015-Jim Howard MBA: What is the best way to detect ketosis?

Ketones and ketosis are everywhere in the news. 
What are ketone bodies? 
Why are they good for us? 
How do we measure them?

Our guest today is Jim Howard, the CEO of biomarker-based startup  Readout Health. Their product  Biosense is the first clinical-grade, handheld device that measures nutritional ketosis for chronic disease and longevity/wellness focused consumers. He is a digital health executive with an MBA from University of Missouri-Saint Louis.


What are the three ketone bodies and the three general ways to detect them?
Three Ketone bodies are produced as a by‐product of fat metabolism. When the liver metabolizes circulating free fatty acids, they are transformed into acetyl‐CoA, a molecule used in the production of energy. Depending on the glucose level, acetyl‐CoA can be diverted to produce acetoacetate, the first of three ketone bodies. From acetoacetate, two other ketone bodies, β‐hydroxybutyrate and acetone, are produced by enzymatic degradation or spontaneous decarboxylation, respectively.

All three ketone bodies circulate in the bloodstream. Acetone, because of its small size, diffuses into the lung and appears in the exhaled breath. The devices we will be discussing detect levels of acetone from this process. Deep lung measurement is a technique to assess acetone levels.

Biosense Breath Ketone Monitor -Use the code Lufkin20 for a $20 discount at https://mybiosense.com/ 


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Robert Lufkin  0:00  

Welcome back to the health longevity secrets show and I’m Dr. Robert Lufkin ketones and ketosis is everywhere in the news. What are ketone bodies? Why are they good for us? And how do we measure them? Our guest today is Jim Howard, who happens to be the CEO of biomarker based startup readout health. They make biosense, the first clinical grade handheld device that measures nutritional ketosis for chronic disease and longevity wellness focused consumers. He is a 27 year digital health executive with an MBA from the University of Missouri St. Louis. Now, please enjoy this interview with Jim Howard. Hey, Jim, welcome to the show.

Jim Howard  0:47  

Thank you for having me. Morning.

Robert Lufkin  0:50  

Yeah, well, ketones are everywhere in the media, a ketogenic diet, keto friendly, all these things today, we get to dive into this area with a real expert in the field. But before we do that, maybe you could just take a moment and tell us your your journey, how you came to be interested in this this area?

Jim Howard  1:15  

Yeah, you know, ketogenesis, or ketosis in general, as a as a therapy, chronic disease therapy is has always been fascinating to me in the past, probably five years, you know, we as a company, you know, we focus on that state, as opposed to a keto diet. We don’t care what the protocol is. But I got interested. My background, was in pharmacy and pharmaceutical industry and then into digital health. So is looking for digital methods to treat or prevent chronic disease and spend some time with a big company and respiratory diagnostics. The next thing you know, I was working with Washington University and tech transfers with bio STL. And that’s how this kind of came about when someone knocked on my door and said, Hey, Jim, will you look at this, this technology that these guys are building out in California, I happen to have had a ketogenic household, my wife is a cancer survivor. And so she’s for remission purposes, she’s probably gonna adopt that the rest of her life. I ultimately adopted it after her arm pulling in and I had six knee surgeries and the impact to inflammation and my ability to do things. I mean, within a week, this is probably four or five years ago, I then adopted that ketosis lifestyle myself. So that’s how it all happened. And then this technology of being able to provide kind of a full day resolution of ketosis dropped on my lap, and I jumped at it. So I’m invested in the company, my firm invested in the company, and here I am, right now, with biosense in the market. So that was my story.

Robert Lufkin  2:53  

Well, that’s fascinating. I love it that you’re you’re a true believer and a practitioner of ketosis, you can speak from experience and, and ketones are not only everywhere, and ketosis not only everywhere in the in the public media, but also in the scientific literature, we’re seeing a revolution in our understanding of chronic disease that I’m sure we’ll get into today about how these molecules affect a variety of diseases that, you know, 10 years ago, we didn’t really appreciate or understand. So let’s let’s start from the beginning. What what what are ketones? What are ketosis? What is ketosis?

