Metabolic Health Interventions - Lessons from Levels

Key takeaways from Josh Clemente’s Levels newsletter on optimizing metabolic health through lifestyle interventions.

Cholesterol Optimization

Results: Three consecutive quarters of sustained ApoB improvement with zero medication.

The Stack:

• 35g+ fiber daily — Mostly from psyllium husk mixed into a morning yogurt bowl, plus vegetables and legumes throughout the day
• Saturated fat under 10% of calories — Roughly 25g/day
• Toku Nattokinase (10,800 FU) — A high-dose enzyme with emerging evidence for lipid improvement and potential plaque reduction

Glucose Management

Challenge: Fasting glucose had been climbing due to sleep disruption (new baby).

Interventions:

• 1g of Vitamin C daily
• Controlling carbs in the evenings
• Consistent exercise
• Improving sleep quality

Result: ~6% improvement in fasting glucose, targeting low 90s.

Iron Management

Issue: Iron saturation at 54% (above 45% is flagged). Common in men—without regular iron loss, iron accumulates in organs over time, acting as an oxidant that drives inflammation.

Solution: Blood donation. Each donation removes roughly 250mg of iron. The body then draws on stored iron (ferritin) to replace it, effectively eliminating the excess.

New Research: CGM + AI Predicts Disease Better Than Standard Blood Tests

A foundation model called GluFormer was trained on over 10 million glucose measurements from 10k+ people without diabetes.

Key findings:

• The model identified people at elevated risk of diabetes and cardiovascular death far more effectively than HbA1c
• The top 25% predicted risk group contained 66% of people who developed diabetes and 69% of cardiovascular deaths
• Adding dietary logging data dramatically improved prediction accuracy

The takeaway: CGM data combined with lifestyle factors contains more predictive information about health than snapshot blood tests.

Food Recommendation

Ella’s Flats Sweet Minis — Crunchy, semi-sweet with no added sugar, 5g protein and 5g fiber per 28g serving. Good for snacking or crumbling over yogurt.