Health Longevity Secrets

What Is Next After the Apple Watch?

• Robert Lufkin MD

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What if you could see your inflammation—and your pace of aging—from your kitchen table? We sit down with Bob Messerschmidt, an optical engineer turned Apple platform architect who helped seed Apple Health and the Apple Watch, then left to build a simple at-home device that measures ESR, a century‑old inflammation marker with fresh relevance for longevity.

We unpack why chronic inflammation drives heart disease, stroke, neurodegeneration, and metabolic dysfunction, and why a single, trackable number can change behavior more than any abstract advice. You’ll hear a clear breakdown of ESR vs CRP: how CRP reacts fast to single-protein changes while ESR integrates multiple inflammatory pathways over several days, often acting like a steadier signal for lifestyle experiments. We explore compelling evidence that ESR rises with age in Western populations—functioning as a biological clock—yet flattens in agrarian cohorts, underscoring how environment and habits accelerate “inflammaging.”

Beyond theory, we get practical. Our guest shares what actually lowers ESR: meaningful weight loss, GLP‑1 therapies, omega‑3 rich fish, better sleep, daily movement, strength training, stress control, and even tart cherry juice. We talk about the design constraints that make wrist sensors tricky, why Apple prioritizes validation over speed, and how bringing blood-based testing into the home removes friction that once sidelined ESR in centralized lab workflows. With more than ten thousand tests across a diverse user base, the team is preparing anonymized insights and research in underserved communities to show which interventions move the needle in the real world.

If you want a reliable, weekly feedback loop that ties your choices to measurable change, this conversation maps the path. Subscribe, share with a friend who cares about longevity, and leave a review to help more people discover smarter ways to measure and lower inflammation.

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SPEAKER_01:

Hey Bob, welcome to the program.

SPEAKER_00:

Dr. Rob, how are you? Very nice to see you.

SPEAKER_01:

I'm so excited about our discussion today. And I guess maybe to start off, your history is fascinating. I mean, you started out studying biochemistry and optics, and then you then you went to build a famous device for Apple Computer that you worked on that we wear on our wrists. Still well. So maybe maybe tell us a little bit about that journey, and you know, maybe what you know the moment that you thought, hey, I'm just not gonna build devices for companies, I'm gonna build a device that makes inflammation visible in every home. So how did how did you get from there to here?

SPEAKER_00:

It's a long story, if we if we have uh if we have some time. I did start out in biochemistry and thought I was gonna go to med school actually back when I was in high school. My brother, my older brother, did go to medical school. He's a cardiac surgeon. But uh I was more interested in building instrumentation even from the early days. And so at the University of Pennsylvania, I got uh I was, you know, had financial aid like a lot of us did, and I worked in a work-study job in a laboratory, and the job was there were there were actually two jobs. One was either making uh uh making up solutions for biochemistry studies. Uh we were studying the mechanisms of muscle contraction in that lab. But there was another job, work-study job, that was putting together all the instrumentation. And I was always a very mechanical guy, and I realized that that uh, and and the professor realized that that's really what resonated for me was building instruments, and and so over my admittedly very long career, it's always been building instrumentation of one form or another. And also very entrepreneurial, right, right from the start in my early career, early, mid, and later career. Always working at most happily anyway, at small companies, either other people's startups or startups that I myself had founded. Um in the and and and I was always doing things related to spectroscopy, even from the early days. And uh I just sort of had a natural affinity for optics and geometric optics and lenses and mirrors and uh systems involving those things. And so um uh infrared spectroscopy, vibrational spectroscopy has always been my bailiwick. The uh the the the shift towards uh consumer consumer-facing things was uh when I had I had a technology that was an optical system to measure things non-invasively. So it could send a beam of light into human tissue and and measure things, various things. I I won't go into detail about what could be measured, but uh I thought, well, this is something that a consumer company, a consumer company getting into health applications might be interested in. And so uh uh and so back in 2008 I cold emailed Steve Jobs, um, and uh uh you know, which never works, right? And I guessed, I guessed his email, and I guessed wrong at first. And long story short, I guessed again, and uh got uh an email back from Steve Jobs said uh, you know, let's uh kid can I call you? And uh so that started a journey to have the my company was acquired by Apple back in around that time frame, and I became an Apple platform architect. You know, anybody who's an Apple Ophile knows the history of of that of that stage of of Apple. You know, you can read Walt Malt Mossberg's uh excellent book. But I was there in the very early foundational stages of both Apple Health, uh was just starting up, so I was a founding member of that team, and the Apple Watch, which was just a project at that point. It wasn't it wasn't a product, it was it was a project that uh SJ, as we called him, had started up both of those things. And I got to interact with him through the acquisition and through uh uh you know a few early generational uh stages of the projects um before he obviously very unfortunately got uh got very sick. Um and uh um but um uh there there was uh you know he helped me, he helped me get uh under an understanding of why for health, if you really want to change and improve health in the world, having that conversation directly with consumers and giving people an idea of a feeling of self-efficacy to that they can manage their own health. And this is what we've we've come to call now, I I guess we would call digital health. That was really the foundation of it. And um he felt and I came to believe that uh these conversations directly with consumers were the fundamental way we were going to help people become healthier, and so that's what I've you know, at Apple, and then since then I've I've really dived into uh that having the consumer conversation and right now focused on inflammation, which I know you agree is kind of foundational to health. And it came up with the current product, the core device. We have a device that can help people track, because tracking, I think, seeing a number that you can see change over time on a fairly frequent basis, even if it's not continuous, if it's frequently episodic. Having that information, uh, you know, the what we're what we're hoping to offer, what we do offer, is a marker that allows you to track systemic inflammation over time right in your home using a very inexpensive consumerized device. My hope is that it's going to help make a lot of people a lot healthier.

