Connect your app to health data and AI. @YCombinator, @generalcatalyst

Joined November 2021
The triathlon legend @AliBrownleetri is awarded an OBE by Prince William, Prince of Wales The only triathlete to win two individual Olympic gold medals Congrats Al!
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1/ How wrong can your wearable's VO₂max be? I compared lab tests with rest scores for 21 people. The biggest miss: a very impressive 87 in the lab vs 51.
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Apple may have just made one of the most important moves in consumer health. Not because Health Age or Readiness will be perfectly accurate. They won’t be. The interesting shift is from wearables recording data to interpreting it well enough to change behaviour. I really enjoyed digging into the science behind it, especially the population problem, and the fact that inputs like wearable VO₂ max are already estimates. The real innovation may be making complex health data simple enough that people actually do something with it. Link below. @TerraAPI #DigitalHealth #Wearables #HealthTech #Longevity #SportsScience
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OpenAI had no product plan. Fusion was 50 years away. AI could never replace doctors. Vinod Khosla looks at what technology can make possible, not what looks reasonable today. My full conversation with @vkhosla: 0:00 Intro 1:51 When “Do What Users Want” Is Wrong 4:58 Workers, Not Tools for Workers 7:52 The Most Important Founder Decision 10:45 Four Years Destroyed by Polite Investors 12:07 Sam Altman’s Hardest Problem 15:39 Follow the Talent, Not Today’s Failures 16:55 When Every Telecom Company Bet Against TCP/IP 21:13 How European investors ruin companies 23:41 Drug Interactions Kill More Than Breast Cancer 26:44 'I'm getting opinions from doctors, not facts' 30:27 Doctors 73%. AI 88%. Doctors + AI 76%. 36:08 $1T of Healthcare Expertise Should Be Free 38:54 Why the AMA Opposes AI Doctors 41:39 Going Founder Mode on Cancer 44:07 Removing Human Drivers Could Save 30,000 Lives 48:02 Epic Still Runs on a 1960s Language 51:02 Impact Over IRR. OpenAI Made No Sense. 54:17 Light-Rail Capacity Inside a Bicycle Lane
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final climb of Norseman felt like I was slowly falling apart. The data says I was doing almost exactly the opposite. On Saturday, I finished second at the Norseman Extreme Triathlon in 10:18:19. The race combines a 3.8 km swim, a 179 km bike with more than 3,000 metres of climbing, and a marathon finishing at the summit of Gaustatoppen, 1,831 metres above sea level. It is often described as the world’s toughest triathlon. Whether it is or not is subjective. It was certainly very tough. The day itself felt messy and unpredictable. Once I looked at the files, however, a much more coherent story appeared. I paced the swim sensibly, completing it alone in around an hour at roughly 1:35/100 m. I desperately wanted to follow the swimmers ahead, but I knew my limited swim training meant I could probably hold their feet for three to five minutes before paying for it. On the bike, that restraint disappeared, and I was far too optimistic. I rode the steepest part of the opening climb at around 354 W normalised. Later climbs of a similar character were closer to 285–300 W, a massive decline of roughly 15%. The numbers are fairly blunt: I started too hard. The most interesting finding, though, came from the run. I averaged 4:15/km over the flat opening 25 km. On Zombie Hill, that fell to 6:43/km, and on the final off-road climb to the summit it dropped to 11:51/km. Looking only at pace, it appears to be a spectacular collapse. But horizontal pace is a poor measure when the terrain changes so dramatically. My vertical ascent rate was about 726 metres per hour on the road climb and 716 metres per hour over the off-road summit section. A difference of only 1%. Even during the final grind to the summit, when I was hiking more than running, my climbing rate was still around 766 metres per hour. What felt like a dramatic deterioration was actually remarkably consistent output on increasingly difficult terrain. That is probably the clearest lesson from Norseman. It does not simply reward the biggest engine. It rewards the version of your fitness that remains after eight, nine or ten hours, and the mental flexibility to adapt when the race you planned is no longer the race you are doing. Kristian Grue was in a league of his own and defended his title in 9:53:46. Hans Christian Tungesvik finished just 36 seconds behind me, having forced me to find a little more speed in the final kilometre than I thought I had left! I am at least 5% below my old power for this kind of effort and more sensitive to high-intensity efforts than I used to be. But the residual fitness is still there, doing enough to let me take on adventures like this. That feels like a pretty good version of retirement. Link to the full research article below @TerraAPI #Norseman #ExtremeTriathlon #PerformanceData
