Excess Matters

Tag: hot flashes

  • The Science of Menopause by Philippa Kaye: Summary, Key Ideas & Review

    Book in one sentence: A UK GP strips the misinformation out of menopause and replaces it with the actual evidence: hormones, HRT, symptoms, metabolism, and all.

    What Is The Science of Menopause About?

    You ask your doctor about HRT and she says she’s “not really comfortable with it.” You search online and get 457 million results. You find a Facebook group and come away more confused than before. This is the information environment most women are navigating when their bodies start behaving in ways they don’t recognize.

    Dr. Philippa Kaye is a UK GP (general practitioner) and the author of nine books on women’s health. She wrote this one because her consulting room was full of women who didn’t understand what was happening to them, assumed their symptoms were just aging, or were refusing treatments because of clinical trial data from 2002 that was badly misapplied for two decades. The book is structured as a Q&A, so you can open it to “Why am I gaining weight?” or “What is genitourinary syndrome?” and get a direct clinical answer. You can also read it front to back and build a coherent picture of the whole transition.

    At 224 pages, it reads more like a medical briefing than a book. Dense, well-organized, no filler. The tone is what you’d want from a doctor who actually has 30 minutes to talk to you: clear, evidence-grounded, and without an agenda beyond helping you make informed decisions.

    What Does Menopause Actually Do to Your Metabolism?

    This is the section that matters most if weight and eating have been part of your story.

    The average adult gains 1 to 1.5 pounds per year from early adulthood through middle age. That’s not a perimenopause problem specifically. It’s what happens when muscle mass gradually declines with age and nobody replaces it. Muscle burns more calories at rest than fat does, so losing muscle without adding it back creates a slow caloric gap even when nothing else changes. Perimenopause accelerates this process.

    Estrogen also controls where fat gets deposited. As levels fall, fat shifts from the hips and thighs toward the abdomen (visceral fat), and the body simultaneously tries to produce an alternative form of estrogen called estrone from adipose tissue. Visceral fat carries higher metabolic and cardiovascular risk than subcutaneous fat. This is why body composition changes in midlife can feel so different from earlier weight gain (same number on the scale, different distribution, different implications).

    Kaye’s practical recommendation is strength training twice per week as a specific clinical priority, not a general wellness suggestion. The goal isn’t aesthetics. It’s preserving the metabolic engine that’s been quietly losing mass since your thirties. For anyone whose relationship with food and weight has been complicated, this framing is worth sitting with: the changes aren’t a personal failure, and the lever isn’t less food. It’s more muscle.

    “With a lower muscle mass, even if you consume the same amount of food/calories, you will gain weight.” (Philippa Kaye)

    Is HRT Really as Dangerous as Everyone Says?

    The short answer is: the HRT most women are afraid of is not the HRT being prescribed now.

    In the early 2000s, a major US study called the Women’s Health Initiative (WHI) published results suggesting that HRT increased risks of breast cancer and cardiovascular disease. Prescriptions dropped by 50 percent almost overnight. The fear stuck, and it’s still in the room when most women have this conversation with their doctors today.

    Here’s what the coverage got wrong. The average participant in that study was 63 years old. These were not perimenopausal women in their mid-forties. The study also used oral synthetic estrogen and synthetic progestins, formulations that look nothing like what evidence-based practitioners currently prescribe. Kaye walks through the key distinctions:

    • Transdermal estrogen (gel, patch, or spray) bypasses the liver and carries no increased risk of blood clots or stroke. Oral estrogen does carry that risk. Delivery route matters clinically.
    • Micronized progesterone (sometimes called Utrogestan or Gepretix) is body-identical and plant-derived. It carries a much lower breast cancer signal than the synthetic progestins studied in the WHI.
    • Timing matters. HRT started within 10 years of menopause onset may be cardioprotective. Starting much later, in women who already have established cardiovascular disease, carries a different risk profile.

    The WHI findings were real for that population, using those formulations, at those ages. The harm was in applying those conclusions to a completely different group. Kaye doesn’t demonize the researchers. She frames this as a clinical literacy problem, one that has cost women years of unnecessary suffering, bone fractures, and preventable cardiovascular events. Undertreated menopause is its own health crisis, and she makes that case with specifics.

