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If symptoms are starting to get in the way of life - your sleep, your mood, your energy, your relationships - you are not alone, and you do not have to push through. What Is Perimenopause? Perimenopause is the transitional phase leading up to menopause (the point at which a woman has gone 12 consecutive months without a period). This transition can begin anywhere from the mid-30s to the early 50s and typically lasts four to eight years, though this varies considerably between individuals. During this phase, oestrogen and progesterone levels become increasingly erratic before eventually declining. It is this hormonal fluctuation (not simply low oestrogen) that drives many of the symptoms women experience. Common signs include irregular periods, sleep disruption, hot flushes, mood changes, brain fog, joint pain, and changes in libido or vaginal comfort. For more information on how to identify whether or not you are in perimenopause, you can read this blog. The Foundations: Why Lifestyle Still Matters Before we get to specific interventions such as herbal medicine and HRT, it is worth emphasising something that the research is unambiguous about: how you live during this transition directly influences how you experience it and wider health outcomes. The truth is - the basic pillars that apply to support health generally still apply in this season of life; they are evidence-based tools that can reduce symptom severity and more importantly, mitigate possible health concerns down the road. Importantly, we likely do not need to do some 'special perimenopause protocol' as often marketed online. Sleep Sleep is one of the first casualties of perimenopause. Falling and fluctuating oestrogen disrupts the architecture of sleep, reducing slow-wave (deep) sleep and increasing night-time waking. A 2021 systematic review found that sleep disturbance affects up to 60% of perimenopausal women, with hot flushes and mood changes frequently contributing to the picture. Practical steps that are consistently supported in the literature: Keep a consistent sleep and wake time - even on weekends. Reduce alcohol, which fragments sleep architecture even in moderate amounts. Keep your bedroom cool (hot flushes are worsened in a warm environment). Limit screens and bright light in the hour before bed. If waking with anxiety or racing thoughts, consider whether stress management needs attention (see below). Exercise Exercise is arguably the single most evidence-supported lifestyle intervention in perimenopause. A 2023 Cochrane systematic review found that exercise (particularly aerobic and resistance training) significantly reduced the frequency and severity of vasomotor symptoms (hot flushes and night sweats) compared to no intervention. Resistance training deserves special attention. From the mid-30s onward, women lose muscle mass at an accelerating rate: a process driven in part by declining oestrogen. This matters not just for strength and body composition, but for metabolic health, bone density, and long-term independence. Aim for at least two resistance training sessions per week in addition to regular cardiovascular movement. Is there a special perimenopause workout I should do? Not really. Beyond doing resistance and cardiovascular training - there is no good evidence for this at this time for specific 'perimenopause' protocols. The truth is - How you decide to do some resistance cardiovascular training should be based on what is safe, what you prefer, what you will be consistent with, what works for you. Also - any exercise is better than no exercise. Nutrition There is no single “menopause diet”, but the fundamentals of good nutrition become especially important during this phase. Key evidence-backed principles: Adequate protein to support muscle retention and metabolic health. Fibre-rich foods to support gut health, oestrogen clearance, and blood glucose stability. A wide variety of vegetables and fruit for micronutrient density and anti-inflammatory benefit. Adequate micronutrients such as calcium and vitamin D to support bone health - particularly important as fracture risk rises post-menopause. Minimising ultra-processed foods, added sugars, and alcohol, which may worsen hot flushes, sleep, and mood. Nutrition needs beyond the basics should be really looked at on a individualised bases - not just considering nutrient specific needs but also wider context factors such as preferences, home situation, time, resource/access, etc. Stress Management Chronic stress activates the HPA (hypothalamic-pituitary-adrenal) axis, which directly interacts with the HPG (hypothalamic-pituitary-gonadal) axis that governs reproductive hormones. Put simply: chronic, unmanaged stress compounds hormonal dysregulation and can exacerbate symptoms. Research has consistently found associations between high perceived stress and greater vasomotor symptom severity. Mindfulness-based stress reduction (MBSR) has the strongest evidence base among mind-body interventions, with a 2019 meta-analysis demonstrating meaningful reductions in hot flush frequency and self-reported symptom burden. Yoga, breathwork, and regular time in nature are also well-supported for general stress physiology. Social Connection and Community This one is often overlooked but should not be underestimated. Social isolation is independently associated with worse mental health outcomes during perimenopause. Conversely, strong social support is protective against depression and anxiety, which are disproportionately common during this transition. Investing in meaningful relationships and community, whether that is friendships, a group class, or a support network , is genuinely therapeutic and associated with positive health outcomes. Regular Health Checks Due to the physiological change that is happening (physiological change = stress on the body), perimenopause can be a window of increased vulnerability for certain health concerns. Oestrogen has a protective effect on cardiovascular and metabolic health - as it declines, risk profiles shift. Research shows that women with pre-existing metabolic dysfunction (e.g. insulin resistance, elevated triglycerides) tend to experience more severe vasomotor symptoms, and vice versa. During this phase, it is worth discussing the following with your GP: Cardiovascular health: blood pressure, cholesterol (including LDL, HDL, and triglycerides). Metabolic health: fasting glucose or HbA1c. Bone health: consider a DEXA scan if you have risk factors for osteoporosis. Thyroid function: thyroid disorders are common in perimenopausal women and can mimic or worsen symptoms. Stress/mood - depression/anxiety, other mental health concerns may need more targetted comprehensive treatment. Individuals who have had a history of mental health concerns may be more at risk in this season of life to developing a mental health episode that needs support. Remember also that there is a bidirectional relationship between mental health and hormone health - in other words, mental health can impact how we go through perimenopause. What About HRT? “I’m doing all of the above and still struggling.” I hear you - this was me too. These foundations are not optional, but for many women they are not enough on their own. You do not have to just cope. Hormone replacement therapy (HRT), now more commonly called menopausal hormone therapy (MHT), has had a complicated history. A large study published in 2002 (the Women’s Health Initiative) generated widespread fear about the risks of HRT, leading to a dramatic decline in prescribing that lasted nearly two decades. However, this study has since been extensively critiqued. Its findings were misrepresented in media reporting, the formulations studied are now considered outdated, and the risk data was largely driven by a specific subgroup (older women who started HRT more than 10 years after menopause). The evidence we have today is far more reassuring. For example, the 2022 NICE (National Institute for Health and Care Excellence) guidelines on menopause concluded that for the majority of women under 60, or within 10 years of menopause, the benefits of HRT outweigh the risks. Similarly, the Australasian Menopause Society and the International Menopause Society have issued updated guidance aligning with this position. A few important points to understand about HRT: HRT does not restore hormone levels to what they were at 25. It supplements them sufficiently to buffer symptoms during the transition - think of it as taking the edge off a volatile process. HRT can be provided in different dosages, forms and combinations - depending on individual needs. HRT is often offered in a form that is bio-identical to our hormones such as estradiol and utrogestin. Combined oral contraceptives actually contain significantly higher doses of oestrogen than standard HRT. If you are still on the pill in your 40s, the idea of HRT being “high dose” is a misconception. Transdermal (skin patch or gel) forms of oestrogen carry a lower risk of blood clots than oral forms, and are generally preferred in modern prescribing. There are contraindications for a small proportion of women but even in some of these cases, options exist and research is continuing to be developed. For example, localised vaginal oestrogen (applied directly to the vaginal tissue) is not meaningfully absorbed systemically and may still be appropriate for women with a history of hormone-sensitive cancers who are experiencing genitourinary symptoms such as vaginal dryness, recurrent UTIs, or urinary incontinence. Some of the systemic benefits of HRT include: relief from hot flashes and night sweats relief from vaginal dryness (vaginal estrogen) improved sexual health better bone health improved sleep lower risk of depression/anxiety improved joint pain, skin, hair In Australia and New Zealand, these are the guidelines that GPs should be following: Potential side effects and risks of systemic therapy: Possible side effects include: vaginal spotting or bleeding, which usually stops within 6 months temporary breast soreness bloating (fluid retention) headaches Talk with your GP or ob-gyn if these side effects trouble you or last longer than expected. In some cases, dosages can be lowered alleviated these side effects. Furthermore, the form you use may be relevant to types of symptoms - the body processes different forms in different ways Whilst the risks have been found to be far less than previous thought, HRT, like most medications still may pose some risks in some individuals. You