Is There a Connection Between Diet and Autoimmune Disease?
A quick answer might be “no” at first glance. However, if we dig deeper we may see that there is in fact a very intimate connection between diet (and other lifestyle factors) and autoimmune disease (as well as other diseases).
In this article I examine the relationship between diet, lifestyle factors, and environmental factors in their role in triggering, or perpetuating, autoimmune disease.
Diet Defined
I define diet as the entirety of foods consumed on a regular basis. This includes fresh food, cooked food, frozen food, vegetables, fruits, nuts, fats, sweets, anything and everything you eat or drink. It doesn’t matter if it is “healthy” or not. If you consume it, it is part of your diet. As a result, it contributes to your overall state of health and well-being. And if you’re reading this and thinking, “my health is not what I’d envisioned or want it to be”, most likely your diet has contributed to that too.
Where diet is concerned, we have to examine all aspects of it to discover which parts of it are contributing to health and which are detracting from it. Your diet dictates your health as a whole, but also your gut health specifically. And here’s the claim I’m going to make: your diet (and lifestyle) affects the health of your gut microbial community, which in turn affects the health of your gut, which contributes to your overall health or disease, particularly autoimmune disease.
The gut is responsible for roughly 80% of your immune system. Your immune system is made up of various types of cells, many of which are housed in the gut lining. This is because the gut is where we encounter foreign substances for the first time. Your gut is responsible for knowing which substances are safe to allow in and which are not safe. It’s not that your gut gets confused sometimes and lets the wrong substance pass through, it’s that if the gut lining is disrupted or damaged, substances that should not have, pass through.
The Gut Lining
There are four types of tissue in the body: muscle tissue, nervous tissue (the brain and nerves), connective tissue (tendons, ligaments, or fascia that connect bones to bones or bones to muscles, or muscles to muscles), and epithelial tissue (that lines organs, hollow structures like blood vessels, inner surfaces of cavities like your mouth and nasal passages, and intestinal lining).
The intestinal epithelium or gut lining is composed of a single layer of cells held together by tight junctions. This single layer of epithelial cells make up the majority of the intestinal barrier and are mostly absorptive cells. You can think of this as a wall of tiles held together by tiny staples. When the staples are strong, the tiles are held tightly together, when the staples get damaged, they loosen up or break, and let substances pass through that shouldn’t be there or that are larger than what they would normally need to be if the tiles were held closely together. This is what is referred to as intestinal hyperpermeability, or leaky gut.
This is where the problems begin.
Remember that roughly 80% of your immune system resides in your gut. When a molecule passes through that is bigger than it should be, it is not recognized by your immune system as something that is harmless. Your immune system is trained to recognize certain molecules and something as simple as two proteins joined together would make each unrecognizable and your immune system immediately attacks it.
Your Trillion Closest Friends
Recent research on the intestinal flora or microbiome reveal that diet greatly impacts the composition of the gut microbiome. The microbiome is composed of trillions of bacteria that live within the colon. It may be prudent to mention here that there are different bacteria that live in different parts of the body as well. For example, the skin, respiratory system, gut, and nasal passages, (and vaginal canal for women) have their own microbiomes. They are all slightly different, even in the same host, and translocation of bacteria from one area to another is not a good thing.
Generally speaking, the greater the diversity of the gut microbiome the better for the host. Research has also shown that eating certain foods will promote more of one type of bacteria versus another to flourish. Eating a variety of foods will promote higher diversity of commensal (beneficial) species and help to crowd out pathogenic species. Certain medications will disrupt the microbiome allowing unfavorable bacteria to multiply. Antibiotics will decimate all the bacteria (good and bad) and some strains may take months to come back.
Antibiotics: Friend or Foe?
Why are these intestinal bugs so important? The mindset of medicine from the last 50 years, was that we should eradicate all these “bugs” living within us. That it was these bacteria that were causing all our ills. As a result, antibiotics were in fashion to use at the earliest indication of a problem, whether or not it was wise, useful, or necessary. Overuse of antibiotics, created dangerous situations of “super bugs” (bacteria that are resistant to more common antibiotics and require stronger versions). Now we know so much more, and yet we are still just scratching the surface. Commensal bacteria contribute to your health (and the health of your colon), they produce vitamins, and most importantly keep pathogenic bacteria from overgrowing.