Jim Howard  3:37  

Yeah, sure, I mean, I mean ketone bodies obviously are what are produced when you’re in that state while on the other side of the metabolic switch so if you just think about in general a metabolic switch, you’re either burning glucose or you’re burning fat as a fuel or ketone bodies. The the damage is undone on the other side of the metabolic switch, so burning fat or X, you know, fat oxidation. So we there’s a lot of interest right now. And in CGM, for example, for consumers and and bringing your glucose in range. And that can prevent further This is a very general statement that could prevent further weight loss, prevent further acceleration of type two diabetes, for example, but undo the damage, you know, and certainly studies and Alzheimer’s type two diabetes on and on and on. Getting to that state of fat oxidation is critical. Okay, so it plays a key role of prevention, chronic disease prevention and longevity healthspan. In treatment, so many treatment protocols right now and then the reversal. So yes, me. Yeah.

Robert Lufkin  4:42  

Well, I’m sorry, I let me just amplify that. One thing for our audience CGM is of course we’ve talked about before continuous glucose monitors and wait, what you’re underscoring, I think, is the point that CGM will allow us to track the glucose levels down to a basic level but you could have a low glucose but not be in ketosis. And so what you’re saying is monitoring ketosis allows you to see when the switch is fully switched to. That’s right to ketosis rather than just low glucose utilization. And I think that factor in this biological switch and undoing the damage.

Jim Howard  5:18  

Yeah. And then you hear about metabolic flexibility with your ability to go back and forth in between cities, which happens over time. And so in that state of ketosis, and again, keto diet is, you know, gets a lot of the press for the past few years, certainly now, intermittent fasting has probably even overtaking the keto diet. But it doesn’t matter what the protocol is, every weight loss protocol is chasing fat burner, fat oxidation. But the key thing is, is how do you package that up into a protocol? Or how do you track it all day long as you eat, you know, much like continuous glucose monitoring monitors your glucose levels, you really need to be able to track that, to see what the impact of your actions are. So So what has been missing in the market is the ability to modify behaviors, in metabolic behaviors with data beyond, you know, on this side of the metabolic switch, and that’s, that’s really what was missing. I’ll give you an example. My wife, you know, a cancer survivor, and she’s in ketosis all the time, or tries to be, she was pricking her finger in the morning, assuming that was her measurement the rest of the day, and that’s very common. So she was getting a false positive, you know, after fasting for 14 hours and things like that. So So how do you? How do you start to really track what happens in your body physiologically, and that’s that’s kind of where we come into play. And, you know, there’s three different types of ketones that you can measure. And we measure one of those that we think is the most effective.

Robert Lufkin  6:50  

Now, you mentioned metabolic flexibility. It is that’s it, the ability to switch back between these two metabolic states. Right? Is that a downside to remaining in ketosis all the time? Do you lose your metabolic flexibility? You mentioned your wife’s in ketosis and I know of many, many individuals who stay in ketosis for for health reasons is that, is that a downside for that?

Jim Howard  7:16  

No, I don’t believe so. I’m, I’m not a physician. But I, I would say that those that practice ketosis, regardless of the therapy, you know, whatever it is the protocol to get you into that, if we’re the ones that when we come out of ketosis, and you know, maybe it’s a weekend to go to a party or something like that, you can get right back into it very, very quickly, whereas someone that each standard American diet, and they, for the first time, get into ketosis, maybe it’s from fasting after three days, and it takes a lot longer, a lot longer. If someone’s not used to it. They will come out of ketosis right away, and it’s much more difficult to get back in. But you do that over time. It’s like riding a bike and you become metabolically flexible, your body’s able to go in and out of that. And it just depends on what you’re trying to do. If you’re in weight loss, you know, you’re obese, you probably want to stay in ketosis for a while and you know, you can cycle in and out on occasion. If you’re epileptic, epileptics tend to stay at very high levels of ketosis to prevent seizures. Alzheimer’s, were part of a protocol there deal Britten’s protocol, you know, they’re trying to put you into a moderate level of ketosis really, for the rest of your life for the most part. So it really depends. And then, you know, in health span, that’s where it gets really interesting is you trying to get an autophagy state or seek a toffee G, you know, on occasion to, to really start to regenerate cells. And we can get into that too, but those are the different things. It’s different for everybody.

