FASTING FOR MENOPAUSE
Author: Dr. Felice Gersh
Introduction
As women approach menopause, a natural and transformative process unfolds within their bodies Their ovarian estrogen (estradiol), progesterone, and testosterone levels gradually decline (1) These hormones play vital roles in regulating metabolism and body composition, and unfortunately these sex hormone deficiencies can contribute to diseases typically associated with aging This shift may increase the body’s tendency to store fat, making menopausal women more susceptible to weight gain, insulin resistance, and worsening cardiometabolic health (2) In fact, a 2018 statistic highlights a staggering reality: more than 43% of women navigating menopause struggle with obesity (3)
These metabolic changes set off a health cascade, becoming risk factors themselves for increasingly serious health conditions such as diabetes, heart disease, fatty liver disease, cancer, dementia, and osteoporosis (4) Clearly, targeted interventions are needed to support women as they transition through this new phase of life By understanding the connection between hormones, metabolism, and disease and by embracing strategies that restore metabolic homeostasis, women can take charge of their wellbeing during menopause.
Historically, the primary interventions for menopausal women seeking significant weight loss have focused on lifestyle and dietary changes and have often yielded more frustration than success. The inadequacy of the old “just eat less and move more ” approach has encouraged women to try more modern pharmacotherapy (taking weight loss medications) and surgical (like bariatric surgery) solutions, which often yield quick, significant results but introduce their own significant long term health risks (5)
There is clearly a need for highly effective, evidence-based, safe, and cost-reasonable interventions that enable women to take control of their health Among emerging therapies that can fill this gap, intermittent fasting (IF) stands out IF is an all-encompassing term for a variety of fasting practices that alternate between structured periods of eating and fasting
Popular types of IF include:
Daily time restricted eating patterns that limit eating to an 8-12 hour window and then support fasting for the remaining 12-16 hours each day
Alternate day fasting, where an individual eats one day and doesn’t eat the next
The 5:2 Diet, where an individual eats normally for five days of the week and fasts or practices severe calorie restriction on the other two days of the week
In general, IF dietary plans have a very favorable safety profile for most people and show significant impact on obesity and diabetes. They also increase the body’s resilience to stress and improve health markers associated with prolonged longevity.(6)
Intermittent fasting practices typically limit fasting to 24 hours or less because longer fasts are more difficult to sustain and introduce increased health risks However, prolonged fasting is another category of fasting that lasts longer than two days has shown incredible effects on metabolic markers that go beyond anything seen with IF regimens (7) If longer fasting could be made safe and feasible for the general population, the health impacts could be dramatic
The Fasting Mimicking Diet (FMD) was carefully designed, scientifically formulated, and clinically tested to overcome these challenges By creating a specifically portioned diet of foods that sustain the fasting state, this protocol allows individuals to access the metabolic and restorative benefits of longer fasting while still enjoying nourishing foods
The FMD increases weight loss, but unlike many diets, the weight that is lost comes primarily from fat stores Critically, individuals on the FMD preserve their lean muscle mass, which is important for maintaining musculoskeletal health, insulin sensitivity, and overall fitness (8) The FMD also increases insulin sensitivity, lowers blood pressures, decreases chronic inflammation, and improves blood markers for cardiometabolic health.(9)
While there is strong data to support the benefits of fasting, limited studies focus on women in menopause. Emerging evidence is beginning to reveal the promising benefits of incorporating fasting as an effective dietary practice for women in this period of their lives Let's explore the results
FASTING AND HORMONES
During the menopause transition, many of the negative symptoms that women experience are caused by fluctuating and generally decreasing levels of ovarian estrogen (estradiol) and progesterone Consequently, it is critical that any interventions for this population do not exacerbate hormonal fluctuations or accelerate their decline
So far, the data on fasting and women in menopause has been very reassuring In a recent study, obese postmenopausal women practiced daily time restricted eating by limiting their food consumption to a 4-6 hour eating window each day for 8 weeks By fasting for 16-18 hours per day for approximately two months, participants saw no changes in many critical sex hormones, including testosterone, androstenedione, sex hormone
binding globulin (SHBG), estradiol, estrone, and progesterone (10) Additionally, participants experienced promising and significant weight loss results with minimal to no impact on hormone levels
FASTING AND WEIGHT LOSS
Two additional studies that followed obese menopausal women over time added to the data supporting that IF diets can significantly help with weight loss (11,12) Regardless of whether it was time restricted eating or alternate day fasting, women lost a meaningful amount of weight The studies also support that weight loss doesn’t plateau. In general, results show that the longer participants committed to a fasting routine, the more weight they lost.
