The Autoimmune Protocol Diet (AIP Diet) : Does it help? - Amy Burkhart, MD, RD (2024)

By Amy Burkhart MD, RD

Autoimmune diseases are on the rise. Most current treatment options for autoimmune disorders are medications that suppress or modify the immune system. Patients are searching for other options. Enter the AIP diet- The Autoimmune Protocol Diet. But does it really help? What does the science show? And, do people who live with autoimmune disease say it has positive benefits?

The AIP diet eliminates foods that may worsen symptoms or increase inflammation.

The AIP diet, or Autoimmune Protocol diet, is designed to help individuals with autoimmune conditions alleviate symptoms and enhance their overall well-being. This nutrition plan incorporates nutrient-rich foods that minimize inflammation and support a healthy gut flora. Given that the gut plays a central role in the immune system, enhancing gut balance may contribute to the self-regulation of the immune system.

The specific definition of the Autoimmune Protocol Diet varies depending on the source, but in general, the AIP diet

Eliminates:

• Dairy
• Food additives (e.g. nitrates, emulsifiers, preservatives) (1)
• Gluten
• Grains
• Nuts and seeds
• Legumes (beans, peanuts)
• Nightshade vegetables (tomatoes, peppers, potatoes, and eggplant)
• Oils (e.g. soy and canola oil)
• Added sugars and sweeteners
• Coffee and alcohol

And Includes:

• Chicken
• Coconut and coconut oil
• Fish
• Fruits
• Meat
• Vegetables (except for nightshades)

An autoimmune condition occurs when the body’s immune system loses the ability to tell which cells are its own cells vs. actual threats.

The immune system can turn against the body, targeting its own cells and organs, leading to lasting damage and ongoing health issues. An instance of such a condition is Type 1 diabetes, where the immune system attacks the pancreas cells, impairing their ability to produce insulin permanently. Following diagnosis, individuals with Type 1 diabetes must continually administer insulin through injections for the rest of their lives.

There are many other autoimmune conditions. A few are listed here:

• Celiac disease
• Crohn’s disease
• Hashimoto’s thyroiditis
• Lupus
• Multiple sclerosis
• Rheumatoid arthritis
• Sjögren’s syndrome
• Transverse myelitis
• Ulcerative colitis

Autoimmune conditions are being diagnosed faster than can be explained by genetics. While genes certainly play a role in the development of autoimmune conditions, the diet may also play an important part.

The food and drink we consume may be one of the biggest modifiable influences on our risk of autoimmune disease.

While genes may make us more genetically vulnerable to an autoimmune condition, diet has a great influence on our overall health. The effect of diet on autoimmune disease is no longer being overlooked. Celiac disease is an autoimmune disorder that is treated solely by diet. We know that the gluten-free diet used to treat celiac disease positively changes the person’s microbiome (gut bacteria).

The microbiome is a key player in regulating the immune system. But what about other autoimmune diseases? Scientists are more readily investigating diet as an adjunctive treatment for autoimmune diseases.

Studies have shown that having a diverse and robust population of healthy bacteria living in your gut can positively influence someone with autoimmune disease. The bacterial diversity of the gut is greatly affected by diet. Thus, altering one’s diet in a particular way can be used to increase microbial diversity in the gut.

Increased diversity of gut bacteria is a good thing. (2, 3, 4, 5). The AIP diet focuses on foods that improve the diversity of gut bacteria. The goal of doing this is to modify our body’s immune response (6).

The Autoimmune Protocol Diet dates back about 20 years.

Dr. Loren Cordain, a professor at the University of Colorado, is credited with the development of the AIP diet. She proposed that inflammation arises in individuals with autoimmune diseases due to the consumption of specific foods.

Research on the Autoimmune Protocol Diet is emerging.

Read below for specific conditions that have been studied in relation to the AIP diet.

The AIP diet may be helpful because it lowers inflammation (8).

In 2017, the initial study using the AIP diet as an intervention for inflammatory bowel disease concluded. The study involved 15 individuals diagnosed with either Crohn’s disease or ulcerative colitis.

