Susan's Place Transgender Resources

So I'm wondering if there is an ideal diet for mtf girls that have just started hrt. I'm quite skinny and have sort of a petite body to begin with. I'm 20, 5'7 and 122 pounds. My metabolism is very fast and efficient but from what I've heard that's going to change sometimes once on hrt.
Thanks!!!  :)

Estradiol and progesterone increase fat deposition in thighs, butt, breasts, face and just overall make you "softer". Estradiol also is supposed to inhibit fat deposition in the waist area. Cellulite usually increases with the loss of testosterone.

As far as I'm concerned, a diet low in carbs and unlimited in fat/protein (according to cravings) is optimal for keeping weight under control. Progesterone tends to increase weight much more, I think.

You could have a look here:
https://www.susans.org/forums/index.php/topic,190328.msg1695279.html#msg1695279


*hugs*

As with any "diet" it's important to limit simple carbs and sugars, especially added sugar. Complex carbs and dietary fiber are very important however, so cutting carbs alone is too simplistic. Also, with fat, it's important to limit saturated fats and go for more healthy fats. When it comes to protein, try to maximize your protein per calorie. For example, beef has a lot of protein, but it's not worth the calories and saturated fat that comes with it. Look at beans and brown rice or quinoa as your base for most dinner meals, instead of a meat with a white rice/ veggie side.

I'm considerably older than you (unless we were elves and then we'd be like classmates) and lost a lot of weight, about 45 pounds, about 7-8 yrs before HRT and i kept if off.

Part of motivation was a more lithe or feminine figure. What worked for me was pretty simple; eating often, portion control, and sticking with proteins and complex carbs. If i have a treat like ice cream, pie, cake or even an english muffin covered in butter, it is once per week only. I also became more athletic , get my heart pumping heavily 2 days per week and lightly perhaps 3 days per week.

HRT increased my appetite big time so far and I'm craving things like Tomatoes for some reason, but i have kept my weight steady by sticking to the above.

Look up Alex on Facebook. She runs a great trans-fitness group. https://www.facebook.com/alexagutier

Quote from: KatelynBG on November 03, 2015, 06:21:04 PM
with fat, it's important to limit saturated fats and go for more healthy fats.

The idea that saturated fat is unhealthy is scientifically outdated and recently there have meta-analyses showing that there is indeed no association between saturated fat and increased cardiovascular risk (or mortality). Lots and lots of studies disproving this. Just do the research and you will see for yourself. I have tons of documentation on this.

Including more fat (saturated fat as well) and reducing carbs significantly improves blood pressure, triglycerides, HDL, Cholesterol:HDL ratio, LDL particle size, VLDL, markers of inflammation, insulin sensitivity, blood glucose and weight. Without cutting calories and often more significantly than low fat regimes.

Yes, I didn't phrase my post there exactly as I wanted to. What we have seen over the last 20 years is pete cut sat fat significantly, but have replaced it with sugar. This is a disastrous way to go about it.

Is there a typical time for metabolism slowing down on HRT?


I've been on for a bit over a week, no changes yet.  I started eating less in late september, have been aiming for about 1200 calories a day, and have managed to take of 15 pounds since then.  I'm hoping 1200 ish will keep up even with HRT, especially with holidays approaching and 1200 being something you inhale just by walking in a room. :)

I've been on HRT for 10 months and if my metabolism is slowing down at all it's very gradual.

Also, I'm not really sure the hormones directly affect the base metabolism anyway.  Men do generally have a faster metabolism by a couple of hundred calories but is this simply due to testosterone or is it due to the increased muscle mass enabled by testosterone?  I believe it's the latter.

If this is true then simply altering the hormonal balance will not change metabolism.  What it will do slowly and over time is reduce muscle mass which will then in turn reduce metabolism.

If you have a lot of muscle to lose your metabolism might reduce by a few hundred calories.  If you are starting out without much muscle your metabolism might not change much at all.

Any significant change though will probably take a few years.


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Quote from: KayXo on November 08, 2015, 04:18:53 PM]Including more fat (saturated fat as well) and reducing carbs significantly improves blood pressure, triglycerides, HDL, Cholesterol:HDL ratio, LDL particle size, VLDL, markers of inflammation, insulin sensitivity, blood glucose and weight. Without cutting calories and often more significantly than low fat regimes.

