From Nina:

I don’t read a lot of diet books, but it just so happens that I’ve been on Weight Watchers since the holidays, so I am thinking more than usual about my weight, what I eat, and how my hormonal changes are affecting my body overall. When a Random House publicist sent us a galley of this new book, THE HORMONE FIX by Dr. Anna Cabeca, DO, OBGYN, FACOG, which comes out in March 2019, I was intrigued.

Dr. Cabeca writes well, has an intriguing voice, and relates to the reader very much woman to woman, as one of us. She’s suffered personal tragedy, manages a big career, and struggles with her weight and moods just as much as we all do. The secret for her, and the one she passionately believes in, is a version of all the ketogenic diets (very low carb, high fat), but one that has a few twists that hopefully make it easier to follow.

I can’t say I’m chugging down her green shakes every morning yet, but I am tempted. I did believe her, reading this, that her plan would work, and I was interested to learn more about the roles that Insulin, Cortisol, and Oxytocin play in all this, since I feel like we’re usually so preoccupied with Estrogen…


From the Intro to the book:

Being a gynecologist and obstetrician for over two decades has given me the true honor and pleasure of taking care of generations of women at different stages of their lives, from their early teens through pregnancies, menopause, and well after. Wherever you are on that continuum, let’s imagine it’s you in my office. We’re discussing your health and hormones and how you are honestly feeling. I close the door, and we sit down to talk after your annual Pap smear and physical exam. It’s a vulnerable moment, I know. You’ve probably grappled with weight gain—maybe a little or a lot. Perhaps you’ve felt very forgetful, anxious, or moodier than before. Maybe you’ve started having hot flashes that go off like silent bombs inside you, or night sweats that make you want to sleep with the covers off, then on, then off again.

And what’s your sex drive like? Is it fizzling out? Do you tire easily? Can’t sleep a whole night, or wake up still tired? On top of everything else, do you no longer enjoy yourself or feel like your life isn’t at all what it should be?

You might tell me about other symptoms. Perhaps you’ve been gaining weight, and you don’t know why. Your relationships are fragmenting, along with your confidence. Thoughts may be swirling through your mind like: “Will I ever feel better? Am I just going downhill from here? Am I just going crazy? Or maybe there is something very wrong with me! Is it early Alzheimer’s? Do I have cancer—thyroid, breast, ovarian? Is there something in my labs or my exam? Do I need a surgeon? Psychiatrist? Divorce attorney?”

Whoa, now!

I understand what’s happening to you. You’re struggling with the physical, mental, and emotional indignities of hormonal fluctuations and an ensuing “metabolic stall.” The result: weight gain, hot flashes, night sweats, fatigue, insomnia, memory loss, hair loss, brain fog, irritability, diminished libido, discomfort during sex, pain, and more. Your body is winding down its reproductive machinery, and you feel like you’re losing control—and losing your mind.

Too many women are resigned to accepting these changes, living unhappily with them, and muddling through for years to come. Many others will agree to be unnecessarily medicated for their symptoms. They’re told this is normal or it’s the best it’s going to get. I know this because I often meet women after they have tried everything else and have gotten fed up with their medical care—yet still haven’t given up hope.

And I also know what you’re going through because I’ve been in this terrible place—twice!

My first experience with these hormonal changes occurred long before I approached menopause, and was triggered by a personal tragedy—my eighteen-month-old son died in a terrible and senseless accident. My insurmountable stress, deep grief, and subsequent depression thrust me into premature menopause and ovarian failure. My hormones were a mess. I was eighty pounds overweight. I couldn’t lose a pound no matter how hard I tried. I started to lose my hair in clumps. My joints ached. At the time, I was the mother of three (two daughters and one stepdaughter), and I very much wanted another child. But because of my tragedy-induced premature hormonal changes, I was told by experts I could never get pregnant again and that I would have to live this way forever. I was devastated.

