Spondylitis Association of America

Low Starch Diet vs. Gluten-Free Diet

Posted By: Alice10

Low Starch Diet vs. Gluten-Free Diet - 08/13/19 09:13 AM

Hello everyone,

I would like to try easing my symptoms through diet. I've read the thread "Diet and Ankylosing Spondylitis" that contains plenty of very interesting information. To my understanding, the diet mainly discussed in that thread is the Low Starch Diet. But I've also read about the Gluten-Free Diet widely discussed by Dr. Seignalet.
Since these two diets are quite different, I was wondering if I should try one rather than the other. Does anyone have some experience trying these two diets and finding one more beneficial than the other?

By the way, I'm already following a dairy-free diet and I've been a vegetarian for 20+ years.


Posted By: RAHMBA

Re: Low Starch Diet vs. Gluten-Free Diet - 08/13/19 11:07 PM

There are a ton of past posts about diet here.

I think people in the UK and USA like to try the No Starch Diet. It seems people in other parts of the world try other diets for AS.

rather than trying a diet, I'd recommend doing an elimination diet with a HCP. basically you and your HCP create a plan to test different foods. you can test starch & gluten in that process.

For me, I also have UC, I find it best to avoid inflammatory foods and seek anti-inflammatory foods.

I also found that weighing on the lower end of my range is better than upper end.

Plus b/c of the UC, I need to avoid cruciferous vegis, seeds, raw vegis in general. I also need to limit dairy from cow.

For past 7 years, my flares from AS have been rare, so I feel like I have more wiggle room when it comes to diet. also I used to be very strict with the full UC diet, but my colon has had no inflammation for over ten years. I still abstain from cruciferous vegis. and watch the intake of inflammatory foods, while making anti-inflammatory food choices.

hope that is helpful and makes sense.

kindest, Rich
Posted By: FayeK

Re: Low Starch Diet vs. Gluten-Free Diet - 08/14/19 02:00 PM

Hi Alice
My rheumatologist told me "No carbs, sugar or alcohol." then I came to this forum and read about the No Starch Diet. While trying to acquire a copy of Sinclair's book (didn't) I found The Keystone Approach by Rebecca Fett and a lot of other autoimmune programs. The Fett plan suited me best so I have been following the Advance Plan plus Elimination of common food sensitivities (nightshades, dairy, eggs, nuts...) for 11 weeks. It isn't a vegetarian program but an adapted Mediterranean diet. Mostly lean protein and leafy greens. No starch or added sugars so no carbs. If you use soy products for your protein, those are not allowed. There are 3 levels of restrictions. The website keystonebook(dot)com may help you decide if it is right for you. My gut feels so much better I haven't had the desire to add back most of the eliminated items. Weirdly, little or no reduction in my joint/muscle pain symptoms. I committed myself to 6 months then re-evaluate. This is such a strict program that I feel if it doesn't work that food restriction is not going to help me. I can't comment on the other diet programs out there but I don't see any harm in trying them short term. As an aside, I've lost weight I didn't need to lose.
Best wishes.
Posted By: Alice10

Re: Low Starch Diet vs. Gluten-Free Diet - 08/19/19 10:36 AM

Hello Rich,

Thank you very much for your reply and your info.
And indeed, there are a lot of posts on that forum about diet! I didn't realize that with the default settings I was only seeing the posts from the last 3 months... Thanks :-)

Hello Faye,

Thank you for your advice and the link to the Website on the Keystone approach, it seems really interesting.
So many possible diets to try... But, like you, I think that there is no harm trying them. And with a bit of luck, one of them will work for me :-)


Posted By: phoneyfarmer

Re: Low Starch Diet vs. Gluten-Free Diet - 08/24/19 03:19 PM

Hi Alice,

As Rich mentioned, an elimination diet would be more helpful. Remember, SpA is an immune-mediated disease which means it is a combination of our immune system *and* an environmental trigger. The key to management is to identify the triggers, and avoid them. Your triggers are unique to you. What works for me or someone else may not work or not be as effect for you. Our work is find our individual triggers. It's an on-going job of finding and refining this list. Also, keep in mind that as your body heals and adjusts, your tolerance for these triggers can change. Some of theories behind this include healing a leaky gut and changing the microflora balance in your gut.

