The Nutrient-Dense Kitchen: Applying the Autoimmune Protocol [transcript]

Written by Christopher Kelly

Nov. 29, 2019

[0:00:00]

Christopher:    Mickey Trescott, thank you so much for joining me here at the Ancestral Health Symposium. I am delighted to be recording with you in person. Tell me about nutrient density. Why should anyone care about nutrient density? What is nutrient density?

Mickey:    Yeah, thank you so much for having me here, Chris. Nutrient density basically refers to the nutrients that a food has, relative to the calories that it has. It's a way of looking at the flip side compared to energy density of a food. It's how many nutrients that food has, either a spectrum of nutrients or a quantity of a nutrient. 

    It's not really like a yes or a no, if a food is nutrient-dense or not, you can argue a lot of different angles, but which food have those highest quantities of certain nutrients which we can get into, can be micronutrients like vitamins and minerals. It can be things like fiber which we're less good at quantifying, and even things like phytonutrients which we don't quantify at all, and things like that, different fats.

Christopher:    I'll take a step back, and I'll say a few more words about Mickey. Mickey was the first person to produce a useful resource for my wife, Julie. What was the name of that, Autoimmune Paleo…

Mickey:    The Autoimmune Paleo Cookbook.

Christopher:    Cookbook, and I don't think it was even available as a physical book at the time my wife purchased it.

Mickey:    That's way back. 

Christopher:    Yes, way back.

Mickey:    It was like in 2012.

Christopher:    Yeah, 2012. This was the book that my wife used to recover my health and, yeah, you've got a very special place in our heart for that reason.

Mickey:    That's awesome. That's sweet.

Christopher:    You've since gone onto bigger and better things with Angie, and the brand is Autoimmune Wellness?

Mickey:    Yes, yes. I started blogging personally with my own story with autoimmune disease about eight years ago, and I wrote that Autoimmune Paleo Cookbook because I had a background in cooking. Obviously I was doing these AIP crazy things for myself. There were no recipes for it yet. I started with an e-book and then self-published a cookbook. 

    Angie and I met just through supporting each other through our blogs. We were trying to inspire the same community, and we thought that it would be better if we did it together. So we collaborated and created Autoimmune Wellness.

Christopher:    Good for you. Tell us a little bit more about your autoimmune journey. How was the diet important for -- that's the thing that's almost really confusing for me when I met AIP celebrities in person is you always look fantastic. I thought these people were supposed to be chronically ill. They're not at all.

Mickey:    Yeah, that's interesting. I was 26 when I was diagnosed, and I had been searching for about a year which is, on the autoimmune side of things, pretty early actually to get a diagnosis. Autoimmune patients --

Christopher:    What was the diagnosis?

Mickey:    Hashimoto's and celiac. Autoimmune patients usually go an average of 4.6 years to get diagnosed. I got actually relatively quick diagnosis but then I actually needed six doctors to get diagnosed which is pretty typical for people.

Christopher:    Was is it the same doctor that diagnosed both autoimmune diseases?

Mickey:    Yes, yes. So, by the sixth doctor, I had identified that I was hypothyroid. I looked the way that I look now. Of course my skin and my eyes and my expression and my body composition was a little different, but I was more or less the same shape, a young woman. When I went into the doctor's office, they said, "You don't look like someone that can be suffering from this disease." That's how I was dismissed over and over and over. 

    Because a lot of doctors have a picture of what they think hypothyroidism looks like and when they have someone coming in, complaining of hair falling out, cold hands and feet, low energy, just like bone-crushing fatigue; they think that you can't possibly be experiencing this without some of the other symptoms that they think is a hallmark of hypothyroidism which is weight gain. I hadn't gained weight.

    So, once I educated myself and learned that I had all these symptoms of thyroid disease, not every single one, but my body temperature was 93, 94 degrees on average, 24/7.

Christopher:    Wow, that's freezing, isn't it? That really is cold.

Mickey:    When you go in, to have them say, "Oh, no, it's not your thyroid," it was shocking. So, by the sixth doctor, I demanded antibody testing. Because the previous doctors had tested my thyroid, they had not tested antibodies.

Christopher:    How did you even know to ask for that?

Mickey:    Just by Googling, looking at support groups.

Christopher:    What year was this?

Mickey:    2011-ish, and just learning that thyroid patients were often dismissed, that doctors often didn't order the right lab tests. There was this thing called Hashimoto's. By the time I got the Hashimoto's diagnosis, I knew that's what I had because I had researched. I said, this has to be what I have. Of course the antibodies were positive, and the doctor thought, let's test you for celiac antibodies which was super smart. I was really grateful. The transglutaminase antibodies came back positive. It was like a two-for-one, but from that point on, I got sicker.

[0:05:01]

    I had been vegan for ten years before that point. I had asked every doctor if my diet was contributing to my illness. They all said no. I had done gluten-free. I had done an elimination diet but not a Paleo style or not an AIP style. I had identified that gluten was obviously the problem. I had celiac disease. After I got that diagnosis, the doctor said, "There's nothing we can do. You don't need thyroid medication. You're already on a gluten-free diet. Keep doing what you're doing."

    Those three months after were just a disaster for me. I was at the hospital three times. I had horrible pleurisy which is an inflammation lining the lungs so every breath that I took was sharp and painful. I had joint pain and muscle pain and fatigue so bad that I couldn't get out of bed. I lost my job. I started slurring my speech. I would fall over if I needed to pick something up off the floor. I was so uncoordinated and dizzy. I lost feeling on the left side of my body. I could go on and on. 

    I was terrified. I was convinced I was going to die. That was what led me to finding out about Paleo Ancestral Health and eventually AIP, was just looking into what do humans need because there's something I'm not getting, and that's the rabbit hole that led me to where I'm at now, recovering my health.

Christopher:    Is your story typical? You've grown a large community. I've heard you speak on several occasions. You think the community aspect is very important? Is your story typical? Is that serious?

Mickey:    No, it's not typical. I think vegetarianism and veganism really set me up to experience illness in a much deeper way. I see a lot of people in my community that suffered a low-grade for a far longer period of time. I suspect I would have been in that situation had I at least been eating meat or animal products to get that basic nutrition. 

