journal article·2026-01-29Open access

Autoimmune Protocol Diet (AIP) for Food Allergies: A Novel Immunonutrition Approach

Eleni C. Pardali, Maria G. Grammatikopoulou

Applied Sciences· Volume 16· Issue 3

Abstract

The prevalence of allergies is increasing worldwide. In addition to pharmacological treatment, dietary management represents an established component of food allergy care. Elimination diets have long been recognized as an effective therapy for certain conditions, including food allergies. The Autoimmune Protocol (AIP) diet, a restrictive elimination diet originally developed for patients with autoimmune diseases, has gained popularity recently. Its underlying rationale, centered on immune regulation, intestinal epithelial barrier function, and gut dysbiosis, suggests potential relevance to food allergies. Moreover, the AIP excludes most of the major food allergens, which may support symptom reduction and facilitate the identification of individual dietary triggers. The role of histamine in allergic responses further highlights the AIP’s potential applicability in cases of histamine intolerance, where reducing the overall histamine burden could be beneficial. This narrative review aimed to synthesize the limited available evidence on the AIP and explore its potential implementation, mechanisms, and limitations in the context of food allergies.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Food Allergy and Anaphylaxis Research · Mast cells and histamine · Urticaria and Related Conditions

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Immunonutrition Unit, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41223 Larissa, Greece

References (96)

