Psoriasis Diet: Foods to Eat and Avoid

From verywellhealth.com

While there is no single psoriasis diet that works for everyone, certain foods are known to trigger symptoms in many people living with the disease. On the flip side, certain dietary approaches have been shown to reduce symptoms of psoriasis, including a reduced-calorie diet or a gluten-free diet.

With that being said, foods that trigger psoriasis in one person may not trigger psoriasis in another. By keeping a food journal and working with a healthcare provider, you may be able to pinpoint which foods are problematic and which are beneficial if trying to manage this common but often challenging autoimmune disease. 

Claudia Totir / Getty Images

How Diet and Psoriasis Are Related

Psoriasis is a chronic autoimmune disease in which the body's immune system attacks skin cells with inflammation, causing them to multiply faster than they can be shed. This causes the cells to pile up on the surface of the skin, creating itchy, dry, scaly plaques.  The symptoms tend to come and go in episodic flares lasting for weeks or months.

Psoriasis flares can occur spontaneously for no known reason or be instigated by any number of triggers, including psychological stress, chronic infections, skin trauma, changes in climate, cigarette smoking, and other autoimmune diseases.

The association between psoriasis and food is less clear given that the triggers can vary from one person to the next. With that said, risk factors like obesity are greatly influenced by diet, while certain foods are known to promote or temper inflammation.

While there is no consistent diet to help treat psoriasis in all people, scientists have identified certain dietary patterns that contribute to psoriasis symptoms. These insights can help you build a personalized diet plan, often through a process of trial and error, with your healthcare provider.

Psoriasis and Weight Loss

Obesity is a well-known risk factor for psoriasis, increasing the risk of the disease by nearly twofold compared to people of normal weight. This is mainly due to high levels of chronic inflammation spurred by the build-up of fat cells in the body.

Not only does obesity increase the risk of psoriasis, but it also dramatically increases the failure rate of psoriasis treatments, including topical steroids and oral or topical immunosuppressants.

As such, weight reduction is an important step to not only improving your overall health but also alleviating symptoms of psoriasis.

This is evidenced in part by a 2014 study in the British Journal of Dermatology which concluded that, among people with obesity, a calorie-restricted diet coupled with routine exercise reduced the severity of psoriasis by around 48% after 20 weeks.

Foods to eat on a weight-loss diet include:

• Fresh, frozen, or unsweetened canned fruits
• Raw, grilled, steamed, or sautéed vegetables
• Fat-free or low-fat dairy, including unsweetened dairy
• Lean animal protein, including skinless poultry and fish, either grilled or baked
• Alternative sources of protein, including eggs, beans, nuts, and tofu

Foods to avoid include:

• Fried or breaded foods
• Fast food or processed foods (including processed meats and baked goods)
• Fatty red meat
• Foods high in salt, sugar, and saturated fat
• Whole milk or cheese
• Butter or cream sauces

A calorie-restricted diet should be directed by a healthcare provider or nutritionist to ensure you get the daily nutrition needed to remain healthy.

Psoriasis and Inflammation

Inflammation is a normal response to any disease or condition that causes the body harm. However, with psoriasis, the inflammatory response is inappropriate, targeting normal cells rather than harmful ones.

While medications are the first-line approach to tempering this inappropriate immune response, studies suggest that certain anti-inflammatory foods may also help.

According to research, inflammatory foods like sugar or trans fat can independently trigger psoriasis in some people. This is especially true for people with obesity, uncontrolled diabetes (whose bodies are already under chronic inflammation), or inflammatory bowel disease (an autoimmune digestive disorder).

Eating anti-inflammatory foods may have the opposite effect, easing the frequency or severity of psoriasis flares. These same foods also tend to be beneficial for people with obesity, diabetes, and inflammatory bowel disease.

