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Autoimmune disease and the gut

Written by Casey Wise | Tuesday, 16 August 2022

nutrition

A healthy gut needs two key components — a healthy and intact gut lining and a diverse and balanced microbiome. When these components are compromised, the gut becomes dysfunctional and over time can trigger autoimmune disease.

In my last blog post, we took a dive into autoimmune disease and some of the underlying factors that cause this immune system dysfunction. We briefly touched on the link between autoimmune disease and gut health, although research in this area is so compelling that it’s worthwhile to unpack this connection even further.

To recap, a healthy gut requires two key components:

  1. A healthy and intact gut lining that keeps the contents of the gut e.g. food particles and toxins from escaping into the bloodstream
  2. A diverse and balanced microbiome with healthy amounts of beneficial bacteria and no harmful bacterial or fungal overgrowth

When these components are comprised (as a result of poor diet, chronic stress, medications, environmental toxins, chemotherapy, etc.) the gut becomes dysfunctional. A permeable or ‘leaky’ gut lining allows pathogens, undigested food proteins, and toxins to leak through the intestinal barrier and into the bloodstream. Inflammation and immune system activation follow as these foreign particles are marked as threats to the body which, over time, can trigger issues such as food sensitivities and autoimmunity.

The microbiota that reside in the gastrointestinal tract further influence immune homeostasis. With 70-80% of the body’s immune cells also residing in the gut (in gut-associated lymphoid tissue), the two have a symbiotic relationship to ensure that the body is protected from any harmful pathogens it may encounter. Our gut microbes act as sensors within the intestinal epithelium and fire off signals when foreign bacteria are detected, which subsequently mobilise immune cells (such as neutrophils, macrophages, T cells and B cells) into action. When dysbiosis is present however, this process is impaired, and the gut microbiota lacks the resilience and diversity required to establish healthy and balanced immune responses.

Understanding that the health of the gut determines the health of the immune system opens up new treatment avenues for those suffering from autoimmune conditions. Practitioners may like to consider the following in addition to pain management strategies:

  • Investigating intestinal permeability (‘leaky gut’), and working to reduce inflammation and heal and seal the gut lining
  • Investigating bacterial imbalance, and working to nourish healthy gut flora and improve the diversity of microbes

From a nutritional standpoint, a good start is to reduce the consumption of inflammatory foods that damage the gut lining, such as refined carbohydrates and sugars, trans fats, processed meats and alcohol. Instead, centring the diet around antioxidant and anti-inflammatory nutrients (like the ones listed below) will help to nourish the gut lining and strengthen immunity:

  • Vitamin A: Carrots, apricots, pumpkin, peaches, egg yolk, green leafy vegetables
  • Vitamin C: Berries, citrus fruits, kiwifruit, papaya, broccoli, cauliflower
  • Vitamin E: Almonds, sunflower seeds, sesame seeds, extra virgin olive oil
  • Zinc: Oysters, shellfish, cashews, Brazil nuts, sunflower and pumpkin seeds
  • Omega 3s: Fish, fish oils, chia seeds, flaxseeds, walnuts, seaweed, tofu
  • Turmeric and ginger: Fresh or ground

Incorporating a mix of prebiotic and probiotic foods into the diet can assist in repopulating beneficial gut bacteria and improving the diversity of the microbiome. Prebiotics are special plant fibres that cannot be digested by the body but serve as food for the beneficial bacteria of the gut. Probiotics are live bacterial strains that are naturally contained in fermented foods. Some examples of both are listed below:

Prebiotics

  • Resistant starch: Cooked and cooled potatoes e.g. a cold potato salad
  • Inulin: Garlic, onion, leeks, asparagus, artichokes, green bananas, rolled oats
  • Pectin: Apples, citrus peels, apricots, peaches

Probiotics

  • Sauerkraut and kimchi
  • Kombucha
  • Yoghurts and kefir
  • Tofu and tempeh
  • Miso

References

Belkaid, Y., & Hand, T. W. (2014). Role of the microbiota in immunity and inflammation. Cell, 157(1), 121–141. https://doi.org/10.1016/j.cell.2014.03.011

Wu, H. J., & Wu, E. (2012). The role of gut microbiota in immune homeostasis and autoimmunity. Gut Microbes, 3(1), 4–14. https://doi.org/10.4161/gmic.19320

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Casey Wise

Casey is a practicing Clinical Nutritionist (BHSc Nutritional & Dietetic Medicine) and Endeavour College graduate based in Brisbane, Queensland. Her areas of expertise are autoimmune disease and gut health, and the interconnection between the two.

Casey's journey into nutrition began after being diagnosed with rheumatoid arthritis at just 17 years old and experiencing first-hand the transformative power of adopting a nutritious diet and healing the gut. This, combined with her education and clinical experience, has allowed Casey to develop a holistic and integrative approach to nutrition and cemented her passion for helping others to lead their healthiest, most fulfilling lives.

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