Associations between diet quality indices and psoriasis severity: results from the Asking People with Psoriasis about Lifestyle and Eating (APPLE) cross-sectional study

Sylvia Zanesco; Thiviyani Maruthappu; Christopher Griffiths; Kathryn Dalrymple; Rachel Gibson; Wendy Hall

doi:10.1017/S0007114525000340

Associations between diet quality indices and psoriasis severity: results from the Asking People with Psoriasis about Lifestyle and Eating (APPLE) cross-sectional study

Sylvia Zanesco^*, Thiviyani Maruthappu, Christopher Griffiths, Kathryn Dalrymple, Rachel Gibson, Wendy Hall

^*Corresponding author for this work

Nutritional Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Psoriasis is a chronic immune-inflammatory skin disease. Cross-sectional research examining diet quality indices (DQIs) in psoriasis has focused on the Mediterranean diet and is confined to Mediterranean populations, thereby lacking generalisability to other populations. We explored associations between DQIs and the likelihood of reporting a higher psoriasis severity. This was an online cross-sectional study recruiting adult volunteers with psoriasis (n=257). A 147-item food frequency questionnaire evaluated adherence to the Mediterranean Diet Score (MDS), the Dietary Approaches to Stop Hypertension (DASH) score, and the Plant-based Diet Index (PDI); original (oPDI), healthy (hPDI), and unhealthy (uPDI) subtypes. Psoriasis severity was determined with the self-assessed Simplified Psoriasis Index. When adjusted for age, sex, smoking, alcohol over-consumption, energy intake, and psychological morbidity, multinomial logistic regression analyses revealed an increased likelihood of reporting a higher psoriasis severity in participants with a very low adherence to DASH OR = 3.75, 95% CI 1.313 - 10.700, P = 0.01), and hPDI (OR = 4.04, 95% CI 1.251 - 13.064, P = 0.02) patterns. A reduced likelihood of reporting a higher psoriasis severity was shown in participants with low adherence to the uPDI (OR = 0.25, 95% CI 0.085 - 0.716, P = 0.01). With further adjustment for body mass index (BMI), a very low adherence to the oPDI was significantly associated with an increased likelihood of reporting a higher psoriasis severity (OR = 3.46, 95% CI 1.029 - 11.656, P = 0.05). Dietary interventions and assessment should be introduced in the care-pathway for psoriasis management.

Original language	English
Journal	British Journal of Nutrition
Early online date	20 Feb 2025
DOIs	https://doi.org/10.1017/S0007114525000340
Publication status	E-pub ahead of print - 20 Feb 2025

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@article{7f1b18645940441bb8298296a55a364c,

title = "Associations between diet quality indices and psoriasis severity: results from the Asking People with Psoriasis about Lifestyle and Eating (APPLE) cross-sectional study",

abstract = "Psoriasis is a chronic immune-inflammatory skin disease. Cross-sectional research examining diet quality indices (DQIs) in psoriasis has focused on the Mediterranean diet and is confined to Mediterranean populations, thereby lacking generalisability to other populations. We explored associations between DQIs and the likelihood of reporting a higher psoriasis severity. This was an online cross-sectional study recruiting adult volunteers with psoriasis (n=257). A 147-item food frequency questionnaire evaluated adherence to the Mediterranean Diet Score (MDS), the Dietary Approaches to Stop Hypertension (DASH) score, and the Plant-based Diet Index (PDI); original (oPDI), healthy (hPDI), and unhealthy (uPDI) subtypes. Psoriasis severity was determined with the self-assessed Simplified Psoriasis Index. When adjusted for age, sex, smoking, alcohol over-consumption, energy intake, and psychological morbidity, multinomial logistic regression analyses revealed an increased likelihood of reporting a higher psoriasis severity in participants with a very low adherence to DASH OR = 3.75, 95% CI 1.313 - 10.700, P = 0.01), and hPDI (OR = 4.04, 95% CI 1.251 - 13.064, P = 0.02) patterns. A reduced likelihood of reporting a higher psoriasis severity was shown in participants with low adherence to the uPDI (OR = 0.25, 95% CI 0.085 - 0.716, P = 0.01). With further adjustment for body mass index (BMI), a very low adherence to the oPDI was significantly associated with an increased likelihood of reporting a higher psoriasis severity (OR = 3.46, 95% CI 1.029 - 11.656, P = 0.05). Dietary interventions and assessment should be introduced in the care-pathway for psoriasis management.",

author = "Sylvia Zanesco and Thiviyani Maruthappu and Christopher Griffiths and Kathryn Dalrymple and Rachel Gibson and Wendy Hall",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society.",

