PSORIASIS and DIET – Part 2

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In Part 1 we reviewed the research into diet and the various ways in which ones diet can impact on one’s health and the development of diseases such as psoriasis and arthritis.

Part 2 will concentrate on certain foods that can have a positive impact on one’s health and assist in the repair/healing processes.

It is known that throughout life, environmental conditions and dietary compounds influence gene expression. Only recently it has been observed that exposure to specific phytochemicals can affect gene expression via reversible epigenetic mechanisms and gets recorded in our “epigenome” through life. Epigenetics refers to heritable phenotypical differences or changes in gene expression that are not attributable to changes in DNA sequence, but rather depend on variations in DNA methylation, chromatin structure or microRNA profiles. As such, our dietary epigenetic imprint superposed on our genome may rewire gene expression patterns in the body and the host immune system, and protect against inflammatory disorders, cancer and ageing. 1

It has also been found that the metabolism of nutrients may vary person to person and ultimately result in different health status depending on the genotype of an individual. Nutrigenomic trends towards individualizing/personalizing foods (both to avoid and to consume) and nutritional supplementation, that leads to individual strategies to not only maintain good health but, more importantly, to assist in repair processes.

Phytochemicals/ phytonutrients/ phytonutriceuticals are organic compounds derived from plants that have health protective effects. Besides the common nutrients such as carbohydrates, amino acids and protein, there are certain non- nutrient phytochemicals in vegetables that have biological activity against chronic diseases. They are low in fat and like all plant products, contain no cholesterol. Most phytochemicals are found in relatively small quantities in vegetable crops. However, when consumed in sufficient quantities, phytochemicals contribute significantly towards protecting living cells against chronic diseases. 2

Cruciferous vegetables are vegetables of the family Brassicaceae (also called Cruciferae) which includes vegetable, such as kale, red and white cabbage, broccoli, brussels sprouts, cauliflower, turnip, Chinese cabbage and pak choi. This group of vegetables contains well-known antioxidants, such as vitamins C, E, carotenoids and antioxidant enzymes such as catalase, superoxide dismutase (SOD) and peroxidase, which are found in fresh vegetables. these vegetables are also rich in beneficial plant’s metabolites, which include sulfur containing glucosinolates, anthocyanins, flavonoids, terpenes, S-methylcysteine sulfoxide, coumarins and other minor compounds.4,5 Studies have also identified many compounds that have been isolated from Brassica vegetables and the pharmacological studies in vitro or in vivo have shown that they have a large spectrum of biological activities, including antiinflammatory, antibacterial, antifungal, antitumor, antimutagenic, neuroprotective and antioxidative properties. 4,5

The health potential of Brassica vegetables are partially attributed to their intricate fusion of phytochemicals and their antioxidant activity. Recently, considerable research has been aimed at the detection of plant derived natural antioxidants which can be utilized for human consumption for prevention of non-transmissible chronic diseases and promotion of health. Phytochemicals from Brassica vegetables may act on different and complementary levels. They prevent oxidative stress, induce detoxification enzymes and stimulate the immune system. Reactive oxygen species (ROS) in the body can cause lipid and protein oxidation, DNA damage, base modification and modulation of gene expression. 4,5

Antioxidants counteract, or neutralize, the harmful effects of free radicals. These antioxidants act as scavengers for these tree radicals and reactive oxygen species, thereby preventing them from disrupting the chemical stability of the cells. A variety of external factors such as inflammation, cigarette smoke, air pollutants, radiation (X-rays and ultra-violet rays) can promote free radical formation in our body. Consequently, individuals exposed to these sources of oxidants would require a greater supply of dietary antioxidants. 2 Skin is a major target of oxidative stress due to reactive oxygen species (ROS). Antioxidants attenuate the damaging effects of ROS and can impair and/or reverse many of the events that contribute to excessive growth and reproduction of skin cells. Increased ROS production in patients of psoriasis and decreased concentration of antioxidants leads to oxidative stress, which indicates lipid peroxidation. This may lead to cell damage by continuous chain reactions damaging the cell membranes and tissues. 3 Imbalance between ROS and antioxidants causes oxidative stress. Oxidative stress may be caused by antioxidant deficiency in the diets or increased production of free radicals caused by stress, smoking, environmental contaminations. Antioxidants and other bioactive compounds detoxify ROS and prevent damage to cellular macromolecules and organelles through multi-mechanisms. In human body, several mechanisms are known to defend from free radicals (for example antioxidant enzymes), however in some cases there is a need more substances to overcome their impact. Consumption of vegetables including Brassica species has been strongly associated with the reduced risk of chronic diseases, such as cardiovascular disease, diabetes, and age-related functional decline. 4,5 Antioxidants are also effective in reducing free radical damage of collagen and elastin, the fibers that support the skin structure.6