    For women who can’t or don’t want to use HRT, the non-hormonal options get the same rigorous treatment. Fezolinetant (brand name Veoza, FDA-approved 2023) is the first non-hormonal prescription drug specifically targeting the mechanism of hot flashes. SSRIs and SNRIs reduce hot flash frequency by 30 to 60 percent. CBT is clinically validated for hot flashes, insomnia, anxiety, and depression. The book rates each option by evidence quality, which is more useful than a list.

    What About the Symptoms Nobody Talks About?

    Hot flashes get the most airtime, but Kaye explains why they happen in a way most books skip. The hypothalamus keeps body temperature within a narrow range. Estrogen normally moderates a peptide called neurokinin B (NKB). As estrogen falls, NKB overstimulates the thermoregulatory center via NK3 receptors, and the brain reads a temperature emergency that isn’t happening. The body launches its heat-dissipation response: vasodilation, flushing, sweating. Core body temperature doesn’t actually rise. You’re cooling something that isn’t hot. Understanding this mechanism explains why fezolinetant works without hormones: it blocks the NK3 receptor directly.

    Mood symptoms are consistently misidentified. Perimenopausal women are 40 percent more likely to be diagnosed with depression than premenopausal women, and mood changes (anxiety, irritability, low mood, brain fog) often show up before hot flashes do. Women in their mid-forties get put on antidepressants with nobody connecting the symptoms to hormonal fluctuation. Estrogen supports serotonin synthesis and receptor sensitivity; progesterone acts on GABA receptors. As both hormones decline and swing erratically (Kaye’s phrase: “a roller-coaster”), the neurochemical scaffolding for mood stability is progressively removed. HRT can resolve hormonally-driven mood symptoms that antidepressants alone won’t touch.

    Genitourinary syndrome of menopause (GSM) is the symptom with the worst visibility gap. It covers vaginal dryness, painful sex, recurrent UTIs, and urinary urgency, and it affects over half of postmenopausal women. Unlike hot flashes, which often ease over time, GSM is progressive without treatment. Vaginal estrogen is the definitive fix: local application, minimal systemic absorption, safe for most women including breast cancer survivors, reduces UTI frequency by more than 50 percent in studies. It takes three to six months for full effect and should be continued long-term because the condition is chronic. Women don’t report it (stigma, or the assumption that sex is just supposed to hurt now), and clinicians often don’t ask. The silence around GSM costs women years of avoidable suffering that is, in most cases, straightforwardly treatable.

    Is The Science of Menopause Worth Reading?

    Read this if you want one reliable, clinical reference on perimenopause and you’re done wading through wellness influencer content that can’t tell you why hot flashes happen or what micronized progesterone actually is. Kaye treats readers as adults. For anyone who has struggled with weight and wants to understand the metabolic mechanics of this transition (not just “eat less, exercise more”), the muscle mass and fat distribution sections are unusually well-sourced and direct. If you’re on a GLP-1 medication and navigating perimenopause at the same time, the sections on muscle preservation and metabolic rate are directly relevant to how both interventions interact.

    Skip it if you want a diet plan, a step-by-step protocol, or extended personal narrative. This is a reference book. The lifestyle chapter is evidence-grounded but concise: it points to what works and why, without building out full programs. Also worth noting: Kaye is a UK GP, so her treatment recommendations follow NICE guidelines, which sometimes differ from US FDA approvals. The distinctions are flagged in the text, but you’ll need to translate some of it.

    One caveat: The reader rating reflects the fact that some readers found it too dense or too clinical. That’s accurate. It reads like a thorough GP who won’t waste your appointment. Whether that’s a feature or a bug depends entirely on what you showed up for.

    Books Like The Science of Menopause

    BookAuthorBest For
    Menopause BootcampSuzanne Gilberg-LenzA warmer, more lifestyle-forward companion to Kaye’s clinical lens
    The Menopause BrainLisa MosconiGoes deep on the cognitive and neuroprotective angle Kaye covers briefly
    The Great Menopause MythKristin JohnsonFunctional medicine approach, more integrative, less evidence-rigorous
    The Power of HormonesMax NieuwdorpBroader hormonal context, useful for understanding the full endocrine picture
    It’s Your HormonesGeoffrey RedmondUS-focused, clinical, good for understanding HRT formulation options in more depth

  • MenuPause by Anna Cabeca: Summary, Key Ideas & Review

    Book in one sentence: A rotating five-plan eating system built specifically for women who are doing everything right and still not losing weight during menopause.

