The Paleo Approach for Autoimmune Disease: An Interview with Sarah Ballantyne, PhD

People come to Paleo and the Whole30 for a variety of reasons—weight loss,  increased energy, better sleep, and most important, improved health. Increasingly, more and more people are turning to this lifestyle change to relieve or eliminate the symptoms of their autoimmune condition.

In part one of this two-part series, we talk to autoimmune Sarah Ballantyne of The Paleo Mom about her new book, The Paleo Approach. Sarah gives us an overview of autoimmune conditions and how her proven approach helps to reduce or eliminate symptoms. In part two, Melissa Hartwig (co-founder of the Whole30) and Sarah discuss how to get started with your own Paleo approach.

Sarah Ballantyne’s Paleo Approach for Autoimmune Disease

Give me the not-too-science-y definition of an autoimmune condition, and a few examples.

An autoimmune condition is any disease that is caused by a targeted attack of our own immune systems against proteins, cells, or tissues in the human body.  Which autoimmune disease you have is determined by which tissues are damaged by the immune system.  Common examples of autoimmune diseases include: psoriasis, rheumatoid arthritis, type 1 diabetes, lupus, multiple sclerosis, and Hashimoto’s thyroiditis.

Refer to this 3-page PDF (from The Paleo Approach) for a comprehensive list of autoimmune conditions.

What is the purpose of an autoimmune dietary protocol (AIP)—how does changing your food impact your immune system and your disease?

 There are really strong links between diet and the development of autoimmune disease, and the AIP breaks those links.

The AIP is designed to regulate the immune system in two ways.  First, the AIP dramatically increases the nutrient-density of the diet—micronutrient deficiencies may contribute to the development of autoimmune disease.  This provides the body with the nutrients required for the immune system to function normally and those required to heal damaged tissues.  Second, the AIP removes foods that stimulate the immune system, whether directly via dysregulation of hormones like insulin, or by damaging the gut or contributing to gut dysbiosis (where the wrong numbers or types of bacteria are growing within the digestive tract.) This is important because the probiotic bacteria in our guts are essential controllers of our immune systems.

Is doing the Whole30 enough to see an improvement or elimination of autoimmune symptoms?

It definitely can be for many people!  By regulating blood sugars, and by eliminating grains, legumes, dairy, and alcohol, many people will see vast improvement in the symptoms of their autoimmune diseases—and some will even see their diseases go into remission.  I typically recommend that people currently eating a typical Western diet and contemplating the AIP (and who are not currently in a major health crisis) start with a program like the Whole30 and see how far that gets them.

I also recommend that these people “look ahead” to the AIP and understand the importance of nutrient-dense foods like organ meat, seafood, and vegetables and why foods like nightshades, eggs, nuts, and seeds might be a problem. I also recommend people prioritize sleep, stress management, and healthy activity.

On top of the Whole30 (which eliminates added sugar, alcohol, grains, legumes, and dairy), what else should people eliminate from their diets if they have an AI condition?

The AIP eliminates eggs, nightshades (tomatoes, peppers, eggplant, chilies, etc.), and all nuts and seeds (even the best choices like cashews, hazelnuts, and macadamia nuts).  But, the AIP is just as much about which foods to eat more of as it is about extra eliminations.

I recommend eating at least three servings a week of oily cold-water fish (more if you’re eating much poultry or unable to afford or source grass-fed and pasture-raised meat), and four servings a week of offal (organ meat like liver, heart, and kidney, and unusual cuts of meat like skin, bone marrow, cheek, feet, and jowl), plus large servings of a variety of vegetables at every meal.

I thought eggs and tomatoes were healthy! Why do you have to eliminate these foods too?

The very frustrating thing for people with autoimmune disease (and I know because I’m one of them!) is that our immune systems are more sensitive to being stimulated in a dysfunctional and unproductive way.  Unfortunately, vegetables from the nightshade family, like tomatoes (and maybe especially tomatoes) have several different immune-stimulating compounds in them—two of which have been investigated for use in vaccines!  Egg whites contain a molecule called lysozyme which acts as a carrier for other immune-stimulating compounds to enter through the gut barrier and into the body.  I know that my body reacts worse to a bite of tomato than it does to a bite of bread (not that that’s fun either)!

You mentioned lifestyle factors back there—not just diet.  Why are lifestyle recommendations part of the AIP?

Stress, lack of sufficient sleep, disrupted circadian rhythms, inactivity, and overly intense activity are all contributors to immune dysfunction.  And in fact, these are just as important to address (maybe even more so!) than diet.  Lifestyle modifications are not a part of the AIP as it has been defined through the years, but became a major part of The Paleo Approach as I researched their importance.

Specifically, I recommend getting at least eight hours of sleep every night (nine or ten is better when you’re first starting out); managing and reducing stress (reducing stress would be like saying “no” or asking for help; managing stress would be like taking up meditation, yoga classes, taking a bath, or making time for a hobby); spending time outside every day and making sure your environment is dim in the evenings (to support normal circadian rhythms); and incorporating mild and moderate intensity activity (like walking, yoga, swimming, strength training) throughout your day while avoiding activity that is overly intense (like endurance running and HIIT workouts).  All of these recommendations are derived from the effects of these lifestyle factors on hormones that regulate the immune system and gut health.

