Habits and Hustle

Episode 525: Dr. Vonda Wright: Fitness Over 40 and the Strength Habits That Prevent Physical Decline

87 min
Feb 3, 20264 months ago
Listen to Episode
Summary

Dr. Vonda Wright, an orthopedic sports surgeon and researcher, discusses how physical decline is largely preventable through strength training, jumping, and consistent movement rather than inevitable aging. She challenges myths about running destroying knees, explains why the critical decade for health investment is 35-45, and provides evidence-based guidance on muscle preservation, bone density, and longevity strategies for both men and women.

Insights
  • Physical decline is primarily driven by sedentary lifestyle, not biological aging—active 70-year-olds retain nearly identical muscle architecture to active 40-year-olds
  • The 'critical decade' of 35-45 is when women should prioritize strength training due to hormonal changes and remaining physiological reserve before menopause
  • Running itself doesn't cause arthritis; weak glutes and poor movement patterns do—cross-training and strength work are essential for runners
  • Bones are metabolic endocrine organs that communicate with muscle, fat, and brain; jumping 20 times daily with 4x body weight impact is critical for bone density
  • GLP-1 medications can be useful tools for metabolic management but must be paired with adequate protein intake and strength training to preserve muscle mass
Trends
Longevity and anti-aging have shifted from niche to mainstream—aging is now positioned as optimizable rather than inevitableWomen-specific health research and messaging is gaining prominence as awareness grows that women are not 'small men' physiologicallyStrength training and resistance exercise are being repositioned as primary health interventions, not secondary to cardioSkepticism toward unproven peptides and biohacking supplements is growing among credentialed practitioners despite consumer enthusiasmMetabolic flexibility and base-rate training concepts are entering mainstream fitness discourse beyond elite athlete circlesBoard certification and credential verification are becoming consumer-facing differentiators in the longevity medicine spaceMenopause and perimenopause are being reframed as optimization opportunities rather than decline periodsMovement snacking and non-exercise activity thermogenesis (NEAT) are gaining recognition as critical health levers
Topics
Musculoskeletal aging and muscle stem cell rejuvenationCritical decade framework (ages 35-45) for health interventionStrength training for women over 40Bone density preservation through impact exercise and jumpingRunner injury prevention and glute activationPerimenopause and menopause hormone optimizationGLP-1 medications and body composition managementSenescent cells and fisetin supplementationNAD+ precursors (NMN vs NR) for cellular energyPeptide sourcing and safety concerns (BPC-157, copper peptides)Base-rate training and metabolic flexibilitySingle-leg strength training and proprioceptionWeighted vests for workload increaseBoard certification standards in medical practiceCalorie and macronutrient tracking for awareness
Companies
University of Pittsburgh
Dr. Wright's research group (PRIMA) conducted 15-year studies on masters athletes and muscle retention
University of Chicago
Medical school Dr. Wright attended, ranked in top 10 medical schools at the time
Rush University
Chicago nursing program where Dr. Wright earned bachelor's and master's degrees in nursing in 3 years
Genfinity
Company that tests intracellular NAD+ levels to measure effectiveness of NAD+ supplementation
Momentous
Supplement brand providing protein, creatine, and omega-3 products featured in episode sponsorship
Rho Nutrition
Liposomal glutathione supplement brand featured in episode sponsorship
People
Dr. Vonda Wright
Orthopedic sports surgeon, researcher on musculoskeletal aging, author of 'Unbreakable,' practicing physician
Stacey Sims
Exercise physiologist known for research on women's physiology and the tagline 'women are not little men'
Joe De Sena
Spartan Race founder and neighbor of Dr. Wright; challenges her to athletic competitions and death camp activities
Courtney De Sena
Wife of Joe De Sena; watches children at summer camps with Dr. Wright
Quotes
"Muscle is nature's spanks."
Dr. Vonda WrightMid-episode
"The inevitability of slowing down is what happens when you're either injured in your cartilage gets ripped off your bones as a young athlete or you're just too friggin sedentary."
Dr. Vonda WrightEarly-mid episode
"If your goal is endurance, okay, but that's not my goal at this age, my goal is strength and power."
Dr. Vonda WrightMid-episode
"I am the orthopedic surgeon that meets you in the emergency room when you have lost all your muscle mass, when you have lost all your bone density because you've starved yourself or you're not lifting or you're not jumping."
Dr. Vonda WrightLate episode
"A body in motion stays in motion. That's correct. It's totally accurate. The physics of it is totally accurate."
Dr. Vonda WrightEarly episode
Full Transcript
I got his Tony Robbins you're listening to Habits in Hustle, Crush It. His joint pain, muscle loss and slowing down really just part of getting older, I should hope not. In this Habits in Hustle episode, I'm joined by orthopedic sports surgeon Dr. Vonder Wright to get real about what actually drives physical decline and why the body's critical decade sits between mid-30s and mid-40s. We also get into why running doesn't destroy your knees, why real performance decline happens much later than we've been led to believe, and why muscle is about survival and capability, not aesthetics or vanity. If you care about staying strong, independent and physically capable as you get older, this episode will challenge how you think about training and what actually matters. So sit tight and stay tuned. All right, you guys, I have a very special guest. I always say we have a very special guest, but this time I'm not holding with this time. No, but I'm really excited about you. We have Dr. Vonder Wright on the podcast today. Her new book is called Unbreakable, New Ish. New Ish? A woman is guided to aging with power, but it's actually not just a woman's guide, to be honest. It should actually be called a guide to aging with power, but we'll get into that. We've been trying to have Dr. Vonder on for a while, but the schedules were not really coinciding, but we are so happy to have you. So thank you for being on Habits and Hussle. Thanks for having me. Oh gosh, it's a real pleasure. What we were saying before we even started, which I find to be, it's actually kind of sad that I'm so impressed by this, but you are a practicing doctor. So many people sit in the chair that you're in right now and they don't practice. They've stopped practicing many years ago and they kind of just do the media stuff. And when I actually meet somebody who does the job that they are talking about day to day, it's a breath of fresh air. You're like, whoa. Yeah, it really is actually. So I mean, can you kind of just kind of go back to who you are, what you're kind of just a little bit of your journey and what kind of brings you here today? So you're right. I am a practicing orthopedic sports surgeon. And so my entire career, I've gotten to take care of athletes and active people of all ages and skill levels. And while doing that, and so the surgery I do every Wednesday, I did it last Wednesday, I'll do it next Wednesday. Just one surgery? No, no, no, multiple days. A full day. Yeah. Okay. So you know, big surgeries through teeny tiny apertures. In fact, listen to this. When I do knee surgery now, most of my knee surgery is done through needles. We don't even cut people anymore. The cameras we use, the high definition cameras are on wires. And so it just takes going in through a needle. So what it does for people, like you hurt your knee and it's clicking and painful and we go, we take out the little part that's hurting you. You will be walking out of the hospital. You could have been awake during the surgery if you wanted. Most people want to be a little sedated, but you will need no narcotics. And your knee isn't swollen up from all of the fluid that we use to do regular arthroscopy. So this kind of high-tech needle scoping that I do is so good for people. And so that, see how excited I get about surgery. I've been doing 25 years. But 25 years. Yeah, I've been a surgeon 25 years. And then what's interesting, so you know, sports surgeries, what I do, but my research and thus writing a book like this has always been about musculoskeletal aging. From the laboratory where we were looking at muscle stem cells and how to make them rejuvenate to what's the best treatment to keep you in your own joints and not have to send you off for a metal joint. So that's always been my research focus. But about 13, 14 years ago, I really added this third bubble to this Venn diagram of me of taking care of the whole woman. Now, it doesn't mean I don't take care of men. I still take care of men and women athletes, but really focusing on how women age and what makes us different because men and women are different down to a cellular level. You know, do you remember that book, Men are for Mars, Women are for Venus? Yeah, about how we respond to things to a cellular level. That's true. See, that's interesting. Stacey Sims, I'm sure you know who she is. She has this tagline that got super famous in viral, like, you know, women are not little men, not the whole men, which is interesting because we've been kind of been treated like small men or whole, you know, how we get treated with even like the kind of exercise and workouts we do, what we eat and how even I got all these questions, but the cold plunge and all the things. And I love to get your perspective. Well, I find so interesting about you though when I really did a deep dive was, yes, you do all this orthopedics like your surgeon, but you used to be a cancer doctor. I was a cancer nurse. I cancer nurse. That's why I meant a cancer nurse. And then you went back to medical school, like 28 or something. At a late age, isn't that interesting? Yes. And I find that I found that to be really interesting. So what made you like, can you talk? I'm just, I'm just really curious. I want to go back. Let's go back. How did you go from being a cancer nurse and then kind of give it to the surgeon? Yeah. And by the way, that's like 12 years extra of school, isn't it? Oh my God. It sure is. Yeah. Thank you for noticing. It was a long time. Yeah. But you know what I think, would I do it again? If I could do what I do now, sure, I do it again because I'm very happy doing what I