Yeah, so it’s the Starbucks Story all over again…

About a year ago I switched from regular chewing gum to a brand sweetened with xylitol after learning how it benefits your teeth, I checked the ingredients, saw the word “natural,” and quickly pressed the order button. I hadn’t researched anything. I’d read a label and told myself a story about it. Stupid is as stupid does.

What I Learned Researching this Field Note

A 2025 UCLA pilot study found that chewing gum sheds an average of 100 microplastic particles per gram — some brands as high as 600 — which means a single large piece can release over 3,000 particles, and a regular chewer working through 160 to 180 sticks a year could be swallowing roughly 30,000 microplastics annually from gum alone.

A separate 2025 study out of Queen's University Belfast, using a more sensitive detection method, measured over 250,000 micro- and nano-plastic particles in one chewer's saliva after a full hour with a single piece.

What’s more, the UCLA study did test five "natural" gum brands — and found they shed comparable microplastics to the synthetic ones — but the researchers never disclosed which brands those were.

What I Actually Do

As far a chewing gum goes — nothing. I don’t chew it. Not no mo. To keep up my xylitol routine, I switched to mints.

Rabbit Hole

There's no standardized third-party certification for "plastic-free chewing gum" the way there's USDA Organic for food or TÜV/BPI for compostable packaging. What you'll find instead is self-declared marketing — brands that list a fully disclosed “natural” chicle base instead of the catch-all "gum base" term, and lean on the word "plastic-free" without a certifying body behind that specific claim.

Under FDA rule 21 CFR 172.615, every ingredient inside a gum’s base can be listed under one word: “gum base.” Under this umbrella, approved ingredients include Polyisobutylene, the plastic in tire inner tubes, and polyvinyl acetate, the polymer in wood glue. No brand is required to say which of the 46 approved substances they used.

I searched high and low for a plastic-free gum and found the UK product Milliways. The ingredient list is seven items, chicle (a natural latex sap) is named directly, no “gum base” catch-all. Milliways’ own marketing calls itself “the only gum brand in the UK to be certified biodegradable and plastic-free.”

I looked for the certifying body behind that claim — BPI and TÜV Austria are the two real organizations that certify biodegradability, and I could not find Milliways listed on either registry, on their own site, or in any press coverage I read. Nobody, as far as I can find, has run Milliways through the same saliva analysis UCLA or Belfast ran on the anonymous ten brands. Full ingredient disclosure is real and laudible. “Certified plastic-free” is a claim I can’t verify.

I’m not switching to Milliways. Until a proven third-party tests the actual product it doesn’t go in my mouth on the strength of an unverifiable marketing claim.

Verdict

The correction here is admitting I that bought a story instead of a fact — and I’m not doing that twice in the same piece. Super-stupid is as stupid does repeatedly.

After searching for a xylitol mint that does not contain “natural flavors” — a legal catch-all (like "gum base”) that can hide dozens of undisclosed compounds behind one vague term —

I landed on Peppersmith, a well-established UK brand with flavoring (in this case mint oil) sourced from a named single farm in Hampshire, England — steam-distilled and disclosed, not sourced-and-blended-from-unnamed-suppliers the way "natural flavors" legally allows.

Trying, probably failing, to be less stupider.

Studies Cited

Lowe, L., Leonard, J., & Mohanty, S.K. (2025). Ingestion of microplastics during chewing gum consumption. Journal of Hazardous Materials Letters, 6, 100164. https://doi.org/10.1016/j.hazl.2025.100164

Pant, U., Tate, J., Birse, N., Liu, X., Elliott, C., & Cao, C. (2025). Nanoparticle-on-film SERS for assessing micro- and nanoplastics released into the oral cavity from chewing gum. Journal of Hazardous Materials (publication cited via Queen’s University Belfast press release; DOI unconfirmed — preprint available at SSRN). Preprint: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4993352 | University release: https://www.qub.ac.uk/News/Allnews/2025/StopchewingNewresearchrevealstheshockingnumberofmicroplasticsinasinglepieceofgum.html

Fox News. “Chewing gum, even ‘natural’ ones, can release microplastics in saliva, study says” (confirms UCLA researchers did not disclose the ten tested brand names). https://www.foxnews.com/food-drink/chewing-gum-may-release-thousands-microplastics-saliva-study-says

U.S. Food and Drug Administration. 21 CFR § 172.615 — Chewing gum base (primary regulatory text; source for the 46-substance count and open GRAS clause). https://www.ecfr.gov/current/title-21/chapter-I/subchapter-B/part-172/subpart-G/section-172.615

Milliways company claims (”certified biodegradable and plastic-free”) sourced from Milliways’ own site and press releases, not independently verified: https://www.milliwaysfood.com/pages/marks-spencer-meets-milliways | https://www.prnewswire.com/news-releases/milliways-plastic-free-chewing-gum-brand-raises-3-million-to-accelerate-us-growth-302673344.html

Peppersmith. Ingredient sourcing claims (Hampshire farm, steam-distilled mint oil) sourced from the brand’s own site, not independently verified: https://peppersmith.co.uk/pages/ingredients

^{Some links in this post are affiliate links, meaning I earn a small commission if you purchase through them — at no extra cost to you. I have a simple rule: I only link to products I actually use myself. Not products I've been sent, not products I've been paid to mention — products that have earned a place in my own routine after my own research. The commission helps keep this publication going. The recommendation is the same either way.}

Here’s a story that makes me look “totally sane.” After I first moved to Los Angeles, in my 20’s, I house-sat a friend’s apartment for a few weeks while I got my footing. He was a working actor so was always away on film shoots. Sweet deal for me.

He had this huge bag of Hershey’s Cookies ‘n’ Creme mini-bars sitting in the cupboard. I love white chocolate, so I ate one. Then another. I didn’t decide to keep going, and yet, in a few hours, the entire two-pound bag was gone. That afternoon I went out and bought a replacement bag so my friend wouldn’t know.

The next morning, I bought another bag to replace the replacement bag.

I wasn’t actually hungry when I ate any of it. It felt more like the food itself had hijacked my brain. Years later, once I started actually reading the research, I found out that “hijacked” is a lot closer to the truth than I expected.

Breakfast is my favorite meal. Who am I kidding, every meal is my favorite meal, but especially breakfast — which for years consisted of American breakfasty things: toast, bagels, muffins, cheesy eggs, sugary cereals, fruit juice, bacon, hash browns, pancakes, etc. The yoozh.

And, throughout all those years, no matter how much I ate, I’d be pillaging the kitchen again within the next few hours and careening towards a post-sugar coma by early afternoon.

After many ignorant years of weight gain and IBS, I finally learned that — for me — a breakfast of protein, fiber, good fat and just a few, specific carbs for breakfast — kept my binge-prone brain from hijacking my diet and improved my life dramatically.

What I Actually Do

Breakfast is two courses, every morning: the spiced eggs from Daily Routine IV, then the chia skyr bowl. I get back from the sunrise walk with the chia seeds already thirty-plus minutes into their soak in homemade kefir — that’s where Daily Routine III left off.

NOTE: At first blush, this may seem like a lot. It’s routine for me now, so it feels easy, but go at your own pace. Work your way up to the kefir or flax if you need to.

Here’s the full build for “The Chia Skyr Yogurt Bowl”:

• The chia-kefir soak

  • 1 tbsp chia seeds, pre-soaked 30+ minutes in—

  • ½ cup homemade kefir

• 1 cup skyr “yogurt”

  • Icelandic Provisions, Siggi’s, etc.

  • I use the low-fat version until I hit my goal weight, then will use full-fat

• 5g creatine monohydrate

• 3 tbsp of barley beta-glucan powder

• 2 tbsp ground flaxseed

  • Ground weekly in a nut grinder — any longer and it can go rancid

  • Stored in an amber, air-tight jar in the fridge

• 1 tsp Ceylon cinnamon (REMOVED! - see below)

• ½ cup organic berries

  • black, blue, straw or rasp — on rotation

Everything goes in the bowl in that order — mix the skyr and chia-kefir soak first, creatine stirred through while the mix still cold enough to mask the texture and metallic after-taste, cinnamon/barley/flax folded in next, berries last so they don’t bleed into everything else.

So the rule became simple: protein and fat lead, carbs are along for the ride, and sugar in that specific fat-plus-sugar combination doesn’t get anywhere near my mouth at breakfast.

Science

The foundational data for protein and fat over carbs to curb appetite is Holt’s 1995 Satiety Index of Common Foods, which fed subjects isoenergetic portions of 38 different foods and tracked hunger over two hours.

Protein content correlated positively with satiety (“fullness”) scores. Fat, on its own, actually correlated negatively — because “protein and fat” aren’t interchangeable satiety tools working the same way. Protein’s effect on fullness is well-established and fairly robust. Fat’s contribution is more about slowing gastric emptying and being calorically dense, not about being independently more filling per calorie.

On the carb side specifically: a 2014 controlled trial found that a high-carbohydrate, low-fat breakfast produced an earlier post-meal glucose peak and crash, and that earlier crash predicted an earlier return of hunger, compared with a low-carb, high-fat breakfast. Sound familiar?

That’s the mechanism behind what I noticed, but it’s not universally settled — a 2025 study in Cell Metabolism directly tested the “glucose spike causes hunger” model and found that while high-glycemic meals did produce the expected glucose and insulin swings, they did not reliably produce more hunger or more eating afterward.

The honest read: the mechanism connecting carbs, glucose swings, and hunger is real, but individual response varies enough that a study can find the opposite of what you’d predict. “But everybody is different” isn’t a hedge — it’s the actual state of the science.

My nose-dive into those Hershey’s bags has a name in the research: hyper-palatable food. A 2019 study developed the first quantitative definition — foods that combine fat and sugar (or fat and sodium, or carbs and sodium) at ratios that essentially never occur together in nature.

These specific nutrient combinations activate the brain’s reward circuitry more strongly than either fat or sugar produces alone, and they do it in a way that overrides the normal signals that are supposed to tell you to stop eating.

That’s a mechanistic explanation, not an excuse — but it’s also not a lack-of-willpower story, which is the part I got wrong about myself for years. Stack that reward-circuit effect on top of the glucose-spike-and-crash pattern from the carbs above and you get something close to what happened in that apartment.

The better approach isn’t complicated, even if it took me years to actually implement it:

Keep hyper-palatable, engineered fat-and-sugar combinations out of the house, and default to foods where protein, fiber, and unprocessed fat are doing the work instead.

There’s no engineered fat-sugar ratio in skyr, kefir, nuts, and berries.

Skyr

What’s in this bowl is skyr, which is not actually yogurt — Siggi’s and Icelandic Provisions both make it with rennet, the same enzyme category used in cheesemaking, which is why food scientists classify it as a strained fresh cheese rather than a cultured yogurt, despite living next to the yogurt in every grocery case in America.

It’s made from skim milk, heated and cultured with live bacterial strains (traditionally heirloom cultures passed down for close to a thousand years in Iceland), then strained hard enough that it takes roughly four cups of milk to produce one cup of finished skyr.

The straining is what makes it useful here. Protein concentrates as whey is removed, landing skyr around 15-18g of protein per 150g serving — modestly ahead of most Greek yogurts at the same weight, and almost entirely casein, the slow-digesting milk protein that (unlike fast-digesting whey) releases amino acids into the bloodstream over hours rather than spiking and clearing quickly.

That slow release is doing real work in this bowl: it’s a big part of why protein-forward breakfasts hold off hunger longer than the Holt satiety data would predict from protein content alone, and it’s the reason skyr works better folded into a slow morning than as a pre-workout shake.

Beyond that, skyr is a dense source of calcium, phosphorus, B12, and zinc, it carries live bacterial cultures into a gut that benefits from the traffic, and — the reason it earned a spot in this bowl over a shake or a bar — it’s slow, filling, and doesn’t ask me to trust my own portion control the way the Hershey’s bag did.

Creatine

Creatine monohydrate combined with resistance training is one of the best-supported supplement interventions in sports nutrition. A meta-analysis specific to adults over 50 found that creatine supplementation during resistance training produced greater gains in lean tissue mass and muscular strength than resistance training alone.

The International Society of Sports Nutrition’s position stand — the closest thing this field has to a consensus document — concludes creatine is both safe and effective for increasing strength and lean mass when paired with training.

Five grams a day, which is what’s in this bowl, is the standard maintenance dose used across nearly all of this research. (Separately, there’s an emerging and genuinely interesting body of research on creatine and cognition — modest effects on memory and processing speed, no clear effect on executive function — but that’s not the reason it’s in this bowl, and I’m not going to borrow that evidence to justify a decision made for a different reason.)

Creapure is the closest thing this category has to a real purity standard: a single, patented, tightly controlled manufacturing process independently verified. I use this brand.

Barley Beta-Glucan and Cholesterol

While oat bran has been the traditional source of beta-glucan, barley beta-glucan carries its own FDA-authorized cholesterol claim after five clinical trials consistently showed lower total and LDL cholesterol from whole-grain and dry-milled barley products at a threshold of ≥3g/day.

In the large intestine, it acts as food for beneficial gut bacteria, promoting a healthy microbiome. This breakdown produces short-chain fatty acids that fuel colon cells and trigger the production of satiety hormones like glucagon-like peptide-1 (GLP-1).

CeraBeta is a 100% non-GMO barley beta-glucan concentrate. Three tablespoons delivers 3.0g — the full clinical threshold in a single serving, alongside 5g of total dietary fiber, 2g of protein, and about 39 calories. That’s a meaningfully higher concentration than you’d get from oat bran, which runs closer to 5-6% beta-glucan by weight.

One disclosure that belongs in this section regardless of the cholesterol claim: barley contains gluten. Anyone with celiac disease or a gluten sensitivity needs to know that before this bowl becomes a daily habit, independent of anything beta-glucan does for their lipids.

Ceylon Cinnamon

Why Ceylon cinnamon specifically, and not the cassia cinnamon found in most grocery stores? This is actually an important safety choice. Cassia cinnamon — the common variety — contains substantially more coumarin, a compound that’s toxic at high intakes.

