Monday, May 2, 2011
Paleo for Autoimmune Disorders
General Paleo is awesome for the majority of people and is a good starting point for getting healthy. For people with autoimmune disorders like Celiac Disease, Hashimoto's Thyroiditis, Fibromyalgia, Rheumatoid Arthritis and others, a slightly more restricted version may be necessary.
First, a little background on autoimmune disease: autoimmune diseases, in a nutshell, are where the body's immune system attacks its own cells, mistaking them for foreign invaders. Which type of disease you get is dependent on which cells get attacked. A number of autoimmune conditions have been linked to gluten intolerance, dairy intolerance and or leaky gut (Rhumatoid arthritis, Celiac and Type I Diabetes have all been linked to one or more of those intolerances). I just read this paper over the weekend which made it pretty clear rheumatoid arthritis and leaky gut caused by lectins have a significant correlation and the paper lays down a number of suggested mechanisms for why this occurs.
A few quotes:
"Approximately 20% of all patients with inflammatory bowel diseases are complicated by joint inflammation" (suggests a link between gut inflammation and joint pain)
"legume and cereal lectins alter the microflora of the gut causing both inflammation and increased intestinal permeability..."
"wheat containing diets can increase intestinal permeability and thereby allow the gut-derived antigens to access to the periphery"
The main point of the article was that in people who are genetically susceptible, these foods pass through the intestine in bigger pieces than they are supposed to, and then some kind of viral or bacterial infection (even the flu) can be the trigger for this chain of events, causing the immune system to overreact and start attacking "self" because the particles bind to proteins that are similar in structure to parts of "self" so the immune system gets confused. (It is even more complicated than this so if you are a biochemist and I am not explaining this well, please correct me-- trying to keep it simple!) So it explains why some people can go their whole lives eating grains and legumes and never have problems, but some are prone to this "leaky gut" and it causes different types of autoimmune diseases depending on which cells are mimicked.
The only way for the gut to fully heal is to remove the offending foods. What I am not clear on, is whether or not you have to remove these foods for life, or only until the gut heals. Matt LaLonde, biochemist extraordinaire, was on Robb Wolf's podcast recently and he said eggs, grains, alcohol, nightshades, nuts and seeds, and NSAIDS (like Advil, which are murder on your gut lining) to be eliminated FOR LIFE. (In a subsequent podcast over at the Healthy Skeptic he went even further saying that basically just grass fed meats and vegetables were all that were appropriate for people with severe autoimmune disorders!) Robb Wolf does not seem to take it so far. He has Celiac Disease, an autoimmune condition, and I know he has said he eats eggs and occasionally gluten free grains. I sent him a question for the podcast to clarify his position on this, but he gets so many questions we may or may not ever get a response. (Incidentally the Mat LaLonde podcast was my favorite ever and I've already listened to it at least twice! Definitely check it out).
As far as I know I don't have an autoimmune disease (I have blood work pending on the state of my thyroid) but I am definitely at genetic risk: my mom and both my grandmothers have Hashimoto's Thyroiditis and Rheumatoid Arthritis, and my dad has late onset type one diabetes, also an autoimmune condition. I also believe that as a nutritionist, I should never recommend something to a client without trying to myself so for the month of May, I'm doing the autoimmune protocol. This means in addition to my paleo diet, no eggs, no nightshades (tomatoes are the only ones I've been eating), no nuts (been eating a few too many of these since we came back from Hawaii with bags of macadamias!). I'm also going to cut WAY back on chocolate and fructose for a month, which is not necessarily part of the autoimmune protocol, I just have been overdoing it on those.
In the mean time I did something bad to my right knee last Thursday at Crossfit so I'm going to have to miss a few days, which doesn't make me very happy! But if I'm having trouble going up and down the stairs in my house, I'm probably not ready for the WOD.