Recently I’ve been getting great sleep (without any major changes in general lifestyle or stress levels). I made a bunch of changes at once. One, all or some combination of them are having an effect. Here’s the list:
  • Comfortable mattress: This is obvious. What’s not obvious is how much effort people have already put into testing every available mattress and writing up their findings in detail. It’s worth spending time on Sleep Like the Dead and Sleepjunkie before buying a mattress to find one that suits you. (It’s possible spending a lot of time researching a mattress makes it feel more comfortable through placebo effect, which is fine by me).
  • Eat dinner early: I’d often eat dinner within an hour of going to sleep. Now I’ve been eating at least 4.5 hours before going to bed (related to starting a Intermittent Fasting protocol).
  • Oil diffuser: I turn on an oil diffuser with lavender scents about 45 minutes before going to sleep.
  • Reading fiction: I read an hour of fiction. I typically don’t read much fiction and would use any spare reading time for non-fiction/learning. That makes my mind too active though and it’s also tough to focus on dense material after a long day.
  • 10 min meditation: After reading I do a 10 minute guided sleep meditation on Simple Habit or Headspace. I think taking long deep breaths is 90% of the benefit vs the actual meditation.
  • Sleep stories: Calm has a feature called Sleep Stories, which are exactly what they sound like — bedtime stories for adults. I was skeptical at first but I’ve found them amazing for keeping you getting wrapped up in your thoughts and staying awake. I’m usually asleep before the end of one.
  • No phone in bedroom: The only electronics allowed are my Kindle and an old iPhone with just the Spotify, Calm, Headspace and Simple Habit apps.

Two other things I’ve used for a while are:

  • Blackout curtains: Make your room as dark as possible (I don’t like using a sleep mask)
  • Sunlight alarm clock: Wakes you up gradually.

Finally, the best advice on getting good sleep I’ve heard was from Naval — “don’t run a company” :)

(Edit: As many of my friends have noted, all of these suggestions will be utterly useless if you have kids).

My experiments with preventing heart disease

I wrote previously how learning that I had a family history of early heart disease prompted me to take a more proactive approach to managing my health. After getting tested for a number of markers associated with heart disease, and scoring in the high range for some of them, I began forming an action plan.

Of course I knew the basic plan would be to "eat well and exercise", as per the advice most doctors would offer. But I wanted more specifics. What's *my* optimal diet for preventing heart disease? Which has the greater effect, diet or exercise? Is focusing on one alone sufficient? How much should I be exercising?


I began by focusing on just diet. Generally I eat pretty well, avoiding sugar and refined carbs. This helps keep my weight under control (I have an endomorphic body type) but I do eat a fair amount of meat (minimum twice a day) and especially red meat (minimum twice a week). There seemed to be much literature advocating a plant-based diet as a means of not only preventing heart disease but reversing it. The physician behind much of this work, Dr Dean Ornish, worked with Bill Cinton to help him recover from his quadruple bypass in 2004.

I decided to try a modified version of the strict plant-based diet. I cut out all meat, fish, dairy and restricted eggs to a maximum of twice a week.  I found this change much tougher than I'd expected, I felt gassy and low-energy after the second week.  After one month I made a modification and switched to occasionally having lean, white meat or fish for dinner but still no red meat at all. I found this more workable and would still often go days without any meat at all.

After two months I ran another set of blood tests to see if my heart disease markers had changed:

Marker Change Target
Total Cholesterol 206 mg/dL (+/- 0%) < 200 mg/dL
LDL (bad cholesterol) 127 -> 119 mg/dL (- 6%) < 100 mg/dL
HDL (good cholesterol) 70 -> 77 mg/dL (+ 10%) > 40 mg/dL

I was happy to see improvement in the ratio of my LDL and HDL.  Even though it'd only been two months,  I was somewhat surprised that my total cholesterol hadn't changed at all though.  This made me curious about the exact link between diet and cholesterol.  I began looking into the research connecting them. I discovered something that stunned me. For 70% of people, diet supposedly has minimal effect on their cholesterol levels (more detailed explanation below).

More concerning to me was that my dietary change had negligible effect on two of the more advanced heart disease markers, in fact they showed a tiny increase:

Marker Change Target
Apo(B) 98 -> 102 mg/dL (+ 4%) < 80 mg/dL
Lp(a) 148 -> 151 nmol/L (+ 2%) < 75 mg/dL

I found there was considerable evidence that Apo(B) may actually be a more important predictor of heart disease risk than LDL cholesterol. The Canadian Cardiovascular Society has included Apo(B) in its heart disease management guideline since 2009.  A quick explanation of the theory is that the number of cholesterol particles you have, is more important than your total amount of cholesterol.  Apo(B) count is a proxy for the number of cholesterol particles because each particle has exactly one Apo(B) molecule. 

