I Cant Eat Raw Vegetables
My digestive tract has a lot of healing to do and I plan to stay on the GAPS diet for at least 3 more years. Currently, I am unable to digest any raw vegetables or any form of nuts and seeds. I know this will get better with time and as I correct my stomach acid levels.
In the meantime, I eat my raw goat milk yogurt. It is important to consume a raw food with each meal due to the digestion enzymes in raw foods.
Autoimmune Protocol Clinical Trials
Lets review the clinically-validated benefits of the Autoimmune Protocol !
Konijeti GG, Kim N, Lewis JD, Groven S, Chandrasekaran A, Grandhe S, Diamant C, Singh E, Oliveira G, Wang X, Molparia B, Torkamani A. Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease. Inflamm Bowel Dis. 2017 Nov 23:2054-2060. doi: 10.1097/MIB.0000000000001221.
This 2017 study evaluated the efficacy of the Autoimmune Protocol for management of inflammatory bowel disease.
Fifteen patients with active inflammatory bowel disease9 participants with Crohns disease and 6 with ulcerative colitis, and 47% of which were on biologicswere placed on the Autoimmune Protocol by transitioning gradually over 6 weeks , followed by 5-weeks maintaining the strict elimination phase of the AIP . Patients were closely monitored and given access to health coaching. They were also given two books The Paleo Approach by Dr. Sarah Ballantyne, PhD and The Autoimmune Wellness Handbook by Mickey Trescott, NTP and Angie Alt, NTC, CHC, as resources for following the protocol. This study evaluated disease markers for IBD including the Harvey-Bradshaw Index for those with Crohns disease, and Mayo Score for those with Ulcerative Colitisboth of which are pain and symptom scoresas well as endoscopy improvements and laboratory markers.
What Causes Crohn’s Disease
Experts and researchers do not know what causes Crohns disease. Its currently called an idiopathic disease, one for which the cause is not known or understood. The disease does tend to run in families, but most people with IBD do not have a close family member with the disease.
There have been hundreds of genes found that are associated with IBD. However, not everyone who has these genes will go on to develop a form of the disease.
The theory is that there are environmental triggers that turn on the disease. These could be any combination of things that affect the makeup of the bacteria, viruses, and fungi found in the digestive system . The factors that change the microbiome could include the environment, diet, and/or genetics.
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Is Ulcerative Colitis An Autoimmune Disease Causes & Diet
Ulcerative colitis is considered to be an autoimmune disease
Ulcerative colitis is considered to be an autoimmune disease. With autoimmune disorders, your immune system goes awry and attacks your own body instead of defending it from infections and illnesses.
The main abnormality that causes inflammation in ulcerative colitis is an exaggerated T cell response that causes swelling and ulcers in the inner layer of the large intestine. The imbalance between the T cells, a type of white blood cell essential to the immune system, and natural killer cells causes the secretion of many chemicals in the gut that damage the cells in the lining.
What Is The Autoimmune Protocol Diet
The AIP diet is similar to the paleo diet, which focuses on removing refined grains and sugar. Its designed to remove foods that may trigger autoimmunity, inflammation, and imbalances in gut bacteria that occur in conditions such as Hashimotos disease, lupus, and inflammatory bowel diseases , including Crohns disease and ulcerative colitis.
The diet begins by eliminating foods that may trigger inflammation and development of autoimmunity, including:
- grains
- alcohol
- food additives and artificial sweeteners
Whats left is basically fruits and vegetables, minimally processed meats, fermented foods, teas, and other natural foods that dont fit into any of the categories above.
After adhering to the AIP diet for at least one month , the eliminated foods are gradually reintroduced into the diet, one at a time, to see what your food triggers may be.
Thanks to ulcerative colitis, my body is incredibly sensitive toward anything I put in it, so I will not try anything new with my diet unless its backed by science and hard facts.
