I want to start plain and honest. I have some terrible news that most of us, myself included, do not like to fully acknowledge. We are all going to die. Saying it out loud sounds blunt and morbid, but I think confronting that fact is how we make better choices about how we live. A book called Outlive by Peter Attia MD shook me awake. I listened to the audiobook one restless night and found it equal parts terrifying and clarifying. The book reframes how we think about health, not just to extend years, but to extend the quality of those years.

I watched a short video summary by Raylen Davis that helped crystallize a lot of what I felt after reading Outlive. It resonated because this is not theoretical for me. The idea of spending the last decade of my life diminished, immobile, or mentally absent is a powerful motivator. I do not want to live to an extremely old age if that means losing the ability to move, play, remember, or engage with the people I love.

• Why Outlive hit me so hard
• How I reorganized my thinking: the three pillars
• The Four Horsemen explained and what they mean for daily life
• What I changed immediately: three high impact habits
• Diet, metabolic health, and screening
• My supplement protocol with doses and rationale
• How I track progress and adjust over time
• Practical daily routine: a blueprint you can steal
• Frequently Asked Questions
• Closing thoughts and next steps

Source: Amazon

Peter Attia organizes his argument around what he calls the Four Horsemen of chronic disease. These are the causes that account for most of the death and disability in modern societies: cancer, cardiovascular disease, neurodegenerative disease such as Alzheimer’s, and the spectrum of foundational metabolic disease like type 2 diabetes and nonalcoholic fatty liver disease. Attia estimates that roughly 80 percent of deaths are tied to one of these categories. That number is chilling when you picture your own parents or grandparents and the way they aged.

The book is not just numbers. Off the top of my head I keep returning to a story Peter tells about a woman in her early sixties who loved gardening. She slipped, injured her shoulder, and because her recovery was slow she gradually became less active. Shoulder pain turned into back pain, back pain turned into hip pain, and within ten years she developed dementia. At a funeral everyone said it was a blessing she did not suffer with dementia for long. But Peter kept thinking about the ten years she spent essentially imprisoned in her own home, unable to be outside with the thing she loved. That image terrified me. I thought of my grandmother who had dementia and struggled with obesity, and my grandfather who had multiple cancers before succumbing to pancreatic cancer. I did not want those sorts of declines to be my fate if I could do anything to avoid them.

Harvard’s health law and bioethics hub offers a thoughtful review that highlights how Attia weaves scientific insight with personal storytelling to make the case for proactive longevity.

Outlive does not offer a single magic bullet. Instead it asks us to look at health through the lens of preventing the Four Horsemen and it proposes daily, practical foundations. In GQ’s interview, Attia discusses the shortcomings of conventional “Medicine 2.0” and introduces his proactive, prevention-centered “Medicine 3.0.”

In my reading and now in practice, I organize those foundations into three pillars: cognitive, physical, and emotional. If you take care of those three domains, you dramatically change the odds of having a long life with high function.

• Cognitive means protecting and strengthening the brain so you remember, think clearly, and can safely navigate daily life.
• Physical is about strength, mobility, balance, and metabolic health so you can stand up after a fall, play with your grandchildren, and remain independent.
• Emotional is about stress management, resilience, and how you interpret and respond to daily events.

Those are the big buckets. Each bucket has daily, weekly, and periodic actions you can take. Below I will lay out concrete practice, including exact supplements I take and doses I recommend based on available evidence and common clinical practice. I want to be direct: I am not a physician. I am summarizing what I learned from Attia, from reputable clinical literature, and from my own practical experiments. Before you start any supplement or medication, run this by your doctor and get appropriate labs. That said, I will give specific dosages and rationales so you have a clear, implementable plan if you decide to move forward.

Understanding the Four Horsemen helps you prioritize. If the vast majority of death and disability come from these categories, then your daily choices should focus on lowering your risk for them. Briefly:

1. Cancer: Many cancers are affected by genetics, environment, and behaviors. Screening and early detection matter. Diet, exercise, and metabolic health influence risk for some cancers.
2. Cardiovascular disease: Heart attacks and strokes remain leading causes of death. Lipids, blood pressure, inflammation, fitness, and body composition are major modifiable levers.
3. Neurodegenerative disease: Alzheimer disease and other dementias are costly in terms of quality of life. Risk reduction centers on metabolic health, sleep, exercise, cognitive engagement, and vascular health.
4. Foundational metabolic disease: This includes insulin resistance, type 2 diabetes, obesity, and fatty liver disease. These conditions amplify risk for cardiovascular disease and dementia.

