anywhere in the country is really a positive to have in your back pocket if you need it. And I have an example where I was testing McDonald’s chicken nuggets versus these Bojangles chicken tenders. And frankly, I expected that the Bojangles food would be higher quality, but it turned out that McDonald’s chicken nuggets, without sauce, were actually a really good blood sugar control for me. And the Bojangles, for whatever reason, had this like thick breading, which was, essentially a diabetic blood sugar response for me. And all this stuff, we’re making choices throughout the day that we, in some cases, think are going to be more optimal than others. And it could be totally backfiring because we just don’t have any data.

Another prime one for me, I used to consume a lot of pressed juices. So pressing out, the idea is that you get a lot of vitamins and minerals if you can compact a large number of servings into a single drink. And so, when I was first starting this company, I was chatting with my co-founder Sam and we were going into an investor meeting, and I stopped on the way in, at this organic pressed juice cart. And there was a drink on the menu called Health drink. And it was just carrot, apple, and celery. There were no additives, no sugar. I watched them take the fruit and vegetables out of the basket and press them. And I drank this during the meeting to demonstrate, I expected some elevation in my blood sugar, and at the end of that meeting, I’m go to check my glucose, my level was over 200 milligrams per deciliter. And it stayed there for over an hour. And this, by the way, is a full blown diabetic blood sugar response. And I have rarely seen anything close to that since, and we’re talking doughnuts, full blown desserts, etc… And so, again, this is apple, carrots, celery. And people are making choices every day, like occasionally you’ll have someone who goes on a pressed juice diet because they think this is going to be the healthiest thing for me. And they might restrict calories to the point that they starve themselves down a few pounds. But what is that doing in terms of cellular damage? If your blood sugar is elevated and you have no idea. And I wouldn’t advocate that anyone completely avoid juices, it’s just, the question is how are you specifically responding to those things? And this is where the data is so valuable.

And I’ll give one more example here – oatmeal. So Google oatmeal and it will come up, or Google the healthiest breakfast rather, and I guarantee you oatmeal will be on the top three, no matter what page you look at. It’s heart-healthy grains, right? It’s the breakfast that you should go on if you have heart concerns. About 75% of people who have tested oatmeal in the Levels dataset have an extremely high, borderline pre-diabetic or above blood sugar response to it. And that’s plain, cooked with water, no brown sugar, no maple syrup. It’s just causing these elevations for people. Because in many cases it’s a fairly processed grain, it’s cooked to the point of, essentially very quick dissolution in the digestive system. And you get this, like extreme blood sugar response, which is going to induce an insulin response, which is going to cause your blood sugar to come crashing back down. And you’re going to be hungry and you’re going to be shaky and you’re going be looking for something else, two hours later. So all of these little anecdotes stack up to, basically a different direction in metabolic health long-term. Having the information and course correcting on the small choices we may be making, even when we don’t even like them, we just think they’re healthy for us, is really powerful and it’s completely changed my approach.

[00:41:29] Jonathan Levi: Fascinating. And I did what, you touched perfectly on what I wanted to ask next, which is giving people a little hope – This is all a reversible, right? You’ve talked about a study where they were able to reverse the effects of diabetes, but also, if you’re insulin resistant, if you intervene, this is all reversible, am I correct to say that?

[00:41:48] Josh Clemente: Absolutely. Yep. There’s very strong evidence across the board that the effects of insulin resistance can be improved. And even to the point where the body has broken down and you are a full-blown diabetic. This can also be, at least the strong symptoms, can be reversed through diet alone. And being able to take the out-of-control blood sugar of type 2 diabetes and bring it into completely normal range through just diet is what companies like Virta have demonstrated.

For me, particularly, I was, again, borderline or full-blown pre-diabetic. I call myself borderline because my A1C had not yet broken the threshold that is considered diagnostic of pre-diabetes. But my average glucose was like 113, which is, according to the ADA, pre-diabetic. So I have, throughout the course of the last 2 years using this technology, not only as a guide, but also as accountability, I’ve brought my average glucose down into the low nineties. It’s 91 right now. And it’s basically 91 +/- 10 points all day, every day. And if I choose to indulge, I see the consequences there. I see the numbers and it reinforces my choices. It drives me stronger towards clinging to my decisions. And so that reduction, for me, of an average glucose from 115 down to 91, first of all, is going to be very closely tied with insulin sensitivity. And so I’ve seen an improvement in my responses to carbohydrates, again, when I do choose to indulge, which is indicative of improvements in insulin sensitivity.

And then overall, it’s just reduced my exposure to the effects of the glycemic rollercoaster. Which induces all this hormonal cascade downstream. So my fatigue levels, much improved. Coffee now, after 11:00 AM is just basically an indulgence. If I choose to do it, I do, but it’s not a requirement the way it used to be. Again, I was drinking 12 cups a day, minimum. And now I’m at like 1-2. Yeah. And so, that again, is indicative that things are getting back on track for me and my metabolic health, my glycemic control, by bringing it all down lower, flatter, smoother, I’m regulating my insulin responses as well.

