LIVE BETTER LONGER
Maximize your health in your 40s and beyond. There are three ways to do it:
1. Buy this book, understand it, and do everything Peter tells you to do. Cost: $20 plus gear.
2. Hire Peter to be your doctor. He only takes a small number of clients, you go to him.
Cost: $150,000 per year.
3. Work with me to plan and execute a simple program that makes you stronger, more resilient, more accountable, and more attractive than you are now.
The 80/20 rule: get the basics right
Peter’s body of work is extensive and covers hundreds of topics. I believe you can do 20 percent of all he prescribes and get 80 percent of the results by doing the basics well.
The basics
Don’t smoke
Get rid of excess body fat
Reduce your insulin resistance, even if you’re not pre-diabetic
Exercise to build muscle and bone like your life depends on it
Manage your cardiac and stroke risk
Manage your hypertension
Manage your cancer risk
Manage your cognitive-decline risk
Rebuild bone in all areas and keep bones strong
Reduce your alcohol intake to give you the most
pleasure for the least consumption.Adjust your diet and supplement as necessary
Chances are, you need to focus on about half of these to increase your future quality of life significantly. For medical issues, you should talk with your doctor. After that, the best recipe for extending your quality of life is vigorous, muscle-building, weight-enhanced exercise, and a few supplements. If you want the prize, start building the habits you’ll need for the rest of your life. See our program page to learn more.
Longevity training begins at 40
I talk with too many 70-year-olds who wish they weren’t in their current condition. The day you turn 40, you should not think of the coming decade as a new chapter in your life. You should think of it as the first chapter in the second book. It’s a time to say goodbye to some old habits and pick up some new ones.
Reduce insulin resistance now. Don’t wait. Work to get your A1c below 5.4. Now is the time. I know you can’t imagine being 60 yet, but you will be, and giving up a few things you love to have 5 decades of fantastic health is going to be worth it. Talk with me about optimizing your diet for the future.
Lose the weight now. You can’t lose fat and gain muscle at the same time. You should be under 15 percent body fat (men) or 24 percent (women). The longer you carry extra pounds, the harder they are to take off later, and the more insulin resistant you become. Jump on it now and be glad you did later.
Stop being a sport specialist. Most people at age 40 are doing about two sports: running and yoga, or tennis and pilates, etc. This is not enough. You may look great. You may feel energetic. You may feel decades away from 50, but you aren’t. You’re already losing bone and probably muscle. You can lead the way into this next book of your life by building muscle and bone now.
Get the right doctors and tests in place. When you become my client, I send you a list of tests I want you to get, and I explain why you never ever need a DEXA scan for bone density. I meet too many women who start hormone-replacement too late, and too many men not testing the right things, so they are flying blind. Many doctors are not well equipped to help you stay out of the medical system in the future.
Insulin resistance is the big factor
Scientists are learning more and more that insulin resistance is the platform on which disease is built. Everything from kidney disease to osteoporosis to pregnancy and cancer is in some way made worse by insulin resistance. In fact, it may turn out that insulin sensitivity is more of a factor in heart disease than cholesterol is.
This is why it’s so important to get started on longevity early. No fructose. Almost no sugar. Almost no alcohol. More protein. I give my clients a custom diet plan that works for where they are and what they enjoy, with an eye on the prize of living to 100 in great shape and with lots of energy.
If your A1c is over 5.7, you are heading toward diabetes. This is an emergency situation. You have to get more serious about turning your insulin sensitivity around and building healthy habits for the future.
Read Why We Get Sick to learn more about insulin sensitivity, and watch the videos on this website.
Testimonials
David came along at the right time, offering the right kind of advice. He gave me the incentive to get active again and work back into the shape I was in 20 years ago. He’s making sure I don’t get injured, but it’s still very challenging. I should have started sooner, but I’m catching up now.
— Mike in the UK
David is very knowledgeable and offers great advice for men and women to help with nutrition, exercise, and supplementation. He knows all about hormone replacement therapy, which most women start too late. He encourages you to build muscle safely. David is a great resource!
— Kathleen in Arizona
An hour talking with David Siegel about longevity will change what you do for the next 30 years of your life.
— Brian in Rhode Island
I truly believe that starting off on the right foot—doing things correctly from the beginning—sets the stage for strong and lasting success. I’d love to help David spread the word about his coaching skills and support his journey to inspire more people.
— Lisa in Florida
David is the real deal. We've been working together for six weeks, he has changed my mindset and motivation. I’m getting stronger with less weight. With his program, you start to see results immediately.
— Steve in Virginia
David's been working with me on tennis elbow and sleep issues for a few weeks now, I'm much more hopeful that I will have a good solution sooner than I would have otherwise. I'm looking forward to having him coach me on my gym workouts.