Robert Lufkin  8:49  

So those are some of the health benefits of toffee G and and you mentioned the three ketone bodies. Could you Would you mind explaining those for our audience? Yeah, so

Jim Howard  9:03  

I think at the core to really understand is that aceto acetate is what is metabolized that is one of the three ketones that is what is metabolized by the mitochondria. So call that the key ketone. And it could be measured syrena serum tests, which is generally only available at a hospital or send out lab, or it can be measured in urine. So a urine strip so your job is very inexpensive, often used, you know, in the hospital Ed, your body will adapt. If you’re in ketosis, your body will adapt, you know, over time so so there’s the limitations there just gives a range and you really can’t use that over the course of you know, beyond a few weeks. So that’s that’s kind of one then you have bhB which is generally what most I would say most people use in the consumer market. So bhB has been around for a while. There are commodity devices that measure that and that in a hospital, there would be a venous draw, that’s the gold standard, a capillary measurement is going to be about 20% off. It’s good, it’s not great. But that’s what most consumers use. Key to understand is that bhB is a storage ketone. Okay, so over time, if you says your body starts to adapt, you probably will need to store less and less bhB. And bhp is what is depleted right away, like when you go exercise, you will deplete ketones in your in your blood, and then use those. So it’s a storage ketone. And that can, you know, a sudo acetate converts into into bhB. And then bhB converts back into pseudo acetate, so it’s kind of going back and forth. The third ketone is acetone. And acetone is extruded in the breath. And that’s a one way street. Okay, this sido acetate to breath ketones, and that is what we measure. And arguably, that is the closest comparison and that conversion from a pseudo acetate to acetone is what is being used, okay, as opposed to what is being stored. The difficulty with breath acetone in the past is extremely difficult to get a reliable and repeatable measurement, as you know, so you’ve looked at this before. And so there until we came around, once I saw the work that these guys were doing, originally with verta health in San Francisco, and then others is, is the ability to fractionate your breath. So you can’t have a reliable breath measurement unless you’re only measuring the right party of breath. So let’s just say you’ve got your breath is 90, what 5% ambient air. The difficulty before is that you blow into a device, and you’re really measuring mostly they’re around you. So the patent that biosense has is released, released to really have a clinical grade measurement, and it shocks out 95% of your breath. And it only measures just the last two cc’s of your breath. And that’s what’s interacting with your, with your lung tissue. Okay, and it’s highly, highly concentrated. So that’s what could replace essentially, a blood measurements. And we had a clinical trial a couple of years ago to prove

Robert Lufkin  12:20  

that. So that that’s the the deep lung measurement that that your your particular product has a has a patent on.

Jim Howard  12:31  

That’s right. That’s right. So it’s deep lung sampling or fractionated breath sampling. And, and that basically that allows you to then plot out throughout the day, what is that? What is that key tune alteration based on what you eat or what you exercise, you know, your exercise, so it’s just following your metabolic pattern throughout the day and building that area under the curve. And that’s what, what Noah has been able to really do. And that’s it’s critical, especially when you start to build that digital health products, digital therapeutics, you need to have that just like CGM, you got to have that area under the curve.

Robert Lufkin  13:06  

Yeah, yeah, absolutely. back to the basics on the metabolic switch, before we dive deeper into that, what, what are the triggers for the metabolic switch? What what causes our body to switch to one side or the other? And how do we influence that?

Jim Howard  13:26  

Yeah, I would say that there’s there’s three, three primary kind of functional areas that we look at that, that puts us into that metabolic switch and low, you know, initially, low levels of ketosis. One would be, you know, your nutrition, okay? So nutrition can be broken down by a carb restrictive protocol, you know, one in six Americans right now, or carb restricted protocol, that’ll probably increase over time. So whatever the protocol is, you know, in all your diets are trying to put you into some type of fat oxidative state or some katatak state. So, so that would be at nutrition primarily in a carbohydrate reduction number. The second part of that would be just caloric restriction or fasting is a really good way to do it. So fasting is easy, because you just don’t do anything. Right. That’s the problem with fasting, though, is that people believe and they read, I can do this 18 six diet, eat whatever I want in those six hours, and then not eat for 18. I can tell you’re not going to get into ketosis. Unless you are metabolically flexible, and it’s highly doubtful in American diet, you’re going to have any impact with an 18 six diet. I mean, there’s some benefits, but you’re not going to have you’re not going to go into ketosis

Robert Lufkin  14:43  

and that’s assume earlier that’s assuming you’re consuming carbs in the six if you just a fats and protein in the sixth then you conceivably could be in ketosis.

