Dhru Purohit Show - The Number #1 Aging Mistake You’re Making and How to Build Strength and Become Unstoppable at Any Age

Episode Date: August 27, 2025

This episode is brought to you by Cozy Earth, Branch Basics, and Bon Charge. ​​Despite what most people think, aging does not have to mean decline. With the right mindset, proper nutrition, and consistent movement, you can take control of your health, build resilience, and stay strong, balanced, and unbreakable well into the later decades of life. Today’s guest shows us how. Today on The Dhru Purohit Show, Dhru sits down with Dr. Vonda Wright to unpack the misconceptions surrounding aging, especially the belief that aging automatically means decline. She emphasizes the importance of mindset, hormone optimization, and lifestyle adjustments in enabling women to approach aging with strength and positivity. They explore the critical role of nutrition, physical activity, and mental resilience in maintaining health and vitality through midlife. Dr. Wright also introduces her FACE protocol, a framework designed to promote long-term physical resilience. If you’re looking for inspiration to prioritize your health, stay strong, and become unbreakable as you age, this episode is for you. Dr. Vonda Wright is a double-board-certified orthopedic surgeon, researcher, and expert in active aging and mobility. With over 20 years of experience, she specializes in helping athletes and active individuals maintain strength, mobility, and injury-free status at every stage of life. Dr. Wright combines cutting-edge technology with minimally invasive techniques and a patient-first approach to deliver personalized, high-performance care. Beyond the operating room, she’s a passionate advocate for helping people lead vibrant, active lives well into their later years. In this episode, Dhru and Dr. Wright dive into:  Why believing that aging means decline is destructive to our health (00:30) How Dr. Wright helps women change their perspective about aging (3:15) Core beliefs women hold about aging (5:10) Dr. Wright's personal story and the steps she took to embrace aging (8:07) What are these aging "ticking time bombs"? (18:18) The effects of estrogen during perimenopause and menopause (21:12) Changes to our bones during aging and the causes of bone deterioration (23:45) Best practices to get the hormonal help women need (36:15) The FACE framework: flexibility and joint mobility, aerobic, carry a load, equilibrium, and foot speed (42:07) How strategically stressing our bodies improves health (45:24) How to improve your VO2 max and Dr. Wright’s resistance training protocol (49:42) The top nutrition tips and supplements for bone health (1:09:42) Committing to resilience (1:24:42) Final thoughts (1:26:10) Also mentioned in this episode: Unbreakable: A Woman's Guide to Aging with Power Alloy Health Midi Health  For more on Dr. Wright, follow her on Facebook, X/Twitter, Instagram, YouTube, LinkedIn, or visit her Website. This episode is brought to you by Cozy Earth, Branch Basics, and Bon Charge. Right now, get 40% off your Cozy Earth sheets and sleepwear. Just head over to cozyearth.com/dhru and use code DHRUP. Right now, Branch Basics is offering 15% off the Premium Starter Kit; just go to branchbasics.com and use code DHRU. Make 2025 your cleanest, healthiest year yet with Branch Basics! Right now, Bon Charge is offering my community 15% off. Just go to boncharge.com/DHRU and use code DHRU to save 15%. Sign up for Dhru’s Try This Newsletter Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome to the podcast. You are here today to talk about how women, especially, but also men, can step into their power and rise above fear when it comes to the topic of aging. But to do that, it is so, so important that we destroy, eviscerate old beliefs, ideas that are holding so many people back. And you start off with the big one in your new book, which is fantastic, Unbreakable. Let's dig into it. And that first belief is aging means decline.

There's nothing I can do about it. Why is this belief so destructive and why does it hold so many people, especially women, back? You know, our brains will believe what we tell it, right? Our brains, if we tell our brains, oh, I feel terrible today, our brain will believe that. But if we say, despite feeling terrible, it's going to be a great day. I'm going to feel good. I'm going to the sunshine, it changes our very perspective. It is the same way with aging.

There is this myth in this country and lots of places in the world that aging is an inevitable decline from vitality to frailty and that we have no control. There's nothing we can do. And that like so many people say to me, I don't want to age like my mother did because what they see is sometimes frailty and disease. But my research and the research of many very smart people, and I'm thankful they're working so hard on that, shows that when we intervene and when we get in front of this, not only with mindset, but with lifestyle and new inventions, that we can be healthy, vital, active, joyful, long into the foreseeable future. But I believe that it starts with believing that we can. and then our behaviors will follow.

I think I was reading a statistic that almost 3,000 women every day are entering into menopause. Does that sound about right? Yeah. If we're going to be very centric in the United States, although I realize people globally are listening, that 80 million people are women over 40 in this country. They are all very close to perimenopause and menopause. because when you think about it, we're birthed, right? And then eventually we all die. In between, if we live long enough, everybody born with ovaries, everybody will go through menopause,

whether it's natural retirement, whether it's surgical retirement, whether it's chemical retirement of the ovaries. There's no escaping it. And it's everybody, 51% of the population. So for these 80 million women in the United States who are in this period of life and are looking for answers and are paying attention to this podcast, but many of them wake up every day feeling tired, heavy, unseen, how do you help them step into the idea that actually there's a major opportunity for them at this stage? How do you help them go from this feels off to actually there's an opportunity right now and it's not too late to completely change your life? Well, first, if you don't mind, I'd like to give a framework for people to think about this, right? So we can be affronted by the total chaos of our hormones or we can realize that we are entering a phase. And I made up this word, but it suits me, of menolescence.

This is a transitional phase. This is not an accident. So it helps us because if we think back to adolescence and when we were coming into our hormones and how chaotic that was and we didn't feel like ourselves and we didn't know ourselves and our bodies were changing. And then we pivot that to menolessence when we're going to stop making those. We're like, oh, well, if it was so hard to get our hormones, of course it's going to be a little chaotic. because the reality is that estrogen works on every body system, from the brain to the muscles to the heart,

every system has alpha and beta receptors. So it's going to feel like chaos. So the first framework is menelessence is hormonal. It's physical. It is psychological. But you know what, Drew, it's also social. It affects our relationships with our partners, with our children, with our coworkers. And it just helps us to understand that it's many things and to give ourselves grace.

And then once we have an understanding of how this transition goes, we can get in front of each one of those. Hormonally, physically, mentally, relationship-wise. To me, it just makes sense. You know, I want to come back to this topic of beliefs and connect the last idea that you shared to them. You mentioned that so many women told you both as an individual, as a doctor, as a friend of theirs, that I don't want to age like my mom did, like my aunt did. What do you think, in addition to the idea that aging automatically means decline, what were some other core beliefs that that generation had that led to how they aged,

which led to so many women feeling like, I don't want to age that way? You know what? The one thing that I see consistently in women of all ages is this, idea that suffering is okay and the longer you suffer is just the lot in life. Because when women, I'm still a practicing surgeon, I see patients every week. And when they come to my office, among other things they say, they'll start out a conversation with, you know, I don't know what's going on, but I feel like I'm falling apart. And sometimes these are their words. They say, and you know what? I think I'm going crazy because this person told me now there's nothing wrong. This person told me,

Somebody else told me I'm just getting old to suck it up. But you know what, Doc, I did not want to come in here today because you know what? I have a high pain tolerance to a woman as if it's a badge of honor to suffer as long as we can. So when we say, I don't want to age like my mother, I think what women are observing is decades of their mothers not feeling well, becoming frail, not being vibrant like they once were when they were children and they're thinking, I don't want to be that way. I want to be vibrant. And yet, even though now there are great examples of women in midlife being authentic and active and top of their gain, we need more examples so that it becomes the norm that we expect us to age well into the distant future. I think this idea of, well, we just got to suffer or that's what I see. No wonder we don't want to age like our mothers if that's what we see happening. I love how you said that using a lot of this new information, which again, you talk about in your book that you've been such a huge advocate for, we can change the expectation of how women. Again, this conversation is about women. So it's okay to say that. It's about how women can age what's possible for them. Which is obviously women are in charge of the health of the households for so many families. That's going to make men healthier too.