SPEAKER_01:

Well, we're we're we'll definitely get to that, but be before we leave Apple. I mean, that's such a such a great story with the email EC jobs and uh getting the response like that. And and certainly uh what an exciting time to be at that company when when their attention was directed to consumer health, and you know, it was it was just such a visionary period, and certainly, you know, other companies have been there, or you know, Google and Microsoft and all are that eventually were focusing on consumer health. And to be clear, you're no longer with Apple, right? So you don't speak for them. But I I was wondering the the Apple Watch has so many revolutionary features and and the development was so powerful, but it seems like in the last few years it's kind of it's sort of peaked. In other words, um not seeing the rate of innovation of you know other things on the watch. And is that is that what I mean just speculation, is that that maybe all the low-hanging fruit has been grabbed and or is it a difference in you know corporate vision of Apple and other companies that you know look elsewhere? Or or what's why do you think uh you know the Apple Watch today is not that different than the Apple Watch of a few years ago, really, even. You know, we're not we're not having that pace of like, oh wow, here's another you know, glue. Is is that over-regulation with the FDA? What's going on?

SPEAKER_00:

It's not there's no, I don't believe there's over-regulation. I think Apple regulates their output a lot more stringently than FDA could ever regulate their output. And they always have. Uh, maybe not a thousand, but he'd see lots of innovative things in a week. You know, most of them never saw the light of day. And I think I think that's still the culture at Apple, that there's there's a really strong filter at Apple, stronger than at any of the other digital health companies. So you're not you're not going to see a feature in an Apple Watch that isn't like really, really strongly valid. And uh I don't think I don't think you'll ever get that, I don't think they'll ever have a situation where uh you know where where something is gets to market and is thought to be inaccurate. I mean you can look at, for example, the pulse, the pulsox, not the pulsox, but the uh photoplathismography, just the pulse rate measurements on the Apple Watch, uh, and how accurate are they, or how how how accurate are the sleep uh the sleep parameters and so forth. And uh, you know, time and time again I see these reports, you know, that are done by independent studies, and the Apple devices are always the most valid and the most highly correlated with uh with the uh the gold standard clinical numbers. Um so I I think you know, if there's a problem, I I mean I I think that's just slow. You know, it takes it takes a long time to generate that degree of validity in data when it comes to digital health. And I would say that's I I value that and I wouldn't I wouldn't do it a different way. But it is it is maddening because I think we're I think we're very early days in terms of uh uh in term in terms of what will be possible to do in terms of body worn measurements, but you just can't you can't move faster than the data.

