Chapter 4

Getting Started

Yes, it is time to get started. And remember, it doesn’t have to be done perfectly; there is no failure here. It is about taking your next right step, one at a time, and just that positive action leads you to success. You now understand the role of your hormones in how badly you’ve been feeling and why you are experiencing peri- or postmenopausal symptoms. You also now see how the combination of ketogenic eating and alkalinizing your body greatly helps reduce those symptoms. In other words, you’re ready to go!

It’s now time to fix your hormones, ease those symptoms, lose weight, control your insatiable cravings, feel more energetic, improve your digestion, and more. To do that, you’ll kick things off with the 10-Day Keto-Green Quick Start Detox. The feeling of empowerment that comes from fixing your hormones is just ten days away.

I’ve taken thousands of women through this ten-day process (followed by the twenty-one-day Keto-Green eating plan in Chapter 6) with wonderful outcomes. Their self-assessment questionnaires and lab results reveal the positive health changes behind their feelings: lower inflammation, improved adrenal gland functioning, normalized progesterone, better blood glucose control, and more. As a result, I often hear, “I haven’t felt this good in decades!” Or “I don’t even remember ever feeling this good!” And “I actually like myself again!”

I remember one woman, eighty-two-year-old Cheryl. She lived in a house beside a pond and had a rowboat in her backyard that she had not used in seven years. After doing the ten-day plan, Cheryl put that boat in the water and started rowing like crazy. Amazing! Her success and the successes of my other patients can be yours too—once you do the ten-day Quick Start.

Detoxifying Your Hormones

This Quick Start is a detox plan. I know that many people hear “detoxify” or “detoxification” and immediately think of a drug or alcohol detox, or even a regimen of water and juices. My plan is none of these. On the contrary, it involves delicious foods and smoothies—five days of an alkalinizing and cleansing diet, followed by five more days in which you induce fat-burning ketosis while continuing to stay alkaline. So over the next ten days, you’ll give your body a break—a real rest and reset that will build the solid foundation for disease prevention for the rest of your life.

Detoxification is vital. On a daily basis, you are exposed to chemicals and toxins of all kinds, and it is high time to clean these out. Many of these toxins have been disrupting your natural hormone balance for decades. They enter your body through pesticides, herbicides, plastics, food, water, skin care products, direct exposure, and air. Once there, they mimic hormones such as estrogen, causing a disruption in your natural hormonal balance by affecting hormone communication and signaling.

This toxic assault taxes your liver and kidneys, both of which try desperately to break down these toxins and get them out of the body. But it’s tough. Toxins do a lot of damage fairly quickly. For one thing, they significantly affect the trillions of healthy bacteria in the gut (the microbiome), which should be working to metabolize nutrients, make vitamins, and especially detoxify harmful forms of estrogen that you are exposed to from the metabolism of our own estrogens or from the environment. Toxic forms of estrogen can increase our risk of breast cancer, endometriosis, infertility, and autoimmune diseases. When you’ve been subjected to this stew of toxic chemicals and hormone disruptors, you often have severe problems with digestion, metabolism, and inflammation. Other manifestations of toxic exposure include worsening PMS symptoms, early symptoms of approaching menopause (such as hot flashes and mood swings), a tougher transition through menopause, and greater odds of hormone-related cancers. These toxins negatively affect our genetics and can cause DNA adducts—mutations in genes that result from exposure to specific carcinogens and lead to cancer.

The problems don’t end there. An imbalance in your gut microbiota can increase levels of an enzyme called beta-glucuronidase, which in turn triggers reabsorption of estrogen back into circulation. This leads to estrogen dominance, a condition in which you have insufficient progesterone to balance the effects of estrogen in your body. Symptoms include breast swelling and tenderness, cramps, bloating, headaches or migraines, irritability, anxiety, depression, food cravings, brain fog, sleep difficulties, and lowered libido.

HEALTHY METABOLISM OF ESTROGEN

 

Estrogen is metabolized by your liver. It converts excess estrogen into breakdown products that can be eliminated from the body. Within the liver there are three main pathways through which estrogen can be metabolized. I compare these to the three rivers that encircle St. Simon’s Island, Georgia (where I live), and flow into the Atlantic Ocean. Two of these rivers—the Satilla and the Altamaha Rivers—are quite polluted due to paper mills and other industries. The Georgia Department of Natural Resources samples fish from water bodies each year to test for contaminants such as PCBs, chlordane, and mercury, and has determined that you can’t safely eat fish from the Satilla or Altamaha more than once a week (and for some types of fish, only once per month). The third, the Sapelo River, is not polluted and therefore great for recreation and fishing.

