Aloha Reader,

Upside-Down Pilates

In this episode of Upside-Down Pilates, we focus on building the strength needed to perform the Side Bend exercise using the resistance band, magic circle, balance ball, foam roller, and reformer.

Our Anatomy Minute for the day highlights the cross-lateral connection of the internal and external obliques.

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Are you ready to be healthy and thrive? If you would like a personalized program to help you move from pain to freedom, please fill out this form to see if we are a good fit to work together.

I work with clients all over the world via Zoom or in my fully equipped studio in downtown Honolulu. No equipment is required for Zoom sessions.

Upside-Down Nourishment

A cancer diagnosis can be scary, but research shows that the gut microbiome is a key modifiable factor that can support prevention, treatment, and overall health. Here is a look at how gut health interacts with cancer care:

The Gut Microbiome and Breast Cancer

Dysbiosis (lower microbial diversity and fewer short-chain fatty acids, or SCFAs) is common in breast cancer and is linked to chronic inflammation and immune dysregulation. Four main pathways connect the gut to breast cancer: estrogen metabolism, immune regulation, microbial metabolites, and the gut–brain axis. The estrobolome is especially relevant for HR+ cancers, as gut bacteria can reactivate estrogen in the colon and raise circulating levels. Conversely, butyrate helps protect the gut barrier and shows anti-tumor effects in preclinical models. While promising, much of this evidence remains mechanistic and is still being evaluated in human trials.

Interactions Between Cancer Treatments and the Gut

Cancer therapies and the gut microbiome directly influence each other. Chemotherapy can reduce diversity and deplete beneficial microbes such as F. prausnitzii, Bifidobacterium, and Akkermansia. In turn, low baseline diversity is linked to more severe side effects like neutropenia. For example, 81–90% of patients taking abemaciclib (Verzenio) experience diarrhea, with pre-existing GI conditions increasing the odds of moderate to severe symptoms by roughly 4.5 times. Emerging research also suggests gut microbes influence tamoxifen-related fatty liver and immunotherapy responses. Because many cancer drugs have a narrow therapeutic window, always consult the oncology team before making specific recommendations.

Nutrition Strategies for Gut Support

A diet rich in diverse fibers and polyphenols supports microbial diversity and SCFA production. However, response to diet varies based on individual microbiome composition. For instance, soy foods are linked to lower recurrence rates—including in estrogen receptor-positive survivors—partly due to equol, a compound produced by specific gut microbes. Additionally, multi-strain probiotics or synbiotics may ease chemotherapy side effects, but they require careful application: avoid Saccharomyces boulardii in critically ill patients, use caution during immunotherapy, and always coordinate care with the oncology team.

The dysbiosis (lower microbial diversity and fewer short-chain fatty acids, or SCFAs) common in breast cancer is linked to chronic inflammation, immune dysregulation, and joint pain.

To learn how to address the root causes of joint pain, inflammation, immune dysregulation, and breast cancer, join the waitlist for my upcoming joint pain course to get first dibs and a reduced rate:

If you are interested in personalized support through our Upside-Down Nourishment programs, please fill out this form to see if we are a good fit:

(Note: I work with clients worldwide via Zoom.)

Remember, self-care is healthcare!

Have a beautiful day,

Lisa