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 make 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 Cynthia Thurlow.com. I appreciate each and every listener. This is your update on the Midlife Minute. This is third in a series on fiber, talking specifically about how to increase your fiber without bloating. Really, really common concern for women is bloating in middle age and how do we address it? And so what I find for a lot of women is they tell me I try adding more fiber and I just felt worse. I was more bloated than ever. My stomach felt distended all day. I thought fiber is supposed to help now make things worse. So they stopped fiber altogether and they assume fiber isn't for them. They're convinced that they have to have a fiber free diet because they don't tolerate it. And in most instances, the problem isn't actually the fiber itself. It's either too much, too frequently, wrong type of fiber, or what's going on in the gut as they're navigating the perimenopause to menopause transition. So I want to talk to you about the physiology behind fiber, why midlife changes the equation as it pertains to fiber and how to increase fiber in a way that supports your metabolism, hormones, and gut health without all the bloating. It is possible. I promise you I've been there. I've totally been there. So why does fiber matter in midlife? Let's just do a quick review. So we know in perimenopause and menopause, our estrogen levels fluctuate and eventually decline. Same thing with progesterone. And most women think of estrogen predominantly about bikini medicine. We think about it in terms of fertility, but estrogen has potent effects on insulin sensitivity, fat distribution, brain function, immune regulation, and most importantly, the gut microbiome. And so as estradiol, which is the predominant form of estrogen, our bodies make prior to menopause, as it starts declining, we start seeing reduced microbial diversity. So the species in the microbiome start to shift towards more inflammatory, potentially opportunistic and problematic organisms. We get lower levels of beneficial bacteria, which increases inflammation. We have reduced short chain fatty acid production. So in each one of these little vignettes on fiber, I've tried to talk about the importance of short chain fatty acids. And most women will experience some degree of slowed gut motility, which is both a combination of smooth muscle contractility from a reduction in progesterone and alterations in nitric oxide production, courtesy of lowered estradiol levels. And so it's really interesting how this shows up. Number one, new underlying food sensitivities. I became extremely sensitive to dairy, obscenely so. Number two, bloating or constipation, weight loss resistance, and then also blood sugar swings. So suddenly women will say, I used to be able to tolerate X, Y, or Z. And now I feel like I get a massive drop in my blood sugar response after consuming an otherwise healthy meal. And that's when fiber can really be critically important to help modulate some of these changes. So I think many of us still think about fiber in terms of constipation, like grandma took fiber or psyllium husk or metamucil to prevent constipation, but it's so much more than that. It really has a lot of metabolic and hormonal effects. Number one, it helps with blood sugar regulation. So we know that soluble fiber forms a gel-like substance in the gut, which slows the absorption of carbohydrates. It reduces post-meal glucose spikes and improves insulin sensitivity. I'm looking at research. So if you're watching the video and you see me looking down at paper, I made a lot of notes and I want to make sure I get through all the content. So if you see me looking down, it's just to keep me on task. These things are especially important in midlife as our insulin sensitivity tends to decrease. Number two, we know that it helps feed beneficial gut bacteria. So I've talked about how fiber feeds the colonocytes in the large intestine or colon. We know that certain fibers are fermented by the gut bacteria. And when this happens as a byproduct, our body produces short chain fatty acids. So common ones are acetate, propionate, butyrate. I always think of butyrate as like the unsung hero of the gut in particular because it's a signaling molecule So it fuels the cells that line the colon So it a fuel source It reduces inflammation It strengthens the gut barrier It also crosses the blood barrier which is something that is designed to be impermeable but for substances like butyrate can cross the blood-brain barrier. It's also important for supporting immune regulation. So lower butyrate levels are associated with obesity, poor metabolic health, inflammatory conditions, autoimmunity. And think about it. We know that women, as they are navigating this perimenopause to menopause transition, are four to five times more likely to be diagnosed with an autoimmune condition. So a lot of it has to do with a breakdown in that small intestinal lining, plus or minus these alterations in immune function. So immunosenescence, aging of the immune system plays a huge role. Next