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T1 - Associations between diet quality indices and psoriasis severity: results from the Asking People with Psoriasis about Lifestyle and Eating (APPLE) cross-sectional study

AU - Zanesco, Sylvia

AU - Maruthappu, Thiviyani

AU - Griffiths, Christopher

AU - Dalrymple, Kathryn

AU - Gibson, Rachel

AU - Hall, Wendy

PY - 2025/2/20

Y1 - 2025/2/20

N2 - Psoriasis is a chronic immune-inflammatory skin disease. Cross-sectional research examining diet quality indices (DQIs) in psoriasis has focused on the Mediterranean diet and is confined to Mediterranean populations, thereby lacking generalisability to other populations. We explored associations between DQIs and the likelihood of reporting a higher psoriasis severity. This was an online cross-sectional study recruiting adult volunteers with psoriasis (n=257). A 147-item food frequency questionnaire evaluated adherence to the Mediterranean Diet Score (MDS), the Dietary Approaches to Stop Hypertension (DASH) score, and the Plant-based Diet Index (PDI); original (oPDI), healthy (hPDI), and unhealthy (uPDI) subtypes. Psoriasis severity was determined with the self-assessed Simplified Psoriasis Index. When adjusted for age, sex, smoking, alcohol over-consumption, energy intake, and psychological morbidity, multinomial logistic regression analyses revealed an increased likelihood of reporting a higher psoriasis severity in participants with a very low adherence to DASH OR = 3.75, 95% CI 1.313 - 10.700, P = 0.01), and hPDI (OR = 4.04, 95% CI 1.251 - 13.064, P = 0.02) patterns. A reduced likelihood of reporting a higher psoriasis severity was shown in participants with low adherence to the uPDI (OR = 0.25, 95% CI 0.085 - 0.716, P = 0.01). With further adjustment for body mass index (BMI), a very low adherence to the oPDI was significantly associated with an increased likelihood of reporting a higher psoriasis severity (OR = 3.46, 95% CI 1.029 - 11.656, P = 0.05). Dietary interventions and assessment should be introduced in the care-pathway for psoriasis management.

AB - Psoriasis is a chronic immune-inflammatory skin disease. Cross-sectional research examining diet quality indices (DQIs) in psoriasis has focused on the Mediterranean diet and is confined to Mediterranean populations, thereby lacking generalisability to other populations. We explored associations between DQIs and the likelihood of reporting a higher psoriasis severity. This was an online cross-sectional study recruiting adult volunteers with psoriasis (n=257). A 147-item food frequency questionnaire evaluated adherence to the Mediterranean Diet Score (MDS), the Dietary Approaches to Stop Hypertension (DASH) score, and the Plant-based Diet Index (PDI); original (oPDI), healthy (hPDI), and unhealthy (uPDI) subtypes. Psoriasis severity was determined with the self-assessed Simplified Psoriasis Index. When adjusted for age, sex, smoking, alcohol over-consumption, energy intake, and psychological morbidity, multinomial logistic regression analyses revealed an increased likelihood of reporting a higher psoriasis severity in participants with a very low adherence to DASH OR = 3.75, 95% CI 1.313 - 10.700, P = 0.01), and hPDI (OR = 4.04, 95% CI 1.251 - 13.064, P = 0.02) patterns. A reduced likelihood of reporting a higher psoriasis severity was shown in participants with low adherence to the uPDI (OR = 0.25, 95% CI 0.085 - 0.716, P = 0.01). With further adjustment for body mass index (BMI), a very low adherence to the oPDI was significantly associated with an increased likelihood of reporting a higher psoriasis severity (OR = 3.46, 95% CI 1.029 - 11.656, P = 0.05). Dietary interventions and assessment should be introduced in the care-pathway for psoriasis management.

UR - http://www.scopus.com/inward/record.url?scp=85218736531&partnerID=8YFLogxK

U2 - 10.1017/S0007114525000340

DO - 10.1017/S0007114525000340

M3 - Article

SN - 0007-1145

JO - British Journal of Nutrition

JF - British Journal of Nutrition

ER -

Associations between diet quality indices and psoriasis severity: results from the Asking People with Psoriasis about Lifestyle and Eating (APPLE) cross-sectional study

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