NiaHealth’s Sameer Dhar on Bringing Proactive Healthcare to Millions and Why Founders Need to Prioritize Their Health

Sameer Dhar built his first healthcare startup while living in nursing homes for a year, sold it to Swedish giant Essity in just 18 months, then spent four years figuring out his next move. Now as CEO of NiaHealth, he’s on a mission to bring top-tier proactive healthcare to millions of people through advanced diagnostics and personalized health insights.

In this conversation, Sameer shares his unconventional path from diabetes researcher to investment banker to healthcare entrepreneur, why he believes founders are literally killing themselves building companies, and how NiaHealth is disrupting Canada’s executive health market while working toward making preventive care accessible to everyone.

Here’s the full conversation.

Mark MacLeod:

In this episode, I sit down with Sameer Dhar, co-founder and CEO of NiaHealth. I tell my CEOs all the time, a healthy person has 100 priorities. A sick person has one priority, which is to no longer be sick. Nia is helping people do that by giving them access to proactive care. The same dashboard and information that you have running your company, they give you for your health.

I’ve been a customer and it is having a massive positive impact on my life. And so that’s why I wanted to have Sameer on here to talk about his journey and to talk about the importance of health for founders. I really hope you check this episode out.

Sameer, welcome to The Startup CEO Show. It’s a true pleasure to have you here. How are you doing today?

Sameer Dhar:

Pleasure to be here. Thanks for having me on. Doing all right. Doing all right, Mark.

Mark MacLeod:

Good stuff. So often I’ve had guests on the podcast that I have known personally before, and so Sameer and I are seeing each other for the first time. But I feel like I know Sameer really well because he’s been my personal health advocate and telling me to get on with things. And so I really appreciated that.

As we were chatting about before we got started, your service is having a very positive impact on my life. So I’m grateful for that. But let’s take a Step back and maybe just tell folks what it is that NiaHealth does.

Sameer Dhar:

So, NiaHealth is trying to bring top-tier proactive health to millions of people. We think that bringing the best in class evidence to the masses is something that the public system, especially in a country like Canada needs. And so yeah, we facilitate advanced diagnostics, whether it be blood work, VO2 max, DEXA scans, gut microbiome testing, you name it, and coalesce that into a super-friendly user interface to help flag your biggest risks to health span and longevity. Here’s the most actionable set of things that you can do to get in front of that risk.

And we pair a number of our packages with clinician consults. So, clinicians who are up to date on the latest science and can help you flag risks early and get onto a journey that’ll get you in front of that risk.

Mark MacLeod:

I love it. It’s pretty inspiring, to be honest. You know, many startups talk about how they’re going to change the world, but you’re literally changing your clients’ worlds. So it’s pretty massive.

Sameer Dhar:

Yeah. Well, I know, I appreciate you saying that and I appreciate you being our customer too, and being a part of that story.

Mark MacLeod:

No, I’m grateful. You and I were chatting before we started. There are real health pathologies that run in my family, and I’m generally anti-Western medicine. Like, I’ll take medication as an absolute last resort. You know, in full transparency, I have high LDL that runs in my family, and so I’m working with Sameer’s service to deal with that, and I’d rather treat that through lifestyle and Ayurveda versus going on statins. And so I love that you arm me with like the data and getting ahead of it to work on that.

So, if I understand your career trajectory correctly, you’re a diabetes researcher and an investment banker, an entrepreneur. That seems like a pretty crazy journey. Maybe just connect the dots, how did you get to be here today?

Sameer Dhar:

Well, yeah, I mean I think going through undergrad, like many folks, you kind of don’t know what you don’t know, and so you try a bunch of different things and let the process guide you in that way. And so you know, initially my sister’s a physician, and I’ve got people in my family who are in the healthcare field in general. And so you thought, hey, maybe becoming a doctor might be the best. So I did research in labs on diabetes, etc.

But I found that that type of repeat routine type tasks and orientation was not necessarily my shtick. Always been investing in the stock market and stuff like that. So I thought, hey, after that, maybe business finance might be a play to play to be made. But you know, I found that when I went into high finance and worked at different, whether it be pension fund, private equity, and then I did a summer at an investment banking. Again, that type of work just did not feel that fulfilling.

And I think I always had this juxtaposition of when you’re in that world against making a real difference in people’s lives on the ground. Coming out of high school, I started a charitable organization that impacted the lives of many families across Alberta and engaged hundreds of thousands of students towards local poverty relief.

So, once you’ve been able to motivate the heart of a volunteer and make change actually happen on the ground and see people’s lives being impacted for the better, it’s hard when you’re you’re working 80 or 100 hours a week and trying to get up in the morning. So, those are some kind of pivotal experiences or foundational experiences along the way during my undergrad degree that then eventually kind of forced me into a path of entrepreneurship as kind of the misfit in all other things. So I had to find a different path.

