Michele's Reviews > Outlive: The Science & Art of Longevity

** spoiler alert ** I hesitated to write a review for a long time because the book had so much potential. But as I kept reading it I kept getting more and more disappointed.

I'll start this review with what I think is a good part of the book: the first two chapters. They give a framework for thinking about health (i.e. not just lifespan but also healthspan, as Attia talks about often on his podcast), and overview (with minimal detail) the 4 major killers (which Attia calls the "Horsemen diseases"). Ignoring the occasional fact or tidbit that is out of place in these overview chapters, the high level overview is well written, well edited, and contains a good way of framing the problem.

The rest of the book does not live up to the outline presented in the overview. In the strictest sense it does follow this outline, but it doesn't deliver on the promised depth, understanding, comprehensiveness, and insight.

An alternate title for the book could have been "A really detailed chapter on cardiovascular/cerebrovascular disease and then a bunch of musings." It was very clear that the detail achieved in the early chapter about cardiovascular/cerebrovascular disease was not carried through for the rest of the book. Attia himself says that because of his family history, he cares a lot about cardiovascular/cerebrovascular disease, and I think that is extremely clear from the discussion of mechanism, function, and prevention. The chapter on cancer, in contrast, is much less detailed, rigorous, and frankly much less insightful.

There are a few chapters devoted to exercise. If you have listened to Attia's podcast you know he is obsessed with exercise, and these chapters don't even try to hide his biases there. I'm not a gym rat (and never will be) but don't shy away from exercise and I felt like these chapters basically told me that if I'm not exercising all the darn time to these specifications then I'm doing something wrong. Sure, exercise is great for healthspan and lifespan (the mechanisms which are discussed in the cardiovascular/cerebrovascular disease chapter), but I didn't gain much insight into how to make this practical by reading these chapters.

Lastly, I felt like a book on longevity that does not address mental health and social connection in a scientific way is severely missing the point. The discussion about centenarians and the last chapter about emotional health are missing discussions about family connection, friendships, lower stress living, community, etc. that have been shown to correlate with healthspan and lifespan. (The last chapter on emotional health in this book, while vulnerable for Attia personally, isn't actually helpful to someone interested in longevity).

As I got to the end of the book I realized that the book is more like a giant blog post about Attia's life and what he understands about longevity (but actually more like cardiovascular health) from a physical standpoint (and how exercise can help those things) rather than a holistic overview of things we know that influence longevity.

Overall I was disappointed; I had listened to many episodes of Attia's podcast and was hoping to get an overview of many topics comprehensive to the science of longevity. Instead I got a detailed discussion about cardiovascular/cerebrovascular disease, some parts of Attia's life story, and a justification of Attia's obsession for exercise. I won't be recommending this book to anyone.