Show source-provided references
1. Loh, W., and Tang, M.L.K. (2018). The Epidemiology of Food Allergy in the Global Context. Int. J. Environ. Res. Public Health, 15.10.3390/ijerph15092043 ↗
2. Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 354 Diseases and Injuries for 195 Countries and Territories, 1990–2017: A Systematic Analysis for the Global Burden of Disease Study 2017
3. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel10.1016/j.jaci.2010.10.008 ↗
4. Gut-Microbiota-Targeted Diets Modulate Human Immune Status10.1016/j.cell.2021.06.019 ↗
5. Effect of Elimination Diets on Food-Specific IgE Antibodies and Lymphocyte Proliferative Responses to Food Antigens in Atopic Dermatitis Patients Exhibiting Sensitivity to Food Allergens10.1016/0091-6749(93)90273-I ↗
6. Fischer, K., Jones, M., and O’Neill, H.M. (2025). Prevalence of Intolerance to Amines and Salicylates in Individuals with Atopic Dermatitis: A Systematic Review and Meta-Analysis. Nutrients, 17.10.3390/nu17101628 ↗
7. Autoimmune Protocol Diet: A Personalized Elimination Diet for Patients with Autoimmune Diseases10.1016/j.metop.2024.100342 ↗
8. Ballantyne, S. (2013). The Paleo Approach: Reverse Autoimmune Disease and Heal Your Body, Victory Belt Publishing.
9. The Epithelial Barrier Theory and Its Associated Diseases10.1111/all.16318 ↗
10. Food Allergy: Immune Mechanisms, Diagnosis and Immunotherapy10.1038/nri.2016.111 ↗
11. (2026, January 22). Canva. Available online: https://www.canva.com/.
12. Gargano, D., Appanna, R., Santonicola, A., De Bartolomeis, F., Stellato, C., Cianferoni, A., Casolaro, V., and Iovino, P. (2021). Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns. Nutrients, 13.10.3390/nu13051638 ↗
13. Does the Epithelial Barrier Hypothesis Explain the Increase in Allergy, Autoimmunity and Other Chronic Conditions?10.1038/s41577-021-00538-7 ↗
14. Regulation of Intestinal Epithelial Permeability by Tight Junctions10.1007/s00018-012-1070-x ↗
15. Intestinal Permeability Disturbances: Causes, Diseases and Therapy10.1007/s10238-024-01496-9 ↗
16. Food Allergies: The Basics10.1053/j.gastro.2015.02.006 ↗
17. Gut Dysbiosis Promotes the Breakdown of Oral Tolerance Mediated through Dysfunction of Mucosal Dendritic Cells10.1016/j.celrep.2023.112431 ↗
18. Triggers of IgE Class Switching and Allergy Development10.1080/07853890701449354 ↗
19. Role Played by Th2 Type Cytokines in IgE Mediated Allergy and Asthma10.4103/0970-2113.63609 ↗
20. Mu, Q., Kirby, J., Reilly, C.M., and Luo, X.M. (2017). Leaky Gut As a Danger Signal for Autoimmune Diseases. Front. Immunol., 8.10.3389/fimmu.2017.00598 ↗
21. Tight Junction Defects in Patients with Atopic Dermatitis10.1016/j.jaci.2010.10.018 ↗
22. Moon, T.C., Befus, A.D., and Kulka, M. (2014). Mast Cell Mediators: Their Differential Release and the Secretory Pathways Involved. Front. Immunol., 5.10.3389/fimmu.2014.00569 ↗
23. Food Sensitization Is Associated with Atopic Dermatitis Severity, Gut-Derived Metabolites and Leaky Gut in Adults10.1002/clt2.70094 ↗
24. IL-10 Enhances IgE-Independent IL-33-Mediated Mast Cell Cytokine Production10.4049/jimmunol.198.Supp.145.8 ↗
25. Arroyo Hornero, R., Hamad, I., Côrte-Real, B., and Kleinewietfeld, M. (2020). The Impact of Dietary Components on Regulatory T Cells and Disease. Front. Immunol., 11.10.3389/fimmu.2020.00253 ↗
26. The Effect of Bacterial, Viral and Fungal Infection on Mast Cell Reactivity in the Allergic Setting10.1159/000323350 ↗
27. Chun, J., and Toldi, G. (2022). The Impact of Short-Chain Fatty Acids on Neonatal Regulatory T Cells. Nutrients, 14.10.3390/nu14183670 ↗
28. Short-Chain Fatty Acids: Linking Diet, the Microbiome and Immunity10.1038/s41577-024-01014-8 ↗
29. The Microbial Metabolites, Short-Chain Fatty Acids, Regulate Colonic Treg Cell Homeostasis10.1126/science.1241165 ↗
30. Commensal Microbe-Derived Butyrate Induces the Differentiation of Colonic Regulatory T Cells10.1038/nature12721 ↗
31. Bifidobacteria Can Protect from Enteropathogenic Infection through Production of Acetate10.1038/nature09646 ↗
32. Szukalska, I., Ziętek, M., Brodowski, J., and Szczuko, M. (2025). The Association Between Short-Chain Fatty Acids and the Incidence of Food Allergies—Systematic Review. Nutrients, 17.10.3390/nu17193117 ↗
