12 Essential Tips for Primal Women

12 Essential Tips for Primal Women FinalLook: I’m a man. I’ve lived a different experience than the average woman, with totally different equipment and different concentrations of hormones coursing through my body. But I have a daughter and a wife and a good head on my shoulders that’s spent the last 30 years thinking about health, nutrition, and fitness for humans, so I have a few things to offer.

So let’s get right down to today’s post. What follows are 12 tips for Primal women. Or any woman, really.

(Men, too: if some of the things mentioned in today’s post aren’t working for you, and the tips seem to apply, go for it!)

1. You don’t have to fast (and maybe shouldn’t)

Amidst the growing acceptance of intermittent fasting as a legitimate tool for healthy aging and weight loss emerges the realization that men and women may respond to it differently. Whereas in men the response to fasting is usually positive, it’s more mixed in women. For instance:

One study found that while IF improved insulin sensitivity in male subjects, female subjects saw no such improvement and actually experienced worse glucose tolerance.

In another, obese men and women dropped body fat, body weight, blood pressure, total cholesterol, LDL cholesterol, and triglycercides on a fasting regimen. Healthy people may have different responses. Perimenopausal women were also excluded from the study.

And most recently, researchers found that women respond negatively to an energy deficit induced by fasting but positively to one induced by exercise.

Women can fast, but the conditions for success are narrower. If you want to try fasting, you may have success with shorter fasting periods (skip a meal instead of two), less frequent fasting (once a week or every two weeks).

2. You need to lift

Everyone needs to lift, but no one needs to lift more than women who’ve spent their whole lives avoiding it after hearing that lifting will make them “bulky.” Chances are, they haven’t lifted. Chances are even if they’ve managed to get into the gym with the intent of lifting, little niggling doubts remain and increase the chance they’ll veer away from the weight room toward the spin class. Or they actually lift but stick to baby weights rather than barbells. Lifting won’t make you bulky (unless you’re taking exogenous substances that render your hormonal profile more similar to a man’s). Lifting will:

Improve your bone density (osteoporosis hits women harder than men).

Improve fat burning.

Increase lean mass.

There’s no reason not to lift.

3. Your “ideal” body fat percentage is higher than you think

Women carry more fat on average than men. They just do. And when you look at a healthy woman’s body, her true body fat percentage is likely higher than you think. For a man, 12-15% body fat is healthy, while for women the healthiest (in general; everything is relative and there are always exceptions) body fat level is 18-25%.

So when you get your body fat tested and it’s 25% or even higher, don’t freak out. You carry weight differently than men. What’s high for a man may be completely normal for you. A woman can look about as lean as a guy but have far more body fat as a percentage of overall weight. This can cause anxiety—those cover models look like they’re 12% body fat but are actually closer to 20%—but it shouldn’t.

4. Junk in the trunk might be treasure

For many women it’s completely natural to have a higher body fat level and accumulate more fat in the gluteofemoral region–the hips, butt, and thighs–because that’s where women store DHA for future baby brain construction. That’s probably why gluteofemoral fat is notoriously stubborn and hard to burn – because it’s a reliable, secure way to store an important nutrient (DHA) that’s often scarce during pregnancy. In fact, having that kind of fat is actually a sign of good metabolic health.

Embrace your lower body fat, since it correlates strongly with health.

5. Don’t try to eat as much as the guys

It’s not just an illusion that many men seem to be able to eat whatever they want without gaining an ounce. Men are generally larger, with more muscle mass. Just to stay at their normal weight they require more calories. They can get away with more calories. But since women are smaller in general (fair warning: I’m going to be doing a lot of generalizing because it produces actionable advice for the most people), they can’t. But that food is so good and your husband is enjoying so much more of it. Unfair? Sure. So be sure to pop him one next time he’s not looking in retribution (not really though).

Being Primal usually takes care of the “inadvertent calorie reduction” thing pretty well, but not always. Be aware that you don’t need to keep up with your husband/boyfriend/guy friends/etc at dinner. And make sure you’re eating nutrient dense foods. Since you have fewer calories to “work with,” you need to make the most of the ones you eat.

6. Beware the female athlete triad

When women combine heavy, intense training with undereating, they may develop the “female athlete triad“: disordered eating, osteoporosis, amenorrhea. If all that sounds extreme, it is but it isn’t; the triad is shockingly common among adolescent and young adult female athletes.

Don’t train too hard. Don’t eat too little. Avoid doing both concurrently, or else your bone, reproductive, and psychological health can suffer.

7. Don’t diet too hard

I know, I know. There’s all this seemingly conflicting information being strewn about. Don’t eat too much. Don’t eat too little! Don’t exercise too much! That’s just the reality, though: in general, women can’t get away with as many metabolic perturbations as men. Whereas men can skip a day or two’s meals and actually come out leaner, healthier, and happier, women often respond negatively to the same stimulus. Men can train really hard and it takes a while for the negative effects to accumulate (remember, I did it for decades before enough was enough); women usually can’t. And men can usually get away with more restrictive diets, like eating very-low carb or super low-calorie for extended periods. In my experience, women usually can’t.

So be aware of all that. Eat the food. When losing weight, which really means “losing fat,” sometimes you need to eat a little more than you think.

8. Get your calcium (and the nutrients necessary to absorb and utilize it)

Across their lives, women have a higher risk of osteoporosis than men. There are a lot of reasons why this discrepancy may exist, but a major one is inadequate calcium intake. Women need more calcium than men.

If you tolerate it, full-fat dairy is a fantastic source of calcium. Highly bioavailable and comes packaged with lots of other nutrients that help it absorb properly.

Leafy greens are pretty good sources of calcium, but I wouldn’t rely on them for the entirety of your calcium intake.

Bone-in small fish, like canned sardines, give tons of calcium. And like the dairy, canned fish comes with many other important nutrients.

9. You might need a few more carbs

The Primal Blueprint recommends quite a varied range of carbohydrate intake. While detractors like to focus on the “low-carb” part of things, I’ve always said that eating around 150 grams of carbs per day is perfectly sustainable, healthy, and sufficiently low-carb. And a sizable portion of my female readers, friends, and clients all seem to do better toward the upper end of that range, in the 100-150 grams per day tier. Many do great on lower amounts, too.

Just don’t think you have to go ketogenic, or avoid berries, or count the carbs in spinach.

10. Get a handle on stress

Much of the research has been in animals, but the bulk of it suggests that females are more susceptible to the negative effects of stress than men. In female mice, chronic stress has a greater chance to cause depression. Girls appear to be more sensitive to the negative psychological effects of child abuse. Overall, females have a greater potential for dysregulated “stress reactivity” in response to stressors and show higher rates of stress-related disorders.

Even “physical” stress, like the oxidative damage caused by exposure to airborne pollution, is more potent in women than men. Female smokers, for instance, show evidence of more oxidative damage than equivalent male smokers.

11. Get your sleep

A recent study found that inadequate sleep was more likely to cause “psychological distress and greater feelings of hostility, depression, and anger” in women than men.

Once again, it’s not fair. It can’t be ignored, though.

12. Watch your iron intake after menopause

For most of your life, you’ve got a built-in iron regulator: your period. Every month, you lose a little iron. You may have even needed to focus on getting more iron to account for the iron lost through menstruation. And through certain phases of life, like pregnancy, your iron needs are higher.

But after you stop getting your period, you’re no longer losing iron. You’re accumulating it, just like men do. And while it may be a confluence of factors, increased iron may be partially responsible for the overall increase in health problems that typically ensue with menopause. If you’re no longer shedding iron regularly, check out all the ways you can use your diet and other lifestyle habits to regulate your iron intake and absorption.

That’s it for today, everyone. It’s not an exhaustive list by any means. I’m sure I’ve missed some things, so now it’s your turn to help out down below.

Women: what tips, tricks, and practices have you found indispensable for your Primal journey?

