Role of the Mediterranean diet in the treatment of psoriatic arthritis: a review

Psoriatic arthritis (PsA) is a chronic inflammatory disease involving joints, entheses, and skin, driven by dysregulated immune pathways such as IL-23/IL-17 and TNF-α signaling. Growing evidence suggests that diet can modulate systemic inflammation and influence disease outcomes. The Mediterranean diet (MD), rich in monounsaturated fats, omega-3 fatty acids, fiber, and antioxidants, has demonstrated anti-inflammatory and immunomodulatory effects across several chronic inflammatory conditions. This review summarizes current evidence on the role of the MD in PsA management. Higher adherence to the MD has been associated with lower disease activity, reduced inflammatory markers, and improved quality of life in patients with PsA, independent of body mass index. However, findings remain limited by small sample sizes, heterogeneous methodologies, and potential confounders such as physical activity and pharmacologic treatment. Overall, the MD represents a promising adjunctive strategy for mitigating systemic inflammation and improving clinical outcomes in PsA, warranting further investigation through large, well-designed randomized controlled trials.