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Dr. Vonda Wright

Appearances

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

0.349

Runners who only run are hurt a lot, and it's usually due to a motion imbalance. So I always do this test to show them whether your butt muscles are strong enough to keep your pelvis straight and whether you're strong enough to keep your knee from falling into this position.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1008.358

That is the reality that I see every day as an orthopedic surgeon on call. But there are other reasons to care about the bones because fracture is a big one. Bones, and it makes sense, nature is so conservative. Bones are in our body from the top of our head to our pinky toe, right? Bones are master communicators. We think of muscle, which we're all talking about now, and bone.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1036.569

and adipose and everything as siloed organs that don't have much to do with each other except they live next to each other. The fact of the matter is, for instance, when we're talking about the musculoskeletal system—bone, tendon, ligament, muscle, fat, cartilage, muscle stem cells— They're all derived from the same stem cell, the mesenchymal stem cell. So they're not distant neighbors.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1066.323

They're cousins. And they all speak in the same language. They may have different dialects. I was thinking about an example of this, you know, how in the UK, English is the language. But depending on what parish you live in or which country within the UK, English sounds very different. But it's the same language. So within musculoskeletal tissue, muscle and bone are not separate.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1092.373

They are one ecosystem, such that... When muscle releases a protein called irisin, it talks to the bone. When bone releases a protein called osteocalcin, it talks to the muscle. But in the case of bone, osteocalcin, if we just stick with that protein, it talks to the whole body.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1116.577

When your osteoblasts, the bone building cells in your bones, release osteocalcin, it goes to your brain and has a neuroprotective effect by decreasing inflammation. It goes to your brain and causes the synthesis of neurons in the hippocampus. It goes to the pancreas and helps with insulin insensitivity. It goes to the muscle and helps the muscles scoop up glucose out of the blood, right?

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1146.734

If you're a man, osteocalcin can travel to the testes and that organ, the lytic cells under stimulation of osteocalcin will produce testosterone. So It's like a miracle and a wonder that we just think of bones as the strong, silent type that hold up our muscle. Because actually bone and the proteins that it produces are master communicators.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1173.369

And it makes so much sense because we have bone everywhere in our bodies. Why wouldn't our bodies use it like that?

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1181.943

Well, and it is a frame, right? What's muscle without bone? Just a heap of metabolic tissue, right? It makes us, gives us our statue, but it's a master communicator. The framework is almost a secondary job, in my opinion.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1217.91

So we've talked about the bone being structural, right? It holds you up. It gives you your stature. We've talked about bone being a master communicator. Another job of the bone is as your body's storehouse. Two really, really important, maybe if we just talk about one of them, calcium. Calcium is a critical mineral in our body.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1239.243

We need it for muscle contraction, for pushing molecules across cell membranes. but we've got to store it somewhere. So when we eat food, our intestines pull it out of the food we eat and stores it in our bones. And so our body is always sensing how much calcium, how much phosphorus do we have? What do we need? When our body senses that we need more, It goes to the bone.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1267.315

It tickles the osteoclast and say, osteoclast, we need some more calcium. The osteoclast breaks down some bone, releases calcium, and it goes into the body for use. And then the body has enough to use. The body does not just keep piling it in because hypercalcemia causes heart arrhythmias. It's bad, right? The body is perfectly in homeostasis, in balance. So when the bone has released enough,

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1295.652

It sits back and keeps storing it, right? The calcium your body doesn't need, if the bone is full, it's excreted through the kidneys. And this is a really fine balance between building bone, releasing the storehouse of minerals into the bloodstream, or saying, oh, we've got enough. Let's send it out in our urine. The body is such a miracle like that.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1329.446

So, you know, there are lots of things that go into bone fragility or osteopenia, and one of them is not laying down enough bone in our youth. You asked me earlier about changes across a lifespan. When it comes to bone... What's interesting is that I get very, very young women in my clinic, 25, 28, whom for various reasons I do a bone density test on, and they already have brittle bone.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1359.234

I know, it's shocking. Well, I think that happens for a number of reasons. Number one, we didn't build enough bone. There is still a myth in this country that women have to be teeny tiny, that we have to starve ourselves. And when that happens, many women do not have consistent menstrual cycles and estrogen, which then helps us lay down bone. So that's number one.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1383.988

Yes, it does. Critical role. So we're not laying down enough. Or maybe... We're athletes. Title IX, which is the law that equalized sport for women in college, is 53 years old. So maybe young women are not laying down enough bone because they're expending so much energy, 10,000 calories a day, and then they're not refeeding in the way. So they're always living in a state of energy deficit.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1412.734

and not laying down enough bone. Or maybe young women are coming to my office with not enough bone because we're raising an entire generation of sedentary children who are sitting around in their basements playing games, building brains, but not building bodies. That is borne out by looking out of the University of Wisconsin. Orthopedic researchers there studied which women's sports

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

143.974

So, you know, as a sports doctor over the years, we've learned how to take really high-performing athletes, you know, those who are winning all the time, who need to continually get better and better and better at their craft. And over the 30 years of my career, we've gone from really focusing on how they train

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1441.513

build the best bone, and it's gymnastics. It is the pounding and the feeding of those athletes that builds the best bone. So we have trouble with not enough brittle bones in adolescence because we're not building it. The second place in the lifespan that we may become low in bone density, and hear me, people, I am not saying not to breastfeed.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1466.164

I mean, in my children, my child, I breastfed for a year. It's really great for babies. But a woman breastfeeding will lose 20% of her bone density in the first six months of breastfeeding. And if she's not really careful to get 500 milligrams of calcium a day in her food or through supplementation, she will not build it back.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1490.02

And then if you have children in succession, because many women are waiting until 30s to have their first child and then have less time, we may never build back bone. So that's another key point that people don't realize could be dangerous to the bones. And then finally, yes, is this period around perimenopause, starting around 45, when estrogen levels become very high?

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1515.649

chaotic and then ultimately zero, that can cause the rapid decline in bone density and bone weakness that you're actually asking me about. And that's because estrogen is critical for controlling the absorption, this part, the absorption of bone. And without estrogen controlling the absorption, it just keeps breaking down bone faster than the osteoblast, the building cells can build it.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1569.389

Absolutely. To build everything. You know, we make mitochondria most the energy of our cells. We make a lot of mitochondria in our youth. If we're not active in our youth, we don't have the anabolic stimulus as much to make as much mitochondria. If we are sedentary children, we will make bone, but we will not build bone to the extent we do if we're bashing it every day.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1593.328

And I think the data out of Wisconsin is a good illustration of that.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1603.675

And that's what my study from the National Senior Games shows, that by impacting your bones across your lifespan, you can change your bone density.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1620.821

Yeah. And the data I gave you was specifically for breastfeeding.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1625.984

So for breastfeeding mothers, you will lose about 500 milligrams of calcium a day as you're making milk for your child. You must replace that. I like people to replace their calcium with whole food, right? With prunes and dates and high calcium dairy, if you will. If you simply cannot do that, okay, take a supplement. But if you forget to do that, I mean, I get it. I was a young mother.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

163.59

the periodization of their training to the last time I was at the University of Pittsburgh, I was the medical director of the UPMC Lemieux Sports Complex, which is where the Pittsburgh Penguins are housed. And it had gotten so scientific. They had a full-time chef. Every meal from breakfast, lunch, dinner, every meal on the planes were prepared because when it comes down to split-second agility,

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1652.086

I'm exhausted. I wasn't a young mother. I was a 40-year-old mother. Exhausted. You have to be so mindful as the baby's latching on to eat some calcium, eat your yogurt, eat your calcium, chew from whole foods, if you will, so that you rebuild your bone, which you're completely capable of doing.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1670.041

Studies show you will rebuild your bone, but not if you're not aware, not if you're in the, I've got to lose the baby fat starving phase. Let's not do that.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1689.471

Well, if we just talk about, just choose one of the proteins that bone makes, osteocalcin. So as that's released into the bloodstream, one of the places it goes is into the brain and it can cause, it can aid in the neuroprotective effects. So what does that mean? Under normal metabolism, we develop free radicals due to normal metabolism cell work. We develop oxidative stress.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1726.898

And osteocalcin works to decrease that oxidative damage, to repair cells in the brain. So that's number one. Number two... It stimulates the release of something called brain-derived neurotrophic protein, BDNF factor, which stimulates the growth of neurons in a part of the brain called the hippocampus, which is involved in memory. And here's the opposite side of it.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1753.549

We know in people that have low bone density, They also have higher brain cognitive dysfunction with age and vice versa. There's an association in the literature with osteoporosis and cognitive decline and vice versa.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1779.963

I think the critical decade for most of our health, Stephen, is no later than 35 to 45 for men and women. That's because we know for women... that's when estrogen starts to decline or become chaotic. So when we're in our 30s to 40s, that is the time to get all of our health habits together. It's time to get a physical to see what your baseline labs are.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1804.992

I think it would be critical for men and women, particularly men. To get a baseline testosterone so that in the future, when we're thinking about supplementing testosterone, we're supplementing back to your particular level. Because in the future, let's say when you're 50, a man's testosterone could be 600, which falls within the normal range.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1825.525

But if he's still feeling low energy, not himself, a lot of tendon and ligaments injuries, well, his young testosterone might have been 800 or 1,000. So I like people to get baseline labs if they've never been to the doctor before, around 35, all things, so that we know what we're returning you to, number one.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1847.505

Number two, if you have been so busy with your career and stepped away from any semblance of mobility and resistance training, now is the time. Because had I known then what I know now, when I was 40, I was training for triathlons. I was an aerobic athlete, right? I ran, I biked.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1868.074

But what I would have done then with what I know now is I would have been lifting a lot of weight to build maximum muscle while I still had the most hormones to start at a better place. Because you can build muscle, but it's better to start from a higher average. So get some labs, make a relationship with a doctor, get all your preventive screening. Do not blow that off.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1893.889

Develop the habits that are going to carry you through a lifetime, whether it's smart anti-inflammatory nutrition, whether it's getting into a resistance training program, building up your cardiac machine. I saw that you were running a lot now and we want the highest possible VO2 max that we can as we enter into midlife because we never want as we age to cross something called the fragility line.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

191.028

Top of brain thinking, every little bit counts. And so in the 30 years of my medical career, it's gone from just learning more about performance science of how to train to how to feed people to how to recover people. So instead of doing, for instance, I think Dara Torres was talking about her Olympic runs in her 40s, right? She trained much differently when she was 24.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1921.978

So VO2 max is the measure of, it's the ultimate measure of fitness. How much oxygen you are capable of pulling out of the air and diffusing across your lungs into your blood. World-class athletes. I was just at the U.S. Olympic Center in Park City, Utah. Those athletes have a VO2 max of 75, 80, sometimes 90, right?

