574: Why women should lift heavier & eat more | Vonda Wright, MD, MS
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As 2025 kicks off, it's time to rethink your fitness resolutions. Getting toned isn't about cutting calories, lifting light, or eating less. It's about fueling your body, challenging your limits, and building strength that lasts. And today we're diving into what it really means to feel strong, energized, and unstoppable. Joining us is Dr. Vonda Wright, one of our scientific advisors on our newly formed Scientific Advisory Board. Dr. Vonda, thank you so much for joining us.

We love Vonda because she is a trailblazing orthopedic sports medicine surgeon with over 20 years of experience helping people move better and live longer. From working with athletes to empowering women at every stage of life, she's passionate about helping us all trade the mindset of less for one of abundance, more strength, more health, and more confidence.

In today's show, Dr. Wright breaks down everything you need to know about building muscle, lifting heavy, and optimizing your diet to fuel your goals. We'll also touch on revolutionary shifts in women's health, hydration hacks, the importance of mobility, and the benefits of creatine for longevity. Yes, creatine, one of our favorite products here. Oh, and spoiler alert, carbs are definitely back on the menu. I'm here for it. Join me as we redefine what fitness means for women with Dr. Vonda Wright.

All right. So it's January 2025. Here we go. Let's say I'm a woman and I'm listening and I do all the right things. I'm pretty much always on doing the right things, but I really want to get a bit more toned. Where do I start? Well, you know what? I don't want to make what we're going to talk about

any kind of gate or any kind of barrier? Because I love that your audience is always on. They're always doing the right thing. They're always... So how do you then take it to the next level? Because I don't ever like to say, oh, it's one more thing to do. I think once you master a certain set of behaviors, it's no longer a stress generator for you.

And so we can easily layer on, well, how do we get a little bit more healthy? So the best way to recompose a body, which is how I frame talking about our body. I never talk about losing weight. This is the one and only time in 2025 you're probably going to hear me say online belly fat or mellow belly. I just don't talk like that.

because what we need to do is re-compose our bodies, right? And I say it like that because we're not trying to be skinny. There are lots of people who are skinny fat, meaning they have, they're really skinny like my pinky, but 50% of them is adipose tissue, which is metabolically unhealthy. So when we say toned, we're just defining as re-composing our

to having a lot of muscle mass, right? I think that's what you want us to get at. So how do we do that? Well, one of the ways I like people to do it is really to become a deep learner of what they're eating, right? Because we're not trying to add

well, number one, you have to eat to be toned, right? We cannot fall into the myth. And it's a hard lesson. Even if you're always on, it is a hard lesson that women of my generation were taught since infancy, they have to be little and they have to weigh a certain amount. And so getting over the mindset hurdle of I'm going to eat more to be more toned, it really matters what I eat. So you and I often talk about the fact that

To build the muscle we need, we need to be in front of how much protein we're getting. Whether that comes from whole food or it comes from whey isolate protein that we use as, and I don't like to call it a supplement. It's a feeding. I call it a feeding during the day. When I describe dividing the total protein we need into four to five episodes, three whole,

whole food episodes to additional feedings, one of which in my life is whey protein isolate. But I think a cool fact for people listening is we're not just making that up. We're not just trying to add something in nature, in nature designing the best food for our babies.

The highest quality protein, which highest quality means that which contains branched chain amino acid, leucine in particular. Where does that come from? Where is the best example in nature? Breast milk. So if nature designates high quality protein as a way to feed the most important little people in our lives, then that's why I follow suit. So

high quality protein from whole foods and other feedings such as whey protein isolate. So you have to have that building block to feed how we're going to tone. So I like to teach the people that I serve to recompose. I do this, recompose, not lose weight with two activities. Number one,

We have to let it be. Let's pause there for a second, just on diet, because I think this is a really important note. Because in years past, and you mentioned, you know, in your generation, this wasn't a thing. I think it's multi-generations with women. And just to like make a point of saying how incredible it is that here we are in January 25, and we're talking about getting toned. And you're saying you need to essentially eat.

more. We're talking about five times a day. And I can't think of any other moment in history, with the exception of the last year or so, where we're saying to women, hey, if you want to get more toned, you need to eat three to five times a day. And you're going to prioritize protein,

And you're going to make sure it's high quality protein. You got to make sure you get that two and a half grams of leucine in that protein to activate muscle protein synthesis because you don't want any protein for the sake of eating protein. You want protein so that can feed help feed those growing muscles. Make make sure those muscles are lean. But I just want to pause there and just like recognize that.

We're saying you got to eat more. Like that's like, I mean, if you want to lose, if you want to get toned, you got to actually eat more to some degree. I did just say that. And people are like, what? Don't I have to spend...

