Outlive: The Science and Art of Longevity

Great Take Away Points
I first learned about Dr. Attia through watching the series ‘Limitless.’ I found the series to be extremely inspiring, and ultimately life-changing. I then stumbled across a Youtube clip where someone was discussing this book, which led to my purchase of it. It is a very thick book with which I took my time reading, in chunks. (I did not read the last two sections on sleep and emotional health).I read through some of the 1 and 2 star reviews on Goodreads. Many mentioned that the book could be significantly shorter and that they did not like all of the personal stories that Dr. Attia shared. However, I found each of the stories to be quite helpful in putting the information into context. And I think the overall intent of this book was/is two-fold. It was not only written to present ‘information,’ but also Dr. Attia’s personal testament of his journey as he learned new things, changed his perspectives, struggles in life, etc. The addition of this deeply intimate information helps to make the book more personable versus cold and mechanic. And who knows, writing this book may have also provided Dr. Attia with some degree of inner peace and resolution. What is so wrong with that?There are many focal points of this book, but for this book review, I will address what I find to be key take away points, and my perspective of those points discussed by Dr. Attia.READABIITY: Some parts of the book could be difficult for people to understand if they do not have a medical background, fortunately I do. For those who do not, and really want to understand, have Internet access handy so that you can cross-reference between the Internet and the book as you go along. NOTE: There are many parts of the book where animal research studies are discussed. I must preface that I struggle reading about animal studies, as I am anti-animal testing activist. But I do understand why the studies are mentioned in the book.PHILOSOPHY: Dr. Attia makes several comparisons between Medicine 2.0 and Medicine 3.0. I think many Primary Care providers who read and subsequently reviewed this book may have felt offended by Dr. Attia’s views on what he describes as our current healthcare model (Medicine 2.0). However, Dr. Attia is not pointing fingers and intending to insult Primary Care providers. He is simply pointing out flaws in our current healthcare model and how it should shift to a different focus, which I 100% agree with!For those who chose to be insulted by this, shame on you. If you are a Primary Care provider, it is also not your fault that your practice is based upon Medicine 2.0, as you have to operate within the restrictive system and in accordance with insurance coverage. Embrace the Medicine 3.0 philosophy and save it for the day when, perhaps, our current healthcare model will shift closer to it. Everyone will be better off for it.PREVENTATIVE TESTS: I found it odd when a reviewer mentioned that they know many adults who lived to old ages without any fancy tests. That is a strange thing to write, because Dr. Attia does NOT imply that having a bunch of tests contributes to living longer or healthier. Conversely, he implies that having preventative tests provides knowledge of one’s current health state. That knowledge can then enable people to make changes that can contribute to living longer and healthier versus being a ticking time bomb and continuing on the same physiological path. How that reviewer misconstrued these two vastly different concepts is beyond me. This reviewer continued on to say that these seniors also smoked, drank, ate what they wanted, etc. However, I cannot help but wonder about their quality of life, and whether they were active and enjoy(ed) pursing hobbies/interests OR if they were simply ‘existing’ as couch potatoes. These are two vastly different concepts, and is the focal point that Dr. Attia expresses throughout the book.On another note, Dr. Attia describes the perfect world where everyone has access to a plethora of preventative tests. Many of these preventative tests (scans, blood, etc.) are not covered by typical insurance plans, which means people have to pay out of pocket for them. I do plan to have most of the screening tests done that he recommends, because I want that in-depth knowledge of my current health state. However, doing all of these are just out of reach for many, or until patients reach a certain age (DEXA scan, for example).MACRO NUTRITION: As many others mentioned, I do not think that any new/novel information about macro nutrition was presented. Some reviewers got the impression that Dr. Attia is pro-Keto diet. But I did not infer that at all. Conversely, I thought Dr. Attia did a great job with pointing out key advantages and disadvantages of many different types of diets, not just Keto. And I think he made it quite clear that no one type of nutrition regimen/approach is going to work for everyone. This point was made quite clear when he discussed his friend/patient (the Lipidologist) who benefited from a fasting regimen. I also think he did a good job explaining how different macro nutrients affect the body in an easy to understand fashion. I particularly found the information about Fructose and Purine quite interesting.EXERCISE: It was made abundantly clear that Dr. Attia believes that exercise is the foundation for good health, which I agree with! He describes, in detail, how exercise is the best preventative tool for the “Horsemen.” Yes, it makes good sense: Exercise = improved blood flow = improved perfusion AND = building and/or maintenance of muscle tissue and maintenance of bone = potential reduced risk for the “Horseman.” But in reality, is it really THAT simple? I do not think so. There are so many other factors that come into play.Additionally, what is disheartening, and what other reviewers found discouraging about this, is how complex Dr. Attia makes exercise out to be. While I agree with the benefits of all the different types of exercises he discusses, I also think it is unrealistic for many people to achieve all of it in it’s entirety. Again, it comes back to the perfect world where there are no life-stressors, no major time consuming life-demands, not having to work a full-time job, etc.For example, let’s talk about a rich celebrity who is one of Dr, Attia’s patients: Chris Hemsworth. I am not criticizing or picking on Mr. Hemsworth. Below is just a great example that helps my point hit home here.Does he work a 40-hour week desk job, staring at a computer all day? No. Is he on his feet all day working at a store helping customers? No. Does he come home from that job, after a commute, and have to try to squeeze in a workout? No.Does he have personal trainers and nutritional coaches? Yes. Does he have plenty of time most days to exercise and enjoy leisurely activities? Yes. Is his job as an actor focused on being physically fit? Yes. Is he able to wake up naturally most days instead of being blasted awake by an alarm clock? Yes. Does he have plenty of income to not have to worry about paying the bills? Yes.This is the perfect world that Dr. Attia describes. Not everyone has enough time in the day to devote to exercising like Dr. Attia believes is necessary. I am a poly-outdoorsman, and I am an endurance (non-professional) athlete. I would love nothing more than to have the amazing opportunity to devote as much time as I want to exercise and my outdoor sports versus working a full-time job. However, that is not my reality despite how much I would like it to be.For most people who live in the real world, doing some exercise each day/week just has to be enough because that’s all they can do. So to even remotely imply that that amount just isn’t enough to obtain a long, healthy lifespan is quite sad. This is where the notion of ‘weekend warriors’ comes into play. For some, weekends are the only time that people have to exercise and/or recreate in the outdoors. This pattern does not align with Dr Attia’s ideology, but doing something on the weekends is better than doing nothing at all.What I do think readers can benefit and take away from this section of the book is to, perhaps, incorporate different exercises into their daily/weekly regimen that they may not have thought of. This is key! For myself, I have now incorporated new things into my exercise regimen because I have a better understanding of how they can have a long-term impact.FINAL THOUGHTS: This is not a concrete book of science. It is a book that discusses some scientific information combined with Dr. Attia’s life-experiences. I think it is a well-rounded book because of this. Take whatever information you found useful and run with it! Be as active as you possibly can each day/week, keep your body trim, and feed it with good nutrition. For us “Commoners,” that is the best we can do.

