Good Life Project - A Groundbreaking Approach to Health | Dr. Casey Means

Episode Date: January 19, 2023

If you weren’t paying attention to your health before the last few years, you are now. Question is, what should we actually be paying attention to? And, are there major things, early or even real-time indicators that could tell us how our day-to-day choices are affecting everything from our energy to level of pain, inflammation, fatigue, mental health and risk of chronic illness or life-altering disease, but that most of us are missing? These are the questions I pose to today’s guest, Dr. Casey Means, as we explore the world of metabolic and mitochondrial health and how technology is now becoming available on more of a mass scale that can help us reclaim control over so many aspects of our immediate and long-term wellbeing. And even guide our behavioral choices, from food to movement to meditation in real-time. And, I also share my own experience running my own, personal experiments with this emerging tech.You can find Casey at: Levels Website | Casey's Instagram | Levels InstagramIf you LOVED this episode you’ll also love the conversations we had with Dr. Aviva Romm about hormones, well-being, and the struggles of modern healthcare.Check out our offerings & partners: My New Book SparkedMy New Podcast SPARKED: We’re looking for special guest “wisdom-seekers” to share the moment you’re in, then pose questions to Jonathan and the Sparked Braintrust to be answered, “on air.” To submit your “moment & question” for consideration to be on the show go to sparketype.com/submit. Visit Our Sponsor Page For Great Resources & Discount Codes Hosted on Acast. See acast.com/privacy for more information.

So much of the way we're living our lives right now are distinctly hurting our mitochondria. That is foundational for us to do anything. And then the dysfunction that ensues results in a lot of the chronic diseases we're dealing with today. So we need to be addressing metabolic dysfunction head on. So Pretty Safe Pet, if you weren't paying attention to your health before the last few years, you probably are now. And the question is, what should we actually be paying attention to? And are there major things, early or even real-time indicators that could tell us how our day-to-day choices are affecting everything from our energy to the level of pain, inflammation, fatigue, mental health,

or risk of chronic illness, or even life-altering disease, but that most of us aren't focused on or missing, or maybe metrics that we don't even know exist. These are the questions I pose to today's guest, Dr. Casey Means, as we explore the world of metabolic and mitochondrial health, and how technology is now becoming available on more of a mass scale that can help us really reclaim control over so many aspects of our immediate and long-term well-being and even guide our behavioral choices from food to movement to meditation to conversations to what we say yes or no to in real time. And I also share my own experience running my own personal experiments

with this very emerging tech. So Casey is a Stanford trained physician who's on a bit of a mission to maximize human potential and reverse the epidemic of preventable chronic disease by empowering people with tech-enabled tools that really help them make better lifestyle choices, making a big change herself, leaving the practice of medicine behind. And we talk about why she made this choice in a fair amount of detail. It's pretty big. She's now the chief medical officer

and co-founder of Metabolic Health Company Levels and also the associate editor of the International Journal of Disease Reversal and Prevention. Her perspective and insights have recently been featured everywhere from New York Times to Men's Health, Forbes, and so many other places. In this conversation, we dive into a series of really critical insights about metabolic health. What is metabolic health, even when we're talking about it? What is mitochondrial health? All these sort of medical terms, what does it actually mean to us on a live day-to-day experience? And what is the impact on everything from our overall health and energy levels to potentially life-altering or even ending conditions? And how can science and tech

begin to change the game and give people more power in making better decisions before we unwittingly head down the road to declining wellness? So excited to share this conversation with you. I'm Jonathan Fields, and this is Good Life Project. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping.

And it's the fastest-charging Apple Watch, getting you 8 hours of charge in just 15 minutes. The Apple Watch Series 10. Available for the first time in glossy jet black aluminum. Compared to previous generations, iPhone XS or later required. Charge time and actual results will vary. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were gonna be fun. January 24th. Tell me how to fly this thing. Mark Wahlberg. You know what the difference between me and you is? You're gonna to die. Don't shoot him.

We need him. Y'all need a pilot. Flight risk. You know, I think an interesting starting off point before we sort of like really dive into the world of metabolic health is a little bit about you. Because from what I understand, you start in this fairly traditional, very mainstream, relatively prescribed path in medicine. You come out of Stanford, Stanford Med School, and you are doing the thing, like focusing on head and neck, ENT.

And there's a linear path for most people when you head into the profession. You're going down that path. You're excelling. You're building a career. And then you make this really interesting left turn. And I'm so curious about what happens that makes you say, I'm doing the thing, I'm checking the boxes. It seems to be working, but something about it is not working for me. It's funny. You said left turn. I was like, it was a left turn that definitely turned into a

right turn. It's interesting. It wasn't working for me, but what really wasn't working was that it wasn't working for the patients. I think when you step back for just a minute and look at the healthcare system in America as a whole, the illusion of this being the best system in the world, it really breaks down quickly because we're spending over $4 trillion a year on healthcare costs right now, the majority of which is going towards chronic disease management. And every single year, our chronic disease rates are going up. People are getting sicker.

People are getting more depressed. People are getting more depressed. People are getting heavier. So something's not working. And as a physician, you're really sort of in the middle of this. And if you're seeing these trends around you and not questioning, whoa, what's going on here? The more we spend, the worse people are getting. That's the definition of unsustainable. And so I did the very dangerous thing that I think a lot of doctors are starting to do now, which is ask why. Why is this happening?

And I think when you start asking why, it leads you down a wild rabbit hole that for me really got me to a couple of revelations. I think one was really just around the economics of health care and the incentives and the fact that this is a system that's designed to grow. It's one of the biggest industries in the country. And the way that we practice medicine right now, growth means more sick patients in the system for longer. And so that is an invisible hand, an incentive that is challenging. And a chronically ill patient

that gets better is no longer a customer for that system. And I think every single doctor I have ever met wants to do right by patients and wants to help patients. But when you're in a system with a business model that's predicated on more heads in beds in a hospital, that creates challenges. In the surgical world, a lot of what you're incentivized to do is more surgery. And so that's explicitly stated. You are meant to do more surgeries, see more patients, and generate more RVUs for the hospital. And there's a lot of people, a lot of administrators watching your numbers and making sure that you're staying productive. And what really was the wake-up call for me was looking at most of the conditions that

I was treating in ear, nose, and throat, head, and neck surgery, and realizing most of these conditions that I'm treating are ultimately disorders of chronic inflammation. It's amazing. You just write down a lot of the things that you're working on. It's all these itises. So sinusitis, mastoiditis, laryngitis, tracheitis, esophagitis, cellulitis, otitis, perititis, it's all itises. And itis is the suffix in medicine that means inflammation. And I thought, this is so interesting. This patient population is basically chronically inflamed. And what does that mean? That means the immune system has been activated, jacked up in some way, and it's not turning off.

And what does that mean? What that means is that the body's perceiving a threat that it needs to fight, and that threat isn't going away. So I started thinking of my patient in this different light of like, if there is a threat in the body and it's chronic, what is it? And essentially what is the body afraid of? Like, like inflammation is fear in the body on the biochemical cellular level. Oh, that's such an interesting frame match. I never really thought about it that way. Yeah. When you start thinking about that way, I think it shifts your perspective of your patient. And, and so that led down the rabbit hole of like, what is causing this fear? And why are all the cells freaking out?

