Most people have something that they pursue with an almost obsessive passion: For me it is basketball. While I loved the game and played as often as I could, I relied on my ability to ‘power through’ rather than on my skills to continue playing.
With age, I noticed that the ‘powering through’ was getting decreasingly intense. As 2025 rolled in, I decided to finally work on getting fitter off the court so that I could do better on it.
As I embarked upon this journey, the sheer volume of information (and contradictions) available from various sources left me clueless about where the starting point even should be. To cut a long story short, I anchored myself (on a friend’s recommendation) to this book on health and longevity by Peter Attia: Outlive.
I found the book’s approach refreshing: The first few pages underlining how one should approach health and longevity, the next section talking about the workings of the major diseases plaguing modern mankind in a ‘biology for non-biologists’ manner; and the last section detailing actions that individuals can/should take to prevent, recover and/or delay disease.
This note talks about Part 1: Concepts and frameworks that should form the basis of our outlook on health and longevity. The book obviously does a much better job of this than the next few paragraphs would; I am only putting down concepts and thoughts that strongly resonated with me.
Lifespan… Healthspan… What is (or should be) the goal?
Most folks are familiar with lifespan: The number of years one lives. The book introduced a very interesting vector to this: Healthspan. Healthspan can be thought of as the quality of one’s life, in terms of what their body can afford them.
When I am X years old (as X keeps increasing), can I climb up a flight of stairs, can I hold a spoon and eat cereal by myself, can I play basketball for 30 minutes and still have a grand old time?
While most of medical science focuses on extending lifespan, maintaining healthspan as life progresses is something that is slowly coming to the forefront. This evolution can be thought of as three phases of medicine:
The evolution of medicine can be understood in three phases:
Medicine 1.0 (Until early 19th century):
Relied on philosophical thinking and observation.
If the doctor, healer, or elder had seen, heard, or read about an ailment and its management, that is what they would prescribe.
Medicine 2.0 (Mid-19th century - Present):
Relies on the scientific method.
A hypothesis is formed (based on philosophies, observations, or even a hunch) and then tested to prove or disprove it.
This experimentation leads to proven methods of diagnosis, treatment, and cure.
It has been highly effective for acute illnesses (such as flu and cholera) and for injuries.
Medicine 3.0 (Future of medicine?):
Relies on root cause analysis and early prevention.
Instead of waiting for a problem to appear, the focus is on finding out why it occurs and solving it at the source, thereby preventing its emergence.
Considered more effective for long-horizon diseases such as diabetes, heart disease, and cancer.
Note
lIf you are tempted to criticise a particular phase after learning of its shortcomings, do keep in mind that the next phase was possible only because of its predecessor.
Part 1 did a great job in piquing my interest towards the question What are the root causes of ‘long-term diseases’ and is there anything I can do about it?
Here is a snapshot of the contents of the rest of the book:
The book identifies four major long-term diseases (or in the Biblical reference, the Four Horsemen):
1.Metabolic Dysfunction (Diabetes, Liver Damage etc.)
2.Heart Disease
3.Cancer
4.Neurological Disease (Alzheimer’s, Parkinson’setc.)
Part 2 delves into each of these horsemen in detail, talks about their mechanisms, progression, treatment, control and prevention. Part 3 talks about tactics, a guide of sorts to how to approach your daily life (physical strength, mental strength and their key contributors of exercise, diet, rest and supplements).
If you have reached this far in the article, I would strongly recommend that you pick the book up and read it - the topic seems to be of interest to you and Peter Attia does a MUCH better job of explaining it than this semi-hastily written note. For those of you who are not into reading 400-page books (Reiterating: it is very well written), I hope to follow this up with more on what I took away from the book along with scraps I have collected from this wonderful place called the internet (and some person with the initials A.I.). Stay tuned…