HOWEVER…

While researching this article, I discovered that almost every brand of Ceylon and cassia cinnamon have been third-party tested and found to include concerning amounts of heavy metals including lead, cadmium, mercury and arsenic — even brands that claimed to be “verified non-detect for all metals” were contaminated.

Lead Safe Mama, a community-funded, third-party, product testing site states the following:

“Conclusion: While Cinnamon may have historically had health-protective properties / beneficial qualities, the contamination levels ubiquitous in modern Cinnamon products likely entirely negate any potential health benefits (at best), and regular consumption of modern Cinnamon (regardless of the type of Cinnamon — but including Ceylon Cinnamon) is more likely to cause harm than to impart benefits.”

I’ll continue to rabbit hole this, but for now it’s bye-bye cinnamon.

Ground flaxseed

Flaxseed’s fatty acids oxidize quickly once ground and exposed to air, room temperature, and light — rancidity that’s both a taste problem and a nutrient-quality problem. Fresh-grinding in a spice-and-nut grinder weekly and refrigerating is standard food-science practice for ground flax, not an idiosyncrasy. I store the whole seeds in the freezer.

On the health-claim side, flaxseed lignans are associated with reduced breast cancer risk in observational studies, and some trials show modest glycemic and lipid benefits. At 2 tablespoons (14g) daily, this bowl lands right at the entry point of that evidence base, and it's in range of the dose (16g/day) shown to meaningfully improve blood sugar and A1C in one trial.

It's still well short of the ≥30g/day sustained for 12+ weeks that the strongest lipid-lowering and lignan-cancer-risk trial data used — nearly all of that higher-dose data comes from diabetic or postmenopausal populations studied at 2-4x this amount — so I'm not claiming this dose delivers those specific outcomes. But 2 tbsp is no longer just a fiber-and-micronutrient afterthought; it's a real, evidence-consistent daily dose in its own right.

Similar to cinnamon, flaxseeds have been found to contain elevated levels of cadmium, which it absorbs from the soil. This brand was flagged in multiple secondary write-ups as the standout low-cadmium performer and is ConsumerLab’s Top Pick for whole flaxseed.

Strength isn’t on my list as its own line item, but it’s the mechanism that permits the physically demanding stuff I want to still be doing decades from now. That won’t happen if I let the muscle mass slide the way fifty-five-year-olds are statistically prone to.

That’s what weight training is actually for, and this bowl is the unglamorous support system behind it: eating in a way that doesn’t leave me hunting for a snack an hour later, giving the training and my body the raw materials they need, and, equally important, my gut the ability to work correctly.

It’s the same simple logic as the walk, the oral care, the water — stack enough of them and they hold up something bigger than themselves. I wish that was Cookies & Cream, but alas…

Studies Cited

• Holt SHA, Brand Miller JC, Petocz P, Farmakalidis E. A satiety index of common foods. Eur J Clin Nutr. 1995;49(9):675-690.
  https://pubmed.ncbi.nlm.nih.gov/7498104/

• Chandler-Laney PC, Morrison SA, Goree LL, Ellis AC, Casazza K, Desmond R, Gower BA. Return of hunger following a relatively high carbohydrate breakfast is associated with earlier recorded glucose peak and nadir. Appetite. 2014;80:236-241.
  https://pmc.ncbi.nlm.nih.gov/articles/PMC4204795/

• Liu Y, Mei H, Xue L, et al., Speakman JR. Testing the carbohydrate-insulin model: Short-term metabolic responses to consumption of meals with varying glycemic index in healthy adults. Cell Metab. 2025;37(3):606-615.e3.
  https://www.cell.com/cell-metabolism/fulltext/S1550-4131(25)00015-4

• Fazzino TL, Rohde K, Sullivan DK. Hyper-Palatable Foods: Development of a Quantitative Definition and Application to the US Food System Database. Obesity. 2019;27(11):1761-1768.
  https://onlinelibrary.wiley.com/doi/abs/10.1002/oby.22639

• DiFeliceantonio AG, Coppin G, Rigoux L, Edwin Thanarajah S, Dagher A, Tittgemeyer M, Small DM. Supra-Additive Effects of Combining Fat and Carbohydrate on Food Reward. Cell Metab. 2018;28(1):33-44.e3.
  https://www.cell.com/fulltext/S1550-4131(18)30325-5

• Chilibeck PD, Kaviani M, Candow DG, et al. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med. 2017;8:213-226.
  https://pmc.ncbi.nlm.nih.gov/articles/PMC5679696/

• Kreider RB, Kalman DS, Antonio J, et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr. 2017;14:18.
  https://doi.org/10.1186/s12970-017-0173-z

• U.S. FDA. Food Labeling: Health Claims; Soluble Dietary Fiber From Certain Foods and Coronary Heart Disease (barley beta-glucan interim final rule). Federal Register. December 23, 2005.
  https://www.federalregister.gov/documents/2005/12/23/05-24387/food-labeling-health-claims-soluble-dietary-fiber-from-certain-foods-and-coronary-heart-disease

• Woehrlin F, Fry H, Abraham K, Preiss-Weigert A. Quantification of Flavoring Constituents in Cinnamon: High Variation of Coumarin in Cassia Bark from the German Retail Market and in Authentic Samples from Indonesia. J Agric Food Chem. 2010;58(19):10568-10575.
  https://pubmed.ncbi.nlm.nih.gov/20853872/

• European Food Safety Authority. Opinion on Coumarin, tolerable daily intake of 0.1 mg/kg bw/day. EFSA Journal. 2004;104:1-36 (reaffirmed 2008).

• Rubin T. Chart Comparing Independent, Third-Party Laboratory Test Results of Popular Cinnamon Products. Lead Safe Mama, LLC.
  https://tamararubin.com/2024/12/cinnamon-chart/

^{Some links in this post are affiliate links, meaning I earn a small commission if you purchase through them — at no extra cost to you. I have a simple rule: I only link to products I actually use myself. Not products I've been sent, not products I've been paid to mention — products that have earned a place in my own routine after my own research. The commission helps keep this publication going. The recommendation is the same either way.}

The pan goes on the stove before I take off my shoes.

That’s not a metaphor — I’ve actually timed it — two eggs, softly scrambled, are on my plate seven minutes after returning from my sunrise walk. The sequencing is intentional. So is everything else about this meal.

What I Actually Do

A tablespoon of extra virgin olive oil in a well-seasoned, non-stick carbon-steel pan on low heat. I crack two organic, pastured eggs before the oil has fully warmed and keep the whole thing moving continuously with a silicone spatula — no hard edges, nothing rubbery. Before they begin to firm up, I mix in about a teaspoon of a spice mix I keep next to the stove in a glass spice jar:

• 1/8 tsp freshly ground black pepper

• 1/4 tsp turmeric

• 1/4 tsp garlic powder

• 1/8 tsp ground ginger

The curds are still wet when I pull them from the pan. The 1/2 tsp of sumac goes on after plating. The whole thing is eaten before the rest of my breakfast. Protein first. This is not an accident.

Down the Rabbit Hole

Extra virgin olive oil contains oleocanthal, a polyphenol compound that inhibits COX-1 and COX-2 enzymes — the same anti-inflammatory mechanism as ibuprofen, delivered at low doses with every meal. A landmark 2005 paper in Nature (Beauchamp et al.) identified this, and the compound’s concentration correlates directly with the oil’s polyphenol content, which is why quality matters. Butter raises LDL; EVOO reduces it — and evidence from RCTs shows it does so without lowering HDL.

In the context of the Mediterranean dietary pattern, EVOO is consistently associated with reduced cardiovascular risk across large-scale trials. At the low heat I use for scrambled eggs, there’s no oxidation concern. There is much more to say about olive oil, which I’ll save for a later post, but this EVOO is the tested and certified high-polyphenol brand I use daily.

On eggs and the cholesterol myth—

The fear around dietary cholesterol is one of the more durable errors in nutrition science.

For decades, the assumption held that eating cholesterol raised blood cholesterol — a hypothesis that has largely collapsed under scrutiny.

A comprehensive umbrella review and meta-analysis published in January 2025 in Nutrition, Metabolism and Cardiovascular Diseases — one of the most thorough analyses to date — found that while egg consumption produces modest increases in both LDL and HDL cholesterol, it has no significant effect on the LDL/HDL ratio. That ratio is what actually predicts cardiovascular risk. The same review found no association between egg consumption and cardiovascular outcomes or all-cause mortality.

On pastured eggs versus the other kind—

Not all eggs are built the same — this is not a marketing claim, it’s a measurable nutritional reality. A 2010 Pennsylvania State University study found that—

—pastured hens produce eggs with roughly twice the vitamin E and twice the omega-3 fatty acids of caged hens, along with significantly higher levels of beta-carotene and vitamin A.

The omega-6 to omega-3 ratio in conventional eggs can run as high as 20:1. In pastured eggs, it falls closer to 2:1 or 3:1. Since chronic omega-6/omega-3 imbalance is associated with systemic inflammation, you’re making a meaningfully better choice when you buy the expensive carton.

On the spice mix (and why the combination matters)—

Four spices go into the pan while the eggs are still liquid.

• Ginger’s gingerols and shogaols are anti-inflammatory compounds that inhibit some of the same pathways as ibuprofen — without the gastrointestinal toll.

• Garlic powder delivers sulfur compounds linked to modest cardiovascular benefits and improved immune function.

• Turmeric’s curcumin is one of the most-studied anti-inflammatory compounds in the human diet, with a substantial body of evidence on oxidative stress and inflammatory markers.

But the reason black pepper and turmeric belong together is a synergy most don’t know about. Piperine — the active compound in black pepper — increases curcumin absorption by up to 2,000%. That figure comes from a 1998 clinical study published in Planta Medica, and it has held up. A small pinch of black pepper next to turmeric is a massive pharmacokinetic upgrade.

On the sumac—

Sumac — Rhus coriaria, the deep red powder I finish the eggs with — has one of the highest measured antioxidant capacities of any culinary spice, with an ORAC value around 312,000 per 100 grams. A 2025 systematic review and meta-analysis found that supplementation at 3g/day or more for more than six weeks produces meaningful reductions in oxidative stress markers and improvements in insulin resistance. A separate 2025 dose-response meta-analysis focused specifically on high-sensitivity CRP confirmed statistically significant reductions in this key inflammatory marker across multiple randomized controlled trials.

Sumac degrades when exposed to heat, so we sprinkle it on after plating. I love the flavor, it adds a citrusy brightness that works. The anti-inflammatory data is what made me start, but now I can’t eat eggs without it.

Why eat eggs first—

A body of research from Weill Cornell’s Comprehensive Weight Control Center, led by endocrinologist Alpana Shukla, has established that the sequence in which you consume the components of a meal produces significantly different metabolic outcomes — even when total calories and macronutrients are identical.

Eating protein and vegetables before carbohydrates blunts postprandial glucose spikes by more than 40%.

A 2025 paper in Diabetes Care confirmed that carbohydrates-last food ordering improves continuous glucose monitor time-in-range and reduces glycemic variability.

Protein first is a meaningful metabolic decision that costs nothing to make.

Verdicts

Two eggs, pastured if you can find them. Cook ‘em low and slow. Don’t fear the cholesterol story — the ratio is what counts, and eggs don’t move it against you. Spice them well. The sumac is doing more than it looks like. And whatever else you’re having at any meal, eat the protein first.

The bucket list items that matter most to me — the physical ones, the ones that require a body that actually works — don’t get done on the back of one good habit. They get done when enough unremarkable decisions compound over enough time.

I devour this every morning. Next week we’ll get to the rest of the breakfast.

Studies

• Beauchamp GK et al. (2005). “Phytochemistry: Ibuprofen-like activity in extra-virgin olive oil.” Nature, 437, 45–46. https://doi.org/10.1038/437045a

• Formisano E et al. [NMCD umbrella review] (2025). “Effect of egg consumption on health outcomes. Nutrition, Metabolism and Cardiovascular Diseases. https://www.nmcd-journal.com/article/S0939-4753(25)00003-1/fulltext

• Karsten HD, Patterson PH et al. (2010). “Vitamins A, E and fatty acid composition of the eggs of caged hens and pastured hens.” Renewable Agriculture and Food Systems, 25(1), 45–54. https://www.cambridge.org/core/journals/renewable-agriculture-and-food-systems/article/abs/vitamins-a-e-and-fatty-acid-composition-of-the-eggs-of-caged-hens-and-pastured-hens/552BA04E5A9E3CD7E49E405B339ECA32

• Shoba G et al. (1998). “Influence of piperine on the pharmacokinetics of curcumin in animals and human volunteers.” Planta Medica, 64(4), 353–56. https://doi.org/10.1055/s-2006-957450

• [Sumac metabolic health systematic review] (2025). “Rhus coriaria L. and Human Metabolic Health: A Systematic Review and Meta-Analysis.” PMC12671535. https://pmc.ncbi.nlm.nih.gov/articles/PMC12671535/

• [Sumac and hs-CRP dose-response meta-analysis] (2025). “Sumac (Rhus coriaria L.) Supplementation on High-Sensitivity C-Reactive Protein Concentrations in Adults: A Systematic Review and Dose-Response Meta-Analysis.” PMC12504994. https://pmc.ncbi.nlm.nih.gov/articles/PMC12504994/

• Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. (2015). “Food Order Has a Significant Impact on Postprandial Glucose and Insulin Levels.” Diabetes Care, 38(7), e98–e99. https://doi.org/10.2337/dc15-0429

• Touhamy S et al. (2025). “Carbohydrates-Last Food Order Improves Time in Range and Reduces Glycemic Variability.” Diabetes Care, 48(2), e15. https://diabetesjournals.org/care/article/48/2/e15/157633/

I suffered from IBS (Irritable Bowel Syndrome) for thirty years because I was an abusive a-hole to my gut microbiome — mostly because I didn’t know it existed. Nowadays, I treat my stomach considerably better, and it has responded the way you would expect anything to behave when you finally stop poisoning it.

Not to brag, but my morning poops are nothing short of exquisite.

THE ROUTINE

This starts immediately after capping the toothpaste.

Sunfiber Water

Fill a jar with 500ml water — I use a masonry jar with milliliter demarcations. Add one scoop of Sunfiber powder. Stir briskly until fully dissolved. And chug.

