In recent years, there has been a surge of interest in the role of diet in managing chronic inflammation and autoimmune conditions. Both the anti-inflammatory diet and the autoimmune protocol (AIP) have garnered attention for their potential benefits in this area. While both diets aim to reduce inflammation in the body, they differ significantly in their approach and guidelines. This article provides a comprehensive overview of these two dietary approaches, highlighting their differences, similarities, benefits, and potential drawbacks.
Understanding Inflammation
Inflammation is a natural immune response that protects the body from pathogens and injuries. It is a healthy response by our immune system. When a foreign invader enters the body, such as bacteria, viruses, or allergens, or an injury occurs, our immune cells act quickly. We may sneeze or cough to rid the body of an offending agent. We may feel pain and swelling at the site of a cut or injury to signal us to be gentle with this delicate area. Blood flows in rapidly, which may produce warmth or redness. These are signs that our immune system is repairing damaged tissue or fighting invaders.
However, inflammation becomes harmful when it is prolonged and begins to damage healthy cells, creating a pro-inflammatory state. Another problem is due to genetic deviants causing the body’s immune system to constantly attack cells. This sometimes occurs with autoimmune disorders like lupus, fibromyalgia, multiple sclerosis, rheumatoid arthritis, type 1 diabetes, and Crohn’s disease. Sometimes an unhealthy lifestyle from lack of exercise, high stress, and calorie-rich diets can trigger chronic low levels of inflammation throughout the entire body, termed metaflammation.
The Anti-Inflammatory Diet
An anti-inflammatory diet is promoted as a remedy to battle inflammation in the body. It emphasizes eating a wide variety of fruits and vegetables, unsaturated fats, minimally refined whole grains, tea, coffee, herbs, spices, and oily fish. An anti-inflammatory diet does not follow strict rules about calories or portion sizes. It suggests a variety of anti-inflammatory foods to eat daily, rather than focusing on eating one or two specific foods or nutrients. This ensures a greater variety of protective food components, some of which may work synergistically to boost immunity. These foods provide plant chemicals (phytochemicals), antioxidants, and fiber that prevent cellular stresses, inhibit inflammatory signals caused by the immune system, promote healthy gut microbiota, and slow down digestion to prevent surges in blood glucose.
Core Principles
The core of the anti-inflammatory diet lies in its focus on incorporating whole foods that are naturally rich in nutrients known to combat inflammation. This dietary approach prioritizes a rich intake of fruits and vegetables, which are sources of antioxidants and phytochemicals, alongside whole grains that provide essential fiber. Healthy fats, particularly those containing omega-3 fatty acids found in fish, like salmon and in flaxseeds, play a crucial role in moderating the body’s inflammatory response.
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Foods to Include
An example of an anti-inflammatory food list may look something like:
- Fresh fruit: Like apples, berries, avocados and oranges
- Fresh vegetables: Like leafy greens, peppers and broccoli
- Lean protein: Like chicken and turkey
- Fatty fish: Including salmon, tuna, herring or mackerel
- Whole grains: Like brown rice, wild rice and oats
- Legumes: Like dried beans and peas
- Nuts and seeds: Including walnuts
- Spices: Like turmeric and cinnamon
- Healthy oils: Like extra virgin olive oil (EVOO)
Foods to Avoid
The anti-inflammatory diet advocates for minimizing intake of foods that can exacerbate inflammation, such as processed items, those high in sugar, and trans fats. Foods to avoid or limit include:
- Sweets: Like commercially baked goods, pre-packaged desserts, ice cream and candy
- Packaged snacks: Like potato chips and microwave popcorn
- Processed meats: Including bacon, sausage, hot dogs, bologna, pepperoni and salami
- Processed cheeses: Like nacho cheese dip and American cheese slices
- Sugary drinks: Including soda and sports drinks
- Fried foods: Like fried chicken and French fries
Benefits
The health benefits of an anti-inflammatory diet include:
- Clearer skin
- Decreased muscle or joint pain
- Decreased swelling in your hands and feet
- Fewer headaches
- Improved gastrointestinal symptoms (diarrhea, gas, nausea, stomach pain)
- Improved sleep
- Less anxiety, stress and/or brain fog
- Less bloating
- Lower blood pressure
- Lower blood sugar
- More energy
- Weight loss
Popular Anti-Inflammatory Diets
Popular dietary patterns that are anti-inflammatory include the Mediterranean diet, DASH diet, and vegetarian diets.
