You buying his book surprises me! Can’t wait to hear what you think.
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Trust me. It surprises me too. 
I mentioned that I bought a book titled “Outlive The Science and Art of Longevity” and they laughed.
For instance, my family looks at what I eat and says “no chance, but thank you.”
I’ve said this on the “Fitness” thread before, but quite often when someone asks me “What are you training for?” I’ll respond by saying “Not to die.” 
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I can say with absolute certainty you’re not going to win that race. 
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agree. I bought the book and am making my way through it and it has some solid advice. But he is a little extreme for most people.
Catsitting for the little kid. Found a copy of the book on the kitchen counter in her apartment and borrowed it. Tried to read before bedtime today… god save the Queen from boredom. Ended up browsing Nordstrom sale instead and bought an Akris skirt. 
I might not live long, but I will look smashing in that skirt while I still can wear it to work.
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Only if you define “death” as “the irreversible cessation of all biological functions that sustain an organism.” I don’t define it that way. “Death” begins much earlier than we think.
So, what I’m talking about or what the book is speaking to, is “slow death.” Death as a “slow process.”
Heart disease, cancer, neurodegenerative diseases (Dementia, Alzheimer’s, Parkinson’s, etc.), and Type 2 diabetes and related metobolic dysfunction, what the author calls the “Four Horsemen” of chronic disease, may likely be progressing for months, years, decades.
That is the “death” that I’m trying to avoid, and what appears to be the author’s narrative, at least thus far. I’m attacking “slow death,” with diet, training, sleep, etc.
More to read, but so far, I find it interesting.
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Lung disease is another slow death. Sadly, to the extent it’s genetic, that’s hard to counter. To the extent exercise and avoiding lung irritants helps (yup helps a lot), eating a good diet, exercising and sleep are all helpful like the other conditions mentioned above.
BTW, the author, Dr. Peter Attia, graduated from Stanford Medical school and finished his surgical residency at Johns Hopkins.
What you’re talking about is health span. Dead is dead. 
Attia did train at two impressive institutions. There’s no doubt he’s a sharp guy. That said, none of his formal training is in the realm that he talks about now. Per his own description he delivers other people’s messages.
Where I have a problem with him is that he intuits things based on his gut feelings. For example he wants blood glucose at 90 with a standard deviation of only 10. There is no evidence supporting this. In fact it’s just as possible that spikes are beneficial causing adaptation much like exercise does. Again, no evidence for either theory.
He’s also fine if glucose spikes after exercise. No argument that exercise is beneficial, but why is that spike any less harmful?
All in all I like most of what he says, but people, even some physicians, take what he says as gospel, when some of what he espouses is fringy at best.
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You’re more than welcome to disagree with his narrative. But IMO, for example, once exhibiting signs or being diagnosed with dementia or Alzheimer’s, as examples, that’s not really “life” to me. “Death” begins once chronic disease(s), such as those, takes hold of the body.
My definition of death is more broad.
I have a long way to go, but so far, he’s preaching to the choir.
Eric Topol’s review of the book is good (spoiler alert, he mostly likes it – but agrees with @eyemgh that Attia sometimes gets ahead of his skis (espouses something without proof)). I just ordered the book. I have been listening to his podcasts for some time.
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FWIW, I’ve been following Attia for almost 15 years, since he was all in on keto and hated statins.
I still follow him, even though the above got me in trouble.
If he gets out over his skis too far, such as taking the drug rapamycin, that suppresses the immune system, according to the book review, or total body MRI’s to detect cancer early, I know that’s a bridge too far for me.
Although, as an example, I do get a DXA scan every 1-2 years for its information. Again, I’m not that deep into the book, so it’s hard to comment too much.
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My understanding is – and you may know this – he has reversed his thinking on keto.
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Yep, but not before I developed cardiovascular disease, by eschewing statins. My cholesterol fractionation was “good” according to his earlier thinking. In retrospect, even according to him now…not. It was one of those things that made intuitive sense based on the data at the time and turned out to be wrong.
All I’m saying is that he has a lot of great evidence based information. You just need to know when he’s making stuff up and decide whether or not you want to sign on. It’s not without risk.
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Thanks for posting the review.
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I’m a born skeptic so I take most things with a grain of salt, especially from someone so certain that they are correct.
He is a fan of wearing a continuous glucose monitor for a long period of time regardless of whether you have diabetes or not. Frankly, he lost me at rapamycin and other mTOR inhibitors.
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I think a CGM in the absence of a diabetes diagnosis can be useful. My HbA1c for example is 5.8, but I eat well, am thin, exercise regularly and have a VO2 Max that puts me in the middle of the highest quartile. I know it’s accurate and not a disorder of RBC size or longevity, because my last lab drawn fasting blood sugar was 120, confirming the 5.8 A1c. The weird thing is that my blood glucose is under 100 when I go to bed and rarely hits 120 postprandial. What I found out is that I was crashing down to 70 at night, stimulating gluconeogenesis just to keep cellular functions happy. The problem is that it’s muscle protein that gets “eaten” to create that needed glucose. Without a CGM I would have never known that. I’ve yet to figure out how to fix it, but with a CGM I can do tweaks to diet, both in content and timing, along with monitoring the impact of different types of exercise. Once I figure it out though, that thing is gone. People can get too obsessive about data, maybe to the point that the anxiety over it is detrimental.
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I just got the book as well. I’ll be curious to hear your thoughts. Im always interested in what we can do to live healthier lives.
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