    What Is MenuPause About?

    You’ve been eating well. You cut the sugar, added the greens, maybe tried keto for a few months. It worked, until it didn’t. The scale stopped moving right around the same time the hot flashes started, and now you’re stuck with both.

    MenuPause is the third book from Anna Cabeca, a triple-board-certified OB-GYN who went through early menopause twice (once at 39, once in her late 40s) and built a clinical framework around what actually moved the needle for her and her patients. The first two books, The Hormone Fix and Keto-Green 16, established her core approach. This one is the applied version: five distinct 6-day eating plans designed to rotate based on what your body is currently doing. The point isn’t to find the one perfect diet. The point is that rotating between plans prevents the metabolic adaptation that causes most menopausal weight-loss attempts to stall.

    It reads part cookbook, part symptom management manual. More than 100 recipes are mapped to specific plan restrictions, and a symptom-matching system helps you pick the right plan for right now. If you’ve read Cabeca before, this extends the framework rather than replacing it. If you haven’t, it’s accessible on its own.

    Why the Plateau Happens {#why-the-plateau-happens}

    Most diet books assume the body works the same way at 50 as it did at 35. Cabeca argues that’s the core mistake. She lays out six physiological mechanisms operating simultaneously during menopause, and understanding which ones are most active for you determines which plan to use.

    Estrogen imbalance shifts where fat gets stored. As estrogen falls, fat moves away from hips and thighs toward the abdomen. It also disrupts leptin and neuropeptide Y, the hormones controlling hunger and fullness (an animal study at Oregon Health and Science University found this disruption alone caused a 67% increase in food intake).

    Estrogen dominance coexists with low estrogen in a way that seems contradictory. Environmental estrogens from plastics, pesticides, and petrochemicals accumulate in fat cells as the liver’s clearance capacity declines. The result is relative dominance even as systemic estrogen is technically falling.

    Insulin resistance deepens as declining estrogen impairs the cell’s response to insulin. Every snack triggers a spike. Those repeated spikes, Cabeca argues, are the direct driver of hot flashes, brain fog, and the specific kind of fatigue that doesn’t respond to sleep.

    Low vitamin D follows declining estrogen, because estrogen supports vitamin D production. Low D independently increases fat storage and worsens hot flashes.

    Muscle loss accelerates sharply after 50. Less muscle means a slower resting metabolic rate, and most calorie-restriction diets make this worse by accelerating the muscle loss.

    Cortisol elevation is where menopause meets the decade that also tends to bring aging parents, career transitions, and adolescent kids. Cortisol raises blood sugar, promotes abdominal fat storage, and suppresses the sex hormones the body most needs.

    The practical payoff of this framework: if your dominant issue is autoimmune inflammation, you need a different plan than if your issue is a plateau from standard keto. One diet cannot address all six mechanisms equally. That’s the core design logic of the whole system.

    How the Five Plans Actually Work {#how-the-five-plans-actually-work}

    Each plan runs six days. Plans 1 through 4 are targeted interventions. Plan 5 is the long-term default. The rotation logic is what separates this from a typical cookbook: different dietary patterns produce different adaptive responses, and cycling between them prevents the body from settling into a state where any single approach stops working.

    Plan 1: Keto-Green Extreme

    The most restrictive. Eliminates grains, dairy, eggs, legumes, nightshades, nuts, seeds, and most fruit. What’s left: animal protein, leafy greens, and healthy fats.

    This one targets weight-loss resistance caused by autoimmune inflammation. When the immune system is chronically overactivated (Hashimoto’s, rheumatoid arthritis, lupus), fat cells become physically inflamed and can’t release stored fat. Removing the primary dietary triggers of autoimmune activation is what breaks the cycle. Annie, one of Cabeca’s patients, was having 60 hot flashes a day after surgical menopause. After 2.5 months on this plan: zero.

    Plan 2: Keto-Green Plant-Based Detox

    A fully vegan version of the keto-green approach, using tempeh, tofu, lentils, and legumes as protein. It targets digestive complaints, elevated cholesterol, and cardiovascular risk. Cabeca also recommends it two to three times a year for all women as a gut reset and estrogen detox, regardless of symptoms.

