Understanding the inflammation spectrum

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This is the age of inflammation, said Will Cole, DC, IFMCP, founder of Cole Natural Health Centers, at the 2020 Integrative Healthcare Symposium in New York City.

More than 60 percent of American adults have a chronic disease, and 40 percent have two or more chronic disease, Cole said. Someone has a heart attack every 40 seconds, cancer is the second leading cause of death, 50 million Americans have an autoimmune disease, and almost half of Americans has prediabetes or diabetes.

What do these conditions have in common? Inflammation, Cole said. In fact, studies have linked high inflammatory levels to several conditions, including autoimmune conditions, cancer, chronic fatigue, depression, metabolic syndrome, and sleep apnea.

Inflammation doesn’t happen overnight, Cole said. For example, when someone is diagnosed with an autoimmune condition, they have already been experiencing autoimmune inflammation for four to 10 years, Cole said.

Inflammation spectrum lab tests, Cole said, include:

  • C-reactive protein
  • Homocysteine
  • Ferritin
  • Microbiome panel
  • Intestinal permeability
  • Multiple autoimmune-reactivity labs
  • Cross-reactivity labs
  • Methylation gene labs
  • Cannabinoid gene

To help a patient identify their inflammation profile, rank the following on a scale of one to 10, one being optimal health and 10 being chronic health problems. This allows the practitioner to identify and treat inflammation before it gets worse, Cole said. A person’s inflammation profile includes:

  • Brain and nervous system
  • Digestive tract
  • Liver, kidneys, and lymphatic system
  • Liver, pancreas, and cellular insulin receptor sites
  • Endocrine system
  • Muscles, joints, and connective tissue
  • Immune system
  • Polyinflammation

Cole said he stresses the importance of bio-individuality. On person’s food medicine is another person’s food problem, he said. According to Cole, 99 percent of our genes were formed before the development of agriculture around 10,000 years ago, and 77 percent of inflammatory reactions are determined by lifestyle factors with the remainder determined by genetics. Therefore, what causes inflammation is unique to the individual, as is what lowers inflammation for a particular patient.

“It’s about finding your inflammation triggers and your inflammation calmers,” said Cole. “If I hung my hat on one way of doing things that’s going to solve all my patients’ woes, I’d be proven wrong all day long. We have to keep an open mind and stay flexible to hearing our clients instead of thinking there is only one way. What works for one person may not work for another.”

Cole recommends several strategies to reducing inflammation, all of which should be tailored to this individual’s needs based on their lab values, including:

  • Elimination diet, reducing sugar intake, limiting alcohol intake, and intermittent fasting
  • Eating wild-caught fish and quality fish oil
  • Managing stress, getting quality sleep, practicing mindfulness, and positive thinking
  • Supplement with B vitamins, fat-soluble vitamins including vitamins A, E, and K, zeaxanthin and B-cryptoxanthin, probiotics and prebiotics, magnesium, coffee or green tea, vitamin C, and cannabidiol (CBD) oil
  • Physical activity, tai chi, and yoga
  • Increasing Nrf-2 and decrease NFkB
  • Getting more peroxisome proliferator activated receptors (PPARs)
  • Checking and balancing hormones
  • Avoiding mixing refined carbohydrates and fat, and eating healthy fats away from healthy carbohydrates
  • Adopting ketotarian diet

Cole’s ketotarian diet is a central component of his approach to reducing inflammation. A high-fat, moderate protein, and low-carb eating plan, the ketotarian diet is mostly plant-based, eliminating meat and dairy and focusing on plant-centric sources of fats. It allows some animal sources of protein and fats, including eggs, ghee, and fish. Ketotarian food staples include:

  • Non-starchy vegetables like leafy greens
  • Low-sugar fruits like berries
  • Plant-based fats, like avocado and olive oil
  • Organic eggs
  • Ghee
  • Wild-caught fish and fresh seafood

Implementing a ketotarian diet will depend on the individual’s needs and preferences, but the goal is to create metabolic flexibility and ketosis is a useful tool to achieve this. The ketogenic diet has been thought of as a fat-burner, which can lower inflammation but is also a signaling molecule and epigenetic modulator, working on anti-inflammatory pathways.

Cole does recommend incorporating time-restricted feeding and intermittent fasting. The ketogenic diet can mimic the effects of fasting, but they do go hand-in-hand, he said.

“We’re seeing [inflammation] cases more and more,” said Cole. “It’s important for us to not delegitimize people when they’re talking about the suffering they’re going through, to listen to them, and figure out what’s really going on. We need to keep open-minded about what things haven’t been looked at so we can treat them well.”