Bone to Be Strong: Rethinking Women’s Health and Longevity with Vonda Wright, MD

[00:00:00] Dr. Vonda Wright: When anthropologists dig up bones and they start talking about the civilizations, “Oh, these were warrior people. They ate this. They were in this kind of battle. Oh, they had this injury.”  It's not because one shred of soft tissue remains, it's because our bone tells our life story. And when you think about it like that, why aren't we paying more attention to them? By the way?

[00:00:24] Dr. Melinda Ring: This is Next Level Health. I'm your host, Dr. Melinda Ring, director of the Osher Center for Integrative Health at Northwestern University. On this show, we explore ways to take actionable steps towards optimizing our health with leaders in the integrative, functional, and lifestyle medicine fields who believe in science-backed and time-tested approaches to well-being. Let's take your health to the next level.

[00:00:54] Dr. Melinda Ring: Many of us don't think much about our bones and muscles until an injury occurs, or a diagnosis like osteoporosis gets our attention. But my guest today makes the case that our musculoskeletal system affects far more than movement. It influences our metabolism, brain health, independence, and even how well we age. Dr. Vonda Wright is a double board-certified orthopedic surgeon with subspecialty certification in sports medicine. Her latest book, "Unbreakable: A Woman's Guide to Aging With Power," is a New York Times bestseller that gives women practical tools to build strength, resilience, and vitality across the lifespan. She is also the physician who named the musculoskeletal syndrome of menopause, giving language to what so many midlife women feel in their joints, muscles, and bones. Today we're talking about why muscle and bone may be two of our most important longevity organs, what changes during the menopause transition, and what women can realistically do to stay strong and capable for decades to come. Dr. Wright, welcome to Next Level Health.

[00:01:59] Dr. Vonda Wright: Thank you so much for having me.

[00:02:01] Dr. Melinda Ring: Thanks for being here. This week, I had brunch, dinner, and met a friend walking a dog who all said, "Have you heard of Dr. Vonda Wright?" And so, um, you are—you are on women's minds. I will just tell you that.

[00:02:14] Dr. Vonda Wright: Well, that either means that I'm doing something right or I'm doing something so wrong that everybody knows about it, right? It could be ridiculous or it could be right. So I hope it's the, uh—

[00:02:24] Dr. Melinda Ring: It was all positive. They're all reading your book, and I'm actually even reading it for the second time because there's so much information in there. So, uh, I—which I agree, I went through it. I've got little sticky notes all over it. You say, we are not the victims of the passage of time, and yet many women are taught as you age your health declines, you become less valuable, less vital. What would you say to women about, like, what's misunderstood about normal aging and the power that we actually have to change their trajectory?

[00:02:59] Dr. Vonda Wright: Thank God we age, because if not, we must still like—might be 12 going through puberty or living in our, you know, doing all the things young people do, so aging is not the culprit. We know there are 13 what we call hallmarks of aging that do happen as our cells mature as we accumulate years. But the reality is 13 of those are modifiable, even the expression of our genes by our lifestyle. So to say that aging is an inevitable decline from vitality down some slippery slope to frailty about which there is nothing we can do is, frankly, a cop-out, in my opinion. And any doctor that tells you, "Oh, you're just getting old, give up"—I mean, that is a cop-out because the data are so clear that nutrition is medicine, mobility is medicine, not smoking and drinking is medicine, and that we can modify the very way we age. There is no debate, and yet sometimes people do not take up the mantle and take control. They just sit back and wait for time to happen, right? So that's what I mean when I talk about I do not believe that we are the victims of the passage of time. We are the victim of our own mindset and our ability to invest in ourselves. Will we be different as we age? Sure. I am very different than I was 30 years ago. I frankly think I'm better now than I was then, and I'm certainly as strong now as I was then. But it doesn't mean that it's inevitable. One thing that's interesting to note, and the reason why I did my research at the University of Pittsburgh on musculoskeletal aging, is that when we do big NIH-funded population studies, like the one I always talk about is the Health ABC—it's a big NIH study. It studied a cohort of 70-year-olds and just followed them, right? And from population studies, you would think that aging is an inevitable decline. There's nothing you can do 'cause you see frailty, you see disease, you see, uh, dementia. But what do we know about the population of the United States? That 60% to 70% of all people do no form of movement or exercise any day of the week and that our diets of processed food are abysmal. So I contended that what we see in research about aging is not actually aging, it's a sedentary lifestyle. So that's why at the University of Pittsburgh I put together a research group, a multidisciplinary research group called PRIMA, the Performance and Research Initiative for Masters Athletes. And I studied athletes over 40 who had taken the variable of sedentary living out of the studies, and over 15 years, what we found is that you can preserve your muscle, you can preserve your bone, you can preserve your performance, your speed, if you will—how fast you go through life—and you can preserve your brains, all with the medicine of mobility.

