I am neither a nutritionist nor a chef, but I am intensely committed to helping my patients—and you—get the best nutrition possible from the foods you eat. As I’ve mentioned, one of the most powerful ways to prevent disease, keep your estrogen and other hormones in balance, and fortify yourself against the effects of aging is through food. Healthy eating begins with making a commitment to yourself to build your body with food.
Let me be clear: I am not an absolutist. I love food and want to encourage you to love food, enjoy your meals, and savor a delicious variety of foods to delight your palate and your stomach. My approach offers you simple strategies to maintain your weight, lose pounds without deprivation or overthinking, or add calories to your diet if you can benefit from some healthy weight gain. Healthy eating ensures a healthy brain and body. You don’t want to restrict types of food or get caught up in counting calories—typically those strategies backfire and only trigger obsessing about food. Building your body with food is also not about eating raw, going vegan, or drinking only green juice or fruit smoothies.
Healthy eating is about learning how a well-rounded selection of foods and satisfying meals will keep you healthy and also allow you to find the weight that is right for you. My approach is not a series of tricks to lose weight fast or a list of eat this and don’t eat that. Whether you’re a vegan, vegetarian, or carnivore, your eating strategy should incorporate a few fundamental principles: eat a diet that balances all food groups; moderate portion sizes; choose foods that are fresh, organic, and non-GMO, avoiding processed foods. When you stick to these three basic rules, you will end up making good choices. I’m going to ask you to emphasize lean proteins, such as fish, chicken, bison, and pork tenderloin—pasture-raised—and to limit dairy, sugar, starchy carbohydrates, and processed foods. I’m also going to introduce you to some important sources of good fats, such as olive oil, nuts, and seeds, which will help keep your blood sugar in balance, regulate your metabolism, and make your brain work better. The omega-3 fatty acids in these foods are protective against inflammation, cognitive decline, and hormonal imbalance. I also recommend that you increase your fiber intake to maintain proper digestion and improve your metabolism.
You will also find a guide to supplements—vitamins, minerals, and a probiotic—that will make up for anything missing in your diet and also reinforce a healthy gut, a crucial element to maintain hormonal balance, boost your ability to fight stress, and protect your overall health.
My approach to eating for wellness and hormonal balance works for women of all ages—whether you’re in your twenties or forties or sixties. However, I have included some suggestions to keep in mind for each decade of health.
But my biggest message about food is this: it’s meant to be enjoyed! I want you to embrace this approach to eating so that you can learn to love food again. Above all, you should think about food and eating as pleasurable! Many of my patients have been obsessed with fad diets, which usually restrict calories in order to lose unwanted pounds. I can say with great confidence that if you follow the general recommendations I have outlined, you will feel not only better (more balanced and without cravings) but also feel good, healthy, and fit.
Throughout this book, I’ve asked you to make a few key mind shifts, and one of the most important relates to how you think about food. Instead of thinking that you have to avoid certain foods, reduce the number of calories, and otherwise deprive yourself, think about food as a source of nutrition. And if we didn’t live in a culture that is dominated by processed, packaged foods offered in jumbo sizes but, instead, ate a clean, plant-based diet of fresh foods, with just enough lean protein, good fats, and fiber, this mind shift would be easy. Unfortunately, we are up against a pervasive disease factory (yes, that’s how I think of processed foods). The scientific evidence is clear: the typical “Western” diet, which is starchy and high in refined carbohydrates and sugar, relies heavily on red meat and processed meats, and includes “convenient” processed foods with chemical additives and unhealthful fats, is dangerous to health. The twin epidemics of obesity and type 2 diabetes clearly indicate the pervasive health hazards associated with the Western diet, which is typically consumed in big portions and strips even some healthful foods of their nutrient value through processing.
Keeping estrogen levels healthy is important for overall wellness and for brain health, but it will also help you eat a healthful diet. Estrogen influences levels of the hormone leptin, which is critical to appetite control. Leptin acts as a check against hunger, and it promotes feelings of fullness and satiety. When estrogen is deficient, leptin levels diminish—and hunger spikes. Low leptin triggers cravings for starchy, sugary, and fatty foods and a tendency to overeat and to binge eat. Low levels of leptin are also linked to an increased risk for neurodegeneration and neurodegenerative disease. At the same time, you don’t want leptin levels to get too high. Chronically high leptin is associated with leptin resistance and obesity. When someone is severely overweight, the leptin-signaling mechanism breaks down. Even though there’s plenty of leptin and plenty of stored fat (used for energy), your body gets triggered to eat.
Insulin resistance (IR) is another metabolic disorder that is related to hormone disruption. A common consequence of a high-sugar, high-carbohydrate diet, IR also destroys brain cells and impairs the brain’s basic functioning. IR interferes with the brain’s ability to consume glucose (glycogen), the fuel that powers the brain. IR also damages neurons that protect and facilitate memory. Both insulin resistance and diabetes are associated with cognitive impairment, memory problems, and neurodegeneration, including increased risk for Alzheimer’s disease.
