The Autoimmune Protocol (AIP) is a diet designed for autoimmune disease sufferers to reduce inflammation, balance hormones and help promote healing. But what is it, exactly? And is it right for you?
I get asked a lot of questions about AIP, so I thought I would do a series of posts to help answer some questions and provide some easy-to-digest (pun intended) information for y’all. My hope is that this series will help you understand how this healing protocol works, as well as how to incorporate it into your life more easily.
First up in the three-part series: What is the Autoimmune Protocol (AIP)?
Autoimmune Protocol Overview
Autoimmune disease is an epidemic in our modern society. There are currently more than 24 million individuals with one or more autoimmune disease, in the US alone. And there are over 90 known autoimmune diseases. Some of the most common autoimmune diseases (Hashimoto’s, type I diabetes, celiac, multiple sclerosis, and rheumatoid arthritis) are just the tip of the iceberg. There are also no known cures for any autoimmune disease, and most require lifelong treatment. Additionally, having one autoimmune disease means you are at an increased risk of developing another.
Your risk for developing an autoimmune disease depends on three factors:
- Genetic susceptibility.
- An environmental trigger (i.e. a traumatic event, an infection, stress, etc.)
- Leaky gut (aka intestinal hyper-permeability, or damaged intestinal lining)
While you can’t control your genetics, and you often can’t control some environmental triggers (like a bacterial or parasitic infection), you can have an influence over your gut health! Making improvements to your diet and lifestyle are the key to healing your leaky gut. And while diet and lifestyle changes can be overwhelming, this is actually fantastic news! It means the power to help heal your disease, and reduce or eliminate your symptoms, is in your hands! And that’s what the Autoimmune Protocol is all about!
The Autoimmune Protocol (aka AIP) is an elimination diet designed specifically for those with one or more autoimmune disease. It can also be helpful for those who suspect they are on the path to developing an autoimmune disease, but haven’t received a diagnosis yet. The protocol aims to reduce inflammation, heal leaky gut (aka intestinal hyper-permeability) and balance hormones. These improvements, in turn, can help improve or even reverse autoimmune disease!
To be clear, the Autoimmune Protocol is not a cure for autoimmune disease. There is currently no cure for any autoimmune disease. Rather, AIP is a system of diet and lifestyle factors you can utilize in tandem with conventional medicine to help alleviate your symptoms, improve your bloodwork, reduce inflammation and help reduce your risk of developing another autoimmune disease.
Autoimmune Protocol (AIP) Elimination Phase
The Autoimmune Protocol was developed by Dr. Sarah Ballantyne, and is based on the Paleo diet, with a few additional restrictions specific to autoimmune disease sufferers. It begins with an elimination phase, in which you eliminate all dietary triggers that could potentially be fueling inflammation and aggravating autoimmune symptoms. During the elimination phase, you will avoid foods that increase intestinal permeability (aka cause leaky gut), drive up inflammation and promote the production of auto-antibodies (immune proteins that mistakenly attack your own tissues). In addition to eliminating certain pro-inflammatory foods, you will incorporate more anti-inflammatory, nutrient-dense foods into your diet. These foods can help heal leaky gut, improve vitamin and mineral deficiencies, and reduce inflammation.
Here are the lists of foods to avoid and foods to incorporate on the Autoimmune Protocol:
Foods to Avoid on the AIP
- Grains and pseudo-grains.
- This includes corn, rice, wheat, barley, oats, quinoa, amaranth, chia, buckwheat, etc. It also includes foods derived from them, such as pasta, bread and breakfast cereals. Be especially cautious about hidden gluten in commercially prepared food items and gluten cross-reactive foods. Gluten is obviously a major problem for those with celiac disease. But did you know it can also contribute to inflammation and leaky gut in every other autoimmune disease?
- All legumes (including those in their pods, such as green beans and snow peas), beans, lentils, peas, peanuts, soy and soy products. This includes foods derived from legumes, such as tofu, tempeh, vegetarian “meat” products, and peanut butter. It also includes products containing soy isolates, such as soy lecithin.
- Dairy products.
