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.
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:
Check out six popular diets, along with information on how they may benefit people with PsA.
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:
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.
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.
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.
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.
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.
Several foods, herbs, and spices with anti-inflammatory properties can be added to meals or snacks.
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.
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.