Book Notes: Outlive-The Science and Art of Longevity (Part 1)

Chapter 11: Exercise-The Most Powerful Longevity Drug

According to Dr. Attia, exercise is a key to extending lifespan as well as the quality of that lifespan.

  • “…exercise has the greatest power to determine how you will live out the rest of your life.”
  • “It delays the onset of chronic diseases, pretty much across the board, but it is also amazingly effective at extending and improving healthspan.”
  • “Study after study has found that regular exercisers live as much as a decade longer than sedentary people”

Even small doses of exercise are highly beneficial

“Going from zero weekly exercise to just ninety minutes per week can reduce your risk of dying from all causes by 14 percent. It’s very hard to find a drug that can do that.”

VO2max is thought to be a key marker of cardiorespiratory fitness

  • “It turns out that peak aerobic cardiorespiratory fitness, measured in terms of VO2 max, is perhaps the single most powerful marker for longevity”
  • “Poor cardiorespiratory fitness carries a greater relative risk than smoking”
  • It’s also hard to have too much fitness. “As the authors of the JAMA study concluded, Cardiorespiratory fitness is inversely associated with long-term mortality with no observed upper limit of benefit”

VO2 max can be measured scientifically in a specialty health care lab, or it can be estimated by some fitness trackers, like an Apple watch.

Strength training is also an important dimension of exercise

  • “A ten-year observational study of roughly 4,500 subjects ages fifty and older found that those with low muscler mass were at 40 to 50 percent greater risk of mortality than controls, over the study period. Further analysis revealed that it’s not the mere muscle mass that matters, but the strength of those muscles.”
  • “…at least one study suggests….Researchers following a group of approximately 1,500 men over forty with hypertension, for an average of about eighteen years, found that even if a man was in the bottom half of cardiorespiratory fitness, his risk of all-cause mortality was still almost 48 percent lower if he was in the top third of the group in terms of strength versus the bottom third.”

Biochemistry supports the potential role of exercise in mitigating Alzheimer’s Disease

“When we are exercising, our muscles generate molecules known as cytokines that send signals to other parts of our bodies, helping to strengthen our immune system and stimulate the growth of new muscle and stronger bones. Endurance exercise such as running or cycling helps generate another potent molecule called brain-derived neutrophic factor, or BDNF, that improves the health and function of the hippocampus, a part of the brain that plans an essential role in memory. Exercise helps keep the brain vascalature healthy, and it may also help preserve brain volume. “

It’s important that we consider which activities of daily living we want to be able to do throughout our entire lives. Dr. Attia calls this a “Centenarian Decathlon”. Everyone’s list is different, but here’s a starting point that he provides in the book.

  • Hike 1.5 miles on a hilly trail
  • Get up off the floor under your own power, using a maximum of one arm for support.
  • Pick up a young child from the floor
  • Carry two five-pound bags of groceries for five blocks
  • Life a twenty-pound suitcase into the overhead compartment of a plane.
  • Balance on one leg for thirty seconds, eyes open. (Bonus points. Eyes closed, fifteen seconds)
  • Have sex
  • Climb four flights of stairs in three minutes
  • Open a jar
  • Do thirty consecutive jump-rope skips.

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