Ah, perimenopause and its fluctuating hormones – the Christmas gift that keeps on giving! And I’m not just talking hot flushes or mood swings.
As women enter their midlife years a myriad of changes occurs, which can often lead to unwelcome symptoms, including bloating, cramping and general digestive discomfort.
There are few things worse than tummy troubles when you're faced with a packed diary of festive socialising. Too bloated to fit into your LBD? Worried about embarrassing gurgling, bad smells or even frantic dashes to the bathroom at the office Christmas party? It's no fun.
As a nutrition practitioner, I’m always amazed at how long some of my clients have been putting up with their symptoms – and it’s usually not the main reason they’re coming to see me.
It's a parallel universe
Your gut ‘microbiome’ is a parallel universe of all kinds of different microorganisms, running the length of your digestive tract – from your mouth to... well, the other end.
There are tens of trillions of them – and most of them are bacteria. The balance of these bacteria in your digestive system has implications for your health in general, not just your gut. It’s important to have the right kinds of bacteria in the right places. An imbalance (when there are more unfavourable bacteria and other microorganisms) is what we nutritionists call ‘dysbiosis’.
Dysbiosis can result in your digestive system becoming a more favourable environment for yeasts like candida or parasites. There are some places you don’t really want many bacteria, whether good or bad. Too many bacteria in the small intestine, for example, can lead to a condition known as SIBO – Small Intestinal Bacterial Overgrowth.
Your Migrating Motor Complex
One cause of SIBO and other digestive symptoms is that your Migrating Motor Complex (MMC) is not working optimally.
The MMC is a housekeeping process that carries out a sweep of the digestive tract to move along left-over particles of food, bacteria and metabolites into the colon for excretion. This process can only happen when there is no food in the system, and it takes around 90-120 minutes to complete.
So if it takes around 2 hours to digest a meal and the MMC needs another 2 hours to do its thing, then we should be leaving at least 4 hours between meals to optimise digestion. The second you pop another mince pie in your mouth, or a cheeky Quality Street, the whole process stops.
A sub-optimal MMC can lead to undigested food being left for bacteria to feast on and proliferate. The result is bloating, wind, nausea, diarrhoea and constipation - essentially, all those symptoms you might be linking to your irritable bowel syndrome (IBS).
In the UK, on average we consume over 5,000 calories on Christmas Day alone! That’s well over two and a half times the recommended daily intake for women!
There are a variety of reasons why the holidays might create more tummy troubles than the rest of the year:
1) Eating more than you usually do puts more pressure on your digestive system
2) Drinking a lot more alcohol in general, but also when you eat, dilutes stomach acid, making it more difficult to properly digest your food. Plus your liver has to work harder to detoxify all that extra booze.
3) Eating more rich, creamy foods can trigger heartburn or reflux or else make IBS symptoms worse.
4) Snacking between meals means your MMC doesn't get a chance to do its 'sweep' so undigested food is left behind for bacteria to feast on - cue bloating and gas!
5) More late nights and lack of sleep can increase stress levels and that interferes with your body's ability to digest.
6 simple tips to improve your midlife digestion
Festive food and drink can be tough on the digestive system but it doesn’t have to be that way. Just follow these simple tips to trouble-proof your tummy and avoid the festive bloat this Christmas - or at any time of the year, in fact!
1. Use your senses
The first step in the digestive process is often overlooked, but it’s a really important one. Known as the cephalic phase, it’s triggered when you see or smell food. You are literally whetting your appetite.
When you start thinking about the lovely meal you are going to prepare you are getting your digestive juices flowing. The enzymes in your saliva help you break down your food more easily, so when the time comes, your body is ready to start digesting food before you have even cut the first slice – never mind actually put anything in your mouth.
It may sound an incredibly simple step – and it is – but these days we are often so busy that we don’t make the time to think about our food in this way. If you find you’re always eating on the go, throwing a sandwich down your neck at your desk or eating on your lap in front of the TV, this is a vital step you are missing out.
