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Weight Loss, Strength, Hormones and Optimizing Keto with Dr. Stephanie Estima: 2

I am so excited to share this episode with you. Today I am chatting with Dr. Stephanie Estima. After meeting her at the Keto Diet Summit where we were both speakers, I knew I had to have her come on and talk to us. Dr. Stephanie Estima is a mother, best-selling author, podcast host and coach. Tune in as we go over several topics such as brain and cardiovascular health, fitness, hormones, life span versus your healthspan and keto and menopause

We also get into keto cycling, therapeutic interventions, as well as mindset. 

Dr. Stephanie also shares her knowledge on pre-Mmenopausal needs, considerations for keto and menopause, the benefits of lifting weights, and how to find the right sustainability when it comes to your own diet. This is a jam-packed show, and we're excited to hear your thoughts.

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Watch the interview with Dr. Stephanie Estima on YouTube.


Show Notes:
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Cheryl McColgan: Hi Everyone, welcome.  Today, I'm here with Dr. Stephanie Estima. First of all, she has a new book out, which is amazing. And second of all, she's really focused on making sure that your hormones stay in balance while you're on keto, which can be a particular problem for us, ladies. So welcome, Dr. Stephanie Estima. Could you just tell us some of your background, how you found the low carb diet, how you got into it and your interest in this subject? 

Keto for Brain Health

Dr. Stephanie Estima: So I have been, you know, for most of my career, very interested in brain health and brain metabolism, and the ketogenic diet was something that I came across maybe for, well maybe five or six years ago now in terms of some of the benefits that it can have for cognition, for mood, for sleep. I started implementing it in my practice.

That was when I still when I had a brick-and-mortar practice and it had a profound result in my patients. So it's something that I've always been very, very cognizant towards is this idea of how can we change some of the things in our life, whether that's nutrition or movement or supplementation or stress reduction as a way to level our brain health in some way. The ketogenic diet, I'm sure we'll talk about it today and I'm sure you've talked about this on the podcast before.

It's one of those protocols that is very, very efficient for reducing inflammation in the brain, for helping with clarity of thought, helping with sleep and all the things that are important when we're thinking about long-term brain aging and brain health. 

Cheryl McColgan: I'm so glad that you brought up that subject because it's also part of my background. I have graduate training and clinical neuropsychology was my focus. So part of the reason I also came to this space, into this way of eating is because of brain function. Once I read the research and became aware of this, it was kind of like, once you see it, you can't unsee it…right? Like you're saying, you put your patients on that. Probably they came to it for weight loss. A lot of people come to keto for that reason, but then people realize it has other amazing benefits. Could you talk a little bit about your clinical practice and some of the effects that you saw in your patients once they started living this kind of lifestyle? 

Keto for Weight Loss

Dr. Stephanie Estima: So I would say you're very right that most people would come for weight loss, but they would stay for all the other benefits. Like no one ever comes is like, “You know what? I would love to improve my mood.” They want that but they don't necessarily think that the ketogenic diet is going to be the way that that's going to happen. So weight loss is one of the more profound, particularly early results that we see when you are starting to restrict your carbohydrate because, you know, you start using up your glycogen stores and as you start to use that, you're also getting rid of some of the water that you have. So for every molecule of of glycogen that you store carbohydrate, you're also pairing it with three to four molecules of water. So we often see a rapid weight loss in the first couple of weeks doing keto. So that also makes people feel great because now they feel less bloated and they're more motivated to sort of stay the course.

Some of the things I already mentioned: clarity, sleep. A lot of people say I sleep a lot better now. They feel like they have a sustained amount of energy so that they don't have those highs and lows during the day where they eat then they have this carb crash and they start to have this carb coma rather than a 45 minutes later are going back for a bagel or a muffin or whatever it is. Particularly, I would see this in my female patients as well.

Two to four in the afternoon is the time window when we started seeing like an aggregation of more calories and we have our lunch at 12:00 or 1:00 o'clock. But if the macronutrients are not structured to give you sustainable, long-burning energy, a couple of hours later, you're already hungry. So we would see people starting to get like their little snacks and a little picky type of foods eating around that time. So women who are going on keto or at least the conditioning program that I was structuring for them would say, I don't think I can have my lunch and then I don't really want to eat again until I get home for dinner time. So that was also a really huge benefit as well.

