Dr. Peter Attia

And why are women more injured by falls than men? These are the questions that I think we should spend a moment on. So let's start with the why do falls happen? You touched on it a moment ago. As we age, we don't just lose our balance, but we're losing something else that people my age and certainly her age take for granted, which is called reactivity.

And why are women more injured by falls than men? These are the questions that I think we should spend a moment on. So let's start with the why do falls happen? You touched on it a moment ago. As we age, we don't just lose our balance, but we're losing something else that people my age and certainly her age take for granted, which is called reactivity.

So the other day I was in the woods because one of my kids accidentally kicked the soccer ball down into the woods. So I had to go and get it. And as you can imagine, the ground is very uneven and it's covered in leaves and twigs and branches. So you can't even see what you're stepping on. I'm sure you can all picture exactly what this is like. Every step is a sprained ankle waiting to happen.

So the other day I was in the woods because one of my kids accidentally kicked the soccer ball down into the woods. So I had to go and get it. And as you can imagine, the ground is very uneven and it's covered in leaves and twigs and branches. So you can't even see what you're stepping on. I'm sure you can all picture exactly what this is like. Every step is a sprained ankle waiting to happen.

And sure enough, at one point I step into something that wasn't as it appeared and I got jolted. And I had to react very quickly with my leg to put it in the right place so I wouldn't fall. And I did. And I'm here sitting here talking about it, and I don't even remember which leg it was. That's how insignificant this was.

And sure enough, at one point I step into something that wasn't as it appeared and I got jolted. And I had to react very quickly with my leg to put it in the right place so I wouldn't fall. And I did. And I'm here sitting here talking about it, and I don't even remember which leg it was. That's how insignificant this was.

But the type of muscle fiber that was necessary to do that, which if we want to get technical, is called a 2A muscle fiber, is the type of muscle fiber that is responsible for explosive movement. It's the type of muscle fiber that is the most powerful muscle fiber. Well, those muscle fibers start getting weaker and weaker and shrinking at about the age of 25.

But the type of muscle fiber that was necessary to do that, which if we want to get technical, is called a 2A muscle fiber, is the type of muscle fiber that is responsible for explosive movement. It's the type of muscle fiber that is the most powerful muscle fiber. Well, those muscle fibers start getting weaker and weaker and shrinking at about the age of 25.

So I'm long past my peak in my early 50s, but I still have enough to hold me on. But at some point, they really, really start to diminish. And by the time someone's your age... You got threads of those things left. So you're losing those things. Now, the good news is you can train these muscle fibers, but the only way to train them is to move very heavy weights.

So I'm long past my peak in my early 50s, but I still have enough to hold me on. But at some point, they really, really start to diminish. And by the time someone's your age... You got threads of those things left. So you're losing those things. Now, the good news is you can train these muscle fibers, but the only way to train them is to move very heavy weights.

Sounds crazy, counterintuitive, but that's what we have to do. We have to move really heavy weights and we have to train them. in movement patterns like that, which means, for example, bouncing, moving side to side, jumping rope. Things like that are necessary for our feet to have the reactivity that you had when you were young.

Sounds crazy, counterintuitive, but that's what we have to do. We have to move really heavy weights and we have to train them. in movement patterns like that, which means, for example, bouncing, moving side to side, jumping rope. Things like that are necessary for our feet to have the reactivity that you had when you were young.

A second obvious issue as we age is a reduction in bone density and a reduction in muscle mass. And this is the reason why women are more susceptible than men to these injuries, because for obvious reasons, women have less muscle mass on average and have lower bone density on average, in part due to the fact that many women didn't receive hormones after menopause.

A second obvious issue as we age is a reduction in bone density and a reduction in muscle mass. And this is the reason why women are more susceptible than men to these injuries, because for obvious reasons, women have less muscle mass on average and have lower bone density on average, in part due to the fact that many women didn't receive hormones after menopause.

And as their estrogen levels went down after menopause, their bones got disproportionately weaker relative to men because estrogen turns out to be the most important hormone in preserving bone density. And so all of these things taken together are what mean that falling is something we have to be very mindful of at any age. But boy, does it play a bigger role above the age of 65.

And as their estrogen levels went down after menopause, their bones got disproportionately weaker relative to men because estrogen turns out to be the most important hormone in preserving bone density. And so all of these things taken together are what mean that falling is something we have to be very mindful of at any age. But boy, does it play a bigger role above the age of 65.

And again, I won't ask for a show of hands, but I would be shocked. if no one in this audience knew somebody, if not personally, who hadn't experienced a significant fall that resulted in a broken hip or a broken femur. And the tragedy of that type of accident is that in many cases, it's not fully recoverable. So you have the proportion of people that will die as a result of that.

And again, I won't ask for a show of hands, but I would be shocked. if no one in this audience knew somebody, if not personally, who hadn't experienced a significant fall that resulted in a broken hip or a broken femur. And the tragedy of that type of accident is that in many cases, it's not fully recoverable. So you have the proportion of people that will die as a result of that.

But even the people who live, often about 50% of them never regain the same level of mobility they had before. So all of this to me points back to the idea that we want to be exercising as much as possible.

But even the people who live, often about 50% of them never regain the same level of mobility they had before. So all of this to me points back to the idea that we want to be exercising as much as possible.