Sarah Ballantyne: How She Lost 120 Pounds, Why Paleo is Not a Diet, & The Science of Autoimmunity

No matter how brilliant or accomplished someone seems, it’s important to remember that they’re human, too.

Although Dr. Sarah Ballantyne earned her doctorate at 26, she was 120 pounds overweight and had a litany of health conditions.

That all changed when she discovered the destructive – and healing – powers of the food we eat.

As a scientist, Dr. Sarah Ballantyne is deeply interested in understanding how food interacts with our gut barriers, immune systems, and hormones to influence health.

On this show, you’re about to learn:

• How Dr. Sarah lost 120 pounds by focusing on nutrition
• Why eating Paleo-ish is backed by cutting edge nutritional research
• Why sleep is as important as food
• How the immune system affects weight and health, much more…

 
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Sarah Ballantyne: Research Scientist & “The Paleo Mom”

Abel: Sarah Ballantyne, Ph.D. is the creator of the award-winning online resource ThePaleoMom.com; cohost of the top-rated The Paleo View Podcast; and New York Times bestselling author of The Paleo Approach, The Paleo Approach Cookbook and The Healing Kitchen.

Just so you know, Dr. Ballantyne is a certified smartypants, earning her doctorate in medical biophysics at the age of 26. She went on to write the definitive book on Paleo – it’s a freaking textbook!

Dr. Ballantyne, thanks so much for coming on the show!

There aren’t enough people out there working in the field of nutrition as true scientists.

Let’s start with your background – before you started eating and living in this way, you were 120 pounds overweight and had a litany of health conditions. What happened?

I started having health problems at the age of seven when I had mono for six months. From there, I’ve had normal energy levels and started struggling with my weight, although I really didn’t gain a lot until I hit puberty. I was just always that tired kid that fell asleep thirty seconds into the car ride and had to be shaken awake when we got there.

As I got older and nerdier, I got less healthy. By the time I was in my teens, I was morbidly obese, I had terrible acne, scalp psoriasis, dry hair, my eyebrows were falling out, I had migraines and terrible hormonal symptoms. And as I progressed through my scientific education, I started having more problems.

Now I have this autoimmune condition, and is my thyroid is not working? Oh, and then I had adult onset asthma so severe that I was apartment-bound for three months because I was coughing up blood.

I was also developing weird allergies like a topical allergy to cardboard. If I touched a box I would break out all over my skin.

I had acid reflux, depression and anxiety, carpal tunnel syndrome, tendonitis, and the list goes on.

I wholeheartedly believed that my doctors were the reason I was able to do this medical research career. I thought, “I’m giving back to the medical community by devoting my life to academics.”

Academics was also what really resonated with me. From the time I was 5 or 6, if you asked me what I wanted to do when I grew up, I’d say, “I want to make a difference.”

So, I pursued a career in medical research… and I was very sick. I worked 80 – 100 hours a week in a highly competitive environment. I was studying the immune system, cancer biology, and epithelial cell barriers. These are scientific concepts so relevant to the paleo diet—but at the time, there was no nutritional component. It was all pharmaceutical.

Then I hit a wall. I got pregnant, and I had gestational diabetes. I had preeclampsia when I went into labor, which was a 97.5 hour labor. Not cool. And I just crashed.

I had a baby that didn’t sleep and was collicy, and I realized that I can’t do both of these things. I want to be the best mother in the world and have this high power academic career, but I can’t do both.

I knew about this program the NIH runs which allows women to take time off their academic careers once they hit the doctorate level. You can take up to 8 years off. I thought, I’m going to take this time off, use this program for 8 years, and then go back to work.

Now I’m just doing this one really hard thing of being a mother, which gave me what I needed in terms of time and lower stress levels and what I need in terms of my health.

It gave me the opportunity to sort out what was going on in my own body. It took about five years, I lost a lot of weight following a low carb diet, but I got sicker and sicker as I got lighter and lighter. So, I had to really dig deep and take this scientific background and apply it to my own health.

