If you have seen me in the past 2 weeks or follow me on social media, you will know that I have been reading Outlive by Dr Peter Attia. A book about The Science and Art of Longevity. It is truly brilliant and I HIGHLY encourage you read it yourself. Especially if you work in healthcare, but even if you don’t, if you can read or listen to this book, please please do.
Here are some of my biggest personal take aways after reading it.
1. What am I doing now for my 80 year old self?
This was a bit of a light bulb moment for me when I read this. I tend to think of my day to day exercise, eating and emotional health in the context of how they are helping or serving me TODAY or with reaching an exercise goal like an upcoming running race. When really, I should be thinking about how what I am doing now impacts on how strong and resilient I am going to be in my old age.
The research he shares about how muscles decline naturally with age and menopause is sobering. We need to really be increasing and optimising our strength and stability NOW to allow for how this is going to happen in the future. I need to be thinking more long term in how I look after myself day to day and week to week.
2. Exercise is even more important than nutrition for health.
Over and over again this book highlighted how exercise is the MOST important and powerful tool we have at our disposal. Alzheimers, cardio vascular disease, cancer and bone health are all positively impacted by exercise.
I found his explanation of how exercise makes our mitochondria in our cells even use up old cells that could potentially turn to cancer or disease for fuel to work out. Fascinating. In my mind I now imagine that instead of the potentially cancer causing cells lurking around in the shadows and jumping at the risk of becoming cancer (with my history of melanoma cancer I am on high alert for anything cancer related) they are instead being ground up with a pestle and mortar and being used as fuel for my mitochondria while I exercise!
I have not found my same rhythm with work outs as I had developed in the past few years since we moved to our new home. It is ironic that that I was reading this book in the week I was buying the weights in order to begin my home work out program with my old personal trainer. In a terrible stroke of luck, an 8kg kettle bell weight fell out the shopping trolley and broke my big toe in a number of places.
Reading this book inspired me to do a modified version of my strength work out this morning, broken and bruised toe and all. Anything that gets my mitochondria working is better than nothing!
I have also realised from reading this book that I am not doing enough ‘zone two’ training. Longer steady work outs where you can still talk, but it’s not that easy breezy to hold a conversation. I want to start incorporating more of these into my weeks and may have told my husband we now need to buy a watt exercise bike so I can do so! Or I need to do longer slower runs when my broken toe has healed.
A friend of mine who is a Doctor sent me a message and said that she disliked this book as there is no way you can do as much exercise as he says we should be doing. And I can see what she is saying. But I think my take away is anything is better than nothing. And we ideally need a variety of cardio workouts, weight training, stability and flexibility work and zone 2 training.
3. Flossing, sleeping, saunas and exercising can help to reduce the risk of Alzheimers.
I haven’t had my genetic testing done to see if my have the gene that predisposes me to Alzheimers. But as my Granny battled with it, I suspect I may have the gene. I was fascinated to read that it’s not all crosswords and sudokus as I had thought may keep my brain away from developing it. But again exercise is my most powerful tool.
There is also research that shows that regular flossing can reduce our alzheimers risk as the gingevitis bacteria in our mouths has been linked to it. I’ve already upped my flossing since reading that! There is also an interesting part about the benefits of saunas (not sure I will take this up though as Durban summers feel like they are a permanent sauna). And then sleep. Sleeping is where the brain gets to do it’s own housekeeping and it appears Alzheimers is one of the many things on the list that a good nights sleep is beneficial for.
4. Being overweight is usually no good for you at all. But being of normal weight doesn’t necessarily mean you are metabolically healthy.
There is a difference between being metabolically healthy and not. This isn’t to do solely to do with your weight, but often correlates with it. If you are overweight, there is a 62 % chance you are metabolically unhealthy. But if you are not obese, there is still a 22% chance you are metabolically unhealthy. And the bad news is that not only is tummy fat the most annoying, it is also the WORST for our general health. You may be one of the 1/3 of people who are obese, but your bloods show you are metabolically well. But you may also be one of the 1/5 people whose weight is fine, but your bloods and organs say otherwise.
This chapter made me grateful for having lost the 15kgs of weight I did after learning about glucose metabolism 2 years ago. And has reminded me of the importance of not thinking all is well just because someones weight is considered normal.
5. The crisis of abundance. Our ancient genes weren’t created for the endless sources of food available to us today.
The excessive calories found in the shelves that are never empty in our supermarkets are causing chaos for our weight on the scale and our poor livers. The leading cause of fatty liver disease and liver damage in people needing liver transplants used to be almost solely from excessive alcohol intake.
Non-alcoholic fatty liver disease (NASH) is when there is more fat entering the liver than exiting it (largely thanks to our poorer and more processed diet), which can lead to liver disease requiring surgery.
