Dr. 50 Something

S2 E1 Goodbye Nursing Home Insurance, Hello Muscle Mass!

• Nicole Norris MD

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Ready to retire your bathroom scale and measure what actually moves your health? We kick off season two by redefining midlife vitality through one powerful lens: body composition. Instead of chasing a shrinking number, we focus on growing what protects you—lean muscle—and reducing what harms you—visceral fat. Along the way, we explain why BMI mislabels strong bodies, how to track fat and muscle accurately, and the daily habits that add more good years to your life.

We share real-world outcomes from hormone optimization, where patients report deeper sleep, steadier moods, and a renewed sense of well-being that becomes a positive addiction. Then we map the next level: using DEXA and home impedance devices to monitor trends, celebrating increases in lean mass even when total weight rises, and steering training and nutrition with data instead of guesswork. Muscle emerges as more than strength; it is metabolic armor that stabilizes blood sugar, lowers inflammation, and slashes risk for diabetes, heart disease, stroke, and several cancers.

From there, we lay out the Get Fit framework: 10,000 to 15,000 daily steps, progressive strength training, protein-forward meals, and sleep as a non-negotiable performance tool. We normalize lifting heavy with guidance, gamify recovery with wearables, and use GLP-1s and select peptides strategically when food noise or recovery blocks progress. For those who stall due to gut issues, we preview GI mapping and food sensitivity testing to remove hidden barriers and unlock sustainable change.

If you’re ready to trade vague goals for measurable wins, this is your roadmap to a stronger, leaner, and sharper midlife. Follow the show, share it with a friend who needs a spark, and leave a review to help more listeners find practical, science-backed ways to age with power.

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SPEAKER_00:

