Reversing Autoimmune Disease
By Dr. Justin Marchegiani
When your immune system response can’t distinguish between your body and any toxins you’ve ingested, the result is called ‘systemic inflammation:’ when your body attacks its own tissues. Your body might intend to fight off an infection or an allergen, but instead points the attack at your joints or your thyroid, or maybe even your whole body. This is how autoimmune conditions, such as arthritis, celiac disease, thyroid disorders, and lupus, begin to grow.
Causes of Autoimmune Disease
Autoimmune diseases typically stem from one of the following causes:
Genetic Predisposition: While your genes alone do not condone you to a fate of autoimmunity, having a family history is a good indicator that you should be proactive in preventing an autoimmune disease from developing.
The pathogenesis of autoimmune disease is multifactorial, meaning, just because you may have inherited the genes for an autoimmune disease, it does not necessarily mean you will develop one. Studies have shown that some combination of genetic and environmental factors are what ultimately cause or prevent autoimmunity from developing. In this article, we are going to break down some of the ways to prevent this from happening.
Leaky Gut: Food allergies, toxins in our food and environment, stress, gut dysbiosis and an inflammatory diet are causes of leaky gut. Leaky gut occurs when the gut lining is compromised, allowing large food particles and toxins to leak into the bloodstream, causing inflammation and autoimmunity.
Autoimmune conditions affect at least 50 million Americans, as well as millions more worldwide. However, autoimmune disease seems to exist almost exclusively in first-world countries. This is possibly linked to the diversity of the microbiome: in developed countries, we are regularly exposed to antibiotics and consume genetically modified foods laden with pesticides. These contribute to reducing the diversity of our microbiomes. Those in less developed countries have a wider range of gut flora, and don’t suffer from the same autoimmune diseases.
Trauma: Overwhelming stress or trauma, whether it be physical or emotional, such as a difficult break up, the death of a loved one, or a car accident, is enough to send your body into overdrive and trigger autoimmunity. The immune response due to physical stress (injury) causes profound inflammation, which is known to trigger autoimmune disease.
Up to 80% of people note that they experienced uncommon emotional stress before the onset of their autoimmune disease. Stress-related hormones are presumed to cause immune dysregulation, resulting in autoimmune disease. Stress can be responsible for more than just the onset of autoimmunity, it also feeds continues a vicious cycle of feeding the condition.
Prevention and Reversal of Autoimmunity
- Eliminate any foods causing allergies or sensitivities. Here is a breakdown of what an elimination diet entails. Basically, by eliminating foods that are potential allergens, you’ll learn what your body feels like when you aren’t ingesting inflammatory foods. Then, you add back foods gradually and are able to pinpoint which foods are triggers for your autoimmunity or other issues you may have been experiencing.
- Heal your gut to reduce inflammation. Your gut houses 70% of your immune system. If you don’t have a healthy gut balance, your immune system will be severely affected, contributing to autoimmune disease. An elimination diet can help you learn which foods are serving you and which are hurting your gut.
- High quality probiotic supplements, eating and drinking probiotics in the forms of kombucha and sauerkraut, and drinking bone broth will all support a healthy gut!
- Proper vitamin D levels. Research shows a strong correlation between vitamin D deficiency and autoimmune disease, cancer, and other serious diseases. This article studies the link between vitamin D and autoimmune disease in depth. Getting time in the sun, as well as supplementing with quality vitamin D, are ways to reverse and reduce risk of developing autoimmunity.
- Glutathione, the “master antioxidant,” helps your body detox any toxins you ingest. Glutathione is also a major player in immune system regulation, meaning it plays an important role in autoimmunity.
- Zinc is essential for white blood cell production, and provides powerful immune system support (maybe you’ve heard zinc recommended to get over a cold quickly). In fact, studies have shown that those with a zinc deficiency are more susceptible to developing diseases.
- Get good sleep will lower inflammation, heal your body, and reduce cravings for carbs, sugar, processed foods, and other junk that contributes to autoimmunity.
- Magnesium A deficiency in magnesium increases production of proinflammatory cytokines, raising your body’s total level of inflammation, a trigger for autoimmunity. Magnesium deficiency is rampant in our society due to chronic stress, soil depletion, and high-sugar diets, so it is important to supplement with magnesium.
- B vitamins support your immune system, hormones, sleep patterns, and much more. Vitamin B12 plays a role in your body’s production of white blood cells, which are essential components of your immune system. With lowered white blood cells, you are much more susceptible to illness, including autoimmunity.
- Reduce stress Studies show stress can act as both a trigger and a modulator in autoimmunity, and stress-reducing techniques (yoga, meditation, massage) are viable treatment options.
- Activated charcoal can be taken if you have consumed a food you are sensitive to, or any less than ideal foods. Activated charcoal binds to toxins to protect your body from inflammation.
If you are dealing an autoimmune disease, or have suspicions, please schedule a consultation with a qualified functional medicine doctor to assess your needs and help you heal.
