In short
Rerun episode on “the musculoskeletal syndrome of menopause,” explaining how declining estrogen in perimenopause drives inflammation, muscle loss, and bone loss—leading to frailty and chronic disease risk—and what to do about it with strength training, nutrition, and whole-person care.
Guest backgrounds
Dr. Vonda Wright is an orthopedic surgeon and mobility specialist, focused on longevity for women. She discusses her own athlete history (triathlete; later knee injuries including meniscus root tear and osteonecrosis) and her practice approach as a “whole person doctor.”
Key claims
Healthspan matters more than lifespan (average healthspan ~63 years). Less than ~30% of health aging is genetic; lifestyle via epigenetics changes gene expression. Estrogen is anti-inflammatory (e.g., affects TNF and inflammasome). Perimenopause can include arthralgia and frozen shoulder (“can’t hook your bra” sign), plus rapid arthritis progression, sarcopenia/osteoporosis continuum (osteosarcopenia), and fat redistribution. Frail is “fatal.”
Notable examples
A 57-year-old woman who avoided hormones and later broke her hip due to osteoporosis; a 19-year-old ACL tear where anxiety, rehab access, and nutrition/social support were addressed.
Written by AI. May contain mistakes. Listen to the episode to check what was said.
Chapters
Tap a time to open that second in VODefining Healthspan vs. Lifespan
2:14 to 3:00
Discussion on the concepts of healthspan and lifespan and their implications.
“Welcome to season two of The Body Pod, where we are beginning this season with the best of the best, Dr.”
Lifestyle Choices and Health Outcomes
3:00 to 5:55
Exploring how lifestyle choices influence health and aging rather than genetics.
“Okay, so let's go back, starting with healthspan versus lifespan.”
The Role of Estrogen in Women’s Health
5:55 to 8:05
Discussing the impact of estrogen on inflammation and musculoskeletal health.
“And we have an amazing example of that last year.”
Symptoms of Estrogen Decline
8:05 to 11:15
Detailing symptoms related to declining estrogen levels, such as arthralgia and frozen shoulder.
“There are some genetically predetermined diseases, but for most of us, our health and longevity is specific.”
Impact of Aging on Musculoskeletal Health
12:35 to 14:00
Discussing how aging affects muscle mass, bone density, and overall health.
“monthly, and other limits in terms apply.”
Understanding Osteonecrosis and Its Implications
14:00 to 16:34
Learn about osteonecrosis, its causes, and treatment options.
“I had a complete root tear of the meniscus.”
Common Injuries in Midlife Athletes
16:34 to 18:41
Explore the types of injuries common in midlife athletes and their causes.
“selfishly for me because I had been hitting bone on bone because I was undiagnosed for six months.”
The Importance of Starting with Fundamentals
18:59 to 21:53
Understand the need for a solid foundation in fitness before progressing.
“And so if we have big traumatic injuries, no matter what age we are, I've had 20-year-old football players with end-stage arthritis because they've just had a big traumatic injury.”
The Critical Connection Between Muscle and Bone
21:54 to 26:47
Discover how muscle and bone interact and why it's vital for health.
“you, I think is critical for progressing to a place where you can slam the weights around.”
Addressing Women's Health in Aging
26:48 to 28:05
Learn about the impact of aging on women's health regarding muscles and bones.
“So, you know, you guys are in the prime of life.”
Show all 20 chapters
The Importance of Muscle and Bone Health in Women
28:05 to 29:45
Learn why caring for muscles and bones is crucial for women, especially as they age.
“That, my friends, is the future of women if we allow ourselves to become frail because we do not care for our muscles and our bones.”
Nutrition's Role in Bone and Muscle Health
29:50 to 35:20
Understand the importance of nutrition and its impact on muscle and bone health.
“Let's shift the conversation to also talk about how important nutrition is when we're talking about bone and muscle for someone that is in a low energy availability or red S state.”
Supplements for Bone and Muscle Health
35:32 to 42:00
Explore essential supplements that can support bone and muscle health.
“Even healthy yogurt has nine grams of added sugar.”
Whole Person Care in Orthopedics
42:00 to 47:38
Explore the holistic approach to orthopedic care focusing on mobility and overall health.
“Let's treat this and, you know, go on your way.”
Challenges in Healthcare and Insurance
47:38 to 49:46
Discuss the limitations imposed by insurance on patient care and the need for reform.
“I actually, I'm going to shout out hospital for special surgery because that's where I had my surgery.”
Principles of Bone Health and Longevity
51:27 to 56:00
Examine effective strategies for building strong bones and promoting longevity.
“So it's about optimizing your health, lifting heavy, base training, why sprinting is so good for you to recompose your body.”
Jumping for Bone Health
56:00 to 58:25
Learn about the importance of jumping exercises and their impact on bone health.
“Start in a squat, vertical leap up and land hard.”
Starting from Zero: Simple Health Tips
58:25 to 1:00:07
Discover easy steps to start improving your health and well-being.
“Um, but if you had some, like a few takeaways for, for someone listening, that's like, okay, I get it.”
The Sitting Epidemic and Its Effects
1:00:07 to 1:02:28
Understand the negative impact of sitting on health and back pain.
“But if you're doing that for seven days, at the end of seven days, your taste buds will change and you won't crave it as much anymore.”
Gratitude and Future Collaboration
1:02:28 to 1:04:49
Expressing appreciation for the conversation and future opportunities to connect.
“Even, you know, as an orthopedic surgeon, three days a week, I'm sitting writing or doing that kind of work.”
Transcript
Automatic transcript. May contain errors.0:00Hey, it's Haley. If you're a woman in midlife who has done everything right and those stubborn pounds won't move, stay with me for a minute. You cut your calories, you've added more cardio, you try harder than anyone around you, and the scale just sat there while your energy crashed and the weight crept back on. In midlife, your hormones, sleep, muscle, and your bones all change the math. I want you to be the woman who knows exactly what her body needs now and can make a fat loss phase work for her lifestyle. Fat Loss Happens Education is seven weeks of evidence-based guidance from registered nutritionists, menopause doctors, and exercise physiologists with me right there alongside you.
