Our mission at the LL&F Club is to help everyone prolong a good life that’s full of joy. It very much felt this way at our latest event at Stanford University that was a true health-geek paradise!
If you ever wondered what’s the connection between (1) algorithmic analysis of blood/DNA bio-markers to improve life-habits, (2) fourteen local organic farms, (3) simple hacks for getting traction in a world of distraction (4) monitoring glucose (5) a 100% chocolate and (6) the healing powers of the placebo effect — the short answer is: these are all fascinating, new, and sometimes surprising ways to Live Long and Flourish that we uncovered and discussed in our meetup at Stanford last week.
During that evening we indulged in insights from Club members who shared Healthy HACKS⁺, Motivating TRICKS* and Science MAPS^ based on their personal experience and expertise about our brain & mind, what we eat, our activity, and how we manage health risks.
This dynamic rich experience combined with a truly phenomenal group of people (technologists, medical experts, entrepreneurs, designers, investors, health & wellness enthusiasts, engineers, philanthropists, researchers, inventors, writers, and more…) resulted in a vibrant conversation about fascinating topics that affect 100% of all human beings 100% of the time!
And as we always do, we wrapped it all in a fun celebration of the senses with incredible tastes, smells, textures and colors of healthy tasty foods and drinks we had sourced from local farmers and artisans.
We were very thankful to Stanford University for hosting us in the Main quad surrounded by more than a century of inspiring human wisdom, as well as by the beauty of palm trees, red roses, and Auguste Rodin’s famous sculptures of The Burghers of Calais.
Now, it’s time to dive in, recap our experience, and share the love with you too. Sit back, you’re in for a real life-treat!
Discovering Your Inner Age with the Help of Blood Bio-makers
LL&Fer Fernanda Gandara opened the evening with a personal story about her experience with Inside Tracker, an algorithmic engine that analyzes blood samples, DNA, and lifestyle habits to create an ultra-personalized healthy-living plan. This Health Hack+ helped her establish a baseline for starting to optimize a life that’s happier, healthier and longer, as opposed to just waiting for her health to naturally deteriorate.
Fernanda used to work at Human Longevity, a company in SoCal that has developed a battery of tests to help people understand where they are on the spectrum of health. They based their analysis on a database of sequenced genomes and phenotypic data (of physical traits) to uncover unprecedented insights capable of transforming healthcare from reactive to proactive. However, this comprehensive approach that was started by Craig Venter (who was the first scientist to sequence the human genome) came with a price tag that’s not very cheap (to say the least)… So to explore another way suitable for the rest of us who cannot afford $25,000 to get tested, Fernanda chose to independently try Inside Tracker.
To start, she chose a test of 43 blood bio-markers, an analysis of her DNA (she was able to upload her 23&Me data to Inside Tracker), and an assessment of her “InnerAge” (which was calculated by InsideTracker using a proprietary algorithm that we were not able to decipher and still curious to understand better.) The 43 blood bio-markers were grouped under 9 different categories, making it clearer to Fernanda how they relate to her health.
Based on these she received recommendations on foods/supplements that could be helpful to optimize the bio-markers that were at risk or “needed work.” These formed a set of daily easy actions she would need to take to optimize her health and improve her score. For example, she was low on vitamin D so the engine recommended action was to spend more time in the sun and take a vitamin D supplement every day.
After she agreed to adopt the recommendations, Insider Tracker started sending her daily notifications to remind her what she needs to do. That was a nice Motivational Trick* that we liked, especially because Fernanda found the reminders to be very helpful. We were also pleased to discover this Motivational Trick* early in the event because it was very much in line with the insights from another presentation by another LL&F Club member, Nir, that came up later in the event. Stay tuned to connect the dots!
Fernanda, who takes pride in being healthy and fit, was quite surprised/disappointed to see that Inside Tracker calculated her InnerAge to be 12 years above her biological age (!?) With a healthy grain of salt (or two), but an open mind, she shared that Inside Tracker’s recommended actions to bring that InnerAge down were very easy to act on, and got her intrigued to see how that number would change when she acts on the recommendations and gets retested in 3 months.
We are very curious too and will continue monitoring the score with Fernanda together and we’ll keep you posted in three months time… Most of the recommendations Fernanda received from Insides Tracker to help optimize her health were around what she eats, which was a great segue to Maya Adam’s presentation about our (sometimes complicated) relationship with food.
