All About the AIP Diet: What it is and Why I’m On It

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Pumpkin Smoothie

About a year ago, my husband was struggling with some seemingly random and unrelated health issues—all relatively minor, but still annoying for him and worrying for me. I was doing some research about dietary solutions to his issues (because, hi, I’m a food blogger), and during one Google search, I stumbled onto the Autoimmune Protocol Diet (or AIP for short).

At the time, I looked at the list of what you couldn’t eat (which, let’s be honest, was pretty much EVERYTHING we ate—beans, tomatoes, grains, seeds, nuts), and immediately thought, “Psh. That’s crazy. That’s too restrictive. That will never do.” And my husband agreed. His health problems weren’t that scary to try a diet that felt so drastic.

Fast forward to August of this year, and I’m so sick I can barely make it from the bed to the bathroom. I’m in and out of the hospital and doctor’s offices and have enough blood drawn to stock a blood bank. And no one can figure out what is wrong with me. The only thing every health care professional could agree on: I have some sort of infectious process that is wreaking havoc on my body and they have no idea how to treat it.

And then I saw a naturopath, and his very first suggestion to me was to cut out all grains (not just gluten). I scoffed. Like audibly (embarassingly) scoffed in his office. Whole grains were a staple of my (mostly plant-based) diet! I eat healthy! I can’t give up grains!

He countered that for some folks, whole grains are healthy, but with my body and immune system in such rough shape, removing anything that even might be causing more inflammation couldn’t hurt. There are plenty of vegetables which can give you the whole grain fiber you need. Which seemed like sane logic, but my farro-loving heart was still über skeptical.

And then I read a book that suggested the same thing. And then another book. And then I mentioned it to my family doctor, and she told me it’s worth a shot, because grains can be really tricky to digest for some folks. And then I saw a different naturopath who suggested that not only do I cut out all grains, but that I also try eating a high-fat diet to help boost my immune system.

And that’s when I realized that, okay, maybe I should actually look into this whole grain-free lifestyle thing a bit more. I was hearing it from too many different sources to just write it off as hogwash. So I started doing my own research. And I started to realize there was some evidence-based foundation to these suggestions I had been hearing.

At this point, I was so sick, I could barely choke down a slice of dry toast a day, so honestly, I was ready to try anything. Cutting out bread certainly wasn’t going to make anything worse. So I dove in and cut out all grains (gluten and non-gluten ones) on August 29, 2017.

A crazy thing started happening: I started to feel better. Not 100% better, not even 10% better, but a half percent there, a quarter percent here—which after weeks and weeks of feeling progressively worse every day felt like a damn miracle.

About this time is when I remembered the AIP diet. I went back and read it again, and suddenly, it didn’t feel so restrictive. You know what’s restrictive? Feeling so nauseous that it takes you two hours to eat a handful of dry Cheerios. Comparatively, not being able to eat tomatoes or cashews didn’t really feel like that big of a deal. I read an encyclopedic, research-based book (honestly, it’s more like a textbook) by Sarah Ballantyne called The Paleo Approach that really outlines the AIP protocol. And I started to realize that going “full AIP” might be worth it. My doctors weren’t giving me any answers, so it was time I took my healing into my own hands. What did I have to lose? I dove face-first into AIP on September 10, 2017.

So what exactly is the AIP Diet?

The AIP Diet is a short term, therapeutic diet that removes foods that most commonly cause adverse reactions in people. These kinds of reactions can range from extremely severe (like going into anaphylaxis after eating peanuts) to extremely minor (like your skin itching a little bit after you eat kiwis). More often than not, the reactions are so minor that we don’t even notice them—or if we do notice them, don’t attribute them to the food we are eating.

Which sounds not so bad. I mean, a minor reaction, what’s the big deal? Well, one of my naturopaths put it this way—your immune system is like a cup. And so you fill up your cup a little bit with a food reaction. And then you add a little more because you’re stressed at work. And then a little more because your kid brought a cold home from school. And then a little more because you haven’t been sleeping well. And a little more because of seasonal allergies. And before you know it, your immune system cup is overflowing and has no room to function well. All those little drips and drops add up, and the idea of the AIP diet is to try to identify and remove what foods are filling up your immune system cup.

AIP Coconut Porridge

Beyond the immune support, the AIP diet focuses, at it’s core, on nutrient density—basically getting the most nutrient bang for your caloric buck. That means that while you’ll find recipes for AIP cookies and AIP pancakes out there, those are considered treats that should be eaten extremely rarely—they just aren’t packed with the high level of nutrients your body needs to heal. Every plateful of AIP food should be fueling the healing in your body. This means tons of veggies, good-quality meat, seafood, and fish, and some fruits. This also means trying to find the highest quality options that will fit within your resource limitations. Free range meats, organic produce, and fresh foods take preference over other options (but doing the best you can with what you have is always my philosophy).

The AIP Diet is designed to be done short-term to promote healing—with a bare minimum recommendation of 30 days—and after you feel well again, you slowly start to reintroduce foods and gauge your body’s reaction to them. Because your body is healed, you’ll have a clean slate to observe food reactions, no matter how minor they may be. And then you have the information to make decisions about what foods can come back into your diet regularly, occasionally, rarely, or never.

So what can’t you eat?

No sugar-coating this one. It’s restrictive. You can’t eat: beans and legumes, eggs, nightshades (tomatoes, potatoes, eggplant, peppers, etc.), seeds (including seed-based spices like cumin), nuts (including nut milks like almond milk), dairy, grains (both gluten-containing and gluten-free grains), corn, soy, pseudo-grains (quinoa, amaranth, etc.), processed foods, vegetable oils, alcohol, coffee, chocolate.

Is it just about food?

Nope, food is just one aspect of the AIP “diet.” It’s the one that most people focus on because it’s the most dramatic, but living AIP also means doing other stuff like resetting your circadian rhythms (basically, re-teaching your body that dark=sleepytime and light=wakeytime), protecting your sleep, relieving stress, getting moderate and regular activity, fostering connections with people you love, and doing activities that bring you joy.

