In this episode, Daniel sits down with the Founder and President of Levels, Josh Clemente. With Levels, Josh is attempting to bring blood-glucose monitoring into the mainstream as a consumer product. Driven by his own personal health journey, he is convinced that consistent and accurate blood-glucose feedback will produce more knowledgeable choices and dramatically impact the health and lifestyle of millions of people for the better. Others are likewise convinced as Josh has raised 4 million dollars in venture capital and also has a 40,000 customer waitlist.
While working at SpaceEx, Josh began to evaluate his work-life balance and the effect it was having on his physical health. His relentless pursuit of feedback led him to identify a product need and envision the company that would meet it. Listen as Josh shares his journey from life as a pre-diabetic to his now pre-magnate status as he prepares to launch Levels into the stratosphere of med-tech companies.
- Backstory: Amidst his work as a chemical engineer with SpaceEx, Josh began to evaluate his work-life-balance and the effect it was having on his body. (1:27)
- Josh talks glucose and metabolism and the science behind his Startup (3:06)
- Identifying the industry need: bringing the monitoring of blood glucose levels to the masses as a consumer product (6:00)
- Levels solves core problems that consumers aren’t even aware that they have: He explains how good fitness doesn’t always equate to good health (7:15) Josh explains how acutely personal feedback is crucial for understanding your own health. (10:21)
- Creating Demand: How Levels already has 40,000 customers on a waitlist before their public launch. (15:22)
- Industry Foresight: Anticipating continued advances in the personal med-tech industry, Josh plans for Level’s expansion and development. (23:22)
- The importance of customer experience: how Levels brings sophisticated technology to the customer through an easy and elegant application. (28:58)
- The brilliant “first principles” advice Josh gleaned from his time at SpaceEx (33:08)
- How the rookie fundraiser raised 4 million in venture capital (36:43)
- Josh shares an early mistake he made and the valuable lesson he learned through it (39:44)
- Dan asks Josh to share his secret weapons for success (41:23)
These are great insights from a great entrepreneur!
Product Market Misfits is a weekly podcast that helps entrepreneurs learn more about starting companies and getting funded by sharing conversations with world-class venture-backed founders who are one or two steps ahead of you on the path to success. For more, visit us at www.ProductMarketMisfits.com
Dan Hightower 00:10
This is Dan Hightower with Product Market Misfits and we have an amazing guest here today to talk about all things from what it’s like to work at SpaceX to Quantified Self with a company called Levels, which you can find at levelshealth.com. The Levels team has raised around 4 million from some amazing investors including Zion Scott Bannister, Matthew Dellavedova, Julia Lipton, Michael Arrington, Loupe Ventures, Basecamp Fund, Shrug Capital, Todd Goldberg, and Rahul Bora. And has previously worked at some amazing companies including Y Combinator Back Kardash, Google, Hyperloop, and SpaceX. Levels tracks your blood glucose in real-time so you can maximize your diet and exercise. I’m very excited to welcome Josh Clemente, founder of Levels to Product-Market Misfits today. On the personal side, Josh is a mechanical engineer and CrossFit level two trainer. At SpaceX, he led a team to develop life support systems that sustain astronauts on the May 2020 trip to the International Space Station aboard Dragon Endeavor, which was the first new crew-carrying spacecraft since 1980. So I’m incredibly excited to hear how and why Josh made the jump from SpaceX to Quantified Self.
Dan Hightower 01:15
Josh great to connect with you, man, I’ve used the product for the last like month super excited about it levels is has changed my behavior in some ways we can dive into. But before we do, I’d love to hear from you about how you got to where you are.
Josh Clemente 01:31
Yeah, great to speak with you as well. And I’m excited to hear that the product is working well. I got here kind of through a circuitous route. I’m an aerospace engineer. I’m a mechanical engineer by training. I spent close to six years at SpaceX originally working on spacecraft mechanical systems. And then I started working on life support development, pressurized systems, breathing gas suit, oxygen controls, fire suppression controls, things that astronauts will need to visit the space station and beyond. And the first vehicle I worked on flew in May of this year with Doug and Bob to the International Space Station. And so I worked on that program and had an amazing time. But after six years at SpaceX, pretty stressful environment, I was basically burning out mentally, physically, my quality of work-life balance was non-existent. And my diet, exercise, sleep, stress foundations, were all just disastrous. And I was feeling some pretty intense fatigue, like just really strong fatigue waves every single day that I’d gotten to the point of interfering with my ability to function effectively. And so that is the process by which I slowly but surely discovered metabolism, metabolic function, which underlies energetic energy production, and got obsessed with the human body and physiology. And that led me down a rabbit hole, which ultimately led to starting Levels, which is a company entirely focused on helping people optimize their own lifestyle so that they can improve metabolic function and maximize their quality of life.
Dan Hightower 03:02
Yeah, no, I’m super excited to dive into that. So, you know, for those of us whose like, physiology, stops at the mitochondria is the powerhouse of the cell, can you like break down for us simply the importance of glucose, and then more generally talk about that, within the context of how Levels works?
Josh Clemente 03:24
Yeah. So metabolism is basically the descriptor for all of the energetic processes that cells contain so so all of our cells, they require energy to function. And the way we use our food and environment to create that energy is called our metabolism. So it’s a very broad definition. But suffice to say that we have an extremely crucial system here that runs on the fuel we provide it. And the two primary fuel sources in the modern human diet are glucose, which is a monosaccharide, it’s a sugar, and fat, which, you know, there are a variety of sources and that macronutrient is essentially named. It’s the same thing when you consume fat and it is free fatty acid, and then it gets oxidized as fatty acid oxidation. Whereas with glucose, we don’t really consume glucose, we consume carbohydrates, which break down into different sugars, glucose being the primary one in our blood. And so glucose is absolutely critical for the human body to function. However, it’s also an extremely reactive molecule. So in the presence of oxygen, you can create some pretty nasty byproducts if glucose levels are too high. And the contrast is that if glucose levels get too low, the brain and other tissues that really need that energy start to shut down very quickly. So there’s a tight bound that glucose levels have to be maintained within in order for us to run effectively. And this is like every tissue in the body is affected by glucose control. So what we have in modern society is a situation where over time we’ve begun to defeat the systems that Control glucose within that tight vein bound. And the runaway symptoms of this are not typically blamed on a lack of glucose control. They’re often called by different names, things like PCLS, you’ve got cardiovascular disease, you’ve got stroke, you’ve got type two diabetes, you’ve got mental conditions like dementia, and Alzheimer’s, which is now being called type three diabetes. So you have all of these disparate descriptors that essentially define the same thing, which is metabolic breakdown and insulin resistance. And so when you know the human body is running at proper, sort of inside its proper ranges, and everything is nicely controlled, you have hormonal balance, you don’t have a lot of runaway systems, you don’t have a lot of those reactive byproducts being produced. And that’s when the body’s at its peak potential, and you can really maximize healthspan. But when things go poorly, in one way or the other, without a feedback loop to the person, this is when you start to have chronic lifestyle illnesses setting in and, and the biggest ones here in the United States are the ones I just listed.
