Personalized BIOFEEDBACK and OPTIMAL metabolic health with Maziar Brumand | LEVELS Health

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Welcome to another episode of the Longevity and Lifestyle Podcast. I'm your host, Claudia von Boeselager. I'm here to uncover the groundbreaking strategies and tools and practices from the world's pioneering experts to help you live at your best and reach your highest potential. Today's guest is Mazir Brahmand. Maz is Head of Business and Product Development at Levels Health. So Levels helps you see through a continuous glucose monitor how food, exercise, sleep, and stress affects your health and gives you personal insights so that you can optimize your nutrition and activity. The continuous glucose monitor that Levels uses, which you wear on your arm, is connected with a beautiful app interface. So with amazing insights, we'll talk about that all soon. I've had the pleasure of using Levels and had a real epiphany while I was using it. I was noticing that I was waking up all during the night thanks to my Oura Ring, but only thanks to using the continuous glucose monitor did I realize I was hypoglycemic during the night because my intermittent fasting windows were a little bit too wide. And the easy solution was having some almond butter that was of course sugar and palm-free before bed. So I'm a huge fan and just disclaimer that I have invested in Levels as well, but I'm super excited to have them on. So welcome to the podcast, Mads. So great to have you on today.

Thank you. It's a pleasure being here, Claudia.

So, Mads, I'd love to start with Levels Health, right? So you guys measure blood glucose levels to give insights into metabolic health. But can you share for people, because when people hear glucose levels, they think, oh, you have to be a diabetic. But can you share why measuring glucose levels is so important for everyone?

Yeah, of course. I think even stepping back a little bit further, Levels is about biofeedback. So we wanna look inside your body based on how your body's doing and the molecules are interacting to see what changes you can make. And glucose is a really important molecule in your body, specifically what is metabolism. Metabolism is how your body produces and uses energy. And glucose is obviously one of the major energy sources. So how the food that you eat and how that interacts in your body really determine how you feel. And obviously if you progress and you've mismanaged your glucose for a long time, it turns into different diseases, which are basis of most of the chronic diseases like diabetes, hypertension, and all the other ones. But really way before that, how you feel is really affected by how your body produces and uses energy, which glucose is a big component. By being able to measure that, you have real-time feedback to know how you should eat. For example, I used to get, when you eat a big lunch about 2 o'clock, you have this head nod thing. That's because of what you ate and how your body reacted. And by wearing a glucose monitor, you can actually see how the glucose in your body changed. And the crash is what typically creates that head nod. And so by then learning what not to eat or how to eat it, you can really affect that outcome and you feel great. I've changed my diet. I know a lot of people have, and mid-afternoon head knock is a thing of the past, thankfully.

So I know that's, it's amazing as well. And I think for me, one of the big insights also was I was making these like what I thought was really healthy sweet potato soup with other vegetables in it as well. But I was just then observing as that red line was going up, as my glucose levels were just rising. So everyone metabolizes food a bit differently, and that's what's so beautiful about this, that biofeedback, it's personalized. So for one person, they have no change in blood sugar, whereas for somebody else, it's just spiking. That's the beauty of this personalized biofeedback.

Yeah, funny story for me. I used to eat oats for many years. After a while, you become a creature of habit. At least I did for breakfast. I would just eat that same thing. It's just easy and fast. And sometimes didn't eat oats without milk. So just dried oats, which my girlfriend made fun of me. And my in-laws would joke that's what horses eat, but I liked it and I thought it was the healthiest thing in the world until I put a CGM on. And this was actually when I was learning about Levels and getting interested in the company, and I was just shocked at the response. And this thing that I've been eating for 10 years thinking it's the most healthy thing was doing some crazy things to my glucose. And so that's one of the weird things where sometimes you wanna eat something cause it's delicious and you do it and you're like, I'll deal with the consequences. But sometimes you eat something, you think it's healthy for you, but it's actually affecting your metabolism in a big way. So anyways, I think there's a lot of things like that. Levels helps you just make swaps, easy changes and things like that, that it's almost like a win-win. There's no free lunch in the world, but some of these things seem like free lunches. Like I never liked oats that much to start, but I had it because I was healthy and I can just have something else.

Yeah.

And so So that was a revelation for me.

And I think it's so beautiful as well, because I've had a lot of people come to me and they're like, it's so confusing. And what am I supposed to eat? And I think that this is the beauty of it, that it's not a one-size-fits-all. People from different cultures, different backgrounds, white rice might work very well for them. Whereas in other cultures, people suffer, have spikes in their glucose as well. So I think that's a perfect example. I think people are eating something healthy, like me with the sweet potato. I was like, this is really good for me, but actually the effect and what's happening on the body and for brain fog and things like that as well is quite extreme. Yeah. Yeah. Let's talk about metabolic disease and the metabolic disease epidemic. So can you explain for my audience what exactly is this metabolic disease epidemic, Moz?

A lot of it results from insulin insensitivity. Basically over time, as you consume more and more sugars or carbohydrates, your body becomes less sensitive to insulin and it causes your blood glucose levels to rise. And that becomes the basis for a lot of these diseases. That I think 8 or 9 out of the top 10 that affect mortality are borne by metabolic diseases. So it's really the basis for a lot of things that the world struggles from. And so it's one of those things that if we can get ahead of, and this happens very slowly, so it could happen over a 10-year period. So it's not one of those things that it happens overnight. Getting ahead of it is really the goal. So you don't have to be already diabetic or you don't already have to have these terrible chronic diseases. You need to care about it a lot earlier, and it has a lot of health benefits too, and feeling good and feeling your best and having energy to play with your kids, having energy to do work, exercise. It's a lot before it actually becomes disease, but when it does become a disease, it becomes quite debilitating and difficult to manage. So we're trying to get ahead of it. Think of it this way. Somebody might think that they only need a scale when they're massively overweight, but the reality is no, you need a scale way before you become overweight. Catch that trajectory. And I think Levels is in that place where we really wanna help people before they get there and really help them live their best life. And obviously if it progresses into chronic diseases, it's a tough thing to manage, but it's one of those things you wanna get ahead of a lot sooner than when you actually need it.

