{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T18:12:58Z","timestamp":1785780778273,"version":"3.56.0"},"reference-count":83,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T00:00:00Z","timestamp":1775260800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Musculoskeletal Care"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals with rheumatoid arthritis (RA) often ask whether dietary changes or food exclusions can reduce symptoms. The Autoimmune Protocol (AIP) diet, an elimination\u2010based approach, is popular on social media, with anecdotal reports of benefit, but lacks clinical evaluation in RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the feasibility and effectiveness of an AIP diet on patient\u2010reported outcomes (PROs) in adults with RA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single\u2010arm, open\u2010label pilot study, nine adults with RA followed their usual diet for 4\u00a0weeks and then an 8\u2010week AIP diet in a free\u2010living 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\u2010day weighed food records and biometric measurements (weight and waist circumference) collected at baseline and every 4\u00a0weeks. Adherence and ease of implementation were recorded weekly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine participants (7 females, 2 males, aged 40\u201363\u00a0years) completed the intervention. From baseline to end week 12, mean RAPID3 scores decreased from 2.73\/10 (range 0.2\u20135.37) to 0.99 (0\u20132.5). 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\u20136.35) to 1.02 (0\u20132.96). Fatigue, sleep and pain improved. Mean body mass index reduced from 26.3\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      to 24.5\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . The diet was feasible with high adherence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An 8\u2010week 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      Number ACTRN12624001391561.\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.anzctr.org.au\/ACTRN12624001391561.aspx\">https:\/\/www.anzctr.org.au\/ACTRN12624001391561.aspx<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/msc.70214","type":"journal-article","created":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T10:44:28Z","timestamp":1775299468000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Effect of an Autoimmune Protocol (AIP) Diet in Adults With Rheumatoid Arthritis: A Single Arm Crossover Pilot Feasibility Study"],"prefix":"10.1002","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1110-7108","authenticated-orcid":false,"given":"Julianne J.","family":"McNeill","sequence":"first","affiliation":[{"name":"School of Sport &amp; Recreation, Human Potential Centre, Faculty of Health and Environmental Sciences Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2397-767X","authenticated-orcid":false,"given":"Gael J.","family":"Mearns","sequence":"additional","affiliation":[{"name":"School of Clinical Sciences, Faculty of Health and Environmental Sciences Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9201-8678","authenticated-orcid":false,"given":"Rebecca","family":"Grainger","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Otago Wellington  Wellington New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6185-7663","authenticated-orcid":false,"given":"Caryn","family":"Zinn","sequence":"additional","affiliation":[{"name":"School of Sport &amp; Recreation, Human Potential Centre, Faculty of Health and Environmental Sciences Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,4]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.4556"},{"key":"e_1_2_14_3_1","unstructured":"AIP Certified2024.Autoimmune Paleo Certified Coach Directory.https:\/\/directory.aipcertified.com\/search_results."},{"key":"e_1_2_14_4_1","unstructured":"AIP Diet Support Group.2026. \u201cAIP Diet Support Group Cassava Reactivity.\u201d Facebook Group (June).https:\/\/www.facebook.com\/groups\/214499956197010\/search\/?q=reaction%20cassava."},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21710"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells11152436"},{"key":"e_1_2_14_7_1","volume-title":"The Paleo Approach, Reverse Autoimmune Disease and Heal Your Body","author":"Ballantyne S.","year":"2013"},{"key":"e_1_2_14_8_1","unstructured":"Ballantyne S. M.Trescott andA. G.Alt.2022.Autoimmune Paleo Certified Coach Directory.http:\/\/aipcertified.com\/."},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0220619"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2004.03.023"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40744\u2010022\u201000483\u20104"},{"issue":"5","key":"e_1_2_14_12_1","article-title":"RAPID3? Aptly Named","volume":"32","author":"Berthelot J.\u2010M.","year":"2014","journal-title":"Clinical & Experimental Rheumatology"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/eji.202048876"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.4081\/reumatismo.2020.1296"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031\u20109406(10)61949\u20109"},{"issue":"10","key":"e_1_2_14_16_1","first-page":"8","article-title":"Rheumatoid Arthritis Improvement After Exposure to an Anti\u2010Inflammatory \u2018ITIS\u2019 Diet is Associated With Changes of Gut Microbiome and Systemic Metabolome","volume":"72","author":"Coras R.","year":"2020","journal-title":"Arthritis & Rheumatology"},{"issue":"9","key":"e_1_2_14_17_1","article-title":"The \u2018ITIS\u2019 Diet Improves Fatigue in Patients With Rheumatoid Arthritis and Is Associated With Changes in Metabolome and Fecal Microbiome","volume":"73","author":"Coras R.","year":"2021","journal-title":"Arthritis & Rheumatology"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000059677"},{"key":"e_1_2_14_19_1","first-page":"161","volume-title":"The Paleo Answer, 7 Days to Lose Weight, Feel Great, Stay Young","author":"Cordain L.","year":"2012"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114500000271"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2020.12.014"},{"issue":"12","key":"e_1_2_14_22_1","first-page":"43","article-title":"The Elimination\/Challenge Diet","volume":"95","author":"Denton C.","year":"2012","journal-title":"Minnesota