- Mediterranean Diet: The Mediterranean diet is a pattern of eating based on typical diets in countries near the Mediterranean Sea, such as Greece, Italy, and Spain. This diet contains lots of vegetables, fruit, olive oil, whole grains, and beans and moderate amounts of fish, chicken, low-fat dairy, and nuts. The diet limits red meat, sugary drinks (including fruit juice), salt, processed foods, and processed meats.
- DASH Diet: The DASH (Dietary Approaches to Stop Hypertension) diet is designed to help treat or prevent high blood pressure. It emphasizes fruits, vegetables, low-fat dairy, whole grains, fish, poultry, beans, seeds, and nuts. It limits sodium, red meat, sweets, and sugary drinks.
- Vegetarian Diets: Vegetarian diets are based on large amounts of whole grains, fruits, vegetables, legumes, and nuts. A meta-analysis of 17 observational cross-sectional studies found that following a vegetarian diet (including vegan diets with no animal foods and lacto-ovo-vegetarian diets with eggs and dairy) for at least 2 years was associated with lower C-reactive protein levels, a pro-inflammatory marker, than in omnivores who had no dietary restrictions.
- MIND Diet: The MIND diet, a hybrid of the DASH and Mediterranean diets, is an anti-inflammatory eating plan that includes whole grains, vegetables especially green leafy types, berries, olive oil, beans, nuts, fish and poultry, and limits fried/fast food, butter, cheese, sweets, and red meat.
The Autoimmune Protocol (AIP) Diet
The Autoimmune Protocol, often referred to as AIP, takes a stringent approach to diet with the aim of alleviating symptoms associated with autoimmune disorders. The AIP diet is a personalized elimination diet that aims to determine and exclude the foods that might trigger immune responses, leading to inflammation and symptomatology associated with autoimmune diseases. Focusing on gut health and the importance of the gut microbiome in immune regulation and overall well-being, the AIP starts by eliminating foods that might create negative effects on the patients and continues by developing a personalized and tailored diet plan for them. This comprehensive approach aims to mitigate symptoms and improve quality of life of individuals with autoimmune conditions.
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Core Principles
By eliminating a comprehensive list of foods believed to provoke inflammation and immune response, the AIP goes beyond the general anti-inflammatory diet principles. It targets the removal of grains, dairy, legumes, nightshades (such as tomatoes and peppers), eggs, nuts, seeds, and any processed foods. Instead, it promotes a diet rich in vegetables (excluding nightshades), lean meats, certain seafood, fermented foods, and healthy fats, focusing heavily on nutrient density to support the body’s healing. AIP also emphasizes the importance of a healthy gut, suggesting that a compromised gut barrier could contribute to autoimmune reactions. To support gut health, it encourages the consumption of bone broths and fermented foods while stressing the importance of lifestyle adjustments.
The AIP diet is rooted in the principles of the paleo diet, which focuses on nutrient-dense, whole foods while eliminating ultraprocessed foods and some additional foods, such as whole grains, that supposedly interfere with nutrient absorption or promote inflammation. The AIP diet is also based on the premise that autoimmune disorders arise from a leaky gut. The theory behind leaky gut syndrome is that the lining of your intestines may be compromised, allowing toxins and bacteria to enter your bloodstream, according to Cleveland Clinic.
The Three Phases of the AIP Diet
The AIP encompasses three phases: elimination, reintroduction, and maintenance.
1. Elimination Phase
During the first phase, grains, legumes, nightshades, nuts, seeds, dairy, eggs, coffee, and alcohol are completely removed from the diet. In addition, all refined sugars, oils, processed foods, food additives, artificial colors, and flavorings are excluded due to their contribution to gut dysfunction. The use of non-steroidal anti-inflammatory drugs (NSAIDs) is also avoided during this phase. Patients are encouraged to consume nutrient-dense whole foods, such as vegetables, fruits, mono- and poly-unsaturated fatty acids, tubers, wild game, poultry, organ, and non-processed meats. Gluten-rich grains are avoided, as their glycoprotein extract, gliadin, is implicated in autoimmunity. This phase spans from 6 weeks to 6 months. This prolonged duration stems from plasma B-cells living from a few days to a few months, while immunoglobin G (IgG) antibodies (mostly associated with immune tolerance) have a half-life of 21 days.
