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Listen Up: Dave W. Comments Widely on ‘Anti-P Diets’
from Dave W.

Hiya, Ed! I don't mind being called a 'scientist', but a 'zealot'?!?  [grin]

You wrote, in part:

“Some of us, on the other hand, may have compelling needs to try dietary approaches, which is why I don’t say don’t.” (More About Dr. Connolly.)

Don't get me wrong, Ed, please.  The only thing I was really arguing against was spending hard-earned money on Connolly's book, even if it is "guaranteed."

There's absolutely no evidence in the medical literature (since 1965, at least, which is what's searchable on the Internet) that any "one size fits all" diet like Connolly's does anything for psoriasis.  At least, what's on Connolly's web site suggests that his diet is a one-size-fits-all kinda deal — I haven't read the book.  One-size-fits-all diets have generally failed miserably for weight loss (the "fad" diets), and there's no compelling reason to believe that any of the ones available for psoriasis work any better than any of the others (there are at least five right now, if you include anti-candida).

It's also important to keep in mind that people like Connolly or Pagano probably DO NOT KNOW how well their dietary suggestions work.  People tell me that "thousands" of psoriatics have been helped by Pagano, but that number is absolutely meaningless without also knowing how many people tried Pagano's diet for many months without improvement (it is more than zero).  And since the majority of people who try the diet won't be under his direct care, but instead will have simply bought the book, there's no way for Pagano to track the true numbers.

That said, there is far too much anecdotal evidence that diet can affect SOMETHING about psoriasis for me to nay-say the whole idea of a dietary approach.  However, I am a firm believer that everyone's dietary triggers are probably going to be different, for the most part.  Thus, if a dietary angle on treating psoriasis is what a person wants, I would suggest a highly personalized trial-and-error regimen, where one food at a time is eliminated from the diet for a few weeks, to see if there's any response.  If no response, feel free to chow down on that food again.  If yes, you've identified a "suspect food."

"Suspect foods" should be re-introduced, to see if psoriasis gets worse again when eating that food.  If not, then the food is no longer a suspect, and it was probably either spontaneous remission, or something else changed to reduce the flakiness.  If the symptoms get worse again, then eliminate that food again, and see if the symptoms get better again.

People should repeat the re-introduction and elimination of any suspect foods as many times as they want (one at a time, for at least a couple of weeks), until THEY feel comfortable that those particular foods are truly "at fault."  People will probably want to give their favorite foods many chances before they consign them to the "inedible" list (or at least the list which is titled "I know I'm going to regret this in the morning, but...").

Some flakers who've never tried a dietary approach before sometimes already know that their psoriasis gets worse after eating some food they don't eat very often.  (Probably the most common trigger "foods" are alcoholic beverages.)  Those already-suspect foods are probably the ones to try to eliminate first.

One of the most comprehensive descriptions of dietary modifications for psoriasis you or anyone else will ever see is on my web site, at  

http://members.aol.com/psorsite/docs/terry.html

In this LAYMAN's opinion (always consult with a competent doctor before modifying your diet or psoriasis treatments), the above is the best general dietary advice for psoriasis sufferers who are interested in a dietary approach to treating this disease.  It's not "strict" (unless you're really attached to some food or another), it won't help you lose weight (unless you find all your trigger foods are high in calories), and it sure isn't a "cure" (no more than insulin injections are a "cure" for diabetes), but it's probably a heck of a lot easier to follow, and a lot more productive, than any one-size-fits-all diet can be.  It also has the advantage of not being grounded in bizarre pseudoscientific ideas like "bioenergy" or the words of a psychic.

This is all important to note, for people like J.D., and it might very well, as you noted, be a symptom of some sort of allergic response which triggers or exacerbates psoriasis.

Now, all of THAT having been said, there IS a single one-size-fits-all dietary plan that may indeed have good effects for a certain small fraction of psoriatics.  A Swedish researcher found, through published scientific studies, that 16% of flakers are gluten intolerant (as contrasted to 10% of  the general population).  When some 30-something of those gluten-intolerant psoriatics were put on a gluten-free diet (GFD), nearly all of them had their psoriasis symptoms go into remission, completely.

