Josh Clemente on Why You Should Monitor Your Blood Sugar Even If You Aren’t Diabetic

In this episode of the Adversity Advantage Podcast with Doug Bopst, Levels founder Josh Clemente shares how he got started on the glucose monitoring journey. He explained why appearances can be deceiving: someone who looks outwardly healthy might not have healthy glucose levels, even if they look thin or fit. And not all foods we think of as healthy are good for our bodies.

Battling mysterious fatigue

While working at SpaceX, Josh hit a health wall and started to investigate.

I was rapidly hitting a burnout that I had never felt before. Every day was becoming more and more challenging to get through, both mentally and physically. So, I was experiencing these, it’s hard to describe other than just the symptomatic episodes where I would just need to sit down and catch my breath. And by the way, at the same time, I’m a CrossFit trainer. I’ve played sports my whole life. I’ve never had body weight issues. I’m someone who thinks of themselves as objectively healthy. So, this was not making much sense where I’m in the middle of a workday. I’m walking from one meeting to another and feeling like I need to sit down and wipe the cold sweat off my brow. It made no sense. I’m also experiencing a lot of irritation and frustration and just general mood disorder. My sense of humor over who knows how long has suddenly sort of vanished and I feel like I’m constantly aggravated and trying to hold my temper. And so, these things are happening while I’m also in sort of the most stressful and important phase of my career.

The origin of Levels

Once Josh finally got his hands on a CGM, he was able to link his symptoms with out-of-whack blood sugar.

I eventually got a continuous glucose monitor. These are devices. I’m happy to jump into the tech on them in a minute. But I got myself one, and within about a week realized that I was either pre-diabetic or borderline, depending on who you ask. And this was based on the real-time data that was coming from the device, not the morning fasting glucose prick, which is what my doctor took. And so, I went into kind of just, this became my passion. And I went into changing my approach to daily decisions on making around nutrition, exercise, sleep and stress. I was able to completely change my blood sugar control with this little device and realized, there’s a huge potential here to make this technology the future of wellness and to help reverse the trends of metabolic dysfunction in this country and globally that are driven by people flying blind. Every day making decisions that are not driven by data.

Almost all Americans have metabolic dysfunction

It’s scary, but true. And in order to close the loop on the problem, we need to get data and education into the hands of more Americans.

In 2018, the University of North Carolina ran a study that showed that 88% of American adults have some metabolic dysfunction. So, if you imagine a world where that, the burden of controlling chronic illness or preventing it was not on your doctor, but it was actually on you, the individual. And physicians could instead focus on the truly nonpreventable illnesses, and helping those who have terminal illness and maintaining sort of a sickness-oriented approach as opposed to a prevention-oriented approach, we would unlock a tremendous amount in both directions, right? So, that’s what Levels ultimately seeks to do is to close the loop for the individual between the actions they’re taking and the reactions your bodies are experiencing, right? That is the end goal is that people learn from feedback. You can’t take one data point once a year and figure out what to do for lunch, right? That’s what Levels can do. You sit down, you’re going to eat a meal for lunch, what are you going to eat and why.

How technology can fill the void

Technology like Levels is vital because it provides insight not just into the dietary aspect of health, but also into levers like sleep, stress, and lifestyle.

Where technology can fill the void tremendously is to enforce for people that the decisions you make every day stack up into an outcome. They compound on each other and it’s not just about food. It’s also about stress. It’s about exercise. It’s about sleep quality. But all together, if we have insight into them, we can start to tease apart the dependencies. And rather than it being some abstract thing you read about in the textbook, it’s “Oh, that meal was a nine out of 10 for me, or that meal is a two out of 10 for me.” And this is based on biological data that I’m collecting in real time. It’s a real paradigm shift in how we think about providing advice on lifestyle. We can move away from generalities like eat healthier and workout more. And start specifically saying, “You are the type of person that responds well to fruit sugars and you’re the type of person that responds well to grain sugars.” Because there’s so much individual variability at stake, it’s really hard to provide a one-size fits all solution.

The body is a chemistry set

Many factors come into play in terms of when and how your body responds to glucose.

The human body is not an oven where you put food in and burn it off in the heat turns into energy where a chemistry is set. And when you introduce chemicals, other chemicals are introduced in response in order to break them down and those are enzymes, those are hormones. At the end of the day, it’s a chemistry set. And at the point where you are showing that two people are having the opposite responses to two foods, the implication is that the chemistry that’s happening in their bodies is also very different from those two foods. Now, we need more studies in order to demonstrate explicitly whether insulin levels are rising at the same rates for the two different foods or whether they’re opposite. But at the end of the day, what we can show is that by measuring an output to specific actions we’re taking. We can start to become more nuanced about our individual approaches and we can bias away from kicking the system repeatedly. The interesting thing about metabolic dysfunction is that it does not manifest in one way for all people.

Not all unhealthy people gain weight

It’s easy to think of weight gain as the only indicator of poor health. But as Josh discovered firsthand, that’s not the case.

The reality is that some of us do not gain weight. Our, what we would call a phenotype, which is the way that our genes sort of express in the real world, do not bias towards weight gain for whatever reason. However, for those of us like myself, never had a problem with weight gain, but was having extreme, I was having symptoms throughout my life. And most of it was oriented around mental clarity, around fatigue, general malaise. That was the way that my erratic blood sugar and insulin control was manifesting for me. And what’s interesting is that my family, we don’t have a lot of weight gain or type 2 diabetes. What we do have is dementia and cardiovascular disease that runs in my family. And so, understanding more about the nuance of metabolic dysfunction and how it manifests for different people has really helped me to embrace the fact that weight is only one of the potential outcomes. And each of us has a responsibility to understand the potential outcomes for the choices we’re making.

Treat your health like a bank account

Your overall health is comprised of deposits (good lifestyle and diet) and withdrawals (bad lifestyle and diet).

Imagine that you were given a bank account and you’re never allowed to check it except once a year. And there are deposits and withdrawals happening all day every day. And you’re told, “Do not overdraw this account, otherwise you die.” This is similar to what we’re doing. We’re depositing and withdrawing from this bank account every day, hundreds of times a day and we’re not checking the balance except one second once a year. It’s nearly impossible to balance that equation. And so, if we can increase the amount of information available to the individual in an effortless way and make it interesting, engaging and actionable, people can start to make better choices for themselves. They don’t have to worry about the average person or about society in general. And then once you do that times enough people, you’ve sort of changed society.

Not all “healthy” foods are good for you

One important education point that Levels can prove is that not all foods collectively recognized or marketed as healthy are good for you.

Just eating straight-up sugar is always going to show up on the CGM negatively, right? So, there is no person who can just pound Skittles and they’re going to be fine. Their blood sugar is you’re just dumping so much refined sugar right into the bloodstream, there’s nothing your body can do about it. It’s really bad. I think we need to raise awareness of that, but most people know that. Where it starts to get interesting is when you’re looking at people who are eating foods that they think are objectively healthy, based on what they’ve learned. And a great example of this is oatmeal. And yet, they’re getting a counterintuitive negative response. And so, foods like oatmeal, which are just basically refined carbs without really any balance in the meal. There’s really only one macronutrient there, which is carbohydrate. They tend to overwhelm the system. And so people, last time we dug deep on this, oatmeal was one of the top worst performing foods in the data set.

