Truemed 如何激励美国人投资预防

When you look at our food system today, the majority of what people are eating is ultraprocessed crap. The average child spends less time outside than a maximum-security prisoner. People are spending 8-plus hours on their phones.

We are in the midst of one of the biggest problems in the country. If we don’t fix this, America is going to have even more serious problems. The environment that we exist in is structurally hard to be healthy, which is why you see the default health outcomes in the U.S. being so poor.

Why not just universal basic ompic? Why doesn’t that solve the problem?

I think the problem now is that we’re feeding our kids poison, and all of them are sick. I think many of our problems are downstream of the fact that the majority of the country is just sick. No matter if we get rich or whatever, if most of the country is sick, it’s kind of like, what is the point?

You’ve been on a quest for the last few years to uncover and make a dent in solving our food crisis, our health crisis, and our disease crisis. Why don’t you trace your journey a little bit into how you became obsessed with this? Then we’ll get into what we’re up to.

Peter Seal has this idea of a secret, and I feel like the idea that what you eat, your lifestyle, and all these things impact your health outcomes, your energy, and how you feel—I came across that idea when I was 20, and it felt like a secret. If you look at any data in the U.S., U.S. health care outcomes are horrible. They’re bad, and they’re getting worse. Obesity, heart disease, and all of these conditions are basically at record levels and continue to go up.

As I started to read more about our food system, environmental toxins, and all these sorts of things, I became more and more convinced that the answer to everyone’s questions—“What’s going on with our obesity crisis? Why are we so sick?”—is simply that we exist in an environment that systematically outputs unhealthy people. This idea that you could just change your food, change your diet, change your exercise, change your environment, and that would naturally lead to much better health outcomes feels to me like this secret that I believed in, invested in, and started companies behind for 15 years, but that the average person still does not totally, fully internalize. So I just became obsessed with this idea the first time I came across it, when I was around 20.

You yourself have gone out of your way to go against the grain in terms of your own personal life and trying to be healthy, but it’s very difficult to be healthy today. It’s almost like what people used to say when they were canceling people on Twitter all the time: “Hey, just build your own Twitter. You want your own information? You could just build your own.” Similarly, you have to build your own food.

Totally. In so many ways, I feel like health used to just be an output of the environment that we existed in. My great-grandmother lived until she was 95, very healthy until the day she died. She never shopped organic. She never avoided seed oils or asked for no seed oils at the grocery store. She never did any of the insanity that I’ve had to learn, figure out, and do.

That’s primarily because she lived and grew up in an environment that was not sickness-promoting. She was not exposed to 40,000 novel chemical compounds that exist in the U.S. or eating foods that were addictive, made her feel shitty, and impacted her health. I think the environment that we exist in is structurally hard to be healthy, which is why you see the default health outcomes in the U.S. being so poor.

How are the Amish exempt from this, just as an example? What do they do differently?

They do a lot differently. You should go to one of the communities. There are a lot of things they do very differently from you and me. Basically, they’re eating food that is grown locally and seasonally all the time. They’re outside all the time, working with their hands. They’re existing in a tight-knit community, and there’s a whole host of environmental and lifestyle differences that the Amish have.

You can argue, is it 100% necessary to live like the Amish to have better health outcomes? But certainly, they have much better health outcomes, and they live very differently from you or me.

But they’re not doomscrolling like us. So how do they make it?

They’re uninformed. I know they might live longer, but at what cost?

When did things start to get really bad? Has it just been a monotonic decline for the last century, or was there a moment when things started to escalate? What happened?

Things started to get much worse in the 1970s. My view is that this is around the time when you started to see childhood obesity tick up. You started to see obesity, heart disease, and things like this start to move. In my view, a big reason for that is that there was a lot of shareholder and other pressure specifically geared toward big food companies around that time.

