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May 3, 2021

in guest/interview , health , weight loss by allan

Intuitive fasting with Dr. Will Cole

December 23, 2019

in guest/interview , health by allan

The inflammation spectrum with Dr. Will Cole

Get it on Audible

Allan: 03:15 Dr. Cole, welcome back to 40+ Fitness.

Dr. Cole: 03:18 Well thanks for having me. I'm excited to talk again.

Allan: 03:21 Yeah. On, on, I think it was episode 340 and I'll make sure it had a link in the show notes I had you on for Ketotarian, an excellent book for folks that want to be plant-based but also are interested in the keto lifestyle. I thought that was a great book. It changed the way I eat. I can honestly say that because I, I've incorporated a lot more vegetables into my diet as a result of that book, whereas before I was probably more carnivore than I really want to admit. But that book changed me. And now with this book, I'm thinking, you know, every time I have a pain or ache, I'm like, okay, is that inflammation? Do I need to change what I'm eating? So the book we're going to talk about today is called the Inflammation Spectrum. And it's a really, really good book for anyone who suffers from inflammation. How they can change their diet and lifestyle to live just a better, healthier life.

Dr. Cole: 04:13 Thank you. Yeah. And the concept of the inflammation spectrum, I'm writing about it for a long time, about 10 years at this point, but the, I actually talked about it in book form, in passing in Ketotarian cause beta hydroxybutyrate the ketone is a signaling molecule. It's a epigenetic modulator, so it helps to down regulate these proinflammatory cytokines like NF Kappa B and the NLRP three inflammasome. So I talked about how inflammation exists on a spectrum and Ketotarian and how beta hydroxybutyrate to ketone helps to lower that inflammation. So I wanted my second book to be a deep dive into this concept of the inflammations spectrum. And then ways to lower inflammation beyond ketosis are being mostly plant-based keto or Ketotarian, but just other food ways and other nonfood ways to calm inflammation. Because like you said, the aches and pains, like that's definitely one part, part of inflammation.

More...

Dr. Cole: 05:12 But inflammation is so much more and it's impacting so much more, more in more ways than people realize. So when you dealing with autoimmune issues, that's inflammatory, diabetes and heart disease and cancer, those are all inflammatory. And then mental health issues like anxiety and depression and brain fog and fatigue. There's a whole field of scientific literature kind of circling around what's known as the cytokine model of cognitive function. It's basically how inflammation cytokines are pro-inflammatory cells, how inflammation is impacting how our brain works. So it's so far reaching a chronic inflammation is, so I wanted to really give people tools to help to empower them because are largely overcomeable and reversible and he liberal and man at the very, very least manageable things.

Allan: 06:04 Yeah. I, you know, I'll have a conversation with a client and you know, then they might tell me, you know, I've, I've got a little bit of swelling and soreness and it's a little warm in my knee because they're having gout. And you know, from that perspective, they know, okay, there's an inflammation there. That's what that, that's what that is. But understanding what we can actually do with our food to kind of solve that, I think is really a critical tool because sometimes the doctors can't do anything but give you a medication. And you hope that it's going to work.

Dr. Cole: 06:37 Right? Right. Well, yeah. I mean, I think the training in that model of care and mainstream medicine is largely that it's to diagnose a disease and match it with the medications. So with inflammatory issues, it's, you know, if you're on, if you have an autoimmune condition, you're giving steroids or immunosuppressants to lower the autoimmune and inflammatory response. If you have a blood sugar problem, a diabetes, you're going to be given a medication or an injectable insulin and so on and so forth. I mean, these are all, well, what's, what's actually causing these in the first place? These are not, these health problems are not due to a medication deficiency. So hello, it's actually find, okay, let's deal with the inflammation because the body is interconnected and inflammation in one area can be get inflammation in other areas. But also the question that I'm having in the book is what's driving the inflammation too. So looking at food and looking at chronic infections and gut issues and all of these things that can drive the inflammation

Allan: 07:38 And, and one of the concepts she got into early in the book, and I'm glad you did this because I'll be talking to folks in like, you know, everybody should eat this way. Everybody should do this thing. This is the right way. And I'm thinking, well, no, it's not because things that I do today you know, I couldn't get, you know, I, I can't do today that I was doing back when I was younger. So there's this concept you bring up called bio individuality that can get a little bit into that concept. And then one basic question I have beyond that is we change over time or something happens where we're able to tolerate less, or is it just that we've always had the sensitivity, it just built up to a chronic state?

Dr. Cole: 08:19 Well, I'll probably a bit of both depending on who you're talking to. I think these largely are chronic health problems is this is the inflammation spectrum itself where you have mild symptoms like mild fatigue or background anxiety maybe might allow some mild digestive problems on one end of the inflammation spectrum all the way to the other end, which is the autoimmune disease or the, you know, whatever diagnosis call you're talking about. And then everything in between. So part of that is just the fact that when you're on with the lower end of the inflammation spectrum, things are going to be less volatile and less prone to flares when you're on the lower end of the inflammation spectrum. But the more you're progressed on that road, things are more volatile and you have less wiggle room. You ha you have less leeway as far as what you got away with quote unquote, before when you were lower on the inflammation spectrum scale.

