1. Amy Brown1 & Padmini Shankar2
PSORIASIS, DIET AND DIETARY SUPPLEMENTS – A REVIEW
Amy Brown1 & Padmini Shankar2
1Department of Complementary and Alternative Medicine, John A Burns School of Medicine, University of Hawaii, Honolulu, HI 96813
2Department of Health and Kinesiology, Georgia Southern University, Statesboro, GA
ABSTRACT
STRONG SCIENTIFIC EVIDENCE
WEAK SCIENTIFIC EVIDENCE
RISK FACTORS
RISK FACTORS:
Genetic
Immunology
Other factors
Stress
Obesity
Alcoholism
Streptococcal infection
Certain medications
Cigarette smoking
HIV
Type 2 diabetes
Metabolic syndrome
Crohn’s or celiac disease
GLUTEN FREE DIET (if AGA positive):
Increased risk of celiac disease in
psoriasis patients
Test for higher antibody levels of transglu-
taminase and gliadin for IgA
VITAMIN D SUPPLEMENTATION:
Calcitriol is the biologically active form
Inhibits proliferation of keratinocytes
This down regulation and induction of
differentiation are vitamin D3 mediated
mechanisms in treatment of psoriasis
Potential side effects of vitamin D include hyper-
calciuria, hypercalcemia and kidney stones
FASTING/STARVATION DIET:
Fasting may have therapeutic benefits for
alleviating psoriasis symptoms
Obesity seems to be a risk factor for psoriasis
PAGANO DIET (Elimination Type Diet):
ALLOWS: Fish, lean poultry and lamb, fresh
fruits & vegetables, almonds, fiber supple-
ment, low-fat yogurt, gelatin, omega-3 foods
and teas
AVOIDS: Sugar, soda, grains and flour, high-fat
and fried foods, red meats, and shellfish
EVENING PRIMROSE:
Efamol Marine is capsule containing evening
primrose and marine fish oil
Treatment produced no significant reduction of
psoriasis symptoms
TAURINE RESTRICTION:
Taurine is naturally occurring sulfonic acid
derived from cysteine
ZINC SULFATE SUPPLEMENT:
Mixed results from 5 studies
BACKGROUND:
Psoriasis is the most prevalent autoimmune disease in the United States afflicting approximately 2% of Americans. An overgrowth of skin cells results appearing as thickened, red, scaly, silvery patches. No specific dietary recommendations from the American Dietetic Association exist.
PURPOSE:
The purpose of this narrative review was to search for studies testing the effectiveness of any diets or dietary supplements in reducing psoriasis symptoms.
METHODS:
A literature search on Medline (1950 to January 2011) was conducted using the key words “psoriasis and diet,” “psoriasis and supplement,” “psoriasis and herb,” cross-referencing, and general searching. A summary table was used to categorize treatments as either “strong scientific evidence,” “some scientific evidence”, or
“weak or no scientific evidence.”
SOME SCIENTIFIC EVIDENCE
RICE DIET:
AKA Kemper diet, consists of large amounts of
carbohydrates in the form of rice, with little
protein, sodium and fat
LOW-PROTEIN DIET
Protein is necessary for the proliferation and
exfoliation growth of cells in psoriatic plaques
Limiting protein will limit cell growth
VEGETARIAN DIETS
Increased ingestion of vegetables related
to decreased psoriatic symptoms
Increased dietary fiber decreases transit
time, which prevents harmful substances from
being absorbed into the bloodstream
LOW-FAT DIET
High dietary fat may exacerbate psoriasis
FISH OIL SUPPLEMENTATION:
Arachidonic acid levels high in psoriatic patients
Leukotriene B4, a metabolite of AA, may be a
mediator of inflammation
Fish oil decreases L B4 synthesis by neutrophils
CONCLUSIONS
Certain elimination diets and dietary
supplements may reduce psoriasis symptoms
Translating the research into clinical practice
suggests that a customized elimination diet
tailored for people with psoriasis would be:
Low-protein
Low-fat
Gluten-free (if AGA positive)
Vegetarian
Supplements: vitamin D and fish oil
Clinical research needed
to confirm above