Psoriasis diet: What to avoid and what to eat?

Key Points:

• Psoriasis is a chronic autoimmune disorder affecting millions
• While medication is available, diet plays a role in managing flare-ups
• A personalized anti-inflammatory diet can help
• A Registered Dietitian can help you track potential triggers and balance your diet.

Millions of Americans suffer from psoriasis, a chronic autoimmune disorder. If you are one of them, you may be looking for help. 

Research shows that apart from medication, a well-balanced diet can help manage your psoriasis symptoms.

However, there is a lot of information about diets for psoriasis, and it can get overwhelming. So, let's sort through the clutter and look at what to avoid and what to eat for psoriasis.

How does diet affect psoriasis?

Suzanna Thoe, RD, a Registered Dietitian, explains, "While psoriasis is not caused by food and there is no cure, dietary changes can help you manage your symptoms. The key is to lower inflammation throughout the body. Also, while diet can be a trigger, your lifestyle, stress level, and more also play a role."

Psoriasis is an autoimmune disease where the skin overproduces cells that become thick, scaly plaques on the body. These dry plaques can be itchy, and their appearance can cause distress and discomfort.

We do not know the exact cause of psoriasis, but like in other autoimmune disorders, the immune system attacks its own cells, causing inflammation.

What foods cause inflammation?

Certain foods are known to be more inflammatory than others.

Highly processed foods

Basically, anything in a box or a sealed bag that is sold in a store and cannot be easily made at home, white bread, highly-refined white rice, and other simple carbohydrates.

Added sugars 

Processed foods and soda are often rich in sugar, a big contributor to chronic inflammation. 

Added sugars refer to any sugars or sweetener syrups added to food during processing, and concentrated fruit or vegetable juices. Foods rich in added sugars lead to an insulin spike, which releases inflammatory cells called cytokines, causing inflammation in the body.

Deep-fried or highly fatty foods

Eating saturated and trans fats in excess can lead to chronic inflammation. These include partially hydrogenated oils commonly found in processed foods like fried and baked goods, margarine, and snacks like chips or microwave popcorn. 

Saturated fats include fatty meat, full-fat dairy products like butter and cheese, and oils like coconut oil. 

Eating too much of these foods can aggravate psoriasis symptoms, and contribute to cardiovascular disease, diabetes, and obesity. Fatty foods may also promote the growth of unhealthy bacteria in our gut, which can aggravate inflammation.

Salty foods

Dietary guidelines recommend less than 2,300 mg of sodium a day, which is about a teaspoon of salt a day. But most Americans consume more than 3,400 mg a day! 

According to the CDC (Centers for Disease Control and Prevention), 90% of Americans consume too much salt. 70% of this sodium is from processed and restaurant foods. High-salt foods include deli meat, pre-packaged meat, and commercially baked bread.

Alcohol

Although not technically considered food, alcohol can contribute to psoriatic flare-ups in different ways. 

Alcohol increases our susceptibility to infections, stimulates the growth of keratin cells (a build-up of these cells is found in psoriasis), and increases the production of inflammatory cells called cytokines.

Red meat

Red meat, especially beef, has an inflammatory omega-6 fatty acid called arachidonic acid. Studies show that an excess of this acid can contribute to inflammatory diseases like psoriasis.

Gluten (if you are sensitive to it)

There is no evidence that gluten triggers or causes psoriasis. However, a gluten-free diet can help if you have a gluten intolerance or Celiac disease. In fact, some studies show that people with psoriasis are more than twice as likely to have Celiac disease (versus people without psoriasis). 

However, if you do not have gluten sensitivity, a gluten-free diet will not impact your psoriasis symptoms.

Dairy

This is a little controversial. There are some who tell you to quit dairy because it causes inflammation. This could be because milk fat contains arachidonic acid. However, a review of over 50 studies shows no proof that dairy causes inflammation. 

In fact, the review showed that dairy had an anti-inflammatory effect on people with metabolic disorders. 

However, dairy was responsible for inflammation in people who were allergic to cow's milk. So, it all boils down to whether you have a dairy or lactose intolerance or not.

Nightshade vegetables

Nightshades are tomatoes, peppers (except black pepper), potatoes (not sweet potatoes), and eggplant. They are rich in nutrients, fiber, and anti-oxidant and anti-inflammatory properties. 

According to Suzanna Thoe, RD, "While some people believe that they should be avoided, there is no evidence that nightshades cause or trigger psoriasis or other autoimmune disorders. These veggies do have small amounts of solanine, a chemical that is toxic in large doses. So, unless you have a strong sensitivity to solanine, feel free to include nightshades in your diet."

What foods should you eat if you have psoriasis?

On a high level, a diet rich in fruits, vegetables, and healthy fats like omega-3 fatty acids may have anti-inflammatory properties.

