Ep 30 Importance of Glucose Monitoring, Metabolic Health, & Closed Feedback Loop with Josh Clemente

There’s no magic bullet for diet. Many people come to this conclusion through trial and error. But Josh Clemente and the team at Levels have backed it up with data. The fact is that every person’s metabolism is different, and the “optimum” diet for each person needs to be personalized. Josh founded Levels so that everyone can nail down their perfect lifestyle. The key? Continuous glucose monitors, which measure your glucose levels in real-time. Josh and his team are hoping to take the technology mainstream, so that everyone can stay get healthy and stay healthy. On The Rest and Recovery Podcast, Josh chatted with host Scott Shortmeyer about the importance of daily choices.

• Check out Levels
• Follow Levels on LinkedIn or Twitter
• Connect with Josh Clemente on LinkedIn or Twitter
• Connect with Dr. Casey Means on LinkedIn or Twitter
• Check out The Rest and Recovery Podcast
• Connect with Scott Shortmeyer on Twitter

07:07 – A brief history of CGMs

Glucose is the primary molecule that drives our metabolic system. CGM technology was developed to monitor glucose in diabetics who do not have proper insulin control.

“Glucose being the primary molecule is the one that ultimately drives our experiences, our hormonal cascade, our weight gain or weight loss, basically all of our energetic processes – that’s what we call the metabolic system. Given glucose has a primary role in metabolism, continuous glucose monitoring is a technology that was developed initially for the monitoring of those glycaemic levels for those with diabetes. The reason that you have to do this is diabetes is a condition where control of glucose is lost. The body tries normally to maintain a very tight band of glucose. And we can explain some of those reasons further along, but let’s just say that the body tries to maintain a tight control band for glucose. When some control mechanism like insulin is lost, these glucose levels start to get out of control. This is where, in diabetes, you start to introduce injections of insulin or other means of controlling glucose. That’s where continuous glucose monitoring initially started as a tool for the management of diabetes. It’s now getting to the point where it’s ready for a more general wellness audience.”

09:41 – Levels is not anti-sugar, it’s pro-choice

What Levels is trying to do is to empower people to make better dietary and lifestyle choices with fast, timely, and accurate feedback for those choices regardless of their dietary philosophies.

“Every human being is powered by glucose essentially. At Levels, we’re not opposed to glucose. No, we’re not anti-sugar. The fact is that we use it in all of our cellular processes. The concern is, as we’ve touched on at the very beginning of the show, there is a very broad spectrum of metabolic dysfunction. And typically we think of glucose problems or metabolic problems as just diabetes. Actually, there’s a massive variety here. Things like PCOS, sexual dysfunction, mental and cognitive dysfunction, cardiovascular disease, all are very closely connected to glycaemic and specifically metabolic breakdown. What we’re doing with continuous glucose monitoring and the development trajectory of the technology is we are making it more available and therefore more useful for the other 90% of the spectrum of metabolic dysfunction that doesn’t fit the category of diagnosable diabetes. Beyond that, not just for the illness reasons, but also for the optimization of personal performance and wellness, rest, recovery, the biggest lever is that control of glycemic control and insulin mechanisms are sleep, stress, diet, and exercise. All of these things can be improved and you have better information about how your choices are affecting you.”

16:37 – Why Levels does not push any dietary philosophy

Every individual has a different and unique response to diet. Therefore, Levels is trying to help everyone find a diet that works for them based on their own reaction to what they eat.

“We don’t say you have to eat this certain way, vegan or keto or any of those philosophies of eating. Instead, we just say whatever your philosophy is, you should ground it in data. You can optimize a vegan diet. You can optimize a ketogenic diet using data. It’s very important that as we touched on those specific sensitivities that you may have, you should see that and understand that there are consequences to these decisions. You can just navigate around them by either something as simple as taking a walk after we know it’s extremely powerful in terms of controlling a large-scale response, which could infantry us inflammation and free radicals or you could mix up your macronutrient order. So having a nice green salad before a meal has been shown both in the research and in our database to have a profound effect on those meal responses.”

21:17 – Reversing chronic illnesses with diet

In 2018, it was shown that diabetes could be reversed with a ketogenic diet. This proves that diet can create sustainable change through everyday choices as long as the choices are based on data.

“You may have heard in 2018, they showed some initial results on the reversal of type two diabetes using a ketogenic diet without pharmaceutical intervention. They were able to get off insulin and all these other meds. So that’s very promising, and actually, those results have been maintained now for three years straight. The reversal is sustainable. That’s really fascinating because it shows that this dietary lever that we can pull on can both work on the preventative and the reversal directions. It’s a totally great point. I don’t think there’s anything to the argument that we’re just going to get sick as we get older. We have tons of information from blue zones and areas around the world where people are healthy and cognitively sharp all the way into a hundred years old and plus, and you know what we need to start orienting around this concept of healthspan, more so than lifespan. Life span is the number of years you live, healthspan is the number of years you are living, like going out and being able to be functional and able to have independence and just feeling in control. I think that the choices that we make today, compound over a year to decades into an ultimate outcome.”

23:39 – How to make better choices

When people start seeing the impact of their choices in real time, it becomes easier and easier to make better decisions. That’s what Levels is doing with the CGM technology.

“One of the really interesting things from our user base is just the complete light bulb moments or changes the conversation around what you might consider to be negative feedback loops. Like, you go to the doctor and they tell you, you should eat better or work out more. And that kind of sounds like chatting information and you’re like, okay yeah. But it’s just a burger. I’ll just have one. Now we’re seeing that people will eat that burger and they’ll see a very large sustain completely out of family results of their glucose levels. They explode, they sustain very high long durations, come crashing down. People start to use this interoception where they start to perceive the way they feel and connect it now to real information. That completely changes their perspective going forward. It’s almost like you don’t have to tell that person to avoid that situation. They have seen a consequence and it’s an objective consequence, which they otherwise never had.”

26:30 – Is pressed juice just as bad as soda?

In some people pressed juice can create just as big a glucose spike as a soda. It is important to understand what works for each individual’s body through data, which is what CGM enables.

“One of the largest glucose excursions I’ve ever had was I went to a pressed juice cart and I got a carrot, celery, and apple juice. It was just all pressed, no additives. And my glucose levels were sustained in a diabetic blood sugar range, somewhere that you typically would not go unless you have an actual metabolic breakdown and then were resting for several hours. It was an extremely eye-opening moment for me. I shared this with someone else who was around at the time and she said, this is crazy. I go to that cart every morning instead of to the Dunkin donuts for a frappuccino because it’s the healthier choice. It’s not to say that you should avoid pressed juice or vegetable juice or anything. I think there are exceptional ways to eat vegetables and fruits that would not cause an excursion without processing them that way. But in general, again, there’s that personalization element where it’s not clear to me that someone else like she would respond the same way I did. But when you have that information, you can now realize that many people may be making that choice by just drinking orange juice every morning instead of soda, but actually having the same response.”

