Category: Practical

If you want to reach a Healthspan of 100+ years, you definitely need to play with a Continuous Glucose Monitor (CGM) at least a couple of times in your life. Read below to understand what it is and why it is so important. I’m not a doctor (and I assume you’re not either), so I’m over-simplifying the complexity of the human body to explain everything.

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The CGM

A CGM looks like a small white coin (see below on my arm).

The one I’ve chosen is called Frestyle Libre 3 from Abott Technologies (I have absolutely no stake, no hidden interest whatsoever in this company), it costs roughly $75. It lasts exactly 14 days from the moment you install it on your arm until it expires and you have to take it out and throw it. Its job is to measure the concentration of glucose in your blood every minute.

The role of Glucose in your Body

In a nutshell, Glucose is the fuel of your cells. When you eat, your digestive system breaks down food into different components, and glucose is sent into your bloodstream. If there’s too little of it, your cells don’t have enough energy. When there’s too much of it, serious and dramatic consequences may occur (such as loss of vision, kidney damage, etc …). So your body has an efficient lever to maintain your glucose level under control, a hormone produced by your pancreas, called insulin. Insulin may be considered as “the hormone of abundance”, because when you’re eating more than your body needs (abundance), the production of insulin will tell your body to store that additional glucose in your cells (mostly fat cells, liver and muscle cells).

So what?

You eat sugar, it flows into your bloodstream, then insulin tells your cells to absorb it, end of the story, so far so good right? Well, not quite, and this is where things get tricky and interesting!

During your first decades of life, this glucose / insulin system works perfectly, fine-tuning your glucose levels 24/24 and 7/7 to keep you healthy. However, as you grow older, your cells may become resistant to insulin, so that your pancreas needs to produce more and more insulin to keep your glucose levels within the desired limits, which is called “insulin resistance”. Most of the time, this happens because of decades of excessive quantities of sugar you ingest, associated with glucose spikes in your blood, which generates insulin spikes to compensate. Eventually, this vicious circle of your pancreas producing more and more insulin, and your cells becoming more and more resistant to insulin, ends up into diabetes (or more generally metabolic disorder), which means your body just can’t control glucose in your blood anymore.

If you want to live long and healthy, you want to avoid this at all costs. Metabolic disorder is the “foundation” of all the chronic diseases, which means that people suffering from this will have a skyrocketing probability of suffering from every other age-related major chronic disease (neuro-degenerative, cancer & cardio-vascular).

From Theory to Practice: Flatten the curve!

Now that you know how important it is to keep your glucose levels within a normal range, let’s get from theory to practice! So ideally, you want a fasting glucose level between 60 and 99 mg/dl (in the morning when you wake up, before having breakfast), and during the day, a glucose level as flat as possible. When you eat, depending on your diet, the glucose level will rise, then insulin will bring it back down, but you want small rather than ample variation around the mean.

Each individual will react differently to different foods, so this is why a CGM is essential, you can’t rely on how an average person reacts to a specific food. You need your own user’s manual!

So you have 14 days with a CGM on the back of your arm, this is the one time in your life you can eat the most delicious but unreasonably unhealthy food, just to see how your glucose levels spike (or not). Try everything, junk food, sugar, cake, soda, you name it. Let’s roll baby!

My personal use case

I’ve been wearing my firs CGM for 4 days now, and I’ve tried around 30 different foods, and here’s some examples of what I’ve learned about myself:

– fast-food skyrockets my glucose levels, I mean really crazy, above 230 mg/dl (which is huge), I’ve tested a Quick Giant + a big Coca-Cola + nuggets + lots of ketchup and mayonnaise. Yummy, so delicious, what a pitty!

– those delicious Liegeois with whipped cram send my glucose level to the sky also

– curiously, Taboulet Oriental (Tabbouleh) and Corn also triggered a spike, even more so than a that delicous but super-sugary chocolate “Toblerone”

– orange jus, fruits, potatoes, and pasta seem to be well tolerated, generating no spike of glucose

– 1h of moderate effort like jogging does not seem to influence my glucose

I’ll still test: different types of alcohol, and also sleep deprivation to see how it affects my body’s ability to control blood glucose. It seems from some studies that on average, sleep deprivation reduces your body’s ability to control glucose by as much as 40%. I can’t wait to test this!

Watch out for prediabetes

In addition to helping you understand what food to avoid, a CGM may also teach you something even more important, which is what your diabetes profile is. Oh boy could you have a big surprise (read below)! Diabetes is when your body can’t deal with glucose, because the insulin is either not produced in enough quantity, either because your cells don’t respond to it anymore :

– a glucose level of <100 mg/dl is OK

– a glucose level of 100 – 125 mg/dl means you may be prediabetic.