These companies are today around 150 years old. Almost every big food company is shareholder-owned. They are not run or controlled by CEOs; they’re basically just these lumbering corporations that the market is optimizing for earnings per share. What that means is that, for the last 50 years, these companies have consistently decided to trade a real ingredient for something that’s kind of a fake version of that. They’ve moved from strawberries to strawberry flavoring, or they’ve moved from sugar to high-fructose corn syrup.

You roll this out over a 50-year period, and you look at our food system today: the majority of what people are eating is ultraprocessed crap that is addictive, not nutrient-dense, and full of environmental toxins and chemical compounds—things like this that, in our entire millions of years of evolution, the human body has never encountered. I think that shift started in the ’70s, and it’s compounded generationally.

It certainly doesn’t help today that the average child spends less time outside than a maximum-security prisoner. Most kids today are getting around 70% of their diet from ultraprocessed foods. People are spending 8-plus hours on their phones. All these sorts of things are factors, but I really think that our food system started to become uniquely poisonous in the ’70s. That is why, especially in the U.S., you started to see many health care and health outcomes trend in such a negative direction, especially relative to the rest of the world.

What are the levers that could make a dent in reversing some of these trends as they relate to the food system?

From a food-system standpoint, I think the biggest single lever that we could pull—which would be extraordinarily politically challenging—is fixing our crop-subsidy system. If you look at it, the U.S. government over the last decade has spent close to $100 billion on crop subsidies. They’re basically subsidizing corn, soy, and wheat so that American farmers can grow corn, soy, and wheat.

Because it’s subsidized, it’s artificially cheap, so we grow a lot of it. Because it’s subsidized, it’s artificially cheap, and these big food companies use it in everything. These big food companies have basically gone on a 30-year journey to replace sugar with high-fructose corn syrup, or to replace olive oil or something like that with soybean oil, which is highly processed and inflammatory and causes obesity and all sorts of problems in rat and human models.

I think that this wholesale swapping—taking the worst ingredients in their most highly processed form and replacing them with an ingredient that humans traditionally ate—is one of the root causes of chronic disease. Today, the average American gets almost 20% of their caloric intake from soybean oil. This is historically anomalous. It’s not because anyone wants soybean oil. You’re probably not a big consumer of soybean oil or anything like that. It’s just because it’s artificially cheap, and because it’s artificially cheap, it ends up in everything. I think that is one of the core root causes of what is going wrong in our food system today.

Is that a uniquely U.S. problem, or is this—

Yeah, it’s a uniquely U.S. problem. The U.S. food system, relative to Europe or something like that—Europe has many smaller countries that tend to lean much more into a local food and agriculture system. They also don’t have as much federal intervention in their food system.

The U.S., in many ways, has this subsidy of corn, soy, and wheat. It had good intent. A lot of the crop-subsidy stuff started with a Farm Bill in the ’80s, when farmers were exposed to inclement weather and bad conditions that were impacting their crop yields. The U.S. government stepped in and said, “Okay, we’re going to try and keep these farmers solvent.”

I think the intent was good, but now here we are years later, with billions a year going toward these crop subsidies that are making Americans sick.

And I think we used to say, “Okay, we just need to make sure that we’re growing enough calories and make sure that Americans are not dying of starvation. Make sure our kids have enough to eat.” I think now the problem is that we’re feeding our kids poison, and all of them are sick. Why not just universal basic ompic? I mean, what’s—why doesn’t that solve the problem?

Yeah. Well, I think there are 2 things. One, I think GLP-1s are potentially an incredibly interesting technology. I think we are in the midst of the worst chronic disease crisis, one of the biggest problems in the country. If we don’t fix this, America is going to have even more serious problems 20 years from now. Given that the average American is overweight—we’re looking at almost 80% rates of overweight or obesity—I think it does make sense to put a bunch of these people on a GLP-1 to try to jump-start them in a direction where they are moving toward health.

