Outlive Quotes

“The greatest obstacle to discovery is not ignorance—it is the illusion of knowledge. —Daniel J. Boorstin”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“One macronutrient, in particular, demands more of our attention than most people realize: not carbs, not fat, but protein becomes critically important as we age.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in. —BISHOP DESMOND TUTU”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Unfortunately, in today’s unhealthy society, “normal” or “average” is not the same as “optimal.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Each night, when I go to sleep, I die. And the next morning, when I wake up, I am reborn. —Mahatma Gandhi”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“The single most powerful item in our preventive tool kit is exercise, which has a two-pronged impact on Alzheimer’s disease risk: it helps maintain glucose homeostasis, and it improves the health of our vasculature”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“The study reported a 24 percent relative increase in the risk of breast cancer among a subset of women taking HRT, and headlines all over the world condemned HRT as a dangerous, cancer-causing therapy. All of a sudden, on the basis of this one study, hormone replacement treatment became virtually taboo. This reported 24 percent risk increase sounded scary indeed. But nobody seemed to care that the absolute risk increase of breast cancer for women in the study remained minuscule. Roughly five out of every one thousand women in the HRT group developed breast cancer, versus four out of every one thousand in the control group, who received no hormones.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. 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. Similarly, there’s no billing code for putting a patient on a comprehensive exercise program designed to maintain her muscle mass and sense of balance while building her resistance to injury. But if she falls and breaks her hip, then her surgery and physical therapy will be covered. Nearly all the money flows to treatment rather than prevention—and when I say “prevention,” I mean prevention of human suffering.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“But if you really want to raise your VO2 max, you need to train this zone more specifically. Typically, for patients who are new to exercising, we introduce VO2 max training after about five or six months of steady zone 2 work.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“I am increasingly persuaded that our 24-7 addiction to screens and social media is perhaps our most destructive habit, not only to our ability to sleep but to our mental health in general. So I banish those from my evenings (or at least, I try to). Turn off the computer and put away your phone at least an hour before bedtime. Do NOT bring your laptop or phone into bed with you.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“I never won a fight in the ring;
I always won in preparation. —MUHAMMAD ALI”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“How much protein do we actually need? It varies from person to person. In my patients I typically set 1.6 g/kg/day as the minimum, which is twice the RDA.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Our tactics in Medicine 3.0 fall into five broad domains: exercise, nutrition, sleep, emotional health, and exogenous molecules, meaning drugs, hormones, or supplements.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Of course, exercise is not just one thing, so I break it down into its components of aerobic efficiency, maximum aerobic output (VO2 max), strength, and stability, all of which we’ll discuss in more detail.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“WHAT’S GOOD FOR THE HEART IS GOOD FOR THE BRAIN. That is, vascular health (meaning low apoB, low inflammation, and low oxidative stress) is crucial to brain health. WHAT’S GOOD FOR THE LIVER (AND PANCREAS) IS GOOD FOR THE BRAIN. Metabolic health is crucial to brain health. TIME IS KEY. We need to think about prevention early, and the more the deck is stacked against you genetically, the harder you need to work and the sooner you need to start. As with cardiovascular disease, we need to play a very long game. OUR MOST POWERFUL TOOL FOR PREVENTING COGNITIVE DECLINE IS EXERCISE. We’ve talked a lot about diet and metabolism, but exercise appears to act in multiple ways (vascular, metabolic) to preserve brain health; we’ll get into more detail in Part III, but exercise—lots of it—is a foundation of our Alzheimer’s-prevention program.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Next is diet or nutrition—or as I prefer to call it, nutritional biochemistry. The third domain is sleep, which has gone underappreciated by Medicine 2.0 until relatively recently. The fourth domain encompasses a set of tools and techniques to manage and improve emotional health. Our fifth and final domain consists of the various drugs, supplements, and hormones that doctors learn about in medical school and beyond. I lump these into one bucket called exogenous molecules, meaning molecules we ingest that come from outside the body.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“We spend so much of our time in car seats, in desk chairs, at computers, and peering at our various devices that modern life sometimes seems like an all-out assault on the integrity of our spine. The spine has three parts: lumbar (lower back), thoracic (midback), and cervical (neck) spine. Radiologists see so much degeneration in the cervical spine, brought on by years of hunching forward to look at phones, that they have a name for it: “tech neck.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“Poor or disordered breathing can affect our motor control and make us susceptible to injury, studies have found. In one experiment, researchers found that combining a breathing challenge (reducing the amount of oxygen available to study subjects) with a weight challenge reduced the subjects’ ability to stabilize their spine. In real-world terms, this means that someone who is breathing hard (and poorly) while shoveling snow is putting themselves at increased risk of a back injury. It’s extremely subtle, but the way in which someone breathes gives tremendous insight to how they move their body and, more importantly, how they stabilize their movements.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“This study found that someone of below-average VO2 max for their age and sex (that is, between the 25th and 50th percentiles) is at double the risk of all-cause mortality compared to someone in the top quartile (75th to 97.6th percentiles). Thus, poor cardiorespiratory fitness carries a greater relative risk of death than smoking.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“I think people get old when they stop thinking about the future,” Ric told me. “If you want to find someone’s true age, listen to them. If they talk about the past and they talk about all the things that happened that they did, they’ve gotten old. If they think about their dreams, their aspirations, what they’re still looking forward to—they’re young.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“found that grip strength, an excellent proxy for overall strength, was strongly and inversely associated with the incidence of dementia (see figure 8). People in the lowest quartile of grip strength (i.e., the weakest) had a 72 percent higher incidence of dementia, compared to those in the top quartile.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“As Terry had written: “Family pathology rolls from generation to generation like a fire in the woods taking down everything in its path until one person, in one generation, has the courage to turn and face the flames. That person brings peace to his ancestors and spares the children that follow.” I wanted to be that person.”
― Peter Attia, Outlive: The Science and Art of Longevity

