How to Control Your Blood Sugar & Spike Your Energy – Levels Health with Dave Asprey : 797

Bulletproof Radio. A state of high performance.

You're listening to Bulletproof Radio with Dave Asprey. Today we're going to talk about something awesome. It's metabolic flexibility, metabolic fitness, and how you can actually look at it in real time and what you can learn from doing that. Our guest today is Josh Clementi, who is a founder of Levels Health. He started this company the day he figured out his metabolic dysfunction was screwing up the way he performed during the day. Sounds familiar. I had the same thing happen to me in Silicon Valley. But he found his glucose levels were all over the place in the pre diabetic range. And he's a mechanical engineer and a CrossFit level 2 trainer, but his day job is designing life support systems for astronauts and rescue systems for emergency response teams. So it's this weird combination of engineering, brain wanting to go to Mars and stuff like that, as well as, why can't I hack this stuff myself? So this is if there was a stereotypical perfect guest to talk about biohacking and controlling your own biology and hacking everything. This is the man. Josh, welcome to the show.

Dave, couldn't be happier to be here.

All right, you were a SpaceX guy figuring out how to keep Bob, Ben, Ken and Doug Hurley alive on their May 2020 trip to the ISS.

Good work.

They're alive. So a mission accomplished, right?

Thank you. Yeah, I think so.

I had an opportunity to talk with the president of SpaceX, Gwynne Shotwell, a little while ago and she's been there for I think, 17 years now.

Oh, yeah, from the beginning.

And I said, okay, you've been there for 17 years. And I know that you're hardening systems that go to space. And if you're not an engineer, hardening a system means making it so that it's highly resilient and it'll handle radiation and stress and gravity and all that kind of stuff that we don't have to deal with as much on Earth? And my question for it was, how much have you invested? How much work have you done in hardening humans to go into space? And she looked at me, she goes, no one's ever asked me that question before. We haven't done that. And I'm like, how is it that we can hack spaceships to carry mushy blobs of not very metabolically strong flesh when we couldn't just hack the flesh a little bit? So maybe our spaceships could be a little bit better. I don't know. I've always thought you like that. It has to Be up your alley. But Anyway, that's my SpaceX story, because I believe for us to do that sort of stuff, we have to know way more about what our body's doing and way more about what our environment, including in a spaceship, is doing to us. And you were on the path of the spaceship way. Tell me what happened with your blood sugar and how you figured it out.

Yeah, so it's funny, the process was almost like discovering that there are options for hardening the body that I wasn't taking into account. And so that's kind of how things went. I was. I was working on this program. It was by far the most stressful and probably the most serious and important part of my career at that time. You know, I was leading a small team. We were developing the breathing apparatus and a number of other pressurized life support systems for the crew Dragon capsule. And I'm, you know, relatively fit, I have to say. You know, I've been working out my whole life. I've played sports. I thought that I should feel really healthy and be performing really well. Being in my late 20s and, you know, essentially as fit as I've ever been, that was not the case. I felt really unhealthy day after day, and it was continuing, continually declining. And so I got to this.

Yes, okay, I got. I get this. This is like my Silicon Valley experience too. Okay, I feel you, brother. Keep going.

It sounds like it's resonating. Yeah. So it's just like day after day, things are heading in worse directions. And I'm getting to the point where every sort of workday is me with an IV drip of coffee, dragging myself from one meeting to the. To another and trying to maintain a facade of positive mood and maintain performance. And really, mood, I think, is what drove me because I felt like a different person mentally. I was not. Like I was losing my sense of humor. I was losing my determination. It was a lot of stuff that. That really frustrated and confused me.

Hypoglybitschy. Is that a. Is that a good word?

That's. That. That could work. Yeah, that. That's a great way to frame it. And so. But what was interesting is that I was reading some research from Dom d' Agostino, actually in. At the University of South Florida. And so Dom is, as you know, really one of the foremost ketogenic researchers out there. And this paper that I was reading was actually specific to my work. I was designing oxygen life support systems. And I was reading this paper because it was discussing central nervous system toxicity and essentially this is what can happen to an organism. And if in a high pressure, high oxygen environment for too long, you can actually suffer a seizure. So the brain. The oxygen concentration is so high that the reactivity goes up, and essentially, tissues start to malfunction. You get a lot of reaction, reactive oxygen species, and ultimately central nervous system goes haywire. And so this was a situation I was thinking a lot about. And this paper that Dom had written studied rodents in this environment, except that they put them in a ketogenic state. So they fed them a ketogenic macronutrient ratio. And this simple switch in diet extended the time to seizure by five times in certain. In certain of the. Of the rodents. And that paper, like, totally blew my mind. I mean, at this point, I was a person who is kind of a calorie. Is a calorie absolutist. Work out really hard. You can eat anything.

What was this?

This was 2015. Time frame, 2015 and 2016.

So Dom was. I think it was Gus, number 40 out of 800 and something on bulletproof radio. So 2014, this is. This is when I had really. Bulletproof was just coming out for executives called the bulletproof executive, because, like, what you've dealt with, there are millions of other people working high stress, high cognitive capacity jobs with the word facade to use it. It's endemic. It's epidemic. It's everywhere. And I love the story there. You're like, okay, I got this. You read a paper on ketosis. You're like, oh, five times more resilience. Maybe I use that.

And, yeah, it was just like, wait a minute. So. So you're telling me that there's a nutritional protocol that gives you essentially superpowers, and, of course, this is extrapolating from rodents to humans. But I was just like, what am I doing to ensure that I'm making good decisions every day? You know, I feel like total garbage. Doesn't matter how many hours I put in the gym. I don't feel. I certainly don't feel healthy. And I have no objective data to tell me that I am healthy. So that led to that first paper, triggered, like, this something in me where I was like, I got to learn more about metabolism, physiology. This is, like. This is so obvious. Every cell in my body needs energy. I don't feel any energy right now. So something's malfunctioning in this system. So I just started to research and dig into it and kind of, as a byproduct, decided to start pricking my finger to measure blood sugar. And this Was like, it's the primary energy molecule in the body, might as well start there, right? It's the gas gauge. So I started pricking my finger. I was getting a ton of random numbers.

How do you like that, pricking your finger every day? I did that in 1998 when the doctor told me, maybe it's your blood sugar, like how many times a day were you pricking?

At one point, I was pricking 60 times a day.

Yeah, it sucks, right? You're bringing me back.

Okay, so you've been there. I mean, it was. Not only was it uncomfortable and messy and weird, but also the data was not useful because I was only able to prick my finger when I had spare time. Right. And so I'm, it's like I'm at home and I'm about to go to work or I'm, I'm about to go to sleep. And that's when I would prick a bunch of times to try and get any amount of data stream. Right. And, and ultimately this didn't lead me anywhere. I just saw a scatter plot. It wasn't giving me any insight. Um, I read a book actually by Rob Wolf called Wired to Eat, and this was now early 2017. And that's the first time that I had read about continuous glucose monitors. And so he just has a blurb in the book and it's like, yeah, there's a device used for the management of diabetes which streams glucose full time. And I was like, bingo, that's what I need. Went to my doctor and asked for one. He said, no, you don't have diabetes, you don't need it. Right. So I kind of left confused, continued to try to get one, ultimately did. And within two weeks I had enough data to know that I was either borderline pre diabetic or full blown pre diabetic, depending on who you ask. And this is all despite having less than 10% body fat and never having ever heard anything about my glucose from a primary care practitioner or really anyone up until that point, it was just total.

