Pro Tips from Ted Naiman MD and Virta Health


(Patricia) #62

I have also read that seniors need more protein in order to preserve muscle mass, but I want to be careful not to eat too much protein that would then produce glucose. What’s an old gal to do? :grinning:

(Michael - Don't expect miracles and you won't be disappointed.) #63

@Tulip Gluconeogenesis is demand driven, not supply driven. Your liver can make glucose out of fat just as happily as from protein. So don’t worry about it.

(Michele) #64

Such an awesome read. Long but worth reading and should be compulsory for anyone committed to good health. Like many things keto is a tool on a path. Make sure you understand the tool and use it as it could be used to maximise the best outcome.

(Jane) #65

I can attest to that!

Measured my blood glucose when water fasting only and have seen it go up 50 units with no intake of glucose so my liver made it from my fat.

(PJ) #66

So don’t eat fat calories just to eat it
But don’t eat too few calories or you screw up your RMR
But just eat to satiation
Except if satiation is too few calories
This is a catch-22 cycle that must be brain-crunching especially for new people.

The underlying question I think most people would have, after wading through the minutae, is: “For me, what is my RMR, and once I have that approximate magical number, how many calories UNDER that can I eat, without reducing my RMR – yet still lose at least some fat?”

(For simplicity we will assume that the Cosmic Nexus of Menopause is within the Great RMR Mystery.)

(An aside: This idea that people should just eat intuitively is hilarious. I’m sure it probably works for some normal people. Lots of people who come to keto eating do it because they are not normal and often haven’t been for eons – their appetite, as well as their metabolism, is totally deranged. There needs to be some better guideline than “satiety” for people who either are almost never satiated until they’re so overstuffed they’re vomiting, or who have so little appetite that satiation at 600 calories every few days seems ok.)

So, protein. One guy says 120g protein is a fair middling amount for a normal person. Also says you should eat 70% fat. 120*4=480 calories. Since even spices and garlic and such have carbs, we’ll allot 5% carbs. That leaves 70% exactly. If 120g is 25% protein then the diet has 1920 calories a day, of which 1344 are for fats. 1,344 calories is ~150 grams fat (rounding). That is A LOT OF fat. Now maybe everyone else chews on gigantic strips of fat surrounding every piece of meat they have, or eats 20 strips of bacon a day, but holy crap, I love fats but getting that many down my throat regularly is a massive PITA. So far I only manage it with garlic cheese spread, and while I’m on that topic, if it wasn’t for cheese my ‘high fat’ diet would be completely screwed.

But if I weren’t “intentionally and deliberately” eating more fat, in order that I would have enough calories, I would be undereating. At least, we assume, since I still weigh 380 and while much lighter than I began, that’s still more than my refrigerator. And it was great to lose weight while eating minimal calories and decent protein, except I’m pretty sure I lost more hair than fat, and I’d frakkin like it back again.

And what is under eating, anyway. I know people living on 1200 calories a day and keto and they cannot seem to lose weight. Is that because they under-ate for all that time and now there is “nowhere lower to go.” Ah, ok, so keep the calories up to a decent number because as noted above, the body can only pull so much from your own fat at once, so exogenous fat makes up the difference. Great. What difference is that, precisely? 50 calories? 1000 calories? Does someone have any kind of number? I mean sure we’d have to have an RMR to begin with but say we do (I ‘kind of’ do). How much under that can one eat without causing problem adaptations in the metabolic rate?

Or maybe it’s just not about calories. Maybe it’s always about nutrients and if we lived on mostly ruminants and a randomly unpredictable assortment of additions – some of which are slightly carby, just not insanely so and always brief – maybe that’s the ticket.

Perhaps it should be some consolation that as black-box-mystery as women in menopause seem to be (I’m 54 in Sep and clearly in the early stages of it), apparently ‘metabolism’ is nearly as mysterious for the world at large.


LOVE that.

Yes, and it’s a whole extra mystery too lolol.

I agree that there’s a catch 22 element to the intake/satiation/nutritional reqs thing. Fortunately new people needn’t worry about such nuances though, they can, and should, just eat fat and keto foods ad libitum.

It’s the fat-adapted oldies that this catch 22 really takes over the edge, lol. Especially for the obese - when 100% fat-adapted and the body is eating your own fat, you’re not actually undereating!

Another aspect to the topic is “what is a high fat body?” If you ask most menopausal gals who are staring at/holding their two extra handfulls of insta-belly fat, we might feel like we qualify for a high fat body - even those of us whose waist measurements and waist-to-height ratios are not technically overweight or obese. A degree of extra subcutaneous fat is not unhealthy for midlife folks - and some studies even proclaim that more subcutaneous fat at ages 50+ is a sign of health! :thinking:

I’m arriving more and more to an opinion that midife females once officially menopausal aren’t likely to speed recomp without strength training and/or fasting… and that - for the non-obese/non-IR at least - recomp can naturally speed up a couple of years post-menopause anyway once the hormonal havoc settles…


The mid-section takes time, many seasons. The science behind it is that we don’t burn subcutaneous belly fat directly. First the fat in the fat cells is swapped out with water and re-purposed - moved to replace the visceral fat that we do burn. This means that after initial belly shrinkage on keto, the measurements may actually go up before they go down again. I’ve been pondering this lately… The belly is the last to go, and it doesn’t have much to do with weight - it’s about recomposition.

(LJ) #69

Well said, thank you for the words to put around this.

(Patricia) #70

Thanks for the info!