Dr. Cole: 09:14 So that's part of it. And by the, some, by the time someone's diagnosed with an autoimmune condition or diabetes or any other chronic health problem, the things were brewing, like the inflammation spectrum was brewing for four to 10 years prior to that. From that diagnosis, meaning when someone's diagnosed with, with autoimmune condition or diabetes or any other chronic health problem, it didn't happen overnight. It took time. So definitely that's a component to it. And one that I talk about at length in the book and then the other is that there's a lot of variables to consider. I think that bio-individuality is definitely the heart of functional medicine and we have to find out what our body loves beyond food tribalism or you know, like a, a trend or F bad, like what's actually right for you. And that's that self exploration that I wanted the reader to go through.

Dr. Cole: 10:08 And it's a process that I coach patients through and consult them with to start asking these questions, start looking at these areas around their life that impact how they feel, the impacts, their energy levels or the digestion or their inflammatory symptoms. No matter how it's manifesting in their life. So it's definitely the book is while it's giving people pointers and giving statistics on things ultimately I'm teaching the reader how to find out what their body loves and hates. It's all, I mean, obviously it's under the umbrella of real foods, but underneath the umbrella of real foods, what macros worked for. Somebody like how much proteins, fats and carbs, his bio individual, some people do better on one way, a macro ratio, some people do better on other, same with micronutrients and same with food choices. So we're kind of asking these questions in the book for people to get that food piece that I think a lot of people are really yearning for because there is so much conflicting information and dr Google is like quite a confusing physician when you, you can really use, use Google to substantiate anything that you want to, whether it's your worst fears or an agenda that you have at a click of a button.

Dr. Cole: 11:22 So I really want people to sort of get beyond the noise and really just check in with themselves to see what works for them.

Allan: 11:28 Yeah, dr Google scares me, but dr Facebook really just terrifies me. You know, I read the posts on there and someone's like, well, you know go on a dry fast. I'm like, well, okay you know, some of those things just scare me to no end that. And so, you know, understanding what works for you I think is critically important and not just doing what someone else does because they said at work, you know, that's their experiment of one and good for them. I'm glad it worked. But you know, there, there's an approach here. And I like your approach cause you take an, this is actually kind of I'm not gonna that was eye opening, but it was something I knew, but I guess it's intrinsically new, but just really hadn't put them all together to think of it in these terms. But there are eight primary systems that you talk about in the book where inflammation occurs. And as it starts to spike up and one if it's not managed, then it spills over. And so can you kind of talk about the eight primary systems where inflammation occurs?

Dr. Cole: 12:32 Yeah. and again, when I went through the book, it's interesting and you know, cause you read the book, but basically the symbolic meaning of eight and you know, seven is this sort of number of order and systems and completion that we have seven days of the week, et cetera. And, and eight is going to move and beyond that limitations and getting freedom from health problems or freedom from food, disillusionment or whatever. But, and then I saw all these connections like, okay, I normally put people on these, these protocols for like eight weeks. And then I saw, okay, these eight foods that I see clinically and all of the stuff that was born out of my clinical experience, I started seeing these similarities. I'm like, okay, this is a awesome way to make it easy to understand. And I think it was a, a really a powerful thing for me to kind of see the, the synchronicity of a lot of the things I was putting together for the book over the, you know, two years I'd been working on it.

Dr. Cole: 13:28 The so the eight areas of the inflammation spectrum are things that I just see consulting patients and that's my day job is, is not writing books. It's, it's consulting patients online via webcam and kind of seeing the different areas of inflammation in people's body. So we start the book off with a quiz so people can kind of see where they're at on the inflammation spectrum. We actually have the quiz for free on dr wilko.com too, for people who want to just take the quiz. But it's in the book and we look at the brain, we look at the gut. We look at hormones, we look at the blood sugar regulations system. You look at the musculoskeletal system, we look at the detoxification system, we look at the immune autoimmune inflammation spectrum as well. And then the eighth is the interconnectedness of the seven.

Dr. Cole: 14:21 It's the PO concept of poly inflammation or you know, inflammation in one area can have a ripple effect, a down like a, a cascade of inflammation and other areas of the body. So things going on in the gut can impact the brain. Things that happen in the brain can impact the hormones to the brain. Adrenal was the brain, thyroid at the brain, ovarian or to stickler access and so on and so forth. The body is brilliantly interconnected. So for example, if somebody with one auto, I mean conditions that have 50 to 70% risk depending on who you're talking to and the health problem you're talking about. A is at risk for other autoimmune type problems or what's called poly auto immunity, where I got the term poly inflammation. So it's just kind of looking at the different, eh, the types of inflammation. So, depending on your quiz score and where you fall on the inflammation spectrum, which again, this, the quiz is just adapted from questions that I ask patients. And then they, at that point, they can kind of have their own plan that's based on the quiz score that is adapted from protocols that I put patients on. So it is that's, that's what the inflammation spectrum is and those are the, the seven sections and then the eight section being the interconnectedness.