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About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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142 thoughts on “12 Essential Tips for Primal Women”

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  1. I think it would be more accurate to say that men have “somewhat different” equipment than women. The clitoris is surprisingly similar to a penis, if you look under the surface of the body. Men and women are actually more alike than we are different, and the recommendations in this article reflect that.

    1. While were are more alike than different our differences are pretty profound. A clitoris is like a penis only in that they are both formed from the same fetal tissue. Beyond that they are radically different in purpose, function and response.

      Bat wings are actually just big mammalian hands with webs of skin. The genetic instructions on how to build a proper limb is the same in all mammals as well. But bat’s hands are radically different in purpose and function than a human’s hand.

      Scientists usually use male mice in their studies because they are biologically simpler and more static than female rats. Almost all the animal studies are done with males of their species. And then when they try their new discovery/treatment on a female rat they often find that results are completely different.

      So yes, we are all made of the same stuff. More alike than different. But the differences are quite profound and real and they do matter.

      1. The clitoris and penis are not “radically different.” They’re super similar. Besides the fact that most of the clitoris is internal and most of the penis is external, the only differences are the clitoris exists solely for pleasure (the penis obviously has reproductive and peeing functions) and that the clitoris has twice the number of nerve endings and is able to have multiple orgasms.

        Educate yourself: https://projects.huffingtonpost.com/cliteracy

        1. Sure, other than all those major differences you just listed regarding function and purpose, they are super similar. Just like a motorcycle is just like a car, except for the number of cylinders, the number of wheels, the number of passengers it can hold, and the way it steers, brakes and accelerates. My cat is also just like a dog, except for the fact it’s not in every way that matters. Italian food is just like Chinese…noodles, sauces, served on a plate…except they are completely different and you’d be really upset if your ordered linguine and got chow mien and waiter said, hey it has noodles and sauce, it’s super similar!

    2. Pretty sure he was referring to a woman’s menstrual cycle. It’s a natural way to chelate iron from the blood. This is why men should donate blood

  2. Really interesting, I used to do the 5:2 fasting but have really struggled with it this year. At the same time I have started perimenopause, I hadn’t made the connection. I can generally skip breakfast but not during my cycle. So the fasting thing is something I will have to monitor.

    I have lifted weights for years, I originally had the “Strong Women Stay Young” book,which I have given to my mum who lifts weights in her 70s. It advocates lifting heavy weights with less reps. I also tolerate dairy pretty well so greek yoghurt and cheese is definitely part of my diet.

    Thanks for the reminder to be gentle about body fat, dieting and carb content too. The portion control advice is pertinent as my partner and I have just had a conversation about meals I make being big enough for him, as I can certainly eat less than he does.

    1. I am 50 and perimenopausal. Recently put on couple of kilo (over 6 months), and thought to try the 5:2 – or the 16 hour fast (skipping breakfast) – I packed on an extra 2 kilo in a single week!

      Went back to normal paleo, regularly eating 30 grams of protein each meal and lost it in 2 weeks.

      The fasting is not for my body.

  3. Sleep can be a problem for older women. I and nearly all my friends who are post menopause have problems sleeping. It’s annoying to be told not to skimp on sleep when insomnia and the menopause seem to go hand in hand.

    1. I’m only still in perimenopause and good sleep is a distant memory. Every little noise wakes me up. I rise unrested every morning and drag myself through the day. So that’s it for the rest of my life 🙁

      1. I had the same problem with every little noise waking me up, especially since my husband snores, but I have “discovered” silicon earplugs – they are little lifesavers and I sleep sooo much better now that I use them at night. I’d tried the foam earplugs but they make my ears sore, the silicon ones do not. I’ve even slept through thunderstorms! You don’t have to be exhausted for the rest of your life, invest in silicon earplugs!

        1. Snoring husband has been banned to the couch for years. Even so, I hear his snoring even with a wall between us. Thanks for the tip about the silicon. I will try it. Problem is I have a small child and need to hear if she cries at night.

        2. Has the snoring husband had a sleep study done to determine if he has obstructive sleep apnea?

        3. No, and likely will not. He is a lifelong smoker, eats crap, and doesn’t seem interested in improving any aspect of his health at the moment. Unfortunately a sleep study would be low on his priority list. Hence the couch.

          1. I know this is an old thread, but in case you see it, have *you* had a sleep study? My husband snores, but when we both had sleep studies it turned out I was the one with the problem, not him. I was waking up fully every few hours but waking up a little bit (not enough to realize I was waking but enough to screw me over the next morning) about 20 times per hour. Now I sleep with a CPAP and am sleeping better than I have in decades.

            I wish I had found it sooner, but at least now when I have a bad night, it’s what I used to call a good night, so I have some perspective.

      2. I’m 41 and male so I’ve no idea if this will help you at all, but I recently (in the last few weeks) finally seem to have solved 4+ years of intermittent sleep problems (no problem falling asleep, but shallow sleep in the second of the night and waking early feeling crappy) by eating a bunch of carbs before bed – a full bowl of rice, sometimes going back for seconds, however much it takes to feel satisfied (not necessarily “full”, but satisfied). Interestingly the timing (before bed) seems to be key, spreading those carbs thru the day doesn’t seem to make the same difference. Might be worth a try, I feel your pain, crappy sleep makes life a painful struggle.

        1. Thanks for the suggestion, but I have diabetes and eating a big bowl of rice also is, and must sadly remain, a distant memory.

        2. I am doing that at the moment. I am doing it a bit like carb backloading (John Kiefer) and mostly keeping the fats out of the pre bed cab meal. I think it has something to do with better insulin sensitivity at night. Dave Asprey has recently also had a go at some honey before bedtime.

        3. Thank you for the suggestion. Since the start of menopause, a good night’s sleep is a distant memory.

          I am going to give this a try, mainly because my sleep problems are the same as you have listed – no trouble falling asleep, and sleeping solidly for 4 hours (regardless of what time I go to bed) – but once I wake that first time after 4 hours, I toss and turn and wake constantly, and by the time I have to get up I feel behind the 8-ball before the day has even started.

          I’m curious though, has the carb-loading before bed affected your weight at all?

      3. Have you ever tried diffusing some lavender in your room while you sleep? Lavender seems to work really well in both those young and old as a calming effect. I’ve used it with my children to get them to go to sleep, and I’ve given it to my elderly aunt who is just wound up really tight and has trouble relaxing. It’s quite versatile. Majestic Pure makes a great lavender essential oil, and it’s very mild – I’ve used it directly on my skin with no adverse effect. I’ve sprinkled drops on my son’s pillow for a restful sleep. Also you might try using valerian root about 1/2 hour before bed – you can find it in any drugstore or supermarket with a pharmacy. It’s herbal so it’s also very mild, no druggy feeling, and I can honestly say it was a lifesaver after I had insomnia for about a month – tried drinking myself to sleep, tried OTC pills, combined those two, nothing worked. Doctor prescribed me prozac – do you believe that? – needless to say it didn’t work. Valerian root did. Above all, please do not give up hope. Keep trying 🙂 And we’ll keep praying for you.

        1. I have taken valerian before and it did not have any effect. But the lavender is worth a try. Thanks for the suggestion.

      4. I am 57 and am now fully into the menopausal stage but almost 10 years ago I started seeing a doctor who specializes in bio-identical hormone replacement. His website is http://www.hormonereplacement.com and he has an archive of many scientific articles regarding symptoms during all phases of male and female reproductive health. I recommend it highly. I sleep like a baby now that I have been replacing with bio-identical progesterone. We lose this hormone more rapidly as we age and it is a big contributor to the estrogen dominant heavy bleeding that often occurs during perimenopause, which I had. Progesterone replacement fixed that for me in one cycle of taking it and greatly improved my sleep!

    2. I use a white noise machine. Works like a charm. In fact, it works so well that I have to drag it with me when I travel because I’ve become so habituated to it that I physically have problems relaxing without it. Sigh…it’s still way better than not sleeping throughout the night.