Absolutely. But I love that idea that we're changing that expectation. you even say yourself that as a woman, as a doctor, as a physician, that aging kind of caught you off guard yourself. You were 47, right? And you felt yourself, you used this quote, you felt like your body was falling apart. That included pain, some weight gain, brain fog. I think the quote from your book is, I didn't think aging would happen to me. Can you talk about that? Thank you for being such a so so observant in my book because I do tell my own story. And the irony, Drew, is that my entire academic body of work, I was an academic surgeon for 20 years, which means I did the research, was on aging and longevity.

And yet when I got there, it's exactly what I said. I'm like, oh, my God, it's happening to me. I didn't think it would happen to me. The night sweats, the brain fog so that I could not remember the names of instruments in the OAR. Think how frightening that is. I mean, I could describe what I wanted. I could pick up off the table. But nouns escaped me to the point that I started looking up signs of early Alzheimer's, right,

to see if my brain, which is the best part of me was going. That was frightening. I'm an athlete. I was, you know, training for triathlon. I've always been fit. I had a very hard time getting out of bed because of the arthritis. which is the inflammation that comes with estrogen walks out the door. Not to mention, my family may differ with this, jokingly, but I'm a very calm person.

I don't get excited about much because, you know, I'm in life and death all the time in the OR, so daily life. But this made me enraged all the time. And these things that I felt, these changes, these changes in attitude, this rage, this is what so many women also report. And it's what affects them, their jobs, their marriage. And so, yeah, you're right. I didn't think it was going to happen to me, but it sure did and thank God it did because now I can help so many other women.

Let's talk about that. What were some of the first blind spots that you saw out of that moment that had you feel like, wow, not only do I want to figure this out for other women, but I want to figure this out for myself. One of the first things I ever did was make my hormone optimization decision. So I'm sure you've talked about this before. Before 2002, women in this country were offered hormone replacement at this time in our lives, because I've already told you that every organ in our body has estrogen receptors, alpha and beta. So, of course, every organ is going to be affected. Well, in 2002, the Women's Health Initiative took estrogen effectively away from the following generations

because if it's interpretation of its data, now that study has been walked back, But the long-term effect drew is that 40% of women before that study were replacing their hormones and now only 4%. So the first step in stepping in front of this for me was learning the data because I refuse and I refused to have any woman that I care for remotely or virtually or in real life make their decisions based on fear. You can base your decisions on facts and still decide not to hormone optimize by replacing. but you cannot do it based on fear. And because I believe every woman is a cogent being and has agency to make the decision. So I'm never going to tell you to make it. But I'm going to say, well, I made the decision to optimize my hormones because it infers a 30 to 40% decrease in all cause mortality.

It decreases cardiovascular disease. It is thought, and we're still working out these data, to preserve brain. But I'm going to tell you for sure, Drew, as a musculoskeletal doctor, everybody else can argue about the relative merits of estrogen replacement for different body parts, but for bone and muscle. There is no element of question in the data. Estrogen is critical for the maintenance of bones and is actually FDA approved for prevention of osteoprocess and postmenopausal women. So if for no other reason, I want people to be educated. So that's number one. To come back, that's number one, to make your hormone decision based on facts, not fear.

And that's what I did. Number two is to really examine how our lifestyle is going. Because what many women will tell you is that I'm doing the same things I always did. And yet I don't feel like myself or I've gained the weight. And that's hormonal. I mean, it's nothing you're doing wrong. I have found in myself and the women I care for, we need. to focus our energies physically in a different way. And I can't do what I always did. I was a

distance runner. I was doing endurance things. And that just doesn't work for me anymore. And so we just have to be willing to make the lifestyle changes, which include things like, which you've talked about many times on the show, the protein question, the complex carb eating, the making sure we're getting the micronutrients we need because our gut microbiome is not absorbing quite as well as we did all of those lifestyle changes. But I think one of the biggest ways to get in front of this change is something I've already talked about with you is pivoting our mindset. I call it mindset mobilization. If we are here in midlife, but we're stuck, I always look over my left shoulder, looking over our left shoulder and thinking, oh my God, 25 was amazing and remembering our youth, which probably was

amazing, but it's kind of easy, right? We have to pivot that mindset to know that now we can be our most authentic. We can still be as good as we ever were. Hopefully we have more financial stability, relationship stability than we ever did so that the rest of the life can actually be the best. And that's what women who have gotten in front of this report. That's powerful. You know, once you switch out of fear and you start to step into understanding, which is a huge part of your message, you can start to look at the hallmarks of aging and see how they play into where you are.

Because if we want everyone, especially women, to feel incredible, the question is, what has to come out of balance, out of whack, for us to not feel good or for women not to feel good? And in the book, you talk about how after you going through your own sort of wake-up call, you dug into this, your entire career is about this.

and you started identifying these ticking time bombs that are so crucial for everyone to understand men and women because they're a huge part of how we age. If we get a good understanding of them and get ahead of them because we're not being motivated by fear, we can now start to influence them. Which one would you like to start off with for us to give a little bit of a preview to the audience

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So in the normal aging process, and I just want to say that I don't view aging as abnormal, actually, from the moment of our conception to the moment of our death, every day we're aging. So that's natural, right? It's how we do it that matters. So there are a series of papers that outline, well, what are the hallmarks of aging? What happens in our body as time passes? And in Unbreakable, I've chosen six that are really things that I want to focus on, things like what happens to our mitochondria, what happens to our stem cell nests, what happens to our gut microbiome, what happens to our insulin sensitivity? And so I explained some of the science of what is a mitochondria anyway, other than we know it's the

powerhouse of the cell. Why is it so important? factors affect it. But for each of these time bombs, I'm later going to explain what I call the shields, the lifestyle, the nutrition, the medications, the biohacks, if you will, that can build shields against these time bombs. But what I really tried to do for the first time is talk about aging and these time bombs of aging from the perspective of being a female. Because we have so many resources within the longevity community, many books written, but the perspective has never been specifically focused on the 51%. And so, for instance, when I talk about mitochondria in aging, what happens

to our energy fireballs, our machines? Well, I talk about the fact that mitochondria have both estrogen alpha and beta receptors, and the change in estrogen levels affect how, mitochondria replicate, how they do their jobs, how they handle their antioxidant function. So it's not just, oh, mitochondria ceased to function. It's estrogen is critical for the functioning of mitochondria. When you don't have estrogen, of course we're going to feel low energy. We're going to make less mitochondria, we're going to have less mitochondria replication. that's how I've tried to lay out this entire new science of aging from a perspective of people born with ovaries, whom I know are a lot of your audience. They're really smart people just to take it up a level as you were talking about.

I love that contextualization because longevity has been seen so much through the male lens. And when it can be contextualized, there's a whole deeper understanding. So maybe we could go through a couple of these and I could ask you for some more contextualization. So, you know, one of the first ones you talk about is DNA damage, cellular inflammation. How does this period of life, perimenopause into menopause, how does that specifically impact women in a unique way with these change of hormones from a cellular and inflammation standpoint? Estrogen is thought of as a sex hormone. It's actually not a sex hormone. It's a hormone, just like thyroid hormone.

And so estrogen has plays a huge role in inflammation in the body through several pathways, but one is by affecting a large molecule in the immune system called the inflammazone. It causes dysregulation of that molecule. It also has an effect on inflammatory cytokines such as the inner lukins, one through six, right? So estrogen is not available to help control those cytokines because, remember in the body, we are under constant homeostasis. We're like the three bears. Too little's bad.

