Why This Breakfast is NON-NEGOTIABLE for Insulin Resistance

Hello everybody. Most days I do not eat breakfast. Yes, I don't eat breakfast. But when a patient comes in and says, "Hey doc, I am stalling. My ketones are on the floor. My glucose is slowly creeping in the wrong direction." I tell them, "Eat breakfast. Eat a high-fat, high-protein breakfast, even if you're not hungry." And they might follow that for a couple of days. But if you check back in at about 10 to 14 days, they're off the rails again. They cannot stick to it. And I think that fail teaches us more about how this process might look good on paper, but tonight's show is going to show you why breakfast is one of the biggest ways for you to assess success on a keto diet and how you're going to learn well, what does perfect enough look like for you if you're in a stall. Stick around to the end because I'm doing this show because I need to push reset on a couple of things and there's a couple of truth serums coming at the end of the show where I show you the live answers of what my continuous glucose meter showed me in the last week. And I'm beta testing a continuous ketone meter. And boy, does that tell on me.

All right, thanks for tuning in. I did check my numbers right before the show started. Glucose 66, ketones 3.1. I'm definitely feeling a little high, like woo. But it is uh not because I fasted really good. In fact, you're going to see that at the end that I totally messed it up and then I I'm pushing reset, but I started the reset last week. So, yeah, you're going to feel right at home. If you're having a struggle bus, I will lead the way. [laughter]

Uh, I do want to just say a special shout out to the folks that are um uh that have said hello from different parts of the country. Uh, several of you uh showed up at the Pinch Chasers this morning. Again, I just have a really special thanks for the folks that do that and help me uh just stick to the um the the teachable moments and then it's your stories that really do help me do a better job. So, yes, we are talking about something that I I really think um if you're new to keto like within the first six weeks, this might be a bit of an advanced lesson for you. But if you've been to keto and then you've done that thing where you go on and off and you're a little better and you're a little worse, then you're gonna love this because uh it is that zone that I do a really good job of teaching in Keto Continuum, the book that I wrote, the workbooks that I uh that I use to teach that. Yet, in that process of getting people from a disaster and then to the best, there's this middle zone. This part where I didn't even get of it a whole number on the keto continuum. It's around keto continuum 6.5, but it's when they graduate from keto continuum 5 to keto continuum 6.5. So for those those folks that have been out um uh around the channel for a while, you'll know that that means keto continuum 5 is a season of of 16:8, which means you eat for eight hours in the day and you do not eat for 16 hours in the day. And how you how that lands in your schedule and really how your numbers first thing in the morning show you is it working for you? Are you getting better or is it going in the wrong direction? Which so many people said, gosh, it worked for me for so long, I don't know why I can't get this to go in the right direction. So stick around. It has everything to do with breakfast uh and we are going to teach you why and how. How do I do that? And again, I led with, most days I don't eat breakfast. All right, here we go. Let's get over to my um uh yeah, iPad. Actually, I'll do that this way so you can see my head.

All right. So, here is a couple things I want to point out. We are starting at keto continuum five, which is 16 hours of fasting and eight hours of eating. And if you look at this uh slide, it's something I've used many times on the show. So, retaching what these lines mean seems like old news, but I do think it's important. The red line is your glucose. So you can see this patient is around a baseline of 100 and then those ketones, well, they're in this spot. They're slumping and they're doing great. They're doing a 16:8 and they have succeeded at this for the first chapter of their ketogenic change. That first meal shows up just around lunchtime, maybe. Uh, and then they don't really stop eating until somewhere near 8:00. The effect of that is still quite impactful on their body. And of as a result of that uh burst and valley and the timing of that burst and valley, those uh ketones are low. They are never getting to one. Uh, so again, nutritional ketosis 0.5. They are touching that a little bit in the middle of the night, but for the most part, their ketones are like 0.2, 0.3. Same thing many of you say as uh they as they um get into trouble. So, I see lots of comments on that.

All right. So, what happens next? Well, you write into the channel or you read the book Keto Continuum and we say, "All right, I need you to narrow up that eating window." So, you'll notice here that this eating time is a little closer to 7:00. The noon one still starts about the same time. Uh, I didn't draw in if they're doing much of anything for that morning drink. Uh, so we're just going to assume these folks are doing black coffee or minimal, very minimal uh fat in their coffee in the morning. But again, they're arriving at this part of the story uh with success. They've got some 70 lbs lost. We had a a few check-ins this morning that says, you know, but it worked. I got I'm I'm down almost 80 pounds. 70, 80 pounds. Another one lost 100 pounds. It's in this section where you get them to reverse the insulin resistance uh when they get stuck here. So, that first one, they took that eating window and, you know, they ate till 8:00 at night. Uh, then they ate till 7:00 at night. Now, you can see I've taken it to 6:00 at night. Still getting that first meal starting at around noon. And some of my folks, they eat at noon. Um, but um, actually, this was this is drawn at 2 o'clock. I'm sorry. So, 2:00 uh to this is uh this is to 6:00. So, now you have a 4-hour eating window. Again, people succeed at this and some people stay with a 4-hour um eating window eating window for the whole time. They don't need anything further. Good job. Carry on. Tune in to you know, one or two of these YouTube lives in the next two years. They are just doing great. But most people with insulin resistance get to this part and it doesn't unlock the fat cells anymore. They're really not raising ketones first thing in the morning.