So true. When I eat more meat, my overall Cholesterol goes up, but most of that is HDL, so the ratio improves. If I reduce my meat consumption, my HDL drops below 40, which is considered low. People don't realize that red meat contains a ton of Oleic Acid (48% of the fat by weight), which is the same fat that is promoted as making Olive Oil, Almonds, etc..."healthy".

The type of fat that should be avoided is Artificial Trans Fat (Hydrogenated or Partially Hydrogenated Oils). Even Trans Fat is healthy when it is natural. Conjugated Lineoleic Acid (CLA) is a naturally occurring Trans (technically, it has both Cis and Trans bonds) Fat, which is marketed for its health benefits.

Quote from: melissa_h on November 09, 2015, 02:24:01 PM
Is there a typical time for metabolism slowing down on HRT?

I don't think it's about metabolism but more about how estradiol increases fat deposition in certain areas of the body (i.e. gluteofemoral, breasts, etc) due to interaction with other proteins/hormones in fat tissue in certain regions. It has been shown it actually inhibits fat deposition in the waist area.

Things happen in a matter of months.

QuoteI started eating less in late september, have been aiming for about 1200 calories a day, and have managed to take of 15 pounds since then.  I'm hoping 1200 ish will keep up even with HRT, especially with holidays approaching and 1200 being something you inhale just by walking in a room. :)

Weight is strongly affected by hormones. Cutting calories isn't healthy and has been found to be an ineffective long-term solution to healthy weight maintenance. Having enough of sex hormones, having no other hormonal problems, being under very little stress and limiting carb intake (while increasing fat intake to compensate, protein is not a good source of energy) seems to be quite successful at keeping weight at a healthy level. Carbs stimulate insulin which is lipogenic while fat doesn't and protein, very little...

If you wish, you can read "Why we get fat" from Gary Taubes for more detailed information.

Sharing my opinion, I'm not a doctor. Hope this helps. :)

I appreciate it :)   I tend to do well when I go with portion control, there will always be little slips along the way, but just trying for an everything in moderation approach without ruling out anything specific.

I've been down the atkins road before, and while highly effective in my 20's, in my 30's, it was less so, and calories mattered more. 

My goal is to consume decent foods, at a lower rate, and see how things go.  Right now, it's been pretty effective. Lunch used to be my nemisis, frequently hitting the 1000+ mark.  Keeping that meal under 500 has worked well.

Keep in mind, I'm not doing anything diet or low fat in this. Real food only, fresh veggies, real proteins, cheese ... worst thing on the list is probably white bread. :)

Setting your calories to an arbitrary 1200 may or may not be the best weight loss strategy.  How much you need to eat every day is really dependent on the combination of current weight, how much you need to lose to obtain a health body fat level, and daily activity level.  An activity tracker can give you that last part.

You may be able to eat more than 1200 cal while still losing weight steadily and not feeling so deprived.




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Quote from: KayXo on November 03, 2015, 01:43:33 PM
Estradiol and progesterone increase fat deposition in thighs, butt, breasts, face and just overall make you "softer". Estradiol also is supposed to inhibit fat deposition in the waist area. Cellulite usually increases with the loss of testosterone.

As far as I'm concerned, a diet low in carbs and unlimited in fat/protein (according to cravings) is optimal for keeping weight under control. Progesterone tends to increase weight much more, I think.

This is spot on


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The problem with going super low in carbs is that carbs supply the energy needed for any "brisk" activity and supply all the energy needed for brain function all the time.


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It's all about getting the right carbs. Fiber carbs and the sugar from natural fruit are perfectly fine. Soft drinks, added sugar and sugar from fruit juices are big no no's. My diet is 40% fat, 10% protein and 55% healthy carbs.

Yes, exactly.  Also, cutting out most refined sugars allows you to eat more in bulk which prevents major hunger pangs.

Mine is currently around 50% carbs, 30% fat, and 20% protein and while I don't obsess over those numbers my daily eating is usually close.  I'm losing weight easily at about 1500 to 1600 cal each day without feeling majorly deprived.


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Yep balance is key.  I did atkins many years ago and came to the realization that carbs are going to sneak in anyway.

