The Truth about Metabolic Dysfunction and How to Address It Head On w/ Dr. Casey Means on Essentially You

7:47 – From Surgeon to seeker of metabolic health

Dr. Casey Means was a busy ENT surgeon when she got hooked on the question of why so many of her patients suffered from inflammatory issues.

“And what was so interesting to me was that so many of the conditions I was treating in ENT were fundamentally disorders of chronic inflammation. They all were the ‘itises,” the words that have ‘itis’ on the end usually mean there’s inflammation. And so sinusitis, thyroiditis. So I stepped back after about four or five years and said, big picture, why does everyone have chronic inflammation?… And that got me on what was this ultimately absolutely fulfilling and amazing journey towards really a much more holistic practice. Because when you think about it, a lot of chronic inflammation is really rooted in our choices that we make every day. It’s diet, it’s lifestyle, it’s what we’re exposing ourselves to in our food, how much sugar we’re eating, whether we’re getting enough sleep, how we’re responding to acute stress, whether we’re moving or whether we’re sedentary, the toxins we’re exposed to in our food, water, and air.”

 

15:43 – Diagnosing energy breakdowns

When our cells can’t get the energy they need to function properly, physical function begins to break down in a wide variety of ways.

“Metabolism is so critical because this is the way that we make energy from our food and our environment. This is how our body takes substrates that we take in and converts them into a type of energy that we can use. And this is the reality, is that we have trillions of cells in our body. We are made up entirely of cells. That’s the reality. And every single cell for it to work needs energy to function. It needs a usable form of energy, and that’s created from our metabolism. And so you can imagine when that process starts breaking down and your cells are not getting the energy they need to do basic function, we start seeing symptoms emerge, and then we start seeing disease emerge. And so you can imagine, like if that process isn’t going well, it’s going to affect everything. And that is really why the face of metabolic dysfunction is so broad. It’s not just diabetes, it’s not obesity. It can affect every single organ system in the body, wherever that metabolic dysfunction is most showing up.”

17:22 – Snacking leads to spiking

With so much food available to us in modern times, it’s easy for a vicious cycle of insulin resistance to unfold.

“We live in this world of an abundance of energetic substrates. We are not lacking for the building blocks that we can convert into energy. So the way it works in the body is you take in glucose and fat, and our cells can take those in and then convert them into usable sources of energy like ATP. And the issue used to be way back in the day that there wasn’t enough of that. We didn’t have enough food and resources. It was hard to find these things. Now we have sugar and fat, literally everywhere…when there’s too much of that glucose, you’re going to store some of that extra glucose as fat. You’re just going to shuttle it into your fat cells for later use one day. So one, that’s driving the fat storage. But the other thing is when that glucose is going up all the time from all those snacks we’re eating and eating multiple times per day, that’s a lot of insulin spikes that have to happen. And when that insulin starts getting high and that’s happening frequently, our cells get a little confused. Because they’re like, there’s so much insulin around, this is not normal. Why is there so much? And it actually, the cells become resistant to insulin.”

21:22 – Fad diets have limited power

If Dr. Means has learned anything, it’s that everyone’s metabolism is different. A specific diet or food routine won’t necessarily benefit everyone.

“If we’re talking about getting on top of glucose, the next logical question is well how in the world do we do that? We just eat a low-carb diet? Do we eat a keto diet? Do we go carnivore? These are all diets that have been centered around keeping glucose really low. But the issue is one, they’re very restrictive. And two, like you mentioned, everyone has a different response to carbohydrates. So you and I could both take in the exact same carbohydrate rich food, like a banana, and have completely different glucose responses in our blood, which is a little confusing. We’re eating the same food, wouldn’t the same amount of glucose go into the blood? But there’s so many steps between carb in the mouth and actual glucose in the blood. And one of the big things is the microbiome. So how your microbiome processes that the carbohydrate that you eat has a big impact on how much the glucose and how fast it will raise in the bloodstream.”

23:16 – To dial in the perfect diet, you need testing

Traditional testing via a glucometer won’t tell you when you’re going to spike or why. A continuous glucose monitor like Level’s CGM will.

“Of course there’s these blanketed low-carb diets. But really to get into nuance of it and really have what I would call more of a liberated glycaemic-friendly diet, it’s really all about testing. So there’s a couple of ways you can do that. Traditionally you could just walk into a pharmacy and buy a fingerstick glucose monitor called a glucometer. And that’s where you prick your finger. You take a little bit of blood and you put it in a meter and it’ll give you one time point of glucose. And that’s helpful, but there’s a few limitations to that. One is that you’re only getting one data point at one point in time. Two is that you actually don’t really know when after the meal you’re going to have your peak of your glucose spike after a meal…But the newer tool that is really interesting is a continuous glucose monitor. So this is a small wearable device. It’s about the size of a quarter and it sticks on the back of your arm and has a tiny, painless, little teeny four-millimeter probe that goes under the skin that’s like a piece of dental floss. And that’s actually going to sample your glucose 24 hours a day, basically constantly, and send that information to your smartphone.”

 

26:37 – High intensity workouts can lead to spikes

While food-related spikes are bad and should be avoided, exercise-related glucose spikes are a natural adaptive response.

“A lot of exercises can help your muscles take up more glucose and you can kind of see a glucose drop during exercise. But with high intensity exercises like you mentioned like the Peloton workout, this actually is going to send this little signal to your body of, oh my gosh, this is a high intensity workout. We need lots of energy to fuel our muscles. And that signal, which is mediated through the stress hormone cortisol, is actually going to cause you to dump some stored glucose from your body into the bloodstream. And you might actually see a glucose elevation in response to a high-intensity workout, whereas you might see a glucose lowering with your more moderate or less intense workouts, like a walk or yoga or something like that. And I just want to caveat that that glucose spike with high intensity workouts is not necessarily a bad thing for metabolic health like the food-related spikes are. Because that’s a really adaptive response – our body is providing glucose to our muscles for a high intensity workout.”

28:01 – Your body registers stress as a threat

That stressful email is doing more harm than you thought. According to Dr. Means, you body treats feelings of stress as a threat, releasing hormones that impact your glucose levels.

“Going on stage, giving a big talk to your company or something like that, or even having a stressful conversation with a loved one – this is a stress, our body registers that as stress. And it will release cortisol and other catecholamine hormones which tell our body there’s a threat, you’re in trouble. Even though it’s a psychological threat, it thinks it’s some sort of intense physical threat and it also will dump glucose to basically help you in that time of threat. So back in the day, when stress was much more like physical, like we were being chased by a lion that was useful. But now when it’s just because we get a stressful email, it’s not so useful…So continuous glucose monitoring can also help us understand how our stress is impacting our glucose levels and our metabolic health and kind of help us get that in check and really be a motivator for helping us adopt those mind-body strategies that we know can help keep us calm in the face of some of these acute triggers.”