Beware of the juice cleanse

Fruit can be good for your body, but typically not when concentrated as juice or taken in excess. More is not always better.

Oftentimes, people are going on juice cleanses, thinking that this is going to just detoxify and purge the bad food they’re eating from their system. The reality is that if you eat whole fruits and whole vegetables, you’re getting all of the fiber and the matrix that that carbohydrate that’s in the juice is supposed to be suspended in. And that will slow digestion and allow you to process the meal more effectively. And I think we have in society, a lot of this sort of “If some is good, more is better” philosophy. So, if an orange is good, we should strain out all the pulp and drink 10 of them in one sitting. And these are the types of lessons that you can learn very quickly that, that’s actually not quite the case.

Movement is your secret weapon

Even if you cave and enjoy an indulgent meal, there are things you can do to offset the impact, such as take a walk afterwards.

In general, the secret weapon is movement. So throughout the dataset and we build challenges through the app to help people do this. But when you eat an indulgent meal, we recommend that you take 15 or 20 minutes right afterwards and just take a walk. And the activation of the large muscles in the posterior chain pulls glucose directly out of the bloodstream without any insulin. And so that is truly like it’s the trump card. It’s the thing that you can do no matter what to help improve your blood sugar response even to the most sort of egregious carbohydrate and insult at any time. And so, these are the sort of tactical pieces that for each individual, there’ll be varying degrees of effect, but they hold for almost everyone.

Josh Clemente: Last time we dug deep on this, oatmeal was one of the top worst performing foods in the data set and I think what’s interesting about that is that a lot of people are eating oatmeal, because they’ve heard that it’s “heart healthy” and if you Google healthiest breakfast, oatmeal is going to be in the top three on every list you look at. And I think that’s part of the sort of misguided marketing or I’m not entirely sure how, but it’s in some way, because there is some fiber in oatmeal, it has this reputation.

Josh Clemente: When you actually look at it, it’s again, just carbohydrates and it’s actually fairly processed. And so, they break down very quickly and most people have a very large blood sugar elevation, and then a crash and that crash is associated with more insulin release. And oftentimes, the sensations of hunger and irritability and fatigue that I described, and you’re looking for your next meal two hours later. So, oatmeal is a really big one. You can dig into the specific benefits of more processed version of anything.

Doug Bopst: I’m Doug Bopst, personal trainer, bestselling author and entrepreneur, and I’m on a mission to help others become the best version of themselves. So, I’d like to welcome you to the Adversity Advantage Podcast, where we will help you use obstacles, failures, and setbacks to give you that edge needed for success. I’ll be interviewing people from all walks of life on how they overcame trials and turn them into triumphs. So please, sit back, relax and get ready to be absolutely blown away by some of the wisdom and stories you’re about to hear.

Doug Bopst: Welcome back to another episode of the Adversity Advantage. I’m your host, Doug Bopst. And today’s guest is Josh Clemente. Josh is the co-founder of Levels, which is the first consumer program that lets an individual know how food and lifestyle choices are directly affecting blood sugar and metabolic health in real time. They pair glucose monitoring with intelligence software to support healthy blood sugar levels. Some early users have included professional athletes, bio hackers, the weight loss community, and other health enthusiasts.

Doug Bopst: This chat serves as a great follow-up to the convo I had with Cyrus Khambatta on the pod not too long ago, where we dove deep into the topics of insulin resistance and diabetes. I definitely invite you to check that episode out if you missed it.

Doug Bopst: The dialogue today with Josh, certainly, will touch on these subjects, but we spend quite a bit of time chatting about the incredible technology he has helped to create and the data that has come from it. Josh is also a mechanical engineer and CrossFit level 2 trainer. At SpaceX, he led a team to develop life support systems that in May of 2020 began sustaining astronauts on trips to and from the International Space Station aboard Crew Dragon, which was the first human-rated commercial spacecraft in history.

Doug Bopst: In our conversation, Josh walks you through his “adversity advantage” story, and shares why he decided to leave working for SpaceX after he experienced a health scare of his own that led him down a path of self-discovery that changed his life and inspired him to co-found Levels. Josh shares the benefits of using a continuous glucose monitor and how it can help shift the way we treat metabolic health issues.

Doug Bopst: We talked about how certain foods affect insulin and how some widely promoted health foods can actually negatively impact blood sugar levels. Josh talks about how exercise impacts your metabolic health and flexibility and how certain types of exercise impact blood glucose levels. Our discussion also dovetails into sleep and stress and how they all play into this equation and what you can do to use them to your advantage.

Doug Bopst: Levels is currently in beta mode and not available to the public, but Josh has created a special page for y’all if you want to bypass the 115,000 plus waitlist and purchase one now, in which I will include the link in the show notes. So, let’s get this conversation going. And welcome Josh Clemente to the Adversity Advantage podcast.

Doug Bopst: Josh Clemente, welcome to the Adversity Advantage podcast.

Josh Clemente: Thanks a lot for having me, Doug. This is going to be exciting.

Doug Bopst: I’m super pumped to chat with you. Because, initially, when I heard of the company Levels and continued glucose monitoring, excuse me, I was like, “Does this really work? What’s the point of all this?” And then I thought more deeply into it. And I was like, “There’s a lot there.” Because typically, let’s just say, the average person if they’re lucky to go to the doctor once a year, and they don’t really know what their levels of health are like or they don’t know what their blood work is like.

Doug Bopst: And just say that that day, they get their blood sugar tested. And in that moment, maybe it’s low, maybe it’s normal, but throughout the rest of the day, they could have these spikes that could push them in the threshold of being pre-diabetic, having type 2 diabetes, whatever the case may be. Or there’s also the people that already know that they have pre-diabetes or that they’re diabetic, and they’re pricking their finger once a day. And again, it could be the same thing where they are getting a reading based on that time, but later on in the day, their numbers and sugar levels could go way up and down based on what they’re eating, based on their movement. And I think there’s a lot there to unpack, because let’s face it, 88 million Americans are pre-diabetic right now. And the craziest thing about all this is that 84% of those 88 million have no idea they’re pre-diabetic.

Doug Bopst: But before we dive into this insane technology that you’ve helped to create, I’m interested in knowing what made you make this shift into the health and wellness space when you were working at SpaceX. You were helping, I guess, if I understand correctly, get spaceships off the ground. Now, what forced you to make that change?

Josh Clemente: Well, yeah, it was to make a long story short, it was a sort of a patient zero experience. So, my background is mechanical engineering. I focus on systems engineering, heat transfer, things like this. I wanted to work on cars and/or flying machines. And I didn’t think I’d make it to be able to work on spacecraft. But because I learned from a young age how to build stuff, and SpaceX was kind of an underdog in the aerospace world, they needed people who could not just design but also build, I had the opportunity. I was early. I joined there in 2010, right after they first made orbit.

Josh Clemente: And so, my career was built around scrappy, pulling off solutions to complex problems with scrappy execution. And working in an environment where we were always very close to dying as an organization if we did not achieve success on the next flight. And it was an amazing experience. It got me introduced to the concept of first principles thinking, which is getting rid of the clutter and excess around a problem and just solving the core, sort of function that is necessary in order to achieve success. And seeing that in action was really powerful.

