Diet and Psoriasis: Are They Connected?
Many patients with psoriasis want to try non-medical interventions to complement the therapies that they receive. Patients recognize that psoriasis can have many comorbid conditions, such as gastrointestinal disease, and wonder if a change in diet can help, but they often don’t discuss this with their physician.1 If diet is discussed, it is often not discussed in detail, as there are not many study-backed recommendations for physicians and patients. This is a missed opportunity as diet is one aspect of care that patients feel that they can take initiative on, which is an important motivating factor.
Recently, an article in the Journal of the American Medical Association (JAMA) looked at studies that have been done that show how dietary changes can affect psoriasis and psoriatic arthritis. By taking the time to do a literature review, and compile these studies, the Dermatologist at JAMA could give physicians recommendations based on scientific evidence that could help psoriasis patients have a better quality of life.
A connection with Celiac Disease?
Physicians have noted for some time that patients who have psoriasis are more likely to have gluten sensitivity, or celiac disease.1 Researchers studied patients who had psoriasis and celiac disease and found that eliminating gluten not only stopped celiac symptoms but also reduced the severity of the patients’ psoriasis. It is recommended that psoriasis patients who test positive for gluten sensitivity should follow a gluten-free diet for both celiac and psoriasis.1 That being said, researchers did not find that a gluten-free diet helped psoriasis patients who do not have celiac disease. Researchers further stated that they didn’t recommend testing for gluten sensitivity in patients who aren’t exhibiting any symptoms as the test can have a high chance of false-positive results.
Dietary supplements and psoriasis symptoms
Researchers also looked at dietary supplements and wondered if there was any evidence that these could help reduce psoriasis symptoms. Researchers specifically looked at fish oil, Vitamin D, selenium, Vitamin B-12 and micronutrients. While most of these supplements are not shown to have any effect, there is evidence that Vitamin D may help, especially in patients with psoriatic arthritis.1 A Vitamin D supplement is not recommended for psoriasis patients who have a normal Vitamin D level.
Dietary weight loss
Researchers did recommend dietary weight loss for all overweight psoriasis patients. There is a strong correlation between psoriasis and obesity, and it appears that as patients carry more excess weight, their outbreaks become more frequent, severe and less responsive to treatment.1 Dietary weight loss is specifically about the reduction of calories that a person consumes in a day, not weight loss that is brought on through exercise or weight loss surgery. A weight loss through lowered calorie intake can reduce psoriasis severity, increase quality of life, and can maintain these benefits for a year or more.1 Patients who reduce calories also tend to have better response to medical therapies. This dietary weight loss also seems to help patients with psoriatic arthritis.
None of these dietary recommendations are meant to take the place of medical treatment, but rather to be used in combination with current treatments. Patients should always consult with their physician before starting a new diet or exercise regimen. Be sure to have an open discussion with your health care team so that together you can make the best decisions for your health.
Does your psoriasis skin feel out of control? How are you managing?