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Welcome to The Modern Midlife Collective—where midlife isn’t a crisis, it’s a rebirth. Hosted by Dr. Ade Akindipe, DNP, and Dr. Jillian Woodruff, MD, this is the podcast for women ready to unapologetically own their power, thrive through the ups and downs of hormones, weight, and self-care, and show the world that thriving at 40 and beyond isn’t just possible—it’s your birthright.
Biweekly, we bring you science-backed insights on hormones, menopause, longevity, and sexual health—real tools to empower women in midlife and beyond. With a fearless blend of functional medicine, real-life wisdom, and no-nonsense empowerment, we’re here to challenge the norms, break through the barriers, and help you step into a life of vitality, confidence, and unstoppable strength.
Ready to rise? Let’s do this.
Jillian Woodruff MD (00:25)
What if the reason your body isn't responding the way it used to isn't because you're doing something wrong? What if it's because your physiology has changed and your strategy hasn't caught up yet? Midlife is not metabolic failure. It's metabolic recalibration. Estrogen shifts, insulin sensitivity changes, fat distribution changes, muscle mass declines more easily. The strategy that worked at 32 will not work at 47.
Today's episode is especially meaningful because we are welcoming our very first guest to the Modern Midlife
Jillian Woodruff MD (00:59)
And before we begin, I need to mention that Dr. Adey isn't able to record with us today, but this conversation very much reflects the work that we both care so deeply about. Today, we are diving into midlife nutrition. We aren't going to be talking about trends or detoxes or extreme restriction, but we're talking about what's actually happening physiologically and how nutrition interacts with metabolism, with digestion, with...
inflammation, with hormone shifts. And I am so excited to welcome Ashley Koch. She is a functional nutritionist. She is my dear friend, a lifelong friend from childhood. And she works extensively with women navigating perimenopause and menopause. And she has a particular focus on gut health and metabolic optimization.
So I'm so glad she's here. She's actually taking care of me and many of my family members and also cares for the patients here in Alaska. I'm going to just let her come and tell us more about her because I think she's amazing and I can go on and on.
Ashley Koch, MS, CNS (02:08)
Well, that's a beautiful welcome. I'm so lucky to be here as your first guest on your podcast. And I'm such a fan of both you and Dr. Day. And I've had the privilege of getting to work alongside you in supporting your patients and doing a lot of work around midlife nutrition. So I'm so happy to be here talking about midlife nutrition for your listeners. For me, I...
got into midlife nutrition as I started to hit midlife and really start to put the pieces together that nutrition was a really important lever that we need to be paying attention to as we're going through midlife changes and beyond. And I'm excited to dive into that a little bit today.
Jillian Woodruff MD (02:44)
Yes, well tell us more about yourself, what you do day to day and why you got into functional nutrition. You said how you got into midlife nutrition because you entered midlife, but what interested you with nutrition to begin with?
Ashley Koch, MS, CNS (03:00)
Yeah, so day to day, I have mostly a virtual practice where I see clients. So I get to work with a lot of clients in Alaska. I'm based in Portland, Oregon, but I also get to work with clients in California and across the country. There are some states I don't serve, but many states I can serve. so day to day, looks like making connections over Zoom. A lot of clients wanted to go virtual with nutrition. Not many were coming back into the office after the pandemic. And so it was really easy to grow my practice being based here in Portland.
I meet with clients, sometimes it's a first visit, which will be 75 minutes and I get to learn a lot about their health. And then sometimes it's a quick follow-up, 30 minutes here and there. And often I get to work with clients over six months, really making shifts in what they're doing with their nutrition and lifestyle from a functional nutrition lens with clients. For me, I got into nutrition because I had a child who wasn't thriving.
So when my daughter was born, she was incredibly sick the first couple of years of life. And I started working with a bunch of doctors ⁓ and eventually functional medicine doctors who figured out that food and nutrition were a big piece of why she wasn't thriving. She had some nutrient deficiencies. She was reacting to certain foods and she wasn't thriving. And I started learning about nutrition and nutrition was how I helped my daughter heal.
