Few subjects are as misunderstood as women, food and hormones. Like so many women, I lost the ability to manage my weight easily in my 30s. Looking back, this was probably caused by a combination of toxic stress, the demands of motherhood and getting older.
But the experience inspired me to shift my career as a doctor from gynaecology to precision medicine, specialising in hormones. As a result, over the past 15 years I’ve been able to help so many women who came to me feeling overtired, cranky, frazzled and — inevitably — lamenting the extra pounds they had put on, despite their best efforts to exercise and eat correctly.
More often than not, these issues start when women enter midlife. Those holiday pounds become harder to shed. The diets you turned to in the past just don’t seem to deliver results any more.
Even more disheartening, diets that work for the men in your life don’t seem to have the same effect for you.
Dr Sara Gottfried (pictured) has devised a new hormone-focused diet, specially for midlife women, that promises to shift excess pounds
You may be surprised to learn that the solution cannot be found by counting calories or clocking up miles on the treadmill. It lies, instead, in understanding female hormones.
After years of research, I have devised a new hormone-focused diet, tailored specially for midlife women, that promises not only to shift those excess pounds but to allow you finally to feel like yourself again.
Why do women get middle-age spread?
Your metabolism is the sum of all the biochemical reactions in your body, including those related to hormones, which dictate how you feel and determine how fast or slow you burn calories.
And as we get older, the whole process slows down.
Metabolic hormones are involved in thousands of micro-communications and processes in the body. They include the hormones involved in satiety (leptin, insulin); hunger (ghrelin, cortisol); female qualities (oestrogen); more masculine qualities (testosterone, which controls vitality and muscle mass); and fat-burning (insulin, growth hormone and cortisol).
Weight can start to pile on because levels of many hormones naturally start to fall in our 20s (testosterone, DHEA), 30s (growth hormone, progesterone) and 40s/50s (oestrogen). At the same time, other key metabolic hormones — insulin and leptin (and its cousin ghrelin, the hunger hormone) — can rise.
Together and individually, these hormones govern our response to food. But the relationship is a two-way one: food regulates those metabolic hormones, too.
The key lies in eating the right foods in the right way to support metabolic-boosting hormones, and avoiding foods and lifestyle habits that slow your metabolism and contribute to premature ageing.
Losing fat after the age of 35 is not about discipline so much as what to eat, when to eat it, and how your food talks to your hormones.
Dr Sara Gottfried (pictured) said focusing on your hormones can help to improve metabolism, lose fat and maintain healthy body weight by burning rather than storing fat
Our hormones rule our bodies, dictating how we think, feel and look. And while I can’t turn back the clock to give you the hormones you had in your early 20s (and the fast metabolism that came with them), the good news is there are science-based guidelines to bring key hormones back into balance.
I have discovered that when you focus on your hormones, you can improve metabolism, lose fat and finally maintain a healthy body weight by burning rather than storing fat. At the same time, you can resolve nagging, unpleasant symptoms such as fatigue, cravings, moodiness, insomnia and a weak immune system.
We now know what works to resolve hormone imbalances, especially in women over the age of 35. The key is to begin with your diet, because what you eat is the backbone of every hormone you make.
Don’t diet like a man
Treat yourself to a sauna
Growth hormone helps to maintain body fat, lean muscle mass, bone, tendons and brain function. It decreases in midlife women — but studies have shown that a 30 to 60-minute sauna raises growth hormone by up to 140 per cent after one session.
I am convinced many diet plans fail because they are designed by men for men, and not for women’s complex hormonal needs.
For instance, the science shows that ketogenic diets (low in carbohydrates, high in fats) work better for men than for women. We are not totally sure why women respond differently, but hormones play a primary role.
There is the fact that women are twice as likely as men to suffer from stress, anxiety and depression. Women more commonly experience thyroid problems and autoimmune issues. Women’s bodies don’t always respond as well to carbohydrate restriction and calorie restriction.
So hormones dictate your success (or not) on any diet. You won’t see the results you want if you don’t factor hormones into the equation.
