Who wants to add Dr. to their names? Soon, we’ll become our own physicians. This is the CEO and founder of Levels, Josh Clemente’s crazy prediction.
Clemente discusses his health battles and experiments he conducted while working at Space X. These all led to the founding of Levels, a monitor and service which tracks your metabolic health.
So, how will we become our own physicians?
Thanks to innovations in the health sector, we are able to access our personal health data in real-time more than ever. Although this is not necessarily new, we also now have the tools to interpret the data and control our health. We specifically discuss the significance of glucose to our metabolic health and the four key stressors that humans struggle with in our day-to-day lives. We’ll let you in on the secret, they’re stress control, nutrition management, exercise and sleep quality.
Josh also doesn’t separate mental health from physical health as he explains these are all one system working together for our overall Health.
Health is wealth and we’re investing in ourselves and our newfound control! 💸
Let us know what you think of this idea and this podcast at michael@firstminute.capital
Also...
Who wants to add Dr. to their names? Soon, we’ll become our own physicians. This is the CEO and founder of Levels, Josh Clemente’s crazy prediction.
Clemente discusses his health battles and experiments he conducted while working at Space X. These all led to the founding of Levels, a monitor and service which tracks your metabolic health.
So, how will we become our own physicians?
Thanks to innovations in the health sector, we are able to access our personal health data in real-time more than ever. Although this is not necessarily new, we also now have the tools to interpret the data and control our health. We specifically discuss the significance of glucose to our metabolic health and the four key stressors that humans struggle with in our day-to-day lives. We’ll let you in on the secret, they’re stress control, nutrition management, exercise and sleep quality.
Josh also doesn’t separate mental health from physical health as he explains these are all one system working together for our overall Health.
Health is wealth and we’re investing in ourselves and our newfound control! 💸
Let us know what you think of this idea and this podcast at michael@firstminute.capital
Also...
Michael Stothard from firstminute capital
Hello and welcome to Crazy Intel. It's not a podcast about big ideas. Every episode, we bring on a new guest to talk about a prediction for the future, which, on the face of it, sounds a little bit crazy.
Michael Stothard from firstminute capital
I'm your host, Michael Stothard, an early stage tech investor at first minute capital. And today I'm joined by Josh Clement, the co-founder of Levels. Hi, Josh, thank you so much for being here.
Josh Clemente from Levels
Thanks a lot for having me on, Michael. I'm really excited to chat.
Michael Stothard from firstminute capital
I'm really, really excited about this. I've been reading about you in Levels for a really long time, so I'm really excited. But before we go into your totally crazy idea, or maybe not so crazy, can we just start with just what levels is, what it does, what you're building?
Josh Clemente from Levels
Yes. So levels is the platform that will allow individuals to understand how food affects their health in real time. So it's a it's a software and behavior change platform that connects with molecular sensors. So sensors that you wear continuously and that currently measure the level of sugar in the blood on a continuous basis and sugar is a as a very high leverage indicator of how your body is processing food.
Josh Clemente from Levels
And it is related to a lot of metabolic complications down the road. And so we can dove into what all that means. But essentially what we're doing is empowering individuals to immediately understand within minutes, not within years, how their lifestyle is affecting their health and set themselves up for success.
Michael Stothard from firstminute capital
And can you give us just a minute on the history of this? Because I feel like glucose is very much in vogue at the moment. Continuous glucose monitoring is not brand new, but new ish. Can you give us a little sense of, you know, the history of this and I guess what people have realized about the significance of glucose for your health or metabolic health in the last couple of years?
Josh Clemente from Levels
Yeah, absolutely. So, you know, I think metabolic health does not have the same ring to it, the same commonality that we have with mental health and physical health. But the really interesting thing is that it is the foundation that mental health and physical health are built on. So just just briefly on what metabolic health means or what metabolism is.
Josh Clemente from Levels
Metabolism is the way our bodies use our food and environment to generate energy. So every cell in the body, from the brain to the organs to the muscle, has to generate energy in order to survive in the way that it does. This is through processes, metabolic processes, which take the fuels that we provide, the fats, the carbohydrates, the proteins, and turn them into that energy system.
Josh Clemente from Levels
And so when metabolic health starts to break down, when we start to lose the ability to generate energy, for example, in the brain, what we get is poor mental health. We get deterioration of the brain, the same with the muscle and with the fat tissue as these cellular systems start to lose their capacity to generate energy efficiently, we become we become sick in that specific region.
Josh Clemente from Levels
And this can be whole body. You can see people who are deteriorating sort of simultaneously across multiple, you know, mental and physical elements where we can see individuals who struggle with one specific sort of syndrome related to the function of of that part of the body. But what we are shining a light on is that there's a shared root cause here, which is the metabolic function or the metabolic fitness of that individual and of the tissue throughout their bodies.
