Today, I review, link to, and excerpt from Dr. Boz‘s “95% of you are doing keto wrong. Here’s how to do it right”.
All that follows is from the above resource.
Transcript
95% of you do keto wrong. Here’s how you
do it right. As a doctor, I’ve guided
thousands of patients to a complete
reversal of their medical problems using
the ketogenic diet. And now, I’m finally
giving you my complete step-by-step
framework presented in full with no
steps skipped. Whether you’re suffering
from chronic disease, insulin
resistance, or just a little belly fat,
this video is for you. Step one, eat
every 2 to four hours. Okay, let’s be
honest. This is where most Americans
live. This is the starting line. Your
body is fueled entirely on glucose, and
you are a slave to your next meal. You
have to refuel every few hours to avoid
that dreaded blood sugar crash, which
leaves you feeling tired and irritable
and foggy. In this state, your body
never ever fuels on a ketone. This
environment grows medical problems that
I see every day in my clinic. But I
include this step for a critical reason.
Nobody is perfect. Life happens. And
even if you fall off of the wagon, you
never fall so far off that we can’t keep
you on the map. When you’re ready, take
a deep breath, put your chin up, and
proceed to step two, which is where the
work begins. Eat less than 20 total
carbs per day. This is the first rule of
keto. We drop your total carbohydrates
to under 20 gram a day. And this is the
only number that counts right now. Not
net carbs, not calories, not fiber. only
focus on your daily total carbohydrates
intake being under 20 total grams. This
forces your body to burn through stored
blood sugar. And at the same time,
you’ll find you can naturally go longer
between meals. Unlike the roller coaster
spike and crash that you get eating
carbs, eating high fat provides a stable
satiety for 6 to 8 hours. This is
hormones working for you. Chronically
high insulin has locked your own body
fat away in storage, and you must
consume the fat to restore those
fat-based hormones and send a signal
that it’s safe to start burning fat for
fuel. Your body’s chemistry does the
heavy lifting. You just have to eat the
fat. Start your day with bacon and eggs.
If you scramble the eggs, add the full
fat cheese. If you don’t want bacon, add
80% ground beef soaked in butter. Eat
until you’re full. Most keto beginners
are tempted to skip breakfast. Don’t do
this. Even if you’re not particularly
hungry in the morning, force yourself to
eat breakfast for this step
specifically. Leaving your house into a
world of temptation is a recipe for
disaster if you aren’t completely
satiated. And at the beginning, you need
all the help you can get. Your first
tool is the simple urine ketone strip.
Keep them in the bathroom and test every
time you pee. By day four of eating less
than 20 carbs per day with high fat,
most patients will see this little strip
turn pink, indicating that your body has
successfully made ketones. This is the
first win. If it takes you longer than 4
days to turn that strip pink, it could
be a few causes. The first is your
ketone strips are bad. If your strips
are more than a month old, it’s likely
they got exposed to that fresh air and
time will deactivate the sponges. So,
buy a new canister. The second one is
you’re drinking too much alcohol.
Alcohol is a fuel just like glucose and
ketones and it will be preferentially
burned by your mitochondria along with
the fact that you might be tempted to
eat more carbs than you should when you
drink. This will block ketosis. The best
answer is to abstain completely for the
first 6 weeks. If you choose to continue
after 6 weeks, stick with those low carb
cocktails or dry wine. I even had
patients mix their distilled alcohol
drinks with ketones. Not my idea, but it
worked. When they felt the need for
alcohol, ketones added to those
distilled drinks seem to derail them the
least. Number three is you’re sicker
than you thought. Insulin resistance,
type 1 diabetes, or type 2 diabetes can
all affect how long it takes for your
first ketone. The answer is the same for
all of these problems. Keep going. You
will make ketones. If you keep eating
the fat and less than 20 total carbs per
day, you’ll get there. Number three is
accidentally miss a meal. This is this
magical moment that I learned from
patients. After several weeks, maybe
even up to 10 weeks, you’ll be busy at
work. You’ll look up at the clock and
realize it’s 3:00 in the afternoon and
you completely forgot to eat lunch. You
weren’t hungry. This is the first step
that you’re becoming keto adapted. That
satiety, that appetite suppressant came
from hormones that you make from fat.
And your appetite is decreasing because
you are successful at burning your own
body’s fat in between meals. Do not
force this moment. This step asks you to
listen for a very important signal from
your fat-based hormones. If those
fat-based hormones are wimpy, you are
due for failure. If you take on the next
step before you feel this, do not look
at the scale. The most important signal
right now is to succeed at the absence
of hunger. And some patients haven’t had
that for decades because the next step
is where you take over the work from
your chemistry. Right now till this
point, the chemistry carried you. But be
prepared. You need a little willpower
for the next step. Four is to eat two
meals per day. What happened by accident
in step three now becomes a conscious
choice. You are no longer a victim to
your hunger. You are in control. You
choose to eat two meals per day. You are
no longer the slave to the next meal.
Your body is so well fueled by its own
energy stores that it’s simply does not
need to be fed every few hours. More
aptly, this step could be called two
bololises of food per day. The word
bolus means anytime you’re chewing on
food. We don’t make the distinction
between meals and snacking on this plan
because your body does not know the
difference. Yeah. Anytime you put food
in your mouth, you’re stimulating
insulin. This is particularly true with
those who’ve been the sickest.
Carbohydrates spike insulin the highest,
protein is a little less, and fat is the
smallest bump, but it’s still present.