You were a CrossFit trainer at the time, right?

CrossFit level one trainer. I'm now a level two. Definitely pushed hard in the gym, cared a lot about being healthy and just had this underlying mayhem.

Going exercise didn't fix your blood sugar all by itself. That's not. Come on, man, calories are calories. Exercise fixes everything. Get with the program.

I have to say, I think it even could be worse where the way that I was exercising was highest intensity all the time, no matter what it's like I'm putting in 120% of my effort and potentially putting me into a chronically stressed, poorly recovered state. And so it was actually the case that I think my exercise was pushing me more into metabolic dysfunction and coupling with all of the work stress and the poor sleep and then of course the poor nutrition decisions because I didn't have a closed loop feedback system. In combination, the whole environment of my body was just stress and destruction.

I love closed loop feedback process. You're saying words that are almost romantic to another engineer, so you need to back off a little, Matt. No, I'm kidding. But what is a closed loop feedback system for non engineers listening?

So basically, if you're designing a system that needs to be controlled in some way, let's just say cruise control on a car, there are two ways to do it. You can do an open loop system, which is essentially you provide an input, you push the accelerator until the car is moving at a certain speed and then you don't take any other inputs, right? It's just that's where the accelerator stays and that's how fast the car goes. And that's called open loop because you're not taking in new feedback. But then you could have a closed loop feedback system which is where there are other sensors on the car that are, for example, measuring the distance to the car in front of you and, and feeding that back into the computer and saying okay, slow down or speed up in order to maintain an appropriate safe gap. So the difference is that the system number one does not take into account any new information when it's making inputs. System number two takes into account every decision that's been made prior and new information that's developing in order to improve the decisions being made. We as humans are living in a open loop environment, right? We're, we're flying blind essentially when it comes to our health. Every day you're making hundreds of decisions, hundreds of lifestyle choices that ultimately directly affect your risk of chronic illness and ultimate and who you are and what you are composed of and those compound in either a positive or a negative direction. And unfortunately, because we're flying blind, we're, we're in an open loop state. We don't get feedback on whether those are heading in a positive or negative direction for sometimes decades. I mean, in my case, if I hadn't stumbled on this, I could have ended up with a serious and potentially much more harmful condition because I didn't get feedback until a diagnosis. So yeah, I think, I think that the concept of open versus closed loop feedback is critical to bring into the mainstream of health and wellness.

The idea of using blood glucose, which is a mark for how much of the most common energy is available in the blood right now and how good is your body at regulating it. As a real time feedback thing, it's really powerful. And I'd been fantasizing about an implantable when I first started pricking my fingers, but we were still a ways away from that. When I was at Basis, which was the first company to get heart rate from the wrist reliably. It's the same tech that's now in the Apple Watch and we sold it to Intel a long time ago. I was thinking, how do I get blood sugar from the rest? I need blood sugar, blood sugar, blood sugar. Because it was a big fantasy. The first experience I had with it though, when I first started Bulletproof coffee and just writing about it, a lot of type one diabetics got in. They're like, oh my God, this MCT oil is a backup thing. So even if my blood sugar crashes, I don't go into a diabetic coma. So thank you. And one of them mailed me her Dexcom monitor. She's like, this is my old one. I got a new one. I know you'll like this as a biohacker. I'm like, yes. I finally got a cgm and I played with it, but getting new sensors without a prescription, like you said, was a big issue. And we fast forward to now. I did get a prescription for a CGM a few years ago, and I was on the Dr. Oz Show. He's like, what's that weird white thing on your arm? I'm like, oh, this is my robot arm. It's got like my sensor and it's got my aura ring. And he's like, well, it looks weird, but okay, you know, it looks weird on camera. But once I said cgm, he knew, right, what it was because he's a very brilliant doctor. And it was still really hard to get. I had to order it from Europe and all sorts of hurdles. And then you guys come along at levels and you're like, oh, here. You know, we. We can just do it. And I was like, okay. But I didn't get that much value from just plain continuous glucose monitoring. Cause I'm like, great, I have a graph, but I can't correlate it to my behavior. And I. And I turn on the Levels app. I'm like, oh my God. I can take a picture of my food and the level of control from having your app to just go, oh, I need to crank up the amount of protein, the ratio of protein to carbs, even though I'm eating relatively resistant starch in a meal to get my blood sugar to go to 120 after the meal for less than two hours instead of going up to 140. Right. Like, okay, that's really useful because that blood sugar thing for brains and whatever else, it, it matters. But if you want to live a very long time, high blood sugar, I mean, it cooks the inside of your veins. It's correlated with all sorts of bad aging things. Even if you have good blood sugar control just after a meal, if it spikes. So now you're like, what's spiking it? And I've just had so much fun looking at my blood sugar going, wow, I wonder why I did that. Oh, yeah, I only slept three hours last night. That's why it went up as high as it did. And this is invisible even to someone who has a good sense of your body. You're very unlikely to know unless your blood Sugar is at 65 or something. You're not really in ketosis. You'll just say, I feel like a zombie. How many people do you think now are walking around with blood sugar regulation issues who just have no freaking clue?

Well, I can guess that it's significant, but I can give some stats from the CDC which tell us that it is significant. So right now the numbers are over 120 million Americans have pre diabetes or diabetes.

Is there a difference in your opinion?

Well, here's the thing is that we have these sort of mental models about health where you are healthy until you're not. And it's totally not true. Right. There is no line in the sand where you suddenly fall into diabetes. We've drawn an arbitrary line on the metabolic health spectrum. And we've said this here is diabetes, and this is slightly better, that's pre diabetes. And that everything else is healthy. And it's completely. It's giving us this distorted perception of what's really happening, which is that all of us are pre diabetic. And if we don't make the right choices, we will all be diabetic. Because that is the way the human body works. If you feed it the wrong inputs for long enough, you will ultimately end up with an insulin resistant state and glucose dysregulation. And so now we've got a situation where 90 million American adults have prediabetes, 84% of them don't know they have it. And how are you expecting us to right the ship when people don't know there's something wrong? Right? I mean, there is no feedback loop happening for these people. And so we're heading in a direction where Potentially close to 200 million people could be type 2 diabetic by 2030, 2040, just in the US just in the United States. And right now we have half a billion globally. And of course most of this is happening in developing countries and that number is increasing at an increasing rate due to the number of countries that are developing rapidly. And I think what's happening here is that, and again, this is just type 2 diabetes. The insulin resistance and metabolic dysfunction epidemic touches far more than that. It crosses from type 2 diabetes into obesity, Alzheimer's, dementia, cardiovascular disease, high blood pressure, cancer. I mean, the list goes on. But what, what we're talking about here, let's, if we just talk about that type 2 diabetes situation, you know, how do we get there and why, why don't we know that we're going off the rails? And as you mentioned, this stuff is invisible. And the reason I think it's invisible is that, you know, for millions of years humans were evolving in scarcity, right? We were, we were just constantly in a state of fasting, like just hunting and gathering our way to the next calories. And so every calorie was a life saving calorie. If you came across something that was edible, you eat it immediately because you needed it to survive. And so we never developed this sensory feedback mechanism for the quality of our nutrition. There was no reason for your body to say, oh, don't eat that, that's not good for you, because that, that actually was good for you because you would otherwise starve to death. Now we're in this sedentary situation, right, where we are able to short circuit our metabolic systems eating more, more processed carbs in a single sitting than a prehistoric human would come across in a lifetime. And now without that evolved sensory feedback mechanism, we're in trouble fast. And I think that's why we got from barely 1% of the population having type 2 diabetes in 1960 to now well over 10% in climbing.