So, we then uh tighten it even further. So, look at that. Now, you have that first um meal, that that meal just around the 2:00 mark. Uh, again, this one is around the uh 6:00 mark and that 4-hour window, nicely done. Notice what's happened over here is you now have ketones that have gone above that. They are not in the 0.5 when they're sleeping. That those ketones really do rise. And you're going to see my continuous ketone meter. What happens in my body. Uh, a really advanced ketogenic state even when I'm not fasting, people. And I had a I had a Fourth of July two days ago that was well, I'll show you the numbers. What happens at this one? Yeah, this was the um the one where they're eating at two and they're trying to be done at 5:00. This is where folks fail. Now, it's for a couple of reasons. That eating window is only 3 hours wide, which isn't bad. There's that could be okay, but it's that you end eating when most of the world starts eating. So that means if your if your eating window ends at 5:00, that doesn't mean you start eating at 5:00. That means you're done. The last bite is down the gullet in your stomach by 5:00 p.m. And it is much like telling that patient, go eat breakfast first thing in the morning, even if you're not hungry. And then you let them go into the wild and a few weeks later, they're not doing they're now they're doing worse. They're just they're really failing because it's this social contract that's really impacting their choices and and they've been able to really follow the rules up until this point. So that fail uh of a three-hour window starting at 2:00 and ending at 5:00 p.m. uh we say, let me let me back it up. Let's increase that time to this is I think a one o'clock uh opening window and this is again the 5:00 p.m. So they get to eat for a longer period of time and now that uh 4-hour window gives them back to the the season that they were successful at. But the real goal is focus on that 5:00 stop time. They're not going to be perfect at it first. They are going to struggle. But once you get that 14 days in a row, 21 days in a row that you quit eating at at 5:00 p.m., well, then we move to the next level. We go down a little bit further. This one is at 11:00 a.m. Uh, and this ends again. I think this one was 3:00 p.m. Uh, so looking at that again, it's a it's a nice um 4-hour window. They that that part feels safe. Um, and this might have been at the 4:00 p.m. Oh, and here is uh again, sliding those windows closer together and then graduating right here uh at 6.5 at one of the best uh signs of a 10:00 to 2:00 p.m. eating window.

Okay, let me just show you this in a different way. When you look at um where people reach out saying, "I'm stuck. I'm stuck." They are at a six-hour eating window and um their ketones are terrible. They're they're 0.2, 0.3. Doc, I don't know what happened. It must be menopause. I can't seem to get this to go. This was working forever and now it's not. And if you slide back to those slides, you'll see, yep, the ketones are sunk. You're not giving them enough time for insulin to undo because the bedtime, the last hour of I mean, the last bite of food is going in too late. Uh, so your digestion and those hormones that release fat are too high while you're sleeping. So we say, "Okay, next step down is a 5-hour eating window." 5-hour eating window. And they succeed at this for a little while. So now you've got a little shaved off at the end. Again, they don't really get hungry, uh, or they start to kind of get a little bit hungry at noon and can make it till 2:00 because they love the evening hours. In the evening is when you have the highest return of joy and pleasure and you know, the dopamine hit that you've practiced forever is eating later in the evening and we recognize that. I recognize that. I struggle with that. Um, but as you start to improve it, each of these chapters of lowering and and shrinking this eating window, you'll notice the opening time we're trying to keep the same for right now. Uh, we're really saying focus here. Focus on closing that eating window uh earlier by a little bit, by a little bit. And you don't do this for a night. You do this through a birthday, through a Fourth of July, through a temptation, a time where the social pressure is higher than normal. But it's not the first time you're reaching for, you know what, I'm just I can't eat this late. It really upsets my stomach. It really affects my health problems. You know, whatever words you need to to say. Uh, again, should be pretty well received in most people saying, "Look, I'm really trying to work on my health. I can't eat this late. Please don't offer me that." Uh, makes them uncomfortable, but hang out in the moment. And this is the fail. This is the part where uh I've seen it many, many times is when they get this down to a three-hour eating window and they're playing with the simp the end time of 5:00 p.m. So, we say, "All right, undo. Push undo. Take it back to four hours." So, here you had four hours and we're going to go back to to four hours, but we're going to stick to that ending of 5:00 p.m. And this is uh it's telling. This is very uh it's a I've seen this over and over and over again. We're now to a 4-hour window and the first week they do it well. I'm going to show you what mine looks like here in a minute because once they succeed, once they get to that rhythm that okay, I have I have stopped eating at 5:00 p.m. for the better part of two months. I mean, it it usually they stumble at the beginning. So, I'm looking for a full three to four weeks of consistently stopping eating at that hour and and you're looking for trouble. You're looking for temptation. Can you get through it? Do you have the skill set? And I I often talk about this as maturity around food. Can you make those more mature decisions around food? And I'm saying not always me. Uh, as I look at struggles for uh what to do with this uh this broken um set of ketones uh and we're struggling around breakfast. Um, I I I I tell people, look, uh you're going to struggle and you'll know the struggle is over when the numbers get better. Uh, if it was that easy, everybody would be on a ketogenic diet. So, then we're we're getting to the final two steps down here of 11:00 to to uh 11:00 a.m. to 3:00 p.m. and then the ultimate 10:00 to 2:00.

