EP302: Level-Up Your Health with Dr. Casey Means

In this episode of Fit2Fat2Fit Experience Podcast with Drew Manning, Dr. Casey Means explains why tracking your glucose levels is much more than a passing health hack. It could be the key to fighting against false food marketing and battling chronic disease. Once people start to understand the physical impacts of food, we can change widespread discourse and habits for the better.

Inflammation is at the root of chronic disease

Dr. Means was a practicing surgeon when she had an epiphany about illness.

I was treating things like sinusitis and thyroiditis and laryngitis and all these itises are essentially – that suffix itis means inflammation and it got me really scratching my head saying, “Wow, there’s so much of this inflammatory illness that we’re seeing in our country and in particular here in my field,” and kind of had a sense that so much of the food we’re eating and the lifestyles we’re leading can trigger so much inflammation. These industrialized processed foods that we’re eating, the refined seed and vegetable oils, sugar, refined sugar, refined carbohydrates, these can generate inflammation in the body and yet in conventional medicine and Western medicine, we really don’t talk about these triggers. We don’t talk about diet. We don’t talk about lifestyle.

The wake up call to “band-aid” medicine

Instead of putting a band-aid on healthy issues, we should try to prevent them from happening in the first place.

There’s a lot of physicians that I think are waking up to this and realizing we’re really just reacting to symptoms and we’re putting Band-Aids on things. What would the system look like if we actually were more focused on root causes and focused on all the decisions and lifestyle choices that went into generating health, and how could we treat at that level? How could we empower people to be actually fundamentally healthier and not just turn around and react to disease once it manifests? And that’s the long story short about my journey is moving from this reactive way of treating patients to thinking about what would the system look like if we actually just empowered people with their own health information to understand how all their daily choices are affecting their health so that they can make better personalized decisions that will lead to long-term health and longevity? And that’s really how I moved away from surgery and ultimately became a health tech entrepreneur to really look at technology that can scale, that can address some of these key root cause factors that are leading to so much of the healthcare morbidity in our country.

Take the mystery out of diet

There’s only one true way to find the best diet for your body: a continuous glucose monitor.

Levels, simply put, breaks through the mystery of trying to guess what the perfect diet is, and we do this by empowering individuals with real-time, continuous metabolic data to understand exactly how food is affecting them. So it kind of answers the question of people are out there trying to figure out what to eat. It’s like, “What do I have for breakfast that is healthy for me?” We help people answer that question. And the way we do that is we facilitate access to this technology that you and I have been talking about, the continuous glucose monitor. And this is a small wearable device that you stick on the back of your arm and it actually has a little teeny, teeny probe that goes under the skin, totally painlessly, that tracks our blood sugar in real-time, 24 hours a day, seven days a week, and sends that information to your smartphone.

Avoid blood sugar spikes and crashes

When your glucose is on a rollercoaster, you feel the effects in multiple physical ways.

You ideally want to avoid really high-magnitude spikes and crashes as much as you can. So that’s like you eat something and your blood sugar immediately skyrockets, and then you come crashing down, and that rollercoaster in glucose often feels like a rollercoaster in our own body. That might be where we feel like, “Oh, my gosh.” We got a surge of energy and then we came crashing down. Or it might feel like you crash and you feel a little bit anxious and jittery and moody. So that objective rollercoaster can often feel like a subjective rollercoaster, as well. We also know biologically that when you have a really big spike, that can lead to some problems in the body. So things like inflammation, things like oxidative stress, which is the body producing sort of reactive metabolic byproducts that can be damaging to ourselves. It can also lead to a process called glycation, which is where when there’s high blood sugar around, that sugar, it sticks to things in the body like fats and proteins and causes problems with how they function.

The perils of the Standard American Diet

The average western diet confuses and sickens the body.

Just by eating the Standard American Diet, spiking our glucose, we’re also spiking our insulin. And when you spike that insulin over and over and over again, the cells actually are like, “Whoa, there’s a lot of insulin coming at us. We’re being asked to take a lot of glucose up into the cells,” and they put a block on it and that block is called insulin resistance. And it’s actually a cellular process where the cells become less sensitive to that hormone signal and that then sends the body into a little confusion because it’s like, “Well, we got to get this glucose out of the bloodstream and we got to get into the cells, but we’re being blocked by this insulin resistance.” So then the body pumps out more insulin to overcome that block and then you can imagine, if that insulin is also a signal to block any fat burning for energy, the more insulin you got, the more problems you’re going to have breaking down that fat for use, and for people who are interested in weight loss to actually mobilize that fat for energy and therefore weight loss. And so it turns into this vicious cycle.

Feeling “hangry” can be blamed on glucose

If you’re like Levels founder Josh Clemente, you might find yourself looking healthy on the outside but feeling off on the inside.

There’s two examples that might help bring this home, which is one is this idea of sort of hanger or this real desperation to eat something. You get really anxious when you haven’t eaten for a few hours. If people wake up and they feel like, “I have to have breakfast immediately when I wake up or I’m going to not feel good or be anxious,” or in between meals, they start to get a little bit like hangry because they haven’t eaten for four or six hours, that might be a sign that your body’s not flipping into fat-burning well. You’re basically so dependent on glucose that you can’t go without it for a little while because your body’s not able to really use alternate fuel sources. That’s not where we want to be. We want to be able to kind of go without. If we go eight hours without food, our bodies aren’t going crazy and sending a stress response because we’re able to be using that fat.

Food is the building blocks of the body

The phrase “you are what you eat” has always been true.

We eat three times a day or more, most people more. But we eat about, on average, a ton of food per year, like a car’s worth. It’s so much food and that is all, every single bite, every single atom in that food in that ton of food is information. It is the information that tells our body whether to store or burn fat, how our hormones should work, what our cell membranes should be made of, which genes should be expressed. It’s just pure chemical information for our bodies. That’s what food is. It’s also the building blocks for our bodies, so it’s information and building blocks and yet we have literally zero idea what it’s doing to our body. No idea. Like you eat a Rice Krispies Treat, is it causing inflammation? Is it causing my insulin to go up? Is it causing oxidative stress? Is it making me happy? Is it making me sad? We don’t have any of that information and I really think that’s the future is unpacking that a little bit.

The role of technology on diet

It’s easy to scoff at the idea of tracking your every bite. But the truth is that diet and lifestyle are the root of nearly all illness.

People might say like, “We’ve been eating for millennia and why do we need technology now to help us?” And the answer is that we are facing such an uphill battle now with food. With the way that food has been transformed from real, whole, clean, unprocessed food which the body knows how to handle beautifully and has evolved to handle, we’re not eating any of that anymore. The average American, 70% of their calories are coming from ultra-processed foods that is completely different chemical and molecular information than what we were evolved to eat. And what we’re seeing as a result of that is that the vast majority of American adults have chronic illness that are related to diet and lifestyle.