should always ask your GP or OB-GYN what these small risks are and if they are relevant to you. How long should I be on HRT When to stop HRT is an individual decision that should be discussed with your GP or ob-gyn. Some women stop within five years or when their symptoms stop being bothersome. Most women will no longer have hot flashes by 7-10 years after their final menstrual period. But others continue to use HRT after their 50s to relieve sypmtoms. Use of HRT should always be based on their risks, benefits, and symptoms of each individual. Coming off HRT can cause sypmtoms to come back. These sypmtoms can be temporary, however, for some they can be as severe as when they first started. Symptoms such as vaginal dryness should be expected to get worse when HRT stops, which underscores the importance of local (vaginal) hormone therapy. As a naturopath and nutritionist, it is not within my scope of practice to prescribe medications including HRT. What is within my scope is to help you understand all the tools available, stay up to date with evidence, work collaboratively with your GP or specialist, and advocate for you within that relationship. If you feel your symptoms are not being taken seriously, I strongly encourage you to ask for a referral to a GP that has up-to-date menopause training or gynaecologist. What About Natural Alternatives? Herbal Medicines Several herbal medicines have some reasonable evidence for symptom support in the later stages of reproductive phase and earlier stages of perimenopause, or for women where HRT is not appropriate or not desired. However, they must be individually considered - what works well for one hormonal pattern may be counterproductive for another. Furthermore, we can also use herbal medicine and nutrients to support HRT in some contexts based on presentation and needs. A couple herbs that come up frequently in media deserve some honest context: Black cohosh (Cimicifuga racemosa): Has some evidence for vasomotor symptoms in the early phases. A 2010 Cochrane review and several subsequent meta-analyses support a modest but meaningful reduction in hot flush frequency. It does not appear to have oestrogenic activity, however, which is why it has less efficacy in the later phases of perimenopause and will not support wider systemic symptoms associated with estrogen decline. Chaste tree / Vitex agnus-castus: Primarily useful in the earlier perimenopausal period, where progesterone deficiency relative to oestrogen is more relevant. Evidence supports its use for luteal phase symptoms (e.g. PMS-type changes, breast tenderness, irregular cycles), and primary ovarian insufficiency, especially when trying to support fertility. It is Less useful once ovulation has largely ceased and is appropriate in some presentations such as a higher LH:FSH ratio often seen in PCOS phenotypes. Soy Isoflavones: The Nuanced Case Of all the non-pharmaceutical options, soy isoflavones have the strongest and most clinically relevant evidence base for support perimenopause and menopause. They are also relatively safe and can be used across a range of contexts. Soy isoflavones act as phytoestrogens, plant compounds with a weak oestrogen-like structure that can bind to oestrogen beta receptors and modulate their activity. Crucially, they appear to behave differently depending on the hormonal context: they have a mild oestrogenic effect when oestrogen is low (as in menopause), and may have a mild anti-oestrogenic effect when oestrogen is relatively high. For more information on soy isoflavones - I wrote another blog on soy isoflavones here. An important reality check: once oestrogen is genuinely declining and ovulation is no longer occurring (meaning progesterone is not being produced), herbal medicines cannot replicate the physiological role of these hormones. No herb equates to HRT when true hormonal depletion is the issue. HRT can be extremely helpful - but it may not be the magic bullet social media is telling us it is I want to be transparent: I am a strong advocate for HRT and have personally benefitted enormously from it. But it would be doing you a disservice to present it as a complete solution in isolation, which is what is happening online in some cases. Here is what HRT does and does not do: HRT can significantly improve sleep, hot flushes, mood stability, and brain fog. Better sleep and mood have downstream benefits for energy, motivation, food choices, and the capacity to exercise. HRT does not build muscle on its own - resistance training does that. (This claim circulates on social media and is not supported by evidence.) HRT does not correct metabolic dysfunction. If insulin resistance or elevated HbA1c is part of your picture, targeted nutrition and lifestyle intervention is still essential. Alcohol will still disrupt your sleep on HRT. Sleep hygiene still matters. HRT does not replace the protective value of exercise for cardiovascular health, bone density, and muscle mass. HRT can improve mood, however, if depression/anxiety is still getting in the way of day to day life, it is important that this is followed up with appropriate support. The truth is the most effective approach to perimenopause is not any single intervention - it is a genuinely a comprehensive and holistic one. Furthermore, the basics outlined above still crucially matter. HRT (where appropriate and desired) works best as part of a broader strategy that includes the foundations covered above. Where to From Here? If you are in the perimenopause transition and want personalised support - whether that is navigating your options, working on the foundations, or preparing for a conversation with your GP, I offer a complimentary Vitality Strategy Call to help identify where to start. You can book directly at wellkind.co.nz. We also have a monthly fireside chat, a free online group call to address topics covered over the month in newsletters and blogs. Key References American College of Obstetricians & Gynecologists. (2026). Menopause: What your ob-Gyn wants you to know. Vis N.E. et al. (2015). Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Internal Medicine, 175(4), 531–539. Baber R.J., et al. (2016). IMS Recommendations on women’s midlife health and menopause hormone therapy. Climacteric, 19(2), 109–150. Daley A. et al. (2015). Exercise for vasomotor menopausal symptoms. Cochrane Database of Systematic Reviews, (9). Franco O.H. et al. (2016). Use of plant-based therapies and menopausal symptoms: a systematic review and meta-analysis. JAMA, 315(23), 2554–2563. Peng W. et al. (2019). Mind-body therapies for menopausal symptoms: A meta-analysis. Climacteric, 22(4), 359–369. Rietjens I.M.C.M. et al. (2017). The potential health effects of dietary phytoestrogens. British Journal of Pharmacology, 174(11), 1263–1280. This blog is for educational purposes only and does not constitute medical advice. Please consult a qualified health professional before making changes to your health management.

Perimenopause and menopause are having a moment - it does not take long before something flashes before your eyeballs making you question whether every physiological sensation may in fact be a sign that you are in perimenopause. Whilst I am happy that women's health is getting some more attention, remembering that there are some generations including my mother's, that had a blackout of information and support during this phase of life, it is important that we do not pathologise this period of life or get caught up with mis/dis - information. So, whilst I often eye-roll at a lot of content out there, I am pleased to see that research and medical advice is catching up and that women are beginning to get better support to transition through this stage of life. One question I get asked a lot in the clinic when someone is experiencing menstrual cycle stuff with other symptoms - am I in perimenopause? Officially, based on what's called the STRAW +10 criteria, early perimenopause for those that have a uterus, is defined by persistent variability in menstrual cycle length; specifically, a difference of 7 or more days in consecutive cycles, recurring within 10 cycles of first occurring. At first changes might be subtle, like a shorter cycle, fewer days of bleeding, heavier or lighter flow, spotting instead of a period. In other words, cycles continue but become persistently irregular. If a cycle is missed (≥60 days of amenorrhea), this signals the a likely later phase in the menopausal transition, which is often accompanied by consistently elevated FSH (>25 IU/L) and greater symptom burden. (Harlow et al., 2012) Menopause itself is defined retrospectively; confirmed 12 months after the final menstruation. The menopausal transition can last anywhere from around 4 to 8 years on average, though individual experience varies considerably. As noted in the STRAW +10, there are two late reproductive phases (3a and 3b) just before perimenopause, where women may experience symptoms such as worsening PMS. These individuals may have regular cycle lengths to slightly shorter, normal to slightly rising/variable FSH, low AMH, low follicular count. The worsening of PMS symptoms can be a first sign of transition. Typically, women enter perimenopause in their 40s, though it is possible to have symptoms earlier. Early menopause is defined by having the last period before the age of 45. If the last period is before the age of 40 this is defined as premature menopause. There is another condition call Premature Ovarian Insufficiency (POI), that looks like early/premature menopause but it is not. For early/premature menopuase or POI - it is important to understand what this means for long term health as well as the support/treatment that is available (more to come on this in another blog). Beyond physiology - the broader implications of this period of life to consider include: Associated symptoms of menopause transition can impact the quality of life of women and all those with ovaries The impact on workplace performance impacts both personal and societal financial outcomes. Some symptoms may be a sign of future health risks for some women (e.g. vasomotor symptoms and sleep issues may be associated with increased risk of bone and cardiovascular risk; vasomotor symptoms and depression may be associated with increased risk for cognitive decline) Geographical location and ethnicity influence the prevalence of varying symptoms. Individual factors such mental health, stress & trauma, metabolic health and socioeconomic status may considerably worsen the experience of menopause. Potential