by Nick Taranto
It was the most legitimate approach to personalized nutrition that I had found, and I was excited to schedule my visit. Until I asked about the price:
Twenty-five thousand dollars.
Twenty-five thousand dollars for an eight-hour exam? Really?
And that, in a nutshell, is the reality of personalized nutrition today: It exists, but at a price point that is only affordable for those with a few spare million to burn. Personalized health and nutrition, while increasingly feasible from a technology perspective, is still insanely expensive—at least for mere mortals. I was excited to know that pioneers like Craig Venter were working on problems of this magnitude and complexity, but similar to the journey that supercomputers made from the early 1980s to today’s iPhone, both from a cost and feasibility perspective, personalized nutrition has a long way to go before you will find it in the average consumer’s pocket.
Dori and the Chamber
I didn’t have a spare $100,000 or even a measly $25,000 sitting around under my couch cushions, so I looked for a more reasonably priced alternative to the billionaires’ wellness plan. The same doctor whom I mentioned above who provides personalized nutrition and health solutions to Manhattan’s elite suggested that I connect with Avigdor Dori Arad, a Ph.D. candidate in nutrition and exercise physiology at Columbia University.
Dori and I hit it off immediately. He is lean, five foot eight, with a shaved head, a thick Israeli accent, and a big smile. Dori was born and raised in Israel and started his career as the commanding officer of a fitness and combat unit within the Israel Defense Forces. From 2005 to 2009, he studied nutrition at UConn while playing Division I soccer, where he eventually won the Big East Most Valuable Player of the year award, in addition to Big East Championships in 2007 and 2009. Prior to starting his Ph.D. at Columbia, Dori returned to Israel to play professional soccer.
As we talked, and as I reflected on what I had learned so far, I came to a realization similar to Larry’s: If you want good health, you can’t just blindly trust how you feel. Dori invited me to his lab at Saint Luke’s Hospital so that I could take my self-exploration to the next level.
Most of Dori’s research focuses on metabolism, exercise physiology, and human performance. I wanted to more deeply understand how much and what I should be eating to maintain optimal health, and Dori offered to work with me. We put a plan in place to determine exactly how many calories I needed to consume every day and what type of food I should consume in order to lose weight, gain muscle, and optimize my life as much as possible.
I met Dori up at Columbia one day, and he showed me around his lab. “People can get comfortable with many situations, but they can be in danger,” he told me. “For example, you can think your household budget is balancing, but if for twenty years you don’t look at your paycheck and you never look at your credit card bill, imagine what could happen. After twenty years, you realize you haven’t been making as much money as you thought, but you kept spending—then you wake up and find you are in life-threatening debt.
“The analogy holds true for the body. Most people have no idea how much energy they need or how much they burn. Over the years, we have become more sedentary, and the amount of energy that people now burn has decreased significantly. People think we burn the same amount that we burned on average historically, but that’s not true—due to commuting, online shopping, working at a desk—we are now burning much less energy than we did historically. Additionally, we are taking in many more calories than we think because of how food is now produced and prepared.”
The same way people have an accountant to help with their personal finances and taxes, Dori recommends that most people work with a nutritionist to help balance their caloric budget. There is too much confusing information today, and people need help.
“There is definitely a lot of nonsense out there,” Dori told me, “but there’s nothing better than the metabolic chamber for determining what your body actually burns each day.”
The metabolic chamber. Even the name sounds scary!
Dori and his team built the chamber from scratch in order to have the most accurate instrument for measuring calorimetry in the world. It is a ten-foot-by-ten-foot sealed-off bariatric chamber (the door is a used submarine hatch!) where Dori’s team can monitor oxygen input and carbon dioxide output. With the ability to measure oxygen consumption down to the milliliter per kilogram per second, Dori can tell his patients down to the calorie exactly how much they should be eating in order to maintain, gain, or lose weight.
