Mixed Dietary Patterns Among Patients With Psoriasis

Medscape

29-05-2025

A recent study found that patients with psoriasis showed better adherence to a Mediterranean-style diet but a higher consumption of processed foods than participants without psoriasis. However, patients with more severe psoriasis and with comorbidities were more likely to have a lower overall diet quality, suggesting opportunities for targeted dietary interventions.
METHODOLOGY:
Researchers analysed 2613 patients with psoriasis (mean age, 56.5 years) identified through self-report and/or linked health records at baseline using data from the UK Biobank and compared them with 120,555 participants without psoriasis (mean age, 56.2 years).
Dietary intake was assessed through online 24-hour recalls conducted every 3-4 months over 1 year through the Oxford WebQ questionnaire.
Researchers estimated participants' adherence to national food-based dietary guidelines (Eatwell Guide) and a Mediterranean-style diet by nutrient and food group intakes determined from 24-hour dietary recalls.
Associations among the severity of psoriasis, presence of major comorbidities, and diet quality were evaluated using regression models with covariate adjustments.
TAKEAWAY:
Both groups had the same Eatwell Guide score (mean ± SD, 3.9 ± 1.7), but the psoriasis group had a higher Alternative Mediterranean Diet score than the non-psoriasis group (mean ± SD, 4.4 ± 1.8 vs 3.8 ± 1.7; P < .0001).
< .0001). Patients with psoriasis reported a significantly higher intake of red and processed meat, sodium, free sugars, and alcohol than participants without the condition (all P < .05).
< .05). Patients with psoriasis who had one or more comorbidities had significantly lower Eatwell Guide and Alternative Mediterranean Diet scores (beta coefficient [β], −0.184; 95% CI, −0.354 to −0.014; P = .034 and β, −0.266; 95% CI, −0.442 to −0.089; P = .003, respectively).
= .034 and β, −0.266; 95% CI, −0.442 to −0.089; = .003, respectively). The proportion of patients with psoriasis who had at least five portions of fruits and vegetables per day was significantly lower for those on systemic treatment than for those with no reported treatment (odds ratio, 0.69; 95% CI, 0.48-0.98; P = .040).
IN PRACTICE:
"Participants with psoriasis showed slightly better adherence to a Mediterranean-style diet (assessed between 0 and 6 years after recruitment) compared to those without psoriasis, which may indicate an active interest in dietary changes for symptom management in this population. However, their diets were also higher in processed meat, sodium, free sugars, and alcohol," the authors wrote. "These findings underscore the role of dietary management in preventative care for psoriasis," they concluded.
SOURCE:
This study was led by Yifan Xu, PhD, Department of Nutritional Sciences, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, England. It was published online on May 21, 2025, in Clinical Nutrition .
LIMITATIONS:
The cross-sectional study design limited the establishment of causal inference, as dietary changes may have occurred both before and after diagnosis. Self-reported 24-hour recall data may have been subjected to misreporting and recall bias. The assessment of psoriasis severity on the basis of self-reported medication use lacked the reliability offered by clinical measurements like the Psoriasis Area and Severity Index or Dermatology Life Quality Index. The study population's restricted age range at enrolment (40-69 years) and tendency towards health consciousness limited the study's generalisability.
DISCLOSURES:
This study was funded by a grant from the British Skin Foundation. One author declared receiving honoraria and/or research grants from AbbVie, Almirall, Anaptysbio, Artax, Boehringer Ingelheim, Boots UK, Bristol Meyers Squibb, Evelo Bioscience, GSK, Inmagene, Johnson & Johnson, Lilly, Novartis, Sun Pharma, and UCB.