[00:06:15] Dr. Melinda Ring: In your book you talked about your dad, and my dad was also an inspiration in his 90s playing pickleball. And I—there's no question, like, movement has kept him much younger than his peers. It's—it's amazing what you can see when—when you see the people who are doing it and have continued to do it as they aged.

[00:06:34] Dr. Vonda Wright: Your father and my father and me, compared to many women my age, have more freedom because it's really maintaining my capacity to do what I want, when I want, with whom I want, which is freedom. Because what you see in the elderly is they lose their freedom. They have to live in nursing homes. They have to be in wheelchairs if they lose their musculoskeletal capacity. So the whole goal of my whole mantra, as I distill it over time and repeating it, is the maintenance of our freedom.

[00:07:11] Dr. Melinda Ring: Yeah. I love that. Most people think of muscle and bone as just structures that help us move. Can you talk a little bit about those as part of, uh, you know, as—as one of our most important longevity systems, even beyond movement?

[00:07:26] Dr. Vonda Wright: Absolutely. So you are right. Bones are thought of, if thought of at all—usually not thought of at all until they fracture—it's just structural, right? And they just hold us up, which they do. You know, what is muscle without bone? It's just a heaping pile of meat on a counter, like a chicken breast, right? It's a metabolic organ, but nothing more without the cooperation of bone. The same with bone without the other tissues of the musculoskeletal system, which are muscle, tendon, ligament, bone, fat, spine disc, the annulus, right, muscle stem cells, cartilage—they're all related tissue. They all come from one stem cell. So if all of these eight or nine tissues come from one common origin, it makes a lot of sense that they're capable of communicating. And so all of those tissues communicate with each other by releasing substances or cytokines, or muscle releases myokines, right? So fat releases leptin. Well, each one of these releases dozens and hundreds. But for instance, fat releases leptin, uh, muscle releases myostatin, uh, bone releases osteocalcin. So if we're talking about bone, it is structural. It is the storehouse of all the minerals that our other organs need, primarily calcium, right? Every tissue in the body produces the electrical signal, if you will—it's pretty basic, but the—the communication needs calcium, right, stored in the bones. They're incubators. They're the birthplace of our baby blood cells in our pelvis and in our long bones. Uh, most people don't know that. Where do our cells come from? Our bones. But not only that, bones are master communicators, meaning they release substances: osteocalcin that goes to the brain, stimulates production of bone—of brain-derived neurotrophic factor, and builds a better brain, right? Amazing. Osteocalcin goes through the pancreas and is involved in insulin resistance, to the gut and involved in absorption. Um, another substance that the bone produces goes through the brain and is involved in satiety, or how hungry you are. Bone is this master communicator, not just a dead piece of structure holding you up. And if I were designing a human, why wouldn't I use bone as a communicator? Because it goes from the top of our head to the bottom of our toe. There's no part that doesn't connect. Amazing use of form follows function. Here's another interesting thing about bone that nobody thinks about: It is the last will and testament of your life. So when we dig up—when anthropologists dig up bones and they start talking about the civilizations, "Oh, these were warrior people. They ate this. They were in this kind of battle. Oh, they had this injury"—it's not because one shred of soft tissue remains, it's because our bone tells our life story. And when you think about it like that, why aren't we paying more attention to them, by the way?

[00:10:45] Dr. Melinda Ring: Well, I—I have always been a huge advocate for, uh, women getting—well, really anybody, but since our focus is women, you know, getting bone density tests, for example, at a much earlier age than the current guidelines recommend, um, just so many women didn't reach what we would think of as an ideal peak bone mass at 30.