32:24 – Accountability that works

Your Fitbit can tell you exactly how many steps you’ve taken, but until now, we haven’t had comparable technology for diet’s impact on the body. A CGM changes that.

“We all walk around with our Fitbits and our Oura Rings and our Whoops, and these fabulous products that help motivate us to make behavior changes consistently. And there has been research that shows that if you wear a Fitbit, you will be more active. It actually has a measurable impact on making people more active. And we have just never had this for nutrition. There’s no tool that we’ve had that closes the loop between every day, how are you doing on nutrition? We can go out and take a two mile walk and know exactly how many steps that’s giving us. And we don’t have that for a meal. We don’t know that if we eat this meal, this is the impact it had on our body. And so that’s what excites me so much about continuous glucose monitoring is that finally we can close the loop and create a one-to-one relationship between this food I ate and then what it did to me. And when you start having that closed loop biofeedback, it really keeps you so accountable.”

39:23 – Pair protein with fat & eat it before carbs

Two rules of thumb for glucose health are to eat a serving of protein or healthy fat right before carbs. You should also avoid eating carbs alone – eat some protein first.

“So there have been studies that basically have had people eat a fat load or a protein load before eating a carb load. So in these studies, it’s like having three ounces of almonds before two slices of white bread for fat. And then for protein, having eggs before having bread. And they show that if you do that before eating the exact same carb, you can lower the post-meal glucose spike. So typically we talk about balanced meals, but I think that’s really where it’s coming from. You don’t really want to be eating like a carb alone. And in my personal life, having now used a continuous glucose monitor for over a year and these days barely ever getting glucose spikes – it’s dialed in now. I can’t reach for fruit without reaching for protein and fat. It’s wired now in my brain. So if I’m reaching for an apple or a pear, first of all I’ll often choose a less ripe version because they often have less sugar. And two I’ll put some tahini or some almond butter or some chia seeds or pair it with an unsweetened cashew yogurt to basically get that sort of blunting effect. So fat and protein pairing. The second thing is meal sequencing. You don’t want to eat your carbs alone first. You want to eat the proteins before the carbs.”

41:45 – Hydrate on an empty stomach

Ancient medicine recommends drinking water on an empty stomach versus with meals. There may be some truth to this, as water with meals can cause glucose spikes.

“Another kind of quirky one is water. People who chug water during a meal sometimes will see a higher glucose spike. And this has actually been studied in multiple studies. People who drink about 300 milliliters of fluid with their meals have higher glucose spikes. And I think the reason for this is that it’s getting all this food to your small intestines faster, and you’re just absorbing it faster. But when you look back at some ancient traditions, like Ayurvedic medicine, there’s actually many traditions that do say: drink water in the morning on an empty stomach. Don’t drink your water with meals. So there’s some interesting maybe traditional wisdom there that may be related to how we digest the food. And then I would say some of the last ones are fiber. Fiber is totally your friend, usually in relation to glucose. Again, there’s going to be individual variability, but in most studies that I have seen, adding fiber to meals will lower your glycemic response.”

45:23 – Taking the mystery out of glucose

With a Levels CGM, you can instantly see the impact that your daily choices are having on your body – and modify your behavior accordingly.

“We’ve created software that helps people get to the root of all these things and figure out what’s working for them, what’s not working for them, and be able to actually make those behavior changes. So people are pulling in the data from their continuous glucose monitor into the app, as well as other metrics like their Apple Health and their Google Fit data. And so starting to correlate when I eat this, these are the things that seem to be driving my glucose up. And we help parse that out for people to make it really actionable. And I think a lot of people aren’t familiar with the glucose numbers, 132, 287, what is right? Where do we want to shoot for? So we just take all that mystery out, and there’s an optimal zone to be in. We grade all of your meals and activities with just a simple 1-10 score of how much of a metabolic impact it had, taking into account a lot of these complex background metrics, but what the person sees is just their score. Was this meal an A, was it a B, was it a B-, and how can we improve it?”

Dr. Casey Means: [00:00:00] We have trillions of cells in our body. We are made up entirely of cells. That’s the reality. And every single cell, for it to work, needs energy to function. It needs a usable form of energy, and that’s created from our metabolism. And so you can imagine when that process starts breaking down, and your cells are not getting the energy they need to do basic function, we start seeing symptoms emerge, and then we start seeing disease emerge. And so you can imagine, like if that process isn’t going well, it’s going to affect everything. And that is really why the face of metabolic dysfunction is so broad.

Dr. Mariza: [00:00:40] Welcome back to the Essentially You Podcast, all about reinventing your health with safer, cheaper, more effective natural solutions and powerful lifestyle changes, so that you become the CEO of your health. I am your host, Dr. Mariza Snyder. I don’t know about you, but it feels a bit crazy that this pandemic is continuing at a rapid rate. And we are seeing more cases this month. I know that many of us are still concerned for our families and maybe even ourselves. But one thing’s for sure, the healthier our body and our immune system is, the better prepared we are to fight this virus or any virus for that matter. Now, as a practitioner and researcher, I am most concerned about the co-morbidities that millions of people have here in the US. One of the biggest co-morbidity that often gets overlooked and ignored is metabolic dysfunction.

This is the system that regulates our cellular energy and feeds our cellular powerhouses known as the mitochondria, directly connected to your cardiovascular system. When we suffer from metabolic dysfunction, we experience increased inflammation, insulin resistance, and weight resistance. This causes prediabetes, diabetes, obesity, and other chronic conditions. This predisposes us to a weakened immune system and causes us to become more vulnerable to this virus.

I don’t know about you, but the spectrum of metabolic dysfunction concerns me because it can start so young. It’s one of the areas I believe that we’ve got to focus on, not just for our overall health, but to keep our immune system super healthy during this crazy pandemic. Goodness knows, I have no idea how long this is going to go.

So what I did today is I wanted to invite Dr. Casey Means to join me and talk about metabolic dysfunction, and how we can start to take hold of our metabolism and our health. Now one of the most important ways that Dr. Casey and I agree upon, is monitoring our metabolism by using a continuous glucose monitor and tracking our blood glucose levels throughout the day, to fully know which foods are sabotaging our insulin, our metabolism, and most importantly, our energy levels, because it is all tied together.

And I don’t know about you, but I could use all the energy I can get right now. Before we jump into this powerful conversation, I want to quickly share something with you that I have been using for my energy levels for the past several months. See, I’m always looking for more effective and easy ways to boost my antioxidant levels and to get added energy.

Recently, I added Organifi Green Juice to my morning routine and Whoa, what a game changer. Their organic green juice is made with 11 superfoods and designed to boost energy levels, and naturally detoxify the body, which I love. This is the first thing that I’m doing every morning with 16 ounces of water.

And it literally takes 30 seconds to make. And then I sip on it before breakfast. My body has been feeling extra hydrated, and I know that my gut and liver are primed for the day. Now since I’ve been drinking this green juice, I have noticed that I am more focused and productive all day long, not just in the morning.