Like those first two rivers, there are two estrogen pathways that are toxic and unhealthy; and like the Sapelo River, the third pathway is healthier and preferred. That third pathway is called the 2-methyl-hydroxy pathway. If the body can convert estrogens along it, you will be healthier and reduce your risk of cancer. But if your body converts along the 16-alpha-hydroxy pathway or the 4-hydroxy pathway, you have a greater risk of cancer. These pathways can be assessed by urine or blood testing. (For more information, see the Resources.) Don’t worry about remembering the chemical names of all the pathways. Just remember that the 2-methyl-hydroxy pathway is healthy and can be supported by detoxifying your body, eating probiotic rich foods, and including certain types of vegetables (methyl-group-containing veggies) in your diet.

Without getting too technical, methyl groups are made up of just a single carbon molecule with three hydrogen molecules surrounding it. Nutrients high in methyl groups include vitamin B12, folate, vitamin B6, choline, and the amino acids methionine and betaine. These nutrients support a process in which these methyl groups are added to proteins, DNA, homocysteine, and other molecules to keep your body detoxifying and functioning well. This is called methylation. Think of methylation like the spark plug in your car—it stimulates these reactions. Your body undertakes methylation billions of times in a single second. A breakdown in this process increases risks for infertility, osteoporosis, cancer, cervical dysplasia, depression, and dementia. Vegetables with methylation-supporting nutrients are the very same foods that are high in B vitamins, such as leafy green vegetables, fruits, whole grains, beans, peas, lentils, sunflower seeds, and nuts. Animal foods like egg yolk, chicken, turkey, fish, beef, pork, lamb, and liver also provide methyl groups.

Your Quick Start Guidelines

There’s no way around this news: in order to begin fixing your hormones, you’re going to need to eliminate a few things from your nutritional repertoire. But take heart, because you can return some of these foods and drinks to your lineup after the initial ten-day Quick Start. That said, many women report that they don’t want these things once they’ve taken them out of their diet. You too may find that your taste for these things has diminished once you’ve detoxified and stabilized your hormones. Also, remember that what you eat is only part of it; the lifestyle hacks that I talk about at the end of the book are another part. Let’s get started!

Do Away with Sugar

Sugar has a big impact on hormones. If you’re eating sugar (whether natural sugars or artificial sweeteners), then your hormones are being affected on a daily basis. If you’ve been eating sugar all your life, then it possibly affected your ability to conceive, your ability to stay at an ideal weight, and even your ability to breeze through menopause. Sugar has a direct effect on hormonal conditions such as polycystic ovary syndrome. Too much sugar is also a strong inducer of inflammation, so it’s a definite no-no for most of us, especially as we get older. Last, sugar also numbs the brain’s sensor that prevents overeating. This means that your brain effectively stops releasing hormones like oxytocin to signal that you’re full, and you’re more likely to continue eating.

If you just can’t imagine life without sugar in your coffee or tea, replace sugar with a bit of monkfruit-based sweetener, stevia, or xylitol. Cinnamon and pure vanilla extract can also satisfy a sweet tooth. Yes, my southern belles, say “no thank you” to sweet tea!

Let me add that fruit is a source of the sugar fructose, and too much fructose is not helpful for hormone balance. For this reason, you avoid fruit on my Quick Start plan.

Say No to Diet Sodas

You’ve heard that diet drinks aren’t good for you, but how bad could they be? For one thing, diet sodas are high in phosphoric acid, which increases your risk of bone fracture. On the pH scale, most diet sodas come in at between 2.38 and 4.75—acidic enough to dissolve the enamel on your teeth! Your body has to neutralize the acid you just drank. It does so by extracting calcium from your bones. This leads to low bone-mineral density and the potential for breakage. In fact, women who drink three or more cola-based sodas daily have almost 4 percent less bone-mineral density in their hips than non-soda-drinkers.

Second, the artificial sweeteners in diet sodas cause weight gain. The physiological reasons behind this are not yet completely understood, but we know that there are sweet taste receptors in the mouth that send a “Calories are coming!” message to other parts of the body. The body starts turning on its digestive process, secreting more insulin, and stimulating hunger hormones—all of which signal the body to eat more and store more fat. Artificial sweeteners also trigger insulin resistance, making us put on fat. Bottom line: cut out the diet soda. (And cut out regular soda too!)

Get Off Gluten and Grains

Gluten is a protein found in wheat, rye, barley, malt, brewer’s yeast, and sometimes oats. It also hides in the craziest places: chewing gum, some condiments (especially soy sauce), salad dressings, flavored coffees, snack foods, canned soups, a lot of processed foods, and some lunch meats (to keep them moist longer).

