How do you want to spend the last decade of your life? Do you want to be weak, bedridden, and mentally foggy? Or do you want to be busy doing whatever brings you joy?<\/p>\n\n\n\n
According to Peter Attia’s Outlive: The Science and Art of Longevity<\/em>, you can extend the active and fulfilling part of your life by building the right healthy habits. And, the earlier you start building these habits, the better chance you have of circumventing mental and physical decline.<\/p>\n\n\n\n Continue reading for an overview of this book that just might lengthen your life.<\/p>\n\n\n\n\n\n\n\n In our overview of Peter Attia’s Outlive: The Science and Art of Longevity<\/em>, we\u2019ll begin by detailing the chronic diseases you must avoid to live a long and active life, and we\u2019ll explain what causes these diseases. Then, we\u2019ll describe the actions you can take to avoid these diseases, explaining how best to exercise, what to eat, and a few other miscellaneous health tips.<\/p>\n\n\n\n Attia is a medical doctor and surgeon. He\u2019s the creator of Early Medical<\/a>, an intensive online course on personal wellness and longevity. He also hosts the podcast The Drive<\/em><\/a>, which features conversations with experts on health, longevity, and performance. Attia wrote Outlive<\/em><\/a> to be a practical guidebook that a general audience can use to improve and lengthen their lives.<\/p>\n\n\n\n According to Attia, the key to avoiding physical and mental decline in old age is preventing four specific chronic diseases: <\/strong>heart disease, cancer, neurodegenerative diseases (like Alzheimer\u2019s and dementia), and type 2 diabetes. By chronic<\/em>, we mean that these diseases progress throughout a person\u2019s life rather than coming and going quickly, like a cold or flu. As you grow older, your chance of contracting these four diseases increases, and they\u2019re responsible for the vast majority of deaths in the elderly. <\/strong>Even if these diseases don\u2019t kill you, they greatly hinder your physical and mental capabilities, reducing your quality of life.<\/p>\n\n\n\n To avoid these diseases, take early preventative action.<\/strong> Although they often appear to strike suddenly, they don\u2019t present crippling physical and mental symptoms until after they\u2019ve slowly progressed for decades inside your body. Attia contends that by fighting these diseases decades before they present themselves, you\u2019ll often be able to avert them entirely.<\/p>\n\n\n\n Unfortunately, in our current medical system, doctors and hospitals often use a fee-for-service model\u2014this means that doctors get paid for administering expensive treatment, not for prescribing low-cost preventative measures. They neglect to diagnose patients with these chronic diseases until severe symptoms manifest, at which point it\u2019s much more difficult to stall or reverse their progression. For this reason, you can\u2019t just rely on your doctor to keep you healthy\u2014you must take your health into your own hands and proactively work to prevent these chronic diseases<\/strong>.<\/p>\n\n\n\n How, specifically, can you avoid these four chronic diseases? Attia notes that although these diseases cause your body to break down in totally different ways, there\u2019s an incredibly common yet preventable health condition that directly causes all four: metabolic dysfunction<\/a><\/em>.<\/strong> By keeping your metabolism healthy, you can greatly reduce your risk of contracting all four chronic diseases.<\/p>\n\n\n\n Next, we\u2019ll explain what metabolic dysfunction is and what causes it. Then, we\u2019ll detail how metabolic dysfunction leads to all four chronic diseases.<\/p>\n\n\n\n Attia explains that \u201cmetabolism\u201d is the process by which your body converts the food and other nutrients you consume into energy and materials used to build, repair, and maintain your body. However, if you regularly ingest more nutrients than you need\u2014in other words, if you consume too many calories\u2014your body will start storing them in increasingly unhealthy ways.