The fact that you are reading this article is a positive step in the right direction. It means you’re likely noticing that how you eat plays a role in how you feel, especially when it comes to flares in autoimmune diseases like RA, Psoriasis, IBD, etc. It also means that maybe you have stumbled into the black hole of anti-inflammatory diets. There are so many diets out there, each claiming to eliminate serious disease manifestations like fatigue, pain, digestive issues and skin issues - but what are these diets? How are they different? And which might be a good fit for you?

This article dives into some of the most popular dietary approaches to give you a better understanding of the landscape. Many of these approaches are considered “elimination diets” because they focus on removing specific things like gluten or dairy from a person’s diet. Keep in mind, none of these diets will work 100% for everyone across the board. It is important to put in the effort, and track your diet and symptoms to truly identify what YOUR body is reacting to. If you’re looking for help on that, make sure to schedule a chat with one of our teammates to learn more about Mymee.

Dietary approaches included in this article (click to skip to a section):

• The Autoimmune Protocol Diet (AIP)
• The Paleo Diet
• Ketogenic or KETO diet
• Wahl's Protocol Diet
• Low FODMAP Diet
• The Mymee Approach

The Autoimmune Protocol Diet (AIP)

WHAT IT IS:

The Autoimmune Protocol diet (AIP) is thought to help heal the gut and reduce unwanted inflammation caused by autoimmune conditions. This diet is fairly restrictive and mainly comprises meats and vegetables. It is an elimination approach because a person is meant to stop eating all non-AIP foods for a few weeks. Then, one-by-one, foods are added back into the diet. It’s important that a person waits a few days to a week before adding another food back in so as to pinpoint the cause of any adverse reactions. If a person notices side effects after reintroducing a food, then they are meant to remove it from their diet completely, as it is likely a source of inflammation. Usually the diet is tried for several weeks, but some feel so good eating this way that they continue it as a long-term choice.

Foods to AVOID:

• Grains
• Legumes (beans, soy, peanuts, hummus, etc)
• Dairy products (including raw products)
• Processed foods
• Refined sugars
• Industrial seed oils (vegetable or canola oils)
• Eggs
• Nuts and seeds including coffee, chocolate, spices such as coriander and cumin)
• Nightshade vegetables (tomatoes, peppers, eggplants, white potatoes, goji berries, and more)
• Chewing Gum
• Alternative sweeteners
• Emulsifiers and food thickeners, such as guar gum, xanthan (and other) gums, carrageenan, and lecithin to name a few.    
• Alcohol
• NSAIDs (anti-inflammatory painkillers like ibuprofen (Advil), aspirin (Bufferin) and naproxen sodium (Aleve) 

Best for:

• IBS
• IBD
• Lupus
• Rheumatoid arthritis
• Crohn’s disease
• Psoriasis
• Other autoimmune diseases

Pros:

• The benefits of feeling better may outweigh the burdens of the strict diet
• There is a focus on eating healthy foods so it’s likely your body will react positively over time
• You may enjoy having control over what you put in your body, especially if you feel better and experience less inflammation

Cons:

• Very restrictive and may be hard to follow.  
• Not personalized, assumes that the “allowed” foods are good for everyone across the board and the prohibited foods are bad for everyone, which is not always the case
• Difficult for vegans or vegetarians to follow due to high meat consumption and limited legumes and nuts where vegans get most of their protein
• Not diverse; When you eliminate grains, you miss out on B vitamins, fiber and iron

The Paleo Diet

What it is:

A paleo diet typically includes lean meats, fish, fruits, vegetables, nuts and seeds — foods that in the past could be obtained by hunting and gathering. This diet was first started by functional medicine practitioners, but quickly became a “health” phenomenon. Since paleo-style eating emphasizes whole foods, lean proteins, vegetables, etc., this is a massive improvement over the average Western diet so most anyone experiences benefit. 

