Big Idea Daily | Outlive

The book has three parts.

In Part I, Attia walks us through the evolution of health care and maps out the high level objectives, strategy, and tactics for the book.

In Part II, he walks us through what the longest-lived people have in common and the top three challenges we face in our quest to Outlive: heart disease, cancer, and Alzheimer’s.

In Part III, we get into the practical tactics for our plan to live longer, better including: exercise (Attia’s #1 recommendation for longevity!), nutrition (more specifically “nutritional biochemistry”!), sleep (learn to love it—it’s the best medicine for your brain!), and our emotional well-being (and the high price of ignoring it).

That passage is from the second chapter in Part I called “Medicine 3.0: Rethinking Medicine for the Age of Chronic Disease.” Here’s the quick overview of Medicine 1.0, 2.0, and 3.0...

Attia tells us that: “The first era, exemplified by Hippocrates but lasting almost two thousand years after his death, is what I call Medicine 1.0. Its conclusions were based on direct observation and abetted more or less by pure guesswork, some of which was on target and some not so much.”

Then we have Medicine 2.0 which “arrived in the mid-nineteenth century with the advent of the germ theory of disease, which supplanted the idea that most illness was spread by ‘miasmas’ or bad air. This led to improved sanitary practices by physicians and ultimately the development of antibiotics.” Although “Medicine 2.0 was transformational” in many ways, it “has proved far less successful against long-term diseases such as cancer,” heart disease and Alzheimer’s.

There are FOUR distinctions between 2.0 and 3.0: “First, Medicine 3.0 places a far greater emphasis on prevention than treatment.” Second: “Medicine 3.0 considers the patient as a unique individual.” Third: “In Medicine 3.0, our starting point is the honest assessment, and acceptance, of risk—including the risk of doing nothing.” Fourth: “Perhaps largest shift is that where Medicine 2.0 focuses largely on lifespan, and is almost entirely geared toward staving off death, Medicine 3.0 pays far more attention to maintaining healthspan, the quality of life.”

He brings it all together at the very end of the chapter when he tells us: “Which brings us to perhaps the most important difference between Medicine 2.0 and Medicine 3.0. In Medicine 2.0, you are a passenger on the ship, being carried along somewhat passively. Medicine 3.0 demands much more from you, the patient: You must be well-informed, medically literate to a reasonably degree, clear-eyed about your goals, and cognizant of the true nature of risk. You must be willing to change ingrained habits, accept new challenges, and venture outside of your comfort zone if necessary. You are always participating, never passive. You confront problems, even uncomfortable or scary ones, rather than ignoring them until it’s too late. You have skin in the game, in a very literal sense. And you make important decisions.

Because in this scenario, you are no longer a passenger on the ship; you are the captain.”