Foods to eat on the AIP diet during the elimination phase:
- Vegetables: All vegetables are encouraged except nightshades (tomatoes, potatoes, eggplant, peppers).
- Fruits: Moderate amounts are allowed, with an emphasis on low-sugar options, like berries and apples.
- Meats and seafood: Grass-fed beef, pasture-raised poultry, wild-caught fish and organ meats (such as liver) are allowed.
- Fats: Avocado oil, coconut oil, olive oil and animal fats, like tallow or lard, are emphasized.
- Bone broth: Bone broth is encouraged because it has amino acids that support gut healing.
- Fermented foods: Sauerkraut, kimchi (without nightshades), and coconut yogurt are encouraged to promote gut health.
- Herbs and spices: Include any non-seed-based healthy spices that you like, such as garlic, turmeric and ginger.
Foods to avoid on the AIP diet during the elimination phase:
- Grains: All grains, including wheat, rice, oats, corn, quinoa and barley, are excluded.
- Legumes: You’ll avoid beans, lentils, peas, peanuts and soy.
- Dairy: Milk, cheese, yogurt and butter are prohibited in the elimination phase.
- Eggs: Avoid both yolks and whites.
- Nuts and seeds: These are avoided in all forms, including nut and seed butters and seed-based spices, like cumin and mustard.
- Nightshade vegetables: Tomatoes, peppers, eggplant and potatoes are restricted.
- Refined sugar and sweeteners: All sweeteners are excluded. That means avoiding honey, maple syrup, table sugar and zero-calorie substitutes (even those deemed natural).
- Processed and refined foods: Anything with additives, preservatives or artificial ingredients is avoided.
- Alcohol and caffeine: These substances aren’t allowed during the elimination phase as they can contribute to inflammation and irritate the gut.
2. Reintroduction Phase
During the second phase, eliminated foods are reintroduced to identify the ones that trigger individual responses. Generally, there is no rule of thumb on how to initiate the reintroduction. The most common manner is to reintroduce the foods that each patient enjoys the most, or the ones that are less likely to induce negative responses, in an effort to increase the food options. With this in mind, foods have been categorized into four groups based on their likelihood of being well-tolerated. Group 1 consists of egg yolks, legumes, seed oils, and nut oils. Group 2 includes nuts and seeds, cocoa, egg whites, and alcohol. Group 3 comprises cashews and pistachios, eggplant, coffee, and fermented dairy, while Group 4 includes all dairy, white rice, nightshades, alcohol, and gluten-free grains. This phase is time-consuming; if performed methodically however, it results in distinct beneficial health outcomes for each individual.
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After reintroducing a single food, you’ll monitor for symptoms such as fatigue, joint pain, headaches, digestive issues, or skin reactions. If no symptoms occur within five to seven days, you can keep eating that food. If symptoms return, the food is considered a trigger and should be eliminated again.
3. Maintenance Phase
The last AIP phase involves maintaining the protocol and has no specific duration. It aims to provide a healthy diet and lifestyle that will reduce autoimmune responses. In this manner, each patient adopts a dietary pattern associated with a lack of intolerances, considering the reintroduction phase responses.
Once you get through all the reintroductions, you’ll be in maintenance mode. At this point, you’ll continue to avoid your identified trigger foods, though you may decide to eat them in small amounts at times (say, a social event). This is a personal choice. You can factor in the benefits of following the AIP diet compared to the drawbacks.
Benefits
Some small studies have shown that it can offer meaningful improvements for those with autoimmune conditions.
- A study among 15 people with Crohn’s disease or colitis found that the AIP diet resulted in less frequent bowel movements and improved stress.
- Another small study, this one among 16 women with Hashimoto’s thyroiditis, found significant improvements in quality of life measures, such as increased vitality.
- Additionally, a clinical study involving nine people with rheumatoid arthritis found that following the AIP diet improved pain, sleep and fatigue.
Drawbacks
While the AIP diet may help manage some autoimmune symptoms, it’s a big undertaking. Potential drawbacks to consider:
- Highly restrictive: The elimination phase of the AIP diet is very restrictive. It removes a wide range of foods, including many nutritious foods, such as certain vegetables, nuts and legumes.
- Nutrient deficiencies: Eliminating entire food groups can increase the risk of nutrient deficiencies.
