Clear.bio tackles diseases of affluence with data-driven nutritional advice

By Aafke Eppinga

In the Netherlands, 14 percent of adults are severely overweight and 1.2 million people have type 2 diabetes. By 2040, that number is expected to be 1.5 million. Piet Hein van Dam made it his life’s mission to reduce Western diseases of affluence. The seed was planted when he wanted to buy a drink in the United States with only $1 in his pocket. To his great surprise, he was able to buy a can of Coke, but not a bottle of water.

In 2019, Van Dam founded Clear.bio, together with Madelon Bracke: a start-up that provides real-time nutritional advice based on the user’s biodata. The company has since been officially recognized as a healthcare provider and Van Dam was voted one of the top 50 healthtech CEOs by American Technology Innovators last year. In this episode of Start-up of the Day, Yvette Ruts-Wolters, head of marketing, talks about the technology behind this innovation and looks ahead to the future.

What does Clear.bio do?

“We give people insight into how their bodies respond to nutrition, and how they can improve their own health at home with personal nutrition tips and coaching. Nutrition is essential to your health. But how do you know which foods are good for you? For example, one person gets a high blood sugar after eating a banana, while for another, blood sugar levels hardly react at all. For good health, it is important that your blood sugar is stably low. We give our users insight into that, and tips and help to improve that level themselves.

Science has long taught us that everyone reacts differently to food. However, this knowledge is still rarely applied in daily practice. That’s where we come in: digital precision dietetics through personal glucometry.

Clear.bio is mainly used by people who want to control their diabetes or reduce their risk of it. It is estimated that over a million people in the Netherlands have pre-diabetes. If you can also help them before they develop type 2 diabetes, that’s a huge win.”

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How do you do that?

“We have two data sets; blood sugar data and nutrition data. We obtain the blood sugar data using a sensor. After a user places a sensor on his upper arm, this sensor measures blood sugar levels in real time for two weeks. Nutrition-related data we collect as the user records all food and drink in the Clear.bio app for those two weeks.

Clear.bio links these data sets so that the user can see directly in the app how his blood sugar reacts to a specific meal or snack. This forms the basis for our nutritional advice. Is certain food not right? Then the app immediately suggests other food choices that are. Via the chat function in the app, our dieticians help users on their way to understanding their blood sugar levels and changing eating behavior.

I just spoke with a user. She was very shocked by the effect candy has on her blood sugar. She saw this immediately in the Clear.bio app. Seeing this effect prompted her to make different choices for next time. Finally, we are using AI to learn from all the data of the total of five thousand users we have already helped, also for predictive modeling on nutritional advice.”

Why did you chose to focus on people with diabetes type 2?

“We tested our proposition on various target groups; from elite athletes, entrepreneurs, the elderly to people with type 2 diabetes. Our results showed that we can achieve the greatest health gains with this last target group. Also, with this target group the urgency is the highest.”

What is the biggest challenge?

“The biggest challenge for 2023 is to get a proper place in the healthcare system. Last year we did clinical studies to demonstrate the value of our digital precision dietetics for the user, healthcare professional and insurer. This year we are doing clinical studies with healthcare groups and practices in Rotterdam and Flevoland, among others, to determine how best to implement Clear.bio in the healthcare system.

Our goal is for our digital precision dietetics to be reimbursed and prescribed. A tough job, especially since there needs to be a mind shift: from earning from sick people to preventing sick people. We are going for de-medicalization and de-hospitalization, so this year we want to demonstrate how this can work in practice. So we don’t just fit into an existing box. That actually applies to everything we do. Another example. Every healthcare provider is required to report on the quality delivered. There are set standards for that. But how do you measure and compare the quality of our digital precision dietetics through such a standard? A simple example. We don’t “discuss” treatment progress, we “show” it in our app.

Creating urgency on the need and reimbursement for prevention within healthcare is another, big challenge. It is precisely up to healthtech clubs like us, to break through walls here. Because we can demonstrate, data-driven, the impact of preventive care on the user, healthcare professional (relieve healthcare) and insurer (reduce healthcare costs in the long term). Anyway, first let’s get a good place in the healthcare system.”

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Where do you want to stand in 5 years?

“The goal for this year is clear: to be prescribed and reimbursed under the basic health insurance in the Netherlands. We will also start pilots in Brazil and Portugal this year, because our ambitions transcend national borders. We are going to investigate what impact our digital precision dietetics has in a different culture with different lifestyles and eating patterns. We not only want to learn from the data, but also look at their healthcare system. In these countries, for example, there is already more interest in preventive care. Ultimately, our mission is to help millions of people with type 2 diabetes become the best and healthiest version of themselves. With data instead of pills.”