I think I'm just trying to remember in my head, I think it's two doctors, at least one who've been on the show who just flat out said pre diabetes is diabetes. And I am of that opinion, the fact that I have level 3 diabetes versus level 10 diabetes, it's a slippery slope. So what we're talking about there, and if you get rid of in the data, younger kids, it can be a problem, but it's less of an issue. And you're now looking at at least a third of people, so one out of three, and they don't have to be fat for this to be a problem. Okay, now if someone doesn't use the levels, continuous glucose monitoring stuff, how would they ever know?

Well, right now the state of things is pretty grim. It's, it's a situation where we use, we use these metrics, which unfortunately are single point measurements, right? They, you go in once a year or, or even fewer times than that, and you get blood work and you get one point in time measurement, and that is usually your fasting glucose. For the most part. We people don't get an A1C test, which is an average glucose approximation, unless there's already a concern from a fasting glucose check. And the unfortunate thing is that fasting glucose is the last thing to go wrong. Um, the reason for that is that you are fasting and your body is in a state of stasis or close to it. What's actually happening is that your body's breaking down after every meal and after every lifestyle decision you're making. It's those moments of dynamic blood sugar response that really define whether or not you are metabolically healthy. So when I eat a meal that has carbohydrates in it, can my body process that, or am I going to release a ton of insulin and my cells can't respond because they're insulin resistant and my blood sugar is going to stay high in the presence of that insulin. So that's the question. It's not whether or not 11 hours after dinner my blood sugar is down in some arbitrary range. And so this is how we are. Where we are is we're using screening measures which check one point and then they extrapolate that to your entire health. And as an engineer, you know, you never define a system by one point. I mean, it's absolutely outrageous to imagine that you can predict how healthy someone is from, from one point measurement. So we really have to, you know, unfortunately right the ship by proliferating this technology in a very mainstream way. It has to be the case because of that. You know, 84% of the 90 million Americans who have prediabetes, because they don't know they have, has to be the case that they stumble upon it, like me, by trying an interesting product that tells them more about themselves. And in doing so they discover, wow, this is not as good as I had expected. And luckily, because I'VE come across this. I can now make changes. Otherwise. Otherwise, I just think either we have to implement some sort of social scale mandatory testing or like opt in testing or something, or you're just never going to uncover it. There's just. You won't find it.

Out of the couple trillion dollars that we spent on, on COVID testing, do you think that that's saving more lives compared to spending a couple trillion dollars on blood glucose monitoring for the entire country to create healthier metabolisms? I totally don't expect you to answer that because that would be a PR nightmare. But I will answer it. Here's the deal. If you have blood sugar regulation problems, your risk of dying from all infections is much higher. So if we were interested in making sure fewer people died, we would make sure that we did what it took as a country to get our blood sugar under control. And it's just that simple. And if you're in the government and you're listening to this, do the math already. This is a clear and present danger that's there every year that kills more people every year than probably all viral infections put together, I would imagine. So, like it's that big of a deal.

I totally agree. It was interesting. Well, my co founder, Casey, she's a Stanford trained surgeon turned functional medicine doctor and then she joined LEVELS because she realized how rampant the inflammatory problems of metabolic dysfunction were in her practice and in her surgery. But she wrote an early review of the data on Covid and the connections to diabetes. And so that review was profound. I mean, in Mexico, for example, the mortality from COVID was twice as high for people that had diabetes. I mean, 200% likelihood of death, that's not minimal. What we should describe it as is the collision of two pandemics. You have a viral pandemic hitting a population that is already diseased. And the situation is that we can vaccinate ourselves from this strain of virus because luckily we have the technology to have quickly developed it. But there will be another one and there will be another one after that. And if our population isn't resilient enough to have an immune system that can fight viral infections, because it is, you know, frankly, undermined or hampered by insulin resistance and all of the byproducts thereof, we won't ever get there. So it is incumbent on each individual person, and I think also on society in general, to improve our metabolic health and therefore the resilience of our entire population. And not just here in the US but globally. I mean, this is, this is clearly as we've seen from COVID It's a clear and present danger, as you said.

When I go into the app and I say what I ate, either type it in or take a picture and then I can look, okay, how high did my blood sugar go up and how long did it stay elevated? The goal of eating foods where there's a moderate rise that goes down relatively quickly, you do that, it was the right meal. And if it goes, you know, to 170 and stays there for two or three hours, maybe that shouldn't be what you eat regularly. Like it and it can be different for different people, which is, which is really well established. Are you guys seeing enough data now? I know you've got like 75,000 people on your wait list, but do you have enough data to be able to say, oh, it turns out that everyone who drinks a diet soda or eats, I don't know, some kind of food sees this and like, these are the clear and present danger foods, or do you not have that kind of data?

We do have that. So our data set is we're currently taking in more data per week than we brought in for the entire first half of the company's life. And so the data set is now the largest of its kind in terms of continuous blood sugar information for people without diabetes paired with lifestyle information. So no data set like this has existed and it's growing exponentially. So the beauty of that is that we will ultimately have the ability to do what you're asking right now. We still at this point are in the early stages of basically refining our data set and our approach to combing through it. And we have some phenomenal data science folks on our team that are bringing out some really brilliant insights. I can't yet state with confidence because we want to make sure that they're statistically significant and such. But let's just say that in the future these data driven insights I think will ultimately change the, the misleading marketing that is possible today with food. So you will not be able to trick an informed and data driven audience with labeling because they will have feedback. So you say this food is good for you or heart healthy. Your blood Sugar goes to 170 like you said, for two to three hours and then crashes. Well, we know glycemic variability is closely related to cardiovascular disease, so that'll be an easy one.

I am to the point. If a food has heart healthy stamped on it, it just means don't eat it. I mean, what it means is it has no fat and especially no saturated fat. Which is a precious nutritional substance. And when you eat it, it's basically just like mainlining sugar. Like you might as well just go have some ice cream.

Much of the time people are. So people come into the Levels app, which, you know, by the way, the levels system exists to answer the question, what should I eat and why? With objective data from your body in real time.

When matters too.

And when. And so, you know, people come into the program and they have preexisting notions built, built on what we all have, which is, you know, without data, we have Internet advice and we have food labeling and, or maybe something that worked for a friend. And they come in and they're trying their regular, their diet and oftentimes, you know, people will be eating oatmeal, right? And if you Google the healthiest breakfast, right, top look at a list of healthy breakfasts, top three, oatmeal is going to be on it every time. That's just how, like that's what the Internet says. And so people are eating oatmeal for breakfast and a large number, significant portion. Last time I checked, it was something like 70% of people in our dataset who ate oatmeal had an extremely poor blood sugar response to it. And I mean, one of the worst that they would have through the entire program. And that is highly counterintuitive because oatmeal, we are told, is a heart healthy breakfast. And of course, this doesn't mean that no one should eat oatmeal. I mean, I think to each their own. And also there is that personalized element that we talked about. Some people are just fantastic carb metabolizers. But for those people who are eating it with the intention of being healthier, with the intention of treating their hearts, right, I have to say, you know, it's, it's important that we correct the record about oatmeal. It is not necessarily heart healthy and certainly only for a subset of the population. So it's just that that's the type of thing that becomes an urban myth and it gets spread.

