Ankylosing spondylitis is a chronic inflammatory condition and a type of arthritis. It usually causes pain, stiffness, and reduced mobility in the spine. However, it can also affect other joints. Some people may find symptom relief by making dietary changes, though evidence supporting this is limited.

There is currently no cure for ankylosing spondylitis. However, getting an early diagnosis and using appropriate management techniques can help a person cope with the symptoms and reduce their risk of complications.

This article discusses how dietary choices can impact ankylosing spondylitis, which foods to eat and avoid, and the complications that this condition can trigger.

a woman eating an apple because it is one of the foods that helps with her ankylosing spondylitisShare on Pinterest
Research into whether the diet affects ankylosing spondylitis is limited.

Although there is no specific diet for people with ankylosing spondylitis, consuming certain foods may help people cope with 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 ankylosing spondylitis in more detail.

Ankylosing spondylitis and weight management

Maintaining a healthy weight is important for people with ankylosing spondylitis, as excess weight places stress on the bones and joints of the body. This can make the symptoms worse.

Having overweight is also a risk factor for the development of osteoarthritis.

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 recommend that people with rheumatoid arthritis follow an anti-inflammatory diet. These foods may also benefit those with ankylosing spondylitis, which is a similar inflammatory condition.

People with ankylosing spondylitis may find that the foods and nutrients in this section can help ease the symptoms of the condition.

However, one 2018 review advised that only very limited evidence supports a link between diet and ankylosing spondylitis. Many of the studies were too small and unreliable to confirm any conclusions.

People with ankylosing spondylitis can try using diet alongside conventional treatments to reduce the symptoms. Unless a person has intolerances or allergies, these dietary changes should be safe to try.

Omega-3 fatty acids

A 2012 review of research indicates that a diet high in these essential fats has a consistent but modest positive effect on the joint inflammation associated with rheumatoid arthritis.

The following foods are good sources of omega-3 fatty acids:

  • chia seeds
  • fatty fish, such as salmon, sardines, and tuna
  • flaxseeds
  • flaxseed oil
  • walnuts

However, this review took place quite some time ago, and its format is limited. For this reason, more research is necessary to confirm how effective omega-3 fatty acids are for inflammation in people with ankylosing spondylitis.

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 Ankylosing Spondylitis Society of the United Kingdom recommend eating fruits and vegetables of different colors. These contain a wide array of antioxidant compounds that help protect against disease.

Whole grains

Whole grains — including brown rice, corn, quinoa, buckwheat, and oatmeal — are high in fiber and nutrients. According to one 2018 meta-analysis, they may also help reduce inflammation across the body.

However, some people may find that grains containing gluten — such as wheat, rye, and barley — trigger their ankylosing spondylitis symptoms.

Calcium-rich foods

Ankylosing spondylitis weakens the bones, which is why calcium-rich foods are so important. Calcium is essential for improving bone strength. Food sources high in calcium include:

  • dark leafy greens, such as watercress and kale
  • broccoli
  • Chinese cabbage
  • low fat dairy products
  • fortified plant milks
  • almonds
  • canned sardines with bones
  • fortified tofu
  • fortified cereals

Vitamin D

Vitamin D allows the body to absorb calcium and is another vital nutrient for healthy bones.

One 2015 review of research reports that higher levels of vitamin D are associated with a lower risk of developing ankylosing spondylitis. 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

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 randomized trial from 2009.

Ginger: People have used ginger as an anti-inflammatory remedy for centuries. Recent research supports this.

Turmeric: One of the main components in turmeric is curcumin, which is a compound that may help reduce inflammation.

In this article, learn about the progression of ankylosing spondylitis.

Foods that trigger inflammation may make the symptoms of ankylosing spondylitis worse. These foods include:

Sugar

According to one 2018 systematic review, sugar and refined foods can lead to inflammation in the body.

As a result, those with ankylosing spondylitis may wish to reduce the amount of sugary foods and beverages they consume, including desserts, candy, pastries, sodas, and juices.