How to incorporate an autoimmune plan – Podcast #71
In this podcast episode, Dr. Justin Marchegiani and Evan Brand get into an in-depth discussion about autoimmune diet and its foundations. They put together pieces of the puzzle to help us better understand how to incorporate an autoimmune plan. During this interview, they shine the light on an autoimmune diet and shares how we can use a Paleo template as a foundational piece and modify it.
Get inspired to stick to this plan to help heal your gut and reduce inflammation so the body can start healing. Find out how following an autoimmune plan can make a big difference. Learn how to reduce dietary stress by just taking it easy on yourself during this process which is a time for healing. Discover the ways to make it easy to follow the plan when you listen to this podcast.
In this episode, topics include:
1:24 What is autoimmunity?
3:28 Causes of autoimmune conditions
4:34 Paleo Diet/Template and AIP
21:40 Lifestyle piece and daily life application
25:00 Planning and preparation
Dr. Justin Marchegiani: It’s Dr. J in the house today with Evan Brand. Evan, what’s going on?
Evan Brand: Hey, man, we’ve had a great day so far. We’ve been productively working behind the scenes. I don’t think people comprehend the amount of work that it takes to get this content out to them.
Dr. Justin Marchegiani: It really does. Not only the content but how to display it. I’m trying to do some redesign stuff on my site to make it a little more user-friendly and we’ve also been talking about doing more periscope, scoping if you will, which will give patients and different viewers the ability to watch us live and ask questions and get instantaneous feedback.
Evan Brand: Yeah, so search for us. By the time you hear this, Dr. J will have his periscope going. I’ve got my periscope going, search for me. I’ve got followers on there and I’ve never even told anybody that I have it. So that’s pretty cool.
Dr. Justin Marchegiani: Yeah, my periscope name is justinhealth, all lower case, no spaces. I imagine yours is what–notjustpaleo or evanbrand?
Evan Brand: Yeah, either way. They can search your name and find you or they can search your tags. It’s the same for me.
Dr. Justin Marchegiani: Got it. Great. Well, today we talked about in the–the pre-show that we wanted to talk about the autoimmune diet. The kind of the first steps of treating an autoimmune condition. And again, check out the last podcast on leaky gut that just came out recently because leaky gut’s really gonna be one of the underlying mechanisms in which autoimmune conditions start. So just kind of back up a bit, so autoimmunity is nothing more than your immune system starting to attack self and depending on what tissue is attacked, that’s basically the diagnosis you get. So if you start attacking your myelin and your nervous system, you get MS. If you’re attacking the midbrain where your dopamine is produced in the substantia nigra in the back of your brainstem, that’s Parkinson’s. If something happens, let’s say, in your peripheral nerve, that could be Guillain-Barre or even polio potentially, but typically Guillain-Barre. Also thyroid, Hashimoto’s, pancreas, type 1 diabetes. If it’s your–end of your colon, it’s ulcerative colitis. If it’s your small intestine, it’s Crohn’s, right? So you can just go–the list goes on. If it’s the microvilli in your small intestine, right? The little vacuum cleaner that suck up nutrients, that’s celiac. So you can see all of these different conditions basically just get a fancy name based off of what tissue is being destroyed. It’s kinda like how medicine works, big fancy diagnosis, I mean, if you just said, you have autoimmunity of your intestine, it would be a lot easier to understand that than say Crohn’s. So that’s kinda how conventional medicine works in labeling things and now the next step, the first piece of the puzzle is obviously gonna be the lifestyle and the diet piece. Because when we have an autoimmune condition, this leaky gut phenomenon is happening. You can go back to that old podcast but that’s where the tight junctions in your gut–imagine a zipper, imagine that zipper being nice and tight, or the analogy we gave in the last podcast as interlock your fingers like you’re saying a prayer and imagine pulling those fingers apart just a little bit so you see daylight, or imagine the zipper just being zipped down just a bit, that’s like that tight junction. It starts to open up and undigested food particles, bacteria, infectious material can start to go into the bloodstream and create inflammation and the immune system is hyperresponding and in the process, this thing known as molecular mimicry occurs where we start to attack other tissues or other proteins that look similar to what’s floating in the bloodstream.
Evan Brand: Yeah, so maybe we should talk about some of the causes, too. I mean, you talked about the lifestyle stuff getting on in check–a lot of people, I’m just gonna reel some of these off, now this is not an exhaustive list, but these are some of the things that you and I have both been trained on, the cause, you know, the “splinters” of autoimmunity. So you get the emotional, cognitive stress, unhealthy coping patterns, you got poor nutrition, you got GI stress, adrenal stress or burnout, you got hormone stress which, you know, you work with hormones all the time, it’s massive for gut issues; inflammation like we’ve already talked about and then toxins. And you know, we’re talking about the diet, so obviously we’re not gonna have time to cover all of those, but taking baby steps in each direction is the only way that makes sense because it’s not one magic thing that’s gonna fix you. It’s not one poisonous thing that’s causing you your issues, it’s a combination of likely dozens or hundreds of different causes that are all adding up to cause this condition.
