On Trend: The Autoimmune Protocol Diet - The Good, The Bad, and The Ugly

The Autoimmune Protocol Diet has been growing in popularity over the last few years and is often referred to as the Paleo Diet, though many say it is the stricter version of the Paleo Diet. And strict might be putting it lightly because this a highly restrictive diet!

The autoimmune protocol diet has been attributed to Loren Cordain, PhD, a scientist who discovered that certain foods can sometimes trigger inflammation in people with autoimmune disease. The theory behind this diet is that autoimmune diseases, such as Rheumatoid Arthritis, Psoriatic Arthritis, Lupus, Ankylosing Spondylitis, Sjogren’s Syndrome or Juvenile Idiopathic Arthritis, are caused by “leaky gut” a.k.a. increased intestinal permeability, and that certain foods that can increase intestinal inflammation need to be eliminated from your diet.

This intestinal permeability is believed to occur when the tiny gaps in the intestinal lining called Tight Junctions that normally allow water and nutrients to pass through to the bloodstream, become loose and allow toxins and bacteria to pass through causing chronic inflammatory responses and potential immune system response. Leaky gut is not recognized as a medical diagnosis because there is a lack of robust scientific research that recognizes it as the cause of autoimmune diseases, but it is medically recognized as a potential symptom. For example, studies have shown that patients with Inflammatory Bowel Disease (IBD) are likely to have leaky gut syndrome, and as you may already know, patients with inflammatory arthritis can develop IBD.

This is a really interesting theory, right? Theories are important to keep scientific research moving forward, but let’s learn a bit more about what exactly it is, and whether it is right for you.

When I said that the AIP Diet is highly restrictive, I wasn’t kidding. There is a long list of foods that must be eliminated for at least 6 weeks (or forever in some instances), before slowly reintroducing them one at a time to your diet to see what causes an immune response. It is thought that the following list of foods is pro-inflammatory, which causes intestinal inflammation, and prohibits the healing of the gut lining that is meant to protect against these unnecessary immune responses.

Foods NOT Allowed:

• Grains: This includes eliminating ALL grains including oats, wheat, corn, quinoa, millet, the list goes on and on.

• Legumes: For example, beans, soybeans and soy products, lentils, green beans, peanuts, and hummus.

• Dairy products: All dairy products (including raw dairy products) such as yogurt, butter, ghee, milk, and cheese.

• Processed Foods: Prepared items like frozen meals, processed meats, snacks such as chips or granola bars, and boxed cereals to name just a few.

• Refined Sugars: This means cane sugar, corn syrup and the like; however, there are some promoters of AIP who recommend eliminating all sugars including sugar alternatives such as xylitol or stevia.

• Seed Oils: These include vegetable, sunflower or canola oils and all nut oils.

• Eggs

• Nuts and Seeds: This doesn’t just mean your typical nuts, but also foods such as coffee, chocolate, and certain spices such as coriander, cumin, black pepper, anise, fennel, mustard, or caraway.

• Nightshade Vegetables: This most notably includes tomatoes, all peppers, eggplants, paprika, and potatoes. Please refer to my blog post Are Nightshades the Culprit of your Arthritis Flare-up? for more information on why I believe that nightshades could be a part of your anti-inflammatory lifestyle.

• Emulsifiers and Food Thickeners: Additives used in certain foods to stabilize by keeping solids and liquids from separating in a food product and to improve texture and mouthfeel. They include starches, pectin and gums.

• NSAIDs: This stands for Nonsteroidal Anti-inflammatory Drugs such as Ibuprofen (Advil), Aspirin and Naproxin (Aleve).

• Alcohol

That’s a lengthy list of restricted foods! So, what exactly are the foods that are permitted for consumption on the AIP Diet?

Foods Allowed:

• Meats: The list for meat is extensive and non-restrictive, for example, grass-fed beef, fish, poultry, pork, organ meats, bone broth, and game are all approved for consumption on the AIP Diet.

• Vegetables: Excluding the nightshade vegetables listed above. The fruit is permitted in small quantities.

• Coconut Products: This includes coconut oil, which is one of the approved oils on the AIP Diet.

• Olive Oil: As with the MedDiet and Anti-inflammatory diet introduced earlier in this series, olive oil is an excellent choice for healthy fat in the AIP Diet.

• Fermented Foods: Any fermented product that does not contain dairy is approved on the AIP Diet, for example, kombucha, non-dairy kefir, sauerkraut, kimchi, and other fermented vegetables.

• Vinegars: A variety of vinegars are ok for consumption such as balsamic, red wine, and apple cider vinegars, but it is important that they have no added sugar.

• Sweeteners: Very limited amounts of honey and maple syrup are permitted on the AIP Diet.

• Herbs: Most herbs are permitted for use on the AIP Diet, however in cases such as cilantro, it is specified that the leaves are allowed, but the seeds cannot be consumed.

• Gelatin from Grass-fed Beef and Arrowroot Starch: While most thickening agents are eliminated on this diet, these are two options for adding texture and mouthfeel to recipes.

The Good:

While this diet is very restrictive, it does promote foods that are nutrient-dense and that contain omega-3 fatty acids, which we have learned throughout this series is an important nutrient for reducing inflammation. A small study conducted in 2017 that looked at the effects of the AIP Diet on patients with Inflammatory Bowel Diseases saw promising results with reducing symptoms and endoscopic inflammation. However, this study had a very small and non-randomized sample, therefore more research is needed in this area. There is no shortage of warriors of autoimmune diseases online to tell you about their experiences on the AIP Diet and how it has improved their quality of life. These stories are very inspiring, but this is anecdotal evidence, not scientific, and does not take into consideration different medical histories, lifestyles, and biological makeup of individual patients.

The Bad:

AIP is an extremely restrictive diet. Whenever foods need to be eliminated from your diet it can be really challenging to stick with it. This is not to say that you can’t restart the diet, but it can take a toll on your mental health if you feel that you have to start back at zero. Additionally, restriction diets have the potential to lead to disordered eating. In situations where foods are considered “good and bad”, or there is a chronic restriction of certain foods, it can also take a toll on your mental health. It is very important to have a system of support if you are considering the AIP Diet.

The Ugly:

You could be eliminating important nutrients and vitamins that your body needs for optimal health. The AIP Diet eliminates the grains food group from your diet. Whole grains contain B vitamins such as thiamin, riboflavin, niacin, and folate; and minerals such as iron, selenium and magnesium, all of which are necessary for cell development and metabolism. Whole grains are also important in lowering your risk of a number of chronic diseases like cardiovascular disease, diabetes mellitus or chronic inflammation. While patients with celiac disease or gluten sensitivities must avoid many grains, it is important to find alternative sources to ensure important nutrients, vitamins and minerals are still being consumed.

Most importantly, if you are considering this diet, I urge you to speak with your healthcare provider and seek out the guidance of a Registered Dietitian to ensure that you are still getting the nutrients and essential vitamins and minerals your body needs. With any restrictive diet, there is a risk of eliminating important nutrients that helps keep your body functioning at its best.

Special thanks to Cheryl Anderson, 3rd-year nutrition student at Ryerson University who assisted with the research and writing for this post.

See other posts on this series:

On Trend: The Anti-inflammatory Diet & Arthritis. Is there a connection?

On Trend: The Mediterranean Diet "The Anti-Diet"

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