Outlive – Peter Attia, M.D.

I recently got round to reading Peter Attia’s book – Outlive. (Yes, I know I’m a little late to the party but there are so many books and it’s hard keeping up to date 😉

For those that don’t know, Peter Attia is an MD who specialises as a longevity physician. 

Peter’s story goes a little like this …. 

After graduating from medical school where he trained to be a surgeon, Peter soon started witnessing the downfall of being a Doctor. The medical way was all treatment and had no consideration towards preventative practices. Ultimately he became disillusioned and left medicine. 

He then spent a few years in consultancy, then working for an energy company before returning to medicine in his 30’s after a fixation on his own health. 

Peter now practised medicine 3.0 a term coined by Peter that is a model of medicine that focuses on prevention. Essentially, what does one need to do right now – today in order to be the fitness and healthiest one can be in 20,30,40 years from now. 

I personally think this is a much needed shift in how we need to start looking at our health

The ideas behind medicine 3.0 look not just at lifespan but also healthspan. Simply put lifespan is a measure of how long you’re gonna live but healthspan is the measurement of the quality of your life. 

In my eyes there is no point in getting to 100 years of age: 

– If you’re riddled with aches and pains. 

– If you can’t get out of bed 

– If you’re completely reliant on others to get you through the day 

On the other hand at 100 if you have your health in check, you can do whatever it is that you most enjoy doing then that’s a win. 

For some of my clients, they want to be out gardening in their 100s, others want to be able to pick up their grandkids and get down on the floor and play with them. Some of them probably want to be skydiving in their 100s. 

With all that said here is a quick review on the training portion of the book 

“Exercise is by far the most potent longevity ‘drug,’” says Attia in his book Outlive. “The data is unambiguous: Exercise not only delays actual death but also prevents both cognitive and physical decline better than any other intervention. It is the single most potent tool we have in the health-span-enhancing toolkit—and that includes nutrition, sleep, and meds.”

In order to become kick-ass (as Peter puts it) in your 100s you have to train. Peter’s concept is the Centurion Decathlon  – the 10 most important physical tasks that you want to be able to achieve for the rest of your life. 

These are personal tasks but Peter has a few examples of his own  

1. Hike 1.5 miles on a hilly trail
2. Get up off the floor under your own power, using a maximum of one arm for support
3. Pick up a young child off the floor
4. Carry two five-pound bags of groceries for five blocks
5. Lift a twenty-pound suitcase into the overhead compartment of a plane
6. Balance on one leg for thirty seconds, eyes open (bonus points: eyes closed, fifteen seconds)
7. Have sex
8. Climb four flights of stairs in three minutes
9. Open a jar
10. Do thirty consecutive jump-rope skips

Although I do like Peter’s top 10, I’m going to Shamelessly plug… 

At Results Personal Training we also use a set of standards (Both research and in the trenches based)

As a rule of thumb I don’t want you (the client) to specialise in your training. Specialist are amazing at their thing but they have huge holes in so many other things 

For example I have had powerlifters that could deadlift 300 plus kilos but would get tired and winded climbing a small flight of stairs 

I’ve had ultrarunners that could perform a marathon with no training but would get injured getting the shopping bags from the car. 

My goal for you is to be a Master Generalist. I want you to be good (not the best) but good at everything you put your hand too. 

If you have to help a friend move furniture – it’s not a problem because you can squat, deadlift and pull a decent amount. You can control your body and you can move with poise

If you want to go on a biking adventure then again it’s not a problem because your fitness is honed, you have endurance, speed, agility and power. 

Essentially you can do whatever the task is in front of you. You can do it with ease and grace 

Peter’s concepts can be broken down into 4 categories or pillars 

Pillar 1 – Stability 

Peter typically spends about 1 hour a week on stability training, this is done in blocks of 5 to 10 minutes before resistance training sessions 

Stability is learning to control your body. Stability is the secret sauce that allows you to create the most force in the safest manner. 

