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00:03
Welcome, hi, I'm Mikki and this is Mikkipedia, where I sit down and chat to doctors, professors, athletes, practitioners, and experts in their fields related to health, nutrition, fitness, and wellbeing, and I'm delighted that you're here.

00:26
Hey everyone, it's Mikki here. You're listening to Mikkipedia, and this week on the podcast, I speak to Gil Blander, the founder of InsideTracker, a revolutionary platform that empowers individuals to optimize their health by tracking and improving their biomarkers. Not just biomarkers, actually. There are a lot of other things that InsideTracker tracks. So Gil shares his journey into the world of longevity and health, shooting light on how InsideTracker is pioneering personalized health optimization.

00:56
We discussed Gil's passion for longevity, the science behind biomarkers used in InsideTracker, how personalized health data may lead to significant behavior change, their own inner age calculation as a behavior change tool, and to get published research, including the biosignatures of endurance runners, something very near and dear to my heart and maybe yours.

01:21
It goes without saying that this episode is a must listen for anyone interested in the cutting edge of health optimization, longevity science and personalized wellbeing. So Gil Blander, PhD, is an internationally recognized biologist, longevity expert and the founder of InsideTracker. With a profound passion for aging research and personalized health, Gil has dedicated over two decades to exploring the science of longevity and biomarker analysis.

01:49
Holding a PhD from the Wiseman Institute of Science and having conducted post-doctoral research at MIT, Gil's academic and professional journey has been focused on that intersection of biology, technology, and health optimization. Through InsideTracker, he aimed to empower individuals to take control of their health by providing them with personalized, data-driven insights to live longer, healthier lives.

02:15
Gil's work has been featured in major publications and he continues to be a leading voice in the fields of biotechnology and personalized health. And for what it's worth, I didn't think Inside Tracker was available in New Zealand, but you can update your data. I always learn things on these podcasts. So it doesn't surprise me when loads of people touch base with me saying that they do too. So we have links to both Gil and Inside Tracker in the show notes, so absolutely go there for more information.

02:43
And of course, Gil also has a podcast, Longevity by Design, and I've got a link to that in the podcast notes as well. All right, team, enjoy the conversation. Gil, thank you so much for taking the time to speak with me this morning about Inside Tracker, Longevity, Wellness, Biomarkers by Feedback, all of those, you know, really good things. I'd love to just start with

03:11
your own story in the InsideTracker company, because, you know, obviously, you must have had a keen interest in understanding the kind of biomarker longevity space well before you sort of kicked off into InsideTracker. So can you give us a little bit about how you sort of built the company and where you started? Yeah, absolutely. First of all, thank you for inviting me.

03:38
And yeah, from a very young age, I was fascinated by the aging process, actually from the age of 12. And the reason for that is that the relative of mine passed. And instead of being worried about her, I was worried about myself. I realized that I wanted forever. And from that time, I decided to dedicate my life to try to understand why do we age? How can we delay onset of aging related diseases?

04:04
And how can we improve the quality of life and actually improve our health span? Maybe we'll discuss it later. And not only live longer, but also live better. So I decided to study biology and did my PhD at the Weizmann Institute of Science in Israel. And then they moved here to Boston to MIT.

04:28
and they spent five years at one of the best labs that started aging in the world. The lab of Lenny Guarente is the scientist that discovered CIR-2 or the CIR-2-NIN as a master aging regulator. He showed that they increased lifespan in yeast, also in worms. He showed also that CIR-2 is a yeast on the acetylase.

04:53
protein that's utilized and it's an NAD dependent that's utilized, which is interesting. A lot of people are now really interested in NAD and that's one of the reasons why. And I spent five years with him. It was a great experience. And during that time, we started to be exposed to the biotech, pharmaceutical, high tech environment of Kendall Square. Kendall Square is actually where is my office right now. And I'm talking to you.

05:22
my office is basically the area around MIT. And there are thousands of companies in this area, biotech, high tech, pharmaceutical. And I started to be exposed to some of them and realized that maybe I can contribute more to humanity if I start my own company than being a professor in academia. So after five years at MIT, I left the university, moved to the industry.

05:50
working in a computational biology company for a couple of years. During that time, I started to research caloric restriction, which is a regime that we're known to extend lifespan in the organism. I tried to understand what is the molecular pathway, why caloric restriction extends lifespan in the organism. During that work, I started to realize that it's not easy to mimic caloric restriction.

06:19
And then I started to be exposed to the nutrition domain. Before that, my interest wasn't in nutrition, but I realized at that time that there are around 8,000 food items that we can consume or available for us. We are now building an application, so I know that the average, at least American, in the average week, only consume around 45 food items.

06:45
We have 8,000 food items available for us and we consume only 45 of them. And also what we realize, and I assume that you realize as well, not necessarily we are consuming the right food that's good for us. We consume what's available, but not what is fit for us. And that's what I call a person's nutrition. And that's basically the moment that brought me to InstaTracker. The idea is let's try to feed the right food for the right person.

