Testing Ketones With Breath Or Blood: Which is a Better Tool?

Dr. Joel Rosen: All right. Hello, everyone. And welcome back to another edition of the truth about your health podcast where we teach exhausted and burnt-out adults the truth about adrenal fatigue so that they can get their health back quickly. And today I’m joined by a special guest, Jim Howard. He is a 20-year-old healthy 28-year health technology executive, and current CEO of Rita weed out health in St. Louis. Jim’s career started in the pharma industry before transitioning to digital health in the early 2000s, to digital health back in the BlackBerry days.

He’s now the co-founder of readout health, which is the maker of sense, which really what we’re going to be talking about today, which is a medical device that tracks fat burning, trans providing real-time feedback, gamification, lots of really cool things on exercise, food behavior modification, specifically as it relates to the exhausted and burnt out adult So, and Jim lives in St. Louis and has lived on a low carb lifestyle since 2018. Jim, thank you so much for being here today. I appreciate you spending time with us.


Jim Howard: Yeah, thank you so much. Look forward to our chat here.


Dr. Joel Rosen: Yeah. So as I always like to start off with your health journey. I know you’ve had multiple surgeries on your knee. So why don’t you give us a little background on just it sounds like you live in integrity with not just manufacturing and supporting health industries in technology that can really transform our health? But it sounds like you have a story and you have the integrity of practicing what you preach. So why don’t you kind of give us a bit of a background on how you got there and just sort of the gym Howard? I guess the elevator version of what’s going on? How did you get here?


Jim Howard: Yeah, so this is, you know, I was an athlete is played college soccer, and I ended up having six knee surgeries way back then. And is a was a Ginosar typical athlete, I ran a lot had, you know, bone on bone joints. And my wife was cute genic for a different chronic disease that was more serious and had adopted a ketogenic lifestyle specifically, and I watched her weight kind of fluctuate up and down. And I noticed that she was doing her fingerprick in the morning.

And I always kind of wonder like, you know, ketones go up and down. So you’re getting the snapshot in the morning and she was really struggling with retaining that weight loss and we just something was put on my lap. Essentially, what happened again, is I was starting to adopt out of convenience, the ketogenic lifestyle, and I was having a really fast impact to my on my knee being able to run the ski for the first time in a long time, just is pure inflammation at the same time.

The venture firm that I work with had this science project put on our lap, like, hey, these guys figured out, there are two guys that figured out how to measure just the right part of your breath that could replace a blood measurement. That kind of sounds like Theranos, right? And it was like lots. So check that out. And that ended up being the early part of Biosense.

And my investment firm, we actually invested in it, I invested in it personally. And then I run the company now and I live the lifestyle of fasting, some cute ketogenic diet I use it’s kind of a variety, mainly fasting. And using that as the therapy and using you know, our own tool like you do, you know, like using it and dosing this, this very therapeutic level of ketosis.


Dr. Joel Rosen: How long ago was that? What like, what time frame? Are we looking at Chrono?


Jim Howard: Yeah, that was 2019. Really right after I had started to adopt the ketogenic at the time, it’s just a pure ketogenic, ketogenic lifestyle. So now we work with whatever the is always carb restriction, but it doesn’t really matter to us. So yeah, that was a few years ago. And then we want spice since two years ago in the consumer market and have learned tons.


Dr. Joel Rosen: So that’s, where we are. Yeah, And that’s what we want to hear. So as relates to the people that I work with, there’s a common myth, a sacred cow of, oh, I have an adrenal fatigue problem, which, of course, as soon as you bring that to the doctor, they look at you like you’re crazy, or they’re going to be the that difficult person that’s doing this internet research.

But they’re also told, Hey, you got to eat small meals more frequently, because your cortisol levels are low, your blood sugar is going to drop, and then ultimately, that creates a whole host of other problems because their glucose is always going to be high. So but on the flip side, there’s also misinformation about Oh, I gotta eat 80% keto, or I gotta eat 80% fat and the ketogenic lifestyle is really where it’s at.

But I guess for you with the tool that you’ve developed and all the insights that you’ve learned, well, now how do we use the information what You can gain to dictate what is the right approach for that person?


Jim Howard: Yeah, that’s a great point. Because that’s it’s personalized medicine, precision medicine, precision, nutrition, and all of that. And, you know, I think one of the things you said in the first part of that the job was that you know, our physicians, our physicians didn’t, you know, they didn’t say, our primary care doctors, they didn’t study nutrition. They didn’t, they may have had 15 total hours of nutrition education, they’ll be the first ones to talk about that we work with a lot of physicians, you know, we’re a clinical company.

