METABOLIC SYNDROME explained on this week’s Keto Consults Live w/ Jennifer Marie and Dr Boz

METABOLIC SYNDROME explained on this week’s Keto Consults Live w/ Jennifer Marie and Dr Boz

Check out the video on METABOLIC SYNDROME explained on this week’s Keto Consults Live w/ Jennifer Marie and Dr Boz.
All right everybody its dr. Bosworth and once again I swear there's going to be a day that I push record and nothing goes wrong this last reset I had no camera so I hope you can see me I'm dr. Bosworth welcome to my channel and we are live streaming today with one of my favorite guests Jennifer Murray Jennifer Murray has been on the show several times our.

Conversation started nearly nearly let's see how long ago was that I think it was November was when we first met and the conversation started with she wanted to help she reached out to me for help with a weight loss process and said that I've been she'd been keto for over 18 months and as we talked I said I have a huge.

Amount of followers that don't have a lot of resources for cooking I can give you plenty of science-based lessons but I can't give you a very good cooking lesson if it's a takes a little longer than 15 minutes to think about probably not gonna happen in my house so that's where I invited Jennifer Murray to come on to my channel I'm gonna do my best to.

Bring her on to this this little chat here so there she is yeah you can see Jennifer mmm give a thumbs up to Jennifer 4 and say welcome to our channel so usually we are recording on Sunday nights but she traveled this week and so instead I said Jennifer let's let's do a follow up in the middle of the week and we're gonna do this on.

YouTube so that I get a chance to use some of the teachable moments that I've been wanting to talk about with Jennifer's case so we also have a couple of really cool announcements that we're going to talk about today and then at the end we'll take your questions so once again thanks for hanging in there it did take a little 15-20 minutes to.

Figure out how to get the camera to work after it wasn't working and appreciate everybody being patient so we're gonna start with just asking Jennifer she she had almost a week and a half now since I've checked in with her so I'm gonna pass the mic over to her and say how have you been I've been great how you been I miss you I will.

Tell you it is a much easier go at it when you are the leader of our of our talks I am getting better though it is a skill set that if one if one little thing isn't working you know Jennifer unfortunately got to hear me as I'm like why can't I see myself I'm like just stand by Jennifer is I'm working on this but the the week actually was.

Interrupted because you had some traveling and the traveling was I really was Quito and it was a sounds pretty fun so why don't you give us an update of what you did so I went to low carb Denver I'm from Texas so first of all I saw some snow I know I know I'm sorry I know you guys are having really bad weather but most importantly I got to.

Hang out with some really amazing people in the low-carb keto space like Jason funk dr. Eric Westman oh my gosh there's so many I was in awe the talent and the scientists the doctors the nurses the dieticians the professor's I was just surrounded by the most amazing people on the planet and it was just a lot of information to take in and I'm still.

Digesting it right like it's just so exciting you know the other part the first time I went to a keto conference it was a one of the metabolic conferences about three years ago and I didn't know any of those names and now III remember reflecting back and in fact looking at my notes from the first one saying oh this guy lectured directly to.

Me as the first you know the first time I went to a conference but it really does almost solidify that you're not on this journey by yourself that there really are some you know you it can feel a little lonely especially as leader of a big you know you've got a great big Facebook page and and following on your own website.

I again often feel like I'm talking to myself on a YouTube channel that's filled with an audience but it's it's not with real people so it's one of those places where I find such such satisfaction with meeting people that are also on the journey just a couple of announcements here so now that I've caught my breath and kind of got over.

The hiccups of our start if you will help us by learning a little bit about you today we have a very specific question and that is when I want to know first of all where you're from but second of all I want to know if you have a keto cookbook in your home and so not just what I've done many times which is Google a recipe or look it up on the.

Internet or make it up I do not recommend you copy me but if you have a keto cookbook in your home I want to know so the if you watching the comments as we do this – so I'll be watching to see where you're from and if you've got a keto cookbook so as you were there you know when a couple of the text I got from you one of them was dr. Westman who.

Is between him and dr. Fung I'll just give you some background for a physician talk when you look at the personalities of day one in medical school they've actually studied this they look across the room and if they profile people the personalities that select different industries are unique those who select to be a psychiatrist are a different.

Profile than those who select to be a pathologist dr. Westman dr. Fung and I are all internal medicine so we didn't know we were gonna do that on day one maybe they did but I didn't but as you kind of collect who is who thinks like you and who is detective or internal medicine tends to be we like really tough problems we like you know getting.

Really into the science of things and a very thorough explanation you know dr. Westman went on to practice at Duke University but really spent most of his career addressing health problems with with weight so they've called it several different things now calling it a heal clinic but incredible teacher and rooted in the the.

Science of how do you hack the metabolism in your body to improve it Jason Fung also an internal medicine physician he started out internal medicine is what you do before you become a nephrologist and of course so every time I hear them lecture every time I read one of their books or read one of their blog posts I feel like this.

Comfort that they speak a language that's very very nice for me so when you met dr. Westman you got to hear about one of his ideas which is the heal clinics why didn't you explain what that is so yeah I was actually very interested in heal clinics before I met him and I went to go sign up but I wasn't exactly sure what it was so I had.

A really long conversation with him basically they have a they will have a relationship heal clinic so it's kind of like the relationship between Target and Starbucks where Starbucks is inside of a target meal clinics is going to be the keto low-carb specialty within clinics which is super exciting right because as we lead these big groups the biggest.

Problem is how can I find a doctor where can I find my doctor that supports low-carb and keto because there's there's so many doctors that just don't have this information that is so valuable to us right and so you sign out through them and basically it's almost no this is a great way to explain it but it's almost like you get a sponsor or a.

