Nutrient Density, Ketosis and Chronic Inflammation with Dr. Cheryl Burdette

Hello and welcome to the Dr. Jockers Functional nutrition Podcast. The show designed to give you science based solutions to improve your health and life. I'm Dr. David Jockers, Dr. Of Natural Medicine, Chiropractor and Functional Nutrition practitioner and I'm the host of this podcast. I'm here to tell you that your body was created to heal itself and on this show we focus on strategies you can apply today to heal and function at your best. I'm excited about today's podcast, but before we jump in, I wanted to remind you to download this month's Special gift@drjockersgift.com from Keto Meal plans, smoothie recipes to fasting Quick Start Guides, we have a new complimentary gift every single month. To get your Gift, simply visit drjockersgift.com that's D R J O C K E R S g I f t.com thanks for spending time with me and let's go into the show. This podcast is brought to you by Island Bliss, which is a product from the Earth Eco Foods line. Imagine feeling like you're in the tropics with every sip you take. That's the Island Bliss experience. It's loaded with superfoods and sweet enough to satisfy any sweet tooth. They have 12 organic greens that support a gut nourishing mood, elevating energy increasing and metabolism boosting protocol. They've added in their Vitaberry blend, they've got turmeric in there and they've got a prebiotic probiotic blend. All of that together makes Island Bliss the easiest way to get nourishing superfoods every day. Now I don't know about you, but most green drinks that I've tasted are chalky and bitter and they leave a lot to be desired. But Island Bliss actually tastes really good. Not only that, it's dairy free, soy free and gluten free and so it's loaded with superfoods, organic and tastes amazing. You guys are gonna love it. You can actually check it out when you go to earthechofoods.com and use the coupon code Jockers at checkout to save 15% off. Check out the Island Bliss again. You guys are going to love it. It's going to give you energy, take away cravings and really give you the boost that you need. How would you like to win a 90 day supply of Paleo Valley Turmeric Complex? Turmeric is one of the best supplements you can take to keep inflammation under control, to support your brain, your gut and your skin and really keep you healthy and strong and feeling great and you can win a 90 day supply now by going to ratemypodcast.com Jockers leave a review for our podcast and then send a screenshot or a confirmation of the review to assistantsoctorjockers.com Winners will be announced and contacted on November 30th and will receive a 90 day supply of the Paleo Valley Tumeric Complex. So that just may be you. On top of that, when you leave a review you help us reach more people and impact more lives. So thanks so much for doing that and I'm pulling for you, hoping that you will be the one that wins the 90 day supply of Paleo Valley Turmeric Complex. So again, Simply go to ratemypodcast.com Jockers leave a review and then send a screenshot or confirmation of the review to assistancerjockers.com to be entered to win. Hey friends, this podcast is actually an interview that I did a few years ago for a project I worked on called the Keto Edge Summit. The Keto Edge Summit was basically where I interviewed, I think it was like 36, 40 of the top keto experts in the world. We talked about all things keto. We talked about how to get the best results out of the diet, we talked about biohacking strategies to do to help improve your digestive system, to help improve your brain health, your energy and really get the most out of life. And so this interview is with one of my good friends who is an expert in many different areas and you'll see as we dive into this topic, just how deep we go and the quality of the content that you get. And so just a reminder, this is roughly, I think I did these interviews in 2017, 2018, so a few years old, but the content is just as relevant and I know that it will make a difference in your life. So you will enjoy this content. And if you wouldn't mind just leaving us a rating or review, your reviews really, really count. They mean the world to us and they help us get seen by more people. So if you just go to your Apple itunes player and rate us and leave a review, that will really help.

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Hey everybody, welcome to the Keto Edge Summit where we are dispelling the myths, helping you overcome the hurdles, and empowering you to improve your brain and your body through the ketogenic lifestyle. I'm your host, Dr. David Jockers and I'VE got a great guest today. This is Dr. Cheryl Burdett. And Dr. Cheryl is actually a naturopathic doctor. She works at Progressive Medical, which is one of the largest integrative health clinics really in the entire world. And it's based out of Atlanta, Georgia. And she's also a co owner of Dunwoody Labs, which is like a leading lab provider that provides a lot of labs for functional medicine, this kind of this new model of healthcare called functional medicine, looking at basically trying to find really where the underlying root cause of chronic disease is or major symptoms and helping people get to that root cause and really trying to help them optimize their overall health. And so, so great to have you, Cheryl. Yes, for sure. And as we get started here, just share with our audience really what inspired you to become a naturopathic doctor and to really do what you're doing today, working with Progressive?

Well, it just seemed that there was such an obvious need. So my path was very organic, doing pre med and psychology, dual majoring in those two areas. And, and I thought surely there must be some overlap between the mind and the body. Surely these shouldn't be as divided as disciplines as we've got them boxed out to be at this moment in time. And so my last class in psychology was called self regulation, biofeedback and meditation. And I worked with some studies there and we looked at how we could self regulate. And one of the things that we would work with people on is we would to attach them to electrodes and then give them some biofeedback, meaning they could see what was going on inside their body. In this study that we were working on, we worked to teach college students to either take their body temperature up or down. And what we found is the ones that came and practiced and worked on that could move their body temperature by 3 degrees on call, either up or down, they got a dollar for every degree they could take it one direction or another. And so my mind was really blown to think, wow, the mind can control even things like body temperature. Now maybe that that's not so useful in everyday life, but you apply that kind of philosophy to things like blood pressure or anxiety or helping you get to sleep at night. And so what we quickly see is the brain is one of the most powerful tools that we have. And if we're really going to influence root cause change, then teaching the brain to do things more accurately makes a lot of sense. So then from there I went to college guides. I looked to see are there medical schools that are more interdisciplinary and What I found was not exactly, but there were these things called naturopathic medical schools that I had never heard of and really never experienced. But I thought, this is what I want to do. I want to treat the whole person, not the mind in one box and the body in another, but everything together. So that led me on my path to naturopathic medicine.