Completely. And as my audience will know, I've talked about this openly as well. My mother suffers from dementia as well, and I've had Dr. Del Bretesen on who has a protocol to reverse Alzheimer's, but you have to catch it on time. And a lot of these diseases, as you're saying, are like 10 years in the making, some are 20 years in the making, such as Alzheimer's. So by knowing your values and by knowing where you are in advance, you want to form a baseline, and then how do you optimize it from there versus continuing on the decline as well. And I feel like it's so empowering as well, right? So it's like you can take your health and your life back into your own hands and actually live at your best. So yeah, one of the really great tools for that as well. What would you say are some of the biggest impacts of poor metabolic health? What are some of the main diseases you even see from your members that are able to really improve their health thanks to using Levels?

Yeah, we're, we're a wellness company, so we are not in the disease world as that world is quite regulated. So we're really trying to place in the wellness space and really try to help people achieve optimal life and things that on the, on the wellness front, a big thing is energy, like having energy to do the things that you want to do. I think that's a big one. I think people that wanna manage their weight, that's a big one too. There's a lot of good research and I think Peter Attia has done a really fantastic job. He's had many episodes talking about this where when you become, when you consume too many carbohydrates or sugar and you have high levels of insulin, that shuts off your fat. And so by managing that level, people can avoid that, right? Everybody that wants to manage their weight, they wanna burn fat. They don't wanna lose weight, they wanna burn fat. And so your levels of your glucose that leads to insulin response controls that. And so really trying to manage that so that you can stay a healthy weight is another aspect that you can use continuous glucose monitors for, because you can kind of see how your body's reacting to the food and therefore control that. So I think managing your weight has a big component there. I think mental clarity is another one. Obviously if you're not optimally fueled or have energy, you will have more brain fog and being tired. And obviously if you don't manage it for a long time and your body becomes insensitive to insulin, then obviously it triggers a host of other chronic diseases, which diabetes is obviously one of them. Hypertension, dyslipidemia, yeah, and other things that cause long-term health issues. And there is some research that suggests that maybe even Alzheimer's is related to glucose dysregulation or insulin dysregulation.

Yeah, exactly. Now that's— bad things that can happen. Yeah. That's also from Dr. DeBettis and like his research, there's 38 different drivers of Alzheimer's and cognitive decline, of which is also the insulin sensitivity, and that's why they recommend part of it is the ketogenic diet as well, just to feed the brain ketones versus from glucose as well.

Yeah.

What are some of the ideal glucose level ranges that people should be looking out for to stay within?

Yeah, there's a lot of research out there on this, but I think around 100 is typically known as a good level. So you wanna try to stay around 100 and try to manage spikes post-meal to manageable levels. Within our app, we try to encourage people to not spike more than points from a meal. Mm-hmm. And try to keep your baseline around 100. That's the two numbers that we try to manage. I think different people have different perspectives on what's optimal. I think between 100 without a meal and then between 100 10 to 120 after a meal and no more than a 30 spike is what we try to recommend. But that's generally the accepted numbers.

And how, what role, obviously food is one element of it, but how or what role does things like sleep, stress, exercise play on glucose levels as well?

Yeah, there's a lot of research going into this space. So obviously food, right? Let's talk about food for a second. Some foods are obvious that they're probably gonna spike your glucose. Some food are not, right? It's like For me, bananas are— I might as well be eating ice cream than bananas, as an example. And I prefer ice cream way more than bananas. And when I eat a banana, I think I'm doing something super healthy. But bananas spike me like 50, 60 points. Wow. And so there are some things that we know are probably not good for us. If you eat a donut, like, nobody eats a donut thinking that's good for them. So that's fine. It's just what you do and you do it. Don't do it frequently. And that's okay. But the things that you don't know are the ones that we're trying to help people. There is so much packaged food and processed food today that do really crazy things to our body, and you could see it. So there are pretty much sugar in most things these days in packaged or processed foods. A lot of them are kind of hidden, like things you wouldn't necessarily think as sweet. Most breads that you buy at the grocery store have sugar. I don't know why bread needs sugar. The sourdough, like the olden days, you would get a sourdough, like you don't need to put sugar in there, but most breads do. A lot of people know bread is probably gonna spike them, but there are some things that you probably don't even think would spike you and you eat them. And for example, you could have a soup for lunch, right? Thinking you're eating the most healthy thing, but there's tons of added sugar in most of the prepared soups. So that's one thing that you might be eating soup every day for lunch thinking you're doing the healthy thing, but you're actually spiking your glucose, which triggers with the downstream things that are not good for you. Or somebody might eat a salad thinking they're doing the healthy thing, but in the salad dressing there's tons of sugar. And so you could be eating salad thinking you're doing the best thing for your health, but consuming 30 grams of sugar. Again, these are the things that are non-obvious. And then there's a bunch of stuff that just uniquely people respond to differently. For example, for me, potatoes don't do anything. I could eat french fries if I wanted to, or just baked potato all day and nothing. But if I eat a piece of bread, it will do crazy things. Another one, for example, like we don't recommend that people drink alcohol. People may enjoy a drink. For me, beer causes 50, 60-point spikes, and I always felt really tired after even drinking one beer. I thought it's the alcohol. But I just react differently to beer than I do, for example, to a cider. And so like even optimizations like that really help you choose the things that your body uniquely reacts to. And everybody's different. And that's why relying on biofeedback instead of just general knowledge is one of the powerful things, because what works for me may not for you. And I might just be preaching to you that this is the greatest thing, and maybe because we're friends, you may be like, okay, I'm just gonna do that. But that may not be the right thing for you. Really looking inside your body and getting biofeedback and then optimizing it is, I think, what Levels helps you do, which may be very different from me to my brother, even to my spouse, to, uh, children. Yeah.

