Autoimmune Protocol (AIP) Diet

Last Updated: July 6 2022

The Autoimmune Protocol (AIP) diet — an extension of the Paleolithic diet — is a multiphase elimination diet used to reduce symptoms of autoimmune diseases. It’s based on the theory that certain foods trigger inflammation or cause an imbalanced gut microbiome. A few open-label, uncontrolled studies suggest improvements in quality of life, IBD disease activity, and inflammatory markers, but more research is needed.

Autoimmune Protocol (AIP) Diet is most often used for

What is the AIP diet?

The AIP diet is an extension of the Paleolithic diet and was developed by Sarah Ballantyne, PhD, who earned her doctorate in medical biophysics. [1] She authored her AIP diet book in 2014 after experimenting with a Paleolithic diet to improve her own health.

The diet is based on the theory that certain foods could trigger inflammation or cause dysbiosis (an unbalanced gut microbiome), worsening autoimmune disease activity. It is a multiphase elimination diet that encourages the inclusion of bone broth and fermented foods, as well as lifestyle habits such as sleep hygiene, physical activity, and stress management.

How is the AIP diet implemented?

The AIP is an elimination diet that initially restricts:

  • Grains
  • Legumes
  • Nightshade vegetables
  • Dairy
  • Eggs
  • Nuts
  • Seeds
  • Ultra-processed oils
  • Coffee
  • Refined or artificial sweeteners
  • Alcohol
  • Food additives
  • Non-steroidal anti-inflammatory drugs (NSAIDS)

These are replaced with:

  • Approved vegetables
  • Fruits
  • Certain varieties of yam and potato
  • Minimally processed meat
  • Minimally processed vegetable oils
  • Maple syrup
  • Honey
  • Vinegar
  • Bone broth
  • Nondairy fermented foods

Protocols vary, and some recommend limiting saturated fats, omega-6 fats, natural sugars, and fruits. The length of the elimination phase depends on how quickly a person notices improvements. During the reintroduction phase, foods are introduced individually, about one week apart. The AIP also encourages health-supporting lifestyle habits such as sleep hygiene, physical activity, and stress management.

What are the benefits of the AIP diet?

Current research on the AIP is limited to open-label (where participants are aware of their treatment), uncontrolled exploratory studies that have examined the effects of the diet on inflammatory bowel disease (IBD) and Hashimoto’s thyroiditis. Improvements in quality of life, IBD disease activity, and markers of inflammation were reported, but randomized controlled trials (RCTs) are needed to confirm these early findings. [2][3][1]

The AIP diet could improve health by encouraging people to increase their physical activity and improve their sleep and stress management habits. It could also increase fruit, vegetable, and fiber intake while reducing the consumption of highly processed foods. Diets high in fiber and polyphenols (beneficial compounds in plants) have been shown to reduce markers of intestinal permeability (or “leaky gut”) and increase quality of life in people with IBD. [4][5]

What are the drawbacks of the AIP diet?

The AIP is a restrictive diet that may be difficult to adhere to and could place people at risk of nutrient deficiencies if they follow the elimination phase for too long.

Research on the AIP is extremely limited, and the current studies don’t provide strong evidence that the diet itself is improving disease activity. The studies experienced high dropout rates; a few of the participants with IBD experienced worsening disease activity; and no markers of thyroid function or thyroid antibodies changed after 10 weeks on the AIP diet in women with Hashimoto’s thyroiditis. Without control groups, it’s impossible to determine whether the observed improvements happened as a result of time, the placebo effect, or other factors. Notably, all three studies on the AIP for IBD relief came from a single experiment done by one research group on the same participants.

What else is Autoimmune Protocol (AIP) Diet known as?
Note that Autoimmune Protocol (AIP) Diet is also known as:
  • AIP
Examine Database
References
1.^Gauree G Konijeti, NaMee Kim, James D Lewis, Shauna Groven, Anita Chandrasekaran, Sirisha Grandhe, Caroline Diamant, Emily Singh, Glenn Oliveira, Xiaoyun Wang, Bhuvan Molparia, Ali TorkamaniEfficacy of the Autoimmune Protocol Diet for Inflammatory Bowel DiseaseInflamm Bowel Dis.(2017 Nov)
2.^Anita Chandrasekaran, Shauna Groven, James D Lewis, Susan S Levy, Caroline Diamant, Emily Singh, Gauree Gupta KonijetiAn Autoimmune Protocol Diet Improves Patient-Reported Quality of Life in Inflammatory Bowel DiseaseCrohns Colitis 360.(2019 Oct)
4.^Julia Fritsch, Luis Garces, Maria A Quintero, Judith Pignac-Kobinger, Ana M Santander, Irina Fernández, Yuguang J Ban, Deukwoo Kwon, Matthew C Phillips, Karina Knight, Qingqing Mao, Rebeca Santaolalla, Xi S Chen, Mukil Maruthamuthu, Norma Solis, Oriana M Damas, David H Kerman, Amar R Deshpande, John E Lewis, Chi Chen, Maria T AbreuLow-Fat, High-Fiber Diet Reduces Markers of Inflammation and Dysbiosis and Improves Quality of Life in Patients With Ulcerative ColitisClin Gastroenterol Hepatol.(2021 Jun)
5.^Cristian Del Bo', Stefano Bernardi, Antonio Cherubini, Marisa Porrini, Giorgio Gargari, Nicole Hidalgo-Liberona, Raúl González-Domínguez, Raul Zamora-Ros, Gregorio Peron, Mirko Marino, Letizia Gigliotti, Mark S Winterbone, Benjamin Kirkup, Paul A Kroon, Cristina Andres-Lacueva, Simone Guglielmetti, Patrizia RisoA polyphenol-rich dietary pattern improves intestinal permeability, evaluated as serum zonulin levels, in older subjects: The MaPLE randomised controlled trialClin Nutr.(2021 May)
6.^Mingxia Ji, Xiaofei Hong, Mengyan Chen, Tiejiang Chen, Jiao Wang, Ning ZhangDietary inflammatory index and cardiovascular risk and mortality: A meta-analysis of cohort studiesMedicine (Baltimore).(2020 May)
7.^Fang-Hua Liu, Chuan Liu, Ting-Ting Gong, Song Gao, Hui Sun, Yu-Ting Jiang, Jia-Yu Zhang, Meng Zhang, Chang Gao, Xin-Yu Li, Yu-Hong Zhao, Qi-Jun WuDietary Inflammatory Index and Health Outcomes: An Umbrella Review of Systematic Review and Meta-Analyses of Observational StudiesFront Nutr.(2021 May 19)
8.^Anne-Sophie van Lanen, Angelika de Bree, Arno GreylingEfficacy of a low-FODMAP diet in adult irritable bowel syndrome: a systematic review and meta-analysisEur J Nutr.(2021 Sep)
9.^David L Suskind, Dale Lee, Young-Mo Kim, Ghassan Wahbeh, Namita Singh, Kimberly Braly, Mason Nuding, Carrie D Nicora, Samuel O Purvine, Mary S Lipton, Janet K Jansson, William C NelsonThe Specific Carbohydrate Diet and Diet Modification as Induction Therapy for Pediatric Crohn's Disease: A Randomized Diet Controlled TrialNutrients.(2020 Dec 6)
11.^Stanley A Cohen, Benjamin D Gold, Salvatore Oliva, Jeffery Lewis, Angela Stallworth, Bailey Koch, Laura Eshee, David MasonClinical and mucosal improvement with specific carbohydrate diet in pediatric Crohn diseaseJ Pediatr Gastroenterol Nutr.(2014 Oct)