If you’re one of the millions of people in the U.S. with the inflammatory disease psoriatic arthritis (PsA), you’ve probably wondered if changing the way you eat can help manage your condition. While there’s no one diet proven to manage the symptoms of psoriatic arthritis, there are a number of diet tweaks to help you increase your energy, maintain a healthy weight, decrease inflammation, and reduce your risk of developing several related conditions like diabetes and heart disease.
Psoriatic arthritis is a type of arthritis that occurs alongside psoriasis, a chronic, inflammatory skin and nail disease. People with PsA may have red scaly rashes and thick, pitted fingernails as well as inflammation and joint pain that can occur in other types of arthritis.
A Healthy Diet for a Healthy Weight
The diet most proven to help manage symptoms of psoriatic arthritis, according to the medical board of the National Psoriasis Foundation, is one that helps people with the condition reach a healthy weight.
The reason: Excess pounds may make it harder to control psoriatic arthritis symptoms.
People whose body mass index fell in the obese category (30 or greater) were 48 percent less likely than those with a healthy BMI (18.5-24.9) to have minimal symptoms like pain and swollen joints in a study published in the journal Annals of Rheumatic Disease. People who fell in the overweight BMI category (higher than 25) were 35 percent less likely.
Obesity may make certain psoriatic arthritis treatments, including disease-modifying drugs (DMARDs) and biologics, less effective and reduce patients’ changes of getting to low disease activity or remission. In fact, a narrative review published in Rheumatology and Therapy found that people who lost five percent or more of their baseline weight were more likely to have minimal disease activity.
How Weight Impacts Psoriatic Arthritis Symptoms
Researchers say that fat tissue in the body releases inflammation-causing proteins, which can further exacerbate an already inflamed body. “Fat is essentially an inflammatory organ,” says Alexis Ogdie, MD, Director of the Penn Psoriatic Arthritis and Spondyloarthritis program at the University of Pennsylvania.
What’s more, extra pounds may put even more impact on the joints than you’d think. “The rule of thumb is that every 10 pounds on the body is 25 pounds to the knee,” says Ogdie.
An Anti-Inflammatory Diet for Psoriatic Arthritis
Since psoriatic arthritis is an inflammatory condition, following an anti-inflammatory diet is often recommended to help control symptoms.
But the science of how exactly anti-inflammatory diets may — or may not — help people with psoriatic arthritis is complicated and still developing. For example, some research shows that anti-inflammatory diets may not help people with PsA. When scientists tracked the diets of more than 80,000 women over four years, they found that those who ate an anti-inflammatory diet were no less likely to develop psoriatic arthritis compared with those who ate a pro-inflammatory diet.
While this may indicate that diet isn’t necessarily a silver bullet for PsA, there are still other reasons to follow an anti-inflammatory diet pattern. There is convincing evidence eating this type of diet pattern may help with weight loss as well as help prevent or manage diabetes and heart disease, which research shows are more common comorbidities in people with PsA.
A balanced diet that is heavy in fruits and vegetables, whole grains, lean proteins, fish, legumes, nuts, seeds, and plant-based fats is thought of as an anti-inflammatory diet. You may also hear this diet pattern referred to as a “Mediterranean diet.”
An anti-inflammatory diet pattern limits a number of foods that are considered pro-inflammatory. Those foods include fatty red meats, added sugars (and foods that are high in added sugars like packaged sweet snacks and sodas), and refined carbs like white bread, pasta, and rice. Here’s advice on how to cut out sugar to help manage your arthritis.
It’s possible that the inflammation caused by eating these foods can exacerbate inflammation in a person with PsA; some people with psoriatic arthritis do find avoiding these foods in favor of a more anti-inflammatory diet helps, says Dr. Ogdie.
Here are a few anti-inflammatory foods you’ll want to be sure to include in a healthy diet for psoriatic arthritis:
Fruits and vegetables
Produce loaded with antioxidants can help cut down on inflammation. Aim to get a range of colors each day from less processed fruits and vegetables. Fresh produce always works, but frozen is a nutritious option that’s also more affordable.
Fish, especially fatty fish like salmon and mackerel, are loaded with anti-inflammatory omega-3 fatty acids. Research shows that omega-3 fatty acids may help protect people with psoriatic arthritis against heart disease.
Eating nuts frequently is linked with lower levels of inflammation in the body. Choose the ones you like the best: Peanuts, almonds, walnuts, cashews, pistachios, and pecans are all great choices.
Refined grain foods can increase levels of inflammatory proteins in the body; whole grain foods, however, have been found to have the opposite effect. They’re also full in fiber, which can help steady blood sugar, boost weight loss, and prevent heart disease. Choose grain foods like brown rice, whole-grain bread, quinoa, barley, and wheat berries to reap the benefits.
Bottom line: While there’s no one diet recommended for psoriatic arthritis, it’s generally a good idea to discuss good nutrition with your health care provider. Together, you can decide which foods to eat (and which ones to avoid) to better manage your PsA as well as your overall health.
Arulselvan P, et al. Role of antioxidants and natural products in inflammation. Oxidative Medicine and Cellular Longevity. October 2016. doi: https://doi.org/10.1155/2016/5276130.
Bridgman AC, et al. Inflammatory dietary pattern and incident psoriasis, psoriatic arthritis, and atopic dermatitis in women: A cohort study. Journal of the American Academy of Dermatology. June 2019. doi: https://doi.org/10.1016/j.jaad.2019.02.038.
Eder L, et al. Obesity is associated with a lower probability of achieving sustained minimal disease activity state among patients with psoriatic arthritis. Annals of the Rheumatic Diseases. 2015. doi: https://doi.org//10.1136/annrheumdis-2013-204448.
Ford AR, et al. Dietary recommendations for adults with psoriasis or psoriatic arthritis from the medical board of the national psoriasis foundation: a systematic review. JAMA Dermatology. August 2018. doi: https://doi.org/10.1001/jamadermatol.2018.1412.
Kristensen S, et al. The effect of marine n-3 polyunsaturated fatty acids on cardiac autonomic and hemodynamic function in patients with psoriatic arthritis: a randomised, double-blind, placebo-controlled trial. Lipids in Health and Disease. December 2016. doi: https://doi.org/10.1186/s12944-016-0382-5.
Kumthekar A, et al. Obesity and psoriatic arthritis: a narrative review. Rheumatology and Therapy. September 2020. doi: https://doi.org/10.1007/s40744-020-00215-6.
Perez-Chada LM, et al. Comorbidities associated with psoriatic arthritis: review and update. Clinical Immunology. May 2020. doi: https://doi.org/10.1016/j.clim.2020.108397.