inflammation | The Paleo Mom

Teaser Excerpt from The Paleo Approach–The Importance of Sleep

April 4, 2013 in Practical Tips, Stress and Sleep, The Paleo Approach Excerpts

There are many topics that I am researching and writing about for the book that I’ve been meaning to write about for the blog for ages (the book just gives me a firm deadline). I have decided take some of these topics (especially the more blog-sized ones) and publish them as teaser excerpts for the book (also because I think this information should be here too).

The book also contains a detailed (yet easy-to-follow) description of the components of the immune system, including a great quick reference guide to help you as you read through the book. So, when you read this section in the book, you’ll already know why modulating Th1, Th2 and Th17 cells is important and you’ll already understand the essential role that regulatory T-cells play in the immune system.

For a quick primer: Th1, Th2 and Th17 cells are subtypes of lymphocytes (white blood cells) that can be over-activated in autoimmune disease and cause damage. Regulatory T-cells are another subtype of lymphocyte that are supposed to keep all the other immune cells in check and suppress both over-activation of the immune system and autoimmunity (they tend to be deficient in autoimmune disease). Cytokines are chemical messengers of inflammation. Monocytes and neutrophils are types of white blood cell responsible for generalized inflammation (part of the innate immune system whereas B-cells and T-cells are part of the adaptive immune system). B-cells are the type of lymphocyte that produce antibodies.

So, forgive the references to Chapter 7 and page numbers with no number. While you’ll have to wait until the book is out in September to read those sections, in the meantime, please enjoy this part of Chapter 4: Lifestyle Factors That Contribute to Autoimmune Disease.

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“A good laugh and a long sleep are the best cures in the doctor’s book.”

–Irish Proverb

In the last 50 years, the average amount of time that Americans sleep each night has decreased by 1.5–2 hours. That’s a staggering amount of sleep—equivalent to a full month of continuous sleep every year—that we need but are not getting. Epidemiological studies show a strong correlation between short or disturbed sleep and obesity, diabetes and cardiovascular disease. In fact, lack of adequate sleep has been associated of increased morbidity and mortality from all causes. This means that if you consistently don’t get enough sleep, you have a much higher risk of getting sick and/or dying. Period. Studies have also evaluated the role that sleep plays in healing from specific diseases, like breast cancer, and show that the less you sleep, the less likely you are to survive.

Frankly, scientists still don’t really understand why we need sleep, why we need as much as we do, and what our bodies are actually doing while we sleep. But, it is obvious that sleep is important for human health. Studies that evaluate the physiological changes caused by not sleeping or not getting enough sleep can be very instructive in understanding just how critically important sleep is. For those with autoimmune disease, it is especially important to understand the role that sleep has in inflammation, stimulating the immune system, and regulating hormones (which themselves modulate the immune system).

Just plain old not getting enough sleep causes inflammation even in young, healthy people. A variety of studies evaluating the effects of acute sleep deprivation (typically by restricting sleep to 4 hours per night) for several consecutive days (typically 3 to 5) have shown increases in markers of inflammation and the numbers of white blood cells in the blood. Specifically, even just three consecutive nights of not enough sleep can cause increased monocytes, neutrophils and B-cells in the blood, increased proinflammatory cytokines (including cytokines known to stimulate maturation of naïve T-cells into Th1, Th2, and Th17 cells), increased C-reactive protein (a marker of inflammation), increased total cholesterol and increased low density lipoprotein cholesterol (LDL).

Even just one night of lost sleep (40 hours without sleep) causes inflammation in young, healthy people. Just pulling a single all-nighter dramatically increases markers of inflammation in the blood, including C-reactive protein and proinflammatory cytokines. Studies that evaluated not just sleep deprivation but also recovery after sleep restriction (with the idea of simulating a typical workweek where someone might get less sleep for 4 or 5 nights straight and then try to make up for it on the weekend) have also shown that the proinflammatory cytokine known to stimulate Th17 cell development persists for at least two days after increasing sleep to 8 hours per night, even though other markers of inflammation have recovered. This means that even if you try and “catch up” on your sleep during the weekend, the stimulation to the immune system keeps going. If you follow this stereotypical pattern of not getting enough sleep during the week and sleeping in on the weekend, you still run the risk of cumulatively causing detrimental changes in the immune system. Certainly, you can recover from lack of sleep, but it takes persistence, consistency and commitment—even during the week.

