AIP (Autoimmune Protocol) Diet: Plan, Foods, & Tips​

By Charlie Huntington, M.A., Ph.D. Candidate
The Autoimmune Protocol diet is an emerging tool for reducing the painful symptoms of autoimmune diseases. How does it work, and who should be trying this diet?
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I grew up thinking I was not a person with allergies. It was not until I began sampling traditional Middle Eastern desserts during my Arabic classes in college that I realized I might be allergic to something. After a couple rounds of eating something delicious and finding my throat scratchy and my stomach churning, I figured out that the culprit was tahini, the paste made from sesame seeds that is a common ingredient in many Middle Eastern meals. 
I started avoiding foods with tahini or sesame oil in them, and my problem was solved.

I feel grateful that my food limitations are so, well, limited. For many people, especially those with chronic medical conditions, the symptoms they experience are consistent and debilitating, and medications may not offer much relief. It has long been recognized that our diets may play a role in our physical health symptoms, and doctors and researchers have recently begun to suggest that one form of treatment for these medical conditions could be to eliminate foods from one’s diet that make the symptoms worse. In this article, we will take a look at one of those dietary protocols, the Autoimmune Protocol diet, to see how it might be useful to you or people you know.
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What Is the AIP Diet (Autoimmune Protocol)? (A Definition)​

As its name suggests, the Autoimmune Protocol diet, or AIP diet, is designed to help people with autoimmune conditions. Autoimmune diseases occur when our bodies’ immune systems mistakenly attack healthy cells in our own bodies, having misperceived that there is a threat to our health (Wolter et al., 2021). These diseases include inflammatory bowel disease (IBD), rheumatoid arthritis, type 1 diabetes mellitus, and multiple sclerosis, among others.
 
Interestingly, these diseases have become increasingly common in the last century, particularly in industrialized countries such as the United States, a trend we can attribute in part to changes in our environments and our diets (Wolter et al., 2021). More recently, research has consistently demonstrated that people with autoimmune diseases have different, less adaptive gut microbiomes than people without autoimmune diseases. This has led researchers and doctors to propose that restoring a healthy gut microbiome in people with autoimmune diseases may be a form of treatment for their autoimmune diseases (Wolter et al., 2021).
 
In particular, the AIP diet was designed specifically to help reduce inflammation in our guts (Wolter et al., 2021). Similar to diets such as the paleolithic diet, it is designed from the perspective that our modern diets have moved far away from the foods we evolved to consume. This mismatch is thought to lead to an inflamed gut, with serious consequences for our immune systems—namely, that they may struggle to accurately detect and respond to threats to our health, often targeting parts of our bodies that are actually already in good health.
 
Thus, the AIP diet may be a way to eliminate or reduce the dietary factors that contribute to autoimmune diseases. It aims to reduce our exposure to highly processed foods and foods that reflect modern food science and redirect us back toward the diets of our ancestors. For example, highly processed foods provide cheap and easily consumed fuel for our bodies. While this may be very effective when I am, for example, running an all-day trail race that requires me to constantly restore my energy reserves, it is less effective in the rest of my life. In fact, my body and yours are designed to subsist on minimally processed foods that take a longer time to digest and include more fiber; when we don’t get this kind of fuel, our bodies, including our immune systems, start to go haywire (Ungar et al., 2006).
 
Thus, the goal of the AIP diet is to return us to eating foods similar to what our ancestors ate, with the goal of improving our gut health and reducing our autoimmune disease symptoms. Then it suggests that we gradually reintroduce foods to see if their return is followed by an increase in those same symptoms. In this way, we can identify which foods are most triggering for our autoimmune conditions.
 
The AIP diet draws heavily on a paleolithic diet as a model, but it may go even further than a paleo diet in restricting foods. Remember, the goal of the AIP diet is to reduce autoimmune symptoms, and this may involve giving up foods that are “allowed” in a paleo diet.​

Benefits of the AIP Diet​

The primary benefit of the AIP diet is that it reduces or eliminates the dieter’s exposure to processed and ultraprocessed foods, which are known to contribute to all sorts of negative health outcomes (Elizabeth et al., 2020). Foods such as candy, soft drinks, and frozen pizzas contain high amounts of carbohydrates and sugars that our guts find very taxing to process; over time, this wears them down and they cannot support our immune systems as effectively. At the same time, these foods provide little in the way of healthy nutrients, further depleting our abilities to fuel our bodies effectively. By initiating an AIP diet, the dieter takes these unhealthy foods out of their diet and gives themselves the chance to eat more nutrient-dense foods.
 
Another advantage of the AIP diet is that it gives you a chance to identify exactly which foods seem to be associated with the symptoms of any autoimmune condition you might have. No diet is going to be equally effective for everyone because each dieter possesses a unique combination of genetic factors, cultural food patterns, and eating practices shaped by their family life, all of which combine to give them a unique diet and therefore a unique gut microbiome (David et al., 2014). However, a dietary protocol that involves systematically examining the possible impacts of individual foods can help dieters identify just the right combination of foods for optimal management of their autoimmune disease. This approach might also protect against the pattern of most diets, which is that many people stop following them because they are experienced as too rigid or specific and are not understood as personally helpful (Mirmiran et al., 2021).
 
