Psoriasis is an autoimmune disease, NOT contagious and basically chronic, characterized by abnormal patches on the skin.
The skin lesions of psoriasis can vary in gravity, from small and localized, to completely cover the body. Diagnosis is based on the analysis of signs and symptoms.
Psoriasis can be divided into five types:
- plaque psoriasis or vulgar psoriasis (90% of cases);
- guttate psoriasis (numerous drops-shaped spots);
- reverse psoriasis (affects the skin folds);
- pustular psoriasis (presence of pus in lesions);
- erythrodermic psoriasis (when the rash becomes very widespread).
It is hypothesized that psoriasis may have a genetic etiology that is activated by environmental factors.
The symptoms worsen in the cold season and with the use of some drugs, such as, for example, beta-blockers and NSAIDs. Infections and psychological stress also play a negative role.
Other theories on the origin of psoriasis focus on pre-existing dermatological infections, comorbidities of various kinds and autoimmune factors involved in nutrition.
There is currently no cure, however, available treatments can help control symptoms. These may include:
- steroid creams and vitamin D3 ointments or similar (sufficient in 75% of cases)
- cortisone and / or suppressors of the immune system.
The disease affects 2-4% of the population, with equal frequency between men and women, and is associated with an increased risk of psoriatic arthritis, lymphomas, cardiovascular diseases, Crohn's disease and depression.
Psoriatic arthritis affects up to 30% of people with psoriasis.
What does the Diet have to do with it?
In addition to the above, many other factors can influence psoriatic discomfort. Among these, some dietary variables are also observed, such as:
- Excessive alcohol consumption
- Shortage in omega 3 fatty acids (eicosapentaenoic acid or EPA and / nutrition / haha htmldocosahexaenoic or DHA) and antioxidants
- Gluten consumption, but ONLY in the presence of celiac disease; not surprisingly, in patients with anti-gliadin antibodies, the severity of psoriatic disease tends to decrease after just 3 months of a gluten-free diet.
NB . Gluten is an exclusive protein of some cereals such as: wheat, spelled, spelled, rye, barley, oats and sorghum.
Psoriasis and Obesity
Among the fundamental dietary principles for psoriasis control, the first is undoubtedly weight control in case of excessive BMI.
A 2014 study published in the "Journal of the American Academy of Dermatology" revealed a correlation between obesity and the increased risk of psoriatic disease.
Researchers have found that an increase in body mass index (BMI) is associated with an increased risk of developing psoriasis and psoriatic arthritis, as well as an increase in the severity of symptoms.
Obesity can provide the necessary boost to trigger psoriasis in people who are already predisposed; this is because fat cells secrete cytokines, or proteins that can trigger inflammation.
Furthermore, obesity can decrease the therapeutic effect of some drugs.
Another study conducted in the same year and published in the "British Journal of Dermatology" identified an association between weight loss and psoriasis severity reduction. This in-depth analysis analyzed the outcome of a "dietary intervention" associated with exercise, over the course of 20 weeks. A clear correlation emerged between weight loss and psoriasis improvement. Furthermore, patients who lost more weight showed a further improvement in the disease; it is however necessary to specify that even a modest weight loss can have a great impact on the improvement of the disease.
The long-term effects are yet to be discovered; however, the importance of weight loss in obese individuals - as part of the overall treatment for psoriasis and its comorbidities - is decidedly incontrovertible.
How to lose weight
First of all, significant and urgent weight loss in psoriasis is essential only with a body mass index of 30 or above (calculate your body mass index). If it is between 25 and 29.9, although desirable, it can be obtained in longer times.
To reduce the excess weight it is possible to use two different systems:
- Reduce daily energy as a percentage; a 30% reduction is aimed at a weight loss of about 3 kilograms per month.
- Eliminate as many calories as the weight to lose, taking into account that each kilogram includes about 7, 000 calories. Ultimately, to lose 3 kilograms a month it is enough to eliminate about 750 calories a day.
