Vegan vs. Paleo for Autoimmune Disease - Which One Works Better?

This post uses the word “diet” defined as “the sum of food consumed by a person or other organism”, not a calorie-restricted meal plan for weight loss. Let’s go on to see if vegan vs. paleo for autoimmune disease works better.

Diet and nutrition play a huge role for those with autoimmune disease and chronic illness trying to improve their health.

Maybe you have Celiac Disease and extensive damage to the lining of your gut, and going gluten free alone isn’t resolving your symptoms or healing your gut lining.

Or, perhaps you have a different autoimmune disease and you’re trying to improve the trajectory by healing your gut and reducing inflammation through diet.

You might have multiple, severe food intolerances and you’re wondering how you will ever be able to eat a variety of nutritious food again.

Maybe you have symptoms of malabsorption and unexplained weight loss or gain and intestinal hyperpermeability, but you don’t know why.

Or, maybe you have gut dysbiosis (SIBO or bacterial/yeast overgrowth), and you’ve developed a compromised intestinal barrier as a result.

Whatever your why, you’re here reading this post for one reason – you want to know what type of diet is going to best help you heal.

The core objective of any diet that is designed to help someone with autoimmune disease and chronic illness can be summarized with a few points like these.

Eliminate whichever foods are causing harm to your gut
Include a variety of foods to nourish and improve your gut health
Cut out any foods that are contributing to inflammation and worsening your autoimmune symptoms
Consume plenty of foods that reduce inflammation and improve your autoimmune symptoms

The problem is, there is no one diet plan that will accomplish the above.

A comprehensive body of research has found that overall, the most healthful diets that promote wellness and longevity are plant-based diets. These are rich in whole grains, legumes, vegetables, fruit, nuts and seeds, and healthy sources of fat, with moderate amounts of minimally processed animal products, and limited amounts of red meat, processed meat, added sugar, and highly processed foods (source 1, 2, 3). Numerous studies have also demonstrated that well-planned vegetarian and vegan diets are appropriate for humans of all life stages, including children and pregnant women, and they are “healthful, nutritionally adequate, and may provide health benefits for the prevention and treatment of some diseases” (source).

However, people with chronic illness and autoimmune disease do not always have expected reactions to healthy lifestyle choices that benefit the average person or population as whole.

One person might experience near remission of their symptoms by following an Autoimmune Paleo (AIP) pattern of eating. Another person might feel severely ill on AIP, but thrive eating a vegan diet with a daily green smoothie.

This can be extremely frustrating and confusing when you’re trying to figure out a way of eating that works for you.

The goal of this post is to help work through the confusion.

We’ll break down the most well known autoimmune and gut-healing diet plans into three categories – paleo, neutral, and vegan – and go over the reasoning behind each one and why you might feel better or worse eating that way. At the end, we’ll finish with a takeaway on how to find the right diet for you.

So, vegan verses paleo for autoimmune disease – which one works better?

I don’t like to use the term “leaky gut” because it’s a buzzword in the wellness community that modern medicine loves to hate. I would be a millionaire if I had a dollar for every time I heard or read a doctor say online that leaky gut isn’t a real diagnosis.

Instead, I like to use the term intestinal hyperpermeability. It’s not as easy to say or type, but it’s a phenomenon that has been extensively researched and has a lot of evidence for its validity.

Intestinal hyperpermeability happens when something causes damage to the lining of the intestines, loosening the tight junctions so partially-digested food particles, viruses, bacteria, and yeast can “leak” through (and back into) the intestines.

Paleo and Primal Diets for Healing the Gut and Autoimmune Disease

GAPS, Specific Carbohydrate Diet (SCD), and Autoimmune Paleo (AIP)

Dr. Natasha Campbell-McBride founded the GAPS diet.

This gut-healing diet plan begins with an introductory phase where you consume only a small, specific amount of food and then gradually add in the rest of the foods allowed on the diet, as tolerated.

Foods allowed on the diet include animal fats, ghee, meat, fish, eggs, homemade yogurt and kefir, non-starchy vegetables, fruit, tree nuts in moderation, coconut oil, and cold-pressed olive oil.