Importance of Waist to Hip Ratio

I think body composition changes. We would see the waist to hip ratio improve. So people are slimming down their waist relative to their hips, which is an indicator for longevity. We want to make sure that, if you were to say right now, if you were to take a measuring tape and measure your navel at the level of your navel and then again, measure at the widest part of your hips and you divide those numbers into each other, you want that number to be at least point eight like no higher than point eight and lower if possible. So we would start to see improvement there. And of course, with that indicating the visceral fat, if your waist is smaller than your hips, you are starting to create that more hourglass. figure, which we don't even have to talk about the esthetics. This is the ideal shape for a woman when we're thinking about longevity because if she's accumulating a lot of weight through her waist relative to her hips, we know that that's likely an accumulation of visceral fat and it's going to be harder for her organs to actually do the things that they're supposed to do. And of course, it looks good, right? We get all this talk about vanity, but in terms of some of the metabolic parameters about ways to hip ratio, it was a really great improvement in that as well. 

Cheryl McColgan: Yeah, I'm really glad that you mentioned the visceral fat thing because it also you can probably speak to this more clearly, but you mentioned,  it doesn't allow your organs to work as well, that sort of thing. And it's also linked to all of these sort of diseases of aging like heart disease and probably everything…diabetes etc. I think that when your waist-hip ratio gets out of balance, you're more at risk for basically every kind of particularly metabolically related disease. Any further thoughts on heart disease being associated with visceral fat?

Visceral Fat and Cardiovascular Disease

Dr. Stephanie Estima: When we think about cardiovascular health, both across the board, men and women, it is the number one killer, right? We often are as women. I think we're very scared of the C-word. We're very scared of cancer, particularly breast cancer. I think there's a lot of focus put on that. And I must say, I'm not saying that not important for us. It is. There's also some schools of thought that are actually proposing now that cancer does have some of its roots in metabolic dysregulation, but cardiovascular disease is still the number one killer for women. And my focus is really on female physiology.

I don't know if I mentioned that in the beginning, but you know, I have a really big interest in some of these proxies, like the ketogenic diet, like fasting, supplementation and working out as it applies to women. Cardiovascular disease is the number one killer and we want to be, especially when we're thinking about how can we live a longer life, we also want to be paying attention to. So that would be called lifespan, like the span of years that you live. But we also want to be thinking about health span. So all of those years, how many of those are spent healthy? So when we think about ways that we can augment that ways that, we can make that to extend that healthspan, one of the ways one of the easier ways to do that is through manipulation in our diet. I love the ketogenic diet for women, trying to get a woman into pure ketosis for a short period of time. So I love therapeutic intervention of the ketogenic diet. 

Should You Stay in Ketosis Long Term?

Then I actually sort of differ from a lot of people in the general community in that I don't think that women should be in ketosis forever. I do think that over the long term, when we are thinking about honoring our female physiology, honoring our hormones, honoring the different hormonal values that we will go through not only as a reproductive woman, but as a woman who has the emotional cycle. When we are menopausal as well there is a certain cadence that we adhere to. So I love the idea of ketosis cycling and I talk about that in my book The Betty Body.

If you're watching, this is my beautiful book baby and we spend a lot of time in the book talking about this sort of phase one, which is that therapeutic intervention of ketosis and then moving into keto cycling for women. So a week on, a week off, a week on, a week off. And then there's other things that we talk about, like protein cycling and carbohydrate cycling in order to support our hormones, to support our cardiovascular health, as we've been talking about and to support overall health, which is kind of like it's not there's no point in living in a long time if you're diseased and dying.

Importance of Muscle Mass and Strength Training As We Age

We want to be living a long life that's healthy and robust. I'm already training, I sort of say this jokingly, but I'm training to be the best, the favorite grandmother like I want to be. I want to be the grandma that can get down on the floor, play with my grandkids, pick them up, be able to get up off the floor, unassisted. If I'm traveling, I want to be able to carry my own luggage. I want to be able to put it into the overhead bin. I want to be able to do push-ups. I'll say if you'll allow me to get on my soapbox, a push-up is a push-up on your toes, not on your knees. So, you know, we call them ladies pushups and I get a little like nervous tic when I hear that because there's no such thing as the lady's push-up! Push-ups on your toes is the equivalent of squats your booty. We want to be thinking about the ability to push our own body weight and to be able to pull our own body weight is able to do pus-ups. These are things that I think about when I'm thinking about how I'm going to be the favorite grandma and in 20 or 30 years from now. 

