AIP Diet Food List: What to Eat and What to Avoid for Autoimmune Health

Living with an autoimmune condition can sometimes feel like a constant battle as your body turns against you, making everyday activities exhausting. Between doctor visits, medications, good days, and unexpected flare-ups, many turn to social media for real-world examples and relatable creators to find alternative approaches. Unsurprisingly, diet is considered one of the holistic ‘solutions’ for autoimmune problems.

Autoimmune protocol diet, or AIP, is a nutritional approach that aims to reduce chronic inflammation and support gut health by potentially ‘calming’ the immune system. The main idea is to eliminate all foods that may trigger an immune response and slowly reintroduce them one by one over time to determine which foods are ‘safe’ and which are not for you.

Despite this protocol's increasing popularity, there is a lack of scientific agreement on its effectiveness. We believed it was important to investigate this further. In this article, I will explain and provide detailed information about AIP, including a detailed allowed food list, an example meal plan, and considerations to remember before starting this diet.

What is the AIP diet?

AIP is an anti-inflammatory elimination diet designed to exclude foods that could trigger an immune response. The rationale behind the autoimmune protocol is that it may reduce inflammation and improve autoimmune symptoms. The typical diet plan involves three different phases.

Disclaimer:

Regulatory authorities do not recognize this dietary pattern in medical guidelines for managing autoimmune conditions.

Elimination phase

As the name suggests, the first phase of the AIP diet involves completely eliminating several food groups that are claimed to potentially increase inflammation or disrupt gut health. Instead, you should focus on anti-inflammatory and gut health-supporting foods.

I will provide a detailed food list and meal plan below, but the ‘forbidden’ items include grains, legumes, nightshade vegetables, nuts, seeds, dairy, eggs, coffee, alcohol, refined sugars, oil, and any food additives.

You should eat whole, nutrient-dense food and meals of allowed vegetables, fruits, healthy fats, wild and organic meat, fish, and seafood. Certain herbs and spices, non-dairy fermented foods, some dressings, and natural sweeteners like honey are also allowed. You have to be careful about which are AIP-friendly and which are not, but it is reassuring to know that you will not need to eat bland, flavorless food.

This phase can last from six weeks to six months. Due to how restrictive the elimination phase is, working closely with a nutritionist is advised to ensure you are not doing more damage and developing nutrient deficiencies in the process. Highly restrictive diets and eliminating whole food groups are not recommended for the general population unless advised by a healthcare professional or due to intolerances.

Reintroduction phase

The main point of the second phase is to slowly and gradually reintroduce the eliminated foods to check which trigger negative responses and which are safe. There are no strict rules on which foods you should reintroduce first; most people start with the ones they like or miss the most.

The key is to introduce one food at a time in small amounts, for example, a spoonful one day, two the next, and so on, to ensure you tolerate the food consistently. It is also important to introduce one food at a time to be sure which food is causing an adverse reaction.

This phase can be time-consuming and confusing. I suggest gamifying it a bit and tracking the food, its amounts, and how you feel right after, after a few hours, and so on an app, Notion, or a food journal. I would also suggest tracking your sensitivity to some foods in terms of quantity and frequency. For example, you may be able to tolerate up to three eggs once or twice a week, but having them several days in a row triggers a reaction. Reintroducing eliminated foods is paramount, as staying in the first overly restrictive phase is neither sustainable nor healthy and can lead to serious nutritional deficiencies or disordered relationships with food.

Maintenance phase

Like any diet, it is only effective when it can be maintained. You did the main work during the elimination and reintroduction phases, and now you have to apply it long-term. Hopefully, you have identified which foods cause you no problems and can be fully reintroduced, which you tolerate in moderate amounts or on rarer occasions, and which are a no-go. This allows you to create personalized dietary guidelines and patterns.

That being said, AIP does not have conclusive scientific evidence or supporting studies on its effectiveness. There is no clear line between the reintroduction and maintenance phases, and some improvisation is required. You may want to continue reintroducing some foods if you are not allergic, or may find that some foods you thought were safe cause a reaction later on.

AIP vs. anti-inflammatory diet

An anti-inflammatory diet is a trendy umbrella term for diets that aim to reduce inflammation. They claim to have a holistic approach to health and wellness and focus on whole, minimally processed foods. While some of those diets may indirectly address inflammation to some extent and are more researched within the field, others, like the paleo diet, lack any substantiation and are generally seen as anti-inflammatory due to their focus on whole foods. Examples include:

• Mediterranean diet
• The dietary approaches to stop hypertension (DASH) diet
• Paleo diet
• Traditional Okinawan, Nordic, or Mexican diets

These diets tend to focus on fruits and vegetables as the base of every meal, whole grains, healthy fats, and lean or plant-based proteins. Red meat, dairy, alcohol, and processed foods are eaten in smaller amounts and only occasionally. However, only the Mediterranean and DASH diets are more scientifically backed and are encouraged to follow in certain situations or as a generally ‘healthy’ dietary pattern. The others are more of a trend and lack scientific support.