do now. But so I got out of college and with one of those really useful degrees like biology. And thank God there was a nursing shortage. So there's a university in Chicago where I'm from called, it's called Rush University now. It's called Rush Presbyterian St. Luke's, whereas if you had a legitimate college degree in three years, you could study really hard and get a bachelor's degree in nursing and a master's degree in three years. So I was very young. I was 23 years old. I had the energy to go to school all day, sleep in the library and you know, go work on a floor at night. So in three years, I got a bachelor's degree in nursing and then became a cancer nurse. And so then my job, and I love that you're asking me to tell this story because you cannot be a 23 year old young woman, treating women in the struggle of their lives. At that time, cancer care was all done in the hospital, not very much outpatient like it is now. Every month for six months, a woman would come in and get her chemotherapy. She would be in the hospital for a week and it was a model of care at that time called primary nursing, meaning if I was your nurse for the first month, you were there. I was your nurse every month. You were there. And so you can envision how over a six month process where I am your primary caregiver and you are in the struggle of your life, the influence that kind of relationship would have on a young woman. Absolutely. And so, you know, I saw many women leave the hospital victorious and live full lives. And I saw many women never leave the hospital because it was just not to be for them. But it taught me so much about the worth of a woman and how strong she is. And the fact that you're just trying to be normal so all night long, we're shopping on QVC together as I'm hanging your Kibo. She's clicking the, she's doing whatever she would normally do, right? Wow. But you know what it did? It means that in my current house, I may or may not have replaced the other ladies' curtains because sometimes things don't matter to me. Right. No, exactly. Since I've seen women dying in my hands and I just think sometimes there's something more important to think about. Right. So you're more like, so you've always, well, obviously you're very compassionate and empathetic. I mean, people don't can't do that job, especially at that age. Yeah. And when you speak in general, you can tell you actually genuinely care. Sometimes I cry. Don't make me cry. Okay. I'll try not to. Okay. But I mean, that's not, that's, but that's what I'm saying. Like you obviously have a big heart. Yeah. You can't do a job like that and not care and not care. Yeah. So what made you stop doing that? Right. Good question. And then go into the rest of the stuff. So I was really young, but I was, I learned really quickly. And so after about three years on the floor, I was promoted to help run the Rush Cancer Institute. And about four years into that, I realized that I learned what I was going to learn. And I was only 26 years old or something. So I started thinking, what am I going to do the rest of my life? And I could go into pure research and spend my life in a laboratory. But I can't do that because I need to take care of people. Or I could have gone into business. Business was hiring nurses all the time. But I can't do that because I need to take care of people. And so medical school allowed me to do good research and take care of people. And so I went back to the classes I needed and then thankfully got into the University of Chicago, which is a really great medical school. So you went, by the way, that's what you're kind of like always, it's one of the best. Yeah, it's one of the best. Yeah. If not the best. I don't know if it's the best, but it's, at the time it was in the top 10 medical school. What's bad medical school? I mean, by the way, people think always a hardware that is, that's like, really good school. I think it's rank number one, isn't it? I don't know. I don't want to misspeak. Certainly is a really good medical school. And I feel so thankful and fortunate to have been to go there because, you know, I'm used to being a smart gal, but I go to University of Chicago and all these kids are so freaking smart. Yeah. Amazing. So I just soaked it all in. But it becomes very apparent in medical school who's going to become a surgeon and who's going to become a medical doctor because we think differently. Really? Yes. Medical doctors in general, such a gross generalization. But in general, people go into medicine fields, absorb data differently. They process it differently. They make decisions over a longer period of time surgeons. We assimilate data quickly. We make decisions quickly. We activate the decisions quickly because we've got to go to the OR. So we're decisive. We're decisive. We're decisive. We just process data differently. But thank God for the medical doctors, right? Thank God that they're the assimilators. We make quick decisions. And I'm that. I assimilate data. I make a decision. And then I'm thankfully very good with my hands. So it all fit together for me. So then, okay. So then because at your book, I was kind of thinking at the beginning, it could be for anybody because it was a lot of the things that you talk about. But do you specialize in women then? Like do you operate only on women? You operate on everybody. So what made you kind of write a book that was kind of more, because for women? And even like get into this path of like writing books and doing speaking. Like if you were, you were obviously a very successful surgeon. What kind of made you then kind of go this direction? So with my research on musculoskeletal aging, when I got out of my fellowship in the early 2000s, I realized. But was there a hold on? Was there a pivotal moment where you're like, you know what? I really need to like do deep dive on this muscular aging situation. Like just be happy to you or something that you know or... I think it happened because I realized that there was nobody studying it. Oh, okay. That I saw in my own life that my dad, who's 86 now, I cannot remember a day in my life where he was not out running. He's an endurance athlete. Right. And as he aged, I just was at races with him. And in the, I tell this story that when I was a child, it was safe enough in Kansas where we had a farm. He could just take me to a five K, leave me by the flag pole and go off from the race and come back. And then there was this lady in my town who was so frigging old. We would all wait for her to come in from this race and anticipate her coming. And then we would cheer her on only to find out as an adult that her name is Millie. Millie was 60 years old, which is so not old these days. Wow. But when I was a child in the 70s, you could not fathom old people being athletic, right? That's true. And so as then I saw my dad aging and I realized nobody was answering these questions I thought I have got. So there was this myth in society that aging is this inevitable decline from vitality to frailty and there's nothing you can do about it. And in the back of my mind, I knew about Millie and I saw my dad and on the back can't be true. And so if I did research that took the variable of sedentary living, which is the real killer, if I took that variable away, what were we capable of? And so my research group and I, my research group at University of Pittsburgh was called Prima, the Performance and Research Initiative for Masters athletes, so 40 and over people. We found over a series of 15 years of research that you can retain your muscle mass and there's a very famous picture on the internet. People pop it up all the time at the three that look like stakes, but that's my research. Nobody even cites me anymore. Can you talk about that? Because I think some people probably don't know. I saw it. Yeah. So we answered that. I'll talk about it. We answered that research. Can you retain your muscle mass? Yes. Can you retain your bone? Yes. Can you, at what age do we really slow down? I looked at race times and it's mid 70s. It's not 50. It's mid 70s. What age? What age do we really slow down? And the answer is in your 70s? Yes. I can explain that study too. Because people think at 50 when hallmarks sends out the rest in peace cards that life is over, the reality is that for people who are chronically active, our study found that there is less than 2% decline in eye studied runners from 100 meters to 10,000 meters. And I looked at their racing times. And these are all competing athletes in the national senior games. So you have to be 15 over to compete in these games. And you have to have won your state games to be at the national level. So what I found was between 50 and mid 70s, you declined in your time less than 2% a year. So that means that the guy who won the mile race in my study, one of them, just a random 50 year old, won it in 5 minutes and 34 seconds. The 70 year old who won his mile race won it in 7 minutes. So he's not winning it in 15 minutes. He's winning it in 7 minutes, which is fast, even for a 40 year old person, right? So this inevitability of slowing down is what happens when you're either injured in your cartilage gets ripped off your bones as a young athlete or you're just too friggin sedentary, right? So that is the kind of work we were doing just showing that the inevitability of decline is more dependent on your lifestyle than on true biology. So basically the whole saying like a body in motion stays in motion. That's correct. It's totally accurate. The physics of it is totally accurate, right? And so the study, the muscle study that you see popping up on the internet all the time, it's three pictures of muscle. There's a picture of a 40 year old thigh, a 75 year old thigh, and a 70 year old thigh. And the 40 and the 70 has gorgeous muscle architecture. It frankly, if you want to put a common word to it, I always call it a flank steak, really lean, not fatty and feel traded, very thin peripheral fat. So you have a 40 year old triathlete, a 70 year old triathlete who looks almost the same as the 40, but my control group in this study were people sitting around. The picture I show in the middle has muscle architecture that is so marbled, it looks like wagyu beef. Like that is not healthy muscle. We eat that, but that is not healthy. There are thick lines of fat under the skin between the skin and the muscle. And the bone, when you look at the bone in the middle, it has very thin cortex or the outer ring. So sitting around for 35 years takes you from lean to, I call it rump roast, but the medical term for it is osteo, meaning poor bone quality, sarco, meaning bad muscle quality, b-city, osteosarco b-city, too