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Autoimmune Disease—the “Leak” in Your Gut Autoimmune diseases are a disaster and there are no good medicines available (steroids work, but the treatment is worse than the disease). They’ve been around for centuries, but there’s been a clear uptick in the last fifty years. Why? Two hypotheses have been proffered to explain it: the barrier hypothesis (our skin or lungs are letting in antigens) and the hygiene hypothesis (we don’t eat dirt and are too hygienic). But in fact, in the gut, they’re the same thing; because the gut is the dirtiest place in the world—one hundred trillion bacteria to have to fend off at all times—you don’t need an intestine, you need a fortress. We’ve known for a while that leaky gut is akin to chinks in the walls of that fortress. Antigens, like enemy soldiers, escape through those chinks into the bloodstream, where T cells and antibodies react against them. But in a case of mistaken identity, these immune cells then accidentally identify parts of your body as foreign invaders and generate an immune response to kill them off, a process termed molecular mimicry. Then there are two new twists. First, it appears that one autoimmune disease, called ankylosing spondylitis, produces antibodies to a gut bacterium called Klebsiella pneumoniae. Conversely, a different autoimmune disease called rheumatoid arthritis produces antibodies to a second gut bacterium called Proteus mirabilis. Now, this might not seem that earth-shattering, but recent work has shown that the refined carbohydrates in processed food feed those two bacteria in particular, and that carbohydrate restriction improves both of these diseases. Indeed, a low-sugar, high-fiber Mediterranean diet has been shown to be efficacious at prevention and treatment of rheumatoid arthritis. Furthermore, introduction of fiber to the diet appears to improve asthma (frequently an autoimmune disease), likely by improving gut function and reducing inflammation.
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Robert H. Lustig (Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine)