It took me a long time to figure out that our liver and gall bladder are so affected by hormonal changes as we age.
Despite my efforts at daily exercise, eating well and trying to look after myself, the weight stacked on. I think the hardest part was the bloating and ‘puffiness’ around my eyes and the thickness around my middle and even my legs were getting bigger. All of my clothes just felt tight. It was depressing. But my angst about my weight paled in comparison to the arrival of a new worry – heart palpitations, high blood pressure and cholesterol levels that were climbing through the roof. I could see my Doctor reaching for the prescription pad ready to write ‘statins’. My only thoughts were of my mother in her early 60’s who put on lots of weight, developed hypertension, took statin medication for years and ended up having a stroke in her early 80’s. Suddenly the ‘healthy ageing trajectory that I desired, seemed hopeless not only because of the family history, but because I was undertaking my doctoral studies and most of the research on women’s health as they aged presented similar declining-health trajectories.
But reading this research was my saviour. Because when I learnt, through my women’s healthy ageing studies, that the liver and gall-bladder both change in structure and function as we move towards post-menopause, my upper abdominal weight gain, bloating and increasing cholesterol levels and fatigue made sense. On oral HRT at the time, I also learnt that HRT places an additional burden on the liver, as do all medications that many women take as we move through menopause.
“There is an interplay of hormonal issues and ageing that create a unique path for development of liver problems and liver disease in menopausal women, making chronic liver disease a significant burden on women’s health in their post-menopause years.” [Brady, C., 2015].*
Changing weight, cholesterol and bloating can send us into further health chaos as we move through menopause. Whilst the focus is usually on cardiac health when we visit our Doctor with changing cholesterol and weight (which it should be), how many of us are being told that our liver health matters too?
In both of the MyMT™ programmes I have an entire 1 hour podcast/webinar devoted to the scientific evidence about how to turn around our liver health in a way that helps rejuventate our ageing liver. The liver is the only organ that is ‘adaptogenic’ which means that it heals and repairs, but we need to achieve this in a systematic way over at least 6 weeks. Once we do this, we have the ability to turn around our energy, weight, cholesterol and bloating at this time of life. As I discovered myself, if we are going to change our health as we age, then the liver is the organ to focus on.
For those who want to lose their abdominal and diaphragmatic fat, listening to this module is crucial. It’s how Dianne lost 20kg of menopause weight and she did this without having to do all the exhaustive exercise that we think that we need to do to burn calories for weight loss. I used to believe this too. Meeting up with Dianne at my Brisbane seminar last year and hearing about her amazing transformation was so wonderful.
I worry about women in menopause going on the high-fat, high-protein diets that are popularised as a ‘one-size-fits-all’ diet these days. These diets don’t fit with the current scientific research on how we need to eat as we move through menopause. This is why positioning our menopause transition in women’s ageing and following the women’s health research changed my life too. It allowed me to better understand how our body is adjusting to our changing hormones in menopause – some of these changes have a lot to do with how the liver and gallbladder change as we get older. And for those of you who have had your gallbladder removed over the years, there are changes to your fat intake that you may need to adjust as well.
Understanding that the liver is the hero in the story of your weight loss, energy and health as you age is important.
The work of Professor Carla Brady, who has researched the liver in menopause, helped me understand this. Her work changed my life and when my Doctor was concerned about my changing cholesterol and cardiac health, it’s why I turned to the liver instead.
Changes in diet and lifestyle have led to a dramatic increase in the prevalence of obesity and metabolic syndrome in Western countries and many Asian countries. This has resulted in a significant increase in the incidence of nonalcoholic fatty liver disease (NAFLD), [Watanabe, et al, 2015). Non-alcoholic Fatty Liver Disease (NAFLD) doubles in incidence in women as they move through menopause. This condition increases inflammation in the liver.