Jim Howard  14:54  

Sure, yeah. That’s a great

Robert Lufkin  14:55  

but a normal if you if you went back and ate a bunch of crap In that six, six window then that would essentially flip the switch is what you’re saying

Jim Howard  15:05  

is that exactly, you’re not going to get very far, you might start to produce a few ketone bodies real low levels, but it’s not going to do much for you that so it’s nutrition number one is number two is going to be exercise exercise is the second big one. So you can start to, you know, you know, the more you exercise, you’ll deplete your glycogen stores. And then and that’s a great way by the way to start a fast is deplete your glycogen stores. And we can talk about some cool personal protocols down the line. And, and then you’ll have an interesting thing and ketones is that your bhB could go down and during the exercise, because you’re going to grab all those and use those and your storage ketones, your circulating ketones are going to be gone. Whereas your breath, ketones will be going up. Okay, and they’ll all come back down together. So that’s, that’s an interesting phenomenon there. Then you have, the third one would be exogenous ketones. So you know, that people like Brianna Stubbs out at the buck Institute, doing a lot of research on the impact of of that, so that can elevate ketones and put you into ketosis for a pretty short time, though, you know, generally, the three hour time frame, you’ve seen a lot of elite athletes start to do that you’re starting to see, we see it in Alzheimer’s protocols also. So it’s kind of an easy way to get into ketosis. It’s very expensive.

Robert Lufkin  16:28  

And also, like medium chain fatty acids, coconut oil that some people using as supplements or other exogenous sources, to raise the raise the levels on the monitors, right?

Jim Howard  16:43  

Yeah, exactly. So that’s a good way to kind of cheat the system and get get it elevated or jumpstart. Next, I used to use a lot of MCT oil, I don’t really need to anymore, but yeah, so those are the three primary ways to really jumpstart and maintaining your elevation of ketones. So yeah,

Robert Lufkin  17:03  

and, and so it’s basically, we want to switch from from glucose slash glycogen metabolism to ketone metabolism. And to do that, we have to cut out the sources of glucose. And we then after that, we have to deplete the glycogen stores, which can take, you know, 12 hours or more in average person, and then the ketosis kicks in if the person isn’t keto adapted, when it’s nice. By keto adapted, we’re meaning they have low glycogen stores so that they immediately go into ketosis and also metabolically

Jim Howard  17:42  

flexible, right? That’s right. Yeah, exactly. And that’s, that’s where you start to really see. And then if you can, you know, that’s kind of step one was, is that literally, step one is going to, let’s stop doing the damage ourselves in these, this is kind of universal protocols. Stop the damage. Now let’s start to dress you know, some some healthy habits to drive behavior modification, and have we provide the data and our say, here’s the data to support that and everything you do. Okay, it’s working great. Now I have the motivation with biosense the device, you blow into it to get that, that, that feedback, and then really kind of the ultimate goal is, now let’s really start to seek the cellular regeneration and focus on you know, now I’m starting to be healthy, I want to focus on longevity and health span, I want to live a long time free of chronic disease. And and that’s the that’s the real cool thing about this. And I wish that more clinicians were starting to engage in that, you know, and that, that way of treating patients and prevention as well, especially metabolic disorders, but we’re seeing some early adopters, and that’s exciting.

Robert Lufkin  18:50  

Yeah, like, Yeah, well, yeah, it’s fascinating. We just spoke with Kara Fitzgerald on the show, who’s a practitioner on the East Coast, who did an interesting actual randomized prospective clinical trial, a pilot study of about 40 people, but it was using lifestyle for eight weeks lifestyle changes, and they measure their epigenetic DNA methylation clocks, and it showed that a lifestyle regimen for eight weeks resulted in a three year reversal in in their longevity clocks as measured by DNA methylation and, and it’s a pilot study, but it and it involved the ketogenic diet, of course, among other things, and other factors, but and she may be he may have even been using the biosense monitor with it, but great, it’s fascinating work that’s being his work that’s being done in that area. What are some of the the clinical areas you meant you touched on a few of them there with Dale in his work on Alzheimer’s disease, and what’s the common theme with ketosis and how does it affect all all these different diseases that are seemingly unrelated?

