March 28, 2023 • 27 mins
In a special two-episode series, the New York Times best-selling author, scientist and physician tells why women’s health needs are different from men’s, and shares her female-focused plan to help women live a healthier life. On today’s episode: The focus is on food, as Dr. Sara takes us through her achievable and empowering healthy-living plan created especially for women: The Gottfried Protocol. She tells why the protocol works so well for women, how to do it, and how it can make a difference in your outlook and even your weight in just four weeks.
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Speaker 1 (00:02):
I saw a lot of women I called them my
Keto refugees who were coming to my practice and they
went on keto maybe with a male coworker or a partner,
and had a similar experience to me. But they also
noticed they weren't sleeping as well, they weren't deriving some
of those benefits that men experience on keto, and so
(00:22):
that got me just figure out, Okay, how do we
work around this, How do we get this to work
for women too? That was doctor Sarah Godfried, scientist, researcher,
and best selling author. Doctor Sarah, as she likes to
be called, has an innovative, amazingly effective approach to women's health,
(00:43):
an approach that can help women deal with stress, get
more energy, and even achieve our healthiest weight. I'm Kim
Azarelli and this is Seneca's Conversations Today. We're bringing you
part two of our conversation about women's health with doctor
Sarah Godfried from our series Seneca's One Women to Hear.
In our previous episode with doctor Sarah, we learned why
(01:04):
women's physiology is different from men's and what that means
for our health. And we learned that a healthy metabolism
is the key to a healthy life now, just in
time to get the new year off to a great start.
Doctor Sarah takes us through her approach to women's health,
what she calls the Godfreed Protocol. We'll learn why the
(01:24):
protocol works so well for women, how to do it,
and how it can make a difference for you, Doctor Sarah.
Great to have you back on the show. Thanks. Obviously,
we've gotten to know each other a little bit over
the past several months, and I probably watched many of
your videos and I pheel I know you very well
and have read your book and started on what you
(01:45):
called the Godfreed Protocol, which is a four week plan
that you've laid out really well in your new book, Women,
Food and Hormones. And I just want to say it's working.
It is absolutely working. Yay. That's how I feel. I
feel like I have I don't know, so many good
things have happened. In fact, this is just anecdotal, but
I'm going to stick with it. Someone who lives in
(02:06):
my building stopped me on the street yesterday. Actually we
ranch each other in the elevator. He saw me on
the street and he said, you know, Kim, I was
going to stop and say hello. But then I thought, no,
that woman looks too young to be Kim. And I've
actually lost quite a bit of weight, but I think
feeling more importantly, I just have a lot more energy,
and I feel like this protocol is really like the answer.
(02:29):
And I'm becoming a little bit of a proselytizer because
everywhere I go, I'm like, well, what's your feeding window?
And you know, what are your net carves? And so
I think we need to tell the world about the
protocol so that I'm not just talking to myself and
that people understand all this vocabulary. But Sarah, you wrote
this with a very specific goal in mind, which is
you've done the research, you've lived the research, and you
(02:52):
do believe that there is a difference between men and women.
And we all know that there is in terms of
hormonal changes and biology, and you've put together what I
think is a pretty genius protocol. So how did you
come on this realization that there was a true difference
between what men and women needed in this type of
In this type of I don't want to call it
(03:13):
a diet, because it's not a diet, it's a lifestyle. Well,
I would say first, my entire career has been devoted
to sex differences, not for the purpose of one up
being or one downing one gender or another, but really
for the purpose of understanding both men and women. So
this came full circle for me about five years ago
(03:36):
when I went on a keytogeneic diet with my husband.
He rapidly dropped about twenty pounds. I had some initial success,
and then it backfired, it stopped working. I actually gained weight,
and that's what got me on this path of looking
at Okay, we know there's sex differences, we know there's
gender differences when it comes to metabolic health. Let's go
(03:57):
a little deeper. Let's understand why, especially the classic ketogenic
diet was not working for me and was not working
for frankly, hundreds of women in my practice. So that
got me on this path to look at things like
the testosterone advantage. We know, for instance, that women have
ten to twenty times less testosterone than men, and yet
(04:19):
it's still our most prevalent hormone. So it's a hormone
that we really need to be managing and tracking. It's
responsible not just for sex drive and muscle mass, but
also confidence and agency and so that was one of
the first pieces, was looking at some of these hormonal
sex differences that were responsible for this difference that I
(04:41):
saw with my husband, and there's a long list of them.
You know. One is that because men have more testosterone,
they have more lean body mass about fifty percent more
than women, they've got lower fat masks. We think women
need more fat mask to make hormones because fat is
the backbone of the hor months that you make. There's
(05:01):
many other differences. Estrogen can sometimes get in the way
of success with a ketogenic diet. We also, I believe
women may need more carbohydrates for the production of serotonin.
So serotonin, as many know, is that neurotransmitter that's responsible
for sleep, mood, appetite, and carbohydrates helped to raise serotonin.
(05:28):
So I saw a lot of women I call them
my keto refugees who are coming to my practice, and
they went on keto maybe with a male coworker or
a partner, and had a similar experience to me. But
they also noticed they weren't sleeping as well, they weren't
deriving some of those benefits that men experience on keto,
(05:49):
and so that got me to figure out Okay, how
do we work around this? How do we get this
to work for women too? You know, it's so interesting, Like,
there's so many things that you've already said that I
believe are sort of myths that are really things that
I'm learning by talking to you and reading your work
and the research. You know, this idea that first of all,
that fat is bad, you know, is always something that
(06:11):
I think you've kind of educated me on, and this
type of research has educated me on. Also the testosterone
myth that you know, testosteronees a guy's thing. I think
that's really interesting what you just said, and I'd love
to learn more about that. And then also the relationship
with carps. So I hope we get into all three
of those as you talk to us about the protocol. Yeah,
I'd say the myth about fat being bad is one
(06:32):
that just will not die. We have so much data now,
you know, over the past few decades really showing that
fat is essential. You know, seventy percent of your brain
is fat. When you eat fat, it helps you feel
more satisfied in terms of appetite. It's also, as I mentioned,
(06:53):
the backbone, especially of sex hormones like estrogen, progesterone, testosterone DHA.