All right. So, there's two things I want to teach about before I go to the next step. And one of them was last week I introduced this and many of you challenged um the um uh the the system. Uh, as you go to bosmd.com, we have a bot. So, I wanted to show you how this bot could work uh in real time uh for questions just like what we're struggling with. Now, again, be nice. This is only a week old. Uh, we've been working on it for a long time. But here, if I would ask the bot, um, what does Dr. Dr. Bos say about eating breakfast? And then see what it says. And what I want you to see is let's hope I I um give. Oh, it doesn't like that. Let me try one more time. Uh, let's say um uh if I am stalled, can I eat or should I eat breakfast? All right. See what it does there. Uh, again, I didn't uh this is a live on the site. I didn't um waiting for a team. Oh, it's ask. Oh, once I escalated, it's going to need a teammate. So, that's a real person. You know, I tested this right before the gal went home. It wasn't this question, though. So, um All right. So, let's see if it does better for you by you guys typing in questions for that. But this is the dream of what it should be able to do is say there are articles out there that I have talked about. There are videos out there that I have talked about and as we perfect this um the questions get linked to um sources. So what I want I wanted to show you is um what is the Dr. Bos ratio? Let's see if I can do that. I think once I trigger that it needs a person, it might always need the person and she just went home about 15 minutes ago. Uh, so it might it's waiting for a teammate. All right, so I triggered it with in real time. Welcome to a live show. >> [laughter] >> Uh, [clears throat] and let's get back to what are you going to do about a um a stalled process when um when the the cliffnotes answer is supposed to be, hey, um do you have uh should you be eating breakfast? Should you be eating breakfast? Uh, all right, let's go back to our slides um over here.

So yes, uh one of my ways to look at this um uh the process of where does your eating window fit? Um I like to point out the place where people fail is when they shrink it to three hours and when they put that ending time at 5:00. It just if you're going to find a fail in many of the people that um that have been through this, that one gets them. Uh the three-hour window and the um and the 5:00 p.m. because of what it does socially. So this morning when I looked at the pinch chasers and I I opened with a check-in question, do you eat breakfast or do you not? And if you look around the room, we have lots of people like me that struggle and they do well for a season and they then they don't do so well. And of course, coming to the pinch chasers just helps to say you're not alone. But let me show you what the experts were doing. So in the room, we had a couple of experts. And as uh you look at what their answers were, they were at the bottom here. They were this is what I do. I open up my eating window around 10:00. Uh, they had a very strict um uh set of rules for what they were eating. Uh, some of them was uh bacon, eggs, uh very the number, how much butter if they had if they needed a snack, they would actually have a little more bite of butter. They were really high fat. And I'll tell you, the folks that that land in this um uh section, they've got high stakes. They've got serious medical problems that I I really I pray for them. I want them to win. Um uh but I look at them and say, "Yeah, they're leading the room because their numbers are awesome." And when you look at the behaviors behind the changes they've had to make, uh they've had to look at a very a lonesome journey of a medical condition that it cannot be resurrected once it goes in the wrong direction. So they win. Um, but there were only a couple of them at the Pinch Chasers that were really in that season of wonderful numbers, really not eating after 2:00 in the afternoon and um, in many click cases, eating way better than than probably I've ever eaten.

So, let's go on to the rest of us. And this is where the rest of us hung out. You looked across that room and sure, most of us are not eating this late at night that we're in the Pinchasers room. Um, they we figured out that can't happen if you're really going to succeed at this. And it's in the numbers. You cannot get a good ketone number the next morning. They'll succeed for a while, but they really uh slide back into that struggle bus of low ketones and a slightly drifting glucose for for weeks. Uh uh, in fact, one of one of the uh places where when I look at what happens uh to habit creep, that creep of habits that you did a good job of uh, I like to point out that my habit creep creep habit creep was uh starting to well, it started to happen over the last about two and a half months. The year prior to that, I was hurricane homeless and my kitchen was not available and I set a rule that I wasn't going to go through fast food and I really was going to not do that thing that I did when a refrigerator was around. And that was I was not going to snack at night. I was not going to go to the fridge when the movie got a little scary or when I got a little irritated or when the when the soccer team totally lost to the opponents. I said it did last night. The first thing I wanted to do was go to the fridge and just have something something like it is such a reflex for comfort for me. And I can blame my parents like, "Oh, you know, too much swans ice cream as a kid on the farm uh whenever it was a sad day that we had ice cream." Okay, get over it. That's I can find a way through that. But the hurricane made me perfect because I didn't have a refrigerator at night for a for like nine months. And then after we moved, you know, got back and our house got back to semi-normal, it was a year. I did great for a year. And in that year, I lost like 20 pounds. Not a little bit when you're only 53. That and I'm a keto. I teach this stuff. Shouldn't I be perfect? No, I'm not perfect. And it's that silly habit at night that I kept opening up my eating window, having a little bite of something that was creeping back in.

