Pelvic Floor Problems

Transcript:

MELANIE: Welcome to Dishing Up Nutrition. Today's podcast is brought to you by Nutritional Weight & Wellness. We're a company in Minnesota that specializes in nutrition education and counseling. My name is Melanie Beasley, and I'm a Licensed and Registered Dietitian, and I'm here today with my cohost, Kara Carper, who's a Licensed Nutritionist, and she's also a board Certified Nutrition Specialist.

So, we are looking forward to talking about a topic today that's not often talked about in general conversation, and the title of our show is Pelvic Floor Problems.

KARA: Melanie, I know that you and the other licensed and registered dietitians meet together on a regular basis to discuss new research, kind of bounce ideas off one another; kind of bounce ideas off one another when it comes to specific health conditions of your clients. And another thing that I've heard gets talked about at these meetings is what would be a relevant podcast topic for upcoming shows?

So in fact, the idea for today's show, pelvic floor problems, that was brought up by one of our dietitians and she said she had three female clients over a four week timeframe; they all came to see her for an appointment and they all mentioned that they were struggling with things like leaky bladder, overactive bladder, urinary incontinence, urinary tract infections. So it turns out the bladder issues were not what actually led them to make the initial nutrition appointment. So that was kind of interesting.

MELANIE: It really is interesting. And I find that as well, Kara, when I'm seeing clients is that, they might make an appointment with me to talk about elevated cholesterol or that stubborn weight that won't come off. But when we go over their comprehensive health history forms, this is when I get to peek behind the curtain and discover other health issues and concerns and pelvic floor does come up.

KARA: Mm hmm. And when it comes to problems related to the pelvic floor, I wonder, is it just easy to justify those symptoms or maybe assume that they're normal? That could be one reason that it's not something clients bring up proactively. So, listeners, think to yourself, are you someone who maybe has kind of a leaky bladder or maybe a lot?

Maybe it's when you sneeze, cough, or lift something or jump. Perhaps you also struggle with constipation and maybe you only have one bowel movement every other day and when you do, you have to push and strain and it doesn't come easily.

MELANIE: So uncomfortable. I think it's common nature to justify symptoms like those and write them off as it's part of life or part of getting older. Or you might even think, you're just used to the discomfort and so it's normal or something you'll just have to deal with your whole life. Well, we want our listeners to understand that leaky or overactive bladder is not normal. And it's common, but that doesn't mean it has to be a normal part of aging post childbirth and beyond.

Overviewing 2 types of pelvic floor problems

KARA: Right. And, when it comes to, in general, pelvic floor problems, there are two different types of problems. The most common scenario, and this is for both men and women, is having a pelvic floor muscle. Yes, your pelvic floor is a group of muscles, and those muscles have weakened over time. And that creates muscles that are chronically in a relaxed state, and so it can be harder to strengthen them. So those weak muscles are what can lead to things like bladder incontinence or bowel incontinence.

It can also lead to organ prolapse. Organ prolapse is when the pelvic floor muscles aren't supporting your important organs like the uterus, the rectum. bladder or vagina. And sometimes those organs can kind of drop or fall in the body.

MELANIE: Yeah. And women will describe this to me as a feeling of pressure all the time. And other problems is less common and is another one that can be very debilitating is when your pelvic floor muscles are chronically tight and they don't switch over into a relaxed state. It's like having a Charley horse where the muscles are just tight and constricted, and often this is what leads to pelvic floor pain and that feeling of tightness. It's pretty miserable.

KARA: Yeah. I, fortunately, I've never experienced it, but I mean, it really is considered chronic pain.

MELANIE: And women put up with this silently. It's just, it's pretty miserable according to what my clients have told me.

KARA: Mm-Hmm. You know, Melanie, it's really interesting that pelvic floor problems can vary so much because not only is constipated a pelvic floor issue, but so is the opposite problem. So if you're someone that struggles with loose stools, maybe you even have a bowel movement or leakage in your pants before you're able to get to a bathroom.