Coach as you would with a a and it's very hands-on your coach only gets eight people that they can help but you get their phone number so if you're sitting there making dinner and you don't understand an ingredient you can call your coach Wow yeah that's awesome you know I think it's the same thing though that you and I are doing in many ways on.

A very superficial level he's taken this to the next level where we can see the questions come in we can see our inbox is filled with these questions and you and I use your experience in my my love of teaching and expertise to educate and really the it is that except on a personal level in the community is where.

They belong so you know that is a he's one of my heroes so is dr. Fung and I just was so happy that you got to meet him and hear his ideas he actually pinged you a couple of things that I wanted to you had you said I left and I wanted to get some lab tests done and why don't you tell like just to remind folks about the history that you've had.

And why you wanted to go get some of those lab tests done so yeah I'm I'm still on my keto journey I've lost thirty more to lose yeah congratulations that's a big deal it's really big everybody yes and thanks to coach me through the stalls and teaching me about a minute fasting actually getting me through intermittent fasting because I'm.

Not one of those people who like it there are people who like it did you know that there are some who think this is really fun I continue to practice it but I I kind of think of it as like piano lessons at those years where you're learning an instrument you're just the joist not there yet maybe some David I'm I just do it anyway I was able.

To meet dr. Eric Westman and have a very detailed conversation with him about his clinic his goals and all the things that he's doing and then after a really neat conversation he actually came to sit by me in the conference and we started talking a little bit about me and how I had a very long time ago in 96 I think it was I had the ruined Y procedure.

Which is actually a bariatric procedure very intense where they know how to explain them no I can help you with this so yeah this is a very classic weight reduction surgery it's very well documented that this is you know the only way you can lose a hundred pounds and I you know they have lots of criteria in the clinic saying we don't.

Allow weed let the insurance companies pay for it until they are a certain level of heaviness and did your insurance cover it when you did it yes I had tried multiple things to lose weight through low fat everything I was told to do I did and I never lost weight and yes I was one of I mean this was in the very.

Beginning where it was almost unheard of for insurance to cover it I was one of the first approved to get it done right so we're gonna I have a little lesson compared today just talking about not just the ruin why but also dr. Westman said well has dr. Bosworth ordered some of these tests and where are you at we are waiting for some of the results to.

Come back we just had those done Monday or Tuesday but the discussion that having because because you did lose the weight and then you put weight back on is that right that is correct yes right and you know several times you know you've said you know my husband and I have both you and your husband of both lost weight and we've talked about well.

You know aren't you good enough isn't this a good enough weight loss and we're gonna we're gonna unpack that a little bit today but before we do that I didn't get a chance to really coach Jennifer before this Jennifer I'm in a flash of a picture of your your big announcement so they can still hear you and I'm gonna bout to flash this up if I can do this.

Right um let's see here oh really me all right there we go okay so I am gonna show a picture why don't you use this moment before we go into our little lesson about your big announcement that you made on your channel last week and I said oh we need to have you on my channel to make this announcement it is in the show notes down here too but I'll.

Let her steal the airwaves here so why don't you go ahead and tell us what your big announcement is so my big announcement this is so exciting I have a keto cookbook it's called keto friendly recipes and it has been amazing amazing to just be able to contribute so I have a love for food obviously but making keto friendly food and having.

That love for food like it really has to taste good so selfishly I really wanted all of my favorite favorite tried-and-true successful recipes all in one book and when houghton mifflin harcourt my publisher reached out to me to do this I was like heck yeah let's do it so you know that that's amazing you just said the word.

Publisher and I it kind of gives me the tingles because after writing a book those aren't easy to have them call you give me give everybody a little story about how this happened oh my gosh so I was not out looking to make a cookbook deal I had one smaller publisher reach out to me kind of walk through the things and I thought that's a lot of.

Work and there's not a whole lot of money and no I wasn't ready to do it last summer HMH reached out to me and I was thinking hmm is this a scam I was like who just called I mean who wants to just send you an email from New York and doesn't it seem that all the scammers are from New York well they're not your neighbor.

I mean scams don't happen near you they happen far away from you right that's so we were going through email and I get a good sense of people when I talk on the phone so I was like we need to have a phone conversation and sure enough I got on phone and very quickly realized this was a legit deal and then I didn't okay this may be a little bit ignorant on my.

Part but when I think of harcourt i always thought of education material and i remember laughs no I remember seeing Harcourt on the back of all of any book that had to do with school so I asked them what does HMH want to do cook books for and he he kind of chuckled and he said Oh sweetie he was very nice about it and he said do you know the old.

Betty Crocker red and white gingham cookbook and I was like are you kidding that's only like the og of cookbooks and I knew three different versions the years that I had and he goes that's our cookbook he goes it's the longest selling oh my goodness it's been successful for 80 years I just about melted in my city so the connection that.

Year was you know one of your top books for cooking and now they were reaching out to you and you didn't you didn't seek it out like this is where you know if you've got if you've ever written a book and you say well now what do I do with it you know most people don't get this magical phone call so it's really a testimony just to say the connection.

You've made with your audience and just how much trust you have from the people that you've been educating and you've been helping for so long you know I've put the link in the chat over here so that they can order your book I also put the link that Jennifer Murray says if you'll pre-order the book she has a gift for you and that is why don't you.

Explain what is in the gift so I the book doesn't print until May the 7 so I was thinking what can I give the audience if somebody first of all if you if you need a cookbook this is like the best I am specialty at very easy recipes these are not gonna be recipes where you don't understand the ingredients or you.

