What question did this study set out to answer?

The study aims to evaluate the feasibility and effectiveness of the AIP diet on patient-reported outcomes in adults with rheumatoid arthritis.

April 6, 2026Open Access

The Effect of an Autoimmune Protocol (AIP) Diet in Adults With Rheumatoid Arthritis: A Single Arm Crossover Pilot Feasibility Study

JMJulianne McNeillAuckland University of Technology GMGael MearnsAuckland University of Technology RGRebecca GraingerUniversity of Otago

Key Points

The study aims to evaluate the feasibility and effectiveness of the AIP diet on patient-reported outcomes in adults with rheumatoid arthritis.
Single-arm, open-label pilot study design
Nine adults with RA followed their usual diet for 4 weeks
Participants then followed an 8-week AIP diet in a free-living context
Weekly assessments included RAPID3 and RAID scores along with food records and biometric measurements
Adherence and implementation ease were recorded weekly
Mean RAPID3 scores decreased significantly from 2.73 to 0.99
Four participants showed a clinically meaningful reduction; three reached remission with low disease activity
Mean RAID scores dropped from 3.13 to 1.02
Improvements noted in fatigue, sleep, and pain for several participants
Mean body mass index reduced from 26.3 to 24.5 kg/m²

Abstract

ABSTRACT Background Individuals with rheumatoid arthritis (RA) often ask whether dietary changes or food exclusions can reduce symptoms. The Autoimmune Protocol (AIP) diet, an elimination‐based approach, is popular on social media, with anecdotal reports of benefit, but lacks clinical evaluation in RA. Objectives To assess the feasibility and effectiveness of an AIP diet on patient‐reported outcomes (PROs) in adults with RA. Methods In this single‐arm, open‐label pilot study, nine adults with RA followed their usual diet for 4 weeks and then an 8‐week AIP diet in a free‐living context. Weekly PRO measures included the Routine Assessment of Patient Index Data 3 (RAPID3) and RA Impact of Disease (RAID) as primary outcomes. Secondary outcomes included 3‐day weighed food records and biometric measurements (weight and waist circumference) collected at baseline and every 4 weeks. Adherence and ease of implementation were recorded weekly. Results Nine participants (7 females, 2 males, aged 40–63 years) completed the intervention. From baseline to end week 12, mean RAPID3 scores decreased from 2.73/10 (range 0.2–5.37) to 0.99 (0–2.5). Four participants demonstrated a clinically meaningful reduction and three others reached remission from low disease activity. Mean RAID scores decreased from 3.13/10 (0.1–6.35) to 1.02 (0–2.96). Fatigue, sleep and pain improved. Mean body mass index reduced from 26.3 kg/m 2 to 24.5 kg/m 2 . The diet was feasible with high adherence. Conclusions An 8‐week AIP diet was associated with improvements in PROs in seven of nine participants. These pilot findings support further controlled trials to confirm efficacy and explore mechanisms as a potential adjunct therapy for RA. Trial Registration Number ACTRN12624001391561. https://www.anzctr.org.au/ACTRN12624001391561.aspx

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