– a glucose level >125 mg/dl means you have diabetes

Knowing a couple of things related to prediabetes are of essence for your healthspan:

– prediabetes is most of the time asymptomatic, you don’t know it, you don’t feel it – until it is too late!

– prediabetics have an order of magnitude of 5 years of delay between their prediabetic condition and “type 2” diabetes. This is 5 years they won’t event be aware of, because as explained below, this is asymptomatic.

– this condition is extremely common, 80 million americans have it (out of 330 million roughly), which is almost 25%!

Prediabetes: if I may have it, you may have it!

Now, I’ve kept the most interesting part for the end of this article: during my first 4 days of CGM usage, my device has consistently measured a glucose level above 100 mg/dl, with variations between 100 and 200 mg/dl, and most of the values being around 110 mg/dl. If you’re carefully read what I’ve written above, you should understand that this means that I may be prediabetic.

I thought of myself as being almost perfectly healthy, and I invest a great deal of time and effort into staying into shape: I don’t drink, don’t smoke, I’m not overweight, I eat healthy (or so I think), I sleep well, I’m not stressed, I practice sports 5 times / week, etc …

It’s true that I have one diabetes “type 2” case in my family, but I thought it was because of a lack of care.

I have to do additional exams, before I consider this as a certainty, but my takeaway here for you is double:

1. if I have prediabetes, you may have it, don’t sleep on it before it is too late. Remember that 1 in 4 people have it.

2. detected and acted upon early, prediabetes is reversible. Don’t waste your time, don’t act like like an ostrich hiding its head in the sand, and hoping for the best.

Because I do care so much about your short and long term health, I want to ask 2 questions: Are you going to look elsewhere and hope for the best when it comes to your diabetes profile? Or are you going to start finding out as much as possible about your body by ordering a CGM today?

Some readers (thanks Gene!) told me the recent discoveries in medecine were fascinating, but most of all, they were interested in having actionable insights into what they could do TODAY to improve their Healthspan. I’m giving a couple of prioritized measures to take. Let’s dive into it!

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The Youth Pill

I will maybe dissapoint you, but just as there is no silver bullet to get rich, there is no magic pill to keep you young and healthy today (by the way, I’ll write a dedicated post about how similar longevity and money management are, stay tuned!). What we do have, however, is the ability to explore one’s health and body, and come up with a personalised, risk adjusted, long term plan to follow in order to reach 100+ healthy years. Depending on how quickly science moves forward, new breakthroughs are expected to help us improve even more our strategy and tactics, and eventually increase our odds to leave even longer and healthier lives (there’s a very interesting concept related to this, called Longevity Escape Velocity, which I’ll explain in the very following weeks).

First step: find a Medical Doctor specialized in Longevity Medecine

Every time when I think of Longevity, I first think of Money Management and try to evaluate how I would react in a similar situation. How to start in Longevity? Well, how did I start Investing in first place? A year and a half ago, I was a total ignorant in Money Management. One of the very first things I’ve done, was to get some professional help (from Finance Advisors and Investment Banks). I have considered none of what these Experts say as “Guaranteed 100% Verified Knowledge”, but I have questioned each one of their assumptions, statements and theories, and built mine on top (and most times against) those constructs. What resulted from this exploration process was a personal set of principles, convictions and an encompassing strategy which consistently guides my steps when it comes to Investing, that are sometimes similar but sometimes opposite to the so called “expert advice”.

Similarly, when it comes to Longevity, if there was only one thing you had to do to start your Longevity Journey, that one single step is, without any doubt, to find a Longevity Expert to assist you! The Human Body is a marvel of complexity, and what you’ll want to avoid at all costs is to hurt yourself by taking decisions based on an over-simplified version of what’s happening with you and how your body works. A Medical Doctor will assist you, help you take informed decisions.

Just so that you understand what to expect from such an Expert, this is how he will be able to help you:

– help you list the lab exams (blood, urine, etc.) you need to do, the ideal frequency for you, and interpret them. For example, if you have a cancer family history, you’ll want to do some detection tests more frequently. Same for Calcium Plaque for Artherosclerosis. This is highly technical, and unless you’re a health professional yourself, you’ll need guidance on it.

– help you find a Long term Longevity Strategy for you to execute. This amounts to finding the weak points in your health (current or to come), and build long term strategies to downplay them. For example, if you have a certain predisposition for Diabetes called LP(a), you’ll probably want to keep your LDL as low as possible (way below the commonly admitted threshold agreed upon in “standard medecine”).