I started looking at food sensitivities and how they played a role. In my research I just happened on one of Loren Cordain’s articles about the paleo diet that had a more scientific lean, and I went okay this sounds intimidating and hard… but the science pulled me in.

I tried paleo 4 1/2 years ago. In 2 weeks I was able to go off 6 prescription medications. Share on X

It was an eye opening experience for me to see how powerful food really is. That became the beginning of my transformation. I started taking the academic research other people were doing and bringing it to the public without dumbing down the research, then adding actions: What does that tell us and not tell us? How do we incorporate this new piece of information into what we already know?

It’s something I feel there aren’t very many people doing—being that bridge between academia and the everyday person.

There are tens of thousands of studies that inform us as to what the best food choices are, why it’s important to sleep, why stress management is critical, and why we should live in sync with the sun. We understand this at a cellular molecular level, but that information isn’t brought to the public.

Academia will say that you wouldn’t understand this, so let me explain it using a dump truck and legos.

I want to take five minutes instead of thirty seconds to actually explain and empower people with education, so they can make the best choices within their own lives.

This was the year I had to go back to research if I was going to do it, and I didn’t. I found this other purpose in life that’s still hitting this desire to make a difference in the world, but a less trodden path, more challenging, and more rewarding.

Understanding How Your Body Works: Cellular Biology 101

Abel: I think it suits you. You don’t often see people who are able to bridge that gap between the actual research and looking at what’s on your plate. How do you do it?

Part of why I’m good at bridging that gap is because of my scientific background. I have a bachelor’s in Physics, a PhD in Medical Biophysics, went into a cardiology lab for my first post-doctoral research fellowship, and then a cell biology lab.

In that process of going from physicist to a biologist, it involved teaching myself a lot of things that I would have learned if I had done my bachelor in microbiology or cell biology. When I started my PhD, I was reading papers with a medical dictionary because I didn’t understand the jargon.

You can say “leukocyte” or you can say white blood cell. You can use a word that’s still an accurate word, not lose the meaning, and suddenly make that language approachable.

I have been passionate about scientific literacy since I knew it was a thing in high school. I was tutoring, giving inspirational talks to encourage women in science, I was speaking in public, judging science fairs, and taking on a huge range of roles geared at making science more accessible. I can draw on that experience and it really matters to me to be that bridge.

I respect the public’s intelligence.

People want to understand the science, and I want to provide that opportunity. @ThePaleoMom Share on X

I want to bring real science to people. In my life, that motivates me. Understanding the detailed cellular biology of what happens when I eat that food? It helps me make the better choice.

That’s what I feel I have to contribute to the world.

Abel: Someone might be thinking, “I have a dry itchy scalp, I’m run down, or I have acne.” These thing are actually linked to a systemic problem in your body related to autoimmunity. Can you talk about the mechanisms behind healing with food?

Most of us are familiar with the immune system. It’s incredibly complex, involving cells and hormones and chemical messengers. It’s probably the most complex system in our bodies (maybe short of the central nervous system), and its job is to protect us.

What it’s typically protecting us from is some kind of foreign invader: Bacteria, virus, parasite, dirt, a sliver, an open wound. Part of the healing, if you cut yourself, is the immune system’s response for making sure infection doesn’t spread over the body.

The immune system’s job is to protect us, and to do that it has a whole pile of ways to identify that foreign invader. What happens in autoimmune disease is that our body loses the ability to tell the difference between a foreign invader and our own body. And what’s fascinating is there’s this accident that happens in everyone’s bodies called auto antibody formation.

Antibodies are an incredibly specialized protein and we make a few million different ones, and each antibody recognizes a specific protein. One that recognizes a bacteria in a cell wall could say, “Aha, you’re that bacteria I fought off a few years ago. I know how to beat you.”

