Elimination diets for serious health problems
This post is based on some information I sent a friend who is struggling with multiple autoimmune issues. I thought it would be good to share it with everyone.
These are my thoughts on a few different approaches to use elimination diets to address autoimmune issues. My caveat is that diet is hugely personal; different people need different things, and there are practical and emotional components to all of this as well. There are likely not any simple answers, and over the long term, most people will need to tinker until they find what works for them rather than to blindly follow advice. This is meant as a starting point, or at the least, food for thought (pun! hahaha).
There are a couple different approaches you can take depending on your personality, your goals, your stress levels, and your practical limitations. I'll call them:
Just the Big Triggers
I'd recommend doing any of these as an elimination protocol: a period of time strictly eliminating the chosen foods and then reintroducing them one at a time and see how you feel. That way you can find out what you're really reacting to. Some people suggest lots of testing at an allergist, but that's expensive and less reliable: there can still be sensitivities and dysfunction even if you test negative for specific foods. For all of these approaches, it’s a good idea to avoid artificial colors and flavors, preservatives, artificial sweeteners, and trans (hydrogenated) fats.
Just the Big Triggers
This approach is the easiest to implement, as it's just going after the two biggest autoimmune triggers, gluten and dairy. A lot of people see big results from just this. The key is to be super strict about it - read labels and control your food to make sure you're getting no exposure at all. In this approach, feel free to eat gluten free and dairy free replacements as needed. Allowing these things makes social situations easier. You can get just about anything gluten and dairy free. It's so much easier than when I started this 9 years ago! I think the biggest challenge is changing habits and being vigilant, especially with loved ones who want you to have "just one cookie to feel better" or who put soy sauce in the chicken without realizing it has gluten. Special occasions can also be tricky. But it is do-able!
In this approach, your goal is to go after the biggest culprits and reduce inflammation. In addition to strict avoidance of gluten and dairy, you also avoid industrial vegetable/seed oils with lots of polyunsaturated fat (canola, soybean, corn, safflower, sunflower, peanut) and use monounsaturated (olive, avocado) and saturated fat (meat and eggs, coconut) instead. With no gallbladder, you'll need to take in a lot less fat, so it's especially important, I think, to make sure the fat you do eat is very high quality. You also avoid most other grains. You might make an exception for rice as that seems to be more innocuous. That means that a lot of the gluten-free options are off the table, but you'd be surprised at how many grain-free options are available now that there's a market for it. You also avoid legumes (beans and pulses) and soy, and keep refined sugars to a minimum. I've been on a version of this for 9 years, with more leeway in recent years but moving back into a more strict version in the last couple months. You can find many, many paleo recipes and ideas on the internet.
Autoimmune Protocol (AIP)
This is a standard diet in the Paleo world used to address a variety of autoimmune disorders. Some people follow it long-term, though it's more often used as a shorter-term elimination diet to figure out triggers. This approach cuts out all of the same things in the Paleo-ish approach, plus eggs, nuts, chocolate, coffee, and nightshades (eggplant, peppers, tomatoes, potatoes). As with paleo, you can find lots of AIP recipes and ideas with a little googling.
That's my moniker. Sledgehammer is if you are really suffering, you are fed up, and you want to maximize your chance of eliminating all problem foods. It's probably easier here to say what you can eat than to list what you can't. You can eat: meat (grass-fed or pastured if possible), seafood, good fats like olive oil, coconut oil, coconut products, vegetables minus nightshades, and some fruits - the ones that are low sugar, like berries and citrus, and maybe apples, plus apple cider vinegar, salt, and bone broth. Here you'd basically have to prepare all your food and not eat out or get prepared food at all. It's not the most convenient option, but it is a sledgehammer, and there still as a surprising variety of very tasty food that you can eat.
If you decide to tackle any of these options and want some support, don't hesitate to throw questions at me. I'm happy to help. I've found that controlling my food (and experimenting) has really allowed me to take charge of my health - I find it more empowering than limiting. Good luck and I hope this can make a difference for you!