Podcast Review: Insulin Doctor with Dr. Annette Bosworth

⬅️ Back to Podcasts

PODCAST REVIEW INFORMATION

• Title: 🎙️ Insulin Doctor: This Is The First Sign Of Dementia! The Shocking Link Between Keto & Brain Decline!
• Show: The Diary Of A CEO
• Host: Steven Bartlett (founder of Social Chain, investor)
• Guest: Dr. Annette Bosworth, MD (internal medicine physician, 25 years clinical experience, author of KetoCONTINUUM)
• Episode: Duration: 1h51m
• Publication Date: 2025-11-24
• Original Episode: YouTube Apple Podcasts

🎧 Listen to the Podcast

📺 Watch here

📋 PRE-ANALYSIS: E-E-A-T & RED FLAG ASSESSMENT

Evaluate the episode before writing your review. Score each element 1-5 (5 = highest).

Experience: 5 / Dr. Bosworth built clinical practice treating insulin resistance for 25 years, reversed her mother’s cancer using ketogenic diet, personally maintained ketosis for 10 years, and coached 200+ patients through intensive 21-day programs.

Expertise: 4 / Board-certified internist with deep specialization in metabolic health; demonstrates pattern recognition across thousands of patients. Loses one point for overstating causality in complex diseases without always citing primary research.

Authoritativeness: 4 / Runs established medical practice, bestselling author, 304K+ YouTube subscribers. However, claims lack endorsement from major medical institutions and contradict some established guidelines.

Trust: 3 / Transparent about personal and family health journeys, discloses KetonIQ investment at 1:11:41, provides specific metrics (70% cancer marker reduction, 0.5 ketone threshold). Red flags: downplays risks of extreme fasting, uses anecdotal evidence for cancer claims without peer-reviewed validation.

RED FLAGS (if any):

• Misleading Information: Claims ketogenic diet “reversed” Alzheimer’s in Down syndrome patient; evidence is anecdotal, not clinical trial data.
• Untrustworthy: Financial conflict; guest is investor in KetonIQ, promoted at 1:11:41 without clear upfront disclosure.
• YMYL Risk: Recommends 72-hour fasts for cancer patients and 100-day sardine-only diets without adequate discussion of contraindications, malnutrition risk, or medical supervision requirements.

Verdict: Proceed with review but flag concerning claims for editorial review. Episode provides valuable metabolic insights but requires strong caveats around medical advice.

⚖️ VERDICT

Overall Rating: 7/10

Dr. Boz delivers a masterclass on insulin resistance with compelling clinical stories and actionable metrics, but her cancer reversal claims exceed current evidence and she underplays the risks of extreme ketogenic protocols. Worth listening for the metabolic framework; just verify any medical claims with your physician.

🎯 ONE-SENTENCE ASSESSMENT

This episode weaponizes personal testimony and clinical anecdotes to make a provocative case for ketogenic diets while skating past the evidence gaps and risks that should temper its boldest claims.

📊 EVALUATION CRITERIA

📝 REVIEW SUMMARY

What the Episode Covers

Dr. Annette Bosworth argues insulin resistance (not glucose) is the primary driver of chronic disease. She maps how excess insulin causes skin tags, hairless toes, abdominal fat, and neurodegenerative debris that leads to Alzheimer’s. The episode demonstrates real-time ketone testing on host Steven Bartlett (ratio: 95), herself (ratio: 48), and producer Jack (ratio: 888). She presents her 12-step KetoContinuum protocol, extreme sardine challenge, and claims of reversing cancer markers 70% in 6 weeks. The final 30 minutes pivots to her legal persecution: 12 felony charges for petition signature verification that resulted in 24-year prison sentence (later probated).

Who Created It & Why It Matters

Dr. Boz brings 25 years of internal medicine experience treating “unsolvable” cases. She built her practice after corporate medicine burned her out; she spent 9.5 months under Medicaid fraud investigation for giving $350 IV iron treatments to homeless patients. Her mother’s 2015 cancer diagnosis forced her to test ketogenic therapy under life-or-death pressure. That patient-zero experience, where cancer markers dropped 70% in 6 weeks, shaped her clinical model. Her authority derives from thousands of patient outcomes, not institutional affiliations. She’s been keto for 10 years personally, proving long-term adherence possible.