The reason I was willing to give the AIP diet a try was because I discovered there were several research studies conducted specifically to find out if the AIP diet was effective for people with IBD.
For example, a 2017
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While There Are Many Unknown Factors At Play With The Development And Expression Of An Autoimmune Condition Diet Is One We Can Control
Of course, it is important to ensure you have adequate sleep, lower stress, exercise, and maintain healthy vitamin D levels. All have been shown to affect inflammation, a key component of autoimmune disease.
But, now we know the effect of diet on autoimmune disease is real. Thus far, the studies done on the specific effect of the AIP diet on autoimmune disease have been positive. They have been shown to help lower inflammation and improve quality of life by reducing symptoms and improving energy.
The AIP diet isnt for everyone. It can be challenging for the reasons mentioned above. But, for those looking for options, it just may prove to be your missing link.
Can Elimination Diets Cure It
Up to 60% of IBD patients have tried an elimination diet to relieve ulcerative colitis symptoms .
Unfortunately, the only known cure is total surgical removal of the colon and rectum .
There is no scientific proof that any diet can cause remission on its own. However, limited evidence suggests that certain diets can greatly improve comfort and quality of life.
The impact of diet on inflammatory bowel disease. Click to enlarge. Image .
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What To Do During A Flare
Medications are used to manage flares and induce remission as quickly as possible.
Doctors may prescribe a corticosteroid , antibiotic, 5-aminosalicylate, immunomodulator or biologic.
In addition, certain diet changes may help shorten flares. Some tips to keep in mind:
- Keep a food and symptom journal during flares to identify bothersome foods. This also ensures that foods are not avoided without cause.
- Eat small, more frequent meals as opposed to 3 large meals in a day .
- Ask your doctor whether to limit fiber until symptoms pass. Eating a maximum of 10 grams of fiber per day may reduce irritation and lower the risk of intestinal blockage. Once you are in remission, gradually increase your fiber intake, depending on how much you can tolerate, until you reach the recommended daily intake of 2530 grams.
- Drink plenty of fluids to avoid dehydration.
So What Am I Not Eating
First of all, I continue to follow a basic paleo eating plan that strictly avoids all grains, legumes, and refined sugar. Of these, the most important for me is to avoid anything containing gluten because of its role in creating intestinal permeability , and I have always found that legumes, especially peanuts, cause varying degrees of digestive distress. For now, I am also continuing to avoid nuts, most seeds, coffee, and alcohol because they are gut irritants and may cause an immune response.
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What The Research Does Show
A study published in May 2014 in the journal Gut showed that a high intake of omega-3 fatty acids found primarily in seafood, and part of the Paleo diet lowers the risk of UC, while a high intake of saturated fats increases the risk. Another study published in November 2013 in the journal Gastroenterology found that high fiber intake is shown to reduce the risk of Crohns.
So we have high-level epidemiological evidence that ones diet probably influences ones risk of IBD and that the Western diet, which is high in fat and sugar and low in fiber, may be one of the culprits,” says Dr. Loftus.
One problem with a dietary solution is that a diet that works for one person with IBD may not work for another. There are probably over 50 types of IBD,” Loftus says. We cant say that one diet will work for everybody, just like no one drug works for everyone.
Colleen Webb, RD, of the center for inflammatory bowel disease at the Weill Cornell Medical Center in New York City, agrees but believes that the Paleo diet can be beneficial. Any diet that eliminates highly processed foods, colorants, stabilizers, additives and other unrecognized ingredients will make people feel better, she says, adding that diets like Paleo influence the growth of good bacteria in the gut, which strengthens the immune system.
What Is Ulcerative Colitis
Ulcerative colitis is a chronic type of inflammatory bowel disease , like Crohns disease and microscopic colitis that affects the colon .
Recent studies estimate that IBD affects 2 million people worldwide .
Ulcerative colitis causes inflammation and sores in the inner lining of the colon. Inflammation often begins in the rectum, but it can spread throughout the large intestine.