Excessive intake of refined carbohydrates (nonvegetable carbs) in processed foods is associated with health risks and chronic illness. A typical Western diet elevates a woman’s risk for breast cancer, particularly for hormone-receptor-positive breast cancer.
In addition, a diet high in refined carbohydrates and sugars damages brain cells and brain function. Trans fats and saturated fats found in processed foods undermine memory and cognitive abilities. Red meat and dairy eaten frequently can cause similar damage. The typical Western diet is deficient in omega-3 fatty acids, which are found in fish, nuts, and healthy oils, and this deficiency is linked to cognitive decline. A diet high in saturated fat and sugar also lowers levels of BDNF (brain-derived neurotrophic factor), a protein that’s essential to brain health and to the survival of neurons. BDNF actually worsens the effects of traumatic brain injury.
Women with type 2 diabetes are more likely to have problems with brain function and memory. Indeed, studies show that women with diabetes and metabolic syndrome show more frequent signs of early cognitive decline. But people with type 2 diabetes perform better cognitively after consuming a single, low-glycemic, low-carbohydrate meal.
The classic Western diet, which is made up of more than 50 percent starchy or sweet, nonfibrous carbs, is at the root of a host of illnesses:
Excess carbohydrate consumption, even in early life, can increase a child’s vulnerability to obesity and insulin resistance throughout her adult life.
In contrast, my approach to eating, which is a blend of Mediterranean and keto diets, has many benefits for your health. When you emphasize lots of organic vegetables, eat just enough lean protein, include sufficient good fats, and reduce sugar and starchy carbs, you will
Signs That Weight Gain and Dietary Challenges Are Hormone Related
Estrogen and other hormone imbalances can lead to weight gain at many points throughout a woman’s life. Here are some indications of when weight gain is likely to be tied to your hormones:
I like to think of my approach to healthy eating as “Mediterranean meets keto.” For years, my family and I have followed a Mediterranean diet that is rich in healthy omega-3 fats from olive oil and nuts and emphasizes seasonal, simple dishes that are easy to make from local produce and that include fish, poultry, and lean meats. This way of eating has also worked well for most of my patients. However, in the past few years, I’ve updated my approach because I’ve found that many of my patients need more direction in creating meals that rely on these basic dietary building blocks. Whereas the Mediterranean diet allows for moderate amounts of grains and legumes (pasta, lentils, chickpeas, and other beans), keto takes a narrower stance, reducing or eliminating these altogether. A ketogenic diet is a very low-carb diet designed to put your body in fat-burning mode. When you take out sugar and starchy carbohydrates from pasta and bread, for instance, your body has less glucose to rely on for energy. In this low-glucose state, it will signal the liver to produce ketones, energy molecules that metabolize fat. (If you have type 1 diabetes, take medicine for high blood pressure, or are breast-feeding, do not do a keto diet.)
Although I believe either of these two approaches is healthy and will support your hormonal balance, you need to discover for yourself which one actually makes you feel better. Gloria, a thirty-eight-year-old patient of mine, has metabolic syndrome (a group of conditions that are tied to insulin resistance); years of being overweight and sedentary led to this cluster of symptoms, which makes it difficult for her to process starchy carbs and sugar. So for her a strict keto approach works best. Ariel, who is forty-six, has always been active and her weight is steady. She can enjoy pasta once or even twice a week and an occasional sweet dessert without feeling sluggish or putting on weight. The Mediterranean approach, which allows for more sugar and carbs, works great for her. In contrast, if Gloria eats even a small portion of pasta, she feels “puffy” the next day and begins to crave bread.
You might be like Gloria or like Ariel or somewhere in between. As you take on the mind-set that food is nutrition—enjoyable nutrition—pay attention to how your eating different foods makes you feel. Keep notes in your journal. Write down your responses to a meal: Did you feel sated or satisfied? Were you hungry an hour later? Did you feel sluggish or bloated the day after? Are you experiencing any food cravings?
And while I don’t want you to go “scale crazy,” weighing yourself can be helpful to see how certain foods agree with you or not. Keep a record of where you are when you start this healthy eating approach and how you fare over the next six months. You might make special note of where you are in your cycle when you have any reactions to certain foods or, if you are menopausal, how these reactions change as you start your HRT and make any adjustments to it with your doctor.
Without a doubt, low estrogen and other hormone deficiencies make it more difficult for women to lose weight, and they make it all too easy to gain weight. Estrogen deficiency triggers other changes in hormones that alter appetite and can make you feel more inclined to eat the “wrong” foods and to eat too much of them. Unhealthful eating and excess weight are catalysts for other health issues—high blood pressure, metabolic problems, and insulin resistance among them—and also may wear down your confidence, energy, pride in your body and appearance, interest in physical exercise, and desire for sex.
As a culture, we need to enhance our awareness of the power of vegetables as a rich source of nutrients and fiber. The cheapest food we can buy is vegetables—and there is so much natural variability in their colors, smells, and taste for us to enjoy.