We sealed the chamber one morning at 8:00 A.M., and I didn’t come out until the next morning. I brought in all my own food and fluids. I exercised on a stationary bike. I wrote. And I welcomed the reprieve from the boisterous office and two young kids—it felt a bit like I was on a monk’s retreat to the soul of my metabolism!
Following my session in the chamber, Dori provided me with reams of data that I pored over: total energy expenditure, sleep energy expenditure, exercise energy expenditure, my twenty-four-hour respiratory exchange ratio. My fitness and health had never been this quantified before, and as the old MBA axiom goes, if you can’t measure it, you can’t manage it. I worked with Dori to develop a nutrition plan based off hard data. I finally knew what my body needed to be healthy, and I felt good.
Feast or Future?
Not everyone sees the quantified self in a positive light. Do we actually need to know this much about ourselves to be healthy? Is such an obsession with health even healthy? In 1996, a new eating disorder was coined: orthorexia, which literally means a “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat better.16 But orthorexics become obsessed with health, purity, and food quality—and spend much of their time and mental energy determining what and how much to eat, and dealing with the consequences when their willpower falls prey to the plate of warm chocolate chip cookies in the kitchen.17
At the peak of my quantified self/biohacking/nutrition obsession, I had sent my poop out to a lab to map my microbiome; sent my blood to a lab to perform a food sensitivity test; shipped four additional vials of blood to another lab to track over one hundred blood biomarkers. I had spat in tubes and shipped them across the country to have my DNA genotyped. I was using two different diet-tracking apps and three different fitness platforms on my phone. And, of course, I had sequestered myself in a metabolic chamber for twenty-four hours.
One night when I was in the depths of my quantified nutrition self-experimentation, I found myself in my kitchen with my newborn second daughter slung over one shoulder. I propped her bottle of breast milk on the window ledge where we have a rocking chair and a view of the Hudson River and the Freedom Tower. It was the last day in June, and the sun was still setting, casting bold orange rays against the symmetrical inverted triangles of the Freedom Tower. It was my wife’s first night off from baby duty and she was out with friends, and I was planning to set up shop by the window and watch the sunset while I fed my daughter.
Instead what happened is this: I spent the next forty-five minutes on my nutrition-tracking app hunched over my kitchen counter, scanning cheese, spinach, and ground chia seeds and inputting other ingredients like eggs, garlic, and kale. By the time I was done juggling my daughter and inputting all the ingredients, I turned around to find that it was pitch black outside, and I had missed the sunset.
And then it hit me: This was emblematic of what can happen when food becomes nothing more than nutrition. I could and should have spent the last minutes of the day staring at the sun reflecting off the river and the Western Hemisphere’s tallest building. Instead I spent that time looking like Gollum addicted to his precious phone, pecking away, inputting data points to make sure that I was accurately tracking myself.
Optimizing happiness, health, and longevity is complex. At this point in human history, we have the capabilities to quantify the self to the extent needed to tailor optimal nutrition, health, and living—but the solutions are cumbersome, expens
ive, and often end up stripping the healthy joy from life. We will get there soon (within the next decade or two), but for now, the quantified self requires far too much manual input (and obsession) to make it a reality for most people.
So, in the interim, because we don’t have the answers, let’s not pretend like we do. We all need to do our own research and testing to figure out what blend of nutrition, stress, sleep, and exercise works best for each one of us as individuals. There is no one-size-fits-all approach, there are no shortcuts—and for many of us, being healthy is healthier without having to worry about health.
The fundamental challenge here is that the only bridge to the future is through technology, innovation, and behavior change. These transformations will not come overnight, but due to their initial cost, they will by necessity have to start with the “elite”—folks willing to pay top dollar for life enhancements that at first probably seem ludicrous—think of the $100,000 annual longevity program or the car phone back in the 1980s.