Josh Clemente from Levels
And so we start to see this sort of coming up in various labels and various focuses. You know, we have we have infertility and we have erectile dysfunction and we have stroke and heart disease and diabetes and mental health. And we talk about all these things as their own vertical. It's like this is a thing that affects certain people.
Josh Clemente from Levels
And here's your support group and here's your symptoms. That and the reality is that what we need to be talking about is the shared root cause of metabolic fitness or the lack thereof. And there are there are several really, really strong indicators that take decades to really get out of control to the point where we assign a disease to them.
Josh Clemente from Levels
But that can indicate whether or not you are metabolically fit or heading in the wrong direction. And this is what levels is doing, is we're generating a platform where we can provide continuous data to show you the exactly how your body is processing your foods, the dynamic response that your body has to the choices you're making every day.
Josh Clemente from Levels
And it is the compounding effect of those choices that leads us in a direction, and I can share a lot more on that. But the point is that, you know, there's this there's this recent, I think, increase in the rate case, the people paying attention to the words metabolic health and metabolism. And that's fantastic because it's leading us in the right direction.
Josh Clemente from Levels
We're starting to pay attention to the shared foundation of the problems that we experience, the quality and quantity of life risks that we that we all experience.
Michael Stothard from firstminute capital
I want to get onto your big crazy idea, but just just to just just to go one step deeper into that. When I go to the gym, I make my self fit in a way that I suppose I don't really understand. But I feel like I get better and I can do more running. If I do more running, how?
Michael Stothard from firstminute capital
What is your metabolic what is your metabolic unfitness exactly? And how do you train it? Like, how do you go to the gym for your metabolism?
Josh Clemente from Levels
Excellent question. So as with most things, the the fitness or the optimization of a system requires continuous, repetitive effort. You go to the gym, you lift weights. What you're doing is you're loading your muscle fibers, you're creating a little micro tears which signal to the body. This muscle specifically needs to be strengthened so that it can survive whatever the load is being put on it repeatedly.
Josh Clemente from Levels
And so it builds strength in that region and over time you get stronger, faster, it's better, whatever it is that you're working in the same way with metabolic health. If we want to generate cellular efficiency, cellular basically the ability for our bodies to take in the the fuels that we're providing it break them down effectively without toxic byproducts and without excess storage of fat and without excess byproducts like hormones that go haywire.
Josh Clemente from Levels
We have to be able to, over time, practice a few key lovers. And those are stress control, nutrition management, exercise and sleep quality. Those are the four levers of metabolic health. And you'll notice there's a lot of overlap with physical fitness, right? There's a lot of overlap with mental fitness. And again, it's the it's the root foundation of those.
Josh Clemente from Levels
So in order to improve our cellular function and truly to maintain metabolic health, we need to be able to see and understand how our bodies respond to the foods that we are providing them. We need to exercise our muscle because our muscle is it's the largest fuel think in the body. So our muscle is what our muscle and brain really is.
Josh Clemente from Levels
What uses all of the calories that we that we burn in a day. And so properly exercising the body signals to the body that it needs to be burning fuel, not just storing it. And so that's how we we have weight, overweight and adiposity and and then sleep quality and stress management. So cortisol, which is the main hormone correlated with stress, is called a glucocorticoid.
Josh Clemente from Levels
So it's a essentially what it is. It's a hormone that interferes with glucose response. It tells the body to rapidly increase the amount of sugar glucose in the blood because there's a lot of stress around. And this is an evolutionary response to a threat. So we used to use cortisol to tell the body quickly, increase the amount of fuel in my blood because I might need to escape the tiger or the lion that's chasing us nowadays.
Josh Clemente from Levels
That's not a lion or a tiger. It's an email inbox that has 200 messages on it. And so we are we are constantly sort of under these stressors that are driving our bodies to respond physiologically in ways that that really undermine our metabolic health. And then sleep, you know, is such a major vector. So there have been studies that have shown that just sleeping 4 hours a night for six days can increase the glucose disposal rate.
Josh Clemente from Levels
So basically, I'm sorry, that can decrease the glucose disposal rate in the blood by 40% and it can increase the insulin response to a meal by 30%. So this is this is essentially a micro pre-diabetes experience. And that happens after just six days of sleeping, 4 hours a night. So essentially the levers that we're playing with a really powerful and yet we don't have insight into these effects and they're largely asymptomatic for years.
Josh Clemente from Levels
So when we say metabolic fitness or the lack thereof, what we're describing is really the efficiency and the the capability of your body to generate the proper amount of fuel without unnecessary byproducts so that we can live our lives sustainably.
Michael Stothard from firstminute capital
You talk about empowering people to make to make the right choices, which I think ties us neatly into your big, crazy, crazy idea for us. Could you please tell us something that sounds completely ridiculous but actually you think will come to pass?
