Bill Gifford

Peter Attia

The Science and Art of Longevity

Outlive

Studies have found that approximately one-third of those folks who are obese by BMI are actually metabolically healthy, by many of the same parameters used to define the metabolic syndrome (blood pressure, triglycerides, cholesterol, and fasting glucose, among others). At the same time, Some studies have found that between 20 and 40 percent of nonobese adults may be metabolically unhealthy, by those same measures.

But not everyone who is obese is metabolically unhealthy, and not everyone who is metabolically unhealthy is obese. There's more to metabolic health than meets the eye.

Luana Lima

So we will break down this thing called exercise into its most important components: strength, stability, aerobic efficiency, and peak aerobic capacity.  

Extremely thorough, well-written, funny, intelligent book. Enjoyed every piece of it. Even more fascinated by my health and my life. 

Robin Collura

“Outlive” by Peter Attia dives into what he calls medicine 3.0, or the latest science on health and longevity, combined with practical advice anyone can use to live better today and beat four types of chronic disease with the four pillars of good health: exercise, nutrition, sleep, and emotional health (last one is from his own experience).

Here are key highlights that I picked up from this audible:

Erwin Lemuel Oliva

“Outlive” by Peter Attia dives into what he calls medicine 3.0, or the latest science on health and longevity, combined with practical advice anyone can use to live better today and beat four types of chronic disease with the four pillars of good health: exercise, nutrition, sleep, and emotional health (last one is from his own experience).

Here are key highlights that I picked up from this audible:

1. The most important part of longevity (living a longer life) is exercise. Our goal is to go from zero workouts to getting any regular movement at all. 

2. He also defines longevity in two ways: increasing both health span and life span, where health span is the number of years that you are healthy.

2. Consider a “Centenarian Decathlon.” Your Centenarian (people who live to 100 or more) Decathlon is a list of 10 exercises you’d like to still be able to perform when you’re 100 years old. 

3. There's no perfect diet. Dietary restriction is just one strategy to help you achieve better eating behavior. Nothing beats combining calorie restriction (eat less), dietary restriction, and time restriction when it comes to eating. 

4. Sleep is underrated. We all need to sleep not only to recover but to live longer.

Andrew John Kinney

Peter Attia has a useful combination of skills; he is a medical doctor who is also a math geek (he nearly became an engineer), and he's an athlete who trains with intense dedication. He makes an excellent point about the binary nature of medical diagnoses, calling the current standard of treatment "medicine 2.0", an approach designed to treat acute conditions, but not well suited to preventing chronic conditions from becoming acute. For that, we need what he calls medicine 3.0. Medicine 2.0 says if one's fasting blood glucose is > 126mg/dl, that person is diabetic; at less than 126, they are not diabetic. Attia says that adults should be concerned if their glucose is close to 100, and they should be aiming for 80 or less; the point is that most of these test results are on a spectrum, and if we wait until we exceed the magic number of 126, it may well be too late to reverse the trend toward diabetes with exercise and diet changes. Attia spends a lot of text explaining how to interpret cholesterol results, genetic markers for Alzheimer's, and many other test results, and he explains which tests are most useful, and which are really not very helpful at all.

Dr. Attia emphasizes how important exercise is to remaining healthy as we age, and he pushes strength training hard, making the point that if we do nothing to retain muscle mass as we age, we will lose strength through a natural process of atrophy. If one does nothing to retain strength, we eventually end up unable to complete simple tasks like lifting a suitcase, and it is the myriad of small tasks requiring strength that allow a person to remain independent in old age. Attia also pushes the need for aerobic training because of the clear benefits to the vascular system and hence to the brain. More and more research is showing most mental decline to be a side effect of poor cardiovascular health in combination with other metabolic problems like diabetes or pre-diabetes.

Attia covers cardiovascular health in detail, including tests that he recommends in addition to the normal LDL and HDL readings. He addresses cancer, and the correlation between good metabolic health and avoiding cancer. But he returns again and again to the importance of exercise, and how it is the most important thing a person can do to preserve good health as they age. There is a great deal of densely written, data-filled text on this subject, and as a former somewhat-competitive runner, I follow where he is going with regard to VO2 Max, etc, but he makes a great point, which is, we should want to be decathletes, not marathon runners. Because the decathlete is relatively fast, but also strong, and nimble, and as normal humans, that's what we need, not the specialization of the marathoner. There is a lot of helpful information about training for strength, and aerobic fitness, and stability. All good stuff.

There are two sections on nutrition, which I really enjoyed, and then a section on the importance of good sleep and how to get it. Finally he deals with emotional health. This is the most personal section; I am often surprised to learn of the trauma other people are carrying, and it turns out Dr. Attia is another high-performing individual who was a victim of abuse at a young age, and he describes his long-delayed treatment and therapy to deal with the lasting effects of the abuse.

I would recommend this book to anyone who is trying to improve their fitness, their health, and their chances of living into old age as an active and healthy individual.

Listened to 40% of the book and then read a few reviews online before deciding to drop the book. Peter Attia strikes me as just another guy who thinks he knows more than everyone else, the establishment is wrong, so you need to listen to him. 