[00:11:10] Dr. Vonda Wright: Yeah.

[00:11:11] Dr. Melinda Ring: They weren't eating enough calcium, they exercised over eating disorders, all kinds of things. And—and then they're entering perimenopause and the rapid decline already at a—already with—with, uh, a weak starting place. When do you think women should get their first bone density tests?

[00:11:30] Dr. Vonda Wright: I get DEXA scans on everybody. Everybody. And so, uh, I recommend just off the bat, let's just start at 40. You get your mammogram, you get your bone density. Pretty soon you get your colonoscopy because on average, perimenopause starts at 45, but we see women in their early 30s that already are exhibiting the "I don't feel like myself," and that's hormonal, right? So you would be surprised. I get DEXA scans on everybody; 30-year-olds have poor bone density.

[00:12:04] Dr. Melinda Ring: Perimenopause and, uh, your own—I know you talked about your own experience with it as a wake-up call—these are the women I see also, and my friends and everybody is in the perimenopause, menopause, and after transition. We all know the hormones go crazy during this time period, but what—what happens then in this window of time that makes it doubly important for us to protect muscle and bone and metabolic health? Like, what do you wish that women were told before they entered perimenopause?

[00:12:37] Dr. Vonda Wright: So your audience probably knows this, but remember, what is perimenopause anyway? Well, our estrogen is largely made by the follicle of the egg that we produce every month, right? And so by the time we're 40, we have about 1%—1% to 3% of our eggs left, and it's just not enough to produce the kind of estrogen that our brains are used to seeing. So what our brains do, because our brain's in constant communication through the bloodstream—so in the brain, it doesn't see enough estrogen because we're not making it because we don't have enough eggs. The brain's entire job is keeping the body level, homeostasis, so it starts pumping out follicle-stimulating hormones from the brain, which momentarily stimulates the higher production of estrogen. And so perimenopause, you have very low estrogen being produced by the remaining follicle of the egg, which goes to the brain. The brain goes like, "Oh my God, oh my God! Here's some more follicle-stimulating hormone," and raises the estrogen. And so instead of having a normal cyclical rise and fall of estrogen, progesterone, and testosterone every 28 days as we hopefully do when we're young, it can be chaotic and crazy: low estrogen, high estrogen, all within one day based on our brain trying to keep up. But what we know is in perimenopause, estrogen declines until there's so few eggs left you stop producing it at all and you stop having periods, and that is the one day of menopause, right? The reason it's so critical to step in front of education—knowing what to do, knowing whether you're gonna make a hormone optimization decision, knowing how to maintain your muscle and bone—is because this decade between the onset of perimenopause and menopause, your 40s, is prime preventive time, because every decade after 30, if you do nothing, you'll lose a percent of your muscle. So that's about 20% by the time you hit your menopause. And that's significant. During perimenopause, especially the three years prior to your menopause and the two years after, you have a rapid loss of bone because estrogen is so critical in the balance between bone breakdown and bone building. So when we have a full complement of our hormones, the osteoclast—the bone-resorbing cell—and the osteoblast—the bone-building cell—are in homeostasis, but without the controlling factor of estrogen on the osteoclast, we break down more bone than we build, to the tune of going from losing about 1% a year to losing more than 3% a year. So we can lose about 20% of our bone in our 40s and not even know it. So perimenopause is a critical time to get educated, understand your position on hormone optimization, and maybe start on hormones. I start very young, you know, 40 or women in their early 40s on hormones. And then step in front of: How do I lift? How am I gonna maintain my bones? All the things ahead of time before we hit 50 in menopause and we're just hit like a Mack truck. Like, how do I make up for lost time?

[00:16:02] Dr. Melinda Ring: And then I was talking to a colleague this morning who was saying, "Oh, first I had plantar fasciitis, now my hip is bothering me" in the perimenopause. And I know I had my own frozen shoulder arrive during what, in retrospect, was perimenopause. So it's not just bones that are affected, right? I know you're talking about the bone loss with estrogen, but, uh, it's all of the supporting elements as well that are affected and—and part of—in these hormone transitions.

