Ari Tulla of ELO Health Envisions a New Era of Personalized Nutrition - #118

How do gaming, nutrition, and healthcare technologies intertwine to revolutionize personalized health?  connects these dots from his experiences in mobile gaming to his deep dive into the world of healthcare and nutrition. 

Fueled by his wife's health crisis, our guest, Ari Tulla, CEO of ELO, drew connections between the tech evolution in the auto industry and the potential for a similar transformation in healthcare. This is his story.

In this episode, Ari paints a riveting picture of how technology and healthcare intersect. He delves deep into his unique insights, comparing the digital transformation of the auto industry to the potential shift awaiting healthcare. His mission is to harness the power of food as a healing tool, backed by the strength of machine learning and AI. Ari's company, ELO, is leading the charge towards personalized, precise, and proactive nutrition programs, with a vision to make food not only tastier but more health-centric.

Looking ahead, Ari shares his views on the exciting future of personalized healthcare. From integrating wearable data into the ELO platform to crafting proteins tailored to individual workout and strain profiles, the opportunities seem limitless. We also discuss the concept of LO Health, a forward-thinking approach that ELO is using to tackle nutrient deficiencies. Ari is optimistic about the role of innovative technologies like satbots in providing immediate responses, further enhancing the personal touch in healthcare. Join us on this enlightening journey of discovery and innovation that promises to change the way we look at health, nutrition, and technology.

Connect with Ari Tulla:
LinkedIn: https://www.linkedin.com/in/aritulla/
ELO Health: https://elo.health
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Theme Song : Rage Against
Written & Performed by Logan Gritton & Colin Gailey
(c) 2016 Mercury Retro Recordings

Transcript

Jack Heald: 0:36

Well, hey folks, it's the Stay Off my Operating Table podcast. We've got a little different kind of show today. I'm looking forward to how this goes. We literally have no idea how this is going to work out. We're joined today by Ari Tola, who's the CEO. Do I pronounce your last name correctly?

Ari Tulla: 0:56

Perfectly.

Jack Heald: 0:57

Ari Tola, CEO of a company called. Is it pronounced ELO or just ELO? Hello, Hello, hello, smart nutrition. When I see that, I can't help but think of the electric light orchestra, which is All right. Well, Phil, this guy's got an interesting one.

Dr. Phillip Ovadia: 1:23

Yeah, definitely. You know, when first became aware of him and you know I was very fascinated by his background lots of involvements with different aspects of health tech and you know pretty interesting stuff that they're doing at ELO, and so excited to get to know Ari and to hear a little bit about some of his current endeavors. So, ari, why don't you introduce yourself to our audience, give a little bit of your background and then we can kind of talk about some of the stuff that you've done and are now doing?

Ari Tulla: 2:01

Yeah, yeah, thanks guys. Really great to be here. And a quick background. I'm from Finland, moved to California about 16 years ago and if I speak funny or you don't understand me, play my Finnish roots and my old language I have and.

Ari Tulla: 2:22

But you know, I spent my 90s in playing video games and I was very fortunate to be one of the early people to get to play online and actually became one of the early people who made money by playing video games, and two times I spent building video games, so I was involved in a lot of the early mobile games that you know. Today, mobile games are a massive phenomenon. You know, when we started, we had like 40 people in a room building the first games and then 20, 21s. I dedicated completely almost on building two companies Better Doctor and Quest Analytics, focusing on helping people to access healthcare, finding the right doctor, building a better network of doctors, and the 22s. I think I'm going to spend 100% on nutrition and trying to do a bit of the same thing we did at the Better Doctor and Quest, where we help people navigate care, and now we want to help people to navigate the complicated world of nutrition and food.

Jack Heald: 3:27

So on your website you said that leading Better Doctor and Quest Analytics were a personal vendetta to build a better healthcare system. First of all, I love the phrasing. Secondly, why was this a vendetta? And why was it personal? Because maybe all vendettas are personal, but why was it a vendetta?

Ari Tulla: 3:55

There's a movie that I made in 2000,. Something called Beef of Vendetta. Oh yeah, I love the movie. I think we also got to rewatch that movie. I haven't seen it for a long time. I need to see it again. You reminded me of that.

Ari Tulla: 4:08

Yeah, so I've been a tech person. I'm a technologist. I believe in the idea that you can deploy innovations. You can use the new technology to evolve people's lives. Sometimes we take a misstep, like with social media, maybe with the smartphones, we adopt them too hard, we become too addicted, like the gaming as well. But for me, it all started in 2002.

Ari Tulla: 4:36

My wife then she was a girlfriend at the time she had a thyroid tumor. Out of nowhere. A 20-year-old woman has a his size tumor on her neck that's taken away, together with half the other thyroid and that, as it often does, it led into autoimmune diseases, conditions that are unknown Today. We know what more than we did 20 years ago and we got a verdict that says fine. So the help system in Finland at the time. It did exactly what it took away the tumor, it healed her, yet it left her in a position to be medicated for life with the cocktail that makes it impossible to get pregnant. So we've been able to have a family at that young age and later we got married and of course you start thinking about your legacy, your life, and we definitely wanted to have a family. So we spent almost a decade of our life trying to navigate that problem, first in Europe and then later in the US, and we talked to maybe 50 different doctors. We went to the Eastern medicine, the Western medicine and finally we got help from a person who navigated us into kind of like an anti-inflammatory diet where you eat low carb. We went off meat, we went off any type of carbs at its sugar, and that did help. And today, of course, we know that that type of diet can treat type 2 diabetes. It can heal it and reverse it. It can help even LSA. A lot of different diseases that are complicated and hard to treat can be now helped with this diet. So it did work.

