The final ‘E’ in the EMBRACE protocol in my book ‘Life After Menopause‘ focuses on elimination. In the first of 3 excerpts from my book, we are going to firstly look at the role of your gut and microbiome health in how well you age. And stick with me to the end where I'm going to explain a little bit about our new Microbiome Explorer test that we are getting great results with in clinic.
Watch the video or listen to the podcast (episode 171).
A healthy gut is foundational to our health and how we age. Going beyond simply digesting your food, your gut is a complex ecosystem, essentially acting as a ‘second brain’. It’s a control centre, regulating inflammation, your immune system, nutrient absorption, hormone production and even your mental health.
What is your gut microbiome?
Your gut is a long tube that starts at your mouth and ends at your anus, working tirelessly to break down the food you eat, absorb essential nutrients and expel waste. Within this tube, there's a bustling city with millions of inhabitants (your microbiome). These little helpers form a diverse community of microorganisms, including bacteria, viruses, fungi and other microbes, and they play a vital role in everything from digestion to immunity, and even influence your mood.
The National Institutes of Health state that within your gut microbiome, there are a whopping 8 million genes at play. To put it in perspective, this means your body hosts 360 times more bacterial genes than human genes!
Just as a well run city relies on its community and services, a healthy body relies on a well balanced gut with a strong lining. When this balance is off, it can trigger a chain reaction of health issues, from digestive troubles to hormone imbalances and immune dysfunction, affecting your overall wellbeing and
crucially how well you age.
The impact of menopause
By midlife, your gut has taken a lot of abuse, from your diet (sugar, alcohol, processed or takeaway foods, low fibre, etc.), to stress, toxins, antibiotics and other medications. And then menopause, no surprise, has an impact. Your sex hormones aren’t just about reproduction; they also interact with the gut
microbiome, influencing how food is broken down, nutrients are absorbed, and even how fat is stored.
Equally there’s a collection of microbes that influence how oestrogen is metabolised and used by the body (the ‘oestrobolome’). Lower levels of sex hormones post menopause can upset this delicate balance, increasing the risk of varying digestive issues as well as weight gain and chronic diseases.
What’s more, the gut-brain axis (the super communication highway) means that changes in gut health can have a knock-on effect on mental wellbeing. Your gut helps produce neurotransmitters like serotonin, which keeps your mood stable.
So, you see, it’s all connected – your hormones, gut health, immune system and even your mental health are part of this intricate web, which becomes more crucial to manage during and beyond menopause.
What does a healthy microbiome do for us?
- Nutrient absorption and digestion: Microbes assist in breaking down complex carbohydrates, fibre and proteins that our bodies can’t digest on their own – and they help in the absorption of essential nutrients.
- Immune system: The microbiome interacts with immune cells, helping them to identify harmful pathogens. This interaction is crucial for developing and maintaining a robust immuneresponse.
- Synthesis of vitamins: Gut bacteria synthesise certain vitamins, notably vitamin K and some B vitamins, which are essential for various bodily functions, including blood clotting and energy metabolism.
- Gut barrier integrity: The microbiome helps maintain the integrity of the gut lining, acting as a barrier against harmful substances and pathogens. This is essential for preventing conditions like leaky gut syndrome, which can lead to inflammation, autoimmune conditions and other health issues.
- Metabolic regulation: Gut bacteria influence metabolism and have been linked to the regulation of body weight and fat storage. Imbalances in the gut microbiome have been associated with metabolic disorders like obesity and type 2 diabetes.
- Mental health and mood: Gut bacteria produce neurotransmitters and other chemicals that influence brain function and mood, potentially affecting conditions like depression and anxiety. It’s thought as much as 90% of your serotonin is produced in the gut!
- Inflammation reduction: A healthy gut microbiome can help regulate inflammation in the body, preventing chronic inflamm-aging.
Microbiome diversity seems to be a key differential. Recent research found that older adults with a more unique pattern of changes in their gut microbiome were found to be healthier and have longer lifespans compared to those with less microbiome diversity. Bacteria can process information and communicate rapidly, even impacting your thoughts and actions. That’s why it’s important to give your gut bugs the right kind of food.
