Announcing Modified AIP: A 2024 Update to the Autoimmune Protocol

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. 

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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