Outlive
A practical, actionable approach to seeking longevity
👋 Hello, my friends. I hope you’re enjoying your Sunday.
I’ve got 3 things to share with you today:
The latest episode of the Intentional Wisdom podcast
Some thoughts on Peter Attia’s new book, Outlive
4 healthy additions to your content diet
Let’s do this.
Ep.21 - John Wilson - Life Lessons from On and Off the Pitch
Imagine growing up as a young black kid in a small, rural town in South Carolina and deciding against all of the established norms of your community that your game was going to be… soccer.
That’s exactly what John Wilson did back in the mid-80’s and while it instantly made him a fish out of water, it also set the stage for an incredibly impressive career.
John went on to play for the #1 college team in the country at the time – Clemson University - where he won an ACC championship. He was later drafted into the MLS where he played for multiple teams and won an MLS Cup before finding his way back to South Carolina where he’s become a staple in the community and specifically the Charleston Battery soccer club for many years now.
In the conversation, John and I cover everything from his background, to his views on youth sports, to lessons he’s learned dealing with injury, failure and even an identity crisis. I hope you enjoy this conversation as much as I did.
Outlive - The Science & Art of Longevity
I’ve recently become mildly obsessed with Peter Attia’s new book, Outlive. Okay, a little more than mildly. I’ve become so obsessed, in fact, that the book recently accompanied me on a trip to see my doctor (see photographic evidence above), much to his chagrin.
If you don’t know Peter Attia, he is a Stanford and Hopkins trained doctor and surgeon, and surgical oncology fellow at the National Cancer Institute. He also happens to host one of the most popular health-focused podcasts on the planet, The Drive.
The premise of the book is this: What if we looked at the 4 things that are most likely to kill us (or seriously detract from our health in our later years) and worked backwards, in a very scientific way, to figure out the steps we could take today to greatly reduce the probability of these things killing us or incapacitating us in the last decade or two of our lives?
In the book, Attia takes a deep dive into each of what he terms the 4 Horsemen of Chronic Disease:
Cancer
Diabetes
Heart Disease
Alzheimer's
The result is the most sober, practical and realistic approach I’ve seen on longevity to-date. The bad news is that there really aren’t any magic pills and the prospects of breakthrough technologies that might have our lifespans breaking 120 or even 150 don’t look particularly close.
The good news is that with a combination of screening technologies and proven tactics around sleep, nutrition, and exercise, we can very realistically decrease the odds of chronic diseases killing us early or taking away our quality of life late.
Author William Gibson famously said “The future is already here — it’s just not evenly distributed.” When reading Attia’s book, one gets the feeling that this is very much the case when it comes to healthcare.
For me, the chapter on Heart Disease alone was worth the price of admission - and the one that I happened to spend the most time talking with my doctor about. Attia’s thesis is that given what we now know about heart disease, there is absolutely no reason that it should be among even the top-10 causes of death, let alone #1.
He sees it as largely preventable, assuming we take action early enough. What does action look like? Knowing your family history is a good start. From there, Attia strongly recommends a series of blood tests including LDL-c, apoB, and LP(a), along with body scans including a calcium scan and a CT angiogram to get a complete picture (in some cases literally) of your current and future risk of atherosclerosis - the thickening or hardening of arteries that ultimately leads to heart attacks.
The problem one faces in looking to implement some of Attia’s recommendations is that “Medicine 2.0” - as he terms the current system - is set up to deal only with acute problems while largely ignoring (or at least not reimbursing) so-called Medicine 3.0 tactics, which focus mainly on prevention.
I encountered this myself in asking my doctor for the tests above. He agreed to everything but the CT angiogram (“you need to talk to the cardiologist if you want that”) but several of the tests meant coming out of pocket to pay for them.
There are legitimate arguments for not conducting as expansive of an array of tests as Attia recommends. And by the way, I’m just talking about heart disease here; he also has a host of recommendations for things like colonoscopies starting at 40 (which I 100% endorse), and even things like liquid biopsies and gene testing for Alzheimer’s related variants.
The arguments against such a litany of tests include (usually first) money - these things tend to cost a lot. Then there can be risks such as radiation from too many scans. And then there are more philosophical questions like “Would I even do anything differently if I knew I had that gene variant? Would I even want to know?”
Those are personal questions. For me, the answer is that I want to know. Give me ALL the information. To me, information is power and it’s step 1 to doing something about it.
I could go on but I think I’ll leave it here for now. I expect to write more about this book and my experiences implementing some of its recommendations in the months to come.
But if this short article has whet your appetite, you might enjoy the book. Here’s what I did: I started with the audio book. It’s 17 hours long, so it’s an investment of time. But seriously, I do think it’s actual investment in your own health. And if you learn something that saves or greatly improves your life, it’s a small investment. I then also picked up the print book so I could go back and reference certain chapters.
At the risk of way overselling this book, I will say this: For the first time in my life, after reading this, I feel like I can map out a practical, realistic plan to live longer and healthier - not just try 100 different tactics and hope my number doesn’t come up for a freak cancer diagnosis or heart issue. Are those still risks? Of course they are. But the whole point of the book is to use the latest technologies and information out there to put the odds in your favor.
If you end up reading Outlive, I’d love to hear what you think.
Content Diet
Podcast: Peter Attia and Rich Roll - Unlocking the Science of Longevity
If you’re not ready to dive into the full 17-hour audiobook yet, this is the interview I heard that first got me interested. Roll & Attia hit some of the high points and cover parts of Attia’s own gripping story, including his battles with depression. An excellent conversation. If you want to go further down the Attia/cardio rabbit hole, this episode from The Drive podcast was also incredibly informative.
Podcast: Timothy O’Donnell and Rich Roll - The Elite Ironman who Survived a Mid-Race Heart Attack
Can you tell I’m a little bit focused on heart health at the moment? This was a fascinating conversation about exactly what the title suggests.
Book: The Wager: A Tale of Shipwreck, Mutiny and Murder - by David Grann
And for something completely different… Check out this riveting true story about a 1700’s shipwreck, complete with murder, mutiny and survival against all odds. If you loved Shackleton’s Endurance like me, this one will be up your alley. Thanks to recent podcast guest Candice Millard for this recommendation!
And finally…. here is my full YouTube interview with John Wilson. If you’ve subscribed to my YouTube channel already, thank you! If not, I’d love for you to check it out. We’re early there at 200 subscribers but growing fast.
Thanks so much. See you in two weeks!
Greg