In the last decade, the autoimmune protocol (AIP) diet has gained significant popularity, with more and more people adopting it to help treat their autoimmune conditions. Proponents of the diet claim it also helps them improve their energy levels.
But are these benefits scientifically proven? And is the protocol safe?
In this guide, we’ll dive into the basics of the autoimmune protocol diet, including what it is, what foods are included in the diet, and what to expect when you go on the protocol.
The AIP diet is the natural outgrowth of decades of thought about how our modern diet impacts our health.
In 1975, gastroenterologist Walter L. Voegtlin published a book called The Stone Age Diet. Dr. Voegtlin believed that humans evolve too slowly to keep up with rapid changes in our environment. This idea, known as the evolutionary discordance hypothesis, posits that while the modern diet has changed greatly, genetically our bodies are stuck in the Stone Age, or Paleolithic era. According to this hypothesis, for optimum health we should eat the way our ancient ancestors did.
Later authors built on the evolutionary discordance hypothesis:
The autoimmune protocol diet is considered an offshoot of the paleo diet. It is designed to remove foods that can trigger an immune system response, possibly leading to inflammation and autoimmune disease.
The autoimmune protocol diet is an extension of the paleolithic diet with an autoimmune twist. Similar to the paleo diet, the AIP diet has an initial elimination phase, in which food groups that are considered problematic are removed from the diet.
The AIP diet removes:
The autoimmune protocol diet is an extension of the paleolithic diet with an autoimmune twist. Similar to the paleo diet, the AIP diet has an initial elimination phase, in which food groups that are considered problematic are removed from the diet.
The AIP diet is intended to be broken down into three phases:
The Elimination Phase
During the initial phase foods, food additives, and medications that may cause inflammation, allergic reactions, or imbalance in the gut microbiome (dysbiosis) are eliminated from the diet. Many of these foods are implicated in inflammatory bowel disease (IBD). (Source)
The Reintroduction Phase
This phase involves systematic reintroduction of eliminated foods to allow the individual to identify unique food groups that cause their symptoms and aggravate diseases, and to see which food groups are problematic for them. (Source)
This process is also called an elimination-provocation challenge. After the challenge is completed, the individual will have a list of their most problematic foods, or triggers. Avoiding these triggers may help alleviate disease symptoms.
The Personalization Phase
The personalization phase is designed to be specific to the individual in order to improve their symptoms and well-being. The purpose is to avoid foods that can trigger intestinal inflammation and other symptoms. (Source)
The AIP diet may be helpful for people with autoimmune diseases. The main goal of the diet is to nourish the body and improve its ability to heal itself. Like the paleo diet, the AIP diet emphasizes whole foods and nutrient-dense sources of carbohydrates, fats, and protein. It also places a strong emphasis on antioxidants and anti-inflammatory foods. It is possible this lifestyle intervention may prevent the need for medications for some autoimmune conditions.
Autoimmune disorders occur when your immune system mistakenly attacks your own body, causing inflammation that can damage tissues and organs. Autoimmune disorders can occur at any age and affect both males and females, but they are most common in women. Although the exact cause of autoimmune disorders is unknown, it is thought that genetics, environmental factors, and lifestyle choices play roles. (Source)
One environmental factor — and lifestyle choice — that is under your control is your diet. Following the AIP diet may help you manage your autoimmune disease symptoms. (Source)
There is evidence to suggest the AIP diet may help alleviate symptoms, improve quality of life, and promote healing in people with autoimmune disease. Studies report that some participants notice positive changes within the first four weeks of the elimination diet. (Source)
Following the AIP diet may be beneficial for these autoimmune diseases:
These gastrointestinal disorders include Crohn’s disease and ulcerative colitis. The use of dietary modification via AIP diet, along with IBD therapy, has been shown to be effective at treating IBD. (Source)
A study published in the journal Cureus found an online, community-based AIP diet and lifestyle program improved quality of life and symptoms for middle-aged women with Hashimoto’s thyroiditis. There were no statistically significant changes in thyroid functions or thyroid hormones, but AIP may have decreased systemic inflammation. (Source)
Psoriasis is a chronic inflammatory skin disease. Nutrition is suggested as a key factor for development of psoriasis, and patients are advised to follow a balanced diet with sufficient intake of fish and dietary fiber. Dietary changes for psoriasis should supplement first-line treatments including medications. (Source)
This autoimmune disease and its associated inflammation may be modulated by diet. While more study is needed, evidence suggests lupus symptoms may be reduced by restricting calories while emphasizing intake of polyunsaturated fats, protein, fiber, and vitamins. (Source)
Factors such as diet may impact the development and severity of symptoms of the autoimmune disease multiple sclerosis. (Source)
The first phase of the AIP diet requires elimination of a large number of foods that are part of a typical Western diet. Included are foods that may be pro-inflammatory, may upset the balance of the gut microbiome, or are common allergens. Many of these foods are also highly nutritious and are recommended in the personalization phase of the AIP diet for those who can tolerate them.
