550: The Real Reason People Break Down After 40 (It’s Not "Getting Older") | Vonda Wright, MD

What's going on, everybody? It's episode 550 of The Genius Life. What up, everybody? Welcome back to the show. I'm your host, Max Lugavere, and you're listening to The Genius Life, a show where we go deep on health and performance without turning your brain into oatmeal in the process. Today's guest is Dr. Vonda Wright. She's an orthopedic surgeon, longevity clinician, and author of the new book Unbreakable. And this conversation is basically a blueprint for staying strong, mobile, and often operating table for as long as humanly possible. We get into why muscle is the ultimate longevity lever, how sedentary aging isn't destiny, and what she's seen firsthand in the OR that'll make you take strength training and especially bone health way more seriously. We also talk practical, actionable stuff, how much protein actually matters, why spreading it out across the day can quiet food noise, and how to implement her surprisingly simple daily prescription so that you don't become a statistic after a fall. If you've ever wondered whether being skinny automatically equals healthy or why some people seem to fall apart in midlife while others get stronger, you're going to love this episode. As always, listen all the way through the end. You're not going to want to miss a beat. And don't forget to share this episode with friends and loved ones that you think may benefit from And if you're enjoying the show, please take two seconds to leave a rating and review on your podcast app of choice and make sure that you're subscribed here and on YouTube. And a separate ask, if you want a weekly no BS breakdown of the most useful health science tools and discounts that I actually use, my free weekly newsletter is where I put the good stuff. It's free, no spam and loved by over 120,000 high performers, which still kind of blows my mind. Grab it at maxlugavere.com slash newsletter. Now with all that out of the way, here's my conversation with Dr. Vonda Wright. Here we go. Dr. Vonda Wright, welcome to the show. How are you doing? I'm so glad to be here, actually. So great to have you. Oh, thank you. I love what we're, I mean, I guess I know what we're about to talk about. We're about to talk about strength, muscle, and its relationship to aging well and preventing disease and living a long and healthy life. Yeah. You know, the mantra I was telling you earlier for my entire career as an orthopedic surgeon was not, I'm going to put more metal in bones. I'm going to be there for you when you fall, which I am. Believe me, I am. But my whole goal was that you would never end up in my office or in my ER. And so no matter what I'm talking about, it is always prevention. And how do we not only prevent musculoskeletal problems, which we can talk about, but how do we stay healthy, vital, active, joyful for the rest of our lives? And if we don't conscientiously think about it from a very younger age, you'll end up in my ER. You'll end up with multiple itises in various tendons. So if I can prevent that, I'll quit my job. If there's nobody else to treat, that's okay, right? Best kind of physician. How do I keep you out of my office for as long as possible? Exactly right. When did the value of muscle and strength first emerge to you as something worth talking about publicly? So you know what, in the last years of my residency, I was involved in some research projects with athletes over 50. They're called the National Senior Games. And if you ever have a chance to go watch, you will be so inspired. So to get into these senior Olympics, if you will, you have to have won your state race. So here are people who, in general, Hallmark and society will say, okay, you've peaked out. It's an all downhill climb. Running the 50-year-old guy who won the mile in the year that I started studying midlife and beyond, won it in 437. I mean, really? 437? And so the 70-year-old guy who won the mile race, won it in seven minutes. And for me, that put a light bulb onto something I had witnessed my entire life, which was my own father in midlife and beyond being an endurance athlete. So I started thinking about there's this mantra that aging is this decline and that there's nothing we can do about it. And that's because most of that research is done on populations. And I air quote populations because if you know this, you're in this space. When we look at the U.S. population, 60 to 70 percent of people really do not invest daily in their mobility and their smart nutrition, right? They just let time go and become victims of time. So I knew that if the research said that we were going to decline and we were studying populations, we observed that because of how sedentary our people were. So that by studying masters athletes who these are, these aren't pro athletes. These are people like you and me with day jobs who just invest in their mobility every day. What I found over a series of 15 years of studies is that you can preserve your muscle, your bone, your brain, your cartilage, all these things that we think inevitably decline. They decline if we sit on our couch throughout our entire life. So trying to keep you out of my office and out of my ER, knowing that we have the data to prove it, it becomes like, look how excited I get, like a passion, like I've got to save these people. Because I've seen what happens at the end of life when we do not pay attention. It's work worth doing, right? Of course. So would you say that if you're able-bodied today, there really is no excuse? I say that, you know, our bodies are designed to move. When we look at a structural aspects of our body, if we were designed to sit still, we would be designed like a mushroom with a big white stock and all the good stuff on top. But that is so not our strongest muscles are below our belly button. So if you follow nature and design and creation, we are created to move people. Can you imagine being designed to sit? Well, we would be like Jabba the Hutt or literally a shiitake mushroom. I mean, honestly. Yeah. So there's never really a point at which it becomes too late. You know, there's the first studies that I looked at when I started down this road, and there have been recent ones in JAMA, show that even 90-year-old people in nursing homes, when put through chair exercises for as little as six weeks, can increase their function by more than 150%. So that can mean the difference between getting up and down from a chair, opening your, feeding yourself, right? And so the gains that we see in really, really elderly people may not be the same, are not the same gains we see in younger people like us, but we retrain the neuromuscular pathways, the connections between our brain telling our muscles how to fire. And in retraining those, we gain tremendous function in our 90s. The failure is accepting that sedentary and decrepit is your destiny. You ever see those on social media? Sometimes you'll see memes that juxtapose like a 40-year-old today versus a 40-year-old 50 years ago. There's like a night and day difference. Completely, completely. And you know, In the turn of the century, in the 1900s, the life expectancy was about 46 for men. We don't actually, we didn't keep track for women. But if that was really end of life or median age, that is a huge difference because most of us in our 40s feel like, okay, maybe we haven't even yet begun. Like we've got so much runway still to reach our peak, right? It's a mindset difference. It's a societal difference. It's a life expectancy difference. Yeah. I mean, you see some people today that look that are that, you know, that are 40. Yeah. And yet they look like they're 40 in dog years. Whereas, you know, others just that they don't look that much different from how they likely looked at 30. I mean, I'm 43. I'm in the best shape I've ever been in. Exactly. Exactly. But yet I look at like older generations and I don't know, there doesn't seem to be an embrace of proper nutrition, activity, exercise resistance training as there is among younger populations? Well, when I first started doing this work, I was telling, we were briefly discussing it. I wrote my first book in 2008, built off of what I learned from these senior and master athletes, right? It was called Fitness After 40. And I launched it with some exercise equipment and Dick's Sporting Goods, within one year, we