Changing your diet is rarely considered a primary treatment modality for most diseases, except diabetes, certain digestive disorders (such as celiac disease), and other specific health conditions. There is insufficient clinical research to suggest that dietary changes will cure psoriatic arthritis (PsA). But many people with psoriatic arthritis report that changes in diet improved their symptoms. Some research data supports these claims that eating and avoiding certain foods helps alleviate some PsA symptoms. So, what are the symptoms of psoriatic arthritis, and what type of eating plan is said to help improve this chronic (long-term) condition?
What Is Psoriatic Arthritis?
Psoriatic arthritis is a long-term (chronic) inflammatory disorder that attacks the skin and joints. The first symptoms of psoriatic arthritis (PsA) typically appear between ages 30 and 50, though it can occur at any age. Other facts about psoriatic arthritis include:
- Approximately 1 in 3 people with psoriasis develop psoriatic arthritis.
- Approximately 85% of those with PsA develop skin symptoms such as red, flaky patches (known as plaques) before they develop joint symptoms
- Although psoriatic arthritis is nearly 50% less likely to occur in Blacks than Caucasians, the condition has a worse psychological impact on Blacks than in Caucasians (according to a study in Clinical Rheumatology).
- Black people with psoriatic arthritis are less likely to use medication to relieve skin symptoms than Caucasian people. Still, in studies, only one in four people achieved significant relief of symptoms (including those who took medication).
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Diets For Psoriatic Arthritis Symptom Relief
Three eating plans, including a low-calorie, anti-inflammatory, and gluten-free diet, have been shown to improve symptoms of psoriatic arthritis. There are several possible explanations for why these diets work for some people with PsA. For example, certain foods may worsen inflammation associated with psoriatic arthritis. Furthermore, taking charge of your diet and other aspects of your health (such as exercising regularly) is known to reduce inflammation associated with PsA, improve the immune system, and lower stress that often exacerbates (worsens) the symptoms of the disease.
Low-Calorie Diet
Besides contributing to the development of psoriatic arthritis, obesity may increase flare-ups or make them worse. The body releases inflammatory substances, such as cytokines, from fat tissue, which increases inflammation associated with psoriatic arthritis. A 2015 study published by the British Journal of Dermatology concluded that eating low-calorie meals and exercising three times per week reduced the severity of psoriatic symptoms in 48% of those in the study. Here are some tips for reducing calories in your daily diet:
- Remove skin and trim fat from meat and poultry
- Bake or broil foods instead of frying or deep frying
- Using fresh herbs can help replace some of the flavor lost by reducing grease and fat
- Exchange complex carbohydrates (sugars) found in white sugar, white flour, white pasta with whole grains, and other complex carbohydrates (such as whole wheat, brown rice, quinoa, and barley)
- Avoid sugary drinks and processed foods loaded with sugar and salt
- Use a healthy, low-calorie natural sweetener (such as stevia)
- Avoid chemically made sweeteners such as NutraSweet, aspartame, and other brands
- Eliminate saturated fats and trans fats (often found in processed and fast foods)
- Substitute saturated fats for healthy fats such as those from wild-caught salmon and avocados
- Fill your plate with 50% fresh fruits and vegetables and a quarter of the plate for a lean protein (such as baked chicken), and the remaining quarter for whole grains.
- Use a small amount of healthy oil that doesn’t break down when frying (such as avocado oil)
- Use homemade salad dressings (such as those made with virgin olive oil) in place of store-bought versions
- Avoid foods loaded with mayonnaise and other types of hidden fats (read labels)
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Anti-Inflammatory Diet
Certain foods can cause inflammation, so avoiding them can help you manage psoriasis and psoriatic arthritis. The anti-inflammatory diet includes foods rich in antioxidants (such as berries and other bright-colored fruits and vegetables) and high in omega-3 fatty acids. Foods to avoid on the anti-inflammatory diet include processed sugary, high saturated fat (such as red meat), and foods high in omega 6 fatty acids (found in many cooking oils and processed foods).
Foods to Eat on the Anti-Inflammatory Diet
- Wild-caught fish with omega-3 fatty acids (such as salmon, mackerel, herring, lake trout, sardines, and albacore tuna)
- Low saturated fat protein sources (such as chicken with the skin removed or lean turkey)
- Bright colored fruits and vegetables with antioxidants to help lower inflammation
- Bright green leafy vegetables (such as kale and spinach)
- Foods that are high in antioxidants (such as fresh berries and cherries)
- Whole grains (including ancient grains such as farro, millet, and quinoa, as well as cheaper varieties that have nutritional value like oats, brown rice, and whole wheat)
- Beans and legumes (such as garbanzo beans, lentils, navy beans, cannellini beans, and other beans (low in fat, high in fiber and B vitamins, serve as a suitable replacement for reducing fatty meat such as beef)
- Nuts (walnuts, pecans, pepitas, Brazil nuts, and more)
Food to Avoid on an Anti-Inflammatory Diet
- Dairy (milk, ice cream cheese, butter, and whole milk yogurt)
- High-fructose corn syrup
- Margarine
- Red meat
- Processed carbohydrates (such as refined sugar and flour)
- Trans fat
- Vegetable oil (such as sunflower and safflower oil)
- Foods high in the glycemic index (such as processed, low fiber, sugary and fatty foods like cakes, doughnuts, and pies)
The Mediterranean Diet is an excellent anti-inflammatory diet that includes most of the same foods listed here.
According to Harvard Health, “The Mediterranean diet is ranked high among doctors and dietitians, and for good reason.
Studies show it protects against diseases linked to inflammation.” According to JAMA Dermatology, eating the Mediterranean diet for two years may reduce the severity of psoriasis symptoms by 29%.
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Gluten-Free Diet
People with psoriatic arthritis are likely to have more than one autoimmune disease (called polyautoimmunity). Celiac disease is a condition people with PsA often get. It is an autoimmune disorder characterized by the body’s adverse reaction to foods with gluten. A 2015 study published in the Journal of the American Academy of Dermatology found that those with PsA were twice as likely to have celiac disease compared to the general population.
Foods with gluten that can cause symptoms of gluten intolerance, nausea, vomiting, bloating and gas, as well as weight loss include:
- Wheat
- Rye
- Barley
- Seitan (a meat substitute)
- Wheat varieties and derivatives (such as spelt, durum, couscous, semolina, farina, farro, wheat berries, bulgur, wheat bran, wheat starch, wheat germ, and graham flour)
If you are sensitive to foods with gluten, consult with your health care provider. You may need to get a test for celiac disease. It’s never a good idea to go on a gluten-free diet (or any other type of diet) unless you consult with your health care provider. The gluten-free diet is difficult to stick to; it has risks such as high incidence of weight gain, nutritional deficiencies (wheat products are enriched with added nutrients, such as B Vitamins), and a higher risk of cardiovascular disease.