FROM THE ACADEMYQuestion of the Month

Is There Research iPsoriasis?

PERSONS SKIN CONSTANTLY

or severe psoriasisvely baolveme

dermatologist commenting on theiHOPE study, Many of the other dis-

riasis severity. http://www.psoriasis.org/surface area inv508 JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICSsed on bodynt compared

news/stories/2013/08/08/risk-of-serious-medical-events-increases-with-psoriasis-severity. Accessed December 23, 2013.medical comorbimild, moderate,classied objecti

Center by sending an e-mail toknowledge@eatright.org.

http://dx.doi.org/10.1016/j.jand.2014.01.003not advised to follow a gluten-freediet.The Incident Health Outcomes and

Psoriasis Events (iHOPE) Study, whichexamined the prevalence of major

dity in patients with

6. Yeung H, Takeshita J, Mehta NN, et al. Pso-riasis severity and the prevalence of majormedical comorbidity: A population-basedstudy. JAMA Dermatol. 2013;149(10):1173-1179.

7. National Psoriasis Foundation. Study: Risk ofserious medical events increases with pso-

This article was written by EleeseCunningham, RDN, of the Academyof Nutrition and Dietetics KnowledgeCenter Team, Chicago, IL. Academymembers can contact the KnowledgeAsheds dead cells and producesnew ones in a process calledcell turnover. Normally, ittakes about a month for new cells thatgrow deep in the skin to rise to thesurface, but in psoriasis this process isaccelerated and new cells rise frombelow the skin surface in a matter ofdays.1 Overgrowths of cells accumulateon the skin surface resulting in red, a-ky, crusty patches covered with silverylesions. Despite the fact that it is not acontagious disorder and the patchesare not infectious, people with the con-dition can suffer from social exclusion.According to the National PsoriasisFoundation (NPF), psoriasis is the mostprevalent autoimmune disease in theUnited States, and studies indicate asmany as 7.5 million Americans sufferfrom it.2

As is often the case in patients withchronic diseases, people with psoriasisturn to diet in hopes of a positiveimpact on their condition. A postersession presented at the 2011 Food &Nutrition Conference & Expo in SanDiego, CA, summarized a literaturesearch on Medline (1950 to January2011) for studies testing the effec-tiveness of any diets or dietary sup-plements in reducing psoriasissymptoms.3 Approximately 228 arti-cles were found, including articles onthe impact of obesity on psoriasis andthe effectiveness of a gluten-free dieton psoriasis, among other factors. Themeeting abstract for the poster sessionnoted some evidence supportive of alow-calorie/low-energy diet. In 2013, asmall clinical trial based in Denmarkto Support a Spec

reported what they believed to be therst results of a study on the effectsof weight loss using the severityof psoriasis as a primary endpoint.The researchers found that obese pa-tients with psoriasis who lost weightthrough a low-calorie diet experienceda signicant improvement in theirquality of life compared with obesepsoriasis patients who didnt loseweight. In the randomized clinicaltrial, 27 patients were assigned toan intervention group that followeda low-calorie diet, and 26 patientswere assigned to a control groupthat continued to eat ordinary healthyfoods. The participants met every 2weeks for a total of eight group ses-sions led by the study dietitian. Thepatients on a low-calorie diet endedup losing nearly 34 lb in 16 weeks,and reported improvements in boththeir psoriasis symptoms and theiroverall quality of life.3

There are data that suggest thatfollowing a gluten-free diet mayameliorate symptoms in individualswith chronic autoimmune diseaseconditions such as psoriasis.4 How-ever, the NPF states that the jury isstill out on this topic. In some cases,eliminating gluten does seem to helpreduce psoriasis. In a smaller numberof cases, eliminating gluten can leadto dramatic improvements.5 If celiacdisease or gluten sensitivity is sus-pected, a registered dietitian nutri-tionist should coordinate care with aphysician to evaluate the patient foreither of these conditions in order todetermine the appropriateness of agluten-free diet. For the client withpsoriasis who does not also have ce-liac disease or gluten sensitivity, it is 2eases linked to psoriasis are linked toobesity, and several of the diseasesindicated in the study are alreadylinked to obesity, too, like diabetes andhypertension. Exercising, eating right,quitting smoking, and treating psoria-sis can help prevent comorbidities.7

References1. MedlinePlus. Psoriasis. http://www.nlm.nih.

gov/medlineplus/psoriasis.html. AccessedDecember 23, 2013.

2. National Psoriasis Foundation. FrequentlyAsked Questions. http://www.psoriasis.org/page.aspx?pid375. Accessed December23, 2013.

3. Brown AC, Shankar P. Psoriasis, diet,and dietary supplementsA review [ab-stract]. J Am Diet Assoc. 2011;111(suppl 2):A33.

4. Jensen P, Zachariae C, Christensen R, et al.Effect of weight loss on the severity ofpsoriasis: A randomized clinical study.JAMA Dermatol. 2013;149(7):795-801.

5. Gaesser GA, Angadi SS. Gluten-free diet:Imprudent dietary advice for the generalpopulation? J Acad Nutr Diet. 2012;112(9):1330-1333.c Diet for

with that in patients without psoriasis,found a denite link between theseverity of a persons psoriasis and theodds that person may develop severalother diseases,6 including:

chronic pulmonary disease; diabetes; mild liver disease; myocardial infarction and

peripheral vascular disease(cardiovascular disease);

peptic ulcer disease; renal disease; and other rheumatological diseases.6,7

According to Mark Lebwohl, MD, a014 by the Academy of Nutrition and Dietetics.

Is There Research to Support a Specific Diet for Psoriasis?References