Once in awhile, we make an antibody by mistake that binds to a protein that’s a natural protein to our bodies. I have hashimoto’s thyroiditis. My body is making antibodies against thyroglobulin, it’s a protein involved in thyroid hormone production in my thyroid gland.

Abel: Your immune system is literally attacking your own thyroid.

My immune system has decided my thyroid is the same thing as a virus or a parasite and is trying to get rid of it. This accident happens in everybody, but we have several different mechanisms that recognize the accident and shut it down.

What happens in autoimmune disease is the failsafe fails, and then we don't recognize the accident. Share on X

When you combine that with triggers of the immune system, you’re turned on and get revved up. These triggers can be things like: toxin exposure, hormones, diet, lifestyle factors, not getting enough sleep, feeling stressed. People with autoimmune disease recognise this as a flair. For me, the start was mono. Epston barre is a well known trigger for autoimmune disease.

So, I’ve made this accident in the antibody, I’ve lost the ability to understand I did that, now I’ve got my immune system revved up… so what am I going to attack? This thing I’ve already decided is a foreign invader—my thyroid, my brain, my skin cells, or my joints. The difference between autoimmune diseases is exactly what tissues are being attacked, but the breakdown of autoimmune disease is the same.

What we can do is support the failsafe part of the immune system doing its job. And we can support that part whose job is to turn off the immune system.

There’s this part of the immune system whose job it is to reign, and it’s that part that is not working very well. All disease has rampant inflammation. If you can turn off the immune system, you can mitigate that inflammation. With autoimmune disease it’s hard to get that to turn off, but it’s totally possible.

Some of the things we can do to reign in the immune system are completely within our power. The immune system is a tremendous nutrient hog. It uses nutrient resources like no other system in the human body—every mineral, every vitamin, a whole pile of amino acids, and fatty acids—and it needs all of those things. And it turns out, the stuff we are most likely to be deficient in: Vitamin D, iron, calcium, retinyl esters (the animal form of vitamin A), and zinc. Those are the things the regulatory arm of the immune system needs to work.

Not getting enough sleep is inflammatory. Being stressed, being sedentary, not spending enough time outside, those things are inflammatory. And then you throw in nutritional deficiency, and we don’t have the resources to turn off inflammation… so, of course we’re so sick!

You can take back control by following a nutrient dense diet, avoiding foods that are inflammatory, eating foods that support optimal gut health, getting enough sleep, improving resilience to stress. That’s different than reducing stress. Instead, it means providing your body with mechanisms to respond in a more reigned-in way when we have a psychological stressor. This could be going for a walk, meditation, not relying on caffeine, getting enough sleep, being active but not pushing too hard. Suddenly, you’ve created an opportunity for your immune system to go, “Oh wait, what am I doing? I’m attacking me!”

You can turn off the attacks depending on: how long you’ve had your disease, how aggressive it’s been, and how well you’re implementing the strategies. Some people will put their autoimmune disease in complete remission or slow it down.

My autoimmune disease went undiagnosed for three decades, so my thyroid was being attacked for three decades. I will never live without thyroid replacement hormones, but my disease isn’t progressing.

Once you’ve developed one autoimmune disease you can expect one every ten years for the rest of your life. I don’t want another one. I’ve reached my limit, I’m done for my life. So to me, these strategies become about regaining health but also maintaining health for the rest of our lives.

Why Paleo Is Not A Diet

I always think of it as the Paleo lifestyle, rather than the paleo diet. In part because it incorporates lifestyle, but also because I’m a lifer.

I have discovered how powerful the strategy is. There’s room for me to tinker and experiment, and find the line between what my body needs to thrive and what it will tolerate. It’s about finding that space in between those two extremes, but I don’t ever intend to revert back to anything.

I’m off of medications, I’ve had the energy I’ve never had in my life, the focus I’ve never had in my life, I feel comfortable in my body and I’m getting strong. I have all these things coming together and I’m not going to give that up.