Do we Have to Have a Complicated Relationship with our Food?
Maya, who is a professor and the director of health education at Stanford’s School of Medicine started her presentation by reminding us how we’re hardwired to love our food because it initially came to us from our parents, who took care of us and gave us so much attention and love growing up.
Maya also explained how, unfortunately, later in life, too many of us find ourselves in abusive relationships with the foods we eat. Just like an abusive spouse/peer/boss, these foods are hurting us but for some peculiar reason we keep coming back for more. To demonstrate, Maya mentioned the old series of Tums commercials that (gruesomely) illustrated the abusive/aggressive/combative relationship that too many of us have with what we eat. Perplexing and shockingly real!
Maya suggested that one root cause of the problem is that we buy too much of our food from large businesses that mostly optimize for making money, not for their customers’ health and well-being. These businesses make foods that are cheaper, lasts longer, are deeply engineered to ‘taste better’, and have a texture that sells more. Unfortunately, too many times these come at the expense of the eater’s health and well being, which these businesses neither get paid for nor do they get penalized for the harm they cause.
Maya also pointed out the pitfalls of episodic diets, telling us half jokingly how her husband Lawrence (who participated in our Stanford meeting as well) decided once to go on a vegan-free-carb-free diet, and how the only thing he actually lost was 13 friends ;) Instead of episodic diets, Maya advocated for a more sustainable lifestyle shift. She spoke about the merit of cooking at home, while controlling the ingredients we use to prepare our food, and where they’re purchased. Furthermore, she shared how eating what she prepares together with people she loves has provided many benefits to her and the people she cares for most, and how it helps them all flourish as a family.
But for many of us, re-building our relationship with food means that we will need to first find an easy way to understand how certain foods affect our day-to-day wellbeing, and based on these insights create the feedback-loops that will help optimize our lives. This means that we will need to first start measuring. At the LL&F Club we believe that ongoing life-optimization would result in a healthy and energetic body, a sharp and peaceful mind, as well as in enhanced stamina and joy. But how do we get there when we crave sugar so badly?
Sebastian Caliri had a Hack+ for that — Continuous Glucose Monitoring (CGM). The solution that has been used to help patients with diabetes is now moving into the mainstream by getting smaller, less invasive, and more accessible to the masses, and we were curious to see what it can mean to casual users vs. ones who must use CGM regularly to manage a condition.
Continuous Glucose Monitoring For All
Sebastian started his fascinating talk by explaining to all of us about this fast growing trend that folks are buzzing about recently: CGM, aka: Continuous Glucose Monitoring. A CGM works through a tiny sensor inserted under the skin, usually on the user’s belly or arm.
The sensor measures the user’s interstitial glucose level, which is the glucose found in the fluid between the cells. The sensor tests glucose every few minutes. A transmitter wirelessly sends the information to a monitor (e.g., a cell phone).
Sebastian then continued with reviewing some of the known benefits of (CGM) for type 2 diabetics. He cited several peer-review journal articles showing that there is evidence linking postprandial glycaemia (the presence of blood glucose after a meal) and glycaemic variability (blood glucose variability) to the development of cardiovascular disease. These two were also linked to the impairment in cognition and in exercise performance(1) (2)
Lawrence (Maya’s husband who’s actively managing type 1 diabetes for years) was also generous to share his experience and to suggest that having used CGM for years, it’s now hard for him to comprehend how he and other folks were able to manage type 1 diabetes effectively and efficiently before it existed.
In the vibrant conversation that ensued we also learned that Andrew, who is the CEO of Prenuvo (one of the best Healthy Hacks+ we presented in our previous event), actually used CGM for understanding and controlling his own blood glucose levels. Differently from Sebastian and Lawrence, Andrew did so to lose weight and to keep it steady. Andrew told the Club that using CGM he experienced meaningful weight reduction thanks to his awareness of what he ate, and also about his surprising discoveries of which foods caused spikes in his glucose levels, and which ones didn’t.