Allan: 15:36 And, and I guess, you know, sometimes it, it's probably difficult to, to know how bad inflammation is affecting, you know, perfect example I'll give you is when I first went on to Quito and all of a sudden, you know, I'm cutting out grains and I actually, I cut out dairy when I first went into ketosis and I was like, wow. I, I didn't realize how foggy things were. So while I didn't recognize that there was you know, there was some, it probably some inflammation there. I, I benefited. And so I think if you're, if you're dealing with stomach issues, like irritable bowel and you start working on that problem, you're probably gonna notice benefits and some of these other systems as well.

Dr. Cole: 16:18 Yeah, for sure. Absolutely. That's something that I sadly, I see on an almost hourly basis. This sort of, it's not one thing, it's a confluence of factors that kind of give rise to some why somebody feels the way that they do.

Allan: 16:32 But we, we almost take it as normal. It's like, you know, that Bob is how we were, you know, I, you know, I can't, I can't eat certain foods because I in all ended up with the stomach problems, so I don't go out with friends anymore. You know? So it's, it, it really is kind of a snowball in that, you know, you're, what you're doing, what you're eating is affecting your life, but what, what you're now not doing is affecting your,

Dr. Cole: 16:56 Your happiness. Yeah. Yeah. And so many people, you're right, just settle for it. Cause they're like, well that's me. Or that's just part of growing older or that's just, they don't even think about it. It's not even, doesn't even give rise to even have thought. They just know that's their limitation or what they struggle with, whether that's energy or a food issue or a digestive problem or any other inflammatory health problem is something that I talk about throughout the book. Cause ubiquity doesn't necessarily equate with normalcy. Just because you're going through something every day doesn't necessarily mean you should settle for it. And yeah, that's the case for a lot of my patients.

Allan: 17:32 Oh wow. Yes. now what you're basically doing with your, you call it the core four and the eliminate they're effectively elimination style diets. But you've set them kind of at two different levels based on how, how we score. So someone who's doing reasonably well, well they can just do the core four. It's an easier program. Someone who's done, I like having some major issues, they may want to go further into eliminate. Can you kind of talk about those two? Compare and contrast them?

Dr. Cole: 18:05 Yeah, sure. So core four is the people that scored lower on the quiz score. And that's for a time. We are removing grains, added sugar, high Omega six oils like canola oil, vegetable oil and dairy. And then we have quite detailed descriptions in the book, especially upon reintroduction of those foods, like the types of grains and the types of bad sugar and the types of oils and the types of dairy, like the [inaudible] fermented, all this different variables we cut. I cut the guesswork out of it as much as possible because I'm not making a blanket statement against those foods. I really want the person to find out what works for the body and what doesn't. Like I had do not have a horse in the race when it comes to that. And that's the heart of bio-individuality. So when people enjoy certain foods, some people feel fine on certain foods.

Dr. Cole: 18:55 Okay, let that be that, let that be for that person. I'm okay with it. But as long as it's not impacting your quality of life, as long as you're living the life you want to live and you're not having a negative impact in your life as far as health is concerned, then go for it. So that's the core four and then the four more core, four plus four more are the eliminate. See my play on words like does not end in that book. Too much fun with that. But core four plus four more is the night shades, nuts and seeds, legumes or beans and eggs. Again, all whole foods, all real foods. I am not demonizing any one of those foods, but I'm talking about the different proteins like lectins and alkaloids and albumin and casein and all the different stuff that we, that research shows for some people could be problematic.

Dr. Cole: 19:45 So we talk about bio-individuality with that. And you may find like through that experience of food, you do fine with the six of those foods, but not with the two or you do fine with half but not the other half. That is the clarity and the food piece that I want people to find. But you don't know when things are all the, when you're disillusioned, biochemically speaking, when you're having inflammation and imbalances and reactivities and you don't know what, what's way is up and which way is down. So the process, and you're right, I mean the elimination diet and the way that we targeting this is still the gold standard in clinical nutrition and functional medicine. As long as it's properly formulated and reintroduction is properly formulated too. So we put it all in there. So you know, like really the gold standard when it comes to knowing what your body loves and what your body hates when it comes to foods.

Dr. Cole: 20:38 So that allows whoever, however you prefer to eat, whether you eat keto or paleo or men at a training or more plant based or more carnivorous, you will know what foods work best for you under that paradigm. So I was very clear on this. This is not a Quito book like my first, well this is not a plant based book. This is not any type of way. This is just looking at the research, looking at clinical experience. And so you can eat the best Kito diet that you can eat. You can eat the best plant based diet that you can eat when you learn what your body loves. So that's what the inflammation spectrum is all about.

Allan: 21:12 And, and that's again, when, as I went through the book, I was like, this is, this has to be the best book I've ever read on elimination diets. It walks them through step by step. It gives them exactly a Y a and it provides a lot of information about these [inaudible] that I, you know, I didn't even know. I didn't know there were two types of cases. I suspected that there were good proteins and bad proteins at some level you know, we like to say there's good protein, good fats and bad fats and there's good carbs and there's bad carbs. And, and I've always said, I said, I think for each individual there's probably some bad proteins that they should avoid. And the only way we're really gonna know that is by eliminating them and then systematically reinduce re reintroducing them.

