Since inception in 2011, the Autoimmune Protocol (AIP) has not undergone any major updates or changes and has existed as originally conceived by experts and used by the autoimmune community. Today, that is changing with the announcement of a new option: Modified AIP Elimination. This post serves to provide the rationale behind this change as well as provide links for learning more about the new protocol.
Reasons to update AIP
First, let’s discuss some AIP history and what led to these changes. Originally, Sarah Ballantyne, PhD. wrote extensively about and refined the protocol on her blog and in her books, which formed the foundations of the AIP protocol and movement. These foundations led to collaboration between leaders in the AIP community in the creation of the AIP Certified Coach Practitioner Training, serving to educate healthcare providers in best practices for using AIP with their clients and patients.
Additionally, Sarah’s research and writing sparked interest from the medical community to formally study the efficacy of AIP for various autoimmune conditions, including Crohn’s disease, ulcerative colitis, Hashimoto’s thyroiditis, rheumatoid arthritis, and psoriasis. While medical research into the efficacy of AIP is still in its infancy, early results have shown promise at helping those with autoimmune disease achieve a higher quality of life, less symptom burden, and need less medication (you can read a review of all the results here).
Now that there is an emerging body of research into the efficacy of AIP, as well as a large group of practitioners with many collective years of expertise in AIP implementation and customization, it is time for analysis to see what is working and what could be made better for the next wave of individuals looking to embark on the protocol. Here are the major reasons why the Autoimmune Protocol is being updated now:
#1 Many patients in the AIP medical studies saw results before reaching a full elimination
In each of the AIP medical studies, a 6-week, gradual transition was used to ease patients into the elimination phase, which was then maintained for 4 more weeks. In the AIP IBD Study, 73% of patients achieved clinical remission at week 5, which was 1 week before the full elimination was complete. In this study, all of these patients then maintained clinical remission throughout the duration of the study and no additional patients reached clinical remission after this point. What this tells us is that it is likely the earliest eliminations, specifically, that were most responsible for the favorable results and that the full elimination phase may not have been necessary for all of them.
#2 AIP Certified Coaches are reporting good results without a full elimination
The Autoimmune Protocol has now been in widespread use in the practitioner community for many years through AIP Certified Coach. Nearly 1,000 healthcare providers from all types of backgrounds and specialties have been trained and certified to implement AIP in their work. In surveying the graduate community, AIP Certified Coaches have told us that they often find the original protocol is more restrictive than necessary and they are often modifying the list of eliminations to suit their clients’ and patients’ needs. They also report that they continue to see good results using a modified or less restricted elimination protocol.
#3 Other elimination diet research indicates that stricter is not always better
When AIP was conceived there was very little research into the efficacy of elimination diets to help manage autoimmune disease, especially conducted directly with humans. In the last decade, this has changed and many studies have been published using different elimination protocols for specific autoimmune conditions, especially gluten-free and dairy-free diets. The promising results from studies using fewer eliminations shows that for some patients and conditions, progress can be made with a simpler approach.
#4 Increasing accessibility, affordability, and sustainability can widen the reach of AIP
Food access and budget have always been major barriers to individuals implementing the Autoimmune Protocol, both on their own or in working with a coach. Some patients are simply not able to source or afford the ingredients needed to implement a full elimination, and others don’t have the time to prepare the entirety of their meals from scratch. In this case, we’ve long recommended modifying the protocol to accommodate those facing these barriers, but providing an official version of the protocol that is more budget-friendly and accessible will allow even more people to find healing through AIP.
The process of updating AIP
Updating AIP in 2024 has come out of consultation with many key players in the AIP community over the course of a few months. We interviewed researchers who performed the AIP medical studies and research in other similar areas, as well as experts and writers in the area of autoimmune health. We also surveyed and interviewed key members of the AIP Certified Coach community who predominantly work with autoimmune patients or clients. Lastly, we considered recent scientific evidence for elimination diets, food allergies/sensitivities, and reintroduction protocols in the new approach.
What we learned from this exploration was two-fold: first, that the original protocol still had high value and efficacy in both research and practice. And second, that many researchers and AIP Certified Coaches were confident that some patients would be best served by a less-restrictive option. This led to the creation of two separate options for the elimination phase which are detailed below.
Introducing: Core AIP and Modified AIP
Going forward, there are now two versions of the Elimination Phase, to be known as AIP Core Elimination and AIP Modified Elimination.
The original protocol, as used in the AIP medical studies and original AIP literature is not changing and will now be known as AIP Core Elimination. The intention is to preserve the original protocol for research comparison and to use with patients or clients who either need a stricter approach or can implement it easily (due to support, finances, or time).
