Summary
Ben Azadi hosts Dr. Annette Bosworth (Dr. Boz) for an in-person conversation covering the metabolic damage of sugar, insulin resistance in children, A1C testing, and the sardine fasting protocol. Dr. Boz explains her 72-hour sardine challenge: patients eat nothing but sardines (with bones and skin, in olive oil) for three days. She uses this protocol to break through weight loss plateaus in insulin-resistant patients. Dr. Boz details how sardines provide maximum satiety through omega-3 fats while delivering a very low insulin response. She reports that patients' ketone numbers peak the day after completing the sardine challenge (3-4 mmol), and glucose drops 15-30 points in three days. The episode includes a live sardine-eating segment where Ben tries sardines for the first time on camera. They also discuss sugar vs. smoking, childhood fatty liver disease, heat therapy benefits, and why sardine bones are a superior source of bioavailable calcium.
Key Points
- Dr. Boz's sardine protocol: 72 hours eating only sardines (with bones and skin) in olive oil, ad libitum
- The sardine challenge starts at the first bite and ends at the last bite on the 72nd hour
- Patients typically eat 3-4 cans on day one, similar on day two, then just 1-2 cans by day three as satiety kicks in
- Best ketone numbers come the day after completing the challenge — ketones at 3-4 mmol as a group
- Glucose drops 15-30 points in just three days of the sardine challenge
- Sardine bones are a super absorbable form of calcium due to pressure cooking and omega-3 fat delivery
- Sardines have a worse smell than taste — they're more palatable than canned tuna but smell stronger
- Use sardines in olive oil, never in vegetable oils
- The protocol is most effective for insulin-resistant patients who have plateaued on keto
- Sugar creates more chemical trauma to the brain than most people realize — high insulin works slowly but devastatingly
Key Moments
Dr. Boz explains why sardines deliver maximum satiety and omega-3 benefits
Dr. Boz explains why sardines are the ideal food for metabolic reset. Omega-3 fats deliver powerful satiety signals that insulin-resistant patients have lost. She argues that satiating whole food beats supplements for long-term behavior change, and sardines are available in every grocery store worldwide.
"When you look across the metrics of what foods deliver satiety, your omega-3 fats are really powerful in satiety. When you track human behavior for what is a behavior change that somebody does today that they're still doing in five years, satiating food is going to last way longer than a supplement."
Sardine bones are a super absorbable form of calcium
Dr. Boz reveals that the pressure cooking process used in canning sardines makes the bones a highly bioavailable calcium source. When delivered alongside omega-3 fats, the calcium absorption rate is exceptionally high. She tells patients to skip calcium supplements and just eat sardines.
"The pressure cooking in the way they do it makes that, especially when the bones are still in there, is a super absorbable version of calcium. The absorption rate is so powerful when you have it delivered right along with that omega-3 fats. I don't take calcium supplements. I tell patients, just eat sardines."
The 72-hour sardine challenge protocol — eat only sardines, ad libitum
Dr. Boz lays out her 72-hour sardine challenge for insulin-resistant patients: eat nothing but sardines in oil for 3 days, as much as you want, whenever you want. Patients typically eat 3-4 cans on day one, similar on day two, then just 1-2 cans by day three as natural satiety kicks in.
"I don't care if you get up at two o'clock in the morning, anytime you want to eat, sardines is the menu. So ad libitum as much as you want, as long as it's sardines. And then watch what happens."
Live sardine taste test — Ben tries sardines on camera
Ben Azadi eats sardines for the first time on camera as Dr. Boz coaches him through it. He chose boneless/skinless for his first attempt. Dr. Boz notes that sardines smell worse than they taste, and are actually more palatable than canned tuna despite the stronger odor.
"Sardines are a much more palatable fish than tuna. It's not as tangy as tuna, but they are the worst smelling."
