Review Article

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

Aikaterini A. Kalogeropoulou

• Clinical Dietitian - Nutritionist, Athens, Greece

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Keywords: Ankylosing spondylitis, Vitamin D supplementation, Diet, Starch diet, Systemic inflammation

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Abstract

Ankylosing spondylitis (AS) is an inflammatory rheumatic disorder that burdens predominantly the spine and sacroiliac joints. The exact factors that define the development and evolution of the AS remain unclear. The ambiguity around the therapeutic treatment of vitamin D, regarding its immunomodulatory and anti-inflammatory effects in the development of the AS, provides an attractive field of investigation. The connection of the disease with intestinal gut microbiota is well documented, allowing for investigating the role of nutrition, including prebiotics and probiotics, on well-being and functionality of people with AS. The beneficial effect of low starch diet and the anti-inflammatory effect of the Mediterranean diet are landmarks in the development of AS. Additionally, it can be argued that the progression of the disease was compounded, among the Inuit population of Alaska, by the change in their nutrition that was rich in omega-3 polyunsaturated fatty acids and low carbohydrate, to a “Western-Diet” that is high in carbohydrate (sugar and starch) and saturated fat. This review investigates the relationship between diet and disease progression, as well as identifies a dietary pattern that could improve the well-being of people with AS. Finally, this review investigates the therapeutic effect of vitamin D supplementation in the disease progress.

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