So Lets Start Here – How is autoimmune disease caused and what is the autoimmune diet?
What happens is the immune system loses its ability to identify differences between proteins belonging to your own body with proteins belonging to a foreign invader (like a bacteria, virus or parasite). Your immune system attacks those proteins/cells and the build up of damage to cells, tissues including organs in the body causes the symptoms. What separates one autoimmune disease from another is which proteins/cells are attacked by the immune system. In Hashimoto’s Thyroiditis, the thyroid gland is attacked. In Rheumatoid Arthritis, the tissues of your joints are attacked. In psoriasis, proteins within the layers of cells that make up your skin are attacked. However, the root cause is the same.
Genetic predisposition to autoimmunity makes up about one third of your risk of developing an autoimmune disease. The other two thirds of your risk come from environmental factors, which include: diet, lifestyle, infections, exposure to toxins, hormones, weight, etc. You can’t control your genetics but you do have a considerable amount of control over your diet and lifestyle (and the extent that these affect hormones and weight and even toxin exposure).
So what can we do?
If you remove the foods that bring about/cause a leaky gut, gut dysbiosis (the wrong numbers, relative quantities, or types of microorganisms typically growing in the wrong locations in your gut), hormone imbalance, and that stimulate inflammation and the immune system, you can create the opportunity for your body to heal. You can create an environment in your body conducive to healing by addressing important lifestyle factors, like stress and sleep and by changing your focus to eating nutrient-dense foods that support optimal gut health (and optimal health of your gut microorganisms).
By making these changes you can restore the levels of important nutrients and provide all of the building blocks that your body needs to heal and properly regulate the immune system, helping to resolve inflammation and support organ function.
This is not a cure (once your body learns to attack itself, it can never un-learn this), but you can put your disease into remission, often permanently. Depending on how long you have had your disease and how aggressive it is, there may be permanent damage (which might, for example mean that you need to take organ support supplements such as thyroid hormone in the case of Hashimoto’s thyroiditis for the rest of your life), but you can stop your immune system from attacking your body and heal substantially.
The autoimmune diet is suitable for everyone with diagnosed autoimmune disorders or with suspected autoimmune diseases. It is an extremely nutrient-dense diet that is free of foods that irritate the gut, cause gut dysbiosis and activate the immune system. You will not be missing out on any nutrients and this diet is absolutely appropriate to follow for the rest of your life. If you have a specific autoimmune disease that causes extra food sensitivities, those should be taken into account with your food choices. Nutrient deficiency is one of the most important contributors to autoimmune disease. Even if you have been following a paleo, primal, GAPS, SCD, or WAPF diet for a while, it is very likely that you have not corrected nutrient deficiencies.
Every autoimmune disease which has been tested, gut dysbiosis and a leaky gut has been found present, and are believed to be involved in all autoimmune diseases. The presence of gut dysbiosis and a leaky gut are directly related to diet and lifestyle (the foods you eat, the foods you don’t eat, how much sleep you get and how stressed you are).
The diet recommendations of the autoimmune diet (The Paleo Approach) are all designed to help heal the gut, to restore normal/healthy gut microorganisms, to reduce inflammation and to regulate the immune system both through healing the gut, regulating hormones and addressing micronutrient deficiencies.
It’s not just about changing your diet though as the AIP prioritises sleep, managing stress, protecting circadian rhythms, and incorporating plenty of mild to moderately-intense activity. In fact, it warns, if you ignore these lifestyle factors, you might completely undermine all of the efforts you are making with your diet.
How do we do it?
The autoimmune diet is very strict, and to get the great results that you want you must be willing to stick to a strict paleo diet with no cheating. So:
- No grains
- No legumes
- No dairy
- No refined sugars
- No modern vegetable oils
- No processed food chemicals
Gluten should be banned for life. Grains and legumes should never be consumed.
Dairy of any kind (even grass-fed ghee which can still have trace lactose and dairy proteins!) should be avoided initially. This may be true for the rest of your life but some people may be able to reintroduce many foods after their diseases are in remission.
In addition, if you have an autoimmune condition, you should completely avoid:
- Eggs (especially the whites)
- Seeds (including cocoa, coffee and seed-based spices)
- Nightshades (potatoes, tomatoes, eggplants, sweet and hot peppers, cayenne, red pepper, tomatillos, goji berries etc. and spices derived from peppers, including paprika)
- Potential Gluten Cross-Reactive Foods
- Fructose consumption in excess of 20g per day
- NSAIDS (like aspirin or ibuprofen)
- Non-nutritive sweeteners (yes, all of them, even stevia)
- Emulsifiers, thickeners, and other food additives
There are a variety of reasons these are omitted, including: causing gut irritation, causing gut dysbiosis (overgrowths are most common), acting as carrier molecules across the gut barrier, acting as adjuvants (stimulating the immune system), increasing gut permeability, causing inflammation. In addition, you should ensure that your blood sugar levels are well managed (this should happen naturally but for those with a history of diabetes, obesity, and/or metabolic syndrome, using a glucometer may be helpful). This does not mean low carb. It just means not high carb.
There is also some evidence that hormonal birth control can contribute to hunger and digestive hormone dysregulation, leading to inflammation and immune activation.
Perhaps even more importantly than removing foods that negatively impact gut health or stimulate the immune system, is eating a nutrient-dense diet.
Micronutrient deficiencies are the strongest diet-related factors contributing to increased risk of autoimmune disease. If you have autoimmune disease, it is highly likely that you are deficient in one or more of: fat soluble vitamins (A,D,E,K), several minerals (zinc, iron, copper, magnesium, selenium, iodine, etc.), B-vitamins, vitamin C, antioxidants and other non-vitamin nutrients (like CoQ10), omega-3 fatty acid (in relation to omega-6 fatty acid intake), certain amino acids (like glycine), and fiber.
So, just as some foods should be eliminated, there is also a focus on eating more of the following:
- organ meat and offal (aim for 5 times per week, the more the better)
- fish and shellfish (wild is best, but farmed is fine) (aim for at least 3 times per week, the more the better)
- vegetables of all kinds, as much variety as possible and the whole rainbow, aim for 8-14 cups per day
- Green vegetables
- Colorful vegetables and fruit (red, purple, blue, yellow, orange, white)
- Cruciferous vegetables (broccoli, cabbage, kale, turnips, arugula, cauliflower, brussels sprouts, watercress, mustard greens, etc.)
- Sea vegetables (excluding algae like chlorella and spirulina which are immune stimulators)
- quality meats (grass-fed, pasture-raised, wild as much as possible) (poultry in moderation due to high omega-6 content unless you are eating a ton of fish)
- quality fats (pasture-raised/grass-fed animal fats [rendered or as part of your meat], fatty fish, olive, avocado, coconut, palm [not palm kernel])
- fruit (keeping fructose intake between 10g and 20 g daily)
- probiotic foods (fermented vegetables or fruit, kombucha, water kefir, coconut milk kefir, coconut milk yogurt, supplements)
- glycine-rich foods (anything with connective tissue, joints or skin, organ meat, and bone broth)
It is also very helpful to drink plenty of water between meals and to make sure you are consuming enough food. The body is not very efficient at healing itself when you are running a caloric deficit (you shouldn’t have to gain weight to heal, but losing weight may be a competing goal for now).
More about eating on the autoimmune diet can be found here “What to eat?“