Q: I’m due to undergo gastric bypass surgery. Has there ever been a case where a reduction of inflammation due its procedure lessens the severity of psoriasis? If so is the surgery alone to take credit OR the dietary protocol prior to and after surgery?
A: (Dr. Ogdie) There have been a couple studies with bariatric surgery (i.e., gastric bypass) - many people do improve in terms of psoriasis (and psoriatic arthritis); I’ll also be interested to hear Dr. Hwang’s input. We usually think it’s because of the loss of fat mass but it’s not totally clear
Q: What is the control diet again? Sorry, can't remember. Are you using the Mediterranean Diet as control?
A: (Jackie Domire, NPF) The control diet is the standard chow fed to the mice that has a mix of carb/fat/proteins.
A: (Dr. Hwang) The standard control diet is something developed over years by vets for mice. It is hard to characterize as a Mediterranean diet per se but I’d say there are some similarities in terms of the relative amounts of sugar, fat, protein levels. Mice are naturally vegetarians so fiber is a large part of their normal diets. Thanks for your question.
Q: I’m currently on the Autoimmune Protocol Diet (AIP) for psoriatic arthritis, which is basically a Paleo Plus diet that includes A LOT of (good, grass-fed) meats and relies greatly on organ meats as well as a lot of “healthy” fats, including animal fats. That is antithetical to the Mediterranean diet you mentioned as a positive for psoriatic disease earlier. Can you please speak to this disparity? Is there a chance that so much (even good!) meat is exacerbating my PA?
A: (Dr. Ogdie) Each person is a little different - sometimes meat is a culprit but sometimes not; some people consider elimination diets to try to figure out the triggers - you can even try to take out that piece for a bit to see how things go and what happens when you re-introduce it for a bit
A: (Dr. Hwang) I think that many diets could potentially be fine as long as the overall calorie count is low enough to counter obesity. Our work however implicates simple sugars and we are trying to figure how the high sugars make our mice more susceptible to psoriatic type inflammation. Thanks for your question.
Q: I don’t know if the inflammation is related to my PsA, but gut inflammation I believe is a co-morbidity.
A: (Dr. Hwang) Alexis makes great points about inflammatory bowel disease, much of it subclinical, being found in Ps patients. We are just beginning to explore the connection between the two. One intriguing hypothesis is that the inflammation in the gut can regulate the inflammation in the skin. That’s something my lab is currently working on. This is a different thought from the idea that Ps is a disease in which the gut and skin inflammation are both caused by the same genetic or environmental triggers. Thanks for your question.
Q: I ponder if the weight loss studies noted impact in Chronic fatigue?
A: (Dr. Hwang) Certain diets that are high in proteins like the ketogenic diet are well known to induce fatigue. There are some cons to ketogenic diets, including increased risk of renal disease.
Q: My problem is often about food preparation and having the energy to put a heathy dish together. Some days I literally have enough energy at the end of the day to open a can of garbanzo beans and eat some baby tomatoes.
A: (Dr. Hwang) Chronic fatigue may come from many different possible sources so would encourage you to speak to your primary care doctor, since it is very symptomatic. For busy people, some people have benefits from cooking on weekends and using that during the week. The trouble with processed foods is that they often do include large amounts of the things we don’t want in the diet (the high fats and sugars).