On Purpose with Jay Shetty - Dr. Vonda Wright: Formula to Lose Weight and Gain Muscle (Why your Current Workout is Not Giving You Results)

Episode Date: April 14, 2025

How often do you work out? What’s been the biggest challenge in your fitness journey so far? In today’s episode, Jay sits down with Dr. Vonda Wright, an orthopedic surgeon and researcher specializing in active aging and longevity. If you’ve ever wondered how to stay feeling youthful as you age, lose stubborn fat, and improve your sleep,, this conversation is packed with life changing insights. Jay and Dr. Wright start by debunking the myth that aging is an inevitable decline. Dr. Wright explains how lifestyle choices in your 20s and 30s directly impact how you feel in your 40s, 50s, and beyond. They dive into how excess fat, especially around the belly, isn’t just about appearance—it’s a sign of inflammation that accelerates aging. Dr. Wright shares how movement, muscle mass, and diet play a crucial role in fat loss and energy levels. They also explore the powerful body-brain connection. Dr. Wright breaks down how physical activity releases key proteins that protect the brain from cognitive decline and diseases like dementia. Jay and Dr. Wright discuss how poor sleep can sabotage fat loss, slow down recovery, and disrupt hormones—leading to more cravings, weight gain, and reduced longevity. In this interview, you'll learn: How fat storage impacts aging and energy levels. The critical role of sleep in weight loss and brain function. How movement and muscle mass keep you youthful. How lifestyle choices in your 30s affect long-term health. Why fitness-based friendships can improve your health. If you want to stay sharp, maintain a healthy weight, and build lasting habits that help you thrive for decades, this episode gives you the tools to start now. With Love and Gratitude, Jay Shetty Join over 750,000 people to receive my most transformative wisdom directly in your inbox every single week with my free Monk Mode newsletter. Subscribe here. What We Discuss: 00:00 Intro  01:43 Your Perception Of Aging Is A Myth 05:31 Develop Healthy Habits in Your 20s 10:07 Why Your Sleep Can Fall Apart in Midlife 16:58 Can You Restock Years Of Not Sleeping? 22:09 Sleep Deprivation is Sabotaging Your Weight Loss 26:45 The Weight Loss Formula That Actually Works  36:04 There Is A Difference Between Being Healthy & Fit 43:13 Fitness Is A Great Way To Connect 46:17 How To Lose Stubborn Belly Fat 55:30 The Body Brain Connection is Integral to  1:01:39 Don’t Make Excuses to Start Making Changes In Your Life 1:04:24 Mobility is One of the Most Important Skills for Aging Well  1:09:51 Break Free from Your Limiting Beliefs 1:17:15 Vonda Wright on Final 5 Episode Resources: Vonda Wright| Website Vonda Wright| YouTube  Vonda Wright| Linkedin Vonda Wright| Instagram Vonda Wright| Facebook Vonda Wright| TiktokSee omnystudio.com/listener for privacy information.

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At what age are we actually old? Visit jsheddy.me forward slash tour and get yours today. At what age are we actually old? I believe that our perception of aging has to do with what we view of the future. Is there something that happens in our 35 to 45 range that our sleep starts to become less consistent? How do we lose that stubborn belly fat? to 45 range that our sleep starts to become less consistent. How do we lose that stubborn belly fat? Weight is not the measure for me. It's body composition.

I never say lose weight. I say we are going to recompose your body. Why is it that the high intensity interval training is not having the desired result? Listen. Many people die for 20 years. Jay, what's something you used to believe to be true about health that you don't today? If someone listening right now is between the ages of 20 to 30, what are those specific

healthy habits that we need to invest in that are non-negotiable? That is the perfect time to figure out your life habits. Learn to prioritize your health over those things that are going to tear you down. If someone said to you, I want to lose weight, what is the best, healthiest, quickest way I can do it? The number one health and wellness podcast. Jay Shetty. Jay Shetty. The one, the only Jay Shetty.

Hey everyone, welcome back to On Purpose, the place you come to become happier, healthier and more healed. I'm so grateful to have your ears and your eyes for the next hour or so. Thank you so much for tuning in. Today's guest is Dr. Vonda Wright, an accomplished orthopedic surgeon, author, podcast host and researcher recognized for her expertise in sports medicine and active aging. Dr. Wright is a motivational speaker and author of the successful book, Dr. Wright's Guide to Thrive, Four Steps to Body, Brains and Bliss, which helps readers use practical advice to take action, change their attitude and measure their

achievement for a more fulfilling life. Please welcome to On Purpose, Dr. Vonda Wright. Dr. Wright, it is great to have you here. Truly my pleasure. So thankful to have you and there are so many things I want to ask you about. I was sharing with you earlier. I really appreciate your clarity. I appreciate your contextual advice, the thoughtfulness with which you approve it, your incredible academic background as well.

And I want to dive straight into a question that I'm asking almost because I think it's something we all subconsciously believe. And I wanted to ask you, at what age are we actually old? I believe that our perception of aging has to do with what we view of the future. I have never believed the myth that is pervasive in this country, that aging is an inevitable decline from vitality of youth to frailty.

I've never believed that. And there have been so many examples of people in my own life, in the athletes I've taken care of, and even the regular people. I believe we can change the trajectory of our future by investing in ourselves today. I think that, and I've seen this, not only research, I say I think this, but research has backed this up, that when we invest in our health as a daily basis, whether it's our mobility or our sleep or our nutrition or a variety of relationships we have, that we don't have to go down this slippery slope to frailty in which many people in our country die for 20 years, Jay, between 60 and 80. It's just three doctors visits a week, I believe,

that we can be healthy, vital, active, joyful, and hopefully die peacefully in our sleep. But that takes intention. That takes purposeful activity every day, because time will take over if we just let physics take over. I really love that perspective that you have. And I've had experience of that. I remember in my early 20s,

obviously feeling exceptionally healthy from a natural standpoint. In my late 20s to early 30s, almost experiencing a dip because of a lack of focus and a lack of attention. And then now in my late 30s, feeling the best that I've ever felt. And it's really fascinating to see how even our ideas and language around aging, I think we used to say,

oh, well, I don't want to be 30. And people still feel that. Oh my gosh, I'm turning 30. And then people will say, oh, well, I don't want to be 30. And people still feel that. Oh my gosh, I'm turning 30. And then people will say, oh my gosh, I'm going to be 40 now. Now I'm 50. And now people, we age ourselves by how we talk about age,

how we dress, how we think about our age. So I want to ask you, if someone listening right now is between the ages of 20 to 30, what should their priorities be? What should they be focused on? And we'll focus on other generations next. right now is between the ages of 20 to 30, what should their priorities be? What should they be focused on? And we'll focus on other generations next. Absolutely.

If you're in your 20s, going into your 30s, think about that time of life. There's a lot of uncertainty in that time, right? You're just finishing your education. You may or may not have the job of your dreams. You may be living with your parents, but that is the perfect time when there are probably still other people

taking care of you in some way to figure out your life habits, right? That is not the time to skate along on your youthful zest or your youthful biology, but learn to sleep. Learn to prioritize your health over, for instance, those things that are going to tear you down. I mean, listen, we're all young. We all want to go out. We all want to burn the midnight oil. But now is the time to respect yourself enough to make the decisions

to say, okay, five days a week, I'm going to focus on my career. I'm going to focus on getting ahead. I am going to take care of my body. And because I'm young, I can play around a few days. But if we do that seven days a week, we end up a decade later with no habits, probably this beer belly we never wanted and you're getting teased with our friends. So I think it's time now as we're enjoying our youth

to develop habits that will last a lifetime. How much harder is it in our 30s and then in our 40s to shift to those healthy habits than if we started earlier? I think if we start earlier, it's just our lifestyle. It's how we live, right? It often, and I tell people this at any age, that as we're layering on our health habits, I tell people this at any age that as we're layering on our health habits, it may seem like a lot at first, but if it's just how we live, then it's no extra stress, right? For instance, if you're used to mobility almost every day, if you're used to making food choices that do not involve a lot of fried foods or you understand that you can't be drunk every night and still be healthy, then it is no effort to live that way versus, oh my gosh, I've got to do these five or six things.

