Outlive: The Science and Art of Longevity

I first learned about Dr. Attia through watching the series 'Limitless.' I found the series to be extremely inspiring, and ultimately life-changing. I then stumbled across a Youtube clip where someone was discussing this book, which led to my purchase of it. It is a very thick book with which I took my time reading, in chunks. (I did not read the last two sections on sleep and emotional health).I read through some of the 1 and 2 star reviews on Goodreads. Many mentioned that the book could be significantly shorter and that they did not like all of the personal stories that Dr. Attia shared. However, I found each of the stories to be quite helpful in putting the information into context. And I think the overall intent of this book was/is two-fold. It was not only written to present 'information,' but also Dr. Attia's personal testament of his journey as he learned new things, changed his perspectives, struggles in life, etc. The addition of this deeply intimate information helps to make the book more personable versus cold and mechanic. And who knows, writing this book may have also provided Dr. Attia with some degree of inner peace and resolution. What is so wrong with that?There are many focal points of this book, but for this book review, I will address what I find to be key take away points, and my perspective of those points discussed by Dr. Attia.READABIITY: Some parts of the book could be difficult for people to understand if they do not have a medical background, fortunately I do. For those who do not, and really want to understand, have Internet access handy so that you can cross-reference between the Internet and the book as you go along. NOTE: There are many parts of the book where animal research studies are discussed. I must preface that I struggle reading about animal studies, as I am anti-animal testing activist. But I do understand why the studies are mentioned in the book.PHILOSOPHY: Dr. Attia makes several comparisons between Medicine 2.0 and Medicine 3.0. I think many Primary Care providers who read and subsequently reviewed this book may have felt offended by Dr. Attia's views on what he describes as our current healthcare model (Medicine 2.0). However, Dr. Attia is not pointing fingers and intending to insult Primary Care providers. He is simply pointing out flaws in our current healthcare model and how it should shift to a different focus, which I 100% agree with!For those who chose to be insulted by this, shame on you. If you are a Primary Care provider, it is also not your fault that your practice is based upon Medicine 2.0, as you have to operate within the restrictive system and in accordance with insurance coverage. Embrace the Medicine 3.0 philosophy and save it for the day when, perhaps, our current healthcare model will shift closer to it. Everyone will be better off for it.PREVENTATIVE TESTS: I found it odd when a reviewer mentioned that they know many adults who lived to old ages without any fancy tests. That is a strange thing to write, because Dr. Attia does NOT imply that having a bunch of tests contributes to living longer or healthier. Conversely, he implies that having preventative tests provides knowledge of one's current health state. That knowledge can then enable people to make changes that can contribute to living longer and healthier versus being a ticking time bomb and continuing on the same physiological path. How that reviewer misconstrued these two vastly different concepts is beyond me. This reviewer continued on to say that these seniors also smoked, drank, ate what they wanted, etc. However, I cannot help but wonder about their quality of life, and whether they were active and enjoy(ed) pursing hobbies/interests OR if they were simply 'existing' as couch potatoes. These are two vastly different concepts, and is the focal point that Dr. Attia expresses throughout the book.On another note, Dr. Attia describes the perfect world where everyone has access to a plethora of preventative tests. Many of these preventative tests (scans, blood, etc.) are not covered by typical insurance plans, which means people have to pay out of pocket for them. I do plan to have most of the screening tests done that he recommends, because I want that in-depth knowledge of my current health state. However, doing all of these are just out of reach for many, or until patients reach a certain age (DEXA scan, for example).MACRO NUTRITION: As many others mentioned, I do not think that any new/novel information about macro nutrition was presented. Some reviewers got the impression that Dr. Attia is pro-Keto diet. But I did not infer that at all. Conversely, I thought Dr. Attia did a great job with pointing out key advantages and disadvantages of many different types of diets, not just Keto. And I think he made it quite clear that no one type of nutrition regimen/approach is going to work for everyone. This point was made quite clear when he discussed his friend/patient (the Lipidologist) who benefited from a fasting regimen. I also think he did a good job explaining how different macro nutrients affect the body in an easy to understand fashion. I particularly found the information about Fructose and Purine quite interesting.EXERCISE: It was made abundantly clear that Dr. Attia believes that exercise is the foundation for good health, which I agree with! He describes, in detail, how exercise is the best preventative tool for the "Horsemen." Yes, it makes good sense: Exercise = improved blood flow = improved perfusion AND = building and/or maintenance of muscle tissue and maintenance of bone = potential reduced risk for the "Horseman." But in reality, is it really THAT simple? I do not think so. There are so many other factors that come into play.Additionally, what is disheartening, and what other reviewers found discouraging about this, is how complex Dr. Attia makes exercise out to be. While I agree with the benefits of all the different types of exercises he discusses, I also think it is unrealistic for many people to achieve all of it in it's entirety. Again, it comes back to the perfect world where there are no life-stressors, no major time consuming life-demands, not having to work a full-time job, etc.For example, let's talk about a rich celebrity who is one of Dr, Attia's patients: Chris Hemsworth. I am not criticizing or picking on Mr. Hemsworth. Below is just a great example that helps my point hit home here.Does he work a 40-hour week desk job, staring at a computer all day? No. Is he on his feet all day working at a store helping customers? No. Does he come home from that job, after a commute, and have to try to squeeze in a workout? No.Does he have personal trainers and nutritional coaches? Yes. Does he have plenty of time most days to exercise and enjoy leisurely activities? Yes. Is his job as an actor focused on being physically fit? Yes. Is he able to wake up naturally most days instead of being blasted awake by an alarm clock? Yes. Does he have plenty of income to not have to worry about paying the bills? Yes.This is the perfect world that Dr. Attia describes. Not everyone has enough time in the day to devote to exercising like Dr. Attia believes is necessary. I am a poly-outdoorsman, and I am an endurance (non-professional) athlete. I would love nothing more than to have the amazing opportunity to devote as much time as I want to exercise and my outdoor sports versus working a full-time job. However, that is not my reality despite how much I would like it to be.For most people who live in the real world, doing some exercise each day/week just has to be enough because that's all they can do. So to even remotely imply that that amount just isn't enough to obtain a long, healthy lifespan is quite sad. This is where the notion of 'weekend warriors' comes into play. For some, weekends are the only time that people have to exercise and/or recreate in the outdoors. This pattern does not align with Dr Attia's ideology, but doing something on the weekends is better than doing nothing at all.What I do think readers can benefit and take away from this section of the book is to, perhaps, incorporate different exercises into their daily/weekly regimen that they may not have thought of. This is key! For myself, I have now incorporated new things into my exercise regimen because I have a better understanding of how they can have a long-term impact.FINAL THOUGHTS: This is not a concrete book of science. It is a book that discusses some scientific information combined with Dr. Attia's life-experiences. I think it is a well-rounded book because of this. Take whatever information you found useful and run with it! Be as active as you possibly can each day/week, keep your body trim, and feed it with good nutrition. For us "Commoners," that is the best we can do.

