Sabina Gal, Co-founder and CEO of kahla
How can we monitor our actions now to create a healthy lifestyle in the future? Sabina Gal, an integrative health coach and co-founder and CEO of the kahla app, highlights the importance of every daily choice — including sleep, nutrition and exercise — as valuable data that shapes wellbeing. The kahla app empowers women by simplifying the tracking of symptoms and lifestyle factors. Despite challenges in women's health research, kahla allows individuals to take charge of their health by offering personalized tools for prevention and a deeper understanding of the body. This technology uses the transformative potential of daily lifestyle choices to move us toward a future of longevity and vibrant health through simple proactive steps.
Sabina Gal is the co-founder and CEO of kahla, a mobile app that helps women understand how lifestyle factors affect their health symptoms.
She is also an integrative health coach with a focus on women's health.
She currently is living in NYC, has studied and lived in London, UK and is originally from Romania.
Show Notes
Sabina Gal shares her background in technology startups and a health challenge that led to creating the kahla app. [02:21]
A vision for the future in which we will use data to understand our own health symptoms and conditions. [06:09]
How does the kahla app empower women? [08:50]
How can we improve our healthspan? [10:42]
What is metabolic health and how does it affect women? [13:33]
Why are women disproportionately affected by a large number of chronic conditions? [14:46]
What are the pillars of health that we can focus on for a healthier future? [18:53]
What is the kahla app and how does it work? [22:40]
How can a continuous glucose monitor (CGM) prevent future disease? [26:04]
How does a CGM work and what are the benefits? [29:05]
Every action that we take on a daily basis is data that can help us live a long, healthy life. [31:39]
Transcript
Bisi Williams 00:04
I'm Bisi Williams, you're listening to Health2049
Sabina Gal 00:08
Everything that we do, every little action that we take on a daily basis from the way we sleep, the way we move, the way we eat is actually data. Data that we can choose to inform how our health is going to evolve over time and whether we're going to prevent disease and live long, healthy lives, or whether we're going to have to unfortunately bear the consequences of conditions and symptoms that are going to negatively impact the quality and longevity of our lives.
Bisi Williams 00:45
Hi, my name is Bisi Williams and welcome to Health2049. Today, my guest is Sabina Gal. She is co-founder and CEO of kahla, a mobile app that helps women understand how lifestyle factors affect their health symptoms. She is also an integrative health coach with a focus on women's health. Sabina, Welcome to Health 2049.
Sabina Gal 02:13
Thank you. Lovely to meet you. And thank you for having me.
Bisi Williams 02:17
I'm so excited to have you on the show. Sabina, tell us a bit about your interesting background.
Sabina Gal 02:21
I'm originally from Romania and I've been living in New York for the past six years. Before that I actually lived in London in the UK where I studied and I worked in technology startups for most of my 20s, early and late 20s. After I moved to New York, I actually started having some personal health issues that got me very, very interested in health, particularly women's health. And because I was trying to really figure out my own health problems and dive really deep into what was causing those issues, I decided to get more knowledge and study women's health. And that's when I became a certified integrative health coach. And a few years later, because I was trying to really get to the root of my unexplained and weird symptoms, I started building this massive spreadsheet where I was tracking a lot of different factors and a lot of different symptoms and trying to find patterns and correlations. And after about, I want to say six to nine months of daily tracking, I had this massive, massive amount of data in front of my eyes. However, it was very difficult to be able to actually see patterns and correlations. And so I had this aha moment when I thought to myself, okay, there has to be a better way to do this, a spreadsheet cannot be the only way or the best way. And I thought okay, what if we had an algorithm that was able to take this kind of large amount of data and look at the different correlations and patterns and then give you a simple summarized overview of what could be causing symptoms. And what was interesting is that at the same time, my sister, I have a younger sister who at the moment lives in Bucharest, Romania, she was also dealing with some health issues. It was through this process that we actually discovered that we have some autoimmune conditions that run in our family. She was struggling with a very different condition, but very, very similar in terms of having unexplained symptoms that would just flare up and she could not put her finger on what was causing the symptoms. And so she was using the same kind of spreadsheet method for tracking what was happening and we would both have calls and compare notes and try to share what we were learning and because we were doing it at the same time and because we became so invested in this process, we decided that we should start our company together.
