Over eight million Americans live with psoriasis, a chronic autoimmune condition causing inflamed, itchy, and scaly skin. While traditional treatments like medication and light therapy exist, some turn to dietary approaches – including the Pagano diet – hoping for relief. This article breaks down what the Pagano diet entails, the science behind it (or lack thereof), and whether it’s worth considering.
What Is the Pagano Diet?
Created by chiropractor John Pagano, this plan frames psoriasis as a result of “leaky gut” syndrome: a theory that toxins escape the digestive system through damaged intestinal walls, triggering skin inflammation. Pagano’s diet aims to “heal” the gut by eliminating foods believed to worsen permeability and inflammation.
However, experts clarify: while gut health does influence psoriasis, the “toxin” concept is outdated. The condition is primarily an immune-mediated disease, where a dysfunctional immune system attacks the body, including the skin. Gut inflammation can contribute, but the focus should be on regulating the immune response, not just “detoxing.”
Foods to Eat and Avoid
The Pagano diet divides foods into strict categories:
Allowed: Fruits (excluding citrus and strawberries), vegetables, wild-caught fish, poultry, lamb, small amounts of dairy, brown/wild rice (in moderation), 2–4 eggs weekly (not fried), and oils like coconut, olive, sesame, grapeseed, and flaxseed. Herbal teas are also permitted.
Restricted: Red meat, margarine, shellfish, coffee, gluten, fried foods, added sugars, and alcohol. Notably, the diet also forbids nightshade vegetables (eggplant, peppers, tomatoes, white potatoes) – despite some research suggesting these are not inflammatory.
Does the Science Back It Up?
The short answer: not really. While some individuals report symptom improvement on the Pagano diet, studies are limited and inconclusive. One survey showed improvements, but similar results were observed with vegan and paleo diets, suggesting that overall dietary changes – not just this specific plan – may be at play.
One area with some support is gluten restriction. Individuals with both psoriasis and celiac disease (or diagnosed gluten sensitivity) may benefit from a gluten-free approach. However, for others, needlessly cutting out gluten is unlikely to provide meaningful relief.
Inflammation: The Core Principle
The diet centers around reducing inflammation, which is a key factor in psoriasis. Chronic inflammation drives the autoimmune response, causing skin symptoms and potentially affecting other organs. An anti-inflammatory diet rich in fruits, vegetables, healthy fats (olive oil, avocado, fatty fish), whole grains, and legumes can be helpful – but doesn’t require the Pagano diet’s extreme restrictions.
The claim that alkaline foods “heal” the gut is largely unproven. The human body tightly regulates pH levels regardless of dietary intake.
Is It Healthy?
Despite lacking definitive psoriasis-specific research, the Pagano diet isn’t inherently unhealthy. Its emphasis on nutrient-rich foods and reduced processed sugars aligns with general healthy eating guidelines. This can be particularly beneficial, as psoriasis is linked to higher risks of cardiovascular disease, obesity, and metabolic syndrome.
However, the diet’s restrictiveness carries risks. Cutting out entire food groups can lead to nutrient deficiencies, disordered eating patterns, and unnecessary deprivation.
The Bottom Line
Currently, medical treatments remain more effective for psoriasis management than the Pagano diet alone. While adopting an anti-inflammatory approach to eating may provide some symptom relief, strict adherence to this particular plan isn’t supported by strong scientific evidence.
If you have psoriasis and are considering dietary changes, consult a dermatologist or registered dietitian first. A balanced, evidence-based approach is more likely to yield lasting benefits.
