Fight Psoriatic Inflammation With These 8 Food Rules

Nobody likes a diet with a ton of strict caveats. That’s why Stuart Kaplan, M.D., chief of rheumatology at South Nassau Communities Hospital in Hewlett, NY, advises a classic well-balanced diet that’s rich in fruits, vegetables, and lean proteins like fish. It’s in keeping with the popular Mediterranean diet, which research suggests has anti-inflammatory properties that may help with the chronic inflammation of psoriatic disease, Dr. Woolf says. The general guidelines: Eat mostly vegetables, fruits, nuts, seeds, legumes, whole grains, fish, and healthy fats; limit red meat and dairy; and avoid added sugars and highly processed foods.

Does pain often have you reaching for the bottle of ibuprofen? A dose of extra virgin olive oil (EVOO) may deliver similar results. A review of studies published in Current Pharmaceutical Design found virgin olive oil (often labeled “extra virgin” at the grocery store) contains a compound called oleocanthal that prevents the production of pro-inflammatory enzymes in the body—similar to the way ibuprofen works. Virgin or extra virgin olive oil not only tastes better, but it also has fewer chemicals than regular olive oil due to higher production standards.

As long as you aren’t allergic, nuts are about as close to the perfect snack as you can get—convenient, tasty, and high in antioxidants, healthy fats, and fiber to keep you feeling full for hours. Even better, a study published in the American Journal of Clinical Nutrition found frequent nut consumption (five or more servings per week) is associated with less inflammation (though scientists aren’t exactly sure which component of nuts, or if the combination of all of them, is responsible). Dr. Woolf recommends eating a handful of nuts—such as walnuts, peanuts, almonds, or pistachios—as a snack or sprinkling them on oatmeal or a salad at least three times per week.

All healthy fats have their virtues, but research shows one reigns supreme as an inflammation warrior: omega-3 polyunsaturated fatty acids (PUFA). These are essential fats, meaning the body can’t make them from scratch but must get them from food. The best sources include flax seeds, walnuts, chia seeds, and cold-water fatty fish such as salmon, mackerel, tuna, herring, and sardines (all mainstays of the Mediterranean diet, BTW). Dr. Woolf’s recommendation: Aim to eat three servings of fish per week (one serving = three ounces, which is about the size of a fresh bar of soap) to regularly reap the anti-inflammatory benefits.

It’s universal healthy eating advice, but Dr. Kaplan and Dr. Woolf agree that limiting heavily processed foods (think processed meats such as bacon and hot dogs, packaged cookies and potato chips, and candy) is especially important if you have psoriatic disease. Not only are these foods often devoid of nutrients, but studies have linked eating too many processed foods with increased production of pro-inflammatory molecules and reduced anti-inflammatory molecules in the body. Not the reaction you want from your afternoon nosh.

Saying bye to gluten? Not so fast. Being gluten-free is trendy these days, so patients with psoriatic disease often ask whether it’s smart for them, Dr. Kaplan says. “Many of my patients say they feel better when they go gluten-free, but there isn’t a lot of scientific data to back that up,” he says. The exception? If you’ve tested positive for markers of gluten sensitivity or been diagnosed with celiac disease. Then, a gluten-free diet can lower GI symptoms like abdominal pain and diarrhea and psoriasis severity, Dr. Woolf explains. (More on celiac in the next slide…)

If you’ve never been tested for markers of gluten sensitivity or celiac disease, it’s worth discussing with your doctor. Research shows people with psoriatic disease are more likely to develop other autoimmune diseases, including celiac disease. If you test positive, a gluten-free diet may improve psoriasis severity, Dr. Woolf says. “But going gluten-free has not been proven helpful for patients with PsA or psoriasis who test negative for gluten sensitivity and celiac,” she says.

Nutrient supps have gained popularity among patients with psoriasis and PsA, Dr. Woolf says, but there’s not enough evidence they can help for her to recommend them. Patients often ask about vitamin D, vitamin B12, selenium, and omega-3 fatty acids in fish oils, in particular. That’s why a large review published in the Journal of the American Academy of Dermatology examined how rigorously each of these has been studied for treating psoriasis. Fish oil showed the highest evidence of benefit, but the ultimate conclusion was that more detailed studies are needed for all. Always talk to your doctor before taking any new supplement.