Gluten-containing foods can interfere with digestive health and eventually gut bacteria. They’ve been proven to trigger inflammation, heartburn, autoimmune disorders, neurological and behavioral issues, skin issues, osteoporosis, chronic fatigue, and other conditions.

It wasn’t always this way. Gluten is not the same as it was decades ago. That’s because modern farming practices have blended varieties of wheat to create hybrids that grow faster, yield more, are more resistant to insects, and create fluffier bread and grain foods. But they are also higher in gluten. The American way has been to eat cereal for breakfast, sandwiches for lunch, and rolls at dinner—and hence we are taking in a lot of gluten. Our digestive systems just can’t handle that much of it. Gluten-containing foods are eliminated on the Quick Start. But don’t worry. You’ll enjoy your break from gluten and reap the benefits.

AGAINST THE GRAIN: MYCOTOXINS IN FOOD

 

Another reason to reduce or eliminate grains is because of mycotoxins. Some of the most prevalent toxins in the environment, mycotoxins are chemicals produced by fungi that often contaminate grains, nuts, beans, fruit, and coffee beans. Breathed in or ingested via food, mycotoxins cause symptoms such as weakened immunity, fever, pneumonia-like symptoms, heart disease, asthma, sinusitis, cancer, memory loss, vision loss, chronic fatigue, skin rashes, depression, ADHD, anxiety, and liver damage.

There are many different types of mycotoxins. One very interesting form, zearalenone (ZEN), is considered a “mycoestrogen.” This means it has a molecular structure similar to estrogen. It can activate estrogen receptors and create reproductive system changes in both animals and humans.

ZEN has been used since 1969 in the U.S. cattle industry to boost animal growth rates, but it has been banned by the European Union. It has also been linked to breast enlargement in humans. In the body, ZEN has been shown to promote breast cancer cell growth in estrogen-receptor-positive cancers. It is also now connected to precocious puberty (puberty that begins before age eight) in girls.

ZEN is found in grain products including breakfast cereal, bread, pasta, beer, and processed foods—more reasons to leave wheat, barley, and corn out of your diet.

Ease Off Certain Beverages

I’m not going to recommend that you give up coffee. With a pH of 5, black coffee is less acidic than soda. It also contains high levels of antioxidants your body can easily absorb. But I am going to recommend that you keep your intake to one cup a day. Too much caffeine triggers an upswing in cortisol and other stress hormones, which has a weight gain effect, as I’ve explained. Green tea is a great substitute for coffee, so you might want to drink it exclusively, or just as a substitute for your usual second cup of coffee. It contains a little less caffeine, while providing lots of antioxidants. This may explain why the green-tea-drinking Japanese enjoy low levels of cancer despite their high incidence of smoking.

Another beverage to watch is alcohol. It’s a depressant and generally high in sugar too. Plus alcohol relaxes your inhibitions, making it tough to stay on a healthy detoxifying diet through the whole ten days.

You may have heard that a glass of red wine a day is good for you because of the heart-healthy antioxidant resveratrol—and that’s been proven. However, I believe that drinking wine while experiencing the fun and joy of being with friends and family produces more oxytocin, and that is the real elixir of longevity. You can get the same oxytocin burst, though, without the wine. So forgo your usual cabernet or chardonnay during the next ten days. Instead, check out my Kool Keto Mocktail, on this page. For that occasional adult beverage, I do have some good news: tequila and potato vodka do not cause a significant increase in blood glucose and insulin—see my favorite indulgence, my Te-Keto Cocktail, on this page. And know that you’ll be able to ease it back in for days eleven to twenty-one.

Stay Hydrated

When you are well hydrated, you’re less hungry (thirst can often be disguised as hunger). Staying hydrated allows your kidneys to get rid of toxins and helps your liver to more effectively metabolize fat.

As surgeons, we are taught that “the solution to pollution is dilution,” and this is all the more important as you are detoxing. So how much is enough? One way to judge is by looking at the color of your urine. It should be clear (unclouded) and a very light yellow. A general rule of thumb: each day you should be drinking (between meals) approximately half your body weight in ounces of water. This is probably better based on your ideal weight, not your actual weight. For example, if your ideal weight is 140 pounds, you should drink 70 ounces of water daily, which amounts to about six 12-ounce bottles. Use common sense, though—if you’re a marathoner running in the heat, you need more, and if you’re a sedentary worker indoors, you probably need less.

But…Drink Less Water with Your Meals

When we ingest food, digestive juices pour into our stomachs. Drinking fluids dilutes these important juices, as well as the enzymes required for good digestion. If you want to drink with your meal, limit your intake to about 4 ounces. Ideally, you’ll stop drinking twenty minutes prior to your meal and resume drinking two hours afterward. After a simple salad or smoothie, waiting 1 hour is typically long enough. The purest water choice is filtered water. Drink plenty of it between meals.