And the things that are improving are fatigue, stress, mood, for me is a huge one. I’ve experienced, just consistency across the board, in terms of mood. Where before I just had a lot of oscillations there, lot of ups and downs that kind of matched my fatigue levels. And so all these improvements are telling me that under the skin, not only are glucose levels improving, but the key markers, like insulin resistance are also improving. And so I’m going to continue taking data on this and just try to get better with time. And I’m also starting to incorporate a lot of mitochondrial training. So zone 2 cardio, which Peter Attia talks a lot about and Dom D’Agostino talks about. But essentially, just trying to train the mitochondria to metabolize fat instead of glucose. So favoring the fat stores that I have on my body.

The average person, even with 10% body fat has over 80,000 calories of energy stored as fat on their bodies. And you only have about 2000 calories of glucose available. So if you want to improve fitness, you want to improve endurance, you want your body to be able to tap into that. And so that’s called metabolic flexibility. So all of this stuff I’m currently working on, it’s going to be a work in progress because, again, for the last 30 years of my life I haven’t really done anything to improve or optimize diet. So it’ll be a constant thing for us but we can all improve. No matter where we are we can always point towards optimization.

[00:45:06] Jonathan Levi: That is a fantastic note to begin winding down on Josh. I want to thank you so much for coming on the show. We spent the whole time just talking about blood glucose, which is awesome. Cause I love to geek out and get into the weeds. I do want to ask about the product Levels. I understand I was very fortunate to get a copy, so thank you for that. And thank you to Tom, on your team, who reached out to me. But I understand there’s a real heck of a wait list if people want to get in. But, listeners of the show might not have to wait, tell us more about that and when people can get their hands on it.

[00:45:38] Josh Clemente: Yeah. So right now we’re in beta modes. We have about a 1000 people who have gone through the program and experienced the iterations. And we’ve released about 300 or 400 iterations of the product. Now, as we’re approaching what we’re calling, the set of features that is allowing easy, actionable, behavior change and improvement, we’re getting ready to launch. That being said, we have over 25,000 people on our wait list. And we’ve got a link that you can share with your audience that will allow them to skip to the head of that waitlist and get their hands on the early release product sooner. And yeah, we’ll share that in the show notes, I think. Or if you’d like to read it out now, please do.

[00:46:14] Jonathan Levi: Yeah, the link I have here is levels.link/superhumanacademy and we will definitely put that in the show notes as well.

[00:46:22] Josh Clemente: Awesome. Yeah, and what you can expect to experience in that program is, 28 days of continuous glucose monitoring with the Levels software. Where you can log your lifestyle, understand the effects of diet, exercise, sleep, and stress, and how those are inducing or working against you in terms of metabolic control. And Jonathan, I  was listening to your episode with Kelly Starrett, who I really respect and admire. I’ve read his books and just love what he does. And he had a lot of quotes that really reminded me of what we’re doing here at Levels. One thing he said was, “If you’re an average human, start from the assumption that you’re compromised.” And that just resonates today when it comes to metabolic health. So 88%, a recent study from the University of North Carolina, 88% of us adults are metabolically unhealthy.

We are in a state where 90 million US adults have pre-diabetes and 90% of them don’t know it. 35 million have type 2 diabetes. Which is entirely preventable and is the number one cause of cardiovascular disease. Again, associated with Alzheimer’s. All of these things are happening because we don’t have a closed feedback loop. And so at Levels, we are all about behavior change through tight feedback loops. And another thing that Kelly basically said, “A movement practice sets us up to understand what’s going on in real time so that we can improve it, manage it, ameliorate it. We don’t have to wait until something breaks until we realize what’s going on.” That’s exactly what we’re doing here at Levels. By having metabolic awareness, a data stream to connect action to reaction, you’re doing exactly that. You’re understanding what’s happening in real time. Not some day in the future when you break through a threshold and realize you’re sick. This is all about taking the front seat in your own health and saying that I care about physical fitness, mental fitness, but also metabolic fitness. These are all closely coupled and we need data to drive our choices.

[00:48:02] Jonathan Levi: Fantastic. And wise words. Mr. Josh Clemente. I really want to thank you for coming on the show today. It’s been an absolute pleasure. But before I let you go, I just want to ask, what’s the one message you hope people take away from this episode and carry with them for the rest of their lives?

[00:48:16] Josh Clemente: I would say that you are in complete control. None of this stuff is out of our hands and no matter where you are on the metabolic health journey, you can just start by putting one foot in front of the other. And I mean that pun intended. Having a bit more activity in our lives, something we can all benefit from. And something I’ve learned, even as someone who’s a CrossFit trainer, I found that the benefits of working and staying moving are much stronger than I had ever realized. And especially as it relates to metabolic health, close to meal times, just take simple strolls, get out there, enjoy the neighborhood, enjoy the weather. Have a conversation with a friend and go for a walk. And that is one thing that I think that I’ll be doing until, hopefully well into my nineties. And I hope that everyone else will take that away from the show, is that movement is life.

[00:49:00] Jonathan Levi: Fantastic. Mr. Josh Clemente, thanks for coming on the show. It was a blast and I learned a ton.

[00:49:03] Josh Clemente: Thanks so much for having me.

[00:49:08] Narrator: Thanks for tuning into the award-winning Superhuman Academy podcast. For more great skills and strategies, or for links to any of the resources mentioned in this episode, visit superhuman.blog. While you’re at it, please take a moment to share this episode with a friend and leave us a review on iTunes. We’ll see you next week.