A Book Review on Longevity
Outlive, a best seller by Peter Attia, describes his thinking and research on longevity. He is a surgeon trained at Stanford and Johns Hopkins who was distressed by seeing patients die as a result of illnesses that could have been aborted, or at least managed, if the medical profession were more focused on prevention and early detection of illness. The four major categories of illness that kill the majority of patients are heart disease, cancer, neuro-degenerative illnesses like Alzheimer's Disease and type 2 diabetes. He describes the physiology of each of these illnesses in detail and offers suggestions for detecting them as they are beginning.
He describes Medicine 1.0 as the realization that illnesses are not caused by the gods, but rather by factors on Earth. Medicine 2.0 began with the discovery that germs can cause illnesses, and that doctors should practice sanitary exercises (e.g., handwashing) when dealing with patients. And Medicine 2.0 refers to the way medicine is practiced today: treating illnesses after they become obvious. He describes the realization that our major categories of illness begin decades before they become obvious, and that they should be addressed at those beginnings, as the beginning of Medicine 3.0.
He advocates thinking not only of lifespan but of "healthspan," the decades that we can remain healthy and active as the decades go by.
In addition to using various tests to detect illnesses earlier, he advocates prevention by exercise, nutrition, sleep, emotional health, and when necessary, medications. Here are some main takeaways:
• Exercise: In his view exercise is even more important than diet because we lose muscle mass as we age, which leads to frailty and the inability to continue to do things we enjoy, such as sports, and even ADLs (Activities of Daily Living), which refers to the activities we need to do to take care of ourselves. Moreover, the exercise he prioritizes is strength training, to maintain, as best we can, our decreasing muscle mass over the years. Strength training includes being able to use our strength to move quickly. And grip strength is very important.
• Nutrition: He emphasizes getting enough protein for the same reason that he prioritizes strength training, which is to counter the loss of muscle mass that comes with aging.
• Sleep: He describes the physiological importance of sleep to counteract aging, and recommends the usual measures to help us sleep: dark, quiet room with no lights from electronic devices, etc.
• Emotional health: He very openly describes his own lack of emotional health due to early trauma, and his struggle to accept the need for therapy. He has found it very helpful.
He describes himself as an exercise fanatic, and it seems that this character trait of energetic persistence to achieve a goal also applies to his study of the ways we can maximize our longevity. Perhaps he will achieve his goal of bringing Medicine 3.0 into the mainstream of medical research and practice.
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