found that people in their 40s, and I was in my 40s then, could not stand the number 40, as if it was some horrible state of life, not admitting that aging is the most natural process we do. It's just how we age that really matters. And so we had to rebrand as Thrive and wrote another book just to reframe all the arguments that I had ever made that we are not the victims of this passage of time. If we step in front of this and harness what we know is true, I don't know if you ever feel like you're banging your head against a wall, but we know what to do and we don't do it. And we know what to do. So, but it goes back to even mindset. When I was originally writing, your point is, I witness your Your point is that generation, even 20 years ago, people did not think that this message was valuable. And now health and how in shape you are, are almost a measure of success. It's not just money anymore or boats or houses or projects. It's are you physically successful with the choices you are making? And I actually kind of love that pivot. Yeah. So it definitely has changed over time. So great. Yeah, it's like having a flat stomach in a way is like the new Rolex. Oh, right, right. And we're all wearing, not today, but sleeveless t-shirts so that we can see that we're actually working out our arms or whatever. I'd rather it be a physical measure of strength, which we know being physical strong is a measure of brain strength and just everything is so related. Sometimes medicine wants to put everybody in their silo, but it's one organism. It's one organization. Everybody's collaborating. Now, when you, because you're an orthopedic surgeon by trade, like, do you see differences when you are, you know, in the OR? Oh, let's talk about that. Comparing people who are fit, who've had a life of, you know, where they've embraced fitness and healthy habits as compared to people who are, you know, maybe have embraced those habits less so? I'm going to tell you from both a clinical, and I'll give you examples, orthopedic put metal and bones all the way down to the cellular level. Because for many years, I had a stem cell lab at the University of Pittsburgh. Activity, investing every day in our physical health has profound differences. So let me give you surgical examples. So when I do a rotator cuff repair, you know, it involves pulling over the muscles that lift our arm. I should do it this way so we don't block your camera. Lift our arms, pulling them back down to the bone where they once lived. So to do that, you have to make little holes, if you will, in the bone to put a little screw in to pull the muscle back, right? In people who have taken care of their bones and muscles, it's a little bit of manual labor for me because I tap it in and I'm tapping it in. For people who have just lived their lives, not been concerned with their skeletal longevity, it's like butter. Whoa. I could press it in with my finger. I need no tap. I need no hammer. And that's frightening because if with no effort I can push a screw into their bone, then think about what falling off a curb would mean to them. Or, you know, you're skiing and instead of just falling and getting back up, you shatter something. So at a very tissue level, you can see the difference. We see differences in recovery from people who come in with normal muscle mass, which is our aim is 50% of body weight is muscle, right? versus people who are skinny fat, meaning they look thin, but they've got no muscle mass, or just completely, here's a term I use a lot, osteosarco-obesity, which means they have bad bones, osteoporosis, low muscle mass, sarcopenia, and are obese. That triple whammy just sets you up not only for the musculoskeletal things I see, but for the metabolic things and the brain, right? So it's remarkable. But even down to the stem cell level, let me tell you about this. I once did an experiment where we were looking at the level of a protein called Clotho. Clotho, it's all over social media right now. It's a fascinating protein. We were looking at it several, about two decades ago. It's called the longevity protein. Every organ interacts with clotho in a positive way. And without it, in animal models, we find without clotho, very young animals, mice, will die old. They're chronologically young, but they're metabolically very old, right? So I wanted to see, okay, if we know that we can increase clotho levels with physical muscle contraction, with skeletal muscle contraction, let's prove it. So I took my master's athletes over 50, and I took a control group of sedentary young people in their 30s. And it wasn't surprising that my younger master's athletes, 50-ish, had the highest level of this longevity protein clotho in their bloodstreams. But what was surprising is that my 70 and above athletes had much higher levels of this longevity protein clotho than my sedentary 30-year-olds. So something as simple as skeletal muscle contraction changes us physiologically from the tissue level, like my example from rotator cuff, all the way down to the cellular level. I don't know how much more motivation we need. Amen. I mean, come on, people. So you can essentially cut the bones of a non-fit person like butter. They feel like butter when I'm working with them. It's a big problem. For instance, when someone falls down and breaks their hip, whether they're a man or a woman, if they have severe osteoporosis, which is poor bone health, it's hard to keep the metal in from just slicing right through. It's a big problem for orthopedic surgeons. And we've gotten around it technically, but it impacts healing. It impacts all things. Isn't that interesting? It's crazy. Yeah. There's no doubt you've heard me talk about creatine. creatine. It's one of the most well-researched and underrated supplements out there with evidence supporting everything from brain energy, metabolism, and mood to muscle recovery and strength. What I love about the Momentus 3 is that it bundles creatine with omega-3s and high-quality protein, three of the most evidence-backed foundational nutrients for overall health and performance. 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My, uh, my dad had his shoulder replaced, but I mean, he, he, he destroyed his rotator cuff by walking into a, uh, by accident into his, the sliding door on it. Oh, wow. He must have been walking fast. He was walking pretty fast. It was like his terrace and he, but he's, he's never, I mean, you know, I love my dad. My dad listens to the show. Hi dad. But yeah, he's, he's never, I'm trying to always trying to get him to exercise, to do anything that he can exercise wise, but he's a baby boomer. He doesn't exercise. Yeah. And he walked into this like sliding door, broke his, you know, his, and that like set him up for a replacement, needing a replacement. We call that healing with steel and thank God we can do it. But how amazing would have been for him never to have broken. Exactly. And the three months it takes to recover from that, for instance. Yeah. If muscle were a drug, how much would you prescribe for longevity? A gram per pound a day. I sure would. At a minimum. You talk about this a lot. The leucine threshold, high quality protein. Let's talk about it. Not just BS protein, right? I don't know that there's truly BS protein, but there's better and worse protein. Yeah, high quality. High quality protein. So tell us, in terms of a dose, how much protein should we be eating? And then I want to get into the lifestyle, like the exercise recommendation, but why is protein important? You know, protein, people don't realize that muscles are made of protein. 