Can the Paleo Diet fix autoimmune disease?
Written by Nick L. Pfeffer B.EX CEPS (bio at bottom of post)
Some claim that the paleolithic diet is the solution to a vast range of ailments; from obesity to cardiovascular disease and diabetes, and even autoimmune disorders. Have they really found the answer?
Opinions on what exactly constitutes a healthy diet are wide-ranging and vastly different. Although it may be tempting to jump on a promising trend, dieting regimes should be strictly controlled by medical professionals and not followed verbatim straight from the nearest gossip magazine.
From Atkins to Fletcherism, the cabbage soup diet to the master cleanse; we are constantly bombarded with fads on a daily basis who all promise a ‘quick-fix’ and rapid results. One particular diet trend which is on the up&up is the “Caveman” or Paleo Diet. It is a much lauded regime, particularly within the CrossFit community, and the focus of numerous research studies.
I constantly get asked diet related questions when I’m training CrossFit. From pre and post-workout suggestions, gluten-free living to the Paleo lifestyle. Personally I like the premise of the Paleolithic diet; the focus on consuming lean meats and vegetables, and avoiding highly processed ‘junk’ foods, resonates well with my personal approach to nutrition. However there are some quite wild claims to the benefits of the Paleo Diet, so I figured I would address these questions here.
Can the Paleo Diet heal a damaged gut?
What exactly is Paleo? I’d like to explore some of the claims proponents of the diet are making, in particular the suggestion that following a Paleo diet can heal a damaged gut.
The original Food Guide Pyramid as you may remember it, was created nearly 20 years ago by the U.S Department of Agriculture (USDA). The since familiar symbol became an icon for families striving to follow a healthy balanced diet, and was used as a basis for nutritional values throughout public institutions. However, the original food pyramid has since become an outdated, antiquated approach to dieting. As researchers uncovered new data, the original recommendation in the USDA Pyramid appeared flawed. Elements that had previously been considered gospel, such as limiting fats as a whole, or links between eggs and cholesterol, were turned upside down. Today we know that there is a major difference between the consumption of saturated hard fats from products such as bacon, compared to the healthier fats from foods like olive oils. We also know that egg yolks are one of the most nutritious products nature has created (read about benefits off eggs here). Today our knowledge of nutrition has improved in leaps and bounds from what we knew 20 odd years ago.
Over the years, as the decades passed, not only did our understanding of food groups grow, but also the knowledge of cause-effect of diet on disease. The USDA have since presented two new revisions on the food pyramid; the “MyPyramid Food Guidance System” in 2005, and in 2011 the “MyPlate Guide”. These revisions much like the one in 1992 have been met with much scepticism. This is particularly true within the Paleo community.
The basis of Paleo
At the recent Health and Wellbeing Expo in New York, the ‘Godfather’ of Paleo, Loren Cordain, presented his ‘evolution-ary’ basis for following the diet of our forefathers. Many of you will be familiar with this diet which promotes the consumption of free-range meats, nuts, fruits and berries while avoiding dairy, grains, starches and processed sugars. Cordain is at the forefront of research claiming the success of following this diet. He explains that the Paleo Diet is based on the foundation principle that because the human genome has changed little between the present day man and the hunter-gatherers 10,000 years ago, our nutritional requirements are almost identical to the pre-modern-agricultural man.
Followers of the Paleo Diet claim that due to our bodies being slow to adjust, our metabolic system has been unable to adapt to the changes in the different foods which have become available since the advent of modern agriculture (1). Through choosing to avoid the ‘staple’ foods such as grains and breads, which form the basis of our everyday meals, The Paleo diet essentially flips the healthy-food pyramid which we have so far used as a basis for healthy living, on its head.
The paleo food pyramid looks like this:
So what foods must you avoid if you want to follow a paleolithic diet?
Robb Wolf, a research biochemist and previous student of Professor Cordain, runs a hugely successful website, podcast and publishing company on the back of the Paleo diet (from which he no doubt makes a generous profit). On his website’s main page he lists associated benefits of the Paleo Diet for diabetic patients, patients with cardiovascular disease (CVD) and autoimmune disorders. He offers a series of articles on the impact of nutrition on autoimmune disease. Claiming to have “discovered” a singular cure for the most common diseases of our time is rich in the very least, and I think it deserves an investigation.
One particularly interesting thesis piece written by Matt Baran-Mickle, describes a rapid rate of rise in chronic inflammation in the industrialised countries, and explores the cause. Chronic inflammation is a perpetual, non-lethal activation of our immune system. This manifests into disease states such as coeliac disease.
Ingesting gluten is, as you know, the environmental trigger of coeliac disease. The protein gliadin (and other prolamins) found in grains such as wheat, are associated with intestinal damage (1). The resulting inflammation from the over-activity of our immune system may cause a variety of further symptoms (Learn the most important coeliac disease facts here). The most frequently noted in coeliacs is the destruction of the microvilli in the gastrointestinal tract. These finger-like projections which line a ‘healthy’ GI, aid in the absorption of nutrients such as iron, vitamin B12, water, lipids and sodium bicarbonate. When the microvilli is damaged, the body cannot properly absorb these nutrients.
