Begin Again with Davina McCall - Sitting Is The Silent Killer! This Causes Sedentary Death Syndrome. The Truth About Early Ageing. Dr. Vonda Wright.

Episode Date: December 12, 2024

In this episode of Begin Again Davina is joined by Dr. Vonda Wright, a world leading expert on the science of ageing well. Dr Wright is a pioneering surgeon, researcher, and author who shares her expertise on longevity, mobility and the lifestyle habits that will help you build physical resilience and achieve vitality. Dr Wright’s Website: www.drvondawright.com Follow me here: www.instagram.com/beginagain https://www.tiktok.com/@beginagainpod  (00:00) Intro (01:22) Early Career in Oncology and Transition to Orthopaedics (04:35) Biggest Challenges of Becoming an Orthopaedic Surgeon (06:39) Life Expectancy Trends in the U.S. (07:17) Understanding the Aging Process (12:17) How Men and Women Age Differently (14:04) The Connection Between Muscles, Bones, and the Brain (18:26) Best Practices for Bone Health (21:47) Essential Bone Health Tips for Your Late 20s and Early 30s (25:15) Recovering Physically and Mentally After Injury (26:28) Zoe Ad (27:55) Understanding Lower Heart Rates During Base Training Workouts (33:00) Why It’s Never Too Late to Start Exercising (33:55) Shocking Percentage of Americans Who Don’t Exercise (34:29) The Average Daily Time Spent Sitting (37:15) Tips for Staying Active With a Desk Job (38:44) How Sleep Impacts Physical and Mental Health (41:45) Understanding Menopause and Its Effects (47:09) How Talking About Menopause Can Support Others (48:27) Key Takeaways Sponsored by: ZOE - https://zoe.com and use code DAVINA10 SetArtwork provided by Kimi Zoet. Enquiries: [e-mail] https://g2ul0.app.link/oQMAPbdSGNb Learn more about your ad choices. Visit megaphone.fm/adchoices

We are killing ourselves by sitting around. I see 28-year-olds, 30-year-olds, early 40-year-olds, already with bone deficit. Why is this happening? When you read medical studies, our aging process means we have to become frail and decrepit. That can't be true. I mean, we have all the tools. If we do not pay attention, I think people can start dying.

Oh, my God. There are 33 chronic diseases that kill us, heart disease, stroke, that are directly impacted by the way we move, how we use our bodies. By saving mobility, I am going to save you from the ravages of chronic disease. How do you stop that? There are three main components. Number one, I am having to fight this voice in my head that's telling me, well, maybe you're slowing down a bit because you're 57. Bodies will respond to the positive stimuli we place on it, no matter what our age, nutrition, pounding your bones.

There's irrefutable evidence that walking will increase you. your lifespan. The next thing we need to do is make sure that everybody can do that. To me, every little bit counts. Being healthy is evidence of success. I don't want to live till 110 if I'm not going to be vital and joyful. It's like the one magic pill. You've slightly blown my mind. Well, Dr. von der We're right. It's so lovely to meet you. I wanted to ask you a little bit about your medical degrees, but you actually were working in oncology first. What got you? to kind of change that into the more muscular skeletal. Yeah.

My first medical jobs were as a nurse. So right after my bachelor's degree, I went back to school, became an oncology nurse. And at the time, in the United States, it was called primary nursing, meaning it was one nurse and four patients, and that's it. There were no extended helpers. It was just, and so it was an amazing time. And so I did that for about six years. And really, I'm a quick learner. I work very hard. I had gotten out of that what I was going to get out of that. So I had to make the next move. And I was only, I don't know, 26 or something. And so I decided, you know, when you change directions, you have to do the whole evaluation of what you value. I value taking care of people. I value learning and research. And going back to medical school, it will allow me to do both of those things. And plus, I've got my Chinese mother in my ear going, You should be a doctor. You should be a doctor. Right. I mean, I don't know. It was the influence of that. I think now because I have such a passion for teaching, I could have been very, very happy as a fourth grade teacher. Because at 10, you know, fourth grade teachers teach 10-year-olds, which is this magical time in a child's life. They're old enough to learn. They're not so old. They're flipping their hair at you. But so I had to keep learning and I had to take care of people. Went back to medical school at 28.

And then in medical school, you divide out very quickly, basically around the way your brain works, whether you're going down a surgical pathway or a medicine pathway. And thank God I have my farm hands that I, these hands can see. My brain can see in 3D. Right. And my hands can make it. And I think that's just how I work and all the work I did on the farm. But then you get there and you're like, oh, I'm a coming to a surgeon.

