- We reduce energy intake via calorie restriction (CR), dietary restriction (DR), or time restriction (TR).

   - CR requires tracking every calorie, very difficult long-term. DR eliminates foods, but compliance varies.

   - TR/fasting works for some but risks muscle loss if protein...

   - Metabolic dysfunction underlies obesity and is linked to the "Four Horsemen" diseases. It must be addressed first.

   - Metabolic dysfunction is affecting 1 in 4 people globally.

   - But it's overlooked since early stages may not change standard blood tests. We must detect issue...

   - The APOE e4 gene variant significantly increases Alzheimer's risk but is not deterministic. Other genetic and lifestyle factors also matter.

   - Prevention is currently our only option against Alzheimer's. Key strategies include optimizing vascular and metabolic health, exercise, slee...

  - It aims to optimize healthspan (quality of life), not just lifespan. Medicine 2.0 just prolongs life.

   - Patients must be active participants and "captains" of their health in Medicine 3.0, not passive.

   - Medicine 3.0 represents an evolution in mindset, not just technology. W...

   - Centenarians delay onset of cancer, cardiovascular disease, diabetes by up to 30 years compared to averages.

   - We can't copy some of their vices, but can learn from their ability to resist chronic diseases for so long.

   - Tactics like nutrition, exercise, sleep can help buil...

   - Film yourself to compare intent to reality. Narrow the gap via focused drills.

   - For the sedentary, exercise can profoundly improve capacity and function - it makes people younger.

   - Stability gives the confidence to enjoy life and not fear falling. It lets us keep doing wh...

   - Autophagy declines with age but can be stimulated by exercise, fasting, rapamycin - improving cellular health.

   - Rapamycin is already approved for humans but side effects have limited its use for longevity. New studies show it may enhance immunity.

   - Dogs are being tested s...

   - Restricting calories extends lifespan in nearly every animal tested, by 15-45%. This points to a link between nutrition and longevity.

   - The drug rapamycin, discovered in soil on Easter Island, also extends lifespan in mice and other animals.

   - Rapamycin acts on the mTOR pr...

   - Strength training is like retirement saving - it builds a "reserve" of muscle and bone to protect us as we age.

   - Muscle strength declines 2-3x faster than mass. Power declines even faster. So heavy weights are key.

   - Bone mineral density and muscle mass decline in parallel...

    -Carb tolerance is highly individualized. CGM helps determine ideal carbohydrate intake.

   - Increase intake of MUFAs like olive oil. Supplement EPA/DHA. Titrate to goal RBC levels.

   - Avoid too much fructose, especially in liquid form.

   - Find a sustainable balance of ...

   - Heart disease is the #1 global killer but need not be - it should rank much lower with the right prevention.

   - Atherosclerosis (The buildup of plaque in the arteries, which leads to heart attacks and strokes. ) begins in youth but progresses slowly before causing events like heart a...

   - We actually know little for certain about nutrition. Most studies are flawed, leading to confusion.

   - Clinical trials have poor compliance over long periods. Results average out individual variation.

   - Healthy user bias skews many studies. Healthy people tend to have health...

   - The first step is believing you can change. Then commit to the ongoing hard work of unpacking trauma, altering self-talk, reframing situations, and replacing knee-jerk reactions with thoughtful responses.

   - Make emotional health as much a priority as physical fitness. This is impera...

Modern medicine is much better at treating "fast" causes of death like infections and trauma than "slow" causes like heart disease, cancer, and neurodegenerative diseases.

These chronic "slow" diseases actually begin dev...

   - Medicine is transitioning from an era focused on infectious diseases (Medicine 2.0) to one focused on chronic diseases (Medicine 3.0).

   - Medicine 2.0 evolved to treat acute injuries and infections but has made little progress against chronic illnesses like heart disease and cancer.

 - Medicine 3.0 says lower apoB as early and as much as possible. Like smoking, address the root cause regardless of short-term risk.

   - Extremely low LDL-C levels are safe; plaque likely wouldn't occur if everyone had childhood LDL-C levels (10-20 mg/dL).

   - Diet, exercise, and d...

   - Emotional health is a crucial component of overall healthspan and longevity. Unresolved emotional issues can lead to misery, self-destructive behavior, and early death.

   - Dialectical behavior therapy provides useful tools for emotional regulation and building distress tolerance. Min...

