Welcome to Everyday Wellness Podcast. I'm your host, Nurse Practitioner, Cynthia Thurlow. This podcast is designed to educate, empower, and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives. This is the start of a new Thursday series called The Midlife Minute that is really designed to address listeners' questions in a little bit longer length of time and or deeper dive into topics. Ideally we're going to keep these podcasts under 20 minutes. Occasionally we may go over to 30, but I'm trying to reinforce some key concepts and ensure that I'm addressing listeners' questions in a way that's really helpful. So the questions that I will be addressing topics are going to be items that I'm being asked over and over and over again. I hope you enjoy this series. Please share with your friends. And as you know, you can always send your questions to support at synthiethurlow.com. I appreciate each and every listener. This is the Midlife Minute. This is going to be a fiber centric series. This is number one in the series of three, the fiber gap in midlife. Now let me be really clear. I jokingly say this, but I mean this. Fiber is the new F word. It's not glamorous. It's not trendy. It's not particularly exciting, but it's one of the most powerful tools we have for supporting our metabolism, gut health, and hormones in midlife. Now I have a lot of patients that will tell me I don't tolerate any fiber. And I had a point in my life where I didn't tolerate fiber at all. After being on antibiotics for six weeks in 2019, I really didn't tolerate much, if at all, any fiber for at least 18 to 24 months. So fiber in many circumstances can be very number one, bio-individual. Number two, it is still important. And in my book, The Menopause Guide, I talk about all the reasons why fiber is really critically important as we're aging and our hormones are declining. So if you're impairing menopause and menopause and you're dealing with bloating, constipation, changes in your lipid values, or even worsening insulin resistance or issues with glucose dysregulation, there's a very good reason why the lack of fiber can exacerbate this. And it's something that I see over and over again, not just with my own clients, but even in the research and in talking to other providers. And it's not because you're doing anything intrinsically wrong. It's not that you lack discipline. And these kind of common things that we think contribute to why we have all these symptoms. But I would actually argue that your lack of fiber in your diet may be exacerbating these things. And when we look at statistics, I think the average American is eating anywhere from five to 10 grams of fiber a day, which is just much too low. In fact, there are increasing prevalence and incidence of colorectal cancer in younger patients. And with the experts I've spoken to, people that do colonoscopies that are board certified gastroenterologists, they have all mentioned they suspect the lack of fiber in the diet is probably contributing to this. So this fiber gap that I'm kind of alluding to, I think it can impact gut motility, combat blood sugar stability, cholesterol levels, not just total cholesterol, but other lipid markers, satiety. And we know that it affects the microbiome diversity. I talk a lot about as estradiol in particular is declining. We will see changes in diversity of species in the microbiome. Why does that matter? Because we start to see more inflammatory species. We start to see less short chain fatty acid production. We start to see more leaky gut. All of these things are a negative net impact of the hormonal changes that we're seeing in perimenopause and menopause. So fiber is not just about digestion. It's not about grandma's metamucil. It's a metabolic and hormonal regulator. And you'll see me looking if you're watching the video down at paper because I did quite a bit of research for my book, but then I also re-looked at research before recording this little midlife minute podcast. So why does fiber matter more in midlife? As I mentioned, as estradiol is declining, we're going to see changes in alterations and insulin sensitivity. We're going to see shifts in body composition, which I know is so incredibly frustrating. We start to see changes in not only in muscle mass, but also fat-free mass. And we start to see less subcutaneous fat. And we start to see more visceral fat. That's the fat around our abdominal organs. So if your waist size is changing, that is to be expected if you're not actively working against some of these hormonal changes. We get changes in gut motility. And that is both a byproduct of alterations in progesterone, which impacts smooth muscle contractility. It is also a byproduct of a loss of estradiol that impacts nitric oxide production, which is very important for gut motility. I can recall I'm not exaggerating at least 10 years ago telling my GYN, telling my internist that I felt like when I ate, things didn't move as quickly through my digestive system. And because of that, I felt like I wasn't as hungry as I once was. So it becomes this kind of vicious cycle if you're not aware of it and if you're not working against it. So we know that fiber helps with gut motility and addressing the microbial diversity changes. We know that fiber helps slow the absorption of glucose. So I know that like glucose goddess talks a lot about fiber, starting your meal. There is science to support this that will actually help slow blood sugar rises. It helps to bind bile acids and lower LDL cholesterol. I know my listeners know it's not just about LDL, but we know that