The Autoimmune Protocol Diet, or AIP diet for short, is a more extreme version of the Paleolithic diet. Part elimination diet strategy, part lifestyle, AIP was created as a short term, therapeutic diet to create a clean slate for those suffering from autoimmune disorders.

For example, Celiac disease is an immune reaction to eating gluten, so those who suffer from that autoimmune disease stay away from grains. Basically, the AIP diet removes foods that most commonly cause adverse reactions and replaces them with incredibly nutrient-dense, anti-inflammatory foods.

However, as Dr. Sarah Ballantyne points out in her book, The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body, this diet isn’t just for people who suffer from autoimmune disease—it’s for anyone who is interested in optimizing their health and preventing chronic illness. Dr. Ballantyne, who earned her doctorate in medical biophysics and spent years researching innate immunity and inflammation, says the AIP diet can benefit those with other illnesses as well. She states it can “appreciably reduce cardiovascular risk factors, manage type 2 diabetes, improve asthma, allergies, and other immune-related health issues.”

To say that the incidence of certain autoimmune diseases like multiple sclerosis and type 1 diabetes has risen in recent decades is an understatement. Back in 2005, the NIH estimated that up to 23.5 million people in the US had 24 of the 100-plus autoimmune diseases, a sharp increase from a 1996 estimate of 8.5 million. The American Autoimmune Related Diseases Association (AARDA), a nonprofit health agency dedicated to increasing awareness of autoimmune diseases, nearly doubles what the NIH stated 15 years ago, estimating that 50 million Americans have been diagnosed with autoimmune diseases.

What is Autoimmune Disease?

Our immune system is made up of different organs, cells, and proteins that work together to protect our body from foreign invaders, including bacteria, viruses, fungi, and toxins. Autoimmunity is when the immune system misdirects its response and starts attacking the very cells and tissues it is meant to protect. According to Dr. Sara Gottfried, this overactive immune system “leads to chronic inflammation and tissue destruction,” when it is then classified as a disease.

Anatomically, autoimmune disease is very diverse. What separates one disease from another is simply which organ is under siege. There aren’t really autoimmune specialists. Which MD you see depends on what’s ailing you. If you’ve got rheumatoid arthritis, you see a rheumatologist. Hypothyroidism? Endocrinologist. Celiac disease? Gastroenterologist. Psoriasis? Dermatologist. Some people don’t even realize that their condition is autoimmune-related.

According to the Washington Post, the most common autoimmune diseases include “type 1 diabetes, rheumatoid arthritis, multiple sclerosis, lupus, celiac disease, psoriasis, inflammatory bowel disease, and Crohn’s disease.” Yet as previously mentioned, there are a boatload more.

Disproportionately Affects Women

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Approximately 80 percent of people with autoimmune conditions are female. According to a 2011 report published by the AARDA, autoimmune diseases are the top killer of women in the US. That’s because they are the second highest cause of chronic illness and one of the top 10 reasons women die before the age of 65. The US Department of Health and Human Services' Office on Women's Health says these conditions tend to develop during the childbearing years. Although hormones are a factor, there is no one cause for autoimmune disease, so researchers aren’t exactly sure why women are being targeted. It may have to do with estrogen’s effect on the autoimmune response, but it has also been connected to pregnancy.

Key Factors

No one knows why or how people develop autoimmune disease, but a confluence of events causes the body to produce an immune response to itself. The three key factors are genes, environment, and diet and lifestyle (sleep, physical activity, and stress management). According to Dr. Ballantyne, “Genetic predisposition accounts for approximately one-third of your risk of developing an autoimmune disease, the other two-thirds comes from your environment, your diet, and your lifestyle.”

Symptoms

You may have an autoimmune disease and not know it. Allergies, anxiety and depression, blood pressure changes (usually low), digestive problems, extreme fatigue, low blood sugar, memory problems, migraines, muscle and joint pain, muscle weakness, PMS, rashes, recurrent headaches, resistance to weight loss, sleep disturbances, susceptibility to infections, swollen glands, thyroid problems, unexplained weight changes, and yeast infections are all symptoms which may be caused by autoimmunity and can be associated with the early stages of autoimmune disease.

Chronic inflammation is present in many (if not all) chronic diseases, especially in autoimmune diseases, including rheumatoid arthritis, inflammatory bowel disease, lupus, gout, and diabetes. That’s because “one of the common responses of our immune systems to perceived triggers is increased inflammation” according to the The Autoimmune Wellness Handbook, which also mentions, “With inflammation comes all sorts of aches, pains, and uncomfortable symptoms.”

Nutrition or Lack Thereof

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So much of what ails us comes down to what we feed ourselves. This is especially true with autoimmunity, as the gut immune system contains 70-80 percent of our body's immune cells. Furthermore, “some foods cause inflammation and imbalances in key hormones that regulate the immune system; some foods irritate the lining of the gut, interfere with digestion, and deplete nutrients from the body” according to The Paleo Approach.

A review entitled Role of “Western Diet” in Inflammatory Autoimmune Diseases that was published in the medical journal Current Allergy and Asthma Reports states that not only do “nutritional patterns collectively termed the ‘Western diet,’ including high-fat and cholesterol, high-protein, high-sugar, and excess salt intake, as well as frequent consumption of processed and ‘fast foods,’ promote obesity, metabolic syndrome, and cardiovascular disease,” but “these factors have also gained high interest as possible promoters of autoimmune diseases.”