For me, low starch is my principle trigger. Limiting starch intake has allowed me to dramatically reduce my medications. After following this diet for years, I now find I am able to tolerate rice and potatoes in small quantities. Pizza is still a killer. If I eat a slice, I can guarantee that 6 days later I will feel like crap.

I'm going to offer something that is opposite to conventional wisdom. Take it as you will. I'm not sure that a vegetarian diet is fundamentally a "healthy" diet. Yes, it can be but our bodies have not evolved to be vegetarians. There are many good ethical reasons to be vegetarian, e.g., animal cruelty and environmental reasons, but it is not really a good strategy for optimal health. I also agree that the Western diet includes too much animal proteins and not nearly enough fruits and vegetables. You will very hard pressed to eliminate starches and maintain a healthful vegetarian diet. I tend to avoid vegetarian dishes and restaurants. Vegetable-based proteins nearly always come with starches. This is purely a scientific argument, I make no judgement or criticism of your personal integrity. But I do challenge you to consider what you are trying to accomplish through your vegetarian diet. If it is to improve your health, I recommend challenging the conventional wisdom. If it is for ethical reasons, you should be able to find a balance where you are fueling your body with the feedstock it needs while still respecting you ethical goals.

Hope you find this helpful if a bit challenging. Good luck.

Posted By: achala

Re: Low Starch Diet vs. Gluten-Free Diet - 08/30/19 03:38 PM

In addition to my Iritis/AS, I have been diagnosed with eosinophilic gastritis, so the gut component is there. Do people with eosinophilic gastritis that do not have HLA B27 + get AS I dont know, but in my case connections could be in the gut. (I am HLA B27+).

I observed 3 things being on low starch/Mediterranean diet for over a year:

1. eating bread starts the constipation, that leads to inflammation. yes, I was able to sense uveitis flare coming because of the constipation after I ate bread like crazy on holiday.
2. foods high in fructans like: cabbage, okra, onions, pistachios start bloating, gases, and diarrhea in my intestines.
3. foods high in fiber: Forrest fruits especially, makes it all more regular and no pain, especially in case when you have hemorrhoids.

someone recently recommended to me ALCAT tests, although I am little reluctant to take those as are expensive and reading people didn't have much success following elimination diet based on ALCAT tests.

Some time ago i even called American Partnership for Eosinophilic Disorders (APFED), and indeed they told me they dont recommend any food allergen test as unreliable, but elimination diets.

I only wonder how it is possible, during elimination diet, to detect the level of inflammation at home?
I mean every time I have to wait for another episode of uveitis to confirm tomatoes are not good for me?

then I also have been told another environmental factor that should be take into account is the heavy metals sensitivity, crom/titanium/etc
this can be checked with lymphoblastic transformation test ....

hard work/discipline and money to research your body ...
no wonder Humira is more sought solution ....
Posted By: Alice10

Re: Low Starch Diet vs. Gluten-Free Diet - 09/01/19 05:01 PM

***As of today, I'm gluten and dairy-free!***

Hello Larry,

Thank you very much for your input about elimination diets. I like what you say about the fact that AS is a combination of our immune system and an environmental trigger. I think this is a crucial point when trying to get better when suffering from AS (and other immune-mediated diseases).
Thank you also for your thoughts about the vegetarian diet. I'm vegetarian for ethical reasons and not for health reasons. I'm really not an expert in nutrition, but from what I've read/heard, meat isn't so good for your health. There are more and more studies that link some cancers (like colorectal) to the (over?)consumption of meat. And I'm not so sure that the human body is well adapted to the digestion/assimilation of meat, some theories declare quite the opposite.
But, as I said, I'm not vegetarian for health reasons and I'm really not trying to convince you of anything, I just wanted to add my point of view to a subject that I find interesting :-)

Hello Achala,

Thank you very much for sharing your observations concerning your diet.

In my case, I would detect/tract my level of inflammation based on my pain level (joints + guts), as well as my overall well-being (fatigue, mental fog,...). But in your case, I agree that waiting for an episode of uveitis to detect your inflammation isn't great... Do you only get uveitis or do you have other symptoms that could inform your about your inflammation?

