Autoimmune Diseases and the Paleo
as if they were foreign invaders.
In the case of ulcerative colitis, strong immune responses are directed against specific proteins in the colon. With multiple sclerosis, the sheaths that cover the nerves are destroyed. In rheumatoid arthritis, the joints are attacked by the immune system. More than a hundred specific diseases are known to be autoimmune in nature, and you will probably recognize a few of the more common ones listed in the table below.
One of the surprising facts about autoimmune diseases is that environmental elements represent 70 percent of the risk for developing these illnesses. Genetics play a lesser role, with 30 percent of the risk being attributed to inherited factors. Up until the last five to ten years, autoimmune diseases were the black boxes of the medical world. We really had no idea how or why environmental factors triggered these diseases in genetically susceptible people.
Some astonishing developments have occurred in the past five years, particularly from Dr. Alessio Fasano at the University of Maryland Center for Celiac Research, that have helped to unravel the mysteries underlying autoimmune diseases. Work from Dr. Fasano’s group, as well as from other scientists worldwide, shows that a “leaky gut,” or increased intestinal permeability, plays a crucial initial step in triggering some, if not all, autoimmune diseases.
THE MOST COMMON AUTOIMMUNE DISEASES
Disease Tissue or Organ
Affected Prevalence Alopecia areata Hair follicle 170 per
100,000 Ankylosing
spondylitis
Spine and sacroiliac joints
129 per 100,000 Autoimmune
uticaria Skin 330 per
100,000 Celiac disease Small intestine 400 per
100,000 Crohn’s disease Gastrointestinal
tract
184 per 100,000 Diabetes, type 1 Pancreas 120 per
100,000 Graves’ disease Thyroid gland 1,120 per
100,000 Hashimoto’s
thyroiditis Thyroid gland 9,460 per 100,000 Lupus
erythematosus
Any tissue in the body
510 per 100,000
Multiple 140 per
Multiple
sclerosis Brain, nerves 140 per 100,000
Psoriasis Skin 2,020 per
100,000 Rheumatoid
arthritis Joints 920 per
100,000 Scleroderma Skin, other organs 110 per
100,000 Ulcerative colitis Colon 35-100 per
100,000
Uveitis Anterior eye 850 per
100,000
Vitiligo Skin 740 per
100,000
Amazingly, wheat—consumed by almost every person on the planet—has been found to be one of the primary culprits underlying leaky gut, not just in autoimmune patients, but also in healthy people. Wheat contains a protein called gliadin, which interacts with gut receptors to set off a cascade of hormonal events ultimately allowing the intestinal contents (food and bacteria) to interact with the immune system. Withdrawal of wheat from celiac patients
completely cures disease symptoms, and scientific evidence increasingly shows that this strategy may work for other autoimmune diseases, including type 1 diabetes, if it is caught early.
Dr. Fasano’s finding doesn’t really affect Paleo Dieters, because all grains, including wheat, have never been part of the menu. However, since the discovery that a leaky gut most likely represents a necessary first step in the development of autoimmunity, it has become clear to me and my scientific colleagues that any dietary element capable of increasing intestinal permeability should also be suspect in autoimmune diseases. As we pored over the scientific literature, we discovered the following list of foods and substances, in addition to gliadin in wheat, that promote a leaky gut:
• Alcohol
• Nonsteroidal anti-inflammatory drugs (NSAIDs):
aspirin, ibuprofen, naproxen
• Oral contraceptives
• Antacids containing aluminum hydroxide (alum)
• Capsaicin-containing chili peppers
• Certain saponin- or glycoalkaloid-containing foods
• Certain lectin-containing foods
At first glance, this list doesn’t seem to be very impressive, as you may not recognize all the common foods that contain lectins, saponins, and glycoalkaloids. So let me be a little more up-front and point out these
problematic foods.
Let’s start with lectins. Almost all grains and legumes contain lectins, most of which increase intestinal permeability. Because the Paleo Diet has always been a grain-free and legume-free diet, there really is nothing new here, except that now we are beginning to understand why the Paleo Diet has such potent therapeutic and curative powers for autoimmune patients: it is virtually free of the lectins known to increase intestinal permeability.
The most recent twist to the Paleo Diet and autoimmune diseases involves saponins, toxic compounds found in many plants that ward off microbial and insect attacks.
Unfortunately, saponins are bad news not only for insects and microbes, which try to eat them, but also for humans. If we eat saponins in large enough amounts, they can become lethally toxic. Even at low doses they may cause a leaky gut. Beans (legumes) and soy products are concentrated sources of gut-permeating saponins. Once again, this is why the Paleo Diet is such good medicine for autoimmune patients, as these foods have never been part of the Paleo Diet.
When I wrote The Paleo Diet eight years ago, I advised you not to eat potatoes, mainly because of their high glycemic load, which adversely affects blood sugar and insulin levels. It turns out that this recommendation is also good advice for people with autoimmune diseases. I now know that potatoes contain two specific saponins called
glycoalkaloids (alpha solanine and alpha chaconine), which increase intestinal permeability. Eliminating potatoes from your diet not only prevents blood glucose and insulin surges but also helps to prevent a leaky gut and autoimmune diseases.
Paleo Diets are good therapy for people with autoimmune diseases because they are devoid of lectin- containing grains, lectin- and saponin-containing legumes, and saponin- and lectin-containing potatoes. Do your gut a favor and kick these foods out of your diet. While you are at it, make sure you also avoid milk and dairy products, per my original recommendations in The Paleo Diet.
Epidemiological (population) studies have frequently implicated milk and dairy foods in numerous autoimmune diseases, including type 1 diabetes, rheumatoid arthritis, and multiple sclerosis. Furthermore, experimental studies have demonstrated that certain cow milk proteins can actually cause the animal equivalent of multiple sclerosis in rats. Because the Paleo Diet is devoid of dairy, grains, legumes, and potatoes, it’s no wonder it’s such good medicine for people with autoimmune diseases.
Besides contributing to a leaky gut, certain dietary saponins agitate the immune system in a manner that makes it much more likely to cause autoimmune diseases.
Saponins have long been used by immunologists to boost the effectiveness of vaccines in revving up the immune system. So the bottom line is, if you have an autoimmune disease, you should avoid saponins.
In addition to legumes and potatoes, other commonly consumed foods containing saponins that may contribute to a leaky gut include green tomatoes, alfalfa sprouts, quinoa, amaranth, and soft drinks containing the additive quillaja. A final note of caution for autoimmune patients: avoid hot chili peppers, hot sauces, and salsas. These foods contain high concentrations of capsaicin, another food element that increases intestinal permeability.