for significant influence on interpersonal relationships and family structure. Importantly - perimenopause and menopause are not pathologies but a natural transitional stage of life. Some women will transition without too much distress or needing too much support. If the changes do not interfere with quality of life and your daily functioning, support may not be necessary. However, for many women, the symptoms experienced during this season of life can impact day to day life and quality of life. For these women, research and clinical evidence suggest that support is well indicated and that early and comprehensive management improves both short-term symptoms and long-term health outcomes. When bleeding changes raise a red flag Many changes in the menstrual cycle are normal but some changes can be unsettling and impact quality of life. If you have any of the following changes in bleeding/cycles for more than 2 cycles, it is a good idea to chat with your GP and see an ob/gyn for evaluation: bleeding that soaks through one or more tampons or pads every hour bleeding that lasts more than 7 days flooding or gushing when you stand up passing large blood clots the size of a quarter or larger bleeding or spotting after sexual intercourse bleeding between cycles cycles longer than 35 days or shorter than 21 What is actually happening in this phase of life? As we age, so do our ovaries. This impacts our hormones produced by the ovaries as well as from other sites in the body. Before estrogen does its decline, it rollercoasters often resulting in ‘high estrogen-like’ symptoms such as heavier bleeding, breast pain, mood symptoms/anxiety. This is compounded by the declining progesterone from poor ovulatory cycles. (Hardringham, 2025) These changes in hormones impact more than just our reproductive system and this is because our hormones play important roles throughout our body. This image shows how estrogen functions in different parts of the body... (Farkas et al, 2022) (Monteleone et al., 2018) With estrogen having wide multi-systemic functions - it makes sense that individuals can experience multi-systemic symptoms during perimenopause/post-menopause. This is where things can get a little messy, however, as many of these symptoms can be related to other things going on and not necessarily perimenopause. It is therefore, important to discuss your symptoms in context with a practitioner who can look at the big picture, rule out possible other causes, and support your individual needs. What else might contribute to timing and earlier onset Other things that may be relevant to when you might go through menopause is family history. Knowing when your mother went through menopause can be helpful. Other factors that can influence the timing of perimenopause include trauma/stress, health conditions, smoking, other chemical exposure, ethnicity, & short menstrual cycles. The take away…. We do have guidelines that can help us determine whether you are in perimenopause. If you are not feeling yourself, it is always worth talking to your doctor. Tracking your cycle & symptoms can be a helpful way to identify with a practitioner what you are experiencing as well as the patterns that may be happening to get a holistic picture. You can download this tracker linked below or use one of the many apps available to help you. Hormone blood tests are not necessary to determine whether someone is in perimenopause or prescribe support such as HRT but they can be a helpful way to assess what is actually going on with your hormones and provide more personalised comprehensive support. Key hormone blood tests that can be helpful and the days to test them if you are still cycling: Day 2 of your cycle test (second day of full menstruation): FSH LH E2 Prolactin Free testosterone DHEA Day 21 of your cycle test or 7 days post-ovulation: Free T (including SHBG) A Point on Differential Diagnosis As mentioned above, there can be other things that result in missed/irregular periods as well as other symptoms that can be associated with perimenopause. I am brining this up because in the age of social media and dr. google - it is very easy to self-diagnose and possibly incorrectly. There are other reasons we may be experiencing our symptoms. PCOS for example can result in metabolic changes, weight changes, irregular/missed cycles. Other conditions that need careful consideration - especially if someone is younger than 40 - include hypothalamic amenorrhea and primary ovarian insufficiency. Thyroid issues can also lead to period changes, metabolic changes, poor temperature regulation, reduced libido. Not only are there possible other contributing factors that may need to be considered or at least ruled out - it can be more than one thing at once. For me personally - I have a thyroid condition and had primary ovarian insufficiency that likely kicked off my perimenopause early - both needed to be addressed. The point is - whilst, yes, a range of symptoms can be perimenopause - they can also be other things and it is important to look at whole picture and assess what is really going on - identifying other potential contributors that may require different or additional support. ...More posts to come on how to support yourself through this phase of life. If you are wanting some more support, --> stay tuned to our weekly newsletters this month focused on perimenopause. --> join our fireside chat at 12pm nz time on Saturday May 30th. Subscribers get free access. --> for more 1:1 support schedule a free vitality strategy call to discuss pathways of support.

How your mental health and nervous system may be contributing to your gut issues We often hear about how the gut can impact the brain but the relationship runs both ways. Mental health is now recognised as a key contributing driver in many cases of IBS subtypes and functional dyspepsia. This has given rise to the field of neurogastroenterology, which explores the gut-brain axis in clinical depth, and to a formalised diagnostic framework for disorders of gut-brain interaction (Rome IV, 2016). "The gut-brain axis (GBA) consists of bidirectional communication between the central and the enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions" ~ (Carabotti et al., 2015). (Carabotti et al., 2015) How the brain and nervous system can impact your gut 1. Pain perception  For some people, the way pain signals are processed between the gut and the brain becomes dysregulated, a phenomenon known as visceral hypersensitivity. The nervous system loses its ability to appropriately downregulate pain, leading to heightened and persistent discomfort. Both neuromodulator therapies and behavioural interventions (such as gut-directed hypnotherapy and CBT) have demonstrated efficacy in resetting this system and reducing symptoms. (Rome, 2021) 2. Motility  The autonomic nervous system directly regulates gut motility. When autonomic function is disrupted, digestion can slow or accelerate, contributing to symptoms such as constipation, diarrhoea, or bloating. Research in neurological injury models, including traumatic brain injury, demonstrates that neuroinflammation can impair autonomic control and significantly disrupt motility patterns (Hanscom et al., 2021), illustrating how upstream nervous system dysfunction translates to downstream gut consequences. 3. Gut immune function and intestinal barrier integrity  nervous system imbalance via the autonomic system or the HPA axis, commonly associated with chronic, unmanaged stress,  can impact gut immune function and promote a pro-inflammatory state. Evidence indicates this increases vulnerability to intestinal barrier permeability, a mechanism that may underlie stress-related flares in gut symptoms (Leigh et al., 2023). 4. Microbiome composition  Emerging evidence from observational and animal studies suggests that chronic stress can alter gut microbiome composition, though robust human RCT data in this area remains limited (Leigh et al., 2023). This is an active area of research with clinical relevance that warrants monitoring.  The Autonomic Organisation of The Gut (Leigh et al., 2023) Because the gut-brain relationship is bidirectional, the downstream gut changes described above can in turn further dysregulate nervous system function, creating a reinforcing cycle that can be difficult to break without addressing both systems holistically. If you notice that stress reliably worsens your digestive symptoms, nervous system support should be part of your gut health plan. Here are some things to consider for nervous system support that supports gut health… Protect your sleep : sleep is the primary period of nervous system repair and regulation. Move your body :  regular exercise supports autonomic balance and reduces stress reactivity. Build sustainable stress management strategies :  this looks different for everyone - the goal is not to remove stress but rather ensure you can manage it constructively and recover. There is a lot of evidence based tools that you can be supported with including: mindfulness, CBT, hypnotherapy, counselling, etc.  Slow down at mealtimes : This is HUGELY underrated and yet so important.  Sitting down, taking a few slow breaths before eating, and chewing thoroughly helps shift your nervous system into parasympathetic ('rest and digest') dominance, which is the optimal state for digestion. Prioritise nutrient-dense wholefoods : Key nutrients including B vitamins, zinc, magnesium, and omega-3 fatty acids are essential precursors for neurotransmitter synthesis and neurological resilience, which in turn supports gut-brain signalling. Address underlying anxiety or depression :  If these are present, they are likely bidirectionally reinforcing gut symptoms. Seek appropriate support.  Supporting gut health can also positively feedback to the brain and nervous system. For more on targeted gut support, see post on fibre, prebiotics and polyphenols and find some more practical gut health foundations here. If symptoms persist, personalised clinical assessment is recommended as the mechanisms above interact differently in each person. If you would like more support in this area... --> join our fireside discussion - a live group call at the end of every month (last saturday of the month at 12pm) with a registered practitioner to discuss topics highlighted in monthly newsletters and blogs. Subscribers to the newsletter get complimentary access to these live events. Subscribe via www.wellkind.co.nz . --> to begin a personalised 1:1 support journey schedule a complimentary vitality strategy call.

