Each day Levels assigns you a Metabolic Score, which "is a rating that helps you better understand the success of your daily lifestyle choices." After wearing the CGM for a few days, I casually thought to myself, "Hrm, it's pretty hard to get a good score -- say in the 80s -- if you eat essentially any carbs at all." Best I can tell -- from my own experience and from watching various testimonals on Levels from others on YouTube -- Levels' Metabolic Score is designed to encourage you not to eat anything that causes an even moderate rise in your blood sugar. This sounds -- at first -- like a very reasonable and admirable point of view. The problem is: Eating food that has any carbs at all causes a moderate rise in your blood sugar. For instance, let's say that I eat the following for breakfast:
Seems like a pretty healthy breakfast, right?
Let's also say that after eating this breakfast -- at say 7:30am -- you don't eat or drink anything until dinner time (not a single calorie), meaning you skip lunch and don't eat again until 5pm that day. You might think that, by 5pm, you'd be able to look down at your Levels Metabolic Score and see a number that would suggest you're making healthy choices that day, right? Nope.
I adopted this exact routine shown above for multiple days, and by 5pm each I'd be lucky to have a score that was 75 -- many days it would be between 70 and 75. Why? Because eating the breakfast shown above has exactly 62.6 total carbs (39.6 net carbs). And that generally causes my blood sugar to rise to about 120, and then slowly fall back down to normal levels.
For context, the International Diabetes Federation's guidelines for managing post-meal glucose levels suggests that nondiabetic people should have a glucose level of no higher than 140 mg/dl after meals, and glucose should return to pre-meal levels within 2-3 hours. So despite eating a meal that precisely falls within these guidelines, Levels scores your day as being between a C and C- -- and keep in mind that, at 5pm, I had yet to even eat my largest meal of the day (dinner).
This brings me to main problem with Levels: it is punishingly strict and opionated. At first I thought that this approach was inspring and likely to be an effective change agent in people's lives. Then, however, I realized that eating essentially anything other than protein and fat gave you less than great Metabolic Score. That is, Levels appears to be very much anti-carb. And their bias against carbs isn't limited to just simple carbs (which are of course harmful and should essentially always be avoided on any diet), but are also against complex, healthy carbs. As a result, to get a good Metabolic Score in Levels you have two choices: (1) Don't eat (I tried this, it works in Levels), or (2) Eat essentialy only protein or fat.
Now don't get me wrong, I'm not anti-keto or anti-LCHF. It's one way to live your life. I myself have adopted a LCHF diet many times in my life -- just this year I lost 26 pounds in about 100 days doing LCHF. But LCHF isn't for everyone, and it's certainly not the only diet that will bring about solid metabolic health.
Take, for example, the Mederterian Diet. Any idea how many carb grams per day this diet suggests? Here's the answer (for a person consuming 2,000 calories per day):
That's right, 238 carb grams per day (again, an important thing to note here is that virtually all of those carbs should be complex, healthy carbs -- the Mederterian Diet certainly doesn't want you eating simple carbs). Why is this interesting? Because if you eat according to the Mederterian Diet, and consume 238 grams of carbs per day, Levels will likely assign you a Metabolic Score in the 60s or possibly 50s, indicating that you are making poor choices with respect to your metabolic health.
But that's just not true, as studies have shown over and over again that the Mederterian Diet is excellent for overall metabolic health. Consider the following (bolded font added by me):
So what does all of this mean?
Now you might be saying, "Who cares? Just ignore the Metabolic Score." And that's a fair statement. But it's also reallllllllly hard to do -- it's hard not to feel really frustrated and even (at least for me) sad that eating super healthy results in a seemingly well-respected medical device telling you, "Meh, your diet kinda sucks."
Where does this leave me? It leaves me wishing that Levels -- who has designed a truly awesome App along with constructing a world-class customer support team -- badly needs to be less opionated and less harsh when it comes to grading you. Should Levels tell you not to eat simple carbs? Absolutley. Should Levels be very upfront if your data suggests that you're eating too often in the day, which is causing your blood sugar level to remain constantly elevated? For sure. Should Levels warn you if your baseline numbers are indicating that you might be pre-diabetic? No doubt. But Levels should not be telling people that consuming between 100-250 grams of complex carbs per day -- across two meals, each spread out by 9+ hours of fasting -- is worthy of a C or C- score. That's just not true, and it can trigger people to either throw up their hands and abandon the data provided by the CGM (which is a mistake) or to incorrectly believe that a LCHF diet is the only way to achieve to solid metabolic health, which is entirely false.