That said, I don’t at all think that giving universal GLP-1s to everyone is necessarily a universal solve. There’s just a very poor history of saying, “Here is an intervention that is going to solve all of our problems as a species.” I think it is quite unlikely that Ozempic is the one thing that is going to be a cure-all. Just to use one example, how does Ozempic work? It basically turns down someone’s appetite, so you’re just eating less. If you’re still eating the same crap the average American is eating today, but you’re on ompic and eating less of it, you are almost certainly going to be deficient in protein and micronutrients and a bunch of things that will have long-term health implications if you undereat or don’t get enough of those nutrients for a very long period of time. So I think we fundamentally have to solve the food issue if we want to have a healthy country.

By the way, have we yet updated our food pyramid, in the sense that we have an accurate understanding of what we should be getting on a country level in terms of nutrients?

Yeah, the new food pyramid is a tremendous improvement over the old guidelines. Not only is the site super sexy—Joe Gibbia did a great job on that—but finally, for the first time, people are saying, “Eat whole foods, eat more vegetables, eat meats and other well-sourced sources of protein, vegetables, and fruits.”

It’s crazy that it took until now to say maybe we shouldn’t be giving kids 15 servings of whole grain and saying that sugar is totally fine for kids under 2. We recommend some amount of sugar for kids under the age of 2, which were the past administration’s guidelines. So I think they’re a tremendously positive step.

And so, for people who want to make a difference in the food system, you mentioned that policy recommendation. What about people who want to do something directly? You obviously, before TrueMed, started a bone broth company. What are other big companies that could be built in the space, or opportunities to make a difference?

Yeah, I think there are a ton of opportunities. Within the space, I think the core problem is that a bunch of these lifestyle interventions—eating a healthier diet, exercising, taking certain supplements, taking peptides if that makes sense for your individual person and risk profile—all of these things can be considered healthcare interventions.

And yet, if you look at our healthcare system, nothing in the healthcare system thinks about someone who is at risk of heart disease exercising as a healthcare intervention. No payer pays for it. No one incentivizes you to do that. It’s just like a doctor saying, “Yeah, you should clean up your diet and exercise.”

I think there is a tremendous, tremendous opportunity for people who want to make a dent in this problem. Figuring out how to make these sorts of lifestyle interventions part of the healthcare system is what we’re doing at Trummed, and incentivizing people to actually invest in their health, invest in prevention, and invest in things that move the needle from a chronic disease standpoint.

Yeah. So let’s get to TrueMed first. First, trace the idea maze a little bit. You’ve been obsessed with this problem, this kind of meta-problem, this series of problems, and it’s kind of like, where do you even start? I’m sure you picked over every nook and cranny. How did you settle on, “Hey, this was the opportunity”? What were maybe some other things you considered?

Yeah. In growing Kettle & Fire, basically, when we launched, it was $16 a carton for 16 ounces of bone broth, and everyone was like, “This is good, but this is very expensive.” Now, 9 years in, we’re in every grocery store in the country, and the average price per box is about $7. More people buy it, but they’re also like, “This is very expensive.”

I had that experience and then looked at things like Costco and Walmart, which are the 2 largest sellers of organic products in the country. To me, that is a signal that people want to invest in products that are good for them. They want to buy products that leave them better off, healthier, and the like, but it’s just cost-prohibitive.

And then, if you look at the healthcare system, we have this weird dynamic where, if I am at risk of cardiovascular disease or heart disease, I can exercise, I can eat well, and I can do all of these things that will prevent an acute heart attack or something like that, and basically none of that is covered. It’s all cash pay. I’m paying out of pocket. I’m doing all of that kind of stuff totally on my own.

Whereas if you take someone who doesn’t do any of those things, basically, they have a heart attack early, and then the healthcare system will pay hundreds of thousands or millions of dollars to manage that person’s condition for the rest of their lives. So I think that fundamentally we need to incentivize people to invest in prevention, to invest in leveraging lifestyle interventions that can make a dent in chronic conditions.