Josh Clemente from Levels
Yeah. So the way I would frame it, my, my big crazy idea is that we are going to become our own physicians. So what I mean by that is that we are attempting in the modern era to control our health over long time periods. We that is what we are hoping to achieve. And yet we've sort of split apart the concept of my health status and the individual responsible for it.
Josh Clemente from Levels
We're making our physicians responsible for maintaining our health when in reality, as I've mentioned, it is the lifestyle decisions we're making which compound over years and decades that lead us to a specific health outcome. It's not my physician taking those actions, it's me. And so I am going to be the one who takes over the control of my health over long time periods in much the same way that I have control over my financial health over long time periods.
Josh Clemente from Levels
And the we will be able to relieve the medical system of non-emergency health care. So our physicians will continue to be there to support us in tragic circumstances of accidents, of, you know, sort of communicable or non-communicable diseases that are sort of the epidemic variety. And they will help us in those those crux circumstances when we really need expertize.
Josh Clemente from Levels
But otherwise, we will become our physicians. We will understand our health in real time, and we will be making educated and informed decisions. The strategy for our decision making will be data driven and it will be personalized, and we will be able to alleviate the medical system accordingly.
Michael Stothard from firstminute capital
What was amazing about what you were just saying was that there seem to be two kind of things you can do with this information. And part of what you can do with levels is specifically target people who have pre-diabetes or diabetes, which I believe and you can tell me is a huge, huge, huge issue. I think about those 80 million people in the US alone with pre-diabetes, but there was also a much broader set of improvements in people's and people's lives.
Michael Stothard from firstminute capital
Right. And actually by taking control of this area, you could, you know, maybe a bit like quitting smoking. You know, you could reduce your chances of everything else going wrong by 20% or whatever it is.
Josh Clemente from Levels
Yeah. I thank you for taking that up because it's the statistics are really interesting. Most of us, again, think about labels. We think about, oh, diabetes. That's a different type of person than me. I don't have that problem or stroke or, again, adiposity. So what what I want to get across here is that metabolic health and really what I've I've dropped the metabolic I now talk about health in the health maintenance sort of concept and that is this is an issue that is personal to everyone.
Josh Clemente from Levels
You you either know someone or are related to someone or are someone who will develop a serious chronic condition that will end your life or that person's life early. That is that's where the statistics show we are. These are not typically acute deaths and we are unfortunately complicit in them. So these are the slow, asymptomatic deaths related to chronic lifestyle disease.
Josh Clemente from Levels
And to put some numbers here, you brought up diabetes, which is typically the it's the one main condition that we really think of when we think about blood sugar. So in the UK, 27% of the population is either pre-diabetic or has type two diabetes. That is increasing rapidly in the United States, 100 million Americans have prediabetes or type two diabetes, and 84% of them don't know it right.
Josh Clemente from Levels
They have no idea that they have this rapidly developing condition. These are these are similar numbers in most of the developing world right now. Rapidly increasing, two thirds of the UK are overweight or obese and that rate is accelerating and adiposity. We're overweight now accounts for more deaths than smoking in England and Scotland. So we're now at a point where the the deaths caused by, again, these are these are lifestyle related deaths still, whether smoking or related to adiposity, we have control.
Josh Clemente from Levels
These are preventable. But the problem is that the conversation is entirely different between them. We we sort of with smoking, we know, hey, look, this is a decision that's being made. There's an acute challenge to our health that is happening. We've got to intervene. We've got to try and change this with adiposity or really with lifestyle decisions. Generally, we have this huge disconnect between the action we take and the reaction our body experiences decades later, when we get a diagnosis and we say, Oh wow, where did this come from?
Josh Clemente from Levels
And I really want to connect those dots in a more acute way. And this is the behavior change concept that we're talking about that levels. It's that when I sit down and I eat lunch, what do I eat and why today? That question is really, really hard for people to answer. You know, usually it's related to a taste good or I read about it on the Internet or it's a diet program that somebody recommended to me.
Josh Clemente from Levels
In most cases, there is no objective data that comes from my body related to my health, especially nothing that came from the medical system telling me what I should eat and why. And there is an opportunity today with technology to close that loop in real time to show people why you should eat something. And the data is really is really striking on, first of all, why this is a problem that technology is needed to solve.
Josh Clemente from Levels
You know, a lot of people, I think their gut reaction is, well, why don't we just eat the things we've always eaten? And I think that's a fair question. However, the food system has changed pretty dramatically across the years, and now there were battling convenience or battling marketing messages, and we don't have objective truth. And so this is where I think technology can really cut through all of that and provide us with a very clear instructions that from the body telling us this does or does not work the way that we expect it to for our health.