So we work with a lot, but there’s, you know, there are very few people that really, really understand metabolism, fat metabolism, especially, you know unless you’re a kind of an endocrine endocrinologist that’s really specialized in this space. So there are just so so few people like you, and I meet at the metabolic health summit. So with that in mind, it’s like that’s not, we can’t just rely on your primary care physician on weight loss or on you know, diabetes reversal and things like that.

So I’ve really kind of an early takeaway was like, wait a minute, we’re, we’re learning so much right now. And you cannot expect healthcare to be caught up to that. So people like you are really helping with that. So. So when it comes to these different dietary protocols, all of them that put you into this state of this therapeutic state of this Metabolic flexibility, where you’re burning fat and fuel as your fuel source, when you’re burning fat, to get into that state, everybody is different, you know, we used to think, okay, it’s the ketogenic diet or whatever, it doesn’t really matter. Like, that’s going to work for some people, other people can be vegan and low carb, and it’s going to produce ketone bodies.

So think of just ketosis as the state of really fat oxidation. And that’s the reality when is fat oxidation. So, you know, you can limit carbohydrates in just what let’s say, you just watch your blood sugar, watch your blood sugar and keep that, you know, you can mobilize, that’s the mobilization, you can mobilize, you know, triglycerides into, you know, turning into, you know, what could be or will be metabolized by the mitochondria, but that’s just mobilized you to metabolize that and convert fatty acids into ketone bodies that are used as fuel, you get to be in a very carb restrictive environment, okay.

And to do that, it doesn’t matter what the protocol is, as long as there’s, there’s, you know, some type of carbohydrate restriction, so it could be a carnivore, it could be low carb, it could be ketogenic, which is high fat, low carb, you know, it’s whatever the flavor of the day is, we don’t, we don’t really care medications can do the suit, some medications can limit, you know, like an StLt inhibitor, we don’t, doesn’t really matter that makes you pee out glucose. So whatever it is, that gets you into that fat, oxidative state, that’s where the benefits are.

And these benefits, you know, with Biosense, you know, this is used by us, but you know, you go to like, you blow a five and it’s a zero to 40, you just blow into this device, these lower levels are where your weight loss happens, your higher, you know, moderate levels where I need to be from my knees, and that’s where your chronic inflammation is.

And that’s where I get checked, I, I have to be in that, really, for the rest of my life. And because when I kind of come out of that state for a few days, you know, my knee balloons up, and I can’t even carry my kids, and that’s not good. So it’s different for everybody. And that’s the key thing is that you know, you got to use a device to get feedback. And if you don’t have feedback, you don’t know what that specific what a banana does the Joe Versus the banana does jam. And everybody’s different, you know, so different.


Dr. Joel Rosen: Right? And I liked that you touched upon it doesn’t really matter. I think that we are seeing the trend of keto coming onto the scene. And now we’re really realizing it’s about achieving metabolic flexibility by multitasking, if you will, being aware of your circadian rhythm and making sure that you get good movement and you’re surrounded with friends and family and you know, you’re keeping to a routine, but at the same time, you’re doing things to make sure that your body has the ability to tap into oxygen, oxygen for forbade oxygenation and for energy production.

So I guess take us through because I feel a lot of people that do listen to this are sophisticated, and they have done glucose testing with the Keto meter or the Keto Mojo. And I think that’s a good starting point in terms of okay, well, how’s this different Besides, it’s so much easier to not have to prick your finger throughout the day, you’re measuring your breath, but what are the differences metabolically in terms of what do beta-hydroxybutyrate I guess keep Bones signify versus acetone what with breath. Tell us about that.


Jim Howard: Yeah, there are three different types of ketone bodies. There’s the one that’s most frequently measured, arguably most frequently measured is going to be beta-hydroxybutyrate. And that’s, that’s a storage ketone. It’s actually not what your body metabolizes it’s stored in that and converted into acetyl acetate. That’s what your mitochondria actually metabolize. And then acetone is how it leaves your body. That’s your excess. So acetone is Su acetate is pretty, pretty tight. Right?

