Rebecca Valdez is a registered dietitian nutritionist and nutrition communications consultant, passionate about food justice, equity, and sustainability.
Anita Chandrasekaran, MD, MPH, is board-certified in internal medicine and rheumatology and currently works as a rheumatologist at Hartford Healthcare Medical Group in Connecticut.
Psoriatic arthritis (PsA) is an inflammatory disorder that can develop in individuals with the autoimmune condition psoriasis. It is a multisystem condition. This means it can impact many different parts of the body and cause a variety of symptoms, including joint pain and stiffness, swelling of the fingers and toes, skin and nail lesions, and back pain.
PsA treatment typically involves medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), or biologics. Along with following a prescribed treatment regimen, research has also shown that diet is an important part of PsA management. Some foods can help PsA symptoms, while others may make symptoms worse.
Learn which foods you should avoid and which foods you should add to your diet in order to keep your PsA symptoms under control.
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Since PsA is a disease characterized by inflammation, avoiding inflammatory foods may be helpful in reducing the severity of your condition.
Red meat, including beef, pork, lamb, and veal, contains high levels of saturated fatty acids (SFA). Diets that are high in SFAs are associated with many chronic inflammatory conditions, including obesity, type 2 diabetes, and cardiovascular disease. Red meat also contains heme, a compound that binds oxygen in the bloodstream and gives meat its red color. Some evidence suggests that heme may be damaging to the gut and contribute to systemic inflammation.
Ultra-processed foods such as prepackaged snacks, sweets, soft drinks, fast food, and processed meats have been linked to increased inflammation in the body. These foods often contain high amounts of saturated fat and sugar, which both contribute to inflammation and can increase the severity of PsA symptoms.
Low-fat dairy products such as milk, yogurt, and cheese can be beneficial when consumed in moderation by those without dairy intolerances or allergies. However, many people with PsA may have lactose intolerance (being unable to completely digest the sugar in milk) or dairy allergies, and consuming dairy products can lead to discomfort and exacerbation of symptoms.
High-fat dairy products such as whole milk, full-fat cheese, and ice cream are also high in saturated fats and may contribute to weight gain and obesity, which can trigger an inflammatory state that worsens PsA symptoms.
Consuming excessive amounts of sugar, found in many ultra-processed foods and drinks, is linked with obesity, metabolic syndrome (diseases that when combined can contribute to heart disease, stroke, and type 2 diabetes), and other inflammatory diseases, such as PsA.
Sugar can cause an abundance of pro-inflammatory cytokines, which are molecular messengers that tell cells what to do. High amounts of pro-inflammatory cytokines combined with low levels of anti-inflammatory cytokines contribute to increased inflammation, which can worsen the symptoms of PsA.
Eggplant is a member of the nightshade family, which also includes peppers, tomatoes, potatoes, and paprika. It has been proposed that nightshade plants may contribute to arthritis symptoms, due to their high solanine content, an alkaloid compound that can be toxic in high amounts and promote inflammation. However, evidence suggests that for most people, eating nightshades such as eggplant does not cause excess inflammation.
Some people may have a nightshade intolerance or a nightshade allergy that can cause mild to severe symptoms that mimic PsA symptoms, including skin rashes, gastrointestinal symptoms, or sore muscles and joints.
If you suspect you have a nightshade allergy, talk to your healthcare provider about getting an allergy test.
Just as there are foods that can aggravate inflammation, there are plenty of healthy foods that contain anti-inflammatory compounds that may help relieve the symptoms of PsA.
Fruits and vegetables are full of vitamins, minerals, phytochemicals, and antioxidants that have anti-inflammatory effects. A diet rich in fruits and vegetables can also help with weight loss and weight management, as these foods are relatively low in calories and high in fiber, keeping you full without exceeding your energy needs.