<\/strong><\/p>\n\n\n\n Your body converts much of the food you eat into glucose (also known as blood sugar), a form of energy that\u2019s easily stored, transported, and utilized. If your body doesn\u2019t need to immediately burn that glucose as energy, it can store it in healthy ways: in your muscles and liver as a compound called glycogen<\/em>, or as subcutaneous fat<\/em>, the healthy layer of fat found under your skin all over your body. However, Attia warns that once this storage is full, your body begins storing this energy in places where it doesn\u2019t belong<\/strong>; for instance, unhealthy visceral fat. <\/em>This is <\/em>abdominal fat that surrounds important internal organs and causes dangerous inflammation (an immune response that can cause pain, swelling, and other symptoms). <\/p>\n\n\n\n Eventually, after you\u2019ve consumed too many nutrients over an extended time, tiny bits of fat squeeze their way inside muscle cells<\/em>. Attia explains that this fat weakens your cells\u2019 ability to absorb glucose from the bloodstream and use it as energy<\/strong>. Your pancreas tries to compensate for this damage by increasing production of insulin<\/em>, the hormone that helps push blood glucose into cells that need it. Unfortunately, if your cells are overloaded with elevated insulin for too long, they become less responsive to insulin and absorb even less glucose\u2014a condition called <\/strong>insulin resistance<\/a><\/em><\/strong>.<\/strong> Insulin resistance directly causes all four of the chronic diseases we mentioned before.<\/p>\n\n\n\n The term \u201cmetabolic dysfunction\u201d refers to this condition as a whole\u2014insulin resistance is one main component of metabolic dysfunction.<\/p>\n\n\n\n How could metabolic dysfunction and insulin resistance cause four wildly different chronic diseases? Let\u2019s examine all four.<\/p>\n\n\n\n First, extreme metabolic dysfunction is<\/em> type 2 diabetes<\/strong>. Attia explains that you qualify for a diagnosis of type 2 diabetes when you reach a certain level of chronically elevated blood sugar and insulin resistance.<\/p>\n\n\n\n Second, metabolic dysfunction directly increases your risk of cardiovascular disease<\/strong>, Attia states. When your metabolism is dysfunctional, your blood pressure increases, damaging the walls of your blood vessels. This damage increases your risk of harmful cardiovascular incidents by causing plaque to build up along your vessel walls. This may eventually clog your blood vessels or force a clot into the bloodstream, causing a heart attack or stroke.<\/p>\n\n\n\n Third, metabolic dysfunction provides the perfect environment for cancer cells to grow.<\/strong> Attia explains that cancer cells consume more glucose than healthy cells do, and they use insulin to absorb these vast amounts of glucose. The more insulin is in your bloodstream, the more fuel is available for cancer cells to grow.<\/p>\n\n\n\n Finally, Attia asserts that metabolic dysfunction causes neurodegeneration<\/em>: <\/strong>chronic damage to your brain.<\/strong> To function properly, the brain needs a lot of energy\u2014typically in the form of glucose\u2014and it depends in part on insulin to get the glucose it needs. In particular, the parts of the brain responsible for memory appear to be more dependent on insulin than other parts. If you trigger insulin resistance in the brain, the memory systems can\u2019t get the energy they need, and neurodegeneration sets in.<\/p>\n\n\n\n Now that we\u2019ve explored the chronic diseases you need to prevent if you want to age healthily, let\u2019s discuss Attia\u2019s tips on how to prevent them. We\u2019ll begin with his tips on exercising.<\/p>\n\n\n\n Attia contends that consistent exercise is the number one habit you can practice to improve your health<\/a>.<\/strong> As we\u2019ll see, it significantly increases your lifespan and helps ward off all the major chronic diseases.<\/p>\n\n\n\n Attia assumes that one main reason you want to avoid disease is so you can keep doing the things that bring you joy. He outlines a set of exercise guidelines intended to help you reach this goal: to maintain enough physical fitness to do everything active you want to do<\/strong> for as long as possible. If you want to continue playing basketball with your friends through your twilight years, or if you just want to be able to walk your dog and tend your garden, Attia recommends regularly practicing three types of exercise: Zone 2 endurance training, VO2<\/sub> max sprint training, and muscle-centered strength training. Let\u2019s discuss each of these in turn.