Mine was a health crisis that traditional medicine could not solve. I couldn’t even solve it, despite being an Emory University–trained, board-certified ob-gyn and expert in functional medicine, plus a consultant in age management medicine. Dismissed by fellow doctors, I was informed that I would just have to live with infertility, weight gain, depression, fatigue, and hair loss. The only solution I was offered was antidepressants and sleeping pills. I felt shattered.

But I would not let myself stay broken.

I refused their options because I had seen my mother struggle under the weight of many medications, and I had to live for my daughters and search out solutions for myself. Survival alone was not enough. Eventually, by using an early version of the diet and lifestyle program I share in my book, I lost those eighty pounds and went on to compete in a sprint triathlon (which is quite a personal accomplishment, because I hate to run!). My hormones leveled. My depression lifted, and I became someone who felt great all the time. Joyously, at age forty-one, I conceived a healthy baby girl. What traditional medicine said could not be done was done.

The second time happened in my late forties, more or less when most women expect to start transitioning away from monthly periods and into menopause. But just because it was expected didn’t mean it was easy! My hormones mounted another attack on me. Weight gain that creeped to five pounds, ten pounds, then twenty pounds. More fatigue. Emotional volatility. Stress that made me feel like jumper cables were attached to my heart.

I didn’t take this lying down. I went looking for answers and help. Unfortunately, I was again met with a “Well, this is normal” attitude and an ill-equipped medical system that could not, and would not, help. Can you relate? We’re expected to tolerate and power through these disturb- ing changes, medicate them, or grin and bear them, right? No!

I knew what I had done previously to lose weight, fix my hormones, and overcome complete metabolic stall. I began to tinker with those same solutions again. It took me a lot of trial and error before I figured out the best way to reclaim my body, mind, and soul once again. I changed the way I ate. I changed lifestyle habits that were standing in my way. I tapped into my inner power and felt more contented and spiritually at peace.

Ultimately, I got myself back in tune. I was able to keep the creeping weight off, felt much more even-keeled—and really, like a younger version of myself. And that happy experience has inspired me to help other women, especially those struggling through hormonal chaos with no- where to turn.

One Component of Her Plan:

The Role of Alkalinity in the Hormone Fix

In simple terms, an alkaline diet is a way of eating that emphasizes non- acidifying foods over acidifying ones. You base your food choices around those that lower the acid levels in your body. It is a versatile diet that suits all of us.

A study published in The American Journal of Clinical Nutrition in 2003 analyzed 159 hypothetical pre-agricultural diets. Itfound that 87 percent of these diets were “net base producing”—which means they were eating an alkaline diet, not an acidic one.

By contrast, the average Western diet has been shown to be “net acid producing.” We already know that this sort of diet has created an obesity epidemic and is causing health issues such as cancer, heart disease, and a range of neurological disorders. Now it is becoming clearer that an alkaline diet may help prevent many of these illnesses. One reason is that it is better matched to our genetic makeup and supports healthy and diverse gut microbiota.

To understand alkalinity, let’s flashback to high school chemistry: We measure pH on a scale ranging from 0 to 14, with 0 at the acid end, 14 at the alkaline end, and 7 being neutral (pH stands for “power of hydrogen”; it measures the total hydrogen ion concentration in a solution). The ocean has a pH of about 8.1. Your pool? An optimal pH for a pool is 7.4, which mirrors the pH of the human eyes, as well as the pH of our mucous membranes.

The human body works hard around the clock to maintain a slightly alkaline pH level in the blood, and to do so, it must clear out any excess of acid. Your body has a precise mechanism for maintaining its blood acid-base balance, and the mechanism ensures that the pH of blood doesn’t shift much at all. It is tightly controlled by the kidneys and lungs to stay at around 7.4, with a very tight range from 7.35 to 7.45. This is critical for human life because even a small variation in blood pH is life-threatening. This tight regulation declines with age, and there can be an increase in metabolic acidosis because most modern diets are acidic. That’s another reason why eating alkaline is even more important as we age.