Core Argument & Evidence

Thesis: Chronic hyperinsulinemia drives all major degenerative diseases. Ketones provide clean mitochondrial fuel that reverses this damage.

Evidence Presented:

• Anecdotal: Down syndrome patient spoke first three-syllable word after 3 weeks keto; mother’s cancer markers dropped 70%; patients reversed gray hair; zero Parkinson’s patients in 25-year practice
• Quantitative: Dr. Boz Ratio (glucose/ketones) >100 indicates insulin resistance; 20g total carbs (not net) required for therapeutic ketosis; 0.5 mmol/L ketone threshold; 8-hour insulin clearance after late meals
• Mechanistic: Ketones bypass insulin-resistant glucose transporters at blood-brain barrier; high insulin blocks vitamin D mobilization; GLP-1 naturally elevates in ketosis
• Study Mentions: Wahberg effect (glucose-dependent cancer metabolism), military soldier power increases (50% at 18 months), but no citations provided

Gaps: No mention of failed keto interventions. No discussion of APOE4 genotype risks. No long-term adherence rates beyond self-selected success stories.

Practical Applications

Immediate Actions:

• Calculate your Dr. Boz Ratio: prick finger for glucose and ketones, divide glucose by ketones. Aim for <100.
• Stop eating after 6 PM; move calories to morning. One bite after 6 PM = 10 bites before noon for metabolic cost.
• Day 6-9 of keto initiation: eat only sardines in oil (3 cans/day) to force ketone production and experience satiety.

For Specific Audiences:

• Prediabetics: Use urine ketone strips first to avoid fingersticks, transition to blood meter when compliant
• Cancer patients undergoing chemo: 36-72 hour fasts before treatment, exogenous ketones day-of to preserve muscle mass
• Women in menopause: Must achieve ketosis 20+ days/month; hormones won’t normalize until insulin drops
• Athletes: 18-month adaptation required for 50% power increase; don’t start keto within 4 weeks of competition

🧠 INSIGHTS

Strengths

• 1. Real-time ketone testing on three people creates powerful visual proof. Jack’s sky-high ratio (888) versus Bartlett’s moderate (95) versus her optimal (48) demonstrates insulin resistance spectrum in 90 seconds flat. Host’s shock at his 0.1 ketone level makes abstract biochemistry visceral.
• 2. Cancer story at 1:14:19 carries emotional weight because she admits fear: “I said, ‘Mom, do you trust me?’ I’m like a fool.” This vulnerability builds trust where data alone fails. The 70% marker drop is specific; she names the 30% chemo benchmark, showing she understands conventional standards.
• 3. Down syndrome patient anecdote at 34:03 reveals clinical pattern recognition. She connects trisomy 21’s accelerated Alzheimer’s timeline to insulin hypothesis, then provides objective outcome (three-syllable speech). This demonstrates diagnostic expertise beyond cookbook medicine.

Limitations & Gaps

• 1. Cancer reversal claim contradicts oncological consensus. She states ketogenic diet alone dropped markers 70% in 6 weeks, but doesn’t disclose cancer type (T-cell lymphoma), stage, or whether patient received simultaneous conventional treatment. Omits that Warburg effect varies wildly across tumor types; many cancers readily metabolize ketones.
• 2. No pushback from host on extreme recommendations. When she advocates 72-hour fasts for “resetting metabolism” at 51:20, Bartlett doesn’t ask about muscle catabolism, electrolyte imbalance, or contraindications for underweight patients. This creates false impression of universal safety.
• 3. Financial conflict disclosed too late. She mentions KetonIQ investment at 1:11:41, after promoting exogenous ketones for 5 minutes. Earlier disclosure at first mention would meet FTC guidelines. She frames investment as credibility signal rather than bias.

How This Connects to Broader Trends

• 1. Metabolic psychiatry movement. Her claim that depression and brain fog stem from “brain trash” accumulation aligns with emerging research on mitochondrial dysfunction in mental illness. However, she conflates correlation (insulin resistance in depressed patients) with causation without addressing confounders like inflammation or trauma.
• 2. Medical establishment backlash against alternative practitioners. Her felony conviction story (12 felonies for petition signature technicalities) mirrors cases of other doctors facing licensing board retaliation for prescribing off-label treatments. This narrative positions keto as counterculture rebellion, which may appeal to listeners distrustful of “Medicine 2.0” but obscures legitimate concerns about evidence standards.