Chew Your Food Well

Chewing very thoroughly helps saliva break down your food. This eases digestion because food can then move through your system more easily, helping to prevent heartburn and embarrassing gas. It will also help you naturally limit your intake because you’ll be better able to recognize your body’s fullness signals.

I recommend that you chew each bite twenty to thirty times. When my daughter Amira was eight, she told me that chewing a grape so many times was really hard. Of course, she’s right about that—obviously a single grape doesn’t need that many chews! But give this practice a try. It can become a mindfulness practice that teaches you to fully enjoy your food. Not only that, you’ll discover how well chewing allows your food to dissolve and digest.

Quick Start Detoxifying Foods

Here’s a quick overview of what you’ll eat for the next ten days:

Mostly alkaline foods. You’ll be consuming a diet that is essentially 80 percent alkaline and 20 percent acidic (the suggested daily meal plans starting on this page show you how). Diets that are alkaline decrease inflammation, improve immune response, and assist with detoxification and fat loss.

Foods that detoxify harmful estrogens. Many of us need to eat more cruciferous vegetables such as broccoli, cauliflower, Brussels sprouts, and cabbage. These veggies contain influential plant chemicals, namely indole-3 carbinol (I3C) and diindolylmethane (DIM), that detoxify harmful estrogen molecules. Cruciferous veggies also release sulfur-containing nutrients that help the liver detoxify and block cancer cell formation.

Foods that are anti-inflammatory. Included in the Quick Start are foods high in omega-3 fats: organic grass-fed beef, organic poultry, and wild-caught salmon. Plant-based fats such as avocados, coconut oil, and olive oil are all potent anti-inflammatory foods, as well as hormone-balancing. So are nuts like almonds and Brazil nuts and seeds such as flaxseeds and chia seeds.

Foods that offer liver-detoxifying nutrients. Onions, garlic, and scallions are rich in sulfur-containing amino acids that not only are prebiotic foods but also help the liver detoxify more efficiently and reduce the production of excess estrogen. Delicious herbs such as oregano, thyme, rosemary, and sage are loaded with nutrients that promote liver detoxification too. A particularly powerful detoxifying herb is turmeric. In a review study published in The Journal of Laboratory Automation in 2016, researchers pointed out that curcumin, the active ingredient in turmeric, has a potent ability to destroy estrogen-receptor-positive cancer cells (most commonly found in breast cancer).

Foods that control insulin and blood sugar levels. Excess insulin in the bloodstream sets in motion a process in the body that overproduces estrogens, which can float around and enter target tissues. Limiting your intake of carbohydrates and getting into ketosis helps prevent this.

A daily Keto-Green smoothie. Each day, you’ll enjoy a delicious, quick, easy-to-make smoothie that gets you alkaline in the morning because it’s full of greens, healthy fats, and other alkalinizing ingredients. See recipes starting on this page.

Bone broth. Another integral part of the Quick Start is bone broth (or, for vegetarians, an alkaline broth). It is so alkalinizing, full of hormone-balancing minerals, and supportive of balanced hormones and overall health. It helps with digestion, joint function, immunity, skin (it’s loaded with collagen), and virtually every other function in the body. It’s also high in magnesium, which most of us are deficient in. Everything from blood pressure to energy depends on magnesium, so giving your body more of it is a good idea. The best part is that bone broth is supereasy to make; see this page for the recipe. You can also purchase it.

Supplements. Because the body is designed to heal itself and be healthy—that’s what it wants to do—I recommend helping it along with dietary supplements. See this page for a simple list and for advice on reading labels and choosing wisely.

The 10-Day Keto-Green Quick Start Detox Food List

What follows is a list of the many foods you can eat over the next ten days. This list is reprinted at the back of the book on a page you can more easily tear out and bring with you to the grocery store as a shopping list.

As much as possible, please choose organic, fresh whole foods and protein sources that are wild caught over farm raised, free range over caged, and grass fed over grain fed.

