It is estimated that more than 50 million people have autoimmune diseases in America alone. Although the systems affected and symptoms present will vary from condition to condition and person to person, the underlying cause for at least 100 different diseases is an immune system that doesn’t function as it should. Instead of protecting us from outside invaders like bacteria, parasites or viruses, the immune systems of those of us with autoimmune disease mistake our own cells and tissues for the very invaders from which they are supposed to protect us. A healthy person will create antibodies in response to an external threat, like, say, a virus, that then seek out, bind to and mark the virus as something that needs to be destroyed and removed from the body. However, people with autoimmune diseases actually create autoantibodies that attack healthy cells and tissues. Our bodies essentially turn on themselves (more on that later) and the cumulative damage that causes over time eventually manifests as symptoms of autoimmune disease, whether that’s arthritis, which attacks the joints, or celiac disease, which attacks the small intestine, or Hashimoto’s disease, which attacks the thyroid, just to name a few. Doesn’t sound like much fun, does it?
When most people think about autoimmune disease, they think of it as something that is genetic; something that they cannot influence or treat proactively, other than by managing symptoms. That’s certainly what I was told and believed when I was diagnosed years ago with Hashimoto’s disease. I dutifully took my thyroid medication and thought that was all I could do, even though I continued to have symptoms and feel all-around terrible. But now for the good news: that’s not necessarily true! While genetics are a necessary component in the development of autoimmune disease and can cause an individual to be genetically predisposed to producing the autoantibodies that lay the foundation for autoimmune disease, there are other contributing factors. Those necessary contributing factors are an individual’s environment and their lifestyle, which includes diet.
Environmental factors trigger autoimmune disease and can include a range of different circumstances: illness and infection, exposure to chemicals, levels of stress and hormonal imbalances, among others. Lifestyle factors such as sleep, exercise and diet also play a role in triggering autoimmune diseases and flares. But now for some more good news: those environmental and lifestyle factors can be managed or even removed! What does that mean? That it is possible to get rid of those autoimmune disease triggers, stop autoimmune flares and symptoms and begin to heal from the inside out. Ultimately, it’s possible to encourage your body to stop attacking itself, repair the damage it has done and even get healthy again!
But before I can tell you a bit more about the “how” of all of this, I need to tell you a little bit more about the “why” of autoimmune disease. There’s a common thread that ties all autoimmune diseases together, regardless of the symptoms, systems affected or specific disease. It’s kind of a mouthful, so brace yourself: increased intestinal permeability. Lucky for you, I’m just going to go ahead and refer to that from now on as “leaky gut.” Research into autoimmune disease seems to show that it is a necessary precursor to the development of autoimmune disease.
“Leaky gut” means that the intestines have become more permeable than they should be. The gut is a barrier that is supposed to take in the things the body needs (like nutrients from food) and prevent things that should be exiting the body (like bacteria or food waste) from getting into the body. When the intestinal barrier becomes more permeable, it begins to allow things into the body that shouldn’t be present. That, in turn, triggers the immune response needed for autoimmune disease to develop. I talked a little earlier about how environment and lifestyle are contributing factors in the development of autoimmune disease: that is because leaky gut is caused by environment and lifestyle. What does that mean? That leaky gut can be healed through changing those environmental and lifestyle factors, including diet. So if leaky gut is necessary for the development of autoimmune disease, but it is caused by diet and lifestyle factors, here’s the important take away: it is possible to heal a leaky gut by addressing those factors. In doing so, you can begin to heal from your autoimmune disease!
When I first started on my healing journey, I began by adopting the Paleo diet. That meant removing all grains, beans, legumes, processed oils, dairy products and refined sugar from my diet. I originally turned to eating Paleo as a way of dealing with my own Hashimoto’s symptoms. I found that it dramatically improved and reduced the weird nagging side effects that still persisted, even though my blood tests were all coming back “normal.” The thing was, though, that I still didn’t feel normal. Some of the symptoms had gone, but quite a few were still hanging on determinedly!
And that’s when I learned about the Paleo autoimmune protocol, or AIP, through the work of Dr. Sarah Ballantyne, PhD, also known through her website as the Paleo Mom. Sarah studied the science behind autoimmunity and came up with the dietary modifications necessary to adapt the Paleo diet for people with autoimmune diseases. Sarah clearly laid out the definitive guide to the AIP in her book The Paleo Approach, and all of the recipes in this book comply with the protocol that she devised.