Does that make sense? Yeah. But biologically, how much harder is it to like, say, lose that belly fat? The good news is, is that recently a study was released that showed our first big hit of biologic aging is about 40. Now, that doesn't mean that you can... What does that mean? Yeah. That means at a cellular level, the repair mechanisms become less efficient. It means that our pluripotent stem cells, which we have not only from our bone marrow but in every cell, are actually less young. That being said, lifestyle can rejuvenate those, and we've done this part of my research having done those studies. But so when I say at 40 is the first big hit, our actual intracellular biology becomes less efficient. We are able

to clear the toxins and metabolism less efficiently. We are able to clear the toxins and metabolism less efficiently. We're able to reduce the proteins that our cells make in normal living from our DNA less effectively. So I don't want to give 30-year-olds a pass. I call the time between 35 and 45 the critical decade, just to get everything established, to get in the best shape of your life so that you're actually starting midlife. Because when you look at life expectancy, midlife is 40, right? And so we tend to think, oh, when I get old, well, 40 is midlife. If we arrive there having taken care of the habits, it is significantly easier.

Now it's easier to start at 40 than it is at 65. I don't want to be discouraging to people if you've missed the boat on 2030s, but that's what I mean by biologically, there's a big hit about 44. So I'm 37 right now. I'm seven years away from the first hit. From that first hit.

What would be the top priorities for someone between that 35 to 45? What are those specific healthy habits that we need to invest in that are non-negotiables? With the experience of age and working this long, your top priority is to figure out how to sleep through the night. Because secondarily, if I tell you to go build muscle mass and to work on your VO2 max, which we can talk about all those things, if you're exhausted, if you are not aware of your circadian rhythm and when you should be going to sleep and when you're waking up, you will not have the energy or the brain power to do the secondary things, which number two is mobility. I'm an orthopedic surgeon. It's top of mind for me. Everybody's

talking about it now. We are to build lean muscle mass. But what people forget about is this is prime time in both men and women's lives to build your bone. We top out at bone density around 30, right? So what does that mean? Well, we need the thickest, strongest bones because we literally do live off that for the rest of our lives. Now, we can get into this, but you can build bone back, but you need the best bones. And that's what I would focus on, muscle and bone. And then finally, everybody needs to not treat their bodies like a garbage can. We are not a trash disposal. Everything can't go in. This is a temple. This is a meticulously designed machine. And just like we would take care of the machines of our cars

by what we put in it, many people don't think of their bodies in the same way. Yeah, so well said and so simply put, I deeply appreciate how practical and thoughtful they are. Let's dive into each one of them. Is there something that happens in our 35 to 45 and onward range that our sleep starts to become less consistent? Well, particularly for women, 40 to 45 becomes a critical time that they might not even be

aware of because what we know, and you've probably heard of this before, I've heard it on your podcast, women are born with the amount of eggs that we're ever going to have at birth. It's a miracle, right? And we slowly use those such that at age 40, we only have 1% left. Well, it's our eggs that make our estrogen. So as our total number of eggs declines, so does our estrogen. And that's about the time when women go from this normal cyclic pattern of hormones up and down to haywire.

And that's when we don't build muscle as well. We don't build bone as well. But our sleep becomes disturbed because our circadian rhythm is off. And so it is not uncommon for women in their 40s. This is such a common time. We're all waking up at 3.37 in the morning, not only because our sugar is dipping and our bodies are waking us up to save our lives, but because of the hormonal fluctuations. So sleep becomes really difficult. But think about in our early 40s, because many women have chosen to put off childbearing, they may have just come off of the time when their children are up all night,

and now they're plagued by not being able to sleep. So it becomes a real big problem. For men, men don't realize it, but men can start losing testosterone in their early 40s too. And the caveat to that is your testosterone may still be in the normal range, 250 to over a thousand, but most men don't check their testosterone when they're 20 or 30. So, you still may be in the normal range, but your normal, I'm making a random person up here, your normal may be 850 and now you're 450. So for your body, it's a dramatic change and that affects sleep cycles and everything. So that's why sleep in our forties becomes more difficult.

That is fascinating. I don't think I've ever heard both those explanations for it in that way. So what do we do about it? Because I know so many people, so many friends that are going through exactly what you're saying, their sleep has started to decline. They wake up more often in the middle of the night. They find it harder to go back to sleep. What changes do they need to make?

Because if sleep is the pillar of everything that we're about to talk about, I think it's really important that we help people figure that out. I totally agree with you because there was a time in my life when I didn't sleep. In graduate school, and then I had a baby, and then I was in residency, and it frightens me how much sleep I lost because we know now it's so critical for longevity in biology. But the things I'm about to say to you are not rocket science and yet I find it hard for people to get in a habit of doing. Science shows us we must go to bed and wake up at the same time to set our daily clock. During the night, we build up a protein called adenosine. We wake up and it's at our highest. We try to see the sun unless it's the dead of winter

to start our day. But if we have uneven sleep schedules, then that clock is off. So protecting your go to bedtime and protecting your waking up time. So for instance, I live on the East coast. We're on the West coast. I have stayed on East coast time. And that happens to me when I come down, do you do that? Yes. And then you're not exhausted or jet lagged. It's a little weird if you have to do business or go out, but if I'm having a

party at my house, I'm like, see yourselves out guys, you have fun. I'm going to bed. It's a little weird if you have to do business or go out, but if I'm having a party at my house, I'm like, see yourselves out, guys. You have fun. I'm going to bed. It's 930. So for our house, it's 930 to 5, like clockwork, number one. Number two, I am not a holder to intermittent fasting, but what I am a holder to is time restricted, meaning I'm going to eat as early as possible so that by 9.30, everything is out of my digestive system.

I'm spending no energy, and that helps us sleep better. Number three, I always say don't throw rocks at me, but in midlife, especially for midlife women, alcohol is a total sleep disruptor because when we're young, we think, oh, of course that makes me sleep better. What it does is it makes us pass out. But if you're tracking your sleep, you'll see that you're not entering into the really deep sleep levels. And this is being talked about a lot lately, except I don't see people adjusting to it. I mean, I find that when I work with my longevity patients, they're willing to do almost anything except give up the glass or two or four of wine at dinner because it's so cultural. It's almost like a ritual.

People come to believe that they need that to relax when in fact, it inhibits their sleep. Timing of sleep, we talked about not eating three hours, we've talked about alcohol. And then you know something I do, something that's very helpful is I take my magnesium, which is a supplement that I think most people need, especially for bones, at night. I also suggest that women, if they're taking progesterone, take it at night. And then all the other lifestyle things, blue glasses, turn off your phones, which I find hard to do personally,

but those are all legitimate ways to help regulate. And then as things as silly as if you find you're waking up at 3.37 every morning, like clockwork, you know what the clock is going to say, that may be your blood sugar. And I know it's my blood sugar because I often wear a continuous glucose monitor. So if you eat a little bit of protein right before bed, just a titch, not a meal, not enough to disrupt this other advice I've given you, that will make your sugar not dip so low and your liver will not

and your body will not wake you up because your body wakes you up. I know because I wear a CGM when I wake up that way, my blood sugar is 50 or 40 and my body's just trying to save my life. And what do you want it to be when you wake up? Well, fasting blood glucose should be 85 or lower. That is the level that we should all strive for. Not 100, not 110, which many people walk around with in midlife. 85. I couldn't be more excited to share something truly special with all you tea lovers out there.

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You've, we were talking about your wonderful daughter earlier and other children. And when you look at that and you look at that time in your life, when you were staying up and taking care of your kids and having erratic wake up and sleep times, how do you get that back? Can you get that back or is that just a period that you write off and accept that? I lost that sleep. You know, I don't believe there's any research that shows that I can restock 11 years of not sleeping, but my obligation to myself now is to start today.