An evidence-based tool frequently utilised in my clinic to evaluate an individual's gut health is the Bristol Stool Chart. Along with some clinical questioning, this chart aids us in starting to comprehend the state of a person's gut health. (ROME, 2000) The optimal frequency for bowel movements is 1 to 3 times daily, with a consistency corresponding to type 3, 4, or 5 on the Bristol Stool Chart. The ROME criteria serve as the current diagnostic tool for evaluating IBS subtypes. If an individual experiences abnormal stools more than 25% of the time, they might qualify for an IBS subtype diagnosis. The Bristol stool chart can help identify warning signs of other digestive problems that might need additional examination. For instance, the presence of blood in stools is a warning sign and should always be investigated further by your primary care physician (GP). If you find that your bowel motion frequency and type are not ideal, it is a good idea to talk to a registered practitioner. References The Rome Foundation - https://theromefoundation.org

The dietary foundations for good gut health include adequate fibre, prebiotics, and polyphenols. Fibre Fibre is important. It helps keep our gut healthy, which has a positive knock on effect to other systems in body including cardio metabolic. The Ministry of Health recommmends that adult women need at least 25 g of fibre a day and men need at least 30 g. The fact is, a large portion of the population are not meeting these daily requirements. There are different types of fibre: soluble, soluble, prebiotic (Hechtman, 2025) Fibre helps improve satiety, motility patterns as well as feed beneficial bacteria in the gut, which produce short chain fatty acids, lower inflammation, and modulate the immune and metabolic system. Fibre can also help increase mucus membrane secretion, protecting gut barrier function, which also helps immune function. Prebiotic Fibre There are many types of prebiotic fibre - all of which modulate and improve the microbiome helping increase beneficial bacteria and reduce pathogenic bacteria. (Hechtman, 2025) Benefits of Prebiotic Fibre (Scott et al., 2020) Polyphenols Polyphenols are phytochemicals found in plant foods (e.g. berries, cocoa, green tea, turmeric). Polyphenols are antiinflammatory and antioxidants. They also modulate and improve our gut microbiome, increasing beneficial bacteria such as bifidobacterium spp. akkermansia spp, and lactobacillus spp.. They support the health of barrier function and help it specifically reduce pathogenic bacteria growth. Foods that heal (Hechtman, 2025) Eating mostly wholefoods and eating a diverse range of plants is one of the best ways to access fibre, prebiotics, and polyphenols. By doing so we can protect and improve not only our gut health but health overall. NOTE: If fibre causes more digestive issues, it is important to address the root cause and work with a practitioner. Some of the underlying issues may include SIBO, dysbiosis, and thyroid issues. In these circumstances, specialised therapeutic care may be required. Wanting to learn more? ---> join our monthly live fireside chat (last saturday of the month at 12pm). Subscribers to the Wellkind newsletter get free access. ---> for more personalised support, schedule a 1:1 vitality strategy call here

“I am seeing you to help me with my period, why are you asking about my gut???” In my clinical practice I specialise in AFAB’s (assigned female at birth) reproductive health (e.g. menstrual cycle health) BUT at the root of so many of these presentations, we often find the gut being an upstream contributing driver of what is going on. So, while I wouldn't have called myself a gut specialist when I started out, I continue to upskill in evidence-based gut health support because whether someone is dealing with PMS, PMDD, PCOS, endometriosis, hypothalamic amenorrhea, or perimenopause symptoms, we need to consider the gut as a possible contributing factor. Naturopathic medicine has long placed the gut at the centre of whole-body health. More current research is now clarifying how  this works, not just that it matters, but the specific biological mechanisms involved - which is so cool. The microbiome and gut barrier is very important in immune signalling, inflammation, neurotransmitter production, nutrient metabolism, and hormone metabolism/regulation. Our gut health is therefore, deeply interconnected with nearly every system in our body. Let’s look at a few big reasons how your gut health connects with your hormones…. The estrobolome Within your gut microbiome lives a functionally distinct subset of bacteria more recently referred to as the estrobolome .   These bacteria produce enzymes called β-glucuronidase and β-glucuronidase is responsible for deconjugating oestrogen in the gut (essentially stripping off a molecule that tagged with in the liver and signalling  it for excretion via the colon) allowing it to be reabsorbed into circulation.  Now β-glucuronidase activity is not uniformly "good" or "bad",  its up- and down-regulation appears to be partly life-stage dependent, and both excess and deficiency have clinical relevance depending on the individual's hormonal context. When the estrobolome is healthy and diverse, this recycling is well-regulated.  When it is disrupted, however, through dysbiosis (when opportunistic bacteria that produce it overcrowd the beneficial bacteria), excess reabsorption may contribute to oestrogen dominance symptoms, while an underactive estrobolome may contribute to lower circulating oestrogen.  In other words, the health of your microbiome impacts how oestrogen is regulated in your body and we actually have tools that can improve this directly when things get out of whack.  LPS, inflammation, and reproductive health In addition to β-glucuronidase activity, other aspects of gut health can impact our hormones and cycle. Opportunistic bacteria can also produce lipopolysaccharide (LPS): an inflammatory molecule. LPS causes inflammation in the gut and can also translocate into circulation if the barrier of the gut is compromised, triggering low-grade systemic inflammation and elevating further inflammation and immune activation.  Elevated LPS has been associated with both endometriosis, PCOS, PMS, PMDD, and may contribute to severe perimenopause symptoms in some cases. Addressing these bacteria can help lower LPS and therefore inflammation and immune activation.  Histamine Some gut bacteria are histamine-producers, and when these are overrepresented, histamine load can become excessive. Oestrogen upregulates histamine receptors, meaning the oestrogen-histamine relationship is bidirectional: high histamine can worsen oestrogen-related symptoms, and high oestrogen can increase histamine sensitivity. This is particularly relevant for women with premenstrual or perimenopausal mood symptoms, anxiety, as well as allergy hypersensitivity & reactivity.  Absorption issues Finally, we need nutrients to support the production, metabolism, and function of hormones as well as reproductive health in general. Things impacting absorption such a lack of the good bacteria that help convert certain nutrients into their active forms, digestive enzymes, and inflammation may impact our nutrient status, which can then impact our hormone/reproductive health.  What about perimenopause?  Whilst we are still needing stronger evidence and better controlled trials, some research suggests that gut health may impact symptom severity during the perimenopause/menopause transition. For example, some studies suggest that post-menopausal women with menopausal syndrome  (symptomatic menopause) have higher rates of gut health issues compared to asymptomatic menopausal women, which  suggests the microbiome may modulate symptom burden. It is interesting research that we need more of! Soy isoflavones are evidence based nutrients we can use to support all reproductive health issues including perimenopause symptoms as well as protect long term health with AFABS. For more information on this read our previous blog on soy isoflavones . Improved gut health may help with better absorption and, therefore utilisation of these nutrients. In general, it is suggested that aging alone impacts the health of our microbiome with a likely decrease in microbiome diversity and more wear and tear on barrier function through an increase in oxidative stress. Whether it is the perimenopause transition or just aging - the main point is, we can definitely support our gut health to support our overall health throughout our lifetime as a protective factor for overall health. What this all means and what you can do: practical starting points Supporting your gut health is a protective factor not just for reproductive health but health overall. Some of the basic evidence based things to consider: Prioritise wholefoods: A wholefoods diet rich in lean protein, omega 3 fatty acids, veggies, whole grain, legumes, etc provide nutrient density as well as keep inflammation and oxidative stress down. This in general supports gut health.  Eat for diversity: Aiming for 30+ different plant foods per week (vegetables, fruits, legumes, nuts, seeds, wholegrains) has been shown to be a strong predictor of microbiome diversity (McDonald et al., 2018). Make sure you are getting enough fibre: Fibre in general is really great for gut health and research shows most of us are not getting enough. Adult men need a minimum of 30 g and women 25 g. Fibre keeps motility patterns healthy (which helps the excretion part of conjugated estrogen, which supports gut health.  Fibre also feeds beneficial bacteria in the gut acting as a prebiotic.  Include fermented foods if tolerated: A more recent randomised control trial showed that a high-fermented-food diet significantly increased microbiome diversity and reduced inflammatory markers (Wastyk et al., 2021). If an individual has histamine issues, they may not tolerate fermented foods well. Addressing the root cause of this so that you can tolerate these foods and get the benefit from them is possible - find some support if needed.  Prioritise sleep & manage stress: The gut-brain axis is bidirectional and mechanistically well-established. Sleep deprivation and chronic stress alters gut motility, barrier function, and microbial composition.  Move your body and recover: Exercise is also shown to have a relationship with our gut health. Varghese et al. (2024) in a literature review discuss how combining aerobic and resistance training significantly affects bacterial diversity, linked to a lower prevalence of chronic metabolic disorders. Furthermore, exercise enhances gut microbiome diversity, increases SCFA production, improves nutrient utilization, and modulates neural and hormonal pathways, improving gut barrier integrity. Recovery is important as some literature also suggests that high-intensity exercise for a long duration can cause a leaky gut and consequent systemic inflammation, which may disrupt the microbial balance. Protect your microbiome and gut barrier:  Minimise unnecessary long term antibiotic use, NSAID use, excessive alcohol, smoking, processed food that can disrupt microbial balance and barrier integrity. If you do need to use these medications long term, speak with your practitioner about how you can protect your gut health in the process.  Consider working with a qualified practitioner and testing if symptoms persist.  If you've been doing "all the right things" and still struggling, further testing and targetted support may be a good idea. Seeing your GP can be a great start as they can do some routine tests. Working with a naturopath for more targeted gut support is helpful as well.  If you would like more support in this area.... --> join our fireside discussion - a live group call at the end of every month (last saturday of the month at 12pm) with a registered practitioner to discuss topics highlighted in monthly newsletters and blogs. Subscribers to the newsletter get complimentary access to these live events. Subscribe via www.wellkind.co.nz . --> to begin a personalised 1:1 support journey schedule a complimentary vitality strategy call.

