In people with autoimmune diseases, the immune system identifies healthy body tissues as foreign and launches an immune attack against cells that are healthy. An autoimmune disease is, therefore, an out-of-sync immune response where the immune system turns against the body's own healthy cells and tissues. There are more than 100 autoimmune diseases, with some of the common ones being rheumatoid arthritis, psoriasis, type 1 diabetes, inflammatory bowel disease (IBD), Crohn’s disease, celiac disease, multiple sclerosis, and lupus. 

Living with an autoimmune disease can be challenging, with periodic flare-ups of inflammatory symptoms. However, many people with autoimmune disorders find that eating or avoiding certain foods can make a difference in their symptoms. So, what to eat when you have an autoimmune disease? And what foods should you avoid to reduce inflammation? Continue reading to learn more about anti-inflammatory diets, including the autoimmune protocol or AIP diet. 

What aggravates autoimmune diseases? 

The development of autoimmune diseases is believed to be a combination of genetic and environmental factors that affect the immune system. The exact cause is unknown, but microorganisms (bacterial or viral infections) and certain drugs are believed to trigger the immune system. This is more likely to happen in people who are genetically predisposed to the development of autoimmune disorders. A western diet with high fats and sugars is thought to be one of the factors linked to inflammation, however it is not proven.

What is the autoimmune protocol diet?

The autoimmune protocol (AIP) diet is an elimination diet that helps identify foods that trigger an immune response and triggers symptoms in people with autoimmune disorders. The goal of the AIP diet is to discover which foods cause pain, inflammation, fatigue, joint pain, and other symptoms of autoimmune diseases.

The thinking behind the autoimmune protocol (AIP) diet is that certain foods increase intestinal permeability, thereby increasing the chances of developing a “leaky gut.” It is believed that when food particles escape from a leaky gut and enter the bloodstream, they trigger an abnormal immune response, leading to flare-ups of autoimmune symptoms. The AIP diet is also believed to rebalance the good and bad bacteria in the gut.

The AIP diet, similar to the paleo diet but stricter, focuses on eliminating foods that can lead to a leaky gut and replacing them with foods that are believed to heal the gut mucosa. While experts believe the leaky gut theory is a plausible explanation for why certain foods cause flares of autoimmune diseases, research has not shown a direct cause-effect relationship. The evidence supporting the usefulness of the AIP or autoimmune protocol diet is therefore promising but limited.

What foods are bad for autoimmune disease? 

Whether you’ve been newly diagnosed with an autoimmune disease like rheumatoid arthritis or you’ve been living with it for a while, figuring out what foods might be triggering your flare-ups is something worth trying. It can help keep inflammation down and help you go longer between autoimmune attacks. Some of the foods to avoid that are known to affect the immune system in people with autoimmune diseases include:

• Nightshade vegetables like potatoes, tomatoes, peppers, eggplants
• Grains like wheat, rice, oats, rye, barley, and foods made from grains such as breakfast cereals, bread, pasta. (The AIP diet removes gluten which is believed to cause inflammation in susceptible individuals).
• Legumes like lentils, peas, beans, peanuts, and foods made from them such as tofu, peanut butter, mock meats
• Eggs
• Dairy products like milk, cream, cheese, butter
• Processed vegetable oils
• Refined sugars
• Nuts and seeds
• Beverages like coffee and alcohol
• Food additives including artificial sweeteners, food colors, thickeners, etc.

Why are potatoes bad for autoimmune disease?

An autoimmune protocol diet can be challenging to follow and can affect your lifestyle (for example, what you eat in social situations). It requires the elimination (and subsequent reintroduction one at a time) of common foods that are dietary staples for many people, such as potatoes and tomatoes. In particular, nightshade vegetables like potatoes are frequently blamed for causing flare-ups of autoimmune diseases. Research has shown that these vegetables contain substances called alkaloids like solanine in green potatoes that can trigger the immune system and cause inflammation in people with autoimmune disease. Besides irritating the gut, they are also believed to cause joint inflammation and flare-ups of rheumatoid arthritis. But, according to the arthritis foundation, the belief that eating nightshade vegetables worsens arthritis is a myth. They claim people with arthritis may benefit from the high nutrition content in nightshades.

What foods help autoimmune conditions? 

Certain foods are believed to reduce inflammation and help people with autoimmune conditions such as rheumatoid arthritis, celiac disease, multiple sclerosis, and others. Foods to eat if you have an autoimmune disease include:

• All vegetables except nightshade vegetables. Vegetables from the squash family (butternut, pumpkin, zucchini) are recommended to control inflammation because they contain omega-3 fatty acids and antioxidants.
• Tubers such as yams, sweet potatoes, taro, Jerusalem artichokes
• Fresh fruit
• Seafood, poultry, and other minimally processed meats
• Fermented and probiotic foods, especially non-dairy fermented foods like kombucha, kimchi, pickles, and sauerkraut. If you cannot eat probiotic-rich foods, a probiotic supplement may help.
• Vegetable oils that are minimally processed such as olive oil, coconut oil, avocado oil
• Herbs and spices not derived from seeds
• Balsamic vinegar, red wine vinegar, apple cider vinegar (no-added-sugar vinegars)
• Natural sweeteners like honey and maple syrup
• Bone broth
• Green tea and black tea (in moderation)

Should I try an anti-inflammatory diet for autoimmune disease?

Anti-inflammatory diets like the autoimmune protocol AIP diet are designed to help reduce pain, inflammation, and other symptoms of autoimmune diseases. They can help people with autoimmune diseases such as lupus, inflammatory bowel disease, celiac disease, and rheumatoid arthritis have more good days and go longer between flare ups. By helping such patients identify the foods that may be triggering their autoimmune symptoms, an elimination diet can aid disease management. However, keep in mind that there is no guarantee that the AIP or any other anti-inflammatory diet will reduce inflammation and other autoimmune disease symptoms.

One of the downsides of an elimination diet such as the autoimmune protocol diet is that it can affect overall health and nutrition by reducing the intake of essential nutrients. If followed for a long time, it can lead to nutrient deficiencies, such as a vitamin deficiency. Also, if you find the AIP diet helps, you may be fearful of reintroducing the foods you have eliminated. This can be problematic, making it difficult for you to meet your daily nutrition requirements.

If you decide to give an anti-inflammatory diet for an autoimmune disease a try, you should do it under the medical advice and supervision of a dietitian or healthcare professional. This will help you more accurately pinpoint what foods could be causing your symptoms while continuing to meet your nutrition requirements as best as possible.

References:

1. https://medlineplus.gov/ency/article/000816.htm#:

2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8001864/

3. https://pubmed.ncbi.nlm.nih.gov/20198430/