And I’m not experiencing energy slumps around four or five o’clock. Plus I love how easy it is to travel with on the go. And because I’m loving this, Organify has given me an awesome promo code to use and share with you that you can add it to your morning routine for more added energy and cellular support.

So if you are ready for easy, effective energy, like starting right now in the morning, just go and use the promo code Dr. Mariza, that’s D R M A R I Z A, and you’ll get 15% off your entire order at Organifi.com/DrMariza. Now to make it simple, I will have the link to Organifi.com/DrMariza in the show notes for this episode, which is episode 236.

I can’t wait for you to experience all the energy that I have been loving these last couple of months. Now let’s jump into my interview with Dr. Casey Means, but before I do, I want to quickly sing her praises. Dr. Casey Means is a Stanford trained medical doctor, biochemical researcher and surgeon turned metabolic health Renegade.

She’s the chief medical officer of a pioneering digital health startup called Levels. She is leveraging breakthrough technology to solve the epidemic threatening our health, and the wellbeing of 88% of the US population, which is also known as a metabolic dysfunction. Let’s welcome her to the show.

Welcome to the essentially you podcast. Dr. Casey means, how are you doing today, girl?

Dr. Casey Means: [00:05:43] I am doing great. I am so happy to be here. Oh my

Dr. Mariza: [00:05:46] gosh. I feel like we almost had a full fledge interview before the interview because I love this topic. So much, and I love that you have pioneered this technology that we’re gonna be talking about today.

What we’re talking about, probably one of the sexiest topics that I think are out there. I don’t know if my audience will agree, but that food is molecular information and what that means for each and every one of us. Is how we really need to be using food wisely and how it’s communicating with our body.

Now, before we get into the nuts and bolts and the nitty gritty of what all that means specifically around metabolic dysfunction. I want to just have you share a little bit about your journey and how you walked in to this. Beautiful area of metabolic health. And what was the driver that defining moment for you when you knew you wanted to really kind of solve the problem of what I would consider almost 90% of Americans at least are dealing with today.

Dr. Casey Means: [00:06:50] Yeah, absolutely. Thank you again so much for having me on and talking about this topic that I know we both love so much, which is glucose control and metabolic health. And so a little bit about my journey to this. So I’m a medical doctor and I. And the COO and the co-founder and chief medical officer of this metabolic health company Levels.

And the mission of our company is to spread metabolic awareness. We want everyone to understand what’s going on in their own metabolism and be able to act on that so they can move the needle in the right direction. And I started very far from this. So I actually. Went to medical school and went into surgery residency.

So I was in the surgical world for almost five years as an ear nose and throat surgery resident. And that’s like all diseases, of the head and neck. So you think about sinusitis and ear infections and Hashimoto’s thyroiditis and vocal cord problems like polyps and granulomas and and head and neck cancers as well.

And what was so interesting to me, Was that so many of the conditions I was treating in ENT were fundamentally disorders of chronic inflammation. They all were the itises. The words that have itis on the end usually mean there’s inflammation. And so sinusitis, this is inflammation, itis.

So I stepped back after about four or five years and said, why big picture? Like, why is everyone have chronic inflammation? It shouldn’t be that our immune systems are constantly on overdrive. And we know that so many chronic illnesses these days are rooted in chronic inflammation, things like heart disease.

Obesity even Alzheimer’s dementia, diabetes, and I’m treating these other conditions that seems so different from those diseases. What’s the relationship between obesity and sinusitis. But when you actually look at the deep molecular biology of it, a lot of its conditions have the exact same inflammatory profiles.

The actual. Compounds in the blood that are elevated in these conditions are similar things like TNF alpha and interleukin six and all these fancy, cytokine names. And so it was really interesting to me. Why are so many people having this up-regulation of this immune threat?

And that got me on this. What was ultimately absolutely fulfilling and amazing journey towards really a much more holistic practice, because when you think about it, a lot of chronic inflammation is really rooted in our choices that we make every day. It’s diet it’s lifestyle. It’s what we’re exposing ourselves to in our food, how much sugar we’re eating, whether we’re getting enough.

Sleep how we’re responding to acute stress, whether we’re moving or whether we’re sedentary, the toxins we’re exposed to in our food, water, and air. These are all things that are translated in our body as molecular information into either a threat or a sign of, homeostasis. And so how that ultimately led to metabolic health was that so many people in our country have metabolic dysfunction.

And there was that study out of UNC a year or two ago that showed that. 88% of people in America, like you said, almost 90% of people have metabolic dysfunction. They have at least one sign of metabolic dysfunction, whether it’s a perturbations in cholesterol or a waist to hip ratio or glucose, and this is almost entirely preventable.

This is all based on these choices. And that metabolic dysfunction is a key driver of chronic inflammation. As you’ve talked about a lot on your podcast. And, I think this is not. Talked about enough. And I think that it is low hanging fruit for what we can do to move. Health at scale in the right direction.

And I also think there’s really no, steroid or antibiotic or surgery that’s can really mop up the mess when there is some of this fundamental core physiology that’s perturbed. And so I became just obsessed with how are you going to scale the behavior changes that need to happen to create conditions in the body that allow for metabolic health, for stable glucose, for less inflammation.

And behavior change is a hard nut to crack. Like it’s a lot easier in a lot of ways to prescribe a pill. And in some cases I had to do the mop-up, which is what we’re doing. We’re doing pop up, we’re instead of turning off the faucet we’re mopping up the floor. We have a lot of dirty towels.

Oh my God. So many dirty towels, so many dirty mops, lots of buckets. And it’s like, all we have to do is turn off that faucet. And that faucet is what we do every day. So that’s what I’m really interested in as a physician is how do we merge what we know about medicine with tools that can engender behavior change and do it in a really big way for lots and lots of people.

That’s really, my focus at this point is supporting digital health products. That scale behavior change for healthy physiology.

Dr. Mariza: [00:11:31] I want to take a moment and I just want to celebrate you, from going to surgical ear, nose and throat to kind of putting together the pieces, because so often people go to their doctor’s, let’s say specifically for ear, nose and throat, and there’s no connecting the dots.

And we just go down that rabbit hole and then we never go down this rabbit hole. And so to be a PR to be a physician, to be a surgical physician, and to just look at the bigger landscape and know that deep knowing that there’s a bigger root cause here. And it is, it’s not just impacting ear, nose and throat, but some of the biggest comorbidities that we are dealing with today, More than ever.

I was thinking about this the other day, I’ve have 10 friends under the age of 45. Who’ve been diagnosed with cancer. I have an uncle who’s 55 who just had a triple bypass and he found out before, just right before his triple bypass that he had insulin dependent diabetes and how that was missed.

Just blows my mind. We think about, we look at all the people in our lives who, like you said, you think about 90% of the population, people like they’re within your immediate family, you’ve lost family to these conditions. And then as you’re looking down your path, you wonder, I had my mom.

