The Midlife Muscle Loss Lie: How to Stay Strong at Any Age | Dr. Vonda Wright

According to Dr. Vonda Wright, almost everything we believe about aging and muscle loss is wrong. The research that told you to expect decline was built on populations where 70 percent of participants barely moved. Which means the trajectory most of us are bracing for is not biology. It is behavior. You do not have to be a statistic.

Dr. Vonda Wright is an orthopedic surgeon, researcher, and the founder of PRIMA, the Performance and Research Initiative for Masters Athletes at the University of Pittsburgh. She has spent her career studying what happens to the body when people stay active, not what happens when they don’t. Her book, Unbreakable: A Woman’s Guide to Aging with Power, distills what that research actually shows about muscle, bone, hormones, and aging in midlife.

What you will explore in this conversation:

If you have been told that your MRI findings, your arthritis, your bulging disc, or your bone density numbers mean you cannot or should not lift, this conversation is for you.

You can find Vonda at: Website | Instagram | Episode Transcript

Next week, I am sitting down with Sari Botton to talk about why the life you keep putting off might be the most honest thing about you — and what it actually takes to stop waiting for permission to live it. Be sure to follow Good Life Project wherever you get your podcasts, so you don’t miss it.

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Episode Transcript:

Jonathan Fields: [00:00:00] Ever been told physical decline in muscle loss is just a natural part of aging. Turns out it’s a complete lie. Research tells us you can reverse it once you know how. In today’s episode, you’ll discover how the science on muscle loss and aging got it so wrong. The relationship between menopause, muscle loss, and joint pain all over the body. We’ll talk about the critical decade in midlife, when building muscle is most important, and why you’re still never too old to begin, and how well intended advice to avoid weights can be devastating and destructive, even coming from well-intended professionals. And finally, what to immediately focus on to start rebuilding muscle bone mobility and health. Our guide is renowned orthopedic surgeon, researcher, and author of Unbreakable Doctor Vonda Wright. I’m Jonathan Fields and this is Good Life Project. And we’ll jump right in after this short break.

Jonathan Fields: [00:00:58] We are always looking at different aspects of what happens to our bodies, to our minds, as we move into the later years in life. Um, and there’s often so much mythology that gets built around that. Um, so much great information, often coupled with misinformation. And it’s so hard for folks who are just out in the public to figure out what is what. Yeah. Um, you make a really bold invitation, um, invite us to reconsider what we call normal aging and say like, this isn’t actually biology, it’s behavior. You call it sedentary science. Take me into this concept. What do we mean by that? And how did you come to this?

Vonda Wright: [00:01:41] So, you know, um, what we know about aging is done from by and large now. Now I’ve done some work. Other people have subsequently done work in active people. But by and large, what we know about aging is from population studies. And I’ll give you an example. There’s a giant NIH funded study, multicenter study called the health ABC that was going on. Uh, when was that? In the late 90s or early. It was in the 90s and early 2000. And what it did is it followed a cohort of 70 year olds across a decade of their lives and just observed and there were some active intervention studies. But what do we know about so it’s population. And so everything they observed. Took into account, or was secondary to the fact that 70% of people in the United States live secondary lives. So when I say things like, uh, we die of sedentary death or the science is all in a sedentary science, it’s because do we truly know the trajectory of aging in people who remain chronically active. And so I’m not talking about pro athletes who may remain active or medal winners. I’m talking about mere mortal athletes like me who just just invest every day in their mobility. What are we capable of if we take away the variable of sedentary living? And so what we find is starkly different than what we find in sedentary populations, who just wait for time to happen, as if longevity is a timeline instead of longevity being built by design.

Jonathan Fields: [00:03:32] Mhm. Yeah. So then, is it fair to say that most of what we’ve been told about this is what happens as we get older? Like this is the process of decline that you should expect to meet your body to meet your muscular skeletal, you know, your all of your different systems that most of that information, it, it sounds like, is based largely on large scale studies that measure populations that don’t distinguish between people who are actually staying intensely or moderately active well into the midlife and later life. And those who, as you describe, if 70% or so of people are largely sedentary. Mhm. Um, so we’re sort of taking the assumptions about sedentary life as we age and applying them to everybody. Is that right?

Vonda Wright: [00:04:20] That’s true. Now, if if you find yourself in the sedentary bucket, then we know a lot about what we can predict about your aging and ultimate frailty and the things that happen when, when we don’t use this body that we’ve been given. Now, there are hallmarks of aging things. I call in my book Time Bombs of Aging that are real biologic processes like senescence, which is and we can go into this. But senescence essentially means cells are so damaged after their normal lifespan that they don’t go into normal apoptosis and therefore accumulate and do bad things in our body, or let’s say till telomere length shortening or, uh, inflammation. There are 13 hallmarks of aging that we know are normal biologic processes. But the way that sedentary living fits into that is, number one, nothing’s wrong with aging. It’s the way we live. Number two, there are hallmarks of aging. But if we choose to not act upon our body’s own capacity to modulate how we age, then we know how that’s going to turn out. But what do we know? We know that between 70 and 90% of our health and aging is due to the lifestyle factors that we do today. We can change senescent load. We can change telomere length, we can change inflammatory status. The list goes on. Right. So you know what it does, Jonathan. It puts hope and power in our hands. Aging with frailty is not inevitable. We can change it if we choose to.