Risky for older joints, if you take the exercise endorsements literally.
Allowing common sense (with supplementary googling of issues that are mentioned) to be your guide, there is value in the book. The author seems to endorse some views on exercise that I would not take literally. If, for instance, you take his exercise endorsements literally, you are apt to damage your joints.As an example of a bizarre exercise recommendation, the mentions that, when rucking, your rucksack contents should ideally be half of your own body weight. Orthopedic websites say that it should not exceed 10% of your body weight. Again, good luck to your joints if you follow this advice literally.Sometimes there is a sense that the author is rather too “wound up”: He recommends taking a camera and tripod along with you to the gym and filming yourself as you exercise in order to improve. He recommends doing this EVERY DAY. Yes, you actually lug a tripod and camera with you to a gym, every day of your life and film yourself to improve your manner of exercising.Unless you are a medical student, you can safely skip over the numerous paragraphs of detailed physiological process that he describes. Some of the terms that he uses again much later in the book are not defined, as if he assumes the reader has memorized their definitions early on. His intensity evidently carries him away with this arcane information.The last “confessional” chapter adds nothing to the book and to the reader who has followed him along to that point, seems somehow embarrassing. Such a chapter really wasn’t necessary and has little to do with the thesis of the book.Here’s what I take from the book:The number one influencer on longevity is exercise. But if you exercise while defying orthopedic injuries (tendons, joints, etc.) you won’t be able to exercise at all.If you’re older, the author endorses the view that your protein intake should be approximately double that of the traditional recommendations. (This “double” recommendation occurs on various medical websites as well, if I remember). That’s apparently because older people “process” protein less efficiently and because protein helps retain/build lean muscle mass. That, at least, is what I remember reading. BUT there are a number of studies that indicate that higher protein intake of animal-dairy point to a higher incidence of heart disease. On the other hand, plant protein (I don’t know the rate of consumption) seems to be associated with a lower rate of CVD. And high protein intake is not advisable if you have kidney disease. And there is no evidence that higher protein intake will help repair tendons, ligaments/joints. Nor will collagen-chondroitin, it seems, although they may confer an anti-inflammatory effect. Joint disintegration is the normal part of aging, as I understand.The book is worth buying because in general, it has good content and the author is earnest in examining everything that does/probably does or doesn’t/probably doesn’t promote good health and longevity. In addition, his podcast is worth subscribing to. I’ve found discussions of issues I’ve always wondered about and have expanded my knowledge of other important areas of health.

Decisamente interessante. Una evidenza speciale, durante la lettura, ad un farmaco che ha veramente un ottimo riscontro, anche se la sua destinazione è rivolta ad un altro tipo d’impiego.

Well-written despite the complex subject matter. An engaging and informative read. I would say, read this when you’re 35 and reap the benefits for decades.Many older people will read this with regret. But for those in their 30s or 40s, this is essential.