    Because when you're dealing with an autoimmune disease and then you're also dealing with deficiencies of zinc and B vitamins and iron and the fat-soluble vitamins, those are all critical for tissue repair and immune system function. That was a major, major player for me and so I would say that most of the population, even a Standard American Diet is incredibly nutrient-deficient, but a vegan diet is taking it to the next level. I think that's why I got so sick.

    That being said, there are stories of people out there who have actually been far sicker than me that have recovered using AIP. Now that we're eight years in, I think more people are feeling "normal," able to hold a job, take care of their families but just feel terrible throughout all of it. 

    That's a very common picture where especially young women are who I speak to a lot because I'm a young woman, I have a voice in this community, just feeling like they're aging faster. Their bodies are just not feeling as energetic and as strong as they should be.

    A lot of those nonspecific-type symptoms are really dismissed in our medical community when people go in to seek help. So, yeah, I don't know if that quite answers the question, but everyone has a different journey.

Christopher:    It does answer the question. It's interesting to think about that, that when you have a serious health problem, it brings things to a head quickly. It's like either do or die.

Mickey:    Yes, and there's actually a lot of value in that. I don't know that I would ever have stopped being vegan had I not had such a severe health crisis because it was very close to my heart, and it was very important to me.

Christopher:    Yeah, how many people are walking around with a low-grade IC? You can't know what you could feel like. It's only in the absence of symptoms do you notice the difference.

Mickey:    For some people, that low-grade IC isn't worth the learning curve of actually implementing some diet and lifestyle practices that will make them feel better. They just don't know how to get over that hump because the IC, it's just not motivating enough. Right?

Christopher:    Yeah, absolutely. What autoimmune diseases have you -- I mean, I know you're not a doctor, and you don't have a ton of data showing antibody levels changing over time, but do you have any sense, any feel for which autoimmune conditions responds the best to the protocol?

Mickey:    So, over the years, of course we have lots of anecdotes. I've got lots of friends, other bloggers, I know obviously the people that I'm really connected to, the clients I've worked with, other providers that I work with, there's lots of anecdotal picking up different data points. Different autoimmune diseases have different ways you can work with, how the autoimmune protocol might help. 

    The focus that I like to think about when implementing something like AIP is what nutrients a person might need specific to their condition. If they have a skin condition, if they're really good at incorporating nutrients that affect the skin, like fat-soluble vitamins A and D, zinc and vitamin C which are co-factors for collagen production, collagen and bone growth.

[0:10:13]

    So, someone can do AIP in a way that doesn't really take that seriously, or someone could do AIP and really add all those extra things in. It's less about how AIP works for a particular condition but how someone's understanding of their condition has enabled them to get more mileage out of something like AIP.

    Like that psoriasis person, I've heard of the psoriasis people that skin conditions can take a lot of time to heal because the skin is such a large organ, and it takes a lot of nutrients. When the skin is repairing itself, it's going to hog up a lot of resources, and it's not going to be something that all of a sudden turns around.

    On the other hand, something like rheumatoid arthritis where pain is a big issue in the joints with inflammation, people with RA tend to turnaround pretty quickly. It might be a matter of weeks with someone with joint pain versus a matter of months for someone with psoriasis. I think those differences are just on how the body breaks down those different tissues. 

    Hashimoto, which I have, can be tricky. It can take a long time for some of the really big changes that people are looking for to happen just because it takes a long time for the body to balance out all those hormones. There's a lot of feedback loops and different things that are affected when you're working with the metabolism.

Christopher:    Why is the autoimmune diet not a nutrient-dense diet anyway -- I mean, compared to the diet I was eating before, in particular when you factored in all the anti-nutrients I was consuming. Maybe there's something in the pasta that binds some of the nutrient elements that I might need to repair the damage then certainly the AIP looks very nutrient-dense, but obviously you must have seen a problem that worth addressing in a book.

Mickey:    I think one of the reasons why the Autoimmune Protocol works so well, a lot of people like to focus on eliminating triggers and sensitivities and foods with anti-nutrients, which I think is really valuable. It's part of why it works. The other part of why it works is because it is extra nutrient-dense. 

    It's actually the most nutrient-dense therapeutic diet out there. It eliminates all the foods that are non-nutrient dense or having anti-nutrients inhibit digestion of nutrients or dysbiosis which is going to interfere with nutrient absorption, but it includes the foods and actually encourages extra nutrient-dense foods, so things like seafood and shellfish and organ meats, colorful fruits and vegetables, all that kind of things.

    AIP is a very nutrient-dense diet, but there is a range in how people can implement it. There isn’t a requirement to eat a certain type or amount of nutrient-dense food. It's just, in the beginning, it was talked about in a way that these foods are important, and the people who were doing AIP were, like me, very, very sick, didn't need their hands held. There were no resources out there. 

    I was literally thinking that I was going to die if I didn't figure this out. When I read the material that I was reading about nutrient-density, about bone broth, about organ meats, I jumped in with both feet, and I ate all those foods. I wasn't making AIP cake or brownies, whatever, these things that are just replacing whatever they're eating before.

Christopher:    Slightly different version of the shit that got you into trouble in the first place.

Mickey:    Exactly. I was eating meat and vegetables and broth, and repeating over and over and over. Even back then, I was really conscious about or our community was really conscious about carbs. It wasn't keto. It wasn't low carb. We were even being very careful about things like sweet potatoes and overdoing fruit. Everybody that I knew that was doing AIP was doing extremely nutrient-dense, low glycemic fruits like berries. We were watching the things like sweet potatoes and --

Christopher:    Why was that? Was that because of some particular plant compound or were you just worried about -- 

Mickey:    Because there was a lot of information at that time. Even Paleo was carb-phobic in the beginning. It was pre keto's explosion, but it was even before potatoes were considered Paleo. Even in the Paleo community, it was like, don't eat a sweet potato. You might not actually be Paleo.

