Transforming Personal Wellness: The Future of Health Tech

I think in a Canadian context, there's very limited competition right now, partly because I think the bias in Canada is that, hey, we got a universal healthcare system. Healthcare should be publicly funded. There's a question mark around a lot of entrepreneurs about whether or not people are willing to pay for their own health and whether or not there's a viable, a truly like, you know, world-changing viable opportunity in this country. Yeah, I mean, this is global. I mean, it's happening in Europe. There's companies emerging. Companies raising tons of money everywhere to do this because I think we're seeing the same opportunity across health systems, whether you're in the US, whether you're in the UK, the EU, Canada, etc. Health systems are suffering and are not able to necessarily deliver on the type of care that people, as they're getting educated about their own health in ways in which they weren't before, they want to be able to manage their health and do things a little differently. So yeah, I think this same opportunity exists across many geographies.

Welcome to the Startup CEO Show. I'm your host, Mark MacLeod. In this episode, I sit down with Sameer Dhar, co-founder and CEO of Nia Health. I tell my CEOs all the time, a healthy person has 100 priorities. A sick person has one priority, which is to no longer be sick. Nia is helping people do that by giving them access to proactive care, the same dashboard and information that you have running your company. They give you for your health. I've been a customer and I can tell you that, in fact, I am a customer and it is having a massive positive impact on my life. And so that's why I wanted to have Samir on here to talk about his journey and to talk about the importance of health for founders. I really hope you check this episode out. Samir, welcome to the Startup CEO Show. It's a true pleasure to have you here. How are you doing today?

Pleasure to be here. Thanks for having me on. Doing all right. Doing all right, Mark.

Good stuff. So, you know, often I've had guests on the podcast that I have known personally before. And so Samir and I are seeing each other for the first time, but I feel like I know Samir really well because he's been like my personal health advocate and telling me to get on with things. And so I, I really appreciated that. And as we were chatting about before we got started, your service is having a very positive impact on my life. So I'm grateful for that. But let's take a step back and maybe just tell folks what, what is, what it is that Nia Health does. Yeah.

So Nia Health is trying to bring top-tier proactive health to millions of people. We think that, you know, bringing, bringing the best-in-class evidence to the masses is something that the public system, especially in a country like Canada, uh, needs. And so yeah, we facilitate advanced diagnostics, whether it be blood work, uh, VO2 max, DEXA scans, gut microbiome testing, um, you name it, and coalesce that into a super, uh, friendly user interface to help flag here's your biggest risks to healthspan and longevity. Here's the most actionable set of things that you can do to get in front of that risk. Uh, and we pair a number of our packages with clinician consults. So clinicians who are up to date on the latest science and can help you flag risk early and get onto a journey that'll get you in front of that risk.

I love it. It's pretty inspiring, to be honest. I think about, you know, many startups talk about how they're going to change the world, but you're literally changing your clients' worlds, right? So it's pretty massive.

Yeah. Well, and I appreciate you saying that, and I appreciate you being our customer too, and being a part of that story.

No, I'm grateful. Yeah, I got, you and I were chatting before we started, right? There's real health pathologies that run in, in my family. And I'm generally anti-Western medicine. Like I'll take medication as an absolute last resort. You know, like I, in full transparency, you know, I have high LDL that runs in my family. And so I'm working with Samir's service to deal with that. And I'd rather treat that through lifestyle and Ayurveda versus going on statins. And so I love that you arm me with like the data and getting ahead of it to work on that.

Yeah.

So you were a, if I understand your career trajectory correctly, you're a diabetes researcher and an investment banker, an entrepreneur. That seems like a pretty crazy journey. Maybe just connect the dots. How did you get to be here today?

Well, yeah, I mean, I think going through undergrad, like many folks, you kind of don't know what you don't know. And so you try a bunch of different things and let the process guide you in that way. And so, you know, initially my sister's a physician. I've got people in my family are in the healthcare field in general. And so you thought, hey, maybe become a doctor, it might be the path. So, you know, you did research in labs, in diabetes, et cetera. But I found that that type of, again, that type of rote memorization slash, you know, kind of repeat routine type tasks and orientation was not necessarily my, my shtick. Always been investing in the stock market and stuff like that. So we thought, I thought, hey, after that, maybe business finance might be, might be a play to play to be made. But, you know, I found that when I went into, you know, high finance and worked at different, whether it be pension fund, private equity, and then, you know, I did a summer at an investment banking, I worked at Salomon, that, that again, the type of work just did not feel that fulfilling. And I think I always had this juxtaposition of, of, um, when you're in that world, uh, against, you know, making a real difference in people's lives on the ground. Coming out of high school, I had started a charitable organization that impacted the lives of many families across Alberta, engaged hundreds of thousands of students towards local poverty relief. So once you've been able to motivate the heart of a volunteer and make change actually happen on the ground and see people's lives being really impacted for the better, it's hard when you're working 80 or 100 hours a week behind an Excel spreadsheet and PowerPoint slides and trying to get up in the morning. So, those are some kind of pivotal kind of experiences or foundational experiences I would say along the way during my undergrad degree that then, you know, eventually, you know, kind of force-fed me into a path of entrepreneurship as kind of the misfit, misfit in all other things. So, I had to find a different path.

