Psoriasis and Exercise: A Review

Abstract

Psoriasis is a prevalent inflammatory skin disorder that is associated with a number of comorbidities including cardiovascular disease and metabolic syndrome. Exercise can influence the outcomes of chronic inflammatory diseases, and the presence of these diseases can also influence physical activity in afflicted patients. We reviewed the available literature published on exercise in psoriasis patients and aimed to explore physical activity levels, barriers to exercise, physical fitness, exercise as a prevention strategy as well as a treatment modality. Overall, patients with moderate to severe psoriasis are more sedentary than the general population and experience barriers to exercise secondary to their skin disease. Moderate to vigorous exercise may be an independent preventative factor in reducing the incident risk of developing psoriasis and the utilization of exercise as a weight loss strategy may improve disease severity especially in overweight patients. Expert panels agree that exercise can be beneficial as an adjunct treatment in patients with psoriasis who are overweight; however, more randomized clinical trials are needed to establish these links.

The Impact of Diet and Physical Activity on Psoriasis: A Narrative Review of the Current Evidence

“…Physical inactivity, defined as “An insufficient physical activity level to meet present physical activity recommendations” [ 74 ], is one of the crucial factors responsible for obesity and abdominal fatness [ 75 ]. Fat cells (adipocytes) are a source of pro-inflammatory adipokines (leptin and resistin).…”

“…They can induce T helper 17 cells secreting pro-inflammatory cytokines (TNF-α and IL-6) and CRP [ 76 ]. Obesity, fatness, and physical inactivity are likely critical risk factors for psoriasis development [ 75 ]. Evidence has shown that regular physical exercise (PE) of moderate intensity (50–<60% VO 2 max) (e.g., walking, dancing, yoga, badminton, downhill skiing, gardening) is an important factor regulating ROS/RNS levels in cells, protecting them against low levels.…”

“…As regular moderate-to-vigorous PE has essential anti-inflammatory and antioxidative abilities, a significant question is what dose of PE and intensity is needed to reduce the risk of psoriasis. Evidence has long demonstrated that patients with psoriasis take up less intensive PA than those without psoriasis [ 4 , 75 ] and have a higher risk of developing cardiovascular disease, obesity, and metabolic alteration, among others [ 86 ]. In recent years, two reviews and meta-analyses have quantified the association of psoriasis with PA [ 4 , 75 ].…”

“…Evidence has long demonstrated that patients with psoriasis take up less intensive PA than those without psoriasis [ 4 , 75 ] and have a higher risk of developing cardiovascular disease, obesity, and metabolic alteration, among others [ 86 ]. In recent years, two reviews and meta-analyses have quantified the association of psoriasis with PA [ 4 , 75 ]. A review and meta-analysis by Zheng et al [ 4 ] based on 13 observational studies performed from January 1970 to February 2017 demonstrated that patients with severe psoriasis performed vigorous PE 32% less often than controls.…”

Do Sleep Disorders and Western Diet Influence Psoriasis? A Scoping Review

“…At the same time, the pathological manifestations of PsO (phenotype) are the product of the intricate interaction between genetic susceptibility [ 15 ] and environmental factors (i.e., diet or circadian rhythm) [ 16 ] ( Figure 1 ). Several studies pointed out that in western societies, unhealthy lifestyles may deeply condition the PsO march and flare frequency; in particular, unbalanced diets (i.e., western diet) with high fat and/or high sugar [ 17 , 18 ], inadequate sleep [ 19 ] and insufficient physical activity [ 20 ] may be triggers. Furthermore, all these PsO triggers may converge in creating gut dysbiosis [ 21 ], not necessarily identifiable as small intestinal bacterial overgrowth (SIBO) [ 22 ], but potentially critical for PsO and psoriatic arthritis (PsA) flares.…”