much fat, not enough muscle, not enough bone. And that is the state of people in this country. This metabolic disaster we have going on has more to do with sedentary living than almost anything, I think. That's crazy. So the 70 year old who was active and the 40 year old that was active almost look exactly the same. Almost identical. They're not, but they're almost identical. So what would you say percentage wise would they look different? The infiltration of fat on the 70 year old is statistically different, but looking at the two slices with the naked eye, you can't perceive the difference. So what is the difference? It's not as firm, not as lean, like what would be the difference? It's not quite as lean. The 70 year old is not quite as lean. When I tested the actual people, they're not quite as strong. Why? Well, there is a loss over time of type two muscle fibers, the fast twitch muscle, so you lose power, right? Even with the maintenance of good muscle mass, we don't generate as much power as we once did, but that is not an excuse to just let it go. No, and also what you're saying is it's not that much of a loss that people think. No. So people think you're going to be this like frail or flabby person. Maybe you're 10% less. So you know what, there are other studies not done by me show that lifting weights infers a 20, seriously lifting infers a 20 year advantage such that an 80 year old who lifts weights is as strong as a 60 year old who doesn't. And that can make the difference between falling down and dying or remaining capable. Well, I was going to ask you because we're talking about these endurance athletes. And there's a lot of, I mean, you tell me if this is a myth or not, but there's a lot of chatter about the fact that when you are a runner, you're breaking, you're basically you're breaking your lean, you're breaking down lean muscle mass. You're being really, you're being hard on your joints, your mobility. That's what causes flabby. But all the things, what would you say to people who then say cardio is bad or endurance training is bad if since you see this all the time? Yeah. Well, number one, I think it's important to realize for people to hear from me and other people saying that there is no evidence that running itself causes arthritis. The actual act of running does not cause arthritis. What causes arthritis or joint breakdown is traumatic injury. I used to be the head football doctor for the University of Pittsburgh. And I had 20 year old lineman whose knees were just crushed. They looked like 70 year old people because they had twisted. You get a 300 pound guy against a 300 pound guy and their cartilage can't withstand it, right? So trauma or being chronically heavy will wear out cartilage, right? Our joints bear seven to ten times body weight. So if we're bearing an extra 100 pounds of body weight, that's an extra thousand pounds of pressure across a cartilage layer. Cartilage is the slicker than ice coating of the end of the bone. It literally is slicker than ice until it starts to be ruined by excessive weight or trauma. So running itself only produces 2.5 times body weight on average and itself doesn't cause arthritis. But why do runners break down so often? I do say publicly and runners hate me for this, but it's okay. I have passed through the stage where I only did marathons and was that kind of person. Runners break down and I see them in my clinic every three weeks or so. Runners who only want run are the weakest athletes that I have because running does not generally activate the glutes. If you're only running and you're not feeding, you're going to break down the very muscle that you're trying to build. Now I cannot explain why that genetically amazing people like some of the Kenyans who renaw in all these races or these genetics running specimens, that has to be genetics in the cytoplasm they're born with. But for average people, we need to feed our bodies to build the muscle that's going to keep us on the road. We need to when runners come into me, for instance, with knee pain and to your knee pain, their patella are jiggling all over. I try to stand them on one leg because I examine the whole person. I find that many times their glutes are so weak that standing on one leg, their pelvis is are tilting and their knees are falling into this position called valgus. I laugh for a friend. Okay, go on. Because remember, a thousand steps a mile, a runner is on one leg in a 30 degree squat. If you can't do this at that one time in my office in a controlled situation because your glutes aren't firing and you're just weak, think what it's doing, the repetition of a thousand steps a mile. Oh, yeah. So basically, it's just a repetition. So like, I was going to add. It's bad mechanics, it's repetition and it's weakness. So would you recommend, so I would think that you would say, can you tell me, cross-training is the best form of exercise. Amazing. So in the original books that I wrote so long ago, it was all about runners must cross-training. Here's how you do it. The runners must dynamically warm up. At the time when I started writing runners just went out the door and didn't warm anything up. Now they've gotten smarter and people have designed entire dynamic warm-ups for runners and lifting programs because the idea is to get to stay on the road and not have to come into my office every three weeks with knees that are, the patellas aren't tracking well or your IT band on the side of your leg is so painful because your glutes are not so important. It's a bit of a diatic, a bit of a terrible. It's terrible, right? Is it just from over use, isn't it? It's just from over use. Tight hamstrings, weak core, although I can't imagine you have a weak core. But I, listen, I mean, this is a thing, right? Like I think running is my priority. Everything else I'll do is like secondary because the running is like, for me I call it brain training. It's for your brain. It's my brain because nothing will like click my dopamine that way and get my brain activated the same way. I get that. So it's really hard for me. That's why I think running is my number one exercise on the planet. So is long slow run your thing or sprinting? So what I'll do is I will not run outside because now because of injury, I'm so scared because it's something that's so important to me that I'll only run on a treadmill even though, even though it's boring, is anything, but it still activates my brain. So it's good enough for me. But I will wait train and I will do all the other things. You'll do the other things. I'll do the wait train. I'll do all this stuff. I can't stand because just a quasi balance it, but not to the same level. Like people are always like, what do you do? What do you do? Like I'll do all the, I'll cycle, I'll bike. But if I don't run, I also think the running is the gateway drug for me for everything else. If I even run like 20 minutes a day, I have so much more energy and so much more productive that I can work out, I can work out for 10 hours afterwards. If I didn't do that one thing, that one session of running, I would be much more lethargic. Is that normal? Have you heard this before? Well, I've experienced it. My best, my best brain work happens on a run with no music. Really? I like solve world peace. Interesting. So I understand that actually because you're thinking of all the things like, I wish I had a piece of paper. No, I do watch what I do. I have my, because my best ideas come from like when I'm like running. Because you got so much blood flow through your brain. You're like, oh my god, it's there. That's what I was trying to figure out. So I read this thing or I saw you talk about this. It was on a TED talk, multiple talks, where you're saying the keys to like longevity in general. And I totally think I was like, this is why I loved you. This is one of the things I saw like she's my lady. You said jump, jump, jump, jumping. Jumping, please. Yes. It was jumping heavy weights. Yes. Super important. You were scared of it. And base training. Right. That what you said low heart rate based training with intermittent sprint intervals. Okay. So if someone only had 20 minutes a day, three days a week, that's it. That's it. What would you tell them to do? Lift heavy shit. Just steal from Stacey Sims. Yeah. Lift heavy. 20 minutes, three times. 20 minutes. Because. No, no flexibility, no cardio, no nothing. If it was, well, I'm not saying, no, that's not enough. You can say 20 minutes is never going to be enough. But if that's all I've got, if you're saying that's it, because the rest of the time I'm chained to chair, I'm going to say, well, let's get you a different life buddy. 100%. And by the way, before you've answered the question, what I don't get is people are on the phone all day. There's no excuse for them to be sitting at a table. No one is watching you. You can be walking. I love that you said that because I challenge people from stages to send me pictures. Me too. In their boardrooms doing wall squats. Or can you take all your calls, walking please? Oh, by the way, I refuse to do zooms with staring at you. I only do them for like an introductory call. If I don't know the person, there's no need for me to stare at you for 45 minutes after that and waste like to me. You could be walking around. I could be walking around. I could be cleaning out my closets and talking. Anything. Or I could be walking. I have this like all these non-negotiables like I won't get into a car if it's two miles or under. I'll walk everywhere. Even in LA. Even in LA. I will not get in a car. I will walk everywhere. That's good here in New York. And I would listen. I would anywhere. I wouldn't care if it's a meeting, if it's a dinner, if it's a cocktail party, if it's two miles or under, I am walking my ass to that place. Because to me, I have these frameworks that I have to work with in. But I find that's the killer. People are just sitting around all day. Absolutely. I mean, think about, I had an assistant once when I was doing trauma at Pittsburgh. And she said to me, I mean, bless her heart. She said to me, Vonda, I don't walk. And I believed her because she drove her car into the garage. There was a door of parking garage into our office. She sat at the desk. We were there all day in the car back. I believed her. Yeah. Right? So if we have 20 minutes a day and the rest of our day is like that, okay, you're going to lose tweets. Okay, let me, let me change. I'm going to give you another scenario. If someone can say, okay, I have 20 minutes, five days a week. Okay. Then you're going to lift heavy twice and you're going to lift with your legs. Sorry. Because the