Diabetes is one of those pesky chronic diseases. Was that like a planting of the seed that, hey, chronic peace is a thing and I should work on that eventually? Did those dots connect, or that's just a random coincidence?

You know, I wish, I wish I would say that the dots connected kind of, uh, viscerally in my head that way, but I don't think that was necessarily the case. I think I've always, in, in some part of me, has always had this desire to make a meaningful contribution to the world. Uh, so the places where I've felt the most at home have always been when I'm working on a problem that I feel is worthy or meaningful. And that, you know, and I think in the entrepreneurial context, that win or lose, because, you know, the odds of failure are always high, but that win or lose, it was a worthy cause. I think that's kind of my heuristic for if I'm working on something that's worth working on. I love it.

Now, you had a prior startup in the healthcare space called SensaSure. Is that right?

Correct. Yep.

And if I understand correctly, as part of that, you lived in nursing homes for a year. That seems like a wild level of commitment. Maybe just tell folks what SensaSure did just to give us context and how you ended up living in a nursing home.

Yeah. So SensaSure, uh, at SensaSure we built a, a sensor-based solution to managing incontinence of all things in nursing homes.

Oh yeah. What a shitty problem.

Sorry, dad joke. The puns. I had never heard that one before, Mark.

No, I'm sure you haven't.

But so we, we basically built this sensor that you put on the outside of any adult incontinence product or diaper, attract if elders soil themselves, and wirelessly nursing staff could see on any web-enabled device if they needed to be changed. And, and it was funny because kind of connecting the dots back to my my journey as an undergrad trying to figure out what to do with my life. The only reason I got into entrepreneurship after was, you know, number one, because you were, you had self-selected out of the traditional paths. And two, I got into the Next 36, which I don't know if you're— oh yeah, you must be familiar with Mark MacLeod. But that changed my life because it showed me that even at the age of 20, not knowing what incontinence even meant, uh, that you could embark on a journey to solve a problem that you knew nothing about, but that you thought was worthy and you identified a gap. Yeah. And so in essence, Living at Nursing Homes came about, I mean, for a few different reasons. One was, as I just mentioned, we didn't even know what incontinence meant as 20-year-olds, right? And I happened to fall into the space a little bit because, you know, I identified, hey, elder care. Is a problem that we're gonna have an increasing set of problems around, given that we've got an aging population. It's not a sector that's super sexy slash a lot of innovation happening in, especially at that time, which is about over 10 years ago. But it's one which is probably rife with opportunity to make a difference. And so it started by talking to a ton of different stakeholders in the space, geriatricians, care home administrators, nursing staff, and saying, You know, where does your day suck? And I think that was the, that was the first level of, of understanding that, hey, there, there's problems to be solved here. Incontinence appears to be something that keeps coming up. So what, what is that? Why is that a problem? And I think why live at nursing homes? Because one, you're trying to, you're trying to go deeper on that problem space and understand it. But, but two, I mean, practically speaking, we didn't raise a ton of money in that journey. So. You know, you get to live with your team and live and breathe the problem together rent-free no matter where you are in North America. That side benefits of that as well.

So I don't know if they still do this, but my understanding Next36 would create founding teams, right? Like you were just sort of jammed together. Is that right?

Correct. Yeah.

And it's funny because Y Combinator released a study about the number one predictor of startup success. And the number one predictor was actually the length of time that the co-founders knew each other beforehand. This was the opposite. How was that experience getting forced, getting into a forced relationship?

I don't know if I still hold the record. I think during the course of Censysure's journey, I probably went through 6 out of 7 quote unquote co-founders. And partly for, you know, I think the reasons that you just mentioned, right? It's super, it's such a challenging journey. And if you don't have that trust and you don't have that conviction, especially at the young age of, you know, your early 20s, late teens, whatever it might be, knowing who you are, why you're doing the things that you're doing, having the resilience and fortitude personally to persist past all those challenges individually, but then collectively it's hard, right? To find the right match of all these things. There was a point during the Censysure journey where literally you're building a medical device in a sector that I, you know, had knew nothing about. And I didn't have a co-founder, you know, because the ones that I was previously with, they ended up deciding to go take a job at McKinsey or Palantir or whatever the thing might be. And so, yeah, you kind of were faced up against your back up against the wall trying to figure out how am I going to keep this journey going? Is it worth continuing to go? So yeah, I think it is. It's a super challenging thing to get the co-founder dynamics. Right, and to find the right partners to go on the journey with.

You were able to bring this to a successful exit to Essity. Maybe tell us about that journey.

Yeah, I mean, it was a super quick exit, like from start to exit, it was 18 months or 18 to 24 months basically.

Oh wow, that is fast.

Yeah. And we were basically in a place where you had learned enough about the space that you knew we needed distribution partnerships to make the model work. And so we had reached out to a bunch of the major diaper manufacturers globally to, not just, not for any exit potential, but really just to see, hey, would they be interested in getting involved in our next fundraise? Would there be some sort of distribution deal that we could come up with, et cetera? Yeah, I think just one thing led to another with Essity 'cause they were definitely, I still think, our market leaders in the space globally. And we're looking for a continuous means of being able to monitor incontinence in nursing homes. So we, you know, one thing led to another and then that exit ended up happening and I worked with them for a few years and then yeah, that, that it was a, it was a great experience, a great initial experience as a young 20-something-year-old.

