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Review

Beneficial Effect of Dietary Fiber on Hyperuricemia in Rats and Humans: A Review

Published Online:https://doi.org/10.1024/0300-9831/a000548

Abstract. Hyperuricemia is recognized as a lifestyle-related disease and the prevalence is increasing in many parts of the world. Excessive intake of purines increases serum uric acid concentration and is thought to be one factor causative of hyperuricemia. Therefore, it is thought that prevention of hyperuricemia by dietary control may be very important. This is an article of our basic research regarding the role of dietary fiber in the suppression of hyperuricemia induced by dietary purines in rats; in addition, clinical research suggesting the possibility that dietary fiber intake has a beneficial effect on the prevention or suppression of hyperuricemia in humans is discussed. Our own studies reveal that the test dietary fiber significantly suppresses the elevation of serum uric acid concentration induced by dietary RNA (12.3–46.2%), adenosine-5′-monophosphate (9.5–23.2%), adenosine (10.7–20.4%), or adenine (16.3–38.9%) and suppresses experimental hyperuricemia in rats. The mechanism is presumed to be mediated by suppression of the digestion and/or absorption of dietary purines by dietary fiber. In clinical studies, intake of dietary fiber decreases serum uric acid concentrations. Reports of recent epidemiological studies indicate that higher levels of hyperuricemia increase the prevalence of its comorbidities (e.g., chronic kidney disease, obesity, hypertension, diabetes, and cardiovascular disease) and dietary fiber intake is associated with significantly lower risk for hyperuricemia and its comorbidities. We wish to emphasize the importance of recognizing the validity of increased dietary fiber intake as a preventive or suppressive method for hyperuricemia and its comorbidities.

References

  • 1 Hu, F.B., & Willett, W.C. (2002) Optimal diets for prevention of coronary heart disease. JAMA. 288, 2569–2578. First citation in articleCrossref MedlineGoogle Scholar

  • 2 American Heart Association Nutrition Committee Lichtenstein, A.H., Appel, L.J., Brands, M., Carnethon, M., Daniels, S., Franch, H.A., Franklin, B., Kris-Etherton, P., Harris, W.S., Howard, B., Karanja, N., Lefevre, M., Rudel, L., Sacks, F., Van Horn, L., Winston, M., & Wylie-Rosett, J. (2006) Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 114, 82–96. First citation in articleCrossref MedlineGoogle Scholar

  • 3 Bulló, M., Casas-Agustench, P., Amigó-Correig, P., Aranceta, J., & Salas-Salvadó, J. (2007) Inflammation, obesity and comorbidities: the role of diet. Public Health Nutr. 10, 1164–1172. First citation in articleCrossref MedlineGoogle Scholar

  • 4 Psaltopoulou, T., Naska, A., Orfanos, P., Trichopoulos, D., Mountokalakis, T., & Trichopoulou, A. (2004) Olive oil, the Mediterranean diet, and arterial blood pressure: the Greek European Prospective Investigation into Cancer and Nutrition (EPIC) study. Am J Clin Nutr. 80, 1012–1018. First citation in articleCrossref MedlineGoogle Scholar

  • 5 Choi, H.K. (2010) A prescription for lifestyle change in patients with hyperuricemia and gout. Curr Opin Rheumatol. 22, 165–172. First citation in articleCrossref MedlineGoogle Scholar

  • 6 Teramoto, T., Sasaki, J., Ishibashi, S., Birou, S., Daida, H., Dohi, S., Egusa, G., Hiro, T., Hirobe, K., Iida, M., Kihara, S., Kinoshita, M., Maruyama, C., Ohta, T., Okamura, T., Yamashita, S., Yokode, M., & Yokote, K. (2014) Executive summary of the Japan Atherosclerosis Society (JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan – 2012 version. J Atheroscler Thromb. 20, 517–523. First citation in articleCrossrefGoogle Scholar

  • 7 Treatment Guide for Diabetes Editorial Committee. (2012) Treatment guide for diabetes 2012–2013. Tokyo: Bunkodo, 110 (in Japanese) First citation in articleGoogle Scholar

  • 8 Ogihara, T., Kikuchi, K., Matsuoka, H., Fujita, T., Higaki, J., Horiuchi, M., Imai, Y., Imaizumi, T., Ito, S., Iwao, H., Kario, K., Kawano, Y., Kim-Mitsuyama, S., Kimura, G., Matsubara, H., Matsuura, H., Naruse, M., Saito, I., Shimada, K., Shimamoto, K., Suzuki, H., Takishita, S., Tanahashi, N., Tsuchihashi, T., Uchiyama, M., Ueda, S., Ueshima, H., Umemura, S., Ishimitsu, T., Rakugi, H., & on behalf of The Japanese Society of Hypertension Committee. (2009) The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009). Hypertens Res. 32, 3–107. First citation in articleCrossref MedlineGoogle Scholar

  • 9 Chobanian, A.V., Bakris, G.L., Black, H.R., Cushman, W.C., Green, L.A., Izzo, J.L. Jr., Jones, D.W., Materson, B.J., Oparil, S., Wright, J.T. Jr., Roccella, E.J., & National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. (2003) The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 289, 2560–2572. First citation in articleCrossref MedlineGoogle Scholar

  • 10 Sacks, F.M., Svetkey, L.P., Vollmer, W.M., Appel, L.J., Bray, G.A., Harsha, D., Obarzanek, E., Conlin, P.R., Miller, E.R. 3rd., Simons-Morton, D.G., Karanja, N., Lin, P.H., & DASH-Sodium Collaborative Research Group. (2001) Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH) diet. DASH-Sodium Collaborative Research Group. N Engl J Med. 344, 3–10. First citation in articleCrossref MedlineGoogle Scholar