All of the foods and substances that are disallowed on the AIP are those that contribute to causing leaky gut by causing irritation and damage to the gut. They are also foods that are nutrient deficient and hormonal disruptors. Removing them means that the gut is not being constantly irritated or damaged and our hormones aren’t being constantly disrupted. In turn, this provides the environment in which the gut can begin to heal and autoimmune disease symptoms can begin to lessen and even improve. Which is what we all want, right?
The AIP starts with an elimination period of at least 60 days in which these damaging and nutrient-deficient foods are removed completely from the diet to give the gut a chance to heal. Cutting out these foods also promotes hormonal regulation, which, in turn, facilitates further healing of the immune system. Sounds neat, huh? So here’s the list of foods to be avoided on the AIP:
• grains
• dairy products
• legumes
• processed vegetable oils and sugars
• eggs
• nuts and seeds
• nightshades
• coffee
• alcohol
While fruit is allowed on the AIP, the aim is to keep fructose levels lower than 20 grams per day since excessive fructose can also be problematic while healing the gut.
So I told you we’re not supposed to eat nightshades on the AIP. But what is a nightshade? Ever heard of belladonna … also known as deadly nightshade? It’s as poisonous as it sounds and is one plant in a botanical family with thousands of varieties, including other not-so-friendly plants like tobacco. While most of us don’t tend to think about nightshades in our day-to-day life, when it comes to the AIP, we do need to know about the edible plants from the nightshade family so we can avoid them.
The nightshade family as a whole contains substances that are irritating to and can damage the gut, and provoke an autoimmune response—which is exactly what we are trying to avoid by following the AIP! Here is a list of the most common edible nightshade plants that are avoided while on the AIP:
• bell peppers and “sweet” peppers
• chili peppers of all types
• eggplant
• pimentos
• potatoes (not including sweet potatoes)
• tomatoes and tomatillos
And while we are avoiding nightshades, we want to also avoid the spices and seasonings that are derived from nightshade plants, such as:
• cayenne pepper
• chili pepper flakes
• chili powder
• curry powder
• paprika
• red pepper flakes
As I mentioned earlier, since we’re cutting out all not-tummy-friendly seeds as part of the AIP, we also need to know about other spices and seasonings that are derived from seeds so that we can avoid them, too. Here’s a quick list:
• celery seed
• coriander seed (the leaves, cilantro, are fine)
• cumin
• dill seed (the leaves are fine)
• fennel seed (the plant’s bulb is fine)
• fenugreek seed
• mustard
• poppy seeds
• sesame seeds
Trying to avoid these nightshade and seed-based spices also means being exceptionally careful when it comes to buying or using prepared spice blends. Read the labels carefully, or make your own. Don’t worry—every recipe in this book is 100 percent safe for the elimination phase and cuts out the guesswork for you!
It’s at about this time after reeling over that list of “can’t have” foods that people start to look at me as if I’ve sprouted 17 new heads. I know, it sounds like a challenge. It’s at times like these that I feel like the Severus Snape of the food world: I’m the killjoy with a bunch of mean rules that are designed to make you suffer … but all the while, I’ve actually been working on a plan for your own good. Really. I promise. Pinky swear.
Even people who have been eating Paleo for quite some time can balk at the idea of giving up eggs for breakfast, their coffee habit and their nut-flour-based treats. Like I mentioned earlier, I did myself! But the AIP isn’t about restriction. This book is going to show you that even eating a “restrictive” AIP-compliant diet can be simple, delicious and varied. You just need to know where to start. So here’s a list of foods that are allowed while following the Paleo autoimmune protocol and are the building blocks for tasty meals:
• all meats, including offal and bone broths
• healthy fats, such as avocado, olive oil and animal fats (yes, really!)
• all vegetables (except nightshades)
• all fruits (except nightshades)
• all herbs and seasonings that come from the leaves of plants
• some spices
• lacto-fermented, probiotic foods and drinks, such as sauerkraut and other vegetables, kombucha and water kefir
• coconut products such as coconut oil, milk and cream (coconut flour and coconut flakes are okay, but only in moderation)
That list may not look like much, but my recipes are here to help! Did you know that it’s possible to enjoy a curry dish without tomatoes or dairy products? Or that you can make tailgate-worthy wings without hot sauce? How about a grain-free alternative to croutons? Well, you can—and I’ve created the recipes in this cookbook to show you how!
Remember when I talked about healing the gut earlier? That’s the beauty of the AIP. It does start with an elimination period where lots of familiar foods are gone. But once that elimination period is up, there is a reintroduction process through which you can figure out which of those foods on the no-fly lists above you may be able to tolerate.