Healing your body doesn’t just happen in the gym, in the kitchen, or at the doctor’s office, it happens in your bedroom, on the phone with your friends, and while you’re knitting a scarf for your sister. I venture to say that if you just focus on the food aspect of AIP, you’re not really going to get the full benefits of the protocol. Trust me, if you cut out grains but still only get six hours of sleep at night and spend all your day stressed out, your body isn’t going to get a chance to heal.

Who does the AIP Diet help?

Based on the name (duh), the Autoimmune Protocol is designed for folks fighting autoimmune diseases. There are hundreds of these nasty little suckers—Hashimoto’s, Graves, multiple sclerosis, rheumatoid arthritis, lupus, Celiac’s—and they all come back to one idea: the immune system is going haywire. And the AIP helps calm the immune system down.

But, the AIP isn’t just for people with autoimmune issues. Anytime your immune system is struggling, it can be useful. If you feel like your immune system just isn’t up to snuff, it’s worth researching and speaking with your healthcare professional about. I personally haven’t been diagnosed with an autoimmune disorder (and don’t think I have one), but I’m still finding a lot of benefits to AIP—and I’m grateful that my health care professionals are on board with me eating this way. I truly believe it’s helping to support my immune system, and get my body back to “normal” (or maybe even better!).

The AIP is an extreme dietary change, and I just wouldn’t recommend it for anyone. It’s a therapeutic diet, meaning it’s not just something you pick up and do for funsies like trying to cut out Diet Coke for a month. The AIP is a treatment for an illness or disorder, and the hope is that once you’ve completed your treatment, you’ll be better and can stop the therapeutic diet (or at least, stop doing it to the extreme).

So, what exactly am I eating?

Want to see what a typical day looks like? Well, here you go:

Yogurt Bowl Breakfast

Breakfast: Plain (homemade) coconut yogurt with pumpkin puree, cinnamon apples, pomegranate arils, and AIP granola (still perfecting my granola recipe!). I drizzled a tiny splash of maple syrup on top of the whole bowl. I was totally sugar-free (not even adding natural sweeteners) for about six weeks, but I’m slowly bringing some honey and maple syrup back into my life.

Breakfast on AIP can be really tricky, because almost all of the “normal” breakfast foods are out (eggs, toast, pancakes, oatmeal)—even this yogurt bowl, while technically AIP compliant, isn’t 100% in the spirit of AIP (it’s not nutrient-dense enough and focuses too much on fruit). I’ve mostly been rotating between two breakfasts—loaded yogurt bowls and what I’m calling sweet potato scrambles—bacon, garlic, onion, sweet potatoes, and some sort of greens all scrambled together. I can’t wait to bring back eggs in!

LunchInstant Pot beef stroganoff over mashed cauliflower with spinach salad and apple cider dressing. Before August, I was eating an almost entirely plant-based diet (plus eggs and the occasional serving of fish or seafood), so going back to eating meat has been a transition, to say the least. We cut out meat for a variety of reasons, and it’s been an emotional journey to get okay with bringing meat back onto my plate regularly. Thankfully, cutting out dairy last year made that part of AIP no big deal at all!

I truly believe that there is no one-size-fits-all optimal diet for humans. What I need nutritionally might be different from what you need. And what I need now might be different from what I need in six months. I think we do the best we can with the information and resources we have at the time, and right now, having meat as a regular part of my diet is my best. And I hope eventually I can bring back some plant-based protein sources (beans, I miss you, please wait for me), and get back to more of a flexitarian diet.

Snack: Part of AIP is really not focusing on snacking a lot (only doing it if you need a snack not because it’s “snack time”), and I honestly haven’t really needed to do much snacking since going AIP. I think part of it is that my meals are so nutrient-dense now that they’re keeping me fuller longer, but also, my appetite still isn’t 100% back to where it was pre-illness. When I do snack, I grab an apple (hellooooooo, honeycrisps!) and some plantain chips.

Dinner: Chicken gnocchi soup (based off of this recipe, but made AIP with sweet potato/cassava gnocchi and coconut milk). One of my biggest symptoms during my mystery illness has been a lack of appetite. It’s gotten better in the past month or so—for a while there, it felt like I was chewing wet cement anytime I put food in my mouth—but I still rarely have an appetite after about 3pm. Now that the weather is cooler, soup has been my answer to my lack of appetite. A small bowl of soup is enough to give me some nutrition without making me feel nauseous. Sometimes, I’ll also just heat up a cup of chicken broth and have that for dinner.

One of my doctors (gosh, I can’t remember which one), said a lack of appetite is a pretty typical immune system response when you are fighting something—hence why you never really want to eat a full Thanksgiving dinner when you have the flu. Your body switches energy from digestion to illness fighting, and you just aren’t as hungry—and that’s totally fine. I’ve been told to go with it. I listen to my body and focus on simple foods when I’m not feeling hungry but know that I “need” to eat—smoothies, soups, broths, applesauce, etc.

When can you bring stuff back in?

Now! I’m now on my 7th week of AIP, and I’m starting to feel well enough to reintroduce some foods! It sounds really exciting (and it is), but it’s also an incredibly slow process. To do it “right,” it takes about 10 days to reintroduce each and every food item, and you have to do them all separately. So pecans separate from walnuts. Chia seeds separate from flax seeds. It can take folks months or even years to do a full reintroduction process properly.

For now, I’m just starting off with the foods that I really miss, and that list is actually surprisingly short—eggs, cumin, and some sort of protein/fiber seed (like chia, flax, or hemp). I started reintroductions with egg yolks, and that has gone well, so I think I might try bringing back in cumin next.

So what does this change at Wholefully?

In some ways, absolutely nothing, but it other ways, obviously lots. There are 564 recipes on Wholefully (I just checked!), and almost all of those are not AIP compliant. My team and I are working really hard to go back through those recipes to retest them, rewrite them, and rephotograph them so they are the best they can be. Which means you’ll still be seeing tons of non-AIP recipes coming through your computer screen as we work (like the Slow Cooker Ham and Beans update we did on Tuesday). I am so grateful to have an amazing team of talented women working for me helping me make Wholefully the best resource out there for healthy eating made simple—whatever “healthy eating” means to you.

But I’m also feeling well enough to get back to recipe developing again, and because this is how I’m eating, inherently the vast majority of my new recipes are going to be AIP-compliant. But I don’t think they are only for folks following AIP. Some upcoming recipes include: Anti-Inflammatory Turmeric Chicken Zoodle Soup, Turkey Florentine Meatballs with Pesto Spaghetti Squash, and Pumpkin Spice Breakfast Porridge. Call me crazy, but I think anyone could, should, and would like those dishes—AIP or not!