0:43You learn how protein, training, hormones, and recovery work together in midlife and how to hold on to your results long after the course ends. We start the live course in September. To get first access in August, go to hayleyhappensfitness.com forward slash fatlosshappenseducation or grab the link in the show notes. Now, back to the show.
1:09What's up, everybody? It's Bretzky, and America is turning 250. And I can't think of a better way to celebrate that than playing on an American-owned social casino, spinquest.com. With all of your favorite games, live craps, bubble craps, live blackjack, There's no better place to play for free and win real cash prizes. SpinQuest.com. SpinQuest is a free-to-play social casino. Avoid where prohibited. Visit SpinQuest.com for more details. Today on The Body Pod, we are providing a rerun of some of our favorite and most popular episodes. This week, I have the pleasure of reintroducing you to the Dr.
1:52Vonda Wright episode. This episode is one of my favorites with Dr. Vonda Wright because we dive deep into the musculoskeletal syndrome of menopause and what that means for you and how being frail is fatal. Join me while we rerun this incredible episode with Dr. Vonda Wright. Hey everyone, this is Haley. And I'm Laura. And welcome to The Body Pod.
2:24Welcome to season two of The Body Pod, where we are beginning this season with the best of the best, Dr. Vonda Wright. Dr. Wright is an orthopedic surgeon and mobility specialist and has made a name for herself for being one of the top longevity specialists for women. We dive into the musculoskeletal syndrome of menopause, the importance of a foundation phase of training, the connection between muscle and bone, and how we can change the trajectory of our lives for the better with strength training. Let's get into the show. Okay, so let's go back, starting with healthspan versus lifespan. bad? You know, when we think about how long we're going to live, we typically, you know, we talk about the rare person who lives to 114, you know, the blue zones, people 114.
3:22Or we talk about longevity, we're trying to, you know, some of the longevity men think that the baby's being born now
3:29Dr. Vonda Wright:will will not die until they're 120. And that's fine. I mean, and I, I think that everything that the three of us do, will extend our lifespan. The average life expectancy in this country for men is 77.6 years now. It's gone down since COVID. And for women is slightly more. But that is not the number of years that we will be healthy. Papers have been published that show that the average health span, those years that we can expect not to be limited by disease, is only 63. 63 is not that old. And it is on average when people retire to live the life they envision. And what happens if they have not invested along their lives and staying in their health span, they will spend three days a week in the doctor's office during the last 20 years of their lives.
4:27Dr. Vonda Wright:Now, do I expect to live longer than that? Well, ladies, my goal is 97. And I can tell you why that's my goal. Please. 97 is just after that is icing. Well, because I had my last child at 40 and I am currently 57. And so if I can stick around until my youngest child is my age, everybody's going to be good. Actually, my youngest child is so independent, she'd be good now. But I'm just saying, if I can stick around until she's 57, I'm going to be good. And so I've just arbitrarily said 97, but to get to 97 takes an investment now and took an investment when I was 40, right? You can't just start in your, in your, you know, sixties and seventies and expect to optimize the way we could, if we started when we were 35 or 40.
5:18And so I've got this whole kick going on that I post about
5:22Dr. Vonda Wright:with some frequency called 40-ish. It's like, let's get our proverbial shit together in the critical decade, which in my mind is 35 to 45, when the women still have estrogen, when we're still healthy enough, because we're trying to extend our health span to equal our lifespan. And so that both of them, instead of health span going like this and then dropping, and then you still have to live 20 years, that they both come together, right? And then bloop, whenever it's done, you just go to sleep. And we have an amazing example of that last year. I know, that's what I want. Look at Queen Elizabeth.
6:05She got frail, but she was still doing her thing. On Tuesday, she met with the prime minister. On Thursday, she just went to sleep and didn't wake up. I'm raising my hand for that kind of exit, right? Yes. So that's what I mean by health span versus lifespan. Something else you say about this that goes along with it is that I love is our health and aging is predetermined by our lifestyle choices, not our genes. I feel like this is so powerful. Will you talk about that? Yeah. You know, all of us, you know, when we're being formed in utero, receive genes from our father, genes from our mother. And many, you know, we, for many years, we said, that's our destiny.
6:54We can't do anything about it. My dad had this. My mom had this. My family for three generations have been big boned. By the way, there's no such thing as big boned. That's an excuse for not building enough muscle, etc. etc that's what i was told my whole life big bones sorry my dear bones are about 15 of our total weight that's it so you can't yeah oh but the thing is we now know that less than 30 percent and depend on depending on who you believe 10 of our health and aging is predetermined by the our genome. When we work out, when you put people through a workout, 9 ,800 of our genes are
7:38Dr. Vonda Wright:stimulated to be transcribed. Transcribed simply means the genes turn on and make proteins. Your activity affects what your genetics do. That is what the field of epigenetics is all about. Broccoli is not just broccoli. It's the phytochemicals that come from plants. Sprinting is not just sprinting. It stimulates all kinds of genes, gene transcription. And so we can have a little excuse. There are some genetically predetermined diseases, but for most of us, our health and longevity is specific. Okay. So what is the role of estrogen as it relates to these inflammatory injuries that women tend to get over the age of 40 that you see in your practice?
8:35So I love that you've asked me about the role of estrogen in the musculoskeletal system. I've just published a paper. It's just in the proof stage. It'll be out. I'll send it to you. Naming the nomenclature, the musculoskeletal syndrome of menopause, because here's what happens. Women in midlife, as every month of our lives after puberty, women's hormones go up and down every 14 days, and thus we have a period. Men, if you're puberty, and their testosterone stays pretty level. So when we have used up a huge percentage of our eggs, usually by the
9:10Dr. Vonda Wright:age of 40, we only have 1 % left, the amount of estrogen we produce every cycle starts to decline, And that's the onset of perimenopause. But even before we have the symptoms of hot flashes, night sweats, brain fog, start losing muscle and bone that we become aware of, our hormones, both estrogen and testosterone are declining. And so what that does in a variety of the musculoskeletal tissues and in our immune system is changes all the amazing thing that estrogen does for us. So when it comes to inflammation, estrogen is a huge anti-inflammatory. It works directly to regulate a chemical called tumor necrosis factor, which is a huge inflammatory cytokine, as well as working in the immune system on a molecule called the inflammasome.
