Living with chronic inflammation from autoimmune disorders can be challenging, often accompanied by a great deal of pain. Navigating the complexities of what to eat and what to avoid can further exacerbate daily stress. The Autoimmune Protocol Diet (AIP), a specialized dietary approach, offers a potential solution by focusing on relieving inflammation in the digestive tract and promoting overall well-being.
It's important to note that the AIP diet hasn't been rigorously studied, and there aren't any official guidelines for it. It closely mimics an elimination diet, which typically involves these components:
- Eliminating food triggers that irritate the gut for two to three weeks.
- Reintroducing foods while carefully monitoring any symptoms.
- Focusing on long-term maintenance based on individual tolerance.
This article serves as a comprehensive guide, exploring the impact of autoimmune disorders on the body and identifying foods that are compatible with the AIP diet.
Understanding Autoimmune Disorders
The immune system, comprised of the lymphatic system and white blood cells, constantly screens the body for harmful germs, bacteria, and viruses. White blood cells are activated when a threat is identified, initiating an inflammatory response to maintain health. Once the threat is eliminated, the inflammation subsides.
Autoimmune disorders arise when the immune system mistakenly targets healthy organs and tissues, leading to chronic inflammation and a significant reduction in quality of life. Long-term inflammation can manifest in various side effects, including persistent fatigue, swelling, widespread pain, and changes in the skin.
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Examples of common autoimmune diseases include:
- Type 1 Diabetes
- Lupus
- Rheumatoid Arthritis
- Thyroid diseases, such as Graves' disease (hyperthyroidism) and Hashimoto's (hypothyroidism)
- Psoriasis
While there isn't a cure for autoimmune conditions, they can be managed through evidence-based practices, including dietary strategies like the AIP diet, regular physical activity, and medications.
What is the AIP Diet?
The Autoimmune Protocol (AIP) diet, sometimes referred to as the Autoimmune Paleolithic Diet, is designed to reduce inflammation by eliminating trigger foods that contain organic compounds and proteins that may worsen digestive inflammatory responses. This diet is not the same as the low FODMAP diet, which focuses on reducing symptoms linked to carbohydrate intake.
By adhering to the AIP diet plan and eliminating specific foods, the inflammatory response decreases, providing the body with an opportunity to recover and allowing the gut wall lining to heal. While this restrictive diet plan may not be suitable for everyone, it can be beneficial for individuals suffering from chronic inflammation related to an autoimmune condition.
The AIP Diet Plan
The AIP diet is a stricter adaptation of the Paleolithic diet, excluding processed and ultra-processed foods (UPFs) such as cookies, chips, crackers, candy, and breakfast cereals. Instead, it emphasizes the consumption of vegetables, fruits, lean protein sources (including seafood), and certain plant-based milks.
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There are known adverse health effects associated with a high intake of UPFs, including unwanted weight gain, heart disease, and certain cancers, particularly colon cancer. UPFs are typically high in refined sugars, fats, and salt, which can contribute to elevated levels of inflammation. For these reasons, UPFs are not recommended on the AIP diet plan.
Other foods that are not AIP-compatible include:
- Nightshade vegetables: Tomatoes, eggplant, potatoes, and peppers (including bell peppers and chili peppers)
- Nuts and seeds: Only eliminate if they worsen symptoms; most people don’t need to restrict 100% of these foods.
- All grains
- Legumes and beans
- Coffee and alcohol
- Eggs
- Refined sugars: White sugar, brown sugar, and high fructose corn syrup
- Animal-based dairy products
Individual health and digestion are unique, so this list serves as a guideline. As you progress through the AIP diet plan, you can tailor it to best suit your individual needs. Consulting with a registered dietitian specializing in inflammation can provide additional support.
Different Phases of the AIP Diet Plan
Due to the limited evidence and lack of rigorous guidelines, the AIP diet is typically structured as an elimination diet, involving these three steps:
- Elimination Phase: Eliminate common trigger foods that may increase the body’s inflammatory response. The duration of this phase is determined by your healthcare provider and is temporary.
- Reintroduction Phase: Reintroduce foods back into your diet one at a time and carefully monitor your symptoms to identify any sensitivities.
- Maintenance Phase: Develop a sustainable, personalized diet based on the knowledge gained in the first two phases.
A registered dietitian can provide invaluable assistance throughout these phases.
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What Does the Research Say?
Research studies on the efficacy of the AIP diet plan have shown promising results in reducing inflammation, but more research is needed to validate these findings.
Inflammatory Bowel Disease
Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, can be managed through diet. However, painful flare-ups can occur, causing inflammation in the intestinal walls and heightened sensitivity to certain foods and beverages. These events can lead to fatigue, fever, diarrhea, blood in the stool, and decreased appetite.
A 2017 research study observed 15 participants following the AIP diet for approximately three weeks. After 11 weeks, an endoscopy revealed a decrease in visible inflammation along the gut walls. These findings suggest that the AIP diet plan may benefit individuals with IBD.
Hashimoto’s
Hashimoto's is an autoimmune disorder that targets and destroys thyroid cells, resulting in hypothyroidism. While medication is often used to manage thyroid levels, a 2019 study explored the role of the AIP diet in individuals diagnosed with Hashimoto's.