And there are technical terms for not being able to hold it long enough to get to a toilet. You know, you've heard us say urinary incontinence. For a bowel movement, it's called fecal incontinence. And that just means someone's not able to hold their urine or their feces and they kind of start going in their pants before they can get to a restroom.

MELANIE: The dietitian at our company who had three clients with similar issues, she said that her clients were wearing adult incontinence briefs, which is basically a very large sanitary pad that helps to prevent accidents from leaking out of the underwear or pants and just trying to get on with your life.

KARA: Exactly. Yeah. The dietitian working with these clients did mention that they had to alter their lifestyles. Think about it. You know, if you're afraid that you're not going to make it to the restroom in time, would you change your plans? We hear about both men and women not wanting to venture out somewhere if they don't think there's going to be a bathroom readily available.

And you hear about people avoiding certain exercises that may be higher impact or not lifting because they're afraid they're going to have an accident and it may aggravate some of those issues.

Nutrition can affect pelvic floor health

MELANIE: It's really depressing and life altering and you may be wondering what nutrition has to do with pelvic floor health. And we have some great information in our show today, and we'll be talking about what foods and beverages you can incorporate more of to give you some relief from your pelvic floor issues.

And there are also foods and beverages you want to cut back on or eliminate to try to get some relief. And many people don't make that connection that nutrition may have an impact or even a big impact on improving pelvic floor problems.

KARA: And I just want to reiterate that this applies to both men and women.

MELANIE: Yeah, good point.

KARA: We all have a pelvis. We all have a pelvic floor. We all have a bladder, a bowel, and reproductive organs. Of course, issues with the pelvic floor can look different for men and women just because of anatomy. And I found something in the journal called Nature. It was reported last year in 2023 that 32 percent of women have at least one pelvic floor problem in their lifetime. And 16 percent of men will have a pelvic floor related issue.

What does our pelvic floor look like & where is it located?

MELANIE: Interesting. Yeah. Those are some good numbers I was not aware of. Well, I want to paint a visual picture of what our pelvic floor looks like and where it's located. Your pelvic floor is made up of muscles sort of in the shape of a hammock. Imagine a hammock that's able to move and bounce up and down, but it also needs to be supportive. It has to be firm, supportive, but flexible. Pelvic floor muscles stretch from your pubic bone in the front of your body to your tailbone in the back.

KARA: And, one reason problems with the pelvic floor are not always easily diagnosed is because, like we've been talking about, the symptoms can vary so much. The pelvic floor is a set of muscles and the job is to support many different organs. For women, the pelvic floor muscles are supporting the uterus, the bladder, and the colon. And for men, the pelvic floor muscles are supporting the colon and the bladder.

MELANIE: Yeah. I'm not sure why the pelvic floor doesn't get talked about more because it is so important, and the pelvic floor has three openings or like I think about them as the three outlets in women with their three openings in the pelvic floor. It's going to be the urethra, the anus and the vagina. And in men there are two openings, obviously the urethra and the anus.

KARA: And most people can feel to some extent where their pelvic floor muscles are. It's sort of this like mysterious thing, but imagine you're driving, you're in your car, you really have to urinate, but you know, you need to hold it until you get to your destination where there's going to be a bathroom. So you would naturally be squeezing some of those pelvic floor muscles just by holding in urine.

MELANIE: Yeah. And if you're in that same situation in your vehicle, but you feel a bowel movement coming, you'd also be contracting the pelvic floor muscles, hold that in as well. It serves a huge purpose.

What does a healthy pelvic floor support?

KARA: Yeah, absolutely. And when the pelvic floor is healthy and everything's working like it should, it's going to help control going to the bathroom and some sexual function. So squeezing your pelvic floor muscles narrows the openings that Melanie just mentioned, those 3 openings or two openings in men. And that’s so urine or feces can’t escape. But then relaxing the muscles widens the opens so that you can actually go to the bathroom.