  • 11 Appel, L.J., Moore, T.J., Obarzanek, E., Vollmer, W.M., Svetkey, L.P., Sacks, F.M., Bray, G.A., Vogt, T.M., Cutler, J.A., Windhauser, M.M., Lin, P.H., & Karanja, N. (1997) A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med. 336, 1117–1124. First citation in articleCrossref MedlineGoogle Scholar

  • 12 American Diabetes Association. (2002) Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care. 25, 202–212. First citation in articleCrossref MedlineGoogle Scholar

  • 13 Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD). (2000) Recommendations for the nutritional management of patients with diabetes mellitus. Eur J Clin Nutr. 54, 353–355. First citation in articleCrossref MedlineGoogle Scholar

  • 14 Khanna, D., Fitzgerald, J.D., Khanna, P.P., Bae, S., Singh, M.K., Neogi, T., Pillinger, M.H., Merill, J., Lee, S., Prakash, S., Kaldas, M., Gogia, M., Perez-Ruiz, F., Taylor, W., Lioté, F., Choi, H., Singh, J.A., Dalbeth, N., Kaplan, S., Niyyar, V., Jones, D., Yarows, S.A., Roessler, B., Kerr, G., King, C., Levy, G., Furst, D.E., Edwards, N.L., Mandell, B., Schumacher, H.R., Robbins, M., Wenger, N., & Terkeltaub, R. (2012) 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Research. 64, 1431–1446. First citation in articleCrossrefGoogle Scholar

  • 15 Anderson, J.W., Baird, P., Davis, R.H. Jr., Ferreri, S., Knudtson, M., Koraym, A., Waters, V., & Williams, C.L. (2009) Health benefits of dietary fiber. Nutr Rev. 67, 188–205. First citation in articleCrossref MedlineGoogle Scholar

  • 16 Kaczmarczyk, M.M., Miller, M.J., & Freund, G.G. (2012) The health benefits of dietary fiber: beyond the usual suspects of type 2 diabetes mellitus, cardiovascular disease and colon cancer. Metabolism. 61, 1058–1066. First citation in articleCrossref MedlineGoogle Scholar

  • 17 Jenkins, D.J., Kendall, C.W., Vuksan, V., Vidgen, E., Parker, T., Faulkner, D., Mehling, C.C., Garsetti, M., Testolin, G., Cunnane, S.C., Ryan, M.A., & Corey, P.N. (2002) Soluble fiber intake at a dose approved by the US Food and Drug Administration for a claim of health benefits: serum lipid risk factors for cardiovascular disease assessed in a randomized controlled crossover trial. Am J Clin Nutr. 75, 834–839. First citation in articleCrossref MedlineGoogle Scholar

  • 18 Anderson, J.W., Akanji, A.O., & Randles, K.M. (2001) Treatment of diabetes with high-fiber diets. In G.A. SpillerEd., Handbook of dietary fiber in human nutrition (vol. 3, pp. 373). Boca Raton, FL: CRC Press LLC. First citation in articleCrossrefGoogle Scholar

  • 19 Anderson, J.W., & Jhaveri, M. (2012) In S.S. ChoN. AlmeidaEds., Epidemiological studies of dietary fiber and cardiovascular disease. Dietary fiber and health (pp. 121). Boca Raton, FL: CRC Press LLC. First citation in articleGoogle Scholar

  • 20 Lattimer, J.M., & Haub, M.D. (2010) Effects of dietary fiber and its components on metabolic health. Nutrients. 2, 1266–1289. First citation in articleCrossref MedlineGoogle Scholar

  • 21 Nicklas, T.A., O’neil, C., Slavin, J.L., & Cho, S.S. (2012) Consumption of total fiber and types of fiber are associated with a lower prevalence of obesity and abdominal adiposity in U.S. adults. NHANES 1999–2006. Dietary fiber and health. (Cho, S.S.Almeida, N.eds., pp. 71, CRC Press LLC, Boca Raton, FL. First citation in articleGoogle Scholar

  • 22 Koh-Banerjee, P., & Rimm, E.B. (2003) Whole grain consumption and weight gain: a review of the epidemiological evidence, potential mechanisms and opportunities for future research. Proc Nutr Soc. 62, 25–29. First citation in articleCrossref MedlineGoogle Scholar

  • 23 Streppel, M.T., Arends, L.R., van’t Veer, P., Grobbee, D.E., & Geleijnse, J.M. (2005) Dietary fiber and blood pressure: a meta-analysis of randomized placebo-controlled trials. Arch Intern Med. 165, 150–156. First citation in articleCrossref MedlineGoogle Scholar

  • 24 Lairon, D., Arnault, N., Bertrais, S., Planells, R., Clero, E., Hercberg, S., & Boutron-Ruault, M.C. (2005) Dietary fiber intake and risk factors for cardiovascular disease in French adults. Am J Clin Nutr. 82, 1185–1194. First citation in articleCrossref MedlineGoogle Scholar

  • 25 Fujii, H., Iwase, M., Ohkuma, T., Ogata-Kaizu, S., Ide, H., Kikuchi, Y., Idewaki, Y., Joudai, T., Hirakawa, Y., Uchida, K., Sasaki, S., Nakamura, U., & Kitazono, T. (2013) Impact of dietary fiber intake on glycemic control, cardiovascular risk factors and chronic kidney disease in Japanese patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry. Nutr J. 12, 159. First citation in articleCrossref MedlineGoogle Scholar

  • 26 Robinson, P.C., Taylor, W.J., & Merriman, T.R. (2012) Systematic review of the prevalence of gout and hyperuricaemia in Australia. Intern Med J. 42, 997–1007. First citation in articleCrossref MedlineGoogle Scholar