30:18 – The sweet spot between too much and too little

Sleeping too little and too much are both detrimental to health. It’s hard to find the sweet spot between the two extremes. The same goes for diet, exercise, and lifestyle. This is where data can help people make better decisions.

“So for sleep, you think, well, if more sleep is good, then most sleep is the best. That’s actually not true. It’s inversely correlated with lifespan. People who sleep too much, which may have some other confounders there, but also have the same issues that those who sleep too little do. And with salt, eating too much can cause high blood pressure, but eating none can kill you. This is kind of the same with everything, where we can find the right balance if we’re constantly getting some feedback on whether that choice is. Like, where are we in the sweet spot? And this is where some of the metrics that we track, like time and range and postprandial excursion are really useful where we would get that glucose data stream after a meal, it’s all analyzed by an algorithm that we’ve produced that can give you a score based on how you personally responded to that specific meal.”

39:34 – The challenge of having a nuanced conversation with blunt instruments

It’s hard to answer questions like what should I eat, how much, how often, and such nuanced questions with a once-a-year glucose test. That’s why we need CGM to help inform real-time decision making.

“I think the more nuance we can bring to the conversation, the better our insights can be. We use these extremely blunt instruments, like a glycaemic index. The glycemic index is normalized across the entire population. It may be true that if you drink pure glucose, it will have the highest glycemic response for everyone, of any food they consume. But the question is how high does your glucose go versus mine? That is completely lost in the glycemic index. There is no absolute value that you can orient yourself. I might be a five. You might be an eight. Actually, if you look at the numbers, it’s more like you might be a 500 and I might be at 100. The people who go into the data sets that go into calculation, there are multiples of each other who are all normalized down to a 100. So your 500 and my 100 are both one hundred on glycemic index calculation. And so that’s where all the nuances are removed. So it’s not true that we all experienced the same response.”

44:27 – Changing behaviors by facing immediate consequences

With CGM people can quickly know whether or not a new diet, exercise, or lifestyle changes are working for them or not.

“The beauty again, is that metabolic awareness – seeing things happen in real-time, like when your body speaks to you, you listen. Like people just don’t really push back against that data source. But then you also get this beautiful accountability component where, when you have this device on you and once you have explored all the different sensitivities you have, you understand what’s going to happen. Now, you know that if I make that choice that I know will be detrimental, I’m going to have to see the data, I’m going to have to face myself…I’m one of those people, I used to have a really out-of-control candy addiction. I wasn’t overweight. And so I didn’t have that consequence feedback loop where the scale was going up in the bathroom. Instead, I was just experiencing under the radar metabolic breakdown. And so I haven’t touched candy literally in two years, ever since I started using CGM. It was not a moment where I was like, I’m going to make this extremely challenging, cold turkey decision. The possibility just ceased to exist when I saw how it responded to brown rice. It was just like, man, there’s no way sugar candy is going to come back into my life. That’s the type of thing that I think this enables.”

48:55 – Josh’s recovery method

Josh was always good at working out. CGM showed him that what he needs to improve is his rest and relaxation routine. He’s currently focusing on getting enough sleep and active recovery like stretching.

“I think what’s interesting is that CGM has really influenced my approach here to rest and recovery personally. And so making better dietary choices leading up to sleep. But also I really limited my alcohol consumption now as a result of not just glucose information, although it is very closely tied, but the way that I see how in my sleep tracker, how poorly I sleep, and how poorly I recover if I have any alcohol, even after like 5:00 PM. I would say that those are the two kinds of lifestyle-oriented ones. I’m a CrossFit Level 2 trainer. I care a lot about exercise and fitness. I’ve been starting to push my way away from CrossFit and closer to triathlon stuff. I’ve taken a recent interest there. I’m just now getting to the point where I really am putting a lot of miles in and I have to start being more cautious about stretching and active recovery and that’s something I never have really done. And it’s a personal challenge right now that I’m working through.”

Scott Shortmeyer: [00:00:00] in this episode, I speak with Josh Clemente. He is Co-founder of Levels Health, and we get into metabolic health, the need and importance of continuous glucose monitoring and how the wearables space has exploded being able to integrate technology, health, and that they’re on the forefront of being an element that can really transform – There’s devices out there that are monitoring a variety of things, but to be able to track your glucose has significant impact. Historically these types of devices had been used for those in chronic states, used with diabetes and these other chronic diseases, but with the growing number of the population that is actually pre-diabetic based on a variety of things, including our food supply, that the importance of early detection is critical.

And not only that, in the longterm, it can impact the ever skyrocketing healthcare costs. Also the fact that we don’t have to be sick as we get older and this is an opportunity in which you can start using tools like Levels Health and impact that for yourself and then be able to customize your own menu options, your own food based on how you respond, to be able to optimize your guide that will give you the best performance each day, no matter what you’re doing, if you’re out doing a marathon or running the kids to school or working in corporate America, whatever it looks like, you’re optimized, you’re clearheaded and diet has a huge impact on that and being able to manage your glucose is huge and addresses the ever-growing metabolic health concerns.

Thanks for listening. Please rate and review, share with anyone that needs to hear this. Grateful for you. Remember, be what? Be rested. Be well.

Before we get into this episode, I just want to give a shout out to Pure Spectrum CBD Oil. It’s something that I’ve been using as of late and it has really helped with the quality of rest. It’s improved my heart rate variability. It’s improved my deep sleep and so I’m feeling much more refreshed, more vibrant when I wake up in the mornings. So I would encourage you to give it a try and use the code RRPOD to check out purespectrumcbd.com. Thanks. Enjoy the episode.

With me today is the Founder of Levels Health, Josh Clemente, and Josh, welcome to the show.

Josh Clemente: [00:02:59] It’s great to be here. I really appreciate you bringing me on.

Scott Shortmeyer: [00:03:01] Yeah. I’m looking forward to this conversation. It’s interesting times where we live, just not even in the last three to four months, but in the space of IT and wearables. My background is in IT and been using wearables for years, but it seems the last few years, the things have really exploded to get to what I’ve also heard on other episodes is that personalized health where it’s not just a one-size-fits-all and it seems like you guys in Levels fits right there. So I’m looking forward to digging into this.