07:14
And based on that, allowed the person to optimize himself or herself and allow them to live a better longer. And then we said, okay, but how would you, we know that Mickey needs this food and Gil needs that food. It's very hard to know. So we said, let's find biomarkers, something that will tell us exactly what are the deficiency of Mickey versus Gil. And based on that, when we know the deficiency, let's provide to her the right food.

07:43
right supplement, right exercise, right lifestyle changes to allow hair to live a better longer. And that was the genesis of the idea of InstaTragure. We very early zoom into blood biomarkers because blood biomarker for me is like a liquid gold. It's validated and calibrated. It's a

08:10
kind of data that your clinician making medical decision based on it. So it's a well known, a lot of peer review, scientific publications. So very scientific. So we can come and tell you if your, your glucose is high and your LDL is high and maybe your testosterone is low and vitamin D is low. What is the best food for you to eat? What is the best exercise for you to do? What is the best supplement to take or stop taking? And what is the lifestyle changes that you should do in order to optimize a

08:40
your body. The most important, the most complex machine that we have. And then in the last few years, we added a few more modalities. So it's not only blood anymore. We are looking at the DNA data, data from physiological markers like a fitness tracker. And we're also asking our users some questions. And now we are adding more modality. Maybe we'll have time to discuss it. So that's the story in a nutshell.

09:07
That's great. That's a big nut, really, to crack. I always wonder this with academics, once you get tenure in an institute, to give that up to go forth with this idea. I think it's quite courageous, Gil. Few people would probably make that leap. Obviously, it's been very successful for you as well. I'm keen. This is a bit of a tangent. I was just listening to Brian Johnson on a podcast. Do you know? You know it. Yeah.

09:37
Yeah. Yeah, I don't know him. I know about him. Yeah. So for the listeners who are unfamiliar, I think you'll know who I'm talking about when I describe. He's a man who's dedicated his life to not dying. That is his major premise. And it almost seems less about health and more about the not dying actually. And I feel like they're quite different things. I just am curious to hear any of your thoughts like it, because it's not too

10:06
He's taken it to the absolute and almost an unlivable extreme for most people. But obviously InsideTracker is designed to be helpful and useful for the individual to implement realistic changes. Yeah, so maybe a bit of a background about Brian Johnson. So he's a very successful entrepreneur that made a lot of money.

10:30
And there are a lot of people like that in the, let's say, longevity domain. Bezos is another one and there are a lot of other that basically made a lot of money. And then they realized what is the thing that I can't have? What I cannot buy with money? And let's say there are a few things that you cannot buy with money. One of them is health and one is longevity. So all of them are now pouring a lot of money in the domain to try to.

10:58
to find a way for them to extend their life span. So again, from the stories that I read about Brian, he made a lot of money, but he lived not a very healthy life. When he decided to change it, he invested, as I said, around $2 million to do a lot of tests and try to understand what's happening with his body. Now he's consuming like a few hundreds of supplements and they're living a very...

11:27
I would say a tough life without any excitement, because everything is very controlled based on what a physician are telling him. And he's trying by that to optimize himself and to live a better longer. I think that it's interesting. I think that it's good for, in my opinion, it's a bit too extreme. I don't think that a lot of people can do that.

11:57
And I also think that it's not available for a normal person because it's a, as I said, he spent $2 million on testing himself. That's not something that an average person can do. But I think that the direction is good. And I think that's good for the longevity domain that there is some someone like him that taking it to the extreme and trying to prove a point. So high level, I think that it's a positive.

12:24
If you look into that specifically, I think that's a bit too extreme. Yeah. And you know, and I think that there is a sort of, I don't know, like you can chase longevity and not dying, or the average person can focus much more on just living a healthy, whatever years they've got in their life, living them as healthy as possible based on some of the markers that inside tracker sort of analyze. So.

12:50
How did you decide on those sort of biomarkers, the big pillars that you're focusing on? Yeah, that's a good question. So I'm going back, I don't know, 15 years back, and when we realized that we want to test blood biomarkers, I looked at the catalog of a big diagnostic company, like Quest Diagnostic. Quest Diagnostic is the biggest diagnostic company in the US.

13:16
And I've seen that there are thousands of a biomarker, blood biomarker that you can test. So I immediately understood that it will be way too expensive for a user to test all of them. And also you might not have enough blood in your body to test them. So we came with a simple criteria of what are the biomarker that we want to test. And the first point was it should be biomarker of health and not a disease.

13:46
So I don't want to look at the biomarker related to a breast cancer or a other cancer, but more biomarker or cells like glucose, our metabolism, hormones, and other markers that basically look more on health because the health care system already looking at the biomarker disease. So that was the first one. The second was that the

14:10
those biomarkers should be out of the normal range for at least 1% of the population, because they didn't want to waste their money. There are some markers that show a very rare issue that occur in one in a million. I don't think that it's fair for the user to test it if it's only one in a million. So I said at least 1%. And the last one is that those biomarkers can be

14:40
Meaning you don't need to take a drug. You can use a natural and simple intervention to modulate those markers. And based on that, we are having today around 50 blood biomarkers that we are testing. We started with much smaller amount. We started with 10 and we started to increase it with time. Yeah, and have you noticed a sort of shift in the data that you now receive because you've got a more complete set of biomarkers? Like at what point are you like...