Jim Howard  20:07  

Yeah, I would say probably the lowest hanging fruit or melt metabolic disorders. So pre diabetes, obesity, type two diabetes reversal, this are the, you know, when, you know, when I first got involved, the company with the project was initially collaborating with verta health to find some type of methodology to track, you know, track ketosis levels for type two diabetes reversal, then that kind of morphed into some other areas, too. We, we have an upcoming trial in type one diabetes, for decay with an STL t we have current trials and pet we have a pancreatic cancer trial at Washington University and insulin resistance trial at washu. We have upcoming trials in glioblastoma, that’s actually instead of California. So some of these are targeted therapies. And, you know, treatments for cancer. They we have an infertility study right now using a seven day fasting therapy for women, and then they’ll do it for men and infertility. That’s in Germany, at Charity Hospital. So we’ve got I think, 11, or 12 lined up, we have a very significant pharma study coming up starting next month and metabolic disorder space, a phase two trial, I can’t comment on that. But there’s a number of really exciting opportunities for us where we enable research because we provide that full day resolution of your metabolic journey for ketosis specifically. So it’s hard, it’s hard to, you know, think about it. How can you have a therapy, let’s use obesity as an example. I’m an obesity physician. I see this patient once a week, and I have absolutely no idea what happens to them when they leave my office. They come back a week later, and they tell me that they’ve done everything that I’ve asked them to do, and they step on a scale. It’s it’s a horrible, horrible way to treat a patient. And as we all know, it’s not working. And obesity is, you know, on its way to 49% in the US by 2030. So, so what if you can provide transparency and say, Look, here graphically, I can see that this patient on Tuesday through Friday was compliant with my protocol to be in low levels of fat oxidation. And then two days over the weekend, they came out but barely came out. And, you know, I can see that 80% of the time they followed my protocol, do you think that the weight, the weight loss is probably going to be there, okay. And then you can start to get a little more aggressive net therapy, maybe start to take them off meal replacement, because they’re now starting to do some things on the road. So without that data, it’s just a guess it really, really is it guests and that can be translated into other things, too. So you know, the Bredesen protocol is really cool for Alzheimer’s, early onset propensity, where they put people on a protocol for fasting and now they can see, you know, what, what is exactly happening to them as their ketone levels, getting into these optimal levels in a two day fasts or one day fast, whatever it ends up being. So, you know, we just provide the transparency to confirm, validates and motivate Simple as that.

Robert Lufkin  23:24  

Yeah, I mean, it, it seems like what you’ve you’ve got as a tool to monitor, you know, basic levels of ketosis, which, you know, originally would you think it would be just to apply to a narrow area, but what we’re seeing is a transformation of our understanding of chronic disease in healthcare. And now, as you mentioned, we’re we’re seeing our understanding of Alzheimer’s disease to be at a basic level dependent on metabolism and ketone, ketone and carb ketosis and carbohydrate restriction, right helps many, many patients with with Alzheimer’s disease. We had a cardiac surgeon on this program, Phil Aveda who’s transforming his practice to help rather than treat patients on his table. He wants to prevent them from getting cardiac disease, and the way he does it is with changing your metabolic state, put them into ketosis and a key tonic, low carb diet and some other factors, but we see it being applied there for cardiovascular disease, and as you mentioned, in certain forms of cancer, it can, ketosis can be very effective. It’s just It’s amazing. It seems to be underlying more and more things that we look at it it’s it’s such such a powerful tool.

Jim Howard  24:45  

Yeah, the the research published last year Kyle mcommerce at St. Louis University with this is in mice but for heart failure, really promising data of a high fat low carb protocol and and the reversal of heart heart failure. So, you know, enhanced ejection fraction. So we have an upcoming study that Grant has been submitted at Harvard for study with with license in that regard. So yeah, there’s, it’s, it’s really, really interesting. And to be honest, it’s not surprising when you look at what our bodies were originally built to do, and how they were expected to had the frequency that we ate, and, and, and really how our diet has changed just in the last 100 years with chronic disease just taken off with that, you know, 100 years ago, we died from from different things, and we died at birth, we died from infectious disease, we didn’t die from chronic disease nearly as much as we do today. So it’s great. I mean, two years ago, there were 82 clinical trials with ketosis. And, today, any any given week, there’s anywhere from 220 to 225 clinical trials right now, so it’s tripled in just two years. The interesting thing is there’s no registered digital endpoints for pharma trials with ketosis, there’s a major imbalance of you know, the translational side and what will come to market so we’re that’s what we’re here to help.

