What are the common physical signs of insulin resistance?

The first sign is often increased abdominal girth. Other indicators include skin tags (small, mushroom-like growths found in areas like armpits), acanthosis nigricans (darker, thicker, velvety skin, often on the back of the neck or elbow creases), and in older patients, hair loss on the toes extending up the legs.

How long does it take to enter a ketogenic state and feel the benefits, especially if I'm insulin resistant?

For severely insulin-resistant individuals, it can take up to 15 days of strict carb restriction (under 20g/day) to start producing ketones. Dr. Bosworth herself took 9 months, including a 22-mile fasted hike, to achieve ketosis due to severe resistance. However, once metabolically adapted, one can typically re-enter ketosis within 12 hours after a high-carb meal.

Does a ketogenic diet or ketones impact athletic performance and muscle repair?

Initially, athletic performance might dip for 3-4 weeks. However, studies on military personnel showed that after 6 months on a ketogenic diet, power increased by 20%, and after 18 months, by almost 50% compared to counterparts. Ketones also significantly reduce inflammation, speeding up muscle repair after strenuous exercise or injury, which is especially beneficial as one ages.

How are cognitive decline conditions like Alzheimer's and dementia linked to diet, and can ketosis help?

Cognitive decline is often linked to the brain's struggle to use glucose efficiently, sometimes called 'Type 3 diabetes.' Ketones offer an alternative, cleaner fuel source for the brain, even in insulin-resistant states, boosting mitochondrial function, reducing inflammation, and potentially protecting neurons. Dr. Bosworth shares a profound story of a Down syndrome patient with Alzheimer's who regained cognitive function on a ketogenic diet.

What is the 'Dr. Bos ratio' and how do I measure my blood glucose and ketone levels at home?

The Dr. Bos ratio is calculated by dividing your blood glucose by your blood ketone level. You want a low ratio, ideally below 95 when burning fat. At-home blood meters can measure both glucose and ketones from a finger prick. A good ketone reading is 0.5 mmol/L or greater (without triple-digit blood sugar) to indicate fat burning and ketone production.

Are there natural ways to suppress appetite and reduce cravings without GLP-1 agonist injections?

Yes, a ketogenic state naturally raises GLP-1 hormones, which suppress appetite and eliminate cravings, similar to the effects of GLP-1 injections like Ozempic, but through a natural, non-addictive pathway. Increasing allulose and butyrate (a ketone-like fat) in the diet can also boost GLP-1 production.

What key supplements does Dr. Bosworth recommend daily?

She emphasizes Vitamin D (as it's a hormone crucial for cell function and often inefficiently utilized with high insulin), Magnesium (a vital 'spark plug' for countless bodily processes, often low in modern diets), and exogenous ketones (like Keton IQ) to aid in jumpstarting or maintaining ketosis, especially for those with chronic insulin resistance or specific medical needs like cancer patients undergoing chemotherapy. She also highly recommends Methylene Blue for brain energy and Creatine for brain function, muscle, and jet lag.

How did Dr. Bosworth's personal legal battle and career challenges shape her approach to medicine?

Dr. Bosworth faced a 'breaking point' with corporate medicine when she was investigated for 'Medicaid fraud' for providing expensive IV iron treatments to impoverished, malnourished patients. Despite a harsh initial conviction of 12 felonies and a 24-year prison sentence, she persevered, appealed to the Supreme Court, and ultimately had all charges dismissed. This experience solidified her resolve to fight for patients' health and advocate for practices focused on true healing over symptom management, reinforcing her core purpose.

Insulin Doctor: This Is The First Sign Of Dementia! The Shocking Link Between Keto & Brain Decline!

The Diary Of A CEO

People & Blogs5 min read112 min video

Nov 24, 2025|3,879,338 views|120,960|9,435

The Diary Of A CEO steven bartlett steve bartlett podcast the diary of a CEO podcast life lessons CEO

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Key Moments

TL;DR

Unlock health with keto: reverse insulin resistance, boost brain function, and more.

Key Insights

High insulin levels are linked to chronic diseases including cancer, high blood pressure, and brain issues like depression, brain fog, Alzheimer's, and Parkinson's.