Those insulin spikes, no matter how
small, are the enemy of progress. Choose
to sit down and eat a meal twice per day
and keep your mouth closed to food the
rest of the time. The goal here is
consistency. Do this successfully for
seven days in a row before you move on
to the next step. Number five is called
168. Now we formalize your two meals
into a schedule with a classic
intermittent fasting protocol called
168. This means that you will eat all of
the food inside an 8-hour window. For
the other 16 hours, you fast. No eating,
no snacking, no chewing. And that does
mean you gum chewers have to come to a
truth moment. That is 16 hours nothing
but water and salt. However, at this
stage we do not count the fat in your
coffee as starting your eating window.
Keep your coffee filled with fat. That
butter, heavy cream or MCT oil in your
morning drink is your training wheels.
It keeps you satiated and provides
steady energy in this phase. A common
question I get is when should my 8 hour
window start? The answer is simple. Pick
one that fits your life and stick with
it. If you eat supper with your family,
your window might not begin until noon
and end at 8:00 p.m. a night. The key at
this stage is consistency, not perfect
timing. We will fine-tune that timing
later on in this continuum. Succeed at
168 for at least 2 weeks before
advancing to the next step. And that’s
called number six, advanced 168. You’ve
mastered the 16-hour fast with the help
of your fatty coffee, and now it’s time
to take the training wheels off. In this
step, you clean up your morning drink.
For the full 16 hours of your fast, you
consume no fat, no MCT, no butter, no
sweeteners, no calories, only salt,
water, black coffee, and plain tea are
allowed. Your body is now efficient at
burning its own fat. You don’t need to
give it extra fuel in the morning. It’s
time to let your own fat stores do the
work. This is where you begin to
practice a technique that I call land
and squeeze. You’ve successfully landed
on a consistent 8-hour eating window.
Now you earn the right to squeeze. You
can start to progressively shrink that
window. Maybe this week the window is 7
hours. And in a few weeks, you might
even be comfortable with 6 hours of
eating and 18 hours of fasting. You are
gently guiding your body towards a
longer daily fast, letting your
chemistry lead more of the day. It’s
important to understand that this phase
can be a destination in and of itself.
While it may only take a few months to
get here, you can live in the advanced
168 stage for years, continuing to
improve your health. Do not be in a rush
to get the next step. This is where deep
steady healing begins. And now we have
number seven called 23 in one. Welcome
to OMAD. One meal per day. Now you are
shrinking your eating window to just one
hour a day. And for 23 hours, you have a
clean fast. Not only does this amplify
the healing benefits of fasting, but you
start to practice using the muscle of
saying no to food. This is also where
your tools need an upgrade. If you have
not already, it’s time to graduate from
those urine ketone strips to blood
ketone meters. Urine strips told you if
you were making enough ketones to pee
out excess energy. The blood meter tells
you how much ketosis you’re in, which is
a crucial part of this advanced
metabolism. Number eight is called just
that, advanced 231 or advanced OMAD. At
this stage, we fine-tune your OMAD
schedule to align with your body’s
natural clock. You will move your single
eating hour to be within 11 hours of
sunrise. This matches your metabolism to
your circadian rhythm while maximizing
the benefits of this whole equation.
This is where the mental game gets real
and doing this with a community makes
all the difference. Your key measurement
now is the Dr. Bos ratio. That’s the
blood glucose divided by the blood
ketones, which you will check first
thing in the morning and again right
before you eat. This gives you that peak
into what your insulin is doing on that
day. Next, number nine, the 36-hour
fast. Now, we move from building your
baseline metabolism to strategically
stressing your metabolism for greater
healing. A 36-hour fast is your first
step, and it’s simple. You eat dinner on
Monday night, get up on Tuesday, do not
eat at all on Tuesday, but on Wednesday
morning, you get breakfast. By starting
in the evening, you get to use two
cycles of sleep to your advantage. And
it really is doable. This is an advanced
tool, and a word of warning is critical
here. If you are on any medications for
blood pressure or blood sugar, you must
do this under the doctor’s supervision.
your medical needs will change and you
can have a dangerous drop in your blood
pressure or blood sugar if you don’t
adjust them properly. And number 10, a
36-hour fast without the celebration
meal. And personally, this was a really
hard step for me. This step is purely
psychological. You must break the mental
connection that says fasting is a
punishment that earns you the reward of
a splurge because it’s not. The fast is
a tool for healing. After your 36 hours,
you simply return to a normal pattern
eating without a celebration meal. And
this demonstrates true mastery over that
food psychology. This is a great time to
lead a group fast with your tribe. And
now number 11 is the 48 hour fast. And a
48-hour fast is logistically different
from a 36-hour. While the 36-hour fast
shifts your eating schedule, a 48 hour
keeps your meal time consistent. And
this was much easier for me. You eat
dinner on Monday night, fast all of
Tuesday, and then eat dinner again on
Wednesday night. It’s a simple,
repeatable pattern that is safe to try
up to twice a week. And finally, we have
the 12step, which is a 72-hour fast.
This is the pinnacle. A 72-hour fast is
a powerful therapeutic tool for the
major metabolic reset. This is not for
everyday life. This is a focused
challenge. The protocol is to fast for
72 hours once a week for eight
consecutive weeks. The rest of the week,
you return to a comfortable baseline,
whether that’s a 168, an 186, a 24, or
an OMAD. This sustained intermittent
stress pushes your body to its peak
state of healing and repair. And this is
where the most profound transformations
happen. What do you eat on a ketogenic
diet to reverse insulin resistance?
Well, before you go to the grocery
store, click here to watch my food