Ari Tulla: 6:20

And then we found out that, despite heavy effort, we had to go IVF and we got pregnant after maybe 11 years of the work and then we lost our first son Totally irrelevant thing on this. So it's like this whole long panel that ends up into the worst possible scenario for the parents, and I decided a few years ago to start talking about this publicly, because now we have two healthy, beautiful kids who are 9 and 5. And our life is great. But it is really hard for a long time. Many people don't talk about these things like losses, and many people get miscarriages, many people lose their children, they keep it inside and in the end it eats you alive. So that became kind of my vendetta in a sense.

Ari Tulla: 7:04

I was in a European healthcare system where you are getting a doctor who you get. You don't really have a selection bias or problem like we do in the US. And then I came here to California. I was very fortunate to have a big company I was at Nokia at the time and they, you know you get your stuff back in Europe and they sit them here, they give you apartment keys and easy micros in a way. But you know, we got this golden card, one of these cattle like health plans. You can go to any doctor you want and there are a million of them and we didn't know who to go and we were vulnerable, we were weak, we were looking for solutions.

Ari Tulla: 7:40

So we navigated the healthcare system for a long time and felt that it's really difficult and that's kind of where the idea of a better doctor came to be. And, of course, you know, along the way, food became medicine for me and my wife and we have, you know, the itself to improve. So I'm a, you know, a fervent believer of food as medicine for a long time and when we had our loss, we decided to. You know, we kind of sold our stuff and we, we pundered all the money into one fund and we started to invest in startups. That's kind of what I know. So we did that and we've been investing for small amounts of money, but like 65 companies then, and I've been investing a lot of food, tech and health and ways and human performance, that type of companies, and some of them are now doing really well. So we learned a lot along the way and I really wanted to build the third company in healthcare in the space of nutrition.

Dr. Phillip Ovadia: 8:31

Yeah, great story. You know, and as a heart surgeon now for 30 years, you know deep, deep in the quagmire that has the medical system certainly appreciate. You know, you recognizing and the problem that exists and that is, you know how to find a good doctor. And it's something we talk about a lot on this program actually, because you know whether you're in Europe and get assigned a doctor or you're here in the US and your insurance plan basically says, well, go see the guy down the street. You know it's very hit or miss, you know, and unfortunately doctors are oftentimes sort of handcuffed by what they can do and what they've been taught and their knowledge base and may not recognize the power of nutrition and the food that we eat.

Dr. Phillip Ovadia: 9:30

So very interesting to hear how you, you know, experience that and came across it. Talk a little bit about you know sort of technology and health, because one of the things that's always amazed me about the healthcare system is, yes, we have a lot of you know, cutting edge technology and new instruments and tools to use for surgical procedures, all of that stuff, but at the same time we still use fax machines and beepers and it always really amazed me that dichotomy, how you know, technologically backwards we can be at the same time, while you know, having all of this cutting edge stuff to me available to us. So I'd love to hear kind of your perspective on, you know, tech and healthcare.

Ari Tulla: 10:27

I think I have a really unique background in a sense, but I've been really lucky to be able to to witness firsthand the internet. I was happened to be in the right place as a kid and I was connected I don't know like 93 or something like that one of the first people in Europe my dad had access to university and you know that's how I got in there, you know, before we invented the World Wide Web and the website and stuff like that, really. So I've been seeing that, that crawl from the beginning, where you had a few people who heard about it and then suddenly it became a huge thing in 2000s when, you know, we spent billions and billions on stupid companies that you know never did anything valuable except the PowerPoint egg. And then finally, you know, in 2010-20, it finally became real. And then I, you know I saw Nokia at the time when they were building the first smartphone it was called N95, the first device you can actually have video, web browser and email and we saw the data. We first launched it internally at Nokia 200,000 people and we were like what's happening? Because, you know, people were starting to use it in a way that was unbelievable. We had like four hours of use time. It used to be 20 minutes of phone calls and nobody was making phone calls anymore, so it completely went upside down and we knew immediately that this would change the world Even the first people probably in the world to know that. So that was a really interesting moment to be.

Ari Tulla: 11:49

And then, if you think about the healthcare and you know I'm coming into healthcare from very outside, from the bleeding edge of tech, and the problem we have is that we have not, because of certain regulations and the city of the system, we haven't been able to adopt the basic things yet, like if you think about the differentiation it's a word we don't use a lot anymore. We used a lot 10 years ago, but the idea is that, you know, industries are moving from the offline to online. Online, of course, means that we go off paper, we go into databases in the cloud where we can actually look at the data in scale. And then, of course, we went mobile to make the user experience better, to have this sort of always on mentality where you have a phone with you and the other side, the customer, also has a phone, you can interact with it. And of course, today we are talking mainly about the AI, but you can't really do machine learning and AI before you have moved the industry into the, into the cloud, and that's still something we are doing, and I've given many, many talks about this topic and it's a long story.