It's so personalized as well. And that's why I find this so exciting that people can do that too. And really even just to give it a try because I think the insights, even for 2 weeks or a month or whatever the case may be, But you know, so many people I know who have tried Levels, they were like, oh, this was so surprising for me, or I couldn't believe this, or whatever it was. And I had one real epiphany with the blood sugar overnight. So that was a real, I can't believe this is happening. And my intermittent fasting and everything I was doing, and then the sweet potato soup. So that's sadly I miss it because it did taste good and I made it myself. So it was all fresh ingredients, but it's just, I can't have that.

Sleep is a big factor. If I get 4 or 5 hours of sleep, my glucose variability goes really out of control the next day. Even the things that wouldn't spike me normally would, my baseline changes. So sleep is a big factor. It's probably the most underrated one is that, and it's a threshold for me. So if I get 7 or 8, probably doesn't matter. But if I get 4 hours, for sure the next day I won't be able to control my glucose variability and I will just feel like I need to eat and typically high dense energy foods and it's not good. Once you get the sleep wrong, like the next day is kind of done pretty much. And then you say, okay, this was lost. I'll try to recover a different day. Exactly. So sleep has a big impact. Also timing of eating to sleep for me has a big impact. I've experimented and people have on the team have experimented. For me, if I eat a few hours before bed and if I do a really light exercise, I have a stationary bike at home. And if I even do 15 to 20 minutes of zone 1, basically low heart rate exercise, my quality of sleep improves significantly. My glucose control improves significantly. So I think timing of sleep, what you eat, when you eat it, and then if you do a light exercise, some people love to go for a walk after dinner, or if you, for me, it's easier to just do stationary bike. So I think sleep is a big one. Exercise, obviously, I think is one of those If there is a silver bullet, like that's as close as you get to it, regular exercise. But exercise, if you do an intense exercise and your body needs to break down glycogen to give fuel to your, to your body so you can do the exercise, you will see a spike. But that spike is not a bad one. It's very different than eating and spiking versus doing high-intensity activity spiking. It's just your body converting one type of fuel to another type of fuel so you can use it. And so we have actually in our app, we do have an ability for somebody to say, hey, I did a strenuous exercise. So obviously if you do it on your watch or any kind of wearable, we'll see you did an exercise and then you can mark it as strenuous. So we won't count that as a spike because that spike is fundamentally very different than a food spike. And then the, the stress one, In cases where you're really stressed or nervous, again, your body goes into the fight or flight mode and does convert glucose. So you will see a spike from big stress. So we've heard from our members and people on the team that, for example, if they're really a nervous presenter right before a presentation, they'll see a huge spike. Or if they get into a fight with their spouse or one of their friends that they care about, they see a huge spike. So stress has a big impact and there's tons of research that shows that a stress response does create these types of events. And so it's really important to, if you really want to manage your glucose, I think managing stress and these kind of type of events is really helpful.

It's so important as well. And I just, it reminded me of something, a friend of mine who used to work in investment banking, and this is back in the day when it was like the 18, 20-hour days. And like, I'm hardly eating anything and I'm not losing weight, but it's just that presence of that fight or flight, the cortisol as well, and just As you're saying as well, the glucose levels will just be totally out of whack, lack of sleep as well. So I think stress is just so fundamental. And as you said it as well, sleep and sleep and weight loss, I think people underestimate that as well. And it's only since I took sleep a little bit more seriously that I really noticed also with cognition, so many things, mood, it's so many benefits. Maz, I'd love to hear your opinion on the keto diet., and what your members are also seeing. Obviously from blood glucose spiking level, that should not be the case, but are there different effects? What are you seeing around your members with who are on the keto diet?