All four are connected. For example, insulin resistance worsens inflammatory profiles and vascular health which increases dementia risk and risk for heart disease. The practical consequence is that an integrated approach that improves metabolic health will reduce risk across all four horsemen.

After reading Outlive and reflecting on my family history, I implemented three immediate changes that were simple to start and powerful in effect. They are:

1. Make physical activity consistent over the long term rather than chasing short-term PRs.
2. Prioritize sleep and recovery proactively.
3. Manage stress by taking agency over my reactions and building structured mental practices like journaling.

Below I explain the exact practical steps I took and the full supplement and testing plan I implemented through my resource at Better Life. I document what I personally use, why I chose each item, and the dosages I find appropriate for a generally healthy adult. Consult your clinician and adjust for sex, age, medication use, and special medical conditions.

1. Consistency in physical training

I was an athlete growing up. My mindset around training had been goal oriented. I chased PRs and then burned out or took prolonged breaks. That model is a liability if your primary aim is longterm function. Peter Attia argues that we should think about physical capability as a compound asset. Small consistent investments beat sporadic, extreme efforts. So I stopped measuring success only by max lifts or numbers and started measuring it by the habit itself: did I move today?

Here is the plan I now use and recommend to clients on Betterlifeprotocols.com:

Weekly structure

• Strength training: 2 full body sessions per week minimum, ideally 3. Each session focuses on compound lifts: squat or hinge, push, pull, and loaded carry. Example: Monday, Wednesday, Friday with intensity moderated so I never consistently train to failure.
• Zone 2 cardio: 3 sessions per week of 30 to 60 minutes at a pace where you can hold a conversation. This builds mitochondrial and cardiovascular endurance and is one of Attia’s central recommendations for longevity.
• Mobility and balance: daily 5 to 10 minutes of targeted mobility drills and balance work. Include single-leg stands and gait drills. These are fall prevention strategies.
• Daily non-exercise activity: aim for at least 8,000 to 12,000 steps per day. Walking is underrated and has outsized benefits for metabolic health.

Strength program specifics

• Sets and reps: 2 to 4 sets of 6 to 12 reps for most compound movements. Use a weight that leaves 1 to 3 reps in reserve on most sets.
• Progression: add small weight increments or extra set/reps over weeks. The goal is consistency, not maximal attempts every session.
• Example session:

1. Warm up: 5 to 10 minutes of light cardio and dynamic mobility.
2. Squat or Romanian deadlift: 3 sets of 6 to 8 reps.
3. Bench press or push-up progression: 3 sets of 6 to 10 reps.
4. Pull-up or row: 3 sets of 6 to 10 reps.
5. Farmer carry or loaded carry: 3 rounds of 40 to 60 seconds.
6. Core work and mobility cooldown.

A practical hack I borrowed from an old coach is the idea of “two pull-ups every day” if your max is 10 pull-ups. Two daily reps, performed on most days, accumulate far more volume over months than performing max sets infrequently. This is the principle of low-dose consistency.

Protein and body composition

To preserve lean mass and support recovery I aim for 1.2 to 1.6 grams of protein per kilogram of body weight per day depending on training volume. That is a reasonable target to support strength training and metabolic health. If you weigh 80 kilograms, that equals 96 to 128 grams of protein daily. Prioritize whole food sources first and supplement with high quality whey or plant protein if necessary.

2. Sleep as a primary longevity tool

Before Outlive, I treated sleep as something I slotted around work and family. After digesting Attia’s chapters on sleep, I realized sleep is not optional. The brain consolidates memory, clears metabolic waste, and performs restorative processes during sleep. Poor sleep increases risk for cardiovascular disease, worsens insulin sensitivity, and is linked to higher dementia risk.

I started wearing a Whoop band to track sleep and to gamify recovery. I had owned it for months but only recently used it to prioritize sleep metrics over workout strain. If I notice my recovery is low and my physiological strain is high, I opt for a walk and an early bedtime rather than forcing a hard workout. That single habit shift has kept me healthier, less sick, and more consistent.

