Intermittent Fasting Diet for Psoriasis and Psoriatic Arthritis

Overseen By Ashley N Gray, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Ohio State University

Must not be taking: Weight loss drugs

Disqualifiers: Pregnancy, Insulin-dependent diabetes, Severe heart disease, others

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

Compensation: Varies

Number of Visits: 7

Duration: 24 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines whether intermittent fasting can improve symptoms of psoriasis and psoriatic arthritis and enhance quality of life. Participants will be divided into two groups: one will practice intermittent fasting, eating only during an 8-hour window each day for the first 12 weeks, while the other will maintain their usual diet. The study will last 24 weeks, with regular progress checks through video visits. Those with mild to moderate plaque psoriasis, who are overweight, and have not recently changed their psoriasis treatment may be suitable candidates. The trial's primary goal is to assess the feasibility of a larger study in the future. As an unphased trial, this study provides a unique opportunity to contribute to groundbreaking research that could lead to new treatment options.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, you must not have changed your systemic psoriasis treatment in the 6 weeks before joining the study.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that intermittent fasting (IMF) is generally safe and easy for most people to follow. One study found that the 16:8 fasting method, where individuals eat during an 8-hour window and fast for the remaining 16 hours, can help manage severe plaque psoriasis safely. Another study suggested that intermittent fasting might also benefit other autoimmune diseases, like multiple sclerosis and rheumatoid arthritis, without major safety concerns.

While specific data on the safety of intermittent fasting for psoriatic arthritis is lacking, these findings suggest it is likely safe. Intermittent fasting is not a new concept and has been used by many for various health benefits. However, as with any dietary change, consulting a healthcare provider is advisable, especially for those with existing health conditions. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using an intermittent fasting diet for psoriasis and psoriatic arthritis because it offers a unique approach compared to traditional treatments like topical creams, oral medications, or biologics. Unlike these standard therapies, which often focus on reducing inflammation through medication, intermittent fasting could help by potentially altering metabolism and reducing systemic inflammation naturally. This method gives patients a non-drug option, which could minimize side effects and provide a more sustainable, lifestyle-based solution. Additionally, intermittent fasting allows flexibility, as patients can choose their eating hours, making it a potentially more adaptable and comfortable lifestyle change.

What evidence suggests that intermittent fasting might be an effective treatment for psoriasis and psoriatic arthritis?

Research has shown that intermittent fasting (IMF) might help manage psoriasis, a skin condition that causes red, itchy patches. One study found that people with severe chronic plaque psoriasis improved by following a 16:8 fasting schedule, which involves eating only during an 8-hour period each day. Other research indicates that intermittent fasting can lower inflammation, a key issue in both psoriasis and psoriatic arthritis (PsA). Fasting may also boost gut health, potentially benefiting those with autoimmune diseases like PsA. In this trial, participants in the Intermittent Fasting Group will follow a similar 16:8 fasting schedule for 12 weeks. Overall, these findings suggest that intermittent fasting could be a promising way to reduce symptoms in people with psoriasis and PsA. ^{1 2 3 4 6}

Who Is on the Research Team?

Benjamin H. Kaffenberger, MD

Principal Investigator

Ohio State University

Are You a Good Fit for This Trial?

This trial is for adults over 18 with mild to moderate plaque psoriasis, who are overweight and have been stable on their current psoriasis treatment for at least 6 weeks. It's not suitable for insulin-dependent diabetics, pregnant or breastfeeding individuals, those with severe organ disease, or anyone using medical weight loss treatments.

Inclusion Criteria

You weigh more than what is considered healthy for your height.

I have mild to moderate plaque psoriasis and treatments haven't worked.

Ability to consent and follow dietary instructions

Exclusion Criteria

My obesity is caused by a medical condition.

I do not have severe heart, kidney, or liver disease.

I use insulin for my diabetes.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are enrolled in a dietary intervention for a 24-week period, with an initial 12 weeks of intermittent fasting or standard routine diet, followed by 12 weeks of normal dietary habits.

24 weeks

6 visits (virtual) every 4 weeks

Follow-up

Participants are monitored for changes in disease state and quality of life after returning to their initial dietary routines.

12 weeks

1 visit (virtual) at the end of the study

What Are the Treatments Tested in This Trial?

Interventions

• Intermittent Fasting Diet

Trial Overview The study tests if an Intermittent Fasting Diet (IMF) can improve the severity of psoriasis and Psoriatic Arthritis (PsA), as well as quality of life. Participants will either follow the IMF diet or their usual diet for 24 weeks. The effects will be monitored through regular check-ins and assessments by a physician.

How Is the Trial Designed?

Group I: Intermittent Fasting Group Experimental Treatment 1 Intervention

Patients in this group will do intermittent fasting dieting for 12 weeks, meaning they will only eat for 8 hours per day. They may choose whichever 8 hours they want. Only water can be consumed during the fasting period. For the last 12 weeks of the study, they will resume their normal diet.

Group II: Standard Routine Diet Group Active Control 1 Intervention

Patients will continue with their normal diets for the 24 week duration of the study.

Who Is Running the Clinical Trial?

Ohio State University

Lead Sponsor

Trials

891

Recruited

2,659,000+

National Psoriasis Foundation

Collaborator

Trials

12

Recruited

1,900+

Published Research Related to This Trial

The Diet and Psoriasis Project (DIEPP) is investigating the relationship between dietary factors and psoriasis severity, focusing on the Mediterranean diet and time-restricted eating as potential therapeutic strategies.

