Outlive

February 20, 2023
This rigorous debut by physician Attia dispenses guidance on living longer while staying healthier. “The odds are overwhelming that you will die as a result of... heart disease, cancer, neurodegenerative disease, or type 2 diabetes,” he writes, outlining strategies to stave off these four “chronic diseases of aging.” The author’s medical philosophy emphasizes prevention over treatment, recognizes that what works for one person might not work for the next, evaluates “risk versus reward versus cost” on a case-by-case basis, and prioritizes maintaining one’s “healthspan.” He strikes the delicate balance between providing scientific background and keeping his explanations accessible, as when he relates that long-distance running and biking help fend off neurodegenerative disease because they cause the body to generate a molecule that bolsters the health of brain structures implicated in storing memories. Attia’s acknowledgement that diets aren’t one-size-fits-all is a welcome departure from the overgeneralizations of similar volumes, and he provides recommendations on modulating protein, fat, and carbohydrate intake depending on one’s age, sex, and activity levels. The familiar suggestions to reduce stress, eat healthier, and exercise are elevated by the depth of detail and lucid prose that Attia brings to the table. This stands a notch above other fare aimed at boosting health and longevity.

A data- and anecdote-rich invitation to live better, and perhaps a little longer, by making scientifically smart choices. Trained as an oncological surgeon, Attia became interested in longevity because he saw that the "Four Horsemen" worked against it: diabetes, heart disease, cancer, and Alzheimer's disease. All play a role in an unhealthy system, and all interrelate. If you have Type 2 diabetes, then your chances of developing heart disease, cancer, and neurological disorders increases, and if your goal is to live well in old age, then it behooves you to change your ways in order to keep your insulin reception levels in the clear. How to do so? Attia avoids toss-off recommendations, instead examining categories of self-care. One powerful component of healthful living is the sort of exercise that burns body fats and sugar most efficiently. This, too, interrelates with diet. "The best science out there," he writes, "says that what you eat matters, but the first-order term is how you eat: how many calories you take into your body." Accordingly, caloric reduction strategies play a role, combating the effects of what he calls the Standard American Diet, "our default food environment." Attia, a lucid and careful writer, eschews easy recipes for what to eat and how to exercise, for his conception of what he calls Medicine 3.0 tailors self-care to self, as in "know thyself." Therein lies a key point: His book abounds in science and not pat prescriptions precisely because biology doesn't have the same axiomatic certainties as mathematics and because, in order to participate in Medicine 3.0, readers must be truly active and not reactive. "You must be well informed, medically literate to a reasonable degree, clear-eyed about your goals, and cognizant of the true nature of risk," he writes. It may not produce a new Methuselah, but Attia's welcome book deserves the attention of anyone seeking a healthier life.

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