Jonathan Fields: [00:06:12] Mhm. So let’s tease out a little bit more detail what aging and frailty versus what would you what would you describe as the opposite of aging? Aging and frailty.

Vonda Wright: [00:06:22] Aging with power.

Jonathan Fields: [00:06:24] Aging with power.

Vonda Wright: [00:06:25] And what does that mean? You know what, when I think about that, what is aging with power mean to me? I want at every age to do what I want to do, when I want to do it to the highest capacity that I can do it. You know, uh, if I choose to sit in a wheelchair, it’s because I want to be first in line at the airport. Not because I have to write, not because my mobility has drained away from me. If I choose to travel alone when I’m in my 80s and 90s, I want to have built my health to be able to do that. So when I talk about aging with power, it’s physically, but it’s also a mindset shift that it’s possible, right? And so what I see is an orthopedic surgeon is that many times men and women get caught up in our busy lives where we’re building our careers, we’re building our families, we’re just feeling fine. So we don’t invest in the capacity of this body until we reach an age when we’re like, oh my goodness, I can’t get up from a chair anymore, or I can’t hop over this thing or I’m going to fall down, right? That is not an inevitability. That is the consequence most of the time of not reinvesting every day in our mobility.

Jonathan Fields: [00:07:50] Mhm. I mean, it’s interesting, right? Because we’ve all heard the variations of ideas. Like once you hit your mid 30s, maybe 40s, every year, there’s this inevitable shrinking of your muscle tissue in your body and that maybe you can do something to slow it down, maybe even stop it. But it’s really hard to do anything about that. That’s sort of like this common thing that has been out there for a long time and that, you know, by the time you’re in your 70s, if you’re fortunate to live into your 80s or 90s that the muscle mass on your body, which is so important in letting you move through the world and also helping all different systems function is just going to be a lot less than it was ten, 20, 30, 40 years ago. What’s take me to the counterargument?

Vonda Wright: [00:08:40] So do we reach peak bone density, muscle mass, brain function. Heart capacity. By the time we’re 30. Well, there is science to bear that out that we reach a peak. Is it necessary to give in to the slow, steady decline that men go through? Men decline at about 1% per year due to the loss of their testosterone and other things. Well, I would contend that although the numbers thrown out are as. You’ll lose 3 to 8% of your muscle mass per decade after 30. Right. Can you lose that much? Yes you can. Can you build muscle at any age? And there’s plenty of examples of this. Yes you can. Or is it inevitable that you’re going to lose so much bone density over time? Uh, it can be that way. But can you maintain and build bone? Plenty of examples. Yes you can, but not without reinvesting every day in a lifestyle that maintains that. But here’s the question. What if you wait too long? I get lots of. I get lots of emails and stuff from people like, oh my God, oh my God, I’m 60. And I finally got the message. Is it too late for me? Absolutely not. There are plenty of examples with proper lifting, proper feeding that we can rebuild the body.

Vonda Wright: [00:10:08] Will we rebuild it to 20? Maybe not. But can we rebuild it to healthy, vital, active, joyful, doing anything we want to do? I’ve seen it. I take care a lot of. I had a 63 year old who came to train with us because he wanted to hike to base camp again. The last time he did it was 23. He wanted to go again. He’s 63. He knows he’s probably not going to do it at 97. What’s the point? But I mean, his muscle mass was tremendous. I just think that people give in too soon, right? They’re like, ah, it’s going to happen anyway. There was a study that came out last year that did show that there are two distinct, uh, inflection points for aging 44 and about 60. Interesting. It’s interesting to me. Do I read that as a study that shows the inevitability of time and oh my God, there’s nothing you can do. No, I use that as if I don’t do anything about it. I’m about to have a giant new inflection point and that I use as a hopeful motivation, knowing that at my age, I have more muscle now than I did when I was 40. And if I believe the inevitability of decline, how could that be possible?

Jonathan Fields: [00:11:24] Mhm. Talk to me about because I think a lot of people are probably joining us saying like, this sounds really interesting. Um, talk to me about the, the, the three MRI images that. Oh, yeah. You’ll often explore because I think it just really illustrates this idea that it is never too late.

Vonda Wright: [00:11:44] I love that you bring that up. And so in 2011, I at the University of Pittsburgh, where I spent my academic career in orthopedics, I was fortunate to be surrounded by an entire menu of great scientists. And so we put together a working group called prima, the Performance and Research Initiative for Masters athletes, which means I only studied people over 40. Right. If you weren’t 40, you weren’t cool enough and you weren’t old enough. So one of the studies we did tried to answer the question, if we invest every day in our mobility, can we retain our muscle mass? And so now again, the people I studied were not professional athletes. They were runners, triathletes. They were just people who invested every day. So we used MRI. We we did MRIs of the thighs of people from 40. I can’t remember the oldest. I’d have to look it up 87 or something. And we did what are called axial slices, which for in layman’s terms, looks like you cut a ham, right. The the Christmas ham. And so in the middle of these images, which probably, as I’m describing it, some of your listeners are going to say, hey, I’ve seen that picture because it’s taken on a life of its own.

