Discussion Board

Dear Jeff,

I am a long-time sufferer of ankylosing spondylitis. I started the symptoms around age 20, and I am 47 now. I am HLA B-27 positive. At age 19, I had a total colectomy due to ulcerative colitis going out of control. I have also had Graves disease. Obviously, I have a plethora of auto-immune disorders.

I have had success with the McDougall diet in vastly reducing my symptoms. I have not been able to follow the McDougall diet 100%, so I am only assuming (with some certainty) that my symptoms would completely disappear if I were to be strict enough with my diet.

I have fairly recently been talking to my 19-year-old nephew who also has AS. He is willing to try diet to relieve his symptoms. He has been on the high protein/low carb diet described below, for a short time, and is finding great relief from it. I am thrilled that it is helping him. I know I was so miserable at that time in my life I would have done anything for relief. However, I see big health issues in him trying to maintain this diet for a lifetime, or even a long period of time.

Below is a quote from an article (link to complete article below that)...

"So this leaves two big questions. How do you get rid of Klebsiella? And does it actually help AS patients if this microbe is eliminated from the body? That brings us back to the high-protein, low-carb diet. Bacterial studies were carried out on 47 people on a high-carb/ low-protein diet and compared to another 45 people on a low-carb/ high-protein diet. Those on the low-carb diet were found to have around 50 times less Klebsiella organisms in their colon (Finegold SM, Sutter VL, Sugihara PT et al. Am J Clin Nutr 1977; 30(11): 1781-1792). Ebringer argued that resistant starch in the diet (starch that cannot be digested by our own enzymes) was feeding the growth of Klebsiella because it could be broken down by bacterial fermentation. This led him to develop the following low-starch diet plan for his AS patients:
1. Increase meat and fish, beans and peas, nuts, vegetables, fruits, milk and milk products. 
2. Reduce bread, potatoes, crisps, rice, pasta, cereals, cakes and biscuits."
http://www.thehealthierlife.co.uk/natur ... 00044.html

So why does the Ebringer Diet, which is a polar opposite to the McDougall diet, work?

It appears that both of these diets can be effective. Both diets help AS, but only one is healthy and safe to continue with for a lifetime. If gut permeability is reduced by eating a low protein, starch-based diet, would the Klebsiella, assuming it is still in the gut, be rendered harmless because it would no longer pass through the gut wall to cause the auto-immune reaction?

Am I way off in this thinking? I would love some insight into this. I think my nephew will eventually be willing to try a plant based diet, but for now he'll stick to what's working for him, but he realizes that he does need starches in his diet...

Thanks for your time!