    So, a lot of people implemented AIP in a really nutrient-dense way in the beginning, and all of those people were widely successful. The people that I was really connected with, with diseases like MS, rheumatoid arthritis, different skin conditions, Hashimoto's, and so we were the ones that started writing and creating the resources. Fast forward seven, eight years, and now you can go to a grocery store and there are things labeled AIP.

Christopher:    No way.

Mickey:    Totally, and it's hard because I want to be supportive of the community. I want to have resources for people to have snacks and prepared food products, but those products tend to be the less nutrient-dense and satisfying more of the cravings for sweet things or starchy things instead of actually healing our bodies with real nutrient-dense foods which most often need to come from our kitchen, cooked at home, which is a really hard problem to solve.

[0:15:23]

    So, I decided to write The Nutrient-Dense Kitchen just to remind everybody, hey, I've been with this movement from the beginning, and I'm just going to give you guys a big reminder that nutrient-dense is important. I'm going to provide you with some material about why it's important, and not just for people with autoimmune disease.

    It's important for people that have kids. You want to feed your kids nutrient-dense food. Iif you're pregnant or thinking about becoming pregnant, nutrient density is important to you. If you're aging and getting old, nutrient density is important to everybody.

    You can layer it on any diet. You can layer nutrient density on keto or AIP. You can use it as a lens to view any diet. I think that's a cool way of looking at it. That actually opens it up outside our community too.

Christopher:    What are the biggest problems or most common mistakes you see within the community? I can kicks things off a little bit. What we see with our athletic population is they tend to under-eat. Any time you restrict food choices, people tend to eat less, and that seems especially prevalent on keto and AIP. We have these athletes that are training many hours per week, and they end up eating not enough food. 

    In particular, for some reason I've never really fully been able to get my head around, they struggle with ideas for carbohydrates. If you take away my white rice and my bread and my pasta then what the hell am I going to eat for carbohydrates? Of course there are starchy root crops. You mentioned sweet potatoes and fruit and all kinds of things that you can eat. You eliminated a couple of common food items, but that's just our funny thing, under-eating. What are the most common mistakes you see in the wider --

Mickey:    That's actually, probably big on our list too, is under-eating starchy carbs for people that actually need them. Some people do better on a lower carb, starch-free approach and actually feel triggered by starchy carbs. A lot of people will do an AIP diet, and they will just not even knowingly start doing keto and start eating greens and everything. Then they're like, I have headaches. I'm really tired.

    For people with autoimmune disease, they're coming at this from an angle where there's a pretty high motivation and pretty high symptoms and then adding something that's going to make them feel worse in some way is really off-putting, like when they're developing something new. Especially people with thyroid conditions, they've got to be real careful not to get too low on the carbs so encouraging them to actually incorporate the starchy carbs.

    A lot of these starchy carbs are foods that they may not be familiar with either. Sweet potato is probably the most well-known one, but it's, okay, taro, yuca, plantain. Maybe winter squash is a little starchy. Introducing them to some of those vegetables if they're not really a vegetable fan, they're definitely going to be missing out on that side of things. That's definitely something that we see a lot is people that under-eat the starchy carbs.

    Some people also, they want to replace whatever their blood sugar crash food was with another blood sugar crash food that tends to be AIP. There are some overlaps between diets. You can have a snack of a banana and some watermelon or whatever as AIP, and that's not really setting you up for success in managing your blood sugar. 

Christopher:    It's actually perpetuating the problem. 

Mickey:    These are the people that I see wanting to transition maybe cold turkey, pasting a list on their fridge, going out and going, well, what's AIP and easy? They just buy a ton of fruit and then when they get hungry in the late afternoon, they're just bingeing on fruit. They're perpetuating this blood sugar issue which can be a big problem for people with autoimmune disease. Instead of, what I recommend is to have a snack like paté and to have some paté and cucumber sauces or…

Christopher:    I remember your liver paté with bacon. So many people have copied that recipe now. You see it everywhere.

Mickey:    It's a good one. It's a good one. It has convinced many --

Christopher:    I'm sure it was new when you got it.

Mickey:    No.

Christopher:    It was new to me anyway at that time in 2011.

Mickey:    Totally, and I have one with apples too. I was actually just talking to a woman here today who was like, oh, it's still hard for me. I tried the bacon one. I was like, blow your mind, make the bacon paté and then also throw the apples in it because the more you're watering it down and you're making it more palatable. So, people can try that but having something that actually has nutrients that's going to give you energy when you're low energy instead of giving yourself sugar, starch, is just going to help manage that blood sugar. 

    I think a lot of people that come to AIP aren't necessarily thinking my blood sugar is out of whack until they cut out all these foods that they're eating in the wrong times of day and the wrong macronutrients. They go, oh, my gosh, why am I shaky? Why am I getting headaches? It's because you're not eating your croissant at 11 am anymore. You know what I mean? So, understanding that blood sugar management and fueling with nutrients is really --

[0:20:21]

Christopher:    Getting feedback, that's my thing at the moment. Where's the feedback? I definitely have that problem, was diagnosed as diabetic, a fasting glucose of 126, and I certainly have that lack of metabolic flexibility in terms of my ability to access stored fat in the fasted state and perpetuating the problem with poor food choices and measuring fasting, well, not fasting just fasting but glucose in general with the finger stick test was very helpful. Is that how other people are figuring this stuff out?

Mickey:    I don't think our community is that nerdy in general. 

Christopher:    Nerdy, I like that.

Mickey:    It's tricky because autoimmune disease is so prevalent, and people are starting from a level that a lot of times, Angie calls it Walmart AIP where it's just someone who, they're shopping at a big-box store. They don't know what a health food store is. They've never been to a farmers' market, but they're very motivated by their illness. They don't want another gadget. There are a lot of barriers to them figuring out how to cook and prepare and eat healthy foods. So, identifying what that barrier is for them and helping them get over that, it's tricky.

Christopher:    Is there an epidemic of people that are realizing they're going to have to cook? I know that you've mentioned --

Mickey:    Oh, my gosh. 

Christopher:    Do you still do the basket thing?

Mickey:    There's an epidemic of people who are learning that leftovers are okay to eat. That's a big eye roll for me.