Food is a trillion-dollar business

Companies have a big stake in making food taste great and appear healthy.

I’m really a believer in giving people a little bit more power in the face of these multi-trillion dollar industries that are designed to sell you food through essentially addictive qualities of the food and pleasure-inducing qualities of the food that just are basically putting you on a treadmill towards getting sick. So we’re just facing different challenges and I think you’ve touched on something else which is really about body awareness and learning how you feel after eating. You can do that with or without a continuous glucose monitor, but something I really like about technology like a CGM, in the same way that I like wearing a WHOOP to understand my sleep better, is that you start to link choices you’re making with objective data with a subjective feeling, and that trifecta of choice, objective data, subjective feeling, I think really solidifies body awareness.

Using CGMs to shift the world of nutrition

Dr. Means believes that technology like Levels can be a true game-changer once it is more widely adopted.

I think as more and more people start using continuous glucose monitoring and we start to see really these larger data sets of how people are responding to the same types of foods, we’re going to be able to surface a lot of aggregated insights for people about what foods work for most people and what foods don’t, and really have this new, large scale objective analysis of everything we’re seeing in the store. So as opposed to going into the store and having to just trust some marketing claim on the box, you can actually look to objective data for many, many, many people and use that to help you determine your choices. So that’s, I think, really exciting. I think the way that that might shift sort of the culture of food marketing, also nutrition influencers and nutrition sort of like the loud voices and the dogmatic voice in the nutrition space and just cut through a lot of that with objective data. I think it’s going to be really positive for the nutrition world.

Drew Manning: All right. Hello. Hi, everyone. What’s up? How are you guys doing? It’s me, Drew Manning, and you are listening to the Fit2Fat2Fit Experience Podcast.

Drew Manning: On today’s episode I have a good friend of mine, Dr. Casey Means, and if any of you remember my Fit2Fat2Forty journey, you might remember I was wearing a black patch on the back of my arm and a lot of you asked what that is. It’s a continuous glucose monitor or CGM device, and Dr. Casey Means is the chief medical officer and co-founder of the company Levels which is the company that I use for my CGM device. And so I’m going to be talking to her about all things blood glucose levels and what that means for you, and why this little patch on the back of my arm is so valuable for everyone, not just diabetics, but for everyone out there.

Drew Manning: So a little bit about Dr. Casey Means. Like I said, she’s the chief medical officer and co-founder of the company Levels, as well as the associate editor of the International Journal of Disease Reversal and Prevention. After studying undergrad and medical at Stanford, she went to Oregon Health and Science University for her surgical training, and she became an ear nose and throat surgeon but after noticing that the root cause of every problem in the majority of her surgeries was inflammation, she started to focus on why these patients were inflamed in the first place.

Drew Manning: And so from there, she went to train in functional medicine and she opened her own practice which focused more on the deeper dives into the root cause of inflammatory problems and focusing on glucose monitors and the data and information that we get from them and how that data affects behavioral change. So if you want to learn more about, one, how to get this device and how it works, but also what this data means to you if you do get this data, and what you can do with it to improve your health.

Drew Manning: So stay tuned for that. Before we jump in, a shout out to our show sponsor and this show is sponsored by Levels, actually. If you go to the URL levels.link/fit2fat2fit, with the number 2 in between, so levels.link/fit2fat2fit you can bypass the waiting list, which I believe is around 30,000 people on the waiting list. You can bypass the waiting list by using my code Fit2Fat2Fit. So once again, that’s levels.link/fit2fat2fit if you want to see if you qualify for one of these CGM devices. I know a lot of people in the industry use these. A lot of famous biohackers and athletes, and these aren’t people that are diabetic. These are all kinds of people.

Drew Manning: And I continue to use mine even after my Fit2Fat2Forty journey. I love having the information on hand to be able to check my glucose levels whenever I want to as many times during the day. It’s so convenient just to scan that device on your arm or wherever you put it with your phone and then, boom, it pops up in real time what your blood sugar level is, so you can monitor that. So go to levels.link/fit2fat2fit.

Drew Manning: This episode is also brought to you by Complete Wellness which is my lineup of supplements, and if you haven’t checked yet, we just launched our new whey protein flavors, and our most popular one so far is peanut butter chocolate, but we also have vanilla ice cream and chocolate milkshake flavors which are to die for, as well.

Drew Manning: But if you use the code Podcast, you will get 20% off your order at completewellness.com, but we also have a full lineup of products, keto-friendly products like we have some complete grains, we have a keto pre-workout, we have BHBs, keto meal replacement, grass-fed collagen protein. We have a new powdered bone broth which is amazing, and other health and wellness products like Vitamin D3 plus K2 which everyone should be taking that. But we also have things like krill oil and turmeric and apple cider vinegar pills, and these vitamins and supplements are available at completewellness.com and if you use the code Podcast, you can get 20% off. All right, let’s go hang out with Dr. Casey Means.

Drew Manning: All right. Dr. Casey, welcome to the show. How are you doing today?

Dr. Casey Means: I’m doing great. It’s so great to be here chatting with you, Drew. Thanks so much for having me on.

Drew Manning: Yeah, it’s a pleasure to have you on. I’m so glad that we connected. Just thinking back to how we got connected, I remember seeing Dr. Dom D’Agostino, who’s been on this podcast now and he’s very well known in the keto community. Saw him with a CGM on and it was your company, I believe, and so I was like, “I’ll reach out to these guys and see if they want to do something for my Fit2Fat2Forty journey.” So I think that’s how we met, right?

Dr. Casey Means: Yeah, I think so. And Dom is a medical advisor for Levels and doing some awesome research with the company and so we’re super grateful to get to work with him and learn from him. He’s kind of the expert on this topic.

Drew Manning: Yeah, and it’s so funny because before I did my Fit2Fat2Forty journey, he would do these mini experiments where he would eat like a keto cookie and then he would eat a normal cookie, and so he was kind of already doing a little bit of Fit2Fat2Fit kind of experimentation, but without getting fat. So it’s just kind of showing people the glucose response to certain foods so I thought that was very interesting.

Dr. Casey Means: Yeah, absolutely. He does such an amazing job doing really structured sort of N of one experiments with himself and sharing them on his social media and in his amazing newsletter at KetoNutrition, and really highlights the really interesting concept of, I think, two things. One, like you just mentioned with the keto cookie or regular cookie that there are different versions of the same types of foods that we love that can have just profoundly different impacts on our blood sugar and our overall health.

