Ankylosing spondylitis (AS) is a chronic, inflammatory autoimmune disease that primarily affects the spine and sacroiliac joints, causing pain, stiffness, and reduced mobility. While medication and physical therapy are standard treatments, lifestyle changes, particularly diet, can play a significant role in managing symptoms and reducing inflammatory flare-ups. The cornerstone of a spondylitis-friendly diet is to reduce systemic inflammation. This often means limiting or avoiding certain food groups that are known to trigger or exacerbate inflammatory responses in the body.
The primary pro-inflammatory food groups to limit
A modern "Westernized diet," often high in processed and fatty foods, has been linked to increased inflammatory markers. For individuals with spondylitis, reducing these items is a sensible first step.
Processed foods and refined carbs
Processed foods are often loaded with unhealthy fats, added sugars, and high levels of sodium, all of which can increase inflammation. They offer little nutritional value and can contribute to weight gain, placing extra stress on the joints. Similarly, refined carbohydrates, or refined grains, have been stripped of their fiber and nutrients and are linked to higher inflammatory markers in the blood.
- Processed meat: Lunch meats, sausages, hot dogs, and cured meats contain nitrates and other additives that can trigger inflammation.
- Packaged snacks: Chips, cookies, crackers, and other shelf-stable snacks are typically high in unhealthy fats, sugar, and sodium.
- Refined grains: White bread, white rice, pasta, and pastries cause rapid spikes in blood sugar that can increase inflammatory cytokines.
Sugary foods and beverages
Excessive intake of refined sugars and sugar-sweetened drinks is a significant contributor to chronic inflammation. Sugar can lead to the production of pro-inflammatory cytokines and contribute to insulin resistance over time.
- Sugary drinks: Soda, fruit juices, and energy drinks are major sources of added sugars.
- Sweets and desserts: Candy, pastries, and ice cream can spike blood sugar levels and promote inflammation.
- Hidden sugars: Check food labels for sources like high-fructose corn syrup and sucrose in packaged items.
High-fat foods and unhealthy fats
While healthy fats like omega-3s are beneficial, consuming too many unhealthy fats can increase inflammation. Trans fats and saturated fats are the main culprits to avoid.
- Trans fats: Found in fried foods, commercial baked goods, and some processed snacks. The FDA has phased these out, but small amounts can still exist.
- Saturated fats: Primarily from animal products like red meat, full-fat dairy, and some plant-based oils (coconut, palm kernel).
- Excess omega-6 fatty acids: While an essential fatty acid, an imbalance favoring omega-6 over anti-inflammatory omega-3s can promote inflammation. Omega-6s are high in many vegetable oils (corn, safflower, soy) and processed foods.
Other dietary considerations for spondylitis
Aside from the most common inflammatory triggers, certain food sensitivities and habits can affect individuals differently.
Alcohol and caffeine
Excessive alcohol consumption is particularly concerning for people with spondylitis. It can negatively impact bone density, raising the risk of osteoporosis, a condition already more common in AS patients. Alcohol can also interfere with medications. Excessive caffeine may also affect bone health and sleep quality, both important factors for managing spondylitis.
Gluten and dairy sensitivity
Some people with spondylitis report that their symptoms worsen after consuming gluten (found in wheat, barley, and rye) or dairy. This is not a universal experience, and scientific evidence linking these universally to AS flare-ups is limited. However, given the link between AS and gut inflammation, individual sensitivities could play a role. A food diary and an elimination diet under the guidance of a healthcare professional can help identify if these are personal triggers.
High-sodium foods
Some studies suggest a link between high salt intake and the production of inflammatory cells relevant to autoimmune conditions. It is wise to moderate intake of high-sodium foods, especially since some AS medications can cause sodium retention.
Foods to embrace vs. avoid: A comparison table
| Foods to Prioritize (Anti-inflammatory) | Foods to Consider Limiting/Avoiding (Pro-inflammatory) |
|---|---|
| Fruits and vegetables: A wide variety provides antioxidants and fiber. | Processed foods: Packaged snacks, frozen dinners, and fast food. |
| Omega-3 rich foods: Fatty fish (salmon, sardines), flaxseeds, and walnuts. | Refined sugars and beverages: Soda, juice, candy, and desserts. |
| Lean protein sources: Poultry, fish, legumes, and tofu. | Red meat: Excessive consumption is linked to higher inflammatory markers. |
| Whole grains: Brown rice, quinoa, and oats (if tolerated). | Saturated and trans fats: Fried foods and full-fat dairy products. |
| Healthy oils: Extra-virgin olive oil and avocado oil. | Excessive alcohol: Weakens bones and can interact with medication. |
| Anti-inflammatory spices: Turmeric, ginger, and garlic. | High-sodium foods: Canned items, processed meats, and fast food. |
How to identify your dietary triggers
Since everyone's body is different, what triggers inflammation in one person may not affect another. Following these steps can help you pinpoint your personal sensitivities:
- Keep a Food Journal: For at least a month, track your daily food and drink intake alongside your symptoms (pain, stiffness, fatigue). This can reveal patterns between specific foods and flare-ups.
- Consider an Elimination Diet: With medical supervision, remove suspected trigger foods for a period of time. Afterward, reintroduce them one by one while monitoring for a return of symptoms.
- Consult a Professional: A registered dietitian can provide personalized guidance, ensuring you maintain a nutritionally balanced diet throughout the process.
Conclusion
While a specific "spondylitis diet" doesn't exist, focusing on a broad anti-inflammatory eating pattern, similar to the Mediterranean diet, can be a beneficial complementary strategy for managing symptoms. The key takeaway is to minimize processed and sugary items while maximizing whole, nutrient-dense foods. Identifying individual sensitivities through careful tracking is also vital. Always consult with a healthcare provider before making significant dietary changes, especially regarding bone health concerns and potential interactions with medication. Combining a smart nutritional plan with medical treatment can lead to a better quality of life for those living with spondylitis.
For more information and support on managing spondylitis, you can visit the Spondylitis Association of America.