Just to, you know, I wanna tease out kind of the actionable insight for folks who are listening, right? 'Cause you know, you were in a very specific market, but this notion of like, you didn't approach SIT to be bought, you approached to partner, maybe get some investment, and they were just like, well, screw it. If I'm gonna do this, I might as well just do it all the way. Like, was that init— like, I guess, how did that— tell, you know, don't reveal anything you can't reveal, but like, how did it move from a commercial discussion to a, hey, we want to buy you?

Yeah, I mean, I think it was through the course of getting to know each other and knowing that we weren't actually looking— at no point in our initial discussions were we saying, hey, we want you to buy us, come buy us. We were like, and frankly, we were living and breathing it, right? Like how many founding teams are living in nursing homes and fully committed to the journey? And I think even as we were building Sens Assure, and even as I'm building Nia, it can't, you can't get up and I don't know, I can't get up in the morning to think about an exit. Like that's just, it's just not an inspiring thought. You've got to get up in the morning, especially for what the type of businesses that I've been involved with to try to change the world.. And so, so, you know, an exit in many ways is a bit of a demoralizing thought, if anything, right? It doesn't give me the conviction to, to get up in the morning and get through the hard times. But everyone's different. But, but that, that, that kind of is the culture that I think we fostered. And so when you actually live and breathe it that way, I think it comes across if you're authentic with potential partners, right? You're having the discussions, they're coming, like we actually had as part of their diligence of the opportunity. We had someone fly from Sweden to the nursing home that we were at the time living at, right? And they came and saw what we were doing and they saw it with their own eyes. And I think that gets, I mean, it gets people excited. It gets people excited to want to lean in and potentially see if there's something to be done. Ultimately, in that circumstance, you know, for them it didn't make sense to, minority invest or anything like that. They wanted it as a competitive advantage against, you know, the rest of the market as they were going out to sell their core product offering. So we ultimately had to decide if we were ready to sell at that point or not.

Did patents make sense for you early? Was this a thing you tried to patent?

Yeah, we had to patent. And honestly, that's the interesting thing. In the early stages, we hate spending money on lawyers slash, you know, on IP, which is like this intangible asset. It becomes tangible though, I, you know, during the acquisition process, because the acquirer, regardless of, you know, the real, the reality of it being that you're, you're at that stage, you're buying, you're buying the know-how, the team, et cetera. But IP becomes a big part of the equation, especially for a publicly traded entity.

That makes sense. Coincidentally, I had Joanna Griffiths from NYX on the podcast recently, and I can see the, you know, I haven't studied Essity in detail, but I can see some connective tissue between what you did and what her product does, even though it's a different end consumer.

Yeah. Yeah. No, it's, uh, it's super cool to, to see other, uh, other Canadians, uh, partnering with a, a Swedish-based entity. Not, not a, not, not the American counterparts, 'cause there are a lot of, A lot of the space is American-based companies, so.

So let's get into Nia. What was the origin of it? How did you come up with it and what is your vision for Nia?

Yeah, so in terms of origin, I, after having left StanzaSure and left S&D, I had a really hard time actually trying to figure out what my next opportunity was. It took me 4 years between businesses to kind of get going on to the next adventure. And, um, I'm happy to get into that, but I'll gloss over to say like what, why Nia. Uh, one of the threads that I had pulled on from the sensor sur journey was to say, okay, at the end of life, if you live it a certain way, you might end up in one of these institutions. Right. And, and from living and breathing that for a year, it's definitely an animated thought.

Sorry.

It was another death joke. Keep, keep. Yeah, exactly. Keep, keep, keep. Keep healthy as long as possible, right? And how do we live in a world where you can age in place, age in community, and not have to kind of get to that institutional set of living? I don't think anybody wants that as their aspirational way to be at the end. And so if you, you know, and if you deconstruct, you know, how do you prevent yourself from getting in there? It has to start a lot earlier than, you know, in your 60s, 70s, 80s, et cetera. Right. Although you could, you could probably, you know, make a dent at any age. And, and I think what has, what happened for me is, you know, I went to these blue zones where people, you know, lived the longest. Although there's some, some, some question marks around the validity of, of the whole concept in, in recent years. Yeah. I mean, there, there's, yeah, there's, there's been some, question marks. Some research has come out to say, is, is, are these blue zones actually real or was it faulty statistics, et cetera?

I mean, they're, the mortality rates are real. Again, is it causal or coincidental? I don't like, but they, they do live to 100 at, you know, at the rate that they live at, right?

Well, there's a number of holes that have been poked like around the birth records and whether or not those are valid. So, So again, without getting into that, I would say that, you know, I still went to 3 out of 5 of them. And NIA is actually named after one of them. Sardinia is where NIA came from. But I think too, with this whole popularization of longevity through thought leaders like Peter Attia, Andrew Huberman, et cetera, it's created an interest, a kind of maybe contributing to the zeitgeist of, of the broader consumer population, even in a publicly funded healthcare environment like Canada, being interested in owning their own health in a different way. So to me, I think the, the opportunity for me personally is let's keep people outta nursing homes. Let's keep 'em as healthy as long as possible over a lifetime, and let's operationalize best-in-class Evidence in medicine to the masses. So to me, I'm, I'm very, very particular about this because there's lots of companies that can be built around selling $10,000 checkup assessments, health checkup assessments, or $20,000. You pick, the sky's the limit really, right? Like in terms of how much money you can spend on it. To me, it's the more animating thought is how do you get this to millions? Which means you have to make it super efficient. And yet not sacrifice on the quality and evidence-based quality.

