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Outlive: The Science and Art of Longevity 精装 – 2023年 3月 28日
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“One of the most important books you’ll ever read.”—Steven D. Levitt, New York Times bestselling author of Freakonomics
AN ECONOMIST AND BLOOMBERG BEST BOOK OF THE YEAR
Wouldn’t you like to live longer? And better? In this operating manual for longevity, Dr. Peter Attia draws on the latest science to deliver innovative nutritional interventions, techniques for optimizing exercise and sleep, and tools for addressing emotional and mental health.
For all its successes, mainstream medicine has failed to make much progress against the diseases of aging that kill most people: heart disease, cancer, Alzheimer’s disease, and type 2 diabetes. Too often, it intervenes with treatments too late to help, prolonging lifespan at the expense of healthspan, or quality of life. Dr. Attia believes we must replace this outdated framework with a personalized, proactive strategy for longevity, one where we take action now, rather than waiting.
This is not “biohacking,” it’s science: a well-founded strategic and tactical approach to extending lifespan while also improving our physical, cognitive, and emotional health. Dr. Attia’s aim is less to tell you what to do and more to help you learn how to think about long-term health, in order to create the best plan for you as an individual. In Outlive, readers will discover:
• Why the cholesterol test at your annual physical doesn’t tell you enough about your actual risk of dying from a heart attack.
• That you may already suffer from an extremely common yet underdiagnosed liver condition that could be a precursor to the chronic diseases of aging.
• Why exercise is the most potent pro-longevity “drug”—and how to begin training for the “Centenarian Decathlon.”
• Why you should forget about diets, and focus instead on nutritional biochemistry, using technology and data to personalize your eating pattern.
• Why striving for physical health and longevity, but ignoring emotional health, could be the ultimate curse of all.
Aging and longevity are far more malleable than we think; our fate is not set in stone. With the right roadmap, you can plot a different path for your life, one that lets you outlive your genes to make each decade better than the one before.
- 纸书页数496页
- 语言英语
- 出版社Harmony
- 出版日期2023年 3月 28日
- 尺寸18.34 x 3.68 x 23.52 cm
- ISBN-100593236599
- ISBN-13978-0593236598
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“In Outlive, Peter Attia explores the science of not just prolonging life, but also prolonging aliveness. Attia makes the crucial connection between overall health and relational health.”—Esther Perel, New York Times bestselling author, psychotherapist, and podcast host of Where Should We Begin?
“Finally, there is a modern, thorough, clear, and actionable manual for how to maximize our immediate and long-term health. Firmly grounded in data and real-life conditions, Outlive makes obvious which actions we all need to take, and just as important, what all we need to pay attention to in order to live a long, vital life. As the most accurate and comprehensive health guide published to date, Outlive is not just informative, it is important.”—Andrew Huberman, PhD, professor, Department of Neurobiology at Stanford University School of Medicine, creator of the Huberman Lab podcast
“Dr. Peter Attia is my doctor and also my friend. He is a specialist in longevity and someone I trust with my life. What separates him from others is his pursuit of quality of life from all angles—physical, emotional, mental, relational, and spiritual health. This incredible book is a call to action and a reminder to always participate, and never be passive. It will arm you with the tools you need to live a long, meaningful, and fulfilling life.”—Hugh Jackman
“In Outlive, Peter Attia has delivered the definitive look at the complex subject of longevity. Comprehensive and rigorous, Outlive is full of surprising insights into the diseases of aging that will likely kill most of us, and the tactics and techniques that can help us live longer and in better health. Attia’s writing surprises and delights us, while provoking a new way to think about longevity.”—Siddhartha Mukherjee, author of the Pulitzer Prize winner The Emperor of All Maladies and the New York Times bestseller The Song of the Cell
作者简介
Bill Gifford is a veteran journalist and author of the New York Times bestseller Spring Chicken: Stay Young Forever (Or Die Trying). His work has appeared in Outside, Scientific American, Bloomberg Businessweek, Men’s Health, and numerous other publications.
文摘
The Long Game
From Fast Death to Slow Death
There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they’re falling in. —Bishop Desmond Tutu
I’ll never forget the first patient whom I ever saw die. It was early in my second year of medical school, and I was spending a Saturday evening volunteering at the hospital, which is something the school encouraged us to do. But we were only supposed to observe, because by that point we knew just enough to be dangerous.