Got to go some store order it online like these are real recipes that I make for my own family but I started to think how could I help the people who are gonna order this book pre-order and I decided to make a big combination of recipes three months worth of recipes shopping lists and meal plans and it's a digital file that I will give to you.

Free if you preorder the book and I had one printed out yeah and how thick that baby is I added so much value in there that I didn't even realize how much stuff I have that I really like so if you pre-order the book you can actually take the receipt in the pre-order go to low carb inspirations com forward slash pre-order.

And claim your digital downloads and you can print them off like I did and you can start using those right now right so we're gonna save Jennifer I've asked her to save her favorite recipe from the book to talk about in a few minutes we're gonna go into her little medical lesson and do some teaching here for a minute and.

While we do that I will I do still want to know it for those of you that have just joined us please give us a shout out of where you're from and then we want to know how many people out there have a keto cookbook in their in their home or in their kitchen these are the I'll tell Jennifer this jennifer has the kind of recipes that even I can.

Follow I do not boast about being a good cook I am a great physician but cooking better be fast easy and quick thank goodness when you cook with high fat it usually tastes pretty good but I've still managed to screw up several recipes so Jennifer's got her favorite recipe hanging out there for us but I wanted to.

Go through something that Jennifer had mentioned a few probably two months ago now and for those of you that haven't followed her story there is a playlist on my website that is called consults with doctor Baz this is one of my favorite playlists because it is really me talking to a patient me educating Jennifer Marie and definitely looking.

Into her her health problems and looking into what it means to to really tackle one of these problems her problem what that she reached out to was a it was a weight problem she wanted to know well gee doc how how do I decrease the the weight I've been stable on keto for six months or actually been probably more than that but it been eighteen months.

That she'd been keto and her her Plateau is really where she was struggling to say I don't know what to do about this so I said well let's do some biohacking let's get you testing yourself let's teach you a few things we got three of the first several months and had some pretty good breakthrough is about Jennifer Marie understanding.

Herself better but there was a comment that she said and I can't even remember if the comment was online or offline where she says you know my husband's just says I've lost so much weight I look great enough for him you know even if I never lost the extra and I think there are probably 40 pounds we were still looking at losing then it.

Doesn't really matter and so I'm gonna turn over to maybe let's see here I yeah there we go I'm gonna turn over to some of these a couple of slides and I might have to fix this to give me just a second here we're gonna pull that down a little bit just so you can see that slide so this is one of the slides that I teach from.

And this is something that dr. Westman used this word when talking with Jennifer Marie and the word is called metabolic syndrome we're gonna come back to this slide and I want you to focus on this one so metabolic syndrome is a word that's used by physicians like dr. Fung like me and like dr. Westman and instantly in my mind I think of patients.

That kind of look like the guy in the center there the the inflamed patient with lots of insulin and immediately when somebody says I think I have metabolic syndrome you know this this is what my mind does is that I instantly think about the risk factors just to make it clear to everybody what it what metabolic syndrome is is it is the phase.

That people get stuck in before their sugars get abnormal in a diabetic journey so when people get overweight their system does certain markers and changes and metabolic syndrome is three of the five of these one of them is obesity and the first the first one there that first marker is measured by waist line what is the the number of.

Inches that you are in your waist line BMI is another way to measure it but waist line are what this this team used is their criteria so for for men it was 40 inches around their waist and for women it was 35 I have Jennifer muted right now but I'm gonna ask her what her waistline is when we started when she started keto what it was when we met and.

What it is now and even if she doesn't know exactly it's just one of those things that as we talked about you know her husband says you know you've still got great this is you're doing so great you really do you really need to lose the rest of this weight and this is the question that I'm addressing saying I want you to.

Think about what I think about when I see people who have been overweight for a long time I instantly think about their chemistry a couple of things are that their HDL cholesterol is low below 40 their triglycerides are above 150 and their fasting sugars are above a hundred the other criteria is high blood pressure with a number of 130 over 85 so.

You look at this criteria and I'll be honest it doesn't often mean what you think it does I have Jennifer back on line now and just gonna take see I think I have to do it this way give me one second I think I gotta do this yeah there we go so I one place you don't have sound the others the other scene you have sound so.

Now you have sound but if you look at that criteria that I just went through you know one of one of the first steps is to say when patients are overweight and they don't think it has a lot to do with what's going on on the inside it's it is a struggle to fast forward their brain and get to the level where we say no no there is a serious problem that.

Hides underneath being overweight and your goal of getting down to your bought your the body weight that you want to get to is absolutely spot-on for what you should be getting to you know I have lots of people say if fat and happy is is okay my cholesterol still looks good and what I can tend to talk about is there is a level of insulin that is.

Creating a flame throughout your body and you may not recognize the loss of some of those brain tissues or the the problem with high inflammation at this stage of their life but I take them to the grave and I can show you this last season of life of high inflammation and what it looks like so do you know your waistline so first of all I just have to.

Brag on you for just a minute because the way you explained this science is just so easy to understand am I right guys couldn't tell her in the comments like I feel I feel like I just want to tell her we love her because she explains things that I can understand I can sit in with doctors and sometimes it just goes over.

My head I just love you for that so thank you so I don't know my waistline when I first started I actually just measured it today and you didn't even ask I did that and you didn't but I was ordering something online and I just measured it probably two hours ago so I do know that I don't know that I want to share it so you don't have to so that is.

Almost out of the range of danger isn't that amazing so I mean you had said something a bit ago where you were shopping because clothes needed to fit differently so we know that this has gone down in your case and to have a waistline of 35 or less gets you out of the the danger zone for metabolic syndrome and you know as I flip back.

Over to some of some of these slides I really find that the the key to to the message that I want patients to dial into is when people say hey my cholesterol is high doc or hey my cholesterol is good doc I don't really think about that as much as I think about the markers inside a metabolic syndrome when I look at metabolic.