The GAPS diet proposes that people with chronic illness and autoimmune diseases can’t process complex carbohydrates properly, so they ferment in the intestines, where opportunistic and harmful bacteria feed on them, leading to gut dysbiosis. For this reason, the diet excludes disaccharides and polysaccharides like sugar, lactose, grains, and starchy vegetables.

The Paleo belief system in general (which GAPS falls under) claims that specific antinutrients (lectins especially) in grains, legumes, tree nuts, and some vegetables damage the lining of the gut. Some studies have shown that lectins such as gluten increase zonulin production in the intestines of people who are more highly predisposed to autoimmune disease, which loosens the junctions in the lining of the gut and causes or exacerbates gut permeability. To combat this problem, the GAPS diet excludes grains and legumes.

The core purpose of the GAPS diet is to optimize the gut microbiome in turn to optimize immune health. Removal of sugar, lactose, grains, and starchy vegetables supposedly starves opportunistic and harmful bacteria. Including fiber-rich, non-starchy vegetables and probiotic-rich fermented foods such as kefir, yogurt, kimchi, and sauerkraut feeds beneficial bacteria and yeast.

Ideally, one would stay on the GAPS diet for approximately two years, and then begin reintroducing foods in stages to see how they are tolerated.

The Specific Carbohydrate Diet (SCD) – founded by Dr. Sidney Valentine – is actually the diet that inspired the creation of GAPS, so they are VERY similar.

The only difference between the two is that the importance of homemade bone broth is stressed more on SCD for the purpose of collagen production to heal the gut lining, while homemade, fermented dairy products like yogurt and kefir are allowed on GAPS, but not SCD.

The Autoimmune Paleo Diet (AIP) – discovered by Dr. Loren Cordain and developed further by Dr. Sarah Ballantyne – is like Paleo, but with more restrictions.

A traditional Paleo diet excludes all grains, legumes, most dairy, and highly processed food on the premise that our paleolithic ancestors didn’t eat them and we haven’t evolved to digest them properly, so they cause more harm than good.

Similar to the GAPS diet, the AIP diet claims gut dysbiois plays a huge role in the development of autoimmune disease. The AIP diet adheres to the same principal that diets including sugar, grains, and starchy vegetables cause or exacerbate gut dysbiois, so their removal is key to improving the gut microbiome.

The core principal behind the AIP diet is to remove potential inflammatory food triggers and include AIP-compliant vegetables, fruit, meat, bone broth, and fermented foods to support the gut microbiome and aid in collagen production to heal the gut lining.

In addition to the grains, legumes, and most dairy eliminated on the Paleo diet, the AIP diet also excludes nightshades (tomatoes, peppers, eggplants, and potatoes), tree nuts, butter, chocolate, eggs, gums, tapioca, alcohol, and xylitol and stevia. These foods are believed to contain antinutrients and irritants that will further damage an already compromised gut lining.

After strictly follow the AIP diet for several months, once you’ve noticed significant symptom improvement, you can begin to reintroduce foods in stages to see what you tolerate and what you don’t.

Why might you feel better on Paleo and Primal diets?

If you were consuming a Standard American Diet before with lots of ultra processed food, you may feel better because of eating more minimally processed, nutrient-dense food and not having ultra processed food in your diet.
You may be meeting nutrient needs that weren’t being met before, with the increase of nutrient-dense food in your diet.
If you were consuming a lot of grains and legumes before, but not traditionally preparing them with soaking, boiling/pressure-cooking, sprouting, and/or fermenting, you may have experienced a benefit from the removal of grains and legumes from your diet. Especially if you do not tolerate gluten, but you were eating it before. Your gut lining may be able to do some substantial repair and your inflammation may go down quite a bit.
You don’t tolerate grains and legumes at at all, even when they’re prepared traditionally in a way that destroys antinutrients.
If nightshades are one of your trigger foods, you may experience a reduction in inflammation when you cut them out.
Some people with thyroid conditions do not tolerate the phytoestrogens in soy very much, so if you were eating soy before, you may feel better without it in your diet.
A diet lower in carbohydrates may be a better fit for your unique health needs.
Primal and Paleo diets are high in amino acids, especially those the body uses to form collagen, which is an essential component of gut repair. You may feel better due to your body having more resources with which to make collagen.
If you were not consuming probiotic and prebiotic-rich foods before, your gut health may be benefitting from the addition of fermented foods.

