Josh Clemente, Founder of Levels

Biowearables are all the rage. But how many of them actually provide data that you can easily act on? Levels Health is hoping to take real-time blood glucose levels and turn the data into easily digestible feedback that can serve to change your life for the better. Josh Clemente, co-founder of Levels, doesn’t think a Ph.D should be required to figure out which life choices are healthy – and which aren’t.  Because every individual processes food and other lifestyle factors differently, getting personalized insight is key. On Fitt Insider, Josh spoke with host Joe Vennare about the transformational power of holistic health.

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2:08 – No one should need a Ph.D. to understand nutrition

While there has been much advancement in data collection and biowearables, most people still don’t have a good understanding of how to use that data. That’s where Levels comes in.

“These devices are factory calibrated to correspond to your interstitial glucose levels, which is the glucose in your skin to your blood glucose levels. And there is a small patch that you wear full-time continuously for about two weeks, and they can communicate wirelessly with any new smartphone. And so you now have a technology that allows you to have what is in essence, a biowearable. So similar to the way you would wear a Garmin or an Apple Watch, you can now wear a device that is giving you a much deeper metric than your step count or your heart rate. The interesting thing is all this hardware development has been critical to you to advance the technology, but it has not come with a corresponding improvement in the actionability of the data itself. You can get a raw data stream from this technology that was developed for diabetes management, but how do you know how to tailor your sleep for example, or your exercise timing, or your diet? What do you add and remove without a Ph.D. level understanding of a glucose curve and what matters about it, like the rate of change, and how high it goes, how long it stays high? It’s very challenging to use this effectively. Levels’ core competency is data science, analytics, and the accessibility of the hardware. So giving people an access pathway to this prescription-quality, clinical-grade hardware.”

4:02 – A qualitative experience

Josh’s personal experience with chronic fatigue, energy crashes, and CGM detective-work opened his eyes to the fact that everyone has their own struggles and performance goals.

“I personally have an invested interest in this technology doing what we intend for it to do, which is to make metabolic health, metabolic fitness easy and obvious. We have made significant strides in developing the specific layers and features in a platform and an app that allows you to seize on the issues that you are dealing with. Everyone has their own qualitative experience. Everyone has their own struggles or performance goals, whether that’s losing weight, shaving a few tenths off a 50K, reversing a long-term inflammatory concern. There are many things people are struggling with, but the biggest one and one that I dealt with was where I just wanted to make it through the workday with my energy levels intact. I was struggling. I was working at SpaceX on life support systems, and I was pretty familiar with this space. I’m a CrossFit trainer. I have always thought that I was up to speed on my nutrition and how my diet should be tailored for optimal energy. Yet at the same time, I was just totally flagging. I needed caffeine to get me through the day. Two o’clock was like, I was crashing, unable to make the next meeting. I realized by using continuous glucose monitoring that my diet explicitly was causing extreme variations in my blood sugar.”

7:20 – Metabolic health is a spectrum

Diabetes experts are beginning to agree that metabolic health exists on a spectrum, where there is risk and reward inherent in every daily choice.

“There’s an international commission of diabetes experts who convened in 2009 and they published some really interesting findings. And that was that this traditional understanding of metabolic health as a threshold disorder where you are healthy until suddenly you are not is completely wrong. What’s really happening is there is a spectrum upon which there is no lower bound where there is no risk. Essentially, improving your metabolic health markers will always come with a corresponding improvement in your long-term risk. It doesn’t matter really whether you are an elite athlete or whether you are someone who has been struggling with lifelong chronic health issues. The point is that the information that you need is currently available in your body. You just need to tap into it and use it.”

15:01 – The many lessons to be learned with CGM

Josh has been using a CGM for the past two years and he’s still learning new things about his health and body.

“The nuance between how you will respond to the same meal is so widespread, so deep that it’s hard to tell within the first month, it’s hard to even describe how many lessons can be learned. You’re learning things about timing. You’re learning things about macronutrient composition. You’re learning things about the effects of stress, work meetings, aggressive coworkers that you’re dealing with. All of these things can influence the way that you’re responding to a meal that you just consumed. And so there are so many levers to pull, to start to bring in mindfulness, to start to bring in sleep, and then, of course, the diet and exercise. We found that the people just a month, for many of them, you can learn many, many lessons. But for myself, for example, I’ve been wearing this for two years and I am using this technology in the same way as I was at the very beginning with the added benefit of accountability. The lessons I’ve already learned are being reinforced daily, but then the ongoing benefit is that when I’m wearing the technology, I know at this point how I will likely respond to specific choices. And the beauty of it is it’s like having a trainer in the room with you 24/7 that you’re going to have to face the music. If you make that choice that goes against your goals, you’re going to see the data and you’re going to see the scoring.”

