My guest this week is Justin Mares. Justin is the founder of TrueMed and has previously founded three different health food brands that collectively do $100M+ in annual revenue.  Every time I speak with him, he makes me reflect on my own health and the state of our health more broadly. This conversation is no different. As Justin puts it, we're in a health crisis that could ultimately bankrupt our country. We talk about the inputs, incentives, and potential solutions related to that crisis, and then move into his experiences building and investing in consumer brands. We finish with a fascinating discussion on why it's more common to see repeat founders these days. Please enjoy my great conversation with Justin Mares.

Founders Podcast
Founders Episode 136 - Estee Lauder
Founders Episode 288 - Ralph Lauren

For the full show notes, transcript, and links to mentioned content, check out the episode page here. 

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Invest Like the Best is a property of Colossus, LLC. For more episodes of Invest Like the Best, visit joincolossus.com/episodes. 

Past guests include Tobi Lutke, Kevin Systrom, Mike Krieger, John Collison, Kat Cole, Marc Andreessen, Matthew Ball, Bill Gurley, Anu Hariharan, Ben Thompson, and many more.

Follow us on Twitter: @patrick_oshag | @JoinColossus

Show Notes
(00:03:06) - (First question) - Framing the overall problem of the US health system
(00:04:12) - What it would take for America’s health crisis to affect global competitiveness
(00:11:05) - Important changes that have contributed to the decline of health in the US 
(00:14:53) - Other system settings and incentives have contributed to America’s health crisis
(00:16:51) - Thoughts on Ozempic and attempts to engineer solutions for chronic disease
(00:20:07) - Mental health decline, infertility, and other problems tied to the health crisis 
(00:24:33) - When he first discovered this problem and became passionate about it
(00:26:56) - The difficulties of building a health-centric bone broth company 
(00:31:49) - Why no one has a built supply chain sourcing service to create scale economies
(00:34:44) - Other companies he’s built and other things he’s doing to fight the problem 
(00:40:15) - Going to market to simplify the HSA consumer experience 
(00:43:04) - The world of water, environmental toxins and forever chemicals writ large
(00:47:17) - The difficulty in avoiding forever chemicals in our everyday lives 
(00:51:51) - How he searches for and decides on new businesses to start or invest in   
(00:56:52) - The growing popularity and promise of psychedelic therapy 
(00:58:48) - Personality traits of people who feel most at home in Edge City
(01:01:36) - Strategies on sourcing and connecting with ambitious and talented people
(01:06:56) - Childhood nutrition and the impact of their diets and health on society 
(01:11:26) - Capital formation and creating new businesses in a systematic way
(01:19:57) - The kindest thing anyone has ever done for him 

This episode is brought to you by Tegas, the modern research platform for leading investors.

Stretch your research budget with flexible expert calls you can trust.

At a fraction of the cost of traditional expert networks, Tegas customers pay only what an expert charges with 0 markups and no confusing call credits, netting an average of 70% savings.

Tegas offers the ability to schedule 30 minute meetings, an offer you won't find anywhere else.

With white glove custom sourcing for every project and Robust compliance measures, including a dedicated 50 plus person analyst team that vets every call transcript.

TGIS ensures your privacy and protection as the industry innovator for qualitative insights.

TGIS helps you find the right experts you need at a quality and speed that can't be matched for a limited time.

As a listener, you can trial TGIS for free by visiting tgis.co slash Patrick.

Before we transition to the episode, I want to highlight the Founders podcast, which is part of our Colossus network.

David Senra, who hosts Founders has devoted his life to learning from history's greatest entrepreneurs, and every week he distills the lessons of a different founder.

If you want an entry point, I highly recommend starting with episode 136 on Estee Lauder or episode 288 on Ralph Lauren.

I hosted David on Invest Like the Best last summer, and it's hard not to walk away insanely energized after listening to any episode with him.

You can find a link to founders and those episodes in the show notes of this conversation.

You can also search all past transcripts on our website, joincolossus.com.

I'm Patrick O'Shaughnessy and this is Invest Like the Best.

This show is an open-ended exploration of markets, ideas, stories, and strategies that will help you better invest both your time and your money.

Invest Like The Best is part of the Colossus family of podcasts, and you can access all our podcasts, including edited transcripts, show notes, and other resources to keep learning at joincolossus.com.

Patrick O'Shaughnessy is the CEO and founding partner of Positive Sum and the CEO of O'Shaughnessy Asset Management.

