This is a post on Health with the book “Outlive” by Dr. Peter Attia as the background. You may have heard of many different types / methods / systems of losing weight, gaining strength and living healthy. This book is, I consider, a very holistic approach. The big sign is that there is no one cute name (e.g. keto, low-carb, IF, six-minute strength, hiit … etc) and there is no trashing of everything else.

Health Span vs Life Span

Attia defines a new term Health Span. Lifespan we all know - how long one lives. Health span then is how long one lives well and be able to perform all the normal stuff. (of course, “normal” is very subjective but you can figure out the general things that are good to be able to do). So our aim should be to increase health span too.

Testing testing testing

There are many blood tests and other lab tests (body scans … etc) that can reveal something that is developing in the wrong way or wrong reasons. Prevention or stopping from acceleration is far far better.

There are many listed and these can be used to diagnose an incipient condition, years ahead. Prevention is better than cure.

Four horsemen of Death

We look at the odds of the big ones. And try our best to prevent these. That’s as much as we can do. The four major causes :

(a) and (b) are the ones that we understand more about and have some ways of “curing” or “stopping”. And they are also the ones that are most preventable.

(c) As we all know, there is really NO cure. There are barely some guesses for why. For some cancers, yes, we know well -> asbestos, smoking/tobacco, drinking/alcohol … etc.

(d) This is even more tricky. It is even harder to predict or cure.

But there are still a few things that can be done to keep away (c) and (d) - as best as we know of and we can. The rest are all just playing the odds.

Managing Health

Then we come to how we actually manage the health – there are a few aspects to it and this is a combination of many things.

0. Pre-existing Condition

IF you are already having any pre-existing condition, then your best bet is to read this book but immediately take it to your doctor / health-team and then work with them. Don’t try any of this on your own. Consider this an important disclaimer.

1. Diet

You are what you eat. The whole dietary science is just about 100 years old. Long story short : take any new advice with a grain of salt (or maybe keep the salt away, who knows). All diets (mostly) can be classified in three groups.

The ideal diet would be a mix of all the above three components adjusted to your body type / lifestyle / generally accepted science.

2. Exercise

This is basically the best cheat we have against the four horsemen. Quality of life (especially as we age) is proportional to how fit we are - not just in looks. There are two components here : Endurance (aerobic) and Strength (anaerobic). BOTH are important.

3. Sleep

Cannot stress this enough. This plays a way bigger role than most folks realize OR one that we realize but just don’t follow.

4. Mental Health / Stress / Anxiety

Again, another thing that absolutely no one will disagree on but is much harder to watch out for or care about.

Thus a good approach involves a very good combination of 5, 6, 7, and 8 as listed above. The main thing to watch out for is that it is too easy to overdo something. It is also easy to delude oneself that they are doing X but doing it wrongly or suboptimally.

For e.g., one can be Vegan and can be eating total trash –> all sugar products, very high carbs (refined/white flour/grains) .. etc. OR one can be doing HIIT or strength training (weights) but overdoing it and not allowing enough time for recovery or not eating well to compensate the extra stress or even not sleepign well. One can be doing IF excessively and be doing sub-optimal things (like eating sugar, high carbs, not exercising) … so on. All these could negatively hamper one’s well being.

Optimizing for simple numbers like Weight or BMI is not going to cut it. It is a great start but let’s put it this way: if the weight is high or bmi is very high, that’s definitely bad. But if it is around normal, other important things need not necessarily be normal. (yeah, I know, it’s tricky).

5. Medications

There is a section on other medications that one can take : like vitamins … etc. This is more of an icing on the cake.

Take it all in stride

To conclude, this is just my addendum. This book can get you over concerned too. Above all, your “happiness” is the best compass to watch out for and optimize for. Of course, this is guided by knowledge and reason. (So those who want to play the game of “I am very happy when I get a gallon of vanilla ice cream while binge watching Netflix” … good luck!). Joking aside, it is extremely easy to over-worry and be obsessive about various things / tests / dos and donts … the bad news is they will occur .. but the good news is we now catch them (at least the “meta cognition” type of way) and try to course correct.

One of my gripes with the book is this : the level of thoroughness / obsessiveness prescribed. But then again, Attia is a “lifespan / healthspan guy” - he is supposed to be so and if he wants to prescribe stuff to spend as much time “living doing things so one can be living longer” so be it. Up to each of us to calibrate our own. Everything is best done by understanding it clearly and from a calm state of mind.

There are no quick shortcuts. If anyone promises that, be wary of it. (better yet, run away!).

Quick Takeaways

1. Test yourself.

This is the easiest. Do your physical regularly. Ask for more tests. (cost of some of these are very affordable for the benefit they provide). Other than lab tests, there is “DexaFit” like labs which measure body composition. Or VO2 max or resting metabolic rate ….. etc.

2. Use the “smart” devices

It is also criminal not to be using a smart watch / phone for health. Something like apple watch can track your sleep, heart rate (resting heart rate, heart rate variability) - normal times as well as during and after exercises … etc.

3. Exercise

Another one of the easiest to say: For starters, incorporate some kind of exercise. Be it even walking. Combine it with some music or audiobooks - and you are hitting two birds in one stone.

4. Diet

Sadly there is no one magic pill …. (as much as whatever new drug claims to be?) … this is super tricky.

5. Sleep

Well, sleep well – the obvious way is that you feel rested and not sleepy/tired during the day .. but (B) can help too to empirically put a number on your sleep/restedness.


Hope that was useful and serves as a motivation for you to get the book and read it thoroughly. Please do. This is especially for those who want to tweak or incorporate “just one more thing” or will just enquire about section 3 point 14), hey I am doing X, can I do Y …. It is better to read, understand and then implement than go by secondary “telephone message passing” style and then wondering what went wrong.

Maybe, I will just “one more thing” to a healthy / happy life – this is my own … come with all my bias …. come on, it’s free, on the house. Read. Read books. They help a lot.

Read this book, figure it out, live it out. It’s worth it. Your life depends on it.

Long live (with a wonderful health span too) and prosper.