Longevity Articles

Longevity Expert Series: Dr. Peter Attia and the Centenarian Decathlon

Longevity Expert Series: Dr. Peter Attia and the Centenarian Decathlon

Dr. Peter Attia is a renowned physician and longevity expert, holding an M.D. from Stanford University. His multifaceted career has encompassed surgical oncology, healthcare consulting, and venture capitalism, providing him a broad perspective on health and well-being. Dr. Attia's focus on lifespan extension merges rigorous scientific research with practical lifestyle interventions. He is the founder of Attia Medical, PC, a practice dedicated to exploring the limits of human performance and lifespan. A prolific writer and speaker, Dr. Attia disseminates his insights through various platforms, including a highly regarded blog and podcast. His work offers an evidence-based approach to redefining aging and optimizing healthspan. 

Life doesn't have to slow down as you age. With the right mindset, proactive strategies, and a well-planned regimen, you can stay vibrant and active well into your golden years. Here's an overview of the tactics employed by the renowned physician and longevity expert, Dr. Peter Attia, on how to train for a fulfilling life at 100. 

Dr. Attia is not affiliated with ProHealth and no endorsement of our products is implied. Our team respects the scientists, researchers, and doctors who are making breakthroughs in longevity science and our goal is to bring more visibility to these pioneers. 

Redefining Aging 

Aging, while a natural process, should not be equated with inevitable decline in physiological function or quality of life. Dr. Peter Attia stands at the forefront of a paradigm shift that challenges this traditional narrative. His work postulates that aging can be better understood as a set of malleable processes rather than a fixed eventuality. A central tenet of Dr. Attia's philosophy is that the medical focus needs to transition from disease-specific interventions to understanding the core processes that underlie aging itself. By doing so, we can intervene earlier in life in a way that impacts a broad array of age-related maladies. 

Dr. Attia employs a multifaceted approach that incorporates metabolic wellness, hormone optimization, and lifestyle factors such as sleep and stress management to modify the trajectory of aging. He asserts that many of the systemic issues we associate with aging—such as low energy levels, chronic inflammation, and a decline in cognitive function—can be ameliorated or even reversed through targeted interventions such as specific movement practices, dietary changes, and pharmaceutical use. His work also emphasizes the importance of metrics, utilizing advanced biomarker testing to provide quantifiable indicators of biological age as opposed to chronological age. He understands that testing once is only a snapshot, where repeated or continuous testing leads to better insight into how our bodies are working. 

By shifting the discourse from 'managing decline' to 'optimizing function,' Dr. Attia's work encourages a proactive rather than reactive approach to aging, thus opening up possibilities for improved performance in the short and long term. 

peter attia

Dr. Peter Attia 

The Centenarian Decathlon 

The Centenarian Decathlon is a framework that provides a set of functional objectives aiming to quantify the quality of life in an individual's later years. The decathlon identifies ten essential physical tasks that encapsulate the capabilities we strive to maintain into our centenarian years. These tasks range from the basic, such as walking and maintaining balance, to the more complex, like being able to carry a load up a flight of stairs. The idea is not merely to survive into old age, but to thrive and function at a high level. 

Informed by both scientific research and clinical experience, this framework functions as a strategic blueprint for long-term health planning. Dr. Attia argues that to win the "decathlon," individuals must craft a thoughtful plan that extends beyond basic exercise and diet. He advocates for an integrated approach involving hormonal balance, cognitive fitness, and metabolic health. Advanced diagnostic biomarker monitoring are also recommended to track progress and fine-tune individualized interventions. 

The Centenarian Decathlon shifts the focus from managing dysfunction to promoting vitality, emphasizing functional independence and physical capability. Dr. Attia's model serves as an instructive guide for those committed to maximizing the quality of their later life, informed by data and directed by specific, achievable markers of physical prowess. 

The Marginal Decade 

The term "Marginal Decade" refers to the last decade of your life. It's a period where physical health declines, affecting quality of life. By understanding that this decline is not inevitable, we can take action to mitigate its effects and strive for a healthier, more active marginal decade. We might not know when our marginal decade is, but it’s signs are a lack of resiliency and declining health. We want to push out our marginal decade as long as possible, which is achieved by maintaining robust health and function that is characteristic of mid-life. 

The Importance of Backcasting 

Backcasting refers to the practice of envisioning your desired end-state (being active and capable at 100, for example) and working backward to identify the steps necessary to reach that goal. This approach allows you to establish a clear plan, so you know exactly what you need to do today to maintain your physical abilities as you age. One example is, if you want to play with your grandchildren at 100, you may want to maintain the ability to sit on the floor and get up unassisted. If you would like to ski or rock climb at the same age, your backcasting plan would include a number of other movements with some degree of strength, agility, and cognitive processing power. 

Choosing Your Own Centenarian Decathlon 

The Centenarian Decathlon is unique to each individual. It's about identifying the physical tasks that are most important to you and that you want to be able to perform in your later years. These tasks could range from lifting a 30-pound weight to playing with your grandkids. By aligning your training regimen with these tasks, you can ensure that you maintain the skills and abilities that matter most to you. 

Training for the Centenarian Decathlon, as conceptualized by Dr. Peter Attia, presents a comprehensive approach to aging that emphasizes four core elements of physical exercise: stability, strength, aerobic performance, and anaerobic output. Each component serves specific functional purposes and collectively contributes to optimizing healthspan. 