Cheryl McColgan: I love it! So how I came in contact with Dr. Stephanie is that we spoke at the Keto Diet Summit and I knew right from the beginning…by hearing,you talk and seeing you, that my philosophy is just it's so in line with what you were saying. I was just literally talking on live on Instagram before we got on here and I was kind of talking about getting ready to record with Dr. Stephanie.

This weekend we were we were snowboarding in Utah where they got like about four feet of snow in, I don't know, a few hours or so. This is a little extreme, I realize, but I do have a point here and it's coming. So I'll be forty-eight here in about a month. And I think about this a lot, too. I want to be able to be healthy enough and strong enough to do the activities that I love. And also we have two boys. I'm hoping we'll have some grandbabies at some point and all of that.

I think if people can wrap their mind around making that their purpose rather than always making it about weight loss, that is what makes this lifestyle so sustainable to me because I know that every day that I make choices, it's because I want to be able to go get on my snowboard in four feet of powder and like, survive that. I just think as a mindset thing for weight loss, if people can start to think about those longer-term goals, their core values, that really helps them stay on the diet or stay on all the things that we need to do, as you mentioned, like doing our pushups, doing our workouts and that sort of thing. 

Identifying Your Why To Make Better Habits Easier

Dr. Stephanie Estima: Yeah. And I love what you're saying because I think that when we only think about it in the context of weight loss, we tend to think a short term lends to that. So we tend to say, well, in two months, I want to be five pounds or 10 pounds lighter, whatever it is or for the high school reunion and that's happening in four months. I want to be able to get into such and such dress, which is fine. Those are great goals to have. But you also want to layer that on with a long-term view because what is the point? I also want to honor my inner self here, like there's no point in doing all this work is just going to come back again. Right? So if you are thinking about fat loss, if this is something that is important to you, it would behoove you to think about the short-term goal, but also to be thinking about how can I sustain this over a year, two years, ten years, two decades? Because that is actually the hardest part.

We've all seen the biggest loser and weight loss shows where they can an extraordinary amount of weight in a short amount of time. But of course, we also know that the success of those people on Biggest Loser…90 percent of the participants gain the weight back because they haven't actually learned how to have these lifestyle modifications, how to be able to bring in some of these small little habits into the everyday.

They go back to their life, they go back to the same stress, the same coping mechanisms. And then, we see the weight gain come back again and sometimes many times more so. So they may have started off at an obese weight. They lose the weight on the show, they go back and then they're heavier than they ever were. So I'm really interested in how we can take small little habits that are not hard to implement every single day and be able to consistently apply them and to have that commitment to that consistency over the long period of time over that long velvety. And that's how we really get some of those great results that we're talking about.

Differences Between Men and Women for Keto

Cheryl McColgan: For example the brain stuff…the longer you do keto, the better it gets. I have noticed in my husband the same. He keeps saying he really thinks, and he's 54, that his brain function feels just so much more clear and easier to remember things since going low carb. Everything that we have to worry about as normal aging brains, not just later on with neurodegenerative disease, where they're kind of calling it a type three diabetes now, but also just normal brain function that kind of starts to decline as we get older, unfortunately. So that's probably a pretty good lead-in to your book about how people can implement these things on a daily basis. Talking about carb cycling and since you're focused on women in particular, I'd love it if you could talk about the diet in relation to people maybe like 20s, 30s, 40s as we age in any slight differences there that you found really help people. 

Dirty Keto vs Clean Keto

Dr. Stephanie Estima: Sure. So the book was, you know, divided. We divided women into two main cohorts, right? So cohort is women who in their reproductive age. So that includes loosely up to about age 50. So you should be ovulating every month if you are a woman or a female body and beyond in menopause, that's sort of the second cohort. So around roughly 50-52. For most of us, where we are no longer cycling, we no longer have a menstrual or reproductive cycle anymore [keto and menopause]. So what do we think about this in the context of women? One of the things that when I used to do when I first started running a ketogenic diet in the clinic, I was totally running it like a guy, like I was, being truthful and transparent here…it was like bacon, butter, burgers and repeat, right? Sort of very, you know, it's been very commonly called like dirty keto right? It was like anything, but avoid all the carbs at all costs. And very quickly, I recognize that there was a difference in the results that we were getting between our men are women.

