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The Ancestral Diet for Women: 4 Health Conditions that Benefit from a Whole-Foods Approach

by Katie Melville, Ph.D.

Published on

Think the Paleo diet is only for men? Think again. An ancestral diet provides high-quality nutrition for almost all genders, lifestyles, and health goals—women included.

Ancestral diet for women
An ancestral diet offers many health benefits for women. iStock/RyanJLane

Read on to learn how an ancestral diet can be applied specifically to women in four different scenarios: polycystic ovary syndrome (PCOS), Hashimoto’s disease, pregnancy and breastfeeding, and postmenopause.

An ancestral (or Paleo) diet offers a variety of health benefits for women and can help support health through pregnancy, breastfeeding, menopause, and more. Check out this article from Katie Melville for more. #paleo #nutrition #wellness

An Ancestral Diet for Women: The Cavewoman Diet?

An ancestral diet is based on the diets of our Paleolithic hunter–gatherer ancestors, who were virtually free from modern-day chronic diseases. (1, 2, 3) In brief, an ancestral diet includes a variety of:

  • Starchy and non-starchy vegetables
  • Animal products, from muscle meat and organ meats to bone marrow and bone broth
  • Fruits, nuts, and seeds
  • Sometimes even legumes, beans, and/or dairy
An ancestral diet is often called the Paleo diet and even sometimes the caveman diet. Many of the high-profile Paleo diet experts are men. But is an ancestral diet also appropriate for women? The answer is a resounding yes.

Women’s nutritional needs can differ from men’s, such as during pregnancy, or with a condition like PCOS. An ancestral diet isn’t a one-size-fits-all approach, but rather a template that can be tailored to an individual’s needs. This article will discuss how a Paleo template can work with women in four different scenarios.

How an Ancestral Diet Helps PCOS

PCOS is a very common cause of infertility, and it is the most common form of hormonal imbalance in women, affecting 4 to 10 percent of adult females. (4, 5) A PCOS diagnosis usually requires at least two of the following:

  • Multiple ovarian follicles of a certain kind and number viewed via ultrasound
  • Elevated androgen levels
  • Very irregular, often long cycles that often are anovulatory

Instead of a stand-alone condition, PCOS is better characterized by a collection of signs and symptoms. (6) Other common characteristics include insulin resistance, obesity, and chronic inflammation. (7, 8, 9) An ancestral diet can help with each of these conditions:

  • Elevated insulin: In clinical trials, Paleo diets have been shown to improve fasting glucose and insulin sensitivity. (10, 11)
  • Obesity: Paleo diets are generally more satiating than the standard American diet. (12, 13) As a result, a Paleo diet leads to spontaneous lower calorie consumption and weight loss.
  • Inflammation: The processed sugar, refined carbohydrates, and industrial seed oils in the standard American diet increase chronic inflammation. Void of these substances, a Paleo diet naturally reduces markers of inflammation, including C-reactive protein (CRP) and interleukin 6 (IL-6). (14, 15, 16)

Consider Low-Carb or Keto

A low-carb or even ketogenic version of the Paleo diet can be especially beneficial for addressing insulin resistance and obesity. (17, 18, 19, 20) For PCOS in particular, a ketogenic diet has been shown to improve female fertility in case studies, through improving insulin resistance, helping with weight loss, and inducing ovulation. (21) A pilot study also showed that in addition to reducing body weight and insulin levels, 24 weeks of a ketogenic diet also lowered testosterone levels in women with PCOS. (22) Finally, a meta-analysis and review of eight clinical trials reported that a low-carb diet reduced insulin resistance, promoted weight loss, and decreased testosterone levels in women with PCOS. (23)

Alleviating Hashimoto’s Disease with Diet

Women are five to eight times more likely to suffer from a thyroid disorder compared to men. One in eight women will develop a thyroid disorder during her lifetime. Hypothyroidism, where thyroid hormone levels are low, affects nearly 5 percent of Americans. (24)

The most common cause of hypothyroidism is Hashimoto’s disease, which actually is an autoimmune condition. In Hashimoto’s, the body attacks the thyroid gland as it would a foreign substance, resulting in decreased thyroid hormone levels over time. Symptoms include: (25)