Josh Clemente: [00:03:33] Awesome. Yeah. I’m very excited about it personally as well. It’s been a life changing couple of years for me in this respect, taking more control over my own daily decisions and then ultimately realizing that this is not just a problem that I personally am experiencing and I’ll take you into specifically what I mean by that, but also a problem that a vast majority now of the population globally is experiencing. So I’m excited to dive in.

Scott Shortmeyer: [00:03:58] Yeah. Yeah. You touched on something that we’ll probably cover on things – Health is not binary as in you’re healthy or you’re not. There seems to be more of a continuum that’s getting unpacked over the last maybe couple of years and I think you guys are right in that space.

Josh Clemente: [00:04:13] Exactly.

Scott Shortmeyer: [00:04:13] But before we get into Levels, maybe we, like the movies that flashback, how you started to get to this point at Levels and what was that journey professionally and personally?

Josh Clemente: [00:04:24] Absolutely. Yeah. So my background is aerospace engineering. I started out at SpaceX after school and was focused primarily on structural work and then ultimately, headed in the direction of my own personal interests, which was into life support systems development. Basically the last half of my career was spent developing astronaut life support systems, which ultimately just took Bob Behnken and Doug Hurley to the International Space Station in May.

Scott Shortmeyer: [00:04:51] Wow!

Josh Clemente: [00:04:51] That program was the defining one of my career there at SpaceX and introduced me to a huge amount of human performance information and the cutting edge of research for divers and astronauts and those who are constantly performing at the peak. And so that exposure actually is what led me to start to take stock of my own decisions each day and how I was optimizing my lifestyle for longevity and health span and what I found I didn’t really like. Upon doing some inventory, I realized that I was experiencing just significant fatigue levels or just a general disagreement between how I could perform in the gym or looked maybe aesthetically and how I felt inside. And so I think that’s exactly what we’re talking about. We all land somewhere on this metabolic spectrum and the way that our metabolic health manifests can be visual. It can be cognitive, it can be the way that we feel, the way that we look and ultimately the long-term risk factors we carry.

Scott Shortmeyer: [00:05:44] Yeah. Yeah. And I can relate to that to a degree as a runner, been relatively conditioned and on paper, you would think I’d be the ideal health, but always felt like something was just off. You just know your own body enough to know something’s not quite right, but you don’t know what it is.

Josh Clemente: [00:06:00] Oh, yeah. I know the feeling well. That’s exactly the one I described and it is my experience with continuous glucose monitoring personally, which it was very challenging to get my hands on this technology early on, and I can explain more about what this is further in the show, but my experience with this tech and having a closed feedback loop between my actions and the reactions that occurred, that actually highlighted for me that it was my own choices that I was making each day, specifically with diet, that were introducing these massive energy swings, which were ultimately a function of the energy levels in my body, the glucose levels. Yeah, that connecting the dots between how I felt and this vague sensation of “Something’s off here,” very qualitative, very subjective to, “I now have an objective data stream and I can make choices that are, again, influenced by my prior data that I’ve gathered,” which is very paradigm shifting.

Scott Shortmeyer: [00:06:50] So why don’t we touch on the term so those listening can understand what we’re referring to? You mentioned CGM or continuous glucose monitoring. What is that exactly? And where has it historically been found? Or who has been using that?

Josh Clemente: [00:07:04] Absolutely. Just let’s start off with glucose. So glucose is the primary energy source for the average modern human. What that means is when you consume carbohydrates, you digest them and a molecule called glucose, which is sugar is released into the blood stream. So this disperses into the body’s tissues, eventually it enters the individual cells where it’s used to power cellular function. There are other macronutrients, which include fat and exogenous and endogenous ketones, which can also generate energy. And so, glucose being the primary molecule is the one that ultimately drives our experiences, our hormonal cascade, our weight gain or weight loss, basically all of our energetic processes. And that’s what we call the metabolic system. So, given glucose’s primary role in metabolism, continuous glucose monitoring is a technology that was developed initially for the monitoring of those glycemic levels for those with diabetes. And the reason that you have to do this is diabetes is a condition where control of glucose is lost. So the body tries, normally, to maintain a very tight band of glucose and we can explain some of those reasons further along, but let’s just say that the body tries to maintain a tight control band for glucose and when some control mechanism like insulin is lost these glucose levels start to get out of control and this is where, in diabetes, you start to introduce injections of insulin or other means of controlling glucose. And that’s where continuous glucose monitoring initially started was as a tool for the management of diabetes. It’s now getting to the point where it’s ready for a more general wellness audience.

Scott Shortmeyer: [00:08:38] Yeah. And so it’s more of somebody who had an extreme or systemic issue where it seems like now  things are slipping more into the general population, I’ll call it, who can take advantage of this.

Josh Clemente: [00:08:53] Right. Exactly. As I mentioned, every human being is powered by glucose essentially and we at Levels, we’re not opposed to glucose. No, we’re not anti sugar. The fact is that we use it in all of our cellular processes. The concern is, as we’ve touched on at the very beginning of the show, there is a very broad spectrum of metabolic dysfunction and typically we think of glucose problems or metabolic problems as just diabetes. Actually, there’s a massive variety here and things like PCOS, sexual dysfunction, mental and cognitive dysfunction, cardiovascular disease, all these are very closely connected to glycemic, and specifically, metabolic breakdown.

And so what we’re doing with continuous glucose monitoring and the development trajectory of the technology is it’s becoming more available and therefore more useful for the other 90% of the spectrum of metabolic dysfunction that doesn’t fit the category of diagnosable diabetes. And beyond that, not just for the se illness reasons, but also for the optimization of personal performance and wellness, rest, recovery. So the biggest lever is the control, glycemic control and insulin mechanisms are sleep, stress, diet, and exercise. And so all of these things can be improved when you have better information about how your choices are affecting you.

Scott Shortmeyer: [00:10:06] Yeah. Yeah. And that’s huge, because like you were saying earlier, both of us, that you know how you feel, but you don’t know why. And it seems like this can really pinpoint, zero in on that personalized wellness journey to really discover, “Okay. I ate whatever, fill in the blank, an orange and I’m feeling a certain way.” You would think, “Okay. It’s good for me, but it might be doing something to your body that isn’t processing it.” So, is that fair – ?

Josh Clemente: [00:10:34] Yeah. That’s effectively one of the primary use cases now. In fact, even in the management of diabetes, one of the key use cases of continuous glucose monitoring is being able to identify the dietary factors for that individual that cause large excursions. And you can use that information to meter your insulin or what have you or to maybe avoid it altogether. But for the person who’s not monitoring diabetes, and this is me, I actually initially used continuous glucose monitoring and found out that these energy fluctuations I was experiencing, which I touched on at the beginning of the show, these were increasing with my – I blamed them on aging and I was like, “What’s going on? I’m still -” I was in my late twenties, but I was like, “How is it that my mood and my fatigue levels are just so off right now?” Every single day is a struggle. I’m drinking coffee just to make it through the afternoon. Two o’clock in the afternoon is like the witching hour for me. I’m just lolling in my seat.