<\/p>\n\n\n\n First, Attia recommends regular \u201cZone 2\u201d aerobic exercise. Exercise experts describe the intensity of a given exercise using one of five \u201czones.\u201d Zone 2 is light-to-moderate exercise: pushing yourself<\/a> just hard enough that it\u2019s slightly uncomfortable to speak.<\/p>\n\n\n\n Zone 2 exercise is beneficial because it causes your cells to produce more high-quality mitochondria<\/em><\/strong>\u2014organelles in your cells that metabolize glucose and fatty acids into energy. The more mitochondria you have and the stronger they are, the more fat and glucose they can burn. This frees up storage space for calories you eat that would otherwise cause metabolic dysfunction.<\/p>\n\n\n\n Attia recommends that the average person engage in Zone 2 exercise for at least<\/em> three hours a week. That said, if you\u2019re recovering from a sedentary lifestyle<\/a>, Attia notes that two 30-minute sessions per week are enough to drastically reform your health.<\/p>\n\n\n\n Second, Attia recommends increasing your VO2<\/sub> max<\/em>: the volume of oxygen that your body can effectively transport and utilize to create energy while you\u2019re pushing yourself to your physical limits. This number, more than any other, precisely reflects your overall physical fitness. The higher your VO2<\/sub> max, the more physical activities you\u2019ll be able to perform and enjoy.<\/strong><\/p>\n\n\n\n Why do you need a high VO2<\/sub> max to be physically fit? Attia explains that your cells need oxygen to convert glucose and fats into energy. Exercise increases the demand for oxygen throughout your body, and the more intensely you exercise, the more likely it is that your oxygen demand will exceed your VO2<\/sub> max. At this point, your cells lose oxygen and must resort to less efficient means of energy generation. You\u2019ll hit your physical limit and won\u2019t be able to complete whatever physical activity you\u2019re trying to do.<\/p>\n\n\n\n VO2<\/sub> max declines sharply as you age. So, to do all the physical tasks you want to in your elderly years, compensate for this decline by training your VO2<\/sub> max as much as possible<\/strong>. Attia adds that, aside from enabling an active lifestyle, a high VO2<\/sub> max will reduce your risk of disease\u2014research shows that VO2<\/sub> max is strongly correlated with a longer lifespan.<\/p>\n\n\n\n To improve your VO2<\/sub> max, Attia recommends a high-intensity interval exercise rhythm: Warm up, then perform four-minute spurts of aerobic exercise at the fastest pace you can steadily maintain for those four minutes. Take four minutes of recovery by exercising at a slow, easy pace. Repeat this sprint-rest cycle four to six times, then cool down. Doing this once a week is enough to gradually raise your VO2 <\/sub>max.<\/p>\n\n\n\n Finally, Attia recommends building as much muscle as possible. Research shows that, the bigger and stronger your muscles are, the longer you\u2019ll live and the healthier you\u2019ll be.<\/strong><\/p>\n\n\n\n One reason for this is that the more muscle mass you have, the easier it is to be metabolically healthy<\/strong>. Attia states that muscle tissue is better at metabolizing glucose than other parts of your body, So, the more muscle you have, the easier it is to keep your blood sugar low and stable. Additionally, building muscle increases your capacity to store glucose as glycogen for short-term energy consumption, rather than storing it as potentially harmful fat.<\/p>\n\n\n\n Unfortunately, around the time someone turns 65, they begin losing muscle at an alarming rate. Unless you build up above-average muscle mass before<\/em> this time, your muscle mass will drop low enough during your elderly years to leave you significantly more vulnerable to chronic disease and injury. Attia recommends regular strength training (specifically, weightlifting) to prevent this as much as possible.