The new protocol, a less-strict and more accessible version will be known as AIP Modified Elimination. This new protocol incorporates what we’ve learned about foods that are well-tolerated in the autoimmune community, and is simplified for ease of implementation, budget, and accessibility.
You can read more about which foods are included and avoided in both Core AIP and Modified AIP Elimination protocols at the updated Definitive Guide to AIP.
Which protocol to start with?
This then leads to the question of which protocol a person should choose when they embark on the Autoimmune Protocol. That depends!
The goal of AIP has always been to discover the least-restrictive dietary approach that produces the best health for each person. With this in mind, Modified AIP is an ideal starting point for most people as it is more affordable, accessible, takes less time to implement, and still removes the most potentially-problematic foods. Ideally, modified AIP produces the desired result and then a person can move on to the reintroduction phase, sparing them a drawn-out elimination and reintroduction process.
There are a few reasons why a person would choose Core AIP to begin with. They may have a condition, like IBD, where research indicates that the elimination phase has a good chance of producing results quickly. Or they may have another condition that is potentially serious and are highly motivated to transition and implement to find relief. Lastly, they may not experience some of the barriers that make Core AIP difficult to implement – like a lack of cooking skill, financial flexibility, or support at home.
If you are looking for resources to start Core or Modified AIP, click here or on the image below to get our AIP Quicklstart Guide sent to your inbox, including food lists, meal plans, and more!
FAQ:
Is anything changing about the original AIP protocol?
No, the original protocol is now simply known as “Core AIP” for differentiation. All of the foods eliminated, included, timeline, and reintroduction procedure remain the same. See the updated Definitive Guide to AIP for food lists and more information.
Who has the right to update AIP?
There is no one expert that owns the rights to determine what the AIP protocol entails, and Dr. Sarah Ballantyne, whose work formed the foundation of the AIP movement, has moved on from researching and working with the autoimmune community. This is why this update is coming by consensus from the leaders of the AIP Certified Coach community as well as researchers who have studied the protocol in medical studies.
What happens to all of the recipes and resources labeled AIP?
All of the recipes, meal plans, and other resources created for Core AIP also apply to Modified AIP, since Core AIP simply has more eliminations than Modified AIP. As more resources for Modified AIP are created, a distinction will emerge and each person navigating either protocol should be careful to check recipes for compliant ingredients. Be sure to bookmark the updated Definitive Guide to AIP for reference as it will always contain the most current protocol information and food lists.
How does this change the reintroduction protocol?
The reintroduction protocol following Core AIP is the same as it was originally, and the reintroduction protocol following Modified AIP simply starts further along in the process since many foods in various reintroduction stages are already included during the elimination phase. You can learn more at the updated Reintroduction Guide.
This is a big update, and one that is bound to increase the amount of people who are positively affected by embarking on the Autoimmune Protocol. If you have any questions that aren’t addressed here, feel free to post them in the comments!
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Downloadable resources
If you are looking to get started with AIP, you will want to sign up to get the AIP Quick Start Guide. Just pop your email in the box below and we will send you the following resources over the course of a week:
- Complete, printable lists of the foods to avoid and include during AIP
- A 2-week AIP meal plan and shopping list
- A 90-minute batch cooking video from Mickey
- Printable guides on food reintroductions and reactions
You will then be subscribed to our occasional newsletter, where we deliver free, exclusive content in the form of tips, articles, recipes, news, and more. By signing up, you will be the first to know about what is happening in the autoimmune community!
50 comments
This is exciting news! Thanks for sharing the updated research!
My pleasure, Beth!
Thank you for your research and this article. I started the AIP elimination diet 9 years ago with amazing results! I have added many foods back into my diet. Now I’m eager to try adding legumes.
So happy to hear, Deb, and I hope those legumes treat you well!
Is there a food list for the modified aip ?
Hi Nadia! You can find the food lists at the updated AIP Definitive Guide: https://autoimmunewellness.com/what-is-aip-the-definitive-guide/
This link goes to and article published in 2016. Is this the updated guide?
Hi Jodi, if you read the top of that post, you’ll see it was updated in 2024!
This is so helpful! Thank you.
I can’t tell from the two lists if the modified AIP includes or excludes vegetable oils such as safflower, sunflower, canola and other vegetable oils. Can you clarify?
Carolyn,
Seed and vegetable oils are included on Modified AIP, but because they occur in a lot of processed foods, it is likely they will be minimized naturally.
Wow… really? Allowing seed oils? I am all for progress and easing things up so more people can access it… but this strikes at the heart and legitimacy of the information being given to us. Seed oils are HORRIBLE for us. They should not even be on the radar at all. This is kind of shocking as someone who has followed the tenets of AIP moving into a paleo lifestyle for almost a decade. Really disappointing.