SPEAKER_01:

Yeah, and and uh yeah, it's it's not a bug, it's a feature. And uh and uh and and maybe maybe we just mine that form factor. You know, it's like it's like the phone, you know, the phone is it's it's it's sort of asymptotically approaching, you know, very there are very few things each year that come out, you can't expect it to improve, and maybe maybe it's the same thing with uh body measurements and the watch and health measurements, but well, yeah.

SPEAKER_00:

You bring up a really good point. The wrist is a uniquely bad place to get any sort of health data. I mean, it's like it's like the last place you would choose on the body to to get any sort of signals, you know, either optical signals or quite frankly, electrical signals. But that's driven by you know user acceptance, right? So people already wear a thing on their wrist. And you know, to a lesser extent, people already wear a thing on their finger. You know, you're not gonna get, you know, Apple always felt, uh the you know, the the the the really smart people at Apple anyway, always felt that you're not gonna get a lot of not going to get a lot of traction with, for example, a a chest patch. You're never gonna see, you know, you know, from an electro Yeah, right, right, yeah, exactly. From an electrochemistry point of view, you would like both of those things, right? You'd like an an EEG sort of band on your forehead, and you'd you'd like a chest patch going across the midline, you know, and you'd you'd be you'd really have a nice electrochemistry setup, but you're you're never gonna see that with an Apple logo on it.

SPEAKER_01:

Yeah, no, that that that makes a lot of sense. Well, well, I'm there there's one parameter the Apple Watch doesn't measure that now that you you have brought to brought to fruition, and we're gonna talk about, we're gonna talk about your company Core Health and it and how it measures inflammation via really unprecedented and an at-home device. And full disclosure, I'm an advisor to Core Health, but I only advise those companies that I'm excited about and that I would use myself and for my family members. But before we before we talk about the device, let's step back and maybe just set the stage on what is inflammation, why is it important, you know, what give us the inflammation 101 for our listeners who may not be on top of this right now.

SPEAKER_00:

Right, right. Okay. Well, I I feel a little self-conscious doing that with uh because you because you're more expert at it than uh than than I, but I'll you know, so stop me if I say anything wrong. But um you know, but but um when I started reading articles about um uh what is sort of root cause, right, when it comes to all sorts of chronic conditions, and started reading people making the connection with uh inflammation in the body. I knew right then, you know, this was upon you know have having already left Apple, but I knew this was a thing that I wanted to focus on, a way to get a number, a trackable number that could be related to inflammation. And if there was any other matrix in which I could make the measurement besides a blood sample, I you know, I would be doing it that way. But we are using a blood sample from from a finger stick. Um the so inflammation is uh is is a process you read all the time that it can be either good inflammation or bad inflammation. So the body does use inflammation as a way to repair itself. But um, you know, there is uh there's there's some really excellent tests that it's a it's a very complicated set of biochemical systems in your body, ends up producing proteins, and they're usually produced uh in the liver. And uh these these inflammatory proteins are uh and there's there's a wide array of them, they're called acute phase reactants, and uh they are there's a soup of proteins that can be measured in blood. So they're there are all kinds of indicators of uh of an inflammatory process. And so so there are several long-standing markers that have been available for years. In the case of the marker that I look at, erythrocyte sedimentation rate, it's been around for over a hundred years. You know, if you have if you have a measurement, let's let's make the analogy to blood pressure. Blood pressure is something that you can measure. And uh so then what scientists do is they try to use a measurement that they that they have and they're curious about, and they try to correlate it with uh with outcomes. And so uh it's in the case of blood pressure, for example, it's very uh it's blood pressure is a prognostic indicator of morbidity and mortality if you have blood pressure over 120 over 80. And some people say the lower the lower the better. Um uh erythrocyte sedimentation rate as an inflammation marker is the same way. So, you know, it's a it's a it's a compound marker or signal, it's almost a vital sign, like like blood pressure is, of a process and a series of processes in your body. And when this marker is higher, it's correlated with an increased level of morbidity and mortality, all cause morbidity and mortality. So the inverse of of mortality is longevity. So uh a lower ESR number, well studied, as I said, for over a hundred years in the literature, a lower ESR number is correlated with more longevity. So, you know, the the just just at a very sort of high level, it's a it's a strong independent prognostic indicator of longevity. So if I can, and it and it's it's fungible. So it's a it's a number that you can impact through either you know medical interventions, but you know, what what I'm more interested in is lifestyle interventions as a way to as a way to lower in in inflammation and lower uh sedimentation rate. Um it's very it's very it's a very fungible number. You can impact it with dietary changes, uh, activity changes, sleep changes, and so forth and so on. So to me, to me, um it's a marker, I don't, I don't want to be sacrilegious, but it's it's almost a marker that is, you know, let's say it's foundational, that it can uh it can it can really if if you only had one number to track to manage your your chronic health, your your your chronic uh uh wellness, uh I would I would uh I would I would choose uh you know uh an indicator of inflammation and uh and I do. So that's why that's why I track my inflammation weekly. Um yeah.