Bisi Williams 02:28
I love it, that sisterhood. Now, I'm sorry that you have this ailment, but I want to touch on something here. I read recently in the New York Times a huge article about the huge mysteries of women's health. And I'm thinking we're 51% of the population now. In 2049, 30 years from now, we'll have solved this generally, like women's health and symptoms and issues won't be a mystery, which I'm looking forward to. But it astounds me that with all of the knowledge that we have, that there isn't a systematic way of looking at what is ailing women. So I love the idea of the company that you've started with your sister, and tell me based on what you know now, 30 years from now, can you tell us what health will look like from your perspective?
Sabina Gal 06:09
Absolutely. So I think 30 years from now, we're going to live in a world where individuals have a lot more control over their health, and the data is with the individual. I think part of the reason why so many women struggle with health issues that are not easily identified or easily solved is because we are used to giving control and giving the rest of the responsibility for our health to external sources, like doctors in the medical establishment. However, doctors and the medical establishment are not incentivized to spend hours on end to try to get to the root of our symptoms. The way the system works and the way they are incentivized is to find the quickest, fastest, easiest, most affordable solution to or not necessarily solution, treatment, I should say to a problem. And that doesn't always necessarily solve the problem, it can mask the problem, it can make the problem feel less bad in the moment, but it doesn't necessarily get to the root of what is causing the problem. So in 30 years, I think with the help of technology, and with the help of technology making tools that are very easy to use, and affordable, and putting those tools in the hands of actual consumers and patients and in people in the general public, we will have so much more information about our own bodies, and a much better understanding of our own bodies. And an easy way to gather data over a long period of time in order to be able to really go deeply into understanding what is causing symptoms and conditions. And so we are not going to rely so much on a yearly visit to the doctor that lasts maybe 10 or 15 minutes, in which of course, you cannot even begin to get to the root of so many of the conditions and symptoms that women struggle with today.
Bisi Williams 08:05
You know what I find interesting about your vision, and just the story between you and your sister is that you were comparing notes and that you had the wherewithal to look at your symptoms and recognize that something was wrong, first of all, so trusting your own bodies. Two, actually understanding that something is not right as you understand your condition. And then three, the ability to compare notes. I'm wondering, in your research for your company, if you just found that all the compendiums of medical books and science and the pedagogy at school perhaps doesn't actually have a comprehensive database, if you will, or information about the experiences of women and their bodies? I'm just throwing that out there.
Sabina Gal 08:50
No, you are actually absolutely right. It is a huge problem. And it is a very well known problem, at least in the medical field, not necessarily by the general public, that in most studies, most clinical studies and randomized control trials are done on men, not on women, and even those that are done on women, very often they exclude women of color, minorities. So you have a huge gap of data when it comes to having the science and literature on women's health. There are a number of actually, many treatments and solutions that were only researched on on men, not on women and so that's why for us kahla is very important to empower women to really understand their bodies because oftentimes the solutions that we'll be presented with might not work very well for you because they were not designed to work for you. They were designed to work for 35 year old men who might have very different needs than let's say, a 25 year old woman who at the same time I have very different needs than a 45 year old woman who may be going through perimenopause, and is experiencing a completely different set of hormonal changes that need to be addressed in a very specific targeted way.
Bisi Williams 10:13
I find this interesting. So, we're talking about design here and how you're looking at it from a comprehensive view in terms of taking all of the complexities of women's symptoms, and women's health, and putting it in an app. And I'm curious to find out with this citizen science, how do you imagine it will coalesce with a, let's just call it textbook medicine?
Sabina Gal 10:42
Well, I think again, we definitely need to textbook medicine. I'm not the kind of person to dismiss Western medicine and for so many different reasons, you might end up needing to have care in a proper hospital and being surrounded by a team of doctors. And that is absolutely essential. However, when we talk about prevention, prevention is not something that happens in the doctor's office and prevention again, it’s not something that happens during your annual visit. Prevention is something that happens every single day, and the individual is much more responsible, but then maybe we were educated to believe that we are about taking care of our longevity and taking all the preventative measures that we can to ensure not only that we don't get sick, but then we actually get to live a long healthy life, because you have, of course lifespan, but you also have health span. And health span is actually just as important. It's not enough to live to 90 years old if the last 20 or 30 years of your life are terrible, because you are in a terrible health condition. And so I think where those two intersect is at the individual level where through your lifestyle choices every single day, you can make really important steps towards meeting your medical team halfway, because it's one thing to end up needing to have to be taken care of, and to have treatment and medication for different conditions. But if you're actually taking the proactive steps, to be in good health as much as possible because you're never going to be able to control everything, you are going to get to a place where you're going to feel a bit more empowered. And you're going to feel like you do have at least some measure of control over your own health and our app is mostly focused on very simple lifestyle tools. Because if you look at a lot of the chronic conditions that plague not only women, but actually a lot of Americans and a lot of the world, for most of those conditions, lifestyle interventions are actually the first line of treatment, before medication, before any kind of big intervention surgeries or anything like that. It is advised to apply different lifestyle modifications in order to even reverse certain conditions.