Josh Clemente from Levels
So so I'll get to that in just a second. But I wanted to loop back and expand on the, you know, the crazy numbers of pre-diabetes and diabetes. That's, again, just one condition metabolic syndrome, which is kind of a basket of of metrics related to metabolic dysfunction. So obesity is one insulin resistance. Insulin is a hormone that takes glucose out of the bloodstream and puts it into the cells to be either turned into fat or used as energy dyslipidemia, which is where cholesterol numbers and lipids, blood fats are out of control and high blood pressure.
Josh Clemente from Levels
These are all associated metabolic syndrome, metabolic syndrome is correlated, causal or associated with almost every leading cause of chronic illness and death in the world. And this is stroke, heart attack, cancer, COVID 19, kidney and respiratory diseases and Alzheimer's. And the way that that interference occurs is, you know, Alzheimer's, heart attack, stroke. This is typically over time, the insulin resistance breaks down the tissues, ability to generate energy cells start to die and they become essentially, you start to get blockages and you start to get lack of function with kidney and respiratory diseases.
Josh Clemente from Levels
These are the associations typically due to immune system reduction. So with COVID 19, the correlations are very strong between people who have poor blood sugar control, poor metabolic health and risk of death or risk of acute hospitalization. That's due to the immune system dysfunction that happens with metabolic illness. And so what I wanted to do there is just identify that even though the numbers are out of control with pre-diabetes and diabetes, that's just one of the categories that we pay attention to.
Josh Clemente from Levels
And when we're talking about metabolic fitness and the effects, the positive effects are that we can intervene upstream of all of these causes of illness and death. And so in you know, in the near term, we are going to have widespread, accessible and actionable availability of this information so that we can make closed loop decisions around what we eat and why, how we sleep and why when we exercise and what we do and our stress management.
Josh Clemente from Levels
And that is going to give us a powerful lever to prevent these long term illnesses.
Michael Stothard from firstminute capital
So can you give us just the story of how you got into all of that? I mean, obviously, like bio hacking, measuring your own, you know, everything. It's been a trend in the last ten years, but the glucose thing has been more recent. What what drove you to it? Were you always a big fan of of this kind of thing?
Josh Clemente from Levels
Well, you know, to be honest, no. So I kind of think of myself as sort of a patient zero for this this technology sort a kind of rewind. I've played sports most of my life. I'm an engineer. I'm an aerospace engineer. So I work at Space X straight out of school. And I was leading a team that was developing the breathing apparatus, kind of life support systems for the astronauts on the crew dragon capsule.
Josh Clemente from Levels
So that that vehicle has now flown for Space X and brought crew members to the International Space Station. But at the time I was working on it, we were still very much in development. And while I was on that program, two things happened to me and the the overlap of these two things was maybe fortuitous, but I certainly defined why this is so important to me.
Josh Clemente from Levels
Firstly, I became aware of some research which showed that essentially, okay, I'll try and keep this. Try not to get too far in the weeds, but essentially when mice are exposed, well, humans at any any animal, any mammal is exposed to high pressure, high oxygen environments. They have a high risk of seizure. So essentially the brain, because oxygen is highly reactive, the brain can go into a seizure if the oxygen levels are above a certain level.
Josh Clemente from Levels
That's kind of contradictory. We think oxygen is is super healthy. It definitely is. We need it. But above a certain level, it becomes actually toxic to the brain. So because I was designing the oxygen system, I was thinking about this problem, you know, what happens if there is a high oxygen environment due to a failure or something like that?
Josh Clemente from Levels
And I became aware of this research which showed that when mice are exposed to that high pressure, high action environment, but they are on a ketogenic diet. Right. So they are they are fed high fat foods or or even specifically fed ketones. Directly ketones. Are there a fat molecule which the body can produce or which you can you can take exogenous leaves.
Josh Clemente from Levels
And so when they are fat fed ketones, they survive five times longer before having a central nervous system seizure. The only change, again, is the fact that they are on a ketogenic diet as opposed to a standard diet. That study completely changed my worldview because up until that point, I was a person who thought, based on my sports history and just being kind of a fitness fanatic, I was I was also a CrossFit trainer at this time, so I was teaching classes in the mornings, and I had always considered every calorie to be the same.
Josh Clemente from Levels
So a calorie is a calorie, and whether it's from Skittles, candy or broccoli, what you're getting is energy. And it doesn't really matter what the food is. This study completely changed that for me. It showed me that there are basically super physiological gifts that were given to these creatures that allowed them to live five times longer just by changing the food they're eating.
Josh Clemente from Levels
So that combined with a moment in time where I had personally hit what I call physical rock bottom. So I was the physically fittest I had ever been, right? So I was lifting the most weight. I was able to jump high and run fast, but I felt terminally ill. And I actually told my doctor, I think I have a condition.
Josh Clemente from Levels
I don't know what it is, but I feel really, really sick every day. My my mental my cognitive condition is is poor. I feel low energy. I feel like I want to curl up under my desk and sleep it off. I get these cold sweat, shaky episodes, and I get really irritable. I don't know what's going on. It feels really I've never experienced before.
