The effect of dietary approaches to stop hypertension and ketogenic diets intervention on serum uric acid concentration: a systematic review and meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 37380733 · doi:10.1038/s41598-023-37672-2
What was done
A systematic review and meta-analysis of randomized controlled trials (RCTs) searched across Embase, Web of Science, PubMed, and Scopus through March 2023. The authors evaluated the effect of Dietary Approaches to Stop Hypertension (DASH) and ketogenic diet (KD) interventions of at least 2 weeks duration on serum uric acid (UA) concentrations in adults. Summary effect sizes were calculated using random-effects models.
What was found
Ten RCTs were identified: - DASH diet (4 RCTs, n = 590): Statistically significant decrease in serum UA after at least 4 weeks of intervention (mean difference [MD] = -0.25 mg/dL; 95% CI: -0.40 to -0.10 mg/dL; p < 0.01; I² = 0%). - Ketogenic diet (6 RCTs, n = 267): No significant change in serum UA (MD = 0.26 mg/dL; 95% CI: -0.47 to 0.98 mg/dL; I² = 95.32%). Subgroup analysis of very low-calorie ketogenic diets (VLCKD) also showed no significant reduction (MD = -0.04 mg/dL; 95% CI: -0.29 to 0.22 mg/dL; I² = 0%).
Why it matters
The DASH diet produces a consistent, modest reduction in serum uric acid levels, supporting its clinical use for hyperuricemia states such as gout. In contrast, ketogenic diets showed substantial between-study heterogeneity with no clear overall impact on uric acid concentrations.
Limits
The analysis included few trials overall (10 RCTs; 4 DASH, 6 KD) with limited total sample sizes. Ketogenic diet trials had extreme statistical heterogeneity (I² = 95.32%). Clinical outcomes like gout flares were not reported.
Cited by
- context Entering ketosis causes a temporary spike in uric acid, which is an antioxidant with greater antioxidant capacity in human blood than vitamin C.
- context Uric acid levels rise during the initial adaptation phase of entering ketosis.