How to Choose Between Keto, Paleo, AIP and other Popular Diets

The Case:

Anna is experiencing IBS, fatigue, anxiety and generally doesn’t feel well.
She was diagnosed with Hashimoto’s years ago but doctors did not offer real solutions.
She wanted to try adjusting her diet but research led her down a deep rabbit hole that left her confused about the best diet for her IBS, autoimmunity and other symptoms.

The Investigation

There is a lot of information on the internet and some of it is conflicting which makes it very hard to figure out which one to try. This inundation of sometimes conflicting information can be overwhelming and that’s exactly what Anna was experiencing when she came to me. There were a lot of things to take into consideration in finding the right nutrition plan for Anna.

Joining me on the show to talk more about the overwhelming amount of diet information is Risa Groux. She’s a Functional Nutritionist, Certified Autoimmune Coach and author of FOODFRAME: Diet is a Four-Letter Word. It’s a comprehensive guide to using functional nutrition guidelines to identify the root causes of various health issues so I knew she was the perfect person to consult with on Anna’s case.

What are the Most Popular Diets for Autoimmunity Right Now?

Some of the most popular diets are Paleo, Ketogenic, Autoimmune Protocol, Vegan, Low FODMAP and Low Lectin. One of the first things that Risa recommends when considering following a set diet is to take into consideration your health status. For example, if you are pre-diabetic, diabetic, SIBO (small intestine bacterial overgrowth), IBS (Irritable Bowel Syndrome), or if you have an autoimmune disease, there may be diets that are better suited to you or not suitable to you.

What is the Paleo Diet?

Risa says this diet has the broadest appeal and as result it is the most commonly recommended. Many people know of it as the ‘Caveman diet’ because it focuses on the things that we ate at the beginning of time. This includes animal protein (not deep fried, of course), and some plant carbohydrates like sweet potatoes and yams. It also includes good fats like olives, nuts, seeds, and eggs. It doesn’t include foods that came later like legumes, grains, sugar, processed foods, and alcohol.

One of the other things to avoid on this diet is any food that might have pesticides, herbicides, chemicals, dyes, toxins (there are over 3000 approved for human consumption) or be GMO since these were also not around during primitive times.

This diet is very good for anyone dealing with inflammation and blood sugar issues.

PROS

Helps regulate the blood sugar
Good for skin
Good for blood pressure and cardiovascular health
Reduces inflammation
Promotes weight loss
Increases energy

CONS

Can be challenging for vegans

What is a Ketogenic Diet?

The ketogenic diet, also known as ‘Keto’ is a diet that helps get the body into a ketosis by changing the fuel source from carbohydrates or sugars (the most common fuel source for our bodies) to fat. Typically, the pancreas creates insulin and glycogen and drives it into the cells. Then mitochondria uses those to make energy.

By avoiding carbohydrates on the ketogenic diet, you change your metabolic state into ketosis which then uses fat as fuel. To stay in the state of ketosis, your diet needs to be 70-80% quality fats. The diet also allows for animal protein (since it has no carbohydrates), and a very small amount (less than 20 g/day) of low-carb vegetables.

Anyone on this diet will need to drink a lot of water to keep the colon hydrated since the diet contains very little fiber. The diet should not be a long-term diet. Risa suggests 3 months as a good length of time for Keto.

PROS

Good for blood sugar regulation
Good for diabetics
Effective for weight loss
Good for heart disease
Helps with acne
Improves brain fog and supports brain function

CONS

Hard to get sufficient fiber
Difficult to stay in and track state of ketosis
Not suggested for anyone who struggles to digest or absorb fat or has had their gallbladder removed.
Difficult for anyone who needs to travel
Not as good for women, especially if they have adrenal issues
Not suggested for anyone with kidney issues

What is the Autoimmune Protocol (AIP) Diet?

The autoimmune protocol diet, often referred to as AIP, is similar to paleo and low lectin but was developed specifically to help those with autoimmune issues reset. It is especially helpful for those who have just been diagnosed and are experiencing a lot of symptoms but can also benefit those who do not have autoimmune issues. It’s an elimination diet that is intended to last 30-90 days.

The diet itself is very similar to the Paleo diet but it goes a few steps further as it also eliminates nightshades which include tomatoes, potatoes (except yams and sweet potatoes), eggplant, peppers (except black pepper) and Goji berries. The diet also removes some nuts, seeds, dairy and eggs.

On this diet, you are allowed to eat animal protein, vegetables, sweet potato, yams and some good fats – so it’s very restrictive. After the prescribed time, you can start adding foods back in, slowly and one at a time, to help identify specific issues that may cause problems for you individually.

PROS

Cleans out the system
Helps identify potential triggers
Anyone can do it and benefit, not just autoimmune
Decreases systemic inflammation.
Improves gut health
Decreases blood sugars

CONS

Temporary solution as it only last 30-90 days (but it can be repeated periodically)
Very restrictive

What’s in a Low Lectin Diet?