And that is what's so cool about naturopathy. My mom is actually a naturopath. I was trained originally as a chiropractor. And so it's kind of that holistic model looking at every system and how it intertwines.

Right.

And so key. And that kind of takes us right into our topic of inflammation.

Right.

And I know you're an expert in inflammation, and we know inflammation is the root cause really, of every kind of degenerative disease. And so can you explain to our audience really, what inflammation is? Define that for us.

Yeah.

And I think if we're gonna practice medicine in today's society, we all need to be experts in inflammation. Because really, when we get to the root cause of chronic conditions, inflammation plays some role. It might not be the entire story, but it's gonna be a piece of that pie. And so when I talk to patients, I talk to them about how there's really a difference between your diagnosis, the condition, you have the label on it, Attention deficit disorder or depression or als. There's a difference between the diagnosis and the process behind the diagnosis. And so when we start to think about a process behind a diagnosis, to me, there are a handful of areas that we really have to master as clinicians, and inflammation's right up top. My short list is inflammation, oxidative stress, you gotta correct nutritional deficiencies, you gotta reduce toxic body burden, and you gotta deal with mental emotional stress. And if we think about those five core processes, there's hardly a diagnosis that won't get better when we begin to think about those pieces. So, simply put, inflammation is kind of a fire that cooks your genetics. And when we think about most chronic conditions, you're not born with a chronic condition. You don't come onto this planet with rheumatoid arthritis. You don't come onto this planet necessarily with fibromyalgia. You don't come onto this planet with diabetes. So your genetics, it wasn't just inherent in your genetics that they were always going to express that. But what happens is we have a choice of that brew that we can cook our genetics in, and we can cook our genetics in a brew of high nutrition and low toxic body Burden and low inflammation or the opposite. We can cook our genetics in a fire that I would describe as being that inflammatory process. And when we cook our genetics in a more inflamed environment, that's what causes more pathology and symptoms to express itself. But conversely, the optimistic, the good news is as we reduce inflammation, we can reduce that process that exacerbates that genetic expression and really put the genie back in the bottle, so to speak. So patients often think in terms of, I have a diagnosis, I have a label, I have a condition. And that's right. But that's the first half of the story. It's not only what you have, but the process that drives that condition. And inflammation drives things like weight gain, drives fatigue, drives diabetes, drives many of the chronic conditions that we're dealing with in Western society today.

Yeah, and let's jump into that. What are the major symptoms? Like if somebody's out there, what are symptoms that they may experience that would clue them in? That inflammation? That they're being burned up, I guess you could say. Right. Or that they've turned on that fire of inflammation inside their system?

So many people are going to jump straight to pain. And that's correct. That's absolutely true. Inflammation can drive pain. We think about spraining an ankle or a wrist and it gets inflamed, it turns red, and you can kind of already see that idea of a fire going on. And so that's accurate. But what we also maybe don't realize as much is that we don't always feel inflammation. And so one of the most common markers of inflammation out there is something called a C reactive protein. And this goes up in Crohn's and colitis conditions of the GI tract. It can even go up in depression and anxiety, but you don't always feel it. It's standardly used as a marker of cardiovascular disease. And so you don't feel your heart hurting, but inflammation is going on. So yes, inflammation can drive pain, but inflammation can drive many conditions out there, from depression to autoimmune conditions to weight gain. Inflammation makes those genetics more aggressive in terms of a pathology that you have. So the more we lower the inflammatory load, the more likely we are to help most conditions out there. And inflammation also drives the rate at which we age. So therefore, not just wrinkling and losing our hair, but an increase in age related conditions that accelerates that aging process. That's cardiovascular disease, that's dementia, that's more arthritis. And so the more we can lower our inflammatory load, the more we slow the process of aging, the more we turn off age related conditions.

Yeah, absolutely. And so inflammation though, it is a necessary process, right? Absolutely. It is something that we need. We just have, we deal with an issue where we have too much inflammation. Is that correct?

Absolutely. So yes, it does. So you could say inflammation is when the immune system gets turned on. And a lot of inflammatory mediators come from our immune system, things like cytokines and interleukins. And so of course we need that. We need the immune system to get turned on when we're fighting a virus or a bacteria. And if we had none of that, then our immune system would sit dormant and we would be weak. However, just like you said, life on planet Earth puts us in a state of where we're constantly bombarded by chemicals in our food and toxins in our air and pollutants in our water. And all of that irritates the system or creates more of that fire, more of that inflammation. So more often than not, we're in a condition of excessive inflammation and that drives pathology. And then another way to think about that is think about how often people out there are taking anti inflammatories, whether or not we're talking about for pain or non steroidal anti inflammatory, like an aspirin or something for a headache. All of those are examples of when inflammation has gone too far. And so by keeping the inflammatory load down, this is again one of the best ways to keep conditions from being accelerated in terms of symptoms and outcomes.