Vonda Wright: [00:13:00] Jonathan. It’s everywhere on the internet. But I love that it’s so illustrative. The first picture of the 40 year old thigh shows a giant femur bone in the middle. It’s thick. It’s got a thick cortex around that. On the top are beautiful quadriceps. Around the back are beautiful hamstrings, and there’s a very thin layer of peripheral fat, which shows up white in MRIs. When we looked inside that muscle with special NIH software, we found that there was not much intramuscular adipose tissue or marbling. These were not Wagyu beef. These were lean flank steak people. And so we did that at every age group and compared it to sedentary people. What happened? So at 40, we have this gorgeous example of bone, muscle and fat ratio. The second picture in the lineup is my control group. Group of sedentary people sat around at their desks for 35 years, hoping the time would be their friend. And what we found was that the cortex of their the bone in the middle was very thin, which represents osteopenia or osteoporosis. The muscle itself had lost its distinct architecture. You could no longer tell the sheets of gorgeous muscle, and you can see with your naked eye the fatty infiltration, the intramuscular adipose tissue, and there was a thick rind an inch or more of fat.

Vonda Wright: [00:14:34] Now, fat is not just an innocuous tissue hanging around in bad places. It is a noxious metabolic organ. And so that’s what you see in the middle. But what do you see on the other side? You see the same type of axial slice, meaning the ham like slice of a 70 year old triathlete, not a pro athlete, but someone who is just but just investing every day. And what you see is the same thick rind bone muscle architecture that you can recognize. Very thin fat layer. And when we looked inside again, not much marbling. Now we tested the strength of these people. And it wasn’t until the mid 60s that their strength was statistically different. Functionally not that different, but enough to be statistically different. So these three photos of the 40 year old And the 70 year old, who look almost identical, has become a beacon of hope for people like. Does this even matter? Can I retain my muscle mass? Am I in control of my skeletal longevity? The answer is much more than you think you are. So let’s get at it.

Jonathan Fields: [00:15:50] Yeah. I mean, which is it’s so compelling. Um, because it really does bump up against this idea that so many of us have been told for so many years that there is all you can hope to do on your best day is slow the process. Um, but, you know, like their decline is inevitable. It’s going to come. Um, and you’re showing visually, you know, and in data that we can do a lot of things, like we are not powerless against this process, that it is much less about inevitability or even DNA and much more about what we say yes and no to on a daily basis. Does that, does that land completely?

Vonda Wright: [00:16:28] Jonathan. We have the power to choose. We can choose to let time sweep us away and become frail, or we can get in front of it. As I like to say. Am I going to lose muscle? Well, the hallmarks of aging says I will. Well, what am I going to do about that? Right? How do I still be able to carry something of a mountain if I choose to? You know, I mean, I happen to choose to last month, last summer, I can still do it right, because I don’t you like the thought of having that choice, Jonathan?

Jonathan Fields: [00:16:59] Well, of course, I mean, I think everybody has that choice. You know, I’m somebody who turned 60 last year and, um, I’m in that season where I’m like, I would love to hang on to what I have or maybe even expand on it or, you know, I, I’m very fortunate. I spent my whole adult life in New York City. We were in Boulder, Colorado now. So I, I hike in gorgeous mountains 4 or 5 days a week, year round. And I want to keep doing that. And I want to go up challenging steep faces. And I want to do all these things for as long as I can. So, um, no, it’s very inspiring. And we’ll be right back after a word from our sponsors. I’d love to focus in on a lot of our community are women in the middle season of life. And you have coined this phrase mental essence, um, which describes sort of like this suite of things. Tell me what you mean by that and why naming it really matters, um, almost as much as treating it.

Vonda Wright: [00:17:59] Oh, thank you for going down this road. So about five years ago, when a small group of us which has now grown to be, you know, nationally, started talking about the transitions women go through in midlife, out loud shouting instead of saying, oh, they’re getting old or they’re going through menopause. So I started thinking about how to communicate it in a way that people would understand. And so I thought, you know, my husband and I were a blended family. We have six children. We have gone through adolescence and puberty six times. Right. Everybody knows the chaos in a person’s life when they get their hormones. It’s hormonal, psychological, physiological, social. Well, I started thinking about what happens in menopause when estrogen walks out the door. Our our ovaries lose, they retire. They essentially senesce. They’re unable to produce estrogen. It is the same physiologic chaos. It is hormonal, psychological, and physiological and social. It affects everybody surrounding the woman in the center of the family. So I made up the word menopause essence because people instantly get it. They’re like, oh, it’s not just the cessation of your menses. It’s this whole environmental and physiologic and and change. But I think words matter, Jonathan. And so I tend to make up a lot of words, mental lessons. Maybe we’ll talk about the musculoskeletal syndrome of menopause, skeletal longevity. And I just made up another one, the skeletonization of women, because I think when we can say something like mental essence and people immediately understand that it’s this cataclysmic ecosystem of change. It helps people explain themselves better, or maybe not feel quite so gaslit when they go to the doctor, or they tell their spouse something I don’t feel like myself. And maybe they’re told, well, of course not. You’re just getting old. Well, of course you’re getting old. We’re all getting old. But this is different.