I think keto diet could be different for different people, especially research has shown that women respond to keto diets different than men. So I think there are modified keto diets that accounts for some of this. I think in certain phases of cycle, you may need more carbohydrates for cycling women. So I think it's important. Take the context into consideration for keto diets. So it may work really well for some people and not so well for others. So I think just knowing that, again, there's no one-size-fits-all is really important. For the people that it does work for, it could be quite powerful. I've experimented with it for a while, and I find that I don't need as much sleep, so my body's a lot more tuned to being able to deal with less sleep. My energy levels are a lot higher. I find that I don't have crashes or that hangry feeling that we all get when we're really hungry and we don't eat for a while. Like, I don't get that anymore. The head nods are completely gone because you don't have these rollercoaster of energy changes. So effectively keto diet, what it does, it changes your fuel source from glucose to fat. And so what that does is if you think about, we all carry around 100,000 to 200,000 calories worth of fat. Even if we're slim, right? So you take somebody that let's say is 150 pounds. Well, let's just take an average person, right? Average slim person. And you say that their body fat levels are 10 to 15%. So they're carrying anywhere between 15 to 20 pounds of fat. And so each pound of fat is about 4,000 calories. So a slim person is carrying something like 60,000 to 80,000 calories in fat, and then you can go up from there. Some people maybe carry 200,000. So there's no shortage of energy in our body. It's just your body knowing how to use it. And so when you switch to a ketogenic diet, your body learns to use fat as a fuel source directly instead of glucose as an energy source. And because of that, you have this constant energy resource that's available that's decoupled from eating. And so what that does is obviously you're burning that fat and then when you eat it, you obviously replenish it, but you have a very stable energy source where you don't do this, which means that your energy's constant. You don't have these moments of hangry. Mm-hmm. And it also helps with sleep. I think for the people that works, it works. And there are many types of ketogenic diets. There is the really strict one that keeps the carbohydrates to really low levels and is very hard to maintain. And there's a modified version where you try to avoid added sugars, but you could have starches, complex carbs as part of your meal and also as part of a mixed meal. And if you build an exercise where you're consuming that carbohydrates as well, it creates a balance where you can actually have the best of both worlds where you can have the stable energy of ketogenic diet but not have to be so strict so that you can't maintain it. So I think the, thing that's constant between diets is do the thing that you can do for a long time and you're not just cycling in and out because the cycling in and out inevitably leads to ups and downs and people being in there, in it for a month, but killing themselves and then out of it for 9 months because they're just trying to recover from that.

And then they have a spike in the wrong direction.

Exactly. So I think ketogenic diets, I think the, the net of it, at least from my perspective, it's different for different people. And then do the thing. That you can sustain, because if you don't sustain it, then you're just going to go through the roller coaster and you're just going to defeat the purpose.

I think that's a really valid point. And I think also because it's such a high-fat diet that if you have too many carbohydrates or even too much protein, I think people don't realize that as well, that you're just, you're not in ketosis and you're just consuming a lot of fat as well. So it's almost binary, like a very strict one as well. But I think, yeah, if you can find that balance and for different people to try different things also. So, Maz, I want to ask you some rapid-fire questions. Thinking of the word successful, who's the first person who comes to mind and why?

That's a really good question. I joked once with my friend, one of my friends, that he is the picture of success in my mind. And he wasn't traditionally what you would call successful, somebody that has a lot of money. Success to me is you're doing something you love and helping other people, helping improve the world., but at the same time leading a balanced life. I think that's success to me, meaning you're doing the thing you love, you're helping improve the world, but you also have a rich family life, friends. And that was the picture of my friend that we all went to business school and we were all trying to go for these crazy high stress jobs. And somehow he got a job that was very successful. But also, like, he wasn't like the rest of us, super stressed, like killing himself. He had a really great family life, really great friend life, and was really successful. So I think success is being able to do what you love, contributing to the world, but also not being a one-dimensional person where once you take you out of your job or the thing you're doing, you're not really— don't have any other dimensions. You're actually a full person still. That people love being around, that get energized from, and you're contributing to that community that's around you. So to me, that's success.

That's a beautiful definition. I love that. Thank you. Mas, do you have a favorite quote or piece of advice that's been a real game changer for you?

Oof. There is a lot of them. There's a, there's an old proverb that's translated, so it's in a different language, but so it's translated. Which says, not every sphere is a walnut. And the concept behind it is that don't be fooled by what— and really look at things in depth. And this is really the concept of thinking for yourself and really going deep into something. Whereas something may meet the eye to be something, but in reality it's something else. And I think what that really helps is you— it helps you into your actions with people and things, where we always tend— our first inclination is to judge something by its cover, book by its cover. But really stopping yourself and saying there's more to this situation or this person or this whatever it is, and really seeking to be more curious, seeking to understand the person or the situation or whatever it is, and really saying no to that, like, quick brain, like, make a judgment, move on. It's like, no, take your time, understand the situation, and be curious. And I think that has— that's been one of my favorite ones.

I love that as well. Be curious and just taking things not at face value. You can meet the most incredible people and experience amazing things from that as well. So I've had that experience as well. You can learn something incredible from every single person on this planet if you're open to it. Yeah. I love that.

That's how we think about our members. Like we have had feedback from our members where somebody may be upset because we took a feature away. And it's a 2-page email and you, it starts with it, why did you take this away? And then it ends with like how they think about the product and how they use the product. It's very quick to look at the first paragraph and be discouraged, but then you read it and you understand them and then we'll take that back and have a great discussion in the product team and design team and say, hey, this is how this member feels and this is how they experience this thing and It helps us be a lot more empathetic and really take that in and try to understand.

Oh, that's so powerful. And also the fact that they would write like a 2-page email to really explain exactly how beautiful for you to get such detailed feedback to incorporate it. Mars, in the last 5 years, what have been some things that you've got better at saying no to? So distractions, invitations, et cetera.

It's really fantastic. Kids have been a real game changer for me. And so I have two of them, fortunate enough to have two of them, and they're really fantastic. And you really think about what's important in life, and it really clarifies where you spend your time. And when you're young, you spend the time on a lot of things, and meet a lot of people, you do a lot of things. And I was one of those people. I just wanted to do this experience and that experience, do skydiving, do paragliding, do like scuba diving, do all these crazy things, some of which people were concerned because of safety risk. But anyways, you just do them all. But then when you have kids, it becomes really clarifying. Or, okay, what are my priorities? Number one, My kids, my wife, I'm a wrong writer. Number 2 is what impact I will have in the world through my work. And then number 3 is my community, like friends, extended family, and obviously health is in there as the foundation because if you're not healthy, you can't do any of them. That's the foundation. It's almost not, not a choice. Yeah. Yeah. And so that really clarifies what you spend time on and you prioritize based on that stack rank. Of. And then if there is extra time, obviously spend on other stuff, but you're— it makes it really clear for me, like, what are the priorities and what should I spend my time on.

