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Dr. Annette Bosworth (Dr. Boz), an internal medicine physician with 25 years of experience, reveals how most chronic health problems could be reversed if people knew how to consistently produce ketones. Through her experience treating complex medical cases and her personal journey with her cancer-stricken mother, Dr. Boz has developed a systematic approach to metabolic health centered on ketosis. (03:26) She explains how high insulin levels create "trash" in the brain and body, leading to premature aging and chronic diseases like diabetes, Alzheimer's, and cancer. The conversation covers practical strategies for achieving ketosis, measuring metabolic markers, and maintaining long-term health through dietary interventions.
Dr. Annette Bosworth is an internal medicine physician with over 25 years of experience specializing in chronic disease management and ketogenic interventions. She educates through her popular YouTube platform and is the bestselling author of several books including "KetoCONTINUUM: Consistently Keto Diet for Life." Despite facing legal challenges including 12 felony charges (later overturned) for her unconventional approach to treating underserved patients, she has continued her mission to help people reverse medical problems through ketogenic living.
Steven Bartlett is the host of The Diary of a CEO podcast and a successful entrepreneur and investor. He brings curiosity and personal experience to health discussions, often experimenting with various dietary approaches including ketogenic diets and intermittent fasting for optimal cognitive performance.
Dr. Boz reveals that eating late at night significantly accelerates aging and disease progression. (09:59) She explains that one bite of food after 6 PM is equivalent to 10 bites before noon in terms of metabolic cost. This occurs because late-night eating stimulates excessive insulin production, which continues churning throughout the night, preventing the body from taking out cellular "trash." The solution is to move calories toward morning and stop eating by mid-afternoon when possible, especially as you age.
Practical Example: Replace your typical dinner-heavy eating pattern with a substantial breakfast and lunch, finishing all food intake by 3-4 PM.
Most people develop high insulin levels without knowing it, as their glucose appears normal on standard blood tests. (14:07) Dr. Boz emphasizes that excess insulin is what creates cancer, high blood pressure, brain fog, and accelerated aging. The key signs include abdominal weight gain, skin tags in armpits and groin, dark velvety skin on the neck, and hairless toes. This insulin resistance develops gradually over years through processed food consumption and poor meal timing.
Practical Example: Check for skin tags or dark patches on your neck - these are early warning signs that your insulin levels have been elevated for too long.
The body stores glucose as glycogen, and this must be completely depleted before ketone production begins. (18:55) For severely insulin-resistant individuals, this process can take up to 15 days of strict carbohydrate restriction (under 20 grams total carbs daily). Dr. Boz emphasizes that you cannot burn fat or produce ketones while insulin remains elevated - the body will always use stored glucose first.
Practical Example: Use ketone test strips or blood ketone meters to verify you're actually in ketosis rather than assuming dietary changes are working.
Ketones offer several advantages over glucose as brain fuel: they produce less cellular debris, provide longer-lasting energy, and can cross the blood-brain barrier even when the brain is insulin resistant. (25:58) Dr. Boz notes that burning ketones creates an antioxidant state inside cells where it's needed most. For cognitive performance, ketones enable sustained focus for hours without the energy crashes associated with glucose metabolism.
Practical Example: Podcasters and professionals requiring sustained mental performance often report dramatically improved focus and articulation when in a ketogenic state versus a higher-carb diet.
When patients struggle to achieve ketosis despite following ketogenic principles, Dr. Boz prescribes eating only sardines for 3-72 hours. (56:48) Sardines are high in fat, protein, omega-3s, and vitamin D while being affordable and nutrient-dense. This eliminates decision-making around food choices while providing optimal macronutrients for ketosis. One patient ate only sardines for 100 days and experienced remarkable health transformations including reversed gray hair and dramatically improved vitamin D levels.
Practical Example: When struggling to enter ketosis, replace all meals with canned sardines in oil for 2-3 days to reset your metabolism and eliminate food decision fatigue.