When we think of gut health - we mostly think about what is happening in our puku but oral health is part of gut health.  Digestion starts in the mouth with the action of chewing as well as the release of a digestive enzyme amylase. We also have an oral microbiome, which research is learning more about.  Once again there is a bidirectional relationship between our oral health and other systems in the body.  For example, there is a bidirectional relationship between oral health and our cardiometabolic system. Periodontitis (gum disease) is an inflammatory disease of the soft and hard tissues supporting the teeth that has been associated with cardiometabolic disease. A meta-analysis found that individuals with diabetes had an increased risk of developing peridontal disease and those with peridontal disease also had an increased risk of developing diabetes (Sanz et al., 2021). Other research showed that even people without diabetes had more chances of having higher hba1c (a marker of glucose control) if they had oral health issues (King et al., 2022).  The risk factors for periodontitis are poor oral hygiene and also risk factors known for cardiometabolic disease, including tobacco smoking, poor nutrition, poor sleep and physical inactivity. Another important oral health presentation associated with increased risk of oral health conditioners as well as cardiometabolic disease is dry mouth. Dry mouth further impacts mucous membranes, reducing beneficial bacteria and creating conditions for pathogenic bacteria to thrive. Excessive mouth breathing can exacerbate this as well as sleep issues associated with mouth breathing such as snoring and sleep apnea.  Inflammation created by bacteria in the mouth can also lead to systemic inflammation, which further exacerbates possible underlying mechanisms associated with cardiometabolic conditions. Furthermore, pathogenic bacteria in the mouth can also be found systemically.  Taking care of your oral health is important beyond just what is happening in your mouth.  —> make sure to see the dentist regularly and follow their advice for maintaining good oral hygiene  —> Take care of your metabolic health (read previous blog post on this ) —> make sure you are mostly breathing through your nose, especially when you sleep —> if sleep issues like snoring persist, consider further investigation for possible sleep apnea —> support gut health in general (read this post for more information) —> seek personalised holistic health support if symptoms persist If you would like more support in this area.... --> join our fireside discussion - a live group call at the end of every month (last saturday of the month at 12pm) with a registered practitioner to discuss topics highlighted in monthly newsletters and blogs. Subscribers to the newsletter get complimentary access to these live events. Subscribe via www.wellkind.co.nz . --> to begin a personalised 1:1 support journey schedule a complimentary vitality strategy call.

Malnourishment is something I see frequently in clinic. The two most common nutrition patterns I observe are: Overfed and undernourished (too many calories for energy demand plus a deficit in nutrients) Underfed and undernourished (too little calories for energy demand plus a deficit in nutrients) In fact, I do not think I have ever done a nutritional analysis with a client where there was not at least a few nutrient needs identified and likely contributing to their health concern. The underlying commonality is the same: undernourishment. One specific pattern stands out that I often see ---> In the pursuit of weight loss, many people become highly focused on calories in versus calories out. While thermodynamics cannot be argued, this narrow focus often overlooks an important factor: micronutrient sufficiency. Individuals are willing to sacrifice consistency of nutrient status for maintaining the 'deficit'. TRUTH - Micronutrient sufficiency is required for sustainability of health - and can even be argued for sustainabiliity of weight loss. This is why I never look at weight loss in isolation as a practitioner - I prioritise health...always. When the body is undernourished, health becomes compromised and compromised health is a major risk factor for chronic disease - including metabolic disease. Some may argue that weight loss alone improves metabolic markers. While weight loss can certainly contribute to metabolic improvements, research in pre-diabetes and diabetes shows that weight loss in isolation has less impact than addressing overall health holistically. In other words, improving nourishment and supporting metabolic health leads to better long-term outcomes. A wide range of micronutrients are required to support healthy metabolic function, including (but not limited to): B vitamins, Omega-3 fatty acids, Vitamin D, Chromium, Zinc, Taurine, iron, Magnesium. Nutrient deficiencies can also disrupt other physiological systems that influence metabolic health. For example, nutrient inadequacy can impair sleep quality , which in turn increases insulin resistance . It can increase stress hormones, which puts more pressure on a range of systems including the metabolic system. It can impact hormone balance, neurotransmitter synthesis, bone health, gut health, liver function....the list could go on. There is also the concept of sarcopenic metabolic dysfunction , where low muscle mass contributes to impaired metabolic health. Not getting enough protein impacts muscle synthesis and maintenance. This is why health needs to be viewed through a holistic lens . A calorie deficit alone may result in weight loss, but if health becomes compromised in the process, the long-term outcome is not necessarily better - and in many cases can be worse. Checking in on your micronutrient status can be valuable. Routine blood tests can assess several key nutrients, including: B12, Folate, Iron, Vitamin D. Other labs can also indicate possible deficiencies including a complete blood count, inflammatory markers like CRP/homocysteine. Another option is to track food intake for a short period using a credible nutrient analysis program. Cronometer is one tool I often recommend, as it provides detailed micronutrient tracking. Malnourishment compromises overall health and contributes to metabolic dysfunction. It is never worth the sacrifice. To learn more about how to support your metabolic health holistically, check out my previous blog on metabolic health. If you want more personalised support with your health: --> As a subscriber to Wellkind's newsletter, you are invited to a monthly Fireside Chat live online. --> Schedule a 1:1 vitality strategy call to talk about your personalised health needs with a registered practitioner.

The New Year is a time when many of us set lofty goals. It serves as a temporal landmark , which can boost our motivation for change. This is beneficial, especially when it creates a sense of collective momentum to take action. However, by this time of year, many have already abandoned their resolutions. Why does this happen? Here are some common reasons: Goals may not be realistic based on timeframes, needs, priorities, or relevance to a bigger “why.” The actions required to achieve the goal may not be sustainable. The needs and problems that current “less desirable” behaviours solve are often overlooked, leading to internal conflict. The non-linear nature of growth is frequently misunderstood. Small wins go unnoticed, and people struggle to stick with the inevitable ups and downs of the process. Limiting core beliefs can obstruct progress. Bringing Depth and Meaning to What You Want to Achieve When selecting a goal, it's essential to dig deeper. Why is this goal important to you? What values does it align with? What identity are you building or aspiring to? What is the cost of not achieving it? Understanding your deeper “why” and the cost of inaction provides leverage. It helps you choose something meaningful, relevant, and aligned with your values and identity. For instance, you might want to become more active to gain energy, vitality, and the ability to play with your children. You may wish to say yes to more activities, like hiking with friends, while also protecting your mental health and managing daily responsibilities without feeling exhausted. Knowing your “why” infuses meaning and purpose into your actions. Breaking Things Down into Bite-Size Actions Practically speaking, goals need to be broken down into actionable steps. They should meet you where you are. As James Clear, author of Atomic Habits , says, “Dream big, start small.” Taking on too much at once is rarely sustainable. Small changes can compound over time. When I work with clients on nutrition, we often make small adjustments to meals they already enjoy. Instead of overhauling their entire diet, we enhance what they’re already doing in a way that feels achievable. This approach builds confidence and capacity. Appreciating Realistic Timeframes We often overestimate what we can achieve in the short term while underestimating what we can accomplish in the long term. Change is possible, but it can be challenging. It takes time and requires steady consistency. Your goal may need to be broken down even further. Most things take longer than we anticipate. Rushing timeframes can lead to unsustainable actions, unforeseen trade-offs, and missed targets. Consulting someone who understands realistic timeframes for your goal can be incredibly beneficial. Understanding the Needs Behind Your Current Behaviour All behaviour serves a purpose and meets a need. From this perspective, behaviour is not “wrong”; it solves a problem. Even habits we want to change are fulfilling some need. If you try to replace a behaviour without addressing the need it satisfies, change is often unsustainable. This understanding allows us to better comprehend our personal needs and values. It fosters compassion for why we act as we do. From there, we can find more intentional ways to meet those needs in a manner that serves us better. Moreover, wherever our focus lies, it is not elsewhere. Every decision and action comes with trade-offs. Weighing these in advance can reduce friction and minimise surprises along the way. Embracing the Non-Linear Nature of Growth The hard truth is that achievement does not occur in a linear fashion. The process is messy, challenging, and full of ebbs and flows. It resembles a rollercoaster more than a straight line. You will encounter valleys that may make you want to quit. When things feel wobbly or stagnant, many abandon their goals, believing they have failed. In reality, this is simply part of the journey. With practice, while the valleys may never feel good, we can become comfortable with discomfort. We start to appreciate the process itself. Many people become so fixated on their desired outcome that they overlook the small wins occurring along the way. Surviving a valley and remaining committed to the process is a win in itself. Mindset shifts are also victories. Consistently taking action is a significant win. Building awareness and staying engaged leads to deeper fulfilment and appreciation of growth. Your Mindset Matters Finally, our core beliefs and mindset influence our behaviour, both consciously and unconsciously. Common limiting beliefs include: “I’m doomed to fail,” “I’m not X enough,” “Others will judge me,” or “Because I haven’t taken care of myself, it’s too hard now; there’s no point in trying.” We often seek evidence that supports these beliefs, magnifying confirming evidence while minimising or ignoring anything that contradicts them. This, in turn, shapes our behaviour. If we desire meaningful, sustainable change, we must be willing to examine our mindset and core beliefs. Working on building a growth mindset can be a transformative step. It’s Okay to Try Again Like many, I’ve wanted to throw in the towel on more than one occasion. Reflecting on why something didn’t work, making adjustments based on the points above, and trying again is part of the journey. It’s human, it leads to growth, and it’s brave. You don’t need to wait until the New Year. You can start again at any moment—whether that’s the next minute, hour, or day—on your terms. Change is not easy for any of us. The people you may compare yourself to are also navigating their own bumpy, winding roads. If you are in the arena, giving something a go, you are growing, and that is already a significant win. Be curious and compassionate. Remember, you are human, and stay engaged in the process.