And I, of course, as an ENT and as a doctor, the tools we have for that problem is, well, steroids. Steroids are anti-inflammatories. So it's like, here, just load the body with all these steroids. And that sort of artificially decreases inflammation. But you know what it doesn't do? It doesn't get rid of the fear. It doesn't get rid of the threat. What was actually causing it? A question we were never trained to ask or answer. And so if the steroids don't work, if the antibiotics don't work, what do you do? You take them to the operating room. You bust a hole in that inflamed tissue and you suck out the pus that's generated from

everything being swollen and clogged from that chronic inflammation, from that immune activity happening in those tissues, causing swelling, causing backup, causing pus, bust a hole, suck it out. Again, does nothing for the threat, does nothing for the fear, does nothing for the underlying physiology that's leading to that. And so this was a system that in my little very focused world of the body, I could no longer really feel good about just doing sort of what I felt to be sort of superficial reactive approaches. And so that's what led me on a very, what now has been an over four or five year journey towards doing something differently and sort of really getting to the root of

that question is what are all these American bodies afraid of? What are they reacting to? And I think a second piece of this was just having gone through medical school, of course, and, and having a framework for sort of what was the root cause of a lot of the chronic conditions we were seeing, which felt so separate from ENT. Like you look at our chronic diseases like stroke, Alzheimer's, cancer, type 2 diabetes, obesity, chronic liver disease, and they feel very, very separate from the ENT conditions. And when I started thinking about it through this lens, I realized, wait a minute, all of those conditions are also related to chronic

inflammation. We know on the biochemical level, there's an upregulation of cytokines and TNF-alpha and interleukin-6 and CRP levels will be elevated in these conditions. And it's like, is it possible these could be connected? Is it possible the body is all connected? And I think in our system with 42 medical subspecialties and this idea that you are the best doctor if you're focusing on the smallest part of the body. You think about an ENT actually, after five years of ENT surgical training, you can actually do two more additional years of training. So seven years total after medical school and become an otologist or a rhinologist, literally one part of the ENT. So if you're an otologist,

you're basically focusing on one square inch of the entire body. And that's considered, we celebrate that. And so in that system where that is what we're striving towards, the idea that you would zoom out and say, how is diabetes connected to sinusitis? How is obesity and chronic liver disease connected to these chronic ear infections? That's actually really not encouraged. And so that is the journey that I think a lot of doctors are starting to go on to unwind this very funneled path we've been on that is not leading to better outcomes in the American body. We are getting sicker every year. So it's really, it started with why and it's ended with a lot of different directions. And of course, putting down the

scalpel and deciding that I'm not going to cut into patients and profit hugely off of that until I figure out a little bit more about why patients are getting and staying sick. Yeah. I mean, it's so interesting. I think you're right. There is a subset of medicine that has been shifting. I remember I knew some of the very early people into the world of what back in the day was called functional medicine. And then they were complementary and integrative. And 20 years ago, you were a pariah in the industry. If you even hinted at being sort of like, you know, interested in a systems-based approach, like everything, let's actually look for the source code level, you know, like seed of fear or inflammation. And you almost had to leave the

profession or, or because you had to literally operate outside of accepted standards of care, which meant like I knew physicians in the very early days who were really concerned about, you know, like, God forbid something like you don't have a good outcome, your malpractice insurance isn't going to cover you. And they were afraid of, you know, like literally being bankrupted by doing something that they felt genuinely was in the best interest, was the highest level of care they could provide for their patient community. It's amazing to me and hopeful to see that there does seem to be a sea change happening within the industry. It still feels like it's very early days.

And I think a lot of the installed base still raises eyebrows. But am I imagining that into existence or does there seem to be a growing movement? I do agree that there is a movement starting or growing. And I absolutely feel that I am continuing on the shoulders of giants. People like Andrew Weil and Mark Hyman and Jeff Bland and Sarah Gottfried and Terry Walls and just incredible David Perlmutter. The list goes on and on and on. Who were the people who 20, 30 years ago started asking why? But it's still definitely a minority of doctors. In many states, healthcare is one of the first or

second largest employers. And so, you know, you don't, there's that saying or something of like, you know, you don't, something's like creating someone's livelihood. Like it's a little bit less of an incentive for them to really question it. And so I really, I have empathy for that. And I think there were a lot of like privileges I had in my life that allowed me to step away, to be honest. Like, for instance, the top one being a super supportive family and just a family sense that actually questioning things and doing things differently is very celebrated as opposed to something that, you know, like my family basically threw a party when I decided to leave, you know, the surgical world for these very philosophical reasons versus I had several colleagues at the time who were desperate to break out, but couldn't for different reasons. They were supporting their families month to month. They did not feel like they could disappoint the family that had gone into debt to put them through medical school, et cetera. So there's a lot of forces that keep people in the system that I have a lot of empathy for, but I do think there's more

and more opportunity. The wellness space has exploded, for instance. And so there's just generally more opportunity, I think, for people to have a bit of a path when they exit. There's the Institute for Functional Medicine. People can get additional training and start their practice. So that is different, but it's still in some ways demonized within the system because it's a threat to the system as it is. If you start saying like, hey, I actually think a lot of these conditions are connected and maybe we should treat at that level. And maybe that would actually help all these patients' symptoms and conditions. Well, that is actually a big problem for the 15 subspecialists that that patient is seeing. But that is the belief that I think a lot of these more forward-thinking practitioners have, which is that there are some root cause pathways that we know are related to so many of our conditions.

And we actually know a lot of them are modifiable through diet and lifestyle. And so chronic inflammation being one of them, mitochondrial dysfunction being another one. If you go on PubMed and search essentially every chronic disease right now that's killing Americans and search mitochondrial dysfunction or mitochondria behind it, you're going to see dozens and dozens and dozens of dozens of papers. And we know that a lot of things in the way we're living right now impact the mitochondria from that environmental toxins that are being pumped out year after year to the chronic overnutrition of refined and processed grains and sugars to even sedentary behavior, chronic stress. And so you start, I think a lot of what this ends up

becoming is becoming a person who either on paper or in your mind starts creating a lot of Venn diagrams about, okay, this physiologic pathway overlaps with all of these conditions, which overlaps with some of these nutritional and dietary strategies. So what's the center of that? And is that the future of that? And is that the future of medicine? And I think the answer is yes. And I think that's really, really exciting, but it does take a sort of stopping and pulling yourself, popping up from what you're doing and looking around. And the name for what this is called is systems and network biology, which has ultimately kind of led into this new world of functional medicine. But really what it is, is a whole multi-decade movement towards the systems

and network biology, which basically the way to visualize it is if you imagine like five conditions right now, the way we look at it. So let's say cancer, arthritis, depression, fatty liver disease, Alzheimer's, dementia. Right now in our system, those would be completely siloed. They'd be in five different silos. They would have five different medications, obviously, chemotherapy for one, insulin and metformin for another, non-steroidal anti-inflammatories for another, you know, an Alzheimer's drug, five different medications, no question, five different doctors. But in a systems and network biology approach, imagine taking each of the conditions and starting to draw lines between them. And those lines are physiologic cellular pathways that we know are active or upregulated

or downregulated in all of them. So for instance, the NF kappa B inflammatory pathway, genetic pathway, maybe upregulated in all of them, or TNF alpha, this inflammatory cytokine upregulated in all of them, that web, so you go from silos to a web and that web where there's connections between several things, then you start thinking, maybe we treat that connecting factor and maybe all of them would get better. So it's a totally, totally different approach than the way we approach things in medicine. And they say that it takes, you know, there's, there's studies that show it takes 17 years to move from what's in the research to what's in clinical practice. And we are in the middle of that right now, basically. That's what we're in right now

is like, because of proteomics and metabolomics and all the genomics things that have happened over the last 15, 20 years, we actually understand much more what's going on cellularly in the body and disease. We used to not be able to see on that level. We didn't have the tools. So all we really had was the symptoms and the signs, you know, the, what does the blood work show and what are the symptoms? And so if you're looking at things through the lens of symptoms or even looking at the tissue under the microscope, a liver cell looks different than a brain cell. A liver cell looks different than a pancreatic cell. So the people looking things over the microscope, the people looking at the symptoms, they all

do look different, of course. So you'd think, oh, of course they need to be treated differently. But then when you go a level deeper, when you look at the actual cellular pathways, and this is recent stuff, you realize, holy shit, maybe they're actually the same. And they're actually just showing up in different cell types as different quote unquote diseases. But really maybe we need to look at this as like, oh my God, what if there's actually some similarities here we can treat? So we're in that awkward in-between zone where this is becoming more understood, but it hasn't moved into clinical

practice yet. And because of course that would really shift things in the system. And so now practicing in that way is essentially by a lot of people called pseudoscience because it hasn't yet made it from sort of the more research to the clinical realm. And so that's the challenge. But I do think, yes, to answer your question, there's wonderful trends happening. And I think it's a very exciting and optimistic time. And every single day I get messages from doctors who are looking to move in this direction. And that really, really heartens me.

