16 June, 2014

header image: simplebites.net

When we first launched the Whole30 five years ago, there weren’t specific instructions for those with autoimmune disease—they did the same program as everyone else. We soon discovered, however, that there are “healthy” foods allowed on the Whole30 that may trigger symptoms in someone with a highly sensitive immune system—foods that should be excluded on top of the usual Whole30 rules for this population to see the best results.

Since then, the number of resources for following a Paleo Autoimmune Protocol (AIP) has exploded. There are websites, blogs, books, and guides designed to help you navigate the tricky and often intimidating waters of an autoimmune elimination diet. However, most of these resources are geared towards preparing you for the program and walking you through it. For those who have done the Whole30, you know that the elimination portion of the diet is only one piece—a careful, systematic, scientific reintroduction is just as important.

The AIP reintroduction protocol can be tricky, as there are so many foods to evaluate, and reintroducing them one at a time can be difficult. Until now, there hasn’t been a book devoted just to this part of the protocol. After reading Eileen Laird’s e-book, “Reintroducing Foods on the Paleo Autoimmune Protocol,” we realized this was the piece so many of you were missing.

In this book, the AIP reintroduction protocol is spelled out clearly, in amazing detail. There are options for the order of your reintroduction, specific reintroduction directions, a sample reintroduction journal, and carefully designed recipes to help  you reintroduce one food at a time, without “cross-contamination” of other off-plan foods.

We asked author Eileen Laird to share more about her new e-book, and the background of her own AIP experience.

Reintroducing Foods on the Paleo Autoimmune Protocol

Did you jump right into an AIP, or did you begin your journey with a Paleo, Primal, or Weston A. Price-style diet?

Prior to the AIP, I followed a nutrient-dense version of the paleo diet. There were no “SWYPO” SAD foods. It was bone broth every day, organic grassfed meats and vegetables, organ meats, seafood, fermented foods. I was very focused on healing. I enjoyed fruit and the occasional treat, but there was no bingeing—it was very close to a Whole30. It took me out of crisis and set me on the path to healing. I went from excruciating daily pain to mild pain, from daily joint flares to just a few flares per month.

After six months, I plateaued in my healing, and that’s when I dove into the AIP. I’m glad I did, because I learned that nightshades are my biggest food trigger. Removing those from my diet (with some other AIP modifications) eliminated my flares altogether.

What was the hardest part about your AIP, and how did you manage that?

The restrictions were emotionally tough for me.  I’m a rebel by nature, and although I understood the theory behind the AIP, I had yet to prove to myself that it would help me. Starting the AIP is an act of faith, and I admit, there were moments when I thought whoever created the AIP were just mean people who wanted to suck the fun out of my kitchen.

I handled it by keeping my eye on the goal. I wanted to feel better. I also reminded myself that the AIP isn’t forever. It’s an elimination protocol, designed to be temporary. So, I looked forward to the reintroductions with hope, and tried to be as creative as possible with my AIP recipes. I also understood that if I fell off the AIP wagon, I’d have to start over on day one. It’s the science of an elimination diet. I didn’t want that, so I stayed the course.

You mention the emotional aspects of completing the AIP and going through reintroduction. What can people expect (generally) with the AIP and reintroduction period, physically and psychologically?

The reintroduction process is a science experiment—one of the most important of your life. You’re basically testing your body to see what exacerbates your autoimmune disease. It’s emotional, because you have such high hopes with each food reintroduction. If you’re successful (no inflammatory response), you’re elated and your diet just expanded, which is an awesome feeling after the elimination protocol. If a reintroduction fails (when you get an inflammatory response), it’s natural to grieve, because it often means giving up a favorite food for a long time.

There’s good news, though: The longer you avoid foods that trigger your inflammation, the more your symptoms improve, and no food can equal the reward of reversing autoimmunity and reclaiming your life. It’s also not forever. If a reintroduction fails, try again in six months. Often as we heal, we’re able to successfully reintroduce more and more foods.