Carotenoids are yellow, red and orange pigments present in many fruits and vegetables. In the diet they act as powerful antioxidants and are believed to protect the body against free radical attack. Several studies on the bioavailability of B -carotene from vegetables in the human diet have shown that in broccoli it ranges from 22- 24%, in carrots 19-34%, and in leafy vegetables it ranges from 3-6%. Flavonols include quercetin, kaempferol, fisetin, and myricetin. Quercetin is the most important flavonoid in vegetables. It has been detected in onion. Kaempferol, myricetin, and fisetin have also been detected in onion as well as lettuce, and endive.

Anthocyanins give vegetable leaves and fruits their purple and or/red colour, such as in purple cabbage, purple broccoli, purple sweet potato, rhubarb, purple radish and onion. Anthocyanins have also been shown to protect mammalian cell lipoproteins from damage by free radicals. 2

Constant inflammation plays an essential role in many human illnesses and isothiocyanates (ITCs) slow down the activity of many inflammation mechanisms, restrain cyclooxygenase 2, and permanently inactivate the macrophage migration inhibitory factor. Studies have attributed ITCs with  anti-inflammatory abilities . They have been shown to reduce carrageenan-induced rat paw oedema, lessen ear oedema formation and induce leukocyte clearance in inflamed mouse skin and in studies using Human skin organ culture, has been shown to  reduce the expression and secretion of proinflammatory cytokines in human monocytes, macrophage-like cells and inflamed skin.7

As with anything diet should be balanced and any changes should be discussed with your Practitioner.

Also read our blog “PSORIASIS and DIET – Part 1, PSORIASIS and COMORBIDITIES, PSORIASIS and ALCOHOL and PSORIASIS and WATER INTAKE “.

REFERENCES

  • Vanden Berghe W. and Haegeman G.; Epigenetic Remedies by Dietary Phytochemicals Against Inflammatory Skin Disorders: Myth or Reality?; Curr Drug Metab.2010 Jun 1;11(5):436-50.
  • Pradeep Kumar Singh and K. Mallikarjuna Rao (2012): “Phytochemicals in Vegetables and their Health Benefits”, Asian Journal of Agriculture and Rural Development, Vol. 2, No. 2, pp. 177-183
  • Priya R. et al.; Oxidative stress in psoriasis.; Biomedical Research 2013; 25 (1): 132-134
  • Kapusta-Duch J. et al.; The beneficial effects of Brassica vegetables on human health; Rocz Panstw Zakl Hig 2012, 63, Nr 4, 389 – 395
  • Priya Sharma, Sonia Kapoor; Biopharmaceutical aspects of Brassica vegetables; Journal of Pharmacognosy and Phytochemistry 2015; 4(1): 140-147
  • Basavaraj, K H, C Seemanthini, and R Rashmi. “DIET IN DERMATOLOGY: PRESENT PERSPECTIVES.”Indian Journal of Dermatology 3 (2010): 205–210. PMC. Web. 16 Feb. 2016.
  • Yehuda H. et al.; Isothiocyanates inhibit psoriasis-related proinflammatory factors in human skin; Inflamm. Res. (2012) 61:735–742 DOI 10.1007/s00011-012-0465-3

PSORIASIS and DIET – Part 1

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For many years Dermatologists, General Practitioner’s and many researchers considered that patients who stated that eating certain foods made their psoriasis  worse as being utterly mistaken or delusional. However, over the last several years there has slowly been a change of thought and we are now seeing the results of several recent studies and clinical trials on various nutritional and dietary therapies for psoriasis. And the results have made it clear that diet may influence the health outcome for patients.