15:07
know, we could bring 70 in, but it's not actually going to change the value of what you're getting as a company from data and what the individual is getting. Yeah, so I think that it's a bit different what the company is getting. We, you know, the more the merrier, because then we can slice and dice the data. And I think that in the question that you sent to me, we will discuss some of the papers that we published about our data. But I think that for the user,

15:34
It's really hard to say because the science make progress all the time and more and more information is coming. I can give you a few examples of markers that we added recently, which I think that they are very important. One of them is APO-lipoprotein B or APO-B, which is a marker of, it's a better marker to assess whether you have a risk for cardiovascular diseases.

16:01
And before that, we only looked at the HDL, LDL, triglycerides and so on. So that's a marker that is important that in the recent years have been shown again and again that is much more accurate to predict the risk of cardiovascular diseases. So we decided to edit. So we added it recently, but the thing that it had a lot of value. Another marker is insulin. And before that, we only looked at

16:31
a fasting glucose and A1C. And insulin is basically showing how good your body function in producing this hormone insulin and allow you to absorb the glucose into the cells. And it also can show you an early warning about someone that is starting to get in the direction into being diabetic. So I think that those are two examples of markers that literally we added last year or year before.

17:01
and still there is a value. So in my opinion, we'll continue to have a value like that. But I think that it's more like the 80-20 rule. So we definitely cover the 80%, but still the 20% will continue to come and the science make advance. So we'll continue to add more market space on that. Yeah, nice. And Gil, how do physicians view a company like InsideTracker and the information that you're giving out to consumers? And the reason I ask is,

17:30
As a nutritionist who is interested in this information for my clients, when I send my client along to their New Zealand Neurogeneral Practitioners, and they discuss with their doctor, these are the markers that I'd like to test, that person isn't going in necessarily because they're feeling poorly, but they just want to be proactive about their health. That's not always viewed as favorably. How is it viewed and what's your experience with that?

18:00
Yeah, it's a good question. I think that's a pretty big question. And maybe I should provide the background. So at least in the US, the health care system, including the physician, and I'm not talking about all of them, but the majority of them are more looking at the treatment of disease than preventing a disease. So basically, when you come to them and before recording, you inform me that you are a marathon runner and so on.

18:28
They are not looking at you as someone that wants to optimize yourself. It's more like if Mickey is broken, how can we fix it? And I think that the right view should be Mickey is in a position today, how can we make her as good as possible for her to continue to be in the best position as long as possible.

18:54
And that's what a insta-trucker is trying to do. So it's more like prevention and less about treatment. If you are broken, go to the clinician. If you want to be as the situation that you are today or better, come to insta-trucker and we'll allow you to optimize yourself and they take you to the best that you can be based on your potential. So I think that that's the situation. Now there are more and more clinicians that understand that.

19:22
and I don't know if you have the term longevity clinics or other that basically preventative clinician, they are really trying to do what we are doing and they're trying to, let's say look at the person holistically and try to find what are the small issues that we have today and let's try to

19:48
fix those small issue in order for him not to have a big issue in the near or far future. And we are already working with a few of those clinicians. And I think that that's the future. The future will be a preventative longevity clinician that basically trying to allow us to be better and not telling us, come to me only when you are broken and we'll take care of you.

20:17
sense. And there are of course doctors here who feel similarly in that space. And I guess just the way the system is set up, it's not designed to have extensive conversations with your doctor about staying healthy. You've got like 15 minutes to talk about what's wrong with you rather than, you know, what's right. So I think that plays a large role in it.

20:45
And it's this idea that I am 46, but with my biomarkers and when I get measured, I might be 51 because of the running and the metabolic stress on the body, or I could be 39 because I've optimized my cardiovascular health. So I guess there's a lot of critique around using the idea of something like inner age or biological age because they're based on soft outcomes.

21:15
hard outcomes? Like what's your take on it? Or what's I guess your response to that kind of critique? Yeah, so biological age, I think that it's a good tool to allow a person to have one number that he can compare with his chronological age. All of us know what is our age. It's something that I don't know anyone in the world that doesn't know how old he is. And

21:44
am I younger than my chronological age or older than my chronological age can give you a reference point that you can understand. And my point is it's not very important if your inner age of biological age is 51, 52, 51.2, but it's more important is what is the relationship between it and your chronological age.

22:13
older than your chronological age, meaning that most likely something in your body is not working well or something needs to be fixed. If it's younger, it's better, it's functioning better than the comparable population, but it can almost always be better. Even if you are younger than your chronological age, you can always strive to be better.