   - Total burden of apoB (A protein found on LDL) particles (LDL + VLDL) over time determines risk, not total cholesterol or LDL-C (The concentration of cholesterol inside LDL particles) alone.

   - Lp(a) (An especially damaging lipoprotein particle that increases risk of early heart attac...

   - But screening is limited - we only have good tests for a few common cancers.

   - Medicine 3.0 says use multiple modalities (colonoscopy, mammogram, MRI, etc.) together to improve accuracy.

   - Liquid biopsies to detect tumor DNA in blood could identify cancers earlier and help ...

   - The objective is to extend lifespan and healthspan - to live longer and better.

   - To achieve this requires first developing an effective strategy, not just rushing to tactics. Strategy derives from the objective.

   - The strategy is to understand and address the aging process...

 - The goal is to empower patients to take action to improve their fitness, nutrition, sleep, and emotional health.

   - Our only aim is to live longer and better. We must rewrite the narrative of decline and figure out a personal longevity plan.

   - Medicine 2.0 offers little real guidance on exercise. We must take responsibility for our fitness.

   - Exercise is true "prehab" - physical therapy before we need it. It's the most powerful longevity tool we have.

   - We train not just to be fit now but to armor ourselves again...

   - Alzheimer's disease is the most common form of dementia, affecting over 6 million people in the US. Other neurodegenerative diseases like Lewy body dementia, Parkinson's, ALS, and Huntington's also cause dementia.

   - The origins and causes of Alzheimer's are not fully understood. The...

   - The key insight is that we should pursue longevity not out of regret for the past, but for the sake of the future - to fulfill dreams and aspirations.

   - True age is not defined by years lived but by whether one's mindset remains fixed on the past versus looking ahead to future hopes...

   - Alzheimer's can be detected in very early stages through comprehensive cognitive testing. Distinguishing it from other neurodegenerative diseases is important for prevention.

   -While daunting, Alzheimer's is not impossible to prevent. We must embrace the concepts of Medicine 3.0 like...

   - Stability enables safe, efficient transmission of force through muscles and bones, not joints. It makes us bulletproof.

   - Stability begins with the breath - it affects posture, spine position, and movement.

   - Grounding the feet and toe strength build the foundation. Balance...

   - Sleep is essential for brain health and function. Lack of sleep impairs cognitive performance, memory, and emotional regulation.

   - Deep, restorative sleep allows the brain to clear out amyloid-beta and tau proteins, which build up in Alzheimer's disease. Good sleep may help prevent ...

   - To sleep better: make the bedroom pitch black and cool, avoid alcohol and food before bed, reduce evening exposure to blue light from screens, exercise earlier in the day, establish a consistent wake-up time, use relaxation techniques.

   - Addressing sleep issues through changes to sl...

   - Feedback and iteration will help us find your ideal eating pattern for metabolic health.

   - We should focus more on major issues like calories and protein than minor food choices.

   - Our genes haven't changed much, but our environment has, creating a mismatch that leads to "diseases of civilization." We must adapt with smart tactics.

   - The 5 key tactical domains are exercise, nutrition, sleep, emotional health, and pharmaceuticals/supplements. We'll focus on the...

Book Summary of "OUTLIVE: The Science & Art of Longevity" by Peter Attia

   - Fructose and uric acid were once beneficial but now promote fat gain and metabolic issues in excess.

   - We evolved to store fat to survive famines. But now calories and fructose are nearly unlimited.

   - Medicine 3.0 would monitor for earliest signs like fatty liver, inflammat...

   - Centenarians live to 100+ often in relatively good health, delaying chronic diseases for decades.

   - This phase shift in time is key - they stay biologically younger than their age. We want to emulate this.

   - Centenarian longevity is partly genetic luck, but behavior likely ...

  - Exercise strongly correlates with longer lifespan and improved healthspan across physical, cognitive, and emotional domains.

   -Higher VO2 max and greater strength are very strongly associated with lower mortality. Exercise acts like an endogenous drug.

   - We must go beyond gen...

   - Tactics flow from the strategy and include exercise, nutrition, sleep, emotional health. Drugs/supplements are also considered.

   - Exercise is the most powerful longevity "drug." Nutrition matters, but calories are key, not any one diet.

   - Sleep and emotional health are crit...

   - Before heavy lifting, assess movement with tests for stability (next chapter). This is most important.

   - The goal is not big biceps now but rather strength to accomplish tasks and prevent injuries later.

   - We train strength now to build reserves for our Centenarian Decathlo...