For instance, a ketogenic diet may not provide enough carbohydrates for midlife women. Carbs help to mitigate the stress response, lower cortisol, boost growth hormone and support thyroid function.
Furthermore, oestrogen levels can get out of balance in women who eat what I call a ‘lazy keto’ diet, such as fast-food burgers wrapped in lettuce with bacon on top, and forget to eat sufficient vegetables to feed good microbes in the gut.
A healthy oestrogen balance relies on a healthy ecosystem of microbes. But eating lots of animal products (meat and cheese) while skimping on vegetables risks a rise in the levels of misbehaving members of the oestrogen family.
Dr Sara Gottfried (pictured) said eating moderate amounts of protein can help to jump-start growth hormone, testosterone and other metabolic hormones
That is why I have devised my own plan, which I call The Gottfried Protocol, designed to sidestep this ‘keto paradox’ with a programme that is tailor-made for a woman’s body.
My diet includes a detox component (avoid dietary toxins and prioritise naturally low-carb vegetables that assist with detoxification, such as leafy greens, brassicas, asparagus, peppers, onions, garlic, aubergine, cucumber, celery, courgette, radishes and mushrooms); a modified carb count (quality carbs); healthy fats; protein; and an element of intermittent fasting.
It’s not just men who need testosterone. Women often struggle when this metabolismboosting hormone drops
In my experience with patients, this contributes to healthy gut function, improved hormones and significant fat loss. Plus, you won’t feel hungry — honestly!
A DIET TAILOR-MADE FOR WOMEN
The Gottfried protocol rules are:
Eat healthy protein
You need moderate amounts of protein to help jump-start growth hormone, testosterone and other metabolic hormones.
Sources of this protein are grass-fed beef (from pasture-fed cows that are never fattened with grain, which increases inflammation); oily fish (salmon, mackerel, anchovies, sardines and herring); whey protein shakes; eggs; and chicken.
kale and avocado shake
Dr Sara recommends a kale and avocado shake after fasting
This is my favourite go-to shake most mornings after a 14-hour fast.
- 175-225ml filtered water
- 35-70g kale, spinach or mixed greens
- ¼ of an avocado
- 1-3 tsp flaxseed
- 1-3 tsp soaked chia seeds (or other nuts or seeds)
- ½ – 1 tablespoon medium-chain triglyceride (MCT) oil or avocado oil, nut butters or cacao nibs
- 1-2 scoops fibre such as spirulina, dark cacao powder or cinnamon
- 6 ice cubes
METHOD: Combine ingredients and blitz in a blender.
Eat healthy fats
If you have increased belly fat and insulin and blood sugar problems — which are a common driver of weight gain, inflammation and even breast cancer — then your body may be producing more of the types of fat that make you inflamed and resistant to weight loss.
You can redress that balance by eating healthy omega 3-rich fats found in flaxseed and oily fish, adding medium-chain triglyceride (MCT) oil [sold at Holland & Barrett and Ocado as coconut oil] and chia seeds to your smoothies, and macadamia nuts and avocado oil to your salad. This will help you to feel full, slowing down the spikes in blood sugar that can make you accumulate fat, helping your body to be more sensitive to insulin and keeping the fat-burning switch in the ‘on’ position.
Up your fibre
Overall, a ketogenic diet may be an easier path to weight loss because it helps you feel more satisfied than calorie-restricted diets do. Getting your body to flip the switch from burning carbohydrates to burning fat offers fascinating health benefits: improved mental focus, better memory and attention, less inflammation and weight loss.
I find that a temporarily restrictive approach to carbohydrates, starting with 35 g to 50 g per day, is most effective.
However, for this plan to work for women, it is important that you get your carbs from the best possible sources. I recommend avoiding all sugar and refined carbohydrates.
You could use your daily carb ‘allowance’ on a small pancake, a small portion of cooked pasta or rice, or a slice of bread. But I recommend you enjoy it as salad and vegetables.
A total of 30 g of vegetable carbohydrates translates to a huge plate piled high with broccoli or cauliflower. This ensures that you get the fibre you need to beat your fat hormones and improve weight loss.
