What Is the Autoimmune Paleo Diet?
Autoimmune paleo, or AIP, is a hybrid diet. It combines aspects of elimination diets used to reduce disease-triggering foods with the paleo diet — the popular plan for meat lovers.
In particular, autoimmune paleo is meant to ease symptoms of autoimmune disorders, in which your immune system mistakenly attacks the body itself, instead of attacking outside invaders such as bacteria and viruses.
What Is an Autoimmune Disease?
Common autoimmune disorders include:
— Rheumatoid arthritis.
— Inflammatory bowel disease.
— Multiple sclerosis.
— Type 1 diabetes.
— Thyroid diseases (Graves’ disease, Hashimoto thyroiditis).
— Psoriasis and psoriatic arthritis.
Autoimmune symptoms are wide-ranging and vary by specific conditions. Flare-ups of fatigue, brain fog, migraines and chronic headaches, pain, skin rashes, muscle and joint aches, digestive problems, weakness, weight-loss resistance and sleep problems are among the many possible symptoms of autoimmune diseases.
How Does the Paleo Autoimmune Diet Work?
Cutting out foods that tend to cause or worsen symptoms is a hallmark of elimination diets. Core paleo principles include concentrating on caveman-era foods like meat, poultry, fish, fruits and veggies while avoiding foods like dairy, refined sugar, grains and legumes that came after.
Autoimmune paleo builds on paleo by further concentrating on foods thought to ease inflammation and resulting autoimmune symptoms. Liver and other organ meats, grass-fed beef and other lean meats, bone broth and seafood are AIP staples, along with certain veggies and fruits. Yogurt and other fermented foods, and oils such as avocado, coconut and olive oils are also advised.
On the other hand, the autoimmune protocol eliminates foods thought to exacerbate inflammation and related symptoms for at least a month. Nightshade veggies like eggplant, peppers, potatoes and tomatoes, grains, dairy, eggs, legumes, seeds and nuts, alcohol, food additives and artificial sugars are avoided. During this time, you keep a food journal and also track your overall health and symptoms.
Certain healthy foods, like nuts and seeds, are initially eliminated on the autoimmune paleo protocol. That’s because people with autoimmune diseases commonly develop food intolerances to nuts and seeds, and so they have to be ruled out (or identified) as triggers when they’re gradually reintroduced.
In the reintroduction phases, you gradually reintroduce the restricted foods, one by one. If your particular autoimmune symptoms flare up with a certain food, this suggests it’s an individual trigger that you should keep avoiding. By identifying specific food groups or foods that seem to trigger flares, you can adapt the diet to meet your own needs.
Autoimmune Paleo Overview
Autoimmune paleo is:
— An elimination diet.
— Virtually gluten-free.
— Can be adapted for halal or kosher diets.
What Are the Benefits of the Autoimmune Paleo Diet?
Autoimmune Paleo Pros
— Possible autoimmune symptom relief.
— Clearly defined plan for gradually reintroducing foods.
— Online resources/supports/apps available.
— Fiber- and protein-rich foods can promote satiety.
Autoimmune Paleo Cons
— Painstaking food and symptom monitoring.
— Limited research on the effectiveness of this diet.
— Many off-limit foods or food groups, including healthy ones.
— Lots of rules to remember.
— Eating out is limited.
— Could fall short nutritionally.
— Difficult for vegans or vegetarians.
Can I Lose Weight on the Autoimmune Paleo Diet?
You might lose weight on the autoimmune paleo diet, although it’s not a given. The top diet priority is to pinpoint triggering foods to reduce autoimmune symptoms. But there is some crossover because many eliminated foods on AIP — like dairy items, alcoholic beverages and food additives — can also contribute to weight gain. So there can be a weight-loss ‘bonus.’
It depends on which changes an individual is making, says Camila Martin, a registered dietitian at UW Health in Madison, Wisconsin. “If we’re not eating cakes or cookies, or highly processed grains, then it could result in some weight loss,” she says. “But if we’re replacing our nuts and seeds — which can fill us up and sustain our energy levels so that we have enough energy to go exercise — that’s where we might actually see the opposite and we might gain weight.”
Health Benefits of Autoimmune Paleo
Sarah Ballantyne, founder of the Paleo Mom website, has been influential in developing the autoimmune protocol/autoimmune paleo diet. Ballantyne, with an extensive background in medical research, has written books including “The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body” and “The Healing Cookbook.”
According to Ballantyne’s website, the paleo autoimmune protocol addresses four key areas affecting chronic and autoimmune diseases: nutritional deficiencies, gut health, hormone regulation and immune system regulation.
Health research focused specifically on autoimmune paleo is limited so far, but there are more studies on related aspects like paleo health effects, or of other diets considered to have anti-inflammatory effects, like the Mediterranean diet or DASH. A (non-paleo) anti-inflammatory diet is being looked at for its potential to help people with rheumatoid arthritis, an autoimmune condition.
It’s unclear whether autoimmune paleo promotes heart health. Although more research is available on the paleo diet in general, results on heart health have been mixed.
Small studies suggest that following a paleo diet may help improve glucose tolerance and insulin sensitivity (indicators of prediabetes) or improve glucose control in people with Type 2 diabetes.
