# Peter Attia & Outlive: A European Take

Peter Attia's "Outlive" (2023) rests on three ideas: the Four Horsemen (atherosclerotic cardiovascular disease, cancer, neurodegeneration, and metabolic dysfunction, which cause most deaths before 85), Medicine 3.0 (proactive, individualised care that targets healthspan, not just lifespan), and the Centenarian Decathlon (list the 10 physical capacities you want in your final decade, then train backwards). The most useful and free takeaway is to picture your life at 85 and plan backwards from there. At Attia's intensity, the screening and labs are largely self-pay in German-speaking countries, and much of his most striking advice rests on his private-practice experience rather than randomised trials.

The Four Horsemen, Medicine 3.0, and the Centenarian Decathlon, explained for European readers

## On this page

- Who is Peter Attia?
- The Four Horsemen
- Medicine 3.0
- Centenarian Decathlon
- How Do You Apply Attia's Framework in Europe?

## FAQ

- Do I need to have read Outlive?
- Do Attia's screening suggestions translate to Germany?
- What is the difference between Attia and Huberman?
- What does Attia's approach cost in Germany?
- Which doctor should I see in Germany?

## Sources

- Helgerud J, Høydal K, Wang E, et al.. (2007). Aerobic high-intensity intervals improve VO2max more than moderate training (Norwegian 4x4 protocol). Medicine & Science in Sports & Exercise. https://doi.org/10.1249/mss.0b013e3180304570
- Mandsager K, Harb S, Cremer P, Phelan D, Nissen SE, Jaber W. (2018). Cardiorespiratory Fitness and Long-Term Mortality (the elite-fitness reference). JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2018.3605
- de Brito LBB, Ricardo DR, de Araújo DSMS, Ramos PS, Myers J, de Araújo CGS. (2014). Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology. https://doi.org/10.1177/2047487312471759
- Tsimikas S. (2017). A Test in Context: Lipoprotein(a) — Diagnosis, Prognosis, Controversies, and Emerging Therapies. Journal of the American College of Cardiology. https://doi.org/10.1016/j.jacc.2016.11.042
- Sniderman AD, Thanassoulis G, Glavinovic T, et al.. (2019). Apolipoprotein B Particles and Cardiovascular Disease: A Narrative Review. JAMA Cardiology. https://doi.org/10.1001/jamacardio.2019.3780
- Moel M, Harinath G, Lee V, Nyquist A, Morgan SL, Isman A, Zalzala S. (2025). Influence of rapamycin on safety and healthspan metrics after one year: PEARL trial results. Aging (Albany NY). https://doi.org/10.18632/aging.206235
- Cruz-Jentoft AJ, Bahat G, Bauer J, et al.. (2019). EWGSOP2 Sarcopenia: revised European consensus on definition and diagnosis. Age and Ageing. https://doi.org/10.1093/ageing/afy169

_Full guide: https://longevity-switzerland.com/en/guide/peter-attia-outlive_

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_Canonical: https://longevity-switzerland.com/en/guide/peter-attia-outlive · Part of Longevity Cities · Updated 2026-05-22_