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Randomized Controlled Trial
. 2024 Feb 20;25(5):2475.
doi: 10.3390/ijms25052475.

The Effect of a Ketogenic Diet versus Mediterranean Diet on Clinical and Biochemical Markers of Inflammation in Patients with Obesity and Psoriatic Arthritis: A Randomized Crossover Trial

Vaia Lambadiari  1 , Pelagia Katsimbri  2 , Aikaterini Kountouri  1 , Emmanouil Korakas  1 , Argyro Papathanasi  3 , Eirini Maratou  4 , George Pavlidis  5 , Loukia Pliouta  1 , Ignatios Ikonomidis  5 , Sofia Malisova  6 , Dionysios Vlachos  7 , Evangelia Papadavid  3
Affiliations
Randomized Controlled Trial

The Effect of a Ketogenic Diet versus Mediterranean Diet on Clinical and Biochemical Markers of Inflammation in Patients with Obesity and Psoriatic Arthritis: A Randomized Crossover Trial

Vaia Lambadiari et al. Int J Mol Sci. .

Abstract

The effect of different diet patterns on psoriasis (PSO) and psoriatic arthritis (PSA) is unknown. Τhe aim of our study was to evaluate the effectiveness of a Mediterranean diet (MD) and Ketogenic diet (KD), in patients with PSO and PSA. Twenty-six patients were randomly assigned to start either with MD or KD for a period of 8 weeks. After a 6-week washout interval, the two groups were crossed over to the other type of diet for 8 weeks. At the end of this study, MD and KD resulted in significant reduction in weight (p = 0.002, p < 0.001, respectively), in BMI (p = 0.006, p < 0.001, respectively), in waist circumference (WC) (p = 0.001, p < 0.001, respectively), in total fat mass (p = 0.007, p < 0.001, respectively), and in visceral fat (p = 0.01, p < 0.001, respectively), in comparison with baseline. After KD, patients displayed a significant reduction in the Psoriasis Area and Severity Index (PASI) (p = 0.04), Disease Activity Index of Psoriatic Arthritis (DAPSA) (p = 0.004), interleukin (IL)-6 (p = 0.047), IL-17 (p = 0.042), and IL-23 (p = 0.037), whereas no significant differences were observed in these markers after MD (p > 0.05), compared to baseline. The 22-week MD-KD diet program in patients with PSO and PSA led to beneficial results in markers of inflammation and disease activity, which were mainly attributed to KD.

Keywords: DAPSA score; Ketogenic diet; Mediterranean diet; PASI score; diet intervention; inflammation; interleukins; obesity; psoriasis; psoriatic arthritis.

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Conflict of interest statement

D.V. is general director of Evivios Med. S.M. is a dietician in Evivios Med.

Figures

Figure 1
Figure 1
CONSORT flow diagram showing the progress through the phases of the trial.
Figure 2
Figure 2
The effect of diet intervention on (A) DAPSA and (B) PASI. MD: Mediterranean Diet; KD: Ketogenic Diet; PASI: Psoriasis Area and Severity Index; DAPSA: Disease Activity Index for Psoriatic Arthritis.
Figure 3
Figure 3
The effect of diet intervention on (A) ΙL-6 and (B) IL-17. MD: Mediterranean diet; KD: Ketogenic diet.
Figure 4
Figure 4
Design and analysis of crossover trial.
See this image and copyright information in PMC

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