This summary of Peter Attia’s book, “Outlive,” plucks the takeaways from his enormously helpful book. This is more than a health book. “Outlive” is not a beginner’s book to health and fitness. It assumes a basic knowledge and readers have been actively seeking healthy habits already. By dispensing with the “get out and walk” pep talk and the “don’t drink soft drinks” type of advice, Attia is able to jump into next level science, studies, and antidotes for already healthy minded people.
You can also watch our review on YouTube.
Introduction
- Medicine must become more focused on preventive care. Many people die of preventable disease.
- Peter Attia is a medical doctor with impressive degrees and an interest in longevity.
Chapter 1 – The Long Game
- Medicine focuses on healing sick people, but fixing problems is much less successful than preventing health risk in the first place.
- Attia identifies what he calls the four horsemen – heart disease, cancer, neurodegenerative disease, and type 2 diabetes. These four are the primary killers of people and substantially reduce quality of life.
Chapter 2 – Medicine 3.0
- There has been little progress against the four horsemen. What he calls medicine 2.0 made tremendous strides in hygiene and antibiotics, but medicine has made little progress against the biggest problems.
- Medicine 3.0 is Attia’s version of a new medical age. In it there are four concentrations:
- Prevention
- Individualized care
- Assessing risk
- Focus on quality of life and lifespan
- Each of us must be proactive.
Chapter 3 – Objective, Strategy, and Tactics
- The big picture is this: If we do nothing, our health declines over the decades so that our quality of life during the second half of life is low. Medicine 2.0 has the ability to expand life for another 5-10 years at the end, but at a low quality of life.
- Medicine 3.0 is about keeping great health for the duration of your life, so you have a high quality of life and then you die.
- Each of us must develop a vision for how you want to age and your future, then find a plan to get there.
Chapter 4 – Centenarians
- People who life past 100 years often have great genes that help them get there. The key is they keep heart disease, cancer, cognitive decline, and diabetes away. Can our actions and environment keep the horsemen away?
- If most of us are proactive, we can push the four horsemen out so they don’t affect us in our 60s and 70s.
Chapter 5 – Eat Less, Live Longer?
- Reduce food to lengthen life.
- Caloric restriction improves lifespan in rats and monkeys, and reduces aging.
- Essentially “what we eat and how we metabolize it appear to play an outsized role in longevity.”
Chapters 6 – The Crises of Abundance
- Metabolic dysfunction is the problem. Many healthy weight people have metabolic dysfunction but no signs of it.
- More “bad” or “empty” calories is unhealthy. We must reduce simple carbs and sugars (high fructose corn syrup, white sugar, soft drinks, bread, etc.).
- Metabolic Syndrome occurs when you have 3 or more of the following:
- High blood pressure
- High triglycerides
- Low HDL cholesterol
- Waist circumference is too large
- Elevated fasting glucose
- What’s tricky is that skinny people can have metabolic syndrome.
- If you are metabolically healthy, you prevent or delay many health problems including the four horsemen.
Chapter 7 – The Ticker
- Heat disease is the leading cause of death.
- Heart disease and type 2 diabetes are totally preventable.
- 50% of heat attacks in men are before 65 years old so it’s not just an old man problem.
- The cardiovascular system – heart, arteries, and all of it – begins to decline after adolescence.
- Control lipids with a healthy diet and not smoking, and sometimes medication.
Chapter 8 – The Runaway Cell
- Cancer is the 2nd leading cause of death behind heart disease.
- There has been little progress, but lots of money on the cancer front.
- Prevention, more targeted and effective treatments, and early detection are the only things we can do.
- Attia is a big fan of early and regular screening.
Chapter 9 – Chasing Memory
- Nothing we can do but eat healthy and exercise decades in advance.
Chapter 10 – Thinking Tactically
5 things to slow the four horsemen:
- Exercise
- Healthy diet
- Sleep
- Emotional health
- Drugs, supplements, and hormones
Chapter 11 – Exercise
- Exercise is the most important thing you can do for your health and longevity.
- Diversify exercise by doing lots of zone 2 work (slightly elevated heart rate), some strength training, and some high intensity work.
- There is a correlation between high VO2 max and longevity.
- Weight training is great – simple workouts and complex.
Chapter 12 – Training 101
- Focus on cardio, strength, and stability.
- Zone 2 (conversational pace) is very important.
- Interval training to improve VO2 max is also crucial.
- Example: 4 minutes hard, 4 minute recover x 4-6
- Strength training is necessary by using wights, rucking and carrying things, grip strength, etc.
Chapter 13 – Stability
- It’s often overlooked but very important. This includes working on everything from balance to core strength.
Chapter 14 – Nutrition 3.0
- Most people need fewer calories and more exercise to build muscle.
- Nutrition is essential to fight off the four horsemen and maintain health.
- Nutrition is simple:
- Don’t eat too many calories – especially useless simple carbs and sugar
- Consume protein and essential fats
- Get vitamins and minerals
- Avoid pathogens like E. Coli, lead, and mercury
- Coming up with a plan is essential because there is so much useless food all around.
Chapter 15 – Putting Nutritional Biochemistry Into Practice
- Drop the SAD – Standard American Diet. The SAD involves overeating, consuming too many simple carbs like bread and cereal, indulging in food with high-fructose corn syrup and white sugar, and failing to load up on the correct nutrients.
- We all need to 1) eat less, 2) cut our unhealthy food, and 3) reduce time in which we eat.
- Calorie restriction can lead to a longer life. Studies show that monkeys that eat 25% less over two decades outlived monkeys that eat whatever they wanted, and they were overall healthier.
- Calorie restriction only works if the calories we consume are healthy and beneficial.
- Alcohol is not good for health, but if you do drink have no more than 7 drinks per week and no more than 2 per day.
- Protein is essential to building muscle mass and longevity. We need more than is recommended. A 180 Lb. man needs 130 grams of protein daily.
- Fat: we need to eat fat, but make it healthier fats from nuts, olive oil, and avocados – natural sources of fat are necessary in moderation
- Fasting: There are benefits, but the drawbacks are that people overindulge during eating periods and they have trouble eating enough protein
Chapter 16 – The Awakening
- Quality sleep is good for your physical health and brain (according to many studies)
- Shoot for 8 hours, but at least 7
- Achieve quality sleep by doing these things:
- limit alcohol and not after 6pm
- don’t eat three hours before bed
- avoid screens and stimulating electronics
- avoid work and stress related emails an hour before bed
- sleep in a cool and dark room
- give yourself 8 hours to sleep so go to bed early
Chapter 17 – Work in Progress
Emotional health should not be overlooked or ignored. Deal with the past and the present or it will tank your entire life.
Overall, it’s a great book and adds to the health and fitness conversation. For more, purchase the book here. You can watch our review on YouTube or visit our Instagram page for more. If you like this book, you might also enjoy one of our parenting or marriage book reviews.
