The Truth About Creatine & Exercise! 30% Of People Will Die From This! The Healthy Ageing Doctor

Here are the top 10 key takeaways from Dr. Vonda Wright's discussion on bone health, hormones, and healthy aging that could transform how you approach fitness and longevity.

1. Bone health is critically important yet often overlooked

Bone health is far more important than most people realize. Dr. Wright emphasizes that she's "on a rampage to make bone sexy again" because in the United States, at least 50% of women will develop osteoporosis along with 2 million men. The statistics are alarming: one in two women will have an osteoporotic fracture in their lifetime, women experience 70% of all hip fractures, and if you break your hip, 50% of the time you won't return to pre-fall function. Even more concerning, 30% of people who experience hip fractures will die from complications.

Contrary to popular belief, bones aren't just a static frame for our body. They're dynamic tissues that communicate with the rest of the body through proteins like osteocalcin. This protein travels to the brain providing neuroprotective effects, helps with insulin sensitivity in the pancreas, assists muscles in glucose uptake, and even contributes to testosterone production in men. Bones serve multiple functions beyond structural support, acting as storehouses for essential minerals and as "master communicators" throughout the body's systems.

2. Impact exercises are crucial for maintaining bone density

The podcast reveals that impact exercises are essential for maintaining bone density throughout life. Dr. Wright's research with the National Senior Games showed that athletes who participated in "bounding sports" where bones experience impact (like basketball, running, volleyball) maintained significantly higher bone density into their 80s compared to those who participated in non-impact sports like swimming or bowling.

This impact stimulation causes bones to build up over time and is as important for maintaining bone density as factors we can't control like age, chromosomes, and family history. The evidence suggests that while estrogen loss in women is inevitable with age, the resulting bone density loss doesn't have to lead to osteoporosis, fractures, and frailty if proper impact exercise is maintained. This finding challenges the common assumption that bone loss is an unavoidable consequence of aging.

3. The bone-brain connection affects cognitive health

There exists what Dr. Wright calls a "bone-brain axis" that many people are unaware of. When bone releases the protein osteocalcin into the bloodstream, it travels to the brain where it provides neuroprotective effects by decreasing inflammation and oxidative damage. Additionally, it stimulates the release of Brain-Derived Neurotrophic Factor (BDNF), which promotes neuron growth in the hippocampus, an area involved in memory.

Research shows a strong correlation between low bone density and cognitive decline. People with osteoporosis tend to have higher rates of cognitive dysfunction as they age, and vice versa. This connection highlights why maintaining bone health isn't just about preventing fractures but also supporting brain function. The relationship between these seemingly unrelated systems demonstrates the intricate way our body's components interact to maintain overall health.

4. Menopause significantly impacts musculoskeletal health

Menopause causes profound changes to women's musculoskeletal health due to the decline of estrogen. Dr. Wright has identified this collection of symptoms as the "Musculoskeletal Syndrome of Menopause," which includes inflammation, frozen shoulder, sarcopenia (loss of lean muscle mass), bone density loss, and increased tendon and ligament problems. These issues occur because every musculoskeletal tissue has estrogen receptors, and when these receptors sit empty due to menopause, various problems arise.

The impact is so significant that Dr. Wright published a paper on this syndrome that has been downloaded nearly 300,000 times, far exceeding the typical 10,000 downloads for articles in top medical journals. This extraordinary response indicates a vast unmet need for information about these symptoms. Dr. Wright believes hormone replacement therapy can help prevent these issues by filling those empty estrogen receptors, though she emphasizes each woman should make her own informed decision "based on science and not fear."

5. Breastfeeding affects bone density and requires calcium supplementation

A surprising revelation from the podcast is that breastfeeding mothers lose approximately 20% of their bone density in the first six months of nursing. This occurs because about 500 milligrams of calcium are depleted daily during milk production. If mothers don't replenish this calcium through diet or supplementation, they may never fully rebuild their bone density, especially if they have children in succession.

Dr. Wright recommends that breastfeeding mothers consume 500 milligrams of calcium daily, preferably through whole foods like prunes, dates, and high-calcium dairy products. She cautions against the "I've got to lose the baby fat" starvation phase, as adequate nutrition is essential for rebuilding bone. While emphasizing the importance of breastfeeding for babies, she stresses that mothers must be mindful of their own calcium intake during this period to protect their long-term bone health.