  • 27 Trifirò, G., Morabito, P., Cavagna, L., Ferrajolo, C., Pecchioli, S., Simonetti, M., Bianchini, E., Medea, G., Cricelli, C., Caputi, A.P., & Mazzaglia, G. (2013) Epidemiology of gout and hyperuricaemia in Italy during the years 2005–2009: a nationwide population-based study. Ann Rheum Dis. 72, 694–700. First citation in articleCrossref MedlineGoogle Scholar

  • 28 Yamanaka, H. (2010) Japanese guideline for the management of hyperuricemia and gout: second edition. Nucleosides Nucleotides Nucleic Acids. 30, 1018–1029. First citation in articleCrossrefGoogle Scholar

  • 29 Zhu, Y., Pandya, B.J., & Choi, H.K. (2011) Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 63, 3136–3141. First citation in articleCrossref MedlineGoogle Scholar

  • 30 Ryu, K.A., Kang, H.H., Kim, S.Y., Yoo, M.K., Kim, J.S., Lee, C.H., & Wie, G.A. (2014) Comparison of nutrient intake and diet quality between hyperuricemia subjects and controls in Korea. Clin Nutr Res. 3, 56–63. First citation in articleCrossref MedlineGoogle Scholar

  • 31 Miao, Z., Li, C., Chen, Y., Zhao, S., Wang, Y., Wang, Z., Chen, X., Xu, F., Wang, F., Sun, R., Hu, J., Song, W., Yan, S., & Wang, C.-Y. (2008) Dietary and lifestyle changes associated with high prevalence of hyperuricemia and gout in the Shandong coastal cities of Eastern China. J Rheumatol. 35, 1859–1864. First citation in articleMedlineGoogle Scholar

  • 32 Stamp, L.K., Wells, J.E., Pitama, S., Faatoese, A., Doughty, R.N., Whalley, G., Richards, A.M., & Cameron, V.A. (2013) Hyperuricaemia and gout in New Zealand rural and urban Māori and non-Māori communities. Intern Med J. 43, 678–684. First citation in articleCrossref MedlineGoogle Scholar

  • 33 Liu, H., Zhang, X.-M., Wang, Y.-L., & Liu, B.-C. (2014) Prevalence of hyperuricemia among Chinese adults: a national cross-sectional survey using multistage, stratified sampling. J Nephrol. 27, 653–658. First citation in articleCrossref MedlineGoogle Scholar

  • 34 Perez-Ruiz, F., Calabozo, M., Erauskin, G.G., Ruibal, A., & Herrero-Beites, A.M. (2002) Renal underexcretion of uric acid is present in patients with apparent high urinary uric acid output. Arthritis Rheum. 47, 610–613. First citation in articleCrossref MedlineGoogle Scholar

  • 35 Choi, H.K., Mount, D.B., & Reginato, A.M. (2005) Pathogenesis of gout. Ann Intern Med. 143, 499–516. First citation in articleCrossref MedlineGoogle Scholar

  • 36 Ruggiero, C., Cherubini, A., Ble, A., Bos, A.J., Maggio, M., Dixit, V.D., Lauretani, F., Bandinelli, S., Senin, U., & Ferrucci, L. (2006) Uric acid and inflammatory markers. Eur Heart J. 27, 1174–1181. First citation in articleCrossref MedlineGoogle Scholar

  • 37 Roubenoff, R., Klag, M.J., Mead, L.A., Liang, K.Y., Seidler, A.J., & Hochberg, M.C. (1991) Incidence and risk factors for gout in white men. JAMA. 266, 3004–3007. First citation in articleCrossref MedlineGoogle Scholar

  • 38 Takahashi, S., Yamamoto, T., Tsutsumi, Z., Moriwaki, Y., Yamakita, J., & Higashino, K. (1997) Close correlation between visceral fat accumulation and uric acid metabolism in healthy men. Metabolism. 46, 1162–1165. First citation in articleCrossref MedlineGoogle Scholar

  • 39 Emmerson, B.T. (1996) The management of gout. N Engl J Med. 334, 445–451. First citation in articleCrossref MedlineGoogle Scholar

  • 40 Choi, H.K., Atkinson, K., Karlson, E.W., & Curhan, G. (2005) Obesity, weight change, hypertension, diuretic use, and risk of gout in men: the health professionals follow-up study. Arch Intern Med. 165, 742–748. First citation in articleCrossref MedlineGoogle Scholar

  • 41 Johnson, R.J., Kang, D.-H., Feig, D., Kivlighn, S., Kanellis, J., Watanabe, S., Tuttle, K.R., Rodriguez-Iturbe, B., Herrera-Acosta, J., & Mazzali, M. (2003) Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension. 41, 1183–1190. First citation in articleCrossref MedlineGoogle Scholar

  • 42 Hamburger, M., Baraf, H.S.B., Adamson, T.C. III, Basile, J., Bass, L., Cole, B., Doghramji, P.P., Guadagnoli, G.A., Hamburger, F., Harford, R., Lieberman, J.A. III, Mandel, D.R., Mandelbrot, D.A., McClain, B.P., Mizuno, E., Morton, A.H., Mount, D.B., Pope, R.S., Rosenthal, K.G., Setoodeh, K., Skosey, J.L., & Lawrence Edwards, N. (2011) 2011 Recommendations for the diagnosis and management of gout and hyperuricemia. Postgrad Med. 123(Suppl 1), 3–36. First citation in articleCrossref MedlineGoogle Scholar

  • 43 Nieto, F.J., Iribarren, C., Gross, M.D., Comstock, G.W., & Cutler, R.G. (2000) Uric acid and serum antioxidant capacity: a reaction to atherosclerosis? Atherosclerosis. 148, 131–139. First citation in articleCrossref MedlineGoogle Scholar

  • 44 Alderman, M.H. (2002) Uric acid and cardiovascular risk. Curr Opin Pharmacol. 2, 126–130. First citation in articleCrossref MedlineGoogle Scholar