Too much is too bad. But right there in the middle, we are constantly adjusting. Well, without estrogen as a force for adjusting inflammation, women become highly inflamed. Not only at a cellular level, but as a tissue level, for instance, women come into my office all the time with frozen shoulder, meaning out of nowhere. their shoulders are exquisitely painful and they don't move. Literally, if you can see this, they can't raise their arm like this, and this can happen within a week.

And it's not because they hurt themselves. It's because the shoulder is very sensitive to inflammation. And without estrogen, we're highly inflamed. And so, you know, that's one example. And that turns into feeling of systemic inflammation. We know that inflammation or inflamaging, as longevity people like to call it, is one of the stimuli for chronic cancer. disease. In women, inflammation affects bone density. An inflamed system decreases the ability to make

new bone, which is also a problem. So it's not just feeling inflamed. It's not just body parts such as the shoulder that are affected. It's things like bones. But isn't that interesting how everything's connected like that? It's so interesting. And when you see some of the stats that you talk about in your book, like the one that just blew my mind, you know, my older sister Herschel, shout out to her. She helps me with this podcast, and she's going through this stage of perimenopause in her life. And we were chatting about it, texting it back and forth. But the stat was up to 20% of a woman's bone density can be lost in the years immediately following menopause. Like, that's so crazy when we talk about this conversation. Yes. So let's think about that. Why could

that possibly happen? Well, it's exactly what I just got done saying. Our bodies live in homeostasis. When it comes to bone, we have these cells called the osteoblast, which are the bone builders. They're laying down bone. They're building your bones. There's a cousin cell called the osteoclast with a C that's reabsorbing bone because the bone contains 99% of all of our body's calcium, which is not just structural. We need it for all the chemical reactions in our body. So the osteoclast is harvesting it. The osteoblast is building it. Without estrogen, the osteoclast is a crazy child.

It just keeps eating bone and eating bone and eating bone. And the dynamic balance is no longer balanced. And we resort more bone with our osteoclasts than we do with our osteoblasts. And we lose a huge percentage. And that's bad enough in itself. But listen to this. I get Dexas scans, which is a way to measure bone on everybody in my clinic. And I have 20-year-olds and 22-year-olds and 30-year-olds who come to me and I measure their bone density.

and they're already osteopenic, which means low bone density. So we think of bone as something that only happens bone health in midlife and beyond. But the reality is all of your younger listeners or listeners who have younger children need to be really concerned that we're building bone while they're children because we reach peak bone density between 15 and 25, we estimate. That is the time to be easy. to be jumping, to be building muscle, so that then we enter those years of breakdown with enough bone. But why aren't our kids building enough bone these days?

Well, when I think about it, I think there is a population of young women who are so active. We are in the, I think we've had Title IX for 54 years, which was the law that equalized sports and men and women. Well, I'm a sports doctor, so I take care a lot of these women's teams. and if they're burning five to seven thousand calories a day working out, but not eating enough, like so many of my teams did, they refueled with gummy worms, for goodness sakes. We're an energy deficit. We're going to skip periods. We're not going to lay down bone, right?

That's one reason. The second reason I often think of is women persist, although we're trying to change this, in believing we have to be as small as our pinkies, that we cannot take up a lot of space, that we have to be skinny. Well, we're not laying down enough bone. Or the third reason young people are not laying down enough bone is probably sedentary living. You know, we are raising a generation of digital people who don't have to move to communicate, right? So this whole generation is progressing and not laying down bone.

And then we get into the childbearing years, which can also be attacks on our bones. And please, people listening out there, hear what I say before I say this. because I get a lot of heat for saying this if people don't listen to the whole explanation. We can lose a lot of bone when we are pregnant or breastfeeding. Here's why. To build a baby,

we need calcium and minerals. And where are we going to get that? Well, we're going to eat it, but if we don't eat enough, our body's going to borrow it from our bones. And so there is a phenomenon called osteoprocess of pregnancy where we lose bone density building a baby. And then if we choose to breastfeed, it takes about 500 milligrams a day of calcium to make enough milk to breastfeed a baby.

Now, the good news is our bodies know this is happening and can totally rebuild. We can totally rebuild our bone in this reproductive period. But what I see is that many times women don't. They're not eating enough. They're not exercising enough. They're just exhausted. Listen, I've been there. It's exhausting.

And so then we reach midlife. we're starting behind the eight ball. And then we lose the 15 to 20% that you ask me about. And that's why one in two women, one in two, it's either me or your sister, are going to end up with an osteoporotic fracture in our lifetime. And if that fracture is a hip fracture, 50% of the time, we do not return to pre-fall function, meaning we can't live in the house. We can't drive the car. We have to have help. and unfortunately 30% of the time will die of a complication.

So I'm not kidding when I say this bone health is bad at midlife, but it's a lifelong process. Yeah. It's so scary, but the reminder in this entire conversation is that it doesn't have to be that way. There's a lot that can be done. There's a lot that can be done. And you have a whole list of things, which we're going to get to in a second. But before we get there, there's still a little bit to understand. about the contextualization about how this hormonal shift in life uniquely impacts women in a way

that when you get it, you can take empowered action. So one of the other areas that you talk about inside of your book is when it relates to aging is oxidative stress and how this unique hormonal milieu impacts women in a very specific way. Can you share a little bit more about that? After a long day of meetings or podcasting, travels and workouts, or just trying to stay on top of life, there's nothing better than sinking into a bed that feels like pure luxury. And for me, that experience starts with cozy Earth's sheets, which is why I'm super pumped to tell you about Cozy Earth, one of the sponsors of today's episode. Their best-selling bamboo sheets are insanely, insanely soft, temperature, regulating, and naturally

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Trust me, your sleep and your mornings will thank you. So part of the natural way that cells metabolize, in that natural way, We create as a byproduct of chemical reactions things called free radicals or ROS. They're just byproducts of metabolism. Thankfully, our body has systems called TAC to deal with that. But as I said earlier, without estrogen, we have decreased antioxidant defenses. we have decreased ability to deal with all these free radicals that we make. So those accumulate.

It causes inflammation. It changes the pH of our body and leads to this inflamaging, which then ages us and causes diseases. So when I talk about longevity and women and the perspective of the hallmarks of aging, the time bombs, I like to go back to root cause. Part of women's response to these time bombs of aging has to be. be adding estrogen back into the system so that we can re-regulate all this dysregulation that goes on when estrogen no longer fills the alpha and beta receptors. And while I still hold to every woman gets to make that decision, the fact of the matter is, I believe that estrogen is the elixir of longevity in women.

That is, it is critical in root cause to how are we going to age better? well, we're not going to deprive a system of one of its key ingredients and expect it to function the way we want it to. So from a metabolic and inflammatory, even a stem cell, we know that bone marrow stem cells have estrogen beta receptors on them. And with low estrogen, it causes a decreased regenerative capacity of those stem cells. So they're less able to divide. They're less able to repair. So it affects everything. You know, in addition to estrogen, there's also the other hormones that are there.

