The Diary Of A CEO with Steven Bartlett

Episode: Insulin Doctor: This Is The First Sign Of Dementia! The Shocking Link Between Keto & Brain Decline!
Date: November 24, 2025
Guest: Dr. Annette Bosworth (Dr. Boz), Internist and Ketogenic Diet Expert

Episode Overview

In this enlightening conversation, Steven Bartlett sits down with Dr. Annette Bosworth, also known as Dr. Boz, to explore the critical—yet largely misunderstood—role of insulin in brain health, chronic disease, and aging. Building on Dr. Boz’s years of experience managing complex chronic illnesses, the episode delves into the connection between insulin resistance, cognitive decline, and why ketogenic diets might hold the key to prevention and remarkable personal transformation. With deeply practical advice, personal anecdotes, and the science behind metabolic health, this episode is both a wake-up call and a guide to radical health improvement.

Purpose:
To equip listeners with new awareness and actionable steps to prevent brain decline, address chronic illness, and optimize both mental and physical performance—primarily by understanding insulin and the power of ketones.

Key Discussion Points & Insights

1. The Hidden Epidemic: Chronic Disease & Brain Decline

• Internal Medicine and "Taking Out the Trash"

  • Dr. Boz explains the role of an internist: "If the internal medicine team can't figure it out, you're gonna die." (04:08)
  • Problems like high blood pressure, weight gain, and brain fog are "signals that your body has made more trash than it cleaned up." (04:46)
  • Chronic high insulin is behind most patients' problems, often years before formal disease sets in.

• The Power of Ketones

  • "Most of the reasons people come to see me could be reversed if they knew how to make ketones on a regular basis." (03:26)
  • Making ketones regularly is likened to routinely "taking out the trash" in the body and brain. (05:13)

2. Insulin: What You Don’t Know Can Hurt You

• Insulin Explained: "Insulin insulates...it makes you fluffy."

  • "When it's in excess, it will store energy for when you go through a famine. It will also cause you to grow." (12:02)
  • High insulin stores excess energy as fat but also increases inflammation and cellular "trash."

• Most People Are Unaware

  • "You need to take the trash out routinely. Which means that insulin, which has been smoldering higher than you think... hides that the debris is being made. And you don't know it." (14:43)
  • The chronic, unseen damage of high insulin leads to fast aging, brain fog, and is linked with depression, Alzheimer's, Parkinson's, and autoimmunity.

3. Signs of Insulin Resistance

• Physical Markers
  • Abdominal weight gain ("abdominal girth"), skin tags, darker thicker skin on the neck (acanthosis nigricans), hair loss on the toes and legs.
  • "Skin tags... they'll fall off when your insulin's lower." (19:39)
  • "As my patients age... they just stop growing hair on your toes." (21:02)
• Functional Markers
  • Needing to eat every 2–3 hours, constant fatigue, inability to stay focused for extended periods.

4. Ketogenic Diet: How and Why

• Transitioning to Ketosis

  • "You cannot make a ketone if your insulin's high." (15:05)
  • Dr. Boz explains the lag for some people: it can take 1–2 weeks (or more) to deplete glycogen stores and produce ketones, especially for the insulin resistant. (18:34)
  • Personal story: "I tried to get into a state of ketosis for like nine months… I almost gave up thinking this is junk science." (29:44)

• Ketone Benefits

  • Cleaner, longer-lasting fuel with less byproduct and lower inflammation. (24:45)
  • "Burning ketones is an antioxidant state... especially inside the cell." (24:45)
  • Ketones can cross the blood-brain barrier independent of insulin, providing sustained mental energy even when the brain is insulin resistant. (25:09)

  Notable Quote:

  • "Name a game where you don't use your brain. There isn't one. If you're looking at performance... the most discipline, the less impulsivity. All of those things improve when that brain is being fueled with ketones." — Dr. Boz (25:25)

5. Ketogenic Diet, Exercise & Performance

• Repair & Strength Gains
  • Ketogenic state dramatically reduces recovery time and inflammation after strenuous workouts, especially as you age. (32:16)
  • Long-term keto adaptation can boost muscular power up to 50% over 18 months compared to non-keto peers (35:46).