We can reverse the hands of time by the lifestyle we do today. I can become biologically younger, but I don't honestly think that I can get back 11 years of sleep. But if we continue in those habits, we just perpetuate the badness, right? What can we do during those years for the women that are listening, the parents that are listening? What can you do during those years where that piece of advice is going to be impossible to follow naturally? What can they do to cushion that impact? Well, and this is so pertinent. I lived through it.

I have daughters who are having children now. Simple things like children can be scheduled. They will learn to go to bed at a certain time and wake up at a certain time. Not newborn infants, but once they get big enough, about three months, six months, depending how big they are, they can learn a schedule. So let's schedule them. They might wake up in the middle of the night. It always happens. But if there's no schedule, children feel a little insecure and will wake up more. So that's number one. Number two, give yourself the grace. I want to talk to all young

parents. Give yourself the grace that when your child goes down for a nap, young children less than three years old usually have two naps a day. Give yourself the grace that the minute they go to sleep, you don't have to go clean the house or get on email and lay down and sleep too. Just collect sleep, right? And then all the other habits. You may feel like you need a glass of wine to relax. That's just going to disrupt your sleep more. So those are simple things. I think the biggest thing that I just said is young parents, please give yourselves the grace. It's an imperfect time in your life. You can't be in control of everything and your child is not going to break. Children are so resilient. So as an old mother, I'm saying that to the young mothers. There's no perfect way, the young parents,

there's no perfect way but have the grace to take the rest, leave the dishes in the sink. Do not think that everything has to be perfect in that really chaotic time in your life. Yeah, I think one of the things that is really challenging people right now is our cortisol levels are so high. We think of, or we've trained ourselves to believe that certain things help us rest and decompress. But as you were saying with alcohol, they don't really. And I think the same is true for watching something. And I used to always feel like, okay, well, I can stay up because I want to watch my favorite show. But actually that decompression that I get from watching a show

versus if I changed that for sleep, the sleep would have been far more relaxing and rejuvenating. So, say I finish all my daily chores and everything that I have to do at 10 p.m. If I had the choice to get into bed at 10 and fall asleep or watch a show for an hour and a half, or an hour or whatever it is, it would be better for me to go to sleep. But we've trained ourselves to believe, no, the drink or the show will make me feel better. Right. How do we kind of deal with that emotional feeling that makes us say,

well, the show and the glass of wine is better versus like, no, this rest is actually going to do more work than any of that could? I think rituals, which is what you're talking about, you have a ritual of relaxing with wine, a ritual of watching a show. I think rituals in life are actually helpful. The bedtime ritual cannot be stimulating, right? It doesn't mean that you can't watch 20 minutes of something that's relaxing, but please do not over-stimulate your brain with some murder mystery or some, you know, I don't even know the shows where people shoot each other, right? That's not going to relax your nervous system, right? So the ritual of slowing down, maybe some rom-com or something

non-stressful or some beautiful music. It's okay to have a ritual of drinking something, but I find hot tea or something soothing. The ritual then will help you train your body to go to sleep. But the ritual can't be stimulating. It's self-defeating. Yeah. And I'm sorry, because of streaming, the show will be there tomorrow. It's not like it's the only time you'll have it available. Yeah.

It's not like it used to be. Absolutely. And what's alcohol actually doing you'll have it available. Yeah, it's not like it used to be. Absolutely. And what's alcohol actually doing? Why is it disrupting our sleep? Why is it that we can't get deep sleep with alcohol? What's actually going on? You know, and I'm not a sleep expert, but I think it changes the way we enter into REM sleep.

It changes the depth of us being able to descend into the deeper and at a molecular level, I don't know. But what I do know from having reading enough and watching my own, I don't want to say brands out loud, but watching my own device, I can see that, and I don't drink anymore actually, but I used to see how I just would never end up in deeper sleep. Yeah, I know. Definitely. I think it's really fascinating to hear that. What's the... We're talking about this powerful decade of 35 to 45.

What's happening to our bones and muscles during that time if we do nothing? Well, if we sit around and do nothing, then most of us in this country live in relative energy excess, right? It's not that we're in relative energy deficiency, which is its own set of problems, but excess. So with excess and sedentary living, our body has to get rid of the glucose we consume. So in our bodies, whether we're eating protein or fat or carbohydrates, it's all used for fuel and when we over fuel, it's going to accumulate. So we're going to gain weight as fat. And I want to distinguish that for all of us that weight is not the measure for me, it's body composition. Because I once was invited to Fashion Week and I was a fish out of water. But one of the things I observed

is that there were very, very thin women who if I put them in a body composition machine, probably had very, very low muscle mass. So it's very possible to look thin but be mostly fat, which is metabolically unfavorable. So imagine what happens if we're actually visualizing the adipose tissue. And as we age, there is a syndrome called sarco-bacity, which means we have too much adipose tissue and too little muscle. So if we're in relative energy excess, we're going to accumulate that unhealthy metabolic tissue and not make enough muscle. I'm going to tell you, I mean, I'm a surgeon, right?

Our bodies with energy excess, they're like scrambling. The closet's full, the cupboards are full. Where are we going to put this fat? I find it in the shoulder joint, which is not supposed to have that much fat. I find it infiltrating muscle as I'm operating because our body is just trying to stick it places because there's just too much of it. That's what happens, especially because many, many jobs now are sedentary jobs. They're brain jobs.

They're not laborish jobs. We're actually getting up and using our bodies, which frankly is what we're designed for. We're designed to move. So it's kind of against nature to sit around all day, but that's what happens. Yeah. And that's so scary to hear. Yeah. Because as you said, the older we get, the harder it will be to lose.

But here's the good news. Yeah. You can totally reverse that, but I hate the reason I pointed out weight is because the words we use are, I'm going to lose weight. I never say that. I say, we are going to recompose your body. We are going to build muscle and in doing so we will replace muscle with fat. Muscle weighs more than fat per volume.

And so your weight may not change, but your composition will be vastly different and therefore your metabolism. Yeah. I've been working on that consistently, probably just for the last six months. Yes. And I saw drastic shifts in my skeletal muscle mass. Yes. My weight practically stayed the same, but my body composition is what was changing.

And doesn't it feel and look different? It feels and looks different completely, but it was fascinating to me. And it was exactly what you were saying. It was weight training, eating more protein in my diet, cutting out sugars, and it was simple changes, but it was incredible to see how it looked different on paper, it felt different, it looked different in real life, but my weight was exactly the same. Exactly right.

And it doesn't take that long. What would you say if someone says, I want to change my body composition. If someone said to you, I want to lose weight in their words, in your words, change the body composition. I want to lose weight. What is the best, healthiest, quickest way I can do it?

I work mainly with midlife people, 40 to 65. And in midlife people, here's the secret sauce. We are going to lift heavy. We're going to stop doing the youthful 20 reps, 15 reps of a weight. We are going to do for women. My recipe is four reps, four sets. For men, it can be eight reps, is four reps, four sets. For men, it can be eight reps, four sets. But what does that mean? Of the four compound lifts, a push-pull with the upper body. So bench press pull-ups or some pull, right? That's the upper body compound motions. Meaning, in simple words, that we use multiple muscles across multiple joints. For the leg, it's squats and deadlifts, four reps, four sets, at least twice a week. Better four if we can fit it in. But I'll take two if we can't do four.

And then we augment those with supportive lifts. So for a bench press, four reps, four sets, heavy weights, the supplemental lifts are biceps, triceps, our cosmetic muscles that we see consistently doing that, number one. Number two, you have to feed that muscle build with protein, right? It's all that everybody's talking about it right now. It's the truth.

Great research has shown that even, and I don't suggest this, but even a higher protein diet alone will help your body build muscle mass, even without lifting. I don't suggest it, but that's what the data show. Here's something that is the recomposer. So you're lifting, you're feeding, and you're sprinting. And sprinting, I know, right? Sprinting does not mean you're running down a track like Usain Bolt.