And you say that it's a huge part of story. And also there's a lack of or decline in testosterone and growth hormone. Can we touch on those for a moment? People think testosterone is only a male hormone. Actually, men make estrogen and testosterone. Women make estrogen and testosterone. And women have declines in testosterone just like estrogen, not so precipitous, not so falling off a cliff. but we do see declines. Testosterone is also critical for bone density. It helps control the osteoclast. We think it plays a role in muscle regeneration. It's certainly in a very anecdotal way. When I take it myself or put women back, put women on it, it is like the spark of life. It's like the extra icing on the cake, if you will, in terms of energy. And I can't tell you biochemically how it does that. But,

from a perception sense when people are going, when I put them on estrogen and then progesterone if they have a uterus to protect their endometrium, when I add that extra layer of testosterone, they feel like themselves again. Powerful. On the topic of growth hormone, just want to touch on just briefly, so much of that is also impacted by the lifestyle that women are living. And it's a great reminder that your message is, if we don't use it in. our day to day, we're going to lose it. So it's not an automatic assumption that growth hormone

is going to go down, but it really is a reminder that we have to step into, this goes for everybody, but in particular in this conversation for women, step into this idea of really utilizing our body and that our bodies were made for movement. That's right. I mean, I often say in a kidding way, if you look at us as intentionally designed, nature is very conservative. If we were meant to be sedentary, we would be built like a mushroom with a very broad sessile stock, just a wide base that doesn't go anywhere, but we're not. We are made with our biggest muscles below our belly button, which says we're designed to move to your point. But when I think about growth hormone in particular, I think about the fact that midlife women, for a variety of reasons, do not sleep.

We wake up at 3.37 or 237. It's like clockwork. It's either due to a drop in sugar. It's due to our hormones. But as you've talked about before, growth hormone is produced most abundantly at night during our regenerative sleep. So if we're not sleeping due to all these things,

due to lack of estrogen, we're not making enough growth hormone, which is really key to, muscle and bone and brain and just continuing to grow and not slide downhill. So isn't that interesting? I mean, estrogen again, I'm like a broken record. And I realize that there are women who choose not to do it. And that's where the other lifestyle choices, because estrogen is not a cure-all. You just take estrogen. It's not going to make you age perfectly to 97. You have to reinvest the energy in your body through your lifestyle. What are the stats that of women, 40 plus, less than two or three percent of them are on

some version of hormonal therapy? And or the women that are listening today, they're like, hey, I'm in that category. I've been hearing about this, but I'm just starting this phase of my life. What are the best practices that you found for helping them connect with the right level of care, but then also to help shape that care so that they continue to get their needs met when it comes to the topic of hormone replacement therapy if they decide to go down that. I've just heard, even for my family member, sister, that it's an ongoing thing. Finding the right doctor, getting that level of care, tweaking it. So what are the best practices from your side of things that our audience could walk away with?

So number one, you must become a scholar of midlife yourself. You must take ownership and responsibility. There is nobody on a white horse going to ride in to save you at this time of life. You must take control of it. By reading, I don't know if you've had these guests, but the book that changed my life is called Estrogen Matters. It's all the world's data on the relative safety of estrogen, testosterone, progesterone, in one place written by Avram Blooming, an oncologist,

and Carol Tavaris, a social scientist. If you're a data person, read the book so that you can make a decision based on facts, not fear, number one. Number two, to find good data, you want to take your advice, and I'm going to, you know what, I realize not all the good experts out there have what I'm about to say, and they are good experts, but you need to get your medical care from a board certified doctor. So after you get out of college, you can go to medical school. it's four years, you get in, you graduate with medical degree. Technically, you have a degree of doctor. That does not mean that you've chosen to do a residency, which is post-medical school training in the specialty that you're doing.

For instance, when I got out of medical school, I was not a surgeon. I could not replace your ACL or do shoulder surgery or hip surgery. I had a medical degree, but after medicine, you do a residency. along the way you're taking at least three exams to get your medical license, right? So you can get a medical degree and not have a license to practice. You can't practice medicine. And then when you're done with your residency, to be board certified, which is the point, I am asking people to go to the highest level expert, the board certified people,

because that takes two or three extra exams to say, I have trained to the highest level. we have to re-exam every five to 10 years. I ask people to seek their information from board-certified clinicians because you deserve it. You deserve the best information. I'm going to tell you for sure within menopause care, sometimes it's hard. I'm going to give people that because of the women's health initiative, an entire generation of women of doctors were not trained in menopause or midlife care. So it's my personal vision and those of people that I collect. around the country to train up an army of doctors that can adequately take care of women in midlife,

whether it's menopause, their heart disease, their bone, and just not pretend that they're little men and that everything applies that we learn from men to women because the truth is that until 1993, researchers were not required to have women in their studies. And so much of the data that we have is performed on a very narrow group of people, usually honestly, usually Caucasian. men, and then that data is applied to everybody, no matter what your gender is, no matter what your race is. And we're all different. So it's hard. I just want to acknowledge it's hard. So first to educate, find board certified doctors. If you can't find one in your hometown, there are many now, two or three in particular that I love, telehealth companies with board

certified clinicians that can meet you where you are in your living room to give you good advice. And so that's how I advise my own patients. Yeah. Do you feel comfortable mentioning some names? We can include them in the show notes. Oh, I do. That's okay with you. Yeah, absolutely. Oh, absolutely. Two companies I work with mostly, there is a telehealth company that is, and I know all these people staffed with doctors that are experts in general menopause all the way up to complex breast cancer. And that's my alloy, A-L-L-O-I-O-Y.com. The other group that I work with a lot is called MIDI-M-I-Halth.com. They are staffed with doctors and nurse practitioners, and they take some forms of insurance. Those are companies that I trust to have experts, and I've sent many of my

patients to them and have been very happy with it. So if you can't find someone in your hometown, those are resources because what you cannot accept, you cannot accept someone just saying to you blowing you off, gaslighting you saying, oh, you're just getting all deal with it. Women suffer. You're going to suffer. That's a cop-out. That is not working hard enough for you as a patient. if a clinician says that to you. Powerful reminder. Powerful reminder. So now that we've busted some beliefs,

we've understood the hallmarks of aging and how they in particular impact women, which is so key. And you've doubled down on making sure that all women have this conversation and get educated, become the CEO of their health when it comes to all topics, but especially hormone replacement therapy, right? Get all the facts that are there.

So now that we've built that foundation, what's the next crucial piece as part of this journey of women who are listening today and are saying, I want to be unbreakable? So what we do in the book, after we explain the science, is I have access to brilliant medical students,

one of which is a big data scientist. So we gathered the world's data on what test, can we do to really see where we are on the longevity scale. So we accumulated eight of them and we have an unbreakable assessment score. Some of the top three that are so meaningful, there are eight, but the top three are what is your V-O-2 max, meaning what is your fitness level? We can talk about that. What is your grip strength? And can you do sit to stand? Can you get up off the floor, right? Those three of the eight are the most powerful. And so we help people assess those.

The next thing we do, because you can't know where you're going unless you know where you are, right? The next thing we do is help people pivot their mindset and goal set because then we enter into the whole lifestyle. I frame the lifestyle building around this acronym that I've used for years. I find my patients do best when I frame things in acronyms. And the acronym for building a physical resilience is Face, F-A-C-E, your future. Everybody's talking about lifting weights right now, right? Everybody's talking about Zone 2, not Zone 2 sprinting. And we can talk about all those things.

But in Face, we actually start out with flexibility and joint mobility. Because if you are the Tin Man and nothing moves. It doesn't matter how strong your muscles are through a limited range of motion. It's why lack of joint mobility is why old people hunch over and shuffle along. We've all seen that. It's because their joints don't move. So if we're building a resilient physical plant, we're going to maintain our flexibility and joint mobility. Step one, F.

A is aerobic. I like my people to do 80% based training at low heart rate. and 20% sprint intervals. And this dichotomous way to train is based on the research of a physiologist named Enigo San Martino. And he trains Tour to France athletes. So I'm not asking people to do anything that pro-endurance athletes don't do. We're going to do base training 80% of the time. Then we're going to sprint.

And I'll talk about why that's important. Then we're going to carry a load. FAC carry a load. I like my people to lift heavy. to failure. And then finally, E, equilibrium, and foot speed. We forget all the time to add this. We need to stay balanced so we don't fall over and break. And we need to have agility or foot speed, just like athletes, so that we don't trip over our work bag sitting next to our desk, land up on our hip and break it. So those are the four components of how I prescribe physical resilience.

