Diet plan for ankylosing spondylitis is designed to help you avoid foods that are known to cause inflammation- causing symptoms such as stomach ache, headaches, joint pain, chest pain. This plan is a treatment for the disease of ankylosing spondylitis, which is often considered to be autoimmune and inflammatory conditions. The diet aims at recovery from the bowel, back pain, fatigue, nausea and osteoporosis as experienced by sufferers of this disease.
What food is good for ankylosing spondylitis?
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 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 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 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 the good functional ability and remain in employment. Patients with severe persistent disease may develop progressive spinal fusion and functional decline.
AS and diet
Although there is no specific diet for people with AS, consuming certain foods may help people manage symptoms of the condition.
Different foods can affect a person’s body weight, for example, and they might also play a role in inflammation.
The sections below cover diet’s role in AS in more detail.
AS and weight management
The Spondylitis Association of America notes that maintaining a moderate weight is important for people with AS, as excess weight places stress on the bones and joints of the body. This can make the symptoms worse.
Diet and inflammation
Adopting an anti-inflammatory diet may help reduce inflammation in the body. The foods in this type of diet are similar to those of the Mediterranean diet.
The Arthritis Foundation recommends that people with rheumatoid arthritis (RA) follow an anti-inflammatory diet. These foods may also benefit those with AS, which is a similar inflammatory condition.
Foods to reduce inflammation in those with AS
The following foods may help reduce inflammation.
Omega-3 fatty acids
A 2017 reviewTrusted Source indicates that a diet high in these essential fats has a consistent but modest positive effect on joint inflammation associated with RA.
The following foods are good sources of omega-3 fatty acids:
- chia seeds
- fatty fish, such as salmon, sardines, and tuna
- flaxseed
- flaxseed oil
- walnuts
A 2020 reviewTrusted Source notes that more research is necessary to confirm how effective omega-3 fatty acids are for reducing inflammation in people with AS. However, the authors note that older studies, such as a small clinical trial in 2006Trusted Source, found that high doses of omega-3 fatty acid supplementation may decrease the disease activity of AS.
Whole grains
Whole grains are high in fiber and nutrients. Examples of whole grains include:
- brown rice
- corn
- quinoa
- buckwheat
- oatmeal
According to a 2018 meta-analysisTrusted Source, whole grains may also help reduce inflammation across the body.
However, some people may find that grains containing gluten — such as barley, wheat, and rye — trigger their AS symptoms.
Anti-inflammatory herbs and spices
Certain herbs and spices may also be anti-inflammatory, including:
- Garlic: Some compounds in garlic exhibit anti-inflammatory properties, according to a review from 2015Trusted Source.
- Ginger: People have used ginger as an anti-inflammatory remedy for centuries. 2015 research notes that gingerols, a major compound in ginger, can help reduce arthritis and pain.
- Turmeric: One of the main components in turmeric is curcumin, which is a compound that may help reduce inflammation.
Other beneficial foods
Eating plenty of fruits and vegetables, alongside foods containing calcium and vitamin D, may benefit those with AS.
Fruits and vegetables
Eating a variety of fruits and vegetables each day ensures a high intake of many of the vitamins and minerals necessary for overall health. These foods also tend to be low in calories and high in fiber.
The National Axial Spondyloarthritis Society (NASS) of the United Kingdom recommends eating fruits and vegetables of different colors. These contain a wide array of antioxidant compounds that help protect against disease.
Calcium-rich foods
AS weakens the bones, which is why calcium-rich foods are so important. Calcium is essential for improvingTrusted Source bone strength.
Food sources high in calcium include:
- dark leafy greens, such as watercress and kale
- broccoli
- fortified plant milks
- almonds
- low fat dairy products
- canned sardines with bones
- Chinese cabbage
- fortified tofu
- fortified cereals
Vitamin D
Vitamin D allows the body to absorb calcium and is another vital nutrient for healthy bones.
One 2015 reviewTrusted Source reports that higher levels of vitamin D are associated with a lower risk of developing AS. Also, people with higher vitamin D levels are less likely to have symptoms related to the condition.
The body gets vitamin D from sun exposure and foods such as:
- fish and seafood
- egg yolk
- cod liver oil
- fortified products, such as juices, cereals, dairy, plant-based milk, and tofu
Foods and diets to avoid
Foods that trigger inflammation may worsen AS symptoms. These foods include:
Sugar
According to one 2018 systematic reviewTrusted Source, added sugar and refined foods can lead to inflammation in the body.
As a result, those with AS may wish to reduce the amount of sugary foods and beverages they consume, including:
- desserts
- candy
- pastries
- sodas
- juices
Salt and high sodium foods
In 2014, researchersTrusted Source found a connection between high salt intake and the production of an inflammatory cell that has links to autoimmune conditions, such as AS.
Although a low sodium diet cannot reverse AS, reducing salt intake is a good idea to help manage the condition.
Red meat
Red meat containsTrusted Source certain compounds that can aggravate inflammation.
