Evaluating the Effect of the EAT-Lancet Diet on Pemphigus Vulgaris Severity: Insights From a Cross-Sectional Study

This study investigated the association between adherence to the EAT-Lancet diet-a predominantly plant-based, anti-inflammatory dietary pattern-and the severity of pemphigus vulgaris (PV), a rare autoimmune blistering disease.

This cross-sectional study was conducted in an Iranian population with a high incidence of PV and included 138 newly diagnosed patients. Disease severity was assessed using the Pemphigus Disease Area Index (PDAI).

The findings revealed a significant inverse association between adherence to the EAT-Lancet diet and PV severity. After adjus[tment for potential confounders, including age, sex, BMI, corticosteroid use, and caloric and carbohydrate intake, higher adherence to the diet remained consistently associated with markedly lower odds of severe PV (OR: 0.10; 95% CI: 0.02-0.40; p for trend = 0.001), suggesting that dietary patterns may influence disease activity and progression.

Although this cross-sectional study has several important limitations-including the inability to establish temporality, potential reverse causation, and a small number of severe cases-the observed association between higher adherence to the EAT-Lancet diet and lower pemphigus vulgaris severity should be interpreted as hypothesis-generating. These findings may justify further research in larger longitudinal cohorts or dietary intervention trials, but they do not provide sufficient evidence to support dietary modification as an adjunctive clinical strategy for PV management at this stage.