Discover the Surprising Benefits and Hidden Risks of the Keto Diet for Women Over 40!

Finding yourself confused by the seemingly endless promotion of weight-loss strategies and diet plans? The ketogenic or “keto” diet is a low-carbohydrate, fat-rich eating plan that has gained considerable attention as a potential weight-loss strategy. But, as with much of the medical world, most of the research has been conducted on men. There's no way for me to tell you exactly how you will respond to the keto diet because we all have different genetics, ages, stress levels, sleep, and activity levels. This article explores the keto diet specifically for women over 40, examining its potential benefits and risks, and providing guidance on how to approach this diet safely and effectively.

What is the Keto Diet?

The ketogenic diet is a very low carb, high fat diet that shares many similarities with the Atkins and low carb diets. In the 19th century, the ketogenic diet was commonly used to help control diabetes. In 1920 it was introduced as an effective treatment for epilepsy in children in whom medication was ineffective. Today, other low-carb diets including the Paleo, South Beach, and Dukan diets are all high in protein but moderate in fat. The premise of the ketogenic diet for weight loss is that if you deprive the body of glucose-the main source of energy for all cells in the body, which is obtained by eating carbohydrate foods-an alternative fuel called ketones is produced from stored fat (thus, the term “keto”-genic). It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis. When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain.

Generally, popular ketogenic resources suggest an average of 70-80% fat from total daily calories, 5-10% carbohydrate, and 10-20% protein. For a 2000-calorie diet, this translates to about 165 grams fat, 40 grams carbohydrate, and 75 grams protein.

How the Keto Diet Works

The keto diet aims to force your body into using a different type of fuel. Burning fat seems like an ideal way to lose pounds. The keto diet limits carbohydrates, forcing your body to burn fat for fuel instead. When these stores are full, they are converted into fat. In this state, your body breaks down fats into molecules called ketones. Ketones serve as an alternative fuel source.

The brain demands the most glucose in a steady supply, about 120 grams daily, because it cannot store glucose. During fasting, or when very little carbohydrate is eaten, the body first pulls stored glucose from the liver and temporarily breaks down muscle to release glucose. If this continues for 3-4 days and stored glucose is fully depleted, blood levels of a hormone called insulin decrease, and the body begins to use fat as its primary fuel. The liver produces ketone bodies from fat, which can be used in the absence of glucose. When ketone bodies accumulate in the blood, this is called ketosis. Healthy individuals naturally experience mild ketosis during periods of fasting (e.g., sleeping overnight) and very strenuous exercise. Proponents of the ketogenic diet state that if the diet is carefully followed, blood levels of ketones should not reach a harmful level (known as “ketoacidosis”) as the brain will use ketones for fuel, and healthy individuals will typically produce enough insulin to prevent excessive ketones from forming.

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Foods to Eat and Avoid on Keto

Many versions of ketogenic diets exist, but all ban carb-rich foods. Some of these foods may be obvious: starches from both refined and whole grains like breads, cereals, pasta, rice, and cookies; potatoes, corn, and other starchy vegetables; and fruit juices. Some that may not be so obvious are beans, legumes, and most fruits.

Most ketogenic plans allow foods high in saturated fat, such as fatty cuts of meat, processed meats, lard, and butter, as well as sources of unsaturated fats, such as nuts, seeds, avocados, plant oils, and oily fish. Strong emphasis on fats at each meal and snack to meet the high-fat requirement. Some dairy foods may be allowed. Although dairy can be a significant source of fat, some are high in natural lactose sugar such as cream, ice cream, and full-fat milk so they are restricted. Protein stays moderate. Certain fruits in small portions like berries. Fruits other than from the allowed list, unless factored into designated carbohydrate restriction.

Foods to Avoid:

Sugary foods: soda, fruit juice, smoothies, cake, ice cream, candy, etc.
Grains or starches: wheat-based products, rice, pasta, cereal, etc.
Fruit: all fruit, except small portions of berries or strawberries
Beans or legumes: peas, kidney beans, lentils, chickpeas, etc.
Root vegetables and tubers: potatoes, sweet potatoes, carrots, parsnips, etc.
Low fat or diet products: low fat mayonnaise, salad dressings, and condiments
Some condiments or sauces: barbecue sauce, honey mustard, teriyaki sauce, ketchup, etc.
Unhealthy fats: processed vegetable oils, mayonnaise, etc.
Alcohol: beer, wine, liquor, mixed drinks
Sugar-free diet foods: sugar-free candies, syrups, puddings, sweeteners, desserts, etc.