Over time, as the cost curve drops, what were once overpriced technological trinkets will become interwoven with how we all think about day-to-day life. Over the span of thirty years, the car phone evolved from a bauble for narcissistic Wall Street types to the smartphone, which is now used by billions of people around the world. The same evolution will take place over the coming decades for “bioenhancements.” Those technologies, services, and products that today are the playthings of billionaires will in a matter of years redefine how we all live our lives.
At a certain point, I found that it’s “healthier” to pull back from the brink of obsession and to return to treating food as food and not nutrition. The World Health Organization defines health as an optimal physical, mental, and social state with the absence of disease. As Dori told me after my chamber session, “In the United States today, many people are compromising their health, and the perspective is not ‘How do I optimize my health?’ but rather ‘How do I just survive and make it through the day?’ I work with a lot of clinical patients who for many years were not in good health, and when you talk to them about eating well, it looks and feels much different from what they actually do.
“We are in the process of moving from disease-centered to patient-centered medicine, and this means looking at health holistically. Not just ‘Does this guy have a problem with his weight?’ but also ‘Does this guy have the right social support network around him? Does he exhibit tendencies toward depression?’ A person is not one dimension, and this is vital to optimizing health.”
At Plated, our Second Core Belief is: The definition of healthy living is intensely personal. Over the next ten years, we will see an accelerated digital transformation of nutrition and the role it plays within medicine, health care, and social policy more broadly. I am a true believer that food can be either medicine or poison. However, far too many doctors do not start with food and nutrition but rather treat it as an afterthought. This must change, and at Plated, we will help make the change happen.
At Plated, we are building a future where technology (Fitbit, Apple Watch), biomedical and nutritional data collection (23andMe, uBiome), cloud computing, food sourcing and manufacturing, and delivery infrastructure come together to provide a personalized, convenient, and affordable answer to the question “What should I eat?”
In the next and final course, I’ll share more about why and how we started Plated, acknowledging that the entire experience that surrounds food is multidimensional, with many opportunities for improvement. We see the future of food, nutrition, and health—and we’re building Plated to get there faster.
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Picture of an Evolved Eater
Michael Ibrahim, Dorchester, Massachusetts
I started Plated as a life choice to get healthier, and I’ve been a happy customer for almost four years. I’ve now lost a total of 130 pounds, and I have Plated to thank for that.
I’m originally from Kentucky of all places, and I moved to Boston for the art scene. Growing up in the South, the food landscape was primarily fast food, or just crap. With no access to fresh food and farmers’ markets, you’re conditioned to what is fast, easy, and cheap. My parents didn’t cook, and I never learned how to cook. This came with me when I became an adult, even in Boston. Before Plated, dinner was pretty terrible. I ate amazingly large quantities of just terrible crap.
After Plated, now I don’t even go to the grocery store anymore. People come over, and they look in my cupboards, and there’s like one thing of vanilla and some salt and pepper, and they’re like, “Do you not eat?” Plated has completely changed how I think about and eat food. I no longer go to the grocery store or order takeout or buy food the “traditional way.”
Plated for me was about learning to be fluent in the language of good food, learning how to use olive oil, how to chop veggies, that kind of simple stuff that no one taught me. I can now transcribe that to when I’m out at restaurants, I know how food is prepared and if it’s good for me. Plated was an education moment of how to prepare food and become an educated person when it comes to food. Plated is part food discovery and part Julia Child cooking course, and this whole lifelong journey you go on, not to make it sound weird, but I discovered this whole new potential part of my life, and I just needed the tools to unlock it.
When I first tried Plated, weight loss wasn’t even on the menu. I was just tired of eating the same three foods, and takeout was really expensive. I used Plated as a springboard to make better life decisions. I’ve learned that it is much better to have a balanced portion of really amazing-tasting food than two pounds of bland mess. Plated also got me thinking of balancing exercise with good eating, and a Fitbit later, I’m walking fifteen thousand steps a day. I know that Plated is not a “diet plan,” but having portioned, healthy, and fresh food delivered weekly was just what I needed to get me going on my journey. Plated really was the first step in a whole series of life changes and life adjustments for me. Food change led to cutting things out, which led to being more active, which led to enjoying life and being able to live as I had always dreamed of living.