Here are the food groups included in the AIP elimination phase, along with the rationale behind each elimination:
Legumes are high in lectins and saponins, substances that are commonly consumed in a wide variety of foods. They are excluded during the AIP elimination phase because research suggests they have the ability to harm cells that line the intestinal tract and upset the balance of the microbiome. (Source)
It’s well known that omega-3 and omega-6 fatty acids are good for health, but an unbalanced ratio of the two kinds is believed to be pro-inflammatory. Unprocessed oils with a healthier omega-3 to omega-6 ratio can be added back to the diet during the reintroduction phase. (Source)
Nonsteroidal anti-inflammatory drugs do, as the name suggests, reduce inflammation. However, they can also be hard on the gastrointestinal tract and have the potential to disrupt the intestinal barrier. (Source)
Grains are considered to have the same kind of potentially harmful effects as legumes and are included in the elimination phase for the same reasons.
Nuts and seeds have many nutritional benefits, but allergies to them are common enough that they naturally have a place in an elimination diet. Many people are able to successfully reintroduce at least some nuts and seeds to their diet.
Consumption of processed sugars has long been shown to contribute to inflammation and chronic conditions such as heart disease and obesity, but more recently it has been correlated with exacerbation of autoimmune diseases such as lupus. (Source)
Citrus and nightshade vegetables are suggested to generate sensitivities in large proportions of the population. Eggplants, tomatoes, and potatoes may contain solanine, which may increase intestinal permeability and be detrimental to certain diseases. (Source, Source)
The effects on the intestinal tract of common additives including guar and xanthan gums, carrageenan, and lecithin have been studied for years with few hard conclusions. A new study in the journal Microbiome reports evidence that many emulsifiers have detrimental effects on the gut microbiome and promote intestinal inflammation. (Source)
Studies have found alcohol may both encourage growth of harmful microbes in the gut and disrupt the intestinal lining. Alcohol intoxication also increases the risk of IBD. (Source, Source, Source)
Choline and carnitine, which are present in dairy, are metabolized by the bacterium Prevotella copri into pro-inflammatory substances. (Source)
Non-nutritive sweeteners, which have few if any calories, are often promoted as healthier alternatives to calorie-rich sugars. In vitro lab studies have suggested that these sweeteners, which bind to taste receptors located throughout the body, may affect hormone secretion. In vivo studies, however, have not confirmed this occurs in humans, and more research is needed. (Source)
Choline and carnitine are also present in eggs. Eggs are also high in fat. A high-fat diet has been shown to have a detrimental effect on autoimmune diseases. (Source)
The foods included in the AIP diet are intended to maximize nutritional value while minimizing autoimmune and inflammation triggers.
Fruits and vegetables are high in fiber, which helps control blood pressure, blood sugar, and cholesterol. However, too much fiber intake may lead to low absorption of nutrients. Polyphenols, especially flavonoids, are bioactive components found in fruits, vegetables, and tea that have a beneficial impact on gut microbiota.
