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Hello and welcome to Zoe Recap, where each week we find the best bits from one of our podcast episodes to help you improve your health. Today we're talking about muscle mass. For many people, losing weight is the ultimate health goal. However, focusing solely on lowering the number on the scale often means overlooking something crucial, muscle mass. We know that increasing muscle makes us stronger, but it also plays a surprising role in metabolism and helps keep unwanted fat at bay. Dr. Vonda Wright joins me to explain why improving your body composition may be the smarter goal for lifelong health.
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Muscle is a critical vehicle for pulling glucose out of the blood, turning it into the energy our body needs, often to contract the very muscle where it's made. So you can think of it as a glucose sink, as an energy sink for our body, which is critical, right? The more muscle you have, the more efficient you are at doing that.
C
And why is that important? Vonda why does it matter that I've got these muscles to pull in this blood sugar out of my blood?
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Well, I'm sure you've spoken many times about the roles of high blood sugar in the body. And at a very, very simple level, it's like we're barbecuing our body from the inside out, where high blood sugar causes this chronic inflammation in which is the cause of many chronic diseases, which is high inflammation. Sugar causes an internal process that produces these substances called ages, which literally, I think of it as an internal barbecue. It's crystallizing inside of our body.
C
Doesn't sound good.
B
It doesn't sound good. It doesn't feel good. High inflammation is one of the reasons people get joint pain. Frozen shoulder. One of the reasons we have the highly inflamed process of unchecked diabetes. I mean, all these things work together. And muscle is critical for helping control that glucose balance because when there's too much circulating, it is stored in fat. There's only so much our liver can store, about 2,000 calories worth, and then the rest of it has to be stored somewhere. And I'm going to tell you for sure that I find in joints where we shouldn't have this because I'm an arthroscopist, fatty stores. It's like putting fat into the closets because there's nowhere else to put it. We have so much excess energy, our body has to store it somewhere. It stores it in fat and then it shoves the fat a lot of places. You should not have big layers of fat in our shoulder joint, in the other, the hip joint, for instance. But yet I find it There pretty frequently.
C
And so having more muscle helps pull this glucose, this blood sugar out of your bloodstream and helps to fight what you're describing.
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That's right. In a more efficient way, instead of just storing it in any convenient but unhealthy fat globule.
C
What goes on to our muscles? If we decide to go into a calorie restricted diet, which is I guess the way we've all been told we should lose weight historically and even today. Right. If you start to use these GLP1 drugs, you still end up not being hungry. So then you go into this sort of calorie restriction.
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What happens to our muscles? Yeah, well, we know that when we just calorie restrict, we lose, depending on who you read, 20, 40, 50% of the total weight on the scale in muscle, we will lose fat. But a large portion of what we lose will be muscle. Because our body has a hierarchy of needs. Our body perceives certain tissues like bone and muscle as not only functional, but storehouses.
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You're saying it sort of as though it's obvious, but that's pretty shocking. I generally would think about it as like, well, you lose fat. Cause after all, you're still walking around,
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you will lose fat.
C
Yes, but I think many people like me will be surprised that you would lose any muscle at all.
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Well listen, when people are sick in the hospital for a week, it's estimated you can lose 9% of your muscle mass from laying still.
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9% in a week. Yeah.
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Cachexia and being ill and drawing from your muscle as a source of energy can lead to profound changes. If I put a cast on your leg for one week and you're not contracting that muscle, your body will view it as non vital and will start using it and you will have atrophy. It's interesting what the body does because back to the hierarchy of needs. In a situation where we're calorie restricted, our brain still is a very hungry organ and needs energy and your body's gonna take it from somewhere. So if we're not intaking enough food, our body is gonna start using the storehouses to convert to energy. For the brain to keep it alive, for the heart to keep it alive. Right. The vital functions, muscle is an accessory.
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Does that change depending upon how much body fat you have? So if you're living with obesity and so you have a lot of excess fat, does that mean in that case it only takes it from your fat or do you have muscle loss?
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Yeah, it's my understanding you have muscle loss no matter where you Start. The absolute poundage may be different, but the percentage is similar. If we want to minimize muscle loss during the period when we're calorie restricting, then we need to feed ourselves enough protein so that we have the protein building blocks to maintain our muscle mass. We should also be lifting to try to build muscle that we feed with the protein as we calorie restrict. Because, for instance, you can eat a lot of protein on a 1500 calorie meal plan, right? So if you're maintenance is 1800 calories and you're trying to restrict by 300, you can still eat a lot of protein within that number of calories. You know, you have to choose, you have to eat lean meats and lean sources, but it's completely possible.
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VONDA I want to come back to this thing about weight versus body composition. You've mentioned muscle loss, but at this point I'm not clear how that fits in with not just looking at the bathroom scales.
