WHAT IS THE PALEO AUTOIMMUNE PROTOCOL?

T HE PALEO AUTOIMMUNE PROTOCOL (ALSO REFERRED to as AIP) is a specific version of the Paleo diet with special adaptations made to address autoimmune conditions. It is a powerful healing tool designed to reduce chronic inflammation in the body, restore a healthy digestive tract, and regulate the immune system .

Your body has an amazing ability to heal itself when given the proper resources and the opportunity to do so. The basic principles of the Paleo Autoimmune Protocol rest on that theory. AIP stresses that by eating a real food diet and focusing on nutrient density, you can set the stage for healing to occur and reverse the effects of autoimmune disease.

In her book “The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body,” Sarah Ballantyne explains the mechanism of autoimmune disease. I recommend her book if you wish to delve deeper into the scientific aspects of autoimmunity and AIP.

In a nutshell, autoimmune disease is caused by the immune system mistakenly attacking your own body and organs rather than protecting them. For example, in the case of Hashimoto’s Thyroiditis, the immune system attacks the thyroid.

The presence of gut dysbiosis (having the wrong kind or wrong number of bacteria in the gut) and a leaky gut (increased intestinal permeability) are almost always involved with autoimmune disease. The good news is we can help our gut and regulate our immune system with an appropriate diet and a few basic lifestyle changes.

The Paleo Autoimmune Protocol can be divided into 3 phases:
1.the elimination phase ,
2.the reintroduction phase , AND
3.the maintenance phase .

THE ELIMINATION PHASE

The elimination phase contains a double-edged approach:

1) Remove all potential trigger foods that create chronic harmful inflammation and irritate the gut.
2) Add nutrient-dense foods to provide the body with the building blocks needed to repair and heal the gut.

Eliminate Inflammatory Foods  

There are several reasons why we eliminate inflammatory foods on the Paleo Autoimmune Protocol. They provide little nutrition (but a lot of calories), are difficult to digest, compromise gut microbiome, contribute to hormone dysregulation, and increase inflammation in the body.

Any and all of these things can trigger an autoimmune response. For this reason, it is best to remove all trigger foods until you can figure out your own food allergies and sensitivities. Think of the elimination phase as a reset button for your body. This is the time in which deep healing can happen.

This seems like a good opportunity to talk about the temporary nature of the elimination phase. This phase of restricted eating is not meant to last forever. It is meant to be a time of calming, a time of healing. Nearly everyone embarking on this journey will require a minimum of 30 days in the elimination phase, some will require longer, but no one will need to remain there forever. A restricted life is not the goal—health is.

The Plan  

The elimination phase of AIP requires you to eliminate many foods that are already restricted on a standard Paleo diet including grains (and gluten), dried legumes (including soy and peanuts), food chemicals and additives, and refined and processed foods.

In addition to this, there are further problematic foods to avoid on the Paleo Autoimmune Protocol including dairy, eggs, nightshades, nuts and seeds (including coffee and cocoa), fresh legumes (green beans, green peas), and alcohol. (See table on page 33 –34 for a complete list of foods to avoid .)

Some people embrace AIP and eliminate these inflammatory foods all at once. Others prefer a more progressive approach. A good example of a more progressive method is the online coaching program developed by Angie Alt called “SAD to AIP in SIX”. The basic principle of her program is to remove one group of problematic foods per week, for 6 weeks, ending up on a strict AIP elimination phase diet.

Whether you dive in headfirst or slowly dip your toes in, your commitment to the Paleo Autoimmune Protocol is paramount. There is no 70/30 or 80/20 on AIP. You need to commit fully to this healing phase in order to see improvements.

Add Nutrient-Dense Foods  

Please don’t be alarmed by the foods you need to eliminate when beginning AIP. There are still plenty of wholesome, health-promoting, delicious foods you can eat! There is literally a bounty of health-promoting foods available to you!

If you are suffering from an autoimmune disease, chances are you have nutrient deficiencies. Nutrients such as vitamins and minerals are essential for good health, which is why you will focus on eating the most nutrient-dense foods you can find while on the protocol.

I know it sounds daunting, but believe me, you won’t have to sacrifice flavor or variety in order to heal. In fact, the recipes in this cookbook will show you how to prepare delicious meals that you and your family will love—even crave!

These delicious, nutrient-dense foods include: grass-fed meats, organ meats, wild-caught seafood, a wide variety of both green and colorful vegetables, fruit, healthy fats, fermented foods, and bone broth.