– help you with tactics to improve (or maintain) your health, which means practical stuff to apply today. This may consist in a plethora of measures, just to give you a couple of examples: specific diet changes, physical activity, drugs, etc … This is where it gets tricky, because you’ll probably have the option to take some drugs that are commonly used for specific conditions, so they’ll improve some aspects of your health, while deteriorating some others, which may still be a good deal for you. The deeper you’ll go into it, the more this will be subject to a trial and error process, and risk adjustment.

– help you in real time with the dynamics of the whole process, how to adjust your strategy to the new scientific breakthroughs, the new problems that may arise in your health, what additional tests to do (or what to stop doing), etc. You are a living human being, you evolve, just as does the scientific knowledge associated with your body. Setting it up once and for all is great, but it’s not enough, you need to keep yourself updated!

As you see, the key word for the Assistance you’ll get from a Longevity Doctor is “help”, he will assist you, guide your journey, but you’ll have to make the final choices for yourself. You’re the CEO of your own health, nobody decides for you when it comes for such important decisions.

Important caveats here:

– just as there’s no absolute investment strategy, as each one of us evaluates and reacts to risk in different ways, there is no absolute Longevity action plan for you to execute blindly. No doctor will ever give you that (in fact anyone can tell you what to do, but that will be most likely sub-optimal). You have to find your own balance between short terms vs long terms risk, efforts and rewards. Just like in Investment, there are some no-brainers to apply with maximum confidence, but once you’ve executed that, you’ll never be able to sleep on your 2 years, you’ll never be 100% sure that you’ve taken the absolute right decisions. But you’ll improve systematically towards that goal!

– as of 2023, you’ll have a hard time finding Medical Doctors who understand what Longevity is and how to help you with it. This field is brand new, reaching some basic level of awareness in some countries and less in others. Things aren’t easy. When you’ll find such a Doctor, they may be overly expensive (I mean $30k / week), or pain incompetent. This is definitely harder that just visiting a doctor for a sore throat consultation. I’m taking about this in one of my previous posts. It’s going to be tough, but it’s definitely worth it! I’m openly sharing who’s my doctor and others I was able to find, with whoever wants to know more. Just write me and I’ll help you with that.

Next steps: some examples

I’d say that being assisted by a Longevity Medical Doctor is more or less the only aspect that should be common to everyone, and you should do prior to any concrete initiative to Improve your Long Term Healthspan. Once you have that in place, congratulations, you may be interested in taking other more tactical measures according to your preferences, lifestyle, and goals, such as:

– use some wearables. For example, I use an Oura Ring, which tracks a bunch of biomarkers, such as HRV (Heart Rate Variability), temperature, sleep quantity and quality, general physical shape, etc…

For me, the Oura Ring was a game changer, because before wearing it, I was overtraining and putting more pressure on myself that I was able to bear. This resulted in poor physical performance, a weakened immune system, chronic stress. All of these were blind spots before I was able to understand them thanks to my Oura Ring. The balance between effort and relaxation is a very important factor when it come to long term health.

– read as much as possible on longevity and functional medecine. Just as you sometimes have difficult Investment Decisions to take, and no one is more suitable than yourself to take them for you, there will be similarly difficult Health Decisions you’ll need to take. In order to be best prepared for such situations to come, you’ll have to read as much documentation as possible, on how the body works, and focus on your specific weaknesses. There are books, films, clinical studies, experts, new technologies coming down the road, in those fields. Find out as much as possible about them. Depending on how serious some condition is in your case, you may be tempted to test more or less experimental treatments (depending on the laws in your country of course).

– other tactics include CGM (Continuous Glucose Monitors), Epigenetic Clocks, Glycan Age Clocks, various invasive and non invasive tests, HBOT, Red Light Therapies, etc … but I’ll elaborate on those in detail in my next blog posts.

Overall, at first sight, it may seem a bit conceptual, daunting and blurry, but again, just as with Investing, after some time and effort to understand how it works, you’ll end up creating your own style, strategy and tactics with your own appropriate amount of regular adjustments and allocated time to it. It will most likely come down to specific measures to take in terms of food intake, physical activity, sleep/rest, lifestyle, and maybe (this is the trickiest) preventive supplements or drugs you’ll maybe take.

Main takeaway: statistically speaking, healthy food can get you more than 12 years of additional lifespan (and probably much more in terms of healthspan).

