I was diagnosed with AS in November and have experienced a major decline since then. I cannot take NSAIDs, due to gastritis, and Humira seemed to be ineffective. I just started Remicade this past Wednesday, and I am also on Methotrexate. I stopped the Humira mid-June in order to start the Remicade, but my insurance changed and it took longer than expected to get pre-authorized. Since stopping the Humira, I now realize how much it was actually working. However, being that I was on weekly Humira and still developed iritis in May, it simply was not enough. I am now in the midst of a terrible flare and am also battling iritis for the second time.

That being said, I have been doing much research about all of the various diets: gluten-free, anti-inflammatory, low-starch, etc. Honestly, I feel like my head is spinning. We were initially going to try gluten-free, but I have decided that I want to combine the anti-inflammatory with the LSD. The problem is that I am Italian and love my pasta. We don't eat it that often, but when we do, I still want to be able to enjoy it (hence, the reason that I am doing doing a NSD). My question is, for the times that we DO eat pasta, would it be reasonable to substitute the regular pasta for whole wheat? Everything else I am willing to give up, but I just cannot completely give up the pasta.

So now comes the part where I beg you all for tips! LOL! As I said, this is all very overwhelming. Some say avoid dairy, others say no nightshades, etc, etc, etc. Do I start by just eliminating everything and slowly adding things back in? Or is it better to start with a simple LSD, eating less processed foods and lower fats, and if I am not seeing a difference, then I can start to eliminate things?

On a good note...for breakfast this morning I had eggs and a cup of low-fat yogurt with gluten-free trail mix. I am WAY more full than I ever am after eating a bowl of cereal. I am excited to make this lifestyle change. Even if it doesn't do anything for my AS symptoms, it'll help me to eat healthier and hopefully shed some weight as well. My husband is also excited to do this with me. Over the past few months we have made a lot of changes as it is, including paying more attention to food labels and not buying things with ingredients that you cannot pronounce. Even our ice cream (we love ice cream), we have switched to the all-natural stuff.

Well, it's great to meet you all and I am definitely ready to do this.

I'd substitute regular pasta for a rice noodle, on the basis that rice seems to be better tolerated of all the grains. It does taste a bit different (actually quite a bit), but once you get used to it it should be fine. Perhaps start by using rice noodles with an asian style dish rather than as a traditional italian pasta type, then once you understand the taste of the rice noodles and haven't had the wheat based stuff for a while you could use if for italian.

The other possibility is to do something quite different, like using spaghetti squash (a vegetable that has a spaghetti like centre) or bean thread vermicilli, or very finely cut strips of some other vegetable?

I've also just heard a suggestion of doing a lasagne using leeks instead of pasta. And a while back I found a website that had some suggestions for lo-carb (which is usually low starch) pizza - you get all the flavour of the pizza, with a kind of "crust" or base to support it, but none of the carb. The low carb forums actually had some really inventive ways of using food.

If I am ever eating low starch when I am out, I just fill up on other stuff (more veg, a slightly larger serve of protein). Also have a think about how else you could be eating your favourite pasta sauces - it doesn't always have to be on spaghetti.

But, chances are that once you really start to see the benefits of avoiding pasta, you might find that it rapidly becomes a very unattractive option. I've been gluten free (coeliac) for probably 15 years now, and I initially told myself I'd ease into it gently and not go totally gluten free for about six months. I actually did it in two weeks, and there is no way I would knowingly put it in my body again. And I was a real bread junkie up to that point. You just have to figure out a whole new way of eating and stick to it. But it doesn't have to be that different from what the rest of the family are eating.

Hi, Kim:

It was iritis that drove me to the NSD and kept me on the straight-and-narrow for many years; suppose I ate starches until I really needed glasses!



Regret You have already had iritis, so my tactical suggestion is to begin with the most extreme diet, that is Carol Sinclair's NSD--plus eliminate dairy if only for several weeks at the maximum. Best to get into fullest remission possible, and then add back potentially provocative foods.

This may get moved to NSD Forum, but it is important for everyone to understand what You know instinctively--that if You are already on a tnf-a inhibitor and still develop iritis, it is certainly not keeping the AS in proper control.

Even fasting for up to a week would help jump-start Your NSD efforts, so please keep this in mind; it is a rocky road ahead and sometimes You might feel that You are falling behind as much as moving forward.