Ari Tulla: 12:53

But maybe one point that is interesting for people I think about what is already an industry that went through this chains. First you have travel. I mean, how many people go to travel agents? I mean, we don't probably even know what if there's a travel agent anymore. Anyway, how many people are, you know, buying CDs or DVDs? I think you know Amazon. Just sorry, the Netflix stopped sending DVDs like two weeks ago. That was the business they started and they stopped it. So it's all digital, everything and it's so different. Today we are all cutting cable like nobody has cable in 10 years now it's all gonna be off and we are paying now to 15 different places. I don't know it's better to pay the cable company 15 different people that we can depend about that. But the point is that those industries already moved online and you know millions of people who displaced globally. There were millions of travel agents. There were millions of people you know doing these things before and now what we have at the moment.

Ari Tulla: 13:50

We have automotive. Think about your car. You know, 10 years ago, none of us had an electric car. Now all of us are buying electric car because it's a better car. It's, of course, you know, environmentally nice and you know it acts very faster, it's easy to pluck it in at home. It's just a better thing. But we didn't have those 10 years ago. We didn't have Uber. So in San Francisco, where there's no taxes anymore, there are. There are more self-driving cars here in the city today than there are taxes in the city. So it's just the unbelievable things, and we are in a halfway point of this. So when we end up this same in automotive, we will have cars that don't have a steering wheel. We would like to be banned of driving a car in certain areas because we are too bad at driving as humans. So that's what it looks like.

Ari Tulla: 14:35

Think about this. What will healthcare look like when we go? Because we are in the beginning of the chasm. Automotive is in the chasm today and we have no idea what it is. Banking, by the way, and money is in the chasm today, in the middle of it, like we have Bitcoin. We haven't even seen cash for many, you know, months that will happen in healthcare and the world will look so different.

Ari Tulla: 14:55

And I have huge amount of empathy for any doctor, any caregiver, anyone working in a healthcare system because by default and you guys are better than anyone that you know healthcare and the patient interaction is all about data. You are analyzing the patient. You know you look at the face. We have an unbelievable ability as humans to look at your face and and see if you're healthy or not. I bet you guys know if somebody has a heart is. You can look at the eyes and the face and you know the color of the skin, all these things.

Ari Tulla: 15:25

But basically, what we take, we take.

Ari Tulla: 15:26

You know the basic vitals how tall are you, how much you weight, what is the blood pressure?

Ari Tulla: 15:32

Do you smoke all data points and if you are seeing two or three thousand or four thousand patients a year, you can't remember all of them.

Ari Tulla: 15:40

So what do you end up going? You're using the EMR that suck and then you are pulling the record out. You are inputting more data. You spend half an hour with every person. You have, of course, more if you are a specialist, but you know you don't have the time to really go deep into it, and I think the truth is that the algorithms and AI will be much better than a human at analyzing data, and I think we have a moment when there will be an assistant AI assistant for me and you and everybody, for the consumers but there also will be a really capable bot that will help every doctor to navigate and then the doctor will make the decisions in that, but there will be this sort of support function and that will make everything faster and I think we have a better healthcare and better care of the people because we can have an eye contact. We don't need to have this sort of EMR contact that we have today.

Jack Heald: 16:33

I'm not sure I want to ask all the questions that spring to mind, because I just flat don't want to go that direction. Let's go directly to LO Health. I went online and did the personal survey. I thought it was really interesting. I don't want to steal your thunder, though. Tell us about LO Health and how your help and move healthcare technology farther along that S-curve that most industries are going through. I thought it was really interesting.

Ari Tulla: 17:30

I decided to take a step at this new idea. I had thought about it for a long time. I had been helping and investing companies in the space already. Some of them are doing amazing work, like Verde Health, who is reversing type 2 diabetes and has done that for more than 20,000 to 30,000 people today One of the most impactful companies we can see in healthcare. I was learning from these masters and trying to look at what I can do and what I can bring to the game. I am really good at spending an idea, raising money, getting people around rallying. I have two co-founders with Soin. I am a long-time co-founder at CTO Tapio, who is working together 17 years, every day. It has been a long battle. I think it is the fifth company we are working together. Now I have a long-time friend, also called Mikko Silvanto, who had been at Apple for a decade. He was one of the designers in Sony. I've seen One of those 10 people who made all the products we use every day the headphones, laptops, ipads, iphones and so forth. We decided to look at this. What can we do? We can raise money, collect, assemble people together to build an idea.

Ari Tulla: 18:46

We wanted to validate this food as medicine. What need to be done to validate that it can work. Many people already know it works, but what do we need to validate so people can really believe and see the outcomes? We started from this concept that we want to build a system where we are assessing people. In the beginning, you talked about the questionnaire, the assessment we do. How can we assess people? We can do a health questionnaire. That has been done by every medical practice in the world for the last 100 years. It is a beautiful method of collecting data. You can make a really good questionnaire in a way that you can really understand a lot about the person. You can use that to then analyze what the needs are. You can also do as many of us do all the time blood biomarkers. We built a blood biomarker collection system so we can send an at-home collection kit to people and they do a fingerprint and we analyze the data Very close to the data that you get from any function today.

Ari Tulla: 19:43

We also decided that because we've been working for so many years in this area of tech, which is the devices we have now, like the Apple Watch and the Aura Ring and the WOOP and the Glucose Monitor, we want to take all that data as well. We have the wearable data, the biomarker data, the traditional one like blood or urine or whatever. Then we take the assessment of the questionnaire and panel that together, throw it to the AI and see what the AI can do to recommend you the right nutrition that can help you to achieve your goals, maintain your health or even help you gain better health. That took about two years to build the system and now we've been live running thousands of people through it and it seems to work pretty well.