[00:16:33] Dr. Vonda Wright: Absolutely. So in the paper, "The Musculoskeletal Syndrome of Menopause," where we put words around what I was hearing in clinic, uh, women would come into me and say—and they always have, but then I started listening with a better knowledge—they would say, "You know, I think I'm falling apart," because multiple things were going on. Hip, elbow, feet, everything. "I think I'm going crazy because I went to my clinician and they said, 'Nothing's wrong with you. You're just getting old.'" But they couldn't suffer anymore. And so as I began educating myself, the reality is that there are estrogen receptors, little baskets for estrogen, on every single musculoskeletal tissue—everyone. Remember, musculoskeletal tissues are related; they're cousins, so that makes sense that it's on tendon, ligament, bone, cartilage. Do you know we have known in the literature for 100 years, since 1925 when the first paper on the arthritis of menopause was published, that cartilage—the spongy end of the bone—has estrogen receptors? So without estrogen, that's why women have a rapid onset of—of arthritis after age 50. Before age 50 men have more; after 50 women can rapidly decline due to the fact estrogen's not sitting on their cartilage, plus the fact that on average women can gain 20 to 30 pounds, and—and even a 10% increase in weight can give us knee pain. So there's every tissue covered in estrogen receptors. So that gives us tendonitis, right? Tendons have estrogen receptors, that gives us weak bone, that gives us weak muscles. So it gives us a frozen shoulder because estrogen is a powerful, profound anti-inflammatory. It regulates inflammatory cytokines. It works directly on a structure in the—in the immune system called the inflammasome. So without estrogen, women show up with total body pain called arthralgia, and unless a clinician knows about the relationship between estrogen and perimenopause, they may be sent off for a 100-biomarker rheumatology workup, and it may come back all negative, and they're still labeled seronegative rheumatoid, right? Which is a—is a real diagnosis, but the reality is maybe it's undiagnosed perimenopause. The same thing—I'll probably make a lot of people angry when I say this, but there are actual clinical diagnostic factors for diagnosing fibromyalgia, but I'm sorry, total body pain can also be the inflammation of perimenopause. And could we try getting at the root cause, which is loss of estrogen, before we pile out all these pharmaceuticals, right? So arthralgia, but frozen shoulder, my friend, happens anytime you have high inflammation. So men with uncontrolled diabetes get frozen shoulder. Women with uncontrolled diabetes get frozen shoulder. Perimenopausal women who have never been inflamed before get frozen shoulder 'cause the shoulder is sensitive. And do you know how long we've known about that relationship? Decades. Do you know how long we've known about the relationship between estrogen and bone? 86 years. I spoke in front of the International Cartilage Repair & Joint Preservation Society and I said, "We've known a hundred years, what have we done about it?" People just trying to stimulate new lines of research, and young—I—I actually said if I were a young researcher, I would make my whole career on this 'cause nothing exists.

[00:20:26] Dr. Melinda Ring: Let's think about, like, beyond hormones. What's the—what are the top things that we need to do? And—and I'm really curious too, in the book, you know, you give...Maybe an ideal plan of what we can do for exercise. I'm also curious as to, like, what's the minimum? Because, uh, is—is there a minimum dose where we're gonna have a benefit for the women who are like, "Well, I can't do 60 minutes of Zone 2 work and strength training and things like that"? Is—is there a starting place, or—or, you know, what do you tell women?

