Learning log #1: The Centenarian Decathlon
Thinking tactically about longevity, the 5 knobs we can tweak and aiming to become a decathlete
One of my goals this year is to start documenting everything I learn. That is already far-fetched given the sheer number of things I learn every day. Currently, I am reading 5 books: Outlive by Peter Attia, Six Easy Pieces by Richard Feynman, Code: The Hidden Language of Computer Hardware and Software by Charles Petzold, AI Engineering by Chip Huyen and Glucose Revolution by Jessie Inchauspé (a.k.a. Glucose Goddess).
Just last night I have printed 2 more books on operating systems and parallel programming. I haven’t even mentioned yet the video lectures I watch. I think you get the point. I love learning. That is what I want to spend all of my time doing. If I had all the money in the world and there were no problems to solve, I would happily spend the rest of my life learning and building new things. After much soul searching, I have decided this is the purpose of my life.
You might think it is impossible to remember whatever I learn this way. You are right. I usually forget most of what I learn, except a few nuggets that left a big dent. I don’t regret it (too much) as I had fun while I was learning, even if most of it didn’t stick.
But, from now, I want what I learn to stick. Even if that means learning fewer things over a year or sticking with the same things to learn for a longer period of time. I want information to transform into knowledge and wisdom. That is why I set this goal of writing about what I learn. Along with helping me revise and identify the crux of what I learn, it also helps me fulfil my constant urge to write.
I love writing. It serves as a workout for my mind. I enjoy being inside my head when I am doing it—seeing a rough, vague idea transform into a concrete thought. But whenever I sit down to write, I feel confused about what to write. I know I am not a novelist. I have no stories inside me that I want to bring to life (yet). And then, there is the nagging question of whether anyone even wants to read what I write. This is the biggest hindrance. But when I write about what I learn, it vanishes because even if no one in the world cares about it, I do. I am writing for me. Maybe this can be applied to writing about anything I want to. But I am not there yet. My audience is me. Anyone else reading this is a bonus (hi there!).
Now that I have set the context, I can get to the meat.
As I said above, I recently started reading Outlive - The Science & Art of Longevity by Peter Attia. I am disillusioned enough to know that a lot of what happens in life is outside of my control. I might follow all the recommended things with complete precision and discipline but still end up feeling depressed or end up dying by some other random cause. But I felt drawn towards understanding the latest that science has to offer about how things truly work under the hood and what can we do to improve our quality of life, for however long we get to live. What is the point of being alive at 80 and being bedridden for most of the day every day? I want to be able to lift and run and jump and play as I wish even in that age, if I get to live until then. Another ulterior motive is to figure out how I can help ensure a good quality of life for my mom who has already agreed to be the audience as I practice the Feynman technique with her.
The book is structured into 3 sections with the objective of the book and the fundamentals behind various causes for mortality described in the first two and the solutions being discussed in the last one. I have jumped straight to the solutions for now. A younger version of me would hesitate from doing this and definitely never admit doing it. But life is short and there are too many books to read. I do plan on learning those fundamentals but only if the solutions appeal to me. It is a THICK book and going through it is going to feel like a marathon, especially if I make notes. I want some assurance that it will be worth it.
Thinking Tactically
Peter starts the section on solutions by explaining why we need to think tactically about how we approach longevity.
The following diseases are called diseases of civilisation—cancer, heart disease, type 2 diabetes and dementia—because they seem to have spread in line with industrialization and urbanization. Although modern life has helped increase lifespans and raised living standards, it has also created conditions that limit our longevity.
Our environment has changed drastically in the last 1-2 centuries in terms of our food supply, eating habits, activity levels and the structure of our social networks making this new environment toxic for us in terms of what we eat, how we move (or don’t move) and how we sleep (or don’t sleep). But our genes have hardly changed. They don’t match our environment anymore.
To defeat this enemy, we need to understand it first, which is the purpose of the first 2 sections of the book. Our goal from this section is to figure out what concrete actions we can take to reduce our risk of disease and death while improving our quality of life as we age.
There are 5 tactical knobs to turn:
Exercise: aerobic efficiency, maximum aerobic output (VO₂ max), strength and stability
Diet/nutrition
Sleep
Emotional health
Drugs and supplements
While everyone wants to optimise exercise, sleep, diet and emotional health, the specifics of how to achieve that are vague. There are too many options. Our tactics have to be specific and targeted, derived from data and intuition, and refined with feedback and iteration. Relatively small tweaks can cause a significant effect if compounded over time.
3 questions to ask as we begin this journey:
Are you overnourished (too many calories) or undernourished (too few calories)?
Are you undermuscled or adequately muscled?
Are you metabolically healthy?
There is a strong overlap between those who are metabolically unhealthy and those who are overnourished or undermuscled. The goals of our tactics have to span all the knobs we can tweak. For example, for an undermuscled and overnourished person, the goal is not weight loss but fat loss and muscle gain.
Exercise: The most powerful longevity drug
Exercise has the greatest power to determine how we live the rest of our lives. It can:
Increase our lifespan by several years
Delay the onset of chronic diseases
Improve and extend our healthspan
Reverse physical decline
Reverse cognitive decline
Lifespan = the number of years we live
Healthspan = how many of those years we remain healthy and disease free
Even a little bit of daily activity is better than nothing. Brisk walking alone can yield a lot of benefits. Regular exercisers live upto a decade longer than sedentary people, stay in better health and with less morbidity from causes related to metabolic dysfunction.
Asking a binary question like whether one should do cardio or strength training is not the right approach. We need to do more cardio and lift more weights. The data on exercise spells it out very clearly that the more of it we do, the better off we are.