What do I want to do? Well, the reason orthopedics is so amazing is we get to take care of people from the minute of their birth. Some babies have orthopedic problems to the minute of our death. We can work with athletes, which is what I do in general, athletes and active people. Or we can work with people who have cancer or spine problems. So there's really not a population orthopedics does not cover. And so orthopedics just by definition is all of your joints, all your muscles. all your bones. And the reason it continues to be so fascinating to me, even though this is the

mantra I wrote down when I started my career is that by saving mobility the way we move, how we use our bodies, I am going to save you from the ravages of chronic disease because it's like the one magic pill. I mean, you've seen that. You've seen that in the line, right? You can literally watch, I guess you've had the perfect insight into when that happens to somebody, what age. You must have just been constantly asking yourself questions. Why is it happening to people so young? I mean, what was the biggest shock do you think when you became an orthopedic surgeon where you were like, why is this happening? I love that question because it has driven me. I am still as curious about this today as I was the first day I stepped out of my

fellowship. And that is why do we age the way we age? Or why do I see this? Why do I see this? people becoming frail and decrepit. I mean, we have all the tools. We have 605 muscles. We have 260 bones. We have this miraculous system. And yet when you read medical studies about populations of people, the picture you get is that our aging process means we have to become frail and decrepit. We start with this vitality and vigor of youth. And then we steadily decline. And I said, that can't be true for every person. What is it that's making that happen? And I think it's also fed by the fact that my own father, every day of my life, I cannot remember a day when he was not outrunning. He's a runner. Sometimes he'd be gone on the farm running so long. My mother and I are like, where's dad?

Which route did he go today? How old are you talking? Is he still running now? Oh, yeah. He's he's turning 85 next year. And he's gone from being a marathon distance runner. about 10 years ago, he got a total hip. He was still doing it. And now at 85, I have to say things like Tim, could you please not go nine miles today? We live in Florida. It's 600 degrees outside. Could you please just, can we do three? So, but that example of being healthy, vital, active, joyful, I see in my own house. Healthy active. Healthy, vital, active, joyful. Healthy, active. I love that. Healthy, vital, active, joyful. Joyful.

Yes. That's what we want. I mean, there are so many things I want to ask you. Then ask. Because, well, because, you know, well, what's the life expectancy in the States? What's the kind of average life expectancy? I have better news for people in the UK. Okay.

81. 81. 81 in the UK. United States 77.6. Lots of reasons, I think, for that. 81. So if for babies born today, we can look ahead, oh, 81, although now there is a growing, growing population of centarians, 100 years old, super centarians, 110 years old. But on average, 81 years old. So as somebody, what was interesting for me when I hit 50, I everything changed. And I went through

a dark year of like, oh my God, I'm looking towards the ends of my life. to then thinking, how am I going to make this the greatest chapter of my life? And, you know, anybody that's listening or watching, I would say you want to start prepping for this in your 30s, even your 20s. You are so right. It's never too early to start prepping for the rest of your life. I don't want to live till 110 if I'm not going to be vital and joyful. Yes. So what patterns are you seeing in the discrepancy between the age,

that people die at and the age that people start losing quality of life. I think people can start dying at 30 if we do not pay attention to this literal temple that we live in, right? So I talk sometimes about this critical decade. And when do we finally start paying attention? Well, like you, I was a little wigged out by 40, but then I had Isabella at, my daughter, my youngest daughter at 40. And so I was all into young women activities, like raising a baby. But I agree with you. At 50, I saw my own mortality. And I felt a little like, what? Okay. I am, I'm clearly maybe a little, if life is a bell curve and 45 is in the middle. And it, and I felt those things you felt, I felt a little depressed about it. I mean, I didn't, I didn't change.

anything in what I was doing, but it really, for the first time, because I don't know about you, maybe I never thought I was going to age or get old or have to change. Because I've had the privilege like you. I've seen your career of being active and jumping around. And I do all those, I mean, I do Spartan races at, you know, and somebody said, Vanda Wright at her age is doing a Spartan race. And for me, my reaction was, what do you mean? age. Why wouldn't I do a Spartan race, right? So could you explain what a Spartan race is? Just very quickly

for somebody in the UK that might not know. So you've probably seen pictures of the crazy obstacle races where you're going in the mud, you're crawling under barbed wire, you're going over eight foot walls. There's a whole genre of obstacle races that honestly have now become an Olympic sport. Isn't that crazy? In 28, obstacle course racing is going to be an Olympic sport. Isn't that crazy? So I'm 57, that 57 would be a reason not to just do what I want to do when I want to do it. I want to ask you something about that specifically because I do think that as I'm getting older, I am having to fight this voice in my head that's telling me, well, maybe you're slowing down a bit because you're 57. I mean, how do you stop that?