Metabolism refers to all the chemical processes required to maintain life. Broadly, it includes three core functions: Breaking down food into energy used by cells Building and repairing tissues using nutrient building blocks Eliminating waste In a healthy metabolism, the body can switch easily between fuel sources: Glucose (from food) Glycogen (stored carbohydrate) Fat (stored energy) This ability is known as metabolic flexibility . When flexibility is strong, energy is steady. When it declines, the body becomes increasingly dependent on glucose and loses efficient access to stored fuel, even when plenty exists. Metabolic dysfunction occurs when the body loses its ability to efficiently produce, regulate, and use energy. It is a common and overlooked driver of fatigue and other health concerns. The Role of Insulin in Metabolic Health When metabolic health declines, fuel access becomes impaired. Insulin is a hormone released by the pancreas when glucose enters the bloodstream. Its role is to move glucose into cells for energy or storage. When cells stop responding properly to insulin (a state called insulin resistance ) several things happen: The body produces more insulin Glucose struggles to enter cells Blood sugar levels rise Fat storage increases Access to stored energy decreases Cells become energy-deprived despite energy abundance This creates a paradox: The problem is not necessarily a lack of energy. It is impaired energy access and regulation. Contributing Factors to Metabolic Dysfunction Metabolic imbalance rarely has a single cause. Common contributors include: Poor sleep Chronic stress Sedentary lifestyle and low lean muscle mass Inflammatory dietary patterns with lack of wholefoods Smoking and alcohol Hormonal transitions or conditions (midlife, PCOS) Long-term stress load Restrictive or chronic yo-yo dieting Thyroid dysfunction Metabolic dysfunction is often the result of cumulative strain of a combination of some of the above. How Metabolic Imbalance Impacts Health Metabolic health affects nearly every system in the body. Poor metabolic health is linked to increased risk of: Heart disease Stroke Metabolic Syndrome (Pre-diabetes) and Type 2 diabetes Liver and kidney conditions Dementia and neurodegenerative disease PCOS and other hormonal imbalances/conditions Gestational diabetes Intensified perimenopause and menopause symptoms Chronic inflammation Immune dysregulation Reduced stress resilience Even cancer... Be Your Own Detective: How to Investigate Metabolic Health Metabolic irregularities can exist for years before diabetes or disease is diagnosed. Early signs are often subtle and easy to miss. Being proactive prevents long term consequences. Common Symptoms of Metabolic Dysfunction Fatigue or big energy crashes (especially after eating) Constant hunger or poor satiety Energy crashes - especially after eating Brain fog Excessive sugar cravings Frequent urination at night Irregular periods or PCOS Skin tags Darkened skin folds (neck, armpits, knuckles) High blood pressure Central abdominal weight gain BUT people can be ‘thin’ and have metabolic issues Strong cravings Fatigue Unstable blood sugar Increased inflammation Increased waist to hip circumference (note: it is possible to have thin frame and still have metabolic imbalance) Blood Tests That Can Indicate Metabolic Imbalance Blood Sugar & Insulin Regulation Fasting glucose Fasting insulin HbA1c HOMA-IR Oral glucose tolerance test (if needed) Cholesterol & Lipids Triglycerides HDL LDL Total cholesterol Liver Health ALT AST GGT ALP Inflammation CRP (C-reactive protein) Thyroid Signalling TSH Free T3 Free T4 Foundations to Improving Metabolic Health Nutrition Principles Lower inflammation. Stabilise blood sugar. Improve insulin sensitivity. The goal is to restore the body’s ability to access and use stable energy efficiently. 1. Build blood-sugar-stable meals Every meal should include: Protein  → stabilises glucose, improves insulin sensitivity, supports lean muscle (a glucose sink), reduces cravings, stabilises energy Fibre  → slows absorption and reduces inflammation Colourful veggies → reduces inflammation and oxidation, provides micronutrient density Healthy fats  → support energy and hormones Whole-food complex carbohydrates  → fuel without glucose overload 3. Lower inflammatory load Reducing ultra-processed foods, added sugars, refined carbs, and alcohol excess, while increasing fibre, omega-3 fats, and colourful veggies and fruits, lean proteins, and whole grains  directly stabilises blood sugar and improves insulin sensitivity. Inflammation isn’t just about food, it’s about stress, sleep, blood sugar swings, and under-fuelling  too. I will talk about lifestyle foundations below but let’s stop to look at underfuelling because it is often missed when it comes to metabolic health - most people think it is only connected with overconsumption of food. Under-fueling can lead to low energy availability, which puts a lot of stress on the body. States of low energy availability , where energy intake is lower than what’s needed for basic metabolic functions plus activity, are associated with maladaptive physiological changes. It can lead to: Impaired immune function Altered hormone signalling Increased inflammatory system activation Suppressed key metabolic pathways Because the immune and metabolic systems are tightly linked, chronic energy deficit can disrupt immune tolerance and promote inflammation, which contributes to metabolic dysregulation.  How to Build a Metabolically Healthy Plate Think function first: ½ plate → Fibre-rich colourful plants (non-starchy vegetables, salad, legumes, greens)→ slows glucose absorption, feeds the microbiome, reduces inflammation, builds nutrient density ¼ plate → Protein (fish, eggs, poultry, meat, tofu, tempeh, legumes, Greek yoghurt)→ stabilises blood sugar, improves insulin sensitivity, supports muscle, stabilise energy ¼ plate → Whole-food carbohydrates (root veg, fruit, whole grains, legumes)→ provides fuel without glucose overload + Healthy fats (olive oil, avocado, nuts, seeds, oily fish)→ hormone support, inflammation control, energy stability Other Evidence-Based Simple & Practical Nutrition Insights and Tools Small habits → big metabolic shifts: Apple cider vinegar before meals 1–2 tsp in water 10–15 minutes before eating may reduce glucose spikes and improve insulin sensitivity (not suitable for reflux/gastritis and also should be consumed with a straw to protect teeth enamel) Eat in this order Fibre → Protein → Carbs. Same meal, different order = better blood sugar control Exercise Snack or Brief Walk after meals - 1-10 min of moderate to vigorous activity (e.g. stairs, squats, star jumps) or 10–30 minutes moderate improves glucose uptake and insulin sensitivity Avoid liquid sugar - avoid juices, sodas, and other sugary beverages. Eat consistently - Regular meal timing supports insulin signalling and metabolic stability as well as may improve sleep patterns (which improaves insulin sensitivity) Lifestyle Foundations That Support Metabolic Health and Restore Energy Sleep. Stress. Movement. Safety. Connection. We often think metabolic health is built in the kitchen. But your metabolism is regulated just as powerfully by your nervous system, hormones, sleep, stress load, movement patterns, and sense of safety . 1. Sleep: The Master Metabolic Regulator Sleep is one of the strongest predictors of metabolic health. Poor sleep: Increases insulin resistance Raises inflammation Disrupts hunger hormones (ghrelin/leptin) Raises cortisol Impairs glucose control Increases cravings Worsens fatigue Disrupts mitochondrial function Sleep deprivation tells the body it is under threat → which shifts metabolism into stress mode , not repair mode. Practical Sleep Strategies: Consistent sleep and wake times (even weekends) Morning daylight exposure No screens 60 minutes before bed Low light in the evening Protein-rich dinner to stabilise night-time glucose Reduce late caffeine Magnesium-rich foods in the evening Cool, dark sleeping environment Nervous system down-regulation before bed 2. Stress: A Metabolic Load, Not Just a Feeling - Cultivate Safety A chronically stressed nervous system signals danger and survival --> creating a more physiological stress. Chronic stress directly drives: Insulin resistance Inflammation Blood sugar instability Fat storage Hormonal disruption Immune dysregulation Mitochondrial dysfunction Cortisol and adrenaline are metabolic hormones. They change how your body uses energy . Your metabolism responds more to perceived stress  than actual threat. Practical Stress Regulation Tools to Cultivate Safety: Breathwork (slow nasal breathing, long exhales) Daily outdoor exposure Nervous system regulation practices Boundaries around work and stimulation Regular meals (blood sugar stability = nervous system safety) Walking breaks Somatic regulation (movement, shaking, stretching) Digital boundaries Reducing cognitive overload 3. Movement: Sensitising Cells to Insulin Exercise significantly improves cell signalling and is a power lever we can pull for metabolic health. Movement: Improves insulin sensitivity Increases glucose uptake into muscle Lowers inflammation Improves mitochondrial density Improves metabolic flexibility Regulates stress hormones Improves sleep quality Slowing down Rituals and routines Muscle is a glucose sink : the more metabolically active muscle you have, the better your blood sugar control. Focusing on building lean muscle is a great way to improve metabolic health. 