Christopher:    That's the number one question is what shall I eat for breakfast? Well, whatever you had for dinner the night before.

Mickey:    I know. I know. People always tell me -- I'm really patient with a lot of questions, but like, "I don't like leftovers." I'm like, I'm sorry, that's not a problem. Having the money to afford nice, quality, organic food, having the time or the support in your life to cook, said, nice, quality, organic food and then not liking eating it two meals in a row, I'm sorry.

Christopher:    It's super weird, isn't it? That's definitely a learned thing. I'm sure you can unlearn it as well.

Mickey:    Yeah, exactly. So, if people want to cook, I tell them if they want to cook three meals a day from scratch then they're welcome to do so, but they're going to get tired pretty quick. They're not going to have time for anything else in their lives. Batch cooking really saves time, and there are ways you can work around things. 

    You can bank sauces in the freezer. You can do a big protein, a big batch of veggies and then pull out a sauce cube, pesto one day, curry the next day and just rotate through if you're someone who really can't handle the same flavor two meals in a row. It just takes organization. It's not an unsolvable problem.

Christopher:    Yeah. Talk about the, I was going to use the term behavioral science, but I realize that's completely inappropriate here. What we're really referring to is, in the recent study with Angie and Rob, you saw a zero dropout from the clinical trial, apart from one woman who got pregnant. What the heck! I've coached people on this diet. My wife has coached people on this diet. It's hard. It's really hard. Yet somehow, here you are, achieving the zero dropout rate. Is there something you know about behavioral science that I don't know?

Mickey:    Well, first of all, Angie's program is incredible, and she has been doing this for five years. She has seen thousands of people go through the program, and every single time she does it, she updates it. Her programming is meant to piece off implementation of AIP in such small and management chunks that by the time they get to the Autoimmune Protocol which is six weeks; six weeks later, these people that never thought they would be able to implement something like AIP, they're there because of all these pieces. Part of that is just the eliminations are phased and they're slow. 

    Week One, they only remove, I think it's gluten. I don't even think it's grains. It's gluten and nightshades. Second week, they do grains and dairy, so they add on the eliminations, slow. Every week, they're in a group together that has community. They have constant coaching. They have exercises where they're all making their meal plans for the next week. They're verifying ingredients of different things, coming up with meal ideas, supporting each other in these ways that when you do something in a community of people that are rooting for you and they're doing the same thing and you have someone to look to for advice if you have a problem, it's hard not to be successful when you're set up that way.

    Part of it is that the group health coaching model is really powerful, and getting people into small groups -- because AIP is really isolating. When we feel isolated, when we feel alone, when we feel like we're the only person doing this, we have to white-knuckle it then we have to use willpower. When it feels like we're swimming in the soup of everybody else is doing the same thing and we're in it together, it just becomes natural. It becomes easy.

[0:25:16]

Christopher:    Yeah, it's very interesting for me to connect the dots. Small and manageable changes that compound over time, it sounds a lot like the Seeds journal that Simon talked about on the podcast. 

    The problem we have with athletes in particular and people like them -- I wouldn't say we'd all identify as athletes -- is this kind of, when I find out about something, I'd go all in. Do you ever hear that? I go all in. If I can't start it this afternoon, I might as well not do it at all. Then when I go on a business trip next week and there's no AIP menu and I don't have my kitchen then damn it all to hell. I'm not going to do anything. Is that just a weird me thing or --

Mickey:    Yeah, and everyone's personality type is different. We encourage a lot of people to dig into their personality type. I'm really into personality lifestyle, so we can go down a real deep wormhole right here, but something as simple as Gretchen Rubin's Four Tendencies, are you familiar with that framework?

Christopher:    Yeah, I am. I question it because what's it based on? Isn't that something that she just made up? Or is that based on behavioral science literature?

Mickey:    I think she made it up, but I think she has some pretty cool categories that I have seen in working with clients and in myself. Understanding what your tendency is, like I'm an upholder, so I need internal and external expectations pretty easily.

Christopher:    The other thing I question about it is this very fixed mindset. I'm a particular type in all situations for all perpetuity. That just cannot be true. It's too simple.

Mickey:    Yeah, I'm with you on that, but I also understand that like for an obliger, and a lot of people are obligers, they need external accountability. Identifying when someone is the type of person that they can take on a change and they can self-manage that change, I'm that type of person. I discovered AIP, and I'm like, I'm doing this. The next day I did it and it was never hard for me. 

    When people ask, "Well, what did you do when you talked to your friends?" It's like, I don't know. I said I'm doing this thing. It wasn't hard for me. I realized that my personality type is very different. It sounds like, for you, if you find out about something and you're all in, you're not the typical person there who is always looking outside for people to create structure, whether that's in their work or whatever. 

    That's the majority of people in the world are going to need some external accountability. How do you build that structure for the people that actually need the accountability or people that question, understanding that they need to go through a whole questioning process of understanding why they're doing something. Otherwise they're not going to do it. 

    If a medical study is going to help them understand that this actually works, the science is there, that might satisfy a questioner. Then they go, okay, I'm all in now that I know that there's actually research behind this or that I know that other people have done this and it has worked for them. Until they reach that point, if someone just tells them to do something, they might be like, eh, I don't know.

Christopher:    Have you never run into the loser-avoidance bias? You can tell I've been hanging out with Simon too long, the loser-avoidance bias. Imagine you have this group of accountability. Everybody is going to check in and you're going to talk about what you've achieved that week or whatever, in a group. What people tend to find is that when you fall off, there's this loser-avoidance thing. It's shameful to go back to the group and admit that you didn't do the thing that you were supposed to do last week. It's so polarizing. You then, rather than forcing you to stay part of the group, it forces you away. 

Mickey:    Yeah, that will actually be a really good question for Angie because she's in the groups, and she's running them. I know what you're talking about from experiencing it before in other setups. 

Christopher:    Start-up, I think I can show in the show notes, the example of a fitness start-up that failed because they failed to know that there was such a thing as an avoidance bias.