And so I got my first CGM and saw that I was having these massive excursions in blood sugar after my meals. And ultimately I actually was either borderline or fully pre-diabetic depending on who you asked to analyze the data.

Scott Shortmeyer: [00:11:38] Really.

Josh Clemente: [00:11:38] And I had absolutely no idea that this was up until that moment of connecting the real-time information, seeing the real-time information. And what was happening is the meals that I was consuming were high in complex carbohydrates, which I assumed was a healthy choice, and my goal was to maintain at that time, a certain muscle mass, and so I was consuming fairly large meals with large numbers of carbohydrates as a glycogen replenishment approach. And these carbohydrates, I’m quite sensitive to and they were causing some massive excursions, which would ultimately lead to several hours of what’s called hyperglycemia, so elevated glucose levels followed by a big crash, which is when the insulin would surge out into my bloodstream to pull the glucose out into the cells and that’s when my blood sugar would plummet and right around that time, so about two hours after lunch, is where I am just desperate for a coffee. I’m literally crawling my way to the cafe or whatever to get the next fuel surge and repeat the whole cycle.

Scott Shortmeyer: [00:12:33] Yeah. It’s like the parenting joke of the kid’s sugar rush, of that spike. They’re running all over the place and then they crash. Adults go through the same thing. Right?

Josh Clemente: [00:12:44] Exactly. There is a huge spectrum of glycemic sensitivity and one of the most fascinating outcomes of the proliferation of CGM technology is that we’ve now had several large-scale studies.

One was done in 2015 in Israel that showed in people without diabetes, the vast individuality of glucose sensitivity. So of your personal response or these individuals’ personal response to the same foods. So I’ll just drop an anecdote here, but they picked out an example, which was two individuals, both ate a banana and a cookie made from wheat and they had equal and opposite responses in terms of blood sugar response to those two foods. So the point being that you can not only have a varying amount of response to a food, but you can actually have the opposite response to someone else. So a spike or a flat line, depending on whether you’re more sensitive to, for example, a fruit sugar in the banana case or a grain sugar in the wheat case.

And so we have seen this at scale in the Levels program now, and I personally see this all the time. You have these – We in society assume that glucose control is just all the same up until something breaks. And then now you’re in the diabetes management zone. But the reality is that there is a very slow progression of chronic choices that we make without information about the result and because there’s so much variation, there’s no one-size-fits-all choice that we can all make. And so now then, this leads to just – It can be overwhelming because you’re like, “Oh man! How am I supposed to know what I should do, because there are so many choices, I don’t know if I can make the right one without some unnecessary or unintended consequence?” The reality is that the choice you should make should be influenced by your own data. And so that’s what we believe is that bringing more real-time biowearable information on glucose, heart rate is another one that we’ve had for some time. This can help us influence and close the loop between choice and response.

Scott Shortmeyer: [00:14:29] Yeah. That’s huge because somewhat anecdotally you see over the last few years and it’s always been the case is the diet. Diet is supposed to be with how you eat regularly, but you keep seeing these different quote unquote “fad” diets and some people will lose a ton of weight, some people will feel completely sick on it. And so whether it’s keto or paleo or whatever, it’s almost like if it works for one person – This can help clarify why it will or won’t work for someone or instead of jumping into one, you can pick the right one right away.

Josh Clemente: [00:14:59] Exactly. So last point is really where we like to focus. So the beautiful thing about glucose is it’s in all of our bodies. It’s not something that you can opt into. What you can do is you can – And so what that means is that there’s no real dietary philosophy that we push. We don’t say you have to eat this certain way, vegan or keto or any of those sub philosophies of eating. Instead, we just say whatever your philosophy is, you should ground it in data. So you can optimize a vegan diet. You can optimize a ketogenic diet, both using data. It’s very important that, as we touched on those specific sensitivities that you may have, you should know that, see that, and understand that there are consequences to these decisions and you can just navigate around them by either something as simple as taking a walk after meals, extremely powerful in terms of controlling a large scale response, which could introduce inflammation and free radicals. Alternatively, you could mix up your macronutrient order. So having a nice green salad before a meal has been shown both in the research and in our database to have a profound effect on this meal response. All of these levers that you can pull on, your sleep is one of the biggest factors. If you have five and a half hours of sleep versus eight, you will have a completely different acute insulin resistance. Right? So the way that your body processes insulin, which – Sorry, responds to insulin, which helps process glucose is dramatically affected by the restless sleep that you experienced. And so, that acute stress that you get from a short night’s sleep can really affect how you respond to meals and so you should maybe navigate around that by making different dietary choices or exercise choices a day after a red-eye flight, for example. And so it’s all very – No, again, it can sound overwhelming, because there’s so many variables here, but when you have real-time insight, you can just make the decision in the moment with the information available.

Scott Shortmeyer: [00:16:42] Yeah. Based on that last point on the sleep piece, it seems like it’s bi-directional, where sleep is your body recovering and being able to adapt to its optimal level, so then when you enter the next day you can receive the inputs, I eat food the right way, but if you also sleep too little or, excuse me. Yeah. It just seems like they’re cohabitating there.

Josh Clemente: [00:17:06] Yeah. They’re working in tension and in tandem almost where poor sleep means poor responses and poor responses means poor sleep and it can be a vicious cycle. This is all pretty well documented and I personally have several examples where I try to – I’m not much of a biohacker, but I do track my heart rate and heart rate variability and glucose and I see the effects, again, of – If I have a heavy meal at the end of the night, I will see glucose elevations throughout the night, which correlate very closely with heart rate and stress, which is a heart rate variability metric. And this can manifest as a reduced recovery score the next morning from my wearable, which provides me a recovery score. And the reciprocal of that is, again, we talked about it a minute ago, which is that poor sleep affects your insulin resistance. You’ll have this acute insulin resistance situation, so at breakfast that was perfectly fine, keeps you glucose levels right in the target range on a normal day, can be a large excursion and can throw off your hormonal balance, whether or not you’re in weight gain mode because of your insulin levels or burning fat more freely. All of this stuff can be affected by just a simple missed night of sleep and this data can help announce this to you. Across the board sleep is just such an important area of focus. Now you’ve got Americans sleeping something like 25% less than they were a hundred years ago and at the same time we’ve gone from less than 1% of the population having diabetes to more than 10%. So these metrics are moving in the same direction and in the wrong direction. And so we really have to focus on this recovery element, not just for metabolic health, not just for sleep health, but also for metabolic health.

