“Bonus Decade” is the opposite of Marginal Decade (see below), with a “bonus decade” referring to when we both live longer and without pain. For Attia, this is our key objective: “to delay death, and to get the most out of our extra years. The rest of our lives becomes a time to relish rather than to dread” (40). Achieving bonus decades takes commitment and research on our part.

Cancer is one of Attia’s Four Horsemen diseases. Cancer is a group of diseases characterized by two properties: uncontrolled cellular growth (cancer cells do not stop growing when they should) and metastasis (or the ability of cancer cells to travel from one part of the body to another place where they should not be). The latter is responsible for most cancer patient deaths. Smoking, obesity, and type 2 diabetes are leading risk factors for cancer. Cancer prevention is more difficult than the other Horsemen diseases since it involves some degree of bad luck in the form of cellular mutations, which we cannot yet control. However, Attia advocates for one key prevention strategy: repairing metabolic health. By addressing our metabolic health (e.g., obesity, type 2 diabetes, and insulin resistance), we can reduce our cancer risk.