That's amazing. I'd love to go into them a little bit deeper if that's okay. But before we do, I think an important part of this conversation, every step in the right direction is great. And, right, there's an end that's there. Part of that is that we've had so many individuals, top researchers, come on this podcast, talk about the benefits of things like walking and getting in your 8 to 10,000 steps. And those are beautiful. And yoga is fantastic. And you are the first person to say you're not here to poo any of those things.

And there's a big butt. And the big butt is it's not often enough if we're truly on this path of wanting to be unbreakable. Did I get that right? Yes. I want everybody to walk a lot. I want everybody to be as flexible as possible. But that, my friends, in my experience, as a 25-year orthopedic surgeon treating 100,000 patients is unlikely to end you, keep you out of a nursing home or from breaking your hip. because I know lots of people who do Pilates so often.

I had a lady the other day she's done 1,335 sessions of Pilates. And her core is probably stronger than mine will ever be, but she's a very low muscle mass. And she's frail. And so I'm afraid she's going to fall down and break something, right? And so, and I'm not poo-pooing it. I suggested I posted about it the other day. But you have to strategically stress this body.

You have to teach us that it's, still alive, and that's what sprint intervals do. When we get our heart rate up to as high as it will go for 30 seconds, for me, I think I'm going to fall off the back of the treadmill. I'm trying to go so fast. I'm going to fly off like a bug, but that teaches us, that helps reestablish our neuromuscular pathways. That provides enough strategic stress that it improves our cardiac function, right? If we're not stressing our body, it doesn't know to improve. So, yes, I guess the short answer, which I never give, Yes, you're right. I think those simple things are fine, but they're never going to be enough. So we said we're going to unpack, face a little bit more and kind of contextualize it in the context of, you know, a weekly routine maybe or a daily routine that people have.

So the F, again, is flexibility and mobility. Yes. If there were, and the book is fantastic. It goes super detailed into this. So please, everybody pick up a copy. We have a link of the show notes. You can pre-order right now depending on when the podcast comes out and, you know, buy a copy for you. For your friends, family, it's fantastic. But high level, we have inside of there, you have some daily mobility practices. You have pre-workout that's there that you recommend. So let's share some of those practical tips that somebody could incorporate into their life.

Every single day of your life, it is important to go through basic flexibility. So if you do that in your daily yoga, in your daily Pilates, that's fine. That's enough. I'm not asking you to move more. But if you're not someone who does those practices, a daily dynamic warm up. And there are about 10 things. It's warming up every joint. It's arm circles.

It's hip circles. It's walking high knee lunges. It's this silly thing called an inchworm that looks like you're doing a downward-facing dog, except you're walking your feet in. It's deep squatting like you're a child. You know, children squat down and they're low to the ground. Each one of these 10 warm. ups, the total, it'll take you like 10 minutes, mobilizes every single joint from your shoulders

to your hips, to your knees, to your ankles. Because to continue to be mobile, we have to keep them fluid and moving, or they will get stiff. So every day there's this warm up. And we have to make sure and put our joints through full range of motion. It is very common for me when people come into my office with knee pain or maybe their Achilles tendon is sore. I test their ankle motion and their ankles have become very stiff and don't even come up to 90 degrees anymore. They're stuck like this, which changes their whole walking pattern. So that's what I mean. Every day invest in a flexibility routine.

Beautiful. I love it. You talked about aerobic exercise. And you also shared about how when we are really looking at these markers to see how well are we aging, V-O-2 Max is one of the things. that has shown the highest correlation of people who are aging well when they have a high V-O-2 max. We've done some episodes on this. We've had some people that you're a fan of on the podcast like Andy Galpin, but just give our audience a little bit of a refresher. And then how you recommend that people get started, a lot of our audience is probably doing some level of strength training,

some level of aerobic training. But then how do they really consistently grow that level of V-O-2 max? Yeah, so just to summarize, V-O-2-Max is the ultimate measure of fitness. At the formula level, it's a measure of cardiac output, how much oxygen is diffusing from the blood coming from the heart across the lungs. And so that is a function of your genetics, but it's also a function of your lifelong fitness. And so here's how to apply it, right? Because I'm sure Andy has told you all the science of it, but here's how to apply it. We know that with no intervention, part of the natural time bombs of aging is to lose about 10% of your V-O-2 max per decade. You just decline in your cardiovascular fitness if you do not reinvest in it.

Well, why does that even matter? There is a line in the sand called the fragility line, the frailty line, after which you cannot live by yourself because you can't get up from a chair, let alone take care of yourself. For men, it's about 18. No, for men, it's 15. For women, it's 18. And so if we're declining 10% per decade, we never want to reach that line. So let's give you an example. My last time I had my VO2 max measured was 50. And I don't do it very often because I got to tell you for sure, guys, when you do it to the full extent, it's painful. In the book, we describe how you can just do a partial a substitute and extrapolate. But my V-O-2 max was somewhere around 48 to 50 at 50.

So that if I... Which is great. It's great. It was great. Because I was an endurance athlete, right? So at 50, let's just take a round number so I don't have to do math. At 50, by 60, I'll lose 5%. I'm at 45.

By 70, round math, 40. By 80, 35, I'm never going to reach the frailty line. But what if I never was in shape? What if I was sedentary my whole life? And I arrived at midlife at 30. There's a really high chance if I live long enough, I'm going to be past the frailty line. If you can't get up from a chair, it's one of the big reasons you end up in assisted living. Because your family can't be there 24-7, right?

That's how we apply V02 Max. It's not just for elite athletes. It's for mere mortal athletes like me. and everyday people. So the way we get in front of this, now when I prescribe lifestyles, I like to layer on because if I tell you,

here are the 32 things you have to do, it's just you get frozen from not being able to do it. Once you feel very comfortable with your 80-20, your base training in your lactate threshold, you're sprinting,

then I advise people to layer on once a week specific VO2 max training. Let's differentiate sprint intervals from VO2 max training. Sprint interval training is going as fast as you possibly can, whether it's on a treadmill, a track, a rower, a versa climber, an alpine. It's about your heart rate. You're just trying to jack your heart rate as high as, it is safe for you.

And do that for 30 seconds. and then you completely recover. It takes me, I can get my heart rate up to about 1 to 86, think I'm going to fly off the treadmill, and then I'm going to recover for two to three minutes. That's what it takes me to get it back down to 130. And I do that four times. That is sprint interval training.

If I'm saying now we're going to layer on V-O-2 max training once a week, you are going to do four by four, meaning four minutes as hard as you can go, and then you're going to recover for four minutes, only four minutes, and you do that three to four times. That then is more specific to V-O-2 max and longevity. I think we do the sprint intervals to stimulate.

We're alive, we need to build better bone, we need to stimulate our stem cells, but this VO2 max training is for our cardiac fitness and our longevity. No, that's great. I think they call it sometimes the Norwee, region four by four, right? That is what it is. Yes. Thank you for reminding me. Yes. Yeah. No, that's fantastic. Okay. So one question on the practicalities of sprinting. There's a lot of women that are listening today that are doing some aerobic training that are doing some resistance training because

they've really gotten that memo. They're prioritizing things like protein because, you know, they've been paying attention. Sprinting might be a little bit new to them. So if somebody's completely new to sprinting, what is a gradual way to get started for them? Well, number one, I want to reiterate, it doesn't have to take place on a track. I mean, you think of Shakiri Richardson or somebody where it hasn't, doesn't have to be that way. It's about your heart rate. So if I were going to start sprinting on a track or an indoor or the street, I might start with skipping, right? Because you could jog, but how do you graduate from just jogging or running to speed up fast enough that you're flying? I think skipping is a great interval because you can go much faster skipping because you're bounding up in the air.