Our staple foods tend to be nutritionally sparse. Many of us suffer from micronutrient deficiencies. The Autoimmune Wellness Handbook states that “many of us are deficient in fat-soluble vitamins (A, D, E, and K); minerals like zinc, iron, or magnesium; B vitamins, vitamin C, antioxidants, non-vitamin nutrients, and certain amino acids.” These nutrients and flora are important because they promote a healthy gut.

Umm...Weren’t You Going to Tell Us About the AIP Diet?

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As mentioned earlier, the AIP diet is not just a diet, but a lifestyle that helps regulate the immune system by “providing the body with the nutritional resources required for immune regulation, gut health, hormone regulation and tissue healing” as described by Dr. Ballantyne on her blog The Paleo Mom. It puts the emphasis on nutrient-dense foods and cuts out anything that may trigger inflammation.

The AIP diet could be called the “even picker paleo diet” because it eliminates foods like nightshades (i.e. tomatoes and peppers), eggs, nuts, seeds, and alcohol that may stimulate the immune system or harm the gut environment.

Lifestyle

Inflammation is triggered by inadequate sleep, stress, and being sedentary. So the lifestyle portion of the protocol is just as important as what you can and cannot eat on the AIP diet when it comes to reducing inflammation. Sufficient sleep, stress management, activity, and spending time outdoors, as well as forming a support system are all important immune modulators. It goes without saying that smoking and alcohol consumption may also be risk factors. Together with dietary changes, these lifestyle changes regulate your immune system, reduce inflammation, and promote healing.

What You Can’t Eat

Don’t freak out about what all is or is not on this list, it’s not forever. This is called the elimination phase, and it’s about getting to a healthy baseline then building back up from there.

Alcohol
Chocolate
Coffee
Dairy
Eggs
Food additives including emulsifiers and thickeners
Grains (corn, oats, quinoa, rice, wild rice)
Legumes (beans, peas, chickpeas, lentils, soybeans, peanuts)
Nightshades (potatoes, tomatoes, eggplants, bell peppers)
Non-nutritive sweeteners (Equal, Sweet and Low, Splenda)
NSAIDS (aspirin or ibuprofen)
Nuts (including nut butters, flours and oils)
Potential gluten cross-reactive foods
Refined and processed sugars and oils
Seeds (and products derived from seeds such as seed oil)
Spices derived from peppers, including black pepper, and paprika
Seed-based spices

What You Can Have a Little Of

Moderate your intake of:
Coconut
Fructose (from fruits and starchy vegetables)
Fruits and veggies with a high-glycemic-load (includes dried fruit like dates)
Natural sugars (like honey)
Saturated fat (aiming for 10-15% of total calories)
Unrefined salt such as Himalayan pink salt

What You Can Eat

Animal fats
Fish (preferably wild-caught, at least 3x/week): anchovy, bass, catfish, cod, crappie, haddock, halibut, herring, mackerel, mahi-mahi, perch, snapper, swordfish, tilapia, tuna, walleye
Fruit: apples, apricots, avocados, blackberries, blueberries, cantaloupe, cherries, clementines, coconut, cranberries, cucumbers, grapefruit, grapes, guava, honeydew, huckleberries, kiwifruit, lemons, limes, mangoes, mulberries, nectarines, okra, olives, oranges, papaya, passionfruit, peaches, persimmons, pineapple, plantains, plums, pomegranate, pumpkin, raspberries, strawberries, squash, tangerines, watermelon, zucchini
Gycine-rich foods (5x/week): offal, organ meat, bone broth
Herbs and spices
Meat: basically any mammal, including beef, bison, deer, lamb, and pork
Mushrooms
Oils: (healthy, plant-based): avocado oil, coconut oil, olive oil, palm oil
Probiotic/fermented foods (coconut milk yogurt, fermented vegetables or fruit, kombucha, kefir)
Poultry (in moderation): basically any bird, including chicken, duck, guinea hen, turkey essentially any bird Shellfish: clams, crab, crawfish, lobster, mussels, octopus, oysters, prawns, scallops, shrimp
Vegetables (8 servings/day): artichokes, arugula, asparagus, beets, broccoli, Brussels sprouts, cabbage, carrots, cauliflower, celery, chives, collard greens, endive, fennel, horseradish, garlic, ginger, kale, leek, lettuce, mustard greens, onions, shallots, spinach, sweet potatoes, Swiss chard, radishes, and turnips

See complete list here.

Tips

Taste the rainbow—the more colorful the better!
Variety is the spice of life, mix it up as much as you can.
Source the best quality ingredients you can. Buy quality meats, poultry, fish, and shellfish. They should be grass-fed, pasture-raised, or wild-caught if possible.
Cook with quality fats listed above.
Make AIP-friendly substitutions to your regular recipes. Olives and fish sauce can replicate the umami flavor of tomatoes.
Plan ahead. Following this strict diet is extremely hard, so you’ll want to be prepared with plenty of foods you can eat.

Recipe Resources

Reintroduction

Once you start feeling better, which could take anywhere from one month to one year, you can start reintroducing foods in stages. Start gradually, being careful to pay attention to your body’s reaction. Keep an eye out for gastrointestinal symptoms, low energy, sugar cravings, sleep issues, headaches, extra mucus, allergic reactions, aches and pains, skin changes, mood issues, anxiety, and lowered stress tolerance.

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