LessWrong (30+ Karma)

“Outlive: A Critical Review” by MichaelDickens


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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 [...]
  • ---

    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.

    ---

    First published:

    July 4th, 2025

    Source:

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

    ---

    Narrated by TYPE III AUDIO.

    ---

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