Sleep deprivation is also associated with increased susceptibility to infection. In fact, the less sleep you get, the more likely you are to catch the common cold. Getting adequate sleep can also protect you from infection. One study even showed that the longer the sleep duration, the lower the incidence of parasitic infections in mammals.

Inadequate sleep also has profound effects on hunger hormones and metabolism (recall that hunger hormones such as insulin, leptin, ghrelin, and cortisol are important modulators of the immune system, see page ##, ## and ##). For example, when food intake is measured following sleep deprivation (5 consecutive days of 4 hours sleep), people tend to eat substantially (20%!) more than normal. However, it doesn’t take five full days of inadequate sleep to see dramatic effects on insulin, cortisol, and leptin. One study showed that even a single night of partial sleep (4 hours) causes insulin resistance in healthy people. Another study showed that a single night of partial sleep (3 hours, in this case) caused reduced morning cortisol levels (when cortisol should be its highest) and elevated afternoon/evening cortisol (when cortisol should be gradually decreasing) and elevated morning leptin levels. This means that one night of three or four hours sleep causes insulin resistance, dysregulated cortisol and increased leptin. One late bedtime because you went to a late night movie or a party at the boss’ house. One.

Inadequate sleep has also been investigated as a possible cause of autoimmune disease. In an animal model of psoriasis, sleep deprivation caused significant increases in proinflammatory cytokines, cortisol levels, and increases in specific proteins in the skin associated with symptoms of psoriasis (like the flaking, dry, scaly skin). In an animal model of multiple sclerosis, mice subjected to sleep deprivation developed the disease earlier than mice that slept normally. Once the mice developed multiple sclerosis, sleep deprivation caused increased disease activity and pain sensitivity. Furthermore, sleep disturbances are commonly reported by people with chronic inflammatory conditions (such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease and asthma). Whether the sleep disturbances cause the disease or the disease causes the sleep disturbances is not well understood. However, such sleep disturbances are known to worsen the course of the disease, aggravate disease symptoms such as pain and fatigue, increase disease activity and lower quality of life. Yes, sleep is important.

So, how much sleep do you need? There is no clear answer to this. Consensus is that healthy adults need 7-10 hours of sleep per night. If you are trying to heal from an autoimmune disease, don’t be surprised if what your body needs is on the longer end of that range (say 9 to 10 hours) or even exceeding that range (some people with autoimmune disease report needing 12 hours of sleep every night to heal).

Getting enough sleep isn’t just about preventing inflammation; it’s also about repairing the body and modulating the immune system. Certainly, the process of tissue repair in the body is predominantly performed during sleep. However, an important study showed that regulatory T-cell activities follow a circadian rhythm, meaning that, just like many functions within the human body, they increase and decrease throughout the day. In healthy people, regulatory T-cells are highest in the blood at night with lowest numbers in the morning (similar to melatonin production and the opposite of cortisol). The activity of the regulatory T-cells also follows a circadian rhythm, having the highest suppressive activity during sleep and lowest in the morning. When volunteers were subjected to sleep deprivation, the suppressive activity of their regulatory T-cells was decreased (even though the actual numbers of T-cells remained the same). This implies that sleep is required for the suppressive activity of regulatory T-cells, meaning that if you want to modulate your immune system and reverse your autoimmune disease, sleep is critical.

If you have an autoimmune disease (I generally assume you do if you are reading this book) and aren’t getting 8 hours of good sleep every night, I cannot emphasize enough the importance of putting sleep on the top of your priority list. You need sleep. Now. Tonight. Every night. Seriously, stop reading and go to bed. Strategies for prioritizing sleep and what to do if you are trying to get more sleep but just can’t are discussed in Chapter 7.

Bollinger, T., et al., Sleep-dependent activity of T cells and regulatory T cells, Clin Exp Immunol. 2009 Feb;155(2):231-8

Bosy-Westphal, A., et al., Influence of partial sleep deprivation on energy balance and insulin sensitivity in healthy women, Obes Facts. 2008;1(5):266-73

Boudjeltia KZ, et al., Sleep restriction increases white blood cells, mainly neutrophil count, in young healthy men: a pilot study, Vasc Health Risk Manag. 2008;4(6):1467-70.