Bisi Williams 13:20
So I love that. So tell me more. I mean, I'm completely tracking with you. And tell me why is your idea and vision important? And how does it make the world a better place?
Sabina Gal 13:33
So if you look at some of the data on women's health, actually, women account for more than 70% of the people affected by certain conditions such as autoimmune conditions, chronic pain, hormonal imbalances, even things like digestive issues and stress also affect women twice as much compared to men. And then you have metabolic health, which actually is a huge problem in our in the Western world right now because so many people suffer from metabolic dysfunction. And that can be pre diabetes, diabetes, heart disease, which is actually the number one cause of death in women. A lot of women actually fear breast cancer and for good reason, but fewer women know that heart disease is the number one killer for women. And if you are in poor metabolic health, that increases your risk even more.
Bisi Williams 14:27
I didn't know that. Those numbers that you're sharing with us Sabina, 70% of people have chronic pain are women and hormonal unbalances.
Sabina Gal 14:41
And autoimmune conditions. Yes.
Bisi Williams 14:44
And so tell me more.
Sabina Gal 14:46
Yes. So the reason why that happens is again and I'm gonna go back a little bit to what I was talking about before, which is that women go through so many hormonal changes. So you have puberty, you have your reproductive years, you have menopause. And whenever those changes take place, everything in our body gets more susceptible to different shifts that might not necessarily be positive shifts. And so there are certain conditions that just simply affect women disproportionately because of our different genetic makeup, and because of those different changes that we go through throughout the different phases of our lives. And so then even for women, if you look at, let's say, you take something like type two diabetes, which unfortunately is on the rise, if you look at that, women compared to men, women who develop type two diabetes by age 40, they will have a two fold increase of heart disease compared to men. And if you look at something like dementia, or Alzheimer's, women outnumber men two to one worldwide and more recent studies have discovered that actually, Alzheimer's is highly correlated with poor metabolic health and blood sugar imbalances. Alzheimer's is actually now called type three diabetes. And so because women are so disproportionately affected by a large number of chronic conditions and you couple that with the fact that a lot of women actually feel dismissed or have their symptoms then downplayed by doctors, that makes it so imperative to give women tools for them to be able to understand their own health, not just to understand it, but to actually track it over time. Because we're now in 2049 and you have been given tools, tech tools that are affordable, easy to use, that you have them daily in your pocket, because we all have access to a smartphone, at least in 2049. Probably a much better, smarter smartphone than today. And you'll be able to track those changes over many years. And let's say you're a woman in your late 40s or 50s about to enter menopause, you have actually been able to track the slight, but daily shifts and changes that have been happening to you for the past, let's say 20 years, every single day, and you have so many data points that have taken you to a place where you have a very deep understanding of where you started from and where you are right now, and how you can manage all of the changes that are yet to come. And again, it's all about those small lifestyle interventions that you can do every single day, in order to be in a more prepared position no matter what life is gonna throw at you and as a woman, unfortunately, you can be sure that you are gonna offer it at one point or another. That is the sad reality.
Bisi Williams 17:52
Or you have the joy of change. I wanted to just track something here that I think is really interesting based on your data. I read a study that millennials, that lovely generation that is carrying forward the rise of diabetes, it's unprecedented in that demographic and if you're saying that by 40, let's just say that the rate of increase for diabetes is happening. And you can start to imagine our future, that if we have young people with chronic conditions today, what does that bode for our health system, if you will, in 2049, 30 years from now, and I love this idea of prevention. And so what in your opinion are some of the small things that women and people can do today to turn the tide?
