Plain language summary
Psoriatic arthritis is an autoimmune disorder marked by persistent inflammation. Recent studies suggest a connection between obesity and psoriasis, as visceral fat contributes to systemic inflammation through the release of inflammatory cytokines and adipocytokines. Dietary approaches like the Mediterranean diet (MD) and Ketogenic diet (KD) can potentially aid in weight loss and inflammation reduction. This randomised crossover study examined the effectiveness of a classic Mediterranean diet and an isocaloric Ketogenic diet over twenty-two weeks in patients with psoriatic arthritis, obesity, and pre-existing psoriasis. The findings demonstrated significant improvements in weight, body mass index, waist circumference, total fat mass, and visceral fat with both the Mediterranean and Ketogenic diets. However, the Ketogenic diet showed a statistically significant improvement in psoriasis and psoriatic arthritis, as well as in the levels of inflammatory biomarkers, compared to the Mediterranean diet. Healthcare professionals can leverage the findings of this study to understand the beneficial effects of the Mediterranean and Ketogenic diets on metabolic markers, inflammatory markers, and psoriasis. However, additional robust studies are needed to confirm these results, as the existing research on this topic is limited.
Abstract
The effect of different diet patterns on psoriasis (PSO) and psoriatic arthritis (PSA) is unknown. Τhe aim of our study was to evaluate the effectiveness of a Mediterranean diet (MD) and Ketogenic diet (KD), in patients with PSO and PSA. Twenty-six patients were randomly assigned to start either with MD or KD for a period of 8 weeks. After a 6-week washout interval, the two groups were crossed over to the other type of diet for 8 weeks. At the end of this study, MD and KD resulted in significant reduction in weight (p = 0.002, p < 0.001, respectively), in BMI (p = 0.006, p < 0.001, respectively), in waist circumference (WC) (p = 0.001, p < 0.001, respectively), in total fat mass (p = 0.007, p < 0.001, respectively), and in visceral fat (p = 0.01, p < 0.001, respectively), in comparison with baseline. After KD, patients displayed a significant reduction in the Psoriasis Area and Severity Index (PASI) (p = 0.04), Disease Activity Index of Psoriatic Arthritis (DAPSA) (p = 0.004), interleukin (IL)-6 (p = 0.047), IL-17 (p = 0.042), and IL-23 (p = 0.037), whereas no significant differences were observed in these markers after MD (p > 0.05), compared to baseline. The 22-week MD-KD diet program in patients with PSO and PSA led to beneficial results in markers of inflammation and disease activity, which were mainly attributed to KD.
Methodological quality
Jadad score
:
3
Allocation concealment
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No