Syndrome this red bar is the measure of those with metabolic syndrome and these were specifically selected to not have diabetes yet they have metabolic syndrome but look at the death rates the mortality rates that went up by almost 20% all cause mortality over the 25 years of people that were studied that had metabolic syndrome if they did not.

Have metabolic syndrome and again that metabolic syndrome is three of the five of these we're gonna look at Jennifer Jennifer Murray's cholesterol here in just a minute to show you where she does does she fit into the metabolic syndrome or not anymore so going back to that death rate you know looking at cardiovascular mortality specifically.

Like the deaths care that patients get saying hey you're if you go on that high-fat diet you're going to have a heart attack that's gonna raise your cholesterol and I'm here to tell you it's not the cholesterol that increases the risk of death it is this metabolic syndrome and part.

Of metabolic syndrome I like this picture here it shows all of the organs and what happens to them when they when the patient is overweight you know looking at that that tummy and as much as this this is a man but women have just the same issues where the the tax on their systems from just being overweight continues to age their body.

Faster and especially when you start to measure things like the doctor basri she oh we're gonna do one more little slide here that I think is super helpful to teach and that is when we look at predicting death this is again another way to look at the data that I presented with in these little columns here this is one way to present the data but.

Here's another way that I like how they sorted this out again it's 25 years that they follow these patients and they divided them they checked several things but one of them that they looked at was what are their insulin levels especially the fasting insulin levels and they divided the patients into five sections with the lowest on the in that green.

Line there and the highest in that purple line there so of these five quintiles the highest insulin is what predicted who died the most often this was all major heart disease was the was this slide but there's another one for all cause mortality again saying when we look at cholesterol problems we think of patients that look like this they are.

Tired they are inflamed on the inside and that little devil up in the corner is insulin you can talk about don't demonize insulin and I'm like no we're gonna demonize insulin it has been over used and over produced in most of the bodies of my patients and you know one of the key tricks to looking at how do you get people to lose weight you can.

Burn fat by ditching these carbs this is a this is a diagram that came from dr. Volek and dr. phinius book where they said you know when we measured insulin levels if they ate 20 carbs per day it was a very low level of insulin when they got up to 30 carbs per day their insulin got a little higher but man by the time you got to fifty or a hundred.

Carbs or heavens up to 150 carbs you are not to burning fat anymore your insulin will go high enough that it commands that you do not burn burn insulin anymore I mean that you do not burn fat and I really think that slide teaches a lot about when when we're trying to study and help a patient get a better your back on air there girl yeah when we.

Look at patients and say how could we possibly translate what we know inside their medical their medical health history and the years of seeing patients to say when I look at patient data I look at the numbers that come in and I say who is it that I'm most worried about it comes with people who have those high triglycerides which is one.

Section of the the cholesterol profile I look at something called highly sensitive c-reactive protein which is an inflammatory marker that is a better predictor of health problems than any of the any of the single cholesterol profile I'm gonna put your cholesterol numbers up here I don't know if you remember them but I have them here let.

Me read them out loud here so I'm gonna take your picture away and say okay well I almost you almost can see him okay so when it comes to the the cholesterol numbers that we checked in Jennifer Marie it was let's see how long ago that was the for you did them in let's see here I can almost get this to see there we go you did them in August of 2018 but.

You'd also done them before we met so I'm gonna slide that up just a little and get this down a little the cholesterol numbers before we met she had a total cholesterol of 230 in August of last year but then her 2016 numbers they were 183 and her August of 2013 that's before she went Kido was 185 what I like to look at are.

That her HDL went from a 63 up to an 85 and you know there's a there's another several of the lectures that when I was out at the conference that I went to earlier this year an amazing connection to how much we can predict about the risk that Jennifer Murray has for a heart a sudden heart attack or any kind of life event is related to one of them.

Is her weight and one of them is her HDL cholesterol one of them is her waistline one of them is her blood pressure and these markers do a much better job of predicting is she going to have a problem as opposed to looking just at that total cholesterol or even her LDL cholesterol her LDL cholesterol those are great numbers it was 108 than a.

Hundred and 114 all of them under the 120 that is the guidelines for saying hey we should make sure that their cholesterol is low specifically that LDL or bad cholesterol and you know when you look more closely her healthy cholesterol as she became hedo went up from 60 in you know right around 60 to almost 85 which is incredibly protective.

I will give comment to this triglyceride that's a hundred and seventy seven and that is that when I asked Jennifer Marie if she your back on air by the way when Jennifer Marie did she remember the rules about getting her cholesterol checked and she's like no I think I could eat you know even hours before I got my cholesterol checked and I'm like.

Well it's really not a good way to check triglycerides if you've had a meal within a few hours of checking your blood tests those triglycerides are a response to that meal and you know as a physician I mean I know I learned that I know I was tested on that but as you get kind of lazy in your years of practicing trying to remember to explain all the.

Rules to every patient I'm sure I missed it sometimes too or wasn't quite as strict as I needed to be but it's you know she doesn't remember fasting before that last set of blood tests which would correlate to such a high jump in her triglycerides all right so I I want you to hear that when we look at how we've worked on getting your your weight off.

One of the first things we talked about was the Zipit zone the time where there was nothing going in your mouth you want to just give a brief you know kind of overview of the last few months where you started some of the ways you've kind of had troubles and then other ways where you've been really great as far as restrictions yeah so my.

History I was hypoglycemic so you got to remember that we eat every hour every two hours it's even just little bits throughout the whole day so this went on for years and I'm sure a lot of your audience can relate so even quitting two hours before bed was probably a start doing the first 12-hour window it almost seemed like a bit of a challenge because.

