I’m JJ Virgin, PhD dropout, sorry mom, turned four time New York Times best selling author. Yes, I’m a certified nutrition specialist, fitness hall of famer, and I speak at health conferences and trainings around the globe, but I’m driven by my insatiable curiosity and love of science to keep asking questions, digging for answers, and sharing the information I uncover with as many people as I can.And that’s why I created the Well Beyond 40 podcast. To synthesize and simplify the science of health into actionable strategies to help you thrive. In each episode, we’ll talk about what’s working in the world of wellness, from personalized nutrition and healing your metabolism, to healthy aging and prescriptive fitness.

Join me on the journey to better health so you can love how you look and feel right now and have the energy to play full out. At 100. As I started getting into perimenopause, I noticed some things. Maybe you can relate. I noticed that all of a sudden I could not recover from my workouts and I just couldn’t work out as hard as I was used to doing.

And at first I didn’t connect the dots. And thankfully I went to a dentist because my gums were bleeding and he said, Oh, that’s your estrogens lowered. And boom, Got, got the estrogen replaced and I was back hitting at the gym, but I’ve always wanted to dig into this subject about, um, working out the musculoskeletal system, uh, osteoporosis and menopause.

And so I was so excited to find Dr. Vonda Wright. I started following her on Instagram and she has an amazing Instagram channel and was so intrigued because there are so few Female orthopedic sports surgeons out there. She is one of the unicorns out there. She’s also an author, a speaker, a researcher, and an innovator.

And her work really is the intersection of longevity, performance, and Orthopedics. So we are going to be digging into a lot of very cool stuff today. Everything from, um, how to avoid a fall, what her, her ideal exercise regimen is for this great formula that she gives for post menopausal women, and much, much more.

She has Uh, practice in Lake Nono, which I was like, she lives literally an hour from me. So next time we do this, we’ll do this in person. She’s the founder and CEO of Pre Precision Longevity, and the host of Hot for Your Health. Her IG handle is at Dr. Vonda Wright, and we’re gonna put all of the show notes.

We jj virgin.com/dr. Vonda V-O-N-D-A. And I will be right back with Dr. Vonda. Stay with me,

Dr. Vonda Wright. Welcome to the show. Thank you so much. You are a legend, my friend. It’s an honor to be here. Oh, stop it.

I literally have been stalking you. So, because I was like, this woman is a total unicorn and we’ll have the most unique, incredible perspective on menopause because you are one of the few orthopedic surgeons out there.

Like I just, I actually don’t know any. Other female orthopedic surgeons. I mean, how many are there?

You know what, in the, when I started training and, uh, at the time there were three percent. So, you know, try to find one of us. At this point, there’s six percent attending surgeons. So still try to find one of us.

Um, we’re making progress, but we are not at critical mass. And I think that’s, That’s important for women or anybody, but there’s so much data, JJ, that female surgeons have better outcomes and, uh, of our, of our surgeries and care. So it’s an important public health thing, right?

Well, I was going to say female managers, female founders.

We could go on and on. It is interesting though, because when you look in the integrative and functional medicine space, it’s about 70 percent female. Oh. Yeah. Yeah. Cause I, I have another business called MindShare Collaborative and it’s where a lot of the integrative health people get together to collaborate and it’s 70 percent female because of follow the statistics.

So I just think it’s interesting because, you know, there’s a lot that starts to shift as we go through perimenopause and beyond in terms of. Joint health. And I’m sure there’s a lot you can see in your joints that could help you also with navigating menopause. So I was like, this is such a great perspective.

Yeah. Uh, so that’s where I would love to do is kind of look at this intersection and kind of go, what the heck does orthopedics and hormonal health have to do with one another?

Yeah. Well, almost everything JJ, because like, so like what we’re, we know now, it seems like we’ve been talking about this forever.

People like you and I who talk about this all the time, but the fact of the matter is There’s still women, in Monday when they came into my clinic, I said, has anyone ever talked to you about your hormones? And they’re like, no, what’s that? Right. So there’s still, there seems in the little ecosystem we have, everybody’s talking about it, but the fact of the matter is in the country, nobody is talking about it.

And only 7 percent of all women in the country are being prescribed. hormone replacement therapy. So really? Yes. 7%. So yeah. But when you ask me the question, what do hormones and the musculoskeletal system have to do with each other? And I say everything it’s because every sub tissue type of the musculoskeletal system, right?

All musculoskeletal tissues come from the same type of stem cell and then just differentiate whether it’s bone, muscle, cartilage, fat. They all have common origins and they all have estrogen receptors. So every month when our hormones fluctuate, Our, our, our musculoskeletal system is affected. That’s one of the reasons why young women have most of the ACL ruptures.