50% of bone is made of protein, right? And so people also don realize that our body prioritizes function Brain over everything right We must have energy for the brain We must have energy to move and to do the work that we do. If we are not feeding ourselves, our body's going to use what it has stored, whether it's our bone for mineral and protein, whether it's our muscle for protein. So why are we going to put ourselves behind the eight ball of normal aging in which we lose bone and muscle anyway by not feeding ourselves? I don't even understand that. It's like hating ourselves to not eat, right? And so we think we're loving ourselves, but the reality is unless we take some baseline levels of the basic macronutrients that we need, we're not serving our self-preservation goals. And so when I'm working with people, in the literature, I can defend 0.8 grams per pound. I prescribe for my orthopedic patients, my precision longevity patients, at least a gram per pound because we don't absorb it all, because we're not perfect. Some days we're going to get more, some days we're going to get less. And unless I see no downside to more protein than enough protein, right? Because with enough protein, one gram per ideal pound, that is high quality. That means meeting this leucine threshold of 2.5 grams, depending on your age, right? We are going to maximize muscle protein synthesis. We are going to restore what we use every day for daily functions without drawing on the storehouses we have, because that's what our body's going to do, is use the storehouses we have. Now, people say a lot of things to me when I'm taking care of them. And one of the first things I have people do is actually count because we completely underestimate what we're eating. We underestimate the calories we're eating and we overestimate how much macronutrients we think we're getting. Most people, including mostly the women I take care of will say, well, I'm probably getting enough. I'm like, well, let's count it. Let's make sure we're getting enough. because what I find is people are, women are getting 60 to 90 grams a day, which I don't know many 90 pound women. And if I do, I'm afraid that they're skinny fat, right? I'm afraid for them. Yeah. I bet many women aren't even getting that. You're probably right. I mean, I just, many that I've encountered on social media will assume that they eat two eggs in the morning. Oh, two eggs is 12 grams and eight grams of fat. Right. And so it's interesting you say that because the next thing people, women say to me is, that is so much food. I could never eat that much food until I just lay out. When you eat high quality protein, it's actually very low volume. And when I post about, here's what I eat in a day, it's not that much volume. People are surprised. And I mean, simple examples. I mean, you write books like this, but two thirds cup of green tea. yogurt is between 15 and 20 grams. That's a lot. And then you add something on top. But if we prioritize quality over volume of protein, yes, it's a lot to eat if you're going to get it in beans. It's four cups of beans. But if we're going to get it in a cup of egg whites and an omelet, it's not a very big volume. So I just find that it requires more education and less guessing and less just putting up these guardrails that mean nothing, right? Can we please investigate what you're actually eating? Takes a little bit of planning. You're worth the planning. Because as your listeners know, high quality protein space throughout the day adds to satiety. You're not freaking hungry all the time. So years ago when I was 47, when I first went through period, when I became conscious of perimenopause, I cut out sugar altogether. And I don't know why I chose the date I did, but I'm like, just one day, I'm like, I am done. It was right before Thanksgiving, which is a bad time to cut out sugar. But with cutting out sugar and being protein forward, I am no longer starving multiple times a day. Because, you know, I happen to wear a glucose monitor, and I know how steady my blood sugar is, and I know what makes it spike, which I try not to make it do, including things like the OR. My liver is pouring out glucose because it's so stressful. It's such high activity, which it's supposed to do, right? But I guess that's all to say that I find in my patients, people don't get enough protein. They just simply do not know what they're eating. So we count not to be data dependent, but just so you know, and that getting enough high quality protein, whey protein isolate, animal proteins, they all have different percentages of leucine, which is the critical amino acid for muscle building. Tell me if I'm wrong, because I know you know this, but whey protein an animal has 12, 10 to 12% of it is leucine, all the way down to vegetable proteins is about 6%. So it stands to reason you have to eat a lot more of those to get the same benefit. So it's okay to be a vegetarian. Of course. You just got to eat a lot more food to get the protein you need. No, you're 100% right. That's why sometimes you'll see on if you, I mean, literally do this. It's not dogma. We're not being dogmatic at all. You can go to any supplement store, Whole Foods, whatever, and you can compare, take two protein powders, like a plant-based protein powder and then a whey protein powder, assuming they both list out the amino acid content on each. And you'll see that when comparing, if you control for total grams of protein, like you take a 20 gram dose of whey protein and a 20 gram dose of plant protein, chances are you're going to see two grams of leucine in the whey protein, but you're going to see less leucine for the same 20 gram quote unquote dose of protein in the plant protein, you more likely than not are going to see less leucine. And therefore less downstream effects that you're really going for, right? Yeah. So you got to eat more of the protein of the plant protein to hit that same anabolic threshold. Exactly. Which isn't just important for building muscle, by the way, it's important for maintaining muscle. Of course. All right. Because remember going back to your body's going to take what it needs to maintain vital organs like your brain and your heart. And so it is interesting. And I think part of it is just a lack of education. I mean, even I'm sure you were involved with it, maybe, but all on top of the way that the food pyramid is now incredibly different than it was. And people didn't understand the last one or the first one, and then they didn't understand the plate. And now maybe they don't. It's just, let's educate ourselves, right? Let's, I admit that I don't know much about finance, but if my life depended on it, oh my God, I would become an expert, right? So I'm asking people in all genres of careers to this, your life does depend on this. Let's figure it out. It's so true. I love what you touched on earlier. You said evenly distributed throughout the day. I was reading this review and something stood out to me, blew my mind. It was a review by Don Lehman. And it pointed out that most adults in the United States, they get the majority of their protein in their last meal of the day. They start their days at dinner. They start their days maybe with 10 grams of protein. They'll have 20 grams of protein maybe at lunch. And then they save their big protein bolus for like dinner. And I hope that's not at eight o'clock before you go to bed at nine. That's generally it though. But it's like, it's, they skew their protein intake for like late in the day. It's not evenly distributed. What are the benefits of distributing it more evenly throughout the day? Well, when you reach your leucine threshold in a meal, then you will have enough to maintain muscle protein synthesis across the day. Number one. Number two, protein is a satiety factor. It digests longer. but, and I'm not a nutritionist, but high levels of protein acts like nature's GLP-1 in the gut, in the absorption, right? So you have this natural satiety. And so I'm not one of those people. I'm like a hobbit. I'm a two-breakfast person. I get up and I eat the yogurt and then a few hours later when I go, I eat an actual protein breakfast. When I didn't do that, let's take an example. When I didn't do that when I was 47, I would eat something, I don't even remember, at 10 o'clock I'm so starved that I can't work anymore. And my top brain, which happens in the morning before 2 p.m., it's just not as capable as it was. But with at least 30 grams in the morning. I'm not hungry again until around midday, right? And then after that, I am not hungry again until later. So my brain is not always obsessed with where I'm going to find food. And I realized that a lot of people have issues with food buzz and the constant thinking about it. But when you spread your protein out, because it is a natural GLP-1, it works like that and satiety, it helps with that buzz, not only that, but giving you the building blocks you need all across the day. And then you stop eating a few hours before you go to sleep so that your brain doesn't, your GI system doesn't work so hard so that you can recover and start again. Hmm. Quiet's the food noise. I love that. Yeah. This episode of the show is sponsored by function health. Cholesterol is one of those biomarkers that absolutely matters for heart health, but it's not the whole picture. A standard physical usually checks LDL cholesterol, but it often skips other important markers like ApoB, insulin, inflammation, and other indicators of metabolic health, things that can quietly drive risk long before problems show up. Something that always surprises me is that most people wait until they're once a year physical to get labs, and even then they're typically just getting a small slice of the information that could actually help with prevention. That's why I think Function Health is dope. 