Dr. Casey Means

Casey is the Co-Founder & Chief Medical Officer at Levels, a software company that gives you real-time feedback on how food affects your health. Last month, Levels announced a $38 million Series A alongside a $300 million valuation to continue its mission of solving the metabolic health crisis.

On her morning routine.

I don’t have a set bedtime, but I try to get up about exactly 8 hours after I go to sleep. Because we don’t have meetings at Levels (more about that here), it allows total flexibility for wake up time. Generally, I sleep between about midnight and 8am. I do a lot of writing in my work at Levels, and I find that I am often most creative later at night. The flexible schedule at Levels due to being a fully remote and asynchronous company allows me to flow with my creative juices and not have to worry about being up at a very specific, early hour. A core tenant of Levels culture is to “treat people like adults,” so our schedules are fully in our control. 

I get sunlight and nature first thing in the morning. I wrote an article about why here. Sunlight exposure in the morning is critical for metabolic health. I use the method from James Clear’s “Atomic Habits” to habit stack, so I habit stack brushing my teeth with getting morning sunlight and grounding. Here’s how: the second I turn my tooth brush on, I take a barefoot walk outside and usually get 2 full laps around my house during the 2-3 minutes that I’m brushing my teeth. It probably weirds my neighbors out, but checks the boxes of sunlight and nature exposure first thing in the morning! 

I then drink about 28-32 ounces of reverse osmosis filtered water with lemon and pink himalayan sea salt (or if I’m tight on time, electrolyte powder like LMNT or Ultima), and make some decaf organic coffee with a splash of homemade nut milk. I stopped drinking caffeine after reading Why We Sleep by Matt Walker and Caffeine by Michael Pollan. 

I then wash my face and get ready for the day with exclusively non-toxic, all natural personal care and beauty products. Oddly enough, this ties right back to metabolic health. We know now (and a lot of this research has been uncovered by our medical advisor Dr. Robert Lustig) that many chemicals in our home and personal care products contain highly damaging toxic chemicals that can greatly disturb our cell biology and metabolism. We now have a name for these metabolism disrupting, fat-promoting chemicals: obesogens, and they are everywhere: shampoo, deodorant, lotion, cologne, toothpaste, plastic containers, makeup, etc. A great place to find out whether your products are safe is ewg.org. Every 2 weeks, I’ll apply a new CGM sensor to my arm to track my blood sugar through Levels. 

I then spend about 30 minutes reading some sort of grounding text, writing in my journal for a few minutes based on some reflective/self-discovery prompts, and meditating for 12-15 minutes. I generally try to read something that draws me into “the bigger picture,” like Marcus Aurelius, Seneca, Mary Oliver or Rumi poetry, The Way of Zen, Thich Nhat Hanh, Pema Chondron, or things like that. Things that draw me into awe at the universe and the cosmic eternal journey we are all on. Being awe-inspired and centered in the beginning of the day fills my cup and I find it to be a defense against getting too emotionally pulled into any occurrences of the day.

After dealing with the loss of my mother suddenly last year, I have naturally become less flustered by day-to-day BS.  I usually meditate with the Sam Harris app (Waking Up) or Tamara Levitt from Calm. Meditation reminds me that my thoughts are fleeting whims and to not react to them or take them too seriously. Reading, writing, and meditating - even for a short period of time - helps me start the day in an uplifted, awe-inspired, grateful, grounded way. 

I generally don’t eat breakfast, and that way I can get 14-16 hours of fasting in each day; my first meal is usually around 11am. Then I get to my treadmill desk by about 9:15am to start the day. Here is a Notion page of my office set up (we document everything at Levels, including our workspaces to share best practices).

On her nutrition regimen.

The main principle of my diet is to eat unprocessed, whole foods that were thoughtfully raised in a clean way (organic, ideally regenerative). When you put largely unprocessed foods in the body, the body is set up for success. As the Levels Dietary philosophy says, “nearly all whole foods are generally good from a nutritional perspective” - it’s the processing that makes foods problematic. 

I eat a ton of colorful vegetables, beans, lentils, nuts, seeds, spices, low-glycemic fruits, unsweetened non-dairy yogurt and nut-milks, and small amounts of omega-3 rich fish (like salmon and sardines), pasture raised eggs, and grass fed beef. Food is a huge creative outlet for me - I love coming up with colorful nutrient-filled plant based concoctions to fuel my body and mind. If interested in more about this, I have about 1000 pictures of meals I’ve made in my saved story highlights on instagram, so go wild.

In crafting meals, I optimize for maximal omega-3 fats, antioxidants (protective plant chemicals), diverse micronutrients (vitamins, minerals), fiber, probiotics (like sauerkraut and yogurt), and anti-inflammatory compounds (like turmeric). I believe food is medicine, and I’m always looking at nutrition through the lens of what my cells, genes, and microbiome need to be happy and do their jobs properly. I’ve written more about my dietary philosophy here and in this podcast. I also have a ton about my food philosophy in my newsletter (sign up here). I don’t eat gluten or dairy, and I avoid refined sugar. 

