Casey Means is the Chief Medical Officer and co-founder of Levels, a health technology company with the mission of reversing the world’s metabolic health crisis. She has been on the faculty at Stanford University, lecturing on metabolic health and health technology. She received her undergraduate degree with honors from Stanford, where she was President of her class. She graduated from Stanford Medical School and trained in Head & Neck Surgery at Oregon Health and Science University.
Calley Means is a Co-Founder of TrueMed and an advocate for policy to change health incentives. He is a graduate of Stanford and Harvard Business School.
Below, co-authors Casey and Calley share five key insights from their new book, Good Energy: The Surprising Connection Between Metabolism and Limitless Health. Listen to the audio version—read by Casey—in the Next Big Idea App.
1. “Optimization culture” and the longevity conversations have lost their way.
We’re missing the forest for the trees in the longevity, diet, and health-optimization conversation, and it is limiting us from truly thriving on the deepest level. You might have heard advice like “cold plunge for 12 minutes a week to build brown fat,” “do 150 minutes of zone two training per week,” or “try a carnivore diet.” Despite endless noise and strong opinions in the health and fitness space, however, Americans are getting sicker, fatter, more depressed, and more infertile every year. Fewer than 25 percent of Americans meet basic physical activity guidelines, and chronic disease and obesity rates are going up every year. What’s going on?
The reality is that everyone being confused about the right strategy for health is the goal. Our healthcare system profits off our long-term illness and symptoms and benefits from us being divorced from our common sense and joyful connection with our bodies and our environment. The answer to health is not about endless protocols and bio-hacking optimizations. Science is showing us clearly that the thing that leads to nearly every chronic disease in the modern Western world is metabolic dysfunction, which is easy to test and easy to improve. Yet, most doctors don’t understand it. This keeps us in a game of playing whack-a-mole symptom management medicine. We do not get to the root cause. This is good for the bottom line of the healthcare business but not good for patients.
Metabolism refers to the set of cellular mechanisms that transform food into energy that can power every cell in the body. It’s converting the 70 metric tons of food we take in our lifetimes to energy that our body can use to power everything. It is the foundation of all health because, without energy, nothing works. The most recent research shows that in 93 percent of Americans, metabolism is not working properly, and the body is underpowered—this is called Bad Energy.
You might not have thought much about whether you have Good Energy or not. When cellular energy production is working well, you don’t have to “think” about it or be conscious of it. It just is. Your body has an exquisite set of mechanisms that make Good Energy happen every second of every day; these cellular mechanisms create sustained and balanced energy, distribute it to every cell in your body, and clean up the residues from the process that would otherwise clog up the system.
When you hold the keys to this one critical bodily process, you can be an outlier—a truly positive kind of outlier. You can feel vital and enlivened and function with clarity of mind. You can enjoy a balanced weight, a pain-free body, healthy skin, and a stable mood. If you’re of childbearing age and hoping to have kids, you can enjoy the natural state of fertility that is your birthright. If you’re getting older, you can live relieved of the nagging anxiety that precipitous physical or mental decline awaits you or a disease that “runs in the family.”
The secret to holding the keys to Good Energy is simpler than we’ve been led to believe, and it does not entail complicated protocols, specializations, prescription medicines, or fancy or expensive treatments. This is the re-frame we need to shift the trajectory of American health: the huge misconception that being healthy is complicated. It’s not, but more than $10 trillion dollars of industry want you to think it is.
2. The future of health must be about connection, not silos.
The average American sees over 20 different types of doctors before they die. There are over 100 medical specialties. This increased specialization has tracked with worse outcomes.
The siloed view of diseases, symptoms, and specialists harms us because it fails to recognize the connected nature of the body, as well as the body’s connection to everything around it, from sunlight to food to soil to air. In ignoring the root causes of what actually leads to disease inside our cells, we have relentlessly focused on symptoms, which are merely the manifestation of cellular dysfunction. We ignore the cellular dysfunction and confuse the symptoms for the disease—to disastrous effect. This is spending your life weeding but never pulling the weed out from the roots. It’s also akin to spending your life mopping up the floor but never turning off the faucet. This is why the more we spend on American healthcare managing symptoms, the sicker we’re getting every year. We’re not focused on the core physiology, like metabolic dysfunction, that connects most chronic diseases in the modern world.
“We ignore the cellular dysfunction and confuse the symptoms for the disease—to disastrous effect.”
The future of health is about connection—specifically connection in four areas. First is the connection between the root causes of our symptoms and diseases. Our ailments are connected rather than siloed. Research is only recently allowing us to see this clearly, and now we have tools and technology—such as at-home labs, continuous glucose monitors, wearables, and more—to truly understand what’s happening inside our cells at the molecular level and realize how interconnected everything is.
Second is the connection between our bodies and the natural world. Think about the sun, soil, food, and water. As we crush land and ocean biodiversity with industrial agriculture and fishing, we create toxic and nutrient-depleted food that directly hurts our metabolism. As we orient toward a Good Energy framework, we can necessarily heal our cells and the earth, which are inextricably interlinked.
Third is the connection between humans. The connection we have in deep trusting relationships is the foundation for nervous system regulation, and currently, loneliness is killing us.