Summary: Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and sores in the colon.
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Other Research On Plant
Theres one other research paper published in 2018 that looks at why a plant-based diet is a good recommendation for most cases of IBD .
The main argument is as follows:
- While theres a lot to learn about IBD still, it appears to be triggered worldwide by environmental factors .
- In particular, current research suggests that IBD is a result of mucosal inflammation that forms as a response to certain gut microbiota .
- Plant-based diets help improve the diversity of gut microbiota, and reduce inflammation, thereby helping to achieve remission of IBS symptoms in most patients.
While the outcomes look very promising, theres a lot of research to be done still to discover exactly why a plant-based diet is effective and to have more confidence in this conclusion.
The graph below compares remission rates of Crohns disease after being treated with different diets and medications.
The first column is a combination of a plant-based diet and infliximab , which achieved an amazing 96% remission rate.
Symptoms Of Ulcerative Colitis
Some people with ulcerative colitis have only occasional symptoms. For others, the symptoms are constant. The symptoms a person experiences can vary depending on the severity of the inflammation and where it occurs in the large intestine.
Common symptoms include:
- diarrhea, often with blood and mucus
- cramping abdominal pain, especially in the lower abdomen
- a frequent sensation of needing to have a bowel movement
- little advance warning before a bowel movement
- the need to wake from sleep to have bowel movements
- feeling tired
- dehydration
- low red blood cell count
Some people with ulcerative colitis develop pain or soreness in the joints, irritated eyes, and rashes.
The symptoms of ulcerative colitis can suddenly get worse. This is called a flare. Then symptoms may fade away. This is called remission. Some individuals with ulcerative colitis have symptoms only rarely, others have flares and remissions, others have symptoms all or most of the time.
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Sad To Aip In 6 Weeks
For the study, 15 patients were enrolled that had been living with IBD for an average of 19 years. A team including a nutritional therapist and registered dietitian led the participants through a six-week phased elimination program to transition from their current diet to AIP. They remained on the full AIP diet for five weeks. Mayo score or Harvey-Bradshaw score was determined at baseline, after the six weeks of phased elimination, and at eleven weeks after a month on full AIP. Seven of the 15 patients were actively taking medications to help manage the symptoms of their disease during the intervention. Patients who were identified as deficient in vitamin D or iron were also started on nutritional supplements to correct these deficiencies.
What Have I Reintroduced
Typically, a paleo autoimmune protocol diet excludes eggs, nightshades , seeds, and nuts, in addition to the grains, legumes, and dairy that a standard paleo diet avoids. Once significant improvement in the autoimmune disease have occurred , one can begin reintroducing foods one at a time. Experts recommend reintroducing the foods that are least likely to cause a reaction first.
Sarah Ballantyne of The Paleo Mom, says that the foods least likely to be problematic are egg yolks, ghee from grass-fed dairy, and seed-based spices, and the foods most likely to be problematic are egg whites, chili peppers, potatoes, and tomatoes. She has a great post explaining this and detailing how to conduct reintroductions that I highly recommend reading. As a summary, I created the following chart:
I started out following this chart exactly. The first food I tried was egg yolks and the second was one of the seed-based spices Id most been missing . Both of those went very well.
Then I got impatient and decided to try whole eggs. Even though I knew that egg whites are highly likely to be problematic according to expert research, Ive always felt like eggs were a safe food for me that I could always handle well even if my disease was highly active. I was prepared to back down and remove them from my diet immediately, but I was very thankful to discover that I could eat them without problem.
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The Effect Of A Plant
As far as Im aware, this is the only study published so far that looks at the effect of a plant-based on ulcerative colitis.
While thats not exactly what were looking for, it still may provide some insights.
They provided patients with a mostly lacto-ovo vegetarian diet while in the hospital, and educated them on how to follow a similar diet outside the hospital.
There were a few big findings.
First, by the time most of the patients left the hospital, they had already seen significant improvements in symptoms.
