Interestingly, Darryn, there have been studies done on identical twins with regard to kleb. p. The studies found pretty much that kleb. p. proliferation was no different in the twin/family member with AS and the one without. That's very loosely put, by the way, as I haven't the studies infront of me and haven't the time to look for them. The reason as stated by Dr. E. was that the researchers didn't limit the study to AS patients whose CRP and ESR numbers were elevated, indicating to him that those patients were not in the middle of active disease. However, since ESR in particular and CRP to a lesser extent, do not elevate in all patients with AS (some rheumies are now figuring it out and no longer consider these accurate indicators of AS disease activity) I would say that Dr. E.'s research can only be valid to those patients whose numbers do increase.
A double-blind, controlled study would be impossible, as you point out. There is no guarantee that the patient is actually strictly following the diet and no way to force them to unless you put them in a prison cell for six months.
One note: as a new member you are not familiar with how divisive this particular subject has been around here. It has led to awful arguments (flame wars in reality), and there is a direct link between those arguments and some of our members who no longer come here because they no longer felt safe sharing here because of things that were said to them. A lot of heartache has been the result. Mig was on the ball with this one, even tho Inky was really only trying to be light-hearted as it turned out. Just wanted to let you know why Mig stepped in.
Hugs,
