For all those who are trying to live well with autoimmune disease or who are already following the Autoimmune Protocol and need guidance on reintroducing foods on the AIP (see the complete AIP Food Guide here), there’s a new, great contribution to the autoimmune wellness world.
Angie Alt (author of the Alternative Autoimmune Cookbook) and Mickey Trescott (author of the Auotoimmune Paleo Cookbook) just published an amazing book called The Autoimmune Wellness Handbook, that pieces together all the wonderful research made by Dr. Sarah Ballantyne (aka The Paleo Mom)in The Paleo Approach with a step-by-step approach to autoimmunity: from the first diagnosis to all the necessary lifestyle and dietary changes needed to address the issue in a holistic, natural way and the food reintroduction phase.
Angie and Mickey have been active for years in the autoimmune wellness world, and created online, group coaching programs for those who want to get started with the AIP called SAD to AIP in SIX and a video course to maximize kitchen time, minimize work load and get delicious allergen-free food on the table called AIP Batch Cook.
Their new Autoimmune Wellness Handbook goes way beyond nutrition to inform, empower, and guide those who are on a healing journey from chronic illness.
I couldn’t be more happy to chat with Mickey and Angie and pick their brain on their experience writing the book, in particular on a subject that many AIPers have trouble with, like reintroducing foods on the AIP.
Mickey & Angie on Reintroducing Foods on the AIP
- What is the new contribution that this book brings into the autoimmune protocol landscape?
Angie: The new contribution we are making is in organizing a clear, manageable approach to the autoimmune protocol. Rather than getting bogged down in information overload, we have pulled together all the pieces and made the science of AIP applicable to real life. Beyond that, we’ve presented this process in an extremely empowered way and proposed an alternate way of thinking about autoimmune disease and one’s health care in general, encouraging readers to combine the best of medical care with dietary and lifestyle modifications, so they can live vibrantly despite disease.
- Have you seen stories of complete remission following the protocol?
Mickey: We don’t like to use the term “remission” when talking about autoimmune healing – it often gives people a sense of false hope, or that there is some line to be crossed when their healing is finished. Instead, we like to look at health on a spectrum – and anyone, no matter where their state of health, can improve upon their circumstances. That being said, many people with varying types and severities of autoimmune diseases have been helped by using the autoimmune protocol – just take a peek at the stories of recovery collection on our website!
- What about taking cheat days on the AIP? I am not talking about major inflammatory triggers like dairy or gluten, but what about going out and just having rice or one specific food (like almond butter or white potatoes) once a month?
Angie: It is true that during your elimination phase, the restrictions can at times be challenging, but “cheat days” aren’t appropriate in the context of AIP. For those of us choosing this healing path, the goals are far beyond “look good naked.” We are hoping to heal and better manage serious chronic illnesses, in many cases dramatically improving quality of life. Taking the time to carefully calm inflammation, allowing the immune system to modulate and giving yourself a clean slate to measure future food reintroductions by, is well worth skipping cheat days.
- What is the best tip you can give to those who are approaching the reintroduction phase?
Mickey: Take things slow, follow the suggested order and method of reintroduction, and be gentle on yourself if things don’t go well! Expect to spend a long time reintroducing foods, be patient – this is where you will learn to find your individualized diet.
- I feel like a mistake many people do (myself included) is that they wait too long before they start reintroducing foods. Your book explains very well that it’s easier to be able to tolerate some of the foods in the early stages of the reintroduction. Could you elaborate on this?
Angie: The stages of reintroduction were first carefully researched by Dr. Sarah Ballantyne. They go in order from least likely to provoke a reaction and most nutrient-dense, to most likely to provoke a reaction and least nutrient-dense. For example, egg yolks are in Stage 1 because they aren’t as likely as egg white to produce a food sensitivity reaction and their nutrient value is very high, while wheat is in Stage 4 because it is very likely to produce a reaction, and in comparison to other foods, has a low nutrient value. Following this process, most folks will eventually tolerate well the foods in the early stages, but many will not tolerate and may even want to permanently avoid foods in the late stages (like gluten).
- Some of the foods in Stage 1 are spices. What’s the best way to reintroduce them?
Mickey: As per our instructions in The Autoimmune Wellness Handbook spices, along with all other foods, are to be introduced systematically one at a time. Otherwise, how will you know how a particular ingredient affects you? Yes, it is overwhelming, but it is the only way to truly know how those ingredients affect your body.
- Most of the foods in Stage 4 include items that are not eaten on a standard paleo diet, such as grains and legumes. Are these reintroductions only recommended if you have achieved full remission from your autoimmune disease?
Angie: Anyone who feels they’ve reached a happy, healthy, stable place in their wellness journey, regardless of achieving “full remission” (a term we avoid), can attempt reintroduction of Stage 4 foods when they are ready. They may find that some of these foods work well for them, like white rice or white potatoes. There are some foods in Stage 4 though, especially the gluten-containing grains and tomatoes, which are very likely to cause a sensitivity reaction and even lead to an autoimmune flare. From that perspective, many people will want to avoid those foods permanently.
8. You mentioned that one should take 30 to 90 days on the AIP before beginning to introduce foods. Could you elaborate?
Mickey: At 90 days, if a person sees no changes (even small changes, like better digestion, skin, etc.), then we recommend seeing a healthcare practitioner for help troubleshooting. Many people have issues that cannot be resolved with a restricted diet—like SIBO (Small Intestine Bacterial Overgrowth), candida, parasites, and other gut imbalances. In addition, hormone imbalance, methylation dysfunction, and heavy metal toxicity are other issues that could be ruled out. The bottom line is we don’t think it is appropriate for folks to continue plugging away at a restricted diet if they aren’t seeing results – at that point it is time to get a practitioner on board.
All in all, a thorough reintroduction stage can take months. While the elimination diet does make it so a person can read their food sensitivities more easily (they seem “clear” without all the background “noise” of inflammation), I’m not aware of any research showing that avoiding a food produces a sensitivity or an allergy. My experience is that as the gut heals successfully over time, people are able to introduce more foods into their diet. This is demonstrated by people like myself who early on in their protocol could not tolerate any nightshades, but years later are able to tolerate some of the nightshade family, like potatoes and peppers. I suggest working through the reintroduction protocol as it is suggested, and seek help from a practitioner if a person needs help troubleshooting.
- Some of the foods that one is supposed to reintroduce seem rather mundane, like spices for example. It seems overwhelming to wait eight months to reintroduce a staple like rice. Is it possible to skip around in the phases and selectively pick foods to reintroduce which would be more exciting to have in your diet?
Angie: Yes. A person can choose to tackle the stages in a different order or skip around, however, how well you react to several foods in an early stage is often a good gauge for your likely ability to tolerate foods in the next stage, so it can be valuable to take a methodical approach. I often encourage my clients to try at least two-three Stage 1 foods first and if we have positive experiences with those, I start allowing the client to skip around a bit more based on preferences or convenience (for example attempting white rice, which is an easy staple, especially when traveling). However, if the client starts to have a lot of negative reactions, that tells me more healing is necessary and slowing down and following the more clearly staged approach will be best.
- What are your latest projects that you have coming up? Is there anything else you’d like the readers to know?
Mickey: Since Angie and I just spent the last two years writing this book, our next project is to give our bodies the rest and relaxation they deserve after this busy season! We are looking forward to practicing what we preach, getting into the rhythm of winter, spending time connecting with our families and nourishing our bodies with rest and great food.
For more info about Mickey and Angie, check out their website http://www.autoimmune-paleo.com and don’t forget to leave your feedback by leaving a comment below!!