is fiber is important for supporting estrogen metabolism. There is something called the estrobilum. It is part of the microbiome. It is an estrogen processing system in the body. and the bacteria there help break down estrogen. So think about it as they are designed to break down estrogen, create a little present and then help shuttle it out of the body in your poop. It helps get the estrogen ready to be eliminated from the body and maintains a hormonal balance. But when fiber intake is low, estrogen has the propensity for being reabsorbed. So it isn't properly broken down. There's an enzyme called beta-glucuronidase and if that's not working effectively, we can end up recirculating that estrogen, which as you can imagine, doesn't make us feel very good. And I think a great deal about the symptoms that most women complain about breast tenderness, brain fog, weight loss resistance, mood swings, all of which can be magnified in the setting of recirculated estrogen. So fiber helps bind estrogen in the gut to poop it out. That's the most simple way to put it. Why fiber causes so much bloating in women? I think it's very beneficial, but it's also very bio-individual. And so number one, your microbiome is not ready for the fiber. This certainly happened to me after a lengthy course of antibiotics. If you want to go back, I have an incredible Substack article talking about this, like what happened to me when I was in the hospital in 2019. I could not eat fiber for 18 to 24 months at all. But when you cannot tolerate fiber, it is a sign that something is off in the gut. I always think about what's going on in the gut microbiome, you may not have the right species of microbiome metabolites, bacteria, viruses, fungi, protozoa. If the microbiome is not ready, then this can also be exacerbated by low fiber diets, processed carbohydrates, which we know about 70% of Americans, that's what they are consuming as their primary fuel source, little plant diversity. So that's why we talk about what plants are important to have in our diet. I certainly have interviewed lots of experts and the experts talk about how you want to have 30 plant varieties a week. That doesn't mean 30 in one day, but over the course of the week, having different types of plant-based materials. The other thing that I see is a lot of women, they hear me say, you need to increase your fiber. So they go from five or 10 grams to 50 and they get bloated because their body is not ready to accept all that fiber. And so the bacteria that are there or the microorganisms that are there in the microbiome are just not able to accommodate the load of fiber that they receive. So if you are dealing with an upregulation and fermentation in the gut, you may experience bloating, gas, cramping, irregular bowel movements, constipation, diarrhea. And we know that there's something called microbial adaptation. So it takes time. You cannot go from 10 to 50 grams in 24 hours. You're going to be miserable. And the research actually shows that the microbiome can shift substantially in as few as two to three weeks when fiber intake increases, but that adjustment takes time. Those little microorganisms are so smart. They're trying to accommodate, but they are not miracle workers, right? So we have to do this slowly. The other thing is not all fiber is the same. So everyone's heard about soluble versus insoluble. So there's soluble and insoluble, fermentable fibers, and then non-fermentable fibers. So we're going to go through each one of these pretty quickly just to kind of give you an overview. Highly fermentable fibers like those found in beans, onions, or inulin powders can produce a lot of gas. This is why I'm not a huge fan of people starting with supplements to try to make up for the lack of food diversity. So like inulin is a great product, right? But it can be really, really bloating. I don't tolerate a ton of inulin. In fact, Lily's dark chocolate usually has some inulin in it. And I can tell if I've eaten a little too much, because I will get really bloated. So like for me personally, I have to be careful with inulin. Gentler fibers are things like chia seeds, ground flax seed. Remember I've talked about in other videos, chia and flax seeds are like the magic bullet. I have the most perfect poop. And I sometimes will recommend to women a tablespoon of fresh ground chia, a tablespoon of fresh ground flax fixes so much constipation that women have. Let me be clear. If constipation is new or bothersome, you need to have that checked out. Do not ignore that. Other gentler fibers, psyllium, oats, cooked vegetables are all good, really nice options. And they tend to be better tolerated than like inulin, which as I mentioned, even for myself, I eat quite a bit of fiber can make me incredibly bloated. 