Food can indeed be medicine, especially when dealing with conditions like mold illness, also known as biotoxin illness or Chronic Inflammatory Response Syndrome (CIRS). For those who have explored various avenues to manage their symptoms without achieving a satisfactory quality of life, certain foods, particularly those high in amylose, may be a contributing factor.
The no-amylose diet is an evidence-based dietary intervention that forms a part of the Shoemaker Protocol for biotoxin-related illnesses. For some CIRS sufferers, eliminating amylose can alleviate the severity of symptoms and expedite recovery, particularly when implemented during specific phases of the Shoemaker protocol.
This article provides an in-depth look into the no-amylose diet, including who might benefit from it, how it impacts inflammation, its role within the Shoemaker Protocol, permissible and restricted foods, and alternative or complementary dietary approaches.
Understanding the No-Amylose Diet
The no-amylose diet involves the elimination of foods high in amylose, a complex carbohydrate and type of resistant starch found in grains, legumes, tubers, root vegetables, and high-glycemic index foods. When salivary amylase breaks down amylose in the mouth, it leads to a rapid influx of sugar into the bloodstream. Subsequently, the pancreas releases insulin to regulate blood sugar levels.
The primary objective of the no-amylose diet is to prevent the swift elevation of blood sugar and the subsequent surge of insulin that occurs after consuming high-amylose foods. This process can exacerbate systemic inflammation in individuals with CIRS. Complex metabolic processes involving the endocrine and immune systems are also at play, with leptin acting as an interface between metabolism and the inflammatory response.
Read also: The Hoxsey Diet
The Science Underlying the No-Amylose Diet
The no-amylose diet is rooted in the science of resetting the expression of genes governing insulin and leptin, which collaborate at the cellular level to facilitate glucose transport across cell membranes. In CIRS, biotoxins impair leptin receptors, disrupting leptin binding and potentially increasing or prolonging membrane permeability.
This disruption creates an environment conducive to an increased flow of leptin and insulin, along with pro-inflammatory cytokines like tumor-necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6). The heightened circulation of cytokines further intensifies the low-grade chronic inflammation characteristic of CIRS, as indicated by specific Shoemaker-protocol biomarkers. Elevated matrix metalloproteinase-9 (MMP-9) and low vascular endothelial growth factor (VEGF) are two such biomarkers that can be addressed through the no-amylose diet.
Impaired leptin binding also triggers increased leptin production to compensate, leading to greater fatty acid storage in fat cells and subsequent weight gain, a common occurrence in CIRS. By removing high-amylose foods, leptin receptors have an opportunity to reset, thereby re-regulating cell membrane permeability, insulin release, leptin production, and the circulation of pro-inflammatory cytokines. Furthermore, the no-amylose diet can facilitate quicker weight loss by addressing the root cause, even when individuals have reached a plateau with conventional diet and exercise.
Is the No-Amylose Diet Right for You?
While the prospect of another elimination diet may seem daunting, the no-amylose diet need not be overly restrictive. It doesn’t involve meticulous measuring or calorie counting; instead, one can enjoy a variety of delicious, amylose-free meals and snacks.
However, it's essential to recognize that the no-amylose diet isn't universally necessary. Amylose isn't detrimental for most healthy individuals and offers evidence-based benefits, including its role as a prebiotic. As it resists digestion in the small intestine, it reaches the large intestine, where it undergoes fermentation and supports the growth of beneficial bacteria like Bifidobacterium and Lactobacillus, contributing to a healthy microbiome.
Read also: Walnut Keto Guide
According to Dr. Ritchie Shoemaker, the no-amylose diet is recommended for individuals with CIRS who exhibit elevated levels of:
- Matrix metalloproteinase-9 (MMP-9)
- Leptin
- Plasminogen Activator Inhibitor 1 (PAI-1)
Increased levels of these biomarkers indicate inflammation in CIRS. In such cases, the Shoemaker protocol advises the no-amylose diet combined with either high-dose Omega-3 fatty acids or the medication Actos, although the latter's use has decreased due to side effects and the increased risk of bladder cancer with long-term use.
Understanding the Biomarkers
MMP-9: This enzyme breaks down and repairs tissues to support a healthy immune response. However, in CIRS, the overwhelmed biotoxin pathway leads to elevated inflammatory cytokines, prompting neutrophils and macrophages (white blood cells) to release excessive MMP-9. Elevated MMP-9 increases blood vessel permeability, allowing inflammatory agents to circulate more freely throughout the body, affecting the brain, lungs, nerves, muscles, and joints, leading to common CIRS symptoms such as brain fog, fatigue, muscle pain, and post-exercise exhaustion. The no-amylose diet, along with high-dose Omega-3 fatty acids or Actos, reduces MMP-9 by upregulating peroxisome proliferator-activated receptors (PPAR-gamma), promoting insulin sensitization and enhanced glucose metabolism.
Leptin: This hormone and cytokine, released by fat cells in response to food intake, contributes to homeostasis by reducing hunger and promoting feelings of fullness. However, when leptin receptors in the brain are damaged, cytokines bind to them, preventing leptin from binding. This dysregulates the proopiomelanocortin (POMC) pathway, reducing the production of melanocyte stimulating hormone (MSH). MSH deficiency can cause cognitive impairment, headache, muscle ache, unstable temperature, and difficulty concentrating. It is also associated with reduced endorphin production, increasing pain sensitivity. Pairing the no-amylose diet with high-dose Omega-3 fatty acids or Actos can lower leptin levels, allowing the body to reset the expression of genes that regulate insulin and leptin resistance.
