The importance of a healthy diet can’t be overstated. For example, eating vitamin-packed fruits and vegetables and staying away from foods high in saturated fat is good for your heart.
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Over the years, studies have shown that what you eat can also help reduce the symptoms and impact of certain chronic conditions — including psoriasis.
Yes, says dermatologist Anthony Fernandez, MD, PhD, especially if you have obesity or are considered to be overweight. “We have great evidence to support that losing weight via a hypocaloric (low-calorie) diet will improve the overall severity of your psoriasis.”
Of course, it’s not just how much you eat — but what you eat — that also makes a difference when you change your diet.
It’s common to see lists of specific trigger foods to shy away from if you have psoriasis. But following those restrictions typically isn’t necessary, says Dr. Fernandez. “In general, we do not recommend that people living with psoriasis avoid a specific food.” In many cases, that’s because there’s no scientific evidence that certain foods are a psoriasis trigger. For example, Dr. Fernandez notes there’s no proof that eggs can cause a flare.
But occasionally, you might feel that eating certain foods does affect your psoriasis. “We certainly see people who come in and say, ‘I feel like whenever I eat this certain type of food, my psoriasis flares,’” says Dr. Fernandez.
In a case like that, you might need to pay more attention to how you feel when you eat this food, or avoid it altogether, and see if it makes a difference over time. “We’re always open to experimenting with simple, safe things like that,” says Dr. Fernandez. “Everyone’s unique and may have a unique trigger for their disease. We’ll take it seriously if brought up.”
With all that being said, Dr. Fernandez notes there are broad categories of foods that can make psoriasis act up.
We need body fat to survive because it plays an important role in our overall health. But body fat is pro-inflammatory. That means having more of it can encourage more inflammation, which isn’t good for psoriasis. Dr. Fernandez recommends staying away from calorie-rich foods that make it more likely you’ll accumulate body fat — in other words, things such as fried fast food or sugar-heavy desserts.
With alcohol, moderation is also key. “We know people who drink alcohol are at increased risk for developing psoriasis,” says Dr. Fernandez. “But abstaining from alcohol doesn’t always result in any significant long-term improvement of the disease.” Instead, follow doctor recommendations for alcohol intake and don’t overdo it.
You might’ve heard that taking a supplement that’s known to have anti-inflammatory properties, like turmeric, can help with psoriasis. Science doesn’t necessarily back this assertion, though. “Short of knowing ‘Well, if you take too much of this supplement, it can do something harmful,’ we will usually say, ‘Go ahead and try taking it,’” he says. “But there simply is no strong evidence at the moment to support any supplements are going to make a difference with psoriasis.”
On its own, a specific diet isn’t the only way to manage psoriasis. “There’s no one diet that we know for sure is the best diet for patients,” says Dr. Fernandez. “And we don’t necessarily recommend this as the only therapy. Most people will not improve with diet alone to the point where they don’t need other medicines.”
However, some diets are better than others in terms of helping with psoriasis.
Research has shown the positive impact of the Mediterranean diet. “That’s probably the one most people recommend when discussing how to change your diet and improve your psoriasis,” says Dr. Fernandez. “This diet involves foods that have anti-inflammatory properties. They’re low in fat. They’re low in calories. Most of them are natural.”
With the Mediterranean diet, expect to eat a lot of fruits and vegetables, nuts and grains. You’ll get your protein from fish such as salmon and cook with olive oil. You won’t eat a lot of dairy, red meat or sweet treats.
An indulgence here or there is OK, though. “I never like to tell people that you have to start on the Mediterranean diet and only eat foods within the Mediterranean diet,” says Dr. Fernandez. “Occasionally, eating foods that are really tasty but maybe heavy in calories is fine as a reward. In general, however, trying to avoid too many of those foods can be very important to controlling psoriasis and minimizing the medication that you need to take to control your psoriasis.”
Following a low-calorie diet is another good way to deal with psoriasis. “Losing weight has been proven to improve psoriasis severity,” says Dr. Fernandez. If you’re classified as overweight or have obesity, following a low-calorie diet can be especially helpful to manage psoriasis.
It’s less clear whether a low-calorie diet can help you manage psoriasis if you aren’t classified as overweight or have obesity, though. “We don’t know yet,” says Dr. Fernandez. “We need to do research to determine if such a diet will help you in that case.”
One of the more common assumptions is that a gluten-free diet can help with psoriasis. However, Dr. Fernandez says that’s not the case for most people. In fact, research has even supported that a gluten-free diet won’t help your psoriasis.
“The reality is a gluten-free diet makes no difference unless you have laboratory evidence that you are sensitive to gluten,” he says. “And we can test for that when appropriate.” That means if you’re already showing clinical signs and symptoms of gluten sensitivity, Dr. Fernandez adds. “Just having psoriasis is not enough evidence to warrant testing.”
You may have read that other diets can help with psoriasis. These might include a veggie-heavy plant-based diet or the high-fat keto diet. There’s also one called the Pagano diet, which shares some similarities with the Mediterranean diet.
Dr. Fernandez stresses that there’s not yet any strong evidence that says these diets can help with psoriasis. But researchers are conducting studies to see whether particular approaches to food (such as the keto diet) might help with psoriasis. “There is interest in exploring other diets for psoriasis — and better evidence may be available in the future,” he adds.
As with supplements, however, doctors are OK with people following different diets as long as they won’t hurt their health. “If you want to try something like the Pagano diet, then as long as we think that diet is healthy in general — or it’s not so extreme that you’re going to be limiting yourself from getting some essential nutrients — then we’ll say it’s OK,” he says.
Unfortunately, we can’t cure psoriasis through diet. In fact, there isn’t any cure for psoriasis. But in addition to diet, there are ways to manage the condition.
“Exercise is good for your immune system, and can also help promote weight loss because of the calories that you burn,” says Dr. Fernandez. “Wellness, in general, is good to strive for. Strategies such as eating well, exercising and getting enough sleep are all keys to help minimize the chances you’re going to flare.”
Dr. Fernandez notes that certain people improve so much with diet and exercise that they don’t need medication. “But we think of that as more the exception, and we certainly don’t say that’s all you need to do,” he stresses, noting that neither exercise nor diet, in general, are recommended as sole alternatives to medications.
“For some people, the improvements they see through exercise and diet might mean all they need is a topical medicine to control psoriasis, as opposed to a pill or an injectable medicine that affects their immune system systemically and can come with other side effects,” says Dr. Fernandez.
And, chances are, people with moderate to severe psoriasis will likely always need medication, he adds. “However, we do believe we can minimize the medications you need to take through wellness and diet.”