Lectins are under the umbrella of antinutrients. They are found in the protective shell of seeds and some vegetable and fruit skins. It can be difficult for the digestive system to break down which can in turn cause inflammation especially if someone has leaky gut syndrome. We know that inflammation is the driver disease.

The diet requires the elimination of a lot of fruit and vegetable skins and seeds including tomatoes, squashes, cucumbers and some tropical fruits like bananas, dates, and coconuts. It also excludes dairy, legumes, grains, cashews, and corn. Even grains that are gluten-free like quinoa are excluded.

PROS

Some find it easier than AIP with similar benefits
Does allow for some sugar alcohols

CONS

Suitable for everyone
Anyone with IBS, IBD or SIBO will need to further restrict the Low-Lectin diet to remove sugar alcohols.

What is the Low FODMAP Diet?

FODMAP is an acronym and it stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols which are short-chain sugars that get fermented in the system but they absorb water. As a result, they typically cause bloating and gastric upset.

This diet recommended for anyone who has chronic bloating, has been diagnosed with IBS or IBD. The Low FODMAP diet is an elimination diet that usually lasts 30-90 days. Risa says you’ll get the best results if you start off strict.

You want to eliminate any foods that you personally feel causes bloating. You also eliminate cruciferous vegetables (cauliflower, broccoli, kale, cabbage, brussel sprouts) as well as some other vegetables like artichokes, onion, garlic and veggies with high carbohydrates.

PROS

Good for reducing inflammation
Good for those with IBS

CONS

Very challenging
Not many commercially produced foods available (more coming on the market now)

What is a Vegan Diet?

The vegan diet restricts all food that is of animal origin including byproducts of animals like dairy, gelatin, rennet, and honey.

Risa is not a fan of the vegan (or even the healthy vegetarian diet) because she believes that every meal should have protein, fat, and fiber which, she believes, can be very challenging in a vegan or vegetarian diet. This is why she stopped being a vegan.

The vegan diet is especially challenging for anyone with SIBO since most vegan diets include a lot of lectins and high FODMAP foods which will cause inflammation and bloating. The vegan diet, according to Risa, can also be challenging for regulating blood sugars and weight since it typically contains a lot of carbohydrates in the form of beans, nuts, and seeds.

PROS

Studies suggest it helps fight or possibly reverse/mitigate certain cancers and heart disease

CONS

Blood sugar needs to be monitored
Not really great for anyone with the gene mutation MTHFR which prevents us from methylating or processing B12 and folate B9
Can be difficult to get sufficient fiber (women need about 25 grams per day and men need 38 grams)
May be deficient in dietary Zinc
May be deficient in omega3 fatty acids (which is often from fish consumption)
May include consumption of GMO soy

Mystery Solved

As Risa explained, there are many things to take into consideration when selecting a therapeutic diet. We are all unique and our diets should be too. While it’s helpful to look at some of these main rules, it’s also important to listen to our body. I wholeheartedly believe over restriction is not ideal in the long run. Limiting things while we are fixing the gut, calming the immune system and supporting the body, may be valuable in the short term.

We have to diversify our gut microbiome and that can only happen with a diverse diet, it’s not just about probiotics.

With Anna, we started with a low lectin, low iodine diet to help calm her immune response.

We supported her gut and liver pathways while also optimizing her thyroid. This is a process that takes some time. When done correctly and in the right order (this is something I actually teach in my step-by-step Hashimoto’s program) it is very effective.

Conclusion

Once we completed that, Anna felt so so so much better! Her energy improved, her IBS completely resolved and her thyroid antibodies came way down. We started to slowly introduce one new food at a time. The process of re-introducing foods can take a month or more but Anna was patient and abided by the motto, ‘slow and steady’.

Happy Ending

Anna was able to add back in a lot of foods. She now follows a gluten-free, dairy-free diet but is able to have grains, legumes, and lectin. She limits refined foods and sugars which is always a good practice. She finds this diet to be very manageable for the long term especially because she is feeling so much better.

Eliminating Health Mysteries

For Anna we were able to find that missing piece of the health puzzle and help her regain her health. Could an individualized therapeutic diet be the missing clue for you or someone in your life?

Links:

Resources mentioned

Thanks to my guest Risa Groux. You can connect with her through her website and on Facebook and Instagram.

Related Podcast Episodes:

The Case of Daily Bloating and Gas w/ Dr. Seth Osgood Counting Calories Not Working for Weight Loss? Try This Instead [Ask Inna] More Answers to Your Hashimoto’s Questions (Part 2) What Does a Nutritionist Feed her Kids to Foster Good, Lifelong Eating Habits? How to Reprogram your Gut Microbiome for Optimal Digestion, Weight Loss and Anti-Aging

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