As always, thank you so much for tagging along, making my recipes, and sharing my posts. A blog is such a unique thing because it is inherently tied to one person and the ups-and-downs and changes of their life—and the fact that you guys continue to ride on this roller coaster with me just means the world to me.

The Autoimmune Protocol


Autoimmune disease is an epidemic in our society, affecting an estimated 50 million Americans. But it doesn’t have to be. Although genetic predisposition accounts for approximately one-third of your risk of developing an autoimmune disease, the other two-thirds comes from your environment, your diet, and your lifestyle. In fact, experts are increasingly recognizing that certain dietary factors are key contributors to autoimmune disease, placing these autoimmune conditions in the same class of diet- and lifestyle-related diseases as type 2 diabetes, cardiovascular disease, and obesity. This means that autoimmune disease is directly linked to our food choices and how we decide to live your life. It also means that we can manage and reverse autoimmune disease simply by changing how you eat and making more informed choices about sleep, activity, and stress… and that’s some pretty darned good news!

There are more than one hundred confirmed autoimmune diseases and many more diseases that are suspected of having autoimmune origins (download a complete list here). The root cause of all autoimmune diseases is the same: our immune system, which is supposed to protect us from invading microorganisms, turns against us and attacks our proteins, cells, and tissues instead. Which proteins, cells, and tissues are attacked determines the autoimmune disease and its symptoms. In Hashimoto’s thyroiditis, the thyroid gland is attacked. In Rheumatoid Arthritis, the tissues of your joints are attacked. In psoriasis, proteins within the layers of cells that make up your skin are attacked. However, the root cause is the same.  The Paleo Autoimmune Protocol, typically abbreviated AIP, is a powerful strategy that uses diet and lifestyle to regulate the immune system, putting an end to these attacks and giving the body the opportunity to heal.

Learn the ins and outs of the Autoimmune Protocol with The AIP Lecture Series!  This 6-week video-based online course will teach you the scientific foundation for the diet and lifestyle tenets of the Autoimmune Protocol. Think of this course as going to college for your health! The session starts March 19th, 2018!

Learn More


What is the AIP?

The Autoimmune Protocol, or AIP, is a specialized version of the Paleo diet, with an even greater focus on nutrient density and even stricter guidelines for which foods should be eliminated. Foods can be viewed as having two kinds of constituents within them: those that promote health (like nutrients!) and those that undermine health (like inflammatory compounds). (While there are constituents that neither promote nor undermine health, they are not used to evaluate the merit of an individual food.) Some foods are obvious wins for a health-promoting diet because they have tons of beneficial constituents and very few or no constituents that undermine health—good examples of these superfoods are organ meats, seafood, and most vegetables. Other foods are obvious fails because they have a relative lack of health-promoting constituents and are rife with problematic compounds—good examples are gluten-containing grains, peanuts, and most soy products. But many foods fall into the amorphous world of gray in between these two extremes. Tomatoes, for example, have some exciting nutrients, but they also contain several compounds that are so effective at stimulating the immune system that they have been investigated for use in vaccines as adjuvants (the chemicals in vaccines that enhance your immune response to whatever you’re getting immunized against). The biggest difference between a standard Paleo diet and the Autoimmune Protocol is where we draw the line between “yes” foods and “no” foods in order to get more health-promoting compounds and fewer detrimental compounds in our diet. Those who are typically quite healthy can tolerate less-optimal foods than those who aren’t. You can think of the Autoimmune Protocol as a pickier version of the Paleo diet; it accepts only those foods that are clear winners.

As such, the Autoimmune Protocol places greater emphasis on the most nutrient-dense foods in our food supply, including organ meat, seafood, and vegetables. And the Autoimmune Protocol eliminates foods allowed on the typical Paleo diet that have compounds that may stimulate the immune system or harm the gut environment, including nightshades (like tomatoes and peppers), eggs, nuts, seeds, and alcohol. The goal of the Autoimmune Protocol is to flood the body with nutrients while simultaneously avoiding any food that might be contributing to disease (or at the very least interfering with our efforts to heal). It is an elimination diet strategy, cutting out the foods that are most likely to be holding back our health. After a period of time, many of the excluded foods, especially those that have nutritional merit despite also containing some (but not too much) potentially detrimental compounds, can be reintroduced.

While the Paleo diet is sometimes labeled as a fad diet, its health benefits are supported by scientific research. The body of research pitting Paleo against other dietary strategies is in its infancy, but the studies that have been performed uniformly support Paleo. They prove that it beats out other recommended diets, even the Mediterranean diet, for weight loss, management of diabetes, improvement of cardiovascular disease risk factors, and reversal of metabolic syndrome. Studies have also shown that it has therapeutic potential for the debilitating autoimmune disease secondary progressing multiple sclerosis. And while anecdotal stories cannot be used to validate any dietary approach, the tens of thousands (and counting!) of people who have successfully used variations of the Paleo diet, including the Autoimmune Protocol, to mitigate and even completely reverse their diseases is compelling. See Paleo Diet Clinical Trials and Studies.

In a recent study, fifteen patients with active inflammatory bowel disease were placed on the Paleo Autoimmune Protocol following a 6-week gradual transition followed by a 5-week maintenance phase. (In fact, patients were given my first book, The Paleo Approach, as a resource for following the protocol.) Clinical remission was achieved by week 6 in eleven of the fifteen participants (73%!!), and they stayed in remission throughout the 5-week maintenance phase of the study.


How Does The Autoimmune Protocol Work?