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So after about 30, when we're peaked bone, peaked muscle, although we can certainly build bone and muscle afterwards, but in our youth, we're like, okay, let's build the highest level of peak we can. Men and women will age at about 1% decline for a few years. and then men will continue this very slow decline. Women, and depending on what age this happens for them, as their ovaries age, and we have wild fluctuations in our estrogen, wild, and then ultimately no, our aging rapidly increases. Because estrogen is a hormone, not a sex hormone, but the hormone that controls so many bodily functions from our brain to our bones. And without it, we have rapid aging of our brains, of our hearts. Oh my God, if I just talk about the musculoskeletal system, losing three to 8% of our muscle mass, which then decreases the number of calories we burn in a steady state, which puts us behind the eight ball for almost everything, including developing metabolic disease. And bone, without getting in front of this in our late 30s, early 40s, we can lose from loss of estrogen alone, 15 to 20% of our bone density, which can end up in death. I don't want to sugarcoat this, you know, so we were talking and I wanted to introduce the way I'm thinking about this question and longevity for the first time this year. And that I think the real white space, the real gap in the way we're thinking about longevity for both men and women. Everybody, you, me, every content person, every author is telling people that mobility is medicine. You must move. Exercise is going to save your brain. It's going to save your heart. But what I see as an orthopedic surgeon is that unless we step in front of our skeletal longevity, movement as medicine is not accessible to us. Because when I suggest all the exercise things, or if I told you my mantra for my career is, by saving your mobility, I'm saving you from the ravages of chronic disease. I can tell people all I want, that you must move, you must exercise. And the responses I get for people in 50 men and women is, my knees hurt too much. I've got bone-on-bone arthritis. I've got every tendonitis you've ever heard of. I've fractured. So if we step backwards and talk about how we're aging and the earliest point that we start to see that, for men, I see them showing up with all these advanced itises, and it happens so often, like a young guy like you will come in and you'll say, I don't know what's going on, but I'm lifting the way I always lift, but my elbow has no point and it's a tendonitis, or my knees have tendonitis, or my hips. And when a man comes in with multiple tendon problems that they've never had, and they've always been robust, I am checking their testosterone before they walk out the door because this steady decline in testosterone men have can reach a point where even though if we measure it, the number might be, let's say, 400. The reference labs I use, the normal is between 250 and over 1,000 for men. So even in a guy comes in in his mid-40s or older who's feeling low energy, tendinitis everywhere. I check a testosterone and it might still be 400 or 500. But when you were in your early 30s, 40s, it might have been closer to 1000. So that delta means something to your musculoskeletal system. So for your guys listening, if that's happening to you, that would be the first musculoskeletal. Okay, we need to step in front of this and give your body everything it needs. For women, it starts as early as their perimenopause. I wrote this paper last year called the Musculoskeletal Syndrome of Menopause, which really talks about all the ways estrogen affects the skeletal longevity. We've already talked about muscle. We're going to lose muscle without estrogen. We're going to lose a lot of bone, but it has been known for a hundred years and we've done nothing about it. A hundred years, the first paper was published that when you lose your estrogen, you have more arthritis, which if your listeners have not heard this, cartilage is the smoother than ice end cap of every bone, which makes when you move your joints, you don't feel your joints, right? When that cartilage starts to wear away, like the tread on a tire goes bald, you get lots of inflammation and stiffness and pain until it's bone on bone. That rapidly increases for women after we lose our estrogen. Like that, we get highly inflamed. Our whole body hurts. You may have seen people talking about frozen shoulder. Out of nowhere, your shoulder won't move. Well, that's not a shoulder problem. That's an inflammation problem that happens when women lose their estrogen. Back discs start to degrade. Back pain is almost endemic in this country. For women, that's contributed to by estrogen. Down to the stem cell level that we used to study in my stem cell lab, estrogen is critical for the rejuvenation of stem cells. And all these tissues for women start to age long before they do for men. I don't see men showing up with these itises until they're in their 50s generally. For women, it can be in their early 40s. And when I say we have to step in front of skeletal longevity, I can tell people all I want to that you need to exercise, you need to jump, you need to lift weights heavy. But if your whole skeletal system is failing you, you don't have access to that, right? So I think we need to, and I'm going to do this because I'm the musculoskeletal doctor around here, step into this white space because you can't out-supplement, you can't out-gadget, you can't out-buyer marker longevity if your skeletal longevity is not keeping up with what we're recommending. Does that make sense? It makes total sense. So is there a way to come back from degenerated cartilage or is it like once it's gone, it's gone? We get one set. We get one set of cartilage, but there are many things we can do about it, right? We can know it could come and step in front of it and make our hormone optimization decision. We can know that our joint health is affected by our body weight and our muscle strength, right? When people come to me with arthritis, they're surprised that I don't stop at, here's an injection, the medical, the medical, or go get some surgery. In fact, I never start with that. We start with, we need to get you strong as a bull again, because the muscles cushion the impact. We need to help you unload your joint. Joint spare four, depending on who you read, four to seven times body weight. And so if we've gained 30 pounds, and that all fat no muscle right Then that up to 300 pounds of pressure against this very fragile tissue So we get strong we unload we anti Inflammation can be due to almost anything the terrible stuff we eat the stress in our lives If we've decided to put any kind of nicotine into our bodies, there's so many reasons we can be inflamed, but that's going to hurt your joints, right? And it's going to degrade your cartilage. So we go through all those lifestyle interventions to step in front of this before I ever talk about medical things. I am a huge fan, and I do it all the time, of using our own bodies to heal ourselves by using something like platelet-rich plasma. Platelets in your body are not only there to plug the holes when we cut ourselves shaving, but they contain all the growth factors our body uses to start healing. And so when we take that from the blood and put it in a joint, we initiate a huge anti-inflammatory effect. So those are all the ways we can step in front of this aging process where we began this conversation. But the best thing to do is recognize that this can happen and have a plan for it in our late 30s, our early 40s, right? There is no reason to wait like our parents did or baby boomers tend to do until