Dr. Cole: 22:02 Yeah, exactly. Exactly. And that's the thing. I mean, people can just put the time in to kind of really give their, give themselves to that feedback. Because once you're on the other side of it, it is a no brainer because you feel better. Inflammation is calmed, you are residing more in vibrant wellness. And at that point it's like, okay, I like feeling better more than I missed that food. Like I don't really think about it because that food makes me feel really lousy. Why would I want to go back to eating that way? So that's the paradigm shift and the sort of like you are able to see things a lot more clearly both physiologically because you have left brain fog and more energy, but also you just have more biofeedback cause you kind of know, Hey, best food makes me feel bad. But most people don't even know. Like we talk about the ketogenic diet, maybe people have problems with dairy or certain fats or eggs and they're eating it thinking it's great cause it's just Quito. Well maybe not. Maybe you need to reformulate your ketogenic diet in a new way. So we talk about all those nuances in the book.

Allan: 23:08 Yeah. And like I said, it, it really, it really dives deep into it, but it, it sets it out very, very simply along with putting in recipes. So, you know, you don't have to guess. And I liked, I like also you can you want through and kind of talked about different supplements that can protect us or help us deal with each and every one of these eight systems as we're going through that. Along with some, some positive mind stuff with the mantra. So again, all those, just like I said, it's like resonated with this book really, really well. Beyond the food though and I'm glad you did this. You talk about eight lifestyle habits

Dr. Cole: 23:46 That can also help us through this journey and you, and again, as part of this process that you go through cool before and eliminate you walk us through adding these into our lifestyle as well. Could you, could you talk about those? Yeah, it was such a big important part for me to include these because it's not just about food and you could have the perfect macros on point. You could have eating, eat cleanest, like foods amazingly like a good stuff. But if you're like not dealing with the non food things, like if you're serving a body, a big slice of stress every day or if you're consumed with your smartphone and you're scrolling endlessly. I mean looking at the blue light and the FOMO inducing content like stress and shame and social isolation, those are all impacting inflammation levels as well. So we have to look at all these, what I call in the book non-food and flamers that also instruct our biochemistry because that is the connection there.

Dr. Cole: 24:45 I mean our external life impacts our physiology. And then in turn our physiology impacts our external life. Like we in structs on what we do or we're not doing our thoughts and emotions and all that stuff. So looking at that bi-directional relationship between us and the world around us or epigenetics really. So it's that's the non-food inflame or so we talk about stress in detail and all its different forms. Like we made eight nonfood and flamers to go along those eight weeks for the people that are on the eliminate track. And then for people that are on the core four track, they can just go and pick the ones they want to work with. But I would encourage honestly any reader to go through the eight a nonfood and flamers because the things that most people, most of us are going through to various degrees and there are things that are in many ways more insidious than the food.

Dr. Cole: 25:39 Like it's easy to say go off of sugar for X amount of weeks or go off of nightshades for this amount of weeks and bring introduced them, but it's a little bit harder when it's like negative self talk or it's screen addiction or like social media addiction or whatever the case may be. It's a little bit more permeated into our daily life beyond just meals. So I really wanted to raise the awareness of people realizing the fact that it's not just about the food. We have to look at all this other stuff too. We have to look at things like sleep as well. I don't know if I mentioned that or not, but all of these things, just one night of poor sleep will spike high sensitivity, C reactive protein, HS, CRP, which is an inflammatory marker that we look at to gauge inflammation from a lab standpoint. So definitely important because I see it a lot of times with patients is they have the food down pretty good, but it's the non-food stuff there is sabotaging them. Absolutely. So Dr. Cole, I define wellness as being the healthiest fittest and happiest you can be. What are three strategies or tactics to get

Allan: 26:44 And stay? Well,

Dr. Cole: 26:46 I would say decrease the amount of sugar you're consuming. Increase the amount of healthy fats you're focusing on. Specifically things like all lobes and olive oil and [inaudible] and oil. Although avocado oil and third, I would be bring an act of stillness into your life. So whether that's mindfulness of breathing or just getting out in nature or just turning off all technology and just being, I think those are the three things that I would say impact people the most.

Allan: 27:17 I completely agree. Those are perfect. I'm in the process of developing another episode. I'm going to talk about my favorite health and fitness books. And I'm glad I waited to record that episode because you're definitely hot. I love this book. I do think you should get out, go out and get the Inflammation Spectrum. If you're, if you're feeling anything and you know, there's some inflammation in your life. This is, this is the tool, this is, this is what I would recommend you get. So a doctor called people wanted to learn more about you, learn more about the book Inflammation Spectrum, where would you like for me to send them?

Dr. Cole: 27:51 Yeah, and thank you again for the kind words and for having me back on. I really appreciate it. Is that everything's a drwillcole.com. And on Instagram it's our Dr. Will Cole, but we offer a free webcam or health evaluation for people. If they want a functional medicine perspective on their case. And we just launched it online in group class, which I'm really pumped about too. So yeah, we have all that going on. They can get that information and they can order the books at drwillcole.com too.

Allan: 28:21 You can go to 40plusfitnesspodcast.com/413 and I'll be sure to have the link there. So Dr. Cole, thank you so much for being a part of 40+ Fitness.

