Most of us have a fundamental aspiration: to live long and healthy lives. Today, the combination of advancements in medical science and our understanding of lifestyle factors has opened new horizons for this ambition. Pioneers in the realm of health and longevity, Dr. Peter Attia and Dr. Andrew Huberman, share their valuable insights into enhancing longevity and reducing the risk of all-cause mortality. In their enlightening discussion, they uncover the role of exercise in longevity, the impact of various lifestyle choices, and practical ways to improve overall health.
Unveiling the Core Factors of Longevity
Dr. Peter Attia, a recognized longevity specialist, takes a deep dive into the primary determinants of a long and healthy life. He highlights several lifestyle choices that significantly impact all-cause mortality, which measures the risk of dying from any cause.
Smoking: Contrary to popular belief, smoking doesn't necessarily shorten your lifespan by 40%. Instead, it elevates your risk of death at any given moment by 40%, as compared to non-smokers. Over time, this increased risk adds up, inevitably impacting your longevity.
High Blood Pressure: Hypertension or high blood pressure can enhance your risk of all-cause mortality by approximately 20-25%.
End-stage Kidney Disease: This critical condition, often resultant from uncontrolled type 2 diabetes or profound hypertension, amplifies the risk of all-cause mortality by a staggering 175%.
Type 2 Diabetes: People with type 2 diabetes face an estimated 25% increase in all-cause mortality.
So, given these potential hazards, how can one promote longevity? The answers might be simpler than you imagine.
Strength and Muscle Mass: The Secret to a Long Life
One of the most straightforward and effective strategies to promote longevity and decrease all-cause mortality is to build muscle mass and strength. When comparing individuals with low muscle mass to those with high muscle mass, the former group demonstrated about a 200% increase in all-cause mortality as they aged.
However, when further examining this data, it becomes clear that muscle mass alone is not the driving factor. Instead, the association is tied more closely to strength. Individuals with low strength had about a 250% greater risk of mortality compared to those with high strength. Some common measures of strength include grip strength, leg extensions, and the ability to maintain a squatted position without support.
Dr. Attia's Strength Metrics Assessment, which includes 11 challenging tests like dead hangs and leg extensions, serves as a practical example of how strength can be quantified and monitored. In his practice, the goal for a 40-year-old woman is to be able to dead hang for a minute and a half and a 40-year-old man for two minutes.
Cardiorespiratory Fitness: A Key to Longevity
While muscle strength is essential, Dr. Attia highlights that cardiorespiratory fitness is arguably the most crucial factor impacting all-cause mortality. He illustrates this by comparing individuals in the bottom 25% of VO2 max (a measure of cardiorespiratory fitness) to those in the top 2.5% In the same vein, Attia stressed on another critical parameter for longevity: cardiorespiratory fitness. While it might not sound as sexy or sell as many gym memberships as six-pack abs, cardiorespiratory fitness has an even more significant association with longevity than muscle strength.
Attia explained the immense impact of cardiorespiratory fitness on the risk of all-cause mortality by comparing people in different fitness brackets. If you are in the bottom 25% for your age and sex in terms of VO2 max (a measurement of your body's ability to utilize oxygen effectively), and you compare yourself with people in the 50th to 75th percentile, you find a startling 2x difference in the risk of all-cause mortality. This discrepancy becomes even more pronounced when comparing the bottom 25% to the top 2.5% for a given age, yielding a whopping 5x difference or 400% increase in all-cause mortality. This means that those in the top 2.5% fitness level for their age are five times less likely to die from any cause compared to those in the bottom 25%.
It's vital to clarify that when we talk about being in the top 2.5%, we're not discussing marathon runners or elite athletes. A person who exercises consistently and maintains a good level of fitness can still reach the 'elite' level in their age group.
After the importance of strength and cardiovascular fitness was established, Dr. Huberman asked Attia how one could achieve such high levels of fitness, considering their tremendous positive impact on health and longevity.
Dr. Attia emphasized the importance of having your exercise house in order before considering other aspects of health, such as diet or supplements. He shared his frustration with the disproportionate attention given to dietary nuances and supplement wars compared to exercise, the paramount determinant of longevity. According to Dr. Attia, until you can deadlift your body weight for ten reps, until your VO2 max is at least to the 75th percentile, and you can do a dead hang for at least a minute, you should not delve into arguments about diet and supplements.
This led to a light-hearted moment where Dr. Huberman coined "Attia's rule," which essentially says that you shouldn't discuss supplements or nutrition until you've met the following fitness criteria: a dead hang for a minute (or a minute and a half for a 40-year-old woman and two minutes for a 40-year-old man), an air squat at 90 degrees for two minutes, and a farmer's carry of your body weight (for men) or 75% of body weight (for women) for two minutes.
If it sounds harsh, it's only because the stakes are high. Physical fitness isn't just about looking good. It's about our very survival. It's about ensuring that we can not only add years to our life but life to our years, that we can not only live longer but live better, healthier, and more fulfilled lives.
Dr. Attia emphasized that these measures of fitness were crucial indirect measures of our health and longevity, touching upon critical aspects like grip strength, mobility, and cardiorespiratory fitness. By meeting these fitness criteria, we significantly increase our chances of becoming what Dr. Attia refers to as a "Centenarian Decathlete" — someone living their final decade, from 90 to 100 years old, at their best.
In conclusion, the conversation between Dr. Peter Attia and Dr. Andrew Huberman is a treasure trove of insights and practical advice about how to live longer, healthier lives. However, it's not just about following a list of exercises; it's about embracing a paradigm shift in our understanding of health, fitness, and longevity. It redefines the ultimate goal of health not just as the absence of disease but as the capacity to function optimally for as long as possible.
To achieve this goal, the conversation provides specific recommendations:
- Strength training: Deadlift your body weight for ten reps. This targets muscle strength and bone density, both of which are key indicators of longevity.
- Cardiorespiratory fitness: Aim to be in the top 25% for your age and sex in terms of VO2 max. This is achieved through consistent aerobic exercise like running, swimming, cycling, and other activities that increase your heart rate over a sustained period.
- Grip strength and mobility: Be able to do a dead hang for at least a minute. It not only indicates grip strength but also gives a sense of overall body strength and control.
- Muscle endurance: Do an air squat at 90 degrees for two minutes. This demonstrates the endurance and strength of your lower body, which is crucial for mobility and balance as you age.
- Core and overall strength: Be able to perform a farmer's carry of your body weight (for men) or 75% of body weight (for women) for two minutes. This activity tests your overall body strength, stability, and balance, all of which are critical for maintaining functionality as you age.
Dr. Attia emphasizes that the true potential of these exercises goes beyond the immediate fitness gains; it's about altering the trajectory of our health. By meeting these fitness criteria, we not only extend our lifespan but also compress the period of our lives during which we might be in poor health. This is often referred to as 'healthspan', and the aim is to increase this as much as possible relative to our lifespan.
While these guidelines might seem challenging, Dr. Attia reiterates the importance of gradual, consistent effort. It's about making exercise a non-negotiable part of your daily routine and progressively increasing your capacity over time.
The conversation underscores the idea that there's no quick fix or magic pill for health and longevity. Instead, the secret lies in the age-old wisdom of regular physical activity and maintaining optimal fitness levels. It's about embracing a lifestyle that prioritizes health and longevity over superficial, short-term gains. And perhaps most importantly, it's about recognizing that we each have a significant degree of control over our own health outcomes, and that by making the right choices today, we can set ourselves up for a longer, healthier, and more fulfilling life.