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December 23, 2019

The inflammation spectrum with Dr. Will Cole

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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.

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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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