Sprinting is a heart rate function. So I like people to do their cardio really in three ways, but it's layered on. Number one, 80% of the time we're spending in low heart rate based training. This is based on endurance athlete data from Inigo San Martino who has a lab in my building. That's why I use his method. But low heart rate, 80% of the time, twice a week, we sprint, which means we're getting our heart rate up as fast as it can go. Now, I happen to do mine on a treadmill and I'm running as fast as I can without falling off the back.

But you could do it on a rower, you could do it on an elliptical, you could do it on one of those Alpine machines or on the road running up these hills here. It doesn't matter, but you're leaving nothing in the tank. That is different than high intensity interval training when you're going at 75 to 85 and that's when a lot of people get hurt and have

to come to the orthopedic surgeon because they do that five days a week. What I'm asking you to do is do strategic stress as high heart rate as your heart or your cardiologist will let you go twice a week. It is that stimulus coupled with heavy lifting, coupled with feeding, that's going to recompose your body. Wow. And I've seen it time and time again. Why is it that the high intensity interval training is not having the desired result? It is too intense to truly be restorative, to truly that the base training, to truly, which is about 60, 65 of your maximum heart rate, to

truly be restorative, to truly allow your mitochondria, which are the energy organelles in your body, to become efficient, to use all the food substrates. But it is not stressful enough to really stimulate your body, especially for women in midlife who have lost their estrogen by and large, or for men whose testosterone is, you need that kind of stimulus for your body to think, oh my God, I really need to lay on some muscle and change my body composition. And listen, I used to do high intensity interval training every day because I get bored. And I'm like, I'm just going to sprint this out. But it wasn't at the top of my heart rate, it was just below it. This is what happens.

You do that five days a week, you develop muscle imbalances, you get hurt, you come to your orthopedic surgeon, they say rest, which I actually don't believe in. I believe in active recovery for three weeks. Well, your brain gets angry at you because it's used to the daily dopamine hit and it's just a miserable way to cycle in and out of injury. So this 80-20 method is not only backed up by great scientists, but I've seen it in me, I've seen it in the people I take care of it. It is the key to recomposition. So we've got the 80% low heart rate, we've got the 20% sprinting. When you've got that down and it's your lifestyle, then what I would love for people

to do is work on their VO2 max. Talk to me about that. VO2 max is the absolute measure of your fitness. It's oxygen, how your oxygen is diffusing from your blood to your lungs and your heart's using it, right? The O2 max, unaided, unsupplemented, will decline 10% per decade as we age. We just get less efficient. No way. Yes. Our stroke volume, which is how much blood your heart releases per pump, the diffusion across your lungs, it all declines with age unless you work on it. But

why is that important? You're like, oh, good, my VO2 max, why is that important? Here's why it's important. There is a line called the fragility line, the frailty line, after which you can no longer take care of yourself, which none of us, it's hard to fathom now in midlife or in youth, but many 70, 80, 90 year olds get to it. And what it means with the VO2 max less than 18 for the man, less than 16 for the woman, which is the frailty line, you can't take care of yourself. You're going to have to move out of this house or move in with your children or, God forbid, move to a nursing home because if you can't get up from a chair, you can't take care of

yourself. So here's how it goes. I usually give people my example just so the numbers mean something. So when I was 50, the last time I did my VO2 max, and it hurts, so people don't like to do it very often, but my VO2 max is 45. If I did nothing, by the time I was 60 using round numbers, it would be 40. At 70, it would be 35. At 80, it would be 30, 90, 25. At no point in my life will I cross the frailty line. So we got to work on that because you can increase your VO2 max.

So you never reach that frailty. So how do you do it? It's a different kind of working out. So sprinting, you sprint for 30 seconds and then you completely recover four times. Right. Nothing in between. No, no way.

You just, you just get off the treadmill and you rest, you recover. Your heart rate comes back down. Takes me a couple of minutes, two or three minutes for VO two max training. It's four minutes as hard as you can go. So it's slower than your sprint, but it's still full out for four minutes. And then you only recover for four minutes and then you do it again. So twice, three times. So it's very stressful, but that's what will build your VO two max.

So it seems like a lot to say it all at once, but once you layer it on, you do VO two max once a week, once a week it on, you do the O2 max once a week. Just once a week? Yeah, just do it on Mondays. How did we evolve to need that kind of training? Because it seems so specific and mathematical and- Well, it's specific and mathematical because some brilliant PhD has figured out that this is how you do it. But I think that historically, when we had to hunt our food,

not being able to get up out of a chair is a bad thing for hunter-gatherers, right? And so I think we would just get it in our lifestyle. We would be walking all day to forage. We would be stocking something, and then we're sprinting to go catch it, right? I think it's the way we lived. And we don't live that way. So now we have to have this formula. That's interesting.

Yeah, no, that's what I was trying to place. I was like, that's so fascinating that this four minutes, four minutes off. And when you hear about these things, you go, well, how did humans get there? That's kind of where my mind goes. Yeah, but think of the way a lioness hunts. Yeah. If we do an analogy to a hunter, lioness will stalk their prey for a very long time. And then they rush.

Yeah. Yeah. Wow. Never thought about that. I know. But it makes a lot of sense and we're not running after our food, but. Not most days. Yeah.

For the people that are going to be mad if I don't ask this question. Okay. How do we lose that stubborn belly fat? Number one, let's give ourselves some grace that this is the way the human body is. Any person who's had a child is going to be transformed. And that is just the way it is, right? Don't crucify yourself.

That being said, if we're living in a time of excess energy all the time, the way that I've described for you, the high intensity interval, let's clarify that, the sprint intervals plus the weight lifting is what's going to transform your body. You may never get rid of that extra little inch, but you'll get rid of most of it. You'll get rid of the back fat. You'll get rid of the heavy hips people don't like. And you will decrease visceral fat. The fat that is inside smothering your organs will decrease. And that's what we really want, right? What's the difference between the good fat and the bad fat around our belly?

Because I feel like we don't know the difference. The, the peripheral fat is that which you can pinch, whether it's on your hips or in your belly, around your belly button. That's not the fat that's going to really kill you. That's the annoying fat. That fat does make a protein called leptin, which is bad for your metabolism. It is bad for your bones. But it is the visceral fat, the fat that you can only see on a body composition or an MRI, that literally we've got this apron in our body, under our skin, under there's a layer called fascia, it's white like you would see on a steak. It's an apron of fat over our organs, it's a protective.

Well, that gets thicker and then fat is deposited around our organs and that fat, the visceral fat, is metabolically different than the peripheral that you can pinch. And it's that visceral fat that is what causes chronic inflammation that leads to disease. So, yes, cosmetically, we want to get rid of the peripheral fat, but metabolically, we got to control the deep visceral fat. You've worked with so many athletes and I just want to, I want to kind of go on from the tangent before we come back, but I wonder with the athletes you've worked with and to your earlier comments around models

and being at Fashion Week, I was going to ask you which sport do you find the actually healthiest people in versus just fittest or what is the difference and how do you see it? Does that make sense? Let me think about that. Yeah. I'll give you three examples and I'll tell you why. I think soccer players have the best cardiovascular machine because on average a high level soccer player will run six to 10 miles on the pitch over the course of the 90 minutes at different speeds, right? Maybe they're jogging up the pitch and then minutes at different speeds, right? Maybe they're jogging

up the pitch and then they're sprinting, right? So they're getting it all in. And usually they're muscular people, but they look more like runners than people who lift weights, even though I know they do, right? So that's one group. The other group that I've had the privilege of taking care of that I think get it all in are rugby players. They're running up their pitch, they're sprinting, but they have to be full of muscle. Because if you've seen both male and female rugby players, they are physically lifting each other up as they – if no one's seen rugby, they're not going to know what I'm talking about. You know rugby. Yeah.

So they lift each other up to catch the ball in the air. That takes tremendous strength, not to mention rocking and I mean, just the engagement they do. Yeah. I played rugby growing up. I loved it. I love rugby so much. They're just penultimate.