      1. Ditto but with an old fan… I bring it everywhere with me. The only places I don’t need it are at the cottage or in the woods camping.

  4. So no tips on managing prostate problems in today’s article eh?

  5. Excellent article. We women have been so screwed by the advice of twentysomething male health gurus. Very low carb can be really bad for us. I now look at women’s gluteofemoral fat as a sign of female power. I wish I could’ve felt that way 20 years ago.

  6. I had a trainer about a year ago say that female bf of 15% was ideal. I really struggled with that as my body was not having it. I would get to around 19-20% and my body just stayed there. Thank you Mark! Now I know that I am lean and normal.

  7. Just being around women my whole life I concur with the sleep and carb recommendations. My partner needs more carbs and sleep than me. I’ve noticed this to be pretty consistent with the women I know. Unfortunately it also seems the very act of having children induces life long mild insomnia in women. Almost all the moms I know when from predictable sleep to fitful sleep when they had children and it never went back to normal.

    Anyway, I know when me and my guy friends feel depleted we tend to seek out protein while our female partners seek out carbohydrates.

    1. My husband and I realized we have very different sleep needs after our second child was born, and that I develop terrible depression with sleep deprivation. At that point, he took nights and just fed him a bottle. He still gets up with the kids in the morning, but now they sleep through the night so he is getting enough sleep. This worked out very well for us. He had an easier time also because he can nap where I just can’t. Due to this, neither of us have the fitful sleep most moms develop as a result of years of interrupted sleep. He never developed that, amazingly. And, our son has a very close relationship to his Dad that mirrors the one he has with me, probably from the nighttime bonding.

    2. I guess I’m one of the lucky moms who did not wind up with life long mild insomnia. I’ve got two children (22 & 13) and I sleep like a rock, or a toddler, and have for most of my life. I fall asleep quickly and rarely wake at night, unless the cat steps on my face. (She wants petted and doesn’t care that I’m asleep.) My husband is jealous of my ability to sleep through just about anything, including most thunderstorms and the transformer that blew close enough to the house that it rattled the windows. Maybe it’s because both girls slept with me as babies, I don’t know.

      I will however wake up when a sleep walking child walks into the room and just stands and stares at us. Was kind of weird the first time, until we realized she was sleep walking. Fortunately, in that state, she follows directions really well, but only if they’re repeated several times.

  8. #5! Oh my goodness. I’ve learned that one the hard way. Before I moved in w/my partner I didn’t have too much trouble staying at my ‘happy’ weight. Now I’ve had to consciously monitor my portion sizes. I can’t let him make my plate for me or I’d end up with a mountain of food on it. Of course he stays at 17%body fat no matter what he does or doesn’t eat.

    1. Can’t tell you how many times I’ve said 1/3 for me, 2/3 for you. I have a tendency to eat what’s on my plate, he hands me a plate and I finish it all. 🙁

  9. Great – now if my body would just stay asleep…I can’t seem to get past 6 hours without (unwanted) sleeping pills, and even then it’s hit-or-miss and I don’t like taking 2 since they make me groggy the next day. I can eat well, exercise reasonably (not too much or too little, with a mix of lifting and running), practice good sleep hygiene (mostly – in bed by 10:30pm and I only take the sleep pills when my sleep deficit gets obnoxious), and still wake up at 4am regularly. I’m 42 with 2 kids (ages 8 and 11), and I suspect that I am not alone on this issue. Is there any useful research out there with proven ideas for improving sleep duration in women, other than the obvious stuff already mentioned in my comment?

    1. If you live in a state that allows cannabis use, a very small piece of Indica cannabis chocolate (2-5mg THC at most) one hour before be will lull you gently into a very deep sleep for about 6-8 hours or more. You won’t get high and you’ll wake up feeling relaxed and refreshed. Great for inflammation and pain as well.

      1. Yup, thanks…not legal here, and even if it were, I’m in a drug-testable job!

      2. Thanks, Clay. I usually take a little melatonin if I can’t sleep, but I’ll try the Indica cannabis chocolate. I live in Colorado so obtaining it shouldn’t be a problem. Is there a particular brand I should look for?

        1. In Colorado, Bhang Bar is a good safe bet. Get a low dose indica bar (like 60mg if you can find it) so it’s easier to portion out. It’s really annoying to try and shave off 5 milligrams on a 180 mg bar.

    2. GABA. This stuff works incredibly well. But do monitor how it affects your mood. Sometimes it can worsen PMS or depression, if you have a history. Sometimes it can improve these things too, though.
      Natural Calm also helps.
      Or, getting a lot of daylight exposure, or changing when you exercise. But stop with the sleeping pills. That stuff actually can start damaging your ability to sleep well, and you don’t even realize it is happening.

    3. Have you been to a sleep doctor to get a sleep study done? Other than crappy sleep and family history, I’m well outside the usual parameters for sleep apnea, but I have it anyway. If you’re eating well, exercising, practicing good sleep hygiene, and (most importantly) feel tired/groggy/etc, then you really need to go see a sleep doctor.

      My sleep doctor first treated my insomnia (no meds, either!) and then did an at-home sleep study to check for sleep apnea since my insurance wouldn’t pay for an in-lab test. It’s not a big deal and I am getting better, more restful sleep now, even if I’m getting the same or less hours of actually being in bed sleeping (or attempting to sleep.)

      On a side note, I don’t know if you’ve ever been treated for depression, but sleep disorders are often misdiagnosed as mild depression in women. Furthermore, women are less-likely to be referred for testing for Obstructive Sleep Apnea (OSA) than men because nearly every study out there has been exclusively done with men, so the symptoms and risk factors are geared toward men. This means that things that would indicate OSA in women are often overlooked.

      While the book is old and most of the information can be found by looking at several different sites online, my sleep doctor also recommended the book No More Sleepless Nights as a one-stop-shop for a variety of helpful tips and tools for getting better sleep. If you can pick it up inexpensively second-hand, it can save a lot of time spent searching for things online.

      1. I’m having a sleep study done next week, because when I took my husband to get a sleep study so that he could get a new CPAP, they ran through a list of potential indicators of a sleep disorder – grinding your teeth, talking, kicking/hitting, snoring, stopping breathing while asleep. He answered no to all but the last 2, I answered yes to all but the last one. Sigh. I’ve already attempted on in home sleep study, but it has to be redone because the pulse/ox kept going out. Hopefully we can get that resolved.

        I don’t think its OSA, but could be. A more likely issue is that I don’t go to be early enough and am sleep deprived. That can cause all but snoring, which is probably caused by congestion. Plus, even as a teen, when I was getting enough sleep, I’d talk in my sleep. As for grinding my teeth, I only do that when I’m married. I quit grinding them after my first and second divorce. And I got married again anyway…

    4. Please forgive me if this sounds like a joke, but when you wake up, can you fall back asleep? I’ve always been a light sleeper & when I was young I just thought that waking up meant it was time to get up. My mind would start focusing on the day ahead & so I went years with an average of 5 hours a night.

      Then it dawned on me that I should at least try to go back to sleep! Now I meditate &/or listen to restful podcasts if I wake up early, & very often I can get in another sleep period of an hour and a half or so. It may not be the solid 8 hours that my husband gets, but it’s better than 5!

    5. +1 to the GABA suggestion. I take it in combination with L-Theanine before bed. I also take magnesium (threonate has less GI impact) which seems to help me get back to sleep if I wake up after 4 or 5 or 6 hours.