Josh Clemente: So I went through, I was there about six years. And during the last half, I was able to lead a team that was developing the pressurized life support systems for astronauts. So, the equipment we were designing is that which was introducing oxygen into the atmosphere of the vehicle, injecting it into the spacesuits for breathing, making sure that the concentrations and pressures, basically, the environment inside the spacecraft, and the spacesuits is the same as on Earth or as close to it as possible so that people can live. And so, that was an amazing project.

Josh Clemente: And while I was on it, two things were happening. One, I was rapidly hitting a burnout that I had never felt before. Every day was becoming more and more challenging to get through, both mentally and physically. So, I was experiencing these, it’s hard to describe other than just the symptomatic episodes where I would just need to sit down and catch my breath. And by the way, at the same time, I’m a CrossFit trainer. I’ve played sports my whole life. I’ve never had body weight issues. I’m someone who thinks of themselves as objectively healthy.

Josh Clemente: So, this was not making much sense where I’m in the middle of a workday. I’m walking from one meeting to another and feeling like I need to sit down and wipe the cold sweat off my brow. It made no sense. I’m also experiencing a lot of irritation and frustration and just general mood disorder. My sense of humor over who knows how long has suddenly sort of vanished and I feel like I’m constantly aggravated and trying to hold my temper. And so, these things are happening while I’m also in sort of the most stressful and important phase of my career.

Josh Clemente: And secondly, I’m being exposed to a lot of information about the human performance approach that NASA takes to keeping astronauts healthy. So, they have people who are going into orbit, sometimes for up to a year, and they can’t get sick, right? It’s just, there is no urgent care. There’s no hospital system. You can’t get sick when you’re on orbit. And the approach there was very much taking a lot of data and building an intentional lifestyle with it. And I came across one paper.

Josh Clemente: And so this was, by the way, it was obvious that this was very different from the way I was living my life. It’s like I had zero data that was guiding my decisions every day. I was doing things that I Googled or that somebody else did, who was jacked in the gym. It was like there was nothing that was driven by data. And so finally, the piece that really got my wheels turning was I read a paper by Dominic D’Agostino, who’s a researcher at the University of South Florida. And this paper discussed, it was very explicitly connected to my oxygen project that I was working on. Where if you’re exposed to too much high pressure oxygen, it’s a very reactive molecule, it can basically start to attack the tissues in your brain and you can experience central nervous system shutdown.

Josh Clemente: And so, Dom was studying the effects of a ketogenic diet on protecting, rodents in this case, from that environment, so by giving them a ketogenic diet, they were able to extend the lifespan of these rodents for up to five times the length of time without a central nervous system shut down. And that was just by feeding them different macronutrients, in this case, ketogenic diet. Obviously, it’s a higher fat content. It allows your body to produce ketone molecules, which can cross the blood-brain barrier and provide energy to the brain.

Josh Clemente: So, reading that study totally blew my mind because up until that point, I was a person who believed very strictly in calories or calories. And whether it’s broccoli or Skittles, the energy content is all that matters, there’s nothing else going on. And so, the fact that just a macronutrient change, just getting more fat in the diet, basically gave these mice what amounted to a superpower was earth shattering for me. And I needed to know more. And so, I started on the side to just dive deep into the biochemistry and nutritional implications of different dietary approaches.

Josh Clemente: And I started to prick my finger to measure blood sugar, because that’s the primary energy molecule for most people. And I was feeling these energy fluctuations and I was thinking, “Hah, maybe I’ll find something.” Long-story short, I would get a cloud of data in the morning, a cloud of data after work, nothing in between, and it gave me no information. I went to my doctor. I had a bunch of bloodwork done. Everything came back totally normal. Business as usual.

Josh Clemente: A few weeks later, I read a book called Wired to Eat by Robb Wolf and in it, he discussed this technology called a continuous glucose monitor, which allowed you to take measurements of blood sugar on an ongoing basis wirelessly. And so, this is exactly what I wanted. I was like, “That’s the missing link.” I asked my doctor for one, and he flat out denied me and was somewhat patronizing in the sense that he said I am wrong to want this. “You do not need this thing. It’s for people who are sick. You’re not sick. As we know, I took one data point and told you that.”

Josh Clemente: And so, I came away from that conversation even more confused. Why is it that I have to ask someone else for access to the data that my body is generating for information purposes? And secondly, why and this is coming from a systems engineer, why would I wait until something breaks before I start measuring it? In the world of systems engineering, you design these systems such that you can measure anything that you don’t want to break well in advance and so that you capture the failure mode when it happens, and you can ideally prevent it from happening.

Josh Clemente: So anyway, I eventually got a continuous glucose monitor. These are devices. I’m happy to jump into the tech on them in a minute. But I got myself one, and within about a week realized that I was either pre-diabetic or borderline, depending on who you ask. And this was based on the real-time data that was coming from the device, not the morning fasting glucose prick, which is what my doctor took. And so, I went into kind of just, this became my passion.

Josh Clemente: And I went into changing my approach to daily decisions on making around nutrition, exercise, sleep and stress. I was able to completely change my blood sugar control with this little device and realized, there’s a huge potential here to make this technology the future of wellness and to help reverse the trends of metabolic dysfunction in this country and globally that are driven by people flying blind. Every day making decisions that are not driven by data. And so that was kind of the origin.

Doug Bopst: And I think what’s interesting is this story that you hear from your doctor. Again, I’m not a person who’s against traditional medicine, but I do think there is a lot of room to incorporate proactive approaches to your health. That’s what’s going to solve this epidemic that we’re in, right? This obesity epidemic. This pre-diabetic epidemic. It’s going to be the result of people taking control of their health, control their decisions and doing the things at home that are going to better themselves.

Doug Bopst: Because like I said, at the beginning of our conversation, if you go to the doctor once a year and if you go to the doctor once a year, which a lot of people don’t and during that one time you get pricked to see where your blood sugar is at, that’s one time. Again, if you go to the doctor, that’s one minute, one minute out of the entire year where you’re going to actually see your blood sugar. You’re not counting all of the other times throughout that year where your blood sugars are going to have these massive spikes up and down.

Doug Bopst: And where I think I want to go with the conversation, I want to dive into the tech of this because I invite those who want to get more of an understanding on pre-diabetes and insulin resistance to go listen to the podcast I did with Cyrus Khambatta of mastering diabetes, where we went super in depth on this. But I think with you, Josh, I think there’s another kind of hack that you have unpacked is this ability to track data using a device, so you can actually see what actually works and what doesn’t work when it comes to maintaining healthy insulin levels, maintaining healthy blood sugars. So, why is it so important for people to continually track their blood glucose levels in your research and what you’ve learned versus just getting your finger pricked once a day if you’re somebody who has diabetes or prediabetes?

Josh Clemente: Yeah. Well, so first of all, it’s really an astute point that we’re measuring, we’re basically extrapolating all of human health based on a single data point that represents one instant. It’s not even a minute, it’s one instant at which we measured your glucose and then we’re extrapolating that to your entire health. So, metabolism is the set of processes that take our food and environment and turn them into energy. And if our cells cannot do that effectively and efficiently, then we cannot achieve physical health or mental health because our brains and our bodies are made up of cells which require energy, right? So, this metabolic health layer underlies health entirely.