Run her hemoglobin A1C back in June. And it was a 5.6 and that is almost pre-diabetic. And honestly, in my opinion, it is one of the things I was telling my mama, which I’m SU I told her I was going to be interviewing you. I was so excited. I was like, Oh, I gotta be interviewing her. Because I wanted to really get into this, but I told my mom, you non-negotiable, she’s got to have a continuous glucose monitor.

And it was really excited to learn about this technology today too, because I was hoping that maybe this was the system that we were going to get her. And I’m really excited for it. So like it hits home in so many ways. If I do really want to celebrate you and just say thank you for connecting the dots and deciding that there’s a bigger mission out there for you, and that will serve the greater population.

Dr. Casey Means: [00:13:32] Thank you. That is so kind and right back at you, for leading this as well in your work. And I think that, but honestly, the people I have to think slash blame are the amazing people who have put out this information in such a great way. And because there were basically authors that I was reading all throughout my training, who planted some of these seeds and it was a lot of the functional and longevity medicine doctors.

I was reading. Mark Hyman UltraMind solution and the blood solution. I was reading Joel Fermin and Sarah got for you the hormone cure Terry Walls, David Sinclair, longevity, Jason Fung, the obesity code and the diabetes code. It’s just, there are so many amazing thinkers out there who are thinking differently and.

I would be, I would have these little, my earbuds and listening to these books that paint a really unique root cause picture of health care, and really are thinking, so much about how we like to think of diseases as isolated silos in our system, that they’re all different, that you’re acne, depression, obesity.

And cancer are all totally different things. When in fact there’s so much core root cause, stuff, connecting these, and how can we treat it that level. And that’s what I took from a lot of these books I was reading. And of course there’s now all these, there’s podcasts and there’s YouTube.

And I think it’s amazing how people are promoting this different way of thinking. And I have to say once it slips in and you start thinking that way, it’s really hard to undo it. And so I’m very grateful and I think it’s certainly have to. Pass the compliment on to the people who are inspiring so many out there, especially, young physicians.

So yeah.

Dr. Mariza: [00:15:10] Agreed. Yeah. Those are some dear colleagues and friends of mine as well. And so yes, this is definitely not news to me. I’m excited though, the way that you’re embarking on this. So let’s get into the basics because I know, one thing I know that my audience knows about, they know they understand inflammation and they know.

They understand their metabolism in the sense that maybe it ain’t working for them anymore, like what is going on with my metabolism. So let’s talk a little bit about what metabolism is and why it plays one of the most central roles in our body and our body’s function.

Dr. Casey Means: [00:15:42] Yes, absolutely.

So metabolism is so critical because this is the way that we make energy from our food and our environment. This is how our body takes substrates that we take in and converts them into a type of energy that we can use. And this is the reality is that we have trillions of cells in our body. We are made up entirely of cells.

That’s the reality and every single cell for it to work needs energy to function, it needs a usable form of energy and that’s created from our metabolism. And so you can imagine when that process starts breaking down and your cells are not getting the energy, they need to do basic function. We start seeing symptoms emerge, and then we start seeing disease emerge.

And so you can imagine, like if that process isn’t going well, it’s going to affect everything. And that is really why. The face of metabolic dysfunction is so broad. It’s not just diabetes, it’s not obesity. It is. It’s, it can affect every single organ system in the body, wherever that metabolic dysfunction is most showing up.

So maybe it’s showing up mostly in the ovaries. That looks like polycystic ovarian syndrome. Maybe it’s showing up mostly in the brain. That’s. All timers dementia, chronic fatigue, chronic pain, depression, anxiety, all diseases associated with blood sugar dysregulation. Maybe it’s showing up in the liver as non-alcoholic fatty liver disease.

Maybe it’s the kidney has chronic kidney disease. Maybe it’s the eyes is retinopathy. There’s no part of the body that does not have a metabolic associated disease because when those pathways are perturbed, the cells can’t get the energy. They break down, we have symptom and disease. And the interesting thing is that.

We live in this world of an abundance of energetic substrates. We are not lacking for the building blocks that we can convert into energy. So the way it works in the body is, you take in glucose and fat and ourselves can take those in and then convert them into usable sources of energy like ATP.

And it’s the issue used to be way back in the day that there wasn’t enough of that. We didn’t have enough food and resources. It was hard to find these things. Now we have sugar. And fat, literally everywhere. So we have metabolic dysfunction related to that abundance because what happens as but just to kind of re-summarize it for listeners is that when you’re taking in lots of extra sugar or carbohydrates, And that’s hitting your bloodstream.

Your body responds by releasing insulin from the pancreas, and that’s a hormone. That’s going to tell yourselves to take up that glucose out of the bloodstream and use it. And when there’s too much of that glucose, you’re going to store some of that extra glucose as fat. You’re just going to shuttle it into your fat cells for later.

Use one day. So one that’s driving the fat storage, but the other thing is when that glucose is. Going up all the time from all those snacks, we’re eating and eating multiple times per day. That’s a lot of insulin spikes that have to happen. And when that insulin starts getting high and has hap that’s happening frequently, our cells get a little confused, cause they’re like, there’s so much insulin around, this is not normal.

Why is there so much? And it actually, the cells become resistant to insulin. They become. Basically block the signal to kind of protect themselves. So what happens is your body pumps out more insulin to try and force the glucose into the cells. And this creates this totally vicious cycle of insulin resistance.

And the problem with having higher insulin is that insulin aside from letting glucose come up into the cells, it also puts a block on fat burning because if we have the choice of using glucose or fat for energy, if the body has a signal that there’s lots of glucose around, which is. When there’s high insulin, it thinks that it’s not going to tap into your fat.

So it blocks fat burning. So especially for people who are dealing with issues of weight, like 74% of Americans are, who are overweight or obese, you can imagine really low-hanging fruit is to get on top of your insulin Levels and your glucose Levels. And when you get your insulin Levels kind of more controlled, you can take that break off and allow that fat burning to happen again.

So it’s really interesting. The vicious cycle that develops, but the beauty is. We can move in the wrong direction on this pathway. We can also move in the right direction. It’s not a one-way street, it’s a spectrum that we can kind of move back and forth on. And when we do control our blood sugar, we control our insulin and our body becomes insulin sensitive again, and that is moving towards metabolic fitness and metabolic function.

And that’s really what we want. We want ourselves to process energy effectively. We want to keep insulin down. We want to be able to switch between fat burning and glucose burning based on what is available. And that’s possible for everyone based on, how we live and the choices we make.

Dr. MarizaDr. Mariza: [00:20:25] So true.

100%. And I love the positive spin that we can absolutely go in the right direction. Like our bodies are resilient, they can rebound, we know that to be true. And so let’s talk a little bit about, I want to get into kind of optimal diet, but I want to talk about just monitoring glucose. I know that every single one of us is unique.