So we really need to function. The question is how
do you personalize the amount of fat. So when I
was in medical school and Kim, this was a very
long time ago. So nineteen eighty nine, when I was
(07:14):
in medical school, I went off of fat. I did
a plant based diet, and my hormones became a hot
mess because my estrogen dropped, my breast got smaller, my
mood was worse, my cholesterol dropped significantly. We know that's
a marker of depression. So I really believe that we
(07:36):
need to have these food groups and we've got to
figure out, Okay, what's the right dose of carbs, what's
the right dose of fat, what's the right dose of protein,
so that you really have that metabolic health that we're after, right,
because I mean, the popular culture is avoid fat, skim scam,
scam again, this equation of like fat meaning that you're
going to be fat well, and it hasn't worked. It's
(07:58):
been a failed experiment. You know, as we have eaten
more carbhydrates, especially refined carbs, what's happened is that we've
got a higher and higher incidence of diabetes. We know
that somewhere around eighty eight percent of the US population
is metabolically unhealthy. Many of them don't even know it,
(08:19):
and so this advice that came down through the nineteen
seventies and eighties to cut back on fat really has
been a misfire. It just hasn't worked. And so a
more balanced approach I think is the way to go.
But for many women, as they become more balanced, they
need to have a therapeutic pulse the way that I
(08:40):
describe it in the book. So that's really how I
developed the Gutt Freed Protocol to help women do this
four week pulse where they can really personalize how much
of each of these macronutrients carbs, protein, fat are the
best for them. So take us through how it works.
What is the protocol and why do you set it
at four weeks? It four weeks because I think it's doable.
(09:02):
I also think that when you stay in ketosis longer,
there's some risks in terms of your cholesterol as well
as your level of inflammation, and so I think four
weeks is a pulse that is manageable. The first part
of the protocol, the first pillar is detoxification, and I
(09:23):
give folks about a week to get into a state
of open detoxification pathways. I think that's really important, especially
to flip that switch between burning carbs, which many of
us are stuck in I was in my thirties and forties,
to burning fat, which is really the goal with ketosis.
(09:45):
So that first part is detoxification. I want women to
be pooping every single morning. I want to really increase
the amount of vegetables. I think we can all agree
that that's healthy. That's the cruciprous vegetables broccoli, hauliflower, russ routes, radishes, etc.
As well as the alium vegetables, So that includes onion, scarlet, gleak,
(10:07):
the methylating vegetables. Those are the ones that help you
inactivate certain hormones like estrogen, and that includes the dark
green leafies. So detoxification is the first part. I see
in my practice all the time that women just don't
have their detox pathways open. Maybe it's because they're having
a glass or two of wine every night, or they're
(10:28):
over the age of forty and things just slow down,
you know. I think a lot of women notice that
as hangovers hitting a little bit harder, affecting their sleep
more and so we've got to help out the liver.
So that's the first part of the protocol. Then you
move into nutritional ketosis, where you're eating with the macronutrient
ratio that I found to be the most effective for women.
(10:50):
That includes sixty to seventy percent of your total calories
each day from fat, mostly plant based fat. So there
was just a study published by David Ludwig at Harvard
showing that if you keep your total saturated fat per
day at twenty one percent or less, that's necessitated with
the best cardiometabolic function going forward. So sixty to seventy
(11:14):
percent your total calories from fat, a portion of that
from saturated fat if you'd like to eat animal fat,
twenty percent of your calories from protein, that's a moderate
protein diet, and then about the remainder, so ten to
twenty percent of your calories from carbohydrates. But those carbs
really need to come from vegetables. And what I advise
(11:37):
is that you simplify this by focusing on net carbs,
so less than twenty to twenty five net carbs per day,
and that allows you to get the fiber that you
need to support your hormones as well. As to support
the benevolent microbes that are in your gut. So that's
the second pillar. The third pillar is intermittent fasting because
(11:59):
that really allow allows people to eat more carbydrates. So
it kind of depends on what some of your issues
are how long that window should be. I love that
you mentioned, you know, those new parlance that you've been using,
like with your feeding window. You know, generally what I
like is for people to start with about a fourteen
hour overnight fast and then a ten hour feeding window. Yeah,
(12:24):
that really worked for me. I mean I started actually
with sixteen eight, but then I read in your book
or maybe in one of our conversations that you know,
women don't need to kind of shock the system. It's
better to kind of ease into it. And so I'm
switched to a fourteen ten, which is very doable. And
I have to say that now I'm not really hungry
before that, and I feel weird eating after that, like
(12:46):
it doesn't occur to me. So I feel like my
body really appreciates it, actually, and I think that's one
thing that I'm learning from this whole experience, which I
again I won't call a diet, and I would love
to talk to you about diet culture, but you know
this lifestyle, like, I feel like my body is happy
you're in this mode, so it doesn't feel like I'm
being deprived. I feel actually the opposite. That's certainly part
of the benefit of this protocol. You know, it's designed
(13:08):
to get you into ketosis so that you have the
flexibility to switch your metabolism from burning carbs to burning fat.
