The AIP Diet: A Beginner's Guide to Understanding Autoimmune Protocol

Understanding the AIP Diet

Popular diets are oftentimes more fad than friend, since a lot of diets come and go without much benefit. The AIP diet, or Autoimmune Protocol, on the other hand, is a diet with the potential for helping people struggling with autoimmune diseases.

What is the Autoimmune Protocol (AIP)?

The Autoimmune Protocol (AIP) is a specialized dietary approach to help manage and reduce symptoms of autoimmune diseases, including inflammatory bowel disease (IBD), Hashimoto’s thyroiditis, and rheumatoid arthritis, among others. 

Autoimmunity is a process where the body’s immune system mistakenly attacks its own tissues in response to what it perceives as foreign invaders. While we want our immune systems to stomp out real threats like bacteria and viruses, the response becomes dysregulated during autoimmunity, leading to inflammation and tissue damage. 

Origins and Purpose

The AIP diet was originally designed by Dr. Loren Cordain, a researcher focused on evolutionary medicine, dietary practices, and the development of autoimmune conditions. He believed that certain foods could trigger inflammation in people with autoimmune diseases. Eliminating these foods from the diet could potentially help manage the conditions. 

Difference from the Paleo Diet

The AIP and Paleo diets are similar in that both emphasize whole, nutrient-dense foods and eliminate processed foods, grains, legumes (beans and lentils), and dairy (in most cases).

However, AIP is more restrictive and specifically designed for therapeutic benefit for individuals with autoimmune diseases. For example, the AIP diet additionally restricts eggs, nightshades (plants such as tomatoes, eggplant, potatoes, and certain spices), and nuts and seeds, which may trigger an immune response in those with autoimmunity. Additionally, AIP is meant to be a phased approach, with eventual reintroduction of foods after symptoms improve. 

The Science Behind the AIP Diet

How It Affects the Immune System

The AIP diet aims to reduce inflammation by removing potential inflammatory food triggers for a short period of time. Doing so allows the immune system and gut intestinal barrier to return to a more regulated (less-inflamed) state to alleviate symptoms and heal damaged tissue. 

Research and Studies

Current research on the AIP diet is mostly limited to studying how the diet impacts people with inflammatory bowel disease (IBD) and Hashimoto’s thyroiditis. Studies show that following the diet can help improve quality of life, IBD disease activity, and inflammation markers. However, additional research is needed to confirm these results as well as understand if the AIP diet is supportive for other autoimmune disorders.

Phases of the AIP Diet

The AIP diet involves two phases: the elimination phase and the reintroduction phase.

The Elimination Phase

Foods to Avoid

During the AIP elimination phase, the following foods should be avoided until symptoms improve: 

• Grains (pasta, rice, barley, bulgur, farro, quinoa, couscous, bread)

• Legumes (beans, peanuts, peas, chickpeas, etc.)

• Nightshade vegetables (tomatoes, eggplant, peppers, tomatillos, etc.)

• Dairy

• Eggs

• Nuts

• Seeds (chia, pumpkin, sunflower, flax, hemp)

• Ultra-processed oils, such as corn oil, soybean oil, and canola oil

• Coffee

• Refined or artificial sweeteners

• Alcohol

• Artificial sweeteners, such as sucralose, saccharin, and aspartame

• Food additives, such as modified food starch, artificial food dyes and thickeners like guar gum and carrageenan
  
  
  

In addition to these foods, the AIP diet also eliminates the use of non-steroidal anti-inflammatory drugs (NSAIDS). However, always talk to your healthcare provider before making any changes to your medication regimen.

The Reintroduction Phase

Once symptoms have improved following the elimination phase, you can begin the reintroduction phase.

How to Reintroduce Foods

The avoided foods should be reintroduced one by one to identify whether or not you can tolerate the foods without symptoms of sensitivity.

While there are different suggested protocols for reintroducing foods, the general process usually looks similar:

Reintroduce one avoided food at a time, usually in multiple small portions over the course of a day. Next, avoid that food (and any new reintroductions) for at least one day and up to 3 days, often called “washout days.” This enables you to isolate and connect any symptoms back to the reintroduced food. 

With each new reintroduction trial, you may want to choose a food from a different food group or category. For example, you could begin by reintroducing yogurt (dairy), followed by eggs a few days later, then followed by nuts, and so on. 

