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6 Diets for Psoriatic Arthritis

Updated on November 1, 2022

Psoriatic arthritis (PsA) is a type of inflammatory arthritis. If you’re among the 30 percent of people with psoriasis who also have PsA, changing your diet may help control joint pain, swelling, and other life-altering symptoms of this chronic inflammatory condition, according to the National Psoriasis Foundation (NPF). Adopting healthy eating habits can also prevent or reduce the risk of developing heart disease, diabetes, and other chronic (ongoing) illnesses that are more common in people with PsA.

Which Diets Can Help Psoriatic Arthritis?

Although no single diet has been proved to treat or cure PsA, there are steps you can take to manage it. In the absence of dietary guidelines for PsA, physicians recommend following a balanced, healthy diet rich in whole, fresh foods — similar to those advised by the American Heart Association and American Cancer Society.

Eliminating inflammatory trigger foods may also help control PsA, according to a 2017 national survey of NPF members’ dietary habits. When survey respondents made dietary changes — including cutting out alcohol, gluten, nightshade vegetables (tomatoes, white potatoes, eggplant, and peppers), and other foods believed to cause psoriatic flares — more than half experienced a reduction in PsA symptoms.

Psoriatic arthritis: risk factors, symptoms, and treatment

    Which diets helped them achieve these results? The Pagano diet (based on the theory that psoriasis is caused by toxic buildup, also known as leaky gut, in the intestine), a vegan diet, and the Paleo (caveman) diet were most frequently cited. Gluten-free, low-carbohydrate, Mediterranean, and vegetarian diets were also identified as beneficial.

    The best, most successful diets for PsA incorporate anti-inflammatory and weight-loss approaches, according to researchers in the NPF study. Most of the diets mentioned by respondents offer those features.

    Researchers caution, however, that treating PsA with diet alone is neither a safe nor an effective way to manage symptoms. Medical treatments that include dietary interventions have the greatest opportunity to reduce disease severity and the risk of developing comorbid (multiple) conditions, according to a 2018 systematic review in JAMA Dermatology.

    Study authors recommended the following interventions for people with psoriatic disease:

    • A weight-reduction diet for those with a higher body weight
    • A gluten-free diet for those testing positive for celiac disease
    • Vitamin D supplementation for people with PsA

    Check out six popular diets, along with information on how they may benefit people with PsA.

    1. The Anti-Inflammatory Diet

    An anti-inflammatory diet is one of the most popular nutritional choices among members of MyPsoriasisTeam. Diets in this category include the Mediterranean diet and the DASH diet.

    These diets are high in fresh fruits, vegetables, nuts, whole grains, and extra-virgin olive oil. They eliminate foods that may trigger a flare or worsen disease activity. Foods to limit or avoid on the Mediterranean or Dash diet plans include saturated fats, refined sugars, and refined carbs, such as white bread.

    Staples of anti-inflammatory diets include:

    • Fresh fruits and vegetables — Blueberries, cherries, collards, spinach, kale, Swiss chard, and beet greens all contain antioxidants that can help decrease inflammation.
    • Olive oil — The cornerstone of the Mediterranean diet, olive oil is loaded with heart-healthy fats and oleocanthal (a component of olive oil), which has similar pain relief properties as nonsteroidal anti-inflammatory drugs (NSAIDs).
    • Fish and omega 3s — Fatty fish, such as salmon and mackerel, are high in omega-3s, a type of polyunsaturated fatty acid with anti-inflammatory properties that may help protect people with PsA against heart disease.
    • Whole grains — Whole grains, such as brown rice, whole grain bread, quinoa, barley, and wheat berries, contain fiber, which may also decrease inflammation.
    • Nuts — Peanuts, almonds, walnuts, cashews, pistachios, and pecans have been linked with lower levels of inflammation in the body.
    • Beans — High in dietary fiber and protein, beans have significant antioxidant and anti-inflammatory compounds.

    A diet of anti-inflammatory foods, however, may not work for everyone with PsA or prevent someone from developing PsA or psoriasis. A 2019 study of 85,000 nurses from the Journal of the American Academy of Dermatology showed that the risk of developing psoriatic disease was equal, whether they ate an anti-inflammatory diet or not.

