Nutritionally Balanced Diet for Psoriasis

Overseen By Abhijit J Chaudhari, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of California, Davis

Must not be taking: Anti-diabetics, Systemic psoriasis meds

Disqualifiers: Vegan, Claustrophobia, Uncontrolled diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

5 Participants Needed

Trial Summary

What is the purpose of this trial?

Psoriasis is a chronic inflammatory disease that affects the skin and joints in 2-3 % of people in the United States. This inflammation of the skin, joints, and blood vessels in patients with psoriasis has been measured by older PET Scan technology but with limitations. With the new EXPLORER PET scanner technology, the investigators are testing to see if the EXPLORER is better than previous PET scanners and improve our ability to assess inflammation in patients. Also, it is known that the typical Western Diet - high in saturated fats, added sugars, and low in fiber - contributes to obesity and inflammation worldwide. There is evidence in animals that these signs of inflammation are reversible within 4 weeks when changed to a more balanced diet. Thus, this study aims to assess whether there are detectable decreases in inflammation of the skin and body of psoriasis patients who usually eat a Western Diet on an EXPLORER PET scan following 6 weeks of a more balanced diet.

Will I have to stop taking my current medications?

If you are taking systemic medications for psoriasis or psoriatic arthritis, you must stop them for at least 3 months before the trial and during the trial. Other medications are not specifically mentioned, so it's best to discuss with the trial team.

What data supports the effectiveness of the treatment Nutritionally Balanced Diet for Psoriasis?

Research suggests that a healthy lifestyle, including a balanced diet, can improve psoriasis symptoms. A Mediterranean diet, which is rich in fiber, vitamins, and anti-inflammatory components, may help control psoriasis by positively affecting gut health and reducing inflammation. ^{1 2 3 4 5}

Is a nutritionally balanced diet safe for humans?

The studies reviewed do not specifically address the safety of a nutritionally balanced diet, but they do not report any safety concerns related to diet in the context of psoriasis or other conditions. ^{6 7 8 9 10}

How is the Nutritionally Balanced Diet treatment for psoriasis different from other treatments?

The Nutritionally Balanced Diet for psoriasis is unique because it focuses on a healthy eating plan that includes a variety of foods like whole grains, fruits, and vegetables, rather than medication. This approach is similar to the DASH and Mediterranean diets, which are known for improving overall health and managing conditions like high blood pressure and diabetes. ^{11 12 13 14 15}

Research Team

Samuel T Hwang, MD, PhD

Principal Investigator

UC Davis SOM Department of Dermatology

Eligibility Criteria

This trial is for people with psoriasis, a skin and joint condition. Participants should be those typically consuming a Western Diet high in saturated fats and sugars. The study will use the EXPLORER PET scanner to measure changes in their inflammation after switching to a balanced diet.

Inclusion Criteria

I can fast for at least 6 hours before and during my scan appointment.

I am over 18 years old.

No strenuous exercise for 24 hours prior to being scanned

Exclusion Criteria

I have been on medication for psoriasis or psoriatic arthritis for at least 3 months.

My blood sugar is not higher than 180 mg/dl and my diabetes is under control.

Vegan, vegetarian, or have food allergy or intolerance to the ingredients of the diet

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Assessment

Participants undergo baseline PET/CT scans and blood sample collection to measure inflammation markers

1 week

1 visit (in-person)

Dietary Intervention

Participants receive a nutritionally balanced diet for 6 weeks, with meals prepared by a commercial kitchen

6 weeks

Weekly check-ins (virtual)

Post-Intervention Assessment

Participants undergo follow-up PET/CT scans and blood sample collection to measure changes in inflammation markers

1 week

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the dietary intervention

4 weeks

Treatment Details

Interventions

• Nutritionally Balanced Diet

Trial Overview The trial is testing if a nutritionally balanced diet can reduce systemic and cutaneous (skin) inflammation in psoriasis patients. It involves dietary counseling and uses advanced EXPLORER PET scanning technology to quantify inflammation before and after the dietary intervention.

Participant Groups

Group I: Dietary Intervention Experimental Treatment 1 Intervention

Participants will receive breakfast, lunch, and dinner in the form of fully cooked, ready-to-heat standardized meals for 6 weeks that are prepared by a commercial kitchen.

Who Is Running the Clinical Trial?

University of California, Davis

Lead Sponsor

Trials

958

Recruited

4,816,000+

Findings from Research

Weight loss and a healthy lifestyle significantly improve psoriasis symptoms, as indicated by a reduction in the Psoriasis Area and Severity Index (PASI) score for patients with moderate to severe disease.