6. Keto and Brain Degeneration

• Direct Link to Dementia & Alzheimer's

  • "When I hear [about getting lost driving], we are 15 years too late. It is 15 years of building up trash in that brain." (35:31)
  • Early and ongoing ketogenic states can halt or reverse cognitive decline—a Down syndrome patient reversed Alzheimer’s symptoms on keto within three weeks, including previously impossible speech. (37:27)

  Notable Quote:

  • "Her world opened up again because her brain, which had Alzheimer's, no longer had that diagnosis." — Dr. Boz (38:31)

• Scientific Context:

  • "Studies show that in dementia, especially in Alzheimer's, the brain struggles to use glucose efficiently. Ketones provide an alternative, cleaner fuel source." — Steven (39:03)

7. Monitoring Your Keto State

• Blood Ketone Testing Demonstration (41:03)

  • Blood ketone ≥0.5 mmol/L (with non-high glucose) indicates good ketosis.
  • "When you look at the combination of them, I do a little math and say your Dr. Boz ratio is like 95. So you are burning fat right now." (41:55)

• Sardine Fast and Practical Keto Habits

  • Sardine-only fasts force ketosis thanks to high-quality fat and protein, offering a simple, affordable protocol. (56:22)
  • For stubborn cases, "Eat butter for a day. That's 100% fat." (59:55)

8. The Keto Continuum

• 12-Step Process to Consistent Keto
  • Begins with eating every 2–3 hours and progresses to intermittent fasting (16:8 up to 23:1), ending with advanced fasting of 36–72 hours for deep metabolic reset.
  • Many "fall off" and rejoin at earlier steps; monitoring is key, not just diet alone. (48:43)

9. Common Myths: Women, Fiber, Supplements

• Women & Keto:
  • Women can and should do keto, with proper adaptation. "If you have too much insulin in your body, you have to do this to get the pancreas to make less insulin over time." (52:44)
• Fiber & The Gut:
  • "Fiber is for farting." Dr. Boz downplays the necessity for fiber, noting that a carnivore diet with fatty fish can improve gut health and mood, contrary to conventional wisdom. (64:07)
• Key Supplements:
  • Vitamin D, magnesium, Omega-3. Dr. Boz highlights those especially for people on low-carb/carnivore, emphasizing most are deficient nonetheless. (68:40–72:10)

10. Exogenous Ketones and Their Role

• Jump-starting or Maintaining Ketosis
  • "When you are making ketones, your body makes more ketones. So if you jumpstart it by swallowing some, you get better tomorrow." (74:17)
  • Useful for those coming off a carb binge, very insulin resistant, or under cancer treatment. (75:03)

11. Cancer, Chronic Illness & Personal Stories

• Cancer and Keto: The Warburg Effect
  • Dr. Boz's mother ("Grandma Rose") thrived after switching to keto and had a 70% reduction in cancer markers within six weeks, far superior to chemotherapy expectations. (79:31)
  • While not a cure, keto creates an environment hostile to cancer and supports resilience during harsh treatments. (82:13)

12. Motivation, Mindset, and Overcoming Crisis

• Discipline and Why-Power
  • Motivation often surges from crisis, but long-term change requires a deep, personal "why."
  • "Your biggest failure, your biggest insecurity can be your power by reframing it… That’s how people stay motivated. It's a truth serum." (92:43)

Notable Quotes

• On the Modern Problem:

  • "All of these are signals that your body has made more trash than it cleaned up. And there were some rules to humans that you missed." — Dr. Boz (04:46)

• On Ketones & Brain Power:

  • "When you're in a ketogenic state and not in a ketogenic state, the brain power, the concentration, ... It is a night and day difference." — Dr. Boz (26:28)

