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Menopause and Gut Health: Is there a link?

In more recent years there has been growing interest in the area of gut health and its connection to medical conditions. We know that optimising our gut health can help support overall good health but what does the current evidence tells us about menopause and gut health?

What is Gut Health?

There are around 1000 bacteria that can live inside of our gut, with each person having a unique combination of around 100-150 bacteria. Gut health refers to promoting good bacteria in the gut. Gut bacteria have several roles including digestion, protection from disease, production of vitamins, and immune support. This means that it is important to look after our gut flora to promote long-term health [1]. 

How Does Gut Health Link to the Menopause?

In terms of gut health for menopause, there are a number of studies observing the possible links. One study found that menopause caused disturbances in two of the most abundant gut bacteria. This disturbance was different in pre- and postmenopausal women with differing levels of oestrogen, suggesting that the bacteria may contribute to oestrogen balance. This link suggests that maintaining a healthy gut flora may help to prevent oestrogen-related diseases and other health problems. 

Additionally, this study identified that low microbial diversity and enzymatic activity in the gut may affect oestrogen levels. This is because when gut bacteria diversity and enzymatic activity was low, more oestrogen was found to be excreted from the body in faeces and urine. Low oestrogen is responsible for many of the symptoms of menopause, meaning that it is important to try to conserve as much oestrogen as possible in the body [2]. 

Menopause and gut microbiome

Furthermore, changes to the gut microbiome are associated with increased adiposity, a decrease in metabolic rate, and insulin resistance. These factors all increase the risk of obesity and its associated health risks. The alterations that menopause cause to gut flora could explain the increased risk of metabolic syndrome following menopause and show the importance of addressing gut dysbiosis [3].

Finally, gut health has been linked to mental health. Changes to the balance of the bacteria in our gut has been linked to the incidence of mental illnesses, such as anxiety and depression. Low mood can be a symptom of menopause therefore it is important to promote gut health to prevent the incidence of other mental illnesses [4]. To learn more about food and mood, read this blog post.

Nutritional Considerations for Menopause and Gut Health

There are numerous ways in which gut health can be promoted by dietary changes. Fibre plays an important role in gut health by promoting gut bacterial diversity and healthy digestion. The recommended intake of fibre is 30g a day. Most people in the UK only consume around 20g a day. Fibre can be found in fruit, vegetables, wholegrains, beans, and nuts. You can increase your fibre intake by[5]:

  • adding vegetables to every meal
  • switching to wholegrains from refined carbohydrates
  • snacking on nuts .

You can learn more about the role of fibre in our diets here.

Prebiotics and probiotics for menopause and gut health

You may have also heard of prebiotics and probiotics when discussing gut health. Prebiotics are used to feed the gut microbiota and when broken down they release beneficial products into the bloodstream. They can be found in foods like asparagus, chicory, bananas, berries, artichokes, and barley. There are also a number of prebiotics available to buy in supplement form. However, there is limited research on the effectiveness of these supplements [6].

Probiotics are live bacteria and yeasts that aim to promote the natural balance of gut bacteria. They are most commonly found in fermented foods, can be added to foods, or taken as a supplement. Foods containing probiotics include yogurt, kefir, kombucha, sauerkraut, pickles, tempeh, sourdough bread, and kimchi [7]. There are numerous studies reporting the effectiveness of probiotics in promoting gut health and in the treatment of gastrointestinal diseases, such as irritable bowel syndrome and Clostridium difficile disease [8]. Further information about prebiotics and probiotics for gut health, can be found here.

Finally, ensuring that you eat a wide variety of foods can promote gut health. Different foods are more suitable for different microbes. Therefore, it is important to eat a wide variety of plant-based foods such as fruit, vegetables, legumes, nuts, and wholegrains [9].

Top Tips for Menopause and Gut Health

  1. Increase your fibre intake by adding hidden veggies to soups and curries, to promote gut bacterial diversity.
  2. Eat more fermented foods, such as sauerkraut, kefir, and kimchi, to increase your probiotic intake.
  3. Eat asparagus, berries, bananas, artichokes, and barley to increase your prebiotic intake.
  4. Include a wide variety of plant-based foods in your diet to ensure that your gut bacteria are being fed suitably.
  5. Snack on fruit, vegetables, beans, wholegrains, and nuts to increase your fibre intake.

References

[1] https://www.bda.uk.com/resource/give-your-friendly-gut-bacteria-a-helping-hand.html

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8268108/ 

[3] https://pubmed.ncbi.nlm.nih.gov/33235036/#:~:text=Menopause%20has%20been%20shown%20to,changes%20attenuated%20by%20estrogen%20administration 

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/ 

[5] https://pubmed.ncbi.nlm.nih.gov/29902436/ 

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463098/ 

[7] https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know 

[8] https://pubmed.ncbi.nlm.nih.gov/22529959/#:~:text=Probiotics%20had%20a%20positive%20significant,CI)%200.51%2D0.65).

[9] https://pubmed.ncbi.nlm.nih.gov/34020448/

Caroline Hill Dietitian
Caroline Hill Dietitian and owner of Caroline Hill Nutrition

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