The main difference between AIP and anti-inflammatory diets is that AIP involves a strict protocol and eliminating numerous foods. In contrast, anti-inflammatory diets focus on local and seasonal produce and whole foods, but indulgent or processed foods in moderation. There is some overlap in foods that should be avoided or minimized between the two approaches, such as dairy, refined sugar, and alcohol. Still, AIP also limits certain vegetables and fruits, which is generally not the case for anti-inflammatory diets.

What’s included in the AIP diet foods

I looked through some blogs online, and most people suggest focusing on what you can eat. The AIP diet food list includes:

AIP diet meal plan

We do not promote this diet as it lacks scientific evidence, but if you decide to undertake this protocol, here are some meal ideas and a possible weekly meal plan.

To keep it more budget-friendly, feel free to repeat protein sources or opt for cuts on sale. Organ meats are usually cheaper. Buy seasonal or frozen vegetables that tend to be cheaper, and feel free to repeat those throughout the week, too. I included some repeating dinners and lunches to make planning and prepping easier, but feel free to rotate the same dinners and lunches more times.

Restrictions and avoidance on the AIP diet

The foods that should be cut out during the elimination phase are:

Non-steroidal and anti-inflammatory drugs (NSAIDs) should also be avoided, according to some sources, but as WellnessPulse, we are against such recommendations. Only your doctor can determine whether you should avoid certain drugs for your condition, and diet generally should not substitute for medications.

According to the diet’s mechanisms of action, the immune system reacts to antigens that are not recognized as part of the self, usually sugar or protein molecules. In autoimmune conditions, the body attacks self-cells, and it is believed that gut permeability and health may be negatively affected. Thus, removing possible allergen triggers and foods that may harm gut health is supposed to help ‘heal the gut’ and allow you to identify your immune-triggering foods during reintroduction.

I asked Kristy Thomas, a registered nutritionist, why common foods like eggs and dairy are restricted. She said, “Eggs have proteins such as lysozyme and albumin, which can be troublesome for the immune system. Consequently, dairy, particularly cow’s milk, contains lactose and casein, which may be inflammatory to the gut and increase inflammation for some people. Because autoimmune diseases are related to an overactive immune system, it makes sense to avoid these foods to reduce symptoms.” However, only a small percentage of people react negatively to these proteins.

Despite the logic behind AIP, it is essential to remember that individual variability is present here. These foods mentioned do not universally cause inflammation in the general population or even within those with autoimmune conditions. Most people would benefit from the nutrients found in dairy, eggs, whole grains, and various ‘forbidden’ vegetables.

Furthermore, the correlation between some foods and immune symptoms is not a defined causational link. Just because we remove a food item and symptoms improve, it does not entirely mean that this particular food was the cause of the symptoms, as other factors, such as lifestyle, disease stage and progression, and other triggers, are at play.

The science behind the AIP diet

The idea behind using diet to manage autoimmune symptoms comes from studies linking the gut microbiota to the immune system. The gastrointestinal tract is home to a complex microorganism system that has evolved to live with its host (you). Terms like ‘healthy gut’ and ‘good bacteria’ indicate a balanced system dominated by beneficial bacteria and other microorganisms that support the host's health by contributing to digestion regulation and aiding the immune system. On the other hand, emerging research shows that a gut microbiome disruption may be linked to certain autoimmune disorders.

Your diet is a factor influencing your gut microbiome composition. High-fiber food feeds ‘good’ bacteria, and a varied diet can support gut microbiome versatility, but limited evidence from high-quality human studies exists on the AIP diet.

A small, uncontrolled clinical trial of 15 participants with Crohn's disease or ulcerative colitis provided dietary guidance and coaching for them to follow an autoimmune protocol diet. The elimination week lasted 6 weeks and was followed by a 5-week maintenance phase during which food group reintroduction was not allowed in this study. The results demonstrated an improvement in the frequency of bowel movements, the ability to engage in leisure or sports activities, and the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) scores as early as week three.

Despite promising results, this study is limited by a small sample size, no control group, and reliance on self-reports. Also, a progressive decline in survey participation was seen, possibly due to the restrictive diet and the lack of understanding of the reintroduction phase.

Another study looked at the effects of AIP on rheumatoid arthritis (RA). Participants who were on stable medication and had no dietary restrictions followed their usual diets for four weeks, then the AIP protocol for eight weeks, and completed weekly questionnaires. Out of nine participants who completed the study, four showed improvements in fatigue, sleep, and pain. However, this study was also very small to draw conclusions.

