If you’re living with the aches and pains of psoriatic arthritis (PsA), you are not alone — and there’s more in your control than you might think. PsA is a chronic (ongoing) inflammatory arthritis, and if you're among the 30 percent of people with psoriasis who also have PsA, you know the challenges all too well.

Although managing PsA can be tough, even small tweaks to what you eat could make a big difference in controlling joint pain, swelling, and fatigue. What’s more, adopting a balanced diet can protect your heart and reduce the risk of developing heart disease, diabetes, and other conditions linked to PsA.

Let’s look at how simple changes to your meals can support your joints and help you feel better overall.

Which Diets Can Help Psoriatic Arthritis?

Because there aren’t specific dietary guidelines for PsA, doctors might suggest an autoimmune protocol diet, which involves following a balanced, healthy diet with plenty of whole, fresh foods — similar to what’s recommended by the American Heart Association and American Cancer Society.

You may find that certain foods trigger PsA symptoms. A national survey of people with psoriasis found that avoiding common inflammatory foods — like alcohol, gluten (protein found in certain grains), and nightshade vegetables (tomatoes, white potatoes, eggplant, and peppers) — helped ease their symptoms. For those with PsA, cutting out these foods could also make a difference.

A systematic review of research found that the best diets for PsA focus on reducing inflammation and supporting weight loss. The study authors recommended:

• 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

Relying on diet alone isn’t a safe or effective way to manage PsA symptoms. The best results come from combining medical treatments with dietary changes, which can help reduce symptoms and lower the risk of developing other health issues.

Below are examples of diet plans that may help your PsA symptoms.

1. The Anti-Inflammatory Diet

An anti-inflammatory diet, such as the Mediterranean diet, is one of the most popular choices among members of MyPsoriasisTeam. Anti-inflammatory diets include some of the best foods for PsA. They 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 include saturated fats, refined sugars, and refined carbs, such as white bread.

Essentials of anti-inflammatory diets include:

• Fresh fruits and vegetables — Blueberries, cherries, collard greens, spinach, kale, Swiss chard, and beet greens all contain antioxidants (plant nutrients that protect cells) that can help decrease inflammation.
• Olive oil — The cornerstone of the Mediterranean diet, olive oil is loaded with heart-healthy and anti-inflammatory fats.
• Fish and omega 3s — Fatty fish, such as salmon and mackerel, are high in omega-3s, a healthy type of fat with anti-inflammatory properties that may help protect people with PsA against heart disease. Good plant-based sources of omega 3s include flaxseed, chia seeds, and walnuts.
• Whole grains — Brown rice, whole grain bread, quinoa, barley, and wheat berries contain fiber, which helps regulate blood sugar and may also decrease inflammation.
• Nuts — Peanuts, almonds, walnuts, cashews, pistachios, and pecans have healthy fats and fiber that may 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 Journal of the American Academy of Dermatology study showed that the risk of developing psoriatic disease was the same, whether or not participants ate an anti-inflammatory diet.

2. Weight-Loss Diets

According to the National Psoriasis Foundation (NPF), the best diet for managing PsA symptoms is one that helps people attain a healthy weight and takes pressure off the joints. A small 2019 study found that obesity is associated with higher disease activity, poorer treatment response, and a higher risk of other inflammatory conditions. When participants in the study lost weight, their joint pain and swelling decreased.

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 recommends a gluten-free diet only for people with specific gluten sensitivities, such as celiac disease. That’s because going gluten-free can sometimes mean missing out on certain nutrients. Studies from the Journal of the American Academy of Dermatology show that celiac disease is more common in people with psoriasis or PsA, and testing can help you find out if gluten sensitivity is a factor for you.

3 Controversial Diets for Psoriatic Arthritis

Many people find that certain diet trends help with their PsA symptoms. Some of these eating plans may not have evidence to support their effectiveness, and in some cases, these diets may also be harmful to your health. Be sure to check in with your doctor before starting a new diet.

1. Carnivore Diet

The carnivore diet typically involves eating only meat, with no other food groups. Some followers of the carnivore diet for PsA stick to a single type of meat, while others include a variety of meats and animal products.

Supporters of the carnivore diet sometimes argue that plant-based foods are toxic and cause inflammation, though there is limited evidence to back this up. No formal clinical trials have researched the carnivore diet’s specific effects on PsA, making it difficult to draw strong conclusions at this point.

It’s also important to note that the potential inflammatory effect of carbohydrates depends on the processing. For instance, healthy carbohydrates like whole grains provide vitamins and minerals and are less likely to cause blood sugar spikes and inflammation.

Some people say they feel better on the carnivore diet, but many claims about its benefits aren’t backed by science and should be taken with caution. Cutting out all grains, legumes, fruits, and vegetables can lead to health problems, such as high cholesterol, hypertension, vitamin deficiency, and constipation from inadequate fiber.

2. Detox Diet

A detox diet for psoriasis typically involves fasting or avoiding certain foods or drinks, followed by restricted eating. Many detox diets recommend removing inflammatory foods such as alcohol, sugar, dairy, and gluten, similar to other anti-inflammatory diets used for autoimmune conditions, in which the immune system mistakenly attacks healthy cells.

Some supporters of the detox diet suggest it can ease symptoms by ridding the body of toxins and substances that may trigger flare-ups. However, according to Mayo Clinic, there’s little evidence to support this claim.

Cutting out certain foods can be helpful, but restrictive detox diets can also lead to nutrient deficiencies, so it’s important to be careful. Talk to a doctor before trying these diets, as they aren’t a replacement for medical treatment.

3. Dr. Pagano Diet

Dr. Pagano, a chiropractic physician, believed psoriasis is linked to leaky gut syndrome and can be managed through natural, unprocessed foods, beverages, and nutrients. His diet focuses on cutting out foods that create acid, like red meat and processed foods, and encourages eating more alkaline foods, such as specific fruits and vegetables. It also includes drinking fresh juices and water while avoiding nightshades, dairy, gluten, coffee, alcohol, added sugars, and fried foods.

Some elements of the Pagano diet, such as avoiding processed foods, sugar, and alcohol, align with general dietary advice for inflammatory conditions like PsA. It’s also true that certain foods the diet eliminates, such as nightshades and gluten, may trigger flare-ups in some people, but the response is different in everyone.

There are no peer-reviewed studies specifically on Dr. Pagano’s diet effectiveness. His approach is based on personal experiences, interactions with individuals, and testimonials.

Talk to Your Doctor

Although diet changes don’t cure PsA, some can help manage symptoms and support your overall health. Diets that focus on reducing inflammation, like the Mediterranean diet or a balanced weight-loss plan, have some evidence behind them and may be worth trying. On the other hand, restrictive diets like the carnivore or detox diets aren’t backed by strong science and can carry health risks. Before making big changes to your diet, talk with your doctor about what might work best for you.

Find Your Team

On MyPsoriasisTeam, the social network for people with psoriasis or psoriatic arthritis and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with psoriatic arthritis.

Have you tried changing your diet to help with psoriatic arthritis symptoms? Has it made you feel better? Share your experience in the comments below, or start a conversation by posting on your Activities page.