A study of some 20,000 eczema and psoriasis patients by the Department of Medical Nutrition, Donau University Krems in Austria, found that the patients showed, besides allergic reactions to foods, an increasing number of pseudo allergic reactions caused by toxic-irritative pollutants (formaldehyde, exhaust particles, food additives, nicotine, wood preservatives, pesticides, heavy metals) which are responsible for the inflammatory process behind the complex symptoms. The Researchers found that 60% of all patients had raised concentrations of circulating immune complexes with food-specific IgE- and IgG responsible for the delayed (Type III) allergic reactions. They found that both in atopic eczema and in psoriasis patients had pseudo allergic  reactions against biogenic amines and had constantly raised serum histamine levels. Previously published results showed significantly reduced DAO activities in  thrombocyte rich plasma of atopic eczema and psoriasis patients explaining their intolerance reactions to histamine, tyramine and octopamine rich foods.1 Diamine oxidase (DAO) is an essential enzyme in the body that breaks down histamine. The body then takes the break-down products (called imidazole compounds) and excretes them through the kidneys into the urine.

Biogenic amines play important role in human body such as: regulation of body and stomach pH, gastric acid secretion, the immune response and cell growth and differentiation. At the same time, amines are important for the growth, renovation and metabolism of every organ in body and are also essential for maintaining the high metabolic activity of the normal functioning and immunological system of the gut. Despite these roles, the consumption of foods with high content of biogenic amines can cause adverse reactions such as nausea, headaches, cardiac palpitation, hot flushes, oral burning, gastric intestinal problems, renal intoxication, rashes and changes in blood pressure. Different biogenic amines can cause different side effects such as: excess tyramine intake could cause hypertension whereas serotonin is a vasoconstrictor. People having deficient natural mechanisms for detoxifying biogenic amines due to genetic defects or due to the intake of antidepressant medicines such as monoamine oxidase inhibitors may experience allergen-type reactions characterized by difficulty in breathing, itching, rash, vomiting, fever and hypertension. 2

Histamine is found in fermented alcoholic beverages, especially wine, champagne and beer,

bacon, salami, luncheon meats and hot dogs,  sour cream, sour milk, buttermilk, sour dough  bread, etc., dried apricots, prunes, dates, figs, raisins, citrus fruits, aged cheese – camembert, brie, blue vein and including goat cheese, walnuts, cashews, and peanuts,  avocados, eggplant, spinach, and tomatoes and smoked fish and certain species of fish: mackerel, tuna, anchovies, sardines.

Psoriasis is considered to be an autoimmune disease and in severe, uncontrollable psoriasis histamine antagonists are of value in reducing disease activity. Histamine formation and release raises the possibility, that histamine is one of the molecules involved in pathogenesis  of autoimmune diseases. 3,5

Tyramine is found in fava beans and tomatoes, broad beans, concentrated yeast extract spreads and bouillons, salamis and mortadella, beer as well as the above foods.

Tyramine, derived from tyrosine, mimics the effects of adrenaline, causing increased heart activity and raising blood pressure. Research has suggested that psychological stress can induce exacerbation of psoriasis. It is further hypothesized that these stress effects on the course and outcome of psoriasis are caused by neuroendocrine modulation of immune functions.4 Excess levels of tyramine releases adrenaline from storage vesicles.4,5 When chronic illness is involved and the body is in a state of chronic stress the adrenal glands begin to work overtime. Over a period of  time the adrenal glands begin to suffer from adrenal fatigue. Impaired adrenal function is associated with the incidence of autoimmune diseases such as skin conditions and arthritis.6

Octopamine is found in green bean, edamame (soybeans), avocados, bananas, pineapple, eggplants, figs, red plums, raspberries, peanuts, Brazil nuts, coconuts, processed meat, yeast as well as the above foods

Octopamine is closely related to the hormone norepinephrine, Researchers studying patients with psoriasis whose psoriasis is associated with increased levels of psychological stress, found that in the psoriasis patients there were significantly increased norepinephrine blood levels compared with non-psoriasis controls. The researchers concluded that there was a positive correlation between the severity of psoriasis and high levels of norepinephrine. 7

