What Is the AIP Diet?
Autoimmune diseases like lupus and myositis are on the rise. Scholars estimate that 10 million people in the United States deal with autoimmune diseases. [1] [2]
The autoimmune protocol (AIP) is one of the diets you might have heard about that’s designed to reduce inflammation and improve the symptoms of autoimmune diseases, such as ankylosing spondylitis, rheumatoid arthritis, celiac disease, and lupus. If you or a loved one has an autoimmune condition, you might be curious to learn more. So, what is AIP? How does AIP compare to keto and can the two diets work together? Let’s look at the autoimmune protocol.
What Is Autoimmune Disease?
Healthy people produce antibodies that fight infections and attack harmful cells in their bodies. In people with autoimmune disorders like rheumatoid arthritis or lupus, the immune system isn’t functioning properly and produces antibodies that attack healthy tissues and cells instead.
People without autoimmune disorders have low, normal levels of inflammation. People with autoimmune disorders have much higher levels of systemic inflammation, leading to a range of symptoms, including:
- Brain fog
- Abdominal pain
- Joint pain
- Fatigue
- Nerve and tissue damage
The cause of autoimmune disease isn’t exactly clear, and multiple factors could play a role, such as:
- Genetics
- Infection
- Toxicity
- Stress
- Inflammation
- Medication use
Damage to the intestinal lining and increased intestinal permeability (leaky gut) could also be involved, and more fascinating research in this area is underway. [3]
What Is AIP?
AIP is like a stricter form of the paleo diet. Some foods and drinks like gluten and alcohol are believed to possibly increase the permeability of the gut lining and increase the chances of leaky gut, which could heighten the risk of or worsen autoimmune disease. The AIP diet eliminates these foods and switches them out for nutritious foods believed to heal the gut and diminish the symptoms of autoimmune diseases. [4]
The diet removes ingredients that provoke abnormal immune responses in certain people, such as wheat and milk. [5]
Elimination
The first phase of the AIP diet is the elimination, where you remove foods and medications from your diet that could be causing inflammation and an imbalance of good and bad bacteria in your gut.
Until you notice a reduction in symptoms, avoid the following:
- Eggs
- Nightshade vegetables
- Grains
- Legumes
- Nuts
- Seeds
- Dairy
- Tobacco
- Alcohol
- Coffee
- Food additives, emulsifiers, and thickeners
- Refined and processed sugars
- Seed oils and heavily processed fats and oils
- Medications like non-steroidal anti-inflammatory drugs (NSAIDS). [6] [7]
Focus on getting plenty of sleep, stress relief, exercise, and nutrient-dense foods, for instance:
- Fermented foods
- Bone broth
- Minimally processed meat
- Vegetables (excluding nightshades)
- Fresh fruits in moderation
- Tubers
- Herbs and spices (not derived from a seed)
- Vinegar
- Natural sweeteners
- Certain teas (like black and green tea)
Some AIP diets initially remove dried and fresh fruits and all sweeteners, while others allow 1-2 daily servings of fruit.
Most people maintain the elimination phase for at least 30-90 days, with many people reporting improvements within the first few weeks.
Reintroduction Phase
During the reintroduction phase, you reintroduce the avoided foods, one at a time, based on your tolerance. The idea is to pinpoint which foods might be contributing to your symptoms. Allow at least 5-7 days before reintroducing a food, which gives you time to notice if symptoms reappear.
When you reintroduce a food, consume a small amount of the food (maybe a teaspoon) a few times a day and then avoid it for 5-6 days. If you experience symptoms, end the test and avoid the food. If you’re not experiencing any symptoms, try eating a normal amount of the food, such as one tablespoon, and avoid it for 5-6 days. If you don’t have any symptoms for those 5-6 days, you can add those foods you tolerate well back into your diet.
Your food tolerance could change over time, so you might decide to repeat the reintroduction tests in the future for the foods that failed the test the first time.
Try not to reintroduce foods around certain times or events that could influence your autoimmune disease, such as during an infection, after an intense workout, a poor night’s sleep, or when you’re feeling really stressed.
When introducing dairy, go for dairy with the lowest lactose concentration first, like fermented dairy or ghee.
The internet and the grapevine are full of stories of people reporting positive outcomes with their autoimmune conditions when they followed AIP. They report significant improvements in symptoms like fatigue, skin problems, and gut or joint pain. Some small scientific studies have also shown promise.
How Does the AIP Diet Compare to Keto?
AIP and keto share similarities, and there is plenty of overlap. Most of what you eat on a standard keto diet is already suitable for AIP. For example, you might eat meat and fish, avocados, and low-carb veggies.
It is possible to do AIP and keto, but you will need to make some modifications. If you’re planning on following an AIP version of keto, you’ll need to watch out for carbs from sweet potatoes, starchy tubers, and fruits.
For the AIP diet, you’ll also need to ditch the nuts and seeds, which are prevalent on most keto diets. This means saying goodbye to all those nut flour recipes. You’ll also need to eliminate the common allergenic foods, like eggs, nightshade veggies, and dairy. Make sure you’re eating enough healthy fats to stay satiated on AIP keto and focus on lower-sugar keto-friendly fruits like berries.
Many of the foods you avoid on AIP are also avoided on keto, including starchy grains and beans, and processed sugars. Both keto and some AIP protocols recommend lowering your intake of high-glycemic fruits and veggies, such as dried fruit, plantains, and sweet potatoes.
Keto diets limit carbohydrate intake to around 50 grams of net carbs or less. To shift your body into the metabolic state of ketosis, you need to consume enough fat and drop your carb intake to a very low level, which is not a given on the AIP diet.
Following an AIP ketogenic diet could optimize results for those with autoimmune diseases. Not only are you reaping the benefits of ketosis, but you’re also giving your body a break from possible allergens, processed foods, and additives.
References
National Institutes of Health (NIH). Marker of Autoimmunity Increases in U.S. Marker of autoimmunity increases in U.S. | National Institutes of Health (NIH)
John Hopkins Medicine. Prevalence of Autoimmune Diseases. Prevalence of Autoimmune Diseases - Autoimmune Disease | Johns Hopkins Pathology (jhu.edu)
Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky gut as a danger signal for autoimmune diseases. Front Immunol, DOI: 10.3389/fimmu.2017.00598
Chandrasekaran, A., Molparia, B., Akhtar, E., Wang, X., Lewis, J. D…Konijeti, G. G. (2019). The autoimmune protocol diet modifies intestinal RNA expression in inflammatory bowel disease. Crohns Colitis 360, DOI: 10.1093/crocol/otz016
Vojdani, A. (2015). Molecular mimicry as a mechanism for food immune reactivities and autoimmunity. Altern Ther Health Med, Molecular mimicry as a mechanism for food immune reactivities and autoimmunity - PubMed (nih.gov)
Abbott, R. D., Sadowski, A., & Alt, A. G. (2019). Efficacy of the autoimmune protocol diet as part of a multi-disciplinary, supported lifestyle intervention for Hashimoto’s thyroiditis. Cureus, 11(4), e4556. DOI: 10.7759/cureus.4556
Chandrasekaran, A., Groven, S., Lewis, J. D., Levy, S. S., Diamant, C…Konijeti, G. G. (2019). An autoimmune protocol diet improves patient-reported quality of life in inflammatory bowel disease. Crohns Colitis 360. DOI: 10.1093/crocol/otz019