On building culture at Levels.

Levels has a profoundly calm and kind culture. We invest incredibly heavily in building a culture where toxic stress does not thrive, and I’ll walk through a few of the elements that feed into a low stress environment below. I’m a believer that stress results from a lack of sense of control and fulfillment, both of which we have in spades at Levels. You can read about how we think about building a functional, low-stress culture in our Culture Handbook which drills into some of our key cultural principles: Trust and Autonomy, Asynchronous and Remote, Honesty and Respect, Disagree and Commit. We believe in:

• Treating one another like adults

• Being tolerant, accepting, and kind

• Having “short toes,” meaning that anyone can contribute to any part of the company at any time. There are no fiefdoms at Levels and nobody's responsibilities are sacred

• A commitment to eliminating gossip

• A “Yes, And…” way of thinking

While we prioritize velocity and shipping fast at Levels, one thing we spend a lot of time on is hiring and onboarding. We focus on hiring to maintain talent density, meaning we hire incredibly talented people, and then trust one another to use discretion and make decisions with good judgment in order to move projects and the business forward. We also onboard through a rigorous 4 week program focused largely on reading memos, cultural immersion, and learning our Tools for optimal asynchronous remote work. 

I loved a line from a conversation between Netflix co-founder Marc Randolph and Levels CEO Sam Corcos, where Marc said “What makes somebody want to work for one company or another? It's fairly straightforward. It's treating them like an adult and surrounding them with stunning colleagues. If you have those two things – my God what a dream job.” This is Levels in a nutshell, and I believe contributes to a culture of peace and low stress. 

We also are intently focused on getting off of tools that promote a false sense of urgency or dependency (notably, email and Slack). We want people to focus their time on deep work, and not to be constantly looking for the next dopamine hit of instant communication. We encourage the use of Mailman, a program that batches your email once or twice a day, and use Threads over Slack, which promotes longer form thought over DMs and quick communication. We also encourage people to turn off notifications for email and Threads. We try to catch communications so that it is a discrete task, rather than a constant distraction. You can see examples of this in an article about Levels’ CEO’s time management, here:  An Exact Breakdown of How One CEO Spent His First Two Years of Company-Building.  We support our team’s ability to use tools effectively through a series of “Levels Productivity Series” that we post to Youtube. Commitment to deep work is a foundational principle at Levels. 

Every few months we do an exercise of creating a “Areas of Responsibility” document that outlines all the areas we are spending our time. In collaboration with Sam (Levels CEO), I’ve used this exercise to iterate on where to double down on attention and focus, and where we could benefit from delegation or hiring. This has allowed me to stay focused on areas where I can provide the most value to the company, and to focus on things I am uniquely qualified to do. This exercise has led to several other hires at the company, notably a Head of Partnerships and Editorial Director, who have been instrumental in scaling the impact of projects I was initially working on. Processes like this contribute to minimizing risk of stress or burnout, because you can stay focused on what you love and what is of highest value. 

We have several optional programs and events at Levels to support professional development and leadership. One of my favorites is the Levels Book Club, where we read books about company culture and development, as well as leadership, and discuss in a fairly rigorous and structured way (everyone writes up detailed notes in Notion before the book club, and proposes action items for the company based on the book. Then we discuss the action items as a group).  Some favorite recent books include No Rules Rules, 15 Commitments of Conscious Leadership, Nonviolent Communication, It Doesn't Have to Be Crazy at Work, and Working Backwards. 

Additionally, everyone at the company has the ability to work with Executive Assistants and it is celebrated when people engage with our EAs and delegate effectively. Our incredible group of Executive Assistants are through Athena and are deeply embedded in our team and culture and are integral to all aspects of our company. The goal is that Levels employees are freed up to do deep work that only they can do, and minimize any repetitive tasks that could be systematized or delegated. 

On fostering a growth mindset.

I surround myself with people who are passionate about physical and mental health and are committed to a growth mindset. This makes it a lot easier to stay healthy, because the people you spend the most time with are supporting healthy choices! 

The simplest thing you can do to get family and friends helping you optimize your health is to make sure your social events kill two birds with one stone: socializing and health. Cook a healthy recipe with a family member (when I visit my dad we love preparing GreenChef plant based meal kits). Schedule a fun boutique workout class or hike with a friend. Schedule a catch up with a friend over a cold plunge and sauna. 

One really amazing thing about Levels culture of radical transparency is that my family and friends are able to stay super up to date on things going on at Levels, because we’re always publishing content on it! Between our Levels podcast (A Whole New Level), our published Friday Forums, our Youtube channel, our Medium Articles, our Levels Newsletter, our social media feed, and our monthly investor updates, my community really knows what’s going on in the Levels world.