Fourth and lastly is the connection between life and death. We must recognize this as an endless cycle of which we are a part. We can make conscious efforts to train our brains to see and appreciate the majesty and grandeur of nature and life cycles, with animals, harvests, the sun, the moon, birth, and death.
3. Don’t trust doctors, trust yourself.
There is a lot of noise in the health space. I implore you to ignore it and focus on two things.
First, focus on your own body awareness. Listen and understand what your body is trying to tell you through your symptoms. Second, focus on your own personal biomarkers and lab tests. Simply focusing on these two things can give you a clear readout of how your health is doing and whether your choices and strategies are working. It cuts through all the warring noise of the food, nutrition, fitness, and health space.
Now is the most exciting time in history because we have the tools and technology to “hear” our own bodies, plus we have access to the canon of basic science to understand what our cells and bodies need to function, plus access to the best of global traditional and spiritual wisdom. Everyone can benefit from becoming knowledgeable about these areas to capitalize on this incredible moment in history. If we simply track and understand basic biomarkers like fasting glucose, triglycerides, hemoglobin a1c, blood pressure, HDL cholesterol, apo B, uric acid, C-reactive protein, liver function tests, fasting insulin, vitamin D, and a few others a few times per year, we are well on our way to really cutting through the noise of health and gaining clarity on whether our strategies are working.
The “best hospitals in the world” are teaching and practicing bad medicine; they are all abjectly failing at preventing and reversing disease. The “diet wars” and “exercise wars” are intended to confuse us. Should you eat a vegan, paleo, or Mediterranean diet, do more zone two, strength training, or Pilates? The more studies that get published on nutrition and exercise, the sicker and heavier Americans are getting. Obesity rates are tracking in parallel with per capita expenditure on fitness. Americans are more confused than ever about what to do and what works.
“Many doctors are doing the wrong things, pushing pills and interventions when an ultra-aggressive stance on diet and behavior would do far more for the patient in front of them.”
I deeply respect doctors, but I want to be very clear on something: many doctors are doing the wrong things, pushing pills and interventions when an ultra-aggressive stance on diet and behavior would do far more for the patient in front of them. Suicide and burnout rates are astronomical in health care, with approximately 400 doctors per year killing themselves. That’s equivalent to about four medical school graduating classes just dropping dead every year by their own hand. Doctors have twice the rate of suicide as the general population. Based on my own experience with depression as a young surgeon, a contributor to this phenomenon is an insidious spiritual crisis about the efficacy of our work. There is also a sense of being trapped in a system that is not working but seems too big to change or escape.
The good news is that our system can be fixed, and the crisis can end. The answers come from listening to your body and what it’s telling you, recognizing symptoms are a gift, and putting into practice simple health solutions.
4. The health solutions are simple.
Seven primary pillars affect your health: Food, Sleep, Movement, Stress Management, Environmental Toxins, Light, and Temperature. When we take stock of these and improve them, we get radically healthier.
One of the most important solutions is food. You can get beyond the diet wars with my five-in, three-out philosophy. To support your metabolic health, prioritize eating five different food categories, each providing key metabolic information for your cells. These five categories are micronutrients and antioxidants, omega-3 fatty acids, probiotics, protein, and fiber.
Then, you remove the three categories of foods that I call the “unholy trinity.” These three are refined added sugar, refined industrial vegetable or seed oils, and refined grains. If you want to learn how to stock your kitchen and what to eat, simply learn a few of your favorite sources of each of the five metabolic healthy categories of foods and mix and match these to create your meals.
Another Good Energy tip is to find ways to build low-grade movement into the fabric of our everyday lives. We’re obsessed with exercise in our culture, yet we’re amongst the fattest in the world. We need to embrace the idea that a body in motion throughout the whole day—not just for an hour a day during a workout—has healthier metabolic physiology.
5. Fearlessness is the highest form of Good Energy.
It is our most fundamental job as humans to take stock of the persistent fear triggers in our lives and work to heal them or limit their exposure. This is more than a physical or mental health journey; it’s a spiritual journey. Why does this matter? Fear and stress crush all components of metabolic health on the cellular level.
“Western culture has sterilized and de-sanctified the awe-inspiring mysteries of the human experience.”
In the span of just a century, we now have the technological capability to be exposed to the threats facing any person, anywhere in the world, 24 hours a day, all live-streamed to a screen in our hands, generating unprecedented chronic stress and fear. Hundreds of millions of people in the U.S. are now suffering from depression, suicide, and drug abuse. Close to 40 percent of U.S. women report a diagnosis of depression in their lifetimes, and a full third of Americans report an anxiety disorder in their lifetime. Three-quarters of young Americans feel unsafe daily. It’s easy to gloss over these statistics, but take a moment to take them in: in a time when life expectancy and standard of living seem to be higher than ever, hundreds of millions of people in the wealthiest country in human history—including children—are suffering from sadness, fear, and profound stress. There has always been suffering in the world, but now we can see exponentially more of it than ever, all at once, on screens we hold in our beds and at the dinner table.
Western culture has sterilized and de-sanctified the awe-inspiring mysteries of the human experience, has separated our lives from nature, and has robbed the health journey of joy and awe. A return to a deep examination of our miraculous opportunity of being alive is the critical missing piece of the health conversation.
To listen to the audio version read by co-author Casey Means, download the Next Big Idea App today:
