Understanding Psoriasis and Diet: Exploring the Impact of Dietary Recommendations on Skin Health

Dietary Recommendations for Psoriasis: Insights from Recent Research

Overview of Psoriasis and Its Impact

Published in JAMA Dermatology, a recent study explored the connections between psoriasis and dietary practices, focusing on four widely recognized dietary recommendations. Psoriasis is a chronic inflammatory skin condition that leads to scaling and irritation, affecting approximately 3.2% of the American populace. Many individuals diagnosed with psoriasis also experience related health issues, such as psoriatic arthritis, gastrointestinal disorders, and cardiometabolic diseases. Although some patients report symptom relief through dietary changes, scientific evidence supporting the benefits of specific dietary recommendations remains limited.

Research by the National Psoriasis Foundation

The National Psoriasis Foundation (NPF) Medical Board conducted a systematic review to identify dietary suggestions for psoriasis patients, with findings published in JAMA Dermatology. The researchers evaluated 55 studies based on the following criteria:
1. Participants had psoriasis, psoriatic arthritis, or both.
2. Studies analyzed dietary patterns or nutritional differences among participants.
3. Outcomes included psoriasis development or changes in severity.

However, it is important to note that, despite the number of studies reviewed, there was insufficient data to draw definitive conclusions regarding pediatric patients with psoriasis.

Dietary Recommendations Assessed

The researchers examined the relationship between psoriasis and diet based on four dietary recommendations:
1. Gluten-free Diet
2. Weight Reduction
3. Dietary Supplements
4. Specific Diets and Food Patterns

Gluten-Free Diet

The gluten-free diet has gained popularity among psoriatic patients seeking to alleviate their symptoms. This interest stems from the fact that individuals with psoriasis have a significantly higher likelihood—100 times greater—of developing other autoimmune diseases, particularly celiac disease. Celiac disease impairs the body’s ability to process gluten and is often confused with gluten sensitivity, which can be tested via blood tests.

For patients with psoriasis who test positive for gluten sensitivity or celiac disease, adopting a gluten-free diet may lead to substantial improvements in their symptoms. However, caution is warranted, as blood tests can yield false positives, potentially leading to unnecessary dietary changes. Furthermore, individuals with psoriasis who do not have gluten sensitivity or celiac disease may not experience any benefits from a gluten-free diet.

Weight Reduction

Extensive research has established a strong correlation between obesity and psoriasis. Obese individuals often face increased risks, including a higher incidence of psoriasis, reduced treatment efficacy, and worsened symptoms. This association is likely linked to elevated body fat and inflammation, which are primary contributors to psoriasis.

Dietary weight reduction refers to weight loss achieved through dietary changes rather than physical exercise or surgical interventions. For psoriatic patients, a hypocaloric diet—consuming fewer calories than the average recommended intake for their age group—has proven effective. Specifically, a caloric intake of 800-1,400 kilocalories is suggested for patients with a BMI of 25 or higher. Implementing this dietary change can yield significant benefits for those with psoriasis and psoriatic arthritis.

Dietary Supplements

Many patients have turned to micronutrient supplements in hopes of improving their psoriatic symptoms. Common supplements include vitamin D (both oral and topical), fish oil, selenium, vitamin B12, folic acid, magnesium, and vitamins A, D, E, and K. Among these, evidence indicates that vitamin D and its derivatives, calcidiol and calcitriol, can have a positive impact on psoriatic patients.

Vitamin D has been shown to reduce psoriasis plaques, with more rapid effects observed with topical application. Oral vitamin D may also be beneficial with extended use. For those suffering from psoriatic arthritis, daily doses of calcidiol and calcitriol between 0.5 and 2.0 micrograms may alleviate severity. Overall, dietary supplementation has the potential to significantly enhance the quality of life for patients.

Specific Diets, Foods, or Diet Patterns

Certain diets, notably the Mediterranean diet and the South Beach Diet, have shown promising results for patients with psoriasis. However, further research is necessary to validate these findings.

Conclusion

Advancements in the understanding of psoriasis indicate that a combination of dietary modifications and medical treatments could lead to improved management of this chronic condition. While psoriasis remains a long-term challenge, effective treatment options are available for mild-to-moderate cases. The data compiled by the National Psoriasis Foundation may empower patients to make informed dietary choices, fostering a future where psoriasis is more easily treatable and preventable.

Reference

Ford, R. A., Siegel, M., Bagel, M., Corodoro, M. K., Garg, A., Gottlieb, A., Green, J. L., Gudjonsson, E. J., Koo, J., Lebwohl, M., Liao, W., Mandelin II, M. A., Markenson, A. J., Mehta, N., Merola, F. J., Prussick, R., Ryan, C., Schwartzman, S., Siegel, L. E., Voorhees, V. S. A., Wu, J. J., Armstrong, W. W. (2018). Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation. JAMA Dermatology.