— Alex in New Jersey
The centenarian olympics
If you run 30 miles a week at age 60, you may be surprised to learn that you are at extreme risk of frailty now. Your grip strength is weak, your hips and spine are are demineralized, and your muscle mass is low overall. You don’t want to be a specialist. You want to be in the top half (or better) of your age group for at least ten — and preferably twenty — activities that put extra stress on your bones and muscles:
Rowing
Dead hang
Biceps
Pull-ups
Chest press
Stairs
Rucking (carrying weight
on your back)
Grip strength
Core strength
Agility
Ab strength
Farmer carry
Sled pull/push
Yoga/balance
Start with ten different challenges and measure your progress. Stay on track to being a competitive decathlete in your 90s and you’ll reap the benefits every year.
In addition, you want to put in at least four hours a week on both cardio exercise (endurance) and peak performance (VO2 max). If this sounds like too much for you, you’re not taking this seriously enough. Keep reading.
Prevent future falls
One in four Americans aged 65 and older falls each year, resulting in about 36 million falls annually. For most people, falls are your number one risk of decreased quality of life.
Falls among older adults lead to more than 800,000 hospitalizations, often due hip fractures and head injuries.
Falls are the leading cause of injury-related death among adults aged 65 and older.
Each year, over 38,000 older adults in the U.S. die as a result of falls.
The five-year mortality rate following a hip fracture is approximately 50%, and the fall usually accelerates cognitive decline.
My go-to guy for osteoporosis is Dr Doug Lucas. He has a book, videos, and an online community. He recommends a particular calcium supplement you can find in our store. You can hire him to be your doctor, but it will cost $13,000 per year. On the other hand, it could add 20 years to your life. If you can afford him, become his patient. Buy his book!
Stair climbing
Attia asks: when you’re 90, would you like to be able to go up four flights of stairs in three minutes? Only the top ten percent of nonagenerians can do that. If you want to be in that category, you’ll need to be able to climb four flights of stairs in the following times, depending on your age:
Age 40: 30 seconds
Age 50: 40 seconds
Age 60: 50 seconds
Age 70: 80 seconds
Age 80: 2 minutes
Age 90: 3 minutes
How long does it take you to climb four floors today? I’m 65 years old. My building has 14-foot floors (17 steps per floor). I can run up four flights in 22 seconds without touching the handrails. How fast can you do it? Get in touch and let me know.
Carry all your groceries home on your back
Andy in 2006
You can do this!
Andy Katchmar, age 79
I began my journey at the age of 64. At that time I weighed around 205. I had several health issues at the beginning, but I persevered and worked towards gaining my health back . The first months were for losing weight mainly. Once I achieved 175, I was better able to handle machines and weights. My weight was a concern since I am only 5’ 5” tall. With the guidance of a personal trainer, I made steady advances. After a year, I was in good shape. I have continued on my own for 15 years now. I am still improving as I age.
Andy today, age 79
Althea Boulware, age 57
When I was 46, I started perimenopause and it seemed like no matter what I did, working out 7 days a week and having a pretty good nutrition regimen, my body had a mind of its own. It was not until I started a structured workout regimen, incorporating drop sets, progression sets, tempo training, time based workouts and just sitting in my discomfort, is when my body started to change. I also researched nutrition and what foods were beneficial for me and which foods I should be wary of. My body started to respond. At 57 I've never felt better.
Geoff Keller, 74
I used to be the king of junk food. I never saw the inside of a gym until age 50. Now my workout program consists of a single, two-hour, no-nonsense resistance training session every four days, as well as three, 40 to 60-minute cardio workouts on a stationary bike weekly. I am in my seventh year of being a whole-foods, plant-based vegan.
Kathleen Donovan, age 60
Fitness has always been a huge part of my life. I’ve always been active, participating in sports in elementary through high school. Continued exercising in college and began weight training. Really got into more heavy weight training over the past 15 years. Love the mental and physical aspects. Truly has been my fountain of youth!
The cost of not doing this
Are you planning to get in shape later? Here are a few scenarios for people diagnosed at age 75:
Scenario 1: Average Health Decline with Multiple Chronic Conditions
Patient with hypertension, type 2 diabetes, and moderate arthritis.
Estimated Healthcare Costs over 10 Years: $65,000
Scenario 2: Progressive Dementia and Assisted Living
Patient diagnosed with early-stage Alzheimer's disease.
Estimated Healthcare Costs over 10 Years: $445,000
Scenario 3: Severe Cardiovascular Disease with Multiple Interventions
Patient with severe coronary artery disease, has undergone a bypass surgery, and has recurrent hospitalizations.
