The Paleo Autoimmune Protocol (AIP) is a version of the Paleo diet that focuses on healing the gut and reducing inflammation in the body to improve symptoms of autoimmunity, digestive disorders, and other health concerns related to a compromised immune system. In addition to eliminating the foods that are restricted in a general Paleo nutrition template, the AIP calms inflammation by temporarily removing additional foods, gut irritants, and lifestyle factors that are known to promote the inflammatory processes and have a negative impact on gut health. Although the AIP can be effective at managing -and even reversing- symptoms of autoimmunity and other chronic diseases, it can also be challenging to navigate and implement properly. If you are following the AIP, but you haven't achieved the results that you were hoping for, consider the following reasons why the AIP may not be working:
1.) You have not committed 100% to the AIP dietary guidelines: "Everything in moderation" or the "80/20 rule" may work for healthy individuals, but not for those who are struggling with symptoms of autoimmunity or chronic disease. The foods that are restricted on the AIP are those that are inflammatory, irritate the gut, negatively stimulate the immune system, and contribute to increased intestinal permeability (leaky gut). Once you remove these foods from your diet, it takes time for the gut to heal. Food reactions often don't become apparent until the offending food has been completely out of your system for several weeks, which is the major reason why the minimum trial period for the AIP is at least 30 days. Continuing to consume even a small amount of AIP-restricted food or indulging in occasional "cheats" during this time may prevent the gut from repairing. The AIP can feel quite restrictive, but keep in mind that it doesn't have to to be a long-term dietary plan (although it can be a healthy lifelong diet if implemented correctly).
2.) You have not maximized the nutrient-density of your AIP template: Many people have a tendency to focus on eliminating the grains, dairy, eggs, legumes, seeds, and nightshades from their diet, but they don't prioritize the addition of nutrient-dense foods, such as organ meats, plentiful vegetables, fatty fish, fermented foods, and bone broth. People with autoimmune disease are more likely to suffer from micronutrient deficiencies and it is best to eat a wide variety of nutrient-dense foods to ensure adequate consumption of critical vitamins, minerals, and other nutrients. Food quality and sourcing contribute greatly to nutrient-density, so opt for organic and local foods, as well as animal meats and fats that have been fed a species-specific diet.
3.) You have not addressed lifestyle factors: Removing toxic and inflammatory foods is a critical component of the AIP, but many people often neglect the lifestyle and environmental factors that impact autoimmunity and chronic disease. The importance of adequate sleep and stress reduction , in particular, cannot be overstated. The National Sleep Foundation recommends at least 7-9 hours of sleep per night for the average adult, and even more sleep may be required for those with an autoimmune disease. Chronic stress contributes to inflammation and dysregulation of the immune system, and it can both serve as an underlying trigger of autoimmune disease and potentiate symptoms. Chronic endurance training, exposure to environmental toxins, and the use of hormonal birth control and certain types of medications are other lifestyle factors that can have a negative impact on gut health. Even if you follow the AIP dietary guidelines strictly, healing won't take place if you don't take steps to address problematic lifestyle factors. (Note: Medications may be necessary for controlling symptoms and ensuring quality of life. Consult with a qualified licensed health care professional before discontinuing any prescription medications.)
4.) You have not given it enough time: The AIP should be followed strictly for a minimum of 30 days before attempting reintroductions. It can sometimes take years or decades for autoimmune and other chronic diseases to develop, and subsequently, it takes time to begin to calm inflammation and repair damage in the body. It can take even more time to achieve remission. Many people will experience some level of symptom improvement after a month, but it is typically not realistic to expect symptoms to resolve completely within this time period. Continuing to follow strict AIP until you achieve the level of symptom control that you desire may be prudent, but it can also be a fine balance to strike between continuing on AIP and restricting foods unnecessarily at the expense of creating psychological stress or even disordered eating. In other words, it is best to seek out a nutrition or functional health professional if you haven't achieved any results after a few months of strict AIP, you become stuck during the reintroductory phase, or you find that the AIP and your food choices are causing you a great deal of stress.
5.) You have not dug deeper into underlying factors: Autoimmune disease is complex and there are many key factors that can contribute to symptoms. Low-level chronic viral or bacterial infections often need to be addressed before significant healing can occur. This may require specialized testing and treatment with prescription medications or professional-grade herbs. Although diet and lifestyle is crucial to healing a leaky gut, supplementation is often necessary to seal and reseed the gut. Also, you may discover that the AIP is not the best approach to address your specific health concerns. Experimentation with a low-FODMAPs diet, a low-histamine/low-oxalate diet, the Specific Carbohydrate Diet, the GAPS diet, or the Wahls Protocol may be necessary. Working with a qualified health care professional will simply the process and ensure that you have customized recommendations to address your specific concerns.
Have you struggled with achieving results on the AIP? Please share your insights and tips in the comments!