Foods to eat:

• Meatfish 
• Eggs 
• Vegetables 
• Fruits 
• Nuts 
• Seeds 
• Herbs 
• Spices 
• Healthy fats and oils

Foods to avoid:

• Sugar 
• Soft drinks 
• Grains/breads 
• Dairy products 
• Legumes 
• Artificial sweeteners 
• Vegetable oils, margarine and trans fats 
• Highly processed foods, including artificial meal replacements  

Best for:

• Those who are interested in weight loss, adrenal health and/or increased or stabilized energy levels
• Diabetics or pre-diabetics, or anyone with blood sugar issues
• Those who are interested in reducing high blood pressure
• Those with high cholesterol, heart disease, autoimmune conditions, leaky gut, hormone imbalance, and/or thyroid issues

Pros:

• Since it is more mainstream, you can find many “paleo friendly” products and recipes
• It is high in fiber, potassium and antioxidants while being low in simple carbohydrates, sodium and sugar 
• Many people report weight loss while on the diet as well as clearer skin and healthier hair

Cons:

• It is restrictive
• You must read ingredient lists, even on foods labeled as “healthy foods”
• Not necessarily created to combat digestive issues 
• Not personalized, assumes that the “allowed” foods are good for everyone across the board
• People with kidney issues or digestion problems should be careful with this diet, as it includes high amounts of potassium, which can be a concern for someone with kidney problems  
• High amounts of fiber in the diet may cause trouble for those with intestinal, digestive issues
• When you eliminate grains, you miss out on B vitamins and iron

Ketogenic Diet (KETO Diet)

What it is:

It’s a low carb, higher fat diet that was originally developed as a treatment for epilepsy in the 1920’s and 1930’s. The Keto Diet is similar to Atkins and low-carb diets because it works by limiting your carbohydrate intake and consuming fats instead. The idea is that your body will go into a “fasting state” where it will burn ketones instead of glucose. By following a meal plan that is 60-75% fat, 15-30% protein, and 5-10% carbs, the body converts its metabolism to a state called ketosis.  Since our body primarily runs on glucose (sugar), restricting carb intake will cause the body  to start to use fat as its energy source.   A study at NIH indicates that the ketogenic diet might have anti-inflammatory effects through increased adenosine production, which indicates it may be helpful for inflammation-associated pain.

Foods to eat:

• Meat
• Fatty fish
• Eggs
• Butter and cream
• Cheese
• Nuts and seeds
• Healthy oils (extra virgin olive oil, coconut oil, avocado oil)
• Avocados
• Low-carb veggies (green veggies, tomatoes, onions, peppers, etc.)
• Condiments (salt, pepper, herbs, spices)

Foods to avoid:

• Sweets and foods high in sugar
• Grains or starches (bread, rice, pasta, cereal, crackers, muffins, etc)
• Fruit (all except small portions of berries)
• Beans or legumes
• Root vegetables and tubers (white and sweet potatoes, carrots, beets, parsnips, etc.)
• Low fat or diet products
• Sugary condiments or sauces
• Unhealthy fats (processed vegetable oils, mayonnaise, etc)
• Alcohol
• Sugar-free diet foods (sugar alcohols, etc).

Best for:

• Most people start the Keto diet to lose weight
• It may also help people with neurodegenerative disorders like Alzheimer’s, Parkinson’s and Multiple Sclerosis (MS) according to NIH
• It may also be helpful for traumatic brain injury and stroke as well as cancer, heart disease, polycystic ovary syndrome, and acne. 
• Reducing inflammation, therefore people with autoimmune disease may feel better when practicing this diet

Pros:

• Can drive significant reductions in blood sugar and insulin levels
• Can drive weight loss, even without reducing calorie intake

Cons:

• The keto diet could cause low blood pressure, kidney stones, constipation, nutrient deficiencies and an increased risk of heart disease
• Keto is not recommended for those with any conditions involving their pancreas, liver, thyroid or gallbladder due to the high intake of meat and fats
• People with kidney disease should avoid high-protein versions of the diet because the excess protein, along with the increased burden of handling ketones and associated loss of body water, could worsen their condition
• Side effects referred to as the “keto flu” that  usually resolve within a few days (poor energy, brain fog, increased hunger, sleep issues, nausea, digestive discomfort, less energy for workouts)
• It can change the mineral balance in the body
• Not a great option for athletes or for those wanting to add muscle mass
• Only works if you stick with it long term
• Can cause LDL levels to rise (unless the types of fat consumed are more from unsaturated fat sources) - ex:  more nuts/avocados and less meat and butter
• One “cheat” can sent you out of ketosis
• Difficult for vegans or vegetarians to follow due to high meat consumption and carb/vegetable restrictions
• Low sex hormone levels and infertility
• Increased infection risk
• When you eliminate grains, you miss out on B vitamins, fiber and iron
• Microbiome disruption
• Nutritional inadequacy
• Low fiber intake could cause constipation
• Strict diets like keto could also cause social isolation or disordered eating

Wahl's Protocol Diet

What it is:

The Wahls Protocol diet is quite similar to the Paleo diet except there are no nightshades and it specifically indicates how much of certain foods to eat. Specifically 6-9 cups of non-starchy vegetables a day and four ounces of protein (fish specifically) twice a week, with a heavy emphasis on veggies. It was designed by a functional medical doctor (Terry Wahls, MD) as a way to reverse her own multiple sclerosis diagnosis. She had been confined to a wheelchair for 4 years and told that was her new way of life. She went Paleo for 5 years but continued to deteriorate. It wasn’t until she started adding in other nutrients that she began to heal and in 1 year of eating the Wahl’s way, she was able to ditch the wheel chair and walk again, and even go for an 18 mile bike ride.

The diet is based around feeding the mitochondria, which produce 90 percent of the chemical energy that cells need to survive and help to transport nutrients throughout the body. The diet has you skip foods that can cause harm at a cellular level and consume nutrient dense, healthy foods.

Foods to eat:

• Vegetables
• Grass-fed meat
• Fish
• Fruit
• Healthy fats

Foods to avoid:

• Sugar
• Processed foods
• Grains
• Soy
• Dairy
• Eggs
• Legumes

Best for:

• Multiple Sclerosis (MS)
• Autoimmunity and other chronic diseases

Pros:

• Since it is like Paleo you can eat many “paleo friendly” products and recipes
• It is high in fiber, potassium and antioxidants while being low in simple carbohydrates, sodium and sugar
• More nutrients are consumed than the standard Paleo diet 

Cons:

(same as Paleo since this is a type of paleo diet)

• Can be too restrictive
• You must read ingredient lists, even on foods labeled as “health foods”
• Not necessarily created to combat digestive issues 
• Not personalized, assumes that the “allowed” foods are good for everyone across the board
• People with kidney issues or digestion problems need to be  careful with this diet, as it includes high amounts of potassium, which can be a concern for someone with kidney problems  
• High amounts of fiber in the diet may cause trouble for those with intestinal, digestive issues
• When you eliminate grains, you miss out on B vitamins, fiber and iron

Low FODMAP

What it is:

FODMAP stands for “fermentable oligo-, di-, mono-saccharides and polyols. FODMAPS are a type of carbohydrate that does not digest but reaches the far end of the intestine where most of our gut bacteria reside. The gut bacteria then use these carbs as fuel. For many individuals, these FODMAPS pass through the intestinal tract unchanged. For those with sensitivities, they can wreak havoc on the digestive system, producing gas, bloating and other digestive symptoms.

Common FODMAPs include :

• Fructose (found in fruits and vegetables as well as table sugar and most added sugars)
• Lactose (found in milk)
• Fructans (found in grains like wheat, spelt, rye and barley)
• Galactans (found in large amounts in legumes)
• Polyols (sugar alcohols like xylitol, sorbitol, maltitol and mannitol as well as in some fruits and vegetables that are used as sweeteners)

With this elimination diet, a person must stop eating certain foods for 6-8 weeks to see if symptoms improve. Once symptoms calm down, foods can be reintroduced back into the diet one at a time (one per week) to see which ones are causing issues. The goal is to figure out which FODMAPS a person is sensitive to.