According to a review of studies published in the International Journal of Molecular Science, foods closely linked to psoriasis flares include:

• Alcohol, including beer and wine
• Sugary foods, including those made with molasses and corn syrup
• Refined carbohydrates, such as white bread, white rice, and plain pasta
• Red meats
• Processed meats, such as sausage, bacon, and salami
• Butter, lard, coconut oil, and palm oil
• Fried foods

Food with anti-inflammatory effects include:

• High-fibre foods, including whole grains, beans, berries, and nuts
• Food rich in vitamin D, like low-fat dairy
• Foods rich in vitamin B12, like tuna, salmon, and eggs
• Food rich in selenium, like shellfish, Brazil nuts, and whole-grain pasta
• Food rich in omega-3 fatty acids, including all fatty fish
• Soybeans, including tofu and edamame
• Probiotic foods, like yogurt, kimchi, kefir, and kombucha

Psoriasis and Gluten

Psoriasis commonly occurs with other autoimmune diseases, during which the flare of one condition can trigger a flare of the other. One example is celiac disease (CD), a chronic autoimmune disorder triggered by the consumption of gluten (a protein found in wheat and several other cereal grains).

Studies have shown that the rate of psoriasis among people with CD is nearly three times greater than among people without CD. Based on these facts, some scientists have theorized that eating on a gluten-free diet may relieve symptoms of psoriasis, at least in some people.

This is evidenced by research published in the Journal of the American Academy of Dermatology in which a gluten-free diet eaten for three months helped ease the severity of psoriasis in not only people with CD but also those with non-celiac gluten sensitivity (NCGS). It appears to do so by lowering levels of antigliadin antibodies (the main antibody linked to both CD and NCGS).

On the other hand, a gluten-free diet does not appear to be useful in controlling psoriasis in people without CD or NGCS.

Foods to avoid on a gluten-free diet include those made with:

• Wheat
• Barley
• Rye
• Durum
• Semolina
• Spelt
• Malt
• Malt extract
• Malt vinegar
• Distilled vinegar
• Brewer’s yeast
• Triticale
• Hydrolyzed vegetable protein
• Hydrolyzed plant protein
• Modified food starch
• Caramel colour
• Dextrin 
• Maltodextrin
• Yeast extract

Foods to eat on a gluten-free diet include:

• Gluten-free grains like amaranth, buckwheat, quinoa, millet, sorghum, and rice
• Fruits
  
• Vegetables
• Unprocessed poultry, meat, and fish
• Beans, peas, and lentils
• Nuts and seeds
• Dairy

If you decide to try a gluten-free diet, it can take several months for the effects to be felt. Many experts suggest that you remain completely gluten-free for at least three months to see if any tangible benefits are achieved.

Other Considerations

When it comes to controlling psoriasis, how you prepare your food may be just as important as the foods you choose to eat. For example:

• Aim to cook in as little fat as possible, such as by grilling, broiling, steaming, or braising your food. Avoid deep-fat frying or pan-frying with a lot of oil.
• Choose healthy oils like extra-virgin olive oil and canola oils over unhealthy ones like coconut oil, palm oil, butter, or lard.
• Choose low-sodium or reduced-sugar versions of foods, such as canned vegetables and jam. Avoid artificial sweeteners in sugar-free foods which some studies suggest may promote inflammation.

It is also important to keep your diet balanced with the ideal mix of fruits and vegetables, fibre, lean protein, and healthy fat. This is especially true if you are on a weight-loss diet, wherein your daily calorie intake may be reduced by anywhere from 500 to 1,000 calories per day.

Regardless of the type of psoriasis diet you try, it is to your benefit to do so under the guidance of a health provider or qualified nutritionist.

Be sure to take it slowly at first rather than make radical changes that are difficult to sustain. With every adjustment of your diet, keep note of your symptoms in a journal, including any side effects you may experience. Over time, you should be able to build a personalized diet plan that helps keep psoriasis symptoms at bay.

Summary

The foods you eat may influence the frequency and severity of psoriasis symptoms. As these trigger foods can vary from one person to the next, different dietary strategies may be needed.