That was the lens through which I was looking at what company I wanted to start after Kettle & Fire. When I met Dr. Mark Kimman, who is a functional medicine doctor and co-founder of Function Health, he mentioned that something he was doing with a bunch of his patients was recommending lifestyle interventions. He would write them something called a letter of medical necessity, which is basically a letter that the IRS has said allows certain people, when an intervention matches a condition they’re working to treat, reverse, or prevent, to use tax-free HSA and FSA dollars on sleep aids, a better diet, supplements, exercise, and things like that.

When Markman told us about that idea, I thought, “This is a really interesting thing. We could basically try to build infrastructure that allows the average person to get one of these letters if they qualify and use the telemedicine rails that Himsow and other companies have spent the last several years building. But rather than prescribing ompic or prescribing TRT, we can actually prescribe food interventions, exercise, and things like that.”

That was the idea and where it started from. I looked at a whole host of other things. I thought about starting a grocery store. I thought about starting a life insurance company that would be aggressive in terms of helping you live longer and making lifestyle interventions. But ultimately, I felt like this was the type of thing that had the potential to direct hundreds of billions of dollars toward lifestyle interventions over the next couple of years, and so it felt like it was the right thing to do.

So, yeah, everyone knows we need to shift more from chronic to preventive care, and this is basically a way to financially incentivize people to do that.

Exactly.

Yeah.

Exactly. One of your ideas is that the root cause of a lot of issues is this mismatch between our genes and our environment. Why don’t you flesh that out a little bit more?

Yeah. Think of an animal in the zoo. An animal in the wild, with few exceptions, can break its leg or get an infection or whatever, but when an animal exists in a species-appropriate environment, that animal tends to be healthy. There’s a natural match between the health of the environment and the health of an animal.

When you take an animal away from its natural habitat and put it in the zoo or something like that, zoo animals exhibit all of these diseases that their counterparts in the wild just don’t get. They have weird tics, they get depressed, and in some notable cases, animals have even killed themselves, which is just something you don’t see in the wild. They get obese; they get all sorts of things.

My take, and what I think is very true, is that the health of an animal is basically a reflection of the health of an animal’s environment. If an animal is existing in an environment that is not health-promoting—you’re in a season of drought or there’s not a lot of food—that animal gets skinny or dies. You can basically see that the animal is not existing in an environment that’s health-promoting.

I think that over the last 100 years or so, we as humans have seen—we’ve built an environment that is not considering, underwriting, or thinking about what is the right thing to do for human health.

How do we promote human health and flourishing? So often, when we think about health, we think about what is going on with you, Erik, and a specific condition, as opposed to thinking about the environment you exist in that leads to you not getting 8,000 steps a day, spending all day on your phone, or eating a terrible diet. No, not you, actually, but I mean—[laughter]—I think that is an important idea that people do not think about enough: how do you shape your environment so that it is naturally health-promoting, as opposed to having to discipline yourself and do all the stuff that most people, frankly, fail at, myself included?

There is this Twitter competition for $1 million for whoever gets the best article. People are doing clickbait stuff, and there is one guy who is like, “How to change your life in a day. How to change your life in an hour”—these kinds of posts. There was one that went super viral: “How to change your life in 1 minute,” and it was a photo of smashing the phone. [laughter]

That’s pretty good. Totally.

Okay, so I’m curious for more. You have talked about this idea that we should take this health crisis as seriously as we take our national security crisis. We as a country have something of a NRA for health, or some kind of collective effort, because it is a problem that the market might not be solving on its own and, in fact, exacerbates. You gave one example, the subsidies. What are some of the biggest levers you think we could pull?

Yeah. I’ll answer that, but just to frame how I think about the problem: if, for example, China or one of our adversaries deployed a bioweapon that made 75% of our population obese or overweight, 45% of kids obese or overweight, and made health care the largest cost in the country all of a sudden because everyone was sick, everyone in America would be up in arms and trying to figure out how to solve this. This is an existential crisis. This is a matter of national security, and we have to make a dent in that.

