Most of us have had that moment where we get our bloodwork back and shake our heads. We’re still our active, health‑minded selves and out of nowhere—rising LDL, ApoB, A1C, and maybe blood pressure and Lp(a), too. This week, preventive cardiology dietitian Michelle Routhenstein joins us to unpack the cardiometabolic chaos and what’s really driving it. She explains estrogen’s protective role in lipids and blood pressure, why standard risk calculators and even calcium scores can miss women’s disease, and which advanced labs are worth asking for. We also dig into how under‑fueling and low‑carb diets can worsen cardiometabolic health and plaque; why complex carbs, fiber, fermented foods, and gut health matter so much; and how to approach protein, red meat, electrolytes, nitric oxide, and statins in a personalized, empowering way—remembering that 80–90% of heart disease remains preventable when women get the right information and advocate for themselves.
Michelle Routhenstein, MS, RD, CDCES, CDN is a preventive cardiology dietitian and founder of Entirely Nourished, a virtual practice focused on personalized, science-based nutrition for heart health. With over 14 years of experience, she helps people improve cardiometabolic risk and manage conditions like atherosclerosis, heart failure, and atrial fibrillation using a whole-person approach. She holds Bachelor’s and Master’s degrees in Clinical Nutrition from New York University, serves on the Forbes Health Advisory Board and the Medical Advisory Committee for the National Menopause Foundation, and is the author of The Truly Easy Heart-Healthy Cookbook and Simple Meal Solutions for High Blood Pressure. Her work has been featured in outlets including Forbes Health, Fox News, Prevention, Women’s Health, and Good Housekeeping, and she works with clients virtually from New York via www.entirelynourished.com
Join us at Feisty Fest September 18-20, 2026: https://feisty.co/events/feisty-fest/
Sign up for our FREE Feisty 40+ newsletter: https://feisty.co/feisty-40/
Learn More about our 2026 Feisty Events, including Bike Camps and Cycling Trips: https://feisty.co/events/
Follow Us on Instagram:
Feisty Menopause: @feistymenopause
Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099
Support our Partners:
Midi Health: You Deserve to Feel Great. Book your virtual visit today at https://www.joinmidi.com/
Previnex: Get 20% off your order with code FEISTYBRAIN at https://www.previnex.com/
Wahoo: Use the code FEISTY2026 to get a free Headwind Smart Fan (value $300) with the purchase of a Wahoo KICKR RUN at https://shorturl.at/WVhdr
Cozy Earth: Use Code HITPLAY at https://cozyearth.com/ for up to 20% off