At some point, a woman in her midthirties came into the ER complaining of shortness of breath. She was Black, from East Palo Alto, a persistent pocket of poverty in that very wealthy town. While the nurses snapped a set of EKG leads on her and fitted an oxygen mask over her nose and mouth, I sat at her side, trying to distract her with small talk. What’s your name? Do you have kids? How long have you been feeling this way?
All of a sudden, her face tightened with fear and she began gasping for breath. Then her eyes rolled back and she lost consciousness.
Within seconds, nurses and doctors flooded into the ER bay and began running a “code” on her, snaking a breathing tube down her airway and injecting her full of potent drugs in a last-ditch effort at resuscitation. Meanwhile, one of the residents began doing chest compressions on her prone body. Every couple of minutes, everyone would step back as the attending physician slapped defibrillation paddles on her chest, and her body would twitch with the immense jolt of electricity. Everything was precisely choreographed; they knew the drill.
I shrank into a corner, trying to stay out of the way, but the resident doing CPR caught my eye and said, “Hey, man, can you come over here and relieve me? Just pump with the same force and rhythm as I am now, oaky?”
So I began doing compressions for the first time in my life on someone who was not a mannequin. But nothing worked. She died, right there on the table, as I was still pounding on her chest. Just a few minutes earlier, I’d been asking about her family. A nurse pulled the sheet up over her face and everyone scattered as quickly as they had arrived.
This was not a rare occurrence for anyone else in the room, but I was freaked out, horrified. What the hell just happened?
I would see many other patients die, but that woman’s death haunted me for years. I now suspect that she probably died because of a massive pulmonary embolism, but I kept wondering, what was really wrong with her? What was going on before she made her way to the ER? And would things have turned out differently if she had had better access to medical care? Could her sad fate have been changed?
Later, as a medical resident at Johns Hopkins, I would learn that death comes at two speeds: fast and slow. In inner-city Baltimore, fast death ruled the streets, meted out by guns, knives, and speeding automobiles. As perverse as it sounds, the violence of the city was a “feature” of the training program. While I chose Hopkins because of its excellence in liver and pancreatic cancer surgery, the fact that it averaged more than ten penetrating trauma cases per day, mostly gunshot or stabbing wounds, meant that my colleagues and I would have ample opportunity to develop our surgical skills repairing bodies that were too often young, black, poor, and male.
If trauma dominated the nighttime, our days belonged to patients with vascular disease, GI disease, and especially cancer. The difference was that these patients’ “wounds” were caused by slow-growing, long-undetected tumors, and not all of them survived either—not even the wealthy ones, the ones who were on top of the world. Cancer doesn’t care how rich you are. Or who your surgeon is, really. If it wants to find a way to kill you, it will. Ultimately, these slow deaths ended up bothering me even more.
But this is not a book about death. Quite the opposite, in fact.
More than twenty-five years after that woman walked into the ER, I’m still practicing medicine, but in a very different way from how I had imagined. I no longer perform cancer surgeries, or any other kind of surgery. If you come to see me with a rash or a broken arm, I probably won’t be of very much help.
So, what do I do?
Good question. If you were to meet me at a party and ask me that, I would do my best to duck out of the conversation. Or I would lie and say I’m a race car driver, which is what I really want to be when I grow up. (Plan B: shepherd.)
My focus as a physician is on longevity. The problem is that I kind of hate the word longevity. It has all sorts of terrible associations, with a centuries-long parade of quacks and charlatans who have claimed to possess the secret elixir to a longer life. I don’t want to be associated with those people, and I’m not arrogant enough to think that I possess some sort of easy answer to this problem, which has puzzled humankind for millennia. If longevity were simple, then there might not be a need for this book.
I’ll start with what longevity isn’t. Longevity does not mean living forever. Or even to age 120, or 150, which some self-proclaimed experts are now routinely promising to their followers. Barring some major breakthrough that, somehow, someway, reverses two billion years of evolutionary history and frees us from time’s arrow, everyone and everything that is alive today will inevitably die. It’s a one-way street.
Nor does longevity mean merely notching more and more birthdays as we slowly wither away. This is what happened to a hapless mythical Greek named Tithonus, who asked the gods for eternal life. To his joy, the gods granted his wish. But because he forgot to ask for eternal youth as well, his body continued to decay. Oops.
