Psoriasis is a chronic immune‑mediated inflammatory skin disease that is strongly associated with metabolic dysregulation and excess adiposity. Dietary strategies that reduce energy intake either by continuous daily caloric restriction (CCR) or time‑limited/periodic intake such as intermittent fasting (IF) or ketogenic diets (Keto) may improve psoriasis severity through weight loss, metabolic improvements, alterations in gut microbiota, and immune-metabolic effects.
Objective
We aimed to compare the therapeutic effectiveness of IF, Keto, and CCR in reducing the severity of psoriasis.
Methods
This study was designed as a systematic review and Meta Analysis. The clinical parameters such as psoriasis extent and outcome measures were evaluated at baseline at different follow up timeframes across studies. Outcome measures were assessed by changes in Psoriasis Area and Severity Index (PASI) scores, quality of life (dermatology life quality index [DLQI]), and metabolic scores.
Results
There was a significant PASI decrease in Keto and CCR cohorts (10-25.6 kg weight loss) compared with IF (0-2kg weight loss). No serious adverse effects were recorded in all interventions.
Limitations
The major limitations were study heterogeneity, lack of head-to-head comparisons, and follow up.
Conclusion
CCR and Keto performed better than IF in managing psoriasis severity, suggesting personalized dietary routines as adjuncts to treatment.  .