No matter if we win the AI race, get rich, or whatever, if most of the country is sick, it is kind of like, what is the point? We are not thriving as a nation. I think many of our political problems are downstream of the fact that the majority of the country is just sick.

If I were able to wave a magic wand and do anything, I think fixing the subsidies would be one thing, for sure, that I would do. Secondly, I would have our health care system invest far more in prevention. You look at other countries that have incredible health outcomes on a per-capita basis. Singapore is a good example. They basically have people who are not quite doctors but are coaches or something like that, who check in with you and try to nudge you toward making better choices.

Then I would take a much stronger stance, much more similar to the one Europe takes, when it comes to certain environmental toxins, chemical regulation, and things like that. In the US, we basically take the approach that if a company makes or manufactures a totally novel environmental chemical and tells us, under current regulations, that it is GRAS—generally recognized as safe—we can introduce it into our food system.

That is how the forever chemicals and stuff like this got into our food system and are basically all over the planet now, because 3M invented them something like 60 years ago and they basically just started using them. In the EU, these novel chemical compounds have to go through something much more like what it takes to get a pharmaceutical approved in the US today. They have to do many years of safety testing, show that it does not cause acute harm, and basically get it approved before it is allowed on the market.

The end result is that we have between 60 and 80,000 chemical compounds in the US that are not allowed in the EU. I think that regulatory approach is one of the hidden reasons why so many people are sick. I think it is one of the reasons that Americans are exposed to more toxic compounds and novel chemical compounds than basically any nation in the world. I think that is a big hidden part of our chronic disease crisis, and it is something you are going to hear a lot more about in the coming years.

Yeah, fascinating. I had one college professor. I have no idea if this is even remotely accurate, but they were convinced that Monsanto was evil—not just in terms of its health impacts. They thought Monsanto was sort of getting involved in all sorts of foreign wars and influencing our foreign policy and stuff.

I say that to ask: could there be competitors to some of these megaplayers? Could startups even emerge, or is it just structurally unsound?

I think it is really hard structurally, and I think that does not mean it is not going to happen. Hopefully it will. But one of the things that you have seen is that, with Monsanto, for example, the pesticide lobby and the chemical and ag lobby are some of the strongest in America.

A big part of what they are doing is—for example, a couple of months ago, Monsanto was lobbying hard and spent tens of millions of dollars to get a rider in a bill that would basically make sure that no one could ever sue them for the potential health impacts of one of their most popular products, glyphosate. That sort of thing happens: these companies get big and provide a bunch of chemicals. Monsanto specifically has done a lot of things that I think are incredibly morally dubious.

Then, once they get big enough, once they start selling billions and billions of dollars of these products, they spend a lot of that money on lobbying and making sure that they are immune from any of the harms and health impacts that come from some of these toxic products that they spray everywhere. Glyphosate is the number 1 pesticide sprayed in the US, and the largest maker of it is spending as much as it can to make sure that glyphosate—which, you know, there have been $14 billion in damages awarded to people who have gotten cancer or other diseases from glyphosate exposure—is protected.

Monsanto is spending as much as it can to try to buy, basically, pesticide liability shields and other things that shield it from competition and/or from the actions and consequences of the diseases its compounds have caused. I think that when these companies can rig the game in that way, it becomes very, very challenging for a startup to come along and make a real play at some of these things.

Yeah. You mentioned a grocery store just as a simple idea. What opportunity has Whole Foods missed with what they have tried to do?

Yeah. I mean, Whole Foods is amazing, and John Mackey was a total pioneer and legendary entrepreneur. I think the thing that grocery stores have not really done—and this is kind of the thesis for Trummed—is think about food as a health care intervention.

To me, I think there is a ton of potential for people to, for example, look at their biomarkers and have a grocery store or some other entity that is responsible for improving their health. If you think increasingly about food and grocery as a health intervention, as part of one’s health care and the fight against chronic disease, you would think about a grocery store very differently than today, which is basically just, “Let’s figure out the sourcing, and then people can buy whatever they want.”