The Paleo Autoimmune Protocol works by addressing four key areas known to be important contributors to chronic and autoimmune diseases. Drawing on insights gleaned from more than 1,200 scientific studies, these diet and lifestyle recommendations specifically target:

  1. Nutrient density. The immune system (and indeed every system in the body) requires an array of vitamins, minerals, antioxidants, essential fatty acids, and amino acids to function normally. Micronutrient deficiencies and imbalances are key players in the development and progression of autoimmune disease. Focusing on consuming the most nutrient-dense foods available enables a synergistic surplus of micronutrients to correct both deficiencies and imbalances, thus supporting regulation of the immune system, hormone systems, detoxification systems, and neurotransmitter production. A nutrient-dense diet further provides the building blocks that the body needs to heal damaged tissues.
  2. Gut health. Gut dysbiosis and leaky gut are key facilitators in the development of autoimmune disease. The foods recommended on the Paleo Autoimmune Protocol support the growth of healthy levels and a healthy variety of gut microorganisms. Foods that irritate or damage the lining of the gut are avoided, while foods that help restore gut barrier function and promote healing are endorsed.
  3. Hormone regulation. What we eat, when we eat, and how much we eat affect a variety of hormones that interact with the immune system. When dietary factors (like eating too much sugar or grazing rather than eating larger meals spaced farther apart) dysregulate these hormones, the immune system is directly affected (typically stimulated). The Paleo Autoimmune Protocol diet is designed to promote regulation of these hormones, thereby regulating the immune system by proxy. These and other essential hormones that impact the immune system are also profoundly affected by how much sleep we get, how much time we spend outside, how much and what kinds of activity we get, and how well we reduce and manage stress.
  4. Immune system regulation. Immune regulation is achieved by restoring a healthy diversity and healthy amounts of gut microorganisms, restoring the barrier function of the gut, providing sufficient amounts of the micronutrients required for the immune system to function normally, and regulating the key hormones that in turn regulate the immune system.

Inflammation is a factor in all chronic illnesses, and this is one area where the foods we eat can make a huge difference. In some cases, an immune system that isn’t regulating itself properly directly causes the illness; in others, inflammation is merely an element of the illness or a contributor to how the illness came about—but it is always a player and a problem. What this means is that reducing inflammation and giving the immune system the resources it needs, as well as the opportunity to regulate itself, can help in every single chronic illness. This is important because inflammation is strongly influenced by what we eat, how well we sleep, how stressed we are, and how active we are. And this is why chronic illness can respond so positively to changes in diet and lifestyle.

Food has therapeutic potential for every chronic illness—but that’s not the same thing as calling food a cure. Depending on the illness you’re struggling with, how long you’ve had it, how aggressive the disease is, and what confounding factors you’re dealing with, dietary changes may get you as far as a complete reversal of your disease, or they may slow the progress of your illness, or they may simply improve your quality of life. These are all successes worth celebrating. Good food may not be the miracle cure you’re hoping for, but it’s pretty darn powerful all the same.

As you adopt the Paleo Autoimmune Protocol, your food choices become focused on consuming the nutrients to support this healing—foods that provide everything your body needs to stop attacking itself, repair damaged tissues, and get healthy again: proteins, carbohydrates, and fats to sustain a normal metabolism, build new tissue, and produce hormones, important proteins, and signaling molecules; and the full range of fat-soluble vitamins, water-soluble vitamins, minerals, and antioxidants to get rid of inflammation, regulate the immune system, and support the normal functioning of all the body’s systems.


What To Eat and What To Avoid

Following the AIP diet involves increasing your intake of nutrient-dense, health-promoting foods while avoiding foods that may be triggers for your disease.

In summary, the rules of what to eat are:

  • organ meat and offal (aim for 5 times per week, the more the better)–read more here.
  • fish and shellfish (wild is best, but farmed is fine) (aim for at least 3 times per week, the more the better)–read more here and here.
  • vegetables of all kinds, as much variety as possible and the whole rainbow, aim for 8-14 cups per day
  • herbs and spices
  • quality meats (grass-fed, pasture-raised, wild as much as possible) (poultry in moderation due to high omega-6 content unless you are eating a ton of fish)
  • quality fats (pasture-raised/grass-fed animal fats [rendered or as part of your meat], fatty fish, olive, avocado, coconut, palm [not palm kernel])
  • fruit (keeping fructose intake between 10g and 40g daily-note that 20g is probably optimal)
  • probiotic/fermented foods (fermented vegetables or fruit, kombucha, water kefir, coconut milk kefir, coconut milk yogurt, supplements)–read about them here and here.
  • glycine-rich foods (anything with connective tissue, joints or skin, organ meat, and bone broth)
  • Source the best-quality ingredients you can.
  • Eat as much variety as possible.the-Paleo-mom-Paleo-aip-yes-foods

In addition, remove the following from your diet:


Moderate your intake of the following:

  • Fructose (from fruits and starchy vegetables, aiming for between 10 and 25 grams per day)
  • Salt (using only unrefined salt such as Himalayan pink salt or Celtic gray salt)
  • Moderate- and high-glycemic-load fruits and vegetables (such as dried fruit, plantain, and taro root)
  • Omega-6 polyunsaturated fatty acid–rich foods (such as poultry and fatty cuts of industrially produced meat)
  • Black and green tea
  • Coconut
  • Natural sugars like blackstrap molasses, maple syrup and honey

This diet is appropriate for everyone with diagnosed autoimmune disorders or with suspected autoimmune diseases. It is very simply an extremely nutrient-dense diet that is devoid of foods that irritate the gut, cause gut dysbiosis and activate the immune system. You will not be missing out on any nutrients and this diet is absolutely appropriate to follow for the rest of your life. If you have a specific autoimmune disease that causes extra food sensitivities, those should be taken into account with your food choices.


Lifestyle Factors

tpm-lifestyleDon’t forget the crucial importance of: getting enough sleep (at least 8-10 hours every night), managing stress (mindful meditation is very well studied in the scientific literature and universally shown to be beneficial), protecting circadian rhythms (being outside during the day, being in the dark at night and avoiding bright lights in the evening), nurturing social connection, having fun, making time for hobbies, relaxing, and getting lots of mild to moderately intense activity (while avoiding intense/strenuous activity). Read more about the Paleo lifestyle here.


Elimination and Reintroduction

The Paleo diet and its stricter, more specific version, the Autoimmune Protocol, can be thought of as nutritional interventions for a diet gone badly awry, overabundant in calories and relatively lacking in vital nutrients. But how well an individual tolerates suboptimal foods—whether we’re talking about something like tomatoes, which are included in the Paleo diet but eliminated on the Autoimmune Protocol, or something like grains, which are not included in either nutritional approach—depends on nutrient status, stress, sleep, activity level, genetics, and health history. As we improve as many of these as possible with diet and lifestyle changes, it’s fairly common to see tolerance of certain foods increase. The Autoimmune Protocol is an elimination diet at its core, designed to cut out the most likely food culprits while flooding the body with nutrients. And the best part about an elimination diet is that eventually, you get to reintroduce foods that you’ve been avoiding.