Mark MacLeod:

Diabetes is one of those pesky chronic diseases. Was that like a planting of the seed that, hey, chronic disease is a thing and I should work on that eventually? Did those dots connect or that’s just a random coincidence?

Sameer Dhar:

You know, I wish I would say that the dots connected kind of viscerally in my head that way, but I don’t think that was necessarily the case. I think some part of me has always had this desire to make a meaningful contribution to the world. So the places where I’ve felt the most at home have always been when I’m working on a problem that I feel is worthy or meaningful and that and I think in the entrepreneurial context, that win or lose, because the odds of failure are always high, it was a worthy cause. I think that’s kind of my heuristic if I’m working on something that’s worth working on.

Mark MacLeod:

I love it. Now, you had a prior startup in the healthcare space called Sensassure.

Sameer Dhar:

Correct, yeah.

Mark MacLeod:

And if I understand correctly, as part of that you lived in nursing homes for a year. That seems like a wild level of commitment. Maybe just tell folks what Sensassure did just to give us context and how you ended up living in a nursing home.

Sameer Dhar:

At Sensassure we built a sensor-based solution to managing incontinence of all things in nursing homes.

Mark MacLeod:

Oh yeah, what a shitty problem. Sorry, dad joke.

Sameer Dhar:

I had never heard that one before, Mark.

Mark MacLeod:

No, I’m sure you haven’t.

Sameer Dhar:

So, we basically built this sensor that you put on the outside of any adult incontinence product or diaper. Elders soil themselves and wirelessly nursing staff could see on any web-enabled device if they needed to be changed. And it was funny because, kind of connecting, the dots back to my journey as an undergrad trying to figure out what to do with my life, the only reason I got into entrepreneurship after was because I had self-selected out of the traditional paths. And I got into the Next 36, which I don’t know if you must be familiar with, Mark.

Mark MacLeod:

Very familiar.

Sameer Dhar:

But that changed my life because it showed me that even at the age of 20, not knowing what incontinence even meant, you could embark on a journey to solve a problem that you knew nothing about but that you thought was worthy and you identified a gap. So, in essence, living at nursing homes came about, I mean for a few different reasons. One was, as I just mentioned, we didn’t even know what incontinence meant as 20-year-olds.

And I happened to fall into the space a little bit because you know, I identified, hey, elder care is a problem that we’re going to have increasing set of problems around given that we’ve got an aging population. It’s not a sector that’s super sexy or with a lot of innovation happening, especially at that time, which was about over 10 years ago. But it’s one that is probably rife with opportunities to make a difference.

And so it started by talking to a ton of different stakeholders in the space. Geriatricians, care home administrators, nursing staff, and saying where does your day suck? And I think that was the first level of understanding that, hey, there are problems to be solved here. Incontinence appears to be something that keeps coming up. So what is that? Why is that a problem?

And I think why live in nursing homes? Because one, you’re trying to go deeper into that problem space and understand it. But two, I mean, practically speaking, we didn’t raise a ton of money in that journey. So you get to live with your team and live and breathe the problem together rent-free, no matter where you are. North America had side benefits of that as well.

Mark MacLeod:

I don’t know if they still do this, but my understanding, Next 36 would create founding teams. Like, you were just sort of jammed together, is that right?

Sameer Dhar:

Correct, yeah.

Mark MacLeod:

And it’s funny because Y Combinator released a study about the number one predictor of startup success. And the number one predictor was actually the length of time that the co-founders knew each other beforehand. This was the opposite. How was that experience getting into a forced relationship?

Sameer Dhar:

I don’t know if I still hold the record. I think during the course of Sensassure, I probably went through six out of seven, quote-unquote co-founders, and partly for I think the reasons that you just mentioned. It’s such a challenging journey. And if you don’t have that trust and you don’t have that conviction, especially at the young age of your early 20s, late teens, whatever it might be, knowing who you are, why you’re doing the things that you’re doing, having the resilience and fortitude personally to persist past all those challenges individually. But then collectively it’s to find the right match of all these things.

There was a point during the Sensassure journey where literally you’re building a medical device in a sector that I knew nothing about and I didn’t have a co-founder because the ones that I was previously with, ended up deciding to go take a job at McKinsey or Palantir or whatever the thing might be.

So, you kind of were faced up against the wall, trying to figure out how am I going to keep this journey going? Is it worth continuing to go? So, yeah, I think it is a super challenging thing to get the co-founder dynamics right and to find the right partners to go on the journey with.

Mark MacLeod:

You were able to bring this to a successful exit to Essity. Tell us about that journey.

Sameer Dhar:

Yeah, I mean it was a super quick exit. Like, from start to exit it was 18 months or 24 months, basically.

Mark MacLeod:

Oh, wow, that is fast.

Sameer Dhar:

And we were basically in a place where you had learned enough about the space that you knew we needed distribution partnerships to make the model work. And so we had reached out to a bunch of the major diaper manufacturers globally not for any exit potential, but really just to see, hey, would they be interested in getting involved in our next fundraiser? Would there be some sort of distribution deal that we could come up with?