Yeah, and that's a great way to put it. It's the inflammatory load on the body. You know, we got a fireplace right here and, and the way I look at inflammation is it's like a fireplace in a house. If the fire's on the fireplace, it's a great thing. You know, it brings warmth to the house, you know, creates a better atmosphere in the house. However, if now we start, you know, throwing gasoline in there and the fire gets out of the fireplace and starts burning down the walls, then we got a major problem. Right. So the fire can be good or bad, kind of like inflammation. If it's contained and controlled, it can be good. But if it gets out of control for doing things in our lifestyle to cause that, then we end up with chronic disease.

It's an excellent point. It's all about balance. So when we talk about these things, it's not all good or all bad, but it turns out our diet, our water, our planet, tends to drive a lot of inflammation that's out there.

Yes. And our topic Today is really how a ketogenic diet, or ketosis in general, affects inflammation. And so really how does the ketogenic diet and somebody basically boosting up and creating ketones in their system, how does that reduce or help modulate that inflammatory load?

Well, it's an area where we get a lot of good research. Yeah, in part, some of that research first comes from the seizure community.

Yeah.

And so what we learned from people that have seizures is that increasing ketones was quite remarkably helpful. And so we began to see that relationship from ketones, something that comes from the breakdown of fat and its relationship to the brain. Now the brain is 85% fat. So drawing a connection about keeping healthy fats going on there, that's one of the first areas where we began to see some research. And then we began to say, okay, can we extrapolate this further? And so another area we get great research is when you compare standard of care for certain brain cancers, glioblastoma, to putting somebody in ketosis this dietary style, and in fact, the diet worked better than standard of care. And that's published research that's on PubMed, where all the peer reviewed medical research is. And so we began to see some really exciting things when we looked at this style of diet. From there, we're all aware how emotionally attached we are to our foods. And then to say people are addicted to foods is really not an understatement because survival depends on it. If we weren't driven to go out and hunt and gather, well, we would have sat in a cave somewhere and died. So our species depends on being addicted to food. I mean, you could say you're addicted to air, you're addicted to water, and you're addicted to food. And so some of that quick fuel from food tends to be more carbohydrates. And so people are, yes, addicted to carbohydrates and very emotionally attached. So the way that played out in the research world is they started trying to set up studies that tried to show fault in terms of diets that increase these ketones. And so a diet that increases ketones is a diet that's low enough in carbohydrates that you're no longer relying on sugar as a primary source of fuel. When the body senses that, it says, I've got to stay alive and I've certainly got to keep my brain alive. And so it says, what can I do for the brain? That's going to be the most successful. And so what it says is in the absence of sugar and carbohydrates I better make some fuel my brain can use, and that's ketones, which come from fat tissue. So many of us think of it also as a weight loss diet, and that part is true. But we should be thinking of it as a brain energizing diet. From that seizure part to the brain tumor, to focus and concentration, to keeping the brain from shrinking. One of the things that we just learned a couple years ago, at least, that we validated in the research, is as your belly gets bigger, your brain gets smaller, your belly makes free radicals or reactive oxygen species that damage the brain. The brain is very fragile in the face of free radicals and inflammation. And ketones are a way to nourish the brain without pushing the envelope of where it's more fragile. So sugar, carbohydrates, they create a high inflammatory load. It's dangerous, difficult for the. There's an antioxidant system in the brain called glutathione peroxidase, and it's difficult for the brain to deal with all of that. In fact, one of the major lab markers that we look at for diabetes, something called a hemoglobin A1c, we start to call that diabetes at a level of about a 6.8. We call it pre diabetes. When you're at 5.7. But long before you get to diabetes all the way down into 5.2, you're already at increased risk for your brain to shrink. So what we know is that sugar and carbohydrates cause the brain to shrink, cause the brain to age more quickly. What we also know is one of the primary fuels that nurtures your brain are these ketones that come from fat tissue. So from pathology, like seizures to brain tumors, all the way down to being more focused and alert and being on our game, so to speak, being in ketones becomes quite important. Kind of another way of putting this is think about what would happen as we would hunt and gather. It wasn't like you'd walk around for an hour and find a rabbit, another hour and find a deer, another hour and find berries. It's not like that. You'd go for long periods of time before that next animal came around. And so the people that survived were the people that could go into ketosis.

Why?

Because it was the thing that would keep the brain most alert. While I'm doing the thing that's most important, hunting, gathering. And so while, of course, I advocate keeping your brain active, of course I talk to people about reading and crossword puzzles, the reality is that exercise does far more for the brain through ketosis than even crossword puzzles or singing or reading does. And that's because that's how we're wired. And I need food. I'm going into a fasting mode. I better keep my brain active so I can find that next deer, I can find that next rabbit. I'll make ketones. That's the thing to keep my brain going. So if you really want to keep your brain the most active, the best thing to do is to keep moving and to keep exercising. And the physiology of that is that it helps us to create more ketones.