Most of my patients instinctively get this. When they first come to see me, they generally insist that they don’t want to live longer, if doing so means lingering on in a state of ever-declining health. Many of them have watched their parents or grandparents endure such a fate, still alive but crippled by physical frailty or dementia. They have no desire to reenact their parents’ suffering. Here’s where I stop them. Just because your parents endured a painful old age, or died younger than they should have, I say, does not mean that you must do the same. The past need not dictate the future. Your longevity is more malleable than you think.
In 1900, life expectancy hovered somewhere south of age fifty, and most people were likely to die from “fast” causes of death: accidents, injuries, and infectious diseases of various kinds. Since then, slow death has supplanted fast death. The majority of people reading this book can expect to die somewhere in their seventies or eighties, give or take, and almost all from “slow” causes. Assuming that you’re not someone who engages in ultrarisky behaviors like base jumping, motorcycle racing, or texting and driving, the odds are overwhelming that you will die as a result of one of the chronic diseases of aging that I call the Four Horsemen: heart disease, cancer, neurodegenerative disease, or type 2 diabetes and related metabolic dysfunction. To achieve longevity—to live longer and live better for longer—we must understand and confront these causes of slow death.
Longevity has two components. The first is how long you live, your chronological lifespan, but the second and equally important part is how well you live—the quality of your years. This is called healthspan, and it is what Tithonus forgot to ask for. Healthspan is typically defined as the period of life when we are free from disability or disease, but I find this too simplistic, too binary. For example, I’m as free from “disability and disease” as when I was a twenty-five-year-old medical student, but my twenty-something self could run circles around fifty-year-old me, both physically and mentally. That’s just a fact. Thus the second part of our plan for longevity is to maintain and improve our physical and mental function.
The key question is, Where am I headed from here? What’s my future trajectory? Already, in midlife, the warning signs abound. I’ve been to funerals for friends from high school, reflecting the steep rise in mortality risk that begins in middle age. At the same time, many of us in our thirties, forties, and fifties are watching our parents disappear down the road to physical disability, dementia, or long-term disease. This is always sad to see, and it reinforces one of my core principles, which is that the only way to create a better future for yourself—to set yourself on a better trajectory—is to start thinking about it and taking action now.
基本信息
- 出版社 : Harmony; 第一版 (2023年 3月 28日)
- 语言 : 英语
- 精装 : 496页
- ISBN-10 : 0593236599
- ISBN-13 : 978-0593236598
- 商品重量 : 635 g
- 尺寸 : 18.34 x 3.68 x 23.52 cm
- 亚马逊热销商品排名: 商品里排第189名图书 (查看图书商品销售排行榜)
- 商品里排第1名解剖学 (图书)
- 商品里排第1名老龄化医疗状况与疾病
- 商品里排第3名长寿秘籍
- 买家评论:
关于作者
Bill Gifford is a veteran magazine writer and editor who writes about extraordinary athletes and cutting-edge health science. After growing up mostly in Washington, D.C., he returned after college to become a staff writer for the legendary Washington City Paper, for a salary paid in beer, rice and beans. He then moved to Philadelphia to write and edit for Philadelphia Magazine for several years. Continuing north along I-95 to New York, he worked as features editor and then "editor-at-large," the world's best job title, for Men's Journal. His freelance work has appeared in Outside magazine, where he is a longtime contributing editor, as well as Bicycling, Wired, Bloomberg Businessweek, Slate, and others, as well as in Best American Sportswriting. His first book, Ledyard, is a biography of the 18th-century explorer, writer, entrepreneur and bon vivant John Ledyard. His latest, Spring Chicken, is a personal investigation into the science of aging.
Peter Attia, MD, is the founder of Early Medical. He received his medical degree from the Stanford University School of Medicine and trained at the Johns Hopkins Hospital in general surgery. He also trained at the NIH as a surgical oncology fellow at the National Cancer Institute, where his research focused on immune-based therapies for melanoma. He serves on the editorial board for the journal Aging. He is the host of The Drive, one of the most popular podcasts covering the topics of health, medicine, and longevity.