22:41
in your example running the Boston Marathon, you can always beat your PR. Even the fastest person in the world can beat his PR. So even the best person with the best inner edge and sub-tracker can make his inner edge a better issue. And that's the idea. So to provide to you a reference, then because our inner edge is open box and we are telling you...

23:08
why you are younger and older and what biomarker contribute for you to be younger and older, you can work on the biomarkers that are the most problematic. When we are providing you a very specific intervention of what food to eat, what supplement to take, what exercise to do, what lifestyle changes to perform in order to optimize these biomarkers. And based on that, most likely we will improve your inner age. So in a way, it's a gamifying the

23:37
biomarker work and allowing users to fight between the chronological and inner edge and make it lower because it's based on blood biomarkers. Most likely if you do that, you'll improve your biomarker related to health and performance, you'll be less sick and hopefully you'll live better longer. We also have data that show that in our population...

24:03
A user that started with inner age that is above their chronological age, a significantly decrease their inner age in the follow up test. And we can see it also in the second follow up and the third follow up in the fourth follow up. So basically it's a good tool for users to, um, try to fight the, uh, let's say the aging process and they try to, uh, to, to get as healthier as possible for long. Yeah.

24:33
What's the difference between your chronological age and your inner age? So currently I'm around five years younger than my chronological age. But in the past I used to be also much older. And it's changing all the time. As I said at the beginning, we are a very complex machine. And I like the analogy of the car.

25:03
Every 5,000 or 10,000 kilometers you take the car into the technician. The technician plug a computer into the car. The computer telling the technician what is wrong with the car. The technician take care of it and then the car is good for another 10,000 kilometers. And then after 10,000 kilometers you take the car again to the technician who is doing it again and again and again. And research shows that since we incorporate this routine maintenance of the car,

25:31
lifespan of the car increased from around 100,000 kilometers to 200,000 kilometers. And I believe that our body is the same. So doing the insert tracker test every, let's say, 5,000 or 10,000 kilometers, allow you to find what are the issues, allow you to receive intervention, do the intervention, and then test your car again after 5,000, 10,000 miles, see what

26:01
Maybe you have a new problem and then take care of it. And that will allow you at the end of the day, offer it to live a better life. Yeah, nice. And I, as I understand it, InsideTracker doesn't give you recommendations based on 50 biomarkers. It sort of groups them up into those pillars that we're just talking about food and exercise and lifestyle and things like that. Yeah. Yeah. Gil, do you ever see any trade-offs?

26:26
I was thinking about this, I was listening to Brian Johnson talk. When you try to optimize for one thing, something else you might actually be unintentionally worsening something else. Have you ever come across that in some of the data that you look at? Yeah, absolutely it can happen. What we are trying to do at InstaTracker, our recommendation, we develop AI application that allow us to provide to you the best.

26:53
intervention for you, holistically based on all the blood biomarkers. So it's not only, I want to improve cholesterol and that's my influence, my inflammation. We know that if your cholesterol and inflammation are high, we'll try to improve both of them at one time. So fine, I call it maybe a focus food, a specific food that can improve both of them at once. But it could be that another marker that is okay right now.

27:20
when you have the intervention will actually shoot up or down and it will change it. So that's why you need to do the test every once a year or twice a year in order to see what okay, I intervene. What was the effect of other unexpected biomarkers? Yeah, yeah. No, that makes perfect sense. And something which piqued my interest.

27:46
like a month or so ago was a report on a study you did on runners. And often, you know, there's, for whatever reason, I see this quite a bit, and maybe it's just in my feed, lots of people talking about how, you know, running extends longevity. And then other people will say, no, no, running like just reduces longevity, and it's not good for your health or your heart, which to my mind is a bit ridiculous. And I'm sure data more supports its role in longevity. But

28:15
I'm really interested in that study that you did that looked at cohorts of runners, which were both professional and recreational, and also sedentary individuals and the difference between their biomarkers. So can we chat about the, I guess, the premise of the study and what you looked at? Yeah. So the idea here was...

28:38
It started by one of our team members that work with a lot of professional data runners. And he asked us to slice and dice our data for them. And when we started to look at that, we've seen a very nice result. And I said, no way, we're going to publish it in a peer review publication. And

29:05
What we have done, we have some amazing runners, like ultra marathon runners, meaning they are not running 42 kilometers, they might run 100 miles. So we have a group of those and then we have, I don't remember the number, I can look at that, but more than 15,000 runners in a different level of running. So it can be people like you that run marathon.

29:34
can be maybe you want to run an ultra marathon, I'm not sure. So you have the marathon runner, let's say it's people that run more like 10k, people that run 5k and some people that I call a couch potato, but you can call it a sedentary group that basically not running at all. And then we decide, okay, let's look at what is the effect of running on the level of blood biomarkers.