legs, the muscles below your belly button are the most important for not falling for metabolic function. They're the biggest in your body. It's not that I'm ignoring your arms, but your arms are not going to kill you if you fall. They'll hurt if you break your shoulder, but they're not going to kill you. It's your spine, your hip, and well, it's your femoral neck that's going to kill you. So two days a week, you're going to lift heavy with your legs. And then you're going to do sprint intervals the other day. You're going to get your heart rate up really high. I would want you to walk during the day in base train, but if we've only got three days a week and we've only got that much price. Five days. Oh, five. Oh, we changed it. Oh, again. So we're going to lift heavy twice a week and we're going to walk three days a week and at least one day of the week, preferably two. At the end of the walk, you're going to sprint because we need to get your heart rate up really high because they do two separate things. Base training is just great for metabolic flexibility. But what that is, I don't think people understand the world's base training. Yeah. So it's the idea that you're working at a low enough heart rate that the mitochondria, the energy organelle, the part of your cells that is responsible for making energy, has the most flexibility to flip in and out of using fat. And then if you increase your work a little more, it's going to flip to carbs without producing a lot of lactic acid. And it is the most metabolically flexible portion, but it's not enough. Right? I do want you once or twice a week to air quotes sprint, meaning it doesn't have to be on a track. It can be on an alpine machine, a roller with a kettlebell. We're going to get your heart rate up as high as you can bear. Mine goes up to 186 as high as I can bear for 30 seconds and then completely recover to three, sometimes four minutes and do that four to six times. Because it's that really intense work that is amazing for mitochondrial replication, for the prolonged metabolic burn you get after a heavy workout like that for your brain stimulation. So there's a lot of advantages to sprinting with a high heart rate. So if that's all we've got five days a week, we're going to lift heavy twice, we're going to walk the other days and at least once of those other days we're going to add sprinting to the end of it. So you're saying then I'm surprised you said twice and not four times a week. Sprinting four times? No, lifting. Oh, lifting heavy four times a week. And then walking once. And walking once. No, I would say walking what I would say part of your day is when you're working is like is to do that. Oh, I didn't know we could do that. Yeah, okay. Well, we're going to if that now is the time to change everything. Oh, we have a standing desk. We take all our phone calls. I mean, so for instance in my office, I see patients on Tuesdays and Thursdays. I have this long hallway and I've counted the steps at one point. I don't sit down all day on purpose. On purpose? The only time I'm sitting down is if you're my patient, I sit down and I have a conversation. But then I'm up and I'm walking all day and I'm pushing my little cart with my computer eight hours. I'm walking up and down this hallway all day on purpose. On purpose? I don't even sit to eat. It's very uncouth of me, but I just carry this food on a fork because I'm not sitting down. On the same way. Okay. Would you say that incline walking is better than running then? You know what? I don't know the actual data on that. But you know what? I've tried this lately. And if I am, for instance, for my base training, I try to keep my heart rate about one 30-ish. I find, of course, I find this, that if it takes me an incline of four and a speed of four and a half-ish to do that, that if I increase the incline to 13, I can walk much slower and I get it over quicker, but I feel my glutes firing. So I think it hits my body in a totally different way than if I'm just walking on a relatively flat surface. Oh, God, no. Yeah. Would you say then to do the incline walk, the high incline or just confuse it and do it sometimes one way, sometimes another way? Well, I think the body likes confusion. Yes. As long as the heart rate stays at the range, I actually don't carry how you get it there. You can be doing handstands, keeping it at 130. You don't have to be curious with you because you're your actual orthopedic surgeon. What is your take on weight-advests then? Oh, let's talk about weight-advests. Yes. So let's. That's. I wear a weighted vest. I wear about a 20 pound weighted vest because what I have found is it increases my workload by about 10%. Meaning that, again, back to the base training. If I without weighted vest that are incline of four or five and a speed of 4.5, if I'm wearing a weighted vest because of the increase in workload from carrying 20 extra pounds, I don't have to go as fast and I don't have to use quite so much incline, but my heart rate gets up, right? I think that's the beauty of weighted vest is to increase the workload you're doing to make you work harder doing the same activity. Right. Does wearing a weighted vest create enough impact that you're going to build better bones? I have not been able to find any data that shows that. Weight-advests plus weight lifting is great for your bones, but weight lifting alone is great for your bones, right? So that's the value I see of weighted vest. I think it adds workload to people. It's great for anybody, but definitely great for people I call adult onset exercises, meaning just getting off the couch for the first time, afraid of getting hurt by increasing intensity. It's a really simple way to get in the intensity club without hurting yourself is to put a little load on. I also think it's really interesting. I mean, it comes from the military, it's rocking and heavy things come from military type environments. So I also think it's good at that. I started wearing a 20 pound weighted vest, not after it became so popular in the women's world, but because I do Spartan races and we have to wear weighted vest going up and down, let's clarify. I do Spartan races in stadiums. I don't do the big open field ones. I do what are called Spartan stadium races, which in Fenway Park or... You do? I do. I do. I hope Joe just said I was the center of it. I know he's my neighbor. He'll be happy to hear that he's always trying to get me to do all of them. You should come with us. I've only done one and he's an animal that guy. He is. But I'm going to try that. You should. You should. Stadium ones. Yes, they're so much fun because I would never have the opportunity to get his in Lake, known of Florida. We're very good friends. In fact, do you know what we do every summer? What? We're so addicted. Our poor children. Oh, I know what he did with those children. He wanted my children. I sent my daughter to death camp. You did? The camp where you have to sign, there is a chance your child will die. I'm like, oh, so I'm not sure. Yeah, okay. But you know what? It was fantastic. And so every summer I go for a week and I sit there with Courtney his wife and we watch the kids. But really? But he then starts talking to you and all of a sudden you've got 60 pounds on your back, walking up the mountain. And he's like, he's like, Vonda, you're responsible. Lead these kids up the mountain to old Jake's cabin or whatever it's called. And somehow he can nibes us. But anyway, that's how I ended up in Spartanry. I was going to say when you said Spartan, I knew you had a joke connection. I have a feeling. Because I live in the same town or not actual neighbors. We live in the same town. And he can't challenge you so many times without me getting, okay, I'll do it just to get you to stop. But then I did it and it's a complete brain bad ass or anything. Like I didn't know how to climb up a 30 foot rope ladder and flip my leg over and I didn't know. I didn't know how to get over an eight foot wall. I didn't know how to lift a hundred pound fan bag. But you figure it out. You just said the magic word. You figure it out. You figure it out. So to me, what all this also does, it gives people a sense of self confidence that they are stronger and more capable. And that is something I want women when they close this book to have hope that they don't have to have a miserable decrepit future that by investing every day in the capacity we have. Because what I can't figure out is why in a gym, women, people pick up the five pound man be pan be wait and do it 35 times until they fail. Because there's a lot of people who think that that's like that repetition, like pilates for example. Right. Right. That's enough. If your goal is endurance, okay, but that's not my goal at this age, my goal is strength and power. But we go to the gym and we underestimate what we're capable of. We go home and we pick up the 40 pound grocery sack or I have a 40 pound grandson for God's sake and we're up on the in the playground. We forget how much how capable we are in life. Absolutely. And we go to the gym and I think also women have this like their fear of being bulky. That's still something. And so that's why pilates is so popular because people think of I do pilates, then I won't get bulky. What is your take on pilates? I think it's fascinating, right? I've done it a few times. I've seen the videos of football teams stronger than God people not being able to do pilates. I think it is great for flexibility, for the small core muscle strength. It's not great for big core post year chain. But the pilates culture is such that women, I don't know, I don't count how many times I lifted in my life, but it's pilates culture to say I've done 3,150 pilates class. Yes. Holy cow. I know. Amazing. That's consistency right there. So my take is it's fine for flexibility, joint range of motion and some steadiness of your core. But if we are trying to be strong and powerful and not become frail and fall down and die from a fall in our kitchen, you have to put some work in. You have to put some lifting work into that in my opinion. Let me share my daily routine game changer with you. It's the momentous 3. I've been using their protein, their creatine and omega 3 combo for months now and the results are undeniable. These nutrients are key for long term health and performance, but hard to get enough of through diet alone. The creatine boosts both physical and your mental performance. The grass fed weight tastes great with no weird aftertaste and the omega 3 is a must for recovery. Since adding these, my energy, my recovery and my overall well-being has really improved. So if you want better performance, this