How I Managed My Psoriatic Arthritis While Sampling the Local Food in Italy

By opting for fresh anti-inflammatory ingredients, I was able to experience local cuisine in all its greatness without triggering a flare.

During my first trip to Italy almost 4 years ago, I fell in love with the food, culture, and people. But my long-standing joint pain, made worse by long flights and inflammatory foods, made it difficult to fully enjoy myself.

Since that trip, I was diagnosed with psoriatic arthritis (PsA), learned the value of a whole-food, plant-based (WFPB) way of eating, and found a knowledgeable physical therapist. I’m now 95% pain-free, almost to my goal weight, and feel better than I have in 30 years.

When my husband and I returned to Italy this fall, we knew it would be challenging to adhere to a WFPB diet.

I decided to try to strike a balance between experiencing Italy’s food on its own terms and keeping the flames of PsA pain under control. My husband, however, was determined to be as close to 100% WFPB as possible.

Here is how we navigated it.

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Florence delivers authentic cuisine — and choices

Florence, located in the food-centric region of Tuscany, revels in its food culture — think Florentine steak, pasta, gelato, and cantucci. Yet restaurants in Florence are also quite friendly to people with dietary restrictions. Most are happy to offer alternatives.

After arriving in the city, we fought off jet lag with a walking food tour.

Since our son and his wife are non-vegans and would be joining us, I chose a food tour that offered traditional Tuscan foods but would accommodate requests for vegetarian options. I came prepared with Meloxicam, an anti-inflammatory, and a lactase supplement.

We started with charcuterie consisting of cheese, sliced meats, and bruschetta, followed by crackers topped with truffle sauces. The last restaurant we visited offered freshly made pasta and Florentine steak but prepared eggplant parmesan for my husband as a vegetarian replacement.

We ended the food tour with cantucci, a cookie similar to biscotti, and vin santo, a sweet dessert wine better suited to cantucci-dunking than drinking.

While my husband declined any meat during the tour, I ate everything. Even though we took different approaches to what we would sacrifice for the Italian food experience, we both enjoyed the tour.

Breakfast doesn’t have to be a pastry and espresso

We used breakfast to sneak in some vegetables and fruit. A small cafe near our apartment offered a varied breakfast and brunch menu with vegan options.

We ate at this adorable cafe two mornings in a row, ordering vegetable poke bowls, avocado toast, and fruit salad. If we couldn’t find a balance at every meal, we could at least pile our morning plates with healthy food to start the day right.

Italian cuisine easily adapts to dietary restrictions

The rest of our dinners in Florence focused on pasta or pizza. These dishes may sound off-limits for people with PsA, but pasta and pizza are two of the most common foundations for vegan or vegetarian Italian dishes. You can add almost any vegetable to them and make a satisfying meal.

We found that restaurants were happy to accommodate other adaptations as well. Requesting pasta or pizza with pesto instead of tomato sauce removed the nightshades that could cause my joints to ache. Some pizzerias offered vegan cheese. For those who don’t tolerate gluten, most restaurants offer gluten-free options.

As for Italian desserts, I did indulge in tiramisu. But we also found several gelaterias that offered vegan gelato. It’s all about balance!

The Cinque Terre: Challenging hikes and cuisine

After a stop in the lovely city of Lucca, where we ate poke bowls while overlooking the town, we moved on to the Cinque Terre.

The Cinque Terre, or Five Lands, are five old fishing villages tucked into crevices along the steep and rocky Ligurian coast. The area is a national park with hiking trails connecting the towns.

Because we planned to spend our days hiking a few of the more challenging trails, I knew I wouldn’t want to spend time cooking. I booked a room without a kitchen, although apartments are available to rent in the Cinque Terre.

A pre-trip search for restaurants in Manarola, the town we stayed in, promised a poke bowl restaurant. I assured my husband that if we couldn’t find anything else to eat, we could have poke bowls. When we arrived in Manarola, we discovered that the poke place was closed for the season. Sigh. Time to search for other options.

On our first morning, we enjoyed pancakes and a granola parfait made with soy milk and fresh fruit at a small restaurant. My husband loved their pancakes and asked if we could eat there every morning. Unfortunately, we found the restaurant closed for the rest of our stay. A bar closer to the water was a decent replacement that offered a veggie pie and fresh fruit salad.

We ate all of our dinners in Manarola because we were too tired to catch the train to one of the other villages when we returned from hiking. Fresh pasta and fish dominated the menus, but the main dishes included only a few token vegetables. To increase our intake, we ordered small side dishes of fried or grilled thinly sliced seasonal veggies.

We countered the general lack of vegetables with plenty of fresh fruit from the tiny grocery stores that dotted the town streets. Our backpacks filled with meal or nut bars and apples, plums, and bananas, we’d set out each day to climb the many terraces where olive trees and grapevines grow.

Pisa provides plenty of options

We arrived in Pisa hungry and tired from a long day of sightseeing and train travel. Our host recommended Pizzeria La Paradisea, a fitting name for a restaurant with the most extensive pizza menu I have ever seen. I counted 7 menu pages of pizza with an average of 12 pizzas on each page.

The waiter was happy to accommodate our dietary requests. We dove into two customized vegetarian pizzas so perfect we cleaned our plates.

Our vacation rental offered a full fix-it-yourself kitchen stocked with pastries, bread, muesli, fruit, eggs, plant-based milk, and yogurt. After ruling out the pastries, I settled on scrambled eggs, toast, and nondairy yogurt with muesli and fruit. My husband, sticking to his vegan guns, ate toast and several bowls of muesli with soy milk and fruit.

The next day we visited the Square of Miracles, home of the Leaning Tower of Pisa. On our way back to our rental to pick up our luggage, we found a poke place on the Arno River. The tasty bowl of fresh vegetables and rice almost made up for the lack of vegetables in the Cinque Terre.

The bottom line

As we left Italy, we each felt we had remained true to how we wanted to experience the Italian food culture. My husband sampled his favorite Italian foods — pasta and pizza — while choosing vegan options for other meals.

I balanced inflammatory Italian dishes with whole plant-based foods, with help from Meloxicam and lactase supplements. My PsA didn’t flare up, and I even lost a few pounds from walking and hiking miles each day.

When you’re traveling, it can be tricky to stick to your diet plan as well as you do at home. Swapping out inflammatory ingredients can allow you to experience the local cuisine without triggering your symptoms.

A little advance preparation goes a long way when traveling with PsA. If you’re looking for more tips, check out my article, “How I Manage My Psoriatic Arthritis While Traveling Abroad” before your next trip.