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No, this is, I mean, honestly, there's a much more robust market being built out in the US. Uh, we got players like Function Health, Superpower, you know, a ton of other competitors that have emerged in a US-based context. I think in a Canadian context, there's very limited competition right now, partly because I think the bias in Canada is that, hey, we got a universal healthcare system, healthcare should be publicly funded. There's a question mark around a lot of entrepreneurs about whether or not people are willing to pay for their own health and whether or not there's a viable, a truly like, you know, world-changing viable opportunity in this country alone. So Yeah, I mean, this is global. I mean, it's happening in Europe. There's companies emerging, there's companies raising tons of money everywhere to, to, to, to do this. 'Cause I think we're seeing the same opportunity across health systems, whether you're in the US, whether you're in the UK, the EU, Canada, et cetera. Health systems are suffering and, and are not able to necessarily deliver on the type of care that people, as they're getting educated about their own health in ways in which they weren't before, that they, they want to be able to manage their health and, and, and do things a little differently. So yeah, I think this same opportunity exists across many geographies.

Do you intend to bring this to the US or do you feel like that ship sailed already?

I don't think the ship has sailed. It's still early days. But that being said, when you're trying to focus in the early days on, you know, what's the initial product market fit that you want to go after, it's, you got to be careful not to spread yourself too thin, especially in this type of a model that we're trying to deliver where we don't just hand you a report and then hope that, hope that, you know, you'll come back a year later. We're trying to kind of be a partner in that journey, and that means going deeper on your experience, right? Not just, not just giving you the, the one-off assessment. And, and doing that is, is highly impacted by the geography and geographical considerations, both from a, regulatory perspective, operationalizing it in a healthcare environment. It differs in Canada by province, right? And same thing in the US. So there's a lot of considerations to do it well and to execute tightly. And in Canada alone, it is such a massive opportunity if you get a lot of, if you get a number of things right. So for now, Canada got to execute and then, and I think build the best product. You see what happens in the future.

So I'm on the other end of this as your customer.

Yeah.

And I'm clearly on a subscription.

Yeah.

So do you see this as a SaaS business?

I see it as a tech-enabled service is how we would look at it. We don't have SaaS margins.

But meaning you're thinking of like a consumer in the point of view of a lifetime, pun not intended, right?

Like, you know, yeah, yeah. I'm a full-on Français.

I don't know what's going on. Sorry. It's one of those days.

No, it's good. It's good. It's good. I'll laugh at it. I'll laugh at all the puns all day long. Yeah, no, I, we, back to my point about making this a true partnership so that it's not just this one-off, oh, I just want to see if I got any risk and then away I forget about it. I throw the report away, whatever the thing might be. We want people to actually take up the recommendations. Come back and want to see their progress, introduce other best-in-class ways of understanding where their risk might lie now or in the future. And then, you know, just being that place that people keep coming back to as they're kind of, I hate to use the cliché 'cause everyone's trying to make the digital front door to healthcare, but in a sense, we think we have a right to own that opportunity and be a complement to, not a replacement for, the public system or primary care. And in fact, if, if everything we do works correctly, we will take a lot of burden off of, off of the public system as time passes.

Yeah. I've noticed that you write letters that I can give to my doctor.

Yes.

Which is cool.

Yeah. And actually that's a really important point because what we've, what we've built is again, tech-enabled solution that is independent of clinician. So we will look at the latest evidence and interpret that regardless of who your, who your, who your clinician might be. And we'll, we'll interpret it based on the latest reference ranges and, you know, ideas about prevention from a global perspective. But to your point, one of the key elements that I think is missing in a lot of the competitors in the US and, and whatnot is what's the transition for people who might need that next step through the other health system players. What, how do you make sure that is as, as seamless as possible? So for us, when we give you that Family Doc letter, which let's say 70, 80% of customers need some sort of follow-up through primary care, um, that we suggest it, the, the, we make sure that, that the, the recommendations in that letter are done based on Canadian guidelines. So you know that as that consumer, you're empowered with information that your primary care provider, your family doc, your nurse practitioner, that they should be able to help you follow up on. 'Cause we're advising based on Canadian guidelines when we do that.

So, you know, there's an election coming up in Canada soon. I don't wanna get into politics per se, but obviously these kind of macro topics are starting to come up now as people are talking about different candidates. And I've, you know, I, I spend most of my time with CEOs like yourself, many of whom, you know, are post-exit and let's face it, wealthy. And, you know, they have concerns like taxes. Let's park that. But, you know, with healthcare specifically, a complaint that I've heard more than once recently is basically like, I pay, you know, because I have my taxes are so high, I pay so much into healthcare. And I have the exact same experience as someone who pays a lot less and the same wait times and like they're frustrated. And I feel that demographic, which is the 1% or the 5% or whatever, is like, screw public healthcare. Gimme two-tier, gimme private. You know, a lot of my CEOs prior to Nia showing up were Cleveland Clinic customers, MedCan customers. Like, what are your thoughts on that? Like, I, you know, for you, and you're clearly like, not an offering for like the true masses yet. Like this is still like, you have to be in a privileged position to sign up for it. Like, do you see yourself segmenting that market and like really going after the top tier? And if, if it's, if you have the impact, like, I guess, what are your thoughts on this two-tier? Let's take a step back. Two-tier versus true public.