My idea was that I think there is a ton of room for a grocery store that is a more active participant in your health—telling you to eat certain things, tracking your macros, and doing all these sorts of things that I think would solve a lot of problems for people.

Yeah. So, let’s talk more about what else we would do if we fully identified the health crisis as one of our main national priorities. Maybe we could start looking at it in light of what some of the pillars or main principles were, and maybe talk about where they are so far.

Yeah. So I think that you have seen, across all of health care and across all of food, just corporate capture of our food guidelines, our health guidelines, and all these sorts of things. The previous FDA commissioner’s stated goal with running the FDA—their number 1 goal—was to combat misinformation. The current one is to make Americans healthy.

That means GRAS reform, so cleaning up how we regulate chemicals. That means fixing school lunches and fixing military lunches—basically, what we feed kids. Eighty percent of schools have contracts with soda companies. These soda companies will literally pay a school district to put these vending machines all over the schools. It helps fund schools, but it also comes at the cost of getting kids sick.

So I think cleaning up school lunches, cleaning up military lunches, and cleaning up the food guidelines are all important.

Second thing is improving and streamlining the way that we look at regulating drugs, making it faster for companies to lean in and launch innovative therapies that can make a dent in the chronic disease crisis. And just trying to bring common sense back into the way that we think about health, the way that we think about food, and trying to make a dent in the chronic disease crisis.

Are any of these ingredients, foods, or soda so addictive, dangerous, or appealing that they should be outlawed? How do we think about that?

No, I actually don’t think that many of these things should be outlawed. I do think that consumer choice is a very important thing. But specifically with kids, we have guidelines, and we already don’t think that kids should have free choice—we don’t let them drink, for instance—so I think that there is a place for soda in this country.

I also think that if you want to drink soda all the time, we probably shouldn’t be subsidizing it by subsidizing high-fructose corn syrup. We probably should not have Coca-Cola spending $140 million to influence our nutrition guidelines, as they have over the last 15 years.

I think it’s things like that where, a lot of times, the big food companies and people will fall back on this idea of consumer choice. I think it’s very important, but we’re also currently grappling with an incredibly important chronic disease crisis. If we don’t make an effort to uniquely address this thing, I think that the U.S. is in an incredibly tough spot 10, 20, or 30 years from now.

I want to ask you about psychedelics. Is that in this discourse at all? Does that move outcomes for us, or is that kind of not really?

Not really. I think that if you just look at the data, psychedelics are an incredibly powerful intervention. Ketamine therapy, or ketamine-assisted therapy, works better than SSRIs in many cases, especially for treating things that are very intense, like treatment-resistant depression and PTSD.

I think that for many of our veterans and others who suffer from PTSD and intense depression, psychedelics should be part of a menu of treatments that we are open to giving people. I think that we probably vastly underinvest in them. There’s a ton of really promising research around their efficacy.

I think it’s an open question how ready the average American is to think about these things not as a group of people dropping acid in Golden Gate Park in the ’60s, but as a vital mental health therapy for people who are really struggling. I’m very supportive of looking at psychedelics as another therapy that can address the many mental health and depression issues that we have in this country.

If you look at it just through that lens—a therapy that has few to no side effects, especially when done with doctor oversight and things like this—I think they should be part of how we treat and address many of the mental health crises that we see today.

Are there any other really big levers that you would focus on if one of your main goals was to target the mental health crisis?

I think that we are hugely underestimating the impact of biological health and how that is tied to mental health. There are some really interesting studies around taking a functional medicine approach, where you come in and say you’re depressed, and rather than doing talk therapy and things like this, which statistics show don’t work very well for many people, we focus on reducing your inflammation and fixing your gut.