🏗️ KEY FRAMEWORKS PRESENTED

Dr. Boz Ratio

Measures metabolic efficiency by dividing blood glucose (mg/dL) by blood ketones (mmol/L). Ratio <100 indicates insulin sensitivity and effective ketosis; >200 signals severe insulin resistance. In practice: Bartlett scored 95 (borderline), Dr. Boz 48 (optimal), producer Jack 888 (critically resistant). Utility: Simple home metric correlating with clinical insulin resistance. Limitation: Doesn’t account for individual metabolic variation or dawn phenomenon.

KetoContinuum

12-step progression from chronic grazing to therapeutic fasting:

1. Eat every 2-3 hours
2. Cut to 20g total carbs
3. Urine ketone positive
4. Skip first meal
5. 16:8 time-restricted eating
6. 23:1 OMAD
7. 36-hour fasts
8. 72-hour fasts
9. Metabolic flexibility (use both fuels)
10. Autophagy maintenance
11. Hormone optimization
12. Lifelong ketosis with periodic resets

Steps 5-8 require moving eating window toward sunrise; most patients fail here. Framework value: Recognizes insulin resistance severity demands escalating intensity. Gap: No exit strategy; implies permanent ketosis required.

💬 NOTABLE QUOTES

1. “Most people have been making buckets of insulin without knowing it. It is what makes cancer. It is what makes high blood pressure. It is what makes debris in the brain, which is linked to depression, brain fog, Alzheimer’s, and Parkinson’s.” - Dr. Boz Significance: Condenses entire metabolic hypothesis into digestible metaphor; frames insulin as hidden killer.

2. “I have seen patients that have reversed their gray hair on a ketogenic diet.” - Dr. Boz Significance: Anecdote that sticks; connects vanity concern (aging) to deep metabolic change.

3. “She had never said a three-syllable word in her whole life. For the first time in her whole life, three weeks onto a ketogenic diet.” - Dr. Boz, describing Down syndrome patient Significance: Most powerful clinical story; objective outcome (speech) that listeners can verify.

4. “One bite of food after 6:00 PM is worth 10 bites of food before noon.” - Dr. Boz Significance: Concrete rule that creates immediate behavior change; memorable heuristic.

5. “I’m the first person in the history of the United States of America to be investigated for not witnessing a signature.” - Dr. Boz Significance: Positions keto advocacy as civil disobedience; explains her credibility struggle.

6. “I was sentenced to 24 years in prison. My kids are sitting behind me.” - Dr. Boz Significance: Raw vulnerability; reveals personal cost of medical nonconformity.

7. “Fiber is for farting.” - Dr. Boz Significance: Memorable dismissal of conventional fiber wisdom; signals carnivore-adjacent stance.

8. “When you’re 54 years old, you should probably put the calories in the morning, not at night.” - Dr. Boz Significance: Age-specific metabolic insight; contrasts with popular intermittent fasting patterns.

📋 APPLICATIONS & HABITS

Practical Guidance from the Episode

• Test your Dr. Boz Ratio every morning for 5 days. If >200, implement 3-day sardine fast: eat unlimited sardines in oil, no carb restriction, no eating window. Expect ketones >1.0 mmol/L by day 3.

• Move last meal to 3:00 PM for 1 week. If social event required, skip breakfast next day rather than eating late. Cortisol-driven glucose release at sunrise makes late eating metabolically expensive.

• For chemotherapy patients: fast 36 hours pre-treatment, take 20mL exogenous ketones morning-of. Preserves muscle mass, provides antioxidant state, improves mental clarity. Requires oncologist supervision.

Common Pitfalls Mentioned

• Eating only low-carb without enough fat. Patient took 15 days to produce ketones because stored glycogen was locked under high insulin; swallowing fat (butter, sardine oil) unlocks it faster.

• Using net carbs instead of total carbs. Guest states, “Fiber is for farting” 20g total carbs is non-negotiable for therapeutic ketosis. Avocado overconsumption (4/day) prevents ketosis despite “net carb” math.

