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EventsMenopause making keto difficult
, medical review by Dr. Bret Scher, MD
in Diet Doctor community, Weight loss 
Our Diet Doctor Facebook group is a forum for our members (free trial available), where you can discuss all things keto or low carb.
What are some hot topics among our members? This is what trended in The Diet Doctor Facebook group last week:
Menopause making keto difficult
Menopause is a topic which is brought up frequently in the Diet Doctor Facebook group. Specifically, many members express how menopause seems to negatively impact their results on keto, or how it makes following the diet more challenging.
Since we know that significant hormonal changes take place during menopause, it’s perhaps not so surprising that many women put on weight, or find that things don’t work like they used to. Keto sometimes helps, but not in every case.
So what’s our advice for menopausal women who struggle with keto? Anne Mullens compiled a list of the top ten tips in her much-read guide on the topic. They are as follows:
- Don’t eat too much protein (keep in the range of 1.2-1.7g/kg/day)
- Don’t eat too much fat (eat to satiety but not more!)
- Try intermittent fasting or time restricted eating
- Watch out for carb creep (consuming more carbs than you realize)
- Cut out alcohol
- Avoid artificial sweeteners
- Begin weight training
- Get enough sleep
- Reduce stress
- Be realistic about how much weight you need to lose and the time it might take
Check out the full guide for a deeper explanation:
Top 10 tips to lose weight for women 40+
Many women in menopause find that along with other symptoms like hot flashes, night sweats and sleep problems, their abdomens thicken and their weight increases.
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You have likely plateaued and will need to further reduce your fat intake to continue losing body fat. Aim for 100g fat and see how you go. When you plateau again, aim for 60g of fat, but don't go any lower.
Must peoples weight loss diets fail because they are low protein, low in fibre from vegetables and likely low in fluids.
Geting protein and fluid intake right, eating intuitively/to satiety and questioning hunger/fasting are valid ways to help create the energy deficit required for fat loss. But fat loss is possible via other diet types as has been shown in the scientific literature time and again (Mediterranean, Vegan, Low Fat etc etc).
Don’t eat too much fat?
So eat what then? DUST???
60g/day of fats is sufficient for hormone production, immune function etc (especially if there is body fat to lose).
20g net carbohydrate of doing keto.
I'd rather not rely to much on any of those numbers, but try to find out what my body really asks for.
I tried to lower my protein intake, but my body responded with more hunger and less strength.
So I returned to the higher protein intake again and those effects disappeared.
Muscle strength and endurance is invaluable in my big garden, whether I operate the brush cutter, the chainsaw or the big manual tools.
What works well however is not to eat anything before late afternoon and not after ten in the evening on most days.
I think you’re spot on. I have had to learn to learn ME first. I’ve had such a difficult time losing weight on keto. I totally believe it can work but I haven’t yet figured out what combo of fat and protein do it for me.
I will be 62 in a few months and I’ve been overweight most of my like. I’ve dieted over and over and over and over again. You want to talk about frustration? Sometimes I think just the stress of thinking and thinking about losing weight is raising my cortisol levels. But I will persevere until I nail it. I would like to lose 50 pounds. I see so many succeeding with keto. People who lose more than twice of what I want to lose. I’m hoping with this forum, I can learn what will work for me. I’m nobody special, but I do know that we all lose differently. I just need to tweak it out for me. I hope my thought process is right.
Keto without iF and a few long term fasts did not work well for me for weight loss. I had lot to lose (95 lbs or so) but after the initial month so of loss, I stalled. and stayed stalled and my other metrics continued to improve a bit - but not the weight. IF and a 5 day fast every few months makes a big difference in my life. but when IFing , I DON'T calorie restrict. ON some of my eating days I hit even hit 3 K. a bit excessive but it happens. macadamia nuts usually. no one can eat just one. But my average for the past few weeks has been 13, 900 per week even though I only eat 4 or maybe 5 days a week and usually only 2 meals a day on those days. and I still lose. .
I agree though that the sleep disorder is real and hard on the body. during bad sleep weeks, I don't feel well or lose weight and I tend to retain fluid. I would love to have the longer /better sleep I had a few decades ago. I was an awesome sleeper :) 9 hours a night with no issues . I'm sure my leptin/ghrelin/coritsol/insulin/serotonin/ gaba /melatoin and and all my other hormones were much better balanced then.
Just seems to highlight no matter how 'advanced' we think we are medically, we really know very little about the complexities and interactions of hormones within the body.
Keep fighting Ladies!