10:00Dr. Vonda Wright:But the end result of not having estrogen sitting, I always do this with my hands. This is an estrogen receptor, this is estrogen. The net effect of having no estrogen sitting in the estrogen receptor is that none of the downstream control mechanisms can happen. And so women become highly inflamed and that manifests in many ways. Number one, arthralgia, which is total body aching. And this was one of the main symptoms that I arrived into perimenopause with. I'm an athlete. I was a dancer. I could do anything with my body. And all of a sudden I couldn't get out of bed because everything hurt. And that I didn't realize that at the time I fully realize it now is due to estrogen becoming lower.
10:51Dr. Vonda Wright:The second thing that manifests as is the ever popular frozen shoulder where women show up with shoulder pain. They didn't hit the shoulder on the bedroom door. They didn't fall. They didn't lift too much. But all of a sudden, their shoulder hurts. And they follow their instincts. They don't move their shoulder. And in less than a week, I'm not kidding you, women will come in unable to hook their bra, which I call the can't hook your bra sign. And they can't hook their arm. And that's just because of the raging inflammation in the shoulder capsule. And it starts out first with hot red pain. over time the pain can go away but the capsule the connective tissue of the shoulder actually contracts and that's where you've got women for years not able to move their arm yeah that is just estrogen walking out the door right um so that's arthralgia that's frozen shoulder um forget whatever plans you have this weekend because you're staying at home and playing on SpinQuest.
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12:38There's nothing like the American Express platinum card. Find out your welcome offer after you apply, which could be as high as 175 ,000 points. Learn more and find out your offer at americanexpress.com slash explore dash platinum. Terms apply. It manifests a lot of other ways within the musculoskeletal system. our cartilage becomes less hardy. We have rapid progression of arthritis. We lose muscle mass
13:03Dr. Vonda Wright:at an alarming rate. We can lose 10%, 10 to 15 % in our perimenopausal period. We lose 3 % of our bone density a year, even before we realize what's happening. And we redistribute our fat, all those things that we become aware of because we suddenly have belly fat and we may never have had it before. But that starts happening. I'm sorry, millennial women, about 43, 44, 45, way before 47, which is when I felt like I was hit by a truck, definitely before 51 or 52, which is the average age of menopause. So there's so much we can do a decade earlier to get in front of this. Okay. So this is like what you call like the, the midlife muscle crisis, like in this age range of 35 to 45.
13:58And I didn't start lifting until I was 41. I read that somewhere. Yeah. I saw you. You were a runner. Yeah. I was a triathlete. I did Ironman. And, um, then I had this massive knee. I had a complete root tear of the meniscus. No good. And so I was non-weight bearing for, you know, six weeks. And I was like, I'm getting certified. Like I'm changing my whole. So I got certified as a personal trainer. I mean, I was teaching Pilates and doing, I was very active my whole life, but it is a doozy. I mean, I had osteonecrosis in the femur, the, you know, for those that don't know osteonecrosis, because some people don't know what's happening.
14:40Do you see that a lot in your patients? Osteonecrosis or osteoporosis? Well, let's talk about necrosis, which not a lot of people will have. Not a lot of people have it, but that's a disaster. So osteonecrosis means bone death.
15:00Dr. Vonda Wright:You have a loss of blood supply in your bone, and bone is a highly vascular structure. But without blood, on the outside of bone, it's like a tree trunk. thick rind bark on the inside. It's like lace. It's called trabeculae. And when you don't have a blood supply that collapses and you can actually, the rounded surface on the end of your femur, for instance, can collapse and become flat and it's irreversible. So that's why when we, for whatever reason, people get the osteonecrosis, it can be for no reason at all. It can be because of chemotherapy or steroids or over drinking, sometimes nothing.
15:38Dr. Vonda Wright:You're like, I did nothing. And still your bone has lost its blood supply. That's why we're so careful to protect weight bearing so that we don't allow your bone to collapse before it heals. So it's irreversible. Well, we have techniques now where we try to, we call it retro drilling. So if this is the patch of osteonecrosis, we're not going to come through your joint and it's up your cartilage. We're going to come from behind. We're going to drill little pathways that we put bone graph in and ask your body to revascularize. Sometimes that works. Sometimes that doesn't work. If it works, give it time.
16:23Dr. Vonda Wright:We'll heal. If it doesn't work, then there's a high chance that your bone will collapse and we'll have to resort to some kind of cartilage restoration technique. Yeah. I mean, that was selfishly for me because I had been hitting bone on bone because I was undiagnosed for six months. And so I just kept running. It's like, cause I was like, I feel like I'm crazy. They're like, we think it's a bone bruise. And I was like, well, okay. So I guess I'm just, you know, living life in pain, but anyhow, I mean, that's, that's one thing, but as a, as a orthopedic surgeon. For these women that are coming over, what is the age range where you see most of the common injuries?
17:08And I assume that's rotator cuff is one of those. The common injuries of midlife or for women? Let's say midlife to like from 35 on. Yeah. So for master's age athletes, which, you know, Masters is defined for anybody outside the Olympic pathway because we have four-year-olds in the Olympics right now, but they're a different athlete than even high-level recreational athletes.
17:35Dr. Vonda Wright:And so most injuries in even high-level recreational athletes come for two reasons. Trauma, we fall off of something, we jump down off of something, we twist hard, or overuse. Too much, too soon, too often, not enough recovery, progressing too quickly. and we just overcome the strength of the tissue, whether it's the tendon, ligament, bone, right? The thing about the musculoskeletal system is even though the bones are dynamic and they're replacing themselves all the time. Happy birthday, America. It's time to celebrate and play your favorite Las Vegas casino games by American-owned spinquest.com.
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18:58Terms apply.
18:59Dr. Vonda Wright:Ligaments, you get one set. Meniscus, you get one set. Cartilage, you get one set. And so if we have big traumatic injuries, no matter what age we are, I've had 20-year-old football players with end-stage arthritis because they've just had a big traumatic injury. So for midlife people, it's either trauma or usually overuse. less so things like I was playing pickup soccer I was running I felt a pop my ACL pop that is due to weakness and muscle imbalance so that would be number three okay yeah and that's like I mean I think that goes along with with what we try to preach yes women are getting the message to lift heavy but there is a progression that you have to do and we have to make sure those small guys are just as healthy as the strong guys, because this is what I see all the time.