Sleep hygiene and targets

• Target 7 to 9 hours per night. Older adults may trend toward the lower end, but chronic deficiency below 7 hours is associated with worse outcomes.
• Keep a consistent sleep window. Go to bed and wake up within a 30 minute window each day if possible.
• Limit caffeine after midday. Caffeine has a long half life for some people and can degrade sleep even if you feel awake.
• Cool, dark, quiet environment. Aim for 60 to 67 degrees Fahrenheit if possible and blackout curtains.
• Pre-sleep routine: light stretching, journaling, no screens for 30 to 60 minutes before bed. Blue light suppresses melatonin.

Supplements I use to support sleep and cognitive recovery

I take a small nightly stack to help sleep and brain recovery. Again, consult your physician before starting any supplement. Here are the items I take and why:

• Magnesium glycinate 300 to 400 mg at night. Magnesium supports relaxation and sleep quality for many people. I prefer glycinate for tolerability. If you have kidney disease, check with a doctor first.
• Low dose melatonin 0.5 to 1 mg when needed for temporary circadian disruption or travel. I avoid nightly high dose melatonin as a chronic solution. Low dose helps with sleep latency without significant next day grogginess for most people.
• L-theanine 100 to 200 mg for occasional use with evening stress or if I have trouble winding down. L-theanine promotes relaxation without sedation.

3. Emotional and mental hygiene

Stress is not something that happens to me. I control how I interpret and respond to events. That sentence took longer to sink in for me than it should have. Outlive and the Stoics both use mortality as a lens, a practice called memento mori. Meditating on the fact that life is finite reduces the perceived importance of petty things. When you realize you have limited time, you are less likely to spend energy on trivial frustrations.

Practically, I developed two daily habits to manage stress and emotional health:

• Journaling at the end of each day where I ask: did I respond well to stress today? Did I take agency where I could? This is not about mood rating; it is about behavior rating. I give myself a score for how I acted and what I could do better.
• Three minute breathing breaks at least twice per day. Simple box breathing or 4-4-8 breath cycles. These reset autonomic tone and reduce sympathetic overdrive.

Taking responsibility for my emotional state reduced chronic stress and improved sleep, which then fed back into better appetite control, recovery, and cognitive clarity. It is remarkable how these systems interact.

Outlive emphasizes metabolic health as the foundation for reducing risk across all four horsemen. Insulin resistance and obesity amplify risk for cardiovascular and neurodegenerative diseases. So improving metabolic markers is a high priority.

Dietary principles I follow

• Prioritize whole foods: vegetables, lean proteins, legumes, and healthy fats.
• Protein at each meal to preserve lean mass. Aim for 20 to 40 grams per meal depending on body size and goals.
• Carbohydrate timing: align higher carbohydrate meals with training sessions rather than late at night when sedentary.
• Time restricted eating: I use a 12 to 14 hour daily fasting window as a simple default. It is not necessary to fast aggressively. The goal is consistent metabolic signaling that favors insulin sensitivity.
• Minimize ultra-processed foods and sugary beverages.

Key labs and screening tests to track and frequency suggestions

Data informs decisions. I recommend getting baseline labs and repeating them at intervals so you can see trends rather than day to day noise. My personal panel and suggested frequencies are below, adapted from what I learned and what I implemented with Betterlife.

• Comprehensive metabolic panel and fasting glucose: annually.
• Hemoglobin A1c and fasting insulin: annually, or every 6 months if abnormal. Consider HOMA-IR calculation.
• Lipid panel with LDL particle number or ApoB: annually. If you have family history or elevated risk get a coronary artery calcium score per clinician guidance.
• High sensitivity CRP: annually to track inflammation.
• Vitamin D 25 OH: annually. I adjust dose based on level with a target of roughly 30 to 50 ng/mL depending on your clinician.
• B12 and methylmalonic acid: annually if you avoid animal products or have symptoms.
• Liver enzymes and fatty liver assessment if you have elevated BMI or metabolic disease: annually.
• Age and sex appropriate cancer screening: colonoscopy, mammography, cervical screening, prostate discussions with your physician.