Stability serves as the cornerstone for all other forms of physical exertion. The importance of stability manifests in everyday activities, such as transitioning from sitting to standing or maintaining balance while navigating uneven terrain. To enhance stability, individuals may engage in exercises that challenge their core muscles and proprioception—our sense of body position in space. Functional exercises like single-leg stands or using stability balls can provide beneficial adaptive challenges. 


Strength maintenance is essential for everyday activities that range from lifting grocery bags to standing from a chair unaided. The decline of muscle mass seen in aging can be attenuated through consistent strength training. Resistance exercises and weightlifting are prime examples of activities that sustain muscle mass and, consequently, functional strength. Focus on multi-joint compound exercises like squats or deadlifts to yield considerable gains in functional strength. Even calisthenics and bodyweight exercises can provide the resistance needed, so there is no need to go to a gym or purchase equipment. 

Longevity Expert Series: Dr. Peter Attia and the Centenarian Decathlon

Aerobic Performance  

Aerobic capacity underpins tasks requiring sustained physical effort. It is the cornerstone for cardiovascular health, playing a role in everything from oxygen transport to cellular energy production. Aerobic exercises, including walking, cycling, and swimming, enhance cardiovascular efficiency and stamina. They are also implicated in improved cognitive function and mood regulation, reinforcing the interconnectedness of physical and mental well-being. Dr. Attia frequently recommends the use of zone 2 cardio, which can be approximated when you are putting out enough effort to make it difficult, but not impossible, to have a conversation. 

Anaerobic Output 

Anaerobic capacity, while less frequently addressed, is essential for tasks demanding quick, intense energy expenditure. Activities such as lifting a heavy object or moving rapidly to avoid falling hinge on anaerobic output. Exercises like sprinting, high-intensity interval training (HIIT), or plyometric jumps can improve anaerobic capacity. 

Setting Fitness Goals Early 

It's never too early to start planning for your Centenarian Decathlon. By setting fitness goals early in life, you can establish a strong foundation of physical health that will serve you well in your later years. If you’re in your 70’s, now is a great time to start training for your 90’s. If you’re in your 30’s or 40’s, even better – take time to get away from your desk and take deliberate action to stay strong and mobile well into  your later years. The sooner you start, the farther you can push your marginal decade. 

Remember – it isn’t just about going to the gym or running every morning. You need to be training for the things you want to do when you’re 100 so you can maintain those abilities. Modern life often drives us to sedentary habits, causing stiffness and loss of function, so we lose strength and mobility. Be mindful of what you’re training yourself for unintentionally, then modify your habits to create a better long-term outcome. 

Overcoming Challenges and Staying Motivated 

Training for the Centenarian Decathlon isn't always easy. It requires discipline, persistence, and a willingness to push beyond your comfort zone. But by staying focused on your goals and remembering why you're training—to live a vibrant, active life at 100—you can stay motivated and overcome any obstacles that come your way. 

In all honesty, training can be boring, so find ways to keep it interesting while maintaining good form. Music, podcasts, shows, and audiobooks make great ambiance for mobility and strength training, and are especially nice for zone 2 cardio. Enlist friends or family members to work with you, so you get the added benefit of improved social bonds. Most importantly, just carve out the time to do the training so you’re less likely to suffer the long decline of debility that is so common in our culture today. 

The Impact of Training on Quality of Life 

Training for the Centenarian Decathlon goes beyond the mere objective of preserving muscle mass or cardiovascular health; it functions as a comprehensive strategy for enhancing overall life quality both now and in the future. Naturally, the benefits of maintaining physical ability—such as ongoing participation in favored activities or outdoor pursuits—are evident. Yet, this framework engenders benefits that extend far beyond the immediately observable. 

For instance, maintaining physical capability into later life can have substantial cognitive and psychological benefits. A well-functioning body is often accompanied by a similarly well-functioning mind, as both are positively influenced by a balanced diet, regular exercise, and proper sleep. Cognitive tasks, whether they are as simple as problem-solving or as complex as strategic planning, are facilitated by good physical health. 

Moreover, this level of physical fitness can facilitate more robust social interactions. An individual capable of walking without assistance can engage in a broader array of social activities, from favorite hobbies and sports to community involvement to more fun interaction with grandchildren. These experiences not only strengthen emotional bonds but can also provide a sense of purpose, a critical component for psychological well-being, especially in later life stages. 

Maintaining physical independence is another often-overlooked benefit. The ability to perform basic daily tasks without external help, such as grocery shopping or cleaning the house, translates into prolonged independence. This autonomy contributes to a more positive self-image, which in itself can be a powerful motivator for sustaining a health-oriented lifestyle. 

Additionally, from a financial standpoint, investing in your physical health now could lead to potential savings on healthcare costs later. A proactive approach to health and wellness can result in a lower incidence of chronic conditions associated with aging, thereby reducing medical expenses over time. We’re not just talking about a couple of bucks, either. Healthcare spending in the US for elder care is truly astronomical. Between costs related to insured services and out of pocket spending, many people over the age of 40 are facing financial hardship just for medical care. You may not be able to control all variables, but you can live a healthy lifestyle that encourages resilience over disability.  

Redefining What It Means to Age 

Aging doesn't have to mean decline and loss. By training for the Centenarian Decathlon, you can redefine what it means to age and strive for a vibrant, active life at 100. It's never too early or too late to start. The best time to start was 20 years ago. The second best time to start is today. Whether you want to be able to play with your grandkids or catch the next wave, imagine what you want to be doing at 100 and build your training plan around that, so you can enjoy more of your life, farther into the future.  


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