It’s why we see performance changes at different times in the month, according to a woman’s cycle. But when we get to the time of our lives that I’m in where estrogen walked out the door, I mean, you’re so far post menopausal, I can’t even remember, but our estrogen receptors on our musculoskeletal system are left bare.

And so, and I say this realizing that people have a really hard time with the perimenopause symptoms of hot flashes, night sweats, brain fog. But in general, those things will diminish with time. But for the musculoskeletal system, if we don’t get in front of loss of muscle mass, loss of bone density, loss of our cartilage, uh, chronic inflammation that causes disease, Those are devastating and life changing, but here’s the deal.

Mostly preventable. If we just knew.

I love that so much because, uh, I just actually told this story on Sean Stevenson’s podcast and I said, you know, I set all these big goals for 50. I was telling you offline about my 50th birthday party with Dr. Sarah Gottfried and Dr. Anna Kaveka. And then I just kind of started coasting.

I was like coasting along. So, I’m not thinking about these things. I started to really look at the statistics for muscle loss as we age. I think, you know, the up to 1 percent per decade or per year each decade after 30 is scary, but the loss of strength and power is And so I started kind of saying, Vonda, Oh, I’m cool.

I, you know, I go to the gym, I lift, but I wasn’t challenging myself. I was sort of like, and then I kind of went, wait a minute, stop it. These statistics are based on the average person who’s doing some walking and kind of calling it in after this. We don’t have to go this way. So knowing What could happen?

What are your, like, what’s happening behind the scenes? Why are we losing that muscle? What, you know, why could we be losing bone? Let’s paint a picture of why it’s happening and then I’d love to go into how we make ourselves not that statistic.

Yeah, so if we want to talk about, uh, maybe we should, maybe we can start by talking about inflammation and the, The two things that people show up in my clinic most frequently about, uh, because muscle and bone loss are silent until mm-Hmm, , you know, it’s happening.

Women come in with, you know, the ever popular frozen shoulder and this was my primary symptom at 47 total body pain such that I could barely get out of bed and I’d always been an athlete. Uh, so I’m usually in control of my body and I’m like, what is going on? Well, the chronic inflammation that happens.

When estrogen walks out the door is because estradiol is an incredible anti inflammatory and works to inhibit the release of cytokines like, you know, things like we read about tumor necrosis factor alpha, right? All the inflammatory things, estrogen is a damper to that. So without it, our body becomes grossly inflamed.

The same kind of reaction happens In our muscles, our muscles contain estrogen receptors, and without estrogen sitting in them, there is increased loss of the normal age related loss of type 2 muscle fibers, and, which is our power fibers, our explosive, uh, which keeps us able to jump out of the way of charging lions, traffic, and whatever.

Um, so there’s that with age, it’s one of the sine qua non of aging, but without estrogen, it’s worse. And without muscle mass, then we become metabolically less healthy because muscle is critical in glucose metabolism. We also, um, gosh, muscle is just so important. Um, without estrogen in place, we stop replicating muscle derived stem cells.

Now, something that I don’t think That isn’t widely known, is, is for most of my career at the University of Pittsburgh, I actually participated in a muscle stem cell lab. At the time, we just called them muscle derived stem cells. Now they’re called satellite cells, which sit in the basement, the lower basement membrane, if you will, of muscle.

But if you want to rejuvenate your health and rejuvenate muscle stem cells, All you have to do is contract skeletal muscle. So everything you’ve been teaching people for years is not only about physique and being strong, but it’s actually about the longevity of your stem cells. And without estrogen, that stops.

But probably, you know, I’m a bone doctor. One of the most critical factors that I talk about is that without the regulation of estrogen, We rapidly lose our bone density and bone is not just the structural thing that holds us up. So I have this on my desk. This is a femur. I talk, here’s my bone example. I know I’m just that geeky, but we just think of it as that scary Halloween skeleton thing, but actually.

Bone is a master communicator. Bone communicates with muscle. They work together in one ecosystem and you don’t know you’re losing your bone at a rate of 20 percent over your perimenopause. Until what happens? We fall and break. We start shrinking. Our bones start aching. So gosh, I could, JG, I could go on and on.

But these are just examples of how critical estrogen sitting in the receptors are.

Yeah, I remember, I actually remember being at the gym and going, what the heck? Just like you, you said you were getting out of bed in the morning and I was like, what is going on? Cause I just couldn’t recover. Yeah, I’m doing the same workout.

I’m like, I can’t do this. What is it? And thankfully, um, cause I didn’t put it together. And then I went over to my dentist and, and I, for a, you know, for a cleaning, I go, man, every time I floss, my gums bleed. And they’re like, Oh, low estrogen. I’m like, Oh, what? They knew that? Yep. I’m so proud of them. I know, and it was a guy, too.