In the context of the AIP diet, meat is considered nutritionally dense with a healthy ratio of omega-3 and omega-6 fatty acids. It is recommended to choose grass-fed beef, bone broth, and organ meats, and to avoid processed meats, which may contain additives.
Microbial activity helps increase the bioavailability of nutrients in fermented foods. They are especially rich in probiotics, which help keep the gut microbiome healthy and may help reduce inflammation. (Source, Source)
Fatty acids are antimicrobial, antifungal, and antiviral, and medium-chain triglycerides in fatty acids such as coconut oil aid in nutrient absorption. They’ve also been shown to be particularly beneficial for managing gastrointestinal disorders, which may help reduce inflammation. The main sources of omega-3 fatty acids are cold-water fish such as wild-caught salmon, sardines, and mackerel. A diet rich in omega-3 fatty acids may help reduce inflammation, but further testing must be done to see if there’s any benefit for those with autoimmune diseases. (Source, Source, Source)
Green tea and its active ingredient, EGCG (epigallocatechin-3-gallate), are anti-inflammatory and have been shown to improve symptoms and decrease the severity in animal models with autoimmune disease. (Source)
Studies show these oils have an overall beneficial effect on autoimmune diseases. (Source)
More studies are needed to fully investigate the influence of a paleolithic-style diet, but the research done so far suggests that, overall, the diet can have a positive effect on health.
The paleolithic diet can elevate levels of HDL, the “good” cholesterol. HDL is known to have antioxidative and anti-inflammatory effects that help protect against autoimmune and other diseases. (Source)
The AIP diet may also help heal a leaky gut, which arises from increased permeability of the intestinal epithelial lining. A leaky gut may allow bacteria and other unwanted substances to pass from the intestines into the bloodstream, leading to an autoimmune reaction. This can then be treated with antibiotics or the AIP diet. (Source, Source)
The AIP diet is safe overall, given that its aim is to cut out foods that are inflammatory triggers. However, the large numbers of foods that are excluded mean there are some concerns to be aware of.
The AIP diet is not intended as a low carbohydrate diet. However, the removal of grains without realizing what vegetable intake is necessary to maintain a healthy level of carbohydrates causes low carbohydrate intake. A lack of carbohydrates, especially complex carbohydrates, can deprive you of highly beneficial nutrients and fiber. (Source)
Research has shown that high-saturated intake can be problematic, especially in certain populations. However, moderate total fat intake, as is encouraged with the AIP framework, is beneficial for the absorption of the fat-soluble vitamins A, D, E, and K, as well as helping to prevent a variety of health concerns related to healthy cell membrane formation. (Source)
The AIP diet, which is more restrictive than the paleo diet, is meant to help reduce inflammation and symptoms of autoimmune diseases. After the elimination and reintroduction phases of the diet, a personalized diet plan can be designed that suits individual needs. More research into the efficacy of the AIP diet for managing autoimmune symptoms is needed, but studies so far show promise. Our Nutritional Therapy Practitioners can help you determine whether the AIP diet is right for you — explore our high-touch care pathways here.
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Lycopene is the phytochemical that gives fruits and vegetables their red color. Lycopene is a potent antioxidant and has anti-inflammatory properties that protect the body from oxidative stress. Lycopene has also been found to decrease “bad” low density lipoprotein (LDL) and increase “good” high density lipoprotein (HDL) cholesterol.
Lycopene may also protect the skin against ultraviolet (UV) damage from the sun. One small study found that participants who added 16milligrams of lycopene to their diet every day had less severe skin reactions to UV light over 10 weeks than a control group without the added lycopene. (Of course, consumption of lycopene-rich foods doesn’t replace sunscreen!)
Carotenoids are responsible for yellow, orange, and red color in many fruits and vegetables. Research suggests that one carotenoid in particular, beta-carotene, may protect against decline in lung function. A study done in 2017 also suggested that eating fruits and vegetables rich in carotenoids such as beta-carotene, alpha-carotene ,and beta-cryptoxanth in had protective effects against lung cancer.