But, but oatmeal has fiber, right?

Yeah, exactly. Well, oatmeal actually has a surprisingly small amount of fiber.

I'm channeling idiocracy where they, they watered the world's crops with Gatorade because it had electrolytes and all the food died. And you know, it's one of those things where just because it has one thing or some small amount of one good thing doesn't mean it's good for you, because there's other bad stuff in there. So I love it. You're picking on oatmeal, which is not a good choice, at least not for most people. And even for the people who do tolerate it, it's probably not a great choice. It's just tolerable. And it feels to me like a lot of our foods, and a lot of this has to do with my new fasting book. A lot of our foods are, you can eat that and you won't starve to death, which is a really powerful thing to know. The problem is, well, we've always eaten that because throughout history a lot of our people were close to starving a lot of the time. So it just become food instead of, that's the backup food for when you can't get stuff that works really, really well. And using data to circle around and be like, well, we can tell ourselves that that's good, but the data lies. And in your case like, look, I'm working out, I'm doing everything right and you've got the pedal all the way to the floor and it's not going any faster. It's very similar to what I went through. Like, God damn it, I'm going to exercise an hour and a half a day, six days a week, 18 months and nothing will stop me because I will lose my weight when it doesn't work. Like, ah, maybe it should be two hours a day. Right, because the assumptions were flawed and I've already just, in using levels over the past, oh, I'm guessing about nine months, I've been better able to follow my own advice. So a classical example, I have said for years, you know, eat before it gets dark, you know, earlier dinner is better, but there's always school and whatever else and it just, it tends to creep up, especially in winter. I'm in Canada where winter gets dark at like 5:30. So I've been saying, all right, what happens if I eat at 6 to 6:30 versus 5 to 5:30 and there's like a 15 point difference in my blood sugar response within an hour of eating. So now I'm really a little bit more militant about eating a little bit earlier because I know it works better versus just saying, all right, maybe I'll just skip dinner and I'll just eat lunch tomorrow because I really don't want to eat at a time when my body's really not ready for it. And to see those correlations, I couldn't see that when I stuck my finger because there's only so much that you can do. And I couldn't see that when I would just use the older CGM apps that didn't have the input your food, see what it did and just the correlation tools. So I'm, I'm truly blown away. That's why, by the way, I don't know if I don't think I mentioned this on a show yet. So I'm an advisor, I'm an investor and stuff like that. And also, guys, partly because of that and also because I try to work out good deals for you. If you go to levels link Dave, you get to go to the front of the line. So there's like 75,000 people trying to get this. There's a backlog to get the devices. So if you want to be one of the first ones. And this isn't like a financial thing, I'm not getting paid on that or anything. This is just like, you know, hey, like, let's do a solid for bulletproof radio people. I just have to say, if you want to fast or you want to have more discipline around your diet, there's nothing like saying, hmm, I'm hungry right now. And then you wave your phone over your levels thing on your arm. You can see mine right here. See, look at that. Here, I'll flex for it, make it look all cool. But if you're watching on YouTube, you saw that. Otherwise you just heard rustling. But what happens is you wave your phone over it and it says, oh, here's your blood sugar levels. And you're like, man, my body just told me I was hungry, but my blood sugar's 105. I got plenty of fuel present. Therefore, that feeling of hunger isn't something that's valid. And then you tell the cells in your body, shut up and use what you got and come back to me when you're actually hungry. And the process of doing that as a real time feedback loop is, has been really helpful even for me at ten point whatever percent body fat, not insulin resistant and relatively dialed in as a biohacker. Right. It still makes a giant difference just because when you're tempted, you check, no, I really don't need that. And the data is so clear, eating fewer meals per day equals less chronic inflammation. And chronic inflammation is the same thing as your mitochondria not being able to to turn air and food into electrons. They're turning into some electrons and some inflammation. Another word for that would be insulin resistance because they couldn't turn the energy into electrons. So that that closed loop has been massively illuminating for me. And yes, I wear My aura ring and I monitor all sorts of crazy stuff. But this is, I would say you might not like this. I'd say it's, it's almost as important as monitoring sleep. And I think you need to get your sleep scores first. But you should get your continuous glucose right after your sleep score. What if there was something you could add to your water to make you perform better, have more energy and protect your cells from damage? Hydrogen is the smallest molecule in the universe and the only one that can get deep inside your cells, mitochondria and even your DNA. It fuels energy production, crushes oxidative stress and supports sharper brain function. Hydrogen's a gas, so you can't take it as a pill. So you either have to breathe it in or infuse it into your water. But your tap bottled or filtered water doesn't have it. That's why I use the Echo Flask. 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Yeah, so on that note, I mean I think that the interesting thing for me has been discovering through CGM the importance of those sleep scores. Because when it's like, okay, I got a poor sleep score, but I don't really know what that drives, it's sort of like, well, it was bad sleep, but I mean, what would happen if I just kept getting bad sleep? Well, then you put on a glucose monitor and I see that a five hour night of sleep versus an eight hour night of sleep is a 40% difference in how my body can metabolize my meals. That's when it clicks. Oh, okay, got it. So when I, every time I get that poor sleep, I'm kicking myself in the head when it comes to my insulin resistance and my ability to metabolize the meals I'm giving. And rather than compromising myself further with poor sleep, I need to be sorry. Rather than compromising myself further with poor nutrition after poor sleep, I need to be even better about my diet because I know I've pulled one of those levers, the sleep lever, and, and I now need to make up for it by not pulling the nutrition lever too because that's going to do double the damage so that that whole sort of Context that, that I think real time biological information gives. It has been key to my understanding of, of not only sleep but also just mental fitness, just mindfulness, being able to understand the mechanisms of stress in my life and trying to take control of them. So yeah, the real time feedback loop with a molecule that is, you know, significant and contingent on the meals I'm, I'm consuming has been a game changer for me in understanding the value of these other metrics.

So you've had the same experience. Do you guys publish how many active users you have versus people trying to get it?

We don't publish it, but I think right now we have something like 1200 active users at any given time. And we're, you know, we're still in that, in that small invitation only beta mode. Dave, you just read out the link. So if people want to come and join us, you know, this is basically part of the process of developing the product. We're rapidly iterating on features, we're taking in customer feedback and essentially creating the product that we believe is going to be intrinsic to the sustained behavior change across, you know, long time periods that is necessary for us to write the Metabolic Health ship here abroad. So if you want to be a part of that, you know, please join us and we'll be slowly increasing that volume. And as you mentioned, we have close to 80,000 people on the wait list right now and tons of insatiable demand and we're looking forward to being able to launch to the broader public once we finish this development process.

Well, it's something I can't wait for. I think a lot of listeners are going to say I want to do this to at least get an understanding. And you've got some really cool medical advisors. All but one of them have been guests on Bulletproof Radio, which made me laugh. Dom D', Agostino, David Perlmutter, a very close friend, Dr. Muller Maloof, who's also a friend, Dr. Sarah Gottfried. These are cool people who are very knowledgeable and looking at, okay, how do we get people who are working with the public and with patients and then saying, how do we make this usable? This is the first usable, just easy to use, zero inconvenience CGM that I've come across. So I want to push you to move your launch date up and well, I think there'll be a lot of people on your waiting list excited to do that. Now there are other wearables that are out there, even some kind of blood based ones. How is this different from other wearables that are out there.