Monitoring and Recording Reactions

After reintroducing a food, monitor for any initial reaction that may occur within 15-20 minutes. Immediate reactions could include symptoms such as skin rashes, congestion, headache, fatigue, bloating, or irritation in the mouth. If any symptoms arise, stop eating the food and plan to avoid it, potentially reintroducing this food again at a later date after reintroducing other foods. If no reaction occurs immediately, plan to eat additional small portions of this food several times throughout the day. Continue to monitor and make note of any reactions during the following “washout days” as well. 

Foods to Include and Avoid

While a big part of the AIP diet is avoiding potential trigger foods to reduce inflammation and tissue damage, perhaps equally important is the focus on eating nutrient-dense foods to help repair those tissues and promote a return to normal functioning.

Approved Foods

The following are a list of approved foods while following the AIP diet. Note that these foods should be unprocessed or minimally processed without additives. 

Vegetables, Fruits, and Meats

Most of your diet during the elimination phase should include vegetables, fruits, and meats, especially grass fed or pasture raised when possible. Plan to get a variety of each of these foods to get a variety of beneficial nutrients for healing. 

Include plenty of vegetables such as dark leafy greens and cruciferous vegetables (if tolerated without gut disturbance). Remember to avoid nightshade vegetables, including tomatoes, eggplants, white potatoes, and peppers and pepper-derived spices such as cayenne and paprika. Sweet potatoes are not a nightshade food and are allowed on AIP. Plan to avoid grain and legume types of vegetables, including corn, peas, and beans. 

Eat fruits as a delicious way to get nutrients and additional anti-inflammatory benefits.

Include meats, poultry, or fish without additives at each meal as your main source of AIP-approved protein. In addition to essential protein, these foods also provide additional nutrients needed for healing, such as vitamins, minerals, and omega-3 fats. 

Importance of Organ Meat

In addition to popular cuts of meat like steak, ground beef, or chicken breasts, which are categorized as “muscle meats” since they mainly come from the muscles of the animals, also plan to include organ meats when you can. Organ meats, such as liver, kidney, heart, and bones, are rich in a host of essential nutrients like vitamin A and zinc, which are necessary for immune function. Plan to include a few servings of these each week into your AIP diet plan for additional nutrition support. If taste is an issue, mix small portions of ground organ meats with muscle meats and herbs and spices (excluding pepper-based ones) to mask the flavor, such as in meatball recipes. 

Fermented Foods and Their Benefits

The AIP diet also encourages consumption of fermented foods to support gut healing. Fermented foods contain probiotics and postbiotics. Probiotics are live, healthy bacteria that support the gut microbiome. Postbiotics are substances produced by the probiotic bacteria that may provide additional health benefits.

Fermented foods that are allowed on the AIP diet include sauerkraut, kimchi, kombucha, vegetables and fruits pickled through fermentation (without vinegar), kefir and yogurt made from coconut milk, and raw unfiltered apple cider vinegar.

Benefits of the AIP Diet

The major purported benefits of the AIP diet include managing and reducing the symptoms of autoimmune conditions and supporting gut healing.

Managing Autoimmune Disorders

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune condition involving inflammation in joints that causes pain, swelling, stiffness, and sometimes joint deformities. Only one small controlled study in 2023 studied the benefits of the AIP diet in people with rheumatoid arthritis. Although the results were promising for reducing symptoms of RA using the AIP diet, additional research is needed.

Inflammatory Bowel Disease

A few studies have observed benefits with the Autoimmune Protocol for people with inflammatory bowel disease (IBD). In one study of individuals with ulcerative colitis (UC), a type of IBD, the AIP diet reduced inflammatory markers. Another study found that participants with either UC or Crohn’s disease experienced improved quality of life after following the AIP diet. However, further investigation is needed.

Improving Overall Health

Gut Health and Leaky Gut

Research suggests that autoimmunity has its origins in a response to stress, be it psychological or physiological. Stress disrupts the function of the intestinal barrier, a process called “leaky gut,” leading to an autoimmune response in the body. Although autoimmune processes are often accompanied by a leaky gut, experts do not yet have consensus on whether or not there is a definite cause-and-effect relationship between these two processes. 

Long-term Quality of Life

For those struggling with an autoimmune condition, symptoms can be debilitating. It is important to find ways to manage the condition by reducing symptoms. 

While the AIP diet can be challenging to follow due to its restrictive nature in the elimination phase, it may be worth it in the long term. Research shows that the AIP diet helps improve quality of life for individuals with Hashimoto’s thyroiditis and IBD. However, no changes in disease markers, like thyroid function or thyroid antibodies, were shown. Additionally, the goal of AIP is to not be so restrictive forever but instead to reintroduce food, with the goal of establishing the broadest diet possible while maintaining tolerance. 

