By now, most researchers agree that traditional Western diets promote obesity and inflammation, factors that exacerbate autoimmune disease. If you have autoimmune disease, changing your diet and lifestyle is an important part of symptom control. For moms, it’s also a great way to model healthy habits for your children.
NO. If your gut works, use it! As both a doctor and a registered dietitian, I know most so-called “detoxes” are anything but! Health professionals divide fasts into three categories: complete fasting (no eating at all), clear liquid diets (also known as juice fasts), and low residue diets.
First, let’s talk about complete fasting. Your gut is full of bacteria – good and bad (more on that later.) We know from hospital patients who are on bowel rest, for medical procedures or because their gastrointestinal tracts don’t work, that fasting leads to infections and inflammation through a process known as bacterial translocation. Basically, when there is no food in the gut, hungry bacteria try to eat the gut. Sometimes, they are so effective, they cross into the bloodstream. In otherwise healthy people, the immune system is usually able to keep bacteria in check before this happens, but either way there is increased inflammation. Just what we don’t want in someone with autoimmune disease!
Some people advocate clear liquid diets or juice fasts as an alternative to complete fasts. We do use liquid diets in the hospital, but not for the reasons you might think. Juices digest passively through pre-made enzymes in the gut, so theoretically, they are a great way to see if someone’s gut is ready for food after surgery or bowel rest for gastrointestinal problems. The problem is, they aren’t much better than a complete fast for controlling gut bacteria. They also wreak havoc on blood sugar, a serious problem for people with diabetes. Even if you don’t have diabetes, they can leave you cranky, irritable, and hungry.
Low residue diets represent a third type of fast. There are many variations on a low residue diet, but all promise to remove “toxins” from your body and still allow you to eat solids. To me, these are the worst kind of junk science, purported by people who have no understanding of nutrition or medicine. Digestion of fats, sugars, and carbohydrates occurs in your mouth, stomach, and small intestine. Residue is what arrives in your large bowel, or colon, after these other nutrients have been removed. Your body is an amazing machine. While some of this residue will be eliminated as feces, along the way, good bacteria in your colon ferment these residues into short-chain fatty acids that are the preferred fuel of the colon and vitamin K that keeps your blood clotting normally. Good bacteria also keep bad bacteria, the kind that causes diarrhea and gastrointestinal infections, in check.
Contrary to what advocates of these diets will tell you, if you take away the residue, you don’t actually take away the toxins. For example, your body manufactures bile to help it digest fats. After they digest the fat, some of these bile salts end up in the colon, where they are highly, highly carcinogenic. What protects your colon from these highly carcinogenic bile salts is residue, both directly and indirectly. It protects directly by physically protecting the colon walls from too much contact with bile salts. It protects indirectly by nourishing the colon, which also produces mucous to protect itself from the bowel contents.
So, while this is more than you probably wanted to know about your gut, the take home message is steer clear of fasting. Any doctor or dietitian will tell you the maxim is, if the gut works, use it.
Yes and no. In order to enjoy the benefits of an autoimmune diet, you must truly change your lifestyle. It’s okay to indulge on a special occasion, such as a celebration. But choose wisely. If you work in an office or attend a mommy group where someone always seems to be bringing in treats to celebrate, then it’s not a celebration. It’s part of your lifestyle.
If you do commit to following an autoimmune diet, solicit the support of friends and family. For acquaintances, have an explanation ready, so you don’t feel obligated to accept whatever goodies someone proffers. Alternatively, take a small portion, try a bite and slip it into the trash later. That way you don’t feel like a party pooper, but you also keep your commitment to yourself.
Diet and regular exercise both enhance wellness in people with autoimmune disease and people in general. I would not hesitate to recommend either on their own, but they work especially well together! Most people eat out of boredom, not out of hunger. Exercise is not only incredibly beneficial on its own; it fills up leisure time that might otherwise be spent snacking. Exercise also helps control appetite and mood, even when you’re done, making you feel better.
This blog post was originally published by AutoimmuneMom.com, and first published on May 15, 2012.