Josh Clemente from Levels
It's it slowly built. So this was happening at the same time. And this is at a time when, again, I was I was leading a very stressful program, heavy deadlines on sleeping poorly. I would go to the gym at 10 p.m. to quote unquote blow off steam and thought that that was leading me to a healthier life and I kind of correlated physical fitness in the gym to health and eventually, you know, my doctor gave me a blood panel and he told me, everything's fine, you're fine.
Josh Clemente from Levels
You're very healthy. In fact, you're one of the healthiest patients that I have. Stop worrying about it. You're totally fine. A friend of mine mentioned to me that I should measure my blood sugar. He said, It sounds to me like you are having hypoglycemia when you have that shaky, cold sweat irritability thing. So I got a fingerstick, a little finger prick glucometer.
Josh Clemente from Levels
So it's this little thing that you put your finger. A little drop of blood goes on a strip and it tells you your blood sugar number. And I got one of these and I started to kind of obsessively measure my blood sugar. And I was tracking it in a spreadsheet to see if I could see anything interesting. And I really couldn't make heads or tails of it.
Josh Clemente from Levels
And then I read a book called Wired to Eat by Rob Wolff. And in that, he talks about this amazing technology of continuous glucose sensor. And I immediately went to my doctor and said, Hey, I'd love to get one of these devices. I think it's going to give me some insight into how my body is functioning. And my doctor said, absolutely not.
Josh Clemente from Levels
And it was kind of just like a scattering of points here, scattering the points there, and nothing really to connect the dots. So I then read a book called Wired to Eat by Rob Wolff. And in this book he describes this this technology, a continuous glucose monitor. And I was instantly like, that's what I need. So this is a device that you wear on your body.
Josh Clemente from Levels
It translate it transmits data continuously to your phone or at discrete data points. But every every like 5 minutes you get a new blood sugar reading and it gives you this beautiful, high resolution, continuous insight into how your body is processing sugar. And I went to my doctor, I said, I need one of these. Yeah, I think it's going to really be helpful for me to understand what's going on.
Josh Clemente from Levels
And he said, that's not for you. That's for people with diabetes and not just diabetes, but uncontrolled diabetes. And my response to him was, well, that doesn't make any sense. I know that 90 plus percent of diabetes is preventable and this is the metric that defines it. Why would we wait until something is catastrophically wrong? You know, as somebody who does engineering on machines for a living, I don't wait until something fails to measure it.
Josh Clemente from Levels
I measure it way ahead so that I can avoid that. Failure like this is frustrating. I'm trying to understand what's going on in my body and you're blocking me from doing that. Why? What who is benefiting from this? And so we had a bit of a back and forth and I left that office with a real chip on my shoulder because I had I felt like there was something backwards about this.
Josh Clemente from Levels
You know, I had I had done enough research to know that rates of this condition were skyrocketing. I personally was feeling bad. This individual had told me to pay attention to it, and yet I was being blocked by the health care system from access. So ultimately a friend of mine went to Australia and he, he actually picked up a few gems.
Josh Clemente from Levels
They happened to be over the counter there and he brought one back to me and within about four days of data I knew something dramatic had to change. My blood sugar was absolute chaos. And I had been reading, you know, just voraciously reading about blood sugar control and what is optimal, what numbers are associated with the higher risks of long term metabolic disease and which numbers are not.
Josh Clemente from Levels
And my my blood sugar was regularly in the pre-diabetic and even diabetic zones, eating the meals that I thought were healthy. And so all of these ideas that I had, you know, that I had to, you know, eat a lot of carbohydrates before any workout or replenish my glycogen stores by eating a ton of sugary foods right after a workout.
Josh Clemente from Levels
That sleep was sort of you can sleep when you're dead, you know, sleep. It doesn't really matter. I'm seeing all of these things dramatically affect I mean, like significantly impact my blood sugar control. And what I was experiencing was this moment when my blood sugar was crashing down from one of these peaks. And that was when I was having these shaky, cold sweat, irritability episodes.
Josh Clemente from Levels
And it was exactly as my friend had mentioned, this was called reactive hypoglycemia. So anyway, I used this glucose data. He used the sensor to just experiment for a few weeks on the nutrition choices I was making, and within literally two weeks I was able to eliminate these major elevations in my blood sugar and just have a much more controlled day and get rid of those reactive hypoglycemic episodes.
Josh Clemente from Levels
And so for me, that was it. It was the light bulb moment. There's an access issue to this technology that is the most it is the most powerful continuous data I've ever seen about my body. Way more interesting than step count or heart rate or heart rate variability. I want to make this more accessible. And and that's what levels these levels is the platform.
Josh Clemente from Levels
I wish I had had that first experience with the CGM.
