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Every living organism depends on energy. As humans, our energy production starts at the cellular level and impacts every action and decision we make. With over 30 trillion cells in your body, it’s paramount that your cells produce energy efficiently and effectively. When your cells act in accordance with their natural state, your body begins to operate and function at an optimal metabolic level. A well-functioning metabolism is the cornerstone of foundational health. And, let’s be honest, that is why you’re here.

Throughout this challenge, you’ve been gaining foundational insights into your metabolic health. Our hope is that your gathered insights propel you further into optimizing your metabolic state. Hopefully, one of these insights has been the understanding that the single most important factor in improving your metabolic health is through healthy behavior changes. Without integrating positive metabolic behaviors, our body will lack the tools necessary to process energy efficiently.

From research over the past few decades, we know that the way to better health is through better behavior. As you have been able to witness, the CGM can really drive and promote healthy behavior changes. The implementation of micro-strategies in an effort to lower your blood glucose can have a profound effect on your metabolic health. The CGM not only brings your attention and awareness to your metabolic and physiological states, but also assists greatly in future decision making.

In our modern world, disruptions and internal imbalances are far too common. And sadly, instead of addressing and mending these disrupted internal states, we choose to exist and function within the path of least resistance. We are quick to dismiss any notion that we are sleep deprived, emotionally or physically stressed, under or over nourished, and energy depleted. For the past several weeks, you’ve been able to witness that metabolic health is not a biometric that suddenly appears. Metabolic health takes time, consistency, effort, and attention to your actions.

Statistically speaking, you or someone you know is dealing with unfavorable blood glucose and insulin levels. As a collective, we are ignoring the basics of fundamental health. The front row seat of the temperament into your own blood glucose levels gives you a glimpse of why metabolic health is such a rampant problem. By human nature, we tend to have dissociative tendencies toward things we cannot observe or measure. It’s widely debated about who said the line “what can be measured, can be managed”, but nonetheless a very sound and true statement.

Lifestyles have drastically changed over the last 100 years, but human DNA remains the same. In fact, researchers estimate that 99% of our genetic makeup hasn’t changed in over 10,000 years. Taking this into account, we are equipped with biological hardware that is intended to be in accordance with an environment that looks very different from that of today. While there is not a solution for accelerating our genetic material to play catch up, there are solutions to how we can best manage, promote, and practice metabolic behaviors for living an energetic life that is disease-free.

When your metabolism is functioning properly, everything in your body begins working better. The primary function of your metabolism is to take inputs such as food and successfully create outputs such as energy. In addition, a well-functioning metabolism will also support your organs, tissues, muscles, and cellular processes. As you’ve learned, your metabolism is not a simple X=Y process. You encounter a number of variables every day that greatly influence your metabolic pathways. The CGM is your equalizer for increasing the efficiency and effectiveness of your metabolism.

This section covers your secondary metabolic levers, intermittent fasting, and how using a CGM can positively influence your decision making and behaviors.

As you continue improving your core metabolic levers, there are a few other important variables to consider for optimizing your metabolic health. Dr. Casey Means, researcher and co-founder of Levels suggests that your microbiome, environmental toxin exposure, and micronutrient status are additional metabolic levers worth considerable attention. These metabolic levers are not direct influencers to your blood glucose levels as those previously discussed but contribute significantly to the overall state of your metabolism. For this reason, we will refer to these as your secondary metabolic levers. When pursuing optimal metabolic health, having the big picture in mind will have the greatest impact. The secondary metabolic levers will take time and consistency to develop, but their contribution to your metabolic health will be significant.

Your microbiome is an integral piece of your metabolism. With the highest populations of bacteria and cells residing within your gut, the number is so staggering that this part of your body can be thought of as its own ecological universe. In fact, your gastrointestinal tract has its very own nervous system, called the Enteric Nervous System (ENS), which is also known as “The Second Brain”. Your ENS is rich in nerve cells and constantly communicates with your first brain.

There are many functions of the digestive system and collectively your microbiome influences your metabolic health, your weight, your mental state, your sleep, your energy, and your immune system. There are over 100 trillion microorganisms residing in your gut and these help metabolize and derive energy from your food sources.

Substantial research and data support a direct link between your gut microbiome and blood glucose metabolism. For this reason, your gut microbiome is another metabolic lever to consider for optimizing your metabolic health.

A 2015 study from the Weizmann Institute measured postprandial glucose responses (PPGR) of 800 healthy individuals wearing continuous glucose monitors for one week. The study gathered data from 46,898 meals and found a wide range of individual glycemic responses from identical meals. This finding was momentous and revolutionized how we think about personalized nutrition today. The study highlights the gut microbiome as the primary factor for the glycemic variance amongst the individuals.