📚 REFERENCES & SOURCES CITED

• Independent Research PDF, StevenBartlett.com, 2025: Document provided but not discussed on-air. Linked in description. Contains 12 studies on ketones and neurodegeneration. Assessment: Guest didn’t reference it; likely included for credibility but not really integrated into arguments. Link: https://stevenbartlett.com/wp-content/uploads/2025/11/DOAC-Dr-Annette-Bosworth-Independent-Research-further-reading-1.pdf

• Wahberg Effect (cancer metabolism), mentioned at 1:20:27. Assessment: Accurately described as glucose-dependency in tumors, but guest overgeneralizes; many cancers adapt to use ketones.

• Military ketogenic diet study (power increase at 18 months), mentioned at 32:25. Assessment: Likely refers to 2019 study on obese soldiers; guest omits that subjects were monitored continuously, not typical outpatient conditions.

• Peter Attia’s Medicine 2.0 framework, referenced at 04:04. Assessment: Proper attribution, but guest conflates his framework with her own more extreme protocols. TMFNK Book review of Outlive

• Joe Rogan sardine arsenic claim, mentioned at 1:02:45. Assessment: Guest tested patient for arsenic after 100-day sardine challenge; no elevation. But n=1, no control for brand/source of sardines.

• Methylene blue mitochondrial research, mentioned at 1:22:42. Assessment: Guest cites autopsy studies showing blue-stained organs as proof of bioavailability. True, but omits that therapeutic doses and safety profile remain controversial.

⚠️ QUALITY & TRUSTWORTHINESS NOTES

Accuracy Check: Claims “ketogenic diet dropped cancer markers 70% in 6 weeks” is misleading. Patient had T-cell lymphoma, likely received concurrent chemotherapy. No oncologist co-signs this interpretation. Warburg effect applies to some cancers, not all.

Bias Assessment: Major financial conflict of interest: guest is investor in KetonIQ, promoted as solution for chemotherapy patients and “ketone jump-start.” Disclosure at 1:11:41 is mid-discussion, not upfront. Guest dismisses all fiber benefits; this contradicts gut microbiome research showing butyrate production from fiber fermentation is distinct from ketone-derived butyrate.

Source Credibility: Relies on anecdotes from clinical practice. No peer-reviewed publications cited for cancer outcomes. Independent research PDF provided but not verbally referenced; appears performative. Contrast with Peter Attia, who cites specific trials on his podcast.

Transparency: Legal persecution story (12 felonies, 24-year sentence) is one-sided. No mention of opposing arguments from state medical board. Creates persecution narrative that deflects from legitimate oversight concerns about extreme dietary prescriptions.

Potential Harm: Recommending 72-hour fasts and carnivore-adjacent diets to cancer patients without oncologist supervision is dangerous. Could cause cachexia, electrolyte imbalance, or delay evidence-based treatment. No discussion of when ketogenic diet is contraindicated (pancreatic insufficiency, eating disorders, certain medications).

🎯 AUDIENCE & RECOMMENDATION

Who Should Listen:

• Individuals with insulin resistance (skin tags, abdominal fat, PCOS) seeking metabolic framework before pharmaceutical intervention
• Caregivers of neurodegenerative disease patients looking for adjunctive lifestyle strategies; must coordinate with neurologist
• Biohackers comfortable with self-quantification who want to implement Dr. Boz Ratio tracking

Who Should Skip:

• Cancer patients, advice could delay conventional treatment. Please consult oncologist before any fasting protocol
• Individuals with history of eating disorders: extreme fasting recommendations are triggering and unsafe
• Anyone seeking balanced nutrition advice: guest’s “fiber is for farting” stance is unnecessarily polarizing and dismisses legitimate gut health research

Optimal Listening Strategy: Listen at 1.25x speed; skip grocery list discussion (57:54-59:22) and sardine taste-test ramble (54:36-57:18). Pause at 40:53 to calculate your own Dr. Boz Ratio if you have a ketone meter. Re-listen to Down syndrome patient story (34:03-38:26) with skepticism; anecdote is compelling but not evidence. Skip legal story (1:34:55-1:46:41) unless interested in medical politics; it doesn’t advance dietary arguments.

Crepi il lupo! 🐺