Bioidentical Hormones Suppress Appetite
Research demonstrates that bioidentical estrogen has a direct effect on appetite control, influencing the hormones that govern hunger and satiety—without incurring the unwanted, unhealthful side effects that come with chemicalized estrogens.
Applied directly to the skin in gel or cream, bioidentical estrogen lowers ghrelin levels, reducing hunger and cravings. Ghrelin is a fast-acting hormone that stimulates hunger. Bioidentical estrogen can lower food intake, and it increases levels of CCK (cholecystokinin), a protein that helps digest fats and proteins and promotes satiety.
The diet–estrogen connection works in both directions. Not only do estrogen levels affect diet, the choices you make about what foods to eat and drink influence estrogen. A poor, unbalanced diet can undermine estrogen and other hormone balance to the detriment of your health. Eating unhealthful foods, including processed foods, introduces estrogen-mimicking chemicals and environmental estrogens into the body. And, as you’ve seen, these so-called foreign invaders also mess up your hormonal balance.
The foundations of the Mediterranean + keto diet are whole, unprocessed foods that do not come preprepared, wrapped in plastics, or sealed in boxes. These foods aren’t made in factories. They are grown in fields and groves or harvested from the ocean. They are in-season juicy fruits and plump vegetables, hearty legumes, rich nuts, green-golden oils, and whole, unprocessed grains. A Mediterranean + keto diet does include animal proteins—primarily fish but also organic, free-range poultry and pasture-raised beef and bison, as well as organic eggs. Your good fats from omega-3 fatty acids come in olives and olive oils, nuts and seeds, and certain fruits, like avocados and coconut. Dairy is not a heavy-duty staple of either approach, but enjoying a piece of hard cheese every now and then is not off-limits.
Starchy vegetables (potatoes, corn, and squash, for example), sweets, and alcohol are consumed only in moderation, if at all. The Mediterranean diet avoids processed foods and their refined and processed sugars, saturated fats and oils, and the chemical additives that are associated with serious and chronic health problems. Keto is further restrictive since it does not include any grains, sweets, or alcohol.
Hundreds of studies over the years have demonstrated the health benefits of the Mediterranean diet, including a reduction in the incidence of diabetes, cardiovascular disease, and some cancers (colon and intestinal, for example). Scientists have also shown that a Mediterranean diet slows aging and can significantly increase longevity.
The Mediterranean diet is also enjoyable, which is just as important. The foods and eating habits allow you to savor and delight in food while also eating mindfully, moderately, and healthfully. Eating the Mediterranean way means creating meals from simple, whole ingredients and then sitting down—ideally with human company and without electronic and digital distractions—to take the time to enjoy the food and connections to other people. Feeling good about food and about the rituals of eating can make a significant difference in how you feel and how you eat. Principles like moderation, portion control, and the discipline to say no to favorite indulgences—all key to weight management and good dietary habits—are a great deal easier to execute when you do them as part of a larger experience of enjoyment and pleasure.
You don’t need to reside on a Tuscan hillside or a pastoral Greek village to enjoy these foods and way of eating. Local, seasonal, and organic fruits and vegetables are available at farmers’ markets and at grocery stores, since the large-scale food purveyors have recognized the demand for organic produce and meats and for foods grown close to home. For a Mediterranean diet, you stock simple, easy-to-procure foods in your pantry: beans and other legumes, high-quality olive oil and other oils, nuts, herbs and spices.
Whether you live in a big-city high-rise or a multigenerational family home along a suburban street, you need to make only one basic commitment: to slow down long enough to taste and savor the food you’re eating, to relax with family or friends—or your own good company—and to take pleasure in feeding yourself well.
The Benefits of Keto
Recent studies have supported the health benefits of a keto diet low in starchy carbs, high in protein and fat, and high in fiber from vegetables; studies have shown
Let’s take a closer look at the makeup of the Mediterranean + keto approach. Essentially, I recommend a roughly even split among the major dietary components:
30 percent protein
30 percent fat
30 percent fiber in the form of fiber-rich vegetables and/or whole grains
The remaining 10 percent? That’s where a little flexibility comes into play. That 10 percent makes room for a glass of wine with dinner, an occasional dessert, a once-in-a-while side of mashed potatoes or bowl of pasta. None of us will eat perfectly every meal of every day. Better to leave a little room for small deviations from your daily eating than to be so strict you abandon healthful practices altogether. Make a real commitment to eating the right foods, in moderate amounts, and do the best you can to live out that commitment at each meal, knowing you have a little flexibility to keep you on track.