    Plan 3: The Carbohydrate Pause

    Zero carbohydrates. Meat, fish, shellfish, eggs, bone broth. No vegetables, no fruit. This is the plateau-breaking shock protocol, with a hard 12-day limit (without plant foods to buffer the acid load, the all-animal diet becomes acidifying). Zinc from animal protein supports testosterone production; vitamin D from fatty fish supports progesterone. One participant lost 7 pounds in 6 days after a three-week plateau on conventional keto.

    Plan 4: Keto-Green Cleanse

    Six days of liquids only: green smoothies, bone broth, vegetable juices, herbal teas. Targets burnout, post-holiday recovery, and cravings resets. The bone broth isn’t decorative: it provides glutamine (gut lining repair) and glycine (sleep architecture). One participant used it after Thanksgiving and ended up three pounds below her goal weight.

    Plan 5: Carbohydrate Modification

    The maintenance default. Gluten-free grains, legumes, sweet potato, and lower-glycemic fruit reintroduce at 50 to 60 grams of carbs per day, adjusting upward toward 75 to 100 grams if the scale cooperates. Most women live here most of the time, returning to Plans 1 through 4 as symptoms flare.

    The Rule That Matters More Than Which Plan You Pick {#the-rule-that-matters-more-than-which-plan-you-pick}

    Across all five plans, one behavioral rule is repeated more than any other: no snacking. Not even healthy snacking.

    This cuts directly against the advice many women have followed for years (“small frequent meals,” “keep blood sugar stable”). Cabeca’s case is the opposite: every eating event triggers insulin release. Fat cells cannot release stored fat while insulin is elevated. The extended period between meals, especially a 16-hour overnight window, is when insulin drops to baseline. That baseline is what allows fat cells to actually open.

    “Although menopause is natural, suffering is optional. This is what MenuPause is all about.” — Chapter 1

    The logic is straightforward and supported by a solid body of evidence on insulin and fat storage. It’s also rarely presented this directly in diet books, possibly because “eat less often” is a harder sell.

    If you’ve been eating clean, exercising, and can’t figure out why nothing is moving, the no-snacking framework alone may reframe what’s happening.

    Is MenuPause Worth Reading? {#is-menupause-worth-reading}

    Read this if you’ve hit a weight-loss plateau during perimenopause or menopause despite a clean diet. Or if you’ve tried standard keto and stopped getting results. Or if you want a cookbook that matches meal plans to specific symptoms rather than prescribing one universal protocol. The rotation model, the symptom-matching logic, and the practical recipe library (over 100 recipes, clearly mapped to plan restrictions) are the genuine strengths.

    Skip it if you need RCT-level evidence before trying any approach. The metabolic adaptation rationale behind diet cycling is reasonable, but the specific plan rotations are based on Cabeca’s clinical experience, not controlled trials. The alkaline diet framework (the claim that urinary pH is a meaningful proxy for systemic hormonal environment) is contested in the mainstream literature.

    One caveat: several protocols feature Cabeca’s own branded supplements prominently (Mighty Maca Plus, Keto-Green Shake). They’re disclosed as hers, but they’re written into the plans in ways that position them as near-necessary. Worth knowing before you start.

    Books Like MenuPause {#books-like-menupause}

    BookAuthorBest For
    The Hormone FixAnna CabecaThe foundational Keto-Green protocol MenuPause builds on
    The Menopause Diet PlanHillary Wright & Elizabeth WardEvidence-based, dietitian-written menopause nutrition guide
    Fast Like a GirlMindy PelzFasting protocols timed to hormonal cycles; complements MenuPause’s what-to-eat approach
    Eat to Thrive During MenopauseBrandi Givens-HuberPractical, recipe-forward menopause nutrition without the integrative medicine framing
    Women, Food and HormonesSara GottfriedHormone-focused ketogenic approach; similar audience, more explicit about evidence quality

  • The Hormone Fix by Anna Cabeca: Summary, Key Ideas & Review

    Book in one sentence: A triple-board-certified OB-GYN argues that menopause weight gain and hot flashes are driven by three upstream hormones (insulin, cortisol, oxytocin), not estrogen, and teaches a practical keto-plus-vegetables plan you can test at home with $8 urine strips.

    What Is The Hormone Fix About?