I take a similar view towards my diet now.  I aim for a 400 cal lunch, probably 800ish for dinner.  I don't snack much, but maybe a candy bar or a handful of crackers every now and again.   By setting a meal target at 1200, and being able to be over/under (usually a bit over) is working for me.

Oh, and as for bad carbs?  I've been using flavored sweetner in my coffee since starting.  Not great, but a nice lift in the morning.  :)


The challenge is, some folks get *really* rigid about particular numbers, so I get some of the concerns raised.  My particular issue was tied to eating way too much at lunch, or at dinner, finishing stuff on the kids' plates while cleaning up. This approach seems to be working reasonably well for me.  Its been many years since I've stepped on a scale and been below 225.

We all have our vices. I've managed to lose 100+ lbs despite eating pizza twice a week.

That's the nice thing about eating balanced.  You don't have to be deprived.  My vice right now is a big bagel and cream cheese every morning.


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I couldn't start a day without my avocado toast and fried egg topper.

Quote from: Deborah on November 11, 2015, 07:55:39 AM
The problem with going super low in carbs is that carbs supply the energy needed for any "brisk" activity and supply all the energy needed for brain function all the time.


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Your body can convert protein to Glucose in the absence of Carbs. I did Atkins for over 2 years in college and had no issue running, etc...In fact, I was in much better shape and had more energy than at any other point in my life, save for when I was under 12 and could run forever without ever feeling tired.

Quote from: KatelynBG on November 11, 2015, 08:36:03 AM
It's all about getting the right carbs. Fiber carbs and the sugar from natural fruit are perfectly fine.

I don't know of any diet that counts Fiber. True fiber (not FOS) contributes ZERO Calories and does not negatively effect Blood Sugar (may even help keep it stable). Atkins deducted Fiber when calculating "Net Carbs".

Bananas would make me hungrier than before I ate them and I could eat an entire Watermelon without any effort. For fruit, I would say berries are the healthiest option - lower in sugar (than Bananas and Melons) and loads of antioxidants. Strawberries make a great dessert.

True vegetables (not grains like rice or corn) other than potatoes are generally quite good for you and are naturally high in fiber and low in other carbs. I like green beans, green peas, carrots (raw), celery, broccoli (raw), cabbage, and romaine lettuce.

Quote from: KatelynBG on November 11, 2015, 09:13:43 AM
We all have our vices. I've managed to lose 100+ lbs despite eating pizza twice a week.

I would love to be able to do that as Pizza tastes great and is super cheap if you know how to find discount codes on retailmenot.com . Unfortunately, I gain 10 pounds just looking at a Pizza.

Probably the real answer is that there is more than one way to successfully diet.  Personally I have been able to lose weight with more than 400 g carbs per day but my activity was a lot higher then too.  Others have success with different strategies.  The best thing is to get educated on nutrition and then track what you eat against what you burn each day.


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I am curious if anyone has tried using weight watchers while trying to lose weight

I use a combination of myfitnesspal, Fitbit, and Apple Watch and health app.

I'm 1 years in and haven't gained any weight  from HRT nor did I change my diet at all. I'm 5'10 and started HRT around 150 now I'm around 140-145. I feel like its more just get started, see what happens and then adjust your eating habits if needed.

Quote from: Deborah on November 11, 2015, 07:55:39 AM
The problem with going super low in carbs is that carbs supply the energy needed for any "brisk" activity and supply all the energy needed for brain function all the time.

Fat and ketones supply most of the energy. The little glucose that is needed is provided by conversion from fatty acids and proteins. If indeed carbs were necessary for energy, Inuits wouldn't have thrived for thousands of years in the Arctic where all their food consisted of protein and fat and barely any carbs (i.e. berries, plants in summer). Same for the Masai people in Africa and there is even a study on two Caucasian males in the States where they thrived on no carb at all.

You should read Jeff Volek, Viljalmur Stefansson (Fat of the Land), Stephen Phinney.

When I was training for and running marathons not eating enough carbs made a very profound impact on my body's ability to keep moving. 

Carbs don't make you get fat.  Eating too much makes you get fat.   If carbs alone made you fat I would have gained a lot of weight when I was eating over 400 grams a day.  Instead I lost weight by keeping a negative energy balance.  I was eating plenty of protein and fat then too, usually over 1000 cal worth.

