BITESIZE | How to Age Well, Stay Independent & “Unbreakable” | Dr Vonda Wright #680

“When you invest in your health and mobility every single day, you are going to age in a different way!” Dr Vonda Wright. Bone health is something most of us don’t think about until much later in life, but the reality is that the foundation for strong, healthy bones is built much, much earlier - and the sooner you start to build this foundation the better. Today's Bitesize is from episode 588 of the podcast with orthopaedic surgeon and internationally recognised authority on active ageing and mobility, Dr Vonda Wright. Vonda explains why we have more control over our bone health than we might realise, why our mid-30s to mid-40s are such a pivotal window for investing in our future health, and she shares some simple, practical strategies that could help protect our bones and keep us strong. Vonda shares her vision of ageing with strength, independence, and vitality - and why she believes we can all take proactive steps to remain unbreakable. By taking simple, consistent steps today, we could build the strength, independence and confidence to live in the way we want for years to come. Thanks to our sponsor ⁠⁠⁠https://thewayapp.com/livemore Show notes and the full podcast are available at drchatterjee.com/588 Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts ⁠⁠https://apple.co/feelbetterlivemore⁠⁠ For other podcast platforms go to ⁠⁠https://fblm.supercast.com. DISCLAIMER: The content in the podcast and on this webpage is not intended to constitute or be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or other qualified health care provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website. Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Rangan Chatterjee?

  Today's bite-sized episode is sponsored by The Way, the only meditation app with a single long-term pathway. Now, if you've tried other meditation apps before, I am certain that The Way will be the one that will finally help you develop a consistent practice. You see, one of the best things about it is that you are not going to get overwhelmed with different options. You simply open the app and do the next meditation, building up your practice step by step. After a few sessions, you will feel as if you've got your own personal meditation teacher, who of course is the wonderful Henry

• 0:41Rangan Chatterjee?

  Schukman, who has appeared as a guest on this podcast on two separate occasions. Now, I personally have been using this app for over six months now, and I absolutely love it. In fact, I love it so much that I have invested in the company to join them in their mission to get more people meditating. For listeners of my podcast, The Way is offering 30 free days to establish your own meditation practice. All you have to do is go to the way apple.com/livemore to get started. Welcome to Feel Better Live More Bite Size, your weekly dose of inspiration, insights and practical ideas to

• 1:26Rangan Chatterjee?

  help you live well and thrive. Each episode brings you some of my favorite moments, useful tools and inspiring ideas from the many incredible conversations I've had on my podcast. Today's bite size is from episode 588 of the podcast with orthopedic surgeon and internationally recognized authority on active aging and mobility, Dr. Vonder Wright. Vonder explains why we have more control over our bone health than we might realize, why our mid 30s to mid 40s are such a pivotal window for investing in our future health.

• 2:08Rangan Chatterjee?

  And she also shares some simple practical strategies that could help protect our bones and keep us strong.

• 2:17Rangan Chatterjee?

  So if we just take that broader theme about how we don't have to age with frailty, we can age with vitality.

• 2:26Speaker 01

  Yes.

• 2:28Rangan Chatterjee?

  When you look around across society, what are some of the common things people are doing that are perhaps resulting in them neglecting their bodies and therefore increasing the speed at which they age?

• 2:43Speaker 01

  I think the first reason people begin to decline, without even realizing it, is this bias or this myth we believe that aging is an inevitable decline and that there's something abnormal about it. But I say quite frequently that aging alone is the most natural thing we do from the minute of our conception to the moment of our death. And it's how we handle the passage of time that matters. But if you believe that there's absolutely nothing you can do about the future, then you're going to resign yourself to the first time you feel an ache or a pain, or the first time you come up against a no as, well, that's just getting old.

• 3:27Speaker 01

  I guess I'll just accept it. And what I find people doing is giving things up one at a time until they don't recognize it. I'll give you some examples. So believing the myth that it's inevitable is, I think, a primary motivator. The second motivator I see is that sometimes people don't believe they're worth the effort. Maybe everybody else is worth the effort, particularly for women. Like the neglect, the self neglect comes because we're not neglecting others, we're investing all of our energy externally and not redirecting anything internally.

• 4:07Speaker 01

  And so those being primary drivers I see in the stepwise allowing decline.

• 4:17Rangan Chatterjee?