Well, right now the wearable market kind of consists of what I like to refer to, and this is not judgmental in any way, but there's sort of superficial metrics which are heart rate, step count, occasionally body temperature, which I think is actually really valuable. Heart rate variability, which is, I would say body temperature and heart rate variability of those two are the most valuable. But the reason I call them superficial is because they're outside the body. It's, they're available to be measured for the most part with your finger, you know, you can measure your pulse, your finger, you can count your steps. And so now with cgm, we're crossing that barrier and we're going kind of below the skin to an invisible metric that we otherwise wouldn't have access to. And so that's why we're calling this bio wearables. This is a brand new space. People are traditionally only using kind of the consumer product wearables that are out there, which are admittedly value. I mean I have two on right now. I wear my Garmin 245 and my Whoop strap and, and you know, I love them. But I think that the future of this technology is incorporating more real time molecule measurement in the body and then using that to close these feedback loops to better understand holistically where I land on the health spectrum and where I need to go.

Okay, that, that makes a lot of sense. You know where the 10,000 steps a day actually came from?

I actually don't. I've read about this recently and I've, I've blanked on it.

I figured this out when I was at basis the, the risk tracking company. I did all this research and in some time it was either 52 or 56, like 1952. The first ever wearable pedometer, it was a mechanical one that clipped your belt, was from a Japanese company. They made up 10,000 steps a day and there is no data to back that up. And we have been saying that ever get your 10,000 steps a day? Because of the power of marketing, it's exactly the same type of behavior that says oatmeal is a healthy breakfast. So just saying. So those are superficial metrics.

Yeah, it's, you know, I think if there's something that is encouraging people to get more steps in, you know, maybe they selected that number because it was like 150% of what most people would get in a day. And so they're like encouraging them to push, I don't know, maybe it came out of thin Air. But as long as it is encouraging people to move in the right direction, like I'm glad they did. So I think that the, the opportunity that is ahead of us, which is to, to take something that is totally on sort of, I would say ill defined, which is our nutrition. And frankly it gives people so much confusion and lack of confidence. Every day you're sitting down, you're going to eat lunch. What do you eat and why? Again, we're going back to the Internet, we're going back to a friend where we're hoping and praying and then we're not finding out until the bathroom scale increases, you know, weeks or months later or we have some sort of poor diagnosis and then how do we know what to change? So I think the real beauty here is that this is, this is an opportunity to provide immediate confidence, to give people that closed loop feedback. You get your meal scores in the, in the Levels app, you get your day scores in the Levels app, you understand your trajectory and then you get insights to tell you this is a low hanging opportunity. Like you can, you can very easily add a walk after this meal or by simply substituting this ingredient for another one, you get such better blood sugar control and therefore hormonal control. And that's the opportunity I think that we have ahead of us is, is to give each individual an ideal personalized sort of lifestyle that they can follow and they don't have to worry about what the rest of the world is doing. It's not about applying an average to each person, it's taking each person, optimizing them. Do that times, many, many people and you get the same social scale change.

The personalization is such a big thing here. There's some confounding factors when I think about it. You look at what say my friends over at Viome are doing and they're saying we can predict based on your gut bacteria what your blood sugar level will be based from food. And they've got pretty good correlative data there where they can say this probably is going to spike. Oatmeal is going to screw you up or it's not. And that science is getting tighter. But the thing is then you get a bad night's sleep or you eat some industrial meat with antibiotics that shift in your gut bacteria before you send in your next test. And so the feedback time of every meal, a few times a day, how am I doing? And then even when you're checking it, you're not just getting that one point, you're getting stored data. So at the End of the day you have a full curve showing what did your blood sugar do even when you were in a meeting and you didn't check it? So you can tune it. But you can also incorporate advice. For instance, maybe intermittent fasting, I don't know, there's a book about that, maybe that's going to be helpful. But you can see, does a 14 hour window work better for you? Does an 18 hour window work better? Are you overdoing it? Because now you're getting insulin resistant. Maybe it's a really bad idea to do that when you're having your period. All of those things are going to be testable with daily changes. And I found it really didn't take long for it to become really clear the things that were causing the little spikes. And there are other spikes that are beneficial and surprising and useful. Like you get an infrared sauna, your blood sugar's gonna go up. You lift heavy, your blood sugar goes up and that's cause your body's actually using cortisol to make extra blood sugar from your muscles or maybe from your fat or I do the biocharger, I had an episode about that a while ago. This is a pulsed electromagnetic frequency, very cool sort of Tesla esque thing. You sit there on certain programs, but not all of them. You get a spike in blood sugar as it's doing stuff your cells and you're like, wow, I can see that A leads to B. And to me, that sense of knowledge and control, it's kind of liberating because otherwise it's just this cloud of mysterious, I know, stuff happens to me. I don't know why.

Right, yeah. Being able to provide dot connections for people is so huge. I like to call them receipts, digital receipts for micro optimizations. So you do a little thing, make a tweak and then you can see whether or not it helped. That's, that's something we've never had. It's been, oh, you know, I think I feel better after, you know, after closing the blinds or putting, putting blackout curtains in my room. I think I feel better and I'm sleeping better. Your recovery score tells you that, you know, now we can do that with nutrition. I think that this new diet is working for me. Well, now, now I can know, right? I can, I can connect these molecules, they, the hormones they drive to long term outcomes I want to avoid. And so if I can watch those fluctuations minutes after consuming something, I know with confidence which direction I'm compounding in, you know, with my lifestyle choices. And that's something That I think is truly liberating and will ultimately give, I think, people not only a better understanding of themselves, but better confidence in the decisions they're making every day.

Do you ever use your levels to sort of do the wrong thing? Like, I really want to eat that giant piece of cheesecake. And you're like, but I know my blood sugar's gonna go up, so I'm just going to pound a bunch of chromium and take a couple extra metformins and do some squ. And I'll manage it.

Well, I definitely, I haven't done all of the above.

That was a yes. I saw it in your eyes.

Well, I definitely use it as a device to improve indulgences. Right. So I know like the biggest one for me is just walking. And that was something that I would never have believed before. The power of a quick, like just 20, 15 minute walk around the neighborhood, casual. The power that that has after me, what you're saying after an indulgent meal to modify the blood sugar response. So that's something I've now almost habitually added to my lifestyle, is if I'm going to eat something with a few extra carbs or if I'm just going to go all in and eat half the cheesecake, I'm going to finish it, put my plate in the sink and I'm going to go walking and I'm just going to enjoy the sights and sounds and talk to a friend or call my mom or whatever it is, but I'm going to go for a walk and I'm going to enjoy it. And I know because I've tested this time after time after time, my posterior chain, the muscles in my, in my legs are sucking that glucose right out of the bloodstream without insulin. And that is improving my body's ability to handle that indulgent kick to the system that I just gave myself. And it allows me to, you know what, frankly, I have a sweet tooth and I love dessert. And so it allows me to go ahead and go off the rails here and there, but do it in a slightly better way than I used to.

