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george grombacher 0:12
the time is right to time is now welcome to life blood be well welcome our guests strong and powerful new sheme A shimmy welcome machine. Thank you for having me. Super excited to have you on machine is the founder and CEO of January their seed stage precision health tech company that harnesses the power of artificial intelligence to prevent, predict, postpone and manage chronic disease. Your Shane, tell us a little bit about your personalized more about your work and why you do what you do.

Noosheen Hashemi 0:43
Okay, well, I’m a tech veteran, angel investor, I’ve been a philanthropist, wife, mother of two amazing kids, daughter, sister, social entrepreneur, and entrepreneur, I’m really proud of what we’re doing in January, right now.

Unknown Speaker 0:59
We are

Unknown Speaker 1:02
helping people on the diabetes spectrum, get to know their bodies really, really well. And to fine tune their bodies to be able to manage to be able to really optimize their lifestyle, to feel good, and to improve their underlying conditions and have, you know, be more metabolically healthy. And I do this, because I’m really, really obsessed with prevention, some of the my own health journey, but also those of my parents, some of my family members, I think finding out too late, it’s really, you know, doesn’t leave you with many choices, the trade offs are really poor. Basically, the later you find out the poor your trade offs, the earlier you find out, the more choices you have. So if you, you know, if you mind your diet a little bit in your old age, you don’t have to, like never eat salt, you know, you don’t have to get sort of heart disease to then never be able to enjoy something. So I really believe in moderation and kind of going starting a little bit early, be you know, make prevention, a model. And I know it’s hard. But I think these days with existence of wearables, we’re able to see inside our bodies, and we can see how things are going. So we have very, very specific things to react to, and very specific things to improve so that we can take prevention, not as a just a generic concept, but as a very, very specific thing that we can do to help ourselves live better and have better health span.

Unknown Speaker 2:39
I love it. So I certainly I’m pretty sure that we have an absolute I was gonna say pandemic endemic, huge, massive problem with with with with people being overweight, obese and diabetes, but give me the stats or Yeah, what, what, what you’re focused on?

Unknown Speaker 3:01
Yeah, so obesity, 38% of the population. 34 million people with diabetes. 22% of them aren’t even diagnosed. So talk about a pandemic that can come in and take your life when you don’t even know you have an underlying condition. Something like 88 million people have pre diabetes. 84% of them don’t even know it, they have not been diagnosed. It’s not part of just unless you get sick and go in and complain, no one’s even checking to see if you may be having diabetes or or pre diabetes. So half of the adult US population has diabetes or prediabetes today, so 122 million people. And we know that people with pre diabetes, if they don’t do something about it, they can develop diabetes. We know we know exactly, because we know of the diabetes prevention study 2002 showed that 50% of the people unless they took on a serious intervention, which in that case meant weight loss would end up with diabetes. So it’s a pretty real thing. And even since I’ve started the numbers have have gone up and you know, obesity is going up everywhere in the world. And diabetes is correlated with it. So it’s really not just a problem in the United States, but it’s a problem across the world. And it’s a it’s a problem that affects us in so many ways that we don’t even realize Of course common comorbidities are really a big problem. Usually you don’t just get one illness you get one or less as you get sick or you pick up other ones. You know there are a lot of people not even qualifying right now for the Armed Forces because they are have obesity and they you know it it really affects us in so many ways. It affects us national defense, it affects us in in many ways. And what a product like ours does, it really helps people understand And their bodies and learn. For example, what are the foods that are spiking their blood sugar in a big way how to hack those foods either eat them a little differently or replace them with other foods. It helps them understand how much fiber they’re eating fiber is essential to health fibers essential to to staving off inflammation and chronic diseases and our ancestral diets had like 150 grams of fiber a day, and the average Americans is eating 10 to 15 grams of fiber a day. So you do have a lot of inflammation you have a lot of you have a lot of problems. So our product helps you figure out how much fiber you’re eating, recommends that you eat more, suggests ways that you can add fiber to your food, it tells you when and how much to workout to be active. It teaches you intermittent fasting, and so many other things. So we’re very focused on a helping people learn about their bodies be giving them very specific levers to pull to tune their lifestyle. And three to live with joy in the real world as in, do not deprive people and do not tell them, you know, just you know, my solution is you just drop 50 pounds, that’s it, I have no other solution for you, or no Refined Flour, no refined sugar, lots of vegetables walk 10,000 steps, well, not everyone can do that. They don’t have the time to do that. They don’t necessarily have the training to do that. I’ve struggled with that myself. I know it’s really a challenge to to be able to act on any of those recommendations because they’re super generic. They’re super draconian, you know, just drop 25 pounds, everything well, workout is true. It’s true that if you drop weight, all of your markers will look better. That’s a fact. But that generic solution doesn’t fit for everyone. And I think we need to give people more specific things that can do as opposed to just these these kind of one size fits all advice that people then find. They can’t keep up with.