Autoimmune disease is a so-called feed-forward-mechanism, where an external trigger starts an automated process without regard for whether or not the outcome is beneficial. In coeliac disease, gluten is the trigger that sets of a physical response in which the body damages its own tissue.
Could the increase in autoimmune prevalence be caused by food?
Worryingly, the rates of autoimmune diseases are on the rise. Recent estimates suggest the incidence of autoimmune disease at 16% in the United States, and coeliac prevalence alone has seen a 400% increase in the last 50 years. This is an increase that can not be attributed to better diagnostic methods or increased awareness alone, and as argued in the hygiene hypothesis; nor can it be attributed to changes in genetics. Strikingly though, we are not seeing the same rates of incidences in non-westernised cultures! Does that prove Professor Cordain right? Is it true as he suggests, that since the human genome has changed little from the paleolithic era, there must be something else at play?
Can we in that context assume that a Paleo no-grain diet proposes a solution to the feed-forward inflammatory loop?
We know that the absence of gluten breaks the disease chain for coeliacs, but does the same ring true for other autoimmune disorders? Can food alone be the answer to this complex problem?
A research paper published in 2011 examines these claims further. It suggests that a “mis-match” between our ancient physiology and the western diet and lifestyle underlies many so-called diseases of civilization; including coronary heart disease, obesity, type 2 diabetes and autoimmune disease. The researchers propose that a diet following the pre-modern agricultural lifestyle would reduce the risk of chronic degenerative diseases.
In the study they reported the positive health markers of the paleolithic civilisations, such as lower systolic blood pressure, lower fasting insulin concentrations, lower BMI and lower fracture rates. Further anthropological reports suggest the hunter-gatherers had lower incidence of chronic degenerative diseases such as Type 2 diabetes, CVD, and cancer (3) in line with the claims of the Paleo Dieters. The Visser study may also offer some support to the claims of the Paleo Diet through the exclusion of grains, which leads to reduced exposure to the prolamins in grains such as wheat, rye and barley. We know that gluten has to be present in the diet of a genetically predisposed coeliac for the disease to manifest, but is it as simple as that in the bigger picture? Can a paleo diet actually fix the greatest health issues faced by western civilisation today? It’s certainly a big claim!
Personally I think the idea poses quite an interesting link, but what does it really mean to suffers of autoimmune disorders such as Coeliac Disease?
The shocking conclusion..
Well, there is none. No definite study exists that can adequately prove an increase in lifespan by following the paleolithic diet. Both the Visser paper and the Cordain group recognise that such claims cannot be made based singularly on diet, and condone the good-old and well-known fact that we need to apply a combination of other measures such as; regular physical exercise, stress-management, adequate sleep and healthy eating to better our mental and physical health. To date there is no study that proves a definite link between a paleolithic diet and the eradication of autoimmune disease, CVD or diabetes. However, we shouldn’t be too quick to ignore what seems to be a valid correlation between the consumption of certain food products and the manifestation of autoimmune diseases. It is my belief that food holds the key to a great many mysteries surrounding our health, and many people find that changing their diets improves their wellbeing. On the other hand, I think it is safe to say that we must keep a certain scepticism towards grand claims of all-encompassing solutions from a singular approach. Unfortunately it is more complex than just that.
I think the main point to be made here is that one should make educated choices in regards to ones health. The paleo diet has elements to it that make a lot of sense, and which could certainly benefit your health, then yet again other claims need more investigation before they can be considered plausible.
I cannot tell you whether or not to choose a paleolithic lifestyle, as different approaches will have dissimilar effects on each and every one of us. I do however believe that any major diet change must be on the basis of careful consideration, and that we must make our choices with the best possible information at hand. You have but one body, and it is far too precious to be thrown at any random fad. What we can agree on however, is that processed foods, saturated fats and sugars need to be kept to an absolute minimum, and that we must keep moving to keep healthy!
In my next article I will, in honour of Movember, explore research behind the correlation behind dairy consumption and the prevalence of prostate cancer -so make sure you check back in a few days time for some shocking facts!
Till then, keep yourself informed and take care of number one!
(1) file:///C:/Users/pfeffn01/Downloads/RRCC-16919-the-western-diet-and-lifestyle-and-diseases-of-civilization_030811.pdf (2) Drago S, El Asmar R, Di Pierro M, et al. Gliadin, zonulin and gut permeability: effects on celiac and non-celiac intestinal mucosa and intestinal cell lines. Scand J Gastroenterol. 2006;41(4):408–419. (3) ). Lindeberg S. Food and Western Disease: Health and Nutrition from an Evolutionary Perspective. Chichester, UK: Wiley-Blackwell; 2010.