<![CDATA[Justin Zackham]]>https://www.thebucketlistlife.cohttps://substackcdn.com/image/fetch/$s_!RpfD!,w_256,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F0fba5af6-41e9-48d7-827d-e8f5602c8c54_357x357.pngJustin Zackhamhttps://www.thebucketlistlife.coSubstackFri, 26 Jun 2026 03:43:27 GMT<![CDATA[The 300-Million-Year-Old Clock in Your Brain That Electric Light Is Destroying]]>https://www.thebucketlistlife.co/p/the-300-million-year-old-clock-inhttps://www.thebucketlistlife.co/p/the-300-million-year-old-clock-inTue, 23 Jun 2026 12:30:31 GMT

“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.

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Studies Cited

]]><![CDATA[FIELD NOTE #3: THE GIRL AT THE WINDOW]]>https://www.thebucketlistlife.co/p/field-note-3-the-girl-at-the-windowhttps://www.thebucketlistlife.co/p/field-note-3-the-girl-at-the-windowFri, 19 Jun 2026 10:30:38 GMT

“It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so.” —often attributed to Mark Twain

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.

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“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).

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]]><![CDATA[How Old Friends Make You Biologically Younger]]>https://www.thebucketlistlife.co/p/how-old-friends-make-you-biologicallyhttps://www.thebucketlistlife.co/p/how-old-friends-make-you-biologicallyTue, 16 Jun 2026 10:31:12 GMT

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

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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

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]]><![CDATA[FRIDAY FIELD NOTE: ]]>https://www.thebucketlistlife.co/p/friday-field-notehttps://www.thebucketlistlife.co/p/friday-field-noteFri, 12 Jun 2026 13:30:40 GMT

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

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]]><![CDATA[How to Be the “Head Coach of Your Healthcare” ]]>https://www.thebucketlistlife.co/p/how-to-be-the-head-coach-of-yourhttps://www.thebucketlistlife.co/p/how-to-be-the-head-coach-of-yourTue, 09 Jun 2026 18:07:07 GMT

“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

]]><![CDATA[FIELD NOTE #1: The "Healthspan vs. Lifespan" Distinction Your Doctor Probably Won't Bring Up ]]>https://www.thebucketlistlife.co/p/field-note-1-the-healthspan-vs-lifespanhttps://www.thebucketlistlife.co/p/field-note-1-the-healthspan-vs-lifespanThu, 04 Jun 2026 14:01:54 GMTCan you get up off the floor right now without using your hands?

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

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]]><![CDATA[Inventing "Bucket Lists" Changed My Life — Years Later, I Had to Write a New List to Save My Life]]>https://www.thebucketlistlife.co/p/inventing-bucket-lists-changed-myhttps://www.thebucketlistlife.co/p/inventing-bucket-lists-changed-myTue, 02 Jun 2026 16:56:40 GMT
A photo of Jack Nicholson's original bucket list prop from the film.
Jack’s original bucket list prop from the film, “The Bucket List.”

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.

Thanks for reading Justin Zackham! Subscribe for free to receive new posts and support my work.

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