    2. The Weight-Loss Diet

    According to the NPF, the best diet for managing PsA symptoms is one that helps people attain a healthy weight and takes pressure off the joints. “Changing my diet helped increase my energy levels and lose weight to reduce impact on my joints,” shared one member of MyPsoriasisTeam.

    A small 2019 study found that obesity not only increases the risk of developing PsA, it’s also associated with higher disease activity, poorer treatment response, and a higher risk of other inflammatory conditions. When participants in the study lost weight, joint pain and swelling decreased.

    The NPF strongly recommends reducing caloric intake among people with higher body weight who have psoriatic disease. Ask your doctor about the best nutrition plan if you’re looking to lose weight.

    3. The Gluten-Free Diet

    Eliminating gluten is popular among members of MyPsoriasisTeam. “I cut out gluten for a while and noticed a huge improvement,” said one member. But the diet doesn’t work for everyone. “Gluten-free has been hit or miss for me — I had a new flare-up today,” added another member.

    The NPF only recommends a gluten-free diet for people with specific gluten sensitivities, such as celiac disease. There is evidence that celiac disease is more prevalent among people with psoriatic diseases. Testing can determine if you’re sensitive to gluten.

    4. The Paleo Diet

    The Paleo (or caveman) diet consists of very high animal protein and low (or no) carbs. Staples include meat, fish, eggs, fruits, and vegetables. Foods to avoid include grains, nuts, dairy, and processed foods.

    Although there’s no evidence that the Paleo diet can reduce symptoms of PsA, clinical studies have generally found that the Paleo diet can improve body mass index (BMI), blood pressure, and cholesterol levels. It may also promote weight loss and reduce joint swelling associated with processed foods. Researchers and physicians, however, caution about the increased risk of heart disease due to higher consumption of red meat and lower consumption of whole grains. The diet may also increase the risk of calcium, vitamin D, and vitamin B deficiencies.

    5. The Gut-Healthy Diet

    The bacteria in your intestines can affect your immune system, metabolism, and weight. Some scientists have suggested that changes in gut bacteria may also increase the risk of developing PsA.

    A 2016 study in the journal Arthritis & Rheumatology found that people with psoriasis and PsA may lack several types of healthful bacteria. Eating fermented foods can help boost those levels in your gut. They include kimchi, kefir (fermented milk drink similar to a thin yogurt), kombucha, sauerkraut, yogurt, and miso. “I’ve noticed that my PsA is not as hot and niggly since I’ve been drinking kefir, which is anti-inflammatory,” said one member.

    6. Incorporating Psoriatic Arthritis-Friendly Foods

    Several foods, herbs, and spices with anti-inflammatory properties can be added to meals or snacks.

    • Green tea — The catechins (a class of flavonoids, plant-based chemicals) in tea are known for their rich antioxidant properties that reduce inflammation. However, studies showing a benefit of drinking green tea for those with psoriasis or PsA are limited.
    • Ginger — A natural anti-inflammatory and antioxidant, ginger has been generally shown to have similar pain-relief properties as NSAIDs; however, studies are limited. One MyPsoriasisTeam member found ginger to be helpful: “I drink ginger and lemon tea. It helps with inflammation on days I have flare-ups.”
    • Turmeric — Similar to ginger, turmeric has many anti-inflammatory properties. Curcumin, the key ingredient, is listed in a 2018 review as a natural remedy that might help reduce inflammation in psoriatic disease. “Cooking with turmeric helps, as does ginger and garlic,” shared one MyPsoriasisTeam member.
    • Vitamin D-rich foods — Evidence suggests that people with psoriatic disease have a higher risk of vitamin D deficiency than others. Good sources of vitamin D include egg yolk, oily fish, fortified dairy products, cereals, and orange juice. You may want to ask your doctor if an evaluation for vitamin D deficiency, including blood work, is appropriate for you.

    Choosing a Psoriatic Arthritis Diet

    Researchers encourage people with PsA to keep a food journal, commit to a trial-and-error approach, and recognize that one diet size doesn’t fit all. Some trendy diets may not be safe for people with psoriatic disease. Discussing dietary options with your doctor or nutritionist can help you take the first steps toward managing PsA.

    Find Your Support

    When you’re navigating lifestyle changes or flare-ups in your symptoms, it can help to have the support of people who understand living with psoriasis. MyPsoriasisTeam is the social network for people with psoriasis and their loved ones. More than 112,000 members come together to ask questions, give advice, and share their stories with others who understand. Lifestyle and diet are some of the most discussed topics.