Dr. Justin Marchegiani: Exactly, exactly. So the first piece of the puzzle that we’re gonna really put as our main focus on today’s podcast is gonna be the diet piece. And everyone that’s probably come in here has already heard of the Paleo diet and if people listen, they know that I don’t like the word diet. Alright, one, the first three letters of the word have the word “die” in it. That’s–that’s not a pretty good way to do it and most people beca–the word diet kinda has a connotation of it being a temporary thing.
Evan Brand: Yeah.
Dr. Justin Marchegiani: It’s not like long-term thing. So I like template and lifestyle plan. So Paleo templates are really kind of good approach. It’s like the foundational piece and everything from there can be modified from a Pal–a Paleo template, whether you go to GAPS or Bulletproof or autoimmune or SCD or whether you do a low FODMAP. All these things can be adjusted based on that template. So today we’re gonna really shine the light on an autoimmune diet. So first off, Paleo is kind of the foundation which is cutting out grains, legumes or dairy and Paleo kind of has another couple of side elements to it whether it’s primal, where you allow butter or a little bit of cream or whether you’re strict Paleo where there’s no butter or cream. Now most people who are Paleo, they can handle some good high quality grass-fed butter or some high quality cream, but again there’s an individuality there. Talk to your functional medicine doctor about that if you need help on it. But when we go to the autoimmune piece, we really graduate to really being 100% grain-free. So no corn, even no rice essentially–
Evan Brand: That’s sad.
Dr. Justin Marchegiani: Yeah, I know. And–you see, rice and corn are a couple of big ones, obviously no oat. Oats, a common cross-reactive one because of the avenin that’s in it. And then you have all the other types of grains there that may–may connect in with it. So like the big gluten-free grain are gonna be like–the big gluten grains are wheat, barley, and rye. Those have the–the primary gluten in it and then every grain outside of wheat, barley, and rye is technically considered gluten-free, so we really cut out all of the gluten-free grains. That would be the rice, that would be the oats, that would be the corn, and anything else that you can think of that would fit in there, even potentially sorghum, all those things. Anything you wanna add there, Evan?
Evan Brand: Yeah, I mean, it’s tough. It’s definitely a strict protocol for people and it’s not something that most people have to do, just we’re talking about a percentage of people that are trying to specific battle some type of illness and you have to be strict. So a lot of people like to talk about the “Oh, the 80-20 rule”. And the 20% of their diet, where they’re “cheating”, they’re eating like Oreos and crap and that doesn’t really work for this type of scenario. You can’t really apply that same logic.
Dr. Justin Marchegiani: Exactly. And again, when you get healthier, my kind of approach is I eat AIP or autoimmune-Paleo about 80% of the time, and then I’m pretty much Paleo the rest with, if I cheat, I’m still gonna still cheat with a gluten-free grain, right? I’ll try to do with either with a coconut flour or almond flour ideally or, you know, a rice flour. So I try to, even if I cheat, it’s still gonna be gluten-free. So we talked about the grain piece, we’re grain-free on an autoimmune diet where in a Paleo approach, maybe some white rice is okay, even maybe some corn is okay for a cheat. So AIP, no grains. Also no legumes in a Paleo, same thing with an autoimmune-Paleo. Dairy, we’re gonna cut out butter, cream, and even ghee off the bat. Some AIP plans allow ghee but again, there’s still potential for some proteins getting in there so we wanna cut out ghee as well. The next piece is nuts. Nuts and seeds, we’d wanna cut out the nuts and seeds, so no almond butters, no almond flours, nothing like that. Next is gonna be nightshades. Nightshades are tomatoes, potatoes, eggplants, and peppers. So if you’re getting that chipotle bowl where you’re putting in all the peppers and stuff, and onions and all that salsa, we wanna cut that out off the bat. And then the last piece of the puzzle is really cutting out the eggs as well. So you look at Paleo, what’s Paleo? It’s basically, you know, gluten-free, ideally no grains on a Paleo, no legumes, and maybe a little bit of the safety area that we talked about. We’re here, we’re doing no grains, no legumes, no dairy, also no nuts, no seeds, no nightshades. Nightshades are tomatoes, potatoes, eggplants, peppers, and also no eggs. Evan, break it down.
Evan Brand: Yeah, I mean, it’s–it’s definitely strict but it has to be because we have to remove any potential chance for anything to disrupt that gut because the process is, we’re trying to heal up that tight junction where these undigested food particles and these toxins that are getting through and causing these conditions are not causing you the condition anymore. So I know it may feel like, “God, what’s left to eat after all this?” But once you get the results, you’re gonna be convinced and you won’t have to–it won’t feel like such a struggle. But I have, you know, I have talked with a few people where they’re like, “Man, this is actually kind of tough starting out.” But it’s just like anything else, it’s a snowball effect. You know, once you get it into effect, it becomes second nature and there’s not as much resistance in you sticking to this plan.