Welcome to the Dr. 50 Something Podcast. I'm your host, Dr. Nicole Norris. Whether you are in the midst of midlife or you want to prevent the physical and mental signs of aging that occur in midlife, this is the podcast for you. This is a show where I share my knowledge, gleaned in family practice, preventative medicine, and aesthetic medicine to shed light on aging, or better yet, how not to feel or look like you are aging. We should be taking an active role in how we age from an early age. We should not settle with growing old gracefully or letting nature take its course. How we age directly affects our confidence, which impacts all of our relationships with those around us. The length of time in our lives that we feel really good in terms of energy, aches and pains, and thought clarity has a definite impact on the mark we can leave on this world. My wish for my listeners is to always be mistaken for being 50 something or less in mind, action, and appearance. Let's go. I'm so thrilled for her and her family, but also really glad she is back to help me create this podcast for you. This is the opening of season two. Season one was not only everything you need to know about why you should optimize your hormones as you age, it was also foundational to your journey to becoming the healthiest version of yourself as you age. As I mentioned in multiple season one podcasts, it can take a year to get your hormones and nutrient levels optimized in the initial phase of our longevity optimization program. Once your hormones are optimized and you are feeling the best you have in years, the majority of our patients have noted a loss of fat and gaining muscle, and they're sleeping well, and they're experiencing a renewed sense of overall well-being. So much so that they often get a little addicted. What do I mean by that? I mean addicted to feeling good, addicted to that sense of well-being, addicted to what more can I do to maintain this feeling? Addicted to hope for the future and living to an older age, but not feeling like an old person. One patient in our practice commented to me that if she could only take one thing with her to a deserted island, it would be her bioidentical hormones. She would be just fine leaving everything else behind. But take my natural hormones? No way, buddy, I'm not going through that again. So addictions are usually thought to have a negative connotation. But in my office, the patients who are addicted to a zest for life are celebrated. And this addiction is encouraged. I call these patients our zestes. So when a zesty comes for a follow-up hormone optimization visit, we ooh and ah over their optimized hormone labs, their incredible HDL and LDL cholesterol, usually off statins, their ideal vitamin D and B12, and their hemoglobin A1C that reflects their loss of visceral fat and so, so much less inflammation in their bodies. At these follow-up visits, we also do a body composition analysis. We are always monitoring percent muscle mass and percent body fat. To me and to my team, this is your most important vital sign. To be at the pinnacle of health as an adult, your percent muscle mass and your percent body fat must be as opposite as possible. And of course, the opposite we are looking for is high muscle mass and low body fat, not the other way around. We have all heard the following statistics on fat. 40% of our US adult population is too fat. And 9% of our population is super fat. This is insane. And honestly, not just about lifestyle choices. I believe hormone imbalances as we age, the prevalence of endocrine disruptors in our environment, and untreated PCOS are probably the root causes of disproportioned fatness in our country. When there are reports published on how fat this country is, they are based on something called body mass index or BMI. If your BMI is 25 to 30, you are classed by your doctor's medical record system as overweight. If it is 30 to 35, you are obese. And if your BMI is over 40, you are severely obese. So how is this number arrived at? Well, very simply, it is an app on your phone that you can download from the app store. It's called a BMI calculator. This takes into account your height and total body weight. Total body weight, of course, includes fat, muscle, bone, water, skin, organs, and blood. Essentially everything in our body. It does not take into account how much muscle you have compared to fat. So, an example would be a 510 in-shape male or female bodybuilder with 200 pounds of total body weight is going to have a BMI over 30 in that BMI app. Their weight is high due to very high muscle mass compared to their height. Hence, the classification of this patient as obese is wrong. And not only that, it's useless. It tells us nothing important about someone's health, and following it does not tell us if a person is getting healthier or not. We really need to be specifically measuring lean muscle mass and percent body fat. Measuring total body fat on a typical scale is a really pointless vital sign. It is misleading and frankly, psychologically destructive. Total body weight fluctuates greatly with hydration, bowel movements, menstrual cycles, and dietary intake of salt and alcohol, which of course cause fluid retention. You really need a body composition device to break it down for you. The gold standard of these devices is called ADEXA, which stands for dual energy X-ray absorptometry. You may have heard of DEXA in terms of a test to measure bone density as we age, a screen for osteoporosis. It does do this, but it can also measure fat mass, lean muscle mass, and visceral fat with incredible accuracy. This device looks like a twin bed and it costs around$60,000. So it is not something most people can keep in their bathroom. However, there are now some home body composition devices that are affordable and small enough for your bathroom. They use electrical currents and measure impedance through different tissues to calculate body composition. They are not as precise as ADEXA, but if you are just following trends of muscle gain and fat loss, they do the job nicely for around$350. Probably my favorite company that makes one for home is called Inbody. We have one of their devices in our office. All of our patients who are in our hormone optimization program have the InBody app on their phone that Bluetooth to the body composition device. So they each have graphs of their muscle mass increasing and body fat decreasing over time. If their muscle is decreasing or fat increasing, which we don't want to see, it does help us to steer the patient's lifestyle habits appropriately. Sometimes patients' total body weight will increase, but their lean muscle mass increased and their percent body fat decreased. So satisfying. Way better than a scale. It is honestly my favorite app on my phone. So why am I putting so much emphasis on building muscle and decreasing fat as we age? Muscle is the currency of aging. The more muscle mass that you have, the more good years you can afford. So let's break this analogy down. When you have higher muscle mass, you have a higher metabolism. You simply burn more calories when you do something physical when you have more muscle. So it is now easier to maintain a healthy weight. Muscle as an organ of the body also regulates blood sugar and prevents insulin resistance. Remember, insulin resistance causes increased visceral fat storage, which is the deep fat around the organs. This visceral fat produces significant inflammation in the body, which just makes you a total setup for diabetes, heart attack, strokes, and many cancers. So because of this, men and women with higher muscle mass across their lifespan have lower risk of all of these major chronic diseases. So to reiterate, more muscle mass means less fat around the organs and less risk of the chronic diseases that our parents have. I also like to tell my patients that your muscle is survival insurance. Of course, muscles provide strength and mobility to perform daily tasks or run away from a threat, but it also greatly decreases our risk of falling and breaking a bone. Patients with more muscle mass also recover from infections and traumatic injuries faster, probably because they have less overall inflammation in their body and better immune systems. So muscle increases your risk of survival no matter what age you are. The last reason to build muscle as you age is nursing home insurance. Nursing home insurance is ridiculously expensive. Now that I am over 50, my insurance agent keeps bringing it up at our yearly review. Well, I've decided to self-insure by building my own muscle mass. I used to see patients in the nursing home every Thursday for about 10 years. Nothing against my patients there or the incredibly dedicated healthcare teams who care for these individuals, but that is not where I want to spend my golden years. I want to live in my own home, be an active member of communities, and travel through airports without a wheelchair. Whatever it costs me to build muscle mass as I age is going to be a way better investment than nursing home insurance. Sometimes we have patients with optimized hormones who still struggle with building muscle mass and decreasing percent body fat. Hormones are bullets, but they are not magic bullets. For these patients, we've developed a lifestyle change program with all the tools needed to get your body composition where you want it to be. We simply call this program get fit. Not get skinny, not get ridiculous bulging muscles, not get sagging skin. This 12-week program consists of weekly health coaching to increase physical activity and a roadmap of how to eat more protein and healthy nutrients with real food. We measure patients' success with our in-body composition device weekly and we prescribe medications such as GLP1s and other peptides to decrease food noise, increase muscle mass, and promote muscle recovery at the gym. We teach healthy habit stacking so that when patients get to their goal, there is much less chance of rebound fat gain or muscle loss. We get patients to shift their mindsets from short walks to 10,000 to 15,000 steps a day. That's what our ancestors did, and there was no 40% fatness then. We also normalize lifting heavy weights. Of course, with a trainer, if they've never done this before, and we pull out all the stops with our sleep coaching. I will sleep when I'm dead is no longer cool. Optimizing sleep is crucial to longevity and ideal body composition. I love my aura ring that gamifies my sleep. I compete against myself every night to see if I can beat the previous night's sleep indices. I'll put a link to aura in the show notes. I will also admit that sometimes, even with our incredible health coaching, we have patients who have GI symptoms that prevent them from eating certain foods and really struggle with changing their diets. And we have some who just get stuck and they can't get to their body composition goals. For these challenging patients, we also offer GI map testing and food sensitivity testing. Ooh, what's that, you ask? I bet all you zesties ears just perked up. Alas, I am getting close to my promised 15-minute keep it short podcast length. So more on GI maps and food sensitivity testing next time. If you have an addiction to having a zest for life and want to not just add years to your life, but add life to your years, keep listening to season two of the Dr. 50 Something Show. Of course, I will also put links in the show notes on how to learn more about our Get Fit program. Make sure to follow this show so you know when the next episode on GI mapping and food sensitivity drops. Thank you for joining this episode of the Dr. 50 Something Show. If you are intrigued by this show and never want to miss an episode, click follow. If you are a really great friend, share it. The content of this episode is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider to answer any questions you may have about your personal medical conditions. Until next time, get fit, get fabulous, get firm, and take care of yourself.