you get there and then you're scrambling. You mentioned nicotine. What is vaping doing to our joints? Okay, we thought we were going to get away with something by not smoking, right? And you know what? I think it was a big deal when Richard Carmona, the 17th Surgeon General of this country, banned indoor smoking. It really stopped what we were seeing. I mean, doctors used to smoke in hospitals, for God's sakes. We used to have these places outside of hospitals called the smoke shack where patients could go out. I mean, thank God that stopped. But what took its place in many places is vaping because, oh, it's water vapor. It's not going to hurt you. But if it still contains nicotine and all the other chemical toxins, we know from solid research that is poison to bones. do not think you're getting away from anything. If we want healthy bones, we are not going to smoke and we're not going to vape. I mean, if you don't care, it's your life. My approach as a physician is I'm going to tell you what I know to be true from the science, from my experience of taking care of 100,000 people in my career, but you still have agency to choose. And you can choose to be healthy, vital, active, joyful, or you can choose to let time take its course and end up in my ER. It's your choice. Yeah, no, it's such a people, I think that there needs, there definitely needs to be more of a focus placed on prevention for so many people. Completely. I think when we're young, we, you know, we have the sense that we're all immortal, that, you know, these conditions that you hear about that make headlines are just like what happens to our parents or our grandparents, but nobody wants to receive that diagnosis. And when you do, I mean, that's the condition often that has begun simmering under the surface years, if not decades. Years ago. Well, and especially when it comes to bone, because I don't want anyone listening to think that these musculoskeletal declines start when you're 50 or 60 or 70. When it comes to bones, for instance, if we look across the lifespan, we reach peak bone density around 30. Let's just talk about women. We can talk about men, but it's less dire for men. Although 2 million men in this country have osteoporosis. Wow. I know. Well, let's talk about men first, then we'll talk about women. Men, because of the effect of testosterone on their bones, start with a higher peak bone density. So you have more to lose over time. There are two peaks or two incidences in a man's life when they have fractures that can affect their longevity. In their 50s, and that's usually when you have had a serious metabolic disease or an autoimmune disease, that's due to disease. For men who have not experienced those things, 70s, 80s, are the time when they show up in the ER with a hip fracture because they've lost enough bone. And for women, we reach a lower peak bone density than men just because we have XX chromosomes and not XYs the way we're made. But what people don't realize is that, and I know this because I do bone scans that tell bone density on everybody that comes into me. I have very young women in their late 20s and 30s with very poor bone density at a time when we are supposed to be peaking out. And when I think about it, I think, well, why is that happening? Well, maybe three reasons. Number one, we have generations of sedentary people that we've raised, right? We're, for every reason, we're sitting down a lot more than we ever did. And without impacting our bones, we're not going to grow the best bone we can. Number two, I thought we were done with this, but I don't, but now I see it reoccurring. We worship skinny, and women are indoctrinated with you have to be tiny, like my pinky, to be of value, or that's the only thing that's valuable. But when you don't build bone because you're not eating enough to have regular periods and ovulate, which is where we make our estrogen, you are not going to build bone. So that's the number two reason. And it scares me because I thought we were making our way out of this with being happy with our bodies as strong bodies. But I think we're going to have another wave. I'm never going to run out of fractures to take care of because of what we're seeing now. But number three, there are a group of young women who are just profound athletes, right? We've had Title IX for 54 years. Women have been in sports a very long time. But unless you refuel with something besides gummy worms and Dunkin' Donuts, right? We're not going to get enough energy to build our muscle and to build our bones. So young women can peak out very low. And then they pass into the fertility years, whether you choose to have children or not, women don't realize that to build a baby, you need between 500 and 1,000 grams of calcium a day, milligrams of calcium a day. If we're not eating enough, either because we're sick or we don't want to get fat when we're, your body is going to prioritize this baby. It's going to take it from your muscle and your bone such that there is an entity called the osteoporosis of pregnancy that leaves many women with spine fractures. Now, here's the good news. Our bodies know this is coming and is designed to rebuild our bone, but only if we find time to eat after we give birth. only if we refeed ourselves and take the months it takes to really restore our bodies to pre-pregnancy health, right? But then there's a second thing during the fertility years that can impact our skeletal longevity and therefore our overall longevity, and that is breastfeeding. Now, I'm a big proponent of breastfeeding. I breastfed my youngest child as long as she would tolerate it, but you have to eat. And I realize that sometimes women are just doing the best they can. They're latching on. I mean, it is, I've done this. It is not easy to do everything at once. But unless we're restoring the calcium that we need, we need about 500 milligrams of calcium to breastfeed a baby a day. We end up with even lower bone density, right? And then what happens? perimenopause without the role of estrogen, the balance between bone building and bone breakdown skews in favor of bone breakdown. And I've already said we can lose 15 to 20% of our bone density. Oh my gosh, this sets us up for what I see in my ERs with very old men and women of any age who break their femur, the big bones in our body, when you break your femur, which is your thigh bone, 70% of femur fractures, hip fractures are in women, 70%. So this bone progression I've talked to you about is real. 30% of the time, you will die in the first year, whether you're a man or a a woman from the complications of having such a major injury. 50% of the time, if you survive, you will not return to the independence you were before. And I don't want to see anybody you love or I love or people we, anybody in this situation. To not be in this situation, it's not that we start thinking about it the day before. We start thinking about it on this whole timeline that we started way back here in our late 20s and 30s. Because if we're going to prevent this, then we have to start here. It's very serious. Yeah. How important is vitamin K2? I remember reading a lot about K2 and osteoblasts and osteoclasts. It's a fascinating vitamin. Yeah. Vitamin D and K2 work in conjunction, not to build bone, but to aid the absorption of calcium from our diets. When I'm talking about nutrition for bone, and I never recommend that people take a calcium pill, a Tums, do not pop Tums to get to affect your bone. We need calcium from our diets. We need vitamin D and K2 working together to absorb enough calcium so that our body can then lay it back into the storehouse. because bone is, you know, it's structural. It holds up our muscles. It is the storehouse for all of our minerals. It is the incubator of our immune system. Fascinating, right? All of our immune cells, our T cells, B cells are made in our pelvis and long bones. It is a master communicator. It produces hormones that talk to muscle and fat and brain and gut. And so we can't afford to let our bones degrade. So I think of K2 as a partner with D to absorb more calcium. I love that. Yeah, there was a calcium, there was a big frenzy around calcium supplementation. I remember my mom would supplement with calcium for a while, but then headlines were made when a study found that calcium supplements by themselves were linked to an increased risk of like... Heart