This is especially true in the husband/wife duo. We have a husband and wife of sign up and they would come in after a week and the guy would say, “Wow this is the best program. I lost like twenty-five pounds!”  And then the woman would sort of be behind him and say I don't know what the hell, but I've lost two pounds and I feel terrible. So I started really digging into how we can nuance the application of this to our female population. There's a couple of tenets that are really true for us. So the first thing is we started changing it for most of our women and this is true for the Betty Body. We talk about this in the Betty Body and this is outlined in the book in detail.

For women, we want to be making sure that we have lots of green leafy vegetables…and so vegetable, just in case anybody is not aware, is a carbohydrate. Right? I think people forget that they know, you know, meat is protein and olive oil. Fat and carbohydrate in vegetables, in my opinion, are important for women because of the phytonutrients that we get.  Especially when we talk about green leafy vegetables, in particular, the brassica family are important for women. So the cauliflower, the broccoli, arugula, all of these things. These also have a component in them called sulforaphane and without sort of getting too nerdy so I lose all of your audience, you know, like sulfur anything.

Cheryl McColgan: I like it, but I don't know about everybody else. 

Importance of Leafy Greens, Braccia and Resistant Starch for Estrogen Disposal

Dr. Stephanie Estima: Yeah, so essentially they amplify liver detoxification, so they are going to help augment. They're going to help improve your liver's ability to take toxins, to take hormones, to change them into intermediates and then to excrete them. Now why this is important for women is, if you are a woman who is 35 or older, you know, 35, to 58 years old, wat you may find in that time period is as your progesterone starts to lower mid to late 30s, you start to see progesterone lowering.

If you do not have sufficient clearance of your estrogen through liver detoxification and your gut, because this is how we actually get rid of that estrogen, it there leaves this inherent weakness for estrogen to hang around too long, let's say, in the bowel, and it can be reabsorbed and reactivated. So now you have extra estrogen that you do not need, and the golden rule for estrogen is to use it and or lose it. You want to use it, you want to use it and then get rid of it because you are always under this anabolic, always under this growth, the influence of this growth hormone, then we have things that grow that shouldn't like cysts in our breasts.

So so it's important for us to consider green leafy vegetables as women, as a way to amp up our liver's ability to detoxify. So that's sort of one thing. It's like this idea of consuming vegetables that have insoluble fiber that's also going to help with your bowel movements. So the other thing I should mention is when you're eating foods that have a lot of insoluble fiber content, your body cannot actually break down the fiber that the carbon chain is too long. The starchy chain is too long, so it actually passes through undigested. And what happens is the fiber will attract water to it. So you're now creating as the bowel itself, as the excrement is sort of, you know, being accumulated in the gut, it's making it softer. So you can actually pass that bowel movement. The roughage is also kind of cleaning things up and you're having regular bowel moments. Which is again, one of the ways that we excrete our estrogen is through having regular bowel movements and a regular bowel movement for most people should be a minimum of once a day minimum.

Importance of Resistant Starch on Keto

So you could have there's this upper limit like you shouldn't be going every time you go to the bathroom but one to three times a day is a sufficient amount of clearance through to the gut. So that's one hallmark. The other hallmark that's really important for women is this idea of resistant starches and a lot of people. I've written articles on this on Medium. You know, I talk about it like a super nerd in the book. But resistant starches are also super important because they are going to they're going to help in your state of ketosis. So again, resistant starch, it resists digestion very similar to insoluble fiber, and it is going to serve as a food source for your large intestine.

So the resistance starch n the large intestine is going to serve as a food source for them, which is going to quell your cravings. This is another thing that I don't know if you've come across this or not, but I find that women like three or four weeks into it, like doing a keto for the first time say, I don't know what the hell's going on, but all I wanted is a pizza. All I want is a burger. I want bread, I want rice and want pasta.

