![]() The concept of a “plant-based diet” can have various definitions in the scientific literature from excluding all animal source foods to including “only” a greater intake of vegetables, fruit, fruit juices, cereals, and legumes, while also preserving the intake of fish, pork, and yoghurt. Finally, we will describe some modifications of exclusive PBDs that patients with UA-associated health problems could follow. Additionally, we review other potentially modifiable diet-related factors that can affect UA levels, such as type of purines ingested and the role of other phytonutrients. We will present and summarize the data on serum UA level changes with transition from mixed Western-type diet to exclusive PBDs. Since UA is the end product of metabolism of purines, there is a concern about increased serum UA concentrations with the transition from a Western-type mixed diet to an exclusive PBD due to introduction of the regular intake of plant foods with a high purine content, containing more than 200–300 mg purine per 100 g of the product. Purines may originate from body’s endogenous synthesis or be ingested with foods of variable purine content. In this review, we will focus not only on the impact of some important individual dietary contents and foods but also on the collective impact of various PBD variants on serum UA levels. In the literature, there is a lack of data evaluating the impact of exclusive PBDs on serum UA, especially from interventional studies, which do not control for this parameter in most cases. While this solid and consistent evidence from interventional and observational studies supports the adoption of PBDs for key noncommunicable chronic diseases in developed countries, we observe a common concern between patients and health-care practitioners about the intake of many otherwise health-promoting plant foods (such as legumes, broccoli, spinach) because of their purine content and uric acid (UA) generation potential.Īlthough the serum UA concentration in each individual represents a complex interplay between nonmodifiable factors, (e.g., genetics), and modifiable factors, (e.g., body weight and lifestyle), the diet and its purine content do play a part in this. These populations mostly or predominately eat PBDs high in complex and low in refined carbohydrates, and they infrequently consume fish and meat. Studies of centenarians across diverse geographical locations consistently associate a PBD pattern with a low incidence and mortality of cancer and cardiovascular diseases. ![]() In interventional studies, PBDs were successfully used to prevent and treat severe coronary heart diseases, type 2 diabetes, early, low grade prostate cancer, and obesity. Plant-based diets (PBDs) are associated with a decreased risk for morbidity and mortality due to most chronic noncommunicable diseases, including cardiovascular diseases, certain types of cancer, metabolic syndrome, type 2 diabetes and obesity. The reasonable consumption of plant foods with a higher purine content as a part of PBDs may therefore be safely tolerated in normouricemic individuals, but additional data is needed in hyperuricemic individuals, especially those with chronic kidney disease. Recent limited data show that even with an exclusive PBD, uric acid concentrations remain in the normal range in short- and long-term dieters. Additionally, type of ingested purines, fiber, vitamin C, and certain lifestyle factors work in concordance to reduce uric acid generation in PBDs. Here, we review the available data on this topic, with a great majority of studies showing reduced risk of hyperuricemia and gout with vegetarian (especially lacto-vegetarian) PBDs. Suboptimally designed PBDs might consequently be associated with increased uric acid levels and gout development. Similar to animal-based food sources (e.g., meat, fish, and animal visceral organs), some plant-based food sources (e.g., certain soy legume products, sea vegetables, and brassica vegetables) also contain a high purine load. ![]() ![]() Plant-based diets (PBDs) are associated with decreased risk of morbidity and mortality associated with important noncommunicable chronic diseases. ![]()
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