Unknown Speaker 7:07
Amen. Half of the population see the diabetic or pre diabetic? If, if I do become diabetic? Is that forever? Or can I become no longer diabetic?

Unknown Speaker 7:20
Well, it really depends what stage you’re at. I think if you if you if you have diabetes, and you have advanced diabetes, and you you’re you’re you’ve lost pancreas function, and you have comorbidities, that’s going to be very difficult to reverse. You can’t if you’re if your pancreas is not producing insulin, or not producing enough of it or not producing it fast enough. You can’t that’s not something you can really reverse. But in terms of very superficially looking at diabetes, so basically, they the current standard of care says that if you have if you’re over a one C of 5.7, you have you’re in pre diabetes range. And if you’re over a once you have 6.5, you’re in the diabetes range. The fact is we are on spectrum people, yes, your blood test does just say that, but a one C is a 90 day average number, but we do we have seen people, you know, somebody could go under extreme stress into a hospital and have blood glucose of 202 days in a row, which would qualify you as someone with diabetes, but that doesn’t mean they really have diabetes. So there there’s a little bit of gray around here. But in terms of if you just get diabetes, or you few have you know, is it possible to improve insulin sensitivity? 100%? Yes, there are several things, for example, and intervention is the combination of intermittent fasting and calorie restriction. So essentially, you’re eating you’re increasing your fasting period versus your eating period. You’ve heard people say about 16 and eight you know, some people are eating 16 hours a day and they’re just not eating for eight hours when they’re sleeping. So you could slowly begin to increase that increase that time where you’re not eating. So you could slowly go to you know, not eating for nine hours not eating for 10 not eating for 11 etc. And the great thing George is that it doesn’t cost any money. It just takes incredible willpower and it also with products like January you learn how to fast because you can see your your blood sugar is still in the safe range, it’s okay to fast you’re not gonna die. nothing terrible is gonna happen here. And if you don’t have diabetes, if your blood sugar goes down a little bit, nothing terrible happens. Of course, if you have type one diabetes, you don’t want to have have have that happen, right? But So basically, if you don’t have advanced diabetes, you can the combination of for example, intermittent fast And then so increasing your fasting period and then restricting your calories. So not great if you’re doing you know, 16 hour fasts or 14 hour fasts or 12 hour fasts and then having two pizzas, that’s not great. But if you do intermittent fasting, and you do calorie restriction, which by the way happens naturally because your stomach shrinks, and you just don’t feel like eating that much. But if you hold to that, and if you are, you know, if you exercise, practice mindful eating, and just because you always got together with your friends, you always have many pizzas that you’re going to do that, again, if you really are listening to your body, and you do exercise, your, you know, you practice your intermittent fasting with calorie restriction, your underlying physiology does, in fact, improve and you can become, you know, it can improve your insulin sensitivity. So, yes, in some ways, you can then take a blood test, you know, you’re and see that your agency has gone down, and by the standard of care definition, you’re no longer diabetic. But if you have advanced in diabetes, and you are now receiving some kind of assistance, like some kind of an insulin assistance, then then reversing is becoming harder and harder. And that stage Got it?