  It's interesting, this idea about mindset or beliefs. You know, if we believe, if we get the message in the world around us that getting older means frailty, means weakness, means you have to give up the things that you don't want to give up necessarily, then of course your behaviors are going to follow

• 4:40Speaker 01

  That's right.

• 4:40Rangan Chatterjee?

  your beliefs. And there's so many things about your new book, Unbreakable, that I really, really enjoy. And in the introduction, you actually say, I contend that although we certainly undergo some life stage changes, what we call normal aging is actually normal aging for stressed out, undernourished people who are not intentionally building muscle, not attending to their hormonal health and not prioritizing mobility.

• 5:11Speaker 01

  Exactly. And what I mean by that is if you go back to the medical literature, there was a study, and there are many studies like this. There was a study called the Health ABC in the United States, funded by our National Institutes of Health, that took a cohort of 70-year-olds and just watched them age over a decade. These were people straight out of the population. Well, what do we know about people in the world and in the United States in particular is that more than 70% of them do not invest any energy, any day in mobility or health habits. So if we're watching a population of people to see how they age,

• 5:55Speaker 01

  and they're truly just a random sample of the population, then you are sampling sedentary people who make very little effort to age in a different way. So I state that so clearly is because I contend and why we formed the research group at the University of Pittsburgh called PRIMA, the Performance and Research Initiative for Masters Athletes, is because I wanted to see what we were capable of if we took the variable of sedentary living out of the way. So we began studying active people, not professional masters age athletes, but people over 40 who were consistently active.

• 6:37Speaker 01

  Many of them were podium-type age group athletes, meaning, you know, winning the 50-year-old podium. So they were invested, but not pros. And what we found was very different than we find in the population. We found over 15 years, we can retain muscle mass and bone density and brain function. And so when I say that we don't really truly know the state of healthy, active aging, it's based on facts, not fiction.

• 7:09Rangan Chatterjee?

  One of my favorite pages in your book is page 27. You have three beautiful images.

• 7:17Speaker 01

  Yeah.

• 7:18Rangan Chatterjee?

  And they are MRI scans of people's thighs.

• 7:22Speaker 01

  Yes.

• 7:24Rangan Chatterjee?

  Do you want to just talk us through those three images? And again, on the YouTube version, I'm going to try and pop that up on screen because I honestly believe that seeing those images will directly motivate someone to change their behavior. I really do. Certainly for me, I'm active, but I'm looking at that going, I need to be more active, right? Because I want a muscle like that when I'm 70.

• 7:46Speaker 01

  And that was the intent of this picture series. So what the picture shows is if you imagine going to the store and buying a ham, like for Christmas, and it has a bone in the middle and the muscles surrounding it, that's what a slice with an MRI through a human thigh looks like. So imagine this round slice with perfect muscles. You can tell that there's gorgeous lean muscle, like a flank steak, across the top of the bone, gorgeous lean muscle in the back, your hamstrings, with very little peripheral fat, you know, the pinchable fat on your leg, very little of it.

• 8:27Speaker 01

  When I looked under a microscope, the 40-year-old triathlete, and it wasn't just one picture, it was a whole series of people, but there was very little fatty infiltrate, or we call that marbling, you know? So essentially, if you have to summarize that picture, the 40-year-old triathlete was a flank steak, lean. Then in the control group, we had people that had sat around for a variety of reasons for 35 years. Listen, the central picture, you can barely tell their muscle. You've lost all your muscle architecture. You lost muscle volume. They're grossly infiltrated with fat. You can see the white streaking.

• 9:09Rangan Chatterjee?

  Yeah.

• 9:09Speaker 01

  And there's a thick rind of peripheral fat.

• 9:13Rangan Chatterjee?

  Yeah.

• 9:13Speaker 01

  It's like the marbling you see in a Wagyu beef. But that is not the story. The story is the third picture, which is a slice of a 70-year-old triathlete, who if you didn't know better, you would think I just took the next slice in a 40-year-old thigh. Beautiful architecture, gorgeous retention of muscle mass, very little fatty infiltration and very little peripheral fat. And here's the beautiful thing. When we tested the strength of these people, we did not find a statistically significant decrease in strength until mid 60s. So what this tells us, this study was trying to answer the question, can we retain our lean muscle mass with recreational-type

• 9:58Speaker 01

  exercise across the lifespan? And the answer is yes.

• 10:02Rangan Chatterjee?