And also, let's face it, if you eat a dessert that has 25 grams of sugar in it, so relatively sweet, but not like 100 gram Frappuccino, extreme explosion, rainbow juice, whatever, but a reasonable dessert that's delicious and sweet and all that, and because you're able to say, oh, well, I had a fat and a protein meal before I had dessert and I'm going to go for a walk and Maybe I'll take some supplements or maybe I'm taking the probiotics that lower my blood sugar. By the way, I see a difference on my levels from those as well. I have permission to do this and it might do something slightly bad to your microbiome, but not very if you do it on occasion, so then you're doing it without taking the hit and you go for a walk. I live in Canada where it's dark and rainy all winter, so my kids make fun of me because if I have something sweet, which don't do it that often, but I do sometimes and you should be able to handle that if you're healthy. But yeah, I'll do 20 or 30 air squats, same thing, posterior chain. Or I'll stand on a vibration platform and they're like, daddy, you're dumb. And I'm like, well yeah, but my blood sugar's stable, so it's all good. But knowing that I wouldn't do that if I did not have my levels because I've seen the advice, how I've quoted all the studies about 20 minutes of walking a day and doing after meals, but it's raining. I'm just not going to. But now I'm motivated. So that motivation for me is awesome. And the idea of monitoring, getting feedback has been a center part of me just disproving. So I was doing everything that was supposed to work. So for 20 plus years it's been at the core and it feels like every year it's getting easier and easier and easier. In 2003 I was working on a stick on heart rate monitor. You had to glue it to your chest and it was a thousand bucks and you had to have a prescription. It's in your watch. It just doesn't even matter. So what's next though? I mean you guys have this nailed. Are you going to be adding other sensors? Am I going to have to like have a row of these like level sensors going all the way down my arm like some sort of, you know, robot from Altered Carbon? Like what? Tell me, tell me the future. You're a space guy. I mean, you have to know the future.

No, you'll just completely replace the arm altogether. It'll just be a biome with one big sensor. Sensors are going to be integrated. No, I think the direction we're heading is no doubt about it, we've opened a new market which is that, you know, the non therapeutic use case for what is ultimately medical technology. You know, this was developed in the medical environment. It was developed for the management of diabetes. But we're showing that the opportunity to ultimately give people the empowerment in their health and wellness before they have something go wrong is here to stay. Right? So this technology, CGM is going to innovate, it's going to get better and better, just like the heart rate monitor did. And ultimately I think we're going to have some sometime in the future non invasive means, but for the time being, we're just going to get better and better versions of what you're wearing and we're going to be in levels would be, I think, intrinsically involved in this innovation, expanding the number of analytes that we're monitoring. You know, the big ones are hormones. I'm very excited and optimistic to get to the point where we can have real time insight into not just glucose, but insulin, which is what I really want to measure. I want to know what's happening with my insulin levels and then cortisol, you know, and eventually I think we can also add in maybe LDL or triglycerides or some other lipid marker that would be interesting. And together you can have a really good insight and also ketones. And I think you'll then have a really good insight into in real time, how is my hormonal condition in response to the fuels I'm consuming and what fuel am I burning? You know, based on your glucose and your real time ketones, you can have a really fantastic understanding of how your body powers itself. And then you can change those ratios by, you know, say, doing more fasting or doing more fasted exercise, which encourages the activation of body fat stores and gets you into a state that allows you to more easily oxidize what you've got on you. And so that's the concept of metabolic flexibility. But overall that's the direction I think we'll head. It won't be a whole row of sensors. I think we're going to see a really nicely consolidated single puck that you'll.

Wear if you would just real quickly add thyroid and melatonin. And on that list, I'd love to see those hormones as well. By the way, all of these are circadian hormones, every single one on your list. So then where we're gonna get is what is it you're doing with your food, what is it you're doing with your movement, and what is it you're doing with your sleep and your light? And those are the major variables of biohacking. There's also, you know, vibration and EMFs and whatever. But the big ones are those. And of course, temperature sensing, which is already a solved problem. And then you've really got all of the things you can manipulate and then it just comes down to, okay, which ones do I have to manipulate for myself given my current state, to get the output put I want from my brain and my body. And that's hard. But when you have 100 million people putting their data into a system, it'll be pretty darn easy to say, well, you know, the most likely solution for you is this, because this is what worked for the other 6,000 weirdos like you out of the 100 million. And this is shortcutting 2,000 years of medicine of what we've been doing with traditional Chinese medicine, with Ayurveda, with all of the historical research, like how do we just better match manage the human body? And I feel like we're so close in our lifetime. This is accessible, the AI work is there and it's improving, the sensing is working, the costs are dropping for all the stuff we need to do. So I don't see a lot of stuff stopping us. But you might have other ideas. What's the most likely thing to slow down that vision?

Well, I think there's a number of things that are currently adapting in real time. I actually believe that we're going to see massive progress very quickly. I'm very optimistic. And you know, the tech, as you mentioned, the technology that's necessary, the machine learning, the large data sets and the way that we can manipulate and understand them, and then also the hardware. You know, there are some really fascinating concepts that are currently in place in sensors, but there's also, you know, more DNA driven sensor technology that's coming available. It's in the research world, it's been demonstrated and we just need to move that from academia into real consumer products. In order to do that, you got to show that there is a market and that people are willing to use it. But most importantly you have to show that it works. Right? So that's what we're doing is the first step is show that this is meaningful, show that people should care about their metabolic health and improving it. And that will be everything that's necessary for I think new innovators to come to the space and bring their new technology. And if anything we've got some regulatory environment and sort of some, I think, old policies that tend to be very onerous to get a new technology to market. And I understand for medical technology it's important to make sure that there's efficacy and that there's safety. But at the same time we had a microelectronics revolution, we had a software revolution. And many of these regulations were written decades before either of those. And it's like the pace of process of progress has outpaced our regulatory ability to keep up. And I think there might be a need to revisit some of that.

When I worked on that stick on cardio patch years ago, we looked at the cost of doing this as a medical device. It's not even invasive. And we said, screw this noise. We're going to go to Med City in India and we're going to go to Singapore, and we're able to do our clinical trials way, way cheaper than in the US And I'm a little concerned that for a lot of this stuff, if the regulatory North American, both the US And Canada, if they don't become a little bit more entrepreneurial about this, we're all just going to be buying our sensors from overseas and sending our data overseas as well. So regulatory is an issue. But I'm surprised you didn't mention privacy, because people are questioning where their data goes and who owns it and all that. I'm happy for my data to be used to help other people figure out how to manage their blood sugar better, but I'd be kind of pissed if you're like, this is Dave's blood sugar. Do you guys want to buy that? With my name and stuff associated? What does the privacy situation look like with you guys? I should have actually asked this before I invested in you, but I didn't.

I'm glad you brought this up. And we're currently drafting what I think is the most comprehensive yet straightforward and accessible privacy policy that I'm aware of. In other words, it is written in plain English, and it tells you exactly what's happening with your data and why, and it gives you full control. So one of the core values of levels is openness and integrity. And, well, those are the two. Two of the core values. And those both combine into our privacy policy, which is that, you know, the first day that I walked into a doctor's office and asked for a cgm, I was told, no, I can't have access to the CGM because I wasn't already sick. And that felt. It felt like a violation because not only did it not make sense that I couldn't have one until I was sick, it also felt like, this is my body and this is data that is happening inside my body that I.

It's a human rights issue.

