June 12, 2019

Blog Update & the Famous Dr. Westman "Page 4 Diet"

Hey Everyone,
Man, I have really been neglecting this blog. I’m very active on Twitter and I’ve been posting videos on my YouTube channel, but the blog, sadly, has been collecting dust. This is a shame for two reasons:

First, even though I seem to be reaching more people with my tweets and videos, writing is, always has been, and likely always will be my first love. I consider myself a writer first and a nutritionist second. I truly like writing, and the beauty of writing my own blog, as opposed to some of the paid “day gig” writing I do to keep my bills paid, is that I get to write about whatever I want to write about, and say things the way I want to say them. I don’t have to answer to anyone, censor myself, or present things in a certain light in order to fit in with someone else’s “message” or brand. Tuit Nutrition is me. My voice, my perspective, and yes, my sarcasm and snark. I start to feel not-so-good when it’s been awhile since I’ve written anything substantial on the blog—something I think is truly educational and helpful for people navigating the crazy world of low carb & keto. Sharing little snippets of this & that on Twitter is great, and I’ve made some important professional connections there, but my blog is where I can really get deeper into things. Write something meaty, something detailed, something to make people think. When I hit publish on that kind of post, I feel a sense of satisfaction and purpose that I rarely ever experience otherwise.

The second reason it’s a shame I’m not blogging regularly is that I know many of you prefer to read, and even though you can hop over to YouTube anytime and watch me talk about any number of keto-related issues, you’d prefer to wait for the next written post. Frankly, my dear readers, I don’t blame you! I, too, prefer reading, and long posts don’t scare me away. My attention span hasn’t yet been decimated to the point that anything longer than a 15-second read gets passed over in favor of a meme with a whopping 4 words on it. (Not that there’s anything wrong with funny memes.) My point is, I know some of you enjoy reading my posts as much as I enjoy writing them, and I feel bad leaving you without something to dig into for such long periods of time. (And I love hearing from those of you who’ve told me you don’t mind my very long posts. Some of you actually like immersing yourself in something a bit more substantial. In that case, we’re a perfect fit.)

With this in mind, I’m committing to blogging a little more regularly than I have been in the last year or so. I won’t commit to once a week because I know myself too well, and I just won’t be able to keep up that pace. But twice a month? I think that can work. And I can’t promise every post will be something of great substance (in fact, I can promise some posts won’t), but I think just getting back in the habit of writing regularly at all will be a good move for me.

Here’s what I have in mind for the coming weeks and months:

PCOS: I’ve been blogging since 2012 (!!!), and considering everything I’ve written about insulin and other hormones, I was stunned to realize I’ve never written about PCOS. How has this been allowed to happen? I don’t know, but the situation will be remedied soon. This will be one of my detailed, science-packed posts for those of you who look forward to those.

High blood sugar on keto: Not everyone tracks blood glucose on a low carb or ketogenic diet, but those who do are sometimes surprised by “high” blood sugar, or if not high-high, higher than they would expect based on eating a diet extremely low in carbohydrate. What gives? Is this something to be worried about? In most cases, no. I’ve said before and I’ll say again: I wish people were required to sit through a 5-hour biochemistry lecture before being allowed to purchase a glucose or ketone monitor. It’s all well and good to want to track some of that data (although it is absolutely not required to be successful), but you have to understand how to interpret the numbers you see. People are making themselves neurotic about their blood sugar level without having the slightest understanding of the various mechanisms and feedback loops responsible for controlling it. (It’s even worse with ketones.) Until this post comes out, you can read a preview of some of what it will include in this article I wrote for Designs for Health (one of those aforementioned paid “day gigs”): Higher Fasting Glucose on Ketogenic Diets: Reason to Worry?  (The post I’ll write for my own blog will address blood glucose in general, not just the fasting level.)

Those are the two main topics I have in mind for longer, more in-depth posts. I might also do one on how insulin affects the skin. This is something I’ve only recently gotten clued in on. I’ve known for a long time that skin tags and acanthosis nigricans can come from chronic hyperinsulinemia, but those aren’t the only things. (And even if they were, it would still be worth writing about for all the people out there who are dealing with those issues and have no clue it’s coming from their diet.) Would this topic be of interest to you?