Dr. Justin Marchegiani: Absolutely and again, it takes no more effort to do the right thing than it does to do the wrong thing, okay? I mean, is going to McDonald’s easy? Yeah, but like the results that you’d get and how you’d feel afterward is just terrible. I could–I could never do that. So it takes no more effort to do the right thing than the wrong thing. You just gotta start making a habit. Get that habit going. So off the bat here, like our goal with this is really to reduce inflammation. Once we reduce inflammation, the body can start healing. And if we’re working with a patient and we kinda get them on adrenal program so we’re supporting inflammation reduction because a lot of people who are autoimmune, they’re adrenals are typically not responding well. They’re in adrenal dysfunction stage 3 where they’re cortisol is very low, so they can’t put out that fire, that internal inflammatory fire. They can’t create inflammation, I mean, they can’t create energy because they’re too busy fighting inflammation, so they’re tired and then because there’s inflammation in their guts and in their body, it typically makes it way to the brain because leaky gut equals leaky brain and they have brain fog. So most people always have this fatigue kind of brain fogging happening and they have a hard time with regulating inflammation so there’s typically maybe a thyroid issue along that line, too, and/or a mitochondrial issue where they can’t generate energy. So this first piece with the autoimmune plan makes a big difference. And I saw a handful patients just this last week that already came in to me, they were Paleo but we just went to the extra autoimmune step and it made a massive difference. Like it really made a huge difference. They noticed 50 to 80% improvement off the bat, because there were some nuts or eggs they were eating that were really making a big difference. Some patients we even have to go the extra level and they hate me when we do this, which is go low FODMAP as well as AIP, and that can really sting but with some people it can make a massive, massive difference.
Evan Brand: Yeah, so have you–this is a side note–we were talking about adrenal dysfunction that’s always happening. Have you even tested anyone that does not have some level of adrenal dysfunction? Because I haven’t seen one perfect result yet.
Dr. Justin Marchegiani: I’ve seen a handful of people that have really good adrenals and then we look at their thyroid side by side, I mean, their thyroid’s really in the tank. So every now and then we see someone with good adrenals or relatively good adrenals and they’re just–thyroid is absolutely in the tank. And sometimes it’s both, right? And that is both the thyroid and the adrenals. Sometimes it’s just the–the thyroid, but for the most part, 95% of the time, it’s the adrenals are gonna be in the tank because they’re you’re stress handling glands. They’re the glandular intercept between the sympathetic nervous system and your body, right? Your nervous system responds and it creates these hormones via the adrenals to manage stress. So that’s how your body connects with the outside stressors via the adrenals, and the adrenals respond to sympathetic nervous system, right? So if people remember from, you know, high school anatomy or biology, right? You have the Fight or Flight. You have the parasympathetics which are the relaxation and digestion, that’s when you’re sleeping, you’re engaging in parasympathetic. And when you’re stressed, right? Think of spidey sense going off, right? That’s the Fight or Flight. That’s like the gas. The parasympathetic’s the brake. So most people when they’re engaging that gas pedal that their–their parasympathetics, right? That’s the Fight or Flight, same word describe the same thing but that’s really stimulating the adrenals to go–to go to work.
Evan Brand: Yeah, a lot of people are stuck in the sympathetic, I mean, the modern world, they–that’s a conversation for a whole another podcast, but the goal alongside with this diet thing is that you’re able to reduce the stress a little bit, so we’re reducing the dietary stress by just taking it easy on yourself during this process. It’s a time of healing and a lot of people, they want to heal and they wanna still run and do all their CrossFit at the same time. You gotta have a balance when you are trying to slow down the–the rate of catabolism of your body, you know, your body eating yourself away.