Ari Tulla: 20:30

What we also do we put in a mix also a person, because the AI is very fallible and they are learning fast but they are still pretty toddler. Like we threw in a mix a dietician who will be communicating with every patient, every member, one-on-one. We can have that human touch coaching layer. And then we started to test people again after the fact, after three months or six months, we test again and see the outcomes. The outcomes have been really good. We've been able to help people to lower the A1C, the LDL, the weight. It's not just because we give people pills or powders or gummies now, but it's really because we have this system. That makes people make better decisions and the coaching is a huge component of that.

Jack Heald: 21:15

Bill, I know you've got some questions, but I want to follow up real quick on the AI situation and because I think this is vital. One of the criticisms of chat, gpt, open, ai's monster engine, is that it's not truly intelligent, in that there's no decision making that's happening. It's ingesting massive amounts of data and doing some pattern recognition with language. There's a very, very old rule in information technology garbage in, garbage out. I want to know about the raw data, the input that the AI is accessing to generate the output recommendations. In other words, how is the raw data that feeds the output being assessed for validity, for accuracy? Obviously you know this, but for our listeners, I'm asking this question because there's just a shit ton of medically wrong, scientifically bad data out there, and it's not just on blogs, it's in peer reviewed studies. There's a study that just came out that red meat is implicated in diabetes. I mean, that's fundamentally bullshit. So how do you make sure the raw data, the data the AI is building, isn't garbage?

Ari Tulla: 23:12

Well, I think let me take maybe one step back and say and I go through, how do we build this? So you know, we built this before ZaptiPT was available, right, and currently we don't use any LLM large language model at all at LLM and I hope we will once there is a guard rails that we can turn it into a coach. When we can turn it into a diet, that makes no sense. But so the system we built is not that complicated. So we took all the human trial research papers in nutrition space it's not that many, like you know, less than 20,000. And we looked at them in the lens of okay, which of them are nutrients that you know we could deliver in a form of a, you know, pill, a powder, gummy or food. And then we picked around about 100 different ingredients. We narrowed it down to 78 or 80 in the end and we had 6000 studies that our team read and basically labeled into the system. So we had a number of people mainly, you know, phd students and stuff like that who were reading every study because you had to change the dosing, you had to understand the context. They were not always done in a way you can just kind of read it with the computer. You had to kind of label them Right. So we did that and we built a system where we looked at all the studies and we looked at the built, like our own score for validity, like we looked at you know where were the publicist. What is the impact of this publication? Is it how credible it is, how many people have been citing the studies and how many people have been sharing them in media and the world? So that gave us some sort of understanding like how impactful the study was.

Ari Tulla: 24:56

And then what we did we built assessments based on the data. We built about 150 assessments. So this can be like your HRB, your sleep, your amount of sleep or your LDL cholesterol or your A1C or your steps you take or your condition that you have diagnosed. Those can be assessments and those are the things we are collecting based on the assessment questionnaire, based on the verbal device data, based on the blood biomarker data. And can we add more assessments? Absolutely, we can add maybe hundreds or more, but those are the ones that were most commonly used in those studies. So we took kind of the assessment helped us then to define also what to assess. Like it helped us to define the panel of blood biomarkers we are doing.

Ari Tulla: 25:44

And then we got that to the market and we did it in a way where we got first people to do, for they started the blood test and then they communicated and connected over Zoom, like we did here with our dietician and our coaches and our health providers, and then in that moment the person assessed them based on a 45 minute discussion, and then they also got data from the algorithm. What did it propose? And we reconciled that and always the person made the final call. So we did thousands of these sessions and every time we did it we let the algorithm learn from the human. Human was learning it to be better, and now we are in a phase where the algorithm is better than the human is. So we have done 10,000 different learning sessions that helped to make it better. And now we are getting the third phase.

Ari Tulla: 26:36

That is the most interesting one, which is now the real world evidence. Are we seeing the same outcome as the study proposed? So the study says that for, let's say, ldl, there's a study about you can do certain supplements and minerals and ingredients that can help it on some level. And then we do that for people and we run them for six months, three months and if the same outcomes are happening, then that study becomes more valid.

Ari Tulla: 27:05

Another study like you are so right, there is absolute garbage that has been published. Some are like 10 people study is 15 people but we have hundreds of people in this cohort so we can have a 10 time because study running already and every person in our LL program is basically an end of one in a clinical trial that's ongoing. We can't publish them, of course, all because we don't have a separate group of placebo, but it will help us to create new science and we believe that once we have 100,000 people who go through the system, we have created more new science than there is science today. We built the algorithm for from.

Dr. Phillip Ovadia: 27:42

Yeah, such a fascinating approach. And so that kind of leads to the question how much validity do we give to the randomized, controlled, peer reviewed studies that are out there versus the thousands or 10 of the thousands, or when you get up to millions, of any equal one type studies, like you're talking about, and you mentioned Verta Health before, which I believe you're invested in, and they're such a great example of this, because the standard dogma that I had learned, certainly and doctors are still learning today is that type two diabetes is a progressive disease, it is not reversible. And now here we have Verta Health and, of course, the work that myself and many of my colleagues are doing, showing over and over and over again that, yes, you can reverse type two diabetes. So where does that balance come? Where tens, hundreds, millions of any equal one versus? Well, the randomized, controlled published study shows something else.