They work hand in hand together. Done, Augustine has got a couple of really good pieces that he’s written about this on his website. So if you’ve ever looked at keto nutrition, but anyway, those are the three types of ketone bodies. So when it comes to beta hydroxy, butyrate in your blood, okay? That is a storage ketone, it is measured, you know, for accuracy from a venous draw, a capillary draw would be what most people would do in the consumer segment. If you’re in a hospital, the good Chancellor using a venous draw, if you’re going to just prick your finger, that’s not the gold standard, that’s about 20% off of what a Venus measurement would be. But it’s a good proxy, you know, use that my wife used that.

Unfortunately, she didn’t use it three times a day. And that’s, and it’s important that you do it multiple times, because you’re only going to get a snapshot. And I can tell you, we proved in a clinical trial, he doesn’t maintain that a single measurement in the morning of whatever you use, be it Biosense Or keto Mojo, or Abbott, whatever, is 50% off of a time-weighted average, because they go up and down, not like glucose, you know, boom, boom, boom, boom, but it’s there’s a reaction.

So you want to look at that, that curve, what’s the area under the curve, you feel like, at one piece of that curve, you don’t know what your dose of ketosis is, and this is really important is that this, you know, let’s just say it’s a curve that kind of bends up, that’s your, your depth and length in ketosis, that is your dose of therapy. And that dose of therapy is no different theoretically, then a dose of a medication. And if you don’t, if you only know that, hey, I took a drug, I’ve no idea how long it lasted. I have no idea how much of it I took, you’re not really fully informed, are you? That’s what kind of.


Dr. Joel Rosen: No, absolutely. Okay, so as far as with the stored beta hydroxy, butyrate, and then your mitochondria use acetyl acetate, and then the acetone is what basically is the proxy of how much acetyl acetate is being utilized. So as far as that being said, what’s great about the biosensors, and perhaps you could elucidate this a little further is, that not only do you have the ability to measure what’s under the curve by consistent readings throughout the day, but you can also see that you’re continually being able to liberate fat and burn ketones as a fuel because it’s going to show consistent rising over time. Can you explain a little bit about that?


Jim Howard: Yeah, sure. So maybe it rises, maybe it goes down depends, like, so you and I were just talking about, you know, the proline diet, and the impact of that, and things like that. So you know, that’s a higher carbohydrate fasting thing where it goes up and then comes down. But the bottom line is, first of all, breath allows you to measure throughout the day, that’s the bottom line. So you get the full picture, you get a video instead of a snapshot.

And by doing that, the problem with breath biomarkers, they’re very difficult to measure. So what we did is we patented the ability to only measure the last two CCs. So you, as you know that you blow into sense, and 98% of your breath goes out the side. So that’s our patent. That’s why it’s the only medical grade option on the market, you can, you can get a version of BIOSes on Amazon for $30, probably, but it does, it’s going to measure ambient air in your breath, it’s not going to measure your end of lung sample. That end of the lung sample, by the way, is the only part that that interacts with your lung tissue.

So that’s what you want, you wanna grab the good stuff, you know, kinda like the coffee that’s sitting there for a week. It looks like water in the very bottom is just coffee. We want that coffee, right? That thick tar and that’s, that’s what replaces a blood measurement. So the key thing is, is when we exercise and when we eat certain foods our ketone bodies will react.

So if you’re eating, you know, if you’re in a state of ketosis, and you eat something that you thought was really healthy, you know, like, hey, these vegetables which are carbohydrate, but as vegetables, some are really high carb and they’re gonna kick you out of this fat oxidative state, and that’s fine. If you got knees like mine. You can feel that pretty quickly. If you got it. Um, you know, otherwise it could be weight, you know, weight gain and things like that. So you just you got to learn about this. It just takes time to figure out. And so what you’re really doing is not that I’m a biohacker.

But really what you’re doing is some kind of low-level biohacking of saying, hey, these foods are different to Joel, than they are to the gym. This exercise is different for me remember, remember the 10,000 steps, everybody gets 10,000 steps? Who knows? If you need 10,000? Maybe you need 20. I mean, I need 30. So the more than medicine and tools and services start to align to this moving body of ours, this precision body that’s just me, and the impact of just me, and my nutritional and genomic makeup, all that the closer we are to really understanding what the hell’s going on.

And that’s what instance we don’t know what the hell’s going on. That is why the tufts study that just came out last month, Tufts University saying that, that 7% of the US population is metabolically healthy 7%. Hopefully, you and I are in that, by the way. Hopefully, I think we are. And that’s too bad. I mean, look, you and I have spent a lot of time on this space, you know, a lot of time working on ourselves. But you know, that’s, that’s a pretty big number of people that are really unhealthy right now. And they just don’t know. I mean, we’re here to help them know, though.