Generally speaking, an obese or overweight person with psoriasis could follow the guidelines below:
- Prefer the consumption of fresh vegetables and fruits
- Prefer whole grains and legumes rather than white flour-based foods
- Avoid foods high in saturated and hydrogenated fats, rich in trans-conformed chains (packaged foods, sweet and savory snacks, fast food, etc.)
- Prefer lean meats, fish and oil seeds, low in saturated fats and rich in unsaturated and / or essential fatty acids
- Avoid refined sugars and processed foods in general.
In principle, all the rules and recommendations for a low-calorie slimming diet apply.
Diet and Heart Health
Psoriasis is an inflammatory disease and exploits, at least in part, the etiological mechanism of atherosclerosis. Consequently, reducing psoriasis is also possible by reducing systemic inflammation (including through weight loss) and improving cardiovascular health. Here are some tips:
- Eat fish at least twice a week, preferably wild and cold water (such as tuna, mackerel, herring and trout); these contain omega 3 essential fatty acids (EPA and DHA), which can help reduce inflammation and disease risk / severity;
- Use dairy products that are low in fat and cholesterol;
- Minimize foods containing hydrogenated vegetable oils (rich in trans chains);
- Maintain blood glucose at optimal levels, consuming carbohydrate-rich foods in moderate portions, preferably with peel or wholegrain and associated with protein foods and mildly lipidic (complete meal, characterized by at least 3 small courses);
- Take less than 1, 500 milligrams of sodium per day (read food labels);
- Limit alcohol, especially in the case of severe psoriasis!
- Promote the supply of antioxidant and anti-inflammatory molecules (see below).
We have repeatedly said that psoriasis is an inflammatory disease. Many individuals affected by this disorder claim to find significant improvements by increasing anti-inflammatory molecules with diet.
The answer may vary based on individual circumstances, compliance and genetics. However, most people respond positively to dietary and lifestyle changes aimed at controlling chronic inflammation.
In the case of psoriasis, the foods to avoid absolutely (because they have been shown to cause or increase inflammation) are:
- Red and fat meats, especially from unsavory breedings
- Refined, processed, processed foods etc.
- Simple added sugars.
Some also suggest eliminating: milk, dairy products and fruit and vegetables that belong to the Solanaceae family (potatoes, tomatoes, peppers, aubergines, etc.); on the other hand, their inflammatory potential is only theoretical and has not found any kind of scientific value.
In contrast, the foods to be included (because they have been shown to reduce inflammation) are:
- Cold water fish (as anticipated, thanks to their richness in EPA and DHA)
- Oil seeds or oleaginous fruits, such as: flax seeds, olive oil and olives, walnuts and walnut oil, etc. These are vegetable sources of linoleic acid (omega 6 fatty acids), alpha-linolenic acid (a type of biologically less active omega 3 than EPA and DHA, but still healthy) and vitamin E
- Fresh fruits and vegetables in bright colors (rich in carotenoids, vitamin E, vitamin C and phenolic substances - all antioxidants); obviously, this partially enters into conflict with the recommendation to exclude the Solanaceae, but there are many other vegetables with overlapping nutritional characteristics: carrots, pumpkin, sweet potatoes, spinach, cabbage, broccoli, blueberries, mangoes, strawberries etc.
Psoriasis and Gluten
The presence of gluten in the celiac diet can worsen a coexisting psoriatic state.
Many studies have evaluated the benefits of a gluten-free diet in case of psoriasis, with or without celiac disease, but not all of them have given overlapping results. The link between psoriasis and gluten (sometimes hidden in processed foods) is not yet clear, but rather recent research estimates that up to 25% of people suffering from psoriasis may be sensitive to gluten.
Celiac disease is caused by a real food intolerance to gluten, which stimulates the immune system against the intestinal epithelium. A gluten-free diet is the only known treatment for this intolerance.