Dan Hightower 05:57
Yeah. And then you’ve done an amazing job of making what was like historically a space, blood glucose monitoring for chronically, you know, diabetic individuals, a space for a product for the masses. And for me, one of the reasons why I was so interested in trying it out, is that I’m, as a registered paramedic, familiar with the brain’s, how greedy the brain is for glucose, and how wrong things can go mentally quickly, even if you’re at the slightest deficit. And I’d be curious to hear how you positioned, you know, how you position levels to be a consumer product, not a medical device, and how you might have leveraged the mental side of the importance of glucose as a, you know, personal performance optimization.
Josh Clemente 06:58
Yeah, so when I first started thinking about diet as an important lever for or nutrition as an important lever for a human being to manage, I was, again at SpaceX, and I was experiencing the cognitive effects of metabolic dysfunction. I’ll get to that in just a second. But, you know, essentially, I had always been a fitness first person. So health is fitness. If you have abs, if you can run fast and jump high and lift heavy weights, you’re healthy, and your nothing could defeat you, and you can eat whatever you want. And so I did exactly that I would work out and then I would eat whatever I wanted, I never put a second thought into it. And eventually, I got to this point, like I said, where all of a sudden, I had this disparity between how I look and how I feel. So I look like I’m healthy. But I feel like I’m the bottom of the bottom, like just the lowest 5% in terms, of health. And I mean, that I literally did not have the energy to make it through a workday. I was reliant on coffee, the way I would be reliant on an IV, and it’s just, it was a requirement. And my mood was completely broken, my concentration was broken, my focus, my recall, all of these things were lagging. And so I was experiencing these effects, but I had no, no label for it. I went to my physician, all of my blood panels came back inside the normal ranges. And I didn’t know much more beyond that. Now, I read a paper, which was written by Don D’Agostino, who has since joined our research board, which is a really cool thing to like, loop all that back together. But yeah, at the time, I read this paper, and it was written about the effects of basically oxygen toxicity on the central nervous system. So when astronauts or divers are exposed to high-pressure oxygen environments, their brains, because of that increased reactivity, oxygen is a very reactive molecule, and so with that increased reactivity basically destroyed tissue in the brain very quickly, and you can have seizures, and you can effectively die very quickly. And I was designing an oxygen system at SpaceX at that time. So this was a very interesting area of focus for me. So I read this paper, and essentially, it showed that for rodents, feeding these rodents, a ketogenic diet can extend their lifespan in the high-pressure option environment by five times. And so that kind of blew me away. It’s like, wait, they’re, they’re just basically eating a fat focused diet rather than a sugar focus diet. And this is giving them the superhuman Power of Living five times longer in a deadly environment. And that was the first wake up call for me that diet can have legitimate physiological benefits. And so I started to look into nutritional strategies. And eventually, that led down the rabbit hole where I came across glucose tracking. Because glucose is the molecule of energy for most humans, I decided, you know what, I now and you know, I can’t ignore the fact that diet matters and nutrition matters. I wonder where my glucose levels are. And so I bought this device that’s called a glucometer. You prick your finger, you bleed on this little test strip and it gives your blood sugar level at that moment. And I started using this it was pricking my finger up to 60 times a day and couldn’t really it was just kind of a point cloud. I wasn’t. You know, I was plotting this stuff in Microsoft Excel. And it was like didn’t make much sense to me. It couldn’t make heads or tails of it. And then I read about this device called a continuous glucose monitor. And this was developed for people with diabetes, to help them monitor their blood, their blood glucose, and meter in insulin. So they inject insulin to help manage their glucose levels. And I said, You know, I need one of those, you know, pricking my finger all day long. That’s the thing I want. I just want the full-time high-resolution stream. So I went to my doctor and asked for one because their prescription only from again, managing diabetes. My physician was like, no way. You know, you’re super healthy. You don’t this is for people who are overweight for people who are sick. You don’t need that. And so that just kind of like doubled my desire to get one. Yeah, eventually I did. And so it took me about six or eight months, I think from that, from that visit, and I had several other physicians on telemedicine platforms turned me down. Eventually, I got one. And within two weeks, I found out that I was pre-diabetic. And my blood sugar control was completely broken. I was all over the place the highest highs and spending up to two hours over 160 milligrams per deciliter, and then crashing back down to hypoglycemic lows, and the separation, the time separation between a meal that I would eat and that crash that I would experience that I felt as shakiness and hunger and irritability was about two hours. And so it’s, it’s pretty hard to connect those dots when you don’t have that feedback loop. And so that that realization, seeing the patterns on this device, suddenly just woke me out of my, my stupor. You know, everything I was doing all day long, I was feeding myself foods that were causing massive instability and roller coasters of glucose, which cause roller coasters of insulin which cause which affect other hormones like ghrelin and leptin, which are hunger and satiety hormones, and all of the, you know, hanger and irritability that we describe in modern society I was experiencing, and I was now seeing it. And so that whole process of realization, and then by consequently using that same data to define a new diet, a new approach to lifestyle that helped my blood sugar stay rock-solid, and experiencing then the benefits of that, like, not superhuman energy, but just controlled energy, the pattern was now fixed. I wasn’t having the highest highs, but nor was I having the lowest lows. And so that whole process, just drilled home for me that this is, by default, a technology that millions and millions of people could benefit from. And although it is certainly necessary for people with diabetes, like we need to make this available, available for the people who need it most. It’s also ready for primetime, it is a consumer product wrapped up in a medical packaging. And so that that’s kind of the core moment where I said, you know, this is what I want to do, I want to bring this to other people.