it's also very important for other lipoproteins like apolipoprotein B. It improves satiety without question and reduces reactive cravings. I think that's a big one that many people are not discussing often enough is that satiety and cravings go hand in hand. If you're not satiated, you're going to have more cravings. If you're more satiated, you'll have less cravings. And it feeds beneficial gut bacteria that support the gut lining. We know that the small intestinal lining has mucus production that helps protect it. And that is a byproduct of a keystone bacteria called acromoncia plus or minus some short chain fatty acids. And that mucus can degrade and can make the small intestinal lining less protected. And we're more likely to develop leaky gut. We know that in that menopausal transition, we're four to five times more likely to develop autoimmune conditions, things like cilia, rheumatoid arthritis, Hashemotus thyroiditis, etc. And I think that I think about fiber very strategically. It can help support a lot of things all at once. And for anyone that's listening that's saying, I just don't tolerate a lot of fiber, I'm not saying that you go from five grams a day to 50, but maybe you're increasing from five to eight or eight to 10 and then slowly increasing it from there. And let's talk about the research. The research shows we've good clinical data on this and one randomized controlled trial, menopause with central obesity. So that kind of truncal obesity that we see who followed a fiber rich dietary pattern showed improvements in metabolic risk factors over just 16 weeks. That's over four months. Another randomized trial using resistant starch, a fermentable fiber demonstrated improve insulin sensitivity in women. These are the things like cool cooked potatoes, cooked, cooled rice, things like that. And in a long-term trial, cilium fiber significantly lowered LDL cholesterol, which is particularly important because lipids tend to rise during menopause independent of diet. Again, my community knows it's not just about LDL, but if LDL is going up, you can likely assume apolipoprotein B or apob is also high. So it's not just about having a daily poop fiber is influencing blood glucose, cholesterol levels and metabolic health at a very foundational level. If you're in perimenopause or menopause and are feeling more fatigued, dizzy, lightheaded, struggling with headaches or noticing your workouts feel harder than they used to, electrolytes may be part of the missing piece. As estrogen declines, we lose some of the fluid regulating and vascular protective effects that hormones once provided. That means blood pressure regulation can shift, cortisol can run higher and many women become more sensitive to dehydration, especially if you're strength training, walking more, intermittent fasting or reducing processed foods. That's why I love element. It is my favorite electrolyte formulation and I've exclusively used their products for the past six years. Element contains a science backed ratio of sodium, potassium and magnesium without sugar, artificial ingredients or unnecessary fillers. It supports hydration at a cellular level, helps reduce muscle cramps, improves energy as well as recovery and can even support better stress resilience. This is particularly helpful in midlife when we're prioritizing metabolic health and muscle preservation. I personally use element throughout the day and it's become a staple in my routine as well as my household. If you'd like to try it, go to drinkelement.com slash Cynthia to receive a free sample pack with any purchase. 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Compared with ordinary AstraXanthin, AX3 has superior bioavailability, purity and environmental sustainability and is better absorbed three times better actually and has been shown to be highly effective in the NIH Interventions Testing Program, the world's most rigorous mammalian lifespan study. I'm really impressed with AX3 and I'm super excited to share this particular podcast interview with AX3's co-founder and CEO. AX3 has also generously offered a 20% discount on your very first order when you visit ax3.life and use promo code SYNTHIA20 at checkout. Again, that's ax3.life and use code SYNTHIA20 at checkout. My family and I are actually taking AstraXanthin to see if we can drop our LP little A. Stay tuned. I think most women fall into the fiber gap, whether it's because there's misinformation, there's fear, there's fear mongering around this conversation. I think we're now very conditioned to believe that protein-centric diets are important and that's great. But I think now we're so focused on eating enough protein, people forget about the fiber piece. So, as I always say, a lot of my patients, a lot of this community does a great job with protein. They get plenty of protein into their diets and that's fantastic. When you're just having animal-based protein or some plant-based protein, what I find is oftentimes very little fiber, especially if it's animal-based protein, because eggs and chicken and steak and pork don't have fiber versus some of the plant-based options do, but they tend to also be very carbohydrate dense. So, I find for a lot of women, they eat a lot of protein and very little fiber. I think there's also this issue surrounding a fear of carbohydrates and some of that is well-intentioned. Obviously, in the intermittent fasting space, there's a lot of conversations around carbohydrates, carbohydrate restriction, ketogenic diets, but I think that the bulk of the concerns about carbohydrates are really the processed