5HT: 5 Healthyish Things, including my top predictions for 2026 and buying a cow

Did someone forward this to you? Join 95,000 readers finding their next health hack. Come hang→

What’s going to happen next year in health? Well, I’ve got some opinions! And so does my buddy Justin Mares, who runs Truemed (which announced a big Series A led by a16z last week) and writes The Next, a must-subscribe health newsletter. Justin is someone I tremendously respect as a builder and thinker in this space—and it was really fun to go back and forth with him on how we think 2026 will shape up.

Anyway, here are our five top predictions:

1️⃣ The rise of the “healthy environment” era

2026 is when health meaningfully expands beyond food and exercise to include the environment you live in. Light exposure, air quality, mold, water, and indoor toxins move from fringe concerns to core health levers. We’re collectively realizing you can eat perfectly and still feel terrible if your bedroom has mold, your air is polluted, or your circadian rhythm is wrecked by bad lighting. 

Imagine a shift toward thinking about environmental toxins as the trans fats of our generation—where people stop saying “that sounds paranoid” and start saying “that sounds obvious.” Solutions (like Lightwork and Light Labs) that help measure and improve our environments will win.

2️⃣ Microplastics become the new sugar

Microplastics are on track to become in the 2020s what sugar was in the 2010s: Everywhere, invisible, and impossible to ignore once you understand the data. As the science sharpens, plastic exposure shifts from an abstract environmental issue to a real metabolic, hormonal, and inflammatory concern. 

Expect rising demand for third-party verification, cleaner materials, and brands that can prove reduced exposure—not just market it. Just as sugar labels rewired food, microplastic awareness rewires how we evaluate products. (Derek’s written about microplastics at length in this special report.)

3️⃣ Say goodbye to diet culture

What’s the hottest diet of 2026? There isn’t one—and that’s the point. After decades of diet tribalism, people are done outsourcing eating rules to fads. Instead, we believe we're entering a functional, personalized phase: More protein, more fiber, and fewer ultra-processed foods—adjusted for individual goals, biology, taste, and lifestyle. AI in particular accelerates this shift, enabling a personal operating system for eating rather than just a belief system.

Plus, things like personalized organ biological clocks—combined with more people getting their biomarkers—may already start leading to hyper-specific health (not just food) recommendations and the rise of a true preventative health system. (Less prediction than hope trafficking, but still.)

4️⃣ Rethinking brain health

Mental health finally starts being treated like what it often is: A metabolic, inflammatory, and brain-energy problem—not just a "chemical imbalance." Metabolic psychiatry moves from journals into everyday care, with a focus on glucose regulation, insulin resistance, inflammation, sleep, gut health, and mitochondrial function.

At the same time, we’re getting more honest about the limits of SSRIs and talk therapy. That’s why interventional psychiatry—like TMS and ketamine-based treatments—keeps gaining ground and establishing "brain medicine" as the discipline (see: Radial). Plus, addressing metabolic dysfunction earlier may meaningfully reduce dementia and cognitive decline.

5️⃣ GLP-1s rewrite appetite, culture, and power

In 2026, GLP-1s will become more health infrastructure than trend. With stronger solutions like retatrutide (GLP-3s?!!), oral options, and falling costs, we’re no longer just treating obesity—we’re rewiring appetite, reward, and impulse at a population level. Less hunger, fewer cravings, lower alcohol consumption, and less food-driven dopamine ripple outward: Dating culture shifts as bodies and confidence normalize; grocery stores reorient toward protein, fiber, produce, and functional staples; restaurants quietly shrink portions and menus. Efficiency-first nutrition—once niche—goes mainstream again (remember Soylent?). 

As GLP-1s reduce demand at scale, Big Food influence weakens. Mainstream awareness of how much Big Food controls/funds influencer-led disinformation and supports sham lobbying groups like "Americans for Ingredient Transparency" will grow. Plus, one of the fastest-growing categories becomes post-GLP-1 maintenance. Broadly, we expect to see a cultural reset in how humans eat, drink, date, and buy food at scale next year.