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1946.622

Mere mortals are considered excellent when they have a VO2 max of around 50 for women, around 50. So... You can build VO2 max and should in the critical decade because once we hit midlife, we will decline 10% a decade if we don't consistently build it up. So what does that look like? So if I started at 50, 50 years old, my last VO2 max was when I was 50. And it was 50.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

1979.122

It was pretty good because I was an endurance person, right? Just in whole numbers, by the time I turn 60, it's going to be 45, 70, 40. 80, 35. I never, ever, ever want to hit 18 if I'm a man or 16 if I'm a woman, because that is the level of VO2 max when we can't get up from a chair by ourselves, when we can't walk across the room, because that takes cardiac function.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2009.073

And so the higher we get our VO2 max in our youth, the more runway we have, even if we don't continue to build it up.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2071.909

Yes. Osteoporosis is the word we use to describe low bone density.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2077.672

So the way we measure osteoporosis is using an x-ray called a DEXA scan, a dual x-ray. And it just measures, it compares your bone density to that of a 30-year-old healthy person. And it gives us something called a T-score. So it's like when you're in school and you're graded on a bell curve and the center of the curve is average, and that's the average for a 30-year-old.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2104.207

When you get a DEXA scan score and it's positive, fantastic. You have bones of a 30-year-old. If you get a T-score on a DEXA scan that's from zero to minus one, it's okay. Minus one is the definition of osteopenia, meaning watch out, your bones are getting weak. The definition of osteoporosis is a T-score of minus 2.5. Increases your risk of fracture by 40% or more.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2135.018

All the bad statistics that I talked to you about come with osteoporosis.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2146.516

Well, 2 million men have osteoporosis. Interestingly, isn't that interesting? You don't think about it as a men's disease. And one in two women will have an osteoporotic fracture, so at least 50% of women. But it's not inevitable. That's why I'm so interested in in catching people early and the critical decade. It's not inevitable, but it will be inevitable if we don't catch it.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2168.898

But here's the thing that's bothersome. In the United States and in many other countries with people I deal with, you cannot get a DEXA scan paid for until you're 65. By 65, the damage is done. Why are we waiting? Even with people who have had a fracture, there's a gap in follow-up such that they should all

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

217.815

And in her 40s, after she had had a child, it was much more about recovery, not as much hours in a pool. So I take all those things that we've learned over the course of my career and now apply them not only to athletes, but to people like you and me who were in high performance jobs. I need to be tip top in every sphere of my life as you do.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2191.566

Have a DEXA scan because the number one thing that predicts future fracture is past fracture. So public service announcement, if you've had a fracture, get a DEXA scan, even if it was a traumatic one, like you had made a car accident. But definitely, if you have fallen, if your dog pulled you down, if it was a low trauma fracture, get a DEXA scan because then at least you'll know where you are.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2225.79

You know, I think you can get clues from your own family.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2229.276

If your mother shrank... If you used to be able to look your mother in the eye, like me, my mother looked me in the eye 5'4", and now she's way down here, we lose height in both men and women due to compression of her spine vertebrae. We lose height. So if your dad shrank, if your mother shrank, that's a good indication that you have a family history where osteoporosis can exist.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2254.819

Or if your mother had a hip fracture. Or if... For some reason, maybe asthma, you've had to be on high dose steroids your whole life or an autoimmune. That's very bad for bones. So from a medical standpoint, from a family history standpoint, from a personal standpoint, usually fracture.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2279.079

Yeah, I'm really glad you asked that. Smoking is a poison to bone healing, whether it is fracture will heal more slowly. In fact, we have a much higher rate of nonunion, which is where we fix a fracture and it still doesn't heal in smokers. We know that there is a big body of data within the orthopedic literature for people who have spine surgery who are smokers.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2300.493

They are not only less healing, but they're more infected. So the noxious chemicals in smoking are very bad for bones.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2313.329

It's all. Vaping might be more dangerous. We just don't have as much literature.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2329.491

That goes back to what we were talking about before, and there's a correlation. I don't believe we worked out the causation, but there's a correlation. We see people with Alzheimer's and people with dangerous osteoporosis are sometimes the same group 30% of the time.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2349.082

People with brain disease also have osteoporosis, and it may be due to this connection that we've talked about between the two organ systems.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2362.242

I do. My Aunt Ida, she was brilliant. She was a teacher. And she stopped remembering. She didn't remember herself. She didn't remember the farm that we were all raised on. That's a really hard thing to witness. Sometimes people with Alzheimer's lose the inhibition and they become angry and enraged and afraid. She never did that. But that's a hard thing to witness.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

238.894

And how do we eat better, recover better, take the principles of performance that we've learned from athletes into high performers and even mere mortal athletes like me?

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2398.916

Well, you know what it has done? It has put an urgency and even it still is a day-to-day battle. I don't want, I think sometimes people think for me personally that because I talk about these things all the time and I do lift heavy and I do the thing, I live the life, I prescribe for people that it's easy and it's not easy.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2417.023

I told you I had finished this book I was writing and there was a big gap in the consistency of this lifestyle. But what motivates me to get back is the question of What would it be like to live without a brain that's preserved? I mean, I don't know. Sometimes I think about if I was aging and I had to choose one, would I choose an able body or an able brain? Isn't that hard?

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

2444.972

I don't know that you do have to choose, but I can't fathom. what life would be like without an able brain. And so for me, that motivates me to lift, to make my skeletal muscles secrete the proteins that go to the brain and build better brain, to eat the foods that are not going to clog my arteries. It's just as a motivator because I want to be this way until I die.

The Diary Of A CEO with Steven Bartlett

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To live longer, stronger, and better. I'm on a rampage to make bones sexy again. Because in the United States, at least 50% of women will get osteoporosis along with 2 million men. Now osteoporosis is low bone density. And studies show that people with low bone density have higher cognitive decline. It increases your risk of fracture.

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Alzheimer's disease is thought of as the third phase of diabetes, right? And so everybody is aware of diabetes and it means you don't process sugar and you have glucose intolerance and your pancreas is no longer functioning and the bad sequela that can come with that. What people are not aware of as much, at least as people who come to my clinic, is pre-diabetes.

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And if you don't mind me diverging a little bit, because it's so important to this question you just asked me, and can we prevent it? And if we got to choose, what would we choose? But I have people coming into my office all the time and I look at their labs and they have a fasting glucose. They've had their labs drawn. They've done what we've said, get in front of your critical decade.

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They've had their fasting glucose drawn and it's 110%. I'm going to tell you. And their hemoglobin A1c is nearing six. So fasting glucose is the glucose that remains in your blood after you haven't eaten for 12 hours. In a normally functioning pancreas metabolic system, we want our fasting glucose to be around 85. Right? That's normal. It means we eat something healthy.

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Insulin comes out of our pancreas, the sugar is put into our muscle, and then the blood sugar is around 85. If it's staying up 110 consistently, we know from the literature that you have a 70 to 100% chance of developing full-blown diabetes within 10 years. But what I see in people coming into my office is I'll say, did anybody ever tell you you were pre-diabetic?

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You know, I am not a brain scientist myself, but I am fortunate to be surrounded by people who are expert in that. So from my own perspective, I've come to appreciate at a much deeper level personally, as well as professionally, the role of sleep. In fact, We've talked about my previous books from the early 2000s before. And when I wrote those books, mobility was king. I wrote only about mobility.

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And either the answer is no or the answer is, oh, yeah, somebody told me they said just make a few, you know, focus more on your exercise. And what I think the reaction to the diagnosis of prediabetes should be is running and screaming to get healthy.

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Because if we know that with a consistent blood sugar in the pre-diabetic range, and we're casually told by our health care provider, oh, just go try to exercise more, you know, just casually approach this, don't eat so many carbs, that is not serious enough.

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Because we know from a preventative standpoint, from a precision longevity standpoint, which is all about prevention, we can prevent you from getting to diabetes in the next 10 years if we're really, really serious. about lifting weights, about cardio health, about anti-inflammatory nutrition, following.

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So I don't view prediabetes as a casual thing at all, because if in 10 years you're going to get diabetes and in 10 more years you're going to have Alzheimer's disease, and I could have prevented that by paying attention when I was 40, It's almost inexcusable that we're not paying more attention to it. 96 million people in the United States have prediabetes. 96 million?

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96 million, according to the American Diabetes Association. I just gave a talk at their annual convention. 96 million have a preventable characteristic that we can prevent them from becoming diabetic and getting Alzheimer's disease, and yet it is too casually spoken of.

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I was an endurance athlete, and I don't have it today. It ran out. But I'm a little obsessed with continuous glucose monitoring.

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So I've been wearing it for about 18 months, and it's so interesting. I told you that I just finished this book, and I've gotten a little bit off my regular intensity, and it changes my blood sugar. So- I run a little – because I haven't been lifting four times a week, only twice a week, because I haven't been sprinting twice a week, like my normal regimen is I lift heavy four times a week.

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On the other days, I do about four days of base training zone two. Two of those days, I sprint. I always eat a lot of protein. That is my lifestyle. And my blood sugar is 85 when I do that. And I'm a midlife woman. And, you know, the metabolic things that happen to midlife women. Even backing off a little bit starts to creep up my blood sugar.

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So this is a constant, daily, habitual lifestyle that we all need to lead. And so when I see that in someone as healthy as me, when my patients show up and they've casually been told that they have something that's going to kill them, I don't think that's enough attention.

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Well, I can tell you, for instance, the dietitians and chefs that make the food for the pro athletes that I've taken care of across my life, they're not only eating meat. They have a very well-balanced diet that includes lots of vegetables, lots of high protein. They take amino acid supplements if they need to fill in the gaps, right, if they're not getting enough leucine or something.

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But they just don't go down one one pathway. I haven't seen that in the pros that I take care of.

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And then as I progressed in my career, I got deeper, deeper, deeper into nutrition. And then I would say, okay, nutrition is number one and mobility is second. But at this phase of evolution of sleep science and knowing how restoring the brain and providing adequate time and nutrients

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Agreed. Agreed. You know, because of the CGM thing, I found that if I only eat protein for breakfast, which egg white omelet or, you know, whatever, just protein, that I needed a little complex carbs in order for about 10 o'clock in the morning to be able to function at a high level with my patients. So now I've added 50 grams of carbs in the morning, but that's not a lot of carbs, not very much.

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I just needed that little complex, but interesting, right?

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I eat 130 grams of protein a day. There's no upper limit on how much protein you can eat in a single setting. I try to get at least 30 because there is a lower threshold for 30. And so if I do that, it takes three meals and a couple snacks a day. That's a lot of volume of food. So I try to eat really dense. So a cup of Greek yogurt is like 18 grams. And A really pure beef stick is another 16.

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So at this point, I've memorized the most dense foods that I can to get that much protein.

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It's a gram per pound. It's a gram per pound, and that's what I need to build muscle. Studies have shown that eating high protein alone without lifting as much as I want myself and others to do will help maintain muscle. And then I eat a lot of vegetables. I don't know. I hope people are not going to throw them at me, but I don't eat fruit except blueberries. Fruit is nature's dessert.

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So if we're going to eat fruit, eat it as dessert. I eat blueberries with my yogurt. And then carbs, I only eat complex carbs if I eat them at all.

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I put sleep first, sleep and recovery first, because you can't do any of these other things without a well-recovered brain. In fact, somebody asked me the other day, about timing of working out and is it always necessary to do it in the morning? Like that's the mantra, get up, go do your workout. And my answer to that was, you have to know how your brain works.

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I think I would put muscle and bone near the same category because you can have all the muscle you want, but if you break your hip, you still have the downstream effects. Now, you're much less likely to break your hip if you're strong, but I think muscle or bone are really important.

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It is never too late. Your body will always rise to the strategic stress you place on it. So there are a lot of and growing number of what used to be anomalies all over the internet of people in their 60s, 70s, 80s and beyond in a gym powerlifting environment. becoming competitive bodybuilders.

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So even if you're starting not being able to get up out of a chair, over a very short amount of time, six months, a year, you can reverse the trajectory of your frailty. But it takes consistency, right?

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Well, and you know what you do for that is nobody expects you to start with powerlifting, squats, deadlifts. Nobody expects that. Moving our body through a range of motion, doing body weight, progressing to free weights, progressing to light kettlebells, progressing to bands. Once you see that your body is capable of adapting and progressing to you will get there pretty rapidly.

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I used to do this program called a start where I would take people fresh off the couch. And over three months, we would get them to a 5K race because 5K is a meaningful distance for people who are sedentary. And over that course of three months, we did a series of body weight and kettlebell type exercises in a circuit followed by walking.

