Can Preventative Medicine Become the Fountain of Youth?

The fountain of youth. The elixir of life. The golden apple. For centuries, such myths have reflected humankind’s obsession with immortality.

With the right magic, the stories proclaim, we can unnaturally lengthen our lives. With enough bravery and smarts, we can evade the cruel grasp of death. Such promises tantalize the imagination, luring us into the false belief that we can escape the wages of sin by our own efforts.

Although Christ offers us everlasting life through him as a free gift, we prefer the fruit that appeals to our own eyes. We prefer a recipe, a formula, an algorithm we can manipulate like clay and claim as our own.

Peter Attia is a physician who left surgical training in favor of a practice focused on longevity. As I read his book Outlive: The Science and Art of Longevity, I wondered how this fascination with immortality has contributed to the book’s soaring popularity.

Outlive has occupied the number one spot on the New York Times bestseller list for months, an especially impressive feat given the length and content of the book. As a nearly 500-page tome of comprehensive descriptions of pathophysiology, it’s no easy read. Are readers hoping to discover a map to the fountain of youth among its pages?

There Is No Elixir of Life

The author would object to an expectation of the fountain of youth. He writes this of the study of longevity: “It has been hopelessly tainted by a centuries-long parade of quacks and charlatans who have claimed to possess the secret elixir to a longer life. I don’t want to be associated with those people, and I’m not arrogant enough to think that I myself have some sort of easy answer to this problem” (9).

Although Christ offers us everlasting life through him as a free gift, we prefer the fruit that appeals to our own eyes. We prefer a recipe, a formula, an algorithm.

Despite this sober-minded assertion, he later promises this: “I hope to convince you that with enough time and effort, you can potentially extend your lifespan by a decade and your healthspan by possibly two, meaning you might hope to function like someone twenty years younger than you” (18).

While he may only hope to help people “live longer and live better,” such language seems guaranteed to excite our elixir-seeking tendencies (215).

The actual content of Outlive is much less sensational than such promises of longevity would suggest. In short, Attia advocates for a preventive approach to the four major chronic diseases that claim so many lives in America: heart disease, type 2 diabetes, cancer, and Alzheimer’s disease.

He offers an exhaustive discussion of the pathophysiology of these conditions, including how they interrelate (and they all do; the link between diabetes and heart disease is especially strong). While his explanations reflect common medical knowledge, they offer the layperson an especially helpful framework for understanding how these chronic diseases develop over time.

We don’t acquire heart disease the way we “catch” the common cold. Attia clearly illustrates how such diseases reflect long-standing processes, with multiple contributors accumulating over years. If we can slow these processes, Attia effectively argues, we can delay disease onset and optimize our health.

Attia’s most fervent recommendations for preventing such diseases will sound familiar: exercise, eat well, sleep, and attend to emotional and mental health. He offers the most detailed and concrete advice on exercise physiology and more general recommendations in the other categories. Most helpful are descriptions of why these interventions matter, again offering readers a deeper understanding of how their daily choices either worsen or attenuate their risk of disease in later years.

Questionable Claims

As a point of caution, while his emphases on nutrition, exercise, and sleep are well-founded, the author makes some recommendations about medications and screening without strong evidence.

There are other ethical issues with this volume. Attia openly dismisses the Hippocratic oath—the principle of “do no harm” that every medical student pledges and that guides physicians to weigh the risks and benefits of treatment—as an excuse for “doing nothing at all.”

To illustrate his point, he offers an anecdote from his residency about a teenager who arrived in the emergency room with a stab wound to the heart. When the teenager lost consciousness, Attia surgically opened the patient’s chest to release blood from around the heart, saving the boy’s life. “Sometimes,” writes Attia about the dramatic moment, “doing nothing is the riskiest choice of all” (25).

Laypeople may not realize this, but this anecdote doesn’t refute the principle of “do no harm” at all. The procedure he performed is the standard of care clearly delineated in trauma surgery guidelines. To do nothing in this scenario wouldn’t have been “doing no harm”; it would have been malpractice.

As a counterpoint, imagine the boy in question was awake and his life wasn’t in danger. Would opening his chest without anesthesia in the middle of the emergency room be good practice in that scenario?

“Do no harm” doesn’t mean “do nothing.” It means “don’t be reckless.” Medical guidelines exist because every intervention has a side effect, and we need to ensure our measures will help more than hurt.

Throughout Outlive, Attia disregards this tenet, recommending medications, monitoring, and cancer screening in situations that our best evidence doesn’t support. He argues that such measures are better than inaction but ignores the fact that every intervention in medicine, even the most innocuous, has the potential for adverse effects.

Pursue Eternal Life

Attia raises the most fascinating and perhaps most pressing question at the end of the book: Why should we seek longevity? He writes with admirable candor about his struggles with mental health and details how initially his fear of death fueled his desire to live longer.

Over time and with counseling, his fear ceded to a commitment to living well so he can best love his family. He emphasizes in this section that all the tinkering with exercise and nutrition won’t matter if our relationships and emotions are in shambles.

For the believer, this question runs even deeper. Christ has already overcome death (1 Cor. 15:54), and through him we have the assurance of eternal life (1 Pet. 1:4; John 3:15–16). For the Christian, the motivation to “live longer, better” is integrally tied with our chief end: to glorify God and enjoy him forever.

For the Christian, the motivation to ‘live longer, better’ is integrally tied with our chief end: to glorify God and enjoy him forever.

What matters most isn’t ultimately our glucose levels, or how early we obtain cancer screening, or even how much we can bench press at 60, but rather how faithfully and for whom we aim to steward our gifts (Rom. 12:6–8; Col. 3:17).

As Paul reminds us, “You are not your own, for you were bought with a price. So glorify God in your body” (1 Cor. 6:19–20).

Books like Outlive can never offer the elixir of life. Eternal life comes to us only by grace alone, through faith alone, in Christ alone. But as we aim to glorify God in all things, reminders about how to care for these bodies he’s given us—how to eat well, sleep well, and move well, so we might serve him well—are always welcome.