So giving yourself these resistant starches is going to help quell those cravings because those cravings are actually a distress signal from your microbiome. So when we quell the cravings we help with sleep. So the microbiome is going to chow down on the resistant starch and release short-chain fatty acids. So now deepening your state of ketosis, it's also going to help with your sleep. It's also going to help repair the digestive lining of the gut. If you are someone who has digestive issues and it's going to get rid of your cravings. So it's sort of like this triple threat. 

It's like this like win, win, win. You always win when you have these two elements in sync in a ketogenic diet for women. There are, I mean, there are other things, but those are sort of the two main goal posts that I like to set for females on a ketogenic diet for it to be sustainable. You can do dirty keto for a month, right? And you'll lose a ton of weight. But it's not really in your best interest to consume bacon with a side of bacon on top of bacon with some bacon, right? Like, we want to be thinking about the phytonutrients and some of the broad variety of food that is available to us. 

Real Food Sources of Resistant Starch

Cheryl McColgan: And so for people that may not be familiar with the term resistant starch yet until today, can you give some examples of the whole food sources for that? Because I know you can get it, obviously you can actually get some of these resistant starches now at in a can because this is such a popular topic. But can you give some people examples of real food sources where they would get resistant starch? 

Dr. Stephanie Estima: So if you were to go to the grocer and buy green bananas and just let them sit on your counter a couple of days later, they're a little less green, a bit more yellow and then a couple of days later, still they're yellow. And if you leave them too long, they turn brown off when you have to make banana bread. So the green, the reason why we don't eat them when they're green is that they're not really sweet right there. They're sort of they're hard. And, you know, they don't have a lot of sweetness and then that's resistant starch.

So green bananas, you can have green plantains as well. I actually like both of those in a powder form, and you can get us at any grocery at this point, as you said. So like green banana flour, green plantain flour. Another whole food example is a raw potato. So again, if you were to look at a raw potato, not super appetizing to bite it, right? It's not really doesn't have a softness to it. And that's because the primary makeup of the starches in the potato is a resistant starch. And of course, as you cook it, you break down. The heat is going to help cleave some of those starch bonds and then it becomes more consumable. So when you eat hot potatoes, you know that is a digestible starch when you, you know, cold potatoes, even ones that have been cooked and then cooled in the fridge. We actually know that there's this crystallization effect that happens if you cool a cooked potato. Same thing with rice. If you cook rice and then you cool it in the fridge overnight and then have it cold the resistant starch has crystallized and so it also acts as a resistant starch for you as well. So those are the whole food examples of it. I always like to take it out so you can get raw potato starch like this, you could help thicken soups or stews with it. And then the green banana and green plantain flour is good as well.

Keto and Menopause

Cheryl McColgan: Awesome, thanks for that. So since you talked about women through their various life stages and always being focused on gut health, that sort of applies to everybody. As a person like myself, that's getting older and at some of my audience is kind of the same age group in that perimenopausal to menopausal stage…you said that that was your two cohorts. Could you maybe talk about how you found keto to work differently or not in older ladies and any tips or practical things that we should be aware of as we get older? Definitely having the resistant starch and the liver support with the veggies, but anything else beyond that? 

Dr. Stephanie Estima: Yeah, I think one of the things we want to be considering for keto and menopause, in that sort of late 40s, early 50s, age range is insulin resistance. And even if you're menopausal, one of the things that we know that happens physiologically is that you become more insulin resistant as you age. And that's not because you done something wrong. That's just sort of what happens over time. The same is true for our muscles. They become more and there's more of this anabolic resistance that develops in the muscle. And what that means is that your muscles are more resistant to growing. So when we are thinking about how we can support our ladies who are sort of late 40s, early 50s or 60s and 70s and beyond, we want to be considering that she tends to be more insulin resistant and her muscles have more anabolic resistance.

I will say that the more that I sort of dove into the literature and learn about insulin resistance, like the more I realize I know nothing about like we learned in school, it was like this lock and key thing. It was like something with insulin was gumming up the receptor. But there's far more to it than that. It's such a simplistic, almost like pedestrian understanding of it. It's far more complex than that. 

