Nutritional approaches to psoriasis | Next Ave

Your skin itches and burns, and you have flaky, inflamed, and red patches on your knees, elbows, and scalp. After weeks of trying to treat it yourself with various over-the-counter ointments (almost never a good idea!), you see a dermatologist who looks at your skin and says, “You have psoriasis.”

You’ve seen all those recent TV commercials about plaque psoriasis, but it never occurred to you that it could be causing your problem, and you certainly never thought it was something that people could get when they get older.

But according to the American Academy of Dermatology, there are two peak incidences of the disease, with the majority of cases occurring between the ages of 20 and 30. However, the peak period for late-onset psoriasis is between 50 and 60 years of age. age, with most people developing it between the ages of 57 and 60. Women usually develop it at a younger age than men.

Psoriasis is a chronic autoimmune disease that affects more than 3% of the US adult population. The immune system becomes overactive, leading to an abnormally rapid cycle in which new skin cells are produced, die, and then accumulate on the skin’s surface.

This causes flaky, dry and cracked skin that itches and bleeds, with lesions most often occurring on the scalp, elbows, knees, trunk, palms and soles of the feet. There may be thick, pitted fingernails.

Jessica Kaffenberger, MD, associate professor of dermatology and division director of medical dermatology at The Ohio State University Wexner Medical Center, says that “psoriasis is a systemic disease, in which inflammation occurs throughout the body but is only visible on the skin.”

She explains that 25-30% of people with the condition develop psoriatic arthritis, usually about seven years after developing psoriasis itself, although a small percentage develop this before the skin manifestations, adding that “psoriatic arthritis is characterized by swelling in the skin.” the back of the leg, heel pain, inflammation of the fingers and toes, and morning stiffness that decreases as the day progresses.”

It is different from osteoarthritis, a degenerative joint disease often associated with aging and often referred to as a “wear and tear disorder.”

The symptoms of psoriasis sometimes go through cycles, lasting for several weeks or months, followed by periods when they diminish or even go into remission. Most cases are mild and can be treated with topical creams and ointments. However, more severe cases may require phototherapy or the administration of oral or biological medications.

The treatment goals are to reduce inflammation, discoloration of the lesions, and the amount of thickness and scaling. Results can be assessed by a change in the PASI (Psoriasis Severity Index), which is used to assess the severity of symptoms and measure the patient’s response to treatment, and by the BSA (body surface area), which estimates the percentage of each body area. affected.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, there are several types of psoriasis, with plaque psoriasis, characterized by raised, red patches of skin covered with silvery-white scales, being the most common. Many people with psoriasis have other serious conditions, including:

• Cardiovascular disease, high blood pressure, high cholesterol
• Metabolic syndrome
• Mental health problems such as depression, anxiety, low self-esteem, social anxiety
• Celiac disease
• Inflammatory bowel disease

Dietary approaches to treating psoriasis

Because there is a high correlation between psoriasis and cardiometabolic disorders, improving diet (likely resulting in weight loss) will positively impact coexisting conditions such as diabetes, cardiovascular disease, metabolic syndrome and fatty liver disease.

The National Psoriasis Foundation recommends eating an anti-inflammatory diet rich in fruits and vegetables, lean proteins, whole grains and healthy unsaturated fats, which describes many of the components of the Mediterranean diet.

“There have been several studies over the years on the best foods or diets for treating psoriasis, as well as the foods that appear to be the most harmful. A diet high in sugar, which is known to worsen inflammation, appears to have the most impact. negative impact on psoriasis symptoms,” says Kaffenberger.

A diet with an excessive intake of simple sugars leads to dysbiosis (an imbalance of the organisms normally present in the intestines) with an increase in bacteria and inflammatory substances called cytokines.

A 2017 study reported in the journal Dermatology and Therapy surveyed more than 1,200 psoriasis patients who were members of the National Psoriasis Foundation and found that about 43% of respondents were unsure whether diet affected their psoriasis.

Those who checked ‘yes’ for dietary influence noted that their symptoms were made worse by sugar, alcohol, tomato and other nightshade vegetables such as eggplant and pepper, gluten and dairy products. Excessive alcohol intake has been linked to the development of psoriasis and an increase in its severity.

Less commonly reported triggers included meat, processed foods, soda, bread, eggs and spicy foods. The study also asked patients if there were any foods that seemed to improve their symptoms. 35.1% of people reported that dietary supplements reduced skin irritation, while others endorsed vegetables, fruit and fish.

Dietary supplements that were helpful included vitamins (particularly vitamin D), probiotics, fish oil/omega-3, and turmeric capsules. Fruits and vegetables provide many antioxidants (such as carotenoids, flavonoids, vitamins and minerals), which are inversely correlated with C-reactive protein (CRP), a measure of inflammation.

Several patients reported favorable results following the Pagano, Vegan and Paleolithic diets, while others praised gluten-free, low-carb and high-protein, Mediterranean and vegetarian diets. The Pagano Diet was developed by chiropractor John Pagano, who wrote the 2008 book “Healing Psoriasis” and believed that psoriasis was a manifestation of leaky gut syndrome, in which the skin works overtime to release toxins.

Coffee, which contains antioxidant-rich polyphenols, has been shown to have an anti-inflammatory effect, suggesting it could benefit psoriasis. Nevertheless, according to the Psoriasis and Psoriatic Arthritis Alliance, the evidence on its usefulness should be more consistent.

Some research shows that increased coffee intake is correlated with an increase in symptoms. In contrast, others show that coffee can increase the effectiveness of some drugs for treating psoriasis.

Research has suggested that its effect on psoriasis is dose-dependent, with moderate consumption (up to three cups per day) relieving symptoms and reducing inflammation, and higher caffeine intake having an adverse effect.

Healthy living and psoriasis

“Because adipose tissue is a metabolically inflammatory substance, weight loss for people with obesity can be extremely helpful in reducing psoriatic symptoms, as well as reducing the comorbidities that often coexist.” says Kaffenberger, who adds that “intermittent fasting has been shown to reduce inflammation and increase lifespan, but many people find it difficult to stick to the diet.”

Now that you’re well aware of the alleged link between diet and psoriasis, you may want to make some changes to improve your healthy eating habits (never a bad idea, whether you have the condition or not). These changes may include:

• Avoid highly processed foods, foods high in saturated fats or trans fats, and foods high in added sugars or refined carbohydrates
• Increase your consumption of plant-based and fiber-rich foods such as vegetables, fruits, nuts, seeds and whole grains
• Eating lean proteins and fatty fish, which are rich in omega-3 fatty acids; limiting your red meat intake
• Consuming healthy unsaturated fats such as extra virgin olive oil and vegetable oils and eating healthy fats such as avocado or dark chocolate