MELANIE: And most people don't think twice about their pelvic floor muscles when they're healthy because they're able to do it automatically. It's not something we have to think about. It's when problems start happening that we pay more attention to what is going on with the bladder, the bowel, or even sex organs.

KARA: Right. And then in addition to the symptoms, we've covered a lot of symptoms so far, like urgency, frequency, the inability to hold or control urine or feces, and also being constipated on the flip side. But it makes sense that with all those muscles and everything that's all the organs that are being supported that there might even be more symptoms involved.

MELANIE: Sure, sure. And pelvic pain, well, pelvic pain or even unexplained low back pain is another sign of an issue with pelvic floor. Not always, right? But it is a sign. Erectile dysfunction, painful intercourse or pain while urinating or having a bowel movement can be symptoms of pelvic floor disorder.

Protein is a key piece to strengthen & build muscle

KARA: And when I was doing research for the show, it really just occurred to me, goodness, you know, this is a group of muscles, really important muscles in the core of our body. And so think about it, just like other muscles, like the biceps on your arm, the hamstrings on your legs. How can we nutritionally support these pelvic floor muscles?

MELANIE: Yeah. I like that you tied that in because it's not something we think about pelvic floor that those are muscles. And protein is going to be a key piece of your diet if we want to strengthen or build any muscle at all. So eating a protein filled breakfast: eggs, turkey sausage, will be digested, broken down into amino acids. And these amino acids are involved in tissue growth and tissue repair. So eating enough protein also improves your immune function and your energy levels. And you want to also include some organic vegetables, natural fat, of course. And I like to cook my eggs in butter and sauté some organic greens like Swiss chard.

KARA: There are just so many benefits of getting adequate protein. We've talked about that in other shows as well. I wanted to mention personally, for me, I really noticed it with my moods and my ability to focus. So let's just say I'm on track with my eating.

Maybe for lunch, I would eat a big, delicious salad with five ounces of grilled chicken. I'd probably pair it with a few different colorful vegetables, maybe half of an avocado and a full fat organic olive oil, kind of a salad dressing. After a meal like that, I feel very satisfied. I'm not going to get an afternoon crash. And it really helps me to just have even moods and stay focused for the rest of the day.

MELANIE: Yeah. So there's so many benefits we've talked about in other podcasts about the benefits of protein, but circling back to the pelvic floor, I have many clients, both men and women who want to know how can I prevent muscle loss as I'm getting older.

And after middle age, we adults lose about 3 percent of our muscle strength every year on the average, and it's never too early to start thinking about how can I prevent muscle loss because the decline in muscle can start around 35 when we are typically starting to lose 1 to 2 percent of our muscle strength each year. Remember, pelvic floor is muscle.

KARA: Yeah, and I like that you said that it's never too early because we encourage you, you know, even with teens and in your early twenties, before you start the muscle loss, start planning ahead. You know, what am I going to do to prevent this muscle loss?

MELANIE: And maintain what you've got.

Constipation & pelvic floor dysfunction can be connected

KARA: Yeah, of course. And so another registered dietitian at Nutritional Weight & Wellness, she emailed me cause she knew we were doing this topic today, and she said, I have a client who recently had a really incredible success story. And so I just wanted to share that story. The client that had been seeing her had severe constipation for a long time. We know how uncomfortable that is and life altering that can be in a not a good way. But this client had also been diagnosed with pelvic floor dysfunction.

MELANIE: Interesting. Well, you know, constipation is when you're not having a bowel movement every day. We need to be doing that every day. And someone is definitely constipated if they're needing to push or strain just to have that bowel movement. Or when they feel like they just are not completely emptying, well, that is constipation. And this is one of the most common reasons a pelvic floor can become weakened or lose some of its structure.