Mickey:    Yeah, but part of it is, why are people in this group? They're in it because they have a health problem that they really want to take care of. That's going to be a different motivation than groups of people, for other reasons, but usually that's a very vulnerable thing to be sharing with a group of people. My understanding is that the connection that people get through being there and working on it together is very positive and everybody is rooting for each other and pulling them back in when they see them slipping.

Christopher:    Have you heard about any in-person meet-ups? I love the idea.

Mickey:    Yeah, we had one just right now.

Christopher:    Okay, that's great.

Mickey:    Yeah, we were down in the courtyard there. We had the San Diego AIP group and one of the San Diego bloggers.

Christopher:    Oh, that's fantastic. Tell me all about this. I'm all for technology. As you know, I've got a degree in Computer Science. I love my coding and stuff. Cal Newport talked about in the podcast recently that maybe these technologies are best used to facilitate real life, in-person meet-ups.

Mickey:    Yeah, so one thing that we noticed over the years was everything went so virtual. We couldn't find community in real life because there aren't very many people doing what we're doing in real life. So, we felt very disconnected. That's how Angie and I got together. We started a blog. There's a whole blogging community of people that we're connected to, social media, but it's all the same is in-person connection.

[0:30:14]

    So, we noticed a bunch of groups popping up all over Facebook and so we advertised, if anybody, someone in San Diego, someone in Denver, someone in New York City, they start a group, they give us the link, we publish it on our website. Now we have over 100 groups all over the world. We have groups in London. We have a group in Egypt. We have Southeast Asia. We have Australia. In the United States, most states have more than one group. Here in California I think there are three or four. 

    Those groups are to facilitate in-person meet-ups. The San Diego group has a few hundred members. We just met up with 15 or so. Someone will make a post, and they will all get together. They know each other. They share resources. They share doctors. They'll support the local businesses that are providing AIP food together which is really fun. So, yeah, definitely encourage that. I think it's a really cool part of the movement.

Christopher:    That's awesome. That's awesome. Is there something I can link to? Where's the main hub that people can find out about that?

Mickey:    There's a page on our website called Find Your AIP Community, and it's just a listing of all the groups.

Christopher:    Right. What about cooking? I see that as one of the main barriers, one of the main objections. If you don't know how to cook and you don't have a Julie that can cook for you, you're in a bad place there. You've really got to learn some basics. Have you ever heard about that, in-person meet-ups batch cooking together, teaching, cooking or --

Mickey:    Totally. Some groups will do more information sharing, and some groups will do picnics and potlucks where everybody can eat safe food together, which I've gone to some --

Christopher:    I'm sure when does that ever happen?

Mickey:    I know. I've been to some meet-ups where it's the first time that some of these people have eaten outside of their home in years, and they start crying. It's a really emotional moment because it is really isolating and so that's really fun.

Christopher:    I miss Mission Heirloom for this reason. Do you ever go to Mission Heirloom? There was this restaurant in the East --

Mickey:    Oh, my gosh, I don't have too much, I'm going to start crying.

Christopher:    Yrmis and Bobby, wasn't it? 

Mickey:    Yes, she's one of my good friends and, yeah, it's sad that they didn't make it work.

Christopher:    Yeah. It was a restaurant in Berkeley, and you could go in and order anything you want. It was all safe.

Mickey:    It was really cool. What they're trying to do is show the world that you can start with an allergen-free menu and then you can add things on that maybe some people can't eat. They had all their dishes were AIP by default, but then you could add on some wild rice or you could add on sous vide egg. It was an additive philosophy versus subtractive. Because whenever I go to a restaurant, I'm like, okay, I'll take this but leave off that, leave off that.

Christopher:    Throw away the bun.

Mickey:    It feels great. I'm spending 20 bucks on something that you just took 30% of the food off. I could have gone home and cooked myself some delicious rib eye or something for the same price. 

    Yeah, cooking is a barrier for people, but what I would say is you eat three times a day. Cooking is a skill that's going to serve every person for the rest of their lives. If you have the means to be the type of person that doesn't have to cook for yourself, great, but most people are not. Most people are going to need to learn how to develop that skill. It's not hard. You don't need a lot of tools. 

    If there are barriers even in mobility and joint pain, there are hacks that you can do. You could use a food processor to shred everything up instead of chopping things. One of the things that I wished I had done when I was very sick and I couldn't stand on my feet for very long, I couldn't chop for very long; everybody in my life was saying, "What can we do to help? What can we do to help?" I was like, there's nothing you can do. Yes, there's something they can do.

Christopher:    Chop some vegetables.

Mickey:    Come over to my house, I'll give you the recipe, and you can cook for me. Sometimes I say that to groups of people, and they're like, "Oh, yeah, that's what I should tell my neighbors and my friends that are trying to be in my life and help me." Then you can have some connection with them, some community, share some gratitude. That's what life is about, helping other people. So, yeah, cooking skill, everyone can --

Christopher:    Do you think part of the reason why -- I'm speculating here entirely with no insider information -- part of the reason why that restaurant failed was because it was in the middle of an area in Berkeley they called the Gourmet Ghetto, and it's surrounded by the world's most tasty food. You might accuse AIP of being less tasty in particular because it eliminates some of the spices that can be really good at making food tasty.

Mickey:    Yeah, that wasn't what it failed. I'll tell you exactly what happened. Their business model was a total success. They were slammed. I'm sure you noticed when you were there, you almost couldn't find a place to sit.

Christopher:    Yeah, it was busy.

Mickey:    People would travel from far and wide. They didn't have enough space.

Christopher:    I mean, if you thought this food would heal you, then…

Mickey:    Oh, God. Then they had the food in jars, so they had a whole takeout. The thing that was tricky is that it was created by people who were visionaries and designers and solving problems by coming up with a different solution and a different way of looking at something. So they created this restaurant but did things completely different from other restaurants in the restaurant industry. 

[0:35:12]

    Their intention was to bring on a partner and they could run it because they weren't restaurant operators. I think they went on their fourth operator, and it was unfortunate. It was like things that happened with partnerships with people that fell through over and over and over. Finally they were like, well, we actually don't want to run the restaurant. They got to the point where they didn't want to do it anymore. It's really frustrating --

Christopher:    It's a tough business. Restaurants are a really tough business.

