Fat Deposition During The Menopause... 

Weight gain during menopause is a bit like finding out your favourite band has released an album exclusively on cassette tape...unexpected, frustrating, and completely at odds with what you thought you knew about the rules.  

Most influencers and advice-givers online have reduced weight gain to a simplistic mantra: “calories in versus calories out.” And while this formula works on paper, menopause has other plans. Specifically, it shifts the dogmatic rules of fat storage, or rather it is our understanding that lags behind... 

The real villain in this story isn’t weight per se; it’s visceral fat. This metabolically active, hormonally mischievous fat doesn’t care what you weigh. You could have a low BMI look great in a bikini, and still be hosting a party of visceral fat around your organs that nobody invited. And menopause? It’s the unrepentant bouncer letting it all in. 

Why visceral fat is different 

To understand the problem, you need to know the enemy. Visceral fat is not the same as the subcutaneous fat that lurks just beneath your skin. Subcutaneous fat is like that quirky friend who’s always there but isn’t causing too much trouble. Visceral fat, on the other hand, is your toxic co-worker...it wraps around your abdominal organs, secretes inflammatory cytokines, and wreaks havoc on your metabolic health. It's strongly linked to cardiovascular disease, insulin resistance, and even cognitive decline. Fun, right? 

What makes visceral fat even more infuriating is its tendency to expand during the transition from perimenopause to menopause, often independent of your calorie intake. This isn’t some simple math problem where you ate more than you burned. No, this is a physiological rebellion driven by hormonal chaos. 

The hormonal betrayal 

During menopause, estrogen levels plummet, and with it goes estrogen’s role in regulating fat storage. Studies highlight that this estrogen drop leads to a redistribution of fat from your thighs and hips (where it was mostly subcutaneous and relatively harmless) to your abdomen, where it’s largely visceral and profoundly harmful. It’s like your body suddenly decided to move all the furniture into one room and then set it on fire. 

Worse, this expansion of visceral fat is partly driven by increased activity of cortisol, the stress hormone. Cortisol tends to rise during menopause, exacerbated by the sleep disturbances, mood swings, and general life stress of this stage. Cortisol, as it turns out, is great at telling your body to store fat right where it’s most dangerous. 

To make matters more existentially bleak, the drop in estrogen affects insulin sensitivity, making it harder to regulate blood sugar. This, combined with decreased muscle mass (another menopause gift), sets the stage for metabolic dysfunction, even if you’re eating the same diet and exercising as you always have. It’s almost poetic: your body, once a bastion of reproductive vitality, now seems hellbent on storing visceral fat as if preparing for an apocalypse that nobody else sees coming. 

What does the research say? 

Much of the research has consistently found that this rapid increase in visceral fat during menopause is not merely a by-product of eating more or exercising less. It’s driven by physiological changes beyond your control. In fact, studies have shown that women who maintain stable caloric intake and physical activity levels can still experience significant increases in visceral fat during this time. The old calories-in, calories-out mantra whilst undeniable as a formula, is far too reductionist for the nuances of perimenopause and menopause. 

It’s a cruel irony: you might weigh the same, but your risk factors for cardiovascular disease, diabetes, and inflammation can skyrocket. 

Actionable steps to combat visceral fat 

So, what can you do to fight this sneaky fat and reclaim your metabolic health?  

1. Embrace resistance training: building muscle is one of the most effective ways to combat visceral fat. Resistance training increases your resting metabolic rate and improves insulin sensitivity. Studies have shown that postmenopausal women who engage in regular strength training have significantly less visceral fat. 

2. Prioritize protein: as muscle mass decreases, so does your metabolic efficiency. consuming adequate protein (around 1.2-2.0 grams per kilogram of body weight daily) can help maintain muscle and keep visceral fat at bay. 

3. Get your cardio in, but don’t overdo it: while endurance exercise can help reduce visceral fat, overdoing it may increase cortisol levels, which can backfire. Aim for moderate-intensity aerobic activity combined with resistance training for the best results. 