Unknown Speaker 11:17
Well, that certainly does make sense. So 88 million people are pre diabetic, let’s just maybe focus on that number. Because that’s, that’s, that’s a pretty big, that’s a massive number of people. And I always am, I want to be kind and to be sensitive. I also fancy myself a pragmatic person. It’s, it’s like a boiling frog, right? The frog doesn’t realize that it’s being cooked to death. Well, if I am pre diabetic, and I am 88 million people, if I’m one of those people, is it’s a function of I don’t understand mindful eating, I don’t understand intermittent fasting, I don’t get exercise, or I understand it, I’m just choosing not to do it. How I I’m looking at are thinking about January as a way to, for lack of a better term gamify this whole process. So to make it a lot more interactive than simply Okay, I’m now going to be mindful about eating. Okay, now that now I’m fast aimed? What are your thoughts on that?

Unknown Speaker 12:28
There are a number of things. One is certainly the the education is definitely an issue I have. I have people seek me out, you know, if I’m in a social setting, or something like that, sometimes people come to me and want to talk to me quietly telling me that they have diabetes, or they’ve just been diagnosed with diabetes, what will they do? And I said to one of them, well, what are you eating for breakfast? And he said, This person has a master’s degree, they hold a very, very high position in a, you know, very unfortunate 10 company. And they said, Well, I have orange juice, and toast and butter and jam. And I said, I said, well, orange juice is one of the highest kind of glycemic, high high glycemic index foods that you could possibly eat. And he said, but especially and so, so. So I think so I think education is definitely part of it. People just don’t literally realize that fruit fruit just fruit sounds so innocent. And we love fruit because it tastes good because also fruit is good for you, because as a lot of fiber, but we have to recognize a certain foods like some watermelon, it’s just crap for most people. Now, I want to say I’m coming from a company where we believe in, you know, we are trying to cater to n of one meaning just one person says highly, highly personalized to you. Most people though we will, I will reckon that most people will have a bit of a spike on a high sugar melon, such as watermelon. And, like orange juice, just as well known that if you give it to many, many different people, under many, many differences or circumstances most people will spike on on orange juice. They had it by itself. So I think part of it is education, just understanding what spikes you. somebody walked over to my co founder Mike Snyder, who has diabetes and said Mike, I’m eating really healthy just salad and fish salad and fish salad and fish all the time. Why am I spiking? I’m wearing a CGM. It shows me I’m spiking and Mike said what else are you eating with it? You said nothing just salad and fish salad and fish. And Mike said Well okay, break it down. For me. It’s fish like how are you cooking it? What have you anyway, the guy was drenching his salad and balsamic vinegar. And that’s where that’s where the spike was coming from. So I think part of it is literally just education people just don’t a lot of food seem totally in Sound like what’s wrong with oatmeal? It’s supposed to be good for you. It’s high fiber supposed to lower your cholesterol. Yes, but it will spike the hell out of your sugar. So I think what we want to do is educate people more. First of all, we have to get away from these one size fits all kind of silver bullet kind of things. So we have to recognize that, you know, certain things, yes, one food may have great fiber, that’s amazing. But they may spike your blood sugar or you take a Staton to lower your cholesterol, but it’s going to increase your risk for diabetes, there are no really free you need to learn that the real you need to learn your body. And then you need to learn the trade offs between things to decide if this is the right thing for you to do or not. So why do we have 88 million people with pre diabetes? Well, we do have high obesity, that’s a factor. We do have very, very little education around food. For example, medical schools offer very little nutrition information to doctors. So doctors are not used to even discussing nutrition with people. So we’re not really pulling that prevention lever. Very much foods are not labeled. That’s really a big deal. Only chain restaurant foods and grocery items are labeled. So everything you eat in your mom and pop shop is not labeled. So people don’t know that this milkshake they’re about to have has 1200 calories, 1200 calories, I saw this myself actually at a chain restaurant, at a burger joint, it said apple pie milkshake. And I thought that just sounds phenomenal. But but they did report the calories. And once I saw it was 1200 calories, I thought, okay, I’ll take a sip from my son’s milkshake, I’m not gonna order a whole one for myself. So I don’t have to, you know, deny myself but I don’t need to drink a whole milkshake.

