Will This Book Extend Your Quality of Life?
Reviewing Outlive: The Science and Art of Longevity by Peter Attia.
Once you reach my age, you think about death in the following ways:
How old will my kids be when I die? (While hoping that’s well into their adulthood.)
Are my or my wife’s parents going to have serious health complications and need at-home care?
What will my final years look like?
If you’re younger, then you most likely exercise for vanity. That was why I did it in my 20’s and 30’s. Your perspective changes.
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Peter Attia seeks to answer those questions in Outlive:The Science and Art of Longevity (amazon affiliate link).
It’s a great book and you should read it, because it’s very hard to find a comprehensive book on health and longevity. Get Serious by Dr. Brett Osborn was the previous book I’d recommend for an all-in-one treatment of health. A lot has happened since Get Serious launched.
What’s going to take you out of the game.
Once you begin to think about an outcome, you look at risk. This is how you always think about big life problems / challenges.
You have two hurdles here. The first one is what will kill you (lifespan). The second one is what will make your life harder or miserable (healthspan).
The four big killers are cardiovascular disease, cancer, neurodegenerative disease (Alzheimer’s / dementia / Parkinson’s), and metabolic syndrome (sarcopenia, type II diabetes, being obese and then getting sick, having a cytokine storm that your body can’t fight off).
Or you don’t have enough muscle mass to catch yourself from a fall.
If I want to live to be 80 or 90 and not confined to a Lazy-B recliner, what do I need to do?
Peter Attia’s model goes a bit beyond this. He wants to live to be 100, and during these last decades of his life, wants to be able to perform various life tasks that we all take for granted:
Bend over to pick your grandkid up
Get up from a sitting position on the floor (while playing with grandchildren) without using both arms
Take a hike
If you’re in your 20’s or 30’s, you’re rolling your eyes going OK BOOMER. And sure, that’s fair. I give 0 second thoughts to that stuff.
Sarcopenia and why I started looking at older people move.
I have multiple gym memberships because sometimes I don’t have time to drive to the bigger gym. At the YMCA, you see a lot of older people exercising, which is great. You’ll notice that most of the men have really skinny legs. It never clicked before.
Sarcopenia is the muscle loss associated with aging. If you remain natty, some degree of muscle loss will happen. If you don’t keep training legs hard, you’ll have stick legs.
Maybe that seems obvious to some of you. For me it was less so as old people in American culture are largely invisible. We don’t give much thought to their lives. Not because we’re malicious. We have our own stuff going on.
You’ll also notice that an older person usually doesn’t get up from a chair like they are doing a squat. They lean into it and use their arms.
We want to start training extra hard today, knowing we are going to loss some of our muscle and strength.
Training the body is building up reserves for retirement. Eventually you’ll have to tap into your savings account. Have as much there as possible.
The decline is real.
If you do nothing, you’re going to lose 10-15% of your cardiorespiratory function as measured by VO2 max a decade. Mitochondria die off. Pounds of muscle go away and never return.
You end up either fat and old, or a stick figure and old. Either way, you’re one fall away from a fractured hip and limited mobility and death. Multiple diabetes medications.
If you train hard and smart, you can reduce the decline dramatically.
If you never trained at all, and are just beginning, lucky you. You’ll make years of gains before you hit a plateau.
It’s a little frustrating to go to the gym and see the weights you put on movements decrease. Without a strong WHY for lifting, it’s easy to lose motivation. Eventually you make the transition to understanding that you’re preserving what you can.
If you are new to exercising / training, then you’ll make newbie gains. You got it good.
But have no delusion. Eventually you’ll hit a plateau and then fight to avoid falling off.
No, 50 isn’t the new 30. VO2 max starts to decline in your mid-20’s, you lose fast twitch muscle fiber around that time as well. You have to really fight like hell to not fall off a cliff.
Why do otherwise smart people hate lifting?
Attia’s book will save lives, especially nerd and normie ones. Here’s why.
For reasons not clear to me, high IQ people are obsessed with “biohacking” gimmicks. You can’t get through to these people. They are “so smart” that their plan to live long is to do anything except hard exercise. Which they look down on as primitive.
For decades disgusting looking and weak people would go WHERE’S THE EVIDENCE?! They really think they are so smart. It’s bizarre. Why wouldn’t you want to move your body? It feels good, man.
Anyway. The evidence is in on exercise, and the Attia podcast shocked me in a lot of ways. I’ll get into those.