A fair number of studies suggest that psoriasis and celiac disease share some genetic and inflammatory pathways; furthermore, it shows that the presence of psoriasis doubles the chances of suffering from celiac disease.
However, despite the anecdotal statements of some patients, there is no concrete evidence that a gluten-free diet can improve psoriasis in people without intollernza.
In the doubt of celiac disease, which sometimes manifests itself with atypical symptoms, diagnostic investigations are needed such as: blood tests, intestinal biopsy, etc. A dietitian can help produce a gluten-free diet that, in general, gives the first results about 90 days from the beginning.
Studies have not shown a direct link between the intake of vitamins and other food supplements and the improvement of psoriasis. Yet many people with the disease report a marked improvement in skin lesions.
Among the most common products in the case of psoriasis, those based on omega 3 fatty acids stand out, as they seem to have a positive impact on systemic inflammation and immunity functioning.
There are three types of these:
- Alpha-linolenic acid
- Eicosapentaenoic acid (EPA)
- Docosahexaenoic acid (DHA)
Alpha-linolenic acid is found in some oil seeds and related vegetable oils.
EPA and DHA are present in fatty fish from cold seas and algae. Fish oil is very rich and is also available in capsule form.
Some individuals with psoriasis suffer from a lack of essential acids; there is also the doubt that the excess of omega 6 (linoleic acid), both proportional and absolute, can increase the inflammatory state; for more information read the article: The right ratio between omega 6 and omega 3.
In that case, research on omega 3 fatty acid supplements has shown that they can help reduce the severity of psoriasis. However, further studies are required to be carried out even on subjects with a normal nutritional intake. The use of high quality standard products is also recommended, as contamination with heavy metals and other unwanted substances is quite common.
Vitamin D is another molecule subject to experimentation in the treatment of psoriasis, since it is believed to have a modulatory effect on the cellular proliferation of the epidermis (excessive in psoriasis). It is a very concentrated active ingredient in some topically applied drugs.
Overall research on the effect of vitamin D in psoriasis is quite limited and limited. A May 2011 report published in "Science Translational Medicine Journal" reported that vitamin D helps counteract the response to psoriasis inflammation. On the other hand, too much vitamin D can be dangerous.
Some argue that an excess could cause serious side effects such as, for example, the disproportionate increase in blood calcium (associated with kidney stones and joint crystal formation).
The main dietary sources of vitamin D are: cod liver oil, salmon, mackerel, tuna, fortified skimmed milk, other dietary foods and eggs (yolk).
It should also be specified that most of the vitamin D is of endogenous synthesis (cutaneous); this occurs on exposure to sunlight, especially in hot seasons. However, it is not necessary that the exposure is prolonged and, under optimal conditions, 10 'are sufficient. To check the concentrations in the body it is essential to perform blood tests.
Glucosamine and Chondroitin
Glucosamine and chondroitin are other dietary supplements that can be taken individually or in pairs. These are specific cartilage molecules; Glucosamine has a mildly anti-inflammatory and stimulating effect on cartilage repair. Chondroitin, on the other hand, is able to promote cartilage elasticity and inhibit its rupture.
Research shows that these two supplements can slow pathological progression and reduce the pain of osteoarthritis but, in the case of psoriatic arthritis, they are totally vain.
MSM, Selenium and Vit. B12
Methylsulfonylmethane (MSM) is a compound containing organic sulfur found in fruits and vegetables. However, it is totally destroyed when food is physically and chemically processed; also for this reason, there are specific supplements of MSM.
Sulfur is necessary for the body to keep connective structures healthy and intact. On the other hand, there is not enough scientific evidence to show that it can exert an analgesic or anti-inflammatory effect.
Some choose to supplement the quota of selenium and vitamin B12, but research shows that they are totally useless.
To conclude, scientific experimentation on the usefulness of certain supplements in the treatment of psoriasis is still rather inconclusive. Before starting any supplementation program it is necessary to consult your doctor in order to avoid a possible chemical interaction with other drugs or complications of various kinds.