Start at half a teaspoon for the first week and work up slowly. The goal is a full scoop (5–6g on most labels) once your gut has adjusted. Going from zero to a full dose can lead to discomfort.

The Chia-Kefir Bowl

Add one tablespoon of chia seeds to a bowl. Cover with roughly half a cup of homemade kefir — 100 to 120ml. Leave it on the counter and go for a walk. By the time you’re back (thirty-plus minutes), the chia has fully hydrated and formed a soft, pudding-like base that’s absorbed the kefir completely. This becomes the foundation of breakfast. What I build on top of it is next week’s post.

Making the Kefir

This is the piece most people will skip, and also, in my experience, the most consequential one. Here is the abbreviated version:

Order live milk kefir grains online. Live, not freeze-dried — the microbial diversity in live grains is meaningfully greater. The grains themselves are actually living colonies of bacteria that resemble rice grains, hence the name. Also, there is something called water kefir for those who don’t do dairy.

Add the grains to a clean jar of fresh whole milk. I use local organic, grass-fed, pasteurized milk — never ultra-pasteurized, which alters the protein structure in ways that interfere with fermentation.

Cover with a breathable lid or cloth that allows CO2 to escape; I use a glass sourdough starter jar that works incredibly well. Leave at room temperature for 48 to 72 hours — depending on the ambient temperature and your personal taste.

Strain through a fine mesh strainer into a funnel slotted into a glass milk jug you keep in the refrigerator. Some people rinse the grains with room-temperature water, others don’t bother.

The hardest part is clicking buy on the grains. Every subsequent batch takes just a couple of minutes. The grains reproduce and are self-sustaining indefinitely with basic care — I’ve had mine for close to a year.

THE BACKSTORY

IBS-C is the low-grade, grinding kind — featuring bloating, unpredictable (often unfortunate) timing, and extended bathroom sessions that produce frustratingly little in exchange for your gut-wrenching effort — I suddenly understand that expression!

My wife has long since abdicated any attempt at understanding why men love to luxuriate in the bathroom, though I can now report — somewhat wistfully — that the duration of my APE (Average Pooping Experience) has dropped substantially. The whole enterprise arrives every morning around coffee time with the pleasantly consistent schedule of a Swiss train.

I want to be careful not to oversell this. I have a colonoscopy scheduled for later this year, and the actual biological evidence will be revealed in the aftermath. I know you’ll be on the edge of your toilet seats for the results, which I’ll gladly share.

What changed was not a prescription or a doctor’s visit, but simply eliminating the diet I’d maintained for most of my adult life — built around the four food groups of Coke Zero; salty processed meats and cheese; white flour; and refined sugar. I replaced it with a diet that actively supports the 38 trillion or so microorganisms living in the human gut. Once I stopped treating them like squatters and more like valued tenants, everything changed.

The research increasingly connects an imbalance between good and bad bacteria to IBS symptoms, systemic inflammation, and a range of downstream effects that extend well beyond digestion.

Low fiber meant starved beneficial bacteria. The ultra-processed ingredients brought preservatives and additives broadly unfriendly to microbial diversity. The added sugar compounded the damage.

What I now do in the five minutes between brushing my teeth and putting my shoes on is the opposite. I feed the good bacteria, and then I deliver more of them into my system. That is the entire protocol.

THE SCIENCE

The framework is the synbiotic — the simultaneous delivery of a prebiotic (fuel for beneficial bacteria) and a probiotic (the bacteria themselves). If you’re trying to rehabilitate an ecosystem that’s been underfed for decades, you need both the seeds and the soil amendment.

WATER

After 7–8 hours without water, the body loses fluid through respiration and light perspiration. Multiple clinical studies have shown that many adults show markers of mild dehydration.

A randomized trial found that 500ml of water after a 12-hour overnight fast significantly improved performance on judgment and decision-making tasks. Attention and short-term memory improvements from rehydration are documented across multiple RCTs.

A 2003 study published in the Journal of Clinical Endocrinology & Metabolism found that drinking 500ml of water increased metabolic rate by 30% within 10 minutes, peaking at 30–40 minutes.

SUNFIBER

Sunfiber (the brand name for PHGG — partially hydrolyzed guar gum) is doing the heavy prebiotic lifting. It resists digestion in the small intestine and reinforces the gut barrier.

A 2016 double-blind, placebo-controlled trial by Niv et al. (Nutrition & Metabolism, 108 IBS patients, 12 weeks at 6g/day) found significant improvement in bloating scores versus placebo — bloating specifically, not overall IBS severity, which is worth being precise about. A separate 2019 randomized trial (44 participants, 5g/day, three months) showed stool-form normalization on the Bristol Stool Scale and a significant increase in Bifidobacterium. PHGG has been shown to relieve IBS symptoms across studies at doses of 5–11g/day.

CHIA SEEDS

The chia is doing entirely different work — the gel it produces when hydrated slows the rate at which food passes through the digestive tract, triggering the stretch receptors that signal fullness. It also improves stool frequency and consistency, flattens glucose spikes after meals, delivers minerals like magnesium and calcium, and helps decrease triglyceride levels.

FERMENTED FOODS

A 2025 meta-analysis published in Frontiers in Nutrition (Mukherjee et al.) pooled 19 randomized controlled trials and 4,328 participants and found statistically significant improvements in bowel movement frequency, stool consistency, and overall gastrointestinal symptom scores in healthy adults consuming fermented foods.

The landmark reference is Wastyk et al. (2021), published in Cell: a randomized trial in which 36 healthy adults were assigned to either a high-fermented-food diet or a high-fiber diet for ten weeks.

The high-fiber group’s microbiome diversity remained stable on average while—

—the fermented-food group showed consistent increases in gut microbiome diversity and significantly decreased levels of 19 inflammatory proteins in blood serum.

KEFIR

Homemade, grain-based kefir is one of the very few common fermented foods that delivers both bacteria and yeasts. (Kombucha, which I loathe, is another, but a 2024 study found that it added nothing to gut microbiome diversity).

In some analyses, kefir has been found to deliver between 30 and 61 distinct strains of yeast and bacteria, whereas standard yogurt has 2.

Note that we’re talking specifically about homemade kefir. Studies have found widespread label inaccuracy in commercial probiotic products. Most commercial kefir brands strip out the yeasts, which cannot be easily stored long term — they release CO2 which deforms the packaging.

Kefiran is a compound unique to grain-based kefir. In animal and cell studies, it dials down inflammation — specifically the chemical messengers your immune system fires when it's running in chronic low-grade overdrive — and acts as an antioxidant.

Separately, during fermentation the bacteria and yeasts digest the milk proteins, breaking them into smaller fragments. In animal and lab studies, these fragments inhibit the same enzyme that common blood pressure medications target — though the human RCT evidence on kefir and blood pressure is not yet conclusive.

The gut microbiome supports energy, mood, and cognitive stamina — which are the substrate for every physical, mental, and social item on the bucket list. Without them, the list is just a document.

Thirty years of a gut that quietly dragged on my life cost me more than I knew at the time; the tax on energy and optimism is real and it compounds.

Five minutes before a walk, building a protocol that my gut microbiome actually benefits from, is not a glamorous intervention. It is, however, the highest-leverage five minutes in my morning — and the one I’m most confident I’ll be glad for when the colonoscopy results come back.

CITATIONS

WATER

Boschmann, M., Steiniger, J., Hille, U., Tank, J., Adams, F., Sharma, A. M., Klaus, S., Luft, F. C., & Jordan, J. (2003). Water-induced thermogenesis. Journal of Clinical Endocrinology & Metabolism, 88(12), 6015–6019.
https://doi.org/10.1210/jc.2003-030780

Edmonds, C. J., Crombie, R., Ballieux, H., Gardner, M. R., & Dawkins, L. (2013). Water supplementation after dehydration improves judgment and decision-making performance.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7271046/

SUNFIBER / PHGG

Niv, E., Halak, A., Tiommny, E., Yanai, H., Strul, H., Naftali, T., & Vaisman, N. (2016). Randomized clinical study: Partially hydrolyzed guar gum (PHGG) versus placebo in the treatment of patients with irritable bowel syndrome. Nutrition & Metabolism, 13, 10.
https://doi.org/10.1186/s12986-016-0070-5
https://pmc.ncbi.nlm.nih.gov/articles/PMC4744437/

Yasukawa, Z., Inoue, R., Ozeki, M., Okubo, T., Takagi, T., Honda, A., & Naito, Y. (2019). Effect of Repeated Consumption of Partially Hydrolyzed Guar Gum on Fecal Characteristics and Gut Microbiota: A Randomized, Double-Blind, Placebo-Controlled, and Parallel-Group Clinical Trial. Nutrients, 11(9), 2170.
https://doi.org/10.3390/nu11092170
https://pmc.ncbi.nlm.nih.gov/articles/PMC6769658/

FERMENTED FOODS

Mukherjee, A., Farsi, D. N., Garcia-Gutierrez, E., et al. (2025). Impact of fermented foods consumption on gastrointestinal wellbeing in healthy adults: a systematic review and meta-analysis. Frontiers in Nutrition, 12, 1668889.
https://doi.org/10.3389/fnut.2025.1668889
https://pmc.ncbi.nlm.nih.gov/articles/PMC12549620/

Wastyk, H. C., Fragiadakis, G. K., Perelman, D., et al. (2021). Gut-microbiota-targeted diets modulate human immune status. Cell, 184(16), 4137–4153.
https://doi.org/10.1016/j.cell.2021.06.019

KOMBUCHA

Ecklu-Mensah, G., Miller, R., Maseng, M. G., et al. (2024). Modulating the human gut microbiome and health markers through kombucha consumption: a controlled clinical study. Scientific Reports, 14, 31647.
https://doi.org/10.1038/s41598-024-80281-w
https://pmc.ncbi.nlm.nih.gov/articles/PMC11686376/

KEFIR — BLOOD PRESSURE / BIOACTIVE PEPTIDES

Amorim, F. G., Coitinho, L. B., Dias, A. T., et al. (2019). Identification of new bioactive peptides from Kefir milk through proteopeptidomics: Bioprospection of antihypertensive molecules. Food Chemistry, 282, 109–119.
https://doi.org/10.1016/j.foodchem.2019.01.010

Rashidbeygi, E., et al. (2025). The Effect of Kefir Consumption on Blood Pressure and C-Reactive Protein: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Endocrinology, Diabetes & Metabolism.
https://doi.org/10.1002/edm2.70124

There’s a woman at my local gym who has never once considered the existence of an inside voice. She holds court in the sauna like she’s giving a TED Talk — thick accent, full volume, zero awareness that she’s essentially screaming inside a small, crowded, cedar-lined box created to instill a sense of relaxation.

A few months back, a father came in with his special needs son, both regulars. The woman had already rocketed into her usual soliloquy, bellowing about her daughter’s brilliance in medical school. The son, quickly reaching his limit, began huffing and muttering under his breath, finally responding loudly to the woman with one of two phrases, delivered with perfect timing and context:

WOMAN: (shouting) JUST LAST WEEK, MY DAUGHTER TOLD ME—

SON: Spaghetti meatballs.

WOMAN: (taken aback) Uh. Anyway, her professor SAID THAT MY DAUGHTER WAS THE BEST—

SON: Bart Simpson! Spaghetti meatballs!

Every night my family hounds me for the latest “Sauna Story” overheard in, as I’ve come to call it, “The Sardine Sweatbox.” More importantly, my family has adopted “spaghetti meatballs” as code for anyone talking uncomfortably loud in public. You’d be surprised how many opportunities we’ve had to use it.

Despite the routine insanity, the sauna has become a mainstay of my routine.

THE RABBIT HOLE

Back near the beginning of the Selfaissance, I stumbled across a YouTube video (it’s long, so best listened to as a podcast) discussing the health benefits of sauna. To that point, my sauna history dated back to my childhood when I was grounded for peeing on the hot rocks at a ski hotel.

What I found is that the sauna — specifically dry heat (not infra-red) at a minimum of 160°F, used consistently — has some of the most compelling longevity data in the habits space. Long-term, large-population, decades-long data.

THE SCIENCE

The landmark work comes from a Finnish research team led by Dr. Jari Laukkanen, who followed over 2,300 middle-aged men in eastern Finland for more than twenty years. Finland is arguably the only country on earth where you can get this kind of sauna data, because a Finn without a sauna is like an American without a TV — technically possible, but culturally suspicious.

Laukkanen found that compared to men who used the sauna once a week, men who used it four to seven times per week had a 63% lower risk of sudden cardiac death, a 48% lower risk of fatal coronary heart disease, and a 40% lower risk of all-cause mortality. A separate analysis from the same cohort found that the most frequent users had a 66% lower risk of dementia and a 65% lower risk of Alzheimer's disease, compared to once-weekly users.

These are massive numbers.

To be precise, this is observational data, meaning the researchers tracked what people did and what happened to them over time — they didn’t randomly assign people to saunas. So the relationship is association, not proven cause. Frequent sauna users may also have other healthy habits that contribute. But the dose-response relationship — more sessions per week, better outcomes, consistently — is the kind of pattern that earns serious scientific attention. And twenty-plus years of follow-up on thousands of people is not a small study.

The cardiovascular and longevity data is the strongest case. The cognitive data is striking enough to take seriously even with the observational caveats. Taken together, this is one of the better-studied low-effort habits in the longevity toolkit — and “low effort” is doing real work in that sentence. You sit. In a hot (hopefully quiet) room. That’s the protocol.

WHAT I DO

Six months in, I dry sauna at my local gym — four to five days a week at around 160-175°F — depending on the crowd — immediately after my workout and before I shower. I started at ten minute sessions and slowly built up to twenty over the first few weeks.

I hydrate both before and after. I also leave out any electronics — over time, the heat can create thermal stress on the batteries and cause internal condensation.

That last part might be an underrated benefit — twenty minutes a day in a room where scrolling is not an option.

Just heat, and your thoughts, and Bart Simpson.