16 hours a day in a fasting state? What? I thought all the athletes are toned because they don't eat. Well, I'm going to tell you for sure, in my 25-year career, I have taken care of at least 100,000 people, many of whom are recreational or high-level athletes, and feeding, for instance, the last big groups of athletes that I took care of at the Division I level or at the pro level were

Feeding is a full time

focus from 6 a.m. We cook their food. We deliver their food. We even make the food on the airplanes to casually think that we can be in the prime of our lives without focusing on what we're eating and just treating our bodies like a garbage disposal, like anything will do. We're just going to put it in because what we really need to focus on is our exercise, which we do, but not at the deficit of

of how we're feeding ourselves. So listen how excited you just got me talking about how pros do it. And then also too, I just make a note because many people often get their initial gut reaction is they're overwhelmed. You know, if I'm doing a gram per pound of body weight and I weigh, you know, so say 150 pounds, that's 150 grams. How am I going to do it? Okay, five feedings, 30 grams a window. For a little context here, four ounces of chicken

is 30 grams of protein. Four ounces of chicken isn't that big of a chicken. Like if you go out to a restaurant, they're probably giving you like 10 to 12 ounces. It's massive. Half a palm. It's yeah. Half a palm. This is four ounces, right? Yeah. So it's doable. So sorry. I just had to make a point of saying like, okay, we're going to, and so the, just spend a little bit more time on diet before we move on an exercise. I think a lot of people know this, but I just don't think you can emphasize it enough. Okay. Protein is the center of the meal.

What do we surround the protein with in terms of how do you think about what else goes on that plate for those three feedings? So for active people, which is your audience, it's mostly who I serve, you actually do need carbs, right? I mean, there's a, yeah, you must have carbs available. And in a racing situation, you probably want something quick.

But in a life situation, how do I move carbs into my life for midlife women in particular, but everyone in general to feed the microbiome, the little trillion organisms that help us live in our gut? We need fiber.

So fiber is a form of carbohydrate. So as you're choosing through your day, and listen, I can't talk to everybody at once here. So I'm not talking to the elite performing athlete whose dietician plans every minute of their day. I'm talking to people like me and you, professionals who are very conscious. So we need our fiber in the form, in general, of complex carbs.

focusing not on simple sugars that are going to pass right through our gut, jack our blood sugar. We need to focus on, okay, a sweet potato is full of stringy fiber. Beans, white northern beans, my favorite kind, are full of fiber. Avocado. So when we're talking about how to load with carbs, we must first think of fiber carbs. Because even if you supplement fiber, which some people do,

It's usually about five grams per scoop. You can, listen, without tremendous GI upset, you cannot just scoop 30 grams of fiber. So that means we must get complex carbs from our diet with a focus on fiber. So that's number two. I ask people to focus on protein first, then carbs, and then fiber.

We'll get our fat. For instance, if we're going to get protein from whole eggs, every yolk has four grams of fat, if that's where you want to get your fat from. Or avocado is full of luscious fat and you'll get enough in a day. That's how I break it down and think about it. Let's say we've got diet dialed in. We've got our three whole foods diet.

whole food-based meals. We've got our whey protein isolate. We do that twice a day, and we're hitting our protein threshold, whatever it might be, depending on our body weight. So we've got that down. We're good. Where should we go next? Let's use that fuel that we just put in, right? Let's use our fuel. So what are we going to use our fuel for? We are going to build some muscle mass. So

For midlife women, and I'll talk about men in a minute, for midlife women, as estrogen at 40, ladies, at 40 starts to decline in a precipitous way, even though we might not hit menopause the last one year from our last period until 51, 52, we see a precipitous decline such that we do not have the anabolic stimulus of estrogen that we once did.

to build muscle. We can build muscle and do build muscle, but the stimulus we now need for longevity and power is to lift heavier.

Right. So, you know, I am trying my hardest, as is a lot of people, to move to progress us from the mamby pamby pink weight era of I only want to lift light weights 60 times because I don't want to get big, which will never happen, people, to OK.

Let's challenge our bodies. Our bodies live in a state of amazing homeostasis. If we're to ever challenge our bodies, we're never going to rise to do better. So what does that mean for lifting?

I like people for longevity and power to focus on the power lifting moves, which are a push-pull of the upper body, so bench press, pull-up type activity, and push-pull on the lower extremities, which some kind of squat, some kind of deadlift. For those four power lifts, we want to lift heavier.

The range that's represented in the literature is three to six repetitions. But listen, I've taken care of about 100,000 people in my career. I think people need it simple. So I've chosen four.

It's heavy, which means if you can lift the weight four times with, you could probably have one rep in reserve. You could probably squeeze out another one with good form, but by six, you're done. That is the weight that we're saying is heavy enough. And lots of women say to me, or lots of people say to me, okay, okay, well, how much is that? Is it 20 pounds, 30?

Each person is different. You have to experiment a little bit and find out what heavy is to you. Now, here's something I want your listeners to do. In January of 25, return all the ugly Christmas sweaters and purchase yourself

a knowledgeable trainer who can teach you the form to lift heavy without hurting yourself. This is an investment that keeps on giving. And listen, I'm not a trainer. I do not own a training studio, so I'm not trying to sell you training. I'm just saying, if you truly want to layer on a lifestyle, you've got to know what you're doing. Now's the time to learn how to hinge and

how to support your needs in these activities so that you don't get hurt and end up in my Monday morning office. So lifting heavy.