I love that. So one thing that makes Levels so unique is your remote working culture. Moz, can you tell and share with my audience a little bit more about that?

Yeah, I think Sam, our CEO, is one of the pioneers in the space, and when I was When I was introduced to Level and I was learning about Levels, it was just mind-boggling how deep that thinking is in the culture. So the company is created as remote first. It's not like many companies where they had a physical space because of COVID they had to figure out how to be remote and they put remote practices and tools together with an office thinking that either they're going to go back or they're going to coexist. Levels was round of thought about how can you create a remote and asynchronous culture. And it is— it becomes a superpower if you do it that way, I believe. And I think Sam, probably that was his vision, is first of all, you can hire anybody anywhere in the world. It doesn't matter. So we have people in Portugal, we have people in Colombia, it doesn't matter. They're all equal. They are our employees. It's not like we have a person in Portugal. No, their employees of levels happen to live in Portugal. And we actually have many people that are nomads. They actually don't have a place and they move around every few months. It just doesn't matter as long as they have an internet connection. It doesn't matter. And so it allows us to attract talent from anywhere in the world. It's really powerful. The second thing it allows us is it allows people to do the best work of their life without having to make choices or trade-offs with their family life or whatever is important to them. Because when you're remote and you're asynchronous, first of all, being remote means you don't have to commute, right? So hours in a car, you get that. Being asynchronous means that you can fit your work within your life. So if somebody, for example, wants to take their kid to school, wants to walk their kid to school at 9 AM, they could do that. A normal job, you just can't do that. You have to be at at your desk at 9 AM or in a meeting at 9 AM. At Levels, like, everybody understands that there's an async remote culture. So if somebody wants to do that, they can. So it's created this culture where you can attract the best talent, allow that best talent to work within their schedules and their life. And also what it does, it makes people a lot more efficient and effective. So imagine how many times, I don't know if you've been where you wanted to give you share an idea, you would call up 10 people and tell them the exact same story. So you basically spent 10 hours giving your ideas on the phone, whereas at Levels, because it's async, we'll record a Loom, which is effectively a video, and share it with the people, and they'll respond back. And the culture is in a way that people understand that you're not being rude by sending them a video, and they also understand how to interact with that and provide feedback. In, in that way. And obviously, like, you send your idea, you share your idea with however many people you want. It only takes you one time to record it. People can give you feedback. You can take that feedback on your own time, think about it, and then respond. And then over time, when you need high bandwidth communication, which is you've got— you've told people your idea, they've given their initial feedback, they've thought about it, then you can go for synchronous to really like have a high bandwidth conversation to refine, change, or do other things. So I think async and remote has enabled levels to do— hire the best talent, do the best work, and be a lot more efficient with our time. And so that all reinforces each other if you think about it, because now people have more time to spend with the things that they care about that's outside the work because they didn't spend 10 hours calling people, telling them about their ideas. So it just created a really powerful, I think, And because it is designed that way, meaning there's a lot of documentation, people know how to use video and audio, and people also respect each other's time, like sync time is really valuable. So people don't just put standard meetings on your calendar. They will only put it if they have a very specific thing with an agenda. So it's created this great environment where people enjoy. Obviously there are downsides, right? It's not all positive. The downside is just very, you have to be very deliberate about keeping the culture that way because entropy or the likelihood to do what's normal always intervenes. So we're also trying to learn how to add the human element in. For example, we have something called the quarterly assemblage where during that time we do things together. And so people have that human element. Or it is okay for people to travel to different regions and spend a few days or a week together to learn about each other and build those relationships. So we manage the async with the sync, recognizing that the sync is also important for the human relationship to develop and the trust to build. So we are creating this culture that you can have your cake and eat it too, hopefully.

It sounds really phenomenal and really pioneering and I definitely think it's the way of the future. And I think if you speak to your average, let's say CEO, they're like, oh, you're going to have challenges with this or it's not going to work. But it seems that it works really well with you guys. And do you think that's the combination of the talent that has been recruited and Sam and the whole team coming together and really focusing on that as a part of the mission? What would you say?

You know, the challenges will happen. It's not that this challenge, like somebody said, you have these challenges and yes, we do. The thing is, how do you continuously evolve and find solutions to the challenges? It's not a set and forget. It's not one of those things that you just say, yep, we figured this out, we wrote the blueprint, then let's just do that. Like every 3 months, every 6 months, we'll reevaluate and say, hey, this is broken about it. So what's the solution to this? So I think just being open to that continuous evolution and having someone like Sam or the leadership team believe in it and really want to work towards solving those problems instead of just throwing our hands up and be like, yep, this doesn't work, let's go back to the old ways. And I think that continuous desire to make this better is what makes it strong and sustainable.

Really phenomenal, very pioneering. And let's talk a little bit about product and design. So you use continuous glucose monitor, which is something obviously that's been around in the market, but the app and the interface and the insights. Can you share with my audience a little bit about the beautiful design and the product that you've created?