19:55Somebody will come in and be like, well, you know, I can't do this because I hurt myself. And I'm like, well, let's talk about it. And everyone wants to just like get right into the fun stuff, the really heavy lifting. And you cannot, you cannot, you do that at a cost. Well, I think it's like anything, right? People, when they talk to me about longevity, They want to go right to the wacko biohacking stuff that I'm happy to discuss with them. Meanwhile, their general health is not optimized. Such a good point.
20:25Dr. Vonda Wright:We don't know what their regular labs are, let alone their biomarker weird labs. So it's the same way with fitness, I think, in that it seems fast and sexy and all their friends are, all their heroes are doing it. Or they look at you guys and they're like, look at these specimens. they don't realize the reps you put in to get there, right? Everybody just wants to jump off. So if I was just writing about this today from my book, if you are a adult onset exerciser, meaning you've never really done it, nobody really taught you, you just never did it, or you are a once upon a timer, meaning we're still talking about high school and we're 40 years old.
21:08Dr. Vonda Wright:okay, get that up. That was a long time ago where you're a new person, you get a new experience. Whatever the situation is, sometimes you just have to start with figuring out where your knee is and where your hip is and how you connect them. And when you move your body, if you want to do a squat, it's a multi-joint activity. And if your ankles aren't limber enough, your form for your squat's not going to be good enough and you're going to hurt yourself. So learning how your body moves, learning to move your body, learning to trust your body. I mean, putting a bar on your back and doing a back squat is scary.
21:48If you don't even know how your body moves or where your butt's
21:51Dr. Vonda Wright:going to end up. So, you know, building a foundation, which I know is really important to you, I think is critical for progressing to a place where you can slam the weights around. I mean, I feel like a badass when I'm putting weight dust on people. That didn't. I know. I feel like such a badass, but that didn't happen overnight. And every time I take a break, I mean, I'm just coming off an unfortunate break because I traveled so much. I knew you were just traveling. It totally screws up my whole routine. I mean, I am back to weights that I, smaller weights that I haven't lifted for a while because I can't get what I need in a hotel.
22:29So anyway, but even now I know what I'm doing. I know what it's supposed to feel like. It's a little scary to put that big rack back on my back. So imagine having not done it ever. Yeah. So please, please take some lessons. I mean, yeah, please. It's start with the fundamentals. So yeah. Yeah. Do you, let's talk about the relationship of the bone and the muscle. I'm really glad you brought this up because I'm chuckling as a, I'm a muscle scientist. I had a muscle stem cell lab for a long time and it was screaming from the mountaintops. It's all about your muscle people. I am so glad people are finally listening to that, right?
23:19But what people need to realize also as an orthopedic surgeon, a bone doctor, is that without your bones, your muscle is just a heap of quivering tissue. It does nothing on its own. It's metabolically active, but without the connection to bone, it's just, it's a pile of hamburger. I mean, not to degrade muscle, but come on people, unless it's connected to bone, nothing moves. So the fact of the matter is bone is structural for allowing muscle to do its magic. It is our storehouse of minerals, but it is a master communicator through the hormones that bone makes. Bone is thought of as, to use a funny analogy, the strong silent type, standing in the corner, not saying much, just looking good.
24:19Bone is a master communicator.
24:21Dr. Vonda Wright:It produces multiple hormones, including one that I'm starting to talk about all the time called osteocalcin. Osteocalcin is like a global communicator. And why wouldn't bones be part of the communication process? We have bones from our head. We have bones in our pinky toe. We're connected, our entire body, by a system of bones. Osteocalcin, for instance, goes to our muscle and helps our muscle and our pancreas regulate insulin sensitivity. Amazing, right? Osteocalcin from the bone. It goes to the brain and helps our brain produce neurotransmitters. For men, it goes to your testicles and helps your lytic cells make testosterone.
25:07Oh my God, it gives a whole new meaning to why men love bones. Seriously. And then there are others. Seriously, I could make a joke, but I won't. You know, there are just so many things bone does that nobody realizes. But the connection between bone and muscle is intimate. muscle, if a muscle is my arm, is connected to bone through a tendon, which is my hand.
Read the full transcript
25:34Dr. Vonda Wright:It connects to a bone like this. But we think muscle is hanging on to bone. No, bone has sent out stem cells and fibers to hold the muscle, the tendon to it. So they're intimately related. They're holding hands. They are not two organs in the separate sides of the universe. They are in the same cul-de-sac, sending out their little messengers to talk all the time. They're a coordinated ecosystem. And so it's kind of amazing. And it's why we talk about things like
26:11osteo, I always have to mix up these words, sarcopenia plus osteoporosis is thought to be one disease, actually. One continuum. We lose muscle. It can't talk to bone. We lose bone. Bone can't help form muscle. It's osteosarcopenia.
26:32Dr. Vonda Wright:There it came out of the depths of my brain. One disease. It's an amazing connection that I just am going to keep talking about every time I have an opportunity now, because it's not just one thing. The importance of muscle and bone are also critical in real life. So, you know, you guys are in the prime of life. I'm in the prime of life. But as an orthopedic surgeon, I have to take call. And when I'm called to the hospital to meet a patient, typically because of the kind of hospital that I have to take call in, the person I find before me is a woman in her 70s or 80s, and she has fallen and broken her hip.
27:19not only because her bones were so weak, but because her muscle mass was so little that she tripped over her rug or her dog or her suitcase, or sometimes didn't trip at all, just fell down at the counter in her kitchen. So there she lays with her broken bone because she didn't have enough muscle mass. She doesn't probably have a lot of protein stores to help heal her. She's laying in bed incontinent because she had the gynecourinary syndrome of menopause from low estrogen. Her heart is so damaged from having low estrogen and her lifestyle that she may be too sick for the medicine doctor to clear for my 45-minute bone surgery.