Well, you might have followed the channel long enough to know that I had a severe injury about 6 months before the hurricane hit. I was um we were checking out a business that was um a sauna and it also had a cold plunge and I stepped out of one of those saunas where you step down out of a it's kind of like a barrel and the floor was wet and my leg slipped while my previous my other leg was still in the in the barrel under the door and I'm pulling on the door as my knee and leg go under the door and instead of your knee, yeah. It went like this. Oh, I could feel Oh, just telling you the story. It was so much pain and I I could feel something rip and I was just a crybaby for at least a week because it was swollen. It was bruised. I was like, "Oh, what did I do?" And then I I got over it. I got better. The pain went away. And especially during that perfection of uh of the habit of snacking at night, the pain in my knee was completely gone. But over the past couple of months, oh well, I've had habit creep. I've had this return of, oh, my numbers are fine. I'm doing fine. I'm doing so good. And then this habit, which is like, you know, once a month, and then it becomes a couple times a month. And now in the last two months, oh, it's terrible. Actually, quite terrible. Uh, and when I look at um the the problems of having uh a little bit of inflammation, nobody notices. I I mean, I can barely even say the word pain, but it's the slightest ache that starts to happen at that injury that reminds me, uh oh, I don't want to keep going in this direction. I mean, I have thousands of patient stories by now that say, this is not good. This is not good. Uh, so that habit creep has been back. At which point I have a social contract that I want [laughter] I want um my husband to be a good husband and say, "Let's let's do this together. Let's take um uh take charge of this." And I'm going to tell you about that right after I do a couple of announcements here.

All right. So, yes, the bot I want you guys using. Please go ahead and do that. I'm going to do one more little uh talk about Dr. Ba's favorites. Uh, I just want to say thank you for everybody who did watch last week's live. Probably one of my favorite lessons I've taught over the years. Um, something I hadn't said out loud on the channel. Um, and it is a pattern of what glucose does to enhance dementia. Really great. Um um I I loved the lesson last week. It's going to come out on Substack uh I think in the next week where when you write it is it is a light little tighter of a message. So, a couple other things that I haven't talked much about, but um I have uh just other things that I'm trying to support are on the Dr. Bos um favorites page. So, we have a uh this is the um chronic. This one is uh oh, biohacking 360. I actually Well, I'm not going to talk about that this week. Let's go to this is the methylene blue person that uh people ask me what do I which methylene blue do I use? Um and I really do like I don't know if you can see these tiny little squares right here. I cut these in fourths. Uh put them in my fridge and they are a um mucosal absorption that happens in your esophagus and in your stomach. That's my favorite methylene blue. Uh, other things on this page that I really do put um support behind is Dr. Trow and his team do a great job of a one or uh one-year consult for an entry payment that does include a coronary artery calcium score in any state in the country. Something I'm never going to tackle is being that well organized and licensed in every state. But his team does an excellent job. If you're saying, "I just want a doctor that does metabolic health to re to order some labs, review them, and even review what my calcium score has to do with anything." Um, uh, give the support to Dr. Trow. You can go in there to see what his prices are. Uh, that's enough for today. Uh, again, Dr. B's favorites are a place where you can support the channel, and I do really appreciate, um, how many of you have done that over the years. Uh, the past couple of weeks also uh wonderful uh support of listening to one of my favorite people's uh podcast that was found uh in the show notes and on Dr. Boss's favorites.