Mickey:    It is. You need someone who understands operations. I have a history of managing cafes, and my husband has a history. We were trying to get in with them. It was frustrating for us because we all knew that this was a business that would work. It's just a restaurant takes someone who wants to be there every single day and run it.

    Bobby and Yrma saw the people that are like, okay, we want to solve this problem and then move onto the next problem and become a part of finding a solution to the next thing. They did what they could, and they showed the world that it could be done. It could be successful. 

    I've noticed a big shift in the types of food and the types of options that are available at all restaurants, especially in the West Coast, and definitely their influence is there, showing that there's a market for things like AIP and allergen-free, that people will purchase food that is really high-quality, really pasture-raised, wild-caught, organic, all of that. There is a huge market for that. People want it.

Christopher:    I want it.

Mickey:    Yeah, I know.

Christopher:    I just went to the Cultured Caveman in Portland. That place makes my heart sing. Again, it's you basically can't go wrong on the happen. That doesn't ever happen for me.

Mickey:    You can walk in, and you can get AIP food. You can get low-FODMAP food. They're great.

Christopher:    The woman, I forgot her name. 

Mickey:    Heather?

Christopher:    Is it Heather?

Mickey:    Yeah, Heather and Joe are the owners.

Christopher:    Okay, yeah, and they've been there for many years.

Mickey:    Oh, yeah, they're killing them.

Christopher:    She's still behind the counter.

Mickey:    I know. You walk in, she's behind the counter. She has got two kids now. They're just so invested in that business. They love their customers and they love serving the community.

Christopher:    It's fantastic food. It's super tasty. So if you're ever in Portland, make sure to make a visit to the Cultured Caveman. Talk about reintroduction. Is AIP forever?

Mickey:    No. Thank you for asking. The Autoimmune Protocol, a lot of people want to call it a diet. I don't like calling it a diet because it's not.

Christopher:    It's a tricky subject, isn't it, because --

Mickey:    It really is.

Christopher:    -- some people, when you say diet, they think of something temporary. When you say diet to me, I think the foods one habitually eats. It is forever.

Mickey:    Exactly, exactly. It's not a diet. It's a template. It's a protocol. However you want to think of it that way, it's a long-term protocol. Don't get me wrong. It's not something you do for a number of weeks, but one to three months in elimination and then you enter reintroduction which could last as little as a month or two. It could last as long as a few years.

    We haven't really defined the post-AIP reintroduction, like rest-of-your-life phase, but really what that is, is the diet that is ideal for your healing process. That might look like including more foods when you're feeling good, so, unfurling the sails, walking in the line a little bit to have some great experiences in your life, maybe when you're traveling or eating a really special restaurant. It might look like battening down the hatches, going back to home base which might be closer to AIP.

    That's what I do for myself when I'm done here. I'm going to go home. I'm going to have lots of bone broth. I'm going to have lots of paté. I'm going to have my safe foods. Even though I have a bunch of reintroductions, I know those are the foods that are going to make me feel the best, and I'm going to do that for a little recovery period until I have my next opportunity to live a little and have some things a little outside.

    It's not really black or white. It's not strict. It's not the same for everyone. It's whatever you make it. The process is an educational experience where everybody learns of what makes their body tick. It's going to be different for everyone.

Christopher:    Yeah, I think most people learn there's something they absolutely can't reintroduce. Right?

Mickey:    Oh, yeah.

Christopher:    And it changes over time as well.

Mickey:    Yeah, so, early on, for me, I reacted to all nightshades really early on. Even three years in, no nightshades. I reacted to them. Then something shifted. I accidentally had some spices somewhere, and I didn't have a reaction. I went, huh, and tried it again a few weeks later. I was like, okay, I didn't have a reaction. A few months later, I was like, I'm going to try this a little warm. I had something with jalapeno in it or something, no problem. I just kept going up the nightshades until I hit bell pepper, tomato, and then I got a reaction. I was like, okay, there's a spectrum here. I can have the potatoes. I can have some cayenne pepper. I didn't try eggplant because I don't like it. 

[0:40:07]

Christopher:    I don't like it either. What is the purpose of eggplant?

Mickey:    It's just a slimy, yucky food. I don't like it. I love tomatoes though. I keep trying to get close to the tomatoes. I'm at the point where if a cut tomato touches something, I can eat the thing it touched, but I can't eat the tomato, which is handy.     Last night I went to a restaurant, and they put tomatoes on my tacos. I just picked them out, and I know that I'm not sensitive to the level where -- 

Christopher:    You couldn't do that with a bun. If I sent you a burger, you couldn't throw away the bun and -- 

Mickey:    Oh, God, no. Or dairy, I'm allergic to even ghee which a lot of people think that because all the proteins are removed --

Christopher:    Yeah, that's what you would have thought, and the lactose is gone.

Mickey:    Exactly. I have an allergy that has not changed. Actually I have been allergic since I was a child, so I have a feeling that that's just part of my experience and with me for life, and I'll avoid dairy.

Christopher:    This is a really good example. You're here at conference, and you've got the stress of travel. You're away from all your normal habits and routines. For me, it's overstimulating. I actually have trouble sleeping last night because it's just a lot of stimulation. It's very relevant, very salient. I have trouble shutting my brain down. If I'm going to talk to people until 10:00 at night, it's really hard.

Mickey:    Yeah, it totally changes. I consider myself in more of in a stress state when I'm presenting or traveling or working like that.

Christopher:    It's a good thing.

Mickey:    Totally, it's hyper-connected. I feel really full on the social. I'm an introvert, and I work from home, so I don't get a lot of face-to-face. I get to have face-to-face with my friends, so I feel I'm getting a full feeling, I found, in this one part of my life that I don't get a lot at home. It's a little draining in the food part especially in eating vegetables and having broth with paté. I'm missing some of that nutrient-dense stuff. I go home. I'll recover a little bit.

    When I travel for fun and I'm more relaxed --

Christopher:    This is not fun.