Your first 30 percent building block is protein. Protein should primarily come from wild-caught fish and lean, organic pork and chicken. The occasional indulgence in red meat should also come from an organic or grass-finished source. (Grass-fed often means the animals were grain fed for most of their lives and then given grass just before being slaughtered.) Animals raised to provide organic meat are raised in open pastures, where their diet comes from grass—not grain or corn. They are free of antibiotics and genetically modified components. Their food is grown without use of chemical pesticides and fertilizers. These products cost more, but they are an important investment in your health. Eggs, especially egg whites, can also provide your diet with protein. Dairy is a source of protein best used in moderation, as is soy. Although soy has been described as having links to cancer, it’s my opinion that these associations are misleading. Soy is a wonderful source of vegetarian protein, though I do recommend you rely on organic, non-GMO sources. Indeed, I suspect that any cancer links from soy are not related to soy as much as they are to the chemicals that accompany nonorganic, pesticide-riddled sources.
Fat is an essential part of your diet, both for health and satisfaction. Fat protects and fuels the brain, helps the body absorb other nutrients, protects the integrity of your body’s cells, and provides a potent source of energy. Chefs say that “fat is flavor.” They’re right. The key is to use healthy, hormone-supporting fat sources. For these, look first and foremost to the Mediterranean diet and its olives and olive oil, nuts, and seeds (like flax and chia), and coconut and avocados. The wild-caught fish and lean animal proteins you’ll be eating provide additional sources of healthy fats. Organic coconut and coconut oil are having a renaissance, and you can find oils to cook with, blend into a smoothie, or use as part of a salad dressing. And even though I don’t want you to do a lot of snacking, a handful of nuts—almonds, cashews, macadamia—is a great source of healthful dietary fat and protein.
The 30 percent of your diet that is fibrous carbohydrates should come primarily from organic vegetable sources rather than grains. Vegetables supply the broad base of nutrients your body needs each day as well as complex carbohydrates that fill the body with fiber and deliver a steady source of energy. The importance of fiber to your diet is hard to overstate. Fiber supports cardiovascular health, aids in healthy digestion and elimination, controls blood sugar, and can lower the risks for some cancers. High-fiber vegetables are low in calories, but their fiber content contributes to a feeling of fullness after eating, which can help you avoid the cravings and perpetual hunger that come from consuming simple carbohydrates in processed grains and sugar.
Dark leafy greens, cruciferous vegetables such as broccoli and cauliflower, vine-ripened tomatoes, hearty root vegetables such as carrots, turnips, and sweet potato—these you can eat richly, abundantly, and with satisfying variety while on a plant-based diet. Also, consider replacing potatoes and rice with fibrous veggies such as celery root, rutabaga, and parsnips—these vegetables offer wonderful flavor and texture without the high glycemic effect on your blood sugar.
You’ll see plenty of soups among my meal suggestions, because they are a convenient, satisfying way to pack vegetables into your daily eating plan.
Organic fruit is actually a carbohydrate, but it does have a place in your diet. It’s important to manage fruit intake carefully, because the body treats fruit just as it does the sugar in alcohol, in terms of how it is broken down and processed. That’s an indication of how you should incorporate fruit into your dietary routine: give it the limited space you give to alcohol, whether you have a glass of wine or a piece of fruit as dessert.
It is not necessary to eliminate all grain-based carbohydrates, including wheat, from your diet (unless you have a gluten sensitivity or celiac disease, which you should address with your physician). Wheat and other grains should comprise a small share of your overall carbohydrate intake. When you do eat grains, opt for organic whole grains rather than processed grain products. You’re better off eating brown rice, toasted barley, or steel-cut oats than sandwich bread or store-bought pasta. I encourage you to branch out beyond wheat products to try other grains, including farro, amaranth, and different varieties of wild rice. These whole grains are satisfying, satiating, and fiber-rich and can add welcome variety to your diet while limiting the amount of gluten you consume.
As I mention above, the remaining 10 percent of your meal is up to you. I recommend that on some days or evenings you give yourself a treat—whether that’s pasta, a glass of wine, or dessert. On other nights, up your veggies and skip that starchy carb altogether. You are going to be able to trust yourself as you become tuned in to how certain foods make you feel.
On Eating Fish
One of the most important elements of a Mediterranean diet is eating as much fish as possible; it’s a great source of lean protein, omega-3 fatty acids, and other nutrients. These potent sources of omega-3 fatty acids offer powerful protection against disease, help the brain maintain its full function, and protect physiological health at the cellular level. I recommend eating fish at least once a week. There are a few important considerations to keep in mind when purchasing fish.
Buy wild-caught. These fish carry far greater amounts of healthy fish oil and omega-3 fats than farmed fish do. Farmed fish also have a higher concentration of unhealthful omega-6 fats than their wild counterparts. Farmed fish are fed antibiotics and, over their life span, accumulate significantly higher levels of toxins and pollutants through the water than wild fish do. Farming fish such as salmon creates a great demand for smaller wild fish to feed the farmed fish. This has led to overfishing of feeder fish such as sardines, mackerel, and others, damaging ecosystems and undermining wild fish populations as a whole. Keep in mind that there is no such thing as “Atlantic Salmon”—salmon do not live in the Atlantic Ocean. Fish marketed this way are typically chemicalized fish.
