Psoriasis is a T-cell mediated inflammatory dermatological disorder that has baffled doctors for many years. The condition can start at any time of life and can present as a few red spots to covering the skin with raw flaky skin all over the body. It is caused by an abnormality of the skin, which increases both the speed at which skin cells are produced and the time they take to mature and reach the outside layers of the skin. This increased cell production is what causes the characteristic signs of psoriasis (dry, reddish patches covered with silvery scales which develop on any part of the body, but most often on the elbows, knees, nails, lower back and scalp).
The prevalence of psoriasis is relatively high in the general population. Between 0.6% and 4.8%, of the population is reported to be affected. Lifestyle factors such as smoking, alcohol consumption, diet, emotional stress and infections have all been linked to psoriasis in epidemiological studies.
In severe cases, the disorder can result in an inadequate nutritional status, which may be further compromised by nutrient-drug interactions. Protein, folate and iron deficiencies have been reported in such cases. Both the general diet and single food components have been suggested to play a role in the aetiology and pathogenesis of psoriasis. Fasting periods, vegetarian diets, and diets rich in omega-3 polyunsaturated fatty acids from fish oils have all been associated with improvement in the symptoms of the disorder in some studies.
What causes Psoriasis?
The cause of psoriasis is unknown, but there is some evidence of disordered arachidonic acid metabolism, which may play a pathogenic role. Studies have found that the skin of people with psoriasis contains high levels of compounds called Leucotrienes, which cause inflammation. Leukotrienes are produced from Arachidonic acid in the body. Arachidonic acid is found in animal fat.
- Avoid alcohol consumption
- Eat a diet that includes good sources of folic acid (fresh green leafy vegetables, fruit, organ, meats, dried nutritional yeast) and Vitamin B12 (yeast, liver, beef, eggs, kidney)
Nutritional treatment of Psoriasis
Food allergies have not been as strongly linked to psoriasis as they have been to other skin disorders such as eczema. At the moment there is no consensus on any specific dietary treatment protocol for psoriasis. Limited evidence exists for a gluten-free diet or a low protein diet, fasting and supplementation with evening primrose oil, taurine, and zinc sulfate. Some evidence appears to A patient with psoriasis should follow a well-balanced and healthy diet to prevent nutritional deficiencies. Individuals who suspect food allergies or intolerances should confirm this with a proper diagnosis (RAST and ELISA are two tests that can be used by a practitioner to confirm a food allergy). It is unwise to follow an elimination or exclusion diet without proper diagnosis of a food allergy, since such a diet can affect the overall well being and nutritional status of a positively associated with increased BMI.
Omega-3 Fatty Acids
Omega-3 is a group of unsaturated fatty acid found primarily in marine oils and algae, and to a lesser extent in plant leaves and some vegetable oils such as canola. Two such important Omega-3 fatty acids are eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA are abundant in fish such as salmon, mackerel, herring, tuna, snoek, trout, sardines and pilchards. EPA, DHA together with alpha-linolenic acid have been shown to reduce inflammation by reducing the synthesis of leukotrienes thought to play a role in psoriasis.
Results of studies evaluating the effect of n-3 polyunsaturated fatty acids in the treatment of psoriasis are inconsistent and many of these were criticized due to methodological and design limitations. The results of the randomized controlled trials are less positive than the uncontrolled trials. 3 out of 4 studies showed a beneficial effect after oral supplementation with omega3 fatty acids. Dietary supplementation with fish oil rich in EPA [fish oil (10g) and EPA (3g)] taken for 8 weeks, for instance, had a great improvement in psoriatic symptoms such as the itching, erythema and scaling in psoriasis.
The improvement occurred in patients with chronic stable psoriasis and was achieved without any other changes in their diet. Treatment with EPA, therefore, may be important as an adjuvant therapy to more conventional medication such as methotrexate, especially for woman of childbearing age. Supplementation with other oils such as evening primrose oil is not recommended. No effect on chronic stable plaque psoriasis was observed in a double-blind trial after the supplementation omega 3 fatty acids (marine oil) and evening prim rose oil in 37 patients with psoriasis.
Eat a variety of foods
- Choose a diet with adequate grain products, vegetables and fruits. Include at least 5 portions of fresh fruit and vegetables per day, especially those rich in Beta-carotene, e.g. carrots, apricots, sweet potato and also those rich in vitamin C e.g. broccoli, orange, cabbage, potato, guava, tomatoes and sweet peppers.
- Choose a diet low in total fat (less than 30% of total energy intake) and saturated fat. Limit the intake of animal fat by eating lean meat and low fat dairy products.
- Gluten free diets could be beneficial for patients with a confirmed allergy or sensitivity to gluten.
- Alcohol is known to cause flare-ups of psoriasis. It stimulates the release of histamine which aggravates skin lesions. Patients should avoid alcohol or use it in moderation or per occasion
- Eat oily fish regularly to increase the intake of omega 3 fatty acids in the diet. Substitute red meat with salmon, mackerel, trout, sardines, pilchards and shellfish at least three times per week.
The following products are recommended for bringing order to the Lifestyle Disorders.
Supplements for Psoriasis
- Milk Thistle
- Protein Powder
Dosage recommendation can be sought from our specialist at My HealthWorks Clinics/ Telephonically.
Yoga for Psoriasis
- Pranayama & Meditation
- Baahya Kumbhak
- Anulom Vilom Pranayama
- Agnisaar Kriya
- Bhramari pranayama