Michael Stothard from firstminute capital
You became your own physician.
Josh Clemente from Levels
That's the direction that just like you should to be able to take. Yeah. You know, I think this is this is the very first step in a journey that I think will will ultimately give people the sense of empowerment that I now feel like having that insight. It's not just about understanding what's happening. It's also for me now about accountability.
Josh Clemente from Levels
It's I understand the connection, the correlation between the choices I'm making, the reactions, my body experiences and my long term objective, which is I want to have a very long, healthy life where I hope to be climbing mountains with my grandkids. And if I'm going to do that, I've got to be in the driver's seat of my health and in the same way that my 2001 pickup truck has a computer on board with thousands of sensors feeding data into it that I can connect to with an OBD two port.
Josh Clemente from Levels
I also can, over time, with the development of this new technology, see my body condition in real time, understand the effects of the choices I've made, and turn those decisions to the optimal for me, the individual. And I just want to touch on that piece, the individuality of it briefly, if that's okay. This is not something for which there's a one size fits all solution.
Josh Clemente from Levels
But to give you a couple examples, in 2015, there was a trial, a study in at the Weizmann Institute in Israel, and they showed that to people. So they basically gave 800 people that do not have diabetes, a continuous glucose monitor, and they had them eat these sort of calibrated meals. They showed that two people can eat the exact same two foods.
Josh Clemente from Levels
In this case, it was a banana and a whole wheat cookie. And they can have equal and opposite blood sugar responses, meaning one person has a huge spike on the banana and is totally non-responsive to the cookie. The other person has the exact opposite response. Huge spike from the cookie, no response to the banana. That implies that there is a serious consequence and a differential consequence between making a decision that seems healthy at face value for one person but is actually not.
Josh Clemente from Levels
And this the study was then replicated at King's College in London. So they showed the same dramatic interpersonal variability and extended even to twins. So people that have the same exact genetic makeup have the same degree of variability. So even among twins, our bodies respond so differently to the choices we make. And when it comes down to you, the explanation for this and how is this possible, that sounds like chaos.
Josh Clemente from Levels
Well, it's that each of us is individual and it's largely contextual. So essentially I mentioned previously that sleep has a huge impact on blood sugar control and insulin resistance. Again, insulin is that hormone that tells the body to take glucose out of the cells and use it for energy or to store it. So, for example, imagine one person has recently had a baby and their their sleep has been totally blown up.
Josh Clemente from Levels
They're no longer sleeping effectively. And their body is now in this induced state of insulin resistance. Well, again, they're going to have a 40% difference in how their body responds to two meals because of that poor sleep. Imagine somebody is fitter than their twin, right? They've been working out. They've lost weight. They've got more muscle mass. Their body is going to respond very differently to the blood sugar impact of a meal than their twin is.
Josh Clemente from Levels
So this is the context that we all you know, we today kind of think of, well, everybody sort of an average person and we can just follow the averages to decide what to eat. That is absolutely not true. If if we really want to make targeted decisions, if we really want to optimize the individual, we have to personalize our choices based on who we are and where we are in our lives in real time.
Josh Clemente from Levels
And this is the technology that can make that happen.
Michael Stothard from firstminute capital
I've been using these continuous glucose monitors with my wife, and the thing that's really wild to me is not just the different reaction to the same foods, but the different reaction to the same foods at different types, different times of day. So like for some, you know, for one of us 9 p.m. might be a great time to have a snack.
Michael Stothard from firstminute capital
And then for the other one, it's completely horrific. And again, I don't know why that is, but it's but is amazing to see in real time.
Josh Clemente from Levels
Yeah. You know it's one of the most I think fun and engaging parts of this is embracing the differences between us and and and the similarities. So I to this day still have some of the worst blood sugar control at that levels. I'm just one of those people that is very, very hyper responsive to not just meals with a lot of carbohydrates, which break down into glucose in the body, but also stressors like caffeine or poor sleep.
Josh Clemente from Levels
If I drink more caffeine than I usually do, my blood sugar goes through the roof and I have kind of an ongoing, elevated day and my responses are much worse to all the other foods. But similarly, I have a very high response to exercise. So if I if I go for a long walk, my blood sugar comes way down super fast and stays nice and low and flat for 4 hours.
Josh Clemente from Levels
And this is one of the really powerful things that we've learned through this technology, is that the impact of very small choices, we call them micro optimizations is really quite strong. So we did a challenge with our with our data set where we had people drink a regular Coca Cola soda and just be sort of stationary, just sit on the couch, watch TV, don't, don't do anything.
Josh Clemente from Levels
And then the next day drink the same Coca Cola and go for a 20 to 30 minute walk. You know nothing. You're not running, you're not sprinting, you're not working out, just strolling around the neighborhood. And the difference between those two examples was about 30% on average. So people had a 30% better blood sugar response to the same can of Coca Cola after they took a walk versus sitting stationary.