Not only does this finding confirm personalized nutrition for metabolic health, but it also demonstrates the association of our microbial matter and blood glucose.

To begin promoting and establishing healthy gut microbes and colonies, adopt a dietary strategy that includes nutrients for your gut microbiome. For example, dietary fibers and resistant starches are known nutrients that increase your short-chain-fatty-acids (SCFAs) production. Through a gut microbial process of bacterial fermentation, your bacteria produces propionate, butyrate, acetate, iso-butyrate, and lactate. These collectively make up the SCFAs and are vital for metabolic health. An increase in SCFA production is shown to improve blood-glucose regulation. In fact, this study found a direct correlation between type 2 diabetics and decreased SCFA production.

To begin increasing your SCFA production focus on whole foods, dietary fibers, resistant starches, and exercise. Additionally, eliminate gut irritants such as refined sugars and starches, seed oils, processed foods, gluten, processed dairy, and in some cases lectin.

Let’s be honest, our modern environments are counter-productive to our biological makeup. In a very short amount of time, the introduction of an excessive amount of environmental toxins into our natural world is unprecedented. A large amount of research indicates that environmental toxins have the ability to disrupt blood glucose, induce obesity, and potentially cause type 2 diabetes. In fact, the evidence pointing directly to developing type 2 diabetes from environmental toxins is so strong that the term diabetogensis now used for classifying various chemical disruptors.

While correlation does not prove causation, we can draw strong inferences about the distinct parallels from the graph. Bolstering the diabetogens theory, the researchers highlighted that certain obese individuals showed no signs of diabetogens in their body, therefore, this reduced their risks of developing diabetes. This finding is significant because it removes the “if obese, then diabetes” correlation. Thus, giving more validity to the study and linking disrupted blood glucose to environmental toxins.

The dysregulated blood glucose from environmental toxins happens on several levels. Broadly speaking, the study attributed decreased insulin production and impared insulin sensitivity as the primary causes.

Estimates of Contribution of Key Diabetogens to Diabetes - table provided by this study.

Toxin | % of DiabetesArsenic | 18BPA | 14Dioxins | 4OCPs | 3PCBs | 13Phthalates | 22PAHs | 16

The dysregulated blood glucose from environmental toxins happens on several levels. Broadly speaking, the study attributed decreased insulin production and impaired insulin sensitivity as the primary causes. Specifically, arsenic damages the pancreatic beta-cells, resulting in decreased insulin production. And, BPA induces insulin resistance by blocking the insulin receptor sites at the cells.

What to do:

As you continue building your optimal metabolic body, the awareness of environmental toxins inducing poor metabolic health needs to be established. There are very simple and straightforward ways to make sure your metabolic processes are not jeopardized by environmental toxins.

Your micronutrient status may not be obvious when it comes to glucose metabolism. However, several key micronutrients are at play for effective glucose metabolism and blood glucose regulation. Several studies indicate that micronutrient deficiencies are common among type-2 diabetics. Micronutrients are vital because of their involvement in mitochondrial support, protein signaling, enzyme activation, anti-inflammatory markers, and glucose and lipid metabolism.

The majority of Americans do not meet their micronutrient requirements. It’s no surprise given that the standard diet is energy-rich and nutrient-depleted. Furthermore, the foods that should bolster your micronutrient status are being grown in unfavorable conditions, causing these “health foods” to be empty in their nutrients. Common farming practices today differ dramatically from 50 years ago. And because of this destruction to our soil, the foods of today are depleted in micronutrients. Below are the most prevalent micronutrients involved with glucose metabolism.

As you continue building your optimal metabolic state, adding the micronutrient component to your metabolic toolbox is something we highly recommended. The micronutrient status of your body is more of a long-term approach for glucose metabolism. Again, the emphasis should be on building a functional metabolic body over time not overnight.

Use the tips below to begin increasing your overall micronutrient status

Intermittent Fasting/Time-Restricted Feeding -

For well over 100 years now, fasting techniques have been shown to have the potential to reverse and cure type 2 diabetes, obesity, and blood glucose abnormalities. In fact, the benefits of fasting are so well established that ~500 years ago the famous healer Paracelsus referred to fasting as “the physician within.” Currently, there are many ways to integrate and practice various fasting techniques. One of the more studied and notable fasting techniques for promoting blood glucose stabilization, insulin sensitivity, and weight loss is intermittent fasting, also known as time-restricted feeding.