- Social and practical challenges: Following the AIP diet can make dining out, social gatherings and traveling difficult. Preparing most, if not all, of your meals may be necessary. This is time-consuming and may be stressful for some people.
- Lack of research: While there is emerging evidence that the AIP diet can help with autoimmune symptoms, the studies are small, short-term and often lack a comparison group. More research is needed to understand the benefits compared to a less-restrictive, whole-foods diet.
- Mental health problems: The strict rules of the elimination phase may lead to feelings of frustration, anxiety or even disordered eating in some people.
Key Differences Between the Anti-Inflammatory Diet and the AIP Diet
A pivotal distinction between the anti-inflammatory diet vs the autoimmune protocol diet (AIP) hinges on their dietary restrictions. The anti-inflammatory diet champions a balanced approach, focusing on a broad intake of whole, nutrient-rich foods that naturally reduce inflammation. It allows for a wider variety of food groups, making it somewhat easier to follow and integrate into a diverse array of lifestyles. On the other hand, the AIP is characterized by its rigorous elimination of numerous food groups. This exclusion list is designed to minimize potential immune triggers. The AIP protocol is designed to mitigate autoimmune reactions by establishing a healthy gut microbiome. This leads to a strong advocacy for foods that support gut integrity which are less emphasized in the anti-inflammatory diet. Both protocols require instruction to be implemented effectively.
Here's a table summarizing the key differences:
| Feature | Anti-Inflammatory Diet | Autoimmune Protocol (AIP) Diet |
|---|---|---|
| Dietary Restrictions | Focuses on incorporating whole foods that combat inflammation. Allows for a wider variety of food groups. | Rigorous elimination of numerous food groups to minimize potential immune triggers. |
| Food Focus | Emphasizes a rich intake of fruits, vegetables, whole grains, and healthy fats. | Promotes a diet rich in vegetables (excluding nightshades), lean meats, certain seafood, fermented foods, and healthy fats, focusing heavily on nutrient density to support the body’s healing. |
| Gut Health Emphasis | Less emphasis on specific foods for gut integrity. | Strong advocacy for foods that support gut integrity, such as bone broths and fermented foods. |
| Implementation | Easier to follow and integrate into diverse lifestyles. | Requires instruction to be implemented effectively, due to the risk of nutrient deficiencies from restricted diets. |
| Phases | No specific phases. | Three phases: elimination, reintroduction, and maintenance. |
| Target Audience | Suitable for those seeking a preventative or general wellness approach. | More targeted for people with diagnosed autoimmune conditions. |
Similarities Between the Anti-Inflammatory Diet and the AIP Diet
While the anti-inflammatory diet and the autoimmune protocol (AIP) may differ in specifics, their core objectives align closely, aiming to mitigate chronic inflammation and bolster immune health. Central to both approaches is the emphasis on whole and unprocessed foods. Each diet encourages a nutritious palette of vegetables, select fruits, and lean proteins. This goal of this combination of foods is to reduce inflammation and promote immune balance. Vitamins, minerals and antioxidants are the trifecta of immune health. In addition to dietary guidelines, these protocols underline the importance of a well-rounded lifestyle to support their objectives. Regular exercise, stress management techniques, and prioritizing sleep are recommended components of both diets, acknowledging that diet is just part of the bigger picture of health.
Which Diet Is Right for You?
Adopting the anti-inflammatory diet or the autoimmune protocol requires careful consideration of your personal health situation and goals. Every individual’s body responds differently to certain foods and dietary changes, making it crucial to customize these protocols to fit your unique needs.
- Start with an Anti-Inflammatory Approach: If you are unsure where to begin, consider starting with an anti-inflammatory approach. This is suitable for those seeking a preventative or general wellness approach. It does not require strict elimination phases or detailed reintroductions.
- Consider the AIP Diet: If you’re dealing with an autoimmune condition and haven’t found relief through other methods, the AIP diet may be worth trying. The AIP diet is more targeted for people with diagnosed autoimmune conditions. The elimination phase is temporary. Its purpose is to calm the immune response, reduce inflammation, and restore integrity to the intestinal barrier.
The Role of a Registered Dietitian
Engaging with a registered dietitian can provide invaluable insights into how these diets can be adapted to support your health journey. They can offer guidance on how to modify food choices, address potential nutrient deficiencies, and incorporate lifestyle changes that complement your dietary efforts.
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