Food and diet

Diet is one of the factors which most strongly affects growth, mental and physical development, and our lives in general.

We live in an age where we have a wealth of information at our fingertips, with all human knowledge just a mouse click away! Not to mention articles in every magazine, television programme, and messages on every kind of media.

Everywhere we turn there are gurus inventing dietary regimens with varying degrees of strictness, able to cure every kind of illness, extraordinary claims requiring extraordinary supporting data, claims which become worthless without scientific studies or statistics to back them up.

Every guru has his own sworn enemy, be it flour, fats, or carbohydrates, spreading fear and confusion. Everyone we talk to is suddenly an expert, dispensing miracle advice left, right and centre.

It seems too good to be true! Because it probably isn’t.

The guru is eclectic and comes in many forms, from your neighbour “reborn” thanks to a bewildering array of magic potions, a Hollywood diet coach, or the taxi-driver moonlighting as a nutritionist…

• Are there books about diet and psoriasis?
• What does a good diet consist of?
• Is there a link between diet and psoriasis?
• The benefits of Mediterranean diet
• The new food pyramid
• Does our lifestyle affect our diet?
• The gut, our second brain
• Can food be a medicine?
• Dietary intolerances
• Drugs and diet: side effects
• Psoriasis and obesity
• Conclusions

Are there books about diet and psoriasis?

There are dozens of websites offering miracle diets to cure psoriasis, as well as various books with names like “The Diet to Cure Psoriasis.” The most famous include:

John Pagano – “Healing Psoriasis: The Natural Alternative”

Jean Seignalet – “Nutrition – the third medicine” in which Dr. Seignalet claims that by following a certain diet, a large percentage of patients improve or are cured of dozens of diseases, including psoriasis (out of 72 patients: 45 complete remissions, 15 remissions of 50-90%, and 12 failures).

Similar titles can be found for dozens of other diseases. In the 1930s, Dr. Catherine Kousmine developed a “miracle diet” for multiple sclerosis.

What does a good diet consist of?

Human beings need a huge variety of nutrients, and cutting out entire categories of foods from our daily diet can have serious consequences.

Today, certain foods essential for good health, such as wholegrain cereals and cold-pressed oils, have all but disappeared from our dinner tables, while the consumption of packaged, conserved, and pre-cooked foods, as well as refined foods such as sugars and flours, has increased dramatically.

A balanced diet means providing our body with the recommended amount of nutrients to:

1. Support growth
2. Maintain our body weight
3. Prevent the development of diseases associated with dietary excesses or deficiencies.

An optimal nutrition requires us to consume those foods which:

1. Optimise and strengthen our own individual physiological functions
2. Ensure health and wellbeing
3. Minimise the risk of disease.

Is there a link between diet and psoriasis?

Psoriasis is a chronic, multifactorial, inflammatory, autoimmune disease (see this link for more information on psoriasis) caused by genetic, environmental and behavioural factors: nutrition is just one piece of a complex puzzle.

The idea of positively changing the course of the disease through diet has always sparked the interest of scientists, who have focused their research on this very topic.

The studies conducted to identify the relationship between diet and psoriasis have often led to conflicting results which have in any case allowed researchers to explore a number of aspects previously considered to be of little importance, such as the relationship between psoriasis and body weight, or the error of believing psoriasis to be a disease of “healthy” individuals, whereas psoriasis patients tend to develop comorbidities such as cardiometabolic diseases, high blood pressure and diabetes, often caused by the lifestyle adopted by patients to “escape” the disease.

Many physicians interviewed believe Mediterranean diet pyramid to be the best approach, albeit with some minor changes.

The benefits of the Mediterranean diet

The word “diet” comes from the Greek term “δίαιτα”, meaning balance, lifestyle. Today, we use the term inappropriately to refer to a low-calorie regimen to lose weight, or to the modification of our way of eating following the onset of disease. It was the American physiologist Ancel Keys, working with the Allied troops during the Second World War, first in Crete and then in Paestum, who first began to realise the health benefits of the diet of those living in the Mediterranean countries. Following a rigorous epidemiological study, known as the “Seven Countries Study” (USA, Japan, Holland, Finland, Yugoslavia, Italy, Greece), he concluded that those living in Mediterranean countries had very low levels of cholesterol and a low incidence of myocardial infarction.

But what does the Mediterranean diet consist of?

It comes from the ancient Greek triad:

• olives
• wheat
• grapes

to which were added:

• meat
• fish 
• vegetables

It is a way of eating based on fresh, seasonal foods, few saturated fats (such as those in whole milk, cream, processed meats and fried foods) in favour of polyunsaturated fats (such as those in olive oil, fish, cereals and pulses).