Abel: You lost weight going low carb, but it wasn’t until you dialed in your diet that you got off of the prescriptions.

One of the major things was understanding the difference between health promoting food and food that could undermine my diet—understanding micronutrients rather than macros. Part of it was focusing my food choices on vitamins and minerals, and not worrying so much about carbohydrates and fat and protein grams.

Women can have very negative thyroid reactions, sex hormone reactions, and stress reactions to a low carb diet, especially when they’re prolonged. Very low carb diets are not for everybody, and women tend to have these counterproductive reactions—it’s great that you’re losing weight, but it’s at the expense of your immune system functioning properly, sex hormones regulating themselves, and your moods.

If you do take an evolutionary biology approach, times of starvation are not times to get pregnant. You’re using a low carb diet to mimic the biological effects of fasting, which also means you’re going to get the biological effects of fasting. That’s why I was getting sick as I was losing weight. But that was a big turning point in my life because it made me think about the difference between thin and healthy.

Leaky Gut & Healthy Bacteria

For me it was about getting thin to get healthy, rather than getting healthy to get thin. It made me change the focus of what I was eating to that effect and then understanding there are compounds in food that undermine it and negatively impact hormones and gut bacteria. They can feed the wrong types of bacteria, impairing how the gut barrier is functioning.

Our gut barrier is phenomenally important. @ThePaleoMom Share on X

Our gut barrier is phenomenally important. What is inside our digestive tract is technically outside our body.

If you just had a straight tube from the mouth to the other end, it’s open to air on each end and everything on the inside is not connected to the inside of our bodies. The gut barrier’s job is to let in what we need from what’s inside our digestive tract, like the nutrients, and not let in what we don’t need, like bacteria and toxins.

We also use our digestive tract as a way to eliminate toxic byproducts from our bodies. For example, our liver is processing things like heavy metals, pesticides we’re exposed to, and also just toxins we produce as part of being aerobic organisms and using oxygen for our metabolism.

One of the down sides is we make a lot of toxins. Our liver will shuttle the toxins into our digestive tract for elimination, so if we absorb them, it’s counterproductive.

That’s why we have this barrier that’s supposed to stop it. There are compounds in food that can actually remove the ability of the barrier to control whether or not it’s going to be open or closed. It’s scary.

When you think about the word leaky gut—it means exactly that. It means we’ve been eating something, undergoing stress, not sleeping can do this, straining with exercise can do this—it basically hampers the ability of the digestive tract to be selective and creates doors that just stay open allowing anything to leak into the body.

You’re letting stuff that’s not supposed to be in the body come into the body. Those are toxins and the bacteria that are good in our gut, but not in our bodies. When that happens, you’re stimulating the immune system. About 70-80% of our immune system surrounds the gut because we know it’s a semipermeable barrier, a place where toxins get in, that’s where we set up our sentries. That’s where the war happens.

What To Do About Wheat, Grains, Soy & Legumes

An incompletely digested protein is a toxin. That place around the gut is a place where we’re supposed to break apart a protein into individual amino acids and then break down those amino acids. But if you have leaky gut, you bring in an incompletely digested protein that’s not supposed to be there.

Proteins can be active. And if there’s a protein that’s supposed to be active in wheat (gluten), you don’t want it in your bloodstream.

A lot of agricultural foods are foods that you eliminate when you take an evolutionary biology approach to create the template of the paleo diet. Alternatively, when you take a biological approach to understanding how the compounds in those foods are interacting with the human body, you come up with the same set of rules.

Grains, especially wheat, soy, and peanuts are terrible—they have compounds in them that cause a leaky gut and are incredibly inflammatory. Legumes, grains, and nightshades that are paleo-friendly but not autoimmune protocol friendly are also on that list.

These foods have compounds in them that have been investigated in scientific study for use in vaccines to stimulate your immune system so that you will develop immunity against he dead virus in that vaccine.

