The word “autoimmune” is something that has been coming up more and more frequently in recent years. An autoimmune disease is essentially any illness where the immune system mistakenly identifies healthy cells as foreign and so attacks them. This might be in a particular area of the body, for example in coeliac disease where the immune system attacks the small intestine. Other autoimmune diseases affect the whole body such as lupus. There are more than eighty different types of autoimmune disease, including Graves’ disease, Crohn’s disease and type 1 diabetes. As well as this there are conditions such as acne, eczema and IBS which are often considered by some to be “autoimmune spectrum disorders,” all characterised by inflammation in the body. Many autoimmune diseases have similar symptoms which overlap with other illnesses, and this can make them hard to diagnose. There are no official figures for how many people in the UK are affected by autoimmune disease, but according to the British Society for Immunology, there are hundreds of thousands of people affected. It is also worth bearing in mind that there are probably many more struggling with low-level conditions that remain as yet undiagnosed. Although many autoimmune diseases are considered to be genetic, factors such as diet, lifestyle and environment can have a significant impact both on symptoms and on development of the autoimmune disease. Although you could probably never be considered “cured” of an autoimmune disease, there is a chance that through diet and lifestyle changes you could put it into remission. This is where Autoimmune Protocol, or AiP for short, comes in. AiP is essentially a variation of the Paleo diet, with additional emphasis on nutrient density and more strict guidelines on foods to be eliminated from the diet. Although it is mostly used to help those with autoimmune disease, the protocol is designed to help heal the immune system and gut flora in general, and so can be beneficial for any type of inflammatory disease or condition. Many of us will have experimented with removing certain foods at some point, and you could be forgiven for thinking AiP is just your standard elimination diet. While it does involve eliminating many different foods, it is much more detailed, with the aim of removing all autoimmune triggers that may cause inflammation in the gut. What are autoimmune triggers? An autoimmune trigger is something that is considered to be a trigger to autoimmune disease, switching on that mistaken response from your body where it begins to attack healthy tissue. The most common trigger – the one we hear a lot about these days – is gluten. If you visit your GP to test for gluten sensitivity, they will usually perform a standard test for anti-transglutamine antibodies which will show whether you have coeliac disease. If this test result is negative, you will usually be told you should carry on eating gluten because there is no allergic response present. However, you don’t need to have coeliac disease to be intolerant to gluten. Like so many things, there is a spectrum and you may find that you have non-coeliac gluten sensitivity. Frustratingly, another autoimmune trigger is gluten-free grain. Many of us, when cutting gluten from our diets will opt for rice or oats instead of wheat-based products. The problem is that the proteins in these grains can be very similar to gluten in their structure and effect on our bodies so they may still elicit an autoimmune response. Sugar is another potential dietary trigger of autoimmunity – and another thing it can be hard to avoid. These days sugar is added to hundreds of pre-packaged foods, even savoury ones. It is worth noting here that it is fructose, a component of sugar, rather than sugar itself that can cause problems in the body. This means that the so-called “healthy” sugars such as agave nectar and honey, are also considered triggers for autoimmunity. The main protein found in milk, casein, can be a major trigger for autoimmunity and inflammation in the body, and so in AiP all dairy products are removed. Sometimes ghee or clarified butter will be used instead of dairy, because the clarification process removes the casein. Some people with autoimmunity disorders can tolerate fermented dairy, but to begin with it’s often best to eliminate all dairy before slowly reintroducing things like ghee or kefir. Nightshade foods such as tomatoes, potatoes and peppers can be a trigger of autoimmunity for many people and so these are removed in AiP. These plants all contain alkaloids in their skins which can cause an inflammatory response in the body. AiP removes these autoimmune triggers, aiming to calm the gut and introduce healthy flora and boost the gut microbiome. There are several different interpretations of AiP, each often focussing on a particular autoimmune disease or condition. Essentially in AiP foods are seen as either promoting health or undermining health. The triggers mentioned above mostly fall clearly into the “undermining” category, while foods such as vegetables and organic meats will fall into the “promoting” category. The majority of foods though will fall into the murky grey area between the two. For example, if you are not sensitive to nightshades then tomatoes are amazingly nutritious and beneficial – but if you are sensitive to them, they are to be avoided. The main difference between a standard Paleo diet and AiP is that there is a distinct line in the sand between “yes foods” and “no foods” – there is little space for grey areas, and the diet allows only those foods that are clearly and definitely beneficial. The main aim of AiP is to flood the body with nutrients while also removing anything that may trigger an autoimmune response. This allows the gut to repair itself, repopulating with healthy, “good” bacteria. Once the symptoms of an autoimmune response have died down those foods that were in the grey area – having some nutritional benefit but possibly a trigger – are slowly reintroduced. If you are thinking of trying AiP, it is worth speaking to a nutritionist or other health practitioner with experience in the field. You will no doubt come up against resistance from friends and family who feel this type of diet is too extreme. While AiP can be seen as an extreme way of getting an autoimmune disease under control, it is one of those things where – aside from withdrawal symptoms from cutting out certain foods – there is no down side. Often the drugs we are prescribed come with a worrying list of side effects, so if a diet protocol can help reduce or even eliminate the need for drugs, it is worth the short term discomfort and inconvenience involved in AiP.