STUDIES CITED

• Laukkanen, T., et al. (2015). Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Internal Medicine, 175(4), 542–548. https://doi.org/10.1001/jamainternmed.2014.8187

• Laukkanen, T., et al. (2017). Sauna bathing is inversely associated with dementia and Alzheimer’s disease in middle-aged Finnish men. Age and Ageing, 46(2), 245–249. https://doi.org/10.1093/ageing/afw212

The thing that finally made me take my oral health seriously wasn’t a flossing lecture from my dentist — I’d become exceptionally skilled at ignoring those. It wasn’t a crown that cost $1,800, though that didn’t help.

It was a study reporting that researchers had found a bacterium commonly associated with gum disease — in the brain tissue of Alzheimer’s patients.

Given that all of the information gathered on this blog is only as effective as a consistent application of the habits over time, I’ve decided to lay everything out chronologically, as it unfolds over the course of any single day.

This routine has become second nature to me. Even though schedule — and middle-aged forgetfulness — often preclude a habit or two, I’ve already reaped incredible dividends over the weeks and months of consistent repetition.

Let’s go back to last week’s sunrise wake/walk episode. I’ve tiptoed out of bed, and made my way into the bathroom.

After failing to pee neatly, I’m standing at the sink marveling at the architecture of my bed-head thinking, as I do every day, that I need a haircut. I’ve got a toothbrush in my hand, and I’m about to do something I’ve never done correctly: my oral hygiene routine.

For decades, my version of this was: brush, rinse, leave — one minute on a generous morning. Maybe.

What broke the arrangement was the Selfaissance. One of the first deep dives I took as I started excavating my health was the microbiome — the broader realization that our bodies host something in the range of 38 trillion bacterial cells at any given moment, and that the ecosystem we maintain inside us has consequences vital to our heath and longevity.

I started with the gut, which is very much in vogue these days — pre- and pro-biotics, the gut-brain connection, GLP-1 drugs, inflammation, all the fun stuff. I quickly realized that you can’t really understand the gut microbiome without going upstream to where digestion begins.

In a 2019 paper in Science Advances — that I read twice in a single sitting — a team of researchers had found Porphyromonas gingivalis — the keystone pathogen in chronic gum disease — consistently present in the postmortem brain tissue of Alzheimer’s patients.

They also found that concentrations of the bacterium’s toxic enzymes, called gingipains correlated directly with the same protein tangles that are a hallmark of Alzheimer’s.

In mice, oral infection with the same bacterium led to brain colonization and increased production of the plaques long associated with Alzheimer’s.

The paper’s title used the phrase “evidence for disease causation.” The researchers themselves were careful to note that more work was needed, but their data was not ambiguous.

I have had mild gum disease for most of my adult life. I know this because my dentists have been notifying me, politely, for decades, and I have been nodding, and promising to floss, and doing nothing of the sort. Reading the Science Advances paper in the middle of my mid-life-crisis was a noisy wakeup call.

The gum-brain connection is broader and more complex than a single study. A 2024 systematic review and meta-analysis found that individuals with periodontal disease had a 22% elevated risk of dementia compared to those with healthy gums.

In contrast, a 15-year prospective cohort of older men in Northern Ireland — one of the most heavily adjusted studies to date — found no significant association between clinical periodontitis and dementia onset once confounders like cardiovascular disease were accounted for. What it did find was that keeping more of your teeth was protective, and that men who declined had higher inflammatory markers.

That's the actual state of the evidence: a real signal across populations, a plausible inflammatory mechanism, and at least one rigorous study that should keep us honest about how much we don't yet know.

The routine I now run is built on a dual-toothpaste principle that I want to be upfront about: it’s my synthesis, grounded in the mechanisms of each individual product, but not something you’d find in a clinical guideline. There is no study to back this specific approach, just an overabundance of hubris and far too much time on my hands.

Having said that, it’s been working great for me so far, though your mileage may vary.

TOOTHPASTE

Stannous fluoride toothpaste is the best established tool for killing oral bacteria. This is different than sodium fluoride, which is what most of us grew up using. Stannous fluoride is a different compound, and head-to-head randomized trials show it produces meaningfully greater reductions in gingivitis, gum bleeding, and inflammation.

Meanwhile hydroxyapatite toothpaste contains the mineral that enamel is made of — it integrates into microscopic surface defects and supports remineralization of the softening enamel that the day's acid exposures caused.

Unlike stannous fluoride, hydroxyapatite is thought to be gentler on the beneficial oral bacteria. Using fluoride twice a day may disrupt more of the total oral microbiome than necessary — so we’re using it to kill the bad actors in the morning, then using hydroxyapatite to let the beneficial microbiome stabilize overnight.

NEVER RINSE

After brushing make sure to spit but never rinse. Britain’s National Health Service (NHS) specifically recommends spitting out excess toothpaste and not rinsing, because rinsing dilutes the fluoride and reduces its preventive effect.

As a result, you may end up ingesting a tiny amount of fluoride. For an adult using a normal pea-sized amount, this is generally not a concern. A 2024 study found that a no-rinse method increased fluoride retention in the mouth for up to 30 minutes and did not significantly affect systemic fluoride levels or toxicity markers.

Young children should continue to rinse. Kids are more likely to swallow toothpaste, and too much swallowed fluoride during tooth development can contribute to dental fluorosis. CDC guidance says everyone over the age of 3 should use no more than a pea-sized amount, and children under 3 should use only a rice-grain-sized smear.

TOOTHBRUSH

I use an oscillating-rotating electric toothbrush; a 2024 meta-analysis comparing oscillating-rotating, sonic, and manual toothbrushes found that oscillating-rotating produced a 72% transition rate to gingival health, versus 54% for sonic and 21% for manual.

DENTAL FLOSS

Believe it or not, PFAS (forever chemicals) in dental floss are a real concern, especially with some “glide,” “smooth,” or PTFE/Teflon-style flosses. But don’t stop flossing; just switch to a PFAS-free option.

A 2019 study found that women who reported using Oral-B Glide had higher blood levels of PFHxS, a PFAS (forever) chemical, than non-users. The study was observational, so it does not prove floss caused the higher PFAS levels, but it raised a legitimate concern. More recent consumer testing has found very high organic fluorine, a screening marker for PFAS, in some floss products. (note: Oral-B stated that Glide has since been reformulated, but this has yet to be independently verified)

I avoid floss labeled or marketed as: PTFE, Teflon, Glide, Smooth Slide, Shred-resistant polymer, or Extra-slippery tape-style floss. Not every slippery floss necessarily has PFAS, but that category is where the concern is highest.

My family and I have tested over a dozen different PFAS/PTFE-free flosses over the past year. Nylon. Silk. Bamboo. Waxed. To say that they hated most of them would be an understatement. They either hurt or fray between your teeth or leave a waxy residue that requires, you guessed it, dental floss to remove.

Thankfully — after much griping and cursing at me — we found a brand that holds together and feels the closest to traditional floss.

XYLITOL

Multiple systematic reviews have confirmed that the sweetener xylitol significantly reduces counts of Streptococcus mutans — the primary decay-causing bacterium. The evidence for xylitol’s effect on actual cavity rates at the population level is more contested.

I use xylitol mints specifically for post-meal bacterial disruption, not as a cavity cure, and the evidence for that specific purpose is solid. I also chew several pieces of xylitol gum throughout the day to keep it going.

What I Actually Do

Morning (before the sunrise walk):

I brush my teeth with Parodontax Complete Protection stannous fluoride toothpaste using an Oral-B Pro 1000 electric oscillating-rotating brush, soft bristles, held at 45 degrees to the gumline. The target is the gumline, not the tooth surface. Light pressure. Oral-B makes two fancier versions of this toothbrush: the iO Series 2 which incudes a pressure sensor and two-minute timer, and the iO Series 5 with a connected app and bluetooth, though they brush exactly the same as the cheaper Pro 1000.

After two minutes spit only. No rinsing. Wait at least 30 minutes (one sunrise walk later) before eating.

Throughout the day:

Many Xylitol mints give funky breath, but I found a Finnish brand that work great — i have 1 after each meal, letting it fully dissolve in my mouth. I also chew 3 to 4 pieces of Xylitol gum interspersed throughout the day, when I can remember. The timing actually matters more than the total quantity as the goal is to continually disrupt the post-meal bacterial response, not to ingest it around the clock.

Night:

Before anything else, I floss first with Dr. Tung’s Smart Floss. For the dentaly ambitious you can floss in the morning as well, but once a day is enough and night is the higher-value slot because you’re heading into a low-salivary-flow period where debris trapped between teeth has more time to do damage.

Then brush for two minutes with RiseWell hydroxyapatite toothpaste. Spit. Done.

Everything on my list requires a functioning brain. That is not a metaphor — it is the operational constraint that makes dementia the most feared item in the catalog of aging outcomes, and the one that most of us are slowest to take seriously in our daily behavior.

A solid dental routine is, among other things, a hedge against that outcome, costing nothing except a rinsing habit I had to unlearn, and a flossing habit that I have, like a real life grownup, finally succumbed to. Plus my breath is spectacular.

Studies Cited

• Dominy SS, Lynch C, Ermini F, et al. Porphyromonas gingivalis in Alzheimer’s disease brains: evidence for disease causation and treatment with small-molecule inhibitors. Science Advances. 2019 Jan 23;5(1):eaau3333. DOI: 10.1126/sciadv.aau3333

• Dibello V, Custodero C, Cavalcanti R, et al. Impact of periodontal disease on cognitive disorders, dementia, and depression: a systematic review and meta-analysis. GeroScience. 2024 Oct;46(5):5133–5169. DOI: 10.1007/s11357-024-01240-z

• Farsi DN, Abadalkareem R, Linden GJ, et al. Periodontitis and incident cognitive decline and dementia: a 15-year prospective cohort study of older men residing in Northern Ireland. Journal of Alzheimer’s Disease. 2026;109(2):980–995. DOI: 10.1177/13872877251401563

• Zou Y, Grender J, Adam R, Levin L. A meta-analysis comparing toothbrush technologies on gingivitis and plaque. International Dental Journal. 2024 Feb;74(1):146–156. DOI: 10.1016/j.identj.2023.06.009 (P&G-funded; low risk of bias per authors; P&G conflict of interest disclosed)

• Parakaw T, Srihirun S, Dararat P, Ruangsawasdi N. Kinetics of fluoride after brushing with the no-rinse method. BMC Oral Health. 2024 Sep;24(1):1050. DOI: 10.1186/s12903-024-04807-4

• Geisinger ML, Geurs NC, Novy B, et al. A randomized double-blind clinical trial evaluating comparative plaque and gingival health associated with commercially available stannous fluoride-containing dentifrices as compared to a sodium fluoride control dentifrice. Journal of Periodontology. 2023 Sep;94(9):1112–1121. DOI: 10.1002/JPER.22-0675

• Boronow KE, Brody JG, Schaider LA, Peaslee GF, Havas L, Cohn BA. Serum concentrations of PFASs and exposure-related behaviors in African American and non-Hispanic white women. Journal of Exposure Science & Environmental Epidemiology. 2019. DOI: 10.1038/s41370-018-0109-y (Note: Oral-B Glide has since been reformulated; independent verification of PFAS-free status pending)

• Nasseripour M, Newton JT, Warburton F, et al. A systematic review and meta-analysis of the role of sugar-free chewing gum on Streptococcus mutans. BMC Oral Health. 2021 Apr 29;21(1):217. DOI: 10.1186/s12903-021-01517-z

• Söderling E, Pienihäkkinen K. Specific effects of xylitol chewing gum on mutans streptococci levels, plaque accumulation and caries occurrence: a systematic review. BMC Oral Health. 2025 Jul 29;25(1):1275. DOI: 10.1186/s12903-025-06602-1

  ---

  ^{Some links in this post are affiliate links, meaning I earn a small commission if you purchase through them at no extra cost to you. I only link to products I actually use myself. Not products I’ve been sent, not products I’ve been paid to mention — products that have earned a place in my own routine after my own research. The commission helps keep this publication going. The recommendation is the same either way.}

My previous article on sunrise walks got me thinking. The light, the sounds, the fresh morning air — all of it lands somewhere between meditation and medicine.

But there’s a thing I haven’t mentioned: I almost always have an earbud in one ear. A podcast. An audiobook. Something I’m “learning from.” I tell myself I’m stacking habits — getting my light exposure, exercise, and feeding my brain — and it feels productive. It feels efficient. I refuse to say “optimized” — that goes in the “retch” category with venti soy lattes.

But I’ve been wondering if listening to a book offers the same benefits as reading one. Would I be better off ditching the ear pod to envelop my ears in the dulcet sounds of early morning nature? Also, is reading a paper book better than digital?

Rabbit holes beckoned…

Right off the bat, I was fully surprised to learn that the case for reading is a longevity one. A 2016 Yale study tracked 3,635 adults over 12 years and found that people who read books for more than 3.5 hours a week were 23 percent less likely to die during the study period.

Book readers lived roughly 23 months longer than non-readers. Not magazine readers. Not newspaper readers. Book readers specifically.

In 2026, a study published in Neurology followed nearly 2,000 adults and found that those with the highest lifetime engagement in intellectually stimulating activities — reading and writing chief among them — delayed the onset of Alzheimer’s by five years and mild cognitive impairment by seven. The most engaged group had roughly 40 percent lower risk.

Naturally I wondered if audiobooks give us the same benefit. The truth is, we don't know — the longevity studies measured reading, not listening, so audiobooks weren't tested separately. However…

We do know that reading vs. listening comprehension appears roughly comparable for narrative material — books you read for pleasure.

A 2016 Bloomsburg University study found no significant differences in comprehension between audiobook listeners and e-reader users for a nonfiction narrative. But that study compared audiobooks to screens — not to paper.

A separate study by psychologist David Daniel found that students who listened to a podcast lesson scored nearly 30 percent lower on comprehension tests than students who read the same material in print.

VERDICT: For a novel on the beach? Audiobooks are just fine. For something dense with facts you actually want to retain? The physical page has the edge.

Then there's the screen question. A meta-analysis across 54 studies found that people who read on paper consistently outperformed those who read on screens in comprehension — a phenomenon researchers call the “screen inferiority effect.”

This effect was significant for expository/informational texts, but not for narrative texts.