Eating less or no red meat may help reduce the symptoms of AS.
High fat foods
The Arthritis Foundation recommends limiting types of fat that cause inflammation, including saturated fats and omega-6 fatty acids.
Foods that contain saturated fats include:
- pizza
- red meat
- cheese and full fat dairy products
- processed foods
Excess consumption of omega-6 fatty acids may trigger the production of pro-inflammatory chemicals.
Foods that contain omega-6 fatty acids include:
- vegetable oils, including corn, safflower, sunflower, and soy oils
- mayonnaise
- salad dressings
- pastries
- processed foods
People should try to avoid trans fats, which may be present in processed foods.
Manufacturers have now phased trans fats out of food due to regulations from the Food and Drug Administration (FDA)Trusted Source. However, manufacturers are allowed to keep a small amount of trans fats in processed foods as long as it is less than 0.5 grams (g)Trusted Source per serving. If there is less than 0.5 g of trans fat in the product, the nutrition label is allowed to indicate 0 g of trans fat.
Wheat and gluten
Gluten-containing grains — such as wheat, rye, and barley — may contribute to inflammation in some people.
A gluten-free diet is helpful for some individuals with RA, and it may also benefit those with AS.
Alcohol
People with AS should try to limit their alcohol intake or completely avoid it.
Heavy alcohol use can affect bone mineral density and increase the risk of osteoporosis. Alcohol may also interact with AS medications and reduce nutrient absorption.
Diet and AS-related gastrointestinal problems
AS has links to inflammatory bowel diseases (IBD), such as Crohn’s disease and ulcerative colitis.
Making certain dietary changes may improve the symptoms of these conditions.
Some recommendations for people with IBD include:
- reducing the intake of high fat foods
- limiting or avoiding alcohol
- cutting back on dairy products
Adopting an anti-inflammatory diet may also help alleviate the symptoms of IBD.
Diet Chart For Ankylosing Spondylitis
Maintaining a healthy weight is the most important factor in ankylosing spondylitis. If the person is overweight it will put extra strain on inflamed joints in patients hips, back and as well as knees. It is very important to know about the specifics of ankylosing spondylitis diet. Eating a lot of fruits and vegetables is very important as they are high in antioxidants. Antioxidants helps to protect cells from substances called free radicals which contribute to inflammation. Whole grains are very good for heart. As the ankylosing spondylitis inflammation can affect the heart of the person, whole grains like quinoa, buckwheat, brown rice must be a part of one’s diet. Having two to three litres of water per day is a must in the Ankylosing Spondylitis Diet. The water helps to reduce inflammation to a large extent. Along with water, all the other fluids can also be very useful except alcohol. Alcohol can make the bones weaker. Omega-3 fatty acid tablets can also be added in a daily diet as they also help to reduce the inflammation. High fat and high cholesterol food are to be avoided in the Ankylosing Spondylitis Diet.
Diet Chart
| Sunday | |
| Breakfast (8:00-8:30AM) | Soya flour roti 3+ 1 tbs green chutney. |
| Mid-Meal (11:00-11:30AM) | 1 cup boilled channa+Bell pepper salad. |
| Lunch (2:00-2:30PM) | 1 cup Brown rice+ Soya chunk curry1/2 cup+ Ladies finger subji 1/2 cup+ 1/2 cup curd |
| Evening (4:00-4:30PM) | 1 cup fruit salad( Don’t stick with particular fruits. Include all different coloured fruits) |
| Dinner (8:00-8:30PM) | Buck wheat roti 2.+ Tomato subji 1/2 cup. |
| Monday | |
| Breakfast (8:00-8:30AM) | Mix veg Poha 1 cup+ 1/2 cup low fat milk. |
| Mid-Meal (11:00-11:30AM) | Broccoli salad 1/2 cup |
| Lunch (2:00-2:30PM) | 1 cup Brown rice + 1/2 cup cluster beans subji+ Fish curry(80 gm fish) 1/2 cup. |
| Evening (4:00-4:30PM) | 1 cup fruit salad( Don’t stick with particular fruits. Include all different coloured fruits) |
| Dinner (8:00-8:30PM) | 2 roti/ Chapathi+ Ladies finger subji 1/2 cup. |
| Tuesday | |
| Breakfast (8:00-8:30AM) | Vegetable Oats Upma 1 cup+ 1/2 cup low fat milk. |
| Mid-Meal (11:00-11:30AM) | plane Yoghurt with raw vegetables / grilled vegetables -1 cup( avoid starchy vegetables) |
| Lunch (2:00-2:30PM) | 1 cup Brown rice + 1/2 cup Kidney beans curry+ Snake guard subji 1/2 cup+1/2 cup curd |