Total Healthcare Costs over 10 Years: $420,000
Scenario 4: Cancer Diagnosis and Treatment
Male diagnosed with prostate cancer (Gleason score of 6), receives unnecessary radical prostatectomy, suffers severe side effects (incontinence and ED) for the rest of his life.
Total Healthcare Costs over 10 Years: $120,000
The prize
Frequently asked questions
What happens during the onboarding session?
You tell me about your health and history. I fill out a form to help you track your progress. Together, we come up with a plan to get started, which will involve some weight training, some cardio exercise, some supplements, and possibly changes to your diet and daily routines. We’ll be working on this for the next eight weeks. By the time the eight weeks are over, you should have a solid foundation for building your future self. Be sure to bring any health records you have to this meeting.
I want to ask a question before I buy
Schedule your discovery call right now!
Will you work with me if I’m seriously overweight?
Possibly. My approach is to work on losing the weight first, which means getting very serious about long-term weight loss. I can help, but you have to do the work.
I’ve tried to quit smoking many times and haven’t been able to. Can you help me?
I’m afraid I can’t. You’ll have to find someone else to help you do that. It’s the most important thing you can do. In fact, if you find an amazing program, let me know so I can tell others.
I have pre-existing conditions. I’m afraid I might not be able to commit.
We all have pre-existing conditions! Even more reason to get seriously strong and stay ahead of your doctors for the years ahead.
Do you subscribe to everything Attia recommends?
Mostly, but that’s because he’s skeptical of all the magic molecules everyone is touting these days. He’s very open minded. He’s willing to look at new evidence and change his opinion. I’m coming around to his protein recommendations (you need more protein as you age). I think he’s right about alcohol (zero is best), and I think he’s right about diet. I like that he changed his mind about caloric restriction. I like that he thinks we’re still mostly guessing and have a lot more to learn. He knows humans aren’t mice. I think he makes the best educated guesses.
Are there experts you don’t like?
Yes. I think David Sinclair lives in a world of mouse and worm studies and fake metrics. Whatever he says extends life I would generally stay away from. Peter Diamandis is usually wrong. Most “functional medicine” claims are nonsense. Walter Willett (Harvard) and the “Mediterranean diet” is mostly a collection of weak evidence for various different products, mostly promoted by companies for profit. How much do we really know about diet? Not much. Don’t read a book like “The China Study” and think you’ve just learned anything about diet.
Are there other experts you like?
I’m a big fan of Gary Taubes, which is how I heard about Peter back in about 2012 or so. His books have been very influential on me. He showed that calories-in/calories-out (the metabolic model) is not a helpful framework for people trying to lose weight. He also showed that saturated fat is not bad and doesn’t cause heart disease. He showed that dietary cholesterol has nothing to do with serum cholesterol. I like Aubrey de Grey as a researcher. I like Daniel Lieberman, he says reasonable things in general. For osteoporosis, I like Dr Doug Lucas. See the books page for more.
Are there other experts you stay away from?
Not that these people are wrong, I simply think they are off in the noise: Andrew Huberman, Bryan Johnson, Valter Longo, and anyone who touts the latest and greatest molecule, probiotic, anti-aging pill, or diet. A few of Huberman’s podcasts are worthwhile, but most are skippable. Anyone who recommends more heavy exercise over worrying about diet is on the right track.
Why don’t you talk about many things Attia writes about?
He talks about a lot of very esoteric research. It’s confusing to most people. I think we can choose about 20 percent of his recommendations and get 80 percent of his results — and he says that himself. If a client has those 20 percent really working, we can start looking at the second-order options. For example, I don’t think anti-oxidants are meaningful for human health. They might be, but they are not a front-line approach to longevity, and most other prescription drugs aren’t, either.
What’s your view on osteoporosis?
I broke the head of my left femur at age 51 (ice skating) and my right femur at age 53 (running). That’s a diagnosis of osteoporosis. I’m very skeptical of osteoporosis drugs — I think the cure is worse than the disease, especially if you take bone-building seriously. There are many interesting drugs in development, I try to keep up with the research. I think the best thing is to get calcium from food and stress your bones often. I’m interested in vibration therapy. I think if you have the money to buy a good vibration plate, you should. There are two main kinds of vibration plates, and the cheap $200 plates on Amazon are terrible. There are vibration plates listed in the store here.
Which supplements do you recommend?
See my stack page.
What about rapamycin?
Not a first-order modality. Not second-order either.
What about cold plunges, red light, early light, saunas, chiropractors, metformin, rapamycin, resveratrol, MNM, Klotho, and all the other things various doctors recommend now?
Noise. For some of these, that may change. For now, build bones and muscle in the gym.
What are your dietary guidelines?
See this page.
Do you want your clients to become vegan?
Absolutely not. I don’t pay much attention to diet.