SPEAKER_01:

So let's so let's let's unpack that a little bit. So inflammation, first of all, it's it's a natural thing. We all have it, right? In fact, if we didn't have inflammation, we'd be dead, right? Because acute inflammation is sort of like stress. Acute stress is good, chronic stress is bad. Well, similarly, acute inflammation, which is like if I stick my finger with a thorn from a rose, there will be redness around there, there will be those acute phase reactants you talk about, things will things will happen in my body that that sort of repels that foreign material and and protect me from that invasion, and then it goes away. So that that that you know little bump in inflammation is good, and it it literally saves my life. And the problem is in society today, there there are things, lifestyle, and as it turns out, aging itself that that drive inflammation all the time, and it gets turned on. So, what does that mean? Well, like you say, that you get all these uh acute phase reactants, and the inflammation drives essentially all the all the chronic diseases of aging. The things we talked about a lot in the show. You know, heart attack is inflammation of the blood vessels, atherosclerosis, stroke is inflammation of the blood vessels. You know, uh Alzheimer's disease is inflammation of the brain. You know, neurodegenerative diseases are inflammation of the brain. Insulin resistance is and diabetes is related to inflammation. And so much so you know, as you point out, Bob, that so many of these chronic diseases are driven by inflammation, and these are the diseases that essentially age us and determine our longevity, that they've even coined a term called inflammaging, right? That is the inflammation that drives aging and all. So it's it's yeah, it's it it's a super important marker that we can actually measure through, you know, through the the test you mentioned. And and there's a there's a another lab test that doctors use also called the CRP. And some of the patients may be familiar with that, or some of the people may be familiar with that, called C reactive protein, that uh doctor will order, and they'll order the this your your test at ESR that is based on the erythrocyte sedimentation rate. And just to be clear, definition erythrocytes are red blood cells, and sedimentation rate is how fast they literally they sediment in through a liquid of the plasma. And if you think about it, the number of the number of those acute phase reactants, those inflammatory particles slow down the the uh descent of the sedimentation rate of the of the blood cells. So you have a it's literally the time it takes to sediment, right, Bob?

SPEAKER_00:

Correct. Yeah, correct. It's it's uh it's actually um there's I don't want to make it too complex, but there's a uh there's there's a process that goes on that's that's regulated by these inflammatory proteins that are in the plasma. And what they do the reason, but we're measuring red cells, so what I mean, why am I talking about two different things? Well, the inflammatory proteins that are in the plasma, they cause surface effects on the red cells, and the red cells then it causes them to become sticky. So stickiness is a bad thing when you're talking about blood, right? You don't want your blood to be sticky. And what happens is the red blood cells clump together, they they they form these stacks of if you know what a red cell looks like, if your audience knows what a red cell looks like, they're kind of frisbee-shaped. They're they're you know pancakes. And so they stack. They stack together in what's called a rouleau, which is a French word for uh a stack. And um and they when they stack together because they're stickier, because there are inflammatory proteins, they uh become heavier and they and they fall faster in the plasma. And so um it you're just early scientists discovered this effect and noticed that it was correlated with health conditions. That's why we have ESR today. Um and uh you know, just like blood pressure. What I mean, blood pressure is not measuring directly a uh, you know, a condition. It's it's a it's a sign. It's a sign of something. And uh, ESR similarly is a sign that there's uh that there are inflammatory proteins present in the blood, CRP being one of them. So ESR is actually measuring CRP along with other inflammatory proteins.