Mickey:    -- it's the opposite. Well, it's opposites. I might eat foods that are a little more borderline for me because -- 

Christopher:    That's why it's going out with a reintroduction. Something like your nightshades, I know where my threshold of nightshades is but once I'm away traveling, that threshold might change. That's what I'm getting at here.

Mickey:    Exactly, exactly. I went to Europe last summer. I was probably the most liberal I've ever been with my diet as far as just eating things that I know either don't make me feel great or pretty far outside what I would normally eat. I was fine. I tolerated better.

    I think it's just because I'm away, less stress. I'm having these great experiences. I'm outside getting sun most of the time, getting a lot of activity, sleeping well. That's a formula for being more resilient. Everybody is going to know for them. Of course you can go on vacation and have a horrible time because of a flight being missed or whatever. You have to know, to read yourself when a good situation is. 

    For a celiac, I always have to be vigilant with restaurants. I can't be, oh, let's just go to any restaurant and see if maybe they can make it gluten-free. I'm never that person. Other people, that might be safe for them, but it's not for me. Once I get the restaurant that can provide me with food that's cross-contamination-free, pretty much anything else, even dairy. If I get a little dairy, I'm like whatever.

Christopher:    My least favorite question in restaurants is, is that a sensitivity, an allergy or a preference? Fuck you.

Mickey:    Yeah, I totally agree. I always say, "No, actually I have a disease." Actually I find it really hard in some places where it's really trendy to eat gluten-free. Actually I imagine this is probably a problem in Santa Cruz. It's a problem in LA where I have family. Because my family members goes, "Oh, you can eat this place and this place and this place. They'll have gluten-free things on their menu," but I've been to so many places where it is not safe for celiacs. They have a lot of --

Christopher:    How do you know? It would be very stressful if you've got this expectation that the food you're about to eat is probably going to harm you then there's a really good chance it's going to harm you regardless of what it is.

Mickey:    Exactly, exactly, you can totally prime yourself. Actually, with reintroductions, a lot of people do that. They think, oh, this is going be something that's really going to bother me, and they might fulfill that.

Christopher:    Whatever you think, you are.

Mickey:    Yeah. So, ask a lot of questions, I do a lot of repeat. Where I live in Portland, there are probably 20 or 30 restaurants that are in my friend's that are gluten-free they eat at. Here' the thing. That 20 or 30 on the list of people I was talking about, I probably eat at six. I just keep going to the same six ones that I know I could be getting food -- I learn from experience. They can give me safe food. It is exciting to me because part of it is, I'm a cook. I'm not going to go spend 25 bucks on something that is like a pile of lettuce with grilled chicken breast or something.

Christopher:    That's what I did yesterday at the True Food Kitchen. I paid $30 for one breast fed patty with a piece of lettuce.

Mickey:    If I'm meeting a big group of people then to me that's worth it, but if I'm going to try and get a meal, uh-uh. I can do it better at home. So I have my places where they cook interesting food, stuff that I don't cook at home, stuff that's safe, and I just tend to hit up the same places.

[0:45:10]

    When I travel, like LA, I know the places that I go. Here, I ask the AIP group, the local group if they had recommendations, and they came back with two or three places in San Diego that are really safe for celiacs. We ate at True Food Kitchen. We ate at Nectarine Grove last night. 

Christopher:    You trust the True Food Kitchen then even if it's fancier the price.

Mickey:    True Food Kitchen is a little dicey for me. It's like Whole Foods hot bar which is also dicey.

Christopher:    Interesting. I used to think I was celiac. I was never sure. I quacked like one. I walked like one. I never got a diagnosis. I'm pretty sure I'm not now just because of a couple of things that have happened that nothing -- for example, I had a gluten-free beer, Primal, in Santa Cruz. I'm like, this is the best gluten-free beer --

Mickey:    Oh, was it a gluten-removed beer? 

Christopher:    It was a regular beer. I said, "This is the best gluten-free beer I've ever tasted, no doubt about it." Then I'm like, "Oh, no, that's --

Mickey:    And then nothing happened.

Christopher:    Nothing happened.

Mickey:    Yeah, the last time I got glutened, I was hanging out with my brother and we had a bunch of beers. There's a gluten-free brewery in Portland called Ground Breaker, and they do some really fun stuff with chestnuts. They're really artsy about it. They have some great beer.

    I bought some of that, and I bought some regular beer. We were sitting around the table. I picked up his beer and took a big swig. I knew right away. I was like, that is not glute-free beer.

Christopher:    It tastes good.

Mickey:    I think Ground Breaker tastes great. For the record, I love them, but it did definitely taste like real beer. I was like, oh, no, what do I do?

Christopher:    Activated charcoal, I don't know. Would that work?

Mickey:    I didn't know. I was having this panic of, okay, if I threw up, would it help? It's liquid. I left it. I got sick. I was sick for two weeks. It took 24 hours to start getting the symptoms. That 24 hours, I was a wreck, waiting in anticipation. What's going to happen? When is it going to happen? We were on vacation. When is it going to happen? Is it going to happen when we're -- it's part of being celiac, but I did it to myself which was weird. Usually, we eat at a restaurant. I start feeling weird. I'm like, is it or was it? I don't know.

Christopher:    That's awful.

Mickey:    There's always that, maybe it's not. Maybe I'm coming down with something. I try to rationalize and be like, well, I don't think I got glutened. I think I just feel a little sick or whatever, which helps me get through, but when I drank the beer, I was like, that was beer. I know I'm going to suffer.

Christopher:    Yeah, I've seen this repeated, the experiment, several times actually in the UK, which is to my delight because I always was a regular and a lover of the some of the wonderful craft beers that they produce in the UK. They produce really good craft beers all over the world, but it was almost really sad to pass up on a really good summer bitter in the UK, served draft in a pub.

Mickey:    My husband is not celiac, and he is gluten-sensitive, very gluten-sensitive. He has had the experience where one day he was like, screw it, I want Coors, and drank Coors. He's fine. He was like, I'm going to go look up how much gluten is in Coors. He actually found out that some of those really cheap beers, they actually have less parts per million/, gluten than -- 

Christopher:    Is it knowable then?