And I think just one thing led to another with Essity because they were definitely our market leaders in the space globally. And we’re looking for a continuous means of being able to monitor incontinence in nursing homes. So one thing led to another and then that exit ended up happening.

And I worked with them for a few years and then, yeah, that was a great experience. A great initial experience as a young 20-something-year-old.

Mark MacLeod:

I want to tease out kind of the actionable insight for folks who are listening. Because you know, you were in a very specific market, but this notion of like, you didn’t approach Essity to be bought, you approached to partner, maybe get some investment. And they were just like, screw it, if I’m going to do this, I might as well just do it all the way. Like, don’t reveal anything you can’t reveal but how did it move from a commercial discussion to a hey, we want to buy you?

Sameer Dhar:

Yeah, I mean, I think it was through the course of getting to know each other and knowing that we weren’t actually looking… At no point in our initial discussions were we saying, hey, we want you to buy us, come buy us. And frankly, we were living and breathing it. Like, how many founding teams are living in nursing homes and fully committed to the journey? And I think as we were building Sensassure and even as I’m building Nia, I can’t get up in the morning to think about an exit. That’s just not an inspiring thought.

You’ve got to get up in the morning, especially for the type of businesses that I’ve been involved with to try to change the world. And so an exit in many ways is a bit of a demoralizing thought, if anything. It doesn’t give me the conviction to get up in the morning and get through the hard times. Everyone’s different but that kind of is the culture that I think we fostered.

And so when you actually live and breathe it that way, I think it comes across if you’re authentic with potential partners when you’re having discussions. Like, as part of their diligence of the opportunity, we had someone fly from Sweden to the nursing home that we were at the time living at. And they came and saw what we were doing. And they saw it with their own eyes. And I think that gets people excited. It gets people excited to want to lean in and potentially see if there’s something to be done.

Ultimately in that circumstance for them, it didn’t make sense to minority invest or anything like that. They wanted it as a competitive advantage against the rest of the market as they were going out to sell their core product offering. So we ultimately had to decide if we were ready to sell at that point or not.

Mark MacLeod:

Did patents make sense for you early? Was this a thing you tried to patent?

Sameer Dhar:

Yeah, we had to patent. And honestly, that’s the interesting thing. In the early stages, we hate spending money on lawyers/IP, which is like this intangible asset. It becomes tangible though during the acquisition process, because the acquirer, regardless of the reality of it being that at that stage you’re buying the know-how, the team, etc. But IP becomes a big part of the equation, especially for a public-traded entity.

Mark MacLeod:

That makes sense. Coincidentally, I had Joanna Griffiths from Knix on the podcast recently and I can see that I haven’t studied Essity in detail, but I can see some connective tissue between what you did and what her product does even though it’s a different end consumer.

Sameer Dhar:

Yeah, it’s super cool to see other Canadians partnering with a Swedish-based entity, not the American counterparts, because a lot of the spaces are American-based companies.

Mark MacLeod:

So, let’s get into Nia. What was the origin of it? How did you come up with it, and what is your vision for Nia?

Sameer Dhar:

So, in terms of origin, after having left Sensassure and Essity, I had a really hard time actually trying to figure out what my next opportunity was. It took me four years between businesses to kind of get going onto the next adventure. And I’m happy to get into that, but I’ll gloss over to say, why Nia?

One of the threads that I had pulled on from the Sensassure journey was to say, okay, at the end of life, if you live in a certain way, you might end up in one of these institutions. And from living and breathing that for a year, it’s definitely an animated thought…

Mark MacLeod:

It scares the shit out of you?

Sameer Dhar:

Yeah, exactly. Keep healthy as long as possible. And how do we live in a world where you can age in place, age in community, and not have to kind of get to that institutional set of living? I don’t think anybody wants that as their aspirational way to be at the end.

And how you prevent yourself from getting in there, it has to start a lot earlier than in your 60s, 70s, 80s, etc. Although you could probably make a dent at any age. And I think what happened to me is I went to these blue zones where people live the longest. Although there are some question marks around the validity of the whole concept in recent years. I mean, there’s been some question marks. Some research has come out to say, are these blue zones actually real or were they faulty statistics, etc.

Mark MacLeod:

I mean, the mortality rates are real. Again, is it causal or coincidental? But they do live to a hundred at the rate that they live at.

Sameer Dhar:

Well, there are a number of holes that have been poked around the birth records and whether or not those are valid. So again, without getting into that, I would say that I still went to three out of five of them and Nia is actually named after one of them. “Sardinia” is where Nia came from.

But I think too, with this whole popularization of longevity through thought leaders like Peter, Tia, Andrew Huberman, it’s created an interest kind of maybe contributing to the zeitgeist of the broader consumer population, even in a publicly funded healthcare environment like Canada, being interested in owning their own health in a different way.

