If you’re among the 30 percent of people with psoriasis who also struggles with psoriatic arthritis (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 illnesses that are more common in people with psoriatic arthritis.

Members of MyPsoriasisTeam who’ve made dietary changes report improvement in psoriatic arthritis symptoms and quality of life:

• “I’ve learned that there’s no cure for PsA, however an anti-inflammatory diet is helping tremendously!”
• “One of the best things I did was go on an elimination diet.”
• “I cut out gluten for a while and noticed a huge improvement.”
• “Sugar has a lot to do with my PsA flare ups.”
• “Diet is key, but I personally don't believe that one diet is for all.”

What’s the Best Psoriatic Arthritis Diet?

While no single diet has been proven to treat or cure psoriatic arthritis, there are steps you can take to manage your psoriatic arthritis. 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 psoriatic arthritis, according to a 2017 national survey of NPF members’ dietary habits. When survey respondents made dietary changes - including cutting out alcohol, gluten, nightshade vegetables and other foods believed to cause psoriatic flares - more than half experienced a reduction in PsA symptoms.

Which diets helped them achieve these results? The Pagano diet (based on the theory that psoriasis is caused by toxic build-up, 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 psoriatic arthritis incorporate anti-inflammatory and weight-loss approaches, according to researchers in the National Psoriasis Foundation study. Most of the diets mentioned by respondents offer those features.

Researchers caution, however, that treating psoriatic arthritis with diet alone is neither a safe, nor effective way to manage symptoms. Medical treatments that include dietary interventions have the greatest opportunity to reduce disease severity and 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 obese people with psoriatic disease
• A gluten-free diet in those testing positive for celiac disease
• Vitamin D supplementation for people with psoriatic arthritis

The Anti-Inflammatory Diet for Psoriatic Arthritis

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 DASH Diet.

These diets are high in fresh fruits, vegetables, nuts, whole grains, and extra virgin olive oil, and 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.

Members of MyPsoriasisTeam report fewer symptoms and overall feeling of well-being after eliminating inflammatory foods from their diets. Here’s what they’re saying:

• “Because I have PsA on my hands and feet, I don’t eat foods that cause inflammation. When I do, I’m a lot worse the next few days.”
• “For me, sugar triggers full-blown PsA flares.”
• “I gave up alcohol last year because the next day I’d be in agony.”
• “As long as I stay away from the worst inflammatory foods, I have very little joint pain. Gluten and sugar have been the biggies!”

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, 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 (PUFA) – whose anti-inflammatory properties 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 present someone from developing psoriatic arthritis or psoriasis. A 2019 cohort study of 85,000 nurses showed that the risk of developing psoriatic disease was equal, whether they ate an anti-inflammatory diet or not.

Other Psoriatic Arthritis-Friendly Foods

Several foods, herbs, and spices can be added to meals for an anti-inflammatory boost:

Green tea: The catechins in tea are known for their rich antioxidant properties that reduce inflammation.

Ginger: A natural anti-inflammatory and antioxidant, ginger has been generally shown to have similar pain-relief properties as non-steroidal anti-inflammatory (NSAID) drugs, according to a 2010 study. “I drink ginger and lemon tea. It helps with inflammation on days I have flare-ups,” said one member of MyPsoriasisTeam.

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 other people. Good sources include: Egg yolk, oily fish, and fortified dairy products, cereals, and orange juice.

Choosing a Psoriatic Arthritis Diet

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

By joining MyPsoriasisTeam, the social network and online support group for those living with psoriasis and psoriatic arthritis, you gain a support group more than 75,000 members strong. Diet is one of the most discussed subjects.

Here are some question-and-answer discussions about diets for psoriatic arthritis:

• I went online and read about anti-inflammatory diets.
• Does an anti-inflammatory diet work?
• Diets and vitamins?

Here are some conversations about diets for psoriatic arthritis:

• “I’d love some help from other sufferers about their diets.”
• “Do certain foods cause flare ups and if so, what foods cause yours?”
• “I read about the benefits of Kefir healing from the inside out.”
• “I read that pineapple is high in anti-inflammatory properties. Anyone have insight they’re willing to share?”

Have psoriatic arthritis diet tips you'd like to discuss? Comment below or go to MyPsoriasisTeam to start the conversation.

Laurie has been a health care writer, reporter, and editor for the past 14 years. Learn more about her here.

Dr. Teitel is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Learn more about him here. Review provided by VeriMed Healthcare Network.