28:04And many times she has the onset of dementia or sometimes Frank Alzheimer's. That, my friends, is the future of women if we allow ourselves to become frail because we do not care for our muscles and our bones. And the millennial women like you guys are getting the message. My generation of women are screaming now to catch up, but it's the baby booming women who thought that only pink weights would do. Pink man be weights would do. And we're never given the opportunity to lift heavy, build their bone, or to make an estrogen decision. So I feel like spreading the word like you're doing and me getting this passionate about it is not just because we love fitness, but because we're trying to save the lives of a generation of women.
28:57I do too. Full body chills. Okay. So I feel like, yes. I mean, and it's never too late. It's never too late. The process looks a little bit different for me on the strength side. If I'm coaching a 70-year-old that's never done anything versus, you know, even a 49-year-old. But forget whatever plans you have this weekend because you're staying at home and playing on SpinQuest. And there's never been a better time to sign up than right now. New users get$30 coin packs for just$10. All the table games you love with hundreds of slot games and real cash prizes. That's at spinquest.com, S-P-I-N-Q-U-E-S-T dot com.
29:42SpinQuest is a free-to-play social casino. Avoid where prohibited. Visit spinquest.com for more details. Let's shift the conversation to also talk about how important nutrition is when we're talking about bone and muscle for someone that is in a low energy availability or red S state. And for those, if you can describe that, because a lot of women still don't know what that is, but, but such a danger for these aggressive dieters or women that I meet women that have been on a diet their whole life. They can't remember when they weren't on a diet and they tell me what they're eating. And I'm like, this isn't you know you're you're sure you're fit now at 40 but what has that done to your bones and your muscle mass well you know uh who you're seeing now women in their 50s and 60s grew up at a time when the model of a beautiful humanness uh were supermodels from the 70s and 80s and they were truly beautiful looking people, but they were this big.
30:55They were this big because they were bone and fat. And listen, I was once invited. Listen, I don't hate supermodels. Please, ladies listening to me, I love you. And I'm so glad you're with me on Instagram, but you know what I'm talking about? You were told to diet, to drink coffee, smoke cigarettes and stay this big because if not, you weren't going to get work, right? So I was invited, I don't even know why, that's another series of stories by Mercedes to go to Fashion Week 20 years ago. And I went and I was so out of water. I don't know a thing about, that's not true. I do know fashion, but I really don't know a thing about fashion.
31:36I'm looking at, just intimidated by all these people, not only because they were supermodels, but because they literally were like this. And that was the standard of time. Well, what that does when you're young is prevent you from laying down bone and muscle, which we max out on unless we invest with rigor at about 30. Nature maxes us out. And then we can build more at every age, but we have to really work at it, right? So I'm getting to the answer of your question. So for women in my generation,
32:13Dr. Vonda Wright:That's why we ended up where we are with needing to build better bone, needing to build more muscle. But listen, here's something people don't think about. We are 52 years into Title IX. Title IX is the law that equalized sports participation for men and women. And I am thankful for that law, such that at the college level, there must be equal participants for women and men. And it's a beautiful law. But here's what I see. Many times, young female athletes, today I see it. I still have 28-year-olds who have broken hips. They are in a constant state of relative energy deficiency, meaning they're working out like crazy.
33:02They're burning 7 ,000 to 10 ,000 calories a day, and they're nowhere eating that. My soccer team, I won't name the school, used to survive on gummy worms and Gatorade. I mean, are we kidding ourselves? If we are outpouring the energy we need to compete in an elite level, we need to refuel morning to night and take in enough protein. And I'm not a sports nutritionist, but for the women I serve, I insist on one gram of protein per ideal pound. Actually build muscle mass. And it has to be high, high quality protein so that we can stimulate this mTOR system, which is the chemical pathway for building muscle.
33:47So it needs to be high in leucine and the essential amino acids, right? It's not just empty calories. It's how you fuel your bodies with enough calories, the enough different kind of macros so that you can build muscle and bone. Because here's what we know. Our bodies are so smart. If it sees that we do not have enough energy to fuel our brain or to keep our heart healthy or to fuel the organs that are going to actually keep us alive, it will sacrifice what it views as accessory. And that is our bone and our muscle. Because bone and muscle rank below brain and heart in the body's hierarchy. And our body will sacrifice those unless there's enough to go around.
34:33Yes, it makes total sense. In addition to nutrition, what are the supplements that you believe really make a difference as far as bone health and muscle? You know what?
34:47Dr. Vonda Wright:I think there are a lot. There are gazillions of them, and I can't keep track of them all. And I find people get really confused if I suggest too many things at once in my practice. So when I talk about this, it's always... What's going on, everyone? It's Bluff here. And you know what's more American than America's 250th birthday? Supporting American-owned companies like SpinQuest, America's number one social casino with over 1 ,000 games like Live Dealer Blackjack and Craps. They're offering new users a$30 coin package for just$10. Go to spinquest.com and sign up today. SpendQuest is a free-to-play social casino.
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35:31Dr. Vonda Wright:One gram of protein per ideal pound. No simple sugar. You have to read labels. We do not eat added sugar. You've got to read every label. Even healthy yogurt has nine grams of added sugar. I'm not against carbs, but I insist on complex carbs and fiber. So you got to really know what you're putting in and read labels about, you know, make bran muffins with wheat germ instead of, you know, whatever. But from a supplement standpoint, we need to have our vitamin D tested. Everybody's low on vitamin D. If you don't have the capacity to have it tested, just start taking it. Most of us will be safe to start taking it anyway.
36:11Two to three international, through a thousand international units, get your vitamin D tested. You don't want it to be over the moon, but most of us live under normal. Vitamin D should be taken with potassium to help its absorption. I like everyone to take 500 milligrams of magnesium, either L-threonate or glycinate. Not citrate unless you want to have diarrhea. There's lots of different kinds of, I mean, if that's your purpose, fine, do that. But L-threonate and glycinate. And then you know what? Everybody talks about it, but it's true. One of the most well-studied supplements is creatine. I started becoming aware of it in 1992 when we started using it in wrestlers to help them build muscle, cut weight.
37:01It's evolved since then. For most people, I tell them to take five grams a day and that's enough. And so let's see those things. And then I'm closing my eyes to look at my cabinet right now to see what's out there. I personally take a NMN supplement so that my body will make that into NAD+. NAD is a coenzyme of more than 400 reactions that our mitochondria need to make energy. And with aging, it drops from an intracellular level of about 60 to the first time I measured mine, it was 18. And how does that manifest? Well, for me, every day about three o 'clock in the afternoon, I would be done like falling asleep on my desk, searching out the next energy source.