I think the opportunity for me personally is let’s keep people out of nursing homes. Let’s keep them as healthy as long as possible over a lifetime and let’s operationalize best-in-class evidence and medicine to the masses. So to me, I’m very, very particular about this because there are lots of companies that can be built around selling $10,000 checkup assessments, health checkup assessments. The sky’s the limit in terms of how much money you can spend on it.

To me, the more animating thought is how do you get this to millions? Which means you have to make it super efficient, yet not sacrifice quality and evidence-based quality.

Mark MacLeod:

Is this a uniquely Canadian opportunity? And if so, why?

Sameer Dhar:

No, this is, I mean honestly, there’s a much more robust market being built out in the US. We have players like Function Health, Superpower, a ton of other competitors that have emerged in a US-based context. I think in a Canadian context there’s very limited competition right now. Partly because I think the bias in Canada is that hey, we got a universal healthcare system. Healthcare should be publicly funded. There’s a question mark around a lot of entrepreneurs about whether or not people are willing to pay for their own health and whether or not there’s a truly world-changing, viable opportunity in this country alone.

So yeah, this is global. I mean, it’s happening in Europe, there are companies emerging, there are companies raising tons of money everywhere to do this. Because I think we’re seeing the same opportunity across health systems. Whether you’re in the US, whether you’re in the UK, the year, Canada, the health systems are suffering and are not able to necessarily deliver the type of care that people as they’re getting educated about their own health in ways in which they weren’t before, that they want to be able to manage their health and do things a little differently.

So yeah, I think this same opportunity exists across many geographies.

Mark MacLeod:

Do you intend to bring this to the US or do you feel like that ship sailed already?

Sameer Dhar:

I don’t think the ship has sailed. It’s still early days. But that being said, when you’re trying to focus in the early days on what’s the initial product market fit that you want to go after, you gotta be careful not to spread yourself too thin, especially in this type of a model that we’re trying to deliver where we don’t just hand you a report and then hope that you’ll come back a year later. We’re trying to kind of be a partner in that journey. And that means going deeper into your experience, not just giving you the one-off assessment.

And doing that is highly impacted by the geography and geographical considerations both from a regulatory perspective, operationalizing it in a healthcare environment. It differs in Canada by province. And same thing in the U.S.

So, there are a lot of considerations to do it well and to execute tightly. In Canada alone, it is such a massive opportunity if you get a number of things right. For now, Canada got to execute and then I think build the best product and see what happens in the future.

Mark MacLeod:

So I’m on the other end of this as your customer and I’m clearly on a subscription. So do you see this as a SaaS business?

Sameer Dhar:

I see it as a tech-enabled service is how we would look at it. We don’t have SaaS margins.

Mark MacLeod:

Meaning, you’re thinking of a consumer from the point of view of a lifetime, pun not intended. Like, I’m full of puns today. I don’t know what’s going on. Sorry, it’s one of those days.

Sameer Dhar:

No, it’s good, it’s good, it’s good. I’ll laugh at all the puns all day long.

And back to my point about making this a true partnership so that it’s not just this one-off “Oh, I just want to see if I got any risk and then away I forget about it. I throw the report away.” Whatever the thing might be, we want people to actually take up the recommendations, come back and want to see their progress and introduce other best-in-class ways of understanding where their risk might lie now or in the future.

And then just being that place that people keep coming back to. I hate to use the cliche because everyone’s trying to make the digital front door to healthcare, but in a sense, we think we have a right to own that opportunity and be a complement to, not a replacement for the public system or primary care. In fact, if everything we do works correctly, we will take a lot of burden off of the public system as time passes.

Mark MacLeod:

Yeah, I’ve noticed that you write letters that I can give to my doctor, which is cool.

Sameer Dhar:

Yeah. And actually, that’s a really important point because what we built is again tech-enabled solution that is independent of a clinician. So we will look at the latest evidence and interpret that regardless of who your clinician might be and we’ll interpret it based on the latest reference ranges and ideas about prevention from a global perspective.

But to your point, one of the key elements that I think is missing in a lot of the competitors in the US and whatnot is what’s the transition for people who might need that next step through the other health system players. How do you make sure that is as seamless as possible?

For us, when we give you that family doc letter, which, let’s say 70, 80% of customers need some sort of follow-up through primary care that we suggest, we make sure that the recommendations in that letter are done based on Canadian guidelines. So, you know that as a consumer, you’re empowered with information that your primary care provider, your family doc, your nurse practitioner should be able to help you follow up on. Because we’re advising based on Canadian guidelines when we do that.

Mark MacLeod:

So there’s an election coming up in Canada soon. I don’t want to get into politics per se, but obviously, these kinds of macro topics are starting to come up now as people are talking about different candidates. And I spend most of my time with CEOs like yourself, many of whom are post-exit and let’s face it, wealthy. And you know, they have concerns like taxes, let’s park that.

But with healthcare specifically, a complaint that I’ve heard more than once recently is basically like, because my taxes are so high, I pay so much into healthcare and I have the exact same experience as someone who pays a lot less and the same wait times and like they’re frustrated. And I feel that demographic, which is the 1% or the 5% or whatever is like screw public healthcare. Gimme two-tier, gimme private.

