HealthSpan Internal Medicine

Japan’s onsen culture offers an interesting example of how a traditional practice can intersect with modern physiology.

Heat exposure increases skin and core temperature, promotes vasodilation, increases blood flow, and places a mild, controlled stress on the cardiovascular system. Regular heat exposure has been associated with benefits for cardiovascular function, relaxation, recovery, and metabolic health.

But I’m equally interested in the context in which heat therapy is practiced.

In Japan, bathing can be a shared experience—something woven into family life and community rather than treated as another individual wellness task. That social connection matters. Human health is shaped not only by what we do to our bodies, but by the relationships and environments in which those behaviors occur.

So perhaps one lesson from onsen culture is this: health-promoting practices may be even more sustainable when they become part of how we connect with one another.

Heat therapy. Nervous system regulation. Cardiovascular health. Community.

Sometimes longevity is both biological and social.

Japan reminded me that some of the most powerful health interventions can be remarkably simple: slow down, step outside, and spend time among trees. 🌲

Forest bathing, or shinrin-yoku, has been studied for its effects on stress physiology, immune function, blood pressure, and overall resilience. The trees themselves release phytoncides—natural compounds that may contribute to some of these benefits.

But for me, the biggest takeaway wasn't discovering something new. It was remembering something I already knew.

Since returning from Japan, I've found myself running the trails in my own neighborhood again and appreciating just how much nature gives us when we stop rushing through it.

You don't need a complicated protocol. Sometimes, you just need trees, time, and the willingness to slow down enough to notice what happens in your body.

Japan changed how our family does breakfast. And I did not see that coming.

Some mornings it was a full traditional spread — grilled fish, rice, pickled vegetables, soft tofu, green tea. Other mornings it was sushi arriving on a conveyor belt at 11am, kids reaching across each other for the next plate, all of us laughing at how completely normal it felt by day three. And yes, some mornings it was 7-Eleven — handrolls, a cold brew, a fruit smoothie — which sounds like a shortcut and somehow tasted like the most intentional convenience food I have ever eaten.

What stayed consistent across all of it was the pattern. Quality protein — fish, eggs, meat — to anchor the day metabolically. Fermented foods in some form, which we know support gut microbiome diversity and, by extension, reduce systemic inflammation that matters for cognitive health over time. Color and variety on the plate. And meals eaten at an actual pace, with the people you love, before a full day ahead.

As a physician, I think about breakfast differently since we returned. Not as a functional task to complete, but as a metabolic and relational anchor. The research on protein at breakfast — for blood sugar stability, satiety signaling, muscle protein synthesis — is solid. The research on fermented food and the gut-brain axis is real. And the research on shared meals and community as a longevity variable is something I am taking more seriously than I ever have.

Honestly, one of my favorite memories from the entire trip is long family breakfasts. No rushing. No screens. Just food, conversation, and everyone fueling up together for whatever the day had in store.

At home we are not doing conveyor belt sushi at 11am, but our breakfast table has more protein, more color, more ferments, and more people sitting at it at the same time.

That is exactly the point.

My recent time in Japan gave me a new perspective on something we often overcomplicate: movement.

One of my reflections from the trip was how naturally physical activity is woven into everyday life. It doesn’t always require a gym, a workout plan, or another item on your to-do list.

That matters for brain health. Regular movement supports circulation, metabolic health, mitochondrial function, and the brain’s ability to stay resilient as we age.

It also made me think about how much our environments shape our habits. When movement is built into daily life, it becomes less about motivation and more about simply living.

So instead of asking, “When will I fit in my workout?” perhaps we can also ask:

How can I build more movement into the life I’m already living?

What could that look like for you? Let us know in the comments.

I just returned from three weeks in Japan, and the trip was unforgettable. What stayed with me the most wasn't the sightseeing. It was seeing the science of healthy aging lived out in everyday life.

Japan is home to one of the world's five Blue Zones and has one of the highest life expectancies on the planet. As a physician vacationing in the area, I found myself observing the daily habits, cultural practices, and systems practiced by the Japanese that support longevity, metabolic health, brain health, and healthy aging.

Over the next four weeks, I'll be sharing the clinical lessons I brought home. More importantly, I'll be sharing how you can apply these very same lessons and healthy habits to your own life.

Because living longer isn't the goal.

Living healthier, stronger, and more independently is.

Still processing everything from this year's IntellxxDNA conference — and it's a full circle kind of gratitude. 🧬🙏

Dr. Kristine Burke and Dr. Sharon Hausman-Cohen — thank you for showing me what it looks like to practice medicine at the level of the individual, not the average. Everything I do clinically traces back to what I learned from you.

To the entire TruNeura and IntellxxDNA team — thank you for building the platform that makes this kind of medicine possible.

And to my fellow speakers — Dr. Jennifer Kraker, Dr. David Socol, Dr. Theresa Pugh, Dr. William Seeds, and JJ Virgin — I left every session smarter than I walked in.

I had the honor of presenting "The Canary Sings Again" — a complex case that I collaborated with Dr. Ilene Naomi Rusk (and Dr Neda Leonard ) on, where genomics and pharmacogenomics helped us find answers no one else could, with outcomes that reminded me exactly why I do this work.

Grateful for this community, this science, and our patients who inspire us to keep searching for answers and solutions. 💛