There were some more notable changes in two of my other makers:

Marker Change Target
Triglycerides (fat in your blood) 80 -> 49 mg/dL (- 39%) < 150 mg/dL
hs-CRP (Inflammation) 3.1 -> 0.8 mg/L (- 77%) <1 mg/L

I was happy to get my triglycerides down but they were already in the healthy range, unlike my other markers. It was also hard to know what to make of the inflammation decrease, since it's a notoriously variable reading (intense exercise or a recovering from a cold could both raise it). Frankly, it was a surprise to me that I'd scored so highly in the first place and I suspect it could have just been a funky reading (human involvement in the testing process means there's an inevitable margin for error on these tests).


During these two months I'd not been exercising at all. Now I kept the same diet and signed up for a crossfit gym, working out there 3x a week. Two months later I ran the tests again. This time I found even fewer changes in my cholesterol levels:

Marker Change Target
Total Cholesterol 206 md/dL (+/- 0%) < 200 mg/dL
LDL (bad cholesterol) 119 mg/dL (+/- 0%) < 100 mg/dL
HDL (good cholesterol) 77 -> 73 md/dL (- 5%) > 40 mg/dL

However I saw some significant movement in my other markers:

Marker Change Target
Apo(B) 102 - 90 mg/dL (- 12%) < 80 mg/dL
Lp(a) 151 -> 88 nmol/L (- 42%) < 75 mg/dL

Given the importance of Apo(B) in particular, as I mentioned above, this was really encouraging. My remaining markers showed some mixed results:

Marker Change Target
Triglycerides 49 -> 61 mg/dL (+ 25%) < 150 mg/dL
hs-CRP (Inflammation) 0.8 -> 0.5 mg/L (- 37.5%) < 1 mg/L

I'm not concerned by the rise in my triglycerides though, as I'm still well within the healthy range. I plan to continue monitoring it and if it keeps continues moving upwards, I'll have plenty of time to figure out a strategy to course correct.  


Given the importance of Apo(B) as a predictor of heart disease and its non-response to my diet-only modification, regular exercise is clearly an essential component of an effective heart disease prevention plan for me.

Looking at my LDL trend, the lack of change in the past two months is interesting. I can think of two explanations; 1) my body is sensitive to dietary cholesterol and I'd have to adopt a strict vegetarian/vegan diet over a longer period of time to bring it down into what's considered the healthy range, 2) my exercise regime increased my body's production of LDL and cancelled out any decrease from my diet modification (there is some precedent that increased muscle mass elevates LDL levels, and since starting crossfit I've gained just over 3lbs of muscle mass).

I plan to continue with my regime of limiting meat intake (I actually quite enjoy it now as it gives me a reason to explore new places and foods for lunch) and regular exercising. Hopefully in another couple of months my Apo(B) in particular will continue moving towards the healthy range.

I've always known that eating well and exercising are things I should be doing but tying them to specific data that affects how long I'm going to live for, gives me a level of motivation I've not felt before.

Thanks to Dr Mager for reading a draft of this.

HN discussion here.



For the full explanation of how cholesterol works, I'd really recommend reading The Straight Dope on Cholesterol. It's an incredibly detailed set of articles though. This is a fairly good summary of the main points, though still a decent read itself. I'll attempt to give a super simple nutshell explanation here:

  • Cholesterol comes both from the food you eat (only animal food products) and is also produced by your liver (it's present in every cell in your body).
  • The type of cholesterol from food is typically too large in size for your cells to absorb it, so it just passes straight through.

Avoiding Heart Disease

This summer my uncle went to see a doctor after complaining about experiencing shortness of breath. He's an officer in the Indian army and has a regular medical checkup every six months so he wasn't expecting to hear anything too shocking. This time, after some prodding from a cardiologist family friend, the doctors did a more extensive checkup. They told him that four of his coronary arteries were severely blocked. It was amazing he hadn't already had a heart attack. He underwent a quadruple bypass and thankfully is recovering well now.