Yeah, we're very fortunate to have some of the most talented people in the team. Our product folks, David, Cosma, and our design, Alan and Victor, are just some of the most incredibly talented people and just great people that I've ever worked with. And I came from Apple, so I've worked with a lot of great designers and product people, but those 4 individuals are just outstanding. And so first of all, like, I'm fortunate to work with them, but I'm not. And so we can't— the thing that makes it special is we really care about our members. And really, like, we wrote a strategy doc. Obviously we write everything down. So most of these things are available. About member centricity and really thinking about our whole goal at Levels is to create value and build trust for our members. Once you do that, then everything comes from— every decision we try to make comes from that place is how do we create value where the value is higher than what we take in as a company. Obviously we're a for-profit company, so, you know, this is still a business, but the goal is how can we create more value than we get? Back. And so everything we think about is in that value creation lens. And that we also want to do it in a high-trust way so that people trust that what we're doing is in service of improving their health. And for example, we made a business decision, for example, to provide CGMs and other hardware services or services at close to cost.. So in order to not be incentivized to sell people more CGMs, to only recommend people to use CGM when we think it will create value for them instead of making our money from CGM. So that pass-through, more or less same thing with labs and things like that. So really made that decision to be in service. So everything we do within product and design is with that lens. And so that's like the, call it the value side of things. And then from the product side of things, we try to think about what are the core pillars that we want to continue to invest in and really stay focused on delivering something that will continuously get better over time. So let's, one of our, one of the things, one of the core pillars of our app, what we call the lifeblood of our app is content. We want to create content that people can connect with and really help improve their lives. And so really when we think about content, we don't just think about, hey, let's just push an article out. We really think about, can this content help people make decisions that will improve their lives? So we think about things like when we tell people to do something, is there within their ability, right? How can we help improve that ability so people can do it? For example, telling somebody that unsweetened almond milk is a good substitute for, I don't know, oat milk, right? That is good. But a lot of people will be wondering, but what brand? What ingredients should I look? Because you have so many different almond milks, like it's, it still has the cognitive load for somebody to figure out like, but what do you really mean? And so closing the gap all the way to say, hey, for example, these 3 brands only have 3 ingredients that you can also buy them at Whole Foods, Safeway, whatever. So really when we create something, we want it to be actionable and increase that ability for our members. And so that's why when we think about, for example, content, we try to create, go deep. Or when we create content, we think about the likelihood that somebody would do It's easy to tell people swap this for kale and that's all, and that doesn't make any sense. Or stop eating desserts. That doesn't make any sense. Like that's too idealistic. So how can we, for example, recommend a dessert that tastes good but, and doesn't spike the glucose? So remember first thinking about the thing that we're creating, how can it actually improve people's lives and how can they actually do it and sustain it and not just be in an idealistic world where we're just preaching to people a bunch of stuff that's not actually actionable. So we'll constantly think about that in our product. The other thing we think about is design first. Maybe that ethos comes from the Apple world. In my experience, it's very easy to have a really beautiful design and then take it to engineering And engineering says, I can't do that. And then at the end, you end up with something that nobody wants because you made all these compromises. It's like, as when I was younger, I loved cars. So you would see these concept cars that maybe Ford or GM or whatever would show you. And oh my God, that's so awesome. I want one of those. And then it gets to production. This looks nothing like that. And I definitely don't want this. And so really thinking about that. Within Levels is that, look, we need something that, again, member-first, something that people want to interact with, and then we'll figure out the engineering instead of, oh, we can only do this. And I don't know if people will like that, but we're just going to go build that. And so that design-first culture, I think, is another aspect. We spend a lot of time thinking about also outcomes. So what we want to do A lot of people may build products and they say, we really want to just retain people and focus on retention. Like many products out there that really have figured out retention. Like you look at any game, any social media, like they figure out the retention game, but then you're like, but what does it mean? Like for the customer, is this really what people like would look back and say, this was good for my life. So within Levels being a health and wellness app, like we really think about the outcome. Outcome. And so when we're building our products, we're thinking about, okay, what does this mean for our members and what kind of value does it actually— outcome does it measure at the end? Is it those things like if they wanted to manage weight, did they do that? If they wanted to manage their energy, did they do that? If they wanted to manage their mood, did they do that? If they want to manage their, some of their biomarkers, that you can get to the lab. So we're really thinking about that and building a research-forward organization that's science-based. Like, one of, one of the, one of the podcasters that I really love is Andrew Huberman and Peter Attia. Those guys are just a head and shoulders above most people, and the reason is because they go deep into the science and explain the science, and everything is in service of that, of how can we help really improve people's lives. So I think Level wants to also, and wants and does think about things that way. And this is why we launched the research effort, is to really understand how by managing, for example, glucose variability, how can we improve these outcomes. So when we think about product and design, it's not just the product and design people that think about like how do we drive retention, but how do we actually drive effectiveness in the product. So that's another pillar of our work.

So beautiful as well, because it helps people really change their lives, improve energy levels, avoid metabolic disease or reverse them potentially as well, and just live better. And that's also my ethos. How do you help people to live at their best so they can reach their fullest potential, make an impact in the world? So, you know, putting all these pieces together. Can you talk about some of the biggest learnings and insights that your members have found most valuable?