Dan Hightower 12:33
So V1 was fingerpicking, like 60 times a day, which doesn’t really work for your current solution, right? Because it’s continuous and when I use it, I’ll see, like, ate some Chinese chicken, which I now call sugar chicken, because my blood glucose went up to like 210, immediately, which is trash and saw the only side of the actual like spike, and returned to normal. And that correlated with how I felt, you know, how you feel after eating a bunch of Chinese chicken. Yeah. And that’s one example. Another is I’m a relatively healthy person. I used to before Levels had like a regular Cliff Bar in the morning, which I thought was like a pretty decent thing. It’s like turns out it’s not. I’ve replaced Cliff Bars now that I saw the spike that it creates with like the Rx bars. I’m still toying with like, which one I really like best. But yeah, I mean, when you’re talking about medical interventions, it’s always like, will prove to me the behavior change, and then I’ll invest in your medical intervention startup. Yeah. I’m seeing myself every time I go into the convenience store and look at the Cliff Bars. I’m like no.
Josh Clemente 13:47
Right? Yeah. So I mean, that is the exact,that’s the example right there. And I think the way we describe this at levels is closed-loop feedback, right. So in controls and control system theory, you have open-loop systems and closed-loop systems. And open-loop systems are where you make decisions, you provide a command, and then you don’t measure the effect of that command in order to influence the next command. Right? That’s called open loop, you’re just making decisions on the fly; flying blind, basically. Closed-loop is where every decision you make is influenced by all of the prior decisions you’ve made, because you are measuring the output of that choice. And so for the way this translates into a product is seeing the effect of your decision immediately after the decision allows you to have context for what that did. Now, today in modern society, we develop our lifestyles based on either no data or the bathroom scale, which takes weeks or months to adjust, or the yearly checkup at the doctor, which has absolutely no functionality for picking what to eat for lunch, right. So you sit you know, you get your printout of blood panel results, and there’s a bunch of numbers on there. How do you know what to eat for lunch? So right I mean that that that those two things are too disconnected in order to be useful. So with Levels, you know you like you said you have Chinese chicken, and then 15 minutes later your blood sugars on a rocket ship ride to lunar orbit. And then you know, 40 minutes after that you’re getting the shakey crashing and you’re hungry again. And that’s the hormonal rollercoaster effect. And so for me, I mean, it’s exactly the same thing. Except it was every single meal. I mean, I seriously felt like, oh, man, like, I haven’t done anything right in years. And some of the worst ones for me and the most shocking were oatmeal. Just plain oatmeal was was a total disaster for me. And I mean, this is something that’s advertised as heart-healthy for everyone. For me, it puts me into a pre-diabetic blood sugar zone. And then a really interesting one was pressed juice. So just carrot, celery, and green apple juice pressed right in front of me, there were no additives, I got it from this organic juice cart. And I hit 210 as well, and stayed up there for about an hour. So what was funny is there was a, there was a girl there who saw this happen, I showed her my blood sugar, and she was like, I skipped the frappuccino to get that that pressed juice every morning. And I what I want is the frappuccino. And it’s, it’s doing the same thing to you. So, you know, for some people, and again, we can get into this. But there’s a lot of individual variability involved here. And so you know, it’s not the case that what happens to me happens to everyone, but it is important that everybody ground their decisions in their own data.
Dan Hightower 16:15
I saw a tweet from someone that said that ice cream is okay for them.
Josh Clemente 16:22
You know, ice cream is, all things considered, it’s a pretty balanced meal. It’s got sugar, it’s got a ton of sugar, a ton of fat, and a ton of protein but those things tend to actually, in combination, manage a blood sugar release. So fat tends to slow down the digestion pathway. And so you go from that rocket ship ride to a slower, more controlled increase. Now, whether or not that’s necessarily healthy for that person, hard to say. But you know, the data is clear that super-high elevations in blood sugar are extremely inflammatory. So you do not want your blood sugar to go very high. Like, you know, you said you went to 210 on Chinese chicken, you know the American Diabetes Association says that, you know, normal people would rarely exceed 140 milligrams per deciliter. And I think that is a lack of data that’s that is driving that statement. I think it’s true that people should not exceed 140. But I think it’s happening all the time. And people just don’t have any feedback on it. And we’re not measuring, you know, the nondiabetic blood sugar space is just completely untapped. Nobody has done high-resolution full-time data in a meaningful way.
Dan Hightower 17:24
That reminds me of like, the average American Heart Rate data. Yeah. But you know, you probably have guessed, your heart rate resting is like 50 beats a minute, or 45 or something like that.
Josh Clemente 17:38
Yeah, it’s like in the 50s and 60s, which,
Dan Hightower 17:40
Which is a diagnosed bradycardia right here. According to the average American. But we have data on heart rate because we’ve been tracking heart rates for centuries, right, right now, or centuries? I don’t know, 50. I don’t know how long.
Josh Clemente 17:55
A couple decades for sure. And I mean, again, this is like these, a lot of these ranges are developed by just averaging the population. It’s like, on average, this is not good. And the problem is that for blood sugar, specifically, the normal zone is just the average of people who don’t yet have diabetes. And unfortunately, if you look at the numbers in society, 88% of American adults are metabolically unhealthy. 90 million American adults have pre-diabetes and 90% of those do not know that they have it. And the reason they don’t know is because they have no feedback. And this is from random sampling by the CDC. And so we have a society that is extremely unhealthy. 70% are overweight or obese. So when you just average the people who haven’t yet been diagnosed, you’re averaging in a huge amount of dysfunction. And so we then have people who are calibrating off of these dysfunctional zones and saying, Oh, I’m healthy, because I’m inside the normal range. And in fact, we’re just slowly ratcheting further and further towards the society being entirely diabetic, which is a terrifying thing. It’s really happening right now. And, you know, we need to shift the whole bell curve back to the left, which is what levels is doing, you know, we’re redefining the ranges that we’re not calling them normal. We’re saying this is what’s optimal. And it may be very challenging to stay there. But the point is that every choice you make you want to be kind of bringing you closer to health, not, you know, bringing you further away.
Dan Hightower 19:11
Yeah. And I do get that when I use the app, I get that game, like the optimal zone, I want to stay the optimal zone. And that’s super interesting, because you have leveraged that great experience in the app in a really seamless medical experience, which is obviously way better than 60 fingerpricks a day to count a lot of people the value here. You are. You’re early days, and you may you’re like not even publicly launched yet, but your waitlist is over like 32,000 people.