I happened to be traveling in India at the time and learnt from my family that my grandfather had a fatal heart attack around the same age my uncle was now (mid 50's). He was also an officer in the army and seemingly in good health. I began wondering if a similar fate lies in store for me. The more I considered it, the more ridiculous it seemed. How could someone spend years thinking they're in good health with no idea that they're actually a ticking time bomb?

I decided to be proactive about managing this risk. I wanted to know what data I should be looking at and tracking over time so I could avoid being completely blindsided one day. I went to see a doctor and explained everything above. Her response, "you're young and healthy, come in for a physical once a year to check your cholesterol numbers and don't worry about it - just eat well and exercise regularly". I found this quite frustrating for two reasons:

  1. My cholesterol numbers came back fine (just like they were last year) but I knew cholesterol couldn't be a sufficient indicator of a healthy heart. My uncle had cholesterol numbers that were fine too.
  2. The advice to "eat well and exercise" didn't seem particularly insightful. To me it felt a lot like saying "don't worry about things for now, come back in 20 years when you have some actual symptoms".

So I started doing my own research into predictors of heart disease risk beyond monitoring cholesterol numbers. I came across three blood tests that seemed important; Apolipoprotein_B (ApoB), High Sensitivity C-Reactive Protein (hs-CRP) and Lipoprotein(a) (Lp(a))[1]. There appeared to be evidence[2] that all three taken together could provide a more accurate overview of heart disease risk than cholesterol alone.

I ordered these tests[3] and found that my levels for all three were elevated and fell into the "at risk" category.  There were a few conclusions I drew from my results:

  • While it's not exactly good news discovering that you have an elevated risk of heart disease, it made me feel better that I wasn't flying totally blind anymore. My mind immediately switched to researching ways to improve these numbers.
  • There seem to be fairly clear guidelines on how to go about reducing Apo(B) and hs-CRP numbers e.g. exercising reduces Apo(B) (though interestingly not LDL ("bad") cholesterol) and eating omega-3 fatty acids reduces inflammation.
  • Lp(a) seems trickier to manage. It appears to be mostly hereditary and I can't find a clear consensus on how to reduce it. It occurs to me that while I thought I wanted to gather data on every aspect of my heart, perhaps what I actually wanted was just the data about the things I can control.
  • My cholesterol numbers were checked again during these tests, in just two weeks my total cholesterol had dropped 14%. It seems incredible that such an important number can fluctuate so much over a couple of weeks and yet most people only measure it once a year, at best.

I've been thinking about whether taking this approach to managing my health is a good idea or not. It's certainly a slippery slope. There's always a new study to read indicating some additional marker or factor that should be taken into account. After a while it can seem somewhat overwhelming. I've been wondering though why didn't I have this level of discussion with my doctor? There are of course the obvious practical reasons. Doctors are busy and explaining heart disease risk to a healthy 28 year old isn't  viewed as a priority. Also running blood tests costs money and it's hard to see the insurance companies being willing to foot the bill for tests that aren't deemed necessary.

Ignoring these for a moment though, I've been thinking about the possible philosophical objections to treating managing your health as a data project. Here's what I've come up with so far:

Heart disease is complex and there's still debate about the validity of these additional markers
There's also debate about how useful linking cholesterol with heart disease risk is and yet that's still a standard test. There certainly appear to be enough studies and trials arguing that hs-CRP, ApoB and LP(a) are important so surely these numbers can't be completely irrelevant. If I want to take a proactive and preventative approach to managing my health, surely gathering the most information possible to form a plan of action seems reasonable?

The advice i.e. manage diet/exercise/stress is still the same. You should be doing it anyway.
True but I find that tying actions to specific numbers/metrics is better e.g. it's easier to lose weight if you weigh yourself regularly. Generic advice to eat well and exercise is not as effective as having a specific number you're trying to improve on e.g. lowering your ApoB count. Being specific also allows you to create a more personalized plan of action.

Optimizing for specific factors before fully understanding them can have unforeseen consequences
An example would be the conclusion by Ancel Keys in the 50's that animal fats caused heart disease, resulting in the American Heart Association pushing the idea of low fat diets to the public. By promoting fats as evil, the real danger of sugar and refined carbohydrates were ignored[4].

I'm not advocating pushing any particular theory or medical opinion on people. What I want is a system where I can choose to have access to my data with the explicit acknowledgement that the behaviour of the human body is inherently complex and uncertain. It's then my decision what course of action I want to take, taking the informed opinion of my doctor into account.