I know that, certain things are going to spike. It’s someone else’s insulin versus another person’s insulin. And I feel like, unless we really know what’s going on, you know what we’re eating with kind of a guessing game. Definitely there’s you can just get rid of sugar. Clearly. There are things that we can eat.

We can take out the snacks. So we’re not constantly in a sugar burning mode. But talk to me about monitoring glucose, monitoring, blood glucose, and what is kind of the gold standard for really understanding how our metabolism and blood sugar work.

Dr. Casey Means: [00:21:20] It’s a great question. Yeah. Cause if we’re talking about getting on top of glucose, th the next logical question is we’ll have how in the world do we do that?

We just eat a low-carb diet. Do we eat a keto diet? Do we go carnivore? These are all diets that have been centered around keeping glucose really low, but the issue is one they’re very restrictive and too. Like you mentioned, everyone has a different response to carbohydrates. So you and I could both take in the exact same carbohydrate, rich food, like a banana and have completely different glucose responses in our blood, which is a little confusing.

It’s written the same food. Wouldn’t the same amount of glucose go into the blood, but there’s so many steps between. Carbon the mouth and actual glucose in the blood. And one of the big things is the microbiome. So how your microbiome process that the carbohydrate that you eat has a big impact on how much the glucose and how fast it will raise in the bloodstream.

Other things that make a difference are your baseline, insulin sensitivity, how much sleep you got the night before? And many other factors, and this is actually been studied in really large populations. There is a really great paper out of Israel about five years ago, called personalized nutrition by prediction of glycemic responses.

And it basically showed that if you monitor a big population of healthy individuals with no blood sugar problems that have been diagnosed and you monitor their blood sugar after standardized meals. So they’re all getting the exact same meal people have. Vastly different responses in terms of their glucose elevation in the blood.

So with the banana example, if I spike really high and my glucose and you don’t, it’s probably a better option for you than it is for me. I’m going to be having that insulin spike. That’s going to kind of be one more hit in terms of moving me down that insulin resistance spectrum. So the beauty of testing your glucose is that you can find out which foods actually have the biggest glycaemic impact.

And you might be surprised on what you find. So of course there’s these, blanketed, low carb diets, but really to get into nuance of it and really have what I would call more of a liberated glycaemic friendly diet. It’s really all about testing. So there’s a couple of ways you can do that traditionally.

You could just walk into a pharmacy and buy a fingerstick glucose monitor called a glucometer. And that’s where you prick your finger. You take a little bit of blood and you put it in a meter and it’ll give you one time, point of glucose and that’s helpful, but there’s a few limitations to that one is that you’re only getting one data point at one point in time.

Two is that you actually don’t really know when after the meal, you’re going to have your peak of your glucose spike after a meal. So you might totally miss it unless you’re checking every few minutes. So it’s a little bit limited in terms of personalizing a diet. What it can do is, you could check your finger.

Glucose every morning and see how your fasting glucose is doing. But the newer tool that is really interesting is a continuous glucose monitor. So this is a small wearable device. It’s about the size of a quarter and it sticks on the back of your arm and has a tiny, painless, little, teeny four millimeter probe that goes under the skin.

That’s like a piece of dental floss and that’s actually going to sample your glucose. 24 hours a day, basically constantly. And send that information to your smartphone. It’s going to do a reading automatically every 15 minutes in the background, but if you want to get extra readings, you can signal it to do that.

So you can really get as many readings as you want per day. So this creates as opposed to these single time point glucose measurements, you’re getting like a full spectrum curve of what’s happening your glucose all throughout the day. So you can see. How much your breakfast spiked your glucose or didn’t how much your snack spiked your glucose or didn’t, and start to understand how many of these spikes you’re having and start to Intuit.

Wow. That’s a lot of spikes. My insulin was probably high throughout a lot of this day. What is that doing to my overall metabolic health and insulin resistance?

Dr. Mariza: [00:25:18] And also activities. Know, when you’re about to go on stage and do public speaking, or you’re doing on the Peloton versus lifting weights, you can see what kind of activities are also raising insulin Levels.

Cause unfortunately stress is tied to insulin too. And I just think it’s really fascinating to be able to look and see how your living impacts your insulin Levels in your blood glucose Levels. It’s

Dr. Casey Means: [00:25:45] such an important point. Yeah. And like you mentioned, there are many other things other than food that actually affect our glucose Levels.

Glucose is really, this is readout, but it has so many input variables. Of course there’s food, but on top of food, there’s about four other things to think about. So one is food timing, like when you’re having the food. Often eating a carbohydrate rich food in the earlier part of the day is going to have a less of a glucose response than if you eat it later at night.

And of course this is individual for each person, but that’s what the research shows. And the reason for this is because we actually at night. When we secrete melatonin to help us fall asleep, that actually has an impact on our insulin sensitivity. It makes us less insulin sensitive. So later at night, you are dynamically different at processing carbs and you are in the morning.

So that’s one. The second thing is exercise. Like you said, a lot of exercises. Can help your muscles take up more glucose and you can kind of see a glucose drop during exercise, but with high intensity exercises, like you mentioned, like the Peleton workout, this actually is going to send this little signal to your body of, Oh my gosh, this is a high intensity workout.

We need lots of energy to fuel our muscles. And that signal, which is mediated through the stress hormone, cortisol is actually going to cause you to dump some stored glucose from your body into the bloodstream. And you might actually see a glucose elevation in response to a high-intensity workout.

Whereas you might see a glucose lowering with your more moderate or less intense workouts, like a walk or yoga or something like that. And I just want to caveat that. That glucose spike with high intensity workouts is not necessarily a bad thing for metabolic health. Like the food-related spikes are because that’s a really adaptive response.

Our body is providing glucose to our muscles for a high intensity workout. And the cool thing about muscle is that there’s actually an insulin independent mechanism of getting glucose into the cells. So just by your muscles working and moving that alone can cause you to take up glucose. You don’t need that insulin hormone to bind.

To the cell as well to get the glucose up. So basically all forms of exercise in the long run are good for glucose control. Even though you might see a little bit of an elevation when you do a high intensity workout, the third thing is stress. So like you said, going on stage, giving a big talk to your company or something like that, or even having a stressful conversation with a loved one.

This is a stress. Our body registers that as stress and it will release cortisol and other catecholamine hormones, which tell our body there’s a threat. You’re in trouble, even though it’s a psychological threat, it thinks that some sort of intense physical threat and it also will dump glucose to basically help you in that time of threat.

So back in the day, when stress was much more like physical, like we were being chased by a lion that was useful. But now when it’s just because we get a stressful email, it’s not so useful. So those stress-related. Cortisol related glucose spikes are not advantageous for our health because our muscles aren’t actually going to be using the glucose.

