There’s no official diet for people with ankylosing spondylitis. But some research suggests a low-starch diet may improve symptoms by reducing inflammation. Members of MySpondylitisTeam have wondered whether a low-starch diet could help them. “Did anybody try the zero-starch diet?” asked one member. Another replied, “It is definitely a tricky diet, but I have found that it definitely helps me.”

When you live with a chronic disease, the endless stream of diet advice and information on natural treatments can feel overwhelming. No two people with spondylitis are exactly alike. As one MySpondylitisTeam member put it, “I just keep reading conflicting information … I know that at the end of the day, it’s specific to the individual, but what works for most?”

With so much mixed information and limited research, it can be hard to commit to major changes in how you eat. In this article, we explain what a low-starch diet is and how it might help manage symptoms of ankylosing spondylitis.

What Is a Low-Starch Diet?

A low-starch diet is an eating plan that limits or avoids starchy foods. Starches, also called complex carbohydrates, are usually a person’s main source of carbs.

Although a low-starch diet may have possible benefits for people with ankylosing spondylitis, it’s important to note that starchy foods aren’t bad for you. If they don’t trigger your symptoms, they can be a healthy part of your diet. Starches are an excellent source of energy and can provide important nutrients like iron, calcium, and fiber. Fiber also supports good digestion.

Foods To Limit in a Low-Starch Diet

If you’re considering a low-starch diet for ankylosing spondylitis, check with your doctor first. Once you start a low-starch diet, you’ll have to avoid or limit several categories of high-starch foods.

Starchy Vegetables and Fruits

Some vegetables are high in starch, such as potatoes, peas, and corn (including popcorn). Certain fruits, like bananas, can also be high in starch.

Dried Beans, Legumes, and Lentils

Many beans, legumes, and lentils contain starch. If you’re following a low-starch diet, you should try to avoid or limit:

• Lima beans
• Pinto beans
• Kidney beans
• Black-eyed peas
• Split peas

Grains

Whole grains and refined grains are both major sources of starch. Whole grains are generally healthier because they contain all parts of the grain, while refined grains are processed foods that contain only the starchiest part.

Grains to avoid or limit on a low-starch or starch-free diet include:

• Oats
• Barley
• Rice
• Wheat
• Bread
• Pasta

How a Low-Starch Diet Might Improve Spondylitis

One small study followed 36 people with ankylosing spondylitis who ate a low-starch diet for nine months. By the end of the study, participants had significantly lower levels of disease activity. Most reported fewer spondylitis symptoms, and some said they needed fewer nonsteroidal anti-inflammatory drugs (NSAIDs) to manage symptoms.

While these results are encouraging, the study was too small to prove that a low-starch diet helps ankylosing spondylitis. More research is needed to confirm if a low-starch diet can improve ankylosing spondylitis and its symptoms.

It’s also important to remember that, when it comes to diet changes, what works for some people might not work for others. Always talk to a healthcare provider before making major changes to your diet.

Can Starch Cause Inflammation?

Some scientists believe a low-starch diet may improve spondylitis symptoms because it may lower inflammation that starts in your gut microbiome.

A type of bacteria that naturally lives in your gut, called Klebsiella, feeds on starches from the starchy foods you eat. When it has plenty of starch to eat, Klebsiella grows and multiplies. This growth triggers a response from your immune system, which might involve inflammation that could make spondylitis symptoms worse.

Some scientists theorize that Klebsiella growth in the gut triggers the development of ankylosing spondylitis in the first place. Research has found a possible link between ankylosing spondylitis and high levels of gut inflammation, which may come from Klebsiella.

What To Eat on a Low-Starch Diet

Because starchy foods make up over a third of most people’s diets, cutting back can be difficult.

Members of MySpondylitisTeam have talked about the challenges of adopting a low-starch diet. One member said, “I’m following the low/no starch diet as much as I can, but it’s so restrictive.” Another mentioned their concerns about starting a low-starch diet. “I am thinking about starting this diet, but I know it’s so strict, so hard.”

Vegetables To Eat on a Low-Starch Diet

Although it can be hard to limit starch, there are still plenty of foods you can enjoy. Nonstarchy vegetables provide fiber, vitamins, and minerals without adding too much starch.

When planning meals on a low-starch diet, reach for nonstarchy vegetables such as:

• Artichokes
• Asparagus
• Bamboo shoots
• Beets
• Cauliflower
• Carrots
• Cabbage
• Celery
• Cucumber
• Eggplant
• Leafy greens
• Mushrooms
• Onions
• Peppers
• Tomatoes
• Turnips

Veggie Chips

You might find it easier to follow a low-starch diet if you swap your favorite starchy foods for nonstarchy alternatives. If you usually enjoy chips, crackers, and cookies, try swapping them for vegetable chips such as kale or beet chips. These can replace traditional potato or corn chips and still give you a crunchy snack.

Cauliflower Rice

Rice is a staple food for more than half of the world’s population, so it can be particularly hard starch to give up. Cauliflower rice is a good substitute, since cauliflower is a nonstarchy vegetable.

Broccoli rice, though less common, also works. Both have mild flavors that blend well into dishes that usually contain rice. You can make these rice alternatives at home by pulsing the veggies in a food processor into tiny rice-like pieces.

Almond Flour Bread

Some alternative breads are made with almond flour instead of wheat flour. These tend to be lower in starch and can be a good option if you’re cutting back.

Veggie Noodles

Veggie noodles can replace pasta in many dishes. You can use spaghetti squash, zucchini, or even carrots cut into noodle shapes for a healthy, low-starch substitute.

Make Your Own Snacks

You can even make your own dried snacks at home, using a food dehydrator. A dehydrator is a simple kitchen device that is easy to use and popular with people following vegan or raw diets. It’s easy to find recipes online. Look for low-starch recipe websites with reviews for tips and advice.

If you enjoy eating crackers with spread, try putting your favorite topping on crisp, fresh veggies like cucumber slices or celery stalks instead.

Talk To Your Doctor

Always talk to your doctor or rheumatologist before making changes to your ankylosing spondylitis management plan. Your doctor can help you experiment with different diet changes and decide if a low-starch or an anti-inflammatory diet is right for you. They might guide you through an elimination diet to see if any foods worsen your spondylitis symptoms. Always let your healthcare provider know if you notice any new or worsening symptoms, like fatigue, after a change in your diet.

You might also benefit from meeting a registered dietitian. A dietitian can give you specific medical advice, help you find easy recipes that fit your dietary goals, and make sure your low-starch diet still provides all the nutrients you need.

Join the Conversation

On MySpondylitisTeam, people share their experiences with ankylosing spondylitis, get advice, and find support from others who understand.

Have your spondylitis symptoms improved while following a low-starch diet? Let others know in the comments below.