Dietary Inflammatory Index in relation to psoriasis risk, cardiovascular risk factors, and clinical outcomes: a case-control study in psoriasis patients

Abstract

Psoriasis is an inflammatory skin disease. Despite the understanding of the disease pathogenesis, the link between diet-induced inflammation and the risk of psoriasis remains underexplored. Therefore, we have examined the capability of literature-derived Energy-adjusted Dietary Inflammatory Index (E-DII) as a predictive tool for inflammation, incidence, and severity of psoriasis (as indexed by The Psoriasis Area Severity Index (PASI)). We have conducted a case-control study consisting of 149 adults (n = 75 cases and n = 74 controls). The E-DII score was calculated based on the dietary intake that was evaluated by a validated 168 item quantity food-frequency questionnaire. The E-DII tertile cut-offs were categorized based on the following cut points: tertiles 1 ≤ −1.99; tertiles 2 = −2.00 - 0.60; tertile 3 ≥ 0.61. Logistic regression models were applied to estimate the multivariable odds ratio (OR) that was adjusted for confounders. Patients with higher pro-inflammatory E-DII had a 3.60-times increased risk of psoriasis relative to patients in tertiles 1 (E-DIIT3 vs E-DIIT1: OR = 3.64; 95% CI 1.51, 8.79, P = 0.005). The severity of disease as indexed by PASI remained associated with E-DII (E-DIIT3 vs E-DIIT1: OR = 3.64; 95% CI 1.74, 7.57, P = 0.015). For each unit increase in E-DII, the odds of disease severity increased by 3-times. Patients consuming a more pro-inflammatory diet were at greater risk of psoriasis. These patients also demonstrate increased disease severity relative to individuals consuming a more anti-inflammatory diet.
 • A pro-inflammatory diet is associated with higher psoriasis incidence
 • Subjects with higher DII scores, had higher inflammatory markers levels.

The role of diet in the management of psoriasis: a scoping review

“…This theme reviews studies that explored the dietary intakes and habitual supplement use of people living with psoriasis (PLwP) (Table 2). The search identified nine studies that explored the dietary intakes of PLwP (45,(51)(52)(53)(54)(55)(56)(57)(58) . Among these, seven performed studies comparing the dietary intakes of PLwP with healthy controls (45,(52)(53)(54)(55)(56)(57) , one compared the dietary intake of PLwP with adults with other chronic inflammatory conditions and recommended national dietary guidelines (58) and six included studies compared the dietary intakes of PLwP depending on levels of psoriasis severity (51)(52)(53)(54)56,57) .…”

“…The search identified nine studies that explored the dietary intakes of PLwP (45,(51)(52)(53)(54)(55)(56)(57)(58) . Among these, seven performed studies comparing the dietary intakes of PLwP with healthy controls (45,(52)(53)(54)(55)(56)(57) , one compared the dietary intake of PLwP with adults with other chronic inflammatory conditions and recommended national dietary guidelines (58) and six included studies compared the dietary intakes of PLwP depending on levels of psoriasis severity (51)(52)(53)(54)56,57) . The search also identified two studies that investigated the habitual supplement use of PLwP compared with controls (59,60) .…”

“…The search also identified two studies that investigated the habitual supplement use of PLwP compared with controls (59,60) . All studies were cross-sectional, seven used food frequency questionnaires (FFQs) to assess dietary intake (45,(51)(52)(53)(54)(55)(56) , one used 3 × 24-h dietary recall (58) and one study used a 7-d food recall (57) .…”

“…Fibre intake was found to be significantly lower in PLwP compared with controls in three studies (45,54,57) . A further study found that fibre intake of PLwP was only 53•3% in females (n = 17) and 65% in males (n = 22) of Polish recommended dietary guidelines (30 g/d).…”

“…Several common significant differences in dietary intakes of food groups were observed between controls and PLwP. Three studies found that fat intake was significantly higher in PLwP compared with controls (52,54,57) . A further study compared dietary intakes of PLwP with the recommended dietary guidelines in Poland and found that the mean dietary intakes of fat in PLwP were 148% of the recommended dietary intakes (58) .…”