Unknown Speaker 16:46
So, so So what else, a lot of our foods, frankly, are created for just, they’re not, you know, as you know, fuel foods, they’re there’s food as entertainment in our country. And so a lot of our packaged foods are at fault. They’re packaged foods have low fiber, and they are high in salt, sugar and fat. So I think that’s another thing that’s making us sick, there’s no question that our food is making us sick. In fact, the food industry is committed to, you know, what’s called bliss point, as you know, just the perfect combination of salt, fat and sugar to keep us addicted to foods. So too much of our foods are getting made in the lab. And so, you know, we ran a clinical trial when we were developing our initial algorithm. And it showed that the amount of fiber people were eating was was, was exactly the opposite. You know, it was it was exactly the opposite of income that they had. So so the less the poorer you are in this country, those fiber you’re eating. And this is another one of the major reasons why we’re seeing this kind of, you know, the client in our health in our society. So there are many, many factors that we can many of them are societal factors that are structural factors that need to be solved. From a structural standpoint, we can label foods, we can increase. We can increase nutrition, education, in college, in medical schools, we can give funding for nutrition science, you know, people are still confused, is caffeine, good or bad? is chocolate good or bad? Is like we should we should invest in in food science and have objective reporting scientific reporting on some of these things? The answer is it really depends on your particular circumstances. But I think we do. Too often we’ve been sold a bill of goods, by big food as well. So I think they need to be held accountable. So there are lots of things that we can do that are that are that are societal. And I think that incentives that insurance companies are giving people for living healthier is brilliant incentives work, they just do. I guess my first love before, before health was economics, incentives work period. So if we can, if we can, you know, encourage people to pay attention, just the same way a credit score works to get you to drive that to get you to, you know, be responsible with your payments, just the way that you are, you know, people put trackers on cars to watch for speed and things like that. Once you get more data, you can close the human behavior loop and right now, right now today with heart rate monitors like Apple Watch, Fitbit will grow with continuous glucose monitors. We already have enough data to be able to see what’s going on inside people’s bodies. And then if we add food, which is what is January’s gift is we have made food into action. about health data, we have labeled foods, 16 million foods and Yelp, we have labeled those. We have also added glycemic index and glycemic load to foods. So once you add that data, and you can track where people are eating, you can immediately dial basically, you can see what foods are spiking them, try to hack those, you can figure out how to deal with those, you know, one of the brilliant things that our company does, because we’re an AI company, we can, we can essentially predict what the person’s glycemic response is going to be. But blood sugar response is going to be any food after four days of training. And we can tell them, yeah, it is really, it is really phenomenal, we can also tell them what impact it would have on their blood sugar, if they walk, let’s say 10 minutes or 25 minutes, so they can see exactly what they need to do to bring that blood sugar back into a healthy range. So we have the information this can all be gamified used by payers by by insurers very, very easily. So I think that’s another lever that can be used by the private sector, because the answer is somewhere between the private sector and government policies. You know, those are the biggest levers and philanthropies important but never as big as the other two. So how does January actually work? So you, you go to our website, january.ai. And you take a telemedicine questionnaire for a visit with a doctor who determines if you can benefit from getting a continuous glucose monitor. And then you go through a transaction, you receive continuous glucose monitors, you need to have a heart rate monitor to use the January product. So you need to currently wear either an apple watch or a Fitbit.