30:03
And high level, what we have seen that people that are running have a better blood biomarkers all over, mostly. There are a few, let's say, outlier of that. For example, cortis or distress hormone, the runner have a bit higher of that. And we know that a marker like ferritin related to iron, especially for women, so they have a bit lower of that. But the rest of the markers like

30:32
the lipids and the inflammation and the glucose and A1C which is a box marker of energy metabolism. All of them look much better in runners than not runners. Some of them we've seen those dependent response, meaning that you're running more.

31:02
the level will be even better. So a good example is LDL cholesterol. So sedentary have the highest level on average of LDL cholesterol. If you let's say low volume runner, let's say a 5k runner, it's a bit better and significant. Then the 10k is a bit better than that. Let's say the marathon runner is a bit better than that. And the ultra marathoners,

31:32
are even a bit better than that. Some other markers, it's a running is making better, but it's enough if I'm trying to give the analogy to run a 5k in order to see the effect. So the goal is in the future maybe, based on the follow up studies, you can come and say you have a high triglyceride, it's enough for you to run a 5k a few times a week.

32:00
and that will give you the effect. You don't need to run ultramarathons for that. So what we're trying to build in the future is a sort of an algorithm that will suggest for a person what exercise and how long they should exercise in order to optimize a specific parker. So that's one outcome of the paper. Another outcome that we have seen that there is a very strong correlation with BMI.

32:28
Again, which is, in my opinion, it's not surprise at all. You want more, your BMI is lower. So, and we see it also as a dose dependent effect. By the way, we see it both in males and females. What is interesting is that there is, we integrate here also genetics and look at the polygenic score related to BMI, meaning what is the, there is a correlation between

32:57
having a high BMI, part of it is genetic, not all of it, but part of it. Meaning if you have a better gene for BMI, you have a less risk to have high BMI. If you have a worse gene for BMI, you have a better chance to have higher chance to have high BMI. So what we said, let's try to see

33:24
whether running can offset it. So can running fight your high BMI? And what we have seen is, and we divide the population into three different groups, high risk, middle risk, and low risk. And indeed, we have seen in the sanitary population that the subpopulation that have a high risk for

33:54
A high BMI indeed have a much higher BMI than some that have the lowest. But when we looked at it for runners, especially for a high distance runners, we have seen that running offset that. So meaning that even if you have a high risk for high BMI, if you run, you have a better chance to beat your potential and don't want a high BMI. And we know that.

34:23
BMI is a risk factor for a lot of diseases. So it's also interesting to show that running can offset the higher genetic risk for high BMI. Yeah, and I know that a lot of people will critique the use of BMI because at an individual basis, it's not so helpful, but I mean, as you mentioned, this was a study done in over 23,000 runners when we sort of grouped them. So it's completely appropriate to use a marker like that because we're talking at that group level.

34:52
I guess this just goes to show, doesn't it, the nature versus nurture playing out in that genetic story? Because you did mention, Gil, that using genetic data is now part of InsideTracker. How do you make a decision as to what genes to look at? For example, we are looking at BMI and obesity risk. What's that sort of criteria? Is it easy enough to describe that?

35:21
Yeah, so yeah, we have a genetic team in the company led by an amazing PhD scientist that basically research it. And we are looking at a polygenic score, maybe basically aggregation of a lot of single nucleotide polymorphisms. So we are not looking at one gene or 10 genes.

35:51
location of the DNA, we combine all of it together and develop a risk score for example, what is your risk score to have high cholesterol or high glucose or high A1C or high A1B. So one way to do that is to develop a risk score for specific blood biomarker.

36:18
more about things that related to longevity, for example, grip strengths. So grip strengths is really correlated with longevity. And apparently there is a genetic predisposition for me, for example, when we develop this risk score, we found that I am in the bottom 2% for a potential to have high grip strengths, okay, which is crazy. Yeah.

36:45
there is an apparatus called Magnometer that you can, and when I tried it, I've seen, yeah, my grip strength is pretty weak. Interesting. So that's basically made me to start working in the gym and lifting weight and doing a farmer carry and leaning on the pole and all of that in order to improve my grip strength. So you can see a good example of a.

37:15
a score that doesn't connect at all to blood biomarker, but connected to a surrogate marker of longevity. And based on that, you can change your behavior and hopefully beat that. And I feel like I'm much more stronger right now and I can see it also in the magnometer. Another one is a bone mineral density that we are looking at a risk score for that, especially important for post-menopausal women.

37:44
So we are looking at a, we are actually launching in a few weeks a new report related to healthspan related DNA scores that are not necessarily correlated with blood biomarkers, but correlated with longevity. So I'm sorry Gil, did you just say that you've got genetic tests that look at your risk of visceral fat or low bone mineral density or you're actually doing a dextrose scan, you're measuring visceral

38:13
this is all sort of not genetic but using those tests? Yeah, no, those are genetic tests. Yeah, it's basically a list. Yeah, amazing. Then you can do, you can go and do a dextrose scan and find your visceral fat, the bone mineral density, and all of that. There are also other ways to do that. But yeah, so those are things that are important that most of us don't know.