For more advanced personalization, you can also explore DNA-based insights to see how your genetics influence metabolism, inflammation, and nutrient needs.

I built a supplement stack to support metabolic, cardiovascular, and cognitive health. These are the items I personally use. I list dose, timing, and the rationale. Again, check with your clinician and get labs before starting.

• Vitamin D3 2,000 to 5,000 IU daily. Take with vitamin K2 for optimal absorption. I personally use the Better Life VIP protocol stack which includes CanPrev Vitamin D3 + K2 (120 softgels). Rationale: supports bone health, immunity, and is associated with better outcomes in multiple observational studies. Adjust based on serum 25 OH vitamin D level. Aim for 30 to 50 ng/mL in most adults.
• Vitamin K2 MK-7 100 mcg daily with vitamin D. Rationale: supports calcium homeostasis and may direct calcium toward bone instead of vascular deposition. Take with fat containing meal.
• Omega-3 fish oil 1,000 to 2,000 mg combined EPA plus DHA daily. Prefer formulations that provide at least 500 mg DHA. Rationale: supports cardiovascular health and has anti-inflammatory effects. Quality matters; choose third party tested brands.
• Magnesium glycinate 300 to 400 mg at night. Rationale: supports sleep, muscle relaxation, and metabolic processes.
• Creatine monohydrate 3 grams daily. Rationale: preserves lean mass, supports brain energetics, and is safe for most people. Take any time of day with water or mixed into a shake.
• Nicotinamide riboside or nicotinamide mononucleotide NR 250 to 500 mg daily or NMN 250 to 500 mg daily. Rationale: support NAD levels and mitochondrial function. Evidence in humans is emerging. Cost and access vary.
• Curcumin with piperine 500 mg twice daily standardized extract. Rationale: anti-inflammatory effects in multiple studies. Piperine increases absorption.
• B complex with methylfolate and methyl B12 daily as directed on product label. Rationale: supports homocysteine metabolism and cognitive health. If you have low B12 or are older, consider methylcobalamin 1,000 mcg sublingual daily or weekly depending on levels.
• Berberine 500 mg two times daily with meals if you have insulin resistance or elevated fasting glucose. Rationale: a plant compound that mimics some metformin effects on glucose. Talk to a clinician before starting as it can interact with drugs.
• Probiotic daily as per product label, focusing on a multi-strain product with documented CFU counts and evidence for gut health.
• Multivitamin daily to fill dietary gaps; choose a product without megadoses beyond established upper limits.
• Additional targeted options for brain: DHA 500 to 1,000 mg if your fish intake is low, and citicoline 250 to 500 mg daily for some people supporting cognition.

Why these choices? They target the major pathways Peter Attia highlights: metabolic function, inflammation control, vascular health, mitochondrial support, and brain energetics. I also emphasize low cost, good safety profiles, and measurable outcomes via labs where applicable.

Medications or prescription-level interventions

Attia discusses prescription interventions like statins, antihypertensives, and medications that affect aging biology such as metformin. I will not advise anyone to start a prescription. If you have risk factors for cardiovascular disease, speak to your physician about statins and blood pressure management. If you are at high risk for metabolic disease, discuss metformin, or other interventions with a clinician. For some people, under professional supervision, these prescriptions are appropriate. Do not self-prescribe.

My approach is iterative. I gather baseline labs, implement the lifestyle stack, monitor subjective and objective signals, and adjust every 3 to 6 months based on results. If you want structured support doing this, Better Life offers the Integrate program to help apply these routines step-by-step into daily life.

Key performance indicators I watch:

• Sleep quantity and quality as measured by devices like Whoop or by simple subjective scores.
• Resting heart rate and heart rate variability trends.
• Strength and functional performance: can I carry groceries, pick up my child, perform stairs without breathlessness?
• Lab trends: A1c, fasting insulin, lipid particle number, CRP, vitamin D, liver enzymes.
• Emotional measures: journaling scores about how I respond to stress and how often I feel overwhelmed.

I do not obsess over single data points. Trends matter. If CRP creeps up and sleep declines, I look at stress, incremental weight gain, and possible dietary contributors and course correct before a small problem becomes large.

Here is a day-in-the-life routine that I actually follow more often than not. It combines the pillars into a practical schedule.

