CHAPTER THREE
HOW TO REINTRODUCE FOODS
AS YOUR BODY HEALS and you begin feeling measurably better, you can start reintroducing foods into your diet, one by one, monitoring yourself for symptoms. This reintroduction process will help you determine your own food intolerances, which in turn will allow you to tailor your diet to meet your own personal needs and preferences.
Does this mean that you will go back to eating like you did before beginning AIP? No. While the ultimate goal of the reintroduction process is to widen your diet as much as possible, in order to maintain optimal health, you will have to stay away from all foods harmful to the gut. For instance, Dr. Sarah Ballantyne recommends staying away from gluten and soy forever. She further recommends avoiding processed sugar, refined vegetable oils, food additives, and in general, all foods poor in nutrients. Once your symptoms are fully under control and you have successfully introduced many nutrient-dense foods, you may be able to occasionally eat other things. Certain gluten-free grains, such as rice and organic corn, for instance, as well as soaked and sprouted legumes, can be welcome additions to your diet provided they do not exacerbate your autoimmune condition.
Only you will know how strict you need to be to maintain a level of good health. This phase is about experimenting. Remember, you always have the option of reverting to the elimination phase should your symptoms creep up once again.
STARTING REINTRODUCTIONS
There is no universal rule as to when you should start reintroducing foods. The timing depends on how long it will take your body to return to a level of good health, and on this we are all different.
Dr. Ballantyne recommends a bare minimum of 30 days on AIP, though many people opt to remain in the elimination phase longer. At the very least, wait until your gut has sufficiently healed before attempting any reintroductions. You will know that your gut is functioning properly when you can digest your food well without gastrointestinal distress, your autoimmune disease is no longer active, and your symptoms have subsided.
Give your body time to heal and avoid rushing the process. It will be worth the wait! Know that the longer you wait, the more resilient your body becomes, increasing the chances of successful reintroductions.
The lifestyle aspect of the Autoimmune Protocol also influences how you will react to a reintroduced food. More than ever, make sure your stress is under control, you are sleeping well, you are exercising, and if possible, you are spending time in nature. When these elements are in balance, your body will more easily tolerate the reintroduction of new foods, which of course is the goal.
HOW TO REINTRODUCE FOODS
The reintroduction process, also called food challenge, may seem slow and meticulous, but it is important to follow the steps in order to detect not only strong, fast-appearing food reactions, but also the more insidious ones that may crop up after several days. Remember, slow and steady wins the race!
Reactions will usually appear within 1 to 4 hours after eating the offending food, with symptoms culminating within 24 hours. In some cases, it may take up to 3 to 7 days for a reaction to surface. If you notice any symptom at any time during the food challenge, stop immediately and wait until your symptoms have completely subsided before trying again.
It is a good idea to keep a daily food journal as you navigate the reintroduction process. Jotting down what you eat, when you eat it, and if you notice any change at all in how you feel, including physical symptoms and mood fluctuations, will help you identify patterns between the food you eat and the reactions you experience.
FOOD CHALLENGE PROCEDURE
* STEP 1: Choose a food to reintroduce. Eat 1/2 teaspoon and wait 15 minutes. If symptoms appear, stop.
* STEP 2: If no symptoms appear, eat 1 full teaspoon and wait another 15 minutes. If symptoms appear, stop.
* STEP 3: If no symptoms appear, eat 11/2 teaspoons and wait 2 to 3 hours. If symptoms appear, stop.
* STEP 4: If no symptoms appear, eat a normal-size portion and wait 3 days (up to 7 days if you are particularly sensitive and react easily to many foods). During this period, do not eat more of the food you challenged and do not eat any other new food. If symptoms appear, stop. If no symptoms appear, congratulations! This food is now potentially safe for you to eat.
When reintroducing spices, prepare a dish and season generously with the spice you are challenging. Follow the standard procedure, starting with one small bite, then two bites, and then three bites, before eating a normal-size portion.
When reintroducing alcoholic beverages, drink a small serving (8–9 ounces [230–260 ml] of gluten-free beer or cider, 5 ounces [145 ml] of wine, 3–4 ounces [85–120 ml] of fortified wine, 2–3 ounces [60–85 ml] of liqueur, or 1–11/2 ounces [30–45 ml] spirits), and then wait 1 week before having another serving, watching for symptoms. Do not exceed two servings of alcohol per week if you have an autoimmune disease.