Some people may benefit from a weight-loss diet which reduces overall inflammation in the body. Others may benefit from a gluten-free diet if they have gluten intolerance or celiac disease. Others still may benefit from eating anti-inflammatory foods (like fatty fish and whole grains) and avoiding inflammatory foods (like red meat and sugar).

https://www.verywellhealth.com/changing-your-diet-to-cure-psoriasis-2788274 

Ask an Expert: How Important Is Lifestyle for Managing Psoriasis?

From verywellhealth.com 

Meet the Expert

Marisa Garshick, MD, is a board-certified dermatologist and clinical assistant professor of dermatology, practicing at the Medical Dermatology and Cosmetic Surgery Centre in New York City.

Verywell Health: What are some helpful ways that people with psoriasis can avoid triggers and flare-ups?

Dr. Garshick: Those with psoriasis can avoid triggers and flares by minimising injury or trauma to the skin. Psoriasis can worsen in the setting of the Koebner phenomenon, where injury to the skin can trigger new plaques to develop. This is why getting tattoos can actually trigger psoriasis in those who are susceptible.

Keeping the skin moisturized can be helpful to keep the skin feeling soft and smooth and also to minimize the itching that may aggravate psoriasis. Since some medicines and infections may trigger psoriasis, it is important to let your provider know that you have psoriasis if you are taking any new medications or if you develop an infection.

Verywell Health: What other aspects of a person's life are important in managing their condition?

Dr. Garshick: Reducing alcohol intake and stopping smoking may help to reduce flare-ups and triggers. Additionally, keeping the skin moisturized can ease dryness and itching. In general, it is important to use gentle skin care products to minimize irritation on the skin. That said, the use of gentle exfoliants can be helpful to get rid of dead skin build-up that can be seen in psoriasis.

Certain medications may worsen psoriasis so it is always important to consult your provider before taking a new medicine. Stress can contribute to psoriasis, so stress management is important, as are lifestyle changes, including healthy eating and exercise.

https://www.verywellhealth.com/ask-an-expert-lifestyle-and-psoriasis-management-11689122

Vacationing by the sea is good for the skin, new survey suggests

From forbes.com.au/life

The sea boasts natural antiseptic properties, which may help to cleanse the skin and reduce inflammation

Getting through the winter months is never easy—and if you live somewhere that gets dark and cold for nearly half the year, you’re likely all too familiar with its effects on mental health and wellness. The winter months are hard on the skin in particular with dryness and dullness becoming the normal baseline—and it can be even worse for those who suffer from skin conditions like psoriasis or acne.

While tropical holidays have always been popular come wintertime, a new survey from Scenic Cruises suggests that vacationing by the sea isn’t just a great way to kick back and unwind in the sun but can also be very good for the skin.

The survey suggested that 41% of vacationers reported more radiant skin after a vacation by the sea and 32% felt their skin was softer while 25% noticed more hydrated skin—and as it turns out, there’s science behind why holiday-makers come back with healthier-looking and feeling skin.

“Just 10 minutes in mineral-rich seawater can leave your skin noticeably softer, smoother, and more radiant,” explained Nicola Jones, skincare expert and founder of Face Junkie, adding that sea air is also rich in minerals such as magnesium, potassium, and sodium, which can contribute to healthier skin. 

“The high humidity in coastal areas helps to hydrate the skin, which is why many people notice a softer skin and a glow in their complexion while on holiday.”

                                                                                                                (Getty)

The survey also found that 13% of participants found relief from conditions like eczema or psoriasis, which is a significant number given that chronic conditions such as these can be difficult to treat topically.

Jones pointed out that sea air and seawater really can provide relief for certain conditions and diseases, though. “The salt in seawater has natural antiseptic properties, which can help cleanse the skin and reduce inflammation,” she explained. “For conditions such as eczema and psoriasis, the minerals in seawater can soothe irritation and promote healing. However, I recommend rinsing off seawater to prevent dryness caused by salt residue.”

