Transcription
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 shopping guide. I'll see you there.