Foods to eat:

• Alternative milks such as almond, coconut, and rice milks
• Bananas
• Bell peppers
• Blueberries
• Bok Choy
• Cantaloupe
• Carrots
• Celery
• Corn
• Cucumbers
• Eggplant
• Ginger
• Green beans
• Grapefruit
• Grapes
• Kiwi
• Lemons/limes
• Mandarins
• Melons (except watermelon)
• Olives
• Green onions only
• Oranges
• Parsnips
• Potatoes
• Passionfruit
• Quinoa
• Raspberries/strawberries
• Radishes
• Oats
• Potatoes
• Quinoa
• Rice
• Green leafy vegetables such as spinach, lettuce, kale, etc.
• Squash
• Sweet potatoes/yams
• Tapioca
• Tangerines
• Tomatoes
• Turnips
• Water chestnuts
• Meat, fish and eggs
• All fats and oils
• Most herbs and spices
• Nuts and seeds (except pistachios)
• Maple syrup, molasses, and stevia

Foods to avoid:

• Anything made with wheat, barley or rye
• Apples
• Artichokes
• Artificial sweeteners (even those in chewing gum)
• Beans
• Cashews
• Cauliflower
• Dried fruits
• Fruit juices
• Garlic and onions
• High fructose corn syrup (including many sweet packaged products as well as sweetened beverages like soft drinks)
• Honey
• Ice cream 
• Mushrooms
• Pistachios
• Watermelon
• Beer, wine
• Prebiotics (inulin, chicory, FOS)

Best for:

• Those with intestinal disorders, including Irritable Bowel Syndrome (IBS) and Small Intestinal Bacterial Overgrowth (SIBO), or conditions associated with Inflammatory Bowel Disease (IBD) such as Crohn’s or ulcerative colitis.
• If you frequently experience digestive upset, FODMAPs should be suspect.

Pros:

• Most have symptoms ease right away after starting a low FODMAP diet and feel the most relief after 7 days
• There are many foods you can eat on this diet

Cons:

• FODMAPs aren’t bad for everyone and many foods that are high in them encourage growth of good bacteria in the gut  
• Some of the foods in the allowed section are not good for people who do not tolerate nightshades
• Everyone is different and some may not tolerate some of the approved foods
• The diet is unlikely to work if you only eliminate some of the high-FODMAP foods but not others

Mymee

What is Mymee:

Mymee is a digital care program that is truly personalized for each individual. Because there are very few foods which are “good” or “bad” for everyone across the board, the program uses the body’s own data to decode what works (or does not work) for each person. Mymee is not just about eliminations, but also focuses on identifying elements that are deficient in a person’s body and providing a guided way to add them back in.

Foods to eat:

• Mymee does not advocate that foods are inherently “healthy” or “good” for everyone across the board, although nutrient-dense foods are favored over processed ones

Foods to avoid:

• Any food that is found to be correlated to increased symptoms for an individual via their data is removed

Best for:

• All autoimmune diseases, including both prevalent and rare diagnoses 
• Many chronic diseases that “flare” or have fluctuations in symptom frequency or severity

Pros:

• Oftentimes, whole categories of food do not need to be eliminated because triggers can be pinpointed down to specific spices or ingredients
• Dietary guidance is based on data and is specific to each individual
• Tracking is easy to incorporate into daily life because no detailed descriptions or measurements are needed - simply take a photo of your meal to track
• Work with a personal health coach each week (someone who listens and suggests best practices for your unique situation)
• It’s easy to stick to because the coach and the data visualizations provide extra accountability
• Health coaches have mastered their own autoimmune challenges, so understand the obstacles first-hand 
• Guidance goes beyond dietary. Environmental and lifestyle components can also be addressed (including sleeping habits, stress levels and physical health)

Cons:

• Mymee is not covered by most insurance
• Mymee requires a level of commitment to achieve full benefits, a participant must be willing to track, have phone sessions with their health coach and incorporate recommendations

Improving your health starts with understanding your own body and learning to read it's signals. So while all these dietary approaches are a step in the right direction, having a personalized and customized plan is the optimal way to master your machine. We'd be honored to be part of your health journey and invite you to schedule an informational call with on of our specialists to learn more.