Interview with Dr AMODE: "Psoriasis and Nutrition."

"A varied and balanced Mediterranean‐style diet and appropriate physical activity contribute to the control of cardiovascular risk factors (comorbidities)," according to Dr AMODE.

A low-fat Mediterranean diet low in animal protein, combined with healthy lifestyle habits and endurance exercise to counteract a sedentary lifestyle (five sessions per week of 30 minutes or three sessions per week of 90 minutes), as well as general self-care, also contributes to management. In inflammatory diseases, it is advisable to limit carbohydrate (sugar) intake, since these are pro-inflammatory. Indeed, a diet rich in essential fatty acids can help reduce systemic inflammation. Balancing one’s diet removes an aggravating factor, but it does not cure psoriasis.

It all depends on where you’re starting from. If your diet is particularly unbalanced, there’s potential for improvement simply by restoring nutritional balance. On the other hand, if you already maintain a healthy lifestyle yet suffer from severe psoriasis, changing your dietary habits won’t yield any noticeable benefits. In this scenario, it’s likely due to elevated inflammation levels and perhaps an immuno-genetic factor involving a prominent Th17 cascade that drives the psoriasis.

"No dietary regimen can treat psoriasis, but as previously mentioned, diet plays a role in controlling cardiovascular risk factors (hypertension, diabetes, overweight) that are associated with psoriatic disease."

Several diets, foods and ingredients have proved promising in their capacity to potentially reduce or prevent inflammation in the body, but further investigations are still needed.

"A poor diet contributes to a certain degree of systemic inflammation that paves the way for inflammatory diseases and cardiovascular diseases. Moreover, alcohol consumption is a well-recognised triggering factor."

The usual recommendation regarding alcohol is fewer than three drinks per day for men and fewer than two drinks per day for women, and to avoid daily consumption.

"A healthy lifestyle, underpinned by a balanced diet, is recommended. There is no documented evidence supporting the benefit of nutritional supplementation," says Dr Amode.

Balanced diet = sufficient fibre intake to limit glycaemic peaks, but also omega-3, ‑6 and ‑9, which contribute to immune homeostasis. Nutritional supplementation has not been proven effective in treating psoriasis. At best, it can enhance cosmetic quality and the skin’s hydrating properties, but it does not cure psoriasis.

Obviously, if the patient has an unbalanced diet, it may be possible to compensate for this deficiency with dietary supplements, always on the advice of a healthcare professional. However, supplementation is not a treatment. Furthermore, dietary supplements are not regulated in the same way as medicinal products. Oversight is considerably less stringent, and it is easier to bring them to market.