Participants adhered to a 6-week elimination diet, gradually excluding foods prohibited on the Autoimmune Protocol Diet. Following this initial period, they maintained the full AIP diet for an additional five weeks. Remarkably, after the initial six weeks, 73% achieved remission and sustained it throughout the diet.

Notably, two patients experienced exacerbated symptoms, potentially attributed to anatomical differences. Follow-up endoscopy tests also revealed a reduction in inflammation.

After 10 weeks, the AIP diet in conjunction with lifestyle changes showed significant improvement in the quality of life, disease burden, and inflammation markers in the blood.

A 2019 study used the AIP diet, in conjunction with lifestyle changes, to assess the effect on people with Hashimoto’s thyroid disease.

While this was a small study, it paves the way for larger studies looking at this diet and factors that may help the 14 million people (in the US alone) with this common autoimmune disorder.

These changes helped people with MS feel better and have fewer symptoms.

In 2015, there was a study that found people with multiple sclerosis, a disease attacking the nervous system, felt better when they made dietary changes similar to the AIP.

Dr. Terry Wahls, a doctor with multiple sclerosis herself, came up with the diet used in the study. When regular medicine didn’t work for her, she tried a diet called modified paleo AIP, along with making other changes to her daily life.

Dr. Wahls went from needing a wheelchair to being able to ride her bicycle. Because the plan includes not just dietary changes but also things like daily stretching, taking extra nutrients, and managing stress, it’s hard to say if all the improvements are only because of the diet.

Even though it’s a small study, the fact that the overall plan seemed to help is good news for a tough illness. We still need more studies to understand this connection even further.

Dr. Alessio Fasano discovered zonulin, the protein that determines how leaky (permeable) the gut is. (11).

While he is not researching the AIP diet specifically, he has done extensive research on gluten and autoimmune conditions.

Gluten may cause leaky gut syndrome and make autoimmune conditions worse for some people (12). This is yet another example of how diet may affect autoimmune disease.

The AIP diet eliminates many common food groups that we enjoy for comfort, celebrations, and convenience.

Eating in a way that limits your food choices can be hard on your feelings and friendships, especially if you do it for a long time.

Trying the AIP diet can also be expensive and means you need to make most of your own meals if you can’t afford an AIP meal delivery service. If you’re already tired from an autoimmune condition, just making a small change in your diet can feel like a really big deal.

Making such a big change in how you live might seem like a lot. But if changing what you eat can make your life better, it might be worth trying, as long as you’re ready for the challenge.

AIP Breakfast: Chicken sausage, blueberries, herbal tea

AIP Lunch: Spaghetti squash with ground beef with a side salad

AIP Dinner: Salmon, sweet potato wedges, sauteed mushrooms in coconut oil

AIP Snack: Plantain chips

A few of the following AIP meal delivery services might be available near you.

While many restaurants may have a hard time providing you with compliant AIP meals, AIP meal delivery kits or services may be an option.

• Paleo On The Go
• Pete’s Paleo
• The Good Kitchen
• Wild Zora

While there are many unknown factors at play with the development and expression of an autoimmune condition, diet is one we can control.

Making sure you get enough sleep, manage stress, exercise, and keep your vitamin D levels in check is important. All of these things can impact inflammation, which is important always, but especially in autoimmune diseases.

Now, we’ve found out that what you eat can affect autoimmune diseases. The studies on the AIP diet so far show good results. This special diet has been proven to help bring down inflammation and make life better by easing symptoms and boosting energy.

The AIP diet might not work for everyone because it can be challenging. But if you’re looking for help with your autoimmune condition, it might be the answer you have been searching for.

• Efficacy Of The Autoimmune Protocol Diet For Inflammatory Bowel Disease
• Efficacy Of The Autoimmune Diet For Hashimoto’s Thyroid Disease
• The Autoimmune Protocol Diet And Effect On Quality Of Life In Inflammatory Bowel Disease
• The Autoimmune Protocol Diet And Its Effect On Gene Expression In Inflammatory Bowel Disease