4. Manage stress: easier said than done, but stress management is crucial. Practice like mindfulness, reading books or even just daily walks can reduce cortisol levels and help curb visceral fat accumulation. 

5. Optimize your diet: focus on anti-inflammatory foods like fatty fish, nuts, seeds, and leafy greens. Minimize consumption of heavily processed, high energy density foods, which often due to their hyperpalatable nature, can lead to overconsumption and can exacerbate insulin resistance and visceral fat storage. 

6. Consider HRT (hormone replacement therapy): under the guidance of a healthcare professional and if required based on your symptoms could help mitigate some of the hormonal changes that drive visceral fat accumulation. However, this is not a panacea for every single symptom under the sun! 

7. Sleep like your life depends on it: because it does... Poor sleep increases cortisol and disrupts insulin sensitivity, both of which contribute to visceral fat.  

The societal blind spot 

Menopause is a stage of life that society often pretends doesn’t exist... or worse, treats as an unfortunate by-product of aging that women should endure quietly. There’s little appreciation for the altered physiology and metabolic challenges women face during this time. The advice to “just eat less and move more” is not only reductionist but also profoundly dismissive of the complex interplay of hormones, fat, and metabolism. 

If anything, menopause should be a time of empowerment; a moment to reassess, adapt, and embrace the fact that your body is changing in ways that demand new strategies and new understandings. Visceral fat is not just a cosmetic concern; it’s a metabolic landmine and addressing it is not just about looking good; it’s about living well. 

P.S If you want to learn more about health from the microbiome to improving your sleep check out my book:

P.P.S the kindle version for people in the UK is still only 99p! 

How To Recover Your Gut After Antibiotics... 

Let’s be clear: antibiotics are essential. But they also cause profound and often irreversible changes to the delicate ecosystem of the gut microbiome. This microscopic metropolis in your intestines is home to trillions of bacteria, many of which are critical for your health.

They digest fibre, produce vitamins, regulate your immune system, and protect you from the nastier bacteria lurking in the shadows. But when antibiotics sweep through, they don’t just take out the bad bacteria. They also wipe out the good ones, leaving your gut like a post-apocalyptic wasteland where pathogenic gangs like Clostridioides difficile and Staphylococcus aureus can run amok. 

Since 2000, global antibiotic use has skyrocketed by 66%. That’s great for treating infections but terrible for your gut. The most affected gut bacteria include the Bacteroidetes, Firmicutes, and Actinobacteria—names that sound like alien factions in a sci-fi novel but are actually your gut’s best defense team. When they’re gone, the gut ecosystem can collapse, and pathogens take center stage, often leading to diarrhea, inflammation, and other delightful side effects. 

Now, here’s the issue: the impact of antibiotics doesn’t just vanish when you stop taking them. The gut microbiome may remain altered for months or even longer. Studies show that in healthy adults, gut diversity drops within a day of finishing antibiotics and can stay compromised for six months. In some cases, the microbiome shifts into a new, less ideal "stable state," resembling something you’d expect in a patient in intensive care. These changes can increase the risk of obesity, inflammatory bowel disease, and even neurodevelopmental disorders in the long term. 

And don’t think this is just an adult problem. When infants are exposed to antibiotics, they face an increased lifetime risk of asthma, obesity, and infections, thanks to disruptions in their developing gut microbiomes. It’s like pulling the foundation out from under a building while you’re still constructing it. 

So, what can you do? While there’s no magic wand to undo the effects of antibiotics, science does offer some strategies to limit the damage: 

First up: probiotics.  

These are the "good bacteria" supplements that can help prevent antibiotic-associated diarrhea and support gut health. But don’t just grab the first probiotic you see at the store. The benefits are strain-specific, meaning not all probiotics are effective. Two of the best-researched options are Saccharomyces boulardii (a yeast) and Lacticaseibacillus rhamnosus GG (a bacterium). Yeast probiotics, in particular, have an edge - they survive the stomach’s acid bath and can work alongside antibiotics without being destroyed. 