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在计算整体星级评定和按星级划分的百分比时,我们不使用简单的平均值。我们的系统会考虑评论的时间以及评论者是否在亚马逊上购买了商品等因素。系统还对评论进行了分析,以验证其可信度。
详细了解买家评论在亚马逊上的运作方式10 key points from the book “Outlive”
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I read through some of the 1 and 2 star reviews on Goodreads. Many mentioned that the book could be significantly shorter and that they did not like all of the personal stories that Dr. Attia shared. However, I found each of the stories to be quite helpful in putting the information into context. And I think the overall intent of this book was/is two-fold. It was not only written to present 'information,' but also Dr. Attia's personal testament of his journey as he learned new things, changed his perspectives, struggles in life, etc. The addition of this deeply intimate information helps to make the book more personable versus cold and mechanic. And who knows, writing this book may have also provided Dr. Attia with some degree of inner peace and resolution. What is so wrong with that?
There are many focal points of this book, but for this book review, I will address what I find to be key take away points, and my perspective of those points discussed by Dr. Attia.
READABIITY: Some parts of the book could be difficult for people to understand if they do not have a medical background, fortunately I do. For those who do not, and really want to understand, have Internet access handy so that you can cross-reference between the Internet and the book as you go along. NOTE: There are many parts of the book where animal research studies are discussed. I must preface that I struggle reading about animal studies, as I am anti-animal testing activist. But I do understand why the studies are mentioned in the book.
PHILOSOPHY: Dr. Attia makes several comparisons between Medicine 2.0 and Medicine 3.0. I think many Primary Care providers who read and subsequently reviewed this book may have felt offended by Dr. Attia's views on what he describes as our current healthcare model (Medicine 2.0). However, Dr. Attia is not pointing fingers and intending to insult Primary Care providers. He is simply pointing out flaws in our current healthcare model and how it should shift to a different focus, which I 100% agree with!
For those who chose to be insulted by this, shame on you. If you are a Primary Care provider, it is also not your fault that your practice is based upon Medicine 2.0, as you have to operate within the restrictive system and in accordance with insurance coverage. Embrace the Medicine 3.0 philosophy and save it for the day when, perhaps, our current healthcare model will shift closer to it. Everyone will be better off for it.
PREVENTATIVE TESTS: I found it odd when a reviewer mentioned that they know many adults who lived to old ages without any fancy tests. That is a strange thing to write, because Dr. Attia does NOT imply that having a bunch of tests contributes to living longer or healthier. Conversely, he implies that having preventative tests provides knowledge of one's current health state. That knowledge can then enable people to make changes that can contribute to living longer and healthier versus being a ticking time bomb and continuing on the same physiological path. How that reviewer misconstrued these two vastly different concepts is beyond me. This reviewer continued on to say that these seniors also smoked, drank, ate what they wanted, etc. However, I cannot help but wonder about their quality of life, and whether they were active and enjoy(ed) pursing hobbies/interests OR if they were simply 'existing' as couch potatoes. These are two vastly different concepts, and is the focal point that Dr. Attia expresses throughout the book.
On another note, Dr. Attia describes the perfect world where everyone has access to a plethora of preventative tests. Many of these preventative tests (scans, blood, etc.) are not covered by typical insurance plans, which means people have to pay out of pocket for them. I do plan to have most of the screening tests done that he recommends, because I want that in-depth knowledge of my current health state. However, doing all of these are just out of reach for many, or until patients reach a certain age (DEXA scan, for example).
MACRO NUTRITION: As many others mentioned, I do not think that any new/novel information about macro nutrition was presented. Some reviewers got the impression that Dr. Attia is pro-Keto diet. But I did not infer that at all. Conversely, I thought Dr. Attia did a great job with pointing out key advantages and disadvantages of many different types of diets, not just Keto. And I think he made it quite clear that no one type of nutrition regimen/approach is going to work for everyone. This point was made quite clear when he discussed his friend/patient (the Lipidologist) who benefited from a fasting regimen. I also think he did a good job explaining how different macro nutrients affect the body in an easy to understand fashion. I particularly found the information about Fructose and Purine quite interesting.
EXERCISE: It was made abundantly clear that Dr. Attia believes that exercise is the foundation for good health, which I agree with! He describes, in detail, how exercise is the best preventative tool for the "Horsemen." Yes, it makes good sense: Exercise = improved blood flow = improved perfusion AND = building and/or maintenance of muscle tissue and maintenance of bone = potential reduced risk for the "Horseman." But in reality, is it really THAT simple? I do not think so. There are so many other factors that come into play.
Additionally, what is disheartening, and what other reviewers found discouraging about this, is how complex Dr. Attia makes exercise out to be. While I agree with the benefits of all the different types of exercises he discusses, I also think it is unrealistic for many people to achieve all of it in it's entirety. Again, it comes back to the perfect world where there are no life-stressors, no major time consuming life-demands, not having to work a full-time job, etc.