disease. Yeah. I don't know if those data continue to bear out, but calcium in its normal proportions that we find in food, in its normal being absorbed from the gut is better than just dumping a chemical load of calcium in. That makes sense, yeah. Like a super normal. Yeah, 500 milligrams is all our gut can absorb. Well, let's get it in mushrooms and bok choy and figs and dates and salmon with bones in it. Yeah. Dairy. What's one thing that everybody listening to this should do starting today in order to ensure that they stay off your operating table? Well, I think everybody in the country has gotten the muscle message. And I was talking this morning with someone. They're like, women are busy. They can't do everything. And I'm like, you're right. Of course you're right. I'm a busy woman like everybody else. So if you do one thing, you've got to learn to lift weights. But even strong women break. I've had plenty of strong women break. I mean, I typically show an example of one of my patients. She was 57. She was determined not to age like her mother, who aged frail and obese. She was going to do everything possible. So she lifted really heavy, but she didn't feed herself and she didn't optimize her hormones and she broke her hip at 57. Now we got her back. Thank God she's back in the gym, but even strong women break. So people have gotten the muscle message, but I need you to start jumping around and impacting your bones. Bones are stimulated to become stronger when you're jumping around and impacting them. As little as 20 jumps a day, it can be jumping up and down on the floor, hopping off the last step. It can be jump rope. I don't care. Jumping jacks. We just need to put a little mechanical force across our bones because our bones take that mechanical force and translate it into the chemical signal that tells the bone building cells, the osteoblasts, you got to lay down more bone. She's doing crazy stuff up there again. So let's jump around a little bit, but let's not forget something so simple that we can do it every day when we're brushing our teeth or we can get more sophisticated is balance and foot speed. Because you can be strong, but if you fall, if you trip and fall, which I see all the time, that's when you break. Very rarely do people break and then fall, meaning bone is so brittle, it breaks and then you fall. Mostly you fall and then you break. And then if it's your hip, 30% of the time you die. Let's not go there. No, so fall resilience. Fall resilience. And you get there from retraining your balance, which is simple, tree pose, standing on one leg. So many ways. I post about it all the time. And then here's another one that I add for people that I work with is foot speed, right? We lose type two muscle fibers, which is the power fibers first before the endurance fibers. And so that slows us down. Our reaction speed goes down. Well, to prevent falls, we have to have a little bit of reaction speed, right? So I actually have protocols to train people on foot speed. They're really simple, just retraining those neuromuscular pathways so that we react faster. So if we do trip, we can catch ourselves without landing hard and breaking something. That's so, yeah, that's incredible. I mean, I see people doing that at the gym sometimes. Like you said, those like ladder tracks. Those little ladders. You can do it sitting at your desk like this. And people think I'm saying, oh, here's some more things to add on to your day. But you can retrain your balance taking phone calls, standing at the sink, brushing your teeth. You can do foot speed sitting at your desk. These are not extra things. These are things you can just incorporate, right? To lift weights, you kind of got to go somewhere, where there's some weights, but to do the balance, range of motion, foot speed, you can do them anywhere. Yeah. I mean, we do this stuff as kids. Oh my gosh. Let's be children again. Yeah. They had it right. And playing is great for our brains. The complex movements, the thinking while we're running, playing is great for your brains. Man. What is there a, what's the most preventable orthopedic surgery that you still see far too often? Let's see. Well, a very, very, very unfortunately common injury in orthopedic surgery, I'm a sports surgeon, is an ACL tear, right? So in our knees, we have at least five big ligamentous complexes. The ligaments are the ropes, if you will, that hold our bones together. In the middle of our knee, between our thigh bone, our femur and our tibia, our shin bone, are two giant ligament complexes. They're about the size of my finger. The ACL prevents your tibia from sliding forward. Your PCL prevents your tibia from sliding back. Both important, but athletes tear their ACLs all the time. The position that athletes tear it in is almost always the same. They're on one leg. their butt core and hips are not strong enough to keep them balanced. They drop the opposite hip and the knee that tears goes like this. I know it's a predictable, you can see it with every replay. Hip drops, goes like this, and it tears the ACL. Now, preventing that is something we know how to do. It has to do with butt core and hip strength, glute core and hip strength. It has to do with balance, retraining neuromuscular pathways. For women, it has to do with our hormonal status. And it seems like there's not enough research about this, but in orthopedic sports, we've known about this a very long time. And yet 70% of all ACL tears are in women. And depending on the sport, very high incidence. Are you talking just professional sports? No, no, all sports. All sports. Yeah. And so we know why, or we know a lot of things about why our techniques have improved a lot for repairing, but wouldn't it be amazing to never get there? And to, I find a lot of youth sports, don't get me started on youth sports. I take care of a lot of young athletes. With the year round play we are doing in choosing one sport early, historically, the best athletes in the world didn't play only that sport their whole lives. They were multi-sport athletes. They're just great athletes, right? My husband was a pro athlete, and he played all sports until he chose hockey as his pro sport, right? That builds a whole body. But when we insist children specialize early, and then we only teach them the skills of the sport, not to become an athlete, they are so susceptible to injury. And ACL being an injury, it's an adult injury. You only get one ACL. And even though we can reconstruct it, it's never as good as the one that you were born with. So that was a very long answer, but you get me down a pathway of being an orthopedic sports surgeon. And that's part of what skeletal longevity is about, right? Because if we take out your knee cartilage as a 20-year-old football lineman, I mean, I was the head doctor for the football team at the university in Pittsburgh, and some of my O-line and D-line were very young men, but they had destroyed cartilage. That is an old knee, or that is an old spine. And then you get to be 40, and we're telling you you need to exercise all the time so they don't get diabetes, but we've got no skeletal longevity. So it's not always due to trauma, but you see where I'm going with, if we want the options, the access to true longevity, which all of us are telling you requires exercise and mobility well then we have to not take for granted what enables us to move like our bones our tendons our ligaments our muscle I mean come on people Our muscle without our bones, tendons, and ligaments, it's just a heaping pile of metabolic tissue, right? Everybody has to work together. It's a heaping pile of steak. That's right. It's steak on a counter. Human steak. Yeah. Do you operate on the body like toes to top of the head? You know, in orthopedics, you can do everything, but most of us that do it at a high level, we specialize. So I'm specialized in sports, which means I did extra training. And so I mainly operate on the shoulders, hips, and knees. I was a hip arthroscopist in the early stages of hip arthroscopy. So we divide because when you're a true expert at something, you can't be good at everything, right? So I never do hands. I never do feet. I do not do elbows, but shoulders, hips, and knees. You need enough reps, like everything, to become a true expert. Wow. Spine, do you ever do spine? Never spine. Spine is of itself its own subspecialty and should