17:10 – The power of seeing results in real-time

Levels integrates with other biowearables to collect holistic data about diet and lifestyle to help people get the full picture of the impact of their choices around food, sleep, and exercise.

“The biggest thing that we do is we bring in inputs. This would be your choices around diet, exercise, and sleep, for example, through integrations with Apple Health Kit, Google Fit, so that we can take in additional wearable data that you might already be using. And then also we bring in your food logging. We don’t require everyone to tap in the calories and grams of the macronutrient split. What we’re trying to do is just drive up adherence maximally so that the individual logs their lifestyle choice, and then the Levels algorithm follows along as your glucose response. And because these devices are measuring continuously, you have a very rich high-resolution data set. Levels will analyze your body’s response to a choice that you make, or a series of choices that happen in close proximity to each other. And then it provides you with essentially a grade or a review, a rating on that series of decisions. A classic example would be you eat a personal pizza and you lie on the couch. So you’ll get a score for that choice. Depending on how you respond to the ingredients of that pizza, your stress environment, your genetics, your microbiome, even your body composition will all impact how you respond to that pizza.”

22:21 – A transformational stop for individuals and the society

Having access to real-time glucose information can lead to transformational behavioral change for both the individuals and society at large. This is particularly important as the US is facing a metabolic crisis at an epidemic level.

“We have a straight-up metabolic health epidemic. 88% of the country is metabolically unhealthy. We’ve got metabolic breakdown associated with seven of the top 10 causes of death here in the US. There are 90 million people in the United States that have pre-type two diabetes and 90% of those do not know they have that condition. Metabolic breakdown, specifically glucose dysregulation is associated with cardiovascular disease, it’s associated with Alzheimer’s disease, it’s associated with cancer. We have in this country and globally increasing rates of metabolic dysfunction. To have access to real-time metabolic information to real-time glucose information, to be able to optimize around that is I think a completely new and in a different category which again is the bio wearable category than what we’ve seen from other wearables. It’s a truly transformational step in the right direction for people to be able to, at an individual level, see and identify the actions that contribute to metabolic balance control, flexibility, fitness, whatever term you’d like to use, but the choices that are associated with better long-term outcomes and just make them on their own individually.”

24:41 – The larger goal that Levels is pursuing

Beyond just measuring glucose, Levels is looking to add even more analytes to build out a high-resolution model of each individual and their metabolic condition in real-time.

“The thing that’s going on that I think is really fascinating is that we have a very understudied or straight up unstudied space here. We have now Levels, the largest non-diabetic glucose dataset ever, and that kind of tells you something. It tells you that despite all of this technology development, what we have is a really good understanding of what dysfunction looks like, but we don’t have a good understanding of what normal and what optimal looks like because it’s not been studied with high-resolution information, like continuous glucose monitoring. The roadmap is, glucose is a single metric. It’s a very valuable one. It’s one that, as I mentioned, is associated with a lot of long-term breakdowns and many of the concerns that we have in this country and abroad. But what we need to do is continue to expand our understanding of metabolic optimization…we’re going to continue to introduce additional technology, additional analytics, and move to the mainstream.”

30:14 – Closing the loop between an action and a reaction

Getting data and feedback from a Levels CGM is like listening to your body talk. This functions to close the loop between actions taken and the impact they are having on the body.

“You’re not born physically fit. Metabolic fitness is exactly the same. You have to know, you have to have information that you are regularly updating and you have to make choices that initially require some effort, and ultimately with repetition become a habit and that leads to the long-term goals that you’re looking for. We start that process with metabolic awareness, which is closing the loop between an action and a reaction. And that’s what lights the bulb for people. That’s when they realize, Oh, man, this is amazing. My body is speaking to me and I understand now what I can do differently and ultimately get onto the right trajectory. So education, content production, it’s going to be a huge component of Levels’ approach for the entire life of the company. We want a very exciting, interesting lifestyle brand that people want to be a part of – a community that people come to better understand how to tweak inside of the main product. How can we continue to evolve technology? We’re always going to look to our audience and our customers for that. We’re very community-oriented.”

Joe Vennare: [00:00] Hi everyone. It’s Joe Vennare, the host of Fitt Insider, the show where I talk with the entrepreneurs, executives and investors who are redefining the business of fitness and wellness. Today, I’m joined by Josh Clemente, the founder of Levels, a metabolic fitness company. In today’s episode, we talked about continuous glucose monitoring and using Levels to unlock real-time feedback on lifestyle choices, like what you eat, how you exercise and the quality of your sleep. We also discuss Josh’s plan to make metabolic fitness mainstream in hopes of tackling obesity, diabetes, and other chronic elements. Let’s get into it. Hi, Josh, welcome to Fitt Insider, thanks for joining us.