Ari Tulla: 28:59

I think, luckily, we work and Elo is 100% working in the field of food and nutrition. So luckily these are substances we can buy in every grocery store. They are all very benign. So there is no, we don't use drugs at all. So basically doing these studies is easy in a way that we don't need to have that rigor. If you have, like you have new molecule that we have never used, Of course you have to be very, very careful with it and you have to be having all these guardrails. So I think anyone using food today they have this super power in a way taken to this thing and study and it's more about the questions and the system you built around the platform if you can collect the data. Everybody is eating already. We have seven, eight billion people on the planet that we eat every day and we have some different outcomes from it.

Ari Tulla: 29:51

So I think it's very difficult to do a double possible randomized trial in food. It's only been done a few times in the history, Like we had the biosphere too, when we had people ended up badly, but we learn a lot. And then there's some prison studies done back in the days and some very ugly studies done by walker criminals that actually were really insightful in back in the days because you had a group of people and like mental asylums in the US, there were studies done that were really absolutely horrendous but they gave a lot of insight. But I don't know how do we do a study today that we take people who don't eat or we take people who eat very specific thing or like the supersize me idea. How do we take people and give them the worst? I mean that's not ethical. So I don't really know how to do it. Because all these meta studies that we do when we find these things that you know the red meat causes cancer and all these things, I mean I think the carcinokines out there and it probably is true if you burn the food.

Ari Tulla: 30:57

But the point that some people say meat is somehow poison, I mean I've been a vegetarian vegan for a long time. I've been eating meat now for the last few years and you can eat meat that is likely to be very healthy for you. So we at LO we don't believe in dogma, we don't believe in diet. Diet in our vocabulary is basically this is not a real construct. It's a limitation we put to our simple reptile brain to do certain things in a certain order. If you have a computer and AI helping you, you don't need to think about the diet, and the point is that you could eat the stuff if you love it in hamburgers, or if you love pizza, you can eat the pizza, the burger, to be such that it's super healthy and good for you and it can be done almost as tasty. So there's a lot we can do. I think Whoa, whoa, whoa, whoa, let's let's work, let's back up there.

Jack Heald: 31:44

We can, with the right intelligence, create a pizza that's good for you. I just want to. I want to just let that settle for a moment. Oh, problem we need to solve. I am so. I think that may be one of the single most profound statements we've ever had on this show a pizza that is good for. I had to give up pizza years ago. Oh, this would make me so happy. I apologize.

Dr. Phillip Ovadia: 32:16

I got some recipe We'll talk about off air, so you know. So one of the kind of you know places I guess I'm going to in my mind is balance between nutrients and food. So you know, because some might hear what you're saying and interpreted as well. You know, we don't need to eat food anymore. We just need the computer to kind of tell us what balance of nutrients we need and you know we'll just pop the. You know whatever it is. You know you guys have gummies, and I'm not criticizing the gummies, but you know, theoretically you say, okay, well, here's the super gummy that just has all the nutrients you need. And you know, let, we don't need to eat food anymore. Yet obviously, as human beings we evolved eating food. So how do you kind of view that balance?

Ari Tulla: 33:13

I mean, my company is not a supplement company. We are. We call what we do smart nutrition. So we are trying to build systems that are helping people, like I said, eat better and get healthier, and you guys both know that. You know that is very doable and not that difficult. It just requires a lot of behavioural gains and a lot of education, and sometimes too difficult for people to do so.

Ari Tulla: 33:39

Supplements are supplements. They are called supplements that supplement your health and, of course, like I think we all know, many people have basic deficiencies today, like vitamin D. Maybe 60, 70% of people have low vitamin D. If you pump it up, you're going to feel different. B, b12, many people who are vegan vegetarian they default have a B12 deficiency. Iron is a big deal. We know that. You know more than half the woman over 35 have a big deficiency of protein. They're going to be having brittle bones when they get older. So if you are a woman over 35, I would highly recommend you to focus on having a protein in your day, not once, but twice or three times, because you're just not going to have enough muscle density and muscle to be a person you want to be at your 70s and 80s, so at Ello, I think we are looking at this in a way that what can we do to not interfere your life two months? What can we do to help you and build products that are going to be exciting, tasty, easy for you? The world has to be better, not more difficult, if we want to have millions of people to change the way how they eat.

Ari Tulla: 34:55

Today, ello Musk we can debate about his merits on many things, but he built a car that is a better car, not a better electric car. The Tesla is a better car. That's why it's the most sold vehicle today in the whole world the wire model. What can we do here? Can we build, not again, another healthcare monster or Frankenstein that nobody wants to use or understand? What if we put something better? What if people something is tastier and learns about you? Like? We are trying to build things today at Ello that are personalized for you. That's the crowned idea we have Make them personal to you. We also try to make them precise, that they are grounded in real science, not the voodoo, and we are trying to make them proactive, that they get better over time. The whole system learns about you. It learns about the whole mass of people using it, but also about you, and not only from the perspective of maybe helping you to get your blood biomarkers right or get your needle on the wave scale to be right, but also making it better tasting.

Ari Tulla: 35:57

How many times the only person that asks you today about the taste of food who listens is a mom. Mom actually asks you is it too salty? And you say it's too salty. The mom will change the recipe. Your restaurant, the Italian restaurant, you go. You tell them this pizza size is too salty. They are never going to think about like ban this person. You don't like to see this person anymore. He's not wanted here. Nobody will change the recipe based on feedback. But what if it's good? What if I could say that I never want to have this olives again, I never want to have this type of thing again and it never sells again. If that's a grocery basket or meal delivery or whatever, that would be kind of cool.