Josh Clemente: And so the fact that we are extrapolating from single data points is that in other industries, it would get you fired to do the equivalent. And I’m not saying that, I’m not blaming anyone other than just the system itself is not currently providing us enough insight. To loop back quickly on the medical system, right now, we have a burden of chronic illness in our country that far exceeds that 88 million people who have pre-diabetes. Over 120 million Americans have pre-diabetes or type 2 diabetes, both of which are preventable. And so that’s where we need to be focusing.

Josh Clemente: And we’re not even talking about the other comorbidities associated like cardiovascular disease, stroke. Alzheimer’s disease is being called type 3 diabetes, because of the insulin resistance in the brain that it accumulates. Cancer has metabolic roots. There is so much chronic preventable illness in the world that our medical system, which was previously supposed to care for those who had experienced accidents or had terminal illnesses and diseases that were communicable. We have now basically pivoted to just treating lifestyle-related chronic illness.

Josh Clemente: And so, if you can imagine a world where, and by the way, in 2018, the University of North Carolina ran a study that showed that 88% of American adults have some metabolic dysfunction. So, if you imagine a world where that, the burden of controlling chronic illness or preventing it was not on your doctor, but it was actually on you, the individual. And physicians could instead focus on the truly nonpreventable illnesses, and helping those who have terminal illness and maintaining sort of a sickness-oriented approach as opposed to a prevention-oriented approach, we would unlock a tremendous amount in both directions, right?

Josh Clemente: So, that’s what Levels ultimately seeks to do is to close the loop for the individual between the actions they’re taking and the reactions your bodies are experiencing, right? That is the end goal is that people learn from feedback. You can’t take one data point once a year and figure out what to do for lunch, right? That’s what Levels can do. You sit down, you’re going to eat a meal for lunch, what are you going to eat and why. Today, I ask that question, most people look at me and give me a blank stare and say what I would have said three years ago. I mean, I don’t know. It’s going to taste good. It’s going to be something I probably read about on the internet, or someone recommended to me. Other than that, I’ve got nothing.

Josh Clemente: And so, this is where technology can fill the void tremendously is to enforce for people that the decisions you make every day stack up into an outcome. They compound on each other and it’s not just about food. It’s also about stress. It’s about exercise. It’s about sleep quality. But all together, if we have insight into them, we can start to tease apart the dependencies. And rather than it being some abstract thing you read about in the textbook, it’s “Oh, that meal was a nine out of 10 for me, or that meal is a two out of 10 for me.” And this is based on biological data that I’m collecting in real time.

Josh Clemente: It’s a real paradigm shift in how we think about providing advice on lifestyle. We can move away from generalities like eat healthier and workout more. And start specifically saying, “You are the type of person that responds well to fruit sugars and you’re the type of person that responds well to grain sugars.” Because there’s so much individual variability at stake, it’s really hard to provide a one-size fits all solution.

Josh Clemente: So, I’m glad you touched on your episode with Cyrus. I thought it was awesome. There’s so much nuance, again, in the individual that I think when it comes down to just saying like ketogenic diet or a plant-based diet, it’s like those are tools in the toolset. And you, the individual, can decide based on data, ideally, what works best for you. And I’m certainly not here to say everyone should be ketogenic. I’m not.

Josh Clemente: I eat hundreds of grams of carbs, but the way that I eat them is very data driven. It’s mostly fiber. It’s always in a mixed meal with balanced macronutrients, including protein and fat. And I exercise a lot around those more indulgent meals. And so, those are the things that I’ve learned through that real-time data introduced to me through this device.

Doug Bopst: Yeah. I want to touch on a an important point that you made where it talks about you can’t base your lifestyle based on one data point. I want people to listening to this to imagine. Let’s just say that you had no idea what your weight was unless you stepped on a scale. And let’s just say that your stomach didn’t expand, none of that happened, right? Because, I mean, that’s typically how we can tell if we gained weight. Imagine if you only go to the doctor once a year and that’s the only time you could weigh yourself, how unhealthy would we be, right?

Doug Bopst: We would have no clue what our weight was. We’d have no clue what our body fat was. We’d have no clue what our health was like. And so, I think with this technology, the one thing that really fascinates me because I’m somebody who likes to be able to track stuff. I want to be able to know where I’m going. I want to be able to know where I’m at. Because then you could start to see trends, so if you’re wearing something like this. And it’s a patch, and you wear it, I believe in the back of your arm.

Doug Bopst: And you can start to see, let’s just say for instance, that you’re somebody who likes to eat keto or you’re somebody who likes to eat plant-based or whatever nutrition approach you follow, you could say like, “How does it really impact my blood sugar over the course of a week, over the course of a month, over the course of two weeks?” And then here’s the other thing that I think is cool. Imagine, we all hear what stress does to our body and how we “will gain weight if we’re stressed because of what it does to our insulin levels.” Now imagine if you’re able to track what your blood sugar is like during times of stress. And it’s going to hopefully fire people up even more to take better care of themselves when they are stressed.

Doug Bopst: So, I just wanted to bring that up because I think that was an important correlation for people to make. Because I’m sure there’s a lot of people that are listening to this who are like, “Oh, I’m healthy or why do I even need to bother with my blood sugar? I know I’m in good shape.” But you thought that kind of, too, based when you were working at SpaceX. And there’s a lot of people that have no idea how unhealthy their vitals are until sometimes it’s too late.

Josh Clemente: Definitely, there was a study in 2015, at the Weizmann Institute. And basically what they did is they put continuous glucose monitors on 800 people and these people did not have diabetes. And they then had them eat standardized meals over the course of about a week. And at the end of the study, they showed that two people can eat the exact same two foods, in this case, it was banana and a cookie made with wheat flour. And they can have equal and opposite blood sugar responses to those two foods. So, one person spikes on the bananas, flat on the cookie, the other person spikes on the cookie and is flat on the banana.

Josh Clemente: And the implications here are, the human body is not an oven where you put food in and burn it off in the heat turns into energy where a chemistry is set. And when you introduce chemicals, other chemicals are introduced in response in order to break them down and those are enzymes, those are hormones. At the end of the day, it’s a chemistry set. And at the point where you are showing that two people are having the opposite responses to two foods, the implication is that the chemistry that’s happening in their bodies is also very different from those two foods.

Josh Clemente: Now, we need more studies in order to demonstrate explicitly whether insulin levels are rising at the same rates for the two different foods or whether they’re opposite. But at the end of the day, what we can show is that by measuring an output to specific actions we’re taking. We can start to become more nuanced about our individual approaches and we can bias away from kicking the system repeatedly. The interesting thing about metabolic dysfunction is that it does not manifest in one way for all people. We have in our minds as a society that metabolic unhealth is something like having a slow metabolism or a fast metabolism. And that you will either be heavy, very overweight if you have a slow metabolism or you’ll be very lean and that that’s either unhealthy or healthy.

Josh Clemente: The reality is that some of us do not gain weight. Our, what we would call a, phenotype, which is the way that our genes sort of express in the real world, do not bias towards weight gain for whatever reason. However, for those of us like myself, never had a problem with weight gain, but was having extreme, I was having symptoms throughout my life. And most of it was oriented around mental clarity, around fatigue, general malaise. That was the way that my erratic blood sugar and insulin control was manifesting for me. And what’s interesting is that my family, we don’t have a lot of weight gain or type 2 diabetes. What we do have is dementia and cardiovascular disease that runs in my family.