Jonathan Fields: [00:20:17] Mhm. You just brought up musculoskeletal syndrome of menopause, which, um, so take me into this also, right? Because, you know, part of what you’re describing are changes, um, systemic changes, physiological changes, behavioral changes, relational changes, but there’s a basket of, quote, symptoms or feelings that tend to land in the body during this season that so often have been looked at, just disparate. And you’re like, no, no, no, no, there’s something more connected happening here. So take me into this concept.

Vonda Wright: [00:20:53] You know, the first thing people have to realize is that there are estrogen receptors on every tissue in the body, the brain, the heart, the pain, everything. I can’t name one that doesn’t have estrogen receptors. The musculoskeletal tissues are the same. Bone tendon ligament. Muscle fat is a musculoskeletal tissue, cartilage, muscle stem cells, the disc, the annulus of the spine all have estrogen receptors. So that’s that’s fact number one right? Every tissue. So you know, I’ve been an orthopedic surgeon since 1999. And over all those years, women have always come into me with their frozen shoulders or saying, my body totally hurts. And I don’t know why, but it wasn’t until I went through my own mental essence. You know, I was in. I always like to say I was in the best shape of my life at 40. I really was until maybe now. Um, and at 47, I thought I was going to die when estrogen walked out. Right at that point, I started listening to people differently because I understood what it meant when they came in and told me that their entire body hurt, it made a difference to me to know that frozen shoulder was an inflammatory process. And without estrogen, we are highly inflamed. And then I started digging deep. Because I’m a curious person. I have to know everything. And do you know what I found, Jonathan? I found that for 100 years, 100 years, we have known about something called the arthritis of menopause. 1925 the paper was written. Do you think anyone’s picked up the mantle? Not so much.

Vonda Wright: [00:22:42] In fact, I just presented last year to the International Society of Cartilage Research because they’re like, you’re talking about something I think it has to do with us. And so my entire hope was to spark a new generation of researchers to solve this 100 year old problem. Do you know how long we’ve known the association between estrogen and bone density? 86 years. The first papers put it together. And yet we have millions of women with osteoporosis that we haven’t solved, and 1 in 2 women having an osteoporotic fracture and, you know, name a name a tissue in the skeletal system. So as I started reading, I’m like, there’s estrogen receptors on every tissue. We’ve known these associations. I’m like, we need a language. Because, Jonathan, when a woman goes into a doctor and says, my, my shoulder won’t move, my total body hurts. I don’t know why my knees hurt my back. In a 15 minute insurance based doctor’s visit, it is understandable that the eyes glaze over because we’re like, how are we going to solve six problems at once? But when someone comes in and says, or the doctor has read this paper that we wrote and says, I’m 46 and my total body hurts, and I think I have the musculoskeletal syndrome of menopause. It creates a common language and an ability to frame what’s going on. Well, what’s the root cause of that? Many times the root cause is decline in estrogen and nothing structural at all.

Jonathan Fields: [00:24:23] How much exposure has this concept and this language had in the profession? Like, because I would imagine that a lot of people are going to walk into their local or long time doctor’s office and say, like all the things you just said, my knee hurts, my shoulder hurts, this hurts, all these different things. And as you just described, oftentimes there’s no shame or blame on the practitioner. They are operating very often in a system which gives them 7 to 15 minutes to do everything. Um, so often, just on a practical basis, you know, it’s like, well, we can address one of these, maybe two at the most, then come back maybe another time or 4 or 5 more times. How do you get a concept like this to be mainstream language and to just be on the tip of the tongue when somebody. When a woman goes into a practitioner and says, this is what’s going on, and the practitioner can just kind of be like, maybe we need to actually take a broader look. Maybe there’s something bigger going on.

Vonda Wright: [00:25:25] You know, I think there’s a couple things to unwrap there. Number one, uh, I couldn’t be more pleased with the exposure of this particular paper has gotten, you know, we published it in the International Menopause Society journal Climacteric Climacteric. I always say that word wrong. Climacteric. And, you know, it’s been downloaded almost 550,000 times, which is got to be a world record for a paper. And I don’t say that because, oh my God, it’s a Nobel laureate paper. It’s just Jonathan. It shows that the need is so great, right? It’s people are starving. Women are starving for information. So number one, it’s had a life of its own. But number two, I really the second thing to unpack is that every one of the women I ever talked to, whether it’s individually in my clinic like today or from a giant stage, one of the main points that I try to translate is that they have to become completely literate in midlife and what’s happening to them. They need to be able to converse in the language of perimenopause and menopause because. Because gone are the days when the paternalistic era of doctor knows everything. Gone are those days.

