After two failed attempts at trying to follow the classic ketogenic diet, I came up with the Gottfried Protocol, an approach that worked for me and can work for many women. It’s a modified ketogenic diet that starts with detoxification, which is missing in the classic ketogenic diet yet needed for most women to burn fat. And it includes more carbs, which support women’s hormonal balance. [Editor’s note: The classic ketogenic diet is generally a high-fat, moderate-protein, and low-carbohydrate diet.]
The three pillars of the protocol are detoxification, nutritional ketosis, and low-stress intermittent fasting. The sequence is important. The three pillars are followed for four weeks. Then you add back healthy carbohydrates in five-gram increments to define your carb threshold. It’s been successful in my medical practice for hundreds of women. More about each step:
Step 1: Detoxification. Detoxification clears your liver of toxins and eliminates recirculating hormones that are poorly affecting your metabolism. Clinically, we call this metabolic detoxification. For most of my female patients, their bodies are not detoxing well. So in this protocol, we integrate things that help, such as more polyphenols from plant-based foods, including oils; cruciferous vegetables, like broccoli, Brussels sprouts, cabbage, and cauliflower; and dark green leafy vegetables. And pooping daily is also important for the detoxing process.
Step 2: Nutritional ketosis. Your body enters nutritional ketosis when you follow a food plan that is high in fat, moderate in protein, and low in carbohydrates. I have adjusted the classic ketogenic diet by increasing the carbohydrates to make it more effective at restoring insulin levels in women. But with this diet, you’re still eating lots of plants and consuming tablespoons of extra virgin olive oil—occasionally medium-chain triglyceride oil—along with prebiotics and probiotics. We track net carbs and other macronutrients, calculate your ketogenic ratio, and if you’re up for it, measure your glucose-ketone ratio (more about this in the book).
Step 3: Intermittent fasting. What I love most about intermittent fasting is that it’s a back door to ketosis. This type of fasting means you don’t eat for twelve to twenty-four hours in a single day. Intermittent fasting improves the balance of many hormones (e.g., insulin, ghrelin, leptin, and cortisol) and leads to metabolic switching, which suppresses insulin and glucose to a level that triggers your body to switch from burning carbohydrates to burning fat. Fasting can help regulate inflammation, increase brain function, and lower blood pressure, and it may modulate leptin so that you feel more satisfied.
About the hormones:
Insulin moves glucose into your cells.
Leptin tells you when you’re full.
Cortisol is the stress hormone that controls blood sugar levels and regulates metabolism and inflammation.
Ghrelin, known as the hunger hormone, tells you when you’re hungry.
Thyroid hormones regulate metabolism.
Testosterone is involved in muscle growth and repair, sex drive, and mood.
Growth hormone deficiency can contribute to anxiety, premature aging, fatigue, and belly fat accumulation.