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Outlive The Science And Art Of Longevity

28 May 2023 | book health

Attia, Peter, and Bill Gifford. Outlive: The Science and Art of Longevity. Vermilion, 2023.

https://peterattiamd.com/outlive/

Summary

This book covers the cognative, physical, and emotional decline that occurs as we age. They then address steps we can take to minimize how far down this slope we shide using exercise, sleep, emotional heath, nutrition, and drugs. Attia and Gifford review in detail studies and the state of the art of each tactic cutting through the hyperbole common in reporting. Below I’ve caputred notes of interst to me as well as actions I can take to put these solutions into practice.

Workout and sleep more, eat and drink less. As we age our physical and cognative abilities degrade significantly from our current starting point. To improve our future capability we need to improve our starting position and continually work to combat the areas aging affects the most. We should strive to be at a peak of holistic performance while continuously monitoring our condition to address risks as early as possible.

Terms

  • Mendelian Randomization ~ A tool to bridge long term trials using natural randomization.
  • DNS ~ dynamic neuromuscular stabilization
  • CR ~ Calorie restriction (calorie counting)
  • DR ~ Dietary restrictions (diets)
  • TR ~ Time restrictions (fasting)

Aging

  • Centenarions not only live longer but they age better over time. Instead of focusing on individual fixes, a holistic method is required to reduce confounding factors.
  • Autophagy is the cells process for cleaning our old matter. As we age this process decreases. Calorie restriction or Repamycin may improve autophagy.

What to Monitor

  • Metabolic Syndrome, three of more of the following
    • Blood Pressure: > 130/85
    • Triglycerides: > 150 mg/dL
    • HDL chloresterol: < 40 mg/dL (<50 in women)
    • Waist circumference: > 40” (>35” in women)
    • Fasting glucose: > 110 mg/dL
  • A dexa scan anually to track viscerol fat, body fat, and bone density.
  • Colonoscopy at 40, repeated often depending on results.
    • Early detection is the best hope for reducing cancer mortality.
  • apo B testing, heat disease precursur.
  • Measure LDL, target < 20 mg/dL (hard to hit!)
  • Lipid lower drugs (statins) should be considered early.
  • Early signs of trouble
    • Increase in uric acid
    • Increase in homocysteine
    • Chronic inflamation
    • Increase in ALT liver enzymes

Cardio

  • Zone 2 ~ A speed fast enough that a conversation becomes strained.
    • The maximum level of effort we can maintain without accumulating lactate.
    • With a lactate monitor: 1.7 - 2.0 millimoles
    • ~ 70 - 85% of peak heart rate
    • Three hours per week or four 45 minute sessions minimum
    • Two Watts per kilogram reasonable, shoot for 3 W/kg
  • VO2 Max
    • Train for as high a V02 max as possible
    • Four mins (max pace you can sustain for four minutes), four minutes jogging, repeat four - six times.
    • Once per week unless training for an event

Strength

  • Grip Strength
    • 60 second Farmers walk, 1/2 body weight in each hand
    • 120 second hang on pull up bar
  • Pulling motions
    • Pull ups and Rows
  • Eccentric strength
    • Down phase of pull ups, pull downs
    • Dead lifts, rows, downhill rucking
  • Hip Hinging, high load
    • Single leg step ups, weights, video yourself to watch form.
    • Split stance RDLs

Stability

#1 Do yourself no harm!

  • Work on stability 2 x per week, for 1 hour. 15 minutes other days.
  • Attia Exercise Videos
  • DNS, www.rehabps.com
  • Good breathing
    • Chest, stomach, sides should expand evenly
    • Inhalation should be quiet, compared to breathing into your chest.
  • Feet are the starting point for most activities
    • ‘toe yoga’
  • One leg balance, eyes closed, > 10 seconds
  • Use all four corners of your feet
  • Slow cat-cow
    • Improve tech neck
    • Learn spinal segment control, feel each vertebre position.
  • Shoulders, Scapular CARS
  • Film to see what you are doing versus what you think you are doing.

Nutrition

  • Protein when active. Its hard to eat too much protein, but it shoudl be split into multiple times during the day.
    • 1 gram / pound body weight / day
    • equal to: 1 oz / 30 lbs body weight, 0.1 lbs / 50 lbs body weight
    • Focus on Leucine, Lycine, and Methionine
    • 3 or 4 grams / day of leucine and lycine.
    • 1 gram / day of methionine
    • Increase lycine if trying to increase lean mass. 2/3 grams / serving, 4 x / day
    • Attia eats two meals with protein, has a protein snack, and a protein shake.
  • Common paths. No one solution works for everyone. Often a combination is succesful.
    • CR ~ Calorie restriction (calorie counting)
    • DR ~ Dietary restrictions (diets)
    • TR ~ Time restrictions (fasting)
  • Dont over drink, < 7 glasses / week and < 2 / day.
  • Eat more olive oil, avacado, nuts, and salmon.
  • EPA and DHA supplements
  • Attia has ideal fat ratios for his patients, but it is determined on a patient by patient basis.
  • Fasting
    • No clear benefits unless done deliberately for extreeme cases
    • Intermitant fasting barely works in the 8/16 ratio. This ratio makes it really difficult to get the protein required. It could be useful as a CR tool however.

Sleep

  • Ashwagandha - potential sleep supplement
  • Use a sleep tracker, but don’t stress the results.
  • Good sleep environment
    • Remove all light sources. Dark curtains, no LEDs.
    • Warmer lights at night
    • Cold bed room, ~65 C