All right, so let's finish. Uh, if you are um if you are struggling like what I I talked about here, the this area between eating windows from here all the way down, those are my people. Um, so what did I do to my husband? Uh, I said, "All right, honey. Here's the three rules when you are stuck in a stall." And much like me, the the stall wasn't so much in my numbers. It was in the symptoms returning and a habit that I did really good at for a while and now I wasn't. So there's the first rule is set a rule that you can succeed at. So I did not say, "Honey, we are eating breakfast and we're not eating after that." That is way too far of a shift for what Chad and I usually do. What I did say is, "Honey, we're gonna we're going to have only sardines on the menu from 3:00 on." It's not that I can't eat after 3:00. And sometimes I don't get out of here and I forgot to eat uh the sardines that I packed or that were here. And now it's six o'clock and my own rule is busted, but I don't I'm hungry. I don't want to not eat. And um okay, no problem. The only thing left on the menu is sardines from 3:00 on. Uh, now selling this to my husband was something I tried last week and he said, "All right, we can do this. Um, but not for the 4th of July." No, we did not have plans, big plans for the 4th of July, but that was like the negotiation started with, "Okay, okay, but not on the 4th of July." Like, "All right, honey, okay, fine." Uh, the second thing that is the rule is set this uh enhanced behavior for a time period. Uh, if I look at one of the hardest uh things for me to learn in the world of medicine, it was well, yeah, humans are not perfect. They would come in for addiction recovery. They would look around the support group and what and say, "What do you mean you're never going to have a beer again?" And everybody looking at the newbie would say, "Yeah, it hasn't served you very well." I mean, that's what the unspoken message would be. Uh, and what what is very important at the beginning of a behavior change is to give yourself a time period. Uh, I'm going to do this for four weeks, for a 100 days, for six weeks. Find a time period that you and your con, you know, the social contract, who is this with, will agree to. So I said to Chad, "All right, so 3:00 on and we are going to do this until the solar eclipse. There is a total solar eclipse coming on August 12th and in the last 3 years we have been uh lucky enough to go to Iceland and it's this awesome place to watch the solar eclipse and we are going to go we're going to go to the Iceland and watch the solar eclipse and I'm super excited about it. I I'm counting down to it. And so that timer is a good place to say, "All right, and then when we're we're going to relax, whatever that means, I don't want to talk about. I don't want to have him say, 'Should I book restaurants now?'" No, no, no. That's not how we do things. We are last minute people. If you've ever seen them, like the fact that we have booked out and planned for a solar eclipse in and of itself is a modern miracle. But here it is. Okay. So, number one, you set a rule that you can succeed at. 3:00 on sardines only. Number two, have a specific date that you're going to be done by. Okay. We're going to be done by August 12th. That's when the solar eclipse is happening. And then number three is to keep track. If you read uh James Clear's Atomic Habits, I had the book sitting here a minute ago. That atomic habit book teaches you to stack things, adding to behaviors and then to keep track. Um, we talk about something called a blue November where when you put an X on the calendar where you did a good job and then you don't put an X when you don't achieve your goal. Again, you're looking for a solid 3 to four weeks where you do a behavior again and again. And I'm happily married, so I know better than to come home and be the carb police to my husband. That's not how happily stayed marriages work. But I do want the truth serum. So, we're going to show you my truth serum. And I'll tell you that um I I brought a Dexcom uh glucose meter home for my husband last week. It's got a 14-day period. And then I had somebody send us um a uh let's do this one. Send us a couple of these continuous ketone meters. So, as I look at this, I put one on him and I put one on me. And he has been known for bragging about how much better he is at making ketones. So, I'll just show you. Here is uh the 14 days. Um, here is 7 days. And when I look at the 7-day um let's just go let's dive into that a little tighter here. Um, that um go over here to here and okay. So we're going to take this back to um let's go back to last week. So a week ago I said this. All right, honey. I'm coming home. We're going to have only sardines after 3:00. And if you go, you can see that that says July 1st. That was Wednesday, right? And by 11:45 in the morning, ketones are 1.9, doing pretty good. Um, and then, you know, life isn't terrible there, but it says, okay, by midnight or something, they're down or 1.4. It's bouncing around a little bit. Uh, again, do not look at these ketone meters as something you need to succeed, but um, it is kind of fun to watch what uh the ketone meter is doing. I did this about four years ago, and it was such a terrible experience, I didn't even talk about it. I've been checking the proximity for how well this ketone continuous ketone meter again goes in just like a continuous glucose meter does to for measuring ketones while also measuring glucose and it's better, but you can't buy it if you're in the United States. So they sent me a couple of samples. I'm supposed to be beta testing it again. I put one on husband and one on me and you can go back and look for the last 24 hours. Let me show you what um what this looks like. This is my Dexcom and let's go over here so you can see that. Here is Saturday, July 4th. But let's go back to the first. Oops. This way. Um, so here's the first again. My glucose uh get up in the morning. Maybe I did a workout. Yeah, probably did a workout there. Um, and then had a cup of coffee. And but then here I'm eating sardines. It's a pretty I'm not fasting on July 1st. I'm just doing my regular day. So, look at how flat that was. You go to July 2nd. Something happened with the meter there. Again, pretty flat. Um, but I'm guessing I might have messed up here. I mean, for my blood sugar, Oh, I I got in the sauna there. For my blood sugar to jump, that's probably when I got in the sauna on Thursday. Uh, and I'm preparing. I have a really big had a really big event on Friday of last week. One of my favorite things, but I was nervous. Um, oh yeah, I got nervous. And look what I did here. I must have eaten here. So, I probably ate when I got out of the sauna, which is late, but that's sardines. And I must have broke the rule there, right? Okay. All right. I'm human. Um, so then the third comes and I don't sleep that great. So, I wake up in the morning with a blood sugar that's a little higher than I like. So, five five uh six 6 a.m. uh 100. And it's cuz I'm nervous. I I know that's what happened. And I had this presentation that started at like 8:30. This is what happens when cortisol is high. I did not eat here. I had black coffee. Uh, there are no calories going in. There's no sardines going in. And then it was the post um event crash that I think we did finally eat around here. But I was that was heavy. That was a lot. I loved it. In fact, thanks to PT County for inviting me. Uh, I got to really give the beginning of my brains course to a hundred law enforcement officers. Super privilege. But I want to show you what happens on the 4th of July. Oh yeah, baby. Look at that. 180. Okay, so remember how he said, "Okay, we're not doing sardines on the 4th of July." Still, you get up and God, what did I eat? I must have had something naughty at Starbucks. Uh, cuz it's that's way too high. That's not normal. But it's the Fourth of July and I'm not keeping track. But my CGM is [laughter] Let's just [clears throat] show you what happened to my um to my um my numbers on. So, let's go back. I think I can go five days here. Yeah. So, now here is uh the 3rd of July. That's where my big presentation was. And then the 4th of July happens and I have to like lean in to see that. So, that's 4:30 in the morning. Um, and that's 11:30 in the morning. I don't even know how I had that many curtains, but then it falls to the floor. I mean, like those are 0.0.0. And that's not cuz the meter's not reading. That's actually because it's 0.0. There is no ketones being made for that section. And then uh I don't know how the heck I made ketones on the 5th by midnight. Okay, I turned midnight. So, something woke up uh, you know, but it went right back to that 0.0 point. That's that's what it should be. I had So, the next morning, we're now on Sunday. Uh, we're on the day after I was naughty. And by naughty, I mean, wasn't that I didn't have a bunch of cake or anything, but I might have had some fruit. Uh, Fourth of July fruit, probably. Yeah, there were peaches around. So, uh, but now it's Sunday and I'm back to eating sardines and there's a few ketones there. This is on the this is on the 5th is when that happened. So, the 6th is yesterday when I was fasting and those ketones go a little higher. Let's just take a look over to what my um my my fourth fifth of July um Oh, lucky me. My my meter didn't work for there for a while. Thank you, Jesus. So, then we go to the Monday the 6th. Here. I'm fasting. Uh, and I did a workout in the morning. So, that's probably what that is. And then I, um, get home from work and I did the sauna not very long. It was so wimpy and I felt terrible. I was like, um, so if you look at that, 7:00 p.m., my glucose is 85. It's probably when I did the sauna. Uh, let's go back over to the um the the 6th of July. So, let's go back to the last three days. 6th of July, um, there we go. And we'll go to um yeah, there we go. Is 7:00 p.m. is that's midnight. Um, so, go right in here. So, yeah, ketones aren't great, but they're not terrible. They're just I'm I'm trying to work out. My glucose is stable. And you can see the sauna. This is like what? Four o'clock, five o'clock, six o'clock. Oh, this big spike is probably where I right after I got into the sauna. So, I'm stressing my metabolism and ketones are made.