Why might you feel worse on Paleo and Primal diets?

If you have multiple food intolerances, cutting your food intake down to a few items in Phase 1 of these Paleo/Primal diets may exacerbate the problem. If you have intestinal hyperpermeability and you consume a particular food on a regular basis, it gives your body the perfect opportunity to make antibodies to those partially-digested food particles and develop a food intolerance.
If you were consuming a more plant-based diet with grains and legumes before, you may have experienced a sharp drop in your fiber intake. Beneficial bacteria and yeast in the gut feed on fiber and resistant starch, so you may not be consuming enough fiber anymore to sustain your gut microbiome as it was. Diet changes have been shown to rapidly alter the microbiome composition in the gut, so with the strong connection between the gut, brain, and immune system, it’s possible this new diet altered your gut microbiome in a way that was unhelpful or even detrimental for your unique biological needs.
If you were already gluten-free and preparing grains and legumes with traditional methods like soaking, boiling/pressure-cooking, sprouting, and/or fermenting, you may not experience a benefit from cutting grains and legumes out of your diet.
The brain requires carbohydrates as a primary energy source, even though the rest of the body is able to burn fat for energy if it needs to. If you have neurological chronic illnesses and/or autoimmune diseases (like I do), it’s possible your brain needs more energy than average to handle these neurological conditions. With a sudden drop in carbohydrates, your brain may not be getting the amount of glucose it needs to function, resulting in negative symptoms.
It’s possible a lower-carbohydrate diet is not right for your unique biological needs. This may especially happen if you have a low body fat percentage, struggle to gain/maintain weight, have a high metabolism, or are physically active.
Some people with GI conditions do not digest high levels of fat very well, especially saturated fat. For that reason, being on a diet with a high percentage of calories coming from saturated fat may worsen GI symptoms.
Certain foods that are eaten frequently on Paleo/Primal diets include fish, fermented foods, and bone broth. All of these are high in histamine, which may exacerbate symptoms in people with histamine intolerance or Mast Cell Activation Syndrome.
You may not tolerate meat, dairy, and/or eggs.
Animal products like meat, dairy, and eggs have been shown to increase certain inflammatory markers in the body, which may worsen your inflammation and cause an uptick of symptoms (source 1, 2, 3).
If you were eating a lot of legumes before, you may feel worse due to the removal of legumes from your diet. Legumes like beans, lentils, and peas are extremely high in soluble fiber, which acts as a binder for bile from the liver. When you are consuming a lot of them, bile the liver has used for detoxification can be eliminated in bowel movements instead of recirculated through the digestive system.
If your carbohydrate intake has dropped a lot at once, you may be experiencing a die off reaction. Harmful bacteria and yeast in the gut like Candida feed on simple carbohydrates and sugar, so a drop in carbohydrates can cause some of these harmful microbes to begin dying, which releases a large amount of toxins into the bloodstream at one time. This type of die off reaction overwhelms the detox organs of the body. It’s best to lower your carbohydrate intake a little bit at a time, to avoid this.

Neutral Diets for Healing the Gut and Autoimmune Disease

The Elemental Diet

The Elemental Diet is for people who become so desperately sick after eating that they can no longer tolerate any food.

The idea behind The Elemental Diet is that you consume shakes made of crude dextrose, protein, fat, and vitamins/minerals, but don’t eat any food your body has to digest.

In this way, your body can get all the nutrients it needs without having to digest anything and you don’t starve from not being able to eat.

Absorb Plus sells both a vegetarian version with whey protein, and a vegan version with brown rice protein.

While following the Absorb Plus plan, individuals take wild oregano and probiotics to mitigate gut dysbiosis. Other supplements in the plan include aloe vera juice, slippery elm, marshmallow root, licorice root, and NAC to soothe and repair the intestinal wall.

