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What Is the Best Diet for Ankylosing Spondylitis (AS)?

Ankylosing spondylitis is a type of arthritis that affects the spine and large joints. The best diet for ankylosing spondylitis includes the Mediterranean diet or a diet rich in lean protein, vegetables and fruit that eliminates refined flour, sugar, alcohol and processed foods.
Ankylosing spondylitis is a type of arthritis that affects the spine and large joints. The best diet for ankylosing spondylitis includes the Mediterranean diet or a diet rich in lean protein, vegetables and fruit that eliminates refined flour, sugar, alcohol and processed foods.

The anti-inflammatory and low starch, gluten and sugar free diet is proving to be useful for quite a few ankylosing spondylitis (AS) patients (less inflammation and pain). However, patients with AS may eat anything that is usually considered healthy. They should stop a particular food only if it is suggested by the doctor. Apart from this, if they feel that any particular food they ingest is causing problems, they must monitor symptoms and then consult a doctor about eliminating such foods from their diet. Irrespective of whether people have AS or not, eating healthy food and maintaining a balanced diet (no junk) is essential for health and well-being. 

Common food recommendations for patients suffering from ankylosing spondylitis

  • Reduce the following:
    • Avoid any type of food made with refined flour and that is high in sugar. For example, bread, biscuits, white rice, cream, crackers, cakes, puddings and pies.
    • Reduce intake of pasta, noodles, macaroni and pizza made with refined flour.
    • Quit smoking. Smoking is particularly troublesome for people with ankylosing spondylitis because the condition can affect the mobility of the rib cage.
    • Avoid alcohol and any type of preservatives.
    • Avoid foods that are high in sodium, such as chips and preserved and ready-to-eat foods.
  • Increase the following:
    • Eat plenty of protein, vegetables and fruit. The more colors on the plate, the better.
    • Include any type of unprocessed meat at least once in the diet (fish, poultry, pork and lamb). Lean protein, such as fish and chicken, is the best.
    • Increase the intake of all vegetables (cabbage, cauliflower, sprouts, courgettes, peppers, mushrooms, spinach, broccoli or carrots).
    • Include most of the available seasonal fruits in the diet.
    • There are no restrictions on spices (pepper, salt or herbs).
    • Blanched almonds, pine nuts and sesame seeds can be included in the daily diet.
    • Increase the intake of foods rich in omega-3 fatty acids and vitamin D.
    • Dietary supplements (especially vitamin D) might help individuals get the extra nutrients they are missing.
    • The Mediterranean diet often shows promising effects in individuals suffering from AS.
  • Foods that may need to be checked:
    • Start by eliminating all dairy products for two months.
    • If this doesn’t help, experiment with the elimination of wheat, corn, soy, sugar and citrus fruits one at a time.

Patients who experience limited relief through medications should try diet and lifestyle changes. A few studies indicated that the ankylosing spondylosis may be caused by altered gut flora. Improved immune function and remodeling of the gut microbiome by taking probiotics and a healthy diet ought to work as a cure for some people.

What are the common triggers of ankylosing spondylitis?

Ankylosing spondylitis (AS) occurs when the body’s immune system begins to attack its own joints for reasons that are not yet understood. The joints between bones in the spine and the joints between the spine and the pelvis are usually the first targets of this immune attack. Researchers were able to indicate a few common triggers in patients with AS.

  • Some people with the gene marker HLA-B27 may develop the disease. However, not everyone may develop AS despite HLA-B27 presence.
  • Many people with ankylosing spondylitis either have another family member with it or they have another family member who has a rheumatologic or autoimmune condition. The risk of developing AS is increased if there are family members who have this condition even if the patient does not have HLA-B27 genes.
  • AS affects men at a disproportionate rate, striking them earlier in life and causing more severe symptoms. Women who develop the health condition often have a milder form.
  • More than 80 percent of people with AS receive a diagnosis by the age of 30 years and 95 percent of people by the age of 45 years old.
  • Research also suggests that environmental, bacterial and gastrointestinal infections may have roles in triggering this disease. The sexually transmitted infections, Chlamydia trachomatis and Neisseria gonorrhoeae are the common organisms responsible for reactive arthritis, which is related to AS.
  • AS is more prevalent in Caucasians, Asians or Hispanics.

What is the best medication for ankylosing spondylitis (AS)?

Studies show that nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor α (TNFα) blockers have positive effects on ankylosing spondylitis patients.

  • Patients who are treated with these drugs found improvement in their pain, physical function and morning stiffness.
  • NSAIDs are recommended as the first-line medications and TNFα blockers are recommended for patients with persistently high disease activity despite conventional therapy.
  • Hence, the combination of these drugs may be considered as the best medication for ankylosing spondylitis.

What is the outlook of ankylosing spondylitis?

The long-term outlook for people with ankylosing spondylitis (AS) varies and is hard to predict. Maintaining a healthy diet, regular physical activity, physiotherapy and stress management play a key role in the management of ankylosing spondylosis. In many cases, at the onset of the disease, symptoms are not constant and are limited to one side of the body. As the disease progresses, pain and stiffness generally become more severe and more regular. Research shows that patients with mild or limited AS often retain good functional ability and remain in employment. Patients with severe persistent disease may develop progressive spinal fusion and functional decline.

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