I’m like, he’s Wow. Right? I mean, very, very impressive. Yeah. Um, however, I did tear my ACL, uh, when I was 17, and then completely severed it at 22.

Oh, no.

So

When you

said the ACL thing, I’m like, yup. Um, yup. And so I think most women don’t think about estrogen as so important for building muscle. Like you just don’t, you think testosterone, you don’t realize that.

Nope, not for women, for women, you got to have that estrogen in there. So I’m glad that you brought that up. Um, I’d love to just back up on the bone density. One of my theories is, is if we’ve got good muscles, you know, if we’re building muscle, that bone density is a lagging indicator of not having enough muscle mass.

And in a perfect world, I’d love to see it that we’re starting to look at DEXA scans when girls are in their teens. What, what are you, what are you recommending for looking at this? And, and tracking skeletal muscle mass and bone density and when, et cetera.

You know what I’m seeing, you know, JG, my, my day job is as an orthopedic sports doctor.

So I’ve worked with active young women my entire career and what, and I was the head doctor for several division one schools. And so what we see is that when it, let’s just talk about bone. So we just a little biology, we stopped laying down bone, meaning, meaning building bone. Around 30 ish, right? So after 30, we’re either maintaining Or when we lose our estrogen, losing, unless we’re really active in trying to rebuild.

So, but that’s assuming we build bone in the first place. Because I don’t know about you, but when I was growing up, I was always an athlete. I had irregular periods. My fat was very low. And so I may have gone six months without a period. And because I was a dancer, I’m like, okay, I’m getting away with something.

What I was doing was not laying down enough bone. So I get many women Now who come to me, I had a 28 year old who broke her hip, not because she was doing crazy stuff, but because she had never laid down enough bone. And so, yes, when we look at studies of college women, because now at this point we do DEXA scans on, on freshmen coming into collegiate programs, we find a lot of young women.

We have been fed the lie that women have to be teeny tiny at all times, right? And starve ourselves and not eat enough protein. So, we must lay down bone across our youth. So when do I think that we should You get DEXA scans? I’m hesitating because I get so passionate about it. DEXA scans as a baseline?

Well, if your mother is shrinking, if your grandmother broke her hip, if you have taken prednisone because of another illness your whole life, if you ever smoked, if you have fallen and fractured, now’s the time. Whether that’s 30, definitely by 40. I think we need baseline DEXA scans by 40. Okay. But, you know, scientists will tell us that DEXA scans are not the end all be all because the other factor that goes into fracture, which is why we care, one of the reasons we care about bones, is their resilience, their ability to to resist stress and strain and not falling.

So it’s not only building bone in our youth, Figuring out our bone status and being very aggressive about that just because insurance won’t pay for a DEXA scan before we’re 65, that’s not the final answer. Which

is obscene, by the way, like that’s obscene. Right,

right. What are we trying to figure out then when it’s nearly too late to do anything about it?

The egg’s scrambled at that point, right? Yes, yes, you’re so right. Uh, we need to do it early. We can buy DEXA scans. Some gyms, some, some imaging places will do it for as low as 99. So you just have to, I say, you know, a paper like, but I have health insurance, why should I pay? Because you should. And number two, even if we can’t afford it, let’s save our 7.

18 coffee money a day. Which, you know, expensive, handmade coffees. Just save it for 10 days and go save your bones. So that’s me being very like, let’s get in front of this people. Cause bones are silent. Until they break and then they scream at you. And it’s one of the main reasons women die.

I know the statistics on it, I’d love you to share those, are just crazy.

So one in two women, 50%, one of us, you or I, will have I don’t think you or I are

going

to be Not I, but if there are two women in a room and they’re looking at each other, this is what they used to say to us in medical school, look to your right, look to your left, one of you will not be finishing. Look to your right, look to your left, One of you will have a fracture.

When you fall and break a hip, like this bone I just happen to have in my office, when you break your femoral neck, 50 percent of the time you will not return to pre fall function, meaning you won’t be living in the house where you raised your kids, you won’t be driving a car, all the things we value in our independence, and here’s the kicker, 30 percent of the time we die.

From our fractures. Here’s a real story that was told to me yesterday. I am still taking trauma call. I don’t, you know, at this late age in my career, you’d think I’d be done, but I’m not. So this is how it happens. There was a woman who came in who was 89 years old, is 89 years old, and she was independent.

Her son who’s in his high sixties, almost 70, lives in New York. She lives here in Florida. And she, um, independent, drives her car, takes, goes to social clubs, drives her girlfriends around because they don’t have licenses and she does. She fell, um, and she was so fragile without knowing it. She broke her pelvis in four places, she tried to break her fall, held out her arm, broke her shoulder, broke her scapula, broke multiple ribs.