I am rambling on and on, but listen, we feed ourselves, then we lift heavy. Well, especially with squatting. That's one where if you get the form wrong, you're in for potential knee injury, lower back injury. Even someone, I'm someone who knows how to do it. And if I'm not, there have been times where I've gotten a little sloppy with posture and

and formed and went a little too heavy and that's a little tweak. Okay. I'm laid up for two weeks, three weeks maybe. And that was, I shouldn't have done that. Well, and the other thing that, that, that point brings up exactly is that when we're talking about the compound lifts that are really going to tone us and build muscle mass, it's not just about our muscles or our skeleton. This is a brain thing.

body access move because they're complex multi-joint moves and so you can't be distracted while you're doing it this is not the time to have a conversation or break up with somebody you must be concentrating on your form going up and down because your brain is trying to recruit

muscle bundles, muscle fiber bundles, and make sure your back far enough over your heels. So I just wanted to add that mind-body component because it's about your brain as well as your muscles at that point. It is. And even though I am a fan of using machines, I think this makes the case for more free weights because you can kind of just like zone out and work through a machine.

But when you've got free weights, you have to consciously pay attention to form and what's happening. And so it is more of a workout for the brain, if you will. And you know what? That keeps us younger when we have better brains. So it's all these things. So I'm going to come back to the brain body again. But let's talk about, okay, I'm lifting. I've got those exercises. How do you think about that?

number of sets and how many days per week for someone, again, who's busy? Yeah. So the research shows that you can be effective with two times a week. If on those two days, it's a total body, you do your bench and you do an upper body, you do a lower body.

two days a week, I think, but they have to be quality lifts, right? So when you're lifting for that one hour, twice a week, that's what you're doing. You're not playing around. We're not, we're lifting because it's not only we start out and this is just the way that my strength coach started me doing this many years ago. And so I, I'm a creature of habit now. So we have a compound lift of the day. Let's say it's my bench press.

And then that same day, we have the accessory lifts. To the accessory lifts to a bench press, for instance, biceps, triceps, lats, delt, rows. Those accessory lifts, we lift a little lighter, but we do eight reps, right? So it's heavy lifting.

In our compound lift, our accessory lifts are still heavy, but not as heavy. We do eight reps, three sets, three to four sets. And then I always, in my workouts, throw in a core workout. I don't think we can get enough core because it's how we keep our low back stable. It's how we don't get injured because our pelvis is the center of the universe. So the core is every workout with...

with the compound lift followed by the accessory lifts. And that'll take you an hour. And so to summarize, so we've got our bench press or incline press or maybe pushups for some folks, and we're going to want to go a little bit heavier there. Same with the squats, same with some sort of pull-ups or something for the back that's like a big pull movement. You could be even a lat pull down. You're going to want to go heavy, three to four sets, call it

four to five reps. And then for the accessories, whether it's the shoulders, whether it's some complimentary back work, the biceps, the triceps, three to four sets, but like eight reps. And yeah, that probably will take you an hour. You probably get through it faster if you don't really rest between sets. If you go from one to another, do you have a view on that for someone who does like the circuit training, if you will, or do you prefer rest?

For the big compound motions, where it's a mind-body concentration, you're really lifting heavy, we need to rest, usually a couple minutes. For the accessory, I do it and I prescribe it as you just described. We go, I'm making this up, we go from one exercise to the next to the next because they're not working the same muscle group and they're not compound. Biceps to triceps,

to rows, bisets to triceps, and just continuous in a circuit until we've done the sets. And yeah, that'll take you probably an hour, twice a week. Let's talk about mobility. I want to...

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so you feel completely in the zone the entire journey. Learn more at toyota.com slash toyotacrownfamily. Again, that's toyota.com slash toyotacrownfamily. Let's slip one little thing in here because we're talking about lifting for muscle, lifting to be toned. But as an orthopedic surgeon, I want everybody to remember that muscle mass will help build bone. And bone...

is not just the strong, silent type hanging around, holding up your muscles. Listen, if we didn't have bone, your muscles would just be like a quivering pile of connective tissue. Bone is structurally critical. But people also, and hopefully as 2025 goes on, they'll hear me say a lot, the bone is a metabolic organ. It releases hormones that build energy.

neurotrophins. They build neurons. It works with your muscles and your pancreas for glucose metabolism. In men, it helps produce testosterone in the testes. So when you lift weights, it stimulates your body to build better bone, which then works in collaboration from everything else. So we don't want to forget that as a bonus round for what you just do when you slam the deadlifts to the floor.

So then how do we round out the food, which we talked about, the muscle building with our cardiovascular system, right? I mean, during the Richard Simmons era and the Jane Fonda era, that's all we focused on, right? And now it kind of gets a bad rap or a second seat rap, but we can't forget it. But it's different now. For midlife people, we still need the really big stimulus, right?

right? We need a huge stimulus to build our cardiovascular system. We cannot just exercise in the dim middle where our heart rate's up, but it's not hard enough, which is lower level, high intensity interval training. So maybe your heart rate's up in the 70s, the orange light goes on, but it's not up near maximum heart rate. So what I see is

in the performance place that I work is people who are out doing high intensity interval training, but it's not truly high intensity and they do it every day.