It's true that protein and fat, particularly fat, can provide most of your energy at low exertion levels, usually when your heart is beating less than around 70% max.  At higher exertion levels the body requires glycogen which is produced from eating carbs.  The reason is that fat requires oxygen to be converted to energy.  At lower exertion levels there is plenty of oxygen available so mostly fat is used. 

At higher exertion levels where more energy is required there is not enough oxygen to convert enough fat to supply immediate energy requirements.  So the body increasingly relies on glycogen that it can convert to energy without oxygen.

Yes, you can easily live without carbs.  But your ability to exert yourself at high intensities for any extended length of time will be severely limited.

I'm just happy that my stomach is shrinking.  Even on days where I'm eating more than what I'm aiming for, I feel full faster, which limits larger meals.  A local sushi place does 2 rolls for $10 or 3 for $12.  Kind of a no-brainer to do 3, but I was full after 2.  I can't remember that ever happening, and the remainder became a little appetizer before dinner.

Quote from: melissa_h on November 20, 2015, 08:56:01 AM
I'm just happy that my stomach is shrinking. 

Yaaay.  That's the important thing.  Find out what works for you, losing the weight while still feeling good, and then stick with it.

Quote from: Deborah on November 19, 2015, 10:49:05 PM
When I was training for and running marathons not eating enough carbs made a very profound impact on my body's ability to keep moving. 

Carbs don't make you get fat.  Eating too much makes you get fat.   If carbs alone made you fat I would have gained a lot of weight when I was eating over 400 grams a day.  Instead I lost weight by keeping a negative energy balance.  I was eating plenty of protein and fat then too, usually over 1000 cal worth.

If you are extremely active (Athlete, Olympian, etc..) the carbs won't hurt your waistline. For the rest of us, Carbs tend to make us hungrier. Rice is particularly bad in my experience. If I eat a meal with rice, I'm hungry again almost immediately afterwards. I suspect this is the reason Chinese Food leaves people hungry again so quickly. Some carbs are worse than others, but Fat and Protein does seem to keep me satisfied longer and with less total Calories.

I like to drink.  I know alcohol should be limited on HRT, but is it okay?

Quote from: shoko on November 20, 2015, 10:50:39 AM
I like to drink.  I know alcohol should be limited on HRT, but is it okay?

To me at least, it seems somewhat self limiting.  I feel somewhat dehydrated to begin with from the Sprio, and have found myself consuming less.  Now I'm only on week 3, but instead of a glass of wine around 9pm, I'm much more likely to be drinking water.

I'm not forcing that, but it's just what I'm currently craving/feeling.  Definitely still fun to have drinks along the way though.  :)    I wasn't cautioned about anything specific on that front with my APN (after discussing my normal habits), but as with anything, some degree of moderation is probably a good idea, particularly when you first get started. 

Recommendations from your own healthcare provider should be held in much higher regard than what I just posted. :) 

Quote from: lisarenee on November 20, 2015, 09:58:51 AM
If you are extremely active (Athlete, Olympian, etc..) the carbs won't hurt your waistline. For the rest of us, Carbs tend to make us hungrier. Rice is particularly bad in my experience. If I eat a meal with rice, I'm hungry again almost immediately afterwards. I suspect this is the reason Chinese Food leaves people hungry again so quickly. Some carbs are worse than others, but Fat and Protein does seem to keep me satisfied longer and with less total Calories.

White rice has this effect, brown rice should not. I prefer quinoa to both anyway.

Quote from: shoko on November 20, 2015, 10:50:39 AM
I like to drink.  I know alcohol should be limited on HRT, but is it okay?

Well even many cis women stick to the light stuff... like cider and light wine...
and I'd say none is best...
there are fruit juices, and water and tea....

Quote from: shoko on November 20, 2015, 10:50:39 AM
I like to drink.  I know alcohol should be limited on HRT, but is it okay?

I once had a legendary tolerance to alcohol. I have lost it with age and HRT i think was a nail in its coffin. The most i can really do is light stuff, wine, beer and cider and then only a couple drinks. More than a couple and i will definitely pay for it. Still, i think wine is good for me health so i tend to have a glass every other day or so.