Ari Tulla: 36:35

So food, breakfast is a key and we can modify breakfast. I think good breakfast could be X, an omelet, spinach, maybe some meat if you want some protein, or it could be a protein, say egg, for example. That we can do already at LO and that's pretty good. I do it every day. I eat my own dog food. I've been having my own LO protein, say, for the last two years every morning today as well, and it works really well.

Ari Tulla: 37:02

And then I think the other point here is that you have concepts like how do we get the lunch done properly? I think lunch should be like a salad with the protein or something very simple. But then at dinner I think you know that should be your time, and I don't think anyone should tell people what the dinner is, because food in the end is sacred. Breaking bread, you know, made us humans. We set in a campfire and we learn to speak and we learn to. You know paint and we learn to be humans. So we can't sense that. And I think there's some sculpture and stuff in the dinner that we don't sense that. And I think the one meal a day that you don't worry about too much, I think you're going to be fine.

Jack Heald: 37:41

I love that idea. There will be those who argue with it, but I love the idea that gathering together to break bread is a fundamental component of what it means to be human, and there's far more to sharing a meal than just the chemical aspect of it. I want to talk about the wearable data. You talked about biomarkers, assessments and then the wearable data. Is there a plan to integrate wearables data into LO's database?

Ari Tulla: 38:26

70% of people who use a lot of the day or members. They have connected Apple, health and one or more variable devices to do the platform. Some people have to link as many as seven devices and then we get you into sleep. Sleep, hrv, weight, blood pressure, blood goals, everything.

Jack Heald: 38:48

The data is that you've got the hooks already. Yeah, it's happening.

Dr. Phillip Ovadia: 38:54

Yeah, how do you yeah.

Dr. Phillip Ovadia: 38:58

How are you going about the problem of filtering that data properly? Obviously, there's a lot of data that gets generated by these wearables, all sorts of different parameters that you can look at. I think one of the challenges today for clinicians like myself and we say, yeah, great, we want to have more data on people, we want to have insight into their daily lives, rather than just the couple of times a year that they happen to be sitting in front of us. It becomes a challenge to know, among all this data, how do we start to pick out what's actually relevant?

Ari Tulla: 39:37

Yeah, I 100% agree and I think there's a really real problem of the race condition, because this person who has seven devices happens to be in need. I'm a guinea pig of all these things. How the heck do we know at ELO if I have three devices tracking every bike ride and my run and my sleep? It's very confusing. We need to pick one. That's not going to be a trivial thing to do. The more data we have, it's not only about the race condition but also the comparability of the different devices. They all calibrate differently. They all may be okay in their own way if you compare only that data, but if you take this data and that data, it's the same as a blood testing. You go to the.

Ari Tulla: 40:23

I'm a member of Kaiser Permanente One. Maybe a year ago I went to every Kaiser lab in the Bay Area at the same time. I basically gave them my blood at the same time and did the same panel and the results were very different. Even in a high-end hospital you get different results. There's a 20% error rate on basic biomarker results. I want to make a point to people who said that our system sucks because we have maybe 10% variance. The variance happens in every lab depending on calibration and stuff like that.

Ari Tulla: 40:54

I think the practical example we do not use all of the data yet because I don't think we have human understanding yet on what HRV means in daytime. I mean, we are starting to understand it, but we are not going to be able, as a company focusing on the Tristan, to be building these panoramic theories. We have to have partners who are developing them. There has to be science that already is established. We can't create the new science. It's too much work for us. Many things we have today in our back-end. We do look, but it doesn't impact on every product.

Ari Tulla: 41:27

But practical example our protein product is basically fully customized to you. Every month we are sending you one or two bags, depending if you want to do a daily protein or if you want to do only a recovery protein. People use it differently Every month. We calibrate that based on your workout profile or your strain profile. Last month, for example, I was doing a lot more bike riding and a lot more endurance activities. I compete in rock climbing. I try to be very active. I broke my toe. I couldn't rock climb so I went on the bike. So it changed my monthly utilization completely.

Ari Tulla: 42:07

I was very curious to see how it will evolve my product. Suddenly, I was added electrolytes into my product because I was doing a lot longer exercises, I was sweating more and it was really hot here in the Bay Area, so it knew the place I'm exercising. Then, of course, there was also something like the BCAA, a special amino acid plant. I think I get something like tart cere or something that was good for my recovery after long endurance activities. The whole product changed and it was no carbs before and now it was added carbs for the recovery. That's how it works. After every workout today, when I do, I use Trava, I use Apple. Whatever I use to track it, it will tell me after my workout how much of that recovery product I need the dosing. So I built a real-time dosing there. That's pretty cool that you have this daily feedback loop and then you can utilize the wearable devices in a very new way.

Jack Heald: 43:02

So that's what the app is for on the phone. I was going to ask you what's the app doing.