You know, a lot of my CEOs prior to Nia showing up were Cleveland Clinic customers, and Medcan customers. Like, what are your thoughts on that? You’re clearly not an offering for the true masses yet, this is still you have to be in a privileged position to sign up for it. Like, do you see yourself segmenting that market and really going after the top tier? What are your thoughts on two-tier versus true republic?

Sameer Dhar:

Yeah. So, my ultimate dream and this is part of our approach because we are super evidence-based and we’re focused on trying to drive outcomes and we’re actually, we’re doing a study with the U of A right now on some of the outcomes that we’re potentially going to be able to show over time in our client base, which is again another differentiator between us and a lot of competition in terms of how we’re approaching things.

But if I focus on those first principles of what we do actually prevents disease from occurring because we motivate behavior change, we allow people to take action early, we empower them in over their health in a way that no public system or health system is able to do today. Then other payers inevitably will come in.

Like, insurers should come on board, government should eventually pay for it. To me, to ensure that I am on the track to do that and I don’t get caught in the trap of, hey, I’d love to just get 10,000 customers who are paying me 50,000 a year or whatever the thing is, you have to know what your vision or mission is.

And because the company could be built up very differently, we’re not looking to just serve people who can pay 50,000 bucks a year. That’s just not an exciting opportunity for us. You know, you said we’re not quite there yet. Totally agree. But that is where kind of our end game is solely focused on.

Now to get there, we do have to charge $299. It’s still not something that everybody can access. But what I can say about it is we’ve had 20% of our customer base be executive health users across all the major providers in the country. It wasn’t our intent, but what has emerged is this kind of realization that a lot of what happens in executive health today is not necessarily the most efficient use of healthcare resources.

When I say that, what I mean by it is we’re doing a number of tests that might not be the most clinically efficacious but are potentially expensive to deliver. So things like doing an ultrasound every year, an EKG, things that actually make sense to do, especially on an annual basis. Instead, our approach is we take the most clinically efficacious tests that are evidence-based and we deliver them in the most efficient way possible, and in a way that’s convenient and in a way that also is more up-to-date than even what executive health players might be doing.

Our blood-based panels are best in class and often more expansive than what you might be finding in executive health. How we interpret is not just based on what the public system has to say, which is very different than most executive health players in Canada. So this has evolved as kind of an opportunity for us against executive health. We have legs to stand on when we deliver, we come to you, we’re more convenient, we take the most clinically efficacious tests and deliver them more efficiently. And that means that we can drop price-point as well, even for that audience.

So we’re in this stage of we’ve built a product experience where we’ve identified several different segments to whom we can apply. And I think the net of it ends up being that we will not only disrupt potentially executive health, but we will be able to do that and bring this increasingly to the masses by focusing on outcomes.

Mark MacLeod:

I love it. He’s an unpopular character at the moment in some circles, but it reminds me almost of the Tesla approach. Tesla built the Roadster which was high-priced and then went to the S which was also high priced and took some time before it got down to the Model 3. Is it a similar logic in your mind?

Sameer Dhar:

It might be. I mean, I sometimes struggle with it because if we were truly taking that approach then we would maybe just be starting and only offering our $1,299 or maybe even a higher price point as the starting point. But I think kind of back to my point about why we want to exist and acknowledge the nuance of healthcare versus automotive and healthcare in a publicly funded system where people care and we care about working with a concept that everybody should eventually have access to great top-tier care. We do offer something at a price point that the middle class at least can definitely stomach, $299 bucks.

That’s something that many in the middle class might go for birthday dinner with their loved ones and that type of money might be acceptable to spend. So why wouldn’t that be acceptable to also spend to get best-in-class care and insight into your health?

So yeah, I would say that there’s a nuance because even at the start of the race here, we aren’t just offering the thing that the frankly the affluent and the wealthy can access and no one else. We have already created and we’re intent on continuing that journey of creating a more and more accessible solution. So yeah, that’s why I struggle a little bit with just the kind of Model S as the starting point.

Mark MacLeod:

So it’s probably fair to say that a hundred percent of the people watching or listening to this are within your 20% kind of entrepreneur executive class. So I’d love to take a few moments and just talk about the need for this kind of service for these people.

I’ll kick it off, I only coach CEOs and I watch these founder CEOs almost kill themselves trying to turn a vision into reality and create something out of nothing with zero work-life balance. And I’m okay with that. Like, no one who masters anything is a balanced human. Michael Jordan wasn’t a balanced human. You know, like any rock stars, they’re not balanced. So I’m okay with that.

But you also need to have some kind of practice to sustain yourself. And like I tell people all the time, a healthy person has a hundred priorities and a sick person has one priority, which is to be healthy. So I’m probably preaching to the converted, but maybe from your vantage point, talk about the need for this for the entrepreneurs who are listening.

