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Journal Compilation © 2020 Acta Dermato-Venereologica. doi: 10.2340/00015555-3380 Psoriasis is a chronic inflammatory and hyperproliferative skin disorder with a prevalence of approximately 2–3% in the western world (1). Insulin levels are influenced by factors such as diet and lifestyle, and since insulin possesses both pro-inflammatory and hyperproliferative effects, it may play a role in the pathogenesis of psoriasis (2–4). It has been shown that weight loss in obese patients with psoriasis may positively affect the severity of the skin disease (5). A study including women with polycystic ovary syndrome showed that a high protein-to-carbohydrate (HP) diet, with protein accounted for at least 40% of the energy, 30% was derived from fat, and the rest from carbohydrates, resulted in greater weight loss and reduced insulin production compared with a normal control diet (6). The HP group reduced their weight and C-peptide levels (indicative of pancreatic insulin production) (7). Based on these studies, the balanced protein-to-fat-to-carbohydrate ratio (PFC) diet, was developed. The PFC diet is an insulin-lowering iso-caloric, ad libitum, diet in which protein accounts for 33% of the total energy, 33% of the total energy is derived from carbohydrates, and 33% from fat. The aim of this study was to investigate the effects of a PFC diet on the severity of psoriasis.

Recruitment and Retention in a Randomized Control Trial of Increased Dietary Protein-to-Carbohydrate Ratios in Patients with Psoriasis