March 7, 2018

Cheat Meals on Keto or Low Carb: A New Perspective

I ate 9 grapes.
They kicked me out of ketosis!

I ate a donut!
How soon until I’m back in ketosis?!

I went to the Chinese buffet, and … I don’t know, I just lost my ever-lovin’ mind and ate ALL. THE. THINGS.
Have I completely and totally wrecked *everything?*

Yes, folks, it’s time for a post about cheat meals.

Rather than having to answer the same questions over and over and (attempt to) instill sanity into people time and again, I thought it would be easier to put my thoughts together in one place so that when situations like the above arise, as they inevitably and often do, I can point people here instead of writing the same email response eleventy-six times.

Feel free to link to this post when you come across similar sentiments from low-carb and keto newbies freaking out because they jumped head-first into a stack of pancakes and syrup.

Lots to cover here, but I’ll try to keep it more succinct than usual. (Insert LOL.)
If you’re pressed for time and want a one paragraph summary, scroll down to the bottom for the tl;dr.

March 1, 2018

Update: Podcasts, Videos, Alzheimer's, and More

Hey Everyone!
Just wanted to let you know I’ve updated two tabs on the site:


I’ve done a bunch of interviews about the book and the concept in general – that Alzheimer’s disease is a metabolic problem – one the scientific literature regularly refers to as “type 3 diabetes,” or “brain insulin resistance.”

On the Alzheimer’s tab, you can find links to all my published articles and blog posts, as well as links to some of my favorite scientific papers on Alzheimer’s.

Podcasts & Videos

If you’ve been reading the blog for a while but have never heard my voice or seen what I look like (other than the photo on the blog), you can check me out in these videos and podcasts.  You’ll notice differences in my face and general appearance, depending when the various videos were recorded.  That’s what trying to figure out your thyroid will do to you!  Swollen looking in one video, down 15 pounds in another only a few months later.  The info in this one is great, but my thyroid-related weight gain had reared its head again.  In my opinion, I look best in this one and this one.) 

For those of you who are familiar with prominent low carb physician and researcher Eric Westman, MD, I’ve recorded two videos for his Adapt Your Life Program, one on Alzheimer’s, and one called “Keto Sense and Nonsense.”  The latter one goes hand-in-hand with this blog post I wrote about keeping low carb and keto simple, and how UNcomplicated they really are.  (If you’re interested in the blog series on insulin I mention during the Alzheimer’s video, you can check it out here.)

Another video I’d like to share with you is a webinar I did for the Irish Institute of Nutrition & Health.  It’s a bit long – about 2 hours – but it’s the most detailed and informative presentation I’ve ever given.  (I’ve given this talk, called “Nourish Your Neurons,” at professional conferences.)  There’s a Q&A for the last approximately 40 minutes. I recommend watching through to the end, because there’s some good extra information during that time.  You can download and save the file here (it’s a very large file), or simply watch it here. 

Posts for KetoDiet

I’m happy to announce I’ve joined the writing team at Martina Slajerova’s KetoDiet/KetoDiet App.  I am humbled to be part of this team, as I am in the company of people I deeply respect, including Franziska Spritzler, Bill Lagakos, Emily Maguire, and other nutrition professionals.

If you’re not familiar with Martina, she’s an AMAZING and prolific recipe developer and all-around good person.  She has several great keto cookbooks out, not to mention all the fabulous recipes available for free on her website.  (I reviewed The KetoDiet Cookbook here, and the Sweet & Savory Fat Bombs cookbook here.)

Three of my articles have been published so far: 

There will be several more articles in the coming months, including basic ones on things like meal prep and dining out on low carb/keto, and some that are a bit more in-depth on insulin resistance and associated metabolic dysfunction.

The best way to stay up to date on my latest publications, podcasts, other interviews, and public appearances (yes, I do occasionally leave the house and interact with other humans!) is to follow me on Twitter:  

P.S.  I’m working on three new posts that I’m very excited about.  Lots of fascinating stuff to talk about.  I think they’ll blow your mind, just like they did mine.  They’re a bit in-depth, though, so they’re going to take a while to write.  I’ll be posting some less heavy-hitting stuff in the meantime, but just know that some really good and educational stuff is on the horizon.  Y’all know that what I love about the blog is that when I learn new things that change the way I see insulin, type 2 diabetes, obesity, cancer, and more, I get to share those insights with you!   

Disclaimer: Amy Berger, MS, CNS, NTP, is not a physician and Tuit Nutrition, LLC, is not a medical practice. The information contained on this site is not intended to diagnose, treat, cure, or prevent any medical condition and is not to be used as a substitute for the care and guidance of a physician. Links in this post and all others may direct you to, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.

February 14, 2018

Is There a Male Equivalent to PCOS? (a.k.a. The Detrimental Effects of Hyperinsulinemia on Men's Health)

Insulin has gotten a bad reputation in the low carb and keto communities. But insulin isn’t a bad thing. Too much insulin, too often, is a bad thing. If you ask people whose homes are threatened by wildfires whether lots of rain would be a good thing, you’ll probably get a very different answer than if you ask people whose homes have just been destroyed by hurricane floods. Water is not a problem; too much or too little water is a problem, and it’s the same with insulin.

