Dietary Intervention and Supplements in the Management of Psoriasis: Current Perspectives

Abstract

Nutrition is a complex topic encompassing diet and a variety of supplements including vitamins, fish oil, herbal products, and probiotics. Patients with psoriasis display high interest in understanding the potential impact of nutritional modifications on their psoriasis. In this review, we examine the evidence for nutritional interventions in psoriasis and summarize important concepts. We found that certain diets, such as low-calorie diets for obese patients, gluten-free diets for patients with comorbid celiac disease, and the Mediterranean diet, may have benefits for psoriasis patients. Supplements in general do not show strong evidence of benefit, though more studies are required given the heterogeneity of these trials. Finally, the gut microbiome has drawn considerable interest in recent years, with specific probiotics showing promising results for psoriasis patients and warranting further exploration.

The Role of Diet in Children with Psoriasis: Emerging Evidence and Current Issues

“…A low-calorie diet (LCD) is an alimentary regimen characterized by caloric intake restriction and is recommended for patients with excess body weight [ 1 ].…”

“…Data in adult obese patients with psoriasis suggest a positive association between LCDs, weight reduction, and better control of psoriasis [ 1 ]. In fact, a meta-analysis of six randomized control trials demonstrated that obese patients who received an LCD were significantly more likely to achieve a 75% or greater reduction in PASI score from baseline (PASI75; Relative Risk [RR]: 1.47, 95% CI: 1.27–1.69) and to have a reduction in mean PASI score of −2.59 (95% CI: −4.09, −1.09) [ 46 ].…”

“…Many observational and interventional studies have been conducted in these patients: they showed that a specific alimentary regimen determines a decrease in PASI score on the basis of an accurate patient selection; in particular, LCD has a role in obese patients with psoriasis and GFD in patients with psoriasis and CD or positivity to an antigliadine test. Furthermore, these diets have shown also to decrease cardiovascular risk, which is known to be increased in patients with psoriasis [ 1 , 10 ].…”

“…Psoriasis is an immune-mediated inflammatory systemic disease with skin tropism and a chronic relapsing course [ 1 , 2 ]. It affects about 1–2% of the population in the world and in 22–33% of cases starts in childhood [ 3 ].…”

“…It affects about 1–2% of the population in the world and in 22–33% of cases starts in childhood [ 3 ]. Despite its unknown etiology, psoriasis is characterized by an interaction between multiple genetic and environmental risk factors [ 1 , 2 ].…”