All right. So, why am I taking so much time to show you this? Because this is what it looks like to fail. Uh, like I said, a rule. It was last week. I made the social contract with husband. I said, "No, no, honey. We're going to do these three things. We're going to do this until our big vacation and we're going to keep track." And let me tell you, what is the biggest motivator for me to eat sardines after 3:00 and then begin to move that first consumption of food earlier into the afternoon, like noon, maybe even 11:00 in the morning. And that I should really be eating a can of sardines at 11:00 in the morning because guess what happens after I eat a can of sardines? I am not hungry for like 12 hours. And if I'm trying to improve on a habit, one that has been sabotaging me at night where I mean, one of those little bumps on there for the glucose was radishes. That's not terrible, but it's not on my menu. And it's something my husband puts in the fridge and he likes and I should just not touch it. Should not touch it. Not that it's that bad, but it's the beginning of a behavior that I've put to sleep. I was really good at this for over a year. And it's this slow creep back where placing a couple of rules, looking at my I mean, honestly, looking at my eating window and saying, "When's the last time that you had breakfast four days in a row without eating after lunch?" I mean, afternoon. And again, if I was uh underweight or I was, you know, really trying to reverse an autoimmune disorder, there would be another like the stakes would be higher. I would do a better job. But when I look at uh a room full of pinch chasers saying, "Who's doing the best?" They are people whose breakfast is from 10:00 in the morning, their eating window is from 10:00 in the morning till 2:00 in the afternoon. That's consistent. They don't fart around. They don't play around. And they have the best numbers. They are reversing their Parkinson's disease in front of me. It is unbelievable. They have taken insulin resistance that's been there for 50 years and I can't see I can't find it in their numbers. They are consistently having a ketone production north of 1.5, north of 2.0. Not sometimes, pretty much all the time. How do they do that? Well, their breakfast is consistent. And we had a deeper discussion at the Pinch Chasers about what time breakfast should be, but at least getting it between 10:00 and 2:00 as your eating window. Super uh super goal for uh patients who've done it. Not only do they put breakfast on the meal, it's not something you can land at like I was telling people, "Just eat breakfast, don't eat afterwards." You're missing all of the social things that you have to contract that you have to address in order to succeed. And that's why breakfast is the most important way to say, are you succeeding at keto or not?

