Dietary Improvement in Psoriatic Arthritis Save

The results of the DIETA trial showed that dietary changes may control psoriatic arthritis (PsA) disease activity, independent of weight loss.  

The study set out to investigate whether dietary changes or antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with PsA.

The DIETA trial included 97 PsA patients who were treated for 12-week and randomized into three groups: 1) Diet-placebo (hypocaloric diet + placebo supplementation); 2) Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; or 3) Placebo. Dietary history was assessed along with body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA). 

At 12 weeks, disease activity outcomes were improved in Diet-placebo group (hypocaloric)

• DAS28-CRP - 0.6 ± 0.9; p = 0.004
• BASDAI scores - 1.39 ± 1.97; p = 0.001
• A higher proportion of patients achieved minimal disease activity (MDA) in all groups.

The Diet-fish supplementation group showed significant weight loss (- 1.79 ± 2.4; p = 0.004), as well as waist circumference (- 3.28 ± 3.5, p < 0.001) and body fat (- 1.2 ± 2.2, p = 0.006) reductions.

There was no significant correlation between weight loss and disease activity improvement.

Additionally, each 100-cal daily intake increase caused a 3.4-fold DAS28-ESR impairment.

While the hypocaloric intervention benefitted disease activity (regardless of weight loss), Adding omega-3 supplementation caused relevant body composition changes but not disease activity improvement.