Yeah, I think one of them— I think that one of the biggest ones is related to energy levels. And everybody thinks— not everybody, But I at least thought that the energy dips and flows during the day was normal, which is like part of life. Everybody gets that mid-afternoon dip and you either get up from your desk and go for a walk, or which you should do anyways, or have 2 cups of coffee. And so really understanding. That doesn't have to be the way where you wake up in the morning and you're starving and you, that's the first thing you gotta eat. But hey, I gotta get to work, so I'm just gonna grab a bar or something unhealthy and eat it. And so really understanding that doesn't have to be, you can actually manage your energy levels in a way that it supports you and your life instead of the other way around. So instead of being slave to your metabolism, it's the other way. The metabolism is here to help you achieve the best And you're here to do. And so I think that was a big one for me as I've entered middle age officially. It's all relative longevity. Oh, right. Life gets in the way in the sense like when I was in my twenties or thirties, I could spend as much time on exercise as I wanted. I used to train the, and race long distance triathlons. So by definition, I was consuming a lot of time. Calories and I was burning them. But as you kind of, kids come along and you get into your middle age and you're no longer invincible and you're trying to allocate your time to different things that you need to do, just being a lot more efficient with that time was really important. And one of the things that helps me when I actually put on the glucose monitor is I can manage that, the glucose spikes. And what that does is to stay in shape and feel good, I don't have to spend as much time working out. So if I need to work out, I don't know, just pick time, like 15 hours a week of activity, which is a lot. Most people, it's 2 hours a day every day. And it's hard to do that when you have kids, when you have family obligations, when you have a lot of work. And so what this allowed me to do, the CGM and the levels allowed me to do is achieve the same physical and energy levels with a lot less requirement for high-intensity activity because I didn't go through these crazy— Yeah, I was just pretty constant. So I think that was another one that, that really helped me manage my, like, what I felt like my wellness, my peak, uh, physical like wellbeing.

Mads, what excites you most about the future of health, wellbeing, and longevity over the coming years and beyond?

Yeah, one of the things I alluded to this, I spent 9 years at Apple and it's one of the most high integrity companies that I've ever worked with. And I was really privileged to work with my people there. And because I was part of the, when I joined Apple, I started, in a new technologies group where we looked at new technologies for the company. And as health became more and more of a focus for the company, I was fortunate enough to be in the technology. So I took an active and leading role there. And I saw Apple create the platform for personalizing health. So creating obviously ubiquitous mobile devices in everybody's hand, but also really doubling down. Exactly. Doubling down on creating a platform where people can store their health information on their phones in a private way and become in control of their health. So Apple was really— it wasn't an accident. It was a very deliberate decision to give people back control of their health, to create this platform where people can now decide who they want to share their information with and how other people can build on top of this platform to help them manage their health. So Apple went with this member or customer first and central and in control of their health, which enabled everybody then to build all these great health apps, including Levels, on top of that platform. To me, that personalization of health and technologies like Apple provided, and I think Google has the same, to allow people to take control of their health, because the person that cares about your most about your health is you. It's not the insurance company, it's not the doctor, it's not your gym instructor, it's your grandmother. Yeah, you are the person. So giving that to the person, I think, is gonna create this and has created this long-term change in how we manage our health. And what I'm most excited about is that personalization of health and putting people at the center of their health so they can make a decision. Either voting with their dollars to the technologies that they think most impacts and improves their health, and then to just having awareness and being a part of the conversation. Instead of just going to the doctor and say, doctors, what should I do? Now people are self-educating and they're going to the doctors and say, hey, I learned about this, what do you think? And it's a much more of a two-way conversation instead of a one-way conversation. So I'm really excited about that. And obviously there's so many great things and so many smart people now thinking about that because it now creates that ability. Instead of being locked, your health information being locked somewhere that nobody can work on, the member or the person can now decide to make that available to these great researchers to do this great research. And so I'm really excited about that. I think when I was— I love working at Apple, and the only reason I left was I looked deep and said, what do I wanna do with the next 10 years of my life that could make a huge leap in, in health? And I've looked at two things. One was mental health. The second was metabolic health. Mental health, obviously this is COVID time, so it was just front and center and it's a lot of work, more work needs to be done there. Yeah. But metabolic health was the basis for a lot of the chronic diseases. As I said, I think 8 or 9 of the top 10 and causing about 75% of our healthcare spend. And it is something that the biofeedback tool exists. So CGM exists, whereas for mental health, it's a little bit harder. You can't look in your brain and see how that's doing just yet. But that was the basis, metabolic health and how your body produces and uses energy, and which is a cause for all things, was really what excited me. And I think that's a place If you ask me what I'm most excited about is that— is can we actually change the trajectory of these chronic diseases that are relatively a new problem if you look at in the history of humanity? And I think we have a really good chance to changing that trajectory. And it's, it shouldn't be inevitable, right? Like you go to your doctor and someone, you're getting to your 40s, 50s, so I'm just going to give you metformin and it's just what happens. And you're like, no, that's not just what happens. That shouldn't be just what happens. And really changing that trajectory, I think what I'm personally excited about.

It's really, really exciting. I'm very passionate about that as well. And thank you for sharing those beautiful stories as well. And I think that allowing that shift in people to take back their health, to be empowered, to educate them, which is— you guys have fantastic content as well and really explain in depth so people can understand and just to live in a much better way and think of the billions and trillions of dollars in the healthcare system that can just be rechanneled into people living really well and just living better lives and full of energy as well. So exciting times ahead. And tell us with Levels Health, what does the roadmap look like over the next sort of 12 to 18 months? What are you guys planning?

When I was at Apple and somebody asked that question, the answer would be like, I can't tell you. Yeah. I love— we're a very open company, so we can talk about it. I think content is a big area of focus for us. We really want to create content that's actionable, that people relate to, that people want to engage with. That's a big one. I think we've done a lot of work to create science-forward but also engaging blog And so bringing a lot of that into the app and more. And so focusing on obviously long-form articles, but also videos, audio, podcasts. And so really bringing that and making that a core part of the app experience and also doing it in a just like we have something that we call internally event-based insights. What that is, when you do something, let's say you log, I don't know, protein for breakfast. And you get a bad score. It triggers based on the algorithm within the app. It triggers as well and says, hey, we saw that you logged oatmeal. We saw that you didn't get a poor score from it. Here's an alternative and here is a recipe to make that alternative. And it could be a video. And here's potentially where you can buy the ingredients for it. So really creating both proactive and reactive material. So it just feels like we're responsive to you and your life and being personalized with that.

