Anti-inflammatory diet options: Wow. This is a BIG topic. And your FxM practitioner or nutritionist may have their own opinion. We’re going to touch on the highlights here of select diets with an overall approach. There’s a great deal more information you can read online (see Resources or search on each diet’s title for more information).
Again, this becomes a personal choice and journey, some of which is informed by what your or your loved one’s individual needs are, what resonates with you, and what is a more manageable change. For example, our family includes young adult children and we all live busy lives. We have found, at the end of the day, that while we found it quite valuable to learn certain PRINCIPLES about anti-inflammatory dietary eating, we are deeply grateful that there’s a mainstream dietary way of eating that’s got it all put together for us. Thank goodness because, for people like me who are working in several areas and trying to figure out not just diet but the whole big picture, I’m deeply grateful that there is a protocol that’s put all of the ingredients together for me in recipes already: that’s ACTIONABLE.
For us, that’s the Paleo diet (3). All of the big inflammatory antagonists are absent from these recipes and yet, you don’t think about what’s NOT in the meals; you think about the deliciousness that IS in the meals. The Paleo diet emphasizes clean vegetables and meats and is one of, if not the, top diet for people with autoimmunity (4):
“The paleo diet is named for its basis in eating as our ancestors did—meats, fish, poultry, vegetables, fruits, nuts, and seeds. A paleo diet eliminates refined and processed foods, as well as sugar, legumes and all grains (including gluten-free grains). It is automatically a rather low carbohydrate diet and organic options are preferred.” – Robb Wolf, author of The Paleo Solution
For people with active inflammation, the Paleo Autoimmune Protocol or AIP (5), is a further filter on the Paleo diet. In addition to the Paleo basis, the AIP also excludes eggs, nightshades (predominantly tomatoes and peppers), nuts and seeds, and select spices. The AIP is first an elimination diet that then adds back foods systematically once symptoms have subsided, so you can see which foods you can ultimately tolerate without symptoms. Read more about the AIP in Option 3, below.
The Wahls Diet is another dietary approach that is a further iteration of the Paleo diet. The Wahls (6) diets is named for physician Terry Wahls who contracted MS, underwent conventional treatment and, not having made progress, developed a diet similar to Paleo and GAPS, but which puts an even greater emphasis on vegetables to ensure proper nutrition of the mytochondria related to MS. Note that MS has been identified as an autoimmune disorder.
There is also the Specific Carbohydrate Diet or SCD (7) diet, which restricts selected starches, fruits, and vegetables (carbohydrates) to aid digestion. Many people have found it to be helpful for digestive disorders in particular. It was groundbreaking when it was first developed. The GAPS diet (8) has evolved from the SCD diet, and focuses on helping the gut to calm and heal. GAPS stands for Gut and Psychology Syndrome and, as its name implies, takes into account more of a whole-person view.
Another option is a low FODMAP diet (9). FODMAPS are fermentable carbs, and they can be troubling to some people, especially those with digestive disorders. Here you also learn about specific foods vs. food categories, which can be less intuitive to manage but, like the SCD approach, they provide a specific map to follow.
Elaine Laird of Phoenix Helix, who has done a lot of work on diet to recover her own health in the face of RA, and who made many years’ progress and continues to inspire others despite needing to add pharmaceuticals to her regimen in 2017, does a comparison of GAPS, Paleo and Wahls diets (10). Mickey Trescott also does an analysis of the AIP vs. other healing diets.(11) or see our own Diet Matrix to compare them all.
There are other anti-inflammatory diets out there if you search, including a food pyramid by Dr. Weil (remember Dr. Weil, before all the ads and vitamin promotions?). Dr. Weil’s anti-inflammatory diet includes dairy, legumes and grains that have since been found to be inflammatory in studies and are generally not advised for people with autoimmune issues (reference Dr. Perlmutter’s subsequent body of work, for example, author of Grain Brain).
In fact, you may find you need less restriction, such as a Modified Paleo Diet, as in what Dr. Perlmutter (author of Grain Brain, among other ground-breaking books) advocates. His is also a very healthful option that also enjoys the support of many other functional medicine practitioners in the field. Our family, for example, are currently in the Modified Paleo camp. This is largely because – just being honest – we find that we can do it. Grass-fed butter, for example, is allowed in a Modified Paleo Diet, where dairy is avoided altogether in more restrictive diets.
I also “modify” the Paleo diet a bit on my own, as tolerated. For example, we use unsweetened goat milk kefir in smoothies and as dessert; goat milk protein is fairly close to human protein in molecular structure, making it more easily tolerated in the digestive system, and the fermentation of the milk in the kefir product is very good for the gut (plus, it’s delicious). When we break diet, it’s to low-junk Gluten Free (GF) eating. We don’t digress beyond that because, quite frankly, it’s just not worth it. We’ve seen all too well the difference between GF eating and eating gluten and, once you’ve made the transition, you really just never go back. Being sick just gets old, and it’s not necessary anymore — eating GF is not like it was in the 1970s, where your alternative choices were cardboard. Today, it’s relatively easy (if you’re not Celiac – 100% restriction can be hard when eating out). Note that what I mean when I say low-junk Gluten Free is that many GF foods are loaded with sugar. So, you need to read the label. Remember that eating Paleo on the whole is manageable. It’s available, and your key guide while out and about shopping and dining is “meat and vegetables.” That’s pretty easy to remember.
You may be interested in this video with Dr. Oz (12) on the Paleo diet. The focus is on losing weight as well as managing disease, and finding your “code” to help you succeed in sustaining a Paleo diet. It features Chris Kresser (13); note that he does talk about ways that you can potentially include foods that are typically inflammatory to most people with an autoimmune disease, like cow’s milk dairy and legumes, as part of this ‘individuation’ process. We’d recommend doing an elimination diet or discussing it with your practitioner before considering these – you need to know whether you can tolerate them – especially since there are such good alternatives, and it’s not necessary to risk symptoms to enjoy dining pleasure.
The best way to find out which diet is best for you is to do an elimination and reintroduction diet – Option 3 – observing symptoms throughout. This is really the only way to truly identify and achieve the widest diversity of foods that you can tolerate as an individual.