Timing matters too. Probiotics are most effective when taken from the start of your antibiotic course and continued for at least a week after finishing. However, the perfect duration for restoring your gut to its former glory is still up for debate.  

Next, there’s diet.  

A low-fiber diet can make the damage worse, delaying recovery. Your gut bacteria thrive on fermentable fiber found in foods like beans, oats, bananas, and leafy greens. These fibers act as prebiotics, feeding the good bacteria and helping them bounce back faster. Eating fiber after antibiotics is like planting seeds in a barren field - it helps regrow the microbiome and keeps pathogens in check. 

For the adventurous, there’s the cutting-edge world of fecal microbiota transplants (FMT).  

Yes, it’s exactly what it sounds like: transplanting poop. While it’s not for the faint-hearted, FMT has shown promise in rapidly restoring gut health. Researchers are also developing synthetic microbial communities and drugs that selectively protect beneficial bacteria while targeting pathogens, though these are still in the pipeline. 

Finally, and most importantly, use antibiotics responsibly.  

Don’t demand them for every sniffle or sore throat - most of which are caused by viruses that antibiotics can’t touch. Let antibiotics do their superhero thing when truly needed, but don’t call them in for every minor inconvenience. 

The bottom line is this: antibiotics are a double-edged sword. They save lives, but they also leave scars on your gut’s delicate ecosystem. And as we learn more about the microbiome, it’s clear that these scars can have long-term consequences for your health. So, respect the power of antibiotics, nourish your gut, and maybe think twice before taking them for that mild cold. Your gut bacteria will thank you, even if they can’t send you a thank-you note. 

The Most Scientific Way To Quit Vaping? 

If you’ve made it your New Year’s resolution to quit vaping in 2025? Congratulations, you’re joining the ranks of people trying to kick an addiction to a USB stick masquerading as a lifestyle choice.  

The good news is, science might have your back; assuming you can sift through the mountain of advice, much of which boils down to: “Just stop, bro.” 

Thankfully a team of scientists, including some brainy types from the University of Oxford, recently set out to answer the burning question: What actually works when it comes to quitting vaping? After combing through nine studies and 5,000 participants, their answer boils down to...it depends how old you are. 

If you’re a teenager or a young adult (13 to 24), motivational text messages seem to work best. Yes, really. The very thing you use to scroll through memes, group chats, and TikTok is also your potential savior. Programs like This Is Quitting send texts that alternate between practical advice (Keep your hands busy—stress balls, binder clips, whatever keeps the vape out of them) and motivational gems (Quitting is hard, but so are you). Think of it as your mom texting you, except less guilt and more dopamine.  

One study found this approach made teens 35% more likely to quit vaping. So, basically, your smartphone addiction might just help you quit your nicotine addiction. Poetic, isn’t it? 

For those in the older crowd - 25 and up, otherwise known as people with back pain and favorite kitchen gadgets; the analysis points to varenicline, a prescription medication that’s been helping smokers quit for years. Sold under names like Chantix or Champix, it works by tricking your brain into thinking it’s still getting nicotine, all while gently releasing dopamine to take the edge off. It’s been available through the NHS in the UK as an anti-smoking pill since late 2024, but early studies suggest it might help vapers too. Imagine fooling your brain into submission...it's like Inception, but with fewer explosions and more side effects. 

Of course, before you start mentally drafting thank-you notes to science, a word of caution: this research is still in its infancy, much like your nephew who throws tantrums at family dinners. One of the study’s senior authors, warns that while varenicline and text messages show promise, the findings aren’t definitive. More research is needed; because, as always, science takes its sweet time. 

There’s also the tricky problem of relapse. Many people who switch to vaping as a way to escape smoking want to quit vaping without boomeranging back to cigarettes. It’s a tightrope walk: drop the vape, avoid the smokes, don’t fall off and plunge into a nicotine-fueled abyss.  