SPEAKER_01:

Okay, and and the the CRP test is a is also a blood test, but you have to send it into a lab, and then it typically takes a few days to get the result uh from from your doctor. And now the real breakthrough that that you have with the core health device, and maybe show maybe show it to the people. It's beautifully designed. It looks like an Apple product. How could that be? It's clean, white, you know.

SPEAKER_00:

Absolutely. So so this is the device. Yeah, I mean, uh yeah, I won't I won't say we didn't uh learn that I didn't learn anything at uh Apple, but it's very simple, and uh I have an old broken down one here. There's normally a dust cover there, but that's what it looks like. And then there's uh a test tube also, and these are single-use disposable test tubes, and you put a small amount of blood in this test tube, fill it up from a finger stick, and you put it put it in the device.

SPEAKER_01:

Yeah, and so so then so the difference between the CRP is and the real breakthrough of this device is I can do it at my home and I get the result essentially right away. Uh I don't have to send it into a lab and wait a few days to get the result back. So I could track things even day by day or even hour by hour if I wanted to.

SPEAKER_00:

That's right.

SPEAKER_01:

And before we leave this, we get into this more. Before we leave CRP, what's the difference between ESR and CRP as far as far as how they measure inflammation? We talked about how they measure it, and the CRP is a single protein, it's a subset of the total proteins that the ESR measures on your device. So, how does that translate into clinically actual differences between those two measurements? Or are they are they completely the same in a machine?

SPEAKER_00:

No, they're not completely better. They're not completely the same. So there are uh, and uh let me let me let me try to summarize here, um, they are in in comparative studies where people have looked at uh uh gotten a blood sample and looked at both the CRP and the ESR, they're strongly overlapped. So when uh in 87% of the of the samples that they had in one study, uh when ESR is high, CRP is also high, and when ESR is low, CRP is also low. So they're they're 87%, 85 to 87% overlapped. There are edge cases where they don't give the same information, and that's because the kinetics are different. So CRP is a single protein, and therefore you can imagine since it's reflecting just one protein, it's quicker to go up and quicker to come back down again. So it's uh it's uh much more of a rapid response. Imagine, like you're you were looking at an instantaneous glucose level, and PSR is a little more time averaged, it's a little bit slower to rise and a little bit slower to fall. And you could think of that like the measurement, the similar glucose measurement is called hemoglobin A1C. It's a it's the longer-term effect of hemoglobin A1C is kind of like a 90-day average. It tells you what your blood glucose has been doing over the last 90 days. ESR is not that much of an average, it's like a it's like a several day average of what your inflammation has been doing. So, you know, I wouldn't I actually would not recommend measuring uh ESR daily. I would measure it on a weekly basis. Uh, that's what we we recommend to people, and people typically do it either weekly or monthly. Don't have to do it, you don't have to do it weekly, but uh that would be the best cadence. And last but not least, they're different because CRP is one inflammatory marker, it's produced in the liver, um, and it it doesn't reflect as many inflammatory pathways as R does. So ESR is reflecting some inflammatory pathways that CRP misses. So you could use one or the other. We we focused on ESR for all kinds of productization reasons, and it uh it's a very good marker. Can I say one other thing about it? I know you want to jump in, but I I want to say the the the uh uh ESR was and well it still is a very often ordered lab test, but when laboratory medicine went to centralized blood testing, ESR became less uh less commonly prescribed because you really need fresh blood in order to measure it. You you want to measure ESR on a blood sample that's less than four hours old. And now we're talking about regional blood laboratories where you know they're they're drawn at a phlebotomist's office and then they're shipped off somewhere to lab core or quest have a central lab somewhere. It's very often more than four hours before that sample gets run. It could be 12 hours, it could be 24 hours. And it's not really possible to get an accurate ESR if you have to, if if the sample is that old. It just uh there's no storage condition that allows you to get uh you know a perfectly accurate ESR number. So this this idea of measuring in the home has once again made ESR a useful test and a very good test.