Pick fish low on the food chain. Smaller fish typically fall lower on the food chain than larger fish do. Small fish are less contaminated by mercury and other toxins. Anchovies, sardines, and shrimp are some good examples of smaller fish that are potent sources of nutrition.
Choose sustainable seafood. Supporting sustainable fisheries is one way to protect the health of the oceans and their fish populations. Standing at the fish counter and trying to determine what is the most sustainable choice can be daunting. There are resources that can simplify the process.
Any approach to eating well should be simple. These four rules can be your guide to making healthy choices that help you either lose or maintain weight.
Eat meals. Although some new diets recommend eating five meals a day, including two snacks, our bodies are not really designed to take in and digest food so frequently. Digestion takes a lot of energy and time. The key is to eat whole meals that are satisfying so that you don’t really need to eat snacks. The only people who should snack are those who are prone to severe hypoglycemia. Ideally, there should be about twelve hours between breakfast and dinner. Snacking makes it more difficult to keep an accurate assessment of what you’re eating during the day and raises overall daily calorie consumption. Snacking contributes to weight gain and makes it harder to lose weight and keep weight off. Snacking may also reinforce tendencies to eat under emotional stress. Instead of relying on snacks to keep you satisfied, focus on high-fiber meals that don’t skimp on healthy fats. Keep in mind that most extra pounds come from overconsumption of protein and non-fibrous (aka starchy) carbohydrates, so, as you will see in my meal plan, I have emphasized vegetables and healthy fats, avoiding too much protein and/or carbs. If you want to lose weight by resetting your body’s natural satiety signals, you may want to investigate a simple version of intermittent fasting, in which you skip breakfast and eat two simple meals a day.
Stay hydrated. You need to drink plenty of water. A general rule of thumb is five eight-ounce glasses of water per day. Water detoxifies your body’s organs—from your skin to your liver. Water helps keep your digestion engine and metabolism moving. It also helps fight against the environmental pollutants that advance aging. However, many of my patients have trouble accomplishing this feat. I point out that water is contained in a lot of their vegetables and fruit and other water-dense foods. What’s key is learning to stay properly hydrated. There’s a new fad to drink alkaline or electrolyte water; helping your body balance an acidic environment with this type of water is a good idea, but you never want to drink this water with a meal, as you need an acidic environment to digest your food properly. A great way to set up your digestion for the day is to drink room-temperature water with some lemon or vinegar; this primes your digestive system and aids metabolism. You can also enjoy the health benefits of coffee and tea. In particular, green tea and coffee contain ingredients that have been shown to have anti-inflammatory, anticancer, and anticholesterol properties.
Learn to say no to sugar. Food can be described as either high-glycemic or low-glycemic, according to how strongly it signals your body to convert sugar into glucose. If a food produces a strong and immediate insulin response, it is considered high-glycemic; if a food contains fiber, protein, or fat, it will have a low-glycemic effect on your body. My approach to eating is low-glycemic because it encourages you to avoid starchy and sweet foods that have a strong insulin response and then flood your body with excess glucose. When blood sugar gets too high, not only do you experience cravings for more sugar but also your body becomes somewhat addicted to the “high” of blood sugar. Chronic high blood sugar is truly alarming in its capacity to cause damage to the body. Regular and excessive consumption of sugar—particularly refined sugars—taxes the metabolic and cardiovascular systems, suppresses immune function, and contributes to inflammation. Sugar consumption accelerates aging and is a contributor to most diseases.
If you have trouble saying no to sugar, you are not alone. However, the more you consume fresh vegetables, lean protein, and healthy fats, the less you will crave sugar. You will also keep your blood sugar in balance and avoid the inflammatory states that cause the illnesses listed here. Women may be especially vulnerable to sugar addiction because of cravings that occur as a result of fluctuating hormones during menstruation, pregnancy, perimenopause, and menopause.
Choose your meats wisely. I enjoy steak. That’s the simple truth. I would love to tuck into a hearty T-bone on a regular basis, but I do it only occasionally. Red meat is higher in calories and in saturated fats than other leaner animal proteins. It is also particularly unhealthful when consumed regularly, in part because of its nutritional content and in part because of the manner in which it is often cooked. Recently, the World Health Organization classified processed or non-grass-finished meat—including beef, pork, and lamb—as a likely carcinogen, and a probable cause of colorectal cancer. In the same step, the WHO classified processed meats—meats that have been cured or otherwise processed into products such as bacon, sausage, and hot dogs—as definite carcinogens that contribute significantly to colorectal cancer risk. Eating meat regularly (more than three times per week) raises risk for breast cancer dramatically: eating 1.5 servings of red meat daily elevates breast cancer risk by 97 percent. Regular red meat consumption also increases cardiovascular disease, elevates risk for diabetes, and is associated with shorter life span than vegetarian diets.