So I’m not trying to demonize insulin. I wrote an 8-part blog series detailing the gnarly and nefarious effects of chronically elevated insulin (soon to be 9 or 10 parts -- new posts coming soon!), but the operative phrase there is chronically elevated. In and of itself, insulin isnt a problem. (Just ask a type 1 diabetic.) The bad stuff happens only when insulin is too high, too often. Now that that’s out of the way, on with the show!

We know for certain that PCOS (polycystic ovarian syndrome)—which is “is the most common endocrinopathy of reproductive aged women affecting 6-10% of the population,”—is driven primarily by chronic hyperinsulinemia. (Incidence may be as high as 18% among certain cohorts when different diagnostic criteria are used, putting the number of women affected worldwide at around 10 million.)

“Hyperinsulinemia associated with insulin resistance has been causally linked to all features of the syndrome, such as hyperandrogenism, reproductive disorders, acne, hirsutism and metabolic disturbances.” (De Leo et al., 2004)

In fact, the causal link (not just an association!) between hyperinsulinema and PCOS is so well-known (and so powerful) that metformin—best known as a diabetes drug—is among the frontline pharmaceutical interventions for PCOS. Keep this in mind as you read about the men’s issues here.

Facial hair, acne, oily skin, mood swings, weight gain, menstrual irregularities, and infertility are not the only signs and symptoms of PCOS. These signs & symptoms are driven by the underlying hormonal disturbances, which include: elevated insulin, increased adrenal androgen synthesis (more testosterone and/or DHEA), decreased sex hormone binding globulin (SHBG), increased luteinizing hormone (LH), and decreased follicle stimulating hormone (FSH). And while the stereotypical PCOS patient is overweight or obese, as many as 50% of women with PCOS are not overweight or obese. (Remember, chronic hyperinsulinemia leads to obesity in some people, but not all. There are millions of people walking around with a “normal” body weight, but sky-high insulin levels.)

Since men produce all of these hormones as well, could there be a male equivalent of PCOS?

You bet your bald spot there is!
Let’s take a look at three different areas where chronic hyperinsulinemia has adverse effects on men:

  • Early onset androgenetic alopecia (a.k.a. male-pattern baldness)
  • Erectile dysfunction
  • Benign prostatic hypertrophy (BPH) – enlargement of the prostate gland

January 31, 2018

Book Review: The Case Against Sugar

Gary Taubes wrote another book.

Gary Taubes! (*Fangirl squee!*)

Do I really need to say more?

I don’t, but since this is my blog, I will.

TL;DR: I loved this book and you will too. READ IT.

If you don’t read a lot of blogs and websites outside the low carb bubble, then allow me to tell you that there’s a large contingent of people who loathe Taubes. He takes a boatload of criticism, as does anyone who writes something that condemns or exonerates something other people love or hate (e.g., red meat and saturated fats, refined carbohydrates, and raw milk). But put me squarely in the camp that loves his work and is grateful for his meticulous research. (The endnotes and bibliography of Good Calories, Bad Calories are almost as large as my entire book.) I’m not saying he’s right about everything, nor that I agree with him on everything. I’m only saying I’m a big fan and have been for several years.

I had the pleasure of meeting Gary in spring 2017, first at a reading and book signing in Washington, DC, and then a few weeks later at a literary event in Charlottesville, VA. I actually drove him from Charlottesville back up to Dulles airport in my neck of the woods, so we had some time to chat and shoot the low carb breeze. Let me tell you, folks: I read GCBC during my deployment in Iraq, circa 2008. Having always been a sucker for salt & pepper hair, intellect, and a wry and somewhat dark sense of humor, I developed an immediate nerd crush on Gary. Never in my wildest imagination—and mine is pretty wild—did I think nine years later, I’d have him all to myself on the road for two hours.

Get your minds out of the gutter. Nothing happened except good conversation and Gary being an exceptionally good sport about the fact that my decade-old car has seen better days. (He assured me that his car is older and in even worse disrepair. We writers don’t exactly break the bank; not even ones like Gary, who garner big advances and have multiple bestsellers to their names.) Without revealing too much, I’ll say that it was really nice to talk with a writer of Gary’s caliber, and to find out that many of the emotional demons that plague me are not unique to me. Gary deals with his by throwing himself into work; I deal with mine by avoiding work. Neither strategy is all that healthy, long term. But I can look to Gary as someone with a lot of dark thoughts and inner turmoil who still manages to get shit done produce great work. It helps that he has a wife and two sons depending on him, so he sort of has to bring home the proverbial (and literal) bacon. 

As an aside, Gary has spent time in France, and he longs for it. As he talked about it, his desire to be there—and, maybe, to be the person he was when he was there—was palpable. He has also written and spoken a lot about his history as a smoker. I could totally see him as the quintessential ex-pat, sitting at a roadside cafĂ© in Paris, sipping coffee and reading poetry, complete with a black turtleneck and a cigarette.  

