The 5 Best Diets for Psoriatic Arthritis
No boring bites here. These diets are full of flavor, and they come with one awesome benefit—fewer psoriatic arthritis flares!by Emily Shiffer Health Writer
It’s no secret that what you eat can impact your health. And if you have a chronic disease, diet plays a huge role in keeping symptoms at bay.
“This is especially true for people who have too much inflammation in their body, which is what happens with psoriatic arthritis,” says Robin Foroutan, R.D.N., an integrative medicine dietitian and spokesperson for the Academy of Nutrition and Dietetics.
It is estimated that about one in five patients with psoriasis will develop psoriatic arthritis, an autoimmune condition that can lead to inflammation that damages your skin and your joints.
“Many different foods, especially foods high in antioxidants, can help the body balance inflammation, and that’s why diet is so important,” says Foroutan.
On the flip side, “some foods are pro-inflammatory in and of themselves, meaning they trigger an inflammatory cascade,” says Foroutan. “For someone with PsA, that’s like pouring gasoline on a wildfire.”
Are You Pro Anti-Inflammatory Diet?
According to the National Psoriasis Foundation, an anti-inflammatory diet composed of lean proteins, whole grains, and fresh produce is often recommended for those with psoriatic arthritis.
“Many diets will claim that they are anti-inflammatory. However, certain diets score better when it comes to research and efficacy–these diets include the Mediterranean Diet, the Dash Diet, and a Vegetarian Diet,” says Angel Planells, R.D.N., Seattle-based registered dietitian nutritionist and spokesperson for the Academy of Nutrition & Dietetics. “These diets have a higher intake of health protective nutrients (fruits, vegetables, nuts, seeds, healthy fats, lean protein).”
“On the most basic level, sugar, white refined grains, processed red meat and any food that provides minimal to no nutrient density should be avoided,” says Kristin Kirkpatrick, R.D.N., registered dietitian nutritionist and lead dietitian at Wellness Nutrition Services at Cleveland Clinic Wellness & Preventive Medicine. “What should be adhered to are colorful foods representing high phytonutrient/antioxidant levels often found in plants, such as fruits, vegetables and whole grains.”
The good news is that studies have found there are actually a bunch of diet plans that can help you eat to beat inflammation. Here’s a rundown on five of the top picks, plus their pros and cons, and who might want to consider them.
Basics: The Mediterranean Diet consists of mostly vegetables, fruits, and whole grains, moderate amounts of dairy, fish, and meat (with minimal amount of red meat), and minimal processed foods and sugar. Healthy fats, especially extra virgin olive oil, also get a big check mark in this diet.
Pros for PsA: The Mediterranean Diet is considered an ‘anti-inflammatory’ diet. One study found that patients with PsA who followed a Mediterranean Diet compared to those who didn’t reported lower levels of PsA disease activity.
Cons for PsA: According to Harvard University, the Mediterranean Diet could increase your risk of excess calorie intake, as portion size isn’t emphasized, which may cause weight gain.
You might like it if: You are looking to decrease the amount of processed foods you eat and increase the amount of produce.
Basics: The ‘DASH’ stands for Dietary Approaches to Stop Hypertension. It was designed as a diet to lower blood pressure, and it puts major stock in vegetables, fruits, and low-fat dairy foods. Also empasized are moderate amounts of whole grains, fish, poultry, and nuts as well as low-sodium intake.
Pros for PsA: Like the Mediterranean Diet, the DASH Diet cuts out foods known to increase PsA symptoms, including processed foods. Since it's goal is to improve heart health, this diet is another pro for those with PsA, who are at higher risk of developing heart disease.
Cons for PsA: This diet was specifically created to lower blood pressure, which may not be necessary for those with PsA (i.e. those who do not have hypertension).
You might like it if: You are looking to improve your heart health (along with your PsA symptoms).
Basics: This diet (a.k.a. the Caveman Diet) consists of primarily lean meat, fruit, fish, nuts and seeds, and cuts out the junk food and most processed foods, which can contribute to inflammation. It eliminates potentially inflammatory foods like gluten and dairy, and it allows for lots of anti-inflammatory veggies, herbs, spices, fatty fish, and high-quality meats and fats.
Pros for PsA: There’s a version of Paleo called the AIP diet, or auto-immune paleo diet (which is an elimination-style Paleo diet), that can also be remarkably helpful for anyone with an autoimmune condition. The AIP diet requires focus on food quality and includes trial elimination of many otherwise healthy foods like eggs, beans and legumes, which are technically anti-inflammatory.
Cons for PSA: If people were to eat too much meat and not enough veggies (which is easy to do with this diet), the level of anti-inflammatory protection would go down.
You might like it if: You're up for meal planning and prepping, and you want to lose or maintain your weight.
Basics: This somewhat customizable diet implements different time cycles of fasting and eating. There are many different fasting methods, including the 16/8 method where you fast for 16 hours and have an 8-hour eating window. There’s also the “Eat-Stop-Eat” method where you fast for 24 hours once or twice a week.
Pros for PsA: There is some evidence that Intermittent Fasting (IF) can help regulate the immune system and reduce inflammation, especially when paired with anti-inflammatory foods like green leafy vegetables, fatty fish, and olive oil. One study published in the journal Nutrients found that after a month of fasting, patients with PsA reported lower inflammation markers.
Cons for PsA: It may prevent you from attaining as many nutrients as possible if you limit the amount of time (and consequently the amount of food) you eat using IF. And simply limiting the periods when you’re eating without adjusting your diet to include anti-inflammatory foods likely won’t result in major PsA improvements.
You might like it if: You want to practice portion control and simplify your lifestyle (since you don't have to think about when to eat, only what to eat).
Basics: This diet consists of plants, plants, and more plants. Obvi.
Pros for PsA: “The different colors you see in plant foods are signals that the food is high in ‘phytonutrients’, a.k.a. antioxidants,” says Foroutan. “These foods help the body balance inflammation and can help modulate an overactive immune system.” In other words, when you eat foods that are high in antioxidants, like vegetables, you prevent the production of inflammatory compounds and fight destructive ‘oxidant’ molecules that attack healthy cells, leading to inflammation.
Cons for PsA: Plant-based diets often lack foods that contain vitamin D like fatty fish, cheese, and egg yolks, which is not ideal. One study published in Arthritis Research & Therapy, found that nearly 41% of participants with psoriatic arthritis had a vitamin D deficiency.
You might like it if: You’re trying to cut back on your meat intake (which can come with a lot of inflammation-causing saturated fats), and up your consumption of veggies.
- Anti-Inflammatory Diet: National Psoriasis Foundation. (2019). “Anti-Inflammatory Diet.”
- Metabolic Comorbidities: Arthritis Foundation. (n.d.). “Metabolic Comorbidities of Psoriatic Arthritis.”
- Artificial Sweeteners: Neuroscience News. (2018). “Artificial Sweeteners Have Toxic Effects on Gut Bacteria.”
- Diet and Inflammation: Cell. (2019). “Dietary Intake Regulates the Circulating Inflammatory Monocyte Pool.”
- Intermittent Fasting and PsA: Nutrients. (2019). “The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study.” ncbi.nlm.nih.gov/pmc/articles/PMC6471071/