Their cortisol is up. They're exhausted. They're very injured all the time. And they're coming in with injuries. And then their brain gets all upset because they're not getting their dopamine hits. So the way I like people to concentrate on their cardio is like pro athletes do. 80% of the time, they're doing base training.

At lower heart rates, it's still effective for building all the other zones, but we spend 80% of the time there. 20% of the time, we are gutting it out at the top of our heart rate range. True sprint intervals. Now, people think that when I say sprint intervals, I mean you have to do it on a treadmill. No, it's about your heart rate. You can get your heart rate up in the upper zones. For me, it's 186%.

with running on a treadmill, cycling, rowing. The thing that really kills me is the assault bike and the Alpine pole, right? It's just about getting our heart rate up. And it is that sprint interval that stimulates your metabolism enough to really burn fat. So it's the lifting and the sprinting that I have seen to be most effective in recomposing our bodies.

which was your first question anyway. Yeah, so let's go, let's spend a moment on that. I'm glad you went there. So, okay, we're doing the lifting for two days a week. It sounds like the three days is zone two-ish. Three hours broken up into at least 45-minute sessions. So that could be walking, that could be rowing, that could be anything you want, like that 50% to 60% heart rate. And so the all-out, you know, quote-unquote VO2 max training,

everyone, what's your view on, okay, max heart rate, how long, or is it,

the Norwegian protocol where it's that you do it for four minutes and then you kind of go rest for four and then back for four for a total of 32 minutes. You repeat this over and over. How do you approach that one day where you go all out? Well, I think let's separate it though. So we'll talk about VO2 max. What I'm asking people do in sprint intervals is after you're completely warmed up, please do not try this. Rinse off your desk.

Do your zone two, walk for a while, listen to a podcast, turn off the distraction. And for 30 seconds, I ask people to do 30. You could do 10, 30 seconds. You are moving so fast and so hard that your heart rate goes up, but you only have to stay there 30 seconds and then you completely recover. So when I do this on a treadmill, you could do it on any apparatus.

I'm going along in my zone two. I turn off the podcast because I don't want to fly off the back and I punch 11. I'm not very tall. 11 is as fast as I can go on a treadmill. And I sprint my guts out for 30 seconds. We can all do this for 30 seconds. And then I punch it back down to a walking pace and I completely recover. And it takes me two minutes, sometimes three, to bring my heart rate back down to about 130.

We do that four times. That's what I mean by sprint interval. Now let's talk about VO2 max. VO2 max is the maximum, is the true gold standard of fitness. It measures the oxygen diffusion from your lungs into your blood. The fitter you are, the higher your VO2 max. And I want to remind me, I want to talk about the fragility line as it relates to VO2 max.

VO2 max training is what you're talking about, the Norwegian protocol. Four minutes, as fast as you can go, and then only four minutes rest. So it's a little lower because you've got to go four minutes. It's a little lower. It's similar, though. It's similar in training, all out followed by rest, all out rest, except four is a lot more than 30 seconds. Yes. So you'll go faster with your sprint intervals.

And VO2 max, usually we just say once a week, don't, you know, don't kill your once a week VO2 max, a couple sprint intervals. That is how we recompose. We have to have that high stimulation, in my opinion, because I have lots of people who are saying, gosh, no.

Dr. Vonda, I'm doing everything right. I'm out in my high-intensity classes. I do all kinds of Les Mills things in the gym. I'm working hard, and I'm not seeing any change. And I believe you. I think people are working hard. But maybe we're underfeeding. Maybe we're not stimulating our lean muscle mass by lifting hard enough. And maybe we're doing our aerobics so in the middle that we're not reaching maximum stimulation.

So we're wasting a little bit of time. Yeah, it's like that. And I think that happens a lot with many organizations

group fitness classes, which if you know, if you love it, go for it. But you're stuck in the zone three and zone four. It's just like you're above zone two and you're not quite all out at zone five. You're kind of in, for lack of a better, it's like the messy middle, but it's good. It's like you're working out. It's cardio. You should do it. But yeah, you're maybe doing it a little not hard enough and maybe a little too hard. Well, and so I tell my patients, I'm like, you go do that if you need to see your girlfriends.

But if you're trying to really make a difference, then that is the salt and pepper. That is not the workout. It really makes the case, in my view, for walking is kind of like the greatest zone to work out. Yeah. You're not going to hurt yourself. Yeah. The all-out sprint. Rowing, I'm a big fan of. You can get there. The assault bike. Rowing, I love because it's low impact. I don't really like running. Yeah. Well, and I was surprised. I did a...

There's this workout that we do, a group thing. Now, it's not a group class. It's a group challenge called DECA here. I did one the other month. They brought out the Alpine Ski Machine where you're staying. Oh, my God.