How long might it take to see results on an AIP?

This is a tough question to answer, because it can vary wildly from individual to individual.  Some people have reported putting their diseases into remission in as little as three days, but this is by far and away the minority.  Most people take months, some take years.

There are a lot of factors that go into how long it takes to see improvements on the AIP:  what disease you have; how long you’ve had your disease; how aggressive your disease is, how badly damaged the tissues attacked by your disease are; your genetics; what micronutrient deficiencies (or excesses) you have that need to be corrected; how badly damaged your gut barrier is; what types of bacteria and how many are growing where in your gut; how well you implement the AIP (are you really eating organ meat and seafood and tons of veggies?); how well you sleep; how well managed your stress is; how active you are; how much time you spend outside during the day; how much fun you have; whether or not you have extra challenges to healing like an MTHFR gene variant, a chronic infection like a parasite or H. Pylori, or a disease that affects digestive organs; and whether or not you are on medication or supplements that might slow down your healing (especially since some of these require dedication to the AIP for a while before you can start weaning off of them).

Unfortunately, it can be a long slog.  But, most people will at least start to see improvements within the first three months and continue to see gradual improvements over time. I took four to start seeing improvements myself (autoimmune diseases affecting the skin can be some of the slowest to respond simply because the skin is such a low priority organ for the human body when it comes to healing), but everything really came together around the ten month mark.

I generally recommend that anyone who isn’t seeing improvement at the three to four month mark, seek out a functional medicine specialist or holistic doctor to work with to figure out if there are any extra challenges (like chronic infections) that can be addressed.

What kind of encouragement do you have for people just starting out with a Paleo, Whole30, or AIP approach?

Hang in there!  I know from personal experience that making these changes to diet and lifestyle is challenging and requires determination and persistence!  But, I also believe that living with autoimmune disease is more challenging.

I promise it gets easier.  You get used to this new way of eating.  Your taste buds really do change and adapt and being to appreciate these new strange foods.  You figure out how to spend more time in the kitchen and as you get a new repertoire of meals under your belt, you do end up spending less time in the kitchen than at first.  As you start to feel better, you naturally sleep more soundly, your energy level will improve, you’ll start to want to move your body.  And regaining your health is absolutely worth this time of challenge as you learn a better way to eat and to live.

The Paleo Approach

You can learn more about autoimmune disease and avail yourself of the many free resources Sarah has put together on her website, The Paleo Mom.

For an extremely comprehensive overview of the science* behind the AIP and an easy-to-follow program for those wanting to get started with their own Paleo approach to autoimmune disease, check out Sarah’s new book, The Paleo Approach.

*Sarah’s book features a good deal of technical scientific explanations of the mechanism of autoimmune diseases, how certain foods and lifestyle conditions impact the immune system, and the research behind her approach to reduce or eliminate symptoms of autoimmune disease. Please do not be intimidated by the science! Sarah is extremely skilled at making complicated topics simple to understand, but you don’t need to read through all the science to be able to effectively implement her plan.

The Paleo Approach contains a huge amount of practical application (including the most detailed shopping lists we’ve ever seen), and is, in our opinion, the very best resource for even those brand-new to Paleo and the AIP.

Additional Resources for the Paleo AIP

Sarah Ballantyne’s The Paleo Approach
Mickey Trescott’s Autoimmune Paleo Cookbook
Eileen Laird’s AIP reintroduction guide
The Phoenix Helix AIP weekly recipe roundtable

Sarah Ballantyne thumbnailSarah Ballantyne, Ph.D. (a.k.a. The Paleo Mom) is the blogger behind the award-winning blog, cohost of the top-rated and syndicated  The Paleo View podcast, and author of two upcoming books The Paleo Approach and The Paleo Approach Cookbook. Sarah’s personal experiences with autoimmune disease is the reason for the large amount of autoimmune-related content on her blog and the reason why her first two books are focused on how to modify a paleo diet to reverse autoimmune disease.

You can read more about Sarah’s personal journey to Paleo here and see more before and after photos here.

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  1. Mary Anna Singer says

    Looking for the second part of the interview, but couldn’t find it. Any links upcoming?

  2. Stefanie says

    I have a rare neurological disorder called visual snow. We aren’t sure if it’s autoimmune, and I am 7 days into the regular whole 30. I hadn’t finished reading the book in its entirety when I began whole 30 and saw information on the AIP a little late. However, this article suggests trying regular whole 30 first. I was wondering if you recommend if I
    A. Start over to do AIP
    B. Finish whole 30 as is and see how that goes…
    C. Take out the AIP components now (nightshades, nuts, eggs) and just add those back in last when I reintroduce.


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  4. Dawn Herrick says

    Hopefully this isn’t too crazy of a question, so here goes: How can this be modified for a vegan? I’ve been 95% vegan for the past 1.5 yrs and not quite sure what to do regarding this type of diet. Any tips? or advice or plans for modifying this to vegetarians/vegans? Thank you!

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