But enough about Gary. On to the book!

January 26, 2018

Introducing Ketoned Bodies

Confession: I had a hard time writing this post.

I’ve been uncertain of my place in the low carb world for a while now, trying to figure out where I fit in, or even if I fit in.  I’ve been looking at low carb and keto accounts on Instagram lately—something I’d completely avoided until just a few weeks ago.  In looking at the pictures people post, I find myself kind of stunned at the amount of packaged foods and special items marketed toward and targeted at keto eaters: exogenous ketones, powdered MCT oil for your coffee, special “keto collagen,” etc. 

To be clear, I’m not opposed to these kinds of things on principle.  I think they can make low carb and ketogenic diets more fun, more delicious, and easier to stick to, and considering I occasionally share things that might fall into this category, I’d be a hypocrite if I said they have no place in a ketogenic diet.

I guess my beef with those products is that some people’s Instagram accounts are so peppered with them that people who are new to this way of eating might think they have to use them, or that they’re doing something wrong if they get all their food at the local supermarket, rather than having a substantial portion of their diet consist of these esoteric and super-special keto products that can only be ordered online.

Remember: there are only three things—three things—needed to be successful on a ketogenic diet.

With this in mind, I think I’m zeroing in on what my place might be in this community, and I’m becoming more comfortable with it:  I’m the girl who reminds people how simple and UNcomplicated this way of eating is—when we let it be.  I’m the one who talks people down from the proverbial ledge of measuring blood ketones, urine ketones, breath ketones, blood glucose, heart rate variability, and drinking a 500-calorie cup of fatty coffee for breakfast because they’re afraid of the protein in sausages and eggs.  I’m the one keeping it down to earth, doing my best to make this way of eating clear, simple, and accessible to anyone who wants to give it a go, and I increasingly feel drowned out by an ever-widening sea of voices committed to doing the opposite: to adding layer after layer of unnecessary complexity, to the point where people feel like they need a dual PhD in calculus and biochemistry just to figure out what to put in their mouths.

That’s a great way to sell expensive products and gadgets, but if you ask me, it’s a terrible way to get people interested in this way of eating, and to help them get started.     

So, in keeping with my simplicity theme, I’ve written a couple of posts on low carb/ketogenic cooking, to help people see how quick and easy it is to put a meal together, whether you’re cooking for one or two, or to feed a large family.  If you keep your fridge, freezer, and pantry well stocked with low carb staples, you can whip up a delicious and suitable meal in minutes

If you’ve got a busy lifestyle and find yourself pressed for time more often than not, a good strategy for you might be to take a few hours once a week and prepare a large amount of food at once, so there’s plenty of good stuff cooked ahead of time, and it’s waiting in the fridge, ready when you are.  Or, if you’re like me, and you don’t have to worry about feeding picky kids, as long as you’ve got some canned tuna, salmon, or sardines in the pantry, and maybe some kind of vegetable in the fridge or freezer, dinner can be ready in 27 seconds.

HOWEVER, even though I am the queen of emphasizing how fast & easy it is to throw together a low carb meal in minutes, there are times when even I can’t stand the thought of choking down another bite of tuna, or I think I might turn into a cat if I have to pull back the lid on yet another can of sardines.  

On these rare occasions, it’s great to have an alternative.  A real alternative.  A hot meal, high in fat, moderate in protein, low in carbs, made with grass-fed and pastured meats, organic vegetables, and no junky vegetable oils.

This is a tall order, but the people at Ketoned Bodies are doing it!

January 10, 2018

Questions for You

Hey Everyone,

With a new year just having begun, I’ve been giving some thought to how I’d like to proceed in participating in the low carb nutrition and health community.

This might surprise you, but I consider myself a writer first and a nutritionist second. When people ask me what I do, I tend to say I’m a writer who mostly writes about nutrition and health, rather than a nutritionist who also happens to dabble in writing. I love writing. I’ve always loved it. (Even majored it in in college.) I am fortunate that I get to do it for a living: fortunate that someone out there thinks I’m good enough at it that they actually pay me to do it.

However, even though I do enjoy it, for me, writing is an arduous process. It’s not easy, and it never has been. However long you think it takes me to write a post, triple it, and that might come close to the ballpark amount of time it typically takes me to write. (Not including the time it takes to read relevant papers, if it’s one of my more science-heavy posts.) I can’t claim credit for this phrase, but it is absolutely 100% true for me: “I don’t like writing; I like having written.” Meaning, the process of writing—staring at a blank page, filling that page with incomplete, out-of-order, fragmented notes and thoughts, and slowly, painstakingly, turning it all into something coherent and readable—is a struggle and not fun. The fun part comes after that’s all done, and I get to hit “Publish” on my blog. (BTW: the two links in this paragraph are to a blog I had in a former lifetime, long before this nutrition gig.)