Sameer Dhar:

Yeah, well, I think one takeaway from what we know and what we see in our existing customer base is that stress, and lack of sleep, these things show up in your body, right? Like we see it from a biomarker level, right? Your rates of metabolic disease, cardiovascular disease risk, these things are real.

And it’s kind of cliche at this point because we’ve talked a lot about it, but from our vantage point, it rings true, is that if you want to be the most effective CEO or C-suite or leader in a startup context, you have to show up as your best self. And so at least being aware of what it is you might be doing by neglecting such a critical aspect of your engine, I think that it’s important to be aware of it.

And then if you decide that you want to you want to continue to persist down that path, I mean, that’s up to you. It’s kind of this crazy thing in my mind because people ask us sometimes they’re like, oh, well you guys are just going to tell me to exercise more and diet. I know I need to do that. What’s the point of this? And then I ask the same kind of leaders back saying that’s kind of a silly comment. Why? Because, yeah, that’s the equivalent in business is like saying, hey, well, you just gotta increase your revenues and decrease your expenses, and that’s all that you need to build a successful business. Like, you don’t need to track any operating metrics or anything like that.

So why are we with the one body, the one vessel that you got to kind of run your race in life, why is that something that you’re just willing to boil down to the two metrics and say that there’s nothing else to be done there? You don’t tell me anything I don’t already know.

I think there’s a different playbook for managing our lives as founders, as startup executives, or just executives in general, where we can lead in a different way and we can lead ourselves first and understand and own our health.

And I think, by the way, that also will have secondary effects on your teams because if they see the kind of leader codifying that and embodying that spirit of wanting to be healthy, be their whole self is a really important thing, even for teams.

Mark MacLeod:

You know, there’s an interesting trend here, and you look at some of the most successful entrepreneurs, like Jeff Bezos has somehow gotten jacked over the last few years. Same with Mark Zuckerberg to a lesser extent. There are counterexamples. Elon Musk is dad bod. Tobi from Shopify is a lean, mean machine who’s literally, in his spare time, become a professional racing car driver.

These are just a few examples, I could keep going on and on, but there’s an emphasis, a recognition that physical health leads to a better life, but also just far better company performance. Are you seeing that in the people who are coming to you? Are you seeing that or are you having to educate them and evangelize this?

Sameer Dhar:

I think it’s a bit of both, to be honest. There are the folks who are following the longevity space, for example, and are following the playbook, listening to Outlive or reading it, and they’re following a playbook and trying to execute. But I would say that’s still probably the minority. I think the majority… And I feel this myself too, right? Building the company that’s trying to change this, ironically enough, it’s hard, right?

It’s hard because I know I need to be better about it, but how am I gonna do that when I’m working X number of hours per week, right? And I wake up every morning and I’m just focused solely on the mission at hand. Like, it’s a hard thing to wrap your mind around.

And I think one takeaway I’ve had when I’ve observed the progress of some of these types of executive types that we have as part of our customer base is that when they are empowered with consumer-friendly information that they’ve never had before, it serves as this catalyst to see and know what’s going on inside of you simply portrayed, not in crazy medical speak, but just here’s how I’m actually doing inside.

Like, it serves as this wake-up call that doesn’t necessarily require them to go 0 to 100, stop drinking for example, if they enjoy alcohol. But taking incremental steps that actually day over day when you start making some of those shifts or if you end up going and getting that follow-up through primary care, maybe having to take the pharmacotherapy or whatever it needs to be.

It makes a massive difference over time and it’s less scary than when you’re kind of confronting the mountain of like oh my God, I need to change my whole life because I’m a disaster right now. And not having kind of a compass or any kind of indicator of where you’re sitting and how you can get to the next step.

Mark MacLeod:

Well, I can offer you some talking points that I share with my CEOs. First of all, I remind them that today’s performance began last night based on going to sleep, and getting seven to eight or more hours of high-quality sleep, which then just brings up the importance of boundaries, right?

Like, work will expand to fill all available time, and if you don’t carve out time for exercise, time with loved ones, time to eat consciously versus wolfing down food while you watch TV or work, time to actually have some kind of wind down ritual before you go to bed. Like, you need these boundaries, otherwise, life happens to you, you know?

And like, I explained to my CEOs, even when I was running an investment bank and doing six deals at a time, I still went to CrossFit four or five days a week, right? I made that time. And people say I don’t have the energy, but it’s chicken and egg. That’s what gave me the energy, right?

Plus we did some like batshit crazy stuff in CrossFit, like handstand pushups or these crazy One Rep Max deadlifts. Today we did One Rep Max, back squats, and you come into work after that and you’re like, I’m gonna fucking crush today because I just crushed the gym, you know?

Sameer Dhar:

Yeah, yeah, you’re jacked up, you’re ready to go. You have a different level of energy and vigor, for sure.

Mark MacLeod:

And you know, I don’t have any particular genetic advantages. I lived in Scotland till I was 11. Scotland, last time I checked, has the highest incidence of heart disease of any first-world nation. As you and I have talked about, my dad had open heart surgery when he was 36.

