An APCC – Multi Country Anti Inflammatory Diet Study For Psoriasis And Its Co-morbidities: Cardiovascular Diseases, Obesity, Depression, Diabetes And IBD
Psoriasis is a skin condition often associated with systemic diseases, called its comorbidities [1-4]. Reported worldwide, including from some APCC countries [5-9) its burden of disease is published in a WHO Global Report after the 67th World Health Assembly in 2014 [10]. In these diseases, inherited susceptibility genes [11,12] show common inflammatory pathways when exposed to certain lifestyle triggers [13,14], especially the diet [15,16]. Despite the years of current dietary guidelines, supported by the latest Nurses’ Health Study [17] to avoid trans-fats and to replace saturated with polyunsaturated fatty acids (PUFAs), prevalence of these and other inflammatory diseases, remain high [18].
These dietary guidelines on saturated fats are challenged by new studies: A 21 - prospective cohort metaanalysis of 347,747 subjects concludes: there is no significant evidence that dietary saturated fat intake is associated with increased CHD or CVD risk, and more data are needed to elucidate if CVD risks are likely to be influenced by specific nutrients used to replace saturated fat [19]. A wider 32 studies metaanalysis in 512,420 subjects of FAs on: dietary intake; biomarkers; and supplementation, concludes that the evidence does not clearly support CV guidelines to encourage intakes high in PUFAs and low in total saturated fats [20]. On omegas -3&-6 FAs, reanalysis of the Sydney Diet Heart Study reports increased total mortality in higher n-6 intake [21] and n-3 FAs helped delay amyotrophic lateral sclerosis 22], but health benefits are not verified in Alzheimer [23], and post menopausal women [24].
The controversy continues, so this study focuses instead on inflammation – the complex biological response common to these diseases. Our review of physico-chemical and functional properties [25], on 1) Omega 6:3 ratios [26-36]; 2) Carbon chain lengths [37]; 3) Anti- and Pro-Oxidant content [38-42]; 4) Trans-Fats content [43]; 5) Carbon bonds un-/saturation [44]; 6) Genetically modified [45-48]; and 7) Some clinical studies – show pro- or anti- inflammatory functions and effects of the FAs from the two test oils [49-55].
The protocol is up for final review by the University of the Philippines Manila-Research Ethics Board. Moderate psoriasis patients with 1 or more co-morbidities are randomly assigned, 10 each to VCO or Corn. They are controlled by a one-day immersion on, followed by daily phone-app monitoring of: diet, sleep, exercise, infection, other trigger factors. Clinical, serum, non-/lesional skin biopsy immunostains for inflammation markers are done at baseline, after one month, and a month after going back to their usual diet. Their main difference is the oil they use to cook and to prepare food.
Our alternative hypothesis is that saturated VCO is more anti-inflammatory; Corn Oil PUFAs more pro-. If proven and especially if done on more subjects and from the diverse people of APCC member countries, the study can propose an Anti-inflammatory Diet Plate patterned on the Harvard Healthy Plate [56], but include VCO as the healthy dietary oil [57] to help prevent and treat inflammation. APCC countries and worldwide diets vary, but cooking oils are ubiquitous in home food, popular pre-processed, packaged and fast foods, so study results can be applicable to most if not all.
We also suggest others to use this protocol on RBD, other Coconut oils, and with other PUFA oils as control. Other Inflamed skins with systemic problems & diet as a factor are: Acne, Eczema, & Rosacea.