Yeah, absolutely. So obviously we become just more metabolic. Exercise is going to increase our metabolism, so we're going to burn up some of that stress stored sugar and then our insulin levels are going to go down. So we're going to start boosting up those ketones and we're driving up more brain derived neurotropic growth factor in the brain. So we're getting better synaptic development and neurotransmitters and all kinds of good stuff there.

Yeah, that's huge remodeling and new thought process. And of course that's one of the things we want to offset as we're aging.

Yeah, for sure. And so on top of ketosis, what are some other dietary interventions that really help us reduce inflammation in general?

So they all tend to be more in that direction. And some people will go, well, what is a ketotic diet or a paleo diet? They'll say, well, that seems to be like all these fats, so can I go out and eat a Big Mac? No, that's not the way it works. First of all, it needs to be healthy fats. And as we talk about all of these diets, I think a key piece that people need to remember is regardless of what we call the diet, regardless of different labels and maybe slightly different amounts of proteins and fats, they've all got to be on a bed of vegetables. And so we gotta start with phytonutrients. And we've got to get that from having a diet that's probably 50 to 75% vegetables. Now I'm not saying 50 to 75% corn or potatoes mainly I'm talking about green leafies. And so if we start there, if you're getting a vegetable in every meal, then you're ahead of the game. Most people aren't doing that. And so we've got to work on that. Now as we pull more of the leafy greens in, we pull more of our cruciferous vegetables in. Now we can begin to dissect how much protein and how much fats. And so if someone said, well, I'm going to do a paleo diet, they could do a paleo diet that was all steak and bacon. I don't think that's what either you or I are advocating. But you could also do a paleo diet that was lean sources of protein, that had a wide variety of vegetables and were on the right track. However, even a paleo diet, if you eat too much protein. So if you did do all steak and bacon, and so, yes, that would put you into ketosis. You would keep your carbohydrates low enough that that would happen. But you might find, huh, I'm not staying in ketosis. This isn't working for me. Because as it turns out, it's if you get even enough protein, that can kick you out of ketosis. So start with your vegetables. Now think about lean sources of protein, but you gotta have the right amount of fats in there. Those fats are critical for the brain, 85% fat. Those fats are critical for the membrane of every single cell. And every single cell, it's nutrients in and metabolic waste out. And now one of the real benefits of keeping ketosis is not even that first membrane, but the second membrane inside the cell. And that's a membrane that gets you to your mitochondria. And think back to 8th grade cell biology. That's what we call the powerhouse of the cell that makes ATP, all of our energy. And so one of the best ways to make cellular energy is to get into ketosis. Now, a problem people will have is lowering carbohydrates enough to do that. You've got to learn this. And people will say, oh, it takes more time, or, oh, I've got to shop more. Or it may take more time initially as you're learning these things. But I want to encourage people that it actually doesn't take more time for the rest of your life. Yeah, there's a learning curve, but once we learn a new way of eating, I would argue that you could do a ketotic diet many times faster than you could actually drive to McDonald's and get a Big Mac many times faster than you could go out to eat someplace else. And so, okay, yeah, it takes a little time while you're learning new practices, but once you're there, not as much anymore, but that transition and learning how to do that. And so here's a problem that I saw doctors fall into and clinicians fall into, they Said, okay, well, a ketotic diet means lowering your carbohydrates, and when you lower your carbohydrates, you'll begin to make ketones. And so the reason this diet works is because you change your carbohydrate load enough that you've turned on that fat tissue to begin to make these ketones. And so then the advent of seeing exogenous ketones that you could actually take orally began to trickle onto the market and began to be available as tools. I watched clinicians go, well, that can't work, because the whole reason a ketotic diet works is because you go into your own fat tissue and you make your own ketones, and that's how you lose weight. And if you're just taking them exogenously, you're not turning on your fat tissue, so there's no benefit there. And I think a lot of clinicians got stuck in that point. Not true. Because, yes, in order to lose weight, we do have to have our own ketones. You do have to break down your own fat tissue. Tissue. But there's a feedback, and the body is wise. And so if I make my own ketones or if I take my own ketones, it tells my body, aha, we need to change some things metabolically. So when it reads those ketones, whether or not it came from my fat tissue or from a spoon and I put it into my system, it tells my body, run more efficiently. And so it makes the insulin receptors work better so that I'll handle blood sugar in a better way. It tells my body, oh, you're making ketones. We must be in more of a fasting period. And so it turns down my appetite, so I'm not as hungry all the time, so I'm not grabbing something when I first come in the door from work, or I'm not falling out of my good habits because I just can't take it anymore. So, yes, of course we want to create ketones ourself. Of course we want to break down our own fat tissue. We want to stay lean. We know that people that maintain a BMI close to where they were at in high school, in their 80s are 70% less likely to have conditions like diabetes and heart disease and dementia. So, yeah, we want to do all of that. But even when we take them exogenously, our body reads that in a similar way and helps us to get to our own ketones as well, improving insulin resistance, improving my appetite, keeping that under control. So I'm able to maintain this style of diet. Without feeling hungry or without feeling headache or kind of off kilter all the time, for sure.