And not all screens are equal. A Harvard-commissioned study found that e-ink (Kindle, etc.) displays produce two to three times less retinal cell stress than LCD (iPad, etc.) screens. And the circadian data is stark: Reading on an iPad before bed suppresses melatonin by about 50 percent and delays its onset by roughly 90 minutes compared to a paper book. E-ink doesn’t do this, because it reflects ambient light rather than blasting it into your eyes.

VERDICT: For a novel at the beach, or in bed at night? E-ink readers are just fine. For something dense with facts you actually want to retain? Once again, the physical page has the edge. Save the iPad for daytime videos or web browsing.

What I actually do…

Most mornings, I walk with one earbud in — a podcast or audiobook in one ear, the world in the other. I’m not giving that up, but every now and then, I leave the earbud out entirely. I let the tweety-birds and the wind and the silence do the work.

There’s good science behind that too — a concept called Attention Restoration Theory — and the short version is that nature’s quiet complexity recharges the exact cognitive resources you need to focus later. The earbud, even in one ear, blocks some of that.

For bedtime, I am committing here and now to ditch the iPad and read a book on my Boox e-ink tablet, for at least 20 to 30 minutes before sleep.

Incidentally, I chose this model because constantly reaching over to swipe the pages kept me awake. Boox has a Bluetooth device called the Tappy that lets me turn the page with just a small flex of my thumb. I’ve tried other brands with similar devices, but none worked flawlessly.

I also found a great tablet stand that attaches to my bedside table, setting it to the perfect, cock-eyed reading angle when my head is in sleep position on the pillow.

Consuming information in every available moment isn’t the same as learning. Sometimes the most productive thing your brain can do is hold a book. And sometimes it’s to hold nothing at all.

One thing I can say with certainty is that my brain is especially good at the latter.

STUDIES CITED

• Bavishi A, Slade MD, Levy BR. “A chapter a day: Association of book reading with longevity.” Social Science & Medicine. 2016;164:44-48. doi:10.1016/j.socscimed.2016.07.014

• Zammit AR, et al. “Association of Lifetime Intellectual Enrichment With Cognitive Decline and Incident Dementia.” Neurology. 2026. doi:10.1212/WNL.0000000000210434

• Rogowsky BA, Calhoun BM, Tallal P. “Does Modality Matter? The Effects of Reading, Listening and Dual Modality on Comprehension.” SAGE Open. 2016;6(3). doi:10.1177/2158244016669550

• Daniel DB, Woody WD. “They Hear, But Do Not Listen: Retention for Podcasted Material in a Classroom Context.” Teaching of Psychology. 2010;37(3):199-203. doi:10.1080/00986283.2010.488542

• Delgado P, Vargas C, Ackerman R, Salmerón L. “Don’t throw away your printed books: A meta-analysis on the effects of reading media on reading comprehension.” Educational Research Review. 2018;25:23-38. doi:10.1016/j.edurev.2018.09.003

• Harvard T.H. Chan School of Public Health / E Ink. “Effect of Displays on Human Retinal Pigment Epithelial Cells.” Journal of the Society for Information Display. 2023. doi:10.1002/jsid.1191

• Chang A-M, Aeschbach D, Duffy JF, Czeisler CA. “Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness.” PNAS. 2015;112(4):1232-1237. doi:10.1073/pnas.1418490112

• Berman MG, Jonides J, Kaplan S. “The cognitive benefits of interacting with nature.” Psychological Science. 2008;19(12):1207-1212. doi:10.1111/j.1467-9280.2008.02225.x

“Turn your face to the sun and the shadows fall behind you.” —Māori Proverb

MY SLEEP has always been a Jackson Pollock. Hectic. Chaotic. Chronic insomnia with a dose of sleep apnea managed with a mouth guard because I’m too big of a wuss to wear a CPAP. I’d fall asleep, or not, then wake up at 1 AM, 3 AM, 4:30 AM — staring at the ceiling, wrestling pillows, mind flailing, body exhausted but somehow wired. It wasn’t sleep. I was passing out for a few hours and calling it rest. For years.

I’d tried the usual litany. Melatonin. Magnesium. White noise. Sleep podcasts. Expensive mattress. “Cooling” pillows. Nothing stuck because none of it addressed the actual problem.

Then my friend — not a doctor, not a biohacker, just a guy who’d also been sleeping terribly for years — told me he’d started taking a walk to watch the sunrise every morning. Within days, he was falling asleep faster and staying asleep throughout the night. No supplements nor gadgets, just sunlight at the right time.

I thought he was out of his mind. But I was desperate enough to try anything, so the next morning I grabbed my dog’s leash and walked outside at dawn.

That was the beginning of the most significant health change I’ve made in this entire “Selfaissance.”

Thinking this all sounded super fringe-sciencey, I immediately burrowed my way through into a cavalcade of studies on circadian biology. As usual, I couldn’t have been more wrong — this is long-settled science.

Deep in the center of your brain, just above where your optic nerves cross, sits a tiny cluster of about 20,000 neurons called the suprachiasmatic nucleus — the SCN. Think of it as your body’s master clock.

It coordinates when you feel alert, when you feel sleepy, when your body temperature drops, when hormones release, when your cells repair themselves. Every organ in your body takes its timing cues from this one tiny structure.

This clock is ancient. Not centuries old — hundreds of millions of years old. The basic genetic machinery that drives the SCN is found in virtually every mammal, and versions of it appear in organisms as simple as fruit flies. Evolution built this system long before anything resembling a human existed, and it’s been running with Swiss-like precision ever since.

Actually, that’s a lie. The clock doesn’t keep perfect time on its own. Left in total darkness, it drifts — running slightly longer than 24 hours. Every single day, it needs to be reset…

And the reset signal is light.

Our eyes contain specialized cells — only discovered in 2002 — that don’t help with vision at all. Their sole job is to detect the brightness and color of ambient light and transmit that information directly to the SCN.

For all of human history — all 300,000 years of Homo sapiens, and the millions of years of our ancestors before that — these cells have detected the bright, blue-rich light of morning, and told the clock: it’s daytime. Fire up the wake-up sequence. When the light dims and shifts toward the red-orange spectrum of sunset and (as our ancestors were accustomed to) firelight, the signal changes: day is ending. Begin the shutdown.

Thomas Edison—who incidentally called sleep a “criminal waste of time, inherited from our cave days”—patented the incandescent light bulb in 1879, and for the first time in the history of life on Earth, organisms could blast their retinas with bright, blue-spectrum light after sunset. Us humans have been doing it with gusto for the past 147 years, a nano-second of the 300 million years our internal clocks have been ticking.

The problem is simple: evolution doesn’t work that fast. We haven’t adapted yet.

The evolutionary biology of the SCN has been well-documented, going back decades. Meanwhile, the research on what artificial light does to our circadian system is damning and remarkably consistent.

A study published in the Journal of Clinical Endocrinology & Metabolism found that ordinary room lighting — the bulbs in our homes — shortened the body's internal representation of nighttime by roughly 90 minutes in 99% of participants. Not bright light. Not staring at your phone. Just being in a normally lit room in the hours before bed.

A second study from the same research group, published in the Proceedings of the National Academy of Sciences, compared the affects of reading on an iPad vs reading a printed book for four hours before bed. The iPad readers had their melatonin suppressed by 55%, their circadian clock delayed by more than an hour and a half, and they spent less time in REM sleep — the phase most associated with memory, emotional processing, and cognitive recovery. They also took longer to fall asleep and reported feeling groggier the next morning, even after eight full hours in bed.

Conversely, a 2025 observational study in BMC Public Health found that every 30-minute increment of morning sun exposure before 10 AM was associated with a 23-minute earlier sleep midpoint — meaning people who got morning sunlight fell asleep earlier and woke earlier, with better overall sleep quality.

None of this is controversial. It’s well-established biology. But most of us live as if it doesn’t apply to us — lights blazing until midnight, phones blasting our retinas in bed.

We evolved under conditions that no longer exist, and our sleep is paying the price.

After swan diving down far too many rabbity holes, here’s what I do…

I now wake up at the same time every morning. Consistency matters more than any specific hour — the clock needs a predictable signal. For me, that’s usually around 15-minutes before sunrise. At home, I wake automatically. If traveling, I set a backup alarm.

Within minutes of rising, I drink a full glass of water then take my eagerly waiting dog for a 30-minute walk. The destination is nearby hilltop where we can watch the sun appear over the horizon. I don’t wear sunglasses and I don’t fry my retinas staring into the heart of it. The point is to let the long-wavelength red and near-infrared light reach the cells in your eyes that set the clock.

This walk has become my daily anchor and is easily the single most impactful change to my life. No supplement, no device, no food hack has come close to the effect of morning sunlight on my sleep quality, and thusly, the quality of my daily life.

During the day, I get outside as much as possible. Natural light during daytime hours reinforces the signal. If I’m starting at a screen — which I usually am — it’s through medium-red-tinted glasses to cut down the blue light. When possible, I catch a few minutes of the sunset — the shift from blue-dominant to red-dominant light appears to help the transition.

After sunset, I try to wear my darker glasses. Everything I do at night — watching TV, working at my computer, moving around the house — I do through those lenses. They block the blue-spectrum light that would otherwise tell my clock it’s still daytime. I keep the house dim as well — drives my family crazy, but they’re slowly getting used to it.

At bedtime — between 9:30 and 10 as consistently as I can — I read on my iPad. I know I just talked about the study showing iPads suppress melatonin, but here’s the real life version: a reading light bright enough to see a book keeps my wife awake. So I use the iPad’s built-in shortcut that turns the screen fully red — eliminating the blue light entirely. It’s a compromise, not perfect, but it works. Nevertheless, I’m usually zonked within 10 minutes of laying down — a tectonic shift from my former hours of

I keep the curtains open. This was a change I resisted because I assumed darkness was essential for sleep — and it is, during sleep, for most people. But I live out in the country with minimal light pollution, and found that leaving the curtains open lets the earliest pre-dawn light wake me naturally without an alarm. My body is anticipating dawn because it can sense the light shifting. That alone tells me the clock is working.

And the results?

Since I started this protocol, my Apple Watch tells me that I’ve gained over an hour of average nightly sleep. The 1 AM and 3 AM wake-ups have largely disappeared, and when they come they’re short-lived. I fall asleep faster. I wake up feeling rested, not groggy or hungover.

An extra hour doesn’t sound like much until you do the math. That’s seven extra hours of sleep every week. Thirty hours a month. Three hundred and sixty-five hours a year — more than fifteen full days of additional sleep.

Leading an active, aspirational life requires a body and brain that properly recover overnight. You can’t hike the Inca Trail or write the great American novel or be consistently present with the people you love when you’re running on five hours of broken sleep. This is about functioning — and giving yourself enough years and enough good days to do the things that matter.

Sleep isn’t rest. It’s reconstruction. And the blueprint for how to do it has been running in our biology since before our species existed. You just have to stop jamming the signal.

Ra Optics makes both pairs of the tinted glasses I wear. They’re not cheap, and I’m not going to pretend they’re the only option. But they block significantly more blue light than the clear “blue blocker” lenses you see at the drugstore, and they’ve been part of my protocol since the beginning.

Studies Cited

• Gooley JJ, Chamberlain K, Smith KA, et al. Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. Journal of Clinical Endocrinology & Metabolism. 2011;96(3):E463-E472.
  URL: https://pubmed.ncbi.nlm.nih.gov/21193540/

• Chang A-M, Aeschbach D, Duffy JF, Czeisler CA. Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. Proceedings of the National Academy of Sciences. 2015;112(4):1232-1237.
  URL: https://pubmed.ncbi.nlm.nih.gov/25535358/

• Menezes-Júnior LA, Sabião TS, Carraro JCC, et al. The role of sunlight in sleep regulation: analysis of morning, evening and late exposure. BMC Public Health. 2025;25:3362.
  URL: https://pubmed.ncbi.nlm.nih.gov/41053799/

• Beersma DGM, Hiddinga AE. Evolution of time-keeping mechanisms: early emergence and adaptation to photoperiod. Philosophical Transactions of the Royal Society B. 2011;366:2141-2154.

  URL:https://royalsocietypublishing.org/rstb/article-abstract/366/1574/2141/21642/Evolution-of-time-keeping-mechanisms-early?redirectedFrom=fulltext

I pulled into a Starbucks drive-through a few months ago and ordered a “venti soy latte” — a sentence I’m genuinely ashamed to write, and one that has never made me feel whiter or more milquetoast — but I requested it without the plastic stirrer. I felt good about this. Informed, even. I knew that when hot liquids interact with plastic, the plastic interacts right back, shedding microparticles into whatever you’re drinking. No stirrer for this guy. I was protecting my milquetoast self.

The girl at the window asked why. When I blessed her with my knowledge of plastic micro shedding, she smiled patiently then put me in my proper place. “The stirrer is nothing,” she said.

“The real source of plastic isn’t the tiny stick — it’s the lining of the entire cup.”

I sat in my car for a long moment, holding my VSL (venti soy latte —abbreviating still doesn’t excuse it) realizing I’d been worrying about the garnish while ignoring the building.

Hours of rabbit holes later — she was dead right. Every paper to-go cup — Starbucks, Dunkin’, the place on the corner — is lined with a thin layer of polyethylene, a petroleum-based plastic that keeps the hot liquid from dissolving the paper. Without it, your cup would disintegrate in minutes. That lining is roughly five percent of the cup by weight. And when you pour scalding coffee into it, it starts to break down.

Researchers at the Indian Institute of Technology Kharagpur found that hot water left in a standard paper cup for fifteen minutes released approximately 25,000 microplastic particles per 100 milliliters. A venti Starbucks coffee cup is almost six times that volume. Three cups a day, every day, and you’re ingesting quantities of plastic that would sound made up if they weren’t in a peer-reviewed journal.

Why should you care what happens to them once they’re inside you? Because in March 2024, the New England Journal of Medicine published the first study directly linking micro- and nanoplastics found in human arterial plaque with cardiovascular outcomes.

Researchers analyzed plaque removed from the carotid arteries of 304 patients and found that those whose plaque contained detectable plastics had a significantly higher risk of heart attack, stroke, or death over nearly three years of follow-up.

