I've been horrendously inconsistent and I haven't posted it a while. To be honest, I went into full holiday mode in Zanzibar. I have also recently started working again and I needed a bit of time to get into the swing of things. But I'm back now!
Diet is an essential part of life in general, often greatly overlooked and underplayed. The diets of most people today may seem to be somewhat "healthy", but they're actually pretty atrocious. Throw some underlying chronic inflammation into the mix with the high-stress levels of today's world, and a touch of a sedentary lifestyle and you've cooked yourself a pretty nasty concoction. I'm going to shed some light on how diet can play a gigantic role in disease, and how beneficial and downright life saving anti-inflammatory diets are.
Prior to my diagnosis, there were staples that I had in my diet, things I ate every day and absolutely loved, things I swore I'd never give up. These same things, I found out after my first consultation with Dr. Laporta, may, in fact, have been contributing to my inflammatory condition. Carbohydrates, cheese, and baked treats were my kryptonite, to say I loved them is an understatement. But alas, they fall into the group of food that causes inflammation. It must be noted that I was pescatarian and had no intention of eating meat again, at this point. Some other inflammatory foods include grains (wheat, maize, rice, buckwheat, quinoa, spelt, rye, etc), dairy, legumes (peas, beans, lentils, chickpeas, soy, etc) nightshade vegetables (potatoes, tomatoes, peppers, aubergine), nuts, eggs, coffee, cocoa beans, refined oils and sugars, processed foods and preservatives. I will go into some detail explaining how these foods might cause inflammation and how that can perpetuate the vicious inflammatory cycle of autoimmune diseases. I tried this anti-inflammatory diet as a pescatarian for 2 weeks, however, without carbohydrates, legumes and nightshade vegetables, it became impossible for me to sustain myself off a pure pescatarian diet. Reluctantly, and with more than a few tears, I slowly added meat and chicken back into my diet - all grass-fed and pasture-reared.
Before getting into the details, I have to inform you that an anti-inflammatory diet requires dedication, hard work, drastically changing your lifestyle and determination. It is immensely challenging and seems somewhat impossible, but I can assure you that you get used to it, it gets easier and eventually, it becomes your normal. Most importantly, this kind of eating is not only indescribably healthy, but it also adds years onto your life and can help you gain control of your disease.
What is the interplay between gut health and inflammation?
In the gut, we find a diverse colony of bacteria named the microbiome. The microbiome plays an important role in gut health, general systemic metabolism and Cardiometabolic health (cardiovascular and metabolic diseases). The communication between the microbiome and the body is vital for health, it has control over the immune system, the brain (including emotions) and many more. In recent years, this interplay has become a new "hot topic" and a favourite research choice for many specialities and thankfully new research is coming out almost every day. (1)
An important fact to note is that in our guts, we have a balance of bacteria, both good and bad. Ideally, the good bacteria outweigh the bad and keep the bad bacteria in check. However, owing to the overuse of antibiotics and other medications, Western diets which are inflammatory in nature and the deficient of nutrients, the good bacteria are killed off, allowing the "gram negative" bacteria to over-ride the gut. When these gram-negative bacteria die, they release a substance known as lipopolysaccharide or endotoxin. This toxin has a virulent component known as "Lipid A", this means triggers the immune system to mount an enormous attack. With repeated episodes of endotoxin being release, the immune system continuously mounts an inflammatory attack and this results in chronic, underlying inflammation. This chronic underlying inflammation has been linked to an extensive list of conditions, including Autoimmune disease, mental health diseases, cancers and more. (1,2)
Another linking factor between chronic inflammation and gut health is "Leaky Gut Syndrome". There are many studies being conducted currently on this theory and a lot of research being released about it. In order to explain Leaky Gut Syndrome, it is important to understand the anatomy of the healthy gut. The intestines are responsible for the absorption of nutrients from the food that is broken down and "mushed up" by the stomach. From the stomach, the broken down food moves into the intestines where digestive enzymes aid in the absorption of the different food types, ie broken down carbohydrates, proteins, fats, minerals, and vitamins. The intestine is lined by cells known as epithelial cells, these cells are connected to each other and held together by tight junctions. The epithelial cells have finger-like projections known as "microvilli" that arise from there luminal surface (the part of the cell that lines the lumen of the intestine and is exposed to the digestive process). The microvilli increase the surface area of the intestine and therefore allow for greater absorption of nutrients. There is a layer of mucus that lines the intestine, which helps protect the cells of the intestine from being damaged by harmful undigested products. When there is chronic underlying inflammation in the gut, the epithelial cells become inflamed and damage, destroying the microvilli and interrupting the tight junctions. This causes gaps to form between the cells, which allow incompletely digested food particles, toxins, allergens such as gluten and lactose, medications and pathogens to pass through the intestinal barrier, directly into the bloodstream. This results in a massive inflammatory response as the immune cells are triggered to attack, further perpetuating the chronic underlying inflammatory cycle. (1,2,3)
So how does diet fit in?