Does this mean all meat should come off the table? No, but if you’re a regular meat eater, it’s time to switch to grass-finished sources, replace meat with wild-caught fish, or try plant-based protein sources, such as high-protein grains like quinoa, wheatberry, and farro, or legumes, such as lentils and chickpeas.
Good nutrition is the foundation of health. Many people would avoid many chronic diseases such as diabetes, heart disease, and cancers such as breast cancer and colon cancer by reducing their consumption of meat (especially processed meat) and increasing their consumption of fresh vegetables and fruits. Most of all, we need to relearn to enjoy this way of eating!
The Mediterranean + keto way of eating includes a tremendous variety of foods. It’s a diet full of different colors, textures, and tastes. Here is a shopping list to guide you and prep you for the meal plans below.
When choosing your protein sources, try to purchase grass-finished or certified organic meats, including beef, poultry, and pork. When selecting fish, try to obtain wild-caught, with an emphasis on smaller fish less contaminated by mercury and other toxins. In shopping for vegetables, choose organic and in-season vegetables whenever possible, including dark and leafy green vegetables, root vegetables (squash, turnip, carrots), celery and celeriac, tomatoes, eggplant, onions, peppers, and garlic.
Your herbs should be local or organic, fresh or dried, including cilantro, parsley, basil, thyme, rosemary, dill, mint, tarragon, and others, used regularly and in abundance to season food and reduce reliance on fat, sugar, and salt for flavor.
Legumes come in many varieties. They too should be organic or non-GMO, such as lentils, black-eyed peas, black beans, chickpeas, kidney beans, and others, preferably dried, not canned or precooked, unless the label states that the packaging is nonharmful.
Nuts and seeds, including flaxseed, walnuts, almonds, hazelnuts, and others, preferably raw and unsalted, should also be locally sourced, organic, and non-GMO. This is true of your other fat sources, too, including olive oil, olives, grape-seed oil, and coconut and coconut oil. Chia seeds should also be organic.
Here’s your list!
30% Protein List
Animal Proteins (Protein + Fat)
Beef
Bison
Buffalo
Chicken
Eggs
Pork
Turkey
Legumes (Protein + Fat + Fiber)
Adzuki beans
Black beans
Cannellini (white) beans
Chickpeas (garbanzo)
Kidney beans
Lentils
Lima beans
Navy beans
Pinto beans
30 Percent Fiber-Rich Carb List
Nonstarchy Vegetables (Carb + Fiber + Protein)
Artichokes
Arugula
Asparagus
Bamboo shoots
Bean sprouts
Beet greens
Bell peppers (red, yellow, green)
Broccoli
Brussels sprouts
Cabbage
Carrots
Cauliflower
Celery
Collard greens
Cucumber
Eggplant
Endive
Fennel
Flaxseed
Green beans
Kale
Leeks
Lettuce
Mushrooms
Mustard greens
Onions
Radicchio
Radishes
Shallots
Spaghetti squash
Spinach
Squash (acorn, butternut, winter)
Summer squash
Swiss chard
Tomatoes
Turnips
Turnip greens
Watercress
Zucchini
30 Percent Fat List
Fats (Fat + Carb +Fiber) to Enjoy at Each Meal
Avocado
Avocado oil
Chia seed
Coconut oil
Cultured or pastured organic butter
Flaxseed oil
Freshly ground flaxseed meal
Ghee (clarified butter)
MCT oil (highly refined, nutrient-dense coconut oil)
Olive oil (extra-virgin if used in salads)
Olives
Raw nuts: bulk raw almonds, cashews, pecans, walnuts, macadamia, Brazil nuts, pistachios
High-fiber, Starchy Carbohydrate Choices to Enjoy in Moderation (1–2 times per week)
Gluten-free pasta
Sweet potatoes, yams
Your 10 Percent List
Low-Fiber Starchy Carbohydrates to Enjoy in Limited Quantities
Bread
California basmati rice, California wild rice, or sushi rice
Corn
Pasta
White potatoes
Fruits (Enjoy in Moderation)
Apples
Bananas
Blackberries
Blueberries
Boysenberries
Cherries
Grapes
Lemon
Lime
Nectarines
Oranges
Peaches
Pears
Pineapples
Plums
Pomegranates
Raspberries
Strawberries
Tangerines
Watermelon
Supplements for Your Brain
Recently, scientists have been focusing on certain supplements that prevent the aging of the brain. In particular, these supplements have been shown to improve memory and neurogenesis (the creation of new neurons). Take as directed.
