LEVELS – A Whole New Level

High cholesterol. Elevated ApoB. A positive CAC score. Now what?

Most people quickly find themselves trapped between two extremes: simplistic advice to “cut saturated fat” and online influencers insisting cholesterol doesn’t matter at all.
In this episode of A Whole New Level, Mike Haney sits down with clinical research scientist Dr. Kevin Maki to cut through the confusion.

Drawing on more than 35 years of cardiovascular research, Maki explains why heart disease risk is about much more than LDL cholesterol alone. He breaks down the roles of inflammation, blood sugar, family history, kidney function, and lipoproteins, while also making a clear case for something many people resist: LDL and ApoB still matter. A lot.

The evidence increasingly suggests that when it comes to atherosclerosis, lower for longer is better. That has important implications for diet, statins, and how early we should intervene.

Mike and Dr. Maki also tackle saturated fat, seed oils, red meat, industry-funded research, and how to separate evidence from online nutrition debates.

Free course: Improve your metabolic health

Get our free email course on how glucose, nutrition, exercise, sleep, and measurement can help you build habits that support better energy and long-term health: ⁠⁠⁠⁠https://levels.link/wnl⁠

🎙️ About the Guest:
Dr. Kevin Maki is founder and Chief Science Officer of Midwest Biomedical Research and an Adjunct Professor in the School of Public Health at Indiana University. A former president of the National Lipid Association, he has spent more than three decades designing and leading clinical trials focused on cardiovascular disease, diabetes, nutrition, and lipid management.

His research has included studies on cholesterol-lowering therapies, dietary patterns, red meat, seed oils, inflammation, and cardiometabolic risk reduction.

📍What Dr. Kevin Maki & Mike Haney discussed:
0:00 — Dr. Maki’s background in clinical research
4:30 — How industry-funded nutrition research actually works
15:00 — The Framingham Heart Study and the “Big Four” risk factors
20:00 — FLASH-GLICK: the ten factors that drive cardiovascular risk
26:00 — Why inflammation may be the next frontier in prevention
33:00 — LDL, ApoB, and the “lower for longer” principle
42:00 — Particle size, ApoB, and what advanced lipid testing adds
47:00 — Why everyone should know their Lp(a)
51:00 — Saturated fat, seed oils, and the “compared to what?” problem
62:00 — What the red meat evidence actually shows
72:00 — Statins, lifestyle, and LDL treatment goals
82:00 — Why earlier LDL lowering may provide the biggest benefit

🔗 Helpful Links:
Watch the conversation: https://youtu.be/l8QzuuTYxLI
Beef Consumption and Cardiovascular Disease Risk Factors: A Systematic Review and Meta-analysis of Randomized Controlled Trials: https://pmc.ncbi.nlm.nih.gov/articles/PMC11621491/
Low-Density Lipoprotein Cholesterol Lowering and Risk of Major Adverse Cardiovascular Events in Primary Prevention Trials: A Meta-Analysis: https://www.sciencedirect.com/science/article/pii/S1933287426000395
PREDIMED Trial (Mediterranean Diet & Primary Prevention): https://www.nejm.org/doi/abs/10.1056/NEJMoa1200303
CORDIOPREV Trial: https://pubmed.ncbi.nlm.nih.gov/35525255/
The Framingham Heart Study: A Historical Perspective: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61752-3/abstract
Midwest Biomedical Research: https://midwestbiomedicalresearch.com/
National Lipid Association: https://www.lipid.org/

✅ Subscribe here on YouTube: https://youtube.com/levelshealth?sub_confirmation=1

👋 Who we are:
Levels helps you understand your metabolic health with personalized data, expert guidance, and tools that connect your daily choices to measurable changes in your body. Our goal is to help you make better decisions about food, exercise, sleep, and long-term health.

Look for new shows every month on A Whole New Level, where we have in-depth conversations with thought leaders about metabolic health.