Dr. Joel Rosen: Yeah. And so leading into the studies, because I know that’s one of the things that Biosense does is do the research and have information on different applications on that. So I’d be interested to know, what is well first maybe explain what aces are, what it measures you kind of talked about it, and how aces are being used in studies to gather information about proper protocol development.


Jim Howard: Yeah, so we have a wide breadth biomarker research company at the core, right, so we have a device that then shows the measurement in a proprietary way to the medical community needs and assumed a consumer group does too. But you blow into the device, you know, three or four times a day, and it’s gonna build your curve of the trendline, your trendline, essentially, and it’s a zero to 40 measurement, and it’s roughly for the average person, it’s about 10, to one to a beta-hydroxybutyrate. Measurement.

Hopefully, that’s a venous measurement, if you want to be accurate, otherwise, just you know, your capillary draw. So it’s about 10. To one, it’s not 10 to one for everybody, because they’re different ketone bodies. So let me give an example. And it’s kind of getting back to your last question is, you know, when you, when you exercise, your body will pull out beta hydroxy, butyrate, from your, from your circulation, right, so your BH B will go down, when you’re exercising your acetone, your metabolism of fat, fat, as fuel actually is going up.

So you’re you don’t want to pay attention to BHB you’re gonna pay attention to acetone, acetyl acetate, so they’re a little bit different. And then they’ll come back together, you know, after a while, but when it goes up, one goes down. And that’s so they’re a little bit different. But so that’s kind of how this would be used, you know, essentially, is that it’s different for everybody. But that’s, that’s the ACE measurement in the clinical trials that were involved with. What they really want to know is, since we enable this, this curve is a trend to see, hey, this is what happens all day.

Wait a minute, we know that those ketone bodies are tumor toxic, right, we know that apoptosis can really impact a cancerous cell. But and ketones are nutrition to other cells. So what is going on here? So things like that. So we just completed a really positive study on pancreatic cancer, these patients are dying of tumor reduction. I can’t get into the details. This hasn’t been published yet. We have studies on the impact of fasting, and this is in Europe, fasting to female infertility, we’ll do a male fertility one after this.

Really put we have rural health studies in populations that don’t have access, which is really critical right now. But all of these kinds of the 10 studies that we have to farmers’ studies also have one thing in common they want the dose of ketosis, the depth, and length of this incredible therapy. So then you can correlate it with an improvement of a chronic condition. So you know, you and I were both at the metabolic health summit. We heard John Rowe John Rowe is talking about epilepsy.

He’s like hey, everybody out here all you researchers using fat metabolism. You’ve we’ve been doing this wrong we can’t just say go do a diet and in great you’re burning fat as a fuel. So what that’s just like say Hey, everybody goes take a specific drug and take as much as you want. And he was like, we need to understand the depth and length of this, we need to have precise measurements of where the heck our bodies are in this miraculous fat oxidation thing. So we play a role in that we don’t do it all. But we help with that. And these trials are really interesting.


Dr. Joel Rosen: Yeah, I’m interested to see them come out, Jim, because it’s hard, you know, with, let’s say, seven to 8% of the population being metabolically healthy. The term that people throw out a lot is mitochondria, mitochondria. And there’s really no way to measure mitochondrial function. And I think being able to measure ketones, especially acetone over the course of a day and creating the total load, and the total length can be a really good proxy for how well is that mitochondria, efficiently burning fuel, and not creating a lot of exhaust in the process, when it’s not using oxygen and using glucose as a fuel, thereby your ketones would be nonexistent or are low.

So this is a kind of inference of things that are happening metabolically in your body for optimal health. And I know, with aces and the different times in ketosis, that the the the Biosense does with the app, and we can talk about gamification, as you get higher, I guess, between the 15 and 40 Aces, you guys mentioned, or you mentioned, a toughie, G. And would you say that that’s ultimately a marker of if you’re able to get into say, 30 to 3540, Aces consistently, whether it’s through diet modification, activity, stress reduction, inflammation, control, whatever it is that you’re doing, that that is really a good measure, proxy for, for your in autophagy.


Jim Howard: Yeah, well, you know, based on published studies, there was a great one out of Johns Hopkins, I think, two or three years ago, on and this was in mice, but you know, they started to paint the picture of, on average, where would you start to see a toffee G. Now, your coffee is always happening all over your body, but what’s the number that you can associate that with that, where they could say that within a study, so it’s an inferred number, it’s about 1517 kind of different for everybody.