As to the pasta, it makes very little difference whether this is whole wheat or from regular flour; regret the same risks are involved.

Attention should be paid to the major natural cycles in AS: Knowing that a flare can be triggered within several hours of consuming a provocative food, but this flare might not subside for over four and up to ten days; we usually have (with 'normal' diets) so many harmonics of these cycles going on that it is difficult to ascribe feeling worse to any specific meal. It is better to start from a position of no such perturbations but this requires some patience.

If I were experimenting with pasta, I could not eat them within ten days of one to another and, upon achieving natural remission, I would do everything I could to stay AS-free and that might include trying some natural anti-Klebsiella things like the product that contains tannins: Tanalbit.

But I do much more by taking antibiotics; You might be able to design some protocol to help You work around the pasta issue. I once did a severe Indian food meal, taking too many antibiotics; AS symptoms avoided, but I had some gastric distress as the result of increased dosage.

I have plenty of the "Miracle Noodle" stuff. They make a rice, a lasagna noodle, and an angel hair pasta which are all 'manageable,' but not at all appetizing. These pastas are made from mushroom flour, which the company also markets.

HEALTH,
John

whole wheat pasta is no better than regular pasta if you are sensitive to gluten.

spaghetti squash with a meat sauce or tomato sauce with meatballs and lots of romano and I hardly miss the pasta at all.

I've never noticed the nightshades to bother me. If that were the case, I'd think the tomato sauce would be far harder to give up than the pasta.

or a vegetable lasagna where one would layer zucchini, sauce, etc.

As for what else to eliminate. I had to eliminate (cow) dairy because i'm sensitive to the casein protein. It gives me gastritis and constipation. If it bothers you, stop it, but don't stop it just because.

But I might be able to eat goat or sheep milk products. hence why i can perhaps have romano but not parmesan (i like romano far better anyhow).

Same with any other food item. Sometimes a food symptom diary can tell you what to avoid.

I also had blood work done that told me I was sensitive to casein and a little bit to eggs. So no cow's dairy (no milk, no yogurt, no cow's cheese) for me.

My stepfather is Sicilian and thus I grew up eating lots of Italian food. My husband's grandfather was also Italian, thus we still eat lots of italian food. I just don't eat the pasta or any of the cheeses made from cow's milk. That still leaves a lot of italian food. Maybe not what most American's think of as Italian food, maybe not most of what one can get in an american-italian restaurant, but lots of authentic italian food....but I do miss good bread........but one adjusts.

Hey Kim,

Once you make the switch, your body will seriously start to crave real whole fresh foods. I make "zucchini" noodles all the time, and love to coat them in Brazil Nut Pesto or Raw Pad Thai Sauce. I serve them at my Farmers Market booth and they are a HUGE hit! Everyone in town now wants to know where I got my $30 "noodle" maker. Here is a sample of what I am talking about: http://thedeliciousrevolution.com/raw-foods/5-minute-summer-dinner/

This is the best one I have found to use: http://www.amazon.com/World-Cuisine-A498...ords=spiralizer

I personally found tomatoes to be way to inflammatory for me (along with oranges) But I find most other fruits & veggies to be just fine. I eat lots of fresh made basil pesto instead. Recipe includes: Fresh Basil, Garlic, Nutrional Yeast, Olive Oil, Sea Salt, Brazil Nuts or Hemp Seeds.

The road will seem a bit bumpy as you transistion and results don't usually fully come on as fast as we'd like. But I believe your are making one of the best decisions of your life to transistion away from starchy processed "filler" foods in exchange for nutrient dense whole fresh foods.

I eat mostly raw. That means the foods I eat do NOT have to go through a factory or come out of a package. I buy my fruits, veggies, nuts & meats directly from farmers. It makes such a difference! (but I also live in the country so this is easy) I eat tons of fresh fruits, veggies, soaked nuts, pureed seeds, and a little seafood & grassfed beef. I still cook things on occasion (like the meats & some veggies) and I don't feel deprived in the least, instead I feel like I am thriving!

Most of my customers at the farmers market who buy my fresh "raw" starch free/low starch meals LOVE them, and these are peeps who aren't on restrictive diets. I get so many compliments for making "good" food that makes people feel "GOOD!" I am excited to hear how things improve for you over the next few months as you make this transition!

-Andrea