AIP (Autoimmune Protocol) Diet

Introduction

Autoimmune diseases like rheumatoid arthritis, lupus, inflammatory bowel disease (IBD), celiac disease, and many others can interfere with the everyday life of a person. They develop when the immune system mistakenly attacks the body’s healthy cells and tissues. It can occur due to predisposition (genetics), stress, inflammation, infection, or medication use.

AIP diet, or Autoimmune Protocol diet, focuses on reducing inflammation in the gut and, as a result, easing symptoms of autoimmune diseases. Some foods are thought to increase gut permeability, leading to a condition known as a “leaky gut” that may provoke some autoimmune diseases. Therefore, the AIP diet eliminates these foods and promotes eating healthy, nutrient-dense foods to help heal the gut and reduce inflammation.

Key points

AIP diet is an elimination diet. It means that you exclude certain foods from your diet for a fixed period and then reintroduce it, noticing how eating these foods affects your overall state.
The AIP diet consists of two phases called the elimination phase and the reintroduction phase.

Elimination phase

It is the first phase of the AIP diet, which requires you to avoid foods and medications thought to cause an immune response, inflammation in the gut, and disbalance of good and bad bacteria in the gut microflora. This phase lasts until you experience a considerable reduction in the symptoms. Usually, people stay in the elimination phase for 30-90 days.

The following is a list of foods and drugs that you want to exclude from your diet during the elimination phase:

• refined sugars
• coffee
• grains
• nuts
• seeds
• legumes
• dairy products
• eggs
• nightshade vegetables (like tomatoes, potatoes, eggplants, peppers, etc.)
• alcohol
• tobacco
• processed vegetable oils
• food additives
• artificial sweeteners
• NSAIDs (including ibuprofen, diclofenac, naproxen, and high dose aspirin)

In addition to eliminating some foods, this phase promotes eating fresh foods with high nutrient density, fermented foods, minimally processed meat, and bone broth. The elimination phase of the AIP diet also encourages you to make some changes in your lifestyle by managing sleep and stress and introducing physical activity into your everyday life.

Reintroduction phase

The second phase of the AIP diet aims to determine what foods cause a person’s symptoms. By knowing what foods to avoid, the person can reintroduce all other foods that don’t affect their overall well-being and enjoy a diverse diet without unnecessary restrictions.

During the reintroduction phase, you are encouraged to gradually start eating foods prohibited in the elimination phase, one at a time. While reintroducing specific food, you should pay attention to how it impacts your health. In addition, when you add particular food back to your diet, wait 5-7 days before reintroducing another one.

At the end of this phase, you will know which food you should avoid and which one you are tolerant to and can safely eat. However, it is worth mentioning that food tolerance can change over time, so you can try to reintroduce foods that failed for the first time once in a while.

Contraindications

Pregnant and breastfeeding women, underweight and malnourished patients should avoid the AIP diet. In addition, patients with chronic health conditions such as heart or kidney disease, type 2 diabetes, and risk of osteoporosis should consult the doctor before starting this diet.

How to avoid possible nutritional deficiencies

The elimination phase of the AIP diet is pretty restrictive. Therefore, while following it, you may develop deficiencies in some essential nutrients like fiber, calcium, vitamin B-9, vitamin B-12, vitamin D, magnesium, iodine, iron, zinc, potassium, and phosphorous. To ensure that you fulfill your body’s requirements for these nutrients, consider adding some of the following foods to your diet:

• fiber: berries (strawberries, raspberries), avocado, bananas, apples, broccoli, Brussels sprouts, carrots, beets, artichoke, dark chocolate;
• calcium: leafy greens, winter squash, rhubarb, amaranth, tofu, canned salmon, canned sardines, figs;
• vitamin B-9: citrus fruits, leafy greens, broccoli, Brussels sprouts, asparagus, beets, bananas, papaya, avocado, seafood, beef liver;
• vitamin B-12: sardines, tuna, salmon, trout, clams, beef, liver, kidneys, fortified nutritional yeast;
• vitamin D: salmon, tuna, sardines, herring, cod liver oil, beef liver, mushrooms;
• magnesium: tofu, avocado, leafy greens, bananas, salmon, mackerel;
• iodine: iodized salt, fish, shellfish, seaweed, chicken, beef liver, prunes;
• iron: spinach, tofu, broccoli, dried fruits, red meat, beef liver, turkey, fish, shellfish;
• zinc: red meat, poultry, shellfish, kale, mushrooms;
• potassium: bananas, avocado, cantaloupe, oranges, dried fruits, spinach, broccoli, winter squash, salmon, chicken;
• phosphorous: salmon, poultry, beef, pork, seafood, cauliflower, asparagus;

Some people may find it challenging to ensure adequate intake of all these nutrients from their diet. An alternative way to fulfill your body requirements is by taking supplements. Consult with your doctor or dietitian to discuss possible supplements you may need.

Tips on improving your dieting experience

It is essential to ensure that during the second phase of the AIP diet, you reintroduce foods in a proper way to avoid false-negative results. Factors like stress, infection, insufficient sleep, intensive workout, and others can increase the inflammation in the body and interfere with interpreting the results of the tested food. The following steps can be used as a guideline for food reintroduction:

• Step 1: decide what food you will reintroduce and eat it a few times on the testing day. Then avoid this food for 5-6 days.
• Step 2: firstly, eat only a tiny portion of chosen food and wait 15 minutes to see if you have the symptoms.
• Step 3: in the case of symptoms reoccurrence, stop the test and exclude the food from your diet. On the other hand, if you are feeling well after trying a small amount of the food, you can increase the portion size to 1.5 tablespoons and track your overall state for 2-3 hours.
• Step 4: in the case of symptoms reoccurrence, stop the test and exclude the food from your diet. If you feel well, eat a regular portion of the tested food and exclude it from your diet for 5-6 days. During this period, don’t reintroduce other foods. 
• Step 5: If during the 5-6 days period the symptoms didn’t reoccur, you can safely include the tested food into your diet and start testing another one.

In some cases, it is advisable to reintroduce foods in a specific order. For instance, while reintroducing dairy products, you may want to start with the food containing the least amount of lactose.

Conclusions

Overall, the Autoimmune Protocol (AIP) diet can help identify which foods cause inflammation and decrease the symptoms of autoimmune diseases by avoiding such foods.

However, the elimination phase is highly restrictive and may be hard to follow. If you find it difficult to avoid all the foods prohibited in the first phase, you may want to try excluding and testing one food at a time. It is advisable to consult with your doctor before starting the AIP diet.