And the analogy that I often use to describe this
as similar to a prius where you can flip the
switch between burning electricity or burning gas depending on what
(13:30):
type of fuel is available. So the body is really
designed to do this from Stone age times, and many
of us just with the availability of food, especially the
ease of carbohydrates and the deliciousness of carbhydrates, we tend
to overdo it and get too high a dose of carbs,
and that's really what gets us into trouble. But once
(13:52):
you flip that switch, as you have done Kim, and
you start burning fat, then you have ketones in your body,
in your bloodstream, also in your breath and in your urine.
And those keytons are not just a marker of how
successful you are on this God Freed protocol. But they're
also a signaling molecule, so they reduce inflammation. They help
(14:16):
you with being less puffy, they help you get rid
of excess fluid. A lot of us have fluid retention
starting in our forties and fifties, so this is a
major downstream benefit of the ketogenic diet. And then you
also mentioned energy. I think that's a really important piece
to highlight, because ketones are super energizing. They give us
(14:38):
focus and concentration and mental acuity. They help us with
appetite suppression, and that's part of the reason why I
think this approach is so successful for so many women.
I mean it's successful for men too, but for women
in particular. There's a way that I think our culture
makes us hungry, makes us it's hungry for more, makes
(15:01):
us hungry for equality, makes us hungry for soothing, makes
us hungry for greater solace. And what I find is
that those keytones really help with satiety, with feeling like Okay,
I'm at the end of my eating window, I finished
my meal, I'm done, I'm good. I can go focus
on other things without food thoughts kind of driving me
(15:25):
for hours each day. Yeah, I have to say that, like,
my guilt level around food is pretty gone. Like I
don't feel guilty about you know what I mean, Because
usually you're like, oh that was fattening or uh, that
wasn't so healthy, or you know, like there's always some
after effect, and I have to say like, because I'm
sticking to the protocol, I'm like, well this is great,
(15:45):
like olive oil, yes, avocado, as much as you like,
you know what I mean. Like, so the stuff that
I'm eating is good for you, and it happens to
be stuff I like. So I feel I don't feel
that same feeling of like, I mean, I don't want
to put down any particular diet plan, but like you know,
when you're on a plan and you feel like you're checking,
you're always like did I stick to it? Did I
stick to it? Am I sticking to it? I don't
feel that way with this. I feel like, oh, wow,
(16:06):
like this is complete freedom because I like what I'm eating.
I'm feeling a lot better, I'm losing a lot of weight,
and I just it's a totally sustainable lifestyle and it's
not about diet. I'm so glad you mentioned that, because
you know, I think so many of us as women,
exist along this spectrum of somewhat healthy to maybe eat,
(16:30):
disordered eating with restriction with permission, and it can be
tricky to navigate. It can be really tricky to navigate,
and so we end up maybe overindulging or eating something
that we don't think is the best information to be
feeding our bodies. And then we have that guilt that
you're describing, and I think many of us, and I'm
(16:52):
talking about myself here, mostly we then serve penance, you know,
so we go on a strict diet and minutes about
out this white knuckling experience of making sure that you're
following it even though you're hungry all the time. And
what I love about Keytones and about this particular approach
to a ketogenic diet adapted for women, is that it
(17:14):
allows you to just let go of that white knuckling,
so you have, as you described, food freedom. And that's
so beneficial because that really allows us to concentrate on
some of these other things that are so important, like
the mission that you serve, Kim, the mission that I
hope to serve with changing conversations about women's health. And
(17:35):
there's there's something just so delightful about being able to
step away from that hunger and from that, you know,
kind of constant inner saboteur that's telling us, oh no,
you can't eat that. Oh my gosh, you had way
too many bites off that chocolate cake. And so I
love that you're allowed to just awigh from that inner
(17:56):
dialogue that can be so harmful. Yeah, and it's just
too present, right, I think, like that's the whole context
of this conversation, which is the focus on women's appearance,
women's weight, the way we've all been educated, and so
that dialogue, which could be a healthy dialogue, is just
too present, I think in the culture in each of
our heads. You know, it's just taking up too much space.
(18:17):
And I think your point is so well taken. This
frees you from that. And I mean, I'm definitely experiencing that.
I never really you don't know me very well, but
you know, I'm not really like a very appearance focused person.
I'm you know, I'm just so into wanting to do
the things I want to do that I just it's
just not a big priority in my life. I don't
think about it that much. But even I, who I
(18:37):
would say is not that focused on it still had
that inner dialogue all the time of feeling guilty and
just knowing that I was like, you know, maybe that's
not so healthy, Maybe that's like a little fattening. Like
it's just those constant things that you just constantly think about,
and this it just clears up so much space. And
now I'm just I feel like my relationship with food
is much more positive. And you know, my father always
(19:01):
told me food, food is fuel, like that's been his mantra,
and I was like, yeah, great, Dad, Great. But now
I'm like, Okay, I get it. Food is fuel, you know,
and it's it's a different way of thinking about it.
It is a different way of thinking about it. You know.
I think this is really what I hope for women.
You know, I want us to move beyond the ways
(19:21):
that we've internalized diet culture. But I would also say
that the other end of the spectrum fat acceptance, body positivity.
While all of us can get behind the concept of
a more inclusive approach to different body shapes and sizes
and colors, you know, many of us still want to
(19:42):
fit into the clothes that are in our closet. You know,
Like I've invested a lot in the clay where I
want to fit into them. I don't want to just
be a woman who is going through this aching process.
