Diet and Autoimmune Disease: What's the Connection?

Modern medicine has classified over 100 autoimmune diseases. The NIH estimates that these autoimmune diseases affect over 24 million people in the US, with the prevalence of autoimmunity on the rise.

The Autoimmune Protocol Diet, commonly abbreviated as the AIP diet, is a functional medicine tool that some people use to help manage gut health and support a balanced inflammatory response. It is a phased elimination diet that is a modification to the Paleo diet. It focuses on increasing nutrient-dense foods while reducing processed foods that may contribute to inflammation.

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What Is An Autoimmune Disease?

Autoimmune diseases occur when the immune system mistakenly targets the body's own cells and tissues. These diseases may arise due to a combination of genetic factors and environmental or lifestyle triggers.

When functioning optimally, the immune system uses specialized cells and organs to defend against foreign material and invaders (such as toxins, viruses, or bacteria). In the case of autoimmunity, the body's own tissues become the target. For instance, in Type 1 diabetes, the beta cells of the pancreas are affected. With Hashimoto's, the thyroid is involved. In Multiple Sclerosis, the protective layers around the nerves are impacted.

What Are The Signs & Symptoms of Autoimmune Disease

In many autoimmune conditions, chronic inflammation is a common feature. This means symptoms such as redness, heat, pain, or swelling may occur internally or externally.

Depending on which part of the body is affected, symptoms may also include:

• Joint pain or stiffness
• Fatigue
• Weight gain
• Muscle aches
• Skin rashes or color change
• Abdominal pain
• Digestive issues
• Recurring fever
• Dizziness
  

Autoimmune symptoms can be challenging to identify. For some, the symptoms are mild, while for others, they can be more pronounced. A discussion with your healthcare provider can help determine the necessary testing to explore autoimmunity.

Diet and Autoimmune Disease: What's the Connection?

The food you eat can play a role in your overall health, potentially influencing inflammation and immune function.

There is a delicate relationship between our diet and our gut microbiome. Consuming a diet high in processed foods may disrupt our gut microbiome and affect the integrity of our gut lining, which some believe could contribute to a "leaky gut." This condition is thought to allow food particles and toxins to enter the bloodstream, potentially triggering an immune response and contributing to inflammation. This process is considered by some to be a factor in the development of autoimmune diseases.

Another connection between diet and autoimmunity is micronutrient malnutrition. Our bodies require micronutrients (vitamins and minerals) for healthy cell function, immunity, growth, metabolism, and development. A diet lacking in these nutrients may affect cell function. Long-term micronutrient malnutrition is thought to be a factor in many chronic conditions, including autoimmunity. Therefore, the AIP diet emphasizes nutrient-dense foods while reducing foods that may contribute to inflammation.

What is the Autoimmune Protocol Diet?

The AIP diet focuses on replenishing the body with nutrient-dense foods. The essentials of this food plan include wild sources of meat and uncultivated vegetables and fruit. As an elimination diet similar to the Paleo diet, the AIP diet encourages eating patterns that some believe resemble those before the Industrial Age. This means eating more like a hunter and gatherer to support overall health.

The AIP diet goes a step further than the Paleo diet by removing foods that some individuals may find inflammatory. This means avoiding foods such as eggs and seeds that may trigger inflammation in some people.  

Moreover, the AIP diet incorporates lifestyle changes alongside dietary changes. It promotes getting enough sleep, managing stress, and regular exercise to support a balanced immune system.