Yeah. So my ultimate dream, and, and this is, this is part of our approach, 'cause we are super evidence-based and we're focused on trying to drive outcomes. And we're actually, we're doing a study with the U of A right now on some of the outcomes that we're potentially gonna be able to show over time in our client base, which is again, another differentiator between us and a lot of, a lot of competition in terms of how we're approaching things. But if I focus on those first principles of what we do actually prevents disease from occurring because we motivate behavior change, we allow people to take action early, we empower them in over their health in a way that no public system or health system is able to do today, then other payers inevitably will come in. Like, insurers should come on board, government should eventually pay for it, right? That's so, so to me, to ensure that, that I am on the track to do that, and I don't get caught in the trap of, hey, I'd love to just get 10,000 customers who are paying me $50,000 a year, whatever the thing is, you have to be true to your, you have to know what your vision or mission is. And 'cause the company could be built up very differently. We're not looking to just serve people who can pay $50,000 a year. Like that's just not an exciting opportunity for us. It really is cheap. You know, you said we're not quite there yet, totally agree. But that is where kind of our endgame is solely focused on. Now to get there, we do have to, you know, charge, you know, $299. It's still, it's still not something that, you know, everybody can access. But what I can say about it is, and we've had, you know, 20% of our customer base be executive health users across all the major providers in the country. And what has emerged, it wasn't our, wasn't our intent, but what has emerged is this, this kind of realization that a lot of what happens in executive health today is not, it, it's not necessarily the most efficient use of healthcare resources. When I say that, what I mean by it is we're doing a number of tests that might not be the most clinically efficacious, but are potentially expensive to deliver. So things like doing an ultrasound every year, an EKG, like, are these things that actually make sense to do on a, on especially on an annual basis? And And instead what our approach is, is we take the most clinically efficacious tests that are evidence-based and we deliver them in the most efficient way possible, right? And in, in a way that's convenient and, and, and, and in a, in a way that also is more up to date than even what executive health players might be doing, right? So we're using our, our blood-based panels are, are best in class and often more expansive than what you might be finding in executive health. How we interpret is not just based on the, what the public system has to say, which is very different than most executive health players in Canada. So this has evolved as kind of an opportunity for us, which is, you know, against executive health, we have, we have, we have legs to stand on when we deliver. We come to you, we're more convenient, we take the most clinically efficacious tests and deliver them more efficiently. And that means that we can drop price point., as well, even for that audience. So we're in this stage of, you know, we've built a product experience where we, we've identified several different segments to whom we can apply, uh, and, and, and, and in— I think the net of it ends up being that we will not only disrupt potentially executive health, but we will be able to, um, you know, do that and, and, and, and bring this increasingly to the masses by, by focusing on outcomes. I love it.

He's an unpopular character at the moment in some circles, but it reminds me almost of the Tesla approach. Tesla built the Roadster, which was like high priced, and then went to the S, which was also high priced, and, you know, took some time before it got down to the Model 3. Is it a similar logic in your mind?

It might be. I mean, I sometimes struggle with it because if we were truly taking that approach, then we would maybe just be starting and only offering our, you know, $1,299 You know, or maybe even a higher price point as the starting point. But I think kind of back to my point about why, why we want to exist and acknowledging the nuance of healthcare versus automotive, right? And healthcare in a publicly funded system where people care and we care about working with, with working with a concept that everybody should eventually have access to great top tier care. That's, we, we do offer. We do offer something at a price point that the middle class at least can definitely, you know, stomach. $299, $299 bucks. Like, that's something that, that, you know, many in the middle class might, you know, go for birthday dinner with their loved ones, and that type of money might be acceptable to spend. So why wouldn't that be acceptable to also spend, uh, to, to, to get best-in-class care, uh, and insight into your health? Um, so yeah, I, I, I would say that there's a nuance because even at the starting start of the race here. We aren't just offering the thing that, you know, the, frankly, the affluent and the wealthy have, you can access and no one else. We are, we have already created and we're intent upon continuing that journey of creating a more and more accessible solution. So yeah, that's why I struggle a little bit with just the kind of Model S as the starting point.

So it's probably fair to say that 100% of the people watching or listening to this are within your 20% kind of entrepreneur executive class. So I'd love to take a few moments and just talk about the need for this kind of service for these people, right? So I'll speak, I'll kick it off. You know, like I only coach CEOs. And I watch these founder CEOs almost kill themselves trying to turn a vision into reality and, you know, create something out of nothing, you know, zero work-life balance. And I'm okay with that. Like no one who masters anything is a balanced human. Michael Jordan wasn't a balanced human, you know, like any rock stars, they're not balanced. So I'm okay with that. But you need to also have some kind of practices to sustain yourself. Right. And like I tell people all the time, like a healthy person has 100 priorities and a sick person has one priority, which is to be healthy. So I'm probably preaching to the converted, but maybe, you know, from your vantage point, like talk about the need for this, for kind of, yeah, the entrepreneurs who are listening.