Yeah. No, I love seeing that also. And, you know, in places like Cleveland Clinic, like major institutions now starting to embrace it and then creating training and educational programs for physicians who've been in the field for decades often to come say, hey, listen, like consider this. I think the more you see things like that, the more you see big, credible institutions saying there's something to this, the more it's going to start to ripple out. But I agree, you know, we still have a minute or two before it really reaches a tipping point. Mayday, mayday. We've been compromised. The pilot's a hitman. I knew you were going to be fun. January 24th. Tell me how to fly this thing. We'll be right back. here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it

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generations, iPhone Xs are later required. Charge time and actual results will vary. In your own personal exploration, as you're sort of like drilling down and drilling down, drilling down, looking more at a root cause level, one of the things that you really end up focusing in on is metabolic function and dysfunction and its relationship to all those things you're talking about. Inflammation, mitochondrial dysfunction, endothelial dysfunction, arthritis, joint pain, all the disease conditions, degeneration in connective tissue and body, like pretty much everything. Tell me how you landed here. And when we use a word like metabolic

health or metabolic function or dysfunction, what are we actually talking about? When we talk about metabolism, we're fundamentally talking about how the body powers itself, how we make energy in the body, and specifically how we convert food to energy. So we have somewhere around like 37 plus trillion human cells in our body, many more bacterial cells, of course. But every single one of those multi-trillion cells needs energy to function. Just like a car needs gas, every cell needs energy. And the process of making that energy is the most fundamental thing we do. There's literally no other great things in the body can happen until you power it. There's no paint job. There's no oil change. There's nothing that can happen to that car unless it has gas. It's not going to go. And so every cell in the body

needs energy for pretty much every single process it does. And the macro effect of all of those cells doing what they need to do is our life. That's our body. That's our mind. That's everything. Unfortunately, right now we are in a energy crisis in the American, really the Western body. Over the past 50 to 100 years, we've gone from metabolic dysfunction being something that's very rare to metabolic dysfunction being something that 93.2% of American adults have. And so we are in an energy crisis where our bodies are confused about how to power themselves.

And if you don't have a cell that's powered properly, it becomes dysfunctional. And if you have a group of cells that become dysfunctional, that will lead to essentially an organ or a tissue having dysfunction. And what is that? That is that is disease and of course not every disease is rooted in this but that's a huge chunk of what we're dealing with in this country right now if you look at the top 10 leading causes of death in the united states nine of the 10 of the leading causes of death in the united states are related to metabolic dysfunction meaning that they are either directly caused by it or significantly worsened by it. And so we really need to move out of this framing of like, oh, we have all these chronic diseases that are hurting people that are all different. And it's so confusing to know we have a metabolic

dysfunction crisis affecting 93.2% of Americans and a hugely rising number of children. And it's manifesting, it's showing itself in different cell types as these different diseases. In the brain, metabolic dysfunction might look like Alzheimer's disease. In the liver, it can look like fatty liver disease, which turns into liver failure. In the vessels, it can look like hypertension, high blood pressure, and it can look like atherosclerosis, clogged arteries, and therefore a heart attack or a stroke. So in the penis, it can look like erectile dysfunction. In the ovaries, it can look like PCOS. And each one of those can link back to metabolic dysfunction, an issue with how the cells power themselves. And if you then zoom into inside the cell, a lot of where this

is happening is the mitochondria, this part of the cells where this final conversion process of food to energy actually happens. And what we know is that so much of the way we're living our lives right now are distinctly hurting our mitochondria, either directly poisoning and hurting the mitochondria or through the way it interacts with other parts of the cell, like our cell membranes, which transmit signals to the mitochondria or the way we're hurting the genes itself with epigenetic modifications and things like that, which then feed into other signals the mitochondria are getting. All of it is centered around that though, that the way we're living today is distinctly hurting this part of the cell that is foundational

for us to do anything. And then the dysfunction that ensues results in a lot of the chronic diseases we're dealing with today. So we need to be addressing metabolic dysfunction head on. And you asked then sort of like, how did I come to that? And a lot of it was just really observation and reflection and critical thinking. I think the best thing we can do with our big human brains that we've been endowed with through evolution essentially is to stop and think about what you're seeing and analyze it. And I think another issue with the way we're living today is we really don't give ourselves a lot of time to do that. I mean, you obviously do. You have this podcast and you write books and it's incredible and moving the world forward, but we're so busy and we're so

consumed that some of the things that are so obvious right in front of us, that's like sitting in the scientific literature or sitting just by looking at our patients and the fact that, huh, every patient in my clinic who comes in with this problem also has these problems. You know, we label that comorbidities in medicine, but what the heck does that actually mean? Maybe there's shared physiology. Maybe we could do something about that shared physiology. These are things, these are connections we just don't have time to make when you're seeing 40 patients a day or doing seven surgeries a day, working 80 hours a week. And also with the litigiousness like that you talked about on top of it, where if you

step a toe out of the official guidelines of how you're told to practice, you could like literally go to jail or have fear of that. I mean, that doesn't, but that's sort of the world we're living in. And I think that it really just started with observation and friction followed by observation, curiosity, and digging. And then, you know, so inflammation was kind of the start of it, because that was the thing that sort of kicked off my curiosity with the DNT. And then how it led to the metabolic focus in my life is because when you actually start digging deeper than inflammation, you know, we talk, think about inflammation as a root cause of a lot of

chronic diseases now, but there's actually a layer deeper to it. Cause it's like, still, what is causing that inflammation? What is the fear? And in a lot of cases, I think the fear in the cell is the fact that their mitochondria aren't working. And so then the cell is freaking out. And there's actually something called a cell danger response that can happen where when the mitochondria is essentially not working properly, the cell gets very nervous because it can't power itself, nervous biochemically, releasing different factors that basically tell things around it that there's a problem in here. In this cell, there's a problem and that can spur off an inflammatory response. The cells to come around and check it out and see what the problem is.

Do we need to kill this cell? Do we need to get rid of this cell? And so when you go even deeper than the inflammation, basically that led me to really understanding mitochondrial dysfunction. When mitochondria are dysfunctional, they actually produce a lot of reactive byproducts called reactive oxygen species. These are these damaging free radicals that you hear about that go around and damage other things in the cell. This all kicks off that sort of just vicious cycle. So I think of inflammation, oxidative stress, and mitochondrial dysfunction kind of as a vicious cycle.

And I think of these as almost like three, well, in my mind, I kind of think of these as like three sinister actors that kind of work together to create most of our $4 trillion healthcare costs and most of the pain and suffering that we're seeing in the United States physically and mentally. But that's sort of the negative way to look at these processes. The other way to look at these processes is that these are actually totally understandable responses from cells that are dealing with factors that they were never intended to deal with. We were never intended to have our mitochondria and our cells have to process 150 pounds of refined added sugar per year. That is crazy that the body would ever have to see that amount of this substrate and process it. It stresses the cells. It stresses all the cellular machinery.