Dr. Casey Means: And also kind of highlights that between different people, you might have a different response. You really have to test for yourself to know how you’re going to respond because you and I could probably eat that same keto cookie and have very different responses, which is so interesting to see when you’re actually testing the data. So, yeah, I certainly get lots of ideas for self experimentation from following his work.

Drew Manning: Yeah, yeah. We’ll get into all of that and what is a CGM device for those that don’t know, but let’s talk about you and your path and what led you to working for Levels.

Dr. Casey Means: Yeah. So I’m a medical doctor by training and I actually… So after medical school, I went on to do residency in ear, nose and throat, head and neck surgery, and I was about five years into my training doing that and I was sort of struck by this realization that so many of the conditions I was treating as an ear, nose and throat doctor and surgeon were really fundamentally rooted in chronic inflammation.

Dr. Casey Means: I was treating things like sinusitis and thyroiditis and laryngitis and all these itises are essentially… That suffix itis means inflammation and it got me really scratching my head saying, “Wow, there’s so much of this inflammatory illness that we’re seeing in our country and in particular here in my field,” and kind of had a sense that so much of the food we’re eating and the lifestyles we’re leading can trigger so much inflammation. These industrialized processed foods that we’re eating, the refined seed and vegetable oils, sugar, refined sugar, refined carbohydrates, these can generate inflammation in the body and yet in conventional medicine and Western medicine, we really don’t talk about these triggers. We don’t talk about diet. We don’t talk about lifestyle.

Dr. Casey Means: We mostly focus on really just waiting for disease to emerge, naming it and then treating it, usually with pills and medication. And in the case of a lot of ear, nose and throat conditions, anti-inflammatory medications. Things like steroids or you might use antibiotics, and then if those things don’t work, you do surgery. But again, that doesn’t really address the trigger, what is causing this, and so [crosstalk 00:08:33]

Drew Manning: And why do you think that is? I’m curious to know your opinion, why you think that is.

Dr. Casey Means: I think it’s several things. I think one really has to do with the financial incentives of the healthcare system right now. We’ve traditionally been in this fee-for-service model and so fee-for-service means that you get paid for a service, and that service is typically… It’s a lot easier to isolate and quantify a service if it’s sort of a reactive discrete thing, like diagnosing something and then treating it. That sort of diagnosis, treatment. That’s such a big part of what medicine is based on systemically in an economic way.

Dr. Casey Means: Whereas if you’re really being more proactive and trying to really identify many of the different, somewhat nebulous factors that are leading to something, and then counseling and coaching and trying to instill behavior change around those things, that’s a lot harder to kind of wrap up into a simple economic model. And I think that’s led towards a lot of where we’re at now. I think it also has to do with in the mid-20th century, when we sort of decided how we were going to make healthcare a little bit more efficient, we really focused on codes. We code everything in medicine. We code diagnosis, we code treatments. That’s how it all is billed and organized and documented and works.

Dr. Casey Means: But when you start coding things, you really reduce them to these very specific things like sinusitis. So that’s a very efficient way to kind of organize a collection of signs and symptoms, but what that code doesn’t tell you is what the actual physiology happening in the body is. Like maybe there’s up-regulation of inflammatory cytokines that are leading to that problem. Maybe it’s a lot of oxidative stress in the body that’s causing mitochondrial dysfunction that’s leading to cellular pathology that’s leading to that condition. You can’t really code for those actual physiologic processes that are leading to disease.

Dr. Casey Means: Unfortunately what that means is that it feeds into a system that treats the symptoms, which is what you’re coding for, but not actually treats the physiology that’s gone wrong that’s led to disease. So even though metabolic disease and blood sugar dysregulation is related to eight of the 10 leading causes of death in the United States, having out of control blood sugar or having a metabolic dysfunction or chronic inflammation may lead to a lot of the biggest killers in our country, you can’t really code for those things like early insulin resistance or metabolic dysfunction or chronic inflammation. Those aren’t actually things that you can code.

Dr. Casey Means: So it’s kind of this really interesting systemic thing but there’s a lot of physicians that I think are waking up to this and realizing we’re really just reacting to symptoms and we’re putting Band-Aids on things. What would the system look like if we actually were more focused on root causes and focused on all the decisions and lifestyle choices that went into generating health, and how could we treat at that level? How could we empower people to be actually fundamentally healthier and not just turn around and react to disease once it manifests?

Dr. Casey Means: And that’s the long story short about my journey is moving from this reactive way of treating patients to thinking about what would the system look like if we actually just empowered people with their own health information to understand how all their daily choices are affecting their health so that they can make better personalized decisions that will lead to long-term health and longevity? And that’s really how I moved away from surgery and ultimately became a health tech entrepreneur to really look at technology that can scale, that can address some of these key root cause factors that are leading to so much of the healthcare morbidity in our country.

Drew Manning: Yeah, I’m just curious, how did your colleagues… Was there any pushback from them when you transitioned? I’m just curious.

Dr. Casey Means: Yeah, I think…

Drew Manning: Not really. They were supportive of [crosstalk 00:12:46]

Dr. Casey Means: There was a lot of questioning, I think, of like, “What? You’ve invested so much time. Four years of undergrad at Stanford, four years of medical school at Stanford, five years of ear, nose and throat surgical training, really becoming an expert in doing a lot of these procedures. Why would you just move away from that?” And I think, in my heart, it was like, “I don’t really want to cut another patient until I think about whether there’s something we could have done to prevent these conditions.” That really felt alive in me but there were people who didn’t understand that opportunity, like the sunk cost of everything that’d gone into it.

Dr. Casey Means: And I think there was also this kind of pushback that was a little bit like, “Okay, you’re really interested in nutrition and how food affects inflammation,” but there’s not a lot of studies or randomized controlled trials which are really the gold standard in medicine to say like, “Oh, if you eat a different anti-inflammatory diet, your sinusitis is going to be better or you’re going to have less risk of developing head and neck cancer down the road.” There’s not great research on that and so it can be viewed as, “Well, this is sort of not an evidence-based way of practicing medicine.”

Dr. Casey Means: But this is a challenge because nutrition research is very challenging to fit into what we consider gold standard studies in medicine, which is this randomized controlled trial where you take different groups and you give one intervention and you give one a different intervention or no intervention, and you see what happens. That’s a lot, that’s really challenging if you’re doing this with free-living people with a dietary intervention or a lifestyle intervention. It’s hard to control the extraneous variables. It doesn’t fit into that, like give Group A a pill and don’t give Group B a pill and see what happens.