Alkaline Vegetables That Detoxify Estrogen

  • Bok choy

  • Broccoli

  • Brussels sprouts

  • Cabbage

  • Cauliflower

  • Greens: arugula, beet greens, kale, chard, collard, and mustard greens

  • Maca

Other Alkaline Vegetables

  • Alfalfa sprouts

  • Asparagus, green

  • Avocado (I know it’s a fruit )

  • Bamboo shoots

  • Bell peppers

  • Carrots

  • Celery

  • Cucumber

  • Eggplant

  • Greens: lettuces, spinach, and so forth

  • Jalapeño

  • Kimchi

  • Mushrooms

  • Onions

  • Scallions

  • Seaweed: all types, including nori

  • Snow peas

  • Tomatoes

  • Yellow squash

  • Zucchini

Protein Choices

  • Eggs, large, organic, and cage-free

  • Goat cheese

  • Organic chicken and turkey

  • Organic grass-fed beef

  • Pancetta or bacon (nitrate/nitrite free)

  • Protein powder, including collagen or vegetarian protein powder (such as pea and rice protein; choose one with less than 3 grams sugar per serving)

  • Shellfish: shrimp, scallops, or oysters

  • Tofu, miso, or tempeh (see vegan swaps on this page)

  • White fish, such as rainbow trout, tilapia, or sea bass

Liver-Detoxifying Foods and Herbs

  • Artichoke hearts

  • Onions, garlic, and scallions

  • Oregano

  • Rosemary

  • Sage

  • Thyme

Other Quick Start Foods

  • Bone broth (see this page for recipe)

  • Vegetable or alkaline broth (see this page for recipe)

Oils and Vinegars

  • Apple cider vinegar (unfiltered)

  • Avocado oil

  • Coconut oil

  • MCT oil

  • Olive oil, extra-virgin

  • Organic ghee or butter (from grass-fed cows)

  • Rice or coconut vinegar

  • Sesame oil

  • Walnut oil

Herbs and Spices

  • Allspice

  • Basil, fresh or dried

  • Bay leaves

  • Black pepper, ground

  • Chives, fresh

  • Cilantro

  • Cinnamon sticks

  • Dry mustard

  • Garlic powder

  • Ginger root, fresh

  • Lemons

  • Limes

  • Mint, fresh or dried

  • Paprika

  • Parsley, fresh or dried

  • Red pepper flakes

  • Sea salt

  • Tarragon, fresh or dried

Nuts and Seeds

  • Almond or cashew butter

  • Almonds

  • Chia seeds

  • Flaxseeds

  • Pistachios

  • Pumpkin seeds

  • Sesame seeds

  • Sunflower seeds

  • Walnuts

Teas

  • Chai

  • Chamomile

  • Cinnamon

  • Green tea

  • Mushroom tea

  • Other herbal teas

Additional

  • Almond flour

  • Capers

  • Coconut aminos

  • Coffee

  • Full-fat whipping coconut cream

  • Kalamata olives

  • Maca, powdered, or Mighty Maca Plus

  • Nutritional yeast

  • Red curry sauce

  • Roasted red peppers, jarred

  • Tahini

  • Tamari sauce, preferably low-sodium

VEGAN SWAPS

 

Many people are eating less meat—whether to improve their health, the environment, or their budget. If you’re among them, here are some substitutes you can make for animal foods and still stay Keto-Green. I recommend following the ten-day plan as closely as possible and use these swaps for the twenty-one-day plan.

Tofu, miso, or tempeh (non-GMO)

Vegetable burgers

Beans and lentils sparingly

Hummus

Nuts

Vegan protein powder (choose one with less than 3 grams sugar per serving)

Hemp hearts

Portobello mushrooms

The Day 6 Upgrade: Keto-Green Fasting

After five days of Quick Start detoxing, you’ll be ready to ramp up to a form of intermittent fasting, in which you will go fifteen hours between dinner and breakfast without food. Since this is overnight, much of this fast happens when you wouldn’t be eating anyway—when you’re sleeping. Simply have your dinner before 7 P.M., preferably by 5 P.M. After, you can enjoy one cup of tea if you’d like in the evening. This limited fluid will ensure your digestive enzymes stay concentrated and you will be less likely to get up in the middle of the night to use the bathroom. Then during the day, the window in which you eat is roughly a nine-hour period.

On day 8, however, I recommend a one-day liquid fast to empower your detoxification and increase ketosis. You’ll have green smoothies, water, and bone broth, so you really won’t go hungry! You can also make this day a water fasting day, with your physician’s approval.

Keto-Green fasting pushes you into ketosis faster, forces the body to get energy by converting tough-to-budge fat into ketones and find energy reserves beyond stored glucose (thus burning fat), and prevents the need for frequent urination during the night. Besides helping you shed pounds, ketones keep your blood sugar and insulin levels steady, which is why you’ll often feel more energetic with this type of fasting.

Your body will welcome the opportunity to fast. Evolution-wise, our bodies were programmed long ago to withstand periods of fasting. This pattern of eating dates back to ancient times, when people depended on the natural cycles of daylight and nighttime, with food primarily eaten during the day and fasting occurring at night.

A growing body of research suggests that intermittent fasting and time-restricted feeding bestow other powerful health benefits. Take a look.