But let’s not get carried away with optimism. The scientists behind this analysis, published in the Cochrane Database of Systematic Reviews, are quick to point out that what works for one group might not work for another. Sure, text messages might be great for a 15-year-old glued to their phone, but good luck convincing a 40-year-old in the middle of their second divorce that motivational emojis are the key to a nicotine-free life. 

What’s clear is that quitting vaping is as much about psychology as it is about pharmacology. Whether it’s text messages reminding you that you can do hard things, or pills tricking your brain into dopamine release, the path to freedom requires strategy, willpower, and probably a lot of deep sighing. 

So, what’s the takeaway here? Quitting vaping isn’t easy, but it’s not impossible. And while the science may be evolving, one truth remains: the best method is the one you’ll actually stick with. Whether that’s motivational texts or popping pills, the important thing is to take the first step. Consult your doctor, do your research, and remember- there’s more to life than clouds of artificially flavored mist. 

Things Will Go Wrong.... 

No matter how much you plan, how carefully you map out your life, things will go wrong. Gloriously, spectacularly wrong. You could spend years building your perfect sandcastle, only to have a rogue wave of chaos knock it down in seconds. That’s life: part comedy, part tragedy, part cosmic joke that no one told you you’d be starring in. 

You’ll make mistakes...and not the cute, quirky kind that make for good anecdotes at dinner parties. No, you’ll make the kind of mistakes that leave you lying awake at 3 a.m., staring at the ceiling, wondering why no one told you how much being alive involves failing; sometimes publicly, often embarrassingly. You’ll have hiccups, rough patches, breakups, breakdowns, and, if you’re lucky, a few existential crises sprinkled in for good measure. 

Life doesn’t care how much you’ve prepared. You can eat all the right foods, say all the right things, follow every rule, and still get blindsided by the universe. That job you thought you’d land? Someone else got it. That relationship you thought would last forever? It didn’t. That one thing you were so sure you’d never screw up? You screwed it up. And then, when you’re already on the floor, life hands you something worse: bad news, tragedy, loss. It’s like life is trying to make sure you’re paying attention. 

But here’s the unusual bit I’ll say...maybe we should be thankful for the chaos. Imagine a life where nothing ever went wrong, where you never made a mistake, never suffered, never felt the sting of disappointment. Sure, it sounds nice for about five minutes, but it would be flat, colorless, unbearably dull. The bad moments are the contrast that makes the good moments shine. Without darkness, you wouldn’t recognize light. Without heartbreak, you wouldn’t know love. Without failure, success wouldn’t taste nearly as sweet. Ok, I’ll stop the nauseatingly saccharine quotes but you get the point... 

The rough patches give you perspective, and perspective is what turns a life into a story. Every hero in every tale you’ve ever loved faced obstacles right? Dragons to slay, mountains to climb, villains to defeat. Why should your story be any different? Sure, your dragons might look like overdue bills, job rejections, or a failed business that feels like it might crush you, but the principle’s the same. The struggle is what makes the triumph mean something. 

So, here’s the life lesson with a side of existential seasoning: stop trying to control everything. You can’t. Bad things will happen, and you’ll survive them...probably. You’ll keep going, bruised but wiser, and maybe even laugh about it one day. Or not. But either way, it’s all part of the messy, unpredictable, beautifully absurd ride. 

Life is not about avoiding the bad stuff. It’s about learning to live in the middle of it, to laugh at the absurdity, to cry when you need to, and to keep moving forward. The bad stuff...they’re not necessarily the interruptions. They’re the story. And if you’re lucky, it’ll be a damn good one. 

Cholesterol & Dementia... 

Did you know that your cholesterol levels might be quietly conspiring with time to mess with your brain.  

Not content with clogging arteries and ruining pizza nights, cholesterol now seems to be playing the long game, potentially upping your chances of developing dementia.  