This book is fantastic. Anyone with an interest in learning how to live a healthier, longer life should buy a copy and study it. That’s what I did. After reading it I ordered a second copy and gave it to my primary care physician because I wanted him to know where I was coming from in terms of being a patient and how I want to live my life. Outlive, is a goldmine of healthcare information.I became aware of Peter Attia about five years ago when a friend suggested I listen to an episode of The Drive. For those who are unfamiliar with Attia, this is his weekly podcast. After listening to it I was hooked and immediately became a subscriber and began listening to archived episodes. I spend a lot of time commuting and to date I’ve probably listened to two-thirds of the interviews and the Ask Me Anything discussions. So when I received the notification that his long-awaited book was finally going to be published I preordered my copy. Once it arrived I got out my pen and highlighter and went to work.I believe I can speak from a position of strength when it comes to commenting on this book. I have walked a similar career path. Like Attia, I’ve been trained in basic science research. I earned a PhD under the mentorship of the great Philip Gollnick, PhD, one of the pioneers of modern exercise science. Similar to Attia, I’ve also been trained in medicine and surgery having completed a medical degree and a surgical residency in orthopedics.Attia is a voice in the wilderness shouting the message of Medicine 3.0, a philosophy based on the guiding principles of preventing the onset of chronic disease. He defines the time from birth to the onset of chronic disease as healthspan. The period of time from birth to death is lifespan. The goal of Medicine 3.0 is to increase healthspan so that it encompasses most, if not all, of lifespan. Medicine 3.0 is proactive whereas Medicine 2.0 (where we are now) is reactive. Medicine 2.0 begins treatment of an illness or disease only after it has been diagnosed, after the damage has begun. Medicine 3.0 is based on preventing, or delaying, the onset of disease or illness so that treatment is avoided.How does Attia recommend we go about maximizing healthspan? He believes this can be accomplished by focusing on doing everything possible to prevent what he terms, the four horsemen: metabolic syndrome (type-2 diabetes), cardiovascular disease, cancer, and neurodegenerative diseases (Alzheimer’s, Parkinson’s, etc.). The book is broken up into sections devoted to each of the horsemen. A final section, where Attia opens up and presents some of his personal journey, is devoted to emotional health. The importance of this section cannot be overstated. Emotional health probably should be considered the fifth horseman (but that would wreck the Four Horsemen of the Apocalypse metaphor).He focuses on ways to prevent cognitive decline, the slowing of our mental processing speed as we age. An emphasis is placed on exercise, aerobic and strength training, as an intervention. Exercise increases cardiovascular and respiratory function and decreases the loss of muscle size and strength. It also increases bone density and deceases osteopenia and osteoporosis. In short, regular exercise reduces frailty. As frailty increases our risk of mortality increases. He makes the claim that the single most important thing anyone can do to improve healthspan is to exercise on a regular basis. It is better than any drug you can take (with the possible exception of rapamycin), nutrient, or diet.Attia and his co-author Bill Gifford tone down the technical aspects of some of the medical topics to make it more accessible to a lay audience. However, this does not detract from the quality of the information. If anything it makes the book better by reaching a broader audience. If a reader wants more detailed information on a topic they can easily obtain it by culling through the archives of The Drive where in depth interviews with preeminent physicians and scientists are available. He employs a team of highly skilled analysts that are constantly reading the latest scientific publications looking for high-quality research pertinent to his mission. He is at the forefront of Medicine 3.0.If you want to learn more about your physical and emotional health with the goal of living better and longer then read Outlive, the Science & Art of Longevity.

I enjoyed geeking out on this book -though long. Appreciated Peter's personal transparency and authenticity. Some of the scientific parts were difficult to digest as I'm neither a health practitioner nor a scientist. I valued the information especially as someone interested in health, wellness, and the potential vicissitudes of ageing. Got some meaningful nuggets especially re the importance of strength, including grip strength. Love the research support.