I think that's a matter of resilience. I think the battle is five and a half inches between our ears, right? The real battle is in our head. If we absorb the cultural narrative that we have seen from the generation before us, that we just accept at some arbitrary point in time that the light bulb goes off and that we can just cruise on into the end, I think that's what we're fighting against. But I think our generation is going to be the one that pivots it for the millennials, the 43-year-olds and our younger daughters that says, if we continue to invest in our bodies and our brains

every day, like we would invest in maintaining a luxury car or any luxury thing we have. We just don't buy it and leave it to become decrepit. Why do we focus on those material things and not us as our highest evidence of success? To me, being healthy is evidence of success, not some shoes I buy with red souls, right? But it is, it is, it can be a psychological barrier to, oh, I'm just getting old. Let's sit in a chair. But here's the thing. Think about the way we're designed. We're designed with our most powerful muscles below our belly buttons. If we were designed to sit still in any period of our lives, we would be a mushroom. Nature is very specific. We would have a big, flat, sessile stock with all the good stuff going on above. That is not how we're designed. We are designed

to be strongest from our waist down. And it's not like when the light bulb of youth goes off that we grow a sessile stock. No, we retain our... So I'm just making fun of the fact that nature says we are meant to move. I really hope you're enjoying this episode. And if you can, give us a follow. I mean, the other thing I think that people find is that as we get older, leg muscles, glutes, our bottoms, our abs, these are big sets of muscles. Yes, huge. And they're much harder to build and make nice and strong. Is this the same for men and women as we age?

Do we both lose muscle? When does that start happening? So some of the pillars of aging, there are 12 now. There used to be six, but one of them is the loss of lean muscle mass. It's called sarcopenia. part of that is a decrease responsiveness to anabolic steroids such as testosterone and estrogen is just a part of our aging process. But here's the deal.

Our bodies will respond to the positive stimuli we place on it no matter what our age or no matter what our beginning skill level. We begin to see in women declines in our estrogen and testosterone in our early 40s. So even if we're menopausal at 52, the hormonal changes are starting much earlier. And we begin to see the muscle and bone changes in women that early. In men, men have different responses to testosterone because of their genetics than women. So they build more bone initially. They build more muscle mass.

But you do see loss of bone in men. Two million men in the United States have osteoporosis. you lose lean muscle mass starting, you know, in midlife. It's less, it's less evident for men that it is for women, but it happens in people with ovaries and without ovaries. And obviously, muscles are the things that support and protect our skeleton. Would I be right in saying that? Well, I like to frame muscle and bone like this.

We're hearing a lot about muscle these days, which is amazing because my lab was a muscle stem cell lab originally. So I have loved muscles since 2000, honestly, when we began studying muscle satellite cells, which are the stem cells and muscles. Muscles are amazing metabolic organs. We think of, there are three kinds of muscle. There's your heart muscle, and it has its own electrical system doing its thing. We have our smooth muscle, which is in our gut, which houses our microbiome, it digests our food. Everything else is skeletal muscle. So every move you make, whether you move your eyes or whether, you know, we're pumping iron, that is all skeletal muscle. So it is a not only for locomotion, the sliding of the muscle, it's a huge metabolic organ. It helps

regulate our glucose. It releases proteins called myokines that help run our body. But what we forget is that without our bones, which nobody thinks about unless we're talking about our cheekbones. Without our bones, we're just a quivering mass of contracting muscle going nowhere. It is our bones that gives us structure. That's why you and I are able to sit up right now. But the way I think people think about bones is they not to think about them at all. Or if we do, we think of them as the strong, silent type, you know, the person standing in the back of the room, surveying. You don't hear from them. But what I want people to start to understand is, that bones are also a metabolic, hormonally releasing organ. And why wouldn't it be? Our bodies are so

smart. We have bones from the top of our head to the end of our toes. Why wouldn't we give it a job metabolically? So this is new news. So in addition to holding you upright, being responsible for the mineral release, being a storehouse for minerals and all the building blocks of our body, We know bones do that. Did you know? Bones release a hormone called osteocalcin. This hormone, I know, this is so exciting, and people don't talk about it, and I should because I'm the orthopedic surgeon, right?