She is in such bad shape from fractures. And she’s in the ICU, that, um, because it’s so painful when you break bones, that her family decided, because there was so little that could be done with that many fractures, that despite her previous independence, that They send her to hospice to recover. This is not an atypical story.

We go along, we go along until we break something and then 30 percent of us die. And so if we can get in front of this at a young age, not only by all the things I’m sure we’ll talk about how to build bone, but how to build muscle as the supporting agent. We do not have to become frail old women dying from tragic stories like I just told you.

And that’s not hyperbole. I don’t want your audience to think I just came up with this wild story. That is every single day in every emergency room in this country.

Yes. So let’s do our part to stop that. And when I look at it, part of it is of course, improving bone mineral density, but I think a lot of the things that you would do to improve muscle are going to, well, everything that you do to improve muscle improves bone mineral density.

Like I’m a big, big fan of do squats, do overhead presses, load the spine, load the hips. And I love rucking. But when I think about the risk for falling, And you think about, okay, as we’re aging, we’re losing fast twitch muscle fiber. We’re losing that agility, that power. It makes me think we have to design our training programs very differently to really focus on training.

I always say, You don’t train to get better at training, you train to get better so that when you’re out in the wild and you have to move quickly or do something or catch yourself, you can. So what are your recommendations for building muscle when you’re, you know, menopausal? Yeah. Postmenopausal.

Postmenopausal. So, I mean, there’s two areas I’d like to cover with that. If people have listened to me at all, they know that I like people to live as heavy as they can. Now, if you are just starting out, you’ve never picked up anything but a little pink weight and don’t really feel confident, it is totally okay.

To start with body weight, get the motions down, move your body through the squat motion, the deadlift motion, the bench press motion, just so you, you’re, you feel confident in the movement patterns. But as you become more confident, it is important to provide enough stimulus to your muscles that they will actually change because our bodies, why is that necessary?

Our bodies are magicians at maintaining Stability homeostasis, right? We want to be in this. Stress free plane. So if you’re lifting too light and doing 20, 30 reps, and it’s just like a piece of cake to you, it’s a piece of cake to your muscles. You’re not going to build any new muscles or, or strength. So I commonly recommend for four compound motions.

Squats is a compound motion, deadlift. It means it’s multiple joints, including your core, bench press, deadlift. Some kind of pull, lifting as heavy as you can so that four reps leads you not to exhaustion, but near exhaustion. You should only have one or two reps left in you because that’s when we will stimulate muscle protein synthesis.

That’s when we will cause the replication of our stem cells, which is what we want. And frankly, it doesn’t take you forever. So my mantra is lift heavy, And go home.

And

go home. It doesn’t take

that long. I know those 30, like, first of all, you know, you know, I was a group exercise teacher, then a personal trainer.

I mean, and actually was a group exercise teacher when all this was first starting back in the day. And then one of the first personal trainers, but back then you would do, you’d be in these classes to feel the burn and we would do like a hundred repetitions of something stupid, you know, like,

Well, and, and that’s what it took to build up enough lactic acid to feel the burn.

Right. But you know what, to that, I realized the way we, Our training now has changed since, you know, I began working out. I used to have, uh, exercise videos in my living room and just do what you’re talking about. Thank God people were getting the country moving because everything is better than sitting on a couch and me coming to this room.

Everything is better than that.

Everything is better than that. And I look at this and go, all right, for me, my easiest definition of exercise is that you do more than what you’re used to so your body has to adapt.

Mm.

So that means, and I view aging as a snowball rolling down a hill. And I, and I think, all right, like it’ll pick up speed unless you do more than what you’re used to, in which case you can flatten it out.

So that’s what we’ve got to do is be the role models. And I am kind of obsessed with some of this stuff on Instagram now where they have, You know, women in their 70s and 80s, and they have that, that gymnastic grandma, the

green jumpsuit. I know I’ve seen it.

It’s amazing stuff. So, I mean, what do you say to the person who is just, is afraid of lifting weights?

They’re afraid of, you know what I’m going to say, they’re afraid of getting big. Like I, first thing I heard 40 years ago, still hearing it today. I’m afraid of getting big. What do you say?

I have a not so nice thing to say and then I have a real thing to say. The not so nice thing to say is, listen, with 70 percent of our country doing no mobility every day and 40 percent being obese, people are getting big anyway, but in the wrong way.

But if we’re specifically thinking, Oh my goodness, I don’t want to be like a competition bodybuilder. I am going to say, don’t worry, my friends, that is very specific. That takes decades of hard work. The most you’re going to see is, is more toned muscles, clothes that fit you better, more strength. You are not going to become bulky unless you train to become bulky.

It will never happen.