Fasting Prevents Breast Cancer

In one study, breast cancer survivors who typically didn’t eat for at least twelve and a half hours overnight had a 36 percent reduction in the risk of their breast cancer returning, compared with those who had shorter overnight fasts.

Fasting Cleans Defective Cells

Intermittent fasting kick-starts autophagy. This is a process by which the body gets rid of cells that have a greater risk of becoming infected or cancerous. These are cells that also lead to accelerated aging, Alzheimer’s disease, and type 2 diabetes. Think of autophagy like spring cleaning—it tosses out the junk and clears the way for health and vitality.

Eating, however, prevents autophagy. Even a little food triggers an enzyme called mTOR, a powerful inhibitor of autophagy. Too much mTOR can lead to obesity, diabetes, and neurodegenerative diseases. Low levels of mTOR have been found to decrease cancer risk, decrease inflammation, and improve insulin sensitivity, and may also increase longevity. This is why intermittent and prolonged fasting is important for good health.

Fasting Creates a Healthy Gut and Circadian Rhythm

Inside the gut are trillions of healthy bacteria (the microbiome). They are affected not only by what we eat but also by when we eat. In a study published in the scientific journal Cell, researchers discovered that gut bacteria have their own circadian rhythm, like humans have—a clock of sorts, in which our physiological processes are synced to the twenty-four-hour solar cycle of light and dark. For example, your body starts to wind down and prepare for sleep after sunset, and it’s programmed to wake up at sunrise.

When the microbiome’s circadian rhythm is thrown off, there’s trouble: brain fog, slower metabolism, insulin resistance, inability to burn fat, and impaired detoxification. What disrupts the microbiome’s rhythm? Erratic eating patterns, eating all day, and night eating. Fortunately, time-restricted feeding, such as Keto-Green fasting, restores normal gut circadian rhythms and prevents these complications. In other words, intermittent fasting lets your digestive tract “rest and digest.” Giving your digestion a break can also help to heal any damage that you may have done to your gut lining over the years. Remember too that a healthy gut promotes healthy estrogen metabolism.

Fasting Resolves Insulin Resistance

Other studies have found that intermittent fasting helps prevent insulin resistance (which, as you know by now, triggers hot flashes and other menopause symptoms) and enhances hormone function that helps with weight loss, including the loss of belly fat. Keto-Green fasting is thus an excellent way to turn up hormone-balancing a few more notches!

Fasting Keeps Fat Off for Good

Many of us are used to cutting calories to lose weight. But the problem with calorie restriction is that it forces the metabolism to slow down to the lowered calorie intake. If you return to eating a higher amount of calories after the diet, your now slower metabolism makes weight regain inevitable.

Unlike calorie restriction, fasting does not cause weight regain, because during fasting you switch fuel sources from food to stored fat.

Studies have directly compared daily caloric restriction to intermittent fasting. In a 2016 study published in the journal Obesity, researchers compared zero-calorie alternate-day fasting (a form of intermittent fasting) with daily caloric restriction in obese adults.

What were the findings? Fat loss in the trunk, which includes the more dangerous fat packed in around the organs, was almost twice as high with fasting as opposed to calorie cutting. As for body fat, there was almost six times the amount of fat loss using fasting.

The study also addressed a big concern: does fasting burn up muscle? Well, the calorie restrictors lost a significant amount of muscle, but the fasters did not. As it turned out, fasting is four times better at preserving lean mass.

What about the effect of these protocols on metabolism? After all, that’s what determines whether you can keep weight off. With calorie restriction, metabolism fell by 76 calories a day. Using fasting, it dropped only 29 calories a day. Do the math: Daily caloric reduction causes almost two and a half times as much metabolic slowdown as fasting!

FASTING: ITS BENEFITS FOR WOMEN

 

In addition to the benefits of fasting I’ve described, there are other pluses—and best of all, they apply specifically to women. These compelling benefits were enumerated in a scientific review published in 2016 in The Journal of Mid-Life Health. Fasting can:

  • Reduce body weight

  • Slow down the growth of tumors and decrease cancer risk

  • Manage symptoms of polycystic ovary syndrome (PCOS)

  • Improve joint and bone health

  • Help manage blood sugar

  • Protect the heart (particularly intermittent fasting)

  • Reduce risk for menstrual problems

  • Improve mental health during menopause transition

  • Reduce symptoms of anxiety and depression

  • Ease stress levels

I also feel that the upsurge in autoimmune diseases is the result of the constant layering of toxins and demands on our bodies without sufficient time for the body to rest. Fasting allows resting and repair, and quite possibly helps prevent or even reverse these illnesses—for free!