So I’m not a genetic marvel, but I’m 54. I’m the exact same suit size that I was when I was 24. And in CrossFit, I regularly trounce 30-year-olds in the wards. And I take great pride in that because I’m committed to fitness and health, and it feeds every part of my life.

Anyway, this is not about me. Right now, my touch point with Nia is twice a year, a really nice nurse, I’ve had the same one both times, who shows up at my house and takes my blood. It’s super convenient. I pee in a cup and I get a really amazing dashboard. And as a former CFO who’s used to looking at dashboards, I love this.

But then you also go a step further to give me very actionable insights on the lifestyle part. So, I formally interact with you twice a year, but is there a world where you may have different extensions to your product, where I’m interacting with you all the time, maybe a meditation app or these stress reduction daily things like habits to reduce stress or sleep trackers, or do you just integrate with that ecosystem? What are your thoughts on that?

Sameer Dhar:

Yeah, I think very soon you’ll have in the pipeline, the opportunity to connect your wearables and track your progress on kind of different…

Mark MacLeod:

Is that an Oura Ring you have on your finger right now?

Sameer Dhar:

That’s an Oura Ring, yeah. Apple Watch and Oura Ring. But yeah, we want to be that partner that you come back to more and more often. So it’s not just this point in time checkups which I think are the starting point because it gives you the right evidence-based kind of view of where you’re at. But how do we help gamify the experience too so that it also maybe feels a bit less clinical and becomes something that’s more fun and social at the end of the day?

I think I alluded to it earlier, we’ve got the equivalent of if you’re familiar with Levels Health in the US, but basically continuous glucose monitoring to level up your nutrition recommendations, especially if you’ve got pre-diabetes or metabolic risk. How do you understand how your body metabolizes food and get more specific on your nutrition plan, amongst other things?

So, we’re looking at where we’re actively in the next few months you’ll see this as one of our valued customers. You will see these other offerings continue to pop up as we seek to build out the ecosystem of the best-in-class, most evidence-based clinician tools that are kind of deployed in a consumer context but centered in that one dashboard experience that you referred to earlier.

Mark MacLeod:

This may be hard to generalize and if so we’ll move on. But if you had to rank lifestyle factors in terms of most impact downwards, is it sleep then exercise then nutrition? Is there a pecking order if someone’s going to focus on one thing first, is there a general place to start?

Sameer Dhar:

I wouldn’t say that you could just make a blanket statement, especially around those three pillars that you just mentioned, which are pivotal in their own right. I think what’s probably and by the way, my clinician team would kill me anytime I say if I were to make a conjecture they would kill me if I wasn’t referencing the right studies and whatnot.

So, I think the one thing I can say is that I have yet to find someone in our customer base who had it all figured out and there was nothing that they could have tweaked or found in those three buckets in terms of an opportunity to improve on.

And I think that’s a super interesting part. Even the people who self-identify as quote-unquote biohackers, etc, when given this comprehensive view, have something to learn that can move the dial from a lifestyle perspective without pharmacotherapy in one of those three buckets that you just mentioned.

So yeah, to me it’s about getting super-specific and we’re continuing to figure out ways to do that. If you’re getting specific and personalized, so you’re not just telling somebody, hey, you got high cholesterol, go exercise more, which is what you might get in the public system today. It’s what forms of exercise are you doing, duration wise, how many minutes are you truly doing of strength versus zone two versus zone one?

Which of those given your profile, your risks, etc is going to move the needle the most based on where you’re at today and painting that picture for you, telling you a story about your health and how to own your health in a different way that just does not exist today. That’s the kind of magic solution when you create that full picture for somebody and then make it actionable so they can take that immediate next step.

Mark MacLeod:

I love it, I love it. I will say, biohacking is like a small pet peeve for me. Just because it’s sort of setting aside, not to get all woo woo, but like nature has this infinite almost innate knowledge. Like everything else on the earth exists in harmony with the earth except for humans. We think we’ve got it all figured out and we’re better and we’re going to do this and that like we just need to tap into our body’s innate wisdom and it’s going to tell us what we need. We’re just so disconnected from that. Anyway, I’ll stop the rant but that’s just a small pet peeve there.

Sameer Dhar:

Yeah, I think there’s this danger when you do get metrics. You over-index on these metrics to the exclusion of all else that gives life a lot of meaningful aspects of the picture.

Mark MacLeod:

Yeah, yeah, that’s right. And you talked about the Blue Zones and I started watching that Netflix documentary on the Blue Zones and talk about the importance of ikigai, that Japanese concept of having a really clear purpose.

Sameer Dhar:

Yeah, the reason why you get up in the morning. You got to have it. When I was in Okinawa actually I lived with an 80-something-year-old couple for a week. And when I look at all these Blue Zones, the ones that I’ve been to personally, there is something special about just being in an environment where community matters where you have a reason to get up in the morning at any age.