We have tens of thousands of synthetic chemicals that are barely regulated by our government that our bodies are now being barraged in our personal care products, our air, our water, our food, on top of our food, in our food. The body's like, whoa, what do I do with all this? We were not meant to sit for 14 hours a day and stare at blue light. I mean, light is an environmental energetic endocrine disruptor, right? When you just have light all the time going into your eyes. So all of these new things that we have been dealing with over really just the past 50 to 100 years, these processes are essentially a very understandable response from the body of the body saying,

whoa, too much, too fast, can't do this and responding. And that response unfortunately looks like these awful symptoms of diseases that we have. So I think one of the real maxims of functional medicine is symptoms are a sign from the body of what is wrong inside. It's a gift. Symptoms are a gift. And these symptoms that we're having right now in mass in the United States amongst children and adults, the mental health crises, the physical health crises, in a way are a gift telling us, wake up, approach health differently, and start to peel back on some of these modern factors that are completely petrifying the cells of our body and having them go into complete threat and fear mode. You laid it out in a really compelling and hard

to argue with way. And I think anybody who's been alive on the planet for more than a hot minute has experienced some or all of the inputs, the effects, the environmental contributors. And we're probably feeling it in our bodies, in our minds, in our state of wellness or lack of wellness in so many different ways. Another interesting shift in my mind, which is, so you're now one of the co-founders and the chief medical officer of this company called Levels, where a lot of the focus is on making the measurement and decision-making around individual glucose regulation available to the masses in a way where generally you would only be given access to technology, which was remotely like this, if somebody had already diagnosed you as having diabetes or very close to having that. Talk to me about the line that you've drawn between glucose regulation or dysregulation and all these things that we're talking about and why you decided to focus in on this as sort of like

one of the big linchpin levers. Yeah. So this is sort of the next layer of the onion and the funnel that I kind of was going through, which is, okay, so we've got the average American has screwed up mitochondria and metabolic health. So now we need to fix that, right? Like how we got to fix this. And I'm on this planet to have as big a positive impact as I possibly can. I know that. I'm here. I want to have the biggest possible impact I can. So if we're going to have the biggest possible impact on this problem, we've got to fix people's mitochondria. And what are the ways we can do that? The things we were talking about, these environmental inputs. And I'm certain that one of the most useful things that people can do

is pull back on the just outrageous amount of refined sugars and refined ultra-processed grains that we're eating that essentially are barraging the body constantly with this substrate they have to process. So glucose sugar is one of the primary things that we use to convert into energy in the body. And when there's a healthy and normal amount, the body does it, makes energy all as well. When you're putting in 10 to 50 times more per day and per year than the body is able to handle, it completely gums up the system. And you basically end up in a situation where you can't even produce remotely enough energy. And so it's not like the more of this substrate you put in, the more energy you make.

The more you put in, the more it damages these incredibly sensitive pathways within our cells. So basically getting people to be even aware of the amount of sugar, glucose, refined grains that are turning into glucose in the body is sort of step one, awareness, and then can I do something about it? So that's one of the inputs that can lead to problems with metabolism. But what's also interesting is it's bidirectional. The mitochondria, like we talked about, this is converting downstream products of sugar to energy. But the mitochondria, as we talked about, are also affected by all these other things, the sedentary behavior, the chronic stress, the environmental toxins, microbiome

factors, lack of micronutrients in the diet from our soil being crappy these days. All of these things also hurt the mitochondria. And when the mitochondria are hurt, even by any of these other things, so not sugar related, it will actually make your blood sugar more erratic because if the mitochondria themselves are hurt, they're not going to process that glucose properly. And so the glucose will end up like rising in the blood and that'll be a problem. So it's this bi-directional thing where yes, too much glucose and too much sugar will hurt the mitochondria, but also anything else that hurts the mitochondria will make blood sugar more erratic. And so we can show people their blood sugar and help them really exquisitely understand what causes it to be high,

what causes it to be erratic. It's sort of a proxy for understanding your metabolic health. A problem right now is that we don't have a single lab test that says, this is how your mitochondria are doing. Unfortunately, that doesn't exist. We have to kind of use this gestalt of a lot of different lab tests to kind of get a sense of what's happening. And some of those lab tests that we can use is like a fasting insulin level, a fasting glucose level, a hemoglobin A1C, which is about a 90-day average of glucose. We can use our triglyceride level, which is about a 90-day average of glucose. We can use our triglyceride level, which is glucose can convert to triglycerides if there's too much. We can use,

there's more advanced cholesterol panels. We can use inflammatory levels because we know, of course, if there's metabolic dysfunction, it can lead to chronic inflammation. So you can kind of read the tea leaves of these tests and get a sense of your metabolic health. You can look at the amount of fat that's around your organs, which, you know, the simple way to do that is a waist to hip ratio, but you can also do more quantitative metrics. So we're kind of looking at this and you can squint and kind of get a sense of metabolic health. But a really key factor in all of that is how erratic are your blood sugar levels. And so that's really what led to levels,

which is of course, empowering people with continuous glucose monitors to see what's going on with their blood sugar and figure out how to tweak these environmental factors in their life to keep that a lot more stable. Because if you can keep that level more low and stable, it tells you two things. One is that you're essentially putting less stress and pressure on your body to handle a barrage of this, which we know is going to overwhelm ourselves. But two, if you're also affecting all those other factors like the stress and the sleep and the microbiome factors, micronutrients, environmental toxins, exercise, et cetera, you're going to start seeing

your blood sugar levels get more stable as well. So it's kind of both of those pieces, but all of it is sort of centered around how do we create a better environment for our mitochondria, for our cells so that they can be happy and therefore make us and our lives and our bodies happy, AKA less symptoms, less disease. And glucose is a great way to, a very low hanging fruit to get at that. So it really started from reflecting on how to have the biggest impact possible. What is the lowest hanging fruit to help people do that?

What is the most actionable way we can help people do that? And then what technology is available? What is actually possible from a business perspective? And all of that circled up with me and my co-founders to say, we're going to help people exclusively understand their blood sugar and figure out how to improve it as a way to start uprooting this problem that we're in. So it's almost like you looked at glucose levels as this easily accessible, both leading and trailing indicator of all these other things that you're talking about. And one where the technology has gotten to a level where it's just kind of getting

to a place where like an average person can use new tech to be able to track it on literally like an every five minute basis without really even thinking about it just happening on an automated basis. Not too long ago, it was trackable, but you had to essentially just sort of like prick your finger all day long. And people who have progressed to diabetes, that's the life that many have lived for many years. But the newer technology, continuous glucose monitoring in particular, has sort of a harness tech to be able to say, okay, so let's take this one metric, which as you're saying, tells us so much about everything else in the system that you're talking about. Use it as kind of like a proxy for what's going on.

And now we can use technology to be able to actually literally track it in real time throughout the day and actually see the effects of everything from our food choices to our sleep, to the level of stress, to what we're inhaling, to our light, to bites with people that we're in conversation to all these different things. It's kind of this fascinating, it's one metric that tells so much information that just happens to be maybe more easily trackable than a lot of others right now. That's exactly right. I mean, you summed it up perfectly. And I really think of Levels as it's an empowerment company. We are up against,

the cards are very stacked against us right now. We have government food subsidies through our farm bills that directly subsidize disease-causing foods, making them cheaper and more accessible to all of us. We have a built environment where we're encouraged to sit all day. We've, of course, got the tech stuff. We have very little control over environmental toxins. It's in our rain. It's in our shower water. And so the cards are stacked against us. And these are Titanic like force. These are huge forces that are very hard to fight on the individual level. But what we can do is understand what we're allowing to come into our bodies and what that's actually doing to us in real time. And I think closed loop biofeedback

is so useful where like, like you said, it's every five minutes you make a choice and you immediately see what's happening. The reason I think that's so useful and empowering is because it can feel overwhelming. Oh my God, all these things are a problem. What in the world should I do? But if you can start to see like, okay, when I eat this specific thing, I know it's a problem. Well, you can either eliminate that. You can modify it. You know, you can, if it's, let's say we're talking about a food product that spikes your blood sugar, you can take a walk after it. You can pair it with more protein, fat, and fiber. You can do something about it. And you know, it's that thing that's the problem as opposed to the somewhat more disempowering world we've

lived in the past where it's like, I have no idea what's causing the problem. It could be all of it. It could be one thing. I don't know. And so it's a lot of like trial and error. It's a lot of like, you know, just throwing spaghetti at the wall and seeing what's work. And this just really tightens that up and allows you to see, to do experiments, to test things, to figure out what's causing, you know, maybe a problem versus other things, and then learn to modify. And I think what we see in our member base is that very quickly, people figure out what factors are affecting them and can make rapid improvement. And people can say like, oh, well, that must just make you obsessive about tracking your data and all that. And I

actually think for me personally, it's made things a lot less obsessive in sort of a health journey because as opposed to thinking, having to do trial and error with everything, you can zero in on some specific things that are causing problems. So to make that more concrete, for me, for example, my food is very, very dialed in. I pretty much know what works for me, what keeps my blood sugar stable, what's nutrient dense, but my sleep is a problem. Like I stay, I'm writing a book right now. I stay up really late. I get that creative muse late, late, late at night.

