The official line is this…
There is currently no established cure for ankylosing spondylitis (AS).
Instead there are treatment options.
These are designed to manage symptoms, relieve pain, and slow disease progression.
These methods can involve medications, dietary modifications, or a combination.
But there’s a detail worth pausing on for a moment.
The major health organisations, including the The National Institutes of Health (quoted), agree:
“Researchers do not know the cause of ankylosing spondylitis”.
While there are multiple theories, which you can see here, there is no universally agreed cause.
If we can’t agree on the cause itself, it makes it hard to accurately determine whether someone is cured, or how to even define ‘cured’.
If someone regains mobility and no longer feels pain are they cured, or are they just experiencing a temporary relief?
And if they can keep following the same healthy life style, indefinitely, without suffering with pain is that a cure?
There are many people (though not all) who have followed a strict ankylosing spondylitis diet (and avoided starch and other non complaint foods) for a number of years have found that:
✔️ They are now either completely pain free or pain free most of the time
✔️ They are able to enjoy everyday activities as normal
✔️ Some are even able to tolerate starch (and other ‘non safe’ foods) in moderation without repercussion
For these people who achieve ‘pain free’, how do we label it?
Are they cured? Are they in remission?
Again it’s important to note that not everyone has such transformational success.
Some people find they get to 90% pain free on this diet with very occasional flares. Some like to combine it with medication. Others say it has little or no impact at all.
But there is growing evidence to suggest that both the cause, and ‘cure’, for ankylosing spondylitis could centre around modern lifestyles, in particular the Western Diet.
We all have slightly different genes, microbiomes and environments to contend with and this plays such a pivotal factor in autoimmune disease.
Looking to label one specific ‘cure’ may be holding us back
The premise of the Starch Free ankylosing spondylitis diet is this:
People with AS have very active immune systems. This is in part because of a set of genetic components and in part due to environmental factors or triggers.
The immune system ‘over reacts’ when certain foods are consumed in ways others would not.
This problem is likely exacerbated, or triggered, if the patient has poor gut health: specifically with what is sometimes referred to as ‘leaky gut’, or increased gut permeability.
Leaky gut can be caused by a number of factors including poor diet, over exposure to antibiotics and chronic stress.
These are all hallmarks of modern civilisation. Billions of people are exposed to a Western diet and chronic stress is par for the course.
With ankylosing spondylitis the theory behind this diet resolves around a particular microbe called Klebsiella.
This is a microbe which feeds off starch and certain types of lactose, both incredibly prevalent in the Western Diet (think pasta, bread, dairy and so on).
Some studies have found a disproportionally high incidence of Klebsiella in people with ankylosing spondylitis.
Other studies suggest that when the immune system goes to fight this microbe it can cause inflammation, particularly when the fight takes place in certain ‘friendly fire’ locations. This is possibly due to something called molecular mimicry.
The theory proposes that people with a genetic predisposition to AS produce an immune response against Klebsiella bacteria, which are commonly found in the gut.
In some cases, the immune system mistakenly identifies a protein in Klebsiella as similar to a protein in the human body, particularly in the joints. This leads to a chronic inflammation in the joints that can result in AS.
Supporters of the theory suggest that reducing the amount of Klebsiella in the gut through dietary changes or antibiotics could potentially alleviate symptoms in people with AS.
Many people see themselves as ‘cured’ after recalibrating to what their bodies are evolved to deal with
Diet alone isn’t a magic bullet.
Most advocates of the AS diet believe it is the single most transformational element however, there is more to it.
Everyone who experiences success with this says that the following are also essential:
✔️ Regular exercise and stretching
✔️ Reducing stress (in particular chronic stress)
✔️ Tackling unhealthy habits (quitting smoking, cutting back heavy drinking)
Some people may find they get life changing results from following a strict diet and implementing certain lifestyle changes to manage their AS.
Some people may find the task too challenging or may find there need additional help and medication.
Those that experience success might argue that an unhealthy modern diet and lifestyle is the disease and that following a diet and creating a lifestyle that caters to our genetic wheelhouse and microbiome is the cure.