I have no idea if you have an over-burdened liver or not – only you and your Doctor do. But if you are putting on weight in menopause and feeling bloated and you are on Menopause-HRT and your cholesterol levels are changing, then please get your liver health checked. We are a generation of women who have had over 40 years of living in a fast-changing society, with lots of emphasis on changing food production and chemical consumption and toxins that are harmful to our liver health. Hence, we must understand that if we want to lose weight and improve our health as we age, then our liver matters. Current research supports the effect of inflammation gathered over our lifetime on our changing health as we age.
Apart from your heart, your liver is your most precious organ. Your liver interacts with your pancreas, intestinal tract and fat storage cells, so it plays a crucial role in various aspects of not only carbohydrate metabolism but also in fat and protein metabolism too.
I always speak about our changing liver in my Masterclass on Menopause – [don’t forget that I’ve put this ONLINE for you during the lockdown period in New Zealand]. In this powerful webinar, I show you the effect of low oestrogen on liver blood vessels and liver structure. But it’s not just lowering oestrogen that affects the liver. It’s the inflammation that has been building up in the liver for decades. This can be due to diets high in processed foods, exposure to chemicals and hormone disruptors, foods higher in oestrogen and cholesterol and of course, alcohol consumption and stress.
The liver plays a central role in all metabolic processes in the body, especially in fat metabolism.
In fat metabolism the liver cells break down fats and produce energy. These cells also produce about 800 to 1,000 ml of bile per day. This yellow, brownish or olive green liquid is collected in small ducts and then passed on to the main bile duct, which carries the bile to a part of the small intestine called the duodenum. Bile is important for the breakdown and absorption of fats. If you don’t have a gallbladder, then you don’t have this storage capacity role, so the type of fats and when you eat them matters to you as well.
As we age our liver is changing. It shrinks in size and the gall-bladder produces less bile. Bile is the substance that helps to emulsify or break down fats. If our diet is high in fats (including animal fats), then our gallbladder cannot cope with the volume of fats that it has to emulsify. Our gall-bladder, which stores bile, where fats are broken down further, also changes.
We have around 20% less bile being produced as we move through menopause.
What this means is that we may not handle as many fats as we used to – and we must remember that all animal proteins contain fats. Add up all the foods and fluids (e.g. smoothies) that contain fats and over the course of a day, you may be getting a lot of fat in your diet. But these fats and proteins can be too much for our liver and gall-bladder to handle as we move through menopause, And because our liver is also involved in the metabolism of your carbohydrates as well, it becomes burdened with fats – it becomes very hard-working.
But there’s more to the liver story and that is how it affects our blood and therefore, our energy levels.
Blood flows through the liver carrying all sorts of nutrients and also toxic substances. If our liver cells are blocked with the burden of excess fats, then our blood doesn’t detox efficiently either. We end up more tired, breathless and susceptible to immune changes. Turning this around through dietary change and understanding that our liver is on a 24 hour circadian rhythm is important. If we aren’t sleeping, then our liver isn’t working like it used to. Understanding this in your mid-life years is crucial to reducing our bloating and restoring our energy levels as well. It’s what I teach women in my programmes, because without improving our liver health and sleep, we won’t get the weight loss or symptom reduction that we desire.
Liver tissue is made up of lots of smaller units of liver cells called lobules. Many canals carrying blood and bile run between the liver cells. Blood coming from the digestive organs flows through the portal vein to the liver, carrying nutrients, medication and also toxic substances. Once they reach the liver, these substances are processed, stored, altered, detoxified, and passed back into the blood or released in the bowel to be eliminated. In this way the liver can, for example, remove alcohol from your blood and get rid of by-products from the breakdown of medications.
But here’s the thing – with all the amount of fats and proteins that our liver has to process in a day, then other vital nutrients and mineral salts may not be able to be readily absorbed into the blood. Hence I worry about all the women coming through menopause, who have a high-fat and high protein diet.
This can over-burden the gall-bladder and, as I often say in my seminars, as we get older, because our bile production reduces by around 20-30%, this makes it challenging to break down fats and cholesterol which the liver makes as well. I fyou are serious about weight loss in menopause and reducing your bloating, then please join me when you can. Your liver needs some love.
