Let's take a look at the AS sufferer, Kate: a professional photographer who suffers stiffness and pain in her back and neck, and the characteristic chest tightness which can make it hard to breathe (and in my case at least, sometimes make it difficult to wipe one's own arse). She is currently on non-steroidal anti-inflammatories (or NSAIDS in medicalese) which come with their own long list of side-effects. Instead of advocating a calcium and vitamin-D rich diet (AS sufferers are at risk of developing osteopenia, and consequently osteoporosis), or telling her to go and see a physiotherapist IMMEDIATELY, the GP and dietician decide to start Kate on a low-starch diet. At first glance, that doesn't seem too bad. Sort of like a cod-Atkins diet, and we all know how everyone agrees it's a safe way to lose weight...
The low-starch AS diet (also known as the London diet) is a somewhat controversial diet plan devised in response to an as yet unproven theory which states that when starch is eaten by a person with AS it is digested by Klebsiella bacteria. In response to this, the body is said to produce antibodies to attack the bacteria, but which also, as a by-product, attack collagens in the body, causing inflammation. Now, there are lots of success stories on the internet extolling the virtues of this diet. There are also stories telling you to infect yourself with tapeworms to cure your AS. The fact that someone has written about it on the internet does not proof make. Actual scientific evidence for the widespread success of this diet is circumstantial at best, and the fact that it is being given legitimacy by being advocated on telly is, in my humble opinion, irresponsible for the following reasons:
1. Fatigue.
Fatigue is one of the not-oft discussed symptoms of AS. If you cut out bread, potatoes, rice, couscous, quinoa, cereals, pulses, pastas etc, you are cutting out complex carbs which provide us with a LOT of energy. If you are falling asleep multiple times a day, and have no energy to do your exercises, I fail to see how cutting out the cornflakes is going to do you much good. This ties in with #2...
2. Depression
Another rarely discussed by-product of an AS diagnosis, and one which seems relatively common in the AS sufferers I have met, depression can lead to poor diet and low energy levels too.
3. Money
Buying shedloads of meat is expensive. Plus, if you are a veggie, you are probably going to have start at least eating fish, or you will probably die.
4.IT'S DANGEROUS
When a dietician tells you on TV that she wouldn't ever recommend this diet to a normal member of the public because a lack of the above-mentioned starchy foods can lead to bowel cancer and severe digestive problems, that's usually when alarm bells should start ringing. Combine this with the fact that there is a high rate of AS co-occurrence with Crohn's disease and I would, like Kate, be smiling and nodding, but I would also, unlike Kate, be backing away as fast as I could.
As the programme explained, there is no cure for AS, but there *are* drugs which significantly help, and in my case, they radically changed my life (THREE CHEERS FOR ANTI-TNF!). It's nice that for Kate at least, her flare-ups had reduced by half after six weeks on the diet (though considering the inherently variable nature of AS, where sufferers can dance around one day, but can barely walk the next, this is not necessarily a case of correlation = causation). However I find it pretty scary that a newly diagnosed AS sufferer could stumble upon this show and embark on something so unknown, dangerous and ill-advised as a result. Thanks a bunch, Channel 4.