Absolutely. We were talking before we even got started about this study. It's actually Nutrition Metabolism 2009, they took a group of people with Alzheimer's disease, right? So massive inflammation in the brain, which you and I both know that's really the cause of Alzheimer's disease. And all they did no dietary change other than adding exogenous ketones. Now, we recommend, obviously, following a nutrient rich, micronutrient rich ketogenic diet. But they found that all the people that they gave the exogenous ketones to saw significant improvement in cognition.

And what a blessing, because what we know about geriatric cares, you're often in assisted living or a nursing home, and sadly, where the quality of food should be peak, it's not. And so even without having these dietary changes to give the body the thing that the brain needs. So there's another mechanism in there too. And don't let me get too biochemical on you, because sometimes I'll wander in that direction. But when the body sees a ketone, it does something else as well. So all the carbohydrates and the sugar and all that piece of it speaks to us in an evolutionary way. And part of that evolution is that when we are under attack from a bacteria or a virus, that our body says we do need to turn on the immune system, we need a little more inflammation. And so another way that it could increase inflammation is to get the liver to make more sugar glucose, because it says we need a fuel to keep the. If we're gonna be on heightened alert in terms of immune function, then that immune system needs a fuel. And so sugar does work to fuel the immune system to some degree. Now, long term, your white blood cells drop off and there's an impact to that. But in the acute fight, short term, yeah, that's how it loads. And so when it sees these bugs, or now, because when it sees this diet, rich carbohydrate diet, lots of sugar, it does a similar thing. It turns on this molecule called an inflammasome. And an inflammasome upregulates lots of inflammation in the body. It's thinking, it's getting us ready to do a fight because our body still reads the sugar in the same way. It says, oh, lots of sugar, yeah, ramp that immune function. Well, now, lots of sugar isn't necessarily the liver making it. It's our diet giving it to us. So we turn on these inflammasomes we create more inflammation, that inflammation shrinks our brain. The ketones shrink. That inflammasome, if you will, it down regulates that inflammasome, so it turns off one of the major pathways of inflammation that's creating all this havoc. Good if you're fighting a bug. Bad if you're just eating carbohydrates day in, day out, the brain feels that, it senses that and it's like the brain is bombarded and our brain begins to shrink. So even just taking these ketones exogenously allows the brain to plump back up, if you will, making it stronger, helping us remember things, helping us with our day to day activities.

Yeah, just so awesome to understand that.

Now to be able to change the body through diet.

Yeah, exactly. It's so critical.

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And so we're talking about dietary interventions. What are some lifestyle strategies people can do as well to help reduce inflammation in their body?

Yeah, so first and foremost is we got to get off the sofa. And you know, sometimes that can be difficult. So the research says that we don't have to, it doesn't have to be a huge intense amount of exercise. Actually five times a week for 30 minutes walking counts, even some activities around the house count. We've got to do that to keep our brain working. However, the problem that a lot of people find themselves in is they know that they should be out walking, but they're so inflamed. They have knee pain, they're so inflamed. Well, their gut hurts, their brain hurts, all these things are going on that makes it more difficult for them to get started. So again, if we can do some things to shut the inflammation off first, like exogenous ketones, now we can get to a place where you're able to exercise. I hardly see a patient that comes in and says, I had no idea I was supposed to exercise. They know that the trick is how to get in a state where they're able to do that. So Using some of these tools to help augment diet to augment exercise is really where we need to be. So yes, exercise, yes, dietary changes, high carbohydrates, high sugar are just more inflammatory. So a diet high in vegetables, a diet that includes lots of things like turmeric, spice that's used in curries, great anti inflammatory potential, adding in more things like good healthy fats like coconut oil, where some of those medium chain triglycerides you mentioned in the Alzheimer's studies compound come from good healthy fats like olive oil too, when done in a right balance, omega 3s, anti inflammatory fats. And again, we'll see research with all of these things. And back to that brain derived neurotropic factor that you mentioned, making the brain fire and make new pathways and work. And so a diet that's high in vegetables, that's low in carbohydrates, that we include lots of good spices in turmerics and basils and oregano because all of those things are so dense in phytonutrients. My husband's doing something right now where he's cooking something from every country. And so it's really interesting to watch. And one of the things that I noticed about India is when he was making foods from India, the spice mixtures would literally fill a bowl, whereas here we put a half teaspoon, a tablespoon's kind of a dramatic amount. And so I was just thinking of the phytonutrition you see in that. And so again, back to some of those Indian diets, we think curries, right? And so lots of turmeric in those curries and they have some of the lowest incidence of dementia and also some of the lowest incidence of cancers as well. And so I think that we can borrow from that. A diet high in vegetables, high in spices, low in carbohydrates is going to be some of the most anti inflammatory, least inflammatory diet that we can include. We also have an over reliance on some things in a standard American diet, over reliance on bread products or gluten, often an over reliance on dairy and so really limiting some of those carbohydrates, particularly gluten, even if you're not allergic, even if you're not sensitive, it's just a more inflammatory molecule and it's associated with your brain shrinking more too. So pull those things out, don't grab the roll, grab an extra serving of vegetables. When we go out to eat, instead of having the potatoes, pay $2 extra to have them put more vegetables on the Plate instead. There's a lot of easy things that we can do to make this realistic.

Yeah, absolutely. And how about sleep? How critical is that one?