Like lycopene, dietary intake of beta-carotene has protective effects against diseases that are mediated by oxidative stress, such as diabetes, cancer, and autoimmune diseases. High levels of alpha carotene are associated with longevity — one large U.S. study found that high levels of alpha-carotene in the blood were linked with a reduced risk of death over a 14 year period. Aside from its antioxidant effects, the carotenoid beta-cryptoxanthin may prevent bone loss and may have anti-inflammatory and anticancer properties.
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Lutein and zeaxanthin are also part of the carotenoid family, along with beta-carotene, alpha-carotene, and beta-cryptoxanthin. Lutein and zeaxanthin are the only dietary carotenoids that reach the retina, the thin layer of tissue that lines the inside on the back of the eye. They are known to support eye health and have preventative effects against age-related macular degeneration, an eye disease that can lead to the loss of vision as we age. However, lutein and zeaxanthin also have strong antioxidant and anti-inflammatory capabilities. Zeaxanthin can also help to recycle glutathione, another important antioxidant in the body. (9, 15)
Dark green, leafy cruciferous vegetables are a good source of sulfur (isocyanate, sulforaphane, glucosinolate). Our body needs sulfur in order to synthesize certain essential proteins. These sulfur compounds break down into isothiocyanates and indoles in the gut, which are known to have antibacterial, antiviral, antifungal, and anti-inflammatory effects. (36, 52, 33)
Research suggests that sulforaphane may support heart health by reducing inflammation and lowering blood pressure. It may also have antidiabetic effects. One study found that sulforaphane reduced fasting blood sugar in patients with type 2 diabetes. (55, 41, 47)
Glucoraphanin, a glucosinolate that’s found in some cruciferous vegetables, has been found to protect the blood–brain barrier in mice with induced experimental autoimmune encephalomyelitis (used to study MS, which can’t be induced in the same way), suggesting it may reduce the risk of developing MS. (16, 40)
Anthocyanins are phytochemicals that give red, blue, and purple plants their vibrant coloring. Anthocyanins have antioxidant properties that may boost heart health and reduce the risk of developing cardiovascular-related and other chronic diseases. (26)
Anthocyanin-rich foods have been linked to reductions in inflammation and reduced blood sugar concentrations, suggesting they may also have antidiabetic effects. Anthocyanins have also been found to protect eye health. One study found that daily supplementation with pharmaceutical anthocyanins improved the visual function of individuals with normal tension glaucoma (where the optic nerve is damaged despite pressure in the eye being normal). (30, 43)
Other phytochemicals called stilbenoids are typically found in grapes and blueberries. Like anthocyanins, stilbenoids have been shown to have a variety of benefits such as protective effects on the heart and brain, as well as antidiabetic, anticancer, and anti-inflammatory properties. (4)
Allicin, a phytochemical produced when garlic is chopped or crushed, has been associated with a lower risk of coronary events in older adults. Research suggests allicin may help reduce LDL and total cholesterol levels when consumed for more than 2 months. (8, 39)
Garlic is well known for its antimicrobial effects and has historically been used to combat infectious diseases. It is also known to be effective against a variety of bacteria, such as Salmonella, Escherichia coli, and Staphylococcus aureus. (8)
Another phytonutrient that is found in many white, tan, and brown foods is quercetin. Quercetin has anti-inflammatory properties and may be effective against obesity, cancer, viruses, allergies, and high blood pressure. (5)
Serum C-reactive protein (CRP) levels are a biomarker of inflammation in the body. High CRP levels are associated with heart disease, obesity, and lupus. One study done in 2008 found that the intake of foods rich in flavonoids, such as quercetin, is associated with lower serum CRP concentrations. (12)
The thousands of phytochemicals produced by plants for their own protection may also help prevent and treat many of our own medical conditions and diseases. Phytonutrients give fruits, vegetables, grains, nuts, and other plant foods their variety of colors, so “eat the rainbow” to maximize the health benefits offered by these plentiful chemical compounds.
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