Josh Clemente 19:45
I think we’re at 40,000 as of last week.
Dan Hightower 19:47
Yeah, that was like last week, when I asked you how big it was. Now it’s like 40, yeah, it’s amazing. How did you create that level of demand?
Josh Clemente 19:56
Well, first off, I think that the space that we’re in is ripe. People want better information about themselves. They don’t necessarily want better information about the whole average population, they just want to know what how healthy am I? And how can I do better? We’re seeing this with the decentralization of fitness like Peloton and Tonal and all these companies where they’re coming to you, it’s no longer a gym thing. You’ve got wearables that give you your heart rate that tell you how you’re sleeping, that you know, this personal health information trend is a fantastic one. And we’re it’s still nascent, it’s still brand new. But it’s certainly the case that people want personalization. They don’t want to get cut and paste information. And I think we’re hitting this at a prime time when with COVID, for example, they’re very close connections between COVID and metabolic syndrome. So the outcomes for Coronavirus are much worse for people who have pre-existing metabolic dysfunction. Combine that with the fact that people know that they’re flying blind, they have this intuition that, you know, they’re using data in every other part of their lives, except for their own health. And so when you bring a product out that provides a, you know, you’re measuring a molecule in the blood, this is not, you know, it’s not a superficial measurement, like, you know, I can measure my pulse with my finger. And I can measure my step count, you know, by hand, or mentally. But, I can’t measure my blood sugar. And now this device provides a very convenient way of doing that full time to a smartphone with a very seamless and elegant user interface. And so, you know, frankly, it’s been entirely organic. It’s been amazing to watch. But people want to share this stuff with each other, they want to show like this intuitive result, like I always felt this way. And now I have data to back up why I feel this way. You know, after I sleep for five hours, I’m ravenous all day long. Well, now I can see that my blood sugar is completely erratic after I have that short night of sleep. But when I sleep nine hours, my baseline is 20 points lower and my swings after meals are much more controlled. Or the counterintuitive thing, you know, I’ve been having this pressed juice every single day instead of a frappuccino. And then I get my blood sugar monitor, and I find out that that’s causing a disastrous blood sugar spike and crash and like me, you know, this might be the reason that I haven’t been able to lose the weight that I thought I would lose by going on a pressed juice diet. You know, and so it’s those types of things that are reinforcing its positive and negative reinforcement. You know, it’s like it’s demonstrating for you the way your specific body responds to your specific choices. And so all of that just like it combines to provide, you know, in combination with hardware software, and those magic moments, a lot of really shareable opportunities. And so, we’ve been benefiting on social media, we’ve done essentially negligible marketing, you know, this, this 40,000 person waitlist, and, and growing is the effect of people sharing their own stories. And, you know, we do have a lot of people with large followings who have become early adopters, which has been amazing. And so that flywheel effect of people just saying, you know, you know, it’s not that I can necessarily apply with this person’s learning, because there’s so much personalization involved. I need this product myself in order to know for sure,
Dan Hightower 22:57
Yeah, one of the things I caught on was your blood glucose levels, as you exercise are sort of counter-intuitively elevated for a period of time, not drastically, but it’s interesting that you see this like spike when you work out. You know, then you go read about, like, Oh, that’s why it happens anyway, right. Like, there’s learning that happens. And I think it’s super cool.
Dan Hightower 23:17
So many products today are subscribing to the waitlist launch approach. It works really well for consumers. The question it’s like out there in the wild is like, are all waitlist equally valuable? There are different ways of creating a waitlist. How do you balance, you know, building a huge 40,000 person waitlist with creating a waitlist of highly qualified, you know, buyers that are unlikely to churn down the road?
Josh Clemente 23:49
It’s a good question. And I mean, you know, I’m eager to get our product out there for the mainstream and for everyone to be able to enjoy and get it to our waitlist. And it’s something we’re very focused on. At this point, we’re still heavily in development and focus very much on product feedback, and on our early adopters, you know, giving us everything we need to know whether we’re resonating. You know, the ultimate goal is behavior change. There’s no point in doing this, if we’re not affecting positive behavior change. So we are being very intentional about that. And so it’s kind of a time function, you know, the waitlist continues to grow. And there’s definitely feedback effects there, where the larger it is, the faster it grows, and, and so we’re benefiting from that we’ve been in development for some time. But I would say that I’m very confident in the intent of our waitlist, specifically because we’ve done such little performance marketing, and we are not driving large volumes of people through advertising, where you can simply click a link and join. We have a pretty involved form that you have to submit in order to sign up on the waitlist and it’s at the homepage. And again, most of this is coming from organic places like search traffic, podcasts, and from testimonials on Twitter and elsewhere. So, people are, you know, we’ve been focused very much on both product development and on explaining the use case here. So podcasts, for example, are a great opportunity for people to hear specifically how metabolism affects their end goals. You know, you might be a person who has a really exceptional handle on physical fitness like I was. But, you might be dealing with the cognitive dysfunction that you can’t get ahold of. It’s like, Why do I feel so mentally fatigued? Why am I having such a problem with recall and memory? And when you hear on these podcasts, the way that the brain is metabolizing glucose and what happens, the fogginess that sets in and the recall issues that have been demonstrated in the research environment and glucose is not controlled, you start to have this flash this, you know, light bulb moment. And then you go and you look at our blog, and you read our blog posts about cognitive clarity, and it all starts to come together. And that’s when you sign up for the waitlist. And so I think we have this, you know, it is certainly not an optimized funnel onto our waitlist by any means, again, we’re very product-focused. So when you have a waitlist that builds, and the only information out there is highly educational information, I think that goes to show that this is a very intense audience. You know, we could definitely be doing, we could be kind of amping this thing up by providing single-click additions to the waitlist and add your email address and hit enter. Right, I think that’d be doing us a disservice. Right? The way we have it set up right now you have to go through some hoops. And I think that demonstrates that people really do want to get their hands on the product.
Dan Hightower 26:22
Yeah, there are three people in my Twitter DMS right now that reached out, see my tweets about the product. And they’re like, I filled out the form but I haven’t heard back like. Can you help us out? Like, how to get the beta or the trial? Yeah, it’s that’s when you know, you got something right?