It's like going back to childhood than you can just running. And then once you're skipping, you just do it as fast as you can until your body's going to make you convert to sprinting. The same thing for rowing. There's no skipping and rowing, but you can start out slower. And then you can just pull hard as you can for as long as you can. You might only be able to really pull hard maximally three to five times. But as you get used to it, you'll go faster and faster and you'll watch your heart rate go up until it'll stop increasing. It'll get to that place whether you're either too exhausted or it'll stop increasing.

That's great. And is also, you know, if somebody has access to an assault bike at a gym, is that also a good way if they feel like, oh, you know what, I'm not a great runner. I have some bad sort of, you know, dynamics that are there. Is a bike a good way to get started on this as well? A bike's a great way. And I try to block that out of my mind because assault bikes are the ultimate torture, aren't they? But you know what? I do a lot with Spartan racing.

And Spartans love the assault bike. Yeah. Yeah. It's one of my favorite ways to torture myself. Yeah, I bet. I bet. It's arms and legs all at once, isn't it? It's like rowing.

Totally, totally. That's the aerobic side. We're digging into the details of face. Right. The next one is C, the carrying load. the resistance training. Give us a little bit more about your protocol of what you recommend to individuals.

You know, I saw a really great conversation between you and a friend of mine, also a friend of yours, Dr. Gabriel Lyon, where you were saying that in your journey, as you continue to evolve more, you would originally share to people, hey, let's do these body weight workouts. Let's just get you started

because the truth is you wanted to meet people where they were at. And part of that is that because you've continued to do the work, that you're doing. A lot more people are understanding that, in your words, not mine, you can't just go to the gym and pick up these pink dumbbells and feel like you're aging in the right direction. We actually want men and women to carry heavy things. So what is the Dr. Vonda Wright protocol? Yes. And I say no man be pamby pink weights and people don't like it. But here's the deal.

The idea is to lift to failure. You can lift to failure. You can lift to failure. You can lift to by lifting a five pound weight 30 times. But what will that get you? That will get you endurance, right? And that's fine. If your goal is endurance, you do that. A person interested in longevity, I want to live till I'm 97 doing what I want to do when I want to do it, 97 and beyond. I need strength and I need power, power so that I can be agile enough to get off the floor and strength to be able to get up and move things in my house and live. I don't need endurance for that. I need explosive strength.

I could also go to failure with hypertrophy, right? If I'm just interested in giant muscles because I'm competing somewhere, I would do mid-range reps. I would do 10 to 15. I could do those to failure. My goal is not hypertrophy. My goal is strength and power. To gather strength, you have to stimulate,

your body enough to reestablish your neuromuscular pathways, one nerve innervates a bundle of muscle fibers and you want the most of those to fire at once to give you strength, that comes from heavier loads. So I ask people to load to failure with fewer reps. So what does that mean? The range is three to eight. But listen, again, I've been a doctor 25 years and I know what people do. They want to be, at least the people who read my books, are like, don't give me all. options, just tell me what to do. So I tell them four reps, four sets, meaning once you work through body weight and you even know where your hips and knees are, once you feel confident that you have learned the technique of power lifting, the heavy lifts so that you're not going to hurt yourself,

then we're going to lift to failure, meaning I can do four reps. I could probably with good form, squeeze out a fifth rep, but I probably can't do six or seven. I mean, I did this the other day on bench press. I was lifting pretty heavy, and I could get four, and I brought it down, and I could get five, and it was one of these things. You know how your arms kind of go like this, and you're like, oh, my God. And I brought it down. But as I had tried another one, one side was all lopsided. I was afraid I was going to drop it on my chest. I had lifted to failure for that set. That's what I mean. I mean, just to add clarity to this, that is what will help recompose your body and build muscle along with sprint intervals.

That has been the most helpful technique I've seen for women in midlife to get rid of this belly fat that we all hate accumulating. We're like, where'd that come from? Well, so that's what I mean when I say lift heavy to carry a load. And I take the time to explain it now because there are a lot of people like, what is she talking about? What are we lifting so heavy for? Well, number one, I believe we can, no matter what age. And number two, what I really mean is lifting to failure with heavier weights in a safe way. And it takes time.

It may take three months, six months, nine months to learn to lift for strength and power. Is your belief or view that also to. We've always been living these demanding lives through our evolutionary history lens that women have had to lift heavy things and work and constantly be moving throughout the day. And that's what our bodies were designed for. And because we're not doing that, that's why we're in this modern world, which is beautiful. It has a lot of great trappings that we all enjoy. But we were designed to move this way.

Exactly. our bodies are not mistakes. They're biomechanically set up for success in living and lifting and moving. Our motion patterns become corrupted by not moving, by tendons getting tight, by one joint losing motion and the other having to compensate, by being in such a hurry to lift with bad form that we're explosive and then we become hurt all the time and pull hamstrings off or whatever. I see hamstrings off. I see shoulders that become bad because we're just in such a hurry to slap through the workout. So we're designed for this.

I totally agree with you. I mean, just on a very practical example, we should be able to lift our own suitcases to the top of the thing, right? I have three grandchildren. My grandson, he weighs 40 pounds. not because he's obese, but because he's rock solid muscle. And if I want to lift him up, I'm going to lift him up, right? I'm going to give you the example, though, when it hit me over the head, like, oh, my God,

I have got to do something about this. I was maybe 50 at the time. And as an arthro, as a surgeon, I do shoulder surgery with people sitting up. They come in, they lay down on the bed. And for me to do surgery, I lift them up on. the bed until they're sitting and then I do surgery. I lift them up myself. The bed does not do this. So I am under this bed squatting. I'm like at the bottom of a squat and I lift them up. And people weigh anywhere from 150 to 300 pounds and you just get it done. There was one day that I felt

like I couldn't do it. And that was a wake up call for me, that midlife was not going to just take care of itself, that if I wanted to do what I wanted to do when I wanted to do it, I had to reinvest. And for me, that's lifting heavy in the way I've described to you. Powerful. Well, a huge part of the book and part of the face protocol methodology that really a lot of people have not given enough attention to is the E side of things. Right. We had, I'm blanking on her name, but one of the top experts in Gate Health. And she came on our podcast. And she came on our podcast. and told our audience that a huge predictor of what you described earlier about men and women, but in particular women falling and breaking their hip, is how strong their big toe is and their

balance. And our audience was completely blown away. So talk to us about foot speed, toe strength, equilibrium, and what people need to know if they're going to be giving it attention in a way that they're protecting it as they age. So, you know, the simple thing to think is, when was the last time I reached for something lost my balance and kind of stumbled to the side, right? We are trying to be able to stay upright. So we start losing the neuromuscular pathways

that affect balance in our 20s. And so we become more and more unbalanced and tip over. Number one, the second part of E is footstall. meaning we start losing type two muscle fibers, which is our fast twitch fibers in midlife. And if we don't retrain those, we can't get out of the way. So what I train people to do is retrain their balance. And I'll talk about the big toe in a minute. But retrain their balance as easily, it sounds ridiculous, that is ridiculous,

standing on one foot when you brush your teeth in tree pose or something, right? the movement of your upper body will force your core and your lower extremities to regain your balance. Just switch your legs every day and you can totally retrain because we need to be able to stand with our eyes closed for about 20 seconds. And it's not that easy if you've ever tried it. So tree pose brushing your teeth. Or there's another easy balance. It's called balance reach where you stand on one foot and you point your toe. if you will, to 12, point it to three, pointed it to six, and you do 10 rounds of that on each leg,

just to retrain your balance. The way we retrain foot speed is, you know, my office is in this amazing performance center where we have Olympic speed coaches here. And we do the same kind of things with mere mortals like me that we do with our elites. And it's things like, it's called toe taps, heel taps, pogoes, where we're just mimicking fast twitch coordination and speed. It has to be retrained. You can get much better tap, tap, tap, tap of your toe, tap, tap, tap, tap of your heel. And we explain how to do that. In fact, I asked my agility coach to write the protocols that were in this book so that we're