What are GLP-1 drugs actually doing in the body, who are they for, and why might some people want to think twice before treating them like a six-month shortcut?
For years, obesity treatment focused largely on behavior: eat less, move more, stay motivated. Yet many people lost weight only to regain it. According to obesity medicine pioneer Dr. Robert Kushner, that wasn’t a failure of willpower. It was a failure to fully understand the biology driving weight regulation.
In this episode of A Whole New Level, Mike Haney sits down with Kushner, one of the leading figures in obesity medicine and a lead investigator on the landmark STEP trials, to discuss how GLP-1 medications are changing the field. He explains why these drugs may be the first treatments capable of helping patients “fight biology with biology,” why appetite regulation appears to work differently in different people, and why many patients describe a dramatic reduction in food noise after starting treatment.
But this conversation goes beyond how the drugs work. Kushner also addresses one of the biggest questions facing obesity medicine today: who should actually take these medications? He explains why obesity specialists evaluate far more than a number on the scale, why someone hoping to lose a modest amount of weight may want to think carefully before pursuing treatment, and why successful long-term health still requires changes that no medication can provide.
They also discuss obesity as a disease, the promise and limitations of telehealth prescribing, and why maintaining weight loss often requires something deeper than motivation: a shift in identity.

Free course: Improve your metabolic health
Get our free email course on how glucose, nutrition, exercise, sleep, and measurement can help you build habits that support better energy and long-term health: ⁠⁠⁠https://levels.link/wnl⁠

🎙️ About the Guest:
Dr. Robert Kushner is Professor Emeritus of Medicine and Medical Education at Northwestern University Feinberg School of Medicine and one of the pioneers of modern obesity medicine. He is a past president of The Obesity Society, founder and former chair of the American Board of Obesity Medicine, and a lead investigator on the landmark STEP clinical trials that helped establish semaglutide as a treatment for obesity.

📍What Dr. Robert Kushner & Mike Haney discussed:
2:06 — Why obesity is more than willpower
4:34 — The benefits and drawbacks of calling obesity a disease6:27 — Clinical vs. preclinical obesity
17:36 — What obesity medicine misunderstood about weight regain
18:44 — “Fight biology with biology”
25:07 — Why weight maintenance is a different challenge than weight loss
26:49 — The identity shift that helps people keep weight off
27:52 — How GLP-1 drugs actually work
31:09 — Why some people experience constant food noise
34:09 — Why GLP-1s treat obesity but don’t cure it
42:17 — The STEP and SELECT trials
44:15 — Who should consider GLP-1 medications?
45:44 — Why obesity treatment is more than an online prescription
50:44 — What happens after you stop taking GLP-1s?

🔗 Helpful Links:
Watch the conversation: ⁠https://youtu.be/qdssFUAWVck
Dr. Robert Kushner: https://drrobertkushner.com/about/
Northwestern Faculty Profile: https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=11686
STEP Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
SELECT Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2307563

👋 Who we are:
Levels helps you understand your metabolic health with personalized data, expert guidance, and tools that connect your daily choices to measurable changes in your body. Our goal is to help you make better decisions about food, exercise, sleep, and long-term health.

Look for new shows every month on A Whole New Level, where we have in-depth conversations with thought leaders about metabolic health.

Most athletes are told the same basic rule: the harder you train, the more carbs you need. But Dr. Andrew Koutnik argues the science is more complicated.

In this episode, Mike Haney talks with Dr. Koutnik about how the body fuels exercise, why muscle glycogen may not explain “hitting the wall” as neatly as many people think, and why blood glucose, brain energy, insulin, and metabolic flexibility may matter more than conventional sports nutrition advice suggests.

They discuss whether athletes really need 60, 90, or even 120 grams of carbs per hour, why some athletes may perform well on far less, and how to think about fueling as an individual experiment rather than a universal rule. Because apparently even “eat sugar while running” was too simple for human physiology to leave alone.

Free course: Improve your metabolic health
Get our free email course on how glucose, nutrition, exercise, sleep, and measurement can help you build habits that support better energy and long-term health: ⁠⁠https://levels.link/wnl⁠

🎙️ About the Guest:
Dr. Andrew Koutnik is a Visiting Research Scientist at the Florida Institute for Human and Machine Cognition, studying nutrition, metabolism, Type 1 diabetes, and human performance. He earned his PhD in medical sciences from the University of South Florida and has worked with groups including NASA and the Department of Defense.