Leaky gut is a term used to describe increased permeability due to a potentially damaged gut lining. It is claimed that this results in large food particles, microbes, or toxins leaking through the intestinal wall and entering the bloodstream. The immune system may then react to these particles, resulting in inflammation. The idea behind AIP is that a leaky gut worsens autoimmune conditions because of the increase in inflammation.

I asked Thomas for a professional take on AIP. She said, “Based on personal experience, the AIP diet seems to lessen autoimmune disease symptoms. It focuses on inflammatory factors, gut healing, and food intolerances. But I prefer to consider it a short-term solution instead of a long-term commitment. Proper guidance from trained professionals is advisable.”

Potential downsides and important considerations

As already mentioned, there are some risks associated with AIP:

• Lack of scientific proof. AIP diet lacks consensus on effectiveness and precise protocols.
• Restrictive nature. The dietary rules are very restrictive and may be hard to adhere to.
• Possible nutrient deficiencies. Eliminating numerous food groups for a prolonged period may lead to nutritional deficiencies, which, in turn, can worsen symptoms.
• Risk of disordered eating. Severe restrictions can disrupt our relationship with food, especially if you have a history of disordered eating.

Furthermore, one of the main issues is that the AIP protocol, in many ways, goes against healthy dietary recommendations. A healthy and balanced diet is focused on moderation and diversity rather than extreme restriction. Whole grains, all fruits, and vegetables are generally encouraged unless you have diagnosed allergies.

On the other hand, the AIP diet allows certain fruits and vegetables, most animal products, and no grains. Following such a protocol can also take a mental and social toll, as it is tough to go out while following this protocol, and you may miss out on dinners with family and friends, special occasions, and festive foods.

Kristy Thomas added that “the most restrictive nature of the diet and its inconvenience at social gatherings pose serious concerns. The ease of sustaining the diet while dining out or traveling can be challenging. Some may also develop food-related anxiety or reduce anxiety toward what is deemed permissible. If not implemented with caution, one could be deprived of essential nutrients. Despite the increased popularity, there is still a lack of extensive research on the long-term impact on the effectiveness of all autoimmune diseases.”

Seeking guidance and alternatives

There is no consensus in the medical field about the best diet for autoimmune conditions. This is significant because each individual has different autoimmune symptoms and their severity. Numerous autoimmune diseases, such as lupus, Hashimoto’s, and rheumatoid arthritis, have different triggers. Furthermore, each person has different dietary sensitivities and preferences. So, while one finds eggs worsen their conditions, another may thrive eating eggs daily.

However, some principles repeat across the AIP diet and most anti-inflammatory diets:

• Elimination or reduction of ultra-processed foods
• Avoiding refined sugar and seed oils
• Eating more omega-3s, fiber, and antioxidant-containing foods
• Focusing on whole foods

AIP is one of the most restrictive diets, and you may find a personalized elimination diet developed by your healthcare provider more beneficial.

Regardless of which one you opt for, it is best to consult your doctor and a licensed nutritionist to devise a personalized approach and plan to avoid nutritional deficiencies. Having support from a nutritionist may also make the process less overwhelming. There is a risk of eliminating too many foods for too long and then not being sure how to reintroduce them, as well as developing serious deficiencies along the way.

Beyond the food list: holistic considerations

Apart from significant changes in the food list, AIP may increase food-related anxiety, stress, and even a sense of guilt about food. You may find it difficult to enjoy meals, as you are thinking about every ingredient, and going out may seem impossible. During the reintroduction phase, you may be preoccupied with monitoring every sensation for possible signs of intolerance.

Unnecessary and excessive stress about your diet may make managing your conditions harder or even potentially increase inflammation. If you fall into a restrictive mindset for too long, it may even start to develop into an eating disorder, such as orthorexia — an unhealthy obsession with healthy eating.

Nutritional deficiencies may also make autoimmune conditions worse by:

• Potentially disrupting the immune system
• Likely increasing inflammation
• Worsening fatigue, mood, or pain symptoms

The bottom line is that diet may definitely influence quality of life, but it should enhance it rather than be a cause for stress.

Final thoughts

As explained in the article, an autoimmune protocol (AIP) diet aims to improve symptoms of autoimmune disorders by eliminating foods that may disrupt gut health or trigger inflammation. While some people claim it has helped them to manage their condition, such as inflammatory bowel disease, the approach is highly restrictive and is not recognized medically.

AIP lacks scientific evidence for its effectiveness and may only be a band-aid solution for some. Removing numerous food groups and failing to reintroduce them in fear of triggering an immune response can lead to severe physiological and psychological complications. If you try this approach, you should do so under medical guidance and consult a nutritionist.

We would love to hear about your experience and thoughts if you have tried this approach.