Psoriasis patients fare well with Mediterranean diet

For patients with mild to moderate psoriasis, adopting a Mediterranean diet can help relieve their symptoms, as shown in the open-label MEDIPSO* trial.

After 16 weeks, the estimated marginal mean (EMM) change in Psoriasis Area and Severity Index (PASI) score was −3.4 points (95 percent confidence interval [CI], −4.4 to −2.4) among participants who underwent a dietitian-guided Mediterranean diet program that involved nutritional counselling, educational materials, and weekly provision of extra virgin olive oil (intervention group) vs 0.0 (95 percent CI, −1.0 to 1.0) among those who received standard low-fat dietary advice without dietitian supervision (control group) (between-group EMM difference, −3.4, 95 percent CI, −4.8 to −2.0; p<0.001). [JAMA Dermatol 2025;doi:10.1001/jamadermatol.2025.3410]

More participants in the intervention vs the control group met the PASI response thresholds. A total of 68.4 percent in the intervention group achieved a 50-percent reduction in PASI (PASI 50) as opposed to only 11.1 percent in the control group (p<0.001). Moreover, in the intervention group, 47.4 percent reached PASI 75 (p<0.001), 26.3 percent reached PASI 90 (p=0.046), and 10.5 percent reached PASI 100 (p=0.49), whereas none of the participants in the control group met these thresholds.

These improvements in disease severity correlated with increased dietary adherence as measured by the energy-restricted Mediterranean Diet Adherence Screener score (p<0.001) and occurred without significant weight loss, suggesting that the beneficial effect was independent of body weight changes, according to the investigators.

Equally important was that participants in the intervention group were able to reduce their reliance on topical medications, confirming that the skin improvements were not due to increased use of such medications, they added.

Beyond skin outcomes, the intervention was also associated with a significant reduction in HbA_1c compared with the control, with a between-group EMM difference of −4.1 mmol/mol (95 percent CI, −6.9 to −1.3; p=0.01).

“While modest, this change [in glycated haemoglobin] is clinically relevant and supports previous evidence suggesting that Mediterranean diet patterns improve glycaemic control,” the investigators noted. [Nutrients 2023;15:3156]

Taken together, “the findings of this study support the incorporation of structured nutritional interventions as part of comprehensive psoriasis management. A Mediterranean diet is not only culturally acceptable and sustainable but may also offer added cardiometabolic benefits in a population at increased risk of cardiovascular disease,” they said.

The analysis included 38 participants (mean age 46.4 years, 65.8 percent male) with mild to moderate psoriasis. Of these, 19 were in the intervention group and 19 were in the control group. The median PASI score at baseline was 4.8 and 3.8 points in the respective groups.

Several adverse events were documented during the trial, including acute viral bronchitis and scrotal abscess in the intervention group and an upper respiratory tract infection and pneumonia in the control group, none of which required hospitalization. These events were deemed unrelated to the dietary intervention.

“Future multicentre trials with larger samples and longer follow-up are warranted to validate these findings and better define the long-term role of dietary interventions in psoriasis,” the investigators said.

*Impact of the Mediterranean Diet on Patients With Psoriasis