For lighter fare, do you have any suggestions for what you’d like to see? I’ll probably resurrect my series taking apart food labels (“Label Madness Monday”), but what else can I do? How about taking a closer look at research? I already read a lot of studies and articles on keto, insulin, diabetes, and human physiology and metabolism in general. It wouldn’t be much extra effort to write about one of them once a month or so if I come across one that’s worth sharing with you. Maybe a look at the science and then my interpretation/opinion of it. (If you’re interested in this and would want to see my take on multiple studies at once, consider supporting me on Patreon. People who contribute at the $10/month level get access to my monthly Research Review, in which I go into detail on 4-5 studies I’ve read in the previous month. If you’re a fan of my writing but $10/month is out of your price range—and believe me, I totally understand!—you can support me for as little as $2/month. A cup of coffee! Keep me caffeinated so I can burn the midnight oil and get back to what you and I like best: me churning out blog posts.)

I could also post some videos here on the blog, but I figure if you want to watch rather than read, you can go to YouTube. You come here to read, and I aim to please.

I’m open to suggestions for the kind of blog posts you’d like to see, especially if you have ideas for posts that would be shorter and lighter on the science.

The Page 4 Diet

In other news, if you’ve spent any amount of time in the ketogenic/low carb community and you don’t know the name Eric Westman, check your pulse; you might be dead. Dr. Westman has been conducting clinical research on LCHF/keto for 20 years. (Here’s just a handful of his work.) He was co-author of The New Atkins for a New You, as well as Cholesterol Clarity and Keto Clarity. (Keto Clarity is having a 5-year update/revision soon. I know Dr. Westman and the other author, Jimmy Moore, and there were a few things in the original version that they’d say a little differently now, so a revision is a good thing. And Cholesterol Clarity was dynamite as originally written. If you’re worried about “high” cholesterol on keto, get that book and read it, STAT.) In Dr. Westman’s own words, The New Atkins for a New You is the best mainstream book ever written on nutrition—not because he’s a co-author, but because Stephen Phinney, MD, PhD, and Jeff Volek, PhD, RD, wrote the chapters on protein and fat. (His words, not mine.)

Bottom line: Dr. Westman knows his shit stuff. He’s a past president of the Obesity Medicine Association (which has endorsed a low carb/ketogenic diet among their other strategies) and has a 6-month waiting list at his clinic at Duke University, where he specializes exclusively in helping people lose weight, reverse type 2 diabetes and metabolic syndrome, and other related issues.

Dr. Westman is famous for “page 4,” which is the food list he gives his patients. In the handout he gives patients, it’s more like pages 4, 5 and 6, but internet shorthand for it has become “page 4.” He recently boiled it down to one pageone side of a standard 8.5 x 11” sheet of paper. It is the simplest, most straightforward, and most effective way to do keto. 20 grams total carbs (not net!) per dayor less. No nonsense, no gimmicks, no confusion. It is also the strictest form of keto, but guess what? That’s why it’s so effective. If it’s not on page 4, you don’t eat it.

If you’ve been struggling with fat loss on keto for a while, this could be very helpful for you. You would likely be very surprised at what’s on page 4—and maybe even more so by what’s not on page 4. Sorry to break your hearts, but butter, heavy cream, cheese, and mayonnaise are not unlimited. (And no nuts! None!) You know what you are told to eat as much of as you like? Meat! Meat, poultry, seafood, and eggs, so if you’ve been limiting protein and loading everything up with added fat instead because you’ve bought into the fearmongering out there about protein “turning into sugar” or “kicking you out of ketosis,” it might be time for a course correction. (To clarify: if whatever version of keto you’re following is working for you and you’re happy with the results you’re getting, keep going! “If it ain’t broke, don’t fix it.” I’m sharing about page 4 specifically for people who are having a hard time losing body fat – assuming, that is, that they have a substantial amount to lose, not just 5 or so “vanity pounds.”)

If this sounds intriguing to you, you can purchase the famous Page 4 Diet for $9.99. I know ten dollars seems like a lot for one page of information, but you know you can always expect honesty from me, which is why I’m being very clear that this is literally one page (one side!) of paper. And I’m not kidding when I say it’s the simplest and most straightforward way to do keto for fat loss. Plus, people have spent far more on all kinds of gadgets and gizmos, books and programs, that have failed them. Fancy-schmancy technology, trackers, apps, and for what? To still be stymied and not understand why they’re not losing weight. (Lack of fat loss or slow fat loss is the most common reason people contact me for help.) Or, you can get Page 4 for a relatively small amount of money and be on your way to keto success!

There are images and lists claiming to be page 4 all over Pinterest and various other places on the interwebs. Accept no imitations! If it didn’t come from Dr. Westman or from this download site, I can’t guarantee it’s the real thing, with the version of keto he uses in his own clinic. (I would say he created it, but he credits Dr. Robert Atkins and the head nurse at the Atkins Center, Jackie Eberstein, for most of it. Yes, he learned about keto from the late, truly great Dr. Atkins and Jackie. [What, you thought he discovered it all on his own? Heehee.] I’ve written in the past and still believe that the good ol’ Atkins diet is a GREAT way to get started on keto, especially for people totally overwhelmed by conflicting info out there.)