Donga, E., et al., A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects, J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8.

Frey, D.J., et al., The effects of 40 hours of total sleep deprivation on inflammatory markers in healthy young adults, Brain Behav Immun. 2007 Nov;21(8):1050-7

Heslop, P., et al., Sleep duration and mortality: The effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women, Sleep Med. 2002 Jul;3(4):305-14.

Hirotsu, C., et al., Sleep loss and cytokines levels in an experimental model of psoriasis, PLoS One. 2012;7(11)

Lehrer S, et al., Insufficient sleep associated with increased breast cancer mortality, Sleep Med. 2013 Mar 4 pii: S1389-9457(12)00384-X. doi: 10.1016/j.sleep.2012.10.012. [Epub ahead of print]

Lucassen EA, et al., Interacting epidemics? Sleep curtailment, insulin resistance, and obesity, Ann N Y Acad Sci. 2012 Aug;1264(1):110-34

Meier-Ewert HK, et al., Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk, J Am Coll Cardiol. 2004 Feb 18;43(4):678-83.

Palma, B.D., et al., Effects of sleep deprivation on the development of autoimmune disease in an experimental model of systemic lupus erythematosus, Am J Physiol Regul Integr Comp Physiol. 2006 Nov;291(5):R1527-32.

Palma, B.D. & Tufik, S., Increased disease activity is associated with altered sleep architecture in an experimental model of systemic lupus erythematosus, Sleep. 2010 Sep;33(9):1244-8.

Ranjbaran, Z., et al., The relevance of sleep abnormalities to chronic inflammatory conditions, Inflamm Res. 2007 Feb;56(2):51-7.

Reynolds AC, et al., Impact of five nights of sleep restriction on glucose metabolism, leptin and testosterone in young adult men, PLoS One. 2012;7(7)

van Leeuwen WM, et al., Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP, PLoS One. 2009;4(2)

Tags: activity, arthritis, autoimmune, cortisol, cytokine, function, ghrelin, hormone, hunger, immune, inflammation, insulin, late night, leptin, lupus, lymphocyte, multiple, partial sleep, psoriasis, regulatory, resistance, sclerosis, sensitivity, Sleep, Stress, T-cell, Th1, Th17, Th2, the paleo approach, tolerance
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Teaser Excerpt from The Paleo Approach: The Trouble with Stevia

March 11, 2013 in Baking Ingredients, Is It Paleo?, Sugar/Carbs, The Paleo Approach Excerpts

I get often get asked why I do not endorse the consumption of stevia (see my post Is Sugar Paleo? for more information on what sugars/sweeteners I do endorse). So, as I found myself including a section on the trouble with stevia for The Paleo Approach, I felt like this was a good topic to include as a book teaser on the blog. I have a section of Chapter 3 that describes the role that sugars, blood sugar regulation, insulin sensitivity, fructose, sugar alcohols and nonnutritive sweeteners play in propagating inflammation in autoimmune disease. This excerpt is included as a standalone text box following the subsection on nonnutritive sweeteners.

This excerpt is from Chapter 3 (The Diet Link to Autoimmune Disease chapter).

Stevia is often recommended as a natural sugar substitute because it comes from the leaf of a plant (Stevia rebaudiana Bertoni). It tastes sweet on the tongue, requires very small quantities to sweeten baking, and contains no sugar. While some experts advise caution against purified and manufactured forms of stevia, green leaf stevia is typically endorsed. On the surface, it sounds like a perfect solution. However, I do not recommend the consumption of stevia, even in its most natural form. The chemicals responsible for the sweet taste of stevia are called steviol glycosides (there are at least ten different steviol glycosides present in the stevia plant). Purified/manufactured forms of stevia often isolate one or two of these steviol glycosides whereas green leaf stevia (which is simply the dried and powdered leaves of the stevia plant) contain all ten.