Pillar 2  – Strength 

Peter does three 60 minute full body sessions a week. Targeting all the major muscle groups 

After the age of 30 sarcopenia (muscle loss) begins to kick in. Without consistent resistance training you can lose from 3 all the way to 8 percent muscle mass per decade. 

If that’s not enough to scare your butts to the gym, losing muscle will also slow your metabolism and decrease your functional ability and strength. 

Peter bases his resistance sessions around… 

Grip strength – exercises such as farmers carries, deadhangs and pull ups. Grip strength has more correlation to longevity than any other metric. 

Personally I believe grip strengths correlation is more of a by-product of overall strength rather than grip specific. That said a strong grip is a strong grip 

Pulling motions – whether we are climbing El Capitan or simply hauling the shopping bags from the car. Pull ups, chin ups and rows are your go-to’s here 

Hip hinging – deadlifts, lunges, hip thrusts. These exercises all load the glutes and hamstrings your biggest muscles in your body. 

Pillar 3 – Anaerobic Training 

“Peak cardiorespiratory fitness, measured in terms of VO2 max, is perhaps the single most powerful marker for longevity,”

After the age of 25, your V02 max drops by approximately 10 % per decade and as much as 15 % after the age of 50

Peter does one thirty minute anaerobic workout a week. Typically he does 4 minutes hard followed by 4 minutes easy for 4 rounds 

Pillar 4 – Aerobic Training 

If you have ever listened to one of Peter’s podcasts you would know he loves his zone 2 training. Zone 2 is what builds the base for everything else you do in life. It plays a crucial role in preventing chronic disease such as the 4 horsemen Peter describes in his book

• Cardiovascular disease 
• Cancer 
• Cognitive disease (such as Alzheimers) 
• Metabolic disease (such as type 2 diabetes)

Poor mitochondrial function is linked to heart disease, dementia, type 2 diabetes, metabolic syndrome, cancer, and insulin resistance. A study published in Oxidative Medicine and Cellular Longevity found that zone 2 training increases mitochondrial size, number, and function. Which means more efficient workouts, and better metabolic health.

Zone 2 training is between 65-75% of your maximum heart rate, for an extended period of time. Peter recommends doing this on a treadmill, bike, rower or swimming. He does 4 sessions a week at around 45-60 minutes 

Personally I would say that this is a lot of training. I would argue that most of us don’t have 8-10 hours a week to dedicate to training. Even I, who owns a gym and spends my day at the gym, can’t do even close to 8 hours without having Krystie roll her eyes at me or my kids thinking they were fatherless 😉 

My 2 cents is.. more is not better, better is better. Similar to lifespan and healthspan, it’s about the quality and not so much the quantity. 

To conclude 

I did enjoy the book but I can’t say that I agree with everything Peter has to say. For example Peter has a solid fixation on stability training but I would argue that stability is just one side of a coin and to talk about stability one needs to understand the otherside of the coin MOBILITY. 

The book also dives into the 4 horsemen which quite frankly the tone is all a bit depressing. I don’t think it all has to be doom and gloom. 

Then we have nutrition, sleep and mental health. 

As I mentioned I do think that Outlive is a solid book and one that we could all do with reading even if it serves as a gentle reminder or a kick in the ass to do something about your health right now. 

If you have made it this far in my ramblings then first off I would like to thank you for reading my words. It means more to me than you think. So thank you truly 

Secondly my ask is that you don’t become another statistic. I haven’t always been into fitness, for me it was something I found after many years in a rut. And I can say hand on heart that it changed my life. I don’t train to be the fittest or the strongest, I train because it makes me a better person. I’m a better husband, father, brother, son and friend. Training has given me life tools and I cannot stress how much better one feels for training. 

So, if you’re not training consistently then give us an email and let’s see how we can help you get started. 

fitnesscamp@hotmail.com