Important caveat: this is an association, not proof that the plastics caused the events — and some researchers have raised legitimate questions about possible sample contamination. But the signal was strong enough to land in the NEJM, which does not publish hunches.

Now here’s the part that should piss us all off…

In May 2025, Starbucks rolled out a redesigned cup across ten European countries that replaces the polyethylene lining with a mineral-based coating made from silicon dioxide — developed by an Italian company called Qwarzo. Same cup. Same logo. No plastic lining. Home compostable. Widely recyclable. Starbucks described the change as compliant with the EU’s Packaging and Packaging Waste Regulation, which takes binding effect in August 2026 and is pushing companies to eliminate plastic from food-contact packaging.

In the United States? Same polyethylene-lined cup they’ve been using for decades. No announcement. No timeline. To be clear, this isn’t a Starbucks hit piece. They’re a business responding to regulatory pressure, which is exactly what businesses do. But it also means that—

Right now, in an American drive-through, you’re drinking from a cup the Germans, Italians, French, Swedish and other countries deem unsafe for human use.

What I Actually Do

After an afternoon of research I bought a Klean Kanteen Reflect — stainless steel, bamboo cap, food-grade silicone. Three materials. No plastic, no paint, no coating of any kind. Thirty-three bucks. It’s not insulated, which means the outside gets surface-of-the-sun-hot when you fill it with coffee — I wrapped a wide rubber band around the middle and that solved it. Worth the tradeoff for a full stainless steel interior with nothing between the metal and your drink. I hand it through the drive-through window and they pour it right in.

Something I just now learned researching this article: if you want insulation, Klean Kanteen’s TKWide line paired with the Insulated Wide Loop Cap gives you double-wall vacuum insulation and a full stainless steel interior — your drink never touches plastic. Most of the other TKWide caps contain plastic components, so the specific cap matters. Look for the Insulated Wide Loop Cap. I just ordered mine.

The specific brand matters less than the principle: if you drink hot beverages every day, stop renting a plastic-lined paper cup and start owning a vessel that doesn’t shed into your bloodstream.

Then again, if, every morning, you’re saying out loud the words, “Venti soy latte,” maybe you deserve a microplastic or two.

Studies Cited

• Raza, Syed Khalid Mustafa, et al. “Microplastics and other harmful substances released from disposable paper cups into hot water.” Journal of Hazardous Materials, 406, 124680 (2021).

• Marfella, R., et al. “Microplastics and Nanoplastics in Atheromas and Cardiovascular Events.” New England Journal of Medicine, 390(10), 900–910 (2024).

THE BUCKET LIST LIFE | Science-backed habits for a longer, healthier, richer, happier life — from the man who invented the Bucket List.

THE STORY

Three of my closest friends from high school have ended up scattered across the country. One has lived on the West Coast for decades. We see each other rarely — once a year if we’re lucky, but recently he was back East, and so two of us traveled to meet him. We found a park and spent a few hours doing what old friends do: talking, laughing at stories heard and told a hundred times, and catching up on each other’s lives in the way that only really happens in person.

My older son came with me. On the drive home, I explained that these friendships matter to me as much as any in my life. Even though my friends and I connect a scant handful of times a year — we pick up exactly as we left off, as if we’d seen each other yesterday. What I didn’t say — because I still couldn’t find the language for it — was that I always feel physically different after seeing them. Not just good, but better, lighter, in some way that runs deeper than mood.

I’ve always wondered if that feeling was real. What I found, when I started actually looking into the science, is not what I expected — and, as it turns out, it surprised some of the most credentialed experts in the longevity field as well.

THE SCIENCE

Last week I watched a conversation between Dr. Rhonda Patrick (her YouTube channel is fantastic) and Dr. Steve Horvath — the researcher who built the original Horvath epigenetic aging clock, still considered one of the most accurate measures of biological age ever developed. They covered two and a half hours of longevity science: caloric restriction, GLP-1 drugs, omega-3s, exercise thresholds, vegetables versus everything else. When the conversation got to social connection, Horvath described a recent study by researchers at Cornell and Harvard as the biggest surprise he’d encountered in the last six months.

A Harvard researcher named Laura Kubzansky had collaborated on a study to measure whether social connection affects biological aging at the DNA level.

Could having good friends end up written into the chemistry of your DNA?

Horvath didn’t think the connection was close enough to even bother testing. She measured it anyway. The result: the GrimAge clock — one of the best DNA-based tools scientists have for estimating a person’s risk of dying earlier or later than expected, validated across studies involving tens of thousands of people — which showed a significant reduction in biological aging among people with rich, sustained social connections. The pattern showed up across every aging test they ran, especially the ones most closely tied to lifespan. The clearest takeaway was that strong social connections appeared to be linked with slower biological aging.

The paper, published in September, 2025 in Brain, Behavior and Immunity — Health by Anthony Ong, Frank Mann, and Laura Kubzansky, drew on 2,117 adults from the long-running Midlife in the United States (MIDUS) study. The researchers measured what they called “cumulative social advantage” — a composite of connection across family, friendships, community, and emotional support, built across a lifetime. Their conclusion:

People with deeper, more sustained social networks weren’t just emotionally healthier. They were biologically younger.

The mechanism isn’t mysterious. When you’re chronically isolated over time, cortisol (the body’s stress hormone) stays elevated. Sustained higher cortisol drives systemic inflation, impairs immune function, disrupts sleep and raises cardiovascular risk — the same cascade that accelerates cellular aging.

The opposite to isolation is meaningful social contact. When you’re with people you trust, your brain releases oxytocin, which dampens the inflammatory cascade. The body reads genuine connection as safety — and safety as an instruction to stand down from the metabolically expensive maintenance of threat response. That’s not a metaphor for feeling good. It’s a description of what’s happening at the cellular level.

A 2010 meta-analysis by Julianne Holt-Lunstad covering 148 studies and more than 308,000 people found that:

Individuals with strong social relationships had a 50% increased likelihood of survival — as strong of a benefit to human health as quitting smoking.

In 2015, a follow-up analysis of 3.4 million people found that social isolation and loneliness increase the risk of premature death by 26–29%.

The U.S. Surgeon General’s 2023 advisory framed it plainly: lacking social connection increases your risk of early death to a degree comparable to smoking fifteen cigarettes a day.

A 2025 paper in the Journal of the American Geriatrics Society following more than 2,200 adults aged 60 and older over four years found that high social engagement was associated with a 42% lower risk of death.

The Harvard Study of Adult Development, the longest-running study of adult life ever conducted, has tracked thousands of people across 88 years and arrived at one of the simplest findings in all of medicine:

The people most satisfied in their relationships at age 50 were the healthiest at age 80. Not the wealthiest. Not the most physically fit. The most connected.

THE BUCKET LIST CONNECTION

My friends from high school knew me before I became a professional version of myself — before the accumulated habits and losses and choices that shaped who I am now. They relate to an earlier version of me, uncurated, unperformed. I would argue that time with them isn’t just pleasant — it’s corrective.

The central argument of The Bucket List Life is that the list isn’t really about activities. It’s about the person you’re trying to be, and tailoring a life worth extending. These friendships are part of that infrastructure — not a reward for getting everything else right, but a biological component of what getting it right looks like. The epigenetic data now says so. The man who built the aging clock didn’t expect that finding. Neither did I.

So stop scrolling and call a friend!

WHAT I ACTUALLY DO

Honestly: not enough, and I’ve known it for a while.

What I haven’t done is treat this as a health behavior. I’ve treated it the way most people treat important things they assume will survive neglect — with casual good intentions and no real structure. Looking at the mortality data, that’s a mistake I’m done making. I’ve added a quarterly call with each of my closest old friends to my calendar, with a reminder to set at least one in-person meeting per year with each of them.

My other chance is community engagement. The Kubzansky study’s “cumulative social advantage” isn’t just about friendships. It explicitly includes community involvement as one of its four domains. A separate meta-analysis of 14 studies by Okun et al. found that:

Formal volunteering reduced mortality risk in adults over 55 by 24% after controlling for confounding factors.

Separate research tracking participants over multiple years found that sustained volunteering is associated with measurably lower C-reactive protein levels — a marker of the chronic inflammation that drives biological aging.

I have talked about wanting to volunteer for years, but never followed through. So, I recently signed up with a local organization that provides food support, early education, and social services to families in my area. I start next week.

STUDIES CITED

Ong, A.D., Mann, F.D., & Kubzansky, L.D. (2025). Cumulative social advantage is associated with slower epigenetic aging and lower systemic inflammation. Brain, Behavior, and Immunity — Health, 48, 101096. https://doi.org/10.1016/j.bbih.2025.101096

Holt-Lunstad, J., Smith, T.B., & Layton, J.B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7(7), e1000316. https://doi.org/10.1371/journal.pmed.1000316

Holt-Lunstad, J., Smith, T.B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352

Office of the Surgeon General. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General’s advisory on the healing effects of social connection and community. U.S. Department of Health and Human Services. https://www.hhs.gov/surgeongeneral/reports-and-publications/connection/index.html

Abugroun, A., Shah, S.J., Covinsky, K., Hubbard, C., Newman, J.C., & Fang, M.C. (2025). Low social engagement and risk of death in older adults. Journal of the American Geriatrics Society, 73(7), 2166–2175. https://doi.org/10.1111/jgs.19511

Waldinger, R., & Schulz, M. (2023). The Good Life: Lessons from the World’s Longest Scientific Study of Happiness. Simon & Schuster.

https://www.robertwaldinger.com

Okun, M.A., Yeung, E.W., & Brown, S. (2013). Volunteering by older adults and risk of mortality: A meta-analysis. Psychology and Aging, 28(2), 564–577. https://doi.org/10.1037/a0031519

Kim, S., & Ferraro, K.F. (2014). Do productive activities reduce inflammation in later life? Multiple roles, frequency of activities, and C-reactive protein. The Gerontologist, 54(5), 830–839. https://doi.org/10.1093/geront/gnt090

In 2013, researchers at Harvard published a study in The New England Journal of Medicine that tracked ~119,000 men and women for over two decades and asked a simple question: does eating nuts regularly affect how long you live?

People who ate nuts every day died at a 20% lower rate than those who ate none.

The pattern held across heart disease, respiratory diseases, and cancer. The more frequently people ate nuts, the lower their mortality.

This wasn’t a small study. It was decades of data from the Nurses’ Health Study and the Health Professionals Follow-Up Study — two of the most rigorous long-term cohorts in nutritional epidemiology (the study of how dietary patterns relate to health outcomes in populations). And it ran in the NEJM, which doesn’t publish nutrition studies unless the evidence is exceptionally strong.

I eat an evolving nut and seed mixture every morning. One important caveat before the recipe: this is observational data, not an RCT (randomized controlled trial) the gold-standard of scientific research. It tells us that daily nut eaters live longer, but it cannot prove the nuts are the cause. People who eat nuts daily may just exercise more, smoke less, and eat better overall.

However, the findings have been repeated consistently across multiple independent studies on multiple continents, and the mechanics of it — better cholesterol numbers, less inflammation, more stable blood sugar — are well-established.

With that in place, here’s what I currently eat every day.

The Mix

Every Monday morning, I assemble the week’s worth of mixture split into individual mini-jars kept in the fridge. It takes about four minutes.

One warning: nuts are very high in calories. These amounts are tailored to my own weight-loss plan, so nosh accordingly.

6 almonds. The most-studied nut for LDL reduction, with consistent findings across multiple independent meta-analyses. A 2019 Tufts University meta-analysis found almond consumption reduced LDL by roughly 6 mg/dL and total cholesterol by nearly 11 mg/dL.

4 walnut halves. The only common tree nut with meaningful alpha-linolenic acid (ALA) — the plant-based omega-3. If I had to keep only one ingredient in this mix, it would be the walnuts.

6 raw pistachios. A 2014 randomized trial found that daily pistachio eaters had lower blood pressure and better circulation than the control group. A 2015 follow-up found pistachios also lowered total cholesterol and triglycerides.

1 tsp pumpkin seeds. Zinc, magnesium, and phytosterols in a small package. The cost of adding a teaspoon to a daily bowl is essentially zero.

1.5 tsp hemp seeds. Contain all nine essential amino acids — and a favorable omega-6 to omega-3 ratio of roughly 3:1 (House et al., J Agric Food Chem, 2010).

1 tsp chia seeds (pre-soaked separately, stirred into the yogurt bowl). More ALA, soluble fiber that slows glucose absorption, and a gel-like coating that slows digestion. I pre-soak mine in kefir then go for a sunrise walk. Don’t skip the soaking — these seeds absorb a lot of liquid, so people with swallowing issues should be especially careful consuming them dry.

1 tsp cacao nibs (stored separately). The COSMOS trial — a randomized study in 21,000+ adults — found that cocoa flavanol supplementation reduced cardiovascular death by 27%. I include the nibs for the flavanols and the flavor, though I often forget to add them because I’m not very bright.

The Protocol

Sunday morning I measure one day’s worth of each ingredient into seven small glass containers. Each mixture portion goes directly into my daily yogurt bowl. Total active time: four minutes. Cost per day: under a dollar.

IMPORTANT FINAL NOTE: The health benefits nuts come from daily consumption. Whatever form this takes for you, the goal is every day, not a handful when you remember.

Supportive Science

• Bao Y, et al. Association of nut consumption with total and cause-specific mortality. N Engl J Med. 2013;369:2001–2011.

• Guasch-Ferré M, et al. Nut consumption and risk of cardiovascular disease. J Am Coll Cardiol. 2017;70:2519–2532.

• Sauder KA, et al. Pistachio nut consumption modifies systemic hemodynamics. J Am Heart Assoc. 2014;3:e000873.

• Sauder KA, et al. Effects of pistachios on the lipid/lipoprotein profile, glycemic control, inflammation, and endothelial function in type 2 diabetes. Metabolism. 2015;64:1521–1529.

• House JD, Neufeld J, Leson G. Evaluating the quality of protein from hemp seed (Cannabis sativa L.) products through the use of the protein digestibility-corrected amino acid score method. https://pubs.acs.org/doi/10.1021/jf102636b.