How do we stop the inflammation and heal the gut? We cut out whatever is causing the inflammation, right?
While this is true, it is slightly more complex than it seems. Yes, by cutting out inflammatory foods we reduce the amount of inflammatory provoking particles that pass through our gut and we give the gut a chance to heal. But there are other factors that play a role too. Stress has a huge impact on gut health, and while this is a topic for another day, stress management is something that HAS to form part of your protocol if you truly want to heal your gut health.
Inflammatory invoking foods are more complicated than the typical foods that pop into our minds when we think about this topic. Yes, refined sugars, fried food high in saturated fats, fast foods or highly processed/preserved foods are an absolute no-no. It's when we take a closer look at the foods we generally think of as healthy, that we realise just how terrible our diets have become and how much our bodies are being exposed to. I can only speak from the experience I have in South Africa, but here, the majority of our grains and food, in general, are genetically modified, mass-produced, cross-contaminated, factory farmed and contain pesticides, antibiotics, and hormones, with the exception of a few highly priced, organic retail stores(4,5,6,7). These types of foods perpetuate the inflammation cycle immensely. Hence, it is advisable to cut out all of these types of foods as they play a nefarious role in inflammation and inflammatory diseases. One can extrapolate that maintaining a fully organic, grass-fed and pasture-reared diet is essential. Not entirely feasible for those of us who love to eat out, but sacrifices must be made for health.
Research shows that there are links between GMO food and pesticides and gut inflammation. Specifically, a widely used pesticide Glyphosphate has been linked to being a carcinogen, increasing the development of gluten intolerance and Coeliac disease, and it kills off the good bacteria in the microbiome, allowing the bad bacteria to thrive (7). Grain fed meats, dairy and eggs contain high levels of omega 6s from the grains that they are fed. Please refer to the picture below. These omega 6s contain levels of arachidonic acid, which are pro-inflammatory and cause the immune system to react and elicit an inflammatory response. One well-known exception to this is Primrose oil. Primrose oil is an omega 6 but it contains Dihomo-gamma-linoleic acid and follows a deferred pathway, allowing it to be an anti-inflammatory oil. Omega 3s found in fish oils contain Eicosapentaenoic acid, which is an anti-inflammatory oil and therefore helps fight the inflammation in our bodies (8). For this reason, it is important to ensure that the food you eat is grass-fed or pasture reared, a minimum of free range is acceptable.
The Autoimmune Paleo Diet (AIP):
I have mentioned the food groups that provoke inflammation already, and below I have attached the diet I followed. There were many articles I read on this topic, many hours were spent accumulating infromation about the topic and extracting the most important information possible. The image I have attached is a basic summary of all the information I read. The list of foods that have to be eliminated is overwhelming, to say the least. What's worse is knowing that some of them are meant to be cut out of the diet indefinitely. Although the images states the elimination phase is a minimum of 30 days, the general consensus I found was that the elimination phase should be about 8 weeks. I did an 8-week elimination phase - this is meant to be the strict phase of the diet and is potentially one of the most challenging and frustrating things I've ever done, especially as it fell over Christmas, my birthday and New Years. Many people I spoke to said I didn't need to be so strict and that an 80/20 or 90/10 rule should apply, however, from the research I had found, it stated that you had to fully commit to the diet. And so, a day after my initial consultation with Dr. Laporta, I went cold turkey and committed 100% to this new lifestyle. For the full 8 weeks, I adhered strictly to the diet, allowing myself one small cheat on my birthday - 3 glasses of organic red wine - so not really a cheat.
