Nutrition and Psoriasis: The Latest Evidence and How to Approach Nutrition in Clinical Practice.

Psoriasis is a chronic immune-mediated skin condition that is associated with cardiovascular disease, obesity, and other comorbidities. While highly linked to genetics, psoriasis is also significantly impacted by environmental and lifestyle factors. Nutrition and diet are areas of considerable interest for patients, providers, and researchers alike, as patient diets may have a significant impact on disease activity and severity. Diet is also a major modifiable lifestyle factor that patients are empowered to explore and optimize in the management of their psoriasis. In this Therapy in Practice, we summarize the most up-to-date research on various diets proposed to have benefits for patients with psoriasis and conclude with a discussion on how providers may integrate nutrition into clinical practice. The Mediterranean diet emphasizes whole fruits, vegetables, grains, and healthy fats. Given the anti-inflammatory effects and cardiovascular benefits of the Mediterranean diet, it is a good option for patients with psoriasis. A low-calorie diet is often recommended for individuals who are overweight or obese, and there is a strong association between obesity and psoriatic disease activity and progression. For patients with a diagnosis of celiac disease or seropositivity of immunoglobulin A or immunoglobulin G antigliadin antibodies, a gluten-free diet could be beneficial in reducing psoriasis severity. Diet can have a significant role in the management of psoriasis, and patients and providers should work collaboratively to create a sustainable, safe, and effective diet.