The Ankylosing Spondylitis diet
When healthy eating is not so healthy
I have eaten healthily for most of my life, have been vegetarian for the past 20 years, vegan on and off for many years also. In my 20s I started to train in holistic health. I completed training as a Health Kinesiologist which incorporated advanced training in nutrition, anatomy pathology and pharmacology. I am also a fully qualified Bowen therapist and treat people with back issues daily in my clinic, the irony! So, as you can see, I am well versed in health and well-being and have been living this way for most of my life. However, after my official diagnosis and my extensive research, I realised that the things I had been eating were not at all good for me even though they were considered healthy. Being vegetarian I consumed things like beans, pulses, and quinoa daily. All, of these foods, are very high in starch which is not healthy for the gut microbiome of those with AS. I was in fact literally feeding the bad bacteria and making my symptoms worse.
The gut microbiome
Supporting gut health is key for health in general, however, it is of paramount importance for people with autoimmune conditions. There is a multitude of information and support available on the internet concerning this and I urge everyone to do their research. The game-changing research and books I read have included - Dr Alan Ebringer’s work on the No starch diet for AS. Sean Codling on his site www.stopas.co.uk also talks about Dr Ebringer, in fact Sean was one of Dr Ebringers patients. I have been lucky enough to have had some great input from Sean and would recommend people check out his site too. Rebecca Fett’s book called the Keystone Approach which gives very clear guidance and protocol for those with AS on how to heal the gut. I read several books by Dr Steven Gundry his main book is called The Plant Paradox and talks about the lectins in some plants and how certain people can be reactive to these. I have also read extensively about histamine causing foods and have a raft of information, under my belt concerning allergies and intolerance from my Kinesiology work.
The AS no starch diet
Dr Alan Ebringer a now-retired Professor of Rheumatology and Immunology worked with AS patients in the 1980s in London. He pioneered what is now known as the London AS diet or the no starch diet for AS. Ebringer discovered that many patients suffering from AS had a high percentage of the gut bacteria called klebsiella present in their large intestine. When he put one of his patients on a low carb diet because the patient needed to lose weight he also found that his AS symptoms diminished. Ebringer then began advocating this approach with other patients and had high success rates. By not eating starch the Klebsiella bacteria is starved of its main food source and therefore diminishes as do the symptoms of AS.
Following this diet can be tough going, I think this is mainly because we are all so used to consuming starchy, carbohydrate-rich
foods. The main food sources that need to be avoided include; bread, pasta, rice, legumes, pulses, beans, cakes, baked goods, starchy fruits, starchy vegetables. When we look at the modern diet, we can see that it is filled with these foods. Adopting the no starch diet is a radical shift in the way most people eat even those people like me who thought they were eating healthily. I feel it is worth the effort though and will pay dividends in the long run. You have to seriously change your mindset however this is a way of life, not just a diet, it requires a quantum leap mind-shift.
I list below some of my staple foods and ingredients that I can’t live without. This list is not exhaustive however and I am continually finding things to add and sometimes I take things away as they might be problematic. Like everything you should look at your personal intolerances and allergens and I can help you with that with my Kinesiologist hat on in a consultation.
I also want to add that whilst a lot of my recipes are plant based you can add a protein source to many of them such as lean chicken, turkey or fish , oily fish is in fact recommended on this eating plan. I was vegetarian for about 25 years but have started to incorporate oily fish 2 - 3 times per week. That was not an easy transition for me but one that I have to follow for now. As with everything individual needs differ and so it might be that you need to add more protein to the meal plans to make them work for you. This is something I discuss on an individual basis when I work with clients in a consultation in order to find out what is right for them.
Ideally, you are looking to get the following nutrients per day: 50g of carbs, 110 g of fat, 150g protein.
This is a rough guide and will differ for each individual, everyone is different and in a session we talk about this and identify your unique needs.
Blackberries, raspberries, avocados, lemons, limes, oranges
Mushrooms, spring onions, radishes, celery, courgettes, fennel, salad leaves (all types), spinach, cabbage (all types), chicory
Nuts & seeds
Almonds, almond flour, walnuts, walnut flour, pecans, macadamias, hemp seeds, linseeds, pine nuts
Olive oil, avocado oil, hemp oil
Coconut milk, hemp milk
Psyllium husks, coconut flour, cacao, goats and sheep cheese, goats and sheep yogurt, cider vinegar, sea salt, Himalayan pink salt
I got a lot of the “allowed” items from Rebecca Fett’s book - The Keystone Approach, she has a lot of really useful information in the book and on her website.