So if you’re targeting with our device, 20 and that, you know, it takes a few days to get into that, you know, like, it’s hard for me because my cortisol levels but it’s, it’s, you know, you get more efficient over time, you can tell you that you know, the more efficient gets. So you get you, you have the cellular cleanup that you might do on occasion like maybe it’s a monthly fast for two days or whatever.

Get into it, it’s really important that we get into that model of cellular clean up a tapa G is the Nobel Prize in science and what 2016 17 and but you mentioned mitochondria, mitochondrial biogenesis, and that’s specific to the mitochondria. You know, we don’t know where exactly where that is. So if you shoot for those higher numbers, you’re certainly going to get a lot of the benefits to increase insulin sensitivity, obviously, the inflammation comes in a little bit higher, there’s an inflammasome, that is triggered at higher levels of ketosis, probably like the 10 to 20 range, called RP, our p3, I forget what it is.

But it’s an inflammasome. That’s really important for orthopedic surgeries to were not only losing weight, for example, but you’re triggering not only the lack of assembly or inhibiting the assembly of that particular inflammasome. But you’re also regulating and having modulation of that is suppressing that. So it’s pretty important.


Dr. Joel Rosen: Yeah. So I’d be curious to know maybe some of the best practices that you’re seeing with your I guess, with the people that use your tool or some of the clinicians that help with designing protocols and dietary approaches, because what I find to be problematic is its kind of hard for people to behave these major habit changes, and they’re done slowly over time, to where they start off with restricting their carbs or getting more movement or getting more protein, whatever it may be.

But once I guess what I’m trying to ask is, that it’s important to know that you can’t go into ketosis all the time. I mean, it’s important that we have mTOR growth factors to rebuild and maintain lean mass and, and growth and repair and at the same time, we want to do the Yang To the autophagy, to be able to get those aces levels higher. So as far as best practices with flexing into and out of ketosis using the Biosense, what have you seen with some of the, I guess, clinical feedback that you’re getting?


Jim Howard: Yeah, it’s different for everybody. Because again, we’re the tool, we’re not we don’t develop the protocols. So we started with everything. But I would say, you know, like the Bredesen protocol, for example, which is high impact for maybe an early onset for Alzheimer’s, for those with Alzheimer’s, too, you know, they target, you know, a seven, once it’s like, at least once a day, get up to a seven, which is kind of low levels of, you know, you’ve just entered ketosis.

But again, that’s for at least once a day. So you can be cycling in every day at this kind of lower level, that that works really well. You know, you’re 50 years old, and you find out that you’re genetically inclined, you gotta really watch what you eat. I mean, all of us should be watching, right? But then you’ve got, you know, we’ve got epilepsy protocols that are pretty high.

And they have to stay in that all the time. Because right, when you start to come down, it’s really problematic. We have mental health protocols that we work with, you know, where, for example, in schizophrenia, that’s really high impact. You’ve heard Chris Palmer and others talk about that, really, really high impact and mental health, we’re just learning about all this right now.

Those are, you know, if you come off your medications, that’s really dangerous. Because you’re, you’ve been in this cathodic state, that’s more of a permanent thing. So a lot of these are permanent, some of these chronic diseases. You know, I certainly know what’s best for me. And what I recommend to my friends, personally, is that you’re kind of cycling in and out. And I cycled in and out on weekends, you know, right?


Dr. Joel Rosen: Yeah, you got to still live, right, you still gotta have the, I think the creature comforts from time to time. But I think ultimately if you’re listening to this, and you’re thinking, Okay, I kind of understand what they’re saying at a certain level. Think of it as if you’re I that’s what I tell people the gym is, if your body isn’t able to use energy, by our being able to produce energy through oxygen utilization, which is going to be burning aerobic ly and burning healthy fat for fuel, it’s going to be burning oxygen, it’s not going to be using oxygen at all. And it’s going to be going through glycolysis.

And that’s going to really drive up a lot of oxidative processes. And in order to slow that prop that process down, or at least produce more energy more efficiently, you want to really be able to use oxygen for you. And that’s where using ketones as a measure of how well you’re doing comes into play. So as far as the Biosense, because I to be honest with you, I’ve just recently become a lot more conscientious about it. And I am doing a lot more measuring.

And I’m looking at the app more and I liked the idea that it gives me some prompts to be moving more. So you do have the I guess it’s the what do you call it on the actual app? I’m sorry, I just had a brain fart here. But I guess you call it the what is it the door? Yeah, you’re cute. Can you tell us a little bit about that in terms of how we measured with movement as well?