Vonda Wright: [00:26:41] It was over when I was training, right? So I think people need to be as educated as they possibly can. But the reality is, only about 7% of all medical schools cover menopause at all. And only 30% of all ob gyn residencies cover menopause at all. And I can tell you, as an orthopedic surgeon, it was never brought up. Even these associations with musculoskeletal tissue and estrogen. So that’s why I think women have to be completely literate. So how is this information being disseminated? Uh, well, people are reading the papers. They’re downloading it. Uh, there’s a group of us shouting from every mountaintop, uh, trying to educate people. We’re, we’re doing big CME events to try to educate thousands of doctors because they certainly don’t get it in their own medical school. And, um, and I’m thankful for podcasts and the popular press that are picking up the mantle of talking about 40 years of a woman’s life that were never talked about before. I think it’s going to take all of this. Plus, it’s going to take a tremendous, almost insurmountable amount of catching up with the research because women’s health research is vastly behind.

Jonathan Fields: [00:28:01] Let’s spend a little bit more time on things that you brought up a number of times. Now, this idea of preserving bone and preserving muscle. And we want to do this because it allows us to do all the things we want to do in the world, you know. Um, and that doesn’t necessarily mean hike mountains or run triathlons, but it means doing a lot of everyday stuff that again, just slowly sneak away from us. You talk about a critical decade for women, roughly 35 to 45 years old, as the the highest leverage window for building the body that you will have for the rest of your life. Why that window specifically? Um, because and, and I’ll tag this on also, I think you’ve kind of answered it partially, you know, because there will be a lot of people joining us who are older than 45. Mhm. Um, and saying, did I miss my window? So let’s start out with why that window? Why 35 to 45? What happens in there that’s so critical?

Vonda Wright: [00:29:00] I call the critical decade 35 to 45 because think about where we are in life. If we believe that our tissues, by and large peak around 30. Now, every tissue has its own aging process. But let’s just that’s that’s a good line. What else was going on? When you’re in your between 35 and 45? Well, if we know that the average onset, the median onset of perimenopause, when we have so few eggs left that we’re just, we’re sputtering along and it becomes hormonal chaos, that means that in the decade before our ovaries continue to produce enough estrogen, which means that all the tissues are covered, the receptors are covered, and we have the biggest potential to maintain our peak or grow. So I call it let’s get our health standards in order. Let’s figure out our mindset about aging. Good research has shown that you can how you age is deeply impacted by your mindset around aging, right? So let’s pivot our mindsets. Let’s read and become completely literate about what’s to come. You should arrive in perimenopause as an expert in perimenopause. You should arrive in perimenopause knowing which direction you’re going to go with your hormone optimization. You shouldn’t wait until you feel terrible. Let’s figure it out ahead of time and figure out where to get them, because it’s a little hard right now to find a clinician who can prescribe who. There’s not enough clinicians to go around. Number three, if you have not started building the best physical body you can.

Vonda Wright: [00:30:39] Let’s go people. Let’s learn to lift weights. Let’s learn not only how to build bigger muscles, but stronger muscles, because why would we want that? It’s it’s not. It is about now. It’s about feeling amazing now. I never feel more amazing than when I am at my strongest. But the reality is, why do women end up in nursing homes? Well, number one, 70% of all nursing home residents are women. They get there for many, many, many, many reasons. But one, they can’t get up from a chair by themselves, meaning they can’t go to the bathroom by themselves. Or number two, um, their brains are not functioning anymore. They need memory care, they need assistance. Or number three, they’re so incontinent that they can’t be taken care of in their own homes. Well, what is the time to do all the preventive work in muscle building, in pelvic floor? It’s when we have our estrogen in our 30s and early 40s. So mindset, uh, become completely proficient in what’s going to happen. Number three, we have got to start building muscle and lifting weights. So it’s just a part of how we live, not some new habit. Number four, we must invest in our cardio, the number one killer of women in this country is heart disease. It’s not cancer, it’s heart disease. When are we going to build our biggest cardio reserve? Well, let’s start in our 30s. Right. Um, can we please. Uh, I always hesitate. I say things like, can we please stop treating our bodies like a garbage disposal and putting whatever in there, the food, the garbage? Could we establish nutrition standards so that we eat enough protein, we get enough fiber that we it becomes our lifestyle and not just another six week diet that leaves us frustrated that it’s so natural. It takes no effort, right? It’s just how I eat. It’s what I do, right? So it’s those lifestyle things in the 30s, in the critical decade that if we build the biggest US bank, that when we start losing our estrogen in a rapid way, it’s not a slow decline. It’s a precipitous decline that we’re not left left socially, psychologically, physically and hormonally devastated. Right. That’s why I think it’s so critical.

Jonathan Fields: [00:33:16] And we’ll be right back after a word from our sponsors. So let’s circle to the second half of that question that I asked them, because somebody joining us and they’ve just heard you say this and they’re in their 50s or 60s, and they did not pay attention in 35 to 40. And again, we’re like, there’s no shame, no blame here. Like we’ve all had very different access to information and we’re told very different things earlier in life. Right. Um, but I want to make sure that that person who’s joining us is not feeling really defeated by what you just said.