It goes against everything I was taught so there is a bit of a mind shift that you're not gonna have this major sugar low you've been keto for so long you can go for a long time and and you can so for the longest time I don't remember how but for the how long but for the longest time 12 hours really was all my body needed to get the scale moving.

Again and when what numbers were you checking when you said because that was the other thing that we started doing when you when you came on board as you said let's just let's get some science behind how we're gonna help your body be sure to lose weight yes so I had never had a blood meter never had a glucose meter where I needed to check the.

Glucose and ketones and dr. Boz insisted that I poked myself and draw blood so it's not another thing I don't like to do but it really is eye opening to see how she made this ratio and how you can see what's happening within your body and really understand that if you have I mean just understand your sugars when you wake up first thing in the morning.

After you eat certain things and when you start fasting how those get better and better and better it really does help you to stay on track as well yeah you know that's that's one of the hardest parts of accountability is when patients would come in three times a year or four times a year and check their blood tests and.

Expect that to be enough motivation to change behavior there's no way that that is often enough feedback for something that's so intimate in every like minute of our lives is what we choose for our foods how often we eat you know I've I've recently had some conversations with dr. Jason Fung's team and they're fasting.

Teas because I have had so many patients say well what can I have when I fast what can I have when I fast and you know water is water insults are the best I allow black coffee but these fasting teas have been something where I said well I better study this and see what what it does but but the key was if you've got the tools.

Like what you do is which is check your own glucose and check your own ketones and you can take one of these little packs and say okay but what does it do to me and I think that's that's so powerful because metabolism is shifting if you look at your metabolism in November and now you look again today where we're at your improvement in the.

Way your body handles not just fat but also times when you don't put food in the first time I think you were very disciplined and that's always nice but there's been times where you like I don't feel like doing this today and I think those are really important to honor that that's okay but also to say that's how most of the.

World is is they're gonna be good at something for awhile and then kind of the newness of checking your blood Sugar's will wear out but then we say but you still have the ability to check inside your system they say well that I'm not losing weight I'm like before we start with not losing weight I want to know what's going on on the chemistry.

Side of your of your of your body so just kind of I'm gonna flash up this dr. Basri shio chart and I just want you to tell people what's your goal when you when you fast and what or when you are checking your blood sugars what are you trying to reach for what's what have we talked about okay so usually well dr. Paul's ratio is you take your glucose.

Numbers and you divide it by your ketones so you want to get to ratio that it's under 80% for weight loss 40% for immune boosting properties and if you want to go absolutely strict like grandma Rose needed to do to fight cancer it's under 20 which it that lady is a rock star because I have not done that just a couple of times it is very.

Difficult so yeah my goal is always 80% but I'm a bit of a overachievers right you know you look at you look at some of the shifts that when people use this you know ratio to help them estimate what we're really looking at here is what is their insulin and you know the insulin levels inside their body you can go to the lab and look at them but if you get.

A dr. Baz ratio of 20 like grandma Rose does we know that her insulin state is very low insulin is a growth factor it helps things grow you know it insulates us by helping to grow fat cells and storage but it also is a stimulator of I was explaining the other day that a patient had a burn and one of the worst things.

That you can do for a burn is bathe it in insulin because it creates extra cells as that scar tries to mend back together and you've ever felt a keloid scar a very kind of ruddy squishy very dense rope-like scar we know those are made in states of high insulin all right so your your ratio has been 80 quite a few times in the last few weeks you you.

Did another experiment where you put in a continuous glucose monitor and we had a discussion the first week that you you experimented it what what wine did to it and then you were headed on a traveling which was to the second week I think was low carb Denver where you were gonna be testing there so what have you learned in the second week of wearing your.

Glucose monitor so I do keep my sugars very well controlled I did I did learn that and when I travel I think I get way more exercise so I think when I travel my ketones are way higher probably because of the exercise mm-hmm probably because I remain pretty disciplined not to eat really late I'm really exhausted in.

Those things there's a lot of mental stuff happening and meeting people which is always exhausting so I tend to eat early and go to bed kind of early so that's pretty interesting but I did have a situation to where I remember you saying push your limits a little bit I had not cheated in like two years yeah and I came back from a trip really late.

One night and I didn't eat enough I was so hungry and I don't get really really hungry so I knew I didn't eat enough that day and I remember getting off the airplane thinking I'm gonna take an uber straight home and I usually avoid airport food but I needed something and I didn't want it to be right before I go to bed so I stopped at this little kiosk.

Stand and I saw this amazing like pastrami five pieces of really little pieces of pastrami five pieces of little cheese and it looked like olives and I was like ah I'll take that it was ten dollars so devouring that before I get to my uber I eat the cheese I eat the meat and I'm about to open the olives and I'm like these are not hard I was.

Like well that's just goes to show you how much of a keto brain I have because I thought they were olives it turns out they were chocolate covered almond oh my goodness and I was like I heard this little voice in my head dr. Basso test the ratio test to see you know go a little overboard if you have to and I'm like okay I couldn't force myself to.

Cheat before because I was too afraid of that real sugar low and whatnot and I do remember before when I did have sweets that I would like to pair them with a protein because it wouldn't be so much of a sugar crash and I thought well what a better way to cheat than with dark chocolate covered almond right right so I decided to go for it and I ate one and.

I was like oh my god this is so good it was like terribly sweet like a regular cake would be but it was definitely sweet and yet another and I think there was only seven and by the time I got to the sixth and seventh one I cracked it in my mouth spit out the sugar chocolate and just ate the night oh my goodness I know but.

