Dr. Boz [Annette Bosworth, MD] - Keto Diet Explained! Quick and Easy Rules of the Keto Diet

Hi, my name is Dr. Annette Bosworth, and today's video is a quick start to a ketogenic diet. If you've heard of any of the benefits and want to try out this ketogenic diet, watch this video for the best steps to get started and not be terrible at it, because you could be terrible at trying this diet.

Let's start with number one. Number one is to describe this diet. Think of it as no sugar, no starch, high fat. That can sound a little counterintuitive if you've looked at a diet any time in the last 50 years, but this is described as no starch, no sugar, high fat. In my clinic, I use the word anti-inflammatory diet. If they don't like the word keto, I'll just say it's the best anti-inflammatory diet that I can help you with, and that comes from most of your diet being fat. So: no starch, no sugar, high fat.

Number two, I want you to remember the number 20. Hang on to that number; we'll come back to it.

Number three is that I actually want you to go spend some money. I want you to go to your pharmacy and buy urine ketone strips. These ketone strips cost about 15 dollars for maybe 50 of them. Be sure you keep the container closed. If you open the container and leave it open to air, they go bad, so buy a small quantity. Fifty of them for $15, and that is one tool you need to have for this diet. It is super important not to skip that. People start on this diet and say, "I don't know, this ketogenic diet isn't working for me," and my first question is, are you sure you're peeing ketones? It is amazing how much my patients learn when they say, "Doc, I've been on your diet for a week and I'm still not peeing ketones." What that is, is instant feedback that you still have too many carbs in your diet for the way your body is running right now. That number changes over time, but you won't know what your number is without looking, and that's the best part of this diet. So head to your pharmacist and say the words "urine ketone strips."

Number three and a half: I want you to go to the internet and type into a search engine "medium chain triglyceride," or MCT, specifically C8 and C10. This is the kind of fat that is highly absorbed by our bodies and turns into ketones the quickest in your liver. If your liver is not quite used to making these ketones and it's just taken the first few baby steps, this supplement comes in really handy. We're going to do a whole other video about that, so just click, have it delivered in a week, and we'll get to that. You don't need it right away.

Okay, step number four is to empty your cupboards. Yes, this can be difficult. This diet has a lot to do with behaviors and habits, and as we change those behaviors and habits, you cannot believe how tempted patients and people are for those carbohydrates. If they're in the cupboard next to you, it's like asking an alcoholic to serve alcohol at the bar. It is too easy when those temptations are really close. The proximity between you and the closest carbohydrate is really important, and they're everywhere in our life: your work, on the way to work, your commute, at lunch, your neighbor, your friend who is eating carbs. So clean out the one place you control: clean out the cupboards within your home. Get that place to be low on temptations, a place where you are safe and away from all carbs. Temptations are often what sabotage patients in this diet, just like when an alcoholic is trying to rid their home of all the stashes where they've hidden alcohol when they're trying to get sober, or for an addict who sees a syringe, a spoon, or a lighter and is triggered into cravings in an amazing way. Carbohydrates are everywhere, and you're going to trigger cravings just by being in your daily life. Keep your home a sanctuary, and that means cleaning out the cupboards. We want all processed food out of the cupboards. We want white flour, rice, potato, pasta, and all of that cooking and baking stuff that's filled with processed carbohydrates to go out. Once you've done that cupboard clean-out, in fact, when we cleaned out our home I had the kids help me, and if the ingredients had more than 10 items in them, that was a sign of being a processed food. If they counted up on the Hamburger Helper and it had more than 10 ingredients on it, that was going to the donation box.

Step number five is to pause. So many times when I start patients on a diet or when we change a behavior, before they even get used to what's not around, they start reaching for things that aren't so good for their diet and aren't so good for them. So I ask you to not fill the cupboards. Let them sit empty for about three days. You will find simple things to eat that are going to be low in the cupboard space. Do not run out and spend $100 on groceries. Give it time. Just pause. Before you fill the cupboard, once they're empty, rule number five is to pause.

Rule number six is to remember the number 20. It represents the best place to start for how many carbohydrates you can have in a day on a ketogenic diet. I like to have patients start out at 20, and then they're going to report to me whether or not they are peeing ketones. Some people stumble into peeing ketones when they follow that rule. Most often it's men, who have a higher mitochondria count and can turn on ketone production much quicker, but that's not always the case. Sometimes they've been insulin resistant for a very long time and don't pee ketones for the better part of a week. It is in that pause, where I'm waiting to see how long it takes to produce ketones, that you should hold off on filling up that cupboard with items that don't really belong there. For your numbers, step number seven is to actually eat enough fat to feel full.

This is a really important concept. I have done very countercultural experiments with my patients to say, "I need you to eat until you feel full," and they're like, "I don't know, I'm not sure I know what that feels like." It's very common. The reason you feel full is that satiety is a hormonal surge your body should be signaling you, but if you've been on a low calorie, low fat diet, that hormone hasn't been active in a while. They've felt hunger, but that sensation of fullness comes from a loaded bolus, a large amount of food that is high in fat. Many patients say, "Doc, I don't know if I'm feeling full," so I do one of those countercultural experiments and tell them to go get a stick of butter. Yes, a stick of butter. If you fast all night long because you were sleeping, and you get up in the morning, you can have coffee and a stick of butter, and I want you to eat the butter until you feel full. It is incredible what that sensation feels like, and once they mark that in their minds as satiety, they learn to hear that signal over and over again, but many of them haven't felt it for years. Remember, what makes your sugars go up, what makes your insulin go up, is not fat. That stick of butter is going to signal satiety. You're going to make ketones from that. You might get some diarrhea from that, but you will not spike your insulin, and you will not kick yourself out of ketosis. Remember, this is a high-fat diet.

The last rule for a quick start on a ketogenic diet is to eat only when you're hungry. So many of my patients have been programmed to think and understand that breakfast is the most important meal of the day, and they eat breakfast even though they have no hunger. This diet is in hopes that most people are trying to lose weight. There are many other reasons to do this diet, but many people are doing it to lose weight. It is very important that you eat until you're full and then don't eat unless you're hungry. So if it says, "Hey, it's time for supper," but you don't really have any hunger pains, zip it. Don't eat.

Those are the eight rules that I tell patients to begin if you're going to start the ketogenic diet. We have other videos on what to buy when you go shopping and what the deal is with MCT oil, and we'll get to those later. Thanks for watching. Until next time.