38:38
and we are not aware. I didn't know I also have a high risk for visceral fat so I'm trying to work on that as well. Luckily my bone mineral density is great so I know I don't need to worry about it too much right now. So it's basically allowing you to make in a way make a priority list of what should you do in your time. We only have 24 hours a day to work, we need to spend time with our family and

39:05
other, but we need to find, okay, what is the priority in my me time? What should I do in order to allow me to live better longer? And if I'm going back to Brian Johnson, so instead of spending 24-7 on that, what should I do if I have only one hour a day to work, one and a half hours a day? And in such a way, I can help you to find answers. Yeah, nice. And you know, with, if I'm going back to that...

39:32
running score, the runners study, but it was interesting that the blood glucose management wasn't actually that different between sort of runners and non-runners. And I wondered whether it was just because you've got data from people who are interested in health. So they're much more, they might already have sort of healthy behaviors in place and they're just wanting to get some feedback on that. It's just that they don't run. Like, is that, is that your take on that result? Yeah.

40:01
I think that the blood glucose is a tough one. And the reason for that is a lot of runners are waking up early in the morning and go for one and don't eat well before. So the body, again, the body is smart enough that they know how to compensate for that and they know when you wake up, let's release some sugar or some glucose from the liver. And that's why...

40:29
I've seen some papers in the past and again, I've worked with some endurance athletes and a lot of them, when you look at the fasting blood glucose, they have a relatively high fasting blood glucose, but when you look at the hemoglobin A1C, actually it's not too high. So if you look in the paper at the data about the hemoglobin A1C, you can see that running much significantly decreased the A1C.

40:57
than let's say for glucose. So I think that the fasting glucose is more like an artifact of that than a real result. But I've seen a lot of data in the literature in the past that say, hey, running is not good for diabetes or something like that. And I think that that's wrong. It's actually running is pretty good for that. Again, I'm not a...

41:24
in favor of anyone wake up at 5 a.m. for running, if you can wake up at 7 or go to sleep. If you want to wake up at 5 a.m. go to sleep at 8 p.m. Yeah, or 9. 9 is all right as well, I think. Yeah, 9 is okay. But don't compromise your sleep. Sleep is very important. We have an amazing data about that. And also, if you are running for a long time,

41:51
for a long duration, you should fuel your body before. It's not good to wake up at 5 a.m., go for a two hour science and then come home. It's not healthy for your body. And again, we want to maintain our machine for the age 120 and not for the age 42. So be aware that doing that will compromise the machine, the long-term health of the machine. Yeah. And then...

42:20
It's interesting. As I understand it, I mean, I imagine you follow or probably even know Peter Atiyah. He talks about fasting glucose and he's not as sold on using it as a biomarker in his clinic for the reasons that you've discussed, actually, Gil. And so, he's a fan of the CGM. Does InsideTracker either utilize CGM data or is that in the future?

42:51
I think that CGM is amazing for the diabetic and can help them maintain their sugar level. We are trying to be very careful when we introduce a new modality that there is enough peer review scientific publication that show the value of this modality. In the case of CGM, there is no data yet that there is advantage for, let's say, a healthy person to

43:18
to use CGM. I've seen, I used it in the past. I know a lot of people that use it. And there are a lot of freak out moment for a lot of people. I can give you an example. Some people can go, oh, I ate oatmeal and my glucose spike. So I stopped eating oatmeal. So that can be, okay, one outcome of that. Another outcome comes and say, you are looking at the room from the keyhole.

43:47
what I'm talking about is you're looking at the effect of oatmeal on the, that second of effect on the level of glucose, but it's only temporary effect oatmeal has a lot of fiber that can allow you to maintain the glucose for a long time. It's also good for other markers such as cholesterol. I mean, there are a lot of value on for your gut microbiome.

44:14
So to come and say, because you have seen a peak, a high peak in following consuming oatmeal and to come and say, I will stop eating oatmeal or oatmeal is bad, I think that that's a far fetch. And that's what I'm worried about, about adding those tools to the end consumer without having enough scientific data and peer review publication.

44:41
Yeah, and I, for what it's worth, I really like CGM data when I'm working with people if they have it. But just because for the example that you give, then to my mind as a nutritionist, I'm like, well, you know, how do you feel? Because if you have a large spike, you might have a big crash. But also, oatmeal, as you say, good soluble fiber does help with gastrointestinal system, helps bulk up the stool, etc. So, how can you have the oatmeal so you're still having it?

45:10
but you might not be getting so much of a spike. So that's what I like about on an individual level, that kind of data, but I appreciate that, there's so much more to it than just because you're looking at hundreds of thousands of people and how it might be utilized at that individual level. And I guess it's, there's value in having that data as an individual, but knowing how to interpret it is really important. I agree. Gil.

45:38
I was speaking this week to Marco Altini, and he is, as you know, he's an expert in heart rate variability. And we of course talked about, you mentioned sleep before, so can we discuss sort of how InsideTracker looks at those kind of markers for the individual? Yeah, yeah. So yeah, I think that sleep is extremely important.