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Another episode you may enjoy

Keto for vegetarians and vegans with Dr Will Cole

Less...

October 4, 2018

in guest/interview , health , keto by allan

Keto for vegetarians and vegans with Dr Will Cole

In his book, Ketotarian, Dr. Will Cole gives us a guide on keto for vegetarians and vegans. Many people believe that keto and vegetarians and vegans are two different paradigms, but Dr. Cole shows us that we can have the best of both worlds.

Allan (1:05): Dr. Cole, welcome to 40+ Fitness.

Dr. Cole (1:10): Thanks so much for having me.

Allan (1:11): The book is called Ketotarian: The (Mostly) Plant-Based Plan to Burn Fat, Boost Your Energy, Crush Your Cravings, and Calm Inflammation. And just to start out with, I have to thank you profusely for writing this book. If I see another “bacon, bacon, bacon” conversation about keto, if I had hair I would pull it out. It’s one of those things. Yes, we want high fat, but that doesn’t mean that you just do away with the fact that our body needs the nutrition from the food, and not just the fat. So, I really did appreciate your approach to, one, how you explain the process of this working, and two, you actually put it together for folks with recipes and everything else.

Dr. Cole (2:01): Thank you so much, I really appreciate that. And that’s honestly one of the main reasons why I wrote Ketotarian, was to bring something new to the conversation. Like you said, the “bacon” conversation has been done. We don’t need another conventional ketogenic cookbook or health book out there. So I think something fresh, a plant-based, ketogenic conversation has been started.

Allan (2:26): Yes, and that’s why more and more of my clients are asking about this, like, “I really don’t want to eat a lot of meat and I’m trying to stay more vegetarian or more vegan.” There’s been this conversation that’s swelled up from behind me on this. I eat a lot of plants, but it’s within the realms of knowing my macros and knowing what my body can tolerate. Could you take a few moments to explain what ketotarian actually means and how someone would consider doing something like this?

Dr. Cole (3:00): Sure. Ketotarian is a book that we’re talking about. It’s my plant-based ketogenic book. Half of the book is science and health tips and functional medicine sort of perspective, which is where I come from, and ethos of why we’re doing this. And the heart of wellness that I think has to be at the foundation for sustainable wellness is really having self-respect. Self-care is a form of self-respect, and eating healthy foods and taking care of yourself is a form of self-respect. It’s a different conversation that’s being started for a ketogenic book, but I think seeing patients I realized for someone to sustainably be successful for any way that they’re eating, it has to be coming from a place of self- respect, presence, and loving your body enough to nourish it with good foods. So that’s really the cornerstone of Ketotarian in the first half of the book, plus all the health benefits of ketosis and the health benefits of being plant-based, and all the science and research. It’s heavily referenced, as far as the scientific literature is concerned.

And then the second half of the book is recipes, meal plans, all this practical stuff and pretty pictures. There’s over 81 different vegan, keto, vegetarian-keto and pescatarian-keto, or what I call in the book Ketotarian – another play on words – plant-based, but with wild caught fish and shellfish. So people can eat one way, they can just be vegan-keto, or they can eat a mixture of vegan, vegetarian and pescatarian options. And it’s this 8-week, plant-based keto experience for people to shift their body from being a sugar burner to a fat burner, get the anti-inflammatory benefits of ketosis. That’s what they’re doing in ketotarian. So it’s a play on words. I had somebody point out to me, I kind of created a celebrity couple name out of the title of my book. So, like Brangelina, this is ketotarian. It’s this amalgamation of the best of both worlds of being plant-based and keto.

Allan (5:15): The interesting thing is, I have a lot of keto authors on here, and I have a lot of vegetarian and vegan authors on here. It’s because I don’t want to be prescriptive about what someone’s going to eat. I need them to be comfortable that this fits their lifestyle, this fits them as a person. I’ve even said that to people, that when I talk to someone who’s on the keto side, who’s really successful at it – has gotten rid of their inflammation, is healthy, or I talked to someone on the vegan side who’s healthy, they’re always talking about whole food. They’re not talking about packaged things. Some of them do go a little under the bacon side on the keto, but that all said, I think it created this “us versus them” that really didn’t have to exist.

Dr. Cole (6:02): Absolutely. It’s a very strange thing, but I think tribalism is really deep in America right now on many different levels. And I think that this is just one sort of weird aspect of tribalism where it’s completely unnecessary. The dogmatic sides of both camps is just unnecessary, because we actually have way more in common than we don’t. I think Ketotarian illuminated the fact that there are so many commonalities there. And ketogenic, that way of eating, really can be any modality of eating. It could be pescatarian, it could be vegetarian, it could be vegan, it could be more Mediterranean with the fish too. There are so many ways to do it. And then obviously we have the carnivore diet that’s coming up, which is a form of ketosis, a higher protein ketogenic approach. So you have really all these different forms of ketosis, therefore it doesn’t have to be this “us versus them”. It’s just a way of using food to our advantage, to put our body into this anti-inflammatory, fat-burning state.