The benefits of the AIP diet have been established in a few preliminary studies that looked at specific autoimmune diseases and at changes in the bodies of people with those diseases as they underwent the AIP diet. For example, people with ulcerative colitis—a form of inflammation in the digestive tract—showed changes in many biomarkers of inflammation and cellular health when they switched to an AIP diet (Chandrasekaran et al., 2019). Similar changes are found for people with Crohn’s disease, which involves a similar pattern of gut inflammation and painful bowel movements (Konijeti et al., 2017). In fact, in the study by Konijeti and colleagues, most participants no longer met criteria for their inflammatory bowel disease after just over a month on the AIP diet.
 
Similarly, a study of patients with Hashimoto’s thyroiditis, in which the immune system attacks the thyroid glands in the neck, found substantial health benefits for the patients who switched to the AIP diet. Specifically, these patients scored significantly higher on quality of life measures and lower on measures of autoimmune symptoms than they did prior to beginning the diet (Abbott et al., 2019). These patients also showed better immune system health and lost weight, and many were able to reduce the amount of thyroid medication they had to take.
 
At the same time, other immune conditions may not be as affected by our diets, or the research may not exist yet to confirm whether this is an effective course of treatment (Rustad et al., 2022). Thus, it is best to consult with your doctor before beginning a diet like this.​

The AIP Diet Elimination Phase

Okay, so what foods does one actually eat and not eat when on an AIP diet? The first step in the diet is to eliminate foods that may be causing inflammation. This inevitably involves removing refined and processed sugars, food additives, certain oils, nuts and seeds, alcohol, coffee, eggs, dairy, nightshades (a category of vegetables), legumes (such as beans and peanuts), and grains from one’s diet (Konijeti et al., 2017). Although this list may seem exhaustive and intimidating, it actually reflects the full range of foods that have been found to negatively impact our immune systems in some way.

Importantly, removing all of these foods should be done gradually, not all at once. In the best-known study of the AIP diet, the foods on the list mentioned above were gradually phased out over the course of six weeks, giving study participants lots of time to start incorporating other, healthier foods into their diets (Konijeti et al., 2017).​

The AIP Diet Basic Rules

Following the elimination phase, someone on the AIP diet spends several weeks, or perhaps even several months, in what is called the maintenance phase. In this phase, they simply continue the AIP diet and wait to see how their autoimmune symptoms change and stabilize. They also work to incorporate more nutrient-dense and healthful foods into their diets, such as fermented foods or bone broths (Konijeti et al., 2017). Lastly, they also work to eliminate any other sources of potential inflammatory ingredients, such as medications, while increasing other health-promoting behaviors, such as regular exercise and good sleep hygiene.
 
Finally, in the reintroduction phase, the dieter starts to add foods back into their diet, preferably one food or one category of food at a time, observing closely to notice any changes in their symptoms. Foods that seem to cause no changes can safely be eaten moving forward, while those that seem to precipitate the return of or an increase in autoimmune symptoms have now been identified as foods to continue avoiding moving forward. When this process is complete, the AIP dieter has a sense of exactly which foods trigger their autoimmune symptoms—and has become practiced at avoiding them and eating other foods instead.

An AIP Diet Plan

Again, the AIP diet looks very much like a paleolithic diet, meaning that if a caveman couldn’t have found it and eaten it, it is probably not on the menu. However, the AIP diet goes further by eliminating other foods, such as some fruits, nuts, eggs, and nightshade vegetables, that are known to irritate some people’s guts (Konijeti et al., 2017).

The plan can be very specific as to how to reintroduce foods. Suppose you wanted to know whether tomatoes—a nightshade vegetable—were affecting your autoimmune symptoms. Having eliminated tomatoes from your diet, you might eat a very small amount of tomato several times across a single day, then not eat it again and wait for about a week to see if your symptoms changed. If you experienced no symptoms, you could then try again with tomatoes, eating slightly more and waiting again to see if symptoms changed. Then, you would repeat this process with each food you hoped to be able to eat again.​

AIP Diet Food List​

So what foods can you eat on an AIP diet? You can eat vegetables, with the exception of nightshades. You can eat most fruits, although you should not eat too many each day. You can eat meat that has been minimally processed, such as chicken breasts or salmon but not ground beef. You can eat sweet potatoes and other foods in the category of tubers. You should definitely try to consume fermented foods such as kefir, sauerkraut, and kombucha. Bone broths, teas, minimally processed vegetable oils (for example, olive oil or coconut oil), and most herbs and spices are also permitted on this diet.

If you want more information about foods that are okay to eat on an AIP diet, I recommend watching this video:​

Video: Ultimate Autoimmune Paleo (AIP) Food List

Tips for Sticking to the AIP Diet

The AIP diet is pretty restrictive and can be difficult to follow. Tips for success include identifying recipes and having a plan for meals ahead of time, physically removing AIP-prohibited foods from your kitchen, and stocking AIP-compliant foods ahead of time.

Articles Related to the AIP Diet

​Want to learn more? Check out these articles:

Books Related to the AIP Diet

If you’d like to keep learning more, here are a few books that you might be interested in.

Final Thoughts on the AIP Diet​

The AIP diet is specifically designed for people with autoimmune diseases, and it holds a lot of promise as a treatment for these specific conditions. However, it is a very stringent diet, and for people with other health concerns, less intense elimination diets may be a better choice. Again, it’s best to discuss these possibilities with a healthcare provider before making such a big lifestyle decision.

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