  • Hair loss
  • Fatigue
  • Dry skin
  • Cold intolerance
  • Depression
  • Infertility
  • Irritability

Other conditions that are commonly seen in Hashimoto’s disease include:

  • Chronic inflammation, which may drive down thyroid hormone levels further through the HPA-axis (25)
  • Gut issues, including small intestinal bacterial overgrowth (SIBO), intestinal permeability, and gut dysbiosis (26, 27)
  • Gluten intolerance, because certain gluten proteins resemble certain thyroid proteins (28, 29)

Enter the Autoimmune Protocol Diet

Thyroid function depends on many key nutrients, including:

  • Iodine
  • Selenium
  • Zinc
  • Iron
  • Vitamin B12
  • Vitamins A, E, D, and K

A nutrient-dense, varied diet like the Paleo diet helps ensure adequate intake of these nutrients, as well as reduce inflammation and improve gut health. A version of the Paleo diet, called the autoimmune protocol (AIP), was specifically designed to manage autoimmune conditions. (30)

The AIP is similar to a Paleo diet, but excludes additional foods that may exacerbate or trigger autoimmune disease symptoms, like: (30)

  • Dairy
  • Eggs
  • Coffee
  • Alcohol
  • Nuts and seeds
  • Legumes
  • Nightshades

After eliminating these additional foods for a certain period of time, they can be introduced one at a time to identify food sensitivities or triggers.

A pilot study published in 2019 showed the benefits of the AIP for women with Hashimoto’s disease, in addition to lifestyle changes with the support of health coaching. (31) After 10 weeks, six of the 13 women who were initially on thyroid medication were able to lower their doses! That’s a big deal. Often, women who have Hashimoto’s disease have to keep increasing their thyroid medications throughout their lives, but rarely are they able to decrease the dose without significant effort.

Although no significant changes in thyroid function were measured in this groundbreaking study, symptom burden, weight, inflammation, and quality of life were all improved.

Supporting Pregnancy and Breastfeeding through an Ancestral Diet

Pregnant women require an additional 200 to 500 calories per day, and women who are fully breastfeeding require 500 to 700 extra calories per day. (32, 33) But it’s important to make those calories count. Nutrition in the womb and in infancy can follow a child for the rest of their life. (34)

Many doctors advise against a Paleo diet during pregnancy and breastfeeding. You might recall the sensational headlines warning against a low-carb diet during pregnancy for fear of an increased risk of birth defects. (35) But, in actuality, a balanced Paleo diet is a great choice for both pregnancy and breastfeeding.

Growing a human is a lot of work! Some specific nutrients that are especially important during pregnancy and breastfeeding include:

  • Folate
  • Long-chain omega-3 fatty acids EPA and DHA
  • Choline
  • Glycine
  • Fat-soluble vitamins A, D, E, and K2
  • Iron
Many of these nutrients are found in highest concentrations in animal products, like organ meats, pastured eggs, and full-fat dairy, which—surprise!—can all be included in a Paleo template, depending on tolerability.

A small retrospective study, the first of its kind, compared a Paleo diet during pregnancy with a “regular” diet recommended for pregnant women. (36) Women who followed the Paleo diet had better blood glucose tolerance, higher iron levels, and slightly less pregnancy weight gain.

Carb Caution

Breastfeeding may not be the best time to try a low-carb or keto diet. There is some evidence that a lactating mother’s low-carb diet could restrict infant growth. (37) As daily carb intake decreases and approaches keto, the milk hormone prolactin may decrease, adversely affecting milk supply. (38)

While a moderately low-carb diet during pregnancy may not be harmful if done mindfully, being sure to include nourishing, nutrient-rich foods, a keto diet has been shown to adversely affect an infant’s brain structure after birth. (39)

An Ancestral Diet and Menopause

Last but not least, I’d like to address menopause and beyond, a time in a woman’s life that is often not adequately addressed in Paleo circles and nutrition in general. The average age of menopause is around 50. (40) With female life expectancy near 80, this means a woman will spend over a third of her life postmenopause. Let’s give it the attention it deserves.

