Substitution App | Ankylosing Spondylitis Management

In previous articles we looked at the theories linking starch with ankylosing spondylitis (AS) flare and worsening of symptoms.1,2 This month we review an app that could allow you to tackle this problem, helping reduce your starch intake and modifying your diet by suggesting equally tasty alternatives.

With so many other lifestyle changes forced on you by AS, having to actively avoid the meals you love – even if they are contributing to flares or making your symptoms worse –  could feel like the final straw.

Fear not though, because skipping starchy ingredients to help manage the symptoms of AS,1,2 doesn’t mean you can’t still enjoy your favorite recipes. With Substitution the app helps you break down this task into smaller more manageable changes without having to compromise on the overall meal.

Substitute ingredients for compatible alternatives

Substitution lists more than 1,300 ingredients categorized into food groups and specific dietary preferences. The app includes a handy search feature that lets you jump directly to the ingredient you want to swap out. For example, search for an alternative to flour in chocolate brownies and the app will suggest substituting it with pureed black beans. It even gives the quantities to use in the conversion.

Sadly there isn’t a specific section for starch-free diets but the app does include ‘Low Carb’ and ‘Gluten-Free’ sections, both of which can offer guidance.

Taking the pain out of cooking

Even if starch isn’t a trigger for you, too much time in the kitchen on a flare day can still leave you in pain. Substitution can help here too, by looking for time-saving ingredients to use when creating your favorite meal. The app also includes alternatives to common sauces and condiments. Don’t want to spend 30 minutes standing at the stove making an Alfredo white sauce? The app suggests swapping it for a quick tomato sauce.

If the app suggests a cut vegetable, don’t forget that using frozen fruits and vegetables can save you effort and energy. In fact, the nutritional benefits of certain types of frozen foods is the same or similar to that of fresh fruits/vegetables. In ‘What’s for dinner? Five meal hacks for parents with AS’  our very own Bjillian MacKinnon shares this and other top tips to keep meals interesting and easy when your AS is working against you.

Substitution is available on iOS for a small fee of $1.99 or £1.99. Android users or those looking for a free alternative could consider Mealtime, available on Android or iOS, or Yummly which has a gluten-free diet option for low-starch living.

A lifestyle that works for you

Exercising caution when changing your diet is no bad thing but you should always speak to your doctor before making any significant changes to your diet, so that they can help you avoid any unexpected health risks.

If your doctor agrees – and provided you are careful about changing your eating habits – you might be one of the people who finds a small change in diet makes a big difference to their AS symptoms.2


This AS Life is recommending Substitution as a helpful app. While it recommends alternatives to specific ingredients, especially those high in starch, it is not intended to be a medical guide, so remember to consult your doctor before making significant changes to your diet or lifestyle.



1. Rashid T et al. Clin Dev Immunol 2013; 2013:872632. 

2. Ebringer A, Wilson C. Clin Rheumatol 1996; 15 Suppl 1: 62–66. 


This article was written by the resident experts at A social site helping the whole AS community to: Learn. Share. Inspire. Discuss.




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