Dr. Justin Marchegiani: Absolutely. So most people, right? That are going AIP, well, if you’re doing whey protein, cut that out. We’ll do beef protein or we’ll do pea protein or we’ll do collagen. If you’re doing legumes, cut it out. If you’re doing eggs, cut it out. Choose a different meat. Choose some pre-cooked sausages at Whole Foods. If you’re doing dairy, go to coconut oil. Cut out the seeds. Cut out the nuts, right? So my diet this morning was 30 grams of collagen. I did some–some coffee with some butter and MCT. So if I was trying to be, you know, more strict, I would have cut out, probably the coffee. I wouldn’t even have had it, right? I may have just done a chai tea with some MCT. That could have been my alternative. For lunch this morning, I have some chicken thighs and I have some coconut oil and sea salt and some non-starchy veggies. That’s a nice–good AIP meal. And then for dinner tonight, I’ll probably go out to dinner, but I’ll get some kind of a steak or fish, baked or sautéed, and I’ll typically make a request for olive oil or–or I’ll–I’ll even–I’ll do butter a lot of times because I still do really well with butter and add some good vegetables and maybe–maybe a little bit of starch if I’m o–if I’m okay with it. And then after that, if I’m doing sushi, I actually bring my coconut aminos to the sushi place. I don’t do the tamari even. I’ll bring my coconut aminos, and I’ll have my nice, you know, sashimi or if I decide to do a roll like a California or a spider roll, I make sure it’s gluten-free, very minimal amount of white rice, if it–that’s a cheat for me. But if I’m not cheating, we just do sashimi. Maybe a nice seaweed salad and bring my coconut aminos. So there’s ways you can do it. It’s not that hard and I always tell patients, it’s our job isn’t to get you to be like a Puritan, right? Like you need to be so puritanical with your diet. Our job is to get you feeling better. Once you feel better, then now you’re kryptonite detector is–is heightened. So you’re gonna be able to sense where you’re kryptonite is. I wish it was easy like with Superman where it just glows green, right? Gluten, there it is, it’s glowing green on the table, right? You kinda just see it, you’d know. But we don’t have that today. You have to get clean first. Because once clean, then you can appreciate when you’re dirty. So I always tell patients, you can ignore reality but you can’t ignore the consequences of reality. And when you’re already fla–inflamed and tried and not feeling well, you’re kryptonite meter is so low, it’s so dampened, you’re not gonna know whether you’re eating–what you’re eating is good or bad until you’re really super clean for a couple of weeks to–you know, 3-4 weeks, maybe a month, before you notice that significant difference.
Evan Brand: I’m gonna start borrowing that analogy. That’s a great way and a fun way to get it across. So I’ve just told people that you’re gonna become more aware. You’re–you’re–you’re consciousness towards your food gets heightened and you may go to take a bite of something or you may even go to take a supplement one day and that supplement jumps out of your hand, or you go and you’re about to pick up that fork, and you’re like, “Whoa, something doesn’t feel right.” That’s your inherent wisdom that it takes a little bit of time to tune into that self. But it does come.
Dr. Justin Marchegiani: Yeah. And then like my biggest pet peeve and this is like because, you know, when you see a couple of thousand patients and you hear the same thing over and over again, it gets a little annoying but my biggest annoying thing that I get from patients is this. We get them on an autoimmune diet, and yes, it’s restrictive, right? And patients are feeling better and they’re like, “But I wanna just go back and it’s so restrictive.” And I, “Okay, great.” I go, “Let’s–let’s map out what you would be eating if it wasn’t so restrictive.” And it’s like, “Well, I want a bagel in the morning or maybe some bread, or I want some cheese or some yoghurt.” Okay great, so let’s break it down. “The only thing I’m hearing you adding in is grains and dairy. That’s it.” So a lot of times when patients want to add stuff in, it’s really the grains and dairy piece. Even if we’re not even AIP, let’s say it’s just Paleo. And you think with their, you know, their moaning or their irritation that they would have the, you know, the palate of a world-class traveler, right? Trying all these different foods and this and that, but they really just want these simple foods that really isn’t adding that much variety, and I always tell patients the reason why they have that desire is typically because their prodynorphins or these gluteomorphin compounds or casomorphin compounds that are in these foods that hit into that morphine receptor and really cause that–that craving. I mean, it hits the same receptor as heroine and Vicodin. So a lot of times when people are saying, “I want a whole bunch of more variety,” if you look at their diet, there really not a bunch of variety in it. The average person only eats 12 foods. So if we’re just saying, “Hey, let’s eat these 20 versus these 12,” there’s still more variety in which you’re–in which you were getting to begin with, you’re just not eating these crappy, addictive foods and you’re just getting that–you want that opiate kind of stimulation from those compounds.
Evan Brand: Yeah, it’s all the brain chemistry. They’re not really wanting that food. They’re just wanting that hit.
Dr. Justin Marchegiani: Yeah.
Evan Brand: Yeah.
Dr. Justin Marchegiani: Yeah, so I’m like, “Hey,” you know, if you were–if you said you were world-class traveler and you’re having all these different things that soufflés and this, it’s really the same stuff. It’s just instead of eating something that’s a little bit more nutrient-dense and anti-inflammatory and low toxins, we’re eating something that’s pro-inflammatory, nutrient-poor, and the last word there–and toxic, right? The glutens, our lectins, and things like that. So first things first, go AIP. Get clean, right? You can’t appreciate being dirty until you really get clean, and then you’re like, “Ooh, wow, this feels nice!” And then once you’re clean, then you can kinda step down into a more Paleo approach, but you gotta remember, if you add foods back in, you gotta do it once every 3 or 4 days. Eat a little bit to start because, well, if you’re eating a bad food and you eat a lot of it, the more of it is gonna create a more, you know, intense reaction. So let’s have a less intense reaction, add a new food every 3 or 4 days and work with your functional medicine doctor on how to add these things back in so, you know, you–you know that, “Well, maybe if I add these nuts back and maybe it’s brain fog is the symptom.” It may not be a digestive symptom which most people reach for. They’re like, “Oh, it’s gotta be a GI symptom.” No, it could be icky joints. A patient last week, 90% of joint pain gone on an AIP, 90%.