For example, let's talk about a rich celebrity who is one of Dr, Attia's patients: Chris Hemsworth. I am not criticizing or picking on Mr. Hemsworth. Below is just a great example that helps my point hit home here.
Does he work a 40-hour week desk job, staring at a computer all day? No. Is he on his feet all day working at a store helping customers? No. Does he come home from that job, after a commute, and have to try to squeeze in a workout? No.
Does he have personal trainers and nutritional coaches? Yes. Does he have plenty of time most days to exercise and enjoy leisurely activities? Yes. Is his job as an actor focused on being physically fit? Yes. Is he able to wake up naturally most days instead of being blasted awake by an alarm clock? Yes. Does he have plenty of income to not have to worry about paying the bills? Yes.
This is the perfect world that Dr. Attia describes. Not everyone has enough time in the day to devote to exercising like Dr. Attia believes is necessary. I am a poly-outdoorsman, and I am an endurance (non-professional) athlete. I would love nothing more than to have the amazing opportunity to devote as much time as I want to exercise and my outdoor sports versus working a full-time job. However, that is not my reality despite how much I would like it to be.
For most people who live in the real world, doing some exercise each day/week just has to be enough because that's all they can do. So to even remotely imply that that amount just isn't enough to obtain a long, healthy lifespan is quite sad. This is where the notion of 'weekend warriors' comes into play. For some, weekends are the only time that people have to exercise and/or recreate in the outdoors. This pattern does not align with Dr Attia's ideology, but doing something on the weekends is better than doing nothing at all.
What I do think readers can benefit and take away from this section of the book is to, perhaps, incorporate different exercises into their daily/weekly regimen that they may not have thought of. This is key! For myself, I have now incorporated new things into my exercise regimen because I have a better understanding of how they can have a long-term impact.
FINAL THOUGHTS: This is not a concrete book of science. It is a book that discusses some scientific information combined with Dr. Attia's life-experiences. I think it is a well-rounded book because of this. Take whatever information you found useful and run with it! Be as active as you possibly can each day/week, keep your body trim, and feed it with good nutrition. For us "Commoners," that is the best we can do.
So what if I, as a moslem, will be “adding” a final chapter to the book, so as to discuss it within my circle, that imparts a transcendental framework to our quest for a long life beyond the raising of a strong healthy physical horse. If you believe that your existence totally ends with death, it makes perfect sense to embark on a quest to lengthen your life, beyond which there is nothing. But if you belief as I do that there is an eternal component to our essence that continues beyond the entombment of our bodies, then your horizon and end point is limitless. Is the martyr who died defending his people and his family against oppression and tyranny at age 20, achieving a dismal Attia-style longevity, a loser, a tragic figure who fell victim to unfortunate conflicts, or is he worth a thousand longevity-focused horses? To exclusively pamper the animal (body) and ignore the horseman (soul) is to put the cart before the horse. In addition, to preach that we should persevere in trying to lengthen life a few more years, and spend a whole lifetime doing it, strikes me as wasting your life in order to lengthen it.
My advice to friends and family is this: Go ahead and double click on exercise and nutrition; huff and buff to raise your VO2 max, and be stable with firm resolve as you prioritize DNS. But do bear in mind that you are making the horse strong to serve the horseman, and not the other way around. We are not mere shells: eat, move, sleep, copulate, repeat. Get yourself a more spacious framework. Be in control as your phosphorylated spirit commandeer the horse so that the both of you can stand, marsh, live, and die with nobility and honor. “Outliving” to me is a transcendent term, to outdo and go beyond the bounds of your biological carbon-based body, to achieve escape velocity through a noble righteous life on Earth that propels your soul to heaven when biology fails you, so as to justify the reason that God commanded the angels to bow to Adam.
Of course, this is not a book about religion, and of course we agree less on religion than we do nutrition, and of course moslems are a zealot punch (attempt at self-deprecating humor), and of course as a physician I would love to read the 2000 page version (sorry, Penguin Random House). But from my perspective this is a beautifully written book by an author that I and my kids grew to love and admire, one who does not do anything half-way. Read it and reread it but put the material to practice by moving a good amount in between reading spurts.
Although basic advice- exercise 4-5 X a week, eat right, sleep right, etc. maybe nothing you haven't heard before.