Keto and Menopause: Insulin Resistance

However, what we want to be thinking about for these ladies is we want to be thinking about metabolically how can we dispose of more glucose? Because what happens with insulin resistance, essentially in the most basic way that I can explain it, is that we have glucose in the bloodstream. So whether that was sourced from carbohydrate bolus or protein bolus you ate, you have insulin that's elevated and your insulin is not able to get the glucose into the cell because that's her role. Insulin's role in this is the fed state hormone. Her role is to take the glucose, take the substrate, take the fatty acid, the amino acid and put it into your cells so that your cells can create energy.

This is one reason you may want to consider keto and menopause is because of increased insulin resistance.

Now, if your insulin at the same sort of titrate, the same sort of level of secretion is not getting that glucose in what your pancreas does if she releases more insulin, right? Because we are and we're going to try and continue to increase the inflows until we can get that blood glucose at a normal level because we know that glucose hanging around in the blood without doing anything, it can be fatal.

So what we want to think about for our ladies that are a little older is how can we efficiently get rid of that glucose? And one of the answers lies in our muscles. So when we think about our liver, when we think about are the biggest sort of gobblers of glucose are your brain, you know, liver and your muscles. But, by sheer volume, your muscles are the biggest sort of gobblers of glucose, because there's just more of them. So if you can continue to maintain your muscle mass or to ideally improve it as you age, you are going to be a much more efficient glucose disposal agent, because there's just more muscle, right? There's more muscle around and you're going to require more energy to maintain it.

Keto and menopause go together as another way to control glucose.

So one of the things I talk about in a book, there are several chapters that are dedicated to this idea is the idea of resistance training and when and how to train in accordance with your menstrual cycle. And if you're menopausal, his changes. So we want to be thinking about lifting heavy weights and I promise you, do not bulk, do not turn into the Hulk.

Can Women Get Bulky From Strength Training?

You know, I was a figure competitor for a few years, and I wanted to bulk like that. I was trying to bulk and it was very, very difficult. And I was a natural athlete, so not taking any exogenous testosterone or any of those sort of anabolic steroids. And it's hard to do like as a woman, it's hard to do so even if you want it like I did, you know you got you got to work, you got to work so hard. So my my my counsel to women is to lift weights and lift weights until your muscle is fatigued. And there's a lot of different ways that we can bring the muscle to. Fatigue can be with heavy weights, low reps that can be of lighter weight, higher reps is a lot and I sort of outline all of that in the book, but that is one of the best strategies that I think perimenopausal and menopausal women can take in there in terms of the things that they do every day is lifting heavy stuff, because we want to maintain muscle as we age.

Connection Between Dementia and Bone Fractures

The other thing that confers mass is bone density, right? So as our muscles are supple and big and strong, so goes our bones. Our bones and our muscles are sisters. So what happens to one happens to the other. So if you have a lot of lean muscle, strong muscle that's flexible and pliable, you will also have dense bones that are flexible and pliable versus if you are someone who is under muscled and you are starting to move into sarcopenicc obesity, where you have this fatty infiltration of the muscle. Now you are also going to have bones that are brittle and weak. If you image them on x-ray, you'll see sort of this pockmark almost looks like teenage acne, you know, on the bone where we're seeing that gaping holes through the bone, which makes it very brittle and very susceptible to fracture.

We know that this is true for men ands women, truly. But if he were to slip and fall, I can't tell you how many patients I had over the 10 years that I was in practice…a ladies that slipped and fell, then the cognitive dementia that follows that. So it's often like that he fracture your hip. The rates of cognitive decline that follow are significant, they're related to each other. 

Cheryl McColgan: Very interesting. I never heard that one before. I should look into that a little bit more. But while I've got you on that particular subject, one of the things I've been delving into lately, again, as a person that's moving into that part of my life…I'm not as good as resistance training, but I know that it's necessary, but one of the things that I've been delving into recently is it appears that number one, a lot of women have always been diet focused straight and a lot of the things they give up are tend to be protein because they'll start eating a bunch of salads and stuff as they try to lose weight or in an attempt to maintain.

Eating Enough Protein For Muscle Building on Keto

So one of the things I have been looking at to actually build muscle mass is to really make sure that you get the proper not only the proper amount of protein but maybe even a slightly higher level of protein as we get older to maintain. And also that you can just build muscle mass by your diet, possibly with protein. Any further thoughts on that or things that you've seen about that sort of idea? 