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And people started with 51% body fat, not being able to get through the warm-up, not be able to hold themselves up in a plank. And in three months, they could plank for two minutes. They could walk for three miles. They could keep going for the entire 10-minute circuit without having to stop.

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So there is never an age or skill level when our body will not respond to the strategic stress you put on it. So get a trainer for your dad.

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You know, I was just reading this morning, actually, that even with a 10-week hiatus from, let's say you're lifting consistently, even with a 10-week hiatus, you will retain muscle memory so that you don't make serious declines, which is a little relief to me because I'd spent a little while with this book.

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So you retain muscle memory and you can quickly, once you get started again, get back up to the place you were. So all is not lost if you take a few days off. The minimum, if we're really working at it, is a couple days a week, progressively lifting harder for men in midlife. It's about eight reps, four sets for women once we've trained to the place we can lifting heavy, four reps, four sets.

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For instance, my brain is best between 5 a.m. and 2 p.m. That is when I'm going to get all my deep work done. I'm going to be creative. I'm going to think. After 2 p.m., I could build you a house. I can continue operating. But if I'm going to write a book, it's going to be early. So I do not work out in the morning because I'm not going to waste that brain energy.

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And when I say that out loud, I get a lot of comments about somebody's going to get hurt. Well, it's true. But you have to work your way up to that. Like any sport, you have to work your way towards that level. Because what we're trying to do by lifting heavier, especially for women, is replace the anabolic stimulus that estrogen once was. You must work hard enough. Estrogen creates growth.

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We must signal our body by the intensity of our work to build muscle. And lifting heavy does that. So if you're starting on the couch, start with bands. Start with light weights. Start with the mamby-pamby pink weights that I rail against. But don't stay there. Continue to work your way up in a progressive way to heavy lifting, total body at least twice a week to maintain.

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Well, it depends what you want. So lighter weights, higher reps will function for hypertrophy, for bigger total muscle, but not necessarily power and strength. In midlife and beyond, I am lifting for longevity and power. So I'm not as interested as I once was in the bigness of my muscle. I am interested in can it move powerfully over time? Can I get up off the floor?

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Can I lift my suitcase above my head? So lifting for power is lower reps, higher weights. So it just depends what our goal is. You may be focused on hypertrophy right now, which is fine because you've not reached the critical decade.

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So it has to do with muscle is the sink for glucose. It is a key factor in preventing insulin resistance, not to mention strength, staying upright, not falling down, causing a fracture, right? So muscle is a metabolic endocrine organ.

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It releases, when it releases, you know, one of the things it releases is skeletal muscle contraction, biceps curls, causes the transcription of a protein called clotho. which is the longevity protein. About 30 years ago, it was described in Nature. It is the protein when muscle contracts that's transcribed. It works on every organ.

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We know that it's critical for the longevity and repair of organs because mice, who are born without the ability to make clotho, die old, very young. Chronologically, they're very young mice, but they die very old mice because they have not enjoyed this protein clotho. We make clotho by the contraction of skeletal muscle.

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on physical activity when I need it for this deep work. So that's the way I apply brain science. But I'm so lucky to be surrounded in the place I am now with people who put EEGs on your head and map your brain and tell you which brain pathways you're too stressful on and which brain pathways we can train. And you can train the physical brain like a muscle.

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Here's a study I did years ago that showed that I measured clotho level circulating in the blood of older master's athletes, people 60, 70, 80, younger master's athletes, 40, and sedentary people. And what I found that the highest levels of circulating clotho, the longevity protein, were in young athletes, not surprising.

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The second highest level of longevity protein clotho were in old master's athletes, 70, 80. The lowest level of longevity protein were in young sedentary people. So even old athletes had more circulating clotho than young sedentary people. So just the contraction of skeletal muscle can add to your longevity through this protein.

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Another protein that's released with skeletal muscle contraction called galanin is transcribed, goes to the brain, works at a place called the nucleus coerulus, which is critical for resilience. It makes you more resilient. It helps you able to problem solve. And then You know, a very popular protein that is transcribed with skeletal muscle contraction is called irisin.

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It's the exercise protein, which, you know, it works on bone. It works on fat to brown fat, from white fat to brown fat, which has higher thermogenesis. It has higher mitochondrial load. So muscle, just in doing its thing, not just looking pretty in a gym mirror, does all these metabolic functions. And so that's why we think It has such a key role in longevity.

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They don't. You have to make it. Contract your own muscles. Well, you need to feed your muscles. I always quote people one gram per ideal pound. Because listen, I'm an actual practicing person, doctor. And Here's what I know. People need really specific instructions and they can't be confusing. So is there a range of protein people need? Yes, there is.

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But people can remember one gram per ideal pound. So you've got to feed your muscle with protein. High quality protein. The highest quality protein has the greatest percentage of an essential amino acid called leucine. Leucine is not made by the body. It has to be taken in from the outside. It's a branched-train amino acid, and you get it from whey protein.

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The best source in the universe of leucine and whey protein is mother's milk, but most of us don't drink that as adults, so we get it from dairy products. You can get it from plants for everybody that is a plant lover. You just have a much lower percentage. You have to eat a lot more of it. So high quality protein, number one.

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Number two, there's a lot of research for creatine supplementation for both men and women. When I first started being aware of creatine in 1992, it was during the Olympics. I was working with a bunch of wrestlers at that time. We would give very, very high doses. We would cycle the creatine. We would come on and off. Now, steadily, five grams a day will help build muscle. It will help build brain.

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Well, it started out for bodybuilders, but it's for everyone. Actually, it's very well studied.

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Yeah, so there's this company called Nestri that I just happen to have access to and they put EEG helmets on my precision longevity clients and we map their brains and look at For instance, here's an example. Things that are habitual take very little brain energy.

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And it's not at all. You know what, despite podcasts like this and despite me screaming from every mountaintop, I find that there still is an incredible knowledge deficit in the general public about the principles of how to be the healthiest we can be. And an even bigger gap in the ability to take action for ourselves. I mean, and it's not a judgment.

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It's simply an observation that we know what to do, but we don't do it. And we know what to do and we don't do it. Even if we see in our family someone who's going through the throes of diabetes or even on to Alzheimer's, it's still not enough motivation. And I think that's the real problem to solve.

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Sometimes we solve it by scares, right? You know, someone has a tremendous health problem, but sometimes that's not even enough. I have found that it is never going to be motivating enough to try to say, okay, if you do this today in 20 years, you're going to be much better. There's this temporal disconnect. People just don't get it, what they're going to be like at 70.

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I think we have to make you feel good every single day. It's like when we were talking about your brain when you're doing heavy work and cognitive work. If you can feel better every single day, you'll continue the behavior, not for a promise. So I think that is the way to to talk to anybody, it's the way I talk to my patients. Can I make you feel better tomorrow?

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Can I make you feel like a badass because you lifted heavy weights today?

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It's hard until you see someone fracture or you fracture yourself. I agree with you.

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Vitamin D, magnesium, lesser known things, strontium, zinc, boron, and micronutrients. But big things, vitamin D, magnesium.

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And a million others are supposed to join you, I noticed.

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So I hear from a lot of runners that, oh, okay, I'm going to lift with my arms because I'm running. So that means my legs are going to get stronger. Well, what I know from 30 years in practice is that runners who only run are hurt a lot. And here's why.

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Even if we need a lot of brain energy, they become so habitual, our brain turns away energy from them versus things we're learning or things we're stressed about. We devote so much energy to that. So once this company maps our brains, then they have this

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Running builds a big cardiovascular engine, but it does not build muscle mass below your belly generally, unless you're running uphill all the time and you're building glutes. So what happens, running is a single leg sport. If you look at a gait analysis, you're on one leg. At a time, you're never on two legs. In walking, you're in two legs. On running, you're in one leg.

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So if my hands are on someone's pelvis, when we're running, we can't be going like this every single stride.

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Oscillating, like we're walking on a catwalk in fashion week. We want to be running like this. Straight. Straight. Well, that takes tremendous glute strength, butt strength, because it's the glutes that balance the pelvis. If we were in my office and you came in with pain as a runner, I would stand you on one leg to see even if in a controlled environment,

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You could do a single leg squat and keep your pelvis stable without your knee falling in. And if you can't, it just tells me that we have a lot of butt core and hip strength to do.

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It might be useful to you as you're training to have a motion analysis, to have someone stand you on one leg and look at the way that one motion pattern is different from the other. Because if it's predictable like that, there's an imbalance in you. And so it can likely be trained. I mean, I can give you an example in my life if you want to see how that works.

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So when I run and when I increase my speed and distances, I predictably, predictably get left Achilles tendonitis and I get right hip flexor, sharp stabbing pain. Predictably. That is because my left big toe, from wearing high heels all my life, has arthritis. So when I run, I don't run through the center of my foot. I run through the side of my foot.

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Where my pinky is. So instead of running through like this, I run through like this, puts extra stress on my Achilles tendon, changes my gait enough... that it's tight all up through the left side of my body, and my right hip flexor is taking the brunt of that. That is a motion pattern deficit that I know I have.

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training program where it's almost like getting your cognitive brain out of the way and let your subconscious brain reapply energy to the pathways that you actually need, that you've begun to ignore, and it makes you more efficient. And I'm being inadequate in explaining it, but brain scientists believe that you can retrain the brain like a muscle and devote energy to neural pathways.

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So if you were predictably getting the same injury all the single time, it's probably due to something's too tight on one side, something's too weak on the other side. And if you get it evaluated, you could probably train it out of you.

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So what we were talking about is joint health and the fact that every bone in your knee, for instance, if this is your femur, the end of every bone has a bumper of cartilage. Cartilage is a matrix of collagen fibers that has cells in it, and its entire job is to shock absorb. So the bones don't do so much of this. Bones are pretty fragile. But they glide.

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Cartilage has, in physics, a coefficient of friction that is less than ice. So it's smoother than ice. It glides, right? If it's perfect. Cartilage is very subject to the forces of weight such that in our laboratories, when we were doing cartilage research and wanted to damage cartilage, all we had to do is drop a marble on it. So it doesn't take much.

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So if we're carrying around a lot of heavy extra weight and we don't have the muscles to support that, instead of muscles acting like a shock absorber and protecting our cartilage, we're banging more. Now remember, banging is good for bones. It's not good for cartilage. So we want to... make sure that we have a healthy weight so that we're not exerting so much load.

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Because it's seven to nine, we talked about last time, seven to nine times body weight pressure across the joints. And so that's why we want to compose our body and have a body composition, not a weight, a body composition of more muscle than adipose tissue.

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So I know we do this to athletes to try to squeeze performance out of them.

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If you break your hip, 50% of the time, whether you're a man or a woman, you will not return to pre-fall function. And 30% of the time, you will die. And there's a lot that causes bone fragility, such as aging, not building enough bone in our youth. It's our sedentary lifestyles, the myth that women have to be teeny tiny.

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I think it's really helpful to know as much about yourself as possible. So if I'm intaking someone into a program we're going to build, I don't, I weigh them. But what's most important is I do a body composition so that we can go through step by step and say, in your current body, you have, I'm making these numbers up, 32% body fat. You have very little lean muscle.

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So even though you may be okay with the way you look in a mirror, You're skinny fat, meaning you have too little muscle and too much adipose tissue. And we talk about all the things we've talked about, about why we need to build more muscle. But when you see those numbers, numbers don't lie, nor are they judgments. But if you're just looking in the mirror, you may say, oh, that's okay.