— A small study of 15 participants with active inflammatory bowel disease put them on the autoimmune protocol with a six-week elimination phase and then a five-week maintenance phase. Among participants, 11 achieved and maintained remission during the study, meaning their disease became inactive. One participant was hospitalized for a small bowel obstruction, attributed to a significant increase in consumption of raw vegetables, salads and meat. The participant had a previous history of intestinal narrowing — emphasizing the need for counseling and supervision for patients with similar anatomical issues — according to the study published in the November 2017 issue of the journal Inflammatory Bowel Diseases.
— In a pilot study, 17 women previously diagnosed with Hashimoto’s thyroiditis, an autoimmune thyroid disorder, followed the autoimmune protocol diet for 10 weeks. “Marked” improvements were measured in physical and emotional role functioning, vitality and general health, along with a significant decrease in inflammation, according to the study published in April 2019 in the journal Cureus.
— A randomized, controlled study evaluated an anti-inflammatory diet in rheumatoid arthritis. The Swedish study assigned 50 participants with RA to either a diet containing foods considered anti-inflammatory or to a control diet similar to a typical diet in Sweden. Disease activity measurements (blood tests of inflammation) were improved for participants on the anti-inflammatory diet. However, there was no significant difference in joint swelling or tenderness between diet groups, according to the study in the June 2020 issue of the American Journal of Clinical Nutrition.
One theory is that autoimmune paleo helps correct ‘leaky gut.’ According to this explanation, imbalances in your gut bacteria make it easier for inflammation triggers in the environment to cross the gut wall and reach other parts of your body. By eating recommended foods, you help restore the gut’s gatekeeper function and protect the body from harmful germs and allergens. Research is needed to confirm a leaky gut connection.
Health Risks of Autoimmune Paleo Diet
By cutting out certain types of food, you lose out on their proven health benefits. For Martin, the strict elimination of beans, legumes, whole grains, low-fat dairy, eggs and nightshade vegetables stand out as autoimmune paleo red flags.
Although highly processed foods like refined grains, primarily white flour, may have negative health repercussions, Martin notes, whole grains are much different. “We know a ton of research has been done on the benefits of whole grains,” she says. “Whole grains, with the fiber they contain, are really great for the gut microbiome, and really great for the anti-inflammatory process and just general healthy eating.”
Without careful replacement, you could miss out on key nutrients when doing autoimmune paleo by eliminating foods like these:
— Whole grains and legumes for fiber.
— Nightshade veggies for vitamins C and E and their anti-inflammatory role.
— Dairy for protein and muscle health, and for calcium with its role in bone health and cardiac function.
— Eggs for healthy fat and vitamin D.
— Nuts and seeds for omega-3s and their anti-inflammatory properties.
“When people are being highly restrictive in their diet, they have challenges meeting many of their micronutrients, and vitamins and minerals,” Martin says.
On the other hand, eliminating unhealthy foods can be an autoimmune paleo positive. “If implementing this diet means people are replacing the scones and doughnuts they have every morning, or maybe the pizza they have every night for dinner, with a lean protein, a piece of salmon, some fruits and vegetables — excellent,” Martin says. However, she adds, “If we’re taking out things like nuts, seeds and legumes and replacing them with organic bacon, we’re really significantly increasing the saturated fat that’s in their diet.”
Instead of tackling any elimination diet on your own, seek support from experts. Consult with a doctor for autoimmune issues and work with a clinical dietitian for help in removing potential food triggers from your diet without sacrificing important nutrients.
Who Should Not Try This Diet?
People with eating disorders such as orthorexia — which involves an overly intense focus on eating in a healthy way — might not do well on elimination diets including autoimmune paleo.
In general, diets that eliminate entire food categories can potentially increase the risk of vitamin, mineral and other nutritional deficiencies. Eating more meat can contribute to cardiovascular disease.
Food List for Autoimmune Paleo
You’ll embrace certain foods for their nutrient-rich, anti-inflammatory benefits while avoiding other foods with inflammatory or triggering effects.
Foods to Eat on the Autoimmune Paleo Diet
— Bone broth.
— Fermented foods like sauerkraut.
— Grass-fed beef.
— Lean, high-quality meats like bison.
— Leafy greens.
— Non-starchy veggies.
— Fatty fish and shellfish.
Foods to Avoid or Limit on the Autoimmune Paleo Diet
— Nightshade vegetables.
— Seeds and seed oils.
How to Get Started on the Autoimmune Paleo Diet
Let your health care provider know you’re considering autoimmune paleo (or any restrictive diet) in advance, to find out if it’s safe for you. If possible, work with a dietitian to make the healthiest food choices.
Before heading out to the butcher, deli and produce sections of your grocery store, put together an autoimmune paleo food list. Have a blank journal ready to track everything you eat and symptoms you experience throughout elimination and reintroduction phases.
Support and Resources for Autoimmune Paleo
Take advantage of the many supports and available information on AIP before you begin, and as you continue, to make the most of your efforts.
— Coaching from a dietitian.
— RealPlans AIP meal planning app.
— AIP diet and lifestyle private Facebook support group.
More from U.S. News
Update 10/11/22: This story was previously published at an earlier date and has been updated with new information.