Also, here are five smaller predictions just for funsies:

So I got this epic bruise that's finally fading (after 3 weeks). It looked like I got into a bar fight—or kicked by a donkey, IDK—but I didn’t. The real story is far less interesting: I slammed my forearm straight into a piece of furniture in my daughter’s room. Hard. And the second it happened, I knew it was going to leave a mark. And boyyy, did it. 😅

Oddly enough, this monster bruise turned into a reminder of something I’ve been working on accepting: that I can’t—and don’t need to—control everything. After my ER scare earlier this year, I’ve been thinking a lot about what you can control… and everything else. No matter how healthyish you live, things still pop up that you didn’t earn, deserve, or directly cause. Bodies (and life) are weird like that. (All the more reason to be more like Dick Van Dyke, honestly.)

And as we head into the holidays, with people reading this email from some version of “home,” it’s also worth saying: Not all bruises show up on your arm. Not all bruises are visible. People are carrying things you’d never expect. Some are emotional. Some are physical but hidden. Some are disabilities. Some are just the accumulated wear and tear of a hard year—or a hard decade.

As we sit around the table, it’s worth remembering everyone is carrying something, even if you can’t see it (like this bruise photo that now you can’t unsee). Grace and respect cost nothing—and they might be the best thing to bring to the table, or find in your stocking.

Bet you didn’t see this coming on Christmas—but stay with me. I recently learned the vast majority of herpes cases are acquired in childhood. 

WHAT. (Here I’m talking specifically about oral herpes (HSV-1), which is most often spread through infected saliva.) That means the average cold sore that pops up in the teens or adult years might’ve been picked up by sharing toys in day care or getting a forehead kiss from your auntie. And if that’s the case… Why does it still carry so much or, er, any stigma? 

I think part of it is its association with the other strain, HSV-2 (aka genital herpes)—but it shouldn’t be. Both are super common. And oral herpes, in particular, is super duper common—I’m talkin’ 50-80% (!!) of US adults, common.

Yes, once you have it, you have it. But it’s manageable. And odds are, most people you know either have it—or will experience it at some point. Yet it’s still treated as something shameful, creating unnecessary awkwardness at work and in dating. 

I’ve never personally had a cold sore (if only my aunts and uncles were more loving lol), but the stigma around it feels rooted in outdated thinking and way too many hushed conversations. It’s one of many things I hope we continue to destigmatize next year—and beyond.

Okay, so this year I heard about the trend of friends coming together to buy a house, but what I didn’t see coming was friends coming together to buy a cow. 🐮

To back it up: I was in a coffee shop for a meeting the other day and talking about, wouldn’t ya know, microplastics. Then, the person sitting next to us leaned over and shared “me and my friends just bought a cow” as a solution to limit microplastic exposure. 😂

Obviouslyyyy, we had to chime in from that point. So we got into talking and asked all the questions. Whose house does the cow live in? Who gets the first cut? Is there a group chat for cow updates? Who’s in charge of… the cow stuff? You know, really milking the basics. 

The person I was sitting with also brought up an interesting point: Even if you buy a cow from a rancher and know exactly where it’s been, you still have to feed it. And most feed probably contains microplastics, too. So you’re fattening up the cow with the same stuff you’re trying to avoid. It’s like… we can’t escape it. 🤷‍♀️

But as wild as this idea sounds at first, maybe it’s not? (There’s actually an existing Quora thread about the logistics.) Trust in our health system and food quality has gotten so bad people are taking things into their own hands—and bringing their friends along. From buying farms together to starting sauna clubs in the neighborhood, people are bonding over healthyish lifestyles, and I’m into it.

Oh—and shout out to my new friend and cow co-owner, Liv Bradshaw from Too Kismet. 🐮✨

The next time you’ll see me in your inbox it’ll be 2026. And I hope you arrive feeling like Jon Hamm. 

Okay, you now know what I’m curious about—but here’s what everyone else is Googling, according to a few trusty platforms.

👋 Who are you again? I’m Derek Flanzraich—founder of two venture-backed startups in Greatist (👍) and Ness (👎). I’ve worked with brands like GoodRx, Parsley, Midi, Ro, NOCD, and Peloton. I now run Healthyish Content, a premium health content & SEO agency (among other things).

Every Thursday, I share 5 health things I feel strongly about so you can live healthyish. (Disclaimer: I’m more your friend with health benefits. None of this is medical advice.) 

And oh, you also feel strongly about some health things? Hit reply—I’d love to hear it.