doing the same thing that the elites do. But it's really important to retrain that. And I'm not sure if your gate expert was talking about the big toe in the way I'm about to talk about it. But I'm so fascinated you had her on because the gate fascinates me. Unless we heal strike and roll through our big toe, our tibia will not internally rotate, which then our femur will not internally rotate. And we won't fire our glutes. And so many people have weak, dead glutes, and they think it's their glutes when it's actually their ankle and their big toes fault. I don't know if that's what she got into for you. Yeah,

that's exactly. Fascinating. It's the work of an orthopod. I mean, because when somebody comes to me with hip pain, I start at their foot. I'm like, what's going on with your toe motion? Because, listen, if you have no motion in your great toe, you know, as it can't flex up and down, either due to turf toe playing sports or due to wearing high heels, that's my problem. I wear stilettos. My toe got arthritic. We don't roll. We don't roll. through the center of our foot, we'll roll through the side of our foot, which disrupts our whole gate pattern, and we end up clunking along, getting Achilles tendonitis, getting knee pain, getting hip pain because our gate is so disruptive. So you wouldn't think that the big toe is

important, but everything matters. Isn't that interesting? Absolutely. And I recalled her name. Her name is Courtney Conley. Oh. And she's fantastic. You guys got to know each other. Yeah. And one of her recommendations, which I know you've talked about as well, too, is one of the ways to straighten the toe in addition to this balance exercise that you've been mentioning, you know, try to have brushing your teeth, keeping up one foot. Try, try walking barefoot at home.

You know, be barefoot outside a little bit more if you can. Be barefoot at home. Of course, there's barefoot style shoes that people can use. They're very common in the gym. all these things that you can do to take off a little bit more cushion and kind of have you actually use all the different muscles inside of your feet are all part of strengthening this process. Well, and you know, something we do in rehab for people is we put a towel on the floor and have them grab the towel with their toes and bring it towards them like this.

I mean, it sounds silly, but it works, actually. That's powerful. I love that. I want to pivot. We have a couple big topics to talk about here while we have some more time with to you. And thank you again so much for being on this podcast, as I've mentioned. Our audience is a fan. My sisters are huge fans. I'm a fan and your work is so incredible. And this next part that I want to get into is that I want to talk about nutrition, which you chat about inside of the book. And I want

a little bit of a reminder of what are the basics that are important to women in this phase of their life, perimenopause and the menopause. And then also, what are some areas of nutrition that you feel aren't getting as much as attention that you want to double down on when it comes to unbreakable nourishment? I think it's important as we educate ourselves to know the basics, which starts with macros. What is nutrition? And why is it important? Well, remember, we started our conversation with the discussion of mitochondria, which look like little oval pills or they're like, they look like this. Our powerhouses will use substrates, that come from protein, that come from carbohydrates, and that come from fat, right, amino acids, fatty acids, glucose,

and convert that in the mitochondria, in our muscles, to the currency of energy, which is called ATP. ATP is where we're trying to go with our nutrition. Well, if that's where we're trying to go, and we know we need these building blocks, fatty acids, amino acids, glucose, where do we get those from? Amino acids come from protein. They're the basic forms of protein. Fatty acids come from obviously fat, and glucose comes from carbohydrates. Interestingly, there are essential amino acids.

There are essential fatty acids, meaning you've got to eat those. You can't make those in your body. there are no essential glucose. You can make glucose out of fat and protein. Isn't that interesting? So I want people to know those three macros, protein, carbohydrates, fat, and what proportions in their body, right? So let's take protein.

And you talk about this a lot. We need high quality protein, meaning it has a high concentration. of one of the amino acids called leucine. Lusine is an essential amino acid. You need about 2.5% of it with every meal to stimulate muscle protein synthesis. So we can get protein from anything. Listen, cows eat protein all day.

I mean, cows eat grass all day. They're getting enough protein, but you have to eat all day if you don't want to eat animal protein to get enough and you're probably not going to get enough lusine. So high quality protein. and high quality means losing content. I prescribe one gram of protein for ideal pound.

Now the research will support up to 0.73, about 2.86 grams per pound. And then I'm asked, why do you ask for one gram per pound? Well, I don't think you can have too much, number one. Number two, listen, remember, I've been a doctor 25 years. he's doing the math, and we don't absorb it all anyway. So I round it up, and it's one gram. So you've heard this all before. So that's protein. Number two, carbohydrates. If I do one thing to get people out of pain, I ask them to stop with simple sugar. I'm not against carbs at all. We need carbs for energy, but we don't need the sugar addiction that this country has, myself included until I stopped

eating sugar. No added sugar. Read all labels. Even my Greek non-fat, Greek yogurt this morning, managed to sneak in four grams of added sugar somehow, know what you're putting in your body and focus on fibrous carbs. And then finally, fats are not bad, but it is the last micro-nutrient that I pay attention to. So your audience has heard all of those things. The nutrition elements that I want to highlight include understanding what your bones need. because we're having, let's talk about bones, right? What do our bones need? Well, our bones are 50% protein. They need protein. Could you please eat enough protein for your bones? It's not for your muscles. It's for your bones. Number one. Number two, we all know that most of us are deficient in vitamin D because we're either not out in the sun or we're slathered in sunscreen. We must have vitamin D. Have your measure, have your level measured and then supplement. Most of us will tolerate three to four. thousand international units. So you can just, it's not usually dangerous to start, but that, but you do

need to have it measured so you don't overshoot. Number three, we need magnesium. I like people to take about 500 milligrams of magnesium. It's also great for sleep. I recommend of the 17 kinds of magnesium, either L-3inate or glycinate, because those also help with mood and brain. I would stay away from magnesium citrate unless you're trying to affect your bowels. This is what we use in the hospital when we have to do that. So be careful which magnesium you take. And then all the little micronutrients that we get from a well-balanced whole food diet like selenium, boron, zinc, vitamin C, all amazing for bones. The other thing I want people to remember is that when you're drinking sodas. You think I'm going to tell you not to drink sodas because of the sugar. Well,

okay, don't do that. But that tart taste and many sodas that we get, that little after tart taste, that comes from phosphoric acid and that's very bad for your bones. So maybe we skip the six-pack. And if you have to have a diet Coke or a diet something, just do one a day for the sake of your bones. On the topic of bones, a question that we get from a lot of our audience is the topic of calcium. For especially women in this age, let's say for instance, somebody's not getting their calcium from regular dairy consumption, high quality dairy that might be out there. What are the do's and don'ts around supplementation? Some women have written to us before, have asked questions for experts around the idea of, I want to make sure I'm having enough calcium,

but also should I be worried about that calcium building up in the heart from the wrong sources, if I'm not supplementing correctly? What are your thoughts about that? I recommend that you get your calcium from food. So dairy is not the only food that has high calcium. Poached salmon with the, if you poached salmon or you get salmon that's canned right at the source, like you're making salmon patties, that has bones in it. That is so high in calcium.

if you eat that with some frequency, foods like mushrooms and figs and prunes. And there are a variety of foods with high calcium that it's not hard to accumulate 1,200 to 1,800 milligrams a day. And there's even a whole food brand of supplement. It's not a supplement like calcium citrate or it's called, if we're naming brands, it's called S-E-E-N, each little. chewable is whole food and it has 500 milligrams of calcium. So I would rather you get it from your food than any of the supplements that you're talking about because I don't even recommend those at all. That's great.