46:08
intervention that is underrated in our society. And as I said before, we have 24 hours a day and people are trying to find a way to extend it. So the easiest way is to come say, okay, I will go to sleep an hour later and I will wake up an hour before. And suddenly I have two more hours to do the stuff that I like to do. But we have a lot of data that show that

46:36
When people that sleep between seven to nine hours, if you compare them to people that sleep less than that, people that sleep more than that, they have the best level of metabolic related markers such as A1C and cholesterol and triglycerides. They also have the best level of VO2 max and if you want we can discuss that as well. In my opinion, VO2 max is a...

47:04
master regulator of health spend and longevity. We have the amazing data about that and I'm sure that Marco Altini will agree with that. I actually interviewed Marco for our podcast in the past and it was fascinating. We will come back to VO2 because I am interested in that for sure. So yeah, I think that if you're talking about HRV and I would say resting heart rate that

47:33
in my opinion, together, they're going the opposite direction, but they are coming together. I can tell you that a couple of weeks ago I had COVID and I'm using an hour ring, I'm not sure if it's available in New Zealand, but it was cool because I looked at my hour ring and I've seen, hey, my first sign, my temperature jumped. It's always around.

47:58
They don't show you the temperature, but they show you the variation of the temperature. So the day that I fell sick, I looked at the two and a half degrees above my average. And then I've seen that my resting out rate went very high and my HRV plum to the floor. And then with time, I started to see it start to climb.

48:27
back to the right level. So I think that definitely HRV and the resting heart rate are a very important variable that people need to understand. We are actually integrate all of that to InstaTracker and we are providing to users some tips. So for example, if you're wasting heart rate, last night was much higher than it's supposed to be. We are sending you a notification, telling you about that and also,

48:56
provide to you a specific recommendation, what should you do in order to improve your resting heart rate for tomorrow? The same with sleep and the same with other what we call physiological markers. So I think that that's a those markers are important for me. Few reasons. First, they are coming the cadence of the availability of them is very high. Every day you receive your resting heart rate and HRV, some event or even giving you more than once a day.

49:26
You also can easily interpret it and they are having some correlation with some blood biomarkers. The drawback of them that I think that the quality of them is much lower than blood biomarkers. Blood is like a big gold, it's validated and calibrated everything. But in another way, other than CGM, you cannot receive data of blood every day. So I think that there is a some balance

49:56
let's say blood every quarter to once a year, then having the DNA once in a lifetime. And then you have the data from the fitness tracker that come every day. And then it's a mix of all of them together that allow you to, if you combine all of it together and look at the body holistically, you can provide a very personal recommendation for the end user. Yeah, for sure. And with your

50:25
I'm interested in the sleep. Like are there any genetic sort of components to being able to sleep or not? Like I've had this conversation with some friends. Do you like integrate that? Like genes that make you need less sleep or make it harder for you to get good sleep? Like how does that look? Yeah, so first of all, you have are you a morning person or evening person? Yeah, yeah. Okay, so there is definitely a...

50:52
polygenetic score for that. I'm a literally a morning person. So I think we are superior actually to evening people. I think we know that too, right? Morning people are having a less risk of dying early. And there is advantage of that. But it's also good to know because there are some people that, let's say, morning person that behave like an evening person.

51:22
Okay. And then, and then that's, that's, that's not good. Or think about if your spouse is an evening person, you have a morning person, someone need to adjust. So that's, I'm lucky. Both of us are more like a morning person. It's also related to making a decision. Think about, I would never make a big decision at nine PM and I will, I will try not to work after nine PM, because I know that.

51:52
a morning person, but I, I'm, my efficiency at work is like a 10 time better at a, I know, 7 a.m. or 6 a.m. than at 5 p.m. So when I have a tough task, I like to do that at that time. So there are a lot of things that you can learn from based on the morning versus evening. You have also the, the effect of caffeine on your sleep. Some people, I'm, I have a very strong effect.

52:22
Somehow I decided not to drink coffee. I haven't drank coffee for more than five years. See, I think actually that this happens. If you know that, you know, like you can get a genetic test to determine the way you metabolize caffeine, but I think that you probably make a decision earlier in your life that it doesn't make you feel good. So you're not gonna have it, which is almost like proof that you're a slow metabolizer. I don't know. These are things that I think. Yeah, yeah, yeah, absolutely. And...

52:49
So I'm saying that yeah, there is a lot of a genetic for sleep for sure. But the good news is that even if you have a poor genetic, for example, for me, for the grip strength, so let's say you have a high risk for having a high up OB, which suggests that you have a higher risk to have a cardiovascular disease. Even for up OB.