Josh Clemente: And so, understanding more about the nuance of metabolic dysfunction and how it manifests for different people has really helped me to embrace the fact that weight is only one of the potential outcomes. And each of us has a responsibility to understand the potential outcomes for the choices we’re making. And today, that responsibility is very challenging because, as you mentioned, it’s like, I actually to use a different analogy than the scale.

Josh Clemente: Imagine that you were given a bank account and you’re never allowed to check it except once a year. And there are deposits and withdrawals happening all day every day. And you’re told, “Do not overdraw this account, otherwise you die.” This is similar to what we’re doing. We’re depositing and withdrawing from this bank account every day, hundreds of times a day and we’re not checking the balance except one second once a year. It’s nearly impossible to balance that equation.

Josh Clemente: And so, if we can increase the amount of information available to the individual in an effortless way and make it interesting, engaging and actionable, people can start to make better choices for themselves. They don’t have to worry about the average person or about society in general. And then once you do that times enough people, you’ve sort of changed society.

Josh Clemente: I want to quickly zoom in on the technology itself. You mentioned, it’s a patch on the back of the arm. So, for people with diabetes, this whole glucose control issue is extremely acute. If you have diabetes and you’ve lost the insulin sensitivity or if you have type one diabetes and your body no longer produces insulin, high blood sugar can start to be extremely acute, and it could start to destroy tissues in real time and gets very dangerous. So it’s very important that you can measure very quickly, the blood sugar levels that you have circulating in your body.

Josh Clemente: And so, for that reason, this technology was developed to allow people to wear a little patch on their arm. It’s got a small filament that sticks in the skin and that filament is actually interacting with glucose molecules and measuring them directly. And then it sends that wirelessly to your phone. It’s a real, it’s a miracle of technology. And it was developed explicitly for this diabetes case.

Josh Clemente: Now, we’re at the point where the CGM Tech has evolved quite rapidly and has come down in price, has gone up in availability and supply. And it’s now at the point where we can start to sort of open it up to this much larger space where it’s not just for the management of a condition, but you can start to use it to understand the implications of lifestyle. And so that’s where we are today where Levels is building upon that hardware platform, but adding on the layer of insight and action ability to take that sort of raw glucose data.

Josh Clemente: And then help you understand, Well, what does that mean for lunch? What does that mean for dinner? How well did I sleep last night or how poorly was my sleep due to what I ate for dinner yesterday? Those are the types of things you can tease out with behavior change platform built upon this hardware.

Doug Bopst: I think it’s really cool that you’ve intertwined your background in CrossFit. Your background, obviously, with CrossFit comes with some level of education and nutrition and movement with your engineering background. And everything that you learned with what technology working at the companies that you did in the past. And you’ve kind of created like a Tesla, if you will, with this app, because it’s just got all the bells and whistles to be able to not only change the trajectory of how we manage our blood sugars, how we manage diabetes, stuff like that. But like you said, our behavioral health, how we make decisions, our self-awareness, how we can begin to learn how our decisions that we make every single day impact our health.

Doug Bopst: I wanted to ask you, I know you’re a data guy, and you guys have taken a lot of data with what’s worked with people’s blood sugar levels. So I know from just what I’ve read and what I’ve learned that managing blood sugar, like you were saying this a few minutes ago, is very individualized. But what are some of the staples of things that you’ve seen just completely with everybody would just throw off blood sugar levels? And what are the staples that have helped stabilize blood sugar levels, if you could pick a few?

Doug Bopst: We will get you back to this episode of the Adversity Advantage in just one second. But first wanted to let that this podcast is brought to you by Paleovalley. I think I have found a new addiction and that’s the Paleovalley Beef Sticks. When I first came across these, I was honestly quite skeptical being that most beef sticks are highly processed, unhealthy and gross. But after trying the ones from Paleovalley, I was instantly sold, not just for the taste, but because they are grass-finished, grass-fed and fermented. Plus, the company is family owned and accessible, which seals the deal for me.

Doug Bopst: So many people ask, “How can I get more protein in my diet when I don’t have the time?” Paleovalley has you covered with their high quality beef sticks. I have even been recommending them to my personal training clients. They come in many flavors, but personally I am digging the summer sausage and teriyaki. So, if you’d to give one of the best healthy snacks on the market a try, go to paleovalley.com and when you enter in the code “Doug” at checkout, you’ll get 15% off. Again, it’s paleovalley.com and when you enter in the code “Doug” at checkout, you’ll get 15% off. Now, back to the show.

Josh Clemente: Yeah, it’s a great question. It’s something that we write a lot about this on the Levels blog by the way. So, there’s a ton here. There will continue to be more as we unpack and get larger and larger datasets. But we talked about this at the beginning. I’m someone who eats more of a sort of mixed, maybe paleo biased diet. And I certainly eat animal products and a lot of green leafy vegetables, lots of fiber, lots of protein and fat.

Josh Clemente: My co-founder, Casey Means, she’s a functional medicine doctor, former surgeon from Stanford. She’s fully plant-based and both of us are using levels platform and CGM to develop a lifestyle or a nutrition approach that provides balanced glucose for us. And that’s the beauty of this technology is that it doesn’t pick sides. It doesn’t say, the CGM will not tell you to be keto and it will not tell you to be plant-based. But it will tell you dependent on your philosophy towards life, your dietary philosophy, what specifically is working and what is not working.

Josh Clemente: So, there’s a ton of nuance. You can zoom in all the way down to the individuals who are plant-based or zoom all the way out to the entire group. There are trends that holds for everyone. So, just eating straight up sugar is always going to show up on the CGM negatively, right? So, there is no person who can just pound Skittles and they’re going to be fine. Their blood sugar is you’re just dumping so much refined sugar right into the bloodstream, there’s nothing your body can do about it. It’s really bad. I think we need to raise awareness of that, but most people know that.

Josh Clemente: Where it starts to get interesting is when you’re looking at people who are eating foods that they think are objectively healthy, based on what they’ve learned. And a great example of this is oatmeal. And yet, they’re getting a counterintuitive negative response. And so, foods like oatmeal, which are just basically refined carbs without really any balance in the meal. There’s really only one macronutrient there, which is carbohydrate. They tend to overwhelm the system. And so people, last time we dug deep on this, oatmeal was one of the top worst performing foods in the data set.

Josh Clemente: And I think what’s interesting about that is that a lot of people are eating oatmeal, because they’ve heard that it’s “heart healthy.” And this is if you Google healthiest breakfast, oatmeal is going to be in the top three on every list you look at. And I think that’s part of the sort of misguided marketing or I’m not entirely sure how, but it’s in some way, because there is some fiber in oatmeal, it has this reputation.

Josh Clemente: When you actually look at it, it’s, again, just carbohydrates and it’s actually fairly processed and so, they break down very quickly. And most people will have a very large blood sugar elevation, and then a crash. And that crash is associated with more insulin release. And oftentimes, the sensations of hunger and irritability and fatigue that I described, and you’re looking for your next meal two hours later. So, oatmeal is a really big one. You can dig into the specific benefits of more processed version of anything. So, if you look at for example, pressed juice versus whole fruit.