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 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. Stay hydrated, stay strong, especially in midlife. What does comfort that carries you from morning to night feel like? This March, Cozy Earth crafts every piece with care from soft, supportive socks for your steps through the day to breathable comforters that help you rest deeply at night. And let's be clear, in perimenopause and menopause, our sleep is precious. Every detail with Cozy Earth is intentional, so your everyday feels quietly elevated. Their designs focus on comfort in the details because small choices make a lasting difference. And what I always love about Cozy Earth is that these are items that will last a long time. They're high quality. They feel luxurious. They feel amazing next to your skin. They're going to make a lasting impact, a tiny piece of luxury, whether you're on the go or at home. And what I love best about Cozy Earth is they provide a risk-free purchase, 100-night sleep trial. You can try them for yourself. every detail is designed to feel effortlessly comfortable. Returns are super easy, but after feeling this level of comfort, I'm pretty confident you won't let them go. There's also a 10-year warranty built with care and precision because true comfort is meant to endure. Discover how care in every detail transforms simple routines into moments of true comfort and ease, like my bubble blanket, my comforter, my cozy socks, and my pajamas. discover how care in every detail transforms simple routines into moments of true comfort and ease head to cozy earth.com and use my code Cynthia for up to 20% off. And if you get a post purchase survey, be sure to mention you heard about cozy earth right here. Again, that's cozy earth.com and use my code Cynthia for up to 20% off experience the craft behind the comfort and make every day feel intentional. Next thing to think about is underlying digestive issues. So I've talked a lot about digestive fire, how important that is. I see a lot of women who have low stomach acid, low digestive enzymes, they have terrible quality bile. And it's because they've been eating like low fat diets or nonfat diets or just eating adulterated crappy oils. And so sluggish bile flow can contribute to this. Or if you have a lot of dysbiosis, which is essentially weeds in the garden, or if you have SIBO, so small intestinal bacteria overgrowth, which is when microorganisms that are in the large intestine extend into the small intestine, which is not where they are meant to be. And it creates a tremendous amount of gas and bloating. You could also have SIFO, small intestinal fungal overgrowth, although less common to see. And sometimes when you have some of these issues per se, it's like adding gas to a fire. It just can be explosive and bothersome. And so the bloating isn't caused by the fiber itself. It's actually an underlying digestive issue. And so those things need to be worked out. So there's smarter ways to increase your fiber. And I'm going to walk you through these. This is actually what I do with patients. Instead of thinking about high fiber, 25, 30, 40, 50 grams, I want you to think about we're training for a race. That's the analogy I'm going to use. We're training for a race for your microbiome. And so number one, you want to increase slowly. So you want to add about three to five grams of fiber every four to seven days. So sometimes I'll even go more slowly than that. We'll say we'll just going three to five over the course of a week. So it could be on week one, you add a tablespoon of chia seeds. On week two, you could add a serving of berries. On week three, you add half a cup of lentils. Again, lentils and beans and things like that. Sometimes you have to properly prepare them to reduce the likelihood of causing more bloating. These strategies will give your gut bacteria time to adapt. This is very, very important. If you have been eating a lower fiber diet, and I would say track first and then monitor, it's a good way to get a sense of where you are at a starting point. I talk very openly, there are certain vegetables and strategies like the chia and flax seeds that are just really easy for me to use. They don't cause me any bloating whatsoever. They tend to be really well tolerated. Same thing with cooked vegetables. For a lot of They do much better with cooked vegetables versus raw vegetables. Step two, in order to increase your fiber intake, start with gentle, well-tolerated fibers, really emphasizing this a lot. Begin with foods that don't cause as much or excessive fermentation. So good starting options looking at my notes are things like chia seeds ground flax seeds Like I mentioned earlier these are like my ninja warriors Cooked carrots zucchini small amount of oats kiwi which can be helpful for people that have constipation too, or psyllium husk. These fibers are going to be helpful for supporting motility, improving stool consistency. There's something called the Bristol stool chart. And so I highly recommend you can like Google it. I'm not gonna be able to throw it up in this video, but we'll certainly do it for the YouTube one. Bristol stool chart is a really great way. Like the gold standard is a number four. That's what you want to see in the toilet. It has a lot to do with how long the stool stays in transit. So if you have absorbed a lot of water, it can be very pebbly like rabbit turds. It can be painful. People can have a lot of hemorrhoids