    You’ve cleaned up your diet, cut the carbs, added more cardio. The scale hasn’t moved. Meanwhile, the hot flashes, the 3am wake-ups, the fog that sits on top of your brain by 2pm are all still there, maybe worse. If that’s where you are, Anna Cabeca wrote this book for you.

    Cabeca is a triple-board-certified OB-GYN and reproductive endocrinologist with over twenty years of clinical practice. She is also a woman who, in 2006, lost her eighteen-month-old son to drowning, and watched her own body respond to that grief by going into premature ovarian failure, gaining eighty pounds, losing her hair, and being told she would never conceive again. She was forty, medically trained, and could not figure out what was happening to her own body. The protocol in The Hormone Fix is what she developed to recover. She reportedly did, including conceiving the daughter she had been told was impossible.

    That backstory matters because it earns the voice. Cabeca writes as someone who worked out these ideas on her own body first, not just her patients’. The central reframe she offers is this: the hormones driving the worst menopause symptoms are not primarily estrogen and progesterone. They are insulin, cortisol, and oxytocin. Get those three into balance, and the reproductive hormones follow. Ignore them, and no amount of hormone replacement fully compensates.

    What Is the Keto-Green Diet and How Does It Work?

    Standard ketogenic eating works for many women, for a while. Fat loss, clearer thinking, fewer cravings. Then something shifts. Mood destabilizes, inflammation creeps back, weight stalls, and the irritability is hard to explain if you’re “doing everything right.” Cabeca’s clinical observation is that this pattern has a cause: strict keto makes the body acidic over time, and chronic acidity drives inflammation and causes the body to hold onto fat as a protective buffer.

    Her own experience confirmed it. She tested her urine with pH strips while eating strict keto and found herself persistently acidic. “No wonder I felt irritable,” she writes. The fix was simple in concept: add a large volume of alkalinizing vegetables (dark leafy greens, cucumber, zucchini, broccoli, asparagus, celery) to every meal, so the diet hits both fat-burning and alkalinity simultaneously.

    The plate ratio is easy to remember without counting anything:

    • 75% alkalinizing vegetables (by plate surface)
    • A palm-sized amount of protein
    • A golf-ball circle of healthy fat (avocado, olive oil, ghee, nuts)

    Two types of inexpensive urine strips, tested each morning, confirm whether the previous day’s eating actually hit both targets. Ketone strips show whether fat-burning is happening. pH strips show whether the body is alkaline (target: 7.0 or above). Both are available at any pharmacy for a few dollars.

    A word of honesty here: the claim that food directly changes your body’s pH is scientifically shaky. The body regulates blood pH within a very tight range regardless of what you eat. What the strips actually measure is urine pH, which does shift based on what you eat. The practical result of chasing alkaline urine (eating more vegetables alongside keto) is genuinely sound. The mechanism Cabeca offers to explain why it works is less solid than she implies. (That caveat doesn’t make the vegetables a bad idea. It just means the “alkalizing” framing is doing more marketing work than scientific work.)

    What the monitoring system does accomplish, regardless of the mechanism, is real. It personalizes a population-level protocol. Some women hit alkalinity easily but struggle to enter ketosis. Others achieve ketosis quickly but drift acidic from too much protein. The strips tell you which problem is yours. They also prevent the maddening experience of following a program while actually missing both of its targets.

    Why Does Cortisol Make Menopause Worse?

    Chapter 8 is raw in a way most diet books aren’t, and it’s also where the clinical framework gets personal. Cabeca traces the physiology of what happened to her body after her son died: cortisol at crisis levels for months, progesterone suppressed, thyroid impaired, visceral fat accumulating, oxytocin depleted. The chapter makes a clinical argument that many women going through menopause during high-stress life seasons need to hear.

    Chronic stress is not a mood problem. It is a hormonal problem. Cortisol and progesterone compete for the same receptor sites. When cortisol is chronically elevated, progesterone cannot get in. The result: progesterone deficiency symptoms (anxiety, poor sleep, mood swings) even when blood levels look normal on paper. This physiological reality is well-documented and almost never discussed in the average clinical encounter.

    The dietary implications are manageable. The exercise implications are harder to accept. Cabeca argues that intense cardio worsens the hormonal picture for women with chronically elevated cortisol, because vigorous exercise is itself a cortisol stressor. Her prescription runs against most conventional fitness advice: reduce intense exercise, replace it with walking, yoga, and gentle strength work, and treat sleep as a medical intervention rather than a lifestyle preference.