Hi Tangie! I understand you personally don’t agree, but we’ve looked at both the research and what is working in practice, and seed oils are just not coming up as problematic for most, which is why they are included in the modified protocol. You can always choose to avoid them if your personal research and/or believes line up otherwise! Good luck.
Very excited about this! Is there any particular type of coffee I should avoid (type of roast, caffeine level, etc.). Same question for rice. Any particular type of rice I should be leaning towards? Thank you!
Hi Kunal! Happy to hear you are excited. For coffee, I would go for a source that is fresh and avoid pre-ground and instant coffee (easy to come across cross-contamination in food manufacturing, especially gluten). Any kind of rice is included, but if you suspect you might have a sensitivity to rice white rice is usually more tolerable as some people find the bran in brown rice more irritating. Good luck!
Will their be Modified AIP recipes at some point?
Thank you so much for the helpful work you do!
Hi Kris! We don’t have plans to start publishing Modified AIP recipes, but you can work from Core AIP ones and just add rice and/or legumes as needed!
I started AIP in January 2023 to help my hypothyroidism, and I have found very positive results. I am wondering then, should I transition to modified AIP and reintro the foods that are allowed on the modified version first? Or, should I proceed with core AIP re-introductions?
Miranda,
Great to hear! If you have already implemented Core AIP and are seeing improvements, I would reintroduce foods using the Core AIP reintroduction stages. You’ve already done the hard work of implementing that protocol. Good luck to you!
Thank you Mickey for this update and explanation on Sarah’s work! I was definately confused about those of us with AI who cannot eat certain foods. Keep up the great work!
Hi Sherilyn! I’m so happy it has been helpful to you.
I have followed you guys since the early days- I participated in the first ever SAD-AIP-SIX!! 😀 I also got to meet you at Mission Heirloom in Berkeley 🙂
I have always been so grateful for your leadership, and now even more so. The reason I trusted you guys was that your approach was scientific- and, almost as important, that you were autoimmune warriors yourself. My health improved so much, I’ve literally never felt better, or more empowered!!!
However, my life circumstances have changed drastically since then and my diet has gone WAY below the bar of what I need- and my health has plummeted 🙁 I’ve tried in vain so many times to return to AIP and start all over again. But many of the barriers you’ve listed here apply to me now, so I am THRILLED that you guys are keeping current with the research and applying what you’ve learned in clinical practice, and that you’re now able to teach us about another option!
You guys are the BEST and I’m so grateful you’re still around to lead us!! <3
Hi Melissa! Thank you so much for chiming in, and I’m so happy this resonates with you. Wishing you continued luck as you navigate life with autoimmune disease!
If I’m already doing Core AIP, can I switch to modified? If so, is the reintroduction procedure the same or can I speed it up?
Hi Alicia,
If you are already doing Core AIP, I recommend working the reintroduction stages for Core as you’ve already done the work to implement the harder protocol. If you find it isn’t sustainable, you can just switch to Modified AIP, and then reintroduce from there once you feel ready. Hope it helps!
I’m curious why ” Dr. Sarah Ballantyne, whose work formed the foundation of the AIP movement, has moved on from researching and working with the autoimmune community.”?
Any details?
Hi Julie! Sarah has a new project called Nutrivore – you can read more here: https://nutrivore.com/
Where can I find the full program? Not just a list of included foods but how to start I heard you mention removing two food groups a week etc… do I have to work with a coach for that?
Hi Chrissy! We don’t provide a slow transition guide, but that is absolutely something an AIP Certified Coach can help you with. You can find the directory here: http://aipcertified.com.
Is tahini allowed on the modified AIP plan?
Hi Sharon! Yes, tahini is allowed in modified AIP since it is made from sesame seed and seeds are included.
Hi! I’m seeing a list of all the NO foods for AIP modified, but is there a full list of YES foods? My grocery shopping brain could handle that more easily. Thanks! 🙂
Hi Angie! I have printable lists of both foods to avoid and include here: https://autoimmunewellness.myflodesk.com/core-modified-aip-quickstart-food-lists
Hi!
If we can have rice, does that include rice noodles and pasta (made only from rice flour, salt, water) and/or expanded rice cakes?
Thanks!
Hi Miga! If the other ingredients in the product are also included in Modified AIP, then yes that food is compliant. Good luck!
Is quinoa allowed on the modified autoimmune plan?
Hi Sharon! As a pseudo-grain (actually a seed!), quinoa is included in modified AIP.
Hello.
Good luck 🙂
Thanks for the information! I was put onto core AIP (I don’t know whether my doctor is aware of the modified version, but I’ll tell him next time I see him) and experienced major relief in my mental symptoms immediately, with a more gradual relief setting in over the next couple weeks. I’ve been starting to reintroduce things lately and I saw this info.