Yeah. It’s interesting. 40 years of doing this. And the only time I’ve seen people get bigger is when they quit. Ah,

yeah, that’s right. Yeah. You slather on the fat butter and you know, everybody gets

bigger. Yeah. Muscles, metabolic spanks, hold everything in tighter. I love that. What about, um, what about mobility, and cognitive function?

Yeah. You know, um, many years ago, I spent, I did a series of studies early in my career really answering the question, can we be healthy, vital, active, joyful forever, right? And so, because what we know from most medical research that looks at aging, is looking at what pop, the population is doing and what do we know about our population?

Just what I said, 70 percent of them are sedentary. So I did not accept that we had to age in the declining way that sedentary people do. So my whole series of studies were on active people. They weren’t pro athletes, but they committed every day. One of the studies, was on performance, two on bone, one on muscle that now has a life of its own.

But the brain study took five years because I matched the subjects in my study for everything with the sedentary person, their education, their occupation, everything. The only thing that was different is how much mobility they invested in their bodies. And you know what we found? I had a tool called the impact test that was developed at the university of Pittsburgh that measures frontal Uh, the, the executive function of our brain.

And we use that test to compare sedentary people to chronically active people like you and me. And what we found is that three out of the five executive functions, those functions that make us human beings, We’re preserved in chronic exercisers compared to sedentary people. So speed of thinking, uh, complex problem solving, important things in our aging and longevity, exercise, it’s exercise.

And we know that there’s this in following up on that study, we’re looking at some of the reasons why. And a group out of Emory. It showed that a contraction of our skeletal muscle causes transcription or the production of a protein that goes directly to the brain that affects memory. So you think you’re out there working on your lean muscle mass and what you’re doing is working on your brain function.

Yeah, my son, when he was 16, was hit by a car and literally left for dead in the street. Oh my God. Severe traumatic brain injury. I mean, 13 fractures, crushed heel, torn aorta. The doctors literally left, told us to let him, let him go, which we didn’t listen. Um, however, we brought him back from a severe traumatic brain injury and what we used to bring him back from this severe traumatic brain injury is Exercise.

Like we did a lot of stuff, HBOT neurofeedback, but the biggest needle mover of all has been exercise.

That’s amazing.

Yep. Yeah. They said he’d never walk again because of the crushed heel. They said he’d never wake up, you know, on and on and on. I tend to not listen to authority well. You mentioned too, I had no idea about these studies.

You also mentioned something about the muscle piece of this. What did you learn there?

Yeah. So there’s this picture on the internet that it has a life of its own. Here’s the, if I describe it, you may. I heard,

I was trying to find it. Can we link to it in the show notes?

Of course. It’s yeah. And it, uh, so what we did was we.

There’s this study called the Health ABC, which followed a cohort of aging people, 70 for 10 years, and looked at a variety of things. But one of the things they did was look at their lean muscle mass, and what they found in sedentary people is that we lose our muscle architecture, we lose our volume, we become grossly infiltrated with fat.

And I didn’t believe that because I see examples of my 85 year old father whose muscles are still as good as they were when he was 60 because he’s a chronic exerciser. So, what I did was a study that did MRIs, lots of people have MRIs, they know you just lay there and let the magnet work. And I took slices of the quads, and so this picture that I’m describing, at the top there’s a picture of a 40 year old.

Uh, slice of, of, uh, the quads above are gorgeous quadriceps. In the bottom are amazing hamstrings, the femurs right in the middle. It looks like a flank steak. There is no intramuscular adipose tissue. Gorgeous. The center picture is a slice of a sedentary person who’s been sitting around for 35 years. And what you have is raggedy muscle.

You have gross infiltration of fat and a thick rind, two or three inches of peripheral fat. The final picture is a 70 year old triathlete. Most of my athletes were runners and triathletes. Just because of where I was, you would have thought that the third 74 year old picture’s muscles was just another slice of the 40 year old’s.

Gorgeous muscle architecture, very little peripheral fat, no fatty infiltration, still a flank steak, had not turned into a rump roast. This picture has been used all over the internet. I should have named it because it has a light. I should have called it like the Betty picture or something. But what it showed was that we’re in control of our futures when we invest every day in a purposeful way.

It just doesn’t happen by hoping and praying or by thoughtfully investing in our mobility. Even mere mortal, mere mortal athletes like me can retain our lean muscle mass and in doing so preserve our longevity because muscle is just so important in that process.

You know when you look at all those 12 homeworks of aging and, and here’s the thing, my, all my training was as an exercise physiologist and I felt like the peasant of the health world.

Until, until a couple of years ago and I was always lugging people to Gold’s Gym in Venice and going lift weights. I mean this was 35 years ago and now I’m like I’m so smart. You’re the queen. Yes. Finally, I like finally it’s it’s come around but we’re the exercise scientists have are like we’re in. Yes, that’s right.