The ketogenic diet, characterized by low carbs and high fat, can reverse insulin resistance and improve overall health, including brain function, concentration, and energy.

Insulin resistance is indicated by signs such as abdominal girth, skin tags, velvety skin (acanthosis nigricans), and hair loss on extremities.

Ketones offer a cleaner fuel source for the body and brain, reducing cellular trash and inflammation, leading to improved cognitive performance and longer-lasting energy.

The 'Keto Continuum' is a 12-step process designed to help individuals achieve and maintain a consistent ketogenic state for long-term health benefits, including regular 'trash removal' from the body.

Sardines are a highly nutrient-dense, affordable food that can be used as a metabolic reset tool, particularly for individuals struggling to enter ketosis, and are rich in healthy fats and protein.

THE INSULIN RESISTANCE CRISIS AND ITS CONSEQUENCES

Dr. Annette Bosworth, also known as Dr. Boz, highlights that many chronic diseases stem from elevated insulin levels. Excess insulin, often caused by high carbohydrate intake and late-night eating, acts as a 'chronic disease maker.' It contributes to high blood pressure, cancer, and the buildup of debris in the brain, leading to conditions like depression, brain fog, Alzheimer's, and Parkinson's. This persistent high insulin state prevents the body from clearing cellular waste, a critical process for maintaining health and longevity.

THE KETOGENIC DIET AS A REVERSAL TOOL

The ketogenic diet, emphasizing low carbohydrates and high healthy fats, is presented as a primary strategy to reverse insulin resistance and improve overall well-being. By shifting the body's primary fuel source from glucose to ketones, individuals can burn fat more effectively, preserve muscle mass, and experience improvements in brain performance, concentration, and energy. Dr. Boz advocates for a consistent ketogenic approach, calling it the 'Keto Continuum,' to ensure ongoing health benefits and waste removal.

IDENTIFYING INSULIN RESISTANCE

Recognizing the signs of insulin resistance is crucial for early intervention. Physical indicators include increased abdominal girth (belly fat), skin tags (small, mushroom-like growths), and velvety, darkened skin, particularly on the back of the neck and in skin folds (acanthosis nigricans). Additionally, a decline in hair growth on the extremities, starting with the toes and progressing upwards, can signal prolonged high insulin levels. These visible cues suggest the body is accumulating 'trash' that needs to be cleared.

THE BENEFITS OF KETONES FOR BRAIN HEALTH

Ketones offer a superior and cleaner fuel source for the brain compared to glucose, especially when the brain struggles to utilize glucose efficiently due to insulin resistance. Burning ketones produces less metabolic 'trash' and acts as an antioxidant, supporting cellular health and reducing inflammation. Ketones can easily cross the blood-brain barrier, providing sustained energy and improving cognitive functions like focus, discipline, and reducing impulsivity, which is vital for preventing age-related cognitive decline.

THE KETO CONTINUUM AND METABOLIC REVERSAL

Dr. Boz outlines a 12-step 'Keto Continuum' designed for sustainable ketogenic living and metabolic health. This roadmap begins with basic carb reduction and progresses through intermittent fasting (time-restricted eating) and longer fasting periods. The goal is to consistently lower insulin levels, enabling the body to effectively clear cellular waste and transition to burning fat for energy. This structured approach helps individuals re-establish healthy metabolic patterns and avoid falling back into old habits.

SARDINES AS A METABOLIC RESET

Sardines are highlighted as a powerful, nutrient-dense, and affordable food for initiating ketosis and metabolic reset. Their high content of healthy fats and protein promotes satiety and provides essential nutrients. Dr. Boz's 'sardine challenge' involves consuming only sardines for a period, which can help individuals bypass confusion about macronutrient ratios and rapidly enter a ketogenic state, especially those struggling with severe insulin resistance. This focused approach aids in building a stronger gut microbiome and improving nutrient absorption.

SUPPLEMENTATION AND OPTIMAL HEALTH

Key supplements like Vitamin D, Magnesium, and Omega-3 fatty acids are recommended for supporting overall health, especially when dietary intake might be insufficient. Although not a substitute for a ketogenic diet, exogenous ketones can serve as a 'jump start' for the liver in individuals with high insulin resistance. Creatine is also praised for its cognitive benefits, particularly for focus and energy, while methylene blue aids mitochondrial function. These supplements, when used correctly, can augment the benefits of a ketogenic lifestyle.