Evan Brand: For me, it’s when I go from–so say I’ll pull out dairy and then I’ll introduce raw dairy, say like some raw cheese or non-pasteurized cheese and then I’ll come in and add some pasteurized dairy, boom! I’m super brain foggy so that’s my experience. I don’t get GI symptoms. I just–it doesn’t happen but the next day or even 48 hours after, it puts you in just sort of a haze and it’s like, “Man, I need to wipe the windows on my brain and clear this thing out.” And then I go another 48 or 72 hours without it and then I’m back to where I was. So it’s–it’s really interesting to see how mind-blowing how one little swap like that could be in your overall cognitive performance.
Dr. Justin Marchegiani: It is and the AIP for some–I had a girl yesterday–didn’t do anything. I had a guy the day before, 90% improvement in just a week, and some people are in the middle. I’d say the majority of people have a significant benefit but you–it’s like you gotta–you wanna go to the first floor, second floor, or third floor of that house as you build it, but you gotta start with the foundation. And if you skip that AIP foundation and you’re reaching for all these fancy tests, you could be spending thousands of dollars on stuff that may have been addressed with just the diet piece and if we don’t have the diet piece in there, you just, you’re not–you’re not gonna get your bases covered. You’re not gonna have the blood sugar. You’re not gonna have the nutrients. You’re not gonna have the–the nice anti-inflammatory state. You’re not gonna have the toxins down, so you have to have that. You have–you can’t go to second base without going through first base. So consider, first base as like the diet piece and then in the diet, we can even call the lifestyle piece which is meal timing, you know, not going more than 5 hours without eating. Because of the blood sugar piece, even if you’re eating the right foods, but you’re not–you’re going too long, that blood sugar swings are really gonna stimulate your immune system and also your adrenals which could flare up your autoimmune condition and make it worse.
Evan Brand: Let’s talk about some of the application like what you can do in your daily life that’s gonna make this things easier. Do you cook a lot in bulk? That’s been something helpful for me, like if I’m gonna cook a steak, I’ll just do 2 steaks. I’m not saying like the meal prep where you’re cooking 20 different boxes of food, but I will cook maybe double.
Dr. Justin Marchegiani: Got it. So when it comes to this stuff, you know, you got money or you got time. You get one of the two things, right? So if you don’t have time because you’re working so much then you’ll have a little more money. So then I typically, I work a lot because I’m–I’m really busy helping patients and creating content to help people all over the world, so I–I invest in a Snap Kitchen here in Austin, whereby 5 or 6 pre-made local Paleo meals and I’ll–I’ll have them in my freezer and I’ll thaw them out and they’re all local that week and I’ll typically do that for either lunch or dinner and then my wife and I will cook a meal or two and we’ll make that in bulk so we have some food that we can go to and then I have easy meals like pre-cooked sausages that are organic or you know, the smoked salmon or smoked tuna, and then I have like some salad greens that I can grab. I have some salsa or I have some you know Mark’s Paleo or Mark Sisson’s Mayo or some avocado and some stuff that’s really easy that I can make in 5 or 10 minutes like that, or I have the pre-cooked meals or my wife and I will actually take a half hour out and make a nicer meal that has a couple of servings so we can go to town the next few nights after.
Evan Brand: Uh-hmm.
Dr. Justin Marchegiani: How about–
Evan Brand: That’s good, too.
Dr. Justin Marchegiani: How about you? And then in the morning, I have like my good clean protein powders, I either have a beef, a pea, or a collagen or I combine them. I have my–my butter coffee with MCT and then I’ll also have eggs in the morning and/or pre-cooked sausages or leftover dinner. So those are my 3 to 4 that I–I go to and the thing is, you know, I practice this stuff. I have an autoimmune condition so I go to the utmost you know level of compliance as much as I can. One, because I just feel darn good and then two, I’m just trying to be a role model for my patients so when my patient talks to me, I’ve been through, I know exactly what it takes and now that I’m here, I put so little time into it, it’s so easy. For me to start buying and eating crap food would actually be harder for me.
Evan Brand: Yup. Yeah, I’m–I’m about the same, I mean, I get some local grass-fed jerky that’s really good. It doesn’t have any wheat in it. I keep that on-hand. I love to just go get a big bag of some juicy, tender jerky. Sometimes I’ll buy like some grass-fed beef sticks that don’t have any nitrates, anything like that. Those are always cool to have on-hand. Sometimes the Epic bars, I’ve got those Designs For Health, those professional bars now, pretty good.
Dr. Justin Marchegiani: Yeah.
Evan Brand: So I’ll go for the–the grab and go stuff, I mean, if I’m just gonna go head out for a hike and I got too busy to–to eat a full lunch, you know. I–I do break the eat a big meal rule sometimes and just go for, you know, some 30 to 40 grams of fat and protein snacks, and I feel good. I always try to keep a bag of organic pistachios around if I am doing nuts and I’m feeling good with them. Pistachios, oh man, super good.
