Tuesday, January 7, 2014

Food Specific Elimination Diet for Chronic Disease: Introducing the Neopaleo Specific Diet


Food as a cause of the epidemic of chronic inflammatory and autoimmune disease in the "civilized" world is a relatively new concept that is gaining popularity. Loren Cordain, Ph.D. is one of the pioneers in the U. S. in the field of paleolithic nutrition. He and others have published numerous high quality articles on the concept of the hunter-gatherer as a diet that our bodies were meant to follow. These researchers have established solid data that indicate our ancient ancestors who were hunter-gatherers ate little to no grains, legumes or dairy products and appear to have been spared the degenerative, autoimmune and inflammatory diseases that we in the Western or civilized world are experiencing in epidemic proportions.

Archeological and anthropological findings support the absence of many of the diseases of our current civilized world in these ancient cultures. Furthermore, the few remaining "uncivilized" hunter-gatherer tribes or cultures that exist have been found to be largely free of the common diseases of our "civilized" culture. However, when exposed to our more modern diet habits these peoples begin to experience the diseases of our culture. This has been particularly well documented in native eskimo. The diet of hunter-gatherers is variably known as the Hunter-Gatherer diet, caveman diet, Paleolithic diet or just the paleo diet.

More recently Dr. Cordain and others have been researching the role of food lectins as an explanation for the success of the paleolithic diet. Despite his excellent book The Paleo Diet and his website http://www.thepaleodiet.com, there is a general lack of knowledge of this important information in the both the lay and medical community. There is also some confusion and misconceptions about what constitutes a Paleolithic diet. In my experience, as a stomach-intestine specialist who frequently recommends my patients try the "paleo diet", resistance is commonly encountered because of its restrictiveness, difficulty to adhere to in our modern culture and society and uncertainty about how long such a diet should be followed. Much more research into the role of food lectins in human disease is desperately needed.

What follows is my suggestion based on my personal and professional experience with food intolerance and a variety of gastrointestinal and extra-intestinal symptoms (brain, nerves, skin, joints, general energy) combined with lectin and paleolithic diet research. As a specialty trained and board certified gastroenterologist (specialist in digestive diseases) I have modified the paleolithic diet to include the lectin research data as well as information on food allergies and cross reactivity food intolerance occurring in people with pollen allergies. The diet could be termed a Neopaleo Specific Diet® or possibly better a Neopaleo Health Plan®. There may be some future modifications of these initial recommendations. However, in interest of helping individuals who are suffering from food intolerance or toxicity, these preliminary recommendations are offered.

For a minimum of 28 days, preferably 90-120 days, it is recommended that an individual seeking to recover from gut injury ('the leaky gut") and the associated toxicity and inflammatory symptoms avoid all potentially dangerous or high-risk food lectins. This means eliminating all cereal/grains, especially the gluten containing grains (wheat, barely and rye) as well corn and rice; legumes (includes peanut and soy); and dairy products. Because the so-called Nightshades (tomato, potato, pepper and eggplant) have food lectins that have been associated with a variety of inflammatory diseases especially arthritis conditions, they should be excluded initially as well, especially in those with inflammatory type symptoms. Peanut and soybean are both legumes that are very common causes of food allergy and intolerance, and have specific lectins that have been shown to injure the gut and even enter the blood stream potentially facilitating the leaky gut and extra-intestinal symptoms. These are strictly excluded within the first 90 days.

If you are known to be allergic or sensitive to certain foods you should obviously avoid those foods. Implied in the diet is the recommendation that no processed foods be eaten due to the presence of many of the above food lectins in such foods. Oftentimes these food lectins are hidden within the ingredients with labels that are impossible to decipher such as natural flavors, modified food starch, stabilizers, and emulsifiers, etc.

Some people with pollen allergies or latex allergy react to certain foods, in particularly in a particular type of allergy reaction called the "oral allergy syndrome" or OAS. If you have a documented tree, grass, weed pollen, house dust mite or latex allergy you should consider avoiding foods known to cross-react with these allergens.

"What can or am I suppose to eat on this diet?" you ask. The diet consists primarily of lean meat and fish, eggs (if not contraindicated by history of allergy or sensitivity) and fresh fruits and vegetables. The diet becomes an adventure in all natural foods but a challenge to established misperceptions of what constitutes healthy eating. Planning and frequent trips to a grocer with great selections of fresh organic fruits, vegetables and meats and seafood are important for success.

After 90 days of this Neopaleo Specific Diet (NSD)®, foods are gradually re-introduced one at a time, each week, while carefully noting any return of symptoms to suggest residual or ongoing intolerance and/or sensitivity. It is possible that some foods will not be able to be re-introduced without risking adverse health consequences. Those with documented Celiac Disease or non-celiac gluten intolerance or at high risk for Celiac Disease (family history, HLA DQ2, DQ8 or dual minor DQ for gluten sensitivity) are advised not to re-introduce gluten.

Before starting the NSD and while on it, it is advised that you keep track of your symptoms as well as their severity using a 1-10 scale in a food-symptom diary. Body pictures localizing your symptoms are also helpful to track the symptoms and look back on for assessment of response and re-appearance of similar symptoms with re-introduction or challenge of food lectins later. In the near future http://www.thefooddoc.com will offer online food-symptom assessment, diet recommendations specific to individuals based on their known or suspected sensitivities and an online food-symptom diary. However, if you are suffering from apparently unexplained chronic fatigue, gastrointestinal symptoms, or other inflammatory or autoimmune conditions then I would encourage you not to wait to try a elimination diet specific to your history.

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