“Books crowd the market offering health tips for the elderly, suggesting ways they can tweak their activities or their diet to make the most of their later decades—but, “if we don’t have a plan to defeat the minefield of everyday killers,” writes longtime United States Army physician Malish at the outset of this book, “all discussions of aging to 100 are pointless.”

 

He notes the leading killers (as of 2019 data) including heart disease, cancer, stroke, and diabetes, and he points out that many of these maladies are ultimately the result of atherosclerosis, the gradual build-up of plaque on the arteries, which can be lessened or avoided with lifestyle changes adopted much earlier in life. The author offers his readers something he calls the Longevity Mental Model; perhaps controversially, he bases this model on his contention that laziness is the default setting of humans.

 

Per Malish, there’s little point in building unrealistic plans around people making energetic long-term lifestyle choices because most people are too lazy to follow through. Along these lines, he urges both readers and his fellow doctors to adopt what he refers to as “medical realism.” “Medical realists differ from medical idealists because they accept laziness as a condition of humanity,” he writes. “They know that most people won’t reduce their risk factors to the level needed for maximum prevention through diet and exercise.”

 

The author is a very energetic and entertainingly clear-eyed explainer of his core concepts of “offensive weapons” and “defensive measures” that can be used to create real-world benefits for the large majority of people unwilling to undertake effortful long-term preventative measures. Readers who might feel fed up with unrealistically anodyne retirement guides will find the messaging here not only refreshing but eye-opening.”