Paleo vs Vegan for Autoimmune Disease: Which is Better?

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This was a particularly interesting question I came across because before I went vegan, I ate a pretty standard Paleo diet (I even wrote for sites like Paleohacks).

I recently did a bunch of research to find how a vegan diet affects autoimmune disease, so it seemed only natural to tackle this question.

At the end of it all, I found a clear winner: for those with or concerned about autoimmune disease, a vegan diet is the best (or at least the ‘safest’) choice.

I’ll explain why throughout the rest of this post.

The Paleo Diet and Autoimmune Disease 

Autoimmune disease occurs when your immune system attacks healthy tissue, causing inflammation and a whole bunch of related symptoms as a consequence.

It’s not surprising that diets that reduce inflammation typically lessen autoimmune disease symptoms.

A paleo does focus on including a lot of foods that can potentially reduce inflammation (i.e., fruits, vegetables, nuts). However, it does still include meat (animal proteins), which are known to increase inflammation levels (particularly red meat).

So the question becomes whether or not the overall effect is inflammatory or anti-inflammatory.

Very Little Research Has Been Done on The Paleo Diet and Inflammation

Here’s the problem: There’s been very little research done specifically on the Paleo diet.

None that I could find concerning treating autoimmune disease directly.

The only study I could find looked at the effect of the autoimmune protocol diet (AIP), which is an extension of the Paleo diet, on inflammatory bowel disease (IBD).

It’s not clear if IBD is an autoimmune disease itself, but it’s related to some of the more common ones.

So, this study had a sample size of 15, which isn’t great, but it’s something.

The subjects ate followed the AIP, which essentially includes NO:

  • Grains
  • Legumes
  • Nightshades
  • Dairy
  • Eggs
  • Coffee
  • Alcohol
  • Nuts and seeds
  • Refined sugars
  • Oils
  • Food additives

It’s honestly a more restrictive diet than a vegan diet.

It did get some good results.

Clinical remission was achieved at week 6 by 11/15 (73%) study participants, and all 11 maintained clinical remission during the maintenance phase of the study

It helped lessen the symptoms of most patients with IBD.

There are some important caveats to mention as well:

  • It’s a relatively small sample size. The purpose of the research was to see if doing larger studies would be worth it.
  • The levels of C-reactive protein (something your liver makes as an inflammatory response) did not change significantly. So while this modified paleo diet did reduce symptoms (likely by removing trigger substances), it did not reduce the underlying inflammation.

The biggest takeaway is that an AIP diet might help those specifically with certain forms of IBD, but there’s no evidence to suggest that it would help treat autoimmune diseases.

Vegan Diets and Autoimmune Disease

Vegan diets have been studied for decades as a potential aid in treating autoimmune diseases.

The overwhelming evidence has shown that they are quite effective.

Considering the following studies that focused on Rheumatoid Arthritis (a common autoimmune disease):

  • In a study that lasted just 4 weeks, a low-fat vegan diet decreased the severity of symptoms in RA patients including joint pain, swelling, and stiffness.
  • In a 1-year intervention study, subjects were put on a gluten-free vegan diet for 3.5 months, and then gradually transitioned to a vegetarian diet for the rest of the time. After 1 month, patients saw a significant improvement in joint tenderness, swelling, pain, duration of morning stiffness, and other RA symptoms. These improvements were still present at the end of the 1-year study.

There are several more studies that had similar conclusions.

A vegan diet will not cure autoimmune diseases, but it can be a key part of an effective management program.

Summary: Why Vegan Diets Are The Best Choice for Autoimmune Disease

A paleo diet, particularly a modified one like AID, might have beneficial effects for those with certain conditions like IBS. 

However, there’s just no research or evidence that really suggests if a paleo diet has any beneficial (or negative) effects for those with an autoimmune disease.

On the other hand, there’s a small mountain of evidence in support of a vegan diet helping to reduce the underlying inflammation of those with autoimmune diseases, and improving their health.

Based on that, the only things we can reasonably conclude is that a vegan diet is the better choice of the two, and that the paleo diet needs to be studied more before we can know if it’s effective or not.

About the author

Dale Cudmore

Your friendly neighborhood vegan from Toronto. Chemical engineer turned semi-professional soccer player and freelance nutrition writer. I've been vegan for years and try to make life easier for others by sharing what I've learned.

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