Do Intermittent Fasting & Keto Diets Work During Menopause?

If you’ve been subscribing to my newsletter or following me for a while, you know that I’m a big advocate of intuitive eating. My nutrition advice focuses on adding nutrient-rich foods rather than subtracting foods that someone deems “bad.” I don’t believe that there are “bad” or “good” foods. What does that even mean? Your relationship with food is a very personal one and, as such, should be tackled from your perspective, your history with food, and your likes/dislikes. NOT from a baseline of someone else’s opinion of what you should eat. They don’t know anything about you or your body; how are they supposed to know what works for you? 

That said, it is challenging to escape or ignore the constant onslaught of diet ads and promises of “new” ways that will get you the results you want. Because the ads will continue, the questions will also continue to come up, so I’ll continue to help provide awareness and education. To debunk all of the diets out there goes way beyond the scope of this blog, but I do want to address two of the most-promoted diets because they are so well-known and can backfire quite strongly: the ketogenic (keto) diet and intermittent fasting. 

A word of caution: Diets don’t work! At best, they will help you temporarily lose weight, but multiple studies have shown that “more than half of the lost weight was regained within two years, and by five years more than 80% of lost weight was regained.” Thus, the harm you will inflict by starting yet another diet far outweighs the weight loss, which is more than likely temporary. However, the possibility of weight gain is not the worst about dieting–it can also send you spiraling into disordered eating patterns and even eating disorders. You can get more information on the consequences of dieting here.

 The diet industry doesn’t care about your well-being or health.

It cares about your money!

Keto Diet

The ketogenic diet stems from a study by Dr. Russel Wilder in 1921, researching the effect of such a diet in reducing epileptic seizures in children. And it does turn out that it is highly successful for that specific population. 100 years later, this research is getting recycled into a cure-it-all weight loss phenomenon applicable to all and by all. Everyone has become an expert, and online links and recipes are never-ending. The truth is that this type of intervention can be very successful for various conditions if implemented correctly and by a medical professional, not a social media influencer! 

Here are a few facts about keto and menopause:

• You’re not adhering to an actual ketogenic diet unless your body is in a healthy state of ketosis, which can only be known if you measure your ketone levels in your blood. Anything less is a guessing game, and in this case, a guessing game leaves you with a low-carb diet, not a ketogenic diet. 
• It takes several days to get into ketosis. It’s not something you do during the week and take a break from on your “cheat days.” 
• Studies show that low-carb-high-fat diets are not better for losing body fat. This is because, during menopause, your body becomes more insulin sensitive (aka carb-sensitive.) What does this mean? Estrogen and progesterone play a role in how the body processes insulin, so when they both decline, the way the body processes insulin changes, increasing the risk for diabetes. That's why emphasizing the right type of carbohydrates (low-glycemic and high in fiber), not the elimination of carbs, becomes so important. 
• According to Dr. Stacy Sims, a leading researcher in the field of female physiology and nutrition, “When women have low carbohydrate, the body reverts back to the evolutionary perspective, where women had to take care of the kids or the tribe, and it was not advantageous for her to be reproductive or require more food.” It leaves you with: 
• Menstrual cycle, endocrine, and thyroid dysfunction
• More body fat because it sees the restriction as fuel conservation
• You might lose weight in the short run, but with all restrictive diets, the results will plateau, and as soon as they do, chances are you will quit. Research shows that most people gain all the weight plus additional weight after stopping a restrictive diet. 

Intermittent Fasting (IF)

Intermittent fasting is any type of eating plan that makes you go for prolonged periods without eating. There are tons of ways to do it - some do it for certain hours each day (not eating until lunch or dinner, not eating between A and C, etc.) and others for days (1 day off 2 days on, 7 days only drinking water, etc.) 

As with the ketogenic diet, evidence suggests that IF can be very successful for many conditions when done correctly and for specific people. However, as with keto, IF does not have the same positive results in women, especially those going through menopause. 

If you’re interested in the nerdy information on why, here’s a short explanation: IF impacts kisspeptin, a neuropeptide that plays a crucial role in energy intake regulation. A reduction in kisspeptin can increase hunger and influence the production of a hormone called gonadotropin-releasing hormone (GnRH), which is significant to the production of sex hormones. GnRH release happens in specific spurts; timing can be thrown off by fasting, which leads to an impact on estrogen production. It appears that even short-term fasting can throw off this delicate process.

One critical factor of discussion and ongoing research is that we have to consider that the success of diets such as IF and Keto might be attributed to people eating fewer calories rather than the elimination of specific foods or specific times to eat or not to eat. My recommendation regarding food and nutrition is to focus on adding rather than subtracting, and you can read more about this and get some tips here. I’ve also created an entire series called the Menopause Menu dedicated to exploring foods that you can easily assimilate into your diet. 

Note: this is not medical advice, just conclusions based on my scientific and scholarly research.