Psoriatic arthritis and fasting: benefits and risks

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If you have psoriatic arthritis (PsA), the foods that are recommended for you are the same foods that are suitable for people with heart disease, cancer, and diabetes. Many of these foods, such as fruits, vegetables, nuts, and some fish, have anti-inflammatory properties that can help you manage your illness.

Foods that trigger psoriatic arthritis include saturated fat, sugar, alcohol, and simple carbohydrates. They can contribute to weight gain and potentially increase pressure on your joints. Maintaining your weight at a healthy level is the key to managing psoriatic arthritis.

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Types of intermittent fasting

Intermittent fasting is a diet that alternates between fasting and a regular diet. The idea is that while you are fasting, your body uses its sugar supply and burns stored fat. This process is known as metabolic switching.

Fasting times vary, but you can select a schedule that works best for you. Fasting times include:

  • Fast for 16 hours and eat one or two meals during the eight hour period
  • Eat five days, but for two days eat only one meal limited to 500-600 calories

Longer periods without food, such as 24, 36, 48, and 72 hour fasting periods are not necessarily better for you and can be dangerous. Spending too much time without eating might actually encourage your body to start storing more fat in response to starvation.

Benefits for Psoriatic Arthritis

If you have psoriatic arthritis, you will benefit from losing weight if you are overweight. By managing your weight, you can reduce the risk of other PR-related medical problems and reduce the strain on your joints.

In addition to weight loss, animal and human studies show that intermittent fasting speeds up metabolism and influences circadian rhythm, gut microbiota and lifestyle habits. Research shows that intermittent fasting can optimize autophagy, the process by which our body’s cells are recycled and regenerated, and that it can slow cell aging.

Research has also shown that intermittent fasting has a positive impact on psoriatic arthritis activity as measured by the Psoriasis Severity Index (PASI). Intermittent fasting is also associated with improved disease activity scores, enthesitis (inflammation of the entheses), and dactylitis (painful swelling of the fingers and toes).

Studies have further indicated that patients with rheumatoid arthritis (RA), another inflammatory form of arthritis, who engaged in fasting exhibited a rapid immune response with reduced inflammation. However, when the fast was over and food was reintroduced, the inflammation returned and symptoms returned.

Risks

The safety and long-term effects of intermittent fasting are still unclear. You should discuss your plans with your doctor and a nutritionist to determine if intermittent fasting is right for your lifestyle. Intermittent fasting carries the following risks:

  • Feeling sick: You might have headaches, low energy, mood swings, and constipation from fasting. If you experience these side effects, consider reducing the amount of time you fast or fast only periodically rather than continuously.
  • Eat too much: After the fasting period is over, people can overeat and gorge on unhealthy foods on the days they are not fasting. A 2018 study found that when you eat a low-calorie diet, your metabolism slows down and you have a greater appetite. Plus, research has shown that your circadian rhythm is disrupted by time-limited eating, which can lead to metabolic issues.
  • Seniors who lose too much weight: There is not enough evidence of the benefits of intermittent fasting for the elderly. Current studies have only looked at small groups of younger and middle-aged adults for a short time. Losing too much weight can affect bones, the immune system, and energy levels.
  • Potential danger with certain drugs: Many people with PsA also have other health problems like heart disease and diabetes. Intermittent fasting can be dangerous if you have diabetes and are taking medication for high blood pressure or heart disease. Imbalances of certain minerals like sodium, potassium, and other minerals can occur when you are fasting. Also, some medications force you to eat when you take them, or you may experience nausea and stomach irritation.

Who should not fast

Avoid fasting if you are taking medications for diabetes, high blood pressure, and heart disease. In addition, you should not fast if you are pregnant or breastfeeding. Children and the elderly should also avoid fasting.

Psoriatic Arthritis Physician Discussion Guide

Summary

Intermittent fasting involves eating and fasting on a regular schedule. Research has shown that intermittent fasting has many benefits, including speeding up your metabolism, optimizing cell turnover, and weight loss. It could potentially help with psoriatic arthritis by reducing the severity of the disease and relieving symptoms such as enthesitis and dactylitis.

However, it’s also linked to some risks, including overeating after fasting, excessive weight loss, and problems with the medications you take for other conditions.

A word from Verywell

Psoriatic arthritis can be managed. Before you decide to make drastic changes to your diet, like starting intermittent fasting, talk to your doctor and discuss the pros and cons first. When in doubt, talk to a psoriatic arthritis nutritionist. A nutritionist can tell you which foods can cause uncomfortable and painful breakouts and which foods can help.

Frequently Asked Questions

What foods trigger psoriatic arthritis?

Avoid processed meats high in saturated fat and sodium, alcohol, sugary drinks like soda, packaged snacks, white bread, rice, candy, and fried foods. These foods can trigger inflammation and make symptoms of psoriatic arthritis worse.

What are the causes of psoriatic arthritis flare-ups?

Along with an unhealthy diet high in fat, sodium, sugar, and processed foods, skipping and stopping any medication prescribed for the disease can also lead to a flare-up, a time when symptoms increase. Sunburn can cause a skin breakout. Flare-ups caused by injury, called Koebner’s phenomenon, can affect your joints. The key to minimizing flare-ups is to manage stress, get enough sleep, maintain a healthy weight, and exercise regularly.

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