Yeah. Well, I think You know, one takeaway from what we know and what we, we see in our existing customer base is that, you know, stress, lack of sleep, like these things show up in your body, right? Like we, we see it from a biomarker level, right? Your rates of metabolic disease, cardiovascular disease risk, like these things, these things are real. And, and, and I think that for, it's kind of cliché at this point 'cause we've been talked a lot about, but from our vantage point, it rings true, is that if you want to be the most effective CEO or C-suite or leader in a startup context, you got to show up as your best self. And so at least being aware of what these, you know, what it is you might be doing by neglecting such a critical aspect of your engine, I think that it's important to be aware of it. And then if you decide that you want to You know, you want, you want to continue to persist down that path. I mean, that's up to you, but I think that it would be, it's kind of this crazy thing in my mind because people ask us sometimes they're like, oh, well, you know, you guys are just going to tell me to exercise more and diet. I know I need to do that. I'm not what, like, what's the point of this? And then I asked the same kind of leaders back. I say, that's kind of a silly comment. Why? Because, yeah, that's the equivalent in business is like saying, hey, well, you all, you just got to increase your revenues and decrease your expenses and that's That's all that you need to build a successful business. Like you don't need to track any operating metrics or anything like that. So why are we, you know, with the one body, the one vessel that you got to kind of, you know, run your race in life, why is that something that you're just willing to boil down to the two metrics and say that, yeah, there's nothing else to be done there. You don't tell me anything I don't already know. I think there's a different playbook for managing our lives. As founders, as startup executives, or just, you know, executives in general, where we can lead in a different way. And we can lead ourselves first and understand and own our health. And I think, by the way, that also will have secondary effects on your teams. Because if they see the kind of leader codifying that and embodying that spirit of wanting to be healthy, be a, be their whole self. I'm not necessarily saying even be balanced, by the way. That's, I don't think that's necessarily—

No, no, it's separate from balance.

It's separate. Yeah. Yeah. To me it's a really important thing even for teams.

You know, there's an interesting trend here and you look at some of the most successful entrepreneurs like Jeff Bezos has somehow gotten jacked over the last few years. Same with like Mark Zuckerberg. To a lesser extent. There are counterexamples. Elon Musk is, you know, dad bod. Tobi from Shopify is a lean, mean machine who's literally in his spare time become a professional racing car driver. So there's clearly like an— these are just a few examples. I could keep going on and on, but like there's an emphasis, like a recognition that physical health leads to a better life, but also just far better company performance. Are you seeing that? Like the people who are coming to you, do you like, are you, are you seeing that or are you having to educate them and evangelize this?

I think it's a bit of both, to be honest. There are the folks who've, you know, who are following the longevity space, for example, and are, you know, type A, following the playbook, listening to Outlive or reading it, and they're following the playbook and trying to execute. But I would say that's still probably the minority. I think the majority, and I feel this myself too, right? Building the company that's trying to change this, ironically enough, it's hard, right? The majority, it's hard because it's like, yeah, I know I need to be better about it, but how am I going to, you know, how am I going to do that when I'm working X number of hours per week, right? And I wake up every morning and I'm just focused solely on the mission at hand. Like it's really hard it's a hard, it's a hard thing to wrap your, your mind around. And I think one takeaway I've had when I've observed, um, the progress of some of these types of executive types that we have as part of our customer base is that when they are empowered with consumer-friendly information that they've never had before, it serves as this catalyst that is— it sounds so simple, but it serves as a catalyst to see your See you and, and you know what's going on inside of you, simply portrayed not in crazy medical speak, but just here's how I'm actually doing inside. Like it, it serves as this wake-up call that doesn't necessarily require, you know, them to go zero, 100 and, you know, stop drinking, for example, if they, if they enjoy alcohol. But taking incremental steps that actually day over day when you start making some of those shifts, or if you end up going and getting that follow-up through primary care, maybe having to take the, pharmacotherapy or whatever it needs to be. It makes a massive difference. That makes a massive difference over time. And it, and it's less scary than when you're kind of confronting the mountain of like, oh my God, and you changed my whole life because I'm a disaster right now. And not having kind of a compass or any kind of indicator of, of, of, of where you're sitting and how you can, how you can actively get to the next step.

Well, I can offer you up some talking points that I share with my CEOs. Like, first of all, I remind them that today's performance began last night based on going to sleep and getting like 7 to 8 or more hours of like high-quality sleep, which then just brings up the importance of boundaries, right? Like work will expand to fill all available time, right? And if you don't carve out time for exercise, Time with loved ones, time to eat consciously versus wolfing down food while you watch TV or work. Time to actually have some kind of wind-down ritual before you go to bed. Like, you know, you need these boundaries, otherwise life happens to you, you know? And like I explained to my CEOs, like even when I was running an investment bank, and doing 6 deals at a time, I still went to CrossFit 4 or 5 days a week. Right. I made that time and people say I don't have the energy, but it's chicken and egg. Like I told, like, that's what gave me the energy. Right. Plus we did some like batshit crazy stuff in CrossFit, like handstand pushups or these crazy one rep max deadlifts or, you know, today we did one rep max back squats and like, I dunno, you come into work after that and you're like, I'm gonna fucking crush today cuz I just crushed the gym, you know?

Yeah. Yeah. You're jacked, you're jacked up, you're ready to go. You got a different level of energy and vigor for sure. Yeah.