And then I went to pursue my master's because I wanted to help more people in my community and I've been lucky enough to do that.
Jillian Woodruff MD (04:22)
Well, I have really benefited from your expertise and I've also learned a lot about functional nutrition. So for listeners who may not be familiar with that term, what exactly is functional nutrition and how does it differ from the traditional nutrition counseling?
Ashley Koch, MS, CNS (04:39)
Yeah, so functional nutrition is really taking evidence-based nutrition through the functional medicine lens. And I know Dr. Day has talked about functional medicine on this podcast, which has a lot of similarities to lifestyle medicine that you practice. And essentially with functional medicine, we really believe in a system-based approach. So we think that symptoms or diagnosis are happening within the body and it's all connected and the systems are communicating with each other. And so when we address an issue or disease, we have to think about
all of the connecting pieces that are influencing that. So if someone has a digestive condition, there's probably some hormonal elements that are going on. There's a lot of lifestyle factors. And so we use nutrition to address the root cause, the symptoms, the underlying issues, and really take a well-rounded approach to improve outcomes.
Jillian Woodruff MD (05:28)
Well, thank you for sharing that and I do want to say I know how your kiddos are doing but for those that don't, after you share the story of what brought you into nutrition or where your interest started, why don't you tell us how your daughter is doing?
Ashley Koch, MS, CNS (05:43)
She's doing great. So she just turned 12. She's incredibly healthy. She is growing. She's thriving. And nutrition is a big reason for that. So for her, she wasn't growing as much as she should have as a little girl. And now she's incredibly healthy. And she's doing just great. Both of my girls are incredibly healthy. And we feel really lucky.
Jillian Woodruff MD (06:01)
That may be another show is talking about nutrition in childhood because women in midlife often have young ones who are trying to navigate this space as well. Well, we're trying to navigate their nutrition for them, but then give them the tools that they need to thrive one day on their own. So that could be another program that I think that you would be, have something to share with us.
Ashley Koch, MS, CNS (06:23)
Definitely, and I think what's fun when working with women or the men I get to work with is if they start making changes in their home, it influences the entire family and many of the foundations we set in nutrition are beneficial to their children. And so one thing I do when I get to work with clients is a lot of education. So I don't just tell you what you're doing, but I want you to understand why it matters in the body. And you can understand that and take that into your family and share that with the people around you so that you can have an impact in your community as well.
Jillian Woodruff MD (06:50)
Right, model what you want to see, right? And we're today, we are modeling the same shirt. This was not planned with our little bows here. Hey, that's it. That's exactly it. Well, I will let you know, in previous episodes, we have talked about how declining estrogen levels influences fat distribution, insulin sensitivity, resting metabolic rate.
Ashley Koch, MS, CNS (06:59)
We both have great taste.
Jillian Woodruff MD (07:15)
And this is occurring in perimenopause when our estrogen levels are going up and down, they're fluctuating quite a bit. And also in menopause when those levels have just gone down and we see those changes in our body composition. So maybe we should start with ⁓ explaining to us if you can, why does personalized nutrition matter and especially at this stage?
Ashley Koch, MS, CNS (07:39)
Yeah.
So when you look at the lifespan of women, so the average woman will live to be in to 80. And so we're gonna spend a large percentage of our life in post-metapause. And we also know in past that metapause transition, we're two to three times more likely to have cardiovascular disease. Women will often experience as much as 25 % bone loss. We will also see about 30 to 60 % of women might be diagnosed with metabolic syndrome. And if you're familiar with metabolic
syndrome, that's really a combination of things like glucose abnormalities, lipid changes, blood pressure issues, and then changes in terms of visceral fat, increased visceral fat. And so those things are very much influenced by nutrition. So if we make shifts to our nutrition, we can improve blood pressure, cholesterol, glucose, all of those things. And so looking at someone specifically and saying, what's going on,
and what's happening with your biochemistry, looking at your labs, and then really creating a personalized plan that addresses what someone is experiencing can change those outcomes and set them up for success in the last 20 to 30 years of their life.