Josh Clemente: [00:37] Super excited to be here, Joe. Thank you.

Joe Vennare: [00:40] Yeah. Likewise, looking forward to this conversation. And I think just to kick things off, can you tell listeners about what you’re working on at Levels?

Josh Clemente: [00:46] Absolutely. So Levels is the first metabolic fitness company. We close the loop between daily actions and the metabolic reactions that people are experiencing by using the technology, both hardware and software, that is necessary to access and learn from your personal health data, in real time. So the example would be continuous glucose monitoring, which is where we’re starting out. And so our customers are actively learning about their diet, exercise, sleep, stress, all these variables that they have control over, and how they affecting them in real time by accessing their glucose levels, which is the sugar in their blood, that’s an energy source for the body. They’re accessing those and understanding the levels, through the Levels app and analytics platform, in the moment.

Joe Vennare: [01:31] So you kind of touched on it there, the software and hardware to understand that feedback loop. Can you kind of expand on what that software and hardware looks like today, and maybe how people are using it and interacting with the product?

Josh Clemente: [01:44] Sure. So the hardware itself was originally developed for the management of diabetes. And it’s been, you know, sort of in the lab or in various stages of development for several decades now. And it’s reached a point in the technology curve where it is now essentially, it is entirely convenient to use in your daily life. There is no real overhead associated with using it. These devices are a factory calibrated to correspond your interstitial glucose levels, which is the glucose in your skin to your blood glucose levels. And there are a small patch that you wear a full-time continuously for about two weeks, and they can communicate wirelessly with any new smartphone. And so you now have a technology that allows you to have what is in essence, a bio wearable. So similar to the way you would wear a Garmin or an Apple Watch, you can now wear a device that is giving you a much deeper metric than your step count or your heart rate. And so the interesting thing is all this hardware development has been critical to advance the technology, but it has not come with a corresponding improvement in the actionability of the data itself. So you can get a raw data stream from this technology that was developed for diabetes management. But how do you know how to tailor, your sleep for example, or your exercise timing, or your diet? What do you add and remove, without a PhD level understanding of a glucose curve and what matters about it, you know, the rate of change and the how high it goes, how long it stays high. It’s very challenging to use this effectively. And so that is Levels core competency is the data science, the analytics and the accessibility of the hardware. So giving people an access pathway to this prescription quality clinical grade hardware.

Joe Vennare: [03:21] Absolutely. It makes a ton of sense. As someone who’s kind of very interested in this space, and it fits squarely into what we think of now as like personalized health care, personalized wellbeing. All the different ways that we’re getting this data, the devices, the hardware, as you mentioned, that’s really now a consumer product for me to put on and use with the subscription or my smartphone or whatever it might be. When you think about now, somebody kind of putting that glucose monitor on, you have the app that reads it. What are the, you know, the business model, the corresponding product offerings that kind of sit on top of that, that you guys are able to sell?

Josh Clemente: [03:56] So, you know, just to kind of give a high level of how this even began. Like I personally have an invested interest in this technology doing what we intend for it to do, which is to make metabolic health, metabolic fitness easy and obvious. So we need to develop the, and we have made significant strides on developing the specific, sort of layers and features in a platform and an app that allow you again, to seize on the issues that you are dealing with. And everyone has their own qualitative experience, everyone has their own struggles or performance goals, whether that’s losing weight, shaving a few tenths off a 50 K,  reversing a long-term, you know, inflammatory concern. There are many things people are struggling with, but the biggest one and one that I dealt with was, you know, I just wanted to make it through the Workday with my energy levels intact. And I was struggling, I was working at SpaceX on life support systems, and I was pretty familiar with this space. I’m a CrossFit trainer. I have always thought that I was up to speed on my nutrition and how my diet, you know, should be tailored for optimal energy. And yet at the same time, I was just totally flagging. I needed caffeine to get me through the day, two o’clock was like I was crashing, unable to make the next meeting. And so I realized by using continuous glucose monitoring that my diet explicitly was causing extreme variations in my blood sugar, which is a, you know, it is the primary energy molecule in the human, the modern human. And it’s upstream of a huge cascade of hormones that affect how we feel and how our bodies respond to our nutrition. And so it was obvious to me, by using the technology, what I needed to change. But the problem is it took me about 14 months of studying the literature in order to understand explicitly what levers to pull on. And so what Levels is doing is we have to build the platform, the analytics system that takes all that overhead away, so that when you go and you sit down for lunch, you don’t need a PhD, you don’t need a master’s degree in nutrition in order to know what specific changes you’re making. And so, that’s, you know, that’s entirely the focus of the current platform, is building the actionable sort of lifestyle logging necessary to, you know, interact with your glucose levels in real time, and make this, you know, something that you can easily learn from as it happens.

