A Life Worth Living: My Outlive Insights

By Diana Sunshine

Peter Attia, M.D. was the first person I heard to define the difference between “lifespan” (how long you live) and “healthspan” (how well you live). His data-driven approach to health and longevity aligns with my own personal outlook. After pre-ordering his book, Outlive, I read it as soon as it arrived. This post isn’t a summary of the book (you can read it yourself); rather it highlights the five areas I found most insightful.  

Manage Chronic Diseases Early—Before You Get Them

In the U.S., half of all annual deaths can be attributed to four chronic diseases of aging: heart disease, cancer, neurodegenerative conditions such as Alzheimer’s, and metabolic disorders like diabetes. These diseases don’t just happen overnight. The likelihood of getting one of them increases over years of unhealthy lifestyle choices creating multiple risk factors which accumulate over time. Even more concerning is the fact that having one chronic disease dramatically heightens the risk of acquiring another. 

The prevalence of these chronic conditions is so common that the odds of facing one are a coin flip. No matter where you are in your health journey, reducing the risk of developing chronic disease is imperative. Luckily, the preventative measures for these diverse conditions are the same: exercise regularly, eat healthy, get ample sleep, and care for your emotional health. 

The key is not to wait to treat these conditions until a diagnosis. Dr. Attia coins the approach “proactive medicine,” which requires you—the patient—to participate, be informed, and be willing to make hard changes. 

Key insight: It’s up to you to live a healthy lifestyle. If you wait until you are diagnosed with one of these chronic diseases of aging, it’s too late for preventative measures. Instead, you’ll need to work with your physician to manage them aggressively. 

Backward Planning to Get Where You Want to Be

Dr. Attia recommends thinking about healthspan with the mindset of reverse engineering: start with the end game and work backwards to today. Ask yourself, what do you want to be able to do when you are 100 years old? Then, list out the physical tasks that you aspire to be able to do at that age. Don’t forget to consider natural decline, the phenomenon where muscle mass, despite physical activity, declines steeply after 65. To reach your centenarian goals, you must strive to be in your prime physical condition by age 65. And while doing that, ensure you don’t get injured. Injuries are often the culprits behind sedentary lifestyles and a dangerous precursor to a decline in overall health.

Key Insight: Continue to push yourself to be in top physical condition. Don’t fall into the trap of thinking that if you can do it today, you’ll be able to do it tomorrow.

Measure What Matters

Dr. Attia is a Stanford/Johns Hopkins/NIH-trained physician who relies on research and measurement. His approach involves a comprehensive battery of tests, delving deep into specific ranges and ratios that other healthcare practitioners might overlook. This includes blood tests, DEXA scans (for assessing bone density, visceral fat, and lean mass), oral glucose tolerance tests, comprehensive lipoprotein panels, and liver function analyses. He scrutinizes factors such as elevated uric acid, heightened homocysteine levels, chronic inflammation markers, increased ALT liver enzymes, ratios of triglycerides to HDL (high-density lipoprotein) cholesterol, VLDL (very low-density lipoprotein) levels, and elevated insulin. Why? Because these measurements, when assessed within specified ranges, can unveil early indicators of chronic diseases, providing a valuable opportunity for proactive intervention.

Key insight: Work with your primary care doctor to monitor these factors and address any early signs of chronic conditions.

Exercise Is Nearly a Cure-All

Dr. Attia states if you adopt only one new set of habits due to his book, make it exercise. Exercise, which includes aerobic activity, strength training, and stability, is critical for longevity. 

  • Aerobic exercise stimulates the creation of new and more efficient mitochondria and increases your VO2 max, the measurement of the maximum amount of oxygen an individual can utilize during intense exercise. People with a high VO2 max live longer.
  • Strength training stimulates bone growth and is critically important to be able to do the things you want to do when you are 100. Surprisingly, he puts grip strength at the top of his list.
  • Stability exercises reduce the risk of injury. One stability assessment is ensuring you can get up off the ground without using your arms and hands. For a how-to explanation, watch the Barry Get-Up video. 

Key insight: Exercise continues to top the list across all longevity and health research. This further reinforces the notion that “if exercise could be packaged in a pill, it would be the single most widely prescribed and beneficial medicine in the nation.”

Nutrition Is About Quality and Moderation

Looking at nutritional biochemistry, Dr. Attia notes that quality and quantity of food matter. Here are his basic nutrition guidelines: 

  • Don’t eat too many or too few calories. 
  • Consume sufficient proteins and fats. Protein becomes critically important as you age. 
  • Shift fats to monounsaturated fats such as olive oil, avocados, and macadamia nuts. 
  • Get the vitamins and minerals you need.
  • Plants are good to eat, and animals are safe to eat.
  • No dose of alcohol is “healthy.”
  • If your great-grandmother wouldn’t recognize the ingredient, don’t eat it. 

If there were one type of food he would eliminate, it would be fructose-sweetened drinks, both sodas and fruit juices. Fructose causes an increase in uric acid that promotes fat storage, high blood pressure, and is an early warning sign for metabolic health issues. 

Key insight: The overall message: moderation. Dr. Attia leans towards fewer overall calories, fewer overall carbohydrates, and more protein. He notes that a keto diet is beneficial for people with Alzheimer’s, cancer, and metabolic diseases. 

These five insights are not secrets. However, the average person seems to be unaware of them. And, as a collective, they are a means to better health, vitality, and ultimately a longer life with a greater healthspan.

Diana Sunshine is the founder of Big Retired Life. She’s a mission-driven, community builder with 20+ years experience in EdTech, Fundraising, and Non-Profit management.

Throughout the “Top Priorities” section of this blog, we will provide data-backed insights for a long, active retirement.

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