  • 45 Takahashi, M.M., de Oliveira, E.P., de Carvalho, A.L.R., de Souza Dantas, L.A., Burini, F.H.P., Portero-McLellan, K.C., & Burini, R.C. (2011) Metabolic syndrome and dietary components are associated with coronary artery disease risk score in free-living adults: a cross-sectional study. Diabetol Metab Syndr. 3, 7. First citation in articleCrossref MedlineGoogle Scholar

  • 46 Saag, K.G., & Choi, H.K. (2006) Epidemiology, risk factors, and lifestyle modifications for gout. Arthritis Res Ther. 8(suppl 1), S2. First citation in articleCrossref MedlineGoogle Scholar

  • 47 Japanese Society of Nephrology. (2012) Clinical practice guidebook for diagnosis and treatment of chronic kidney disease 2012. Tokyo: Igakusha Co. Ltd, 145 (in Japanese). First citation in articleGoogle Scholar

  • 48 Feig, D.I., Kang, D.-H., & Johnson, R.J. (2008) Uric acid and cardiovascular risk. N Engl J Med. 359, 1811–1821. First citation in articleCrossref MedlineGoogle Scholar

  • 49 Zhu, Y., Pandya, B.J., & Choi, H.K. (2012) Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med. 125, 679–687. First citation in articleCrossref MedlineGoogle Scholar

  • 50 Richette, P., & Bardin, T. (2010) Gout. Lancet. 375, 318–328. First citation in articleCrossref MedlineGoogle Scholar

  • 51 Choi, H.K., Liu, S., & Curhan, G. (2005) Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 52, 283–289. First citation in articleCrossref MedlineGoogle Scholar

  • 52 Yu, K.-H., See, L.-C., Huang, Y.-C., Yang, C.-H., & Sun, J.-H. (2008) Dietary factors associated with hyperuricemia in adults. Semin Arthritis Rheum. 37, 243–250. First citation in articleCrossref MedlineGoogle Scholar

  • 53 Villegas, R., Xiang, Y.-B., Elasy, T., Xu, W.H., Cai, H., Cai, Q., Linton, M.F., Fazio, S., Zheng, W., & Shu, X.-O. (2012) Purine-rich foods, protein intake, and the prevalence of hyperuricemia: the Shanghai Men’s Health Study. Nutr Metab Cardiovasc Dis. 22, 409–416. First citation in articleCrossref MedlineGoogle Scholar

  • 54 Chang, W.C. (2011) Dietary intake and the risk of hyperuricemia, gout and chronic kidney disease in elderly Taiwanese men. Aging Male. 14, 195–202. First citation in articleCrossref MedlineGoogle Scholar

  • 55 Itakura, M. (2009) Metabolic pathway and regulation of uric acid production. Hyperuricemia and Gout. 17, 106–111. (in Japanese). First citation in articleGoogle Scholar

  • 56 Ekpenyong, C.E., & Daniel, N. (2015) Roles of diets and dietary factors in the pathogenesis, management and prevention of abnormal serum uric acid levels. PharmaNutrition. 3, 29–45. First citation in articleCrossrefGoogle Scholar

  • 57 Terkeltaub, R., & Edwards, N.L. (2013) Approach to diet and alcohol in treatment of the patient with gout and hyperuricemia. Gout; Diagnosis and management of gouty arthritis and hyperuricemia. (Terkeltaub, R.Edwards, N.L.eds. vol. 3, pp. 143, Professional Communications Inc, NY. First citation in articleGoogle Scholar

  • 58 Schlesinger, N. (2005) Dietary factors and hyperuricemia. Curr Pharm Des. 11, 4133–4138. First citation in articleCrossref MedlineGoogle Scholar

  • 59 Vuorinen-Markkola, H., & Yki-Järvinen, H. (1994) Hyperuricemia and insulin resistance. J Clin Endocrinol Metab. 78, 25–29. First citation in articleMedlineGoogle Scholar

  • 60 Fam, A.G. (2002) Gout, diet, and the insulin resistance syndrome. J Rheumatol. 29, 1350–1355. First citation in articleMedlineGoogle Scholar

  • 61 Underwood, M. (2006) Diagnosis and management of gout. BMJ. 332, 1315–1319. First citation in articleCrossref MedlineGoogle Scholar

  • 62 Koguchi, T., Wada, M., Ota, T., Nakajima, H., Tadokoro, T., & Maekawa, A. (1997) Effect of dietary fiber on the amount of purine metabolites in the serum and urine of rats. J Agric Sci Tokyo Nogyo Daigaku (Tokyo University of Agriculture). 42, 163–172. First citation in articleGoogle Scholar

  • 63 Koguchi, T., Nakajima, H., Wada, M., Yamamoto, Y., Innami, S., Maekawa, A., & Tadokoro, T. (2002) Dietary fiber suppresses elevations of uric acid and allantoin in serum and urine induced by dietary RNA and increases its excretion to feces in rats. J Nutr Sci Vitaminol. 48, 184–193. First citation in articleCrossref MedlineGoogle Scholar

  • 64 Koguchi, T., Nakajima, H., Koguchi, H., Wada, M., Yamamoto, Y., Innami, S., Maekawa, A., & Tadokoro, T. (2003) Suppressive effect of viscous dietary fiber on elevations of uric acid in serum and urine induced by dietary RNA in rats is associated with strength of viscosity. Int J Vitam Nutr Res. 73, 369–376. First citation in articleLinkGoogle Scholar

  • 65 Koguchi, T., Koguchi, H., Nakajima, H., Takano, S., Yamamoto, Y., Innami, S., Maekawa, A., & Tadokoro, T. (2004) Dietary fiber suppresses elevation of uric acid and urea nitrogen concentrations in serum of rats with renal dysfunction induced by dietary adenine. Int J Vitam Nutr Res. 74, 253–263. First citation in articleLinkGoogle Scholar