And you know, I, I don't have any particular genetic advantages. I lived in Scotland till I was 11. Scotland, last time I checked, has the highest incidence of heart disease of any first world nation. As you and I have talked about, my dad had open heart surgery when he was 36. So I'm not a genetic marvel, but like I'm 54, I'm the exact same suit size that I was when I was 24. And in CrossFit, I regularly trounce 30-year-olds in the WODs. And I take great pride from that because I'm committed to fitness, you know, and, and health and, and it feeds every part of my life. And anyway, this is not about me, but like, so right now my touchpoint with Nia is twice a year. A really nice nurse. I've had the same one both times, shows up at my house and takes my blood. It's super convenient. I pee in a cup and I get like a really amazing dashboard. And this, you know, a former CFO who's used to looking at dashboards, I love this. But then you also go a step further. To give me very actionable insights, right? On the lifestyle part. I'm just wondering, like, do you envision, like, I, so I formally interact with you twice a year, but is there a world where like you may have different extensions to your product where I'm interacting with you all the time? Like maybe a meditation app or these like stress reduction, like daily things, like habits to reduce stress or like sleep trackers, or do you just integrate with that ecosystem? Like, What are your thoughts on that?

Yeah, I think very soon you'll, you'll have in the pipeline the opportunity to connect your wearables and track, track your progress on.

Is that an Oura ring you have on your finger right now?

That's an Oura ring. Yeah. So Apple Watch and Oura ring are my two. But, but yeah, so we would be able to— we want to be that partner that you come back to more and more often. So it's not just, you know, this point in time checkups, which I think are the starting point 'cause it gives you the right evidence-based kind of view of where you're at. But how do we help gamify the experience too so that it's also maybe feels a bit less clinical and becomes something that's more fun slash, you know, social at the end of the day. So wearables is one. I think I alluded to it earlier about, we've got the equivalent of, if you're familiar with Levels Health in the US, but basically continuous glucose monitoring to level up your nutrition recommendations, especially if you got prediabetes or metabolic risk. How can we help? And even if you don't, to be honest, like how do you understand how your body metabolizes food and get more specific on, on your nutrition plan? Amongst other things. So we're looking at— we're actively in the next few months, you'll see this as one of our valued customers, you will see these other offerings continue to pop up as we seek to build out the ecosystem of the best-in-class, most evidence-based clinician tools that are kind of deployed in a consumer context, but centered in that one dashboard experience that that you referred to earlier.

This may be hard to generalize. And so if so, we'll move on. But like, if you had to stack rank lifestyle factors in terms of most impact downwards, like, is it sleep, then exercise, then nutrition? Is there like a pecking order? If someone's going to focus on one thing first, is there a general place to start?

I wouldn't say that there, you can just blanket make a, make the blanket statement. Around, you know, one, especially those three pillars that you just mentioned, which are each so pivotal in their own right. I think what's probably, and, and by the way, my clinician team would kill me anytime I say, if I were to make a conjecture, they would, they would kill me if I wasn't referencing the right studies and whatnot. So I, I think the, the, the one thing I can say is that I have yet to find someone in our customer base who had it all figured out and there was, there was nothing that they could have tweaked or, or, or found in those 3 buckets in terms of an opportunity to improve on. And I think that's the, that's the super interesting part. Even the people who self-identify as quote unquote biohackers, et cetera, when, when given this comprehensive view, they, they have something to learn that can move the dial from a lifestyle perspective without pharmacotherapy in one of those 3 buckets that you just mentioned. So yeah, I think it, it, to me it's about getting super specific and, and we, we're continuing to figure out ways to, to do that. If you're getting specific and personalized, so you're not just telling somebody, hey, you got high cholesterol, go exercise more, which is what you might get in the public system today. It's what forms of exercise are you doing? How, how duration-wise, how, how many minutes are you truly doing of strength versus zone 2 versus zone 1? Which of those, given, given your profile, your risks, et cetera, is going to move the needle the most based on where you're at today and painting that picture for you, telling you a story about your health and how to own your health in a different way that just does not exist today. That's, that's, that's the kind of magic solution is, is when you create that full picture, I think, for somebody and then make it actionable so they can, they can take that immediate next step.

I love it. Although I will say I have a small— biohacking's like a small pet peeve for me. I just, because like it's sort of setting aside, not to get all woo woo, but like nature, like there's this infinite, almost just innate knowledge. Like everything else in on the earth exists in harmony with the earth, except for humans. We figure we've got it all figured out and we're better and we're gonna do this and that. Like we just need to tap into our body's innate wisdom and it's gonna tell us like what we need. Right. We're just so disconnected from that. So anyway, I rant, I'll stop the rant, but that's just a small pet peeve there.

Yeah, no, and I think you're, and I think there's this danger when you do get metrics, you over-index on these metrics to the exclusion of all else and to the exclusion of kind of this more subjective, meaningful, that gives life a lot of meaning aspects of the picture, right?

Yeah. Yeah. That's right. And you talked about the blue zone, right? Meaning, right? Like I started watching that Netflix documentary on the blue zones and talk about the importance of ikigai, right? That Japanese concept of having like a really clear purpose.

Yeah, totally. Or a hazumetsu, a reason why you get up in the morning, you gotta have it.

That's right.

