Can Diet and Exercise Really Impact Psoriasis? A Look at the Evidence.

🔍 Key Finding Patients with psoriasis are less physically active than those without, engaging in less vigorous and regular exercise, potentially due to both physical limitations and psychosocial factors. Dietary interventions, including anti-inflammatory diets and personalized nutrigenomic approaches, may offer additional therapeutic benefits for psoriasis management.

🔬 Methodology Overview

• Design: Narrative review
• Data Sources: PubMed and Google Scholar databases
• Selection Criteria: English language publications between January 2012 and November 2022. Original human studies, reviews, or reviews and meta-analyses examining the association between diet/physical activity and psoriasis. For physical activity studies: Inclusion of relative risk or odds ratio (RR/OR) and 95% confidence intervals (CIs) or quantification of impact, adjusted for confounders or matched.
• Analysis Approach: Qualitative synthesis of findings.
• Scope: Dietary recommendations, nutrigenomics, and the role of diet and physical activity in psoriasis prevention and treatment.

📊 Results

• Patients with severe psoriasis were 32% less likely to perform vigorous physical activity than controls.
• Psoriasis patients engaged in moderate-intensity exercise 60% more often than controls.
• Psoriasis patients were 12% less likely to undertake regular physical exercise than controls.
• Patients with severe psoriasis were 3.42 times less physically active compared to those without psoriasis (OR = 3.42 [95% CI 1.47-7.9]).
• Individuals with psoriasis had a median physical activity level of 693 MET-min/week compared to 2016 MET-min/week in controls.
• Patients with psoriasis chose treadmill speeds 13-18% slower than controls and experienced more pruritus during exercise.
• Vigorous physical activity may reduce the risk of incident psoriasis by 28% (RR = 0.72 [95% CI: 0.59-0.89]).

💡 Clinical Impact This review highlights the importance of personalized anti-inflammatory diets and regular moderate physical activity in managing psoriasis, potentially leading to the development of integrated lifestyle interventions by physicians and physical therapists as part of holistic patient care. This could shift clinical practice towards incorporating dietary counseling and exercise recommendations alongside pharmacological treatments.

🤔 Limitations

• Varied methods used to determine physical activity across studies impacting reliability and validity.
• Small sample sizes and limited research on the topic.
• Few studies considered potential confounding variables like age, BMI, psoriasis type, and diet.
• Lack of specific guidelines for exercise frequency and dose for psoriasis management.
• Insufficient data on the long-term effects of combined diet and exercise interventions.

✨ What It Means For You Physicians and physical therapists should educate psoriasis patients about the benefits of a personalized anti-inflammatory diet and regular moderate-intensity exercise to improve disease management and reduce comorbidities. This includes incorporating nutrigenomic discoveries, such as the impact of nutrients on miRNA modulation, to personalize dietary recommendations and address individual patient needs. Furthermore, addressing patient concerns about exercise-induced discomfort and providing practical strategies to overcome barriers can encourage increased physical activity.

Reference Duchnik E, Kruk J, Tuchowska A, Marchlewicz M. The Impact of Diet and Physical Activity on Psoriasis: A Narrative Review of the Current Evidence. Nutrients. 2023;15:840. https://doi.org/10.3390/nu15040840