Josh Clemente 26:41
Right. Yeah, I mean, we originally anticipated that everyone who signed up would like go right into the Early Access Program. Like there would be a few hundred or a few thousand people. And that we would put them all into the program. But, it quickly got to the point where, you know, for the purposes of the invite only program that we’re running right now, the early access, we just can’t do that much volume and still get high-quality feedback. And so the, you know, we started to have to like sort of sift through and pull people out of the waitlist and now obviously, it’s just kind of been a runaway effect. And sorry, to those three people, we’re gonna get to you soon.
Dan Hightower 27:17
Good problem to have as a startup!
Josh Clemente 27:19
I’m not complaining, that’s for sure.
Dan Hightower 27:21
Yeah, so talking about people adopting cutting edge digital health technology. How do you fit into, so I’m a, I’m an early adopter, I have an Apple Watch. Levels is my, you could count it my second quantified self device. So you could count Levels as my second quantified self device on my body. Play that out five years? How do you want levels to fit into what will probably become like this opportunity to have like 20 things attached to your body? Or maybe they all like, it’s the great bundling of quantified self at some point. I don’t know, I’m super interested to see what you have to say about it.
Josh Clemente 28:06
Yeah, I’ve done a ton of research on the bioengineering possibilities and the electric chemistry that underlies the sensors and the potential for other molecules to be measured. And suffice to say, I’m optimistic. There’s a huge potential here to take the same form factor. So I have on my arm a small disc. I think you might be wearing one as well and it has a little filament in it. And that filament is measuring directly glucose, glucose molecules in the skin cells. So it’s in what’s called the interstitial fluid. So it’s not actually in the bloodstream. It’s in a layer above that. And there are a lot of molecules in that area that can be highly valuable to understand. These are things like lactate, cholesterol levels, free fatty acids, ketones, cortisol, insulin potentially. Those hormones, those last two hormones are the hardest to measure but those others are actually fairly straightforward. And so you can imagine a device that has either a variety of filaments or a single filament with segmented areas on it, that each are measuring a different molecule in the same form factor and all streaming to your smartphone. And so with a device like this, you know, no matter who you are on the metabolic health spectrum, you have a real-time stream of information that describes your entire metabolic substrate. So all of the energy systems and the proportion of molecules that could be tapping into them, or sorry, all the proportion of your energy that is coming from each of these molecules in your bloodstream. And that’s super useful information to both drive behavior change, but also to influence the medical community and help people better understand. You know, if you walk into the physician’s office with three years of lactate, ketone, and glucose information along with nutrition logs and sleep logs from your Apple Watch, you have a complete picture of that person and how they are functioning and both not just how they’re functioning right now, but why they are functioning that way as a function of their lifestyle choices over the past three years. And this can completely change the relationship between physicians and patients because that context is so valuable. So combine that, you know, it’s pretty straightforward to take that little platform and add in an optical heart rate monitor and a step counter right in that and it could replace, you know, you might wear it full time and on the back of your arm, but it can replace all the wrist space. And, you know, you’d have an all in one device that, again, is the great bundling.
Dan Hightower 30:16
Yeah, that’s a huge vision. During my time in the army, did some stressful training from time to time. And there was one study done that I participated in as a three-week field exercise. Day Zero, they ran us through a ton of medical tests, blood draws, we were asking like bone density scans, etc. We were asking them what they were testing for. They were testing for stress hormones, and later, like, midway through, so like 10 days in, they drew blood again for the same hormones, and then again at the end, and then we found out, like, our results, or whatever. And I can’t remember the units of measurement for cortisol, but the chart said it all.
Josh Clemente 31:10
Through the roof?
Dan Hightower 31:11
Oh, yeah, completely through the roof. And that’s just another example of a three, just three blood draws. And like, I’m sure it’s, I’m sure it’s a little bit more complicated, like you said, to measure something like cortisol. But technology makes things easier over time. And that can be incredibly valuable. Like, and not just for performance or special operations or something like that. But like, how does your workweek impact your, your cortisol levels? And, and yeah, insights into what parts of your, your day even stresses you?
Josh Clemente 31:41
It’s not insignificant. I mean, it is so the cortisol, insulin glucose relationship is very strong. So cortisol inhibits the effects of insulin, and insulin, it serves to get glucose out of the blood and into the cells for use as energy or for storage. And so when you have large, high levels of circulating cortisol, you affect your body’s ability to control glucose very negatively. And so people who have sustained, you know, there are diseases called like Cushing’s disease, for example, where cortisol levels are chronically elevated. And these people start to lose the you know, they affect effectively get diabetes, they also get deposits of fat all over their body, which is like basically the dysfunctional insulin relationship, they become very insulin resistant. And so you have that, like in the very long term, that’s a rare case. But, you have a microcosm of that happening for people who have uncontrolled stress levels. And this shows up for people who don’t have any metabolic dysfunction diagnosed. And some of this is like the dawn effect. So in the morning, you might wake up and see your blood sugar just skyrocket. And that could be caused by again, cortisol releasing, that can cause the liver to crank out more glucose and inhibit insulin. I see this personally, like, when I take a red-eye flight, I get poor sleep, my stress levels are up, my heart rates up, my blood sugar is through the roof, and my responses to all the foods I eat is different. Or even just like podcasts, you know, I’ve done quite a few podcast interviews now. But early on, you know, two, three episodes in, my blood sugar would elevate 30 to 40 points as if I had just eaten a sugary meal. Yet, I’m completely fasted, and that’s just the stress of, of the, you know, prepping for this stressful interview. And, so that, seeing that relationship and understanding like, wow, every single day, every time I let those stressful, like work, moments, run away with me, I’m basically working in opposition to my goals, my goals are metabolic control. My goals are weight loss, for example, or, you know, cognitive clarity. I can’t be allowing my metabolism to just sort of get run rampant when just because of this, like lack of mindfulness. And so for me, it means taking a few moments just to center myself and breathe and bring those stress levels down. And I would never have done that without the glucose readout. You know, it’s like, I can’t measure cortisol directly. And this is a great proxy.