Joe Vennare: [06:18] When you think about what that looks like now, and you mentioned kind of having gone through the process of wearing a glucose monitor, trying to figure out, for yourself, what the reactions meant, what you needed to do, reading the literature. And now Levels is simplifying that kind of, where is the gap between those two things because obviously as you mentioned, people wear a glucose monitor for diabetes, for example. But we still kind of have like skyrocketing rates of obesity and diabetes, and here on the other side, the flip side of the equation, we have a ton of people who are kind of interested in optimization, kind of living what we think of as like a high-performance lifestyle. Where does Levels sit on that spectrum. Do you see it more tailored towards that optimization, high-performing individual? Or is this like a mass solution potentially to some of the bigger issues we’re facing?

Josh Clemente: [07:08] Well, you know the ultimate goal here is to make a meaningful dent in metabolic health outcomes around the world.  And so, you know, if you ask any expert, there’s an international commission of diabetes experts who convened in 2009, and they published some really interesting findings. And that was that this traditional understanding of metabolic health as a threshold disorder where you are healthy until suddenly you are not, is completely wrong. And what’s really happening is there is a spectrum, upon which there is no lower bound wherein there is no risk. Essentially, improving your metabolic health markers will always come with a corresponding improvement in your long-term risk. And so it doesn’t matter really whether you are an elite athlete or whether you are someone who has been struggling with lifelong chronic health issues. The point is that the information that you need is coming, is currently available in your body. You just need to tap into it and use it. And so, I would argue that, you know, although we’re entering the market in a premium lifestyle space, you know, similar to many brands, like Peloton where there’s a hardware or software component, it’s an exceptional user experience. We will eventually be the metabolic fitness organization that people come to, to optimize their choices daily, no matter what they’re struggling with or focusing on.

Joe Vennare: [08:29] Yeah, I definitely see that kind of comparison. When you think about maybe a Peloton or other wearable devices, personalized health care, for example. So you can just speak about who the target customer is today, how you’re going about acquiring them. And I know you guys are in kind of a closed beta right now, so maybe you can talk about that a little bit as well.

Josh Clemente: [08:49] Yeah, absolutely. So right now, as a closed beta we’re essentially hand picking or interviewing every single customer that comes through the program. And the intention there is to really understand the specific goals and what these individuals are hoping to acquire through the use of  Levels. And obviously, you know, that feeds into the development process for the technology itself. The primary user group right now is what we’re calling the health seekers or, you know, people who are currently interested in making better choices daily. And, you know, these are people who maybe are, you know, using nutritionists or shopping at higher end organic food stores. You know, they typically will have a fitness trainer or fitness goals of some kind. And so that’s where we’re starting. But as we, you know, one interesting thing is we’re learning that the weight loss crowd in particular is already interested in exactly the same information. So the features that we’ve developed are applying to more than just the, you know, the bio-hacker or the technologist. It’s already applicable to the people on the opposite end of the scale.

Joe Vennare: [10:01] For now, when you’re talking about going in with the health seekers, or maybe someone who’s seeking to improve their fitness, improve their weight loss goals, what does that customer journey look like? You know, maybe I sign up, I’m getting the device, I’m getting a subscription. Can you walk me through what that experience looks like from the consumer end?

Josh Clemente: [10:17] Yeah. So all the technology right now, is regulated in the United States as a class three medical device. And so, what that means is that there is a prescription requirement. So what we’ve done and what we’ve built at Levels is a relationship with a third-party tele-health, 50 state tele-health organization, and there’s physicians. There’s a, you know, as part of the process of onboarding, you know, we have a very direct to consumer, you know, process of ordering. And then during that onboarding, you fill out a medical history form that goes to one of our partner physicians, and they perform a consultation to ensure that this technology is a good fit for you. And so, every one of our users has a prescription for the use of continuous glucose monitoring. And then, if approved during that physician engagement, which is very similar, you can think of like the Hims or the Romans of the world of the direct to consumer, you know, healthcare space. You then receive a pharmacy fulfilled box with, you know, the Levels kits. And inside there are two 14 day prescriptions, continuous glucose monitors. And so, you then onboard into the Levels ecosystem. Download the app, you have full time engagement with the Levels team, and you start by just seeing, you know, measuring your glucose responses to the decisions you’re making daily, and you learn where you are today, so sort of what your baseline is. And then through the ongoing second and third weeks, you start to explore, see whether the edge cases are, how you’re responding to certain factors. And then ultimately in the fourth week, you shoot for optimization. So bringing together all the insights you’ve learned about your specific body, and how you are responding to the decisions you’re making. You shoot for, using the features like our zone scores and our metabolic fitness score, you shoot for that perfect streak. So bringing together all the insights and seeing how much control you can actually exert over the way you respond to your lifestyle. And so the whole program is built as a 28 day program right now. So you can learn a huge amount in that single month, and you can carry that onto your life going forward. And we also offer ongoing subscription options after that first month. The month is a bit more intensive. So you have like daily, weekly, and monthly reports, summary reports to show how you’re trending overall. And so for that ongoing subscription option, all of that information is delivered through the app.