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Most people still think cycling to work is the slower option. Better for your health, better for the environment. But slower. I wasn’t convinced, so I looked at the data. I matched commute looking cycling activities against both TfL journey times and Google’s rush-hour driving estimates. The result surprised me. On 1,628 fully matched weekday commutes: • Cycling beat @TfL estimates on 92% of journeys, with a median saving of 15 minutes. • Cycling beat Google’s rush-hour driving estimate on 75% of journeys, with a median saving of 5 minutes. The busiest commuting corridors into central London were the most striking. Routes from places like Hammersmith, Wandsworth and Clapham to the City consistently favoured the bike, often saving well over 10 minutes. One result I didn’t expect was that the advantage didn’t disappear on longer commutes. I assumed the Tube would become increasingly competitive. Instead, cycling continued to perform remarkably well. That may reflect a group of committed cyclists, or the fact that people are more likely to ride longer distances when the transport network is disrupted. There are important caveats. This data only tells me about the recorded bike activity, not necessarily the entire door-to-door journey. Some people may combine cycling with walking or public transport, while the TfL and Google estimates are complete origin-to-destination trips. So this isn’t a perfect race between transport modes. But the overall pattern is hard to ignore. For many London commuters, the bike isn’t just the healthier choice. It’s the faster one. I’d happily ride even if it took a few minutes longer. I used to commute to school by bike, and still ride E-bikes as much as I can. Fresh air, a bit of movement before work, and seeing London from street level beats sitting underground. It turns out I often get there sooner as well. What’s your experience? Has cycling changed the way you commute? Full research linked to below #activetravel #healthdata #commuting
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"If my doctor disagrees with ChatGPT, I change doctors." @vkhosla about the future of healthcare at the @TerraAPI x @ycombinator startup school dinner: “AI is the only way to scale medicine to be the highest quality. And it’s the only way to be objective, because humans have biases.” "There will be more than one breakthrough companies. Healthcare has too many large niches for there to be only one" The $4 trillion US healthcare system has four rough buckets: 1. Expertise 2. Diagnostics, testing and imaging 3. Drugs and therapeutics 4. Hospitals and critical care Mental health, primary care, chronic disease management, gastroenterology, neurology and endocrinology will be nearly free. “All these things will cost $2 an hour, not $400 an hour, delivered by an AI” “There is zero chance your oncologist remembers the last 5,000 articles on breast cancer that were published, usually in the last year or two. The volume of literature is so high, no human being can keep up.”
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"It's better to be brutally honest than hypocritically polite" - @vkhosla The fireside chat was full of wisdom. Thank you sir and @TerraAPI. We see great innovations happen from places where failures are not treated bad, encouraging people to take risks. Always have your own objectives on why you want to start your company/work on something. All are valid. Successful people have clear objectives. The biggest impact we are gonna see in is healthcare, data shows AI are better than humans in diagnosis and help reduce the false diagnosis and companies backed by khosla ventures showing more than 90% compared to 73% accuracy by humans. #YCStartupSchool @ycombinator #AIxHealthcare
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Terra API retweeted
Perhaps the most @vkhosla line of the night: If his doctor’s answer differs from ChatGPT’s, he is more likely to replace the doctor. His broader point was about agency: take ownership of your health, question conclusions, and even go “founder mode” on cancer. I had the chance to hear Vinod Khosla in person for the first time at the YC Health × AI fireside hosted by @TerraAPI last night. I left incredibly energized. He is every bit the legendary investor and first-principles thinker I had imagined. The message that touched me most was simple: Dream bigger. Take bigger risks. Be willing to fail. What does “big” mean? Healthcare is one example. The world’s best medical knowledge already exists, but most people cannot access the world’s best doctors. AI may be the only way to scale the best medicine to everyone. Another important question was: Who should you listen to? Don’t automatically ask your friends. Are they actually qualified to advise you? Advice from people shaped by large organizations may not help you create a breakthrough. Listen carefully, but have your own reasons and judgment. He mentioned telling Sam Altman something to the effect that nobody around him is fully honest with him. That is why honest disagreement matters. The same applies to customers. Users can describe their problems, but they do not always know the transformation they want. A founder cannot simply say yes to every request. Return to your mission. Decide what should exist. Think from first principles. After the talk, I kept thinking about one question: How do I learn to dream bigger? When I internalized it, I realized I already had my own answers: - Trust myself and remember my purpose - Think from first principles and long term - Start with a focused niche, get fast feedback and early wins, then build toward something much larger - Become more willing to take risks and fail This is something I need to improve. Entrepreneurs make things happen. Time to make it happen.
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Wrapping up YC SUS Day 1 with Health X Khosla @vkhosla @TerraAPI Enjoyed discussion about scaling healthcare with AI. Good creatine gummies too.
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Terra API retweeted
Thanks to @TerraAPI for hosting @vkhosla. Genuinely one of the best talks I’ve ever heard.