Dr. Casey Means: So we don’t have that level of research and some of this sort of more nutritional interventions. We have been so focused on symptoms when we think about medical research, and we focus so much on symptoms when we’re diagnosing conditions. We’re not necessarily focusing on that true cellular physiology and if that’s shifting. We don’t really study that. We don’t have necessarily tests that are as robust to sort of understand those things, and so there’s a lot of things about the research culture that makes it almost seem like, “Oh, a nutritional intervention is less powerful or less evidence-based or what not, than just giving a pill.”

Dr. Casey Means: But I think that is not a function of the reality of the biology. That’s a function of the research and the way we’re doing research. Most of the drugs we’re giving for chronic diseases are not treating or curing the illnesses. They’re just managing symptoms. They’re just managing the downstream effects of diseases. So I’m pretty disillusioned with that whole system and what we consider a win within conventional medicine. We know that food can reverse disease and food can absolutely change cellular physiology and so can lifestyle choices, but unfortunately, until we find a way to shape the research culture around that, there’s going to be naysayers who think that this is not the right approach, unfortunately.

Drew Manning: Okay, yeah. So how did you find Levels or how’d Levels find you?

Dr. Casey Means: Yeah, so Levels was really the brain child of my co-founder Josh Clemente who’s this amazing guy. He’s an aerospace engineer. He ran life support teams at SpaceX, and he had really been thinking about similar things as I was thinking about, but coming from a different angle. While also being an aerospace engineer and doing all this incredible work, he was also a CrossFit instructor and was in his late twenties and from the outside looked like this totally fit, jacked guy, like super healthy. But he was actually feeling exhausted and tired and knew he wasn’t feeling his best on the inside, even though he looked great on the outside, and just started doing a lot of digging. Like, “Why don’t I feel great? Why don’t I feel like I can just take on the world? I should be at the top form. I’m working out. I have this amazing job.”

Dr. Casey Means: And so he started really digging into his health more and he started pricking his finger with sort of a glucometer where you just prick your finger and you take a blood sugar measurement. And what he noticed was that his blood sugar was really, really high. It was higher than it should be and was getting into the pre-diabetic range frequently throughout the day. And this really made him nervous. I think he’d been in that camp of like, “Well, I look great and I’m able to lift all these heavy weights so I can kind of eat whatever I want. I’m healthy. Look at me.” But then he looked at the blood work and was like, “This is not right.”

Dr. Casey Means: And yet his doctors were telling him, “You’re normal weight, you’re totally fine, your fasting glucose…” They never mentioned it. But he was like, “There’s something going on here.” He also noticed that when he was eating things and checking his blood sugar, when his blood sugar would go up and then crash down, that he would feel really tired and lethargic during that crash. And so he really started thinking about like, “Okay, maybe if I keep my blood sugar more steady and try and get into a healthier range, this will help with my energy. And blood sugar is really this key foundational substrate of our energy production in the body and our metabolism. Maybe if I can get that under better control, I can start feeling better.”

Dr. Casey Means: So he starts pricking his finger like 60 times a day to understand that and understand his diet and really took his health into his own hands. Then he discovered that there was a technology called a continuous glucose monitor which you just stick on your arm and it tracks your blood sugar 24 hours a day with no finger pricks, and it’s just sending that information to your smartphone and you can get this full length movie of your glucose, how it’s going up and down after meals, as opposed to having to prick your finger. So he tried to get one, but his doctors would not prescribe him one because he doesn’t have a diagnosis of Type 2 diabetes, and these are indicated for people with diabetes.

Dr. Casey Means: And he thought, “This is crazy. I am on the road to developing diabetes. I know that this data could be really helpful for me in shaping up my diet and lifestyle to prevent this from happening, and I can’t get one? So I’m just going to keep going down a bad trajectory until finally I ultimately cross into that threshold of disease and then I can get access to a tool that helps me be healthier? This is not a good system.”

Dr. Casey Means: So he finally was able to get his hands on one and it just totally changed the way he viewed his diet and his exercise and he really got things under control. And he thought, “I need to bring this to more people. Why are we saving this technology for people who have… These conditions like Type 2 diabetes are largely preventable. Why would we wait until people develop them to give them the tools to take control of their health?” So that’s really how Levels started for him, and I was thinking about it more from this idea of how do we empower people with their personal information to keep them out of the operating room?

Dr. Casey Means: And we actually met really serendipitously. I had put together a slide deck for a company I wanted to start that was not focused on continuous glucose monitoring as the real centralizing sort of thing around this company, but I was actually thinking about how do we use… We order billions of lab tests in the United States every year. How do we leverage all those lab tests to help people really with more behavior change, rather than just giving it to them as information? How do we actually create tools to motivate behavior change?

Dr. Casey Means: I had put together a pitch deck for a company around that, circulated it with my network and someone saw it and said, “Oh, my god. This is so interesting. This is very similar to what my friend Josh…” And he had at that point had teamed up with our CEO, Sam Corcos, and they connected us and it was kind of a match made in heaven. So I initially started consulting for Levels. This was in summer of 2019, about two years ago, while I had, at that time, my own private practice and I was doing a lot of research and writing for them. And it just really snowballed and we realized how much of an impact this could have on so, so many people.

Dr. Casey Means: There’s 130 million American adults with pre-diabetes or Type 2 diabetes. The market for people who could potentially use technology like this to improve their health and prevent disease is monumental. And so over about six months, I ultimately came on full-time and then it’s been about a year and a half since then. There’s five co-founders, Josh, Sam, myself, and our head of engineering and our head of product. And now we’re about a team of 25 and things have just really grown very, very quickly and we just are laser focused on our mission which is to use technology to help people make better choices so that we can ultimately reverse the chronic disease epidemic that we’re facing in the US.

Drew Manning: Yeah, so how does Levels work exactly? Not just the device. Maybe talk a little bit about the device and how it works, but then also how people can get one.

Dr. Casey Means: Yeah, absolutely. So Levels, simply put, breaks through the mystery of trying to guess what the perfect diet is, and we do this by empowering individuals with real time, continuous metabolic data to understand exactly how food is affecting them. So it kind of answers the question of people are out there trying to figure out what to eat. It’s like, “What do I have for breakfast that is healthy for me?” We help people answer that question. And the way we do that is we facilitate access to this technology that you and I have been talking about, the continuous glucose monitor.

