This week I went on a podcast blind date. I got an email with the subject line “Jules, I’m Dr. Betsy Greenleaf – let’s talk midlife vitality with your listeners”. Normally my assistant Caroline would just delete things like this but she was on leave and I was intrigued and so I ended up having an eye-opening chat with Dr Betsy Definitely worth your time!
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Video Version
It started as a blind date through the internet..
And turned into an eye-opening discussion about how our gut health impacts virtually everything in midlife—from our hormones to our weight, mood, and even our sex drive.
This week I’m sharing a fascinating conversation with Dr. Betsy Greenleaf, the first board-certified female urogynecologist in the United States, who’s now working on her fourth board certification in integrative health and wellness.
The Missing Link in Traditional Healthcare
Dr. Betsy made a powerful point early in our conversation: traditional healthcare rarely looks at food as medicine. Instead, it’s all about putting band-aids on symptoms with medications. Yet Hippocrates said way back in 440 BC, “Let food be thy medicine.”
As we hit our forties and beyond, this becomes even more critical. What we could get away with in our twenties—living on Doritos and Oreos, skipping meals to lose weight, or out-exercising a bad diet—simply doesn’t work anymore. With decreasing hormones, everything catches up with us.
The Gut-Everything Connection
Here’s where it gets really interesting. Dr. Betsy explained that there’s a direct connection between:
The gut and the brain (affecting mood and mental clarity)
The gut and our hormones (impacting everything from hot flushes to libido)
The gut and our pelvic health (yes, really!)
Consider these facts:
90% of our happy hormone (serotonin) is made in the gut
80% of our immune system lives in our gut
An unhealthy gut leads to inflammation, which the body interprets as stress
And when your body is stressed? It holds onto weight, suppresses processes like digestion, healing, and reproduction, and decreases hormone production and sex drive.
Your Action Plan for Better Gut Health
If you’re ready to improve your gut health (and reap all the benefits that come with it), here’s Dr. Betsy’s recommended order of priorities:
Step 1: Increase Your Fibre
Aim for 30-40 grams daily from whole food sources like vegetables, legumes, and fruits. Natural sources are best, but if you need a boost, soluble fibre supplements can help.
Important note: If you’re transitioning from a less healthy diet, go slowly! Your gut bacteria need time to adapt. Give yourself 6-12 weeks to build up those healthy bacteria that help you digest fibre-rich foods. Otherwise, you’ll end up bloated and uncomfortable, wondering why “eating healthy” makes you feel horrible.
Step 2: Add Fermented Foods Daily
Think kimchi, sauerkraut, kombucha, yogurt, or kefir. These replenish the healthy bacteria we’ve lost since our cave-dwelling days (when we didn’t have refrigerators and ate more bacteria naturally).
Step 3: Don’t Forget the Fluids
Here’s a critical point that surprised me: 75% of Americans are chronically dehydrated. You need adequate fluids for your gut health and to help that fibre do its job. Otherwise, you’re just creating concrete in your digestive system.
Pro tip: If you struggle with constipation, it’s not just about fibre—it’s about fibre PLUS fluids. Even warm water (or decaf coffee or tea) can help stimulate your colon.
Step 4: Focus on More Vegetables and Whole Foods
Continue reducing processed foods while increasing your vegetable intake. Remember, this is a gradual process—not an overnight transformation.
The Fascinating Science
Dr. Betsy shared some incredible research that really drove these points home:
The Mixed Diet Study: Researchers fed rats either a standard American diet, a completely healthy diet, or a mix of both. The rats with the mixed diet actually developed the most diverse gut microbiome—and diversity equals health.
The Twin Study: Scientists took gut bacteria from human twins (one heavy, one thin) and gave them to rats. The rats that received bacteria from the heavy twin became heavy, while those getting bacteria from the thin twin stayed thin. When they switched the rats’ diets, the rats’ weights switched too. This proves that weight isn’t just about willpower—your gut bacteria play a significant role.
The Hormone-Gut Connection You Need to Know
Here’s something that blew my mind: constipation directly affects your hormones. When stool sits in your large colon, you can actually start reabsorbing estrogen from it, affecting your hormone levels. Sometimes, Dr. Betsy explained, the simple act of “getting people to poop” helps resolve their hormone issues.
Don’t Forget Your Protein
While we’re focusing on gut health, Dr. Betsy reminded us that protein requirements increase as we age (generally one gram per kilogram of ideal body weight). This helps preserve our muscle mass, which we start losing at a rate of 8% per decade starting in our thirties.
The challenge? It’s genuinely hard to eat that much whole protein daily. While protein powders seem convenient, we discussed concerns about artificial sweeteners and highly processed protein isolates. The question remains: have we evolved to eat large quantities of these processed proteins?
The Bottom Line
Midlife vitality isn’t about restrictive diets or punishing exercise routines. It’s about nourishing your gut with fibre, fermented foods, adequate fluids, and whole foods. When you support your gut health, you’re supporting your hormones, your mood, your immune system, your weight, and yes, even your sex drive.
As Dr. Betsy so wisely said, you are what you eat. And in midlife, that’s truer than ever.
Ready to take the first step?
Start by adding more fibre to your diet this week, drink more water, and consider incorporating one fermented food into your daily routine. Your gut—and your whole body—will thank you.
In your corner,
Jules xx
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Resources
Dr Betsy Greenleaf’s website: https://pelvicfloorstore.com
(Get 10% discount with code JOYFUL)
Dr Betsy Greenleaf on Instagram
Dr Betsy Greenleaf on Facebook
Dr Betsey Greenleaf on TikTok
Dr Betsy Greenleaf on Twitter
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See All Joyful Eating for Menopause Podcast Episodes
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