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Today I’d like to talk about food, but not in the way you read about it all day in glossy magazines or TV shows. We know we need to eat healthy. We roughly know what this means. But then, all this is usually presented in a very impractical and clumsy format: a very explicit (and hard to follow) rule of how and what to eat, and then, a very blurry, long term, shady benefit, to “improve one’s life when you’ll be older”. In other words, do a sacrifice NOW, and for a hopeful long term, weakly defined, benefit.

I knew how hard it was to restrain myself from unhealthy (but so tasteful) food, so in order to motivate myself to follow these recommendations, I also needed to evaluate and quantify the future benefit of this effort. By chance, a friend told me about an interesting app to ponder the “effort to benefit” ratio (thank you JB 🙂 ). Under a unsexy and very basic design, this small app is exactly what I needed: you type in some data about yourself and what food you eat right now, and it computes how many additional years of life you get if you start eating healthy food, statistically speaking.

Before I let you know the app, so that you can play with it yourself, a couple of takeaways to remember:

– the difference between eating “average food” and “optimized for longevity food”, is a whooping 12.2 years of lifespan (statistically speaking). If we speak about healthspan (that is years of healthy life, without major diseases), the difference may be even bigger (more about this in future my future posts). Eat junk or “average food” and live 77.8 years (probably in a pitiful shape in the last 10 – 15 years of your life). Eat healthy food and live 90 years old (probably with what is called a compressed morbidity in the last couple of years of your life – which means you’ll be ill a short amount of time before you pass away). Now THAT is a quantified equation I can use to motivate myself to eat healthy in the present.

– the food to eat as much as possible is, with no big surprise: vegetables and fruits

– the food to eat in a moderate quantity is: whole grains, fish and milk

– the food to avoid at all costs (bring it to 0 is possible) are processed meat, red meat and sugar

– one very interesting way to see it (and think of it, when you ponder whether to eat or not a specific product), is to see how many years you’re gaining (or losing) when playing with one or 2 parameters at once: for example, if you don’t eat your vegetables you lose 2 years of lifespan, if you don’t eat vegetables and fruits altogether, and lose 3.8 years of lifespan. And then, taking the right decisions on each category of foods, one by one, adds up considerable years to your lifespan.

The app I’ve used to help me understand how impactful healthy food is for longevity is https://priorityapp.shinyapps.io/Food/. I hope you’ll like it and by playing with it, it will help you decide what makes sense for you in terms of healthy vs tasteful food, between the short term pleasure (eat a tasteful meal), and the long term benefit (live longer healthier).

Here I discuss how I’ve found a Medical Doctor to assist me in my Longevity Journey, and the prices of the different options

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There are several longevity practices that have a favorable risk/reward ratio. However, the best approach to these practices is to seek assistance from a medical doctor and measure everything before, during, and after different treatments.

Unfortunately, this approach was harder than expected. I am a 41-year-old healthy individual and a father of two kids living in France. However, doctors here don’t understand my posture. They say, “Come see me when you have a problem! Do you want to test stuff on yourself, are you crazy?!?” The standard French medical insurance price is low, around 30 euros/session, but it’s impossible to find a qualified specialist. After unsuccessfully trying some old-school doctors, I had to give up and look elsewhere, so I tried longevity clinics.

Longevity clinics are institutions where doctors are trained to help patients preserve or improve their health by evaluating them through extensive tests and medical exams. However, these clinics are very expensive due to the combination of state-of-the-art fact-based technologies and expensive non-essential services like massages and some controversial treatments, amounting to $20,000/year or more. I was only looking for “hard science” part, so I had to look elsewhere.

I attempted to contact some local French longevity specialists who self-labeled as such. However, I’ve found out there’s only a few of them in France, and they’re crazy expensive and super busy (starting at 5000 euros). One of them was “reserved” full-time by a biotech startup, and another missed our meeting. I wasn’t lucky with this approach either.

Eventually, I found a qualified medical doctor in the US at a reasonable price ($350/month). We’ll have remote consultations over the Internet, with a variable frequency of sessions, starting 1 working session / week, and then eventually it will drop to about 1 working session / month. I’m very happy with this solution, and my first consultation with her is this week. My action plan is as follows:

1. Run a series of tests (blood tests, MRI, DNA, hormones, epigenetic clocks, etc.)
2. Explore the results and detect any discrepancies
3. Prioritize and choose the few more important issues to work on
4. Depending on what needs to be improved, try lifestyle changes, food supplements, drugs, and measure how those values improve (or not) over time
5. Share all the protocol and the results with you

I’ll post my first impressions as soon as possible. I can’t wait to see this moving forward!