versus people that say, oh, I have a rapid transit time. I have a lot of diarrhea, loose stools. We don't want that either. That's very little absorption of water as it's moving through the digestive system. But these particular fibers that I mentioned improve motility, improve stool consistency, and then also produce less gas. And that's key. If you're prone to bloating, these are the things you wanna think about. Step three is increasing plant diversity. Remember I mentioned the gold standard is 30 plant varieties over the course of a week. We know that people that do this have more diverse microbiomes. And we know that women really struggle with this as they are navigating that perimenopause to menopause transition. They also tend to have better metabolic health and less inflammation. Plant foods include like fruits and vegetables, herbs, nuts, seeds. So think about it. If you put a big salad together a few times a week, you can easily get to 10. Whole grains or legumes, again, very bio-individual. And you don't have to do this all overnight. It's like just thinking about it in a stepwise approach. Number four, please hydrate your bodies. I talk about this a lot. Hydration's not sexy, but it is so important to ensure that we are properly hydrated. Helps with mentation, helps with sleep, helps with lowering inflammation, also helps with allowing us to be much more regular and that fiber is absorbing water as it's moving through the digestive system. We know that when you don't have enough fluid or enough hydration, your stool is going to be harder. Your gut motility is going to be slowed down. You'll probably have more bloating. And obviously we typically think of this as half your body weight in ounces a day, but really beneficial. And then the other thing is the last step in this is address digestion first if needed. So I think about digestion from a north to south process, right? So you have to be in the parasympathetic, you need to take a couple deep breaths before you breathe. But if diagnostic testing shows that your hydrochloric acid is low, your digestive enzymes are low, that your bile quality is terrible, or if you have dysbiosis that's showing up on stool testing, then this is something that you need to address as well. And let's talk about the gold standard. So depending on who you speak to, research suggests anywhere from 25 to 30 grams of fiber a day because we know this supports metabolic health, supports healthy excretion of estrogen, improves the gut microbiome, supports hormones, cardiovascular health. But the key is this is a marathon and not a race. I wanna continue to emphasize that, that you are going to do a whole lot better if you are not forcing yourself to go from 10 grams of fiber to 30 overnight. You'll really give your body time to process and adapt to this new stimulus, which is the fiber. And the thing that I always tell you is what to expect as your gut is adapting. In the first one to two weeks of increasing your fiber, you may notice a little bit of gas. You may have some slight bloating. You may have changes or alterations in gut. Sorry, you may have changes or alteration in stool consistency. This is completely normal. By week two, week three, week four, you should have more regular bowel movements. You should have less bloating, less gas, improved energy, and hopefully improved appetite regulation. For a lot of women, they're just not satiated and fiber helps with satiety along with protein. So I wanna be really clear, give your microbiome time to adapt. If fiber makes you feel worse, it doesn't mean fiber is the problem per se, right? I think this whole discussion has really been about helping us understand what can be contributing to why we're not tolerating as much fiber. This usually means a couple of things. Usually that you're increasing your fiber too quickly. You chose the wrong type. Remember I mentioned earlier, the less fermentable types are going to be preferential. Your digestion needs additional support. Maybe you need hydrochloric acid. Maybe you need some digestive enzymes. Maybe you need Tudka for biliary support or your microbiome just frankly needs time to adapt. And again, again, again, I'll keep saying everyone needs a little more fiber, very bio-individual, but I hope I've made the argument for you today that there is definitely a way to do this slowly so that you lessen the likelihood that you will experience digestive issues. Keep me posted on what you want to learn more about. This is the third in a series on fiber. We're moving on to a new topic next week, but please know I love your comments. Please send them to support at CynthiaTherlo.com if there's specific things you want to learn about or resources you're looking for. And we have a free Facebook group called the midlife pause backslash my name. That is where there's lots of women and some men very supportive nurturing environment, where I post content and research and ask a lot of questions of the community just so I get a sense for what people are interested in. If you love this podcast episode, please leave a rating and review, subscribe and tell a friend. Bye.
