It’s rare when a book makes me change things in my life.
Today, I’m reviewing a book that did exactly that.
If you’re interested in living a longer and healthier life, I encourage you to read Outlive. More importantly, apply some of the lessons you’ll learn while reading it. It’s a powerful book. Powerful enough, perhaps, to change your life.
Outlive – The Science & Art of Longevity (Amazon Link – I’ll get a small commission at no charge to you if you order) was written by Peter Attia, MD, a medical doctor who has dedicated his life to finding the medical truths behind longevity. He separates fact from fiction and provides a deeply researched and well-documented book on his findings. It’s a bit of a heavy read, with a significant amount of medical terminology mixed in. I found it manageable, however, and the medical explanations add validity to the concepts presented.
Attia is a longevity expert who focuses on prevention. I love his concept of “Medicine 3.0,” where prevention becomes the priority versus the current “treatment” focus of the medical industry. Attia refers to the current industry practice as “Medicine 2.0”, where the medical industry waits until someone has become sick before being treated (diabetes is a classic example). It’s a visionary concept from a visionary doctor.
“Rethinking medicine to live better longer” is the book’s byline, and it’s a perfect summary of Attia’s approach.
Groundbreaking work, this.
If you’ve read enough, feel free to buy Outlive now (Amazon Affiliate link). If you’d rather read my detailed review of the book, read on.I just completed Outlive - The Science & Art of Longevity. It's groundbreaking work and today I'm writing a review of the book. Bottom Line: It's worth a read. Click To Tweet
Outlive – The Science & Art of Longevity
I struggle with how to summarize this book. In my typical review, I’ll provide a chronological summary of the book’s content. The truth is, there is simply too much information in this book to do that effectively. If you don’t believe me, check out the Tweet that Roger Whitney (The Retirement Answer Man) sent after he’d read the book:
In Roger’s weekly email, he made the following statement about Outline (bold emphasis added by me):
“Where to begin? This was the most highlighted and tagged book that I’ve ever read. Peter Attia is a physician with a lot of curiosity about extending our health, not just our longevity. The book’s first half is a lot of science, and the second half shares many practical tips. This book is helping me completely rethink how I approach my health.”
A powerful book, indeed.
Below I’ll provide a summary of the areas in Outlive that resonated with me. Note there are significant elements of the book that I won’t address for the sake of simplicity.
Outlive Has A Unique “Flow”
Attia takes a unique approach to the flow of the book. He argues that too many self-help books focus on the tactics without first thinking about your objectives and strategy. He starts the book with a strong argument that we do medicine wrong (which outlines his objective for this book).
He encourages the medical industry to consider moving to Medicine 3.0, which focuses on proactive prevention rather than reactive treatment (the hallmark of Medicine 2.0). Throughout the book, he shares the approach he uses with his patients, starting with extensive bloodwork and physiological testing he does with every patient. His “Medicine 3.0” tests focus on things that Medicine 2.0 doesn’t consider, and it’s making a difference.
I had my annual bloodwork done while reading the book, and I looked at the results with a far more discerning eye than I’ve done in the past.
One thing to point out: the first half of the book is “heavy.” It includes a lot of medical terminology and reads, at times, more like a textbook than a novel. I encourage you to approach it as a challenge and work to understand it – you’ll find your effort rewarded when you get to the second half of the book, which focuses more on tactics.
Lifespan Vs. Healthspan
Attia focuses on helping his patients achieve a long “Healthspan” vs. traditional medicines approach on Lifespan. What good is a long life if you’re stuck in a wheelchair for your last 10 years? Attia’s approach seeks to resolve this conflict by increasing the odds that you’ll be as healthy as possible throughout the duration of your life.
I’ve always thought in terms of “healthspan,” but didn’t have a name for it until I read this book.
Focusing on doing the things you can do now to maximize your odds of a long “healthspan” should be a goal for each of us, and Attia’s book will help with both the thinking and the tactics required to meet this goal.
The Four Horseman
Attia explains that four key diseases are your real enemies, and modern medicine (2.0) has done little to weaken their effectiveness. In fact, modern society has only strengthened their ability to negatively impact our healthspan (e.g., processed foods). Focus on these four, and you’ll greatly increase your odds of a longer and healthier life. The four are:
- Metabolic Syndrome (e.g., Cholesterol, glucose, etc.)
- Heart Disease
- Alzheimer’s and Other Neurodegenerative Diseases
In Part II of the book, Attia dedicates 150 pages to the deadly four horseman. He explains how they work, why our modern society actually makes them more potent, and steps we can take to reduce their effectiveness. He gets down to the cellular level in explaining how they work and why his recommended actions work.
Fascinating stuff that will motivate you to make some changes in your life.
