Is Low-Carb Good For Female Weight Loss?

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Low-carb diets - meaning diets that are low in carbohydrates - come in many different forms. We're asking the real questions surrounding low-carb diets: what are the benefits for women? Is it possible to lose weight during the menopause with low-carb diets? And, above all, is low-carb even healthy?

Table of contents

As we know from fasting, there are major differences in how the sexes react to certain dieting techniques. Research has shown that intermittent fasting has many advantages for men, while women do not reap the same rewards and often suffer disadvantages from a shortened eating window.

So what's the deal with low carb diets or other diets that largely avoid carbohydrates? Are there differences between men and women? And is low-carb recommended for losing weight during the menopause?

What does low-carb mean?

Our body needs three groups of nutrients to function properly: carbohydrates, proteins and fats. 'Carbs' is short for carbohydrates - and low-carb therefore means fewer carbohydrates. A low-carb diet restricts the amount of carbohydrates that are eaten.

Carbohydrates are the body's main source of energy. During digestion, the intestine breaks down complex carbohydrates into simple sugars (glucose) and releases them into the blood (which is known as our blood sugar). The hormone insulin is released to channel the glucose into the body's cells, which then use it to produce energy. We store excess glucose in our liver and muscles and convert some of it into body fat. Incidentally, the brain uses only glucose as an energy source.

Not all carbohydrates are the same - they can be roughly divided into four groups:

  1. Simple refined (e.g. household sugar, added to processed foods)
  2. Simple natural (e.g. lactose in milk and fructose in fruit)
  3. Complex refined (e.g. white flour)
  4. Complex natural (e.g. wholemeal cereals, beans, lentils)

Good sources of carbohydrates are cereals, fruit, vegetables and pulses (beans, lentils and peas, for example). The more complex the carbohydrates, the slower they are digested and the lower the rise in blood sugar after consumption. They also provide fibre, which is filling and serves as food for the intestinal bacteria.

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Why should you eat low-carb?

People will often tell you the best way to lose a few pounds during the menopause is to "just cut out the carbohydrates." But is it that easy? Or effective? Is cutting out carbohydrates the only way to lose weight? And is it even healthy?

The low-carb diet is often chosen as a diet with weight loss as the primary goal. Some low-carbohydrate diets are also used to support certain illnesses, e.g. type 2 diabetes or the ketogenic diet as one of the oldest treatment methods for epilepsy.

When it comes to losing weight, low-carb also follows the laws of physics. As with all other diets, the first principle of thermodynamics applies to the desired weight loss: eat fewer calories than the body consumes. This is also known as CICO (short for calories in, calories out). 

What do you eat on a low-carb diet to lose weight?

Rather obviously, in low-carb diets carbohydrates are reduced. For example, cereals, pulses, fruit, bread, sweets, pasta, starchy vegetables and sometimes nuts and seeds are restricted. Instead, they are replaced by foods with a high protein and fat content, as well as some non-starchy vegetables.

Low-carb exists in many different forms - some allow small amounts of vegetables and wholemeal products. How low the carbohydrate content is varies with the radical nature of the respective low-carb diet. Three well-known forms of low-carb diets are:

  • Atkins: The Atkins diet popularised low-carb in the 90s. Carbohydrates are reduced over 4 phases. Start with <20g carbohydrates for the first 2 weeks.
  • Keto/ketogenic: The body should go into ketosis, i.e. get its energy from fat (ketones) instead of carbohydrates. You allow for only 20-50g of carbohydrates per day in your diet, instead opting for more protein- & fat-rich foods - approx. 5-10% carbohydrates | 60-80% fat | max 20% protein. Fruit, starchy vegetables and alcohol are severely restricted.
  • Paleo/Stone Age: The focus here is on meat, fish, seafood, eggs, vegetables (particularly those which are low in starch such as cucumbers, tomatoes, courgettes, peppers and many cruciferous vegetables), as well as fruit, roots, nuts and seeds. Strict Paleo diets leave out processed foods, added sugars, grains, pulses and dairy products. Paleo has no fixed rule for the minimum/maximum number of carbohydrates and is therefore not necessarily always defined as "low-carb".

For comparison: the usual Western diet consists of approx. 45-65% carbohydrates. At 1,800 kcal per day, that would be around 200-240 grams of carbohydrates.

Is a low-carb diet good for losing weight?

Recently, a study compared the differences between males and females - in search of answers to the question: How effective is a low-carb diet for women to lose weight?

Why research this?

Well, women often find it more difficult to lose weight than men in general, and weight gain during the menopause is a particular problem for many women. The increase in weight, especially on the stomach is due to hormonal changes and the inherently lower muscle mass that comes with age. Anyone who has ever been on a diet at the same time as a man knows this: while HE easily loses 5-6 kilos in a week, the scales for HER move down by a maximum of -1 kilo. In addition, women on a diet often suffer from low mood, problems with concentration and even irregular periods.

