Patient Blogs | Ankylosing Spondylitis
How Diet Affects My AS
photo of man cutting vegetables

This is for the “AS Diet People.” You know who you are. You suffered with ankylosing spondylitis until you found a solution with a major diet modification. You have this need to shout it from the rooftop. 

When you suffer day after day, year after year and then you find something that works, you want to shout it from the rooftops. You want to say, “I’m better. I figured ankylosing spondylitis (AS) out. AS was ruining my life and now it’s under control. Look what I can do. I can sleep through the night, I wake up ready to go, I can’t remember when fatigue last stopped me in my tracks. That excruciating nonstop pain is gone.”

I’m blessed to know and talk to people around the world I can relate to because they also live with ankylosing spondylitis. One thing I’ve consistently found is that most of us are just doing our best to figure AS out. A common theme is diet. For starters, if you’re overweight, the doctor will suggest you lose weight to help control your AS. I have also heard that they tell people who are underweight to gain a little.

I’ve met several people who have had incredible results from overhauling their diet. They want to shout their good news from the rooftops.

The successful diets vary considerably. Some eliminate nightshades. Some eliminate starch. Some have you eat the same thing day after day. Some are vegetarian or paleo. Some focus on clean foods, anti-inflammatory foods, or Mediterranean foods. The list of successful diets goes on and on. Also, for each type of diet, I’ve met several people that tried it unsuccessfully. They feel AS is way too serious for most of us to eat our way out of it. That’s been my camp.

The catch is that AS affects us differently. For some of us it affects our eyes, gut, and skin and fuses our spine. For others there is fatigue and pain. We also differ in what treatment works. If a medication does nothing for a third of the people in a trial, it’s considered successful. So why would we expect a diet that works for one person to work for everyone? My solution may be informative but not necessarily helpful for you. We all need to figure this out. Plus, our bodies change over time. What works today may not be effective in 10 years.

Over the years, my wife and I have made so many modifications to my diet that it feels natural and we no longer need to think about diet very much. As new issues come up, I make adjustments. There are things that serve me and things that harm me. It’s not just what I eat, it’s when, why, and how it’s prepared. It’s even the gratitude for everything and everyone responsible for food. 

There are thoughtful guides with ancient wisdom and modern scientific approaches to diet. I believe medicine is catching up to what we patients already know. Whether you call it Ayurveda or the gut microbiome, what we eat probably makes a difference.

Diet alone may not make enough of a difference to shout it from the rooftop. For me, it’s a matter of aligning diet, exercise, rest, stress, medications, and even the climate to optimize my health.

One thing I found productive was an allergy elimination diet, which meant going on a very restricted diet for a few weeks, adding in a test food for 3 days, then going back to the restricted diet and testing another food. I know this is odd, but turkey sets off a flare every time.

I also found that I feel better when I weigh on the lower end of my range. I have a history of ulcerative colitis, so there are some foods that I don’t eat and some that I avoid having too much of. I seek anti-inflammatory foods such as turmeric and avoid inflammatory foods like caffeine and heavily processed grains and sugars.

I like a suggestion made by a microbiome researcher: Eat clean and live dirty, meaning eat foods that aren’t chemically treated and spend time outdoors and in the garden. Since I have osteoporosis in my hips (progressive deterioration), I gravitate toward vitamin D, sunlight, and weight-bearing exercise. Staying hydrated is also important for my health.

This only touches the surface of my AS-modified diet. I don’t aim for 100% adherence. I can tolerate an occasional pizza and drink with a friend.

Oh, crud, I guess I’m one of those “AS Diet People.” To some degree, I think most of us are. We find some foods help our AS and others make it worse.

I have perfect faith that you will find something that works. Your symptoms will improve. Your numbers will improve. We are learning more about what works each day. Something will work for you. It may not work for everyone, but go ahead and shout it from your rooftop.



Photo Credit: Neustockimages via Getty Images

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Richard Howard

Richard Howard

Diagnosed since 1990

Richard Howard has been living with ankylosing spondylitis since 1990. He is the chief mission advancement officer of the Spondylitis Association of America and co-lead of the Los Angeles education/support group. Howard serves on the board of directors of WalkASOne and the patient board of the COVID-19 Global Rheumatology Alliance. He enjoys yoga, gardening, reading, and time with his family. Find him on social media @RichAHoward.

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