Salt and high-sodium foods

In 2013, researchers found that adding salt to the diet of animals caused the body to produce an inflammatory cell that has links to autoimmune conditions such as ankylosing spondylitis.

Although a low sodium diet cannot reverse ankylosing spondylitis, reducing salt intake is a good idea to help manage the condition.

Red meat

Red meat contains certain compounds that can aggravate inflammation.

Eating less or no red meat may help reduce the symptoms of ankylosing spondylitis.

High fat foods

The Arthritis Foundation recommend 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

Omega-6 fatty acids, though essential in small quantities, are much too prevalent in people’s diets throughout the United States.

Foods that contain omega-6 fatty acids include:

vegetable oils, including corn, safflower, sunflower, and soy

  • mayonnaise
  • salad dressings
  • pastries
  • processed foods

People should try to avoid trans fats, which are usually present in processed foods. However, manufacturers are phasing trans fats out of food due to FDA regulations.

Starch

A low starch diet called the “London AS Diet” claims to benefit people with ankylosing spondylitis. The theory goes that some types of gut bacteria can trigger the condition, and starch feeds these bacteria.

The evidence supporting the London AS Diet is anecdotal, meaning that although it may work for some people, the Spondylitis Association of America cannot endorse the diet due to a lack of solid research.

Proponents of the diet recommend limiting or excluding specific foods, including:

  • bread and pastries
  • rice
  • potatoes
  • pasta

The diet also suggests eating more:

  • fruit
  • vegetables
  • nuts and seeds
  • eggs
  • fish
  • lean meat
  • low fat dairy

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 rheumatoid arthritis, and it may also be beneficial for those with ankylosing spondylitis.

Alcohol

The relationship between alcohol and rheumatic conditions such as rheumatoid arthritis is not always clear. However, people with ankylosing spondylitis 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 ankylosing spondylitis medications and reduce nutrient absorption.

Other food triggers

Foods that trigger pain and other symptoms of ankylosing spondylitis vary from person to person. Keeping a food diary for a month can help a person pinpoint any foods that seem to make their symptoms worse.

Low calorie, low fat, and low protein diets may not provide enough nutrients to support the immune systems of people with ankylosing spondylitis.

Ankylosing spondylitis 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. For example, research into ankylosing spondylitis and Crohn’s disease suggests that eating less starch can have a beneficial effect on the symptoms of both, especially alongside medical therapies.

Other recommendations for people with IBD include:

  • reducing the intake of high fat foods
  • limiting or avoiding alcohol consumption
  • cutting back on dairy products

Adopting an anti-inflammatory diet may also help alleviate the symptoms of IBD.

Learn which foods to eat during a flare-up of Crohn’s disease here.

The packaging of some dietary supplements may suggest that they could help people with ankylosing spondylitis. However, some supplements are of poor quality, and the body may not readily absorb them. Others may not have the effects that they claim to.

Some of the supplements that manufacturers suggest for ankylosing spondylitis demonstrate no proven benefits for the condition.

However, consuming probiotics may be helpful for people with ankylosing spondylitis, since Klebsiella bacteria have associations with the condition.

It is usually safe to make dietary changes to manage the symptoms of ankylosing spondylitis, especially when a person does this alongside taking the medication or other treatments recommended by a doctor.

However, to ensure adequate nutrient intake, it is important to discuss any dietary changes with a doctor and dietitian beforehand. Certain foods and supplements can interact with medications.

Research does not indicate that managing ankylosing spondylitis through the diet is effective.

Q:

Does smoking marijuana help with rheumatic pain?

A:

Research shows mixed results regarding the usefulness of smoking marijuana to help rheumatic pain. There have been few studies into the short- and long-term effects of using marijuana.

Currently, experts suggest that marijuana use should be a complementary therapy. It should not replace the treatment plan a doctor has put together.

Alana Biggers, M.D., MPH Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.