What Is the Role of Diet and Nutrition with PsA?
While research has not identified a direct link between diet and psoriatic arthritis (PsA), eating a healthy, balanced diet can benefit overall well-being and reduce some of the risks associated with PsA, including heart disease, diabetes, and metabolic syndrome. Diet is a controllable factor in overall health, and people living with chronic diseases like PsA can feel more empowered when managing the controllable aspects of their condition.1,2
Obesity and psoriatic arthritis
People with PsA have a high rate of obesity. Obesity itself increases the risk of developing PsA, and researchers have found that obesity can reduce the effectiveness of certain treatments for PsA, specifically those that target tumor necrosis factor (TNF-alpha).2,3,4
Risks of inflammation
PsA causes an increase in inflammation throughout the body. This abnormal inflammation causes several negative effects in the body. In the joints, it causes stiffness, pain, and swelling. In the blood vessels, it increases the risk of atherosclerosis, the formation of abnormal fatty masses in the arteries, and can ultimately lead to major cardiovascular events.3
Benefits of weight loss
Weight loss not only decreases the risk of developing conditions like heart disease, stroke, and diabetes, it also works with PsA treatment to improve disease symptoms. Research has demonstrated that people who lost weight while taking biologic medication that inhibits TNF-alpha had a greater improvement in symptoms than people taking the medication alone. Researchers believe people with psoriatic disease who are also overweight may experience a double dose of inflammation. Other studies have noted that fat cells secrete many of the same cytokines (chemical messengers) involved in psoriatic disease, such as TNF-alpha.1,5
Heart-healthy diet and lifestyle
The American Heart Association recognizes that healthy eating and a healthy lifestyle are the most important ways to fight heart disease. The Association recommends people begin by understanding their caloric intake. People who want to maintain their weight should be using up at least as many calories as they take in. People who want to lose weight should reduce the amount of calories they consume and increase the amount and intensity of their physical activity.6
There are several recommendations for heart-healthy nutrition, including:
- Eat a variety of fruits and vegetables.
- Eat whole grains, such as whole wheat bread and brown rice, and less refined carbohydrates, such as pasta and white rice.
- Choose low-fat or fat-free (skim) dairy products.
- Choose lean protein sources, such as skinless poultry and fish, and cook them in healthy ways without added fat.
- Limit saturated fat, trans fat, red meat, sweets, and sugar-sweetened beverages.
- Eat less nutrient-poor foods that are high in calories but low in nutrients.
- Alcohol consumption should be limited to no more than one drink per day for women and no more than two drinks per day for men, if consumed at all. Multiple studies have demonstrated that alcohol use increases the risk of psoriatic disease and may influence disease severity.1,6