KARA: And it is so common, but you know, again, it's not normal to need to push and strain or to not have a bowel movement every day. Over time that can weaken those muscles. And often the weakening of the pelvic floor muscles is what leads to loss of control with bladder, urinary leakage, or that feeling of urgency or urinary incontinence.

So that's what happened to this particular client. So she was seeing the dietitian that emailed me, but she was also seeing a physical therapist and the physical therapist specialized in pelvic floor dysfunction. I didn't realize that that was a thing.

A team approach of nutrition + physical therapy is optimal

MELANIE: Yeah. And it's becoming more and more common and we think there are even centers that just are surrounded around pelvic floor because it's gotten to be such a problem. I really like that team approach and you and I are not experts in physical therapy for the pelvic floor, and physical therapists do not have the same knowledge that we do when it comes around nutrition.

So it's teamwork. And if someone is just receiving physical therapy, but not addressing what they're putting in their mouth, it's much less likely that they will get their issue resolved. We've got to resolve that constipation or whatever could be triggering that pelvic floor issue.

KARA: Right. So the physical therapy is an important piece, but so is nutrition.

MELANIE: Yeah. Physical therapists are great.

How much protein is recommended?

KARA: And so guided by her dietitian, this particular client focused on increasing her protein so that she was eating at least a palm size serving three times per day. And for those of you who can't see us, you know, I'm looking at my palm, a serving of cooked protein is about four to six ounces. And so this client was also post-menopausal. She'd been doing strength training for years. And here's like kind of a side benefit after increasing her protein intake, she noticed that she had more strength and could feel and see more muscle when she was doing her workouts.

MELANIE: You know, it's interesting when you say that about look at your palm. I know we say that a lot, but I looked at my palm, eyeballed it, put the amount of protein on my scale, and it was two and a half ounces.

KARA: No.

MELANIE: So I always challenge my clients, get a scale and weigh it out.

KARA: Okay.

MELANIE: And you got a little bitty palms over there too.

KARA: You're right. And I do like a good five ounce serving of cooked protein at my meals.

MELANIE: Yeah. So that's the challenge.

KARA: Thank you for clarifying that.

Pair strength training with adequate protein for muscle support

MELANIE: Weigh it out. So some strength training also paired with adequate protein is such a powerful combination to prevent muscle loss, and also to see gains when it comes to feeling stronger, noticing more muscle and being able to lose body fat. I always say motion is lotion. So when we get moving, things just start working better in our body.  

Tips to relieve constipation & urinary incontinence

KARA: So, I just want to circle back to the constipation issue that this client was experiencing. She really needed to resolve that constipation in order to start having regular bowel movements that didn't require the pushing, the straining, otherwise the pelvic floor problems probably would have just been sustained. And so we recommend a lot of different nutritional solutions for constipation.

And when we come back from break, we'll talk more about those, but not getting enough fiber or pure water are two factors that can lead to being constipated. You're listening to Dishing Up Nutrition. Our topic today is pelvic floor problems.

Melanie and I have been discussing the importance of a healthy functioning pelvic floor and also nutrition tips if you're struggling with issues related to your bowels, your bladder, or reproductive organs. Remember the pelvic floor supports all of these organs and needs to be functioning well to avoid symptoms.

One of the most common symptoms of pelvic floor dysfunction in both men and women is bladder leakage, bladder urgency, or urinary incontinence. So in a moment, we'll give you some tips and additional resources to help reduce those symptoms.

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MELANIE: Welcome back. You're listening to our Dishing Up Nutrition weekly podcast, and we're discussing pelvic floor problems and how they can be addressed with nutrition. One of the most common symptoms is urinary leakage or urgency. Many women and some men wear incontinence pads to prevent an accident, and this can negatively affect their health life. If you're afraid to laugh or do certain exercises or activities in public or worried about where the next bathroom is, it's pretty life disrupting.

