keto bread wooden chopping board with knife and fork sliced banana and cherry tomatoes

Keto Diet and Menopause: Is there a link?

Over the years there has been rising popularity of the keto diet. But does it play a role in menopause? This blog post discusses:

  • what a keto diet is
  • what risks and benefits there may be of following a low carbohydrate diet
  • if there is a link between the keto diet and menopause.

What is the Keto Diet?

A keto or ketogenic diet is a low carbohydrate, high fat, and controlled protein diet, often used as a weight loss diet.

Fat makes up around 80% of an individual’s energy intake following the ketogenic diet. With an adequate intake of protein (around 45g/day for women) and the rest of the energy provided by carbohydrates. The carbohydrates are largely from fruit and vegetables.

The aim of the diet is to mimic the effects of fasting. In fasting, fat is used as the main source of energy. This is known as ketosis.

What are the different types of ketogenic diet?

Over the years there have various versions of a ketogenic diet including[1]:

  • Classical ketogenic diet –
    • Fat provides around 90% of total energy intake
    • Carbohydrates are very limited
  • Modified ketogenic diet –
    • High in fat with limited carbohydrate and unlimited protein intake
  • Medium chain triglyceride diet –
    • Higher intake of protein and carbohydrates
    • Diet contains naturally occurring fat, as well as a medium chain triglyceride fat supplement

Are there any benefits of a keto diet?

Some studies have shown that a ketogenic diet can have several benefits. It can help with weight loss, reduce visceral adiposity (fat stored in the abdomen), and aid in appetite control. There is also some evidence suggesting that eating a high-fat diet can help to lower LDL cholesterol (bad cholesterol), increase HDL cholesterol (good cholesterol), and lower triglyceride levels [2]. 

Furthermore, there is evidence supporting the use of a ketogenic diet for individuals with epilepsy. The exact reason for this is not known. It is reported to reduce the number of epilepsy-related seizures that occur [3].

However, a dietitian should be consulted before starting a keto diet. Any diet which restricts a whole food group can lead to inadequate nutrient intake resulting in vitamin and mineral deficiencies.

Are there any risks of following a keto diet?

Although the ketogenic diet is reported to be beneficial to weight loss. However, there are limited studies on the effects of the long-term health implications.

Whilst following a keto diet an individual may experience symptoms. These can include nausea, vomiting, fatigue, headaches, insomnia, and constipation, in the short-term. Also known as keto flu.

Reported long-term side effects can include:

  • kidney stones
  • hepatic steatosis (fatty liver disease)
  • hypoproteinaemia (low protein levels)
  • vitamin and mineral deficiencies, due to a decreased carbohydrate intake from fruit and vegetable. 

What are the long term effects of the ketogenic diet?

Additionally, the ketogenic diet is a fad diet, this means that it promotes results such as fast weight loss with insufficient scientific evidence [4].

Long-term compliance to this diet is low. People often stick to it for a short period of time and regain the weight lost after coming off the diet. Although this diet may help people to lose weight in the short term, it is not necessarily sustainable and can cause complications in the long term [5].

Carbohydrates in Menopause

In terms of the menopause, carbohydrates are an important source of energy in the body. Starchy carbohydrates, such as potatoes, rice, lentils, and bread, are an ideal source of slow releasing energy to sustain you throughout the day.

Fibre, another type of carbohydrate, is essential to promote good digestive health and to help keep you feeling full after a meal. Sources of dietary fibre include chickpeas, fruit, and vegetables. Fruit and vegetables additionally contain vitamins and minerals which have countless functions in the body.

Should I reduce by carbohydrate intake during the menopause?

Therefore, a ketogenic diet may not be the best choice for everyone. There can be a lot of negative opinions regarding carbohydrates but they play an important role in the body. You can read more about this in our blog “Carbohydrates: Are They Good or Bad for Us?”.

The NHS Eatwell Guide suggests that about a third of the food that we eat should consist of starchy carbohydrates. Additionally, they recommend that we should aim to choose starchy carbohydrates which are also high in fibre.

Foods containing refined sugar should be eaten in small amount and less often as they are not a necessity in our diets. They can be included in moderation as part of a balanced diet.

Fruit and vegetables, containing natural sugars, should also make up around a third of our total food intake, with the aim of eating 5 portions of different fruit and vegetables to reach our 5-a-day.

To incorporate carbohydrates into your meals, you should aim to fill a third of your plate with starchy carbohydrates and another third with fruit and vegetables, at each meal [6].


To summarise, carbohydrates are an important part of our diets. The effectiveness of low-carbohydrate diets, such as the ketogenic diet, have limited long-term evidence and can lead to adverse health effects.

However, it is important to note that the effects of any diet can vary between people, therefore some people may find that it works well for them. When making dietary changes you should aim to make small, sustainable changes that work for you, to increase the chances of you sticking to them.

For more information and advice, contact us at to see how we can support you with making dietary change.  

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Caroline Hill is a specialist menopause dietitian supporting women making dietary change. Caroline uses her extensive knowledge, skills and expertise of food and nutrition to help women manage their symptoms and weight during menopause. Caroline believes in providing sustainable, individualised, evidence-based advice to women making dietary change.

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