carbohydrates, the bread, the pasta. Some people don't tolerate grains, but it's the cookies, the cakes, candy bars, most protein bars are junk, et cetera. It's the processed carbs. Whereas there are some really healthy fiber-dense options that are carbohydrates, like I think about beans, I think about lentils, I think about fruit, I think about plenty of the vegetables that are out there. And unfortunately, when we are paranoid of eating carbohydrates and I know there are women out there that will say to me, oh, I can't eat fruit, I have to be by a low carbohydrate diet, a piece of fruit every day, whether it's an apple, whether it's low glycemic berries, whether you're on vacation, you want some pineapple, that is not what's getting you into trouble. So, I think that's the process of carbohydrates that trick our bodies into thinking we are not consuming as much as we are. So if you are someone that has been carb phobic, I mean, there's no other way to put it, please know that sometimes when women liberalize their carbohydrate intake based on how physically active they are, based on how metabolically healthy they are, in some instances, they start feeling a whole lot better. They're recovering better from their workouts. They're sleeping better. Their thyroid function might improve. So that end of one experimentation that I always encourage you all to do, I think it's still very important here. And if we're talking about tracking macros, 100 grams of protein a day, no more than 20 to 30 carbohydrates per meal, 30 grams of carbohydrates, I think is a good starting pace. Obviously, if you run marathons, you're very physically active, you're doing a lot of work, you can probably buffer up above that. If you are very sedentary, you are not metabolically healthy, you have weight to lose and you're insulin resistant, then maybe you need a little less carbohydrate. People like numbers, and so I say like 20 to 30 grams, I think is reasonable, but we don't want to track our macros forever. I think for a lot of us, we want to get to a point where we can intrinsically say, okay, this is a day I've worked harder. So I'm going to have a little more discretionary carbohydrate versus this is a day when maybe I've been traveling. And because I've been traveling, I have been more sedentary and therefore I'm not going to have as much carbohydrate. Number three, bloating from doing too much too fast. So everyone that's listening is thinking, okay, I need to think more about fiber, but I typically will recommend you track and then increase from there. So if you're getting 15 grams a day, don't suddenly go to 30 because you probably will get bloated, you may get constipated. That's what we want to avoid. This is where we see gas and bloating and discomfort. People then will tell me like, I can't button my pants. I don't feel good. And many people will then say like fiber doesn't work for me. Therefore, I'm not going to consume any. And I think that the more I understand about the changes in the gut microbiome, the more that I would encourage everyone to consume a little more. Maybe it's two grams more in a day. Maybe it's two grams over the course of a week that you're consuming and then kind of going up from there. Your gut bacteria actually need time to adapt to the increase in fiber. So when you consume fiber dense foods, it goes through your digestive system, gets to the large intestine or colon, and that is where these foods will ferment. And from that, we produce short chain fatty acids, which are really, really important. I talk about this a lot on the podcast. They're signaling molecules, one in particular butyrate crosses the blood brain barrier. It's a very important signaling molecule. They're involved in reducing inflammation in the body. They're involved in working in conjunction with keystone bacteria to create mucus that supports the gut lining. There's a lot of really important components to short chain fatty acids which need fiber to be able to do some of this work that I've mentioned. So I want you to think about fiber as something you do gradually and a strategy behind it. I would say add it slowly, divide it into your two to three meals. Make sure you're drinking plenty of water because we don't want you to get bloated and uncomfortable, reminding everyone that when we consume food in general, we want to be in a parasympathetic state. I ask people all the time, where does digestion start? If I ask kids, they'll say my mouth. If I ask most adults, they'll say the same thing. It actually starts in our brains. We need to be in the parasympathetic nervous system in order to properly prepare our bodies to accept the food, to be able to digest and assimilate nutrients, to be able to properly detoxify. And if we're in a stress state, if we're eating on the go, eating in our car, eating off our kids' plates, we're not in a parasympathetic state. And for a lot of people that tell me they're bloated, sometimes something as powerful as sitting down and taking four to five deep breaths can signal to their body it's time to get serious about being able to consume this food. So I think that starting with more fiber earlier in the day is better than just sitting down and eating a massive fibrous dinner, eating a massive fiber dense salad with 15 different kinds of seeds and nuts and fibrous fruits and vegetables. That's probably not ideal. So maybe you add some seeds to a salad. Maybe you include berries or fruit with your, if you tolerate dairy, maybe you're having full fat Greek yogurt. Incorporating legumes or avocado into your meal. Eating more