Josh Clemente from Levels
And the reason for that is, again, our muscles are these huge. There are these energy sinks when you're using the biggest muscles on your body, on your legs to walk around, even though you're not strenuously exercising, your body is using that energy in real time. And so these are the small little tweaks, you know, things like getting an extra few minutes of sleep because as opposed to you, you know, I think watching TV late into the night, which can kind of get our blood pressure up, our cortisol up and disrupt us all all night long.
Josh Clemente from Levels
We're taking little walks, you know, right after meals that we feel are indulgent. These are the little levers that we can pull on. And they seem like insignificant choices. But when you have the data to see that that your body is actually being treated better through this small decision, it's kind of like a receipt. I think of it as a receipt for a transaction.
Josh Clemente from Levels
It's like, okay, I have proof that this is what's going to require. It's going to convince me to continue to do this.
Michael Stothard from firstminute capital
So what do you eat now that you didn't eat before? Or rather, how is what you eat changed?
Josh Clemente from Levels
Well, you know, I think the most important thing is that I now understand something fundamental about the conversation around nutrition. So previously I had thought about nutrition in terms of calories. So a calorie is you know, I want to try to draw a nuance here. The the term we may have all heard, which is a calorie is a calorie is absolutely true.
Josh Clemente from Levels
That is that is a physics statement, meaning a unit of energy equals a unit of energy. That's absolutely true. You know, it might be might be a joule as a jewel or a what does a what you know, these are these are units that are using physics. But what that calorie is packaged in is not equal. So when I said candy versus broccoli, they both contain calories, which are equivalent, but the micronutrient and macronutrient packaging around them is fundamentally different.
Josh Clemente from Levels
And the way that our body has to respond is fundamentally different. So the hormone insulin is a consequential factor here. If I eat ten calories of candy, my body has to produce the hormone insulin in high quantities to quickly get this very quick responding sugar into my cells. Basically, the body needs to control how high the blood sugar gets because it's very reactive.
Josh Clemente from Levels
It starts to kind of attack proteins and cells in the tissue and destroy it. So the blood sugar has to be tightly controlled. So my body has to produce insulin as to shuttle it into the cells and it does not have to do that with broccoli. So broccoli has a lot of fiber. It has a very slow release.
Josh Clemente from Levels
And essentially just my regular movement would allow me to keep blood sugar very nicely controlled of broccoli. It's a fundamentally different response. And the crazy thing that when we impact our systems repeatedly over time, so think about the candy or think about the Coca Cola. When we drink these very fast acting or eat these very fast acting carbohydrates that release a lot of sugar into the blood very quickly, our bodies then have to respond by releasing a lot of insulin into the blood very quickly.
Josh Clemente from Levels
You end up with something called hysteresis, which, you know, there's a if you think about a syringe, if you pull the plunger back on a syringe and let it go, it kind of snaps back its previous condition. There's a little bit of lag in the system. So hysteresis is that concept where there's lag in the system, if you impact your insulin levels over and over and over again, what you do is you end up with a rising baseline.
Josh Clemente from Levels
So over time, your insulin levels, you know, not only are you having higher peaks, but you're also having higher baselines. And this is called insulin resistance. So over time, type two diabetes develops through this dysfunction of insulin resistance where the body becomes it's producing more insulin, but it is responding worse to it. It becomes the cells basically become numb.
Josh Clemente from Levels
And the driver here is that the ultra processed, fast acting foods that that wrap the calories that we consume. So that is the number one thing I've learned is that calories are calories, but food is not food. And removing the processing from my diet is the most important thing. So I've been able to and I've sort of experimented with dietary philosophies and the beauty of, I think a tool like levels or a CGM is that it doesn't have an opinion about your dietary philosophy.
Josh Clemente from Levels
You can be vegan, you can be carnivore, you can be ketogenic diet based, you can do all of those things and eat in a way that provides controlled blood sugar and good metabolic fitness. But you can also eat in all of those ways in a very unhealthy manner. So, you know, you can be a vegan who eats, you know, deep fried potatoes and rice and a lot of candy, you know, nondairy candy and cakes and things like this and have a very poor blood sugar response.
Josh Clemente from Levels
And you can similarly eat a very rich Whole Foods based diet that is entirely plants that are, you know, in their original form, straight out of the ground, straight from the farm and have an exceptional blood sugar control. And so that's the most important thing, is we have to think about food in terms of its its intended state.
Josh Clemente from Levels
So how I eat today is I prioritize protein, a lot of protein every day. I do eat animal meats, but I, I focus on, you know, the intentionally raised sort of I try to get free range, high quality meat. And so that typically means a little bit less because it is more expensive, but the quality is higher and then I try to fill in the gaps with with plants and nuts and seeds.
