People with chronic illnesses, like psoriatic arthritis, are especially prone to the effects of this food-body connection. While diet is by no means the only thing to focus on if you have this inflammatory condition, you also can't effectively manage your symptoms if you ignore what you eat.
"Diet is a piece of the puzzle when treating psoriatic arthritis," Robert Koval, MD, a rheumatologist at Texas Orthopaedics in Austin, Texas tells Health. "Although we cannot rely on diet alone to treat symptoms, eating a healthy, autoimmune, anti-inflammatory diet can definitely help."
What does this "healthy, autoimmune, anti-inflammatory diet" include? Here are five foods you should eat for psoriatic arthritis and five you should avoid, plus everything else you need to know about the link between nutrition and psoriatic arthritis.
How is diet connected to psoriatic arthritis?
In addition to understanding how some foods can increase or decrease your body's inflammatory response, there are two other reasons why it's important to think about your diet when you have psoriatic arthritis: weight management and concurrent risk factors.
According to Dr. Koval, studies have shown that psoriatic arthritis disease activity correlates with patient weight; for example, one small 2019 study published in Arthritis Research and Therapy reports that short-term weight loss had beneficial effects on a majority of disease activity symptoms in obese patients with psoriatic arthritis.
Lisa Young, PhD, RDN, author of Finally Full, Finally Slim and adjunct professor of nutrition at NYU, agrees: "Being overweight can exacerbate symptoms, [so] practicing portion control and choosing low-calorie-dense foods which are high in fibre [can help]," she tells Health.
Secondly, it's important to remember that many factors can lead to the development of psoriatic arthritis, with diet being one of many possible causes.
"I wouldn't say that diet is the absolute cause, however it contributes to the acceleration of symptoms," explains Dr. Koval. "There are many factors, many of which are poorly understood, which lead to the development of this disease, [including] age, sex, genetics, and environmental exposures."
Is there a specific diet to manage psoriatic arthritis symptoms?
It's not necessary or even beneficial, in many cases, to follow a commercialized diet for psoriatic arthritis (in other words, you don't need to "go keto" and throw out all your carbohydrates). Instead, focusing on eating whole, unprocessed foods and limiting the amount of processed or refined foods you eat is a better approach; if you're not sure how to do this on your own, working with a registered dietician or nutritionist will allow you to develop a customized plan that works for you.
"There are certainly some diet principles that help all patients, but you have to find one that is practical and sustainable," says Dr. Koval. "This, along with conventional medications and treatments, can go a long way in controlling symptoms."
The only prescribed diet Dr. Young suggests for people with psoriatic arthritis is the Mediterranean diet, primarily because all the foods you eat are known to be anti-inflammatory (so if you're cutting out inflammatory foods, you'll basically be following a Mediterranean diet whether you really mean to or not).
"[The Mediterranean diet is] rich in fruits and veggies, which contain antioxidants, and is also rich in omega-3 fatty acids...which help reduce inflammation as well as stiffness in the joints," Dr. Young says.
Plus, the diet is really more of a way of life as opposed to a traditional "diet," which means it isn't restrictive, doesn't cut out entire food groups, and isn't focused on counting calories.
What foods should you eat more of with psoriatic arthritis?
Both of our experts agree that you want to focus on foods that are naturally anti-inflammatory, known for reducing blood pressure and cholesterol, improving heart health, and assisting with weight management.
"Eating a healthy, anti-inflammatory diet may help alleviate [arthritis] symptoms," says Dr. Young. "This includes a whole-foods diet rich in healthy fats...along with colourful fruits and veggies high in antioxidants and phytochemicals."
Here are a few foods that both Young and Dr. Koval suggest adding into your diet if you deal with psoriatic arthritis:
Fresh fruits and vegetables
Filling, fibre-rich, and essentially calorie-free, it's hard to go wrong with fresh fruits and vegetables. Most contain soluble fibre, which improves digestive function, as well as a bevy of vitamins, minerals, and nutrients.
Of course, not all fruits and veggies are created equal; to really reap the benefits of fresh fruits and vegetables, focus on ones containing loads of phytonutrients, chemicals found in plants that have antioxidant properties. These include:
- Berries
- Peppers
- Kale
- Cherries
- Apples
- Spinach
- Cantaloupe
- Asparagus
- Carrots
- Broccoli
- Pineapple
A good rule of thumb when it comes to phytonutrients is to look for brightly coloured foods; while this doesn't apply to everything (cauliflower is good for you and it's white), it's still a legit shortcut to choosing healthy foods at the supermarket.