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or you may hate the little belly roll, but you don't hate it enough. But when you see that you have very little muscle mass and a very high percentage of fat, those data alone are sometimes a motivation. And then If we know that we're going to redo that test in three months or six months and track changes over time, that can be an added motivator. Besides tragedy, data can be a motivator.

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Wanting to feel like yourself again. Women in midlife sometimes just say, I just want to feel like myself again. Well, we're different people after our estrogen goes away. And so it takes a different kind of work to feel like ourselves again. But at the end of the day, so tools wise, I think journals are helpful. Tracking, keeping a record of how you felt on a day, what you did that day.

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So, you know, after the understanding of human DNA, knowing what we're truly made of, It pushed us out of a time in medicine where we've been for the last 150 years, which is observe, and one size fits nobody. Now that we've sequenced the human genome, we can develop health plans, your health plan, my health plan. It's not generic. Here's an example.

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CGMs are, you know, I learned what I was going to learn at three months, but I've had it on for 18 months just because that data spurs me on. Like, oh, that was a really stressful OR day. My sugar spiked up even though I wasn't eating. I must have been very high cortisol. I'm releasing so much from my liver. It just informs me about the inner workings of my body.

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But also, at the end of the day, you have to love yourself enough, Stephen. And I can't make you love yourself. And I can't, a number of harassments in my office cannot make you value yourself enough to invest in yourself daily. And at the end of the day, that's what it's going to take.

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Despite everyone talking about it, despite you having lots of conversations about it, I still find a lot of people who have never heard of perimenopause, which is the decade leading up to the day of menopause, which is 365 days after your last menstrual cycle. On average in this country, it's about 51 days. People have not heard of perimenopause. They've never heard of hormone replacement therapy.

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And they don't know what to do about it. And they're ashamed to talk about it because somehow needing things in this country, if you're a woman... have gone unnoticed, for instance, like, oh, I'm just going to suffer through. My mom never talked about it. So I think the myth that you have to suffer is a myth. There is more known now than there's ever been about how using lifestyle to feel better.

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I always encourage women to make their hormone replacement decision based on science and not fear and to make it early.

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I encourage my patients, even in the mid-40s, to read the books, watch the podcasts, identify a clinician, so when it's time for them to make their decision, they've got everything lined up. And you can take hormones while you're still menstruating. There's no reason not to. In fact, that's what birth control is. Birth control is 10 times the dose of hormone replacement therapy.

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So under careful supervision, you can make your decision very early. What I want people to do is educate themselves. I call it menopausal literacy because we have a very low level of menopausal literacy in this country. I want them to make their hormone replacement decision, meaning, am I going to go on them? Where am I going to get them? Can I find a clinician to help me?

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Number three, I would like them to, as we talked about earlier, Build their unbreakable lifestyle. Develop the habits early, not when they're in the throes of menopause and feeling desperate, but early of lifting weights, of cardio that includes base training and sprint intervals, anti-inflammatory nutrition. Early so that it's just the way you live.

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So that when you're feeling so bad, you're not trying to learn all these things at once.

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Like estrogen and testosterone. So estrogen on bones... acts to control the cell that breaks down bones. We talked about in bone health, there's a cell that breaks down bones called the osteoclast with a C and a cell that builds bones called an osteoblast. Estrogen helps control the osteoclast.

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So even in menopause, when there is no estrogen, we're still building bone, but breaking down bone outstrips building bone. So replacing hormones helps rebalance bone breakdown and bone rebuilding. And if we lose our estrogen around the time of this perimenopause, menopause, we can lose 15% of our bone density.

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And if we don't catch it, because insurance only pays for DEXA scans when we're 65, which is far too late, in my opinion, we're behind the eight ball. So I encourage everyone, once they start going through perimenopause, to get a DEXA scan, whether they have to pay for it at their gym, save up their coffee money, it's worth knowing your bone status.

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When I have people who want to talk to me about living healthier longer and we draw a set of biomarkers, it's not 6,000 biomarkers. It's just a set of about 23 that are beyond regular labs. And I see that, for instance, maybe, Stephen, you have a high load of senescent cells. Well, I'm going to specifically design your gap nutrition according to what you need. You might not need

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I'm glad you asked that. In July, my group and I created a nomenclature called the musculoskeletal syndrome of menopause because women were showing up in my office. saying things without prompting. Because I'm a doctor who listens. I sit down on a stool. We have a conversation. I do not chart in front of you. So people talk to me.

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And out of nowhere, women would say to me, Doc, I feel like I'm falling apart. And I don't know what's going on, but I feel like I'm going crazy because I've been told nothing's wrong with me. And I started noticing that more and more as women started coming in with their shoulders not moving, which is an entity called frozen shoulder. And so as I started...

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Looking at this pattern and reading the very few studies that were done, we've known for 30 years that the incidence of arthritis, inflammatory arthritis in women after 50, is much higher than inflammatory arthritis in men. We've known it for 30 years.

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And as I started researching, remember how I said earlier that every musculoskeletal tissue is derived out of the same type of stem cell, the mesenchymal stem cell. All of those tissues—muscle, bone, tendon, ligament, fat— Muscle drive stem cells are all sensitive to estrogen, and without it, several things happen.

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There's something called arthralgia, which is total body pain, meaning your body hurts so much that you can't even get out of bed. That was one of the biggest things I had. I'm an athlete, and I could barely get out of bed because I was so inflamed due to the lack of estrogen. Estrogen is a huge anti-inflammatory agent. So I was totally inflamed. My body hurt. That's called arthralgia.

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Women come in, and I'm not kidding. They come in and they say, my arm won't move. Literally, it won't move. Or I can't hook my bra. That is due to the inflammation of losing estrogen. In Asian cultures, it's called the 50-year-old woman shoulder because it happens to 50-year-old women. It is a sign of the inflammation of losing estrogen.

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We know about sarcopenia, the loss of lean muscle mass, about 20% when you lose your estrogen. We've talked about loss of bone density. We have increased incidence of tendon and ligament problems, Achilles tendon, tennis elbow, patellar tendon, because the collagen fibers of tendon and ligament have estrogen receptors on them. And so everything starts to work less well

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without the presence of estrogen. So I saw all of those things and we gathered the world's data, which isn't a lot. A lot more research needs to be done. And we gave it a nomenclature. We called it and published it as the musculoskeletal syndrome of menopause. Because I tell you for sure, Stephen,

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If someone goes into their doctor's office, which in this country is so restricted in the time that we can spend, and says, I have this and this and this and this and this, six things in 15 minutes, it is difficult to get through that. But if someone comes with a nomenclature of, I think I have the musculoskeletal syndrome of menopause, my arm doesn't move, blah, blah, blah.

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Immediately, you don't have to go through a differential diagnosis of 600 things. You're like, oh, as a doctor. This paper on the musculoskeletal syndrome of menopause has currently been downloaded almost 300,000 times. And to put that in context...

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Some of the biggest journals in the world, medical journals in the world, documented, they did a survey of how many times their best articles had been downloaded. The best scientific journals, their articles are downloaded about 10,000 times. This musculoskeletal syndrome of menopause has been downloaded nearly 300,000, and it's not because... Yes, it's a good paper.

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anything for inflammation because maybe your inflammation labs are good. But historically, what we would have done is say, okay, let's just give everybody the same formula, but now we're able to devise what your body needs at your time. I do the same thing with exercise.

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The need is so great, Stephen, to communicate what the heck is going on with people that I made it open access, meaning you don't have to pay to get this article. And I encourage people to Google it, it'll come up number one, to print it, to read it, to give it to your doctors so that they can understand that you're highly inflamed. That's why your total body hurts.

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That your shoulder doesn't move because you're inflamed. That your knee hurts because you have the arthritis of menopause. And just to build the understanding of what is actually going on with people.

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Well, you know what? Research is a team effort and we all work together. But thank you. It's needed.

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Oh, who does? There are two kinds of arthritis. There's an autoimmune, meaning your body is identifying yourself as not yourself. And that's called rheumatoid arthritis. That is very different than the way I used it today, which is osteoarthritis, which is wear and tear arthritis.

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So wear and tear arthritis can happen through thousands and thousands of repetition on a joint. We were talking earlier about running. It's a thousand steps a mile. It can happen due to trauma.

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I have a lot of, I used to take care of the University of Pittsburgh football team and I had a lot of 20-year-olds with knee arthritis because the impact was so great as linemen hit each other that they would wear out their cartilage. So wear and tear arthritis, osteoarthritis, is loss of the cartilage layer on the end of bone. It causes aching pain. It causes swelling. It causes stiffness.

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And then to the degree that you have it, we can treat you conservatively through a variety of ways, or at the end of the road, we can replace your joints.

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I never say, let's have you do 150 minutes of moderate exercise because I have access to lactate threshold testing where you're walking on a treadmill, running on a treadmill, or on a bike. Every four minutes, we're pricking your finger. And I can tell exactly when your mitochondria, the little energy storehouses in your cells, go from burning fat to burning carbohydrates.

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Here's what I'm telling you. I'm telling you that every musculoskeletal tissue has alpha and beta estrogen receptors. We know that when those sit empty, you will manifest some of the musculoskeletal syndrome of menopause. 80% of us do. What I'm telling you is that

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Estrogen sitting in those receptors can prevent bone loss, can prevent muscle loss, can decrease the inflammation of arthralgia and frozen shoulder. So everyone gets to make their own decision. People are thinking beings. They have agency. They get to make that decision to get out of pain and to prevent the musculoskeletal syndrome of menopause based on science and not fear.

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Yeah. How do they live? Not like this, right? They squat. Yes.

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Yes. Well, back pain is endemic in our population due to our lifestyle. We're sitting here for several hours. I'm probably sitting like this all hunched over at some points. Our cores are relaxed. Our front cores are relaxed. Our lower back is relaxed. There's no stimulus to keep our cores strong sitting in a chair. And we do this 10 hours a day at least, right? That's number one.

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Number two, then 70% of people do no meaningful exercise any time of the week. So we never rebuild it. So we get low back pain due to muscle weakness. And another reason we get low back pain, particularly in women or very elderly men, is compression of our vertebrae, compression fractures of our spine. That can be very painful. It presents as low back pain.

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I want to differentiate for people listening the difference between low back pain and nerve impingement that needs surgery. Low back pain is that aching in your low back, the stiffness. When you go to a doctor with low back pain, they should be telling you how to get stronger, sending you for physical therapy, to stop smoking if you're smoking because that poisons bones, right?

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All the lifestyle things. If you have pain starting in your back, but shooting down your leg like electricity, down the back of your leg, like literally, think about how lightning would feel. That is because a nerve is being impinged as it comes out of your spinal cord. That is something that needs to be examined and looked at.

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But I just want to differentiate that because a lot of people mistake the two.

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I do. And walking treadmills. Because there's so much work that we do during the day that isn't deep work. We're emptying out our email. We're returning some phone calls. We're doing the less brain-heavy parts of our job. All can be done standing. Or I've encouraged groups of people that I work with to hold their meetings doing wall squats. Just don't sit at the board table. Pull up a wall.

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Everybody squat. Better be a pretty quick meeting because that takes a lot of strength. But to build in that kind of mobility, the only time we really need to sit is when we're solving world peace.

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And that place is called the fat max. And that is when your mitochondria, your energy organelles, are most efficient. And that's where we want to work out. 80% of the time. So that's just an example of how I'm going to tell you what heart rate you need to work out in.

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The rest of it, we can stand. And in fact, studies have shown that if we're trying to learn something, it's better to be moving as we learn because the kinetic energy of learning is better for our brains. For instance, I used an example yesterday, actually, when I was teaching people how to time manage.

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And I said, when I'm listening to long form podcasts like this, I can't sit for three hours, but I can walk. and listen, and I retain more, for instance.