Unknown Speaker 21:47
And then you download the app once you’ve received your cgms. And you hook up your your two hardware pieces that you have your CGM and your heart rate with the January app, you start logging your food after four days of baseline information. So we just want you to live totally normally the way you normally live anything that you normally do for the first four days so that we can figure out what your baseline is essentially. And then we get we start a series of experimentations that, that help people experientially figure out what works for them and doesn’t work for them. One of the one of the experiments, for example, is a breakfast experiment, where for four days, you’re eating your normal breakfast, whatever it is, so we know what that is. And then we do give you a sugar shot, which is 75 grams of sugar, it’s almost like to Coca Cola, I think Coca Cola has what 45 grams of sugar or something like that this is 75 grams of sugar. And so you take that so we can see the impact on your blood sugar. And then another day, we suggest that you make a very low glycemic load breakfast. So something like eggs with cheese and you know, so it’s basically fiber protein and, and fat kind of breakfast, and then we compare these breakfast for you. So this is your breakfast. This is pure sugar. And this is a very, very low glycemic index breakfast. And you can see if your breakfast resembles more, which one it resembles more. And you can see that the differences between these things on your blood sugar so so we’re all about experiential learning rather than tell you talk down at you talk at you patronize you give you random generic advice is like, hey, figure it out for yourself. Let’s see the breakfast you’re eating? How does it compare to pure sugar? How does it compare to a very low carb breakfast? And so you can figure out what do you need to tune? And how are you, you’re able to do that just by the heart rate monitor. We’re able to do that with a heart rate monitor and a continuous glucose monitor. But how we can do that. But how we can do that is three and a half years of research. That’s how we do that. So we we start we set out specifically It was our vision to not just throw CGM onto people. So everyone knows the jams are very, very cool. continuous glucose monitors are a fantastic technology. They’ve been around for 20 years or more actually. And they are really magical themselves. You put it on and you can see what’s happening to your blood sugar up and down. That’s great. That’s fantastic. Is it enough? No, it actually isn’t enough because you don’t actually know what’s causing things to go up and down. And that’s where the data synthesis and analysis comes in. That’s where January comes in. So we feel that at least two other pieces of data you need to know is is people’s heart rate and what people are eating because if you know what people are eating you also knowledge fiber they’re eating fiber is critical to glycemic response. It’s critical. So it’s been empirically proven that you can improve your blood sugar response, the more five if you have more fiber in your body from the last 24 hours. So that’s really, really, really important. So what we have done is besides essentially building a huge

Unknown Speaker 25:18
database of foods, including the foods in Yelp, and you know, recipes, millions of recipes, etc, and then labeling these foods, and then adding the glycemic index and glycemic load food labels, then running a clinical trial for over 1000 people, including 250 people with type two diabetes, and then creating our prediction models. Turning then, so so how we can do this? How can we predict because we’ve gone through all this work to be able to say that for George, this is how he’s going to respond to a glass of Chardonnay. Like we’ve actually seen this in people where somebody can spike on one glass of Chardonnay, somebody doesn’t spike until they have three glasses of Chardonnay. And it could be that the person with regards to Chinese always eating cheese with with when they’re having Chardonnay, and the other person is just sipping on Chardonnay by itself. So we can see these things. And we can we can help people understand how much of something to have. So how do we do it? It’s our AI capability. It’s our it’s our primary differentiator differentiator, where we’re able to essentially model for you specifically how you’re going to respond to any of the 16 million foods in our in our database. And with that knowledge, you can decide whether to take that next bite or not, you know what you’re going to throw into your grocery basket, how much of something you can enjoy. So again, we don’t believe that you should deprive people, we don’t think that’s sustainable. We don’t think putting people on a keto diet for five years is sustainable, nor is it healthy. We think it’s important that people live in real world with real foods, because they’re going to get invited to birthday parties, and they’re going to go to the restaurant, and they’re going to they’re going to go to a potluck, and that people are social animals, they’re not going to just, you know, eat from an encyclopedia. So I think they need to be able to live in the real world. But I say that because there are some products out there that just that are encyclopedic. Or at the end, you go through all the all the stuff that they put rigamarole they put you on take this blood test, do that microbiome test, at the end say is eat these things and don’t eat these 10 things. I don’t find that very useful. I mean, it’s informative, for sure. But what do I did today? I’m sitting at a cafe with my friend, should I eat it or not? You know, where was my list? So we sort of see January as a way of just helping you live in real world every day.

Unknown Speaker 27:42
It’s got to fit into our lives, otherwise, it’s not gonna work. Right, Shane? Love it. Lucien, thank you so much for coming on. Where can people learn more about you? And how can we sign up with January,

Unknown Speaker 27:53
they can learn [email protected]. We also have a wonderful log that we keep working on and improving. So look for more on that as well.

Unknown Speaker 28:04
Excellent. Well, if you enjoyed this as much as I did, showing, you’re showing your appreciation and share today’s episode with somebody else who appreciates good ideas, go to january.ai and get involved with the season of me and start really paying attention to your health and your life and solution that actually fits into it. So thanksgiving to shame. Thank you so much. It’s a pleasure to meet you. And until next time, keep fighting the good fight. We’re all in this together.