Joe Vennare: [12:37] And just digging a little deeper on what people are experiencing with the glucose monitor. Ultimately the idea is that, you know, different foods and behaviors, fitness, exercise, sleep, all those things impact the body differently. And so when you’re eating, you know, something that I might perceive to be healthy, actually, it’s sending my glucose skyrocketing and actually terrible for me. So Levels is helping me, kind of see what’s happening, and then I’m able to make these adjustments on an ongoing basis based on, you know what I’m seeing, again, from what you mentioned, the data and that kind of dashboard. When people do that and you think about, so there’s this initial 28 day period, and then the subscriptions that are on top of that, like other wearables that might track, you know, heart rate or step counts, there’s kind of that risk that people just stop using it, right? They get a good sense of like what their, how their body responds and then what they need to do. And then they can kind of taper off, and maybe stop using the device or the subscription. How are you guys thinking about that or combating that?

Josh Clemente: [13:39] So to go back to my original experience with the technology. So I put the CGM technology on for the first time I was having fatigue issues. And what I quickly learned in the first week is that my glucose was way out of range. And after a bit more research, I discovered that I was either pre-diabetic fully or borderline pre-diabetic, depending on who you ask. And the factors here, I was going out of my way to get myself a wholesome meal. Every single day, I cooked all of my own meals. They were entirely whole food space. So I was not using, you know, a bunch of processed junk. And, what was happening is I was just selecting foods that my body did not respond favorably to. And there’s now, with CGM technology, there is a new sort of wave of research coming out. The landmark study was done by the Weizmann Institute in Israel, which showed that two people can eat the exact same two foods and experience an equal and opposite response. So this example was a banana and a cookie made with wheat. And the one person had a large glucose excursion on the banana but was flat on the cookie, and the other person was the opposite. So a large excursion with the cookie and nothing to the banana. And so these personalizations have been then further demonstrated in follow-on studies around the world. And what it’s telling us is that there is no one size fits all solution. Each person is different, and the factors are wide and varied. So the nuance between, you know, how you will respond to the same meal is so widespread. So it’s so deep that it’s hard to tell within the first month. It’s hard to even describe how many lessons can be learned. You’re learning things about timing, you’re learning things about macronutrient composition, you’re learning things about the effects of stress, you know, work meetings, aggressive sort of coworkers that you’re dealing with. All of these things can influence the way that you’re responding to a meal that you just consumed. And so there’s so many levers to pull, to start to bring in mindfulness, to start to bring in sleep, and then of course the diet and exercise, that we found that the people in just a month, for many of them, you can learn many, many lessons. But for myself, for example, I’ve been wearing this for two years, and I am using this technology in the same way as I was at the very beginning, with the added benefit of accountability. So the lessons I’ve already learned are being, sort of reinforced daily, but then the sort of ongoing benefit is that when I’m wearing the technology, I know at this point how I will likely respond to specific choices. And the beauty of it is it’s like having a trainer in the room with you 24/7. You know that you’re going to have to face the music if you make that choice that goes against your goals. You’re going to see the data, and you’re going to see the scoring. And it’s going to really, you know, it’s one of those things that people who are goal-oriented who want to make change, when they see their body telling them that you know, they’re working against their goals, it’s sort of a non-decision. You just don’t do it. And that’s what our users are telling us.

Joe Vennare: [16:38] Yeah, the accountability piece, I think is huge. And having that as you put it, the trainer in the room, I think is a good way of phrasing it. To think about the value from the other side of it, when you talk about interpreting the data, can you talk to us about what people are seeing? So what in response? What feedback is Levels giving them that can help them now interpret these maybe spikes or crashes and things like that, that they see with their energy throughout the day. How does the software work from that standpoint?