The study analysed data from DIETFITS: 609 overweight adults ate either a healthy low-fat diet (HLF - Healthy, Low-Fat Diet) or a healthy low-carbohydrate diet (HLC - Healthy, Low-Carbohydrate Diet) for 12 months. They then looked at how the weight, fat mass and lean mass* changed in women and men.

For the women, the type of diet - i.e. low-carb diet or low-fat diet - made no difference to weight loss success!

*Lean mass includes water and glycogen. With low-carb diets, you initially lose a lot of water weight due to glycogen breakdown.

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Is low-carb good for women?

A low carbohydrate intake seems to have negative effects, especially for women, regardless of whether they are in the menopause or not. The female body goes into high alert more quickly when it receives less energy and nutrients. Alarm means stress and stress upsets all hormones.

Strict low-carb diets, such as the keto diet, are often associated with women but can cause:

  • Menstrual irregularity to the point of stopping periods
  • Negative effects on mood, cognitive abilities ('brain fog') and anxiety & depression
  • Muscle loss accompanied by loss of bone density, which is supremely detrimental to our bodies as muscles already shrink with age anyway
  • Reduced defences & more (chronic) inflammation
  • Rise in stress hormone level in the body, especially cortisol. At the same time, the performance of the thyroid gland decreases, which is entirely counterproductive if you want to lose weight since high cortisol levels and a lack of thyroid hormones lead to weight gain.

Leave low-carb to men?

The existing studies on the benefits of strict low-carb diets such as keto or low-carb high-fat (LCHF) were carried out on men, overweight people and diabetics. They therefore do not reflect what is good for women.

Dr Stacy Sims, an exercise physiologist and nutritionist, clearly rejects strict low-carb diets such as the keto diet on the basis of existing studies, as they place unnecessary additional stress on women's bodies and bring no clear benefits whatsoever.

DISADVANTAGES OF STRICT LOW-CARB DIETS FOR WEIGHT LOSS: THYROID GLAND

Problems with hypothyroidism and Hashimoto's affect women particularly frequently - especially during the menopause. The important thyroid hormone T3 reacts very sensitively to carbohydrate intake. If the amount of calories and carbohydrates decreases, T3 levels and reverse T3 (rT3) also fall. Active women in particular need sufficient amounts of energy and carbohydrates for a healthy thyroid! (1, 2).

Intestinal flora & digestion

Prebiotic fibres are important to keep the microbial intestinal landscape healthy, since the good intestinal bacteria feed on them. On a strict low-carb diet, where there are none or only a few complex carbohydrates and little fruit and vegetables on the menu, the body receives too little fibre. A healthy diet should provide the body with 35-45 grams of fibre per day. Without complex carbohydrates from cereals and vegetables, and without vegetable proteins from pulses, this is almost impossible to achieve.

In addition to imbalances in the intestinal flora, which we often do not notice directly, a lack of fibre is accompanied by flatulence, diarrhoea or constipation. The gut - especially the oestrobolome - also plays a key role in hormone metabolism. This is where it becomes clear that avoiding vegetables and complex grains is not a good idea.

Incidentally, disturbances in the stomach and intestinal flora and the omission of food groups also favour vitamin and mineral deficiencies, e.g. calcium deficiency on a strict Paleo diet ( which involves no milk and too few green leafy vegetables). This is a particular problem during the menopause when considering osteoporosis.

Brain (focus, cognitive performance)

While men on a ketogenic diet often experience cognitive benefits, the opposite is true for women. It increases the activity of the sympathetic nervous system ("fight or flight" nerve) and thus increases anxiety, insomnia and nervousness. Not only that, but your mood also suffers. If you are already struggling with concentration problems and brain fog during the menopause, the strict low-carb diet is particularly counterproductive.

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Disease risks

If carbohydrates are greatly reduced, the intake of fats is inevitably very high. In low carb diets, where these calories come primarily from animal sources, the body receives a lot of saturated fats, which studies have shown promote inflammation in the body and thus favour cardiovascular diseases, some types of cancer and a fatty liver.

Ketosis side effects

The generally known 'side effects' of ketosis in ketogenic diets are well documented. If carbohydrates are reduced quickly and drastically, many are accompanied by: constipation, headaches, muscle cramps, bad breath, fatigue & weakness. 

Incidentally, a woman's activity level also plays a role in the amount of carbohydrates she needs. Those who exercise regularly and do a lot of physical activity usually have a higher carbohydrate requirement. If active people restrict their carbohydrates too much, as is the case with the keto diet, this can slow down the metabolism in the long term, increase stress hormones and reduce muscle-building hormones. (Fewer carbohydrates = less insulin and insulin has an anabolic effect, i.e. builds muscle).