Tip: Consciously spend a little bit of time thinking about the delicious food on your plate before your actually tuck in.
2. Chew your food
How often were you told that as a child? And for good reason! Chewing your food (the second phase of digestion) is key when it comes to good gut health. With proper chewing you are mechanically breaking down the food into smaller pieces so that there’s a greater surface area for the digestive enzymes to work on more easily.
If you’re not chewing properly, it’s highly likely that you’re not digesting your food properly either. And that means you won’t be absorbing the vital nutrients. Not chewing also means the food you eat takes much longer to break down and as it hangs around in your digestive system it can start to ferment, causing uncomfortable wind, gas and bloating. You’ll also start to see undigested food in your stools.
Tip: Don’t worry about chewing a certain number of times – that all depends on what you are eating and various other factors.
Instead just put down your cutlery after each mouthful and make sure you chew until the food loses its texture – if you were to spit it out again it shouldn't be recognisable (don't do that though - it's frowned upon!).
3. Balance your stomach acid
So many people rely on Rennies or other heartburn tablets to manage their digestive troubles because they often wrongly assume they are due to too much stomach acid.
What most nutritionists see more often than not is the exact opposite! Ageing, stress and some medications can make your stomach acid levels drop to the extent that you don’t produce enough to digest food sufficiently.
Why is this important? The stomach acid you produce not only kills any bacteria in the food you are eating, it also breaks down the protein in your meal. If you’re not fully digesting the protein element in food, it can start to ferment, creating gases that force open the oesophageal sphincter muscle (a type of muscle flap) and what little stomach acid there is gets pushed back up. So the burning feeling, especially if accompanied by gas, can be a sign your digestion isn’t working as well as it should be.
Tip: One solution is to have a teaspoon of apple cider vinegar before each main meal as that can help stimulate stomach acid and digestive enzyme production.
Of course there are some people who genuinely produce too much stomach acid. If you try the apple cider vinegar trick and it seems to make things worse, you can neutralise the acid by taking a little bicarbonate of soda stirred into water.
4. Take a digestive enzyme supplement
Digestive enzymes break down your food so your body can absorb the nutrients from it. Unfortunately as we age we naturally produce fewer of these helpful enzymes. You can counteract this by increasing your intake of foods that are naturally higher in them, such as pineapple, papaya or mango. Fermented foods, such as sauerkraut, are also helpful for the digestive process.
Tip: If you are really struggling, you could try taking a digestive enzyme supplement, which will give your system a gentle boost to help it do its job properly. Always speak to a health professional first before taking any supplements or book a free consultation with me to discuss your needs.
5. Take time out
Not eating is almost as important for your health as eating. It’s important to space out your meals to allow the MMC to complete its housekeeping. Leaving 4 hours between meals is a good benchmark to aim for, and gives the body enough time to completely digest the previous meal and have a break before you put it to work again.
Tip: This might require some self-discipline if your house is full of bowls of nuts or towers of chocolate tins over Christmas! Ideally move any sacks out of sight, especially after a meal, to avoid temptation.
6. Walk it off
It can be all too tempting to use the holidays as an excuse to sit on the sofa and eat mince pies until the New Year, but going for a post-prandial walk is when the magic happens!
A gentle walk shortly after you’ve eaten lowers your blood sugar levels, so your body makes less insulin. As insulin is the fat-storage hormone, taking even a 15-minute stroll makes you less likely to store fat and gain weight. Walking can also help improve your digestion as the movement stimulates the stomach and intestines, and increases the speed at which the food moves through the digestive system.
Tip: Grab your antlers or Santa hat and a couple of family members and take a walk around the block and spread a little festive cheer! And while you’re out of the house you can’t be tempted by another sausage roll or Quality Street!
Go ahead and try out these tips for yourself this Christmas and you should see some of your symptoms improve.