Jillian Woodruff MD (08:48)
plan to live until about 102, so I'm really going to need that framework. That foundation is so important,
Ashley Koch, MS, CNS (08:51)
Great. Okay, 50.
Yeah, so for you, it's the last 50 years of your life.
Jillian Woodruff MD (08:58)
Yes, thank you. Thank you for that.
Jillian Woodruff MD (09:01)
You describe midlife as a window of opportunity and I love that framing. What do you mean by that? Is that describing this cardio metabolic risks being mitigated during this time period? Tell us more.
Ashley Koch, MS, CNS (09:16)
It is exactly that. So we know in the literature and the research, there is this time where we can work on prevention and interventions that can help prevent some of the things we were just talking about. So it really begins in perimetopause, which can happen for some women in the early 40s or mid 40s, and it extends in the 10 years after the final menstrual period. And we also know that the risks...
women are up against like cardiovascular disease, diabetes, osteoporosis, dementia, those often emerge 10 to 15 years after the final menstrual period. And so we can use nutrition and lifestyle interventions in this window to really work on prevention and we can help women really live a healthy life in ⁓ the second half of life.
Jillian Woodruff MD (10:03)
So this is really the same window of opportunity that we discuss in the hormone world when we're talking about starting hormone replacement therapy. If you start that hormone replacement therapy close to that time of menopause, and certainly within five to 10 years after menopause, the earlier you start it, the more reduction of risk that you have.
And so one thing I always just like to make sure I tell my patients and to tell other women is that, yes, starting in that window of opportunity gives you the greatest benefit in terms of prevention. However, are still risks or excuse me. Yes, there's risks to everything, but there are still benefits that you receive even when you started outside of this window. You just may already have.
some other risk factors for cardiovascular disease or you may already have cardiovascular disease or you may already have low bone density. And so maybe the prevention aspect isn't there, but you can still have benefit in multiple arenas even in those arenas outside of this window. So if you're not in this window of opportunity, that doesn't mean that you won't have benefit to the things that Ashley is sharing with us today.
Ashley Koch, MS, CNS (11:18)
Yeah, definitely. I've worked with women who are outside of this window, so women who have pre-diabetes or have experienced bone loss. And you can use lifestyle and nutrition interventions to reverse things like this. So I've had clients who are in osteopenia and they reverse their osteopenia with certain lifestyle and nutrition interventions or pre-diabetes or insulin resistance, getting back to insulin sensitivity. And depending on how long it's been going on, it's definitely something we can still work on. And these interventions can have a positive impact on your health.
Jillian Woodruff MD (11:46)
Absolutely. So we know cardiovascular risk accelerates postmenopause. We know bone density shifts, people have lower bone density postmenopause. Visceral fat, we're discussing, we're going to talk more about visceral fat. This increases, and this is the fat around our internal organs. So this isn't the cosmetic fat that maybe...
We are more concerned about sometimes, but this visceral fat, it's metabolic, it's inflammatory, and this significantly affects our long-term health. So as estrogen declines, we see more visceral fat accumulation. And from your experience, what dietary or lifestyle patterns tend to amplify that process? Or perhaps I should ask you, what are some of the other causes of increased visceral fat during this stage of life?
Ashley Koch, MS, CNS (12:39)
Yeah, so there's a few things that come to mind for me when I think about this. So as you mentioned, estrogen declines. And so as estrogen declines, the relationship between estrogen and testosterone changes. And that can cause us to store more fat in our stomach versus storing fat in our hips and thighs like we used to. We also know that
we have a stress response that creates cortisol. So in midlife and post-metapause and metapause, we start seeing that stress is amplified. And so an everyday stressor might feel bigger, which increases our cortisol response. And cortisol can tell our body to store fat in our midsection. We also have this interesting molecule called cortisone. And it's in the abdomen. And we can see cortisone start to change into cortisol, which
also is self-reinforcing that loop of store more visceral fat. And so a lot of different things are happening. And we can see that for some women, they may not gain any weight, but they will increase visceral fat during this time. So a woman who maybe came into this chapter at 160 pounds and is maintaining that weight of 160 pounds can sometimes experience an increase in visceral fat of 50 % and not even realize it. So.