Jini Patel, author of The IBD Remission Diet, writes that after 6-8 weeks your intestines should have had time to heal, since they haven’t had to digest food in quite awhile.

The downside to the elemental diet is, you have to take time off work and stay home through the duration. Since you’re not eating any solid food with fiber to bulk up your stool, you will have urgent liquid bowel movements throughout, which doesn’t work out well unless you’re at home.

Some people like to drink elemental shakes as a weight gain supplement, when taken in addition to a solid food diet. Jonathan tried this while following a 4-day rotation diet for multiple food intolerances (below) and gained close to 15 lbs.

Why might you feel better on The Elemental Diet?

If you become severely ill every time you eat and can’t tolerate food, you may feel better on The Elemental Diet because your body is finally receiving nutrition it can absorb.
If you were not able to consume enough calories before, you may feel better on The Elemental Diet because you are consuming enough calories and may gain much needed muscle and body fat.
Without consuming foods that are irritating you, your symptoms may abate while on The Elemental Diet and your gut may be able to do a lot of repair.

Why might you feel worse on The Elemental Diet?

Elemental shakes like Absorb Plus are very low in fiber, which can dramatically alter your gut microbiome and cause unpleasant symptoms. The supplements recommended on this diet help mitigate this side effect some, but not entirely.
When you’re consuming elemental shakes without other food, you are not getting anything solid in your diet. This will cause urgent, liquid bowel movements. This is of course a temporary side effect, because this is not meant to be a long term diet. However, it is extremely unpleasant and some may not be able to cope even temporarily.
It may be difficult to consume enough calories on The Elemental Diet, especially if you don’t consume enough shakes and add enough oil/fat to them.

The 4-Day Rotation Diet

The 4-Day Rotation Diet is focused on getting the body to stop making antibodies to the partially digested food particles that slip through the intestinal wall into the bloodstream, when a person has intestinal hyperpermeability.

The premise is that it takes about four days for a food item someone eats to completely get through the digestive system. Thus, if you have intestinal hyperpermeability and you consume a particular food on a regular basis, it gives your body the perfect opportunity to make antibodies to those partially-digested food particles and develop a food intolerance.

So, say you eat a banana on day one. You wouldn’t eat a banana again until day five, to make sure your body doesn’t get the chance to make antibodies to banana – or, if it already is making antibodies to banana, give it the chance to STOP.

With other gut-healing diets, people often end up eating the same few foods over and over. Then, after awhile, they develop an intolerance to them, ultimately causing more inflammation and intestinal damage.

It’s a vicious cycle. This diet, however, makes it difficult for that to happen. Therefore, it’s one of the better choices for people with multiple food intolerances.

Why might you feel better on The 4-Day Rotation Diet?

If you have intestinal hyperpermeability and multiple food intolerances, The 4-Day Rotation Diet increases the amount of time you go between consumption of a food, encouraging your immune system to stop antibody production to it. Furthermore, with the reduction of inflammation in your intestines that follows, it gives your gut a chance to do a lot of self-repair.
The 4-Day Rotation Diet makes it easier to pinpoint which foods you are reacting to that may be true food intolerances, so you can remove them from your diet and feel better.

Why might you feel worse on The 4-Day Rotation Diet?

Temporarily, The 4-Day Rotation Diet forces you add foods back into your diet rotation that you may still be reacting to, so it can be an uncomfortable experience until your antibody production and inflammation start to die down and you are able to tell which foods are true intolerances that you should avoid long term.
You may struggle to get enough calories, protein, fat, carbohydrates, and vitamins/minerals on The 4-Day Rotation Diet if you can’t think of enough different foods to consume each of the four days. This can be mitigated with a good meal plan and appropriate supplementation with the help of a nutrition professional.

Vegan Diet for Healing the Gut and Autoimmune Disease

The science behind a vegan diet for healing the gut is unlike many of the above diets.

It’s true that grains, legumes, tree nuts, and certain vegetables have antinutrients like lectins (prolamins and agglutinins), phytates, and oxylates. However, these antinutrients are almost completely inactivated by traditional cooking methods. The minute amount left afterward either has antioxidant properties in the body, or has no effect (sources 1, 2, 3).