    6. I’m gonna agree with Paleo-curious’ remark. I “naturally” wake up at either 3am or 6am, and I always just chalk it up as the end of the night and time to get to work. But then one morning I was so pooped that I laid back down; despite the fact that I hadn’t thought I’d be able to fall back asleep, I slept all the way to 8am, AND woke up refreshed. This is my night/morning routine now, and I always wake up around 8am (unless I went to bed extremely late, then I’m up by 9). It might be worth a try.
      Another thing that works for me… I can’t do it at home (’cause I live in the ghetto), but when I visit my grandmother (out in the suburbs) I’ll leave the windows open. When I wake up at night there’s a lack of morning sounds (birds chirping, neighbors talking, etc.) and my brain seems to immediately recognize that it’s still time to sleep and I’m right back to unconscious.
      One more thought… How’s the light in your bedroom? Do you have a lit up alarm clock, fire alarm with its annoying little red light, a phone that lights up every time an email or notification comes through? It seems like these little things wouldn’t bother us once we’re asleep, but they usually do.

    7. What is GABA? Here it’s Greater Arizona Bicycle Association.

      I took Psych 101 from Dr. James Maas (look him up – Power Sleep is a great book). I have rolling shutters that black out the window, and blackout curtains on the door. The clock sits on its face at night. I don’t bring my phone in the bedroom (it’s on Do Not Disturb after 10pm anyway) and the only TV in the house is downstairs. I use f.lux on my computer, so if I am on it at night (I avoid that), it’s not blue. Light (especially blue light) is not an issue. I find that fresh sheets tend to help, but changing them every couple of days (vs weekly) gets really old.

      I always try to go back to sleep. It doesn’t work, even when combined with meditation and deliberate relaxation.

      You’re right about the sleep pills – they are a bad idea, but since melatonin and relaxation don’t seem to help, they are the only thing I have found that allows me to sleep through.

      On vacation, I slept much better, but it took a couple of days to get there. Incidentally, my husband can sleep like a brick. I do have one unusual variable – he’s only home half the time (airline pilot) so I’m constantly having to readjust from sleeping alone to sleeping with a bear and back, but I wake up regardless.

      Hm, didn’t mean to turn this into a hopeless despair post. Please enlighten me to GABA.

      1. GABA=Gamma-Aminobutyric Acid. I take a supplement called Zen by Allergy Research Group, 2 caps right before bed (makes me sleepy). You can find it on Amazon.

        Melatonin didn’t do anything for keeping me asleep, but it does work if I have to fly across time zones.

        1. Should have clarified – Zen contains both GABA and L-Theanine.

      2. GABA. YES! However, do try it on a night when you don’t have to get up the next day for work.
        I got my husband to try it; it helps him tremendously! He now falls asleep easily, and though he wakes a couple times a night, has no trouble falling back asleep. He also has no drowsiness the next day; just feels rested.

        I tried it once, and I couldn’t wake up. I hit the snooze button 5-6 times….fortunately, I was only getting up early to run a couple errands before work. They didn’t get done. Once up, I didn’t feel drowsy or slow; I just didn’t want to get up! Now, understand that melatonin also knocks me out for 9-10 hours….I’m very sensitive to sleep aids.

        My son was an hour late for work after trying GABA once; now he won’t use it if he doesn’t have a solid 8 hours to sleep.
        Try a half dose, play with it. It may be just the thing for you, after you figure out the right dose for you.

      3. Your remark about fresh sheets reminded me of one of my sister’s sleep rituals: she sprinkles a drop or two of lavender essential oil on her pillow & sheet. I’ve tried it & it doesn’t seem to help me, but she swears by it. Maybe it would help you in between laundering.

      4. Having a spouse that is gone often, can take some getting used to. My husband used to work really weird hours as a haz mat/industrial clean up tech. A 70-80 hour week was the norm for him. He’d work well into the night and/or get called out in the middle of the night. He even was out of town for weeks at a time on some jobs. After that he was a cop, whose shift changed monthly. So I can relate. What helped was that we both have our own sheets and blankets – now neither of us steal the others blankets, which used to be a huge problem. So we’ve got a king sized bed with 2 twin top sheets. (I never make the bed anyway.) A body pillow may help, when he’s gone. It didn’t do anything for me, but others swear by them. Also, since there was the steady whoosh of his CPAP when he was there, I had to have noise in the room, more than the ceiling fan, very quiet soothing music seemed to do the trick for me. (On Pandora, I listen to Ambient Radio, which drives my husband insane.) Which means my phone in the room, but it’s on do not disturb, and face down on a pair of my daughter’s old fleece pajama bottoms. So on the off chance the screen lights up, which it shouldn’t, it won’t bother me. A white noise machine may help.

      5. I have found that in addition to Primal eating, weekly acupuncture from a good Licensed Acupuncturist is my best bet for solid sleep, and for fixing just about everything. Acupuncture and Traditional Chinese Medicine has been a big help to me. And I’m one of those women who used to sleep like a rock until i had kids.

    8. I started seeing a health psychologist for depression, and we have mainly worked on improving my sleep. I don’t always think his suggestions about sleep hygiene and sleep habits will work, but I try them to see for myself. The result: my sleep has improved tremendously. I highly recommend finding someone who is knowledgeable about sleep to help you work make some changes.
      Come to think of it, he recommended “The Primal Blueprint” to me!

    9. I had the same sleep problem and took ambien for years. Then I gradually weaned myself off once I started making and drinking my own kefir daily and I take a good magnesium supplement (time release or whatever they call it). It has helped tremendously. I take 2 in the morning (I notice I am calmer also – I am an elementary teacher!) and I take 2 at night about a half hour before bed. Dosage is 4 a day. But I also take progesterone at night, altho I don’t think this has much to do with it but I might be wrong. I exercise 5 days a week and get up at 4:30 in bed by 9:00 on those days. I am sleeping so much better. I was afraid I was never going to be able to sleep without my ambien, but I do.

        1. Caveat: magnesium can cause loose stools in some people. That much mag would keep me running for the bathroom. Six to eight ounces of pure tart cherry juice seems to help me get into a deeper sleep. Tart cherry juice is well known for helping with both insomnia and inflammation. It’s available at health food stores, Trader Joe’s, and most supermarkets.

  10. I think under number 4, when you wrote, “Embrace your lower body fat, since it correlates strongly with health,” you actually meant “Embrace your *higher* body fat”. Typo?

    1. I think he meant “lower” body fat as in “lower section of the body”.

    2. I read it as the lower portion of your body, as in hips, buttocks and thighs.

      1. This is why correct punctuation is actually handy. “Lower-body fat” would be much clearer. 🙂

        At least he didn’t say “It’s time to eat grandma!”

    3. I think he was referring to the region of the body, not the amount of fat.

  11. Wow, great tips here! I think the whole carb thing varies from person to person. I get most of my carbs from non-starchy veggies and some nuts from time to time, and feel great…focused and full of energy. As long as I am getting enough fat I feel great. But every now and then,especially if I feel a little run down, I need some sweet potato. It really boils down to listening to your body and giving it what it needs, whether that is more sleep, more carbs, more calcium, or all of the above! Oh, and about to eat some sardines!!!

    1. Eat some sardines! My thought exactly. I just finished a BAS as I read today’s post. The BAS was a smoked sardine Caesar. The dressing was a tbs of primal mayo, the oil from the sardine can, lemon juice and a little fish sauce and cracked pepper. I wished this together and added a whole head of farmstead romaine and some parmasian to coat the torn leaves. I put the sardines on top and mixed them in.. It seemed to me like the perfect osteoporosis prevention primal meal.

  12. I can’t even tell you how timely this is for me, and so very appreciated! I just started listening to The Paleo Women podcast last week (very highly recommended) and it’s so refreshing to hear about the benefits of this lifestyle from a female perspective, as well as advice and tips that are geared towards our unique physiology. I’ve been bingeing on all of their episodes since then, so this article is really the cherry on top.

    More please!