So when I was in Okinawa, actually I lived with an 80-something-year-old couple for a week. And I think, you know, when I look at all these blue zones, the ones that I've been to personally, it is something, there is something special, a je ne sais quoi about just being in an environment where community matters, you know, where you have a reason to get up in the morning at any age. And, you know, I think it tends to be in these smaller kind of village, I don't want to say village, but, you know, in many ways they are much smaller geographies that aren't as caught up in the Western flow of materialism and all the other things that we might paint as being quintessentially cosmopolitan Western. So I've always asked myself, like, is there a way to bring that kind of village-type mentality to the way we live our lives? And like, what, you know, what elements are replicable in a Western context, if I can say that.

Yeah, I love that. That's fascinating. Maybe as we begin to wrap up, by the way, I feel like this could be a much longer conversation, but you've got a company to run. So maybe there's gonna have to be a part 2 at some point, but like for folks who are curious about taking charge of their lifestyle and, you know, running their lives perhaps in the same intentional way that they run their companies, like where do you recommend that people start? Like either books you recommend or just apps. I mean, obviously they should come become a Naya Health or Naya Health customer, but like outside of that, you know, what do you recommend?

Honestly, like we're, we're huge fans of the book Outlive by Peter Attia. And actually just on a personal note, that book is, is one of the reasons where I felt or that galvanized me to say this is the right time to take a shot at this opportunity because it just translates the latest evidence from a holistic perspective around your health into kind of very consumer-friendly, non-medical speak, but, or maybe there is some medical speak, but I think it makes it super—

I started reading it on vacation this winter and there's some medical there, but—

There's some medical there for sure, but it's the most kind of consumer-friendly distillation of the latest literature. So I think that is a, that's a phenomenal starting point. And honestly, we find too that the people, once they've, once they've read that book, it's like they're operating from a very different framework and they are super motivated to try to own their health in a way in which, in a way in which maybe they weren't, weren't before. So to me, if that, if you're asking for one, one thing or one book, et cetera, to look at this picture, I'd say that'd be a great start.

Yeah, that's great advice. It's a big book, but in fact, that pile, the bottom book on this pile behind me is that book. But I have this bad habit of reading 5 books at a time, so I'm just like slowly circling my way through.

Cycling, cycling through here.

First of all, I will just say, first of all, I'm like super pumped that we finally speak. I feel like I have a close relationship with you because you look out for me and I appreciate that.

We got your back.

Exactly. And I will say, you know, the opportunity here, we didn't really talk about how you go to market and I don't think we have time to unpack that, but I feel like you have an opportunity for content and thought leadership that is way above just, hey, here's our product and here's its features. Like I was a lead investor back when I was a VC in a company called Unbounce and Unbounce made like these, it was a SaaS platform to build landing pages so you could run marketing campaigns. But almost all of their customers came organically from a blog that they wrote that was, had nothing to do with their product. And it was everything about like the reality of being an online marketer and like just really going into that. And I feel like maybe you're doing some of this already and I just don't know, but like there's so much content to talk about. You could just literally take every point in that Outlive book and turn it into a blog post and like create giant top of funnel.

In a Canadian context and blah, blah, blah as well. Honestly, I think that is really good advice. And no, we haven't done a good enough job of that to date. And I think it's one of those things, you know, from a company building perspective, we spent, you know, last year, a good chunk of last year, we just started last year, by the way, last January, the company, but we spent a good chunk of last year focused on evidence, building a product experience that delighted users, etc. And it's only been, I'd say, in the past 6 months or so where the emphasis around, you know, how does this— how do we, how do we, how do we figure out this go-to-market equation now that we feel like we've got the, the foundational elements in place? Um, that, that this, this— it's a super timely comment is what I'm trying to say, because we've, uh, we've been, we've been percolating on that.

Love it. Last bonus question. Do you follow Bryan Johnson? And if so, what are your thoughts on his Don't Die quest?

I will listen. Like, I think that there's, there, so there's, first of all, there's a spectrum of thought leaders that have emerged in the, in the ecosystem today. And so we try not, our, our approach at NIA has always been about, we go and look at the literature ourselves and decide what we're, we're comfortable suggesting, not suggesting, testing. Not testing. And yeah, I mean, he's definitely one of the furthest from like the center, let's just say. I don't want to say right or left, but like furthest from the center of the thought leaders that have become part of the common vernacular. And I think ultimately each one of them, whether you're kind of you can go in and you can, you know, beat the drum on are they evidence-based? Is this just quacky? Is it crazy? Is it not? I think the thing that I have to say about any of them is that they're helping to build a broader movement that is becoming increasingly mainstream. And that's, I think that broader movement is the one that, you know, that we keep our eye on and is the one that we're most excited about helping to helping to kind of continue to build towards?

Well, yeah, I really would love to see that. I, the thing I know is I will die. That's a given, but I want to have the longest healthspan that I can, and I hope that everyone watching and listening, you know, wants the same thing for themselves. And so this is hard to think of a more important topic.

Well, thanks, uh, thanks for discussing it and having me on your, uh, your podcast here.

My pleasure. Thanks, Samir. Hey, thanks for listening to The Startup CEO Show. If you'd like to connect with me, be sure to visit my website at markmacleod.me or follow me on LinkedIn at The Mark MacLeod or Twitter @MarkMacLeod_. And if you want to tune in again next week, be sure to subscribe on YouTube, Spotify, Apple, or wherever you get your podcasts. We'll see you next time.