And I can see directly on my blood sugar monitor that makes my blood sugar high the next day. And so while sleep might be an issue for me, it might not be an issue for you at all. So there's lots of different ways to get to metabolic dysfunction. And it's usually a confluence of factors, like all the things we've talked about today, these different vectors that all intersect at the mitochondria. And your plan for mitochondrial healing might be a more nutrient-dense diet, more organically grown foods because you need more manganese and selenium and zinc to make your mitochondria work. And maybe you also need to be avoiding or doing more walks after meals or doing more resistance

training. For me, maybe it's that I need to sleep more and I need to do some more meditation because my blood sugar is spiking all the time when I'm stressed, when I'm having calls or meetings or whatever. So our journey might be different. And if we didn't have any feedback on that or any information like a CG, a continuous glucose monitor, show us that and make that sort of be our mirror to what is the real problem in our life, you can imagine you'd just be sort of wondering if all of it's a problem, none of it's a problem, trying different things, seeing if it works. And so I think it cuts through a lot of the noise to give a little bit more signal about for your unique body, for your unique situation right now, what is going to be most effective. I think it's so helpful also because everybody's kind of looking for like, give me the 10 things to eat.

Give me the exercise thing that works for everybody. Give me like the way to sleep. And I think what we're realizing is like, there's no one size fits all. It's not even like there's no one size fits all. There's no one size fits all, even for one person for more than a season or a minute or a month or a week of their life. Like we changed. Like you just said, if you're writing a book for six months, the level of stress or the

level of fragmentation or the level of lack of sleep is going to change your metabolic needs for that six month window. And that may mean that you're saying like, okay, I'm going to say yes to less sleep because I know that's just, that's part of the thing that I've said yes to when saying I'm going to pile a book onto all the others that I'm doing in terms of being a chief medical officer and running a company. But knowing that part of that equation also says, okay, so for that six months, I know that that lack of sleep and potential level of stress is going to kick up glucose levels. The one thing I can control is what goes into me from a nutritional standpoint.

So maybe for those six months, I'm going to really try and dial in my nutrition on a whole different level to see if I can actually keep it lower and less spiky. Totally. And in my situation, it actually totally changes my behavior because I realize, okay, I can keep my blood sugar stable with food. But if I'm, if I got six hours of sleep, my baseline is just going to be higher. And I know that's not great for me. So what I'm going to prioritize this weekend, if I have like 10 wellness behaviors, I could, I could do, I'm prioritizing sleep like that. That's what I'm going to try and do. And, you know, I'm going to push back whatever I had on Saturday morning so that I know I can get a

little bit more sleep. So it just helps clarify for me, this is where I need to lean in right now. Sleep is the problem or stress is the problem. I think the individual nature of it is so valuable for all the reasons we're talking about. But I would say, I think what I don't want people to feel like after listening to this is like, oh my gosh, if I don't have a continuous glucose monitor, I can't achieve my health goals. Cause that's definitely not true. Like, I think we do know enough about what is generally good for the mitochondria and the cells to be able to have like a pretty, I mean, you know, you want to move your body. You want to manage your stress as best as possible. You want to minimize the refined grains and sugars. You want to make sure you're getting enough

sleep and exercise and eating a nutrient dense diet. It's like, if you focus, I think on the basics of the different pillars that the vectors that all go into metabolic health, you know, that is step one, two, three, four, five, six, seven. And I think the personalization, I think it really, really, really helps. But I, you know, I just, just want to put that out there that I think that while this can help cut through the noise and really be a great accountability partner and everyone responds to different foods differently in terms of a metabolic response, there are a lot of key principles that I think, you know, can get us 80 to 90% of the way, the way there. So.

Yeah. And you completely agree with that. The Apple Watch Series 10 is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest charging Apple Watch, getting you eight hours of charge in just 15 minutes.

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I knew you were gonna be fun. January 24th. Tell me how to fly this thing. Mark Wahlberg. You know what the difference between me and you is? You're gonna die. And because I'm a nerd and I'm always, you know, like I wear an ordering, I track everything and I'm always, you know, like I, I wear an ordering, I track everything and I'm always so fascinated. Um, I spent a month or so before we talked wearing a continuous glucose monitor, sort of like tracking everything through the app. I will admit I did get a little obsessive, um, because I was fascinated and because, and I started running experiments. I'm like, what if I eat this?

Or what if I eat this? Or what if I exercise here? Or what if I try and sleep on it? What if I take a nap checking in my levels eat this? Or what if I exercise here? Or what if I try and sleep on? Or what if I take a nap? Checking in my levels of stress. And you're 100% right. There were definitely things where probably 80% of it, I've known. It goes back to what we've known for decades about how to be healthy as human beings on

the planet. And then there were these fascinating surprises for me. And for somebody who I feel like I'm fairly well-read, fairly well-studied, I think about these things. So some of the experiments that I ran, really simple things. I love fruits and vegetables. I'm a fruit and vegetable person. But I also love to eat an apple or two a day.

So I grab a nice big apple and I devour it. And it's sort of like a mid-afternoon snack. I'm like, oh, that's a healthy snack, right? I check my meter about 20, 30 minutes later. I've got a massive glucose spike. I expected some spike because of course, it's going to put some of that into my bloodstream. But I didn't expect that level.

And then my mind is like, okay, so how do we say yes to things like fruits and vegetables or fruits like that, that I happen to like and say yes to the micronutrients and the phytonutrients that are really important in these types of plant-based food, but also do it in a way where I'm not going to see a giant increase in my blood glucose, which is also then going to, like, if that becomes a sustained thing, if I do that every day or twice a day for years, you know, what I'm effectively doing is saying, I love apples. Apples are good for me. But what's happening underneath that is provoking the possibility of sustained inflammation.

Then maybe down the road, metabolic dysfunction and disease. Like, so it was surprising to me how much of an effect that had. But then what I loved is you had this fantastic contribution also. You're constantly sharing strategies and ideas. So then I would run an experiment and say, well, what if I put a little bit of almond butter with that? Or what if somehow I added fiber to the equation? And what I quickly start to realize is I could eat the stuff that I loved and that, you know, like on paper was good for me, but maybe I would do it differently or I would blend the different ways. I wouldn't do it as just a solo snack instead.

And the real-time feedback, while a little bit neurosis provoking in the beginning, once I got sort of like a baseline level of data from it, allowed me to make very different choices in real time and still have a lot of sort of like the nutritious stuff that I knew was good for me, but do it differently. Yeah. That's great to hear that your experience with the apple ended up being one that was sort of the start of a fun path of figuring out, you know, how to maybe modify it or tweak it to allow you to keep eating it without necessarily having some collateral there. Um, I think that's really the positive way, like thing to take from it is like, you could take a walk after eating the apple, you could pair it with fat protein or fiber.