Steviol glycosides are synthesized in the same pathway and end up being structurally very similar to the plant hormones gibberellin and kaurene. This means that steviol glycosides have a hormone structure. The majority of toxicological studies establish that stevia is safe, however there are some studies showing that it can act as a mutagen and may increase the risk of cancer (these studies are in the minority and tend to use quite high concentrations, so they are readily discarded in discussions of the overall safety of consuming stevia). Whether or not stevia causes genetic mutations is not the only cause for concern, however (even if safety studies focus on this particular property). For those with autoimmune disease, in which hormones have such a dramatic impact on disease development and progression, the impact of consuming stevia on hormone regulation is relevant.

There is evidence that steviol glycosides have contraceptive effects in both males and females. In particular, one specific steviol glycoside, called stevioside, has been shown to have potent contraceptive properties in female rats, implying that stevia may have an impact on estrogen, progesterone or both. In another study, male rats fed stevia extracts showed a decrease in fertility, reduced testosterone levels and testicular atrophy, potentially attributable binding of steviol glycosides with an androgen receptor. Although no studies have been conducted evaluating the impact of stevia on fertility in humans, the stevia plant was traditionally used to control the fertility of women by the Guarani Indians in southern Brazil. While small and occasional consumption of stevia likely has little to no impact on general health, it should not be consumed on a regular basis especially by those with altered hormone balance and dysfunctional immune systems.

Brusick DJ. A critical review of the genetic toxicity of steviol and steviol glycosides. Food Chem Toxicol. 2008 Jul;46 Suppl 7:S83-91.

Mazzei Planas G and Kuć J. Contraceptive properties of Stevia rebaudiana. Science. 1968 Nov 29;162(3857):1007.

Melis MS Effects of chronic administration of Stevia rebaudiana on fertility in rats Journal of Ethnopharmacology 1999 Nov 67(2):157–161

Melis MS. Chronic administration of aqueous extract of Stevia rebaudiana in rats: renal effects. Journal of Ethnopharmacology 1995. July 47(3):129–134

Oliveira-Filho RM et al. Chronic administration of aqueous extract of Stevia rebaudiana (Bert.) Bertoni in rats: Endocrine effects. General Pharmacology: The Vascular System. 1989. 20(2):187–191

Tags: androgen, balance, baren, estrogen, female, fertility, genotoxic, glycosides, green, healhty, hormone, inflammation, leaf, male, mutation, non-nutritive, nonnutritive, paleo, Paleolithic, Pregnant, primal, progesterone, Raw, safe, safety, sterile, sterility, stevia, steviol, subsitute, Sugar, testosterone
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My 21-Day Sugar Detox Experiment: The Good and The Great!

January 23, 2013 in 2013, Sarah's Personal AI Struggles

Somewhere around Day 16, it felt like an eternity. But here I am, all of a sudden, done my 21-Day Sugar Detox experiment. And what a valuable and educational experiment it was!

If you recall (from this post), my goal was to test whether or not the hefty amount of fruit (and much less hefty but still present amount of honey, maple syrup and coconut-based baked goods) was perpetuating inflammation in my body and slowing down the healing process. I have an autoimmune disease which is healing slowly on the autoimmune protocol. I have a mild case of SIBO, which means starchy vegetables and high insulin fiber content foods are out (yes, that should have meant coconut flour was out and yet I often found an excuse–and it always set me back). Really, my eating was pretty clean going into the 21-Day Sugar Detox. Even through the holidays, I was doing a very good job sticking to the autoimmune protocol, but I have been using fruit as a crutch, eating 5 or 6 (sometimes more) servings per day.

So, for me, the 21-Day Sugar Detox wasn’t about reigning in bad habits. I hadn’t fallen off the paleo bandwagon. My eating was not crazy. I was just enjoying fruit with every meal. And sometimes snacks. And sometimes before bed. That’s not necessarily a bad thing. I am not part of the anti-fruit paleo camp. And even though I lost most of my weight following a low-carb diet, I’m not even part of the low-carb paleo camp (I understand much more about the relationship between what we eat and hunger hormones and inflammation and weight loss now, see this post for a bit more on leptin). By the way, I’m also not in the “safe starch” paleo camp. I’m more in the “find what works for you” paleo camp. There are so many ways our different bodies react differently to fruit and starchy vegetables and there is a huge amount of individuality in terms of both tolerance of and need for these foods–I believe it would be foolish of me to recommend one prescription for everyone. Without a doubt, eating 6 pieces of fruit a day is not bad for everyone. Many others could eat that much fruit and be optimally healthy. Of course, many others could eat a sun-dried tomato and bell pepper omelet with a cup of coffee dressed with grass-fed heavy cream for breakfast too. Sadly, not me. Sigh.