In total, 77% of patients had some sort of improvement, shown in the graph above.
On top of that, there were lasting effects that suggest treating ulcerative colitis patients with dietary education is more effective than just traditional medication :
Relapse rates after educational hospitalization providing a PBD were far lower than those reported with medication. Educational hospitalization is effective at inducing habitual dietary changes.
They followed up on a yearly basis and had relapse rates far better than expected, at just 2%, 4%, 7%, 19%, and 19%, respectively.
What can we take from this?
Well, there are some obvious limitations. Its a single study with largely self-reported data, so you cant make too many definitive conclusions.
However, it does appear that a plant-based diet is effective at managing ulcerative colitis for most chronic sufferers.
Autoimmune Protocol Clinical Trials And Studies
About Dr. Sarah Ballantyne, PhD
Award-winning public speaker, New York Times bestselling author and world-renowned health expert, Dr. Sarah Ballantyne, PhD believes the key to reversing the current epidemics of chronic disease is scientific literacy. She creates educational resources to help people regain their health through diet and lifestyle choices informed by the most current evidenced-based scientific research.
The Autoimmune Protocol, or AIP, is a science-based diet and lifestyle intervention for autoimmune disease and other chronic illnesses driven by immune dysregulation. You can think of it as a collection of best practices related to diet and lifestyle, not to the exclusion of additional treatments or interventions, that can be individualized to address specific circumstances and goals, framed in the context of a person whose health challenges imply a lower resilience to suboptimal choices.
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The Ultimate Support For Your Aip Journey
Get personalized guidance and support from Dr. Sarah in this 6-week interactive online course!
Thank you for your warmth, your AIP mastery, and your dedication to answering each and every one of our questions with such kindness and attention to detail. Thank you for teaching the science behind the principles. The amount of energy you put into creating this course and responding to us in real-time is felt and APPRECIATED!!-Nicole Wood
This data extension included examining changes in mucosal RNA expression from baseline to the end of the study. In this previous cohort, 5 participants had biopsies collected for analysis at both time points . There was only 1 patient with Crohns disease, therefore the analysis was limited to the 4 patients with ulcerative colitis only.
The results of the study illustrated that there were 324 significant differentially regulated genes, of which 167 were down regulatedthat is they were turned down, and 157 genes were up regulatedthat is they were turned up. The study found beneficial modulation of functional pathways involved in inflammation, DNA repair, metabolic processes, and cellular proliferation.
The authors conclude: Results from this RNA substudy would suggest dietary elimination, along with emphasis on a nutrient-dense diet, has the potential to positively modify inflammation and reduce symptoms in UC.
How Did We Get Involved In A Medical Study
In December of 2015, we were contacted by Dr. Gauree Konijeti, the Director of the Inflammatory Bowel Disease Program Division of Gastroenterology at Scripps Clinic in La Jolla, California. Dr. Konijeti told us that a patient with inflammatory bowel disease had introduced her to AIP and the patients improvement was so remarkable she was inspired to learn more. After further discussion Dr. Konijeti explained that shed like to undertake a medical study of AIP to evaluate its potential efficacy for patients with Crohns and ulcerative colitis. She asked if Angies online group health coaching program, SAD to AIP in SIX, could be used to help the study participants transition to AIP. Our answer, of course, was, YES, YES, YES!!
Medical studies take lots of time, planning, and money to get off the ground. It wasnt until September of 2016 that we were finally ready to get underway. Angie, joined by Amy Kubal, RD and Nicole Erickson, NTC, spent six weeks helping the participants, all of whom had Crohns or ulcerative colitis, slowly work their way through eliminations until they reached the full AIP elimination phase and then spent another five weeks in a maintenance phase. During the process, just like in SAD to AIP in SIX, the participants were introduced to important lifestyle changes too .
We waited another year for all the results to be calculated and the study be published, but now they are ready to be shared!
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