Yeap, taking meds seems so much easier than trying to find out what triggers your body... I would like to stop taking meds because of the long-term effects. But for the moment, as soon as I stop taking NSAI, my pain comes back, which impacts greatly my daily life. Even with the NSAI, the mental fog and the fatigue remain. Since I'm HLA B27 negative and my MRI are clear, I'm not allowed to receive biologics. My only option is then to figure out what my trigger is. Hence the diet.
Posted By: Imnotsure

Re: Low Starch Diet vs. Gluten-Free Diet - 09/05/19 04:10 PM

Originally Posted by Alice10

***As of today, I'm gluten and dairy-free!***

Hello Larry,

Thank you also for your thoughts about the vegetarian diet. I'm vegetarian for ethical reasons and not for health reasons. I'm really not an expert in nutrition, but from what I've read/heard, meat isn't so good for your health. t.

I eat beef and drink water only. I've been doing this for years and I'm far healthier on this than eating carbohydrates in plant material. I do this to reduce my inflammation significantly. If I eat a regular diet of carbohydrates and plant material I have to go on tnf blockers as my AS becomes out of control. If I only eat meat I can control my using meloxicam. And my health is really good. when it comes to reading about what diet works best I never read articles because every single article is just from the other article. Someone takes a study interprets it, posts it and then everyone takes that article and then adjust that into their own words weather truth full or changing the wording to skew the results.
Posted By: vosadrian

Re: Low Starch Diet vs. Gluten-Free Diet - 09/06/19 03:41 AM

I'm thinking of trying the meat/water diet. I've tried the whole food plant based (WFPB) for several months with no benefit. I should note that I am not diagnosed with AS, but have many symptoms. I've tried many medications (MTX, Enbrel, Cosentyx) without benefit. I don't know what is actually going on with me. The reason I mentioned that is because WFPB may be a great diet for AS... it just does not help me with my issues.

I have not yet done NSD. It looks a little difficult to manage (for a newbie) if trying to include a wide variety of foods. You may unintentionally ingest starch and come to a wrong conclusion about the diets benefit to you. My thinking was just eating meat and water for a month or two should give me an idea if NSD works since meat is NSD. Then if it is making a difference I could look into reintroducing other NSD foods to find a diet with more variety that is more long term manageable.

With eating just beef, do you take any supplements? Also I am fairly athletic (cycling 5-10 hours a week at high intensity), and I rely on carbs for energy for this currently. Would I have to adjust the way I do this being on a no carb diet?

I am sure I would get sick of meat, but I can do it for a month or so as an experiment.
Posted By: Alice10

Re: Low Starch Diet vs. Gluten-Free Diet - 09/07/19 06:11 PM

Hello Imnotsure,

You've been eating only beef for several years? You don't have deficiencies? I wonder how you can get enough vitamins, fibers, antioxidants, minerals, ...? It really puzzles me.
I find it a bit sad that you restrict yourself with this mono-diet. All the other food (fish, fruits, vegetables, oil, herbs, legumes,...) are making you feel sick?
Concerning the articles, I find them interesting so that I don't have to start experimenting from scratch. Of course, you must check if the info are reliable. Thanks to my education, I'm lucky enough to know whether the info are reliable or not. I think that articles allow the global community to share crucial info and make progress.

Hello Vosadrian,

Be aware that this mono-diet (meat) will only let you know if your symptoms are coming from food. It won't tell you if the issue is carbs, gluten, dairy, soy, conservatives, additives,...
As I said to Imnotsure, I don't know how you can cope with the deficiencies that this mono-diet would necessary bring.
I hope you will find a diet that is going to make you feel better :-)
Posted By: Imnotsure

Re: Low Starch Diet vs. Gluten-Free Diet - 09/08/19 04:52 PM

Originally Posted by Alice10
Hello Imnotsure,

You've been eating only beef for several years? You don't have deficiencies? I wonder how you can get enough vitamins, fibers, antioxidants, minerals, ...? It really puzzles me.

