Emma Goto
If you've never read Why We Sleep it's a book that basically scares you into getting more sleep by explaining how important it is for your health. (I recommend you read it if you haven't already). Outlive is sort of like the diet and exercise version of that book, where the author really drills into the importance of getting and staying healthy at a younger age so you can reap those benefits as you get older.
The author kicks off the book by emphasising the idea of focusing on your healthspan, not just your lifespan. There's no point making it to 90 if you spend the last 20 years with a fairly poor quality of life, and so it's more about figuring out how you can live to an old age and be fairly mobile and healthy to right near the end.
The other concept he introduces is a term he has coined himself - Medicine 3.0. Today's medicine, or "Medicine 2.0", is about finding a cure for a disease after you get diagnosed, while Medicine 3.0 is about preventing you from needing to be diagnosed in the first place. The author runs some sort of a health clinic, so he sidetracks a bit into the sorts of niche tests he runs on his patients as part of this Medicine 3.0 approach. It's interesting, and I think it's great he's trying to push for something like this, but at the same time, the average reader is not going to have access to those tests for themselves so it's not super helpful. (Also the cynical part of me sees this as marketing for his health clinic).
The middle part of the book goes into his "four horsemen" of diseases that we should be trying to prevent much earlier, which are heart disease, cancer, neurodegenerative diseases (i.e. Alzheimer's) and type 2 diabetes. Sometimes you can just get unlucky with cancer, and there's no known way to stop or cure Alzheimer's, but the general advice here is that exercise and diet are important.
You might mistakenly assume that if you are not obese, you will be fine, but some people (including Asians) are genetically predisposed to not be able to handle even small amounts of extra fat so they could still be experiencing poorer health even if their BMI might not suggest it. I've never been at an overweight BMI but even so have had issues with high cholesterol in the past, so I felt like I could kind of relate to this point.
One of the problems with Medicine 2.0 is that if you don't have an over 5% risk of a heart attack in the next 10 years, then you're not considered at risk. But really we should be aiming to live healthily, for a long time, so you should start caring about these risks earlier, before you reach that 5% risk level. So as an example, although medicine today recommends that people should be aiming for below 70mg/dL for LDL cholesterol, you should actually be aiming for as low as 10-20mg/dL to reduce the risk of heart disease.
Finally the most useful part of the book is near the end, where he gives some actionable tips. The first big one is exercise and your VO2 max level (basically how out of breath you get when you run / how well you can run). There's a table with what is considered an average or above-average VO2 max level per age range, and the author recommends you should be aiming for the elite level in your age range. If you hit that, you should aim for the elite level of 2 decades below your age range.
Your VO2 max declines 10% per decade, so as an example, even if you have the sufficient VO2 max to comfortably hike today, you need a score that is way above that now, to be able to hike into your later years. Your body is going to decline, it's inevitable, but it's about shoring up your health and fitness as much as possible while you are younger so that you can still enjoy life while you are old. As for how to improve your VO2 max? You should do most of your runs as zone 2 (you can still hold a conversation) but do 1 sprint workout a week which involves sprinting for 4 minutes, then dropping back down to a jog until your heart rate drops, and repeating that 4 - 6 times.
The second component of exercise is strength training. Muscle mass is impossible to put on in your 70s and will continue to decline each decade, so you need to put on as much as you can now to make up for it. He doesn't advocate going as heavy as you can, as an injury can put you out for months (which I did to my back this year so I can relate). Instead you should be focusing on stability. He goes into detail about a bunch of exercises you could do for that but it gets a bit harder visualise what he means.
And finally, nutrition! Reducing calorie intake can lead to a longer life, but comes with increased risk of injury, plus it's kind of depressing to diet all of the time, so the author doesn't really recommend it. What's more important is just eating well. He doesn't recommend a specific diet since different things work for different people (Keto, Mediterranean) but the key point is something that's sustainable. Factoring in your weight training, protein becomes really important as well, and he recommends a daily intake of 1.6x your weight in kg.
Surprisingly, although he acknowledges that alcohol has no upsides, his recommendation is to restrict your servings to 7 in a week. I found this point really interesting in that he's recommending people aim for such a high VO2 max level (elite level is no joke, right?) yet is still so lax on the drinking aspect - I would have expected he would just recommend you cut out drinking altogether. So I do feel like there's a bit of the author's bias coming into play here as well.
Finally he caps off the book with a chapter on his own mental health struggles (which were quite severe) - longevity is meaningless if your life sucks - which is fair enough.
Overall, I think that Outlive does inject a bit more of the author's personal bias into it compared to Why We Sleep, hence the 4 star rating, but I definitely recommended reading if you need a bit of a kick up the backside when it comes to your own health.
Originally posted at www.emgoto.com.