There has been a known correlation between Irritable Bowel Diseases such as Crohn’s Disease, Colitis and Irritable Bowel Syndrome (IBS or Leaky Gut), since the 80s. Some researchers have concluded that Psoriasis and IBD are strictly related inflammatory diseases, probably sharing immune-pathogenetic mechanisms. Skin and bowel represent, at the same time, barrier and connection between the inner and the outer sides of the body share similar immune processes which play a key role in maintaining homeostasis and in sustaining pathological processes. 8

 

Solanine is a glyco alkaloid  poison found in species of the nightshade family (solanaceae), e.g. potatoes, tomatoes and eggplant. It can occur naturally in any part of the plant, including the leaves, fruit, and tubers. It is very toxic even in small quantities. Research has shown that the disruption of epithelial barrier integrity is important in the initiation and the cause of inflammatory bowel disease (IBD). Solanine has been found to permeabilize cholesterol-containing membranes, thus leading to the disruption of epithelial barrier integrity. Altered intestinal permeability is believed by some researchers to play a key role in the initiation and propagation of the inflammatory process in conditions other than IBD.9,10  Solanine and related glycoalkaloids are classified as acetylcholinesterase inhibitors leading to increased levels of neurotransmitters which cause prolonged muscle contractions, pain, tenderness, inflammation and stiff body movement. Swollen joints are a clinical manifestation of synovitis and the acute-phase response act as bio marker of pro-inflammatory cytokine production. Solanine may also induce oxidative stress leading to generation of free radicals and alterations in antioxidant and scavengers of oxygen free radicals. 11 There is the potential for solanine to have an adverse effect on psoriatic arthritis. The percentage of arthritic patients who are sensitive to the solanine family of plants might be significantly greater than 10%. A 1982 study published in the Journal of the International Academy of Preventive Medicine demonstrated significant improvements in over 70% of 5,000 (> 3,500) arthritic patients after having eliminated solanine-containing foods from their diets.12

Also read our blog “PSORIASIS and COMORBIDITIES, PSORIASIS and ALCOHOL and PSORIASIS and WATER INTAKE”.

 

REFERENCES

  • Ionescu JG, Constantinescu R, Constantinescu AT; Personalized Anti-Inflammatory Nutrition For Atopic Eczema And Psoriasis Patients; EPMA Journal (2011) 2 (Suppl 1):S157–S165 DOI 10.1007/s13167-011-0118-6
  • Songül ?ahin Ercan, Hüseyin Bozkurt and Çi?dem Soysal ; Significance of Biogenic Amines in Foods and Their Reduction Methods; Journal of Food Science and Engineering 3 (2013) 395-410
  • Nielsen HJ,Hammer JH.; Possible role of histamine in pathogenesis of autoimmune diseases: implications for immunotherapy with histamine-2 receptor antagonists.; Med Hypotheses. 1992 Dec;39(4):349-55.
  • Schmid-Ott G. et al.; Stress-induced endocrine and immunological changes in psoriasis patients and healthy controls. A preliminary study.; Psychother Psychosom.1998;67(1):37-42.
  • Maintz and Novak N.; Histamine and histamine intolerance; Am J Clin Nutr 2007;85:1185–96
  • Physiology of Stress; Chapter 2; http://www.jblearning.com/samples/0763740411/Ch%202_S eaward_Managing%20Stress_5e.pdf
  • Ionescu G,Kiehl R; Increased plasma norepinephrine in psoriasis.; Acta Derm Venereol. 1991;71(2):169-70.
  • Skroza et al.; Correlations between Psoriasis and Inflammatory Bowel Diseases; Hindawi Publishing Corporation BioMed Research International Volume 2013, Article ID 983902, 8 pages http://dx.doi.org/10.1155/2013/983902
  • Patel B. et al.; Potato glycoalkaloids adversely affect intestinal permeability and aggravate inflammatory bowel disease; Volume 8,Issue 5, pages 340–346, September 2002
  • Shah S. Dietary Factors in the Modulation of Inflammatory Bowel Disease Activity.Medscape General Medicine. 2007;9(1):60.
  • Ayad S.K.; Effect of Solanine on Arthritis Symptoms in Postmenopausal Female Albino Rats; Arab Journal of Nuclear Science and Applications, 46(3), (279-285) 2013 27
  • Prousky J. E.; The use of Niacinamide and Solanaceae (Nightshade) Elimination in the Treatment of Osteoarthritis; Journal of Orthomolecular Medicine Vol 30, No 1, 2015