AIP isn’t about finding rare, exotic ingredients. It is about going back to the basics—to simple, real ingredients that will promote health instead of creating inflammation. In truth, the Paleo Autoimmune Protocol is a very simple, healing diet that you will truly relish.

Guidelines for a Happy Gut  

 Eat between 8 to 14 cups of vegetables per day (measured raw)
 Eat a wide variety of colorful fruit and vegetables
 Choose seasonal fruits and vegetables
 Choose organic grass-fed meats, organ meats, and wild-caught seafood (budget permitting)
 Consume healthy fats at every meal
 Consume fermented foods and drinks
 Consume bone broth

Notes on Fruit and AIP Treats  

Fruit is a great source of fiber, vitamins, minerals, and antioxidants, however, while in the elimination phase of AIP it is preferable to keep your daily consumption to between one and three servings per day (about 20 grams of fructose). If you love fruit and feel this may be difficult, think about it in terms of choices. For example, one medium apple has around six grams of fructose while one cup of raspberries has just over two grams of fructose. In general, fresh berries are always a good choice as they have a lower fructose content than other fruit.

Note that dried fruit has a very high glycemic load and should be avoided or eaten sparingly!

Why? Sugar is always sugar, even when it comes from fruit or unprocessed natural sweeteners like honey and maple syrup. In my experience, too much sugar doesn’t mix well with autoimmune disease. Sugar can raise overall inflammation in your body and make autoimmune symptoms worse.

Sweets and desserts made with ingredients compliant with the Paleo Autoimmune Protocol are wonderful and special, but we should treat them as such. A little something sweet to celebrate a special occasion is a wonderful treat, not an everyday occurrence.

Notes on Healthy Fats  

You might be surprised by the important role healthy fats play in the Paleo Autoimmune Protocol. After all, we have been bombarded with scientific literature pointing the finger at all fats as being the culprit for heart disease. It turns out that the long-established dietary recommendation to avoid fat was wrong, leading to grave vitamin deficiencies. In fact, our bodies need healthy fats to function properly. Healthy fats are a fundamental component of our hormones and we need them to properly absorb many fat-soluble vitamins and nutrients.

Plus, it tastes good!

Some examples of recommended healthy fats are avocados (and avocado oil), fatty fish (sardines, mackerel, wild salmon), grass-fed animal prod ucts (including lard and tallow), extra-virgin olive oil, coconut oil and coconut butter, and palm oil.

Try to eat healthy fats at every meal. For example, an avocado sprinkled with sea salt or canned sardines in olive oil both make terrific mid-afternoon snacks. Don’t tell me there isn’t anything to eat on AIP!

THE REINTRODUCTION PHASE

As I mentioned, the elimination phase of the Paleo Autoimmune Protocol is not meant to last forever. It is a temporary time of healing. The next part, the reintroduction phase, is the fun part. This is where you get to bring foods back into your daily diet that you had previously eliminated and you get to begin to truly understand your body—a win-win!

Please note that this doesn’t mean that you will go back to the way you were eating before AIP. All the foods creating gut inflammation, leaky gut, and stimulating the immune system are still off limits, but this is the time when you will start to understand what that means for your long-term diet.

The goal is to progressively reintroduce foods and get you on a diet that more closely resembles a standard paleo or primal diet. The final result of the reintroduction process is different for everyone and will depend on your own food sensibilities.

 When Can I Start?  

As mentioned, everyone will require a minimum of 30 days in the elimination phase, although it is better to wait three to four months. Some people, often those who are severely ill and require a great deal of healing, wait a full year. The longer you wait, the better chance your body has to heal and prepare for new foods. Resist the temptation to rush the reintroductions to satisfy your cravings. Take the time to heal. It will be worth the wait!

If you are still suffering from autoimmune flares, digestive distress, or chronic pain, it is definitely too soon. Wait until you see a significant improvement in your symptoms and your gut has healed before attempting any reintroduction .

It is also important to make sure that all other important aspects of your life are well managed including stress levels, sleep, and exercise. Good health involves far more than the food we eat. AIP, while primarily concerned with food, incorporates all aspects of life.

The bottom line is—there isn’t a hard and fast rule to determine the best time to start reintroductions. Ideally, AIP will help you learn to read the signals your body is sending you. Listen to those signals and exercise your own good judgment. You will know when the time is right.

How Do I Reintroduce Foods?  