[00:21:00] Dr. Vonda Wright: So when we're talking about bone, the eight shields of building better bone—and the first one surprises people, and the first shield is your mindset. Because if you believe that aging is an inevitable decline and there's nothing you can do about it, you will not put in the effort. If you believe that you are not worth the effort, you will not put in the effort. So mindset has to be the first one, and research shows that up to 47% of how you age is influenced by your mindset about aging, and so that is a very important thing not to be skipped over. Number two is hormone optimization, which we talked about, but not just estrogen, progesterone, and testosterone. Number three, if we're talking about bones, we are going to learn to lift weights, and I'll just say it here as I always say it: Yoga and Pilates are amazing, but they're not gonna be enough to build enough muscle to make you as strong as you can be. You're gonna have a great core, you're gonna have some great endurance, but we need to build muscle. And so even if you've never lifted, or maybe you were taught to lift your 5 pounds and do it 30 times and move on, you know what? All lifting is good, but it depends on your goal. My goal is not endurance. I don't wanna lift 5 pounds 30 times. I wanna be strong enough to do what I wanna do when I wanna do it with whom I wanna do it, and strength requires heavier lifting. So that's why in my book I talk about the very research-based way of working up, no matter where you're starting, to a point where you're lifting heavy enough that you can only do it—in my book, I say four times, 4, 5, 6 times, not 25 times, four times, because that is where we build strength. What else do we need as we age? We need power: power not to fall down, power to get up off the floor. And the way we do that is by altering how fast we lift. And that, you know, why people reread "Unbreakable" so many times is because it literally is like a—it's like an information book. It's a workshop book. I literally tell my patients, "Go to page 256," 'cause it's—it's that kind of detail. So mindset, hormones, lifting. Number four, bones require impact. Our bones, to know we need to build, need impact, right? So stomping around works, but jumping and generating four times body weight is what the research says stimulates bones to build. Now let's put that in context. Talking about people who run their whole lives, like, what's wrong with running? Well, actually nothing, but it only generates 1.5 times body weight—or I'm sorry, walking generates 1.5 times body weight, running generates 2.5. Our bones need four times body weight. You can get that—you can jump up off the floor high enough and land hard, or easier, jump off an 8-inch step, which is the last step in your house. Jump down and then jump up, land hard, and then rebound hard 10, 20 times a day, and that will stimulate your bone. Next, we have to retrain our balance, because even if you have good bone, or even if you have bad bone, you may never break it unless you fall. And so many women come to the emergency room and, you know, have to be cared for by an orthopedic surgeon like me when they trip over their little dog or their rug or something they don't see. And so retraining our balance and even our foot speed, you know, how fast we can move, is critical. Why is that? Why do we even care about fracture? 70% of all hip fractures are in women. When—when a woman or a man breaks their hip, 70% of the time they will perish, they will die. And if they live through it, 50% of the time they can't go live at home again. So that is a terrible position. So those are the physical things to do, but nutrition is critical. I ate lunch with a woman yesterday who was like so many women that I—that I observe, and they're food pushers. They get this beautiful plate of food and they push it around all meal, so it looks like they've disturbed it, but they've eaten like three bites. The reality is culture has taught women to be this big. Being this big without muscle, I am telling you, my friends, after 30 years in an emergency room, leads to frailty and fracture. So our bones need protein. Our bones are 50% protein, so we need a protein-forward, anti-inflammatory diet. Women must feed themselves, even women who are trying to lose weight. When you starve, you—I found when I was trying to recompose my body during perimenopause 'cause I gained the weight everybody else did, you have to eat to do that, because the whole eating 500 or 700 calories a day just teaches your body you're starving. I don't prescribe a huge stack of supplements. I think we do labs, we see how our iron and ferritin are, we look at our B12, we look at our vitamin D, and we replace the micronutrients that are obviously suboptimal. In addition to that, I think there's great evidence for omega-3s, 2,000 to 3,000 international units; magnesium, especially if you take it at night to help you sleep; vitamin D, most of us are deficient. Most of us can tolerate 2,000 to 3,000 international units depending on our level. And then there's some other ones that I like. I like, uh, urolithin A—I take one called Mitopure. I like—I do an NAD precursor because it's a critical coenzyme in the body, and I happen to think it—it helps me with my energy, but it's a very small stack, right? It's not 62 things, because here's the truth: You cannot out-supplement a bad diet.

[00:27:16] Dr. Melinda Ring: I always say that. Absolutely. I—I always tell people, I mean, they're called supplements for a reason. They're there to supplement your diet, like they're not there to, you know... Um, how about one that you—you didn't talk about, but so relevant, is calcium?

[00:27:32] Dr. Vonda Wright: So I prefer people get their calcium from their food. I'm not a big—I—I don't think the research bears taking a Tums or—or elemental calcium. Now, I do—I do think that taking calcium in the—in the combination that it exists in nature, like red algae has calcium in combination with other micronutrients, I think the body absorbs that better, and there are clinical studies to back that up. But just pop a few Tums? That is not something I purport. Um, but you know what? Calcium from the diet's not that hard to do unless—if—if you eat dairy, like two-thirds cup of yogurt is 300 milligrams of calcium. Prunes, dates, bok choy, salmon, sardines—you can get enough calcium, um, from your diet.

