Can Specific Diets and Physical Activity Improve HS?

January 2, 2024

Paper Citation: Lorite-Fuentes I, Montero-Vilchez T, Arias-Santiago S, Molina-Leyva A. Potential benefits of the mediterranean diet and physical activity in patients with hidradenitis suppurativa: A cross-sectional study in a Spanish population. Nutrients. 2022;14(3). doi: 10.3390/nu14030551.

Summary: Angela Lo1, BA, and Ann Lin2, DO

1University of Central Florida College of Medicine, FL, USA. 2University of South Florida Morsani College of Medicine, FL, USA.

Background and purpose:

Obesity is the most common comorbidity associated with hidradenitis suppurativa (HS) and is related to more severe disease in genetically pre-disposed individuals. Exercising and eating a Mediterranean diet, which consists of a diet high in fruits, vegetables, legumes, cereals, bread, fish, nuts, and extra virgin olive oil but low in meat, dairy products, eggs, and alcohol, have been postulated to help patients lose weight and improve disease severity. However, there is still a lack of data regarding the effects of dietary modifications and physical activity on HS symptoms. This study explored the association between a Mediterranean diet, physical activity, and HS severity.

How was the project done:

The researchers interviewed 221 patients with HS in Spain. Individuals were evaluated to determine their socio-demographic characteristics (ie, sex, age, height, weight, body mass index) and assess their disease severity including Hurley stage, number of affected areas, nodules, and abscesses/draining tunnels. Participants were also asked to (1) rate their disease activity/symptoms, (2) report their level of physical activity (including intensity, frequency, and duration), and (3) report their level of adherence/consistency with eating a Mediterranean diet.

The results:

Higher adherence to a Mediterranean diet was associated with lower disease severity, symptom intensity and self-reported Hurley stage. Using extra virgin olive oil as the main fat for cooking, and eating poultry rather than red meat played the most important role in reducing HS severity (p<0.05).  Physical activity was also associated with healthier lifestyles, a greater adherence to a Mediterranean diet, and a trend towards lower disease activity. Regardless of diet, a more vigorous exercise routine was associated with both lower self-reported and clinician observed disease activity.

Impact and next steps:

This study highlights the possible benefits of one type of diet for patients with HS. Patients with HS should be encouraged to explore physical and dietary changes as part of their treatment regimen with their care team. While a Mediterranean diet may be one option, more research is needed to determine the effect of other diets for patients with HS. Also, more research is needed to determine if the positive effect on HS severity observed in this study is explained by weight reduction, improved nutrition, or another diet-related factor. 

Photo Credit: Monticelllo https://www.istockphoto.com/photo/food-products-representing-the-nutritarian-diet-gm1473148748-503336489