PAI-1: Elevated plasminogen activator inhibitor 1 (PAI-1) is another CIRS biomarker. Plasminogen activator breaks down blood clots, but elevated PAI-1 impairs its function, potentially leading to clot buildup in blood vessels, increasing the risk of heart attack or stroke. Combined with MMP-9, PAI-1 can exacerbate clot formation and arterial blockage. High-dose Omega 3 or Actos, along with the no-amylose diet, can reduce the cardiovascular risk associated with MMP-9 and PAI-1 by upregulating peroxisome proliferator-activated receptor (PPAR-gamma).
Read also: Weight Loss with Low-FODMAP
Once MMP-9, leptin, and PAI-1 biomarkers normalize, the no-amylose diet is typically no longer required as part of the Shoemaker Protocol. However, many individuals choose to continue the diet due to the significant symptom reduction it provides, including increased energy, reduced joint pain, improved cognition, better mood, and enhanced overall well-being. Some may transition to a low-amylose diet, gradually reintroducing amylose-containing foods to assess tolerance and reaction.
Foods to Avoid on the No-Amylose Diet
Dr. Shoemaker provides a clear list of foods to avoid. Strict adherence to the no-amylose diet is crucial while MMP-9, leptin, and PAI-1 biomarkers are elevated, facilitating progress within the Shoemaker protocol once these levels are corrected. The following foods should be completely eliminated during the strict no-amylose phase:
- Roots and tubers, including white and sweet potatoes, beets, peanuts, carrots, and other vegetables that grow underground (with the exception of onions and garlic).
- Bananas (the only forbidden fruit).
- Wheat and wheat-based products, including bread, pasta, cakes, and cookies.
- Rice.
- Oats.
- Barley.
- Rye.
- Foods with added sugar, sucrose, corn syrup, or maltodextrin.
While the no-amylose diet is gluten-free, it is more restrictive, as rice products are also prohibited.
Foods You Can Eat on the No-Amylose Diet
All foods not on the restricted list are permitted. The 00-2-3 rule serves as a daily guideline for the no-amylose diet: zero amylose, zero sugar, two servings of at least 6-8 ounces of protein each day, and three servings of above-ground vegetables and fruit daily.
The following foods are generally approved:
- Corn (including tortillas and chips, preferably non-GMO).
- Aromatic onions and garlic (exceptions to the below-ground vegetable rule).
- A variety of above-ground vegetables, such as lettuce, tomatoes, spinach, kale, chard, turnip greens, collard greens, peas, cucumbers, celery, peppers, cabbage, and squash.
- Nutritious beans of all kinds (if tolerated).
- A variety of fruits (excluding bananas).
- Meat, fish, and poultry.
- Eggs.
- Healthy fats and proteins from nuts and nut butters (excluding peanuts, which are legumes).
- Sunflower, squash, and pumpkin seeds.
- Dairy products (if tolerated, with low sugar content).
The no-amylose diet offers a wide range of options to ensure adequate nutrition and enjoyable, high-quality, healing meals.
Alternative and Complementary Diets for CIRS and Mold Illness
Individual responses to diets vary, and no single diet works for everyone with mold illness or CIRS. Even for an individual, foods tolerated for months may suddenly trigger reactions. It's essential to be attuned to your body's responses.
While the no-amylose diet can be beneficial for some, other diets may be more suitable:
Low Histamine Diet: This diet restricts foods high in histamine, which can trigger allergy-like symptoms. It is often recommended for individuals with histamine intolerance or mast cell activation syndrome.
Autoimmune Protocol (AIP) Diet: This diet eliminates common triggers of autoimmune diseases, such as grains, legumes, dairy, and nightshade vegetables, while emphasizing nutrient-dense foods that support gut health and immune function.
Ketogenic Diet: This low-carbohydrate, high-fat diet induces ketosis, where the body burns fat for energy instead of glucose. It has shown therapeutic benefits for conditions like epilepsy, type 2 diabetes, and neurological disorders.
Carnivore Diet: This diet involves consuming only animal products, such as meat, fish, eggs, and certain dairy products, while eliminating all plant-based foods. Proponents suggest it can alleviate autoimmune diseases, mental health problems, and gastrointestinal disorders.
It's crucial to consult with a healthcare professional before making significant dietary changes. Healing from mold or CIRS requires an integrated approach beyond diet and nutrition, including avoidance, detoxification, lifestyle changes, and holistic therapies.
It's important to remember that the no-amylose diet is often a temporary measure within the Shoemaker protocol. Once MMP-9, leptin, and PAI-1 biomarkers normalize, amylose can be reintroduced. Even if you experience benefits from remaining amylose-free, it doesn't necessitate lifelong elimination.
Low Amylose Breakfast Recipe
Starting your day with a CIRS-approved, low-amylose breakfast can be both quick and flavorful. This balanced meal will help curb hunger until lunchtime.
Ingredients:
- 1 cup fresh, chopped kale (stems removed)
- 1 tablespoon chopped fresh leafy herbs
- Olive oil
- Sunflower seeds
- Precooked turkey sausage (optional)
Instructions:
- Warm olive oil in a saute pan over medium heat.
- Add crunchy vegetables, sunflower seeds, and precooked turkey sausage (if using). Cook until vegetables are slightly tender, about 1-3 minutes.
- Add kale, stir, and cook until the color changes to vibrant green (about a minute).
- Sprinkle with fresh herbs and stir.
- Serve with homemade berry-infused water or mold-free tea.