How long is eventually? Ideally, you’d wait to reintroduce foods until you’re feeling amazing, but as long as you’re seeing improvements thanks to your diet and lifestyle changes, you can try some reintroductions after three to four weeks. The full protocol for reintroductions, including which foods are best to try reintroducing first, is detailed in Sarah’s book The Paleo Approach. In general, reintroduce only one food every five to seven days and spend that time monitoring yourself for symptoms. Symptoms of a reaction aren’t always obvious, so keep an eye out for the following:

  • Symptoms of your disease returning or worsening
  • Gastrointestinal symptoms: tummy ache, heartburn, nausea, constipation, diarrhea, change in frequency of bowel movements, gas, bloating, undigested or partly digested food particles in stool
  • Reduced energy, fatigue, or energy dips in the afternoon, or a second wind in the late evening that makes it hard to go to bed at a good time
  • Cravings for sugar, fat, or caffeine
  • Pica (craving minerals from nonfood items like clay, chalk, dirt, or sand)
  • Trouble falling asleep or staying asleep, or just not feeling well rested in the morning
  • Headaches (mild to migraine)
  • Dizziness or lightheadedness
  • Increased mucus production: phlegm, runny nose, or postnasal drip
  • Coughing or increased need to clear your throat
  • Itchy eyes or mouth
  • Sneezing
  • Aches and pains: muscle, joint, tendon, or ligament
  • Changes in skin: rashes, acne, dry skin, little pink bumps or spots, dry hair or nails
  • Mood issues: mood swings, feeling low or depressed
  • Feeling anxious, less able to handle stress

The procedure for reintroductions, taken from the procedure used to challenge food allergies and sensitivities, is as follows:

  1. Select a food to challenge. Be prepared to eat it two or three times in one day, then avoid it completely again for a few days.
  2. The first time you eat the food, eat half a teaspoon or even less (one teensy little nibble). Wait fifteen minutes.
  3. If you have any symptoms, don’t eat any more. If you don’t, eat one teaspoon of the food (a small bite). Wait fifteen minutes.
  4. If you have any symptoms, don’t eat any more. If you don’t, eat one and a half teaspoons of the food (a slightly bigger bite).
  5. That’s it for now. Wait two to three hours and monitor yourself for symptoms.
  6. Now eat a normal-sized portion of the food—either by itself or as part of a meal.
  7. Do not eat that food again for five to seven days and don’t reintroduce any other foods during that time. Monitor yourself for symptoms.
  8. If you have no symptoms during the challenge day or at any time in the next five to seven days, you may reincorporate this food into your diet.

It’s best not to be in a hurry to reintroduce foods. Generally, the longer you wait, the more likely you are to be successful. But when you introduce particular foods is ultimately your choice. How you feel is the best gauge, and only you will know if you are ready. A word of caution, though: don’t let cravings influence you. Your decision should be based on how good you feel and how much improvement you’re seeing in your disease. And to help you out with cravings until you’re ready for this phase, we’ve created some amazing comfort food and treat recipes, so you won’t feel like you’re missing out!


Get the Definite Resources for the Autoimmune Protocol

tpa-tables-lr1-1The Paleo Approach is the New York Times bestselling complete guide to using diet and lifestyle to manage autoimmune disease and other chronic illnesses.  With over 400 pages of scientific explanations of the why’s, what’s, and how’s behind diet and lifestyle recommendations to help regulate the immune system and provide the body with the opportunity to heal.  This encyclopedic resource also contains tons of practical information including tips for transitions, working with your doctor, medical test and treatments that might be helpful, troubleshooting, and when and how to reintroduce foods.  This book goes into scientific detail, while keeping explanations accessible and fun to read, and includes over 1200 scientific references. This is the book for people who want to understand the contemporary science behind how the food we eat as well as how we live our daily lives together impact our bodies to either promote health or facilitate disease.

screen-shot-2016-11-07-at-8-36-39-pmThe Paleo Approach Cookbook is the National bestselling companion cookbook to The Paleo ApproachThe Paleo Approach Cookbook is over 400 pages and includes over 200 recipes, all strict autoimmune protocol (AIP), and lots of resources (over 100 pages worth!) to help you be successful in the kitchen while you tackle the diet recommendations in The Paleo Approach.  With such a huge number of recipes (that each include cook time, prep time, servings, tips, variations, nutrition facts, FODMAP alerts), as well as hundreds of recipe variations, there’s something for everyone! The Paleo Approach Cookbook also includes a summary of the diet, cooking guides, kitchen How-Tos, shopping lists, food storage guides, kitchen tool essentials, cooking glossary of terms, time management strategies, how to read labels, recipe Top Ten, alphabetical Yes-No-Maybe-So list of foods,  6 one-week meal plans (two of which are low-FODMAP) and MORE!

THE HEALING KITCHEN COVER-thumbAchieving health through nutritious food choices has never been simpler nor more delicious thanks to The Healing Kitchen! This cookbook makes healing using the Autoimmune Protocol completely accessible to everyone, regardless of your budget, time limitations, or access to specialty grocers.  Armed with more than 175 budget-friendly, quick and easy recipes made with everyday ingredients, you get to minimize time and effort preparing healthful foods without sacrificing flavor! Straightforward explanations and a comprehensive collection of visual guides will teach you which foods are the best choices to mitigate chronic illnesses, including autoimmune disease. Real-life practical tips on everything from cleaning out your pantry and easy ingredient swaps to reinventing leftovers and DIY flavor combinations will help you go from theory to practice effortlessly. Even better, twelve 1-week meal plans with shopping lists takes all the guesswork out of your weekly trip to the grocery store!

