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My New Food and Movement in Managing Ankylosing Spondylitis

Content warning: Eating behaviors and nutrition.

There are usually three camps when it comes to managing ankylosing spondylitis (AS) and other chronic inflammatory conditions. The first is the pharmaceutical camp, which places emphasis on drugs to manage the disease. The second is the holistic camp, which would rather use nutrition, movement, and other methods to manage AS. The third focuses on some healthy combo of both.

I'm firmly part of that latter category; I have used Biologic drugs, frequently turn to anti-inflammatory medications, and likely will use immunosuppressants again in my life. But for the better part of a year, after one of the most intense, all-consuming flare-ups of my life—which lasted from about late November 2021 to about March 2022 (see: the 4-month flare-up), I've been controlling my AS largely through the use of nutrition and movement (and my good friend, Advil, of course).

I made a note about how I've changed my movement and eating habits this year versus in the years before. I am making absolutely no claim that they're a) working for sure since I have no scientific way of proving it, or b) it would work or is even right or healthy for anyone else. In short, maybe this will add to the pile of anecdotal, patient-supplied evidence around eating and movement — and maybe it'll even reflect your own experiences or curiosities.

What I was doing with food before 2022:

Prior to 2022, I was eating a lot of healthy, and mostly-plant-based foods, including plant-based meats. I was also drinking more than I do now (although I took some time off and really enjoyed that feeling). By "more," I mean a couple of glasses of wine a few times a week or a bottle or two of wine a few times a week. These days, I've limited drinking to very special occasions, typically, having a glass or two of wine once per week. I also have reduced plant-based meats, as I've read evidence that they're not exactly good for inflammation. I've drastically cut back on chips, candies, and treats (but I still enjoy a croissant once or twice a week). I eat loads of greens, veggies, couscous, brown rice, fish, tuna, and fruit.

What I'm doing with food in 2022:

The biggest difference I've made is that I now do intermittent fasting (IF) about five days per week, give or take, depending on the week. I eat for about eight hours and fast for about 16 (most of those hours are when I sleep).  At first, I hated it, but it has made the most remarkable, definitive, noticeable difference in my chronic pain and AS activity — more than any drug, more than any movement, and more than reducing stress. There's a lot of clinical research around the gut and AS, as well as IF, chronic pain, and inflammation.

IF is not for everyone, including pregnant people or those with a history of disordered eating.

What I was doing with movement before:

While in quarantine for most of 2020 and early 2021-—before contracting Covid in April 2021, which threw me off for about six months-—I was doing a lot of YouTube workouts.

For me, AS flares are highly related to my movement levels. I am a devotee of the "move it or lose it" camp, unless I can't move or am too fatigued. I feel lucky that my AS was diagnosed during a time in my life when I was using exercise as a tool for mental health support.

In this sense, dedication to movement was built into my life in some sense, and it was and is a non-negotiable for me. I am lucky to have enough mobility to exercise, but I also attribute this to movement. I suppose it's a cycle.

Before this year, I was doing higher-impact HIIT classes in my house, and paying the price. My hips and knees hurt a lot. I was also doing a lot of dance workouts, but I wasn't modifying my movements. Anything too heavy, intense, or pounding is not great for my spine.

What I'm doing with movement now:

These days, I'm walking so much more. I'd love to get 10,000 steps per day but my hips can't take it. I typically can walk up to 7,000 steps before pain takes over, and I try to do that several times per week. I am still dancing regularly, but more intentional with my movements. I also follow a low of low-impact walking workouts, like this.

I feel strong, in control, and in a lot less pain.

How do you use food and movement?

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