The Next, Episode #43
How to reason about weird health theories, AI tutoring, and advice to the young and ambitious
Hi there, and welcome to The Next - my take on health, wellness, and company building.
In the last few years I’ve founded 3 health brands (Kettle & Fire, Perfect Keto, Surely non-alc wine), which do $100M+ in combined annual revenue. I’m now working on TrueMed, which allows health and wellness brands to accept HSA/FSA funds. Previously, I worked in tech and had no experience in CPG, DTC, or any other 3-letter industries.
If you missed past episodes, I recommend checking out Episode 37 on the bonkers Tuft’s Food Compass - the one that claims Lucky Charms are healthier than steak. Otherwise, let’s dive in!
🆕 What’s new
Lately, I’ve been thinking a lot about the benefits of compounding as I’ve seen it in my relationship and in my career. As Einstein said, compounding is the most powerful force in the universe. And boy is it hard to get this force to work for you in the early days of something new.
Instead of feeling momentum, many times you feel you’re getting zero reward for your efforts. When that happens, the temptation to switch lanes, to find a new idea/job/person/city wheedles its way into your brain. And with each lane change, you kill the positive flywheel just starting to churn.
I’ve seen this in my own life, the tendency to half do One Thing, then quickly do another, and another… and one day you wake up, years behind you and no material progress to speak of.
The question then becomes: how do you unlock the ability to work on something for a long time?
In my opinion, you buy this ability. And as an ambitious person, I’m pretty sure the best way to unlock the benefits of long-term compounding is to make your first pile of cash that allows you to cover burn for 2+ years.
Shortly after deciding to go all in on startups, I came up with an arbitrary financial goal: I wanted to make $5M by age 30. I figured that amount would allow me to consistently make around $250k/year, which (to my 20y/o mind) I could not possibly imagine spending more.
I went all out trying to achieve that goal: I launched multiple Udemy courses, put my apartment on Airbnb, flipped motorcycles, launched an email course, bought a business (and then another) did paid talks, wrote a book, paid $500 to have someone ghostwrite a terrible other book under a pseudonym for… reasons.
I’ve written more about my history of side hustles here
The ability to work on something you're passionate about is earned, not given. And in 2018, thanks to the confluence of a few things (Kettle & Fire really working, crypto, etc) I finally got there.
On this side of things, I’m more convinced that (for most young wannabe entrepreneurs) you should do pretty much anything you can to make your first pile of cash and buy your freedom. Start a side hustle, start a business, spin the early stage startup lottery… whatever it takes. Focus on skill development, on accumulating capital as part of a long-term vision. Then figure out your passion on the other side of it.
I’ve been there. If you’re young, hungry, and trying to figure this out, feel free to drop me an email. I’d love to help if I can.
💪 Health stuff
At a lunch a few weeks ago, I was introduced to the terrain theory of disease. I loved it: one of my favorite things in the world is encountering people with vastly different models of how the world works. And boy is this a different model!
Terrain Theory is a competing theory to the near-universally-accepted germ theory of disease: namely, that many diseases are caused by infections pathogens (viruses, bacteria, etc). According to Terrain Theory, pathogens are attracted to unhealthy terrain, and show up when the body is already getting sick. From the article:
In response, [Bechamp] developed what he later called “terrain theory,” which looked quite different from the modern movement. He believed that microorganisms are essentially benign, and that pathogens emerge when structures inside our cells, called microzymes, transform into bacteria in response to unhealthy environmental conditions—like tiny Dr. Jekylls transforming into Mr. Hydes. In other words, he believed that disease causes pathogens, and not the reverse.
According to this theory, that’s why we see viruses and bacteria in sick people: they show up in response to the body already being sick. Proponents of this theory believe that claiming viruses and bacteria cause disease is equivalent to believing that the swelling around a broken ankle caused the break. We have the causality wrong!!!
Now, in case it’s not obvious, I think this idea is bonkers. But talking to the fellow who introduced the idea to me got me thinking: why was I so quick to write this idea off?