Dr. Casey Means: And this is a small wearable device that you stick on the back of your arm and it actually has a little teeny, teeny probe that goes under the skin, totally painlessly, that tracks our blood sugar in real time, 24 hours a day, seven days a week, and sends that information to your smartphone. And then Levels has developed a software that helps make this continuous deep data stream interpretable so that people can really gain the insights about how food’s affecting them and how other lifestyle factors are affecting them. When you exercise, how does that affect your blood sugar? When you get a good night of sleep versus a poor night of sleep, when you’re stressed or not stressed, if you’ve moved, exercised, walked, lifted, whatever, how is that affecting your blood sugar?

Dr. Casey Means: Putting this all together so that people can really start to understand how to keep their blood sugar more stable with less big up and down swings, because we know that when you keep your blood sugar more stable, it’s just one of the lowest hanging fruit ways to up-level your current performance, your current health, but also potentially avoid long-term chronic disease.

Dr. Casey Means: And so that’s what Levels is. So essentially a customer who comes to Levels, they would sign up for a one-month program and they would immediately be connected with a telehealth physician because these devices, these continuous glucose monitors, they’re prescription only. So they would be connected with a telehealth physician who would evaluate them for these devices, for the prescription. If that prescription is approved, then we have a partner pharmacy that ships the individual a month’s worth of these continuous glucose monitoring sensors. And that is two sensors because they each last for 14 days on your body. So you stick it on, you wear it for 14 days, you take it off and then you put the second one on. So you get two sensors that are shipped to you, and that is a month’s worth of sensors. And you get access to the Levels app, which really is that overlay that helps interpret the data.

Dr. Casey Means: And the goal is that by the end of the month, you really have a good sense of which foods are affecting your body in a positive way and which ones are really causing you to be all over the place in terms of your glucose. So it allows people to have that metabolic awareness and to really just cut through all the noise in the nutrition space about you should only eat this type of diet, you need to be keto or paleo or vegan or carnivore or whatever, and actually just test foods for yourself and figure out if it’s working for your body. Because like I said in the very beginning, you and I could eat the exact same cookie or meal and have totally different glucose responses. And for the one of us that that glucose response is quite low and stable, that might be an okay food for that person. But for the person who it causes a huge, huge spike, keeps you elevated with your blood sugar and then crashes down, that’s probably not the best metabolic choice. And if you do that type of choice day after day, month after month, year after year for decades, it’s going to lead you down a problematic path.

Dr. Casey Means: And so that’s what Levels is helping people do is really personalize their diet and lifestyle to keep their glucose more stable so they can feel better now, and then also ideally avoid the long-term chronic disease pathway that so many Americans are unfortunately falling prey to.

Drew Manning: Yeah. And this is exactly why I wanted to team up with you guys when I did my Fit2Fat2Forty experiment was because this was an opportunity to show people, because people see the weight gains. They see me weighing in every week, they see the fat kind of accumulate and they see my body grow, but what I wanted to do is also collect more data to show them what’s happening on the inside of my body. Like when I would eat these foods what it would do to my blood sugar levels, and I think that was very valuable data and eye opening for a lot of people.

Drew Manning: And I think the simplest thing that we do with blood sugar is, okay, spike and crash is bad, right? And then that’s kind of like, people, the way we view it. And maybe you could kind of talk a little bit more about that. Maybe it’s not as simple as just spike and crash is bad. Like don’t get spikes, don’t get crashes, and talk about how someone who maybe gets this device, what do they want to look for? What’s important, what’s not important in looking at this data from your perspective?

Dr. Casey Means: Yeah, so there’s sort of the broad brush strokes, which I think you’ve touched on really nicely, which is that you ideally want to avoid really high magnitude spikes and crashes as much as you can. So that’s like you eat something and your blood sugar immediately skyrockets, and then you come crashing down, and that rollercoaster in glucose often feels like a rollercoaster in our own body. That might be where we feel like, “Oh, my gosh.” We got a surge of energy and then we came crashing down. Or it might feel like you crash and you feel a little bit anxious and jittery and moody. So that objective rollercoaster can often feel like a subjective rollercoaster, as well.

Dr. Casey Means: We also know biologically that when you have a really big spike, that can lead to some problems in the body. So things like inflammation, things like oxidative stress, which is the body producing sort of reactive metabolic byproducts that can be damaging to ourselves. It can also lead to a process called glycation, which is where when there’s high blood sugar around, that sugar, it sticks to things in the body like fats and proteins and causes problems with how they function. So elevated blood sugar and these big spikes and crashes can lead to some of this physiology in the body like inflammation and glycation, oxidative stress, which we want to avoid.

Dr. Casey Means: The second thing is more hormonal. So when you have that big spike, your body to basically allow you to get that blood sugar back to a normal range, releases a bunch of insulin from the pancreas. That’s the hormone that comes into the bloodstream and then helps your cells take up that glucose. So it can either be processed for energy, or if there’s excess stored. They’re stored as chains of glucose that can be used for later or as fat. And so insulin is this really interesting hormone because it signals the body that we need to get the glucose down and we have a bunch of energy substrate as glucose. And with that signal, it has this secondary effect of telling the body, “Don’t burn any fat because we have all this abundant glucose around for energy, and we don’t need to use our fat for energy right now.”

Dr. Casey Means: Glucose and fat are the two main forms of energy that we can use to convert to cellular energy in the body, but when there’s lots of glucose around, we’re going to preferentially use the glucose and not use the fat, and insulin is kind of the conductor of that back and forth. So those spikes have their own damage they can cause and then they can also cause problems for that hormonal pathway of essentially big insulin spikes, which tell your body to store, store, store, and not break down. And over time, if you spike your insulin over and over and over again, which the average American is doing because the majority of our calories in the Standard American Diet, the SAD diet, come from ultra refined grains and carbohydrates and sugars, all of which turn into glucose in the bloodstream and elevate blood sugar.

Dr. Casey Means: So we are, just by eating the Standard American Diet, spiking our glucose, we’re also spiking our insulin. And when you spike that insulin over and over and over again, the cells actually are like, “Whoa, there’s a lot of insulin coming at us. We’re being asked to take a lot of glucose up into the cells,” and they put a block on it and that block is called insulin resistance. And it’s actually a cellular process where the cells become less sensitive to that hormone signal and that then sends the body into a little confusion because it’s like, “Well, we got to get this glucose out of the bloodstream and we got to get into the cells, but we’re being blocked by this insulin resistance.”

Dr. Casey Means: So then the body pumps out more insulin to overcome that block and then you can imagine, if that insulin is also a signal to block any fat burning for energy, the more insulin you got, the more problems you’re going to have breaking down that fat for use, and for people who are interested in weight loss to actually mobilize that fat for energy and therefore weight loss. And so it turns into this vicious cycle where the more glucose spikes you have, the more insulin spikes you have. The more insulin spikes you have, the more insulin resistance you develop. Then you produce more insulin and it’s this kind of vicious cycle.