Allan (7:12): One of the cool things that you brought up in the book is, this is really about being aware and mindful of the food that you are eating. So this is not just happenstance. Obviously, yes, if you eat a predominantly meat-based diet that’s not lean meats, you’re probably going to go into ketosis at some level. If you’re eating a high fat diet with bacon and all the other stuff that’s coming out of boxes that are marked “keto-friendly”, you’re going to go into ketosis. It takes a little bit more, I think, mindfulness and a more sound approach to food when you’re trying to do it from the vegan or vegetarian aspects. And you had this term you used in here called “ketotarianisms”. Could you take a minute to go through those? I think this really highlights what I’m after here, about how you start getting a lot more mindful about your food, you start focusing more on the quality, and you end up a lot healthier for it.

Dr. Cole (8:10): Yeah. So ketotarianisms are the basic tenants of this way of living and eating. It is basically when you are having a healthy fat, add a green, not-starchy vegetable, and then conversely, when you have a non-starchy vegetable, eat a healthy fat. And then eat when you’re hungry, eat until you’re satiated. These are some of the ketotarianisms that people can live. These are basic principles that really are common sense when you read them, if someone wants to keep it simple. In Ketotarian, I wanted to show all the biohacker, science stuff where people can lean into, or they want to take their wellness to the next level, but I realized there are going to be a lot of people that are reading Ketotarian that are new to this, that feel overwhelmed or, “Where do I start?” I think things like the ketotarianisms or the “keeping it simple” options in the book are really a good segue for people to lean into it and still get the benefits of these healthy, real foods without feeling like they have to go zero to 60 and understand all the science to get started. It’s really not necessary at all.

Allan (9:29): I had a client and he was telling me it’s blueberry season and he can’t help himself every time he goes to the farmer’s market. He wants to eat low carb. And our ancestors, when berries were abundant, they ate the berries. There’s nutrients in the berries that your body needs. Enjoy the berries while they’re in season, because you’re only going to get them for a few more weeks, and you’re not going to have the berries. I think a lot of us get tied up in the “We have to eat this way” or “We have to eat that way.” And there’s so much what I would call “biodiversity” of how each of us handles carbs, our insulin resistance, those types of things. One of the things that you had in the book that is a little different than the guidance I see from a lot of the keto space is that instead of focusing on total carbs, which the 20 grams of total carbs is the earmark out there – you’re going to go into ketosis if that’s what you’re eating. But you focus more on net carbs, which allows us effectively to eat a lot more high fiber vegetables. Could you talk about the net carbs? Having net carbs someone could probably get away with and still get into ketosis or get the benefits of the low carb eating. And then compare and contrast that with total carbs.

Dr. Cole (10:45): Sure. So, total carbs are the sum of all fiber, sugar and sugar alcohols and everything. Net carbs is subtracting fiber and sugar alcohols, if there are sugar alcohols in wherever you’re eating. But basically the fiber, the soluble fiber and the insoluble fiber, we’re subtracting in ketotarian, and many other ketogenic resources you’ll find in books and online too. But Ketotarian definitely does talk about how when we’re working on and focusing on real non-starchy vegetables and real plant foods, that’s when you use net carbs. You do not use net carbs whenever you’re eating junk food and boxed foods and you’re just trying to make yourself feel better by having carbs. At that point it’s not in its whole food form, it’s not in alignment fully with nature, and you can manipulate numbers, I think, for the sake of dieting that isn’t going to produce the same results as if you ate an avocado with tons of fiber, or any other vegetable with lots of fiber when it’s in this whole food form. That’s what we’re talking about when we’re considering net carbs.

So, in the book for all the recipes, I give the net carbs because it is basically subtracting all the fiber. What I allow for, or what I recommend I should say, in Ketotarian, is the first week or so – and sometimes people should do longer than a week – they should do about 25 grams of net carbs throughout the day. So every day their max should be 25 grams of net carbs or less. From there they can find their carbs sweet spot during these eight weeks of being in ketosis from this plant-based approach. Now, the max allowance in ketotarian is 55 grams of net carbs a day. I just wanted something basically average to allow people to have lots of vegetables in, but I know as a functional medicine practitioner that there’s biological variability. I realize that there are some people that will do better with a little bit less, there are some people that can get away with a little bit more. I have some people in ketosis up to 100 grams of net carbs from non-starchy vegetables, because they’re insulin sensitive, they don’t have a lot of inflammation, and they’re fine there. They’re fasting and they can get away with this. But most, I think 55 grams. Why I put it in the book is because it’s the middle of the road for most people to get the benefits here. They can implement it into intermittent fasting and time-restricted feeding, and we talk about that in the book. They can still get all these cool benefits while not restricting their plant foods.

Allan (13:33): The great thing about this is, so many of us, when we first start getting into ketosis or thinking about ketosis think we can’t have fruit. A lot of your recipes do actually have fruit in them. So this is an area where we are, because we’re going to go for the high fiber type of fruits. We are going to be able to eat more fruit with this. When I think about the number of how much food you can eat of non-starchy vegetables with that many grams of carbs – that’s pretty substantial. This is going to be the bulk of your food. This is going to be your entree, and not a meat entree. This is going to be your main source of energy and food, less so the proteins that we would normally have in a steak or something like that.