The same as in elimination diets, the AIP's goal is to:

• Support a healthy inflammatory response
• Support a healthy microbiome
• Support gut health with phytonutrients
• Reduce exposure to potential toxins
• Promote body awareness of food
• Identify food triggers
  

Approved Autoimmune Protocol Foods

There are no calorie restrictions or servings to count on the AIP diet. Focus on eating fresh whole foods and filling your plates with plenty of colorful fruits and vegetables, as phytonutrients are thought to support immune function and a healthy inflammatory response. Here's a list of foods that you can eat:

• Meat that is organic and grass-fed
• Wild caught seafood
• Wild game meat, such as bison or venison
• Poultry (organic pasture-raised is best)
• Bone broth
• Organic vegetables
• Organic fruits
• Tubers, such as sweet potato, Jerusalem artichoke, and parsnips
• Green tea
• Vinegar
• Honey or maple syrup in small quantities
• Non-dairy fermented foods
• Herbs and spices

Three Phases of Autoimmune Diet Protocol

Elimination

During this first phase of the AIP diet, completely remove the following:

• All grains
• Dairy
• Eggs
• Nuts and seeds
• Legumes, such as beans, lentils, peanuts
• Nightshades, such as tomatoes, peppers, potatoes, eggplant, and okra
• Coffee
• Chocolate
• Alcohol
• Refined sugars
• Alternative sweeteners, including stevia and xylitol
• Food additives- food dye, flavors, preservatives
• Seed oils, like vegetable and canola oil
• Gums
• Emulsifiers like carrageenan

While there is no hard line on how long this phase should last, the body may need time to adjust to the removal of these foods. A standard functional medicine guideline is to follow an elimination phase for at least three weeks. However, many practitioners have patients follow the elimination phase for extended periods, depending on the individual's needs and response.

Reintroduction

After giving your body time to adjust, you may begin adding foods back in that are least likely to cause inflammation. The goal of this phase is to observe how your body responds to different foods.

Symptoms to look out for as you reintroduce foods:

• Increased mucus production or post-nasal drip
• Itchy eyes or mouth
• Coughing or needing to clear the throat
• Headaches
• Dizziness
• Anxiety or mood swings
• Fatigue
• Muscle aches or joint pain
• Heartburn, indigestion, constipation, or diarrhea
• Symptoms from your condition returning or worsening
  

The Importance of the Reintroduction Phase

Even though you may feel better by this point, it's important to carefully reintroduce foods. There is nutritional value in some of the items on the avoid list. Remember to add foods back in slowly. You don't want to rush this phase. If you experience any reaction to a reintroduced food, remove it and move on to trying the next food on the list. A typical reintroduction is one new food every three days to see if there is a delayed response.

Taking your time and being aware of how foods make you feel can help reestablish a connection between you and your food. During this phase, it is advisable to work with a healthcare provider to help guide you through the steps.

Maintenance

After methodically reintroducing the foods you want to test, you will now have a customized diet that works for your body. Continue to eat the foods that did not cause a reaction and avoid the foods that did. By this phase, you will have also established a self-awareness and reconnection with how food makes you feel.  

Evidence on AIP Diet

While the evidence is limited and more research is needed, some practitioners have observed improvements in their patients' symptoms while following the AIP diet protocol. Some of the studies currently available focus on IBD and Hashimoto's Thyroiditis.

Inflammatory Bowel Disease

Conditions like Crohn's disease and Ulcerative Colitis have shown favorable responses to the AIP diet.

• This study showed that 73% of the participants achieved and maintained clinical remission within 11 weeks of being on the AIP diet.
• Another study showed a reduction in symptoms, improved fecal calprotectin levels, and follow-up endoscopy improvements at week 11. Improvements were noted for Crohn's disease Rutgeerts score and Mayo endoscopy subscore.
  

Hashimoto's Thyroiditis

• With this autoimmune condition of the thyroid, implementing the AIP diet significantly reduced the inflammatory marker hs-CRP and decreased white blood counts. The women in this study also showed a marked improvement in quality-of-life scores. This suggests the AIP diet may have an impact on both the immune system and inflammatory processes.
  

Summary

The AIP diet offers an approach that some people use to address factors believed to contribute to autoimmunity, such as gut health and inflammation. Though there are other ways to support autoimmune conditions, the AIP diet is unique because it emphasizes awareness of the relationship with food and acknowledges the value of lifestyle changes. As with any dietary plan, it is a good idea to work with a healthcare provider to determine if it is a fit and how to get the most out of it.