From healthcentral.com
Some evidence suggests that this protein found in wheat may trigger symptoms in psoriatic disease. We asked the experts for the bottom line
When you live with psoriatic arthritis (PsA), you’re always on the lookout for things that might trigger symptoms, including the foods you eat. With gluten increasingly in the news for its contribution to various health issues, it’s natural to wonder whether a gluten-free diet might help your psoriatic arthritis symptoms.
There is much to be discovered about the exact link between psoriatic disease and gluten, but research suggests a connection exists. In one study, researchers showed psoriasis patients (psoriasis is often the precursor to psoriatic arthritis) are more than twice as likely as the general population to be diagnosed with celiac disease, a condition triggered by gluten intolerance, compared to matched controls.
And according to the Journal of Investigative Dermatology, individuals with celiac disease are at an increased risk of psoriasis. “The connection is not well understood, but both conditions exert their effects through the actions of inflammatory mediators,” says Susan Goodman, M.D., rheumatologist at Hospital for Special Surgery in New York City.
Let’s take a closer look at what that means.
Is Gluten Bad for Psoriatic Arthritis?
“I would not recommend a gluten elimination for people with psoriatic arthritis right off the bat—there is no evidence showing that gluten directly impacts the disease,” say Ashley Baumohl, R.D., a registered dietitian at Northwell Lenox Hill Hospital in New York City.
Baumohl says that diet does play an important role in easing symptoms with psoriatic arthritis, but usually, weight management and inflammation reduction are the primary focus of nutrition interventions. “Focusing on plant-based foods rich in fibre, antioxidants, and polyphenols can reduce oxidative stress on the body,” says Baumohl. Incorporating healthy fats from oily fish, nuts, seeds, and olive oil can have an anti-inflammatory benefit and may lead to a reduction in inflammatory markers we see elevated in arthritis, she says.
On the other hand, if you know you have celiac disease, gluten may be off-limits. “For patients who have celiac disease or gluten sensitivities, having gluten may trigger psoriatic activity,” Baumohl explains, adding that while gluten is not known to cause psoriatic arthritis, “if you feel better after eliminating gluten, it could be indicative of a co-occurring digestive disorder” such as gluten intolerance or celiac disease.
What Is Celiac Disease?
Gluten is a protein found in foods containing wheat, barley, or rye. Celiac disease is an autoimmune condition in which your immune system is triggered by gluten consumption. This reaction damages your small intestine’s lining and prevents it from absorbing nutrients. Celiac disease is estimated to affect 1% of the populations of Europe and North America, but that number jumps up to 10% if you have a first-degree relative, such as a parent or child, who has it, according to the Cleveland Clinic.
This family connection is associated with a recognizable gene mutation (HLA-DQ2 or HLA-DQ8). However, not everyone with that gene mutation will develop celiac disease and not everyone with celiac disease has that gene mutation.
Are People With Celiac More Likely to Get Psoriatic Arthritis?
According to Dr. Goodman, there is a two-way relationship between both conditions. “There is an increase in other autoimmune diseases in patients with psoriatic arthritis,” she says. “Patients with celiac disease are more likely to get psoriasis, and patients with psoriatic arthritis are more likely to get celiac disease.” However, one condition doesn’t cause the other. “While some people with psoriatic arthritis report improvement in their symptoms if they eliminate gluten, there is no evidence that gluten can cause psoriatic arthritis,” Dr. Goodman adds.
Are People With Psoriatic Arthritis More Likely to Get Celiac Disease?
As noted, the relationship between celiac and PsA goes both ways, with each increasing the likelihood of the other. “Since patients with psoriatic disease are known to have an increased risk for other autoimmune diseases, it is not surprising that they are at increased risk for celiac disease,” Dr. Goodman says.
“Looking at large databases including both Kaiser Permanente and an Israeli database, patients with psoriasis are two- to three-fold more likely to have celiac disease than those without psoriasis,” she says.
However, Dr. Goodman says that there isn’t one consensus on how closely the conditions are linked. “The findings are not consistent and other studies have not confirmed these associations,” she explains. “As celiac disease and spondyloarthritis, including psoriatic arthritis, are more common in northern European populations, the differences in study results may reflect the differences in populations studied.”
Following a Gluten-Free Diet
If you’re curious to discover whether reducing or eliminating gluten from your diet might help your psoriatic arthritis symptoms, the National Celiac Association provides sample recipes on their site that match a gluten-free lifestyle:
Breakfast
Today there are many more packaged gluten-free meals available at the grocery store or your favourite restaurant. The National Celiac Association recommends gluten-free muffins, pancakes or crepes, scrambled eggs, hash browns, or a French toast casserole to start your day.
There are plenty of whole foods that are gluten-free as well: Consider eggs, fresh berries (or any raw fruit), and plain yogurt.
Lunch
From a gluten-free sloppy joe mix to taco salad, the National Celiac Association has a variety of lunch ideas to keep you rolling through your day. If sandwiches are more your jam for lunch, there are dozens of gluten-free bread recipes here and of course most grocery stores carry at least one type of gluten-free bread (don’t forget to check the frozen section).
If you aren’t sure if your favourite lunch meat is gluten-free, you can check this website for more information. Looking for vegetarian lunch ideas that are also gluten free? You can find recipes and ideas here.
Snacks
Cottage cheese and fruit, celery and peanut butter, and apples dipped in plain yogurt are all healthy gluten-free snack options. If you are traveling, there are many grab and go healthy snack options that are also gluten-free. It’s easy to find protein bars including Aloha Bars, Perfect Bars, and Kind Breakfast Bars that are gluten free. If you want to put together your own snack for on the go, Betty Crocker provides a variety of ideas and recipes to make at home.
Dinner
As long as you omit foods containing wheat, barley, or rye, your dinner will be gluten-free. That means shrimp and broccoli, chicken with greens beans, and steak served with a baked potato are all fair game. Some sauces may contain gluten, so when in doubt, choose foods that are unprocessed and served without extra dressings.
Talk to Your Doctor
While psoriatic arthritis is considered a joint condition, it’s important that you discuss any gastrointestinal (GI) issues with your rheumatologist. “GI symptoms may be medication-related or may be related to Crohn’s disease or ulcerative colitis, in addition to the possibility of celiac,” says Dr. Goodman. You won’t know for sure what’s going on until you check in with your provider, who may suggests various tests to figure out what’s going on.
https://www.healthcentral.com/condition/psoriatic-arthritis/gluten-and-psoriatic-arthritis-link
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