So I think building content that feels personalized and actionable is a big focus of ours. That's really exciting. And also with geographic expansion, you guys are obviously launched in the United States and my audience are around the world. Yeah. How does that expansion look like?

Yeah, we'd love to take it. We'd love to take it globally. I think our state mission within the company at least is to impact a billion people to help improve metabolic health for a billion people. So that's a big goal, an ambitious goal. And that's not just US, obviously US doesn't have a billion people, but even if it did, that's a global ambition. So the first country we're we're working on actively is the UK. That's launching our, our beta, closed beta, similar to the US. We started with the closed beta so we can learn, and then we made it available to the general public this summer. And I think we're going to try to do the same in the UK. We're going to start with a closed beta and then open it up. So UK, we're really excited about, and we have great people on the ground that are working on it. So really excited about that. And then globally we go from there. I think our ambition is to make it available to as many people as possible around the world regardless of nationality. And so that's the goal. I'm excited about it. Other things in the roadmap that may be also worth touching on, I think we want to, as we talked about effectiveness, right? We want to make sure that this is in fact improving people's health. One of the, one of the well accepted ways where you improve people's health is through your lab results or, and seeing, for example, how is my A1C changing? Is it improving? How is my lipids, which is basically HDL, LDL, or ApoB, which is another way to measure it, changing? Am I actually improving by using Levels? And other molecules. So one of the things that we're investing in is being able to do that, to show you through your lab results that you are improving, or if you're not, like, how can you actionably change that trajectory. So that's another thing, really tying— like, the content is great, and I think we hope that people will enjoy it and will love it, and it will lead to people actually improving their health with these biometrics as well. So So that's another area that we're investing quite a bit in. And another area that we hope will support the entire app, no matter what we work on, is making it more personalized. So it feels like we're meeting people where they are and helping them on a journey instead of having a megaphone and just shouting out of it. That's another part that we're investing in quite a bit.

That's really exciting because obviously people are going to come at it from different levels of awareness and knowledge and things as well. And I really like that also with the biometric data, because obviously you get a blood test done and that's just a snapshot of a day in time, but it's the tracking and testing different things. So if you actually can see that in 6 months, because you implemented certain recommendations that potentially were found in the Levels Health app, And that you're doing much better after that as well. I love that integration. That's really cool. You guys are busy. That's for sure. Maza, as we finish up here, just a couple of questions. Metaphorically speaking, if you could get a message out to a billion people, what would it say and why?

What would it say? Wow. A billion people, a megaphone. That's a big one. I think the biggest thing, this is personal experience, is when we're healthy, health, you take it for granted. And the smallest thing happened and you're like, oh my God, how do they live? Like, how is this even— like, this little thing, like, how can it reduce my quality of life so much? One of my examples, I used to play soccer, and once in a while you break an ankle, a leg, or something, and then you'd be on crutches. And moving across the room, just that distance, seems such hard work. And forget it if you had a vacation set up or time with family or whatever, you just have to cancel people take for granted. That's just simple thing, which is a bone fracture that fixes, and how much it reduces your quality of life. And I think my one message is we only get one body that is really the— or one health that is really the basis for everything we love to do, whether it's taking care of our families, spending time with them, like doing impactful work. And it's almost a foundation that enables us to do everything we love and live a great life. So I think just focusing a little bit more on that and looking not just in the short term— like, breaking a leg is pretty short-term— but these things, decisions that we make every day, are really shaping the future of how we're going to live 10, 20 years later. And so really, one, not taking for granted our health, and two, really investing in it now, because as we get older and these things compound, it's gonna be much harder to change the trajectory.

So I think that's the one thing. Wise words. Mads, where can people learn more about what you're up to? We can link this, so social media, websites, what would you like to share with people? And I can link these in the show notes.

Yeah, we have a blog that has a lot of our deeply researched insights there. It's, as we mentioned earlier. In the show, like, a lot of it is science-based. And so we have great writers, science writers that research. We also have some of the best advisors in the world that we're so fortunate to partner with, and they've just been fantastic every time I talk to one of them. And I think you mentioned David earlier, or Dr. Sinclair, or Don D'Agostino, or Ben Bikman. I could just keep going. Rob Wozniak, like, some of them smartest people in this space and they're just so ahead of their time. So obviously a lot of the stuff that we write is informed by them as well. So I think our blog is a great place. Our Instagram also has a little bit more like quicker to digest information. I think the blog is, you can find it, 5-page deep articles that goes into the science. And then our Instagram will be much more like consumable content. So I think those are probably the two best places to find us.

Amazing. Maz, do you have a final ask, recommendation, or any parting thoughts or message for my audience?

I would just say metabolic health is so important and we hope to change the trajectory of unfortunately the rising rates of chronic disease and some of the outfalls from that. So I think just like to learn about metabolic health, it's the probably one of the best investments people can make in their future self. There's that thing, what advice would you give, you know, or you, when you're 60, your 30-year-old self is probably keep an eye on your metabolic health. So if you're 30, that's probably a good place to start now. So I think just learn about metabolic health and do something about it. Amazing.

And it's never too late to start.

So also if you're older than 30, later than never.

Exactly. Yeah, exactly. Amazing, Miles. Thank you so much for coming on today. Thank you so much for your time.

It was lovely to talk to you.

Thank you, Claudia von Boeselager.

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