Before diving into the specific guidelines, it is important to firmly understand why exercise is so important.
Why is exercise so important?
Aerobic/cardiorespiratory fitness
What it means:
How efficiently can our body deliver oxygen to our muscles and how efficiently can our muscles extract that oxygen to enable to us to do what we want to do (e.g. run/swim/walk)
Manifests in daily life as physical stamina
The more aerobically fit we are, the more energy we have to do what we want to do
VO₂ max
What is it:
The maximum rate at which one can utilise oxygen
Used to measure peak aerobic fitness, when we exercise at the upper limit of effort
The single most powerful marker for longevity
Represented as the volume of oxygen a person can use per kg of body weight per minute (e.g. 40 ml/kg/min for an average 45-year old man, 60 ml/kg/min for an elite endurance athlete).
Going one level deeper:
Our body adapts to the demands placed on it. When we are sedentary, we need less energy to perform all the physiological functions required to stay alive. We might need 300 ml of oxygen per minute to create enough ATP—the fuel that powers our cells.
If we increase the energy demand (e.g. by going out for a run), our breathing quickens and our heart rate increases to extract and utilise more oxygen from the air we breathe to keep our muscles working. The fitter we are, the more oxygen we can consume to make ATP and the better we can perform.
Eventually, we hit a point where we cannot produce more energy from oxygen-dependent pathways and need to switch to less efficient, less sustainable ways of producing power, like the kind we use while sprinting. The amount of oxygen we consume at this level of effort represents our VO₂ max.
What the data says
Higher VO₂ max is associated with lower mortality across the board.
Poor cardiovascular fitness carries a bigger relative risk of death than smoking.
Those in the lowest quartile (0-25%) of VO₂ max for their age group carry a 4 times higher risk of dying than those in the highest quartile (75%-100%).
Even going from the lowest quartile to the next one (25-50%) can reduce the risk of dying by 2 times. Every improvement counts.
Extremely high aerobic fitness is associated with the greatest survival.
There are no observed upper limits to the benefits from exercising.
No drug or intervention can rival this magnitude of benefit.
VO₂ max can be improved with training.
How exercise works as a drug for longevity
It prompts the body to produce its own drug-like chemicals.
When we exercise, our muscles generate molecules (cytokines) that send signals to other parts of our body and help improve our immune system along with stimulating the growth of new muscles and stronger bones.
Endurance exercises generate BDNF (brain-derived neurotrophic factor) which improves the health and functioning of the hippocampus (which plays a key role in memory).
Exercise strengthens our heart and helps maintain our circulatory system, including the health of the blood vessels in the brain.
It helps preserve brain volume, which is why it is strongly recommended for patients at risk of developing Alzheimer’s.
It improves the health of our mitochondria which improves our ability to metabolise both glucose and fat.
Aging
A primary hallmark of aging is the erosion of physical capacity.
Our cardiorespiratory fitness declines due to reduced maximum heart rate.
We lose muscle mass and strength with each decade.
Our bones grow fragile and our joints stiffen.
Our balance falters.
Muscle
Almost as powerfully correlated with living longer as VO₂ max.
Muscle mass alone is not enough. The strength of our muscles matters a lot too, i.e. their ability to generate force.
More muscle mass and stronger muscles supports and protects the body. It maintains metabolic health as muscles consume energy efficiently.
Those with the lowest muscle mass have the highest risk of dying from all causes. Muscle helps us survive old age because it preserves healthspan.
Muscles help keep our bones upright and intact, protecting us from various kinds of troubles, especially from falling—a vastly ignored cause of death and disability in the elderly.
Similar to VO₂ max, it is important to preserve muscle mass at all costs.
Everyone needs to lift weights. If you don’t already, start now. Any one can start at any age.
The Centenarian Decathlon
Many of us become obsessed with or only end up pursuing one kind of physical activity—only walking, only running, only cycling, only strength training. But this leaves us a one-dimensional athlete.
When someone dies, it is usually attributed to a specific cause—pneumonia, Alzheimers’, cancer, etc. What really kills most of us is the slow process of aging. The only way to fight it is to adopt the philosophy of a decathlete.
Decathletes are the most revered of all Olympic athletes. They are not the best at any of the individual events but are considered the greatest because they are very good at so many of them. They are true generalists, but they train like specialists.
We need to start training for the Centenarian Decathlon—the ten most important things we want to be able to do for the rest of our life. We get to decide what these 10 things are (it does not even have to be just 10). They might resemble athletic events, activities of daily living or just our personal interests.
Here are a few examples!
Why it matters
Many of these might seem too simple when you read them. But we need to dig deeper. To be able to hike comfortably on a hilly trail requires a VO₂ max of roughly 30 ml/kg/min. If you haven’t hiked in a while, you might be surprised if you find yourself not being able to do so today. Even if you can do it now, it is not good enough. Your VO₂ max will only decline as you age, unless you do something to prevent that.
To lift a 20-pound suitcase when you are older, you need to be able to lift 40-50 pounds now. To be able to climb four flights of stairs in your 80s, you need to be able to sprint up those stairs today.
In any case, you need to be doing much more now so that you can account for the natural decline in aerobic fitness and strength that comes with aging.
Clearly defining these goals helps us visualize exactly what kind of fitness we need to build and maintain as we get older. It gives us a template and purpose for our training.
It also helps us redefine what is possible in our later years and break free from the assumption that we are bound to be weak and incapable then.
We shift our perspective from trying to be an athlete for a specific event to becoming an athlete for life.
In the next post, I will summarise how to train for the Centenarian Decathlon!
I never won the fight in the ring; I always won in preparation
- Muhammad Ali
Golden! Keep it up bro, thanks for this 👍😃