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The very first one we did on Masters athletes, answering the question, at what age do we really slow down? Because if you believe Hallmark... And all the rest in peace balloons that go around on your 40th or 50th birthday, slowing down is an inevitable part of aging.

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But the fact of the matter is, and our study showed, that when I looked at track and field athletes in every race from 100 meters to 10,000 meters, and I looked at the top eight finishers in every age group in every race, that we do not significantly slow down. until we're past 70. So between 50 and 70, the guy who won the one-mile race finished it in four minutes and 34 seconds.

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The same year of the study, the kid that won the high school mile race did it in four minutes and 17 seconds. The 70-year-old who won the one mile race did it in a little less than seven minutes. It just shows you that if we're slowing down dramatically before our 70s, we've either decided not to train so hard. We're just not trying anymore. We've been terribly injured, right? And we can't.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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Unbreakable goes strong, live long, age with power. And it really picks up the conversation of aging and longevity that I've been talking about for a long time, but really focuses on the longevity of women. So the book is framed around the pillars of aging, which I call time bombs. The time bomb of metabolic dysfunction. The time bomb that we think means our DNA is our destiny, which it is not.

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We can modify ourselves and several others and really explain the science of what's going on and that aging is not an inevitable decline from vitality to frailty unless we cop to that attitude, right? And then the second part of the book... lays out a lifestyle that I call unbreakable. It's about muscle. It's a bone. It's about nutrition. But the most, a very important part is what you just said.

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I'm going to tell you how to fill the gaps in your nutrition instead of just doing broad guidelines because that's the state of the art right now.

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It's about attitude and mindset. And so I help people set standards and goals for what they want based on their values. If I didn't value independence, if I didn't value having my brain till the very end and all the other things that I value, then my goals would be uninformed. I could say, oh, I want to run a marathon at 80, but that's not enough unless it's connected to my values.

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And then further along, we talk about building resilience because brain resilience can be built in the same way that skeletal resilience can. And I believe it takes both of those things to progress and to age with power. And then the final sections of this book really take us to the next level.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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How do we, now that we've optimized our health and decided that we are not the victims of time, I don't believe that. I believe we can shape our future. What do we do for peak performance? How do we continue to squeeze performance out? And what are the cool technologies that can help us?

The Diary Of A CEO with Steven Bartlett

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Last week, I was speaking at the American Diabetes Association and talking about midlife and menopause, which you and I have talked about, and all the metabolic changes that go on when estrogen walks out the door. And we've already talked today about prediabetes and how we need to put on a big alarm because of all the metabolic changes that will lead to diabetes and Alzheimer's.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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But when I look at those two things separately, perimenopause and all the metabolic changes and the lipid changes and the fat distribution and the insulin insensitivity and prediabetes, they are nearly identical. And what we know is that this is another alarm to sound if we have not paid attention in the critical decade of our lives.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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and become pre-diabetic and then are a woman and lose our estrogen, it compounds the normal metabolic changes that happen with insulin resistance to the loss of estrogen. And after menopause, women have more diabetes and therefore more Alzheimer's. And so if I can back all this up and start people thinking about it when we're 35, that is work worth doing.

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You know what, Stephen, if I could get more men to take the attitude that you've just expressed, to have the curiosity to learn about the changes in midlife women, and not only bodily changes, but attitudinal and the sexuality changes, I think we could save a lot of marriages. But I find that...

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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For the lack of knowledge there is amongst the women, there is even less knowledge among the men, but if it's a partnership. So I think your attitude and curiosity is laudable because I think we could save a lot of relationships if everyone felt that way.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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I think how you know when it's enough, when it becomes, if it pertains to work or striving for something or is when you don't love it anymore. When it becomes a grind and you don't love it, that's when it's enough because it's not feeding you.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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Well, I love that question. And the one word answer is yes, every season of our life is different. Let's take bones, for instance. We build, build, build bones until in women we're about 28 and men 30. We reach peak bone mass. we then reach a plateau where we keep our bone density. And then in women, it begins to plummet due to hormonal influences.

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And it's even things like a woman breastfeeding will lose 20% of her bone density in the first six months. But it's not inevitable. And I will lay out a lifestyle that I call unbreakable. It's about muscle, bone, nutrition. But the most important part is mindset.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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For men, men usually maintain their bone density until their 70s when they plummet, unless they have a metabolic problem, an autoimmune disease, or having had the need to take a lot of steroids. And Then you see a big difference at 50. So in bones, that's a good example how every few decades our bones are reacting differently. Muscle is the same way.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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We know that we can gain muscle at any time in our lives, but we do it most easily until we're about 30, right?

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We also know of changes in the way our gut functions as we age, having to do with absorption and the ability of the microvilli in our gut to absorb nutrients and different kinds of nutrients. Women in midlife, for instance, need vitamins that are something called methylated, which means broken down a little more because our gut function is less efficient.

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Well, men, because of the influence of testosterone and the genetics of having XY chromosomes, build more bone initially, thicker cortices, more absolute poundage of bones. And then because of the plummeting of estrogen, which is critical for bone health,

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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women lose bone faster than men, such that after about age of 40, when we get to that plateau, women start to lose bone density about 20% by the time they get to their menopause. And that can have dire effects for women, but that is all due to the role of estrogen on controlling bone density.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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It is not. In 2004, we studied a very large group of master's athletes, meaning athletes 40 and older, in the National Senior Games, which is Olympics for people of that age demographic. And the National Games, you have to have won your state games. to qualify. So these were pretty high-level recreational athletes. So we did a study looking at their bone density across time.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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And the first thing, the first study we found was that with chronic exercise, such as these people did, you could maintain your bone density at a very high proportion into your 80s. The second question we asked was, okay, If we know we can do that, what exercise is really important for that? And so we divided the sports up into bounding sports where the bones were being impacted.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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Yes. And it's because of the plummeting of estrogen, which is critical for muscle, bone, tendon, ligament, back. And without it, it can have dire effects. So you need to know the following.

The Diary Of A CEO with Steven Bartlett

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Like basketball, running, volleyball, anything where you come down hard on your bones versus swimming, bowling, biking. And we found that bashing your bones, impact, was as important in maintaining bone density as things you can't control, like your age, whether you're born with XX chromosomes or XY chromosomes, family history.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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impacting bones, causing them to build up over time is critically important for maintaining bone density. So to answer your question, is loss of bone density inevitable? Loss of estrogen is inevitable. Loss of bone density doesn't have to result in osteoporosis, fracture, and frailty.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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Well, you know what? I'm on a rampage for this year to make bones sexy again. Because here, from a very superficial level, is why we should care. And then I'll tell you from a more scientific level. You know, we only think of our bones usually in a couple times. Like you look in the mirror and somebody tells you, oh, your bone structure is magnificent. Look at this model's bones.

The Diary Of A CEO with Steven Bartlett

The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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And we're all touching our cheekbones. Or we think about them when we hear about a great archaeologist. who's just discovered a new people group, and we can tell from our bones how they lived, how they died, how healthy they were. In fact, in that setting, bone is the last remnant of your whole life. It endures the longest. I mean, the history you talk about in your bones outlives anything.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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Muscle goes away, skin goes away, everything except your bones, which remain. That's fascinating, right? But The other reason we even think about our bones is when they break, right? People think bones are silent, like a strong, silent type just hanging back. Until they break and then they're screaming at you, right? And causing frailty.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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And here's some bone stats because the real answer to the question is coming. One in two women will have an osteoporotic fracture in her lifetime. So it's either me or your partner or me or your assistant, right? One in two will have an osteoporotic fracture. Women have 70% of all hip fractures.

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Hip fractures are one of the main contributors to ending up in a nursing home because you can no longer walk and take care of yourself, right? 70% are women. If you break your hip, 50% of the time, whether you're a man or a woman, you will not return to pre-fall function. You cannot go live in that house where you raised your children.

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The Ageing Doctor: These Are They Early Signs Of Arthritis! If You Run & Don't Do This, Start Now! The Secret Cause of Alzheimer's!

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You may not be able to drive and go be totally independent, right? And 30% of the time, it's a huge number. 30% of the time, you will die, either from the complications of the fracture, from the bed rest, from the infections you get, the bladder infections, just the sequelae of being that sedentary. So those are not meant to scare people.

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There's a light behind the bed. There's ivies dripping with this beeping thing. And it's me and you there. And our entire goal was to give you this poison so that you could live another day, another years, right? The gravity of that, the hope of that was not lost on me. The view of, do you know what women and I would do all night?

The Mel Robbins Podcast

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I would come in and out, and we would be shopping on the home shopping network. I only reflected later, like, what were we doing shopping? We were just trying to be normal women in the grips of the most abnormal situation you could ever be.

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But you can imagine, Mel, how could I be 23 years old, live through the most vulnerable part of a woman's life in which she is fighting for her life, and not come out a different person? I took that six years at the bedside of strong, brilliant, surviving women, and it's flavored the rest of my life.

The Mel Robbins Podcast

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And there might not be a big correlation between pushing chemo and putting metal in bones, but what it has done is provided for me a deep empathy to the human condition.

The Mel Robbins Podcast

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You know what, Mel? I don't mean to cry in public, but I am still a practicing surgeon. I have looked into the eyes of more than 100,000 people in my lifetime as a doctor, and I started as a cancer nurse, right? But I see the future of people today every day when I take call, and this is what it is. And I've got to solve for this. You and I have got to solve for this.

The Mel Robbins Podcast

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When your Aunt Mary breaks her hip, and I'm called to the hospital bed to see her, and She is laying there in excruciating pain, balled up at the bottom of the bed with that horrible blue gown on that we put people in. And she doesn't want to be moved up because it hurts too much, right? From bones that she never even paid attention to, never knew she had because we ignored it.

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Now they're screaming. That's number one. Number two, what's happened to her is she's laying there in a pile of her own urine because she was not treated for the gynecourinary syndrome menopause. Her pelvic floor got weak. So many women do not talk about the fact that they become incontinent in late in life and have urinary tract infection. So she's painful.

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She is incontinent, which if she even realizes it is pretty, she feels ashamed about that. I need to do a 45-minute surgery on her where because she's broken her hip, I need to put a rod down that, the size of my thumb, actually. I cannot do that if her heart is not healthy enough to withstand anesthesia.

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And many times, her heart is so unhealthy because she's taking care of everybody else in the world except herself that the hospitalists have a hard time clearing her heart. And do you know what else? She either has a touch of dementia or she has full-blown Alzheimer's. That is the state of women that I see every time I go to fix a hip on call.

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And do you know in her lucid moments what she is saying to me? She is standing there with her daughter. It's usually the eldest daughter at the bedside. She's looking at me. She's looking at her daughter. And time after time again, she'll say something like, I've not always been like this. I don't know how I got here. Don't ever let this happen to you. Don't get old. Well...

The Mel Robbins Podcast

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I am not blaming her at all. I see the future of women, Mel. I can't not not cry. If we know we have within our hands to change the trajectory of our future, and if we choose to not be the victims of the passage of time, we don't have to end up like all those women I take care of, 30% of whom after they break a hip will die.

The Mel Robbins Podcast

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We can choose another path, but it takes conscious effort and a belief that we are worth it.

The Mel Robbins Podcast

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So when we think about living longer, we quantify that as how many years we're going to live, the lifespan. And in the United States, for women, it's about 81. For men, it's 76.4. But what we know from our research is that life expectancy does not equal health span. Those years in our lives when we are healthy, active, vital, joyful...

The Mel Robbins Podcast

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What we see is people spend the last 20 years of their life going to a doctor's office three times a week in a steady decline. But listen, that is not the way it has to be.

