• Nutrition

Provider Q&A: Metabolic Health with Kerri Louati, MS, RD

Published: July 08, 2025
Updated: July 08, 2025
4 mins

Get to Know Kerri Louati, MS, RD

Kerri Louati, MS, RD, LDN, CDE, is a registered dietitian and certified diabetes educator specializing in nutrition, integrative medicine, functional laboratory interpretations, and functional medicine. She is also the Director of Women's Health Clinical Operations at LifeMD. She previously served as the Director of Nutrition and Coaching with the telehealth platform Optimal Human Health MD. 

Kerri is passionate about working with all age groups and helping people understand the interconnectedness of different systems in the body.

She earned a degree in nutrition science from Bastyr University and a master’s degree in nutritional and functional medicine from the University of Western States. 

Metabolic Health Q&A

1. What inspired you to take an integrative medicine approach? How does it influence how you provide treatment? 

A: Let me begin by saying I have a deep respect for conventional medicine. It excels at surgery, diagnostics, emergency care, and acute interventions. But through my health journey, those of my family, and my experience with patients, I saw the limitations when it came to treating chronic conditions, prevention, and optimal wellness.

My journey into integrative medicine started with my two grandmothers. One of them was diagnosed with cancer and used integrative approaches, such as nutrition, supplements, and lifestyle support, alongside her medical care. The other did not. Their experiences and quality of life during treatment and at the end of life were drastically different. That contrast stayed with me, and it was the first time I truly saw the impact of supporting the body as a whole system, not just addressing symptoms.

Integrative and functional medicine introduced me to a different framework that looks at how nutrition, mindset, movement, environment, and biochemistry work together to either support or burden the body. It's a shift from treating parts in isolation to understanding the interconnectedness of systems.

2. Can you explain more about what a person’s metabolic health means for their overall well-being?

A: Strong metabolic health is one of the most direct ways we can support long-term well-being.

At the most foundational level, our health begins with the health of our cells. So when it comes to metabolic health, we’re really talking about how well our cells and mitochondria are producing energy, how responsive our cells are to hormonal signals (like insulin), and how well our cellular membranes absorb nutrients and expel waste.

So instead of looking at metabolism as just “burning calories,” we see it as a dynamic system that reflects cellular resilience, nutrient sufficiency, and communication between systems. 

The quality of our cellular function influences the bigger picture we see metabolically. For example:

• When cells are responsive to insulin, we maintain better blood sugar balance, which stabilizes energy, mood, and reduces the long-term risk for metabolic disease.

• When mitochondria are producing energy efficiently, we may notice improvements in sleep, focus, and less fatigue and oxidative stress.

• When membranes are healthy, nutrients get in and waste gets out, supporting detox, hormonal balance, and overall vitality.

3. Perimenopause and postmenopause often bring digestive shifts. Can you explain what’s happening in the gut during this time and how women can support their microbiome?

A: Starting in perimenopause, hormone levels, particularly estrogen, begin to decline. The relationship between hormones and the gut is truly a two-way street. As hormone levels decrease during perimenopause and beyond, they can impact the health of the gut, which in turn influences immunity, mood, metabolism, and overall resilience.

This hormonal shift can affect the gut in several ways:

• Reduced estrogen can slow gut motility, which may lead to increased gas, bloating, or constipation.

• Estrogen helps maintain gut lining integrity by supporting mucus production and tight junction proteins. As levels decline, the risk of intestinal permeability ("leaky gut") may increase.

• Estrogen also supports the growth of protective bacteria, like Lactobacillus and Bifidobacterium. When estrogen drops, microbial diversity can shift, increasing the risk of dysbiosis and susceptibility to opportunistic pathogens.

• These microbial shifts can affect the estrobolome, the collection of gut bacteria involved in estrogen metabolism. Disruption in this system can create a feedback loop that further impairs hormone clearance and balance.

• Lower levels of estrogen may contribute to systemic and gut-specific inflammation.

4. How does metabolic imbalance affect menopausal symptoms like hot flashes, mood swings, or fatigue?

A: Metabolic imbalance can absolutely make menopausal symptoms more intense. When our cells are not functioning efficiently, it can lead to low energy production and contribute to persistent fatigue. 

If blood sugar levels are unstable due to poor metabolic function, that can result in more frequent mood swings and emotional fluctuations. When inflammation is already increasing during hormonal changes, any added metabolic inflammation can worsen the overall imbalance.

These symptoms are often expected to some extent during menopause because of the natural hormone shifts, but they become much more disruptive when the body is not well supported. A system that is undernourished, inflamed, or not running efficiently will have a harder time adapting to these changes.