And while I know that anything’s better than nothing, the one thing that I do believe that as we age, we really want to dial in a great exercise prescription that’s dealing with the loss of power and strength and dealing with the

So, I would love for you to share your, because you said move every day, like what would be your way to take someone who, and I think most people that I talk to, it seems like they’re walking, and maybe doing a little yoga or Pilates.

Oh, how about that?

How about that? So, I’m What would you do with, with Sarah who’s doing that?

So

the framework that I use, because people need cues to remember what to do, I call it facing your future. I’ve written about it in some of my, just a framework written about it in some of my books, but facing a future. How midlife people should prescribe movement is flexibility and mobility, F. A is aerobic, and I will outline each one of these briefly.

C, FAC, is carry a load. I purposely did not specify whether you have to throw on plates on a bar or whether we’re using, because there’s lots of ways. And then E is equilibrium. And agility. So let me briefly go through these four so people know, oh, what are the parts of the recipe? Flexibility and mobility.

Unless we keep our muscles out to a decent length and our tendons unbrittle, unless we keep our joints capable of moving through a full range of motion, we are more prone to injury. Going forward and we’ll start shuffling along like old people. Who wants that? I want to walk with a full stride. I think that’s where Pilates and yoga come in.

They are the icing on the cake for flexibility, for mobility, just keeping everything fluid. Flex F, A, aerobic. There are three ways I like to approach this. I used to burn it out six, seven days a week, getting my heart rate up to 186. I could predictably be injured every three Same injuries, my mechanics aren’t perfect, but what we know now is three hours a week of base training, which can be a brisk walk.

You know, even so far as microbursts of activity, there’s great data that shows just running up the stairs a few times a day adds to the picture. training at low heart rate. And we can get into zone two. I, I happen to have the, a lab here. I’m capable of measuring lactate threshold, but it’s a, it’s 181 minus your age.

So around 120, 130, if you’re metabolically healthy. So base training add on top of that. And the way I do this is after I’ve. walked briskly or been on a treadmill or a bike for 45 minutes to an hour at a low heart rate. If I’m on a treadmill, I sprint twice a week. I punch it up to 11 and I go as fast as my little legs.

I’m a short person and carry me without flying off the treadmill, but only for 30 seconds. And then I completely recover. It takes me two to three minutes to recover my heart rate back down to about 130, which is my base. I do that four times. That is what stimulates the neuromuscular pathways which keep Um, uh, stimulating my cardiovascular system.

That is what’s going to stimulate synthesis of satellite stem cells. So we’ve got base, base training, brisk walking, sprinting. And I don’t want people to be freaked out by that word. It’s just going as fast as you can. And then if we really want to layer on the fitness, which I’ve added this year. is we train our, for VO2max once a week.

So just briefly, you’re the scientist, you can go into this for, you’re the exercise scientist, but briefly VO2max is a measure of oxygen exchange from across our lungs, from arterial, And how efficient we are at that is a reflection of our cardiovascular fitness. So the reason that’s important with aging, not in elite fitness, that’s a whole different subject, but with aging is there’s an independence line when it comes to VO2 max.

For women at 16, the measure of, it’s a three digit, uh, label, uh, milliliters for oxygen over time. 16 for men is 18. Here’s how we use that. We never want to get to that line because that means we can’t live independently anymore. We’re too cardiovascularly frail. I’m going to use my numbers. So as an example, if we do not work to maintain our VO2 max level, if we’re too sedentary, we drop our VO2 max 10 percent a decade.

So my current VO2 max is 45. Well, it was when I was 50. I almost need to do it again. When I was 50, it was 45. So if I lose 10 percent by the time I’m 60 in a few years, I’m at 40. At 70, I’ll be at 35. At 80, I’ll be at 30. I am never hitting the loss of independent line. But if I haven’t worked out enough across my lifespan, or there’s a reason why I’m metabolically inefficient and I start out at 50 at 25, 10 percent a year, I’m going to hit my loss of independence line.

So the way you can maintain VO2 max, maybe even increase it, although I’m not sure about that, is to do a VO2 max exer, uh, workout, which is three to four minutes as fast as you can go, recover for three to four minutes. So it’s, it’s slower than sprinting, but it’s hard, right? You don’t want to, it’s hard.

You don’t want to have to do that more than once a week. So. Yeah, so flexibility, aerobic, carry a load, lift heavy enough to stimulate your muscles, right? So, I usually prescribe this in the power moves, push pull upper body, push pull lower body, so, Bench press, pull up, ish. Pull up ish. I’m not good at pull ups, but pull up ish.