Yeah, I tend to agree. And I think I should be the one granting access to other people, including my doctor, to see my blood sugar information. I should not be requesting that.

Amen, brother.

So, so that is the, the, under. The underlying foundation that we're bringing to Levels is that you, the individual, own your data. You can have it removed, you can export it, do whatever you want. We will never sell it to a third party and we will only share it in an anonymized form with others for research purposes if we have your approval. And ultimately that's, that's the intention is that, you know, the data set is not a business model for advertising. The data set is a means, I think, to changing the future of metabolic health by driving large scale research and helping us to understand how people are living, what is improving outcomes and where the opportunity is to I think, remove the biggest offenders for worse health.

That is one of the cleanest and most concise answers I've ever heard to that question. Because it's an issue. And if we just understand, look, it's my data and maybe I'm willing to share it under the right conditions, but the fact that it's mine and I have the right to take it back, it's a very solid view and it's completely the opposite of the way Big Pharma has been looking at it and the regulatory environment's been looking at it. And I think we're going to end up in a situation where there's a group of people who just understands this. And if this group includes you and me, if we increase our influence and help people think about that, we're just going to end up in a world where you have the right to know anything going on in your body without a permissions letter. And that is how it's supposed to be. And if we let it go the other way, only a marketing company or an oppressive government will have rights to it and you won't even get to know or maybe an insurance company. And that's a dark world and it's a world we don't want to create. So I would encourage all of you guys listening. If you're sharing your data with something or another who gets to see it, ask the questions. And especially for small companies like Levels, if you don't like it, you can send them an email and say, what do you think? You're not going to just take this and sell it to some guy who's going to try and push some pharmaceutical stuff on me later. Unless you're cool with that. And you might be, but you should know so thank you for being super clean and ethical on that. And just for real, clear disclosure, I truly did not know what you'd say there. Even though I'm an investor, when I do diligence, it's a question I always ask, and I don't know why I didn't ask. I think because we were rushing it and Andreessen Horowitz was about to do it. And anyway, I'm very happy I backed. And you just made me very, very calm with your answer. I was gonna have to yell at you.

No, I, you know, it's. Again, it's something that the. There is no sort of. In my opinion, there is no other option. The. The only way to, in my opinion, turn around the issues with advertising and misleading marketing is to stop targeting people for. For information that you know about them that they don't know about themselves. That. That's what it comes down to is the reason we're in, I think, a mess right now is that tech companies have your data. They know what they have. You don't know what they have, and they can use it against you. And it is really critically important, especially when it comes to health and wellness matters, that the individual is armed with their data first and foremost. They know what they have, and they allow others to get access to specific parts of it if they are willing to. And again, like you said, some people are going to be able to post this on the Internet. That's. That's totally up to them. I think that is, again, an individual. Right. But at the organizational level, there's just absolutely no defense for something like that.

Have you ever thought about adding a feature so that if the device senses that your blood sugar is going up because you ate the wrong stuff, that it can remotely shock you so that you'll behave yourself better?

That's funny. There is a device out there, I think that that does something similar. It's a behavior change mechanism.

It's called the Pavlok. I invested in those guys a very small amount because it was too funny not to invest, not because I'm sure I'll ever say anything.

I have to admit that I've thought we should at least have that feature because I would take advantage of it. If I can improve my accountability measures by any means, I'm going to consider it.

Crazy enough it actually works. But you really want to be the guy who controls that button, because remote control shocking of humans has really, really dark implications if you've ever had a dog on an electric collar. So we won't be going There. But the other question I have for you, I've talked a lot about electromagnetic frequencies and how chronic exposure to low levels of them actually does affect you metabolically through voltage gating, calcium channels and things like that. What is the level of EMF coming off the device when I'm not scanning it?

So the Libre device, and you know, the manufacturing company that produces those, has all the specifics which are not necessarily released. But we do know that it uses near field communication. So it's an essentially, essentially a passive product where what you're wearing on your arm emits due to the sensor or the reader coming into near field with it. So basically when you move your phone over it, it activates a transmission protocol. So it is not, to my knowledge, and this is necessary to preserve the battery life of the sensor. It is not continuously streaming data in the way that Bluetooth does. Now There are other CGMs that have Bluetooth on and on them and they are kind of emitting a low energy Bluetooth field all the time. But my understanding of the near field communication protocol that's implemented in that sensor is that it is not doing so.

The way it works, at least the last time I dug really deep on this when I was doing the basis thing, is that you create a field with your phone and the field activates the stuff in the puck on your arm and actually provides the electrical charge for it. Much like when you have your key card, there's no battery inside your key card and you wave it over the door, the door creates a field, you wave it through the field. The field creates enough current to cause the microelectronics inside to emit a small signal. So it is as low EMF as you could possibly get because there's no EMF until you put a field on it. And that's pretty cool.

Yeah. So there in the patch that you're wearing, there is actually a small little battery. But what that's doing is it's waking the sensor to take measurements and record them into you onboard storage.

It's a continuous recorder. That's true, there would be an EMF from that, but it's micro.

Micro, okay, about as minimal as it can get. So you're not necessarily broadcasting something.

And compared to even an OURA ring, it's orders of magnitude lower. The OURA ring, you can put it in airplane mode though, and that turns off the transmissions. But it also has a little bit of a microprocessor because it's got to take measurements throughout the day, even if it's not broadcasting them. And for, for people listening who are really into, you know, 5G is going to, you know, neuter mankind and all that stuff, all of these things are small hits. But this kind of device is so tiny compared to the fact that you're walking down a street surrounded by WI fi routers that I don't worry about this and maybe I'm wrong and if you guys think I'm wrong, send me some stuff and I'll read it. But overall I look at benefit versus risk and EMF is not an issue for me with this device at all and I care about it. So.

Okay, yeah, I think on the, on the risk benefit there, you know, as we've mentioned in the statistics, metabolic dysfunction is ravaging us. And I think that those, those numbers, you know, focusing there and using a technology like this for however long the, the individual wants to use it, I, I think it will be a, an educational tool and something that you can use for a very long time into the future. So it probably provides, you know, tremendous benefit in the face of the risk that we're all kind of facing.

I find that sometimes when I, after the 14 day period when the sensor dies and you have to get a new one, I'll take it off and sometimes I replace it right away. Sometimes I wait a few days for whatever reason, I haven't figured out why I wait a few days. How many of your users are just okay, I got to put it right back on right away and how many of them like, you know, it's okay if I missed a day or two? Well.

We have different personality types there, so I think there is a, probably about a 25% of our audience is like, is the hyper focused, you know, they basically. And I'm one of these, I'll put my next sensor on before I take my other one off. And so it'll be warming up before the other sensor comes off the calibration process. So I like to have that continuous data stream because it's just the accountability piece for me. You know, I've learned a lot of lessons from cgm but, but the best part of it is that I know I'm going to see that data. It's going to keep me on the straight and narrow. So I think it's about 20 to 25% of our current user base. The rest tend to take a little time in between sensors. Some people even take a month or two off in between months of use. We have a few people that'll just take a break and they'll implement some lessons learned and then they'll check back in and they like to see how have things improved over that time span. And I think both of those are perfectly righteous ways to approach this. It's, it's up to the individual how you want to use your own data every day and whether or not you want to just do this in chunks. And I, and I think that ultimately at levels we're developing the product in such a way that you can use this however you see fit. You know, we're going to meet you where you are. There's no necessary, you know, requirement that you are wearing this continuously. We certainly respect and understand the people that want to. But if you want to check in here and there, take some time off, totally get it and want to just build it so it's effective for you as well.

