In this episode of The Diary Of A CEO, Dr. Annette Bosworth discusses insulin's role in blood sugar management and fat storage, explaining how consistently high insulin levels can lead to various health issues including accelerated aging and increased disease risk. She outlines the connection between insulin resistance and conditions ranging from cancer to cognitive decline, while describing physical indicators that may signal insulin-related problems.
The discussion explores how ketogenic diets can shift the body from glucose to fat burning, potentially improving brain function and reducing inflammation. Dr. Bosworth shares insights about ketone production, supplementation strategies, and dietary approaches for maintaining ketosis. She includes examples from her medical practice and personal experience, including a case where a ketogenic diet contributed to a patient's cancer recovery.

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Dr. Annette Bosworth explains that [restricted term]'s primary role is managing blood sugar and fat storage. When glycogen storage is full, [restricted term] converts excess glucose to fat. She warns that high [restricted term] levels, especially at night, can accelerate aging and increase disease risk. Signs of [restricted term] resistance include skin tags and darker, thicker skin patches. According to Bosworth, persistently high [restricted term] levels contribute to various conditions, including cancer, high blood pressure, and brain aging.
Bosworth describes how a "fat-forward" diet with under 20 grams of carbohydrates daily helps shift the body from glucose to fat burning. This metabolic shift enhances mitochondrial function and increases brain energy. She notes that achieving ketosis can take up to 15 days due to previously high [restricted term] levels, and recommends monitoring ketone levels with meters and urine strips.
Both Bosworth and host Steven Bartlett report significant cognitive benefits from ketosis, including improved focus and brain function. Bosworth explains that ketones are a cleaner fuel source that can cross the blood-brain barrier even with [restricted term] resistance. She notes that ketosis also aids in muscle repair and reduces inflammation, citing a military study showing significant power improvements in personnel following a ketogenic diet.
Bosworth recommends supplements like creatine and methylene blue to enhance keto diet benefits, particularly for brain health and sleep. She advocates for sardines as a nutrient-dense food for maintaining ketosis, sharing success stories from her patients. The carnivore diet is presented as a more restrictive approach to maintaining ketosis.
Bartlett reveals his commitment to ketosis through co-ownership of a ketone supplement company. Bosworth shares her mother's remarkable recovery from terminal cancer using a ketogenic diet, which led to a 70% drop in cancer markers within six weeks. She also discusses her personal legal challenges and continued dedication to helping patients despite facing imprisonment, eventually having her record expunged due to extensive community service.
1-Page Summary
Annette Bosworth, a physician and expert on metabolic health, explores the critical role of [restricted term] in the body and the detrimental effects of [restricted term] resistance.
[restricted term]'s primary role is to transport glucose from the bloodstream into cells. When a person's glycogen storage in cells and the liver is full, Annette Bosworth explains, [restricted term] prompts the body to convert excess glucose into fat. Additionally, [restricted term] is crucial in managing the fate of every fat molecule within the body.
Bosworth also discusses the negative impact of eating late at night, which can stimulate excessive [restricted term] production and be associated with faster aging and a higher risk of chronic diseases. She highlights that the timing of meals is essential, as high levels of [restricted term] present throughout the night can be the beginning of the disease process. In periods of low food intake when glycogen stores are depleted, [restricted term] levels can decrease, prompting the body to produce ketones.
Signs of [restricted term] resistance include skin tags, often found in armpits or groins, and acanthosis nigricans, where the skin becomes darker and thicker, particularly on the back of the neck or elbows. Another sign Bosworth mentions is a lack of hair on the lower extremities due to the body not sending resources to those follicles, as high [restricted term] levels have persisted for a long time.
Bosworth describes how persistently high [restricted term] levels promote the growth of inflammation and diseases, adding an accumulation of cellular 'trash' in the body that isn't cleared out until [restricted term] levels lower. She points out how high [restricted term] contributes to numerous chronic di ...
Insulin Regulation and Insulin Resistance
Annette Bosworth and Steven Bartlett delve into how the ketogenic diet aids in fat burning and boosting ketone production, which in turn can improve cognitive and physical performance.
Annette Bosworth discusses how a "fat-forward" diet is essential to encourage the body to make ketones. When [restricted term] levels are lowered, the body shifts from running off glucose to burning ketones. She explains that high [restricted term] causes the body to store glucose as glycogen, which blocks fat burning and ketone production until these stores are depleted. This shift to ketone production begins once the glycogen stores are exhausted.
Bosworth advises keeping carb intake under 20 total grams of carbohydrates to prompt the body to switch from glucose to fat as its primary fuel source. Benefits of this metabolic shift include enhanced mitochondrial function and increased energy in brain cells, implying a boost in cognitive performance. She explains that a ketone meter reading of 0.5 or higher is an indicator that the body is burning fat.
Bosworth felt the notable improvements in her mother’s condition after deploying the ketogenic diet as a strategy against cancer. Moreover, she outlines the gut-brain connection and how a strong, healthy microbiome, bolstered by ketones like butyrate, can have cognitive benefits. She also reflects on the transformation seen in her mother’s cognitive and physical state after adopting the ketogenic diet.
Bosworth puts her patients on a diet with 20 total carbohydrates per day to reach ketosis but indicates it can take up to 15 days to start producing ketones due to the previously high [restricted term] levels. She emphasizes the importance of monitoring ketone levels using ketone meters and urine strips and recounts her personal difficulties achieving ketosis after childbirth and a decade of high [restricted term] levels. Her breakthrough into ketosis came after a fasting and 22-mile hike.