This research aims to provide insights into how diet may influence psoriasis and contribute to developing medically approved dietary recommendations, addressing the link between psoriasis and associated conditions like type 2 diabetes and cardiovascular disease.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Approaches to nutrition intervention in plaque psoriasis, a multi-system inflammatory disease-The Diet and Psoriasis Project (DIEPP). Zanesco, S., Hall, W., Gibson, R., et al.[2023]

An energy-restricted diet rich in n-3 polyunsaturated fatty acids (PUFAs) significantly improved clinical outcomes in 44 obese patients with psoriasis over six months, including reductions in psoriasis severity, itch scores, and quality of life measures.

This diet also led to notable improvements in metabolic markers, such as decreased body weight, waist circumference, and serum triglycerides, suggesting that dietary changes can enhance the effectiveness of immuno-modulating therapies in treating psoriasis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Energy-restricted, n-3 polyunsaturated fatty acids-rich diet improves the clinical response to immuno-modulating drugs in obese patients with plaque-type psoriasis: a randomized control clinical trial. Guida, B., Napoleone, A., Trio, R., et al.[2015]

In a study of 108 patients with moderate-to-severe plaque psoriasis, fasting during Ramadan led to a significant reduction in the Psoriasis Area and Severity Index (PASI) score, indicating improved disease severity (mean difference = -0.89, p < 0.0001).

The effectiveness of psoriasis treatments varied, with cyclosporine and IL-17 blockers associated with lower PASI scores after fasting, while apremilast and phototherapy were linked to higher scores, suggesting that dietary and treatment strategies can influence psoriasis outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Ramadan Fasting on the Reduction of PASI Score, in Moderate-To-Severe Psoriatic Patients: A Real-Life Multicenter Study. Damiani, G., Watad, A., Bridgewood, C., et al.[2020]

In a study of 56 patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), Ramadan fasting led to a significant decrease in disease activity for RA, with Disease Activity Scores improving from 4.3 to 3.5 (p < 0.001).

Fasting did not negatively impact medication compliance or tolerance, suggesting that patients can safely fast without fear of compromising their treatment regimen.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Impact of Ramadan diurnal intermittent fasting on rheumatic diseases. Ben Nessib, D., Maatallah, K., Ferjani, H., et al.[2021]

In a study of 37 patients with psoriatic arthritis who fasted for 17 hours daily during Ramadan, significant improvements were observed in disease activity markers, including a decrease in C-reactive protein levels and various disease activity indices, indicating that intermittent fasting may help reduce inflammation and symptoms associated with psoriatic arthritis.

The study suggests that fasting can be a predictor of decreased disease activity in psoriatic arthritis, independent of weight loss, highlighting the potential role of circadian fasting as a therapeutic approach in managing this condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Impact of Intermittent Fasting (Ramadan Fasting) on Psoriatic Arthritis Disease Activity, Enthesitis, and Dactylitis: A Multicentre Study. Adawi, M., Damiani, G., Bragazzi, NL., et al.[2020]

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]

A 2-week period of time-restricted feeding (TRF) significantly reduced psoriasis-like skin lesions in mice, indicating its potential as a therapeutic approach for managing psoriasis.

TRF was found to lower inflammatory cytokines and decrease the number of senescent T cells, while increasing regulatory T cells (CD4+ Treg) in skin lesions, suggesting a mechanism of action that involves modulating immune responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A 2-week time-restricted feeding attenuates psoriasis-like lesions with reduced inflammatory cytokines and immunosenescence in mice. Chen, Y., Li, X., Yang, M., et al.[2023]

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 pilot study involving 24 psoriasis patients will investigate the effects of modified intermittent fasting (MIF) on skin, gut, and metabolic health, comparing it to a regular diet over 12-week periods.

The study aims to assess various health markers, including psoriasis severity and inflammation, to determine how dietary lifestyle changes like MIF can improve psoriasis management and overall health without relying solely on medications.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of Modified Intermittent Fasting in Psoriasis (MANGO): Protocol for a Two-Arm Pilot Randomized Controlled Open Cross-over Study. Grine, L., Hilhorst, N., Michels, N., et al.[2022]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12088499/

Efficacy of Intermittent Fasting in the Management ... Intermittent fasting using 16: 8 protocol is easy to perform and a safe and effective adjuvant for managing severe chronic plaque psoriasis.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT05590247

Role of Intermittent Fasting in Psoriasis and Psoriatic Arthritis Our study aims to determine whether intermittent fasting (IMF) is a valid method to improve psoriasis and psoriatic arthritis (PsA) disease severity and ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12397761/

Effects of Acute Time-Restricted Eating on Inflammation in ... Although specific dietary interventions, such as intermittent fasting and caloric restriction, have been shown to ameliorate inflammation and ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1568997223001428

A promising dietary intervention for autoimmune diseases Intermittent fasting alters and improves gut microbiota in autoimmune diseases. · Intermittent fasting reduces inflammatory markers in autoimmune diseases.

5. researchprotocols.org researchprotocols.org/2022/2/e26405/

The Effects of Modified Intermittent Fasting in Psoriasis ... Modified intermittent fasting (MIF) on 2 nonconsecutive days has shown beneficial effects on metabolic parameters. A significant advantage of ...

6. withpower.com withpower.com/trial/phase-psoriasis-6-2022-ef03e

Intermittent Fasting Diet for Psoriasis and Psoriatic Arthritis Our study aims to determine whether intermittent fasting (IMF) is a valid method to improve psoriasis and psoriatic arthritis (PsA) disease severity and ...