Life is like a voyage on the Arctic Ocean.

The longer we live, the more likely we are to encounter icebergs.

These icebergs represent the four diseases of aging.

Cancer, heart disease, Alzheimer's, and metabolic disease.

If we live long enough, we are bound to encounter one of these.

The goal is to avoid them as long as possible, so we can cruise into our tenth decade and still do the things we enjoy doing.

We don't want to be like a passenger on the Titanic, unknowingly headed towards an iceberg that will cut our journey short in the fifth or sixth decade of our lives, or force us to spend our final decade with a compromised ship that is slowly sinking.

Dr. Peter Atiyah has written Outlive to help us identify the icebergs ahead and course correct.

Rather than being a passenger on the Titanic, we can captain our ship and use radar to steer clear of the four diseases of aging as long as possible.

The best long-range radar we can install on our ships to detect icebergs relies on one calculation.

Insulin resistance.

Atiyah says, In the state of insulin resistance, cancer cells proliferate, brain cells don't get the fuel they need, which leads to Alzheimer's, and our bodies get more inflamed, which accelerates heart disease.

If we can avoid insulin resistance and the metabolic disease that arises from insulin resistance, we can avoid most icebergs en route to our tenth decade of life.

So what is insulin resistance?

The body must maintain roughly one teaspoon of glucose in the blood at all times.

When our blood glucose rises after a meal, our body produces insulin to push the excess glucose into cells.

In a healthy body, insulin is used to push glucose into muscle cells and fat cells under the skin, called subcutaneous fat.

Think of a cell like a balloon, and glucose as air.

Insulin's job is to help inflate the balloon.

However, as the balloon inflates, it gets harder and harder to push air in, so the body produces more insulin.

Eventually, no matter how much insulin is present, muscle cells and subcutaneous fat cells won't accept any more glucose.

With high insulin and high glucose levels in the blood, the body has entered an insulin resistance state.

In a state of insulin resistance, any excess calories get converted into fat and jammed into places no human should have fat, like in the liver, between muscle fibers, like a marbled steak, and between organs, in the midsection.

This is called visceral fat, and it's highly inflammatory.

Atiyah likens this fat spillover to a tub overflowing with water and getting into the vents, floorboards, and carpets, and destroying the house.

As fat spills over into muscles and organs, insulin resistance worsens, causing more fat to accumulate in muscles and organs.

It's a vicious cycle.

We can test to see if we are in an insulin resistant state by measuring our blood glucose after consuming a sugary drink, like a Coca-Cola.

If, after an hour, glucose continues to rise, we are insulin resistant, and we are headed towards an iceberg in the not-too-distant future, unless we change course and alter our lifestyle.

Now, you may assume, as I did, that changing one's diet is the best way to change course and avoid hitting an iceberg, but it's not.

The best tool we have to avoid insulin resistance and prolong our lives is physical exercise.

The title of Atiyah's chapter on exercise is The Most Powerful Longevity Drug.

In that chapter, he says, More than any other tactical domain we discuss in this book, exercise has the greatest power to determine how you will live out the rest of your life.

Going from zero weekly exercise to just 90 minutes per week can reduce your risk of dying from all causes by 14%.

It's very hard to find a drug that can do that.

With the right exercise program, we can train our muscle cells to absorb more glucose and use fat as fuel to keep any fat spillover in check.

Going back to that balloon metaphor, we can use exercise to increase the size and flexibility of our balloon cells.

The ultimate longevity exercise program includes three types of training.

Zone 2 training, VO2 max training, and strength training.

Most people miss these three forms of training because they either don't exercise, which is 77% of Americans, or exercise in the gray zone, between zone 2 and VO2 max training, and think strength training is just for athletes and bodybuilders.

Zone 2 training involves any aerobic exercise, on a stationary bike, treadmill, rower, or outside, you can sustain while barely being able to hold a conversation with someone.

A zone 2 workout should feel almost hard and without any muscle burn.

The longer you can sustain a zone 2 workout, the more the mitochondria in your muscle cells, the power plants of the cell, learn to use fat as fuel.

Next, VO2 max training.

If zone 2 training feels almost hard, then VO2 max training feels very hard.

During VO2 max training, you do an aerobic exercise close to your all-out maximum for 4 minutes, then go easy for 4 minutes, and repeat this 4 times.

You will feel like you're dying during a VO2 max training session, but it's worth it.

Studies show that people who increase their VO2 max from below average in their age group to above average experience a 50% reduction in all-cause mortality.

Mattia says, VO2 max is perhaps the single most powerful marker for longevity.

Next up, strength training.

Strength training vastly improves metabolic health because it produces more lean muscle mass that soaks up excess glucose like a sponge.

A 10-year study of 4,500 subjects over 50 found that those with low muscle mass and low muscle strength were three times more likely to die early.

Mattia says, I think of strength training as a form of retirement saving.

Just as we want to retire with enough money saved up to sustain us for the rest of our lives, we want to reach older age with enough of a reserve of muscle to protect us from injury and allow us to continue to pursue the activities that we enjoy.

Embrace the three forms of training by setting three weekly targets.

Set a zone 2 target of 45 minutes, 4 days a week.

You can use this time to catch up on your favorite TV show while on a stationary bike or treadmill or rower.

Set a VO2 max target of 1 day a week going nearly all out for 4 minutes, then going easy for 4 minutes, and repeating this 4 times.

Then once a year, take a VO2 max test with a medical professional, just google VO2 max test near me, and strive to get in the top 5% of your age group.

And set a strength training target to lift heavy weights three times a week with a focus on grip strength, exercises like the farmer's carry, carrying two heavy objects in your hands, and hip hinging exercises, which are exercises that involve bending at the hip without bending the spine, like doing deadlifts, squats, or step ups on a large box.

Your goal is to be able to do a farmer's carry, walking around a room for 1 minute, while holding half your weight in both hands.

To ensure we don't lose any lean muscle that we gain from strength training, we should consume enough protein to match our weight in grams.

For example, I weigh 195 pounds, so I need to consume 195 grams of protein every day.

However, I must space up my protein intake so I do not consume more than 25% of my daily protein in a single sitting, because excess protein gets turned into glucose by the liver.

Therefore, I aim to eat roughly 50 grams of protein four times a day, around 9am, 12pm, 3pm, and 6pm.

These protein meals either include two chicken breasts, an 8oz steak, an 8oz piece of fish, or a whey protein shake.

Consume 195 grams of protein at 25% increments each day is one of the three eating rules I took away from Outlive.

The other two eating rules are don't eat within 3 hours of bedtime, because eating too close to sleep reduces sleep quality, and stick to an eating plan that keeps my average blood glucose in a safe range.

For one week every few months, I will measure my blood glucose after I eat meals I typically eat with a simple drugstore glucose monitor.

I'll take a glucose measurement at 30 minute intervals for up to 2 hours after each meal to see if what I ate is spiking my glucose levels above 160 on the meter, which would cause my insulin to spike.

And see if my average glucose is above 100 on the glucose meter.

If either is true, I will try eliminating certain foods, like refined carbohydrates, and adding more whole foods to my weekly eating plan.

That was the core message that I gathered from Outlive by Peter Attia.

I've made more highlights in this book than any other book I've read.

I highly recommend this book to everyone.

If you would like a one-page PDF summary of insights that I gathered from this book, just click the link below and I'll be happy to email it to you.

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And as always, thanks for watching, and have yourself a productive week.