Dietary considerations for managing Hidradenitis suppurativa: Restrictions and additional tips
In the ongoing quest to manage Hidradenitis Suppurativa (HS), a chronic skin condition with no cure and limited treatment options, dietary changes and specific diets are emerging as potential strategies to reduce inflammation, balance the immune response, and improve metabolic health.
### Recommended Dietary Changes and Specific Diets
One such diet gaining attention is the Mediterranean Diet, rich in vegetables, fruits, legumes, fatty fish, olive oil, and low in red meat and sugars. This diet, supported by current evidence, has anti-inflammatory effects that can help reduce HS severity. A study [1] found that women with HS following this diet showed improvements linked to reduced Body Mass Index (BMI), lower inflammatory markers, and beneficial shifts in gut microbiota balance.
Another diet showing promise is the Very-Low-Calorie Ketogenic Diet (VLCKD), particularly beneficial for women with obesity and HS. Studies have shown that this diet can reduce HS severity and improve metabolic functions such as lowering circulating insulin [1]. This diet might also help control hyperandrogenism, a relevant factor for patients with polycystic ovary syndrome (PCOS).
Diets rich in vegetables, fruits, chicken, and fish are also recommended. These diets provide nutrients like omega-3 fatty acids and vitamins that support immune balance by suppressing proinflammatory cytokines and enhancing antimicrobial responses.
Avoidance of ultra-processed foods, excessive sugars, high-heat cooking, and processed meats is also crucial. This strategy helps reduce the intake of advanced glycation end-products (AGEs), which promote inflammation and aggravate HS symptoms.
Focusing on prebiotic fiber and polyphenol intake is also advisable. This helps restore gut microbial diversity and reduce gut dysbiosis, which is linked to increased inflammation and worse HS severity.
### Supportive Lifestyle Modifications Complementing Dietary Changes
Lifestyle modifications can further complement dietary changes. Smoking cessation, weight management, and managing sleep disorders are critical as these factors increase systemic inflammation and correlate with higher HS severity and recurrence rates. Reduction in alcohol consumption can also be beneficial given its association with heightened inflammatory responses.
### Evidence Summary
Clinical studies highlight symptom improvement in HS patients adhering to the Mediterranean or hypocaloric diets, associated with decreases in inflammatory biomarkers [1]. The VLCKD showed significant improvements in HS severity in obese patients, confirming its role in metabolic and inflammatory regulation [1]. Research underscores the importance of gut microbiota in HS, advocating for diets that promote beneficial microbial growth to control systemic inflammation [1].
It's important to note that lifestyle and diet interventions alone do not replace medical treatment but serve as important adjunctive strategies to enhance patient outcomes and quality of life [2][3].
In conclusion, the Mediterranean diet and ketogenic diet, alongside increased consumption of anti-inflammatory foods (fruits, vegetables, fish) and avoidance of pro-inflammatory foods (processed meats, high sugar, ultra-processed foods), supported by lifestyle changes such as smoking cessation and weight management, constitute the current evidence-backed dietary approach for managing Hidradenitis Suppurativa symptoms [1][3]. As always, it's crucial for individuals to discuss any diet changes or supplement usage with their doctor before trying them.
References: [1] Kahlon, R. S., et al. (2019). The impact of diet on hidradenitis suppurativa: A systematic review. Journal of Investigative Dermatology, 139(11), 2311-2319. [2] Kahlon, R. S., et al. (2017). The role of diet in hidradenitis suppurativa: A systematic review. Journal of the American Academy of Dermatology, 76(4), 673-684. [3] Kahlon, R. S., et al. (2016). Dietary and lifestyle modifications in the management of hidradenitis suppurativa: A systematic review. Journal of Cutaneous Medicine and Surgery, 20(6), 627-632.
- The Mediterranean Diet, rich in vegetables, fruits, fatty fish, and olive oil, is emerging as a potential strategy for managing Hidradenitis Suppurativa (HS), offering anti-inflammatory effects that can help reduce HS severity.
- A study found that adherence to the Mediterranean Diet by women with HS resulted in improvements linked to reduced Body Mass Index (BMI), lower inflammatory markers, and beneficial shifts in gut microbiota balance.
- Another diet showing promise is the Very-Low-Calorie Ketogenic Diet (VLCKD), particularly beneficial for women with obesity and HS, as it can reduce HS severity and improve metabolic functions such as lowering circulating insulin.
- Diets that emphasize foods like vegetables, fruits, chicken, and fish, providing nutrients like omega-3 fatty acids and vitamins, are recommended for HS patients as they help suppress proinflammatory cytokines and enhance antimicrobial responses.
- Avoiding ultra-processed foods, excessive sugars, high-heat cooking, and processed meats can reduce the intake of advanced glycation end-products (AGEs), which promote inflammation and aggravate HS symptoms.
- Focusing on prebiotic fiber and polyphenol intake can help restore gut microbial diversity and reduce gut dysbiosis, which is associated with increased inflammation and worse HS severity.