The Autoimmune Protocol Lecture SeriesThe AIP Lecture Series is a 6-week video-based online course that teaches the scientific foundation for the diet and lifestyle tenets of the Autoimmune Protocol. is a 6-week video-based, self-directed online course that will teach you the scientific foundation for the diet and lifestyle tenets of the Autoimmune Protocol. Think of this course as going to college for your health! The AIP Lecture Series doesn’t shy away from teaching important scientific concepts. Dr. Sarah Ballantyne, PhD firmly believes that understanding how foods affect our health and the cellular level is an essential motivator for making positive and lasting change, as well as being critical to the self-discovery processes of finding individual tolerance and reintroduction.  But, you don’t need a science background to take this course!  Dr. Sarah explains the scientific evidence for each facet of the Autoimmune Protocol in her signature approachable style using accessible language and visual guides.  If you enjoy Dr. Sarah’s books or articles on this website, you’ll love this course!



Some quick myth-busting and FAQ:

1. Starchy Vegetables (GAPS, SCD): Avoiding starchy vegetables for SIBO has not been validated in the scientific literature (but eating low FODMAP has been proven very effective for people with IBS, IBD and SIBO). Many people do anecdotally find symptom relief from starving overgrowths with these very low carb approaches, but the low carbohydrate/fiber intake can be stressful on the thyroid, cause dysregulated cortisol (and both of those are bad!) and lead to bacterial undergrowth in the digestive tract. The two diet factors that have been shown in the scientific literature to have the most dramatic corrective impact on gut microorganims is high omega-3 fatty acid intake (lots of fish!) and high fiber intake (from vegetables and fruit), both soluble and insoluble. If you do have confirmed SIBO or strong gastrointestinal symptoms, you may want to combine the autoimmune protocol with a low FODMAP approach as a short-term intervention or you may wish to save low FODMAP for troubleshooting a month or two down the road.

2. Insoluble fiber/Leafy Green: While insoluble fiber gets a bad reputation as being an “irritating” fiber, recent studies actually show that higher insoluble fiber intake speeds healing in models of colitis and diverticulitis. Also, the higher the intake of insoluble fiber, the lower the chances someone will have high c-reactive protein (implying that it reduces or prevents inflammation). Soluble fiber reduces the chance of having high c-reactive protein too, but not as much as insoluble fiber. Insoluble fiber also reduces risk of cancer and cardiovascular disease. I can’t find a single scientific journal article that actually shows that insoluble fiber irritates the gut and I have a feeling this is myth. Instead, I can find evidence that it reduces bile acid loss (which ultimately improves digestion), is an essential signal for ghrelin suppression after meals (which has a ton of different important effects in the body), that it improves insulin sensitivity, and helps to remove toxins from the body. I can’t find a single reason why insoluble fiber should be limited. If you have intact pieces of high insoluble fiber vegetables in your stool, add digestive support supplements (especially plant enzymes) and try limiting yourself to cooked vegetables until your digestion improves. For more information, see Part 1Part 2Part 3Part 4 and Part 5 of my Fiber Manifesto series.

3. Goitrogenic vegetables for thyroid disorders: Again, there is no scientific evidence for their exclusion even for those with thyroid disorders. I explain in detail in this post.

4. Fruit: Many people avoid fruit because it is high in sugar. If you have FODMAP-intolerance, you will want to avoid high fructose fruits and everyone will want to keep their fructose intake below 20g per day, but fruit in moderation is endorsed and is actually a great source of vitamins, minerals, fiber and antioxidants. Depending on which fruit you choose, and how you define a serving, you can typically enjoy 2-5 servings of fruit per day and stay below 20g of fructose.

5. Omega-3 intake is very important: Aim for between 1:1 and 1:3 ratio of omega-3 fatty acids to omega-6 fatty acids. If you eat grass-fed, pasture-raised meat, not too much poultry, and some fish, this will be natural. If you eat more conventional meat or more frequent servings of poultry, you will need to increase your intake of oily cold-water fish (like salmon, mackerel, sardines, herring, kipper, anchovies, trout, fresh tuna, and carp). Rendered animal fats used for cooking should always come from grass-fed or pasture-raised animals. Omega-3 fatty acid intake is one of the most important factors for correcting gut dysbiosis. It is better to get your omega-3 fats from fresh fish rather than fish oil. Plants-based omega-3s are predominantly ALA, which is not as usable by your body as the long chain DHA and EPA in fish and pasture-raised/grass-fed meat. Increasing omega-3 fatty acid intake has been shown to dramatically reduce the need for NSAIDs in patients with Rheumatoid Arthritis. 

6. Protein is important: You can heal your body by limiting your animal-based foods to fish and shellfish, but you need protein. The protein in fish and shellfish is more digestible than meat (and meat protein is more digestible than any protein from plants), which may be relevant for those with severely damaged guts.

7. Vegetables are important: don’t skimp on the vegetables. If you are a person who has a very hard time eating large servings of vegetables, smoothies or vegetable juices might be consumed in moderation as part of a meal (and not as a meal replacement because chewing is an important signal for digestion). If you have trouble digesting large amounts of vegetables (if you have any gastrointestinal symptoms or can identify intact vegetable particles in your stool), try taking digestive support supplements with your meals and limiting yourself to cooked vegetables initially (plant enzymes are especially helpful for breaking down fiber). 

8. Gray Areas: egg yolks, legumes with edible pods (such as green beans and snow peas), walnut oil, macadamia nut oil, grass-fed ghee, and gluten-free alcohol when used in cooking are gray areas. I suggest omitting them in the beginning, but can typically be reintroduced much earlier than other foods. Whole coconut products (coconut butter, coconut cream concentrate, creamed coconut, coconut flakes, coconut chips, fresh coconut) should be consumed in moderation (due to being very high in inulin fiber and moderately high in phytic acid). Coconut milk and coconut cream (not to be confused with creamed coconut or coconut cream concentrate) should be guar-gum free and limited to 1 cup per day. Coconut oil is fine if well-tolerated.


carob, rooibos tea, black and green tea in moderation, DGL, apple cider vinegar, wine vinegar, balsamic vinegar, coconut water vinegar, coconut water in moderation, vanilla extract (if cooked), pomegranate molasses in moderation, maple syrup and maple sugar very occasionally, honey very occasionally, dried fruit very occasionally, dates and date sugar very occasionally, molasses very occasionally, unrefined cane sugar (sucanat, evaporated cane juice, muscovado, very occasionally, coconut aminos, are okay.

algae (chlorella, spirulina), wheat grass (contains wheat germ agglutinin), barley grass, brown rice protein, pea protein, hemp protein, licorice root (except DGL), aloe, slippery elm, chia, flax, lemon balm (tea is probably okay but avoid in supplement form), commercial egg replacers, decaf coffee, herbal sleep aids that contain oat seed, some adaptogenic supplements (ashwagandha is a nightshade), are not okay.