I love aching, but the natural aching process is that
women are gaining fat mass as they get older, about
(20:03):
five pounds per decade starting in their forties, and they're
losing muscle mass again about five pounds per decade, and
so you may not even be changing your weight. That's
on a bathroom scale, which I think is a terrible
marker of metabolic health, but it's the one, you know,
It's kind of like shorthand that we use. You know.
(20:24):
What I want is for us to really understand that
some of these changes are occurring, and unless you're doing
something about it, you can wake up at age fifty
five or sixty and start to get these diagnoses that
you don't want, like party vasco disease, a heart attack, hypertension,
even Alzheimer's disease. So all of this is occurring in
(20:47):
the body decades before that scary diagnosis, and I really
want for women to understand that you can be empowered
to do something about it, and it can be, as
you said, a lifestyle that is not actually difficult. It's
it's a way to really grab the reins of your
own health and your destiny, like your health span, that
(21:10):
period of time that you feel fantastic and you're relatively
free of disease. Yeah, I mean, I'm telling you I'm
living it because I do feel that if it was
just for the weight, there's no way I would do it.
I just I'm not motivated enough. You know, I feel
I look good enough. You know, if I am a little,
if I'm ten pounds eavier, I'm it's good enough for me.
Like I'm not you know, I'm not that type of person.
But the idea of being healthier, of feeling healthier, and
(21:34):
of the longevity of the health span, that's super motivating
to me. And so I'm telling myself, you know, this
is just all positive. There's like nothing negative going on
in this, you know, and so that is extremely motivating.
And then thinking that you know, you could be I mean,
I love when you talk about an end of one
because this idea that it's personalized, it's you know, it's
(21:54):
a personalized approach, and you have to know what works
for you. You know, you start to sort of feel
that you feel like what works for you, it doesn't
you know, being able to just understand how your body
reacts to things is very very motivating to me. Just
I think it may be that moving from this sort
of I don't want to say imprecise medicine because I
think that's probably unfair, but I would say maybe generalized
medicine and first segmenting out men versus women, that's a
(22:17):
huge step in the right direction. And then I think
what you're doing, and I think the movement that you're
a kind of part of is doing is telling us
all like, okay, you should know you And I think
that that's a very motivating way to think about health.
It is motivating. And I would even say that imprecision
medicine is a term that's used quite frequently for the
(22:39):
way that medicine has been practiced for over a hundred years.
And by that, I mean when someone has a depression
and they get diagnosed with depression, they often get started
on an antidepressant. And yet we know with most of
the available antidepressants right now, that you have to prescribe
to about ten patients for one patient to benefit. When
(23:04):
it comes to statins, you know, one of the most
common drugs that are prescribed in US medicine, you have
to again prescribe about fifty patients with the statin for
one to benefit. So this is in precision medicine. We
know that the way that you react to food is
different from the way that I react, and the way
(23:24):
that you can really personalize it. The way that you
can step into precision medicine is to really understand, Okay,
what's going to work the best for me? Because there
is no one size fitsal diet. There isn't and this
book is really more about a template for determining how
to personalize diet so that it really supports you and
(23:46):
supports what you want your health for and whatever metrics
make the most sense for you in terms of measuring
your health. So for some people, that might be their
body weight on the bathroom scale. For others, it might
their body composition, the percentage of body fat or their
fat mouse that they have, or their lean body mass.
For some people it might be there fasting glucose or
(24:10):
their average glucose as you've been playing with with your
continuous glucose monitor. So there's so many different ways that
we can define it. But I think this point about
precision medicine is so important because we've always practiced medicine
for the average, and I don't want to be average,
(24:30):
and I don't want you to be average. I want
us to be optimal. I want us to really have
you know, that best possible health, the best possible mitochondria,
you know, those power factories that are inside of ourselves, which,
by the way, start to faulter after age forty in
women eighty percent of women, but not in men, especially
(24:53):
in the brain. And that's why so many women notice
that they have this mental slowdown. Their brain just slows
down a bit in terms of memory, in terms of
word finding, in terms of multitasking after age forty. So
what do we do about that? That's a metabolic problem.
One thing you can do about it is to feat
your brain keytones. That works really well for the majority
(25:16):
of my patients. So, Sarah, I have to thank you
for this. I mean, just this introduction to the protocol
is hugely helpful because I'm learning a lot and it's
a little bit of a new language. But once you
know the language, you can really be freed. So I
highly recommend the book Women, Food and Hormones. But Sarah,
I really want to just thank you for your work
and what you're doing well. Thank you so much, Kim,
(25:38):
It's been such a delight. There is so much to
learn from doctor Sarah about the interplay between women's health, food,
and hormones, but here are some of the key concepts
we can take with us today. First, one of the
things that makes the Godfreed Protocol so effective is that
it's a ketogenic diet tailored specifically for the needs of women,
(26:00):
and it overturns a lot of the myths we've been
trained to believe. In the Godfreed Protocol, fat is good
for you, guilt is bad, and you can stay on
this plan without ever feeling deprived. Second, change can happen
and faster than you think. You can see a big
difference after just four weeks of being on the protocol,
says doctor Sarah. Finally, the Godfreed Protocol allows women to
(26:25):
build a new, more positive relationship with food. The diet
culture encourages women to adapt a mindset of constraint and frankly, guilt,
but the Godfreed Protocol encourages us towards a mindset of abundance,
encouraging us to eat foods that will make us feel
good and live healthier without the guilt. To learn more
about the Godfreed Protocol, go to Sarah Godfried dot com
(26:48):
and check out her new book, Women, Food and Hormones.
Thank you for listening, and please share today's podcast episode
with others in your life. This is Kim Azzarelli, author
of Fast Forward and co founder of Seneca Women. To
learn more about Seneca Women, go to Seneca Women dot com.