Scott Shortmeyer: [00:18:36] Yeah. Exactly. And the word preventive comes to mind because that can cascade into probably four other conversations, about the healthcare system and how it’s back-end loaded as we get older. And the assumption is it’s because we’re aging. That is one reason, but based on your last point, it’s a little bit on what’s been happening on our food supply and things of that nature and the impact on us not being able to catch it sooner. We live this particular lifestyle and then we go over the line in a negative way that can’t be reversed.

Josh Clemente: [00:19:07] Right.

Scott Shortmeyer: [00:19:08] And it seems like this is going to be able to catch it much sooner. So you can, regardless of whether you’re 25 or 45, you can make that adjustment now.

Josh Clemente: [00:19:18] Yeah. It’s interesting, what you just mentioned there. There are some promising studies in particular, our friends at Virta Health that showed, you may have heard. In 2018, they showed some initial results on the reversal of Type 2 diabetes using a ketogenic diet. Without pharmaceutical intervention they were able to get off insulin and all these other meds. So there are some very promising – And actually, by the way those results have been maintained now, I think, for three years straight. So the reversal is sustainable. And that’s really fascinating because it shows that this dietary lever that we can pull on can both work on the preventative and the reversal directions. But yeah, it’s a totally great point. There is no – I don’t think there’s anything to the argument that we’re just going to get sick as we get older. We have tons of information from Blue Zones and areas around the world where people are healthy and cognitively sharp all the way into a hundred years old and plus.

And what we need to start orienting around is this concept of health span more so than lifespan. This is how I personally feel. Life span is the number of years you live, health span is the number of years you are living. So going out and able to be functional and able to have independence and, yeah, just feeling in control. And so I think that the choices that we make today, they compound over a year to decades into an ultimate outcome, and having better information across the board, I think, is the key to everyone being able to better understand. For example, I’m just going to sit down for lunch. What am I going to eat and why? We should just have some rationale behind that decision.

Scott Shortmeyer: [00:20:42] Yeah.

Josh Clemente: [00:20:42] Because today, largely it’s not an individual rationale. There is an average where, “I heard a friend did this,” or “I read on the Internet that I should eat this.” But there is no closed loop, again, where I do something, I see the response and that influences my choices going forward. I strongly believe that across the metabolic spectrum, across the age spectrum, better information is just, is where we have to start in order to even improve the conversation.

Scott Shortmeyer: [00:21:05] Yeah. Better awareness and engagement on our own wellness journey. And that, I think, myself included, is sometimes we just oversimplify the food and the impact and, “Oh, I’m just having a hamburger or whatever,” and we eat it and then we just move on. It’s just food. We don’t think about the influence or consequence of that over time.

Josh Clemente: [00:21:27] Yeah. That’s exactly right. It’s very easy. One of the really interesting things from our user base is just the complete light bulb moments or changes in the conversation around what you might consider to be negative feedback loops. You go to the doctor and they tell you, you should eat better or work out more. Right? And that sounds like chiding information and you’re like, “Okay. Yeah. Yeah. But it’s just a burger. I’ll just have one.” Now we’re seeing that people will eat that burger and they’ll see a very large, sustained, completely out of family results of their glucose levels. They explode, they sustain very high, long durations, come crashing down. People start to use this introception where they start to perceive the way they feel and connect it now to real information. And that completely changes their perspective going forward. It’s almost like you don’t have to tell that person to avoid that situation. They have seen a consequence and it’s an objective consequence, which they otherwise never had.

That’s why I think it’s so fascinating here is that these light bulbs start going off and you’re like, finally, something that is not just generalized advice or subjective. This is real. I can go and compare myself against the population and see how I respond to this food, to these foods and I see the individual variability, whereas a friend or the average population sees a huge elevation due to, for example, bananas, but I personally can eat berries all day with no problems. And it’s these type of things that are both freeing. You’ve got the negative feedback loop with the burger, but then also the positive feedback loop from finding those foods that do work really well for you. And so it just paints in the picture of where should I look to make better choices.

Scott Shortmeyer: [00:22:51] Yeah. It feeds into what I’ll call personal sovereignty. You’re taking ownership of it. You’re not a victim, for lack of better term, of consequence other than your own choices. But you’re now better equipped with the information to make those better choices because you can see the consequence or you can think, it seems like – Again, myself included, at one point was, you’d eat something, you’d feel a certain way, you shouldn’t feel that way after it, but you just accept it as though that’s how I respond to it.

Josh Clemente: [00:23:20] Right.

Scott Shortmeyer: [00:23:20] [inaudible] you feel bloated. But really you shouldn’t be feeling like that after you eat food. You should feel nourished and replenished and some semblance of energy, not either bloated or like you were saying your personal example, the two-hour later crash. We’ve taken that as the cultural norm.

Josh Clemente: [00:23:38] Yeah. Yeah. It goes to this whole complexity and next even more interesting. There are choices that people are making every day that they have been influenced to make because they believe them to be the healthier choice, that because of this personal variability metric, could be actively working against their goals. One example would be me eating all those carbohydrates that I thought was great for glycogen replenishment or something. But another example would be, one of the largest glucose excursions I’ve ever had was, I went to a pressed juice cart and I got a carrot, celery and apple juice. It was just all pressed, no additives and my glucose levels were sustained in a diabetic blood sugar range somewhere that you typically would not go unless you have an actual metabolic breakdown and then you sustained for several hours. So it was an extremely eye-opening moment for me and I shared this with someone else who was around at the time and she said, this is crazy. I go to that cart every morning instead of to the Dunkin Donuts for a frappuccino, because it’s the healthier choice.

And it’s not to say that you should avoid pressed juice or vegetable juice or anything. I think there are exceptional ways to eat vegetables and fruits that would not cause that excursion without processing them that way. But in general, again, there’s that personalization element where it’s not clear to me that someone else like she would respond the same way I did. But when you have that information, you can now realize that many people may be making that choice with just drinking orange juice every morning instead of the soda, but actually having the same response and so maybe instead they should be having a black coffee or maybe even tea as long as it gives them the energy without the sugar rush and they can see the data behind those choices.

And another really interesting one is oatmeal. We have a ton of users in the database who have been gravitating towards oatmeal as breakfast. They don’t really love it but they tell us it’s the healthiest food you can eat. It’s heart healthy. And yet there’s this individual sensitivity to it. I can call it again a pre-diabetic or diabetic blood sugar response every single morning. Just to drive home to the issues with hyperglycemic excursions is that they have real, very real, very tangible, measurable inflammatory and oxidative components to them. It was also – A postprandial hyperglycemic spike can be pro-inflammatory chemicals like IL-6, TNF-α, C-reactive protein. All of these things are measurably increased. All of these inflammatory cytokines that are manually increased after you consume a large meal that causes a huge glucose spike and they are elevated for long durations after and once you have conditions like diabetes, all of these inflammatory markers are typically elevated in someone with continuous hyperglycemic elevations.