Postmenopause is a complex endocrine state, but the main hormonal change is a drastic drop in estrogen, which stops ovulation altogether. This drop in estrogen increases a woman’s risk of both osteoporosis and cardiovascular disease. (41, 42, 43) The severity of unpleasant menopausal symptoms varies, but some common ones include:

  • Night sweats
  • Hot flashes
  • Vaginal dryness
  • Mood alterations, including mood swings and even anxiety and depression
  • Weight gain from an altered metabolic state

Very few studies have looked at a Paleo diet after menopause. Menopause often correlates with increased inflammation, and we already know that a Paleo diet can help with that problem. (44) What’s more, we have lots of evidence that an ancestral diet can help prevent cardiovascular disease.

In the largest randomized diet study of its kind, 70 overweight, postmenopausal women were assigned to either a Paleo diet or the diet recommended by national institutions for 24 months. Serum IL-6 and high-sensitivity CRP, both measures of inflammation, were reduced in the Paleo dieters versus controls. (45) Additionally, the Paleo group lost more weight and lowered blood triglyceride levels. (46)

Put Protein on Your Plate

As humans age, they tend to lose muscle and, therefore, require less protein. But don’t let protein intake drop too low. In a study of postmenopausal women, those who ate the most protein were stronger and had the least body fat. (47)

Nutrients of Interest

If you’re postmenopausal and eating an ancestral diet, you’re most likely getting a variety of nutrients. Some specific nutrients and foods that you might want to give extra attention to are:

  • Full-fat dairy (if tolerated) for vitamin K2 and calcium for bone strength
  • Vitamin D for bone strength
  • Collagen for bone strength
  • Vitamin C for improved memory (48)
  • Vitamin E for help with hot flashes (49)

Some common things to avoid, as they trigger hot flashes, include:

  • Caffeine
  • Alcohol
  • Spicy foods

An Ancestral Diet Is One Part of Ancestral Health

Food is powerful, and has the ability to heal us or hurt us. An ancestral diet is ideal for both men and women, and can be tweaked to accommodate specific needs, like during pregnancy, and specific diseases, like PCOS.

But diet is only a piece of the larger picture of ancestral health. Things like sleep, stress management, movement, and appropriate exercise can carry equal weight in the overall picture of health.

Getting all the pieces of ancestral health to fall into place can be a challenge, but health coaches are uniquely positioned to help with the process. Health coaches who are trained in Functional and ancestral health can leverage their knowledge to better support their clients through diet and lifestyle changes, giving them a better chance of achieving long-term success.

The ADAPT Health Coach Training Program is a year-long, virtual course dedicated to training the next generation of Functional health coaches. We teach our students how to master the skills of a health coach and offer an in-depth education into Functional and ancestral health. If you have a passion for health and for helping others, a career as a health coach could be the right step for you. Click here to find out more about the ADAPT Health Coach Training Program.

Katie Melville
Katie Melville, Ph.D.

Katie Melville earned a Ph.D. in Biomedical Engineering from Cornell University, where she studied the mechanisms of bone formation and resorption. In particular, she elucidated the effects of sex hormones and their receptors on bone mass and architecture. She also researched estrogen's role in bone's response to mechanical loading. She has co-authored several peer-reviewed research papers, written book chapters, and has presented at national conferences, including those held by the Orthopaedic Research Society and the American Society for Bone and Mineral Research.

Her interest in Ancestral Health and Functional Medicine began over a decade ago, when she started following Chris Kresser's articles and podcasts. Over the years, she has made significant changes to her family’s lifestyle, including adopting a Paleo diet template, installing a reverse-osmosis water filter, and incorporating a standing desk into her office space.

Since 2016, she has been honored to be a writer and researcher for Chris Kresser and Kresser Institute, relying on peer-reviewed literature and incorporating Chris's clinic experiences into her articles. Katie strives to understand the current knowledge surrounding human chronic disease, and enjoys digging deep into the scientific literature. She believes the future of healthcare lies in functional medicine.

Katie has also written for Natural Womanhood, a popular website that shares the benefits of fertility tracking and using natural, fertility awareness-based methods of birth control. For continued education, Katie has completed online courses from Stanford on scientific writing and how to critically interpret clinical trials.

Professionally, Katie works for Recruitomics Biotalent Consulting as a Scientific Recruiter for start-up biotech companies in the Boston area. Being in this role exposes her to the latest technological and medical


She lives near Boston with her husband and 3 young children, and she enjoys powerlifting and cooking in her spare time.

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