<\/strong><\/p>\n\n\n\n However, Attia emphasizes that, if you perform intense strength training exercises poorly, they can do more harm than good<\/strong>\u2014specifically, if they cause you to badly injure yourself. Train yourself to use the proper form<\/a> when practicing strength exercises, and use lighter weights until you\u2019ve built up the bodily awareness<\/a> you need to avoid injury when lifting heavier weights.<\/p>\n\n\n\n In addition to exercising correctly, eating a healthy diet is key to maintaining your physical and mental capabilities in old age. Attia emphasizes that what you should eat depends on your unique body\u2014there\u2019s no diet that\u2019s universally the \u201chealthiest\u201d for everyone.<\/strong> Everyone\u2019s body metabolizes food differently, so the exact same diet might help one person and harm another.<\/p>\n\n\n\n Although there\u2019s no universally optimal diet, Attia offers broad dietary advice that would improve the health of most people. In modern times, many follow what\u2019s called the Standard American Diet<\/a>, which is heavy in processed, sugary foods. Consequently, they consume too many calories (which contributes to metabolic dysfunction), yet they still don\u2019t get enough of some key nutrients (especially protein).<\/p>\n\n\n\n Attia asserts that most people should do the following:<\/p>\n\n\n\n Finally, as a side note, Attia states that as long as your metabolism is relatively healthy, practicing the ideal exercise routine is more important than consuming the ideal diet<\/strong>. Although fixing<\/em> your diet is essential if you\u2019re suffering from intense insulin resistance, perfecting<\/em> your diet yields far fewer health benefits than perfecting your exercise routine.<\/p>\n\n\n\n According to Attia, most people consume far less protein than their body needs for optimal health.<\/strong> The body uses protein for countless essential tasks, converting it into important enzymes, hormones, and muscle mass. (Building muscle is necessary to increase health and longevity.)<\/p>\n\n\n\n Although US government agencies recommend consuming 0.8 grams of protein per kilogram of body weight a day, Attia asserts that most people need at least<\/em> double that\u20141.6 grams per kilogram. If you\u2019re active and trying to gain muscle (as almost everyone should be), Attia recommends 2.2 grams per kilogram (or 1 gram per pound of body weight) of protein.<\/p>\n\n\n\n Whereas excess calories from glucose are sometimes stored in unhealthy ways, your kidneys will filter out any excess protein and you\u2019ll excrete it through urine. Therefore, it\u2019s very difficult to eat too much protein<\/a><\/strong>\u20143.7 grams per kilogram of body weight will strain your kidneys, but the vast majority of people never come close to consuming that much.<\/p>\n\n\n\n Most people consume too many carbohydrates,<\/strong> asserts Attia. Although the body uses carbohydrates as its main source of energy, when you consume too many, they raise blood glucose and trigger the overproduction of insulin. This is because your body converts carbohydrates into glucose more readily than any other food group.<\/p>\n\n\n\n That said, Attia notes that carbohydrates in moderation are healthy\u2014and they\u2019re healthier for some people more than others<\/strong>. For instance, although it would be atypical, you may find that cutting carbohydrates out of your diet doesn\u2019t<\/em> help you burn fat or reduce your blood sugar.<\/p>\n\n\n\n The only way to know for sure how your unique metabolism processes carbohydrates is to experiment with your diet until you\u2019ve found one that helps you reach your health goals.<\/p>\n\n\n\n To help you do this, Attia recommends using a continuous glucose monitor (CGM)<\/strong>, an implantable device that allows you to stay aware of your blood sugar levels at all times. Spikes in blood glucose after you\u2019ve eaten something high in carbohydrates indicate times when your body will produce extra insulin in response. By observing what quantities of specific foods cause your glucose (and insulin) to spike, you can learn to avoid or reduce your intake of those foods in the future. Over time, this helps you keep your blood glucose low and avoid insulin resistance.