There's a lot of things we need to be paying attention to in this time because as you mentioned, the visceral fat is more dangerous and metabolically active and things we wanna watch out for. But what's also interesting is that I see women, their taste perceptions are changing. So in this time, our hormones are changing in a way that makes us crave carbohydrates, sugary and salty foods, which leads a lot of women towards unhealthy carbohydrates more than they need or ultra processed foods.
and those foods don't fill in the nutrient gaps that they're actually having in this time. And when you eat more of those foods, we find we're eating less of the important foods like fiber. Most Americans are not getting enough fiber, and then in midlife we need the fiber for a lot of reasons, but if we're eating all these foods that are low in nutrients, ultra-processed, or a lot of carbs, we end up eating less fiber, and fiber makes us feel satiated. And then when we eat a lot of the other foods, we see them eating less protein.
and protein makes us feel satiated. If you don't feel satiated, you're gonna start eating carbs again. So we see this cycle that can happen and all of that can lead to more visceral fat during this time.
Jillian Woodruff MD (14:49)
That's a terrible cycle. I get so many nuggets of information from you. Every time I talk to you, I learn something. And one of the interesting things is you mentioned this time about, yes, I understand we crave more salt. We crave more carbohydrates during this time period of midlife. But I don't think I ever thought about the fact that the taste buds change. And so that actually correlates to our
estrogen receptors because we have estrogen receptors in our salivary glands. So as that estrogen level goes down, it certainly does change the way that we taste food, the way that we desire food. And even as we get older, you see sometimes in our elderly population that they may not even desire to eat food because the taste changes so much that it's not as pleasurable. And so maybe that's why we'll crave more salt because this is our taste buds kind of
aren't functioning efficiently, then we need more, you know, more bang in order to get that satisfaction. interesting to put things together, hormonal pictures, they're like they're puzzles, kind of fitting the pieces together.
Ashley Koch, MS, CNS (15:55)
Yeah, they really are.
we're trying to light up those taste buds. And so we start doing these things to try to light them up. And then it's becoming dull. then that's definitely the cycle. And I get it. So we have to work on working with women to find foods that do light up their taste buds. Because there's a lot of healthy foods we can eat that.
do that same thing. So we have to work with the body to identify those things and create that experience in the body so that they can crave foods that are going to serve them in this time.
Jillian Woodruff MD (16:23)
Yes, light up those taste buds. That's exactly what we need to do. One thing that you've also said in the past is about the fat accumulation. And you mentioned that the ratio estrogen to testosterone changes. And so we start accumulating fat in different areas, but you said it was more of a male pattern. Can you briefly talk about that? That's pretty interesting.
Ashley Koch, MS, CNS (16:46)
Yeah, so we become more androgenic. So men, they commonly gain the weight in the belly. And before this time, we had much more balance, and we could gain weight in some of the common areas and share it across the body. But now we're starting to shift. And so I think we have to be realistic. So when we're working on weight health, we have to think about how
we're working with this body. And so if someone is not, so I've worked with clients who are not using hormone replacement therapy for some of these hormonal shifts. So for the estrogen shift or the shift in testosterone or progesterone. And so if we're working on weight health, there's a lot we can do, but there's some things that the body is gonna naturally wanna do. So no matter what we do, we might store a little more weight in the belly if our body doesn't have that estrogen. And so we have to understand that. And that's just what your body wants to do to keep you safe.
in this part of life. And so being realistic, like bodies are changing, shapes are changing, and some of this is a part of the transition.