All opinions expressed by Patrick and podcast guests are solely their own opinions and do not reflect the opinion of Positive Sum or O'Shaughnessy Asset Management.

I purposes only and should not be relied upon as a basis for investment decisions.

Clients of positive some or O'Shaughnessy asset management may maintain positions in the securities discussed in this podcast.

Justin has built 3 consumer health-focused brands over the past decade.

Every time I speak with him, he makes me reflect on my own health and the state of our health more broadly.

As Justin puts it, we're in a health crisis that could ultimately bankrupt our country.

We talk about the inputs, incentives, and potential solutions related to that crisis, and then move into his experiences building and investing in consumer brands.

We finish with a fascinating discussion on why it's more common to see repeat founders these days.

Please enjoy my great conversation with Justin Mares.

I know we're going to talk a lot about the US health system.

Maybe the right thing is a framing because we all live in this system and probably haven't thought too much about it or take it for granted.

And I think there's some huge underlying problems that trace back maybe 50, 60 years.

Could you begin by just giving what you think is the cleanest frame of the overall problem as you see it having built multiple businesses kind of in and around this space?

I think the core underlying thing that is a massive problem is just that if you look back 50, 60 years ago, chronic disease was basically like not a thing.

And it existed in small ways, but it was not 20% of GDP kids, 40 to 50% of them are diabetic or prediabetic.

It was not like the explosion in chronic illness that we see today across cancer, obesity, infertility, mental depression, all this sort of thing.

So to me, I think the biggest question I think exists in the US right now is, what is going on with the health of our population and how over the last 50 years has it taken such a nosedive and gotten to such a toxic place that I think is literally gonna threaten the competitiveness of the country.

How would that last piece come to fruition like in a dystopian situation?

What would it take for health outcomes or average health status of Americans to be so bad that it actually affected our competitiveness?

But if you look at health care costs, they're outpacing inflation by like 200%.

And So you don't have to fast forward for too long to get a sense of health care costs are almost already at 20% of GDP.

How much longer can health care costs continue increasing at this pace before it like literally bankrupts the country?

And that's not even talking about the human capital issue, which is just, if you think about it, the average child being obese, overweight, 6 in 10 adults have at least 1 chronic illness.

Something like 17 medications are prescribed on average per adult every year.

From a health standpoint, we all know, I mean, if you don't feel your best from a health standpoint, there's no way that you're doing your best, most productive work.

You're not your happiest version, you're not killing it at work, you're not doing almost anything with the vigor and energy that probably we want people to bring to their jobs, bring their relationships, bring everything.

The other thing I think that's just crazy too is I spend so much fucking time reading labels on food, looking at ingredients, understanding like sourcing.

The amount of mental overhead that I put in to understanding sourcing ingredients, what went into this, oh, does this kitchen use seed oils?

Is an unbelievable amount of mental overhead that goes into this stuff.

And if you rewind, like if I asked my grandparents or parents, how did you think about making food and health choices for your kids?

It was basically like, we just bought whatever we're talking about.

I mean, you look at old photos of people on the beach in the 60s and 70s in old TV shows and all these sorts of things.

You just don't have to look back that far to reach a place where people were just for the most part healthy by default and almost never thought about their food as much as I think about food and consumer products and stuff like that today.

What about the evidence that we have from the rest of the world concurrently?

So like the snapshot of the average health status today.

Is there any lessons that we can learn from certain regions or specific countries and what that data might teach us about what's going wrong here in the US?

I think that the thing that you can see very clearly is that we're exporting a Western diet to other countries and they are starting to feel and see the exact same metabolic and health issues that we see here in the US.

Rates of diabetes have gone up something like 10, 000% in China in the last 50 years as a Western diet has come to mainland China.

You see similar things across a lot of the Middle East, many parts of Africa, many parts of South America, even Europe, which many people, myself included, think do a much better job from a food system standpoint than the US does, is still seeing a huge increase in metabolic disease, other chronic diseases and

Obviously, this is like an incredibly challenging problem because of its impact, but also it's really challenging to understand.

We can't say for sure it is X, Y, or Z that's causing this.

And if you go and do thoughtful research, you can kind of pick your explanation and you'll find great evidence for and against the thing, whatever it is, seed oils or whatever it is, the ratio of macronutrients in your diet as the causal factor for this problem.

The problem seems undeniable, like the data is just really bad.

Maybe you can trace for us how you think about answering that question.