Dr. Cole (14:26): Exactly. It’s plant-centric. I think that people can pick their level of where they want to go with this. I’m not saying everyone has to be a vegan-ketogenic eater, but definitely when we bring the vegetarian options like the eggs or the ghee, or the pescatarian options with the fish or the shellfish – it’s still plant-centric. These are just different food medicines to bring into this clean, keto way of eating.

Allan (14:54): And that’s what I really liked about it – it said, “Here are the nutritional aspects of how you’re going to eat. These are the net carbs you can get.” And then beyond that, it went through and said, “If you want to make it a little easier to do this, then here’s the option for you to do the vegetarian versus the vegan, and here’s an add-on if you want to include some fish or shellfish. It’s going to have these particular benefits.” So, it’s something that somebody can really look at their way of eating and be thinking about, “How do I make this work for me?” It’s not just this fixed go. And your recipes also break that down, where there are some recipes that will have fish, some that will have eggs, and others that are completely vegan.

Dr. Cole (15:36): Yeah. And I think to your point, with your client with the berries, that’s something that I really wanted to have, this grace and lightness to food. We shouldn’t be stressing about and obsessing about our food and making food this arduous, negative thing. I wanted to recalibrate the conversation, especially in the keto world, which I think can be a little bit too obsessive with foods, and shaming, and orthorexic in a way. What I wanted to say is, “Let’s do this for eight weeks. Let’s shift the body into ketosis. Let’s get the benefits of ketosis.” But from there, like you said, seasonal ketotarian is mentioned in the book, because during the summer if you want to have more fruits and more natural carbs into your life, you normally buy seasonal fruits – then do that. Some people love that and enjoy that, but during the colder months they’re more in ketosis naturally and eating more of this primal way of cycling ketosis approach throughout the year. And some people do that cyclic approach throughout the week, where they’re doing two to three days higher carbs, the other days in ketosis. Again, this is all in the context of real foods. This, I think, needs to be talked about more in the ketogenic world, because so many of them are very dogmatic in the sense of, if you leave ketosis, you’re somehow doing your body an injustice, and that’s not the point of the ketogenic diet and it’s basically all or nothing. I don’t think it’s all or nothing. If you really say “all or nothing”, you obviously haven’t talked to patients or clients and seen biological variability, because you’ll be proven wrong all day long, hanging your hat on one way of doing anything when it comes to food.

Allan (17:28): They would have to kick me out of the Keto Club, because I do the seasonal ketosis. And that’s because there are certain times of the year where I know it’s going to be easier for me to maintain the low carb and just get a little bit tighter on things. And then there are going to be times when we’re in football season and we’re going to come up on New Year and things like that, and I’m going to want to have a beer. My brother owns a brewery, so I’m going to want to have a beer here and there. But I pick my times, I pick my battles, and I’ll go out of ketosis for a period of time. It’s something that’s natural to me, it’s something that feels good. And I don’t have any kind of metabolic problems, so it’s very easy for me to shift fuel sources, depending on how I approach food.

Dr. Cole (18:11): That’s great. That’s the goal of this eight weeks – to build that metabolic flexibility. And you’re right, not everybody has that. Some people with insulin resistance or diabetes or inflammatory problems can’t get away with that. But the goal is to build as much metabolic flexibility as your body allows you to.

Allan (18:31): Yeah. That’s the other aspect of it – some of us are going to go right into ketosis, not have a big problem with it. Others are going to suffer a little bit more, or some really are going to struggle to get into ketosis because their metabolism is a little bit racked and needs some repair. In the book, you share some tips for individuals that are struggling to get into ketosis. Would you mind sharing some of those tips?

Dr. Cole (19:00): I’m just thinking off the top of my head what’s in the book, but one is, if you’re eating a certain level of real food, net carbs or eating plant foods – I would try lowering the amount of carbs as your body adjusts. The state of ketosis – this metabolic, fat-burning, anti-inflammatory, brain-fueled state that we’re talking about here – is through carb restriction. So it’s not necessarily eating tons and tons of healthy fats, even though healthy fats can increase ketones too. But it’s really the carb restriction primarily that will do it. And then secondarily, it’s what do you fill in from that carb restriction? So, lowering your carbs more. If you’re higher net carbs, maybe lower it below 25 for a time as your body gets more fat-adapted that way.

Another tip to get in ketosis if you’re not in ketosis, is to help your body out with getting the benefits of ketosis and raising blood ketone levels with exogenous ketones. You can use MCT oil or different exogenous ketones in drinks or supplements, or you can increase the amount of circulating ketones in the body to get the benefits of it – basically get your boost of energy, help with brain function, etcetera. So if someone’s making that, they’re in this sort of metabolic purgatory where they’re not becoming a fat burner overnight. It may be they’re going through insulin resistance or other health problems, whether they’re slow to make that transition. You can kind of help your body along with some exogenous ketones as you’re making that metabolic transition.

And then some maybe lesser known ideas to help your body get into ketosis is to deal with stress levels and look at sleep, because cortisol fluctuations when someone’s in stress – that can impact the blood sugar, blood pressure, and ketone production. And looking at sleep levels, sleep optimization, which is another thing to consider. Those are some things that are maybe less commonly thought of when you’re talking about, “I’m going to go keto and get the benefits of going keto. I’m going to lose weight”, or whatever it is. You have to look at stress levels; these are important.