And these are stressful. They’re causing breakdowns and bifurcations of things like skin, your skin health gets worse, your joints, cardiovascular diseases, micro and macro vascular degeneration, retinopathy. All of these issues, they may not be acute and you may not be experiencing symptoms of them immediately, but is it an optimal choice? The likelihood is that, no. Each time you have this inflammatory cascade, you’re causing a little bit of a detriment that you could otherwise avoid if you just made that different choice. It’s all very closely tied, but we just don’t have the window into our biology to know that in the moment. I think that now the technology is finally allowing it.

Scott Shortmeyer: [00:26:41] Yeah. And you mentioned optimal and getting back to the juice you were talking about. It’s more of a degree conversation than an either or, should I have the vegetables or not, or oversimplifying, it’s good for me, yes, it is, but maybe 12 ounces is too much, maybe you should only have four ounces right now or whatever that variability is, based on your individual personalized data.

Josh Clemente: [00:27:08] Yeah. That’s a U shaped curve. It’s so profound here for many things like salt, even sleep. You get too little of it, it’s equally bad as if you get too much of it. And so for sleep, you think, if more sleep is good, then the most sleep is the best. That’s actually not true. It’s inversely correlated  with lifespan. So people who sleep too much, which, they may have some other confounders there, but also have the same issues than those who sleep too little do. And with salt, eating too much and it can cause high blood pressure, but eating none can kill you. And so this is the same with everything where we can find the right balance if we’re constantly getting some feedback on whether that choice is – Where are we in the sweet spot? And this is where some of the metrics that we track, like time and range and postprandial excursion are really useful where we get that glucose data stream after a meal. It’s all analyzed by an algorithm that we produced that can give you a score based on how you personally responded to that specific meal.

And so for something like vegetable juice, again, maybe not 12 ounces or 16 ounces. That might cause an excursion, but it doesn’t mean don’t drink any, maybe half a shot or two or four ounces in the morning, somewhere where that time and range is optimized for getting all of those vitamins and nutrients that you want, but without the consequences of an overdose.

Scott Shortmeyer: [00:28:18] Yeah. So you touched on the actual tool itself. So we talked about what it can provide, what it’s analyzing, what is the user experience, I’ll call it. I saw on the website, it’s a patch. So how does the patch work? What does it link to? Is it -?

Josh Clemente: [00:28:33] Yeah. Technology today is, it’s a wireless patch and the side of it has a filament on it. And that filament is actually in the skin cells. And so you wear this patch for about 14 days, this is currently the industry meter, and that filament is measuring an electrochemical interacting with the glucose levels in your skin. And so that produces an output, which is the amount of glucose in your blood. And that is wirelessly transferred to your cell phone. So it’s basically like any other wearable. You wear the device and then you get the output on your phone. And so the Levels program, what we built, is we leverage existing hardware. So the hardware has been developed. It’s FDA regulated. Here in the US it’s prescription-only. And so we work with existing hardware that is used for the management diabetes, but we are expanding access to the general wellness and performance world for people who are trying to optimize health, just general health seekers, who want it to make better dietary choices, enhance their recovery and all of these other use cases across the metabolic spectrum. And so using the Levels app, which communicates with the devices, you have a continuous data stream of your glucose levels in real time, which we then, using the Levels analytics platform, provide scores for us so that each day you log your lifestyle choices, your exercise is automatically called in from Apple Health Kit, your meals, you just snap a picture of and then we analyze how you respond to that specific choice and provide you with a score and that score is directionally helping you string together streaks of good choices. And these streaks are – Each meal is good, but then each day you also get a score so that you understand how these choices are stacking up in positive or less desirable direction.

So over time you streak these together and over the course of our 2018 program, you get a good understanding of where you are doing well, where there’s room for optimization and you can see, with our reporting, the way that you’ve improved across the 28 days. And then you take that information and you can check in with us regularly. We have about 25% to 30% of our users who choose to just monitor continuously because they realize that this closed feedback loop is so valuable and it almost feels like voluntarily giving up your smartphone would have in 2011. Once you have the data stream, it’s like, “Oh, I can’t get rid of this thing.”

So yeah. That’s the gist of how the program works and happy to give you any of those details.

Scott Shortmeyer: [00:30:48] Yeah. So when you say the patch, you mentioned how it connects. So is it breaking the skin or is it like a -?

Josh Clemente: [00:30:56] Yeah. It’s minimally invasive. The filament does break the skin. It’s very flexible and you just wear it continuously on the arm. And so the comparison here would be, in order to get your glucose level at home, you have to use, the only other technology is, the finger prick, blood sugar monitor. We’ve probably all seen these. It’s a lance that you prick your finger. You get some blood. Put your blood onto a test strip. And that gives you a single data point. With this filament style electrochemical sensor, it has a much smaller filament. It is not actually in the bloodstream. It’s in, what’s called the interstitial fluid, which is in between the skin cells on the arm. And it’s that single filament and you wear it continuously for 14 days. So it’s much less invasive than just your standard,  single point measurement finger stick, but it is regulated as a medical device as it does break the skin there.

Scott Shortmeyer: [00:31:40] Okay. And then you said it’s based off of existing hardware already approved, but can anybody sign up or get this access to it yet?

Josh Clemente: [00:31:50] So right now we’re in beta mode and beta mode we are very interested in optimizing our algorithms to help people ensure that they are getting the most actionability out of the data. And so ultimately, yes, the program is for everyone. It’s for anyone who wants to know more about their bodies, anyone seeking health and optimization. Today, we have a limited number of spots because we are in that beta mode oriented around getting feedback, very intensive feedback. Basically, you’re joining the Level’s team for a month and giving us just as many updates as possible. So, as we near completion of that development period, we’re going to be rolling out our pre-orders very soon and then ultimately we will have just a full launch. You’re going to be able to order it on the website.

Scott Shortmeyer: [00:32:28] Okay. And then, so you have an app. Does it integrate with any others or is that on the roadmap at some point with things like exercise apps and other devices?

Josh Clemente: [00:32:39] Absolutely.

Yeah. Yeah. We have a pretty amazing roadmap. We have two directions. So there’s the external integrations with existing products that people love. An example of this would maybe be an Oura ring or a Whoop strap. All of this communicates through Apple Health Kit and Google Fit, which you already have on your phone. And so we’re starting off with those key operating system based integrations. But we are exploring integrations with all of the other products out there that people are using to monitor their wellness today and performance. And so we will have a roadmap of integrations, but ultimately we at Levels will be the hub for metabolic health.