So, that’s the psychology of reintroductions, but there’s also a physical response. A common question is: “What does a food intolerance reaction feel like?” Honestly, it varies from person to person and includes autoimmune symptoms, digestive symptoms, and gut-brain symptoms. Some examples are: pain, stiffness, muscle fatigue, digestive distress, visual disturbances, skin rashes, insomnia, anxiety, depression, exhaustion, etc. The severity of the reaction is based on the severity of the intolerance. In my e-book, I give you a two-step protocol for reintroductions. The first step identifies acute intolerances (where you need to avoid the food altogether). The second step identifies cumulative inflammation (where you might be able to eat that food once a week, but if you eat it daily, some symptoms will return.)

Sometimes people are afraid of reintroductions, because they feel great on the AIP and don’t want their autoimmune symptoms to return. Here’s the thing: long term, the more diverse your diet, the deeper your nutrition and the better your health. If you stay strict AIP for an especially long time, nutrient deficiencies can result if you’re not very careful. So, reintroductions are an important part of healing. It’s also psychologically important to ease up, if we can. Remember that food intolerance reactions are temporary—they will pass. I also include tips in the e-book for helping inflammation pass quickly.

How did you decide the order of your reintroduction protocol? Is it critical that people follow an exact order, or can they freestyle a bit based on their own preferences?

My e-book offers two ways to reintroduce foods. One is modeled after The Paleo Approach. Sarah Ballantyne divides reintroductions into 4 stages. Stage 1 foods are the ones she suggests people reintroduce first; they are nutrient-dense, and most people are able to reintroduce them successfully (like egg yolks and ghee). Stage 4 foods are ones that some people may never choose to reintroduce (like sprouted grains and legumes).

The second method is reintroduction by category, starting with the least allergenic option. For example, if you want to try reintroducing dairy, you would start with ghee (which is 99% allergen-free) rather than cheese (which is high in casein, one of the most common food intolerances.) This method lets you freestyle by choosing the food category you miss the most, but helps you do it wisely.

What is the biggest mistake people make when completing the AIP reintroduction?

Rushing the process. The AIP is hard to do. It’s restrictive and time consuming. For that reason, many people force themselves through the elimination period (barely) and then binge on all the restricted foods at once. Either that, or they make the mistake of reintroducing a food every three days without giving their body enough time to communicate. Before they know it, their autoimmune symptoms are back, and they have no idea which food is the cause.

The reintroduction process, done correctly, takes three to six months to complete. I know that can be overwhelming to read, but remember what you’re doing here. You are reversing the march of your autoimmunity symptoms, which is no small feat, and this process gives you the information you need to heal. It’s how you develop a personalized diet that’s perfect for you. You are also gaining a powerful skill that once learned, you’ll have for the rest of your life: the ability to talk with your body and understand what it’s saying.

What kind of recipes did you include in your e-book, and why did you choose these specific dishes?

I include 23 recipes in the book, and they’re matched with each food being reintroduced. The challenge was to create recipes that allow you to test one food at a time, because most recipes are a blend of ingredients that would muddy the experiment. So, instead of a salsa that’s full of a variety of nightshades, I include a recipe for slow-roasted tomatoes that lets you reintroduce tomatoes alone. Then, I have different recipes for each of the other nightshade vegetables, because it’s possible to tolerate one or two foods in a category, but not the whole category.

I wrote this guide to be personable and supportive, like a friend is guiding you through the process. I’ve done this myself, and I can help you do it, too. But I also wrote the guide with science in mind, trying to eliminate extra variables, and help you do the best self-experiment possible, to get the accurate results you need. This is our health we’re talking about; I take it very seriously.

Read more about Eileen’s new e-book, Reintroducing Foods on the Paleo 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
Whole30.com interview with Sarah Ballantyne

---

Eileen Laird uses the paleo diet and lifestyle to manage rheumatoid arthritis, reducing her pain by 95% without immunosuppressant or steroid medication. Her blog, Phoenix Helix, features recipes, research and personal stories about the autoimmune experience. She also writes Autoimmune Answers, a regular column in Paleo Magazine, and is the Autoimmune Ambassador for Chowstalker.