Dr. Casey Means: So that’s really the root of what we’re trying to do is help people figure out how to just flatten that whole thing out. Figure out the foods that actually work for your body to keep the glucose spike down and the insulin spike down so over time, you’re not straining these pathways so much and not getting these maladaptive coping mechanisms in the body like insulin resistance. And letting your body just stay really insulin sensitive and metabolically flexible, which is the term… A lot of people, I think, hear this term, metabolically flexible, and may not know what it means from sort of this molecular level but what that means is that when there’s glucose around, you have a normal insulin response, you have normal insulin sensitivity and you can immediately use that glucose for energy, and that’s great.

Dr. Casey Means: And when glucose is not around, like first thing in the morning when you’ve been fasting overnight, or after a longer extended fast, or if you’ve been working out for a few hours and you’ve really burned through a lot of your glucose, in that case, your body wants to be able to switch, immediately flip into fat burning to be able to use that whole other source of energy in your body for energy. And if your insulin at baseline is high because you’re insulin resistant or you’re moving down that pathway, your body is going to have a lot more trouble flipping into fat burning because you’ve got this block, this insulin block.

Dr. Casey Means: So the idea is that if you can over time, keep that glucose more stable, keep these cells more sensitive to insulin, you can bounce back and forth under different conditions between these two states. And there’s two examples that might help bring this home, which is one is this idea of sort of hanger or this real desperation to eat something. You get really anxious when you haven’t eaten for a few hours. If people wake up and they feel like, “I have to have breakfast immediately when I wake up or I’m going to not feel good or be anxious,” or in between meals, they start to get a little bit like hangry because they haven’t eaten for four or six hours, that might be a sign that your body’s not flipping into fat burning well.

Dr. Casey Means: You’re basically so dependent on glucose that you can’t go without it for a little while because your body’s not able to really use alternate fuel sources. That’s not where we want to be. We want to be able to kind of go without. If we go eight hours without food, our bodies aren’t going crazy and sending a stress response because we’re able to be using that fat. The second example is more athletics. You can imagine, you hear this term of bonking where you run for maybe an hour and a half or two hours, do a long bike ride, and you get to this point where you just completely bonk and tap out. You feel like you can’t go anymore no matter what and need to replenish and eat one of the goos or a bar or a banana or a shake or whatever, Gatorade.

Dr. Casey Means: There’s athletes out there who are not bonking these days and those are athletes who are metabolically flexible because they’ve trained their body so well to basically function during exercise under low glucose conditions. Their bodies know how to use fat even during a training event. So they’re sort of bonk proof and there are people out there running marathons fasted because they’re able to do this. And not saying that’s the best option for everyone, but it’s just showing kind of what metabolic flexibility looks like in action.

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Drew Manning: You did such a good job describing what happens in the body and for me, when I did my Fit2Fat2Forty experiment, when I would eat these foods I would get these big spikes and, yes you do feel a rush of energy, but then with that crash, you feel miserable. And then it creates this vicious cycle and this dependency on these types of foods to think, “Okay, well I feel miserable and I felt good when I ate this food, chips, cookies, crackers, soda, whatever it is, I want to keep doing that.” And then boom, boom, boom, six, seven times a day you’re doing that to your body and it’s exhausting.

Drew Manning: That’s what I tried to describe people is I felt like I needed to take a nap all the time. I needed a lot more stimulants to stay awake during the day, and then you think you’re exhausted at night, but your sleep starts to decline. And then when your sleep declines, then your blood sugar responses continues to get worse and worse, and it creates this vicious cycle that this is why it makes transformation so much more difficult.

Drew Manning: And a lot of people think, “Oh, well, just eat less food, eat healthy food and workout and then, boom, all your problems are solved.” It’s like, “Yeah, I get that,” but you take out the mental and emotional component, the emotional attachment to foods, the human experience of life and how we eat our emotions, but then also just feeling miserable and not sleeping efficiently. It’s not like a magic thing where you eat a salad and then all of a sudden your blood sugar is fixed and you feel great and energized all day long. You got to be consistent and continually live this lifestyle in order for your body to feel good so you do start sleeping better, your hormones are more balanced, weight loss becomes more efficient and you have healthy blood sugar responses to foods.

Drew Manning: But it’s more complicated than people think and so I’m glad that you kind of described what happens in the body with these huge spikes and crashes because I think that’s valuable for people to know. And, yeah, sure, you could do this without a CGM device. You don’t obviously need one, but I think for most people, this is something that would be super beneficial. If the whole population had this or had access to this and was able to get one and use this on a daily basis, it makes people more accountable and more aware of what’s happening inside of their body, right?

Drew Manning: It makes them more aware of, “Okay, my blood sugar is up to 200 after eating that Rice Krispies Treat and it’s probably going to crash, which, yep, it did. Okay, now I’m not feeling so good. Okay, now this is the type of behavior I need to be careful of or be aware of and minimize those spikes and crashes to avoid feeling miserable.” And when you feel miserable and you’re stressed out, you want to go for the easy access food that tastes delicious, that makes you feel good temporarily.

Drew Manning: And so it’s a complicated pattern to overcome in your brain but I think Levels makes it a little bit more doable by having this type of device that can help out, I think, so many people. Because the cool thing with Fit2Fat2Forty was I showed one side of it, one side of the coin of like, “Hey, here’s a very unhealthy lifestyle to live and here’s what it does to your blood sugar levels. Now on the flip side, here’s what I’m doing and here’s what you can do to live a healthy lifestyle and here’s the blood sugar responses to kind of match that,” and kind of show people both sides of the coin of what not to do, but then also what to do.

Drew Manning: But it’s very individualized, like you said, and I remember reading the book, I think it’s Wired to Eat by Robb Wolf, and he did a really good job of experimenting with his wife where they would do these blood sugar responses to all kinds of foods. Rice, bananas, cookies. I think it was 30 grams of carbs they measured out and him and his wife would eat them and then they would measure their blood sugar response, and it was like night and day. Her response to certain foods was like nothing happened, and for him, he was pre-diabetic after having half a banana. And so this is why it’s so valuable to know the bio individuality of each person, and not all carbs are bad for everyone. Not everyone’s response to certain carbohydrates is going to be the same, and this is why it’s important to experiment with your own body to find out what works best for you.

Dr. Casey Means: Yeah, man, I think you hit so many good points there and I think something that just strikes me is we eat three times a day or more, most people more. But we eat about, on average, a ton of food per year, like a car’s worth. It’s so much food and that is all, every single bite, every single atom in that food in that ton of food is information. It is the information that tells our body whether to store or burn fat, how our hormones should work, what our cell membranes should be made of, which genes should be expressed. It’s just pure chemical information for our bodies. That’s what food is.