Ari Tulla: 43:08

The app is the connector because we use Apple Health as a gateway and it's not really known broadly, but Apple Health is this unbelievable platform that is using the fire APIs to connect to the EMRs, to the packing of healthcare, so I can connect my Kaiser Permanente, I can connect my Quest Labs, my LabCorp data into Apple Health and then I can also, of course, connect all my wearable devices. So the Apple is the gateway and we use them because it's so easy for you as a consumer to go to Apple Health and you can turn it on and off. You can turn on and off whatever you want for LOO or other partners you want to share the data with, or you can even share it to your doctors or your other health systems from there. So it really is becoming this real health gateway and it's a bit surprising. Many people haven't really followed that, but they have built a really, really robust platform for that.

Jack Heald: 44:00

Okay.

Dr. Phillip Ovadia: 44:00

So that's simple, yeah, no, just amazing. So how far away do you think it is that you'll be able to really design full meal plans for people and kind of give them the shopping list and the recipe and taking in all this data and saying this is what you should be eating in a day? And some of it's going to come from the protein powders, like you mentioned, maybe, or the gummies, but a lot of it's just going to be whole real food and helping people to understand how to construct that meal plan.

Ari Tulla: 44:43

We all do that all already. So our platform is building a whole nutrition plan and that can be delivered in model-in-home ways. So it's just about how quickly are we able to integrate these pieces, like next year, I think. We need to integrate to meal delivery Think about your door, that's so you breathe. We need to integrate to your grocery delivery think about Amazon Press or Instacard, and I hope we can also integrate into that. You walk in the restaurant and then you open the app. It will tell you what to eat. We have the menus, but there's a lot of.

Ari Tulla: 45:15

Every one of these ideas is something that will take a lot of time or work, because it's not easy to do it nationwide. I could do it in San Francisco today, but to do it in a whole country is hard, and we decided that our focus is about taking the data from your body. We talked about these different modalities and then turning it into the plan that we can then deliver for your home, to your kids and countless. So today we are shipping you the protein product, we are shipping you supplements and we are shipping this new, amazing, custom-made gummy vitamin that we 3D print. Seven layers into one gummy represented seven pills. We have 300 million combinations.

Ari Tulla: 45:54

We launched the product last week, so it's like unbelievably exciting for us because we wanted to do something better than the pills. People don't like taking supplement pills, so can we make a better modality and I hope next year we're going to see more products. I think the buy market testing will probably get much more robust, much more complete than we had before, but it will take years to build this. So, in principle, the same algorithm, the same system. Can you basically go and order you the meals or the groceries from Doris in the garden?

Jack Heald: 46:31

I'm looking at the gummies and two questions why did you choose gummies as a platform for the vitamins and supplements? And second question, talk about the 3D printing. That's just so cool.

Ari Tulla: 46:52

When we started the company. I mean, I love science fiction and I'm a big buff of Star Trek, and Star Trek Replicator was my kind of idea. Could we build that? Could we build the device at home that could just print you the food, not just like a gummy but like whole meal? I don't think we can do it today. I think we can do it in a decade from now. Like I said, I think we can do very different things when the time goes forward. We have a robot at home who can do this.

Ari Tulla: 47:19

The gummy was this idea that came from a lot of you know, all of children, all of the kids, the founders and our kids don't even, they don't look like pills we were creating and they were like what are these? Vitamins are gummies in their mind. And we were like huh, like the kids don't even, they don't even want to take the pill. They never can take the pill. They can take the gummy. And then we talked to a lot of people and people were saying you know, the gummies are the future and we love gummies. And why they love gummies is easy it's convenient, fun, it tastes good and the pills are like they smell bad, they are hard to swallow and they are associated to unhealthy behavior or unhealthiness. Because medications is like. Supplements are about like staying healthy. Pills are about, you know, avoiding or not getting more, more in the way.

Ari Tulla: 48:07

So that was the talk in the beginning and we didn't look at the idea that could we do this differently? I was traveling the whole world to, you know, look for partners. So we found a partner who can do, you know, hand-backed protein powder with all these different, hundred different things. It was hard. We found a partner who can do pill packs with hundreds of different pills in the one pack Super difficult. And then we found a partner, in England actually, who was able to do this and we worked with them for two years to to build this modality and now it's live and there was a lot of blood, and blood, sweat and tears went into it because it is a very new thing and we had, for example, to do a study to validate that the gummies are equal to the pills.

Ari Tulla: 48:45

So we took vitamin D, the most common deficiency, and we did the study with with, you know, 40 people on the gummy side, 40 people on the pill side, running for 90 days. We tested the finger prick many punks in the beginning and being a very personal, and then same outcomes. So we kind of knew, know that. You know, in most cases I think the gummies are equal to the pills and of course we had to dose them differently. Most gummy vitamins have, let's say, 200 IU of vitamin D. We pumped it to 2000 IU per layer and it's seven layers so we can have we can have 40 different ingredients in any composition of the layers and we have eight flavors. So we have 389 million combinations today, when we'll also product.

Dr. Phillip Ovadia: 49:27

Wow, and just to point out, you know, which will be certainly relevant to my audience, these are sugar free too. They're not. They're not the typical gummies that are loaded with sugar. So very interesting time.

Ari Tulla: 49:44

Eight calories, no glycemic pump at all. I've tested hundreds of them on the glucose monitor and we they also vegan. So if people are worried about different things like cellopin and stuff like that, what's the vegan version of gubbies made from?

Ari Tulla: 50:05

So we use there's a couple of different. You know there's Eritrol and multital, two different sugar. You know components that we use. And then we have a kind of scaffolding that you know it's different layers, I don't know differently. Sometimes you need to even like micro-capsulate the ingredients because some of them smell or taste really bad, like vitamins, are very bitter, so to keep the taste, you know good, but we try to be very as organic as you can be in building. Of course you have to have certain you know system to keep it together as a coming form.