And so that means we’re also going to introduce additional analytes into the metabolic models we use. So this may be a point in time, lab tests, for example or additional data streams that we see coming to market in the next few months and years where we’ll be able to further increase the resolution of the choices and insights that will help you adjust, each day making better choices what will ultimately be influenced by more than just glucose.

Scott Shortmeyer: [00:33:38] Got it. So continue to fan out around total health and the other elements that influence.

Josh Clemente: [00:33:44] Exactly. Yeah. So we have this concept of metabolic fitness. Well, truely we have two concepts. One is metabolic awareness and that is a passive experience, but one where you finally close the loop between the choice you make and the response, your body experiences. So that’s a defining moment for most people. But then there’s the question of how do you get better? And so metabolic fitness is just like physical fitness or mental wellness or mental fitness, it’s something that you have to put in focus and repetition and put effort in and improve over time as you make     these choices day after day.

And so we are striving for metabolic fitness, and it’s certainly true that glucose is an extremely important metric and one that the majority of the world, frankly, can benefit from optimizing. But we don’t want to just be a local optimizer where we only care about one data stream. The reality is the body is a, it’s a very complicated walking chemistry set and so there’s a lot going on in there and the more we can know the the more we can manage.

Scott Shortmeyer: [00:34:34] Yeah.

Josh Clemente: [00:34:35] As more of this technology becomes available in real-time data monitoring, which of course this is just the first, we’ll be incorporating all of that into our models.

Scott Shortmeyer: [00:34:44] Very cool.

Yeah. This is just, I think it’s just so awesome that we’re able to do this. Like you mentioned, walking chemistry set. I say that all the time and just because we’re just so unique – I’ve made a joke at a simple level. One of my parents might not respond well to garlic but I have no problem.  Silly little things. The same thing is across everything we do and the idea of a one-size-fits-all is a flawed model. You can definitely cluster people into groups and draw correlation, which I’m sure part of the data set is exactly that to better respond to that scale, but at the same time we’re individuals in many levels.

Josh Clemente: [00:35:22] Yeah. I think the more nuance we can bring to the conversation, the better our insights can be. We use these extremely blunt instruments like glycemic index. The glycemic index is normalized across the entire population and it may be true that if you drink pure glucose, it will have the highest glycemic response for everyone of any food they can consume. But the question is how high does your glucose go versus mine? And that is completely lost in the glycemic index. There is no absolute value that you can orient yourself around.

Scott Shortmeyer: [00:35:51] I might be a five, you might be an eight.

Josh Clemente: [00:35:53] And actually, if you look at the numbers, it’s more like you might be a 500 and I might be a 100. So there are multiple times  – So the people who go into the data sets, that go into the glycemic calculation, there are multiples of each other who are all normalized down to a 100. So your 500 and my 100 are both 100s on the glycemic index calculation. And so that’s where all the nuances are removed. And so it’s not true that we all experience the same response and that’s not the intention of the glycemic index. But it’s the way that it is currently used in society. And we have many more examples of this where we use these, again, blunt instruments like an A1c check or a fasting glucose to try to describe the whole person and how their metabolism is operating, how metabolically healthy they are. But the reality is that’s the slowest, that is the slowest metric to respond to metabolic breakdown, fasting glucose. By the time your fasting glucose exceeds the threshold, you’re dynamically [inaudible]. The way that you’re responding to meals and sleep and stress and all that stuff is way broken and it’s much easier to start making better choices. It’s similar to – A degree of separation, a mile is thousands of miles apart at a few hundred miles.

So it’s like this geometric concept for how quickly things can get out of control if you don’t intervene at the right time. The sensitivities thing, we have people who have found these really interesting relationships between foods that they’re allergic to and their glycemic response, and that, we don’t have enough data really to say that that’s causal, but it could be, again, one of those inflammatory or stress responses where the body is under acute stress due to the allergy and so that’s causing an insulin resistance and a glucose response. So much more to unpackage here. Yeah. Yeah. Plenty more to learn.

Scott Shortmeyer: [00:37:32] That’s awesome. Yeah, I’m fascinated to watch where you guys go with this and learn more about it just because I think this is where we have to go on so many levels and it’s now technology enables what we just talked about on the walking chemistry sets that I think before, we just didn’t – Maybe we knew, but there wasn’t a way to really scale that individual approach well and I think it seems we’re at the tipping point or the beginning of that stage.

Josh Clemente: [00:38:01] Yeah. I absolutely agree. I don’t want to point fingers or assign blame to the way that we currently run things in terms of our dietary choices and the metrics that we measure every year, our blood markers. But that was the way the system had to be set up before you had microelectronics, before everyone had a super computer in their pocket. So it’s totally reasonable that’s where we started. It’s just the point, I think, that we need to think about is, now things are very different. Technology has advanced at an unbelievable pace and what hasn’t kept pace is the way that we make choices related to our health. It’s amazing. I always make this metaphor, but I can pull my phone out and I can look at my bank account statement and I can look at today’s deposits and withdrawals and I can look at that 50 years from now, my projected returns on investments and best case, worst case scenarios. I can get expert advice, and this is all very confidential information. But how do I know I’m going to be there in 50 years or 30 years to experience that retirement? I have no similar metric or no similar technology guiding my choices when it relates to my health, which to me is completely broken system.

And we have this data swirling around in our bodies every day. It just needs to be captured and used for better choices. So I think that’s what we’re focused on is shifting us from a reactionary symptom management approach to health care to more of a proactive, you’re way ahead of it because you’re optimizing the way you feel, the way you look each day and that’s coming with corresponding improvement in your long-term risk of these metabolic breakdowns, as opposed to just wait for the breakdown and then respond to it.

Scott Shortmeyer: [00:39:26] Yeah. And it seems like you’re equipping people to make better decisions and help create those better habits that in many cases we may all know we need to make, but we don’t know the what and the why behind it. And it seems like that’s what this will help equip those folks with.

Josh Clemente: [00:39:41] Yeah, I think so. Yeah.

The beauty again, is that metabolic awareness, seeing things happen in real time, when your body speaks to you, you listen. People just, they don’t really push back against that data source. But then you also get this beautiful accountability component where, when you have this device on and you start, once you have explored all the different sensitivities you have and you understand what’s going to happen. Now, you know that if I make that choice that I know will be detrimental, I’m going to have to see the data. I’m going to have to face the music and face myself. And so we have a ton of anecdotes from people who just volunteer and tell us, “Last night my whole company went out for ice cream and I’m on this diet and I just didn’t even want it because I had the data stream and I just knew I’d have to see a glycogenic spike and I knew that my sleep would be bad because of it and it’s thank you. This has completely changed the way I look at that type of choice.” And it’s really fascinating.