Yeah, absolutely. So when we don't sleep, we're more inflamed for sure. We actually make more of something called IL6, one of these interleukins that's high, highly inflammatory. So not sleeping, of course, you would have figured that out already. All of our listeners would know that if I don't sleep, I can't focus as well the next day. But it's not just the next day effect. It's lifelong hard on your brain. That IL6 is hard on your brain. But that IL6 that goes up from not sleeping is also associated with making more plaques in the arteries. So from brain health to cardiovascular health, insomnia is a big deal.

It's a big deal.

So I think the more science we get, the more it underscores the fundamentals, the more it underscores good exercise, good diet and sleeping well. And I understand that none of those things sound novel, but when you look at the science behind them, the science is epigenetic and the science is novel. And what we're learning is within that trio, we have as much anti inflammatory power as a prednisone or a steroid. And that's been my clinical experience that we can do something as anti inflammatory from diet and lifestyle than we can do from prednisone, a steroid. Is it harder work? Absolutely. Taking prednisone, I put that in my mouth once a day, but it has side benefits instead of side effects. And does it happen overnight? No. Can you go out and exercise one day and eat a good diet one day and have an effect like prednisone that you had in that one day? No. But when we employ these things for a period of time, you'll calm down that inflammatory load and you'll do it in a way. This is, you know, I've had many people that whatever the symptom was, from Crohn's to colitis to to rheumatoid arthritis, it was only controlled on these strong anti inflammatories like prednisone. And as we made these dietary changes, as we made these lifestyle changes, that was the first time they were able to get off something like prednisone. And they're able to maintain when they do this. So the power is there. Yes, it's a little more difficult. Yes, it takes more work. But again, with side benefits instead of side effects and really doing things to plan Plump your brain up rather than cloud your brain.

Yeah, absolutely. And so we've talked a lot about the inflammatory load, and you did mention a few lab tests. You mentioned C reactive protein. You also mentioned hemoglobin A1C, which are two great tests that really anybody can get. They can go into their general physician and get those run. What are some other tests? Let's talk about some tests they can get done at their general physician. And then let's also talk about if they're working with a functional medicine doctor or somebody that does a little bit more detailed lab work, what kind of tests they can look for for inflammation.

Yeah. So here's the good news about a number of these markers is that you could go into your primary care physician and ask for. So if I were going to do three things to really bolster what you're getting while you're in there, that you probably wouldn't have any argument about because they're so well researched and they're so widely applicable. We could ask for that C reactive protein, a general marker of inflammation. We could ask for hemoglobin A1C. That would show show us if we're pre diabetic or diabetic. But again, even with mild elevations, lets us know our brain's beginning to shrink. And I would add to that vitamin D. Vitamin D is great for the brain, great for keeping hormones in balance, great for keeping bones dense. And so these markers have such good research, it would be surprising if you got pushback for adding them on.

And what are the optimal ranges? So let's talk about C reactive protein, hemoglobin A1C, vitamin D. Where do you want to see those?

Yeah, excellent point. So something like a C reactive protein, you're often going to see that they'll call that elevated above A three. And that's true. We wouldn't want to see it above a 3. But actually there's research to show it to be a more specific marker of inflammation, even for the gut, than something called calprotectin that we'll often see on stool testing and is often touted as a really good gut marker. And it is. I'm not saying it's a not. The C reactive protein can be even more predictive for things like Crohn's and colitis within that reference range. So I like to see it not just above a three at the top of that range, but really even getting it less than a 2.5, because we know from that 2.5 to 3, there's still accelerated inflammation that's connected with many pathologies out there, very evidence based. Hemoglobin A1c, similar story. So the bottom of that range is often about a 4.5 or so. And then we start to call it Pre diabetes at 5.7 and then about a 6.4 or higher or 6.7. Some might say somewhere in that range, you'd call it a full blown diabetes. But long before that, above 5.2, your brain begins to shrink. So well within the reference range we want to think about, yeah, sure, you're not the highest risk of yet for pre diabetes, but you are for cognitive decline. So let's take a burden off the brain, let's begin to lower that sugar, let's change that metabolism. Vitamin D is another great example. A typical reference range will be 30 to 80. And so patients will go, oh yeah, I'm 31 and I okay, fine, you just made it in. But really, the better research in terms of lowering inflammation is going to be when we are mid range and in some conditions even high normal. For example, the Journal of Neurology found that we were 60% less likely to have episodes of Ms. If you were high normal. In terms of vitamin D, that's really outstanding. There's not a medication that achieves a result like that. So I don't think we should be satisfied sliding into the bottom of the range here. I think. Think about it like as your kid who comes home and says, well yeah, I made a 70, I passed that test. Well, we're probably not jumping up and down about that, right? We'd want to see an 85 or a 90 in terms of a grade. The same is true for me with vitamin D. I don't want you just sliding into range. I want you to have mastered your vitamin D. And so that means being at least mid range and for some conditions upper end of range. What we know about vitamin D is potent in terms of lowering inflammation. It's potent in terms of maintaining brain health. So why would I want you just to be minimally there? I want you to be optimal. So those are some of the ones that I think that we could all get our hands on at almost any time.

So to summarize, C reactive protein 0 to 2.2.5. That's kind of the optimal range where we want it. Hemoglobin A1C 4.5 to about 5.2 in that range, right?

Yeah.

And then, and then we're looking at vitamin D and we want that mid high. So like we're talking about 60 to 80 in that range.