KARA: And I just want to mention that we did a podcast that was all about urinary incontinence. If you just go to our website, weightandwellness.com, and go to the radio or podcast tab and in the search engine, just type in urinary incontinence. And you will be able to listen to an entire show if you'd like more detail on that specific condition.

And we'll summarize some of the key takeaways from that show. It makes sense that certain beverages are going to be more of a bladder irritant. And really the main offenders are beverages that contain alcohol, caffeine, sugar, but also artificial sweeteners.

MELANIE: So if you're having bladder issues and you want to start feeling like yourself again, a great place to start is to look at what beverages you're drinking and really clean those up.

KARA: So caffeinated coffee, caffeinated tea and energy drinks, soda, those are all bladder irritants. And it's both sugary beverages and the artificially sweetened beverages that can lead to more of a leaky or urgent need to urinate.

MELANIE: Drinking just purified water throughout the day; start your day with two big glasses of clean, purified, non-carbonated water.

KARA: Now the reason that we're talking about carbonated water, that might be a surprise for some of you, but this is not the first time I've heard this. Recently I was teaching a virtual, it's called Foundations Nutrition for Weight Loss class series. And one of the class members shared that when she would drink a couple of LaCroix sparkling waters, keep in mind, you know, there's no sugar, no artificial sweeteners, but it was carbonated, she would end up getting up to go to the bathroom several times during the night.

MELANIE: Oh, miserable.

KARA: Right. And so she tied it back to when she did not have the sparkling water, she was not getting up. So it was directly related. So Melanie and I encourage you, track your food, track your beverages, and you can start making connections between what you're eating, what you're drinking, and how your bladder responds, because everyone's going to be a little bit different with what they're more sensitive to.

MELANIE: Bowel and bladder. So you just want to track your food on one side and what time you have symptoms on the other. Scale it on a scale of one to five, five being the worst, and hopefully you'll start seeing a pattern. If not, you can bring that in to one of the nutritionists or dietitians, make an appointment, and help them navigate those waters for you. It can be really hard to figure out those symptoms.

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Fiber, water & gut health importance to relieve constipation

KARA: Right. All right. So, you know, let's just get back to we were the constipation issue and what things, there are a lot of things that can lead to constipation, but some of them are just not getting enough fiber throughout your day, not drinking enough pure water; not having enough good bacteria in the gut or the microbiome can also lead to constipation. So we're just going to briefly cover all of those.

MELANIE: Yeah. I love that you hit on all of those. So we want to remember that vegetables are your number one source of fiber. They also feed your good bacteria. And ideally you want to include organic vegetables at every meal. Focus on the non-starchy kind. A little bit of the starchy is fine. But we always lean into the potatoes, I think.

And most people are not getting enough fiber or vegetables. And the Center for Disease Control stated in 2023 that only 10 percent eat the recommended servings of vegetables each day, just two to three cups for adults. And only 7 percent are getting enough fiber.

KARA: Interesting. Those are not high numbers. 10 percent and 7%. And it doesn't have to be difficult to get adequate vegetables and enough fiber each day. But you really need to be intentional about it. Some of the higher fiber vegetables are going to be the green leafy veggies. And some are not super common. Kale is one that is very high. One cup of cooked kale has almost six grams of fiber. Swiss chard and collard greens are also very high in fiber. So, you know, go to the grocery store, experiment with a variety.

I think even personally, I tend to always go to the spinach and the romaine and the mixed greens, but, and those are all great and they contain fiber, but some of the other ones like the Swiss shard, the collards, they're going to be a little higher.

MELANIE: And clients love that spinach because they grab huge handfuls of it and I'm like, let's switch it up. So not always spinach. I love Brussels sprouts are another good one. One cup contains about six grams of fiber. A really good goal to help bulk up stool and make it easier to pass is to consume at least 25 grams of fiber each day.