We would love to do something about it, but no 1 can seem to agree on the reason that this is happening, and there's all sorts of ancillary factors like business interests and other things that I wanna talk about too.

But how do you personally, I mean, attack this problem, like this knowledge problem, an epistemology problem, like how do you know what might actually be true?

1 of the issues that I would take, even with the framing as you approach it, is like you can find all these studies and whatnot, is I think that our sense-making apparatus, especially as it comes to nutrition, which is a highly multifactorial complex thing, is completely broken, and it's broken intentionally by big food companies, pharma companies, that basically are funding thousands and thousands of studies to make us confused as to are almonds bad, is chocolate bad for you, are ultra-processed foods good or not.

If you look, there have been 50, 000 nutrition studies in the last 2 years that have come out, 50, 000.

Many of these are funded by like Big Food and Big Food related companies.

The NIH spends $1 for every $11 that Big Food spends funding nutrition research.

And so my takeaway from this, and I'll answer your question in a sec, but my takeaway from this is that basically we are operating as a society in a space where our tools for sense making, research studies, the scientific method and the like, are being weaponized and used against us to just muddle and create confusion and make it nearly impossible for 1 person, 1 person who makes the USDA guidelines that go into kids' lunches, for example, to clearly point to causality and go, this is bad and we're gonna fix it.

And I think that right now, Big Food is basically doing, and pulling out the playbook that cigarette companies pulled out 40, 50 years ago of let's fund every possible study that makes it unclear whether or not cigarettes are harmful or whether or not there's a link to lung cancer there.

And they're doing the same thing with food today.

And so what I think about is, for me, the core problem is that 50 years ago, 56 years ago, there was far lower incidence of chronic disease, obesity, overweight, diabetes, and the like.

In the last 50 years, that has completely changed.

Americans are sicker, fatter, more depressed, and fertile, all these sorts of things.

And the kids that are growing up today are in the worst position of any generation of American kids have ever been from a health standpoint.

So for me, I think you look at that and you have to go, what changed?

The biggest thing is the amount of processed foods that we eat in our diet today has massively changed.

The amount of environmental toxins that we're exposed to have hugely, enormously changed.

And I think that you have to start with this.

We have a massive health crisis going on right now.

That's the core thing that you have to start from.

And if you just go back to 1970 and say, let's eat like we were eating in 1970, which is far more whole foods, stuff that is not quite as processed, stuff that has far fewer pesticides that are sprayed on it, less glyphosate, less environmental toxins and the like, that that is probably a really good place to start.

If we were to draw a timeline and we could pick a starting date, let's say it's roughly 1960 or something like that.

What do you think are the most important changes that have happened?

Whether that's regulatory changes, whether that's business changes, whether that's research changes, whatever you think are the important things, because in 1950, let's say, when this wasn't a problem, there were big food companies, big companies of every type.

What are the important things on that timeline that might help us understand how this awful change has come to be.

1 thing I think that was a big change was food subsidies straight up.

If you look since 1995, the US has spent almost 210 billion on subsidies, primarily that go towards 3 things, corn, soy and wheat.

Because the US is hugely subsidizing these 3 crops, it artificially brings the price down at which farmers and big food manufacturers are getting these inputs.

What you see is around the 1970s, 1980s, Many of these big food manufacturers go from using real sugar to using high fructose corn syrup.

McDonald's used to fry all their French fries in beef tallow.

All of a sudden, soybean oil and canola oil become far less expensive because of subsidies and a bunch of other things.

And you start seeing them using vegetable oils and everything.

In 1960, basically 0 percent of the average American's calories came from soybean oil.

Where the average American is getting 20% of their diet from these, in my opinion, toxic soybean oils that has not existed in the human diet in history to date, until now.

What is the source of the subsidies themselves?

Like I wanna keep digging into the causal chain here.

I kinda want my kids eating 20% soybean oil.

But why were the subsidies there in the first place and are they intractable?

Like is there any way out of this problem?

A lot of these subsidies came about in relation to, or as an after effect of World War II.

Basically the government is like, we need to guarantee a food supply, we need to make sure that it's shelf stable so that we can ship it overseas and it can stay for long periods of time and stuff like that.

And so 1 of the things that the government did and Nixon made a push around this is specifically to make it so that these big food companies were okay in using and testing out a bunch of these different chemical stabilizers.

There's this big push towards shelf stability.

And then the government was like, we need to guarantee our own food supply.

Corn, soy, wheat are relatively stable grains that we can ship overseas.

