From healthcentral.com
New research in JAMA Dermatology reveals a potential link between frequent consumption of ultra-processed foods and psoriasis flare-ups
If you're struggling to keep your psoriasis under good control, making a few simple food swaps could help. Psoriasis flare-ups are strongly associated with consumption of ultra-processed foods like chips, cookies, candy, and other packaged fare, according to new research published in JAMA Dermatology.
For the study, researchers used questionnaires to gather data from 18,000 French adults and teens over 15. Around 10% of the people self-identified as having psoriasis, while 4% self-identified as being in the midst of an active psoriasis flare. (Self-identified means that the researchers relied on the individuals to share information about their psoriasis status, but didn't confirm the status with a medical diagnosis.) They collected other health data about the individuals, too, including body mass index (BMI), alcohol intake, and other underlying conditions like heart disease, diabetes, or rheumatoid arthritis.
The questionnaires also asked subjects about their ultra-processed food (UPF) intake—how often did they consume things like packaged baked goods, potato chips, pretzels, candy, sugary breakfast cereals, frozen desserts, frozen meals, and sugary drinks? Based on the responses, the researchers divided the individuals into three groups: People who consumed little to no UPF, those who consumed UPF sometimes, and those who consumed UPF frequently. (Researchers did not specify exact details on what they considered a UPF and max amounts per group.)
From there, the researchers ran the data. The objective: To see if subjects who ate more ultra-processed foods were more prone to psoriasis flares. The correlation, it turned out, was clear. People in the active flare group were about 1.3 times more likely to report frequent consumption of UPF compared to those who had never had a flare. That's even after adjusting for other factors that could potentially contribute to flare likelihood, like higher BMI, alcohol intake, or other underlying inflammatory health conditions.
GettyImages/monticelloTheories Behind the Findings
If you or a loved one has psoriasis, you're probably familiar with the way this inflammatory skin condition is triggered by a faulty immune response that leads to an overproduction of skin cells which then pile up on the skin's surface. The resulting plaques can be thick, red, scaly, and itchy, according to the American Academy of Dermatology (AAD).
Diet doesn't cause psoriasis, notes the Cleveland Clinic, but dermatologists and researchers have long noticed that certain foods tend to bring on flares for certain people. That could be because certain foods, including ultra-processed ones, are pro-inflammatory, the study authors note. "That means they initiate a cascade of inflammatory mediators through their interaction with gut bacteria and the immune system," which could send the immune system into overdrive and trigger a flare, explains Brendan Camp M.D., a board-certified dermatologist with MDCS Dermatology in New York City who was not involved in the JAMA study.
"In my clinic, I've had several patients who note their psoriasis flares increase when they stray from their 'healthier' diets, like during the holidays or on vacation," says Gabriela Cobos, M.D., the associate medical director of outpatient dermatology at Tufts Medical Centre in Boston, MA.
There's also the fact that diets high in UPF may increase the risk for obesity, according to a paper published in the journal Nature. Obesity is a known risk factor for psoriasis and worse flares among people who have the conditions, since excess body fat itself can increase inflammation throughout the body, notes an overview on obesity and psoriasis published in the journal Life.
Do You Need to Swear Off UPF Completely?
The study findings suggest that eating a lot of ultra-processed foods might make you more prone to a flare. Still, says the study authors, more large-scale studies are needed to better understand the role that UPFs play in psoriasis.
It’s also important to note the study's limitations. It was observational, so it wasn't able to prove that UPF causes psoriasis flares. And because the study relied on participants to self-report their skin condition, there is no clinical confirmation that everyone who claimed to have psoriasis actually had it. That might be worth further investigation, notes Dr. Cobos. "What stands out most is when you look at dermatologists’ validated cases, there is loss of significance of findings," she says, explaining that the association between UPF intake and flares dropped slightly when the researchers zeroed in on a group whose psoriasis cases were validated by a dermatologist.
Still, if you're desperate to help your skin look and feel a little better, curbing your processed food intake might be one of several strategies worth talking over with your doctor. "Psoriasis is a chronic, multisystem inflammatory condition influenced by genetics which people cannot control, so I like discussing several risk factors that they do have more control over," Dr. Cobos says.
That includes dietary choices and other healthy behaviours like limiting alcohol and avoiding smoking, she says. If you're overweight, losing weight matters, too. The American Academy of Dermatology reports that a weight-loss diet may improve psoriasis and reduce flare risk in those who are overweight or obese.
Despite the latest research, Dr. Cobos says people living with psoriasis should try not to overthink their diet. "I am a big believer in moderation—I don’t want my patients to feel stressed that if they have one alcoholic drink or eat a cookie or some chips that their psoriasis will worsen," she adds. Just stick to the good-for-you stuff most of the time.