“Outlive: A Critical Review” by MichaelDickens

Outlive: The Science & Art of Longevity by Peter Attia (with Bill Gifford[1]) gives Attia's prescription on how to live longer and stay healthy into old age. In this post, I critically review some of the book's scientific claims that stood out to me.

This is not a comprehensive review. I didn't review assertions that I was pretty sure were true (ex: VO2 max improves longevity), or that were hard for me to evaluate (ex: the mechanics of how LDL cholesterol functions in the body), or that I didn't care about (ex: sleep deprivation impairs one's ability to identify facial expressions).

First, some general notes:

• I have no expertise on any of the subjects in this post. I evaluated claims by doing shallow readings of relevant scientific literature, especially meta-analyses.
• There is a spectrum between two ways of being wrong: "pop science book pushes [...]

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Outline:

(02:19) Disease

(02:22) People with metabolically healthy obesity do not have elevated mortality risk

(07:39) Amyloid beta is implicated in Alzheimers disease

(09:20) HDL cholesterol on its own doesnt prevent heart disease

(10:12) Exercise

(10:52) VO2max is the best predictor of longevity

(15:21) You should train VO2max by doing HIIT at the maximum sustainable pace

(20:26) You should do 3+ hours/week of zone 2 training and one or two sessions/week of HIIT

(23:34) Stability is as important as cardiovascular fitness and strength

(30:23) Nutrition

(30:26) Rhesus monkey studies suggest that calorie restriction improves longevity but only if you eat a fairly unhealthy diet

(38:09) The data are unclear on whether reducing saturated fat intake is beneficial

(45:59) People should take omega-3 supplements

(48:33) Sleep

(48:55) Every animal sleeps

(51:12) We need to sleep 7.5 to 8.5 hours a night

(52:24) Basketball players who were told to sleep for 10 hours a night had better shooting accuracy

(53:07) Lack of sleep increases obesity and diabetes risk

(54:27) A study using Mendelian randomization found that sleeping 6 hours a night increased risk of a heart attack

(57:03) Lack of sleep causes Alzheimers disease

(58:10) Bonus

(58:13) Dunning-Kruger effect

The original text contained 90 footnotes which were omitted from this narration.

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First published:
July 4th, 2025

Source:
https://www.lesswrong.com/posts/QqTiCz2Xz96MuEFsF/outlive-a-critical-review

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Narrated by TYPE III AUDIO.

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