So, try and include more of the following in your diet:

• Fish, lean meat, or plant-based proteins
• Whole vegetables and fruit
• Whole grains
• Nuts
• Seeds (you could ground up a mix of seeds and add them to your breakfast)
• Lentils
• Dairy in moderation - try and choose low-fat varieties.

However, remember that psoriasis flares may depend on how different foods affect you. 

Keep a journal of what you eat and your symptoms. You could even take pictures to track progress. These details can help you figure out your personal psoriasis triggers. 

If you would like to consult with a Registered Dietitian, Fay can help you find one near you, covered by your insurance.

FAQ

What triggers psoriasis (apart from food)?

Apart from nutritional factors, psoriasis can be triggered by:

• Stress
• Tobacco use
• Alcohol
• Skin injuries like cuts or bruises
• Certain infections, like strep throat

Additionally, obesity is linked to psoriasis, and studies show that psoriasis symptoms get better when participants lose weight.

Is caffeine good or bad for psoriasis?

Before you give up your beloved cup of joe, know that there are mixed reviews about coffee and inflammation.

Several studies show that caffeine has anti-inflammatory properties and can lower psoriasis severity, while a study shows that people who drank more than 200 mL of coffee a day had a higher severity of psoriasis.

What should you do? Suzanna Thoe RD suggests that if you love your coffee, try having it without milk and added sugar and note your symptoms. You could also limit your coffee intake to two small cups a day, instead of sipping on caffeine all day.

If you would like to talk to someone about whether caffeine works for you, consider reaching out to a Registered Dietitian.

What is the AIP diet or autoimmune protocol diet? Is it good for psoriasis?

The autoimmune protocol diet (AIP) is a nutrition plan designed to help people battling autoimmune disorders. The diet focuses on foods rich in nutrition like whole vegetables, fruits, lean meats, fish, healthy fats, and fermented foods.

The diet also eliminates food that may cause inflammation. These include grains, legumes, dairy, highly processed foods, and certain oils. Since it cuts out several nutrient sources, it is often used as an elimination diet for a short while, to identify food triggers.

Being highly restrictive, the AIP diet must be followed under the guidance of a healthcare professional or a Registered Dietitian.

Does the Mediterranean diet help with psoriasis?

The Mediterranean diet is rich in whole vegetables, fruit, plant-based foods, whole grains, beans, lentils, fish, and extra virgin olive oil. The diet includes moderate poultry, eggs, and dairy as well.

Compared to the Standard American Diet (SAD), it is low in sugars, fats, and processed foods. It also offers a higher fiber content and is low in high-fat dairy.

So, this type of diet is considered anti-inflammatory, rich in omega-3 fatty acids, and could be helpful for people with psoriasis and other autoimmune conditions. However, more research is needed to know for sure.

Note: You may be sensitive to certain foods, which may trigger psoriasis flare-ups. Consider consulting with a Registered Dietitian to learn more.

Does the keto diet work for psoriasis?

The keto or ketogenic diet is low in carbohydrates and high in fats. On one hand, the keto diet can help you lose weight and lower insulin resistance. Since obesity is linked to psoriasis, you may find an improvement in psoriasis flares.

However, even in studies, the keto diet is used as a preliminary approach, followed by a balanced Mediterranean diet. This is because the keto diet is difficult to sustain in the long term. According to the National Eating Disorder Association (NEDA), 95% of all dieters regain the weight lost during their diet within a year.

Keto also severely restricts many vegetables, fruits, and whole grains, which contain high nutritional value and anti-inflammatory properties.

Additionally, since the keto diet is highly restrictive, it may trigger an eating disorder or disordered eating in people who are vulnerable.

So, let's just say, it depends. Keto has its benefits but does not work for everyone, and it is hard to sustain in the long term. To find what's right for you, consider reaching out to a Registered Dietitian.

Can supplements help with psoriasis?

Although people with psoriasis do take supplements, there is no evidence that they help treat the condition. More research is needed on this front, and it's best to consult with a healthcare professional or Registered Dietitian before starting a new supplement regimen.

Final thoughts

• Your diet does not cause psoriasis, nor does it cure it. However, dietary and lifestyle changes can help you manage psoriasis flares. 
• Avoiding highly processed food, added sugars, red meat, saturated and trans fats, and other inflammatory fare, can help minimize systemic inflammation in the body.
• A healthy diet rich in whole vegetables and fresh fruit, whole grains, omega-3 fatty acids, lean meat, fish, nuts, seeds, and olive oil can help lower inflammation.

You may find that certain foods trigger your psoriasis, while others don't. If you would like to start on a new diet for psoriasis, Fay can help you find a Registered Dietitian near you, covered by insurance.