4. Connection & Social Regulation This is often a missing piece. As mentioned above, the body struggles to heal and be well in survival mode and survival mode is energetically expensive. Positive connection and belonging signal safety  to the nervous system as well as increase other positive emotions and hormones that have a benefit to our metabolic system such as oxytocin. Practical Ways to Cultivate Connection: Time with supportive people Laughter and play Gentle touch and affection Nature exposure Community belonging Supportive relationships Feeling seen and heard Being of service Expressing gratitude Herbal Medicine and Supplement Support Whilst the foundations are the most important, sometimes we can benefit from some supplement tools as well. When selecting supplements it is important to always talk to a qualified and registered naturopath, nutritionist, and herbalist - especially if you have preexisting conditions and/or are taking medication and also to ensure you have access to good quality as well as appropriate dosages. These are some of my top clinical recommendations: Nervous system support Adaptogens to build window of tolerance to stress: Withania Sleep support: Magnesium, glycine, taurine, B6, zinc, chamomile Stress management/anxiety: L-theanine Sugar Cravings fenugreek, licorice (avoid with high blood pressure), cinnamon, gymnema chromium Improve insulin sensitivity Berberine, St. Mary's Thistle, nigella myo-inositol Reduce Inflammation Ginger, turmeric Supporting metabolic health is foundational to long-term vitality. It influences energy, inflammation, hormones, immune function, mood, and resilience. Metabolic dysfunction does not happen overnight — and it does not reverse overnight. But with consistent nutrition and lifestyle foundations, the body is remarkably responsive. If you suspect your metabolic health may need support, I invite you to: Join our first FIRESIDE DISCUSSION via zoom on Saturday 28th March at 12pm nz time. Free to all those subscribd to this newsletter. Zoom link will be emailed in future. Schedule a Vitality Strategy Call to explore whether you'd benefit from more 1:1 personalised support.

“You can be a masterpiece and a work in progress at the same time.” ~ Sophia Bush Many of us carry some history with a ‘diet mentality’ - something I see often in my clinical practice. I often see people trying to dance between caring for their holistic health and avoiding a slide back into control, guilt, or deprivation. This dance is often born from a backlash against diet culture and for good reason. For a long time, we were taught that health equalled leanness, that strict discipline was a virtue, and that food or exercise carried moral weight. Within this framework, self-worth becomes tied to appearance and behaviour: how we look, how much we achieve, how “good” we are being. While these messages still echo through our culture, there’s now a growing movement pushing back; one that embraces intuitive eating, body respect, self-acceptance, and a more compassionate, sustainable approach to wellbeing. This shift is both necessary and powerful. But in this process, I’ve been observing something else -  something that’s leaving many people feeling stuck: health itself has become tangled in the backlash.  In our effort to reject diet culture, we may overcorrect - viewing any proactive effort to support our health as suspect, or as a sign of restriction. Supporting your health with nutrient-dense meals or regular movement doesn’t mean you’re “on a diet.” Choosing protein and vegetables over a scone for lunch isn’t punishment; it’s nourishment. Yet I see many people finding themselves second-guessing these choices, worried about being perceived as obsessive or unkind to themselves. If someone declines a second slice of cake or opts for an early night, they might hear: “Are you on a diet?”  or “Don’t be so good!”  or “Come on, be kind to yourself and give yourself a break.” So how do we navigate this tension - caring for our bodies without slipping into rigidity or guilt? It is  possible to hold both truths at once: to cultivate a deep sense of self-worth and acceptance while also wanting to protect, restore, and strengthen our holistic health. How do we do this? It really comes down to mindset . Restriction Mindset: Control, Fear, and Disconnection Diet culture cultivates a restrictive mindset often which grows from fear;  fear of losing control, gaining weight, or not being “good enough.” It’s a way of relating to health through rules and judgment rather than care and curiosity. It can show up in many forms: Binary thinking: “good” vs. “bad” foods or habits Guilt or shame when we “slip up” Using exercise to punish or ‘earn’ food, rest, or self-worth Avoiding social situations because of food anxiety A sense that health is a test you can fail Physiologically, this mindset can backfire. Chronic stress from guilt or perfectionism raises cortisol, which disrupts digestion, sleep, and immune function. Psychologically, it can disconnect us from our bodies’ signals such as  hunger, fullness, fatigue, pleasure. It can also feed obsessive tendencies and cognitive bias, causing us to overinflate the risks of certain foods or habits. Ultimately, this mindset erodes both physical and mental wellbeing. Nourishment Mindset: Compassion, Curiosity, Presence, and Support A nourishment mindset, on the other hand, is about care over control.  It asks: What would best support me right now? It grows with compassion, curiosity, mindfulness and support. It’s grounded in understanding what holistic health actually means and having a broader set of metrics to gauge it. Instead of focusing narrowly on weight or appearance for example, we might consider energy, mood, sleep, digestion, inflammation, pain, immune function, positive relationships, and sense of purpose through values based action. When we’re aware of these domains, we can make choices that truly nourish our needs. This awareness also brings fluidity: our needs and capacities change, so our behaviour can too. We may be maintaining some domains with regular actions and sometimes we may need to uplift another domain with a more concentrated set of actions.  In the clinic, we assess the domains of holistic health - we look at where strengths are and how these are being maintained and we also look at areas we need to uplift and nurture. We may for example, have a treatment strategy to support gut health and this may require a more concentrated effort on nutrition for a duration of time. As the gut heals and becomes more resilient, an individual may find they can tolerate more foods in moderation.  A personal example: I recently had a chest cold. My immune system was a little overtaxed during recovery. Once I got over the infection, I felt better but was still in a period of convalescence; my body needed to regain the energy it had spent healing. My nutrition, exercise, and rest naturally reflected that. When I went out with my husband and colleagues this past weekend, I enjoyed the social connection but chose not to have the glass of wine I’d usually have, or the dessert. Not because of a rigid rule but because those choices supported my recovery at that moment. This mindset shift takes us from punishment to partnership ; from seeing our bodies as problems to be fixed, to seeing them as living systems that need care, respect, and responsiveness. It embraces continuums of choice and cultivates psychological flexibility, allowing us to adapt as our needs evolve. When you’re coming from a nourishment mindset, you might: Choose meals that help you feel steady, resilient, energised, and well Move in ways that build strength and joy rather than burn calories Rest without guilt, recognising recovery as part of health Allow flexibility in your habits as your needs change See consistency as self-respect, not self-denial Make choices that align with your values and current needs, not just impulses Focus on process over outcomes - as health is a journey NOT a destination Be curious of how you feel after certain behaviours - and use the feedback to learn and support yourself going forward. Perspective The goal isn’t to become perfectly “nourished” all the time. Life will always include moments of stress, overindulgence, or disconnection and that’s okay. What matters most is the tone  of your inner dialogue: Am I approaching this from care or from control? Sometimes, what looks like restriction on the outside (e.g. skipping dessert, adding a salad with your burger, saying no to another drink, or going to bed early) might actually be an act of nourishment. Sometimes nourishment IS having the slice of cake with mates because it brings pleasure, joy and connection. And sometimes, what looks like freedom (e.g.  saying yes to everything) can come from avoidance. Ultimately, context and intention matter far more than the behaviour itself. Also - as our grandmothers often said - everything in moderation. It also means releasing the moral value we attach to our habits. You are not a better or more worthy person because you eat a certain way, exercise consistently, or meditate daily. Your worth is inherent - constant and unchanging - no matter what choices you make. Cultivating self-acceptance isn’t separate from your health journey; it is a necessary part  of it. When we begin from a place of respect and compassion for ourselves, nourishment naturally follows. Reframing  Next time you make a health choice, try asking: Am I moving toward what supports me, or away from what I fear? Is this an act of punishment or of care? What would nourishment look like for me today;  physically, mentally, emotionally? How might this challenge support my growth? Am I doing this to honour my worth or achieve my worth? What are my holistic needs today? When we shift from restriction to nourishment, health stops being a performance and becomes a relationship - one rooted in respect, adaptability, and trust. Because the ultimate goal isn’t to control your body.  It is to honour and care for it. If this resonates with you - i'd love to know:) At WellKind, I help people reconnect with their health through compassion, curiosity, and flexibility so they can restore their vitality and build resilience in a way that moves with life, not against it.