SPEAKER_01:

Yeah, there's one other advantage that we we talked about offline that's fascinating. I want to bring back up about the SR advantages over CRP, and that is we talked about inflammation increasing in everybody with aging, right? Yeah. The older we get, the more inflammation and stuff. And but with CRP, it doesn't reliably increase so much. We can't do a biological clock with it, like an inflammation clock. But what about with ESR?

SPEAKER_00:

Yeah, yeah, ESR, you're absolutely right. That was immediately apparent to me. And well, it's in the literature, but I also see it in the core data. So we I can look at anonymized data in our user population, and the average number, the average reading for is strongly correlated with age, and it's separated, it's different for males and females. So if I if I create a plot of you know all of the user data versus age, I see a linear slope increase for ESR with age. And what is that? You know, what is that when you have a uh you know a slope with age? That's a clock, right? So so ESR as a marker by itself, a single biomarker biological clock, is pretty powerful, right? If you want to know how rapidly you're aging or you know whether you're aging more than the average person in the cohort. And this effect is really interesting. I've the second sort of really interesting thing about this aging effect and the fact that ESR can be used as a clock is if you look in a population of people that are not that don't have sort of Western lifestyle. So if you look in a more primitive or agrarian society, you look at it, you do a population study in that in that cohort, there's no age dependence in that cohort. It turns out that people don't get higher inflammation as they get older if they live in a very sort of agrarian lifestyle where they work hard every day and they they don't eat Twinkies.

SPEAKER_01:

Yeah, it'd be interesting to look at that. I mean, there's all this talk about the Amish. you know and how they you know embrace uh a a more you know assuming super uh ultra processed foods and things and it'd be interesting to look at their especially that's yeah that's fascinating that that the ESR unlike the the C reactor protein is is a reliable biological clock and a measurement of aging so you can you can put yourself on a graph of what what your inflammation age is based on your ESR. And then to kind of follow up on that the great thing about it is that there are now there are interventions that you can do that will lower your ESR and essentially lower your inflammation age and so it's not just it's not just a you know unchanging marker of you know inexorable time passing as until we die but you can actually with lifestyle with other things what kind of things can people do to what have you seen with your your population what works for reversing your inflammation well yeah yeah and I'll talk about myself I've I've been able to greatly lower my inflammation with dietary changes I like a lot of Americans I've struggled with weight you know pretty much my whole life I was overweight in high school and basically my whole life.

SPEAKER_00:

GLP1 agonists have have been a great help to a lot of people and I'm one of them and uh the GLP1 drugs are are highly effective in lowering inflammation. And uh you know I saw that immediately my uh ESR number when I started taking the GLP1 drug and losing weight as a result of that my uh inflammation numbers were cut in half. But yeah there's a lot of uh the the one of the really great things about ESR is uh as we said it it goes up as you get older and uh uh you know I'm not young. So there's there's in in most of our user population there's some headroom. So in in me personally and in our user population there's uh there's headroom. So I wanted to go further and uh so I started looking at all the different anti-inflammatory substances that are available. The things that are really useful to me are uh omega 3s fatty fish is is a really a thing that'll within a period of of a week if I eat salmon three times in that that week and then I test my ESR my uh my inflammation is going to be lower. And another one is very very simple idea is tart cherry juice.

SPEAKER_01:

I talk about this a lot but uh tart cherry juice is something that's really lowered my inflammation precipitously the the inflammation age marker it sounds it it's it's different but it sounds like it has some similarities with the work uh Gordon Lauch is doing on glycon age which is yes glycosylation of sort of a number of proteins in the in the blood and and other inflammatory markers as well. Have you done any correlations with glycan age it's a it's a clock that they that they they make available through their company also.

