DIGESTIVE HEALTH

DIGESTIVE HEALTH

Many women notice digestive changes at midlife, including abdominal pain and discomfort, heartburn, intestinal gas, bloating, and disrupted bowel function (e.g., diarrhea, constipation).

This can be due to a wide range of factors. For instance:

• Sex hormones. Sex hormones have receptors throughout the gastrointestinal (GI) tract and play roles in its function, such as helping to regulate gastric motility and maintain a healthy intestinal lining. This means that changes in hormones can affect changes in GI function. (Many women will already have noticed GI changes throughout their menstrual cycles, such as diarrhea around their periods.)

• Age-related changes in the gut mirobiome. The gut microbiome composition shifts over the course of a lifetime, and a 2019 study found that microbiome diversity plateaus after age 40.

• Digestive secretion and absorption changes. As we age, we often produce less of the key substances that help us break down food - including saliva. (Some alternative medicine practitioners have coined the term "gastropause.")

• Declining physical activity. On average, women at midlife tend to be less active than their younger peers. Physical activity helps move food through the digestive tract.

• Pelvic health and function. Pelvic health changes can affect digestive function, such as being able to effectively evacuate the bowels.

• Poor sleep. This can affect GI function by disrupting the autonomic nervous system, increasing inflammation, and increasing sensitivity to pain and abdominal distention.

• Declining bone density. In particular, changes to spinal vertebrae density can often shorten the spine or cause hunching, compressing the abdominal contents.

• Midlife stressors. Elevated stress generally makes digestion worse.

• New food intolerances. Whether it's saying goodbye to dairy or an epic case of gas after eating broccoli, many women at midlife notice that formerly friendly foods aren't so friendly anymore.

KEY NUTRITION SKILLS

While digestive challenges are generally outside my scope of practice, some basic nutrition behaviors can help. These include:

EATING SLOWLY AND MINDFULLY

Stress is closely linked to GI function. Eating slowly and mindfully, while trying to stay relaxed, can help our digestive tract do its job and decrease indigestion that can result from rushed, anxious eating.

EATING MEALS AT ROUTINE TIMES

Our body prefers a predictable eating schedule and will helpfully secrete digestive hormones and enzymes in advance of regular mealtimes. This can cut down on digestive issues like dyspepsia (i.e., indigestion). How often or exactly when you eat is less important than having a general routine of eating at roughly the same times each day.

EATING ENOUGH FIBER

...ideally from minimally processed foods such as fruits, vegetables, and whole grains.

Especially when combined with lots of water, soluble and insoluble fiber help bulk up stool and keep it moving through the digestive system. If constipation is a problem, some clients might choose to supplement fiber. Most over-the-counter types of fiber supplements (e.g., psyllium) are safe and well tolerated, though some may cause gas and bloating (not all people can tolerate all forms of fiber). If this happens, you can consider using a food journal to identify any problem foods. A fiber supplement specifically designed to be low-FODMAP might help.

Importantly, if you have a digestive disorder (e.g., irritable bowel syndrome, ulcerative colitis, diverticulosis), you should consult your doctor about whether or not a fiber supplement is suitable for you.

DRINKING PLENTY OF WATER

Drinking water helps to moisten digestive contents and move stool through the digestive tract. Plus, though it's the start of the digestive process and structure, the mouth is often forgotten in gastrointestinal health. Saliva production decreases as we age and can affect both dental health and the moistening of food. So help replenish that spit!

Because individual needs vary, a simple guideline is to have you base your water intake on your weight.

• When measuring bodyweight in pounds, you should drink about half your bodyweight in ounces of water every day.

You can make adjustments to this based on activity levels, thirst, and climate.

WHAT YOU CAN DO

If you struggle with your digestive health, you can:

• Keep a "food and digestion" journal. This can help you see the relationshps between what you eat and how you feel. It can also be useful for a future conversation with a healthcare provider if neeeded.

• Realistic planning and problem-solving. You may be busy, rushed, or eating on the run. Try implementing new behaviors, such as eating slowly, in manageable ways. For instance, set a reminder to take a few deep breaths before a meal, or plan at least a few relaxed meals in your calendar.