Jim Howard: Yeah, ketones score really is an area to the curve. So what that means it’s just kind of a number associated with the length and depth of, of wear of your ketone body production, you know, through measured through Biosense. So again, if you’re seeking, it makes it really easy, like, hey, when you get our app, and you’re like, Hey, I’m focusing on inflammation. This is me, like, I wasn’t trying to lose weight, I’m focusing on inflammation.

And you know, through some questions and things like that, it’ll guide you to well, this is probably the score you want, which is actually being on average at this level of aces. But you’re never going to be on average, we eat food, we do different things. And you come in and out of that. So what it’s doing is kind of building this total dose, this therapeutic dose of fat burning.

And for weight loss, it’s excellent, you don’t need weight loss. The good thing about that one is it’s kind of the most common one, but it’s also the lowest level that you need to get to and the easiest you want to get to. And if but if you’re going to lose a lot of weight, just get into higher levels, ketosis so, you know, but that’s what you do. And the app guides you through all of that. And it’s that’s the kind of the gamification of look, this is novel. We’re learning about this right now.

Make it understandable for me is average Joe that’s trying to lose 30, you know, at age 50, or, you know, postmenopausal female that’s got all kinds of hormonal things that I’ve met physicians recommending this and for various reasons, I just need some guidance on how this works. So There’s a little bit of that, you know, brings you there. But it’s, it’s ultimately, you know, we don’t get anybody better. We don’t, you know, we do, we’re just a supportive mechanism where we help make sense of it and make it easy and bring insights that someone in their home can make the change, and get a really quick win to get a quick win.

Where let me give you an example. Here’s one, this is van at pure vanity, put yourself into, you know, a state of ketosis for four days. And look what happens to your face. Okay, look at you know, the inflammation that all of us carry, look at the bags under your eyes, look at all those different things. You just do it for the vanity liquid happens to you know how sugar damages your skin through this glycation process, then all of a sudden, your, you know, your collagen and elastin are no longer suppressed there, they actually can get stiff and, and you know, the more flexible and things like that. So I think that that’s the key thing that you really want to start to look at. And that doesn’t drive it, then it’s all this stuff on the inside. Right, you’ll find a when I guarantee you’ll find that when it is for four or five days, you’ll find a win.


Dr. Joel Rosen: Yeah, and I like the idea that you coined a sort of behavior modification tool because when you have real-time feedback on the choices that you’re making, and how it’s impacting your physiology, let alone how you feel or look, and you’re seeing things getting worse or getting better, you’re going to do less or more of whatever it is that’s going in that direction. And I think the problem has been with a lot of the people that I’ve seen, Jim is, well, they tell me that my blood tests are normal.

And I certainly don’t feel normal. And, you know, I use the analogy, I think it has to have about six 70% Bone Mineral changes for an x-ray to be sensitive enough to pick up the diminished bone density on there. But meanwhile, you can have the processes happening along the way, even though it’s not picking it up. Whereas a device like this kind of redefines or creates a paradigm shift in the way healthcare is practiced, from the point of view, okay, we don’t care if your blood tests are normal, we want to see if you have the ability to be what they are the coin metabolically flexible, where you’re able to drive down your inflammation, you’re able to use oxygen to combust healthy fat, and that’s allowing you to be more effective and efficient and energy producing.

And you can see that that happening. So I kudos to your company to be able to design that. And I like that you actually work on clinical trials to see, hey, we’re learning this as a, as a manufacturer, as a company of what the impact of our tool can be. I guess that leads us to what trends or what clinical trials you’re working on, or what do you see coming through the pike in terms of now that we’ve made that first step of creating this device? I see all of this potential or that potential, what do you see?


Jim Howard:  Yeah, it’s really interesting because there’s so you know, you’ve got to let people are just starting to really when I say people and consumers, we play in the consumer and the research and clinical space, but on the consumer side, we’re, we’re just seeing access that we’ve never had COVID caused a lot of this to you know, could cause that, hey, now you’re in the home, you got to kind of take care of yourself and they’ll say like, oh, wait a minute, I shouldn’t eat anything I want.

Wow, I’m learning about this on my own because my physician doesn’t know. So I think that we’re it’s a different person, the lines are a little bit more gray between clinical you know, somebody can go to you and learn a ton. You know, I don’t know if the average primary care doctor is going to know that much about metabolism anymore, you know unless they’ve just come out of school the last couple of years. So it’s got to be careful there. But my guess where I was going with that is we’ve got an opportunity now people using CGM consumers going out and buying CGM.