Your cholesterol is essentially a hormonal teenager. It sulks, it spikes, it plummets, and if it’s been doing so over several years, you might be looking at a 23% higher risk of general cognitive decline. According to a new study of 10,000 people, it’s the kind of instability that screams for intervention, or at least a stern talking-to. 

Researchers from Monash University suggest that “those experiencing big year-to-year variations may warrant closer monitoring and proactive preventive interventions.” Translation: if your cholesterol can’t keep its act together, you might want to step in before your brain decides to join the chaos. 

This latest research from Monash University focuses on the usual suspects: the so-called “bad cholesterol,” low-density lipoprotein (LDL), and the “good cholesterol,” high-density lipoprotein (HDL). LDL is the villain here, known for clogging arteries and generally ruining your cardiovascular health. HDL, the hero, doesn’t get as much credit as it deserves for helping clear out excess cholesterol. 

The study found that if your LDL cholesterol behaves like a stock market during a recession; wild, unpredictable fluctuations then it could speed up cognitive decline. HDL, on the other hand, seems to remain relatively chill, with no significant impact on your brain’s longevity even when it wavers. So, while LDL swings could be destabilising your brain’s blood flow, HDL seems to be the responsible adult in the room. 

Why do these cholesterol swings wreak such havoc? One theory involves atherosclerotic plaques - the cholesterol blobs in your arteries that sound as delightful as they are dangerous. Fluctuations in LDL might destabilise these plaques, making them more prone to rupture. This can block blood flow to the brain, leading to cognitive decline or, in worst cases, full-blown dementia. It’s the physiological equivalent of shaking a snow globe and hoping the scene settles back down...it rarely does. 

The study observed participants in their 70s from Australia and the US over six years. None of them had dementia at the start, but by the end, 5% had developed it, and nearly 18% showed signs of cognitive decline. The common thread? Those with stable cholesterol levels had significantly lower risks. So, keeping your cholesterol steady might not just save your heart...it might save your mind. 

Now for the good news you can tame your rogue cholesterol levels with simple evidence-backed strategies: 

1. Step away from the couch: Regular movement is one of the best ways to lower LDL and raise HDL. You don’t need a gym membership; brisk walking, gardening, or even pacing while on the phone can do wonders. Aim for at least 30 minutes a day, five times a week. 

2. Embrace fibre like it’s your long-lost friend: Soluble fiber, found in oats, lentils, beans, and even good old psyllium husk, acts like a sponge, soaking up LDL cholesterol and flushing it out before it can wreak havoc. A bowl of oatmeal a day? Your brain and heart will thank you. 

3. Restock your olive oil: Swap saturated fats (butter, cream, processed meats) for unsaturated fats like olive oil, avocado, nuts, and seeds. These fats don’t just taste good...they can actively lower LDL levels. 

4. Quit smoking yesterday: Smoking lowers HDL, which makes LDL even more dangerous. Quitting isn’t easy, but the benefits for your cholesterol and everything else are enormous. 

5. Get some sunshine (or a Vitamin D supplement): Emerging research suggests vitamin D might play a role in cholesterol regulation. If you’re low on vitamin D, a little sun or a cheap supplement might help. 

6. Check your sleep: Poor sleep is linked to higher LDL and lower HDL levels. Prioritise quality shut-eye each night, even if it means saying no to late-night doomscrolling. 

7. Fermented foods are your friends: Foods like kimchi, sauerkraut, and yogurt can help improve gut health, which in turn can influence cholesterol metabolism. A happy gut might just mean a happier brain. 

8. Drink tea, not sugary lattes: Green tea contains compounds called catechins, which may help lower LDL. Plus, it’s a much better choice than calorie-packed coffee drinks loaded with sugar and whipped cream. 

