Autoimmune
conditions and a leaky
gut go hand in hand. In fact, in every autoimmune condition that has been
tested, a leaky gut is present and is a contributing factor to the illness (not
all autoimmune conditions have been tested, but many in the paleo community
assume that leaky gut is a factor in all autoimmune conditions). For
individuals with suspected or diagnosed autoimmune disease, additional dietary
guidelines exist to help address the disease. In many cases, autoimmune
conditions can be put into full remission by following these guidelines. There
is some variability to these guidelines depending on who you ask, so I have
reviewed them and compiled a comprehensive list of not only dietary restrictions
but also food recommendations using information from The
Paleo Solution, The
Paleo Answer, and various podcast and YouTube interviews with Robb Wolf, Prof. Mat Lalonde and Dr. Terry Wahls (author of Food
As Medicine and Minding
My Mitochondria ). These are all great sources for more
information.
It is vitally important to adhere to a
strict paleo diet with no cheating. While other people may be able to
enjoy the occasional bowl of rice, if you suffer from an autoimmune condition
you are not one of these people. Grains, legumes and dairy of any kind (even
grass-fed ghee!) should never be consumed. This will be true for the rest of
your life. In addition, if you have an autoimmune condition, you should
completely avoid:
Eggs
Nuts
Seeds
(including cocoa)
Nightshades
(potatoes, tomatoes, eggplants, sweet and hot peppers and spices derived from
peppers)
Alcohol
NSAIDS (like
aspirin or ibuprofen)
The reason is
that each of these causes gut irritation and/or increased gut permeability (and
in the super sensitive gut of those with autoimmune conditions, they just aren’t
tolerated). There is also some evidence that hormonal birth control can
contribute to hunger and digestive hormone disregulation, leading to
inflammation. However, you may wish to address the other elements in this post
before going off birth control, depending on your personal
circumstances.
Dr. Terry Wahls lays out a very convincing
argument for increased vegetable intake. Her focus is on eating vegetables from
four main groups: green veggies (for the vitamin B, A, C and K content and the
mineral content), colorful veggies (for the flavonoids and polyphenols; at least
3 colors per day but this includes brightly colored fruit like berries),
sulfur-rich veggies (cruciferous veggies, veggies from the onion family,
mushrooms and asparagus), and iodine-rich foods (seaweed). Dr. Wahls recommends
eating 3 cups per day of each of green veggies, colorful veggies and sulfur-rich
veggies as well as at least once serving per week of seaweed. Note: If you
have Grave’s Disease or Hashimotos Thyroiditis, you must also avoid goitrogenic
foods, which include cruciferous veggies, radishes, spinach, peaches, and
strawberries. This does make it a bit trickier to also get your sulfur-rich
veggies, but it’s doable. I also recommend an extra serving of seaweed each
week to support thyroid function.
Meat quality is very
important as this
profoundly impacts the types of fat
that you consume. It is extremely important to be mindful of your omega-3 to
omega-6 fatty acid intake ratio, aiming for between 1:1 and 1:3, as this is
essential for regulating inflammation in your body. The best way to do this is
to ensure that all of your meat, poultry and fish comes from grass-fed, pastured
or wild sources. Grass-fed meat also contains Conjugated Linoleic Acid (CLA),
known to reduce inflammation, promote healing and even fight cancer. The
nutrient profile of pastured/wild meat and fish is superior as well. My post on
the importance of grass-fed
meat contains some suggestions for incorporating it into your diet in a
budget-conscious way. It is also more
important to eat organic produce as much as possible. Whole9Life has a wonderful
chart on when fruits and vegetables are in season including which fruits and
vegetables are important to buy organic and which aren’t, if budget is an
important concern.
Autoimmune
conditions are also typically associated with disruption of normal gut
microflora, often including Small Intestinal Bacterial Overgrowth. For
individuals with suspected or confirmed SIBO, avoidance of starches and sugars
other than monosaccharides (like glucose and fructose) is very important (read
my post Fruits
and Starchy Vegetables with Small Intestinal Bacterial Overgrowth for a list
of which starchy vegetables are okay and which to avoid). It also becomes
important to help repopulate the gut microflora by eating raw fermented foods
(like sauerkraut, coconut milk kefir, or kombucha) or taking a dairy-free
probiotic supplement.
Healing the gut
becomes very important. I highly recommend consuming bone
broth, organ
meat, and coconut
oil on a fairly routine basis as well as making sure that you are getting
adequate vitamin D, whether you are taking a supplement or spending lots
of time outside. Stress
management is very important and I highly recommend doing at least one
of the following: go for daily walks, take up yoga or tai chi, take a class on
meditation, or make time for an activity/hobby that you absolutely love. And I
cannot emphasize enough the importance of getting lots of good quality
sleep. Aim for 8-10 hours of sleep in a cool, pitch-black room,
preferably waking up without the use of an alarm. It may help both stress
hormone regulation and improve sleep quality to drastically reduce your caffeine
intake. Aim for no caffeine if you can. I personally limit my caffeine
consumption to one single shot of espresso in the morning (made into an
americano with extra
virgin coconut oil whipped into it) and a second shot of decaf espresso
(similarly prepared) a couple of hours later.
I know from
experience that this is a very challenging task. I also know from experience
that 90% is not good enough (and the more serious your condition, the more
important compliance is). I know from experience that this increases your food
budget (although perhaps this can be negated by decreasing your medical
expenses). I try and focus on the delicious foods that I do get to eat. I try and focus on the fact that I have a
strategy for improving my health that is far more powerful than any prescription
medication (Note that in many cases you will still need to be on
prescription medications although you may be able to reduce your dose. Please
work with your doctor on this one!). And, compliance gets easier once you start
to see improvement.
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