While the blood pH stays in a very small range, the rest of your body varies in pH level. Your stomach, for example, is very acidic, typically maintaining a pH of less than 3.0 so that it can fully break down the food you eat and kill ingested pathogens. The pH of your vagina is 3.8–4.4, which is protective and kills off unwanted bacteria, but this pH increases as we age. The skin has a pH below 5. By contrast, the pH of the intestines and pancreas is 8.0. Most cells work best when they are on the alkaline side. The pH of urine, however, fluctuates and serves as a window on what is happening at the cellular and hormonal level. Ideally, it is good to see the pH of urine at 7, on average. After intense exercise, we expect it to be more acidic; after a relaxing day in nature, it will likely be more alkaline.

The pH of every system in the body is fine-tuned to its function. Think about it this way: the acidic systems, as a rule, protect and are a first line of defense against pathogens for your body. The alkaline systems nourish, restore, and repair. And the food you eat and the lifestyle you live impact that balance.

Which Foods Are Acidic and Which Are Alkaline

When you’re in doubt about what’s acidic and what’s alkaline, ask your- self two simple questions: Does this food grow from the ground or on a tree? If so, it is probably alkaline, but not always. The other question is whether the food is a flesh food from an animal. Animal flesh foods such as meats are acidic. So are processed foods, especially those with sugar, artificial sweeteners, salt, and other added ingredients.

Some foods have a different pH outside the body than they do inside the body, however. Lemons are a good example. Outside the body, they are an acidic fruit with a pH of 2, but they have an alkalinizing effect inside the body. In fact, lemons confer great alkalinizing effects and are healthful in many ways.

In general, fruits, vegetables, certain vegetable oils, herbs and spices, and nuts and seeds are the most alkaline, due to their nutrient content. Meat, poultry, dairy, sugar, processed foods, caffeine, alcohol, and so forth are the most acidic. Of course, there are some outliers: grains, which grow from the ground, are slightly acidic. And some carbs, such as potatoes and sweet potatoes, are alkaline. As mentioned, you have to be careful about eating a lot of carbs, even the alkaline choices, because doing so can prevent your hormones from getting back in balance and your body from going into ketosis. The diet plans I provide in this book will guide you.

As I have alluded to earlier, staying alkaline is not only about food.

There is also a huge lifestyle component that is key.

Recently, a friend of mine celebrated one evening with a meal of largely acidic foods—cocktails, beef, and a chocolate dessert. The next morning she tested her urine. To her surprise, she was quite alkaline. Why? Well, the fun, laughter, and love she shared with her friends ig- nitedproductionoftwofeel-goodhormones—oxytocinanddopamine— and decreased her stress hormone, cortisol. The result: more alkalinity. In other words, food is only part of the picture!

In fact, only about 25 to 50 percent of becoming alkaline is dietary; the other 50 to 75 percent is influenced by lifestyle factors. These factors include your level of hydration, how much you sleep and exercise, how positive you are (and, conversely, how stressed you are), how often you have bowel movements, and how much you are in touch with nature (getting natural light, walking barefoot, and so forth).


Lots of food for thought, and if you’ve ever been tempted by the promise of ketogenic eating, this is a book worth checking out.

Tags : diet
The Woolfer Newsletter Team
Stephanie Staal and Nina Collins have worked together and adored each other since 1994 when they were both babies in the world of book publishing. Stephanie is a lawyer, journalist, & author of READING WOMEN, and Nina is the founder of "What Would Virginia Woolf Do?" Hillary Richard is also a lawyer and co-host of the Raging Gracefully podcast. Sidney Morss is a recent NYU grad and the youngest member of our team.

1 Comment

  1. Ok – I’m in. Cannot wait to read this and follow the diet and lifestyle etc. because this is me right now written in a few paragraphs. I am happy to forward the newsletter and maybe get a free book, or I will just have to go spend the cash. Thanks for sharing!!!

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