Book summary of Outlive: The Science and Art of Longevity

To live longer and better, focus on exercise, nutrition, sleep, and emotional health.
It's important to consider healthspan as well as lifespan. The quality of your life matters as much as the length.
Fitness is the best predictor of longer life.
Exercise, even in small amounts, can extend lifespan by years. It has the most outsized positive impact on your health.
1. Going from zero to 90 minutes of weekly exercise lowers mortality risk by 14%.
2. Exercise improves circulation and strengthens muscles (including the heart).
3. Exercise can slow down or reverse cognitive decline.
4. Exercise delays chronic diseases.
5. Exercise improves memory.
6. Strength training is important for everyone, young and old, as it improves physical function and mobility.
7. Become an "athlete of life". Keep yourself motivated about your health and train for 10 physical tasks (e.g., going up stairs, playing with your grandchildren) you want to be able to do at 100.
There are three dimensions of fitness: aerobic endurance & efficiency, strength, and stability.
Aerobic endurance & efficiency involves zone 2 cardio and VO2 max interval training.
1. Zone 2 cardio are sustained exercises that require 60% to 70% of your maximum heart rate. Example: fast walking for 30 minutes or 5+ miles.
2. Zone 2 cardio improves endurance and chronic disease prevention.
3. VO2 max interval training improves your body's oxygen utilization and is associated with longevity. It involves high-intensity interval training (HIIT), where you alternate between high-intensity exercises and rest.
4. Incorporate both zone 2 cardio and VO2 max exercises in your routine.
Strength training involves heavy resistance training (e.g., weightlifting). It maintains muscle mass and bone density. Do it four times per week.
Stability is just as important as aerobic exercises. Try to do them (e.g. toe yoga) twice a week for at least an hour.
Grip strength indicates overall strength and is inversely linked to dementia. Do farmer's carries, dead hangs, and exercises involving pulling motions.
Maintaining a balanced healthy diet is crucial for a long and healthy life.
1. Our body has adapted to undernourishment for thousands of years. In modern times, many of us face overnourishment.
2. Key is to find the right balance that works for you in reducing energy/caloric intake and getting adequate protein and healthy fats.
3. Move away from the Standard American Diet (SAD) high in sugar, refined carbs and processed oils.
4. In the late 1970s the average American male weighed 173 lb, now he's just about 200 lb.
5. Try caloric restriction (count calories), dietary restriction (avoid certain foods), or time restriction (intermittent fasting). Use caution. Make sure you still consume enough nutrients to avoid muscle loss.
6. Caloric restriction and quitting smoking are the low-hanging fruits of cancer prevention.
7. Get at least 1g of protein per lb (2.2g/kilo) of body weight daily to maintain muscle mass. Healthy proteins will make you feel fuller. Animal proteins are more effective than plant proteins.
8. Fats are important, they should be a mix of saturated, monounsaturated, and polyunsaturated, emphasizing omega-3s for good brain and heart health.
9. Prefer extra virgin olive oil, avocados, and nuts. Avoid butter, lard, and oils with high omega-6 (e.g., corn, soybean, and sunflower).
10. Cholesterol is not a nutrient of concern for overconsumption. There's no connection between cholesterol in food and cholesterol in blood.
11. There is no amount of alcohol that is healthy.
12. A smoker is 40% more likely to die at any moment than a non-smoker.
13. Get Apo B tests regularly. Apolipoprotein B-100 is a blood test that tells you about your risk for cardiovascular disease, the leading cause of death by far.
Sleep greatly impacts your health.
1. Poor sleep increases risk of cardiovascular diseases, diabetes, accidents, and premature death.
2. 20% of car accidents are caused by sleep deprivation. The author almost died from a car accident because of lack of sleep.
3. Study shows people sleeping <7 hours nightly have a 12% higher risk of early death.
4. Good sleep enhances physical and mental functioning, boosts memory, regulates metabolism, and decreases the likelihood of developing chronic diseases.
5. Drugs like Ambien and Valium can actually harm sleep quality.
6. Tips to improve sleep: reduce the use of screens and blue light before bed, keep bedroom dark and cool (65°F or 18°C), moderate caffeine and alcohol intake, meditate to reduce stress, and create a sleep routine.
7. Half-life of caffeine in the body is up to six hours.
8. NBA superstar LeBron James sleeps with a specialized mattress and pillows for 12 hours/day.
Emotional health is vital for well-being and longevity, and it affects physical health. Do not neglect it.
1. “Why do you want to live longer if you're so unhappy?”
2. It's important to recognize and address emotional health issues early.
3. Seek professional help if you're struggling with emotional or mental health issues (e.g., depression, trauma).
4. Try Dialectical behavior therapy. DBT is a mindfulness-based proven type of psychotherapy that helps regulate emotions and build resilience.
5. Commit to daily practices (e.g., meditation) for long-term wellbeing.
6. Self-reflect and assess your relationship with yourself. Recognize how your past is influencing your present. Address childhood traumas as they might later manifest themselves in harmful forms (e.g., addiction, attachment disorders). Evaluate your self-image and need for external validation.
7. Pursue your dreams and do activities that make you happy.
If you lose your car keys it doesn't mean you're getting Alzhiemer's, it probably means you're distracted and busy.
The current healthcare system focuses more on treatment than on prevention.
1. “Health insurance companies won't pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient's (very expensive) insulin after he has been diagnosed.”
You get old when you stop thinking about the future.

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