Low Starch Diet for Ankylosing Spondylitis: Part 2 – The Scientific Evidence

We have already seen (in the last blog) the theoretical possibility of a ‘Low starch diet’ being beneficial for Ankylosing Spondylitis. Let us now see whether it really works in real life & whether there is sound medical evidence to support it.

Today’s medicine works on the basis of evidence. If a new medicine/ intervention is thought to be useful, it is tested in clinical trials. A group of patients is given the standard treatment & placebo (an inert substance that has no effect on disease activity) while another comparable group is given the standard treatment & the experimental therapy/ intervention. A ‘double blinded study’ that ensures that neither the investigator nor the patient knows whether he is taking the experimental drug or placebo is ideal to avoid any bias; both on the investigator or the patient front. This is not possible for studies with dietary modifications as blinding is not possible & bias tends to creep in.

As against medicines, it is very difficult to keep an exact track of the diet of any patient for obvious reasons. It is extremely difficult to ensure that a patient sticks to a particular diet in the long run throughout the study period.

These two factors make studies based on dietary interventions difficult to conduct as well as interpret.

For the reasons mentioned, there are hardly any studies about ‘low starch diet’ in Ankylosing spondylitis. In 1996, Dr. Ebringer discussed the disease activity trend of one of his patients following the diet for a long period (1983- 1995). His ESR showed a continuously decreasing trend. In another study (mentioned widely on the internet with no reliable data available on any of the medical literature sites) 36 patients received Dr. Ebringer’s diet & showed considerable improvement in symptoms. These two studies would be highly inadequate for any definite conclusions.

So, as we have seen, the utility of ‘low starch diet’ in Ankylosing spondylitis is not yet proven scientifically.

One way of looking at things would be to give it a try & see whether it works. However it has to be weighed against the risks involved in pursuing such a diet.

In the next blogpost, let us look at what a ‘low starch diet’ includes/ excludes & the possible health hazards of such a diet.


  1. It is not “Doctor” Ebringer (the professor’s brother), but “Professor” Ebringer. Subject “Mrs. B” is not a man, but a woman; diet works for women, also. Ebringer’s findings were offered as support for the use of diet in the control of AS, not as any complete scientific study: There is not enough incentive for further studies, as these are usually funded by pharmaceutical companies. University of Maastricht “almost” did a dietary study, but it was scrapped in favor of funding a different project. However, PRIOR to Ebringer’s seminal work in the field, it can be shown that elimination of dietary starches has been used to control “Marie-Strumpell’s:” “A Doctor’s PROVEN New Home Cure for Arthritis,” by Giraud Campbell, D.O. And subsequent continual addition of “anecdotal” evidence that is too compelling to ignore (www.kickas.org NSD success stories) as well as the great work of Dr. Jean Seignalet in France. It all stacks up, especially for Bayesian thinkers.



    1. Dear John,

      Thank you for the valuable comments. I have seen your site & you are doing good work in raising the awareness about & supporting AS patients.

      I have already blogged about the science behind the possible benefit of low starch diet in the prevous post.

      It is true that dietary studies do not find sponsors & are difficult to conduct. However, at the same time, that makes it difficult to recommend them outright.

      I have full respect for the extraordinady work done by Prof Ebringer in this field & I am looking forward to a retrospective analysis of the data of AS patients following his diet at his clinic.

      This data if published would be a great help to Rheumatologists & AS patients.



    2. John, “Marie-Strumpell’s:” “A Doctor’s PROVEN New Home Cure for Arthritis,” by Giraud Campbell, provides as much evidence for the efficacy of coffee enemas as it does the Low Starch Diet (LSD). One would have to control for such confounding variables as coffee enemas if one is to present such a study as evidence of the efficacy of the LSD.



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