“In case my point here isn’t clear enough, let me restate it: don’t ignore protein. It’s the one macronutrient that is absolutely essential to our goals. There’s no minimum requirement for carbohydrates or fats (in practical terms), but if you shortchange protein, you will most certainly pay a price, particularly as you age.”
― Peter Attia, Outlive: The Science and Art of Longevity

“The typical cholesterol panel that you receive and discuss at your annual physical, along with many of the underlying assumptions behind it (e.g., “good” and “bad” cholesterol), is misleading and oversimplified to the point of uselessness.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“The distribution of amino acids is not the same as in animal protein. In particular, plant protein has less of the essential amino acids methionine, lysine, and tryptophan, potentially leading to reduced protein synthesis. Taken together, these two factors tell us that the overall quality of protein derived from plants is significantly lower than that from animal products.”
― Peter Attia, Outlive: The Science and Art of Longevity

“fructose basically tricks our metabolism into thinking that we are depleting energy—and need to take in still more food and store more energy as fat.[*5]”
― Peter Attia, Outlive: The Science and Art of Longevity

“So do red and processed meats actually cause cancer or not? We don’t know, and we will probably never get a more definitive answer, because a clinical trial testing this proposition is unlikely ever to be done. Confusion reigns. Nevertheless, I’m going to stick my neck out and assert that a risk ratio of 1.17 is so minimal that it might not matter that much whether you eat red/processed meats versus some other protein source, like chicken. Clearly, this particular study is very far from providing a definitive answer to the question of whether red meat is “safe” to eat. Yet people have been fighting about it for years.”
― Peter Attia, Outlive: The Science and Art of Longevity

“The overarching point here is that a good night of sleep may depend in part on a good day of wakefulness: one that includes exercise, some outdoor time, sensible eating (no late-night snacking), minimal to no alcohol, proper management of stress, and knowing where to set boundaries around work and other life stressors.”
― Peter Attia MD, Outlive: The Science and Art of Longevity

“One way to track your progression in zone 2 is to measure your output in watts at this level of intensity. (Many stationary bikes can measure your wattage as you ride.) You take your average wattage output for a zone 2 session and divide it by your weight to get your watts per kilogram, which is the number we care about. So if you weigh 60 kilos (about 132 pounds) and can generate 125 watts in zone 2, that works out to a bit more than 2 watts/kg, which is about what one would expect from a reasonably fit person.”
― Peter Attia, Outlive: The Science and Art of Longevity