Milly Gaines
Psoriasis is a chronic autoimmune skin disorder that causes red, scaly, and itchy patches on the skin. It is often accompanied by psoriatic arthritis, an inflammatory joint condition. While diet does not cause psoriasis, certain foods are known to cause inflammation throughout the body, and this widespread irritation can aggravate psoriasis symptoms. For example, diets high in saturated fats and high-fructose corn syrup can lead to non-alcoholic fatty liver disease (NAFLD), which can cause liver fibrosis and cirrhosis. Excessive alcohol consumption can also lead to long-term inflammation and liver damage. Additionally, people with psoriasis are more likely to have other conditions such as obesity, type 2 diabetes, high blood pressure, and elevated cholesterol, which are risk factors for NAFLD. Therefore, it is essential for individuals with psoriasis to maintain a healthy diet and weight to reduce the risk of developing liver disease.
Does our diet possibly cause psoriasis of the liver?
| Characteristics | Values |
|---|---|
| Diet high in saturated fats and high-fructose corn syrup | Can lead to NAFLD and aggravate psoriasis |
| Mediterranean diet | May be a good option for people with psoriasis |
| Alcohol | Can trigger psoriasis flares and worsen NAFLD |
| Dairy products | High in fat, which can lead to inflammation |
| Refined carbohydrates | Highly processed |
| Gluten | Can worsen psoriasis |
| Omega-3 fatty acids | Reduce liver fat in NAFLD |
| Vitamin E supplementation | Reduce inflammation and fibrosis in NASH patients |
| Coffee | Decreases liver scarring or fibrosis |
| Nightshade vegetables | May exacerbate psoriasis |
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What You'll Learn
Alcohol consumption and psoriasis
Alcohol consumption is linked to psoriasis in several ways. Firstly, alcohol can trigger psoriasis flare-ups and worsen symptoms, although the exact mechanism is not yet fully understood. Research suggests that alcohol affects brain chemicals called neurotransmitters, which may play a role in the inflammation process associated with psoriasis. Additionally, alcohol can interfere with the effectiveness of psoriasis treatments, including biologic drugs and methotrexate.
Several studies have found a correlation between alcohol consumption and the severity of psoriasis. One study showed that alcohol intake was associated with an increased risk of developing psoriasis, and another study of 1203 inpatients with psoriasis found a correlation between alcohol consumption and the severity of the disease, particularly in women. A Pakistani study also found a significant association between alcohol consumption and the severity of psoriasis as measured by the PASI score.
Alcohol consumption is also linked to an increased risk of fatty liver disease, which is more common in people with psoriasis. Both heavy drinking and psoriasis are risk factors for this condition. Reducing alcohol intake can lower the risk of developing fatty liver disease. Additionally, alcohol consumption can worsen the psychological impact of psoriasis, which is associated with low self-esteem, anxiety, and depression. Some people with psoriasis may turn to alcohol to cope with the emotional toll of the disease, creating a cycle of worsening symptoms and mental health.
If you suspect that alcohol triggers your psoriasis flare-ups or worsens your symptoms, it is recommended to cut back on your alcohol consumption or quit drinking altogether. Keeping a drink diary and discussing it with your doctor can help determine if alcohol is a trigger for you. It is important to note that everyone's triggers are different, and while alcohol may be a trigger for some, it might not be for others. Experts recommend drinking in moderation, which generally means no more than two drinks per day for men and one drink per day for women. However, it is always best to consult with your doctor to determine a safe drinking limit based on your health, symptoms, and medications.
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Gluten and psoriasis
While there is no cure for psoriasis, certain dietary changes may help ease the symptoms. Research suggests that gluten may worsen psoriasis symptoms in people with high levels of anti-gliadin antibodies (AGA). Antibodies are released when the body is fighting a foreign invader, indicating an immune response to gluten, which could be a sign of gluten sensitivity or even celiac disease.
