How to follow the AIP-diet

Tanja Hakala is a nurse, nutrition coach and reflexologist from Finland with a special interest in the AIP-diet. In this article, she answers our questions about the autoimmune protocol.
AIP-diet blog |

What is AIP?

The main purpose of the AIP diet, or the autoimmune protocol, is to calm our immune system and give the body a chance to recover. Autoimmune diseases are about our immune system turning against our body. For example, they attack tissues and cells with ferocious force, destroying them.

The AIP diet is specifically designed to be a soothing diet - not a way to eat for the rest of your life. Therefore, it's recommended to follow the autoimmune protocol for a maximum of three months, after which you increase the range of foods one food at a time and monitor your body's reactions.

The AIP diet is based on a model called the 4R model in functional medicine. These four elements come from the words remove, replace, reinoculate and repair. The autoimmune protocol is based on these four pillars.

- In the past we used to talk about the 4R protocol, but nowadays it is almost better to talk about the 5R protocol. The fifth R is Rebalance, which is a very important factor in the quest for better well-being. Stress is such an important root cause of autoimmune diseases that the whole protocol should start with balancing life and eliminating stress,' says Tanja Hakala.

What are the most common mistakes you've noticed people make when they start following the AIP diet?

- One-sided and restricted diet. If you've jumped from the so-called "standard diet" to a full AIP diet without any lighter options in between (e.g. paleo, gluten-free, dairy-free), it's hard for people to see "outside the box". When essential daily foods are restricted and banned, it's easy to think "what on earth am I going to eat now?". A diet can easily consist of a few ingredients and become too one-sided. However, AIP is not a very one-sided diet if you know how to structure it properly. Another challenge, of course, is that AIP has been developed in the US, where the vegetation and ingredients are slightly different from those in the Nordic countries. Not everything is available here," says Tanja Hakala.

It can be difficult to cut down on your diet, especially if you've eaten a lot of cereals and dairy products in the past. How do you do it?

 - In many cases, excluding gluten and milk is enough to calm the autoimmune condition. If you start making too many changes at the same time, it's also a stressful situation for your body. It can go horribly wrong and you do more harm than good. You should always consider your own situation as much as possible: what can I do, what do I have the resources to do? Is my life stressful and is it possible to make big changes? If life is hectic, big dietary changes are very stressful in themselves, advises Hakala. So before you make big changes, it's a good idea to first manage the stress or start changing your diet gently by gradually removing the foods you want to cut back on.

For vegetarians and vegans, AIP can seem difficult. What foods can vegans/vegetarians use to make sure they get enough protein and other foods when following the AIP diet?

A vegan cannot eat a completely pure AIP diet because it would not provide enough protein or really all the essential amino acids. However, if a vegetarian supplements their diet with fish and seafood, they will get enough protein. Mushrooms are of course also a good source of protein for vegans.

- The problem with legumes is lectins, which is why legumes are on the AIP diet's list of foods to avoid. Lectins are anti-nutrients that can break down intestinal surface cells and cause leakage in the gut. For the same reason, nuts and seeds should be avoided at first. Nuts and seeds also often cause hypersensitivity and are therefore unsuitable for this diet,' says Tanja Hakala.

- Lectins can be reduced by soaking, sprouting, fermenting and pressure-cooking. For many people this is already enough, and therefore many vegans can also get natural help for their autoimmune disease by following the AIP diet, advises Hakala, who is well versed in AIP.

AIP is not for life, but a soothing diet for a few months at most. Why? 

- AIP is about calming the body's immune system by eliminating anti-nutrients and foods that cause hypersensitivity. Once the body has had time to recover, it may be possible to expand the diet to a Paleo-like diet. Of course, this expansion should be done gradually and one food at a time. Remember to listen for any symptoms that may occur in the body.

- If symptoms worsen or new ones appear, exclude the food that caused the problem. It's not always possible to backtrack, as food intolerances may have arisen either from leaky gut or genetic causes, says Hakala.

- If you follow an overly strict AIP diet, you may develop deficiencies over the course of your life. You may not get the important plant-based fatty acids LA (linolenic acid) and ALA (alpha-linolenic acid) if you don't include any of their seeds, nuts or oils in your diet.

What happens after the AIP diet? Can I then start eating as usual without gastrointestinal problems? Or what does life after AIP look like in terms of meals?

- The AIP diet is not so much designed to relieve gastrointestinal symptoms unless you have IBD (inflammatory bowel disease). So if stomach symptoms alone are a challenge without autoimmune disease, even lighter dietary options can provide relief.

- Once the body has calmed down and symptoms have subsided, the goal is to transition to a Paleo diet after the AIP period. At this stage, many people can eat gluten-free grains without experiencing any symptoms. The diet will therefore usually be expanded to include potato plants, eggs, nuts and seeds, and possibly legumes. When you vary these from day to day, rather than eating the same food every day, the body often copes better with an expanded diet. Gluten is the only food that should be excluded for good. Dairy products also cause problems for many people and are one of the most common causes of hypersensitivity in people with autoimmune diseases, advises Tanja Hakala.

- If the AIP phase doesn't calm things down, it's not just about the food. In this case, you need to go deeper and look for the cause in the gut, stress or food sensitivities (i.e. you may be unknowingly eating something that your body is constantly producing IgG antibodies to).

- It's important to remember individual differences; not everything fits everyone. If you have suffered from an autoimmune disease for many years, it is often a lengthy process and sometimes the slow progression can be frustrating. I myself have suffered from autoimmune diseases for over 20 years and it is only now that the underlying causes are becoming clearer. Slowly but surely," says Hakala.