Cholesterol is more than a number on a blood test; it’s a window into your body’s inner workings. And while the idea of dementia lurking in the shadows of fluctuating LDL levels may seem terrifying, it’s also empowering. You have the tools to manage this. Whether it’s tweaking your diet, moving a bit more, or just checking in with your doctor, small changes can ripple out into big impacts. 

So, the next time you’re about to dismiss cholesterol as just another annoying health metric, remember: it’s not just about saving your heart. It’s about keeping your brain sharp enough to remember why you walked into the kitchen. And if that’s not motivation, what is? 

The Invisible Killer... 

I’ve got a few friends and family in California and the events unfolding out there over the past few weeks have not only been tragic but have really highlighted the impact air quality can have on health... 

Air pollution is the unwelcome guest at life’s party that no one invited, yet somehow it’s everywhere and hanging out in your lungs, cozying up to your brain, and even messing with your gut microbiome.  

Every breath is a cocktail of oxygen, nitrogen, and microscopic chaos, spiced up with particulate matter, volatile organic compounds (VOCs), and other chemical atrocities. 

Let’s start with the lungs, the obvious victims of air pollution’s abusive behavior. Fine particulate matter and ground-level ozone can infiltrate your airways like thieves, causing inflammation. Over time, the relentless assault of high levels of pollution (depending where in the world you are) can increase your risk of chronic lung conditions.  

But air pollution doesn’t stop there. It’s an overachiever in destruction, and it loves to multitask. Those same particles that irritate your lungs can slip into your bloodstream, hitching a ride to your brain. Once there, they contribute to neuroinflammation and oxidative stress, which is science-speak for...they mess things up real bad. Studies have linked air pollution to cognitive decline, increased risk of Alzheimer’s, and even mood disorders. Basically, it’s turning your brain into a fog machine, but not the fun party kind. 

And then there’s your microbiome, the collection of trillions of microbes in your gut that influence everything from digestion to immunity to mental health. Turns out, air pollution can disrupt the delicate balance of this ecosystem, causing dysbiosis...a fancy term for: your gut is having a meltdown. This disruption has been associated with metabolic disorders, systemic inflammation, and, of course, a weakened immune system. Because why not kick you when you’re down? 

So, what can you do? You can’t exactly stop breathing, but you can take steps to minimize your exposure and improve the air quality around you that don’t require a billionaire budget or superpowers: 

1. Become a plant parent: Houseplants like peace lilies, spider plants, and snake plants are not just decorative...there is evidence they can help remove certain indoor air pollutants like benzene and formaldehyde. While they won’t fix outdoor smog, they can make your home’s air slightly less toxic. 

2. Ventilate: Open windows when cooking or using household cleaners, but only if the outdoor air quality isn’t worse than what’s inside. Use exhaust fans in kitchens and bathrooms to reduce indoor pollutants. If you live in an urban area with heavy traffic, ventilate during off-peak hours to avoid the worst of the pollution. 

3. Invest in an air purifier: A good HEPA air purifier can significantly reduce indoor air pollution, including fine particulate matter. Look for one that’s appropriate for your room size and keep it running in spaces where you spend the most time. 

4. Limit your outdoor exposure on high-pollution days: Use air quality apps or websites to track local pollution levels.  

5. Drive less, walk more (if you can): Cars are a major source of air pollution, so walking, cycling, or using public transport isn’t just good for the environment- it’s also good for you. Plus, you’ll get the added bonus of exercise, which helps counteract some of the inflammatory effects of pollution.. 

6. Take care of yourself: Since you can’t avoid all air pollution, focus on strengthening your body’s defences. Eat a diet rich in antioxidants (fruits, vegetables, nuts) to combat oxidative stress. Stay hydrated to keep your airways moist and protected. Regular exercise (in clean air) can also improve lung function. 

Air pollution is a problem you didn’t create but are forced to deal with anyway, much like most of adulthood. But within the haze, there’s a sliver of hope: every small action you take contributes to a larger collective effort. Breathing clean air shouldn’t be a privilege, yet here we are, fighting for it.