We’re just sitting in our computer chair with dumping out glucose because we’re stressed and it’s not great. So can you use glucose monitoring can also help us understand how our stress is impacting our glucose Levels and our metabolic health and kind of help us like, get that in check and. Really be a motivator for helping us adopt those mind body strategies that we know can help keep us calm in the face of some of these, acute triggers.

And the last one I mentioned is sleep. So sleep has a huge impact on glucose Levels, but when we don’t sleep enough, our glucose rises. We’ll see often bigger spikes after meals. You might eat the oatmeal on Monday and oatmeal on Tuesday. And if you didn’t get good sleep Monday night, you might see a much bigger spike on Tuesday morning.

And there’s a lot of reasons for that. There’s many hormones that are essentially screwed up by a lack of sleep, even just one night. Things like. Ghrelin and leptin are satiety, hormones, growth, hormone, cortisol, insulin. All of them are impacted by getting too little sleep. And there’s been some really interesting research where they’ve taken just healthy young people, deprive them of sleep for a few nights.

So in one study they took healthy young men, had them have four hours of sleep for six nights in a row, and basically took them from healthy to pre-diabetic in that sort of amount of time. And it was reversible, but. Clearly, this is not something we want to be doing.

Dr. Mariza: [00:30:14] Don’t try this at home

Dr. Casey Means: [00:30:17] seven to eight hours of sleep, which seems seven to eight, seems to be for most people the best for metabolic health and actually more than eight.

Might be problematic, like it’s too much sleep. So it’s really about that balance of the right circadian rhythm, but sleep, exercise, stress, movement, food timing, and just personalized food choice in general. Those are some of the key pillars of keeping that glucose line of what feeds into that glucose line.

And ultimately we want that glucose to be essentially fairly flat and fairly stable throughout the day. And you can turn all those levers to help make that happen. So

Dr. Mariza: [00:30:53] grateful for you going over all the lever Levels or levers that can actually drive glucose and blood sugar Levels inside of the body and how that has an impact on our metabolism overall, and the importance of it.

One of the things I was really excited about our conversation was really driving home, the importance of continuous monitoring, because you’re right. Even if someone were to buy, just the fingerprint method, From the pharmacy. It is, you said it just doesn’t give us enough information and let’s be honest.

Most of us aren’t even doing that much. And so I think that the more we can have these conversations, it really opens the door for like how important it is to know our numbers and to know our numbers across every single day, really understand what’s happening. I think that the real thing that I’m most excited about with monitoring this on a continuous level is accountability.

More than anything. It’s a, it’s kind of gentle accountability and I find it. It’s very fascinating. I think, I, every time I talk with somebody who has a continuous glucose monitor, just the learning of what foods, spike them, what foods will spike and crash, and then feel the crash on the backend as well.

Feel that physiologically, like it all begins to click into place. And I just don’t think enough of us. One doctors aren’t necessarily on track to just start recommending them. And most of us, we’re just not looking at the importance of this overall.

Dr. Casey Means: [00:32:20] It’s so true. Like I think that accountability piece is so fascinating.

We all walk around with our, our Fitbits and our aura rings and our whoops, and these fabulous products that help motivate us to make behavior changes consistently. And there has been research that shows that if you wear a Fitbit, you will be more active. It actually has a measurable impact on making you be more active.

And we have just never had this. For nutrition. There’s no tool that we’ve had that closes the loop between every day. How are you doing on nutrition and what are you? We can go out and take a two mile walk and know exactly how many steps that’s giving us. And we don’t have that for a meal. We don’t know that if we eat this meal, this is the impact it had on our body.

And so that’s what excites me so much about continuous glucose monitoring is that, finally we can close the loop and create a one-to-one relationship between. This food I ate and then what it did to me. And when you start having that closed loop biofeedback, it really keeps you so accountable.

It’s not fun. It’s not as fun to eat something. Even if you love it, that is you are seeing, it creates immediate with our traditional ways of tracking our impact of food. Wait or yearly glucose checks or yearly cholesterol checks. These things are such lagging indicators that you can’t tie it back to one thing you did.

When you sit down to have the cupcake or whatever, it’s I don’t know if this was the thing that put me over the edge, but with a glucose monitor, you do, you’re like, Oh no this was the cupcake. Like it actually, this finish is not the thing, this isn’t. So it’s it just, it pulls out the rug from some of that reward pathway and it creates a new reward pathway of Oh, it feels really good to have a streak of steady glucose.

And then this is the part that’s so exciting to me, which is that. First you have that excitement of I’m achieving something here. I am replacing the joy of that cookie with the joy of succeeding here and seeing I’m doing something good for my health. But then when you start noticing how it relates to your subjective experience of the day, like you’d mentioned a friend who like has a post-meal energy crash, like that’s the perfect example.

I think a lot of us like. Mid-afternoon you might have had lunch and then it’s 2:00 PM and you’re like, I need a nap. I don’t feel great. I feel tired. Or maybe you feel a little moody, or maybe whatever, you’re tired or, and it’s the post-meal slump. Now imagine you have this data that says, Oh, like that panini I had.

Put my blood glucose up to one 80 and then I crashed down to 60 because what happens is when you have that big spike, all that glucose you surge out all this insulin helps you soak up glucose.

Dr. Mariza: [00:35:12] Yes. You’ve got to get into the cells and then you

Dr. Casey Means: [00:35:16] overshoot and you go too low. And that low is often when that.

Moodiness, anxiety, low energy brain fog, rain. Exactly. And so now all of a sudden you can connect the dots. I think it’s easy for us to miss a tribute that sensation, that, that slump to maybe it’s my coffee crash. Maybe I didn’t sleep. Maybe it was. Food, maybe it’s just my personality.

And now you’re like, no, it was the paninis. It

Dr. Mariza: [00:35:41] was definitely the panini. It was definitely the cupcake. There’s no hiding from that information.

Dr. Casey Means: [00:35:49] And it takes that mystery away. Like finally something with nutrition, not being mysterious and you can start attributing things properly. And then all of a sudden it’s okay if that was the thing that caused that terrible afternoon, then maybe I could.

Take a walk after my penny. Next time maybe I could add some healthy, fat and protein to all that car, which might blunt the glucose spike. Maybe I’ll swap the bread for some almond flour bread next time and see what happens. And then you create this whole loop between subjective experience, objective experience and something you did.

And that trifecta is. The essence of behavior change.

Dr. Mariza: [00:36:27] I would love to talk a little bit about that specifically ways to minimize glucose spikes after a meal. And I know that those were some of the suggestions. Clearly the easiest thing is if that cupcake spikes you. You don’t eat cupcakes.

That’s really what it comes down to. But let’s talk about, an average lunch meal or a breakfast meal. One of my one of my favorite kind of a little quick story I want to share. I run people through a liver and gut detox and it’s really, it’s an inflammation program. And one of the things that as my intention and goal in those 14 days is to reset insulin Levels.