Supplementing Your Diet

I am frequently asked for my opinion on supplements. My position is simple and unequivocal: I recommend them! I’ve spent a lot of time studying and researching the quality, bioavailability, sustainability, and efficacy of various supplements and am therefore very particular about what I recommend. (For what I consider the “gold standard” for supplements, see the Resources section.)

Generally, you can support your energy, detoxification, fat-burning, and hormone balance with the following supplements:

A multivitamin/mineral. This lays an important foundation. By filling gaps in today’s nutrient-depleted food, a multivitamin provides nutritional insurance. Many people also have nutrient deficiencies that put them at a hormonal disadvantage. If your body is lacking in zinc, iron, and B vitamins, for example, you may present symptoms of a hormonal imbalance such as polycystic ovary syndrome, infertility, or miscarriage. The body depends on an intricate balance of nutrients in order to get the reproductive processes working well.

There are many types of multis, and they are not all the same. The ones I recommend have a multivitamin/mineral blend featuring activated vitamins, including folate as 5-MTHF (5-methyltetrahydrofolate), and Albion chelated mineral complexes because these are well absorbed.

Recommended dosage: 2 tablets daily, 1 taken in the morning and 1 in the evening (preferably with food).

Omega-3 fish oil. The important components of fish oil are the omega-3 fatty acids EPA and DHA. In a 2009 study conducted in Canada, 120 women going through menopause were given either a fish oil supplement providing 1,200 milligrams of EPA and DHA or a placebo for two months. Prior to the study, these women averaged about 2.8 hot flashes daily. But after eight weeks, their hot flashes decreased by 55 percent in the EPA and DHA group, but by only 25 percent in the placebo group.

It’s important to choose a high-quality fish oil that is certified by the International Fish Oils Standards (IFOS), guaranteeing quality, potency, and purity. Always look at the supplement facts information, which is broken down by the amount of EPA and DHA oils. A good omega-3 will have 360 milligrams EPA and 240 milligrams DHA per 1,000-milligram capsule. There are newer enzymatically treated omega-3 supplements that boast higher absorption; these are good, especially if you have digestive issues. And if you are worried about a fishy smell when you burp, look for enteric-coated capsules.

Recommended dosage: 1,000 milligrams (with 360 milligrams EPA and 240 milligrams DHA) taken once in the morning and in the evening.

Vitamin C. The human body does not make vitamin C, so it must be obtained through diet or supplements. Vitamin C supplementation boosts immunity, supports the adrenal glands, and enhances collagen formation for healthy skin. Vitamin C is also an important antioxidant that protects cells from heart disease and cancer.

Recommended dosage: Start with a daily dose of 500 to 2,000 milligrams, taken any time of the day. I typically recommend higher doses—4,000 milligrams a day—to women who have experienced frequent urinary tract infections.

Magnesium. This important mineral is essential for over three hundred cellular processes within our body, but too many of us are deficient in it. Indeed, in my own medical practice, 99 percent of patients over age forty have had suboptimal magnesium levels. Deficiencies—which are clearly all too common—can result in cramps, restless legs, palpitations, anxiety, constipation, sore muscles, sleep difficulties, moodiness, and other unpleasant symptoms.

Magnesium comes in many forms. While the most common type, magnesium citrate, is helpful in preventing constipation, our bodies don’t absorb it all that well. Instead, I recommend magnesium malate—a combination of magnesium and malic acid, which supports energy production and may also support antioxidant systems by enhancing glutathione and antioxidant enzymes. Another good option is magnesium lysinate glycinate chelate, which is a highly soluble and easily absorbed form. To support brain health and cognitive function—if this is a priority for you—take the magnesium L-threonate form. It is the only form shown to cross the blood-brain barrier. I personally take this one regularly.

Recommended dosage: 250 milligrams (or up to 1,000 milligrams) taken before bedtime. (Back off the dose if you get loose stools.)

A probiotic. Probiotics are friendly bacteria in supplement form that empower a healthy gastrointestinal tract. Healthwise, probiotics benefit you by curbing the growth of harmful gut bacteria, promoting good digestion, boosting immune function, and increasing your resistance to infection.

Probiotics are equally powerful for healthy hormonal detoxification and even our moods. Sadly, though, these beneficial bugs are under constant assault from our environment, making it crucial to supplement with them as well as eat fermented foods (which are high in probiotics).

Recommended dosage: Typically, one dose of 30 billion CFUs (colony-forming units) taken before bedtime. If you have been diagnosed with small intestine bacterial overgrowth (SIBO), you must correct this condition prior to supplementing with probiotics.