Dr. Casey Means: It’s also the building blocks for our bodies, so it’s information and building blocks and yet we have literally zero idea what it’s doing to our body. No idea. Like you eat a Rice Krispies Treat, is it causing inflammation? Is it causing my insulin to go up? Is it causing oxidative stress? Is it making me happy? Is it making me sad? We don’t have any of that information and I really think that’s the future is unpacking that a little bit. And I think people might say like, “We’ve been eating for millennia and why do we need technology now to help us?”

Dr. Casey Means: And the answer is that we are facing such an uphill battle now with food. With the way that food has been transformed from real, whole, clean, unprocessed food which the body knows how to handle beautifully and has evolved to handle, we’re not eating any of that anymore. The average American, 70% of their calories are coming from ultra processed foods that is completely different chemical and molecular information than what we were evolved to eat. And what we’re seeing as a result of that is that the vast majority of American adults have chronic illness that are related to diet and lifestyle.

Dr. Casey Means: If you just are living a normal kind of go with the flow with American culture related to food and lifestyle, so food, sleep, exercise, how we manage stress, you will get sick. More likely than not, you will get sick if you just go with the flow of American culture. And so it’s totally different than it was a hundred years ago and throughout the rest of human history because we’re facing different challenges. We’re facing a food system that is not designed to keep us healthy, that does not provide us with real food and real molecular information we need for our bodies to know what to do properly.

Dr. Casey Means: And the cultural norms around lifestyle activities like sitting and not sleeping as much as we should, and having chronic exposure to low grade stress, all is telling our body basically it’s under threat and to get sick. So I do think we’re at a time now where tools can be helpful to give us some support in facing these monumental challenges. You walk into the store, it’s just all boxes, right? It’s just boxes with packaged food with labels that almost every box these days has something on it that says it’s healthy. If it’s a Rice Krispies Treat, it might say a low fat food even though it’s got 40 grams of sugar or something like that. If it’s a juice, it’ll say a hundred percent juice, pulp added for fiber. There’s always some claim something can make about…

Dr. Casey Means: If it’s oatmeal, it’ll say this is a high fiber food with whole grains. That’s just the way food marketing works is it’s going to try and trick you into thinking that there’s some feature of this food, this processed food, that is healthy when in fact there’s probably 10 other things in there that are going to be causing problems like the refined vegetable oils and the pesticides that are on the food, and maybe it’s low fat but it’s super high sugar, whatever.

Dr. Casey Means: So I’m really a believer in giving people a little bit more power in the face of these multi-trillion dollar industries that are designed to sell you food through essentially addictive qualities of the food and pleasure-inducing qualities of the food that just are basically putting you on a treadmill towards getting sick. So we’re just facing different challenges and I think you’ve touched on something else which is really about body awareness and learning how you feel after eating. You can do that with or without a continuous glucose monitor, but something I really like about technology like a CGM, in the same way that I like wearing a WHOOP to understand my sleep better, is that you start to link choices you’re making with objective data with a subjective feeling, and that trifecta of choice, objective data, subjective feeling, I think really solidifies body awareness.

Dr. Casey Means: I can see on my WHOOP strap, for instance, “Okay, I got six hours and 40 minutes of sleep. I needed seven hours and 30 minutes of sleep. My recovery score is 35% today and I feel shitty.” So all those things to me tell me this was not a good night’s sleep and then it surfaces like, “Okay, well, I didn’t take my magnesium and I didn’t do breath work and I used a screen device in bed,” or whatever. So you just start learning how you feel and how that relates to your choices. The same thing can happen with food. You can eat a Rice Krispies Treat and spike and crash and feel crappy after that, but it’s hard to unpack that if you don’t actually see with your own eyes that objective response that happened in your body. Like you went up 80 points in your glucose and you crashed down and that’s exactly when you felt bad.

Dr. Casey Means: If you don’t see that objective data, you might misattribute that sensation in your body to something else. You might be like, “Oh, well, I’m tired right now because I didn’t get great sleep last night or because I didn’t have my second cup of coffee this morning or because I’m just having a really stressful morning.” But when you actually see, “No, it was the Rice Krispies Treat. I spiked and I crashed and that’s exactly when I felt crappy.” You can then kind of cut through the misattribution or the multi-variate sort of different things that could have been leading to that and say, “I’m not going to eat this anymore because it did this to me. I know this choice had an impact on me.”

Dr. Casey Means: And so I think that loop and gaining that really granular body awareness is such a key. And our hope with Levels is that in the course of a month, you can have a bunch of experiments like that, build a lot of body awareness and then maybe you continue using the CGM long-term more for accountability and continued learning, but maybe also you’ve developed a lot of those magic moments of body awareness that you can take with you without the device, and just sort of have a better sense of, even without seeing the glucose, knowing what that feels like so you can be a little bit more intuitive about it in the future.

Dr. Casey Means: So body awareness is definitely a huge thing that I think we’re trying to instill in people so they can just kind of have a barometer of what’s going on inside their body that we haven’t had access to before.

Drew Manning: Yeah. I have a quick question that I’ve been curious about. We have these CGM devices, continuous glucose monitor that monitors your glucose levels, what about a continuous ketone monitor where you could… Because it’s a similar process where you prick your finger, put it on a strip. Is there any possibility for… Because it would be interesting to see what glucose and ketone levels are doing. I mean, obviously you kind of know when your glucose is up, your ketones are down. When your glucose is down, your ketones are most likely up. Is there any technology around that possibility in the future?

Dr. Casey Means: Yeah, so there’s nothing that exists right this second, but I think it’s only a matter of time before that becomes something that’s commercialized. It’s so funny, I’m sitting here at my desk surrounded by devices. I’ve got my Biosense ketone breath monitor sitting here and then I’ve got my Keto-Mojo blood ketone monitoring, and I’ve done both of them this morning. And I knew they were going to be low today because we went out for a Father’s Day dinner last night and I just sort of had whatever I wanted and it wasn’t a real super glucose-friendly night. Yeah, the plantain chips were I knew the thing that was going to drop my ketones today, but it is fascinating to merge all those data streams together, and I think continuous ketone monitors would be an excellent addition to kind of that suite.