If it wasn’t for you guys, I wouldn’t have made this change. Plated taught me that life can be better than what I have now.
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Third Course
How to Feed Ten Billion People
8
Don’t Live on Empty Calories or an Empty Mission
One-liner: From the Marine Corps to Wall Street to taking the entrepreneurial plunge—why we started Plated.
From day one in the Marine Corps, I was steeped in a centuries-old culture that rests on principles of dependability, integrity, decisiveness, unselfishness, courage, and enthusiasm. I would lean on these traits, and the importance of building a strong mission-driven culture to support them, later at Plated. A week after leaving active duty with the Marine Corps in 2011, I started work at Goldman Sachs.
Within a month of my start date, the Occupy Wall Street movement started gaining steam in Zuccotti Park. It was a strange time to be simultaneously working on Wall Street and commanding a platoon of American warriors—I was now a reservist with the Marines, spending one long weekend per month with my unit in Memphis. America had waged over a decade of war, we had reengineered the way the world thought about credit and money, and we had changed over six billion individuals’ fashion, eating, and entertainment habits. Suddenly, I found myself working and living at the nexus of the American military and Wall Street, the two forces primarily responsible for the rise of America during the previous century.
From the Desert to the Desk
The decadence on Wall Street was still omnipresent, even after toning things down. Management showered us with perks—complimentary shoes, shorts, heart-rate monitors, spinning classes, yoga studios, saunas, and hot tubs; up to twenty-five dollars in takeout every night you worked past 8:00 P.M.; catered steak lunches—every bell and whistle you could possibly imagine. But I couldn’t get beyond one glaring truth: To me, the company was
missing its Mission, with a capital M.
After coming from the Marine Corps, where everything boiled back up to the mission, I felt totally lost. Monday through Friday on Wall Street was a bizarre juxtaposition to my weekends in Memphis with my reserve unit. I would take a flight down from New York City to Tennessee after work, get in around midnight, and then report for duty at 6:00 the next morning. I’d fly back late on Sunday, sleep a few hours, and drag myself down to Wall Street to be at my desk at 7:00 Monday morning.
I was exhausted, and I was depressed. I was logging twelve-hour days boosting marginal basis points for the world’s richest people. The lack of mission was killing me; I felt my stress levels increasing as I envisioned the rest of my life unfolding in an Excel model. Throughout my time on Wall Street, the only mission I found there was making money, which never came remotely close to satisfying my vision for my life. At one point, a senior partner invited me to join a phone call with one of Europe’s wealthiest families, discussing the intricacies of buying railroads and German shopping malls out of bankruptcy. That was the most fun and interesting thing that happened while I worked in finance. And it was a ten-minute phone call.
The specter of working this job for the next few years, let alone the rest of my life, bummed me out. I found it incredibly tough to sell something that I didn’t fundamentally believe in.
At the same time, admittedly, I certainly wasn’t immune to the litany of perks. The lifestyle and corporate culture were seductive, and I could feel the expensive dinners and daily shoeshines gently nudging me away from any pre–Wall Street trajectory.
Sure, the catered steak lunches and takeout dinners were great, but between my diet, my work hours, and my travel to Memphis, post–Marine Corps active duty, I put on over twenty pounds in under six months. I had started to look sick. I scarfed down doughnuts and coffee for breakfast, bags of chips and enormous sandwiches for lunch, and greasy pad thai takeout for dinner—all the while sitting at my desk from 7:00 A.M. to 7:00 P.M. Nights when I wasn’t eating at work, I went out for drinks and dinner with clients or potential clients. I’d often get home after 10 P.M., crash, wake before sunrise, and start all over again. The bank offered all the free exercise tools and gym equipment you could ask for, but I rarely had the time to use them.