Dr. Boz [Annette Bosworth, MD] - The keto mistake I wish I could undo

Dr. Boz has been battling this for a while. The video begins with a difficult question a doctor often gets: when her mom had her third cancer battle, her cancer returned, and her mom refused chemotherapy after the devastation the last round had caused. Her mom asked, "If it was you, what would you do?" Dr. Boz told her to go home, throw out the carbs, and she did it with her. Six weeks later, her cancer was down by 70 percent and Dr. Boz had lost 10 pounds. This is where their keto journey began, but they made a ton of mistakes in the beginning.

The first mistake was being gluttonous about too much fat for too long. When transitioning to a high fat metabolism, it is essential to nourish your fat-based hormones. These fat-based hormones all begin with cholesterol, which is a form of fat, and in the beginning it is crucial for your body to restore the amount of cholesterol in motion. From that cholesterol you make all those hormones, and this is why the first few weeks of keto feel amazing and improve your energy, your immune system, and your metabolism. In the beginning she was just like everyone else: all of these fat-based hormones were inside her fat cells, and when she changed the chemistry, these hormones not only replenished but became active and were able to leave her fat cells and enter back into her lean tissue, where they improved her immune system and energy. She never felt hungry eating so much fat, loved it, found it tasted great, and it kept her full. But, like anything on the ketogenic diet, things stabilized and she needed to move on and stress her metabolism further in order to continue to get benefits from this new way of living.

She shared what her blood sugars looked like before the ketogenic diet, when she ate three meals a day, and explained that her processed foods shot her blood sugars way up. Starting on the ketogenic diet, those blood sugars lowered when she took in only 20 total carbs. At the same time, a wave of ketones hit her system, which is when she started feeling so well. This also changed her metabolism, but as predicted, her body adapted and those ketones settled down to only the ones she was using during this time of adaptation. Her results stalled. The fact that she accidentally missed a meal should have given her a clue that the chemistry was carrying her. She was doing great, but she didn't take the next step of moving on to only two meals per day. This high fat, three-meal gluttony phase should have only lasted four to six weeks, but she stayed there for months. During this time she wasn't really testing; she was just enjoying this improved metabolism, and the stall went largely unnoticed in her high carb life.

She also used food to comfort herself and tried to do the same thing in this ketogenic lifestyle by using sugar substitutes or trying to recreate comfort foods without the carbs. Her advice is to stay away from fat bombs and keto desserts, because this is not a good plan. She compares it to telling an alcoholic to replace whiskey with wine. Instead of replacing dessert with keto desserts, replace it with community. If you are used to that sweet something after a meal, find a different activity such as a board game, a card game, or other places where you enhance your oxytocin and stimulate that loving hormone within yourself. She says this is a far better plan than a fat bomb. Some of the ways she boosts her oxytocin include praying, writing a gratitude list, playing with a dog, and doing puzzles. When she is looking for distraction, she and her husband find a good show to watch or play games together. They do anything to not focus on food as they wind down from the day.

This brings her to her biggest mistake, mistake number three: measuring. You are not on the ketogenic diet if you are not circulating ketones. Urine ketone strips are great, and she tells patients to pee on them first thing in the morning, as it is a good affirmation that you are making and circulating ketones. However, she waited a whole year to prick her finger and prove she was circulating ketones once she was keto adapted, because that is when the ketones in circulation fall, and you really need a better form of measurement to know whether you are circulating ketones.

Next she describes her system when she went to two meals per day. At first it was a great stress on her metabolism, and eating only twice a day resulted in a wave of ketones. But it wasn't long before her ketones dropped below 0.5 in circulation, and this is when she should have stimulated her metabolism again. The best way to do that was to shrink the hours per day that she allowed herself to eat. This is called closing your window, or time-restricted eating. She did what most people do when they shrink their eating window: she didn't eat in the morning and only had a meal around noon and one in the evening. This worked okay at first, but it didn't take long for those ketones to sink again. She notes that her morning sugar was still fairly high, like half a meal happening in her blood system even though she never ate. The best way to stimulate that metabolism and get a higher wave of ketones for a longer period is to move those two meals earlier in the morning, overlapping that morning rise in glucose. The first time you eat decreases the number of times insulin surges.

For those who are afraid to prick their finger, she offers a pro tip: use the side of the finger and use one of these spring-loaded lancets. You don't feel it, or at least it is so tiny you shouldn't complain. Finally, after you have thrown out all your carbs, watch this video before you shop, because it will save you a lot of money in groceries.