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Healthy Eating for People with AS

Good nutrition is important for everyone but even more critical when dealing with a chronic condition like ankylosing spondylitis (AS). When you have a chronic disease like AS, your body is already under stress and giving the body proper nutrition is one way to support its healthy functioning.

When searching for a diet for AS, it’s important to distinguish between evidence-based information and anecdotal advice. Dietary recommendations are often based on personal experience, and diet changes that help one person may not help another. Some may follow the Ketogenic diet, anti-inflammatory diet, or a diet that is starch-free or plant-based. Remember to use discernment when weighing these recommendations. To date, research has not found that any one particular diet is best for managing AS. It can be helpful to meet with a nutritionist or registered dietician to discuss how to craft a diet that meets your individual needs.

Healthy weight

Maintaining a healthy weight is important for people with AS, as being overweight can put additional stress on the joints and increases a person’s risk of diabetes, heart disease, and cancer. Being underweight is also not recommended, as it may increase a person’s risk of chronic fatigue, anemia, or infections. A healthy diet is one that contains a variety of fruits and vegetables, whole grains, lean proteins, and limited amounts of fats, alcohol, and sweets.1

Bone health

People with AS have an increased risk of osteoporosis, a condition in which the bones are weakened and more likely to fracture. Adequate intake of calcium and vitamin D are important to bone health and play a role in the prevention and treatment of osteoporosis. calcium and vitamin D are usually recommended and taken together because vitamin D helps the bones absorb calcium.2

Supplements are available for vitamin D and calcium, but vitamins and minerals may be better absorbed from the foods we eat. Foods which are high in calcium and vitamin D include fortified dairy and cereal products, broccoli, bok choy, kale, collard greens, soybeans, and almonds.3

Alcohol consumption can also impact bone health and consuming more than 2 alcoholic drinks a day increases the risk of osteoporosis. Alcohol consumption should be limited to protect bones and increase overall health. Alcohol may also have negative effects with certain medications.1

Medication interactions and side effects

Some medications may require dietary changes, and it’s important to discuss all medications with your doctor and understand how they may impact you. Certain medications can impact your sodium or potassium levels. Methotrexate can lower folate levels, and research has found that when folic acid is taken with methotrexate, patients have less side effects and are able to take the medication for longer periods of time.1,4

Food sensitivities

Some people have food sensitivities, and eating certain foods increases symptoms like inflammation and pain. If you suspect you may have food sensitivities, it may be helpful to keep a food diary, tracking what you consume and the symptoms you are experiencing, and work with a nutritionist or registered dietician. Eliminating foods that trigger negative reactions in your body may help relieve symptoms, but too many dietary restrictions may have a negative impact on nutrition and overall health. Working with a professional can ensure you maintain a healthy diet and address individual concerns.

Written by: Emily Downward | Last reviewed: February 2019
  1. Diet’s effect on spondylitis symptoms. Spondylitis Association of America. Available at https://www.spondylitis.org/Diet-Nutrition. Accessed 2/20/19.
  2. Hinze AM, Louie GH. Osteoporosis Management in Ankylosing Spondylitis. Curr Treatm Opt Rheumatol. 2016;2(4):271-282.
  3. List of foods with calcium and vitamin D. American Bone Health. Available at https://americanbonehealth.org/list-of-foods-with-calcium-vitamin-d/. Accessed 2/20/19.
  4. Medication and diet. Spondylitis Association of America. Available at https://www.spondylitis.org/About-Spondylitis/Treatment-Information/Diet-Nutrition/Medication-Diet. Accessed 2/19/19.