Psoriatic Arthritis

Symptoms and severity of psoriatic arthritis can be alleviated with an anti-inflammatory plant-rich diet and healthy lifestyle changes, this has even led to clinical reversal of the condition.

Cases per year

It affects approximately 30% of patients with psoriasis 1 .

General frequency

Around 2.4 million people in the US have psoriatic arthritis.

Risk

Increases the risk of metabolic syndrome (MetS), hypertension, hyperlipidemia, obesity, and diabetes compared with those who have only psoriasis.

Managing psoriatic arthritis with a plant-based diet and lifestyle medicine.

Studies now show that a plant-based diet can help with psoriatic arthritis. Diets rich in vegetables, fruits, and fiber are associated with lower BMI, have anti-inflammatory properties and can help to reduce disease activity and inflammation in these patients.

Dr Yashoda on the power of plant-based diets for arthritis.

Podcasts

Here are some top scientific studies that support the results our clinicians have seen first-hand:

A woman reverses her psoriatic arthritis with a whole-food plant-based diet 

Managing Psoriatic Arthritis With a Whole Food Plant-Based Diet: A Case Study - PMC 

This case study is of a 40-year-old woman who after adopting a whole-foods plant-based diet was able to stop taking methotrexate for her psoriatic arthritis, was discharged from the rheumatology clinic, and remained symptom-free from that dietary change onwards 2

Plant-predominant diet associated with less psoriatic arthritis disease activity 

Mediterranean diet and Psoriatic Arthritis activity: a multicenter cross-sectional study | SpringerLink 

This study looked at the adherence to the mediterranean diet (a plant forward diet) in patients with Psoriatic Arthritis (PsA) and how this may impact on disease activity. The researchers found that participants that adhered less to the mediterranean diet had significantly higher levels of disease activity, and concluded that patients with psoriatic arthritis may benefit from the anti-inflammatory properties of this diet 3.

Weight loss to control psoriatic arthritis

Does weight loss reduce the severity and incidence of psoriasis or psoriatic arthritis? A Critically Appraised Topic - British Journal of Dermatology

Data from 14 combined studies suggests that ​​weight loss following lifestyle interventions (diet or physical activity) can help manage psoriasis and psoriatic arthritis, and achieve a greater likelihood of minimal disease activity 4.

Information about psoriatic arthritis and treatment using diet and lifestyle changes

What is psoriatic arthritis? 

Psoriatic arthritis is a type of inflammatory joint disease that occurs mostly in people with psoriasis, a chronic skin condition characterized by red, scaly patches on the skin 3. Psoriatic arthritis causes inflammation in the joints, which can lead to pain, stiffness, and swelling in the peripheral joints, spine, and fingers. It can also affect other parts of the body, such as the eyes, nails, and tendons. ‘Inflammatory arthritis’ means that there is inflammation present in the affected joints, rather than just wear and tear, which is seen in other types of arthritis. 

What causes psoriatic arthritis? 

The cause of psoriatic arthritis is not fully understood, but it is thought to be related to the immune system. People with psoriasis have an immune system that is overactive and mistakenly attacks healthy cells, leading to the development of the skin condition. This immune dysfunction seen in psoriasis is likely to be the cause of inflammation in the joints in people with psoriatic arthritis.

Alongside psoriasis, other conditions that can often contribute to the inflammation seen in psoriatic arthritis include atherosclerosis, obesity, and metabolic syndrome 3

High severity of psoriatic arthritis and an increased risk of heart disease in these patients have also been explained by unhealthy lifestyles and nutritional aspects such as a lack of plant foods that provide essential anti-inflammatory nutrients 5.

psoriasis compared to psoriatic arthritis, which shows painful, swollen joints as well as sore patches of skin
Psoriasis compared to psoriatic arthritis

Symptoms

The symptoms of psoriatic arthritis can be very similar to those of rheumatoid arthritis, mainly causing joints to become painful and warm to the touch. 

Specifically, psoriatic arthritis can cause:

  • Swollen fingers and toes, painful swelling as a result of inflammation 
  • Lower back pain, often due to the development of axial skeleton disorders associated with psoriatic arthritis which cause inflammation of the spine 
  • Nail changes, the nails may become thick, discolored, or prone to separating from the nail bed
  • Tenderness, pain and swelling over tendons
  • A reduced range of movement
  • Fatigue: People with psoriatic arthritis may feel tired or lacking energy due to the inflammation in their body

Psoriatic arthritis can also lead to devastating health complications; PsA patients show a higher prevalence of metabolic syndrome, hypertension, hyperlipidemia, obesity, and diabetes compared with those who have only psoriasis 5

Diagnosis 

Psoriatic arthritis can be difficult to diagnose as currently there are no conclusive tests and symptoms can overlap with other conditions, such as rheumatoid arthritis. 

Currently, your healthcare provider will make a diagnosis based on your symptoms, medical history, and by ruling out other conditions. This may include: 

  • A blood test: a blood test that can detect rheumatoid arthritis, which is usually negative in patients with psoriatic arthritis 
  • Scans: including X-rays, ultrasounds, or an MRI scan to look at the joints and identify areas of inflammation or new bone growth 

Treatment and Prevention

Following a plant-based diet and maintaining a healthy weight through diet, exercise, sleep, and stress management may improve the management of psoriatic arthritis. Indeed, an individual has even documented clinical reversal of her psoriatic arthritis using a whole-foods plant-based diet. 

A plant-based diet is rich in anti-inflammatory properties which may combat the inflammation seen in psoriatic arthritis and explain why it can help to manage and in some cases reverse the condition. 

Atherosclerosis, metabolic syndrome, and obesity may all contribute to the inflammation seen in psoriatic arthritis. This science is clear that a plant-based diet and healthy lifestyle changes significantly reduce the risk of, and can reverse, these risk factors 3.  

Useful links

Health and Mora with Dr Laurie Marbas

Think you may be struggling with this and need help? Get in touch with us today to make a change. 

References 

1. Mease, P. J. et al. Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics. J. Am. Acad. Dermatol. 69, 729–735 (2013).

2. Lewandowska, M., Dunbar, K. & Kassam, S. Managing Psoriatic Arthritis With a Whole Food Plant-Based Diet: A Case Study. Am. J. Lifestyle Med. 15, 402–406 (2021).

3. Caso, F. et al. Mediterranean diet and Psoriatic Arthritis activity: a multicenter cross-sectional study. Rheumatol. Int. 40, 951–958 (2020).

4. Mahil, S. K. et al. Does weight loss reduce the severity and incidence of psoriasis or psoriatic arthritis? A Critically Appraised Topic. Br. J. Dermatol. 181, 946–953 (2019).

5. Peluso, R. et al. Biomarkers of subclinical atherosclerosis in patients with psoriatic arthritis. Open Access Rheumatol. Res. Rev. Volume 11, 143–156 (2019).

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