Dr. Justin Marchegiani: Yeah, and again, the key is like we’re not trying to make people perfect but get to a place where you feel good and then you can always cheat a little bit, you know. You wanna practice the fundamentals first and then once you get good and you’re like, “Alright, I’m feeling pretty good and you’re getting a little cocky about it.” And you can–you can cheat a little bit here and there, if you wanna do some intermittent fasting or you skip a meal by accident. No biggie.
Evan Brand: Well, what–what we’re really saying I think overall is it’s preparation. If you don’t have enough time or you don’t actually sit down and plan this, “Oh, I’m gonna go buy these pre-made meals,” or “Oh, I’m gonna buy an extra couple pounds of some veggies this week at the market or the store, whatever.” If you just add that one little bit of planning, I find that people do so much better because if you ask them about their–their food, it’s like, “Oh well, I was too busy.” And they just never prioritize this stuff. So maybe this is the–the takeaway for people is that if it’s been tough for you to adapt and to change and get into your groove, totally okay. Just sit down and try to make a little timeout for yourself and you know, say, “Look, I’m gonna block out 30 minutes and I’m gonna figure this thing out.” We’re either gonna find a local place that’s gonna make good meals like Snap Kitchen, which that–man, I do miss Snap Kitchen–
Dr. Justin Marchegiani: That’s good.
Evan Brand: Yeah, or you know, that you’re just gonna go a bunch of food in bulk and cook it, so–
Dr. Justin Marchegiani: Absolutely. And you know what, the money excuse for me doesn’t fly. I was a poor college student. I was given $15,000 a year to live off of and in the Bay Area, I had, I think $500 left over at the end of the month. So all I had was 500, 400 went to food, 100 went to social. So I gave myself $25 a week to spend on social activities which you know, that’s not much, and I–I allocated $75 to $100 on food a week. And I bought chicken thighs in bulk, by the family pack, I bought–instead of going organic, I bought like a free-range kind of a local egg that was a little cheaper. I did tuna. I did salmon. I did some of them canned or I bought them, you know, bulk from Costco and I just, you know, bought a lot of like my spinaches, or my–my veggies either at the local Farmer’s Market or I just got them at Whole Foods or Trader Joe’s in bulk. And I was able to do it. Another big cost-saver was getting the–the veggies frozen, too. And that was a big help. And I buy the organic ones, too. And a lot of times, sometimes the fresh ones after they are a couple days’ old, you only get a day or two out of them. So unless you’re gonna eat them that night, it’s just not gonna work. So I barely had any money to my name when I was a–a college student, even a doctoral student, and it’s funny because in school, so many of the kids I went to school with are so unhealthy because they just weren’t allocating–they didn’t have the right priorities right with their food–with their life, right? They were putting it more into social or events and then letting, you know, their cellphone and everything else at the end. I didn’t even have a smartphone until I graduated because I’m like, well, I’ll put $120 a month into better food. So I lived it. I was in college for 9 years. So I kinda know how to do it. I was under the gun, so I prioritized it. So I could help people with it, I lived it, so now the key is if you’re under, you know, the gun financially, you can try to buy these meats. You can ever go free range if you have to. Good, better, best. You can do the frozen vegetables and if you’re hurting on time, too, like I’ll go after my last patient, I’ll go to the gym–well, before I go to the gym, I’ll throw some chicken thighs with the skin on in the oven, I’ll let it cook for 50 minutes to an hour. I’ll put some vegetables on low and I’ll leave it sautée very slowly with some coconut oil and sea salt. I’ll get a Mediterranean blend over at Whole Foods that’s frozen. I’ll let it sit on there for 45 minutes, go to the gym, come back, dinner’s ready. Five-minute prep time and then it’s back and ready to go and then I have it in Pyrex so then when it’s done, guess what? Put the lid on it. And if you wanna really get hardcore, again, if you’re a bachelor this works. If you have a wife or girlfriend, it won’t work, but you can just eat right out of the Pyrex and then put the lid on and you’re done and there’s no dishes, but you know, once you get family involved, you gotta put it on a plate. You gotta be a little bit more civilized, right? So I get it. Those are 2 options depending on where you live. I–I am little more civilized today now that I’m married, so I put it on a plate and get my nice silverware out and cut it up, but before that wasn’t the case. So that gives you some options how to do it easy and kinda use the in-between time. Use the time you’re at the gym or use the time you’re showering at night and getting ready for bed. Use that time and it doesn’t take more than 5 or 10 minutes to prep. That’s it.
Evan Brand: That’s good advice.
Dr. Justin Marchegiani: Anything you wanna add, Evan?
Evan Brand: No, I mean, not, it’s just funny that you’ve–you’ve been there, done that, because I–I’m still, when Hannah’s gone and I’m at home working, you know, from the home office, I’ll go eat out of the Pyrex but when it’s home for dinner time, I gotta pull it out and put it on a real plate. It’s just hilarious you called that out so accurately.