  13. it’s great to read this post. i got more and more intensely into primal/paleo, becoming lower and lower carb, trying fasting. i got leaner and looked great, but all that surpressed my thyroid and my cycle. i loved the way clothes looked on me and was closer to what fashion says a female body should look like. i also had dry skin, dry everything, was cold, and had lower energy.

    after i started eating more freely again, i had a lot of rebound weight gain, and now now am the biggest i’ve been in my life. my body dysmorphia says i’m fat, but i’m just average. i don’t like having a flabby tummy, but now i feel warm, playful, and my cycle is back, along with all the feelings that come with those hormones.

    now, i’m continuing to eat more carbs, and i watch for the temptation to try to diet, restrict, or fast. i have a woman’s body that wants to feel and be well fed in order to function well. i had thought i’d entered early menopause (i’m now 42), but now i know that i was restricting too much in pursuit of unhealthy ideals, and not listening to my body. i’m learning to be attuned to my body now, and re-learning to eat all foods, overcoming my orthorexic leanings.

    1. Thank you for writing that!
      I too struggle with what feels healthy and with what I think “looks” healthy.
      In my teens I was shockingly slim. Everyone used to comment on it & I perversely loved the attention.
      Now, in my late 30’s, I’m not overweight, but I’m never going to fit into a pair of high school jeans again either. My husband thinks this is good. He says I should look like a woman since that’s what I am. He calls me beautiful & tells me he likes the way I look.
      I really want to believe that I am healthy & beautiful at a size way above supermodel slender, but I’m definitely harder on myself than anyone else. And it’s a struggle sometimes to keep eating for my health instead of calorie restricting to feed my vanity.

  14. Hi all I have a question–

    I’ve been doing about 40-75 grams of carbs a day and I’m doing 24 hour fasts a couple times a week. I just started fasting about a month a go. I’m not losing weight as quickly or as consistently as my boyfriend–and I have a knee injury so I haven’t been able to start Stronglifts yet.

    Lost about 20lbs in 2.5 months and my boyfriend has lost about 35, granted he’s 6 foot and lifting 3 times a week.

    I usually feel ok (sometimes a bit tired), but I’m wondering if upping my carb intake a bit might keep me losing weight primally?

    I feel absolutely fantastic when I have a sweet potato in my dinner with a bunch of veggies, for example, but I also feel guilty for all the carbs.

    1. I’m no expert, but I’ve been reading this website long enough to know that the answer is for you to experiment!! If your body feels better when you eat a sweet potato, it’s trying to tell you something. Give yourself two or three weeks where you up your carb intake to 100-150 grams a day, and just make note of how your body feels; how it feels before and after workouts, how you sleep, how consistent your energy levels are throughout the day, etc. And if at the end of that you find that you feel fantastic and your body responds better to extra carbs, THEN STOP SHAMING YOURSELF FOR IT. This is not a contest, your health journey is your own and should not be compared to anyone else’s. It doesn’t mean that you aren’t “disciplined” enough. You just need to do what works best for your body, period.

    2. I think anyone would call 40-70 grams net carbs for an active person to be pretty low. And I think most people would call a 20 pound weight loss in two and half months pretty remarkable. Perhaps even too fast (then again, I don’t know your stating weight). I was already super fit and active when i decided to improve my diet and I think I lost 27 pounds over about two years with out any muscle loss or energy loss (177lbs to 150lbs at 5″10″ at age 48). And it thought that was quite reasonable and realistic.

      I think your line “I feel absolutely fantastic when I have a sweet potato in my dinner” tells you everything you need to know.

  15. love this – so true! atkins style worked great for me in my 20s and 30s and made me gain fat in my 40s. now i find a more paleo/zone like approach works best for my post menopausal body. moderate carbs (more than i was used to), moderate protein, and less fat (the high fat diets out there right now do nothing but add body fat to my frame).

    thanks sisson!

  16. I do appreciate this list. Women do have specific concerns.

    I’ve learned through trial and error that fasting does not work for me. Whenever I would sit down to eat after fasting, I would want to overeat to compensate, and it was hard to feel fulfilled.

    I do well with low carb (no or very little fruit and starchy vegetables). I tend to want to overeat anything sweet or starchy. Turns out I don’t need them either – I feel great without them.

    The lifting thing, though…I disagree. I do not lift heavy things. I do bodyweight exercises, sure, and my job requires some lifting heavy things, but I leave it at that. Four years ago when I started out on my primal journey I lifted weights regularly. My legs and shoulders became too large – I was uncomfortable, didn’t like the way I looked and my clothes didn’t fit. I think genetics plays a big role in this. I naturally have broader shoulders and larger arms than a lot of women, and lifting just makes it worse. My mom has a similar build to me. So sure, maybe some women can lift and not look “bulky,” but others can’t. I guess that’s the problem with generalizing – I must be an exception!

    1. Kathleen, I bet that means you are already pretty muscular. Your usual exercise may be plenty to keep you strong. I have a friend with that kind of build, while I have to work ridiculously hard to add any muscle at all, & it’s super easy to lose it at times of high stress or low calorie intake. I *wish* I could skip the lifting since it is the only form of exercise I don’t enjoy, but the older I get the harder I have to work out just to hold on to what I have! Every body’s different. (Mark did say his comments were generalizations.)

    2. I’ve done quite a bit of lifting over the course of my life, being a horsewoman. And I’ve always found that women’s shirts are simply not made for a woman w/muscles. I’m not particularly stout, but I do have biceps & delts & have always found off the rack women’s shirts too tight in the arms.

      Don’t let the fashion houses dictate your body shape. Stay healthy, keep lifting (tho’ work may be enough), & stay strong.

      I personally find women w/no muscles rather unattractive.

  17. Thank you, Mark, for injecting some common sense suggestions into the conversation about female health and what that actually looks like! “Get a good night’s sleep? Manage your stress? Eat more? Lift weights? It’s OK to have 25% body fat?” YES-YES-YES!! It’s important for women to hear this as well as men I’ve encountered many times throughout my life men who think I should eat/exercise/sleep/tolerate stress just like they do. NOT! Thank you for the positive affirmation.

  18. Thanks Mark. I have introduced a ‘Fast Friday’ in my routine. I’ve had varying degrees of success (defined by me as fasting from dinner to dinner). I seem to fixate on carbs the longer I fast. I find that dinner to lunch works best for me.

    Also sleep (or lack there of). Do post menopausal women require less sleep? I seem to average 5 to 6 hours and I don’t feel tired or lethargic. In the good old days I’d be napping in the afternoon.

  19. Thanks to this website, I made the first attempt to switching to free weights (dumbbells) last night. I started with weight machines in late Feb at the YMCA through their Fit Start program, Last week I started traveling again for my job, and there are no machines there.

    I did a couple of arm exercises and was surprised that I couldn’t use the same weight except for one exercise (shoulder press at 10 lbs)! No leg work since I I had severe cartilage issues in my knees and have been doing high volume, low exertion to help repair them (based on internet research). I may get a personal trainer to help me transition over to something for my legs. But for now, I’m treadmilling it.

    Sleep? I use melatonin drops (1-1.5 mgs total) and I sleep like a baby.

    Calcium? After a diagnosis almost a year ago with mild osteopenia in my hips, I have started taking Bone Restore from LifeExtension. I eat tons of cruciferous leafy green veggies at home, but on the road, my diet is not all that great.

  20. Good article. However, one thing for the ladies to consider regarding iron intake and periods. After I hit 40 my entire menstrual cycle went absolutely crazy!!! This also happened in my early twenties but after losing 100+ lbs I didn’t have the issue again until after 40. My period would last for (literally) months at a time and be very heavy. I had always been anemic and inconsistent with taking my iron supplement. This may be weird and not make any sense to you but taking my iron is the only thing that got my period back to normal. I found out that when you’re anemic, to put in simple terms, a woman’s body will push the “excess” blood out of the body because it is not getting enough iron to be able to supply oxygen to all of the blood in your body. So it constantly gets rid of blood so the rest of the body can function. So, if you’re anemic, take your iron! I take mine with a chewable vitamin C to help it absorb. It takes a while for the iron to build up in your system but it will. This saved my life so I tell everyone I can especially those having issues with their periods. Thanks Mark.