And so like, let's put money behind this to make sure that America guarantees

Honestly, I don't think that with some exceptions, we're going to talk a lot about the food and healthcare system today.

I think that most of the players in the food system and in the healthcare system are like good people trying to do the right thing.

I just think that the system itself has incentives that are so warped that they're creating really bad outcomes and are like killing hundreds of thousands of Americans.

On the topic of subsidies, here's a good example where I just talked about how almost $210 billion are spent since 1995 on subsidies for corn, soy, wheat.

If you look into the subsidies that are happening today, cigarettes, tobacco, gets 4 times more government subsidies, about 2%, than all fruits and vegetable crops combined.

So if you just look at that incentive alone, the USDA is saying that about 50% of American calories should come from fruits and vegetables.

Yet if you look at how the USDA is allocating funds, 80 plus percent of all of their subsidy dollars are going towards corn, soy, wheat, and something like .45% are going towards fruits and vegetables.

And then we look around as a country and we go like, why is everyone so sick?

Why is everyone eating corn syrup all the time?

What other system settings, I guess, would be the right term?

It could be incentives, could be just something else.

In addition to the subsidies, do you think have most contributed to this problem?

I think that our food has also been weaponized against us.

If you think about, I realize I maybe sound like a conspiracy theorist or something here, but I think that if you look at a book called The Dorito Effect or something like that, There's another book called Salt Sugar Fat, where if you look, these big food companies, similar to Facebook, that's getting a bunch of blowback and TikTok and others, have spent hundreds of millions of dollars to try and engineer the perfect palatable thing that you wanna keep going back for.

And so, not only do we have subsidies, which mean that cheap inputs go into everything, most of those products are controlled by 6 to 7 big food companies that are just mammoth companies that control almost all of our food supply, especially in package form.

But as these big food companies start to swap out real whole ingredients and whole foods for a processed sort of fake version of that thing, their profit margins go up.

And so all of a sudden, they have more money to pour into marketing, more money to pour into R&D.

it's a cycle and more money to figure out how do we make the Dorito the most addicting possible thing that 1 could put in their mouth.

In this book, they talk about how scientists have engineered it so that you have this carby nice crunch and then you have this little oil taste that leaves you wanting more, but it kind of dissipates on the back of the tongue.

And so you're always like, I'm like so close.

They basically weaponize our evolutionary senses to want more and more and more of these toxic addictive foodstuffs.

And just like I don't blame a 2 or 5 year old who gets sucked into TikTok or

an iPad or whatever for falling prey to their base evolutionary senses that a bunch of people in Silicon Valley have taken advantage of, I also don't blame people for getting addicted to these hyper-processed, hyper-palatable, ultra-processed foods.

1 of the reactions that we tend to have to problems like this is engineered, just like the problems are engineered, like engineered solutions.

What do you think of something like Ozempic?

1 of the things that generally I would say that we've done over the last 50 years is we've seen heart disease go up and we've never prescribed more statins than we do today.

We've never prescribed more SSRIs than we do today, still going up.

You basically see all of these issues crop up.

And there's a pharmaceutical solution that is proffered in response to this problem.

And yet, the core metrics on which we measure health and vitality of our population, those things continue to go up.

I think that Ozempic is on the 1 hand set to probably be the most profitable drug or class of drugs, this like class of GLP-1 agonists.

I think it's likely to be 1 of the most profitable drugs that pharma has ever invented.

1, you're seeing a push towards, right now the way it works is it's weekly injections that you are on for the rest of your life.

And if you get off of it, you gain all of the weight back.

You're also seeing an incredible push like this 1 woman

Which is why I think you're starting to see a push to prescribe it to overweight

They'll be on it for literally the rest of their life.

We are extremely early in understanding the side effects of something like cozempic.

And 1 of the most concerning things to me is not only do you gain all the way back after you get off it, but in the early studies that we've seen, which is all that we have, we have no longitudinal studies for this massive biological intervention that all of a sudden we're suggesting kids as young as 12 get on for literally the rest of their life.

But in these early studies, what you're seeing is that 30 to 40% of the weight loss benefits come in the form of muscle mass loss and bone density loss.

If you think about why is it that a super strong fit person can often out exercise their diet or occasionally can for at least a period of time.

In many ways it's because they have muscles that act as glucose sinks.

And so if you're eating a bad diet, your glucose is spiking.

Those muscles can basically like soak up and absorb that energy.