There have been studies that show that just by taking a functional medicine approach—focusing on sleep, focusing on gut health, and focusing on lowering your inflammation through diet and exercise—that combination of therapies works better than just talk therapy and things like that.

I think that we massively underestimate the degree to which we are, as human beings, biological organisms, and our mental health is very tightly coupled to our physical health. I think that we should fund much more research along these lines, in what’s called metabolic psychiatry.

That’s basically the idea that many diseases that we put in the mental health bucket—things like epilepsy, depression, and schizophrenia—have causes that are actually metabolic at root. For example, one of the best therapies for someone who is schizophrenic or epileptic, or even, in many cases, bipolar, is a ketogenic diet. If you put them on a ketogenic diet, these things will, in many cases, just resolve.

That is not something that our current mental health world really underwrites.

Yeah. It reminds me of a conversation I once had with Daniel Gross when he was saying, “Hey, any time someone is feeling depressed, it would behoove them to, before attributing it to some psychological defect or making some deep psychoanalysis about it, first just say, ‘Am I sleeping well? Am I eating well? Am I exercising?’”

Totally. “Have I been outside recently?”

Yeah, totally. I want to shift, lastly, to another topic that you’ve been really curious about for a while, which is consciousness. What has driven your hunch or curiosity there, and where has your thinking drawn you?

Yeah, I think that I have just been interested in this idea of what it means to be healthy. What does it mean to live a life that people are excited about, have energy, and feel great in their bodies and their minds?

I think that consciousness is sort of this root layer of what it means to be alive—what is your experience of being alive, of life? Frankly, we don’t really have a great answer to this right now. A lot of our theories and philosophies about what consciousness is are not great. They’re not predictive, and you ask the average person, or even philosophers who have thought a lot about this, and there’s nothing near consensus.

It’s an area that I’m very interested in. I think we’re going to learn a lot about it in the next decade. I hope to have friends and play somewhat of a role in exploring and learning more about what consciousness is, how to change it, how to improve it, and all these sorts of things.

But yeah, I would put it very much in the personal pet-interest bucket, not in the category of something I’m doing anything around right now.

Well, obviously you’re focused on building True Med, so we’ll close there. But if you could scale yourself infinitely, for people listening who are also obsessed with this problem, is there something else you think is underexplored, whether it’s a research area, a company idea, or some sort of policy that not enough people are looking into, that we haven’t yet discussed and that you want more people to spend time on?

An idea I’ve been thinking about recently is that we mentioned at the beginning that the health of an organism is the health of its environment. In my view, what that means is that if we started thinking about not just improving Erik’s health, but improving the health of all of your friends, your community, and the people around you who exist in the same environment, intervening in and improving your environment could have a much larger impact on health than just optimizing your own health.

I think that there are potentially interesting models for improving one’s environment, whether that’s building a health-oriented city, town, or suburban development, or something like that. It could also be group health insurance for people who are deciding to live differently, make different interventions, and invest in root-cause lifestyle interventions.

I think there are a lot of interesting things that could come about when you start thinking about health through the lens of a community, or tens or hundreds of people, not just through the lens of me as an individual. If I had copies of myself, I would explore companies in that direction.

Yeah, I love that. Let’s close on Truemed and go deeper into it. The company’s done phenomenally, and we’re obviously very lucky to be a part of it. Say more for people who are not familiar with it, in terms of the actual product and the direction it’s going.

Sure. TRMED, basically what it is, is that for people who qualify, we allow them to spend tax-free HSA and FSA dollars on things that treat, reverse, and prevent disease and fall within the lifestyle-intervention category.

We’re partners with Eight Sleep, Peloton, Momentous, and Life Time Fitness. All of these brands, for someone working to treat or prevent heart disease, obesity, or things like this, represent lifestyle interventions that are healthcare.

We’ve built a payment integration that allows people to spend their tax-free HSA dollars on these interventions, and we’re scaling that up. I think that where this can go over the next decade is that every American who is at risk or has some sort of chronic condition should be incentivized. Tax-free money is a great incentive to spend your own dollars on things that treat, reverse, or prevent disease.