Josh Clemente: When I had one of my one of my largest glucose excursions ever, it was after not getting much sleep. I was preparing for a presentation. Went to New York. Stopped at a juice cart on the way into a meeting and got what was called health drink, which was pressed celery, pressed carrot juice, and pressed apple. And I drank this during my meeting. And by the end of the meeting, my blood sugar had more than doubled. It was over 200 milligrams per deciliter.

Josh Clemente: For people who aren’t familiar with the ranges, unless you’re pre diabetic, you should not exceed 140 after a meal. And so, I was over 200 from this pressed juice, which most people would think is very clean. And oftentimes, people are going on juice cleanses, thinking that this is going to just detoxify and purge the bad food they’re eating from their system. The reality is that if you eat whole fruits and whole vegetables, you’re getting all of the fiber and the matrix that that carbohydrate that’s in the juice is supposed to be suspended in. And that will slow digestion and allow you to process the meal more effectively.

Josh Clemente: And I think we have in society, a lot of this sort of “If some is good, more is better” philosophy. So, if an orange is good, we should strain out all the pulp and drink 10 of them in one sitting. And these are the types of lessons that you can learn very quickly that, that’s actually not quite the case. A couple of other interesting findings are that regardless of your approach, if you’re going to eat more carbohydrates. Let’s say that you decide, even though I’m a person who has a fairly negative response to flour.

Josh Clemente: If I decide I’m going to eat some bread with dinner, we found that the macronutrient order, so if you eat, for example, a full meal, including vegetables, protein and some fat prior to eating the more refined carbohydrates, that fiber and the vegetables themselves can actually slow down the rate of digestion and improve the rate that your blood sugar elevates and lower it significantly as well as your insulin response. And this is shown in several studies. We’ve also been able to demonstrate it in our data set.

Josh Clemente: So, what I’ll do is rather than having the bread first, most people will have the bread last and it will be kind of at the end of the meal, I’m mopping up the sauce on my plate, and it’s great, and I also have a much better response. And then in general, the secret weapon is movement. So throughout the dataset and we build challenges through the app to help people do this. But when you eat an indulgent meal, we recommend that you take 15 or 20 minutes right afterwards and just take a walk. And the activation of the large muscles in the posterior chain pulls glucose directly out of the bloodstream without any insulin.

Josh Clemente: And so that is truly like it’s the trump card. It’s the thing that you can do no matter what to help improve your blood sugar response even to the most sort of egregious carbohydrate and insult at any time. And so, these are the sort of tactical pieces that for each individual, there’ll be varying degrees of effect, but they hold for almost everyone.

Doug Bopst: That’s so interesting. And I love how you pointed out the movement piece because I think that’s going to be something that is going to be crucial for anyone looking to make any kind of change in their health. I don’t care if it’s somebody trying to lose weight, improve their blood, sugar, become more metabolically flexible, you got to move your body, right?

Doug Bopst: And I think what happens is people try to pick one thing without doing the other. For instance, people will start working out and they won’t change your nutrition, or people will change your nutrition and they won’t move their body and you have to do both. Not that you have to go and spend hours in the gym and then go completely plant-based or paleo or going to an extreme very quickly. But I think there has to be some level of change in both aspects of the health, right?

Josh Clemente: Right. It’s all context and these decisions, they stack on each other. So the fact that, as I mentioned, taking a 20-minute walk can completely modify your blood sugar response to a meal. That’s indicative of the way that our decisions all blend together. It’s not just, it’s not like avoid that food all together or eat that food solely, it’s how are you living day to day is. You basically have the four big levers – nutrition, exercise, sleep and stress. That’s, those all are the lifestyle decisions you’re making. And they lead to an outcome over time and these things compound.

Josh Clemente: And so, for example, you could be eating an excellent diet, not exercising often and sleeping terribly or not at all. And you can become extremely metabolically unhealthy due to just the elevation in cortisol from not recovering and then cortisol interferes with insulin and glucose control. And so, you can actually induce insulin resistance in people by just depriving them of sleep, acutely. So, all of this stuff can be sort of for naught if you’re not paying attention to the other legs of the stool. So, that’s like that’s a big piece here.

Josh Clemente: One of the most amazing lessons I learned through CGM was the impact of stress. We talked about briefly at the beginning, but it was actually a podcast episode that I was recording and I wasn’t very comfortable and certainly was feeling stress and my blood sugar throughout started to climb. And so, my heart rate is climbing, my blood sugar is climbing, and I peaked at over 140 milligrams per deciliter, which is typically above the pre-diabetic response to a meal, and I have eaten nothing. And so, that’s the effect of cortisol being released. Just being in a fight or flight scenario and having my body basically triggering a flood of glucose into my bloodstream, because I wanted to escape the threat is sort of what the prehistoric roots of that response are.

Josh Clemente: But imagine in a world where you’re constantly experiencing stress over and over and over again, you’re triggering these pathways of glucose release and insulin release without exercise to compensate for it. You’re basically triggering the equivalent of a very poor dietary approach, kicking the system with these floods. And you’re going to experience all the qualitative negative effects of a poor diet as a result, potential weight gain. And certainly just the, I think, elevation and stimulus associated with high cortisol levels, which invariably over time lead to I think longer or poor metabolic and cardiovascular outcomes. And so, it’s really interesting to see those sorts of things happening to you in real time with this device.

Doug Bopst: And I want to dive more into the non-food related things that can impact blood sugar levels like exercise, sleep, stress. I’m trying to figure out where I want to start. I think where I want to go, though, first is to talk about the sleep. But what I want to know is a couple of things like in the research, has there been a sweet spot as far as quantity of sleep? Because I do know that it’s not just quantity, its quality? And what are some quick hacks that you use in your own lifestyle that have proven for yourself to improve your quality of sleep over time?

Josh Clemente: Yeah. It’s a good question. Some of the statistics are pretty interesting to look at related to sleep, and sort of metabolic dysfunction. So, the numbers are Americans are sleeping 25% less on average than we were 100 years ago. And over that same time period, diabetes went from less than 1% of the population to almost just about 10%. So again, I think it points to the same general direction that we’re moving, which is that we’re burning the candle from all directions. And so when it comes to the sweet spot for time, we haven’t honed in on the individual. I think it is actually individually dependent, but there have been a number of studies which have discussed the effects of an acute bout of poor sleep.

Josh Clemente: So, one study that I touched on a second ago was just they deprived a group of good sleep for just a single night. And the next day, they had 40% slower glucose clearance from the bloodstream, right? So, that means they basically are 40% more insulin-resistant than they previously were. And another study showed that normal weight individuals, who often slept less than six and a half hours per night had to secrete about 50% more insulin in order to clear the same amount of glucose out of their bloodstream, right? So it seems to indicate that less than six and a half hours is detrimental. What the exact number is, whether it’s that magic eight number or not, I think it’s probably individual dependent.

Josh Clemente: So for me, I’ve kind of taken these things to mean that I should strive for at least seven and a half hours of sleep. That’s where I tend to, if I get less than that, I’ll tend to wake up groggy, and I’ll see a bit of an elevation in my baseline glucose. And I certainly, in order to achieve restful sleep, not just the duration, I try to wind down and also stop eating anything within about three hours of my bedtime. And I think that’s the biggest, if I was going to say anything that’s worked well for me, it’s removing that digestive energy requirement while I’m trying to sleep.