Fatty fish, such as salmon, tuna, and mackerel, are rich in omega-3 fatty acids, which are known to reduce inflammation throughout the body. Salmon is a great source of vitamin D and vitamin B12. Both vitamins are important in lowering inflammation and have been used to help treat psoriasis. Vitamin D also has positive effects on autoimmunity, which may help reduce the severity of diseases such as PsA.
Compared to refined grains such as white bread, rice, and pasta, whole grains contain more antioxidants, fiber, vitamins, and minerals. Types of whole grains include:
Antioxidants in whole grains are anti-inflammatory. One study found that compared with a diet rich in refined grains, a diet rich in whole grains reduced body weight and low-grade inflammation, both of which can help manage PsA.
Turmeric root has been used in Ayurvedic medicine for centuries to treat the symptoms of joint pain and inflammation in arthritis. The active compound curcumin, present in turmeric, has significant anti-inflammatory, antioxidant, antimicrobial, and anticancer properties. Adding turmeric to your diet, like in a latte or curry stir-fry, may reduce inflammation and managing your symptoms of PsA.
Studies have shown that curcumin may help manage the symptoms of many conditions, such as rheumatoid arthritis (RA) and irritable bowel syndrome (IBS). Most of the data, however, comes from curcumin supplementation, and consuming high doses is linked to gastrointestinal upset, increased risk of bleeding, and other side effects.
Like turmeric, ginger is a root that contains anti-inflammatory and antioxidant compounds that have been used to treat diseases similar to PsA, such as rheumatoid arthritis (RA). The active components in ginger, including gingerol, shogol, and zingerone, can help ease joint pain, a common symptom of PsA. These compounds have been shown to target some of the same pathways as common arthritis medications.
While there are specific foods to avoid and incorporate to help manage psoriatic arthritis, an overall healthy diet is the best way to harness nutrition to help control symptoms. Here are a few diets you may want to consider if you are living with PsA:
Everyone with PsA will have different triggers and dietary patterns that may relieve or exacerbate symptoms. An elimination diet may be helpful in identifying foods that worsen your PsA or make it better. This involves removing foods one at a time to narrow down precisely what is causing a flare-up.
When you eliminate a food, keep a record of your symptoms and how you are feeling. If your symptoms don’t improve, the food you eliminated likely is not the culprit and you should choose another food to eliminate. If your symptoms do improve, reintroduce the food slowly and see if your symptoms come back.
Psoriatic arthritis is an autoimmune condition that can cause serious symptoms, including joint pain, swelling, and skin rashes. Managing symptoms can be challenging, but choosing foods that are anti-inflammatory and rich in antioxidants, vitamins, and minerals may help reduce the severity of PsA.
Try to limit red meat, high-fat dairy, and ultra-processed and sugary foods and beverages, while adding in plenty of fruits, vegetables, whole grains, fatty fish, and anti-inflammatory spices.
Living with PsA can be difficult and overwhelming, even when it comes to making dietary choices to improve symptoms. However, finding the right foods may help you avoid inflammation and PsA flare-ups, as well as make you feel better overall. Discuss a diet plan with your healthcare provider or a licensed nutritionist.
Many things can trigger a PsA flare (or flare-up). Stress, injury, medications, infection, and eating a lot of processed foods, saturated fat, sugar, and alcohol can all aggravate PsA symptoms.
Bananas can be part of a healthy diet for those with PsA. Fruits such as bananas are rich in antioxidants, vitamins, and minerals, which can help reduce inflammation in the body and keep PsA symptoms under control.
Following your treatment plan prescribed by your doctor and maintaining a healthy diet can help prevent PsA from getting worse. Reduce saturated fat and sugar in your diet by limiting or eliminating processed foods, red meat, sugary drinks, and fast food. Increase your intake of antioxidant-rich fruits and vegetables and whole grains, and anti-inflammatory foods such as fatty fish, turmeric, and ginger.
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Rebecca Valdez is a registered dietitian nutritionist and nutrition communications consultant, passionate about food justice, equity, and sustainability.
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