Mickey:    Yeah, there's people on the Internet -- there's a guy who has a whole spreadsheet that has all the cheapest beers on it or at the top. Coors has the least gluten. It's less than ten parts per million which actually the gluten-free-marketed gluten-removed beers, actually have less than 20 parts per million. They actually have more gluten in them, the ones that are marketed as gluten-free. They'd be horrible for someone like me with celiac. I know through the labels --

Christopher:    Do you know how many parts per million you're going to be in?

Mickey:    For a celiac, it's like 0.1. I don't know. The gluten-removed beers, they're brewing beer with wheat and then they're straining it. It's going to make a celiac sick. For someone like him who is gluten-sensitive but maybe at a very, very low, less than ten parts per million, apparently it doesn't affect him.

Christopher:    It's not because they've removed the corn or something?

Mickey:    I think it's a mix. I think it's a mix. It's not gluten-free. That's for sure. I don't want anything to think cheap beer is gluten-free. It is so important but if you're someone who just want a reminisce and have a PBR once in a while, remember your college days. That was a funny revelation which, when you're traveling, go out if you can have it. My philosophy is why suffer through denying yourself something that's going to give you the experience of enjoying something while you're traveling in a healthy way if you're not actually sensitive to it?

Christopher:    Right, doesn't make any sense. You're having people eliminate alcohol in the beginning in the protocol.

[0:50:06]

Mickey:    Yeah, AIP is alcohol-free. It is a reintroduction in two ways. In Stage Three is -- I might be wrong. It might be actually Stage Two, but I think it's Stage Three, we reintroduce small quantities of alcohol. This might be like a few ounces of wine. The gluten-free beers, people should wait until Stage Four because they're usually brewed from other grains that sometimes people have problems with corn, so that's Stage Four.

    Also in Stage Four is more quantity of alcohol. Someone could have what is one normal drink and see how they feel. I've learned that I'm someone that I can have about half of a drink or one drink over a very long period of time, and I'm fine. If I drink a cocktail that doesn't have a lot of sugar in it or a glass of wine, the whole glass of wine, it's too much for me, in a short period of time.

Christopher:    I was talking to one of my friends, John. He actually started wineries and sold them. He was talking about the sulfate problem in wine.

Mickey:    Oh, my gosh, I'm so sensitive to sulfates. That's actually interesting you bring up something that I need to research more because my uncle is winemaker. We actually have a couple of acres of grapes on our property, and I'm always wanting to taste his wine because it's something that he has spent all his time crafting.

    He uses lots of sulfates and get really bad migraines when I have his wine. I thought it was the red wine, but now I think I've narrowed it down. It's the sulfate.

Christopher:    I'm pretty sure John's right. I have the same experience he does which is I get a hangover before I've even finished the glass.

Mickey:    Yes, I always tell people that I feel hung over before I get drunk, so I'm in the same boat as you. If I do a lot of water, if I do white wine or really high-quality sulfate-free, but still small quantities. I think if you become really in tune with your body especially on an autoimmune side, alcohol is just so toxic. That's what being drunk is, is experiencing that toxicity.

Christopher:    You exceed the capacity of your detoxification system.

Mickey:    It's just like, uh, no. The part of me that I love balance, you can tell already. I'm not going to tell anyone. I'm not into dogma. I don't like hard and fast rules. I think of some experiences I've had in my life where I've been traveling with my husband and shared a glass of wine. That was just so memorable and so enriching to my life that I think, that's not the thing that was making that experience, but it definitely added. It was really nice.

    I think everyone can judge once something is adding. It can be a food. It can be a drink. It can be a relationship. It can be an activity. Saying yes or no, I think sometimes we put ourselves into these boxes and force ourselves to do something so hard that it detracts from us having a human experience.

Christopher:    I think that's a good place to wrap up. What did we tell people about? We told people about the Nutrient-Dense Cookbook. Did I get that right?

Mickey:    The Nutrient-Dense Kitchen.

Christopher:    Nutrient-Dense Kitchen, and you made the case for nutrient density, which I wholeheartedly agree in. It makes a lot of sense to me. You told people about the resources that you have online for people implementing the Autoimmune Paleo Protocol including in-person meet-ups. I'm all about that. I'm going to link to that. That's very exciting. I wonder if there's one in Santa Cruz.

    Is there something else I should have asked you about?

Mickey:    I think you pretty much covered it, just lots of activity with these studies so just thanks, everyone, who has donated or enrolled, sharing with our friends. We're enrolling right now for an eczema-psoriasis study, so if anybody knows people that --

Christopher:    Oh, so you're enrolling for the study.

Mickey:    We fundraised, but we just started enrolment today actually. So if anybody has a connection with someone who has not tried a therapeutic diet that has --

Christopher:    This is the challenge, you see. If you're listening to this, we don't want you. We want someone you know that needs this.

Mickey:    Someone you know. Actually they can be someone that you would be like, I don't think they could do this because they're going to get that coaching. They're going to get that group where they going to get walked through every part of the process, and they're hand-held.

Christopher:    I don't know that many people who are influencers enough to get somebody to do something. My mom could definitely benefit from it. Will she do it? Probably not. I don't really have that -- 

Mickey:    You could send her the survey.

Christopher:    You never know. You never know. So, if you know anyone that might benefit from the Autoimmune Protocol that doesn't already do it, is not already listening to -- 

Mickey:    Yeah, and has eczema or psoriasis. The study is just for those conditions.

[0:55:01]

Christopher:    I previously interviewed Rob. I'll link to that episode if you want to know more about the science and the clinical trial. We talked about that in-depth with Rob Abbott. I'll link to that in the show notes. Do you think you'll be doing more of this in the future?

Mickey:    We already have another one in the works for 2020, which we're not ready to announce yet.

Christopher:    Well, I'll follow that closely and with anticipation.

Mickey:    I know. We love your support. You've supported us in the past. We need this community to keep pitching in and sharing the word or however people can help, finding participants. It's all helpful to getting the research out there, so it's awesome.

Christopher:    Thank you. Thank you for everything you do. We really appreciate it.

Mickey:    Yeah, thank you so much.

Christopher:    Cheers.

[0:55:48]    End of Audio

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