I did watch my numbers and boy whoo I I think I checked with that glucose monitor every five minutes which I think dr. Barthold me just do a 15 30 45 minutes two hour oh no no I wanted to see what was happening I checked that thing every five minutes and didn't mind I'm trying to remember didn't my glucose spiked to.

Like 160 something yeah even it might have even been higher than that yeah yeah it was high it was I've never seen it like that and then it came up and I want to say under the hour it started coming back down right it's just shocking to me because I know that when I've had a sugar fit like this before it would last for a long time yeah you know.

I have another patient who is pregnant and did her glucose tolerance test at home with her glucose monitor similar things the glucose monitor is a device that goes in your arm and so you know the first few times you poke your finger it's very kind of stressful and interesting but then it kind of just becomes a pain that you're poking your.

Finger all the time and it's it's kind of a barrier for people to check as often as I want them to check so when they have a glucose monitor in you can just wave the little device over your arm and we get feedback of what is yours what is your sugar doing so it doesn't like cost any more money to check it it's just there and so there's really no.

Barrier you don't even need to take your jacket off you can just wave it over the the device over the receptor in your arm the one barrier is you need a doctor's prescription to get one which I hope that changes someday because I don't think they're that scary either just interesting and with so many people what you could learn in a two-week trial of.

Having a continuous glucose monitor it becomes this place where people say yeah I want to poke my finger I'm like well let's put in a monitor and see how you do and then just watch how their sugars are are these teachable moments and patience have some feedback some like oh look what happened you know go ahead you know.

What let me tell you cuz I got so many questions about this continuous glucose monitor because everybody thinks it's so new so let me just tell them real quick what what the answers are to what everybody asks so first of all yes it is just a little device that you stick in the side of your arm it has this massive amount of adhesive that stays on I took.

A shower every day for the 14 days and it did not come off that's right yeah I was a bit freaked out about having a needle in my arm and I didn't want to sleep on that side I was really weirded out by it after a couple days I didn't even remember it was in so I was sleeping I could not feel it the other thing is one of my husband went to take.

It out I was very nervous as like take it out straight like that oh my gosh when you take it out it's not even like a needle do not know I wouldn't have freaked out so much it's not even a needle you could literally take your finger and go over like this and it's this bendable it's like a fiber optic or a fibrous thing that you know it's a.

Spring-loaded as it goes in so I think that there's a device around it when you insert it but that does not what stays there and so the it's really a cool device because I had both patients kind of do it without me near them and they did it great they and they had no training it was really almost foolproof to get the device correctly inserted and.

Then both of them said the same thing unbelievably comfortable couldn't sometimes forgot it was there and you know I should have explained it a little more that it's a flexible device well so mean the the so the the questions that you got after putting it in were related to how weird is it huh yeah yeah and what spikes you're like I do.

Skinny syrups Jordan skinny syrups and the coffee I didn't do too many cuz I was afraid they taste a little too good and I wondered did they mess with my glucose levels turns out they were fine yeah very you know again a really good teachable moment very good job so when it comes to your progress you've had a lot of travel.

Over the last few weeks do you think that your what's your weight been doing over the last few weeks so what is my weight today my weight today is it was 186 points some Wow and I know when I left I believe I think I've down 2 pounds up in the last two weeks it's still very slow that's probably travel stresses me also.

And this whole book launch is kind of a little bit more stress in the last two weeks well and you know in all fairness this is one of the things where you know I talk all the time about how important it is to support the people that are brave enough to come on my channel and to you know you know join me on Facebook and say hey these folks do a great job.

Of sharing their story and allowing you to be part of their education and one of the biggest ways that we can say thank you to jennifer marie is to help her succeed at this unbelievable dream come true which is you know she didn't you know dream of being an author for the last thirty years this is a passion of hers that has really come to fruition.

And i can't tell you how many comments I get saying I have learned so much from the way you coach jennifer marie and what she's done through her weight loss plateau and just hearing about how her hormones were part of our attention and continued to be part of our attention we have new labs coming back this next week so we'll have some updates for that when.

We when we go live next and the biggest thank you we can talk about is a pre-launch is a way for the publisher to see you know jennifer marie said she had all these fans and you know she's got these followings but are they the kind of people that will support her when she needs it which is buying this this book which is incredibly valuable in that I.

Don't have any way to teach you how to cook I Google most of the mistakes that I make and when it look what I look at in fact there's been a few times saying all right dinners in 40 minutes and I have chicken in the fridge what would you do and she's like here's the recipe ideas and it is it's really easy I have I have.

Used several of her recipes and found boy I could do that that was not too bad I actually found I mean it tasted great and easy instructions and again they're definitely tested recipes that taste good which I have teenagers so you screw up too many of them and they start saying no thanks to all of it so I want you to share before we go on to.

Questions I want you to share in your book which what is your favorite recipe you know you asked me that and that was really difficult because I do try to eat a lot of proteins and I do try to eat very well but there's there's there's one recipe that I really really like and it's a biscuit recipe because I remember in the very beginning when I tried to.

Make I thought biscuits were forbidden and the recipes that I did try they were dry grainy flat mhm and I perfected a recipe that I'm really really proud of and I think I like it because it's not only just a biscuit that you can have any time but I use it for on occasion will do sausage sausage biscuits and gravy um I used the same biscuit recipe.

As on top of a chicken pot pie for like a little bit of breading so it's just it was just one of the favorite ones but if you asked my kids because my kids have tested every recipe that's in the book if you ask them they would probably say it was the cheese sauce and it's probably because the cheese sauce recipe they can put it on their proteins they.