[00:28:21] Dr. Melinda Ring: Yeah. Yeah. And the—the protein side of things, just to go back to that for a minute: In your book, you were like, "I ate 130 grams of protein a day." That's a lot of protein, especially if you are not—it's a lot, it's a lot for—I—it's a lot for women who are shifting from not thinking about it. This is very different from our carb-heavy culture where it was like at dinner you would have protein, but maybe didn't really think about it so much during the day.

[00:28:51] Dr. Vonda Wright: Well, let's kind of—let's walk through a day of 130 grams of protein. 'Cause when I say—really, is it really that hard? Not—actually, not. So let's think about it. Two-thirds—if you're a yogurt eater, two-thirds cup of Greek yogurt has about 25 grams of protein. That's a lot, right, in—in two-thirds cup. It's not a lot of volume. Add an egg—every egg is 6 grams of protein. Three-quarters cup egg white omelet, which is a very small omelet. So there you go, breakfast you're already at 30 grams with not a lot of volume. What if you're only a coffee drinker in the morning and don't want—well, the average scoop of protein powder, the best being whey protein powder, but even pea protein powder, is about 25 grams. Put it in your coffee, make a mocha—a latte. So, what about lunch, for instance? What about lunch? Now, a big salad full of all kinds of cruciferous vegetables looks amazing and has a lot of vitamins and minerals, but it's not that much nutritional value, especially if you make it with iceberg lettuce, especially if you make salad soup, which is where you have this gorgeous salad and you pour salad dressing on it, you shake up the box that it comes in, then you get 500 calories of fat, right? A chicken breast the size of my hand is almost 50 grams of protein. Now, a chicken breast this size seems like a lot, but people eat baked potatoes all the time which are the size of their heads, you know, in our—our world. So I reject that it's that hard to get enough protein if we just identify what contains it, right? The other argument I hear is, "Oh, it's so boring to eat like that all the time. It's the same thing every day." But I heard a great response to that lately: I mean, nobody makes that objection when it's a whole bag of potato chips. It's a potato chip, potato chip. Or, I mean, we eat a whole bag of the same thing; nobody complains. But when it comes to healthy food, suddenly it's an issue, isn't it?

[00:31:09] Dr. Melinda Ring: Yeah, yeah, yeah. I hear you. I hear you. So it sounds like you're okay with some protein powder, you just don't want it to be the main—this is not the—the only source of protein.

[00:31:18] Dr. Vonda Wright: How do you augment? What are we doing all this protein for anyway? We're trying to get the leucine. Three grams of leucine—2.5 to 3 grams of leucine is what stimulates muscle protein synthesis. So, you know, if you're having trouble reaching it, then investigate high-quality branched-chain amino acids where you get your 3 grams of leucine in like a shot.

[00:31:40] Dr. Melinda Ring: I wanted to highlight something that you launched pretty recently, and that is this 29029 trail challenge that you're doing: three mountain marathons, three days. Um, and you're doing this to fund women's health research. Can you tell everyone a little bit about what this challenge is and then why you decided to help fund women's research?

