Associations between lifestyle factors and life quality in people living with psoriasis: results of the Asking People with Psoriasis about Lifestyle and Eating (APPLE) cross-sectional study

Background Lifestyle factors have the potential to enhance well-being and quality of life (QoL). This study aimed to identify lifestyle patterns among UK-based adults with psoriasis and examine associations with QoL. Methods This was a cross-sectional analysis of the ‘Asking People with Psoriasis about Lifestyle and Eating’ (APPLE) study (n=353). QoL, Body Mass Index (BMI), and physical activity were assessed using the Dermatology Life Quality Index (DLQI), self-reported weight and height, and the International Physical Activity Questionnaire. Results Participant demography was: 82% female; mean (SD) age of 41 (13) years; and BMI of 27 (7) kg/m2. When fully adjusted for age, sex, smoking, and alcohol use, compared to individuals in the highest BMI tertile (35 (5) kg/m2), those in the lowest tertile (21 (2) kg/m2) reported a 71% reduced likelihood of QoL impairments (Odds Ratio (OR) = 0.29; 95% CI 0.14–0.59, adjusted P<0.01). Dairy-free, gluten-free, and pescatarian diets were more frequently adopted in individuals reporting healthy BMIs (≈24 kg/m2, adjusted P<0.05). Higher levels of physical activity (2932 (1509) Metabolic Equivalent of Task Minutes per week), and adequate sleep duration (7 (0) hours/day) were associated with lower odds of QoL impairments, although attenuated by multiple testing. Participants affected by embarrassment or self-consciousness related to their psoriasis engaged in less vigorous-intensity and walking activities compared to those who were less affected (adjusted P<0.05). Conclusions Assessing weight status and physical activity in individuals reporting high DLQI scores may help identify modifiable behaviours contributing to poorer QoL and thereby shape interventions.