Josh Clemente: [17:09] So, the biggest thing that we do is we bring in inputs. So this would be your choices around diet, exercise, and sleep, for example, through integrations with Apple health kit, Google fit, so that we can take in additional wearable data that you might already be using. And then also we bring in your food logging. So we don’t require everyone to tap in, you know, the calories and grams of fat, you know, the macronutrient split. What we’re trying to do is just drive up adherence maximally so that the individual logs their lifestyle choice. And then the Levels algorithm follows along as your glucose responds. And because these devices are measuring continuously, you have, you know, a very rich high resolution data set. So, Levels will analyze your response, your body’s response to a choice that you make, or a series of choices that happen in close proximity to each other. And then it provides you with essentially a grade or aa review rating on that series of decisions. So a classic example would be, you eat a personal pizza and you lie on the couch. So you’ll get a score for that choice. Depending on how you respond to the ingredients of that pizza, you know, your stress environment, your genetics, your microbiome, even your body composition will all impact how you respond to that pizza. Now, you’ll get that score from the Levels device. And then you can, you know, for example, the next day eat the exact same pizza. And instead of lying on the couch, you’d go for a 30 or 40 minute walk or even a 15 minute walk, and that walk significantly will impact your body’s metabolic response to that same pizza that you ate yesterday, and it will modify it. And what Levels does, is it passively pulls that information in, understands and shows to you the impact of your choices. So we use comparison functions, we use activity catalogs and we use the zone scores that detect which decisions are impacting each other so that we can show you how modifying your behavior with that walk, is the low hanging fruit. It is the actionable choice that you can make. If you’re going to indulge to still enjoy yourself, well, sort of truncating or modulating your body’s negative response to it. And so these are the kinds of choices. And then another one is sleep. So you see how you respond to a day’s, you know, dietary choices on five and a half hours of sleep, and compare that to after nine hours of sleep, and you’ll see the impact of acute insulin resistance. Which is something that we know has been demonstrated in research trials many times that short sleep really affects how you process insulin, which affects how your body can pull glucose out of your bloodstream. And so when we can show you that, you know, those red eye flights, or just staying up late, watching TV has a meaningful impact on your body’s ability to process the food that you’re giving it. And you can modulate that by just making better sleep decisions. For people who are struggling with weight, weight loss, or for people who are trying to just hit performance goals or just have higher mental clarity in the office, it’s very easy to see these and to make better choices and these sorts of, you know. They sound anecdotal, but the evidence is overwhelmingly demonstrated in clinical trials, and then we’re seeing the individuals also, you know, basically identifying this on their own and choosing to just make a better choice in situ. They haven’t read a bunch of academic journals. They just see how their body’s changing, and choose the better one of the two options.

Joe Vennare: [20:33] Yeah. One piece that is certainly interesting is looking and being able to make that connection, and as you mentioned, close the feedback loop, and help people connect the dots really. And the other piece is what you’re talking about, seeing this on the graph or in the Levels app. It’s something that I’ve actually noticed on social media, where people have started to take screenshots of their app and say, This food did this to me or you know, this particular taking a walk or this helped mitigate the impact of the glucose. So you start to see this really cool, kind of emergence of people sharing the screenshots of their Levels app. And I liken that to, you’ve also seen it with maybe the Whoop band or Eight Sleep, Oura Ring, people, this social validation that they’re using it, they’re learning so much and you know, that it’s working for them. And when I started to think about that, is there a concern that, you know, with all these different devices, watches, Apple watch, Oura Ring Whoop band, Eight Sleep, and then all the different subscriptions that somebody might have, that they’re just, there’s an overload of like these devices or subscriptions that people can choose from?

Josh Clemente: [21:41] Well, I think it’s for certain people, it is certainly the case that you can get data fatigue. But you know, what I would argue is that most of what we’ve seen thus far is what I call superficial metrics. So I can count my own pulse, I can count my own steps, you know, my phone does it. It’s not super useful for the average person to understand, you know, I mean 10,000 steps, closing your rings, it’s really valuable. But, you know, the value of understanding your biological data. So that’s the data that really underlies your long-term health. And this is connected, you know, just to kind of zoom in, talk about some of the problems we’re facing in this country. We have a straight up metabolic health epidemic. 88% of the country is metabolically unhealthy. We’ve got metabolic breakdown associated with seven of the top 10 causes of death here in the US. There are 90 million people in the United States that have pre type two diabetes, and 90% of those do not know they have that condition. So metabolic breakdown, specifically glucose dysregulation is associated with cardiovascular disease. It’s associated with Alzheimer’s diseases, associated with cancer. We have in this country and globally, increasing rates of metabolic dysfunction. And so to have access to real-time metabolic information, to real-time glucose information, to be able to optimize around that is, I think a completely new, it’s entirely new and in a different category, which again is the bio wearable category than what we’ve seen from other wearables. It is a truly transformational step in the right direction for people to be able to at an individual level, see and identify the actions that contribute to metabolic balance control, flexibility, fitness, whatever term you’d like to use. But the choices that are associated with better long-term outcomes, and just make them, you know, on their own individually. You do that enough times, and that compounds into social scale change. And so I would say yes, there certainly is, you know, plenty of questioning of whether the, you know, all the wrist watches are helping people be healthier. But I would argue that this is not super comparable there for those reasons.