The Mel Robbins Podcast

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And so what I spend every day doing now, not only treating people for bones and longevity, but I am teaching them to build this unbreakable lifestyle so that they are not the victims of the passage of time, which we can all succumb to if we're not intentional.

The Mel Robbins Podcast

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Well, when I say things like mobility is medicine, movement is medicine, it's because there is this phenomenon, and I wish I had made this up, called sedentary death syndrome. It is the 33 chronic diseases that kill us in this country. It's everything you've thought of. Heart disease, brain disease, stroke. It is diabetes. All of those 33 chronic diseases...

The Mel Robbins Podcast

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that people die of are directly treated by moving. Because if you have high blood pressure, you'll take a pill for that. If you have cardiac disease, you'll take a pill for that. If you have dementia, you could take a pill for that. One pill, moving your body, is the medicine that positively affects them all. So if we want to cure sedentary death syndrome. It involves the medicine of mobility.

The Mel Robbins Podcast

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Now, let's just take two steps back so that we acknowledge that we don't control everything in the future. There are legitimately these time bombs of aging that just happen at a cellular level. But the thing is, our lifestyle can control our mitochondria, the energy of our cells. They can control how many bad cells circulate around. They're called senescent cells or zombie cells.

The Mel Robbins Podcast

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We can control that by the lifestyle we live. We can control inflammation in our body to a certain extent with the lifestyle we live. And so all these time bombs that age us faster, we are not the victims of the passage of time anymore. If you want to feel better now, then that is an action step. It is not reading more about what could happen to you and putting the book back on the shelf.

The Mel Robbins Podcast

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It is learning how to take action to change the trajectory of the future, or else you are a victim of the passage of time.

The Mel Robbins Podcast

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So When we look at aging studies, you will often find things like, oh, we slow down when we age, we lose our muscle. And some of that is true, right? It is true. I'll concede that. But in big population studies, like there's a study that was going on when I was at the University of Pittsburgh called the Health ABC.

The Mel Robbins Podcast

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They took a cohort, a group of 70-year-olds and just followed them to see what happens. They all slowed down. They developed a lot of body fat. All the things you think about in aging. Well, when you look at the U.S. population, and it's not that different around the world, 70% of us don't do any form of mobility or exercise a day.

The Mel Robbins Podcast

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It's like this thing I described to you, 20 hours sitting down, right? So what do we know from those population studies? We know how we age if we don't move. So my group and I, I formed this group early in my career called PRIMA, the Performance and Research Initiative for Masters Athletes. Masters just means people over 35 or 40. Gotcha.

The Mel Robbins Podcast

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Yeah, it's a category. So... All of my academic research has been investigating what happens if we take sedentary living out of the equation in terms of our aging. And so I was the principal investigator on a number of studies that looked at bone health, muscle health, brain health, our stem cells with aging, all looking at when do we slow down if we continue to be active our entire lives?

The Mel Robbins Podcast

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And we started studying people, active people, they were not professional athletes, asking the question, what are we capable of if we take the variable of sedentary living out of the equation? Can we maintain our muscle mass? Can we maintain our bone density? Can we maintain our brain function? When do we really slow down? And we found that in our active people,

The Mel Robbins Podcast

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35, 40 and up, all the way, I think my oldest in these studies were 103, that yes, indeed, you can maintain your bone density. Yes, indeed, you can maintain your muscle mass. Yes, indeed, you can retain the cognitive function in the front of your brain. Yes, indeed, we can stimulate the production of longevity proteins all together.

The Mel Robbins Podcast

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with something as simple as moving our legs, walking around, competing in a little sports, because remember, we are designed to move.

The Mel Robbins Podcast

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Yeah, yeah. So, you know, the study that you're describing has been published since 2011, and it was one of the first, really, to answer the question, can we maintain our lean muscle mass with simple daily activity? So this series of three pictures has become iconic on the internet. I should have named it because it is everywhere. Gym people put it up in their gyms. But what it shows is this.

The Mel Robbins Podcast

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The study was looking at master's age recreational athletes. Nobody was a pro athlete in this. They were mere mortals like you and me.

The Mel Robbins Podcast

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Yeah, master just means that you're out of the Olympic pipeline. You're a normal human being. You're a normal human being. So my patients were all normal human beings. So in the study that we're looking at, there are three pictures. I did this study using an MRI, which if you've ever had an MRI, you know, you just lay really still, you go into a tube, and it's really loud in there.

The Mel Robbins Podcast

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And all that clanging and banging is we're taking pictures of your body with a magnet. It's such cool technology. So in the first picture... We have slices as if you were slicing up a ham. If you see this picture or if you're imagining it, think of the Christmas ham. There's a bone in the middle. There's a layer of muscle on top. There's a layer of muscle on bottom.

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And there's a very, very thin rind of fat around the outside.

The Mel Robbins Podcast

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So if you look at the 40-year-old slice, I call that exactly what you said, the flank steak. Very lean, no marbling, very thin fat that you don't have to do anything with. And when we tested the strength of these athletes, they were strong. Then if you sit around for 35 or 40 years, this is what happens. The cottage cheese picture I call Kobe beef. Kobe beef? I don't even know what that is.

The Mel Robbins Podcast

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That is that Japanese cow that they massage and all the meat has all this fat in it. So if we sit around for 30 years, we lose all of our muscle architecture. We become very weak. And you're right. It looks very disorganized. And so this person in the middle picture can't get up from a chair.

The Mel Robbins Podcast

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So what are we doing in those last 20 years if we don't pre-plan that? If we don't get in front of this, I call 35 to 45 the critical decade. Why is 35 to 45 the critical decade? Because If I say O25 was easy, by 35, most of us have figured out a little bit to what to do in our careers, unless you're a surgeon like me and you're still training, but figured out some things about life.

The Mel Robbins Podcast

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Sometimes by that point, people have made relationship commitments. Sometimes they've made raising other little people commitments difficult. But you are still young enough with youthful vigor, with youngish stem cells to course correct.

The Mel Robbins Podcast

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So if 35 to 45 is the time to develop the habits of mobility, to develop the habits of lifting weights, to look at what you're eating, your body is not a garbage can that we just shove whatever in, right? Yeah. I mean, you can burn anything for fuel, but should you be burning the noxious, right?

The Mel Robbins Podcast

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Because what happens at 45 for women, and even to some extent for men, is we start going through perimenopause. And it's not a continuation of the game for women. It is a different game. So if we can, in the critical decade, get these habits established, it will not be such a shock as those people who come to my office at 65 and say, oh my God, what do I do now?

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Yeah, aren't we all over for all the cool kids are? Listen, the short answer is no. There is never an age or skill level when the strategic stress you put on your body in the form of all the things, mobility, strength training, smart nutrition, will not dramatically change the trajectory of your health. There is not an age.

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You can still take steps to feel better every day, even if you're sick and you don't feel great every day. You can pick up the phone and talk to somebody in your life. I'm thinking to myself, maybe the only person I still know is the barista. If I'm 97, the only person I know is the barista at a coffee shop, then go say hi to that person every day.

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It's not rocket science, but the basic thing is people don't invest every day in their health and mobility. So critical decade, let's get our proverbial thinking. expletive together. I don't know if I can cuss on your show. You can say whatever you want. Let's get our shit together, people. Can we please stop taking every day for granted because it's easy and you're young?

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And can we please take a minute to notice ourselves? Try to figure out what your body's saying to you, because I'm going to tell you for sure, your body speaks to you every day, whether you're listening or not. Can we please stop abusing ourselves with quite so much alcohol because we can metabolize it when we're young?

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And so what if you've been sitting around for 30 years and you're like, is it too late for me? Am I the guy in the middle picture with the fat rind all over my leg? Listen, remember your primary skill is walking. So if you're doing nothing else right now,

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You put on your headphones, you get up and you take Mel and I with you and you walk around the block because I am not telling you that the first day out the door, you have to do five miles to be successful. You just need to get up from your seated position and invest in yourself.

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That is absolutely the truth. And if you Google, you can find all kinds of examples of people that are seeming anomalies, like mistakes, that they're 92 lifting weights for the first time. Oh, somebody's mother started lifting at 70 and now she's a bodybuilder. That is our troop capacity. to build muscle, to take more steps, to develop relationships. That is our capacity.

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Our capacity and our design is not sedentary living.

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It's what I am. It's my lifestyle. It's not a diet. It is not a six-week exercise program. It is my lifestyle. Because I think people can get overwhelmed with all the information that's out there. What frequency do I have to get on the vibrating plate? How many pounds in my weighted vest? I mean, can I jump? Can I jump on a trampoline?

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Listen, people, we get so caught up in the 99% of minutia when we are not even taking the first step. If we focused on the 1% that we know is true, these things that I... Keep saying and we'll detail for you. If we focus on that, when that is your lifestyle, then you can layer on the complicated stuff. But I really feel, Mel, that we get so caught up in the data overload that we get so paralyzed.

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Even if you're in pain, listen, let's talk about some pain because I am an orthopedic surgeon and people come to me in pain. I get it. You don't want to get hurt by trying something new. I get that a lot. But walking is not something new. That's true. Let's be honest. Or it hurts when I walk. Or I don't have the time. Or listen, I've been doing this so long.

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By the end of the day, I hope that I have changed your whole perspective on aging to realize that you do not have to be the victim of the passage of time and become frail by the simple tools we're talking about today with mobility and all the other things that there is no age, no matter where you find yourself today, there is no age and skill level where it is too late, that your body will always respond to the positive stress you place on it.

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I often say to people, you cannot out excuse me. I have heard it all. If your knees hurt when you walk on dry land, well, then let's go to the local Y, which has a hot pool and a budget program, and let's get in that water and walk, right?

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Even if we have to walk around our kitchen table until we can walk outside, or we have to get up and down from a chair until we can go to a gym, you just have to make the effort because what happens if we don't?

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Joints are the mobile parts of our body. They're comprised of at least two bones, sometimes multiple bones, surrounded by a capsule, which is like an inside skin. Muscles attach around the joint to move it, right? So if we step back and think of the musculoskeletal system, what is that? That is muscles, bones, tendons, ligaments, fat, actually, muscle stem cells.

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All of those tissues that we sometimes put in little boxes, they belong in their own houses, are actually cousins. They are all derived from the same type of cell in the beginning. So they all speak a similar language. Bone we think of, okay, there's on either side of a joint. We think of it as just the skeleton at Halloween, right? Just these structural things, they're hanging out.

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That's all they do is structure. They're like the strong, silent type. You never know where they're there until they say something profound. In Bone's case, it's a fracture. The truth of the matter is, Bone is your body's master communicator. And think about it if we think about how we're formed. There is Bone from the top of our head, to the bottom of our pinky toe, why wouldn't we be designed?

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That bone is not just structural. It is releasing proteins, hormones, osteocalcin is one of them, that communicate everywhere. So when bones release their hormones, I'll give you one example, osteocalcin, it goes to the brain

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And it stimulates the release of something in the brain called brain-derived neurotrophic factor, long word and acronym, which means we build neurons after stimulation from the bone. We know that people with osteoporosis, which means bad bone, weak bone, have more dementia. There is a communication pathway going, right? It's like mind-blowing. Bone sends out osteocalcin to muscle.

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It speaks back to muscle and helps it with metabolizing glucose. Bone sends out osteocalcin to our pancreas, which is where our insulin comes from. So between talking to our muscle and talking to our pancreas, that is glucose metabolism. equilibrium, right? It helps us not be diabetic. If you're a man, osteocalcin goes to your testes and helps you make testosterone.

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So this intercommunication of muscle and bone gives a whole new perspective on just this skeleton in the closet that just...