According to Jones, acne may also benefit from the antibacterial properties of seawater, but if there are open wounds or lesions, she suggested avoiding direct contact or seeking advice from your doctor before self-soothing with sea therapy. The survey reflected this—with 35% of participants reported noticing lessened acne and breakouts after being by the sea.

https://www.forbes.com.au/life/wellness/vacationing-by-the-sea-is-good-for-the-skin-new-survey-suggests/ 

Is Your Psoriatic Arthritis Treatment Still Working?

From healthcentral.com

Warning signs like joint pain, stiffness, and fatigue may mean you need a change of medication or other therapies

Treatments for psoriatic arthritis (PsA) are better than ever today, thanks to targeted drug therapies and a new understanding of this chronic inflammatory condition. But if you’re noticing more joint pain, stiffness, swelling, or other symptoms like severe fatigue or swollen fingers or toes, this could be a sign that your current treatment plan isn’t working as well as it should.

PsA is an immune-mediated disease, where your immune system overacts and mistakenly attacks healthy tissue—in this case, the joints and entheses (areas where tendons and ligaments connect to the bone). Most people who develop PsA also have a history of psoriasis, which causes skin rashes with itchy, scaly patches, although arthritis symptoms can appear before the skin symptoms.

While there’s still no cure for PsA, doctors rely on an array of medications, as well as exercise and physical therapy, to slow progression of the disease and help prevent permanent joint damage. These treatments aim to relieve pain, increase mobility, and reduce inflammation.

But PsA is complicated and there may be times when your treatment plan needs to be tweaked. “PsA is a chronic and evolving condition, which means that over time, inflammation can spread to new joints or areas of the body, requiring adjustments to treatment,” says Paras Karmacharya, M.D., an assistant professor of medicine and the director of the Vanderbilt Psoriatic Arthritis and Spondyloarthritis Centre at Vanderbilt University Medical Centre, in Nashville, TN.

Learning how to tell if your treatment isn’t working properly so you and your doctor can make the necessary adjustments is crucial to preventing the disease from progressing. Consider the following warning signs, as well as what you can do when symptoms appear to be getting worse.

You're Taking More Pain Medication

If you find yourself needing more pain medication such as nonsteroidal anti-inflammatory drugs (NSAIDs) more often, it may be a sign that your PsA is not as well-controlled as it should be, says Katherine Terracina, M.D., an assistant professor in the division of rheumatology at UT Health Houston, TX.

In some cases, an increase in medication use can happen so gradually that you may not even realize it. “I’ve asked patients [during a checkup] questions like, ‘How often are you needing additional pain medicine?’ and ‘Is that normal for you? How many NSAIDs do you normally take in a month?’ and that's actually what triggered them to realize that they have been in more pain,” says Dr. Terracina.

Your Symptoms Are Persistent or Getting Worse

In addition to increasing pain, other signs that your PsA treatment may not be working can include the following, says Dr. Karmacharya:

• Difficulty performing daily activities, such as holding a coffee cup

• Increased frequency or severity of flares

• Joint pain and stiffness that last longer and happen more frequently than normal

• New symptoms, such as psoriasis or joint pain, that crop up in previously unaffected areas of your body

• Persistent skin psoriasis

• Recurrence of symptoms that were previously controlled

• Severe fatigue

• Swollen fingers and toes

Sometimes, it’s hard to tell whether your symptoms are due to a worsening of the underlying disease or a temporary flare, adds Dr. Karmacharya. “If it’s a flare triggered by physical or mental stress, a missed dose of medication, or another temporary factor, we can often manage it with short-term therapy like NSAIDs, low-dose corticosteroids, corticosteroid joint injections, or topicals for psoriasis,” he says. But if these flares become frequent, it may be a sign your current treatment plan is not working. “That’s when we consider increasing the dose, adding additional therapy, or switching medications.”

Your Quality of Life Is Reduced

If you are making decisions about your day-to-day routine based on your symptoms, this could be an indication that your PsA treatments aren’t working as well as they once did. That might mean avoiding going to the beach because you have psoriasis flares and don’t want to show your skin, or skipping the gym because you’re having joint pain. “Avoiding life and things that you normally would do is sometimes a clear sign that worsening symptoms may be more than just the normal, minor flare up,” says Dr. Terracina.