So there is, there’s no sugar, no carbs in this program. And my husband and I always do it with our with our big group, our live group. And usually my husband. He gets in the street and he goes on the straight and narrow and he drops a ton of weight as men will do, but this go around it wasn’t happening.

And I was like, he’s I don’t understand what’s going on. I don’t get it. And I was like I don’t it’s I’m. Watching you like wives do. And I was like I don’t know what you’re doing, but this works. We lock and load you. This should be working. And what was happening is we had this organic granola in the house and we never have organic granola in the house.

It’s, we don’t have these things in the house. And my husband was having these late night snacks of this organic granola. And he was literally just spiking his blood sugar Levels at night time. And you talked about how, what it looks like to have something like that in the morning versus what it looks like to have a late night snack and it was completely disrupting his metabolism.

And I didn’t need a glucose monitor to know. Didn’t know that, but it’s amazing how one little thing can sabotage all the work that you were doing. And so I’m not, I’m definitely not looking for a substitute or a way to minimize one eating. Granola at 11 o’clock at night, just don’t do that.

But what are some things that we should be thinking about for our core meals to kind of keep our insulin or glucose Levels in check? And let’s say snacks are not in the equation. We want to just make sure that those three meals, those solid three males are not significantly raising our glucose Levels.

Dr. Casey Means: [00:38:47] Yeah, that’s such a great question. What are the practical tips? And I’d say I’d caveat this by saying that it’s going to be different for everyone and the granola for another person, maybe wouldn’t have had such a big impact, but that’s the beauty of monitoring is knowing like how it’s affecting.

How it’s interacting with your microbiome, your body type, your insulin, all that stuff. So that’s a sort of caveat, but there are so many tactics that have been studied in the literature and I would be happy to run through some of them. Cause they’re really some practical things that you can at least experiment with, so the first one is food pairing. So how are you, what are you eating your carbohydrates with? So there have been studies that basically have had people eat a fat load or a protein load before eating a carb load. So in these studies, it’s like having three ounces of almonds before two slices of white bread or for fat.

And then for protein having eggs before having. Bread. And they show that if you do that before eating the exact same carb, you can lower the post-meal glucose spike. So typically that’s, we talk about balanced meals, but I think that’s really where it’s coming from. You want to, have these, you don’t really want to be eating like a carb alone and in my personal life, Having now used a continuous glucose monitor for over a year and these days barely ever getting glucose spikes.

That’s just, it’s dialed in now. I can’t reach for fruit without reaching for protein and fat. It’s wired now in my brain. So if I’m reaching for an Apple or a pear. First of all, I’ll often choose a less ripe version because they often have less sugar and two I’ll put some tahini or some almond butter or some chia seeds or something like, or pair it with a cashew yogurt, unsweetened cashew yogurt to basically get that sort of blunting effect.

So fat and protein pairing. The second thing is meal sequencing. You don’t want to eat your carbs alone. First. You want to eat. The proteins before the carbs. Or really anything before the carbs, people who eat a salad before a Carbridge meal have less of a glucose spike, people eat protein before a car bridge meal.

You just don’t want to eat your carbs first. Cause that’s going to set off the insulin. It’s going to set off the glucose. It’s like putting you on the wrong rollercoaster for the meal. So meal sequencing is important. Then there’s really interesting stuff about vinegar and cinnamon. So these are two foods that seem to change our response to glucose.

So they both might be acting as insulin. Sensitizers kind of making us more sensitive to insulin action. So people who take. A shot of white vinegar before a meal have less of a glucose spike after eating carbs after it. So I wouldn’t necessarily recommend that, but you could try, diluting, Apple, cider vinegar, and a glass of water before a meal or having vinegar in a salad dressing when you’re eating carbs.

And the same is true of cinnamon. Add it to the food you’re cooking added to your smoothie, add it to your coffee. Those things can both make a difference. Another kind of quirky. One is water people who chug water during a meal. Sometimes we’ll see a higher glucose spike. And this has actually been studied in multiple studies.

People who drink about 300 milliliters. Of fluid with their meals have higher glucose spikes. And I think the reason for this is that it’s getting all this food to your small intestines faster, and you’re just absorbing it faster. But when you look back at some ancient traditions, like IRA, Vedic medicine, there’s actually many traditions that do say.

Drink water in the morning on an empty stomach. Don’t drink your water with meals. So there’s some interesting, maybe traditional wisdom there that may be related to how we, digest the food. And then I would say some of the last ones are fiber. Fiber is totally your friend, usually in relation to glucose.

Again, there’s going to be individual variability, but. In most studies that I have seen adding fiber to meals will lower your glycemic response. So I’m big on beans, nuts, seeds, adding chia, flax, just some beans on anything I’m cooking. If it’s a breakfast, scramble, put some beans on top.

If it’s salad, I’ll put some beans on top. There’s I just end up putting them on Watts because. That’s carbohydrates that I’m not actually going to digest and her into glucose, they’re going to be digested by my microbiome and actually make helpful byproducts. So fiber is a friend and then the last would be reiterating the meal timing thing.

There’s been some interesting studies where they basically gave two groups of people, the exact same amount of calories and foods per day, but one group ate them between 8:00 AM and 2:00 PM. And one group ate the same food between 8:00 AM and 8:00 PM. So one had a six hour feeding window. And one had a 12 hour feeding window, same foods though, in that window, the group with the shorter feeding window who stopped eating earlier had much lower 24 hour glucose Levels, better metabolic parameters.

So it seems like the more we can kind of. Even if we’re eating really big breakfast and lunch or late lunch, squeezing it into a smaller period seems to be better for our metabolic health. So you can kind of experiment with that. Like how, it’s not about deprivation, it’s about timing. And you can imagine if you’re eating in a shorter window, even if it’s a lot of food you’re getting, you’re probably getting your insulin up during that time, but you’re not spacing that insulin being up for that full 12 hours and making it so that, You’re not fat oxidizing at all during that 12 hours.

So you’re giving your time, your body more time to just have that lower insulin time to kind of reboot metabolically. And then of course walking after meals, that’s, if there’s one, one easy thing to do. It’s walk for 20 minutes after every single meal it’s been shown time and again, in studies to lower glucose responses.

And it’s just, it’s simple. So if you can do it

Dr. Mariza: [00:44:35] love, thank you. Those are all such great tips and what I consider to be really free tips, very easy tips to implement, to help minimize and minimize those glucose spikes now. And I love them because, one of the things that we talked about at the very beginning of this interview was.

It’s hard to change healthy behaviors. It’s hard to make those changes. That’s why I love the idea of monitoring because I feel like it’s going to really drive behavior, but I wanted to talk about how Levels the technology that you have can really help to solve, making these transitions in and healthy lifestyle.

Dr. Casey Means: [00:45:10] Yeah. So what we’ve done at Levels is create a software overlay to this data stream that lets people actually interpret it. Everything we’ve been talking about today on the podcast that might be hard to parse out on your own. So we’ve created software that helps people. Get to the root of all these things and figure out what’s working for them.

