Can good nutrition help with a chronic disease?

| Paula Vokoun RDN

Some people with psoriasis or psoriatic arthritis feel that changing what they eat can help improve their symptoms. Unfortunately, there’s no clear evidence of a definitive link between diet and psoriatic disease. Adding or eliminating one food may help one person but be a trigger for another.

We know that too many calories increases weight and complicates many chronic conditions. Too much saturated fat compromises heart health. Too much processed food promotes inflammation. The single most important thing you can do with diet and possibly psoriatic disease is to try to achieve – and maintain – a healthy weight.

No one treatment works for everyone. The same is true for dietary habits. Speak with a health care provider or registered dietitian before starting a weight loss plan, eliminating foods, or adding vitamins or minerals to your diet.

What are some foods that promote overall health?

Fruits and vegetables. Whether fresh or frozen, canned or dried, cooked or raw — the important thing is to eat them. Carrots, sweet potatoes, strawberries, figs, broccoli, beans, peas, raspberries, apples with the skin and mangoes are some of the least-processed foods out there. Unrefined fats, such as avocado, olive oil and raw nuts, are heart healthy. Eat more whole gains and fewer refined carbohydrates such as pasta and white rice.

Remember that multigrain bread can contain multiple refined grains. Each serving of bread or cereal should have a minimum of 2 to 3 grams of fiber. Dried beans provide fiber, vitamins and minerals, and are an excellent source of protein.

Other nutritious foods include eggs from pasture-raised chicken, unprocessed grass-fed meat and lean protein sources such as skinless chicken. There’s also wild-caught fish, especially oily fish such as mackerel, sardines, salmon, kipper and herring. All seafood is heart healthy.

What are some foods I should avoid?

Avoid processed foods or eat them in moderation. That includes anything with additives, preservatives, artificial sweeteners, refined sugars (molasses and honey are considered refined sugar), salt and trans fats. Our bodies turn trans fat into cholesterol, even if it’s from a vegetable product. Avoid foods with lengthy ingredient lists and long shelf lives. Artificially sweetened drinks and drinks with high fructose corn syrup are highly processed. Whole fruit and a glass of water are better than fruit juice.

Eating processed food in moderation is fine, but watch for sodium, fat and hidden sugar among the first two or three ingredients. Examples of hidden sugars include maltose, brown sugar, corn syrup, cane sugar, honey and fruit juice concentrate.

Alcohol is fine to drink in moderation, but many people report that it increases disease-related symptoms.

Should I switch to organic?

Organic foods are quite expensive, whether they’re local or imported. Also, many organic frozen processed foods that come from other countries don’t have to follow USDA guidelines on what constitutes organic.

Organic foods aren’t necessarily healthier. They’re cleaner — they don’t have the residue of pesticides. The nutritional value is the same. There’s a website called “The Dirty Dozen” ( that lists the 12 worst fruits and vegetables — the ones with the most pesticide residue. You should definitely eat organic versions of those fruits and vegetables if you can. The site also lists “The Clean 15.” These are foods that are easily cleaned of harmful residue. Don’t spend your food budget on organic versions of those.

Should I go gluten-free?

Gluten is a protein found in wheat, rye and barley. Byproducts and hybrids of these grains include triticale, bulgur, spelt, farro, farina, durum, semolina and other processed foods. Some people report that gluten-free diets improve their symptoms. Scientists haven’t found the evidence to support the effectiveness of a gluten-free diet in treating psoriatic disease. However, recent research estimates that one out of four people with psoriasis may be sensitive to gluten, which can provoke the immune system.

To follow a gluten-free diet, read labels carefully. It takes at least three months to completely eliminate gluten from your system. If after that time you’re not sure it worked, try slowly adding gluten back in to your diet. Pay attention to your symptoms like increased itching, joint pain and headaches. It’s possible that the problem may not be gluten but another food such as dairy, sugar, corn or soy.

Talk with your health care provider or a registered dietitian before eliminating foods from your diet or adopting a gluten-free diet. Your doctor can test you for gluten antibodies. If you go on a gluten-free diet and then go see the doctor, you could get a false negative on your blood test.

Is honey beneficial?

Sometimes honey can be just as refined as white table sugar. You can find natural honey, however, and that can be an alternative sweetener, to be used sparingly.

What’s the deal with aloe drinks?

Aloe vera has been shown to be beneficial, topically, for skin conditions. Many people find relief from that. Ingesting aloe juice is anti-inflammatory, so when we talk about anti-inflammatory foods, aloe juice would be one of your options.

Do you have more questions?

Your primary care provider (PCP) can help you manage your overall health and refer you to a nutritionist. Learn how to best work with your PCP by requesting a free booklet. Or, contact an NPF Patient Navigator for resources about diet, psoriatic disease and more.

Paula Vokoun, RDN, spent 30 years as a dietitian with Legacy Health System in Portland, Oregon, where she taught people with chronic diseases to improve their health through medical nutrition therapy. She is a board member of the American Diabetes Association.

Driving discovery, creating community

For more than 50 years, we’ve been driving efforts to cure psoriatic disease and improve the lives of those affected. But there’s still plenty to do! Learn how you can help our advocacy team shape the laws and policies that affect people with psoriasis and psoriatic arthritis – in your state and across the country. Help us raise funds to support research by joining Team NPF, where you can walk, run, cycle, play bingo or create your own fundraising event. If you or someone you love needs free, personalized support for living a healthier life with psoriatic disease, contact our Patient Navigation Center. And keep the National Psoriasis Foundation going strong by making a donation today. Together, we will find a cure.

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