Joe Vennare: [23:50] Right. And I would too. I’m in a hundred percent in agreement, right, that the issues around obesity, diabetes, as it relates to, you know, causes of death and also cancer, all types of other chronic illnesses is a huge issue. But to some extent the idea that, you know, glucose, the response that, the impact it has on our body, and measuring that with a glucose monitor isn’t necessarily new. So going from the place of getting the kind of high performing individuals, these health seekers to use it to full-scale of social change, which is an amazing vision and frankly, I hope you get there or somebody gets there. Like what does that roadmap look like, in your mind to achieve something like that, recognizing that you’re still in the early stages in terms of the company and in developing the platform?

Josh Clemente: [24:39] So the thing that’s going on that I think is really fascinating is that we have a very understudied or straight up unstudied space here. We have now Levels, the largest non-diabetic glucose dataset ever, and that kind of tells you something. It tells you that despite all of this technology development, what we have is a really good understanding of what dysfunction looks like, but we don’t have a good understanding of what normal and what optimal looks like because it’s not been studied with high resolution information, like continuous glucose monitoring. And so, you know, the roadmap is, glucose is a single metric. It’s a very valuable one. It’s one that, as I mentioned, is associated with a lot of long-term breakdown and many of the concerns that we have in this country and abroad. But what we need to do is continue to expand our understanding of metabolic optimization, and so we’ll be introducing on the Levels platform additional analytes. I think the ability to measure free fatty acids, ketones in real time, additional analytes that you might have to get blood tests for if you’re interested, like insulin, like you know, your lipid profile in your bloodstream, all of those metrics that are also, you know, in addition to glucose associated with longevity and health span. And so continuing to build out a high resolution model of each individual and their metabolic condition in real time, and then giving them the technology to make good choices that are optimizing those key variables, those key metrics for a time. And so that is the Levels approach. We’re going to continue to introduce additional technology, additional analytes, and move, you know, to the mainstream. And so, yes, we’re starting with this sort of premium lifestyle brand, which is very targeted towards people who know that they want this, they already are looking for this solution. But ultimately we understand that, you know, the majority of people need this technology for at least some period of time in their lives and you know, someday I don’t see…What’s interesting about technologies is I don’t see it fading out. You know, let’s say that we achieve our goal of reversing metabolic outcomes in this country, and people are healthy and there we no longer have a type two diabetes epidemic. This technology does not become meaningless in that environment. So anyone, no matter who you are, can optimize, and in particular in the performance world, this is a real game changer. It’s a paradigm shift to be able to access your energy levels in real time. And so we have, you know, lead athletes like Anthony Kunkel who’s, you know, he’s an ultra-marathon runner. He’s been fat adapting for 11 years now. So just focusing on improving his ability to oxidize fat for his runs, and he’s using our technology to make even further optimizations because he’s always had to go off these point measurements until now. And so you know, there is a very bright future where across the metabolic spectrum, we are bringing real-time analytes into the hands of people who need them for their specific goals.

Joe Vennare: [27:38] Definitely. And how do you think about kind of bridging that gap as you think about that maybe high performer or health seeker who wants this type of solution and knows that they want it. And then as you start to break into the more mainstream, you know, building the brand, the resources and education that goes along with that, and really the entire kind of funnel that paints you as the leader in metabolic fitness, but also for the education, the resources, again, the brand, the personalities that come along with it. Because initially referencing somebody like Peloton, for example. Obviously you’ve done a great job building the brand, but also leveraging their instructors as, kind of the celebrities and helping them build that audience and market that way, you can kind of go brand by brand who have started at this higher end, and then broken into the main stream. How do you think about doing that from an awareness education resource perspective?