is the way to go. Visit livemomentus.com and use my code Gen for 35% off your first subscription. Trust me, you'll be happy you did. Okay, so I've got two questions. What age should women really take this seriously, the lifting heavy seriously? What does it start to really matter the most? If someone hasn't done anything, let's say at 50, can they reverse the signs of aging? If they've already had muscle mass loss and bone density loss, could they reverse it? Let's start with the first question. What age should we become serious about our health? I have this timeframe that I talk about all the time called the critical decade. For me, answering this question is 35 to 45 because we know there was research that came out last year that there are two critical inflection points with aging, biologic aging, 44 and 60. At about that time, around 40 is when women start noticeably losing their estrogen and start into the whole period of menopause time. So I call 35 to 45 the critical decade to get your health standards together, even if you've never done it before. That is the time because you're still youthful enough that the big inflection points of aging haven't started. For women, you still have a lot of your hormones, even though at 35 obese, start to like to call us geriatric mothers, high risk, whatever, because of the aging of our ovaries. But we still have enough hormones to make profound differences in our physiologic reserve. Because what happens during paring menopause as hormones are so chaotic and then definitely in menopause when we're not producing estrogen anymore, it becomes harder. That being said, I have lots and lots and lots of examples of women in their 50s building a lot of muscle. I did that. You know, my story is at 40, I was in the best shape of my life. I had my youngest child. I was training for triathlons. At 40? When obese called me geriatric mother, thank you, geriatric mother at 40. In fact, I went to the high risk, OBEG doctors, because I'm like, you know, I'm 40. I'm kind of older. You're the healthiest mother we had in today. Wow. You were 40 when you had your first child? Yeah. My 18-year-old. I'm the mother of a blended family of six children. I acquired five amazing young people in my marriage and then I had one. Amazing. Amazing. Yeah. At 40. I went along doing the career thing, best shape of my life, had a baby. And then I hit parry menopause, about 47. And I really thought I was going to die. And I did all the things. I gained the weight. I lost the muscle mass. But were you still lifting weights? I wasn't lifting weights between not lifting heavy. You're doing the manvy. You can't be weighting. I was running and biking and doing that kind of thing. All the cardio stuff. All the cardio. I hadn't lifted heavy since high school. The only reason I lifted Olympic lifting in high school is because the football coach was giving the boys 200-pound club shirts. And I wanted one. And he's like, well, if you come lift all summer and squat 200 pounds, I'll give you a shirt. So there I was, Olympic lifting all summer. And I got myself the stupid shirt. Oh, wow. Right? So I learned how to lift like that. Wow. But I hadn't done it. I went right back to running. So at 47, when I was going through this and I decided I have come back to the side, I have got to get in front of this because at that time, it's more than a decade ago. No one was talking about this. So I learned to lift heavy and I took lessons. I think this is something I'm criticized about online all the time. Like, you can't expect people to go out and know how to lift. No, I don't expect it. I had to hire a strength and did conditioning coach. Yeah. That trained me for a year so that I knew how to power lift, that I could hinge correctly, but I knew how to progressively overload and not hurt myself. And I think that's a great, we're coming up on the holidays. Let's buy somebody some strength conditioning. That's a great investment in yourself though. In investment, right? Instead of another toaster for God's sake. You know what I find so interesting to say this, right? It is the same people who will buy like 20 sweaters and you know, get their hair done once a week or do all these things that like really mean nothing in the grand scheme of things for your overall life, your life. And by the way, you're a parent because you can wear the nicest outfit. They have the most beautiful, blown out hair. But if you don't look fit, if you're not lean and if you're not lean and fit, it doesn't matter. You can wear a burlap sack. You know, like when you're fit, you can wear anything. Your hair can look disheveled. You can look disheveled. It doesn't matter because the thing that I think is the hottest is someone who looks fit and looks like they take care of themselves. Well, and I kiddingly say, but not really kidding. The muscle is nature's spanks. That's, I love that. I love me some cerebellically, but I'm not going to wear spanks. If I need to, then I need to get back on a trip. By the way, I am so happy to hear you say this. Yeah. Because why are we relying on like a pair of spanks to make us look good in an outfit? Well, and it's not to say when I sit here, I probably don't have cellulite, but that's genetic. You know, whatever. Listen. Right. I'm going to help that. And maybe they will, but it's cheating. And so is that. Oh, I feel like, I don't, and also why, like it is cheating. Like I feel like, yeah, you know what? Maybe that is an indication that you should start working out more. So the response we're going to get, I'm going to get, breaking the hill. This 90% of people are going to be, are going to leave comments like, they're right. We just need to invest in our health every day. 10% because this is what happens. We're going to say, why are you shaming women? I am, you're not, I am not shaming women. I just believe so much in the capacity of women to change the trajectory of their lives that I refuse to accept frailty. By the way, I also think things are like things are non-negotiables like my walking anything under two miles. For me personally, I don't want to wear a girdle to look a certain way. No, I'm serious. I know. I didn't even notice. I know. I get it. Like, this is not about saying that someone can't wear a girdle. I'm just saying, I think that, you know, if we eliminate these, you know, easy, easy ways out, and this is going to get me into the next talk topic I'm going to talk to about, which is GLP1's a pet peeve. I'm in there yet. But that's all we're saying. Yeah. So if you love wearing these things, skims, just do it. Just do it. Yeah, I'm going to get, like, back right now. I know. Okay, I'm not shaming you. I'm not firing you. I'm not firing you. I'm not firing you. What did you say exactly? That was a great deal. Muscle is nature's space. Yes. It is. It is. And I also think that, like, I think it's one of these things that I think we're all hypocrites in general, because I think that there was this whole, this whole movement of body positivity, you know, like body, I'm so happy at any, any, any size. Well, then GLP1's became extremely popular and all the people who were shouting from the rooftop that they're, they love being heavy and overweight. To me, I'm just saying this because it's unhealthy. Basically, I don't care how you look, what you do, what you do. But I'm just saying that also all these GLP1's become popular and everybody is now, like, nobody's, no one's fat anymore. There's no, like everyone's overskidding now. Yeah. Like, it's the same people who are yelling about it, who then when they were able to, like, figure out a way to lose the weight they did. So wherever happened to the body positivity, that kind of went out the window. That's gone. And now being skinny is like the thing. I just think we should be honest about it, right? That's where it's nothing wrong with wanting to look good, right? Yes. And in other interviews, I've done, they're like, okay, let's just, if I'm truthful, the host is saying to me, if I'm truthful, part of this is because I like to look good. Well, so do I. I'm as vain as they come. Well, I think most people are, but people don't want to admit it. Like, just be authentic, right? Just be honest. Yeah. I mean, are we doing this for our health? Yes. And it makes me look better in the dress as fit better. So. Yeah. And I like to feel, I like to look, I like to feel fit. Well, you know what I like to feel is like a badass. Yeah. Nothing feels more badassery than, then squatting heavy, sprinting hard or finishing a Spartan race. I'm the only one who needs that to feel like a badass. Yeah, no, that's my whole brain. You know, like why are we like pretending? That's like, and like, here we are, like, even with this whole thing, like we're all, both of us are like pussy footing around what we said about the spaying sort of the girdle, because we're so nervous that someone's going to like get upset with us. They will, but it just happened. But the truth is, that's what every, what, not about that particular thing, but like, why can't people just like admit that they want to look as good as they can? And there's nothing wrong with that. Nothing wrong with it. And fortunately, the stronger and fitter you are physically makes you feel more confident and more mentally, like, it makes you feel better about yourself. It does. And it's not a bad thing. No. No. In fact, I think I was just talking earlier about a sign of success for executives or people leading companies. Well, we tend to measure it in cars and money and whatever exits. Oh, there's another billionaires exit. I think a real sign of success is being able to maintain your health. I think that's the number one thing. Yeah. That's why they have this whole thing about like health as well. Yeah. You know, because without that, by the way, there's no matter. Yeah. You have nothing. And it's not about like, you can still, like, we're not saying you're going to be like a 10 out of 10. We're just saying like, take whatever you have and try to, and try to be strong and healthy and look as best you can for. Everybody has to be a pro athlete. You just have to invest every day in your health and try to be the best version that you can. Okay. So let's get into GLP ones now in peptides. What do you think of this for phenomenon? I think what's interesting is that GLP ones, as you know, are not new. The research has been around for a very long time. What's new is the iterations right now, the three and one and, and, but what is also new is the commonness of it. So I think done well, meaning done with intake enough protein, take, let's say taking GLP ones, taking GLP ones for weight loss