In the end, though, all I've heard so far and see from his recommendations is either speculative and what he thinks, not how I want my medicine to be practiced, or just the basics that we know. Cancer is hard to treat, so focus on prevention and early detection. He argues for more aggressive screening from the point of view of "more screening can save some additional people", which is logical. But that's precisely what medical standards are doing, reassessing over time how often and how early to screen based on the cost and technology available. Peter is just saying "more and earlier" which is always defensible, but not necessarily helpful for a general public policy. 

Eat well and include protein and omega 3s, workout regularly both cardio and to build muscle, sleep well, be careful with sugar and insulin resistance, drink water... Those are the basics and if you do that, and your routine health checks, that's about the best that you can do outside of praying for good genes. If your family has history of certain hereditary conditions or you find markers for higher chance of certain conditions, more aggressively worry about those of course. But that's also part of the standard of care and gets better naturally as technology improves.

The only thing that I'd admit is that many people have bad doctors who don't pay enough attention to their patients. It is these patients that need to be more informed and ask more questions and demand better care. But, I wouldn't say that means following all that Peter recommends. I'd stick to learning the standard of care recommendations and your own health history and using that to talk to your PCP and change PCPs if yours seems to not care well for you. 

Omar Fernandez

Listened to 40% of the book and then read a few reviews online before deciding to drop the book. Peter Attia strikes me as just another guy who thinks he knows more than everyone else, the establishment is wrong, so you need to listen to him. 

In the end, though, all I've heard so far and see from his recommendations is either speculative and what he thinks, not how I want my medicine to be practiced, or just the basics that we know. Cancer is hard to treat, so focus on prevention and early detection. He argues for more aggressive screening from the point of view of "more screening can save some additional people", which is logical. But that's precisely what medical standards are doing, reassessing over time how often and how early to screen based on the cost and technology available. Peter is just saying "more and earlier" which is always defensible, but not necessarily helpful for a general public policy. 

Eat well and include protein and omega 3s, workout regularly both cardio and to build muscle, sleep well, be careful with sugar and insulin resistance, drink water... Those are the basics and if you do that, and your routine health checks, that's about the best that you can do outside of praying for good genes. If your family has history of certain hereditary conditions or you find markers for higher chance of certain conditions, more aggressively worry about those of course. But that's also part of the standard of care and gets better naturally as technology improves.

The only thing that I'd admit is that many people have bad doctors who don't pay enough attention to their patients. It is these patients that need to be more informed and ask more questions and demand better care. But, I wouldn't say that means following all that Peter recommends. I'd stick to learning the standard of care recommendations and your own health history and using that to talk to your PCP and change PCPs if yours seems to not care well for you. 

Pierre

Ostap Gorin

Jim Yellow

Craig Jellick

Ricardo

SF. Sutcliffe 

Matt Messner

Navya R

Robyn Smith

Andréa Mellalieu

This is the ultimate manual for longevity. For all its successes, mainstream medicine has failed to make much progress against the diseases of ageing that kill most people: heart disease, cancer, Alzheimer's disease, and type 2 diabetes. Too often, it intervenes with treatments too late, prolonging lifespan at the expense of quality of life. Dr Peter Attia, the world's top longevity expert, believes we must replace this outdated framework with a personalised, proactive strategy for longevity. This isn't 'biohacking,' it's science: a well-founded strategic approach to extending lifespan while improving our physical, cognitive and emotional health, making each decade better than the one before. With Outlive's practical advice and roadmap, you can plot a different path for your life, one that lets you outlive your genes to make each decade better than the one before.

The Science - and Art - of Longevity

James Haliburton

Erik Horton

Denis

Wouldn’t you like to live longer? And better? In this operating manual for longevity, Dr. Peter Attia draws on the latest science to deliver innovative nutritional interventions, techniques for optimizing exercise and sleep, and tools for addressing emotional and mental health.
 
For all its successes, mainstream medicine has failed to make much progress against the diseases of aging that kill most people: heart disease, cancer, Alzheimer’s disease, and type 2 diabetes. Too often, it intervenes with treatments too late to help, prolonging lifespan at the expense of healthspan, or quality of life. Dr. Attia believes we must replace this outdated framework with a personalized, proactive strategy for longevity, one where we take action now, rather than waiting.
 
This is not “biohacking,” it’s science: a well-founded strategic and tactical approach to extending lifespan while also improving our physical, cognitive, and emotional health. Dr. Attia’s aim is less to tell you what to do and more to help you learn how to think about long-term health, in order to create the best plan for you as an individual. In Outlive, readers will discover:
 
• Why the cholesterol test at your annual physical doesn’t tell you enough about your actual risk of dying from a heart attack.
• That you may already suffer from an extremely common yet underdiagnosed liver condition that could be a precursor to the chronic diseases of aging.
• Why exercise is the most potent pro-longevity “drug”—and how to begin training for the “Centenarian Decathlon.”
• Why you should forget about diets, and focus instead on nutritional biochemistry, using technology and data to personalize your eating pattern.
• Why striving for physical health and longevity, but ignoring emotional health, could be the ultimate curse of all.
 
Aging and longevity are far more malleable than we think; our fate is not set in stone. With the right roadmap, you can plot a different path for your life, one that lets you outlive your genes to make each decade better than the one before.

Outlive The Science and Art of Longevity

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