After laying out the facts, Attia dedicates the final 150 pages of Outlive to presenting his recommended tactics. Using the metaphor of your “Centenarian Decathlon” (a multi-faceted approach to increasing your Healthspan), he walks through a framework of principles that will make a difference in your life. He dedicates a chapter to exercise, which seems obvious. What isn’t so obvious, however, is why exercise should be considered “The Most Powerful Longevity Drug,” an argument made effectively by Attia. An example comes from the following quote on page 217:
“More than any other tactical domain we discuss in this book, exercise has the greatest power to determine how you will live out the rest of your life.”
Powerful writing, that.
More importantly, Attia gets into the details. Strength training vs. cardio? High-intensity cardio or longer periods of lower intensity? What type of exercise should you pursue to have the maximum impact on improving your healthspan? Why is V02 Max important, and what can you do to improve yours (or slow its inevitable decline)? He had a chart in the book that impacted me so much I Googled the source and found this original source. I reached out to creator Jayson Gifford and received his permission to share the chart in today’s post:
When I studied that chart, a light bulb went off in my mind. NOW I understand why it’s so much harder for me to run at 60 years of age – my VO2 max is naturally declining and my body is less efficient in converting oxygen to fuel my physical activity. Take a few minutes to study the chart – I found it to be one of the most impactful charts I’ve ever seen. As we age, activities we once found easy consume a higher % of our VO2 capacity. Finding a way to maintain a higher VO2 will make activities easier than if we do nothing and let aging’s natural progression run its course.
Attia continues the tactical approach with chapters on the importance of stability, nutrition, sleep, and emotional health. His transparency on the personal challenges he’s faced on the emotional health front was raw and powerful. He doesn’t just preach but rather shares his own personal struggles with refreshing honesty.
Three Changes I’ve Made Since Reading Outlive
This book will only improve your life if you actually apply some of the things you learn while reading it. To demonstrate, I thought it appropriate to share three specific changes I’ve made as a result of Attia’s book:
1. Embrace long, slow exercise: I’ve always enjoyed swimming and hiking but felt they weren’t “hard enough” workouts. My typical workouts (Spin and cross-fit/Weights, 3x per week) are high-intensity in nature, and I always feel good when I’ve put in a hard workout.
Attia makes a strong argument, however, that our most effective exercises are actually of the long and slow variety since it’s only through this type of workout that our bodies learn to effectively convert stored fat into energy. Since reading that section of the book, I’ve come to embrace my long swims. It’s also made me feel less guilty about buying my e-MTB since the use of the e-motor on the hills keeps me in the sweet spot of a moderate heart rate where the fat-burning is maximized (instead of going anaerobic as I frequently did prior to having the e-boost).
2. Add more protein to my diet: Attia states that almost all of us under-consume protein, and our muscles deteriorate faster as a result. Our muscle fiber inevitably deteriorates as we age, but adding protein to our diets can slow the process. I also learned the importance of “feeding” our muscles with protein after we work out. I added strength training to my workout routines several years ago, but I never realized the value of refueling them with protein during the recovery period. Based on his comments, I’ve added high-protein shakes to my recovery routine after weight-lifting exercises.
3. Taking Fish Oil: Attia recommends everyone take fish oil, especially if you have high triglycerides. Mine are borderline, but I figured taking a daily supplement of fish oil is an easy addition and can’t do any harm.
Two Opportunities To Improve Outlive
Medical terminology: Attia credits co-author Bill Gifford for helping him simplify some of the medical terminology in the book. Even with that, it’s a heavy read. Given the general audience for whom this book is written, I’d have liked to have seen a bit more “layman definition” for some of the medical explanations given. It’s not a book you can read casually, but rather one in which you’ll find yourself concentrating hard to keep some of the terminology straight in your mind. That said, it’s worth the effort.
Lack of specific actionable advice: Attia is quick to explain that this is not a simple “quick fix” book. He doesn’t recommend any specific diets or any specific exercise routines. Rather, he focuses on principles and the biological implications of different sorts of tactics. In fairness, he states early on that he won’t give detailed personal recommendations, and reading about the extensive tests he conducts with each of his patients before making recommendations gives you insight into his “why”. While I understand his reasoning, I would have liked to have seen some additional tactical advice, perhaps with “conditional qualifiers” to explain what personal situations would warrant which tactics.
Outlive – Conclusion
If you’re interested in maximizing your “healthspan” (healthy years of life), you should read Outlive – The Science & Art of Longevity (Amazing Link). Attia is a longevity expert and you will learn more than you’d imagine about the biological realities of aging, and what you can do to slow the process. The value of his wisdom FAR exceeds the price of the book.
You’ll find yourself wanting to vote to move the medical industry into the world of “Medicine 3.0”, where the experts focus on prevention rather than waiting for a disease to present itself before focusing on treatment. While that’s likely a long way off, the reality is you can apply a bit of “Medicine 3.0” by learning from this book and applying what you learn to your own life.
At times, Outlive is a heavy read, but challenge yourself. It’s worth the effort, and…
…your life will be better as a result.
PS – If you’d like another perspective on the book, check out this review from Chris Mamula at Can I Retire Yet.
Previous Book Reviews (Book images are Amazon affiliate links, the blue title is a link to my book review)