📍What Dr. Andrew Koutnik & Mike Haney discussed:
00:42 Why carbs became central to sports nutrition
05:30 How the body uses carbs, fat, ketones, and lactate for fuel
13:45 Exercise, insulin sensitivity, and blood glucose
21:20 Why muscle glycogen may not explain performance limits
31:00 What “hitting the wall” may really mean
39:15 The case for lower-carb fueling strategies
48:30 Why more carbs don’t always mean better performance
58:00 The problem with 90–120 grams of carbs per hour
1:08:30 How athletes can test fueling for themselves
1:17:00 What this means for everyday exercisers and marathoners

🔗 Helpful Links:Watch the conversation: ⁠https://youtu.be/FfomxfyCchw
Study discussed: Carbohydrate Ingestion on Exercise Metabolism and Physical Performancehttps://academic.oup.com/edrv/article/47/2/191/8432248Related paper: Substrate Oxidation Does Not Influence Middle Distance Running Performancehttps://www.mdpi.com/2072-6643/17/17/2771
Find us on YouTube: https://youtube.com/levelshealth?sub_confirmation=1

📲 Connect:Connect with Dr. Andrew Koutnik: https://andrewkoutnik.com/X: https://x.com/AKoutnikInstagram: https://www.instagram.com/andrewkoutnikphd/Google Scholar: https://scholar.google.com/citations?hl=en&user=2BzUjqkAAAAJ

👋 Who we are:
Levels helps you understand your metabolic health with personalized data, expert guidance, and tools that connect your daily choices to measurable changes in your body. Our goal is to help you make better decisions about food, exercise, sleep, and long-term health.

We can measure more about our health than ever before. Wearables track everything from heart rhythms to glucose trends, and AI can now identify patterns clinicians might miss. But more data does not automatically mean better health outcomes.

In this episode, cardiologist and digital health expert Dr. Ami Bhatt joins Mike Haney to explore why medicine still struggles with prevention, how continuous health data can help patients take more agency, and where AI may actually improve care—not by replacing doctors, but by helping clinicians navigate the right information at the right time.

They discuss the promise and pitfalls of wearables, the challenge of turning constant streams of health information into useful action, and why the future of medicine may depend on what Dr. Bhatt calls “collaborative intelligence”: humans and AI working together to make better decisions earlier.

Free course: Improve your metabolic health
Get our free email course on how glucose, nutrition, exercise, sleep, and measurement can help you build habits that support better energy and long-term health: ⁠⁠⁠⁠⁠https://levels.link/wnl⁠

About the guest: Dr. Ami Bhatt is the chief innovation officer (CIO) at the American College of Cardiology and the Chair of the FDA Digital Health Advisory Committee. She received her undergraduate degree at Harvard University and her Doctor of Medicine at Yale University School of Medicine, and was the Director of Outpatient Cardiology, TeleCardiology, and Adult Congenital Heart Disease at the Massachusetts General Hospital.

Sign Up to Get Your Free Ultimate Guide to Glucose: ⁠⁠⁠⁠⁠⁠⁠https://levels.link/wnl⁠⁠⁠⁠⁠⁠

🎙 What Dr. Ami Bhatt & Mike Haney discuss:
1:19 Why heart disease remains the leading killer despite medical advances
10:17 The opportunity and risk of detecting disease earlier
17:38 What wearables are actually useful for today
30:16 When health tracking creates more anxiety than insight
37:12 Why AI should guide doctors, not replace them
44:27 Dr. Bhatt on “collaborative intelligence” in medicine
1:18:30 Why the future is human judgment plus AI, not AI alone

Levels helps you see how food affects your health, empowering you with the tools needed to achieve health goals and improve healthspan. Levels Members gain access to the Levels app and continuous glucose monitors (CGMs), providing real-time feedback on how diet and lifestyle choices impact your metabolic health.

Look for new shows every month on A Whole New Level, where we have in-depth conversations with thought leaders about metabolic health.

