🥦 The Nutrient You May Need to Double Up On (and No, It’s Not Protein)

The midlife and menopause space is all about the protein. Reasonably so. We need more than the minimum daily requirement to make and maintain muscle as we move through midlife and the menopause transition. That message has landed loud and clear. But there’s another nutrient that can profoundly improve our 40+ health that many women fall woefully short on: fiber.

I’m not alone in this observation. Earlier this month the journal Sports Medicine published an opinion article titled Fibre: The Forgotten Carbohydrate in Sports Nutrition Recommendations, making the same arguments I’m going to make here: the overall health benefits of fiber intake are too important to overlook, yet far too many of us do.

Fiber holds the key to minimizing many, myriad midlife and menopausal woes specifically, including gut, pelvic floor, cardiovascular, and metabolic health. It may even reduce menopausal symptoms like hot flashes. Yet, many women get less than half the recommended amount. Let’s fix that.

Fiber Defined

My Nana used to call fiber “roughage.” I once heard Jack LaLanne tell Howard Stern it was “nature’s broom.” Both definitions are pretty good, actually. Fiber is a type of carbohydrate that comes in a couple of forms, soluble and insoluble. 

Soluble fiber, as the name suggests, dissolves in water and helps manage blood sugar, lowers cholesterol, and helps you feel full longer. Oatmeal (the non-ultraprocessed kind), fruits, veggies, and legumes and nuts are great sources of soluble fiber. Insoluble fiber, again, as the name suggests, does not dissolve in water. It helps speed up the movement of waste through your bowels, prevents constipation, and supports intestinal health. Whole grains, leafy greens, and fruit and veggie skins are good sources. (Many foods will contain both types.)

Why Fiber Rules, Especially for Midlife Women

A big, often overlooked, reason why fiber is so essential at this time of life is for our pelvic floor health. Pelvic organ prolapse — when organs like your uterus, bladder, or rectum, drop from their normal position into or out of your vagina — affects about 50 percent of women and menopause increases the risk. One factor is constipation.

It’s very common to develop constipation during and beyond the menopause transition as estrogen and estrogen receptors in our GI tract decline, affecting the muscles in the colon. Increased stress levels can make it worse.

“Straining from constipation can weaken the pelvic floor, cause prolapse to form in the vagina and make it harder to empty the rectum, setting up a vicious cycle of pushing more and making the prolapse worse and increasing the difficulty of emptying the rectum,” says urogynecologist Kathleen Connell, MD, in episode 82 of Hit Play Not Pause.

“Constipation is something that we are very aggressive about screening and making sure people are getting 30 grams of fiber [each day],” says Connell, who is division chief of urogynecology and reconstructive pelvic surgery at the University of Colorado School of Medicine.

Most women only eat an average of 13.5 grams of fiber a day. That’s about half of the dietary guidelines of 25 grams, and woefully short of the 30 grams a day experts like Connell recommend for menopausal women.

Fiber: The Midlife Disease Fighter

Beyond pelvic floor health (which, let’s face it, is important enough on its own), fiber helps keep you healthy during your peri/menopausal years in myriad other ways.

Fiber nourishes your gut microbiome. The gut microbiome plays a key role in our energy metabolism as well as estrogen metabolism. Menopause alters the gut microbiome. Research suggests that these gut microbiome changes may increase fat gain, lower metabolism, and increase insulin resistance during the menopausal years. Fiber feeds your gut microbiome. The high amount of fiber associated with a plant-based diet may be one of the reasons women who eat more plants have less severe menopause symptoms (which we’ll get to in a bit).

Fiber helps with blood sugar management. As our sex hormones decline, our cells can become more resistant to insulin, making it harder to manage blood sugar. The fluctuations of our hormones during perimenopause can also lead to glucose spikes and crashes. Fiber helps reduce spikes and helps keep your blood sugar stable.

Fiber maintains good metabolic health. Research finds that postmenopausal women who consume the recommended amount of fiber have a healthier metabolic profile and are less likely to have metabolic syndrome (a chronic condition marked by conditions such as excess visceral fat, high blood pressure, high blood sugar, high triglycerides, and/or low HDL cholesterol).

Fiber protects your heart. Menopause can compound traditional heart disease risk factors like abnormal lipid levels. Eating more fiber can help lower your cholesterol levels. Research also shows that those eating higher fiber diets can significantly reduce their risk of having and dying from cardiovascular disease.

Fiber is good for your brain. Fiber may help boost cognitive function when you get older, according to a 2022 study that concluded that “public health interventions aiming at recommended dietary fiber intake may be pivotal in combating cognitive decline associated with advanced age.”

Fiber may help relieve hot flashes. Blood sugar fluctuations may make hot flashes worse, according to research. By keeping your blood sugar levels stable and feeding your gut microbiome, fiber may help reduce hot flashes.

Fiber may improve your mood. Eating more fiber may even stave off depression, as one 2021 study reported that more dietary fiber consumption was linked to reduced odds of depression in women. 

How to Get More Fiber

The first step to boosting your fiber intake is to take stock. Take about 3 days and tally up your grams. Apps like MyPlate and MyFitnessPal can help, but you also can just keep track manually in your notes. 

Once you know your starting point, gradually increase your intake over the course of a couple of weeks, so your gut has a chance to adapt and you don’t end up with gas and bloating from putting in a lot more than you’re accustomed to. 

The easiest way to get more fiber — as well as a boatload of vitamins, minerals, and phytonutrients — is to eat more plant foods like vegetables, fruit, legumes (which are fiber powerhouses), nuts, roots, shoots, and whole grains. As a bonus, you’ll be eating fewer ultraprocessed foods, which have been linked to chronic disease.

Here’s an example of what 30 grams of fiber looks like, according to mayoclinic.org:

1/2 cup of raspberries      4 grams

1 cup broccoli                   5 grams

1 cup of black beans       15 grams

1-ounce almonds             3.5 grams

1 slice of rye bread          2 grams