#89 OUTLIVE: A Review of Dr. Peter Attia's Book on Longevity

Dr. Peter Attia is a doctor who now focuses on the art & science of longevity. He has been on the Joe Rogan Podcast a number of times, Jocko Podcast several times,  Huberman Lab, and a variety of other podcasts. He also hosts this own podcast called "The Drive". He received a medical degree from Stanford University and trained at John's Hopkins. He was a surgical oncology fellow at the National Cancer Institute. 

We review his book OUTLIVE with the following topics:
Longevity Strategy & Tactics
Medicine 3.0
Heart Disease
Cancer
Neurodegenerative Diseases
Exercise
Nutritional Biochemistry
Sleep
Emotional Health

Key points :

The Four Horsemen :
    1.    Heart Disease
    2.    Cancer
    3.    Neurodegenerative Disease
    4.    Metabolic Dysfunction (Syndrome)

Visceral Fat vs Subcutaneous Fat

Metabolic Syndrome (3 or more of the following) :
    1.    high blood pressure (over 130/85)
    2.    high triglycerides (over 150 mg/dL)
    3.    low HDL cholesterol (less than 40 mg/dL in men or less than 50 mg/dL in women)
    4.    central adiposity (waist circumference more than 40inches in men and 35inches in women)
    5.    elevated fasting glucose (over 110 mg/dL)

Specific recommended protocols :
-DEXA scan : annual
-VO2 Max test : annual
-CT angiogram
-Dermatologist
-Colonoscopy starting at age 40 (or earlier if increased risk) and every 2 years thereafter
-Blood work : every 6 months (track and aggressively manage apoB to be at 60 and even better to be at 30)

Neurodegenerative Disease broad strategy :
    1.    What’s good for the heart, is good for the brain (low apoB, low inflammation, low oxidative stress)
    2.    What’s good for the liver & pancreas is good for the brain (metabolic health)
    3.    Time is key (think prevention early)
    4.    Exercise is our most powerful tool to prevent cognitive decline

Exercise tactics :
    1.    Zone 2 cardio at least 3 hours total per week
    2.    VO2 Max Training once per week : 4 rounds of 4 minutes on at a hard pace, 4 minutes off
    3.    Prioritize strength training
    4.    Grip Strength training focus
    5.    Attention to concentric and eccentric loading for all movements (control the weight)
    6.    Pulling movement focus (pull-ups, rows, etc)
    7.    Hip hinging movement focus (deadlift, squat, etc)
    8.    Train stability

Improve your sleep :
    1.    Get 7-9 hours of sleep each night, don’t under sleep, don’t over sleep
    2.    Limit alcohol to one drink prior to 6pm
    3.    Abstain from stimulating electronics 2 hours before bed
    4.    Keep your room cool (mid-sixties) and very dark

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