Can put it on their vegetables but they can eat it by the spoonful stew and I kind of agree on the cheese sauce because I do vividly remember when I was doing keto in the very beginning I went out to eat and I went to a Mexican restaurant and I asked for just fajitas with a side of pico de gallo sour cream cheese and they brought me cheese like a.

Cheese sauce and I didn't think anything of it I don't go out to eat a whole lot and make a whole lot of food at home but I all of it and when I got home I was kicked out of ketosis and I was like but wait a minute I ate everything right and I couldn't believe that in my research I found that restaurants don't serve a.

Cheese sauce a real cheese sauce they serve you a cheese flavored gravy oh I did not know that I mean I don't know you didn't okay because I felt stupid I was like I didn't know that and so I make a real cheese sauce that well not see those are the kinds of things or it's so valuable that you know I have I have learned a lot about cooking and I.

Actually like to cook but it's you know life gets busy and I have this recipes that are in your head that you do all the time and then you try to ki defy them and see if you can make them taste good but no it's the kinds of things where I'm like I don't have any sort of a substitute for anything close to a biscuit my kids would freak out if I.

Came home with something that look like bread so to know that that's got some good instructions and then once again you know it's not that you can't ever have a carb but as soon as you just add back a little bit of the really high you know high carbohydrate breads you're gonna crave that and your sugars will go high you know when when you when you.

Were at low carb Denver you texted me a post at a number of your doctor baz ratio and i think your ketones were like above two and so it was like wow look at that and she's had a conference but it really comes back when you were talking about you know the temptations of the food that are around and then you're really good about saying no and then you.

Combine that with something that you usually don't do which is a lot of walking at one of those conferences i mean walking is one thing but those conferences are pretty much every hour there's a new place to sit and to be so i would contend that one of the reasons your ketones and your glucose were so good on in that despite the traveling.

Was the activity that you pointed out and again that maybe it's that you tempt yourself with food often enough like good food when i go to those conferences i feel like i need to taste all these different things and I I think they affect me more than they do other people because of my sugars definitely go higher when I eat some of.

Them but you didn't have that problem huh no I tend to be um again I don't know I tend to there's I have to go out of my way like here at home I I work out of the house so the the kitchen is here all the time so there's just access to food all the time whereas if I'm busy and when you're in Quito you don't really think about food a whole lot.

Until the evening so it was very easy for me not to worry about food mm-hmm and then going out to eat I mean going out to eat is the hardest but luckily low carb Denver made sure that the hotel had low carb food yes yes yeah so then you're gonna have to teach him how to make this recipe yeah for real like I I think that was one of the other things.

That was very attractive about the last conferences I went to was they had you know people who are good at cooking as the supplier for the recipes and boy the the idea of a biscuit when you said that my mom I I don't know if you can see me but my mouth dropped I'm like a biscuit really there's a and you know I don't make those things very often but on a.

Sunday where we want to spend a little time making breakfast and it's like something special it's really nice to be able to make sausage biscuits and gravy yeah and it's the beginning of Quito in an now you know a couple years into this it's easy to say I don't really miss it but boy at the beginning phases when you're like I just need something that's.

Not going to be the really high carbohydrate types of food and you know just like we talked about sugar substitutes the less you use them the better off you're gonna be the lower the sweet taste the better you're gonna be that craving and cycle are really easy to ignite over and over again but and that journey comes but it.

Doesn't it's not very easy those first six weeks so well I can't wait to get my cookbook and to try that recipe too so thank you well thanks for having me on oh I'm super excited about it I really hope to be one of the sources of a ton of cookbooks for you because the thank you that we deserve to give you of sharing your personal story you know.

Having a private woman as much as your in the in the world of sharing it's it's a very private part of life when we talk about our health care and to invite somebody to say yep this is a place you're struggling I want you to be vulnerable and go on a you know a social media event and share some of the hardest.

Things to struggle with like why are you not losing weight what is the problem and you've just been so brave and so encouraging to so many people that if I can be the source of a bunch of book sales for you I think it would be nothing but a warm-and-fuzzy worth of for the rest of our relationship like she deserves this and I want you to have.

That kind of success as if nothing else a thank you for every one of the people that you've taught standing still and being vulnerable and sharing your cholesterol and your waistline and well thank you too because you have been a dear blessing to my family and I really hope my husband gets to get yes come on to this channel because he has has he.

Has had amazing success with his knee pain and all the stuff that you've done for him and that's his story that he can tell but I really hope he gets that chances yeah we are hoping for those of you listening that that we can do that in the next week because boy I've had a lot of people reach out about how his sleep cycle has been and you know he's a.

He's got a job so sometimes matching him up with the times that were available isn't as easy to schedule but he is on my radar for the next week to get him live and say how are you doing and share that update on his story all right well so I am going to change this scene to just include me and Jennifer I can still hear you in my ear so if you wouldn't.

Mind looking through a couple of those comments to see if you see any that we should take care of ups I gotta take off that little hold on here okay you know there you go Oh whoopsie that's what I need to do sorry hi so yes I am back to try and answer some of these these questions you know when I look at the scroll of comments first of all thank.

You for the folks out there teaching one another I can see some of my favorites that have been you know answering questions and so there's a few questions for Jennifer Marie one of them is what is the max number of carbs in your recipes and again I can hear in my ear so Jennifer do you have an answer for that.

I see so she says eat each recipe is different but she did put all the macros in that cookbook so that you can see what each of the carbohydrate content is in each of those so and I think that's that's a lot of work but it is really important for especially as you're learning how to make these recipes so very very good improvement on that I am.

Going to look for other questions about okay I have hi dr. Bosman from a fellow provider and Gabriel Rocha Roca reversing type 2 diabetes is in my patients at an underserved or free clinic what's your general approach to de-escalating diabetes medications insulin especially so I would actually.

