You likely have heard about the Paleo diet. But have you heard about the Autoimmune Paleo Diet, usually called the Autoimmune Protocol (AIP) Diet?
The standard Paleo diet is based on what our distant ancestors ate when humans were hunters and gatherers. It removes grains, dairy products, legumes, and sugar, all of which are linked to triggering or worsening inflammation and autoimmune reactions.
What Is the AIP Diet & How Does It Work?
The AIP diet goes beyond straight Paleo to eliminate other healthy foods that can sometimes trigger inflammation in people with autoimmune disease. The purpose is to eat as clean a diet as possible for a month or two to heal the immune system and digestive tract lining, then slowly reintroduce eliminated food groups one at a time to assess reactions, identify unique food triggers to your condition, and develop a personalized Paleo diet for optimal healing.
The combination of the Paleo diet and an elimination diet is therapeutic and also is a tool to help you identify your personal triggers that aggravate your autoimmune condition and symptoms. It is more restrictive than Paleo, but it is not designed to stay on so strictly forever. The idea is to follow the elimination phase of the diet for 30 days—and in severe autoimmune conditions, sometimes up to 90 days—until healing starts to occur and uncomfortable symptoms subside or sometimes disappear. Then move into the reintroduction phase of the diet to figure out which foods are good for your body and which aren’t. Here is your step-by-step guide:
Step One: Eliminate These Foods and Beverages
- All grains (including wheat, oats, corn, and rice)
- All milk products (including butter and ghee)
- Nuts and seeds
- Legumes and beans (including soy and peanuts)
- Nightshade vegetables (tomatoes, tomatillos, potatoes, goji berries, eggplant, peppers, and spices like paprika and cayenne pepper)
- All oils (except for olive, avocado, and coconut oils)
- All sugars (including alternative sugars, such as stevia and xylitol)
- Herbs derived from seeds (i.e., allspice, caraway, cumin, mustard)
- Food additives or processed foods
Step 2: Focus on These Foods and Beverages
- Meat (preferably grass-fed), poultry (preferably organic), and fish (wild-caught)
- Vegetables, except for nightshade vegetables
- Sweet potatoes
- Fruit in small quantities
- Coconut (oil, milk, flour, and coconut aminos)
- Avocado, olive, and coconut oils
- Non-dairy fermented foods (including sauerkraut and coconut yogurt)
- Fresh non-seed herbs (i.e., basil, chives, mint, oregano, parsley, ginger, garlic)
- Small amounts of tea and non-seed herbal teas
- Bone broth
- Grass-fed gelatin
- Coconut flour, tiger-nut flour, arrowroot, and tapioca starch
Step 3: Plan Your Breakfast, Lunch, Dinner, and Snacks
Regularly having combinations of the above foods as your base diet requires significantly changing your eating and drinking habits.
Breakfast: To start your day, break out of the routine of traditional breakfast foods and instead eat a scramble of meat and vegetables. Rather than drink coffee in the morning, have one cup of tea, preferably green tea, which reduces inflammation, or drink organic chicken or beef bone broth, which is the beverage of choice to supply nutrients to strengthen and heal the digestive tract lining.
Lunch and Dinner: Keep combining high-quality animal protein and a variety of vegetables in creative ways. This could mean: A main-dish salad with assorted lettuces and vegetables topped with chicken and olive oil, lemon juice, and oregano dressing. Or avocado-tuna salad. Or grass-fed beef stew with garlic, onions, carrots, and white sweet potatoes. Or roasted chicken breast with steamed broccoli and cauliflower topped with homemade gravy made with bone broth and arrowroot.
Snacks: Good snacks include: black, green, or Kalamata olives; coconut butter (also known as coconut manna); EPIC bars that are AIP-compliant, such as the Venison or Beef Sea Salt and Pepper Bars; bone broth; fresh veggies, like carrots, celery, cucumbers, radishes; Inka Chips Roasted Plantain Chips; Jackson’s Honest Sweet Potato Chips; sardines; small portions of leftover food; Gemini Superfoods Whole Tiger Nuts (which are actually tubers, not nuts); and fresh berries with shredded coconut, coconut milk, and cinnamon.