or for, or for stabilizing metabolic chaos in your body has to be done while eating enough protein, while lifting weights so that as you see the scale drop, you really don't see a decline in your muscle because I have both kinds of people in my, I don't give GLP ones, but I have people coming to me who have done it both ways. One who are carefully managed with appropriate doses who are eating 130 grams of protein a day or whatever their weight requires of them and are lifting all the time. And so what you see on their body composition is they re, are, uh, almost a remodeling. We, we maintain our muscle mass while we decrease body fat percentage. I also had a woman the other day who had no management. She just got the medication and she was losing weight which she was thrilled about, but she was losing so much muscle as she was losing fat. There was no regulation. Nobody had told her how to manage her macros and I think that's irresponsible. Yeah. So I think there are indications for it, but it has to be done well. Do you think there's, do you think that people are relying on it too heavily now? As a crutch. As a crutch. Well, let me phrase it this way. I don't have this problem so I don't understand what it is, but so many people have told me that what it does is it eliminates the food buzz in their brain. Yeah, the food noise. The obsession in their brain about every, every thought is about food because I have had really fit people who come to me to manage their inflammation or something and will draw their inflammatory markers and they're off the charts just because they're just so revved up inside. And we'll talk about how they eat and they will do fine all day fighting the food noise until about nine o'clock at night and they just can't, there's no more willpower. Yeah, the willpower is gone. And they're just gorging themselves on every carbon unhealthy thing they can fight. And they're frustrated that they can't make the athletic gains they want. And so they weren't on GLP ones, but that was the some of the, my own patients teaching me about the buzz of food noise that they cannot overcome. Right. And it does, I think it would help with that. I have heard that. But do you believe that because they say all these like secondary things is the inflammation and all these other things? And since you, or you know, you talk a lot about women, a pair of menopause and menopause, is it a tool that you suggest for women who are going through menopause? Does it help with your, with, with going through menopause or parimenopause as a tool? I think it can, I think it can be a tool in the toolbox to assist with getting in front of insulin and sensitivity because what happens is our lipids change our, I mean, I notice this with me, our fasting glucose goes up. For instance, my fasting bloke, I wear a CGM, my fasting all the time. Yeah, because I started it as a three month experiment. And I'm so addicted to my data that I wear it all the time. And I know exactly what carbs are going to do to me. And I know the spike in the plant is obsessive a little bit. Really? Yeah. But so what happens in parimenopause is our metabolic, our metabolism changes and we start redistributing fat from periphery to the viscera. That's why we're not this shape anymore. We're a little bit like this shape. And visceral fat is very dangerous. And so there are times when women are doing all the things. They're lifting. And they're watching and they just can't recompose their bodies. And so I think in that case, it's a good tool that can be paired with making a hormone optimization decision. I am of the mindset that even though I take hormones and I've decided to do that, that every woman is sentient and you get to make your own choice. Right? You have agency to decide that, but you get to decide based on facts, not fear. Right? And so in the same way, you get to decide whether you're going to use the tool of a G.O.P. One. But I'm very opposed to using the tool of a G.O.P. One if you are also not lifting and you are also not eating enough protein to maintain your muscle mass because remember, we've talked about it a lot. I am the orthopedic surgeon that meets you in the emergency room when you have lost all your muscle mass, when you have lost all your bone density because you've starved yourself or you're not lifting or you're not jumping and you're just letting time take you down the pathway. I am the one that meets you crumpled up in the bed with a femur fracture and I don't want to see anybody I love or like or even met in that situation because it's excruciating. And the statistics about death and disability are staggering. You would ask me earlier at what time, at what time in life should we start to get in front of this? I say 35 because we have a long runway. We know that we need to get in front of our bone density and our muscle mass younger so that as we age and we have the natural decline in our, the home marks of aging are real biological processes but the better baselines we start at the more we have to work with even if we're reinvesting every day in muscle mass, every day in jumping. Well, why is jumping so important? Yeah, so the way bones work, so we don't think about bones. I'm on a rampage to get people to think about their bones. Bones, when you think about it, are the only thing that make us look like a human being? Without our bones, we're just a pile of muscle and metabolic tissue. Just pile on the ground like job of the hut. Right, and bones are not talked about enough. Bones are not but and so sometimes people think, oh, bones are silent. They're just structural. They're the backbone of your life. Well, actually they are the backbone of your life. They are. Bones are not silent. Bones are metabolic organs that secrete hormones. They are master communicators from the top of our heads to the bottom of our toes and I'll give you a couple examples. Bones secrete is a hormone called osteocalsin that goes to your brain and helps you build neurons. It stimulates the production of a cytokine called bone-derived neurotrophic hormone. It's better brains. Bone does that. It collaborates with your muscle and your pancreas to regulate glucose and insulin. Your metabolism bone does that. If you're a guy, osteocalsin from your bone goes to your testicles and helps you make testosterone. There's another hormone bone makes called LCN2 that is critical for telling you when you're not hungry anymore. Well, why would bone be interested in metabolism? Well, it's because it's the storehouse of your body. All the minerals your body needs for all the chemical reactions are stored in your bones. Need a little calcium? Go get it from your bone. Need a little phosphorus? Go get it from your bone, right? So it's a structural. It is an endocrin organ. It is a storehouse. It's also an incubator. Our bones and our pelvis and our long bones like our femurs make all of our little baby blood cells. Isn't it fascinating? Wow. Bones are inherent to everything they do. And they're constantly talking to the muscle. Muscle secretes myocines. These myocines aren't just talking to themselves. They talk to the bone. Bone talks to the muscle. Bone and muscle talk to the fat. Fat's an endocrin organ. It releases a hormone called leptin. Everybody's talking. And yet we sit out here thinking, oh, bones are just holding us up. If we think about our bones at all. So I'm trying to get people to be more interested in their bones, make bones sexy for the first time. Because here's how bones work. Why am I talking about jumping all the time? Bones are so smart that we don't just get one set for a lifetime. They are constantly breaking down and rebuilding. It's called remodeling. And there are two main cells that do that. The osteoclast that's breaking down bone, releasing all the chemicals your body needs. And osteoblasts that are rebuilding. And they're in harmony until we lose our estrogen and then we start breaking down more. The majority signal for your bone to build is biomechanical signaling, which is a fancy word for impact. Jumping, mainly jumping, stomping. We did studies that showed that the jumping sports, as you would expect, are more critical for maintaining bone density across the lifespan. Others of my colleagues have done studies on NCAA athletes and found, oh, well, I'm behold, the gymnasts have the best bones, right? Duh. Because of all the jumping. Of the jumping. Yes. So studies have shown that jumping 20 times a day takes the biomechanical stimulus, turns it into biochemical signals to tell the osteoblasts the building cells to build better bone. She's jumping again. We need strong bones, build better bone. And so 20 jumps a day, multi-directional. A couple months ago, I reintroduced hopscotch to the world because three in a row jumps side to side. So true. Yeah, right. Children get it right. That is, if we just go back to what we did as a child, we would be so healthy. Walking jump. Walking jump. What about doing it on a trampoline? Yeah. You know, NASA does that when astronauts come back from space and have to rebuild bone. There are data that rebounding trampolines can produce enough impact to help you. Not enough. We need it. Yeah, we need impact four times body weight. So walking is 1.5 times body weight. Running is about 2.5 times body weight. Jumping off an eight inch step is four times body weight. So just jump off your bottom step. Although I did a retreat recently at Canyon Ranch and they had us jumping just on the floor on a force plate. And even jumping up and down and landing impolitely. Not like a dancer with no sound, but just landing generates four times body weight. So you actually jumping up and down on your grass is better than jumping on a trampoline. Yeah. Yeah. For bone density. For bone density, jumping on your concrete pool deck is better than grass. Grass is probably better than trampoline. So really because it concretes so hard. Yeah, that's the point. But isn't that hard on your ankles or your knees? It can be. People say that to me. And if you haven't jumped in years, it's okay to just do heel rises and thud down. It's okay to pull out your step aerobics thing and jump off the edge. Yeah, it's okay to work. I don't know. How am I that I remember that? I remember that. Right. That was great. That's such a... That should come back. That's so interesting. So I would think that the rebound or the trampoline, like I have like a million trampolines around my house. I saw a big one. I have a big one for my kids because they also thought it's easier for low impact, for your knees, for your hips, for your joints. It is. That's the right thought, but bones don't need low impact. Bones need