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Can Diet Change the Course of Your Psoriasis
The evidence linking diet and the disease may be lacking, but it’s always a good idea to eat wisely. By Howard ChangFor The Itch to Beat PsoriasisOctober 28, 2019Everyday Health BlogsFact-CheckedDietary changes don't replace medical treatment for psoriasis, but they can be complementary to overall health.iStockI’ve often wondered how diet impacts my psoriasis. Trying different special diets began in childhood. My parents introduced diets for me to try to reduce my skin’s redness and scaling. They believed in the “garbage in, garbage out” theory of diet, steering me away from junk food and soda. As Chinese immigrants, they also espoused the healing power of Chinese herbal remedies. I appreciate how caring parents will do most anything to help their child. Mine took me to see the best Chinese herbalists in San Francisco and spent a small fortune buying the prescribed herbs. The smell of those bitter herbal brews simmering for hours remains with me to this day. They also arranged for me to try different diets, such as a pork-free diet and a dairy-free diet. Unfortunately, none of those diets worked the way we hoped to ease the psoriasis symptoms. I didn’t give up experimenting with diets and psoriasis, though. On my own, I tried to drink lots of water to flush out my system. Another time, I avoided nightshades, such as eggplant, tomatoes, and potatoes. Another diet called for steering clear of processed foods along with refined sugar and flour. None of these helped as desired either. Studies on How Diet Affects Psoriasis
All along I wanted to know if any studies or research supported a special diet for psoriasis. I couldn’t deny anecdotal stories of those who felt a particular food or diet helped them. But without the proof of data I remained skeptical that they could help a broader population, including me. In 2018, the National Psoriasis Foundation (NPF) released dietary recommendations for people with psoriatic disease. The NPF based its recommendations on a systematic review of current literature. In all, the authors of the paper, which was published in JAMA Dermatology in August 2018, looked at 55 studies involving 4,534 people living with psoriasis. Here are the recommendations I find most intriguing and how they might affect the way I eat in the future. Targeting Healthy Weight
The NPF’s key dietary recommendation pertained to maintaining a healthy weight for those who are obese or overweight. One of the authors of the paper, Sergio Schwartzman, MD, of Weill Cornell Medical College and the Hospital for Special Surgery in New York City, told MedPage Today in June 2018: "People with psoriatic disease tend to be overweight and to have metabolic syndrome, a complex disorder that also includes hypertension, diabetes, and premature arteriosclerosis.” Dr. Schwartzman continued to recommend “a hypocaloric diet to achieve weight reduction and ideal body weight” for people with psoriasis who are obese and have metabolic syndrome. While I am not overweight or obese, the recommendation encouraged me to keep up with my overall health and have regular checkups for metabolic syndrome. I know that a couple of factors, such as my blood pressure and blood sugar levels, have been borderline for me in the past. Keeping a healthy weight no doubt will go a long way in maintaining overall good health as well. Testing for Gluten-Sensitivity
I frequently hear about eating a gluten-free diet for psoriasis. The researchers note that people with psoriasis are twice as likely to have celiac disease and more often have the “serologic markers of IgG tissue transglutaminase and IgA endomysial antibodies.” Having high levels of these antibodies also correlates to worse skin disease. According to the Celiac Disease Foundation, it is “a serious autoimmune disorder that can occur in genetically predisposed people where the ingestion of gluten leads to damage in the small intestine.” My dermatologist, Christie Carroll, MD, of Dignity Health Medical Foundation in Woodland, California, confirmed that it’s not uncommon for someone to have multiple autoimmune conditions. At my last appointment, we discussed trying a gluten-free diet, and I showed her the study findings. She agreed to order blood tests to check for IgG and IgA antibodies. Two days later the results came back negative for all gluten-sensitivity markers. Dr. Carroll messaged me to report, “Your lab tests for the gluten sensitivity were negative. No need to try the gluten-free diet.” The researchers also noted that no evidence supported a gluten-free diet for those with psoriasis without confirmed celiac disease or positive serological markers. A Second Look at Supplements
The researchers also looked at the role of supplements in soothing psoriasis symptoms. The findings showed conflicted results for fish oil, a popular supplement touted for psoriasis, and ultimately did not recommend it as supplement for psoriasis. Other supplements, such as vitamin D, selenium, and vitamin B12, also showed lack of efficacy. They did note, though, that “one small study suggested potential benefits for combination micronutrient supplements that included multiple vitamins and minerals, along with methotrexate, but the evidence was insufficient for a recommendation to be made.” At the end of the article I did wonder about the effectiveness of other supplements, or those herbal formulations I took as a child. I will keep an eye out for any new studies or literature that report on those in the future. The bottom line, according to the researchers: Dietary changes should be used not as a replacement for standard medical treatment for psoriasis, but complementary to them. That’s a good thing to keep in mind, as I continue to experiment with what works and what doesn’t work with diet and my psoriasis. You can read more about my experiences in my blog for Everyday Health and on my website. Important: The views and opinions expressed in this article are those of the author and not Everyday Health.See More NEWSLETTERS Sign up for our Psoriasis Newsletter
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