Psoriasis and the Mediterranean diet

Photo by G.steph.rocket via Wikimedia Commons

Study shows positive effects of diet on normal-weight patients with psoriasis

A healthy diet is widely considered to play a role in improving psoriasis symptoms, supporting the anti-inflammatory benefits of weight loss in overweight or obese psoriasis patients, but there are benefits independent of weight loss seen in patients of all body weights. That’s according to Dr. Javier Perez-Bootelloof, Hospital Universitario Ramón y Cajal in Madrid, Spain, and colleagues, as reported in the April/May 2026 issue of The Chronicle of Skin & Allergy.

Their randomized, single-centre MEDIPSO (Impact of the Mediterranean Diet on Patients with Psoriasis) trial compared a 16-week, intensive, dietitian-guided Mediterranean diet with standard low-fat dietary advice in 38 adults with mild to moderate psoriasis treated only with stable topical treatment. The intervention group received nutritional counselling, educational materials, and EVOO (suggested consumption of at least four tablespoons daily); the control group received standard low-fat dietary advice without dietitian supervision (JAMA Dermatology (Dec. 2025;161;(12):1215-1223)).

Median baseline PASI was 4.8 [IQR, 3.5-7.1] in the intervention group versus 3.8 [IQR, 3.6-6.2] in the controls. Following the Mediterranean diet resulted in a 75% reduction in PASI (PASI 75) in 47.4% of the intervention group, compared with none of the control group, according to the study. After controlling for potential confounders including topical treatment use and weight change, estimated changes in PASI at week 16 were −3.4 in the intervention group and 0.0 in the control group (p<0.001).

This improvement in disease severity was significantly correlated with increased adherence to the Mediterranean diet, “an association that remained significant after adjustment for age, sex, and BMI in an exploratory analysis,” the group wrote. As measured by the validated questionnaire energy-restricted Mediterranean Diet Adherence Screener (er-MEDAS), the change in score from baseline to week 16 was 8.2 in the intervention group versus 1.3 in the control group (p<0.001).

“Notably, the improvements in this study occurred without significant weight loss, suggesting that the attained beneficial effect was independent of body weight changes,” Dr. Perez-Bootello said.

Asked for his perspective, Dr. Danilo C. Del Campo, of the Chicago Skin Clinic in Chicago said the cardiometabolic benefits are important: “Psoriasis is not just a skin disease. Many of my patients are dealing with high blood pressure, cholesterol, or other markers of metabolic risk. Giving them one more reason to make these dietary shifts can help reinforce healthier habits and may lower their long-term health risks in the process.”

In an interview with The Chronicle of Skin & Allergy, Toronto dermatologist Dr. Sonya Abdulla said, “This is an interesting study showing how metabolic changes can impact treatment response. Here we are looking at a population who have self-selected for behaviour modification—while diet is one point of intervention, there are others including low-impact physical activity (this can be as simple as walking) that were not captured in this data set.”

“Dietary modification can improve A1C levels, but other factors may also be at play, particularly in the context of weight stability. Counselling on lifestyle modification is part of my consultation for all patients with chronic inflammatory skin disease and tailored based on the needs of the patient,” she said.

“The ‘anti-inflammatory diet’ or Mediterranean diet resonates with many patients with chronic inflammatory skin disease and simple cues—‘make your plate look like a rainbow’ are impactful. Our counselling on diet should be part of a more fulsome lifestyle modification strategy—limiting alcohol, smoking cessation, sleeping well, and staying active are all points of intervention. Celebrate the successes with patients, no matter how big or small, and understand that the metabolic impact in chronic inflammatory skin disease should reflect more than the number on the scale,” Dr. Abdulla concluded.

With files from Correspondent Kate Kneisel

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