In 2001, NASH (fatty liver from bad food and drinks) was the reason for just over 1% of liver transplants in the USA. By 2025 it is expected to be the LEADING CAUSE FOR A LIVER TRANSPLANT. We need to actively resist buying easy food that is on a shelf with a long expiry date. For myself, I need to continue to shop on the outer edge of the supermarket aisles where the fresh things are and actively engage in meal planning and cooking from scratch and not getting easy processed foods from the middle of the shop!
6. How glucose is absorbed in the body should be a basic subject at school (I think).
If you have seen any of my social media in the past 2 years you will KNOW how passionate I am about glucose metabolism. It is physiology that we need to understand even on a very simple level. Glucose spikes are no good for anyone and SMALL changes can be so powerful. I lost 15kgs understanding how glucose works and why food order matters. You can watch my Glucose webinar here if you haven’t already. Glucose spikes can lead to insulin resistance and type II Diabetes. Type II Diabetes is one of the BIGGEST public health issues of our lifetime and is unsurprisingly covered extensively in this book. As I have learnt, simple changes and adding more fibre to your diet can be a game changer. Remember, try and avoid carbs on an empty tummy. And eat your fibre first!
7. Statins for the win. If you have cholesterol take statins. But also, check your ApoB.
Being from a family prone to genetic cholesterol issues and being generally very anti-medication myself, after reading this book I can now say I see and understand and believe in statins for anyone with high cholesterol. If I end up with cholesterol issues like many of my family have, I will be embracing the statins as they appear to be far more effective than dietary interventions.
But I will also get my ApoB checked, if you have cholesterol and are reading this, have a google as to why ApoB is important to understand when interpreting your cholesterol results, and make sure your Doctor has checked yours!
8. Fasting may or may not be great and longer fasts can cause muscle loss. Are you eating enough protein?
Dr Attia used to be the poster child for extended fasting, exiting days on water alone. He has now changed his mind about the benefits of longer fasts as he feels that the muscle loss that they can cause are not worth the health benefits. I personally think that we should try and fast for 12 hours between dinner and breakfast. This allows your body to work on some housekeeping of cleaning out old and broken cells and also reduces the opportunity for a late night shnack before bed that then contributes to a glucose rollercoaster over night. Regarding the perfect diet, he concludes there isn’t one.
In fact his concluding sentence in the nutrition chapter is: Stop overthinking nutrition so much. Put the book down. Go outside and exercise.
9. Good sleep is like a performance enhancing drug.
We ideally need 7.5 to 8 hours hours a night. Lack of sleep messes with hormonal balance and can create metabolic dysfunction. A study found that young Athletes who slept less than 6 hours a night were 2.5 times more likely to experience an injury than their peers who slept 8 hours or more. Research has found that people who are sleep deprived almost always underestimate it’s effects on them as they adapt to it. I am so glad my days of small babies waking up in the night are behind me. New Parents reading this, I am sorry if you are in the exhaustion trenches right now.
Poor sleep worsens insulin resistance. But long sleep can be a sign of health problems too. Long sleep = poor quality sleep. People who sleep more than 11 hours are 50 percent more likely to have underlying health issues. High stress makes us sleep poorly. But poor sleep also makes us more stressed. A vicious cycle indeed.
I know I function best on 8 hours a night, and the older I get the more I am trying to prioritise it. This paragraph is not even scratching the surface of why sleep is so essential. If you are battling with sleep, please try and research and work on it!
10. Emotional health is the most important thing of all.
Attia discusses how Misery and unhappiness can also destroy your physical health, just as surely as cancer, heart disease, neurodegenerative diseases, and orthopaedic injury can. Loneliness is linked to a higher chance of dying. I liked how he explained that mental health and emotional health are different, mental health encompasses disease like states such as clinical depression and schizophrenia, which are complex and difficult to treat, but do present with recognisable symptoms. Emotional health incorporates mental health but is also much broader, and less easy to categorise. Emotional health has more to do with how we regulate (and I would say recognise) our own emotions and manage our inter personal relationships.
If I was totally enamoured by this book before I got to the last chapter, Attia’s sharing around his own emotional healing journey made me respect him even more. I actually felt tearful as I read his closing chapter around how if we aren’t dealing with our own emotional health, what is the point of striving for physical health? His words and explanation of the inner work he has done and continues to do reminded me so much of the journey I have been on for the past few years and validated again for me the power of mindfulness. How slowing down, paying close attention to our minds and then seeing if we can respond rather than react and be compassionate towards both ourselves and others has such power to heal. But let’s not be fooled. Mindfulness and reflecting on your thoughts and noticing your brain’s patterns is SO hard. Paying close attention to whats really happening in your mind beneath the every day distractions of life can rip the rug from underneath you as my silent retreat did last year, but the benefits from it are life changing.
Well done if you are still reading thus far, apparently we now have shorter attention spans than goldfish and I personally battle with reading long text on a phone, so I am really proud of you for getting this far. Now go and read his whole book please!