Ankylosing spondylitis (AS) is a chronic, inflammatory form of arthritis primarily affecting the spine, but it can also impact other joints and organs. While medical treatment is crucial for managing this condition, many people find that dietary changes can significantly complement their therapy by reducing systemic inflammation. By understanding the link between certain foods and inflammation, individuals can make informed choices to potentially mitigate symptoms like pain and stiffness.
Pro-inflammatory foods to limit or eliminate
The following foods are known to promote inflammation in the body and are often associated with increased disease activity in autoimmune conditions like AS. Reducing or eliminating them may help manage your symptoms.
Processed and fast foods
These convenience foods are often high in saturated fats, trans fats, added sugars, and sodium—all of which are known to trigger inflammation. Examples include packaged snacks, frozen meals, pre-made sauces, and fried foods. Opting for whole, unprocessed foods is a healthier alternative.
Sugary foods and refined carbohydrates
Excessive consumption of added sugars, especially from sugar-sweetened beverages like sodas and juices, has been linked to increased inflammation. Similarly, refined carbohydrates found in white bread, white rice, pastries, and crackers can raise inflammatory markers in the blood. Replacing these with high-fiber whole grains and fresh produce is a more beneficial approach.
Red and processed meats
Red meat contains compounds like saturated fat that can aggravate inflammation. Some studies suggest that eating less red meat may help reduce AS symptoms, though more research is needed. Processed meats, such as bacon and cold cuts, also contribute to higher inflammation levels and are best limited.
Alcohol
Alcohol consumption can increase systemic inflammation and interfere with nutrient absorption. More concerning for AS patients, some studies have linked alcohol intake to a faster progression of spinal damage. Additionally, alcohol can have dangerous interactions with common AS medications, such as NSAIDs, and contribute to bone density loss. Limiting or avoiding alcohol is often recommended.
Dairy and gluten (based on individual tolerance)
While not universal triggers, some individuals with AS report that dairy products and foods containing gluten (wheat, barley, rye) can worsen their symptoms. This may be linked to the high prevalence of gut inflammation in people with AS. An elimination diet can help identify if these foods are personal triggers.
The power of an anti-inflammatory diet
In contrast to the foods listed above, an anti-inflammatory diet can be a powerful tool for managing AS symptoms. This approach, often resembling the Mediterranean diet, focuses on nutrient-dense foods that help combat inflammation.
Key anti-inflammatory components
- Omega-3 Fatty Acids: Found in fatty fish (salmon, sardines), flaxseed, and walnuts, these fatty acids have a modest but positive effect on joint inflammation.
- Fruits and Vegetables: A wide variety of colorful fruits and vegetables provides antioxidants and fiber, which protect against disease and reduce inflammation. Leafy greens, berries, broccoli, and turmeric are particularly beneficial.
- Whole Grains: Rich in fiber and nutrients, whole grains like brown rice, oats, and quinoa may help reduce inflammation across the body.
- Lean Proteins: Opt for lean proteins like fish, poultry, and legumes over red meat to reduce saturated fat intake.
- Healthy Fats: Use healthy oils like extra-virgin olive oil and avocado oil in place of saturated fats.
What about nightshades and other sensitivities?
Nightshade vegetables (potatoes, peppers, tomatoes) are a popular anecdotal trigger for arthritis patients, but scientific evidence supporting a link to increased inflammation is lacking. However, individual reactions can vary, and a food diary can help determine personal sensitivity. In general, the focus should remain on overall dietary patterns rather than singling out one food group without evidence of a personal reaction. If you suspect a specific food is a trigger, consult a healthcare professional before eliminating it.
Comparison table: Inflammatory vs. anti-inflammatory options
| Food Category | To Avoid (Inflammatory) | Better Alternatives (Anti-inflammatory) |
|---|---|---|
| Carbohydrates | White bread, pasta, pastries, white rice | Brown rice, quinoa, whole-grain oats, sweet potatoes |
| Protein | Red meat, processed meats like bacon and cold cuts | Oily fish (salmon, sardines), legumes, poultry, nuts, seeds |
| Fats | Trans fats, saturated fats (butter, margarine, lard), vegetable oils high in omega-6 | Extra-virgin olive oil, avocado oil, nuts, seeds |
| Snacks/Drinks | Sugary soda, fruit juice, chips, fast food | Water, unsweetened tea, fresh fruit, nuts, roasted chickpeas |
| Alcohol | Heavy consumption of beer, wine, or liquor | Limit or avoid entirely. Talk to your doctor. |
A personalized approach to diet
Given that individual triggers can vary, keeping a food diary is one of the best ways to identify your personal dietary patterns and how they affect your AS symptoms. Record what you eat and drink, noting any changes in pain, stiffness, or other symptoms. This information can be invaluable for you and your healthcare provider when creating a personalized plan. An elimination diet, conducted under medical supervision, may also help pinpoint triggers.
Conclusion
While there is no single best diet for everyone with ankylosing spondylitis, adopting an anti-inflammatory eating pattern can help manage symptoms by reducing systemic inflammation. By focusing on whole, nutrient-dense foods and limiting highly processed, sugary, and high-fat options, you can make a tangible difference in your daily well-being. Always remember that dietary changes are a complementary strategy and should never replace the guidance of your rheumatologist and medical team. For further support and information, the Spondylitis Association of America offers valuable resources.