SPEAKER_00:

We've not we have not done that but um I would expect that I would expect it to be strongly correlated with glycan age or there's another marker that um is basically a marker of it's a it's a it's a spectroscopic marker called uh glyc A G L Y C that's uh basically strongly correlated with the ratio of triglycerides to HTL in your in your blood but it's measured it's measured through a uh nuclear magnetic resonance spectroscopy so I would I would expect to see strong so it's another glycan sort of related thing and I would expect to see strong correlation with uh with both of those markers. Glyc A as a marker was uh was a startup company that got acquired by LabCore um uh 10 years ago now or so there are a lot of really good lab markers that uh indicate inflammation what I'm trying to do that's different is uh you know you can't really do phlebotomy weekly I don't think you know there are there are some people who are trying to do little collection devices that go on your arm and so forth and uh I think those are interesting but I wanted to be able to bring something into the home and get you know a really highly useful number that you could measure without having to send your blood out through the mail. And uh yeah so that's uh everybody is working on a different piece of this I think it's a great community of people but uh yeah uh you know I'm I'm sort of jobsian in my thinking right I don't want I don't want I don't want there to be any friction at all to that prevents people from getting the data and being able to act on it themselves.

SPEAKER_01:

Yeah it's it it's it's fascinating and what you mentioned with the HDL to triglyceride ratio of course many of our listeners will recognize that as a metabolic marker of metabolic dysfunction you know one of the original markers Gerald Raven and others described and yet it's also an inflammation marker and it shows how you know inflammation is really just another face of metabolic dysfunction with insulin resistance and oxidation it's the the common engine that drives all these all these diseases. Absolutely now with with core health in your patient well the your user population because these are a lot of healthy people who just want to be even healthier right that's right and and uh it would be fascinating uh do you have plans to basically release your data in some fashion sort of anonymized de-identified where you go this is the core health report for 2025 uh you know this is our population by age and these are the cohorts over age these are our average values and then this subset used uh you know uh basically did this intervention you know and obviously it's just self-reported and it's you know it's it's not controlled necessarily but it's great you know it's great epidemiological data that you have access to it would really be wonderful if you started making that available to people and it would help inform the users of you know hey what works you know the people who take 10,000 steps a day they have lower you know yeah lower ESR you know and or other things as well and and happy I'd be happy to share it with any researchers who were uh interested in a in a data set it's a it's a really good and pretty sizable we have over 10,000 tests uh uh ESR tests from a you know a really nice diverse population of of people I'd I'd be happy to share that we're also trying to do more on the research side internally so we've just submitted two SBIR phase one proposals collaborating with another researcher in this and a and a public health expert but for the fact that uh Congress failed to reauthorize SBIR funding in the last uh minibus which is a topic for another day perhaps but um but uh the um uh to uh to to study what what what what what the SBIR submission is is to study ESR as a marker of outcomes in in an underserved population so we're looking at a rural uh uh population of people in the state of Wyoming so a lot of uh people from uh from the the reservation and a lot of lower income people who don't necessarily have access to these great digital health tools that uh that we love but the core device is uh uh is low friction enough and low cost enough that it can play an important role in in underserved communities so we're you know we're looking at that aspect also and and I guess those populations unfortunately although they're socioeconomically depressed they're not really agrarian and they're probably inundated with junk foods and and the worse end of the inflammation presumably uh yeah I think I think it'll be uh it'll be we don't know yet but uh I I mean the I mean there are other studies that look at metabolic syndrome which you mentioned right look at that in low income and rural populations and it's uh yeah it is statistically significantly even worse across America is bad enough but in these uh you know these underserved populations it's it's even worse because there there are food deserts out there there you know there's uh you know it's it's expensive to uh you know to go and eat high quality protein every day you know so people are eating uh Big Macs yeah yeah they and one other application that we we've had some fun with Bob we were with me on our last three-day fasting three-day water fast yeah which we did in October with Josh de Mel and a bunch of other folks and we did daily zoom calls but part of it was uh we had Bob and and and other people doing the fast we're we're checking inflammation and maybe this time we'll check it at the beginning and maybe at the end and the daily ones you know for the reason we mentioned but uh we're gonna be doing it again in January January 11th to be sure you're all invited to join us you can you can register on our website and Bob will be there we'll be demoing the device and Josh and me and a bunch of people you're you're welcome to fast along with us or or just uh join in the festivities but uh anyway that'll that'll be a lot of fun kind of thinking like we what do you think about the um looking ahead towards the future you know what do you think um you know with with your background in medicine tech you've obviously seen a lot and what what's the next moonshot that you're thinking of or that or that you're excited about kind of beyond inflammation what's the next frontier of maybe homeblood tech or anything else that you think that people aren't really realizing well uh you know I'm not I think I have a lot of rows to plow still in the uh in the inflammation space but um you know just reflecting back what I get asked about uh a lot I get asked for the people who are really interested in this home data from an a completely in-home information loop I get asked uh all the time for other bar uh other biomarkers so other people really respect and understand the utility of the information that you can get from a blood sample and it doesn't need to be a huge blood sample and it doesn't need to there there are a lot of numbers that you can get from a blood sample if you can it's the the instrumentation is nowhere near as simple as it is for ESR.