Participants had blood drawn at the beginning and end of the study to check thyroid and C-reactive protein levels, a marker of inflammation. After ten weeks, C-reactive protein levels had decreased, indicating reduced inflammation. Although the sample size was small, the findings suggest that the AIP diet plan may help individuals with Hashimoto’s.
Leaky Gut
Leaky gut, characterized by increased permeability of the intestinal walls, is associated with an increased risk of germs and bacteria passing into surrounding tissues, contributing to inflammation and pain. Studies have confirmed that individuals with autoimmune conditions like Crohn's disease often have permeable intestinal walls. The AIP diet plan may improve leaky gut by eliminating foods linked to gut inflammation, although more research is needed.
How Does Diet Help Autoimmune Conditions?
A diet rich in antioxidants may decrease symptoms of inflammation associated with autoimmune conditions. Antioxidant-rich foods include fruits, vegetables, fiber-rich grains, beans, and unsaturated fats. The nutrients in these foods neutralize harmful free radicals, which can worsen inflammation. Research has also demonstrated that individuals with autoimmune conditions who consume anti-inflammatory diets have lower mortality rates.
Getting Started on an AIP Diet
Before starting an AIP diet, consulting with your doctor or a registered dietitian is recommended. This provides an opportunity to ask questions and discuss how to meet your nutritional needs while on the diet.
Because the AIP diet eliminates many foods, ensuring a diverse intake of foods that support your health is crucial. Additionally, it's helpful to clear out your kitchen of non-AIP-approved foods and stock up on AIP-approved alternatives to support your progress.
A Shopping List for the AIP Diet
Here are recommendations for an AIP-friendly grocery list:
- Lean ground proteins: Turkey, chicken, and beef
- Fish rich in omega-3 fatty acids: Salmon and trout; other options include cod, haddock, tilapia, and tuna
- Seafood: Shrimp and scallops
- Most vegetables: Broccoli, cabbage, mushrooms, turnips, zucchini, garlic, Brussels sprouts, and onion (excluding nightshades)
- Starchy vegetables: Sweet potatoes, yams, and squashes
- Most fresh fruits: Berries, apples, oranges, nectarines, pomegranates, and bananas
- Coconut milk
- Honey
- Olive oil and avocado oil
- Fermented foods: Sauerkraut or pickles (dairy-free, sugar-free, and nightshade-free)
- Bone broth
- Herbs and spices: Ginger, garlic, and oregano
Sample AIP Meal Plan
Here is a sample three-day AIP diet plan to try at home:
Day 1
- Breakfast: Sweet potato "toast" (roasted sweet potato slice) topped with mashed avocado and spices like turmeric and cumin.
- Lunch: Baked tuna cakes served over fresh spinach with olive oil and balsamic vinegar.
- Dinner: One-pan chicken with rosemary, parsnips, garlic, and fresh thyme, glazed with avocado oil, salt, cinnamon, and one tablespoon of maple syrup.
Day 2
- Breakfast: Cassava flour pancakes topped with mixed berries.
- Lunch: Nori fish wraps with avocado and pickled vegetables.
- Dinner: Grass-fed steak with a green salad and sauteed mushrooms and squash.
Day 3
- Breakfast: Toasted coconut flakes with fresh fruits and coconut milk.
- Lunch: Chicken lettuce wraps with homemade AIP-friendly Caesar dressing and sliced avocado.
- Dinner: Mediterranean-style shrimp cooked with olive oil, minced garlic, oregano, and basil, served with baked zucchini, carrots, and sweet potatoes.
Are There Any Risks of the AIP Diet Plan?
The AIP diet plan can result in low fiber intake due to the elimination of whole grains, legumes, certain vegetables, nuts, and seeds, which are all high in fiber. Low fiber intake is linked to several diseases, including cancer, heart disease, type 2 diabetes, constipation, and diverticular disease.
The USDA Dietary Guidelines indicate that more than 90% of women and 97% of men are not meeting recommended dietary fiber goals. To address this, prioritize high-fiber vegetables and fruits within your AIP diet plan, such as avocados, berries, broccoli, cabbages, and other cruciferous vegetables.
The Fear Of Moving Forward
Individuals who have experienced relief from chronic inflammation after starting the AIP diet plan may be hesitant to move out of the elimination phase, fearing a return of pain and discomfort. However, it is essential to progress to the reintroduction phase to ensure a sustainable diet with variety. If you feel stuck or fearful, seeking guidance from a trained dietitian can provide actionable steps to move forward while maintaining progress.
Tips for Success
Small, consistent nutrition changes are gentler on your digestive system and easier to follow. Other tips include:
- Focusing on one meal at a time.
- Working with a dietitian specializing in inflammation.
- Making simple, easy-to-follow recipes.
- Documenting symptoms to track any changes.
- Batch cooking meals or components to prepare for the week ahead.
- Preparing AIP-friendly snacks to satisfy unexpected hunger pangs.
- Practicing mindfulness at meals.
Is the AIP Diet Right for Me?
The AIP diet may help you find relief from symptoms associated with an autoimmune disorder or chronic inflammation. If other treatments have not been successful, the AIP diet may be a viable option.
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