I thought I was going to die because that's not a motion I usually use to get my heart rate up. And it just goes to show you can use any apparatus that's available. But can we talk two seconds about what the fragility line is? Yes. And one comment about that Alpine machine before we go to the fragility line is,

What's interesting about that machine, I'll get winded before my heart rate goes to zone five. I have a weird relationship with that machine. I'll start to get tired. Yeah. But sorry, the fragility line. Well, I just want to return a little bit to VO2max because sometimes we associate it with only elite athletes, right? We know elite endurance athletes,

Tour de France, you know, sometimes you're genetically predisposed to have a VO2 max of 75. You're a specimen. That is genetic, right? But even mere mortals like me can affect our VO2 max in the way we've talked about it, right? We can maintain it because what do we know happens with time? What we know is that about every decade that we age, we can lose about...

10% of our VO2 max. And why does that matter? Well, here's why it matters, other than all the healthy reasons, is that there is a VO2 max level, 18 for men, 16 for women, called the fragility line. Below that VO2 max or that fitness level, it's hard for you to get up from a chair by yourself.

You may be able to walk across a room, but you literally can no longer do your activities of daily living. And you know what happens when you cross the fragility line? One in three people in the United States enters a nursing home. Yeah, you lose independence. They can no longer live independently. So what do we do about it? Well, number one, I think it's important to torture yourself a little bit in midlife and

and go get your VO2 max tested. And you can do sub-maximal testing. You don't have to do the full Monty where you're puking on the treadmill. But I think it's important to know

Because then we'll know if I do nothing, I'm expected to lose 10% every decade. And will I reach the fragility line? A, it's predictive. B, it is a great motivator. And because I work in these great performance places, I've done that. So at 50, I did my, I think that was the last time I tortured myself like that. I did my VO2 max and it was about 50. Let's just see. I was 48. Let's use 50 as a round number. So I could expect...

that if I did nothing, I would lose 10% by the time I was 60. So I'd be down to 40. At 70, well, I would be down to 45. At 70, I would be at 40. At no point before I reach 100 am I going to reach the fragility line, thankfully. But if we are already 40 and we have not invested one day of our lives in our cardiovascular fitness,

And it's not a judgment. It's just an urgency to say, oh my God, get off the couch because you're going to end up in a nursing home. What if we start out at 30 or 35? It is not that uncommon for people who have spent their entire lives on a couch. We are going to reach the fragility line. Oh, 100%. This was a wake-up call for me. So I never liked cardio. The last time I ran was the last college basketball game I played in college.

March of 1998. Just never liked it. And, you know, with all the talk about VO2 max and longevity, and I wasn't really too keen on doing the lab test. So I never did it. And, but then Aura launched the feature and it's a, it's a six minute walking test. And the feedback was, is it perfect? No, but it's directionally accurate plus or minus 10%. So you'll gauge like, am I, am I great or am I not great?

So I did it this summer and I got a, and I'm 50 now, I got a 37 and I'm like, Ooh, that's like not that great. And so I need to start doing cardio again. And so just in 90 days, I went from 37 to 42, but one, and I want, it's not like tooting my own horn, although I am proud that I was able to get it up. I'm 50 and I got it up significant 37 to 42. And this is just 90 days.

No matter where you are,

I just started doing like I started rowing. I started doing the once a week pushing myself like I'm not I don't I don't have like a perfect science for it. Sometimes I'll go longer, sometimes I go shorter. I just like started to essentially row and do the skiing at the gym, just like getting cardio. So a lot more zone two and then like getting more zone four and five. It's not the perfect science, but I'm doing it. So what I'm like, OK, what was this look like in six months? Can 42 go to 45? Can I get to 50?

in a year or two maybe maybe not but i'll try but then i started to think about like to your point i'm like pretty fit but like i haven't done cardio what if you're not fit genetics do play a role but i think that fragility line no one wants to lose independence that is scary and we tend not to think about that oh wait because we talk about what happens when you age

That over the course of time, if you don't do cardio, like if that doesn't get someone excited about cardio, I don't know what will. The idea of, okay, I'm living, I'm here, but like I can't walk to get groceries. I can't do the stairs. No one wants that. Well, and you know what? I completely agree with you. What a tremendous motivator for building yourself now to affect the future. But

Something that I find, and I think this is true in all of us, is that we are often more focused on the now than the future. There's a temporal disconnect. I don't know what Fonda's going to be like at 80, so I'm really concerned about what I'm like now. And so I just want to encourage people that while you and I are talking about longevity, which is something central to my practice, sprinting, when you get off the

bike or treadmill and you have just sprinted at the top of your heart rate and you know that only 1% of people over 50 are capable of sprinting, that gives you this badass brain and makes you feel unbreakable. When you

are lifting heavy, when you're lifting your body weight in a deadlift or making it up, one of my high school classmates challenged me, he's a strength coach, challenged me to lift what I did in high school. It's not a lot, but I was squatting 200 pounds in high school and deadlifting 200 pounds. I'm like, when you do that, that is enough for now, right? You will feel so good now

That that is today's motivation. Oh, and oh, yeah, I'll never cross the fragility line. But thank God today, I'm feeling like a badass. I love it. So on the subject, you mentioned brain health and muscle health and the intersection. I'd be remiss not to talk about creatine, why it's critical. Do you know what I did? You're going to love this so much.