Sabina Gal 18:53
Absolutely. So I'm really glad that you're bringing this up, because I’m afraid to imagine if we continue at this rate what the burden on the medical system would look like in 2049. The system is overwhelmed. We are spending an enormous amount of money on trying to fix conditions and problems that could actually be prevented in the first place or reversed through lifestyle modifications. So I think the three things that if every person on this planet would do more of, we would be in so much better shape and they sound very simple and they sound very silly but they are so important. Number one is sleep. So many people don't pay enough attention to sleep. They either don't get enough sleep or they get poor quality sleep and sleep is so important. It is vital for our long term health and well being and we need at least seven to eight hours of sleep and a good quality sleep. That's number one. Number two is what we eat and here of course we can go very, very deep into nutrition and you can go very far into making lots of different kinds of choices. But the number one thing is to really try to limit or eliminate completely processed foods, because processed foods, unfortunately, are what is driving a lot of the metabolic crisis at least in the United States right now. And people are not aware that a lot of the foods that they are eating are highly processed, but if you go shopping in a grocery store, it's all the stuff that fills the shelves, if you walk in a supermarket, you will usually notice that all the produce is concentrated in the middle of the supermarket, and then all the aisles are basically shelves filled with packaged processed foods. So the number one tip here would be to always stay within the center of the supermarket and shop there because that's where you're gonna get all the healthy, amazing foods that are going to nourish your body and protect your body. And then number three, and again, these are all equally important, but I think they're the pillars that are the foundation of health and longevity and prevention, number three is exercise. Very sedentary lives, we spend most of our lives sitting at a desk in front of a computer, we don't move our bodies not nearly as much as we are designed to move our bodies because we are not designed to sit for 12 hours a day and then plop from our desks or sofas and binge watch Netflix, we are made to move, we are made to run, we are made to lift things and carry things. I think if we all paid a little more attention to these three very simple, very basic tools, but really be intentional about spending time on each of those pillars of health. I think the landscape would look much, much different.
Bisi Williams 22:09
Kind of nice. I mean, if I was getting my exercise, I would take a stroll to the grocery store, stay in the produce aisle, get fresh vegetables, come home and then have a great night's sleep. It sounds so simple and I'm not making light of it. That's super duper important. Can you just tell us a little bit about how your app works? I mean, take it through the life of a prepubescent woman and her life's journey, does your app cover that full spectrum of a young woman's life?
Sabina Gal 22:40
Absolutely. So right now, we're still actually in private beta and we have a few 100 people who have been testing the app and giving us amazing feedback. Our plan from the beginning was to launch a very basic version of the app and then get actual input and feedback from real women. And they have helped us tremendously to continue to iterate and build an app with more features. And currently, the way kahla works is that you fill in a very simple questionnaire where we ask you about your symptoms, and your conditions and the symptoms that you choose then become your areas of focus or goals or things to track. And then you have a daily journal that is super easy to fill, it takes only a minute or 30 seconds. Every morning, you do that journal where we ask you about those symptoms. And so let's say that you are tracking maybe fatigue and food cravings, sleep issues and bloating and everyday we would ask you about those four symptoms and you can easily choose from whether you've experienced that symptom that day or you haven't. And then we also ask you a couple of questions related to your lifestyle factors. How was your sleep? How was your stress? Did you get to move your body? Did you hydrate? Are you menstruating, and so on. And then we put all of those together. Every single week and every single month, we show you correlations between those factors and those symptoms. And we're now adding a lot more things that you can track with our app. You can even track stuff like medication, travel, different food groups, let's say you want to see whether dairy affects you or it flares up your symptoms. You can track different food groups, and anything and everything you could possibly think of that could have of course an impact on health symptoms. And then there's an extra layer to our app, which is actually something that I'm very excited about, which is that we want to be able to give women the option to connect with whatever external biomarkers that could be relevant to their health. And that can be blood tests, that can be specialty testing, that can be different sensors and wearables. And because metabolic health is such a huge issue for a lot of women, we have decided to make that our initial focus. And so the first external biomarker integrated with the kahla app is a continuous glucose monitor. So not only women have this tracking app that allows them to track symptoms and lifestyle factors on a daily basis, but they can also wear a continuous glucose monitor, which is a very small device that you attach on the top of your arm that measures your blood sugar continuously in real time 24/7. And that data gets integrated with our app. And for everything that you eat, we give you a score based on your blood sugar response. And we show you how the blood sugar element integrates with all of the other symptoms and factors that you're tracking.
Bisi Williams 25:35
I have a question for you, so when you have a device that's monitoring your glucose, is this when you've been diagnosed with something or is this when you're still trying to figure out what symptoms? Are there, I hate to use this word, but is it an illness or chronic diseases that correlate with some of this?