SPEAKER_00:

ESR requires a very simple instrument and so we would we would need to create a much more complex instrument to measure things in the home. And I'm not the only one working on this but I am very interested in giving people additional data from the gold standard matrix which is blood in their homes so that they can uh you know make additional lifestyle uh or medical medical or uh lifestyle adjustments uh themselves and so more data gotten quickly in a really simple feedback loop is is what I'm interested in in doing another aspect that I'll mention here is how to complete the loop once you know that you have inflammation even if it's even if it's low grade inflammation and you want to do something about it one of the common questions I get is well what do I do next you know it's there's there's a lot of information about that but you know there's friction so what I want to do is I want to I'm talking about with some uh organizations about providing or at least pointing being able to point people to the best the best choices to make in terms of of living a healthier lifestyle so sort of compiling all that information in in one place we want to we want to do a better job of that that's what I see on my near term horizon are those two areas.

SPEAKER_01:

Yeah yeah it'd be nice to have a uh because the the actual inflammation doesn't necessarily indicate its source right it could be from lack of sleep it could be from food it could be from stress could be from a low grade infection even so but but um a uh you know sort of a comprehensive questionnaire or something could help people point them in the right direction when they do the test they could do that's right there's a lot of value added I think you could do with that yeah yeah I think I think we'll be focused on inflammation for the foreseeable future I think it's uh the right the right place to be putting my mind share at the moment. Yeah I mean and think about it if you fix inflammation it's game over with these chronic diseases basically you you reverse inflammation the Alzheimer's disease gets better the you know the such a a factor there you know there have been studies where people get dramatic results by changing the inflammation profile and and this is this is a unique insight into it on a you know on a and on an at-home basis which heretofore hasn't been available so it's it's exactly congratulations on this on this device I'm really excited about it.

SPEAKER_00:

Well I want to I'm happy that you are I I appreciate it.

SPEAKER_01:

I want to be respectful of your time before we leave is there anything we haven't covered in this session you wanted to talk about today. Well I want to make sure to give people to let people know where to get in touch with me and uh uh and where to see the device the the company website is corehealth.comhealth com um and we have a lot of information there that's useful yeah you can reach out to me at high at corehealth.com via email hi at corehealth.com yeah and we're we're pioneering uh some programs with a a local uh weightlifting gym here in LA called Fred Fitness and and if you have a gym or a sports club that you go to you'd like to have them have this device I think just you know they can approach Bob uh call core health and uh you know we're open to doing things like that I think as well. So you know uh we want to get this technology to as many people as possible.

SPEAKER_00:

Yeah yeah we're we're building them as fast as we can um I think we have demonstrated that uh there's a lot of interest from that community the people uh who are fitness enthusiasts um and so yeah I'm very excited about Fred Fitness in the LA area and uh we're gonna do some you know some inflammation testing on site there and uh you know people can see it in action.

SPEAKER_01:

Yeah so Bob maybe we'll we'll put your link to the the company in the show notes but maybe you could just uh say it out loud to people that are listening to this so they'll have it the the website yeah okay it's corehealth.com C-O-R-H-E-A-L-T-H dot com type that into your browser it'll come go right to our site great well thanks thanks so much Bob for what for for what you've done and what you've accomplished here this is such an exciting time now in home monitoring where we're getting access to more and more powerful technologies really get insights into our making making us not just less sick like doctors do but actually making us healthy which is which is amazing. So thanks for sharing sharing time with us Bob and we'll look forward to seeing you again on the program.

SPEAKER_00:

Thank you very much. Appreciate it this was fun that's great.

SPEAKER_01:

We'll let that oh here I'm gonna