10. Meal Composition and Timing. It is better to eat larger meals spaced farther apart and not snack, unless you have a very damaged gut that can not handle digesting large amounts of food all at once. If you are used to grazing, transition slowly. You should not intermittent fast if you have autoimmune disease. You should not endeavor to be in nutritional ketosis if you have an autoimmune disease. You should not eat when under duress. It is better to avoid excessive liquid with your meals, chew your food thoroughly and not rush to the next activity when you eat. You should not eat within 2 hours of bedtime (disrupts sleep). Meals should always include animal foods and plant foods (within the guidelines above), including a quality fat source, and some carbohydrates. There are no firm guidelines for proportion of your meals that are protein, fat and carbohydrate (make sure you get “enough” of each, and then just eat what makes you happy).

11. Useful Supplements:

12. Quality Matters (but it isn’t everything): the better quality food you can source, the better. But if you just can’t afford all grass-fed/pasture-raised meat, wild-caught fish, and organic locally-grown produce, just do the best you can. My post on the importance of grass-fed meat contains some suggestions for incorporating it into your diet in a budget-conscious way. This post ranks different animal proteins to help you prioritize which ones to buy. Whole9Life has a wonderful charton when fruits and vegetables are in season including which fruits and vegetables are important to buy organic and which aren’t, if budget is an important concern.

13. Your body knows best: If you know that a food that is omitted from The Paleo Approach works very well for you (such as raw grass-fed dairy) or if you know that a food normally recommended on The Paleo Approach does not work well for you (such as coconut oil), then it’s find to modify accordingly. If you aren’t sure or aren’t seeing success, go with the above recommendations. If you find something that truly works for you, whatever it is, stick with it.

14. Read 20 Keys to Success on the Autoimmune Protocol for more great tips!


The Autoimmune Protocol is a diet that helps heal the immune system and gut mucosa. It is applicable to any inflammatory disease.

We have a problem in this country with how we eat, treat disease and heal disease. AIP addresses inflammation in the gut that causes Autoimmune Disease. Autoimmune disease is a condition where the body cannot tell the difference between healthy tissue and foreign invaders and a hypersensitive reaction occurs. The body starts self-tissue attack. For months or perhaps years, this self-tissue attack can occur silently until full blown autoimmune disease develops. There are more than 80 types of “official” autoimmune disorders (and MANY more being discovered daily) but all autoimmune disease have in common is tissue self-attacking in places like the thyroid gland, brain tissue or salivary glands, to name a few.

The Autoimmune Protocol (AIP) diet works to reduce inflammation in the intestines. Many elimination diets are not complete enough and often do not remove immune triggers that promote inflammation in the gut. AIP works to calm inflammation in the gut and also calm inflammation in the body. And while autoimmune disease can never be cured, it can be put into remission. The AIP diet is geared toward healing the intestinal mucosa and supporting low inflammation in the body that can temper the fires of an autoimmune flare-up. First I would like to say that this is our interpretation. There is more than one interpretation of how to “follow” the Autoimmune Protocol (AIP) diet. I call it a lifestyle because in a modified form it is how I eat and live my life. It is also how I recommend my autoimmune clients to eat in their own modified form long term as well.

The Autoimmune protocol has been said to be a version of the Paleo diet, but really, I see that it is so much more than that; it is a dramatic way to address inflammation that is driving Autoimmune Disease that has its beginning roots in the gut. Diet is one aspect of healing. And, although it is the largest aspect of long term health, in the short-term, there are other components that require the help of a skilled practitioner. I suggest you find one that is trained. I personally have a professional practice primarily around helping those on this diet as well as nutritional lab work evaluations, supplement protocols and dietary support. Please email me at if you would like to set up an appointment and work together remotely. There are many divergent paths that have an overlap with the AIP lifestyle like Autoimmune disease, adrenal fatigue, H-P Axis imbalances, co-infectins, parasites, SIBO, liver congestion, hormone imbalances, insulin resistance that play a role in how you may use supplements along with the AIP diet to heal your body.  Each person who decides to try the AIP diet should work with their practitioner to determine if they are candidates for a low histamine, low latex and/or low FODMAP in addition to following AIP. This is where you will benefit from having an experienced, clinically seasoned practitioner to help personalize your AIP plan. Other adjunct protocols may include: functional blood chemistry, saliva hormone testing, saliva adrenal testing, stool testing and antibody tests.

Before you start AIP, I encourage you to read this post: When AIP Is A Crutch Not A Cure.

I share this all with you as an expert AIP Nutritionist. I am an authority in the AIP movement. I always recommend working with an experienced practitioner when starting AIP and getting blood work and other functional tests like adrenal/cortisol and hormone saliva tests. If you have dysglycemia, insulin resistance, anemia (not all anemias are from low iron!), intestinal or other infections like h. pylori, SIBO, h-p axis issues, adrenal dysfunction, you may not get better on the AIP diet alone. I see this quite a bit in my nutrition practice.  If you have been on the AIP diet and are not seeing results you wanted, or are looking for a heart-centered approach to autoimmune disease please contact me directly for information on how to set up an appointment with me. I primarily use Skype for both my AIP clients and The Loving Diet Program. For more information about me and working together, go to this page. 