The other group of athletes that I think are tremendous, both in cardiovascular and muscle, believe it or not, I've taken care of three professional ballet companies, the Pittsburgh, the Atlanta, the Orlando. Ballet dancers are some of the best athletes I've ever taken care of, and they do it with such grace. You would never know how hard it is, but it's aerobic and it's muscular.

What are the sports where you see the least healthy, least fit athlete? Well, you know, I think at an elite level you see the least healthy, least fit athletes? Well, you know, I think at an elite level, all athletes are healthy because do not be fooled by the field athletes, the shot putters, the discus, the javelin. You may think that they're not fit because they're carrying extra body fat, but they are tremendous specimens, right? So body morphology can't predict it. Gosh, I'll get in a lot of trouble for this. I was once the, twice, the head football doctor for Division I schools,

Pittsburgh and Georgia State. And linemen are not always the most healthy people. They're strong, they're carrying a lot of extra weight. So, and that bears out because on average is the sad statistics on average, a professional football linemen offensive or defensive, they died of metabolic syndrome in their fifties and sixties. They turn out not to be that healthy. And so I feel like as a sports medicine community, we need to do better for them. But to answer your question, maybe it's that. Yeah.

Yeah. No, I was just intrigued and curious because I think we have a vision of what we think fitness and health looks like. Yeah. And like you said, often we think people are the leanest or people are the skinniest or people are the most built or whatever it may be. And I think that's partly our challenge when we talk about these things,

because most of us are wanting to get healthy either from an aesthetic point of view. You want your summer body, you want your whatever it may be. And then from the other side, there's this feeling from some of us who are just like, I just want to be healthy. I want to be fit enough to take care of my kids. I want to be healthy enough

so that I can spend time with my grandkids. How should someone measure their fitness and health right now if they're listening? Because a lot of people will say, especially when they're younger or on the younger side, they'll say, well, I feel okay. So how do I know if I'm okay, safe, unhealthy? Like, how do I feel that or experience that?

You know, I love that you said okay, because I find a lot of people come to me, or maybe you're asking someone on the street, how are you? I'm fine, you know, that fine. I think many people, because we're so busy, we're taking care of other people, I'm not blaming them, but we live in this state of fine. We're neither hot nor cold. We're this

lukewarm health. We're not dying, but we are not truly optimized, right? So if you're exhausted, if you have trouble sleeping, if you don't have enough energy to do the things that you truly believe that you enjoy in life, maybe you're fine. Maybe we should invest some time and actually get some analytics. Sometimes when I'm bringing people to surgery in the preoperative time, we're asking them questions about their health and do you have this, do you have that? And people will say, I have no health problems. Well, if you've never been checked, if you've never had labs drawn, if you've never been examined, it's not that you have no problems. It's that you don't know.

You don't know. So I would answer that question by saying, if you don't have enough energy, if you're dragging at work, if you can't truly enjoy life, if you don't some days feel like a total badass because you're full of energy and strong, and maybe you're fine, but you're not optimized. And let's invest some time and see where you are. What's the ideal length of workout if someone's working out four days a week? I don't think there's an ideal length. You know, some days my weightlifting takes me 30 minutes because I power through it.

And sometimes it takes an hour. I think ideally, if we're talking about this cardio 80-20 regiment, it's 45 minutes of base training. And if you're adding sprinting, that usually takes another 15 minutes. So weightlifting can take, I don't think you have to be there three hours unless you just want to hang out in the gym. So it doesn't take forever. And it's not about time. It's about what you put in that time.

Yeah. Because I think a lot of people are feeling like I only have 20 minutes a day. Is that true? to hang out in the gym. So it doesn't take forever and it's not about time. It's about what you put in that time. Yeah. Because I think a lot of people are feeling like I only have 20 minutes a day. Is that true? Is that enough? Is that true? Do we only have 20 minutes a day? I've been doing this a very long time and I tease people that you can't out excuse me because over the, I've been practicing 25 years and I've had the privilege

of taking care of probably 100,000 people. I have heard all the excuses. There are some times when you legitimately do not have time, but I would say that is the fraction of the time. And to the I don't have 20 minutes, I ask you to examine literally, and I'm guilty of this, how long we're scrolling, how long we're washing our dishes. Do you really have to spend three hours every night cleaning your house because that's what makes you feel not anxious at the expense of your health. So I think you have more than 20 minutes if that's what you tell me. It is so interesting.

I was looking at it from the point of view of relationships. I was looking at some resets that was talking about how, you know, we say we don't have time together, but the amount of time as a couple we spend in front of the TV is astronomical. It's like, I think it was something like 90 minutes a day minimum. And we're missing out on together time. We're missing out on connection time.

And I was looking at it from a purely romantic, intimate perspective. But then when you look at it through health and, and I think for a lot of us, what I've found it is, is allowing our friendships and our romantic relationships to be around fitness. I remember a friend, a couple of my friends in the city, we've decided that whenever we're hanging out together, we're playing pickleball for one and a half hours, two hours. And we may go out for dinner after that,

but we're playing pickleball for a consistent amount of time where we're all getting a workout or we're going on a hike. And that's now become our form of bonding and friendship rather than, oh, let's go out for dinner. And the dinner was great. We got to enjoy it. But now we're sedentary. We're sitting there for a couple of hours.

Maybe some people I don't drink and most, a few of my friends don't drink, but the ones who are, they're now drinking. Whereas if we're out playing sports, they wouldn't be thinking about that. And same with me and my wife. We found that cold plunging together or going to the infrared sauna together, taking a book or taking our journal or whatever it may be, we had to start replacing activities.

Because you may not have enough time to do it all, but the main form of connection can be around a fitness activity. And actually, you both end up feeling better about yourselves, you feel better about each other. And whether it's a friend or a partner, I feel like everyone walks away from that experience having gained something rather than, you know, doing anything else. And so in the beginning it may take a reframe, but it transforms your relationships and it transforms your health.

And if you're just beginning a relationship or a friendship or even deep into it, the endorphins that you release from the strategic stress actually increase bonding. So it's like a triple goodness. It's fitness, it's relationship, it's increased bonding at a chemical level. Yeah, yeah. Explain, tell me more, tell us more about that. When you exercise, our body releases hormones that are endorphins, it's that high you feel. And having that shared experience, or what if you're doing something like rock climbing

and it's a little terrifying, and the oxytocin and the bonding chemicals that are released because you're terrified in this experience, those actually bond people. You know, that's why people that go through hard experiences together end up as a band of brothers or a tight-knit group. So that can happen in relationship. So advice out there, if you want to bond with this person, do something frightening with them.

Yeah, no, I completely agree with that. One of my first dates that I went on with my wife when we were dating was we went to a ropes course. Oh my goodness. And it was so much fun because there was like trusting each other, helping each other. There was that sense of thrill. And I couldn't agree more that I think when you do... I remember the first time me and my wife went skydiving, we did it together.

The first time we cold plunged, we did it together. Wow. And you're so right. It creates a different connection when you both done something hard together. And also something that's... I think as couples we do... People have to go through so many emotional hardships together.

It's nice to do something physically challenging together. Exactly. That isn't carrying this emotional weight or stress because that's something you probably have on in the background anyway. And so this applies for that. Yeah, I think if you're someone that struggles with finding time, think about the way you spend time with the people you love. And maybe you don't have an extra 20 minutes or 30 minutes,

but you can change the 30 minutes you spend with your friend, or you don't have an extra hour, but you can change the way you spend the hour with your partner, and all of a sudden everything's changing. It's meaningful. It's meaningful. Yeah, it's meaningful. And like you said, it's giving us so many other benefits. You mentioned magnesium earlier.

I did. And we were talking about the need for stronger bones. Yes. What can we do to strengthen our bones? Because I don't think that's a conversation that we're having that much. You know what? I am going to, I'm so glad you came back to that because we think of bones as just like the strong, silent type hanging out, holding up our muscles. They don't say much. That's right. Don't pay attention to our bones. But the fact of the

matter is that without bones, muscle, which we're all enamored with right now, it's just a quivering pile of metabolic tissue. The structure of you, the fact that people recognize you, it's because your bones are holding up your soft tissue, right? And I love to bear with me. I like to think about the importance of bones as even culturally. I mean, Halloween in this country, you view bones as this scary death object, but bones are living. They replace every 10 years. They are the source of all the minerals that your body needs. They are the housing of our internal organs. They are where our immune system is made. Our hematopoietic system is made in our bones.

