Paleo vs Vegan for Autoimmune Disease: Which is Better?


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).

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.


Reducing inflammation typically improves symptoms of autoimmune disease. Vegan diets are generally anti-inflammatory, while Paleo diets can be, but it depends on the specific diet.

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.


We’ll probably never get definite research on the effect of a paleo diet on autoimmune diseases. However, there’s a bit of evidence that a paleo diet that doesn’t include known triggers of inflammation could have some benefit on inflammation-related conditions.

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.


There’s a good amount of evidence showing how a clean vegan diet can be used to help manage autoimmune disorders.

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.

I suppose I should note that some people do a vegan and paleo diet, which is even more restrictive (see vegan paleo protein sources for more).

Follow-Up Questions

What is the main difference between autoimmune diseases and inflammatory conditions like IBD?

The main difference between autoimmune diseases and inflammatory conditions like Inflammatory Bowel Disease (IBD) lies in their underlying causes. Autoimmune diseases occur when the immune system mistakenly targets and attacks the body’s own cells and tissues. In contrast, inflammatory conditions such as IBD involve inflammation as a response to various factors, but the immune system may not necessarily be attacking the body’s own tissues. While both involve inflammation, the specific mechanisms and targets differ between autoimmune diseases and inflammatory conditions.

Can you explain more about the autoimmune protocol diet (AIP) and how it differs from a standard Paleo diet?

The Autoimmune Protocol (AIP) is a specialized version of the Paleo diet designed to reduce inflammation and support individuals with autoimmune conditions. AIP eliminates certain foods that are commonly associated with inflammation and immune system reactions, such as nightshades, eggs, nuts, and seeds. The AIP is more restrictive than a standard Paleo diet, as it aims to identify and eliminate potential triggers for autoimmune reactions. The focus is on nutrient-dense foods to support healing and reduce inflammation, making it a more tailored approach for those with autoimmune issues compared to a general Paleo diet.

How do vegan diets counteract inflammation in the body specifically?

Vegan diets are believed to counteract inflammation in the body due to their emphasis on plant-based foods rich in anti-inflammatory compounds. These diets typically include fruits, vegetables, whole grains, nuts, and seeds that are high in antioxidants, phytochemicals, and fiber. These plant-based components have been associated with reducing inflammation and promoting overall health. Additionally, vegan diets often exclude pro-inflammatory foods like red meat and dairy, contributing to their potential anti-inflammatory effects.

What are the components of a “clean vegan diet” mentioned in the studies?

The term “clean vegan diet” in the studies mentioned on this page refers to a diet that prioritizes whole, minimally processed foods, which includes fruits, vegetables, whole grains, legumes, nuts, and seeds. These foods provide essential nutrients and antioxidants while avoiding highly processed and refined products. In reality, a vegan diet can contain plenty of unhealthy, processed foods, and this will have an effect the overall diet has on inflammation.

About the author

Dale Cudmore

Your friendly neighborhood vegan from Toronto. I've spent over 6 years as a freelance nutrition writer and researcher. During this time, I've tested over 50 vegan protein powders, and over 100 other types of vegan supplements.

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