Sabastian noted that he was surprised to discover that “an-apple-a-day” could have a similar impact on his glucose levels as a sizable candy that day… He also added that tracking his glucose data he realized that it wasn’t just the type of food he ate, but also the timing he ate that food that influenced its impact. To illustrate that, he showed us that consuming half a pint of ice cream right after he worked-out had almost no effects on his interstitial glucose levels. He also shared that the impact of eating free standing carbs (just like eating bread at the beginning of a meal) had a much more serious effect on glucose levels than consuming carbs with and during the meal! Moreover, and surprisingly, munching on Smart Sweets Peach Rings (boasting “only 3 grams of sugar”) caused the single biggest spike in glucose levels he experienced in 14 days!
What Are We Going to Do with Our Sugar Addiction?
During the vibrant conversation on CGM we reached a consensus that addiction to sugar has reached an epidemic level in our society. To counter that, we discussed how using CGM in conjunction with behavior feedback loops can become a game-changer in sustainable weight-loss and long-term weight maintenance. With CGM we can identify what causes glucose spikes and with recommended actions reinforced by feedback loops we can control better what we decide to eat, so we can choose better, get gratification immediately, and feel good long term.
It was great to engage in the conversation two experts in feedback loops: Andrew Lacy, who was also the co-founder of one of the most successful early mobile gaming companies (Tapulous, that is now part of Disney), as well as Nir Eyal, who wrote the best selling book Hooked.
It was also good to have LL&Fers Eitan Shay (the director of product management at Livongo that’s helping diabetes patients manage their condition every day), and Dr. Polina Segalova (who’s managing products with him), participate in the discussion. And finally, it was great to hear from Robin Farmanfarmaian (who wrote the book The Patient as CEO) that United Healthcare has started recently to offer up to $1,400 as an incentive to folks it insures to hook up their wearables (including a Continuous Glucose Monitor, Apple Watch, FitBit etc.) and use this CGM to monitor and control their glucose levels. We hope other insurance companies and large self insured employers would do the same! Having said that, all of us also agreed that humans will remain humans (even if they have an optimizer’s mind) and that they still tend to like their sweets… So we wondered whether there’s a Hack+ for enjoying what many of us crave without incurring the “sugar tax”? The short answer was — yes! It was exciting to have with us a real chocolate artisan to indulge us with a super delicious 100% chocolate with no sugar added!
The Arts & Crafts of Sugar Free 100% Chocolate
Panos Panagos, a lifetime chocolate artisan (and founder of Alegio chocolate), started by offering everyone a taste of his incredible 100% chocolate. His hand crafted (with lots of care) chocolate was a delicious Hack+ that can help folks who crave the addictive taste of chocolate (almost all of us!) to continue enjoying it without any sugar. Panos also showed us a great Healthy Trick*: he urged us not to chew the chocolate in our mouths, but rather let a piece melt on our tongues slowly. This useful Trick* not only enhanced the taste of the chocolate and helped us enjoy it in a deeper and longer way (the aromas of the chocolate evolved beautifully in our mouths), but also was a great way to consume less chocolate by focusing more on the experience and its quality and less on the quantity we ate.
Panos is a true chocolate artisan! He told us how he sources the cocoa beans from a few tiny islands off the shores of Africa where ancient trees (that have not been genetically modified) are still growing naturally. With the great attention he puts into details and his great heart that cares about his customers so much, it’s no wonder that he has a big following for his 100% chocolate (including our friend Michael Pollan, the healthy eating expert who once said that everything he’s learned about food and health can be summed up in seven words: “Eat food, not too much, mostly plants.”). It was time to raise a glass to a deliciously healthful long life (cheering the dense cocoa-nib drink Panos prepared for us with only warm water added to his chocolate.)
And in typical LL&F Club fashion, one of our members, Isaac Weaver, went to complement the great flavors we enjoyed with scientific evidence for the health benefits of chocolate. Isaac found an umbrella Review (an aggregation of multiple meta analyses) in the Journal of Clinical Nutrition(5) that combined 10 systematic reviews looking at 19 outcomes and including approximately one million participants. The good news was that the best available evidence suggested that chocolate consumption is associated with reduced risk of cardiovascular disease death, acute myocardial infarction, stroke, and diabetes.