It's because this is what were taught.
Posted By: vosadrian

Re: Low Starch Diet vs. Gluten-Free Diet - 09/09/19 05:48 AM

Originally Posted by Alice10

Hello Vosadrian,

Be aware that this mono-diet (meat) will only let you know if your symptoms are coming from food. It won't tell you if the issue is carbs, gluten, dairy, soy, conservatives, additives,...
As I said to Imnotsure, I don't know how you can cope with the deficiencies that this mono-diet would necessary bring.
I hope you will find a diet that is going to make you feel better :-)

For me it is an experiment. Nothing intended to be long term. I just want to find out if diet is a factor in my symptoms. Best would be a long term water fast. I can probably do up to about 5 days of that and I may start with that. After that I want to go through a period of time with absolutely no chance of any starch. Meat seems like a good way to do this without wondering about other stuff which could have starch. If I feel better, I start reintroducing foods to determine which ones make me feel bad again.
Posted By: Alice10

Re: Low Starch Diet vs. Gluten-Free Diet - 09/09/19 12:03 PM

Hello Imnotsure,

I'm not sure I fully understand your enigmatic comment. Do you mean that I'm puzzled because of "something taught"? Would you be so kind as to elaborate your comment, I would really appreciate it as I still don't know whether or not you have deficiencies with your mono-diet. And I think it would be very interesting for whoever would like to try the same diet as you. Thank you in advance :-)

Hello Vosadrian,

Yes, if you just want to find out if diet is a factor, that diet might be really useful. It's probably a good starting point. I've also considered fasting for a few days in order to find out if diet was my issue, but I was a bit concerned about fasting while working full time (since I'm already really tired because of the disease).
Let us know about your findings once you'll have tried this mono-diet :-)
Posted By: Imnotsure

Re: Low Starch Diet vs. Gluten-Free Diet - 09/09/19 03:00 PM

What i meat from a comment is that we are told the dangers of meat over the years. you have vegans taking studies and articles rewriting them in their favour. now don't want to get into the politics of this so as for my deficiencies I have none.

I have my blood work every 6 months monitored by my RH to ensure the medication meloxicam that I'm taking it's not taking a toll on my body and regular AS symptom side effects.

Out of the 20 blood test I have accumulated over the years a few things have gone up and down but it was nothing to be concerned about. For example my creatine was low on blood test but it was fine the next. my cholesterol which I'm sure everyone always asks about is fine. My cholesterol is at 450 which may seem high but it's not. Your cholesterol can you jump 20 to 300 points before and after a meal and they really have no way of measuring cholesterol. When you dive deep into what cholesterol does we actually need this. Cholesterol is far from bad.

Now I don't eat just beef I do eat other things to supply nutrients. Meat itself you can survive just fine but if you want more nutrients you have to eat other things.

So this is what I eat. I eat twice a day. Mainly prime rib because it is 30% fat which is my fuel. Depending on how extensive my activity is that day I will eat more fat from a jar that I make myself for energy production. I eat my beef blue. Meaning I only sear the outside at high heat to kill off the bacteria and the middle is basically raw cand it is freaking delicious. If you eat meat grey or done, you destroy all the nutrients which is why you have to eat things blue because cooking it destroys their nutrients in the meat. I do eat eggs every now and then. Every two days I eat cod liver and its own oil. It is high in omega-3. If you take fish oil or cod liver in pills it's already rancid and oxidized and does not do anything. Its awaste of money. I do eat oysters for zinc and in turn increases your libido. Having this disease kind of destroys that.

So, my blood work is perfect and above. My kidney and liver function is above-average. I my inflammatory markers are normal. My vitamin c which people always ask about when eating meat is normal because meat has vitamin c in in it but again when you overcook it you destroy the vitamin c which is why you have it blue. I'm at the point now where I literally crave meat and fat.

Between the prime rib and cod liver, oysters is more than enough to have all the vitamins and minerals you need.

I am not the only one on this diet. There are hundreds and thousands of people that do this to control their autoimmunity diseases. The diet information for ankylosing spondylitis is outdated. It says to stay away from red meat and high-fat yet here I am and hundreds of other people thrive off red meat and high fat omega-3. Stay away from Omega 9 as that is the worst fat for your body for anybody which causes severe inflammation for those with autoimmune diseases. Like peanuts is high in Omega 9 then omega-6 and very little omega-3.

