Review of Outlive by Peter Attia


I recently had the pleasure of reading (actually listening to the audio book) Outlive by Dr. Peter Attia. I found it to be a good primer or review over many of the key topics related to health, longevity, and fitness for life. The author is very much a realist in terms of expectations, so do not expect any futurist visions in this book. I definitely think it’s worth reading and perhaps even re-reading every few years as a reminder of the key points made.

Book Review

In his book, Attia does a great job hammering home the importance of optimizing one’s health years in advance of disease and health issues. While he is preaching to the choir here at Health Hacker, this puts him at odds with much of the mainstream public health profession for recommendations such as early colonoscopy, treating pre-diabetes more similarly to diabetes, aggressive statin usage, and other early diagnostic tests for cancer and other diseases, which critics claim can create a lot of worrisome false alarms. He points out numerous cases where modern health treats problems only after they have progressed to a point that is either beyond repair, or much harder to do so. Who would have thought that cardiovascular disease is already taking root in the average 25 year old? This part was somewhat eye opening, yet it shouldn’t surprise us given the Standard American Diet.

The book also has a greater emphasis on physical conditioning and athletics than many books on longevity. The benefits of exercise are undeniable and Attia rightly labels it as the #1 most important thing to focus on. He includes both cardio and strength training as equal and mandatory components of everyone’s health regimen. And, most importantly, he provides numerous studies to back up his claims.

But I should interject that related topics such as optimal protein intake are somewhat controversial, as those with a career doing longevity research generally encourage downregulation of the pathways involved in building significant muscle mass. Dr. Walter Longo, for example, recommends what would seem like low levels of protein to any gym rat – only 70g of protein for a 200 pound male, and mostly from plant-based foods. The path of extreme fitness also generally leads to injuries and wear and tear, which cause arthritis later in life (or within just a few years for many injuries). Perhaps emphasis needs to be not just on getting more exercise, but on doing so more safely.

But Attia makes some great points about enjoying your later years by having the physical capacity to do the things that make life worth living. He also shares a scary study in which half of 70-something-year-olds doing strength training for 6 full months gained no muscle mass. None! His point is that we need to have a reserve of muscle mass stockpiled for the time in life when aging wittles away at it.

The author concedes early on that this book will not provide information on how to live to 120. He makes no claims to extend maximum human lifespan which he believes is relatively fixed. Instead, his goal is to maximize your healthspan and help you avoid dying early or suffer a long, slow decline. If that sounds good to you, then you should read the book*.

What I didn’t like…The author talks A LOT about himself. I think some readers may enjoy this, but it felt like unnecessary fluff to me. I also want to make it clear that I didn’t agree with everything he says, but I found most of what he said to be good information or at least a good reminder.

Table of Contents

  1. The Long Game: From Fast Death to Slow Death
  2. Medicine 3.0: Rethinking Medicine for the Age of Chronic Disease
  3. Objective, Strategy, Tactics: A Road Map for Reading This Book
  4. Centenarians: The Older You Get, The Healthier You Have Been
  5. Eat Less, Live Longer: The Science of Hunger and Health
  6. The Crisis of Abundance: Can Our Ancient Genes Cope with Our Modern Diet?
  7. The Ticker: Confronting and Preventing Heart Disease, The Deadliest Killer on the Planet
  8. The Runaway Cell: New Ways to Address The Killer That Is Cancer
  9. Chasing Memory: Understanding Alzheimer’s Disease and Other Neurodegenerative Diseases
  10. Thinking Tactically: Building a Framework of Principles That Work for You
  11. Exercise: The Most Powerful Longevity Drug
  12. Training 101: How to Prepare for the Centenarian Decathlon
  13. The Gospel of Stability: Relearning How to Move to Prevent Injury
  14. Nutrition 3.0: You Say Potato, I Say “Nutritional Biochemistry”
  15. Putting Nutritional Biochemistry into Practice: How to Find the Right Eating Pattern for You
  16. The Awakening: How to Learn to Love Sleep, The Best Medicine for Your Brain
  17. Work in Progress: The High Price of Ignoring Emotional Health

What Other People are Saying about Peter Attia’s “Outlive”

  1. A conspicuous absence of footnotes within the main text poses an unexpected challenge for readers. Given Dr. Attia’s often proclaimed commitment to scientific rigor and quantification, it is surprising that one must resort to an indirect method of referring to the back of the book, filtering through page numbers, and then sentences, in hopes of finding an associated note.

  2. Essential information, arguably the crux of the book’s offerings, could be succinctly captured within a 20-30 page booklet, supplemented with footnotes pointing to pertinent studies. Beyond this core, much of the text is populated with personal anecdotes, analogies, and Dr. Attia’s own viewpoints.

  3. The structural formatting of the book does not lend itself well to easy referencing. Locating key pieces of information amid 400 pages of auxiliary material can be a laborious task.

  4. The concluding section delves into Dr. Attia’s personal journey of introspection and self-improvement, particularly his endeavor to overcome less admirable traits. This segues into an introduction of Dialectical Behavior Therapy (DBT). Had Dr. Attia chosen to dedicate an entire book to this subject, emphasizing the underlying research and success rates of DBT, it might have culminated in a more compelling read.

  5. Informational content presented within the book does not appear exclusive; similar or identical information is readily accessible online without any associated costs.

  6. The book’s composition exudes an improvisational tone, as if initially penned as an uninterrupted stream of consciousness. It is conceivable that an editor was later entrusted with the task of instilling some semblance of organization.

  7. Dr. Attia’s heavy reliance on extensive medical monitoring, encompassing facets like bloodwork and glucose levels, raises eyebrows. Running a plethora of tests invariably results in some values deviating from the norm. However, such deviations do not necessarily indicate anomalies. The presumption that halving an already beneficial value will yield enhanced benefits is a leap in logic that could be fraught with inaccuracies.

  8. While the book does discuss centenarians, it seemingly glosses over the fact that many have achieved such longevity without the intensive regimens Dr. Attia champions. This raises the pivotal question of genetic influence on longevity. The anecdotal case of the reviewer’s grandparents, who lived long lives without engaging in specific health regimens or being subjected to nuclear tests, underscores the potential potency of genetics in the longevity equation.

*Affiliate Disclosure

At Health Hacker, we take evidence-based health very seriously. While we do our best to avoid bias and would never promote a product that we don’t believe in, we feel it’s important to mention that as an Amazon Associate, we earn from qualifying purchases through links on this website.

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