• On Motivation:

  • “Your biggest failure, your biggest insecurity can be your power by reframing it.” — Dr. Boz (92:43)

• On Fiber & Gut:

  • "Fiber is for farting." — Dr. Boz (60:22, 64:07)

• On Keto as a Life Practice:

  • “The ketogenic diet doesn’t fail if you just follow the chemistry. The ketogenic diet fails when you have humans who've had wounds, who've had a history, who have stress, who don't sleep.” — Dr. Boz (60:37)

Timestamps for Key Segments

• 03:26 — Ketones: The missing piece in chronic disease
• 12:02–14:43 — What insulin is, how it harms, and why you might not notice
• 19:39 — Visible signs of insulin resistance (skin tags, hairless toes, dirty neck)
• 24:45–25:25 — Ketones: Cleaner brain fuel for mood, focus, and performance
• 35:31–38:31 — Dementia's first signs & ketogenic diet reversing Alzheimer's symptoms
• 41:03–43:15 — Live ketone & glucose testing (Dr. Boz ratio explained)
• 48:43–52:28 — The Keto Continuum: How to truly transition and monitor progress
• 56:22–57:24 — The sardine fast and practical interventions
• 68:40–72:10 — Essential supplements: Vitamin D, magnesium, Omega-3
• 79:31–82:13 — "Grandma Rose": Personal story of keto in beating cancer
• 92:43 — Harnessing insecurity for lasting motivation

Memorable Moments

• Dr. Boz describes her own struggles trying to enter ketosis ("I almost gave up thinking this is junk science." 29:44).
• Example of a Down syndrome patient reversing Alzheimer’s symptoms in three weeks on strict keto (37:27 onward).
• Real-time ketone/glucose testing and live critique of Steven’s and his team's metabolic health (41:03; 45:09).
• Dr. Boz’s reflections on systemic obstacles and her legal battle, which resulted in resilience and renewed purpose (98:02–106:41).
• "Fiber is for farting" — a candid rebuke of mainstream nutrition advice (60:22, 64:07).

Summary Table: Practical Takeaways

| Issue/Concern | Sign/Metric | Dr. Boz’s Prescription | Key Point | |-------------------------------|----------------------------------------|-------------------------------------------|------------------------------------------------------------| | Brain fog, aging, mood swings | Waist size, skin tags, hair loss toes | Track carbs (<20g), measure ketones | Chronic high insulin is to blame—ketones reverse trend | | Fitness plateau, poor recovery| Soreness, low power post-40 | Commit to keto for 6–18 months | Long-term keto adaptation boosts power & recovery | | Motivation | Cycle of relapse/failure | Connect to deep 'why,' address root issues| Mindset is critical for sustained transformation | | Cancer/cognitive decline | Diagnosis or early symptoms | Aggressive ketosis, monitor ratios | Metabolic flexibility and ketones aid resilience and outcome| | Inadequate keto results | Ketones low despite low-carb diet | Eat more fat (e.g., sardines, butter) | High insulin can block ketosis—fat intake helps transition |

Closing Reflection

Steven thanked Dr. Boz for her vulnerability, clarity, and the practical legacy she’s building with her YouTube channel and books. They discuss how true transformation requires knowledge, data, and deep personal motivation—not just prescriptions.

Steven Bartlett:
"You've risen like a phoenix and created so much incredible work... Please do keep going." (110:58)

Dr. Boz:
"God bless you. Thanks for having me here. I'm really excited to be on your show." (111:05)

Further Learning

• Dr. Boz’s Books: "Keto Continuum," "Any Way You Can"
• Dr. Boz’s YouTube Channel: [Link via show notes]

For anyone struggling with chronic illness, cognitive decline, or just stuck in poor energy—this is required listening. The dialogue demystifies insulin, ketones, and the why-power that drives true change. Evidence, stories, and stepwise guidance converge for a genuinely hopeful but challenging roadmap to better health.