It is important for people with AS to eat a well balanced diet
If you have a long term medical condition such as AS it becomes even more important to make sure you eat a good, healthy diet
The two keys to a healthy diet are:
- eating the right amount of food for how active you are
- eating a range of foods to make sure you're getting a balanced diet
Maintaining a healthy weight
It is important for anyone with an arthritic condition to make sure they do not become overweight as this increases the burden on weight-bearing joints and can increase pain.
Research has shown that, during walking, the hips, knees and ankles bear three to five times a person's total body weight. For every pound a person is overweight, three to five pounds of extra weight is added to each knee during walking. In contrast, a ten pound weight loss causes 30 to 50 pounds of extra stress to be removed from the joints.
Healthy balanced diet
A healthy balanced diet contains a variety of types of food, including fruit and vegetables. The recommendation is to eat at least 5 helpings of fruit and vegetables per day (for example 3 helpings of vegetables and 2 of fruit). A healthy diet will also include starch containing foods such as wholemeal bread and wholegrain cereals, which are rich in plant fibre, along with some protein-rich foods such as meat, fish, eggs and lentils. Milk and dairy foods are recommended in moderation.
The Food Standards Agency give 8 tips for eating well:
- Base your meals on starchy foods
- Eat lots of fruit and vegetables
- Eat more fish
- Cut down on saturated fat and sugar
- Try to eat less salt - no more than 6 grams a day
- Get active and try to be a healthy weight
- Drink plenty of water
- Don't skip breakfast
If you want to get the balance of your diet right, use the eatwell plate.
The eatwell plate makes healthy eating easier to understand by showing the types and proportions of foods we need to have a healthy and well balanced diet.
If you would like more helpful hints and tips to improve your diet go to www.eatwell.gov.uk
Special diets
These days magazine articles and web pages bombard us with claims about special diets, foods, or supplements that can cause or cure our ailments. It is appealing to think that there are simple answers to a condition like AS, but unfortunately, most claims for cure-all diets or nutritional supplements have not been scientifically tested to determine if they work and if they are safe. Some are frankly fraudulent, while others have undergone scientific studies that are often incomplete and may be harmful instead of beneficial.
That said, some people do find that certain foods trigger changes in symptoms - either for better or for worse. If you find yourself noticing this type of pattern, try keeping a food diary for a few weeks to find out if indeed what you eat makes a difference or if you have food sensitivities.
Trying a change in diet
You should be suspicious of any diet that claims to treat or cure AS. If such a diet existed, GPs and rheumatologists would know about it and would be recommending it to you. If you are tempted to try a diet, it is recommended that you discuss your plan with your GP or rheumatology team to help ensure that trying the diet will not cause health problems. For example some diets can be deficient in calcium which you need for healthy bones.
Look at diet claims carefully
Does the diet:
- Eliminate any group of foods from the Food Guide Pyramid
- Allow for only a few food types
- Require you to buy special products
- Have potentially harmful effects
- Provide scientific evidence to back its claims, rather than personal testimonies to support it
The Mediterranean diet
There is growing evidence that a Mediterranean diet is good for arthritis. This is a diet based around the traditional foods of poor coastal regions of southern Italy, Crete and Greece in the 1960s. The diet is based around:
- High consumption of virgin olive oil
- High intake of vegetables and fruits
- Use of non refined carbohydrates (portions to be adjusted to physical activity)
- Consumption of oily fish, 3 or 4 times a week (e.g. sardines, mackerel, tuna, halibut, herring and salmon, even if all these don't live in the Mediterranean)
- Consumption of milk, cheese and yogurt (the original cheese was fresh goat cheese). Keep an eye on the saturated fats of the dairy products. Not too much!
- 3 or 4 eggs per week
- Moderate consumption of meat and saturated fats
- One or two small glasses of wine a day, preferably red and at the main meals. White wine and beer are alternatives. Do remember that most 750ml bottles of wine will contain 10 units of alcohol and the advice is not to exceed 2 units a day for a woman and 3 units a day for a man
- Nuts as snacks
The low starch diet
This diet is based on research by Dr. Alan Ebringer, Professor of Immunology at King's College London. He is the lead figure in a group of researchers who have been working on the theory that some types of klebsiella bacteria in the gut of people with AS are involved in triggering the disease process via a complex immune response.
In 1996, in a paper supporting his theory, Dr. Ebringer published the chart of one of the patients that he had been following over a period of time. The patient's erythrocyte sedimentation rate (ESR) showed a clear decline over the time he had followed the diet (1983-1995). ESR is a measure of inflammation and Dr. Ebringer believes that the lowering of the patient's ESR demonstrated the success of this diet.
However, it is recognised that ESR levels in AS are not necessarily indicative of a person's actual symptoms. Some people with high ESR can experience little pain and stiffness, whereas people with low ESR might conversely be in a lot of pain and be very stiff.
Other studies have failed to replicate the results of Dr Ebringer's research into how a low starch diet influenced the growth of klebsiella in the gut and have found that the diet has little or no effect on symptoms.
Some people with AS have told us they have had a good experience with the low starch diet whereas others have found no benefit.
It is difficult to research into diet. When new medicines are tested the researchers might give one group the new medicine and another group a dummy or placebo medicine. Even the doctors treating the patients in the medical trial might not be told which patients are taking the trial medicine and which the dummy medicine so that this knowledge does not influence the results. This is known as a double blind trial. We know from research that double blind trials, in which neither the patient, nor the observer knows which treatment has been given, is the best way to show if a treatment actually works.
However, when researchers experiment with diet and try to look at how diet can influence disease, it is impossible to carry out certain research protocols such as using controls or dummy treatments. Neither the person eating the diet nor the person taking measurements after the diet can be blinded as to which diet has been used. It's also not possible to confirm that someone is sticking rigidly to the diet without any lapses.
For this reason NASS can neither give its sanction nor refute the hypothesis that the low starch diet will help patients with AS. It remains a hotly debated subject amongst doctors. We do however offer the main principles below. It is always important to check with your doctor or member of the rheumatology team before trying any new diet.
Low Starch diet
CUT DOWN ON:
- Bread and bread Products or foods made with wheat, barley, oats, rye and corn flour
- Rice
- Potatoes
INCREASE THE FOLLOWING:
- Meat
- Fish
- Milk and Milk Products
- Eggs
- Vegetables
- Fruits
The diet contains no restrictions on spices or drinks.
Last reviewed: October 2010