Robert Lufkin  26:16  

Yeah, I mean, I guess I guess it should be no surprise. When we look at the these chronic diseases, we’re seeing that the longevity and longevity genes underlie a lot of the chronic diseases and when we look at the longevity genes that are conserved from yeast all the way to human beings, you know, things like sirtuin genes and mtorr and MP kinase are all at least to a major extent nutrient sensing genes and proteins that they may want to deal with nutrient sensing and essentially the metabolic switch, you’re talking about ketosis. Glucose utilization, it’s, it’s really amazing. Thinking about, you mentioned, there are two ways to get into ketosis either with ketogenic diet, in other words, low carbohydrate, or, or fasting, just eliminating carbs and everything else for a period of time till you burn up the glycogen stores and then you switch to fat metabolism and ketosis. Is there any advantage to getting into if I can stay in ketosis all the time with a low carb diet? Is there any additional advantage with fasting? You think?

Jim Howard  27:33  

Well, yeah, I mean, fasting to jumpstart number one, I think there’s a lot of research been done as far as the impact of fasting specifically to toffee G. So you know, that’s, that’s an area of interest where, you know, there are arguments that it should be done through fasting as opposed to just high levels of ketosis through a ketogenic or other CARB restricted protocol. So yeah, I mean, let’s get Peter to. Yeah, really. And he’ll bring on some guests and this is but it’s extremely interesting to us and others, obviously, when it relates to that. I, you know, I use them both. I, you know, I can’t say that I’m strictly ketogenic. I seek ketosis, but there are a lot of there’s a number of ways that you can get into ketosis. That’s not ketogenic. So I would say low carb is the most important thing. And I mean, Weight Watchers can seeking fat oxidation. Jenny Craig is all these they’re just doing it in a way that, you know, is questionable, obviously. So I think that so there’s we’re not tied to the ketogenic diet. It’s whatever the protocol is to get you into ketosis and a fat oxidative state for repair or prevention is fine with us. Before we

Robert Lufkin  28:53  

get into your specific health hacks. Anything else on the bio sense device? Does insurance pay for it? Or patients can just go and buy one from the website? I think correct? Yeah, I mean,

Jim Howard  29:09  

it’s. So in the clinic, we have clinics that just buy in bulk and they can resell it, obviously, like they would with other things to the clinic it does is eligible for a remote patient monitoring codes. So you know, the three primary codes, they’re in a consumer market, it’s HSA and FSA eligible, it’s a $299 device right now. The app is free, and that’s what provides your fasting clock in time and range and things like that. So we’re continue to build that. But that’s it. So it’s a one time purchase. Ultimately, we next year, we will transition into a lower cost device and then a monthly fee as we add machine learning, predictive analytics on weight loss, for example, and then automated coaching built within the app, so I’m giving away the trade secrets But that Wednesday coming out that’ll be in 2022 so so it’s really critical that we were collecting data right now we’ve got a lot of early adopters you know and to build out the machine learning so we’re really excited about what the what the future holds but that’s that’s how you get it we have I mean a lot of different types of clinics med spas coaching you know programs and things like that so we’re we can adapt to all of those Oh that’s great we’re on a website you just get it on our website which is my biosense calm super

Robert Lufkin  30:37  

now as an expert in this in this domain of ketone bodies and ketosis and and health in general and I understand you’re a bio hacker in your spare time that you enjoy doing things on yourself How is this this expertise this knowledge inform the decisions that you make about your own lifestyle choices such as diet exercise or

Jim Howard  31:00  

supplements? Sure, sure. Okay, I would say at the core of it is just a key understanding we in our clinical trial to this and it was showed this is that ketones as one measurement of ketones especially in the morning, is 50% off a time weighted average day. So that’s really critical is that there’s there’s multiple measurements to support a protocol, okay, you need you need three to five measurements to have a true area under the curve and to know so with that in mind, one of the things that I’ve really been working on I have young children and I’m an older Dad, I’m 54 my wife’s 12 years younger than me, and my kids are five and seven so I literally could barely carry my kids after six knee surgeries and for ACLs and all soccer related problems that I had. So I found some quick benefits and my hack that I’ve learned over time number one is address sleep so we this aura ring or bio strap or whatever, it’s get your sleep under control and but then I started doing a lot of fasting once a month to do it like Peter to or Dom D’Agostino was one of our scientific advisors and do a three day fast, I started seeing some immediate benefits on things like facial just share the your aging of your face and a three day fast, you will see the difference of time going backwards a little bit. But it took a long time to do that. And one of the things that biosense allowed me to do and a lot of this is selfish we do the development for myself is that I do a book ended fast now I just do you know, I do strict ketogenic 24 hours, and then I’ll start a fast instead of doing a timed 72 hours, All I care about is 24 hours, in an inferred a takuji state, so that’s above 15 aces. So we you know, aces is your breath acetone measurement, whereas five is entering ketosis 15 is, is kind of a moderate to high level of ketosis and your cell regeneration. So all I want is 24 hours in that 24 hours, about 1525 hours above however long that takes me to do that, all the better. You know, and certainly what gets in the way is you know, I run a company, so things like cortisol. So I do that 24 hours, after 24 hours and do another strict, you know, sub 20 grams of carbs in a day, so that I can keep those ketones elevated. So it’s a nice nice curve at five, you know, four or five days. And they do that once a month. And I can tell you that it it it’s my longevity or health span kind of protocol that is catching on, at least in our office and others and it works pretty well. Okay. I was seeing that my family which does a lot of this too, and none of us got COVID we’re around so many people with COVID. So and if and a five, but