33. Allergy Development and the Intestinal Microflora during the First Year of Life10.1067/mai.2001.118130 ↗
34. Extracellular Vesicle–Derived Protein from Bifidobacterium Longum Alleviates Food Allergy Through Mast Cell Suppression10.1016/j.jaci.2015.08.016 ↗
35. Effects of Bifidobacterial Supplementation to Pregnant Women and Infants in the Prevention of Allergy Development in Infants and on Fecal Microbiota10.2332/allergolint.13-OA-0683 ↗
36. Administration of a Probiotic with Peanut Oral Immunotherapy: A Randomized Trial10.1016/j.jaci.2014.11.034 ↗
37. Antinuclear Antibodies in Autoimmune and Allergic Diseases10.5114/reum.2017.72627 ↗
38. Allergic Diseases and Long-Term Risk of Autoimmune Disorders: Longitudinal Cohort Study and Cluster Analysis10.1183/13993003.00476-2019 ↗
39. Allergy, Family History of Autoimmune Diseases, and the Risk of Multiple Sclerosis
40. Atopic Dermatitis and Risk of Autoimmune Diseases: A Systematic Review and Meta-Analysis10.1186/s13223-021-00597-4 ↗
41. Cow’s Milk Allergy in Infancy and Later Development of Type 1 Diabetes–Nationwide Case-Cohort Study10.1111/pedi.13181 ↗
42. The Role of Histamine in Allergic Diseases10.1016/S0091-6749(05)80223-4 ↗
43. Histamine and Histamine Intolerance10.1093/ajcn/85.5.1185 ↗
44. The Basics of Histamine Biology10.1016/j.anai.2010.08.005 ↗
45. Concomitant Prevalence of Low Serum Diamine Oxidase Activity and Carbohydrate Malabsorption10.1155/2016/4893501 ↗
46. Sánchez-Pérez, S., Comas-Basté, O., Duelo, A., Veciana-Nogués, M.T., Berlanga, M., Latorre-Moratalla, M.L., and Vidal-Carou, M.C. (2022). Intestinal Dysbiosis in Patients with Histamine Intolerance. Nutrients, 14.10.3390/nu14091774 ↗
47. German Guideline for the Management of Adverse Reactions to Ingested Histamine10.1007/s40629-017-0011-5 ↗
48. Hrubisko, M., Danis, R., Huorka, M., and Wawruch, M. (2021). Histamine Intolerance—The More We Know the Less We Know. A Review. Nutrients, 13.10.3390/nu13072228 ↗
49. Kanta, D., Katsamakas, E., Gudiksen, A.M.B., and Jalili, M. (2025). Histamine Metabolism in IBD: Towards Precision Nutrition. Nutrients, 17.10.20944/preprints202507.0059.v1 ↗
50. Non-Responsive Celiac Disease May Coincide with Additional Food Intolerance/Malabsorption, Including Histamine Intolerance10.1016/j.mehy.2020.110404 ↗
51. Sánchez-Pérez, S., Comas-Basté, O., Duelo, A., Veciana-Nogués, M.T., Berlanga, M., Vidal-Carou, M.C., and Latorre-Moratalla, M.L. (2022). The Dietary Treatment of Histamine Intolerance Reduces the Abundance of Some Histamine-Secreting Bacteria of the Gut Microbiota in Histamine Intolerant Women. A Pilot Study. Front. Nutr., 9.10.3389/fnut.2022.1018463 ↗
52. Lyophilised Legume Sprouts as a Functional Ingredient for Diamine Oxidase Enzyme Supplementation in Histamine Intolerance10.1016/j.lwt.2020.109201 ↗
53. Histamine Intolerance and Dietary Management: A Complete Review10.1016/j.aller.2016.04.015 ↗
54. Histamine-Reduced Diet and Increase of Serum Diamine Oxidase Correlating to Diet Compliance in Histamine Intolerance10.1038/s41430-018-0260-5 ↗
55. Histamine Intolerance as a Cause of Chronic Digestive Complaints in Pediatric Patients10.4321/S1130-01082013000400004 ↗
56. Tyramine and Histamine Risk Assessment Related to Consumption of Dry Fermented Sausages by the Spanish Population10.1016/j.fct.2016.11.011 ↗
57. Sánchez-Pérez, S., Comas-Basté, O., Rabell-González, J., Veciana-Nogués, M.T., Latorre-Moratalla, M.L., and Vidal-Carou, M.C. (2018). Biogenic Amines in Plant-Origin Foods: Are They Frequently Underestimated in Low-Histamine Diets?. Foods, 7.10.3390/foods7120205 ↗
58. Sánchez-Pérez, S., Comas-Basté, O., Veciana-Nogués, M.T., Latorre-Moratalla, M.L., and Vidal-Carou, M.C. (2021). Low-Histamine Diets: Is the Exclusion of Foods Justified by Their Histamine Content?. Nutrients, 13.10.3390/nu13051395 ↗
59. Gill, P.A., Inniss, S., Kumagai, T., Rahman, F.Z., and Smith, A.M. (2022). The Role of Diet and Gut Microbiota in Regulating Gastrointestinal and Inflammatory Disease. Front. Immunol., 13.10.3389/fimmu.2022.866059 ↗
60. Role of Maternal Elimination Diets and Human Milk IgA in the Development of Cow’s Milk Allergy in the Infants10.1111/cea.12228 ↗
61. Nutritional Management of Food Allergies10.2500/jfa.2020.2.200032 ↗
62. Role of the Elimination Diet in Adults with Food Allergy10.1016/0091-6749(89)90360-6 ↗