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However, I also recognize, despite the fact people, you can't out excuse me, I've heard them all. I realize that it is very difficult for people to invest in a future they can't see. And so I learned this concept from the banking industry called temporal disconnect.

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The bankers in this country are trying to get us to save 10 cents a day so that we have some money to retire on, and that is difficult for them. I find the same trouble trying to motivate people or have people motivate themselves to invest every day in their mobility. Because everything we've talked about, if you're 40, you can't imagine what you're going to be like when you're 80.

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And so why do you care? Because today you're doing your thing. So how about feeling amazing today? I can tell you for sure, Mel, that when I hop off a treadmill where I have done sprint intervals and not fallen off the back of the treadmill, or I have added five more pounds to my deadlift, Oh my God, I am such a badass when I do that.

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It's not only for my body, it rejuvenates my brain and makes me have hope for the future because I'm going to be that cranky 90-year-old lifting my own suitcase to the top of the thing. And if my old friends can't keep up with me, then I'm going to travel with some young whippersnappers who can keep up with me. But if I want to be like that then...

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So I have an acronym that I use to help form the ideas of exercise for midlife people. It works for everybody, critical decade, but I call it facing your future. Here are the four components we need to work into our life. Facing your future. F-A-C-E, face your future. Okay. Number one. flexibility, and mobility.

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Meaning, if we do not move our joints through their full range of motion, like an old car sitting in a junkyard, we will become stiff. Because the natural history, meaning what happens in time with our tendons and ligaments, is they become tighter and tighter and tighter. That is the way nature happens if we don't invest in making it not so.

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Pilates and yoga are amazing for maintaining flexibility, mobility of the joints. It's also great for core, a solid core. So that's number one. Number two, aerobic. We must invest in a healthy cardiovascular engine. So how do we do that? Well, we grew up in a time where we were high intensity all the time.

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We know now, and my philosophy on this has changed over the years because I'm a curious, evolving person, that I want to work at the two extremes, meaning most high intensity interval training, and I can name several brands of gyms that do this, work you out in a mid-range where it's not light enough that you're not going to get hurt, and

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And it's not intense enough that it's going to stimulate real change in your body. So these HIIT classes where you're working in the middle zones of your heart range are a good way to get injured and see me in my office on Mondays. So when I prescribe aerobic exercise to people, I say walk or slow biking or low heart rate, any apparatus works.

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I say walk, but hear me, any apparatus works or the ground. Do that, and then we're gonna sprint our guts out a couple times a week. Sprinting does not mean you're Usain Bolt on a track. Sprinting is a heart rate phenomenon. So we're gonna work as hard as we can go so that we're almost so working hard we're going to throw up a couple times a week.

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Literally, that sounds absolutely horrible. This is what happens. You're going as fast as you can. Your fast is probably faster than my fast.

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Well, there is that. There is that. But the concept is low heart rate most of the week. So I'm asking you to walk every day. Yep. And then twice a week after you've done your walk, I'm asking you just to go as fast as you can, whether it's on a rower, an alpine, a treadmill. But here's the kicker. It's only 30 seconds. You can do anything for 30 seconds. So I'm going as fast.

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I choose to do it on a treadmill. So I'm just going to give your audience an example. For my walking, I'm at an incline of four to five. Okay. And a speed of about four. So I'm just going along. I'm listening to your podcast. I'm learning. I use it as a multitask learning time. Okay.

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When I am done with that for 45 minutes, I take off all the apparatus because I need my brain to concentrate, and I hit 11 on the tread, the whatever. I don't even know how many miles. It's fast as my legs can go. And I go for 30 seconds, and then I totally turn it off, and I fully recover. 30 seconds with full recovery. four times. This is what happens. It sounds daunting. It is not.

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It's only 30 seconds. That is going to stimulate more connections between our brain and our muscles to contract better together. That is going to build a big cardiac muscle, right? So let's stop wasting our time in the middle. We can take classes because they're fun, but unless you get these two things in on the ends... In midlife, we're not stimulating ourselves enough. So that's F, flexibility.

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A, aerobics. C, carry a load. Notice I didn't call it weightlifting, although it is weightlifting, but you can do it in your house. You can pick up the five-gallon bucket and farmer's carry across the front yard. We need to lift weights.

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We need to lift heavy and midlife because for women in particular, around 45, we enter perimenopause where our regular cyclic hormones go up, go down, go up, go down, become total chaos as our ovaries retire such that by the time we're 50 and our ovaries have completely retired,

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There is a pervasive myth in this country that aging is an inevitable decline from the vitality of youth down some slippery slope to frailty, where we spend the last 20 years of our lives dying. But the fact of the matter is, we actually can be healthy, vital, active, joyful, But people think that they have to go down this slippery slope and that there's nothing they can do about it.

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We do not have the stimulus of estrogen on our muscles anymore to stimulate our muscles to grow so that we do not become the one in three women who ends up frail in a nursing home or with a broken hip, which I'm happy to give you the dire statistics on that. We must build muscle mass. I am all for Pilates for balance and flexibility.

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I am not for anything except learning to lift heavy to build muscle. So what if you've never done it? There are great online programs. We are not without resources these days. This might be the time to invest in yourself by investing in an expert. You take your car to an expert. Take yourself to an expert and have someone teach you the proper techniques so that you don't get hurt

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walk you around the gym so that you have a friendly face taking you around. You don't need years and years of personal training or strength conditioning coaching to learn. You need a few lessons and then you can build on that. And so once you're starting to lift weights, we want to progressively load to lifting heavy. No mamby-pamby pink weights for midlife women.

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We can put down the little weights in the attractive pastel colors that, I know, I'm being so patronizing that we lift 30 times.

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Well, if we think about this from a purely structural standpoint, muscle is what will help us get up and down from a chair. Right. Right? Want to live alone or have the opportunity to live alone? You have to get up and down from a chair. You have to be able to transport yourself to the bathroom. You have to be able to lift a dish into the microwave.

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But if you want to enjoy your life, you need to be able to be strong enough to get out of your house, right? So from a very practical standpoint. But muscle, like bone, are not just structures. They are metabolic organs that talk to each other in a community. So when a muscle contracts, skeletal muscle like your biceps contract, it sends out all these communication factors. One is called irisin.

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It talks to the bone and helps you lay down more bone. It is critical for glucose metabolism, which is our ability to process our food, right? It is critical for the brain. It goes to the brain. But that's not all. Muscle releases a protein when you contract it called clotho, clotho. Clotho was the goddess of the threat of life, right?

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And it was first described in a journal called Nature about 30 years ago. The simple act of contracting skeletal muscle causes our muscle to make this protein Clotho, which is the longevity protein, and goes to all of our organs and keeps them functioning in a healthy, more youthful way. And we know from animal studies that mice That can't make clotho die old, very young.

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They have the potential to behave this way. Let me tell you about another study we did with this protein clotho. So, if I say to you, contract your skeletal muscle, it's going to keep you younger, and you're like, right. Well, we did this study where we measured circulating levels of this protein Clotho in three groups of people. Clotho, the longevity protein.

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I measured it in active people over 70, and I measured it in sedentary people about 35. Well, not surprising, people in midlife who were active had the highest level of longevity protein. But you would think 35 trumps all. It does not. The active people over 70 produced more Clotho longevity protein than 35-year-old sedentary people. Wow.

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So there is not an age or a skill level when the positive stress that we do with our bodies can't change our health. And this is one simple example through a protein called Clotho.

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But the fact of the matter is there's so much we can do to pre-plan our future.

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Oh, E. E is equilibrium and foot speed. I'm so glad you brought us back to that. Equilibrium means can we balance? Every year from about 20, the neuromuscular pathways that connect our brain to our muscles can degrade. And that's why you reach over for something and fall over, right? Or trip and can't catch yourself.

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So in every exercise program I prescribe, we not only have flexibility and mobility, aerobic, carrying a load, but I teach people foot speed. Meaning we're in my little, we're in our, my office is in a giant performance center. And we're teaching people to rapidly move their feet because this is what I do. I come into my office. I throw my work bag next to my desk.

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And if I'm not thinking when I get up from my desk, I get up too soon and I will catch my foot on my bag. Well, if I didn't have the foot speed to hop over my bag, I would land flat on my face, fallen. We break when we fall. So in my book... We can build all the muscle we want, but if we have no balance and can't stay upright, we can still break. And so I teach people that.

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And, you know, something simple to regain balance that I ask people to do is brush their teeth on one foot, like in tree pose. Because that's one foot. It's usually on a carpet or a bath mat. You're moving your body. So if you alternate legs every day, you will regain the core strength, the muscle strength to stay upright with a little bit of imbalance.

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So on a weekly basis, we need to be spending at least three hours a week walking, broken up into 45-minute sessions. So put on your favorite podcast, go learn all week, right? So that's four, go for a walk four times. At least four times a week, right? At a brisk pace, not so fast that you're out of breath, but not so slow that you can solve world peace in your conversation.

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A minimum of twice a week, minimum of twice a week, we must learn to lift heavy. And listen. How heavy? Yeah, I know. I don't expect you to power lift right out the door, but what I do expect you to do is learn to lift your own body weight. Every woman should be able to do 11 pushups, regular pushups. On the knees, okay? No. Oh my God. But listen, you can build up to that.

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I used to teach classes at Pittsburgh called Start, and I did it for nine years. My starters started out with 51% body fat. They could not hold a plank and literally couldn't walk around the track. Over a three-month period, we met with them twice a week. We did a variety of weight-bearing exercises. They not only completed a 3.2-mile walk run, they could hold a plank for two minutes. Wow. I know.

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We have to start by learning to lift our body weight and progress until we can lift heavy. And what lift heavy is defined as, that is the weight- in an upper body push-pull, so something like a bench press, something like a pull-up, lower body push-pull, something like a squat, something like a deadlift. Heavy means what you can lift four to six times.

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To keep it simple for my people, I'm like, four times, which we want to lift to fatigue. Listen, you don't get there overnight. If we're starting at just body weight, it may take you six months, maybe nine. to learn the technique and to work up, but it is so worth it. And listen, I have plenty of examples of women starting in their 60s. There's no age limit on this.

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So heavy is an individual thing, and it just is something we work towards. So walking, lifting at least twice a week, twice a week when you're comfortable with walking, I want you to get your heart rate up really high. And you had a very simple way of doing that. 30 seconds.

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Complete recovery, it takes me, my example is I can get my heart rate up to about 186, and then I, two or three minutes, I completely recover. It's down to 130, 140. And four times you do that? Four times, and then that's it. And then I work on balance every day when I brush my teeth and foot speed. You can jump around, you can skip rope, but that's something else.

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Well, that comes from the knowledge that on the end of every bone, like for instance, I don't know if we can see this, on the end of this bone. Yeah, your whole, what do you, explain what the hell you're holding. I brought you my- It's like a dinosaur bone. It kind of is, except it's a femur. It's the longest bone in your body. It goes from your hip to your knee. Okay. Right?

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And so when people break their hip, this is what we're breaking. So if your Aunt Mary fell down and broke her hip, this is the bone that she's breaking.

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But if we're talking about this question you ask about why people think that running and exercising and lifting is bad for your joints, it comes from the knowledge that when I had a stem cell lab and we wanted to damage cartilage, which is the smoother than ice glistening end of a bone, all we really had to do is drop a marble. on it because it's very pressure sensitive.

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That being said, our joints themselves require mobility to be healthy because the way we feed our joints is through the pressure of the fluid in the joints.

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It does. Moving muscle, moving joints, lubricating cartilage with mobility keeps everything healthy.

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So, you know, if we step back and look at our bodies, I think nature is very conservative. If we were designed to sit still night and day, we would not be designed with our strongest muscles below our belly buttons. We would be sessile like a mushroom with this giant stalk and all the good stuff on top, right? What does sessile mean?

