Is Keto The Best Diet For Tackling Inflammation Once & For All?

Functional Medicine Practitioner By William Cole, D.C., IFMCP
Functional Medicine Practitioner
Dr. Will Cole, D.C., IFMCP, is a leading functional medicine expert who specializes in clinically investigating underlying factors of chronic disease and customizing a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. Cole is also the bestselling author of Ketotarian and The Inflammation Spectrum.

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Our world has undergone rapid change over a relatively short period of time. Our food supply, water supply, the soil we farm on, and air we breathe are all changing and creating new challenges for our health. In many cases, our bodies react to these conditions by developing chronic, systemic inflammation.

Knowing this, it might not surprise you to learn that chronic, systemic inflammation is the root cause of almost all health problems. When you dive deeply into the etiology of various illnesses—like anxiety, depression, fatigue, heart disease, or autoimmune conditions—the roads all lead back to inflammation.

But inflammation is not inherently harmful. In fact, it's an essential part of our immune function. We need inflammation to fight infection and to heal. Without the ability to generate a healthy inflammatory response, we would die. When inflammation runs wild, though, it can be a core component of many of the diseases we face today, especially autoimmune diseases. As with everything in the body, healthy inflammation is all about balance.

Chronic inflammation and autoimmunity is becoming more and more common.

To date, there are close to 100 recognized autoimmune diseases, and an additional 40 that bear an autoimmune component. This number will certainly rise as science continues to discover autoimmune components in more diseases. We live in the Age of Autoimmunity, and the more the scientific community examines this phenomenon, the clearer it becomes that autoimmunity is driven by inflammation.

Because inflammation can affect any part of the body, its manifestations can be far-reaching. Some of the most-common early-onset symptoms of inflammation include:

  • Brain fog
  • Anxiety
  • Pain that travels throughout the body
  • Gastrointestinal flare-ups
  • Fatigue

In the United States alone, it's estimated that 50 million people have been diagnosed with an autoimmune disease. In most cases, the official diagnostic criteria are that the patient's immune system has already destroyed a significant portion of their body; for instance, a diagnosis of autoimmune adrenal issues or Addison's disease, requires 90 percent destruction of the adrenal glands. Equally sobering, major destruction of the neurological or digestive system is required for diagnosis of neurological autoimmunity (e.g., multiple sclerosis) or gut autoimmunity (e.g., celiac disease), respectively.

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Autoimmune diseases and inflammation have everything to do with your lifestyle.

But the autoimmune-inflammation attack that occurs in these conditions does not develop overnight; it's the end stage event of the larger, autoimmune-inflammation spectrum. When someone is diagnosed with an autoimmune condition, they have already been experiencing autoimmune inflammation for an average of about 4 to 10 years. The focus of my functional medicine practice is on addressing the causes of inflammation before the patient reaches that end-stage level of destruction. After all: What sense is there in waiting until you have an autoimmune disease to start caring about inflammation? Especially when, at such a point, the only options typically offered to many people are steroids or immune-suppressing drugs? We can do much better. My practice is about taking proactive steps to tackle inflammation before it leads to something more serious.

So what can you do to fight inflammation now? Studies point to what many in functional medicine have been saying for decades: Lifestyle and diet are paramount. In fact, studies estimate that about 77 percent of immune-system reactions are determined by factors over which we have at least some control, such as our diets, stress levels, and exposure to pollutants, with the remainder determined by genetics.

How the ketogenic diet can help tackle inflammation and autoimmunity.

In my experience, the vast majority of us wield plenty of power to take control of our health by pursuing positive lifestyle interventions. Whether those changes improve our quality of life by 25 percent or 100 percent, any increase is a move in the right direction. Instead of doing the same things we always have, repeatedly, but expecting different results, we can enact positive changes. One of the most profoundly helpful lifestyle applications I have found for calming inflammation and balancing the immune system is the ketogenic diet.

The ketogenic diet does wonders for controlling mechanisms responsible for chronic inflammation. Ketones like B-hydroxybutyrate are not just a form of fuel—they're also signaling molecules and epigenetic modulators that support and create anti-inflammatory pathways. In one example, the ketones produced in nutritional ketosis up-regulate something called the Nrf2 pathway and the powerful anti-inflammatory cytokine IL-10, while down-regulating pro-inflammatory cytokines. The Nrf2 pathway regulates antioxidant-gene induction and works to turn on genes responsible for antioxidant and detox pathways in addition to cell function and inflammation. When the Nrf2 pathway is functioning at optimal levels, inflammation is calmed. When levels are low, inflammation is raised.

When you are in a ketogenic state, the ketones your body produces and uses for fuel are powerful, inflammation-fighting superheroes. ß-hydroxybutyrate (also known as BHB) is a strong anti-inflammatory, inhibiting inflammatory pathways like NFkB, COX-2, and the NLRP3 inflammasome and activating the antioxidant, anti-inflammatory AMPK and Nrf2 pathways. Ketosis has also been shown to stimulate increased autophagy, or cellular repair. The take-home message is that ketones lower the inflammation related to just about every health problem we see today.

Additionally, BHB activates the very important AMPK pathway, which is involved in regulating energy balance and helps reduce inflammation by inhibiting the inflammatory Nf-kB pathways in the body. BHB also exerts a similar effect on pain and inflammation as the NSAID drug ibuprofen, by inhibiting the COX-2 enzyme.

Knowledge is power. This is not about shaming anyone about things they could have done differently in the past. But there's much we can do in the here and now. There is no cure for diagnosed autoimmune conditions, but we in functional medicine seek to give patients tools to manage their health. In many cases, there is a lot you can do to calm inflammation, balance the immune system, and, we hope, put your symptoms into remission. For the undiagnosed people struggling with autoimmune reactivity, there is also much you can do to take control of your health.

William Cole, D.C., IFMCP
William Cole, D.C., IFMCP
Will Cole, D.C., IFMCP, is a leading functional-medicine expert and a Doctor of Chiropractic. He...
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