Dr. Stephanie Estima: Yeah. So I think that there are two places you can build muscle. One is in the gym and the other is in the kitchen, so you can be building muscle by prioritizing protein. And that's actually part of the keto cycling plan. So you sort of have one week off where we're doing keto. And then the other week is like protein and carb cycling. And what that does, of course, is you are going to be driving something called muscle protein synthesis, which is just kind of what it sounds like. It's dry like it's making new muscle protein and you do that by a certain amino acid that starts. This is called Lucene. So leucine is very abundant and you'll find it across protein sources. It tends to be there tends to be a better bang for your buck in whey or animal-derived proteins. You can get it with plant proteins. You just, you know, you've got to eat more. So there's also a caloric consideration there, so you can if you're a vegetarian or vegan.

Keto For Vegans and Vegetarians

I get this question like, can I do keto if I'm vegetarian? The answer's yes. But you do have to be mindful for your calories, and you also have to be a bit of a chemist as well, because I think you have to really be making sure that you're combining of proteins in such a way that you are getting all of your essential amino acids. Where, as you know, I am a meat eater. I can kind of just eat a piece of steak and know that I'm getting my full spectrum of protein here and I'm good with that.

But a vegetarian or vegan, she has to make sure that she's getting the full spectrum of amino acids. And that's something else to consider as well. But you need typically two to two and a half grams of leucine to start the process. So for a whey protein or an animal-derived protein that might be like a chicken breast or something, you might be like 20 to 25 grams of whey protein powder or plant protein. You know, I've done a little bit of research on this because I have I've had women come to me say, I'm a vegetarian, like, I want to do it this way but I don't want animal products.

Muscle Protein Synthesis

You can get it done with soy, protein, protein, but you just you end up having more. So instead of having tofu like a soup of 25 grams to get that, you know, two and a half grams of leucine to start the process, you might need 40 grams or 45 grams, depending on the source. So, you know you want to be thinking about how many calories you're taking and if weight loss is something that's a goal for you, it may require that you restrict calories elsewhere or that you have some animal products.

Cheryl McColgan:

And I would say just for myself, I'm trying to focus on that optimal amount of a protein to start the process of muscle protein synthesis and it can be difficult to eat that much protein in a day. So it has to be really palatable because you kind of lose your appetite for it a little bit when you're eating a lot of protein. And then it's more difficult in the other direction, like, are you consuming enough calories for the day? Which if you're trying to lose weight, that might not be as worrisome. This is probably why a lot of people are attracted to the carnivore diet now, just because it kind of limits calorie and food intake very naturally, much as does keto, just because you're very satiated. 

Dr. Stephanie Estima: Absolutely. 

About the Betty Body Book

Cheryl McColgan: So for the book and I got these when I purchased the book, but you said you have some special little things for people that support the book and purchase it. Can you talk a little bit more about what people get when they buy the Betty Body? 

Dr. Stephanie Estima:

First of all, you can buy the book anywhere in online retailers like Barnes and Noble, Amazon, or anywhere that you would buy books. Once you do, I would love for you to go to There I have put together a program for you so you don't really have to think. Like it's one thing to write a book and have all the science, all the stuff. But the other thing, it's another thing to do it. So what is the how-to? So the how-to is what we've done for you.

We have done four weeks of a pure ketogenic diet. We've given you four weeks of cycling, so up and down with the protein. And we've also given you rehabilitation. And we've also given you beginner workouts, intermediate and advanced workouts because another thing that I hear is like, I want to start weightlifting, but my gym is closed right now and I don't know what to do. So these are all designed for home use with minimal equipment. Most of the time is your own body weight, and if you are someone who is invested in a home gym, of course we give you the options for weights and all of that. And then there's also rehab, which is something that I've spent six years really diving deep into so that's a big deal. A lot of people will say, I want to, you know, I want to resistance training, but I have a slight niggling injury that prevents me from doing it. So we've also included that in the bonuses for the book as well. 