Is it impossible for women to lose weight with a low-carb diet?

No, but don't be fooled by statements like, "She also lost weight with low-carb!" "I read that the Atkins diet also showed improved blood sugar and cholesterol levels."

In fact, almost every calorie-reduced diet helps to reduce excess weight and improve blood sugar and cholesterol levels - at least temporarily (in the first 3 months). After that, it often turns into the opposite: increased abdominal fat, hormonal imbalances, psychosomatic problems such as depression and brain fog.

Strict low-carb is not a problem for a short diet period. However, since there is no evidence of any benefit for women, the question arises: why should you even bother doing it? For women, the disadvantages of a strict low-carb diet heavily outweigh the benefits.

So would you rather go high-carb? Carbohydrates without an upper limit? Or low-fat? Nope, not a good idea. So what about medium-carb?

Healthy weight loss alternative to the low-carb diet medium carb

As is so often the case, it's a question of quantity and balance. Medium-carb is the magic formula. A good, healthy combination is the Mediterranean diet, which is quite carbohydrate-conscious so to say. Lots of vegetables, complex carbohydrates in moderation and hardly any simple carbohydrates such as sugar - which are replaced by plant-based proteins and healthy fats.

  • Saturated fats are swapped for unsaturated fats - heart health rejoice!
  • Instead of meat, butter, cheese and cream, there's olive oil, fatty fish, nuts, seeds and avocado.
  • The proteins are predominantly plant-based from beans and lentils - combined with animal proteins from eggs, fish, seafood and the occasional cheese or poultry.
  • Carbohydrates come primarily from vegetables and wholegrains - preferably all home-prepared, as this prevents hidden sugar from sneaking in.
  • A moderate low-carb diet ensures that you get enough complex carbohydrates on your plate!
  • A large, conclusive study from 2017 showed that a medium low-carb diet is the best way for postmenopausal women to lose weight or keep it off. This consists of around 40% carbohydrates, around 30%-40% proteins and around 20-30% fat.

Dr Stacy Sims also recommends a diet for women that is classified as a "medium carb diet":

  • 40% carbohydrate, 30% protein, 30% fat - that's less carbohydrate than in the usual Western diet and than in the somewhat outdated DGE**, which recommends 55% carbohydrate. It is however also significantly more than strict low-carb diets, which only allow for 10-20% carbohydrates.
  • For the right energy level in everyday life and during sport, she recommends including enough protein in the diet and not restricting fats too much.
  • Above all, she advocates that women should eat enough of the right things: "Women perform better when they are full. Women need to eat!" We can endorse this directly as it's not unusual for menopausal women to have to eat more in order to lose weight.

And: According to Dr Sims, neither ketogenic diets nor strict intermittent fasting have any benefits for women!

The rule of thumb for women's nutrient intake - 40% carbohydrates, 30% protein, 30% fat - is also supported by the experts at Precision Nutrition and a recent study (April 2021) by the Journal of the International Society of Sports Nutrition.

Comparison of nutrient ratios in per cent: Keto, Medium Low-Carb, DGE

Nutrient amounts (grams) in comparison - 1,800 kcal day: Keto, Medium Low-Carb, DGE

low carb diet menopause diet plan balance pie chart

BUT HOW MANY CARBOHYDRATES SHOULD I EAT DURING THE MENOPAUSE?

Don't worry: you don't have to have a scale ready for every meal. Just roughly follow the "hand rule" for every meal:

  • Vegetables: Fist-sized portion
  • Proteins: Palm-sized portion (has the same thickness and diameter as the palm of your hand.)
  • Carbohydrates: (cereals, starchy vegetables, fruit): 1 handful
  • Fats: Thumb-sized portion

or simply fill the plate according to the division of the "food plate".

Conclusion

  1. Not all low carb diets are the same: there are a few people (including women) who do well on a strict low-carbohydrate diet. For the majority, around 70%, a moderate (medium) amount of carbohydrates is ideal. Too few carbohydrates can actually hinder weight loss.
  2. Not all carbs are the same: sugar and simple or refined carbohydrates are "worse", while complex, minimally processed carbohydrates such as wholegrains, vegetables and fruit are "good" and help you lose weight.

Bonus Facts

Everyone is different and everyone tolerates carbohydrates differently. Of course, the gut also plays a role - more precisely, the enterotype of the gut microbiome (usually type 1 or type 2). Different types of bacteria in the gut have different effects on metabolism:

  • Bacteroides-dominated intestinal flora (enterotype 1) can optimally utilise fat, fatty acids, proteins and amino acids - but carbohydrates much less effectively.
  • Prevotella-dominated flora (enterotype 2) can optimally utilise carbohydrates. The probability of enterotype 2 increases with the amount of fibre in the diet and is common in people who eat a lot of fruit and vegetables, especially vegetarians and vegans.

**German Society for Nutrition

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