Lean protein
You need protein to build healthy muscle and repair cell damage, but chicken, turkey, and fish typically have less saturated fat than other meat-based protein sources. In other words, they're more nutrient-dense than calorie-dense, which makes them an excellent choice. You can also opt for non-meat sources of protein, like beans, tofu, green peas, chia seeds, and legumes.
Healthy fats
Here's a tip: monounsaturated fats are good, saturated fats are...less good (we don't like to call any food "bad," per se, because it's all about moderation). But omega-3 fatty acids? They're the best of all. To increase your omega-3 intake, incorporate more fatty fish, like salmon and sardines, nuts, seeds, and olive oil into your diet. In fact, Dr. Young says olive oil has anti-inflammatory properties that may prevent damage to cartilage.
Whole grains
People usually associate any kind of diet with giving up carbs, but that's usually not necessary—instead, swap your refined grains for whole, complex ones. This lets you keep all the belly fat-busting fibre in your diet while skipping all the insulin resistance from white flour, bread, and rice. Whole grains to include in your psoriatic arthritis diet are oats, barley, quinoa, and brown rice, along with whole wheat versions of pasta, bread, and cereals.
Green tea
Green, white, and black tea all include phytonutrients, but green tea has the most. Its anti-inflammatory effects on arthritis patients has actually been studied, though most of the research so far has been on patients with rheumatoid arthritis or osteoarthritis. Still, according to the Arthritis Foundation, green tea's active ingredient may have stronger antioxidant properties than vitamin C, making a solid beverage choice for psoriatic arthritis-sufferers.
Which foods should you try to limit or avoid with psoriatic arthritis?
While no food is completely off limits, some can be troublemakers, according to our experts—especially when they're eaten in excess. These foods can increase your blood insulin levels, contribute to weight gain, and are packed with saturated fats.
"An inflammatory diet is high in processed meats, like deli meats, ultra processed foods including refined grains, and foods high in added sugars like soda, cakes, and candy," says Dr. Young. "These are problematic for psoriatic arthritis and may exacerbate symptoms."
Here are some foods you should limit or try to avoid as best you can, if you have psoriatic arthritis, according to our experts:
Processed meats
Processed meats include everything from deli ham and salami to sausages and bacon; because these foods are preserved during manufacturing, they're often high in sodium, nitrates, and artificial flavourings, all of which can increase your risk of obesity, heart disease, and high cholesterol.
Refined grains
We told you that you didn't need to cut carbs earlier, and we stand by that: you don't need to cut all carbs, but you should at least cut down on certain kinds of carbs. Refined grains, like the ones used to make white bread, white rice, and many other supermarket items like cereals, granola bars, bagels, and crackers, can cause your blood sugar levels to spike, leading not only to a serious sugar crash but insulin resistance.
In case you don't know, higher insulin resistance means more sugar in your bloodstream, which means that sugar eventually gets stored as fat; this is also a leading cause of prediabetes and type 2 diabetes, per the CDC.
Red meat
The research connecting overconsumption of red meat and health problems such as heart disease, obesity, and diabetes is prolific. Because red meat contains more saturated fat than leaner cuts, such as chicken, it's more closely tied to inflammation; according to the Mayo Clinic, this may be because red meat increases the amount of inflammatory markers in your blood, so eating it regularly can cause chronic inflammation.
Dairy
The link between dairy and psoriatic arthritis is less straightforward than it is with, say, processed meats. Some research implies that bone-building dairy can be good for the joints, while other research suggests that dairy is generally an inflammatory, allergenic food that might contribute to arthritis symptoms.
What we know about dairy and arthritis is linked more often to osteoarthritis, our experts add, but if you have psoriatic arthritis, it's worth at least having dairy on your radar: if it seems to exacerbate your symptoms, cut back on it, but if it doesn't, you probably don't need to worry.
Added sugars
The type of sugar that occurs naturally in foods—like fruits, dairy, and some vegetables—is usually well-tolerated by the body and easily digested. But added sugars are a different ballgame: they're lurking basically everywhere, from your sliced bread to your Greek yogurt to your condiments, and the high levels of insulin that occur in your bloodstream when you consume sugar all day can contribute to systemic inflammation. Added sugar can also contribute to weight gain, according to Johns Hopkins Medicine, which can make it harder to maintain an arthritis-friendly weight that's good for your joints.
https://www.health.com/condition/psoriatic-arthritis/psoriatic-arthritis-diet
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