  • 66 Koguchi, T., Koguchi, H., Nakajima, H., Takano, S., Yamamoto, Y., Innami, S., Maekawa, A., & Tadokoro, T. (2004) Suppressive effect of dietary fiber on elevation of serum uric acid concentration induced by dietary adenosine and adenosine-5′-monophosphate in rats. J Jpn Assoc Dietary Fiber Res. 8, 83–91. First citation in articleGoogle Scholar

  • 67 Koguchi, T., Koguchi, H., Nakajima, H., Takano, S., Kobayashi, K.-I., Yamamoto, Y., Wada, M., Innami, S., Maekawa, A., & Tadokoro, T. (2008) Blood glucose and serum uric acid concentrations in streptozotocin-induced diabetic rats fed dietary RNA vary with type of dietary fiber. J Jpn Assoc Dietary Fiber Res. 12, 67–80. First citation in articleGoogle Scholar

  • 68 Carabin, I.G., Lyon, M.R., Wood, S., Pelletier, X., Donazzolo, Y., & Burdock, G.A. (2009) Supplementation of the diet with the functional fiber PolyGlycoplex is well tolerated by healthy subjects in a clinical trial. Nutr J. 8, 9. First citation in articleCrossref MedlineGoogle Scholar

  • 69 Yamaguchi, Y., Ando, C., Tsukamoto, S., Nagao, J., Ueda, T., Yamaguchi, H., & Akaoka, I. (2007) The effect on the serum uric acid level of long-term intake of chitosan-supplemented food and its safety in adults. J Jpn Soc Clin Nutr. 29, 104–113 (in Japanese). First citation in articleGoogle Scholar

  • 70 Shatat, I.F., Abdallah, R.T., Sas, D.J., & Hailpern, S.M. (2012) Serum uric acid in US adolescents: distribution and relationship to demographic characteristics and cardiovascular risk factors. Pediatric Research. 72, 95–100. First citation in articleCrossref MedlineGoogle Scholar

  • 71 Zykova, S.N., Storhaug, H.M., Toft, I., Chadban, S.J., Jenssen, T.G., & White, S.L. (2015) Cross-sectional analysis of nutrition and serum uric acid in two Caucasian cohorts: the AusDiab Study and the Tromsø study. Nutr J. 14, 49. First citation in articleCrossref MedlineGoogle Scholar

  • 72 Sun, S.Z., Flickinger, B.D., Williamson-Hughes, P.S., & Empie, M.W. (2010) Lack of association between dietary fructose and hyperuricemia risk in adults. Nutr Metab (Lond). 7, 16. First citation in articleCrossref MedlineGoogle Scholar

  • 73 Kunitz, M. (1946) A spectrophotometric method for the measurement of ribonuclease activity. J Biol Chem. 164, 563–568. First citation in articleCrossref MedlineGoogle Scholar

  • 74 Harms, V., & Stirling, C.E. (1977) Transport of purine nucleotides and nucleosides by in vitro rabbit ileum. Am J Physiol. 233, E47–E55. First citation in articleMedlineGoogle Scholar

  • 75 Salati, L.M., Gross, C.J., Henderson, L.M., & Savaiano, D.A. (1984) Absorption and metabolism of adenine, adenosine-5′-monophosphate, adenosine and hypoxanthine by the isolated vasculary perfused rat small intestine. J Nutr. 114, 753–760. First citation in articleCrossref MedlineGoogle Scholar

  • 76 Koguchi, T., Tadokoro, T., & Innami, S. (2004) Dietary fiber modulates hyperuricemia induced by dietary purine compounds in rats. Current Topics in Biotechnology. 1, 1–14. First citation in articleGoogle Scholar

  • 77 Dikeman, C.L., & Fahey, G.C. Jr. (2006) Viscosity as related to dietary fiber: a review. Crit Rev Food Sci Nutr. 46, 649–663. First citation in articleCrossref MedlineGoogle Scholar

  • 78 Schneeman, B.O. (1999) Fiber, inulin and oligofructose: similarities and differences. J Nutr. 129, 1424S–1427S. First citation in articleCrossref MedlineGoogle Scholar

  • 79 Rose, D.J., & Hamaker, B.R. (2011) Overview of dietary fiber and its influence on gastrointestinal health. Nondigestible carbohydrates and digestive health. (Paeschke T.M.Aimutis, W.R.eds., pp. 185, Blackwell Publishing, Ltd. Ames, Iowa. First citation in articleCrossrefGoogle Scholar

  • 80 Yao, H.-T., & Chiang, M.-T. (2006) Chitosan shifts the fermentation site toward the distal colon and increases the fecal short-chain fatty acids concentrations in rats. Int J Vitam Nutr Res. 76, 57–64. First citation in articleLinkGoogle Scholar

  • 81 Kaur, N., & Gupta, A.K. (2002) Applications of inulin and oligofructose in health and nutrition. J Biosci. 27, 703–714. First citation in articleCrossref MedlineGoogle Scholar

  • 82 Roberfroid, M.B. (1999) Concepts in functional foods: The case of inulin and oligofructose. J Nutr. 129, 1398S–1401S. First citation in articleCrossref MedlineGoogle Scholar

  • 83 Yamashita, S., Yamashita, K., Yasuda, H., & Ogata, E. (1980) High-fiber diet in the control of diabetes in rats. Endocrinol Japon. 27, 169–173. First citation in articleCrossref MedlineGoogle Scholar