Women need to eat more fibre and non-starchy vegetables than men in order to keep them regular — and women need to go to the loo daily to detoxify and reset their hormones.
The 14:10 fast
The best way to wrangle with those fat-storing hormones (such as cortisol, insulin and leptin) which have been running the show is by introducing intermittent fasting into the mix.
Studies show that intermittent fasting is particularly effective at stimulating the fat-burning benefit of growth hormones.
Dr Sara Gottfried (pictured) said exercising to the point of sweating three times a week, can help you excrete toxins
That is why I recommend a 14:10 protocol (14 hours of overnight fasting, and ten hours for your eating window)
If you start eating several hours after the sun rises (ideally after exercising on an empty stomach) and stop eating a few hours before the sun sets, you will be working with and not against how the human body, male and female, evolved to eat.
This means your body will be more aligned with the release of nearly every hormone you produce. Your efforts will be rewarded with optimal levels of insulin and growth hormone (and other hormones), fat loss, increased energy and stamina, and other health benefits.
Exercise three times a week
The more strenuous it can be, the better. Exercise to the point of sweating, which will help you excrete toxins.
I am obsessed with this combination: two-thirds lifting with heavy weights, even at home; and one third cardio — for example, running, cycling or swimming.
Say no to wine (and other alcohol)
Sorry, but if your hormone levels are out of balance, alcohol makes things worse. So it’s a good idea to abstain from drinking while you’re on this plan.
Think of alcohol as liquid sugar — it goes directly to the liver and can be converted into fat. It will clog your liver, hinder detoxification and make you puffy and resistant to weight loss.
Check if your Testosterone levels are falling, and how to remedy this
One reason why many women struggle to lose weight during the menopause is because this is when your testosterone levels fall precipitously. It’s not just men who need testosterone — it is now recognised as a multi-tasking hormone in women, keeping metabolism strong and reviving flagging libidos. Are your levels low? Take the quiz:
Have you had any of the following symptoms in the past six months?
- Is your body hair thinning, particularly under your arms and in the pubic area?
- Do you notice signs of premature hair loss, at the temples (sides of the forehead)?
- Has your interest in physical activity been fading recently?
- Have you experienced intense emotional stress as an adult?
- Are you a long-distance runner or do you do other regular endurance exercise?
- Has your sex drive declined gradually since your 20s?
- Does it take longer for you to reach orgasm?
- Is intercourse painful or irritating?
- Do you feel more passive or less likely to take risks in daily life?
- Do you feel more sensitive to difficulties, as if your resistance to stress is diminished?
- Do you tend to cling to a negative point of view?
- Are your muscles reduced in volume, tone and strength?
- Have you noticed more cellulite and/or varicose veins?
- Is your skin thin, dry and/or easily sunburned?
- Do you have more joint pain, particularly lower back pain?
- Do you have dry eyes?
- Have you lost height? Become more ‘hunched over’ with your posture?
- Is your body scent less?
- Has fat accumulated at the breasts, waist and/or hips?
If you answered yes to five or more questions, you may have low testosterone. But you can raise your levels naturally with lifestyle changes.
Foods that lower testosterone in women
- Bread, both the refined and wholegrain versions.
- Pastries, and all foods made with flour.
- Sugary and diet drinks.
- Coffee (caffeinated or not).
- Dairy products.
- Any foods with a lot of sugar.
- Restaurant food.
Foods to help raise testosterone
- Home-made food.
- Dark green vegetables.
- Sufficient protein (about 0.75g to 1g per pound of lean body mass: less if you are sedentary; more if you are active). HIIT (high-intensity interval training) exercise will also raise testosterone.
Adapted by LOUISE ATKINSON from Women, Food And Hormones, by Dr Sara Gottfried (Little, Brown, £14.99), out now. © Sarah Gottfried 2021. To order a copy for £13.49 (offer valid to November 1, 2021; UK p&p free on orders over £20), go to mailshop.co.uk/books or call 020 3176 2937.