Seneca's Conversations is a production of the Seneca Women podcast
(27:10):
network and iHeartRadio Have a Great Day. For more podcasts
from iHeartRadio, check out the iHeartRadio app, Apple Podcasts, or
wherever you listen to your favorite shows.
I saw a lot of women I called them my
Keto refugees who were coming to my practice and they
went on keto maybe with a male coworker or a partner,
and had a similar experience to me. But they also
noticed they weren't sleeping as well, they weren't deriving some
of those benefits that men experience on keto, and so
(00:22):
that got me just figure out, Okay, how do we
work around this, How do we get this to work
for women too? That was doctor Sarah Godfried, scientist, researcher,
and best selling author. Doctor Sarah, as she likes to
be called, has an innovative, amazingly effective approach to women's health,
(00:43):
an approach that can help women deal with stress, get
more energy, and even achieve our healthiest weight. I'm Kim
Azarelli and this is Seneca's Conversations Today. We're bringing you
part two of our conversation about women's health with doctor
Sarah Godfried from our series Seneca's One Women to Hear.
In our previous episode with doctor Sarah, we learned why
(01:04):
women's physiology is different from men's and what that means
for our health. And we learned that a healthy metabolism
is the key to a healthy life now, just in
time to get the new year off to a great start.
Doctor Sarah takes us through her approach to women's health,
what she calls the Godfreed Protocol. We'll learn why the
(01:24):
protocol works so well for women, how to do it,
and how it can make a difference for you, Doctor Sarah.
Great to have you back on the show. Thanks. Obviously,
we've gotten to know each other a little bit over
the past several months, and I probably watched many of
your videos and I pheel I know you very well
and have read your book and started on what you
(01:45):
called the Godfreed Protocol, which is a four week plan
that you've laid out really well in your new book, Women,
Food and Hormones. And I just want to say it's working.
It is absolutely working. Yay. That's how I feel. I
feel like I have I don't know, so many good
things have happened. In fact, this is just anecdotal, but
I'm going to stick with it. Someone who lives in
(02:06):
my building stopped me on the street yesterday. Actually we
ranch each other in the elevator. He saw me on
the street and he said, you know, Kim, I was
going to stop and say hello. But then I thought, no,
that woman looks too young to be Kim. And I've
actually lost quite a bit of weight, but I think
feeling more importantly, I just have a lot more energy,
and I feel like this protocol is really like the answer.
(02:29):
And I'm becoming a little bit of a proselytizer because
everywhere I go, I'm like, well, what's your feeding window?
And you know, what are your net carves? And so
I think we need to tell the world about the
protocol so that I'm not just talking to myself and
that people understand all this vocabulary. But Sarah, you wrote
this with a very specific goal in mind, which is
you've done the research, you've lived the research, and you
(02:52):
do believe that there is a difference between men and women.
And we all know that there is in terms of
hormonal changes and biology, and you've put together what I
think is a pretty genius protocol. So how did you
come on this realization that there was a true difference
between what men and women needed in this type of
In this type of I don't want to call it
(03:13):
a diet, because it's not a diet, it's a lifestyle. Well,
I would say first, my entire career has been devoted
to sex differences, not for the purpose of one up
being or one downing one gender or another, but really
for the purpose of understanding both men and women. So
this came full circle for me about five years ago
(03:36):
when I went on a keytogeneic diet with my husband.
He rapidly dropped about twenty pounds. I had some initial success,
and then it backfired, it stopped working. I actually gained weight,
and that's what got me on this path of looking
at Okay, we know there's sex differences, we know there's
gender differences when it comes to metabolic health. Let's go
(03:57):
a little deeper. Let's understand why, especially the classic ketogenic
diet was not working for me and was not working
for frankly, hundreds of women in my practice. So that
got me on this path to look at things like
the testosterone advantage. We know, for instance, that women have
ten to twenty times less testosterone than men, and yet
(04:19):
it's still our most prevalent hormone. So it's a hormone
that we really need to be managing and tracking. It's
responsible not just for sex drive and muscle mass, but
also confidence and agency and so that was one of
the first pieces, was looking at some of these hormonal
sex differences that were responsible for this difference that I
(04:41):
saw with my husband, and there's a long list of them.
You know. One is that because men have more testosterone,
they have more lean body mass about fifty percent more
than women, they've got lower fat masks. We think women
need more fat mask to make hormones because fat is
the backbone of the hor months that you make. There's
(05:01):
many other differences. Estrogen can sometimes get in the way
of success with a ketogenic diet. We also, I believe
women may need more carbohydrates for the production of serotonin.
So serotonin, as many know, is that neurotransmitter that's responsible
for sleep, mood, appetite, and carbohydrates helped to raise serotonin.
(05:28):
So I saw a lot of women I call them
my keto refugees who are coming to my practice, and
they went on keto maybe with a male coworker or
a partner, and had a similar experience to me. But
they also noticed they weren't sleeping as well, they weren't
deriving some of those benefits that men experience on keto,
(05:49):
and so that got me to figure out Okay, how
do we work around this? How do we get this
to work for women too? You know, it's so interesting, Like,
there's so many things that you've already said that I
believe are sort of myths that are really things that
I'm learning by talking to you and reading your work
and the research. You know, this idea that first of all,
that fat is bad, you know, is always something that
(06:11):
I think you've kind of educated me on, and this
type of research has educated me on. Also the testosterone
myth that you know, testosteronees a guy's thing. I think
that's really interesting what you just said, and I'd love
to learn more about that. And then also the relationship
with carps. So I hope we get into all three
of those as you talk to us about the protocol. Yeah,
I'd say the myth about fat being bad is one
(06:32):
that just will not die. We have so much data now,
you know, over the past few decades really showing that
fat is essential. You know, seventy percent of your brain
is fat. When you eat fat, it helps you feel
more satisfied in terms of appetite. It's also, as I mentioned,
(06:53):
the backbone, especially of sex hormones like estrogen, progesterone, testosterone DHA.