Your beautiful liver has evolved it’s function to store glucose. This is because in ancient times we didn’t have access to food that is so readily available now. Men could be away hunting for days on end and women were left to tend the fire, look after children and ‘gather’ fruits, berries and whatever plant foods they could find. They ate less that we typically do today and certainly didn’t have access to processed foods. As such when they did eat, their liver stored up glucose ready for times of scarcity. Over the course of our lifetime, our liver and gallbladder have weakened as these precious organs have been exposed to toxic substances and high fat, protein and processed carbohydrate foods.
I think it’s time to turn that around, don’t you?
There are numerous ways you can restore liver health in menopause, but here are two of my favourite:
- Eat mainly plant fats and until you improve your liver health, then decrease your total fat intake to around 15% of your diet, unless you are doing lots of endurance exercise. (In which case you can go up to around 20-25%).
- Stretch in ways that help to lengthen your diaphragm and massage your liver when you can (in the shower is great). This image below of me stretching is not only a great stretch for our hip-flexor muscles in the front of the thigh, but if you sit all day at a desk and your liver is compressed from fat that accumulates under the diaphragm as it did for me, then it’s a great stretch for your liver and gall-bladder to do at the end of the day.
When we love our liver and gall-bladder by using food as our medicine and we stay active and stretch our body in ways that support the function of our organs, including our liver, gut and lymphatic system, then we begin to restore our energy and our health. With this as the focus in the MyMT™ Transform Me weight loss programme then this is the path you need to take to get back to feeling like ‘you’ again.
The ageing of our organs offers a ‘perfect-storm’ when menopause arrives. This means that we have to learn how to make some lifestyle adjustments to accommodate these changes. Otherwise our weight gain creeps on and on as the years advance. With increased weight gain, then cardiac and metabolic health can change as we move into post-menopause. For too many women, what ensues is frustration and confusion, as, instead of feeling healthy and vibrant, they may feel exhausted, sick and overweight instead.
If this is how you are feeling, then try to come on board the 12 week menopause weight loss programme if you can.
Health and medical researchers already know from research on our mother’s generation, that weight gain around the trunk at this time of life sends women into post-menopause heart disease, obesity and Type 2 diabetes. For many women putting on a lot of belly fat, or if you have the ‘hard-fat’ sitting around your abdomen, then please try to come on board into my ‘Menopause Weight Loss Program . With many of you still experiencing difficulties with the Covid-chaos, I have kept savings of NZ$50 going. The programme is called ‘Transform Me’ because this is what it did for me as well as others. It’s all online and with the savings, this costs only NZ$249 (normally $299) which is UK£135 or AUS$235. There are monthly payment options for the 3 months as well. Please apply the promo code ATHOME20 when you purchase.
Why is it 3 months? Because that’s how long it takes for you to turn around your liver, reset your hormones for your ageing and discover how to change your nutrition, sleep and exercise habits so that you thrive at this stage of life. I can’t wait to help you.
Brady, C. (2015). Liver disease and menopause. World J Gastroenterology, 21(25): 7613-7620.
Cabot, S. (2010). Fatty liver – You can reverse it. Arizona, USA: SCB Inc.
Greger, M. (2020). How not to diet. The groundbreaking science of healthy, perminant weight loss. New York: Flatiron Books.
Kim, H., Kissaleva, T. & Brenner, D. (2015). Aging and liver disease. Curr. Opin Gastroenterol. 31(3): 184–191.
Watanabe, S., Hashimoto, E. et al. (2015). Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. J. Gastroenterology, 50: 364–377.
Wenxia Lu, Sainan Li,Jingjing Li, et al. (2016). Effects of Omega-3 Fatty Acid in Nonalcoholic Fatty Liver Disease: A Meta-Analysis. Gastroenterology Research and Practice, Article ID 1459790, 1-11.