Josh Clemente: [28:36] Yeah. So one of our primary focuses is on the educational component here. It’s hard to argue that metabolic health is not front of mind in society right now, even though we’re faced with all of these, you know, terrifying statistics. It’s not something people think about often. And, traditionally it’s been thought that metabolic health is just something you either have, or you don’t have. You check your blood, you get your biomarkers checked or whatever at your annual checkup once a year. And you predict your entire sort of health trajectory off of these single blood point measurements and you know. It’s something that has to change, it has not adapted as the technology has. And so our focus at Levels is to develop the content and deliver the content to the people who need it, and sort of appeal to them, meet them where they are. So, Casey Means, a Stanford trained medical doctor, former surgeon. She’s one of our Co-founders, and she’s basically taking the lead on the content effort and helping to distribute, you know, through our blog, through cross collaborations and through, for example, podcasts. To help to distribute this information out so that people start to pay attention and realize that metabolic health is not something that sick people have to worry about. It’s something that every person has a responsibility to optimize and can optimize. They can make better choices, and so this is why we use terms like metabolic fitness, right? Metabolic health is the old concept. It’s you either are healthy or you’re not. Fitness is, as we know with physical fitness is something that you have to put in focus, effort and repetition on. You don’t, you’re not born physically fit. And so metabolic fitness is exactly the same. You have to know, you have to have information that you are regularly updating, and you have to make choices that, initially requires some effort. And ultimately with repetition, becomes a habit, and that leads to long-term, the goals that you’re looking for. And so, you know, we start that process with metabolic awareness, which is closing the loop between an action and a reaction. And that’s what lights the bulb for people. That’s when they realize, Oh, man, this is amazing. Like my body is speaking to me, and I understand now what I can do differently and ultimately, you know, to get onto the right trajectory. So education, content production is going to be a huge component of Levels approach for, you know, for the entire life of the company. We want a very exciting, interesting lifestyle brand that people want to be a part of, a community that people come to, to better understand how, you know, to tweak inside of you know, the main product, how can we continue to evolve technology? And we’re always going to look to our audience and our customers for that. So we’re very community oriented. We’re very much educational oriented trying to get this information into the hands of people who need it. And you know, what’ll be interesting is, you know, once we get to the point where we are truly mainstream, which is going to require , you know, some advances in the hardware technology, for sure as to bring prices down and accessibility up, you know, we’ll be seeing, I think a real sort of like a shift where people are by default, you know, concerned with their health information, the way that they were once concerned with their finance information, for example. So using this sort of technology too, to have a good understanding of the “deposits and transactions, the withdrawals” they’re making each day on their long-term metabolic health, and projecting into the future, and ensuring that, you know, not only are they financially set up for retirement, but they’re also going to be healthy enough to enjoy it. So that requires us to start right now with a strong education approach.

Joe Vennare: [32:17] Sure. So we look at that, you know, the brand piece, the information, the education. What else should folks be on the lookout for when you think about maybe the six to eight months, maybe even just closing out this year, what’s in the pipeline and what should we keep an eye out for?

Josh Clemente: [32:33] Well right now, again, we’re in beta. We’re really getting some strong signals that the product is meeting the requirement, which is that behavior change is easy and obvious if people know how to improve from the minute they put the device on, because the Levels software is telling them exactly where to look then we’re succeeding. And so that’s what we’re seeing. And as a result, we’re starting to prep for our full launch, which will be likely, in the early or mid-fall sometime. And at that point, you know, we’ll be probably releasing some pre-orders first through the website and then, ultimately our full launch. Again, this is around the holiday time. And so, you know, people should look out for a. I highly recommend signing up for our waitlist, and we send a lot of great information through there. But we also send out, you know, we publish new blogs, new content. It’s a really meaningful way of understanding why this is relevant. You know, no matter who you are, you are likely struggling with some goal or trying to optimize something in your life that could benefit from better metabolic health. So I highly recommend that. And then yeah, we’ll be launching fairly soon. And, we have a lot of great demand, and I’m very excited to be able to expand, you know, out of this beta mode and into the real thing.

Joe Vennare: [33:47] Yeah. Certainly an exciting time. And in wrapping up, we’ll get you out of here and this, you kind of alluded to a bit. Let me go ahead and give it to folks. Where can they learn more? Get in touch with you, sign up for the beta and all that good stuff.

Josh Clemente: [33:57] Yeah. So LevelsHealth.com or Levels.Health. And the blog is LevelsHealth.com/blog. We highly recommend again, to sign up for the waitlist. You’ll see the email box there on the website, and follow along on Twitter and Instagram @UnlockLevels. And then, you know, I highly recommend my co-founder Casey. She publishes some amazing stuff through her personal Instagram, Dr. Casey’s Kitchen. She’s entirely plant-based, but she uses CGM to tailor a really amazing approach to diet and wellness generally. So people really like to sort of appreciate her approach and see, you know, how this technology can be implemented in a specific dietary philosophy, even though Levels doesn’t have a, you know, an overarching one size fits all approach. And so yeah, reach out to us through those channels and follow along.

Joe Vennare: [34:45] Excellent. And likewise, I encourage people to as well. I follow along with the Levels team on social, and try to keep up with you with what everybody’s doing. So, definitely give them a follow. And Josh, I appreciate you joining us today.

Josh Clemente: [34:55] Yeah, it was awesome. I really appreciate it. These are the topics that I like to explore. So what does the future look like now? We’re going to get there. So I appreciate the questioning.

Joe Vennare: [35:06] Thanks everyone for listening to today’s episode. For more from Fitt insider, visit insider.fit.co and subscribe to our weekly newsletter for insights and analysis on the business of fitness and wellness. Then go ahead and subscribe rate and review the podcast. See you next time.

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