A client of mine woke up this morning, made breakfast, and was ready to start with work on Monday morning as usual. Fast forward 45 minutes later and you find him face down in his bed, napping. “What’s going on?”, he calls me to ask. This client is someone who has managed his autoimmune condition well for the past three years. He’s on an alcohol-free, processed-foods-free diet and leads an active lifestyle. He’s one of my clients that knows how to manage his condition primarily through diet and lifestyle. Flare-ups aren’t a problem usually. What’s happened now?
First, let’s touch on a bit of stats: Autoimmune diseases are especially frequent in western countries, affecting mainly women (Davidson and Diamond, 2001). It has been estimated that more than 700 million people around the world are now affected by an autoimmune disease. Genetics play a role in auto-immune disease, but your environment plays an even greater part in the expression of the disease. Changing diet, lifestyle and behaviour can have a huge impact.
Now that we know autoimmune conditions are felt far and wide; and we can do something about it, let’s dive into what could help.
If you are dealing with an autoimmune flare-up or condition, the following steps might help you to get it under control. I’m not just talking about sweeping the surface clean, but rather addressing the underlying cause of inflammation. Some things you can’t change, like a genetic marker, but there are others you can – how you fuel your body, restore it and energize it. Here are a few key steps that could help you:
- 1. Eat a whole foods diet
Focus on whole, real foods. What comes from the earth, or lives on the earth are good to go. Another rule of thumb – is it packaged? Don’t get it. Could your ancestors access it? Yes. Eat it!
Include organic, grass fed meats. Organ meats, such as liver, is a great source of nutrients and relatively inexpensive. Shellfish and wild caught fish are great, and aim for four servings of fatty fish per week. Incorporate healthy fats – olive oil, avocado oil and animal fats; include fermented foods (see more info in section 4) and fresh, whole fruits into your diet.
- 2. Eat an anti-inflammatory diet
Remove inflammatory and gut damaging foods from your diet. Foods that have the potential to be inflammatory are sugar, gluten, alcohol, industrial seed oils (such as sunflower, canola, grapeseed) and soy. You might ask, “why does sugar have to be on the list?” We now know it’s the sweetest way to cause chaos to your health – not just with autoimmune conditions, but also cancer, diabetes, obesity to name but a few. Stay away from the sweet side of life.
- 3. Eat nutrient dense foods (Wahls Protocol)
Dr. Terry Wahls was diagnosed with multiple sclerosis (MS) and was faced with a bleak prognosis: no cure. She was immediately placed on pharmacological treatment. The disease progressed to the point where she was using a wheelchair to get around. She did some research, and decided to focus on her mitochondrial health because the research showed it to be a key player in conditions like MS.
To get the best out of your mitochondria (the biology peanut gallery says “the mitochondria are the powerhouse of your cells”), you need to eat a nutrient dense diet. Why the focus on the mitochondria? Well, your cells are involved in every bodily function. Our cells participate in cell signalling, they produce hormones, aid in the transport of oxygen throughout our body and regulate programmed cell suicide (McBride et al. 2006). When our mitochondria aren’t working well, our cells are unable to carry out these important functions. Mild mitochondrial dysfunction can result in fatigue and brain fog, while severe dysfunction can cause a wide range of chronic conditions, including autoimmune disease (Nicolson, 2014).
Our mitochondria are especially susceptible to nutrient deficiencies. The Wahls Protocol takes this into account by filling up your daily food with 9 cups of fruit and vegetables. Here are the basic three steps to following the Wahls Protocol:
- Eat three cups of leafy green vegetables, such as kale, spinach, chard and arugula to provide vitamins A, B, C, and K
- Eat three cups of sulfur-rich vegetables, such as broccoli, mushrooms, cabbage, onion and garlic, cauliflower, cabbage, and asparagus to support detoxification
- Eat three cups of colourful fruits and vegetables (ideally three different colours per day), such as beets, avocado, watermelon, carrots, berries, peaches, and citrus for their antioxidants and flavonoids
These three steps are the fundamentals to eating an anti-inflammatory diet. Here’s another step that may help.
- 4. Up your gut health game
Food sensitivities are common for people with autoimmune conditions. Research by Dr. Alessio Fasano shows that gut permeability or “leaky gut” is a prerequisite for developing autoimmune conditions (2012).
Supporting the gut microbiota by including probiotics and prebiotics in your diet is important in reducing your chances of an autoimmune flare-up. Include fermented foods, such as sauerkraut and kimchi; and then glycine-rich foods such as collagen, bone broth, and fattier cuts of meat into your diet to help heal your gut.
- 5. Try a low starch diet
This option may be specifically helpful in people who are positive for the HLA-B27 gene which can predispose people to the following conditions:
- Ankylosing spondylitis
- Crohn’s disease
- Ulcerative colitis
- Reactive arthritis
Starch can be included in a perfectly healthy diet for most people; and it is often recommended in a healthy gut diet to feed the microbiome. However, in some cases, starch can do harm. In an ancient, but important study (Cowling, et al, 1980), it was found that people with ankylosing spondylitis had increased levels of Klebsiella in their gut and a corresponding increase in C-reactive protein (CRP) which indicates disease activity in ankylosing spondylitis. It was found that this bacteria grows a bit too happily on starch.
Another study (Finegold et al., 1977) tested two different types of diets with respect to the antibody, IgA, which indicates an immune response . One diet was high in protein and low in carbohydrates and the other was high in carbohydrates and low in protein.They found that the low starch diet lead to a reduction of total serum IgA, in both healthy controls as well as patients, and furthermore to a decrease in inflammation and symptoms in the AS patients. It was then retested in another study, and again found that a low-starch diet reduced total serum IgA in AS patients (Ebrunger and Wilson, 1996). Good stuff.
To remove starch from your diet, avoid the following for a three to four week period:
- Sweet potatoes
- Unripe bananas
People often find that they can tolerate some forms of starch but not others. Note that white potato and white rice are simple starches and are easily converted into glucose and don’t feed our microbiome, so you don’t need to avoid these. Why only unripe bananas? Unripe bananas are high in resistant starch compared to ripe bananas.
After this initial starch fast, you can add in each starchy vegetable one by one and take a note of any reactions. If you don’t experience any symptoms, your body can tolerate that starchy vegetable and you can add it back into your diet. Symptoms include any of the orignial disease symptoms and/or the following:
- GIT symptoms (gas, bloating, diarrhoea, constipation)
- Headaches or dizziness
- Increased mucous production
- Itchy eyes, mouth, skin
- Aches and pains in muscles/joints
- Changes in skin (rashes, dry skin, acne)
- Mood swings
- Anxiety or depression
If you’re looking for some inspiration, and good experimentation, check out this post by Eileen Laird who took to the challenge of cutting out starch.
Back to my client: we logged his last 24 hour food and found our problem. In the past 24 hours, he’d had lentils, twice. Together, they’d caused a flare up. Brain fog, fatigue, weakness, stiffness.
It was a reminder that the food he eats is vital to his health.
Now I’d like to hear from you – do you find that food affects your auto-immune condition? Did you know about the link between diet and your disease? What have you found to work best for you? Will you try this step by step approach? Share your thoughts in the comments below.