A 16-week Mediterranean diet significantly improved psoriasis severity in adults with mild to moderate psoriasis who were enrolled in a clinical trial.1 These findings suggest that diet could be a powerful adjunct to traditional psoriasis treatment.
This open-label, single-center, single-blind randomized clinical trial is published in JAMA Dermatology.
“The findings of this study support the incorporation of structured nutritional interventions as part of comprehensive psoriasis management,” wrote the researchers of the study. “A Mediterranean diet is not only culturally acceptable and sustainable but may also offer added cardiometabolic benefits in a population at increased risk of cardiovascular disease.”
The Mediterranean diet is a plant-based eating pattern inspired by traditional cuisines of countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain.2 It emphasizes whole foods like fruits, vegetables, whole grains, legumes, nuts, fatty fish, and extra virgin olive oil, while limiting red meat and processed foods. Moreover, the Mediterranean diet has been associated with improved skin health in individuals with chronic inflammatory conditions like psoriasis, due to its antioxidant-rich components that help reduce systemic inflammation.
The study was conducted from February 2024 to March 2025 at a dermatology referral clinic in Madrid, Spain.1 Adults with mild to moderate psoriasis, defined as having Psoriasis Area and Severity Index (PASI) scores of 2 to 10, receiving stable topical therapy were randomized 1:1 to either a 16-week, dietitian-guided Mediterranean diet intervention or a control group receiving standard low-fat dietary advice without dietitian supervision.
The intervention included nutritional counseling, educational materials, and weekly provision of extra virgin olive oil. The primary outcome was change in PASI score from baseline to week 16, assessed by a blinded evaluator. Secondary outcomes included Mediterranean diet adherence, anthropometric and metabolic measures, inflammatory cytokines, and patient-reported outcomes.
At 16 weeks, the researchers found that the Mediterranean diet intervention significantly improved psoriasis severity compared with the control group. The estimated marginal mean (EMM) change in PASI score was −3.4 (95% CI, −4.4 to −2.4) in the intervention group compared with 0.0 (95% CI, −1.0 to 1.0) in the control group, resulting in a between-group difference of −3.4 (95% CI, −4.8 to −2.0; P < .001).
Additionally, 47.4% of participants in the Mediterranean diet group achieved PASI 75, equivalent to a 75% reduction in disease severity; meanwhile, none in the control group reached this milestone. Furthermore, the intervention group showed significant metabolic benefits, including a reduction in hemoglobin A1c levels (between-group EMM difference, −4.1 mmol/mol; 95% CI, −6.9 to −1.3; P = .01), highlighting both dermatologic and cardiometabolic advantages of a Mediterranean diet.
However, the researchers acknowledged some limitations to their results, including the open-label design, more frequent contact in the intervention group, a small sample size, strict exclusion criteria, and the 16-week duration, which limited generalizability and insights into long-term effects.
Despite these limitations, the researchers believe the study adds insight into how a dietary intervention can help reduce psoriasis severity, as well as reduce the risk of cardiovascular disease in an at-risk patient population.
“A greater Mediterranean diet adherence correlated with higher improvement, suggesting a causal relationship,” wrote the researchers. “These findings underscore the value of structured nutritional interventions as adjunctive therapy in psoriasis and highlight the need for larger, long-term studies to further define the role of diet in disease management.”
References
1. Perez-Bootello J, Berna-Rico E, Abbad-Jaime de Aragon C, et al. Mediterranean diet and patients with psoriasis: the MEDIPSO randomized clinical trial. JAMA Dermatol. Published online September 24, 2025. doi:10.1001/jamadermatol.2025.3410
2. Mediterranean diet and MS. Multiple Sclerosis News Today. Accessed October 6, 2025. https://multiplesclerosisnewstoday.com/living-with-ms/ms-diet-nutrition/mediterranean-diet-and-ms/