[00:32:05] Dr. Vonda Wright: Sure. Thanks for giving me the opportunity to do it. You know, I think that sometimes as we age, we begin to, uh, believe that we're not as capable as we once were to do hard things. But I think, in fact, that aging is not for sissies, and to persistently live long and prosper, or be healthy, vital, act joyful, we have to continue to challenge ourselves. So in the last few years, I have just jumped into some Spartan races. You may have heard of Spartan obstacle courses. And you know what? When I put out the challenge, women join me. Groups of women have joined me in Boston when we did one at Fenway, in Tampa Bay twice when we did it at the baseball stadium. So I was looking for a different challenge. And Sara Blakely's husband, whose name is Jesse Itzler, who is himself a brilliant businessman, is into these races where you challenge yourself to do hard things. So 29029 is actually called Everesting. It mimics climbing to the top of Everest. Now, I am never gonna do that because I don't like to be cold, but that challenge, which I'm doing next year for my big birthday, is climbing 29,000 feet up a mountain, and in 36 hours leading up to that is the same thing that Everest trekkers do: They climb 79 miles to base camp. So this year, I'm doing the trails portion of this two-year race: 79 miles. Uh, I've chosen mountains in Park City, Utah, to do it. And so we're doing one mountain marathon a day for three days. Now, what's interesting when you look at who does this race: You might think because it's designed by bros for bros, that's what you're getting. But actually, about 50% of people who do this race are midlife women, which I love. So I jumped in this race and I said, "Now I have to make it about more than me, right?" So I take care of about 4 million women online, and what I hear a lot, both from doctors and women, is: Why don't we, uh, have answers to the research questions we need? Why don't we know? And they're throwing up their hands: Why can't we get any answers? Well, the reality is, of the approximately $48 billion that the NIH spends funding research, less than 10% funds women's health research, and less than 1% of that funds research for women over 40. And yet we spend 40 or 50 years of our lives over 40. So I'm doing a hard thing. I know the huge gap in the research and the tremendous need, and I also know that I take care of about 4 million women online. So I decided to use my challenge to challenge everyday women to join me in moving the mountain, because we're not just trying to move the needle on women's health research, we're trying to move the whole mountain. So I put out the challenge: We're gonna raise $79 million in—uh, $1 million a mile. And that's gonna take every woman listening just to donate her coffee money to say, "I am committed to finding the answers." It's gonna take a few very philanthropic women who have had big exits to say, "I am gonna do my share and put in millions of dollars to build this fund." Now, it's not about me, actually, and I have partnered with—it's the Buck Institute for Research on Aging, which is a world-class research facility, because all the dollars are going to go to fund research looking at ovarian aging. Why do women cataclysmically age differently than men? It has to do with our estrogen and our ovaries, and we have no answers right now, right? We're gonna fund musculoskeletal research and we're gonna fund new investigators, because the way research goes is baby, baby, little baby researchers just out of their grad programs have to do a lot of work before their work will ever merit the big grants. So they need funding so that we can keep the pipeline of women's health research full for the next decades, right? So, three reasons to do this audacious race, but I believe the women of the United States and world will step up because we're powerful and we—we can get things done when we want to.

[00:36:56] Dr. Melinda Ring: Yeah. Well, I love that you're doing it and, uh, I will encourage everybody along with me to contribute to this research that's gonna impact all of us. Any last thoughts for a person listening who's inspired by everything you had to say? We always give this opportunity to—what is one thing you would say to help them reach their next level of health? Any last thoughts for a person listening who's inspired by everything you had to say, we always give this opportunity to, what is one thing you would say to help them reach their next level of health?

[00:37:22] Dr. Vonda Wright: Until you decide that you are worth the effort or worth the—the work, nothing else will matter. And it—it's okay. Women have a problem sometimes focusing on themselves. It is okay to focus on yourself. You are as worthy as your children, your husband, your coworkers. You deserve it.

[00:37:42] Dr. Melinda Ring: Well, thank you so much, uh, Dr. Wright for everything today—helping us see strength is not simply something that we're gonna lose with age, but something that we can continue to build with intention.

[00:37:55] Dr. Vonda Wright: Thank you so much.

[00:37:57] Dr. Melinda Ring: Dr. Vonda Wright's book is "Unbreakable: A Woman's Guide to Aging With Power." And again, we'll link to the book and to Dr. Wright's work in the show notes. And to everyone listening, as she clearly said, you do not have to overhaul your whole life in a week. Start with one action that helps your future self stay strong, steady, and capable, and build from there. If you found this conversation helpful, please follow Next Level Health, share this episode with someone who needs to hear it, and join me again next time as we explore practical, evidence-informed ways to take your health to the next level. Thank you for joining me on this episode of Next Level Health. I hope you found some inspiration and practical insights to enhance your wellness journey. Don't forget to leave a comment on YouTube or a review on Apple Podcasts; I'd love to hear your thoughts and suggestions for future topics or speakers. Be sure to follow Next Level Health with me, Dr. Melinda Ring, as we continue exploring the path to healthier, happier lives together.