Dr Peter Attia’s new book “Outlive: the Science & Art of Longevity” is a fascinating deep dive into the common causes of mortality, Medicine 3.0, and the tools that we can all use to live better and longer.
This post contains affiliate links. I earn commissions when you buy through these links, at no cost to you.
Outlive book review summary
Dr Peter Attia approaches the science & art of longevity with an approach remarkably similar to a McKinsey & Company strategy study. He defines the goal, pareto’s the key drivers, and then defines actionable steps to make progress. I listened to this book on Audible (at 1.3x).
I started this review before fully finishing the book and expected it to just be a summary of the best resource I’ve found on longevity. But Peter’s last chapter on mental health made the book surprisingly more personal. After listening to Peter talk about “why do we want to live longer,” it made me realize that defining our why and what we’d do with extra years is just as important as the tactics.
Longevity and healthspan as key goals
In a nut shell, Dr Atta asks why hasn’t mortality rates declined meaningfully since the 1980s. This is a relevant question, given the trillions spent on new pharmaceutical as well as all of the other basic research since then. He postulates that in order to extend lifespan and healthspan, we need to transition from medecine 2.0 to 3.0.
To explain the above a bit more, Dr Attia defines lifespan (as years that we are alive) as well healthspan (the years in which we are generally healthy). His philosophy is that we want to not only extend our lifespan (live longer) but that we should seek to live the later decades of our life in a state that is generally capable of doing meaningful activities & being free of most pain.
Medicine 2.0 vs 3.0
Dr Attia defines Medicine 2.0 as the current regime of testing and treatment that is generally reactionary to test results above critical levels or the appearance of symptoms. His view is that this approach treats diseases only after they have gotten to critical stages, instead of working to prevent or detect them very early.
The prevention and early detection is where Medicine 3.0 comes in. It revolves around aggressive screening and treatment of diseases (or pre-disease states) early with exercise and medications.
Targeting leading causes of death and suffering
Like a good consultant (which he actually was), Dr Attia proposes that to live longer, we must understand and prevent the four horsemen diseases (which account for the majority of deaths in the United States). These include:
- Cardiovascular disease
- Cancers
- Metabolic disfunction (diabetes)
- Neurodegenerative disease (Alzheimer’s and related conditions)
Basic approaches to increasing lifespan and healthspan
Physical fitness
Peter breaks fitness down into endurance (activities that enhance our VO2 max and ability to burn sugar), strength (those that build muscle), and balance (those that let us navigate an uncertain world). He also goes deeper into Rucking (the art of carrying heavy stuff on your back for long distances).
Early screening / testing
“Outlive” brings the perspective that the current testing regime in medicine 2.0 is not sufficient to give us data early enough to make impactful changes. Peter recommends an increase in specific tests to combat the Four Horsemen diseases early.
Proper nutrition
The book discusses the four macronutrients (alcohol, carbohydrates, fat, and protein) in a logical and easy to understand way. The discussion of why these building blocks are important and how excess in any of them (except protein) can be negative was an amazing refresher of what we all learned in health class. But Peter takes it a step further and explains the science behind nutrition and uses non-commercial language to breakdown the three types of diets (calorie limited, time limited, and nutrient limited).
High quality & proper quantity of sleep
“Outlive” sets sleep up (properly) as the time & process where our body and minds recover. The linkages with Alzheimer’s disease and just the general recovery of our bodies is so critical, that good sleep is essential to daily and long term health. Dr Attia discusses using a sleep tracker (I’m a big fan of the Whoop 4.0) as a way to both measure of sleep as well as look for habits that improve / degrade the quality of our sleep. Like Dr Attia, I was once very guilty of not getting enough sleep and this section is a great reminder of why sleep is so critical (and difficult to achieve when sleeping in hotel rooms).
Address underlying mental issues
This is clearly the most personal portion of the entire book. Dr Attia lays out his personal struggle with mental / emotional health, the toll it took on his family, and his long journey to recovery. I really appreciated the candor and vulnerability that he presented. I won’t try to summarize his story, but the bottom line is that a healthy mental & emotional state makes up much of the ‘why’ for why we want to live longer. If you are angry or otherwise deeply troubled mentally, it’s hard to justify why we want to live longer (other than avoiding death).
Review of Outlive: the Science & Art of Longevity
I enjoyed this book immensly for four key reasons:
1) The book was extremely well written and effectively towed the line between detail and approachability. I really enjoyed the “take a step back” approach to assessing the primary risk factors (four horsemen) and then developing strategies to reduce those risks. His recommendations on how to think about fitness fit very well with my goals for running more and finding ways to build strength during travel (like using my TRX).
2) What could be more important in our life than focusing on our health and longevity? As Dr Atta said, we don’t want to “trade health for wealth.”
3) The book lays out a very logical strategy for using medicine 3.0 concept to positiviely improve our health and (hopefully) lifespan/healthspan. Dr Atta lays out fitness, nutrition, testing, sleep, and mental health as the building blocks for this approach.
4) The inclusion of Peter’s struggle with mental health (and subsequently journey through growth and recovery) make this book feel so personal. I’ve experienced many friends and family members who’ve struggled in this area (especially from the Special Forces community) and his process of healing really resonated.
I would recommend this book to any adult who is interested in how to live longer and better (which really should be all of us). This book touches on many of the concepts that are core to the EffectivExec philosophy (such as prioritizing fitness & sleep / recovery).
In addition to this book, Dr Attia’s website and his podcast “The Drive” are also excellent sources of wisdom for health and longevity.
Check out “Outlive: the Science & Art of Longevity” on Audible or in Hardcover today!
