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Psoriatic Arthritis Diet: The Ultimate Guide

Posted on February 13, 2020
See how 1860 members reacted on this article
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Laurie Berger

If you’re among the 30 percent of people with psoriasis who also deal 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.

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 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 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 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 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.

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 prevent 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.

The Weight-Loss Diet for Psoriatic Arthritis

According to the National Psoriasis Foundation, 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 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 overweight people with psoriatic disease. You should consult your doctor about the best nutrition plan if you’re looking to lose weight.

Other Diets for Psoriatic Arthritis

Gluten-free diet: Skipping 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,” said one member.
The National Psoriasis Foundation 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.
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 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.
Gut-healthy diet: The bacteria in your intestines can affect the immune system, metabolism, and weight. Some scientists have suggested that changes in gut bacteria may also increase the risk of PsA.
A 2016 study 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, 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.

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 NSAIDs, 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, 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. 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 90,000 members strong. Diet is one of the most discussed subjects. Have psoriatic arthritis diet tips you'd like to discuss? Comment below, or go to MyPsoriasisTeam to start the conversation.

To read more from our Psoriatic Arthritis Awareness Center, check out the following resources:

References
  1. 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 — NCBI PubMed
  4. The American Heart Association Diet and Lifestyle Recommendations — American Heart Association
  5. ACS Guidelines on Nutrition and Physical Activity for Cancer Prevention — American Cancer Society
  6. Psoriatic Arthritis: Which Foods are Trigger and Which are Suppressants? — Rheumatoid Arthritis Support Network
  7. Dietary Behaviors in Psoriasis: Patient-Reported Outcomes from a U.S. National Survey — Dermatologic 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 — 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. Very Low-Calorie Diets — NCBI PubMed
  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 — NCBI PubMed
  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 Disorder

A MyPsoriasisTeam Member said:

All Oils are bad for over all health as well as fish. Fish and most seafood produces have high levels of mercury. Paleo diet is a modified Atkins diet which can lead to heart disease. This article… read more

posted 3 months ago

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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.

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