5. What advice would you give to women with diabetes who are going into menopause?

A: The connection between menopause and diabetes is significant and often underrecognized. During menopause, women experience a natural decline in hormones, especially estrogen and progesterone. For women with type 2 diabetes, this can further complicate how the body responds to insulin. 

My advice for women in this phase is to first acknowledge that their body is changing. The strategies that may have worked in the past to manage blood sugar might not be as effective now. This is not a setback, but a sign that the body needs a new kind of support, one that honors this transition and works with it, not against it.

This is the time to lean into a more balanced, whole-person lifestyle. From a nutrition perspective, that means building meals with purpose and consistency. Every meal should include quality protein, fiber-rich vegetables, and healthy fats, along with carbohydrates that are minimally processed and rich in nutrients. The goal is to stabilize blood sugar, support lean muscle, and reduce inflammation. This does not mean eliminating entire food groups. It means learning how to fuel the body in a way that aligns with its changing needs.

Stress management is also essential during this time. It is important to understand that stress alone can raise blood sugar, even if your food choices are spot on. This is why consistent stress support practices, such as walking, breathwork, spending time in nature, or mindful movement, are just as important as nutrition.

Exercise plays a powerful role here too. Regular strength training and movement help improve insulin sensitivity, preserve muscle, and support mental clarity. But it should feel sustainable, not punishing. The goal is to work with the body’s rhythms, not override them.

When we take a step back and look at the full picture, we see that the same qualities that support balanced blood sugar, such as consistency, steadiness, and nourishment, are the same qualities that help create balance in life.

6. What’s something you’ve learned about the relationship between menopause and diet that you believe more women should know?

A: The most important thing I want women to understand is that your body in menopause is different, and it deserves a different kind of support. As hormones like estrogen and progesterone decline, several key shifts occur that directly impact how we respond to food, stress, exercise, and recovery.

One of the most significant changes is the age-related loss of muscle mass, which accelerates during menopause. On average, women can lose up to three to eight percent of muscle mass per decade after 30, and that rate may speed up with hormonal decline. This impacts metabolism, strength, insulin sensitivity, and body composition.

At the same time, lower estrogen levels can lead to increased inflammation, changes in fat distribution, and more difficulty regulating blood sugar. This is why traditional approaches like calorie restriction or over-fasting may actually backfire during this time as they can further stress the system and slow metabolic repair.

Instead, women need to focus on nourishment over restriction. That means:

• Prioritizing high-quality protein to support lean muscle and metabolism

• Building meals that support stable blood sugar and reduce inflammation

• Using strength training to improve insulin sensitivity and preserve muscle

• Supporting mitochondrial and cellular health with nutrient-dense foods, sleep, and recovery

Menopause is not a problem to fix,  it’s a phase to adapt to with knowledge and care. And diet is one of the most powerful tools we have to build strength, stability, and vitality from the inside out.

7. Is there a way to improve symptoms from a metabolic imbalance?

A: The good news is that there are many supportive interventions that can make a difference. These may include targeted nutrition, lifestyle changes, key supplements, or hormone replacement therapy when appropriate and prescribed by a provider. Supporting both metabolic health and hormone balance can help women move through this transition with more ease and resilience.

8. Vitamin D3 and calcium are popular supplements for menopausal women. What are your thoughts on these supplements? What other supplements would you recommend for women in menopause?

A: Vitamin D and calcium are definitely important, especially for women in menopause, when bone density naturally declines. But we can’t look at nutrients in isolation. The body doesn’t work that way. 

The body needs a full spectrum of nutrients working together to function properly. These nutrients are like parts of a machine. If one is missing, the whole system can be affected.

Take calcium, for example. It is only helpful if the body knows how to use it. That is where vitamin K2 comes in. I often describe K2 as the traffic controller. It helps direct calcium to the bones, where we want it, and away from places like the arteries. Without enough K2, you might be taking calcium but not getting the full benefit.

What I really want women to understand is that it is not just about calcium or vitamin D. It is about making sure the body has the full range of nutrients it needs to support everything from bone strength and hormone balance to energy production. 

We all need all of the essential vitamins and minerals, but how much we need can vary based on things like digestion, absorption, inflammation, and genetics. That is why testing can be so helpful. It lets us stop guessing and start personalizing.

Some nutrients are simply harder to get from food in the amounts we need, especially during menopause. This is where targeted supplementation can often make sense. 

In addition to vitamin D and K2, common supplements may include magnesium, B vitamins, omega-3s, and trace minerals. That said, some women may be able to meet their needs through a varied, nutrient-dense diet.

So yes, calcium and vitamin D are important, but they are just part of the bigger picture. The body works as a whole. We need to look at all of the essential nutrients and make sure they are consistently getting into the body, whether through food or supplements.

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