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What you see on the outside is not what's going on on the inside. And I'm going to give you two examples on opposite sides of the spectrum. So a number of years ago, I was invited to go to Fashion Week in New York and I had never gone. And it was amazing. And I was a little out of my element. But I looked around me at all these willowy women, like they were as thin as could possibly be and wearing these clothes. But there was very little evidence at the time. I mean, now models are different body shapes. At the time, I did not see any muscle definition. And we know there exists a phenomenon called skinny fat, meaning you look skinny, you may weigh 100 pounds, but if you do body composition, you have very low lean muscle mass. So that's on one end of the spectrum. On the other end of the spectrum, which I see more often in my orthopedic clinics, is when I take a picture of someone's knee, for instance, and X rays are meant to identify bone, but you can see the shadows of the other tissue. So if we have an elderly person who is skinny, often what I see are the bones. I see a couple inches of fat on the outside in a leg that has a total volume that's small and really thin ribbons of muscle in the quadriceps, which should be one of the most robust muscle groups of our body. So age is not a factor in skinny fat. But what I also see is this phenomenon of you have a very wide leg. It almost goes beyond the scope of our X ray. You have normal sized bones in the middle. There's no such thing as big boned. You're like, oh, you're not big because, well, if you're a big person, you have bigger bones, but proportionally it's still about 15% of your total weight. So you have the bone in the middle. You have these thick rinds of adipose tissue. 3, 4 inches on either side of, again, very wispy muscle.
C
I would love to switch to. Okay, I'm sold on all of this Fonda. You've given me this story about why I'm going to throw the scale out of the window and focus on how I can improve that body composition. Now help me to understand practical, actionable advice about how I do it.
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The first thing I want people to do is become students of themselves. You should not take my word for it. You should not take your word for it. You should become voracious readers of solid information. And you don't have to go all the way back to the scientist papers. Many scientists, you have them on all the time. So choose who you listen to wisely. Number one. Number two, become an observer of your body. Right? Data is okay, we're talking about a scale. Maybe you, for a short amount of time, use a CGM so you can know how the piece of bread affects your blood sugar, makes how you feel. Be an observer. Maybe you get some actual blood work done because you've never bothered before, because you feel fine. When I'm taking someone into the OR and I'm asking them their, their medical history and their midlife and they say, oh, I'm good, I don't have any problems. I say, is that because you know that because you've had an exam and some blood work or because you've never darkened the door of a medical office in your life? There is a difference, right? So after you learn, get some data, then you can build a personalized program for yourself, right? Number four is no matter who you are and what your age, you must learn to lift weights. Because we're not agrarian. We're not lifting logs in the field or pigs over the fence. We're just not. But decide what your goal is, right? If you want endurance, you can lift very light weights for a lot of reps to failure. I mean, you can get to failure with a five pound weight. You just have to lift it. A lot of times, let's say, Vonda,
C
that I'm like, I have no interest in lifting weight. You got me through the door with like, I'd like to lose weight, but then you told me I shouldn't focus on weight, I should focus on body composition.
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Yes.
C
What do I need to do to do that?
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Your cardio needs to be 80, 20, 80% base training, 20% high intensity sprinting. That's about two days a week. And you need to lift weights. Not for endurance, not a lot of reps. Lightweight, not for hypertrophy, which is a little heavier weights, but 10 to 15 reps in general per set. Unless your goal is hypertrophy in aging, My whole focus is longevity and aging. My goal is strength and power. Strength meaning what I can lift in a single lift, power in what I can lift over time. Because I am trying to keep you from falling down. I am trying to keep you independent in your home and not end up in somebody else's care because you're too weak to get up from a chair or climb your own stairs or open the pickle jar and make your own food. Right? So to lift for strength and power, you have to lift heavier. And the ranges on those lifts are three to six reps for four sets to build muscle for strength and power. Four reps times four sets. Because if I get to near failure in four reps, meaning with good form in the power lifts that I do, I can do. Let's do bench press. I can do four reps of bench press and I'm almost a failure. I can eke out 5. It's going like this. One side's going down, but I'm not doing six. So to get to this place where I'm capable of lifting heavy. If you're starting from zero, it takes time. When I decided to recompose my body after perimenopause, I had lifted most of my life. I knew how to do it. I just went to trying to lift heavy. But if you're stepping away from the couch for the first time, you need to work through lifting light first, learning how your body works, learning the proper lifting technique before you attempt these. And then this is a great time to hire a trainer to show you because there is technique is critically important when you lift heavy.
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What sort of exercises do I need to do within this hefty lifting to achieve?
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I think there's a lot of ways. And so I base my lifting and the lifting that I prescribe for people on powerlifting. The upper body, push, pull. So some kind of bench, some kind of weighted pull, lower body push, ball, which means squats and deadlifts. I prefer myself and for people to do them with bars and iron, you can do them with free weights. So those are the four core lifts that we do the heaviest four reps, four sets because they're compound, they take multiple joints, multiple body balance, they take multiple muscle groups to support that. The way we prescribe is the supplemental lifts and I'll describe that we can do eight or 10 of those not to failure. So for the bench press, for instance, if I'm going to do if it's bench press day and I'm going to start with that as my heavy sets to round out the day and upper body, I might do three or four sets of eight to 10 biceps, triceps, lats, delt rows right to augment this to support the heavy lift I do. So that is the basic formula.