So we really need to function. The question is how
do you personalize the amount of fat. So when I
was in medical school and Kim, this was a very
long time ago. So nineteen eighty nine, when I was
(07:14):
in medical school, I went off of fat. I did
a plant based diet, and my hormones became a hot
mess because my estrogen dropped, my breast got smaller, my
mood was worse, my cholesterol dropped significantly. We know that's
a marker of depression. So I really believe that we
(07:36):
need to have these food groups and we've got to
figure out, Okay, what's the right dose of carbs, what's
the right dose of fat, what's the right dose of protein,
so that you really have that metabolic health that we're after, right,
because I mean, the popular culture is avoid fat, skim scam,
scam again, this equation of like fat meaning that you're
going to be fat well, and it hasn't worked. It's
(07:58):
been a failed experiment. You know, as we have eaten
more carbhydrates, especially refined carbs, what's happened is that we've
got a higher and higher incidence of diabetes. We know
that somewhere around eighty eight percent of the US population
is metabolically unhealthy. Many of them don't even know it,
(08:19):
and so this advice that came down through the nineteen
seventies and eighties to cut back on fat really has
been a misfire. It just hasn't worked. And so a
more balanced approach I think is the way to go.
But for many women, as they become more balanced, they
need to have a therapeutic pulse the way that I
(08:40):
describe it in the book. So that's really how I
developed the Gutt Freed Protocol to help women do this
four week pulse where they can really personalize how much
of each of these macronutrients carbs, protein, fat are the
best for them. So take us through how it works.
What is the protocol and why do you set it
at four weeks? It four weeks because I think it's doable.
(09:02):
I also think that when you stay in ketosis longer,
there's some risks in terms of your cholesterol as well
as your level of inflammation, and so I think four
weeks is a pulse that is manageable. The first part
of the protocol, the first pillar is detoxification, and I
(09:23):
give folks about a week to get into a state
of open detoxification pathways. I think that's really important, especially
to flip that switch between burning carbs, which many of
us are stuck in I was in my thirties and forties,
to burning fat, which is really the goal with ketosis.
(09:45):
So that first part is detoxification. I want women to
be pooping every single morning. I want to really increase
the amount of vegetables. I think we can all agree
that that's healthy. That's the cruciprous vegetables broccoli, hauliflower, russ routes, radishes, etc.
As well as the alium vegetables, So that includes onion, scarlet, gleak,
(10:07):
the methylating vegetables. Those are the ones that help you
inactivate certain hormones like estrogen, and that includes the dark
green leafies. So detoxification is the first part. I see
in my practice all the time that women just don't
have their detox pathways open. Maybe it's because they're having
a glass or two of wine every night, or they're
(10:28):
over the age of forty and things just slow down,
you know. I think a lot of women notice that
as hangovers hitting a little bit harder, affecting their sleep
more and so we've got to help out the liver.
So that's the first part of the protocol. Then you
move into nutritional ketosis, where you're eating with the macronutrient
ratio that I found to be the most effective for women.
(10:50):
That includes sixty to seventy percent of your total calories
each day from fat, mostly plant based fat. So there
was just a study published by David Ludwig at Harvard
showing that if you keep your total saturated fat per
day at twenty one percent or less, that's necessitated with
the best cardiometabolic function going forward. So sixty to seventy
(11:14):
percent your total calories from fat, a portion of that
from saturated fat if you'd like to eat animal fat,
twenty percent of your calories from protein, that's a moderate
protein diet, and then about the remainder, so ten to
twenty percent of your calories from carbohydrates. But those carbs
really need to come from vegetables. And what I advise
(11:37):
is that you simplify this by focusing on net carbs,
so less than twenty to twenty five net carbs per day,
and that allows you to get the fiber that you
need to support your hormones as well. As to support
the benevolent microbes that are in your gut. So that's
the second pillar. The third pillar is intermittent fasting because
(11:59):
that really allow allows people to eat more carbydrates. So
it kind of depends on what some of your issues
are how long that window should be. I love that
you mentioned, you know, those new parlance that you've been using,
like with your feeding window. You know, generally what I
like is for people to start with about a fourteen
hour overnight fast and then a ten hour feeding window. Yeah,
(12:24):
that really worked for me. I mean I started actually
with sixteen eight, but then I read in your book
or maybe in one of our conversations that you know,
women don't need to kind of shock the system. It's
better to kind of ease into it. And so I'm
switched to a fourteen ten, which is very doable. And
I have to say that now I'm not really hungry
before that, and I feel weird eating after that, like
(12:46):
it doesn't occur to me. So I feel like my
body really appreciates it, actually, and I think that's one
thing that I'm learning from this whole experience, which I
again I won't call a diet, and I would love
to talk to you about diet culture, but you know
this lifestyle, like, I feel like my body is happy
you're in this mode, so it doesn't feel like I'm
being deprived. I feel actually the opposite. That's certainly part
of the benefit of this protocol. You know, it's designed
(13:08):
to get you into ketosis so that you have the
flexibility to switch your metabolism from burning carbs to burning fat.
