An autoimmune disease is an illness where the immune system mistakenly attacks healthy cells in the body. This might be in a particular area of the body, for example in coeliac disease where the immune system attacks the small intestine, or Hashimoto’s disease where the thyroid gland is gradually destroyed. Other autoimmune diseases, such as lupus, affect the whole body. There are more than 100 different types of autoimmune disease, including Graves’ disease, Crohn’s disease, type 1 diabetes and rheumatoid arthritis. As well as this there are conditions such as acne, eczema and IBS which are often considered to be “autoimmune spectrum disorders,” all characterised by inflammation in the body.
Many autoimmune diseases have similar symptoms which overlap with other illnesses, and this can make them hard to diagnose. There are no official figures for how many people in the UK are affected by autoimmune disease, but according to the British Society for Immunology, there are hundreds of thousands of people affected. It is also worth bearing in mind that there are probably many more struggling with low-level conditions that remain undiagnosed.
Although many autoimmune diseases are considered to be genetic, factors such as diet, lifestyle and environment can have a significant impact both on symptoms and on development of the autoimmune disease. Autoimmune Protocol, or AiP provides strict guidelines to apply to your diet which can help reduce or even completely remove symptoms - effectively putting your condition into remission.
AiP is essentially a variation of the Paleo diet, with additional emphasis on nutrient density. People following AiP will often follow rigid guidelines on foods to be eliminated from the diet, particularly in the initial stages. What you add in is just as important as what you eliminate, and other lifestyle factors such as exercise, sleep and managing stress are all part of the picture. Although AiP is mostly used to help those with autoimmune disease, the protocol is designed to help heal the immune system and gut flora in general, and so can be beneficial for any type of inflammatory disease or condition.
Many of us will have experimented with removing certain foods at some point, and you could be forgiven for thinking AiP is just your standard elimination diet. While it does involve eliminating many different foods, it is much more detailed, with the aim of removing all autoimmune triggers that may cause inflammation in the gut.
What are autoimmune triggers?
An autoimmune trigger is something that is considered to be a trigger to autoimmune disease, switching on that mistaken response from your body where it begins to attack healthy tissue. The most common trigger - the one we hear a lot about these days - is gluten.
If you visit your GP to test for gluten sensitivity, they will offer a standard test for anti-transglutamine antibodies which will show whether you have coeliac disease. Doctors will generally advise you to consume gluten in the weeks leading up to the test to ensure that the antibodies are present. If this test result is negative, you will usually be told you should carry on eating gluten because there is no allergic response present. However, you don’t need to have coeliac disease to be intolerant to gluten. Recent research suggests there is more likely to be a spectrum and you may find that you have non-coeliac gluten sensitivity.
Frustratingly, another autoimmune trigger is gluten-free grain. Many of us, when cutting gluten from our diets will opt for rice or oats instead of wheat-based foods. The problem is that the proteins in these grains can be very similar to gluten in their structure and effect on our bodies so they may still elicit an autoimmune response.
Sugar is another potential dietary trigger of autoimmunity. These days sugar can be hard to avoid as it is added to hundreds of pre-packaged foods, even savoury ones. It is worth noting here that it is fructose, a component of sugar, rather than sugar itself that can cause problems in the body. This means that the so-called “healthy” sugars such as agave nectar and honey, are also considered triggers for autoimmunity.
The main protein found in milk, casein, can be a major trigger for autoimmunity and inflammation in the body, and so in AiP all dairy products are removed. Sometimes ghee or clarified butter will be used instead of dairy, because the clarification process removes the casein. Some people with auto-immunity disorders can tolerate fermented dairy, but to begin with it’s often best to eliminate all dairy before slowly reintroducing things like ghee or kefir.
Nightshade foods such as tomatoes, potatoes and peppers can be a trigger of autoimmunity for many people and so these are removed in AiP. These plants all contain alkaloids in their skins which can cause an inflammatory response in the body.
The AiP diet removes these autoimmune triggers, aiming to calm the gut and introduce healthy flora and boost the gut microbiome. There are several different interpretations of AiP, each often focussing on a particular autoimmune disease or condition.
The main aim of AiP is to flood the body with nutrients while also removing anything that may trigger an autoimmune response. Unfortunately are no ‘cheat days’ when following AiP! Only complete avoidance will allow the gut to repair itself. Longer term, some nutritionally beneficial foods may be slowly reintroduced while carefully monitoring your body’s response to these foods.
If you are thinking of trying AiP, it is worth speaking to a nutritionist or other health practitioner with experience in the field. Many people trying AiP come up against resistance from friends and family who feel this type of diet is too extreme. While AiP can be seen as an extreme way of getting an autoimmune disease under control, there is very little down-side especially compared with a lifetime of prescription medication. After a period of adjustment, you many find that you enjoy and even prefer eating a low inflammation and nutrient dense diet!