Can diet improve PSORIASIS?

What is psoriasis?

• Psoriasis is a chronic inflammatory skin disorder affecting 2-4% of the population. Psoriasis is not contagious.
• Psoriasis occurs when skin cells are replaced more quickly than usual. We don’t know exactly why this happens but it is likely to be caused by dysfunction of the immune system.
• Psoriasis is characterised by the development of raised inflamed red patches that can be painful and itchy. These patches are sometimes covered in silvery white scales and are most often found on the scalp, elbows, knees, buttocks, hands and feet, although sometimes they also appear on the nails and genitals. Patches may appear all over the body or develop in only one or two areas.
• Psoriasis can develop at any age and it runs in families although not everyone who has a family member with psoriasis will get psoriasis as the condition needs a trigger such a stressful event, a skin lesion, hormonal changes (puberty or menopause), a throat infection and smoking or drinking excessively.

Treatment

Your doctor can prescribe topical or oral medication to improve your symptoms.
Diet and lifestyle can play an important role in the development and management of the condition so here are some ideas:

Dietary Recommendations

• Eat plenty of fresh fruit and vegetables which are high in anti-oxidant and anti-inflammatory vitamin C. Fruit and vegetables also contain good levels of fibre that can bind to toxins in the bowel to facilitate their excretion and avoid increasing the burden on the immune system.
• Eat dark coloured fruit vegetables  (pumpkin, sweet potatoes, carrots, broccoli, spinach, peaches, mango, apricots) which are rich in beta-carotene, a precursor to Vitamin A, a nutrient essential for healthy skin which also helps control the rate of skin proliferation and is often deficient in those with psoriasis.
• Avoid red meat, dairy and animal fats as saturated fats are pro-inflammatory and could contribute to the inflammatory cascade involved in psoriasis.
• Have oily fish such as salmon, sardines, mackerel and anchovies twice a week  as they contain omega-3 fatty acids which can help modulate inflammation.
• Flaxseeds and chia-seeds are also high in omega-3 precursors and have anti-inflammatory properties. Try to add them to cereal, bread, yogurt in the morning and soups and salads in lunch/dinner. Ensure flax seeds are ground as the husk is too tough for our gut to digest.
• Include extra-virgin olive oil and olives in salads and cooking (chicken legs cooked in a tomato and olive sauce is packed with good protein and antioxidants) as they contain vitamin E and polyphenols that research shows reduce inflammation [1]
• Eat avocado spread on wholemeal bread and in salads, as it is high in anti-inflammatory and anti-oxidant vitamin E.
• In some cases, psoriasis symptoms improve when the patient follows a gluten free diet [2]. Please note that before eliminating gluten from your diet, you must discuss it with your doctor or nutritional therapist.
• Consume foods rich in zinc such as shellfish, pumpkin, sesame and sunflower seeds and nuts such as cashews, pinenuts, pecans  which is vital for healthy skin and wound healing.
• Avoid/reduce refined carbohydrates (white pasta, bread and rice) and sugars (cakes, biscuits, muffins, ice-cream, etc.) as they release inflammatory cytokines.
• Consume adequate, good quality protein (eggs, fish, chicken, beans, avocado) as skin renewal can deplete your protein stores. Ensure you eat 3 portions the size of your palm everyday.
• Water: combines with fibre in the digestive tract and binds with toxins removing them from the body.  Aim for 1.5 litres of water a day.
• Add ginger (in curries, stir-fries and teas) and turmeric (add to curries, stews, rice dishes) to your diet as they are known to have anti-inflammatory properties.

Lifestyle recommendations

• Reduce alcohol as research points at alcohol use as a potential trigger and also as a contributor to the worsening of psoriasis symptoms. Alcohol abuse can increase the risk of liver disease, which is common in psoriatic patients [3].
• Alcohol also depletes the body’s zinc reserves which is vital for healthy skin and wound healing.
• Stop smoking as it damages the skin by increasing formation of reactive oxygen species. Nicotine stimulates the immune response related to psoriasis. [4]
• Reduce Stress: Yoga and meditation help relax both mind and body and reduce the effects of stress a known trigger for psoriasis.
• Exercise releases endorphins and helps reduce stress.  Additionally, some studies have found that vigorous exercise can be preventative in individuals with genetic risk of psoriasis. [5]
• Sun exposure increases vitamin D production. Vitamin D can help control the proliferation of skin cells in psoriasis. [6]Limit your exposure to 5min/day with out sunscreen as burningis likely to worsen your symptoms.
• Research shows that magnesium in seawater may reduce psoriasis symptoms, so go for a swim in the sea! Magnesium has a relaxing effect on our bodies reducing stress which is one of the known triggers of psoriasis.

REFERENCES:[1] Current Medicinal Chemistry. 2013; 20 (37):4758-76.An up-date of olive oil phenols in inflammation and cancer: molecular mechanisms and clinical implications.Cárdeno A1, Sánchez-Hidalgo M, Alarcón-de-la-Lastra C.[2] World Journal of Gastroenterology. 2007 Apr 14;13(14):2138-9.Celiac disease and skin: Psoriasis associationL Abenavoli, L Leggio, G Gasbarrini, and G Addolorato[3] International  Journal of Dermatology. 2011 Nov;50(11):1323-31Alcohol, psoriasis, liver disease, and anti-psoriasis drugs.Cassano N1, Vestita M, Apruzzi D, Vena GA.[4] British Journal of Dermatology. 2011 Dec;165(6):1162-8.Smoking and pathogenesis of psoriasis: a review of oxidative, inflammatory and genetic mechanisms.Armstrong AW1, Armstrong EJ, Fuller EN, Sockolov ME, Voyles SV.[5] Archives of Dermatology 2012 Aug;148(8):918-24The Association Between Physical Activity and the Risk of Incident PsoriasisMs Hillary C. Frankel, AB, Dr Jiali Han, PhD, Dr Tricia Li, MD, MS, and Dr Abrar A. Qureshi, MD, MPH[6] International Journal of Dermatology. 2011 Feb;164(2):344-55Sun exposure induces rapid immunological changes in skin and peripheral blood in patients with psoriasis.Søyland E1, Heier I, Rodríguez-Gallego C, Mollnes TE, Johansen FE, Holven KB, Halvorsen B, Aukrust P, Jahnsen FL, de la Rosa Carrillo D, Krogstad AL, Nenseter MS.