That's great. I've also heard this hack that I learned from my dentist that you can actually, through a proper process, you can take eggshells that you've used, thoroughly clean them, thoroughly clean them, dry them in the oven. and then you can grind them in a spice grinder, and that's an incredible source of bioavailable calcium. You only want to have up to about a half a teaspoon a day to make sure you don't have any sort of GI issues.

And I looked into this, and this is apparently a thing. So eggshell calcium calcium. That's another thing that's out there. Amazing. Now I'm going to have to look it up. I didn't know. Yeah. Yeah.

Okay. Fantastic. So we've covered the nutrition side. Anything else you want to say about nutrition before I move on? One thing. One last thing, ladies, stop believing the myth that you have to eat a thousand calories a day or you're going to get overweight. In fact, you have to feed yourself to lose weight or your body will think you're starving and hoard the calories. So let's dispel with the myth that A, we have to be as big as our pinky or we're not valuable and B, that we have to starve ourselves to lose weight.

It's not the truth. Super important. Super important. You know, another reason that I know my audience will be so into this book, Unbreakable. Again, it's in the show notes. Audience, please check it out, pre-order. Is that in addition to many of the things you've covered here, which are fantastic and are going to be new for people, there's also this whole conversation about what it really

looks like to step into truly thriving at this stage of life. you know, the basics are there, and you've talked about them, the strength training, the sprinting, the carrying a heavy load, some of the mobility stuff, the nutrition. What are a couple things on the topic of thriving or optimization, as you refer to in the book, that you feel are novel in a way that it's important for the audience to understand that not only is it possible, but it's something that they can actually undertake on their journey. There are so many next-level physical things that we can do, but what I want to go to at this point is building mental hardiness. Because we talk about resilience all the time, right? Getting old is not easy. It's not for sissies.

There's a book called Getting Old is Not for Sissies. It takes a certain mental fortitude, and we talk about resilience all the time, but what is that really? And can we even build that? What does that mean? There's a concept called hardiness. The scientists are Steven Stein and Paul Barclay. tone, who developed this concept of heartiness by studying prisoners of war, current army rangers, or a third group of people who were born with devastating congenital diseases and yet thrived. And they looked at the characteristics that these people had, and they're about 10. And one of them is physical activity. Even, this is an interesting fact related to this, how important the physical part of it,

even the prisoners of war from the Vietnam War that they studied, who for some of them housed in cages for years, the way they retain their sense of agency, their sense of control, their sense of commitment to living was physical activity. They were doing push-ups in the mud. I mean, it's amazing the role of physical activity in harnessing the power of our brains. Thank God, none of us are in that situation today. but what we learned from those scientists and what I and the reason why would an orthod know about this? Well, the fact of the matter is I became certified in hardiness training as coaching during COVID because this is a little off topic, but I'm going to return to your question. There is a very high rate greater than the general population of doctors taking their own lives due to burnout and the stress, especially in orthopedic men. So during COVID, when I had more time, I'm like, I have got to get in front of this for my own

colleagues. So I came upon this concept of heartiness, which in the world of resilience and resilience with aging is the part we can train, right? In resilience, we have the concept of grit, which is Patty Duckworth's concept, right? Grit is that ability to keep going, hitting the wall. We got to get on the other side of the wall. We're going to go, go, go. Hardiness adds the concept of rationality. How do we then, okay, it's not working just to hit it? What else are we going to do? Well, if the goal is to get on the other side of the wall, we could also go around the wall, right? And the concepts that he learned from these three groups that I apply to aging with power and building hardiness is our sense of control. Do we have a modicum of control in this process? Well, if you

believe what I tell you and that we can get in front of this process with lifestyle, that is a little control every day versus just saying, I don't have control. It's inevitable. I can't do anything, right? A hearty person will grab hold of control. Number two is commitment. How committed are we to the goal? In Embracable, I start my first mental chapter on mental health about vision casting and what our values. are and who do we want to be when we age? Well, how committed are we to doing what I want to do when I want to do it? If I'm not committed, I'm going to sit on the couch. If I am committed to that goal, I'm going to do these things, right? And then finally, challenge. Do we see every roadblock as an insurmountable challenge that's just stopping us when we, despite doing all the right

things have a health problem? Or do we take that challenge and realize that we can change that, that we can stay committed? So I think when we're talking about thriving, we can talk about layering on a lot of physical activities or drawing special biomarkers, which I talk about in the book, for performance. But if we don't, again, get our head in the brain to build heartiness, then we might not get there. Does that make sense? It absolutely does. And I think to take it back to something you said at the beginning of the conversation, women have been taught about their life is primarily sacrifice for others. There's even the hormonal, there's even the menopausal theory of evolution, which is that women go into menopause to take themselves out of competition and to put the focus on the young men and women who are raising families. Right? And you cannot truly take care of the people around you if you're not taking care of yourself. And heartiness, I'm hearing from you as you just shared that so beautifully, is a huge through line in that process.

Remember how I said initially when we're talking about the inevitably evaging. People said to me, I don't want to age like my mother. The other thing they say to me is, I don't want to be a burden to my children. So if you don't want to be a burden to those that you have spent your life caring about, then we must be committed to the resilience and heartiness, both mentally and physically, or the very thing that you are saying you don't want is going to happen. I really want people to like take that in. That is, that's a statement right there.

Nobody wants to be that burden, but to actually get there, it requires a little bit of selfishness of focusing on yourself. Yes. And here's a way we can convert this selfishness, because I agree women say that a lot, into giving. If we believe that there's wisdom in growing older and that we can look to our elders as examples, if my millennial children see me, healthy, vital, active, joyful, having my own interests, being thriving, then that is a vision of what they can be and it will show them the way, right? You can't see what you don't.

You can't be what you don't see. So in a way, even though taking time for myself can be perceived as selfish, what I'm doing is teaching the next generation that they can live in a different way. Dr. Vonda Wright, on that note, I couldn't think of a more powerful reminder to conclude today's conversation, that reinvesting in yourself. If you care about your kids, even if you don't have kids, being in inspiration to future generations,

especially for the incredible women listening to this conversation. You want to be an example. You're standing on the shoulders of women that came before you. You want to provide that for the next generation. Taking care of yourself and giving yourself the gift of health and attention and love because you deserve it is the best thing that you could do for the future of humanity. And I want to acknowledge you because you've been on this podcast.

You have the heart of a teacher. You have a heart of a nurse. A lot of people don't know that before becoming an orthopedic surgeon, you were a nurse. And everybody knows I have many family members that are doctors. All the doctors know that it's the nurses that are really doing the work behind the scenes. It is. And today, not only did you do that work by,

putting this book together, explaining it so well. But you've also provided a lens for what's possible. It doesn't have to be the conversation of, I don't want to end up like this example that I've seen previously. And it's now, here is the vision and the example that I want to be for other people. So I want to acknowledge you for providing that vision and that opportunity for our audience today on the podcast. Well, I'm just so thankful that you gave me a time to do that for your people. Yeah. The book is out there. You can get it in pre-order. Yeah. It's called Embreakable. We have a link to it in the show notes. And also, too, I think between the window, I think I saw on Instagram a couple days ago, you also have some fantastic bonuses for people as well. Yes. If you pre-order, our publisher is sending you bonus chapters.

everyone who pre-orders has an opportunity to get on a live with me to answer questions directly. So I think it'll be a fun evening. So pre-order. Yes, please do. Dr. Vonda Wright, thank you again for joining us today on the podcast. My pleasure. Thank you. Hi, everyone, Drew here.

Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode, it would make. mean the world to me. And it's the number one thing that you can do to support this podcast is share with a friend. Share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about. It's my weekly newsletter and it's called Try This. Every Friday, yes, every Friday, 52 weeks a year,

I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. We cover everything from. nutrition to mindset to metabolic health, sleep, community, longevity, and so much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole-body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-H-I-I-T-com and click on the tab that says, try this.