53:16
the coverage of the genetic is only around less than 15%. Meaning that 85% is based on your lifestyle behavior and so on. So nobody can come and say, oh, I'm sorry, I have a bad genetic, my upper B is high because that, and that's it, I'm raising my hands. No, you have 85% of your lifestyle, of your nutrition, of your exercise,

53:46
The only point is you need to work harder. You got a bad car in Vegas, so work harder and try to beat the gifted that receive a good car, that's it. Yeah, yeah, yeah, that's it, right? Like it's, often people who I talk to are almost, they're like, well, I can't do anything about this because my parents also had high cholesterol. So they almost give up before they try it. Or,

54:14
dare I say it, use it as a bit of a justification for not working on it. Because that's actually hard work. Another story that a lot of people used to tell me, oh, you're telling me that running is good. I have a friend who used to be a runner, he ran a marathon, got a cardiovascular event and he died. I said, okay, he's a poor guy that had a very bad luck, but it's a one in a million. How many people, obese people are dying from heart attack every day?

54:43
Don't look at the one in a million, look at the population. 100% Gil. So at InsideTracker and in your office, is everyone there sort of bought into getting their bloods done regularly, making changes? Do you gamify it at your office? I'm sort of curious. Yeah, we are allowing our employees to test as much as they want. We are a...

55:12
based on if they wish to, we are talking about it. Definitely it's more like, you know, it's a medical information. So if someone doesn't want to talk about it, is not talking about it. But we are trying to encourage our users to test for DNA as well, and to have a fitness tracker with them, and then come with an idea, how can we make it better? Because it's very tough. I think that it's a...

55:39
Very tough to provide such a solution that work well and there is a good engagement. So we are definitely encouraging our team to use it as much as they can and help us to make it better. It's a group effort. It's not a gala effort. We have a team of almost 100 people that do it. Yeah, amazing. So it's not me. It's the incredible team. It's the amazing scientists, engineers, business people.

56:09
customer success that making the product amazing. That's a team effort. Yeah, that is awesome. And Gail, I found that running paper super interesting. I know you have other sort of research on the go. What are some things that we can look out for in that information space from InsideTracker over the next year or so?

56:36
Yeah, so we are in the process of developing a few new applications that will come soon. One example that I think that it will be, might be exciting for you is we are using a food recognition platform to allow users to scan his food for a week. And based on that, to receive much deeper information about what macronutrients you consume too much or too little.

57:03
to explain to you why it's important and to show you out of the food that you consumed, what are the food that you should consume more in order to correct this macronutrient. Also to show you how your nutrition interacts with your sleep exercise and what are you doing wrong and what you are doing well. So for example, you eat two hours before sleep and you are surprised that you don't sleep well. Or you exercise.

57:31
is two minutes before you go to sleep also. So think like that, that it's much better to show you, hey, this is your data. You cannot argue with that. You're doing something wrong, please correct it and test again. So that's one thing that we are coming with. We are also adding a few other application based on physiological markers that will provide more value to our users.

58:00
And we're also working on publishing another paper with amazing data. Some of it I discussed with you today, some of it we haven't had the time to discuss. So we have a lot of exciting news from Instatruck. Yeah, that sounds great. And, you know, it's not available in New Zealand, the test itself. And I think it's or at least not to the best of my knowledge.

58:24
But I think a lot of the information that you put out there as a company with your podcast, the presentations I've seen in the publications, there's so much take home stuff for people that even without having the full battery of testing and doing it, they've at least got some more understanding of the lifestyle biomarker behavior sort of connection. Just one correction. The testing and connecting to a lab is not working in New Zealand. But

58:53
Someone in New Zealand can upload his blood result and the DNA data and connect his fitness tracker to his instructor. That's his doable in New Zealand. Oh, that is amazing. We cannot help you to get tested and retrieve your result, but if you have data, you can upload. Oh, thank you. No, that is really good because I wasn't aware of that. So that's really good, really good to know. Gil, can you please for the listener...

59:21
and let us know where we can find your podcast and just more about the things that we've talked about this morning. Yeah. So the podcast called Longevity by Design, and it's, I would say, focused on longevity. We interviewed the best and the brightest in the longevity field, people like David Sinclair and Nir Barzilai and all the leaders of...

59:49
the aging research, we already interviewed more than 50 of the leaders in the aging. The company is InsadTracker, you can find it at insadtracker.com. You can find me on social, on LinkedIn, on Twitter, on Instagram. My name is Gil Blunder and yeah, I'd love to communicate with anyone. Yeah, that's amazing, Gil. Thank you so much for your time. I really appreciate it. Thank you so much.

01:00:28
Alrighty, hopefully you enjoyed that. And as I said earlier, you can actually update your data from here in New Zealand, or upload your data, that is, and just head onto their website and you'll get some details as to how to do that in case you're interested. Next week on the podcast, I have a returning guest.

01:00:47
Guillame Millet and we talk about sex differences in endurance athletes and performance. So I think you're really going to love that. Until next week though, you can catch me over on threads, Instagram and Twitter @mikkiwilliden, Facebook @mikkiwillidennutrition. Head to my website, mikkiwilliden.com and book a one-on-one call with me. All right, team, you have the best week. See you later.