1. Morning: Hydrate with 500 to 750 mL water. Quick mobility routine 5 minutes. Protein rich breakfast with 25 to 40 grams of protein. Take vitamin D3 with K2 and omega-3s with breakfast.
2. Midday: Zone 2 session if time allows, or brisk 30 minute walk. Lunch with vegetables and lean protein. If strength day, do the workout midday. Take berberine with meals if you are using it for glucose control.
3. Afternoon: Short breathing session or 3 minute mindfulness break. Prioritize movement, aim to hit step goal.
4. Evening: Light walk after dinner. Magnesium at night. Journaling and reflection about how I acted today and what I can improve. Bedtime routine with minimal screens and a consistent sleep window.

This is deliberately simple. The greatest risk to longevity is not doing any of these things consistently. Small repeated wins compound over years into preserved function and reduced disease risk.

Q: Is it too late to start working on longevity if I am 50 or 60?

A: No. It is never too late to improve function and reduce risk. Many interventions like exercise, dietary changes, and better sleep improve health at any age. The earlier you start the greater the cumulative benefit, but even midlife interventions meaningfully shift trajectories and can improve quality of life.

Q: Can supplements prevent dementia or heart disease?

A: No supplement should be viewed as a guarantee. Supplements can support biological pathways and reduce risk factors. For example, omega-3s support cardiovascular health and DHA supports brain structure. But the strongest evidence for preventing dementia and heart disease remains lifestyle: exercise, sleep, metabolic control, managing blood pressure and lipids, and regular screening. Consider supplements as adjuncts not miracles.

Q: What are the biggest, simplest changes that move the needle?

A: Based on Outlive and my own experience, the top three are: improve sleep, be consistently active with strength and zone 2 cardio, and reduce chronic stress. Each of these yields improvements across metabolic health, cognition, and cardiovascular risk.

Q: How should I get started if this is overwhelming?

A: Pick one habit and make it daily for 30 days. My recommendation is to start with sleep because it amplifies the benefits of other changes. Fix your sleep window, aim for 7 to 8 hours, and observe changes in mood, recovery, and decision making. Then add consistent movement and a basic supplement protocol if appropriate.

Q: Are there tests I should get before starting supplements?

A: Yes. Get baseline labs including vitamin D, fasting glucose and insulin, A1c, lipid panel, basic metabolic panel, and CRP. If you plan to take berberine or other glucose modulators consult your clinician and get follow up labs. If you are male over 40 speak with your clinician about cardiovascular screening and cancer screening based on family history.

Outlive by Peter Attia is one of the scariest books I have read because it forces you to confront the potential for a long life that is functionally poor. That fear is useful. It motivated me to reorganize how I think about health. I shifted from chasing short term performance metrics to building durable habits that protect cognitive, physical, and emotional function.

If you want to start, here are the immediate actions I recommend:

1. Schedule baseline labs and screening tests, then book a follow up appointment to review them with a clinician.
2. Pick one habit to attack first. Prioritize sleep. Set a consistent bed time and wake time and measure how you feel after two weeks.
3. Start a low-friction exercise habit: two strength sessions per week and daily walking to reach a step goal.
4. Implement the basic supplement stack I outlined if labs and your clinician agree, focusing on vitamin D3 with K2, omega-3s, magnesium, creatine, and possibly NR/NMN.
5. Begin nightly journaling focused on behavior and responses to stress rather than mood alone.

Implement the basic supplement stack I outlined if labs and your clinician agree, focusing on vitamin D3 with K2, omega-3s, magnesium, creatine, and possibly NR/NMN. You can find curated options on our products page.

Finally, I want to emphasize that this is a journey. The point is not to obsess but to be consistent with the highest leverage actions. If I had to pick one idea to leave you with it is this: small, consistent investments in sleep, movement, and stress regulation compound into a dramatically better last decade of life. That is the outcome I am working toward so I can be present, active, and mentally sharp with the people I love.

Go pick up Outlive. It is dense and powerful. I recommend the audiobook if you want to listen at night like I did. Then pick one small habit and keep it. If you want to share what you are changing today and why, post your plan on Betterlifeprotocols.com or discuss with your clinician. We have only so much time. I prefer to spend mine focused on living well.