Outlive By Peter Attia and Bill Gifford

The best book on health, fitness, and longevity I've ever read

Jul 09, 2023

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If there was only one resource I could recommend in regards to health and longevity, Dr. Peter Attia’s Outlive: The Science & Art of Longevity would surely be my choice. Built upon his medical prowess from training as a doctor, research literacy from his time at the National Institute of Health, and mathematical fluency from undergraduate studies in engineering and personal passion for calculus, this book is the summation of a decade’s worth of Attia’s research and discussion with world experts in health, fitness, and longevity.

Much like any other health and longevity book nowadays, Outlive covers the classic pillars of health: exercise, nutrition, sleep, and mental health; though, in my experience, it’s thoroughness, digestibility, actionableness, and lack of tribalism is unmatched. Not only does Attia share his protocols and practices for improving quality and length of life, he shares his frameworks for thinking about the leading causes of death, physical and cognitive decline, and what levers we can pull to impact our longevity. Though it’s cliché, rather than simply telling you WHAT to do with blanket statements, this book teaches you HOW to discern the best strategies and tactics for YOU based on YOUR health objectives (see Chapter 3, Objective, Strategy, Tactics: A Road Map For Reading This Book, for this specifically).

In my opinion, Attia’s most valuable asset is his ability to approach the problem of longevity with an array of different perspectives, from that of an athlete during his time as an elite ultra-endurance swimmer, a doctor through his training as an oncological surgeon, and an analyst during his stint as a risk manager for McKinsey and Company. By combining these vantage points, he is uniquely qualified for deciphering the muddled and multi-faceted world of longevity. But, if you’re not convinced by my opinion alone, check out some of Attia’s appearances on prominent podcasts below, along with some of my favorite content from his own podcast and blog. In addition, I’ll leave some of my most memorable takeaways, quotes, and more from the book. After exploring some of Attia’s perspective-altering content, I suspect you’ll rapidly realize why I feel Outlive: The Science & Art of Longevity overwhelmingly deserves a place in the Inflection Archive.

You can find Outlive on Amazon, Audible, and most other book stores.

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Outlive In One Sentence

Furthering human lifespan (how long you live) and healthspan (how long you live with a high quality of life) calls for Medicine 3.0, whereby we view longevity through the objective of reducing death from the Four Horsemen — heart disease, cancer, neurodegenerative disease, and Type 2 Diabetes / related metabolic dysfunction — by mitigating risk factors early and chronically to combat these diseases before they ever take hold.

If you can only read a few chapters, read…

Chapter 2, Medicine 3.0: Rethinking Medicine for the Age Chronic Disease

Chapter 7, The Ticker: Confronting –and Preventing–Heart Disease, the Deadliest Killer on the Planet

Chapter 11, Exercise: The Most Powerful Longevity Drug

Chapter 14, Nutrition 3.0: You Say Potato, I Say “Nutritional Biochemistry”

Chapter 17, Work in Progress: The High Price of Ignoring Emotional Health

Shortcut Takeaways

1. Most people over-allocate energy towards diet and under-allocate energy towards exercise and sleep. To paraphrase Dr. Attia, “You shouldn’t be arguing about [nuances of diet]...until you can deadlift your body weight for 10 reps.” The most important aspects of a “healthy diet” are that it doesn’t leave you over-nourished (i.e. too many calories) or under-muscled (i.e. too little protein).

2. Exercise — BOTH resistance training and endurance training — is the most powerful tool we have for increasing our lifespan and improving our health span.

3. The leading causes of death in the Developed World — the Four Horsemen: heart disease, cancer, neurodegenerative disease, and Type 2 Diabetes / related metabolic dysfunction — are all long-term conditions, meaning that they develop over decades. As a consequence, conquering these threats to our lifespan and healthspan requires a long term strategy of minimizing risk factors and building our defenses over decades. This is a very different approach than common medical practice today, which is dominated by relatively late treatment, rather than prevention.

Quotes

“When did Noah build the ark? Long before it began to rain. Medicine 2.0 tries to figure out how to get dry after it starts raining. Medicine 3.0 studies meteorology and tries to determine whether we need to build a better roof, or a boat.”

“More than any other tactical domain we discuss in this book, exercise has the greatest power to determine how you will live out the rest of your life…It delays the onset of chronic diseases, pretty much across the board, but it is also amazingly effective at extending and improving healthspan. Not only does it reverse physical decline, which I suppose is somewhat obvious, but it can slow or reverse cognitive decline as well. (It also has benefits in terms of emotional health, although those are harder to quantify). So if you adopt only one new set of habits based on reading this book, it must be in the realm of exercise.”

“Over dinner one night in 2012…I went so far as to declare that it was a pity that we needed to waste time in bed at all. Imagine how much more we could accomplish if we just cut out sleep entirely! There I was again, bravely ascending the flanks of Mount Stupid. But Kirk stopped me short with a simple, Socratic question. If sleep is so unimportant, he asked, then why hasn’t evolution gotten rid of it?”

“Bluntly put: [heart disease] should be the tenth leading cause of death, not the first.”

“If you are reading this and are older than fifteen or so, there is a good chance you already have [fatty streaks] lurking in your arteries…Autopsy data from young people who died from accidents, homicides, or other non-cardiovascular causes have revealed that as many as a third of sixteen- to twenty-year-olds already had actual atherosclerotic lesions or plaques in their coronary arteries when they died. As teenagers.”

“Consider that five grams of glucose, spread out across one’s entire circulatory system, is normal, while seven grams–a teaspoon and a half–means you have diabetes. As I said, the liver is an amazing organ.”

“If we were epidemiologists from Saturn and all we had to go on was articles about centenarians in publications like USA Today and Good Housekeeping, we might conclude that the secret to extreme longevity is the breakfast special at Denny’s, washed down with Jim Bean and a good cigar.”

“It’s very difficult for [cancer] imaging technologies to discern a cancer smaller than about one centimeter in diameter. Even if you assume that this one-centimeter nodule is the only collection of cancer cells in the patient’s body…you’re still talking about more than a billion cancer cells by the time you reach the threshold of traditional detection. If we could catch these recurrent cancers sooner, we might have a better shot at keeping patients in remission.”