It’s a personalized process: Over time, as the gut heals by following AIP principles throughout the elimination period and as you begin reintroducing foods slowly afterwards, you can figure out the foods that trigger autoimmune disease flares for you personally and those that you can safely eat once you have healed, even though they’re not technically part of the AIP template. You might find that you are able to reintroduce eggs successfully, but no longer tolerate coffee. Conversely, somebody else might not be able to deal with eggs, but will find that they are A-OK with seed spices.
The even better news? As you continue to adapt AIP for you, your gut will continue to heal. Which means that you will have a chance to try reintroducing foods again at a later time if you so choose.
In the meantime, though, all the recipes in this book have been tailored to fit within the AIP elimination period. I’m going to take out all of the guesswork for you and show you how to eat delicious food that nourishes your body and heals you from the inside out. Yay!
Taking away the foods that damage the gut and promote inflammatory responses is obviously a huge part of beginning to heal from autoimmune disease. But it’s just as important to start adding things to your lifestyle. There are things other than food to consider: Making sure you get regular exercise, plenty of good quality sleep, minimizing stress and even getting outside in the sun are all important things to work on while healing.
But I’m here to talk about the food—my favorite thing!—and show you how AIP-friendly food can be fabulous. Not only can it taste great, but it can nourish you in a way that is going to help you heal. Can you guess what the best foods are to help you heal? They are all nutrient-dense foods.
Earlier I listed the foods that we don’t want to eat while following the AIP, since one of the key elements of healing is avoiding the things that are not beneficial to the gut, such as alcohol, grains, legumes and sugars, while also removing the foods that are most likely to provoke an unhealthy immune response (and are potentially allergenic), such as eggs, soy, nuts, nightshades, seeds and dairy products. What I want to focus on now, though, is what is left to work with: a huge variety of meats, seafood, fruits, vegetables and healthy fats, as well as herbs and seasonings. All of these ingredients will provide you with the nutrition you need to help regulate your immune system and heal—all while eating delicious and satisfying food.
The key to successfully following the AIP for healing revolves around the idea of nutrient density. In order to heal, we want to eat foods that are as nutrient dense as possible. In fact, it’s important to note that autoimmune diseases are actually linked to poor diets that are lacking vitamins, minerals and other essential nutrients. The AIP is based on the idea of eating nutrient-dense foods—those that are as health-promoting and as nutritious as possible. Foods that contain the valuable vitamins and minerals we need, as well as antioxidants, essential amino acids and fatty acids like omega-3s. These are the foods that will help us get rid of inflammation, regulate our immune systems and become the building blocks of better health. Eating a nutrient dense diet that has plenty of meat, seafood, vegetables and quality fats is the best way to bring about optimal health and healing!
When we talk about nutrient density, we also mean trying to eat as much variety as possible. Sure, eating beef and kale every day would technically be AIP compliant, but it wouldn’t give you the variety of different nutrients you need—not to mention the fact that it would be incredibly boring! Eating a nutrient-dense diet also means mixing things up a little! Try to get as many different foods as possible into your day—that way, you’re getting an array of different nutritional benefits.
Nutrient density is also important for another reason. Taste! Who wants to eat the same meals week in and week out? Nobody! Following the AIP doesn’t have to be dull—and learning to make a variety of different meals from diverse ingredients can be as fun as it is delicious. The recipes in this book are designed to help you make food that embraces these health-enhancing principles, while showing you that you have so many more options than you realized!
When it comes to food and maximizing the healing process, it’s important to emphasize that quality matters. An important component of the AIP is incorporating good-quality, grass-fed or pasture-raised meats wherever possible within your budget. Why the focus on these kinds of meats? They are much more nutrient dense than meat from conventionally farmed animals. Grass-fed and pasture-raised meat is higher in essential vitamins and minerals, and has a healthier, lower ratio of omega-6 to omega-3 fatty acids. The meat from grass-fed animals is leaner than that from conventionally farmed animals because they get so much more exercise, yet that fat is also healthier because it has greater levels of vitamin D from the time they spend outdoors.
Of course, there’s a catch: this higher-quality meat can be more expensive than conventionally farmed meat. But there are ways to make good-quality meat fit into your budget and this cookbook has plenty of recipes that will help you do so. Ground meat is one of the best ways to incorporate grass-fed meat into your meals and I’ve included meals that help you reinvigorate and reinvent this staple in tasty, healing recipes. I’ll show you how to make gut-healing, inexpensive broths and how to incorporate them into meals without even realizing it. Cheaper cuts can be transformed with a little imagination and mastering some simple cooking methods, which is why you’ll find plenty of slow cooker and “low and slow” oven recipes in this book. In fact, those slow-cooking methods are some of the best ways to get all the nutrition from the meat you’re cooking, breaking down the meat so that you can get the benefits of collagen and amino acids from the connective tissues and bones. I’ll even show you how to incorporate organ meats into your diet in ways that are truly delicious, because they are the most nutrient-dense (and cheap!) protein options out there.