There are no mechanisms in today’s health care system for someone to get a gym membership for cheaper than the list price, or to get a gym membership covered by their employer or an insurance provider. That’s the thing—the way that I think about what we’re building is infrastructure that allows and incentivizes people to invest in lifestyle interventions to stave off and prevent different chronic conditions.

I actually have to ask you: What are your thoughts on peptides, and do you have any predictions as it relates to them?

I think peptides are going to be so disruptive to our current health care system. There needs to be way more research. I’m not totally yet a peptide believer, but from early signs—and even just NF1 people taking these things and using them—this seems like a class of compounds that are very effective.

They are not patentable. You can basically buy them for fairly cheap, and I would put them in the bucket of human enhancement companies. Our current health care system and most of our pharmaceuticals are kind of like, “Don’t die. Here’s a statin. Don’t die—take this pill.”

I think these peptides are in a different class. Many of them give you more energy, improve your sex drive, lower your inflammation, and improve your gut health. They’re just a different category of compound. As more people start to experiment with them and try them, you’re going to see really interesting, positive health care outcomes from a class of compounds that no one has thought about for a long period of time.

I think it’s going to be exceptionally disruptive to pharma and a bunch of other players in the health care system.

I’m also curious—for you, or just collectively—are we learning more about optimizing our nutrition? You got into the rape diet, or you were writing about it. What are your thoughts there more broadly?

I think nutrition science is probably among the worst of the sciences in the U.S. right now. Most nutrition science is funded by big food companies. They outfund the NAH 11 to 1 on nutrition science, at least historically. That’s hopefully changing.

There are all of these different diet tribes out there. The Peters, the Ray Pete crowd, are particularly interesting because they’re focused on ramping up your metabolism. For many people, you should just try and experiment with a diet that makes you feel good.

We now have lab tests that you can get through Function or something like that to show how a diet impacts your energy and your biomarkers. You have wearables that can give you feedback on your sleep, your HRV, and your resting heart rate after switching your diet or doing things differently. That combination of getting insight into how these things are making you feel and how they’re impacting your biomarkers means that people should be much more open to experimenting and seeing, “Hey, I’ll try a peing diet for like 90 days and just see how I feel.”

I’m very bullish on people doing N-of-1 dietary exploration and experimentation. I think the peing community is probably the most interesting one out there for me right now.

There are basically 2 schools of thought. There’s the Bryan Johnson school of thought, which is, “We’ve done all the research. We know that you need to eat a plant-based diet. We know that you need to do caloric restriction,” all in the name of longevity. That is the current dogma in many ways.

The Peaters are the exact opposite. Bryan Johnson would say that sugar is bad and that you should not eat carbohydrates. The Peaters are like, “You should eat as much sugar as you possibly can,” mostly in the form of honey, fruit, and things like that. You should really avoid seed oils and things that are going to impair your metabolism.

If Bryan Johnson is like, “I want to eat less and ramp down my metabolism, which means I can live longer,” the Peaters are like, “Ramp it up as much as you can.” The more energy you have, the longer you’re able to use that energy over a long period of time.

It’s such a contrarian view of 100 years of nutrition dogma that says sugar is bad and should be avoided. I think it’s a very interesting idea, and a lot of people in the peing community have seen phenomenal results. I’ve started drinking orange juice and eating fruit in the morning, and I feel great. My biomarkers have gotten even better, even though I’ve been doing probably a decade-plus of mostly low-carb, kind of Paleo. It’s just a very interesting, different lens that’s worth playing with.

Essentially, I’ll have to check out the Peaters. Bryan Johnson has obviously been so interesting on so many topics. One question I was curious about: If I get a girlfriend, should I make a launch video?

[laughter]

Justin, the company is True Med. Thank you so much for coming on the podcast.

Thanks for having me. Lucky to be involved.