Dan Hightower 33:52
That’s huge. Okay. I mean, let me know when cortisol rolls out and I’ll pay. Well, the product itself is beautiful. The application is a really enjoyable experience. And I’d love to dig into that. You know, you come from SpaceX, which I have a follow on question about, obviously. But that’s not a medical community, per se. I know that astronauts have an unbelievable amount of health quantification going on. But, as you thought about launching the company, maybe this has to do with how you selected early found co-founders. But, I’m curious how you thought about bridging the gap into a medical device product, and where you focused your time. You know, you didn’t build a device, you built an incredible experience. And I’d love to hear how you broke all that decision making down.
Josh Clemente 34:49
Yeah. Well, first of all, thank you. I’m glad that you see it the way I see it. I think it’s a really delightful experience. And obviously, there’s plenty of ground to cover but suffice to say you know, the experience of using a CGM to change my own lifestyle was very positive, but it was lacking in experience. It required a huge amount of research into what was happening and why. And the devices currently today, they come with software that is essentially just the bare-bones operating system, you know, the manufacturers of these devices, they’re intent on providing a means of full-time measurement for glucose to people with diabetes. And with when you have diabetes, it’s an immediate need, you need to know your glucose and, really beyond that, it’s up to the provider you’re working with, to make changes and all of that. So when you’re talking about a new audience, the consumer audience, that immediacy is gone. And that sort of acute problem to be solved is not there. Instead, it’s a much broader concept. It’s like specific goals. And it’s, it’s aspirational. And it’s really, you know, in this space of wellness. And the wellness space, you look at companies like Apple with the Apple Watch, you look at companies like Peloton, Tonal, they have exceptional, elegant experiences. People don’t want to make major sacrifices to improve their daily behaviors, right, you got to fit this into a really hardcore lifestyle. In many cases, people have high-intensity schedules, and they don’t have time to figure things out. And so it became clear to me that, although the hardware was not optimized, like there’s plenty of room for improvement, it was very good. And where the experience was lacking was in connecting the dots between that hardware and the end goal, which is specific behavior changes across diet, exercise, sleep and stress. And so, you know, if you want to compare it to heart rate monitoring, for example, optical heart rate sensors are a commoditized product. They’re not expensive. But what takes an optical heart rate sensor and turns it into a whoop strap or an aura ring is the implementation. It’s the user experience. It’s how easy and elegant is the software? And how much does it elevate the focus to like, how much does it filter through the noise and give me the signal basically, and tell me what to do and how. And so that’s kind of what we’re trying to do here is we know that our, the core competency of developing continuous glucose sensors is already managed. That’s, you know, there are great manufacturers, they’re doing amazing things there. They’ve been doing it for decades. Where the opportunity lies is connecting, again, that hardware to the end user and providing an elegant experience to wrap it in. And so that’s where we focused and it really allowed us to do quite a bit very quickly because we were leveraging existing devices. We didn’t have to do that, you know, intensive development process, all the financial, you know, outlay that would come with it. And it allowed us to really focus on the beauty of the experience. And so I have to credit my co founder, David, he’s got an unbelievable design intuition. He’s our product guy. And he’s done a great job along with our contract design agency, The Working Assembly, I want to give them a shout out. Together, they’ve really put together I think, something really beautiful that people can jump into and learn from very quickly.
Dan Hightower 38:04
I would 100% agree.
Dan Hightower 38:06
So back to the SpaceX thing. What did you learn at SpaceX, maybe from like a project management perspective, or people management, or even just how to think about innovation that helps you in your day to day at levels?
Josh Clemente 38:22
Yeah, so SpaceX is a, it’s a really…the best way to describe it is it’s driven by first principles. So that’s something that Elon holds very dear. And first principles are basically the, if you think about a tree, you’ve got the trunk, and then you’ve got all the branches, and then you’ve got all the leaves. And, and so it’s easy to focus on the leaves as the first thing that strikes your eye when you’re looking at a tree. But the leaves are supported by branches, which are supported by the trunk and the trunk are the bare minimum, the basic principles upon which the other the sort of outer design details are attached. And so for any problem, there’s the core problem to solve. And then there are a ton of peripheral problems that you could get distracted trying to optimize. And so what we did at SpaceX was just like, what are the core problems that need to be solved? And if you use first principles, like physics, you know, what is the physical problem? Gravity is a physical problem. You need to get out of gravity well of Earth in order to go explore, explore space. And so you have to find efficient means of, you know, stacking materials and getting, you know, a lot of thrust through a structure and in order to overcome that gravity well and get to Mars. And so, you know, in a lot of cases, it’s like, to build a rocket, how much does the aluminum cost for that much, you know, surface area? It’s like, that’s the first principles problem to solve. And from there, we can decide, alright, is this thing is it possible to build for the price target? So it’s very, very simplistic conversation. You know, we sit in a meeting at SpaceX, and this is something I’m really proud of, essentially, anyone no matter what their background is, would understand the conversation. They might they may not have specific experience with it, but there are no acronyms…there’s no jargon. And it’s all about ensuring that anyone who’s in the conversation, whether a PhD in aeronautics, or, or astrophysics, or a brand new intern who’s still in, you know, in their bachelor degree, they can all contribute to the conversation in the moment, because that’s the only way to foster out of the box thinking, to open the opportunity for anyone to contribute if they have a good idea. So, you know, I think that that’s a really powerful lesson. And it shows that, you know, honestly, we had a lot of people at SpaceX, who had very diverse backgrounds. You know, we had people who had geology backgrounds who were designing rocket structures. And, so it’s very much an open-minded culture where, if you have an entrepreneurial mindset, and you have a motivation, you will learn on the job. And that’s the qualification you need. It’s the demonstration, it’s not a qualification, you don’t need that piece of paper to say that you’re qualified for the position. It’s more so, show us what you can do. And so I think we’re, you know, at levels, we’re taking a very similar mindset where, let’s solve the core problems. The core problems of metabolic dysfunction are people are completely blind to the effects of their choices. So let’s give them the information, the specific information they need. Not a bunch of fluff. And let’s give it to them in a way that is easy to consume. And, then let’s ensure that the team is built on, you know, a foundation that believes in science and challenges their own assumptions, and is willing to challenge the assumptions of others to forge, you know, kind of a new market very quickly. And so I hope we’re echoing SpaceX in some way. Certainly, I try to.
Dan Hightower 41:26
I mean, I see it. You’ve taken almost atomic level, molecular level measurement, and turned it into a beautiful app that’s easy to understand, and sums it up all in like optimal zone language.
