Summary

Medicine is good at reducing fast deaths (accidents), but it’s not good at reducing slow deaths which now represent the majority of deaths in the first world. The reason is that modern medicine intervenes when symptoms appear, but in many cases, that’s too late. Medicine must shift to prevention and personalization.

Slow deaths are deaths caused by heart disease, cancer, neurodegenerative diseases (e.g. Alzheimer), and diabetes. All these causes share the same main characteristics:

These diseases take years or decades to establish themselves. By the time they show their heads in current tests, they have done so much damage and they have so much inertia that the odds are against us.
They are caused by many factors, so few people are completely safe.
They are caused by many factors, so most people have several ways to combat them.

The main tools that we all have to keep them at bay are:

take tests to detect them earlier
do cardiovascular exercise
do strength training exercise
do mobility exercises
eat properly (for you)
sleep properly
stay emotionally healthy

Nothing new, but the book describes in great detail both the problems and the solutions, and provides plenty of evidence, e.g. if your VO2 max is low (bottom 25%), you’re 2x more likely to die in the next decade than someone below average, and 5x more likely compared to someone with an elite level (paper).

Connections

Fitness: Our bodies and minds are fit for a certain environment. They are incredibly resistant to abuse because they evolved to survive in a harsher environment, but they have a limit. Running and lifting weights is the price we have to pay to live long and healthy now that we no longer need to hunt every day (except if you’re Warren Buffet and you can live on a diet of Coca-Cola, McDonalds, and ice cream).
Life: The body is a marvel of engineering. Our bodies have all sorts of layers of defenses against both slow and fast deaths. Our minds are incredibly powerful neural networks, but when you think about all that’s going on in the body at any given moment without a central intelligence directing them… It’s humbling.
Compound interest: We are wired to think linearly, not exponentially. Many of the dynamics of slow death and preventative measures involve multiplicative forces, not additive ones. Do everything you can that doesn’t cost you much to reduce risk, it’s probably having more impact than you think.
Mastery of the mind: I’ve read that prevention, exercise, diet, and sleep are critical to living a healthy life hundreds of times. I think I’m doing better than when I was younger, but I still regularly act in ways that increase my risk, not decrease it. Simple isn’t easy. We don’t need to fear lions anymore, and we now have showers, but at the same time, we have created for ourselves an environment that kills us in ways we aren’t wired against (psychological stress, extreme comfort, crappy food, poisonous air). Don’t settle for average habits unless you want average health.
Antifragility: We have a wonderful living machine that becomes stronger every time you ask it to do a little more than it can currently do. It only needs enough food and sleep.

Why trust the author?

Peter Attia is a medical doctor, a mechanical engineer, and an applied mathematician. He worked at the NIH and the National Cancer Institute. He has had a traumatic past that he recovered from.

He makes money through a clinic for people who can afford to spend $160k per year on preventative care. He also sells an educational program to help people who can’t attend his practice.

The book didn’t make me want to sign up for his clinic or pay for the program. The book is comprehensive and provides clear protocols and guidelines that I have been able to put into practice. I don’t remember feeling like the author was hiding critical information.

How do I grow from this?

The book is a strong reminder to master the basics.

I’ve already used ideas and arguments from the book to convince people close to me to change their habits and, hopefully, increase their “healthspan”.

ISBN: 978-0593236598