Our bones are master communicators releasing many proteins, including one called osteocalcin. Osteocalcin from the bones can go to the brain and cause release of brain neurotrophic factor, which builds neurons. It can go to the pancreas and the muscles and help you with sugar levels. And for men, it goes to the testicles and helps produce testosterone. So just when we think bones are kind of boring, bones are amazing, but even culturally, many cultures, Judaism, Christianity, Buddhism, many Eastern cultures talk about the reanimation of bones. Bones are thought to house the soul in some cultures. And so it's only here that we're like, oh, skeletons. And you know what? When we die, everything goes away except the bones. It's the last record of ourselves, right? So how do we build better bones?

And that's why we need better bones, right? That's, yeah, that just clicked for me. That's all those reasons are why, but how. How we build better bones. Let's talk nutritionally. Bones are 50% protein. It goes back to the same principles. We're not adding on more principles. We're just can we please pay attention to eating protein? Can we eat a non-inflammatory diet so we're not eating seed oils and fried foods and those things that make us hot red fire inside. Can we please make sure we're getting enough vitamin D? Even in sunny places, we slather ourselves, we stay inside, we need vitamin D, we need magnesium. A lot of trace minerals like selenium

and boron and zinc, we get those in our food. If you really wanna be conscientious, you eat six prunes a day. But nutritionally, that's how we take care of our bones. Our bones must have impact. One of the early studies I did on active aging asked the question, can we maintain our bone density? And if we can, what does it take? And I studied masters athletes 40 and over,

and I found that number one, yes, we can maintain our bone density into our 80s. How do we do it? Impact exercise. So I add to every regiment that – I've already told you most of it, right? The lifting, the aerobic, the nutrition. I add to every regiment a jumping practice, whether it's box jumping for impact, whether it's jumping up and down 20 times a day, whether it's 10 minutes three times a week where we're jumping over little hurdles or in a plastic hexagon. It is the impact because this is how bones work. There's a law called Wolf's Law that just summarizes that the mechanical stimulation, biomechanical stimulation, is translated by our little bone cells, osteocytes, into biochemical messages.

Biomechanical stimuli, like jumping up and and down is translated into biochemical stimulus that tells the bone building cells, which are the osteoblasts, to build more bone. So literally get out the jump rope, jump up and down, run up and down the stairs. And it has to be a little impactful. Literally, you got to bash your bones a little bit. That's how you build better bones. Is that why functional exercises like squats and stares and things like that are somewhat better

than machine exercises inside gyms? I prefer functional with free weights and barbells because it requires then you work all of your muscles and it requires neuromuscular pathways to keep you upright, right? It requires balance versus a machine. You're sitting there on a leg press. And frankly, we need to work our muscles in the way that our body works, our

muscles, and there is no time in the history of people that your quadriceps are working sitting on a leg press. They're always squatting. Right? Yeah. Yeah. That's the more natural movement. It is.

Yeah. So as much as your workouts are mimicking natural movements, that's a healthy exercise. You know, even bench press, think about it. I've been traveling a lot lately. I need to lift a 50 pound suitcase above my head into the bin without falling over, hitting somebody with it. And so you practice that with bench pressing and overhead lifts. You spoke about neural pathways there and I know you talk a lot about the body brain connection. What are we losing out? Because if you look at, when we talk about aging, brain aging is such a big part of it. And frightening.

And frightening, very frightening. I mean, I've had so many countless family members, mentors, family friends who've had Alzheimer's, dementia, stage four brain cancer. It's painful to watch the people you love go through it. What is happening? What is that body-brain connection? What are we losing out on the brain when we're not doing the things we've talked about? You know, loss of cognitive function is multifactorial. Dementia is different than pure Alzheimer's

with the plaques that accumulate. But we know for sure, and there's just so much research that we can maintain our brain with the physical activity we do. I mean, for instance, I talked about the role of bone releasing osteocalcin, which goes to the brain. There is another protein that is stimulated to be – it's called transcribed when DNA makes a protein.

When skeletal muscle contracts, it also causes the transcription of a protein called clotho, which is the longevity protein. Part of clotho's role is to go to the brain and stimulate neuron development. So there are studies out of the University of Pittsburgh that showed a six-week walking program will grow the hippocampus, which is the memory part of the brain in double digits. How? You know, I don't know the mechanism that's worked out. But I think at a very basic level, I mean, we'll go back to the hunting analogy. That kind of strategic stress on the body tells our body that we're still living. We're not curled up in a ball in some cave waiting on winter to die.

We are active. We have enough strategic stress that we have to maintain because our body is so highly conserved that if our body doesn't think we're using something, we'll lose it. It will start resorbing like bone. If I put a cast on your leg, you will resorb the bone in your leg. Yeah. So I think the brain is the same way. So back to what maintains a brain. Well, muscle releases a protein that maintains the brain. Bone releases a protein that maintains the brain, right? Fascinating. Isn't that fascinating? So fascinating, yeah. Food has a role. But when we think of midlife, we have to start talking about hormones.

And the work of Lisa Moscone, who is at Cornell in New York, has shown that in women, and probably in men, but her work is in women, the brain is covered in estrogen receptors. So as we lose our estrogen, it affects the brain. That's why when I was going through perimenopause, there was a short period of time when I wasn't on hormones yet. I'm in surgery, and I know that I want the thing that does this, but I could not remember that it was called an atsin. Think how frightening that is for a brain person like me, I use my brain to help people make a living. That was my estrogen receptors being totally empty. But once I replaced my estrogen, my brain is a black box again.

You know, isn't that frightening? But so I think it's multifactorial when we lose it. But I also think that all the lifestyle things we've talked about have proven out in studies to be able to make a real impact on our cognitive function. Yeah, I think a really big thing about for me and all of this, as I'm hearing from you, is just what you said earlier about how little we know about our bodies, about ourselves and how we base it on just how we feel, which isn't the healthiest check. It's almost like you're driving your car and it feels fine. But there's so much going on behind the scenes that if you didn't take it to the

garage and get it checked, you wouldn't know. And it was one of the reasons I recently invested in function health, because I just wanted to find a way to make access to information so much more easy for people and just having access to those lab results and those lab tests, so that you can actually go to your doctor and say, Hey, this came up. Yes. What does this look like? Or I don't understand this or what about this?

And I think that's what's helped me so much. You were just with Darshan, Dr. Shah, who's been my doctor. And I find that he's able to flag to me so many things early on, which means we can deal with it as opposed to end up in a position where it's, you know, too late or hard, harder to reverse. I also find in myself and the people I care for that we come, become a little addicted to our data, which is a good thing. Right.

I become a little competitive with myself when I'm wearing my glucose monitor. Can I keep my glucose at 80 or below versus, oh, it shoots up to a hundred and something because I've eaten something disastrous and I don't want that, right? So you can't change what you don't know. So I think data is amazing for that. Yeah. I think we're living in that time as well, where it's more specific.

It's not just, oh, how many steps did I do or whatever, right? It's so much more specific. And you're so right that the only way to hold ourselves accountable is to see the change. So like you said, if I eat this, I remember I was eating, I was testing it out when I was wearing mine. I don't wear it now, but I was testing it for like three months. And I was eating what was claiming to be, I was in the UK, it was claiming to be a low sugar cereal that was, you know, which on the box looked like it should have been fine.

I don't eat cereal that often, but I do when I travel because it's sometimes harder to find something. I had this low sugar, low fat cereal, whatever it was. My glucose spike was crazy. Well, it's probably because it was, my glucose spike... It was a lie. It was crazy. Well, it's probably because it was rice based, but either way, it was just like crazy spike. And I thought, oh wow, like I would have thought eating that every day would have done nothing to me.