Josh Clemente 41:40
Dan Hightower 41:42
I would say you’ve done that. So you have raised a little bit of money. I’d love to hear the fundraising story. And, you know, this is such a big idea I’m so curious At what point along the journey you raised first money, and what that looked like?
Josh Clemente 41:59
Yeah. So my co-founder, Sam, is he’s a multi-time founder, and just really a powerful mind in the area of network theory, and certainly has a ton of experience with raising and this was my first time raising venture money. So he, you know, he really helped define the right strategy. Because I wasn’t, I did not have the right strategy figured out, you know, in advance. So I had worked on a company prior to Levels called Frontier Biometric. And the goal there was the same as Levels, but I was taking a very slow growth kind of bootstrapped approach. And it became clear to me that that was not the right approach to maximize the chances of success. And I needed to replicate, you know, that SpaceX environment where you have an absolutely dynamite team working on a massive problem together, it was not something I was going to pull off on my own. And Sam was one of the first people I thought of, we teamed up very quickly for levels, and we basically started bringing in money right away. And so we did that on safe notes, mostly in network, people that we knew. So this was this is primarily angels. We had a few small checks from, you know, institutionals. And that was a process of essentially just making phone calls. And Sam has a very strong network, given his prior startup experience. I had access to some networks and so together, we were able to bring in sufficient funds, about a million dollars over the course of a few weeks. And we use that to start to build the team out. From there, we kind of kept a safe note open for a few months. And we ended up raising about close to $4 million on safes over the course of eight months. And we’ve since signed term sheets for our seed raise. And that’s currently undisclosed, but the details will definitely be coming out shortly. And we’ll use those funds to go from this beta phase into our first stage of growth. And so yeah, we’ve been nicely capitalized, we’ve definitely benefited from a fantastic network of investors. You know, just we have people from all walks of life, other startup founders, other investors, we’ve got professional athletes like Matthew Dellavedova, just some really great people who support us in making connections. And it’s been really powerful for me to experience this, like earliest stage of funding and all of the benefits it can bring.
Dan Hightower 44:12
So you went from very little background in fundraising to 4 million raised pretty quickly. I’m curious if you have a preferred resource that got you up to speed? Or maybe it was just your founder, but perhaps not?
Josh Clemente 44:25
Yeah, you know, most of it honestly came from conversations among the founding team. So Sam, again, he has great, great experience with this. Andrew Connor, who’s he runs engineering, my co-founder, he also has quite a bit of investing experience both his own investing, but then also he had he worked at a company that was acquired by Google and became Google Voice. And they had raised money as well. And so he had been through this process themselves and so that that like really helped influence me. I also really looked to a few books like Secrets of Sandhill was helpful to kind of understand the like the real larger-scale institutional investment round. But honestly, when it comes to the earliest money in, it’s all about just relationships, it’s about connecting with people. And so, you know, I think that was the biggest surprise to me was that most angels are looking for a fantastic team. You know, they’re, they’re really the earliest money in and they have to, they have to feel confidence in the people. And so understanding that, you know, I would just, I think the that was most helpful resource to me for me was just to see that you have to demonstrate trust and have that pre-existing relationship in order to really maximize the pace. You know, it’s hard to get quick money from scratch, you’ve got to know, you know, have some, it’s honestly, like, even loose ties, some loose relationship is better than none for sure when it comes to those early conversations.
Dan Hightower 45:43
Okay, so all in it’s been, what, eight months?
Josh Clemente 45:49
It has been since June of 2019. So we’re now at a year and four months. And I had been working on Frontier Biometric for about a year prior to that.
Dan Hightower 45:57
Okay, so what has been the biggest mistake or two that you’ve made?
Josh Clemente 46:02
Let’s see, I, you know, I call this a mistake, I really don’t necessarily think things could have been different because it was a very significant lesson learned. But that time working on this project myself, and essentially trying to define all of the boundary conditions and say, like, here’s the whole business plan, here’s every problem that needs solving, I’ve done all the work in advance now let’s just like hire some contractors to knock it out. That process was extremely educational for me, but it did not move the ball forward very far, all things considered. Now, again, I learned just a huge amount about human physiology, I wrote a white paper those instructive for bringing on the early team. It demonstrated that there was a use case here. It like did a bunch of the educational heavy lifting for bringing other people up to speed on why this has something to do. But I could have accelerated that process by nine months, for sure. And, you know, we could be nine months ahead of schedule from today. So, you know, I kind of call that a bit of a regret that I didn’t, you know, I didn’t treat the scope of the mission with the appropriate execution, if that makes sense. Like, it certainly was clear that this required an all-star team of data scientists and product designers, and you know, I’m over here, a mechanical engineer working on it solo. So I would have definitely accelerated that process if I did it all over.
Dan Hightower 47:22
Make sense? Okay, wrapping up, secret weapons. I asked you what your secret weapons are for an unfair advantage in your work and life. So, what is your secret weapon for staying consistent with your exercise, and nutrition?
Josh Clemente 47:40
Dan Hightower 47:41
And you can’t say Levels.
Josh Clemente 47:44
Okay, I was gonna say Levels, I’m not gonna lie. The accountability there is huge. But without levels, I would say the secret weapon is the acute awareness of how quickly things go wrong when I am not consistent. So the person I become when I do not treat my body appropriately with exercise, sleep, and nutrition is not, it’s not a good one. I do not operate at my peak, and things quickly devolve. And so just my awareness of that allows me to help to stay focused on it. Now I am, I’m a CrossFit level 2 trainer. I really enjoy physical fitness. But, I have kind of evolved away from the super high-intensity workouts. And I’ve started to realize that movement is what is most critical for people. And you get an 80/20 – so 80% of the benefit for 20% of the effort – you get an 80/20 benefit from just doing something. And that doesn’t have to be getting in your car and spending 90 minutes sweating it out on a treadmill, at a gym or lifting heavy weights at the end of a workday. If you just get up and walk around the block two or three times or walk up and down stairs will on a phone call, you get massive benefit both mentally in the reduction in cortisol, but also I’ve seen this with blood sugar control myself, and so you’re getting physiologic benefit. So my secret weapon is having learned that lesson and knowing that if I can just get 100 pushups in before bed. I’m better off than if I say this is a lost cause and I’ll have to workout tomorrow. So I would say that is something to keep in mind. Keep that in the back pocket. Just anything is better than nothing.