Medicine"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar3859"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard\u20102023\u2010224514"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12103207"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.25117"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010017\u20103912\u20101"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1382\u20106689(97)10040\u20100"},{"key":"e_1_2_14_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu8080481"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.142901"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2017.71629"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13103535"},{"key":"e_1_2_14_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00349"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11102392"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02206660"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2021.04.015"},{"key":"e_1_2_14_37_1","doi-asserted-by":"publisher","DOI":"10.26444\/aaem\/166263"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctim.2020.102519"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reumae.2015.11.004"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743\u20107075\u20107\u201085"},{"key":"e_1_2_14_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475\u20102891\u201012\u2010105"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000001221"},{"key":"e_1_2_14_43_1","volume-title":"Autoimmune Paleo Diet Success Stories","author":"Laird E.","year":"2024"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.2020.1734988"},{"key":"e_1_2_14_45_1","doi-asserted-by":"publisher","DOI":"10.2174\/138161211795428911"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0954422425000083"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.1093\/rap\/rkaa013"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25168649"},{"key":"e_1_2_14_49_1","doi-asserted-by":"publisher","DOI":"10.2147\/OARRR.S201556"},{"key":"e_1_2_14_50_1","doi-asserted-by":"publisher","DOI":"10.1079\/PNS19980025"},{"key":"e_1_2_14_51_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075\u2010021\u201002430\u20100"},{"key":"e_1_2_14_52_1","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2015.14190"},{"key":"e_1_2_14_53_1","unstructured":"Omar A. andT.Pincus.2019. \u201cRheumguide RAPID 3 Calculator.\u201dRheumGuide.Ca: Retrieved 3 June 2025 from.https:\/\/www.rheumguide.ca\/rapid3.html."},{"key":"e_1_2_14_54_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1602790"},{"key":"e_1_2_14_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010021\u201001946\u2010w"},{"key":"e_1_2_14_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780290210"},{"key":"e_1_2_14_57_1","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2019.86425"},{"key":"e_1_2_14_58_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.282.6281.2027"},{"key":"e_1_2_14_59_1","doi-asserted-by":"publisher","DOI":"10.1093\/nutrit\/nuaa033"},{"key":"e_1_2_14_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20481"},{"key":"e_1_2_14_61_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110262"},{"key":"e_1_2_14_62_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891\u2010024\u201007742\u20101"},{"key":"e_1_2_14_63_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40744\u2010019\u201000168\u20105"},{"issue":"6","key":"e_1_2_14_64_1","first-page":"532","article-title":"Does Milk Intolerance Affect Seronegative Arthritis in Lactase\u2010Deficient Women?","volume":"21","author":"Ratner D.","year":"1985","journal-title":"Israel Journal of Medical Sciences"},{"key":"e_1_2_14_65_1","unstructured":"RheumCalc.2021. \u201cRheumatoid Arthritis Impact of Disease RAID Calculator.\u201dMedical Web Design MWD Medical. Retrieved 3 June 2025 from.https:\/\/rheumcalc.com\/raid\/."},{"key":"e_1_2_14_66_1","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm\u20102021\u2010003084"},{"key":"e_1_2_14_67_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12048"},{"issue":"9","key":"e_1_2_14_68_1","article-title":"Comparing the ITIS Diet and the Mediterranean Diet in Rheumatoid Arthritis: Preliminary Findings on Clinical and Microbiome Outcomes","volume":"75","author":"Sala Climent M.","year":"2023","journal-title":"Arthritis & Rheumatology"},{"key":"e_1_2_14_69_1","doi-asserted-by":"publisher","DOI":"10.1006\/pmed.2002.1015"},{"key":"e_1_2_14_70_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13124221"},{"key":"e_1_2_14_71_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000284"},{"key":"e_1_2_14_72_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1790030406"},{"key":"e_1_2_14_73_1","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S352984"},{"key":"e_1_2_14_74_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296\u2010015\u20103415\u2010x"},{"key":"e_1_2_14_75_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102021\u2010001959"},{"key":"e_1_2_14_76_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23295"},{"key":"e_1_2_14_77_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23225"},{"key":"e_1_2_14_78_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqaa019"},{"key":"e_1_2_14_79_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsomega.8b01360"},{"key":"e_1_2_14_80_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen\u20102014\u2010000041"},{"key":"e_1_2_14_81_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30925\u20109"},{"key":"e_1_2_14_82_1","doi-asserted-by":"publisher","DOI":"10.1177\/20552173211035399"},{"key":"e_1_2_14_83_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.283.6290.563"},{"key":"e_1_2_14_84_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms26062674"}],"container-title":["Musculoskeletal Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.70214","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/msc.70214","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/msc.70214","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:15:40Z","timestamp":1782486940000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/msc.70214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,4]]},"references-count":83,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/msc.70214"],"URL":"https:\/\/doi.org\/10.1002\/msc.70214","archive":["Portico"],"relation":{},"ISSN":["1478-2189","1557-0681"],"issn-type":[{"value":"1478-2189","type":"print"},{"value":"1557-0681","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,4]]},"assertion":[{"value":"2025-09-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70214"}}