What does this mean?  It means that if you can, you might consider finding a competent medical doctor to test you for your level of antibodies to gliadin.  If it's above a certain threshold, you'd be considered to be gluten intolerant by the above-mentioned researcher's standards, and a GFD may very well get rid of your psoriasis symptoms.  See http://www.gluten.org for more information on gluten intolerance and the GFD.

What DOESN'T it mean?  If you try a GFD and have good results, that does NOT mean that you are gluten intolerant.  It might instead mean that you, by eliminating all gluten-containing foods, have accidentally eliminated the one single food which triggers your psoriasis, and you really may not have any problems with gluten at all.

For example, if the only time you eat salmon is with your morning bagel (as lox), then a GFD will also, "collaterally," eliminate salmon from your diet.  If it's ONLY the salmon that's a problem for you, though, then you're going to be on an EXTREMELY strict diet for very little reason.

The other thing to keep in mind about the GFD and psoriasis is that it's only been demonstrated in two clinical trials, by the same lead researcher.  Thus, it can only be considered to be "preliminary" evidence, and before a zillion people who read FlakeHQ go out and demand anti-gliadin blood tests, they'll have to weigh the costs (I doubt many insurance companies will pay for such tests as diagnostic for psoriasis) versus the possible benefits.

By the way, Avril H.'s letter isn't really a "counter-argument" to mine, as you've described it, if you'll give me my more-illustrating argument above.  But, it does bring a couple of other things to mind, which aren't specifically related to psoriasis.  One is that bread, beer, and other things which "contain yeast" are NOT made using any species of Candida.  Candida wouldn't make a decent loaf of bread or pint of beer.  They use different genuses (genii?  Anyway, not just different species) of yeasts for those things.  And in the U.S.A., where beer is pasteurized (mostly), any yeasts used making it are killed before it's bottled.

Simple sugars, on the other hand, CAN feed yeasts like those of the Candida genus which CAN infect the gut and MIGHT contribute to psoriasis symptoms in some percentage of the flaker population.  The unfortunate thing is that there are no good studies which show any definite linkage between the two, and general antifungal treatments for psoriasis have only shown a mixed response.  So, falling back on the general elimination-type diet described above may still provide a better overall quality of life than a restrictive "anti-Candida" diet may allow.

(Well, never let it be said I can't pontificate with the best of 'em, Ed.  [grin])

And, as another "by the way," my latest Fumaric Acid Esters page is now up on my web site, at:

http://members.aol.com/psorsite/fumaric.html

Also, I wish I could make the Orlando NPF shindig.  I will be there in spirit, though. - Dave W. http://members.aol.com/psorsite/

*****

Ed’s Response:  Good info (again), Dave.  Happy to share it here. 

Surely your proposed method to assessing personal connections between psoriasis and things we eat constitutes the most logical and valid approach, but in toto nearly as improbable as some of the diets you discuss.  I don’t know anybody who would have the patience to eliminate foods one at a time — and for how long? — in a search for a single food that may trigger their P.  Such a procedure could take years and, to be valid, would require no or extremely moderate non-dietary treatments occur during the period of the test (to ensure you could tell if its diet that has effected your P rather than some new goop or systemic drug you’ve also used).  Your correspondent named “Terry,” who wrote the article you reference, is someone who has both had the patience to put into the “research” and the generosity to share the results.

Of course, there is a compromise: narrow the list of foods to eliminate one-at-a-time.  And, I agree with you — start with alcohol.  As Terry’s article points out, beverages in general may be a good place to start “as they are either nutritionally expendable or worthless.” For most people, meat would probably be on that list, perhaps even more narrowly defined; e.g., pork, beef, processed....  And grain products might be on the list; e.g., breads, cereals....

I do encourage FlakeHQ readers interested in dietary approaches to P control read Terry’s article.  The URL, again:

http://members.aol.com/psorsite/docs/terry.html

AND, if the fumaric acid ester therapy has anyone intrigued, definitely check out Dave’s well-researched article at:

http://members.aol.com/psorsite/fumaric.html

Good stuff. -Ed

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