However, the evidence seemed to not be as strong, and deterministic as we’d usually like to see, suggesting a cautiously optimistic outlook on the potential benefits of chocolate combined with a need for additional research to strengthen the evidence. And at the very least we know for sure that 100% chocolate with no sugar added can taste great and do no harm :)
Here’s to Our Local Farmers and Food Artisans
Chocolate was not the only high quality, deliciously healthy food we enjoyed at the event. Since the food we eat has such a profound impact on our health and flourishing, we made a real effort to source, prepare and serve some of the tastiest healthier foods grown and made in our community. We did it all ourselves, with love, just like Maya suggested :) We went to meet the farmers and food artisans in person at San Francisco and Palo Alto farmers markets and purchased the freshest and most delicious ingredients and foods from them directly.
(The pictures are of the REAL farmers and farms we sourced the produce and foods from :)
If you’d like to enjoy the foods we enjoyed as well, here are a few of the best local farmers/artisans we sourced our ingredients from. By all means, feel free to pay them a visit too and say hi:
- Brook and Daughters: Corie Brooks farms 5 acres in Forestville CA
- Everything Under the Sun: Bill Crepps farms 28 acres comprise 5 plots of land in Winters CA
- Tierra Vegetables Sonoma: Brother-and-sister team, Wayne and Lee James farm 28 acres in Santa Rosa and Healdsburg CA
- Star Route Farms: Annabelle Lenderink farms 100 acres in Bolinas CA
- Marin Roots Farm: Jesse and Moira Kuhn farm 35 acres in Petaluma CA
- Capay Organics: Noah Barnes and Thaddeus and Freeman Barsotti farm 500 acres in Yolo County, 165 acres in Central Valley, and 200 acres in the Imperial Valley CA
- Brokaw Ranches: Hank and Ellen Brokaw farm 200 acres in Santa Paula and Soledad CA
- Frog Hollow Farms: Al Courchesne farms 133 acres in Brentwood CA
- Dirty Girl Produce: Joe Schirmer farms 32 acres in Watsonville CA
- Heirloom Organic Gardens: Grant Brians farms 310 acres in the Hollister area CA
- K&J Orchards: Kalayada Ammatya and her two daughters, Aomboon (“Boonie”) and Onanong (“Ona”) farm 104 acres in Winters CA
- Phil Foster Ranches San Benito County: Phil and Katherine Foster farm 250 acres on two ranches near San Juan Bautista and Hollister CA
- Rebecca’s: Baking gluten free, sugar free, vegan pastries in Santa Cruz CA
- Seaquoia: Harvesting Wild California Kelp to Nourish Life on Earth. Santa Cruz CA
We were also happy to have one of the best food artisans in our community, Raw Daddy’s, join us at Stanford to prepare live one of the highlights of the evening: Vegan cones! These uniquely delicious treats were prepared in real time during the event and featured vegan and gluten free flax and hemp cracker cones filled with sweet & savory delights that everyone loved. They were not just tasty and healthy — but they were super fun and easy to eat while moving around the room and chatting with LL&Fers too!
And for dessert, beyond the vegan ice-cream Raw Daddy served in their cones, we also had roasted chestnuts, dried California figs, and Rebecca’s Mighty Blueberry Granola Bar, which was free of gluten, dairy, and soy. And although there was no sugar added to it either — it was still boasting with natural flavors of fruit and oats!
To make sure that our LL&F Club members were informed about which food/drinks they decide to enjoy, how much of them, and when, we also created special labels on the tables marking the nutritional facts of everything we served so members could pick and choose the treats that they like best. The flavor, scent, and color festival that was all around us, in the same room where we had the talks and conversations, contributed to a highly immersive and fun 360-degree flourishing experience!
Speaking of special flavors, a Stanford study disguised as “tasting novelty foods” had helped one of our members, Alex, discover the hidden powers of the placebo effect, which was the next topic of our evening.
Harnessing the Healing Powers of the Placebo Effect
In that Stanford experiment, which Alex illustrated in the diagram above, the cream administered was a simple non-medicated hand cream (with no healing properties) and there were actually no novelty foods involved either. However, after being “tricked” into healing himself with his beliefs, Alex experienced an important a-ha moment. The study sparked in his mind the idea that the power of placebo might be harnessed to produce meaningful physiological changes that can help us live long and flourish.
And wait, there’s more! Another applicable Stanford study that Alex shared showed that the perceived “warmth” and “competence” of the doctor who administered the placebo test had a significant impact on the extent of the recovery(3).