37:56Dr. Vonda Wright:But now that I supplement NMN for my body to make NAD, which is what you have to do. You can't just take NAD, you have to make it. I'm like this. until about 8.30 when I start my bedtime routine. And I notice a huge difference. So that, and then the other thing that I do as part of my longevity practice is I take something called fisetin, which is derived from strawberries, but its role in the body, fisetin and quesetin, is to help eliminate senescent cells. Senescent cells are those cells in your body that have stopped doing their good work and should turn on to program cell death. Because in our bodies, we either have stem cells that can do anything.
38:44You have mature cells that do their job. They're then supposed to turn off and program themselves to die. But some of them get so damaged at the DNA level that they're just sitting there sputtering and churning out bad cytokines. So I want to get rid of those. and so FISA 10 is what I take so it's not many it's five you could take a dozen but those are the basics because I find once I like to layer on lifestyle for my people so once we get these things optimized then we can do more but to hand people a packet of 12 supplements it's just too much it's overwhelming too much this is switching gears a little bit but what's your stance on hormone replacement therapy?
39:32My stance on hormone replacement therapy is that every woman gets to make her own decision because she is a sentient being with agency. But here's what I insist on. When a woman is going to make this decision, I insist that she surround herself with science, that she stops listening to the lady next door or her grandma Minnie or the bad data that has been largely refuted the WHI sorry guys oh good the WHI which was the study published in 1992 which uniformly took hormones away from women has been largely refuted in fact the book that changed my life is called Estrogen Matters. And when I ask women to make their hormone decision, I ask them to read that book.
40:29I'm not asking them to believe me, although many of them do. I want them to know that hormone replacement, in my opinion, will save us from the ravages of chronic disease that I see in women in the hospital, including hip fracture, UTIs that lead to urosipsis, heart disease, and dementia. And so if you choose not to, or you can't because you truly have genetics that will cause you breast and ovarian cancer, fine, but it's still your decision. Here's the other thing I want people to know. Whether you decide to take hormones, estrogen, progesterone, testosterone, whether you decide to do that, or whether you decide not to, They're not a magic bullet.
41:13Yeah, yeah. I could take all the estrogen I wanted all day, but unless I got under a bar and put some plates on it, I am not going to have muscles the way I want to. People think that one thing is enough. It never is. No.
41:28Dr. Vonda Wright:So I just wanted to make that clear, that all hope is not lost if you decide not to or cannot. It's an entire roadmap of things. Yes. And I love that you as a longevity doc talking about all of this instead of just, you know, I mean, I was obviously 41 when I had this knee surgery, but my surgeon who was amazing, but like there was no conversation about anything outside of, oh, this is your problem that you're presented with, that you're coming in with. Let's treat this and, you know, go on your way. Bye bye. Didn't see it. But how do you incorporate that into your practice? Well, I do. And it's evolved over time.
42:15So I am a whole person doctor. And so just because your orthopedic surgeon sees you as a knee doesn't mean you're not going to get good knee care. But that's probably all you're going to get, right?
42:30Dr. Vonda Wright:But as a whole person doctor, I still can fix your root tear. And I can still reconstruct cartilage and all the technical things that we expect orthopedic surgeons to do. But I view my driving force, my why in orthopedic surgery is the mantra. It's on all my slide decks. By saving mobility, by saving your knees so that you can lift, by saving your shoulder, by sending people back to work, by saving their mobility. I am saving them from the ravages of chronic disease. It is never going to be enough for me to know where to put the screws in an ACL ever. I can, I know I was trained at the number one orthopedic hospital in the world, hospital for special surgery, but that is not enough for me.
43:22Right. So here's two examples, three, we have examples all day. I had a 57 year old woman who was being treated by Dr. Google. And she was determined not to age like her mother, who was frail and depressed and all the things that she didn't want to be. So she thought she was eating well, but what she was doing is starving herself. She was lifting really heavy, but she wasn't feeding her body to support that. She had decided not to take hormones because not Not because she had known the literature, but because she was scared by the unknown, right? So she was doing the right thing, but she broke her hip because she wasn't supporting.
44:12She had osteoporosis and she didn't know it. So she came to me. I met her in the ER. We fixed her hip. I fixed her hip. I put metal in it. And I could have left it at that because that was my job as an orthopedic surgeon. but I immediately started asking about nutrition. Do we have enough protein in our body to heal? I started asking about how she was lifting because I knew we needed to correct that. When she got out, I got her a DEXA scan. I set her up with an endocrinologist. We found her a menopause specialist to make her hormone decisions. Not only did I put her in physical therapy, but when she was done with physical therapy, which basically she could walk again.
45:00I hooked her up with our elite trainers in the Lake Nona Performance Club where I am. And the last video I have of her is doing box step-ups, holding a free weight, like a goblet step-up, because we're going to train you back to be healthy, vital, active, joyful. That is whole person care, not just the metal in your bone, but getting you back better than you were. Or I had a 19-year-old the other day, if we're talking about young athletes. He was playing soccer and he felt the ominous pop and he had torn his ACL. But his family was in transition. He tore it at home. They had just moved to Orlando.
45:41They didn't have any doctors. They didn't know anybody. They were moving to a house. So I didn't see him for three weeks after his injury. When he got to me, his thigh had gone from like this to like this. he couldn't move his knee they didn't know anybody in town and he had lost his team remember for athletes your team is your social network yeah so he comes to me and my entire conversation could legitimately have been you tore your acl we got to get your knee moving uh i'll see you in a month or three weeks when you can move it and we'll put some metal in you but that was not my entire conversation my entire conversation was to talking him off the ledge that at 19 years old his sporting life was not over and to calm his anxiety it was to hook him up with great sports therapists who would get his motion back and build his quad it was to set his mom up with a social network of here's how you here's where you go in this town here's where this is because she knew nobody, right?