Spot on. Yeah. And then we know we're more optimal. And so that's a basic starting point that anybody could get their hands on. Now, from there, there's some really powerful markers out there that maybe people aren't looking at as readily. So what I would add to that, if I could add to the standard that people look at one that would come front and center, that also has good research in terms of ketosis is something called 8oHDG and it stands for 8hydroxy2d Iguanosine. A long name, but that's not important. What this marker does is it shows us about inflammation and free radicals. We've all heard free radicals are bad. We know they're squelched by antioxidants. We all know antioxidants are good. Do you know if you're getting enough antioxidants for your body and you might go, yeah, well, I drink green tea and I eat leafy greens and all of these things have antioxidants. And it's a great start. But what about by the time you have symptoms or pathology, is it enough to control where you're at? What about if you're noticing you're not focused as well, or words aren't coming as quickly, is that too much inflammation for the brain that the diet isn't controlling? And so this marker, if I go to the peer reviewed medical research and I only look at humans, not rats, not in a dish, not in dogs or monkeys, but human beings, what I find is There are over 1,000 studies that say when this marker is high, you're more at risk for cancer, but you're also more at risk for brain decline. And so again, when people say, well, that diet, that ketosis diet, that advocates these fats, that can't be good for you, you know what happens with that marker that tells us that if you have free radical excess, that tells us if you are antioxidant deficient. That marker, when we look at people that are in ketosis, that marker comes down. What you see is less DNA damage because the marker goes up and there's more DNA damage. And we all, again, we learned in that biology class that DNA damage, damage is what initiates a cancer change. That's what causes a mutation. So it tracks with those cancer changes, but it also tracks with change to the brain. Why is that? Well, because when you damage the DNA in the nucleus. Now again, we're back to our ninth grade biology here. Think the nucleus, think the brain of the cell. What happens when you damage that nucleus is. It sends a signal to another nucleus, the one in the mitochondria. And that mitochondria is that powerhouse where we make all of that energy. Well, you know, what needs a lot of energy is our brain. And so when we make the mitochondria healthier, we make the brain healthier. And so when ADOHDG is high, not only are we more at risk for cancers, not only do we not have enough antioxidants, but it means our mitochondria is suffering as well, which means your brain's going to suffer. Another interesting phenomenon is that the brain doesn't handle oxidative stress or free radicals very well. The liver, it has all these enzyme systems to handle free radicals. It does a great job of it. Let's think about if you've been out at night and maybe you had a cocktail or two, maybe you even had three. What goes first? Your brain. Right? You can't focus, you feel spacey, you feel off. Not your liver. You don't really have an elevation of liver enzymes because the liver's better at protecting itself. The brain's more fragile. And so when this 8.0hdg is high, when this marker of oxidative stress is high, it's the brain that really suffers first. It is busy. It has to make a lot of energy. And all of that energy has a byproduct of creating free radicals as well. And so it's really, really sensitive. And so we've got to really take care of the brain. So when we see that marker of oxidative stress high, not only do we know the DNA is suffering, but we know our mitochondria, our powerhouse, is suffering, and therefore our brain is suffering. And so what you see is a high ADoHDG. You see that high in things like Alzheimer's or Parkinson's, but you even see it high in depression or bipolar or anxiety. What you also see is a ketogenic diet helps to lower that. What you also see is adding more antioxidants helps to lower that. So again, we're back to our green leafies with our good fats. Now, maybe you're sitting there saying, look, if this has a thousand studies, why isn't it being run on everybody once a year? And it's a real tragedy that it's not. Part of that is because standard of care says you don't run a marker unless you have two. Treatment. And then, sadly, treatment is defined as a pharmaceutical intervention. In standard of care medicine, treatment's not defined as diet or lifestyle Changes. And so they think, well, there's really nothing that we can prescribe for this. Yeah, well, in integrative medicine, we have so many more treatments and of course, we would want to monitor are we doing enough diet and lifestyle change to get the outcome that we want. And this is a pretty perfect marker for that. Simply put, it's a marker of your antioxidant status. And the more antioxidants you have, the better your brain works. And a ketotic diet helps you to do that.

Powerful stuff. Really, really good fun. Really good insight.

You know what it means? It means that the power is in the hands of the patient prescription pad. It means that we can all take responsibility and get to a place we're able to exercise more and make these dietary changes. And if you have problems with that because your knees hurt or your legs hurt, fine, work with a clinician. That can help to get you into a place where you're able to do the real root cause work here. I get it that we're not all. We don't all start in a state where we're able to do these things on day one, whether or not my knee hurts or I'm so depressed or I'm confused that it's difficult to go out to the grocery store and make these choices. Changes. It's understood. But then let's work with a doc. Let's work with somebody in functional medicine or integrative medicine that can help to get us to a place that it becomes easier to make these diet and lifestyle changes.

Yeah, what you're talking about is lifestyle medicine. It's like using lifestyle to have, in a sense, a medicinal effect on our body to impact our genes and allow us to downregulate inflammation, which has been our topic today. Just so powerful. And last thing I wanted to touch on was some supplements, natural supplements people can take to reduce inflammation.