Intermittent fasting should not be confused with caloric restriction or deprivation. Oftentimes, these two concepts are lumped together and they differ greatly. Intermittent fasting and time-restricted feeding is based on controlling the clock, while caloric restriction controls the calories. Restricting calories will inevitably fail because it increases your levels of hunger (ghrelin), while decreasing your metabolic rate. Consequently, this inevitably leads to gaining all of your weight back and possibly adding more.  On the other hand, intermittent fasting is multifaceted in its health-promoting properties. By producing beneficial hormonal changes, intermittent fasting does not decrease your metabolic rate, helps stabilize your blood glucose, reduces inflammation, increases weight loss, and promotes insulin sensitivity.

In this 8-week study, researchers split participants into two groups - a 16/8 time-restricted feeding (TRF) group and a normal diet (ND) group. The TRF group consumed 100% of their calories at 1pm, 4pm, and 8pm leaving a 16hr fasting period, and the ND group consumed the same amount of calories at 8am, 1pm, and 8pm. For both groups, several markers such as IGF-1, blood glucose, insulin, testosterone, adiponectin, leptin, and others were measured at baseline and 8 weeks. The researchers highlighted that after the 8 week period, only the TRF group had a significant decrease in their blood glucose and insulin levels.

For blood glucose regulation, weight loss, and insulin, intermittent fasting or TRF is highly effective because you’re extending periods of not eating. Essentially, this creates an upregulation of several health-promoting pathways, while not raising your blood glucose or insulin. Thus, keeping a regulator on your blood glucose levels and insulin production.

Oftentimes, people can get exhausted just by hearing the term fasting. If that sounds familiar and you happen to be one of these people, consider adopting something approachable like a 4-week intermittent fasting strategy. Starting with a 12-hour intermittent fast is extremely doable and a good baseline. As you become comfortable with this duration, which is usually one week, you gradually increase your fasting duration by two hours. Continue this approach for 4-weeks and you’ve easily hit the 16-hour intermittent fasting duration with the option to increase. This strategy works incredibly well for those that are new to fasting or have been reluctant to begin. Also, it should be noted that eating times do not need to be specific for you to get the benefits. For example, if you had a later meal than usual, start the clock after that meal and roll that over into your following days fast.

Here is a blueprint for the 4-week intermittent fasting approach.

Typically, when you’re determined to change a specific behavior it’s not as straightforward as you imagined. The mind incessantly becomes fixated and anchored in mental, situational, or personal grooves that are reluctant to be disturbed. As you’ve been witnessing through your CGM, the emergence of your metabolic health greatly hinges on dietary and lifestyle behaviors. For metabolic health to develop, certain behaviors must be examined and modified when necessary. Recognizing the interplay between your decisions, behaviors and metabolic health reinforces and strengthens nervous system connectivity. Thus, empowering you to make calculated, thoughtful, and reliable decisions in an effort to shift your metabolic-behaviors.

Whether you continue wearing a CGM or not, your decisions toward dietary and lifestyle behaviors remain the cornerstone for optimal metabolic health. For positive behavior change, there is no question about the immediate change and results the CGM delivers. The closed-loop system makes the CGM one of the very few tools we have to significantly impact decisions made about health. Thus, opening the door to healthy behavior changes.

When it comes to making reliable decisions about metabolic health, the CGM is incredibly useful because of its capability to measure both positive and negative outcomes. Oddly, it’s human nature to ignore negative behaviors until we can see or measure the consequences. Using the addicted cigarette smoker as an example -  if he/she could observe the biochemical degradation each cigarette is causing within the human body, this individual would more than likely have an increased desire to quit.

Direct observation of your metabolic picture is why the closed-loop system is incredibly successful for promoting healthy behaviors. Becoming an observer to your blood glucose levels is the catalyst required for lasting change.

It is said that the average adult makes ~35,000 decisions per day. Reducing this down to micro-decisions that collectively influence your behavior on that particular day, you can begin to understand why behavior change is not so cut and dry.

Metabolic-Algorithms

The use of algorithms are often thought about exclusively for processing computational data. Put simply, algorithms are reliable, data-driven formulas that process information from an input to the output. Turning the wheel ever so slightly to human cognition, we can leverage algorithms to simplify, enhance, and support our decision-making capabilities. Furthermore, let’s apply the concept ‘metabolic-algorithms’ to stand for a systematic approach to generate decisions that promote metabolic health.

Throughout this challenge, you’ve been developing and acquiring data about your metabolic-algorithms. The scans you’ve continuously been taking and measuring contribute to a greater cognitive process that is evolving, forming, and building a metabolic-algorithm database. Take a second and think back to your dietary and lifestyle decisions prior to wearing a CGM. For most of you, a cognitive shift has occurred. I imagine the degree into which you’re considering how certain behaviors can positively or negatively impact your health is much higher. For strengthening your metabolic-algorithms, making decisions, and changing behaviors let’s look into the following concept.

