Managing psoriasis through your diet

A new study says it’s important for people with psoriasis to watch their diet, writes Clodagh Finn.

Managing psoriasis through your diet

A new study says it’s important for people with psoriasis to watch their diet, writes Clodagh Finn.

PEOPLE with psoriasis know only too well what triggers their condition. It could be stress, injury, or infection, but now an extensive study reiterates how important it is to watch what’s on your plate.

Weight management, and in some cases diet, have an important role to play in easing the symptoms of psoriasis, a chronic inflammatory skin disorder that affects about 100,000 people in Ireland.

A major review of research into the skin condition found that psoriasis sufferers who were overweight benefited significantly by following a calorie-reduced diet. Some also found it helpful to eliminate gluten from their diet and/or to boost vitamin D intake, according to a study in the Jama Dermatology journal.

Researchers examined the experience of more than 4,500 patients in 55 studies to find out how changes in diet could help reduce the severity of psoriasis and psoriatic arthritis.

Dr Marina O’Kane, consultant dermatologist and Irish Skin Foundation (ISF) chairwoman, says the foundation already follows some of the advice outlined in the report.

Advising overweight psoriasis sufferers of the benefits of losing weight is already part of standard care for psoriasis patients, she says, adding that it’s very difficult to make other specific dietary recommendations.

“Since psoriasis is a complex condition with many different genetic and environmental influences, it may be that for certain subgroups of patients, diet may be involved — but we don’t have enough good-quality studies,” she tells Feelgood.

While she says some patients reported feeling better when they avoided certain foods, the ISF warned of the dangers of undertaking extreme diets without supervision from a doctor or dietician.

“We agree with the authors’ advice on weight reduction where necessary and we emphasise the importance of a healthy diet (and exercise) to maintain a normal body mass index (BMI). Raised BMI may be associated with more severe psoriasis, as well as cardiovascular disease, diabetes, and hypertension, all of which are more common in psoriasis,” says Dr O’Kane.

She says further research was needed and, at present, the ISF does not recommend any specific diet changes.

At the same time, there is growing evidence to suggest that nutrition has a role to play in the treatment of psoriasis. One study — ‘Environmental Risk Factors in Psoriasis: The Point of View of the Nutritionist — goes so far as to say it played “a major role”.

Paula Mee: More emphasis needs to be put on the considerable benefits of good nutrition.
Paula Mee: More emphasis needs to be put on the considerable benefits of good nutrition.

That study also highlighted the link between the skin condition and being overweight and pointed out the benefits of adopting a healthy lifestyle. Consultant dietician Paula Mee believes part of the problem is that we tend to under-rate the importance of lifestyle in the treatment of illness.

“With any disease, it’s very important that we realise there is a lot we can do in terms of lifestyle,” she says. That might mean trying to manage stress, getting more exercise, or focusing on nutrition and diet.

It is already well-established that stress, alcohol, and smoking can exacerbate psoriasis flare-ups, but Mee believes more emphasis needs to be put on the considerable benefits of good nutrition.

Quoting the 2016 study, she says some people got relief when they increased their intake of cold-water fish, such as salmon, herring, mackerel, and trout, which are high in the essential fatty acid omega 3.

Other good sources of omega 3 are walnuts and chia seeds. Flaxseed and evening primrose oil might also be useful.

Increasing vitamin D, the so-called sunshine vitamin, has also been reported to help in some cases. However, basking in the sun — when it shines — also brings with it a risk of skin cancer, so don’t overdo it, advises Mee, or opt to take a supplement.

It can also be beneficial to include foods that help to fight inflammation — such as berries, seeds, turmeric, and ginger. Everyone benefits from eating plenty of fresh fruit and veg but orange and yellow vegetables, which contain vitamin A, are particularly recommended.

The foods to avoid include alcohol, processed, fried, or sugary foods, but the bottom line, says Paula Mee, is that we need far more research. Nutrition, she says, can have a hugely powerful effect on health: “It should be what we look at first and foremost before we look at a pharmaceutical solution.”

More in this section