Jillian Woodruff MD (17:47)
Now we're talking about subcutaneous fat. So the fat that we're, you know, that we can see on the outside. And then there's visceral fat, the fat that's around our internal organs. The distribution of that, you're thinking about the fat around your, your, you know, intestines, which is in the belly. But there's also fat that's around other organs too. So when it comes to that,
the way that's stored, is that changing the visceral fat or is it just the visceral fat has increased? So the fat around the organs increases, but the fat deposition that we have that we can see the areas change. Does that make sense?
Ashley Koch, MS, CNS (18:22)
Yeah, that's a good question. And I don't know if I know the answer to that question. But I think it's a really good question that we should think about and come back to. And I'm curious. Yeah.
Jillian Woodruff MD (18:29)
Mm-hmm.
The thing that's dangerous, yeah,
right? It's interesting. because all of our organs are extremely important, but the thing about that visceral fat is that it's metabolically active. So it's producing inflammatory cytokines. It's associated with insulin resistance, with cardiovascular disease. yes, we want normal amounts. You do need fat, so we want normal amounts of.
fat, right? And there's fat that's in our around our organs to kind of cushion them as well. But we need a good, the appropriate ratios, just like we want with our hormones, want appropriate ratios. So how do we measure this real fat? How do we know?
Ashley Koch, MS, CNS (19:10)
That's a great question. So there's a couple tools. One that is really affordable is to measure your waistline. So if you track your waistline shifts over time, you can get a sense of whether you're getting an increase in visceral fat. And so that can be taking a tape measure and putting it around your waistline, or that can be taking a string and putting it around your waistline and using something like a yardstick. And so that's a great tool and it's one of the most affordable tools.
But then there are other tools. So there's things out there like in-body scales or other companies are making scales that look at body composition. There's also body composition measurements that you can take with a DEXA, which you might be able to speak to that a little bit more than I can. But I also think what's interesting about some of those tools is it is important to try to check that at the same time of day when possible with similar circumstances.
which can be challenging, you can't always get into gyms have these scales or your doctor's office might have these scales and you can't always get in at the same time, but they can be useful tools for tracking, know, visceral fat and muscle, but also a tape measure can be a great tool.
Jillian Woodruff MD (20:14)
Yeah, you're right. The DEXA scan that you do to look at your bone density to see whether or not you have osteoporosis or osteopenia, they can measure your visceral fat or your fat in general. However, many times those aren't reported. So it depends where you get them done. But usually they're not reported because they are not reimbursable by insurance typically. And so
the DEXA scan because you're going to see, I have osteoporosis? They're just looking at usually one hip and then your spine, your lower spine, and not reporting those other statistics that are given to you, unfortunately.
Ashley Koch, MS, CNS (20:54)
Yeah, yeah, I think locally
here in Portland, you can pay for those metrics, but then it's a big expense, much bigger expense than using a tool, a tape measure or an in-body.
Jillian Woodruff MD (21:04)
Yes, and I have been seeing many officers getting those scales. So I hope to get one of those as well. I think that would give really great information to patients. One thing that I see in my practice that I definitely want to get your thoughts on is when people are told, or typically women, they go to their provider with a symptom and they're told
and they may be obese and so they're told to lose weight and their symptoms will resolve. So for example, a woman comes in with irregular periods, maybe she's spotting between her periods, maybe she has heavy periods or getting heavier and she sees her provider and they see that she is obese and then they say, you need to lose weight. And typically she's young ⁓ and so typically there isn't a true evaluation. There's no labs, there's no evaluation of
insulin resistance or the thyroid or anything. She may be in her 20s and they say you just lose that weight and you're good. And so then she leaves, you know, probably does not come back, continues to have problems and has some shame involved. So she doesn't go back into the office because she doesn't feel like they, they did anything. so then years later she comes back and now she has severe bleeding. She has worsening cycle irregularity. She probably has anemia and
what we're actually seeing is more advanced metabolic dysfunction driving that hormonal disruption. in some women, weight is part of the picture, but in many of the weight gain was a symptom of underlying metabolic or thyroid dysfunction that was never addressed. And so that's the part that's upsetting. The root cause was never investigated.