Why Psoriatic Arthritis Treatment May Stop Working

There are several reasons why your psoriatic arthritis treatments may no longer be working as well as they once did.

Medication Tolerance or Resistance

“Some people may develop a reduced response to their treatment over time, especially with biologics,” says Dr. Karmacharya. “The immune system can sometimes produce antibodies against these medications, making them less effective.” Adding an additional therapy such as a disease-modifying antirheumatic drugs (DMARD), targeted synthetic drugs, or another biologic, or switching to a different medication may help, he says.

Inadequate Dosage

Symptoms may persist because the current dose isn’t strong enough to control inflammation, and an increase or combination therapy may be needed, says Dr. Karmacharya.

If your doctor suspects this may be the problem, they may first suggest increasing the dosage of your current medication, he says.

Missing Doses or Not Taking Medication

“In some cases, you may not take your medication because you don't like how it makes you feel,” says Dr. Terracina. But skipping your meds or not taking them as directed can allow inflammation to return or worsen. Your doctor can help you find a solution, she adds, by reducing the dose and adding another medication, or switching to a different drug altogether.

Disease Progression

“Sometimes, despite compliance, despite no other changes, there comes a point where medications stop working,” says Dr. Terracina. That may require you to try a different medication or increase the dosage of your current treatment.

Other Health Conditions

“Stress, infections, hormonal changes, or lifestyle factors like poor sleep or diet can contribute to worsening symptoms, even if the medication itself is still effective,” says Dr. Karmacharya. And related conditions such as obesity, metabolic syndrome, or inflammatory bowel disease can also affect how your PsA treatment responds, and may require additional treatment. “Addressing these factors may improve symptom control,” he adds.

When to Call Your Doctor

Call your doctor as early as possible about any significant changes, says Dr. Karmacharya. “If symptoms are more severe—such as persistent swelling, increasing pain, significant fatigue, or difficulty with daily activities—I would recommend letting your rheumatologist know as soon as possible,” he says. “The earlier we address uncontrolled inflammation, the better the long-term outcomes in preventing joint damage and maintaining quality of life.” Together, you can figure out what may be causing the problem and find a new treatment plan, whether that involves an adjustment in dose, switching to a different medication, or other measures, he adds.

And be honest and detailed about what you’re experiencing. “In many cases, patients don't want to feel like they’re letting their doctor down,” says Dr. Terracina. You may not tell your doctor that you aren’t taking your medication due to its side effects, for instance, but that’s crucial information. “There are so many medicines out there, we can easily just find a different regimen for you,” she says.

Ultimately, says Dr. Karmacharya, the goal is to regain control over inflammation while maximizing the effectiveness of treatment before making unnecessary switches. “Regular follow-ups and open communication with your rheumatologist are key to long-term disease management.”

Bottom Line

Medications and lifestyle modifications can help slow the progression of psoriatic arthritis, preserve mobility, and help prevent permanent joint damage. They can also reduce inflammation, which reduces your risk of developing related health conditions such as cardiovascular disease, obesity, and depression.

Yet while psoriatic arthritis treatments are often effective, they can sometimes not work as well as they should, or they can stop working due to a variety of factors, including a build-up of medication resistance or worsening of disease. By working closely with your doctor, you can find ways to modify your treatment plan to add or switch medications and make other changes to help you feel better.

https://www.healthcentral.com/article/psoriatic-arthritis-treatments-stop-working?ap=nl2060&rhid=&mui=&lid=141093361&mkt_tok=NTQxLUdLWi0yNDMAAAGZSKJpvLcVzWoSRXo31qNWU76zisLetXxSMRVk6CJvzsmI5jg24ZfHZwKwnR6ElQgyELIuT2Qs1V0IWGhmD53UTPGzfKRA3tjCRYOQ8NS94V_PENG1KdbhQgf_