AIP Update: Week 5

I seem to be getting into a groove with cooking and eating AIP meals, but at the same time, I’m also starting to miss some favorites. It didn’t bother me at first to leave eggs or nuts off my plate, but now I’m feeling their absence. The lack of convenience foods has also made itself very noticeable—the jerkies and other shelf-stable meats I used to eat and which my family still eats are no longer options thanks to their nightshade content. So when I find myself needing a snack, I have a protein problem. Since it’s summer, there are plenty of fruits to snack on, and I always try to pair them with something to reduce the glycemic load, but that something tends to be more fat than protein—olives, avocados, or even a spoonful of coconut butter. My project for today is to make some chicken liver paté, fill it into serving-sized containers, and have that available for my snacks.

That all being said, however, I don’t need snacks as much as I used to, as AIP seems to be keeping my blood sugar quite stable. I like having an afternoon snack, but I can get by without it in a pinch. Last week, for example, I had a singing event that I had to leave for at 4pm, and I didn’t get home until around midnight. I made sure to eat a late, satisfying lunch, and I put some Anti-Inflammatory Meatballs (from The Healing Kitchen) in the freezer a few hours before I had to leave. I took the frozen meatballs plus some fruit and a ton of water with me. After the singing event, my choir went to dinner. I wasn’t able to order anything at the beer garden we went to, but I pulled out my meatballs and fruit, and even though it was much less than a normal dinner would be for me, it was enough to stave off hunger and keep up my energy for a long evening of socializing with my choir mates.

I’ve had some setbacks, too, however. My digestion hasn’t been great, and I’ve been wondering if it’s related to the fact that I’m eating a lot of plantains in one form or another. I’ve been journaling my food intake and symptoms, but I haven’t found a clear pattern yet. I’ve also had several days of massive fatigue—waking up after a good, long night’s sleep and feeling like I barely slept at all, and then having that feeling stick around all day. These days have been isolated incidents so far, but they’re really discouraging. I can barely concentrate on my work (or anything else), and my whole body just feels like lead. And the fact that it comes after a good night makes it all the more mysterious. One thing I think it may indicate is that I need to get a thyroid panel done again. Recent blood work revealed that my TSH is creeping up, but I need to have my doctor look at my other thyroid values to see what, if anything, is going on there.

This week, I’ve been trying to get more organized in the kitchen. Batch cooking is really helping me with having enough AIP foods on hand at all times, but since my husband and kids aren’t eating strict AIP (my husband is mostly Paleo, but our kids are not, even though they eat a healthy, whole foods diet), I find myself making multiple meals far too often. Since I’m doing 90% of the cooking, I’m basically burning out on cooking fast, so I’m trying to harmonize our diets more so that I’m making at most one side extra per meal instead of two entire meals in parallel. I’ll report back on how that goes!

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AIP Update: Week 3

I’m on week 3 of my journey on the Autoimmune Protocol, and I thought I’d give a little update.

The most noticeable difference for me is that I’m hungry! I struggle with my appetite a lot, which has meant that I’m often hovering around the point where being thin becomes being unhealthily underweight. While I do get hungry, it’s often not at meal times, and I frequently find myself feeling physically hungry while not having enough of an appetite to eat. And there are many times when I start eating a meal, only to feel uncomfortably full after eating only a small amount. When this happens, I tend to get hungry or feel weak soon after since it wasn’t actually enough food. So the fact that I’m hungry and have an appetite is huge! I’m eating more, and that’s great news, not least because I was worried I might lose even more weight on the AIP.

While I’m spending a lot of time in the kitchen, I don’t really feel like it’s more time than when I was eating just Paleo. I have finally gotten into the spirit of batch cooking, something I have been trying to do for years. Thanks in large part to my Instant Pot, I can make 3-4 pounds of meat at a time, and I am learning to double my recipes for sides as well (using my giant cast iron wok is very helpful for making mountains of greens at once). This means that I cook large batches a few times a week (our kitchen and fridge aren’t nearly large enough to hold the food that would result from a once weekly cook-up), and most meals are just varying combinations of leftovers, sometimes with one part of it made fresh (like a salad). This past week, I made carnitas with 3 1/2 pounds of pork (using the recipe from The Healing Kitchen), a double batch of plantain tortillas, a double batch of lamb meatballs from The Autoimmune Paleo Cookbook (what a genius idea to put lemon zest and olives in the meatballs!), a huge batch of braised chard, a batch of my AIP breakfast sausage, Mickey Trescott’s turmeric sauce, tzatziki also from The Healing Kitchen, and a huge batch of rhubarb compote (recipe coming soon!). With all of these meal components, I was able to mix and match meats, sauces and veggies, often supplemented by sweet potato hash and/or a fresh salad. The only time I felt desperate in the kitchen was late last week when I had run out of all my batch-cooked protein and I felt too drained after a long day to prepare some meat. My husband bailed me out that evening, but I still had a blood sugar crash and resulting migraine. Lesson learned: be prepared!