• Sesso HD, et al. (COSMOS trial). Effect of cocoa flavanol supplementation for prevention of cardiovascular disease events. Am J Clin Nutr. 2022;115:1490–1500.

“Take your life in your own hands, and what happens?

A terrible thing: no one to blame.”

— Erica Jong

For over a decade, there’s a better than decent chance I was walking around with a Group 1 carcinogen living in my stomach — a cancer-causing bacterium that got treated, but, despite a well-established protocol, never confirmed dead by anyone, including me.

The infection wasn’t the failure. And though my first instinct was to blame the doctors, that wasn’t it either. The failure was me. I didn’t know enough. More to the point, I hadn’t bothered to learn enough to ensure I was getting the proper treatment.

Story

It started with a routine endoscopy/colonoscopy back in 2010, otherwise known as an “Up and Down,” where flexible, fiber-optic scopes examine the bookends of your digestive system. For the record, it’s nowhere near as bad as it’s made out to be. I took this test early (age 40) due to symptoms of irritable bowel syndrome.

The American Cancer Society recommends that average-risk adults (those without a personal or family history of colorectal cancer, inflammatory bowel disease, or symptoms) begin regular screening at age 45 continuing through age 75, with colonoscopy, the most common option, performed every 10 years.

The surgeons removed a bouillabaisse of polyps from my colon and rectum, including, alarmingly, a precancerous lesion called a tubular adenoma. This was small enough (8mm) that the cause for concern was low, though it put me on a faster track to have repeat exams every three years.

This proved to be the right play when, during my next exam in 2014, they removed a 2cm adenoma which, left untreated, carried a meaningful mortality risk over a 10-20 year window. With colon cancer, the two ways to find out you have it are screening or symptoms — and by the time you have symptoms, the cancer is often advanced.

And yet, many people (some of my closest friends, you pea-brains know who you are) refuse to get tested, even though, as my surgeon likes to shout at the top of his lungs, “It’s a preventable f*cking disease!”

AND NOW A FEW FUN FACTS ABOUT COLON CANCER

• In adults under 50, colorectal cancer death rates rose 1.1% annually beginning in 2005, pushing the disease from the fifth leading cause of cancer death in the early 1990s to the first in 2023.

• Those born around 1990 are 2x as likely to get colon cancer and 4x as likely to get rectal cancer as those born in 1950.

• A study of nearly 30,000 women under 50, published in JAMA Oncology (November 13, 2025), found that those with the highest ultra-processed foods intake had a 45% higher risk of developing precancerous polyps compared to those with the lowest intake.

• Among Americans aged 1 and older, an average of 55% of total calories came from ultra-processed foods.

• A meta-analysis of 66 studies found that overweight and obesity significantly increases colorectal cancer risk by 25-57%.

While the disease is curable at Stage I, it is frequently incurable at Stage IV, and yet, roughly 75% of colorectal cancer patients under 50 are diagnosed at an advanced stage. That statistic is largely because under-50s aren’t being screened, so it’s often caught too late.

The psychology of this is well-studied. Anticipated discomfort and embarrassment are the top-cited reasons people don’t screen, followed closely by the feeling that testing for the presence of disease is too much a reminder of our own mortality. Here’s the counterintuitive part: it isn’t general worry about cancer that keeps people away — people who worry more actually tend to screen more. It’s the specific dread of the result — the fear of a positive test — that predicts avoidance. Psychologists call this monitoring vs. blunting: “blunters” duck threatening information even when that information could save their lives.

Back to our story…

In addition to the polyp festivities in my colon, the endoscopy discovered a thriving colony of Helicobacter pylori, a fairly common bacterium, colonizing my stomach. It’s the kind of infection a doctor mentions in passing, so benign that, to this day, I don’t remember having it at all.

According to my records, I was given antibiotics and moved on with my life. I assumed “treated” meant “cured.” Turns out those are not the same word. Here’s where my story turns from bad luck into a missed step: confirming eradication isn’t optional — it’s the protocol.

The 2024 American College of Gastroenterology clinical guideline states that proof of H. pylori eradication is required in all patients at least four weeks after the completion of antibiotics. The reason is blunt: feeling better is a poor indicator of whether the bacteria are actually gone.

I felt great. I never had the confirmation test. Guess what happened next…

A full thirteen years later, a subsequent “Up and Down” again showed H. pylori infecting my stomach. I’ll never know for certain whether I cleared it the first time and got reinfected, or whether I’d been carrying it for over a decade. I’m hoping for the former, as I’ve since learned that the International Agency for Research on Cancer classified H. pylori as a Group 1 human carcinogen (meaning there’s sufficient evidence from studies to show that the agent causes cancer) back in 1994, putting it in the same tier as tobacco and asbestos.

It is considered the primary driver of gastric cancer, implicated in roughly 80–90% of cases. I don’t want to be alarmist — while the infection roughly sextuples the relative risk of non-cardia stomach cancer, the absolute lifetime risk for most infected people stays in the low single digits.

Round two: another course of antibiotics. And here’s the part where I’m truly an idiot — I almost made the exact same mistake again. The reflex to take the pills and move on is that strong.

This time I caught myself. Well into the research phase of my “Selfaissance”, I read up on the infection and discovered the full protocol.

I called up my GP and asked him to prescribe a urea breath test specifically to confirm H. pylori eradication. There was a beat of hesitation, a little “do you really need that?” energy on the phone. I held my ground and explained my reasoning, citing the clinical guideline. We ran it. This time it came back clean.

So the ending is good. But sit with the middle of that story for a second: there is a real possibility I hosted a known carcinogen in my gut for thirteen-plus years because the simplest possible follow-up — a test that takes twenty minutes and involves blowing into a bag — never got ordered, despite being an established part of the treatment.

This raises the obvious next question — what else have we missed?

I have enormous respect for the years of training and the (often miraculous) expertise our physicians bring to the table — expertise none of us could begin to replicate by reading studies in a coffee shop or pounding the table on Substack.

But respect and deference are not the same thing.

You wouldn’t hire an architect to design your dream home without poring over the blueprints, asking questions, and making modifications to suit your way of life. The expert brings expertise you don’t have, but you’re the one who has to live there.

A good GP will ask if you have any questions — a good patient will have some.

So the blame is mine because I never thought to ask. I wholly deferred the care of my health and life to someone else. Never again.

Building the Playbook

Last year, I logged into the portals for every medical system I could remember being a patient of. Some of my tests and treatment results were easy to get; others required phone calls and repeated explanations that neither I, nor anyone I know, still has a fax machine.

A few weeks and many trips to the mailbox later, I had a folder in my documents cloud that held as much of my medical history as I could cobble together. I keep the folder organized as follows:

• Medical History

  • Lab results

  • Imaging reports

  • Diagnoses & Procedures

  • Prescriptions

  • Visit Summaries

  • Research

Now, after every medical visit, for any reason, I ask for a printed copy of the “After Visit Summary” and any follow-up labs or testing. I use a scanner app on my phone. Everything goes into the folder.

I have a standing check-up every 6 months, but this is because of my unique medical history and elevated risk factors (history of AFib, medications for blood pressure and cholesterol, history of GI polyps, history of being a fat ass and current weight-loss regimen).

For most people, annual check-ups are appropriate, depending on age and risk factors, although (and this is super-interesting) several medical bodies, including the Society of General Internal Medicine (SGIM), explicitly advise against the routine annual complete physical for low-risk asymptomatic adults, citing evidence of harm from incidental findings that trigger unnecessary testing. Talk to your doctor. Ask questions about scheduling for your specific situation.

A month before each appointment, I call my GP and ask what tests he’d like me to have before our meeting. I want to walk in with fresh numbers and have something real to discuss beyond the physical exam.

Then I use AI as the analyst sitting on top of that file. Before a scheduled checkup, I’ll feed it my entire history and latest labs, then ask a specific question:

“Based on everything in this folder, what are the major areas of concern, and what are the questions a world-class physician would want me to raise in my next meeting with them?”

AI gets things wrong — sometimes confidently and embarrassingly wrong — so I treat its output as a question generator, never a diagnosis. But it’s extraordinary as a tool for spotting trends across years of data and surfacing the right questions to ask — something no rushed appointment can do for me.

There are also valid privacy concerns with using AI in this fashion, and everyone should do their own research to determine their comfort levels. I’ll do a full post about working with AI and the “instructions” prompts I’m learning to use to (hopefully) manage privacy and efficacy.

I take the AI’s flagged concerns and research them for myself. I pick the ones that concern me and ask my doctor what he thinks. In the end, I walk out with a better sense and command of my current health, and always a visit summary to go into the records.

My gastrointestinal surgeon just retired. No more shouting. I’m due for my latest Up and Down, so I researched the best GI specialist in my area who’s covered by my insurance, and has treated patients with my history. When I go in for my consult, I’ll bring a document summarizing my entire GI history with a link to a Dropbox folder where they can download every report. I’ll ask questions and get a visit summary.

More and more, I’ve been using versions of this process in other parts of my life. It’s been a game changer for some aspects, wholly ineffective in others. Either way, I like that it forces me to question the way I approach things, and to learn about how my body, mind, and life work in ways heretofore taken for granted.

And, please. For the love of yourself, and your loved ones, and all of the adventures still waiting on your bucket list… If you’re 45 or over —

“Get a f*cking colonoscopy!”

Studies Cited

• American Cancer Society. “Colorectal Cancer Screening Guidelines.” cancer.org. — average-risk screening begins at 45; colonoscopy every 10 years.

• Siegel RL, Jemal A, et al. “Leading cancer deaths in people younger than 50 years.” JAMA. 2026;335(7):632-634. Full text via institutional access. Free secondary coverage: Becker’s Hospital Review / ACS press release. — CRC deaths in under-50s rose 1.1%/yr since 2005; now the leading cause of cancer death in this group.

• Siegel RL et al. “Colorectal Cancer Incidence Patterns in the United States, 1974–2013.” JNCI. 2017;109(8):djw322. — those born ~1990 face 2x colon and 4x rectal cancer risk vs. those born ~1950.

• Wang C, Du M, Kim H, et al. “Ultraprocessed Food Consumption and Risk of Early-Onset Colorectal Cancer Precursors Among Women.” JAMA Oncology. Published online November 13, 2025. doi:10.1001/jamaoncol.2025.4777 — 45% higher risk of conventional adenomas in highest vs. lowest UPF quintile (AOR 1.45; n=29,105).

• Williams AM, Couch CA, Emmerich SD, Ogburn DF. “Ultra-processed Food Consumption in Youth and Adults: United States, August 2021–August 2023.” NCHS Data Brief No. 536. August 2025. doi:10.15620/cdc/174612 — 55.0% of total calories from UPFs among those aged 1+.

• Ungvari Z, Fekete M, Varga P, et al. “Overweight and obesity significantly increase colorectal cancer risk: a meta-analysis of 66 studies revealing a 25–57% elevation in risk.” GeroScience. 2024. doi:10.1007/s11357-024-01375-x — pooled HR 1.36 overall; 1.57 men, 1.25 women.

• Miller SM. “Monitoring versus blunting styles of coping with cancer influence the information patients want and need about their disease.” Cancer. 1995;76(2):167-177. — origin of the monitoring/blunting framework (Miller, Fox Chase Cancer Center).

• Kelly KM, et al. “Colorectal cancer information avoidance is associated with screening adherence.” J Behav Med. 2024. doi:10.1007/s10865-024-00482-6 — defensive CRC information avoidance predicts lower screening.

• Helicobacter and Cancer Collaborative Group. “Gastric cancer and Helicobacter pylori: a combined analysis of 12 case-control studies nested within prospective cohorts.” Gut. 2001;49(3):347-353. doi:10.1136/gut.49.3.347 — pooled OR ≈ 3.0; RR ≈ 5.9 when measured ≥10 years before diagnosis (the authors’ “best estimate”).

• IARC Working Group. “Schistosomes, Liver Flukes and Helicobacter pylori.” IARC Monographs Vol. 61, 1994. — H. pylori classified Group 1 carcinogen.

• Chey WD, Howden CW, Moss SF, et al. “ACG Clinical Guideline: Treatment of Helicobacter pylori Infection.” Am J Gastroenterol. 2024;119(9):1730-1753. doi:10.14309/ajg.0000000000002968 — test of cure required in all treated patients ≥4 weeks post-therapy.

• IARC Helicobacter pylori Working Group. “Helicobacter pylori Eradication as a Strategy for Preventing Gastric Cancer.” IARC Working Group Reports No. 8. Lyon: International Agency for Research on Cancer, 2014. — H. pylori as primary driver of ~80% of gastric cancers.

Try it. Sit down on the floor, then stand back up — no hands, no knees, no furniture. Did you make it? Now picture yourself doing it at 80. Or 90.

That’s the healthspan gap, and it’s the whole game.

When I started this self-renaissance — my “selfaissance” — I hurled myself back into the gym with a training program from my twenties. In short order it handed me, in succession: a pulled left hamstring, a sprained right Achilles, turf toe, and plantar fasciitis. And that was after I’d torn my (second) bicep trying to move my son’s vending machine. Surgery followed, then three months of mostly sedentary rehab. I was in absolutely no shape to get into shape.

Getting healthy was killing me.

Here’s the distinction nobody drew for me: your doctor is trained to keep you alive. That is not the same as keeping you alive and well. The space between those two is where a lot of us quietly lose a decade.

Some numbers worth sitting with, from a 2024 Mayo Clinic study in JAMA Network Open:

• Globally, the “healthspan” gap between how long we live and how long we stay healthy has widened to 9.6 years.

• The United States has the largest gap of all 183 countries surveyed: 12.4 years.

• Women carry a gap 2.4 years wider than men — a 25% disparity — driven by neurological, musculoskeletal, and other chronic disease.

In the country that grossly outspends every other on earth for healthcare, the average person now spends more than a decade — the last decade — managing chronic disease. Diabetes, heart disease, dementia, the slow grinding purgatory that can dominate the final years.

Healthspan is how long you stay mobile, sharp, and in control — living the active life you want without your body making the decisions for you. The closer your lifespan and healthspan are aligned, the better you’ll be able to live while you’re still alive.