    Do you have psoriatic arthritis diet tips you’d like to discuss? Comment below, or go to MyPsoriasisTeam to start the conversation.

    References
    1. About Psoriatic Arthritis — National Psoriasis Foundation
    2. Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review — JAMA Dermatology
    3. Comorbidities in Patients With Psoriatic Arthritis — Rambam Maimonides Medical Journal
    4. The American Heart Association Diet and Lifestyle Recommendations — American Heart Association
    5. American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention — American Cancer Society
    6. Psoriatic Arthritis: Which Foods Are Triggers and Which Are Suppressants? — Rheumatoid Arthritis Support Network
    7. Dietary Behaviors in Psoriasis: Patient-Reported Outcomes from a U.S. National Survey — Dermatology and Therapy
    8. Nightshade Vegetables: Are They Bad for Arthritis? — CreakyJoints.org
    9. Living the Mediterranean Lifestyle — American Society for Nutrition
    10. DASH Eating Plan — National Heart, Lung, and Blood Institute
    11. The Ultimate Arthritis Diet — Arthritis Foundation
    12. Role of Antioxidants and Natural Products in Inflammation — Oxidative Medicine and Cellular Longevity
    13. Oleocanthal, a Phenolic Derived From Virgin Olive Oil: A Review of the Beneficial Effects on Inflammatory Disease — International Journal of Molecular Sciences
    14. Omega-3 Fatty Acids — National Institutes of Health
    15. The Effect of Marine n-3 Polyunsaturated Fatty Acids on Cardiac Autonomic and Hemodynamic Function in Patients With Psoriatic Arthritis: A Randomised, Double-Blind, Placebo-Controlled Trial — Lipids in Health and Disease
    16. Can Increasing Fiber Reduce Inflammation? — Arthritis Foundation
    17. Associations Between Nut Consumption and Inflammatory Biomarkers — American Journal of Clinical Nutrition
    18. Inflammatory Dietary Pattern and Incident Psoriasis, Psoriatic Arthritis, and Atopic Dermatitis in Women: A Cohort Study — Journal of the American Academy of Dermatology
    19. Weight Loss Improves Disease Activity in Patients With Psoriatic Arthritis and Obesity: An Interventional Study — Arthritis Research & Therapy
    20. Obesity: Identification, Assessment and Management of Overweight and Obesity in Children, Young People and Adults: Partial Update of CG43 — NICE Clinical Guidelines
    21. Gluten-Free Foods — Celiac Disease Foundation
    22. Diet and Psoriasis: Part 2. Celiac Disease and Role of a Gluten-Free Diet — Journal of the American Academy of Dermatology
    23. Paleolithic Diet — StatPearls
    24. Influence of Paleolithic Diet on Anthropometric Markers in Chronic Diseases: Systematic Review and Meta-Analysis — Nutrition Journal
    25. Heart Disease Biomarker Linked to Paleo Diet — Science Daily
    26. The Microbiome in Psoriasis and Psoriatic Arthritis: The Skin Perspective — Journal of Rheumatology Supplement
    27. Decreased Bacterial Diversity Characterizes an Altered Gut Microbiota in Psoriatic Arthritis and Resembles Dysbiosis of Inflammatory Bowel Disease — Arthritis & Rheumatology
    28. Anti-Inflammatory Properties of Kefir and Its Polysaccharide Extract — Inflammopharmacology
    29. Green Tea Polyphenol Epigallocatechin 3-Gallate in Arthritis: Progress and Promise — Arthritis Research & Therapy
    30. Natural Anti-Inflammatory Agents for Pain Relief — Surgical Neurology International
    31. Complementary and Alternative Remedies for Psoriasis — JAMA Dermatology
    32. Vitamin D and Its Role in Psoriasis: An Overview of the Dermatologist and Nutritionist — Reviews in Endocrine and Metabolic Disorders
      Updated on November 1, 2022
      All updates must be accompanied by text or a picture.

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      Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
      Laurie Berger has been a health care writer, reporter, and editor for the past 14 years. Learn more about her here.
      Scarlett Bergam, M.P.H. is a medical student at George Washington University and a former Fulbright research scholar in Durban, South Africa. Learn more about her here.

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