What is the Autoimmune Protocol (AIP)?
The Autoimmune Protocol (AIP), often referred to as Core AIP, is an elimination diet that takes the principles of the Paleo diet even further. It is specifically designed to help individuals with autoimmune diseases reduce inflammation, heal the gut, and identify individual food sensitivities that may trigger symptoms.
The standard protocol involves a strict elimination phase where foods known to potentially cause inflammation or increase intestinal permeability are removed. This phase typically lasts for 30 to 90 days, or until a significant reduction in symptoms is observed. After this period, a careful, staged reintroduction phase begins to identify specific trigger foods.
Core AIP: The Original Elimination Protocol
The original Core AIP is highly restrictive to provide the body with a complete break from potential dietary triggers. The goal is to calm the immune system and support healing from the ground up. This approach is often recommended for individuals with severe symptoms or those who haven't found relief with less restrictive diets.
Foods eliminated in Core AIP:
- Grains and Pseudo-grains: All grains, including rice, oats, wheat, and gluten-free grains like quinoa, amaranth, and buckwheat.
- Legumes: All beans, lentils, peas, and soy products.
- Dairy: All dairy products, including milk, cheese, and butter.
- Eggs: The entire egg, both whites and yolks.
- Nightshades: Vegetables such as tomatoes, potatoes, eggplants, and peppers, along with spices derived from them.
- Nuts and Seeds: All nuts and seeds, including spices derived from seeds, cocoa, and coffee.
- Processed Foods and Additives: All processed foods, refined sugars, artificial sweeteners, and emulsifiers.
What is Modified AIP?
Modified AIP (mAIP) was developed based on clinical observations that certain foods, traditionally eliminated in the core protocol, are well-tolerated by most people and can make the diet more sustainable. This version maintains the core principles of nutrient-density and gut healing but offers increased flexibility, making it more approachable for those with busy lifestyles, financial constraints, or specific dietary needs like vegetarians.
Modified AIP: A More Accessible Alternative
Introduced by leading practitioners, Modified AIP recognizes that for many, a less restrictive elimination phase can still be highly effective. The modifications are based on the balance between achieving therapeutic goals and ensuring long-term adherence.
Key foods included in Modified AIP that are excluded from Core AIP:
- Rice: Both brown and white rice are permitted.
- Pseudo-grains: Grains like quinoa, amaranth, and buckwheat are allowed.
- Ghee: Clarified butter is permitted, as it has had most dairy proteins removed.
- Legumes: Most legumes are allowed, with the exception of soy and peanuts.
- Seeds: Seeds, as well as coffee and cocoa derived from seeds, are included.
Comparison: AIP vs. Modified AIP
| Feature | Core AIP | Modified AIP |
|---|---|---|
| Restrictiveness | Very restrictive | Less restrictive, more flexible |
| Included Foods | Vegetables (non-nightshade), fruits, quality proteins, healthy fats, organ meats, bone broth, fermented foods | Adds rice, pseudo-grains, most legumes (not soy/peanuts), seeds, ghee, coffee, and cocoa. |
| Excludes Eggs | Yes, all eggs are excluded | Yes, all eggs are excluded. |
| Excludes Nightshades | Yes, all nightshade vegetables and spices | Yes, all nightshade vegetables and spices. |
| Duration of Elimination Phase | Typically 30-90 days, or until symptom improvement is achieved. | Similar timeframe, but reintroductions can differ. |
| Target Audience | Individuals with severe autoimmune symptoms or those who have not responded to less strict protocols. | Individuals with less severe symptoms, or those needing a more sustainable and manageable approach. |
| Sustainability | Can be challenging for long-term adherence due to strictness. | Designed for better long-term adherence due to increased flexibility. |
How to Choose the Right Protocol
Choosing between Core AIP and Modified AIP depends heavily on individual circumstances. It's not a one-size-fits-all approach. For those with significant, persistent symptoms, starting with the strict Core AIP for a period might be necessary to achieve the most profound results. This allows for a clean slate, removing all common irritants to gauge the body's baseline.
For others, the stringent nature of Core AIP may be too overwhelming and could lead to feelings of restriction and failure. For these individuals, starting with the more inclusive Modified AIP can be a less daunting entry point. It still provides significant anti-inflammatory benefits while making meal preparation, social eating, and sustainability much more manageable. The decision should also consider the individual’s cooking abilities, food budget, and support system.
The Reintroduction Phase
Both protocols feature a reintroduction phase, but the starting points differ significantly. On Core AIP, a person must reintroduce foundational items like egg yolks and seeds before moving to more reactive foods. In contrast, the Modified AIP already includes many of these foods, meaning the reintroduction process starts from a less restrictive place. A key takeaway from both protocols is the importance of a journal to track symptoms and reactions during reintroduction to personalize the final diet.
Conclusion: Finding the Right Balance for Your Health
The difference between AIP and modified AIP ultimately comes down to a trade-off between strictness and sustainability. Core AIP offers the most comprehensive elimination for those with severe symptoms, providing a maximal healing environment. Modified AIP, however, recognizes that maximal restriction isn't always necessary or realistic, offering a more flexible pathway that still aligns with the core therapeutic goals of reducing inflammation and supporting gut healing. The best approach is often guided by a healthcare practitioner who can assess your health status and help you find the right balance for your unique needs, ensuring a sustainable and effective journey towards better health. Both versions emphasize nutrient density and a focus on whole foods, representing a powerful tool for managing autoimmune conditions.