I just handed my 85-year-old, and I don't even know why I didn't do it before. I handed my 85-year-old parents, they're both 85, very spry, a box of creatine packets because I'm like, oh my God, this is so good for the brain. Why don't I have my 85-year-olds on this? I just did today because otherwise my mother is playing brain games on her computer and my father...

is translating the Greek New Testament into English just to build his brain. I'm like, oh my God, these people are really invested in their brains. Let's give them some creatine because it's one of the most studied supplements available, right? We know it acts everywhere.

Lots of people who are as old as I am will remember that we started using it in the early 90s. The first time I became aware of it was in 1992 when we would give it to the wrestlers. I was involved in Olympic wrestling. We would give it to the wrestlers to try to build muscle and we had to cycle it and it was very complicated. But since then, the science has evolved so much that we know it's not just good for muscle.

It's good for the brain and that we can take it consistently without having to worry about the cycling business of it, the dehydration business. So I just gave it to my 85-year-olds. I love it. And also, it's good for women. Yeah, it sure is. Of all ages. Yeah. And you mentioned hydration. Let's talk about hydration, too, as it relates to muscle health and brain health and

How do you think about that? Well, let's be specific, right? So let's talk about it in terms of how much we need and let's calculate it. And then what we know about performance and hydration. We'll start there. So why do we want to drink a lot of... Everything counts, by the way. It's not just water. Everything counts. But why do we want to be fully hydrated such that, okay, your audience are health people so that when we go to the

When we go to the bathroom, our urine is straw colored and not orange, right? Why do we want to be that hydrated? Sometimes people think, well, if I drink that much fluid, I'm going to be going back and forth to the bathroom every 10 seconds and I can't do it. But here's the deal. Being adequately hydrated in the space of performance can have a 20% performance difference between being well hydrated and underhydrated.

It's a huge factor. So because hydration or being well hydrated affects every chemical reaction in our body, whether we're running dry or not running dry. So number one. Number two, how do we figure it out? Well, there's the generic eight glasses of water a day. The way we can figure it out is an ounce for every two pounds, for instance. Right.

So half of your weight in ounces of water or ounces of fluid, right? So 120, you need at least 60. For baseline, that doesn't take into account how much we breathe off at night. Like if you weigh yourself consistently, if you just want to do a little experiment, weigh yourself before you go to bed, weigh yourself when you get up, you're likely to be three pounds less in the morning because respiration, if you breathe, you're letting go of water

You're just dropping that much water. So you add that on.

And then for our athletes, we weigh them before practice and we weigh them after practice. Some athletes can lose 11 pounds of water during a practice. All of that needs to be rehydrated before the next workout. So there's baseline hydration, there's respiratory hydration, and then there's performance hydration. And you're also sweating potassium, sodium, magnesium, these key minerals, calcium.

And it matters, like I'm segueing to the muscle health, like you need to stay hydrated if you want to maintain or grow lean muscle mass. Well, and that's true. And listen, you just named off a bunch of electrolytes. Muscles can still contract without electrolytes, but you know what that is? It's a cramp, right? You know, I practice in Florida now, and for people who are underhydrated and have not

alternatively done water and then electrolytes

They're laying on the ground cramping because they're just losing so much fluid and electrolytes, especially their salty sweaters. Meaning we're the ones that when I run marathons at the end of a marathon, my whole face has this line of salt on it because I'm a salty sweater, right? That is evaporated from our sweat. So let's talk about mobility. So to me, as we think about the fragile, like this line we don't want to cross, right?

So it's a little bit of the why, I think, behind the resistance training, the protein, the creatine, the VO2 max. You want to be bone health. You want to be mobile. Think about our posture. That's something else we should talk about. So you don't want to put yourself in this state as you're aging where you're

Maybe it's your posture. Maybe you've ignored your bone health where you're doing all the right things, but you're not mobile. It's like the connective thread, I think.

Right. Well, and that's why I wanted you to elaborate on what you meant by mobility, because years ago I stopped using the word exercise, because when I would say we need to exercise, people's face would glaze over. And I started adopting this framework. You said it's all of our mobility. It's how our body gets through space. And when I talk about mobility, I talk about foreshadowing.

four components of it. And I made up an acronym years ago in my first book, Fitness After 40, called F.A.C.E. I want people to face their future so that when we think of mobility, it's F stands for flexibility and mobility. We actually do need to dynamically warm up before we

do aerobics or cardio. We need to get every joint in our body moving through the full range. And that involves not only just the bones moving through a full range, but the ligaments being long enough, the tendons attaching our muscle to the bone to be long enough. Because when you see little old people shuffling along,

It's because they've lost mobility in all those three factors, right? Their joints have less motion, their tendons and ligaments are tighter. And so I think...