be. It's pretty dangerous. I had spine surgery a year ago. Oh, yeah. No, less than a year ago. Just about a year ago, 11 months ago. Yeah. On your lumbar spine? Lumbar, yeah. Yeah. How do you feel? artificial disc replacement oh that's interesting now see you want an expert at that you don't want a sports surgeon you want a spine surgeon yeah yeah no i had a neurosurgeon who um yeah went in and replaced my l5s1 disc amazing with a titanium yes a disc disc yeah amen will he let you lift heavy now or he said okay what did he say no limitations that's amazing right yeah i mean he said don't be stupid like well you know that's good advice yeah that's sometimes the best advice It is. Don't be an idiot. Harness the wisdom of your age. Yeah. No, I'm not going to do the things that I know put me at risk because, you know, we all have different. I mean, you know better than me, but like we all have different body mechanics. Exactly. You know, like I think one of the problems with like weightlifting now, I mean, it's amazing that more and more people are lifting weights, but there's this you might be inclined to think based on, you know, looking at an Instagram like influencers profile that everybody's meant to deadlift heavy or everybody's meant to back squat heavy. And I don't know. I mean, I'm not an expert, but I don't believe that to be true. I think like everybody has different mechanics and, you know, an exercise that might work really well for your body under heavy, heavy load might not work well for me. Thank God there's like a million ways to do a squat or get at the same range of muscles or a deadlift. There's many ways to work your posterior chain. There's many ways. Now, I like powerlifting, but I realized that not everybody loves powerlifting. So, or the kind of loads that my body needs, which is not as high as other people's needs, right? But what I don't want people to think is that they're fragile. Our bodies are designed to adapt and to work hard. And so if you fail, if you're lifting weights and you choose to lift the lightest possible weight so that you have to fail after 30 reps, that is not time wasted. It's just a lot of time, right? The same with hypertrophy. If you're doing rep sets of 10 to 15 and you fail towards 15, that is not wasted time. That's great time, right? There are so many ways to harness the power of this musculoskeletal system. What I just don't want is people thinking, oh, I'm too old or too frail and using it as an excuse because we know the body will adapt at any age. And so you're powerlifting? Like you're lifting heavy? I do lift heavy. I love it. Well, and you know what? I started lifting heavy in high school. Here's why. I'm not surprised. I would not be denied. But so when I was in high school, girls didn't lift, but I was in the weight room one day and the football team was there and the coach was giving out shirts to the football team that said the 200 Club. And I'm like, I want a shirt. He's like, oh, well. what are you doing here? Number one. But number two, if you squat 200 pounds, I will give you a shirt. So I worked all summer to get that, but I got a 200 pound shirt. So I learned to lift like that when I was young, but then I became a cardio queen. I did a lot of marathons. I was training for triathlon, right? I never really did a triathlon. I had a baby instead, but I was on that cardio path. But it wasn't until I went through perimenopause at 47, which I thought was going to kill me, and realized that unless I rebuilt my muscle in a powerful way, that I was going to end up in somebody's operating room table. So I went back to what I had learned about powerlifting. But 30 years later, I didn't remember technique. And so I think any type of lifting requires meticulous technique. And so I hired a strength and conditioning coach, not just somebody who thought they knew what they were doing, but somebody who had, it's called a CSCS. It's the highest strength conditioning credential you can have to teach me how to power lift. So yes, I do those things, but I don't want you to think for one minute that, you know, I'm lifting 300 pounds or something. But that's interesting you say that. because what keeps me going is actually not knowing that I'm going to stay off my own operating room table because I just had a DEXA scan. I know my bones are good. It's not that. It's because every day I do it, I walk off the gym floor and I feel like a badass today. It's today's motivation that keeps me going back, not this distant future thing because who knows, right? Isn't that interesting? Do you feel that way? It's amazing. Yeah, I do. I totally do. I I feel like it's become such a part of my identity. I just love, yeah, I love a good workout. I love a good pump. I'm not, I don't chase strength because then I would get, I would probably fixate too much on the numbers and I don't want to injure myself. I have certain limitations given my spine. But all that being said, I mean, relative to like, I think many other people probably like, my limitations are very, like I have very few limitations and um yeah and so I take a I take a more bodybuilding approach but I um as opposed to power lifting but I still like I dedicate a lot of my mental energy to uh to resistance training effectively to doing it effectively to making sure that I'm you know that I'm I'm there with a goal I want to provide a very specific stimulus to my body like i'm not just in there doing like you're not wasting your time no i'm not trying to waste my time i mean i love being in the gym like i could be in there in the gym for a while but that's not the goal the goal is to to to get an effective workout yeah which i get that yeah yeah and i love it i too i walk off the floor and i feel like badass yeah i've achieved something yeah but what about like i definitely see a lot of people especially like of an older generation like that are in the gym and they're kind of just like doing whatever like they're doing whatever and like it's amazing if you're in the gym. Like if you're there, like I'm like trying desperately to get my dad to just go to the gym. Yeah. Right. To do anything. Right. But like I still like when you're there, wouldn't you say it's worth kind of knowing what it is that you're doing to some degree? Oh, it's a skill working out as a skill. We're not born known how to work out. You know what we're born knowing how to do walk. I mean, it's our first skill, right? We are not. We are not born knowing body mechanics. We are not born knowing how not to hurt ourselves. And therefore, lots of people end up in my clinic, shoulder problems because they've insisted on military pressing twice. I mean, really people. So I think it's worthy investment. I tease people I take care of. I'm like, don't get another purse. Don't get a new vacuum cleaner. Hire a few trainer sessions so someone can actually show you the body mechanics, how to stack your joints, how to hinge at your waist or how to connect your core to your pelvis so that you're not getting hurt all the time. Because the number one reason people give up exercise once they've started, number one, number two, besides lack of discipline, is they get hurt. And then they get out of the habit. And they think that because one limb is hurt that the other three don't work. That's not true. So I think it's worth the time and investment. Yeah. I see a lot of people like performing exercises that like that, like, if you were just to like, think about a little bit, like, like in terms of physics and whatever, you probably understand that there was, there's a more efficient way to achieve what it is that you're doing. You know, just as an example, like I see a lot of people sometimes with like with dumbbells and they're like rotating their shoulders out and I'm like, gravity goes down. gravity is pulling the weight down, but you're rotating your shoulders out. Like it might be helpful for that exercise that you're doing to maybe use like a cable or something. Yes, or a band. Or a band. I think you have to know what you're working because this is working your infraspinatus, a tiny, tiny little muscle that organizes your shoulder. That is best work with bands or light weights laying on your side. So you're working against gravity, not necessarily this or were they really trying with that to get at their rhomboids or their their back somehow that might not be the best