Alex was on a role! He continued and introduced us to another important study(4) that was conducted with post oral surgery patients. These patients experienced a 39% reduction of pain after they were administered a placebo drug. However, when the researchers administered a drug blocking opioid receptors in the brain, the reduction of pain based on placebo disappeared (!) Alex concluded that this result could imply that the human body may have its own internal ability to synthesize certain types of drugs!
Moreover, the powers of placebo have been validated well beyond medications. For example, a study conducted with Degenerative Meniscal Tear patients showed that there was no significant difference noted when comparing between post recovery core knee symptoms after a sham surgery (where nothing was really done post incision), and real surgery (where a full protocol intervention was performed after the incision.)
Dr. Alia Crum, an Assistant Professor of Psychology at Stanford University and the Principle Investigator of the Stanford Mind & Body Lab conducted research and wrote extensively about this topic. Feel free to enjoy her TED talk Change your mindset, change the game where she shares some of her most intriguing findings.
Alex went further to describe the other side of the coin, also pointing to some risks involved in employing placebo effects. He demonstrated that people who believe in the powers of cupping (like Michael Phelps who displayed his cupping scars proudly while competing in his 5th (!) Olympic games in Rio de Janeiro in 2016) may suffer persistent skin discoloration, scars, burns, and infections although there’s no strong scientific evidence that cupping actually reduces pain or improves performance. But as a sample of one, it sure made Phelps believe it helped him win quite a few medals!
The following Club conversation around how Phepls and each of us can harness the beneficial effects of placebo to enhance our performance and improve our mood, and how to build the mindset to do so sustainably to improve our health and well being, was fascinating. Folks mentioned that although placebo is often dismissed or vilified there’s still a lot of potential in harnessing it to avoid taking unnecessary drugs or performing surgery that’s not really needed. And finally, placebo can also be used to enhance and complement the outcomes of other validated medical interventions administered by doctors every day.
Members of the club also cautioned us that placebo is still not understood well enough, and that it appears to sometimes have an inconsistent impact on different people in different situations. Furthermore, there seem to be many external and internal variables that can influence a placebo’s performance — making placebo an intervention that when not controlled well may result in inconsistent outcomes. In summary, we all agreed that there’s a lot of positive potential around harnessing placebo as a useful Hack+ to LL&F and decided to continue talking about it in future meetups of the Club.
How to Get Traction in a World of Distraction
Discovering the hidden powers of placebo and adding another set of Healthy Hacks+ to our repository helped us get closer to optimizing our well being, but it was clear to all of us that there were still too many distractions and temptations on our way to doing the right thing. To counter these, Nir Eyal shared with us a four step framework and a great toolkit full of Healthy Hacks⁺ and Motivating Tricks* based on the research he conducted for his new best selling book Indistractable, to help us overcome distraction, flourish, and feel good!
In a world full of distractions from media, apps, people around us, our environment, social media and so much more, we all face daily and sometimes hourly challenges keeping on track with what we want to accomplish. This holds true when it comes to our health and well-being and also beyond. To deal/cope with all of this distraction and to overcome it, Nir offered us a bunch of useful Hacks+ and Tricks*:
First, he suggested that we start by understanding our internal triggers, which create the discomfort that leads to distraction (such as boredom, negativity bias, and rumination.) When distraction happens the best way to deal with it according to Nir is to:
- acknowledge it
- reflect about it (with self-compassion and without getting upset)
- “Surf the urge” by letting some time pass between the impulse to act on the distraction immediately, and the actual thoughtful delayed action.
Second, Nir recommended that we make time for “traction” (which is the opposite of distraction). Before distraction presents itself it’s much better to:
· schedule time to do things that matter (and plan the time we invest in traction, rather than the output we hope to get during that time.
· get rid of low value work
· spend less time messaging
Third, “Hack Back” external triggers
Nir shared a fascinating recent study showing that:
- 10 percent of all U.S. deaths are due to medical error
- medical error is the third most common cause of death in the U.S.
Nir continued to share that nurse distraction was found to be one of the most serious causes of these medical errors. To counter that, UCSF found a very effective low-tech and low-cost way to help nurses avoid external distractions: a red vest saying: “Do Not Disturb DRUG ROUND IN PROGRESS.” This helped both deter others from distracting the nurses, as well as helped the nurses get into an a more focused mindset.
