Abstract
Plant-based diets (PBDs) are associated with decreased risk of morbidity and mortality associated with important noncommunicable chronic diseases. 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. Suboptimally designed PBDs might consequently be associated with increased uric acid levels and gout development. 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. Additionally, type of ingested purines, fiber, vitamin C, and certain lifestyle factors work in concordance to reduce uric acid generation in PBDs. Recent limited data show that even with an exclusive PBD, uric acid concentrations remain in the normal range in short- and long-term dieters. 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.
Highlights
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 [1,2,3,4,5,6,7]
The reasonable consumption of plant foods with a higher purine content as a part of PBDs may be safely tolerated in normouricemic individuals, but additional data is needed in hyperuricemic individuals, especially those with chronic kidney disease
Studies of centenarians across diverse geographical locations consistently associate a PBD pattern with a low incidence and mortality of cancer and cardiovascular diseases [15]. These populations mostly or predominately eat PBDs high in complex and low in refined carbohydrates, and they infrequently consume fish and meat. 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 because of their purine content and uric acid (UA)
Summary
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 [1,2,3,4,5,6,7]. Studies of centenarians across diverse geographical locations consistently associate a PBD pattern with a low incidence and mortality of cancer and cardiovascular diseases [15] These populations mostly or predominately eat PBDs high in complex and low in refined carbohydrates, and they infrequently consume fish and meat. 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). We will describe some modifications of exclusive PBDs that patients with UA-associated health problems could follow
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