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Psoriasis is a chronic, inflammatory autoimmune disease that can cause sore, itchy plaques to form on your body. It’s thought to affect 2 to 4 percent of the world’s population and can lead to many other ailments.

Though psoriasis isn’t preventable (it’s hereditary — thanks for nothing, great-uncle Moisha), there are ways to manage flare-ups.

The first step is figuring out your triggers, and your diet may be one of them.

It’s important to note that triggers aren’t universal. Something that causes a flare-up in one person may have no effect on another.

Common psoriasis triggers include:

  • stress
  • obesity/weight gain
  • infections (and anything else that affects your immune system)
  • certain medications
  • injury to the skin
  • smoking

Though this hasn’t been scientifically proven, the National Psoriasis Foundation reports that allergies, diet, and the weather may be triggers as well.

You can’t change the weather, but changing your diet may help you manage your symptoms.

A balanced diet high in anti-inflammatory foods may ease the symptoms of psoriasis. Lean proteins (such as fish, tofu, and beans), healthy fats, whole grains, legumes, and nuts all fit into this category.

Even if a change in your diet doesn’t improve your psoriasis symptoms, it could have a positive effect on your overall health!

Here’s what to stock up on at the grocery store:

Fruits and veggies

Fresh fruits and vegetables are high in antioxidants, have zero cholesterol, and are included in almost all anti-inflammatory diets.

Load up on:

  • leafy greens (kale, spinach, lettuce, arugula)
  • broccoli, cauliflower, cabbage, Brussels sprouts
  • avocados, olives, berries, cherries

Healthy fats

Fish, healthy oils, and omega-3 and omega-6 fatty acids are all good for your body and heart. Studies focusing on fish oil’s effect on psoriasis found that injecting high doses of omega-3s into the bloodstream helped alleviate redness, thickness, and scaling.

More specific research is needed to see how effective omega-3s can be, but don’t let that stop you from taking a daily supplement and adding salmon or tuna to your diet. More on that in a second.

Healthy fats include:

  • fatty fish like salmon, trout, herring, tuna, and sardines
  • walnuts, almonds, peanuts, and nut butters
  • flaxseeds, pumpkin seeds, sunflower seeds, and chia seeds
  • extra-virgin olive oil
  • avocado

Nutritional supplements

In addition to eating the foods we’ve mentioned, taking nutritional supplements may improve your psoriasis symptoms and overall health. Psoriasis has been linked to vitamin deficiencies, so it may be a good idea to discuss supplements with your doctor.

Research indicates that vitamin D supplements help with psoriatic symptoms. But make sure not to take too much of it, or kidney stones could be in your future.

Vitamin B-12 supplements may be beneficial since deficiencies have been linked to psoriasis. But research on their effectiveness is still inconclusive.

A 1989 study found moderate evidence that fish oil supplements improved psoriasis symptoms, especially if participants were also undergoing UVB therapy.

Many people with psoriasis have selenium deficiencies, and supplements have proven mildly effective in reducing symptoms.

Psoriasis is an inflammatory disease, so it makes sense to stay away from foods that cause extra inflammation in your body. Many of these foods are staples in Westerners’ diets, so it’s important to know what to avoid.

Red meat and dairy

On the off chance that these scientific journals aren’t part of a massive a vegan conspiracy, it seems red meat and dairy may not be doing your skin any favors.

They both contain a polyunsaturated fat called arachidonic acid (say that five times fast), which converts into inflammatory compounds. Red meat and dairy also tend to contain higher levels of saturated fat and cholesterol, which also cause inflammation.

Give the cold shoulder to:

  • red meat (beef, pork, lamb, and others)
  • cheese
  • cow’s milk
  • egg yolks

Gluten

People with psoriasis often share certain genetic and inflammatory symptoms with those who have celiac disease, a condition that causes extreme sensitivity to gluten in the small intestine.

Studies have shown that removing gluten from a patient’s diet can noticeably improve their psoriasis symptoms.

We get it: It’s 2019 and half the population has sworn off gluten, yet somehow the foods that contain it are still a mystery. We’ve got you.

Here’s a list of gluten-y foods to avoid:

Gluten-containing grains such as:

  • wheat and wheat varieties, including wheat berries, durum, emmer, semolina, spelt, farina, farro, graham, and einkorn wheat
  • rye, barley, triticale, malt

Gluten-containing foods such as:

  • pasta, noodles, bread, pastries, crackers, croutons, happiness, laughter, pancakes, waffles, beer, gravies, sauces, flour tortillas, breading and coating mixes

Possibly gluten-containing foods such as:

  • french fries, potato chips, the ability to see rainbows, soups, energy bars/granola bars

For a full list of foods that may include gluten (yes, there are still more), check out the Celiac Disease Foundation’s extensive list.