whole plant-based addition. So I like to, like when I go to Kava, which I don't do all that often, but when I do, I usually will get like chicken and steak and then I will also do lentils. So I'm getting some plant-based protein along with animal-based protein and that is what works really well for me. So if someone says I don't tolerate a large dose of beans, sometimes soaking beans or soaking some of these legumes or grains can be very helpful to support digestion. I always say don't do anything extreme. Don't automatically run to mycelium or Ph.G.G., which is partially hydrogenated guar gum. Start with food first. Make sure you do really well with that and then you can support with additional products. I personally like to use a tablespoon of flax and chia in a smoothie. My smoothie is where I dump a bunch of things into it. I count that as a portion of my protein, but then I'm sitting down for at least two other meals during the day. My husband also has a smoothie every day and I just throw a bunch of stuff in there to help protect his gut because he is still coming off of six months of antibiotics for being treated for tuberculosis. And so it's going to take a long time to rebuild his microbiome, but I know it can be done because I know where I was in 2019 and I know where I am in 2026. So hydration is important. Chewing is important. Making sure you're in a parasympathetic state is important. And I want to be really clear. A midlife is not the time to eat less. I think when I talk to women, especially women that are intermittent fasting, they tell me very transparently, I've just gotten to a point where I eat less and less and less. And it's not that I want, I don't want to eat more. I am just no longer hungry. So we have to kind of re-engineer, reintroduce more protein over time. You've really conscientious about tracking at least to get a sense of where we are. And then understanding we ultimately want to nourish our bodies. And I want to be clear about eating more intentionally. And I think fiber along with protein is one of these simplest, most reliable tools we have for supporting the gut microbiome, improving blood sugar stability, improving satiety, improving our lipid markers, and then also rebuilding metabolic resistance. And so I think that we're building metabolic resistance because I think so many of us are no longer metabolically healthy. It's important to understand that metabolic health really is wealth. And I always say this isn't glamorous. It's not sexy, but fiber is really important. So I want you to think about some things to keep it really simple. So I'm going to give you a couple of things. Number one, look at your meals and ask, where is the fiber? And if you're not getting in that meal, make sure you're getting it in your next meal. Add one small fiber source to your meal each day and just do this gradually. I know there are many high achieving women that listen to this podcast and they're like, oh, if I'm consuming 15, I want to get to 50 as quickly as possible. That's probably not going to work well. So try to slowly increase it. Make sure you're staying hydrated. Hydration with electrolytes I think is a great thing to do. And if you're drinking a lot of caffeine, you need more hydration. And then pay attention to how your body responds. So I always say whatever symptom we experience, it's valuable, right? And maybe that that particular fiber is not what's most agreeable to your body. That doesn't mean that you failed. Maybe it gets quantity associated. Maybe you increased it too quickly. Maybe instead of having half a cup of legumes, you need to start with a quarter cup. Instead of having a full tablespoon of flaxen, GSCs, maybe you need half a teaspoon, just as a starting point. And so I think that what I really want to leave everyone with is no extremes, no overnight transformations, just slow and steady winds. And then sometimes the most powerful changes in midlife really are the least glamorous, but most impactful. And so fiber may not be exciting. And as I said earlier, I think of fibers, the new F word, because for some people it is incredibly polarizing. But I think about even a lot of the carnivore community eventually will come to find that they need to include some of these foods into their diet. So I would say carnivore-ish for some of them. But I would make the argument that for nearly everyone listening, fiber needs to be part of the conversation. And certainly, if you have questions or concerns, you can certainly send them to us at support at synthiathorlo.com. We endeavor to include listeners' questions, or we do a compilation like today. A lot of questions about fiber. So I just decided to do a three-part series talking about different aspects of fiber. Stay tuned for the next episode talking about fiber. And don't forget to join our free Facebook group called the Midlife Pause, backslash my name. So the Midlife Pause, slash synthiathorlo. It is a free group. There are mostly women in that group. There are a couple men, lovely, supportive men. We don't tolerate anyone that isn't in that group, but really a great group of people that are just looking for reliable, helpful information. And we have a ton of healthcare professionals in there. I take great pride in that, that they want to be part of that community. And they will occasionally answer and respond to questions. This is not medical advice, but they will occasionally talk about their own patients in a very anonymous way or talk about things that they've seen in clinical practice, which I think is so interesting and so needed.