How to support your microbiome
Mix it up – Increasing the variety of foods in your diet is a great way to improve the diversity of your gut microbiome. Include a wide range of fruits, vegetables, legumes, nuts, seeds and whole grains in your diet. Each type of plant and each colour contain different phytonutrients that beneficial gut bacteria
thrive on. Try to incorporate a variety of colours and different herbs and spices in your meals. Consider a weekly organic veg delivery box to liven up your usual shop and encourage you to cook with new (and seasonal) ingredients.
Add more fibre – Fibre is an all round superhero for your microbiome! It acts as a prebiotic, feeding the good bacteria, which ferment the fibre, producing short-chain fatty acids (SCFAs) like butyrate, which is vital for gut barrier function and has anti inflammatory properties, which are particularly beneficial as the body’s immune response changes post menopause. Fibre also helps with regular bowel movements and preventing constipation, and it contributes to a more diverse and resilient gut microbiome. And it’s been shown to help you live longer. A study published in the American Journal of Epidemiology in 2015 showed that for every additional 10g of fibre consumed per day, the risk of dying decreased by 10%!
Prebiotics – These are foods that feed your good gut bacteria, particularly species like Bifidobacteria and Lactobacilli. By feeding these helpful microbes, prebiotics help them thrive and multiply, leading to a more balanced and diverse gut flora. Prebiotic-rich foods include garlic, onions, leeks and asparagus. Green bananas and cold cooked potatoes, which contain ‘resistant starch’, are also favourite foods for your bugs. Prebiotic supplements often contain key components like inulin, fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), resistant starch, xylo-oligosaccharides (XOS), polydextrose and arabinogalactans, all of which are known to nourish and promote the growth of beneficial gut bacteria.
Probiotics – These friendly bacteria play a key role in maintaining a healthy gut microbiome, ensuring everything from effective digestion to robust immune function. By populating the gut with good bacteria, probiotics help fend off harmful microbes and reinforce the intestinal barrier, acting as a first line of defence against inflammation and infections. Probiotic rich foods include natural yoghurt, kefir, sauerkraut, kimchi, kombucha, miso and good quality sourdough bread. Supplements can be helpful but unless you can see a health practitioner for personalised advice (there are millions of different strains), you’re better off getting your probiotics through food. And if you have to take a course of antibiotics, make sure you balance it with some good-quality probiotics. It won’t affect your antibiotics if you take them separately (e.g. antibiotic in the morning, probiotic at night).
Don't forget your MOUTH!
Oral health isn’t just about nice teeth and avoiding bad breath; your mouth is the gateway to your gastrointestinal tract, and like it or not, is home to a whole community of microorganisms including bacteria, fungi and viruses. This complex ecosystem is known as the oral microbiota and just like the gut microbiota, a healthy balance of bacteria in your mouth is essential to protect against infection, aid digestion and support your immune system.
If there’s any imbalance, harmful bacteria can spread throughout the body and contribute to various health conditions, including cardiovascular disease, diabetes and respiratory infections. Several studies have shown an association between gum disease and increased risk of certain cancers. And there’s growing evidence that it could also be linked with Alzheimer’s disease.
So, we need to practise good oral hygiene every day. This includes regular brushing (electric brushes remove more plaque than manual ones) and flossing to remove plaque and food particles (I use a water flosser), as well as routine dental check ups for professional cleanings and early detection of any oral
health issues.
When symptoms persist – get tested
For some women, symptoms persist despite “doing all the right things”. In these cases, testing can provide clarity.
We’re delighted to now offer the new Microbiome Explorer test, one of the most advanced and comprehensive gut microbiome tests currently available. Unlike basic stool tests, this test uses metagenomic sequencing, allowing us to see not just which microbes are present, but what they are actually doing in the gut.
This gives insight into:
- microbial diversity and balance
- inflammation and gut barrier function
- oestrogen metabolism and hormone recycling
- short chain fatty acid production (key for gut and metabolic health)
It’s an excellent option for anyone with unresolved gut symptoms, a history of digestive issues, or for post menopausal women who want to optimise gut health as part of healthy ageing, rather than guessing with supplements.
Used alongside your clinical picture, Microbiome Explorer allows for far more targeted, personalised support. Contact us if you'd like more info.
This is an excerpt from my book ‘Life After Menopause' – do check it out if you haven't got your copy yet!