Healthline cares about helping our readers build healthy, sustainable habits. We understand that making changes to your life, even small ones, can be intimidating.
Building a healthy routine is especially important for people living with a chronic condition like psoriasis. Everyday factors like diet, stress levels, and exercise habits can have a major effect on psoriasis management and overall well-being.
That’s why Healthline partnered with a psoriasis advocate, Reena Ruparelia, for a Health Makeover.
For 1 month, we paired her with two experts in fitness and nutrition to explore new healthy habits. Sessions with these experts led Ruparelia to transform her everyday routines.
More importantly, though, the experts inspired a new type of mindset — and we hope they’ll inspire you, too.
Reena Ruparelia is a mindfulness life coach, champion of skin positivity, and psoriasis advocate based in Toronto, Canada. She’s been living with psoriasis for more than 25 years.
Her journey as an advocate for the condition began in 2016 when she started her Instagram @psoriasis_thoughts. Through her Instagram, she’s built a platform where an online community of “psoriasis warriors” comes together to share inspiration and connect through live chats.
Ruparelia’s focus on mindfulness, positivity, and openness made her the perfect partner for a Health Makeover with Healthline.
For her fitness consultations, Ruparelia met with Andrea Wool, founder of Autoimmune Strong, an online fitness program designed for people with autoimmune conditions and chronic pain. Wool lives with four autoimmune conditions herself and currently helps thousands of clients around the world learn to work with their bodies, reduce flares, and get stronger.
For her nutrition consultations, Ruparelia met with Rakhi Roy, MS, RD, a dietitian and nutrition coach focused on the gut-skin connection. Roy helps clients with autoimmune conditions reshape their nutrition habits and avoid restriction by focusing on intuitive eating and food freedom. She also lives with an autoimmune condition.
Diet plays an important part in psoriasis management for many people. Although no single diet pattern can cure psoriasis, there’s some evidence that certain foods may help reduce or prevent inflammation that makes psoriasis worse, according to the National Psoriasis Foundation.
For Ruparelia, who consumes a mostly plant-based diet, the nutrition consultations centered on:
- building balanced, nutritious meals that benefit her skin
- learning how to fuel and nourish her body
- resetting long-held food beliefs and fears
- balancing calorie needs to reduce late-night binging and cravings
“I feel afraid to eat three meals a day, and I don’t know what to eat. I’d love to find a way through,” Ruparelia told Roy upon starting their sessions together. She also expressed shame related to snacking and confusion around all of the nutrition information available online.
Throughout the consultations, Roy helped Ruparelia process any eating concerns, confusion, irritability, and shame. She also suggested that people seeking to make diet changes can’t expect to get everything perfect right away.
“That’s how you burn out. This is not a 30-day challenge,” Roy said. “We’re building the foundation for good habits.”
Over the course of 1 month, much of their work together focused on mindful eating. Below are a few suggestions from Roy:
- Eat the rainbow. For skin health, focus on eating naturally red, yellow, and green foods.
- PFF is your BFF. Try to get protein (20 to 30 grams), fat, and fiber (10 grams) — what Roy refers to as PFF — in every meal. Aim for 20 to 30 percent of total calories to come from fat, and avoid unsaturated fat.
- Know your key nutrients. Vitamin A is especially important for skin health, and omega-3 fatty acids have anti-inflammatory effects. Try to get key nutrients from foods before using supplements. If you choose to use a supplement, look for brands that require third-party testing of their products.
- Chew your food. Chewing food to an applesauce texture helps break it down for digestion.
- Time your meals and snacks. Eat every 4 to 6 hours, and stop eating around 2 hours before bedtime. Going long stretches without eating can lead to binging.
- Honor your cravings. Listen to your body and try not to shame yourself for desiring certain foods.
Skin healing and colorism
Ruparelia, like many people with psoriasis, has a long-term goal of getting clearer skin. After a few weeks of following her new diet plan, she reflected that she was having a hard time with not seeing a big difference in her skin.
“I just want [the psoriasis] to go away. And I know it takes time… but I just feel so tired of it.”
“It’s hard because you feel like you’re doing the ‘right things.’ And even though skin clearing isn’t the goal [for this Health Makeover]… I’m attached to that outcome deep down. I’d be lying if I said I wasn’t,” Ruparelia said.
