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Food Fabulous

Notes from midlife

Like keto but better for perimenopausal weight gain

Full-time keto is not the best solution for women over 40. But here's what you do to get the edge keto promises and find something that is kinder to your body, and your life.

It seems you can’t pick up a magazine or newspaper or scroll through your social media newsfeed without hearing how ketogenic diets are the best approach for everything from weight loss and reversing diabetes to managing chronic diseases like cancer and epilepsy. A ketogenic diet is moderate in protein, very high in fat and very low in carbohydrates. The results can be dramatic, yet following that kind of diet can be challenging to stick to on a longer-term basis because it is incredibly restrictive. Is there a solution that combines the benefits of a keto diet with real life? I think so. Perhaps you’ve heard of a new version of this diet called the Hybrid Diet, which was unveiled last month by nutritionist and author Patrick Holford, who was one of the pioneers of the low carb diet in the UK. This diet combines periods of following a high fat ketogenic diet with longer periods of following a low GL blood sugar balancing diet, making it an approach more aligned to ‘real life’. On a personal level, while I appreciate there is a lot going for the keto diet, it can be hard on the adrenals - my view is 100% keto is not a great plan for women in peri-menopause and beyond. Instead, do this. The theory behind it is this: way back when, our bodies were used to alternating between using glucose (from carbohydrates) and fats for fuel. For some months of the year, you could fill your boots with berries, tubers and other plant-based foods (carbohydrates). In the colder months, when plants weren’t available, you would have eaten a protein and fat-based diet besides using your own body fat reserves when food was scarce. Scientists, including nutrition professionals, describe this ability to switch between these two types of fuel as being ‘fat adapted’ or ‘metabolically flexible’. And it is a good thing. The problem is this… Our bodies are so used to relying on glucose (the energy derived from carbs and sugar) as fuel that they have forgotten how to (or rather, become unaccustomed to) use fat instead. This is largely because the modern diet has gradually drifted towards being very carb heavy. Bad science in the 1950s and the subsequent anti-fat propaganda pushed diets away from healthy fats and increasingly towards filling up on bread, pasta and rice. And the food industry since then has been encouraging us to snack between meals – and often not on the ‘right’ things. One of the main issues with eating too many carbs is that this causes blood sugar levels to rise, which increases levels of insulin, and insulin is the fat storage hormone. With prolonged periods of producing too much insulin, our bodies lose their sensitivity to it, so need to produce more, which leads to weight gain and, ultimately, obesity.

Losing sensitivity to insulin (insulin resistance) is what often lurks behind many of the symptoms of perimenopause.

The ketogenic diet, on the other hand, is largely based on fat with moderate protein, and is filling and satisfying. This means no hunger, no cravings and consistent energy levels. This kind of diet forces the body into a state of ketosis, a natural activity that helps you survive when food intake is low. Ketosis triggers a natural metabolic ‘clean up’ and repair process. It can also increase sensitivity to insulin so that, when you do eat carbs, the body metabolises them better.

The downside to the keto diet in perimenopause

… is that the ketogenic diet is very strict and not always compatible with the way most of us live our lives. Cutting out carbs means more than just avoiding the bread, pasta, rice and potatoes that we think of as carbohydrates, but also other foods, including many fruits and a number of starchy vegetables and even some nuts, such as cashews. The solution? Patrick Holford argues that it is actually more desirable to teach your body how to alternate between periods of fuelling with glucose (from low GL foods) and fat. He calls this the ‘dual fuel advantage’, where your body learns to grow healthy and repair as well as learning to use carbohydrates more intelligently, and this keeps weight and energy levels balanced. The Hybrid Diet Patrick’s new book, The Hybrid Diet (£16.99, Piatkus) explains the concept and benefits of the ketogenic diet and the ‘slow carb’ low GL diet, and how you can combine them to reap the health benefits of both. He also introduces intermittent fasting (a regime of having extended periods of not eating anything) as an additional tool for weight and health management. His book guides you through an initial two weeks of a ketogenic diet, followed by alternating three weeks on a ‘slow carb’ diet and another week of keto. Sample menus and recipe ideas are provided. This equates to nine months a year with your body running on glucose and three months on fat – a very similar pattern to the one our ancestors would have had. If you have weight to lose or your energy is flagging, this approach is certainly one to look into. Making substantial changes to your diet can feel tough, particularly if your regular way of eating is very different from the regime you are embarking on. You will have questions and need solutions to have your new plan fit into your lifestyle. As a nutrition practitioner, I work with my clients, so they achieve their health goals and feel supported as they put the changes into practice. If you know your diet needs to change and you’re not sure where – or how – to start, I warmly invite you to book a free 30-minute nutrition MOT with me, by clicking HERE. During this time, you’ll have the opportunity to discuss your goals, and I will share my top tips to help you get started.


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