And just, you don't know. What have been some of the data points that have really helped you to make changes in your life? Well, I've talked several times about this CGM, but I think to your point, I think everyone should do it for three months. They're not that expensive, but they're so critical.

And it helps people really understand the effect of food on them, because from wearing mine, and I wore it for a year because I was just so fascinated. I know exactly when my blood sugar is going to rise by what I do. My blood sugar rises in surgery

because it's stressful. Of course. I am so sensitive to carbs. I try to eat only fibrous carbs, complex carbs, but even that I'm very sensitive to. And I literally am a little crazed about it. I never want to spike. Although spiking and recovering is normal, I just don't like how I feel when I'm like this. So I like to be like this, but I'm very sensitive to carbs. So I eat mostly protein, green leafy vegetables. I personally, because of my sensitivity, don't eat a lot of fruit because it's nature's sugar. For some people, it wouldn't matter for them. That's how I know that in the middle of the night, if I wake up my blood

sugar's 50 and I needed to supplement a little bit so I don't drop that low. I want to say something now about because I definitely want to talk about this is sometimes people will find, oh, their blood sugar's, oh, it's 100, it's 110, it's fine. Or their doctors may say to them, oh, you know what, you're a little borderline, you're 110, just do better. That is not warning enough in my mind because you had asked me earlier, what do I want my blood sugar to be? I want it to be 85 or below

because studies have shown that for every point above 85 that your fasting blood sugar is consistently, that is a 6% chance of developing full-blown diabetes mellitus type 2 in 10 years. So if 85 is what we want and 100 is what you are, 15 times 6 is 100% chance of getting diabetes if you don't change. Diabetes is a precursor to Alzheimer's. And so I'm just so frantic when my patients say to me, oh, because I look at their labs that their doctors have given them, it's 110. Oh, they said I was pre-diabetic. We don't need to worry. I'm like, you do need to worry and here is why. And so I don't mean to scare people, but I think a little fire is sometimes necessary.

I think so too. I think so too. I've heard the same where people are like, Oh, I'm pre-diabetic and then nothing changes. Right. Cause it's not a warning. It's not a warning. Yeah. Yeah.

It's, and I, and sadly, yeah, it's just, you have the control then you have the power then. Yeah. One of the things I wanted to bring up with you was this question of, as we age about mobility, because I feel like you kind of take for granted how your body works and then especially hip mobility. Yes. What are some of the things we can do to improve our mobility? So when I prescribe exercise, especially in midlife, it consists of four things. Flexibility and mobility aerobics we've spoken about,

carrying a load, which is what I call weightlifting, and equilibrium and foot speed. So let's talk about F and E. The acronym is FACE. Let's talk about F and E. Flexibility and mobility means that all of our joints to move well in aging need to be able to go through their full range of motion. You need to fully extend your knee, fully bend your knee. Our aging need to be able to go through their full range of motion. You need to fully extend your knee, fully bend your knee. Our hip needs to be able to at least bend to 90 and fully go straight. When you see people who are aged shuffling down the street, it's often due to muscle weakness and because their joints just don't move anymore.

So how do we prevent that? Well, simple things like going through daily dynamic warm-up, which is simply putting all your joints through their full range of motion every single day. Things like Tai Chi and Pilates and even yoga are amazing for maintaining that full range of motion. It's not only the bones, however, it's not only the capsule that's just the surrounding of the joints, but with time, the cross-linking, and I'll explain more, in our tendons and ligaments become stronger. So tendons and ligaments, which tendons connect muscle to bone, ligaments connect bones to each other, are made of fibers of collagen in sheets.

The bonds between those collagen tighten with age, so tendons and ligaments get stiffer unless we continually put them through their full range of motion, so they don't lose that motion. So the natural progression of aging is tightness and tightness and tightness. But we can reverse that in the ways we talked about. It's a daily practice. Or at least a three or four times a week practice, right? If someone's feeling exceptionally tight in certain areas of their body,

what else can they do to loosen it up? So I like every workout to start with a dynamic warm up, meaning we're going to warm everything up. So I'll just, for instance, it may sound simple, but it is full arm circles, meaning it's, you're pretending to be Michael Phelps, you're putting your arms through your arm, right? Full arm circles, trunk rotations, bending back and forth, twisting side to side. Hip rotations, I just grab a stable surface and bring my hip forward, circle it all around, just 10 reps even.

Or if you wanna sit on a ground, there's this great hip mobility stretch called a 90-90. You just bend your knees to 90 and you go, you go back and forth. Um, and so the same with our knees. I think my trainer has been listening to you. Even doing all of those things. It makes me very happy. Yeah.

Yes. And then there's this wonderful stretch that I, it just feels so good. It's called a, a bookend stretch. You lay on a flat surface, um out to the side like a cross, you bend your knee up, and then you just roll it over. And that stretches your lumbar spine, so you have full mobility. That's a dynamic warm-up. It's not hard, but you must start every workout with that so that as you're sprinting or as you're lifting, that everything is primed and ready. So that's the flexibility part. The E, F-A-C-E is equilibrium and foot speed.

We've talked about muscle, we've talked about bone and fragility. Many people, even with low muscle mass, even with low bone density may be okay until they fall. One critical fall can be, and I can tell you all kinds of stories, but it can mean the difference between life-death, living alone, not living alone.

So what do we do about it? We gotta retrain our balance simply as standing on one foot when you brush your teeth. Literally, you're standing there, tree pose, hand going back and forth. You will retrain the neuromuscular pathways that degrade starting about in your 20s. I love that one. Yeah, easy. I'm going to try that.

You must. And alternate legs on different days of the week, right? You will retrain your balance so quickly because we should be able to balance on one leg for about 20 seconds. Because what happens when we reach over and we just fall over? Yeah, we don't wanna do that. The other thing is it's very common to see

all kinds of athletes doing agility drills. You've seen it on the field, jumping up and down, jumping over barriers. People like you and me need to retrain the ability to have foot speed and agility so that if you're like me and you leave your work bag by the edge of your chair and you get up too quickly, you can catch your foot and hop over it instead of catch your foot and land flat on your face. It's great to hear that there's so many simple ways.

Oh, it's not rocket science. Yeah. And some of this can just be built into our lifestyle rather than having to find other time. That's right. Vonda, you said this earlier and I've been thinking about it as we've been talking because I think you've given such great practical advice. People can get more depth inside your book,

which I highly recommend. Thank you. And we'll be putting the link in the caption so you can order it as you've been listening. I'd really like you to dive into it for the specific advice that as you can tell, Vonda is so tactical and practical. It's great. But really a lot of this comes down to, as you said, it's not time.

Now it's not knowledge. We have it. You're sharing it freely right here. It's emotional. And what I mean by that is we eat our feelings. We feel exhausted because of stress in our life. So we don't work out. We maybe lack self love.