After the 8 weeks, the re-introductory phase begins, in this phase, you slowly begin re-introducing certain food groups back into the diet, monitoring your body's response to each food that is added. If an adverse response is noted, that specific food is thought to cause an inflammatory reaction and should, therefore, be eliminated indefinitely. During this time, I slowly added foods back into my diet, watching my body's response to each food. I did, against the recommendation, allow myself and still allow myself a small cheat once in a while. I'll go out for dinner on chosen special cheat days (about 1 a month) and eat a yummy pasta or have a dessert of some sort. I don't know how acceptable this is as part of the diet, but with close monitoring of my blood markers, it seems to be okay for me to do.
The aim of the diet is to eliminate inflammatory provoking food and to replenish the body with wholesome, hearty, nutrient dense food. A few things I add to the diet that I felt were essentials were; juices, smoothies and tons of hearty stews with bone broth. Dr. Laporta encouraged me to stay away from too many raw vegetables, as they are high in compounds like oxalic acid, which can stimulate the gut and the immune system. In the beginning phase, you want your gut to rest and recover, with as little digestive stress as possible. Well cooked, hearty, nutrient dense foods are the best for this. As you enter into the re-introduction phase, the gut should be healed, and can handle more digestive stress and more complex foods. The more complex the food, the more chance they have of activation the immune system. This is why you need to eliminate the complex foods that contain allergens initially, keeping the gut rested and allowing it to recover and heal.
There were moments where I found this diet so incredibly difficult that I wanted to opt for the easier option and take the Methotrexate and other medications. Thankfully, with the constant support of my family, I pushed through. It has been beyond worth it, I have never felt healthier and more devoted to my health. I have full knowledge and control of what I put into my body and fuel myself with, my body has responded exceptionally well. My markers immediately started declining, my symptoms improved, and eventually, I got myself into remission.
It is important to know, that with determination, will power, commitment and self-belief, you are capable of overcoming pretty much anything. The saying "Where there is a will, there is a way", couldn't be truer. I not only encourage you but I urge you to take control of your health, no matter what treatment regime you follow, whether you have been diagnosed with a condition or whether you're just simply curious, take charge of how you treat your body. Give your body the respect it deserves, and you will be surprised at what you can achieve.
Stay strong and keep fighting!
Sending love,
Cayla
References:
1. Bio-K. (6 August 2018). The Link Between The Microbiome and Chronic Inflammation. Bio-K. https://www.biokplus.com/blog/en_US/gut-health/fiery-relationship-understanding-the-link-between-the-microbiome-and-chronic-inflammation_1. Accessed 15 May 2019.
2.Biologics International Corp.( 25 May 2018). Bacterial Endotoxin Definition. https://www.biologicscorp.com/blog/bacterial-endotoxin-definition/. Accessed 15 May 2019.
3. Harvard Health Blog. (21 September 2017). Leaky gut: What is it and what does it mean for you?. https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451. Accessed 15 May 2019.
4. News24.com. (07 October 2018). Most of South Africans eat Genetically Modified foods. https://www.health.harvard.edu/blog/leaky-gut-what-is-it-and-what-does-it-mean-for-you-2017092212451. Accessed 15 May 2019.
5. The Journalist. (26 August 2014). SA Only Country Allowing GM Staples: we have no choice. https://www.thejournalist.org.za/kau-kauru/gm-staples. Accessed 15 May 2019.
6. The University of Pretoria. (18 October 2018). Pesticides Found in Local Fruits and Vegetables could have Health Risks; UP Academic warns. https://www.up.ac.za/news/post_2727975-pesticides-found-in-local-fruit-and-vegetables-could-have-health-risks-up-academic-warns. Accessed 15 May 2019.
7. Bio-K. (16 May 2018). How Pesticides and GMOs can Impact our Intestinal Microbiota. https://www.biokplus.com/blog/en_CA/gut-health/how-pesticides-and-gmos-can-impact-our-intestinal-microbiota. Accessed 15 May 2019.
8. Horwitz, R. Muller, D. (14 September 2010). Integrative Rheumatology. Pg 93-107. Accessed January 2019.