As the author of the article I want to clarify a few things. First, do read the article, and not just the short-form tips of this post. The tips are all in context in the main article . If you read it, I think Annalise and others who say "not too much fat, not too much protein, what dust?" will then understand. It is all about finding the right balance for you and your body that has you not be hungry between meals, but not gorging on too much fat or protein, either.
We always stress at Diet Doctor that you don't need to count calories. But that does not mean that excess energy doesn't matter. If you are eating too much fat or protein for your body's needs you will burn that first and you won't access the energy in your fat stores.
But, do not starve yourself! This is not a deprivation diet. That is what we mean by eat enough fat to satiety (at meals!). We describe eating one egg in the morning, waiting 20 minutes, and then eating the second egg if you are still hungry. EAt when hungry, stop when full. But keto and low carb are not a licence to eat without limits and snack throughout the day.
Many women, after years of dieting, have a really hard time with understanding hunger cues. Plus, during menopause, our metabolism slows and we may be eating more than we require. We cannot tell you precise measures, as everyone is different, so you have to figure that out for yourself by noting your own cues like whether you are hungry between meals, whether you still have cravings. whether your energy flags at certain times of day. Also measure your blood glucose and ketones.
As Dr. Naiman suggests in the article, prime with fat until you are fully fat-adapted (insulin is low and you are accessing your fat stores) then pull back on the fat you consume, such as stopping fat bombs and bullet proof coffee. But still add enough fat to your meals to keep you satisfied and help you go between meals with no need to snack.
And, if you add in intermittent fasting from time-to-time, weight lifting to help you maintain and build muscle you will up your energy needs (and burn your fat stores.) Also watch sleep and stress, and be careful with alcohol -- as these too can interfere with weight loss.
Read all the comments below the main article - lots of good tips and experience. It is much harder for women in menopause. But these tips works. In fact Samantha, the woman we profiled, eventually lost 17 pounds by paying close attention to those tips we gave her (after gaining weight on keto). She figured out how the tips applied best to her own situation.
I hope that clarification helps. Anne Mullens, Diet Doctor writer and editor
I'm sorry Rachel! Here's a good link for losing weight when 40+. You may not be eating enough!
https://www.dietdoctor.com/top-tips-lose-weight-low-carb-women-40
We have a new 10 week weight loss course you may be interested in as well.
https://www.dietdoctor.com/how-to-lose-weight/10-weeks
You may wish to check with your doctor to see if your hormones are within the normal range now as they could be affecting your hunger levels. You can also always go back to basics and go through our free two week challenge at any time.
https://www.dietdoctor.com/low-carb/get-started
I was surprised how quickly my body adjusted to IF. I usually keep my eating window from 11-7, so I can still go out to dinner or brunch, but the window is tweakable. On the weekends I exercise during the window. Otherwise I usually walk before the window, and strength train right after the window. I no longer experience hangry-ness or bouts of intense carb cravings. My sweet tooth is disappearing too. Sleep is the one thing I still really can’t control, but it’s no different than before my diet started. Definitely not worse.
I'm concerned about the elevated resting heart rate/palpitations and ask if the LCHF contributes/or is a results of it?
Or is the increased resting rate symptomatic of menopause.
It may be as simple as dehydration or a lack of sodium. This article is helpful. If it doesn't alleviate the symptoms, you may wish to check in with your doctor.
https://www.dietdoctor.com/low-carb/side-effects#palpitations
Hang in there, Chynah! This article may be helpful for you.
https://www.dietdoctor.com/top-tips-lose-weight-low-carb-women-40
You can try incorporating one of our more moderate low carb dinner recipes if you'd like to experiment with higher carbs at dinner.
https://www.dietdoctor.com/low-carb/recipes/meals
For that weight, it would be approximately 5-6 oz per meal (if eating 3 meals a day).
Our protein guide may be helpful for you! https://www.dietdoctor.com/food-policy/protein
You would need to multiply by 4 to figure out the amount of beef, about 12 oz in this case.
Does that sound better?
You may view our full recommendations for protein here: https://www.dietdoctor.com/low-carb/protein and our recommendations for fat here: https://www.dietdoctor.com/low-carb/how-much-fat
Keto isn't necessarily a low-fiber diet. This article may be helpful! https://www.dietdoctor.com/a-low-carb-diet-does-not-mean-a-low-fiber-...
The first suggestion is to limit protein to 1.2-1.7g/kg/day. For a female of 5'3", that could be as much as 103 grams of protein a day. The second suggestion is to eat fat to satiety, but not beyond. That is to eat fat until you are satisfied, but not overly full. There is nothing in these suggestions about staying hungry. Good sleep and movement are beneficial to most people.