6-8 Weeks


  • Nuts (including nut oils like walnut and sesame seed oils)
  • Seeds (including flax, chia, pumpkin, sunflower, sesame and culinary herb seeds like cumin and coriander)
  • Beans/Legumes (this includes all beans like kidney, pinto, black as well as Soy in all its forms)
  • Grains (Corn, Wheat, Millet, Buckwheat, Rice, Sorghum, Amaranth, Rye, Spelt, Teff, Kamut, Oats etc)
  • Alternative sweeteners like xylitol, stevia, mannitol
  • Dried fruits and/or over-consumption of fructose (I recommend up to 2 pieces of fruit a day)
  • Dairy Products
  • All Processed Foods
  • Alcohol
  • Chocolate
  • Eggs
  • Gums  (guar gum, Tara gum, Gellan gum, Gum Arabic)
  • Nightshades (tomatoes, potatoes, peppers, eggplant, paprika, mustard seeds, all chili’s including spices)
  • No vegetable oils (NOTE: olive oil, lard, palm oil, cultured grass fed ghee and coconut oils are permitted)
  • Culinary herbs from seeds (mustard, cumin, coriander, fennel, cardamom, fenugreek, caraway, nutmeg, dill seed)
  • Tapicoa. I eliminate this the first 6-8 weeks because it is a known gluten cross reactor according to Cyrex Labs Gluten Cross-Reactivity Test


  • Vegetables (except nightshades)
  • Fruits (limit to 15-20 grams fructose/day)
  • Coconut products including coconut oil, manna, creamed coconut, coconut aminos, canned coconut milk (with no additives like guar gum and carageen or bpa lined cans) shredded coconut (this list does not include coconut sugar and nectar)
  • Fats: olive oil, coconut oil, avocados, lard, bacon fat, cultured ghee (certified to be free of casein and lactose)
  • Fermented Foods (coconut yogurt, kombucha, water and coconut kefir, fermented vegetables)
  • Bone Broth
  • Grass Fed Meats, Poultry and Seafood
  • Non-Seed Herbal Teas
  • Green Tea
  • Vinegars: Apple Cider Vinegar, Coconut vinegar, red wine vinegar, balsamic (that has no added sugar)
  • Sweeteners: occasional and sparse use of honey and maple syrup (1 tsp/day)
  • Herbs: all fresh and non-seed herbs are allowed (basil tarragon, thyme, mint, oregano, rosemary, ginger, turmeric, cinnamon, savory, edible flowers)
  • Binders: Grass Fed Gelatin and Arrowroot Starch (watch the starch however if you have adrenal issues)


High FODMAPS may disagree with some on the AIP diet. For example; nectarines, coconut or onions may bother some people. Whole30’s great Paleo Low FODMAPS shopping list:

If you are reacting to certain starches in foods, it may be a sign that high FODMAPS need to be eliminated from your diet. Also, Ashwaganda is in the nightshade family, and should be eliminated during the first phase of AIP. I find it usually well tolerated in general by most people however. If you are FODMAPS sensitive, eliminate for 10-14 days and then slowly reintroduce.


  1. AIP (autoimmune disease) is a disease of inflammation that causes self-tissue attack
  2. Food is a powerful way to reduce inflammation and calm the immune system
  3. Diet is usually NOT enough and specific protocols of gut healing and removing SIBO and immune support supplements may be needed. Read this post When AIP Is A Crutch Not A Cure.
  4. I recommend personalizing AIP before you start. I recommend the Cyrex Labs Array 10.
  5. Additional Supplements are usually required in my experience to fully heal the gut. Diet is almost NEVER enough to properly heal
  6. I allow green beans, snow peas and sugar snap peas unless low FODMAPS is needed. Because green beans are not mature bean seeds, I allow them. Not everyone in the Paleo world will agree with me about that however and you may consider taking them out during Phase 1. My hard line is no mature beans seeds from the legume family
  7. Brain Chemistry and Adrenal Fatigue are likely culprits in autoimmune disease and need to be addressed. I highly recommend using a skilled practitioner who can properly survey brain and adrenal function and help you. I do not recommend the use of hormones or neurotransmitters in treating brain function (like Melatonin) and advise using caution when using precursors to neurotransmitters. It is my opinion that one cannot treat one without the other.
  8. Undiagnosed Insulin Resistant Hypoglycemia is a big factor in inflammation that can contribute greatly to autoimmune disease, adrenal fatigue and brain dis-regulation. Working with a practitioner who is knowledgeable in ALL of these areas will help you improve more quickly than using 100% diet to heal autoimmune disease.

Eliminating these foods is important to reduce inflammation. All of the above listed foods can be gut irritants and exacerbate dysbiosis in the gut and contribute to SIBO (small intestine bacterial overgrowth). AIP can help address the GALT imbalances (Gut Associated Lymphoid Tissue) in the intestines. Because the gut contains such a large percentage of immune system GALT tissues (70%) that mediate the T & B Lymphocytes that carry out immune system attack by producing antigens or antibodies, the goal of AIP is to reduce this from occurring. It is widely accepted that gut mediated inflammation is applicable for addressing Autoimmune Disease. Below are the studies I have found that link the gut to the immune system. I encourage you to print these articles out and bring them to your doctor.


  1. 72 Hour Rule: It takes 72 hours to produce an immune response to food antigens depending on which one. It can be physical or mental in nature. Lethargy, brain fog, aching joints, rashes, stomach aches, numbness, feeling hung-over, bloating, gas, constipation, insomnia, fatigue, memory loss.
  2. Re-introduce only 1 food every 5 days and when you re-introduce the food,  eat enough of it to elicit a response. A small bite, then a few hours a spoonful and then that night a serving.
  3. Keep a food re-introduction notebook! I work with many, many people who reintroduce food after a cleanse or AIP and they have a sensitivity symptom and can’t remember what or when they did the reintroduction. Writing everything down helps a lot.

I also recommend doing yearly or twice yearly cleanses and support phases, eating fermented foods and bone broth at least 2-3 times a week in 1/2 cup portions. The reason we are compelled to share this all with you, is that food is fun. I believe you can be on the AIP diet and do as a lifestyle. You can be a foodie and do AIP. I love food too much to feel like I cannot eat foods that are satisfying, creative and exciting. Food is spiritual for me. It is my path. Helping others heal is my path. Teaching is my path. As I share my recipes with you, I eat them too. You are not alone in your path to health. We do this journey together.

There are many resources available to you beyond diet and supplements. I talk about them extensively on this blog as well as in my private practice. Looking beyond diet and supplements can be a very valuable endeavor on your path to healing. Here are a few posts to check out:

When You Don’t Get Better on The AIP Diet

Self-Compassion and Autoimmune Disease

Trusting Your Life

Autoimmune Disease As Joy In Disguise

New Program for Autoimmune Disease

Illness as Transformation


Other Fabulous Resources (Some are not AIP but useful for autoimmune disease):