Just like the nurses did, to hack+-back external triggers we should always ask: “Is this trigger really serving me now?” And to do so proactively, we should also uninstall unnecessary distractions (such as mobile apps) entirely and/or change their notification settings. Using these hack+-backs we can eliminate all the distractions that don’t serve us well (and were likely programmed primarily to serve the marketing needs of the creators of these apps/websites/products/services.)
Fourth, reduce distractions with pacts, which means, making unwanted behaviors difficult to perform. To accomplish this we can use, for example, applications such as:
And finally, Nir also suggested a more “zen” Motivational Trick* that costs nothing but can help quite a bit: make identity pacts with ourselves! Say “I’m an indistractable person” while genuinely feeling it and believing it.
Then it was Time for Introspection
Armed with so many useful Hacks+ and Tricks* we felt that we were on track to completing our enjoyable and enriching journey for the evening, but then, Aneel Chima, who’s a professor at Stanford and the director of the Division of Health and Human Performance, reminded us that the road to self optimization was still missing a crucial component. This component is actually the glue that keeps it all together and makes flourishing so much more likely, meaningful, and sustainable. This personal super-power was purpose!
To unveil this unique super-power in each and every one of us, Aneel took us into an introspective quest that started with self discovery. He first asked each of us to think what was personally most meaningful for her/him? Then he continued and asked where does each of us come from? What do we love? What are our strengths, our identities, our core values? Getting both retrospective and introspective helped us ground ourselves and create a strong base on which we could start building the pyramid of our best selves.
Aneel urged us to also see what matters to us beyond ourselves while contemplating these questions in depth, and how we are a part of something bigger and more comprehensive. He suggested that we all explore what is the impact that the world and people around us have had on each and every one of us, and what kind of contribution we would like to make back to this world that’s surrounding us and has given us everything we have.
To dig even deeper into our inner truth, Aneel led us, unexpectedly, into a guided meditation session. With a few moments of deep mindfulness Aneel demonstrated to all of us how to get into a state of deep self reflection. In the following conversations even the Club members who had been most skeptical about the benefits of meditation shared that once they got into this state, it was easier for them to focus, think clearly about what they wanted to accomplish, and feel good about who they were and where they’re going to. Folks also shared with me after the event that the answers to those deep personal questions became clearer in that meditative mindset.
Aneel then explained that combining the answers our members found in their deep introspection should make it easier for them to know who they individually are and what kind of contributions they want to eventually make. But even more importantly, it would help each of us choose a purpose that’s the best fit for them.
The conversation concluded with the realization that neither purpose alone, nor Healthy HACKS⁺, Motivating TRICKS* and Science MAPS^ by themselves would suffice to accomplish our mission of helping everyone prolong a good life that’s full of joy. It was actually the combination of all of these together that could help us get closer and closer to full flourishing.
This enlightening conclusion was in line with our LL&F Club core beliefs and values. We believe that real health is the optimization of our day-to-day wellbeing around a strong core of real purpose. We truly believe that an optimized self armed with purpose and focus would benefit from a healthier and more energetic body and a sharper more peaceful mind generating sustainable happiness and ongoing joy. Luckily, beyond these compelling short term benefits, consistent optimization (while having fun!) would also result in some highly desirable “side effects” such as compression of episodic sickness, prevention of chronic conditions, and the prolonging of a life that’s brighter, happier, and yes, healthier too!
(1) Zeevi et al (2015): https://www.cell.com/abstract/S0092-8674(15)01481-6
Vigersky et al (2012): https://www.ncbi.nlm.nih.gov/pubmed/22100963
(2) Postprandial glucose spike, Blaak et al (2012)
(3) Lauren C. Howe et al Harnessing the placebo effect: exploring the influence of physician characteristics on placebo response.
(4) The mechanism of placebo analgesia. Lancet. Levine, J. D., Gordon, N. C., & Fields, H. L. (1978).
(5) Is chocolate consumption associated with health outcomes? An umbrella review of systematic reviews and meta-analyses. Veronese, Nicola et al. Clinical Nutrition, Volume 38, Issue 3, 1101–1108