Josh Clemente: So, late night snacking, having late dinners, especially big meals after, say, 7:00 PM is just, it’s going to put me into a very light sleep throughout the first say four or five hours. I won’t get into that deep restorative sleep and hit those cycles. So, that’s the biggest one I would recommend is just truncating the eating time, winding down as early as possible. And getting at least, it seems like at least six and a half hours, but ideally closer to that eight, which seems to be what our friends at Whoop and Oura and others are showing with their wearable data.

Doug Bopst: So, are you begin to fasting, too? Because I’ve had multiple people on here, we’ve had the conversation on the positive effects of fasting on blood sugar, which might be counterintuitive to a lot of people because they’re like, “Oh, we need food. I’m going to have a low blood glucose or my blood sugar levels are going to drop if I don’t eat.” But I think what the research is starting to show is it can have the opposite effect where you can actually stabilize your blood glucose levels over time. Is that what you’re seeing it with yourself? I mean, do you fast?

Josh Clemente: I do not. I don’t fast. I don’t do continual sort of time restricted feeding type thing as much right now, but I like to do extended fasts, certainly, a couple of times a year. And what’s amazing about it is I had a similar opinion about what would happen to my body if I stopped eating. And I just assumed, “Oh, blood sugar is going to continually drop until it’s at zero, and then, I will obviously be dead.”

Josh Clemente: The reality is that your body is built with really elegant machinery to account for this. And so, when you do an extended fast and I’ve done this a number of times, say at 72 hours, your glucose has hit just a flatline exactly where your stasis point is. And for me, that’s something like 70 milligrams per deciliter and my blood sugar is just rock solid and flat. And what’s happened is that my body is starting to produce ketones from my adipose tissue, from my body fat.

Josh Clemente: And it might sound like, “Oh, if I’m a lean person, I don’t have body fat.” The reality is that a person with 10 to 15% body fat the average weight, 10 to 15% body fat has close to 80,000 calories of fat stored on their body and only about 2000 calories of glucose stored as glycogen. So, we have a tremendous supply of body fat, even the leanest amongst us and it’s not something where a single day without meals are going to cause a problem.

Josh Clemente: And so, the mechanism that seems to be beneficial, there’s two mechanisms. One, if you’re constantly eating and again, we’re at that chemistry set, you introduce chemicals, other chemicals are being released in response. Over time, if you’re biasing towards say a high-processed carbohydrate, low exercise lifestyle, your body’s releasing insulin constantly in response to all these carbohydrates and you’re not burning it off. So, that your glycogen stores are topped up, your glucose is high in the bloodstream, your insulin is high, because it’s trying to get those cells to open up and let the glucose in.

Josh Clemente: And when you remove that stimulus, you remove the glucose, your body no longer needs to be releasing insulin. And so, it will immediately stop producing more insulin. And then you’ll start to tap into those stores, that’s the fuel tanks that are topped off with glycogen. You’ll burn that off, and then your body has to kick over to body fat, and you’ll start to burn body fat. And so, you’ve reached a low for both glucose and insulin in the blood. And that provides your body at an ability to sort of like you’ve cleaned out the stores and you can start to reset insulin sensitivity. And it seems to be really powerful.

Josh Clemente: People like Dr. Jason Fung, who runs a weight loss clinic that’s based on fasting. Dr. Peter Attia a lot on his episodes about the benefits and about the other mechanism of autophagy where as those sorts of autophagy mechanisms kick in, you start to recycle the cells that may not be performing as well as they previously did. Your body is basically selecting for efficiency. And so, those are some of the benefits that fasting seems to have in the research.

Josh Clemente: And I definitely do it because I just feel good afterwards. It seems a really good reset. Of course, you’re going to lose some weight. So that’s the thing for me as I’m trying to maintain weight balance and not lose too quickly in some cases, so I don’t go super long.

Doug Bopst: Yeah, yeah. That makes that total sense. And I think, any time you can… I mean, because I think what happens is a lot of people like you said, they have this notion where, “It’s going to mess up my blood sugar levels. It’s not going to be positive. I’m not going to be able to produce the right amount of glucose,” or whatever the case is. And then you actually do it and because you’re tracking it, you’re able to actually see raw data on what the truth actually is.

Doug Bopst: Because I think what happens, too, it’s almost a placebo effect in our mind where we’re thinking that we’re not going to be able to have energy or have blood glucose going through our system or whatever. That’s going to play into it and we’re going to spiral out of control. We’re going to create stress. We’re going to do all this stuff to our head, and it’s going to result in throwing our levels off anyway. But I think when you’re wearing this technology, or wearing something that you’re using to track this, you’re actually able to see in real time like, “Well, what is it doing? Is fasting right for me?” Because again, it’s the individual approach is what’s absolutely crucial in all of this stuff we’re talking about. And just really deciding what actually works for you.

Doug Bopst: And so, one of the last pieces I want to talk to you about when it comes to managing blood sugar levels in which you’ve seen in the data is exercise, right? Because there’s various forms of exercise and obviously, as a trainer, I would people to engage in all forms of exercise to some degree that fit their plan. Whether it’s resistance training, cardio, yoga, stretching, Pilates, whatever works in their schedule. But have you seen generally speaking that one like trumps the other when it comes to properly managing glucose levels?

Josh Clemente: This is an area of maximum interest for me right now is that there’s such, it’s really an unstudied space of the biological responses to different exercise modalities. And so, I am somewhat of a hyper responder to whatever exercise I’m doing. And what I mean by that is there are two main thresholds. There’s aerobic exercise where you’re mostly running on, you require oxygen and you’re burning a lot of fat. And then there’s anaerobic where you’re sort of at the top end of your output and you’re burning just glucose and it’s an inefficient process.

Josh Clemente: So, I’ve seen that if my blood sugar or sorry, if my heart rate is above about 85% of my max heart rate, my glucose will actually start to spike dramatically. And the reason for that is that I’m in a stressed state. My body is activating those fight or flight pathways, dumping in cortisol and epinephrine. And that is introducing, it’s telling my body to produce more fuel for this workout. This is an intense effort. We got to survive it, produce a ton of fuel. And my blood sugar, I’ve actually been able to, in an intense CrossFit workout, exceed 200 milligrams per deciliter…

Doug Bopst: Wow.

Josh Clemente: … blood glucose. Now, and I’ll loop back on that in just a sec, below 85% of max heart rate, which would be more aerobic, I see the opposite. So, my glucose will just gradually decline and I can actually bonk. So, I can watch my glucose just decline, decline, decline, and then suddenly, I get symptomatic. I get that shakiness. And if I don’t take on some fuel, I’ll actually bonk and feel no energy and kind of crash.

Josh Clemente: And it’s absolutely fascinating because we have other people on our team, one of the early team members, Mike, you can follow him on Instagram. But you’ll see that he will do a fasted marathon, where he fasts for 18 hours and then he’ll run 26 miles and heart rate below 85%, same thing, his glucose is rock solid flat. No dip like I do.

Doug Bopst: Wow.

Josh Clemente: He doesn’t bonk. And so for me, I just don’t have, I think, I have not trained those metabolic flexibility pathways the way that he has. And I don’t have the ability to do so just yet. I need to work my way up there.