So, how did I feel following the 21-Day Sugar Detox? Check out my updates for week 1 and week 2. Looking back on all three weeks, the first week, I really didn’t notice much difference other than the fact that my skin was doing some weird things. I realize now, that that was a bit of a detox reaction because my skin cleared up dramatically in the second week. Then, I had some fresh coconut on days 15 and 16 and had a very dramatic reaction to it in the sense that I had the worst acne breakout I’ve had in months. And I didn’t even eat that much! So, I have finally accepted that whole coconut is not good for me, dangit. The bright side? Getting my diet so clean during the detox allowed me to finally identify coconut as a trigger without any room for doubt. That knowledge is very valuable for me–even though the actual fact of being sensitive to whole coconut (on top of everything else) can be described by a variety of inappropriate consonant-heavy words. At least the acne seems to be healing quickly.

Aside from acne, I noticed some extremely dramatic improvements in my mental clarity, which started in week 2 and just keeps getting better. This is important for me (especially given the BIG announcement tomorrow). I would never have described myself as suffering from brain fog before, but now that I see just how much more productive and efficient I am and just how much quicker I seem to be able to think, it’s obvious that sugar was impeding my mental processes. I also feel like I’m sleeping better and waking up feeling more rested, which again, I would never have described my sleep quality as lacking beforehand. I also feel like my energy levels are better (and following the healthy pattern of waking up with energy and then gradually running out of energy throughout the day until bedtime).

I also lost 4 lbs during my 21-Day Sugar Detox, 2 lbs in week 2 and 2 lbs in week 3. Weight loss was not one of my goals, but this makes me happy anyway! I actually think that the majority of this weight was bacterial overgrowth (although my body fat percentage did drop too, so maybe it’s a bit of both). I say this because I also have noticed a pretty dramatic reduction in bloating in my abdomen. There I was thinking that my abdomen was hard because I was getting so muscular. Nope, that was SIBO. But, it totally rocks to see that bloating resolve and see the scale move in my favorite direction. I wish I could show you before and after photos (like Stacy of Paleo Parents did! Wow!), but I didn’t take before photos. Suffice it to say, that my I’m fitting into my smallest pants comfortably again and several people who know me well have commented that I look like I’ve lost weight (actually, they started commenting before I technically did lose any weight too!).

I also want to point out here that many people have commented that my meals are huge. They are! And I’ve lost weight! I’ve heard that many people have a tendency to under-eat when they tackle the 21-Day Sugar Detox, or the autoimmune protocol, or if they just want to lose weight. It’s extremely hard for your body to heal and/or lose weight healthily if you are not providing it with enough nutrition. Reducing food intake too much increases cortisol and makes it impossible to lose weight; it also messes with leptin. Eating enough is really important and I hope my meals have helped provide some guidance, both in terms of portion size and in terms of just how many vegetables I eat. That’s another thing that happens when people tackle the autoimmune protocol–they get so scared of starchy vegetables and FODMAPs that they eat very little vegetable matter. Vegetables are important for healing and even if variety is limited (even if some people have a hard time with raw veggies and can only digest them well when cooked), it’s important to remember to eat enough of them! (I will refer you once again to Dr. Terry Wahl’s TedX talk here)

I never experienced a carb flu (although I have caught my daughter’s cold, but I hardly think that counts) or headaches or severe energy crashes–probably because the difference in total carbohydrate intake for me wasn’t as dramatic as many people who tackle the 21-Day Sugar Detox. I had a few days where I felt resentful and begrudged not being able to partake in treats around me, but I got through it. I had a couple of evenings where I felt snacky and normally would have indulged in a bowl of frozen fruit, but avoided the temptation by just going to bed (that’s usually the eating to stay awake bad habit that I still battle from my long years of obesity and metabolic derangement). Let me just add here that yes, I do still sometimes get sick and no, that is not a statement of my diet and lifestyle (unless I am seriously that sensitive to skipping bone broth for few days!). I get sick way way way less often than I used to, don’t get anywhere near as sick as used to be typical for me, and get better much more quickly. But, I do have a dysfunctional immune system due to my autoimmune disease and I expect to always be a person who does catch at least some of the colds and flus going around, especially while living in the petri dish that life with young kids is.

