Approaches to a Psoriatic Arthritis Diet

Let's start with the bottom line: Changing your diet will not cure your psoriatic arthritis. According to the National Psoriasis Foundation, researchers have concluded that there is little evidence that suggests dietary changes will make much difference to your psoriatic disease. That said, there is some anecdotal evidence from people with psoriatic arthritis who claim dietary changes have improved their condition.

We know that diet is among the first things people look to when diagnosed with any condition. It's the most basic way to fight what is going on in your body, or so it would seem. Predictably, people feel like they can regain control by either eating or avoiding certain foods.

While there is no dietary cure for psoriatic arthritis, certain approaches may align with better overall health and may help psoriatic arthritis somewhat. Let's consider what the experts have discovered and suggested.

Obesity has been associated with pro-inflammatory effects (i.e., increases inflammation in the body). There also is a connection between body mass index and the severity of psoriasis. In a study of over 75,000 people with psoriasis, obesity was found to be a risk factor for developing psoriatic arthritis. Some studies have concluded that obesity can potentially affect treatment response in people with psoriatic arthritis. Other studies challenged that conclusion though.

While more studies are needed, enough is known to safely suggest that weight loss diets may be beneficial as a preventative or adjunctive treatment for psoriasis or psoriatic arthritis. Weight loss, when combined with prescription medications, may be effective adjunctive treatments for psoriatic arthritis in some people. Obviously, not every person who has psoriatic arthritis is overweight or obese. But, for those who are, weight loss interventions may help.      

Psoriatic arthritis is an inflammatory type of arthritis. It is generally recognized that people with inflammatory conditions may benefit from an anti-inflammatory diet. To reiterate, there is no dietary cure for psoriatic arthritis, but certain foods are regarded as pro-inflammatory and should be avoided, while other foods reduce inflammation and should be included in your diet. 

Examples of pro-inflammatory foods are fatty red meats, dairy products, nightshade vegetables, high-fat foods, simple refined carbohydrates, and processed foods. Examples of foods that help to reduce inflammation include fish (salmon, herring, sardines, and black cod), seeds, walnuts, and colorful fruits and vegetables. Dr. Weil's Anti-Inflammatory Food Pyramid provides more detail and daily portion suggestions.

People with psoriasis are more likely to have one or more autoimmune diseases compared to the general population. Psoriasis patients are 2.2 times more likely to have celiac disease than those without psoriasis. Studies have suggested that psoriasis and celiac disease share common genetic and inflammatory pathways. Celiac disease is a disease of the small intestine. Since it is known that people with celiac disease must adhere to a gluten-free diet, deductive logic leads us to the possibility that a gluten-free diet could benefit people with psoriasis or psoriatic arthritis. More studies are needed before a definitive conclusion can be drawn.

If you have symptoms associated with celiac disease, such as diarrhea, flatulence, fatigue, and iron-deficiency anemia, your doctor likely will test you for celiac antibodies (IgA EMA or IGA tTG). Positive antibody results would make the case for possible benefit from a gluten-free diet. To confirm celiac disease, however, a biopsy is required. Also, it is possible to have gluten sensitivity without gluten enteropathy (small intestine disease). 

A search on Pubmed.gov turns up zero articles for "Paleo diet and psoriasis" or "Paleo diet and psoriatic arthritis." But, there is a testimonial on the Internet which proclaims that the Paleo diet healed their psoriatic arthritis.

According to thepaleodiet.com, foods you can eat include grass-produced meats, fish/seafood, fresh fruits and vegetables, eggs, nuts and seeds, certain oils (olive, walnut, flaxseed, macadamia, avocado, coconut). Foods you should avoid include cereal grains, legumes, dairy, refined sugar, potatoes, processed foods, salt, and refined vegetable oils.

If you choose to follow the Paleo diet, keep in mind the lack of research supporting it for psoriatic arthritis. As with all of these dietary patterns, if you do try it, working with a dietitian or other health professional can be helpful in making the best food decisions for you.

The Mediterranean Diet focuses on a high intake of fruits and vegetables, legumes, grains and cereals, fish and seafood, and nuts. A low intake of dairy products, meat, and meat products are part of the Mediterranean diet. A moderate intake of wine during meals is acceptable. EVOO (extra virgin olive oil) is the main added fat.

The Mediterranean diet has been touted for reducing the risk of metabolic, cardiovascular, and neoplastic diseases, as well as being protective against chronic degenerative diseases. Study results also have linked the diet to reduced severity of psoriasis.