Jillian Woodruff MD (22:44)
So Ashley, from your perspective, when a woman has been told to just lose weight, how do you begin to unpack what's really going on metabolically?
Ashley Koch, MS, CNS (22:52)
Yeah, so there's a lot of layers that come to weight health. And I think this is an interesting question because I have a dear friend who is a dietitian. Her name is Ashley Koff, K-O-F-F. And she just wrote a book about this topic. And she also went to your alma mater, Duke. And I have her book here on my desk. But it's a great one to check out. And it's called Your Best Shot. And it actually talks a lot about this. it helps.
Jillian Woodruff MD (23:05)
my goodness.
Ashley Koch, MS, CNS (23:18)
us understand that weight exists in an ecosystem. And that's very much how we practice in functional medicine and in functional nutrition is that weight is not just about how many calories in and how many calories you're burning. There is this ecosystem of hormones and she talks about them as switches and there are all these levers we can pull. So when someone comes in and they say their goal is weight loss.
We have a lot of investigation to do because it's not just about what they're eating. We will investigate what are they eating and what's missing and I'll do a full nutrient assessment and get a three day food journal and understand that. But we have to ask questions about like how they're sleeping, how they're moving their body and what's happening with their hormones. How are their cycles if they're still cycling, if they're in peripetapause. We have to ask a lot of questions and then also run labs and look at things like inflammatory markers.
HSCRP, ESR, we have to look at their lipid panel, their triglycerides. We need to look at their A1C, their fasting glucose, their fasting insulin. We need to understand the entire ecosystem. And then we have to ask about their previous health history. So do they have a history of chronic infections? Have they always had hormonal issues? Like learning about what happens when someone was cycling in their 30s tells you so much about how they detox, whether their liver gets what it needs to do its job.
It's an ecosystem. It's incredibly complicated, and it's not just about eat less, change what you're doing, and then you'll lose weight. And so working with someone who understands it's an ecosystem and is going to work with you personally to understand what your body is trying to tell you is going to help you be successful. And it can be really frustrating to just leave your doctor's office, and they just say lose weight, and it'll solve everything, because how? It's not always easy to just lose weight.
Jillian Woodruff MD (25:00)
Yes, okay, this is where personalized nutrition becomes essential. Eat less, not a treatment plan. Just eat healthy is also quite vague and frustrating. And yes, energy balance matters, just as you said, but there's hormones, sleep, gut health, inflammation, they all influence how our calories are processed. and I think sometimes with ⁓ even nutrition, they may even say lose weight and go see a
nutritionist or go see a dietitian. And that also isn't the most helpful thing. I think that people have an idea, some about ⁓ nutritionists that they're just going to tell you to like eat a handful of vegetables and they don't have anything to draw on to know differently, which, you know, in working with you, that is not what I got. That would have been easier perhaps just to a handful of vegetables.
I can do that. But I got a lot of information about how my body responded to certain foods and what should be having more of what you should be having more of what you should be having less of. Do you see that there is that idea that maybe people wouldn't feel like they need to see a nutritionist because they already know everything?
Ashley Koch, MS, CNS (25:53)
Yeah.
Yeah, yeah, I think so. Or, you know, working with clients who have worked with other nutrition providers in the past, there's a lot of approaches. And there's range of education and experiences and tools. We all have different tool belts. And so reaching into a different tool belt might be useful. So I've had clients that work with a nutritionist that's very focused on macronutrients. And so they've got those figured out, but they're still not losing weight. And so as a functional nutritionist,
I can do a lot of things to look at that. So I can look at labs in more depth, and we've partnered on that. And I partnered on that with Dr. Adai, where we run a comprehensive panel and look at someone's health and what's going on. We can also assess nutrient insufficiency or deficiencies and sufficiencies. So we can log and look at food and understand what are some of the things that are missing. There's a lot of things around timing, like when we eat our food. And so we can think about.
how someone's eating their food, like what is their eating window, what time of day, when are they having most of their carbohydrates, because we actually do better with carbohydrates earlier in the day. And we do worse with them later in the day. So we can eat the same carbohydrates in the morning, process them better than we would at 6 p.m. at night. We can look at blood sugar patterns, so we can get your A1C and your fasting glucose and insulin, or we could also put a continuous glucose monitor on you, and we can get data 24-7 that tells us how you're processing certain carbohydrates.