My tolerance for alcohol dropped way down too.  Fortunately my desire for it dropped away too once I started HRT.  I think all that drinking was mostly a coping mechanism that I'm happy to no longer need.

Well it's good to know, hopefully my desire for alcohol will decrease likewise.  I don't want to drink that much anymore anyway.

Quote from: Deborah on November 19, 2015, 10:49:05 PM
When I was training for and running marathons not eating enough carbs made a very profound impact on my body's ability to keep moving.

It takes weeks to get adapted to burning fat and ketones and you must remain below a certain threshold of carbs for that to happen. Also, you must increase salt intake to avoid fatigue, dizziness and headaches, if any. There was a study on that, with Stephen Phinney as one of the authors. Called keto-adaptation. You didn't give it enough time, still consumed too many carbs, not enough fat OR salt. It is important go into this, very well informed or you won't succeed. Certain marathoners actually do better on low carb, break records. :)

QuoteCarbs don't make you get fat.  Eating too much makes you get fat.   If carbs alone made you fat I would have gained a lot of weight when I was eating over 400 grams a day.  Instead I lost weight by keeping a negative energy balance.  I was eating plenty of protein and fat then too, usually over 1000 cal worth.

Over time, too many carbs can make some people fat by rendering them insulin resistant due to chronic high insulin levels. This is well researched. Not everyone reacts the same but in many, it can make them fatter than they would be with less carbs. You may not be gaining weight for genetic reasons or other but excess carbs are harmful for other reasons, driving insulin too high constantly, increasing glucose load on the body. In the last century, we have upped the amount of carbs drastically compared to what we ate for most of humanity's existence. It is not surprising that diabetes has increased, perhaps cancer, heart disease. Read about it, Gary Taubes has provided many details about it in his book. It's been also shown in several studies so it's not just about being fat or slim but about health.

QuoteIt's true that protein and fat, particularly fat, can provide most of your energy at low exertion levels, usually when your heart is beating less than around 70% max.  At higher exertion levels the body requires glycogen which is produced from eating carbs.  The reason is that fat requires oxygen to be converted to energy.  At lower exertion levels there is plenty of oxygen available so mostly fat is used. At higher exertion levels where more energy is required there is not enough oxygen to convert enough fat to supply immediate energy requirements.  So the body increasingly relies on glycogen that it can convert to energy without oxygen. 

Again, not true. Check out Stephen Phinney, Jeff Volek and Peter Attia on endurance, exercising, marathoners, etc. You're about to learn surprising stuff.

If you want to discuss more, pm me instead. :)


On the issue of alcohol, it could interact with estrogen or other stuff taken orally so be cautious. It could increase dehydration and other side-effects seen with Spiro. I don't really enjoy it personally.

Apart from aiding healthy estrogen metabolism with certain foods or supplements there's no such thing as a trans or HRT diet. It just becomes a healthy vs unhealthy diet ordeal, and imho there's not enough focus on the bigger more general picture of dieting in this thread rather than magnifying specifics. Counting calories, weighing in, apps, studies will get people overwhelmed and it's not necessary unless you're at a competition level.

Listen to your body. Learn what makes it feel and look good, and what doesn't. If weight loss is your goal, when you notice that you're getting full, stop eating. If weight gain is your goal pay attention to when you're hungry or feel something's missing. The only drink you need is water. Make sure you're taking in the basic vitamins and micronutrients that any multivitamin can give you.

Quote from: shoko on November 20, 2015, 10:50:39 AMI like to drink.  I know alcohol should be limited on HRT, but is it okay?

It's fine.

...and there's a lot of talk about carbs in this thread - carbs are terrible for your skin, and everyone should aim for healthy radiant skin.

I gained 25 pounds when I started HRT. I have since lost 18 of those pounds since March.

I had to change how I eat and exercise more.

I am eating for the long term and I had a very Healthy diet. My hA1C has been 5 to 5.2 for 2.5 years, the duration I have been on HRT. I incorporate salad with lunch and dinner. I reduced further simply carbs ( rice and such). I incorporated crushed oats into the morning routine.  Because I am anemic I have added wild salmon to my morning routine (2.5 ounces) and an iron pill.

I added stair climbing and I have been going to the gym with a trainer 1 time per week. I also have added running ( 1.5 miles a few times a week and I walk on the other days).