Vonda Wright: [00:33:49] Well, I love that you’ve taken the time to step back for this because here’s what I know. Here’s what I know from observing people in my ecosystem. Here’s what I know from doing the actual science. There is never an age or skill level when your body will not respond to the good stress you put upon it. For instance, when I was starting down the road of researching aging and musculoskeletal longevity, and you do all the background reading and you learn what’s out there, some of the very first studies that I read were done in the early 1990s by Maria Fiatarone, who. Her research group took 90 year old men in nursing homes and did chair exercises with them. And by retraining their neuromuscular pathways over six weeks, they increased their function by more than 100%. 90 year old guys sitting in chairs in a nursing home in six weeks. Right? So there is never an age to. When you can’t reclaim the potential your body has. Your body can rebuild muscle. Your body can stabilize and rebuild bone. I mean, you you can sharpen your brain and there are. There are myriad examples all over the internet now. I mean, they’re everywhere of people showing their transformations from in their 50s being unrecognizable to now in their 60s, being stronger and feeling more healthy and vital and having higher capacity than they’ve had in decades. So will it take longer? The later you start? Sure it will. It’ll take longer. But can you? Yes. Are you worth it? Yes. What is the outcome if you don’t? Well, I see the future of frail women every single day. As an orthopedic surgeon, it is not a future that we would aspire to, but we can step in front of it.

Jonathan Fields: [00:35:56] So I want to make sure I have my head wrapped around it. There is this optimal window somewhere between 35 and 45, and of course, that’s going to be different for each person. But this is a yes and thing, right? Like yes. And if you’re in that window and you’re joining us, like, get at it, get it right. Um, and if you’re past that window, even significantly past that window, that doesn’t mean that you’re foreclosed from. So many of the benefits, it just means you may have to go about it differently. It may take a little bit more intention, a little bit more effort and more time to accumulate many of similar benefits. Is that right?

Vonda Wright: [00:36:33] Completely. You know, if you haven’t stepped away from the couch in 30 years, because whatever you’re busy people depended on you. I start people as simply as going back to the very first skeletal skill we ever learned. We learned to walk when we’re one year old. So I encourage people who are like, I don’t know where to start. It’s just so hard. I haven’t done this. And I mean, listen, you cannot excuse me. I’ve been doing I’m being a doctor a long time. So I say, well, okay, we’re going to start with walking. We’re going to start by walking every day after your largest meal. So we get a dual benefit, right? We’re walking and we’re pushing our glucose into our muscle with activity, and we’re going to do it for seven days. You’re going to commit that you are worth it for seven days. And you know, I say seven days is because in running communities, I used to be a distance runner. That’s a streak. And after seven days of doing something, you don’t want to not do it. You’ve done it for a whole week. So you’re going to do it on the eighth day, and you’re going to do it on the ninth day.

Vonda Wright: [00:37:38] And do you know, I just had a woman in my clinic today who used to be a do competitive bodybuilding, But life happened and health happened and her job happened, right? And so she came to me one month ago. Devastated by not even recognizing herself. And we had this conversation and we just laid out really simple ways to start. And do you know what she reported me today? I’m so proud of her. Every day since she left me, she has taken a walk and she hasn’t missed a day. She has a 30 day streak. It has changed her mindset. It has changed the relationship with her husband because now she’s actually becoming herself again. It has given her the motivation. Now our next step is to get her back into the gym lifting weights so it doesn’t have to start. If you’re listening and you’re in that boat where it’s been 30 years, it doesn’t have to start, uh, in a complicated way. We’re going back to basic skills. You’re going to commit to yourself for a streak because then we can add a little bit at a time. Yeah, I think that makes a lot of sense.

Jonathan Fields: [00:38:56] No it does. Um, you keep referencing lifting and I know part of what you have talked about and written about is not only lifting but lifting heavy. So, so take me into why this matters.

Vonda Wright: [00:39:07] I say you need to lift weights because what happens as we age, we will lose our type two muscle fibers first. Type two muscle fibers are the fast twitch that keep us upright, that keep us from falling down. We also will without rebuilding muscle. The population studies show population studies. Again, we will decline 3 to 8% muscle mass per decade such that by the time we’re 70, we’re 30 or 40% down. It doesn’t have to be that way, but it can be that way. I specifically asked people to lift. All lifting is good, but you got to know why you’re lifting. If you’re lifting for endurance. Then fine. Lift your £5 weight 30 times. You do that. My goal is not endurance. My goal is strength and power. If you’re lifting for the biggest possible muscles hypertrophy, fine. Lift moderate weights 10 to 15 times. That’s not my goal. My goal is to be strong enough to lift my own body or an average sized man out of a dangerous situation, right? It’s for safety. So to build strength, you have to lift heavier weights fewer times. So the the range is 3 to 6. Now I know from taking care of people for so long that people like specific instructions. So in unbreakable, my book, I have chosen four reps, four sets because that’s how I lift, right? That’s how my strength conditioning, uh, coach, he’s a CSCs, which is the highest certification you can get in strength and conditioning taught me to lift. So four reps, four sets that will build strength. But that’s also not where we stop. We need strong and we need power. Why do we need power? So when you trip over your bag that you put by your desk, your fast twitch enough that you don’t fall, right? So how do we build power? Power lifting has to do with tempo. So it’s lighter weights but faster midlife and beyond. I teach people to lift for strength and power because that’s what’s going to keep us from falling down. That’s what’s going to keep us independent and hopefully out of a nursing home.