The Mediterranean diet consists of:

• 3 meals
• 2 snacks
• physical excercise

The World Health Organisation and the Food and Agriculture Organisation recommend consuming at least 400 grammes of fruit and vegetables daily, split into 5 portions spread throughout the day.

For more information on obesity and diet see the talk given by Dr. Andrea Conti (in italian) at the conference “C’è cibo e cibo“.

The NEW food pyramid

As you can see, the base of our new food pyramid consists of 3 essential elements which are often overlooked, but which form an extremely important part of our diet: eating together, water, and physical exercise. Of these three, the element most important for life – water – deserves a particular mention. Find out more about the role of water in the food pyramid.

In general, if you suffer from psoriasis, these are the foods to opt for, and those to eat in moderation:

Foods to eat in moderation:

As already mentioned, fruit and vegetables should be eaten fresh to provide our bodies with the right quantity of vitamins and minerals.

Example: sodium in 100 g of fresh peas 1 mg, in tinned peas 230 mg.

The following fresh foods provide the right quantity of vitamins:

• vitamin C: citrus fruits, strawberries, kiwifruit, blackberries, cabbage, tomatoes
• vitamin A: carrots, spinach, melon, peaches, dandelion, egg yolk, milk, butter, cod liver oil, calf liver
• vitamin D*: whole eggs, sardines, herring, chicken giblets, cod liver oil, milk and milk derivatives
• vitamin E: cold-pressed vegetable oils, nuts (walnuts, hazelnuts, almonds)
• vitamin B12: fish, milk, eggs, green leafy vegetables, rice, brewer’s yeast, offal

*A recent study (Gisondi) has shown that on average, psoriasis sufferers have significantly lower Vitamin D levels than the general population (81 cases out of 145).

The following foods are high in minerals:

• calcium: milk and milk derivatives, dried beans and pulses, nuts, oily fish, sesame seeds
• magnesium: wholegrain cereals, nuts, pulses, cocoa, figs, dates
• potassium: dried fruit (apricots, figs, sultanas), nuts, brewer’s yeast, cabbage, carrots, tomatoes, potatoes, mushrooms, bananas, apples, tuna
• sodium: egg yolks, algae, sardines, celery
• phosphorus: brewer’s yeast, egg yolks, nuts, pulses, milk and cheese, fish, meat, poultry
• sulphur: cabbage, onions, garlic, asparagus, leek, radicchio, fish, eggs, meat, beans, chickpeas

Is diet affected by lifestyle?

The Mediterranean diet food pyramid, which in practical terms translates to a certain way of living, of being, does not only consist of food: socialising and sharing at the dinner table – synonyms of openness and dialogue, moderation, cooking with love and inventiveness, respect for the rhythms and cycles of nature, all combine to create the heritage that is able to combat chronic disease and affect our quality of life.

The term “quality of life” in health terms, according to the World Health Association, generally refers to the wellbeing (emotional, social and physical) of an individual and his or her ability to satisfactorily carry out the activities of daily living.

The gut, our second brain

As well as our diet, we also need to take care of our gut, responsible for a huge range of disorders, especially inflammatory and autoimmune diseases such as psoriasis.

Over the last few years, continuing to study the mechanisms by which our body works, we have come to realise that the role of the gut in the human organism is much more important than once thought (it was considered a peripheral structure with minimal functions), a discovery which has led to the ever-more frequent use of the term second brain when referring to this organ.

This was stated by Michael D. Gershon, expert in anatomy and cell biology at Columbia University, author of the bestselling “The Second Brain”:

“Just think that the gut, while having only a tenth of the neurons of the brain, working independently, helps to fix the memories related to emotions and plays a key role in signalling joy and pain. In short, the intestine is the site of a second brain itself. It is no coincidence the gut cells – explains the American expert – produce 95% of serotonin, the neurotransmitter of well-being.”

Over the last few years, researchers have discovered that the role of the gut microbiota (the intestinal bacterial flora) is of vital importance for our health because it carries out various tasks:

• it regulates the digestion of foods and the absorption of the fundamental nutrients; it
• defends our bodies from pathogens
• produces hormones
• it is constantly in contact with the central nervous system

The key to stress, anxiety and tension is in our belly. The truth is that nutrition significantly influences our thinking and our unconscious mind, as well as demonstrating a direct link with the development of almost all diseases.