Any change in inflammation related to diet takes a while to happen, Roy explained. It can be hard to wait to see results.
“When you tie all the hard work you’re doing now to the end goal, that’s where the self-doubt comes in. You can’t tie the outcome to your self-worth,” Roy said.
“It’s taken up to 5 months to see skin improvements in my other clients with psoriasis,” she added, with the minimum being 6 weeks, based on her experience.
Ruparelia did see some small improvements in her skin during the Health Makeover, which led to new colors and textures: pink, brown, and white patches instead of inflamed red areas.
“The fact that the skin is changing color is a good thing,” said Roy.
Skin conditions appear differently on different skin colors. For many skin conditions, the affected areas will appear red, then turn tan, brown, or purple in a process called post-inflammatory hyperpigmentation. This is especially common in Black and brown skin.
This natural healing process led to a conversation about colorism. Both women are of South Asian descent, and they discussed the prejudice they faced growing up in communities where lighter skin was preferred.
As you heal from skin conditions, Roy explained, “sometimes you think, ‘Why is my skin getting darker?’ And you tie that to your self-worth and your beauty. But know that’s your skin on the other side [of healing]; you are getting your color back.”
As with her nutrition beliefs, Ruparelia did a lot of unlearning and relearning about fitness.
It’s well known that physical activity is associated with many health benefits. Finding the right exercise routine can be challenging for some people with psoriasis who worry about triggering flares with high-intensity activities or sweat.
This was a big concern for Ruparelia. She loves walking, running, yoga, and hiking but finds that some of these activities and heavy sweating cause her psoriasis to get worse.
Upon meeting with Wool, Ruparelia mentioned that she hasn’t always been an active person. She said she’s struggled with being overly critical of herself and constantly feeling like she’s not doing enough physical activity.
Her fitness goals used to center around changing how she looks. Over time, they’ve changed to building strength and feeling good in her body.
Over the month working together, Wool helped Ruparelia reduce her high-intensity exercise, add in targeted strength training, and cope with feelings of laziness. Here are some of Wool’s key recommendations:
- Journal after exercise. Note what you did and how you and your skin feel. This can help you understand what exercises work for you. For Ruparelia, journaling helped her realize which exercises made her feel anxious, angry, and overheated in her body.
- Shift your mindset on effort. You don’t always need to push yourself to the max. When starting out, “aim for 60 percent effort,” said Wool.
- Release, rebuild, restore. The “three R’s” are important when building an exercise routine, especially for people who live with an autoimmune disease. Release muscle tension with foam rolling, rebuild the mind-body connection through gentle strength training movements, and restore your body with plenty of rest.
- Build strength from the center. A strong core is the foundation for a strong body and good form. Abdominal bracing is one effective, low-impact way to get started.
In their sessions, Wool suggested it’s important for Ruparelia and other people with psoriasis to let the body slowly build up to the pressures of exercise. But this process can be hard for some.
In the first weeks of the Health Makeover, Ruparelia reported she felt she wasn’t doing enough exercise: “There’s this fear that I’m going to get weak or that I’m being lazy. Because of this textured relationship I have with my body, being gentle with myself is something I’m learning, because I’m always so hard on myself.”
These feelings are natural, said Wool, and they’re deeply ingrained into our society. In the fitness world especially, messages of laziness and ideal body image are constant.
“When we’re fighting these fears about body image and being lazy, we can look to our body to see what’s actually happening. What’s amazing about psoriasis, which doesn’t happen with all autoimmune diseases, is you have a very physical way of measuring results,” said Wool.
Being patient as your brain relearns new exercise habits is key, as is tuning into the physical messages your body is sending you.
Building healthy routines that work in the long term isn’t easy. If you’re interested in remaking some of your own habits, consider researching and working with experts who understand your specific needs, such as those related to psoriasis.
For Ruparelia, this monthlong Health Makeover was just the beginning. Her work with diet and fitness specialists led her to reexamine some of the fears she held about body image, food, and fitness.
Her transformation started with an open mind and a willingness to try. When taking steps toward healthy habits in your own life, be patient with yourself, check-in about how you’re feeling often, and remember to celebrate your progress along the way.