The basic procedure for reintroducing foods involves eating the chosen new food several times throughout the day and monitoring your body for symptoms. Introduce new foods one at a time and do not rush.

(If you notice symptoms at any time during the process, stop eating the newly introduced food immediately and try again after your symptoms resolve completely.)

1.Choose one food to reintroduce.
2.Eat one half teaspoon and wait for 15 minutes.
3.If no symptoms appear, eat one teaspoon and wait for another 15 minutes.
4.If no symptoms appear, eat one and one half teaspoons and wait two to three hours.
5.If you still have no reaction, eat a normal-size portion, then wait three days before eating it again.

Monitor yourself closely for symptoms. A reaction will usually appear within one to four hours after eating the food, but may take up to three days.

Symptoms will vary from person to person and can be either mild or acute. They usually will exacerbate your autoimmune disease symptoms. Symptoms can include digestive troubles, mood swings, reduced energy, unusual food cravings, sleep disturbances, hives, headaches, skin reaction, joint pain, and brain fog, among others.

In her book “Reintroducing Foods on the Paleo Autoimmune Protocol,” Eileen Laird talks about a “second phase in the reintroduction process .” Laird suggests that after you have successfully completed the five first steps, a sixth step should be undertaken. She suggests eating the new food in small quantities every day for another week. The reason for this added precaution is that not all food reactions are strong or immediate. Some reactions are the result of a cumulative effect that becomes noticeable only after repeated consumption. If, after this extra step, you still feel good, you are in the clear!

 In What Order Do I Reintroduce Foods?  

In her book “The Paleo Approach: Reverse Autoimmune Disease and Heal your Body,” Sarah Ballantyne lays out a template for the order of reintroductions. The guide is divided into four stages, giving priority to the most nutrient-dense foods which are least likely to create a reaction. I encourage you to seek out Sarah Ballantyne’s website (thepaleomom.com ) or her book for any questions you may have.

NOTES ON REINTRODUCTIONS :

 You may be able to tolerate some foods only in small quantities, and even then only occasionally. This is the case for me with coffee and chocolate. I enjoy them as a special treat now and then.

 Keeping a food journal to track the foods you reintroduce and your reactions will make the process easier. It will help you identify patterns and links between foods and symptoms.

 Quantities when reintroducing spices are much smaller than for other foods like nuts or egg whites. A good approach is to prepare a dish that you would season heavily with the spice you wish to test. Then follow the steps outlined previously, starting with a small bite, then two bites, then three, then a whole portion of the dish.

 The reintroduction process for alcoholic beverages differs from other foods. To begin, drink only one small glass of gluten-free alcohol. If no symptoms appear, wait at least one week before having another glass. If the reintroduction is successful, limit your consumption to a maximum of two glasses of alcohol per week.

THE MAINTENANCE PHASE

The process of the reintroduction phase of the Paleo Autoimmune Protocol (also referred to as AIP) will help you discover which foods benefit your body and which foods trigger inflammation and autoimmune flares. The maintenance phase is where you hold it all together.

At this point, your diet will most likely look like a cross between strict AIP and a standard paleo/primal diet. This will be your maintenance diet, or “personalized AIP” as Eileen Laird calls it in her “Simple Guide to the Paleo Autoimmune Protocol.” You are a unique snowflake and your diet will reflect that from here on out!

Know that the foods you tolerate may vary over time. A food that you have reintroduced successfully in the past might become problematic again in the future, especially if your “balance” is compromised (increased stress, poor sleep, infections, etc.). For this reason, it is important to be vigilant and keep an eye out for sneaky, slow-moving symptoms. Be ready to ex clude any trigger foods from your diet should you notice any symptoms creeping in—at least for a while.

As a general rule, anytime you experience a resurgence of old autoimmune symptoms or the presentation of new ones, it is a good idea to retreat to the elimination phase for a period, until your symptoms have completely resolved.

As you get on with your life and start to experiment with new foods, keep the basic principles of the Paleo Autoimmune Protocol top of mind:

 Prioritize nutrient density,
 Eat a wide variety of health-promoting foods, AND
 Keep your gut healthy.

It is important for you to find your own balance. Consider what makes you happy—body, mind, and soul—and build your new healthy life around that balanced approach.

Written by Sophie Van Tiggelen in "Simple French Paleo - Flavorful Allergen-Free Recipes for the Autoimmune Protocol",Digitized, adapted and illustrated to be posted by Leopoldo Costa.