These are compounds that are very good at turning on inflammation and turning on the part of the immune system that is typically the major culprit in breakdown with an autoimmune disease, and we see this in high concentration in grains, legumes, and things like tomatoes.

So, really starting to evaluate foods in terms of, “What do they have in them that’s good?” These are nutrients and the raw materials my body needs to make more of me and make the chemical reactions that happen in every cell in every moment.

And then, “What’s in the food that’s bad?” So, these are things that are going to cause inflammation, not be good for gut health, feed the wrong bacteria, and mess with my hormones.

I put every food on the scale. I want a lot of the good stuff and not very much of the bad stuff. There are some things I’m not going to touch that with a ten foot pole. But oh wait, there’s this huge area of gray in the middle.

We want more good stuff, less bad stuff. We’ve got a genetic predisposition (those of us with autoimmune disease), that means we’re more sensitive. It’s reality, we just need to be more careful. Lifestyle changes the formula – so we’re going to be more sensitive to a food if we’re not sleeping or we’re stressed, which is why the autoimmune protocol includes lifestyle changes.

Abel: So you’re not saying you’ll never eat a tomato again. You’re saying, “get your lifestyle in order and you will be able to tolerate foods that might be slightly inflammatory.”

Give your immune system the opportunity to start regulating itself, and then play with those foods and see what happens. Some people will do very well reintroducing them and some people won’t.

When you look at eliminations on an autoimmune protocol compared to a standard paleo diet, it also eliminates nightshades, all dairy, eggs, nuts and seeds, and alcohol.

For me, the foods I have not ever been able to successfully reintroduce are nightshades and eggs. Turns out I actually have a food intolerance to eggs, which explains that. Nuts and seeds and an occasional glass of wine are ok for me. Part of my health journey was really figuring out what I needed to do to heal, what I needed to do to maintain that, and understanding why.

I don’t want to just know eggs don’t work for me, I want to understand why eggs don’t work for me. So getting that knowledge base and then sharing it with everybody was important.

The Importance Of Sleep

Abel: I know you have a rant on sleep, so why don’t you go for it.

I’ve already alluded to just how important lifestyle factors are. We don’t want to just do this to lose ten pounds for a wedding, we want to do this for the rest of our lives.

When you think about paleo, you think of an active lifestyle with a specific way of guiding food choices. We’re starting to talk a little about stress management and sleep, but we’re not doing it.

We’re getting about 2 hours less sleep a night than we did 50 years ago. @ThePaleoMom Share on X

When you look at western culture as a whole, we’re getting about 2 hours less sleep a night than we did 50 years ago.

I did the math (because of the nerd in me), and it works out to be a whole month of continuous sleep every year that we used to get and don’t get anymore. Something like 60% of us do not even hit 8 hours a night ever.

Seven hours is a bare minimum when you look at hunter gatherers and our understanding of sleep. Sleep is when our brains detoxify. Our brains use 25% of our calories. When we use calories we produce toxic byproducts, or waste. But because of the magical blood brain barrier, our brains can’t eliminate waste like the rest of our body can.

In the brain, the toxins get stored up all day and when we sleep, our brain cells shrink by more than half, our cerebrospinal fluid increases its flow and flushes out the toxic byproducts from our brain. When you don’t sleep enough, you don’t flush those out, and it causes inflammation of the brain. Inflammation of the brain causes problems everywhere.

The effects of not getting enough sleep are great. When you’re sleeping, the regulatory arm of the immune system happens, muscle repair happens, you produce human growth hormone, your memory, moods, everything.

Sleep is amazing, and we don’t get enough of it. @ThePaleoMom Share on X

Even in the Paleo community, the autoimmune protocol is a phenomenal change in food choices for most people. It’s a commitment, but you can see the results right away.

Often we’re putting so much effort into changing the food on our plate—we’re making our own jerky and freezer meals for busy work nights—we’re making all this effort and then we stay up on Facebook all night. Or we watch scary and dramatic TV shows that get us worked up before bed, and we won’t shuffle around our parties to make sure we’re getting enough sleep.