Lastly, my energy seems better. While I’m still getting a noticeable afternoon slump somewhere between 2 and 4 pm, I have found that once I rest a little, I’ve mostly had the energy to pick up my kids from school, come home, and get dinner on the table. And that is not a given. For the most part over the past two years, I have been able to make dinner if my kids come home from school on their own or my husband picks them up. Or I can pick them up, but then someone else has to make dinner, or we need to eat leftovers or takeout. But the past few days, I have been able to do both, and it makes me feel like maybe I just might get my life back with this diet and lifestyle approach.

Sleep Is My Kryptonite

I have struggled with insomnia since early elementary school. It was pretty much always my mind that got in my way—whether I was worried about something bad or excited about something good, I couldn’t seem to switch off my overactive mind well enough to drift off to sleep. It was normal for me to go downstairs hours after I had turned my lights off to tell my parents that I couldn’t sleep. Sometimes eating a snack helped, sometimes my mom would sing or read to me, and sometimes she even read out loud from incredibly dry, dense books to basically bore me to sleep (My first exposure to Homer’s Odyssey was from having it read aloud to me when I was still too young to understand 90% of it.).

This problem waxed and waned over the years, but it meant that I had to get pretty good at functioning on fairly little sleep. When I habitually went to bed late and got up early, I would get so exhausted physically that my insomnia basically disappeared. It was so freeing to be rid of those restless, wakeful hours in bed that I embraced getting only 4 hours of sleep a night throughout much of college. It even became part of my identity: Stephanie, the girl who barely sleeps and drinks her coffee stronger than anyone. I did catch up on sleep from time to time, occasionally sleeping 14 hours at a stretch and waking up completely disoriented, but I basically lived for many years on not nearly enough sleep. And for the most part, it seemed like I was functioning fairly well.

But not anymore. Now, not getting enough sleep makes all my autoimmune symptoms come back, literally overnight.

I’m not sure when it happened, exactly. In fact, I think it was probably quite gradual, but I began to struggle more and more to function when I got less sleep than I really needed. In the six months or so before I was diagnosed with MS, it got even worse, and anything less than 8 hours of sleep was misery, while I simultaneously found it harder and harder to sleep well. Nerve pain in my legs kept me up and made my sleep more restless. Waking up at night became a frequent thing, and once I was awake, I often couldn’t get back to sleep, as I would lie awake panicking about one or more things (most of which never seemed quite so panic-worthy in the light of day). Basically, my sleep had always sucked, but for a long time, I didn’t notice it having a huge impact on my life. That had changed fairly dramatically over a period of several years. And by the time I was close to getting my MS diagnosis, it had progressed to sucking in new ways that had a direct, extreme, miserable impact on my life.

So ever since then, I’ve been finding ways to sleep more and sleep better. Quite a few resources have helped me, the most comprehensive of which has been Go to Bed. Some of the things that I do regularly because they made a difference include:

  • No TV or other screens after 8 pm
  • Dim indoor lighting only after sunset, often accompanied by wearing amber-tinted glasses to block blue light
  • Keep my blood sugar stable (because some anxious 4 am awakenings turned out to be blood sugar crashes)
  • Write down everything on my mind before I go to sleep and then tell myself it’s there to be worried about during the day, not at night
  • A consistent bedtime routine that I stick to religiously, every night, to help my body realize it’s time to sleep
  • Go to bed earlier that I think reasonable even though I don’t want to

As a lifetime night owl, even in early childhood, the last point is by far the most difficult for me. But the price for missing sleep has become too high, so I really try to go to bed by 10, which feels ridiculously early to me. But the more often I do it, the easier it gets. I still can’t wake up at 6:30 feeling good. I don’t think I’ll ever be able to rewire myself to be a natural early riser. But if I get my 8 hours, my morning grumpiness passes fairly quickly, and I can actually make it through the day. But my night owl nature means that this is the part where I slip up most often.