Dr. Justin Marchegiani: Oh, Pyrex is the best invention. I remember in school, in doctorate school, we–a couple of colleagues and I, we’d sit in the back at the lectures and we pull out our Pyrex and everything will be slow, like the silverware will kinda be in the bag and you kinda like jingling and everyone would just turn because we’d be the guys in the back of the room eating our organic meal during the lecture. And you know, we’re always trying to multitask because I can eat and learn versus then taking my lunch time to have to eat. I can do it during class. So I always try to multitask with food. And if you take these principles, you know, with the cooking and cook while you’re showering or cook while at the gym, you can save a lot of time and you could still eat this autoimmune type of plan to start and then add some of foods back in once every 3 or 4 days after to see what works.
Evan Brand: Yup.
Dr. Justin Marchegiani: Anything else you wanna add, Evan?
Evan Brand: No, that was great.
Dr. Justin Marchegiani: We’ve broken it down pretty well, right?
Evan Brand: Yeah, yeah. I mean, sure I can blab, but I think that was great coverage there.
Dr. Justin Marchegiani: Hope everyone listening to this enjoys, we try to provide real-world examples, and just know when you’re listening to us, we apply it. You know, we’re the real deal, you know, we’re going through, we’re doing it, we’re practicing it. One, so we know it, and two, so we can be an example and so our authenticity really shines through in the–in the podcast.
Evan Brand: I will say I–I had a consult with a girl this morning and she was talking about how she had been to several different naturopaths. She lives in Hollywood and she had been to several different naturopaths there and none of them, ever, ever, ever addressed the diet. She said that she was put on a liver detox program and she was put on some digestive enzymes that did not include betaine and she was set on her way and a thousand dollars later, she never had follow-up, she never got better. And that’s–that’s mind-blowing to me that there’s so many people out there that are out of the conventional model because, you know, everybody is demanding it nowadays like this is where this is the future of medicine is going.
Dr. Justin Marchegiani: Yup.
Evan Brand: And it–it has to because, you know, the patients are demanding it but it’s amazing that you can be out of that conventional model and still be so far away from the functional medicine model that we’re talking about and so many people are still dropping money and they’re–they’re losing their hope or their faith in this, for lack of a better word, alternative system that is kicking so much ass if they would just find this sort of realm that we’re talking about today as opposed to the naturopath–conventional naturopath where you just throw a homeopathic remedy or et cetera at the problem and hope it goes away.
Dr. Justin Marchegiani: Yeah, I mean that’s analogous to seeing a contractor building a house without a foundation.
Evan Brand: Yeah.
Dr. Justin Marchegiani: It’s like, “Oh my God, that thing’s gonna blow away.” Right? It’s gonna be so rickety inside there and it’s the same thing. So make sure your doctor’s always emphasizing a good foundational nutritional base and again, remember if you’re diet even is perfect but you don’t have the digestive capacity to break it down because of low stomach acid, low enzymes because of maybe an infection or SIBO or H. pylori or fungal overgrowth, you gotta get that fixed, because even that could really prevent the diet piece from optimizing itself because you just–you can’t break down the food into its constituents so you can encompass them into your metabolism.
Evan Brand: Yeah, even adrenal stress. I mean, if people are trying to eat on the go or they’re not really paying attention, their scrolling on their phone while they’re trying to eat and you’re not actually giving the signal down to secrete hydrochloric acid, that’s a big deal, too. So I try to tell people, “Look, sit down. Enjoy yourself. Take a breath. Ah, I’m so grateful for this food and then eat it.” As opposed to, “Oh yeah.” And then you move on to the next thing. Make it a point to like put your blinders on. I’m eating. This is meal time. I have to nourish my body. Okay, now I’m ready to go back to the busy world.
Dr. Justin Marchegiani: My man, my man. On that note, I’m gonna have a nice dinner or a nice lunch here–it’s lunch time here in Austin. Chicken with a–with coconut flour on it and some nice vegetables and some ground-up cauliflower and it’s a pre-made one from Snap. So I’m gonna do that, I’m gonna heat it up. I’m gonna have that and then I got a patient, so I’m–I’m ready to fuel myself for a–for a great Friday and to a good weekend here.
Evan Brand: That sounds good. I have bison steak thawed out that I have to cook and I’m gonna do some broccoli, some steamed–steamed broccoli, throw a bunch of pink salt and butter, and nosh it.
Dr. Justin Marchegiani: So the question is, are you gonna eat out of your Pyrex now that Hannah’s at work?
Evan Brand: No, this is gonna be on a plate.
Dr. Justin Marchegiani: Oh, okay, wow. You’re stepping it up.
Evan Brand: I’m gonna plate it today.
Dr. Justin Marchegiani: Okay, kudos, Evan! Alright, we’ll be in touch next week, man. Take care. Bye.
Evan Brand: Bye.