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Peter Attia on longevity

Pete’s World

Published: November 20, 2023

Does the name Peter Attia ring a bell?
Well, as of late, this guy’s Youtube channel has caught fire and I have to admit that we’ve been watching his videos quite regularly.
Now if you’re not familiar with the name, Attia’s a Canadian-American physician/fitness expert who just so happens to be one of North America’s leading authorities in the science of longevity.
And amidst the myriad of fitness/longevity related subjects he discusses, a topic that has really caught my attention concerns the relationship between VO2max/muscular fitness and life expectancy.
So let me share with you this fitness advocate’s philosophy with respect to these seemingly critical elements of longevity.
We’ll start with VO2 max and its significance to living longer. And for you non-fitness geeks, let me explain what VO2 max means.
It’s the maximum rate at which the muscles can pull oxygen out of the blood to use for energy.
One’s VO2 max is a great indicator of overall cardiorespiratory fitness - and it can also be used as a great tracking metric.
Attia has shown, by way of a plethora of peer-reviewed studies, that there’s a very clear trend between VO2 max and all-cause mortality.
Attia states that a person’s VO2 max is a useful measure of physical capability simply because it indicates what you can and cannot do.
And this is particularly important because as we age our VO2 max imperceptibly declines by about 10% per decade after age 20, and about 15% per decade after age 50.
Thus, Attia claims that having an average to above-average VO2 max produces a very positive carryover to one’s longevity.
Now his suggestion for a person’s VO2 max goal is a tall one. He believes we should strive to attain an “excellent” level of VO2 max fitness, and that’s not just at an excellent level for our current decade of life but at an excellent level that charts out to be two or more decades below our actual decade of life.
At first glance such a goal sounds preposterous, right, going from let’s say the VO2 max of a couch potato to a VO2 max that charts out to be excellent for a person two decades younger than yourself?
That sounds like pure fantasy.
Not so, according to Attia, this so-called fantasy is indeed doable.
That’s because he’s been attaining such dramatic results with the patients he’s worked with.
VO2 max he claims, can be improved by as much as 17% per year (which is spectacular), “but,” he says, “you need to put in the work.”
He accomplishes this by working his patients up to at least three light-moderate 60-minute cardio sessions per week in anything from running to cycling to rowing to rucking (hiking with a weighted pack) in addition to one weekly 30-minute VO2-max workout encompassing high-intensity, three eight-minute intervals.
Such a workout regime will over time, he says, gradually nudge that stubborn VO2 max number up to an excellent level.
That second cornerstone of longevity entails muscular fitness.
Now muscle like VO2 max is ephemeral - we loose it as we age.
His belief here is that we must curtail muscle loss over the decades such that we can reach our elder years with a muscular “reserve.”
A muscular reserve will protect us from injury, in addition to allowing us to pursue the leisure activities that bring joy to our lives.
The larger this muscle reserve is he says, the better off we’ll be over the long term.
So with respect to muscular fitness, Attia’s exercise prescription for his patients entails three 45- to 60-minute per week total-body strength sessions which emphasize: Grip strength, concentric and eccentric loading (muscle shortening and lengthening), pulling, hip hinging (exercises that promote hip flexion/extension) and core stabilization.
As you can see, Attia’s approach to improving longevity doesn’t involve drugs, nor supplements, nor special pieces of equipment, nor even an odd concoction of superfoods.
His approach entails dedication, time, effort and sweat.
“Exercise,” says Attia, “is by far the most potent longevity drug. Not only that but exercise not only delays actual death but also prevents both cognitive and physical decline better than any other intervention.
“It is the single most potent tool we have in the health-span-enhancing toolkit - and that includes nutrition, sleep and meds.”