While vitamin D supplementation is not recommended for those with normal levels, it is advised for patients with a deficiency, and supplements like selenium and omega-3 fatty acids, along with certain botanical species, have shown benefits for managing psoriasis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutritional strategies for psoriasis: current scientific evidence in clinical trials. Zuccotti, E., Oliveri, M., Girometta, C., et al.[2019]

A low-calorie diet (LCD) can improve psoriasis severity scores (PASI) when combined with other treatments, but it does not maintain remission after stopping medications like cyclosporine or methotrexate.

A fish oil diet significantly reduced psoriasis severity over six months, while other dietary interventions like gluten-free diets and vitamin D showed mixed results, indicating that dietary changes can support but not replace standard psoriasis treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diet and psoriasis. Pona, A., Haidari, W., Kolli, SS., et al.[2019]

A healthy lifestyle, including maintaining a proper body weight and engaging in physical activity, can significantly improve the severity of psoriasis, as shown in a review of studies linking psoriasis with metabolic disorders and nutritional treatments.

Adopting a Mediterranean diet, which is rich in fiber, vitamins, and polyphenols, may help control psoriasis symptoms due to its anti-inflammatory effects and positive influence on gut health, making it a beneficial complement to standard psoriasis therapies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Metabolic Disorders and Psoriasis: Exploring the Role of Nutritional Interventions. Cintoni, M., Palombaro, M., Maramao, FS., et al.[2023]

In a study of 34 men with systemic psoriasis and psoriatic arthritis, a significant portion (70.6%) were either overweight or obese, indicating a concerning nutritional status that may worsen their condition.

Participants exhibited excessive intake of calories, fats, and proteins, which could increase their risk for chronic diseases and negatively impact their quality of life and psoriatic lesions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutritional status and food intake of patients with systemic psoriasis and psoriatic arthritis associated. Solis, MY., de Melo, NS., Macedo, ME., et al.[2019]

A systematic review of 55 studies involving 77,557 participants found that dietary weight reduction through a hypocaloric diet is strongly recommended for overweight and obese patients with psoriasis to help reduce disease severity.

The National Psoriasis Foundation Medical Board suggests a weak recommendation for a gluten-free diet only for patients who test positive for gluten sensitivity, and for those with psoriatic arthritis, vitamin D supplementation and dietary weight reduction are also weakly recommended.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. Ford, AR., Siegel, M., Bagel, J., et al.[2019]

In a study of 6260 participants from the NHANES survey, individuals with psoriasis showed significantly higher levels of vitamin A and α-carotene, suggesting a potential link between these nutrients and the condition.

Psoriasis was also associated with lower sugar intake and a higher body mass index, indicating that dietary factors may play a role in the management and progression of the disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Diet and nutrition in psoriasis: analysis of the National Health and Nutrition Examination Survey (NHANES) in the United States. Johnson, JA., Ma, C., Kanada, KN., et al.[2014]

Psoriatic patients showed a significantly different dietary intake compared to healthy controls, consuming more total and simple carbohydrates, fats, and cholesterol, while having lower protein and fiber intake, which correlated with the severity of their psoriasis as measured by the PASI score.

The study found that lower consumption of monounsaturated fatty acids (MUFA) was a strong predictor of higher PASI scores, suggesting that dietary MUFA may play a role in managing inflammation in psoriatic patients and their cardio-metabolic risk profile.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nutrition: a key environmental dietary factor in clinical severity and cardio-metabolic risk in psoriatic male patients evaluated by 7-day food-frequency questionnaire. Barrea, L., Macchia, PE., Tarantino, G., et al.[2018]

Dietary saturated fatty acids, rather than obesity itself, are linked to worsening psoriasis in individuals with high fat diet-induced obesity, highlighting a specific dietary factor in disease exacerbation.

The study suggests that modifying diet could potentially improve psoriasis symptoms, indicating a possible therapeutic approach through dietary changes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Saturated Fatty Acids as Possible Key Amplifiers of Psoriatic Dermatitis. Nakamizo, S., Honda, T., Kabashima, K.[2019]

Japanese psoriatic patients have distinct dietary habits compared to Western patients, showing higher body mass indices and a greater intake of fish, pulses, and certain vitamins, while consuming less meat.

The study found that psoriasis is associated with a high body mass index and low meat intake, and patients with higher disease severity (as measured by the Psoriasis Area and Severity Index) consumed more confectionery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary habits in Japanese patients with psoriasis and psoriatic arthritis: Low intake of meat in psoriasis and high intake of vitamin A in psoriatic arthritis. Yamashita, H., Morita, T., Ito, M., et al.[2022]

In a study of 13,284 participants, the dietary inflammatory index (DII) was not found to be associated with the occurrence of psoriasis, suggesting that diet-induced inflammation may not play a significant role in developing this skin condition.