Okay, so the real reason for doing the 21-Day Sugar Detox was to see if it would make a difference to my autoimmune disease. And WOW! Did it ever! Below are before and after photos. Now, the before photo was actually taken two months ago, right before I realized that chocolate was a problem for me. I did see improvement in my lesions after cutting out chocolate and then things stabilized again over the holidays (probably because I was eating coconut and so much fruit). So, not all of the difference between before and after can be attributed to the sugar detox, but more than half of it can! (The detox amateur that I am, it never occurred to me to take before and after photos of how I look or my lesions right before starting, so you’ll just have to take my word for it…. I’ll do better next time, I promise!)

Pretty dramatic, right? Every one of those red, raised, scaly lichen planus lesions were very itchy and painful in November. What is still healing and visible now, is flat and not itchy or painful in the slightest! I have not used any steroids or anything other than the autoimmune protocol and the 21-Day Sugar Detox to achieve these results.

Why do I think that eating fruit is such a problem for me? There is a strong link between elevated blood sugar and autoimmune disease. Only a few years ago, I was obese and had pre-diabetes among my laundry list of health conditions. I think it’s fairly obvious that before the detox, I was eating enough fruit to cause enough of a spike in my blood sugar (and enough of a release of insulin) to perpetuate some inflammation and continue to stimulate the immune system. I was healing, so clearly I wasn’t causing such a spike in blood sugar to completely derail all of my other efforts–but regulating my blood sugar more tightly has obviously created an environment within my body more conducive to healing. And that is the whole point. Not everyone with autoimmune disease is going to need to go to these lengths to regulate their blood sugars. This is what I need to do likely because of the long lasting damage being obese did to my metabolism.

So, what did I eat in week 3? I didn’t actually post all of my photos on Facebook this week (in part because I was busy and in part because those meals were very similar to several I had already posted). But, I did take photos, and here is the round-up.

# of cups of bone broth: 1
# of meals with bone broth as an ingredient: 3
# of meals that included organ meat: 10 (heart and liver this week)
# of meals that included fish: 5
# of meals that included bacon: 6 (pastured, sugar-free, nitrate/nitrite-free from )
# of meals that included vegetables: 21
# of meals that included meat on the bone: 1
# of meals that included fermented food: 8
# of meals that included seaweed: 0
# of snacks: 0
# of days with a spoon of coconut oil between meals: 0
# of meals shaped like a smiley face: 2

So, where do I go from here? Not backwards, that’s for sure! This is working just too darned well for me! I have adjusted to 1 or 2 servings of fruit per day and my plan is to keep it that way (especially since my sleep and energy levels seem so good!). It is important to me to allow more flexibility in my life. The autoimmune protocol is restrictive enough and I have to be cautious that I don’t create such a sense of deprivation in myself that I rebel and make really, really bad choices. So, what being off the 21-Day Sugar Detox means for me now is simply that those servings of fruit can be any fruit. In fact, my breakfast this morning (which was my first post-detox meal) looked an awful lot like my breakfasts throughout the 21-Day Sugar Detox, except I ate a bowl of blackberries instead of half a grapefruit. And were those blackberries ever the sweetest most wonderful tasting things ever!

Would I do it again? Yes! In a heartbeat! But, WILL I do it again? I hope I don’t need to. I hope that what I’ve learned stays with me and that this is just the way I eat now. If I can accomplish that, then there will be no need to repeat this experiment. Do I recommend the 21-Day Sugar Detox? Just like everything, I don’t think it’s for everyone. If you know you’re a person for whom firm rules creates disordered eating, then this is not for you. If you know that plowing through an adjustment period to get to the rainbow at the other side works for you, then this is a great way to go. I for one, am greatly enjoying the pot of gold (er, blackberries) at the other side.