I tend to do like a apple with chia pudding or basil seed pudding because there's like 20 grams of fiber in that. And it really, you know, fiber is magical because it actually blocks some of the sugar that gets into the digestion and also slows digestion. So that's wonderful. And I think, you know, one of the things I think about with... Because some people, there's definitely some controversy, I think, with this whole concept of glucose monitoring. Is this going to make people not eat fruit or hate fruit? And our level's dietary philosophy

is very clear. Whole foods aren't really a problem. This is not the battle we're fighting is to figure out which whole foods, unrefined foods are better or worse. If you're eating a whole foods diet with minimal refined products, that's amazing. And that is like the majority of people are not. So step one, move towards whole foods. Within whole food categories like fruit, I think it can be interesting because like you said, fruit has lots of wonderful properties, phytonutrients, fiber, all these antioxidants. There's lots of good stuff in there. But within a category like fruit, are there potential options within that category that do better for your physiology and your body? So even within the apple category, it's like there

might be certain apples that spike your glucose a lot less than other apples. There might be sizes of apples that spike glucose differently. The way you pair them, it might be different. Maybe there's actually a different fruit that you like just as much that causes a third of the glucose response, like raspberries or blueberries or something like that. So it's in no way saying that apples are bad, but it's more like saying, what can we do to make apples work best for you or make fruit in general work best for you? And it's also important to remember that an apple today is

very different from a traditional apple. Now, I'm sure you are eating a nice organic apple, but if you go into the grocery store and see a conventional apple, those apples have been bred to be as sweet and as large as possible because people love that. And so it can wake you up a little bit to like, whoa, this apple, it caused a 70-point glucose response. Maybe there's something, maybe this apple, just start digging and start asking a few more questions like, huh, maybe I should try an organic apple. Maybe I should try a smaller apple or a heritage apple or a farmer's market apple or just like start sort of just going down that journey of like, huh, it's a little, it is a little weird that apple is six inches wide, you know?

And, um, but it's, it's certainly not about like demonizing any whole foods, but more just like thinking a little bit more deeply about it. And I also think it's important to remember that one glucose spike is not going to like hurt anyone over the longterm. Like your body is literally equipped to handle that. You release insulin from the pancreas. It brings down the glucose. You're going to use some of that glucose. You're going to store some of that glucose. It's a process the body knows how to do. However, even one glucose spike, a big spike. So like maybe going up 60, 70, 80 points that can in that one instance lead to essentially a big spike can lead to a big insulin response, which can have you basically soak up all that glucose really fast. It's all just like basically exaggerated response

and cause a crash. And that crash after a spike, which means you're basically going below your baseline before the apple or whatever it was, that's called reactive hypoglycemia. And that's a common graph that people will see when they have a big spike because it goes up and then it goes down to below the baseline and then comes back up. We know that in that dip post-spike, which is called reactive hypoglycemia, that's when people often feel cravings for more sugar. It's when they often feel tired. And there's even some evidence that that's when people feel anxious. And it kind of makes sense. If your blood sugar has crashed, your body's like, what is going on? We need to get this

back up to baseline. We need to have this person eat some food. You have a little bit of this hypervigilance to try and find food. And the body can naturally bring it back up. But research has actually shown that that's when people feel cravings. And the extent of the post-meal dip actually is predictive of like 24 hour caloric intake. And so that's kind of fascinating. So biologically a single glucose spike, not going to cause long-term damage, but subjectively, I try and avoid big spikes and crashes, not just for the long-term damage. But subjectively, I try and avoid big spikes and crashes, not just for the long-term health benefits of those compounding over time, but also for the way it affects my day subjectively. I want to sort of just be those gentle rolling hills that never crash as opposed to big up, big crash. So yeah, long story short,

food is molecular information. A fruit is going to have a lot of good molecular information. We want to make that work for us as best as possible. And some of this information can help with that. There are all these strategies. I think that the three that you mentioned a lot, protein, fat, fiber, right? Combined and of course, healthy versions of these things, not extruded, sort of like shrink-wrapped version of these things to integrate into what you're doing, which may have, sort of like shrink-wrapped version of these things to intuate into what you're doing, which may have the effect of slowing the absorption into the blood or altering in a way which helps sort of like diminish the spike and

keep the overall levels lower. The other thing that I thought was really fascinating, it's why I also happen to like, I just like, I'm an apple guy and you're probably got it. I like baked apples. We don't put sugar or syrup or anything in them. I take the exact same apple I would eat during the day and I bake it in an oven. So literally like I had the identical glucose spike from eating a full raw apple and then having like a couple of bites of a baked apple, the exact same apple.

So preparation must also make some sort of molecular change that changes the way that the exact same food floods into your blood. Would that be right? Yeah. I mean, all of this is going to vary person to person, but that is definitely possible. I mean, cooking does change the accessibility of glucose, right? It might make it more easily digestible because with the heat, you've broken down some of the structural elements of the food. And so it might be just easier and more quicker to absorb. There's a really interesting phenomenon about what's called resistant starches that you're probably aware of.

But basically, if you take a starchy food like a sweet potato or a root vegetable, or I would imagine even a fruit actually as well, and you cook it, and then you put it in the fridge and you cool it, and then you eat it again, some people find that they have on average reduction in glucose response with this concept of resistant starches. And what that concept is, is when you cool it, the molecular structure of the starches actually changes to longer polymers, which are resistant to digestion. So basically you're kind of getting a freebie where some of it's not digested after you cool it. So it's this very cool like chemistry experiment. Now, full disclosure, I've done this in several experiments, rice, sweet potatoes. It does not happen for me. I've never seen my biggest glucose spike ever was a Japanese sweet potato that I cooked, cooled and ate. And so it does, it has not actually panned out for me, like what the science shows, which is kind of why it's fun to test these things out on yourself. But, but we, we certainly see you'll post on Instagram and other places that they've done this experiment and it's worked for them. So, yeah, so that's like a, another example of how, how cooking and processing can change the glucose response for the better or for the worse. And, you know, we'll also see some people find that if they take a fruit that they

normally eat and add it to a green smoothie or add it to a smoothie, they might have a higher glucose response just because of the blending process. I think it could be that it could also be that they're eating it quickly because they're drinking it. Like they're just shooting it down very fast versus an apple that might take, you know take 15 or 20 minutes to eat. So there's all these different factors, but that's the type of exploration people can do to understand which ways of eating things actually lead me to the outcome I want, which might be the more gentle rolling hills through the day, avoiding these spikes and crashes or whatever a person's particular goal is with their glucose. Yeah. And I mean, I ran so many experiments. I tried a smoothie experiment where I did really basic almond milk, protein powder, banana, strawberry, like no other sweeteners put in there,

fairly big spike from that. Next day, I try adding in almond butter to that. And it brings a spike down a bit. And this brings me to another question, which is, you know, if let's say I'm going to have a ancestral grain gluten-free piece of toast or something like that, right? That versus that exact same thing with some mashed avocado in it. In theory, the mashed avocado would help to balance out the glucose response and hopefully lower the spike. But what I'm probably doing is doubling or tripling the caloric load. It's an interesting dance to do between the strategies, I feel like. It definitely is. One thing it's done for me personally is to help me think about, I have maybe like 2000 calories or so that I'm going to eat in this day. And I want to keep my glucose

as stable as possible because it'll make me feel better mentally. And I know it's better for my long-term health. So how do I essentially position those, the different things I want to eat within the day to reach that goal of having a more stable response throughout the day? And so through that lens, you know, it might be that, yeah, that I forego that toast because I'm like, I actually like, don't want to triple my calories for lunch. And I don't really care that much about the toast. And so I'm just going to skip it. Or maybe you're like, I really, really, really want that toast.

And so you're going to eat avocado, but that kind of might impact the other way that you kind of like fit the other calories. And so it's, it, it, it helps me kind of just think of things on a little bit of a, a macro scale and sort of see like, what are the combinations of things I can do to really reach my, my goals for the day? It might be repositioning the timing of when you eat things. So we know that basically when you eat, you might eat the exact same thing in the morning versus the evening and have a totally different glucose response. That's fascinating to me.