I will still be reintroducing properly as I’m already well on my way with the Core AIP, but it’s great to know I can likely start reintroducing more foods and maybe even faster, if I start working on a modified menu (as there’s plenty in the base modified menu that isn’t in the base core menu).
Very exciting times we live in — being on the experimental side of cutting-edge lifestyle changes like this 😀
Hi Kevin! I’m so happy to hear your doctor recommended AIP. Wishing you the best of luck as you navigate the protocol!
[…] seeds instead of cauliflower or the more traditional pine nuts. This would also keep it nut free. As of 2023, the AIP diet was slit into core and modified. Modified is less restrictive and allows seeds like pumpkin seeds and sunflower seeds. Using […]
I would simply like to thank you both for this site. My story is meandering, somewhat dull, and mostly inconclusive, but it’s my story and it’s been extremely frustrating and frightening. I began experiencing dangerous arrhythmias two years ago. At the time, it seemed they were coming out of the blue. I underwent an ablation, which successfully eliminated the “dangerous” part of it, but I’ve continued to experience frequent, long and intense episodes of atrial arrhythmias. The doctor was not interested whatsoever in investigating a root cause; he just kept prescribing more and more meds that were not working. I finally went to a GP, and began to really consider other issues I’d been experiencing for years, but assumed that they were normal or “just me”. I requested a battery of tests, several of which were positive (three pertaining to inflammation and immunity). This GP was just as uninterested and unhelpful as my EP. I was scheduled for another ablation to hopefully treat these nearly constant arrhythmias. Then, one day, I happened upon your website while searching for journals regarding SLE, Sjogren’s and autoimmunity. While I have for over a decade eliminated many foods from my diet, I began the AIP diet two months ago. I have not experienced a single arrhythmic episode in that entire time! My inflammation has markedly decreased, peripheral neuropathy, which has been a constant plague, is gone, and I could go on and on. I also stopped taking the meds my EP prescribed, and have been fine. I emailed the md, and he was underwhelmed; he wasn’t even curious. I canceled the 2nd ablation. My next question is whether to bother to see a rheumatologist for a decisive diagnosis. I still struggle with a lot of issues, many of which seem to correlate to my menstrual cycle, but I’m afraid of encountering another disinterested physician who will put me on more ineffective, destructive drugs.
Anyway, I just wanted to think you for providing recipes and information.
Hi Brynne! How scary! I am so happy AIP has helped you find a manageable level of health. I’ve personally suffered from heart rhythm issues and I know how scary and daunting that can be. I can’t offer specific advice regarding further testing/diagnosis, but I do wish you the best moving forward. Thank you for sharing!
Do you have a cookbook for the modified aip diet
Hi Lorraine! Not yet… but all Core AIP recipes also apply to Modified AIP, so the recipe archives here will be a great resource to you. I would suggest cooking sides of rice or beans as “add ons” to otherwise Core AIP recipes.
Thank you for this info. It’s a game-changer for me! I’m also enjoying your cookbook, which is helping me get started with AIP.
I signed up yesterday to receive the free printables of the food lists on this page, but I never received anything (checked junk mail, too). Could you please check that your autoresponder is working?
Hi Julie! I’m sorry you haven’t received the printables, I can confirm the autoresponder is working. Can you give it a try with a different email address?
Is rice vinegar allowed with modified? Seems like it would be since rice is allowed but I can’t find anything specifically calling it out.
Hi Broderick, yes rice vinegar is included in Modified AIP.
Hi! I have had Ulcerative Colitis for 50 years with it getting worse as I age. Wanting to get away from the prednisone and other suggested meds that can cause cancer, I have followed the Core AIP diet for 10 years. I had good success at the beginning. I added in a few things, but not in the order given – like eggs, green beans, and snacks like Siete chips which have chia seeds or flax seeds, pepper, homemade almond butter and a few nuts, and goat or sheep cheese, grass-fed butter – all with seemingly no problem, UNTIL… I would have a flare up! But not being sure which food may have caused it, I would have to go back to the beginning drinking bone broth and blending vegetables to ease my symptoms and start over AGAIN! I just recently went through a flare-up that could be only controlled with temporary medications. Would you recommend I start at ground 0 AGAIN and be more mindful and intentional with the Core Diet? I believe I read that you recommend the Core Diet for those with Ulcerative Colitis.
Thank you for your wisdom and all the work you do!
Hi Sharon! I am sorry to hear about your flare! It is really up to you if you want to try to go back to Core AIP or try Modified. I would say if you feel like Core AIP is easily achievable for you, then go for that, since you have a history of implementing it successfully and you know it was helpful in the past. If you feel stressed or like you could use a little more flexibility, Modified would be a good try. If that doesn’t seem to help in a few weeks, you can always try to shift to the more restricted protocol later. Whatever you decide, I hope your flare eases soon! Good luck!