In ankylosing spondylitis, an inflammatory form of arthritis, inflammation occurs in the joints and ligaments along the spine without a known cause. Instead of protecting your body by fighting off foreign invaders, your immune system mistakenly attacks your own joints, which can result in joint damage and cause joint pain, swelling, and stiffness, according to the Spondylitis Association of America. Reducing inflammation in your body can help ease the symptoms of ankylosing spondylitis. One potential way to do this is to incorporate anti-inflammatory foods into your diet.

Ankylosing Spondylitis and Your Diet

While diet alone can’t cure or treat ankylosing spondylitis, eliminating foods that increase inflammation, like processed foods and saturated fat, and eating foods that help lower inflammation may help you better manage symptoms like joint pain and stiffness. What foods should you be eating? According to the Arthritis Foundation, a diet rich in fruits, vegetables, whole grains, and omega-3 fatty acid–rich foods like fatty fish may help reduce inflammation. Monica Gulisano, RD, an integrative dietitian and nutritionist and the founder of the Center for Joyful Eating in Durham, North Carolina, creates diets for people with ankylosing spondylitis that replace foods that promote inflammation with inflammation-fighting foods. “Whenever a condition has inflammation as its root cause, the person can really benefit from decreasing inflammation-causing foods in their diet,” Gulisano says. Diet doesn’t cause inflammatory disease, but it can help perpetuate the inflammatory process, she notes. Focusing on anti-inflammatory foods and trying to incorporate them into your diet is important, Gulisano says, but your first step should be cleaning up your diet. “Decreasing, eliminating, or avoiding added sugars from all sources and cleansing your diet of damaged fats are both critical,” she says. (Damaged fats are oxidized fats, which are typically fried fats found in foods like French fries or chips.) The Arthritis Foundation also recommends focusing on a diet that limits processed foods and saturated fats. However, beware of anything marketed as fast and healthy, says Leah Groppo, CDCES, RD, a clinical dietitian at Stanford Health Care in Palo Alto, California, as many items labeled that way aren’t necessarily healthy. “All those things that come in bags and bars tend to be very processed, which isn’t good for your diet,” she says.

What to Eat to Fight Inflammation

Explore the benefits of foods with anti-inflammatory properties, as well as ways to incorporate them into your diet.

Leafy Greens

Leafy greens such as spinach, collard greens, kale, and Swiss chard contain magnesium, which is known to decrease inflammatory markers, says Gulisano. These inflammation-fighting benefits are mostly found in foods more than supplements, she adds. While it doesn’t matter whether you eat them raw or cooked, Gulisano suggests cooking the greens with a little garlic and olive oil for maximum benefit, as garlic also contains magnesium.

Broccoli

This vegetable, part of the cruciferous family, contains an antioxidant called sulforaphane, which may help reduce levels of inflammatory compounds, according to the Arthritis Foundation. Not a fan of broccoli? You may just need to change up the way you cook it. Consider the texture you favor, says Groppo. “Are you a crunchy texture person or more of a soft texture person?” she asks. For example, if you like mashed potatoes, replace those with mashed cauliflower with a few broccoli florets thrown in. Try to think of ways to prepare the vegetable that aren’t a huge leap from what you’re used to, she suggests. “Maybe going straight to plain steamed broccoli is a hard move to make,” she says, suggesting sautéed broccoli with a squirt of lemon juice and some Parmesan cheese instead.

Onions

Onions, garlic, shallots, and leeks are all part of the allium family. “These foods are rich in sulfuric compounds, which have anti-inflammatory properties,” says Gulisano. Onions are also packed with quercetin, a flavonoid that helps inhibit inflammation-causing agents in fats. Apples are a good source of quercetin, too, says Gulisano. While all types of onions are healthy, shallots, red onions, and yellow onions may contain the greatest amounts of these inflammation-fighting compounds, according to the Arthritis Foundation. Try adding raw or cooked onions to your salads, sandwiches, or stir-fries.

Berries

Strawberries, raspberries, blueberries, and blackberries are rich in antioxidants, which help decrease inflammation and fight the effects of free radicals in your body. Much of their inflammation-fighting power comes from anthocyanin, the antioxidant flavonoid that gives them their distinctive color. Berries contain varying levels of antioxidants, so aim to include a variety in your daily diet. Add fresh or frozen berries to smoothies, on top of oatmeal or Greek yogurt, or to salads for a hint of sweetness.

Wild Salmon

“Fatty fish is the superstar protein when it comes to an anti-inflammatory diet due to the omega-3 content,” says Gulisano. “Omega-3s are probably the most studied part of the anti-inflammatory diet,” she says. According to the Arthritis Foundation, omega-3s may help reduce chemicals that create inflammation in your body. While much of the research on omega-3s has focused on rheumatoid arthritis, a small study of people with ankylosing spondylitis published in February 2020 in the journal Reumatologia found that those who took a large dose of omega-3 supplements (4.55 grams three times a day) showed significantly less disease activity than those who took a smaller dose. But due to the small number of participants, the results require more research. Although wild salmon might be on the top of the list, other fish have anti-inflammatory benefits, too, including rainbow trout, mackerel, sardines, and Atlantic cod. “All of these fish are low in mercury and high in omega-3s,” Gulisano says.

Healthy Oils

Replacing butter or margarine with a healthy oil is a good idea, says Groppo. Extra-virgin olive oil, the least refined and processed type of olive oil, contains a number of antioxidant and anti-inflammatory compounds. According to the Canadian Society of Intestinal Research, a compound found in olive oil called oleocanthal is similar to nonsteroidal anti-inflammatory drugs in its ability to decrease inflammation and pain. Use extra-virgin olive oil in dressings and marinades, or drizzle it on food before serving. When choosing an oil for high-heat cooking like stir-frying, look for one with a high smoke point. The smoke point is the temperature at which oil begins to break down and starts to smoke and lose some of its nutritional value. Avocado oil is a good choice, according to the Arthritis Foundation — it has a high smoke point and anti-inflammatory benefits.

Nuts and Seeds

Some nuts and seeds are high in alpha linoleic acid, which is a type of anti-inflammatory omega-3 fatty acid. According to the Arthritis Foundation, the best choices for the biggest health benefits include walnuts, almonds, peanuts, pistachios, chia seeds, and ground flaxseeds. If you don’t like snacking on nuts and seeds, try adding them to dishes that you do like, says Groppo, such as a salad or a main dish like salmon. She cautions to make sure you keep moderation in mind when it comes to adding nuts into your diet because of their high calorie content. Remember that you don’t have to add all these foods to your diet at once. Think about the big picture, Groppo says. Every positive change adds up. Focus on swapping out an unhealthy food that causes inflammation and replacing it with a healthier one that helps fight inflammation.