ORDER OF REINTRODUCTIONS
There are two schools of thought on the order of reintroductions. One theory is to let your cravings guide you. You might very well decide to start with chocolate or coffee, for example, just because you miss it the most. The other theory, which is suggested by Dr. Ballantyne, prioritizes the foods that have the highest nutritional value and the least likelihood of triggering an autoimmune response.
The following is the order of reintroductions as suggested by Dr. Ballantyne. Which food should you choose first to reintroduce into your diet? Once again, there isn’t a general rule here. Dr. Ballantyne’s stages are simply templates—the ultimate decision is up to you.
* STEP 1: egg yolks, fresh legumes (such as peas and green beans), fruit-based spices, seed-based spices, seed and nut oils, grass-fed ghee
* STEP 2: seeds, nuts (except cashews and pistachios), cocoa or chocolate, egg whites, grass-fed butter, alcohol in small quantities
* STEP 3: cashews and pistachios, eggplant, bell peppers, paprika, coffee, grass-fed raw cream, fermented grass-fed dairy (such as yogurt and kefir)
* STEP 4: grass-fed whole milk, grass-fed cheese, chile peppers, tomatoes, potatoes, nightshade spices, alcohol in larger quantities, white rice, soaked and sprouted legumes, soaked and sprouted gluten-free grains, any other food you used to be allergic to* before AIP
* Please keep in mind that those with life-threatening allergies should never attempt to consume that which they are allergic to unless under the express care of a doctor, and those with celiac disease should never knowingly consume gluten.
MANAGING EXPECTATIONS
Ideally, during a food challenge, no symptoms appear and you can incorporate that food back into your general diet. Enjoy this small victory! Be aware, however, that some food reactions, undetectable at first, may increase as you start eating this new food regularly, perhaps on a daily basis. In such situations, stop eating the offending food and give it another try at a later date.
That said, a reaction might occur. Reactions can range anywhere from mild to severe and encompass physical as well as psychological manifestations. Potential symptoms include:
* resurgence of the symptoms of your autoimmune disease;
* gastrointestinal disturbances such as pain, gas, bloating, constipation, or diarrhea;
* sudden fatigue and lack of energy;
* food cravings;
* sleep disturbances;
* headaches;
* brain fog;
* increased mucus production and the need to clear your throat;
* itchy and watery eyes;
* skin rashes;
* aches and pains; and
* mood swings, such as anxiety or feeling depressed.
Although experiencing a reaction can be disheartening, remember that it is not the end of everything. If you react strongly to a food, stop eating it immediately and allow your body to heal. You can always try to introduce the food again later as your gut health improves.
HANDLING FLARE-UPS
Remember that an autoimmune flare-up triggered by a food reintroduction will be temporary. When you stop eating the offending food, your symptoms will fade rapidly. In the meantime, be gentle with yourself and increase your self-care. Below are some suggestions to help you get through the flare-up and quickly get back on track.
1. Slow down as much as you can.
2. Relieve pain if you need to.
3. Prioritize your sleep.
4. Increase your intake of healing foods, such as bone broth, organ meat, and turmeric.
5. Destress and detoxify with an Epsom salts bath.
6. Keep your body moving with gentle exercise.
7. Do all the things that make you happy!
Reintroducing foods is an exciting time, but it is a process. Take your time. Your body will thank you for it!
* Dairy-Free Vanilla-Maple Creamer
* Nightshade-Free Italian Sauce
BREAKFASTS
* Grain-Free & Nut-Free Granola
* Express Cauliflower “Oatmeal”
* Pork-Veggie Breakfast Skillet
* Turkey-Veggie Breakfast Skillet
SMALL BITES
* Cheesy Bacon Sweet Potato Sliders
SOUPS AND SALADS
* Baby Arugula and Root Vegetable Salad
VEGETABLES
* Roasted Root Vegetables and Citrus
* Coleslaw
MEAT-BASED MAIN DISHES
* Honey-Lime Chicken with Peach Salsa
* Versatile Pulled Pork Carnitas
* Slow-Cooked Plum Chicken Stew
SEAFOOD
* Smoked Salmon and Fennel Salad
DESSERTS AND DRINKS
* Gut-Healing Turmeric Gummies
* Vanilla-Strawberry Ice Cream
* Tapioca Pudding with Peach-Lavender Compote
* AIP Mule