Peter Attia on the Best Way to Improve Your Lifespan and Quality of Life

Look at that explosive leaping ability!
Photo from 1982.

On EconTalk (the straightest, whitest, malest podcast outside of Sam Harris' - maybe even moreso) Dr. Attia talked about the best thing we can do to live well in the future:

Is smoking bad for people? Yes. How can we measure this? Well, when we look at all-cause mortality, if we compare a smoker to a non-smoker at any point in time, the smoker has a 40% increase in all-cause mortality in the coming year relative to the non-smoker. So, [smoking has] a hazard ratio of 1.40. That's a very big hazard ratio. 

If you look at the hazard ratio for high blood pressure, it's about 1.29, 1.3. So, 29 to 30% chance greater death in the following year than the non-smoker.

Now, let's talk about the difference between being very fit and not being very fit. If you take 60-year-old men in the bottom 25% [of VO2 max] and you compare them to 60-year-old men in the top 2.5%, the hazard ratio is five. That's 400% difference. If you just compare the bottom 25% to the second quartile - these people are both still below average - the hazard ratio is 1.5. It's a 50% difference.

I could do the same exercise with muscle mass and strength. The reason for this is that VO2 max strength and muscle mass are amazing integrals of work. You can't just decide tomorrow you want to be strong and have a high VO2 max the way you could fix your vitamin D. 

If we improved your VO2 max by 25%, which we could do in two years, it would have a bigger impact on your lifespan and the quality of your life than any other intervention. But it would require work. So, this is the two-edged sword of exercise, which is it does require the most work by far, but it has the most bang for the buck.