Tags: 21, 21DSD, autoimmune, carbohydrates, completed, day, detox, diane, difference, disease, dramatic, eat, energy, fatigue, Food, fruit, healing, How To, illness, inflammation, lichen, planus, protocol, round-up, sanfilippo, Sleep, Sugar, summary, what
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My (Slightly Modified) 21-Day Sugar Detox (and Hitting a Speed Bump on Day 1?! Seriously?!)

January 2, 2013 in 2013

I am doing my first ever 21-Day Sugar Detox. What is this Sugar Detox of which I speak? It is Diane Sanfilippo (of www.BalancedBites.com and Practical Paleo fame) ‘s signature program. Three full weeks of avoiding sugars, sweeteners, dense carbohydrates (with allowances for athletes and pregnant/lactating women), and fruit. For more information, click here.

Many people follow a Sugar Detox as a way of quickly resetting body chemistry (specifically blood sugar regulation) and sensitizing taste buds when they feel that they are riding the sugar roller coaster (intense sugar cravings that lead to sugar binges, followed by sugar highs, followed by sugar lows, followed by more cravings). Within the paleo community, this might mean someone who has been giving into some SAD foods, or someone who has been indulging in too much paleofied baked foods, or even someone who is just feeling like they’re fruit intake is excessive. It is essentially a fast way to reduce sugar cravings (let’s be honest because this really only gets rid of biochemical sugar cravings and not emotional ones) and get back on the bandwagon when we feel things unraveling.

Do I feel like things are unraveling? Actually, no. I feel like I’ve been in completely control over my diet. I’ve been following the autoimmune protocol very strictly, doing a great job of avoiding snacking and eating in the evenings (I’m trying to work on hunger hormone regulation here, more on this in a future post), and have indulged in very limited paleo baking over the last two weeks (mainly because I only made one kind of cookie that didn’t have eggs or nuts in them this year).

So, why am I doing the 21-Day Sugar Detox? Sugar is inflammatory. Fructose reduces leptin sensitivity. Leptin helps regulate the immune system (more on this in a future post too). I have an autoimmune disease. I avoid starches because of SIBO, but I eat a whole lot of fruit. I have been curious for a while whether or not that amount of fruit in my diet is helping or hurting me.

Last time I attempted to substantially reduce my fruit intake (while still not eating starchy vegetables), my body did not respond well to going so low carbohydrate (this was back in the early spring). I had a cortisol response and found my sleep quality decreased substantially. When I increased my carbohydrate intake, my sleep improved and I felt much better. So, I’ve stuck with that. But I know so much more now, and I think it’s time to try again, doing things a little differently than last time.

I figure I typically eat between 100g and 150g of carbohydrates (total, not net) per day, predominantly from fruit and non-starchy vegetables; but a little honey or maple syrup sneak in here and there. I think this is very healthy for most people and I don’t think that most people really need to limit fruit (unless you are dealing with inflammation, autoimmune disease, metabolic syndrome, or having strong sugar cravings). But, I am not most people and many people with autoimmune disease reporting having a very low tolerance for fruit, especially high fructose fruit.

Going too low carbohydrate can also reduce leptin sensitivity, which would totally defeat the purpose here. So, I will be eating plenty of non-starchy vegetables and those higher starch content veggies that I know I tolerate well (like carrots, winter squash and beets). Quantities of beets and butternut squash are limited on the 21-Day Sugar Detox, and I will be adhering to that (because the allowance is already more than I can typically tolerate anyway). I will also be continuing to avoid coffee (oh how I miss it though!) and working to keep my intake of caffeinated teas on the low side (my intake has crept up lately so I really need to get that in check anyway). I will continue to use coconut oil and red palm oil as major fat sources in my diet to hopefully help avoid a cortisol response or reducing my leptin sensitivity.

Oh yeah, and I am doing this while also adhering to the autoimmune protocol.