Push pull on the legs is squat deadlift. Four reps, four sets. And then for the accessory moves, of which there’s hundreds. How many times a week? Uh, minimum of two. I do it four. Okay. But start low. Just get it done a couple times until it’s part of your life. Uh, and then the accessory moves that support the big power lifts, the single joint moves, For instance, if you’re bench pressing, accessories are biceps, triceps, lats, delts, um, rows.

Um, I usually tell people to do 8 for 3 or 4 sets, cause listen JJ, I’m just trying to keep it simple enough. That people will do

it. I’m right there with you. I like, I prioritize big functional moves. I always, you know, say, think about what you need to do in life. Yes. You’re so right. Must get up off the toilet.

You know,

you got to put stuff in the overhead. You got to pick something up off the floor. Let’s do it. Yeah. And don’t you agree because people, I’ll hear people now, you know, I think it was such a, an opportunity to blow my knee out at 17 doing point ballet, which the biggest joke is I did gymnastics, acrobatics and point ballet.

I am six feet tall. Oh, good for you. And my son was doing tricking and parkour. He’s six two. So he, you know, he pulled his tibial tuberosity off his tibia. I mean, we’re just like wrong sports for us. You know, play some basketball. But, um, because of that, you know, my knee basically, I had five different surgeries until finally there.

I kept going, have a replacement. I waited until 52. But I always, it ached, it always hurt. And the way that, I remember when I walked into the office for the surgery, they go, we don’t even know how you’re walking. I go, because it’s so strong. And I trained for the surgery. And the big thing I think that needs to be out there is people will avoid things because of an injury and say why they can’t do something and actually I think that’s why you need to.

I agree. So you validate that because you’re the orthopedic surgeon.

Well and you know to your point, uh, I, I’ve heard every excuse in the book and the very common excuses I hurt my right knee. To which I say, you’ve got two arms, a core and a left knee. Let’s go. Right. You’ve got all the other body parts, but I want to, I don’t want to forget to tell people on this, how to exercise.

I know I’ve been going on forever. We talked about flexibility, aerobic, weightlifting, carrying a load, equilibrium, and agility. We need to train our foot speed. I can’t tell you how many times I’ve gotten up too quickly from my desk and here’s my work bag sitting here and I go to trip over it. But because I work on this, I just hop right over it.

You know, falling is, is one of the main reasons for fracture. So I have the privilege of working with an amazing speed coach. Her real job is, is training collegiate and pro, uh, track and field athletes. But she has taught me and the group of women that I commonly work with, foot speed exercises, pogos, jumping over ladders, jumping back and forth, so that we don’t get old and slow, right?

Slow is Not how we have to age.

And what’s great about those things, like everything you just listed here, you could easily do at home. You can easily do some side jumps, some air squats into a jump. You know, all of these things are easy enough to do. And I might’ve, I, I literally just got a little stress fracture in my foot cause I got way too zealous on my Norwegian four by fours using up downs and squat jumps.

I was like, you know what? Just, Stop. Oh,

I’m so sorry to hear it.

But you know, oh, it backed it right off. It’s fine. But um, a lot of this stuff is easy enough to do at home. You can do a lot of that agility training at home and then you can, I mean, if done correctly, it’s, it’s great interval training too.

Yep, exactly right. No, I agree with you.

I’d love to go back to VO2max just briefly, because you mentioned losing, and I just saw the statistics that said 5 to 15 percent a decade starting at age 30. It sure seems like at age 30, all, like, people are all concerned about age 50. Like, age 30 seems to be that, like, what the heck just happened here?

Um, but, As far as I can tell, though, from what I was reading, it was, it was very variable because of, it could be massively shifted by, you know, exercise. So I just wonder if we can really offset that and have it be 5 percent a decade as opposed to 10 to 15%. It seems like we should be able to.

I think so. I think our bodies are so responsive to the positive stress we put on it.

I think as a population. We’re, we just don’t stress it enough now that we’re no longer agrarian. We don’t farm. We’re not shepherds. We are so digitalized that it doesn’t take a lot of energy on a typical day. So, you know, when I, I grew up on a farm in Kansas and it was a typical day to not sit down from morning to dusk, but now it’s a typical day for most of us to sit down from morning to dusk and just spend an hour a day moving around.

So it’s kind of a, a flipped scenario the way we’re living today.

Yeah, and that study that just came out that said if you’re working out 30 minutes three times a week and sitting the rest of the time you’ve erased it. So I always start with just getting people to get their steps up first because I want to make sure they actually have the activity in.

Is there a, is there a target goal? It seems to be a moving target that, is there something you recommend to people?

It, the, from what I’ve seen in the research, it’s everything from 8, 600 to 12, 000. And I, what I do is people like, I literally have someone I’m working with right now who has over 200 pounds to lose.