Jonathan Fields: [00:41:27] So walk me through what this actually looks like. So, um, and in a practical way, because I don’t know what the percentage, you’ll know the percentages on this of the percentage of both men and women. But from what I remember, it’s higher in women who by the time they’re in their mid 50s, they will have some imaging that says there’s either osteopenia or osteoporosis. I think those numbers are pretty substantial, or they’ve got some imaging or some diagnosis of something happening in a joint or some arthritis or some compression in the discs in their spine or bulging or something like this. And they’ve been told, do not lift because this is going to make everything worse. Where do we go from there?

Vonda Wright: [00:42:18] Lots of people are told that, oh, I have bulging discs in my back. I can’t possibly lift. Oh, I have arthritis in my knees. The best thing for me to do is just to rest. That is not what the data shows. The data show. People with bulging discs not only can lift, but should lift. They have to do it carefully. They have to do it with good form. But the stronger you are, the less pain you’re going to have. Everybody has bulging discs. I mean, random samples of non-painful people will show bulging discs. So the the PT data and the orthopedic data show that strength is so important for people with low back pain and bulging discs. Number one knee. Let’s take knee pain. I’ve got knee pain I can’t lift. Well, you know why? You probably have more knee pain than you have to have. It’s because your butt core and hip are so weak that your knees are pounding together. What if your muscles were so strong that they shock absorbed you? Right? So I think that whole knee jerk reaction of, I don’t know, I’ve got some finding on X-ray is bad data, because what orthopedic surgeons will tell you, like if we’re deciding to go to surgery, if we’re deciding to replace your knee, we don’t treat X-rays, we treat people. And so you wouldn’t even know that you had this on your X-ray unless you were symptomatic. So we don’t treat X-rays. We treat the people. So you may have the worst, the world’s worst X-rays showing the most arthritis. But unless you’re painful or have decreased capacity, there are no limits to what you can do. So show me the data and I’ll change my tune. But it’s the same kind of thing that that when people say, oh, don’t run running’s going to cause arthritis, there are no data to support that. Arthritis is caused by genetics. It’s caused by carrying around too much weight. It’s caused by trauma. It’s caused by high inflammation. But it’s never been shown to be due to the repetitive nature of normal running gait.

Jonathan Fields: [00:44:40] So part of what I hear you saying then is that we may have diagnoses, we may have imaging that show that these things exist in our bodies. Um, that does not by default preclude us from doing this. Um, I would imagine you would also advise people to not just show up on a gym on a random Wednesday, load a bar up with like the heaviest weight that you can find in the gym and go for it. Like there’s an intelligent way to do this.

Vonda Wright: [00:45:11] That’s so right. You were really good at summarizing things. You know what? Lifting weights well takes meticulous form. Are your knees over your ankles or, you know, are you stacking your joints? Are you hinging correctly? Are you bracing so that your back is neutral and not curved? I mean, there are there are thousands of form errors to get hurt in a gym, so I encourage people, if they’re just starting out, this is the perfect time to tell your family, I don’t want a toaster, I don’t, I don’t want a new purse, whatever. Buy me a trainer. And then it behooves the person to find a qualified trainer because there are trainers who just get a certificate off the internet and their trainers who have an exercise physiology degree or have gotten a certification like the CSCs. Know who you’re being trained by, but be trained. Mobility is going to save your life. Skeletal longevity and doing everything you can to maintain it is going to save your life, right? It can be the savior of your life. It can be the gate that keeps you from it. I think it’s really important to think about.

Jonathan Fields: [00:46:23] Yeah. And, and also, I would imagine the thing that makes life, that makes you so much more capable of enjoying the life that you have, no matter how old you get.

Vonda Wright: [00:46:32] Yeah. Nobody aspires to miss out.

Jonathan Fields: [00:46:35] Somebody joining us is probably we’re at a point where they’re kind of nodding along and saying, this sounds like there’s a lot of evidence. You’re clearly somebody who has. It’s astonishing depth of both practical clinical experience and deep in the research. And they’re not alone in saying, yeah, this makes a lot of sense. Yes, I want to do this. I’m going to start tomorrow. Right. Um, and then they get to the gym.

Vonda Wright: [00:46:57] Start today.