OsteoCalcone for men has a role where it causes the testes to release more testosterone. Bones do that. For the last decade, it's been known that there is a bone brain axis of hormonal. I know. Hormonal control. osteocalcin works in the brain to increase neurotransmitter release. So I just, I know, I just had a text from one of the menopausee this morning, the group of doctors. Which one? Which one? Because I love the menopause. You know what? I know. Someone with a 4-4 prefix. So somebody in Great Britain,

it didn't, her name didn't come up. But she's like, yeah, how fascinating that people with dementia often have osteoporosis. And I didn't respond to her. I'm responding here. Well, did you know that there is a bone brain axis where osteocalcin from the bone can help the brain produce more neurochemicals. We also know that a bone is critical for glucose regulation and satiety, meaning that osteocalcin can work with the muscle and the fat to aid in insulin sensitivity. It can go to the pancreas to help the pancreas release more insulin. and I know it's like mind-blowing. And this is the first time I've talked about it on your first show.

Thanks, I'm done. For you newsy types, I think the scoop is important. I'm like, what am I going to tell her? That's fascinating. It is. And Boone also releases, this is a big deal. Releases a protein called lipocalcousin 2. It goes to the brain and tells your brain, okay, I'm full now.

just like the GLP1. So, I mean, this is slightly blowing my mind. I know. Because now I've always just felt like my bone is just a piece of bone. That's right. Dry, dead. Yes. But I don't understand.

How can you look after a bone to make sure that it can do all of these incredible things as best it can? I love for people to notice their bones. And I sometimes suggest getting in front of a mirror naked, which is a very frightening thing sometimes. But it's your body. You own this thing. Let's just notice it. And, okay, you have beautiful cheekbones. Well, we'll notice our cheekbones, right?

But let's notice our clavicles, our collar bones that, you know, if we want to talk about it in terms of fashion, what holds up our gorgeous dresses? But our wrists are the delicate bones of our wrists or our kneecaps are sticking out. Let's just notice these bones, right? That's number one. because you can't love something you don't even notice. Yeah, let's notice it. Well, number two, here's something that I would love everybody to start working on is we don't, remember we were talking about being 50 and suddenly like, oh, my God, what do I need to do

to live long and prosper? Well, I would like women in particular, men and women, because this is a man and woman thing. It's a people thing, not just a woman thing. It's to start noticing their bones in their 30s. We lay down bone, the bulk of our mineral bone, by the time we're 30. And then if we do nothing to continue to invest in it, what are we going to do? Live off that storehouse forever until we're 97, which is my target goal, at least. Is it?

It is. Okay. Because my youngest daughter was born when I was 40 and I'm 57. So I think if I can stay around until she's my age, yeah, that's a lot of bugging my children, right? But anyway, so laying down the bone. Laying down bones. 30. At 30.

Okay, we're going to do the biggest favor in the world to our younger nieces, daughters, and people. We are going to teach them that they're in a prime time to secure their happiness for the rest of their lives by paying attention to their bones before they turn 30. Because that's when you lay down bone. But do you know what I'm seeing? Even the millennial women, the 43-year-old elder millennials who are entering perimenopal. possible. And men are on the last stages of the mistaken societal craze of being little. This is my little person. Yes. We have to be little. We can't take up much space. We can't eat many calories. And in the United States, we've had a law equalizing sports called Title IX for about

53 years. So what's that? What meant was that you must give women as much opportunity in sport, organized sport as men. So if we had 100 male athletes, the colleges have to provide opportunities for 100 female athletes. So with that equalization, we have an entire generation of women who have come through that wonderful thing,

wonderful law, who were very, very active, which you would think meant they would be laying down bone. But if they were in relative calorie deficit, their entire young lives, and very, very active, they might not have laid down enough bone. Right. And that's what I'm seeing. I see 28-year-olds, 30-year-olds, early 40-year-olds,

already with bone deficit. So food is important and exercise. Like what can somebody, if you're talking to somebody in their late 20s, what can they do to lay down the best bone? Yes. So for people at every age, but especially people in their 20s and, and 30s to build better bone. There are three main components.

Number one, let's bash these bones. It sounds crazy, but I need you to jump. I need you to run around. I need you to not just walk up the stairs. I need you to pound up the stairs. Because research has shown, it's irrefutable. The mechanical impact of pounding your bones translates into biochemical feedback, which causes your bone to say, oh, a lot's being expected of us.

Let's lay down better bone. So what we see in athletes, and there is great research coming out of the University of Wisconsin, that shows even in young women comparing young athletes who are gymnasts, that's a lot of pounding of bone versus cyclists or swimmers. Those pounding athletes have much better bone density, thicker rins, cortex, the outside layer of our bones. And that's something we need to do from childhood is to impact our bones. The next thing we need to do is make sure that we're feeding our bones.