    1. I had similar issues before I was diagnosed with Celiac Disease. Even taking supplements didn’t help much. Ditching gluten allowed my body to absorb iron & made my periods bearable again. I never knew that the super-heavy bleeding was my body’s attempt to return to an iron equilibrium– seems kind of counter-productive!

      1. OMG, I am fascinated by this! I’m 32 and have always had long, heavy periods, but they got much worse after my second child (now 5). In january I was diagnosed with a severely overactive thyroid and have been taking carbimazole but last month I also gave in to a (more than) sneaking suspicion that I am intolerant to gluten and gave it up. My period this month was 3 days!! And I didn’t ruin any bedsheets! I had put it down to the carbimazole levelling my hormones but do you think it might have been more to do with the gluten?

  21. A timely article for me. Problem is nothing seems to budge (clothing or scale) unless I restrict my carbs to well under 50g. And then I just get carb crazy. On top of that, nothing budges unless I also calorie restrict to about 1200 or less. It’s wildly frustrating and I feel like I’m fighting a losing battle all the time. One in which I’m either starving or obsessing about what to eat.

    I wish I could sleep better, as I get up on average 3 times a night. I’m always tired, and this is never conducive to having enough energy to increase my much needed physical exercise.

    Sigh. Trying different things to reduce my stress, but it doesn’t seem to be working. Onward I guess.

    1. Might be time to consider seeing a sleep doctor. If you’re having problems sleeping, you’re going to have issues getting rid of weight.

      I am not a sleep doctor, but I’ve been feeling so much better since I (finally) listened to my husband and went to see a specialist. I’m also finally able to keep up with an exercise routine. It’s very easy now, compared to when I was an athlete, but my body got wrecked with pregnancy, my son’s severe FPIs while I was breastfeeding hime (I couldn’t take in enough calories/day, so my body cannibalized my muscle), and untreated insomnia and sleep apnea. Getting my sleeping issues under control makes it easier to exercise, eat better (less carb cravings), and deal with stress. I’m a much happier, more productive person these days, and it’s been less than a year since I started treatment.

      If you’re not getting enough sleep and feeling yucky, please don’t wait as long as I did to get it checked out.

      1. You are probably right, but since my insurance contracts with horrible doctors, I’m just not keen on any. Already seeing an a*hole of a neurologist for headaches (who supposedly does sleep studies etc) and he has not helped me at all. I figured out my own problems and am treating them with MFR massages and getting my BC changed.

        I’m just sick and tired of doctors because every single one I see never has helped me. Maybe it’s my luck with doctors. Maybe it’s that I’m in Los Angeles and LA just sucks. But I don’t want to waste more of my time, or pay ridiculous amounts with them right now. My sleep problems have gone on for years, and the only time I’ve slept through the night were when I had to take stronger pain killers for something, or a muscle relaxer. It’s probably mostly stress related. Mostly I just need a lifestyle change in general, but it’s probably not going to happen in the forseeable future. I’ll keep trying though.

        1. That sucks. Part of the reason I put off doing a sleep study when my husband first mentioned it was that many of them were just pill mills in the area we were living in at that time. 🙁 Then, I had a kid and a thousand and one other excuses for not doing it. I can sympathize. I’ve put off some other major health things because of not having insurance or not having providers around with whom I would be comfortable. I’ve put off going to a dermatologist for two years now because there aren’t female dermatologists in our area and I’m not comfortable being stripped naked in front of a male doctor, no matter how professional. I hope you can find something that will work for you. Not sleeping is horrible.

        2. I’ve never had much luck with doctors either. It seems all they want to do is write a prescription for drugs that I won’t take. Regarding being naked in front of a male doctor, they usually have a female assistant in the room too, so then you have an audience of two people staring at your bare lady parts. Lovely. This isn’t at all for your peace of mind, however. It’s more likely a requirement of their malpractice insurance.

  22. I routinely fast following a moderately early dinner until I eat a late breakfast or early lunch the next day. I rarely snack between meals, so the average is around 15 hours of fasting every day. This pattern seems to come naturally for me and my body doesn’t have a problem with it. For me personally, I don’t find that there’s anything to be gained by fasting for longer periods of time.

    1. That’s exactly what I do, too. Sometimes, if I’ve eaten really early, I’ll have breakfast at breakfast time, but generally I find that if, say, I’m staying with friends and we eat late (as I think most people do) then I skip breakfast. It seems comfortable. And breakfast can happen any time between 9.am and 2pm!

  23. I’m a regular blood donor and plan to continue until they kick me out. Haemoglobin was mostly borderline low until menopause, now it’s always low-mid normal…don’t have to think about it, excess iron not going to be a problem it seems.

  24. It’s truly amazing that Bioidentical Hormone Replacement isn’t mentioned as a way to improve health for women. The no sleeping thing is so triggered by loss of hormones, especially estrogen, after 35 years old and only gets worse for most women (being general here like Mark) esp after 45 years old who can’t sleep well or sometimes at all and has led to deep deep depression/suicide in women. Hormones are so taboo, even in health circles like this, esp since the male steroid debacles, failed studies, and media destruction of hormones as ‘bad’ esp ‘sex’ hormones as cancer ‘causing’. So untrue on many levels. Hormones are essential to life and health. Natural reduction in hormones is really just a way for nonreproductive humans to be eliminated from the planet as quickly as possible. The other things Mark mentioned are great too, but hormone supplementation make them so much easier to implement esp after 40 years old. Otherwise it can be just another gilt trip…esp for women. This is also an over simplification but it’s as important, if not more so, than those mentioned.

  25. Great article and so nice to see women be the focus!
    Regarding post menopause women:

    My own experience (I am almost 64) manifests a need for a few more carbs. Not a lot, but a few more, like a sweet potato more frequently.

    Also, a bit more fat – not additional gobs mind you, but eating fat as a part of your meal. I find at this age if I get ultra strict with carbs or fat restriction I don’t feel as balanced and energetic. It’s not worth it to restrict.

    After menopause it’s pretty hard to completely get rid of the midsection expansion that normally occurs for hormonal reasons as well. I’m not talking about accepting a great big belly, but I have a few more inches around my middle that just won’t go. My naturopath just laughs at me when I complain about it.

    We women have to learn some compassion for our natural biology at any age. Thank you, Mark, for the information. I trust your information and resources.

  26. Great post Mark!! I think all your posts need to come with standards for men and women.

    Sure, it’s not fair that there are biological differences, but I am using the more sleep thing to my advantage! My husband could sleep forever, but I keep telling him my sleep needs are higher, so he has to be the one with the 6:00 am wake up with our 1.5 year old. 🙂

  27. This is such a great post — thoughtful, nuanced, and thought-provoking (asking people to actually think for themselves and not just internalize everything they read). But that’s what we’ve come to expect at MDA. Keep up the great (and important work)!!!

  28. Great article, thanks! I find I have to eat at least 120g of carbs per day to lose any weight. Less than that and I eat too much fat, (maybe to compensate?), and the calories are too high. I also have about 25% bf when I’m at my desirable leanest weight. I fast about 14 hrs a day, just by not eating after dinner and having a late breakfast (I don’t eat until I get hungry, which is around 9:30, after rising around 7:30am.

  29. Great subject!!!!

    Women often have different needs than men. Too bad most of the advice out there is aimed at 20 year old men looking for perfection. It’s hard to imagine that a 20 year man and a 50 year old woman would have the same nutrition and workout needs. But really, everyone is different. You have to experiment with what works for YOU.

    Things that have been helping me: Lose the shame, guilt, self-delusion, and try things out with an honest and curious open mind. If it works, great, if it does not, move on.

    Sleep-as I’ve gotten older (and definitely since having kids) my sleep can be wonky. Getting stressed out about it is almost worse for me than the lack of sleep. I’ve been doing some reading about alternative sleep patterns. The common idea of 8 hours in a row is not what everyone has done through history. Maybe as we age we need to embrace different sleep phasing.