four times body weight to have enough signal to tell the osteoblasts. Oh, it's time to lay down some bone. Wow. So 20 jumps, that's it. That's it. You can break it up 10, 10. So you can do that or you can do 10 minutes of jump training three times a week. There's studies on both sides of it, but you just need to jump. So it can be boring, like jumping jacks or jumping up and down or you can get a weighted jump rope and work your arms and your legs. I do that too. I try to jump like with a jump rope a minute or two a day. Yeah, that's good. You're probably getting hundreds of jumps in. I'm getting a lot of jumps in, but like it's bad on my ankles. Like that's the thing. Like how do you prevent injury? While doing some of these things because that is a thing, right? Like if you're something like what I was going to ask you was like over time, maybe this is just in my head, but someone who's been very active for their whole life is much more prone to injury than someone who's never done anything. And then they start to work out because the wear and tear of your body, I feel like for me example, I may look more fit than Joe blow. But I have like the sciatica. I have an ankle problem. I had like, I had the, I had all these things, right? Because of all the activity versus someone like a friend of mine, like I said, who hasn't really done much. So they don't have any injury. So aren't they going to last longer in life? Aren't they going to have more longevity really because their body's not like badly beaten like mine is? It depends on metabolic and healthy she is. Because if we did her body composition, she might be 45% fat versus, you know, a healthy body composition with 25% fat, right? So it's not apples to apples. It is. You can't compare it. So with, you know, what I do with, I'm married to an old pro athlete with 18 surgeries. So he is definitely an example of using his reps up early in life. Yeah. That being said, he's a professional hockey player. Oh, so there is something. Yeah, no, it's from Boston. Yeah, close enough. Yeah, close enough. So there is something to the reps and this trauma thing. But I think most of us, myself, mere mortals like me that sometimes we get injured, we just ignore it and we don't rehab well enough. And so let's say you have, you have your hip hurts or your back hurts. Well, our body's not stupid. If we have back pain, we have sciatica. It's going to shut off your glute. Good telling me. Yeah. And then if we don't rehab that back, we never get regain the strength back. It pre-disposes us to future injury. So if your ankle is painful, then we need to get you on some band work, some footwork to restraint and all those muscles so that you don't twist it again or whatever happened. So for those of us that have been active across a lifespan and tear big muscles and stuff, we just have to recover them. You know, that's a really good point actually. So then if we're not taking care of these injuries and then they become chronic. They do and our motion patterns change. The gate changes and say, yeah. So I got to look after the sciatica. You do. I'll talk to you off about that. Hamstrings core work. Yeah. I know all the things, but I don't know how to do those things well. No, because my brain, like I get so annoyed, I'm like, I don't want to do that. It's too easy. Yeah, like I want to go run, you know. Or so people with sciatica, should they not run? As sciatica, runners, remember, you have weak glutes. And so if running aggravates your sciatica, I would spend a lot of time making sure your glutes are firing, getting your single leg strength to the place it needs to be, because running is a single leg sport. Thousand steps of myelons need to legs. You said that at the beginning, I said no one to hear it. If there's one exercise, someone should be doing, what would that be? Do I only get ones? Do I have to do squats or deadlifts? Probably squats over deadlifts. Squats? Or single leg squats? One at a time. That's hard. Yeah. Yeah. So how do you train someone, if someone's only doing one exercise, single leg squats are like the hardest thing in the world? Well, you would just start with body weight. I would start with a bench. I wouldn't start with single leg. I'd start with two legs. Just to even see if they can bend their hips and have enough ankle motion. And if you're really starting out, you could start double leg squats to a bench, like getting up from a chair. I mean, that's actually the best one to do. That's a squat, right? Up and down, touch your rear end on a chair. Then when you feel comfortable with that, do it without the chair. Then add five, ten pounds in a sumo squat or... Oh, I'm talking about a single squat. That's a great way to train a single squat. It is also, but if someone fresh off the couch with no notion of how their body works, I would start with two legs. And then when we have some body competence and proprioception going, switch to one leg. Only because I think when people train a squat, like people are always dominant on one side. And they're always going to let that one side get stronger. Do the work. Yeah. So that's why I always think training single leg or single everything, anything. It forces you to activate your right muscle. That's why I say that. So to getting there is really critical. Yeah. It's hard. And then you just gotta... Oh, yes. No way. I know. You can't just start where you are. Now do a pistol squat. Yeah. Oh, how about that? Oh, no. It's going to... No, never going to happen. If you're not taking glutathione, you're missing out on one of the most critical foundations for your health. Your body is dealing with toxins every single day. Pollution. Chemicals. Plastics. Process food. Alcohol. Stress. It's not a question, if you're exposed, it's how much. That's where glutathione comes in. It's often called the master antioxidant, and for good reason. Glutathione protects your cells from oxidative stress and supports your body's natural detox process. When you're stressed, traveling, eating badly, or just giving into the modern world, your glutathione levels drop. So I take reonutrition liposomal glutathione because it's not just glutathione. It's a biome and a basic capsule. It's liposomal, which means your body can actually absorb and use it. 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However, what I am opposed to is whole NAD plus because the body needs to make its own. Exactly. So, I thought, and you're the doctor, that I take something, I take true drug. Do you know what true niogen is? Yes. I've seen that brand. It's a precursor. It tells you two reactions from NR to get to NAD plus. It's a precursor. A precursor. Yeah. And I thought it was really good because it goes into your cells quicker and it can fit... I don't know the proper. It's smaller. It's smaller. So, it actually penetrates. And I heard that NMN doesn't. Well, so I test this. Yeah, tell me. So, there's a company I use, I guess will advertise for them, called Genfinity. And they test intracellular NAD plus. It's the only way to really know whether what you're taking is elevating your levels. Yeah. So, the first time I tested my NAD plus, it was exhausted every day at three o'clock. You know, my day was over at three o'clock. And a normal level of NAD plus intracellularly is about 60 in young people. Mine was at 18. So I started supplementing with NMN and retested and I was back up into my 50s and I could feel the difference in energy. So my only response to does NMN create NAD plus is the experience of me and the people I treat because I test it. Right. That's interesting though. I find there's a whole camp of people who like NMN and there's people who like NR. And then lots of people taking IV NAD plus, which I don't think gets into the cell. Well, this is what I was going to say, all the IVs. They're very popular. And then they have first pass liver function and probably are sucked out of the blood anyway. So you don't recommend those. I don't. I recommend the precursor so your body makes its own because NAD plus works intracellularly. Yeah. What I find interesting, we're like 10 years ago, no one talked about NAD. What, how did this become a thing? Like did you notice like an evolution of how longevity became like kind of a sexy topic in a way? Well, it's funny you asked me that because I started writing books in 2004. The first one was called Fittance After 40. And at that time, it was all about the research that I do now. Forty year olds couldn't stand the number 40. Right. So I had to rebrand to thrive because I had a bunch of products and digs for things. Forty year olds couldn't stand the number 40. So nobody wanted to talk about aging or longevity. It wasn't cool then. And so I have seen this progression to exactly your point. Now we're all about if you're not 40, you're actually not cool yet. You're still all my 30 year old children have yet to arrive. Yeah, yeah, exactly. Yeah. Well, I also feel like the 60 is the new 40. Oh, yeah. Thank God because I'm like, I can't run out of time. Yeah. I know. And I feel like the older I get, I'm like, where did the time go? Like, I feel like it goes by much faster when you hit 40, I feel. I do too. You know, I don't know where the last 10 years went. What about like sauna versus cold plunge for women? We believe in the cold plunge because there's a lot of controversy around that for women. If I believe Stacey Sims, cold plunge is our best for men, right? Because we tolerate, we tolerate cold less well. I do like sauna. I'm not a big fan of infrared sauna. I like the really hot, finished studies, producing high levels of growth hormone. I don't get in them often enough. But you know what's interesting? Like I feel like Stacey said this to me too, that women love heat. They don't love cold and that's for hormone purposes. Now what you're saying about the infrared sauna, again, they don't get hot enough. They don't get hot. They don't get hot at all. Yeah. I'm going to keep that thing on for an hour just to get it to like a place where I can even feel like I'm doing something. I agree. Yeah. Then they say also that that's bad for your brain. Really? That's what they say. You're the doctor. Well, I'm not an expert on sauna. I know. Well, that's another sauna for the... I've read the finished studies that say the hot dry sunas do the trick. But all the research has been on the hot sauna. Yeah. Okay, a couple more questions. It's back to the supplements. Zombie cells. So which are the ones that you... Yeah, let's talk about that. Let's get into supplements for that and everything else on be. So what are zombie cells? There are four destinations of cells in your body. We have