The AIP diet: Can it help your autoimmune condition?

Key Points

• The autoimmune protocol (AIP) diet is a specialized elimination diet designed to help reduce inflammation and identify food triggers for individuals with autoimmune conditions.
• It involves an initial elimination phase (typically 30-90 days) removing common potential irritants like grains, legumes, dairy, eggs, nuts, seeds, and nightshades, followed by a careful reintroduction phase.
• Some small studies suggest potential for symptom improvement in conditions like inflammatory bowel disease (IBD) and Hashimoto's thyroiditis, but robust research is still needed for many autoimmune diseases
• AIP is highly restrictive and carries risks of nutritional deficiencies if not well-planned; working with a registered dietitian is crucial for guidance and safety

If you’re living with an autoimmune condition, you might have heard about the autoimmune protocol (AIP) diet. It's a plan aimed at reducing inflammation and helping you identify foods that might trigger your symptoms.

But what is the AIP diet, exactly? And is there any evidence that it helps ease autoimmune symptoms? This guide breaks down the AIP diet – what it is, how it works, potential benefits, challenges, and what current science says. A personalized approach, ideally with professional guidance, is key.

What exactly is the AIP diet plan? More than just paleo

The AIP diet is an extension of the paleo diet, but is significantly stricter. Its primary goal is to calm an overactive immune system and reduce inflammation, which are hallmarks of autoimmune diseases.

The core idea is an elimination phase, removing foods commonly problematic for people with autoimmunity, followed by systematic reintroduction to pinpoint individual food sensitivities. The AIP diet aims to reduce inflammation, support gut health (by addressing potential "leaky gut" or increased intestinal permeability, as some research explores), and identify personal food triggers.

How does the AIP diet work?

The AIP diet is a structured process with two distinct phases, not a lifelong restriction.

Phase 1: Elimination phase

This is the strictest part. For 30 to 90 days (or until significant symptom improvement), you'll remove a wide range of foods to give your body a break from potential triggers.

Foods typically eliminated include:

• Grains (wheat, rice, corn, oats)
• Legumes (beans, lentils, soy, peanuts)
• Dairy products
• Eggs
• Nuts and seeds (and their butters/oils)
• Nightshade vegetables (tomatoes, potatoes, peppers, eggplant)
• Processed foods, refined sugars, and industrial seed oils
• Alcohol and coffee
• Certain food additives (thickeners like carrageenan)

You temporarily remove these foods because components within them (like gluten, lectins, or alkaloids in nightshades) may be problematic for some individuals with autoimmune conditions by potentially irritating the gut or stimulating the immune system. They’re not inherently problematic – it’s important not to demonize any particular foods. But some people with autoimmune conditions can be triggered by some of these foods.

So, what can you eat? The focus is on whole, unprocessed, nutrient-dense foods:

• Quality meats and fish (grass-fed, wild-caught), including organ meats
• Most vegetables (excluding nightshades), aiming for variety
• Fruits in moderation
• Healthy fats (olive oil, avocado oil, coconut oil, avocados)
• Fermented foods (non-dairy, like sauerkraut, kimchi)
• Bone broth
• Herbs and spices (non-seed, non-nightshade based)

This phase aims to clear out all potential triggers from your system and “reset” before reintroducing each food one at a time.

Phase 2: Reintroduction

Once symptoms noticeably improve, it's time for reintroduction. This is where personalization comes in.

The general process:

1. One food at a time: Choose one food to reintroduce.
2. Start small: A tiny amount on day one.
3. Gradually increase (if no reaction): If no symptoms, try a bit more the next day, then a normal serving.
4. Observe for 3-7 days: Monitor for reactions for several days before trying another new food. Symptoms aren't always immediate.
5. Keep a detailed journal: Note food, amount, date, and any symptoms (digestive, pain, fatigue, skin, mood).

“I remind clients that the elimination phase is temporary and meant to uncover triggers, not a lifelong sentence,” says Sarah Nash, RD. “Focusing on what they can eat and finding satisfying alternatives helps make it more manageable.”

As you can tell, the AIP reintroduction process is complex. Working with a registered dietitian specializing in autoimmune conditions is highly recommended. An RD’s expertise can smooth out the process and help relieve the mental burden of trying to figure it out for yourself.

Identifying true triggers can be complex. Experts suggest stress, gut health at the time, or food quantity can influence reactions. It's not always simple.

Common reintroduction stages: Often, less likely triggers or more nutrient-dense foods are introduced earlier (e.g., egg yolks, certain spices, then seeds/nuts, then nightshades, legumes, and gluten-free grains). Dairy and gluten-containing grains are often last. However, the exact process is always individual and will be determined by your healthcare provider or dietitian.