Absolutely. So exogenous ketones is one. Because once you, as you start to boil through and drill down in the cardiovascular literature and the diabetes literature and even the obesity literature, what you see is inflammation is front and center. Inflammation drives all those conditions. And so the more that we can get rid of inflammation, the better we're going to do. And one of the big players in terms of creating inflammation is, I'm sorry about our emotional attachments, but it is. It's carbohydrates and it's too much sugar. So we've got to get that under control. Exogenous ketones decrease that appetite and make the insulin receptor work better. When that Insulin receptor works better. Our body doesn't have to produce as much insulin to get into the cell. So now we can produce less and that inflammatory cascade goes down. Another thing that sugar does is it makes our gut more permeable. When the gut is more permeable or leaky, this too creates inflammation and upregulation of IL6 and TNFL and all these cytokines again. So just sugar does that. So when we pull that out, that's another way we become less inflamed. So exogenous ketones are definitely one way to lower the inflammatory load because it helps with one of important, the most, most fundamental pieces, which is controlling insulin and controlling metabolism, where a lot of that is coming from. Now let's add to that. A second thing that I would put front and center would be good omega 3 fatty acids. So JAMA says that this reduces 40% of all cause cardiovascular mortality. That's a pretty phenomenal statistic. And a big part of the mechanism of action is controlling inflammation. Now maybe you're thinking, well I thought heart disease was cholesterol and sort of. But it's actually when that cholesterol becomes inflamed that it becomes dangerous. At that point we call it oxidized ldl. That's your inflamed cholesterol. And if I biopsy a plaque, I don't find cholesterol. I don't even find the one called the bad guy, the LDL. What I find is that oxidized LDL that inflamed cholesterol. So omega 3 fatty acids are anti inflammatory and this is why they have such phenomenal outcomes in terms of cardiovascular disease. But remember, the brain is 85% fat. So getting those omega 3s into the brain helps us cognitively as well. A third thing I would add to my regimen, if I had room for one more, would be that turmeric, but concentrated and concentrated into curcumin or curcuminoids, highly anti inflammatory. And therefore when we reduce inflammation, we see studies with curcuminoids in terms of weight loss, reduction in cancer and reduction of dementia as well. So if we can take some tools to help people achieve the diet and lifestyle part. What I've just said is it's not 20 pills, powders and potions, It's a handful of things. And these pieces reduce the joint pain, reduce the confusion, reduce the depression so that we feel better, so we feel able to go to that yoga class, to be able to get out there and begin to walk and to begin to make what I would call the real fundamental changes, which are the diet and lifestyle piece. And so we don't have to feel weighted down by this. I talk to patients about it as being putting together our lightweight bulletproof vest, the thing that will protect us but not weigh us down. If you're willing to do diet and lifestyle, we can get you there. Without 200 pills, powders, and potions, we really set the stage for lowering the inflammatory load, right?

Absolutely. Well, Dr. Burdette, this has been an amazing interview. We really jumped into inflammation, how ketones affect that, lifestyle strategies, lifestyle medicine. It's been awesome. You also jumped into lab tests and how people can really monitor their inflammatory levels inside of their body. And so that's just been a really powerful piece to the Keto Edge Summit. So thank you very much for coming on.

Thanks for having me.

Yeah, for sure.

Sometimes you got to get out there. The power lies in our own heels.

We do absolutely right. The body can heal itself. We just got to remove the interference. For many people, the interference is too much inflammation in their body due to poor lifestyle habits. And getting that back in order, very powerful.

Definitely.

Thank you so much.

You are so welcome. And how do people find out more about you? How do they work with you? I know you work with Progressive Medical as well as Dunwoody Labs. How do they find out about that?

Yeah. So go to www.progressivemedical.com and also if you're looking for some of these markers that help you track this inflammatory load, to really understand what your DNA is doing and what your mitochondria is doing and what your brain is doing, go to infoonwoodylabs.com these are some simple tests. Some of them only require even just urine, just peeing in a cup. So very easy to do. And really, that's what we want to know. We want to track our outcomes. Am I doing enough? And so just like you would track cholesterol, am I tracking the inflammatory load? Because it's that inflammation that accelerates aging. And so info, Dunwoody Labs will get you to a hand of testing and also some clinicians that can help with actualization of this.

Excellent. Thanks so much, Dr. Burdette. Absolutely. And if you've enjoyed this interview and many of the other interviews we've done on the Keto Edge Summit, then I want to encourage you to consider owning the entire Keto Edge Summit for yourself. That way you get access to all of these interviews and transcripts, all of our clinical pearls, so you can really get the fine points of every one of the presentations and be able to put it all into action and live the ketogenic lifestyle and get the benefits that we talked about. Reduced inflammation, improve brain and performance, enhance the mitochondria, so stimulate fat burning. All these awesome benefits and you'll have this in your library for a lifetime. So if you would do that, if you would consider owning it for yourself, we would be honored and we will see you on a future interview. God bless you guys.

Well, that's all for this show and I want to thank you again for spending your valuable time time with me today. And if there was something you heard in this interview that you have questions on or you want to dive into deeper, then drjockers.com is the best place to go. If you enjoyed this episode, please consider taking just a quick moment and giving us a great review. Your reviews help us influence more people and transform more lives. And if you took something valuable away from this episode, then please share it with someone in your life. Or you know it can help. We'll see you soon on a future podcast.

Be blessed everybody.

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