Robert Lufkin  34:05  

yeah, well the metabolic health is key for COVID you know, also Yeah,

Jim Howard  34:11  

yeah. So um, so yeah, there’s a lot to be learned and you can have some fun at it if you like doing what you’re doing and like, the way that you feel as you age. That’s a great

Robert Lufkin  34:22  

absolutely any any supplements that you recommend or that your as part of your protocol.

Jim Howard  34:29  

I do not know. So, not anymore. No.

Robert Lufkin  34:34  

and No Metformin Nope, no, and I won’t even ask about Rafa mice and then

Jim Howard  34:42  

I did I take graph on mice and I think about it at times, but right now I think I’m going down a really good path at a personal level of getting the achieving what I’m looking to achieve and you know from influence. First thing for me is inflammation so you feel that inflammation going away. When you can ski for the first time in 10 years that’s pretty telling tale and I can run where I was in a lot of pain before set it’s just obvious benefits you mentally sharp you are you’re at ease you’re probably a little less rigid You know, my wife used to say you need to go out and run now she doesn’t ask me to do that anymore the running would be more bearable but I think that’s a pretty typical benefits that people see is that you get a little more control of your life

Robert Lufkin  35:33  

back yeah it challenged with with when we make our lifestyle changes is always seeing the benefits and you’re obviously seeing them or are there any particular labs You follow? I mean, you mentioned a toffee G and that’s you know, notoriously hard to heart directly any any surrogates for a toffee G or or just other wellness factors that you look at.

Jim Howard  35:57  

No, I mean I do labs, you know, once a year just make sure everything is in control. You gotta be you gotta watch out and fasting for, you know, your sodium levels, things like that. So, you know, electrolytes, the only supplement I take is electrolytes when I fast and and it’s super critical. You know, that’s the key is when people tell me the keto flu stick your electrolytes should be fine. It won’t happen. But other than that, no, I’m pretty natural. I don’t, I don’t need a lot to achieve the benefits. I mean, I’ve got a device by a sense, that tells me that validates I’m in there. So why buy all these other things. I use a lot of protein powder.

Robert Lufkin  36:38  

Or whatever you’re doing, keep doing it. It looks like here, you’re doing a great job. You mentioned Could you tell us the website once again, and how people can follow you, Jim on social media.

Jim Howard  36:51  

Yeah, so Instagram, and Facebook and all these things. It’s my biosense. So one word, my biosense. It’s a class one device. And it’s available in the US. There’s 1000s of people that have it already. We It was released just last year, it’s the only clinical grade backed by clinical trial breath acetone device, the only non invasive ketone device that that’s on the market right now. And it’s for research, or using the clinic if ketosis is the therapy, and then certainly in the consumer world, too. So

Robert Lufkin  37:28  

for our international audience, is it available outside the United States?

Jim Howard  37:34  

US, Canada, Hong Kong and Singapore?

Robert Lufkin  37:37  

Okay, so you can track it down on the web somewhere?

Jim Howard  37:40  

If If Yeah, and we’ll give a give your listeners a discount to put in the show notes.

Robert Lufkin  37:46  

So great. Oh, that would be wonderful. We’ll have that in the show notes and on the website for people. That’s very, that’s very generous. Well, thanks so much, Jim, for spending. It’s been great to get to know you a little bit and spend an hour with you. with you today. And I look forward to staying in touch and I’d love to have you back on the program in 2022. When the new when the new device comes out the new system, right? It’s going to be great to reach more people.

Jim Howard  38:17  

All right. Thank you so much.

Unknown Speaker  38:20  

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