HORMONE REGULATION FOR WEIGHT MANAGEMENT

Weight loss is fundamentally a hormonal issue, with hormones like GLP-1 playing a significant role in appetite suppression and fat metabolism. The ketogenic diet naturally helps elevate these beneficial hormones by reducing insulin levels and facilitating weight loss. Introducing compounds like allulose and butyrate can further support GLP-1 production, offering a natural alternative to pharmaceutical interventions and helping to curb cravings by making the body more efficient at signaling satiety.

THE MENTAL AND EMOTIONAL ASPECTS OF HEALTH

Achieving lasting health transformations requires addressing not only physiological factors but also mental and emotional well-being. Dr. Boz emphasizes the importance of 'finding your why' – identifying deep-seated motivations and reframing insecurities as sources of strength. Daily devotionals and prayer provide a spiritual foundation, enabling individuals to navigate challenges, maintain a positive outlook, and stay committed to their health goals, even when faced with setbacks or crises.

DR. BOZ'S PERSONAL JOURNEY AND ADVOCACY

Dr. Boz's personal and professional journey, marked by a significant legal battle and a profound commitment to serving underserved populations, underscores her dedication to patient advocacy. Her experience with corporate medicine and subsequent fight against systemic challenges have fueled her passion for educating others on metabolic health. This journey, including her mother's recovery from cancer with the help of a ketogenic diet, solidifies her belief in the power of lifestyle and nutritional interventions for profound health restoration.

Mentioned in This Episode

●Supplements

●Tools

●Books

●People Referenced

Ketogenic Diet & Insulin Resistance Quick Guide

Practical takeaways from this episode

Do This

Quit eating late at night to reduce insulin production.

Keep total carbohydrate intake to less than 20 grams per day to initiate ketosis.

Increase consumption of high-fat, high-protein foods like eggs, beef brisket, ribs, pork belly, and sardines.

Measure blood ketones regularly (aim for 0.5 or greater) and blood glucose (not triple digit) for an optimal Dr. Bos ratio.

Incorporate time-restricted eating (e.g., 16:8 or 23:1 fasting) progressively to adapt your body to fat burning.

Consider exogenous ketones for a 'jump start' to ketosis, especially when re-entering or when immediate energy is needed (e.g., before chemotherapy).

Supplement with Vitamin D and Magnesium, especially if not consuming enough from diet.

Find your 'why' and core motivation to sustain the ketogenic lifestyle long-term.

Avoid This

Don't consume processed foods, or foods from 'boxes and barcodes and bags.'

Don't rely solely on urine ketone strips for long-term monitoring, as they show excess and not necessarily utilization.

Don't overeat foods like avocado, as they can still contribute to carb intake if not portioned.

Don't mistake symptoms like skin tags, dark/thickened skin (acanthosis nigricans), or hair loss on toes as normal aging; these can be signs of high insulin.

Don't dismiss exercise for fat loss and muscle gain; however, prioritize dietary changes first.

Don't start an extreme ketogenic diet immediately before high-performance events like marathons, as muscle adaptation takes time (6-18 months).

Don't use GLP-1 antagonist agonists (like Ozempic) for vanity reasons without understanding the long-term implications, prefer natural methods.

Don't let perceived 'net carbs' mislead; focus on total carbohydrates, especially if severely insulin resistant.

Don't assume creatine is harmful to kidneys without proper testing to avoid false elevations due to the supplement itself.

Ketone & Glucose Levels for Metabolic Status

Data extracted from this episode

Parameter	Host (Stefan)	Dr. Bosworth	Jack (Guest)
Glucose (mg/dL)	86	83	88
Ketones (mmol/L)	0.9	1.7	0.1
Dr. Bos Ratio (Glucose/Ketones)	~95	~49	~880
Metabolic State	Burning fat	Strong fat burning	Making trash (glucose burning)

