Phan C, et al. – Investigators assessed the potential correlation between adherence to an anti-inflammatory Mediterranean diet and the onset and/or severity of psoriasis in this prospective, web-based questionnaire study. Findings revealed that the Mediterranean diet may delay the progression of psoriasis; therefore, consideration should be given to an optimized diet as part of a multidisciplinary intervention for the management of moderate-to-severe psoriasis.

Methods

• In France, the NutriNet-Santé program, an ongoing, observational, web-based questionnaire cohort study launched in May 2009 .
• Researchers conducted this study within the framework of the NutriNet-Santé program, collecting and analyzing data between April 2017 and June 2017.
• They identified the patients with psoriasis via a validated online self-completed questionnaire who were then categorized by disease severity: severe psoriasis, non-severe psoriasis, and psoriasis-free.
• During the first 2 years of participation, data on dietary intake (including alcohol) were gathered in the cohort to calculate the MEDI-LITE score (ranging from 0 [no adherence] to 18 [maximum adherence]).
• They also recorded potentially confounding variables (eg, age, sex, physical activity, body mass index, tobacco use, and a history of cardiovascular disease).
• In order to estimate the risk of having severe psoriasis or non-severe psoriasis compared with being psoriasis-free, adjusted multinomial logistic regression were used in the analysis.

Results

• Among the 158,361 total NutriNet-Santé participants, 35,735 (23%) replied to the psoriasis questionnaire (mean age [SD]: 47.5 [14.0] years; 76% women), of whom 10% reported having psoriasis.
• In 878 cases (24.7%), the condition was considered to be severe, and 299 (8.4%) incident cases were recorded (those arising > 2 years after participant inclusion in the cohort).
• After adjustment for confounding factors, results demonstrated a significant inverse relationship between the MEDI-LITE score and having severe psoriasis: odds ratio (OR), 0.71; 95% CI, 0.55-0.92 for the MEDI-LITE score’s second tertile (score of 8-9); and OR, 0.78; 95% CI, 0.59-1.01 for the third tertile (score of 10-18).