FC26 The MEditerranean Diet and Time-Restricted Eating Dietary Interventions for Psoriasis (METRED-P) study: an interim analysis of the first UK-based diet intervention trial

Abstract There is no dietary guidance for people living with psoriasis in the UK, and evidence from randomized controlled trials (RCTs) is lacking. To address the knowledge gap on the efficacy of anti-inflammatory interventions such as the Mediterranean diet (MD) and Time-Restricted Eating (TRE), the MEditerranean Diet and Time-Restricted Eating Dietary interventions for Psoriasis (METRED-P) study aimed to examine the feasibility and collect pilot data subject to an MD, MD with TRE, or a TRE diet on psoriasis severity, life quality, and body composition. The METRED-P study (NCT05820698) was a single-centre parallel-arm feasibility pilot trial recruiting participants between June 2023 and July 2024. Inclusion criteria consisted of a psoriasis area and severity index (PASI) >5, body mass index (BMI) of 20–40 kg/m2, no systemic treatments (or on stable systemic treatments >6 months), and no underlying conditions. Participants were randomized by variance minimization to a TRE diet (10-h eating with 14-h fasting), an MD (rich in fruits, vegetables, whole-grains, fish, olive oil, and nuts) or an MD with TRE, and attended clinic visits at baseline and 12 weeks for repeat measures. Psoriasis severity was assessed with the PASI, life quality with the Dermatology Life Quality Index (DLQI), and body composition with the Tanita® scale. Twenty-four participants (60% female and 40% male) enrolled in the METRED-P study, and 10 participants completed the study to date. Participants reported a mean (SD) age of 44 (10) years, BMI of 28 (6) kg/m2, and baseline PASI of 10 (4). One-way analysis of variance showed statistically significant mean changes in total body fat % and in DLQI scores (P < 0.05). Post hoc analyses showed TRE improved DLQI scores compared with the MD, −11 (4) points, P < 0.05. TRE resulted in the greatest mean reductions in PASI −5 (4), compared with the MD −2 (3) and MD with TRE −1 (3), but statistical significance was not reached in this interim analysis. This is the first study clinically testing the MD and TRE in people with psoriasis. Whilst the METRED-P study is anticipated to end in October 2024, interim analyses illustrate favourable effects of TRE on life quality; an often-overlooked patient outcome. Given the ease and low cost of administration, TRE could be a consideration for people living with psoriasis. These pilot data will enable sample size calculations for fully powered RCTs to confirm these preliminary findings.