stem cells, which are meaning that they retain their ability to become anything under stimulation. So stem cells become mature cells and do their job. So a mesenchymal stem cell will become a muscle... A mature muscle cell. Doing its job when the mature muscle cell has done its job. It's replicated enough. It's created enough reactive oxygen species that is just tired and needs to die. It turns on genes to undergo program cell death. That is the natural history. There are some of these cells that are so damaged from the life they've lived that they cannot turn on the genes to program cell death. These are the zombie cells that circulate around not doing their good job, not dying so they're just spewing off, noxious cytokines. And high accumulation of these populations of zombie cells have been attributed to increased rates of cancer and inflammation. So there's a big push to eliminate this senescent cell load, which can totally be done with lifestyle and all the things we've talked about. It can also be done with a category of supplements, facetin, cucerton, which I always mispronounce. They're derived from strawberries and berries. It's like risvera tral. You can't get enough of it from the grape leaf, so you have to take it. So there's another scientist that I collaborate with in Veil, whose entire work is on senescent cells. And he has actually done the before and after senescent cell load measuring of giving just regular doses of facetin, and you can significantly decrease the senescent cell load with that herbal remedy. Really? And so how often do you take that? Every day, just, you know, and it's a standard brand that you can buy off Amazon because that's what he had to do for his research. It's like, I need a steady source. We're going to verify it contains facetin, and that's what he uses all his experiments. So facetin. Facetin. I can just find it on Amazon. Yeah, I'll show you. Really? I love that. And then foods. We didn't even cover food yet, nutrition. Is there something that we should be eating every day that we're not eating that people are like are overlooking? I think people in general, at least my patients, when I question them, don't know how much they're eating, and they don't know what they're eating. Part of that is because so much of our food comes in containers. Yeah. It's like 62 ingredients. It's not a piece of broccoli. It's not a chicken breast. Right. And that's what I find more than anything is that people just have no idea what they're consuming. And so when I start to work, I have a both an orthopedic practice and a longevity practice. And the longevity one also helps women in midlife and menopause. So one of the things we start with is tracking everything we eat for three week days and two weekends. Just with a free food tracker, I mean, you can get them for free, just so you know what you're consuming. Right. Because I find people in two camps either I had a woman eating 700 calories a day the other day and you know, 60 grams of protein because she's not that hungry while you're starving while you're not hungry. And so, but she, but we're going to count what she's eating so that she has an awareness of, I mean, she probably has 700 more calories to go before she even begins to be in deficit. I mean, be too many calories. And then I have people on the other hand, which is probably the most of the population, which thinks they're doing okay, but doesn't realize the calorie load that they're eating from the volume of food that they're eating. Yeah. What are real portion sizes? These are all like things that, you know, it's basically the basics. It's so basic. And people are still not aware of the basics. Right. They're like, they're like not, they're dealing with the minutia, right? But not the most fundamental things that make, actually move the need, like the needle. Exactly. So, you know, breakable, I talk about the fact that people come to me fine. I'm like, how are you feeling? Fine. I'm fine. But then they come in that state of non-optimized health and want to go to the really complex rat data, longevity stuff. Totally. And skip everything in between. So, sorry, guys, if you come to me, we're going to optimize your health. Right. You're going to get all everything firing in all cylinders. And then when we're doing that, then what do we do? Because I'm a sports doctor. We can apply the high performance things that we do with athletes. And then when we're at peak performance and you're feeling great and, okay, then I'm open to discussing with you the risks and benefits of things that only have rat data so that you enter this world while eyes wide open. Yes. But I will not skip to that. I mean, you need to find another doctor if that's what you want. Good for you. Yeah. Because also, they make so much money off of this stuff. Yeah. All of the peptides and all the things. And they're hard to source safely. Very hard. I can talk about that because I know a lot of people who are getting these things off of the internet. Off the internet out of the trunk of some gym guys. Yes. Yes. I mean, you don't know where that bottle came from. You don't know what that really is. No. Is it sterile? No. What's the real dose? Because even for longevity doctors, we have this group called longevity doctors and that we're all board certified doctors of some specialty in turn as surgeons, whatever. It is hard. We were just talking about the other day. Where is the most reputable place to get peptides that you're choosing to use them? It is very hard for those of us in the know. So where it came from, the thing I most often ask for is BPC 157. Where did that come from? That came from the bodybuilding, weightlifting world, Army Ranger world, where we're just looking for all kinds of good solutions for people who are really performing at a high level. Well, it trickles down as everyone wants to emulate that. And so I have parents asking me to give that to their teenagers trying to heal. Do I think anecdotally it can make you feel better? Well, there are no data for me to quote to you, but I certainly have a lot of people who swear that it's a miracle. But if you want me to discuss it, then I'm going to discuss the fact that there's no safety data in humans. 100% really. Even for BPC 157. There is not a big body of data. The most prevalent studies are in rats, which if that's fine with you, go in eyes wide open. And I have some people who choose to do that, but then it becomes who you get from. Yep. The guy out of the trunk of his car. Fire beware. That's really scary. I almost everybody I know who's into biohacking long. Yeah, it is on this. Everyone's taking BPC 157 for the dreams of the mission and recovery, all the recovery or the cover peptide for your skin. I mean, I guess the copper peptides the other one. Wouldn't that be amazing if it worked and I could source it appropriately, but I just am at a loss. Oh, this is so fast. How about like, Treze, Epitide and the new one, Rich for the G.O.P. G.O.P ones that are compounded. Oh. Well, there are some things that I'm not opposed to for compounding, but if there is an FDA approved, regulated, you know it's in the pill because it's tested or you know it's in the injectable because I think you should do that. Not the compounding pharmacies are bad, but you just, it depends on the quality of the pharmacy. Yeah. And I think that people don't know. And people don't know. They're just trying, I honestly think most people are just trying to do the best thing. Yeah. Yeah. So would you suggest then not a compound if you can? Like that. Yeah. But those peptides, Matt, that is scary. And do I think we will, we will learn enough that they become safer that we have safety data? I mean, let's hope so. Let's hope we can get studies funded to at least have safety data. Yeah. We just, we just don't. So that's my position on it. And I mean, it's weird for me to be in the longevity space and be so cautious, but I am a practicing surgeon and I'm never going to hurt you. Guess what? That's what I like about you. Well, number one, you're like a real doctor doctor. And that's really important because I think we need more, more view. Yeah. And if you really look at it and what again, I'm going to get bashed here. A lot of people who are pushing this stuff, they're actually not even the real doctors. They have, they put doctor in front of them, but like you were saying that they're not, they didn't finish residency. They're not an MD. And that's what also it gets like, it's, they're, they're selling, it's false advertising. So people then think psychologically, oh, a doctor told me to do it. When maybe you should check the credentials. I think, I think it's important for people to go in eyes wide open. Yeah. So let's just review for one and a half seconds what it means to be a board certified doctor. The highest qualifications you can have within the medical system is to have the board certified credential, which means you finish medical school, which any Tom Dick and Harry who gets in can finish, right? Finish medical school. The next step is to finish a residency, which means you do three to seven extra years, learning how to apply the medical school knowledge to real people. Only then are you able to practice alone. And then you take two to three exams to become board certified for orthopedics. That means that we have to take a written, two written exams. And we have this horrible interview exam where we sit across from a panel of old surgeons and they quiz you on your management. But you know why we do that, not to torture young surgeons, but to ensure that the public is safe and that the people giving them care have had the most training possible. So there's a reason that board certification matters to real doctors. It's really important. I'm glad that you said that. It's very important because people skip this whole, that whole part. And that's what I feel to be very dangerous, especially in the world we live in, where information is free and never with us so much of it. So they say like, and chat GPT hallucinates. And chat, oh my god. And there's so many AI now that like it's really, really, really difficult. So you really have to do your research properly. Yeah. Yeah. Okay. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. Wow. And I have a website, Dr. Vonder Wright. And they should do your quiz. I have an eight-part assessment in this book where you can really see where you stand from a longevity standpoint. Please invest in yourself by reading this book. I know, it's a really good book. And I'm gonna do it. I haven't done the quiz, but I'm gonna do the quiz. Oh, good. Perfect. Thank you for being here. Thank you.