    Carbs-it seems to work better for me to usually avoid fruits and other carbs (not counting non-starch veg), except a 1/2 cup yam in the evening with dinner. Occasional (once or twice a week) increases in carbs can get the scale moving back down. My body seems to get stuck if I don’t change it up sometimes.

    Food intake-tough one. Clearly too many calories has been my problem over the years. My personal issues require me to weigh and measure high calorie foods, but if I restrict too much, my weight loss stops. Delicate balance. Gotta experiment to find the sweet spot, and it might keep changing on you. Frustrating, but true.

    Become an expert in you.

  30. We need more data from women of all ages. I’m past periods but recently suffered from low ferritin which really dragged me down. We can’t make assumptions based on age or gender, we have to do our own experiments and see what works for us. We can’t let other people tell us where we should be, but it helps to hear what has worked for others.

  31. I have a question. I’m 55 and well past menopause (yippee!). I’ve kept 80 pounds off for 30+ years by eating practically nothing and running like a maniac on a treadmill. Over the last two years, I’ve had a surgical repair for an epigastic hernia (hernia above bellybutton) that went dreadfully wrong and left me constantly feeling the hernia patch and with a huge bulge in my stomach (lovely), a broken foot and a broken tailbone. Numerous doctors have told me NOT to lift weights but after two years of limited exercise due to the above, I’ve gained about 10 pounds. I’m burnt out on starving and running BUT will the primal blueprint work for me if I can’t lift weight? Just curious on this group’s opinion. Thanks a lot.

    1. IMO, yes. Start eating and stop running. Walk daily, outside. Focus on real food and real movement…..treadmills are fine when you are stuck inside with a week of solid rain or snow, but generally, get out of the house for your exercise.

      I was skinny/fat….I looked better than most people today, but had terrible joint pain and various injuries that didn’t seem to heal, and some extra belly fat I couldn’t seem to shift, no matter how much I exercised or how little I ate. I started PB March of 2015.
      Now, I’ve lost 18 lbs, have not had ANY hip or knee pain in over a year, and feel great!
      Still working through the menopause/hormonal changes, and trying to get enough sleep, but feel so much better that I will never go back to the SAD or “normal” exercise.

      1. I agree. I think we are designed to walk or sprint. I see people every morning doing these moderate paced runs and I just don’t see the results. They look nearly identical to a sedentary person…except with knee braces. The ones that look syrong and fit are running as a supplement to some other training program. I can’t image why our ancestors would ever jog for 3-5 miles. What would be the point?

  32. Thanks for this, Mark. It’ll be wonderful to share with my female clients and covers a host of common themes that arise in my work.

    Personally and with clients, I find that most of these tips become increasingly essential the older we get. Something that works okay for a while can stop being the best fit in your 30s, 40s, 50s or beyond.

    That said, it’s not all bad. I love working with peri-/post-menopausal women who feel better than they have in a long, long time after transitioning to a primal eating pattern. The lifestyle patterns (sleep, for instance) seem harder for most to change…but sure do make a tremendous difference.

  33. I have never been overweight but I find that since hitting my 40s, I am having blood sugar control issues. If I keep carbs around 30g per day, blood sugar stays in the normal range. Anything above that and there is trouble. Wish I could increase carbs but the high blood sugar is a major issue.

    1. I’ve found that if I eat protein first, then make sure the carbs have fat it has less impact on blood sugar

  34. I’m curious… Robb Wolf recently had Dr Jason Fung on his podcast, and the episode blew my mind. For the last week, I’ve been binge-reading Fung’s website (www.intensivedietarymanagement.com).

    Fung says that women should still (for the most part – there are always exceptions!) fast, but that there’s a huge difference between say, intentional caloric restriction (like a compressed eating window), and a full-on intentional 24 hour plus fast. Where caloric restriction can slow down basal metabolic rate and make you tired, hungry, and cold (like the poor Biggest Loser contestants), Fung says that a 24 hour fast doesn’t have the same effect. Metabolism is upregulated, growth hormone is upregulated, and so is adrenaline – regardless of whether you’re male or female. He does say if you’re suffering from amenorrea or similar problems, not to do it. Very different to traditional calorie restriction and dieting!

    Does anyone have any thoughts on this? Experience with fasting for say two days a week as opposed to compressed eating windows throughout the week? I’ve started fasting for 24 hours on Wednesdays and Saturdays and eating normally (albeit a little less concerned with total calories and macros) on the off days. I’ve only been going a week, so still early days.

    For some reference – 29 year old female, 5′ 3″, approx 72 kg. I walk a lot, strength train 3 days a week, and do some form of short (30 mins/5km) cardio once or twice a week. Body fat percentage is around 27%/28%.

    Love to hear your thoughts!

    1. A lot of people say a lot of things. That doesn’t mean any of it works for all of us. Might be best to take all the “expert” advice out there with a grain of salt, used just as a guideline, and then moderate it according to individual body needs.

    2. I am a 48 year old mom of 3 who started intermittent fasting 2 weeks ago after seeing one of Dr. Fung’s youtube videos. Since then, I have done a 4 day fast, 2– 24 hour fasts, and fasted between 12 and 18 hours on all the other days. I just follow what my body wants to do each day. When I am hungry, I drink some water or tea, and then decide in 15 minutes if I want to go longer or if I want to eat. In 20 days I have had amazing results. I am no longer hungry or angry or shaky if I go without eating. My waist size went down 3 inches. I have lost almost 10 pounds. And best of all, my fasting glucose, which was at 125, has gone way down. One morning it was 86! I have been able to continue to sprint, do yoga and do my heavy weight lifting in the fasted state. In fact, I am improving and making gains more quickly since I started fasting than I did before. One more thing: I feel fantastic! Mark only used 3 studies to say that fasting might not be as useful for women as men. I read each of those studies very carefully (I have a master’s in Science Education), and I am not convinced that they offer much information that suggests women shouldn’t fast. For lots more info on this subject, check out The Obesity Code (Dr. Fung’s book). It is a fun read, and has lots of studies, including the first one Mark shared with us. I love Mark’s blog, but I am a bit puzzled as to why he is suggesting women shouldn’t fast…

  35. Dr Fung, a leading expert on fasting and it’s positive health outcomes, says that women do just as well, and quite often better than men do on a fast. He says lots of myths out there and the ‘women don’t do as well as men’ is one of them.

    1. THanks for pointing this out, Ed. I am a 48 yo woman who resisted intermittent fasting for 4 years while I followed an ancestral lifestyle because I believed the myths about middle-aged women having a hard time with fasting. I finally gave it a try 2 weeks ago, and the results are amazing! And I feel great! I hope that more women can discover how wonderful fasting is, and won’t let others limit them–or make them think that there is something scary or dangerous about fasting. One can always just do a 12 hour fast with 3 square meals (no snacking). Or skip breakfast. Don’t have to fast for super long to get good results. Just need to fast over time… I encourage everyone who has any blood sugar issues at all, or any weight issues, to just give the 12 hour fast a try. (i.e. from 7 at night until 7 the next morning–or whatever 12 hours works best for you) Dr. Jason Fung’s blog has lots of helpful hints for different kinds of fasts and how to get thru them and what you can expect and the science behind them…

  36. Eating a ketogenic diet for the last 4 months is the best I’ve felt in years, maybe ever. High fat seems to be key for me when cutting carbs low. I’m 46, having regular cycles, and sleeping like a champ. I’m losing body fat that I’ve really needed to do and just couldn’t do eating regular paleo. I’ve got zero carb cravings which is amazing!! And, I’m not always hungry. All kinds of little body issues have cleared up and my mental and emotional health is way more stable. So, looks like it really can vary.