We cannot calorie restrict and expect to build enough bone density, partly because our bones require protein and minerals such as calcium, magnesium, vitamin D, but also because if we are calorie restricted, it is very likely that we are not going to have regular menstrual cycles. And that estrogen flux is critical for laying down bone because estrogen and testosterone have a critical role to play in healthy bone manufacturing. So nutrition pounding your bones. Okay, if we want the healthiest bones ever, can we please stop smoking?

We think it's only about lung cancer, but it inhibits bone growth. We know bone will not heal if we've got the poisons that come in smoking in our bodies. And then finally, we need to build some muscle. You know, muscles all the rage right now. But muscle works with bone in this way. So muscle, this hand is muscle, this hand is bone, is connected to our bones through our tendons. My hand is a tendon. So bone will only move if a muscle contracts against it, right?

Through our tendons. Well, that pulling of the tendon against the bone, our body perceives. as mechanical stimuli. So even if you don't want to jump or can't jump or for whatever reason, can't pound your bones, we can build muscle to move our bones and that will build better bone. So those are the three main ways. And that's for young people. That's for everybody.

Okay. Because what I was going to say to you was a couple of years ago, I fell. I did not have a fall. that feels very aging. I fell while I was running in the woods. I tripped over something. Yes, you tripped. A traumatic fall.

And I tore all the ligaments in my ankle. 12 weeks. I was fine. Got back to training. It's absolutely back to normal. But there's something in my head that has made me a little bit more scared of the leaping, the jumping, the running through the forest. like I'm a bit nervous about it again. What do you do about that? That's an aging thing. And that I'm sure

is a big reason why some people stop jumping. We're fearful. We're fearful of injury because it hurts. It was miserable for you for 12 weeks. I know it must have been mad. I know because it affects our brain. Our brains are used to that. So the best way I have found to get back to the place of confidence is just progression, right? So maybe you don't go and go and go. go in the dark woods and run as fast as you can, but maybe you work on speed and agility in a gym. Because just like you found, you would not have been hurt had you not fallen. I trip over my work bag. I carry around this big red bag.

I put it too close to my feet. I get up quickly and I catch my foot on it. But because I still have the foot speed to step over it quickly like a gazelle, I don't fall, right? So doing those little foot drills will give your brain the confidence. that, okay, I may have fallen once, but I got this. It doesn't, it's not my destiny. Let's talk about the sponsors of this podcast. Zoe membership, a personalized nutrition program.

I always get asked why I look after my body, and the answer, I want to look good naked. Joke. Don't worry. That's not it. I do it because I know what my health is worth, and I want to have the best life ever. I mean, every decade has looked very different from the last, but with age comes wisdom. Enough to recognise that the more I invest in my body, the more it pays me back. And I did Zoe's at-home test and learned about the good and the bad microbes in my gut. And then Zoe gave me

specific food scores so I could see which foods my body responds to best. And it's science-led. In random controlled trials, Zoe members who participated in the study saw positive changes to their gut microbiome and energy levels. So if you want to join me, and over 100,000 Zoe members, head to Zoe.com and use code Davina 10 for 10% off. But zoe.com and use code Davina 10. Oh, and by the way, as you clearly like podcasts, you should go and check out their new show, Zoe's Science and Nutrition. It's so good. massive fan. I love how they do all of this research and they give it all away for free. I've read something very interesting in some of your, in some of your writing about,

I've always been about boosting my heart like cardiac, cardio, cardio, cardio, but you're talking about a much lower heart rate when you're working at tools. Talk me through that. Yes. So when we talk about our heart rate and effort in working out, we categorize it in zones. Zone 5 is, is, when we're doing like V-O-2 max testing, which is that the 100%, if you make me keep going, I'm probably going to get sick. It's just too much. Well, that's zone five. That is your maximum heart rate for zone zero is less than what we're doing now, right?

So there is a thought that if we're not, if we're not gutting it out, we're making no progress. And the fact of the matter is that that is not how professional athletes work out. they do not gut it out for four hours every day. Most specifically, endurance athletes, they are very smart on how they use their effort and their heart rate. So we've learned from them that to keep our cardiovascular system the healthiest, to keep our mitochondria, which are the little parts of our cells, mainly living in muscle, that generate our energy in the form of this chemical called ATP, to keep them healthy and

flexible in what fuel they can use, we need to do something called base training, which is keeping our heart rates within a lower zone. How low? It's individual for every person. We, the premise is that we would like to be burning fat for our base training, instead of jumping up and burning carbohydrates during which we build up lactate, lactic acid, which burns in our legs. It decreases our performance.