It's a great question and I love to see their that is one of the things that I didn't expect which is several providers that have ended up you know on the channel and asking questions about how what's your strategy it's for that reason that I try to pick difficult patients to put on the the the channel Jennifer Marie turns out to have some of.

The best numbers for checking her blood sugar and her ketones that I have so she's like my star child but what she was is she had had a big gastric bypass she had had a time where the weight had been on for a long period of time had come off after gastric bypass then gained it back and so she had some special things that we are going to be.

Monitoring we have monitored them once we have labs again that we're gonna go through in the next few weeks but I find that subset of they've really intense about losing weight and it's the other conversation I like to have is how do we not have them do surgeries for weight loss how do we save their money and their the consequences of those weight.

Loss and and teach them how to do keto so I picked Jennifer Marie for that reason and she's just been a star pupil but the other patient that's on the playlist is a type 1 diabetic and I am just so excited to see what she has done in the last eight weeks she's been on every week her average Sugar's when we started was over 300.

She's a type 1 diabetic so she'll never get off of insulin her doesn't make it but just like what this doctors asking is well how do you start where do you begin and you know the first thing that I do when when there are not a type 1 it's the doctors asking the providers asking about a type 2 is I start with any of the insulin-secreting.

Acts which mean the drugs that increase the production of insulin and though there's a class of those that those are the first ones that I'll pull back I keep metformin on as long as I can metformin has other benefits for why we use that and why we like that in fact I'll add metformin to somebody who's in a weight loss stall or struggling with.

Not being able to get those dr. Basra shows down you know the other thing Gabrielle is if you haven't gone to my website Baz MD com there's a free 70 page booklet and if your patients just click through that it links them to several of my teaching videos most of the common questions from that journey it really is an education for the.

Patient that is the hardest part adjusting the medications becomes easy you just start pulling off the you know first the insulin insulin goes off if they're type 2 the next thing is anything that stimulates the insulin and you know like your glipizide z– that class of medications I I'm not a big fan of the ones where it has you sick you.

Know urinate out the glucose I you know I know they're new and I know they're really exciting and it's fun to learn about it but it seems a little odd that you threw that the base plate in the in the kidney that we're gonna force a glucose molecule through that little bitty sliver that's not supposed to let sugar through and I know that it's got.

Good evidence and it does lower their a1c a couple of points but I would totally be pushing a keto diet over that any day I just think there's a there's some there's some future to that drug that's about we don't have any evidence for yet and it's been approved by the FDA so I'm not saying that anything disparaging but I wouldn't do that if it.

Was me and I have not written it once for my patients so so the the question comes back to what's first and it is it is about lowering the insulin and then getting them off the drugs that make insulin produced Jennifer you have any good questions that you found as you're scrolling through not really okay so I've got a.

Couple more that I'll do and then we'll call it I have a couple people on here that fell for the Kraft singles I fell for that too that's not real cheese and there's way more carbs and those than you think when Jennifer was talking about the fake the gravy that's cheesy had having too many carbs in it but it is definitely a.

Trick my family fell for that too let's see lots of good hellos from where people are from somebody asked about the fasting teas yeah those actually that's another little thing that I've recently been very interested in and that they are the ones that Jason Fung talks about where it's the you know tea is a you know what what can you have when you.

Fast and that is that salt that water black coffee and then I've recently been I've added these peak teas and I'll tell you it's it's way more satisfying than I thought it would be I thought no I'm not a tea person I like coffee but I have used this it's a slow brew under a pressure that they use with really pretty they're.

Pretty picky about their tea leaves and then they crystallize it through a dehydration process that just makes for a very enjoyable experience it's not a lot of work to make the tea and there's quite a bit of the antioxidants or the familes which again comes back to our lesson from today which is you know how can I predict who's going to have the.

Highest problem with with their their being overweight you know I think of Oprah as an example she has you know outwardly struggled with her weight and you know she was a she's a big proponent of the the Weight Watchers which doesn't limit your carbohydrates and that journey continues to have her insulin high and she hasn't gotten down to her.

Ideal body weight she really still continues to struggle and when I think of if I was her physician what would be the things I would be concerned of it is as she ages she makes more antioxidants or makes more free radicals than she needs to her body oxidizes kind of a it's you know it's what rusting is is to oxidize but.

When you look at a cholesterol that's been around insulin for a long time that turns into this very fragile and very inflammatory setting and any of the things that we do including good sleep you know keeping our cortisol or managing our stress and then keeping those carbs under 20 but then adding things that do have high antioxidants.

And that's what some of these teas are most known for is they have a high level of the panels that are in there one of the one of the easiest ways to do that is to have a you know whatever it is that you drink on supplied with that and although green teas do have quite a bit in them if the tea leaves are old or if there's any kind of like must musty or.

Fungal you know that happens to tea that's not that uncommon but you'll taste it and it'll taste really bitter and I've just found I don't have haven't had any of that as I've you know sampled these teas and tried to use that as part of my fasting ritual now so those are the big highlights I will continue to look at these comments and try to answer.

Many of them back I just want to say thank you to Harvey laying out their answering some of the questions he is another provider out there really trying to educate folks on the ketogenic diet and I met him at the conference very very thankful to see his help answering some of these questions so I will sign off once again I apologize for the late.

Start but I am here to say thank you to Jennifer Marie so anybody out there that hasn't bought her cookbook or looking for a way to gift a friend a gift this is a great way to say thank you to Jennifer for all that she's done for us as we teach her teach each other and but teach through her ketogenic journey I'm signing off as dr. Boz I have a good one.

Thank you

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