way because if you're trying to get to your upper back maybe true rows are better so i feel like there's so many exercises you can do there are whole books of like 300 ways to lift blah blah blah maybe we need a little instruction a little instruction yeah or or don't be shy like ask the guy in the gym that looks like they know what they're doing It makes a living at it or something. Yeah. Like when people come up to it, it doesn't happen often, but like, you know, on the odd occasion and once in a blue moon that somebody asks me for my advice, like in the gym, I'm more than happy. Like, I love it. That's so nice. Being asked and to provide like a little bit of instruction, you know, like gyms are some of the most welcoming environments. And then also when it comes to training, knowing the proper intensity, right? I think all of these questions go back to why. Why are you there? What are you trying to achieve? When I go to the gym at my age, I am trying to achieve strength and power. To achieve strength in my muscles and power, strength you get with heavier weights, fewer reps, versus hypertrophy, versus endurance. And power comes from varying speed. So I lift like that. But if I were trying to be most concerned about hypertrophy and growing bigger muscles, then I would do 10 to 15 reps, not lower reps. And so you have to ask yourself why. Why are you working only your upper body? I have people who never work their lower body because it looks better. It looks better in a t-shirt to upper body. And I have to remind them that longevity depends on the muscles below your belly button, please. right you have to know your why for everything not just throw it together because then you're wasting your time maybe yeah amen i mean some activities better than none of course but of course given and if you're there yeah it's great kudos to you but it also it pays to like invest a little bit into to figure out why you're there acquiring some knowledge um talk to me about unbreakable so i wrote this book unbreakable which was released in august and i think the world was ready for it because it did very well. It was instantly on the New York Times and the London Times bestseller list. I frame it as the first longevity book from the point of view of women. Remember, we began this conversation that men and women age differently. And so I talk a lot about the role of estrogen, progesterone, and testosterone on women's aging process. I tell stories of my own story, my patient stories of women going in through perimenopause and really reframing the aging process. Because when people close the back cover of the book, my goal is not merely that they've learned how to exercise in a safe way or to eat or the framework, which I call FACE for working out in midlife. when they close the back cover of the book, I hope they walk away with a hope that they've never had, that they know that they do not have to go from the vitality of youth down a slippery slope to frailty into the ER we've been talking about, but that by investing every day in a smart way and educating yourselves, you can be healthy, vital, active, joyful, long into the foreseeable future. That is what I want people to walk away with. And so in Unbreakable, in every section of the book, there are three sections, I spend a lot of time on mindset and on setting goals based on your values, not on some random, I'm going to lose 30 pounds goal, but what do you really value? So I value, just using myself, I value independence. I value getting to do what I want to do when I want to do it. I will ask for help, but only when I want to. I don't want to be stuck, right? Well, if I value that, then my goal will be related to that value, for instance, or I value relationships. And so the first section about mindset talks about setting goals based on values, not just randomly. But then we get later talking about how aging is not for sissies. It is hard, right? But we can build mental and physical resilience to deal with that. And how do we build mental resilience. Well, the good thing is that part of resilience as a whole, if we know about Dr. Duckworth's work on grit, that is just keep going, you keep going, you never stop. There's another portion called hardiness that I talk about in Unbreakable. Hardiness can be trained like a muscle. How do we get our brain to believe and be more hardy so that when it gets tough, we just don't give up, right? Sandwiches between that, Unbreakable talks about the real time bombs of aging. There are real biologic functions that happen. And then I answer those time bombs by teaching you the shields that are going to maintain your skeletal longevity. And then at the end of the book, we talk about all the amazing performance things that I've gotten to take care of pro athletes with. And then finally, we end with once you've gotten all this down, Then we'll talk about the gadgets, the new horizons, the exploratory things that are coming up for us in terms of longevity. So it's gone over really well. People end up very hopeful. They're posting all the time and tagging me about they're doing the lifting, the jumping, the things they never thought they could do. Because now they have a model that they can look to, an example, not me, but the science and the vision that we can age in a different way. we do not have to become frail. We can age with power. I love that. Are there any gadgets or even just like tools that you recommend, not just for your patients, but for people to just have around the house? I think we have to have access to resistance of some kind. So if you don't want to go to a gym, if you can't have enough weight in your house, then you can buy really heavy bands. You have to have some way to provide your body with resistance at home. I think that there are a lot of great data about the value of red light therapy. I don't know the best machine because some of it penetrates, some of it doesn't, depending how close you sit to it. I think there's a lot of great data about dry sauna that's hot enough, right? It has to be very hot to stimulate heat shock proteins, right? So, but those are all more gadgety things. what happens is because i'm still a clinician in both the orthopedic space and the longevity space people will come to me and want to skip ahead to all the fascinating longevity stuff that's going on but they come to me with health that's fine i feel fine i'm getting through my day and so i never skip to the longevity things i'm never gonna even talk about peptides with them until we've gone from fine to optimized. And when you are truly optimized, which doesn't take that long, if you are really invested in it, then I'll put in all the peak performance things that I know work because we've taken care of pro athletes my entire career. Then when you do that, and if you still feel like there's more road to travel, okay, let's do that. But skipping from fine to gadgeting out, that's just not the way the body works, right? So there are great things. I mean, I could name power plates and all kinds of gadgets, but until we are optimized, you're going to have to find another doctor to treat you that way. No, I love that. Well, you're providing a real service for people. So thank you for doing what you do. Thank you for writing Unbreakable. I know you put out tons of content on social media. So yeah, thank you for being such an empowering voice in the space. Thanks for giving me time. Of course. Where can listeners pick up your book? Where can they find you on socials? So on social, I am every day on Instagram at Dr. Vonder Wright, D-R Vonder Wright. And then I post a lot of links so you can get other free material from me there. Unbreakable is everywhere. Just go online, go to a bookstore. It's there to be had. Amazing. The last question that gets asked to everybody on the show, what does living a genius life mean to you? I think living a genius life is knowing yourself well enough, taking the time to know yourself well enough to know what you value and to work towards the goals that relate to that value. Not being a random person. That is a genius life. Living in alignment with your values. Wow. I love it. Well, thank you, Dr. Vonda Wright. Thanks for having me. Thank you guys for listening. Share this episode with friends and loved ones that may benefit from it. And sending love. I'll catch you on the next episode. Peace. Beinated atMO patients.