We'd like to just roll along and use as much fat as possible. Is that the kind of exercise where you can talk while it's not quite this talking, but we could be together on a treadmill and we could be deciding our next big adventure, right? But not a full conversation. So Zone 2, we've heard a lot about it, works us out a place at the threshold of where you're burning fat most efficiently, but we have not yet put on so much effort. They're going to flip to using the carbohydrates that are stored in our bodies. It's called the Fat Max zone.

And it's measured by effort. So when you ask me what heart rate, yours would be different than mine. You can calculate it simply with the simplest way, a little inaccurate, but the simplest way is 181 minus your age. Okay. or where I have my office and a performance center, it's like a Taj Mahal athletic center, we can actually test it. We put you on a treadmill. We poke your finger. We measure your lactate levels.

So when I did it, originally, I was so overtrained at my high zones because that's all I did. I only did high intensity because it felt good. I got bored. I'm going to pound this out. I'm just going to do it and get off. well, I could do that all day long, but I could do that very well. But at my lower zones, I was very untrained. So originally when I did my lactate threshold, my heart rate to burn fat was like 120, which means I'm barely walking to, I'm like, what? But it takes discipline to do that. And then

as you train your lower zones, it is so good for you. My now lactate threshold heart rate is 130. Yeah, you've slightly blown my mind. Oh, because I, I feel like there are so many people that will be watching and listening. Yeah. That will be saying, I don't want to exercise because I hate that feeling like I'm going to vomit and I can't be bothered to do that. Or you don't want to get up in the morning and go and train because you think, oh, God, it's going to be so hard. Yeah. But everybody can do that, can't they? Oh, you know what? That is the best point ever. we learn to walk when we're one. It's like nature's remedy for how to maintain, right? And so if you could commit to walking lots of the day, I mean, there's irrefutable evidence that walking will

increase your lifespan. It will decrease your morbidity from disease. It's simple. There's really no excuse, is there, to go out and walk every day. So the recommendation is three hours a week to walk purposely in this base training mode. But that's not it. I don't want to leave you there. So that is perfect. Everybody can do it twice a week. Everybody can do that. No, but this is quite inspiring. I feel like lots of people don't stop because they think they have to go to, I don't know, likes to buy special clothes. They have to buy special shoes. This is something we can do dress like this. And we should do it dress like this, you know. The other quickly just wanted to say about the walking exercise, that's not age limited either. I mean, you can start, you can start

at any age. There's no age where you kind of think, well, it's too late for me. Every age. In fact, you know what I bought from my 85-year-old mother? Because, you know, she's 85 now and more frail than she was. We live in Florida. There's a pool. So every day, I'll look out the window because we all live together. It's that kind of multi-generational home. And I see her walking around our pool with her little hand weights. But I wanted her to get more motion in, more steps in. So I bought her one of these little sitting, sitting steppers where she can move her legs like she's walking. So we just got to get it in. My mother's 85. If Joy at 85 can do this, What's my problem? What's everybody's problem, right? What's the percentage of people in the states that don't work out? 70%. 70%. I know.

Do you remember that film, Wally? Oh, yeah. I always think about how impactful that spaceship was with all the humans on who were just sitting basically in mobility scooters, and nobody could walk anymore. And I thought how close we are to getting to. that point. I don't think you're exaggerating either. I see it. I see it. How much the time do we sit for on average do you think? Well, let's say we actually sleep for eight hours a day and then we work for eight to ten hours a day. And then to get to work, we go from our homes to our cars to sit

in traffic. So for many people, we're sitting 20 or still not sitting, but still 22 hours a day, 20 hours a day because we'll walk around our homes, which is minimum effort, and the rest of the day even working, we're sitting. And so there's this entire, I wish I had created this. I didn't. A doctor at Columbia University came up with the name, sedentary death syndrome many years ago. I've used that terms since 2000 when I started talking about this. Because you've got to know, this is, I have been trying to scream from the mountaintop since 2000 that we are killing ourselves. by sitting around. That's why all my research has to do with master's athletes where we take the variable of sedentary living out. But sedentary death syndrome is the thought that there are 33 chronic diseases that kill us around the world. It's not just a U.S. problem. 33 chronic diseases, everything you think about, heart disease, stroke, cancer, lung disease that are

directly positively impacted by the mobility we do every day. And so if you have diabetes, you'll have one medication. If you have heart disease, you'll have another medication. Long disease is the same, a different pill. You will come home with a handful of pills and capsules. The one medication that spreads across all of the diseases we die from is mobility, and it can be as simple as walking every day. What I love is that you're not saying exercise.