And so he’s was doing about 2, 500 steps a day. And when I started to look in the research, I’m like, well, what’s the average? It turns out the average is 2, steps a day. Oh, now. I always like to just start and go, okay, well if you’re hitting 4, 000, let’s go to five and then let’s go to six. Let’s just keep raising the floor.

You can always do more. Go crazy. And then once we get up there, I really want the floor to be the floor, minimally eight. And I have a funny story. The other day I was, I was at a hotel, I was at a meeting and I, while I was trying to stand up the whole time, it was like an all day meeting. And I get to the hotel where we’re staying and I’ve got 6, 500 steps and I’m And that we’re on the 16th floor, but I go, honey, I cannot, like, I have to get my steps, because I’ve committed that 8, 000 is my absolute floor.

I have to get my steps. You understand? Yeah, you’re like, of course. And so I said, so let’s take the stairs. He goes, I’m not taking the stairs.

And, and I actually was doing a little IG video and calling him out on that, and he stopped taping. He’s like, honey, you know, anyway, so I take the stairs up. Well, I get up the stairs and it counts for like 300. Oh my gosh. What a ripoff, Aura. So then I’m like, honey, I have to go outside. So he came out with me.

We had to go walk, walk, walk until I got the steps. But, you know, I like to focus on one thing at a time and get that thing dialed in. And I think first thing is just get up, get up, get up. And then we can start those exercise. I, I think that the literature on all these exercise doses is great because who can’t do, you know, 10 air squats, you know, One hour and then maybe in two hours do 10 push ups and that, you know, it just, it’s doable stuff.

Little bursts.

Yeah. You

just got to get it into your schedule.

Yeah. And you know, it, in terms, I love your commitment to your steps. In fact, I even told my husband, I just did this. After long days, we’re just exhausted. So we just kind of sit there for a minute and, you know, watch something fun like Wrexham or some Netflix thing.

But I’m like, okay, too much sitting. I just bought us a walking platform that I’m going to put in the living room.

I’ve got one right here. I’ve got one right next to me. This is a, well this is a standup desk and I’ve got a walking platform and then I got wrecking vests. So, cause you know, I have five and six pound dogs.

You take the five and six pound dogs out for a walk, nothing is happening. Like it’s, you, you probably walked a hundred steps. It’s like walk, walk, pee, walk, walk, sniff, walk. Um, and then we’ll drop them back in the house and go for it. But we got, I got us rucking vests. I’ve got the walking pad. Cause he wasn’t paying attention to it either, but he’ll do what I, he’ll do what I recommend.

He just won’t usually initiate it. But once it’s in his bed, Programme me.

It’ll do. Yeah.

Yes. Yes. Yes. Yes. Now you’ve got a couple things going. Well, you got a lot of stuff going on. So I didn’t realize you were still full time day job and working some of the trauma stuff. And then you’ve also got your podcast.

Yes.

And you also are going to be gifting an ebook, Strong and Courageous, the No Excuse Guide to Thriving Midlife and Perimenopause and Beyond book, which we will put at jjvirgin. com forward slash Dr. Vonda, V O N D A for everybody listening, D R V O N D A. And where else can people find you? Because you’ve got great, I saw you on Instagram and started stalking you.

Well, I love that because I would have never gotten to meet you if it weren’t for Instagram. So I’m so thankful for that. That opportunity. But, uh, I post every day on Instagram. I only have so much time. That is the main place you’ll find me. But I think Um, for deeper dives, I have a YouTube channel by the same name, Dr.

Vonda Wright. I do a podcast called Hot for Your Health and some interesting people on there. Um, and we just have a book coming out in 25. So as soon as that’s ready for my book, I’m going to let you know about it. I’m

very excited. I would love to. I love book launches. Fun, fun. All right. Well, thank you.

Thank you. Thank you. We’ll put all of that at jjvirgin. com forward slash. Dr. Vonda and, uh, I’m sure next time we have to do this in person since you’re only an hour ish. I didn’t realize I will come to Tampa. I didn’t either. I saw and I’m like, what? Yeah. She’s like, no, no. What the heck are we doing? Yeah.

Well, thank you so

much. Awesome.

Be sure to join me next time for more tools, tips, and techniques you can incorporate into everyday life to ensure you look and feel great and are built to last. Check me out on Instagram, Facebook, and my website, jjvirgin. com. And make sure to follow my podcast at subscribetojj. com so you don’t miss a single one.

And hey, if you’re loving what you hear, don’t forget to leave a review. Your reviews make a big difference in helping me reach more incredible women just like you to spread the word about aging powerfully after 40. Thanks for tuning in and I’ll catch you on the next episode.

Hey, JJ here. And just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional information that’s designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment.

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