Sabina Gal 26:04
This is a great question. So those continuous glucose monitors, in short they're called CGM, were initially designed for people with diabetes for them to track their blood sugar. However, in the past five years or so they have become really popular with the general public because they have actually been discovered to be a great tool for monitoring your blood sugar. In terms of preventing future disease or future diabetes, there have been studies that show that continuous glucose monitors are actually better at picking up very early pre diabetes. And they do it much better than let's say, a yearly fasting glucose that you do through a blood draw and your doctors because with a meter CGM, you are actually able to monitor your blood sugar again, in real time content on a continuous basis. And not only do you see what your baseline glucose levels are, but you also get to see really interesting data such as what is your response to different meals? Can you tolerate certain carbohydrates? What are certain foods doing to your blood sugar? How is your blood sugar affected by stress? Because cortisol is known to raise blood sugar. How is your blood sugar affected by our menstrual cycle? Because women are much more insulin resistant in the second half of their menstrual cycle. And so there are a number of really interesting data points that you can collect with a CGM, and you absolutely do not have to have a disease. I will say, however, that a lot of women struggle with something called PCOS, which is polycystic ovary syndrome. And PCOS in the US is the leading cause for infertility in women. What a lot of women don't know is that PCOS is not just a hormonal condition, it's also a metabolic condition because at least 70% of the women who have PCOS are also insulin resistant. And the two are very closely correlated. So for women with a condition such as PCOS, monitoring their blood sugar is actually essential. And we also have currently in kahla, we have a lot of pregnant women who are monitoring their blood sugar because there is a condition called gestational diabetes and that is diabetes that you can develop while you're pregnant. And women who do develop gestational diabetes during pregnancy are again, they have a two fold increased risk for developing type two diabetes when they are not pregnant.
Bisi Williams 28:32
This is fascinating. So what you're doing, and I think this is kind of a breakthrough, is that if you're monitoring now in a preventative fashion, what we eat, how we move right now, you're kind of using this data as a way to prevent a chronic disease from happening. At what point can we stop monitoring, or is this something that needs to be done continuously, do you imagine?
Sabina Gal 29:05
So with the CGM, I actually think that literally every person in this world could benefit from trying it at least one month of blood sugar monitoring because you can learn so much and then you can take those learnings and really be able to tap into your body a bit more and be more aware of okay, so when I eat this food, and before I had no idea, I would have oatmeal and two hours later I would feel fatigue or have an energy crash or feel like I need to eat again. And I had no idea why that was happening. Now because I've tracked with a continuous glucose monitor I know that what's actually happening is that my blood sugar is spiking to a very high level and then it's dropping very quickly, which is causing this sort of fatigue and energy crash to happen. And now I can associate a feeling or a sensation or a symptom to the actual day either, because I have tracked and I know that that is what's happening. If you are someone who has a certain condition, or has a certain genetic predisposition, then you could most definitely track on a more continuous basis and track every month or track every three months, or at least assess once a year to kind of see whether things are changing or improving or which direction they're going in. And it's the same as your bloodwork, you would do your annual blood work and not just do it and put the results in somewhere and never look at them you would assess and see. Okay, how are things changing? How are things? How are things progressing from year to year to year, because it's the only way to actually tell whether there is something that might not be going in the direction that you want it to go.
Bisi Williams 30:56
Sabina this has been fascinating because all of this is available today. And I can see here where kahla is going to be so valuable not only for today, but for the future as women can actually understand themselves in relation to their needs. That this is really a beautiful, personalized app and a way of understanding our bodies and how we use them and what they need. I'm excited for you. Can you just tell me in your final words, when you think about 2049 and 30 years from now, what do you think is the best thing that we can learn today that will help us tomorrow?
Sabina Gal 31:39
The first thing that we can learn today that can help us tomorrow is that everything that we do, every little action that we take on a daily basis from the way we sleep, the way we move, the way we eat is actually data. Data that we can choose to inform how our health is going to evolve over time and whether we're going to prevent disease and live long, healthy lives or whether we're going to have to unfortunately bear the consequences of conditions and symptoms that are going to negatively impact the quality and longevity of our lives.
Bisi Williams 32:18
Sabina Gal, amazing. Thank you for joining us today on Health2049 and for sharing your wonderful views.
Sabina Gal 32:24
Thank you so much for having me.
Bisi Williams 32:28
That's our show for today. That was Sabina Gal sharing her vision for women's health in the year 2049. Thank you for listening.
