With all of the conflicting information out there, it can be confusing to know what to eat and what to avoid. To the rescue: Geraldine M. Jaffe, RDN, CDN, a nutrition consultant and arthritis educator based in New York, answers nine of the most commonly asked questions about eating right with psoriatic arthritis.
1. Is there such a thing as a psoriatic arthritis diet?
There’s no one diet that will cure the condition, but psoriatic arthritis is an inflammatory disease, so an anti-inflammatory diet may help ease symptoms like joint pain and stiffness. The best diets are rich in plant-based foods, which contain antioxidants and other nutrients that tame inflammation. “Half of the plate at any meal, but particularly lunch and dinner, should be fruits and vegetables,” Jaffe says. In addition, load up on whole grains, herbs and spices, nuts and seeds, legumes, and foods rich in monounsaturated and polyunsaturated fats such as avocados. For protein, eat fatty fish, low-fat dairy, eggs, and poultry.
2. What should I eat when my symptoms flare?
Again, while there’s no magic food to instantly soothe symptoms, a plant-based diet can help you feel better in the long term, Jaffe says. With this in mind, be sure to stock up on frozen veggies and prepare extra helpings of healthy meals on days you feel well, she says. This way, you can still eat well during flares.
3. Do I need to go gluten-free?
Research shows that there’s a higher prevalence of celiac disease in people who have psoriasis. And about a third of people with psoriasis go on to develop psoriatic arthritis, according to the National Psoriasis Foundation. Ask your doctor for a blood test to determine if you have celiac disease, which makes gluten attack your gut, says Jaffe. If you do have celiac disease, a gluten-free diet is essential. Otherwise? A gluten-free diet is unnecessary, and can rob your body of important sources of fiber (like barley and bulgur) and other key nutrients. Plus, if a gluten-free diet is not necessary, it might not be worth the hassle, especially on top of the struggles that joint pain can bring, says Jaffe.
4. Do I need to give up dairy?
You generally only need to go dairy-free if you have a milk allergy or are lactose intolerant, which can be confirmed through testing at your doctor’s office. For many people with psoriatic arthritis, a daily serving of milk or yogurt could actually be helpful. This is because these foods are good sources of protein and are often enriched with vitamin D — a key anti-inflammatory nutrient. In fact, “a person who has psoriatic arthritis should have their vitamin D status evaluated,” Jaffe adds.
5. Should I try a special diet, such as keto or Paleo?
Jaffe would steer clear, especially since these fad diets are not anti-inflammatory. If you want to try a diet plan, pick the one that is most researched and based on whole, plant-based food: the Mediterranean diet, Jaffe says. This type of anti-inflammatory diet focuses on fruits and vegetables, whole grains, nuts, legumes, fish, and healthy fats like olive oil. And be sure to talk to your doctor before trying any special diet to ensure that it’s safe for you.
6. Should I take supplements?
If you have a vitamin D deficiency, you’ll need to take this vitamin in supplement form. Otherwise, there is just one supplement Jaffe regularly recommends for people with psoriatic arthritis: fish oil, which is rich in anti-inflammatory omega-3 fatty acids. Two to three grams of purified fish oil is the prescribed dose for many people, but ask your doctor what’s right for you.
7. What about probiotics?
This is a hot topic right now, and research published in January 2015 in Arthritis & Rheumatology shows that people with psoriatic arthritis tend to have an unfavorable mix of gut bacteria. That’s a problem because your gut bacteria protect the mucosal barrier of your intestines, an important component of your immune system. However, it’s unclear whether probiotics can sufficiently shift the bacterial balance in people with psoriatic arthritis. A safer bet: Pile your plate with fiber-rich fruits and vegetables, which can help promote bacterial diversity and tip the scales in favor of the good guys, says Jaffe.
8. What should I eat if I’m overweight?
In that case, your diet may need a makeover. “Obesity fuels inflammation and makes it very difficult to bring psoriatic arthritis under control,” says Jaffe. Here’s why: Excess body fat triggers increased production of inflammatory cytokines, especially one called TNF alpha. Some inflammatory arthritis medications work by inhibiting TNF alpha, but if you have obesity on top of psoriatic arthritis, your TNF alpha levels could be too high for the medicine to be effective, says Jaffe. See a dietitian for help developing an eating plan to manage your weight.
9. Can I ever have dessert?
Yes. Excess sugar promotes inflammation in your body, but an occasional treat is OK (if you’re not trying to lose weight). Snack on a couple squares of antioxidant-rich dark chocolate, and save the more decadent stuff for a moment when it’s really worth it. “If you’re going to have cake with buttercream icing, that should be for a special occasion, not on a daily basis,” says Jaffe.