Dan Hightower 49:19
Yeah, that’s super hard for me coming out of the military where, you know, the people who were in charge of you, if you’re not throwing up in a bucket by the end of what they do to you, then it wasn’t a real workout.
Josh Clemente 49:31
Right. It’s rampant. I mean, I’ve got two brothers in the military and I see it from them too. They come home and they’re like, you know, we’ll do a six-mile run and 100 pull-ups and they’re like, alright, let’s go work out now.
Dan Hightower 49:43
No, I mean, I can’t, like my girlfriend like wants to go on a jog and I can’t just jog. It’s an issue. Yeah. Okay, so secret weapon for Team culture in this now remote world?
Josh Clemente 49:59
Yeah, so Levels has been remote from the very first days. So Sam and I chose to make this a remote company before COVID. This is again in June of 2019. And that was a big change for me personally. Coming from a hardware world, remote doesn’t traditionally work well when you’re working with atoms instead of bits and bytes. And so the things that we’ve learned over the past year have been really amazing. I think the biggest one is transparency is absolutely crucial. And this isn’t just like, you know, a label. It’s a total transparency across the organization. Everyone should be privy to all conversations. And in order for departments, you know, people who work in different verticals inside the organization, if you think about it, like without transparency, there’s no way in a remote setting to feel as though you’re part of something. There’s no way of understanding, like, you may have had a slow week in, let’s say, product or engineering, but if you’re aware of the progress that’s being made in operations, or in product, you know, if you’re engineering, seeing that progress happen, the chatter, the high-level conversations, you know, the founder level discussions, the fundraising developments, that’s the way that you can keep people feeling that motivational pull when they otherwise may not. And so I think a lot of people that work from home, they feel super isolated, and you know, you just lose that connection with other people. But this, this is actually something that can be replicated. And it’s just all about the free flow of information. And you never know when someone will jump in and contribute something super positive to a conversation, or, you know, crack a problem that you otherwise wouldn’t be able to. So I think the thing we lean in hardest on at Levels is transparency. And it’s really beneficial for remote teams. The other thing is just selecting for people who have existing social support systems. So if you know you’re going to be remote, it’s really important to make sure that people are aware. That in person engagement for many is absolutely critical. And you know, if you have a family or friend group that is nearby that you can lean on, and you don’t need that in-office experience to replicate, you know, the social setting, then I think you’ll be much more successful. And that’s really tough for some people. I think we’re seeing a lot of the negative backlash here right now. People are feeling really isolated. So, definitely, I think, ensure that it works for the individual. It’s not for everyone. There’s no way around it.
Dan Hightower 52:12
How do you, you talk about transparency especially within the context of progress as a team, how do you, do you guys use Slack?
Josh Clemente 52:19
Dan Hightower 52:20
So how do you elevate progress as a team transparently in a way that doesn’t get lost in slack chatter? You have a place where that lives? A special vault where everyone can go be a total team?
Josh Clemente 52:34
It’s a great question. You know, I think Slack is actually a really great tool for transparency, if the channels are all open. Or you know, maybe you have one channel where there’s like private health information, something is exchanged in private channels. But other than that, you should have essentially the ability for people to look across channels at, at their whim and let that kind of self select out. I don’t spend a ton of time looking at the code in the engineering channel but it’s certainly there for me to see like when big server systems are down or something like that, you know, I can pop in there. But across the board, I just think like, making sure you and you take the additional minute to announce something interesting. So we have for example channels where we can share emails, like the founding team can just throw emails into slack from, you know, exciting developments. And this may be a new employee joining it may be just a piece of praise that we get from our investor network. But we’re able to just plumb that right into Slack so that everyone else can see it on the fly. And that’s a nice little way of just like creating a little buzz or just providing an afternoon boost for people. And beyond that we have an intentional day, well it’s not a day, it’s an event every week called the Friday forum. And on the Friday forum, we get the whole team together, we go through accomplishments for that week. And we also typically will have a special guest. So this will be like Dom D’Agostino or Ben Beckman or Anna Loof or our research team, or it’ll be like an early adopter or somebody who invested early or somebody who was an earliest customer, and we’ll have them join. And we just go through and just like basically, it’s not a hype, you know, it’s not, it’s not just like a hype meeting. It’s not some sort of party. It’s just genuinely demonstrating the progress has been made across all departments for everyone to see. And we do it synchronously. And it takes about an hour, but it’s great. And then everyone has an opportunity to share something personal at the end that happened that week, as well. And it’s a really nice way of like rounding out the weekend or the week going into the weekend. And have everyone like kind of reflecting on wow, like, you know, again, that that might have sucked for me this week might not have been great for me. But we really move forward, like unbelievably fast this week. And it’s just a way to just reflect on that quickly and together.
Dan Hightower 52:56
I like that. Okay, last one. Secret company for your weapons general tech stack? And not the actual hardware device, like the software.
Josh Clemente 54:42
So I would have to say Retool. Retool allows you to basically build custom internal tooling for your data set. And we use this, basically all of our operations systems are built with Retool. And these are simple sequel queries, but we can build dashboards and visibility systems for our operations team and our customer success team to get into the data set in a really meaningful way. And without like building these custom tools, you know, it would be like unbelievably intensive for the engineering team. But instead, this can take a few minutes running a query, and all of the visibility is like essentially note code built in. And so Retool, I think was like, essentially turnkey. It’s been a phenomenal experience. I’m speaking for engineering, but I’m also speaking for operations and logistics which is you know, kind of what I’ve been working on the past few months here and it’s been awesome to be able to just turn that system on and use the database to keep things running. So definitely a big plug for them.
Dan Hightower 55:37
Well, Josh, the floor is yours. Anything you want to say before we wrap up?
Josh Clemente 55:41
Well, I really appreciate you bringing me on I would recommend if anyone wants to learn more about the metabolism side or the specifics of how that breaks down check out our blog that’s at LevelsHealth.com and then jump on the waitlist. I promise we’ll send some emails and keep you in the loop.
Dan Hightower 55:54
Awesome. Josh, thanks so much for spending time with me today. What you’re doing to change Quantified Self is truly amazing. Thank you so much for listening. Please subscribe for more amazing conversations with founders like Josh and you can find the notes from this episode at ProductMarketMisfits.com. Check out Levels at LevelsHealth.com and read more about the science at LevelsHealth.com/blog or on Instagram and Twitter at Levels.