Now they’re learning that hey, this is what happens to my blood sugar I gotta get that blood sugar down so they don’t have so much insulin, you know, going up and down. And by doing that, now I’m in the first step by the way, but that’s that doesn’t do that’s not where the fat oxidation happens in a toughie G and inflammation reduction all that’s in ketosis. That’s what we measure.

We’re the undoing the bad. Glucose is stopping the bad. Now we do the work where were the worker bees. So I think what we’re starting to see is that consumers are starting to put this together and we sure as heck haven’t done it. You know, we don’t know everything but we will We have learned a lot that, that consumers can do this, we have to package it in a better way.

So it makes sense for all. All health levels of intelligence, okay, that it’s that there are health equities are written all over this that we can, it’s going to make sense for everybody because here are the worst names right now when it comes to diabetes when it comes to obesity, you know, we know go out and rural area, okay, go to an urban area, urban underserved and rural, underserved, okay, and they might be different color people. Okay, they might look different.

But it’s the same problem with diabetes and obesity. And we’ve got to figure that out that it makes sense. And it’s available to everybody. And it’s just a really important part that I know that we as a company are very focused on is, is getting that reach to everybody. And it’s got to be packaged in a way that makes sense for everybody so that’s a big part of the trend that we see in health systems is health equity. And it’s the right thing to do. So our job is to make it super presentable, you know, have the gamification that makes sense to get a little win.

If I need a little when I can get a bigger win. If I blow one, one on this on this device, it’s so easy to use, I’m going to get to two by just getting rid of the bread on my sandwich and having you know, and having an open face something or whatever, but and then if I need to, I know I can get into a fat oxidative state at five. By the end of the week, you now listen, whoa, I’ve got I’m actually losing, I’m using my own physiology, as my fuel.

Isn’t that kind of cool? Taking it from an actual fat, so that might be on my liver, which is really bad, right? Or adipose or you know, adipose tissue that’s actually on your visceral fat, for example, that’s really bad, too. All of a sudden, it’s been shifted into my actual fuel. That’s what fat burning really is. If you can use your own fuel, you’re set to go. You know you got the fuel all over. Let’s just use it.


Dr. Joel Rosen: Yeah, it’s interesting, because I’ve had the opportunity to interview Dorian from keto Mojo. Yeah. And I see a lot of parallels in the sense that okay, you didn’t kind of realize what, what you started, I guess, right? I mean, initially, it’s a device that can help track and get some good feedback. But at the same time, now you’re looking at helping, you know, a bigger purpose of people that need support, and food bills get changed, and healthcare policy gets changed.

I mean, it’s amazing that the fallout and I think the other thing that you mentioned, too, was now that we’re empowering the consumer, to be able to take control of their health and not necessarily be reliant or dependent on a provider to give them the answers, and they can do it themselves. And the other thing that I find kind of ironic, too, is, is that it’s not rocket science, the things that are actually implemented that make the changes like, Oh, so you’re saying if I actually move a little more, and I don’t eat as much, you know, crappy food that my numbers are gonna improve?

Yeah, but you’re gonna actually see it in real-time versus seeing that your blood tests are kind of normal, and they’re, you’re not sick enough, or you just need to be put on this medication to address that. So I think there are a lot of amazing consequences that you may not have anticipated starting with this. You’ve seen that to be true.


Jim Howard: Yeah, it’s, we learned so much. Yeah, we, I mean, look, we’ve got a platform and we’ll add more to the platform. And he’s like, you know, really interested in nutrition AI in this too. But look, who do we learn from, we don’t learn from being in the lab and building all this stuff. We learn from the users, we learn from the clinics that are or the academic researchers that are building things in order for people like you that have had patients, you know, it’s we’re all in this together, we got to figure it out, you know, 93% of us need help. Right? 93 A lot of people.


Dr. Joel Rosen: Yeah. And it’s interesting, too, because I’ve talked to Dave from heads up health. And it’s really great when you can bring in so many different metrics from looking at heart rate variability, looking ketones, and looking at steps and movement.

The only problem was when I found Jim is with the clients that I work with because they were such an early adopter, you’re making them do so much data entry, and they’re already stressed, to begin with, you want to kind of make it as passive as possible so that all they got to do is breathe into a machine or all they got to do is upload something and then a clinician tells them, hey, keep doing this, but you know, stop that versus having them to do it on their own.