  • 84 Cani, P.D., Daubioul, C.A., Reusens, B., Remacle, C., Catillon, G., & Delzenne, N.M. (2005) Involvement of endogenous glucagon-like peptide-1 (7–36) amide on glycaemia-lowering effect of oligofructose in streptozotocin-treated rats. J Endocrinology. 185, 457–465. First citation in articleCrossref MedlineGoogle Scholar

  • 85 Ostman, E.M., Liljeberg Elmståhl, H.G., & Björck, I.M. (2002) Barley bread containing lactic acid improves glucose tolerance at a subsequent meal in healthy men and women. J Nutr. 132, 1173–1175. First citation in articleCrossref MedlineGoogle Scholar

  • 86 Niskanen, L., Laaksonen, D.E., Lindström, J., Eriksson, J.G., Keinänen-Kiukaanniemi, S., Ilanne-Parikka, P., Aunola, S., Hämäläinen, H., Tuomilehto, J., Uusitupa, M., & The Finnish Diabetes Prevention Study Group. (2006) Serum uric acid as a harbinger of metabolic outcome in subjects with impaired glucose tolerance: the Finnish Diabetes Prevention Study. Diabetes Care. 29, 709–711. First citation in articleCrossref MedlineGoogle Scholar

  • 87 Lippi, G., Montagnana, M., Franchini, M., Favaloro, E.J., & Targher, G. (2008) The paradoxical relationship between serum uric acid and cardiovascular disease. Clin Chim Acta. 392, 1–7. First citation in articleCrossref MedlineGoogle Scholar

  • 88 Glantzounis, G.K., Tsimoyiannis, E.C., Kappas, A.M., & Galaris, D.A. (2005) Uric acid and oxidative stress. Curr Pharm Des. 11, 4145–4151. First citation in articleCrossref MedlineGoogle Scholar

  • 89 Domrongkitchaiporn, S., Sritara, P., Kitiyakara, C., Stitchantrakul, W., Krittaphol, V., Lolekha, P., Cheepudomwit, S., & Yipintsoi, T. (2005) Risk factors for development of decreased kidney function in a southeast Asian population: a 12-year cohort study. J Am Soc Nephrol. 16, 791–799. First citation in articleCrossref MedlineGoogle Scholar

  • 90 Iseki, K., Ikemiya, Y., Inoue, C., Iseki, C., Kinjo, K., & Takishita, S. (2004) Significance of hyperuricemia as a risk factor for developing ESRD in a screened cohort. Am J Kidney Dis. 44, 642–650. First citation in articleCrossref MedlineGoogle Scholar

  • 91 Weiner, D.E., Tighiouart, H., Elsayed, E.F., Griffith, J.L., Salem, D.N., & Levey, A.S. (2008) Uric acid and incident kidney disease in the community. J Am Soc Nephrol. 19, 1204–1211. First citation in articleCrossref MedlineGoogle Scholar

  • 92 Yokozawa, Y., Zheng, P.D., Oura, H., & Koizumi, F. (1986) Animal model of adenine-induced chronic renal failure in rats. Nephron. 44, 230–234. First citation in articleCrossref MedlineGoogle Scholar

  • 93 Ali, B.H., Al-Salam, S., Al-Husseni, I., Kayed, R.R., Al-Masroori, N., Al-Harthi, T., Al-Zaabi, M., & Nemmar, A. (2010) Effects of gum arabic in rats with adenine-induced chronic renal failure. Exp Biol Med (Maywood). 235, 373–382. First citation in articleCrossref MedlineGoogle Scholar

  • 94 Yokozawa, T., Oura, H., Zheng, P.D., Fukase, M., Koizumi, F., & Kanaoka, M. (1983) Metabolic effects of dietary purine and pyrimidine bases in rats. Agric Biol Chem. 47, 1297–1304. First citation in articleGoogle Scholar

  • 95 Yokozawa, T., Oura, H., Nakagawa, H., & Okada, T. (1982) Adenine-induced hyperuricemia and renal damage in rats. J Jpn Soc Biosci Biotech Agrochem. 56, 655–663. (in Japanese) First citation in articleGoogle Scholar

  • 96 Brulé, D., Sarwar, G., Savoie, L., Campbell, J., & Zeggelaar, M.V. (1988) Differences in uricogenic effects of dietary purine bases, nucleosides and nucleotides in rats. J Nutr. 118, 780–786. First citation in articleCrossref MedlineGoogle Scholar

  • 97 Ali, A.A., Ali, K.E., Fadlalla, A.E., & Khalid, K.E. (2008) The effects of gum arabic oral treatment on the metabolic profile of chronic renal failure patients under regular haemodialysis in Central Sudan. Nat Prod Res. 22, 12–21. First citation in articleCrossref MedlineGoogle Scholar

  • 98 Jing, S.-B., Li, L., Ji, D., Takiguchi, Y., & Yamaguchi, T. (1997) Effect of chitosan on renal function in patients with chronic renal failure. J Pharm Pharmacol. 49, 721–723. First citation in articleCrossref MedlineGoogle Scholar

  • 99 Bliss, D.Z., Stein, T.P., Schleifer, C.R., & Settle, R.G. (1996) Supplementation with gum arabic fiber increases fecal nitrogen excretion and lowers serum urea nitrogen concentration in chronic renal failure patients consuming a low-protein diet. Am J Clin Nutr. 63, 392–398. First citation in articleCrossref MedlineGoogle Scholar

  • 100 Razdan, A., & Pettersson, D. (1994) Effect of chitin and chitosan on nutrient digestibility and plasma lipid concentrations in broiler chickens. Br J Nutr. 72, 277–288. First citation in articleCrossref MedlineGoogle Scholar

  • 101 Bliss, D.Z. (2004) Dietary fiber in conservative management of chronic renal failure. Pediatr Nephrol. 19, 1069–1070. First citation in articleCrossref MedlineGoogle Scholar