I do take other supplements stop replace the oxidative stress caused by ankylosing. what if I told you I figured out the fatigue that we all have with AS? I did because I'm a motherfuking badass 😏
now it may not necessarily work for other people but it definitely works for the people that I help with her AS.

See when I started my journey tackling this disease I was trying to fix the disease. Stop AS itself. But I realize it's not possible so I change my my research and started to Target things that need to be fixed caused by AS. Our bodies use up so many resources combating this disease because of the pain and inflammation. if you're not replacing has been completed your symptoms are rolling going to get worse so I am replacing what a s is taking away and this is why I'm in literally no pain and almost in complete remission.

I go running, I go mountain biking, I went waterskiing over the weekend and we all know how hard and strenuous water skiing is on your back. I'm shredded and I don't workout but because my job is extremely physical I do about 20k to 30k steps a day. prior to all this and being on tnf blockers I could not do any of this. Let alone get out of bed.

each time at the end of my rheumatologist appointment she says when do you want to schedule and is there any point? And I say to her while we'll keep it at 6 months because something could happen something could change so I'll see you every 6 months.

Some other benefits now point out being on my meat diet. Iglo, I look younger, I have absolutely no body fat on me at all. when you are on a high-fat and no carbohydrate diet you do not store fat. I am 5-11 and I was at 180 lb and now I set on average 145 to 150. I'm usually 150 at the end of the day after Ive eaten in 6 lb of beef.

Have not been sick or taking a day off work for anything medical and over five years now. No cold no flu no nothing. I have three kids and dog and cat and a wife and they're always getting sick. I used to get sick a lot before this. I used to get cold sores and then when I switch to meet my no longer get them. With this by fluke? Coincidence? I don't know other than this is a little thing that I noticed. Cold sores are usually caused by stress induced and if you remove the stresses in the oxidative stress in your body while it should keep the cold sores from breaking out cuz that seems to be logic.

Eating this way can be tough sometimes mentally. I won't lie that I have broken down crying that I miss pizza or my favourite ice cream which was chocolate peanut butter Haagen-Dazs. It took me almost 2 years to not cheat when I first started doing this. And has nothing to do with willpower has to do with old learning to do this way because it completely changes your life and your social life. I carry a barbecue in my pickup truck so I can cook my lunch or if I go to a wedding or anywhere so I can eat. going to parties weddings or social gatherings is tough because you can't eat and you can't drink. As long as I have distilled alcohols I'm okay but I'm not a hard liquor drinker so it's tough down whiskey all night so I just don't do it. I do make beef jerky for snacks got to take a long when I go mountain biking or any sports we're on unable to eat a meal right away.

But when you're at the point that you're in so much pain that you have thought about taking your own life just to get away from it; this is how I'm doing this mono diet.

Posted By: Alice10

Re: Low Starch Diet vs. Gluten-Free Diet - 09/10/19 03:42 PM

Hello Imnotsure,

Thank you for explaining your comment, I understand what you mean now. I don’t see this as you, but that’s ok. You’re pro-meat and I’m not, so let’s just leave it ;-)
I just want to add though, in case other persons than you and I are reading this thread, that vegans don’t “rewrite articles” on their favor. 99% of vegetarians/vegan are just trying to be more respectful toward the nature and the environment (refusal to take part of inhumane factory farming; respect all lives, meaning not killing animals while you can eat other food; reduce the impact of animal agriculture on the environment; etc.).

Thank you very much for your explanations about your diet. I’m very glad for you that you don’t have any deficiency. It does look like this mono-diet is working for you!

I like when you say that you started by trying to fix the disease and then you realized that you need in fact to fix what caused the disease. That’s what I would like to do as well, avoiding the inflammation by changing my diet rather than fixing the inflammation (once it’s already there) by taking meds.

I see that you’re doing a lot of sport, that’s so great. I miss exercising...

Oh yes, I guess your diet must be sometimes difficult when you go out... Just being a vegetarian brings a lot of comments and criticism, so I can imagine that your diet must bring so many (unwanted) comments and remarks... But I’m sure you’ve learned to cope with it or at least ignore it.

Yes, I know that when you’re in great pain, you would do pretty much anything to get better. I’m happy for you that you’ve been able to find what makes you feel better :-)

I wish you the best,

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