Follow the base diet for at least 30 days. When positive change in your condition is observed, then move into the reintroduction phase of the diet.
Step 4: Reintroduce Formerly Off-Limits Foods
The reintroduction phase is a process of slowly and systematically reintroducing foods that you have avoided and then paying attention to any symptoms you experience. This is a process of discovering and learning how different foods affect you. It works most successfully if you keep a food and symptom journal. What to do:
- Eat two to three servings of a new food over the course of one day, and then eat as you have been eating during the elimination phase for the next three days, noting any symptoms that arise. Reactions may not always occur immediately and could occur a day or two later.
- If you experience no symptoms after four days, that food is considered safe, and you are clear to eat that food again, but don’t eat it excessively.
- If you notice uncomfortable symptoms—for example, a flare-up of inflammation and increased pain in your joints after eating tomatoes—put that food back on your avoid list and refrain from eating it for six months before trying again. You may find after six months, your body no longer reacts to that food, or you might find that your body continues to react. This is how you listen to the symptoms your body gives you to identify your personal food triggers.
- Approximately five days after trying one eliminated food, try another, and then record any symptoms, whether good or bad. Keep reintroducing eliminated foods every five to seven days.
Within approximately six weeks to two months, you should be finished with the elimination diet and will have honed your personalized Paleo plan for healing. If you have trouble with this process of fine-tuning the diet, consider working with a nutritionist or health practitioner who specializes in AIP. When the AIP diet is followed correctly, it turns food from a cause of disease to food as medicine.
How the AIP Diet Developed and Evolved
The underpinnings of the Paleo Autoimmune Protocol (AIP) have been attributed to Loren Cordain, PhD, author of The Paleo Diet, who about a decade ago discovered that certain Paleo-compliant foods (e.g., eggs, nightshades, nuts, and seeds) can sometimes trigger inflammation in people with autoimmune diseases and/or tendencies. The diet was further popularized and outlined by Robb Wolff as an elimination diet in his book The Paleo Solution. The AIP diet then was expanded by Sarah Ballantyne, a scientist with autoimmunity who is known as the Paleo Mom, in her book The Paleo Approach. A few other early-adopters blogged about their experiences on the diet.
Though the AIP diet has not been the subject of much scientific research thus far, it is backed by the experiences of numerous people have followed the eating plan and found dramatic improvements in their autoimmune condition and general health. AIP Stories of Recovery are posted monthly on autoimmunewellness.com.
In recent years, the helpfulness of the diet for autoimmune diseases has been documented in the following research.
In 2017, the first-ever medical study on the efficacy of AIP was shown with patients with inflammatory bowel disease (Crohn’s disease and ulcerative colitis). The study found a 73 percent rate of clinical remission achieved at week 5 of the study that was maintained during the elimination phase.
In 2019, another study backed up the clinical benefit from using the AIP diet in patients with inflammatory bowel disease, so much so that 32 percent reported discontinuing steroids, drugs that are often prescribed as a treatment for the condition.
That same year, a study evaluating the use of the AIP diet in patients with Hashimoto’s thyroiditis, an autoimmune condition that affects the thyroid gland, found a 29 percent decrease in inflammation. The participants also reported a reduction in symptoms and improved quality of life.
A version of the AIP diet called the Wahls diet is being studied to determine if the diet helps improve symptoms in patients with multiple sclerosis (MS), an autoimmune neurodegenerative disease. One of the researchers, Terry L. Wahls, MD, author of The Wahls Protocol, says the diet helped her health so much that over time she was able to go from using a wheelchair to biking to work each day. An earlier small study found that people with MS who switched to this diet for a year became much less tired.
Melissa Diane Smith is a health journalist and holistic nutritionist who has more than 20 years of clinical nutrition experience and specializes in using food as medicine. She is the cutting-edge author of Going Against GMOs, Going Against the Grain and Gluten Free Throughout the Year and coauthor of Syndrome X. To learn about her books, long-distance consultations, nutrition coaching programs, or speaking, visit her websites melissadianesmith.com and againstthegrainnutrition.com.