By the way: if you’re wondering why page 4 is so strict—20 grams total carbs per day, maximum, it’s because Dr. Westman has a very broad patient base. All walks of life, all income and education levels. Some of them will not be able to implement a plan that requires them to track every molecule of food they eat or to prick their fingers multiple times a day. He knows not everyone needs to live at 20g or fewer per day, but he starts everyone out that way because when carb intake is that low, you will be in ketosis. You will be burning fat. You will have no need to measure ketones, track your food, weigh and measure your portions—none of that. If you stick to page 4, It. Will. Work. It is beautiful in its simplicity.

In the interest of full disclosure, I am an affiliate for Dr. Westman’s Page 4 Diet, and I will receive one dollar from each sale if you purchase using the link I’ve provided in this post.

Okay! Enough about Page 4. Check it out if you are so inclined; if you need it, you need it; if you don’t, you don’t.

To you, my cherished readers, thanks for staying with me even when there’s a lull on the blog. I mean it when I say writing is my first love, and I feel better even just thinking about getting back to blogging. I hope to have a post up within the next week or two. It will be either the one on PCOS or the one on why blood sugar might be unexpectedly elevated on keto. Not sure which one yet, but stay tuned.  

Disclaimer: Amy Berger, MS, CNS, 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 amazon.com, where I will receive a small amount of the purchase price of any items you buy through my affiliate links.


  1. I would be interested in a series on which supplements are most helpful on a ketogenic diet. Thank you.

  2. Great to hear from you again Amy! Looking forward to your upcoming blogs.

  3. Hi Amy -- this is great news about the blogging, thank you! If you could write about seed oils -- are they are as awful as they seem??? -- that would be amazing. And if you've already considered the topic, even more amazing :) I will look around the internets to see if you've written about the topic already. Thanks again!!!

    1. I haven't written about seed oils yet, but I did do a video on omega-6 (which is one of the main "concerns" people have with regard to these oils) if you want to check that out: https://youtu.be/gvfzijY8I6E

      I'm not as worried about them as others are. I don't consume "a lot" of these oils, but I don't go out of my way to avoid every last molecule of them. (I'm not afraid of regular store-bought ranch dressing, for example.)

  4. Hi Amy! Great to see you blogging again. I've promised myself to blog once a month and hang out on Instagram and twitter in between times. I gave a friend page 4 and she's dropped about 20 pounds, now she's working on the next 20, which takes a little adjusting for many of us!! Good to see you.

  5. How about the effects of different vitamins on fat loss? For example, I found out that Niacin prevents fat loss, which I found interesting. Keep up the blogs!!

  6. Hi Amy, how about a post on vitamin K2 and its ability (in concert with VitaminD and a low carb/keto diet) to halt and potentially reverse coronary artery calcification. There are a couple of RCTs due to report later this year, but in the meantime there is tantalising associational and mechanistic evidence for this. Keep up the great work - love reading the long posts!

  7. Yes, please, to the blog on skin issues.

  8. I would love a new BOOK from you! You are missing out on an opportunity that would drive the Keto community insane with happiness. Let me explain. I bought your book The Alzheimer's Antidote, mainly because a close relative had Alzheimer's, and I wanted to do all I could to prevent it. Much to my great surprise, your book offered an alternative to carb counting and the numbers game. You just gave us lists of low carb food - what to eat, what not to eat, etc., with great explanations, and for the first time in my life, I found low carb effortless without the numbers game. I think some people call this intuitive keto. Anyway, I lost weight and felt great. My thinking is that now you have to take that wonderful information and put it into a weight loss book. So many want to low carb, but are sick of counting carb grams, macros, whatever. We want EASY, and you gave us that. Thank you so much for making low carb DOABLE. Now please, write a weight loss book for the masses. Trust me, people will LOVE it. Thank you for your wonderful book, and all the other wonderful information you put out there. Hugs.

  9. Glad I got page 4 when it was still free.

    1. Thanks for the negativity. Do you feel better having gotten it out of your system?

  10. Is Alzheimer's Antidote still available,?

  11. I paid with PayPal today but didn’t get the download my

    1. Sorry about the difficulty. Please email me directly, or first check your spam folder to see if your link to download accidentally got filtered into your spam.
      My email: tuitnutrition (at) gmail (dot com)

      I have nothing to do with downloading Page 4, but I'll help you if I can.