Josh Clemente: To loop back to the high intensity stuff, because that blood sugar is spiking, a lot of people assume, “Oh, that’s bad for me. That must be if high glucose is bad, I need to avoid that.” The reality is that it’s very, very different physiologically to have a blood sugar response from an intense workout where your body is producing glucose to fuel your muscle effort than it is to have a blood sugar response to a meal that you’re eating. So, totally different. The implications for health are very different.

Josh Clemente: And actually, that high intensity interval training that causes glucose elevations is associated with short-term and long-term insulin sensitivity. So after you finish that workout, your body is going to use insulin more effectively than before it and that effect lasts for multiple days and over time seems to stack up into much better whole body insulin sensitivity. So, it’s actually a very healthy thing. It’s just that that acute response for some of us like myself can get higher than you’d expect and for others, they don’t have those massive elevations.

Josh Clemente: So, all that’s to say, I think exercise is explicitly healthy and people should be doing it. It’s possible to overtrain. Don’t push yourself way too hard. But for most of us, overtraining is not the problem, it’s undertraining. And so, any movement is better than none. And we’ll all see different sort of nuanced responses, eventually, we will be able to target what is best for you, I think, but today, we just don’t know enough.

Doug Bopst: That’s super fascinating, because I think what you’re saying is when you’re anaerobic, your blood sugar levels are higher, which honestly makes sense in a way because if you think about the foundation of muscle growth is glucose and glycogen. So, that would make sense that when you’re taxing your muscles like crazy in an anaerobic way in the short term, that your body is going to need to produce more glucose…

Josh Clemente: Surely.

Doug Bopst: … because of the physiological effect of it, right? And that’s how you build more muscle obviously is by doing that kind of training. And then the opposite will kind of happen, if you will, when you’re more aerobic. Like you mentioned, one of the people who is early… one of the guys who’s early on at Levels, Mike. When he was running the marathon, his levels kind of stayed fairly consistent, but he was running a marathon and so, he was more aerobic.

Doug Bopst: And so I think that the take home message with the last few minutes of our conversation, we’re talking about stress and sleep and nutrition and exercise is that in order to control our blood sugar levels, one of the big things we can do is take care of our stress. And this includes the way we eat, it includes the way we sleep and include the way we move our bodies that will all help to reduce our stress levels. And while there’s going to be certain things that pop up throughout the day, that are going to increase our levels of stress just as a byproduct of life, these are all things that if you can just control these three essentials, your sleep, nutrition and movement, it will help mitigate a lot of that.

Doug Bopst: So, the last thing I want to go into for a few minutes is, so say somebody wants, is interested and they wanted to try this. They want to get a CGM from Levels, what pops up on the app? What can people expect to see when they’re using it and then how can people get one if they want to?

Josh Clemente: So today, we are early as a company. We’re still in what we call our beta mode, so still developing the software. We do have a finite number of invitations per month where we get people in to experience it, but we’re pushing towards our full launch a little bit later this year. So definitely, on the website where you can sign up for the waitlist and we bring people in from that into the beta and then eventually you’ll have access directly once we can launch it.

Josh Clemente: What Levels does today is it’s very much about what we’re calling metabolic awareness. So, helping people understand the reactions to the actions they’re taking, which is the first step. It’s educational. It’s rather than trying to tell you, “Do this, not that,” it’s more so, “Here’s what happens when you do this.” And so today, it’s all about connecting you with intelligence scores to the choices you’re making.

Josh Clemente: So, whether that’s eating a meal and sitting on the couch, and then eating that same meal the next day and going for a walk, you’re going to get scored on how your body, how your blood sugar responded to that choice or series of choices. And those scores will help you understand explicitly where the benefit lies. And then you get things like prompts and insights about trying different challenges. Say to compare brown rice to white rice to understand the effect of fiber or pressed juice to whole fruit. You can then compare meals and identify the degree of difference between different responses and then you get scored on your entire day.

Josh Clemente: So, you get the zone scores for the activities you select and then you get the whole day score, which is our metabolic score, which really helps you understand tracking in a longer term sense how you’re improving or evolving day-by-day. It’s similar to something like a recovery score for a sleep tracker. And so, that’s what you would experience today in the app is you’d be able to look at the glucose. You’d be able to add logs for your lifestyle, nutrition, exercise and sleep. And then you get those scores to help you sort of follow along with where the lessons are and how to make different ones and explore the boundaries of how your body works.

Josh Clemente: In the future, we’ll be much more prepared I think as the… because we’re some of the first to be doing this, we’re building the world’s largest data set on this specific sort of glucose information tied with lifestyle data. And so, we’ll be able to be much more explicit about, “Okay, now that you have metabolic awareness, here’s what to do if you want to achieve X.” And so, that’s the future we’re heading towards.

Doug Bopst: And people are definitely going to want to be going to levelshealth.com to kind of join the waitlist and be able to get their hands on one of these when it becomes available to them. And it’s just super fascinating. I think people who are listening to this, you’re going to want to check this out. And maybe it’s not for you, but just be aware of the wearable technology space because it is a thing – Oura ring, Apple Watch, Whoop, Apollo Neuro, Fitbit. These are all things that I think are here to stay.

Doug Bopst: Because people when it comes to life, when it comes to their health, when it comes to business, they like to be able to track things. They like to be able to see where they’re going. And if you can track where you are with your finances, why not track where you are with your health. And Levels is going to be, is one of those things that you can actually use to not only check where you’re at, but use it as a tool to improve your overall health. Improve your blood sugar levels to see how you respond to different levels of exercise, stress, that sort of thing.

Doug Bopst: So, Josh has been awesome. Thank you so much. So, if people want to check out more about Levels, its levelshealth.com. Where else can people find out more information?

Josh Clemente: Well, the Levels product is we call it the FirstBit bio wearable because it’s not just measuring sort of heart rate or something superficial. The skin is actually measuring a molecule in your body, so it’s sort of a paradigm shift in the wearable space. And a lot of that, seeing that is really visual. And so, I definitely recommend people follow us on Instagram @Levels and on Twitter as well @Levels. And then the blog, which you can get to right from that homepage levelshealth.com.

Josh Clemente: We put a huge amount of effort. It’s one of the core functions at the company into our educational and content materials. So, if you want to learn about not just glucose, but also all of the cellular machinery and why it’s relevant, both to the population abroad and to you, specifically, I would definitely recommend the blog.

Doug Bopst: Sweet. I will make sure to plug all that stuff in the show notes. I will put the Levels’ Twitter page, Levels’ Instagram and then Levels Health website along with a separate link for the blog. You all are definitely going to want to go check out this product. Check out Levels. Dive more into Josh’s story, which I think is incredibly fascinating.

Doug Bopst: And what I want you to do, just like I asked with most of these episodes is if there was a takeaway, maybe with something Josh said about blood sugar levels, something about sleep, stress, I want you to take a screenshot. Tag myself, tag @Levels with a takeaway or something that you’re going to do today to improve your health. Maybe you joined the waitlist and you want to kind of tell us that this episode inspired you to do so. Whatever it is, we’d love to hear feedback.

Doug Bopst: And we, once again, thank you for listening to this episode of the Adversity Advantage. I’m your host, Doug Bopst. We’ll see you next time.