The reason your doctor doesn’t create this plan for you is training, not negligence. Modern medicine can perform miracles once something breaks: stent the artery, manage the diabetes, replace the hip. What it is not built to do is sit you down at 55 and say, “Your bloodwork’s fine for now, but your VO2 max is low for your age, your hip mobility has decreased drastically, and if nothing changes within the next five years you’ll spend your 70s accumulating medical appointments while your spouse has to help you into the bathtub at night.”

There’s no insurance code for that conversation. No prescription beyond, “Take this pill. Exercise more. Eat more broccoli.” So nobody has the talk with you — the plan to get you enjoying your life, for your entire life.

I’ve been having a version of the talk with myself almost daily. As I worked to get my blood tests “within range” — medicine’s way of telling you you’re not dying yet — I started reading health and longevity research and realized “within range” is a wildly low bar. “Within range” gets you to 76. It does not propel you to 90 with your hiking boots still on.

Peter Attia draws the line cleanly. Medicine 2.0 treats disease when it shows up. Medicine 3.0 prevents it from showing up 20 or 30 years early. I’m willing to bet that nobody is practicing Medicine 3.0 on you. You have to practice it on yourself.

You have to become the head coach of your own healthcare.

It’s a lesson I learned recently — and one that could have cost me far more than a torn bicep. More on that next week.

Once you start measuring healthspan instead of lifespan, the clock reads later than you thought, and the daily choices shift. The things I used to find boring — strength training, Zone 2 cardio, sleep, protein, sunrises — stopped being boring. They became the entire game.

Which brings me back to the floor. That sit-to-stand test you just tried isn’t a party trick. In a study of more than 2,000 adults, the people who needed both hands and knees to get up faced a markedly higher risk of dying in the years that followed than those who rose with ease. How you get off the floor says something the blood panel doesn’t.

I’m not anti-doctor. Mine is excellent, listens to my heart and lungs, reads my bloodwork, and refills my prescriptions. I just had to stop waiting for him to ask the questions I needed to be asking myself.

So, can you get up off the floor without your hands? And will you still be able to at 80 or 90?

The honest answer to the second question is the only one that matters. And it’s the one you get to change.

SOURCES AND FURTHER READING

• Garmany A, Terzic A. Global Healthspan-Lifespan Gaps Among 183 World Health Organization Member States. JAMA Network Open. 2024;7(12):e2450241. (Free, open access — full paper: https://pmc.ncbi.nlm.nih.gov/articles/PMC11635540/)

• Mayo Clinic press release (same study, more readable): https://newsnetwork.mayoclinic.org/discussion/the-global-divide-between-longer-life-and-good-health/

• Peter Attia, Outlive — the Medicine 2.0 / 3.0 framing (intro chapter): https://peterattiamd.com/outlive/

• Brito LBB et al. Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology. 2014;21(7):892.

  https://academic.oup.com/eurjpc/article-abstract/21/7/892/5925784

• Sitting–rising test scores predict natural and cardiovascular causes of death in middle-aged and older men and women. European Journal of Preventive Cardiology, 2025. https://academic.oup.com/eurjpc/advance-article/doi/10.1093/eurjpc/zwaf325/8163161

Over the past year, I’ve pored over countless studies and papers, articles and videos chasing the (often elusive) truth about the best research and practices for living a long and healthy life. In short: SCIENCE.

Here’s the short version of what it’s bought me: I’ve naturally lost over 70 lbs – with, sadly, many more to go. My sleep works again. My blood markers have come down. My attention span came back. And somewhere, in the middle of all that, I repaired my marriage, started two companies, and wrote half of a novel. Oh yeah, and this here Substack.

No magic bullets. No GLPs or TRTs or LMNOPs. No quick fixes. Just a collection of habits and shifts in my daily life, based on the collected research of folks much smarter than I could ever hope to be.

“I hope you live a life you’re proud of...

If you’re not, I hope you have the strength to start all over again.”

— The Curious Case of Benjamin Button

screenplay by Eric Roth

It’s more than a tad surreal when you accidentally coin a phrase that enters the global vocabulary. People use the expression every day — at dinner tables, hospital rooms, first dates and eulogies — but have absolutely no idea you exist. When they were younger, I told my kids that they should charge a quarter to anyone they heard using the term — they looked at me like I was insane. That hasn’t changed.

Several decades ago, I wrote the screenplay for the film THE BUCKET LIST. Before that, I was just a broke bartender with a film degree. In an early-morning fit of self-loathing (over my lack of any meaningful progress on any meaningful front) I wrote down a list of “Things To Do Before I Kick The Bucket,” which I shortened to “Justin’s Bucket List.”

A year later I had an idea about how to make it a movie, and that list became a script. Somehow that script found its way to the late, great Rob Reiner, director of classics including Spinal Tap, Stand By Me, When Harry Met Sally, and A Few Good Men. Somehow the script became a film starring Jack Nicholson and Morgan Freeman, and the rest is history.

Believe it or not, the best part of the adventure wasn’t the Hollywood part at all. Not even close.

In the decades since, I’ve received letters and e-mails from people who’ve been inspired to climb mountains (literal and figurative) after seeing the film.

I’ve been lucky enough to meet incandescent people like the amazing Alice Pyne, who, famously, turned her bucket list into a blog and chased the life of her dreams before losing it at age 17.

I’ve had countless conversations with people telling me how they took the idea and changed their lives. Next to loving someone and having them love you back, making even a tiny, positive difference in someone’s life has to be the greatest feeling. I’ve had a wonderful and lucky career, but no professional success has ever nourished me in the way that these experiences have.

Writing THE BUCKET LIST certainly changed my life for the better.

Until it didn’t…

At the suddenly sagging age of 54, it dawned on me—what had long been clear to everyone around me—that the life I was living no longer resembled the life I had planned. What’s more, said life was going to be a lot shorter and far less vibrant than assumed if I didn’t make some (aka many) changes.

Physically, my body was unrecognizable, its bulging hills and vales eternally hidden beneath over-sized shirts and baggy shorts. My shoes were slip-ons (shoelaces were too labor-intensive) and I had just had surgery to repair my second torn bicep, three years removed from heart surgery to stop my burgeoning atrial fibrillation (irregular heart fluctuations) brought on by a mostly sedentary, screen-addled, sleep-deprived, hyper-caloric, modern American lifestyle.

My once-boundless work ethic had evaporated—more than an hour of “work” was enough to send me running into the soft embrace of my iPad, while my attention span had dwindled into capsule-sized, YouTube shorts and Reddit posts. Thanks to my tech-addiction and several years of an ill-advised medication to combat anxiety, I had become Ted Lasso’s attention-deficit goldfish, not in the good way.

Socially, the idea of a dinner party with neighbors or expending more effort than an email or, god forbid, a phone call to maintain lifelong relationships with friends and family had become an allergy. Why talk when you can text? Why text when you can emoji? 🍆

Financially, I went from a very comfortable tax-bracket and a decades-long self-education in investing, to a lazy, undisciplined routine of over-spending and under-saving that applied pressure to my bank accounts and tension to my marriage. In short, I had become, as I’ve come to call it:

OVERFED.

After a ten year estrangement, my brother and I met up at a NY Yankees game to see about restarting our relationship. Though only two years younger than me, he was lean and spry with ruddy cheeks and cords of veins on his arms. He talked of all the ski trips he’d been on, playing sports with his son, the extensive travel he did for work. It was great to see him and even better to see him doing so well.

But, as I drove home, I couldn’t help but compare his vigor to my torpor. His muscle to my man-boobs. He is as close to a physiological match to me as exists on Earth, and thus living proof that my decisions and (in)actions alone had led me to this stodgy point in my life.

The next morning, I input some health data into my Stupid AI and asked it to tell me what I was most likely to die of in the next ten and twenty years. The answer scared the crap out of me.

I immediately asked it to recommend a list of the best calorie-tracking apps. I downloaded one and pre-paid the annual subscription fee. I ate a sugar-packed protein bar for breakfast, wondering how many minutes it would be before I was hungry, and sat down to write, “Justin’s Second List of Things to Do Before I Kick The Bucket”.

It worked once, right?

After twenty years as a professional Hollywood screenwriter, if I have developed any semblance of a superpower it’s that I love, love, love to research. Seeking authenticity in my writing, I have been down countless rabbit holes of scientific studies, Vatican documentaries, self-help books and medical research facilities. I have spoken with cardiologists, psychiatrists, dentists, life coaches, porn stars, writers, investment pros and even professional athletes. When it comes to storytelling, obscure truths are always more compelling than make-believe, if you’re dogged enough to sniff them out.

So I, and my fat ass, dusted off my curiosity of old and started digging. I became so obsessed that my other projects fell by the wayside.

James Clear’s wonderful “Atomic Habits” relates the story of Dave Brailsford, a performance coach brought in to help the flailing British cycling team. He employed a philosophy called “the aggregation of marginal gains.” By making a host of small 1% improvements in all facets of team life—more aerodynamic uniform fabrics, better pillows, more rigorous hand-washing—he lifted them to dozens of Olympic medals and Tour de France victories.

Minus any verifiable athleticism of my own, I’ve taken a similar approach by picking apart every facet of my life and looking for incremental opportunities to improve. Many seemingly great ideas fell away (looking at you natural silk dental floss), while a select few practices began to solidify into a routine.

Along the way, I ventured down innumerable false paths, chasing fad diets, magical supplements with sciency-sounding names, and videos of muscled Chads with sleeve tattoos and the prefix “Doctor” tenuously appended to their name.

As more and more conflicts arose in the deluge of information I was drowning in, I realized I needed a rubric to filter out the slop from actual, verifiable FACTS. I limited my focus to experts who have spent their lives, at the highest levels of science, researching their area of expertise.

This almost too easily ruled out chiropractors selling supplements as they pound the dinner table about the life-saving benefits of tallow, and doctors warning us about the deadly self-defense mechanisms of fruit (yes really). Instead, I focused on published, peer reviewed studies from Harvard, JAMA, and similar bastions of non-B.S., rigorous data from thousands of subjects.

So I locked myself away and read and watched and listened and experimented, until a daily framework began to emerge.

As to how I came to start this Substack, there’s a bit of a story there that hearkens back to that wonderful feeling you get from helping people.

My younger son started a vending machine business at the town swimming pool – we’re partners but he’s definitely the boss. Our first year was full of lessons as our bulletproof, top-of-the-line machine broke down repeatedly.

During one of the many service visits, the technician, an elderly, affable chap named Matt, limped from his truck to the machine. He told us about the three knee replacements he’d had, none of which had worked, and lamented that, after 50 years owning, operating and repairing vending machines, he was finally going to call it quits. He was in constant, significant pain, but in 70 years had never taken any painkillers and wasn’t about to start now.

What’s more, every male member of his family, Matt explained, had died suddenly from “The Widow Maker,” a severe blockage of the major coronary artery that frequently results in sudden death. He had a similar blockage, but was unable to have corrective surgery due to the blood thinners he was taking for his knee.

I had been using AI to build a health chronology for myself, and had discovered a few glaring, potentially deadly, gaps in my treatment – something we’ll discuss at great length next week. I asked Matt if he minded if I put some of his information into ChatGPT to see what came up. Over the next hour, as he disassembled then reassembled the machine, I did a deep dive about knee replacements that “didn’t take” and asked for suggestions.

(As an aside, I am all for using AI as a research or memory tool, but assiduously check every fact myself, and do all of my own writing.)

When we were done, Matt had the name of two doctors who specialized in failed knee replacements and a word-for-word script to use when calling them. I texted him the information as we helped carry his tools back to his truck. He said he’d think about following up, but didn’t like New York City, and didn’t trust the doctors there. Oh well.

My son and I agreed that Matt would never make the call, but were surprised a week later when he texted that he’d called the doctor, read the script, and, after some back and forth, had been moved to the top of the surgery list. “The surgeon feels confident that he can get me back to 85% normal usage. Maybe 90% in time.” Being stubborn, Matt pushed the surgery date to this summer (2026), when it would, “Interfere less with work,” and thanked me.

When I showed the messages to my son, 12, he was beaming. We talked about how I’d learned how important it is to, “Quarterback your own life, especially your health,” and agreed that we’d follow up with Matt to see how his surgery goes. He said he was happy that we hopefully helped Matt, and I agreed.

Which got me thinking… And, it seems, writing…

My only rule is that everything here is something I’m actually using (or testing) on myself. I make no endorsement of any philosophy, diet, or brand beyond that. I’m not a doctor and nothing here is medical advice, just one man’s curiosity.

Since there’s more to life than our latest blood draw, this will gradually expand to encompass all facets of life. I’m looking to unearth everything that will help us improve foundations in all four pillars of health:

Chances are high that I will find newer and better options, and even higher that I will get some of it wrong. I actually love to be wrong–my wife tells me I’m an expert at it–because realizing you’ve been wrong usually means you’ve discovered what’s actually right.

I spend hours on this every day. You won’t have to. My game plan is to cough up two write-ups each week:

THE STACK - Tuesdays

A relatively deep dive on a component of my daily routine and the science behind it. Personally tested and explained in plain English (or as close as I can get). We’ll start in the morning and work our way through the day. We’ll write something called a “Red Eulogy” for ourselves (because thinking about death is super fun!) and interview top minds to answer eternal questions like, “What toothpaste should I use?” (spoiler alert: you should be using more than one).

FIELD NOTES - Fridays

A smaller look at something I’m digging into. A recent study. A product review. A “Wellness Bullshit Watch” debunking a viral trend, phony supplement or guru claim. Maybe even reader questions if anyone ends up following along.

I have no idea if this is going to work, but I’ve committed to spending at least the next year finding out. My life needs to change. I’ve started the process, but have quite a long way to go. Some days I have the strength to keep pushing, other days not so much. This is my accountability. It’s also very likely my mid-life crisis, so hop on in, the water’s warm.

If you’re still reading and, like me, you’ve felt the drift from living a life you’re proud of, then I’m betting you’ll encounter some things that will make you think, maybe even give you the strength to change something small, like, I dunno, your toothpaste.

A 1% adjustment might not seem like a lot, but, as we’ll discover together, it might just change everything about your life.