Book: 20240903 to 20250105, "Outlive" by Bill Gifford and Peter Attia

20240903 - Introduction
Part I
20240903 - Chapter 1 The Long Game: From Fast Death to Slow Death

Medicine's biggest failing is in attempting to treat all these conditions at the wrong end of the timescale - after they are entrenched - rather than before they take root. p16

True. There are two types of diseases. For chronic diseases, the key is early intervention.

20240904 - Chapter 2 Medicine 3.0: Rethinking Medicine for the Age of Chronic Disease

Dr Attia's cross-domain thinking is amazing. Apart from the gene level medicine which may reverse ageing, we have to handle problem at early stage, to prevent compound effect that leads to the collapse of our body.

20240905 - Chapter 3 Objective, Strategy, Tactics: A Road Map for Reading This Book

So far, I agree with everything Dr Attia said.

Strategy and tactics are both crucial.

We don't have perfect solution, but still can do something to improve our lifespan and healthspan.

Part II
20240921 - Chapter 4 Centenarians: The Older You Get, the Healthier You Have Been

Can we give the gene maps of those centenarians and of some normal people to AI to analyze?

20240922 - Chapter 5 Eat Less, Live Longer: The Science of Hunger and Health

Rapamycin. Metformin.

These two seem most likely to extend our lifespan and healthspan.

When will the human trial begin? Since pet(dog) trial is planned to complete at 2026, I guess 2027 can start human trial. If it takes 10 years, then get the conclusion at 2037? So we may have to wait for another 13 years.

Hopefully people can try them earlier than that.

20240922 - Chapter 6 The Crisis of Abundance: Can Our Ancient Genes Cope with Our Modern Diet?

Metabolic syndrome (p94)

1. high blood pressure (>130/85)

2. high triglycerides (>150mg/dL)

3. low HDL cholesterol (<40 mg/dL in men or <50 mg/dL in women)

4. central adiposity(waist circumference >40 inches in men or >35 in women)

5. elevated fasting glucose (>110mg/dL)

Yet diabetes is only one danger: Studies have found that insulin resistance itself is associated with huge increases in one's risk of cancer (up to twelvefold), Alzheimer's disease(fivefold), and death from cardiovascular disease(almost sixfold). p109

It seems that I have insulin resistance, more or less. :-(

20241011 - Chapter 7 The Ticker: Confronting---and Preventing---Heart Disease, the Deadliest Killer on the Planet

Macadamias nuts seems like the best nuts, and not too expensive.

Olive oil is the only choice of cooking oil.

Should I do a complete blood test? Luckly we have Statin now.

20241013 - Chapter 8 The Runaway Cell: New Ways to Address the Killer That Is Cancer

All in all, the best thing we can do to prevent cancers is exercise and eat less.

I don't think that red meat is really harmful, as human have ate red meat for millions of years. More likely, people just take in too much calories.

The Google AlphaFold v3 seems promising to use protein to build Nano robots to kill Cancer cells.

20241101 - Chapter 9 Chasing Memory: Understanding Alzheimer's Disease and Other Neurodegenerative Diseases

Dementia is more like the aging of our blood vessels in our brain.

This is the reason that many diabetes drugs such as metformin help to prolong our healthspan: they improve our blood vessel performance and metabolism.

Exercise of body and brain helps, together with nutrition(keto diet) and good sleep.

What's the role of meditation here?

Part III
20241102 - Chapter 10 Thinking Tactically: Building a Framework of Principles That Work for You

Strategy and tactics are needed.

Exercise can slow down the ageing of our metabolism and muscle effectively.

20241103 - Chapter 11 Exercise: The Most Powerful Longevity Drug

VO2 max and muscle strength are the cause or the result of long healthspan? As they are so closely correlated, a large part of it must be causality.

The purpose of exercise is to improve and protect or organs. This doesn't prolong our healthspan, but push it to the potential limit.

20241127 - Chapter 12 Training 101: How to Prepare for the Centenarian Decathlon

We need to work on at least 4 levels to postpone aging.

1. Metabolics: need healthy mitochondria to generate energy from fat; (zone 2 exercise)

2. Critical organs: need strong organs, such as heart and lung to provide sufficient oxygen; (aerobic/zone 5 exercise)

3. Muscle and bone: to get strength and speed to maintain daily activities; (strength exercise)

4. Brain: to maintain emotion and intelligence; (meditation)

20241129 - Chapter 13 The Gospel of Stability: Relearning How to Move to Prevent Injury

Keep trunk tight. Use feet to balance and support body. Use hands and arms to do the work.

Think carefully, and then use common sense to get correct position.

Get help from youtube and AI.

20241220 - Chapter 14 Nutrition 3.0: You Say Potato, I Say "Nutritional Biochemistry"

Smoking increase the risk of lung cancer by 10 to 25 times. Red meat and processed meat increase the risk of Colon cancer by 17% (0.17). p299

Can we feed pigs or chimpanzees red meat and processed meat, to get convincing conclusion? I guess the change of 20% of food intake doesn't affect much.

If better diet helps, why the maximum life span is still same in the past 200 years?

Extra-virgin olive oil and nuts seem like safe bets, anyway.

20241223 - Chapter 15 Putting Nutritional Biochemistry into Practice: How to Find the Right Eating Pattern for You

Everyone tends to be more insulin sensitive in the morning than in the evening, so it makes sense to front-load our carb consumption earlier in the day. p327

So it's better skipping dinner than breakfast? Not necessarily so, and not to everyone.

Skipping breakfast helps to turn fat into energy, because blood sugar and insulin level is low in the morning.
If we also do some physical exercise, which helps producing Adrenaline and Norepinephrine, let our body to break down stored fat for fuel.

This also means doing exercise in the morning is better than doing it in the evening, to lose weight.

Regarding GI(glycemic index), the best main food is lentils(32), then oats(55), then normal white rice(70), and the worst is sticky rice(90)

Egg and milk is much better than I thought, especially to eld people.
Protein is critical to maintain enough muscle, together with physical exercise. Meat is also good.

Low stress and good sleep, is very important to keep good blood glucose.

Extra protein will be excrete in urine(as urea), just like salt. So no need to worry that we had too many eggs or too much milk, meat. p331

We actually need quite a lot of protein. Two cup of milk and two eggs per day, is definitely fine.

Autophagy only happens with one or even two days fasting. One meal skip a day doesn't lead to autophagy, but lead to loss of muscle. It might be good idea to have two day fasting per year.

20250104 - Chapter 16 The Awakening: How to Learn to Love Sleep, the Best Medicine for Your Brain

What would happen if I drink a large cup of Espresso, then use meditation to help falling into sleep?

Sleep may help a lot to prevent Alzheimer. It's critical to everyone.

No screen one hour before bed!

20250105 - Chapter 17 Work in Progress: The High Price of Ignoring Emotional Health

Reframing entails taking a step back from a situation and then asking yourself, What does this situationlook like through the other person's eyes? How do they see it? And why is your time, your convenience, or your agenda any more important than theirs? p393

People always say that social relationship is the most important factor affecting our happiness. I think what they really mean is emotional health. Without it, everything else is meaning less, including healthspan.

We are only happy with emotional health, which brings us good social relationship.

We don't have to always follow the monkey(thoughts) or the elephant(emotion). We can choose to do different things, and that may change the monkey and the elephant! (related to p405)

That's our real free will.

20250105 - Epilogue

"If you want to find someone's true age, listen to them. If they talk about the past and they talk about all the things that happened that they did, they've gotten old. If they think about their dreams, their aspirations, what they'are still looking forward to - they're young." p411