We don't have a vision, as you said earlier of a healthier life ahead. A lot of us talk about our college days as the best times of our lives. Everything's in the past. And so much of what we've talked about today is practical and tactical, but I A lot of us talk about our college days as the best times of our lives. Everything's in the past. And so much of what we've talked about today is practical and tactical, but I kind of wanted to get to this point of just how do we transform our belief system into recognizing that we're worthy of a healthier life, that we deserve a healthier life, that we're capable of one. And I wanted to ask you about the

similarities between vision casting, as you call it, and manifesting. I love that you've headed in this direction because when I said earlier that I've been practicing a long time and you can't excuse me, I think that people make excuses or don't invest time in themselves for a lot of reasons. One may be busyness, but what that means is you are prioritizing everything else in your life before yourself. And I think that people in relationships do that, parents do that, mothers do it a lot. But if you don't invest in yourself, you will not be able to invest in others. So sometimes it really is as simple as, I've got so much to do, I just can't fit it all in, I'm going to get that done first. It matter priorities. Sometimes I believe you. I believe

what you said, which is it's self-love. I often say things like, until you believe you are worth the daily investment in your health, nothing else will matter. You have to put value in yourself. And whether we were raised that we should be seen and not heard because we're not valuable or that women are told we must be little and cannot take up space and therefore we're not valuable. We need to do the inner work to understand that we have value, not only to each other but to ourselves. We inherently are created with value and that takes a lot of inner work, right? I also think that for people who start out on a journey, they've learned what they need to do. They're like, I'm committed. We're right after the new year and I'm going to do this thing. What happens, I find, I'd be interested in if you think this, we'll start out, we'll do the hard thing, we'll do some harder things. When we do hard things, sometimes we revert to the last place

that we felt safe. And if we revert to the safety of the couch with the bonbons, because psychologically and anxiety wise, that's our safe place. Sometimes it's our safe place that will kill us. Wow. It's just where there's the least mental turmoil. So those are some of the reasons that hit really hard. Yeah. And I really empathize with people because I know when I didn't prioritize it. And it's almost because we're so good psychologically showing up for other people. Yeah. Like that's generally the only time anyone does anything is because they have to show up for

someone else. We show up to work because we're expected to be there. We show up for our kids because you love them and show up for your partner because you feel a responsibility to them. But we haven't been trained or taught to show up for ourselves because it almost feels less than. Or we feel guilty. We feel guilty. That we're being selfish. Here's what's selfish. Gosh, and I'm not really lecturing people, but people say a lot because I take call, I take care of people who have broken big bones and they say things like, oh, I just never want to be a burden to my children. And I understand that, right? Sometimes I respond to them like, well, you took care of them for most of their lives,

maybe they can take care of you. But the reality is that if we do not want to be a burden to other people, then we must take care of ourselves. Because time and physics and energy rolling downhill, there are time bombs of aging, inflammation, senescence, our stem cells get old, that if we do not reinvest in ourselves, the worst can happen. And if that worst for you is being a burden to your children. So if you want insurance against that, then rise above that feeling, you know, prioritize yourself. Vandana, what have I not asked you about today that you feel called to share? I think that if I could find a way to help people understand that they were worth it, that would be the end of my work. Because it's, you're right, I do, I'm a communicator at heart,

I'm a teacher at heart. Then you're brilliant. I like to connect people with their bodies because listen, no wonder people are confused. The language of medicine is Latin. What is the brachial plexus? What is all these Latin anatomy words? How are people supposed to know? My job is to connect you with your body and to love it and understand it. But I'm going to tell you for sure that still 50% of the time, whether it's a regular doctor's visit or people have paid a lot of money to get the best advice in the world, doctor's visit or people have paid a lot of money to get the best advice in the world, they somehow don't take action and they know what to do and don't do it and know what to do

and don't do it. And so I get to the place where I meet them in the emergency room with their broken hip and they're laying there in excruciating pain, frail. And if I could have just gotten them to believe that they were worth the daily investment in their health, that would be work worth doing. But here's the deal, I can't make them. I've come to understand. I can't make you love yourself. I can't make you care about your wellbeing

more than you care about other people's. I can just encourage you care about your well-being more than you care about other peoples. I can just encourage you to do the work if that's what it's going to take to realize that safety is often being strong. Safety is often being mobile. Safety is preservation of your brain. Well said. Vandana, thank you so much. It's been such a joy talking to you today. Oh, my privilege. I've learned so much. You've blown my mind multiple times. I'm so excited for people to read your book. I'm so excited for people to follow your work.

We end every episode of On Purpose with a final five, or a fast five. And so each one of these questions has to be answered in one word to one sentence maximum. And so Dr. Vanda, right, these are your final five. Question number one, what is the best health advice you've ever heard or received? Love yourself enough to give yourself the same grace you give other people. To know that your efforts are not perfect, but that it matters. Just trying matters. Question number two, what is the worst health advice you've ever heard or received?

The worst health advice I've ever heard are all the wacko diets, the grapefruit, the pickle, the soup diet. We are all anything ending in a diet supposes an endpoint. What I am helping people do is build a lifestyle. How we live, not a set amount of time. Let's talk about that for a bit. Do you think that diets can be useful to get people to a lifestyle

or do you think they always kind of boomerang backwards? I think that if you are on a stringent diet, you develop a mindset of austerity and instead of thinking about food occasionally, it's you obsess about it. And that is counterproductive because if you are hungry all the time or obsessed with, oh, I have to only eat half a grapefruit, it takes over your brain versus if you say, the way I eat is that I get a gram of protein per ideal pound. And what does that mean?

Oh, well, I'm going to have an egg white omelet that's 30 grams. This is just how I eat. Here's an example. When I go out to dinner with people who know what I say, they always are watching what I'm ordering. And then they'll say things like, oh, I feel so guilty. I want to have, and I say, don't feel guilt. I am just eating the way I eat. It's not a sacrifice. It's just what I do. So you do you and I'll do me. But it's a funny reaction people have. So do I think diets can be helpful? I think a nutrition

plan can be helpful. Here's how many protein, here's how much carbs, these are the amazing sources. But a six-week diet, I think you get to the end, you may have lost some weight, you've probably lost a lot of muscle, then you'll gain it back and you'll gain back more fat than you lost in the first place. Yeah, and what are we losing when we lose muscle? We're losing the ability to, we're losing physical muscle, we're losing the metabolic power to process our glucose,

we're losing muscle volume to produce irisin, the protein that muscle produces that goes to the brain and variety, we're losing the metabolic capacity and we're losing strength so that we can't get up out of a chair, we fall down more easily. We lose a lot. Yeah, I wish I knew that when I was young. Yeah.

I wish someone had told me that that's what muscle did. I know. It's fascinating. Yeah. I always just thought it was aesthetic when I was young. I had no idea. And it is. But that's the icing.

That is not the cake. Question number three. Can running be bad for you? I want to dispel a myth right now that is so common in the population. That is, there is no evidence that running causes arthritis, right? Running itself, and studies have shown that runners have on the whole have less heart disease, have less metabolic disease. They also, if they don't lift weights, have less muscle. So that is the only reason in my mind

that running can be bad for you because unless you eat, unless you lift weights, your body will eat the muscle that you have. And that's, there's a, for serious runners, there are, they have a body type. They're all thin, very low muscle. That doesn't mean they're not fast. Um, but that's the only time I can think of. Question number four, what's something you used to believe to be true about health that you don't today? I used to believe that six days a week of high intensity interval training was

what was going to make me the healthiest. And that's simply not true. What did it actually do? It made me hurt. It made me exhausted and I didn't recompose my body at all. I stayed the same composition. Why is that? Why, why does, why did it not recompose my body at all. I stayed the same composition. And why is that? Why did it not recompose your body?

Because it wasn't intense enough. It wasn't sprint intervals to really stimulate my body. And when we do the same thing all the time, we develop imbalances and that's where injury comes from. So when I did high intensity interval training five or six days a week, I would always develop left Achilles tendonitis, right hip flexor pain because I have these imbalances and I was augmenting that. I was pounding that five or six days a week. Fifth and final question. Yes. If you could create one law that everyone in the world

had to follow, what would it be? We should walk everywhere. We should be like New Yorkers and Europeans walking all the time. Walking all the time. We're designed for it. Yeah, it's hard in some cities. It is hard. We've made it that way. Yeah, but we've got to find a way. Up the stairs, down the stairs. That's right. Get up from the desk. Our body doesn't care. I love it.

Yeah. That's right. Get up from the dusk. Our body doesn't care. I love it. The book is called Dr. Wright's Guide to Thrive. Four Steps to Body, Brains and Bliss. Dr. Vanderaat, thank you so much for coming on on purpose. I hope you'll come back again and again. Oh, I would love that. And I genuinely learned so much from you today. Thank you so much. My pleasure.

If this year you're trying to live longer, live happier, live healthier, go and check out my conversation with the world's biggest longevity doctor, Peter Attia, on how to slow down aging and why your emotional health is directly impacting your physical health. Acknowledge that there is surprisingly little known about the relationship between nutrition and health and people are going to be shocked to hear that because I think most people think the exact opposite.