63. World Health Organization (WHO) (2025, December 15). In Brief: Priority Food Allergens. Available online: https://www.who.int/publications/i/item/B09009.
64. Efficacy of Elimination Diets in Eosinophilic Esophagitis: A Systematic Review and Meta-Analysis10.1016/j.cgh.2023.01.019 ↗
65. Long-Term Outcomes of the Six-Food Elimination Diet and Food Reintroduction in a Large Cohort of Adults with Eosinophilic Esophagitis10.14309/ajg.0000000000001949 ↗
66. Dietary Elimination for the Treatment of Atopic Dermatitis: A Systematic Review and Meta-Analysis10.1016/j.jaip.2022.06.044 ↗
67. The Impact of the Elimination Diet on Growth and Nutrient Intake in Children with Food Protein Induced Gastrointestinal Allergies10.1186/s13601-016-0115-x ↗
68. Origins and Evolution of the Western Diet: Health Implications for the 21st Century10.1093/ajcn.81.2.341 ↗
69. Modulation of Immune Function by Dietary Lectins in Rheumatoid Arthritis10.1017/S0007114500000271 ↗
70. Cereal Grains: Humanity’s Double-Edged Sword10.1159/000059677 ↗
71. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-Disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis
72. Effects of Autoimmune Protocol (AIP) Diet on Changes in Thyroid Parameters in Hashimoto’s Disease10.26444/aaem/166263 ↗
73. Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease10.1097/MIB.0000000000001221 ↗
74. The Autoimmune Protocol Diet Modifies Intestinal RNA Expression in Inflammatory Bowel Disease10.1093/crocol/otz016 ↗
75. An Autoimmune Protocol Diet Improves Patient-Reported Quality of Life in Inflammatory Bowel Disease10.1093/crocol/otz019 ↗
76. What Is the Efficacy of the Autoimmune Protocol (AIP) Diet in People with Rheumatoid Arthritis? A Mixed-Methods Pilot Intervention Study
77. (2025, December 23). NCT07022574. Autoimmune Protocol Diet Intervention on Proteinuria in IgA Nephropathy Patients. ClinicalTrials.Gov, Available online: https://www.clinicaltrials.gov/study/NCT07022574.
78. Zonulin, a Regulator of Epithelial and Endothelial Barrier Functions, and Its Involvement in Chronic Inflammatory Diseases10.1080/21688370.2016.1251384 ↗
79. Gliadin, Zonulin and Gut Permeability: Effects on Celiac and Non-Celiac Intestinal Mucosa and Intestinal Cell Lines10.1080/00365520500235334 ↗
80. Changes in Intestinal Tight Junction Permeability Associated with Industrial Food Additives Explain the Rising Incidence of Autoimmune Disease10.1016/j.autrev.2015.01.009 ↗
82. Influence of Dietary Components on Regulatory T Cells10.2119/molmed.2011.00311 ↗
83. IgG Antibodies against Food Antigens Are Correlated with Inflammation and Intima Media Thickness in Obese Juveniles
84. The Half-Lives of IgG Subclasses and Specific Antibodies in Patients with Primary Immunodeficiency Who Are Receiving Intravenously Administered Immunoglobulin
85. Blocking Antibodies in Immunotherapy: Quality versus Quantity10.1016/j.jaci.2019.09.024 ↗
86. Joneja, J.M.V. (2003). Dealing with Food Allergies: A Practical Guide to Detecting Culprit Foods and Eating a Healthy, Enjoyable Diet, Bull Publishing Company.
87. Haque, T.T., and Frischmeyer-Guerrerio, P.A. (2022). The Role of TGFβ and Other Cytokines in Regulating Mast Cell Functions in Allergic Inflammation. Int. J. Mol. Sci., 23.10.3390/ijms231810864 ↗
88. Vitamin B-6 Nutriture and Plasma Diamine Oxidase Activity in Pregnant Hispanic Teenagers10.1093/ajcn/44.6.907 ↗
89. Cofactor Levels of Mono- and Diamine Oxidase in Atopic Eczema10.1111/j.1398-9995.1989.tb01074.x ↗
90. Impact of Oral Vitamin C on Histamine Levels and Seasickness10.3233/VES-140509 ↗
91. Allergen Immunotherapy for Food Allergy: Evidence and Outlook10.5414/ALX02319E ↗
92. A Case of Egg Poisoning10.1016/S0140-6736(00)67313-0 ↗
93. Qin, L., Tang, L.-F., Cheng, L., and Wang, H.-Y. (2022). The Clinical Significance of Allergen-Specific IgG4 in Allergic Diseases. Front. Immunol., 13.10.3389/fimmu.2022.1032909 ↗
94. Valero-Moreno, S., Torres-Llanos, R., and Pérez-Marín, M. (2024). Impact of Childhood Food Allergy on Quality of Life: A Systematic Review. Appl. Sci., 14.10.3390/app142310989 ↗
95. Social Determinants and Quality of Life in Food Allergy Management and Treatment10.1016/j.jaip.2025.02.016 ↗
96. Quality of Life in Patients with Food Allergy10.1186/s12948-016-0041-4 ↗