<\/p>\n\n\n\n When you reduce your consumption of carbohydrates and eat the necessary amount of protein, the rest of your diet will primarily be made of <\/strong>fats<\/em><\/strong>. This is perfectly healthy<\/strong>, according to Attia. <\/p>\n\n\n\n Generally speaking, foods high in monounsaturated fats (like olive oil) are healthier than foods high in polyunsaturated fats (like nuts and fish) or foods high in saturated fats (like beef and butter). Attia estimates based on anecdotal evidence that one-third to one-half of people react badly to a diet heavy in saturated fats\u2014it causes them to produce significantly more LDLs and other unhealthy forms of cholesterol, increasing their likelihood of heart disease. That said, for those whose bodies can process it well, saturated fat is perfectly healthy to eat.<\/p>\n\n\n\n Attia notes that, in recent years, fasting\u2014restricting your calorie intake for fixed periods of time\u2014has become an incredibly popular health trend. But, is it good or bad for you?<\/p>\n\n\n\n Fasting is exactly what some people need.<\/strong> If you find fasting easier than trying to follow strict dietary rules, it can help you reduce your calorie intake<\/a> to a healthy level. Additionally, within three days of fasting, you\u2019ll trigger starvation ketosis<\/em>\u2014your body burns fat stores to keep you from feeling hungry, and your cells recycle stray waste materials into functional parts in a process called autophagy<\/em>.<\/p>\n\n\n\n However, Attia argues that, in many cases, fasting can be detrimental to your health. It\u2019s nearly impossible to eat enough protein to support your body during a fast, so you\u2019re likely to lose muscle (which is very unhealthy). For most people, this is too great of a sacrifice to make. Fast only if you have metabolic dysfunction and desperately need to burn fat to avoid chronic disease<\/strong>.<\/p>\n\n\n\n Alongside exercising and amending your diet, Attia also highlights a couple of other habits that are important to staying healthy: getting enough sleep and taking care of your emotional health<\/a>.<\/p>\n\n\n\n To improve your health and longevity, get more sleep.<\/strong> Attia notes that sufficient sleep gives your brain time to organize its memories, while insufficient sleep results in short-term damage to memory and mental acuity.<\/p>\n\n\n\n Additionally, during sleep, your brain cleans away harmful proteins that accumulate between your neurons during the day. If you don\u2019t give your brain time to do this, these proteins will accumulate and cause long-term damage\u2014including neurodegenerative diseases like Alzheimer\u2019s.<\/p>\n\n\n\n Furthermore, multiple studies suggest that poor sleep disrupts your metabolism<\/strong>, making metabolic dysfunction and chronic disease much more likely. Although researchers aren\u2019t totally sure why this is, Attia theorizes that it\u2019s because insufficient sleep puts your body into perpetual fight-or-flight stress. The stress hormone<\/a> cortisol raises blood pressure and triggers the liver to release glucose into the blood. This can lead to insulin resistance and an increased risk of chronic disease.<\/p>\n\n\n\n Finally, Attia emphasizes the importance of taking care of your emotional health. Attia recounts his lifelong journey to overcome feelings of rage toward others and himself, both of which had roots in his childhood trauma. <\/p>\n\n\n\nOverview of Peter Attia’s Outlive<\/em><\/h2>\n\n\n\n
To Live Better, Avoid Chronic Disease<\/h3>\n\n\n\n
What Causes Chronic Disease?<\/h4>\n\n\n\n
Defining Metabolic Dysfunction<\/h5>\n\n\n\n
How Metabolic Dysfunction Causes Chronic Disease<\/h5>\n\n\n\n
How Should I Exercise?<\/h3>\n\n\n\n
Build Endurance Through Zone 2 Training<\/h4>\n\n\n\n
Stretch Your Physical Limits Through VO2<\/sub> Max Training<\/h4>\n\n\n\n
Build Muscle Through Strength Training<\/h4>\n\n\n\n
What Should I Eat?<\/h3>\n\n\n\n
Most People Should Eat More Protein<\/h4>\n\n\n\n
Most People Should Eat Fewer Carbs<\/h4>\n\n\n\n
Complete Your Diet With Fats<\/h4>\n\n\n\n
Fasting Is Sometimes Good for You (But Usually Bad)<\/h4>\n\n\n\n
How Else Can I Stay Healthy?<\/h3>\n\n\n\n
Get Plenty of High-Quality Sleep<\/h4>\n\n\n\n
Take Care of Your Emotional Health<\/h4>\n\n\n\n