  Yeah, it's remarkable that you cannot, at first glance, tell any difference between the MRI of the 40-year-old triathlete and the 70-year-old triathlete. And it goes back to what you said at the start, right? What the bit I quoted to you. What we call normal aging is actually normal aging for stressed out, undernourished people who are not intentionally building muscle. This shows very clearly that if you stay active, right? And you prioritize movement in your life, you can have very similar muscle architecture in your 70s as you can in your 40s.

• 10:41Speaker 01

  Yes.

• 10:41Rangan Chatterjee?

  It is so, so inspiring to see that.

• 10:45Speaker 01

  Yeah.

• 10:46Rangan Chatterjee?

  And it's also actually, at the same time, on one hand, it's inspiring.

• 10:52Rangan Chatterjee?

  And on the other hand, it's depressing. It's depressing how many people

• 10:56Speaker 01

  Oh.

• 10:57Rangan Chatterjee?

  have that middle image. How many people in their seventies have lived a sedentary life? And have got this horrible muscle architecture? And here's the reality. People think that that just affects their muscles. No, that affects every single system in your body. It even affects, as you all know, your cognition.

• 11:17Speaker 01

  Yes.

• 11:18Rangan Chatterjee?

  So there's so much to cover from your book. And I thought we'll never get through it all. But I thought we must go into bone health because I think bone health has been undervalued.

• 11:26Speaker 01

  Completely.

• 11:27Rangan Chatterjee?

  And even I've heard a lot of your interviews. And I think there's, it's easy to focus on, you know, muscle and the strength training and the VO2. And that's all great. And we're going to get to that. But I do think bone needs to be raised in our awareness. So I really wanted to make sure we focused here.

• 11:46Speaker 01

  So there is a normal, natural aging process. And in the book, I talk about what I call the time bombs of aging. They're actually the hallmarks of aging. We know aging happens at a cellular level. But women have stacked on top the loss of estrogen. If we get to musculoskeletal health, which is obviously where I live, there's a natural rate of decline of bone for men and women of about 1% a year in their bone density. During perimenopause, that precipitously increases to two to 3% a year. So that over five to seven years, 10 years, you can lose 20% of your bone density.

• 12:26Speaker 01

  So if you've never built enough bone as a child and now you're going to lose 20% of it predictably, that's why 70% of all hip fractures are in women. Muscle is the same way. We will lose eight to 10% of our muscle mass in the decades surrounding perimenopause. The list goes on and on and on. And so when I say men and women age differently, the most direct contributing factor, lifestyles being equal, has to be, at least in part, due to our estrogen.

• 12:59Rangan Chatterjee?

  Yeah, it's interesting. Simply calling estrogen a sex hormone is so limiting, isn't it? These labels we put on these things. And you could sort of make the same case like with exercise, right? Or physical activity. How for many years in society, it was about weight. Physical activity is what you need to do to maintain a healthy weight. And I would say, I think over the last five or 10 years, realizing that your muscles aren't just dumb muscles sitting there. They're also important for your hormones and all kinds of communication molecules around the body.

• 13:38Speaker 01

  Yes.

• 13:39Rangan Chatterjee?

  And I feel in this book, you're almost giving this kind of new marketing to bone, saying, hey, bone isn't just your structure.

• 13:46Speaker 01

  That's right.

• 13:47Rangan Chatterjee?

  Bone does so many other things.

• 13:50Speaker 01

  Absolutely. And I'm so glad you're giving time to this on this podcast because it is now a vision and mission of mine to help people understand and care about their bones. With bone, you have structure. It gives you human form. It gives you locomotion. But it is a master communicator. Bone produces a multitude of hormones, one of which called osteocalcin. Yeah. Osteocalcin is released by the bone. It goes to your brain. It causes your brain to secrete bone-derived neurotrophic factor, which builds better neurons. So bone is helping you build a better brain? Yes.

• 14:35Speaker 01

  It goes to your muscles and helps with glucose absorption. It goes to your pancreas for insulin release and resistance. In men, it goes to the testicles and helps you produce testosterone. There are bone-brain axes. There are bone-gut axes that are only being worked out. Isn't that fascinating that bones are doing all these things? And listen, if I were designing a human being, why wouldn't I make bone the master communicator? Because we have bone from the top of our skull to the bottom of our pinky toe. It's a highway for communication. But you're right. We never think about it unless we're thinking about fracture.