PROBIOTIC PICKS

 

Probiotics (the word literally means “for life”) consist of different strains of beneficial bacteria. Different strains produce different results, and many strains exist—which is why choosing a probiotic supplement can be confusing. Furthermore, when one probiotic strain has a certain health benefit, you can’t assume that another strain has similar properties.

What I recommend is that you select a probiotic formulated with four of the most highly researched species: Bifidobacterium lactis, Bifidobacterium longum, Lactobacillus acidophilus, and Lactobacillus plantarum. Here is a summary of their specific benefits, based on extensive scientific research.

Bifidobacterium lactis

  • Survives well in the acid environment of the stomach and gut

  • Boosts immunity, thereby increasing resistance to illness and infection

  • Is effective against constipation

  • Helps reduce blood sugar

Bifidobacterium longum

  • Survives well in the acid environment of the stomach and gut

  • Helps reduce depression in people who suffer from irritable bowel syndrome (IBS)

  • Binds with carcinogens to usher them from the body and help prevent colon cancer

  • Reduces DNA damage that can trigger the development of malignant cells

  • Can be used vaginally as well

Lactobacillus acidophilus

  • Survives well in the acid environment of the stomach and gut

  • Boosts immunity

  • Colonizes well in the intestine, but also in the urethra, colon, and vagina (where it inhibits vaginal infections and boosts vaginal and bladder health)

  • Reduces cholesterol

  • Controls urinary tract infections

  • Eases acne

  • Reduces DNA damage that can trigger the development of malignant cells

Lactobacillus plantarum

  • Survives well in the intestines

  • Fights common germs

  • Boosts the immune system

All four of these strains have a long history of safe use. Read labels to make sure that these strains are present and that the product contains live and active bacterial cultures. Also, take a supplement that contains 30 billion CFUs of these strains daily.

A liver detox supplement. If your Medical Symptom Toxicity Questionnaire score (see this page) is above 20, I suggest you get yourself a liver support supplement containing the herb milk thistle. The active ingredient in milk thistle, silymarin, has therapeutic value in treating liver disorders, inflammatory conditions, cancer, neurological problems, skin diseases, and high cholesterol.

Recommended dosage: Follow the manufacturer’s instructions and take in the morning, or before meals for an appetite-suppressant effect.

Fiber supplementation. For detoxification, to aid elimination, and as a prebiotic, it is important to add fiber-rich seeds, such as freshly ground flaxseeds, hemp seeds, and chia seeds, to your foods. Alternatively, you can take a fiber supplement. See the Resources section for recommendations.

Maca. Maca is an adaptogen, which means it can help support your adrenals, especially against the impact of burnout and chronic stress. Additionally, maca helps keep the body from being too acidic (stress is extremely acidifying by itself) because it is very alkalinizing. Maca also supports hormone balance, sex drive, and mood, and it decreases hot flashes.

Unfortunately, maca by itself doesn’t taste so good! My preference is maca combined with other superfoods, as in my Mighty Maca Plus formula, mixed in water or added to a smoothie. Mighty Maca Plus contains superfoods from around the world, such as turmeric, resveratrol, quercetin, cat’s claw herb, cinnamon, apple fiber, spirulina, and others. These have a potent combined antioxidant effect. Plus it tastes great! I have nearly ten years of clinical results and client testimonials praising the benefits clients have gotten with this combination of ingredients, from improvements in blood sugar control to a reduction in hot flashes, reduced cravings, improvement in aches and pains, better mood, increased libido, and more.

Recommended dosage: Follow the manufacturer’s instructions and take in the morning as part of your Keto-Green Shake.

THE POWER OF MACA

 

I first learned about maca when I visited Peru. It’s a radish-like tuber that grows above eleven thousand feet in the country’s central highlands. Maca has long been an important staple for native Peruvians. Highly nutritious, the plant is rich in vitamins, minerals, protein, carbohydrates, fiber, amino acids, and fatty acids.

I experienced the healing power of maca myself. Each day, I drank it mixed in juice (because it tasted terrible in just water) while trying desperately to regain my footing, my fertility, and my life after my son died. I felt its benefits almost immediately—more energy, a better mood, and just feeling more like my old self.

It’s one thing to experience benefits personally, but as a doctor and scientist, I researched with due diligence and found scientific research to prove that maca:

  • Improves female reproductive hormone function

  • Boosts memory

  • Eases depression, anxiety, PMS, and other menopausal symptoms

  • Improves libido

  • Enhances energy and fights fatigue

  • Helps in the treatment of osteoporosis and metabolic syndrome

  • Reduces blood glucose levels

  • Works as an antioxidant

  • Lowers blood pressure

  • Protects the liver and immune system

  • Fights tumors

  • Optimizes ovarian function