I hate the word of exercise. Yeah. Because you know why? You've seen this. People glaze over when you say exercise. They think it's an added chore, not an opportunity to be young and healthy and not even young, aging and healthy and vital. It's a chore. So years ago, I stopped using the word exercise and started using words like mobility or very specifically, let's walk.

Let's carry a load. I very even rarely, until recently said lift weights because people even hate that as a chore. I say carry a load. My grandson, he's only 18 months old or 20 months old, he's like 30 pounds. I mean, that is lift carrying a load, right? It doesn't matter what it is. It's like weighted vests. Because you can walk around the house. Oh, yeah. And you're carrying a load. That's right. Your arms are free. You can, you know, that's also lifting weights. That's it. Any other tips for people who want to be a bit more mobile but don't know how to do it. Say in an office.

nobody knows how we're taking our phone calls. Nobody actually. Oh yeah, they can't see us. They can't see us. Yeah. Get up from your desk and walk around. It's not exercise as we know it, but every step counts towards our body's metabolism. Even, I mean, simple skeletal muscle contraction of your legs, when you're walking around your own office, we'll drive sugar into your muscles, which we want. So walk around your office, take many, many bursts. Just get up, bypass your secretary, run up the stairs, come back down, sit down. They'll think you're crazy, but that's even better because they can't figure you out. Just work fidgeting and mobility into your day.

Park further away. Just a lot, a little extra time. How about making your entire Zoom conference call, pull up on a wall and do wall squats while you're talking to each other? It becomes a cultural thing. I know it sounds a little crazy. but I have had people send me pictures of their meeting with their all wall squatting around the conference. I know. I have pictures of myself when we're rounding on patients. My fellow, my physician's assistant and I, we're wall squatting outside a patient room because I got to stand there for five minutes.

We might as well do something good for ourselves. Every little bit counts. Yeah. How important is this impact of sleep? What kind of effect does that have on our body? Yeah. You know, when I was younger in training, I used to say stupid things like, I'll sleep when I die. I've done the same thing. And now I know that if I don't sleep, I will die. Because the science is so clear that that is not, we think it's just about passing out and being unconscious when actually it is the most regenerative period for not only our brains, but for our whole bodies to sort out what happened in the day. So sleep is critical for all aspects of health and aging. When you read about sleep and how to manage it, the most powerful way to manage your sleep is to get up at the same time every morning and to go to bed at the same time every night. And so it does kind of get wrecked when you travel or when you're on the weekend. But when you realize how critical that is for the way you feel, for having complete brain

capacity and even for how much weight you gain, honestly, then it reprioritizes it. So in our household, you know, I may be having a party at my house, but I am out and in my bedroom at 930. I'm like, let yourselves out, have a good time. Or my daughter's having, I do. If my daughter, my daughter's having friends, I'm like, okay, you know they have to be gone by 930 because I can't have a bunch of teenagers in my house after I'm in bed. But then even on the weekends, my husband and I get up at the same time. We get up at 5 a.m. And we have this really, this little morning ritual. We drink coffee. It's quiet in the house. And it becomes this soothing, low stress time of the day. But what it really does is it sets my circadian clock for the day. Because sleep is, the stimulus to go to sleep is due to

this chemical called adenosine in our body. And when we're asleep, we build it up. It's like an hourglass. We build it up. We get up. We see the sun. And the hourglass turns over. And we slowly use this all day long until when we get to the very last drops of sand, we start to have this tired response. And so if you can't fall asleep at night, there's something wrong with your whole day's rhythm. Right. On top of the fact that, you know, we know in mid-life. We know in mid-life. sleep becomes disrupted, that as we age, we tend to not sleep as much. But things that have helped me get better sleep is I take magnesium at night. Do you? Magnesium L3inate or magnesium glycinate. Yeah, glycinate. Not citrate, my friends, because that has GI consequences,

unless that's what you need. So magnesium at night, if you're taking progesterone, taking that at night, is also a great sleep stimulus. I actually want to get on to the menopause. Because obviously, as to midlife women, it's been something that we've been navigating and we've been shouting about it quite a lot in the UK for a while. I feel like America's having its moment.