Not to mention, the dietary inflammatory index, a fairly recent scientific study, clinically reviewed over 1900 foods to see if each increased, lowered, or had no effect on six inflammatory biomarkers in the human body.

Whole grains, fiber, and a variety of phytonutrients in plant foods scored high for anti-inflammatory activity.

On the other hand, foods high in saturated fat and cholesterol scored high in inflammatory activity (source).

Since meat, eggs, and dairy are linked to the development of heart disease and and multitude of other health problems, as well, proponents of vegan gut-healing diets argue that it’s more beneficial to nix animal products.

Vegan diets specifically designed for healing the gut and autoimmune disease often include –

Daily green smoothies like the one from Dr. Goldner’s Protocol or Ally’s Vegan Vibes for amino acids, phytonutrients, and antioxidants. Dr. Goldner calls this hyper-nourishing the body.
Lots of beans, lentils, and peas, like in The Karen Hurd Bean Protocol, which includes 3-6 servings of legumes per day for a high intake of soluble fiber, to act as a binder for bile. This way, bile the liver has used for detoxification is eliminated in bowel movements instead of recirculated through the digestive system.
Homemade vegetable broth for amino acids, micronutrients, and phytonutrients.
Fermented foods like sauerkraut, natto, miso, non-dairy yogurt, water kefir, and kombucha, to feed beneficial gut bacteria and yeast.
Avoidance of gluten and properly preparing gluten-free grains and legumes via soaking, boiling or pressure cooking, sprouting, and fermenting (eg. sourdough). These cooking methods destroy antinutrients like lectins so you can reap the benefits of gluten-free grains and legumes without the negative effects of antinutrients on your gut health and mineral absorption.
Avoidance of added sugar and highly processed vegan foods like meat substitutes and seitan.

Why might you feel better on a vegan diet?

If you were consuming a Standard American Diet before with lots of ultra processed food, you may feel better because of eating more minimally processed, nutrient-dense food and not having ultra processed food in your diet.
You may be meeting nutrient needs that weren’t being met before, with the increase of nutrient-dense food in your diet.
A diet higher in fiber and complex carbohydrates may be a better fit for your unique health needs. This may especially happen if you have a low body fat percentage, struggle to gain/maintain weight, have a high metabolism, or are physically active.
If you were not consuming probiotic and prebiotic-rich foods before, your gut health may be benefitting from the addition of fermented foods.
Beneficial bacteria and yeast in the gut feed on fiber and resistant starch, so a high intake of complex carbohydrates with fiber and resistant starch may be helping your gut build a flourishing microbiome.
The brain requires carbohydrates as a primary energy source, even though the rest of the body is able to burn fat for energy if it needs to. If you have neurological chronic illnesses and/or autoimmune diseases (like I do), it’s possible your brain needs more energy than average to handle these neurological conditions.
You may not tolerate meat, dairy, and/or eggs.
Animal products like meat, dairy, and eggs have been shown to increase certain inflammatory markers in the body, which may worsen your inflammation and cause an uptick of symptoms (source 1, 2, 3). Thus, the removal of animal products from your diet may be helping reduce inflammation and symptoms.
Some people with GI conditions do not digest high levels of fat very well, especially saturated fat. For that reason, being on a diet with a more moderate fat intake and more unsaturated fat than saturated may improve digestive symptoms.
Legumes like beans, lentils, and peas are extremely high in soluble fiber, which acts as a binder for bile from the liver. When you are consuming a lot of them, bile the liver has used for detoxification can be eliminated in bowel movements instead of recirculated through the digestive system.

Why might you feel worse on a vegan diet?