System 1 and System 2 thinking

In his groundbreaking bestseller ‘Thinking, Fast and Slow’, psychologist Daniel Kahneman brings forth a simple yet brilliant concept that has since widely been adopted by behavioral psychologists around the world. The cognitive concept unpacked and expounded by Kahneman is what is known as System 1 and System 2 thinking. To help understand the cognitive dichotomy, Kahneman describes System 1 (automatic) thinking and System 2 (effortful) thinking as separate agents existing within the mind. Depending on personal or situational circumstances, we either apply automatic or effortful thinking. Simply put, when making a judgement, choice, or decision one of the two systems is recruited and applied.

System 1 - operates quickly and automatically, requiring little or no effort, and no sense of voluntary control. FAST.  Below are System 1 examples given by Kahneman:

System 2 - demands your attention, effort, focus, and concentration. This thinking is more deliberate and orderly. SLOW. Below are System 2 examples given by Kahneman:

Kahneman points out that System 1 thinking can be strongly influenced by System 2 thinking. In fact, one of the distinct tasks of System 2 thinking is to overcome the impulses of System 1 thinking. Therefore, we can deliberately choose to apply System 2 thinking instead of System 1 thinking to certain situations. A deliberate activation of System 2 thinking for decision making and behavior change has the potential to rewire your neural circuitry (neuroplasticity) and undo past negative behaviors.   

Attaching Kahneman’s System 1 and System 2 thinking to Metabolic Health through the CGM. Note: This is strictly opinion-based and framed in the context of promoting healthy behaviors for Metabolic Health

By default, most decisions apply System 1 thinking as the dominant cognitive process. And, this is no surprise given the number of decisions we constantly face every day. If System 2 thinking is used for the ~35,000 decisions processed daily, the cognitive load would most likely cause mental and decision exhaustion to occur. Thus, leading to poor decisions, outcomes and behaviors.

So the question becomes - how do we recruit and apply System 2 thinking to make clearer decisions that promote healthy behaviors, without causing mental and decision fatigue?

Through what is known as a closed-loop system (a direct connection of causation from an input), the CGM offers a unique capability of naturally transferring your System 1 thinking to System 2 thinking. By drawing awareness into what is and isn’t affecting your blood glucose levels, you’re applying attention, effort, and deliberate modes of thought. Thus, recruiting your System 2 thinking for making deliberate decisions that will keep your blood glucose levels within a healthy range. Subsequently, you’re becoming more aware of the necessary behaviors to continue this trend.

For meaningful behavior change, activating and implementing System 2 thinking is an absolute. Kahneman points out that your System 2 thinking becomes hijacked by your System 1 thinking, which leads us to cognitive bias. Irrationality and other errors prone to human thinking. However, the closed-loop system via CGM offers an alternative path. A path that allows you to bypass your System 1 thinking and soundly make decisions that promote healthy behaviors. The ability to adjust your decisions with accuracy, reliability, and validity is the true differentiator for meaningful behavior change. By combining System 2 thinking with your acquired metabolic-algorithms, meaningful behavior change becomes very attainable. In addition, this will inevitably solve for the mental and decision fatigue that is often encountered from behavior change.

Like most processes done repeatedly your System 2 thinking has the capability to integrate and influence your System 1 thinking. Without going into the neuroplasticity jargon, this simply means that you can undo rooted negative behaviors in System 1 thinking and replace those with purposeful positive behaviors from System 2 thinking. The overarching goal here is to consciously drive your metabolic algorithms and System 2 thinking into your System 1 thinking. Thereby, this shifts your metabolic health decisions from effortful cognitive loads to data-driven, automatic behaviors. The outcome of this cognitive shift solidifies and indicates meaningful behavior change has taken place.

By design, the CGM uniquely offers significant advantages for meaningful behavior change. The removal of restraining forces is widely considered to be the seat for behavior change. In this case, restraining forces such as open-loop systems, a lack of awareness about your metabolism and blood glucose, and not having available access to your metabolic data have all been extinguished. It’s a technological marvel that a non-invasive device like the CGM has the potential to drastically and near instantaneously impact your overall health.            

Dietary and lifestyle behaviors are the crux for overall health, wellbeing, and longevity. We cannot afford to continue to treat health as though it’s not essential to a meaningful existence. At its core, optimal health is rudimentary to life as a human being, yet we’ve drifted far away from our natural states and proceed to surrender to external forces.               

Think about your recent metabolic data and insights as a foundational launching point propelling you towards achieving your optimal metabolic state. It’s astonishing to stop and consider the metabolic landscape you’ve discovered in such a short time. Continuing to carve out and create your metabolic body is going to have a significant impact on your health. You’ve come too far to allow yourself to become another statistic that contributes to the overall disease of our population. Trust the strategies and tools you have discovered to fully take control of your health.