Jack Heald: 50:41

Okay, that's wild, all right. Well, while we were sitting here, I took the assessment actually, it took the assessment before we talked. But while we were sitting here, I got the notification that your particular the one, custom designed for my needs, is ready, so I just placed an order. I'm gonna be testing here see how it works. I'm fascinated by the idea. I think the idea has a lot of merit. Phil, I wanna hear your thoughts as a medical professional. Let's critique this thing. As a consumer, I'm like I'll try. It sounds good, let's give it a shot. What are your thoughts as a medical professional?

Dr. Phillip Ovadia: 51:29

Yeah. So I love the concepts. I love, you know, bringing the data and the right data to this problem and helping people to understand what they need to eat, where the deficiencies may be and how we can overcome that. The concept of popping a gummy instead of taking, you know, many of my patients are on long, long list of supplements. It sometimes amazes me how many supplements they're popping in a day and overall I try and minimize that.

Dr. Phillip Ovadia: 52:04

I think, ultimately, we should be getting most of these nutrients from the food that we're eating, and eating nutrient dense real food, which it sounds like you certainly agree with. But there is the realistic. You know that oftentimes we can't, and even our nutrient dense real food these days, because of the way that it's raised sometimes or grown, you know, sometimes is not as nutrient dense as we need it to be. So I love the concept, I love bringing you know the high level data analysis to this problem and, honestly, I look forward to keeping in touch because you know some of the related projects that I'm involved in. I think there'll be a lot of overlap. So really, really glad we had this conversation and I'll probably be taking my assessment later on this evening when we finish up with these, the podcasts and some of the other work I need to do today, but fat really fascinating. So thanks for coming on. Are there any questions?

Jack Heald: 53:10

that we Are there any questions? We should have asked you that we didn't.

Ari Tulla: 53:15

Well, I think you know a big question. A big thank you for us, you know, for you know giving positive feedback. It's hard, you know, work to build new products and you never know if they make any sense before you hear people feedback. And we literally launched this, like you know, a week ago. So we have that really huge amount of time to talk to the customers and the early members. So big thanks for that.

Ari Tulla: 53:37

And I think there is the one element that I think we didn't talk about. That is interesting with the gummy specifically, because there's really no reason why the gummy could not be a delivery vehicle, also for medicine. Of course we need to be very about, you know, can we guard them in a way that the children won't take them or people won't take too many of them, because they really taste quite good? But the key problem I think we have now in healthcare, one of the many problems, is the adherence, and today almost half the medicine is not eaten at all. And then it doesn't really matter if you, as a doctor, you know you give people the right things if they don't even take them, and this applies to antibiotics, it also applies to the $200,000 cancer drugs. People don't take them always. So how can we build the better system? And that's one reason we also have the app that you know. The app is telling me right now here that you know have I taken my daily? You know dosing and so forth.

Ari Tulla: 54:36

So this is the kind of whole idea that you know you have this sort of ability to be closer to the person, and I think the one element that I'm really bullish about today is this concept of having these satbots, once they are ready for the healthcare world, getting them to people's apps and phones in a way that they will be there when you want to talk to somebody and there's no latency Like how many times a doctor will get an email that they respond maybe day or two later because there's not enough time to do it. What if you could get the response in five seconds or two seconds? That will be making the dialogue thousand times more prevalent, and I think people have a lot of questions but they don't always get the answers. I hope we can do that, because 90% of the normal discussion and dialogue in healthcare could probably be done today by satbots and would be creative.

Ari Tulla: 55:30

People have that access immediately and it wouldn't be, because the problem here is that you are getting the best care. If you are loudest of the bumps, you have thousand people and somebody's really loud and they are like coming to the office and they are demanding care. Those people do get the care, but there are also a lot of people who don't say anything and then they come in and they are too sick to be healed and that, to me, is a problem that. Could we use this sort of satbot in a preventative way and screening the people who need help most?

Jack Heald: 56:09

Makes sense, that's good, all right. Well, let's tell our listeners and watchers the next step. If they wanna know more about LO Health, that's up to you.

Ari Tulla: 56:23

Anyone can go to anyone you know. If you wanna try the gummies, the powders, other things we've built, or the best thing, you can go to LOhealth and you can sign up today. We are available in the whole country. Lois Price, to start with the gummies today I think. It's $59 a month, so it's pretty affordable and we live for the feedback. So anyone something find me. I'm Aritola. Linkedin is the platform you find me most easily and I always respond if you send a note.

Jack Heald: 56:53

All right. So that's LO Health. Lohealth E-L-O like electric light or orchestra yes, and also Aritola T-U-L-L-A on LinkedIn. Very good, phil. I confess I had some anxiety about this particular interview. I'm really pleased we did this.

Dr. Phillip Ovadia: 57:18

Yeah, so am I. You know, one of my overarching philosophies, you know, on this whole journey over the past few years, is it's usually worthwhile to talk to interesting people, and Ari certainly fits that bill, and so I think this was great, and I hope the audience enjoys it as well.

Jack Heald: 57:40

All right well for Aritola and Dr Philip Ovedia. This has been the Stay Off my Operating Table podcast. Thanks for sticking with us. These contact information will be available in the show notes, so check it out and we will talk to you next time.