Processed foods

There are tons of reasons not to put processed foods in your body. The most relevant reason when it comes to psoriasis is that they’re full of refined starches, sugars, saturated fats, and trans fats, all of which can cause inflammation.

Plus, processed foods are linked to weight gain and obesity, which are often linked to psoriasis.

Hall of shame:

  • packaged foods like crackers and granola
  • processed meats like bacon, sausage, and deli meat
  • pre-made meals like frozen pizza and some microwaveable dinners (look for those with less fat and sodium and more veggies!)

Nightshade vegetables

Nightshades are part of the Solanaceae plant family, which includes eggplant and tomatoes, among other fruits and vegetables.

They can worsen symptoms of inflammatory bowel disease (which often coexists with psoriasis) by causing inflammation in the intestinal lining.

A 2017 survey sent to the National Psoriasis Institute showed that 52.1 percent of psoriasis patients who were asked to cut nightshades from their diets reported “full clearance or improvement” of their symptoms.

We love eggplant Parm, but it could be aggravating your psoriasis. You might want to try eliminating eggplant and other nightshades from your diet.

50 shades of nightshades to avoid (or maybe just the top 7):

  • eggplant
  • tomatoes
  • peppers
  • potatoes
  • paprika
  • tobacco
  • ashwagandha

Alcohol

We know what you’re thinking. We’ve already suggested you avoid so many enjoyable foods. What else could there be?!

Well… it goes by many names: vino, hooch, moonshine, the hard stuff, adult beverages. Whatever you want to call it, you should try cutting it out of your diet for a little while to see how your skin reacts.

Alcohol is known to have seriously negative side effects on the immune system. It also appears to affect men with psoriasis more negatively than women, even to the point of lowering their response to treatment.

Here are some dietary options to discuss with your doctor or dietitian.

Pagano diet

Dr. John Pagano is a chiropractor who published “Healing Psoriasis: The Natural Alternative,” an in-depth, holistically focused book in which he claims to be able to help people manage psoriasis through specific diet and lifestyle changes.

Pagano defines psoriasis as “the external manifestation of the body’s attempt to ‘throw off’ internal toxins.” He suggests following a high-alkaline (lots of leafy greens), low-acid (minimal red meat and dairy) diet and drinking herbal teas.

In a 2017 study, 72.2 percent of patients saw improvement in their symptoms after following this diet.

Gluten-free diet

People with psoriasis often share certain genetic traits with those who have celiac disease. In the same 2017 study, 52.9 percent of patients saw improvement in their symptoms as a result of following a gluten-free diet.

This diet is pretty straightforward: Cut out gluten and replace it with healthy, balanced, nutritious food choices. Remember, “gluten-free” doesn’t mean low-calorie and doesn’t indicate that foods contain healthy fats.

Vegan diet

A vegan diet is free from any animal products. No meat, fish, poultry, or dairy is allowed. Your diet consists of fresh produce, legumes, fruit, nuts, seeds, and whole grains.

The vegan diet was among the three highest-rated diets that generated positive results for psoriasis patients. When substituting meat with plant-based foods, make sure to plan your meals so you get enough of your daily vitamins and minerals.

Paleo Diet

The Paleo Diet’s website describes the diet as “based upon everyday, modern foods that mimic the food groups of our pre-agricultural, hunter-gatherer ancestors.”

Translation: Channel your inner cave person and fill up on high-protein (lean meats), high-fiber, low-carbohydrate foods. Paleo was the third most effective diet for psoriasis patients.

Mediterranean Diet

The Mediterranean Diet is full of anti-inflammatory foods like olive oil, fresh fish, fruits, and vegetables and includes limited red meat.

Psoriasis patients who followed a Mediterranean diet showed a reduction in psoriasis symptoms. This diet is also recommended for other conditions, such as diabetes and heart disease.

Keto diet

The keto diet is a very-high-fat, very-low-carbohydrate diet that comes with risks and should be followed only with the guidance of a dietitian or medical provider.

Very-low-calorie keto diets have been shown to alleviate some symptoms in relapsing plaque psoriasis, especially in patients with higher body weights. But more research is needed to determine whether keto or a standard low-calorie diet is the best way to go.

Though psoriasis can be mentally and physically taxing, there are things you can do to manage your symptoms. Avoid common triggers and speak to your doctor about finding the right diet.

Research into the effects of specific foods on psoriasis symptoms is ongoing. Each person has different triggers, and keeping a food diary may help you identify yours.