I’m one of those people. I used to have a really out of control candy addiction. I didn’t, I wasn’t overweight and so I didn’t have that consequence feedback loop where the scale was going up in the bathroom. Instead, I was just experiencing probably under the radar metabolic breakdown. And so I haven’t touched candy literally in two years, ever since I started using CGM and it was not a moment where I was like, “I’m going to make this extremely challenging cold Turkey decision.” It just completely, the possibility ceased to exist when I saw how I responded to brown rice. It was just like, “Man, there’s no way sugar, candy is going to come back into my life.” And so that’s the type of thing that I think this enables.

Scott Shortmeyer: [00:40:59] Yeah. Absolutely. Because I can relate. You mentioned earlier and so I just started using one of the bands to track that and this is the Rest and Recovery Podcast, so rest has always been a challenge for me. And so I noticed that exact thought was going through my head yesterday on different choices I made to go to bed earlier or not, whatever, Netflix binge or something stupid. But those little, that little voice in the back of your head saying, are you sure you want to be doing this right now? And you’ve got the data stream now in front of you and you got the score. So yeah, you got that accountability partner in your pocket now.

Josh Clemente: [00:41:36] Yeah. I think it taps into these competitive pathways and these gamification things. I personally want to see the high score every morning when I wake up.

Scott Shortmeyer: [00:41:43] I’m not that green.

Josh Clemente: [00:41:45] Exactly. Yeah. And I think, hey, if that is one of the incentive structures, fantastic, we will tap into it. And I think what was interesting is people love to share this information. It’s very social and it’s something that I am all in favor of improving or maximizing the number of incentives that we can to make people care about this data and about metabolic health, about living holistic, wholesome lives and ultimately benefiting for many, many years in the future just by the choices they make today. So whatever means we need to use and I think that gamification is one beautiful way to do it and these new wearables are tapping that.

Scott Shortmeyer: [00:42:17] Awesome. Josh, we’re coming up on time. Grateful for the time. Before we close out though, I do like to ask a few personal questions. What are you reading right now?

Josh Clemente: [00:42:29] I just finished a book last night that was called “Red Notice”. It’s about an interesting finance and espionage thriller based in Russia. The true story of William Browder. I highly recommend it. And then I’m also reading The Art of – I believe it’s called The Art of Science and Engineering, which is a Stripe Press book that was recommended to me by someone on the team.

Scott Shortmeyer: [00:42:48] Cool. All right. What are you listening to right now? Whether music or podcast?

Josh Clemente: [00:42:55] So a lot of the podcasts I listen to are definitely in the space of wellness and performance optimization. The ones I would definitely recommend, of course beyond this one, would be Peter Attia’s The Drive. It’s an all-time favorite. He is extremely technically competent. Amazing podcast there. And then I really also love, let’s see, what are some others I need to pull out here? I’m going to go with the – I love The Portal by Eric Weinstein. It’s not in the wellness space, but it has this really interesting conversation, so I’m going to stick with those two for right now.

Scott Shortmeyer: [00:43:25] Cool. And then what is your go-to rest and recovery method?

Josh Clemente: [00:43:30] This is something I’ve been spending a lot more time focusing on. I think what’s interesting is that CGM has really influenced my approach here to rest and recovery personally. And so making better dietary choices leading up to sleep. But also I really limit my alcohol consumption now as a result of, not just glucose information, although it is very closely tied, but the way that I see how, again, in my sleep tracker, how poorly I sleep and how poorly I recover if I have any alcohol even after 5:00 PM. And so, I would say that those are the two lifestyle oriented ones.

And then I’m a CrossFit L2 trainer. I care a lot about exercise and fitness and I’ve been starting to push my way away from CrossFit and closer to triathlon stuff. I’ve taken a recent interest there. And so I’m just now getting to the point where I really am putting a lot of miles in and I have to start being more cautious about stretching and active recovery and that’s something I never have really done. It is a personal challenge right now that I’m working through. I am open to tips, I think on the rest and recovery thing. I would defer to you on how to improve that.

Scott Shortmeyer: [00:44:33] Yeah. Yeah. I definitely have some, especially coming from the triathlon and running background. I did a few years in triaths, but more historical runner. And so, yeah. There’s a couple different methods I’ve been using lately that have been helpful. I have a friend who has a facility down the street from me called RxR3. It’s a recovery lounge. And so he has a number of different modalities that you can do like a float tank. I don’t think you’ve ever done that. That is probably my favorite. I think an hour in there is equated to three hours of sleep. A few others, but –

Josh Clemente: [00:45:08] Okay.

Scott Shortmeyer: [00:45:08] Yeah.

Josh Clemente: [00:45:09] Yeah. I’ll have to get those from you offline. Those are, it’s – Yeah, again, a very – Last two years, I started paying much more attention to this.

Scott Shortmeyer: [00:45:15] Great. Josh, again, thank you so much for the time. I look forward to seeing where Levels goes and thanks for pushing this technology forward.

Josh Clemente: [00:45:25] Appreciate it. Yeah. If anyone would like to learn more about the space and about what we’re doing, I highly recommend levelshealth.com/blog. We have a lot about all of these different things on there, and then of course, levelshealth.com and @unlocklevels on social media if you’d like to reach out to us. We’d love it.

Scott Shortmeyer: [00:45:39] Awesome. I’ll be sure to include that in the notes. All right.

Josh Clemente: [00:45:42] I very much appreciate it. Yeah. Great conversation. Thanks for having me on.

Scott Shortmeyer: [00:45:45] Enjoyed it.

Thanks for listening to this episode. Hope you got a lot out of it. I know I had an enjoyable time with Josh. It was educational and look forward to actually trialing the Levels application. I just have the box. I’m looking at it right now and going to get started on giving it a try for the next month. So I look forward to the results.

Also if you’re like me, you’re active and that’s why you need to rest and recover as much as possible. But I’m looking for races and things to do and I recently discovered through our partner Pure Spectrum, that there is an event coming up. It’s online, it’s virtual that you can participate in and right now you can register. It’s open for OCR stars, which is presented by Pure Spectrum. OCR stars was founded by six-time obstacle course racing, world champion, CrossFit athlete and Pure Spectrum ambassador Hunter MacIntyre. This will consist of four workouts over four weeks, beginning November 2nd, with massive cash prizes. So sign up, get on a team and join. But register today at ocrstars.com.