🔗 Helpful links
Watch the conversation: https://youtu.be/d0LJvL1uB4k
Find us on YouTube: ⁠⁠⁠⁠⁠⁠⁠https://youtube.com/levelshealth?sub_confirmation=1⁠⁠⁠⁠⁠⁠⁠

📲 Connect
Connect with Dr. Ami Bhatt on LinkedIn:
https://www.linkedin.com/in/dramibhatt/

Metabolic health is often simplified to a matter of blood sugar, but at its root, it is a complex system of energy substrate signaling. While many view chronic disease as an inevitable part of aging, a systems-thinking approach reveals that maintaining high "flux"—the capacity to efficiently move and clear energy through the body—is the primary lever for longevity. Without the stimulus of regular movement, even the most optimized diet can fail to prevent the accumulation of metabolic waste that leads to insulin resistance and heart disease.

In this episode, we sit down with Greg Mushen, a technologist who turned his engineering mind toward his own biology after conventional medicine failed to address his chronic health issues. Mushen breaks down his "Theory of Flux" and why he believes the key to disease resistance lies in meeting our body's "clearance burden". From studying the activity levels of hunter-gatherer populations to debunking myths about walking and V2 max, Mushen provides a data-driven framework for optimizing health through the lens of evolutionary biology and systems engineering.

Sign Up to Get Your Free Ultimate Guide to Glucose: ⁠⁠⁠⁠⁠⁠https://levels.link/wnl⁠⁠⁠⁠⁠

In this episode, we cover:
The Theory of Flux: Understanding health as the dynamic capacity to move nutrients and fuel through the system rather than a static set of markers.
Insulin Resistance Reimagined: Why blood sugar is a symptom, not the root cause, and how fat accumulation in the liver and muscle disrupts signaling.
The Power of PAL: Why a Physical Activity Level (PAL) of 2.0 is the "golden ratio" observed in disease-free subsistence populations.
Walking vs. HIT: De-bunking the idea that you need high intensity to improve V2 max and why the "area under the curve" for oxygen consumption is what matters.
The Saturated Fat Paradox: Comparing the Messiah and Chimané populations to understand how high activity levels can mitigate the risks of high-fat diets.
Fiber as a Sensor: Why fiber is more than just "throughput" and acts as a critical environmental sensor for metabolic signaling.
The "Walking Grifter" Philosophy: Why walking is the most under-leveraged tool for increasing metabolic flux with the lowest recovery cost.

🎙 What Greg Mushen & Josh Clemente discuss:
[00:53] — Greg’s transition from tech engineering to "debugging" his own biology.
[06:55] — The mold exposure and chronic fatigue that sparked a deep dive into primary literature.
[11:36] — How correcting a copper deficiency became a "point of light" for understanding micronutrients.
[20:53] — Lessons from the Messiah: High saturated fat intake paired with extreme physical activity.
[25:26] — Defining Flux: The capacity to clear substrate and prevent metabolic accumulation.
[30:26] — The PAL 2.0 threshold: Why doubling your basal metabolic rate is the key to warding off chronic disease.
[51:10] — Lipid Kinetics: Using the "sink and drain" analogy to understand LDL residence time.
[01:00:19] — The Integral of Oxygen: Why walking 15,000 steps can be as effective for V2 max as short bursts of HIT.
[01:17:16] — Why Greg changed his mind on plant-based vs. animal protein.
[01:28:24] — Greg's personal stack: From 15k steps and resistance training to PD5 inhibitors and custom fiber blends.

Levels helps you see how food affects your health, empowering you with the tools needed to achieve health goals and improve healthspan. Levels Members gain access to the Levels app and continuous glucose monitors (CGMs), providing real-time feedback on how diet and lifestyle choices impact your metabolic health.

Look for new shows every month on A Whole New Level, where we have in-depth conversations with thought leaders about metabolic health.

🔗 Helpful links
Watch the conversation: https://youtu.be/A1KSG2qyVww⁠
Find us on YouTube: ⁠⁠⁠⁠⁠⁠https://youtube.com/levelshealth?sub_confirmation=1⁠⁠⁠⁠⁠⁠

📲 Connect
Connect with Greg Mushen on LinkedIn:
https://www.linkedin.com/in/gregmushen