Keto For Women: Does It Work?

The ketogenic (keto) diet is a high-fat, low-carb eating plan that shifts the body into a metabolic state called ketosis, where the body uses fat instead of carbs for energy. While the keto diet has shown promise in improving certain aspects of health in women, including body weight and blood sugar control, it is not suitable for everyone.

The keto diet has been shown to be effective for weight loss, particularly for women with polycystic ovarian syndrome (PCOS). It can also help reduce body fat and improve blood sugar control, making it a complementary treatment for certain cancers. However, the keto diet is highly restrictive and may not be suitable for women who are pregnant or breastfeeding.

Additionally, the keto diet can impact women's hormones, including cortisol, estrogen, and thyroid hormones. It may also increase cholesterol levels and disrupt gut health. As such, it is important to consult a healthcare professional before starting any new diet, especially one as restrictive as keto.

Keto and weight loss for women

The keto diet has been shown to be an effective way to lose weight for both men and women. However, there are some key differences in how women respond to the diet, especially in terms of weight loss.

Keto is a high-fat, low-carb eating regimen where 55-70% of calories come from fat, 20-35% from protein, and less than 10% from carbohydrates. This ratio helps the body achieve a fat-burning state called ketosis, where the body uses fat instead of carbohydrates for energy.

While men and women have the same fat-burning machinery and ability to produce ketones, there are some differences. Women's nutritional needs differ depending on their life stage, particularly regarding fertility, pregnancy, and breastfeeding, which require a surplus of nutrients.

The satiating nature of the keto diet can make it easy to under-eat calories, which may be problematic for premenopausal women trying to stay fertile or nursing a baby. However, keto can help overweight women with PCOS improve their hormonal health and lose weight.

Weight Loss Studies in Women

Several studies have shown the effectiveness of keto for weight loss in women:

• Obese women on keto lost more weight than those on a calorie-restricted low-fat diet, even without intentional calorie restriction.
• Overweight women with PCOS lost an average of 21 pounds after 12 weeks on keto.
• Women with endometrial or ovarian cancer lost 16% more visceral fat (belly fat) on keto compared to a high-fiber, low-fat diet.
• A small study on women following a low-calorie keto diet found they lost body fat and experienced decreased food cravings after 14 weeks.

Long-Term Weight Loss

While research supports the use of keto for short-term fat loss, there is a lack of studies on its long-term effects. Some evidence suggests that the weight-loss benefits may decrease around the five-month mark due to the diet's restrictive nature.

Other Considerations

• Less restrictive low-carb diets may have comparable weight loss effects and are easier to sustain long-term.
• The keto diet may not be suitable for women with a history of eating disorders, as it severely restricts certain food groups, which could increase the risk of disordered eating patterns.
• The quality of food choices matters on keto. A review of Japanese adults found that keto diets high in processed animal products or inflammatory fats were associated with increased mortality, while plant-based keto was linked to lower cancer risks.
• It is important to ensure adequate fiber intake on keto, as it is critical for hormone balance and gut health.

Keto and blood sugar control for women

The keto diet has been shown to be effective in improving blood sugar control in women, especially those with type 2 diabetes. This is because the keto diet limits carb intake to less than 10% of total calories, which helps to keep blood sugar levels stable.

Several studies have demonstrated the positive effects of the keto diet on blood sugar control in women. One 4-month study of 58 women with obesity and type 2 diabetes found that a low-calorie keto diet caused significantly greater weight loss and reductions in fasting blood sugar and hemoglobin A1c (HbA1c) than a standard low-calorie diet. HbA1c is a marker of long-term blood sugar control.

Another 2019 case study of a 65-year-old woman with a 26-year history of type 2 diabetes and depression showed that after following a ketogenic diet for 12 weeks, along with psychotherapy and high-intensity exercise, her HbA1c dropped out of the diabetic range, and her fasting blood sugar and markers for clinical depression normalized. Essentially, this case study showed that the ketogenic diet put this woman’s type 2 diabetes into remission.

A 2017 study of 25 people, including 15 women, showed similar results. After 32 weeks of following a keto diet, approximately 55% of the study population had HbA1c levels below the diabetic level, compared with 0% who followed a low-fat diet.

In addition to improving blood sugar control, the keto diet has also been shown to aid in weight loss, improve cancer treatment, and increase energy levels in women. However, it's important to note that the keto diet may not be suitable for all women, especially those with certain medical conditions or who are pregnant or nursing.

While the keto diet has shown promise in improving blood sugar control in women, it is always recommended to consult with a healthcare professional before starting any new diet, as individual needs and considerations may vary.

Keto and cancer treatment for women

The ketogenic diet has been shown to be beneficial when used as a complementary treatment for certain types of cancer in women, alongside traditional medications. However, it is important to note that the ketogenic diet is not suitable for everyone and carries some risks.

One study of 45 women with endometrial or ovarian cancer found that a ketogenic diet increased blood levels of ketone bodies and lowered levels of insulin-like growth factor 1 (IGF-1), a hormone that may promote the spread of cancer cells. The decrease in blood sugar levels seen in those following ketogenic diets creates an inhospitable environment for cancer cells, which may suppress their growth and spread.

Research from 2018 also shows that the ketogenic diet may improve physical function, increase energy levels, and decrease food cravings in people with endometrial and ovarian cancer. The ketogenic diet has also shown promise when used as a treatment alongside standard treatments like chemotherapy for other cancers that affect women, including glioblastoma multiforme, an aggressive cancer that affects the brain.