• 15:18Speaker 01

  And it's funny, people say bones are silent. Bones are not silent, but we just can't hear them until they break. And I'm going to tell you from being in the trauma bay many years, it's excruciating. And I never want someone to have to deal with it. But we think about it, especially bone health with aging, because as we lose our bone density and break big bones like the femur, or you know, the top of the femur is the hip, especially in women. Men break their bones too. Let's just talk about this. Two million men in the United States have osteoporosis. It's not just a disease of women, but more prevalent in women.

• 16:00Speaker 01

  70% of all hip fractures, which is the biggest bone in the body, happen in women. The instant, literally the instant, snap your fingers, the instant you break that bone, you have a 30% chance of dying in the next year. I mean, that's grave, isn't that? That is a grave statistic that if we could think about our 12-year-old and our 17-year-old daughters that we have, to get their bone so strong at peak mass that they never reach that point.

• 16:31Rangan Chatterjee?

  Yeah.

• 16:32Speaker 01

  So I cannot get people motivated in their youth for their old age. So for the women and men in the critical decade, which I call 35 to 45.

• 16:43Rangan Chatterjee?

  I love that. Is it just for women that, or is it for men as well?

• 16:46Speaker 01

  It's for men. It is time to get your proverbial health standards in check. Because if you build a lifestyle where you're eating a non-inflammatory, high-protein diet so that you're able to build, or if you're eating at all, many women decide not to eat enough. We can talk about that. If you've got your food down, and it doesn't mean you can't live and have an occasional, you know what, I had a piece of chocolate before I walked in here. I'm not talking about austerity. The standards of nutrition, a muscle-building practice, a cardiovascular-building practice, it's a lifestyle to you. It is not a burden if that's just the way you live.

• 17:27Speaker 01

  The critical decade is the time to get that in order before you lose your hormones, right? For women, once you hit your mid-40s, now you're adding that burden that we already discussed. And I get, I get scans on people and I find 30-year-olds with very bad bone because they've never built it. Well, then we can do all the things to build better bone, including hormone optimization, muscle building, a smart, high-protein nutrition, jumping around. Because research finds that you need, for the best fracture prevention, a 10-year lead.

• 18:07Speaker 01

  It's okay to start these things when you're 55 or 60, but it's better if it's your lifestyle. And it's, we were talking about this earlier. People give up one thing at a time and don't even realize they're doing that. And the fun play activities that kids just do, like jumping and running, that are so healthy, they give up one at a time. But if it's a family affair and it's just what our family does, maybe they won't give it up as soon. And it'll get the parents back into those behaviors that will build their bones.

• 18:41Rangan Chatterjee?

  Kids love jumping and doing that stuff.

• 18:43Speaker 01

  Oh, playing.

• 18:44Rangan Chatterjee?

  They don't necessarily need to know that when you jump, you're putting sheer force to your bones and the osteoclasts are getting stimulated. Like, sure, some of them do. Maybe my kids have heard that from me. But in general, like, kids like to jump around.

• 18:57Speaker 01

  And you know, when I'm advising adults right now, one of the things when we're talking about building better bone is I'm encouraging people to jump. And I'm, and when I'm talking about the cardio that I prescribe, I'm asking them to sprint.

• 19:11Rangan Chatterjee?

  So a lot of this book is talking about the incredible benefits of movement. And of course, you have this wonderful acronym FACE, right? Which is brilliant. Flexibility, mobility, aerobic activity, carrying a load, and equilibrium and fast speeds. But if we simply look at it through the lens of bone for a minute, there are things that you can do to improve your bone health, right? See, it's interesting, things like swimming and cycling, fantastic aerobic activities. But I say, personally, in my own life over the last years, I've really been thinking about weight-bearing activities.

• 19:51Rangan Chatterjee?

  And if I have limited time to move, and I'm making more and more time to move as I get older, I'm, let's, we'll come to strength shortly. But in terms of more, I guess, what you would call in inverted commas, aerobic activities, I really focus on walking and running.

• 20:10Speaker 01

  Yes.

• 20:12Rangan Chatterjee?

  Don't get me wrong, I like cycling, I like swimming. But I'm thinking, yeah, but those things are not really putting load through my joints.

• 20:20Speaker 01

  They're not.

• 20:21Rangan Chatterjee?

  Right? So they're great, but they're not loading my joints. Whereas walking and running are literally putting pressure through my joints. So I personally, I'm prioritizing those. As a sports medicine specialist, as an orthopedic surgeon, what's your take on that?

