Having a healthy gut is integral to overall wellness. Gut health is linked to not only your digestive system, but also plays a role in metabolism, glucose tolerance, insulin sensitivity, the nervous system, endocrine system, and more. The gut microbiome is made up of trillions of bacterial cells, fungi and other microbes, and is as unique to you as your fingerprint.  Your unique microbiome began development in utero, and is influenced by many factors including but not limited to genetics, a vaginal or cesarean birth, breastfeeding, the environment, exercise and sleep habits, hormones and nutrition. The bacteria in the gut serves as a communicator to other systems in the body. Changes in the bacteria in the gut microbiome can disrupt the messaging function and put you at an increased risk of many systemic conditions including cardiovascular disease, irritable bowel syndrome, type 2 diabetes, mental health concerns, and auto-immune disease.

Menopause and the microbiome  

There is evidence that suggests hormone fluctuations and specifically the decrease in estrogen, influences the microbiome by altering the bacteria that is present in the gut. We also know that estrogen receptors are located in the intestines, brain, bones and adipose tissue (commonly known as body fat). While it is too soon in the research to know if there is a direct relationship between hormone mediated changes in the gut and menopausal symptoms, it is hypothesized that the microbiome may play a mediating factor in body fat increases, cardiovascular disease, and cognitive decline.  

Many women suffer from digestive issues in menopause. This may be attributed to the decrease in estrogen slowing down the motility of the digestive tract, which commonly leads to bloating, gas, and constipation. The hormonal shifts contributing to a change in the bacterial make-up of the gut may also result in poor digestion. The increased stress experienced by many women during menopause can also impact the gut microbiome. The bacteria in the gut communicates with the brain bi-directionally through the gut-brain axis. So if you are experiencing intestinal or digestive distress, it can be the cause -- or the result --of anxiety, stress, or depression.  

It’s probably not surprising that the lack of sleep common with menopause can also impact the gut microbiome. Add in the increased stress from multiple nights of poor sleep combined with all of the above and you have a perfect storm for a less resilient, less diverse microbiome. There are, however, ways to support your gut health and mitigate these effects.  

Essentials for a healthy gut microbiome

A diverse gut is a resilient gut. With an increase in bacterial diversity in the gut, the body becomes more resistant to illness, cardio-respiratory fitness and metabolic health are optimized, and exercise performance is elevated.  So how do you create a diverse, healthy gut?  

• Eat a diverse diet. Gennev supports a food-first approach. A variety of whole foods is key for gut health, mainly from plant sources like fruits, veggies, legumes, beans, and whole grains. ‍
• Fill up on fiber. The resistant carbohydrates found in vegetables, fruits, and whole grains provide bacteria to contribute to the diversity of the gut. ‍
• Fermented foods like plain yogurt, kefir, Kimchi, and sauerkraut benefit the gut by contributing optimal beneficial bacteria in the intestines.  ‍
• Prebiotics help feed the bacteria in your gut and may promote the growth of specific beneficial strains. Some popular prebiotic foods include whole grain oats, bananas, apples, garlic, onion and asparagus. ‍
• Eat the colors of the rainbow. Colorful fruits and vegetables offer phytochemicals (plant chemicals) which can contribute bacteria that helps manage inflammation and mitigate bacteria associated with poor health. Blueberries, raspberries, herbs, and lettuce are great sources of phytochemicals.‍
• Get your omega-3s. Similar to colorful foods, foods containing omega-3s also support the production of anti-inflammatory compounds in the gut. Salmon, anchovies, sardines, walnuts, chia seeds, flaxseeds, and hemp seeds are all great omega-3 sources. ‍
• Exercise. Studies have shown that regular exercise helps to aid in digestion and promote the resiliency of the gut. ‍
• Meditate and prioritize sleep. Both of these activate the parasympathetic or 'rest and digest' response through the gut-brain axis mentioned above. Calming the mind and the body supports a more optimal gut environment.  

When it comes to gut-healthy foods, keep it real, and a little dirty. Eat more plants that are organic or locally grown if you can. And when you are washing your veggies and fruit, a light rinse with water and a rub will suffice. No need to use soap or vigorously scrub as you may lose some of the beneficial bacteria.

Most importantly, have fun in the kitchen! As you transition your meals to include more plants, see how many you can tally in a day. Small additions can add up quickly as you diversify your diet.  Smoothies are a great way to load on beneficial ingredients. And try acai bowls, or grain or salad bowls, where you can layer on beneficial ingredients and gain gut health rewards.  

You want less of these for a healthy gut

• Processed foods
• Refined sugar
• Saturated fat
• Artificial sweeteners
• Stress

In high amounts, these tend to decrease the diversity of the gut microbiome. While it is near impossible to eliminate these all together, it is recommended to limit your intake and prioritize what to add more of.  If possible, limit the use of pain medications, NSAIDs and PPIs as they similarly can decrease diversity of the microbiome.  Speak with your physician before changing anything to your prescribed routine as the benefits of these medications may outweigh the impact on your microbiome.

When your gut microbiome feels off, you may be tempted to try the next new thing that comes your way.  From probiotics and other supplements, to microbiome testing, there are plenty of new products hitting the market to tempt you.  We suggest using a food-first approach as your foundation for a healthy gut.  A diverse diet with a variety of foods is key – even with probiotics.  And most importantly, with microbiome testing - always check-in with your body. This area of study is still quite new, so approach with curiosity and keep an open mind.  And be critical about the results to be sure they fit with what your gut is telling you.  

If you need support in managing your digestive health, Gennev’s integrated care team can help you create a personalized plan designed to meet your wellness goals. Our dietitians have specific microbiome training to help you diversify and optimize your gut health.

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^{The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev's telemedicine doctors before beginning any new treatment or therapy.}