Now when you launch openly, it's 399 for the first month. And that includes all the sensors you need for the first month, hardware, software, everything. And then after that it's 1 99amonth, which is for people who work continuously. And if you're looking to save a little bit of money, like, okay, I'll wear it three weeks out of the month or something, you could stretch that. Do you see the price coming down three, four or five years from now?

Definitely, yeah. One of our. So we wrote a blog post on this and it's called the Level Secret Master Plan. And we ripped that off from Tesla. So when Elon started Tesla, he wanted to make electric vehicles sexy and cool. But what he really wanted to do was change the world. He wanted to reduce carbon emissions due to internal combustion engines. And so the first step that he took is the sexy, cool route. He initially needed to convince people that it's possible to produce a desirable electric vehicle so that they would pay attention. And what he built was the Tesla Roadster, which is very expensive premium car and very few people could get their hands on it. It came down to like the core technology was, was very expensive. But with that first roadster he was able to finance, then the Model S with the Model S was able to get into a slightly lower tier of still premium car buyer. And ultimately the scale of the Model S is what allowed for the Model 3, which is the first mass market electric vehicle ever. And it has changed the dynamics of the automotive industry completely. There's not a single major manufacturer in the world who is not now building electric vehicles into their roadmap because they have to compete with Tesla. So we're taking a similar Approach in the sense that right now the technology is expensive. You know, these sensors are not affordable because they are medical devices. There's a heavy regulatory burden on not just developing them, but then continuing to manufacture them and ultimately to, to distribute them. Right. So all of our devices are fulfilled through a pharmacy partner. There's a prescription requirement. All of that we, we've implemented into our program. So right now we're in this because.

You had to by, by rule of regulation, a lot of which isn't even law. Like regulators aren't writing laws, they're just writing rules that they thought were cool that usually protect some industries, including attorneys, because the regulators are mostly attorneys. So there's, there's a lot of price in there that isn't for the tech, it's for the rules.

That's exactly right. So there, the beauty of that, you know, it's a, it's a situation that we're in today. But the nice thing is that much of that is going to change. It's going to change quickly and that will allow us to get to our end state, which our end state is this is technology that is changing behavior in order to change the world. We want to completely improve the rampant metabolic dysfunction that is attacking every developed nation and we want to turn it around. You know, right now there was a, there was a study in 2018 that said that 88% of American adults are metabolically unhealthy in some form. We need to flip that ratio. It needs to be 12% at most are metabolically unhealthy. In order to get that, we've got to have a mainstream change. That means this can't be a $400 per month program. It's got to be much more affordable. And frankly, it has to be something that employee wellness programs provide and that is more available. And so we're going to get there and we're going to have to do it iteratively by sort of building out first the premium product and then slowly but surely getting down market.

Thank you for saying that. Some people get pissed off at that answer. I actually can buy gluten free muffins at the first garage in all of North America. It turns out it's on Vancouver Island. And the guy who built that garage only had a quarter mile of road and he had to bring his car in by railroad, which was easy because he owned the railroad, which is why he could afford to build a garage and have a car because he was a tycoon. Cars are a little bit more accessible now. Cell phones Same thing, you know, it was the Hollywood producer paying $25aminute with his $40,000 cell phone, filling the trunk of his Mercedes 300D convertible. Okay, now it's a dollar a month in Africa. So it'll happen for this stuff too. And if you're listening to this going, what the heck? It'll come down over time. And it's okay that early adopters pay stupid amounts of money to get a slight benefit because it always increases demand, which always drops the price. And this is just how economics works. So you can be thankful that there are people willing and able to spend 400 bucks to be doing it for their first month because either they're sick enough, they're tired enough, or they're just curious enough. And to them it's worth it. And that investment, over time, it will drop the price. Everything I've ever talked about on the show will be orders of magnitude cheaper 20 years from now. That's just how it works. It's just irritating when you want it now. So your master plan holds water according to all of history that I can find. So I'm going to, I'm going to vote with you there.

Okay. Awesome. Yeah. You know, and I think another thing is that the scale of the, you know, non diseased market is much larger than the scale of the post diagnosis market. Like we have way more people still, despite the bad, the badness of the situation, there's still way more people who don't yet have diabetes. And so bringing it to this new space means massive potential demand and even faster rates of, I think, supply improvement and then price drop. So I'm very optimistic. I like what you said there.

If you had succeeded in the vision already and we flipped it so it was 12% of people, not 88% of people, we would not have a pandemic right now because most people who die have two and a half comorbidities and they're always blood sugar related. One of them, I would say, I don't the exact number, but the vast majority of it, because diabetes precedes cancer and cardiovascular disease and Alzheimer's disease. So if we had proper blood sugar control, the entire world would be more resilient to all kinds of stuff. So that's the order of magnitude we're talking about. But you did say cool and sexy. Now I've just got to say, okay, I'm wearing my levels patch if you guys are watching on YouTube or on Instagram. So I've got it on my arm here. Can you make like a Paris Hilton approved, like, sparkly bling thing for me. Maybe here or like a little smaller sticker. I don't always want to wear a big sticker on my arm. A little smaller.

Well, that's the. So we're going to go in the direction of like Apple Watch, right? They've got all these cool bands and stuff, and even, whoop, you know, they've got the different bands. I think we're going to have an array of options. We want to make sure that this fits the individual and, you know, so that cover you're wearing right now, that was developed for people who are hitting CrossFit workouts and ripping the thing off on doing dips and stuff. And they're sweating a lot and swimming a lot. And it's really resilient. But what we want is for everyone to be proud and comfortable wearing the levels device and they want to share it with people. So I'm very open to all types of feedback on how to make that happen.

I want a Mad Max style leather with a few spikes that go in here so I can feel really like a cyberpunk again. So that, that's my vote.

And there'll probably be an aftermarket for that one.

And I'll be the only customer.

There's that.

All right, Josh, thanks for walking us through what's going on with levels with continuous glucose monitoring. Thanks for deciding that this was a bigger thing to hack than even what you were doing with astronauts. And I think that you're putting your energy into the right place because this is going to help a lot of people. It's going to help them really quickly, and frankly, it'll probably help them become better astronauts, too.

Dave, thanks so much for going through it with me. I mean, I always love this stuff. I really appreciate the fact that we've had basically the same perspective on this. It sounds like so just awesome to chat with you and I appreciate doing it.

If you guys are interested. Levels link. Dave, go to the front of the line. It isn't quite shipping for everyone yet. I'm one of the few lucky early beta testers. It helps to be an investor, but this is coming down the pipe. And I will tell you, if you're a biohacker, if you're looking to change your motivation for fasting, for your diet, for anything else, and you just want to know what works. Every activity you do has a return on investment that isn't dollars. It's did it take a small amount of energy and did it give you a big amount of energy? Back when you learn to regulate your blood sugar by changing your behaviors. By definition it gives you more energy back because you're better at using blood sugar to make energy. So this is one of those things where it's not difficult to use it and the return is very, very large and it lasts for a very long time. So this passes my bar and then some and you guys are going to love it. Levels link Dave and that puts you in front of the line. Thanks guys for listening and I will see you on the next episode.

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