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As you can imagine hosting this podcast, running Zoe, juggling family life. It all keeps me pretty busy. So I try as best I can to stay energized and sharp well in all those parts of my life by fueling my body with the right food, by exercising, and by adding a scoop of daily 30 to my meals every day. If you haven't heard of Daily 30 yet, it's the gut supplement designed by our gut health scientists here at Zoe. It's made of over 30 high quality hand picked plants including seaweed, fungi and different types of fiber. Better yet, it contains ingredients that support gut health, digestion and energy, which is ideal for packed calendars and busy lives. Simply add one scoop a day to any meal for an extra boost of fiber and plant diversity. And because it tastes delicious on just about anything and adds a satisfying crunch, it quite quickly slots into your life, becoming a daily healthy habit you'll always have time for. By the way, whenever we talk about Daily 30 as a good source of fiber, we're required to say that it contains 4 grams of total fat per serving. Obviously that's all amazing healthy fats from plants, so order yours today@zoe.com daily30. Thanks for listening and see you next time.
This episode features Dr. Vonda Wright, an orthopedic surgeon and leading expert on healthy aging, discussing why muscle gain and maintaining strong muscle mass are more important health goals than simple weight loss. The conversation covers the science behind muscle as a critical metabolic organ, debunks misconceptions about weight loss, and provides practical, actionable advice for improving body composition, especially as we age.
Muscle as a “Glucose Sink”:
Dr. Wright explains that muscle tissue plays a vital role in pulling glucose from the blood, converting it into energy for muscle function.
"Muscle is a critical vehicle for pulling glucose out of the blood, turning it into the energy our body needs...you can think of it as a glucose sink."
— Dr. Vonda Wright (00:42)
Muscle’s Role in Metabolism and Chronic Disease:
High blood sugar is compared to “barbecuing our body from the inside out,” generating harmful compounds (AGEs) and chronic inflammation, which is at the root of many diseases.
"Sugar causes an internal process that produces these substances called AGEs, which literally, I think of it as an internal barbecue."
— Dr. Vonda Wright (01:10)
Fat Storage in Unhealthy Places:
Excess energy leads to fat being stored not just under the skin but even within joints and organs, contributing to dysfunction.
"We have so much excess energy, our body has to store it somewhere...You should not have big layers of fat in our shoulder joint."
— Dr. Vonda Wright (01:42)
Muscle Loss During Dieting:
Traditional calorie-restricted diets and GLP-1 drugs (which reduce appetite) often result in significant muscle loss—sometimes up to 40-50% of the weight lost, not just fat.
"When we just calorie restrict, we lose, depending on who you read, 20, 40, 50% of the total weight on the scale in muscle."
— Dr. Vonda Wright (03:15)
Muscle atrophy can occur rapidly, with up to 9% lost in just a week of inactivity (e.g., hospitalization or immobilization).
"When people are sick in the hospital for a week, it's estimated you can lose 9% of your muscle mass from laying still."
— Dr. Vonda Wright (04:03)
Hierarchy of Needs in the Body:
The body doesn't only target fat for energy—muscle is also broken down to supply critical organs (e.g., the brain), regardless of how much excess fat is present.
"Our body has a hierarchy of needs...muscle is an accessory."
— Dr. Vonda Wright (04:12)
Skinny Fat Phenomenon:
Dr. Wright uses examples from fashion and orthopedics to distinguish between being "thin" and having a healthy body composition.
Aging and Muscle Decline:
Muscle loss isn't just a concern for young people; even the elderly can have significant fat stores and very little muscle, regardless of their size.
"On the other end of the spectrum...I see a couple inches of fat on the outside in a leg that has...really thin ribbons of muscle in the quadriceps, which should be one of the most robust muscle groups of our body."
— Dr. Vonda Wright (07:50)
Becoming a “Student of Yourself”:
Personalization:
Build a program that suits your unique needs, goals, and physical starting point.
Strength Training Is Essential:
"You must learn to lift weights...when you lift heavy, technique is critically important."
— Dr. Vonda Wright (09:45, 12:45)
Cardio Recommendations:
Strength and Power Over Hypertrophy:
"My whole focus is longevity and aging. My goal is strength and power...I'm trying to keep you from falling down."
— Dr. Vonda Wright (11:30)
Core Lifts:
"Those are the four core lifts that we do the heaviest—four reps, four sets, because they're compound."
— Dr. Vonda Wright (13:03)
On “Skinny Fat”:
"We know there exists a phenomenon called skinny fat, meaning you look skinny, you may weigh 100 pounds, but if you do body composition, you have very low lean muscle mass."
— Dr. Vonda Wright (06:26)
On Why Lifting Matters for Everyone:
"We're not lifting logs in the field or pigs over the fence. We're just not."
— Dr. Vonda Wright (09:53)
On Lifting for Independence:
"I'm trying to keep you independent in your home—not end up in somebody else's care because you're too weak to get up from a chair or climb your own stairs."
— Dr. Vonda Wright (11:42)
This summary captures the full arc of the episode, focusing on empowering listeners with the science and motivation to prioritize muscle health over mere weight loss.