How Does Diet Affect Your Psoriasis?

From everydayhealth.com

If you have psoriasis, you may have wondered whether certain foods are making your symptoms worse — or whether changing your diet can help.

The answer isn’t straightforward: While psoriasis isn’t caused by what you eat, your diet may still play a role in how the condition — and your symptoms — show up day to day.

“Your diet impacts your health, including your psoriasis. Because the foods we eat can help our immune system function better, or they can trigger more inflammation, it's important to make good choices,” says Steven Daveluy, MD, a professor and the program director in the dermatology department at Wayne State University’s School of Medicine in Dearborn, Michigan. Dr. Daveluy specializes in treating patients with skin diseases, such as psoriasis and eczema. 

Psoriasis is an autoimmune disease that causes inflammation in your skin. Plaque psoriasis, the most common type, looks like thick, scaly patches called plaques. Some foods can “feed the fire of psoriasis,” while anti-inflammatory ones will do the opposite, Daveluy says.

Research on diet and psoriasis is still limited; however, it suggests people with psoriasis report fewer flares when they follow an anti-inflammatory eating pattern, such as the Mediterranean diet, while exercise and losing excess weight have also been effective in combating symptom severity.

That said, dietary triggers are highly individual. What worsens symptoms for one person may have no effect on another. That’s why it’s crucial to work with your dermatologist and wider healthcare team to figure out a personalized approach.

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The Mediterranean Diet for Psoriasis

The Mediterranean diet has long been hailed as helpful in the management of many chronic diseases, psoriasis included. It’s an eating pattern that emphasizes:

• Fruits and vegetables
• Whole grains like whole-wheat bread and brown rice
• Healthy fats from olive oil and nuts
• Fish rich in omega-3 fatty acids
• Poultry and fish over red meat, which is limited

A key selling point for the Mediterranean diet is that it limits ingredients that typically cause inflammation in the body like red meat, fried foods, sugary drinks and ultra-processed snacks. At the same time, it encourages fresh produce, salmon, tuna, chicken and turkey, beans and legumes — all of which are anti-inflammatory and aid in lessening psoriasis symptoms, says Daveluy.

“There are several studies that show if psoriasis patients stick to an anti-inflammatory diet, such as the Mediterranean-style diet or intermittent fasting, their psoriasis is less severe and medications actually work better,” he says.

In one study, Spanish researchers conducting a randomized clinical trial with 38 psoriasis patients found that those who followed a Mediterranean diet for 16 weeks saw a 75 percent reduction in psoriasis severity compared with no change in their counterparts who were advised to follow a low-fat diet.

The diet is high in antioxidants, omega-3 fatty acids, and fibre — a combination that counters oxidative stress and fights inflammation in the body by suppressing pro-inflammatory pathways, says Chris Adigun, MD, a board-certified dermatologist in private practice in Chapel Hill, North Carolina.

Because psoriasis is often linked with other health conditions like heart disease, type 2 diabetes, and obesity, the Mediterranean diet can be helpful by targeting the underlying inflammation that connects both skin symptoms and these comorbidities, she says.

Vegetarian Diets for Psoriasis

While there’s currently little direct research on vegetarian diets and psoriasis, like the Mediterranean diet it’s been tied to less-severe psoriasis symptoms.

In a study of adults with psoriasis, researchers found that people who followed a predominantly plant-based diet — emphasizing fruits, vegetables, legumes, and nuts — tended to report less-severe psoriasis symptoms, while poorer-quality diets and higher intakes of red and processed meat were linked to greater symptom severity.

An earlier review looked at studies on the effects of a plant-based diet on a range of inflammatory skin diseases. It noted that a vegetarian diet is low in saturated and trans fat and high in antioxidants and omega-3s, which reduce inflammation and promote weight loss. Simply adding vegetables into their daily diet led to a “favourable” skin response in 43 percent of people with psoriasis.

Think carefully about constructing a healthy vegetarian diet if you decide to take this route, says Caylee Clay, RDN, a registered dietitian-nutritionist in Brooklyn, New York, who has psoriasis and specializes in helping clients manage autoimmune diseases.

Not all vegetarian diets are inherently anti-inflammatory. “Vegetarian” foods can include fruits and vegetables or french fries and highly processed meat substitutes, Clay notes. But if it’s planned thoughtfully — packed with Mediterranean diet and anti-inflammatory diet staples — you should reap the same benefits, including supporting the gut microbiome via eating a range of plants.

“A clear theme is emerging: eating plenty of plants is likely to improve our health. This is true whether the goal is preventing cancer or reducing psoriasis,” Clay says.

Gluten-Free Diets and Psoriasis

People with psoriasis are twice as likely to have celiac disease as people without the skin condition.

In diagnosed cases of celiac disease, a gluten-free diet is medically necessary and may improve both gastrointestinal and skin symptoms, Dr. Adigun says. But you shouldn’t adopt a gluten-free diet if you don’t have celiac disease as there’s no strong evidence that eliminating gluten benefits people with psoriasis who do not have celiac disease or a non-celiac gluten sensitivity.

You may want to talk to your doctor about gluten testing if you have:

• Digestive symptoms such as chronic bloating, diarrhoea, or abdominal pain
• Iron-deficiency or unexplained nutrient deficiencies
• A personal or family history of celiac disease

But whether you have a gluten-sensitivity or not, it’s important to notice if eating certain foods is regularly followed by worsening symptoms. “For me, my psoriasis and joint pain significantly increase if I consume wheat products regularly,” Clay says. If this applies to you, keep a food journal and talk to your doctor or registered dietitian about ways to edit your daily diet.

Weight Loss and Psoriasis

If you have psoriasis and are overweight, losing weight can help to:

• Manage psoriasis symptoms
• Reduce flares
• Decrease the need for psoriasis medications
• Improve psoriasis treatment outcomes

Fat — or adipose tissue — releases pro-inflammatory cytokines, which are communication signals in the body that trigger inflammation. Cytokines can worsen psoriasis and even block medications that treat psoriasis, Daveluy says.

“This is why studies show that obesity is associated with more severe psoriasis and a higher chance that medications won't work as well to treat it. If a patient is overweight or obese, losing 5 to 10 percent of your body weight often produces benefits,” he says.

Focusing on healthy eating, regular exercise, and getting enough sleep can help you with your weight loss goals. 

These habits will also create a sustainable lifestyle, supporting psoriasis management that complements any medication you're taking, Adigun says. “Psoriasis is a complicated disease, and treatment outcomes are often best with a multifaceted approach.”

The Takeaway

• Your diet doesn’t cause psoriasis, but it can influence how the condition appears day to day and may affect the severity of symptoms.
• The Mediterranean diet may help, as it’s rich in anti-inflammatory foods like fruits, vegetables, whole grains, lean protein sources, and healthy fats that support your immune system while limiting foods that promote inflammation, such as ultra-processed snacks, red meat, sugary drinks, and refined carbohydrates.
• Weight loss can improve psoriasis severity, especially for those who are overweight or obese. A 5 to 10 percent loss of body weight may reduce flares, enhance medication effectiveness, and support long-term overall health, including risk of comorbidities like cardiovascular disease and type 2 diabetes.

https://www.everydayhealth.com/skin-conditions/how-diet-affects-your-psoriasis/