Despite the potential health risks of a pro-inflammatory diet, the analysis indicated that individuals with higher DII scores did not have a higher risk of psoriasis compared to those with lower scores, highlighting the complexity of dietary impacts on skin health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dietary inflammatory potential and psoriasis: A cross-sectional study. Liu, N., Zhang, C., Hua, W.[2023]

A meta-analysis of 10 studies found that diets high in carbohydrates are associated with slightly higher blood pressure compared to diets high in cis-monounsaturated fat, with significant increases in both systolic (2.6 mm Hg) and diastolic (1.8 mm Hg) blood pressure.

While the results suggest a potential benefit of replacing carbohydrates with cis-monounsaturated fats for blood pressure management, the differences in blood pressure were small and may not warrant changes in dietary recommendations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of high-carbohydrate or high-cis-monounsaturated fat diets on blood pressure: a meta-analysis of intervention trials. Shah, M., Adams-Huet, B., Garg, A.[2023]

Adherence to the Mediterranean Diet (MD) is linked to a lower incidence of cardiovascular and cerebrovascular events, with a significant reduction in risk observed as adherence increases, particularly in northern European participants.

In a study of 3703 individuals over 36 months, those with a higher MD score (≥4) experienced fewer vascular events compared to those with lower scores (0-1), suggesting that dietary changes can effectively reduce health risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A priori-defined Mediterranean-like dietary pattern predicts cardiovascular events better in north Europe than in Mediterranean countries. Veglia, F., Baldassarre, D., de Faire, U., et al.[2023]

The Mediterranean Diet (MedDiet) is recognized as one of the healthiest dietary patterns globally, promoting overall health and well-being.

This diet emphasizes a balanced intake of fruits, vegetables, whole grains, and healthy fats, which can contribute to various health benefits, including reduced risk of chronic diseases.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of the Mediterranean Diet on Metabolic Health. De Amicis, R., Menichetti, F., Leone, A.[2023]

The DASH eating plan is beneficial for people with diabetes, as it not only helps control blood pressure but also improves insulin resistance and reduces high cholesterol levels.

This diet encourages a variety of healthy foods, making it suitable for the whole family and effective in managing weight and obesity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

DASH Eating Plan: An Eating Pattern for Diabetes Management. Campbell, AP.[2020]

The Mediterranean diet (MeDi) is associated with improved health outcomes and may help reduce the risk of non-communicable diseases (NCDs), as summarized from 33 articles including systematic reviews and meta-analyses.

Combining the MeDi with physical activity and avoiding tobacco and excessive alcohol consumption enhances its health benefits, suggesting a comprehensive approach to promoting better health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mediterranean diet and health outcomes: a systematic meta-review. Martinez-Lacoba, R., Pardo-Garcia, I., Amo-Saus, E., et al.[2019]

References

1. Italy pubmed.ncbi.nlm.nih.gov

Nutritional strategies for psoriasis: current scientific evidence in clinical trials. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Diet and psoriasis. [2019]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Metabolic Disorders and Psoriasis: Exploring the Role of Nutritional Interventions. [2023]

4. Brazil pubmed.ncbi.nlm.nih.gov

Nutritional status and food intake of patients with systemic psoriasis and psoriatic arthritis associated. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. [2019]

6. England pubmed.ncbi.nlm.nih.gov

Diet and nutrition in psoriasis: analysis of the National Health and Nutrition Examination Survey (NHANES) in the United States. [2014]

7. England pubmed.ncbi.nlm.nih.gov

Nutrition: a key environmental dietary factor in clinical severity and cardio-metabolic risk in psoriatic male patients evaluated by 7-day food-frequency questionnaire. [2018]

8. United States pubmed.ncbi.nlm.nih.gov

Saturated Fatty Acids as Possible Key Amplifiers of Psoriatic Dermatitis. [2019]

9. England pubmed.ncbi.nlm.nih.gov

Dietary habits in Japanese patients with psoriasis and psoriatic arthritis: Low intake of meat in psoriasis and high intake of vitamin A in psoriatic arthritis. [2022]

10. England pubmed.ncbi.nlm.nih.gov

Dietary inflammatory potential and psoriasis: A cross-sectional study. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Effect of high-carbohydrate or high-cis-monounsaturated fat diets on blood pressure: a meta-analysis of intervention trials. [2023]

12. Netherlands pubmed.ncbi.nlm.nih.gov

A priori-defined Mediterranean-like dietary pattern predicts cardiovascular events better in north Europe than in Mediterranean countries. [2023]

13. Switzerland pubmed.ncbi.nlm.nih.gov

The Effect of the Mediterranean Diet on Metabolic Health. [2023]

14. United States pubmed.ncbi.nlm.nih.gov

DASH Eating Plan: An Eating Pattern for Diabetes Management. [2020]

15. England pubmed.ncbi.nlm.nih.gov

Mediterranean diet and health outcomes: a systematic meta-review. [2019]