  37. Have you heard of the Milk Myth? Pasteurized & Homogenized Milk turns it to an acidic food, and in turn requires minerals (like calcium) to be leached from the bones to help neutralize the acid. And we excrete any excess calcium in our urine. This is why high milk consumption is so closely correlated with osteoporosis. So enjoy raw milk and raw milk cheeses.
    If anyone has a different perspective please let me know because this is what I teach my clients.
    Here is an example of an article stating this case:

  38. Learn to meditate. Meditation is not recommended at night in bed as one falls asleep! Works fine with me – I’m 68.

    1. When do you Meditate for it to work for sleep and I know this sounds silly but HOW do you meditate, new to me but I am in my mid 40’s and suffer from pretty severe insomnia (been to Dr, endocrinologist, sleep dr) nobody knows why I’m not sleeping, super healthy, active, happy…. Just need more sleep!

      1. You could try the guided meditations on the Insight Timer app. They are free. There are so many, and they so varied, that you will likely find something that will help you get started.

  39. Thanks for the article! I recently started lifting and using weights at the gym – a significant progression from the bodyweight program I was doing at home. I never was worried about looking bulky, it was more of a “women have less upper body strength” mentality that I block me from trying. Thanks for the encouragement!

    About sleep- I have three children under 9 and have discovered two amazing helpers. 1). Cuddling with the kids. This always puts me happily and deeply to sleep. 2) self hypnosis apps. Many of these are intended for use when awake but there are plenty which help insomnia. I’ve even used them when having trouble getting an older child to nap when the occasion calls for it.

    I have always had trouble fasting but two months ago I switched to daily short fasts of 14 to 18 hours (from the end of dinner to at least noon the following day). I find these much more manageable. It only took about a week or so to adjust and I have had no trouble maintaining at all.

    On another note, can anyone give advice about hormone balance? Ever since we went primal/Paleo my estrogen levels have dropped significantly and I have been having fertility issues. Thanks in advance for any thoughts.

    1. regarding hormones and lack of estrogen. I found pregnenolone to be very effective. it’s considered the “mother of all hormones” in that it will indirectly help your body replace what it is missing. Ie convert the preg to estrogen OR testosterone depending on what you need. It can be very powerful, so I would recommend starting with 5mg daily and monitor for changes before increasing the dose. Some people need 50mg a day, while others are good with just 5mg once a week. For me, after using 5mg 3x a week for a few months everything kicked back into action. This was under the advice of an integrative MD. But no need for an Rx for the Progesterone. Worth at least looking into. Good luck

      1. edit – Pregnenolone. not Progesterone. Progesterone is great but for different need.

  40. This is a great article! Mark your articles are most often awesome – it is hard to find balanced nutrition information out there. This stuff applies across the board, primal or not. People usually want the “always or never” answers. They just don’t exist. This dietitian wants to send you an enormous Thank You for being real, practical and balanced. That’s the stuff that really helps people make sustainable positive change in their lives. Cheers!

  41. I use the Headspace meditation app. It has a sleep pack, which teaches you to change your attitude to sleep. That is, not to fret about not sleeping and also a go to sleep exercise for night time. My youngest is disabled and had awful sleep problems, we went to a sleep clinic, after (mostly) sorting out her sleep I needed to retrain myself to go back to sleep. It really helped, along with blackout blinds, a light clock and lavender oil!

    1. thanks for posting that. i’ve learned i’m not fertile at lower body fat. it’s not just me, apparently! it’s funny how thin women are marketed as “sexy,” when in actuality, those thin women likely have suppressed cycles and no sexual desire at all! that’s how i felt when i was at my thinnest.

  42. Hey Kate and others…thanks for your opinion! I’m going to give the blueprint a whirl even though I can’t lift weight. I love the Primal Mayo and am getting a delivery of grass fed/finished meats and pastured poultry today.

    Bodies really do change as we age and women’s bodies simply need fat. I’ve always been curvy but trim and with a flat belly. The post menopause belly freaked me out! Ultra low fat vegan (a la doctors Fuhrman and MacDougal) really worked for me in my 30s and 40s but not in my mid 50s! I confess, I’m looking forward to eating meat and getting off the damn treadmill!

    Thanks for the support…what a friendly website this is. The vegan websites are like cults!

  43. Hi Mark,

    I am puzzled as to why you are suggesting women won’t get as many benefits as men from fasting. The studies you used seem weak, and sparse! 😉 This has been the most amazing asset to my toolbox since discovering Low Carb/Primal 4 years ago. (I am a 48 yo woman). Please consider looking into this more, and talking with someone like Dr. Jason Fung, and then writing some more on this subject…


  44. Mark, thank you for this! I hope a lot of women see this. I did extended intermittent fasting and very low carb/ketogenic for 6+ months a few years back. Felt great and worked well for the first few months then I slowly started losing energy, was not able to make it through my workouts then even started gaining belly fat! I was so confused. Because of all the info out there I thought the answer was to go even lower carb. Eventually, I recognized I really screwed my hormones up especially with thyroid problems. I started to add in more carbs, eventually going to almost 100 g / day and have finally recovered but it took a good while. Women really need to be careful.

    1. ditto–the same thing happened to me, and i’ve gained a lot of weight to recover and have hormones back to normal.

  45. So sick (particularly) of buff men dishing out advice to women – but hurray, at last, for this today.

    Women have suffered for so long at the hands of the health and fitness industry: they have grown fiscally fat off us.

  46. #1 bothers me: “One study found that while IF improved insulin sensitivity in male subjects, female subjects saw no such improvement and actually experienced worse glucose tolerance.”

    I’m a post-menopausal T2 diabetic & overweight. I’m not able to take the diabetes meds I can afford because the side affects are horrible. So I eat vlc – which has helped, but I still had plenty of BG #s over 140. When I started skipping supper most days (skipping breakfast didn’t work for me), I saw my BG coming down & I finally started losing weight. But the smallest amount of carbs – nuts, berries, & other foods that are supposed to be low carb – spike my BG to unhealthy levels. If skipping a meal on most days is going to make this worse, I feel like I’m in a Catch-22 situation: eat “normal” & have high BGs, or eat vlc w/IF and end up with almost any food with carbs spiking my BG.

    I realize it’s only 1 study, but it’s worrisome. Can someone point me to information that will ease my worries? Even if it’s only a pat on the head & a kindly “there, there.” 🙂

    1. Is it safe to sporadically get the diabetes meds you can’t afford 365 days of the year, and have a period where you eat more carbs and therefore get varied nutrients? Like one week in 4 or something? No idea what I’m talking about with this medically, I just know the desire for consistancy can actually become a trap, shaking things up might mean you can get a wider range of nutrients over a month.

  47. Like many other women, I experienced insomnia for the first time at peri-menopause. I started taking a mung bean and green tea extract (menopause fx) six months ago when the hot flushes and sleepless nights became too much. The flushes disappeared and my sleep went back to normal. With the ups and downs of menopause I can’t be sure this wasn’t going to happen anyway but I continue to take the supplement as the symptoms of menopause were hard to handle.

  48. I have better luck w/IF when I eat breakfast around 7am and lunch/dinner around 4pm…. My 15 /16 hour fast seems easier for my body to tolerate in the evening …
    Also have found if I go too low carb it starts to mess w/ my thyroid levels….

  49. Hopeless without sleep. Hopeless. I consider myself to be doing an Intermittent Fast any time I make it between meals without something sliding into my mouth. And the hormones! Everything changes after 40…

  50. Hey, Mark you wrote the article nailing each and every point in detail what exactly a women should do to loose weights and become fit. I really appreciate the fact that this articles going to help me get my fitness back, as after my pregnancy I gained 5 pounds. Thankyou so much for sharing this wonderful article.

  51. I agree sleep is a very important element to stay healthy. That said, a vast majority of peri-menopausal and menopausal women have interrupted sleep throughout the night from hormone fluctuation. Can you give any advice on how to stay asleep? I already have a very good diet (no sugar, no processed foods, no alcohol, etc.) and I take an ample amount of magnesium at bedtime. I just cannot stop the cycle of waking up at the same time(s) throughout the night. I’ve resorted to medication which is not the path I want to be on.