46:51And so that is, and we talked about nutrition. What are you eating? Are you a typical starving teenager? Or are we getting enough protein and getting the whole family involved in this recovery? That is whole person care. And so when your orthopod was just focused on your root tear, they wanted to fix your root tear so that you would have a knee that functioned in the future. But not everybody chooses to take the approach I take. And I choose to take this approach because what's my mantra? By saving your mobility, I'm saving you from the ravages of chronic disease. So I have a long-term disease perspective and not a short-term put metal and bone perspective.
47:34And that serves me and it serves my patients really well. Yes. I actually, I'm going to shout out hospital for special surgery because that's where I had my surgery. Oh, they're excellent doctors. Oh no, they were, he was, he was taught like one of the best, uh, knee, knee surgeons specifically. And so like, I went to him and I was so desperate by that point. He was like, they're like, uh, he doesn't take insurance. I'm like, I don't care if you could fix my knee. Cause I had been out for like nine months just from other doctors, not. So it was worth it. But I love that you have taken this full body, whole person approach, because really a lot of the stuff comes down to not everything.
48:21I'm never going to fix a knee or anything, but diet, like nutrition and good exercise programming and mobility, they all go hand in hand to help be preventative for a lot of these things. Things are going to come down the pipeline that for some of us that we couldn't have prevented, but a lot of it definitely, I think we can try. I know, I wish more doctors had your mindset of the whole person care. It would really change so many more lives. It would. And in doctor's defense, I have to tell you, The people we should be screaming at is your insurance companies. So true. Because for this hour-long conversation that I had with this family, which is what they needed, insurance companies will pay me half of what a massage therapist makes.
49:13It's a joke. A quarter if you're in New York. Yeah. And so it becomes, you know, doctors are teachers. We would not have gone into this did we not have a heart for people. But when you see yourself getting rushed through clinics, sometimes it's because, gosh, how do I take care of people and keep the lights on? And unfortunately, so we should all be screaming at the insurance companies that we deserve better care, frankly. A million percent. Yeah. Okay. So your book, which, holy cow, I mean, how recent is this? It's recent. My new book? Your new book. that I'm talking about? Unbreakable. Unbreakable.
49:58Actually, this is the first podcast I've talked about it because I just announced the deal. So, you know, Unbreakable, the deal to write it, although I've been writing it for a few months now, has just been announced.
50:12Dr. Vonda Wright:And what it is, is it takes the conversation. It takes what I do. I mean, I have a part of my business called Precision Longevity, where we build precision longevity plans that optimize health, take people through peak performance, because I'm an elite sports doctor. It's what I've done my whole life. I apply what we apply to pro people, to mere mortals like me and executives. And then if we get there, we'll take you to precision longevity and all the interesting things down the road. So this book is meant to surround people with the tools they need, the modern tools they need.
51:14bubble crafts, head on over to spinquest.com. Get yourself a$30 coin pack for just 10 bucks. SpendQuest is a free-to-play social casino. Avoid where prohibited. Visit spinquest.com for more details. To be and live unbreakable physically, mentally, from a resilience standpoint. So it's about optimizing your health, lifting heavy, base training, why sprinting is so good for you to recompose your body. It's about the smart nutrition that we need, but it's also framed in the pillars of longevity. Now it's, it is formulated to give you the principles of what you need to find a good plan that, that will lead you to longevity.
52:02But it's also framed around epigenetics, about around stem cell rejuvenation, about building your telomeres. It's the pillars of aging that are typically viewed in a negative sense. What are the 12 things that are going to kill us as we age? And pivoting that conversation to say, how, when you lift heavy, does the transcription of 9 ,800 genes change our future? I cannot wait for this book. I can't believe we have to wait till 2025. I know, but you know, we'll have a whole year of, you know, I've released
52:36Dr. Vonda Wright:yesterday, I released a little wait list because what I intend to do as it's, I intend to leak out some of the tidbits, like bone information about osteocalcin. And so we'll get stuff along the way, but you're right. It won't be fully out until 25, but it is the extension of the conversation that's happening now, especially as it pertains to midlife women who have been ignored from a programming standpoint, who have been ignored from a research funding standpoint. Have you heard these data? Research funding for midlife women for all NIH funding is about$450 billion. These numbers are not quite right, but the magnitudes are spot on.
53:23Research for women in general about 450 million so 10 i'm research for midlife and menopause 15 million that's it 40 450 billion 450 million 15 million and so no wonder we don't know exactly what to do there's been no research on us it's all been on it's all been on men research is expensive so it's usually done on men and spread across the board. But I think this book is what women will be waiting on because gosh, I love men. I'm married to a man. Most of my colleagues are men, but we have a real bro culture when it comes to longevity. And when I was on, this is just so typical.
54:14Dr. Vonda Wright:And to this, I say, get in line. But I just did a podcast with the diary of a CEO and one of the bro culture guys without listening to one word of the podcast, put up some snarky remark. And I just think to myself, A, get in line. B, there is no place for that because 51 % of all the population in this country are women. So by disregarding women, fit women, unfit women, you are disregarding the majority of people in this country. And that is wrong. Oh, I'm doing an Instagram live with you when your book comes out next year because I'm already going to be talking about it. I was so excited to see that.
55:05I was, finally. Yep. So what would your, okay, so you talked about, we know heavy strength training. We know we have to have a lot of protein. What about the plyometrics? What are some bone tips for keeping really strong bones? Yes. Okay. The way bones build is that they turn the biomechanical stimulus that they feel into biochemical messages to the cells to tell it to resorb or build. So the biomechanical stimulus is jumping, is pounding. Walking's fine. Rebounding is fine. Climbing is fine. But if you really want some bang for your buck, you're jumping rope, you're stomping, you're skipping.
55:58Dr. Vonda Wright:You are, how about this? This is the biggest one. Although I don't do this. It's kind of pain in the butt. it's a squat vertical leap. Start in a squat, vertical leap up and land hard. That gives your bones like 7.5 times impact. Take jumping. That's about four times. It's easier. 20 jumps a day. That will give you enough bio mechanical stimulus to lay down bone. What if I get this question all the time? What if your knees already hurt? What if you can't do that impact? Well, listen, when NASA returns astronauts from space, they use trampolines and rebounding. You can do it. They use vibratory plates for which the research is a little less hardy than rebounding has some really good research.