I get really concerned that we're going to see a future where a bunch of people go on a Zempik and either they become weaker, their bones become less dense, and that creates a class of health problems on its own, or they try and get off and they are literally less able to withstand the glucose impacts of their existing diet and less able to actually work through and correct any of these things.

The second thing I'll quickly say is that if you believe, which I do, and I think that the evidence is very strongly in favor of this, that obesity is a symptom of metabolic dysfunction, Using a drug that you have to take for the rest of your life to address a symptom of metabolic dysfunction is not going to do anything about the massive issues that we see from a chronic disease standpoint.

It's not gonna do anything about inflammation and mental health and fertility and all these other issues that we see that are related to the toxic food that's in our food system.

How do you think about those categories you just mentioned and their relationship to the core problem?

Let's assume the conclusion is right that the principle change is things in the environment and things that we're putting into and onto our bodies.

Why is that relating to things like mental health, to infertility, to reproduction problems?

Like it does seem like all of these things, the data says are up and to the right.

Someone told me recently, I can't remember what the number was, but the percent of Americans on SSRIs, they told me, I couldn't believe, maybe you know it, I could not believe that.

And those, from what I understand, pretty much dead in your consciousness.

Are these things also from the same source problem?

Mental health is extremely tightly coupled with physical health.

I think that it is basically impossible, or much, much, much harder, to be in really horrendous physical health while also have the mental health of super healthy like 25 year old or something.

You can look at a couple stats, male sperm count is down 50% over the last 50 years.

Yeah, you don't have to do the math to be like, oh yeah, I can see that has an impact on fertility.

Today, 26% of women have PCOS, which is the leading cause of infertility.

And so it's 1 of the leading causes of infertility.

And it's now hugely where again, practically didn't exist in the seventies.

You look at in the past 10 years, the number of miscarriages has gone up 10%.

There's even weird things happening around women and teenagers are getting their periods and hitting puberty like 1 to 2 years earlier, historically.

And So I think that you just look at all of these, you look at the mental health, the state of mental health for the average American teenager, there's incredibly strong correlations between diabetes and depression.

You look at that, you look at the stats, the direction these things are going.

You also look at the fact that we know that the majority of 1 serotonin is actually produced in the gut.

There's a massive connection between the brain and the gut over something called the vagus nerve.

And I think that you have to conclude that the health of your body is your mental health.

My doctor who's, I think, incredibly thoughtful and progressive in both his demand for data to reach certain conclusions, but also like certain realities, not everything can be jammed into an RCT.

He's made me very interested in this gut brain thing.

I've heard very smart people start to talk about this.

What is the best evidence that we have that this actually matters?

Because it seems like people completely disregard the health of their gut.

If there is that connection, that's obviously a bad idea.

So how do we know that there is that connection?

This is where I would say that I'm not a doctor, I'm not anything like this.

We're very early in the study and understanding of the gut and the microbiome.

I do think that there are a lot of early but suggestive studies around the impact of gut health on depression and mental health.

There was 1 lit review that came out, it was like a year or 2 ago, where effectively they ran a test and they said, okay, they took people with treatment resistant depression, very depressed people, and 1 group did a talk therapy intervention and the other did a purely nutritional intervention, just geared towards fixing the diet and fixing and changing the composition of microbes in one's gut.

And the people that did just the nutritional intervention basically had much better results from a curing depression standpoint than those that just did talk therapy.

We're very early in understanding the gut brain axis and understanding what does a good microbiome look like.

This is just super early cutting edge stuff.

But if I had to guess and I'm willing to be wrong on this.

The way that I am thinking about mental health and physical health right now is that you can think about physical health as a landscape or a football field or something.

Maybe like a seesaw would be a better example where if it's tilted certain directions, if you're unhealthy, that is just going to skew your ability to feel amazing to have like really strong, robust mental health, just a little bit, it's going to make your emotions slightly more negative.

It's going to make feedback loops that are negative, maybe slightly easier to fall into.

When you sort of feel good and you feel healthy, that kicks off a positive feedback loop in your emotions and your mental health.

And I think that we're very, very early in understanding this sort of thing, but I do think it's 1 of those factors that's going to be incredibly important.

How did you get personally so interested and invested in this?

We're a half hour in, we haven't talked at all about things that you've built, which we're gonna spend plenty of time on.

What was the origin point for you discovering the problem and developing a deep care for the problem?

I started this business called Kettle and Fire when I was 26.

Kettle and Fire now is the number 1 bone broth brand in the country for whatever that's worth.

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Justin Mares - The US Health Crisis