Outlive: The Science and Art of Longevity

Trauma, big T or little t, means having experienced moments of perceived helplessness. The situations in question may or may not have been life-or-death, he explained, “but to a child with an undeveloped brain, it may have seemed that way.”

Medicine 2.0 relies on two types of tactics, broadly speaking: procedures (e.g., surgery) and medications. Our tactics in Medicine 3.0 fall into five broad domains: exercise, nutrition, sleep, emotional health, and exogenous molecules, meaning drugs, hormones, or supplements.

From the standpoint of pure efficacy, CR or caloric restriction is the winner, hands down. This is how bodybuilders shed weight while holding on to muscle mass, and it also allows the most flexibility with food choices. The catch is that you have to do it perfectly—tracking every single thing you eat, and not succumbing to the urge to cheat or snac

Clearly, sleep and cognitive health are deeply intertwined; this is why one of the pillars of Alzheimer’s disease prevention, particularly for our high-risk patients, is improving their sleep. It is not enough merely to spend time in bed; good-quality sleep is essential to long-term brain health. This is the crucial distinction. Sleep that is irreg

Conversely, if your diet is high quality to begin with, and you are metabolically healthy, then only a slight degree of caloric restriction—or simply not eating to excess—can still be beneficial.

When we detect low or rapidly declining BMD in a middle-aged person, we use the following four strategies: Optimize nutrition, focusing on protein and total energy needs (see nutrition chapters). Heavy loading-bearing activity. Strength training, especially with heavy weights, stimulates the growth of bone—more than impact sports such as running (t

One reason I find value in the concept of metabolic syndrome is that it helps us see these disorders as part of a continuum and not a single, binary condition. Its five relatively simple criteria are useful for predicting risk at the population level. But I still feel that reliance on it means waiting too long to declare that there is a problem. Wh

Socratic question. If sleep is so unimportant, he asked, then why hasn’t evolution gotten rid of it? His logic was inarguable. When we are asleep, we are accomplishing nothing useful: we are not reproducing, gathering food, or protecting our family. Even worse, in that slumbering state we are extremely vulnerable to predators and enemies, as I had

Your exoskeleton (muscle) is what keeps your actual skeleton (bones) upright and intact. Having more muscle mass on your exoskeleton appears to protect you from all kinds of trouble, even adverse outcomes following surgery—but most important, it is highly correlated with a lower risk of falling, a leading but oft-ignored cause of death and disabili

I propose that with some unorthodox but very reasonable lifestyle changes, you can minimize the most serious threats to your lifespan and healthspan and achieve your own measure of longevity alpha.