And that could be because of your hormonal balance. So for instance, we tend to become a little bit more insulin resistant at night before we go to bed. That might be an impact of melatonin impacting insulin sensitivity. So you might get almost like more bang for your buck if you eat it in the morning versus if you eat it at night. Or it might be because if you, let's say you have a high intensity interval training workout first thing in the morning, you might find that you have sort of like this zone of really good insulin sensitivity a few hours after that. Well, so maybe that's the time to eat that ancestral grain bread because you tend to just

be more insulin sensitive during that time. So kind of trying to figure out the timing of these things is helpful. Also in terms of timing, a lot of people see that eating fiber protein, sometimes fat before a higher carbohydrate meal makes them want like, first of all, less of the carbohydrates afterwards, but also that they respond better to it. So food sequencing is an interesting aspect of this, of like starting the meal with like a big salad of roughage, maybe eating your cooked vegetables, then eating some protein, whether it's salmon, chicken, tofu, whatever, and then moving into the like potato or the bread. So it's kind of the opposite of how restaurants do it now, which is like bring the bread and the chips first. And then the other

stuff, we actually know that the glucose response is going to be lower. If you sequence these other non less carby foods first, there's other interesting things that people try, like that are based in research literature, like having vinegar before a meal vinegar tends to slow digestion. It tends to, it actually might change some of our, our digestive hormone levels. It may increase insulin sensitivity. So taking apple cider vinegar before a meal, a couple ounces in a glass of water might actually improve the response to something like a piece of bread. And so there's kind of all the, and then of course my absolute favorite is just taking a walk after a higher carbohydrate meal

or actually after any meal, there's research that shows that just a short walk after a meal can improve the glucose response. So I try, it does not always happen, but I try to do at least a walk for five minutes within a half an hour after a meal. And that is like a free pass. And so there's just kind of all these different things that you can do to enjoy what you want to enjoy without necessarily having that like collateral impact. So I don't know if you tried any of those. I tried all of those actually. Did you? Okay. And what'd you notice? Most of them worked for me. So like the, I would have, you know, like even just like a smaller salad, but with avocado in it before I would eat something else. And it seemed to make a real difference for me, you know, so the sequencing thing I thought

was fascinating and it seemed to really help with me. Um, the huge lever for me, like you were just sharing is movement. I'm so fortunate. I literally live in the front range of the Rockies in Colorado. So I would have like, I would run experiment, have like a big lunch, maybe with some stuff that I would think would, you know, like lead to a fairly substantial spike. And then I go out for an aggressive hike, but like, you know, like I'd spend an hour and a half, like just like hiking in the mountains. And I would find that I would come back from that. Not only did I not have a

spike, but I was actually getting low blood glucose alerts because for some reason, my body is so responsive to movement, not even high intensity movement, that it really rapidly down-regulates the glucose response in my body. So that was super fascinating for me to see. And like you said, also, I would have dinner and then I would just go for a walk for 10, 15 minutes afterwards. Made a really meaningful difference. The thing that didn't work for me actually was the thing that I think so many people point to, which was the apple cider vinegar kind of did nothing for me. I tried a couple of different ways.

I tried lemon. Those types of things didn't really make a difference, but movement for me, I realized how important it is to think about how and when I move and how it relates to the regulation of blood glucose. And again, for everyone listening, zooming the lens out, we're kind of using that one metric as sort of like a proxy here for a whole bunch of other big things that are happening in the body. But it was fascinating to me wearing this continuous glucose monitor, knowing that every five minutes it was just automatically telling me like in real time how my body was responding to all these different inputs. I also, I meditate first thing in the morning every day

for about 25 minutes. So I would check it, fasting glucose levels right when I wake up. I'd go and meditate for 25 minutes. And often meditation would cut 10 points off of my fasting glucose levels, which I found fascinating because I don't wake up generally too stressed. But even that small input made a difference for me. So it's so interesting to see. It's amazing. Yeah. I find the same with meditation and I love that. The interesting physiology there is that, sure you're aware of is that basically our stress hormones can actually tell the liver to dump glucose because stress is the signal to the body that we probably have to avoid a physical threat, like the lion chasing us or whatnot. And so the body is very smart and kind to us and says, we are going to mobilize some glucose for you to escape whatever this threat is. But these days, of course, a lot of the threats that we perceive

are more psychological in nature. Obviously, you don't need to run away from the news clip you're seeing on Instagram, but the body still is trying to help you by doing that. And so if you can tell your body through meditation or through whatever means it is that we're actually in a really safe situation and there are not any corporeal threats around us right now, it can actually change the way the body pumps out that glucose from your liver for you. And so there's real physiology to that and science behind it. And then, yeah, I would agree. I think that, oh my gosh, the biggest, simplest takeaway I would say for anyone listening is move after your meal and also

move more frequently throughout the day. I think we have this conception that being active is working out once a day. And that is amazing. If you do that, even that's sometimes hard to do. Right. And, but what some of the research is really showing us is it's actually moving more frequently throughout the day. Even it's very minor stuff like walking for two minutes improves our 24 hour glucose levels and our insulin levels. And so what that might look like is just walking. You could set a timer for every hour, every half hour, and actually get up and just do like five air squats or walk around your house for two minutes. Some really interesting research has shown that if you take people and you have them

do two minutes of walking every half hour throughout the waking day, which can add up to about like 30 minutes of total walking versus if you take that, you have them do 30 minutes, like in the morning or 30 minutes at night, they do a lot better when you take, it's the same amount of time in each scenario, but just spacing it out into two minute blocks every half hour is better for the overall metabolic milieu of the body. And I think this makes a lot of sense to me because we have all this muscle, a huge amount of our body mass is muscle and muscle is essentially a glucose sink. Every time your muscles contract, they're using a ton of glucose to like make ATP.

And so if you use them more, you're just chewing up that glucose. You're feeding it through the system as opposed to our current situation, which is where we're feeding the body 10 to 50 times more sugar per year. And then we're actually sitting more. So it's more substrate, less use versus exercise, which is the opposite. It's actually pulling glucose through the system and using it and processing it. And that's good for the body. And so I think just thinking of muscle as this freebie glucose sink. And the more you use it constitutively throughout the day, the more you're keeping those pathways active and just of just making the machine a little bit more well-oiled on a cellular level. And so kind of visualize the body as it moves, just taking

that glucose out of the bloodstream and essentially making it a lot less damaging situation in the body. So the more you can do that, the better. And I think shooting for a little bit of movement every half hour is super ideal, although it's challenging. I mean, we've been sitting now for probably 45 minutes and haven't stood up. So this happens, but it's good to think about. And the research actually really supports it, which is cool. Yeah, no, I love that. It's definitely made me rethink sort of like weaving just even gentle mobility and movement throughout the day rather than just taking like one bout and going and also zooming the lens out and trying to be as inclusive as we can in this conversation. If movement, if you have physical limitations, if access to physical movement is not something that is all that available to you, the news is that there are still all of these other contributors. There are all these other levers that we can pull. Nobody is excluded

from being able to think about and do things that will affect their metabolic health. Definitely. And it also doesn't have to be walking. Again, this is muscle-centric, not walking-centric. And so any type of movement, whether it's arms or dancing or whatever, walking is sort of like, I think the proxy word for gentle movement, but really it's about doing something to get your muscles to essentially be active. But of course, like you said, that's one of many, many vectors that are involved in metabolic health. And so there's many other pathways towards improving our mitochondrial function. Um, but I think one more point about, um, physical activity in general is I think we're

starting to see more and more that resistance training is really key to successful long-term weight loss to improve metabolic health. And I think this fits with what we were talking about, which is if you have more muscle, this is like more of the freebie glucose sink. So walking's great because it kind of uses the muscle, but actually having more of it just like compounds that. So this combination of like low intensity zone two training that people are talking about, you know, like sort of a speed walk or something like that, plus having more muscle, i.e. resistance training, you know, those two things together, I think are a great strategy for people trying to use exercise for metabolic health. So build the muscle and then essentially use the muscle. And then you've got this thing that doesn't fit into either of those categories, which is high intensity interval training, which is just like more of like that zone five, you know, training,

really getting the heart rate up. And that actually it's fabulous for metabolic health. It improves insulin sensitivity. But what's funny is that people will often see a glucose spike when they do high intensity interval training. I don't know if you had this experience, but because it's a very intense, brief sort of activity, it actually is perceived by the body as a stress, as a cortisol releasing activity. Walking obviously isn't a stress, but when you do your Tabata on the Peloton or whatever, or sprint for 20 seconds, your body's like, oh no, something bad is happening. And so it actually will release glucose to feed the muscles for that. But oddly, it's a different physiology than the stress-related, like the more psychological stress-related responses. And I think the reason for that is because you're actually using the glucose that

gets released from the liver. And so we know that high intensity interval training, even if it does generate a little bit of a glucose spike, which you might see on your CGM, it's a different physiology. And it's actually not, we know that it actually improves insulin sensitivity. So yeah, a lot of conversation, the metabolic space around the zone two training, which is low intensity resistance training and high intensity interval training. And they all are basically positive for different reasons. But I think the good news there, it's like you don't need to be on one rigid exercise path to have some benefits. There's actually lots of different ways to benefit your body. But if you can move, I would say the more, the better.