Josh Clemente from Levels
I think my, my preferences have adapted pretty dramatically from where they were a few years ago. I was a person who grew up just feeding my sweet tooth. You know, I again, I was physically fit. I didn't have a weight problem. And so I eat really whatever I wanted because I thought it was it didn't really matter. And where I am today is, again, high protein, moderate fat, low carb.
Josh Clemente from Levels
And in the original form that this foods were grown in.
Michael Stothard from firstminute capital
Yeah. And people would be interested. What, what else is in your wellness. Wellness stack I guess is one way of thinking about it. Like how else do you like? What else do you do to keep yourself fit and healthy in the broadest way possible?
Josh Clemente from Levels
Well, you know, the four big levers are nutrition, exercise, sleep, stress. So I do my best to, you know, the first one that I, I had to improve on was sleep. I was there was a time in my life where, again, I thought that was something that I could do when I was that, you know, there's no time for sleep.
Josh Clemente from Levels
I now try to get 7 to 8 hours every night I wear I sleep tracking it's a Garmin watch but it it tracks heart rate variability and heart rate. And my objective is to minimize the things that increase my heart rate within 2 hours before bed. And that is typically not eating meals late at night. I avoid alcohol towards the evenings.
Josh Clemente from Levels
I really avoid alcohol during the week now and I don't exercise late at night because I recognize that that drives my my heart rate way up for hours. And I really try to couple this with reducing stress by not doing not doing work late into the night. So I do try to kind of draw a line and focus on calm activities, you know, either hanging out and talking with my wife or reading books or something that's not going to get my brain sort of riled up.
Josh Clemente from Levels
And that is all the intention of improving sleep quality. I use an eat sleep mattress, which is I'm a very warm sleeper, so I'll go to I'll go to sleep feeling very comfortable and then I'll wake up just uncontrollably overheated and it's very disruptive. And so this mattress, the sleep in there, I think there are toppers that that can be put on an existing mattress.
Josh Clemente from Levels
It just allows you to control the temperature of the mattress overnight. And it's really been amazing for me. I sleep rest fully with that. And then beyond that, you know, it's it's all about intentional exercise. From there, I feel mentally and physically, I feel better when I'm being active and I no longer subscribe to exercising at 150% every day.
Josh Clemente from Levels
You know, there was a time when I thought you you didn't do anything unless you were down on the floor after the workout. And at this point, I now understand that the body really needs it needs consistent movement, that it's very mindful. And so I'm trying to do a lot more stretching, a lot more mobility work and really fitting in zone to exercise, which is like my heart rate is actually not super elevated.
Josh Clemente from Levels
It's it's 60 to 70% of my heart rate maximum. And so I'll either go for bike rides or run in that zone and then I lift a lot of kettlebells and dumbbells. So I, I like to do the sort of single, single arm, single leg sort of workouts to, to build strength in those positions and those, those kind of elements in combination.
Josh Clemente from Levels
Help me manage my stress. The sleep helps me. It improves the way that my body responds to my food. And the stress management is kind of an outcropping of the other three pillars.
Josh Clemente from Levels
And presumably it helps not working for space as well. Tend stress and sleep.
Josh Clemente from Levels
You know, of all the pictures I have of me sleeping under my desk, 100% of them are basically.
Michael Stothard from firstminute capital
Oh, fantastic. Well, thank you so much, Josh, for joining us and giving us an insight into your, you know, routines that but more more excitingly, a kind of new world where we can all be our own physicians and where we can take responsibility for our own health and only really get to the doctors and into the medical system when something's gone drastically wrong.
Michael Stothard from firstminute capital
So thank you so much for joining us. I hope you can tell us before we're ending. And thank you so much for joining us.
Josh Clemente from Levels
Thank you, Michael. I really appreciated you sharing your audience and now I'm excited for the future. And I think that's the message I want to leave with is just there's an amazing opportunity that technology is providing for each of us to understand how unique we are and how much we have control over our health. And this is just a very beginning.
Josh Clemente from Levels
We're straight scraping the surface. And I look forward to the health care systems of the future, as well as the health preservation that is available now.
Michael Stothard from firstminute capital
Fantastic. Final question, who who would you like to see? Who's who's the craziest entrepreneur? You know, he'd like to know who is with the craziest ideas you'd like to see on the show next.
Josh Clemente from Levels
Now, that's a that's a great question.
Michael Stothard from firstminute capital
You can come back to me on that one.
Josh Clemente from Levels
Well, you know, I obviously I got to plug Ellen, but also I got to plug my co-founder, Sam. You know, if if you want to get into some really interesting conversation about company building and about culture and how company culture affects everything, you know, I think we could abstract away the level of conversation and replace it with something really interesting with him.
Josh Clemente from Levels
He's he's quite a deep thinker on these things.
Michael Stothard from firstminute capital
Fab. All right. Well, thank you.