The 21-Day Sugar Detox allows 1 green apple or 1 green-tipped banana per day. I will be adding 1 small grapefruit to this list (and probably eating grapefruit every day instead, although just in case I crave a green apple in a couple of weeks, I’m keeping that option open). Why grapefruit? I have a 12-year history of chronic constipation before transitioning to a paleo diet. I am battling SIBO and my digestion is still precarious. I have found that eating grapefruit improves my digestion (probably a combination of digestive enzymes in grapefruit and the acid). I am also taking some digestive support supplements, but I really feel like going grapefruit-free would be counterproductive for me. I also feel that grapefruit falls into the same category as green apples and green bananas: it doesn’t taste very sweet. Grapefruit has the added benefit of being lower in sugar than either green apples or bananas, and having slightly less than half of its sugars as fructose (that beats apples but not bananas). This is my slight modification. The inclusion of grapefruit as an allowed fruit (but still limiting quantity).

What am I hoping to gain on the 21-Day Sugar Detox? I am hoping to better understand the role that fruit is playing in my diet. Is it contributing vitamins and antioxidants and helping control inflammation? Is the sugar content contributing to inflammation? Is my higher carbohydrate intake helping to regulate my cortisol? Is my higher carbohydrate intake inhibiting normal regulation of my immue system? I am not doing this to address sugar cravings. I am not doing this to lose weight (although I’ll take it if I happen to). I am not doing this because I believe that fruit is in any way bad for you (at least most of you).

What will I judge my success on? Well, largely on the symptoms I associated with my autoimmune disease: the look and itchiness of my lichen planus lesions, how my joints feel, the frequency of the mild headaches and tinnitus I sometimes get, how I’m sleeping, my energy level, my mood and my ability to handle stress. The bigger part of this evaluation is going to be how I feel when I add more fruit back in at the end of these three weeks.

So, I’m on Day 1 as I type this. How is it going? I have already hit my first speed bump. My mom is visiting and she also loves grapefruit. We have both been eating grapefruit every day, so we actually shared the last one for breakfast this morning. Because there were so many other things that I had to do today, I sent my husband to the grocery store. I instructed him to look for white grapefruit, since they are the least sweet, then pink if he couldn’t find white. He came home with oroblancos.

I didn’t know what oroblancos were either. They are a cross between an acidless pomelo and a white grapefruit. They look alot like slightly green grapefruit, but have a super thick peel so the fruit inside is the size of an orange, if that. According to Wikipedia, they are sweeter than white grapefruit. I nearly cried when I read that. I also closed some doors a little more forcefully than normal. Now I have no grapefruit in the house (nor green enough bananas nor green apples) and I’m on Day 1 and I won’ t have time to run out to the store for a couple of days.

My mother came to the rescue. She peeled and ate an oroblanco with her lunch. She made such a face at how tart they are, that I agreed to try a segment. Well, they are slightly sweeter than white grapefruit, but they are NOT sweet. Probably about the same as or slightly tarter than the pink grapefruit I’ve been buying. I also don’t like them as much as grapefruit. I figure that’s actually completely in line with 21-Day Sugar Detox philosophy.

So, I’m going to include 1 small grapefruit OR 1 oroblanco. I don’t know if oroblancos will help my digestion as much as grapefruit do, but I figure I can make do for a couple of days until I have time to go out shopping and buy actual grapefruit. So, a speed bump, but not a calamity (even if it felt like one for about twenty minutes).

As mentioned in my New Year’s post, I am going to be the featured blogger for January on The 21-Day Sugar Detox Blog. I also posted photos my meals today on Facebook (I know many people are interested in how do you eat AIP and 21-Day Sugar Detox?!) and will try to keep that up for the next three weeks as much as possible. I will also be posting updates on my Facebook page and Twitter, on the 21-Day Sugar Detox Facebook page, and a post or two on the blog over the next few weeks about how I’m feeling, what effects I may or may not be noticing, and generally how this whole sugar detox thing is going for me.

If you are interested in joining me on this 21-Day Sugar Detox adventure, it’s not too late to start (or you could start February 1st if you wanted to too). This is the biggest group ever and one of the reasons why it is so successful is because of the online community of people making you feel like you are not alone as you go through the (sometimes way not fun) transition to a lower sugar diet. Solidarity!

Tags: 21, autoimmune, balanced, bites, carb, carbohydrate, carbs, day, detx, diane, disease, fruit, illness, inflammation, low, paleo, practical, protocol, sanfilippo, SIBO, starchy, Sugar, Vegetables
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