KARA: And so drinking enough clean filtered water is also very important. Being dehydrated can lead to dry, hard stools that aren't easy to pass. Unfortunately, men and women are often trying to avoid drinking fluids. If you're someone that has bladder urgency or incontinence, you might think to yourself, well, I better not drink water because I don't want to have an accident.

But you know, drinking water is important in that we want to support you to lessen these symptoms of the leakage because being dehydrated, it's also a risk factor for urinary tract infections, which too many urinary tract infections or bladder infections make it more likely that you're going to have pelvic floor problems. So it's kind of the chicken and the egg scenario.

MELANIE: Yeah. Any of that trauma to that region. is going to possibly set you up now. So when I mentioned, if you're going to start incorporating more fiber, you want to start doing it gently and slowly, maybe a half a cup extra a day. And that allows your body to acclimate your gut.

Your digestive system has to start producing enzymes. Slowly, it will acclimate and start producing more and more to break it down. But if you had out the gate, think you've listened to this podcast, three cups of cruciferous, you know, Brussels sprouts, you might have some digestive issues, so you just want to start slow and build your way up if you haven't been eating a lot.

So addressing these things one at a time is going to improve constipation and the digestive microbiome affects the bladder, bowel and reproductive organs, and getting enough good bacteria is critical, especially if someone has been on antibiotics throughout their lifetime. Maybe they've had surgery, which surprisingly, a lot of people don't realize that when you're going through surgery, they infuse you with antibiotics.

Sometimes you didn't even know you were on antibiotics and that kills your good bacteria. So incorporating a little fermented foods, wonderful idea, such as kimchi or, sauerkraut. You don't want to heat these up, because we don't want to kill the little buggers. Right? We want them to be alive and then they get there. And you can also do some homemade, fermented pickles?

KARA: Oh yeah.

MELANIE: There's lots of recipes out there.

KARA: And at the grocery store as well, I mean, there's some sauerkraut that contains the vinegar and some pickles contain the vinegar. But to get the benefit of the fermentation, you'd want to look for ones that do not have the vinegar. So that natural fermentation process.

MELANIE: That's a really good point. There's a lot of pickles you pick up are just pickled through vinegar and not fermentation. So they're not going to have that live bacteria. I'm glad you mentioned that.

KARA: And it depends on the person. It depends on the scenario, but this might be a situation where taking a good quality probiotic supplement would be beneficial. I just remember I was very constipated after I had a caesarean section years ago. So in addition to doing what I was doing, getting a lot of, eating a lot of vegetables, getting enough fiber, drinking water, I really benefited at the time from taking a high dose probiotic supplement.

And some Magnesium Citrate, which acted as a gentle stool softener. So I was just so grateful when I started going to the bathroom again on a regular basis, you know, after those pain medications they give you, those are very constipating.

MELANIE: So if you've had a surgery, anybody's had a surgery, they know. If you've been on pain medication, it's a constipated situation.

KARA: You can go days without going.

MELANIE: Oh, it's terrible.

KARA: And probiotics can be helpful for other scenarios as well. It's kind of interesting. Like it can help with constipation, but it can also help with diarrhea or loose stools or even fecal incontinence.

MELANIE: It's kind of an equalizer.

KARA: It is.

MELANIE: It balances everything out.

KARA: That's a great way to put it. So whether you are someone that strains and has dry stool, or maybe you have loose diarrhea, it's important to have enough good bacteria in your gut to bring everything back into balance.

MELANIE: It can also help with urinary tract infections, so everything in the pelvic area benefits from making sure there's enough good bacteria. Without enough of the beneficial microbes, things, pathogens, such as yeast or bad bacteria can start overpopulating, and too much yeast or bad bacteria can worsen pelvic floor problems like we talked about, making people susceptible to yeast infections, urinary tract infections. So we want that balance.