All right, we're going to get to your questions here in just a minute. Uh, I do want to say a very special thanks for all the folks that do show up week after week. Uh, and especially those that have uh been coming to the Pinchasers. Um, I have uh one more announcement that I said I would um make sure to do and that is this is the the last week that um hold on one more time. Uh, this is the last week that we have uh the Substack at $100 a year. You heard me talk about one of my favorite lectures that I've done in the last five months um is the one I did last week. It is the variability of what your blood sugars are doing and how that's related to dementia. Great story. Not a lot of you tuned in and I will tell you the Substack article is much more organized. I mean, it's writing versus orating. And um one of the benefits for supporting us in our writing efforts, which is what the Substack team uh what I'm doing on Substack, what my team is helping me be um organized for is write down these um these lessons that I teach instead of just speaking them. But putting that in a rhythmical pattern has taken a lot more energy than I thought. Uh, and uh it wasn't until the team came up with an idea of what if I had office hours once a month to answer the questions of people who are supporting us. They pay for the yearly subscription on Substack. The subscription right now is $100, but on July 14th, just around the corner, it goes up to $200 a year. Again, not an astronomical cost, but it is um the price change. And I'll just show you. We are preparing for um this office hours where these are some of the comments that folks have written in. These are truncated, but just know that this is what um these are the three of the top winning questions that we're going to answer on the first Dr. Bos uh office hours. So Susie, I know her actually, writes in and says, "I've been keto for over two years. I've tried carb cycling and experienced some success before menopause hit, but after menopause, I haven't been able to reenter ketosis despite fasting for 16:8 most days. What do I do?" Great question. Really good um teachable case. Uh, the next one is uh Daniela says, uh "I've been carnivore for two years, lost almost 100 pounds. Wow. But I have stalled. My ketones have gone from 0.5 uh haven't gone above 0.5 despite the zero carbs and only eating twice per day." Again, today's message talks a little bit about that, but we're going to give her a specific answer of what's happening and why that why it's happening. And finally, here's another one from Jackie. "Keto and thyroid. Recently, I've been diagnosed with hypothyroidism. My doctor discouraged fasting, but when I stopped, I fell out of keto ketosis. How do I maintain ketosis and heal my thyroid without fasting?" Again, all these are really good specific questions that we will take care of in office hours and you can be part of that if you support support the team on Substack. Uh, the reduced rate which will be the reduced rate for the lifetime of your subscription um ends in seven days. So we'll get one more week to talk about that.

All right, let's go to our questions. Um, and again, today we are looking at [clears throat] um the questions that really have to do with what we've been teaching about. That's what the questions on the live YouTube channel is. You might be noticing that there are no commercials when you join us live. Um, and we do turn those on after the live is over and we only answer questions live. So the team watches what you type in and then they find the questions that match what we're talking about. So, uh, Grandma Nina says, "I have committed to doing a weekly 72-hour continuous water salt fast only. Is that okay? I'm 61." The answer is yes. When I look at the danger of somebody doing a a water fast for 72 hours, what I want would want to make sure of is that you have a flexible metabolism before you begin. When I mean if you go back to the Substack article, but also I think I've done like three YouTube lives on this guy. Uh

He fasted for 21 days. The ketones that he was making at the end of 21 days of not eating was 0.7. This man was doing it wrong. His ketone production was so crippled, so broken that again, 72-hour fast, he was he wasn't making any ketones at the end of 72 hours.

So before you dive in and sacrifice eating for three days, which is not nothing, it's something. We want to know that you can produce ketones. So you should be checking morning ketones, uh, morning fasting ketones first, you know, to o t test on the toilet before you get up and fuss around. What are your numbers? And if you've got ketone production happening in the morning, you're going to do great on a 72-hour fast.

The people who don't do so great, um, I tell them do what I'm doing. Have a set time that you eat only sardines after. Uh, um, I'm pretty healthy, so I picked 3:00 was every anything after 3:00. Now, personally, I don't eat much between, you know, I mean, sometimes I have a little bite on the way to work from Starbucks, but that's like one out of 10 days. Most of the time I just am busy and don't think about eating and I I come up for errand around two or three o'clock and that's a great time for me to eat sardines because I know that I won't do that naughty thing super late at night. Um husband usually has supper for me when I get home and um um when I put in the sardine rule [laughter] he eats at noon and then he isn't coming when I come home he opens a can of sardines for me.

So, what I would want you to do is produce a robust amount of ketones before you start a water 72-hour water fast. Meaning, I want you to succeed, gramina. And that success starts with are you do you have the capability for your liver to make ketones and the cells to use it before you crash and burn with 72 hours of water and salt only. So, um that'd be my only reason why.

Again, one of my favorite lectures that's hidden inside the resources of these online courses are um the science behind fasting and looking at you get most of the return of the of the surge in hormones and that euphoric feeling due to that endocrine response in the 72-hour water fast. When you get to the 3 days or 4 days, 5 days, when you get out north of that, you get a tiny tiny increase in those hormones, but you get a lot of compromise that can happen in folks in their 60s, 70s, 80s. So, the 72-hour fast, I don't have any restrictions as long as you've proven to yourself that you can make ketones rather robustly. And if not, give yourself a 3-w week nothing but sardines after noon and watch what happens to your ketones in the morning.