And the analogy that I often use to describe this
as similar to a prius where you can flip the
switch between burning electricity or burning gas depending on what
(13:30):
type of fuel is available. So the body is really
designed to do this from Stone age times, and many
of us just with the availability of food, especially the
ease of carbohydrates and the deliciousness of carbhydrates, we tend
to overdo it and get too high a dose of carbs,
and that's really what gets us into trouble. But once
(13:52):
you flip that switch, as you have done Kim, and
you start burning fat, then you have ketones in your body,
in your bloodstream, also in your breath and in your urine.
And those keytons are not just a marker of how
successful you are on this God Freed protocol. But they're
also a signaling molecule, so they reduce inflammation. They help
(14:16):
you with being less puffy, they help you get rid
of excess fluid. A lot of us have fluid retention
starting in our forties and fifties, so this is a
major downstream benefit of the ketogenic diet. And then you
also mentioned energy. I think that's a really important piece
to highlight, because ketones are super energizing. They give us
(14:38):
focus and concentration and mental acuity. They help us with
appetite suppression, and that's part of the reason why I
think this approach is so successful for so many women.
I mean it's successful for men too, but for women
in particular. There's a way that I think our culture
makes us hungry, makes us it's hungry for more, makes
(15:01):
us hungry for equality, makes us hungry for soothing, makes
us hungry for greater solace. And what I find is
that those keytones really help with satiety, with feeling like Okay,
I'm at the end of my eating window, I finished
my meal, I'm done, I'm good. I can go focus
on other things without food thoughts kind of driving me
(15:25):
for hours each day. Yeah, I have to say that, like,
my guilt level around food is pretty gone. Like I
don't feel guilty about you know what I mean, Because
usually you're like, oh that was fattening or uh, that
wasn't so healthy, or you know, like there's always some
after effect, and I have to say like, because I'm
sticking to the protocol, I'm like, well this is great,
(15:45):
like olive oil, yes, avocado, as much as you like,
you know what I mean. Like, so the stuff that
I'm eating is good for you, and it happens to
be stuff I like. So I feel I don't feel
that same feeling of like, I mean, I don't want
to put down any particular diet plan, but like you know,
when you're on a plan and you feel like you're checking,
you're always like did I stick to it? Did I
stick to it? Am I sticking to it? I don't
feel that way with this. I feel like, oh, wow,
(16:06):
like this is complete freedom because I like what I'm eating.
I'm feeling a lot better, I'm losing a lot of weight,
and I just it's a totally sustainable lifestyle and it's
not about diet. I'm so glad you mentioned that, because
you know, I think so many of us as women,
exist along this spectrum of somewhat healthy to maybe eat,
(16:30):
disordered eating with restriction with permission, and it can be
tricky to navigate. It can be really tricky to navigate,
and so we end up maybe overindulging or eating something
that we don't think is the best information to be
feeding our bodies. And then we have that guilt that
you're describing, and I think many of us, and I'm
(16:52):
talking about myself here, mostly we then serve penance, you know,
so we go on a strict diet and minutes about
out this white knuckling experience of making sure that you're
following it even though you're hungry all the time. And
what I love about Keytones and about this particular approach
to a ketogenic diet adapted for women, is that it
(17:14):
allows you to just let go of that white knuckling,
so you have, as you described, food freedom. And that's
so beneficial because that really allows us to concentrate on
some of these other things that are so important, like
the mission that you serve, Kim, the mission that I
hope to serve with changing conversations about women's health. And
(17:35):
there's there's something just so delightful about being able to
step away from that hunger and from that, you know,
kind of constant inner saboteur that's telling us, oh no,
you can't eat that. Oh my gosh, you had way
too many bites off that chocolate cake. And so I
love that you're allowed to just awigh from that inner
(17:56):
dialogue that can be so harmful. Yeah, and it's just
too present, right, I think, like that's the whole context
of this conversation, which is the focus on women's appearance,
women's weight, the way we've all been educated, and so
that dialogue, which could be a healthy dialogue, is just
too present, I think in the culture in each of
our heads. You know, it's just taking up too much space.
(18:17):
And I think your point is so well taken. This
frees you from that. And I mean, I'm definitely experiencing that.
I never really you don't know me very well, but
you know, I'm not really like a very appearance focused person.
I'm you know, I'm just so into wanting to do
the things I want to do that I just it's
just not a big priority in my life. I don't
think about it that much. But even I, who I
(18:37):
would say is not that focused on it still had
that inner dialogue all the time of feeling guilty and
just knowing that I was like, you know, maybe that's
not so healthy, Maybe that's like a little fattening. Like
it's just those constant things that you just constantly think about,
and this it just clears up so much space. And
now I'm just I feel like my relationship with food
is much more positive. And you know, my father always
(19:01):
told me food, food is fuel, like that's been his mantra,
and I was like, yeah, great, Dad, Great. But now
I'm like, Okay, I get it. Food is fuel, you know,
and it's it's a different way of thinking about it.
It is a different way of thinking about it. You know.
I think this is really what I hope for women.
You know, I want us to move beyond the ways
(19:21):
that we've internalized diet culture. But I would also say
that the other end of the spectrum fat acceptance, body positivity.
While all of us can get behind the concept of
a more inclusive approach to different body shapes and sizes
and colors, you know, many of us still want to
(19:42):
fit into the clothes that are in our closet. You know,
Like I've invested a lot in the clay where I
want to fit into them. I don't want to just
be a woman who is going through this aching process.
I love aching, but the natural aching process is that
women are gaining fat mass as they get older, about
(20:03):
five pounds per decade starting in their forties, and they're
losing muscle mass again about five pounds per decade, and
so you may not even be changing your weight. That's
on a bathroom scale, which I think is a terrible
marker of metabolic health, but it's the one, you know,
It's kind of like shorthand that we use. You know.