Foods to Eat:

Meat: red meat, steak, ham, sausage, bacon, chicken, and turkey
Fatty fish: salmon, trout, tuna, and mackerel
Eggs: pastured or omega-3 whole eggs
Butter and cream: grass-fed butter and heavy cream
Cheese: unprocessed cheeses like cheddar, goat, cream, blue, or mozzarella
Nuts and seeds: almonds, walnuts, flaxseeds, pumpkin seeds, chia seeds, etc.
Healthy oils: extra virgin olive oil, and avocado oil
Avocados: whole avocados or freshly made guacamole
Low carb veggies: green veggies, tomatoes, onions, peppers, etc.
Condiments: salt, pepper, herbs, and spices

Potential Benefits of Keto for Women Over 40

The ketogenic diet has been shown to produce beneficial metabolic changes in the short-term. The keto diet reduces total carb intake to less than 50 grams a day. Along with weight loss, health parameters associated with carrying excess weight have improved, such as insulin resistance, high blood pressure, and elevated cholesterol and triglycerides. There is also growing interest in the use of low-carbohydrate diets, including the ketogenic diet, for type 2 diabetes.

Weight Loss: A meta-analysis of 13 randomized controlled trials following overweight and obese participants for 1-2 years on either low-fat diets or very-low-carbohydrate ketogenic diets found that the ketogenic diet produced a small but significantly greater reduction in weight, triglycerides, and blood pressure, and a greater increase in HDL and LDL cholesterol compared with the low-fat diet at one year. A study of 39 obese adults placed on a ketogenic very low-calorie diet for 8 weeks found a mean loss of 13% of their starting weight and significant reductions in fat mass, insulin levels, blood pressure, and waist and hip circumferences.
Appetite Suppression: A systematic review of 26 short-term intervention trials evaluated the appetites of overweight and obese individuals on either a very low calorie or ketogenic diet using a standardized and validated appetite scale. Despite losing a significant amount of weight on both diets, participants reported less hunger and a reduced desire to eat compared with baseline measures.
Improved Insulin Sensitivity: The ketogenic diet can boost insulin sensitivity and cause fat loss, leading to significant health benefits for people with type 2 diabetes or prediabetes.
Other Health Benefits: Studies have now shown that the diet can have benefits for a wide variety of different health conditions: Heart disease. The ketogenic diet can help improve risk factors like body fat, HDL (good) cholesterol levels, blood pressure, and blood sugar. Cancer. The diet is currently being explored as an additional treatment for cancer, because it may help slow tumor growth. Alzheimer’s disease. The keto diet may help reduce symptoms of Alzheimer’s disease and slow its progression. Epilepsy. Research has shown that the ketogenic diet can cause significant reductions in seizures in epileptic children. Parkinson’s disease. Although more research is needed, one study found that the diet helped improve symptoms of Parkinson’s disease. Polycystic ovary syndrome. The ketogenic diet can help reduce insulin levels, which may play a key role in polycystic ovary syndrome. Brain injuries. Some research suggests that the diet could improve outcomes of traumatic brain injuries.

Potential Risks and Considerations for Women Over 40

Following a very high-fat diet may be challenging to maintain. Some negative side effects of a long-term ketogenic diet have been suggested, including increased risk of kidney stones and osteoporosis, and increased blood levels of uric acid (a risk factor for gout). Possible nutrient deficiencies may arise if a variety of recommended foods on the ketogenic diet are not included.