Last night, for example, I came home from a really energizing choir rehearsal. I was wide awake, and my mind was active. I couldn’t bring myself to go to bed right away, and even when I did go to bed, I couldn’t calm down enough to sleep for quite a while. So I ended up reading until 1:00 am. And today? It’s not just that I feel like I got 2-3 hours less sleep than I needed. Today, I feel like a stiff, cranky old lady who can’t think straight. My nerve pain is back. I don’t feel like I could possibly go grocery shopping or cook my own food. And it’s discouraging because over the past couple weeks, I’ve been eating well, I’ve been getting gentle movement every day, I’ve been getting a daily dose of sunshine, and as a result, I’ve been feeling really good. It has felt like AIP is helping. It has felt like I don’t have a serious autoimmune disease. It has felt like I can live a normal life. But for about a week now, I’ve been getting just a little less sleep than I should each night—maybe just half an hour less. And then I had one night of less than 6 hours of sleep and all of a sudden, I feel like I have MS. I feel like it’s all too much. I feel like none of the other stuff I’m doing is helping, even though I know it is.

Not getting enough sleep makes me go from feeling healthy to feeling sick in just one night. All the MS symptoms that have faded into the background come back with a vengeance, literally overnight.

It’s easy to get discouraged. It’s easy to think I might as well eat whatever I want because I’m going to all this trouble and I still feel rotten. But that’s not it at all. I just have to get some sleep tonight. I just need to go to bed when my kids go to bed, and I know things will look less bleak in the morning.

What Is Paleo and Why Should I Care?

There are many, many smart people who have written fantastic pieces—ranging from short and sweet FAQs to entire books with hundreds or even thousands of citations—explaining the Paleo diet and what its benefits are. If you’re interested in learning more about the whys and hows, check out one of the websites or books listed in my resources section (coming soon!). If you’re interested in my take, this is how I see it:

If you’ve ever been to a zoo, you’ve probably thought about whether the animals kept there can really thrive in cages, tanks and enclosures much smaller than their natural habitats would have provided. You may have seen giant cats pacing their cages or wondered how an antelope could possibly have enough room to run in its enclosure. You may have heard about how rare it is for pandas to breed sucessfully in captivity. Or you may have visited a zoo or wild animal park that goes to extra lengths to ensure that the immediate environment in which each animal is kept is as close as possible to that which they would encounter in nature. And whether the facility was large or small, you would expect the zookeepers to feed each animal a diet that most closely approximates what they would otherwise be eating in the wild. In other words, you wouldn’t expect a lion to eat grass the same way you wouldn’t expect a zebra to eat meat.

So what do humans eat in the wild?

Well, we don’t really have a lot of current examples to go on, but it should be obvious that “wild” humans don’t eat Twinkies and McDonald’s. Most people can agree that these things are not good for us, and that while we may be able to digest them, they do nothing good for our health. Humans have been around for 2 1/2 million years, give or take, but highly processed food in its current forms has only been around for a few decades. Even minimally processed food has only been available since roughly the 1950s. So what if we all just followed Michael Pollan’s advice to not eat “anything your great-grandmother would not have recognized as food?” Would that be a “wild” human diet?

Not really. And here’s where the Paleo diet really comes into play. It’s not just processed foods we’re not equipped to handle—it’s all kinds of manmade foods, including those that still seem quite natural. For the vast majority of the existence of human life, there was no agriculture to speak of. Humans hunted animal foods and gathered plant foods. But they did not harvest grains in large enough quantities to make anything resembling bread. They didn’t run around chasing wild cattle trying to milk them. They did not have steady access to sweet foods, since fruit was only available for a few months and honey had to be stolen from its makers. They were not vegetarians by choice—when they had the opportunity, they hunted animals and ate them, nose to tail.

Of course, compared to our lifetimes, agriculture has been around for a long time—about 10,000 years—but that’s nothing compared to the 2 1/2-million-year lifespan of the human genus. While there have been some genetic mutations in certain populations that enable better digestion of agricultural foods (the ability to digest lactose beyond early childhood among people of European descent is one good example), we haven’t changed nearly enough over the past 10 millennia to really be equipped to handle grains, dairy, legumes and all that sugar. And we certainly aren’t equipped to handle them in such large quantities and processed forms. We may not get acutely ill upon eating a bagel with cream cheese (unless we have celiac disease or a severe milk allergy), but these foods are a burden on our bodies in subtle ways that can lead to a lot of inflammation and damage over time.

So the Paleo diet removes these “new” foods while adding more of the ones most of us don’t get enough of, especially vegetables and less popular animal foods like organ meat. In a Paleo diet, you stop eating:

  • Grains, both gluten-containing and gluten-free varieties, which also includes corn
  • Dairy (A “Primal” diet would allow full-fat dairy according to individual tolerance.)
  • Legumes, including peanuts and soy
  • Refined vegetable oils (think canola, sunflower, corn, soy, peanut, etc.)
  • Refined sugars

You also emphasize the following foods:

  • Vegetables
  • Grass-fed and pastured meats
  • Wild-caught fish and seafood
  • Organ meats

So why should you care about Paleo? If you’re healthy and feeling great, there may be no reason for you to try it out. But if you have any health problems rooted in inflammation (and most health problems are inflammation-related), you might just be able to improve your quality of life by adopting a Paleo-style diet.

While the Paleo diet is sometimes called a “caveman” diet and the reasoning behind it has a lot to do with what our paleolithic ancestors ate, there is plenty of modern science to back up the claim that this way of eating is health-promoting, with new studies being published all the time. This science focuses less on what our ancestors ate and more on the effects on the body of eating certain foods—especially, but not only, the metabolic effects. If you’d like to delve into the scientific underpinnings more, I recommend checking out Robb Wolf and Sarah Ballantyne, both their blogs and their books. The Internet is also full of anecdotal evidence—testimonials by people with all sorts of health problems who experienced improvement after switching to a Paleo-style diet.

I switched to a Primal diet (meaning I went Paleo but continued to eat full-fat dairy) in 2012 in an effort to get my migraines under control, and within two weeks I was experiencing 75% fewer migraines and had stable blood sugar for the first time in years. I’m not going to move into the wild anytime soon, but ever since I originally made the switch, I’ve been learning to pay attention more to what my primal genes expect me to eat and do on a daily basis, the many factors in my life that are entirely incongruent with those expectations, and what I can do to close the gap as much as possible. Again, without turning into a caveman.

AIP Breakfast Sausage

P1160161Even before I started on the Autoimmune Protocol, just the thought of giving up eggs for breakfast was overwhelming. When I started eating a Primal diet in 2012 and gave up my beloved pastries, bagels, müslis and other breakfast favorites, eggs were what saved me from morning starvation. There were plenty of tasty ways to make eggs—many of which included bacon!—so I didn’t feel deprived. But now, faced with the idea of no longer eating eggs, I knew I would have to find a reliable substitute again. It would need to be something that tasted good enough for me to eat on most days without getting bored. So I adapted a Paleo breakfast sausage recipe to make it AIP-compliant, and it tastes so good that I’ve already gotten several friends hooked on it! I pair the sausage with various veggies, sweet potato hash, and sometimes just a green smoothie. The sausage tastes especially good with sauerkraut.

I use ground pork for these because to me, it’s the meat that pairs best with apple and sage flavors, but you could use beef, lamb or bison if you prefer (UPDATE: I recently made these with beef and did not like the results! I still think pork is the best, and for an alternative, I’d suggest turkey or chicken, not beef.). I haven’t tried it with turkey or chicken, so I can’t vouch for those particular combinations. If you end up trying them with a different meat, let me know how they turn out!

The apple in these patties burns easily if you turn up the heat too high while frying, so definitely use low heat when you’re making them the first few times. Every stove is different, so find the temperature that works best for you.

I know a lot of people like to batch cook things like meat patties. I don’t. I’m not sure why, but I just don’t like the flavor of reheated meat patties (whether they be breakfast sausage or burgers). But I do make them in batches—I just freeze them raw and pop them onto the skillet when I’m ready to make them in the mornings. It takes them a bit longer to cook from frozen, but I think it results in a better flavor, and it gives me plenty of time to get my kids ready for school while the sausage is cooking in the skillet.

Recipe: AIP Breakfast Sausage

Makes 14 sausage patties

Ingredients:

2 lbs ground pork

1 apple, cored, peeled, and grated

1 heaping TBL sea salt

1 tsp powdered ginger

1/2 tsp mace

1/2 tsp fresh rosemary, finely chopped*

1 tsp fresh thyme, finely chopped*

2 tsp fresh sage, finely chopped*

*If you don’t have fresh herbs, you can use dried herbs, but you should halve the amounts given here.

Method:

Combine all the ingredients in a large bowl and mix with a fork or your hands. If you’re lazy like me and you have a stand mixer, you can use the paddle attachment to get an even mix. Form the mixture into patties in the size you desire—I make mine about 2 1/2″ in diameter, which gives me about 14 patties. Fry up any patties you want to eat right away in a small amount of lard, bacon fat or coconut oil and freeze the remainder flat on a tray. Once they’re frozen, put them in a freezer bag for storage in your freezer. When you’re ready to cook them, just pop them onto a preheated skillet and fry them on low heat, covering with a lid at the beginning to facilitate them cooking all the way through.