    She adds breathing practices, gratitude journaling, and nature exposure, framed not as soft suggestions but as cortisol management tools. These interventions have real physiological effects (slow breathing activates the parasympathetic nervous system; gratitude practices measurably reduce cortisol in research settings). Whether the degree of benefit matches the confidence of Cabeca’s prescriptions is harder to pin down, but the direction is right.

    What Does Oxytocin Have to Do With Weight Loss?

    Most people have heard oxytocin described as the “cuddle hormone.” Cabeca makes a bigger claim: oxytocin is a key upstream regulator of wellbeing, and it’s also the one thing conventional medicine cannot prescribe.

    Oxytocin directly opposes cortisol. When oxytocin rises, cortisol falls. When cortisol falls, progesterone receptors open up. On the weight side, oxytocin is involved in satiety signaling and has been shown in animal and human studies to prevent insulin resistance and support fat loss. One 2008 study Cabeca cites found that mice with blocked oxytocin receptors became obese even without eating more food. A 2013 study showed extra oxytocin in humans triggered weight loss.

    “There is a definite physiology behind all this. You’re not going crazy! If you ever experience burnout, emotional disconnection, or withdrawal from things and people you love, it is probably due to cortisol knocking oxytocin down.”

    The behaviors that raise oxytocin reliably include:

    • Twenty-second hugs (below that duration, the oxytocin release is minimal)
    • Sustained eye contact
    • Acts of generosity or service
    • Prayer and meditation
    • Group movement with social components (Zumba, dance classes, group yoga)
    • Sexual intimacy
    • Gratitude journaling

    Cabeca’s framing of these as medical interventions rather than lifestyle suggestions is the book’s most interesting claim. It’s also why the dietary approach alone often fails. A woman eating Keto-Green flawlessly while going through a divorce, caregiving for an ill parent, and sleeping alone has almost no oxytocin inputs. The food cannot compensate for what connection does.

    The oxytocin research is real but still developing. Cabeca applies it with more confidence than the dose-response evidence strictly supports. The twenty-second hug figure, for instance, comes from preliminary research, not a clinical guideline. But the general principle (connection, touch, and warmth measurably affect cortisol and metabolic function) holds up better than it might look at first.

    Is The Hormone Fix Worth Reading?

    Read this if you’re in perimenopause or postmenopause and have tried standard keto, clean eating, or both, and experienced the mood destabilization or eventual stall that many women describe. Also read it if you’ve been told your labs are normal while feeling anything but. Cabeca’s cortisol-progesterone framework explains a lot of that. And read it if you’re already on hormone replacement therapy but want to understand what lifestyle factors might be working against its effectiveness.

    Skip it if you’re premenopausal looking for support with PCOS, endometriosis, or reproductive-age cycle irregularities. Cabeca’s framework is aimed squarely at perimenopause and menopause. Skip it too if you need rigorous dose-response data before adopting supplements. The supplement chapter is thin on that front.

    One caveat: the alkaline science is oversold. The practical instruction it produces (eat more vegetables) is good. The mechanism Cabeca uses to explain why (body pH shifts with food) is not as solid as she presents it. Readers who notice that gap may lose trust in parts of the book that actually earn it. Take the vegetable-heavy eating pattern seriously. Take the pH framing as a useful heuristic, not hard science.

    The practical value here is real. The 16-day plan, the urine strip monitoring system, and the three-hormone framework give perimenopausal and postmenopausal women a coherent starting point that addresses metabolic and lifestyle drivers before (or alongside) conventional hormone therapy. For a lot of women, that starting point is exactly what’s been missing.

    Books Like The Hormone Fix

    BookAuthorBest For
    MenuPauseAnna CabecaCabeca’s follow-up with five different eating plans for different menopause symptoms
    Women Food and HormonesSara Gottfried, MDA similar functional medicine approach with more emphasis on elimination and lab testing
    Fast Like a GirlMindy PelzExtends Cabeca’s fasting angle into a full cyclical fasting protocol for women at all life stages
    The Menopause Diet PlanHillary Wright & Elizabeth WardMore conventional dietitian-led approach; stronger evidence base, less framework-driven
    Eat to Thrive During MenopauseJenn HuberPractical nutrition-forward guide without the keto framing