Another thing to consider is intermittent fasting. If someone’s not intermittent fasting, which will produce increased ketone levels as somebody is intermittent fasting, they should consider that. That’s another way to produce more ketones, get the benefits of ketosis, but it’s also the effect of ketosis. As someone becomes more and more fat-adapted, it’s a natural result of that. You’re just less hungry, your blood sugar’s more stable, you’re less irritable and hangry. So you just randomly will intermittent-fast, not because you’re trying to or you’re thinking about it, but because, “I’m eating when I’m hungry, and if I’m not hungry, I’m not going to eat.” If that involves not eating breakfast or having a lighter meal at a certain part of the day, these variations of intermittent fasting can happen too. So these are some ideas if someone’s having a difficulty, but we have other ones mentioned in the book too.

Allan (22:21): One of my favorites – obviously I’m a personal trainer, so I’m going to like the “movement” one. It’s interesting though – a lot of people will advise people starting into ketosis to actually avoid exercising. And I’ve always had the opposite opinion. While you might not want to exercise at the same intensity, the stress and the cortisol, there is some value to movement and exercise when you’re trying to get into ketosis.

Dr. Cole (22:47): Absolutely. That’s a great one. I think that movement and staying active should be a part of it. It shouldn’t just be food. I think movement is an important part of wellness. Like you said, you may adjust what you’re doing physical activity-wise, but you shouldn’t stop it.

Allan (23:06): Outstanding. Now, if someone wanted to get in touch with you to learn more about the book, where would you like for me to send them?

Dr. Cole (23:15): Everything’s at DrWillCole.com. There are links to the books, but it’s on Amazon and Barnes & Noble, and in independent bookstores too. But everything’s there. I’m seeing patients throughout the week, and we have primarily a virtual clinic where we do webcam consultations for people. So they can get a free health evaluation on DrWillCole.com too.

Allan (23:41): Cool. This is episode 340, so you can go to 40PlusFitnessPodcast.com/340, and I’ll have the links there to Dr. Cole’s site and to the book on Amazon. Dr. Cole, thank you so much for being a part of the 40+ Fitness podcast.

Dr. Cole (23:59): Thanks so much for having me.

Allan (24:06): If you enjoyed today’s episode, would you please take just one moment and leave us a rating and review on the application that you’re listening to this podcast right now? I’d really appreciate it, and it does help other people find the podcast because it tells the people that are hosting these podcast episodes out there on their apps that you’re interested and they know that other people like you might be interested. So please do that. If you can’t figure out how to do that on your app, you can email me directly and I’ll try to figure it out for you. Or you can go to 40PlusFitnessPodcast.com/Review, and that’ll take you to the iTunes where you can launch that and leave a review there. I really appreciate the ratings and reviews. It does help the podcast, it helps me, so thank you very much for that.

Also, I’d really like to continue this conversation a little bit further, so if you haven’t already, why don’t you go ahead and join our Facebook group? You can go to 40PlusFitnessPodcast.com/Group, and that’ll take you to our Facebook group where you can request entry. It’s a really cool group of people, like-minded, all in our 40s, all trying to get healthy and fit. I’d really love to have you out there and have you a part of that conversation. So, go to 40PlusFitnessPodcast.com/Group.

October 5th, here in Pensacola Beach. If you’re anywhere close, you should come down for this. I’m going to be teaching a cooking class on how to cook for Thanksgiving and remain keto. Also, we’re going to have talks from Carl Franklin of 2 Keto Dudes, and myself. It’s going to be a great time to meet other people in the area that are passionate about keto or want to learn more about keto. So, wherever you stand on that spectrum of either being keto and loving it or wanting to know more about keto, this is going to be a great opportunity for you to connect with people and learn a lot more about it. So I’d encourage you to go to 40PlusFitnessPodcast.com/Ketofest, and that’ll take you to the Eventbrite page. There’s a low fee, $15, to attend. That’s really just to offset some of the cost of food. I really want to help you learn about keto, I really want to make sure I get a good event out there, so I didn’t charge a lot for this. I want to make sure it’s accessible to most folks. If you’re anywhere in the area near Pensacola Beach, I’d encourage you to come down for it. It’s October 5th and it’s going to run from 4:00 until 9:00, and of course, maybe a little later than that. You don’t have to be here for the whole thing. It’s really just about learning about keto, learning how to cook keto, and tasting some of the delicious food, because dinner is included. So, go to 40PlusFitnessPodcast.com/Ketofest, and that will take you to the signup page for our little Keto Minifest. And again, Carl Franklin will be here, so it’s a great opportunity to meet him in person.

And then finally, I am still working on the book, and I do need your help. I need your help to be a part of the launch team. If you can go to WellnessRoadmapBook.com, you’ll see a little form there where you can sign up to be on the launch team. The launch team is going to get a lot of extra goodies that are not going out with the book. They’re going to get some previews, they’re going to get some bonus materials that you’re not going to get if you wait for the book to come out. I know you want to learn about the book, I know you want to be a part of it, so please go to WellnessRoadmapBook.com. Thank you.

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