You are not eating a vegan diet high in whole foods, and/or you are consuming too many highly processed vegan alternatives.
You aren’t supplementing vitamins vegans may be low in, like Beta Carotene/Vitamin A, Vitamin B12, DHA and EPA Omega 3 Fatty Acids, and Iron (for women). Additionally, most people need to supplement Vitamin D to maintain a healthy level, whether they are vegan or not.
You are not traditionally preparing your grains and legumes with soaking, boiling/pressure-cooking, sprouting, or fermenting or purchasing products already prepared that way. Or, you don’t tolerate grains and legumes even when they are prepared in the traditional way that destroys the antinutrients.
You are still eating gluten, but you do not tolerate it.
You are not prioritizing high quality protein or planning your macronutrient distribution ratio well. For active people, those with blood sugar regulation problems, those trying to lose weight, or those fighting/recovering from illness, 1.2 to 2 grams of protein per kilogram of body weight is needed.
You are not eating enough healthy fat. It’s recommended to make 35-40% of your daily calorie intake from fat when following healthy eating patterns like Mediterranean. Everyone needs fat in their diet for energy, for absorption of fat soluble vitamins and minerals, for forming the outer membrane of our cells, for cholesterol production, for hormone production and regulation, and more.
A diet higher in complex carbohydrates may not be the right fit for your unique biological needs.
You’re consuming too many carbohydrates for your unique health needs. It is possible to lower your carbohydrate consumption on a vegan diet with the right planning tools.
You are eating too many simple carbohydrates and/or too much sugar in the form of white flour products (bread, pastries, pasta), dried fruit, fruit juice, or added sugar.
You need animal products in your diet to feel your best.
Diets high in fiber and resistant starch can worsen symptoms in some people with GI conditions, so a diet high in fiber and resistant starch could be doing more harm than good for you.
Diet changes have been shown to rapidly alter the microbiome composition in the gut, so with the strong connection between the gut, brain, and immune system, it’s possible this new diet altered your gut microbiome in a way that was unhelpful or even detrimental for your unique biological needs.
You may not tolerate nightshades, if you are eating them.
Soy may be a trigger food for you, if you are eating it. Some people with thyroid conditions do not tolerate the phytoestrogens in soy very much. You don’t have to eat soy on a vegan diet, but many people start out doing so.
You may need organic versions of the conventional foods you are eating (vegetables, fruit, etc.)
If you struggle with IBS symptoms, you may feel worse due to the increase of high-FODMAP foods in your diet.
The digestive system takes time to adjust to the consumption of more legumes (beans, lentils, peas). You may temporarily experience more gas and bloating than usual when you begin increasing legumes in your diet and decreasing animal products. As your small intestine starts producing the enzymes and microbiome needed for this type of diet, the symptoms usually resolve.

So, how do you find the right diet to heal your gut and improve your autoimmune disease and chronic illness?

The answer to the question, “Vegan vs. Paleo for autoimmune disease – which one works better?”, is neither. Why?

Because really, the only way to learn your body’s unique needs is to experiment with your diet and find out answers to questions like the ones below.

Many people with autoimmune disease and chronic illness do well starting with a gluten-free diet, eliminating dairy or switching to a better-tolerated form, limiting added sugar and ultra processed-foods, and emphasizing nutrient-dense foods. For other people, these changes aren’t enough, or aren’t right for them.

Be sure to make any changes one at a time, and slowly. While you may experience a short term reaction when introducing a food you have not eaten before or frequently, severe and long-lasting reactions are a sign you are not tolerating something.

I recommend working with a nutrition professional who is knowledgeable about chronic illness and autoimmune disease while undergoing this process, if at all possible.

If you’d like to search for a nearby nutrition professional, you can browse the following directories:

Academy of Nutrition and Dietetics (Registered Dietitians and Dietetic Technicians, Registered) *After typing in your zip code, select “specialty” and click the box for Integrative-Complementary-Alternative Nutrition
American Nutrition Association (CNS; Certified Nutrition Specialists)
American Clinical Board of Nutrition (DACBN; Diplomate American Board of Clinical Nutrition)
National Association of Nutrition Professionals (NANP; degreed nutritionists who are Board Certified in Holistic Nutrition)

Questions to explore:

Do I tolerate gluten? Most people with autoimmune diseases do not, because gluten triggers the release of zonulin into the gut, which increases intestinal permeability in people with autoimmune disease and people who are predisposed to them. This can trigger the onset of new autoimmune diseases or exacerbate existing ones, and worsen what we call “leaky gut”.
Do I need animal products? If so, which ones? Do I need them to be organic, pastured, grassfed, etc. in order to feel my best? Some people with autoimmune disease and chronic illness find they really need animal products to feel their best, and others find they cause or exacerbate inflammation.
Do I need gluten-free grains? If so, which ones? Do I need them to be organic, soaked, boiled/pressure cooked, sprouted, and/or fermented to feel my best? Some people with autoimmune disease and chronic illness find they really need some grains to feel their best, and others find they cause or exacerbate inflammation.
Do I need legumes like lentils, beans, and peas? Do I need them to be soaked, boiled/pressure cooked, and/or sprouted to feel my best? Some people with autoimmune disease and chronic illness find they really need legumes to feel their best, and others find they cause or exacerbate inflammation.
Do I tolerate soy? How much of it? Do I need it to be organic, fermented, etc. to feel my best? Some people with autoimmune disease and chronic illness find soy helps them get more high quality protein in their diet, and others find it causes or exacerbates inflammation.
Do I tolerate nightshades (tomatoes, potatoes, eggplant, peppers)? If so, do I need them to be organic to feel my best? Some people with autoimmune disease and chronic illness find nightshades don’t affect them at all, and others find they cause or exacerbate inflammation.
Do I need fermented foods? Some people with autoimmune disease and chronic illness find fermented foods to be beneficial for their microbiome and healing the gut, but some people, like those with SIBO, histamine intolerance, or Mast Cell Activation Syndrome, react badly to fermented foods.
How many carbohydrates do I need to feel my best, and from what sources – grains, legumes, vegetables, fruit? Can I tolerate added sugar? Everyone needs carbohydrates in their diet for the brain, for energy, for resistant starch, soluble, and insoluble fiber to control blood sugar, to feed the gut microbiome, to regulate bowel movements, and for fluid balance. Some people with autoimmune disease and chronic illness need a higher percentage of carbohydrates, and others feel better with less. It’s recommended to make 45-65% of your daily calorie intake from carbohydrates.
How much protein do I need to feel my best, and from what sources? Everyone needs protein in their diet for satiety, as the building block of all cells, to catalyze all chemical reactions, to regulate gene expression, to regulate the immune system, for tissue formation (like collagen), and for muscle composition. The minimum protein requirement for inactive people is 0.8 grams of protein per kilogram of body weight. For active people, those with blood sugar regulation problems, those trying to lose weight, or those fighting/recovering from illness, 1.2 to 2 grams of protein per kilogram of body weight is more appropriate. It’s recommended to make 10-35% of your daily calorie intake from protein.
How much fat do I need to feel my best, and from what sources? Everyone needs fat in their diet for energy, for absorption of fat soluble vitamins and minerals, for forming the outer membrane of our cells, for cholesterol production, for hormone production and regulation, and more. Some people with autoimmune disease and chronic illness feel better with a higher percentage of fat, and others, especially those with digestive problems, may struggle to digest a lot of fat in their diet. Some may feel better eating more saturated fat like meat, dairy, eggs, tallow, butter, ghee, coconut oil, and palm oil in their diet. Others may feel better eating more unsaturated fat like olive oil, avocado oil, and other liquid oils, tree nuts, seeds, olives, and avocados. It’s recommended to make 35-40% of your daily calorie intake from fat when following healthy eating patterns like Mediterranean.

When you’re fighting autoimmune disease and chronic illness and trying to help your body heal, it may feel daunting to find the diet that best helps you heal. However, when you’re prepared with accurate nutrition education and the right tools, it is possible. You can do it! I believe in you, friend.

Disclaimer: I am not a licensed doctor and do not diagnose or treat disease. I’m an American Council on Exercise certified health coach with a nutrition speciality and a nutrition college student. After graduation, I will hold the credentials A.S. in Biology, National Board Certified Health and Wellness Coach (NBC-HWC), Board Certified in Holistic Nutrition (BCHS) by the National Association for Nutrition Professionals, and Registered Herbalist (RH) by the American Herbalists Guild. Please do not substitute the information in this educational blog post for the personalized advice from your health practitioner. If you have a health condition and are interested in adopting a specific diet plan, please speak to a registered dietitian or licensed nutritionist so they can help you implement the diet without any harmful side effects.