How to look after gut health through every life stage, according to a nutritionist

Gut health is the foundation of overall wellbeing, influencing digestion, immunity and even mood. But for women, it plays an even greater role, shifting in response to hormonal changes at every life stage. From the gut-brain connection in your twenties and thirties to the impact of perimenopause and menopause in later years, understanding these changes is key to maintaining digestive health and overall wellbeing.

With the right dietary and lifestyle strategies, however, it is easy to support your gut and mitigate common digestive issues, helping you feel your best at every age.

During your twenties and thirties, the gut microbiome is generally diverse and adaptable, but it is still sensitive to lifestyle factors. Research suggests that diet, stress, hormonal contraception and other influences can still cause shifts in microbial diversity and function.

Diet is often neglected at this stage of life, with busy schedules leading to erratic eating patterns, reliance on ultra-processed convenience foods and frequent takeaways and eating out.

Excessive alcohol intake can disrupt the gut microbiome. Check the ingredients as emulsifiers and other additives, usually present in UPFs, may negatively impact gut bacteria. Managing chronic stress is crucial, as it can disrupt gut balance, increasing the likelihood of digestive discomfort.

The gut-brain connection also plays a crucial role in mood regulation, meaning an imbalanced gut may contribute to anxiety and mood swings. A review of current data suggests that modifying the gut microbiome could be an effective way to reduce symptoms of depression and anxiety.

Supporting gut health through diet and lifestyle may therefore play a key role in improving mental wellbeing.

Prebiotic-rich foods help beneficial gut bacteria thrive by providing the fibre they need to produce short-chain fatty acids, which support gut barrier function and reduce inflammation. Some of the best sources include onions, garlic, leeks, asparagus, bananas, apples, artichokes, oats, chicory root and legumes such as lentils and chickpeas.

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Probiotic foods contain live beneficial bacteria that help maintain a balanced gut microbiome, support digestion and may reduce bloating and inflammation.

Regular consumption can enhance microbial diversity and improve overall gut health. Good sources include kimchi, sauerkraut, kefir, miso, tempeh, natto and fermented vegetables such as pickles (when preserved in brine rather than vinegar).

For those in their twenties, maintaining gut health can support digestion and recovery from late nights. Regularly consuming probiotic-rich foods such as kefir or kombucha may help maintain gut balance, which can be beneficial as alcohol can disrupt the gut microbiome. Staying hydrated before and after drinking is key, and electrolyte-rich beverages like coconut water can help replenish lost fluids. Kefir water, kombucha and green tea are gut-friendly drinks that may support digestion and overall gut health while also contributing to fluid intake.

Polyphenol-rich foods contain plant compounds that act as antioxidants, supporting gut health by promoting the growth of beneficial bacteria and reducing oxidative stress and inflammation in the gut.

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Certain polyphenols found in grapes, berries and tea have been shown to enhance microbial diversity; to boost polyphenol intake, include berries, dark chocolate (minimum 70 per cent cocoa), green tea, coffee, extra virgin olive oil, nuts, pomegranates and colourful vegetables such as red onions and purple cabbage in your diet.

Grapes, in particular, are rich in polyphenols like resveratrol and anthocyanins, with some red wines such as tannat, malbec, cabernet sauvignon and pinot noir containing higher levels due to their fermentation with grape skins. While red wine can provide some polyphenols, excessive alcohol intake can disrupt gut bacteria, so the best advice for gut health is to drink in moderation and stay hydrated.

As women approach their forties, fluctuating hormone levels during perimenopause can affect gut motility, digestion and microbiome composition. Oestrogen plays a key role in microbial diversity, so as it declines shifts can occur in gut bacteria that can impact digestion and overall wellbeing.

Common gut-related symptoms during this stage of life include bloating and gas, which can result from changes in gut motility and microbiome shifts. Energy dips may occur as the gut plays a role in nutrient metabolism and blood sugar regulation, while mood swings and anxiety can be influenced by the gut’s production of neurotransmitters such as serotonin. Constipation, which is common in midlife, can also be a result of slower transit time, affecting toxin elimination and oestrogen metabolism.

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As hormone levels fluctuate in your forties and beyond, diet plays a crucial role in maintaining gut health, reducing bloating and supporting overall wellbeing. A strong gut barrier is essential during this time, as it helps prevent inflammation, supports nutrient absorption and contributes to hormonal balance by influencing the gut microbiome.

There is limited direct evidence linking menopause to gut barrier integrity. However, some research suggests that during menopause, microbes may move more easily from the intestines into the body, which could be due to changes in gut bacteria and immune function, potentially increasing low-grade inflammation.

Increasing fibre intake can help, and women in midlife should be aiming to eat at least 30g of fibre daily. Lentils, flaxseeds, oats, leafy greens and nuts are all excellent sources.

Phytoestrogens, plant compounds that mimic oestrogen, may help balance hormone levels while supporting gut microbiome diversity. These can be found in soy products such as tofu and tempeh, as well as flaxseeds and chickpeas. Fermented foods should also be incorporated into the diet to maintain gut microbiome balance, reduce inflammation and improve gut barrier integrity. Sauerkraut, kimchi, kombucha, miso and dairy-free yoghurt with live cultures are all good options.

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Research suggests that hormonal changes during menopause may slow digestion, drying out stools and making them harder to pass, which increases the likelihood of constipation. Simple dietary and lifestyle adjustments can help.

Staying hydrated is essential, with a goal of two to three litres of water daily. Magnesium helps relax bowel muscles and ease constipation, and can be found in pumpkin seeds, spinach, dark chocolate and almonds.

Regular exercise, particularly yoga and brisk walking, can stimulate bowel function. Prebiotic fibres, found in onions, garlic, leeks, resistant starch from cooked and cooled potatoes, green bananas and oats, support beneficial bacteria and soften stools.

Probiotic supplementation may be beneficial for women experiencing digestive discomfort during hormonal transitions. Hormonal fluctuations can impact gut motility, microbial diversity and gut barrier function, leading to gastrointestinal symptoms. Probiotics help restore microbial balance, support digestion and may even influence mood through the gut-brain axis.

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Focusing on soluble fibre can help. Foods like oats, ground flaxseeds and well-cooked leafy greens are great choices as they’re easier on the gut while still feeding beneficial bacteria. Fermented foods such as kefir, kimchi and sauerkraut can also be helpful, but they don’t work for everyone. Some people with IBS find they trigger bloating due to their FODMAP content. A gut-friendly approach is to start small, opting for live yoghurt or lactose-free kefir first, and then gradually introducing other probiotic-rich foods to see what works best for you.

For mood and stress regulation, certain strains of bacteria, Bifidobacterium adolescentis and Bifidobacterium infantis, are more commonly found in supplements rather than food, but gut health is not just about probiotics; lifestyle changes at any age can promote a healthy microbiome. Lifestyle habits such as stress management, regular movement and quality sleep, is the most effective way to mitigate gut-related issues.

As chronic stress can cause inflammation, mindfulness, yoga and quality sleep are key for regulating the gut-brain axis. A diverse microbiome and the presence of beneficial bacteria are also linked to better sleep too.

As women transition through different life stages, maintaining gut health requires a proactive approach. Proper hydration supports digestion and maintains a balanced gut environment, while reducing ultra-processed foods will prevent gut imbalance. Understanding the connection between gut health, hormones and overall wellbeing allows women to take charge of their digestive health at every age.

Rob Hobson is a nutritionist at Bio-Kult, experts in microbiome and gut health supplements