Like the menopausee is strong and alive. It is. UK is ahead of us. You guys have been talking about it for a minute. But what I love about America is I feel like you are, funding a lot of research. You have the money to kind of to do that. But you were just talking about sleep and menopause and how much it can affect you. Honestly, when I was perimenopausal right at the beginning before I knew what it was, sleep was the first thing that was so disrupted by night sweats and needing to weave frequently through the night. I felt like I was going mad. It felt like

some kind of torture. What do you do if you are hitting that stage of life and you need to sleep? Number one, recognize what's going on and that this is a whole metabolic and hormonal transition. And recognize that just like puberty, it can result in beautiful things. We shouldn't feel doomed or sentenced to badness, but just recognize, okay, I've always done hard things. I'm going to figure this out too, right? Women have always done hard things. What was it like for you at that beginning? At the beginning? I couldn't sleep. So therefore, on top of brain fog, which we know is real, because our brain is deprived of estrogen, I had the sleep hunger in my brain. I don't know how you experience it, but it's like there's a block. I know I need to think with my whole brain. It's almost like a physical block in my brain. I get it when I get jet lagged, too. There's just, okay, could we engage our whole brain? So couldn't sleep. My brain was numbed.

Numbed is a good word is numbed. I was hot. My poor husband, I was always cold. I had to start sticking my thermometer leg out of the covers. That's what we call it. Just so body part was cool. I'm sticking my thermometer leg out. I'm up three or four times a night.

I'm like, I never paid this month. My whole life, Matt. And then for me, a huge symptom was, Once I actually decided to get out of bed, I could barely walk because I had arthralgia, the musculoskelet effects of low estrogen profoundly. So that's all going on, you know. So that's what we call here the kind of joint pain. Joint pain, arthritis.

That is one of the things I remember leaning over to put my socks on in the morning and going, that's it. Right. Like, just making all these noises. You're used to be an exercise maven. Like, what's up with that? lost all impetus to work out, be active, I was tired. And I found it incredibly frightening, actually. So what's happening there to our joints? Yes. So just like we have estrogen receptors

in our brains and every other body part, we have estrogen receptors. Estrogen is critical for our musculoskeletal system. So I've recently put together all the things women experience in our musculoskeletal system into a phrase called the musculoskeletal syndrome of menopause so that women have a tool to show up with their doctors instead of saying, I have these six things, which makes doctors faces glaze over saying, I am experiencing the muscular skeletal syndrome of menopause. So what is that? It's on fire inflammation. Estrogen is a huge anti-inflammatory. The way that manifests in our musculoskeletal system is we hurt all over, just like you were describing. And, and, you we get frozen shoulders. Our shoulders don't move. We can't hook our bras. And it's excruciating and can last for

years. So that's the inflammatory part of it. We lose our bones. We've talked about that. We have a rapid increase in losing muscle mass up to 3% a year and what we come floppy and we can't move and not strong. But also, the joint aching is due to the fact that on the end of every bone, if this is a bone, we have an N-cap like a bumper, the silver bumper, like on a car, of something called cartilage, which is a spongy matrix that is smoother than nice. And having that there enables your joints to move without feeling them. Well, lo and behold, there are estrogen receptors sitting on our cartilage matrix. And when estrogen is sitting in those, it causes all kinds of downstream support of that cartilage.

Well, without it, with empty cartel, without empty estrogen receptors, the matrix is unsupported. And what we find is that men before 50 have more arthritis, usually traumatic than women. After 50, women have rapid progression of their arthritis. And you get youngish women with bone-on bone rubbing due to the unsupported matrix, the weight gain, the nutrition. things we put our bodies through. What I love is I do feel like there's a generation of women around our age who are not going quietly into this good night. And how important it is for our daughters to see that getting to your 50s is fucking great.

Oh my God, it's so amazing. I don't know how you feel about it. The three words I use about this time in. my life is, I honestly feel ageless. I don't know what I'm supposed to be like at my age, because I'm defining that, right? I don't know. Numbers mean very little to me these days. I am more authentic now than I have ever been in my entire life. I show up online in my pajamas. I show up dressed. I show up wherever, and I would have never done that. And sorry it took me so long to get here, but something about it.

the experience of life, knowing that I can do harder things than I ever imagined and no longer giving a rat's ass. What people think is so authentic. And then finally, the third word, ageless authentic is indefinable. Like, don't tell me what I'm supposed to be like. I'll tell you what I'm doing right now. See if you can keep up. Vonda, I want to ask you, out of our whole conversation. What do you want to be the most important message that someone takes home from this chat? You know, we've talked about a lot of things from health and my own aging, but here's what I want women to realize, because I don't see women realizing this. As we take care of everyone, you know, our littles, our neighbors, our parents, our multi-generation parents, the people we work with,

It is in our nature is to take care of everyone to our own detriment. We wake up in bodies we don't recognize with brains that don't work and all the things. But here's the deal. I want women to realize and men, I want people to realize that they are worth the daily investment in their health, that you are worth it, that you matter. Because until you make that recognition that you are worth the daily investment in your health, nothing else is going to matter. Thank you.

Thank you. It's amazing. Thank you so much. Thank you for having me.