Which fruits trigger psoriasis flare-ups and what to do about it?
Fruits are an important part of a balanced diet and a major source of vitamins and minerals and phytochemicals that function as antioxidants, phytoestrogens, and anti-inflammatory agents. Fruits also supply dietary fibre and fibre intake is linked to a lower incidence of cardiovascular disease and obesity. However, some people experience flare-ups after consuming sour and acidic varieties.
Fruits that are reported to trigger psoriasis flare-ups
All of the above are rich in vitamins and minerals and have anti–inflammatory and antioxidant health benefits, YET, they are reported to aggravate psoriasis during flare-ups, which could be due to their acidity.
Most of these fruits are initially acidic but after consumption, they have an alkalizing effect. However, their initial acidity could irritate the sensitive stomach lining and intestinal walls (lemon or lime detox water has less acidity and faster alkalizing effect) and worsen symptoms for those with gastrointestinal issues such as H pylori, Gastritis, Ulcer, Acid Reflux (GERD) and Irritable Bowel Syndrome (IBS) and there are numerous studies that suggest a strong link between psoriasis and gastrointestinal conditions.
Strawberries however have more than an acidity to blame. They are number one on the “Dirty Dozen” list of Environmental Working Group (EWG) as the most pesticide-laden fruit for the past six years and contain the most pesticides of any produce even after washing. This could be another reason why strawberries trigger flare-ups for some individuals.
What to do about it?
There is no reason to avoid these fruits if you are not sensitive to them. However, if you are experiencing flareups, eliminate them from your diet until your skin clears and reintroduce them in moderation. Awareness is the key.
- To minimize pesticide exposure, which disrupts the gut microbiota, avoid non-organic strawberries. Organic OR homegrown sweet strawberries in moderation could result in anti-inflammatory effects.
- Replace sour grapes with sweet varieties.
- If you choose to consume pineapples, choose well-ripened sweet varieties and consume in moderation.
- If you crave citrus fruits during flare-ups, keep in mind that Mandarins have less acidity compared to oranges, in fact, mandarins are the least acidic of the citrus fruits.
- Avoid fruit and berry seeds, they are undigestible and could contribute to gastrointestinal irritation.
 Vlachos, Christoforos et al. “Psoriasis and inflammatory bowel disease: links and risks.” Psoriasis (Auckland, N.Z.) vol. 6 73-92. 20 Jul. 2016, doi:10.2147/PTT.S85194
 Yong, Wai Chung et al. “Association between Psoriasis and Helicobacter pylori Infection: A Systematic Review and Meta-analysis.” Indian journal of dermatology vol. 63,3 (2018): 193-200. doi:10.4103/ijd.IJD_531_17
 Watari, Jiro et al. “Helicobacter pylori associated chronic gastritis, clinical syndromes, precancerous lesions, and pathogenesis of gastric cancer development.” World journal of gastroenterology vol. 20,18 (2014): 5461-73. doi:10.3748/wjg.v20.i18.5461
 Parikh NS, Ahlawat R. Helicobacter Pylori. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
 Dirty Dozen™ EWG’s 2021 Shopper’s Guide to Pesticides in Produce™ Environmental Working Group, a 501(c)(3) nonprofit corporation, EIN 52-2148600.
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