Nutrient Deficiencies: It is important to not solely focus on eating high-fat foods, but to include a daily variety of the allowed meats, fish, vegetables, fruits, nuts, and seeds to ensure adequate intakes of fiber, B vitamins, and minerals (iron, magnesium, zinc)-nutrients typically found in foods like whole grains that are restricted from the diet.
Elevated Cholesterol: If you have a history of high cholesterol or heart disease, keto may not be the best choice. Some research does suggest that keto could increase total and LDL (bad) cholesterol, while other studies suggest that it could help increase HDL (good) cholesterol. The differences are likely related to the type of fat in the diet (saturated fat from animals versus fats from plants like olive oil).
Hormonal Imbalance: Since keto can increase your body's hardwired stress response, it can increase cortisol, your primary stress hormone. More cortisol makes it harder to lose weight, which is why I'm not surprised when I hear from women wondering why their male partner or friend had no trouble losing weight on keto, but they in turn gained weight. Sometimes this happens from eating too many calories, but it can also indicate elevated stress hormones.
Menstrual Cycle Irregularities: Since keto impacts your hormones, your menstrual cycle could also be negatively affected. Will this happen to every woman who follows keto? Not necessarily. Some women notice benefits to their cycle from keto, including improved PMS symptoms. So it really depends on your individual response.
Fertility Issues: If your hormones are thrown off, keto could impact fertility and make it more challenging to get pregnant. A review found that low carb and keto diets, with or without calorie deficits, improved the chance of pregnancy for women with PCOS.
Kidney Problems: The kidneys help metabolize protein, and McManus says the keto diet may overload them.
The "Keto Flu": At the start of the diet, people often exhibit symptoms that can be similar to those of menopause. Known as the “keto flu,” this can include headaches, fatigue, sleep problems, and heart palpitations.
Heart disease: Heart disease is a serious issue for midlife women, since once women pass into menopause, they lose the heart protection that estrogen provides. That’s why a keto diet that allows eaters to consume high amounts of saturated fat seems especially dangerous for midlife women, Taub-Dix says.
Constipation: And because of its lack of fiber, many people on keto suffer from constipation.

Keto and Menopause

Perimenopause and menopause may be good times to consider going keto. Some women feel better cycling keto, where they follow a traditional keto diet pattern most of the week but choose one or two days to increase carbs.

Tips for Women Over 40 Considering Keto

Consult with Healthcare Professionals: It is recommended to consult with one’s physician and a dietitian to closely monitor any biochemical changes after starting the regimen, and to create a meal plan that is tailored to one’s existing health conditions and to prevent nutritional deficiencies or other health complications.
Prioritize Plant-Based Fats and Fiber: Prioritizing plants, including fiber-rich veggies and plant-based fats like avocado, olive oil, nuts, and seeds, is vital for healthy hormone balance for all diets, not just keto.
Monitor your body: Pay attention to your body beyond the scale. How's your energy, mood, and sleep? Are you hyper-focused on your diet and can't think about anything else? Check your menstrual cycle (which we will discuss below). In other words, it's vital that you think about your personal reasons and have ways to gauge your response to the keto diet. Every woman will respond differently to the keto diet, so the best way to understand whether keto is right for you is to pay attention to how your body feels if you try it.
Consider Cycling Keto: Some women feel better cycling keto, where they follow a traditional keto diet pattern most of the week but choose one or two days to increase carbs.
Start Slowly: To minimize this, you can try a regular low carb diet for the first few weeks. This may teach your body to burn more fat before you completely eliminate carbs.
Hydrate: Some people also experience dehydration on the keto diet because they’re eliminating glycogen, which holds water, from the bloodstream.
Consider Intermittent Fasting: Intermittent fasting is an approach that allows you to receive the benefits of ketosis while still eating a varied and balanced diet, says Dr. Ring. By cycling between periods of eating and fasting, your body enters “mild ketosis” during the fasting phase. “Unlike the keto diet, which requires strict food restrictions, intermittent fasting lets you enjoy a variety of nutrient-dense foods, such as fruits, vegetables, whole grains and legumes, during eating windows,” Dr. Ring explains.

Alternatives to Keto

A modified carbohydrate diet following the Healthy Eating Plate model may produce adequate health benefits and weight reduction in the general population.

Dr. Cheema advocates making small changes based on your health goals. “People tend to burn out on those big goals and challenges, and then they go back into their own habits,” he explains.

Taub-Dix and many nutritionists prefer the Mediterranean diet.

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