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And I'm going to give you an example from yesterday of a girlfriend of mine in Lake Nona who was a professional tennis player. But it could be anybody. It doesn't have to be a professional. But through the pounding that she did over her life, she did wear out her cartilage. And so I see this vibrant woman at the peak of her career

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In exactly what you're saying, she has knee pain and arthritis and she's not even as old as us. So I could have taken a purely medical route with her. I could have said, okay, I'm going to shoot you up with steroids every few weeks, which I don't do. But I mean, just I choose not to treat my patients with that remedy only. I could have said, okay, when you're ready for a total joint, let me know.

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But knowing that the body will respond with strength to the positive stimuli, we cut out all the inflammatory foods in her life because pain is an inflammatory process. And if we want to be in less pain, then we have to quit junkifying our diet, primary of which is the added sugar that the American food system has to the tune of 16 pounds, if I remember correctly.

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So, you know, Jabba the Hutt had this, you remember from Star Wars?

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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of added sugar a month that we don't even know.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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So I'm not anti-carb. I'm not saying everybody only has to eat protein. I'm saying when you eat carbs, your body responds in a least inflammatory way by eating fiber and complex carbs.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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So this morning here in this studio, I had eggs, which is protein, and some of the most gorgeous complex carb, multi-grain sprouted this and that bread that just came from your local place, which is so much slower digesting, Full of fiber, then a piece of white bread or an English muffin that's going to spike my sugar and it's going to make me inflamed all day long.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Had this giant blubberous appendage he kind of laid on. Yes. Mushrooms have this giant stalk, which doesn't go anywhere. So if we were meant to be immobile, we would have been designed like one of those two beings, but we were not. We were designed with the strongest muscles below our belly buttons. We have two legs. What is the first independent skill we ever learned? Walking.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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But simply changing the way that you eat can go a big change. And when I say, just to clarify that question, added sugar, turn over any label on a packaged food, it's going to say six grams of added sugar, 10, 15 grams. What? Why? So anyway, so number one, let's anti-inflame our diet. And that's what I told her to do. We really focused on

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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feeding the muscle I was going to ask her to build with protein and fiber, right? So that was number one. Number two, people are always interested when they come into me with arthritis. Sometimes we are in pain in our joints because our joints are pounding together, because we don't have enough muscle surrounding our joints to act as shock absorbers. So every step is a pounding, loud motion.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Instead of engaging our butt, core, and hips, our muscles on the front and back of our legs to shock absorb every step. So the second thing I did for her was to get her back to lifting.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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So do you know, I think women want to be slim so they look good in their clothes, right? Yes. I do. I know. I know. Me too. But I don't want to be slim. I want to be lean. Do you know what nature's Spanx is? No. Muscle. So if you have your same size 4, size 6, whatever your people are wearing. 8, 10, 12, whatever. I don't care what the number is. And we're thin.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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We can be 40% fat and thin and you still got this bulgy stuff coming out the side of your bra. But if you are lean, you are spanked up without having to put on all that elastic. So anyway, that's just my funny way of saying muscle is more than, you know, it can be cosmetic, sure. So for this woman, we're talking about her arthritis. We anti-inflamed her diet. We fed her muscle with protein.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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We got her lifting again so her joints aren't pounding. I put her in a pool. We're in Florida, but everywhere in the country, there's indoor, not that expensive pools. And she does her mobility in a pool, several days a week. She's just there moving all her joints. She was describing to me, she's lunging, she's high-kneeing.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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But doing that, getting the mobility in every joint in her body is without pounding. Hmm. And, you know, she was in the hall yesterday showing me how she's like, Vaughn, I haven't been able to lift my knee up to my chest in years. And there she was balancing on one leg. So listen, that is the whole person approach to arthritis.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Not just I'm going to stick some cortisone in you and hope for the best.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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But it doesn't make you strong. It doesn't anti-inflame you. Research shows cortisone lasts about three weeks. That is not enough because you can't give it every three weeks. I mean, I don't not medicalize arthritis and joint pain. I give people their own biology back. I use something miraculous called platelet-rich plasma, which takes blood out of your own arm. It's your blood. It's you.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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We spin off 10 billion of the platelets. Blood separates in a centrifuge spinning by weight, and I pull off the platelet portion. We have great research and multiple studies that show you can profoundly decrease inflammation by giving you back your own platelets because they're not just little sacks that make you stop bleeding. but they are sacks of your own growth factors.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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And so when I want to treat someone in a natural, whole way, I give them back what their body is already making to heal themselves.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Yeah, if you're healthy, absolutely, absolutely.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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It is human nature to move. So what is unnatural, Mel, is not continuing to move.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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You know what? I think sometimes when enough time has passed, you can end up feeling pretty hopeless. I mean, maybe you don't even know how the extra 50 pounds creeped up. Because no one... No one sets out as a goal in life to be immobile and to feel terrible and to be in pain all the time or have to have three closets of different size. That is nobody's goal.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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But I completely understand how time and circumstances can creep up on you, especially, listen, I'm a midlife woman. I went through menopause. I gained the 30 pounds that I then had to get control of and reverse and do all the hard things it took. to get back to feeling like myself again.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Listen, nothing is free, but if you believe anything I've said today is that, you know, just believe me on blind faith that your body will respond just right now. Get up, put on your headphones and go for a walk, even if it's around your kitchen table. If you're feeling like that, like it's just too late for me, I'm whatever age old. It's just too late.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Take the first step and do that today and tomorrow. And if you're worried about the work you have to do at home, listen. There is no such thing as vicious police. If you get done with your dinner and you push back and you're like, I'm going to go invest in myself, I promise. Nobody's gonna come to your house and arrest you for leaving the dishes on the table.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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You are more important than the menial tasks that you prioritize over your own health. So if you're just starting out and you're like, yeah, I wanna do something, just start by going back to your basic skill and taking a walk every day for seven days. I don't care how long it is. Once you've done something for seven days, it's a streak. And you don't wanna break your streak.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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You've done it for seven days, right? What if you're traveling? Well, you know you're going to sit there for two hours, walk around these giant terminals in the airport. Just push that suitcase. That counts.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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So you know what, Mel, if there are 300 million people in this country and we know that 51% of them are women, if we share this with 31 million women and they share this with five of their best friends, we will save the lives of 50% of people in this whole country and everybody they love.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I think that when you look at the statistics in our country and somewhat around the world, that 50, 60, 70% of people do no intentional movement a day. So we get up, We get dressed, we get in our car, we go sit at our desk for 8, 10, 12 hours, get in our car, sit in traffic for two hours. Then if we're lucky, we get eight hours of sleep.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I think we've had a lot of instructions today and a lot of things people can take little steps up, but here's what's not going to happen if what I'm going to say next doesn't occur. You can read anything you want. You can listen to me talk all day and give you instructions, but until you believe that you are worth the daily investment in your health, then nothing else matters.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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you will not take care of yourself until you believe that you are worth it. And so if I could change one thing, From people like you who are experts at helping people believe in themselves, I want people to believe in love of themselves because self-care is really loving yourself to take care of yourself. So if nothing else, please know that you are worth the daily investment in your health.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I think it's work worth doing, right? Yes. It's worth getting up for.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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If you add it up, we are probably like a mushroom in one place, 20 hours a day. That is not what we're designed to do. And so all of that sedentary living that we're doing... Because by nature, our organs work better when we're moving, when we're flexing our muscles, when our bones are being pounded. We age due to lack of mobility.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I love that question because I think that what we do too often is, and I always look over my left shoulder when I do this and say, oh my God, 25 was so amazing. Okay, well, 25 was easy, right? But let's think about that. At 25, I didn't know what you were doing, but I was still going to school. I had no money. I was still going home in summers to live with my parents. And

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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We're worshiping that when I contend to anybody listening, and I may have come to this late, I admit. How old are you? I'm turning 58 on Saturday. Oh, wow. Yeah, so I may have come to this late, but now I would say from 48 on, I am the most authentic, the most indefinable. I get to choose, and that comes from the confidence of of experience that I could not possibly have had at 25.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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So I'm not saying anything against my, I have a 17-year-old, I have all the way up to 36-year-olds and children in our blended family. It's a wonderful thing to be young. But if we are so stuck on the past, we will never be able to pivot, literally pivot our brain and our bodies towards the next 50 years. Because the reality is midlife for men is about 37. For women, it's about 40.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Hold on a second. Midlife. Midlife. For men is 37. Yeah. The life expectancy for men in this country is 76.4. So half of that, you don't even think that you're aging yet, right? Right. But if you really pay attention, and how could life possibly be over at 37? How could it possibly be over at 40? And yet if we don't pivot our mindsets, that's essentially what we're saying.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I want to backpedal for two seconds and pick up on something you just said. For women in this country, it's all about anti-aging. If I do nothing else in the next year or so, I want us to pivot that narrative because it's part of mindset. When you think of, in society, men growing older, we assign the word longevity. It's like legendary. It's about legacy building.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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It's about reflecting on being... For women, we have assigned this word, whether it is in literature, whether it's in our conversations, whether it is in the products we smear all over, anti-aging. As if, Mel, it's a problem. Aging is not a problem to solve. Aging is the most natural thing we do from the moment of conception to the very last minute of our death.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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It is the most natural thing we do. It's how we age that matters. And so I think to circle back to your question, in my career, it has always been my goal to change the way we age in this country. And we cannot do that if we don't believe it's possible. If I'm going through life thinking, oh, when's the next shoe going to drop? I'm just getting older every day. That is not a hopeful perspective.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I believe there's never an age or skill level when people cannot change the trajectory of their health.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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Oh, that's so high. When I trained, it was only three.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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So there began this culture that you had to be strong as an ox and twice as smart, which is a joke to say that orthopedic surgeons are just big, burly, athletic men. The fact of the matter is orthopedic surgeons is one of the most competitive disciplines to get into, so it stands to reason that women would want to get into it. Yes.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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So it has taken a long time for the culture to start accepting women into orthopedic surgery, although we're doing a better job now, obviously, than we ever have, but it's going to take us another 50 years to catch up.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I decided to go into orthopedic surgery because we get to take care of people from the moment of their births to the moment of their deaths. And it's aspirational because if I harness the power of mobility, I can save you from the ravages of chronic disease. So for me, I mean, I love the technical side of putting metal in bones and I use metal No, I use needles now to do arthroscopy.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I don't even have to make incisions. The technology is amazing, but that would never be enough for me because of just who I am and my mindset around taking care of the whole person. So the fact that I can help people aspire to healthy, vital, active, joyful...

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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I'm a much better doctor, and I have a deep empathy and perspective on taking care of the whole person and not just treating you like an ACL or treating... And I'll give you examples of these. Because I was a cancer nurse, so... In the late 80s, early 90s, when I was doing this, there was a tremendous shortage of nurses. And so you get out of college, they say, come train as a nurse.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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And in three years, youthful vigor. In three years, I got another bachelor's degree and a master's degree and started working on 11 Kellogg, which is a cancer floor at Rush University in Chicago. You cannot be 23 years old pushing chemo in the middle of the night to women mostly in the struggle of their lives. and not come out a changed person.

The Mel Robbins Podcast

Look, Feel, & Stay Young Forever: #1 Orthopedic Surgeon’s Proven Protocol

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At the time, most cancer care was done in the hospital. Now it's mostly outpatient. And at that time, nursing was primary nursing, meaning, Mel, if you're in the hospital every month for six months, I would have been your nurse, just me and you. And so in the middle of the night, Chemo is given at night. When I am there with you, and you can imagine, you've seen hospitals, it's dark.