(20:24):
What I want is for us to really understand that
some of these changes are occurring, and unless you're doing
something about it, you can wake up at age fifty
five or sixty and start to get these diagnoses that
you don't want, like party vasco disease, a heart attack, hypertension,
even Alzheimer's disease. So all of this is occurring in
(20:47):
the body decades before that scary diagnosis, and I really
want for women to understand that you can be empowered
to do something about it, and it can be, as
you said, a lifestyle that is not actually difficult. It's
it's a way to really grab the reins of your
own health and your destiny, like your health span, that
(21:10):
period of time that you feel fantastic and you're relatively
free of disease. Yeah, I mean, I'm telling you I'm
living it because I do feel that if it was
just for the weight, there's no way I would do it.
I just I'm not motivated enough. You know, I feel
I look good enough. You know, if I am a little,
if I'm ten pounds eavier, I'm it's good enough for me.
Like I'm not you know, I'm not that type of person.
But the idea of being healthier, of feeling healthier, and
(21:34):
of the longevity of the health span, that's super motivating
to me. And so I'm telling myself, you know, this
is just all positive. There's like nothing negative going on
in this, you know, and so that is extremely motivating.
And then thinking that you know, you could be I mean,
I love when you talk about an end of one
because this idea that it's personalized, it's you know, it's
(21:54):
a personalized approach, and you have to know what works
for you. You know, you start to sort of feel
that you feel like what works for you, it doesn't
you know, being able to just understand how your body
reacts to things is very very motivating to me. Just
I think it may be that moving from this sort
of I don't want to say imprecise medicine because I
think that's probably unfair, but I would say maybe generalized
medicine and first segmenting out men versus women, that's a
(22:17):
huge step in the right direction. And then I think
what you're doing, and I think the movement that you're
a kind of part of is doing is telling us
all like, okay, you should know you And I think
that that's a very motivating way to think about health.
It is motivating. And I would even say that imprecision
medicine is a term that's used quite frequently for the
(22:39):
way that medicine has been practiced for over a hundred years.
And by that, I mean when someone has a depression
and they get diagnosed with depression, they often get started
on an antidepressant. And yet we know with most of
the available antidepressants right now, that you have to prescribe
to about ten patients for one patient to benefit. When
(23:04):
it comes to statins, you know, one of the most
common drugs that are prescribed in US medicine, you have
to again prescribe about fifty patients with the statin for
one to benefit. So this is in precision medicine. We
know that the way that you react to food is
different from the way that I react, and the way
(23:24):
that you can really personalize it. The way that you
can step into precision medicine is to really understand, Okay,
what's going to work the best for me? Because there
is no one size fitsal diet. There isn't and this
book is really more about a template for determining how
to personalize diet so that it really supports you and
(23:46):
supports what you want your health for and whatever metrics
make the most sense for you in terms of measuring
your health. So for some people, that might be their
body weight on the bathroom scale. For others, it might
their body composition, the percentage of body fat or their
fat mouse that they have, or their lean body mass.
For some people it might be there fasting glucose or
(24:10):
their average glucose as you've been playing with with your
continuous glucose monitor. So there's so many different ways that
we can define it. But I think this point about
precision medicine is so important because we've always practiced medicine
for the average, and I don't want to be average,
(24:30):
and I don't want you to be average. I want
us to be optimal. I want us to really have
you know, that best possible health, the best possible mitochondria,
you know, those power factories that are inside of ourselves, which,
by the way, start to faulter after age forty in
women eighty percent of women, but not in men, especially
(24:53):
in the brain. And that's why so many women notice
that they have this mental slowdown. Their brain just slows
down a bit in terms of memory, in terms of
word finding, in terms of multitasking after age forty. So
what do we do about that? That's a metabolic problem.
One thing you can do about it is to feat
your brain keytones. That works really well for the majority
(25:16):
of my patients. So, Sarah, I have to thank you
for this. I mean, just this introduction to the protocol
is hugely helpful because I'm learning a lot and it's
a little bit of a new language. But once you
know the language, you can really be freed. So I
highly recommend the book Women, Food and Hormones. But Sarah,
I really want to just thank you for your work
and what you're doing well. Thank you so much, Kim,
(25:38):
It's been such a delight. There is so much to
learn from doctor Sarah about the interplay between women's health, food,
and hormones, but here are some of the key concepts
we can take with us today. First, one of the
things that makes the Godfreed Protocol so effective is that
it's a ketogenic diet tailored specifically for the needs of women,
(26:00):
and it overturns a lot of the myths we've been
trained to believe. In the Godfreed Protocol, fat is good
for you, guilt is bad, and you can stay on
this plan without ever feeling deprived. Second, change can happen
and faster than you think. You can see a big
difference after just four weeks of being on the protocol,
says doctor Sarah. Finally, the Godfreed Protocol allows women to
(26:25):
build a new, more positive relationship with food. The diet
culture encourages women to adapt a mindset of constraint and frankly, guilt,
but the Godfreed Protocol encourages us towards a mindset of abundance,
encouraging us to eat foods that will make us feel
good and live healthier without the guilt. To learn more
about the Godfreed Protocol, go to Sarah Godfried dot com
(26:48):
and check out her new book, Women, Food and Hormones.
Thank you for listening, and please share today's podcast episode
with others in your life. This is Kim Azzarelli, author
of Fast Forward and co founder of Seneca Women. To
learn more about Seneca Women, go to Seneca Women dot com.
Seneca's Conversations is a production of the Seneca Women podcast
(27:10):
network and iHeartRadio Have a Great Day. For more podcasts
from iHeartRadio, check out the iHeartRadio app, Apple Podcasts, or
wherever you listen to your favorite shows.
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