If you've never read Why We Sleep it's a book that basically scares you into getting more sleep by explaining how important it is for your health. (I recommend you read it if you haven't already). Outlive is sort of like the diet and exercise version of that book, where the author really drills into the importance of getting and staying healthy at a younger age so you can reap those benefits as you get older.
The author kicks off the book by emphasising the idea of focusing on your healthspan, not just your lifespan. There's no point making it to 90 if you spend the last 20 years with a fairly poor quality of life, and so it's more about figuring out how you can live to an old age and be fairly mobile and healthy to right near the end.
The other concept he introduces is a term he has coined himself - Medicine 3.0. Today's medicine, or "Medicine 2.0", is about finding a cure for a disease after you get diagnosed, while Medicine 3.0 is about preventing you from needing to be diagnosed in the first place. The author runs some sort of a health clinic, so he sidetracks a bit into the sorts of niche tests he runs on his patients as part of this Medicine 3.0 approach. It's interesting, and I think it's great he's trying to push for something like this, but at the same time, the average reader is not going to have access to those tests for themselves so it's not super helpful. (Also the cynical part of me sees this as marketing for his health clinic).
The middle part of the book goes into his "four horsemen" of diseases that we should be trying to prevent much earlier, which are heart disease, cancer, neurodegenerative diseases (i.e. Alzheimer's) and type 2 diabetes. Sometimes you can just get unlucky with cancer, and there's no known way to stop or cure Alzheimer's, but the general advice here is that exercise and diet are important.
You might mistakenly assume that if you are not obese, you will be fine, but some people (including Asians) are genetically predisposed to not be able to handle even small amounts of extra fat so they could still be experiencing poorer health even if their BMI might not suggest it. I've never been at an overweight BMI but even so have had issues with high cholesterol in the past, so I felt like I could kind of relate to this point.
One of the problems with Medicine 2.0 is that if you don't have an over 5% risk of a heart attack in the next 10 years, then you're not considered at risk. But really we should be aiming to live healthily, for a long time, so you should start caring about these risks earlier, before you reach that 5% risk level. So as an example, although medicine today recommends that people should be aiming for below 70mg/dL for LDL cholesterol, you should actually be aiming for as low as 10-20mg/dL to reduce the risk of heart disease.
Finally the most useful part of the book is near the end, where he gives some actionable tips. The first big one is exercise and your VO2 max level (basically how out of breath you get when you run / how well you can run). There's a table with what is considered an average or above-average VO2 max level per age range, and the author recommends you should be aiming for the elite level in your age range. If you hit that, you should aim for the elite level of 2 decades below your age range.
Your VO2 max declines 10% per decade, so as an example, even if you have the sufficient VO2 max to comfortably hike today, you need a score that is way above that now, to be able to hike into your later years. Your body is going to decline, it's inevitable, but it's about shoring up your health and fitness as much as possible while you are younger so that you can still enjoy life while you are old. As for how to improve your VO2 max? You should do most of your runs as zone 2 (you can still hold a conversation) but do 1 sprint workout a week which involves sprinting for 4 minutes, then dropping back down to a jog until your heart rate drops, and repeating that 4 - 6 times.
The second component of exercise is strength training. Muscle mass is impossible to put on in your 70s and will continue to decline each decade, so you need to put on as much as you can now to make up for it. He doesn't advocate going as heavy as you can, as an injury can put you out for months (which I did to my back this year so I can relate). Instead you should be focusing on stability. He goes into detail about a bunch of exercises you could do for that but it gets a bit harder visualise what he means.
And finally, nutrition! Reducing calorie intake can lead to a longer life, but comes with increased risk of injury, plus it's kind of depressing to diet all of the time, so the author doesn't really recommend it. What's more important is just eating well. He doesn't recommend a specific diet since different things work for different people (Keto, Mediterranean) but the key point is something that's sustainable. Factoring in your weight training, protein becomes really important as well, and he recommends a daily intake of 1.6x your weight in kg.
Surprisingly, although he acknowledges that alcohol has no upsides, his recommendation is to restrict your servings to 7 in a week. I found this point really interesting in that he's recommending people aim for such a high VO2 max level (elite level is no joke, right?) yet is still so lax on the drinking aspect - I would have expected he would just recommend you cut out drinking altogether. So I do feel like there's a bit of the author's bias coming into play here as well.
Finally he caps off the book with a chapter on his own mental health struggles (which were quite severe) - longevity is meaningless if your life sucks - which is fair enough.
Overall, I think that Outlive does inject a bit more of the author's personal bias into it compared to Why We Sleep, hence the 4 star rating, but I definitely recommended reading if you need a bit of a kick up the backside when it comes to your own health.
Originally posted at www.emgoto.com.