How to Make Keto Sustainable

Cheryl McColgan: Awesome. I'm so excited to try some of that stuff out. The last thing I want to kind of go into is, as we talked about before, that's the point of this podcast is making things sustainable for people. So that we don't lose them because, you know, I hear that lot. People say I tried it for a few weeks and it just didn't work for me. And not just women. They get tired of and I think having somewhat of an understanding about why it's healthier for you, again, going back to knowing your why can help people stay on it. But some of it is too like they don't know what to eat or they just really have those cravings or they want to have a pizza. I try to tell them, hey, you know, you can still do that at some point. But there is some benefit in becoming keto-adapted at the beginning and being a little strict for a while and then moving into cycling. So as you said before you started out with a very traditional approach to keto when you were in clinic and then you kind of moved into this more cycling. Did you find that for people that that sort of cycling aspect of it made it more sustainable over time? And just any other further tips for people about, you know, how to stay with it long term? 

Dr. Stephanie Estima Absolutely. Yeah, it's hard to stay in ketosis all the time. You really do have to watch your carbohydrates very closely. And for some people, depending on their muscle mass and their genetics and their processing, it is easier for them to have more carbohydrates. But for other people, they be kicked out of ketosis with like 15 grams of carbohydrates. So the cycling definitely makes it a lot easier. It makes it a lot more sustainable. And it's also, you know, it's hard to eat the same thing all the time. You just we just tire of it. So that's why the cycling where you're having, you know, a ketogenic week and then a week where your protein, you're increasing your protein and then another week cycling gives you the opportunity to have flexibility.

Trying Keto and Finding What Works for You

This is one of the things that I'm hoping to achieve with the book is that we don't have to have just one way. Now there are many roads that lead to Rome, like if you want to lose weight, there are many ways to do that. This is one of those options and what I have found with implementing this with thousands of women at this point is that this way is very easy thing for most women to do over the long term. So the tips I would offer are that I would encourage anyone if they are looking to to try it even just if you don't want to invest in the book, if that seems like too big of an investment at this point is to just check out my podcast and think about trying some of the things that I talk about there. I talk a lot about keto cycling on that podcast.

You just have to try it. One of the things that we have to learn to be a little bit easier on ourselves, this flexibility is not always like I have to do it. And if it doesn't work it not like you've wasted your time. Actually, if something doesn't work for you, what you've actually gained is a lot of information, right? You gained a lot of information. Why it didn't work. Maybe there was at that particular time in your life a lot of stress and you weren't able to commit to it. Or maybe the diet didn't adapt enough to you.

So I think that I would love for people to get comfortable with the idea of not, failure, which has a negative connotation to it. But I think that the more we try things and the more we allow ourselves to play, the more that we discover who it is that we are and what it is that we need. I think that so often we're just so stiff and we don't want to be beginners and we just want to be the expert. We want to know everything. And is it going to work? I need a guarantee, you know, and I wish life would work like that, but you just got to try. So pinky promise, hopefully, you'll you'll try this book, and it'll work for you. I would love to hear your success stories. 

Long Term Keto

Cheryl McColgan: I love it, too. And I hope we get many people trying this because, I think this approach, it just makes it makes logical sense and still makes logical sense to me when I've been doing this now for five years at this point.  I couldn't have done it that long if I didn't have times where I played with different things or change things up or allowed myself to get kicked out of ketosis, like, who cares? And to be fair, I don't have diabetes. I have very robust metabolism. So I don't have the same issues as other people do. But you only know that by experimenting for yourself, right? So I think that's wonderful advice, Stephanie. So to end up here, I would just like for you to share all of the places that people can find you. You mentioned the book is pretty much available everywhere at this point, but where do people find you online? Where can they hear from more from you? You mentioned your podcast. Tell us all of the things you write. 

Dr. Stephanie Estima: So my podcast is called Better with Dr. Stephanie. Every week we have interviews of thought leaders. I have a sort of a mini-show on there called Geeky Magic, where I'm just like talking about something that really important whether it's metabolism, body composition, you know, fat, whatever it is. So better with Dr. Stephanie the pod.  I'm pretty active on Instagram, so you can find me at dr.stephanie.estima. Then the would be where you can find all of my programming and more information about the book. 

Cheryl McColgan: Fantastic. Well, thank you again. So much for your time and sharing all of your knowledge with us today, and I appreciate it so much. 

Dr. Stephanie Estima: Thank you so much.