We need to feel safe in order to change and grow Our nervous system is hard-wired to sense and respond to anything that may threaten our survival. It’s a finely tuned system, and when danger is real, it serves us well. But in today’s world, we’re constantly bombarded with signals of threat. Whether it’s global news updates, the endless scroll of social media, or marketing ploys telling us we’re broken and need fixing, our nervous system gets triggered again and again. Even if the danger isn’t immediate, the nervous system often cannot tell the difference. When the body perceives threat, the amygdala switches on and higher brain functions like problem-solving and planning switch off. The result? A background hum of stress that keeps us in survival mode demonstrated as fight, flight, freeze, or fawn behaviours as well as hypervigilance or Neuroception, which is the unconscious scanning for safety or danger.  Survival mode is expensive. It drains emotional, mental, and physical energy, often leaving us depleted and run down, which can have an impact downstream on our health . The types of safety we need Physiological Safety Our nervous system needs cues of safety for growth, repair, digestion, and immune function. Without them, the body prioritises short-term survival over long-term health. Parasympathetic activation (the “rest and digest” state) supports digestion, lowers inflammation, and strengthens immunity. Emotional Safety Trust, belonging, and the feeling of being truly seen and accepted for who we are. Attachment research shows that secure relationships free up energy for exploration, risk taking, creativity, and growth. Emotional safety makes space for vulnerability and connection. Psychological Safety The confidence that we can express ourselves, take risks, and make mistakes without fear of ridicule or punishment. Psychological safety is vital for learning, creativity, and authentic living - it is needed for innovation and effective problem solving. As an educator and practitioner, I understand the significance of creating a safe space and positive relationship for students/clients to learn and grow.  Social Safety Healthy relationships grounded in respect, boundaries, and connection. Studies show that oxytocin (the “bonding hormone” released during social support) buffers stress and helps the nervous system relax.  Self-Safety Cultivating inner trust, self-compassion, and practices that reassure the body and mind that it’s okay to soften and rest. Research shows that self-compassion lowers self-criticism and reduces the stress response, creating inner safety that supports resilience. Safety is not a luxury or a “nice-to-have.” It is a basic human need and a foundation for both physical and mental health and it is required for change and growth. Why it matters When we feel safe, the body reallocates resources in powerful ways: Digestion improves Energy stabilises The immune system strengthens Inflammation decreases Mental health is supported Overall, safety is required for our body to maintain homeostasis - a stable equilibrium that is needed for our health.  Feeling safe also increases our tolerance to stress. Neuroscientist Daniel Siegel describes the window of tolerance , the regulated zone where we can learn, adapt, and make meaningful changes. Without safety, we can easily fall outside that window into fight, flight, or shutdown, which makes it difficult to learn and apply new behaviours that support our wellbeing and growth. Feeling safe and being uncomfortable can coexist Fun fact about me - for my honours thesis I worked in a neuroscience lab at Queen's University with Hans Dringenberg. My research was investigating how acute stress (vs. chronic stress) impacted learning and development. In my research (with animals - rats), we found that small acute doses of stress/amygdala activation actually increased learning potential (measured by something called 'long term potentiation'. In other words, not all stress is bad - in fact - stress is needed for growth and adaptation. Change and growth require us to step outside of our comfort zone, embracing tension and challenge, in order to adapt. Feeling safe does not mean things are easy all the time. It means our nervous system understands that the challenge we’re facing is not an existential threat. Psychologists have long noted this balance - the Yerkes-Dodson curve shows that we perform and grow best under moderate challenge, but only if we feel secure enough to meet it. Safety creates the conditions for us to take risks, try new behaviours, and recover when things don’t go as planned.  Practices to cultivate safety  Cultivating safety is an important part of my work as a practitioner/coach. It involves creating a non-judgemental, safe, compassionate space where clients feel seen, understood and supported.  We can intentionally nurture our own safety through mindful practices such as: Intentional Breathing Breathing with longer exhales and from the diaphragm directly stimulates the vagus nerve, shifting the body into a parasympathetic (rest-and-digest) state. Slow, deep breathing reduces heart rate, lowers cortisol, and improves emotional regulation. Somatic Practices (Yoga, Gentle Stretching) Mindful movement helps release stored tension and signals to the body that it is safe to inhabit space fully. Research shows yoga can lower cortisol and improve interoceptive awareness; our ability to sense and respond to internal cues. Walking in Nature Time in natural environments has been shown to lower stress hormones, reduce blood pressure, and restore mental clarity. Nature provides abundant cues of safety such as greenery, rhythmic sounds, and  fresh air, that calm the nervous system and invite presence. Long, Slow Hugs with a Loved One Sustained, nurturing touch stimulates oxytocin, lowers blood pressure, and reduces stress. Physical closeness with someone we trust sends powerful safety signals to both body and brain. Setting Boundaries Around Media Consumption Constant exposure to alarming or sensationalised information keeps the nervous system on high alert. By limiting this input, you reduce unnecessary threat cues, allowing the body to rest and conserve energy for real-life presence. Our brains have not evolved to take on as much information as we do in a day - the flood of information is overwhelming and keeps our nervous system overstimulated. Mindfulness and Grounding Practices Paying attention to the present moment interrupts cycles of fear and rumination. Studies show mindfulness reduces activity in the amygdala, the brain’s fear centre, and increases resilience to stress. Slowing Down Rushing mimics a threat state: shallow breathing, tense muscles, hypervigilance. Choosing to eat slowly, walk at an unhurried pace, or pause before speaking signals to the body that there is no emergency. Slowness itself becomes a cue of safety. Shaping Your Environment Your surroundings constantly send signals to your nervous system. A cluttered, noisy, or chaotic space can heighten stress, while a calming environment with order, natural light, comforting textures, or soothing sounds can act as a powerful cue of safety. Even small adjustments, like adding plants, soft lighting, or a quiet corner, help your body register: this is a safe place to rest and restore OR this is a safe space to take risks and learn. Compassionate self talk The simple act of noticing when you are stressed and gently reminding yourself that whilst things are hard and stressful in the moment - they are not necessarily dangerous. Saying this in your mind engages a different part of your brain, which can help tone down the limbic system noise and help your nervous system avoid going into survival mode. Simply noticing and naming the feelings and sensations you are having as well as acknowledging that - you are safe - can help.  Seeking professional help Sometimes safety practices like breathing, mindfulness, or setting boundaries are enough to bring the nervous system back into balance but sometimes they are not - especially if these responses have been developed from trauma. In these cases, support from a qualified, registered professional can be essential. Trauma research (van der Kolk, 2014) shows that healing often requires safe, guided experiences to help the nervous system learn new patterns. A clinical psychologist or other licensed mental health professional can provide evidence-based approaches such as trauma-focused CBT, EMDR, or somatic therapies, that gently restore a sense of safety and control. Seeking professional can be a brave step toward safety and change. The Bigger Picture Cultivating safety doesn’t mean ignoring the challenges of the world or avoiding all stress. It means creating enough stability inside and around us to meet those challenges and stressors with presence, resilience, and care. It means honouring our own needs to protect and support our health so that we can show up for what matters and be of service to others.  Safety protects more than just our sense of calm, it protects our health and vitality. And perhaps most importantly, it creates the very conditions we need to grow and change.