Dynamic warmups are critical. I think after your workouts, static stretching after your workout is critical. And I also think joint mobility exercises like the 90-90, getting your hips moving, full motion in your shoulders, critical. So that's, can you explain what that looks like? So there's like the common stretching, I'm sitting down and maybe trying to touch or standing up, touching my toes. And then you see the exercises where the, you know, the runners are kind of

Maybe it's like high knees or trying to rotate their hips or waving their arms a little bit, trying to lose. So it's like the loosening up of my getting this right. So in a dynamic warm up, which the purpose of which is to warm up every joint before you use it to get some blood pumping, get your heart rate up a little bit.

It can start out with simple things like hip rotations, hip swings, right? We want to swing back and forth with our hip. We want to rotate our hips through the motion. It can then progress to deep prisoner squats where you're just in the middle of somewhere and you're squatting down as far as you can go and standing up just to get motion through your hips, your knees, your ankles, right?

then you can move to, I'm thinking all the things I love to do. Then I lay down on the grass of the infield of where I am and I do these open books where I flex up my hip and I turn my whole body to one side so that I'm actually getting flexibility within my lumbar and thoracic spine. Then for my upper body, I'll take a PVC pipe

And we'll just go back and forward. Listen, it's not rocket science. Every joint just needs to be put through its full range of motion, warming up that motion as a dynamic warm-up. Those are all the things you're talking about there. And to be clear, this is good for everyone of all ages. This is what you described. I watched my two little girls who are...

almost eight and five and a half when they go work out and play soccer with their coach, their soccer coach or volleyball coach does this with them. And you know what? For you golfers out there, this is good for you too. It's not good enough just to take your clubs out of the trunk, do one of these for two seconds and go tee off. If I just think structure, like golfing, those repetitive movements that are so, I'm like, oh, that's,

Not good. And I think that that's where, again, no matter what age you're at, you should be, you gotta, you gotta work on mobility. You really do. Absolutely. The book end on the other side of that, that people don't talk about a lot, although I talk about it a lot and hopefully people will pick it up is, so we talk about flexibility and mobility. We've already talked about the aerobics. We've already talked about

I'm making the acronym FACE, F-A-C-E-E, C, carry a load. I don't call it weightlifting. There's lots of ways to carry a load. E is equilibrium and agility. Because here's the deal. You can have strong muscles. You can be flexible. But if you do not maintain the foot speed, because what happens with aging, we lose our type two muscle fibers, which are our fast power. We lose them.

If you're like me, you'll sit your work bag by the side of your desk and you'll get up fast and you'll trip over that bag and you'll fall. We need to have the agility to still move fast enough to not fall down because the fact is we are one fall away from devastation and we cannot have that. And even though we kind of pivoted to longevity, everything we just talked about is relevant for the big question I started with, I want to get toned.

All of this. Oh, this is the recipe, people. This is how you do it. Yeah. Who doesn't want to do that? Because toned to me means recomposing to be mostly muscle.

Low adipose, especially visceral adipose, fat is not just hanging around in inconvenient places. It is a noxious metabolic organ that produces adipokines that will kill you. So we are trying to recompose not just to starve ourselves and lose weight during which we will lose 50% fat, 50% muscle. We are trying to trade fat for muscle.

So that we end up toned. I just love the mindset shift there. It's more hopeful, isn't it? It allows us to gain and not lose. And I've said this before, I'll say it again. It's operating from a place of abundance and not scarcity. And it's adding or editing and not depriving or deleting. Yeah. Yeah.

Yeah. Who wants to live like that? Nobody. I'm glad we're here because it's been a long time. It really has. It's been a long time. Although the one thing we may want to, you know, edit or delete. Can we talk about alcohol for a moment? No, no, let's do that. So when I, when people come to work with me and we go through all the things and we're building a plan and I get to, okay, I'm

Now, another component that we should really think about is eliminating alcohol. Even before I get to the whys, which I'm about to get to with you, it's almost an absolute no because we cannot give up the bottle of wine we share at dinner because it's something about the comfort of... And that's fine. Listen.

There are lots of ways to be healthy, but here's why I no longer drink alcohol. I never really did. I'm Asian. I don't have alcohol dehydrogenase, so it was never pretty for me. But here's the reasons, three or four reasons. Number one, I value my sleep. In midlife, people think alcohol puts you to sleep.

Alcohol makes you pass out, but it disrupts your sleep. I value sleep, so that's the reason I suggest we don't do it. Number two, it is a type 2 carcinogen. Who needs that? Number three, it can disrupt and kill our neurons. Who needs less brain power?

And finally, for me specifically as an orthopedic surgeon, I touched on this, but for me as a female orthopedic surgeon, we have five times the rate of breast cancer that the general population does because of our exposure to x-ray surgery.