And that's going to change over time. things you used to process really well in your 30s, you might not be processing really well in your 40s. And putting a glucose monitor on can tell you about that. We can also.
Jillian Woodruff MD (27:44)
Should we be
having our dessert in the morning for breakfast?
Ashley Koch, MS, CNS (27:47)
That's great possibility. That is a possibility for some people. They will find that they can do better. And if that's something that's really important to you, then you might want to do that earlier in the day and not as late in the day. And it can impact, like we can see for some people, if they're more less insulin sensitive, like those carbs, those sugar late in the day are really going to sabotage them later in the day and while they're sleeping. So that's a possibility.
We also know digestion, like we can look at how you're digesting your gut microbiome. There's so many levers in personalized nutrition. We can look at lowering your inflammatory load with what you're eating and measuring that. So I've had clients, we measure their HSCRP, their ESR. We start doing this work together and we see a decline in inflammation based on changing what's on their plate. So there's just a lot of tools we can pull in personalized nutrition to address.
this whole ecosystem and support someone in figuring out what's going on with their body.
Jillian Woodruff MD (28:39)
So I think it would be important to know what is your goal, right? Is it a symptom, like you're feeling fatigue that you need to work on? Is it the transition to perimenopause, to menopause? Is it weight loss? Is it increasing strength for athletic performance? Something, so I guess the outcome will be different and the investigation is different based off of what the goals are of.
your meeting, guess no two people are alike.
Ashley Koch, MS, CNS (29:08)
and you come in, when clients come in, the first question I ask is, what is important with your health that you're working on right now? And they often list out three to five things that are important to them. And then we unpack those things, or we start diving deeper into their health. So we start diving into what diagnosis, what medications are you taking, what supplements are you already taking? And then we go through all the categories, like, tell me about your hormones, tell me about your sleep, your movement, your digestion.
As we look through there, there are gonna be other things that are going on in the body that are probably related to those priorities. And so helping understand the connection between all of those is really important. But first it starts with what's important to you because if we start, like I might think it's about inflammation, but inflammation might not be important to you. For you, it's about your weight health or it's about your cholesterol results that you just got. And so really understanding what's motivating and what's important to you. ⁓
Sometimes it's about being able to get on the floor and not be in pain so you can play with your grandkids. And so we have to start there, wherever it's important to you. And that's what takes you down the personalized path, because it's about you and what's important to you and what motivates
Jillian Woodruff MD (30:14)
Ashley, thank you. This has been such a rich conversation. love how you keep bringing us back to the idea that weight and metabolism exist in an ecosystem, not a simple math equation. Today we covered why midlife is a real window of opportunity, why visceral fat matters for long-term health, and why personalized nutrition is so much more than eat less or even eat healthy. In my opinion, it's about
eating strategically for the physiology you're in. This conversation was so good and so full that we are splitting it into two parts to keep it easy to listen to and actually digest. So in part two, we're going to get into digestion and the gut microbiome, why food intolerances or food tolerances can change in midlife and how gut health connects to inflammation, insulin resistance, and metabolic progress. So Ashley?
Again, thank you, thank you, thank you for being our first guest on the Modern Midlife Collective and for bringing so much clarity to this topic. And listeners, if this episode helped you, share it with a friend, a sister, a coworker, a loved one, someone you care about who might need this perspective. And if you have questions you want us to answer in a future episode, email us at connect at modernmidlifecollective.com. Thank you for listening.
Goodbye.