  • 102 Chesney, R.W., & Patters, A.B. (2006) Acacia gum in chronic renal failure. Therapy. 3, 183–185. First citation in articleCrossrefGoogle Scholar

  • 103 Ramkumar, N., Cheung, A.K., Pappas, L.M., Roberts, W.L., & Beddhu, S. (2004) Association of obesity with inflammation in chronic kidney disease: a cross-sectional study. J Ren Nutr. 14, 201–207. First citation in articleCrossref MedlineGoogle Scholar

  • 104 Shankar, A., Sun, L., Klein, B.E., Lee, K.E., Muntner, P., Nieto, F.J., Tsai, M.Y., Cruickshanks, K.J., Schubert, C.R., Brazy, P.C., Coresh, J., & Klein, R. (2011) Markers of inflammation predict the long-term risk of developing chronic kidney disease: a population-based cohort study. Kidney Int. 80, 1231–1238. First citation in articleCrossref MedlineGoogle Scholar

  • 105 Krishnamurthy, V.M.R., Wei, G., Baird, B.C., Murtaugh, M., Chonchol, M.B., Raphael, K.L., Greene, T., & Beddhu, S. (2012) High dietary fiber intake associated with decreased inflammation and all-cause mortality in patients with chronic kidney disease. Kidney Int. 81, 300–306. First citation in articleCrossref MedlineGoogle Scholar

  • 106 Liu, S., Manson, J.E., Buring, J.E., Stampfer, M.J., Willett, W.C., & Ridker, P.M. (2002) Relation between a diet with a high glycemic load and plasma concentrations of high-sensitivity C-reactive protein in middle-aged women. Am J Clin Nutr. 75, 492–498. First citation in articleCrossref MedlineGoogle Scholar

  • 107 Qi, L., van Dam, R.M., Liu, S., Franz, M., Mantzoros, C., & Hu, F.B. (2006) Whole-grain, bran, and cereal fiber intakes and markers of systemic inflammation in diabetic women. Diabetes Care. 29, 207–211. First citation in articleCrossref MedlineGoogle Scholar

  • 108 Qi, L., Rimm, E., Liu, S., Rifai, N., & Hu, F.B. (2005) Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men. Diabetes Care. 28, 1022–1028. First citation in articleCrossref MedlineGoogle Scholar

  • 109 Evenepoel, P., Meijers, B.K., Bammens, B.R., & Verbeke, K. (2009) Uremic toxins originating from colonic microbial metabolism. Kidney Int Suppl. 114, S12–S19. First citation in articleCrossrefGoogle Scholar

  • 110 Saura-Calixto, F. (2011) Dietary fiber as a carrier of dietary antioxidants: an essential physiological function. J Agric Food Chem. 59, 43–49. First citation in articleCrossref MedlineGoogle Scholar

  • 111 Pérez-Jiménez, J., Serrano, J., Tabernero, M., Arranz, S., Díaz-Rubio, M.E., García-Diz, L., Goñi, I., & Saura-Calixto, F. (2009) Bioavailability of phenolic antioxidants associated with dietary fiber: plasma antioxidant capacity after acute and long-term intake in humans. Plant Food Hum Nutr. 64, 102–107. First citation in articleCrossref MedlineGoogle Scholar

  • 112 Palafox-Carlos, H., Ayala-Zavala, F.J., & González-Aguilar, G.A. (2011) The role of dietary fiber in the bioaccessibility and bioavailability of fruit and vegetable antioxidants. J Food Sci. 76, R6–R15. First citation in articleCrossref MedlineGoogle Scholar

  • 113 Ríos-Hoyo, A., Cortés, M.J., Ríos-Ontiveros, H., Meaney, E., Ceballos, G., & Gutiérrez-Salmeán, G. (2014) Obesity, metabolic syndrome, and dietary therapeutical approaches with a special focus on nutraceuticals (polyphenols): a mini-review. Int J Vitam Nutr Res. 84, 113–123. First citation in articleLinkGoogle Scholar

  • 114 Salmean, Y.A., Segal, M.S., Langkamp-Henken, B., Canales, M.T., Zello, G.A., & Dahl, W.J. (2013) Foods with added fiber lower serum creatinine levels in patients with chronic kidney disease. J Ren Nutr. 23, e29. First citation in articleCrossref MedlineGoogle Scholar

  • 115 Chiavaroli, L., Mirrahimi, A., Sievenpiper, J.L., Jenkins, D.J., & Darling, P.B. (2015) Dietary fiber effects in chronic kidney disease: a systematic review and meta-analysis of controlled feeding trials. Eur J Clin Nutr. 69, 761–768. First citation in articleCrossref MedlineGoogle Scholar

  • 116 Gopinath, B., Harris, D.C., Flood, V.M., Burlutsky, G., Brand-Miller, J., & Mitchell, P. (2011) Carbohydrate nutrition is associated with the 5-year incidence of chronic kidney disease. J Nutr. 141, 433–439. First citation in articleCrossref MedlineGoogle Scholar

  • 117 Strippoli, G.F., Craig, J.C., Rochtchina, E., Flood, V.M., Wang, J.J., & Mitchell, P. (2011) Fluid and nutrient intake and risk of chronic kidney disease. Nephrology. 16, 326–334. First citation in articleCrossref MedlineGoogle Scholar

  • 118 Díaz-López, A., Bulló, M., Basora, J., Martínez-González, M.Á., Guasch-Ferré, M., Estruch, R., Wärnberg, J., Serra-Majem, L., Arós, F., Lapetra, J., Ros, E., Pintó, X., Covas, M.I., & Salas-Salvadó, J. (2013) Cross-sectional associations between macronutrient intake and chronic kidney disease in a population at high cardiovascular risk. Clin Nutr. 32, 606–612. First citation in articleCrossref MedlineGoogle Scholar