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Marketing in SF has reached the sky too not just billboards. @TerraAPI
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Should you stack cold plunge after sauna? We analyzed ~36,000 sauna and cold plunge sessions to find out. Sauna alone wins for recovery. Sauna raises HRV and lowers nighttime heart rate - both the night of and the night after - even after controlling for workouts, alcohol, illness, and stress. Cold plunge alone barely moves the needle. Only 1 of 6 measures was clearly positive. Combining them gives the same heart rate drop as sauna alone, with no extra HRV benefit. The cold isn’t adding anything meaningful on top of the heat.
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Does heat slow runners down, or make them slow down? I studied 3,361 outdoor runs from 878 users, matched against hourly temperature data. A run starting at 25°C was, on average, ~10 sec/km slower and 1.3 km shorter than a run starting at 5°C. But heart rate stayed broadly flat. I expected heat to show up as higher cardiovascular strain at the same pace. It didn’t. The data suggested something different: Runners slowed down slightly, shortened their runs, and kept their effort under control. Wearable data is often treated as pure physiology. But it also captures behaviour. The choice to go out, to go harder, to ease up, to turn back early, or to self-regulate before the body forces you, each reflects a conscious decision. It seems the heat does not make runners slow down; instead, runners slow down because of the heat
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Who actually plays the most football? We analyzed 30,000+ sessions globally as the 2026 World Cup gets underway Chileans top the world at 4.1% logging football regularly - Guatemalans and Hondurans follow Norwegians lead Europe, and nearly a third of their sessions - and those of Brits - happen on Mondays The countries hosting this year's tournament aren't anywhere near the top
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Did you know that eating late meals affects not only your sleep but your heart rate, too?! This was quite hard for me to wrap my head around. At @TerraAPI Research, we analysed thousands of nights of wearable data to explore whether late eating meaningfully impacts sleep. Not in a lab, not in a controlled setting, but in the messy reality of everyday life. There is a relationship between late eating and sleep. Eating closer to bedtime is associated with slightly worse recovery, as evidenced by higher heart rate, later sleep onset, more awake time and small changes in sleep structure (although sleep structure measured with wearables should be taken with a pinch of salt), but the magnitude is modest. If you’re interested, link to the full research is in the comments below
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“The best founders pattern match on success, not failure - and stay ridiculously, stupidly optimistic.” @gralston is the former President of @ycombinator, the true internet pioneer with exits to Yahoo and Apple. He is now running @SAIFVC, since ‘Humanity is running on a tight rope right now’ We discussed: 0:00 Introduction 2:10 Why Silicon Valley celebrates startups 4:45 The single venture deal that created Sand Hill Road 7:55 Startup timing 11:20 The moment he quit HP 16:40 @paulg acquisition framework 26:10 Startups die from suicide 30:50 How to tell if someone is actually better than you 34:20 The day Zuck killed his company in one decision 38:55 The Steve Jobs lesson that still guides him 42:30 The real YC superpower almost nobody talks about 46:40 How far YC can actually scale 54:06 Why AI is more dangerous than people think 01:01:15 Peter Thiel is wrong about competition 01:03:31 Marc Andreessen is wrong about introspection 01:05:18 What he tried to teach his children
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London 'heatwave' with @AliBrownleetri and our running club Run and intervals
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Do people actually sleep better alone or together? Conventional wisdom says having a partner is good for long-term health. In theory a big chunk of that benefit should show up during sleep, our prime recovery window. So I decided to test the hypothesis: Does sharing a bed actually improve sleep and recovery? I analysed a large dataset of wearable sleep records where users had labeled whether they slept alone or with a partner. So what did I find…The results were more nuanced than I expected. • Shared-bed nights showed more awake time (roughly +8-11 minutes) and slightly less total sleep time! I’ll leave it to the reader to hypothesise on this. • Resting heart rate tended to be lower on shared nights in population views, but RMSSD (HRV) was modestly lower. • Alone-dominant users showed more stable night-to-night sleep (lower coefficient of variation). • The patterns held across population, within-person, and lifestyle cohort views, though effect sizes were generally small. The data suggests that, on average, sleeping alone is associated with better sleep continuity (less awake time, more sleep), while the recovery marker story is mixed. Of course, this is all observational. There are clear limitations and potential confounders: people who diligently label their sleep data might not be representative, alone nights often happen during travel, and we can’t cleanly separate causation from correlation. I wouldn’t rush to the spare room just yet. Unless you’re a hardcore recovery optimiser willing to run your own 10+ night experiment (controlling what you can), the data doesn’t scream that sharing a bed is ruining your recovery! Full research in the comments below
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