https://riverside.comRiverside.fm (https://riverside.com)Sat, 14 Nov 2026 04:41:30 GMTMon, 02 Nov 2026 17:28:00 GMT60Amy Wagner, Julie Doyle, Crystal HazletonMissing Pieces brings together a certified nutrition specialist, a physician and a physical therapist to talk about the connected pieces of midlife health. Each episode looks at how nutrition, hormones, metabolism, muscle, gut health and pelvic floor health work together, with practical, realistic steps you can start using right away. This show is for education only and is not medical advice.episodicAmy Wagner, Julie Doyle, Crystal Hazletonamy@awpersonalizednutrition.comno2c4a85d3-8d48-43f6-ab94-1a9537ade5fbTue, 03 Nov 2026 12:36:29 GMTMidlife symptoms are rarely caused by one thing. Certified nutrition specialist Amy Wagner, who holds a master's degree in integrative nutrition, joins physician Julie Doyle and physical therapist Crystal Hazleton to explain how gut, liver and muscle health connect. They share practical steps you can start this week. KEY TAKEAWAYS - Protein needs fiber. High-protein eating without enough fiber can cause bloating and gas, and may fuel low-grade inflammation linked to "leaky gut." - Variety matters. Different fibers feed different gut microbes. Aim for about 35 g a day, split between soluble and insoluble fiber, and add it in small increments. - Short-chain fatty acids (butyrate, propionate, acetate) support the gut lining, satiety signaling and immunity. - Constipation can add to bladder urgency and leaking, and overworked pelvic floor muscles can tire out. - A 20-minute weekly plan: 150 minutes of zone 2 cardio, 1-2 interval sessions and 2 strength sessions. Starter moves: sit-to-stands and countertop push-ups. - Muscle improves blood sugar and insulin sensitivity. In a meta-analysis discussed, exercise cut liver fat by about 30% even without weight change. - Focus on strength, not the scale. Wearables can help you learn your patterns but can also become a source of stress. - Silent insulin resistance can appear in perimenopause, and estrogen affects lipids and heart health. TIMESTAMPS 0:00 Introductions and the gut-liver-muscle axis 1:03 Why protein without fiber backfires 4:38 LPS and leaky gut 8:42 Short-chain fatty acids and the foods that feed them 11:04 Cooked-and-cooled rice and food safety 12:36 Can you get enough fiber from food? 15:42 Constipation, the bladder and the pelvic floor 20:44 The 20-minute workout for busy women 29:23 Norwegian 4x4 and other interval options 33:05 Why muscle matters for blood sugar 36:00 Exercise and liver fat 37:48 Strength over the scale 40:30 Wearables and body signals 44:25 Insulin resistance in perimenopause 47:22 Estrogen, lipids and heart health RESOURCE Stine JG, DiJoseph K, Pattison Z, et al. Exercise Training Is Associated With Treatment Response in Liver Fat Content by MRI Independent of Clinically Significant Body Weight Loss in Patients With NAFLD: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2023 Jul. PMID: 36705333 For education only; not medical advice.no00:48:17The Gut-Liver-Muscle Axis: Fiber, Strength Training and Hormones in Midlifefull