And I think that’s where we’re headed. So one of the questions I have is just on your own health journey because you know, want to get down to the fixing the stress response, and I Understand and as we get, I guess, more, I guess, sophisticated over our own health journey, what would you have told the old gym that was not aware of some of the stuff that the new gym knows, in terms of maybe accelerating your health or being more energized? Or just feeling better? What are some of the tricks of the trade that you’ve learned during your time of getting in this industry?


Jim Howard: Yeah, that’s a great question. I think that you know, holistically, I didn’t realize how connected everything was. And this is I think, I’m a pretty good personal example, to be honest with you, you know, I, I followed this to the tee, that pyramid that kind of bullshit pyramid we were given, it’s caused a lot of the problems. I follow that to a tee I was on, and I wouldn’t say low fat, I was on a no fat diet probably since from 1995 to 2016 17, and had fully transitioned to where I am right now in 2018.

And by doing that, I was pretty much destroying myself. I mean, I was eating, it wasn’t eaten sugar or anything like that. But I mean, the amount of rice and pasta and bread and blah, blah, blah, like all that, I mean, no processed food, there’s just all the stuff that was so high carbohydrate, but natural. And I’m guessing it probably put down about 350 carbs a day 400 Maybe. And my fat intake was nothing. And I was not healthy. I just wasn’t really healthy.

But I thought I was healthy because I was doing everything that I should have done to the tee to the teat, man, gotta love that yogurt. 20 grams of sugar in that yogurt, right? So I think that the unfortunate thing about that was I, I learned late in life, but I mean, the pain point was I couldn’t carry my children up the stairs. I’m an older dad, I had kids at 46 and 48, and I could not physically carry them upstairs. So all of a sudden, when I found this through my wife this lifestyle was permanent.

Now the holistic side of this is that I didn’t realize Yeah, the great inflammation, I can carry them up the stairs, I didn’t realize how much better I slept, I didn’t realize how much that my cute senses, you know, it is like social cognitive ability is so much stronger. And you’re like so aware, I didn’t get tired, you know, the pasta, who, in the middle of the day, and like constantly, then caffeinate up to overcome that. And it was I was doing everything wrong to a band-aid, everything.

And when you start to put yourself together metabolically, you realize Holy Cow insulin resistance is what causes all of these, you know what 30% of cancers, nonalcoholic fatty liver disease. Okay, a lot of these mental health disorders that we’re learning right now like it’s so tied together. And when you just focus on that, get yourself to metabolic flexibility, the wheels kind of fall in place, they don’t fall apart, they fall in place. And that’s kind of cool. And it actually doesn’t even take that long. You notice that when you’re patiently best.


Dr. Joel Rosen: It is. And the thing that you mentioned, though, too, as you’re doing all the things that you were told to do. Right? It’s not like you were a row guy fighting the system and dealing with the consequences. And I think that’s why you still see 93% of the people because they’re still eating the yogurts and the processed carbs, and, and so forth. I mean, they have no clue how much carbs they’re taking in in a given day.

And there’s no wonder we’re sort of in for a tidal wave of metabolic issues if we don’t reverse it, but with technology, like with what you’re doing is the first step to knocking down that that major albatross. So as far as where people you know, go to get the device, it looks like this. I haven’t shown them and for those that are going to watch the video, it’s easy to do. You know, it’s funny, actually. So I don’t I don’t vape not and but it’s so funny like when I’m out in public I think like people are like are thinking that I’m you know, vaping because I’m measuring my breath ketones. Not that there’s anything wrong with that. But um, where do people get that device?


Jim Howard: Yeah, so you can it’s at my biosense.com and we’ll set up a code for your users as well are your new patients and friends that listen to the podcast and it’s just Dr. Joel, Dr. J. o el and they’ll give you $20 off the device is $299. The sensors should last a couple of years if it’s stored appropriately and or more, and it’s unlimited measurements. So it’s 290 $9 $20 was off with that code. And yeah, and then we shipped it from here in St. Louis. So we are the manufacturer and research company to we do it all.


Dr. Joel Rosen: Yeah, I mean, listen, it’s great too because I have both the, you know, the blood marker and the breath meter. And the great thing is you can do it very easily. You don’t have to prick your finger and you’re not paying for the strip’s over and over again to write. So that’s the great thing about it. So hey, Jim, thanks for your time. I appreciate you being here and looking forward to seeing your future success. And I appreciate everything that you do. Yeah.


Jim Howard: Thank you so much. Appreciate. Thank you.

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