Could the AIP diet help your autoimmune condition? What the research says (& doesn't say)

It's vital to acknowledge that no diet, including AIP, cures autoimmune disease. AIP is an investigational approach for symptom management. The National Institutes of Health (NIH) indicates that high-quality research on many dietary interventions for autoimmune diseases is limited.

Here’s what we know so far about these autoimmune conditions and the AIP diet:

Inflammatory bowel disease (IBD - Crohn's, ulcerative colitis): There is some promise with the AIP and IBD, but the information we have so far is based on very small studies. A pilot study found 73% of 15 IBD patients achieved clinical remission by week 6 on AIP, maintained through week 11. They also reported improved quality of life.

Hashimoto's thyroiditis: A small study of 17 women with Hashimoto's on AIP (with health coaching) showed improved quality of life and reduced C-Reactive Protein (an inflammation marker), though thyroid antibodies/function tests didn't significantly change for the group. This suggests potential for symptom management.

Other conditions (rheumatoid arthritis, psoriasis, Lupus, multiple sclerosis, etc): Evidence for AIP is largely anecdotal or theoretical for many other autoimmune diseases. It's experimental for these conditions.

Many studies are small, short-term, and lack control groups. The focus is generally on symptom improvement and quality of life, not "cure." Individual responses vary dramatically.

Potential benefits of an AIP diet plan

When followed carefully, AIP may help you identify your own personal food triggers and, consequently, reduce inflammation. It can also help improve gut health and overall nutrition thanks to its whole-food focus. While it’s a complicated process, the increased attention on your intake can ultimately lead to a stronger food-body connection and help facilitate a stsronger understanding of your body.

Is AIP right for you?

AIP is not without challenges. It is highly restrictive, which can be socially isolating and also runs the risk of nutritional deficiencies. You have to keep a close eye on fiber, calcium, and vitamin B in particular. This is why working with a registered dietitian is crucial.

A restrictive diet naturally requires more time, effort, and, often, cost. You have to spend more time checking labels, planning meals, and cooking for yourself. Buying quality ingredients is often more expensive.

Finally, the AIP diet requires quite a bit of patience. You have to be fully committed to the protocol, with no “cheating” to be sure that the reintroduction is strategically sound. Doing things out of order can muddy your results.

Of course, the diet isn’t viable for everyone, even if someone is a good candidate on paper.  Individuals with a history of eating disorders might struggle with the restrictive nature of the protocol. And pregnant or breastfeeding women require strict medical/dietary supervision.

Tips for getting started with an AIP diet plan

As you take on the AIP diet, keep these tips in mind for success:

• Plan thoroughly: Meal plans, grocery lists, batch cooking
• Focus on allowed foods: Explore recipes with permitted ingredients
• Read labels diligently: Hidden ingredients are common
• Build support: Inform family/friends; use online communities cautiously
• Work with a professional: A registered dietitian experienced with autoimmune conditions is invaluable
• Take care of yourself: Be sure to get enough sleep, mitigate stress, and get an appropriate amount of physical activity

“Think in terms of textures and colors,” suggests Sarah Nash, RD. “Mix roasted, sautéed, and steamed veggies with different herbs and AIP-compliant sauces. Batch-prepping staples like shredded meats, mashed root veggies, and healing broths also makes it easier to mix and match flavorful meals.”

Start the AIP protocol with professional support

The AIP diet is a therapeutic tool for some to identify food triggers and manage symptoms. It’s not a one-size-fits-all solution. The goal is the least restrictive, most nutrient-dense diet supporting your well-being.

Embarking on AIP should ideally be collaborative with your doctor and a knowledgeable registered dietitian to ensure safety and effectiveness. Find a qualified dietitian to support you on the protocol to ensure a strategic (and hopefully successful) approach. Match with a qualified RD covered by your insurance with Fay.

Frequently asked questions (FAQs)

What are the main food groups I have to avoid on the AIP diet elimination phase? During elimination, avoid grains (wheat, rice, corn), legumes (beans, lentils, soy, peanuts), dairy, eggs, nuts, seeds, nightshades (tomatoes, potatoes, peppers, eggplant), processed foods, refined sugars/oils, alcohol, and coffee.

How long should I stay on the AIP elimination phase? Typically 30-90 days, or until significant symptom improvement. It's not permanent; the goal is to move to reintroduction.

Can the AIP diet cure my autoimmune disease? No, AIP is not a cure. It aims to manage symptoms and improve quality of life by reducing inflammation and identifying food triggers. Autoimmune diseases require medical management.

Is the AIP diet the same as Paleo?

AIP is an extension of Paleo, but much stricter. Both eliminate grains, legumes, and dairy, but AIP also removes eggs, nuts, seeds, nightshades, coffee, and alcohol during elimination.

The views expressed by authors and contributors of such content are not endorsed or approved by Fay and are intended for informational purposes only. The content is reviewed by Fay only to confirm educational value and audience interest. You are encouraged to discuss any questions that you may have about your health with a healthcare provider.