Field Notes
Plant-Rich, Low Saturated-Fat Diet Associated With Reduced Psoriasis Severity
A diet of fruits and vegetables, whole grains, low-fat dairy foods, and lean meats, low in salt and sugar, is associated with reduced psoriasis severity, new research finds.
The new study by researchers at King's College London, published in the British Journal of Nutrition, has found significant associations between diet quality and the severity of psoriasis. The findings provide novel insights into how dietary patterns may be related to psoriasis severity in non-Mediterranean populations.
Psoriasis is a long-lasting inflammatory skin disease that causes flaky patches of skin that form scales. Affecting millions worldwide, it is believed to be caused by a problem with the immune system.
The research analyzed data from 257 adults with psoriasis who had completed an online survey. Participants' adherence to various diet quality scores—including the Mediterranean Diet Score, the DASH score, and the Healthy Plant-based Diet Index—was assessed using a food frequency questionnaire. Psoriasis severity was self-assessed using a validated questionnaire.
Key findings from the study indicate that individuals with very low adherence to the DASH diet index and the Healthy Plant-based Diet Index were significantly more likely to report higher psoriasis severity.
Further analysis of the different elements of the DASH dietary pattern revealed that greater red and processed meat intake was associated with more severe psoriasis, even after considering BMI. Fruits, nuts, and legume intakes were also associated with less severe psoriasis, but this relationship wasn’t independent of BMI.
The study was published as part of the Asking People with Psoriasis about Lifestyle and Eating (APPLE) project, and was funded by the Psoriasis Association.
"Our findings point to the potential benefits of dietary interventions in improving patient outcomes," says Sylvia Zanesco, a PhD student from the department of nutritional sciences at King's College London who led the research. "Given the impact of psoriasis on physical and psychological well-being, incorporating dietary assessments into routine care could offer patients additional support in managing their condition."
The DASH dietary pattern was originally designed to lower blood pressure, and emphasizes fruits, vegetables, whole grains, low-fat dairy foods, and lean meats while limiting salt, sugar, and saturated fats. A high Healthy Plant-based Diet Index characterizes a dietary pattern rich in healthy plant foods including fruits and vegetables, whole grains, nuts and seeds, legumes, and plant oils rich in unsaturated fats, as well as being low in animal foods and unhealthy plant foods such as sugary foods and drinks and refined starches.
The study accounted for several confounding factors including age, sex, smoking status, alcohol, energy intake, and mental health, ensuring a comprehensive analysis of dietary patterns that are independently associated with psoriasis severity.
Emphasizing the broader implications of the findings, Wendy Hall, MSc, PhD, RNutr, a professor of nutritional sciences at King's College London and senior author of the study, says: "This research brings much-needed evidence that there may be a role for dietary advice, alongside standard clinical care, in managing symptoms of psoriasis. Our next steps will be to explore whether diets rich in healthful plant foods can reduce symptoms of psoriasis in a controlled clinical trial."
The findings of the study contribute to the growing body of evidence supporting dietary modification as a complementary strategy in psoriasis management to potentially alleviate disease severity and improve patients' quality of life.
Thivi Maruthappu, MA, PhD, FRCP, ANutr, a consultant dermatologist and key investigator on the study, says: "People with psoriasis often ask about how the food they eat affects their skin, and whether changing their diet helps; this research brings us closer to answering these important questions."
— Source: King's College London
Third of Children Worldwide Forecast to Be Obese or Overweight by 2050
Obesity rates are set to skyrocket, with one in six children and adolescents worldwide forecast to be obese by 2050, according to a new study. But with significant increases predicted within the next five years, the researchers stress urgent action now could turn the tide on the public health crisis.
The research, led by Murdoch Children's Research Institute (MCRI) and published in The Lancet, found a third of children and adolescents will be overweight (385 million) or obese (360 million) within the next 25 years. The forecast equates to 356 million children aged 5 to 14 years and 390 million aged 15 to 24 years with one in six facing obesity.
The global obesity rate for those between 5 to 24 years old tripled from 1990 to 2021, rising by 244% to 174 million, suggesting that current approaches to curbing increases in obesity have failed a generation of young people. As of 2021, 493 million children and adolescents were overweight or obese.
Jessica Kerr, PhD, says if immediate five-year action plans are not developed, the future will be bleak for our youth.
"Children and adolescents remain a vulnerable population within the obesity epidemic," she says. Prevention is key as obesity rarely resolves after adolescence.
"This giant burden will not only cost the health system and the economy billions, but complications associated with a high BMI, including diabetes, cancer, heart problems, breathing issues, fertility problems, and mental health challenges, will negatively impact our children and adolescents now and into the future, even holding the potential to impact our grandchildren's risk of obesity and quality of life for decades to come.
"Despite these findings indicating monumental societal failures and a lack of coordinated global action across the entire developmental window to reduce obesity, our results provide optimism that this trajectory can be avoided if action comes before 2030."
The analysis, released on World Obesity Day, used the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study led by the Institute for Health Metrics and Evaluation to estimate the latest overweight and obesity levels and forecasts in 204 countries and territories.
The United Arab Emirates, Cook Islands, Nauru, and Tonga are forcasted to have the highest prevalence while China, Egypt, India, and the United States will have the greatest number of children and adolescents with obesity by 2050.
In Australia, children and adolescents have experienced some of the fastest transitions to obesity in the world. Girls are already more likely to be obese than overweight. Overall, by 2050, 2.2 million of those aged 5 to 24 years are forecasted to be obese and 1.6 million overweight.
Globally, there will be more boys 5 to 14 years with obesity than overweight by 2050.
"Without urgent policy reform, the transition to obesity will be particularly rapid in North Africa, the Middle East, Latin America, and in the Caribbean, where the rise is concurrent with high population numbers and limited resources," Kerr says.
"Many regions have historically had to focus on preventing undernutrition and stunting in children. To prevent a public health emergency from this newer threat, an immediate imperative should be creating national surveillance surveys of obesity in children and adolescents in every country."
Kerr says older adolescent girls aged 15 to 24 years entering their reproductive years were a priority population for intervention.
"Adolescent girls who are obese are a main focus if we are to avoid intergenerational transmission of obesity, chronic conditions, and the dire financial and societal costs across future generations," she says.
"With this age group increasingly being out of school and cared for by adult services, we need to focus interventions at the community and commercial level."
MCRI Professor Susan Sawyer explains governments need to invest in multicomponent strategies that reduce obesity drivers across food and drink, activity, lifestyle, and the built environment.
"While people and families can work to balance their physical activity, diet and sleep, everything in our environments works to counteract these efforts," she says.
"Given this huge global shift in children's and adolescents' weight, we can no longer keep blaming people for their choices. We require governments to step up by addressing regulatory interventions, including taxing sugar-sweetened beverages, banning junk food advertising aimed at children and young people, and funding healthy meals in primary and secondary schools. We also need to consider the benefits of wider policies such as overhauling urban planning to encourage active lifestyles."
— Source: Murdoch Children’s Research Institute