The correlation between lack of sleep and increases in diseases is far stronger than any food related correlation. And when we look at the mechanisms, we can see why this is happening.

I’m not saying diet is not important. I’m saying you can’t work on one and not the other.

So this is the message I really want to focus on in the paleo community right now – just how important sleep is, and that there are simple ways to increase our sleep and the quality of our sleep. With a good night’s sleep, we end up being more productive during the day.

Arianna Huffington is really into the sleep thing. She had a massive crash a few years ago and started getting 8 hours a night, and now she can work less and get more done.

There’s a transition period where your body goes, “Okay we’re paying down some sleep debt.” And you’re really tired. But then you get to the other side of it, it improves moods, you have energy all day, your immune function increase, there’s hormone regulation, appetite regulation, craving eliminations, and weight normalization.

Sleep even does amazing things like – you have a better chance of surviving cancer.

I created a program called “Go to Bed.” From my perspective, the number one barrier people have to getting enough sleep is taking their body and putting it in a bed, turning off the light and turning off the TV.

There are a lot of nuances, like circadian rhythm and sleep hygiene, providing a relaxing sleep environment, hormone regulation, inputs from diet, inputs from activity. There are a lot of things that go into sleep quality, but the number one most of us can do to get more sleep is to decide to get more sleep.

I’ve created a 250 page e-book that’s a full review of the scientific literature, and then tons of practical how-to advice, and then a 14 day challenge that’s designed to be an  implementation to ease you into what I think are the most important habits to get better sleep. The idea is that by the end of 14 days, people are getting better sleep. It addresses routine, but also circadian rhythm entrenchment – the big players.

Habit formation on average takes 66 days, even up to 8 months before repeatedly performing a task becomes easy and you don’t have to think about it. But the two weeks is to ease you into the habits so you can get a taste of why it’s important to continue.

We’ve created a Facebook page and challenges so you can be part of a group of people who are putting sleep on the top of their priority list.

What we’re seeing already is people are losing weight, seeing their appetite regulate, seeing their moods improve in such a short period of time. I went off of six prescription medications on two weeks of paleo. What can better sleep do?

I want to try to bring this to our awareness as an important input into our health. So when we say paleo lifestyle, we think here’s this template for how we eat, here’s why it’s important to be active, and here’s why we go to bed at 9:30 at night.

Abel: You have 110% of my support, because I have a secret weapon… and that’s getting good sleep (almost) every night.

When I talk about health, I often say that we have to choose between the fun choice and the good choice.

What I love is when the good choice becomes the fun choice.

And when you’re getting enough sleep and you can feel that, those choices merge. It’s like when you’ve been paleo for a while and you’re walking through the bakery section of the grocery store and it’s not tempting – it smells vaguely of urine and you’re like, did it always smell of urine? It’s not something you want to put in your mouth.

Suddenly, the apple is the fun choice. All of a sudden I am so happy to be in the produce section in the store instead of the stinky bakery section.

The same thing happens with sleep, and suddenly you can’t wait to go to bed and be asleep because that’s what you feel like doing right now, and you’re going to feel amazing tomorrow.

Abel: Take it from a musician, nothing good happens after 9pm.

But I watched the sunrise this morning, which may not sound like fun, but the way you define fun changes… especially when you get in the habit of acting in your future best interest.

Feeling good becomes so much more rewarding than anything else. What can compete with feeling good? Nothing. We need to inject a lot more focus on lifestyle factors into the paleo movement in order to achieve optimal long term health.

Where To Find Dr. Sarah Ballantyne

Learn more by checking out Sarah’s website, podcast and books. You can also find Sarah on Facebook, Twitter, Instagram and Pinterest.

Before You Go…

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Have you noticed improvements in your health since getting more sleep? What did you think of this interview? Leave a comment below to share your thoughts.

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