And if we already know it's a type 2 carcinogen, we're not going to pile that on. Those are all the reasons, not all of them, many of the reasons I encourage my people to limit or decrease alcohol in their lives. And I'm really surprised, I don't know if you are, at the growing zeitgeist amongst the fitness community to eliminate it. Are you surprised by that? Well, not since we've

I would say the popularity of wearables has really exploded. All you have to do if you wear a whoop or an aura or a garment or whatever you wear, a Fitbit, you look, if you drink alcohol at night, odds are your resting heart rate is going to increase and your HRV is going to decrease. And the more alcohol you drink, the more severely they will...

it will be impacted. And so look, my, I certainly don't drink as much as I used to. I would say I rarely drink now, maybe a special occasion. I'm going to have a drink. I'm going to make sure it's a really good one. You know, I'm going to, if it's an amazing glass of wine or, you know, maybe it's going to, it's going to be, it's going to make it count and I'm probably going to opt to do it earlier in the day, but that's still like very, maybe in the last,

Three months, I've had one to two drinks, maybe. But they were good. Yeah. And you're not missing out on anything. But I do want to add one more caveat to what we are seeing societally within midlife women. And maybe it's always been this way and we didn't notice until now is that

historically, when hormone replacement therapy was taken away, what we saw was a couple things. We saw the prescription of antidepressants went up by 25% because perimenopause has profound mood and brain changes. And so the medical way to treat that is give people antidepressants. And if that's what people need, fine. I am not anti-mental health.

But what we also see is self-medication by increasing doses of alcohol in midlife, which is the last time, that's the last place in your life where you need alcohol because all we're trying to do is sleep.

control our body composition and feel better. And alcohol is counterproductive to all those things. It's really a shame. What is it? The O2 study. We've talked about this in the show, but like we really did a disservice to women on the bad HR, the bad interpretation, essentially the bad study. And it's amazing to see again, like empowering and 24 into 25, whether it's all the, all the people we know, all of our mutual friends have really put HRT back on the map and it's empowering.

And, you know, when you look at up to 10 years, I want to say for African-American women, that's a long period to be miserable. 10 years, I think the range was like five to 10 years, depending on the race played a role here, ethnicity. Yes, race did. So seven years on average, more for African-American women. Yeah. But we're still talking like it's not just like a month.

This is years, five to 10, seven to 10 years of someone's life with sleep disruption, hot flashes. And here we have this treatment over here, HRT, which is

relatively safe and we kind of botched this study and completely you know and even the even the the primary author of that study uh this was documented in uh marty uh mackery's book he interviewed dr russo and even at that point dr russo's like right the data didn't really show it but i believe it yeah

We just went ahead and scared the hell out of women. Generations of women have suffered, yes. Yeah. So if you could go back in time and give 30-year-old Vonda advice, what would it be? You know, when I was 40, I was going to write that book, but I never did.

So what I didn't know at 30 was number one, the best was yet to come. In 30, I was still in med school. I'm like, holy cow. But listen, at 30, do not despair. Yes, you're an adult, but the best is yet to come. Number two, while I still had my estrogen and was not in danger of it declining in any way,

I would have built more muscle. I would have gotten my VO2 max up as high as possible. Although I was a resident and not in control of my sleep. I mean, there were many days, honestly, that I had to choose between eating and sleeping. I would have focused on sleeping more. I mean, I'm so convinced of how critical that is. And then the fourth thing I would have done when I was 30 is...

save more money. And here's why. I know this is a health show, but listen, if we are planning on pivoting our health so that we can live to the latest years we possibly can, somebody's got to pay for that, people. And what the last thing we want to be is endangered in our health because we're so stressed out about money. So it seems weird to insert it here, but if I were 30, I would not only be focusing on my mindset,

The best is yet to come. I am not over the hill. Hallmark was wrong. I would be focusing on building the best body I could while I had the most hormones, and I would be saving a lot of money so that the stress and devastation of the stress of that would not be a factor in my longevity. What's your mantra for 2025? I was made for a time such as this.

And that is an abundance attitude. Let me tell you the evolution in my mantra. For years, when I was growing my career and in the throes of proving myself, my mantra was Italian. I took it from opera singers. It was, when opera singers go on stage, someone will say to them, in bocca al lupo, which translates to,

In the mouth of the wolf, you are about to get into the mouth of the wolf and the person responds, crepe lupo, I'm going to slay the wolf. And so my attitude, I know, for years coming up in orthopedics, coming up as an elite sports doctor, you know, doing all the things is...

Crepe lupo. I'm going to slay the wolf. I'm going to be as tough as possible because I am in the mouth of the wolf, the stress den. But you know what? That is not an abundance attitude. Now, I have pivoted realizing that all this time, and I say things like, I've been talking about the same thing since 2004. People are...

All of this has built to such a time as this, where the National Zeitgeist is truly caring about their mindset, their muscle, their cardiovascular. I see a real shift, and I'm just happy to be part of it. And so I was made for such a time as this. Well said. You are leading the charge, Vonda. Thank you so much for all the amazing work you do. Thank you, thank you, thank you. Well, thank you for having me. I enjoy our conversations.