Article Text

AB1181-HPR Starch Intake and Parameters of Disease Activity, Functional Impact and Quality of Life of Patients with Ankylosing Spondylitis
  1. A. Silva
  2. on behalf of FM Pimentel-Santos, Jaime C. Branco, Fernanda Mesquita
  1. Superior Institute of Health Sciences Egas Moniz, Monte de Caparica, Portugal


Background Ankylosing Spondylitis (AS) is a chronic, inflammatory disease that primarily affects the axial skeleton, causing a progressive limitation of mobility. Some studies have highlighted the association between intake of starch and the disease activity.

Objectives The aim of this study is to confirm the association between starch intake and the parameters of disease activity, functional impact and quality of life of patients with AS.

Methods This is a prospective cohort study. Participants were patients with AS, followed in the Rheumatology Department of CHLO, Hospital de Egas Moniz. They have completed a food diary for five consecutive days, recording the ingested food and the respective amount. The measurement of the starch was based on the reference values of the Table of Food, from Institute Dr. Ricardo Jorge. The BASDAI, BASFI, BASG and SF-36 questionnaires were completed and the CRP and VS values were further analyzed. The analysis of the Pearson's Correlation Coefficient was used to evaluate the possible associations between the variables under study and the starch average ingestion. Subsequently, a Linear Regression Analysis was performed, in order to identify the statistical power of the variables, neutralizing potential confounding variables, namely the gender, age, BMI and drug therapy.

Results 12 patients (9 males and 3 females), aged between 26 and 63 years, have been evaluated. The average daily intake of starch was 185.5±64.5 mg, the average BASDAI was 2.68±2.12, the average BASFI was 3.57±2.56, the average BASG was 3.83±1.92, the average SF-36 was 74.49±9.35, the average CRP was 2.16±2.07 mg/dL and the average VS was 15.03±18.42 mmHg 1st hour. The analysis of the Pearson's Correlation Coefficient has revealed that the average starch intake was significantly associated to three factors: the disease activity (BASDAI) (p<0,05), the functional impact (BASFI) (p<0.05), and the wellness in general (BASG) (p<0.05). It was not observed any association neither with the quality of life questionnaire (SF-36), nor with the inflammation parameters (CRP and VS). By means of Linear Regression Analysis, it was verified that the average intake of starch presents a statistical power of 76.8%, 84.6% and 94.7%, for the BASDAI, BASFI and BASG variables, respectively. The Linear Regression Coefficient shows increases of 3%, 3.9% and 2.9% in BASDAI, BASFI and BASG scores, respectively, by milligram of ingested starch. The confounding variables (gender, age, BMI and drug therapy) revealed a low statistical power.

Conclusions A higher intake of starch seems to be related with an increased activity and with a greater functional impact of the disease. These results allow us to envisage the reduction of the starch content of the patient diet, as a complementary therapeutic approach to the drug therapy.


  1. Alan Ebringer, T. R., Clyde Wilson, Teresa Ptaszynska and Mark Fielder (2006). Ankylosing Spondylitis, HLA-B27 and Klebsiella – An overview - proposal for treatment. Current Rheumatology Reviews 2: 55 - 68.

  2. Ebringer, A. and T. Rashid (2007). B27 disease is a new autoimmune disease that affects millions of people. Ann N Y Acad Sci 1110: 112-120.

  3. Ebringer, A. and C. Wilson (1996). The use of a low starch diet in the treatment of patients suffering from ankylosing spondylitis. Clin Rheumatol 15 Suppl 1: 62-66.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.6030

Statistics from

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.