Yeah. No, I love that. I do want to touch on one other thing before we start to wrap up, which is stress as it contributed to this. There is certainly over the last few years, there has been environmental and circumstantial stressors that I think's become the new abnormal, but we sort of like just, you know, it's in the background now, it's the white noise of our lives. And we probably don't realize how sort of like a raised baseline is affecting us from a metabolic health standpoint, and then tumbling down, you know, like from an inflammation standpoint, disease standpoint. And then when we add in sort of like moments of in moments of stress, like actual occurrences, that just kind of piles onto it. And the fact that stress actually is something that can trigger a glucose response and then inflammation and all these other things that we don't want,

knowing that stress doesn't just suck psychologically, but it literally has physiological responses in the body that can over time, especially if repeated and sustained, lead to pain, illness, disease, dysfunction. I think it leads me to pay more attention to both my baseline levels, like how am I actually doing on a day-to-day basis, and then the frequency and intensity of moments or events that might lead to that. Yeah, it's such a big one. And it actually ties back, I think, to the beginning of this conversation, talking about the inflammation and what is really going on in the body, which I think of inflammation as sort of biochemical fear. And we can certainly

think our way into metabolic dysfunction. I think that literary way, I don't totally mean that, but there's some truth to it. If we are constantly in a state of hypervigilance or feeling like isolated or threatened in some way, like from COVID or whatnot, like that translates in the body through our hormones and through our neurologic sort of milieu to a sense of threat to each of our cells. Our cells hear every thought that we think through hormones, right? And so part of digging our way out of this chronic disease epidemic that we're facing is really people coming to terms with the psychological aspect of our modern lives. And I think on an individual and societal level, we need to be working really hard towards giving people tools, strategies,

communities to help with the chronic stress, hypervigilance, fear, all these things, you know, it's so complex because the media feeds right into this. You know, we literally hear senior people at CNN recorded on tape saying, if it bleeds, it leads. Like there's this desire to get people to be fearful because it gets them wanting to know more information and coming back and this and that. But even having awareness to that, like how the system's working to make us fearful can help us set more boundaries to it. I think knowing that isolation and loneliness, you know, can increase our stress hormones so that if we even have awareness to those things that can help motivate us to figure out ways to feel more connected and to find ways to be more connected. So I think step one is awareness, but no, there's no question that to really reverse

our metabolic and chronic disease epidemic, there's going to be an element to this that has to do with our mental and psychological health, our sense of fear. I actually really believe that the healthcare system weaponizes our fear in a way to keep us dependent on the healthcare system. I've thought about this a lot through my medical training, how there's a lot of this vibe of, you know, if a patient's like, oh, I want to, you know, I have high cholesterol. They hear they have high cholesterol and the patient's like, oh, well, I'd like to try diet and lifestyle strategies first. And the healthcare system's response is kind of like,

well, suit yourself. Like you should be on a statin because you could have a heart attack, but if that's what you want to do, like it's sort of going against medical advice. And it's sort of like, there's this always this looming, like you could die that kind of gets people to do anything the healthcare system wants. Like, well, you should have this surgery because you might die. You should take this medication because you might die. And it's like, I'm going to die one day. The healthcare system is not here to sort of promise immortality. And yet we kind of use this like existential fear of death, I think, against people to really yoke them into doing anything that the doctor wants.

And I think it's actually really, it kind of needs to be brought to the surface because there's also just such a difference in information between the doctor and the patient. And that information divide, like the doctor, for instance, like our lab results, they live like essentially owned by the hospital, right? You have to like fill out paperwork to get your own biomarker data. There's this very much like a gap between what the patient has access to even about their own body and what the doctor does. And that can also generate fear because there's unknowns and you feel like you have to trust and this and that. So something I'm a big proponent for is, you know, people really examining and thinking about this existential fear of death and in some ways

working towards reconciling that. Because I think when you overcome that in some ways, you actually have a lot more power against systems that profit off our fear, whether that's the media or the hospital system. That's a hard task. That's a tall order, of course. But I think it's something that's really, I mean, there's a lot happening in the psychedelic space with people kind of exploring some of this stuff, you know, mindful meditation, all these things. And I think all of it's a sort of a yearning that people might not even totally understand towards essentially not being so trapped by these systems that really do benefit off of our fear and our being petrified. So I think it's a really, yeah, there's a lot there,

but fear and chronic disease are intimately linked and whatever we can do to escape that cycle, I think is positive. And come back to a place of not just being better informed, but just having a stronger sense of agency, like locus of control, right? Like that is just key to our wellbeing. And I feel like it's a good place for us to come full circle in our conversation as well. So in this container, a good life project, if I offer up the phrase to live a good life, what comes up?

For me, to live a good life really centers around the word awe, awe and abundance. I think if I am able to stay in a sense of awe, abundance, curiosity as much of the time as possible, I am living a good life. I initially got into medicine because I had awe at the human body and how amazing it is. And it's just that constant curiosity of digging deeper and just being just totally enamored by just what this experience that we're on in life and the natural world and all the things we don't know that make everything fun. And so, yeah, I think just trying to get into that state as much as possible is really for me to a good life. And I think practically speaking ways to do that are to focus on gratitude. Like I do a lot of thinking about what I'm grateful for, like whether it's just, you know, the light coming through a tree and the dappled light on the ground or having, you know, water that gets pumped into my house every day that is

warm, you know, or all these things like, so gratitude and awe, I think are very interlinked. And so a way to access awe, I think can be just stepping back and looking around and noting all the ways that the world really is wonderful and incredible. And that could feel in conflict with a lot of the things we're talking about today, because it's like, oh my God, things are so bad. But I actually think coming from a place of awe and gratitude allows you to approach some of the hard things that are happening in the world with a bit more sense of energy and optimism that's really positive.

Love that. Thank you. For sure. Thank you. For sure. Thank you. Hey, before you leave, if you love this episode, safe bet you will also love the conversation we had with Dr. Aviva Ram about hormones, wellbeing, and the struggles of modern healthcare. You'll find a link to Aviva's episode in the show notes. And of course, if you haven't already done so, please go ahead and follow Good Life Project in your favorite listening app. And if you found this conversation interesting or inspiring or valuable, and chances are you did since you're still listening here, would you do

me a personal favor, a seven second favor and share it maybe on social or by text or by email, even just with one person, just copy the link from the app you're using and tell those you know, those you love, those you want to help navigate this thing called life a little better so we can all do it better together with more ease and more joy. Tell them to listen. Then even invite them to talk about

what you've both discovered because when podcasts become conversations and conversations become action, that's how we all come alive together. Until next time, I'm Jonathan Fields, signing off for Good Life Project. The Apple Watch Series X is here. It has the biggest display ever. It's also the thinnest Apple Watch ever, making it even more comfortable on your wrist, whether you're running, swimming, or sleeping. And it's the fastest-charging Apple Watch,

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