The chemicals sprayed on foods you eat or are processed with pose another hit to your microbiome. Many people are sensitive to additives, preservatives, and food coloring. Pesticides, fungicides, herbicides, and antibiotics (fed to livestock) also have a negative effect on your microbiome and that very sensitive gut lining. These chemicals irritate the gut lining, loosen tight junctions (leaky gut), and initiate sensitivities producing symptoms like headaches, joint or muscle pain, fatigue, and digestive problems.
Lifestyle Factors
Stress is another thing that greatly impacts your microbiome, gut health, and as a result, overall health. Chronic stress makes it more difficult for commensal bacteria to thrive. It also makes it more difficult for you to breakdown the food you eat and absorb the nutrients from that food. When you are stressed, you eat on the run or in a rush, you forget to chew well (or at all) sometimes swallowing your food after just a couple bites. All of these practices put undue stress on your digestive system, eliciting a response from your immune system. Once the immune system is initiated it is not uncommon to start to see food sensitivities and allergies, and experience many of the symptoms listed above.
Stress also affects your sleep patterns. It may keep you up at night, with trouble falling asleep or you may experience trouble staying asleep. Either way, you do not experience restful sleep and wake up tired. Lack of sleep is harmful for the whole body, not giving it the time it needs to remove toxins and repair tissues, including the brain. This lack of sleep and adequate rest sets you up for health problems now and in the future.
When you are stressed and sleep-deprived, you tend to choose foods that are higher in sugar, looking for a quick burst of energy. Sugary foods not only spike your insulin, they also preferentially allow pathogenic bacteria to flourish, further exacerbating bacterial imbalance or dysbiosis.
Environmental Factors
The environment presents yet another assault on your body. Once there are disruptions in your microbiome, you are at risk for all kinds of health issues like respiratory problems (seasonal allergies); food sensitivities, intolerances, and allergies; skin rashes, the topical “lotions, potions, and perfumes” containing endocrine disruptors (toxic chemicals) can contribute to headaches; these chemicals can also cause fatigue, anxiety and other mood disorders; and inability to think clearly.
This trifecta of diet, stress, and environmental factors can contribute to one more important factor affecting the status of your health – it makes you susceptible to infections! These infections can take root anywhere in your body – the gut, the respiratory system, the joints – and thus, contribute to many different autoimmune processes.
Diet and Nutrient Deficiencies
In addition, the inability to absorb adequate nutrients needed to fuel necessary pathways (for example magnesium, which affects 300 different biochemical reactions and affects a range of symptoms from mood to poop, including depression, and blood pressure and sleep regulation to name a few) affects hormonal balance and can affect the way the thyroid, adrenals, and all other parts of the body function. And it all leads back to the gut! That is where we absorb (or don’t absorb) nutrients. Lack of absorption can lead to deficiencies and one of the main nutrients needed to avoid disease is Vitamin D. Low Vitamin D has been implicated in many disease processes ranging from mood disorders to cancer. It has also been implicated in autoimmune disease.
If you have an autoimmune disease, you know it can be pretty disruptive to your life. You may or may not know, however, that having one autoimmune disease predisposes you to developing other autoimmune diseases.
Individuals with autoimmune disease have been shown to have a reduced diversity of bacteria, specifically reductions in anti-inflammatory species and increases in pro-inflammatory species. They also have deficiencies in vitamins A, C, D, and E, along with deficiencies of minerals such as selenium and zinc, which are necessary for proper immune function. A dampened immune system cannot protect you from intestinal inflammation or infections.
Putting It All Together
So, what is the correct diet to avoid autoimmune disease? I wish I could say there was just one diet that would solve all the problems of all people in the world, but there isn’t. There are many therapeutic diets and since we are all individuals and react to a variety of foods, it is important to test and find out what you are personally sensitive to. Food sensitivities and gut permeability go hand in hand, as part of a cycle, worsening each condition. These inflammatory reactions set off a process that has you wanting more of the foods you are sensitive to and perpetuating the disease. A simple blood test can help you identify the foods you should avoid.
If you are at risk of developing an autoimmune disease or already have an autoimmune disease you are managing, it would be worthwhile to evaluate the presence of leaky gut and then work systematically on cleaning up the diet, stopping food sensitivity reactions. As well as, decreasing the total body burden of toxic chemicals you are exposing yourself to through the environment and personal care products. Finally, it is important to manage stress, doing things that help you feel more at ease and at peace with life. The best gift you can give yourself is the gift of health.