I believe quite a few things that the average person would think is insane. I’m positive that at some point this year, I’ve said things that sounded just as insane as Terrain Theory did to me. How did I “decide” that Terrain Theory is wrong, yet believe that seed oils are bad for you (which certainly does not have scientific consensus today)?
When evaluating out-there (but not necessarily wrong!) ideas like Terrain Theory, I basically run through two mental models in my head.
The first is that the claim “germ theory is incorrect” is quite a claim. And because it’s such an out-there claim, with mountains of evidence supporting germ theory, the burden of proof for Terrain Theory should be quite high. In other domains (like many of the social sciences) with lower burdens of proof for prevailing theories, I’d have lower evidence expectations that a leading theory may be incorrect.
The second mental model I use is from philosopher Karl Popper. He’s said (and David Deutsch echoed in the amazing Beginning of Infinity) that good theories of knowledge have three defining characteristics. Good theories are (1) falsifiable - you can run experiments that will disprove a given prediction. In the case of Terrain Theory, if you ran an experiment in-vitro where you exposed a healthy cell to a virus or bacteria and that cell got sick… well it’s not 100% proven, but it sure does add evidence to the germ theory side of the debate.
Good theories are also (2) predictive: by applying a given theory, one should be able to better predict a future state of the world. Running Terrain Theory through this lens, we would expect that antibiotics, antivirals, and other germ-theory-based approaches to improving healthcare should not work. Instead, what we see is antivirals and antibiotics are among the most effective class of treatments we have, they definitively work in many disease states, and certain diseases (ie smallpox) have effectively been eradicated using vaccines and antivirals. Another point for germ theory.
Lastly, good theories are also (3) prohibitive in that they will claim many potential outcomes are impossible. In this example, germ theory says that one could not get a given cold or flu without exposure to said pathogen (which evidence backs up). Terrain Theory makes no such claims.
Using this framework makes it just a bit easier to suss out theories and beliefs that might be suspect. Which is important! For as I said, I believe a whole bunch of things in the health domain that the average person would not agree with.
If you’re interested, I can write up some of the out-there health hypotheses I have in my next newsletter. I’d also love to hear yours, as this is an area of intense curiosity for me.
🤑 Biz stuff
It’s extremely obvious to me that education is going to be massively shaken up in the coming years. Already the US spends an enormous amount on education, and pays more every year for the same results. Here’s a fun chart from the Cato Institute that lays this out.
Beyond wondering why we are spending hundreds of thousands of dollars to make science scores go down, the obvious conclusion should be… this is not sustainable. Not only is it not sustainable, but it’s not working!
Apparently, no matter how much more we spend on education, the Teachers-You-Can’t-Fire In A Classroom Teaching 30 Kids model doesn’t seem to drive better outcomes than the ones we’re buying today.
You know what does drive incredible outcomes? Mastery learning combined with 1-on-1 tutoring.
Mastery Learning is an approach to education where a student will get introduced to a topic, and only once a student has demonstrated mastery of a topic - multiplication, organic chemistry, whatever - do they move onto the next topic. This is pretty much how anyone learns anything in non-classroom environments: in fact, it’s pretty much only in the classroom where we take the approach that everyone should learn at the same time.
We can do so much better. In 1984, Benjamin Bloom published a paper showing how Mastery Learning combined with 1-on-1 tutoring led to a 2-sigma improvement in learning outcomes. Students who learned using this approach performed better than 98% of students.
It sure seems that a Mastery Learning approach combined with 1-on-1 tutoring could help people learn far, far faster than what we accept as possible today. However, we haven’t implemented these techniques at the societal level because 🤷
I think AI legitimately has the potential to change this. If you haven’t yet seen Sal Khan (of Khan Academy fame) talk about how AI could save education, do yourself a favor and watch it now. You’ll learn more watching that than reading anything I’ll write here 😂
There’s a huge opportunity to use AI tools to help kids learn things hugely faster and more efficiently. With AI tools, we’ll be able to assess mastery more easily than ever. In fact, Alpha School in Austin is already doing this, as is Synthesis School (disclosure, I’m an investor). And with ChatGPT and other AI tools, we’re in early innings of seeing just how these tools can be used to provide personalized, 1-1 tutoring to millions of kids.