Okay, next question is Cal Clan. Uh uh what kinds of things would someone without a thyroid run into on the keto diet? Uh anything different or unusual? You know, uh Cal Clan, I have long since uh avoided talking about the the thyroid relative to the ketogenic diet. Um, it's mostly because the answer comes down to your thyroid is a responsive hormone to metabolism and it does these really crazy things because it's trying to chase your metabolism going up and down. The cause of that up and down metabolism was insulin resistance. When the insulin resistance is reigned in, it doesn't have to be perfect, but just geez, your blood sugars aren't going up and down. They look a lot like my boring blood sugars did a minute ago. The blood sugars are stable. Oh, thyroids are pretty easy to manage after that. Um, that crop of mitochondria that you put out to your cells because you, you know, you had a good little workout for your metabolism, the thyroid can do a much better job with that. Replacing thyroid hormones and studying a thyroid becomes a cinch, becomes a nothing burger once your ketogen once you're in a metabolic health, meaning those uh ketones flow pretty robustly, kind of like what you saw in my numbers there, that you wake up in the morning with ketones in circulation because throughout the night, your cells needed some ketones. The glucose got down to the place where you mobilized fat. Those types of predictors in metabolism ensure that your doctor's going to have the easiest time managing your thyroid dysfunction. But what what's most powerful in my practice has been I cannot believe how many of the thyroid problems go away when they finally get a rain on the blood sugars are stable. Not stable at 140. They are stable at the 75 to 80 range. And my goodness, your little thyroid can do all the things it's supposed to do. So that would be the only thing I would say on that.

Uh, all right. Danielle says, "This is great. Thank you. I am my love language is words of affirmation." So, thank you for the praise. Dr. Bos, can you help me? I'm lost. My morning ketones the last few weeks from eating more protein. Uh, can higher protein stop ketone production? Um, six months, she's six months keto and high fat still needed. Is highfat still needed?

Um so first of all great question common one that I get. Uh what happens when consumption of protein um is higher? Again the protein people have a great marketing team. They are you know protein is healthy, protein is good for you. Build every meal around protein. Actually all those things are true. But when you're trying uh when you're looking at the the use for energy and um somebody who's trying to stay in a ketogenic state, the reason people stay in a ketogenic state, they're trying to reverse an autoimmune disorder, lose some weight, improve their metabolism, you know, find out how to be Benjamin Buttons, meaning that aging process isn't just a pipe dream. Uh it really is a better functioning cell. and when all the cells are functioning better that um that person looks healthier. So all of those are reasons why a ketogenic diet is used and they do pretty good and then they say but my I'm trying to take my protein higher that protein uh can be turned into glucose especially in a very insulin resistant patient. So they come to keto come to the ketogenic diet their insulin resistance is you know off the charts. They drop the carbs to 20. They do pretty good. The fat starts to mobilize. their fat-based hormones start to mobilize and then they get a tickle in their ear saying, "Let me just have more protein." And the increase in protein because they're kind trying to chase a macro tanks their ketogenic state.

So, the number one rule is do not powder your protein. The particle size of the protein really does matter. And when you are insulin resistant, every one of those particles of protein, that beautiful soft, fluffy protein powder that you can scoop out and it just mixes up so perfectly without clumps, yeah, that is highly processed and those particles are so fine and tiny. They're great in my kids who are in their young 20s. Um, but they are not great in my patients who have been insulin resistant for years. And every one of those protein particles registers to the body as a imol a particle of protein that you would have chewed. And that's a that's a ton. So the punch line, don't part don't powder your protein. Uh, and then eat to satiety. I mean, I push you over to um Bella of the Beef and Butter Gal who consumes so much uh steak that it's shocking, but she is she is very healthy. Her consumption is not powdered protein. It is whole food. It's a it's a half a cow a month or whatever she eats. Like I mean she just she's very open about saying look at how much I eat. And then look at her. She looks gorgeous. She's healthy. She's doing so many things right that I you can hardly find a mistake, right? That protein consumption is something her body is able to extract the nutrients for. It does not send her insulin resistance high. Uh and she's not really undoing insulin resistance. Uh she had only a few years of that. Most of the people that watch this channel, I'm going to guess Danielle that you've had insulin resistance for a while. They they got a lot for their undo button. They've been insulin resistant for a decade and um the high consumption of protein is usually a macro that they're chasing. Stop doing that. Eat to satiety. That usually means high fat. Don't particleize powder your protein. Okay. Hope that answered it.

All right. Uh let's see here. All right. That's the last question for the day. We're going to call it a wrap. And I will say again, thank you for all the support of the people who've signed up for Substack. Uh again, I do a lot of things for free, so I really appreciate those of you that have loyally um said yes to uh supporting the things we do. Uh other things that I am uh looking forward to are I'm going to stay sardines after three until the solar eclipse. So, if you're looking to join a challenge, I'll be trying to show you my numbers every week to see is I good. How many X's on my calendar do I get to say I succeeded? See you next week everyone.