KARA: Yeah. And you know, we're not going to spend too much time on the good bacteria, but there are other benefits. If we don't have a healthy microbiome with adequate good guys, like you said, the good guys, we may not be absorbing nutrients from all the wonderful food that we're eating. So someone could easily become nutrient deficient if they have poor intestinal health. And again, tying this back to the pelvic floor, the pelvic floor muscles need to be getting adequate nutrition, just like the rest of the muscles in our body.

MELANIE: And you mentioned another thing that helped with constipation after your C-section. You said magnesium citrate. It's interesting to know that two out of three Americans do not get enough magnesium from their diet. Magnesium is in plenty of foods, but if someone is not eating enough of these foods, they will become deficient.

Plus, magnesium is easily excreted from the body from stress, exercise, sweat, diarrhea, illness. Even eating sugar depletes magnesium. So, most Americans are already deficient. And I want to mention, we're not talking run out and buy some magnesium oxide because it's poorly absorbed. You want to make sure you're getting a good one.

KARA Yeah. And there are food sources as well for magnesium: grass fed meat, the darker leafy green vegetables. I know avocados contain quite a bit of magnesium, nuts are another great source. When I was struggling with constipation, it worked better for me to eat foods, all those foods that I just mentioned that had magnesium, and then I just kind of topped it off with the probiotic, and then 400 milligrams of magnesium citrate. That's what worked for me.

MELANIE: Yeah. So you want to start slow on that citrate for those listeners out there. Don't start out like Kara with the 400. I mean, she's professional, so she knew she was doing, but you don't end up with tipping it into diarrhea.

KARA: Absolutely.

MELANIE: And, Kara, you mentioned becoming constipated after your C-section. Many women find that their pelvic floor problems start either when they're pregnant or post pregnancy. And there are a variety of reasons for this. If we think back to the pelvic floor, muscle, and connective tissues, they have a big job to support the bladder, bowel, and reproductive organs. So when you're pregnant, that's a lot of support they have to provide.

KARA: Extra support. Yeah. I don't think we give these muscles enough credit or attention. I learned so much researching for this show. I have a whole new appreciation for those muscles. So for women, being pregnant is actually a risk factor for weakened pelvic floor muscles as well as stretched out, weakened, or even torn ligaments.

So the ligaments are basically holding the pelvic floor muscles in place and that extra weight that naturally comes from pregnancy and the pushing that can come during a vaginal birth or any sort of tearing during the birth process, any pelvic surgery trauma, and this includes, you know, I want to say this includes birth trauma, it could include sexual trauma. Just like you said, anything in that pelvic region that is traumatic can lead to pelvic floor dysfunction.

Protein supports health & strength of all body tissues

MELANIE: Yep. You know, there's one reason pelvic floor problems are more common for women. Since you brought up stretched or torn ligaments, I'd like to remind our listeners that ligaments are also a tissue. And remember that eating enough protein supports the health and the strength of all tissues in the body, not just the muscles, but the ligaments and tendons as well. So we're very protein forward today.

KARA: We are, but you know, this is really kind of the key. It's the starting point for healing pelvic floor disorder. It's going to help to heal damaged, weak, or torn connective tissues. I picture the pelvic floor muscle, and I did look at some diagrams and I like that analogy to the hammock, but the hammock is being held up by straps. Over time, even just from aging, the straps can start to fray.

Maybe they stretch a little, maybe they sag. That can be from excess weight from pregnancy or just excess weight in general from pushing, straining and definitely from the loss of elastin and collagen that we all experience as we age. So there's a specific type of protein that helps rebuild connective tissues. And that's collagen protein.

MELANIE: Yes. A wonderful source of collagen protein is bone broth and we have a bone building wild rice soup recipe on our website that has a bone broth base. We also have a bone broth recipe on our website. Many natural food coops, they also have premade bone broth and not just any bone broth. We want to make sure it comes from free range, grass fed meat sources.

KARA: It's important to have a good animal source when we're having that broth. Collagen protein is available as well as a powder if you prefer to get your collagen that way. And, we've talked a lot about tissues in the body and how to best support these intricate tissues that surround our reproductive organs, our bladder and our colon.