• 20:37Speaker 01

  I agree. I am not against swimming, great for aerobics.

• 20:41Rangan Chatterjee?

  Yeah, for sure.

• 20:41Speaker 01

  I am not against cycling, aerobics, and building butt, corn, hips muscles. But if you're concerned about building better bones, not only is walking fine, it produces about 1.5 times body weight with the steps. Running is fine, about two and a half times body weight. To, to build better bone, we need four times body weight.

• 21:04Rangan Chatterjee?

  Okay.

• 21:05Speaker 01

  So if we really want to get after it, we're going to jump. And we're going to, we're going to jump at least off an eight-inch step. Because that will produce four times body weight and impact. Because this is the way bones work chemically. The biomechanical impact of you landing hard on both feet from an eight-inch height and then jumping up straight in the air and landing again, that biomechanical impact becomes, through little channels of fluid in your bone, biochemical signal that tells the building cells, oh, I better lay down more bone. She's jumping around again. So the impact becomes the biochemical signal to build bone.

• 21:50Speaker 01

  But it has to be intense enough. So when you jump off, when you're running, I would stop and jump up in town 10 to 20 times. Or you can do it all at one time, three days, three days a week. You can spend 10 minutes jumping in multi-directions. I just posted reintroducing hopscotch to the world, right? Because it's multi-directional play jumping.

• 22:16Speaker 01

  That's what I would add, and it seems logical, but we were studying the Senior Olympics, which is Olympics for people over 50. We found, not surprisingly, that the jumping sports like volleyball, basketball, because of the impact, maintained bones better than the swimming, the running, the badminton, the bowling.

• 22:39Rangan Chatterjee?

  That's really interesting.

• 22:40Speaker 01

  Isn't that fascinating?

• 22:41Rangan Chatterjee?

  And of course skipping ropes are brilliant as well for this.

• 22:44Speaker 01

  Skipping, just skipping on a track. I mean, that kind of impact, getting your knees up really high adds some impact.

• 22:51Rangan Chatterjee?

  Okay. Just a point to clarify. So many people these days are jumping on trampolines or on rebounders. Now, what's interesting on those, of course, there's give when you land. So I'm guessing that you're saying, no, no, you must make sure it's against a hard surface?

• 23:07Speaker 01

  If you have a choice, if you are not so arthritic that you can barely move, please, impact on against a hard surface. That being said, NASA has some good evidence that when they bring astronauts back down from the space stations, they use rebounders.

• 23:23Rangan Chatterjee?

  Right.

• 23:24Speaker 01

  You know, and it can be beneficial. And so start where you are, but all things being equal, if you can jump on a hard surface, jump on a hard surface.

• 23:33Rangan Chatterjee?

  Yeah. Okay, I love that. And of course, the book goes to it in detail. And of course, anything is better than nothing. There's perfection, and there's also make progress in where you are. One that we've not really gone into, which is, as when you arrived today, I sort of shared was one of my favorite things in the book is there's a chapter on mindset and a chapter on resilience.

• 23:55Speaker 01

  Yes.

• 23:56Rangan Chatterjee?

  And in the mindset section, you talk about a vision statement and why you think it's really important for every woman who goes on this journey to have their own vision statement. What's your vision statement?

• 24:10Speaker 01

  You know, I have a vision for being able to do what I want to do, when I want to do it, at all times. It doesn't matter if I'm my age now, or if I'm 97. I want to have that independence because if I'm that independent, then I'm going to have the fullness of life that I've worked for my whole life. I'm going to have the fullness of relationship in an equally giving relationship. I won't be just taking, you know, my children, hopefully I'll be giving back as much to them as they're giving to me in my old age, right? And so I just want that independence.

• 24:51Speaker 01

  And to have that vision, it takes active pursuit now. It's just not going to happen. And all the visions that, and this is what I teach people, have to be based on your values. Who are you? What do you want to be? What do you really value in life? And from that, you can build your vision. Because otherwise, if you don't have that, these are just more things to do without the end purpose.

• 25:17Rangan Chatterjee?

  I really hope you enjoyed this week's Bite Size. Do spread the love by sharing this episode with your friends and family. And if you want more, why don't you go back and listen to the original full conversation with my guest? I hope you have a wonderful weekend. Make sure you have pressed subscribe, and I'll be back next week with my new conversation on Wednesday and the latest episode of Bite Size next Friday.