Jonathan Fields: [00:46:58] Right? Or today in five minutes, ten minutes after we’re done talking. Right. Exactly. Um, and, and they start to do some of the things in particular, let’s talk about lifting because a lot of people have a really negative association with lifting. And while some people actually really do just intrinsically enjoy the activity of lifting heavy weights, a lot of people report that it’s the thing that they loathe. They’ll do it because they know it’s really good for them. They have to, but they don’t. They like they they don’t naturally gravitate towards doing it. I get that. Um, you have a really interesting invitation. Around the end of your book, you ask every reader of unbreakable to write down their own vision. Um. And it sounds like part of this is because your ethos says, um, for a lot of folks, it’s not enough to just say, I have to do this. You have to be moving towards something bigger that you want, where you know, this is going to contribute to the vision that you have in your mind. Is that right?

Vonda Wright: [00:47:57] So I think we, I think we to truly stay motivated, we have to know what we value. So I’ve said to you before at the top of this hour that I value doing what I want, when I want to do it. It makes me angry to not be strong enough or not to be able to do something. I want to ask for help because I want to ask for help, not because I can’t. Right? Well, if that’s what I value. Then my goal is to stay strong enough to do that. Well, if my goal is to stay strong enough to do that, then it’s going to take some work in the form of protein and lifting. Now, I’ll be honest with you and I, I say this all the time. I am not intrinsically motivated to exercise all the time. It is not my personality nor genetics. Do I exercise all the time. Yeah, I do enough. I don’t exercise all the time, but 4 or 5 times a week, right? I do not love it. I do not love powerlifting until I am walking off the powerlifting floor. I’ve dropped the weight, the deadlift for the last time. In that moment when my blood is pumping and I have done something I’ve never done before.

Vonda Wright: [00:49:18] Like maybe I piled on five more pounds than I’ve ever had, and I feel I’m going to swear on your podcast. I feel like a total badass. That’s when I love lifting. And for that five minutes, that’s enough to motivate me to the next time. And then maybe when I, I tend to, I learn to do this from, uh, a bodybuilder named Michelle who runs a group called the Wonder Woman. They take pictures every month of their progress. So you can see the leanness that’s happening from building muscle. So I do that right. I do not love lifting until I’m walking off the floor, or I’m seeing the difference that the the health in my body. And that’s okay. So if your listeners are like, I hate this, why would I want to? It’s okay because you have a bigger. I have a bigger value. Therefore I have a goal. Therefore I have to act on it And just be truthful that every time I do it, I don’t love it till I’m done. That’s the honesty and authenticity it takes to be persistent.

Jonathan Fields: [00:50:31] Yeah, I love that. I mean, and I think so many of us have probably felt that feeling of, um, I love having just done it. You know, it’s like, I feel amazing, I feel confident, I feel strong, I didn’t know I could do that, and now I have this glow because I’ve just shown myself that I could do something I didn’t think I could do or I questioned. And it makes me feel amazing. And now I kind of want to go back, even though I know it might not feel great when I’m doing it because I want to see what else I can do. It feels like a good place for us to come full circle as well. So in this container of Good Life Project, if I offer up the phrase to live a good life, what comes up.

Vonda Wright: [00:51:07] To have lived a good life to me will have been to be healthy and vital and active and really joyful personally and in the lives of my family. That will have been a good life to me.

Jonathan Fields: [00:51:24] Mhm. Thank you. So let’s talk about some of the big ahas and actionable takeaways. The thing that’s really staying with me right now in the conversation is the MRI images. She talked about the 40 year old thigh and the 70 year old triathletes, thigh, almost identical, dense bone, clear muscle architecture, thin fat layer, and then the sedentary control in the middle of that comparison. Same age range, but completely different degraded shrunken tissue. That image just does something to you. It makes the abstraction of, quote, staying active suddenly very concrete and very personal. A few more things I want to walk away really thinking about here. One sedentary science. Almost everything that we have been told about what to expect from aging was studied in people who did not move in any meaningful way. That means the data we’ve been giving about inevitability is not the full story. Second, this term mental essence. This is not just menopause. It’s a hormonal, physiological, psychological, and social upheaval. And naming it that way, it changes how you walk into a doctor’s office and what you’re able to ask for. And third, the critical decade is real. And it is also not a closed door. So whether you’re in or past it, the body responds to good stress at any age. 90-year-old men in nursing home chairs improve their function by more than 100% in six weeks.

Jonathan Fields: [00:52:55] Your window, no matter your age, is never closed. So the next time you hear that, you’re you know, imaging findings mean that you should not lift or that your muscle loss is just part of getting older. Remember this conversation. The data says something different. And as always, this conversation is not medical advice. It’s for the general public and information only for specific guidance, be sure to check with your personal, qualified healthcare and or fitness professional. And hey, before you leave next week, I am sitting down with Sari Botton to talk about why the life that you keep putting off might be the most honest thing about you, and what it actually takes to stop waiting for permission to live it. Be sure to follow Good Life Project wherever you get your podcasts so you don’t miss it. And do me a quick favor, share this conversation with just one person. This episode of Good Life Project was produced by executive producers Lindsey Fox and me, Jonathan Fields. Editing help by Troy Young. Kris Carter crafted our theme music. And of course, if you haven’t already, follow us wherever you get your podcasts so you never miss a conversation. Until next time, I’m Jonathan Fields, signing off for Good Life Project.

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