AIP: Autoimmune Protocol Diet
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?
What is the AIP Diet?
The AIP diet is short for the Autoimmune protocol diet, a nutrition plan to help people with autoimmune conditions lessen symptoms and improve their quality of life. The AIP diet eliminates foods that may worsen symptoms or increase inflammation. It includes nutrient-dense foods that reduce inflammation and promote a healthy gut flora. After all, the gut is the center of the immune system. If you improve your gut balance, you may be able to help your immune system regulate itself. That’s the theory!
What can you eat on an AIP diet?
The specific definition of the AIP diet varies depending on the source, but in general, the AIP diet
- Food additives (eg. nitrates, emulsifiers, preservatives) (1)
- Legumes (beans, peanuts)
- Nightshade vegetables (tomatoes,peppers, potatoes and eggplant)
- Oils (eg. soy and canola oil)
- Added sugars and sweeteners
- Coconut, and coconut oil
- Vegetables (except for nightshades)
What is an autoimmune disease?
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 begins to attack a person’s own cells and organs. This can cause permanent damage and long term problems.
One example of an autoimmune disease is Type 1 diabetes. The body attacks the cells of the pancreas, permanently damaging their ability to make insulin. After diagnosis, a person with Type 1 diabetes will forever need to inject insulin to manage their blood sugar levels because their body will never be able to recover the ability to make insulin.
There are many other autoimmune conditions. A few are listed here:
- Celiac disease
- Crohn’s disease
- Hashimoto’s thyroiditis
- 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. (SOURCE).
The role of food in autoimmune disease
While genes may make us more genetically vulnerable to an autoimmune condition, our interaction with the food and drink we consume may be one of the biggest modifiable influences on our risk of autoimmune disease.
Diet has a great influence on our overall health and 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 changes the person’s microbiome (gut bacteria) in a positive way. The microbiome is emerging as a key player in the regulation of 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 have a positive influence on someone with autoimmune disease. 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 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).
Who created the AIP Diet?
The AIP diet dates back about 20 years to the work of Loren Cordain, Robb Wolf and others. Research and discovery has continued by medical professionals as well as everyday people searching for their own answers to feeling better, including Sarah Ballantyne, Mickey Trescott, Angie Alt (7).
Does research support an AIP diet?
Research on the AIP Diet is emerging and early studies look promising. Keep reading to learn about studies using the AIP that have been done already.
Inflammatory Bowel Disease ( Crohn’s & Ulcerative Colitis)
In 2017, the first known study using the AIP diet as an intervention for inflammatory bowel disease was completed. It included 15 people with either Crohn’s disease or ulcerative colitis.
Participants followed a 6-week elimination diet. During this time they slowly took out the foods not allowed on the AIP diet. After the first 6 weeks, they stayed on the full AIP diet for 5 weeks. After the first 6 weeks, 73% were in remission and stayed in remission for the duration of the time on the diet. It is important to note that two patients did have worsening symptoms which may have been explained by differences in their anatomy. Decreased inflammation was also seen on follow up endoscopy tests.
A subsequent study was done to look for reasons to explain the improvements seen. It found one reason that the AIP diet may be helpful is that it lowers inflammation (8).
Hashimoto's- Autoimmune Hypothyroidism
A 2019 study (9) used the AIP diet in conjunction with lifestyle changes to assess the effect on people with Hashimoto’s thyroid disease. They found that after 10 weeks there was significant improvement in quality of life, disease burden and inflammation markers in the blood. 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.
Multiple Sclerosis (MS)
A 2015 study (10) showed dietary changes similar to AIP in helped people with multiple sclerosis – an autoimmune disease that attacks the nervous system. These changes helped people with MS feel better and have fewer symptoms.
The diet used in the 2015 study was developed by Dr. Terry Wahls, a medical doctor diagnosed with multiple sclerosis. When conventional medication and treatment failed to stop her disease progression, she focused on a strict, modified paleo AIP dietary and lifestyle intervention. Amazingly, Dr. Wahls went from being wheelchair-bound to riding her bicycle. Because the protocol also includes lifestyle modifications; daily stretching, nutritional supplements and stress management it is difficult to attribute the improvements seen to only dietary changes. However, the fact that benefit was seen from the overall plan is promising news for a challenging illness. It is a small study, further studies are needed that isolate out to determine the sole effect of diet.
Dr. Alessio Fasano discovered zonulin, the protein that determines how leaky (permeable) the gut is. (11). And 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 downside of AIP
The AIP diet eliminates many common food groups that we enjoy for comfort, celebrations and convenience. Any dietary intervention that is restrictive can be challenging emotionally and socially, especially if followed long term.
Following the AIP diet can also be expensive and requires someone to prepare most of their own food if they can’t afford a delivery service. For people who are already fatigued because of an autoimmune condition, a simple change in the diet can feel monumental. This drastic of a change may be overwhelming. That being said, if changing your diet can significantly improve your quality of life, it may be worth a try if someone is up to it.
AIP meal delivery can save you time
Sample AIP menu
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
While it is true there are many unknown factors at play with the development and expression of an autoimmune condition, diet is one we can control. Of course it is important to ensure you have adequate sleep, lower stress, exercise and maintain healthy vitamin D levels. All have been shown to affect inflammation, a key component of autoimmune disease.
But, now we know the effect of diet on autoimmune disease is real. The studies done thus far on the specific effect of the AIP diet on autoimmune disease have been positive. They have been shown to help lower inflammation and improve quality of life by reducing symptoms and improving energy.
The AIP diet isn’t for everyone. It can be challenging for the reasons mentioned above. But, for those looking for options it just may prove to be your missing link.
THIS ARTICLE IS COPYRIGHTED BY AMY BURKHART, MD, RD.
Dr. Amy Burkhart is a doctor (M.D.), Registered Dietitian, R.D., and fellowship-trained in integrative medicine. She specializes in treating chronic digestive disorders from an integrative/functional medicine perspective.