However, it is important to note that the ketogenic diet is highly restrictive and may be challenging for cancer patients to adhere to due to its limited food choices. It can also be difficult for those undergoing traditional cancer therapies to consume enough calories while on the diet. Poor compliance makes the diet challenging for people with cancer, especially when food can be a source of comfort.

Furthermore, the ketogenic diet should not be used as a standalone treatment for cancer. While it has shown promise as a complementary treatment, no major cancer group recommends keto diets for either the prevention or treatment of cancer. The diet is not appropriate for everyone, and it could even cause harm. It is always recommended to speak with a medical professional before starting any new diet, especially for those with cancer.

Keto's effect on women's hormones

The keto diet has been shown to have various effects on women's hormones. While it can be beneficial for some, it may have negative consequences for others. Here are some key points to consider:

Weight Loss and Hormone Balance:

• The keto diet can lead to weight loss by increasing fat burning and reducing calorie intake. This weight loss may also impact hormone balance.
• A study found that obese women on a keto diet lost more weight than those on a calorie-restricted low-fat diet.
• For women with polycystic ovary syndrome (PCOS), the keto diet has been shown to improve hormonal imbalances and boost fertility.
• However, rapid weight loss can lead to a decrease in estrogen levels, potentially causing infertility, vaginal atrophy, and increased risk of osteoporosis.

Impact on Stress and Sex Hormones:

• The keto diet may increase the body's stress response, leading to higher levels of cortisol, the primary stress hormone. Elevated cortisol levels can make weight loss more difficult and are linked to anxiety, depression, and heart disease risks.
• Restricting carbohydrates can disrupt the hypothalamic-pituitary-adrenal (HPA) axis, leading to hormonal imbalances and potential HPA axis dysfunction.
• The keto diet may also impact sex hormones, including estrogen. Fiber is essential for removing estrogen from the body, and a keto diet may not provide enough fiber.

Menstrual Cycle and Fertility:

• The keto diet's impact on hormones can affect the menstrual cycle. Excessive weight loss or nutrient depletion may cause reproductive functions like ovulation to shut down, leading to irregular cycles or amenorrhea.
• However, some women report improved PMS symptoms while on the keto diet.
• The impact on fertility is mixed. While some studies suggest that keto can improve fertility in women with PCOS, others caution that nutrient restriction may stress the body, making it challenging to get pregnant.

Blood Sugar and Insulin:

• The keto diet can significantly improve blood sugar and insulin response, which is especially beneficial for women with PCOS who often deal with insulin resistance.
• By reducing the need for insulin, keto can help prevent high insulin levels that make weight loss difficult and potentially lead to type 2 diabetes.

Cholesterol and Heart Health:

• The keto diet's effect on cholesterol is mixed. Some studies suggest it may increase total and LDL ("bad") cholesterol, while others indicate it can increase HDL ("good") cholesterol.
• Women with a history of high cholesterol or heart disease should be cautious about the keto diet and monitor their lipid levels regularly.

Other Considerations:

• The keto diet may be too restrictive for some women, especially those with a history of eating disorders or certain medical conditions affecting the kidneys or liver.
• The quality of food choices matters. Keto diets high in processed animal products or inflammatory fats may be associated with increased health risks.
• Prioritizing plant-based foods, including fiber-rich vegetables, healthy fats, and nutrient-dense whole foods, is essential for hormone balance.
• Cycling keto or combining it with intermittent fasting may be a better approach for some women to optimize benefits while mitigating health risks.

Potential risks of a keto diet for women

The keto diet has been associated with several health benefits for women, including weight loss and improved blood sugar control. However, there are also potential risks that women should consider before starting this diet. Here are some of the potential risks of a keto diet for women:

• Keto and cholesterol: The keto diet may increase total and LDL (bad) cholesterol levels, especially if the diet includes a lot of saturated fat from animal sources. If you have a history of high cholesterol or heart disease, keto may not be recommended due to these potential negative effects on heart health.
• Keto and disordered eating: Any diet that severely restricts certain food groups can increase the risk of disordered eating patterns, such as binging or developing a fear of food or weight gain. If you have a history of eating disorders, keto may not be a healthy choice.
• Keto and missing nutrients: The keto diet may not provide all the essential vitamins and minerals your body needs, such as calcium, vitamin D, magnesium, and phosphorus. Over time, this could lead to nutrient deficiencies. Additionally, the keto diet may not provide enough fiber, which is critical for hormone balance and gut health.
• Keto and kidney health: The keto diet's focus on animal-based and high-fat foods can increase the risk of kidney stones and worsen metabolic acidosis. Individuals with chronic kidney disease should avoid keto as it can lead to a state of acidosis and worsen their condition.
• Keto and digestive issues: The restriction of carbs on the keto diet can make it difficult to meet daily fiber needs, leading to digestive discomfort and constipation.
• Keto and nutrient deficiencies: The keto diet restricts several nutrient-dense foods, such as fruits, whole grains, and legumes, which may result in vitamin and mineral deficiencies over time.
• Keto and low blood sugar: While keto can help manage blood sugar levels in people with diabetes, it may also increase the risk of dangerously low blood sugar levels in individuals with type 1 diabetes.
• Keto and bone health: The keto diet has been linked to impaired bone health, with studies showing decreased bone mineral density and increased markers of bone breakdown.
• Keto and chronic diseases: There is some evidence that the keto diet, especially when focusing on animal-based food sources, may lead to poor health outcomes and increased risk of chronic illnesses such as heart disease and cancer.
• Keto flu: Many people experience flu-like symptoms such as headaches, brain fog, constipation, and muscle cramps when transitioning to the keto diet.

Frequently asked questions