FASTING AND METABOLIC HEALTH
Early evidence suggests that fasting can be a gamechanger for managing metabolic risks in women experiencing menopause In a secondary analysis of the time-restricted eating study, menopausal women who limited their caloric intake to 4-6 hours per day for 8 weeks experienced significant improvements in their metabolic markers These improvements included a notable decrease in total fat mass, fasting insulin, insulin resistance, and 8isoprostane (a marker of oxidative stress) (11) What's even more noteworthy is that when these women lost weight, they lost twice as much fat mass compared to lean mass, which means that they were able to shed more fat than muscle
Additionally, a study conducted on mice that were designed to imitate a post-menopausal state (yes, mice can provide valuable insights) demonstrated that fasting for 16 hours a day can help reduce dangerous stores of excess fat in the liver and improve insulin resistance. These benefits were seen even when the mice were allowed to consume a high-fat diet during their eating window, which implies that even when non-ideal foods are consumed, fasting itself is protective (13) Another fascinating insight was that after an initial 4-week period of consistent weight loss, the mice continued to show improvements in markers for
insulin resistance for an additional two weeks, until the study concluded This suggests that fasting has the potential to enhance metabolic markers independent of weight loss
FASTING AND BONE HEALTH
Women going through menopause have a higher chance of developing osteoporosis, a condition where decreasing bone density causes bones to weaken (14) People with osteoporosis have an increased risk of breaking bones, which can cause pain and disability and can dramatically decrease quality of life and overall longevity
Because weight loss has also been linked to bone loss, it was important for researchers to determine if fasting has any negative impacts on the bone health of menopausal women. Reassuringly, a small study showed that alternate day fasting for a duration of 24 weeks (approximately 5 and a half months) that resulted in moderate weight loss did not have any adverse effects on markers associated with bone metabolism or the total body bone mineral density of menopausal women (12) This implies that crucial indicators of bone formation and breakdown remained stable, and the overall density of the women ’ s bones remained unaffected after the fasting period
CLINICAL APPLICATIONS: THE FASTING MIMICKING DIET
As helpful and promising as IF is for weight loss and metabolic health, prolonged fasting, which means fasting for more than two consecutive days, is able to induce healing from chronic disease states in ways that are unique and distinctive from IF. Prolonged fasting is not simply longer, sustained IF After 48 hours or longer without food, the body triggers a series of protective responses that kickstart cellular cleanup and rejuvenation and optimize metabolism (9)
is great for weight loss and improving metabolism. But because IF programs don’t induce the cellular rejuvenation processes that prolonged fasting does, they can never offer the same healing, diseasereversing potential of longer fasts (9, 15, 16)
A safe, longer fast would be the modern, fasting world’s response to pharmaceutical and surgical weight loss interventions This is where the Fasting Mimicking Diet comes in
The FMD is a plant based diet formulated with scientifically chosen ingredients that avoid the brain and body’s nutrient sensing pathways By avoiding these sensors, the diet tricks the body into simultaneously staying fed while believing it is fasting After 48 hours of mimicked fasting, the body transitions into a metabolic fasted state, which is like flipping a switch from growth mode to repair mode (9) A process known as autophagy kicks in, which activates cells to begin cellular cleanup and allows cellular rejuvenation
CLINICAL BENEFITS OF PROLON’S FMD
Weight Loss
Studies have shown an average of 5 lbs of weight loss after just one 5-day round of the FMD (9) With the FMD, the benefits of weight loss are experienced without committing to daily fasting for months, like those in the time restricted eating and alternate day fasting studies
Additionally, and importantly, the FMD shows weight loss associated with maintenance of lean muscle mass (8,9) This means that while you lose weight, you retain your muscle, which is critical for strength Healthy muscle mass is also critical to maintaining a robust metabolic rate and sustaining weight loss long term.(20)
Reduced Blood Pressure
Over 60% of women over 65 are diagnosed with hypertension, or high blood pressure, which is a major risk factor for increased cardiovascular morbidity and mortality.(21) Although other time restricted eating studies did not significantly change blood pressure in postmenopausal women, the FMD has been shown to significantly reduce blood pressure (9)
Reduced Lipid Levels
(Including Total Cholesterol and LDL)
Menopausal women often have unfavorable lipid profiles compared to premenopausal women, which increases their risk for cardiovascular diseases (22) The FMD has been proven to significantly reduce unfavorable lipid levels, such as total cholesterol and LDL, which lowers overall cardiovascular disease risk (9)
Lower insulin-like growth factor 1 (IGF-1)
Higher IGF-1 levels are linked to breast cancer, and menopause is associated with a higher prevalence of hormone-related cancers such as breast, endometrial and ovarian cancers (23,24) The FMD significantly reduced levels of IGF-1, and early studies are showing promise for the potential role of the FMD for those with breast cancer.(9,17)
Improved Glucose Control
Metabolic syndrome, which may include high insulin levels, insulin resistance, and obesity, is more common in postmenopausal women.(25) Multiple cycles of the FMD showed a reduction in insulin resistance, weight, waist circumference, and other metabolic risk factors that would significantly benefit women during their time in menopause (9, 15)
Conclusion
Emerging evidence suggests that intermittent fasting regimens have minimal to no harmful effects in women experiencing menopause, and more importantly, can bring about positive changes like weight loss and improved insulin resistance However, more in-depth and long-term studies are needed Above and beyond popular IF protocols, the Fasting Mimicking Diet has already demonstrated significant benefits in terms of weight, blood pressure, cholesterol profile, and more While it has not been specifically tested in postmenopausal women, it holds great promise, potentially even surpassing the benefits of time restricted eating or alternate day fasting
So, consider the FMD as a powerful tool in the journey to better health during menopause
Special Thanks To Additional Contributors: Shadera Slatter, MSGH, Alexis Perella, Renee Fitton MS, RD and the team at ProLon.
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