My Favourite Takeaways from "Outlive" by Dr. Peter Attia, MD
Updated: Jun 8
I have long been a fan of Dr. Peter Attia. He is a podcaster, author and practitioner of longevity medicine. Moreover, he is a true scientist with a balanced, patient-centered view.
His latest book, Outlive, is an entertaining, data-driven point of view on maximizing health and longevity. I would strongly recommend this book to anyone interested in enjoying and thriving in physical and emotional health for as long as possible.
Hopefully, that sounds like you.
His notion of "Medicine 3.0" (a preventative, holistic approach to medicine that is inclusive of nutrition and exercise) resonates positively with me. The book is also written very much in the same tone as he speaks, and since his podcast is one of my favourites, that was certainly alright by me. He has a measured, witty way of articulating himself and is able to break down complicated scientific and medical concepts in ways that are easily understood.
Here are some of my favourite takeaways from the Outlive.
Scroll (or, better yet, read through) to the end for links to purchase the book and to various relevant podcast links.
Cancer, Heart Disease and Alzheimer's Are All Awful, and Diabetes Makes Them All Worse
Attia refers to metabolic disorders such as Type II Diabetes and hyperinsulinemia (aka "Type II Diabetes, but we can't call it that yet because the numbers are that bad"), cancer, heart disease and neurodegenerative diseases such as Alzheimer's as "The Four Horsemen" of chronic disease.
However, he distinguishes metabolic disorders as the launchpad of the other three in that having such a disorder drastically increases both one's chances of developing one of the other three diseases, and likely the severity of any and all of them once you are afflicted.
Hyperinsulinemia and Type II Diabetes are, therefore, no joke at any age. If you have been told that you have one of these diseases or are on the brink of being diagnosed with one (just waiting for that HbA1c reading to get a little higher), the best time time to get on top of it is somewhere between 5 years ago and yesterday. The next best time is right now.
We "Know" Next to Nothing About Nutrition
My daughter still faithfully believes that Santa Claus delivers presents to our home every year some time between December 24 at 9:00 pm and December 25 at 5:00 am. While I want her to hold on to this for as long as she sees fit, her belief in no way makes that notion true.
Keto, carnivore, vegan, raw vegan, flexible dieting, Mediterranean, The Zone, Atkins, pescatarian . . . every single one of these diet plans (and fads) promise faithful, zealous followers longer life, smaller waistlines, clearer thinking and moral superiority over friends and family members who have not dedicated themselves to the same form of nutrition.
There seem to be two truths derived when examining these various food religions:
Every single one of them is in fact nutritionally superior to the Standard American Diet (aptly acronymized as SAD); and,
According to independent research, not a single one of them is in any way superior to the others in any definitive way.
If we are going to believe the science, then here is what the science says about nutrition rules to maximize your health span:
Don't eat too much
Don't eat too little
Avoid ingesting food that contains things that will kill you (such as E. Coli, mercury and lead)
Ensure that you are consuming sufficient amounts of protein, essential fats, vitamins and minerals
Furthermore, a constructive set of questions to ask about your own nutrition issues looks something like:
Am I undernourished or overnourished?
Do I have adequate amounts of muscle or inadequate amounts of muscle for my health goals?
Am I truly metabolically healthy or not?
You (Most Likely) Need to Eat More Protein
Conventional nutrition recommendations underemphasize protein, at least according to what Dr. Attia presents in Outlive.
Consuming inadequate protein, particularly as we age, can contribute to the natural degradation of muscles, joints and connective tissues, as well as accelerate sarcopenia (age-related muscle loss).
Conventional nutrition recommendations generally give protein consumption guidelines of 0.8 g / kg of bodyweight. So, for someone who weighs 75 kg (or 165 lbs), that means 60 g of protein per day.
Dr. Attia recommends protein consumption to be 1.6 g / kg of bodyweight per day, and that is at the lower end! So, our same 75 kg subject would optimally consume a minimum of 120 g or protein per day to optimize their healthspan and longevity, with lots of room for more protein consumption if necessary or desired.
According to current, updated science (again, as opposed to religious-like belief or historical continuity of previously held scientific conclusions), protein is not only NOT harmful to the kidneys and digestive system in the current recommended dose ranges, but is absolutely essential for maximizing muscle and skeletal integrity, and therein in preventing chronic disease.
Exercise Is Your Best Bet Against Alzheimer's Disease
According to Dr. Attia, current research is continually showing that exercise is essential for maximizing your health and longevity, and preventing The Four Horsemen of chronic disease mentioned above.
Without a doubt proper sleep, good nutrition and good emotional well-being cannot be ignored in this fight. and should be maximized.
Apparently, however, the most dramatic effects from exercise come in its influence on the prevention of Alzheimer's and other neurodegenerative diseases. In fact, Dr. Attia posits that exercise is the number one effort a person can towards neurodegenerative disease prevention.
Strength Training Matters for Your Entire Lifetime
Typically when considering exercise efforts towards longevity, there is a bias for most people in favour of aerobic and other cardiovascular-oriented forms of training.
There is good reason for this. For example, the number of predictor of longevity is the VO2 Max score (the maximum amount of oxygen that you can take in and use during physical exertion) - an physiological trait developed mostly through effective aerobic and other forms of "cardio" exercise.
Smart, effective strength and appropriate strength training enables that effort, training and activity. In any case, VO2 max will fall to some degree with age. As time goes on, unless measures are taken to preserve adequate muscle mass and strength, that rate will be greater, as will the degradation of your overall health and susceptibility to chronic disease.
Therefore, strength training - in appropriate, considerate and customized forms and doses - matters for your entire lifetime. A lot.
Click here to listen to Dr. Attia interviewed by Bari Weiss, formerly of the New York Times and now of Substack and The Free Press.
Click here for his interview with fellow scientist and health enthusiast Dr. Andrew Huberman.
Visit this link to listen to and subscribe to Dr. Attia's own podcast, The Drive. I highly recommend it!