6. The critical decade for health is 35-45 years old

Dr. Wright identifies ages 35-45 as the "critical decade" for health maintenance. For women, this is when estrogen begins to fluctuate and decline, while men also experience hormonal changes during this period. She recommends getting baseline medical tests, including testosterone levels for men, so future treatments can aim to restore individual optimal levels rather than just reaching "normal" range.

This decade is also crucial for establishing habits that will maintain health throughout life. Dr. Wright advises using this time to develop resistance training habits, build cardiovascular fitness, and establish anti-inflammatory nutrition patterns. She emphasizes the importance of maximizing VO2 max (a measure of fitness indicating how much oxygen your body can use) during this period, as it typically declines by 10% per decade after midlife if not maintained through training. Starting from a higher baseline provides more "runway" before reaching levels associated with functional limitations.

7. Osteoporosis is detectable and preventable

Osteoporosis, which means "low bone density," is measured using a DEXA scan that compares bone density to that of a healthy 30-year-old, yielding a T-score. A positive score indicates excellent bone density, while scores between 0 and -1 are normal. Scores below -1 indicate osteopenia (early bone loss), and scores below -2.5 define osteoporosis, which increases fracture risk by 40% or more.

Despite the prevalence and serious consequences of osteoporosis, many healthcare systems won't cover DEXA scans until age 65, by which time significant damage may have occurred. Dr. Wright advocates for earlier screening, especially for those with risk factors such as previous fractures, family history of height loss or hip fractures, long-term steroid use, or smoking history. She emphasizes that osteoporosis isn't inevitable, but without early detection and intervention, it becomes much more likely to develop serious consequences.

8. Pre-diabetes requires urgent attention

Dr. Wright expresses serious concern about the casual approach to pre-diabetes diagnoses. Approximately 96 million Americans have pre-diabetes, characterized by fasting glucose levels around 110 mg/dL (normal is about 85 mg/dL) and hemoglobin A1C nearing 6. With these numbers, there's a 70-100% chance of developing full diabetes within 10 years if lifestyle changes aren't made.

She believes the typical advice to "just exercise more" or "watch your carbs" doesn't convey the urgency required. Pre-diabetes should trigger "running and screaming to get healthy" through serious commitment to resistance training, cardiovascular exercise, and anti-inflammatory nutrition. The stakes are high: diabetes development often leads to cognitive decline over time, potentially contributing to Alzheimer's disease, which Dr. Wright describes as "the third phase of diabetes." Her continuous glucose monitoring shows how quickly lifestyle changes affect blood sugar levels, underscoring the daily commitment required to maintain metabolic health.

9. One-legged exercises can identify and correct muscle imbalances

Runners who exclusively run often develop injuries due to motion imbalances. Dr. Wright demonstrates the "Trendelenberg sign" test where standing on one leg while doing a single-leg squat reveals whether the glute muscles are strong enough to keep the pelvis straight and prevent the knee from falling inward (valgus position). This test identifies weakness in stabilizing muscles that may contribute to injuries.

These imbalances become magnified during running because it's a single-leg sport with approximately 1,000 steps per mile. If the knee falls inward repeatedly during these steps, structures like the kneecap experience damaging forces. Dr. Wright recommends strengthening exercises like single-leg step-ups, single-leg lunges, and hip hitches to correct these imbalances. This targeted approach addresses the root cause of many running injuries rather than simply treating symptoms as they arise.

10. Sleep and recovery are foundational to all other health measures

Dr. Wright prioritizes sleep and recovery above all other health measures, including nutrition and mobility. She explains that adequate sleep is essential for brain restoration, providing necessary time and nutrients for cognitive function. Without proper recovery, other health initiatives become less effective. Her perspective on sleep's importance has evolved throughout her career, moving it from a secondary consideration to her top priority.

She applies this knowledge to her own schedule, recognizing that her brain functions best between 5:00 a.m. and 2:00 p.m. Rather than following popular advice to exercise in the morning, she reserves her peak mental energy hours for creative and deep thinking work, scheduling physical activity for later in the day. This personalized approach recognizes that optimizing cognitive performance requires understanding one's unique brain function patterns and structuring daily activities accordingly.