Numbers are constantly fluctuating, monitor them too frequently and you'll get stressed
This is actually a direct quote from my doctor. In my opinion it's still not a reason to ignore the numbers. I can opt out of knowing them if I wish but if I want access to that data, why should anyone but me have the right to make the decision? The role of a doctor should include telling me what fluctuations are normal and which ones aren't, rather than just checking in with me once a year.

I'd really like to hear more about what people think about this. Am I missing other major downsides to taking a more proactive approach to managing my own health?  Are there other things I should consider looking at to get a complete picture of my health?


[1] ApoB: This is a protein found on the surface of LDL ("bad cholesterol") particles. A regular cholesterol test tells you how much cholesterol is contained within the LDL particles but doesn't tell you either the number or size of these particles themselves. Each particle contains one molecule of ApoB i.e. ApoB count == the number of LDL particles you have. This means you can also make an inference as to their size. If you have a high ApoB value, your LDL particles are likely to be small and dense which are believed to be a stronger indicator of heart attack risk. There seems to be some debate both for and against the importance of ApoB as a heart disease risk indicator that's more valuable than just measuring LDL. The existence of the debate alone seemed reason enough for me to add it to my list of data to track.
hs-CRP: This is a protein found in the blood and its presence is a sign of inflammation in the body, which is a risk factor for heart disease.  While testing for hs-CRP alone isn't more predictive of heart disease than a regular cholesterol test, it does provide valuable additional information. If your hs-CRP level is higher than 3.0mg/L you're at high risk for cardiovascular disease, according to the American Heart Association.
Lp(a):This is a different form of LDL (Low Density Lipoprotein - also known as "bad" cholesterol) which attaches to a protein called Apo A. It's apparently unclear what Lp(a) actually does but if your level is greater than 30mg/dL it's deemed an increased risk factor for heat attack.


[3] I looked into how I'd get these tests ordered myself and found these options:

  • WellnessFX: A nice looking website that has various packages of tests you can run. The cheapest package that included hs-CRP, ApoB and LP(a) was their Baseline (, priced at $149. It also includes a variety of other tests
  • Directlabs: A dated looking website but offering the option of a la carte tests. Total cost for these three tests: $205
  • Health Tests Direct: Another dated looking website, again with the option of a la carte tests. Total cost: $115.50
I decided to go with WellnessFX since for marginally more money I could get a variety of other tests too.

[4] The opening chapters of Good Calories, Bad Calories contain a detailed explanation of the history involved.


It's been a little while since it was announced I was stepping down to part-time partner at YC. I'd been meaning to say something about it sooner but I've been afk for a while (quite literally as my only electronic travel companion has been my iPad).  Better late than never though.

I joined YC in 2010 mostly out of curiousity. I was amazed how much it had grown since I'd gone through the program myself and it was fascinating to think about what kind of scale it could reach.  The next three and a half years were more interesting than I could have imagined.  Every batch presented a new set of unexpected and novel problems to solve.  We funded over 300 startups during that time and learnt an incredible amount. It's something I'm truly grateful to have been a part of.

I knew though that I missed working on a startup and I decided at the end of 2012 that Winter 2013 would be my last batch as a full-time partner.  'Twasn't an easy decision but I knew it was the right one.

I had various thoughts and idea about things to work on floating around in my head and my instinct was to start building things immediately so I'd be ready to announce my new project within 0.5 seconds of stepping down.  When I took a second to breathe though, one thing kept bugging me. I'd been wanting to go away and travel for the past decade and apart from some short trips here and there, never had. 

I'd first thought about taking a gap year and travelling in 2003 but starting university asap seemed more important. I then thought about doing it after graduating, even started planning with some friends, but I was working full-time on my startup pretty much the day after my final exam.  Now I found myself with the same desire to travel but a new realization that ten years go by pretty fast and having periods of time with no commitments seldom occur, especially as you get older. So this time I decided to actually do it.  By biggest surprised when I mentioned this to people, especially those older than me that I looked up to, was just how unequivocal the encouragement to do it was. 

I've been on the road for 7 weeks now. So far I've visited Mexico, Thailand, Vietnam, Cambodia, The Philippines and Hong Kong. The past month has felt like a year. A barrage of new experiences that have slowed down (my perception of) the passage of time and that's felt wonderful.  I've been exposed to a huge amount of new ideas, information and people over the past few years and it's been great having some time and distance to look back and filter through them.  

