The management of psoriasis through diet.
Dermatologist. Master in Sciences of Health.
DermatologistsBlog.com? What are the main findings of the study?
Dr. Duarte: This review focuses specially on the importance of a low-calorie diet, with or without weight loss. Besides its adjuvant role in managing psoriasis, it also increases rates of response to treatment with cyclosporine or biological.
As we know, fatty tissue acts as an active endocrine tissue and gives rise to a pro-inflammatory state in overweight patients. Functional foods must be better evaluated in studies. Fish oil and omega-3 supplementation are the most associated with clinical improvement.
DermatologistsBlog.com? Were any of the findings unexpected?
Dr. Duarte: Surprisingly, we observed that the role of diet in other immunomodulated diseases, such as Leishmaniasis, in which a protein-energy deficient diet could favor the spread of intracellular parasites.
DermatologistsBlog.com? What should clinicians and patients take away from this study?
Dr. Duarte: Although healthy lifestyle and a low-calorie diet are recommended for most patients with psoriasis, gluten-free diet should be introduced only in those with symptomatic or asymptomatic (positive antibodies to gliadin, or anti-endomysial and anti-transglutaminase antibodies). it is recommended that patients with moderate to severe psoriasis or palmoplantar pustulosis be subjected to autoantibody screening.
The message for patients includes a rich, varied, alcohol-restricted, and low-calorie diet or low-glycemic index food enriched diet. Antioxidants supplementation could be replaced for the intake of fruits and vegetables. Other suggestions are based in the American Heart Association suggestions for a healthy diet: avoid salt, eat fish twice a week, choose high-fiber foods and minimize intake of partially hydrogenated fat.
DermatologistsBlog.com? What recommendations do you have for future research as a result of your study?
Dr. Duarte: Specific supplementations, like zinc, vitamin D, folic acid, as well as many suggested functional food should be better studied.
Folic acid supplementatinos, specially, as it is associated with side-efects, and may cause overexposure in people living in countries in which the fortification of flour is mandatory, such as the United States, Canada, and the United Kingdom.
The management of psoriasis through diet
Gleison Duarte1 Luan Oliveira Barbosa2 Maria Elisa A Rosa1
1Dermatology Division, Alergodermoclin, Salvador, Bahia, Brazil; 2Escola Bahiana de Medicina e Saúde PúblicaSalvador, Bahia, Brazil
Psoriasis: Targets and Therapy 2012:2 45–53