Acetyl-L-Carnitine and Huperzine A (acetylcholine)
Aniracetam
Centrophenoxine
Cerebrolysine (peptide)
Dihexa (or Angiotensin IV peptide)
Galantamine
Ginkgo biloba
HVMN (peptide)
Magnesium
Taurine
Transresveratrol
Semax (peptide)
Sulforaphane
Vinpocetine
Vitamin D
Ideally, we would get all our nutrients from the foods we eat daily and not need to supplement with vitamins and minerals. But for the vast majority of us—even those of us who are committed to eating healthfully and avoiding foods that can cause us harm—a diet that delivers all the necessary nutrients in abundance just isn’t realistically obtainable. We are faced with continual, increasing depletion of nutrients from soil due to pollutants, chemicals, and toxins, which leads to nutrient-deficient or even toxic foods. Toxins in fresh water and the oceans also affect the quality of nutrition we can obtain from wild or farmed foods. For instance, children and pregnant women should not eat freshwater fish because of the high occurrence of mercury in those fish, and certain large-finned ocean fish are also contaminated with mercury. So our bodies need reinforcements, more protective power, to successfully thwart these toxic threats to health. The dosages provided are in line with the amounts that I most often suggest for my patients, but your individual requirements may be different, so always consult with your health care provider about your specific needs.
B complex Supports adrenal health, assists the body in converting food to energy, improves and protects cognitive function, lowers a woman’s risk for breast cancer.
In food: egg whites, lean meats (including poultry), fish, cabbage, lentils, soybeans
Supplement: 25–100 mg daily with food
A full B complex includes B5, B6, B12, and a methylated form of folic acid.
Coenzyme Q10 CoQ10 is a powerful antioxidant and a critical nutrient for cellular health. Studies show CoQ10 protects against breast cancer and extends the survival time for women with breast cancer. People who take statins, beta-blockers, and antidepressant medications have diminished levels of this important enzyme and should often supplement.
Supplement: 100–300 mg daily with food
Turmeric Turmeric, the vibrant orange spice used in Indian and other Southeast Asian cuisines, is a potent anti-inflammatory. It has been shown to improve memory, cognitive function, and learning capacity and protect the nervous system from oxidative stress. Turmeric slows and prevents bone loss. It protects against diabetes, lowers triglyceride levels, and reduces cholesterol. Turmeric boosts levels of vitamins C and E and helps prevent cancer. This nutrient slows aging at the cellular level and extends life span.
Supplement: 600 mg daily with food
Vitamin C This antioxidant protects against breast cancer and lowers breast cancer mortality. It contributes to vascular and cardiovascular health and protects healthy brain function.
In food: dark and leafy greens, citrus fruits, berries, kiwifruit, broccoli, tomatoes
Supplement: 1,000 mg daily
Vitamin D An anti-inflammatory, vitamin D helps protect against breast cancer, skin cancer, and prostate cancer. Vitamin D slows the growth of breast cancers and other cancers. This vitamin offers protection against autoimmune disease and slows aging. Vitamin D is highly protective to the brain, helping dispose of beta-amyloid protein and protecting myelin levels in the brain. It also protects against bone loss and improves muscle strength and mood. Test for vitamin D levels before starting a supplement routine in order to identify the correct dosage. The optimal range is 60–80 ng/mL, and women should not exceed 100 ng/mL. If you are taking more than 1,000 iu daily, do so only in consultation with a physician. And always pair vitamin D with vitamin K or you risk building up calcium deposits in places you don’t want, including the blood vessels!
DHA/EPA (Fish Oil) Anti-inflammatory, with broad and powerful health benefits and protections to cardiovascular health and cognitive health and function. Also has been shown to reduce risks for breast cancer and slow breast cancer growth.
Supplement: 1,000–2,000 mL daily
Ginkgo Biloba Provides cancer protection, including against colon and ovarian cancers. Increases oxygen supply to the brain, works to protect and improve memory and to slow age-related memory loss. Increases antioxidants and reduces oxidative stress and inflammation throughout the body, including the brain. May help treat migraine. Follow the suggested amount on the product.
Vitamin K Helps build bone and can treat osteoporosis. Provides protection to brain health. Offers cancer protection and protects cardiovascular health. Improves insulin sensitivity.
In food: leafy green vegetables, cruciferous vegetables, tomatoes, turnips, parsley (raw), vegetable oils, including olive, soybean, canola, and cottonseed. Hydrogenated oils decrease the body’s ability to absorb vitamin K.
Supplement: 75–150 mcg daily with food
Magnesium Magnesium is a powerful enhancer to overall physiological function. This mineral reduces stress, improves sleep, helps the body absorb nutrients, and moves the bowels for better removal of waste.
In food: legumes, dark leafy greens, fish, nuts. Also found in whole grains and oats.
Supplement: 400–1,000 mg daily with food. Start with the lowest dose and work gradually upward if necessary. Signs that magnesium dose is too high are diarrhea, very soft stool, unusual sleepiness in the daytime or at times when one would expect to be alert.
Quercetin This bioflavonoid provides protection against breast and other cancers and may treat cancers. Working to boost the effectiveness of resveratrol, quercetin also can help minimize the damage to the body from oxidative stress. Quercetin reduces inflammation, protects against neurodegeneration, and reduces hypertension. Follow the dosage suggestion on the product packaging.