His book will save lives as the “too smart / nerdy to exercise people” are provably living in denial and delusion.
Stuff I didn’t know until Attia’s podcast.
I trained martial arts growing up, lifted (back then even poor kids with a garage could have a Weider weight set and duck-taped Everlast heavy bag), had to start running for military PT tests. Anyway, always did physical stuff. Even when I got fat, still lifted and etc.
Did you know that a high VO2 max is associated with a lower risk of death in a way that strength training isn’t? (Reddit gobbers gonna go correlation isn’t causation, congrats, they’re buffoons who haven’t even looked at the research. They toss around midwit lines to make themselves feel smart.)
The data is insane. Raising your VO2 max to an elite level lowers your risk of dying from all causes than smoking increases your risk. In other words, think about how bad a smoking habit it. Upping your VO2 is better than smoking is bad.
That raises the question of how to raise VO2 max, and that’s a great way to get people mad online. “My weights count as cardio,” on the one hand, and the “HIIT is better than slow cardio,” on the other. It’s a lunatic asylum out there with these stupid and hostile debates. (The final chapter in Attia’s book is on mental health. Fitness people should read that one first.)
You increase VO2 max via lots of low-end aerobic activity in Zones 1 and 2, with a hard interval session every 5-10 days (depends on how quickly you recover).
Attia talks about that on his podcast, this book for cyclists has some great information on practical VO2 max intervals.
VO2 max intervals are not like the ones we gym bros spent time in the early 2000’s doing.
Heart Attacks, Apo(b) and Apo(a).
I have blood work going back over 15 years. My cholesterol was always good, relative to LDL and triglyceride ratio to HDL and total cholesterol. The formula was always changing.
Over the years total cholesterol crept up, despite my drinking almost no alcohol and tracking macros. Never gave it much thought as the Cholesterol Wars of decades ago suggested that high cholesterol was overstated as a risk factor for heart disease. We were told to not even track cholesterol but instead get a coronary calcium scan. Which I did, and have a score of 0, i.e., no damage to my articles showed up during this test.
After one episode, I got the Cardio IQ® Advanced Lipid Panel done.
Elevated Apo(b) and Apo(a).
I never would have had that lab done without the Attia podcast.
Attia claims a statin is the only way to bring down those values (which are genetic). I was very anti-statin due to the information circles I travel in. May have to get on one with the Apo(b) remains elevated during my next labs.
Exercising for longevity and Finding Your Why.
I’ve been a physical culture guy for most of my life, but near my late 30’s, really didn’t care that much. Didn’t want to shave my arm hair or whatever for the veins popped.
Once I had kids, then I started to think about living longer for their sake (losing a parent is hard), and not having dementia or being a burden to them in old age.
Cobbled together enough Peter Attia podcast show notes to change.
I used to lift 4-5 times a week. Cardio was occasionally “intervals.” Nothing systematic or structured. Get in, get a pump, maybe ride the Air Bike or do some rounds on the heavy bag.
Now I do a few hours a week of so-called Zone 2 cardio. (That definition is hotly debated as Attia defines Zone 2 based on lactate levels, whereby one used a lactate meter to measure blood lactate levels.)
Others use heart rate to track Zone 2. I don’t need to stress over this stuff, and use the MAF 180 Formula. It’s easier to keep my heart rate in the 130 beats per minute range on an Peloton than walking. Walks are usually more Zone 1, and again, that’s fine for my purposes.
Lift two and a half-time a week. (It works out this way as my training is on a 10 day schedule instead of one week.)
When you’re in your 20’s, you lift as follows: Push, Pull, Legs, Off. Repeat.
In your 40’s and not on testosterone therapy, your “week” might be structured like:
Upper body chest + zone 2.
Upper body back + zone 2.
Upper body chest.
Or close to that.
Depending on your age and overall life stress level (if you have 5 kids and a demanding job, you’ll be able to do less, and that’s OK), you can structure your week or month out however you like.
Key takeaways for exercising for health and lifespan:
2-4 strength training sessions
3-4 Zone 2 @ 45 minutes.
1-2 true VO2 max intervals.
Sometimes you might have more time, then bump the Zone 2 sessions to 90 minutes or more. Other times you can only do 30 minutes. Not a big deal. Take the long view.
You’re not training for a bodybuilding show or contest. You’re making deposits into your life savings account.
(You can and should buy the Outlive: The Science and Art of Longevity by Peter Attia.)
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