| Evening (4:00-4:30PM) | 1 cup fruit salad( Don’t stick with particular fruits. Include all different coloured fruits) |
| Dinner (8:00-8:30PM) | Broken wheat upma 1 cup+ 1/2 cup green beans subji |
| Wednesday | |
| Breakfast (8:00-8:30AM) | Chapati 3+ Egg curry (1 egg) |
| Mid-Meal (11:00-11:30AM) | Tomato Brussel sprouts salad 1/2 cup |
| Lunch (2:00-2:30PM) | Veg pulav rice 1 cup+ 1/2 cup Soya Chunk curry+ 1/2 cup curd |
| Evening (4:00-4:30PM) | 1 cup fruit salad( Don’t stick with particular fruits. Include all different coloured fruits) |
| Dinner (8:00-8:30PM) | Wheat dosa 3 + 1/2 cup Bitter guard subji. |
| Thursday | |
| Breakfast (8:00-8:30AM) | 4 Idli(rice) + Sambar 1/2 cup/ 1 table spoon Gren chutney/ Tomato Chutney |
| Mid-Meal (11:00-11:30AM) | green gram sprouts 1 cup+ Olive oil+ Black pepper |
| Lunch (2:00-2:30PM) | 1 cup brown rice + Chicken curry 1/2 cup + 1/2 cup cabbage subji+ 1/2 cup curd |
| Evening (4:00-4:30PM) | 1 cup fruit salad( Don’t stick with particular fruits. Include all different coloured fruits) |
| Dinner (8:00-8:30PM) | 2 Roti/ chapati+ 1/2 cup mix veg curry |
| Friday | |
| Breakfast (8:00-8:30AM) | Moong dal cheela- 3+ Tomato chutney. |
| Mid-Meal (11:00-11:30AM) | Brussels sprouts salad 1/2 cup |
| Lunch (2:00-2:30PM) | 1 cup Brown rice+ 1/2 cup Dhal+ Palak subji 1/2 cup+ 1/2 cup curd. |
| Evening (4:00-4:30PM) | 1 cup fruit salad( Don’t stick with particular fruits. Include all different coloured fruits) |
| Dinner (8:00-8:30PM) | Broken wheat upma 1 cup+ 1/2 cup green beans subji |
| Saturday | |
| Breakfast (8:00-8:30AM) | Rice dosa-3+ 1/2 cup. |
| Mid-Meal (11:00-11:30AM) | plane Yoghurt with raw vegetables / grilled vegetables -1 cup( avoid starchy vegetables) |
| Lunch (2:00-2:30PM) | 1 cup Brown rice+ Cauliflower subji 1/2 cup+ Dal 1/2 cup |
| Evening (4:00-4:30PM) | 1 cup fruit salad( Don’t stick with particular fruits. Include all different coloured fruits) |
| Dinner (8:00-8:30PM) | 2 Roti / chappathi+Ridge guard subji 1/2 cup. |
Food Items To Limit
- Red Meat : Many cuts of red meat contain high levels of saturated fat, which can exacerbate inflammation and also contribute to obesity.
- Sugar and Refined flour : Your blood sugar levels can surge after you’ve eaten simple carbohydrates that are easily broken down by the body.
- Fried foods : Fried foods contain toxins called advanced glycation end products, which can increase oxidation in the body’s cells. Fried foods are also high in fat and can contribute to obesity.
- Gluten : Gluten, a protein found in grains such as wheat, rye, and barley, may contribute to inflammation in some people.
- Alcohol : Drinking too much alcohol can cause a spike in the body’s levels of C-reactive protein (CRP), which is a powerful signal of inflammation.
- Processed Foods : Processed foods, from supermarket-shelf snacks to meals that come ready-to-eat or require minimal cooking, tend to be loaded with ingredients that cause inflammation.
Do’s And Dont’s
Do’s & Don’ts:
- Identify & Remove Any Food Sensitivities : The most common sensitivities include gluten, dairy, soy, peanuts, eggs, citrus, sugar and corn.
- Hydrate : Aim for around two liters of water per day.
- Eat Pineapples : Pineapples contain an enzyme called bromelain, which has been shown to reduce pain, stiffness, and improve physical function.
- Increase Your Omega 3s : Omega 3 fatty acids, found primarily in fatty fish like anchovies, mackerel and sardines are proven to reduce inflammation, particularly if it stems from autoimmune disease.
- Soy + Avocado : Reduce inflammation and promote cartilage production for those suffering from joint pain.
Food Items You Can Easily Consume
- Broccoli, Brussels sprouts and cabbage. These veggies are part of the cruciferous family, and they are full of a compound called sulforaphane, which helps slow cartilage damage in joints due to osteoarthritis.
- Fatty fish. Fatty fish like salmon, tuna, trout and mackerel are rich in omega-3 fatty acids, which help fight inflammation.
- Garlic. Garlic is a member of the allium family—which also includes onions and leeks. These items contain a compound called diallyl disulfide that may help with a number of diseases—including arthritis.
- Turmeric : Tumeric contains a compound called curcumin, which is beneficial in the management of chronic inflammatory-related joint disease.
- Vitamin C : You can get vitamin C from strawberries, kiwi, pineapple, or cantaloupe.