Transresveratrol This antioxidant is found in the skins of grapes and other berries and is considered part of the explanation for the “French paradox”—the combination of low cardiovascular disease combined with a diet high in saturated fat that exists in France. Transresveratrol protects brain function and health and lowers inflammation throughout the body, and specifically in the brain after injury. Transresveratrol protects against breast cancer and encourages apoptosis, or healthy cell death. This compound can help improve sleep and strengthen sleep-wake cycles. It also may reduce polycystic ovary syndrome.
Supplement: up to 50 mg daily with food
Tocotrienol E and Vitamin E Complex An antioxidant, vitamin E helps prevent cancer and slows cancer growth. This combination provides a complete range of necessary vitamin E compounds, including gamma, delta, and alpha E. Vitamin E functions as a strong antioxidant and promotes brain health.
In food: nuts and seeds and their oils, including sunflower seeds and almonds and their oils; spinach; beet greens; collard greens; fish; wheat germ; olive oil
Supplement: 400–800 iu E complex and 100 mg tocotrienol E daily with food.
Supplements for Weight Loss and Weight Management
These supplements can further boost your metabolism and help you burn calories, improving weight loss. For all supplements, follow the directions on the product for dosage.
Curcumin: decreases body fat, lowers risk for obesity
Transresveratrol: helps optimize metabolic function
ALA (alpha lipoic acid): spurs weight loss, increases insulin sensitivity
L-arginine: decreases body fat
Lovida
The Mediterranean + keto approach is optimal, no matter how old you are or what kinds of hormone supplements you begin. Its holistic, nutrient-rich combinations support long-term hormonal balance, achievement of a healthy weight, and resistance to illness and disease. That said, there are nutritional and dietary priorities that change with age and hormonal life stages. Below are the modifications that are relevant to you now and into the future.
This is the time to create a strong foundation of dietary health and balanced eating habits. In your twenties, metabolism is as robust as it will ever be in your adult lifetime, but don’t let that lead you astray from healthful eating. Rather than use this time to indulge in processed foods loaded with sugar and additives, use your young adulthood to establish the eating practices you’ll rely on for the rest of your life. Learn to cook, invest in organic foods, and keep your sugar indulgence to a minimum.
During these years, you should pay particular attention to eating a diet that includes the following nutrients:
Calcium: Food sources include eggs, tofu, almonds, salmon, cabbage, yogurt, milk
Iron: Food sources include dark greens, whole grains, oats, and lean protein in fish, chicken, and pork
Folate: Food sources include dark greens, citrus, tomatoes, legumes, whole grains
Vitamin C: Food sources include peppers, citrus, tomato
During your forties, it becomes increasingly important to maintain a healthy weight. It also becomes more difficult, thanks to a slowing metabolism and wildly fluctuating hormones. During this decade, you should focus on the following:
Avoiding sugar. This will help keep inflammation in check, reduce uncontrolled appetite and cravings that lead to weight gain, and diminish fatigue and energy crashes.
Limiting starchy carbs and salt. Processed and high-starch grains contribute to bloating, which is common for women in their forties and women in perimenopause. Steer clear of processed grains like pasta and bread or any grain that causes you to bloat. Salty foods also make bloating worse.
No snacking. Planning healthful, satisfying meals will help you feel satisfied and less likely to need to snack throughout the day, which can easily lead to weight gain.
During these years, pay particular attention to eating for brain health and bone health. With metabolism continuing to slow, portion control becomes especially important to keeping weight in check.
Avoid foods that trigger menopause symptoms. Certain foods, including alcohol, chocolate, caffeine, and some spicy foods, can exacerbate night sweats and hot flashes.
Up your healthy fats and fiber. These dietary components will help you feel full and satiated, while also promoting healthy digestion.
Support your bones. Consuming foods rich in calcium, magnesium, vitamin D, and vitamin K can help protect bone strength with age. Wild-caught fish, organic soy foods, nuts and seeds, and dark greens are among the best sources of these minerals and vitamins when you are in your fifties and sixties. Limit caffeine and alcohol to limit bone loss and to avoid blocking absorption of nutrients like calcium that support bones.
Eat for your brain. Many of the foods that support bone health also provide protection for the brain. Focus on lean proteins and healthy fats, from wild-caught fish, organic animal proteins, and organic soy products. Omega-3 fats and fatty acids are essential for brain health. In addition to wild-caught fish, avocados, nuts, and seeds are excellent sources of omega-3s.
Consume organic phytoestrogens. Food sources of estrogen can help supplement the dwindling estrogen in your body. Organic soy products are a good source of phytoestrogens, as are many seeds, including pumpkin, sesame, and sunflower.
YOUR HEALTH JOURNAL: MINDFUL EATING
I highly recommend using your journal as a place to record the foods you eat. Especially as you begin your shift into healthy eating—whether or not you follow my Mediterranean + keto plan to the letter or not—making a habit of thinking about your food choices can have a positive impact on feeling more in control of how you eat, when you eat, and how much you eat. Soon, you may not need such attention to detail. However, any change in habit and the formation of a new habit takes conscious effort and a willingness to be aware.