Dr. Casey Means: Something I find with pairing the continuous glucose data with the ketones, either by breath on Biosensor, blood with the Keto-Mojo is that it’s like the glucose feedback gives you that minute-to-minute biofeedback that helps you really create this closed loop relationship between a specific food choice you’re making and a specific outcome. I ate oatmeal. I spiked, I came down. I now know how oatmeal affects my body. Then ketones, because ketones are ultimately the… They are the result of fat being burned so they’re a signal that your body essentially is metabolically flexible. If you have ketones around, you know that your insulin break, that block on fat burning, was released enough that you were able to process fat and generate the byproduct of fat metabolism with ketones.

Dr. Casey Means: So it’s sort of this readout of what you’re learning from the continuous glucose monitor. It’s like the end result, so that I think the glucose monitor gives you more of the minute-to-minute tactical feedback on what to do and what’s happening. Then the ketone is saying, “Okay, you’ve basically taken what you’ve learned with the CGM, kept your glucose more flat and stable over time, and then this is showing that you had a win.” Like you actually were able to produce fat burning and ketones. So that is a double positive feedback loop that I just get a lot of value from.

Dr. Casey Means: And there’s times when there’s some anomalies, like for instance, my glucose might be quite flat but my ketones are still low. And I’m like, “Well, that’s weird. I kept my glucose really low, so presumably I’m not spiking my insulin with food, but my ketones still… I’m not generating a lot of fat burning. What gives? That’s the idea. It should be one-to-one.” But it’s more complex than that. We know that when you have a really bad night’s sleep, your body is going to become more insulin-resistant acutely, and you’re going to potentially be producing more insulin and so it’s possible that you could have had a really bad night’s sleep and that’s kind of blocking some of your ketone production, but it’s not necessarily showing up. You didn’t have a lot of spikes the day before.

Dr. Casey Means: So it helps with some of that, I think, really nuanced learning which is interesting. So I’m all for a, yeah, a continuous ketone monitor down the road and potentially how cool would it be if they could be integrated together?

Drew Manning: Yeah. Okay, since we’re coming up on time, where do you see Levels going? What does Levels have planned for the future that you can talk to us about?

Dr. Casey Means: Yeah, one of the things I am most excited about is how we’re going to start seeing community interacting within Levels. I think as more and more people start using continuous glucose monitoring and we start to see really these larger data sets of how people are responding to the same types of foods, we’re going to be able to surface a lot of aggregated insights for people about what foods work for most people and what foods don’t, and really have this new, large scale objective analysis of everything we’re seeing in the store.

Dr. Casey Means: So as opposed to going into the store and having to just trust some marketing claim on the box, you can actually look to objective data for many, many, many people and use that to help you determine your choices. So that’s, I think, really exciting. I think the way that that might shift sort of the culture of food marketing, also nutrition influencers and nutrition sort of like the loud voices and the dogmatic voice in the nutrition space and just cut through a lot of that with objective data. I think it’s going to be really positive for the nutrition world.

Dr. Casey Means: I think also the way people can learn from each other within this type of platform will be great. You’re a perfect example. So many people have seen your glucose data that you’ve posted on Instagram, just screenshots and what not. And I bet that’s impacted tens of thousands of people in terms of thinking differently about what they should be eating. If you can imagine that extrapolated to lots of people sharing their information if they want to, like if you want to share what’s going on and sort of crowd source input on it, or use that as a teaching tool to help other people understand, I just think that’s going to be incredibly powerful. There’s something about seeing advice paired with data that I think makes it a lot more powerful.

Dr. Casey Means: And so the way people are going to be able to learn from each other, learn from population data, I think continuous glucose monitoring is a part of that. It’s one thing about diet that we can learn. It’s right now the only technology we have that gives you real time biofeedback on food, but the next 10 years, I think we’re going to be seeing more technology giving you more granular insight about how food’s affecting your body. And then I think this whole population community-based interaction is going to really shift the food industry in a really positive way. So that’s what I’m really excited about.

Drew Manning: Awesome. And so, Dr. Casey, where can people find you, but then also where do you want to send people to for Levels? Because I think we also have a code that people can use to skip the waiting line, is that correct?

Dr. Casey Means: That’s right. Yeah, I’m pretty sure… We can verify this for the show notes, but I think it’s levels.links/fit2fat2fit.

Drew Manning: Yep.

Dr. Casey Means: Is that right?

Drew Manning: Yes, that’s right. I think they can also go and just enter in the code Fit2Fat2Fit, I believe. But we’ll verify that and put that in the show notes for you.

Dr. Casey Means: Yeah, so right now, yeah, we’re in a closed beta program so, unfortunately, right now people can’t just go to the website and sign up for the product. But with the code that Drew just was mentioning, people can skip the 120,000 person wait list and get into the beta program now. For people who just want to learn more about Levels, I recommend going to levelshealth.com and you can sign up for our newsletter and our wait list there. Or go to levelshealth.com/blog which is where we just have so, so, so much information about metabolic health and lots of articles about how to think about blood sugar, stabilize blood sugar, foods that have been shown in our data set to be kind of the worst offenders in terms of glucose, and just lots of information there that people can learn even without having the CGM, and so I’d recommend that one.

Dr. Casey Means: And then we’re @Levels on Instagram and Twitter and constantly reposting people who are sharing what they’re learning by using CGM and so that can really spark a lot of ideas as well for what to do in your own life. And I’m @drcaseyskitchen on Instagram, D-R Casey’s Kitchen, and I’m mostly plant-based. and so I post a lot about plant-based recipes and thoughts on how to get basically stable glucose levels while having a little bit of a higher carbohydrate plant-based diet. So would love to connect with anyone on those platforms.

Drew Manning: Yeah. That is actually great information because I have a lot of people all the time asking about plant-based approaches, and I think you’re a great resource for that. So go follow Dr. Casey, you guys. Thank you for coming on. I really appreciate it and I’ll let you know the next time my next experiment happens. So I’ll keep you posted.

Dr. Casey Means: Thanks, Drew.

Drew Manning: Thank you. Hey, everyone. Thank you so much for listening to this episode on the Fit2Fat2Fit Experience Podcast. I really, really appreciate all your support you’ve shown me throughout all the years. If you love the podcast then please go subscribe to the podcast on iTunes, and also if you love the podcast, please leave us a review. It definitely helps out with rankings which means more people listening to this podcast when they see it. And feel free to reach out to me on social media @fit2fat2fit or at fit2fat2fit.com with suggestions or comments or concerns, anything you think I could do to make this podcast better for you.

Drew Manning: I definitely want to bring the highest quality content to you with the most value because I know you’re investing 30 to 50 minutes per day when you listen to the podcast. So I really appreciate all the support and, like I said, go follow me at @fit2fat2fit on social media if you want to reach out to me about any comments, questions, or concerns. Thank you guys so much and we’ll see you guys back here next week on the Fit2Fat2Fit Experience Podcast.