And you know, I think it tends to be in these, I want to say village, but in many ways, they are much smaller geographies that aren’t as caught up in the western flow of materialism and all the other things that we might paint as being quintessentially cosmopolitan Western.

So, I’ve always asked myself, is there a way to bring that kind of village-type mentality to the way we live our lives, and what elements are replicable in a Western context, if I can say that.

Mark MacLeod:

Yeah, I love that. That’s fascinating. Maybe as we begin to wrap up, by the way, I feel like this could be a much longer conversation, but you’ve got a company to run, so maybe there’s going to have to be a part two at some point.

But like, for folks who are curious about taking charge of their lifestyle and running their lives perhaps in the same intentional way that they run their companies. Like, where do you recommend that people start? Like either books you recommend or just apps. I mean, obviously, they should become a NiaHealth customer. But outside of that, what do you recommend?

Sameer Dhar:

Honestly, we’re huge fans of the book Outlive by Peter Attia. And actually, just on a personal note, that book is one of the reasons why I felt or that galvanized me to say this is the right time to take a shot at this opportunity because it just translates the latest evidence from a holistic perspective around your health into kind of very consumer friendly, non-medical speech. Or maybe there is some medical…

Mark MacLeod:

I started reading it on vacation this winter and there’s some medical there, but…

Sameer Dhar:

There’s some medical there for sure. But it’s the most kind of consumer-friendly distillation of the latest literature. So I think that’s a phenomenal starting point. And honestly, we find too that the people, once they’ve read that book, it’s like they’re operating from a very different framework and they are super motivated to try to own their health in a way in which maybe they weren’t before. To me, if you’re asking for one thing or one book to look at this picture, I’d say that’d be a great start.

Mark MacLeod:

Yeah, that’s great advice. It’s a big book. In fact, the bottom book on this pile behind me is that book. But I have this bad habit of reading five books at a time so I’m just like slowly cycling my way through it.

First of all, I will just say, I’m super pumped that we finally speak. I feel like I have a close relationship with you because you look out for me and I appreciate that. And I will say the opportunity here, we didn’t really talk about your go-to-market and I don’t think we have time to unpack that. But I feel like you have an opportunity for content and thought leadership that is way above just, hey, here’s our product, and here’s its features.

Like, I was a lead investor back when I was a VC in a company called Unbounce and Unbounce was a SaaS platform to build landing pages so you could run marketing campaigns. But almost all of their customers came organically from a blog that they wrote that had nothing to do with their product.

And it was everything about like the reality of being an online marketer and like just really going into that and I feel like maybe you’re doing some of this already and I just don’t know. But like there’s so much content to talk about. You could just literally take every point in that outlived book and turn it into a blog post and create a giant top-of-funnel.

Sameer Dhar:

Honestly, in a Canadian context, I think that is really good advice. And no, we haven’t done a good enough job of that to date. And I think it’s one of those things from a company-building perspective we spent a good chunk of last year. We just started last year, by the way, last January, the company.

But we spent a good chunk of last year focused on evidence, building a product experience that delighted users, etc. And it’s only been, I’d say in the past six months or so where the emphasis around how do we figure out this go-to-market equation now that we feel like we’ve got the foundational elements in place. That is a super timely comment is what I’m trying to say, because we’ve been percolating on that.

Mark MacLeod:

Love it. Last bonus question. Do you follow Brian Johnson and if so, what are your thoughts on his don’t die quest?

Sameer Dhar:

Listen, first of all, there’s a spectrum of thought leaders that have emerged in the ecosystem to date. And so our approach at Nia has always been about we go and look at the literature ourselves and decide what we’re comfortable suggesting, not suggesting, testing, not testing. And yeah, I mean, he’s definitely one of the furthest from the center, let’s just say, if I don’t want to say right or left, but furthest from the center of the thought leaders that have become part of the common vernacular.

And I think ultimately each one of them, you can go in and you can beat the drum on, are they evidence-based? Is this just quacky? Is it crazy? Is it not? I think the thing that I have to say about any of them is that they’re helping to build a broader movement that is becoming increasingly mainstream. And I think that broader movement is the one that we keep our eye on and is the one that we’re most excited about helping continue to build towards.

Mark MacLeod:

Well, yeah, I really would love to see that. The thing I know is I will die. That’s a given. But I want to have the longest health span that I can and I hope that everyone watching and listening wants the same thing for themselves. And so this is hard to think of a more important topic.

Sameer Dhar:

Well, thanks for discussing it and having me on your podcast here.

Mark MacLeod:

My pleasure. Thanks, Sameer.

Hey, thanks for listening to the Startup CEO Show. If you’d like to connect with me, be sure to visit my website at markmacLeod.me, or follow me on LinkedIn at The Mark MacLeod, or X account @markmacleod_, and if you want to tune in again next week, be sure to subscribe on YouTube, Spotify, Apple, or wherever you get your podcasts. We’ll see you next time!