56:51Vibratory plates has a little less. But the thing is what you're doing for women every day is critical. The stimulus of muscle pulling on bone will build better bone. Yeah. So build some muscle and you'll be building better bone. It's actually quite when I have my clients jump, it's like, we go like this far off the ground. It's like, wait, I see the basketball players, you know, and then it's like, wow, this speed and, you know, power really, really can't be neglected either for multiple reasons. That's because their butts are so weak. They have no power. I mean, let's just be honest. It takes butt and leg power to get off the ground.
57:33Yeah. I'm jumping 20 times a day now. Yeah. Jumping 20 times a day. Get a jump rope. When I have my retreats, I give women jump ropes. And they're like, I haven't done this since I was a child. And that's the point. If it's easy enough for a kid to do, it's easy enough for you to do. I know. I text Haley. I'm like, we got to start jump roping. You probably jump rope all the time. No, because, but I had to film it for one of my, um, you know, exercise library. And my husband was like, when's the last time you've skipped? I don't like skip down and then jump rope. I was like, I know I've got, I'm rusty.
58:12Well, it takes real muscular coordination too. Isn't that funny? we just take it for granted. Yeah. Oh, so funny. So if you had some advice, we have a couple of questions that, um, we'll end with that people were really excited about me talking to you. Um, but if you had some, like a few takeaways for, for someone listening, that's like, okay, I get it. I know I need to do this. What would be your advice for any, like three pieces of advice, maybe for anyone who wants to start. Yeah. So if you are truly starting from zero, you've gotten the message, you've decided you're worth it and you just don't know where to start, the easiest thing to do for seven days in a row, just to prove to yourself that you can be consistent is after dinner, push back from the dinner table, leave the dishes on the table and go for a walk.
59:08You have been walking since you've been one year old. There is no skill involved. You know how to do it. But the mere fact that you are walking after a meal, you will start pushing your glucose into your muscles and it will start working on your insulin resistance. The mere fact that you prioritize yourself over the dishes will reinforce for you that you are important. And then the walking, I'm not asking you to walk 8 ,000 steps after dinner, but if you walk that many steps a day, it decreases your all-cause morbidity and mortality up to 30%. You're doing real change without the intimidation of showing up to some big gym and putting a barbell on your back.
1:00:00So that's number one. If you're truly starting out, just commit for seven days. Another easy thing to do if you're starting is on the days you're walking in a row, you're going to stop eating sugar. And it's harder than it sounds. But if you're doing that for seven days, at the end of seven days, your taste buds will change and you won't crave it as much anymore. And you will have started to control your blood sugar, right? I love not to. These are not rocket science. This is easy. And then the last piece of advice, two pieces of advice, find a good foundational program. I mean, when I ask you, Haley, when I just put out a Building Better Bone course, but so many of my women were sitting on the couch and they don't know where to start.
1:00:54And I said, what do they do? You built a foundations course for them. Find a foundations course so someone can hold your hand through how your body moves so that you don't feel so wigged out by it. And the last piece of advice that is really important is to realize that you are worth the daily investment in your health. Nothing is more important, not the people you serve, not the people you love. Until you take care of yourself, nothing else matters. I'm going to cry. This is, that's the best advice. I told you she's the best motivation. I'm like, how do you get all of it in one person? It's amazing.
1:01:44Laura, do you have some questions? Those couple of few questions, and then we're going to get Dr. Dr. Vonda Wright on her way. Honestly, the only thing I wanted, one of the most powerful things that I think goes along with this that is very simple that you talk about is the sitting epidemic. and I feel like we can end with that. I just think it's powerful and it relates to everyone. And so you can kind of just briefly discuss that. You know what?
1:02:22Through the amazing digital technology, right? We are no longer an agrarian society. We're not growing our own food. We're not out chasing animals around. Most of us are sitting most of the day. Even, you know, as an orthopedic surgeon, three days a week, I'm sitting writing or doing that kind of work. The other days of the week, I'm pacing up and down my clinical hallway or I'm doing surgery. But that being said, even for most of us, our lives are spent sitting. When we're sitting hunched over in a chair, our back core, the muscles along our back get really weak. Our front core gets really weak.
1:03:05Our belly sticks out. And we atrophy our glutes. That is a setup for low back pain. 80 % of all people in this country get low back pain. Not because there's something wrong with our backs. There is something wrong with the muscles that support our backs because we sit all day. So that's number one. Number two, we are designed to move. What do I mean by that? If we were designed to sit all day, we would be nature in nature, form follows function. We were made with our strongest bones and our biggest muscles below our belly button. If we were meant to sit all day, we would be made like a mushroom with a big sessile stalk, like Jabba the Hutt, where he's like laying there with a head, right?
1:04:02Nature intended us to sit all day. We would have been designed like that. We were designed to move. That should tell us something. yeah oh okay well this has been such a fantastic conversation i would love love love i'm looking forward to your book we're looking forward to having you on at another point in time and and i just want to thank you for everything that you're sharing in the world and not only for your time today but for just what you're doing for women and the the longevity spectrum that you take and the whole body approach. So thank you for being who you are. And I hope to meet you in person.
1:04:48Me too. Oh, we will. Thank you for having me. It's been fun. Thanks for listening. If you enjoyed this episode, please consider giving us a five-star review and sharing the body pod with your friends. Until next time. You know what? It sucks to be bored. But when I get on my phone and play real casino games on SpinQuest.com, the time flies by. That two-hour wait at the DMV seems like 10 minutes. Play your favorite slots. Live blackjack, live preps with a live dealer. New players,$30 coin packs are on sale for$10. Play SpinQuest.com and you'll never be bored again. SpinQuest is a free-to-play social casino.
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From the publisher
We kick off Season Two with a bang! In this episode, we are joined by the one and only Dr. Vonda Wright, an expert in musculoskeletal health, who takes us deep into the musculoskeletal syndrome of menopause. Dr. Wright discusses the dangers of frailty during menopause and the importance of maintaining musculoskeletal strength as we age. She shares proven strategies and expert tips to enhance longevity and prevent frailty during this life stage. Whether you're navigating menopause now or preparing for it in the future, this episode is packed with essential insights that you won’t want to miss!