As important as it is to include good-quality meats in our diets, it’s probably even more important to include seafood in our meals regularly, because its nutrition profile is the perfect balance to the kinds of meat we were talking about earlier. If you want to get a boost of vitamins A and D and minerals like selenium, then you need to be looking seaward to get your fix!
Certain types of seafood are also amazing sources of healthy omega-3 fatty acids. We definitely want those in our diet for their fantastic anti-inflammatory benefits, and this is even more important if you eat chicken or poultry regularly. Our feathered friends may be delicious, but they’re high in the not-so-helpful omega-6 fatty acids and it’s important to have a healthy balance of omega-3 to omega-6 fatty acids. Seafood really is a superfood—if you eat seafood several times a week, it can help balance out those fatty acid ratios.
When it comes to keeping the budget balanced, seafood is one of the most economical choices, too. Frozen wild-caught seafood is a great protein choice that can be much cheaper than red meat options, especially if you keep an eye out for sales. It’s a great “convenience food,” too—it’s easy and quick to thaw fish fillets or a package of shrimp, which is often a savior for me when it comes to weeknight meals. The other easy option for meals or even a snack is good-quality, BPA-free canned seafood. Canned fish can be way more exciting than tuna: broaden your horizons to the wonders of oily fish like sardines and mackerel or even clams and smoked oysters! All of these little marine prizes can be made into snacks or even a meal in minutes!
Just as variety and quality are what we want when it comes to meat, the same is true of our produce. Buy the best possible fruits and vegetables you can find. If you can shop locally and seasonally, that’s the absolute best way to broaden your horizons—and probably save a dollar or two! Don’t stick to the same old favorites. Mix it up! Try something new, or try preparing vegetables you’re not so crazy about in a different way. We want to eat as many different types of vegetables (and fruits) as possible, and we should be aiming for at least two different vegetables on every plate, to get the fullest possible range of healing nutrients.
To help you out, you’ll find a huge range of ways to incorporate plenty of fresh produce into your meals throughout this cookbook, with some fun and inventive flavor pairings. Vegetables aren’t just for soups, salads and sides—although this book has those, too. Most of the meals in this cookbook use plenty of produce! Without having dairy products and grain-based flours to turn to, I’ve gotten inventive when it comes to making sauces, creating the right texture in a dish or holding things like meatballs together. Which means that this book is full of recipes with “hidden” vegetables! Maybe don’t tell the mini humans about that part …
Did you know that the immune system requires fats? In a world where we’ve all been indoctrinated into the idea that fat is bad and low-fat products are our saviors, it seems hard to believe that we NEED fats. But we do! Our immune systems need fatty acids to function—and I’m talking about both the much-maligned saturated fats as well as monounsaturated fats. Fats are actually essential to the absorption of the fat-soluble vitamins A, D and K—which can all help restore the gut barrier. Clearly, we need our (good) fats!
But here’s the kicker, not all fats are created equal. You’ll notice that most of the recipes in this book call for coconut or avocado oil as the main cooking fats. The fact is, in most cases, you could easily substitute whatever AIP-friendly fat you like for those recommendations. The reason I listed those two is because they’re the most common, easy-to-find AIP-friendly fats, they’re pretty neutral-tasting, and they’re usually liquid at room temperature (although coconut oil will solidify when it’s cooler), which makes them easy to pour or measure. They also have higher smoke points than some of the other options, which makes them suitable for frying. With that said, like with meat and produce, eating a variety of fats is a good thing. Some other options include:
• bacon fat from pasture-raised pigs
• virgin or extra-virgin olive oil (for salads or finishing, not cooking)
• lard rendered from pasture-raised pigs
• palm oil or shortening (make sure it is sustainably sourced)
• tallow rendered from grass-fed beef or lamb
If you have access to these fats or have time to render them yourself, feel free to use them whenever and wherever you like!
So here’s the summary. Following the AIP means basing your daily meals on meat, seafood, vegetables, fats and a little fruit, while eating as many different varieties of those foods as possible to maximize nutrient density. So get this: There’s no fad, there’s no gimmick and there’s no messing around. Eating good-quality, real food while avoiding the things that can trigger immune responses is the key to regulating your immune system and healing from the inside out! Isn’t that pretty freaking amazing?