A normal individual over the course of a lifetime accumulates toxic waste and residues, normally excreted via the kidneys, lungs and bowel, therefore its malfunctioning or blockage is harmful for our wellbeing and requires ongoing “cleaning” from the inside out.

Refined foods (certain flours, sugar, milk) create a film over the walls of the gut, preventing the absorption of vital nutrients, and are best avoided.

Can food be a medicine?

Vegetables are a good source of vitamins, minerals and fibre, the latter very important for regulating intestinal function, as well as reducing the absorption of fats and sugars. Extra-virgin olive oil is a powerful antioxidant. Nuts are high in vitamins and minerals, as well as in unsaturated fats, which help to reduce blood cholesterol and prevent arteriosclerosis. Pulses have long been known for their high content of vegetable protein and fibre.

The Mediterranean diet is associated with a lower risk of Alzheimer’s disease. The suggested consumption of fresh fruit and vegetables is associated with a lower risk of cardiovascular diseases, slows the ageing process, and fights inflammation.

And so it prompts the question: can food be a medicine?

“Let food be thy medicine and medicine be thy food” 390 B.C. Hippocrates

“The doctor of the future will give no medicine, but will interest his patient in the care of the human frame, in diet and in the cause and prevention of disease” – Beginning of the 20th century Edison

“… medicine was divided into three branches: one which cured by diet, another by medicine and the third by surgery… of the three branches of medicine, that branch of medicine which cures by diet, is the most difficult, so also is the noblest…” Aulus Cornelius Celsus – physician

So let us consider foods from another standpoint – as nutraceuticals.

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The word “nutraceutical” is a portmanteau of the words “nutrition” and “pharmaceutical” and refers to food components with significant benefits for human health, both curative and preventive.

Antioxidants are substances able to neutralise free radicals and protect the body from their negative action.

These waste products form in the cells of our body due to various factors such as pollution, cigarette smoke, certain drugs, UV rays, and many others. If a balance is not established between these free radicals and the substances able to neutralise them, known as antioxidants, their oxidising effect can lead to or accelerate various diseases such as Alzheimer’s and Parkinson’s disease, baldness, ageing, and inflammatory and cardiovascular diseases, resulting in damage which can cause progressive “wear and tear” of the body and mind over the long term.

Dietary intolerances

Dietary intolerances are a slow, insidious, and progressive reaction of the intestine, which does not tolerate the ingestion of massive amounts of certain foods. As opposed to food allergies, intolerances begin gradually rather than suddenly, and are always associated with the quantity of the food that is ingested.

What about tests for dietary intolerances?

“Very few of these tests are scientifically proven on a genetic basis; notable exceptions are those for lactose, and partially that for coeliac disease, and a positive result is not sufficient to diagnose the disease.”  Dr. Silvio Nanni

Drugs and diet: side effects

Are there foods which can interact with drugs, interfere with drug treatment, or increase side effects? Some foods can influence the efficacy and the therapeutic effect of a drug.

Alcohol, for example, can increase or reduce the effect of many psychiatric drugs.

Grapefruit juice and seeds should be avoided when taking drugs such as ciclosporin, quinine (anti-malarial), and some calcium antagonists, antihistamines, or drugs used to treat hypertension.

If taken with drugs used to treat heart failure or cardiac arrhythmias, liquorice can render diuretics and drugs used for high blood pressure ineffective.

The caffeine in chocolate can also interact with various stimulants, increasing their effect, or can interfere with the effect of sedative and hypnotic drugs.

Those taking anticoagulants should avoid cranberries, garlic and ginger which increase the risk of bleeding, bananas, eggs, milk and milk derivatives which can render antibiotics ineffective.

In addition, many drugs should be taken between meals.

See this link for a medical document on food and drug interactions.

Psoriasis and obesity

Patients with psoriasis are often overweight compared to the general population and are frequently obese. Find out more about the link between psoriasis and obesity.
It is important for those with psoriasis to keep their body weight under control, because it can affect systemic treatments and their efficacy.
The combination of weight loss, a balanced diet and physical exercise can contribute to reducing both relapses and the severity of the illness.

Conclusions

So to sum up, we can conclude that:

• a dietary approach is fundamental for psoriasis sufferers to optimise the efficacy of treatment
• weight loss is recommended for those at risk of obesity
• the Mediterranean diet is recommended
• patience is key: it will take a while to see lasting results

The long-term impact of diet on psoriasis still remains to be explored.

One last suggestion: to stay in shape, it is best to start the day with a hearty breakfast to reduce the amount of food consumed at lunch and dinner.