Celiac disease is a condition where gluten damages the villi of the intestine. A 2014 study found that 14% of people with psoriasis had high levels of AGA, compared to 5% in the general population. Psoriasis patients are 2.16 times more likely to have celiac disease, and people with celiac are at an increased risk of developing a skin problem called dermatitis herpetiformis, characterised by a burning rash triggered by gluten.
In a 2018 review of 55 studies, the medical board of the National Psoriasis Foundation gave a weak recommendation of following a gluten-free diet, but only for those showing signs of celiac disease or gluten sensitivity. Seventy-three percent of AGA-positive psoriasis patients who followed a gluten-free diet for three months showed an improvement in their Psoriasis Area and Severity Index (PASI) scores. Those with very high AGA levels saw an average 56% decrease in PASI scores, while those with high AGA levels saw an average 36% decrease.
However, the relationship between gluten and psoriasis is not fully understood, and research on the link between the two is mixed. A gluten-free diet is unnecessary for people with psoriasis who do not have gluten sensitivity or celiac disease. Eating gluten may trigger psoriasis symptoms only if one also has celiac disease or gluten sensitivity. Otherwise, avoiding gluten may lead to nutritional deficiencies.
If you suspect gluten is worsening your psoriasis symptoms, consult a healthcare professional. They can help develop a treatment and dietary plan that is safe and suitable for you.
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Dairy and psoriasis
Dairy products tend to be high in fat, which can lead to inflammation. Dairy also contains arachidonic acid, a polyunsaturated fat that can worsen psoriasis symptoms because it can easily be converted into inflammatory compounds. Dairy products that contain cow's milk also contain the protein casein, which has been linked to inflammation. People who are lactose intolerant do not have enough of the digestive enzyme lactase, which can cause chronic gastrointestinal irritation and make inflammation worse.
Some people report that their psoriasis symptoms improve when they cut dairy from their diet. A 2017 survey found that people with psoriasis reported dairy as one of their triggers. However, there is little research on dairy and psoriasis specifically, and experts do not currently recommend dairy-free diets for the treatment of psoriasis. Research has also not found a link between dairy and inflammation, and dairy may even help curb inflammation if you are not allergic to cow's milk.
Cow's milk and dairy products are a great source of calcium, and studies suggest that those with psoriasis generally have low levels of calcium. In a national survey, people with psoriasis reported consuming less dairy and less calcium than the general population. However, most respondents also reported using dietary changes to help manage their skin health, and most people reported the greatest skin improvement when they reduced alcohol, gluten, and nightshade vegetables in their diet and increased consumption of fish or omega-3 fatty acids, vegetables, and vitamin D.
If you are trying to figure out how your diet affects your psoriasis, it is recommended to work with your doctor or a registered dietitian before making major changes to your diet. Keeping a food journal can help you determine if certain foods may be triggering your psoriasis flares.
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The Mediterranean diet and psoriasis
While there is no direct link between diet and psoriasis, certain foods are known to cause inflammation in the body, which can worsen the symptoms of psoriasis. Psoriasis is a chronic inflammatory skin disease that affects 1-2% of the population. It is characterised by red, itchy, scaly patches on the skin. People with psoriasis are more likely to have other conditions, such as obesity, type 2 diabetes, high blood pressure, and elevated cholesterol, which can also increase the risk of liver disease.
The Mediterranean diet is a way of eating that is traditional in the countries surrounding the Mediterranean Sea, including Greece, Italy, Spain, Egypt, Morocco, Libya, Syria, Lebanon, and Israel. It emphasises plant-based foods, fruits, vegetables, whole grains, beans, legumes, fatty fish, and olive oil. The diet also includes moderate amounts of lean poultry, dairy, and eggs.
Several studies have shown a link between the Mediterranean diet and a reduced risk of chronic inflammatory diseases, such as atherogenesis, rheumatoid arthritis, and Crohn's disease. The anti-inflammatory properties of dietary fibres, antioxidants, and polyphenols, which are abundant in the Mediterranean diet, are thought to contribute to its beneficial effects.