For people in their 20s, such as her son who leveraged the diet for focus in law school, she advises cutting carbs to initiate ketosis. Bosworth mentions that typically, ketone production begins about ten days after restricting carbs to 20 per day. She suggests that individuals start with food and menu planning in the kitchen before moving to the gym to induce a ketogenic state.
In a three-week course, Bosworth teaches how to ensure abundant ketone production on an advanced ketogenic diet, which includes a day of eating only sardines to push satiety and nutrient de ...
The Ketogenic Diet and Ketone Production
Annette Bosworth and Steven Bartlett discuss the potential benefits of ketosis on both cognitive function and physical health, with a focus on how ketosis can improve healthspan and lifespan, particularly for individuals with chronic diseases.
Annette Bosworth and Steven Bartlett both testify to the cognitive benefits they've experienced while in a state of ketosis. Bosworth suggests that managing [restricted term] through dietary timing is vital for cognitive functions such as memory and overall performance, emphasizing the dangers of eating late at night for brain health. She claims that cells, including those responsible for hair color, become healthier on a ketogenic diet, an effect that may extend to neurons, improving brain function and energy levels.
Bosworth notes that ketones are a cleaner fuel with less byproduct, existing in an antioxidant state and able to penetrate the blood-brain barrier even in the face of [restricted term] resistance. She shares that as a doctor, she feels a significant difference in her brain power, concentration, and mood control when in a ketogenic state. Bosworth highlights that her son, who's attending Georgetown Law School, noticed an increase in focus while in ketosis, and associates peak brain performance with preventing or mitigating conditions such as early signs of Parkinson's disease.
She emphasizes that many chronic problems result from the brain accumulating too much "trash," affecting mental engagement and the ability to find joy, advocating for "taking out the trash" in the brain to improve function. Meanwhile, Bartlett appreciates the ability to speak, articulate, and maintain focus better during his podcasts when in a fasted ketogenic state.
Studies indicate that in dementia, particularly Alzheimer's, the brain struggles to use glucose efficiently, and ketones offer an alternative fuel. Ketones may protect neurons from damage and support the growth of new neural connections, improving [restricted term] sensitivity and potentially reducing the risk of Alzheimer's, sometimes called type 3 diabetes. Bosworth recounts the marked improvement in cognition for a patient with Down syndrome and Alzheimer's after starting a ketogenic diet, being able to say a three-syllable word for the first time.
Annette Bosworth states that being in a ketogenic state is key for rapid muscle repair after intense exercises like weightlifting, as it significantly reduces inflammation. As people age, the inflammation that aids in muscle repair tends to become chronic, leading to pain and de ...
Cognitive and Physical Benefits of Ketosis
Supplementation and specialized diets are practical approaches that individuals adopt to enhance or maintain the state of ketosis, which is the goal of a ketogenic diet.
Annette Bosworth promotes using supplements like creatine and methylene blue to enhance the benefits of a keto diet. Bosworth takes creatine to support brain health, citing its focus-enhancing properties, particularly for individuals with ADHD. She also notes creatine's ability to help reset sleep patterns, reduce the effects of jet lag, and cites studies involving Navy SEALs who are sleep-deprived.
Bosworth herself takes creatine and methylene blue together daily for their brain benefits and supports her physical activities, which include CrossFit-style workouts. She mentions methylene blue's capability to energize the brain by aiding mitochondrial function.
The carnivore diet is implied as an effective strategy to maintain ketosis due to its very low carbohydrate intake. This approach aligns closely with a ketogenic diet but is more restrictive.
Bosworth promotes sardines as a key food in maintaining ketosis and feeling satiated due to their high fat and protein content and nutrient density. She recommends them for individuals struggling to increase ketone levels and sustain ketosis, despite their pungent smell. Jane, a patient who underwent Bosworth's 21-day program, consumed only sardines for 30 days, leading to significant improvements in health and eating habits.
Bosworth also recounts the positive effects of a carnivorous ketosis diet including sardines on patients with irritab ...
Supplementation and Dietary Approaches to Support Ketosis
Podcast host Steven Bartlett and Dr. Annette Bosworth engage in a revealing discussion about their personal experiences with the ketogenic lifestyle and the transformative impact it's had on both of them.
Steven Bartlett reflects on the importance of physiological condition in determining health outcomes, relating it to the increased risks associated with being overweight during the pandemic. Bartlett is heavily invested in the ketogenic lifestyle, so much so that he co-owns a ketone supplement company. He talks about his personal performance improvements while in a ketogenic state and shares his experience with Ketone IQ, an exogenous ketone product that impressed him enough to invest in the company and take a co-ownership role. He also promotes the product with a discount code, demonstrating his commitment to ketosis.
In an impactful personal anecdote, Annette Bosworth shares the story of her mother's health restoration through a ketogenic diet following a terminal cancer diagnosis. Bosworth describes the ketogenic diet's crucial role in preparing her mother for chemotherapy, noted by a 70% drop in cancer markers after six weeks, exceeding the expected results of chemotherapy alone. Her mother's rejuvenation and return to community roles and activities underscore the potential of the ketogenic diet to dramatically impact health ...
Personal Anecdotes and Case Studies
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