To anyone not part of a teacher’s union, this should be wildly exciting. We can drive better educational outcomes and improve the education of millions of kids across the country, pretty much… for free? Certainly for less than 1/10th of what we spend on childhood education.
I think the combination of these technologies will unlock completely new approaches and kinds of schools. If each child had a 1-on-1 AI tutor that was better than any teachers they have exposure to today, how would that change classroom and school design? How would it reshape the role of teachers?
This is where I get really excited. I’ve long thought that it’s a shame how little schools actually teach. As a child, I spent hours and hours learning to properly write cursive, a schooling decision that’s probably taken a point off American GDP. And spent zero - literally zero - time in school learning to cook, handle my emotions, socilaize, start a business, be outside… nothing.
I think we are (hopefully) on the cusp of an explosion in new models of how kids learn and go to school. When teaching and tutoring comes “for free” with AI tools, why couldn’t kids spend 2-3 hours a day learning from their AI tutors, and the rest playing outside, learning to camp, or learning how to regulate and feel their emotions? Why couldn’t new schools focus on social and emotional learning, rather than rehashing the same dated curriculum year after year at the pace of the slowest kids in the class?
Maybe this is too utopian, but boy would I love to see a world where my kids could spend more time intentionally learning to socialize and emotional mastery. Let’s let AI tools take over the rote parts of education that humans aren’t quite as good at, and double down on what makes us human. That’s an educational future I think is worth working towards.
😌 Dope stuff on the internet
Some of my favorite things since the last newsletter (note: I don’t get paid to recommend anything here):
📰 Article - Many of you have been interested when I’ve written about MDMA therapy in the past. This post does a good job of giving a solid overview of the pros and cons associated with MDMA therapy. I’m a big fan of this and many other psychedelic-assisted therapies, and this is one of the better articles I’ve read on the topic.
📚 Book rec - I recently finished The Creative Act by Rick Rubin. I enjoyed it as a blend of eastern spiritual teachings with “how to be more creative”. My own life has mirrored exactly what the book talks about: as I become more comfortable and confident in myself and lower my ego, better things seem to come out and happen. If you’re looking for creative inspiration, I’d recommend it. Though personally I’d say I enjoyed The War of Art more.
⌚ Cool product - If you happen to be on the market for a sauna (which I highly recommend), you can now buy one using my new company TrueMed! Check out Nordica Sauna here, or let me know if there are other health + wellness brands we should bring onto the TrueMed platform. Just reply to this email!
🎵 Music - I got a special recommendation for y’all this month. After getting married in March, we had a DJ perform what (to my mind) was a pretty epic set. One of our friends had ½ of it mixed into an hour long set - enjoy!
🏀 Random - The Wearable Challenge (a weight loss challenge I launched in February 2020) is kicking off its 20th cohort. If you’re interested in joining, sign up here. It's a month-long challenge where you commit a daily amount ($5, $10, or $20) and work on keeping your blood sugar below 120mg/dL, monitored through a CGM. For every day you succeed, you not only keep your stake but also have the opportunity to win a portion of what others might forfeit. We’ve run 19 cohorts in the past and have seen many participants lose upwards of 50lbs, and learn a ton about their bodies. Fun times 😎
🙋♂️ Ask - As TrueMed begins to ramp up, we will soon begin to recruit for a growth marketing person. If you (or someone you know) is hyper-talented and wants to change the trajectory of health in the US, holler 👋
That’s all I got this month squad! School is ending, summer is beginning, and life goes on. I hope you’re happy, healthy, and enjoying life wherever you are. See you in 30