For those struggling with autoimmunity, there is potential for flares to occur, especially during stressful times. Returning to the elimination phase of the AIP diet during those times may be useful. 

Tips for Success on the AIP Diet

The AIP diet requires significant dietary changes, so it is important to have a plan. A Season registered dietitian can guide you through the elimination and reintroduction phases of the AIP diet.H3: Meal Planning and Preparation

Creating a Weekly Meal Plan

The limited food options when following the AIP diet can make choosing what to eat for meals challenging. To make it easier, create a weekly meal plan ahead of time. Build your meal by starting with a protein source like meat, poultry, or fish. Choose a variety of veggies and add an AIP-approved carbohydrate source, such as sweet potato, plantains, or fruit. Add healthy fats like avocado or olive oil for flavor and added nutrition. 

Batch Cooking 

To make it even easier to follow the AIP diet plan, consider batch cooking. Batch cooking means preparing large portions of foods to be used as leftovers. Plan to batch cook a few protein sources each week, such as oven-baked or grilled chicken and fish and ground beef cooked in a skillet. Next, chop a variety of veggies - roast or steam half of them and leave the other half raw for salads or snacks. Also batch cook starches such as sweet potatoes and plantains.

Use your batch-cooked foods to easily put together a variety of dishes throughout the week to keep things exciting. 

AIP Recipe Ideas

An example of an AIP-approved breakfast could be sausage and sweet potato hash made with a mix of cooked ground meat with roasted sweet potato pieces and a side of avocado. 

For lunch, prepare a salad of chopped cooked chicken and add to a bed of leafy greens and veggies. Top with a drizzle of olive oil and apple cider vinegar for dressing, and serve with fruit on the side. 

For dinner, pair cooked fish with roasted veggies and homemade sweet potato fries. Finish with a dessert of coconut yogurt sweetened with  berries. 

Working with a Registered Dietitian

Finding a Qualified Professional

When looking for a dietitian, consider working with one that specializes in digestive health and autoimmune conditions. Their expertise may be more relevant to your goals. You can find a dietitian through Season Health. To help you get started, take the short 2-minute assessment to get matched to a dietitian that’s right for you and within your insurance network. 

Benefits of Professional Guidance

Following the AIP diet elimination phase and navigating the reintroduction phase on your own can be challenging. Working with a registered dietitian can make it easier. A dietitian can help you create an AIP-approved meal plan while making sure you are meeting all of your nutrition needs. They can support you in reintroducing foods and identifying which foods you are able to tolerate.

Common Challenges and Solutions

Here are some additional tips to help you navigate the challenges of following the AIP diet.

Social Situations and Dining Out

How to Stay on Track

Before dining out, take a look at online restaurant menus for AIP-friendly options. You can also call ahead to ask if the restaurant can accommodate special dietary requests. Look for dishes prepared with simple cooking methods such as grilling and steaming. Opt for simple dishes like grilled meats, steamed or roasted vegetables, and salads. 

Communicating Dietary Needs

Talk to your restaurant server and explain your dietary needs, emphasizing that you need to avoid specific ingredients. If it’s not clear on the menu, ask the server to verify with the chef which ingredients are used in dishes that you are considering. 

Staying Motivated

Tracking Progress

Keep a journal to regularly track any changes in symptoms as you follow the elimination phase as well as when reintroducing foods. Document any improvements or flare-ups, including details like pain levels, digestive issues, skin changes, and energy levels. Plan regular check-ins with your healthcare provider or dietitian to help you assess progress and make any necessary adjustments.

Finding Support Groups

Since following the AIP diet requires quite a bit of change in your day to day routine, joining a support group can help. There are AIP support groups online that discuss meal planning tips, share recipes, and offer support for navigating challenging situations. H2: Conclusion: Is the AIP Diet Right for You?

When making informed decisions about your health, it's important to weigh the pros and cons of the AIP diet. This diet can be a powerful tool in managing autoimmune conditions and promoting a healthier lifestyle, but it requires commitment and careful planning.

Final Thoughts

In the short term, the AIP diet can potentially help reduce inflammation and alleviate autoimmune symptoms. It can also be a useful approach to identify food sensitivities. A well-planned AIP diet emphasizes nutrient-dense, whole foods that can support overall health even beyond the potential for anti-inflammatory and autoimmune support.

In addition to the dietary changes, the AIP diet also encourages holistic lifestyle changes including stress management, regular exercise, and good sleep hygiene which can help support long-term wellbeing.

Whether the AIP diet is right for you ultimately depends on your willingness to make meaningful changes that align with your health objectives.