A 2015 study found that the dietary patterns of patients with psoriasis were less aligned with the Mediterranean diet compared to control patients. The study also showed that lower psoriasis severity was associated with greater adherence to a Mediterranean diet. More recently, a large-scale French study found a statistically significant inverse association between adherence to the Mediterranean diet and the severity of psoriasis, even after adjusting for various confounding factors.
Based on the available evidence, it is recommended that adults with psoriasis consider incorporating elements of the Mediterranean diet into their existing medical therapies. This may help to reduce inflammation and improve their overall health. However, it is always advisable to consult with a doctor or registered dietitian before making any significant dietary changes to ensure a safe and effective approach.
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NAFLD and psoriasis
Nonalcoholic fatty liver disease (NAFLD) is a metabolic disorder that results from abnormal liver metabolism, leading to the accumulation of triglycerides within the liver cells. This condition is characterised by excessive fat storage and inflammation in the liver, which can progress to fibrosis and potentially cirrhosis or liver cancer.
Psoriasis, on the other hand, is an immune-mediated skin disorder with autoimmune characteristics. It is a chronic inflammatory dermatological disease that affects millions worldwide and significantly impacts patients' quality of life.
There is a well-established bidirectional association between NAFLD and psoriasis. Patients with psoriasis have a higher risk of developing NAFLD, and conversely, those with NAFLD are more likely to develop psoriasis. This relationship is supported by multiple studies, including longitudinal cohort studies and hospital-based observational research. The risk of developing psoriasis in patients with NAFLD is particularly elevated in younger individuals.
The exact mechanisms underlying the NAFLD-psoriasis link are not fully understood, but several factors are believed to contribute. Both conditions share common risk factors such as smoking, alcohol consumption, metabolic syndrome, and its component disorders like obesity, insulin resistance, and type 2 diabetes. Additionally, the systemic low-grade inflammation present in both NAFLD and psoriasis can exacerbate each other, creating a cycle of worsening liver damage and skin disease.
The management of NAFLD and psoriasis often involves lifestyle modifications, including dietary changes. Reducing consumption of alcohol, junk food, processed foods, red meat, dairy, and nightshade vegetables may help ease psoriasis symptoms. An anti-inflammatory diet rich in fruits, vegetables, whole grains, beans, seeds, fatty fish, and olive oil is recommended. Weight loss and regular exercise can also decrease liver fat and improve inflammation associated with NAFLD, while also reducing the severity of psoriasis.
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Frequently asked questions
Psoriasis is a chronic (long-term) inflammatory skin disorder. It causes red, scaly, itchy, and sometimes painful patches on the skin. It is an autoimmune disease where the body mistakenly attacks its own tissue.
People with psoriasis are at an increased risk of developing liver disease, specifically non-alcoholic fatty liver disease (NAFLD). NAFLD is a condition where excess fat is stored in liver cells, which can lead to cirrhosis and liver failure. Studies have found that about 30-50% of people with psoriasis also have NAFLD.
While diet alone may not directly cause psoriasis of the liver, certain diets can increase the risk of developing NAFLD, which is commonly associated with psoriasis. Diets high in saturated fats, highly processed foods, and high-fructose corn syrup can contribute to NAFLD. Therefore, dietary choices can indirectly influence the development of psoriasis-related liver issues.
An anti-inflammatory diet is recommended to manage psoriasis symptoms and reduce the risk of NAFLD. The Mediterranean diet, which includes fruits, vegetables, whole grains, beans, seeds, fatty fish, and olive oil, is suggested. Reducing alcohol consumption is crucial, as alcohol can trigger psoriasis flares and worsen NAFLD. Additionally, limiting refined carbohydrates, dairy products, and nightshade vegetables may be beneficial for some individuals.
Yes, it is important to note that certain medications used to treat psoriasis, such as methotrexate, can cause liver problems. Therefore, it is advisable to consult with a healthcare professional before starting any new treatments. Keeping a food journal and working with a registered dietitian can help determine if specific dietary changes are triggering psoriasis flares and impacting liver health.