This is really fun for me, because so often we’re learning from each other about best practices and seeing culture rub off on each other. If a friend of mine is thinking about SEO for their company, or PR, or onboarding processes, or micronutrients, or whether eggs are good to eat, I always have a memo, article, podcast or piece of content we’ve created on that topic – the remote/async culture and the copious amount of evergreen content that we produce really allows you to add value to your community’s life. 

On her go-to wellness products.

I get my blood drawn regularly through the Levels Metabolic Health Panel to ensure I’m in the optimal ranges for key biomarkers, and to get iterative feedback on any new interventions I’m making like shifting up more or less protein and fat in my diet, or trying a new workout regimen like CrossFit. It’s amazing and motivating to see how quickly biomarkers like triglycerides and HDL can change with focused, consistent interventions! To understand some of the most important metabolic biomarkers to track and what levels to keep them out, check out our Ultimate guide to understanding your cholesterol panel and metabolic blood tests.

I of course wear a CGM through Levels to continue to understand my diet better and to stay accountable to healthy choices. It’s a lot easier to stay on track when I know I’m getting feedback on what is causing big spikes. 

I use an EightSleep mattress for optimal thermoregulation at night, and wear a Whoop strap to monitor my sleep and activity (which has had the side effect of getting me to almost completely stop drinking - I hated seeing those terrible recovery scores after even moderate drinking!). I will intermittently wear a Lief Therapeutics HRV tracker to see how different activities during my day like email or press interviews are affecting my HRV, an objective measure of stress. If I see that certain activities are causing my HRV to drop in real-time (meaning it’s causing more stress on my body), it will trigger me to take a deep diaphragmatic breath to help calm the body. 

I have a long list of many of the modalities I use to manage stress here in my newsletter article on stress management. 

I design my supplement regimen based on a nutritional test called NutrEval by Genova Diagnostics. Many functional medicine doctors will order this test for you. It gives you a comprehensive sense of what types and doses of vitamins you might benefit from. I try to get as much nutrients as I can from whole foods, but given that food is becoming more nutrient-poor as our soils are becoming depleted, I find that I still have some supplement needs. I cover the vitamin basics by drinking AG1 by Athletic Greens in the morning, but take extra supplements to meet any particular deficiencies that show up on my testing. 

I get out into nature as much as possible, which is part of the reason I moved to Bend, OR. The beauty of a fully remote team is that you can work anywhere you want, and shape your day how you want. If you want to take a quick 2 hour hike in the middle of a beautiful day, you can. Being in nature measurably lowers stress hormones and improves well being acutely, so it’s a win win for you and your work later in the day. The beauty of living in Bend, OR is that there are trails all over and I can pop outside for short periods of time to get my “nature bathing” fix. 

I have recently gotten into cold plunging and sauna for hot/cold therapy.

A critical wellness tool in my life is weekly therapy. Everything that we experience in this life is a function of how our brain functions and how we see the world. We get coaching for all sorts of things (fitness, nutrition, our business), and in my mind, nothing could be more important than working with a professional who is trained to help unpack your perceptions and the filters through which you see the world. 

On travel and workout routines.

For the last 14 months I have been traveling and fully nomadic, another perk of remote asynchronous work! Levels team members are all over the place and frequently working from nomadic locations like Mexico, Columbia, Portugal, Italy, and elsewhere, so that has thrown a wrench in my ability to belong to a gym. Given that, I leaned on running outdoors, doing Peloton online or Openfit strength training classes, or buying week-long passes to gyms or fitness studios in cities I was visiting.  My workout regimen is always bouncing around and the key thing that matters to me is that I do some movement every day. I just this month settled down in Bend, OR, I recently joined a CrossFit gym to boost up my strength training. We are learning more and more how important resistance training is to metabolic health and blood sugar balance. 

One trick I know works for me if I’m ever in a workout rut is to purchase classes at a boutique workout class like SoulCycle or Barry’s Bootcamp, because once I’ve paid, I know I’m going! Extra motivation if I schedule someone to go with me! 

One of the key things we’re learning more about via metabolic health literature is that it’s incredibly important to move throughout the day and not in just one chunk for a discrete “workout.”  One study looked at walking for a discrete 30-minute period once per day versus walking for just 1 minute 40 seconds every 30 minutes during waking hours. While both groups walked a grand total of 30 minutes, the study showed that the frequent short walks were significantly more effective at reducing post-meal glucose peaks and insulin levels. Moral of the story: I try to get up and move at least every 30 minutes during the day - just walk around the house, run up and down the stairs a few times, or do a couple minutes of air squats. 

And always walking after a meal! We’ve learned from the Levels dataset that just walking for a short period after meals is hugely helpful in balancing blood sugar - we showed this in The Levels Coke Experiment.