What’s not working for them and be able to actually make those behavior changes. So people are pulling in the data from their continuous glucose monitor into the app, as well as other metrics like their Apple health and their Google fit data. And so starting to correlate, when I eat this. These are the things that seem to be driving my glucose app and we help parse that out for people to make it really actionable.

And, I think a lot of people aren’t familiar with the glucose numbers, one 30, two 87, what is right? Where do we want to shoot for? So we just take all that mystery out and. There’s an optimal zone to be in. We grade all of your meals and activities with just a simple one to 10 score of how much of a metabolic impact it had taken into account.

A lot of these complex background metrics, but what the person sees is just their score was this meal and a, was it a, B, was it a B minus? And how can we improve it? So that’s what we’re, w we’ve built. And moving forward, we’ll be adding in lots of other elements to really help with the behavior change process, like the social element to it.

Having people who can support you within your community and cheer you on and give you tips, bringing in lots of challenges that people can try to sort of experiment with what works for them and what doesn’t. And then really great population metrics. So how are you stacking up against other people, in your age group, for all the people who ate a think bar, what is the spectrum of responses to that particular food and so you can kind of get an idea of what others in the population have experienced and and learn from that as well.

So all of those things I think are important for the sustainable behavior change model. I’ve really keeping bill on track. I

Dr. Mariza: [00:47:15] Love that. So much. How does this all fit together? So I know that Levels integrates with a continuous glucose monitor. Is that correct?

Dr. Casey Means: [00:47:25] Yeah, it does. So right now, these continuous glucose monitors are prescription only in the U S so you have to get them in many other countries in the world.

They’re overlapping. Yes,

Dr. Mariza: [00:47:37] they’re over the counter. What is wrong with beds

Dr. Casey Means: [00:47:39] in the U S requires that physician prescription? And the reason is because these have traditionally been tools, wonderful tools for the type one and type two diabetic community manage their condition. But I think as we. As practitioners and people all learn more about how metabolic health is something we should all be caring about.

This is not, you shouldn’t start caring about glucose when you have a diagnosis of diabetes, that’s too late. Like it’s certainly not. Cause you can still make great improvements. Even at that point in time. But it’s, we should all be thinking about it probably 20, 30 years earlier, knowing exactly where we stand on the metabolic health spectrum and be able to actually take action to stay in that.

And why walk into the doctors? Obviously you get a surprise when you could be tracking. We have the tools to track these things now and move in the right direction. So we are expanding that access by having set up a telemedicine network that. When you sign up for the Levels program, which is a one month continuous glucose monitoring program, you’re paired with a physician in your state.

You’re evaluated for prescription. If that prescription is granted, we ship you the sensors straight to your house from our partner pharmacy, you get access to this app and you start your journey to really understanding your metabolic health throughout the course of the month. And getting the, the glucose data stream 24 hours a day.

Dr. Mariza: [00:48:59] I love that so much. So we’re going to have the link. I know in the show notes, because I have a feeling people I know this is, this has been coming up. I know people have been asking for continuous glucose monitors and doctors, not really, maybe having a reason to say yes to the prescription or approve their prescription.

So I love that you guys have set up to make it a lot easier for not only for us to get the monitor, but then also an easy. An easy platform to actually track and understand what’s going on with our health and with our metabolism. So where can we plug in to, I know it’s Levels, health.com, anywhere else that you would love us to plug into.

Dr. Casey means.

Dr. Casey Means: [00:49:42] Yeah. So I would go check out, certainly check out level’s health.com. You can sign up for the wait list. There we are in a beta program right now. And so there is a wait list, but sign up and you’ll get access to our newsletter. And, but where I would really go is level’s health.com/blog. We are writing voraciously about metabolic health and why it relates to.

Everyone, not just people having a diagnosed metabolic condition, why it relates to us, even if we’re young and pretty healthy, this is something we should be thinking about and we can always ask Glover all. I think we can always up-level our lives by getting our metabolic health really in check.

And so we write about that and topics relevant to weight and women’s loss on. Women’s health performance and athletic endurance recovery. And then of course preventing future disease down the road. So check that out. You can also follow. At Levels on Instagram and Twitter. And then I am personally at Dr.

Casey’s kitchen on Instagram and Twitter, and that’s at Dr. Casey’s kitchen and I’m vegan a hundred percent plant-based. And so I write a lot about metabolic health from a plant-based perspective on my platforms. And certainly the company is diet agnostic. There’s no one right diet for everyone.

That’s if there’s anything I’ve learned from glucose monitoring, it’s that, but. For anyone interested in the plant-based perspective, I write a little about that on my platform. So that’s how you can find us.

Dr. Mariza: [00:51:08] Thank you so much. Thank you so much for giving us so many major takeaways today. Really painting the picture of what’s going on without making it overly complicated.

And thank you for offering this I’m excited. Once it comes out of beta.

Dr. Casey Means: [00:51:21] Oh, thank you so much for having me. It’s really wonderful to chat with you about this.

Dr. Mariza: [00:51:26] What a powerful conversation on one of the biggest epidemics facing this nation. As you heard earlier in the interview, we’re talking about 90% of adults here in the United States.

Who’ve got. Some level of metabolic dysfunction. So I have a feeling, at least one person in your life who is suffering from metabolic issues, and you may even find yourself wondering right now, if you yourself should focus on creating a more resilient metabolism. I know that it is always on the top of my mind for my health and the health of my family.

Now, one of the things that Dr. Casey mentioned that really struck me is how a metabolic dysfunction can affect all areas of the body, whether it’s our reproductive hormones, our immune system, our eyesight, even our brain function. It really just depends on where that inflammation is building up in the body that becomes the linchpin.

Now I highly recommend diving into more resources on this topic to really understand how to make strides and changes for your body. Go check out my podcast episode. This is one of my favorite resources that I recorded recently, which was episode two 23. And it was on the number one hormone to watch out for at the age of 40 hint.

It’s not estrogen. And definitely go check out Dr. Casey’s website on her cutting edge technology for tracking and monitoring your metabolic function. Oprah always says, know your numbers. We cannot fix what we can’t track and measure. So the website for Dr. Casey’s new technology for measuring your metabolic function is level’s health.com.

No, that’ll be in the show notes for episode this episode two 36. And lastly, I just want to say thank you so much for joining me today on the essentially you podcast. And the next episode, I just want to dive a little deeper into this topic into our metabolism, but specifically sharing the truth behind stubborn weight gain after 40 years old, because lesbian honest, for some reason, things begin to shift in our forties.

All of a sudden our metabolism is just not as resilient as it used to be. And there’s a couple of key indicators for why that is. And there’s some really incredible lifestyle ways in which you can begin to transform your metabolism and get it right back on track. So I’m excited to jump into what those solutions are in the next episode, coming up this Friday until then.

Have a wonderful

Dr. Casey Means: [00:53:48] week.