If you have any travel trips or suggestions for places to visit I'd be most grateful. Having planned things out in advance over the past few weeks, I'm keeping the next couple of months more flexible and playing things by ear.

If you're thinking about doing something similar and taking some time out, I'd highly recommend reading this post from Michael Wolfe. I also found this post from Naveen, co-founder of Foursquare, quite motivating.

Look forward to seeing everyone when I'm back in September!

Co-founder breakups

The relationship between co-founders is usually the single biggest risk to a startup in the earliest stages, it's certainly the most common reason for failure we see at YC. Having (unfortunately) seen a lot of co-founder breakups over the past couple of years, here is a list of some common causes I've seen that underly the final "we can't reach an agreement on anything, one of us has to leave" conversation.

Being the CEO

The most common reason for breakups is usually when more than one founder has aspirations of being CEO. It's true that titles are generally meaningless when a startup is just two or three people but I believe that being able to answer the question "Who is the CEO?" is important. In fact, it's probably a bad sign if it even needs to be asked. The counter example people often use here is Sergey and Larry but if you speak to people who knew the two of them from the early days, you'll hear that Larry was always the dominant founder.  Over time, one founder usually emerges as the public face of the company e.g. Steve Jobs, Bill Gates, Mark Zuckerberg. Of course they're not the only ones doing the work but you should decide early on how important being this person is to you.  If you find yourself having simmering resentment that you're not the CEO on day one, it's unlikely those feelings will dissipate over time.  


Sometimes one founder will be more committed to the startup than the others, even if the equity split is equal. Perhaps one founder came up with the idea and recruited his friends, who wanted to try out a startup but aren't as passionate about the idea.  This can turn out not to be a problem if the startup hits some reasonable growth (growth is usually a solution to such ails as long as it continues). If not, the "attached" co-founders might start wondering whether they really hated it as much at BigCo as they thought or start debating whether they should return to grad school. In particular if the "main" founder is seen as the public face of the company, the others may not feel as though their personal reputation/identity is intertwined with the startup and thus they have less to lose by leaving. An extreme example of this is when a non-technical founder convinces a technical founder to join the company and gives them 10% or less of the company. Such relationships rarely (if ever) work out.

Uneven equity splits

It's not necessary to have 50/50 equity splits all the time but there should be a good justification for moving away from it dramatically. If one founder came up with the idea, is investing money, has spent a decent period of time working on it, built the first version of the product and found an initial group of users then it can make sense. However if you're still at the idea stage and one founder has significantly less of the company, this can often cause simmering resentment.  In particular this causes problems for companies that started outside of Silicon Valley and move here. The founder with less % will start realizing during conversations with other founders that 50/50 is the most common configuration and inevitably start questioning why that isn't the case with him/her. Remember that if the startup is successful, you'll be working on it for the next 5 - 7+ years of your lives. The majority of the work lies ahead so compensate accordingly.

Different priorities

People enjoy and value different things. To some, solving hard technical problems is more important than anything else. That's great if your company is e.g. Dropbox but not so great if you're starting Airbnb.  If one founder places an emphasis on design above all else while the other treats it as an unnecessary luxury, there will always be constant tension between the two. You might argue that this works fine provided there are clear divisions of responsibility but such divisions are not so black and white at the early stages of a startup. Resources are finite and stretched, it's unlikely you'll be able to accomodate differing top-level priorities, which will seep into the prioritization of everyday tasks. There are broader versions of this e.g. different approaches to work/life balance, different personal weightings of goals such as money/power/status.

Lack of candour

This isn't as specific a cause as the others but I've noticed it a lot so it seems worth mentioning. Sometimes I'll see a team acrimoniously break-up one day over a seemingly trivial thing, despite having seemed calm and fine for months. It almost always turns out there was some simmering ongoing issue that neither founder brought up e.g. perhaps one feels like the other doesn't meet deadlines often enough. Not bringing up these issues immediately causes them to build up over time, where each incident by itself doesn't invoke full-out rage but one day something snaps .  This often happens with shy hackers who don't enjoy dealing with confrontation.  You're doing yourself a disservice if you don't bring up what's on your mind. If you feel like you can't, then you should probably question whether you have the right co-founder. I don't know if this is a recipe for fixing a relationship, it may be that this is just the sign of a broken one, but I do know that these things never just go away by themselves.

Have you encountered or experienced other causes?

Should you find yourself in this unfortunately position of breaking-up, Elad wrote a great blog post detailing your options for dealing with things.