Keto Continuum Stages

Data extracted from this episode

Stage	Focus	Typical Duration	Ketone Indicator
1	Eating every 2-3 hours	Starting point for most	No ketones
2	Cut carbs to < 20g total/day	1-2 weeks (average)	Urine ketones appear
3-4	Beginning meal skipping	By day 10 (average)	Blood ketones present
5 (16:8)	Time-restricted eating (16 hrs fasting)	Ongoing adaptation	Blood ketones present
6	Gradually increase fasting duration	Progressive	Blood ketones present
7 (23:1)	OMAD (One Meal A Day), eating for 1 hour	Progressive	Blood ketones present
9-12	Prolonged fasting (36-72 hours)	As needed for reset (insulin resistant)	Abundant blood ketones

Common Questions

Insulin is a hormone that helps store energy. When it's in excess due to modern diets, it causes fat storage and the 'growth of inflammation' or 'trash' in the body. Chronically high insulin is linked to high blood pressure, cancer, and brain debris, which can manifest as depression, brain fog, Alzheimer's, and Parkinson's.

Topics

Alzheimer's Parkinson's Exogenous Ketones Methylene Blue Sardine Diet Corporate Medicine

Mentioned in this video

supplementBeef brisket

A fatty cut of beef, recommended for increasing fat intake in a ketogenic diet.

supplementRibs

A fatty cut of meat, recommended for increasing fat intake in a ketogenic diet.

personAnnette Bosworth

An insulin resistance specialist with over two decades of experience, advocating for the ketogenic diet to reverse chronic diseases.

bookThe Keto Continuum

Dr. Bosworth's book, published in 2020, outlining a 12-step process for 'consistently keto for life'.

bookAny Way You Can: A Beginner's Guide to Ketones for Life

Another book by Dr. Bosworth, detailing her mother Rose's journey with cancer and the ketogenic diet.

bookThe Keto Continuum Workbook

A practical companion workbook to The Keto Continuum, designed for step-by-step guidance in the clinic.

toolKetone strips (urine)

Cheap and easy urine strips used to test for excess ketones, especially for those early in their ketogenic journey.

toolKetone/Glucose Meter

A device used for finger-prick blood tests to measure both blood glucose and ketone levels, providing a more accurate assessment of metabolic state.

supplementSardines

A nutrient-dense, high-fat, high-protein whole food recommended as an effective and affordable tool to kickstart ketosis.

supplementPork belly

A fatty food, mentioned as a preferred choice for increasing fat intake in a ketogenic diet.

supplementEggs

A high-fat, high-protein food recommended for ketogenic diet, mentioned multiple times.

supplementAvocado

A food with a 'beautiful marketing team' that, despite being considered fatty, can be overeaten and contains too many carbs for strict ketogenic purposes if not mindful of total carb count.

supplementKeton IQ

An exogenous ketone product that, when consumed, rapidly increases blood ketone levels, signaling the liver to produce more ketones and providing a quick energy source, especially useful for jumpstarting ketosis or for cancer patients undergoing chemotherapy.

supplementBeta-hydroxybutyric acid

A liquid form of ketones, formulated without sweeteners, consumed to directly elevate blood ketone levels.

supplementButter

Mentioned as a 100% fat food that can be consumed for a day to drastically increase fat intake and induce ketosis when a patient is struggling.

toolMagnesium float

A method of absorbing magnesium through the skin by soaking in highly salient water, similar to the Dead Sea, used to increase magnesium levels.

supplementGLP-1s (Glucagon-like peptide-1s)

Powerful hormones, produced naturally and stimulated by ketones, that suppress appetite and lead to weight loss; also refers to antagonist agonists medications like Ozempic, though Dr. Bosworth prefers natural methods.

personGrandma Rose

Dr. Bosworth's mother, who reversed her cancer and significantly improved her health by adopting a ketogenic diet, serving as a profound case study.

supplementKetone salts

A form of exogenous ketones, mentioned as an alternative to liquid ketones, used to boost ketone levels.

supplementMethylene blue

An old dye, not monetized, that serves as a powerful brain energizer by facilitating mitochondrial fuel movement; it literally dyes the brain blue upon consumption, indicating it targets brain cells effectively. Used to treat malaria; taken for brain supercharge.

supplementButyrate

A two-carbon fat chain, produced by gut bacteria that chew up fiber or found in the blood as beta-hydroxybutyrate (a ketone), which stimulates GLP-1 and suppresses appetite.

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