- Any animal’s milk, including cow, sheep, or goat, and products derived from them, such as cheeses, kefir, cream cheese, cottage cheese, buttermilk, butter, ghee, and dairy-based protein powders (such as whey or casein).
- Highly processed vegetable oils.
- Canola, corn, cottonseed, palm kernel, rapeseed, safflower, soybean, and sunflower oils.
- Refined or processed sugars, artificial sweeteners and sugar alcohols.
- Cane or beet sugar, agave, corn syrup, brown rice syrup, barley malt syrup, etc. And all artificial sweeteners and sugar alcohols, even those considered “natural” or “paleo,” including aspartame, stevia, monk fruit extract, mannitol and xylitol.
- Processed food additives.
- Avoid any ingredient with a chemical name you don’t recognize. This includes trans fats (hydrogenated and partially-hydrogenated vegetable oils), food colorings, emulsifiers, thickeners, etc.
- This includes all alcohols, even those considered “paleo.” It also includes alcohols in extracts, such as vanilla extract. (Though, you can cook with alcohols and extracts if it cooks long enough to cook the alcohol off).
- Nuts and seeds.
- All nuts and seeds and foods derived from them, such as flours, butter, or oils. This also includes chocolate, cocoa or cacao, as they are all derived from the cacao bean (which is actually a seed). It also includes seed-based spices, such as coriander, cumin, anise, fennel, fenugreek, mustard, and nutmeg. Many fruit-based spices also contain seeds, so those are best avoided during elimination as well.
- Coffee is actually a seed, but I thought I would single it out as it’s own category, as many struggle with this elimination. It should be noted that caffeine itself is not restricted. But reducing or eliminating caffeine can also be beneficial in some autoimmune diseases, especially for those who struggle with anxiety or adrenal fatigue.
- Including egg whites, whole eggs, and products containing eggs.
- Nightshade vegetables.
- Vegetables from the nightshade family, such as eggplant, sweet and hot peppers, potatoes (sweet potatoes are fine), tomatoes, goji berries, etc. This includes spices derived from nightshades, such as paprika, cayenne, chili powder, and many commercially available curry powders.
- Such as aspirin and ibuprofen.
- Immune-stimulating “superfoods.”
- Such as spirulina, chlorella, and medicinal mushroom powders/extracts.
Foods to Include on the AIP
- Organ meats.
- All organ meats, including liver, heart and kidneys (from grass-fed animals, if possible). Aim for 5 servings per week.
- Fish, shellfish and other seafood.
- Wild is best, but farmed is OK. Aim for 3 servings per week, and minimize seafood high in mercury, especially if pregnant or breastfeeding.
- Quality meats.
- Grass-fed, pasture-raised or wild is best. Include a variety, but eat poultry in moderation, due to its high omega-6 content (which is pro-inflammatory).
- Lots of vegetables.
- Include a wide variety of vegetables (except for nightshades). Aim to “eat the rainbow” and get 6-10 servings per day, including:
- Leafy greens, such as lettuce, spinach, kale, collards, celery leaves, carrot tops, etc.
- Colorful vegetables and fruit in the green, red, purple, blue, yellow, orange and white color families, such as red cabbage, blueberries, strawberries, cucumbers, etc.
- Cruciferous vegetables, such as cauliflower, broccoli, cabbage, kale, turnips, arugula, Brussels sprouts, watercress, mustard greens, etc.
- Roots, tubers and winter squash, such as butternut squash, radish, sweet potato, parsnip, beets, fennel, carrots, rutabaga, turnip, acorn squash, spaghetti squash, cassava, etc.
- Allium family vegetables, such as onions, shallots, leek, garlic, chives, etc.
- Sea vegetables, such as nori, kelp and dulse (but excluding algae like chlorella and spirulina which are immune stimulators).
- Mushrooms and other edible fungi, such as shiitake, oyster, enoki, cremini, portabella and chanterelles. Medicinal mushroom extracts and powders are a grey area, and are best avoided for the elimination phase.