Why is healthy fat important to support the pelvic floor?

Can you just talk for a moment about what specific foods are going to act as a lubricant for these tissues? Because we want you to leave today understanding all the different macronutrients and how they can benefit the pelvic floor.

MELANIE: Yeah, absolutely. Our bodies require a certain amount of high quality fats. We need these fats to absorb fat soluble vitamins such as A, D, E, and K. We also need dietary fat to produce hormones. And when hormones are balanced, this helps with muscle tissue repair and growth.

KARA: And let's just go over, what's the right amount of fat? Let's just say for an adult in a day or with a meal.

MELANIE: I would say with a meal, make sure you're getting one to two tablespoons of good healthy fat. Maybe one tablespoon at a snack. And that's going to look like maybe you cook in some butter, a tablespoon of butter, maybe you're using olive oil on a salad, maybe you cook in avocado oil, or you're using coconut oil. I mean, there's a lot of healthy fats out there. We mentioned the avocado, good source of magnesium and healthy fat.

KARA: Yeah. Perfect. Double whammy. And men and women who have been eating low calorie, low fat diets have been missing out on those important healing fats. Not to mention that a low fat eating plan can leave you just feeling hungry and often in a state of deprivation.

We know that being in a state of deprivation can also lead to overeating, maybe binge eating empty calories at the end of the day. So you gave some great ideas on the oils.

MELANIE: Some delicious tree nuts or, you know, some healthy, organic peanut butter. Once I get women who've been eating low fat on eating healthy fats and then we have to sort of reign it in because it makes food delicious.

KARA: That's where we get our flavor is from all these healing fats. Yeah. And I want to mention that when someone's having problems in their pelvic region, there's no doubt inflammation going on behind the scenes. So if you're looking to improve some of these uncomfortable, debilitating symptoms we've been talking about, the inflammation needs to be decreased, and a type of fatty acid, an essential fatty acid that reduces inflammation, it's the omega-3 fatty acid.

You've probably heard people talk about omega-3 fish oil. There are foods that are quite high in omega-3 fats. Some of the fattier types of fish like salmon, herring, and sardines. Egg yolks contain omega-3 fatty acids.

MELANIE: And yes, you said sardines, so that's a challenge for our clients. Go out and try a can of sardines in olive oil.

KARA: Yeah, actually, not, not bad.

MELANIE: Very similar to tuna. I think it's even a little less fishy.

KARA: Yeah, and it does have more omega-3 fats than tuna. Tuna is great as well, though.

MELANIE: But I feel like sardines, you either love them or hate them. It's like cilantro, right? Love it or hate it.

KARA: Try it though.

MELANIE: Try it. You don't know until you try it.

Recap

KARA: So this has been a great discussion today. I think it's a really important topic, pelvic floor disorder. Hopefully you're walking away with some new information because it is such a common problem for both women and men. And so nutritional factors that can really, really help to heal that pelvic floor: make sure you're getting adequate protein, healing fats, eating organic vegetables. You're going to get the minerals, the nutrients, and the fiber that way.

MELANIE: Lots of fiber. We talked about increasing fiber. Make sure you're not constipated. Maybe some magnesium in there to keep your stools soft.

KARA: Drink enough purified water. Add on some bone broth or some collagen to really support the connective tissues.

MELANIE: And something else we didn't mention, but you also want to remove foods that are inflammatory and that might be an appointment with a nutritionist. You can reach us at Nutritional Weight & Wellness at weightandwellness.com.

KARA: Or you can call 651-699-3438.

MELANIE: And make an appointment with one of us. If you feel like you are on the struggle bus with this particular condition.

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Our goal at Nutritional Weight & Wellness is to help each person experience better health through eating real food. It's a simple yet powerful message. Eating real food is life changing. Thank you for listening. Have a wonderful day.