- Include a wide variety of vegetables (except for nightshades). Aim to “eat the rainbow” and get 6-10 servings per day, including:
- Eat a variety of colorful fruit (in moderation). Aim for no more than 1-2 servings per day to maintain stable blood sugar levels.
- Fermented, probiotic-rich foods.
- Fermented fruits and vegetables, kombucha, sauerkraut, lacto-fermented pickles, and coconut kefir, coconut yogurt, or probiotic supplements.
- Healthy fats.
- Herbs and spices.
- Flavor your food with plenty of nutrient-dense fresh or dried herbs and spices derived from the leaves, barks and roots of plants (but excluding those derived from nightshades, seeds and fruits).
- Balsamic, apple cider, white wine, and red wine vinegars (as long as they’re free of added sugars). Don’t consume any vinegars derived from the restricted foods (such as rice vinegar).
- Natural sweeteners.
- Glycine-rich foods.
- Animal products with connective tissue (joints or skin), organ meat, and bone broth.
- Herbal, green, black, matcha, etc. Make sure there are no nightshade or grain ingredients (and watch out for hidden gluten often found in tea bags).
How long should you follow the AIP diet?
The Autoimmune Protocol is both a temporary elimination diet, as well as a permanent lifestyle. It is designed to encourage autoimmune healing by cutting out foods that are most likely to cause inflammation and leaky gut, in most people. But once your symptoms and/or bloodwork have substantially improved, you can begin to reintroduce foods that were originally eliminated, to determine if they are a problem for you. The amount of time it takes to heal, and thus the amount of time you spend in the elimination phase, depends on a wide variety of factors, including the severity of intestinal damage, your sleep habits, exercise routines, stress levels, and environmental factors.
Most people follow the AIP elimination phase for 30 days, up to a few months. Some follow it for longer. I personally followed the elimination phase for 90 days before beginning to reintroduce foods. But the goal of the elimination phase is to heal first, then begin to reintroduce foods. This way, you can better identify which foods may be a trigger for your specific symptoms and tailor your diet for long term healing and symptom management.
Many people feel so great during the elimination phase, they become afraid to reintroduce foods, fearing a flare up of their symptoms. But if you’re feeling well, don’t be afraid to move into the reintroduction phase! Reintroducing foods allows you to get a wider variety of nutrients in your diet, as each food has a different nutrient profile. It also allows you to more easily eat in restaurants, travel, and eat in social situations. And all of those benefits are vital to your mental health, which is vital to your healing.
More Autoimmune Protocol Resources
My favorite AIP books
- The Paleo Approach by Sarah Ballantyne, PhD.
- The book that started it all. Dr. Ballantyne took paleo principles and expanded upon them to create a protocol specific for autoimmune disease sufferers. If you’re interested in the science behind the protocol, this is definitely to book to check out.
- A Simple Guide to the Paleo Autoimmune Protocol by Eileen Laird.
- This is one of the first books I read about the Autoimmune Protocol. It provides easy-to-understand, and easy-to-implement information about the protocol. I highly recommend it for those just starting out.
- The Nutrient Dense Kitchen by Mickey Trescott, NTP.
- This is the first AIP cookbook I bought and it was one of the most valuable resources in my AIP arsenal when I was first starting out. Every recipe is simple enough for a novice, but tasty enough for a chef. And the recipes will help you learn how to incorporate new nutrient-dense foods in fun and delicious ways.
- The Easy Autoimmune Protocol Cookbook by Karissa Long and Katie Austin.
- This is an awesome cookbook with tons of super simple AIP recipes to cook when you’re short on time or energy.
Other AIP Blogs
There are so many good AIP blogs out there, and the list keeps growing every day! Here are a few of my favorites:
Next Up in the Series
Next up in the Autoimmune Protocol Series is AIP Lifestyle Factors. Some of the most profound improvements to your health can be achieved through lifestyle modifications. Food isn’t the only thing that helps you heal!
After discussing AIP Lifestyle Factors, we delve into the nitty gritty of AIP Reintroductions. If you’ve seen substantial healing on AIP and are ready to start reintroducing foods, you’ll definitely want to check out that post!
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