  • 119 Lin, Z., Zhang, B., Liu, X., Jin, R., & Zhu, W. (2014) Effects of chicory inulin on serum metabolites of uric acid, lipids, glucose, and abdominal fat deposition in quails induced by purine-rich diets. J Med Food. 17, 1214–1221. First citation in articleCrossref MedlineGoogle Scholar

  • 120 Dalbeth, N., Wong, S., Gamble, G.D., Horne, A., Mason, B., Pool, B., Fairbanks, L., McQueen, F.M., Cornish, J., Reid, I.R., & Palmano, K. (2010) Acute effect of milk on serum urate concentrations: a randomized controlled crossover trial. Ann Rheum Dis. 69, 1677–1682. First citation in articleCrossref MedlineGoogle Scholar

  • 121 Kakutani-Hatayama, M., Kadoya, M., Okazaki, H., Kurajoh, M., Shoji, T., Koyama, H., Tsutsumi, Z., Moriwaki, Y., Namba, M., & Yamamoto, T. (2015) Nonpharmacological management of gout and hyperuricemia: hints for better lifestyle. Am J Lifestyle Med. 11, 321–329. First citation in articleCrossref MedlineGoogle Scholar

  • 122 Farnworth, E.R., Champagne, C.P., & Van Calsteren, M.-R. (2007) Exopolysaccharides from lactic acid bacteria: food uses, production, chemical structures, and health effects. In Handbook of nutraceuticals and functional foods. (Wildman, R.C.ed.), vol. 2, pp. 353, CRC Press LLC, Boca Raton, FL. First citation in articleCrossrefGoogle Scholar

  • 123 Clifford, A.J., Riumallo, J.A., Young, V.R., & Scrimshaw, N.S. (1976) Effect of oral purines on serum and urinary uric acid of normal, hyperuricemic and gouty humans. J Nutr. 106, 428–434. First citation in articleCrossrefGoogle Scholar

  • 124 Lyu, L.-C., Hsu, C.-Y., Yeh, C.-Y., Lee, M.-S., Huang, S.-H., & Chen, C.-L. (2003) A case-control study of the association of diet and obesity with gout in Taiwan. Am J Clin Nutr. 78, 690–701. First citation in articleCrossref MedlineGoogle Scholar

  • 125 Streppel, M.T., Ocké, M.C., Boshuizen, H.C., Kok, F.J., & Kromhout, D. (2008) Dietary fiber intake in relation to coronary heart disease and all-cause mortality over 40 y: the Zutphen Study. Am J Clin Nutr. 88, 1119–1125. First citation in articleCrossref MedlineGoogle Scholar

  • 126 Mente, A., de Koning, L., Shannon, H.S., & Anand, S.S. (2009) A systematic review of the evidence supporting a causal link between dietary factors and coronary heart disease. Arch Intern Med. 169, 659–669. First citation in articleCrossref MedlineGoogle Scholar

  • 127 Pereira, M.A., O’Reilly, E., Augustsson, K., Fraser, G.E., Goldbourt, U., Heitmann, B.L., Hallmans, G., Knekt, P., Liu, S., Pietinen, P., Spiegelman, D., Stevens, J., Virtamo, J., Willett, W.C., & Ascherio, A. (2004) Dietary fiber and risk of coronary heart disease: a pooled analysis of cohort studies. Arch Intern Med. 164, 370–376. First citation in articleCrossref MedlineGoogle Scholar

  • 128 Bowering, J., Calloway, D.H., Margen, S., & Kaufmann, N.A. (1970) Dietary protein level and uric acid metabolism in normal man. J Nutr. 100, 249–261. First citation in articleCrossref MedlineGoogle Scholar

  • 129 Breneman, C.B., & Tucker, L. (2013) Dietary fibre consumption and insulin resistance – the role of body fat and physical activity. Br J Nutr. 110, 375–383. First citation in articleCrossref MedlineGoogle Scholar

  • 130 Astor, B.C., Hallan, S.I., Miller, E.R. 3rd., Yeung, E., & Coresh, J. (2008) Glomerular filtration rate, albuminuria, and risk of cardiovascular and all-cause mortality in the US population. Am J Epidemiol. 167, 1226–1234. First citation in articleCrossref MedlineGoogle Scholar

  • 131 Lauretani, F., Maggio, M., Pizzarelli, F., Michelassi, S., Ruggiero, C., Ceda, G.P., Bandinelli, S., & Ferrucci, L. (2009) Omega-3 and renal function in older adults. Curr Pharm Des. 15, 4149–4156. First citation in articleCrossref MedlineGoogle Scholar

  • 132 Schmidt, M.I., Watson, R.L., Duncan, B.B., Metcalf, P., Brancati, F.L., Sharrett, A.R., Davis, C.E., & Heiss, G. (1996) Clustering of dyslipidemia, hyperuricemia, diabetes, and hypertension and its association with fasting insulin and central and overall obesity in a general population. Atherosclerosis Risk in Communities Study Investigators. Metabolism. 45, 699–706. First citation in articleCrossref MedlineGoogle Scholar

  • 133 Hajjar, I., & Kotchen, T.A. (2003) Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988–2000. JAMA. 290, 199–206. First citation in articleCrossref MedlineGoogle Scholar

  • 134 Gaffo, A.L., Edwards, N.L., & Saag, K.G. (2009) Gout. Hyperuricemia and cardiovascular disease: how strong is the evidence for a causal link? Arthritis Res Ther. 11, 240. First citation in articleCrossref MedlineGoogle Scholar

  • 135 Roper, N.A., Bilous, R.W., Kelly, W.F., Unwin, N.C., Connolly, V.M., & South Tees Diabetes Mortality Study. (2002) Cause-specific mortality in a population with diabetes: South Tees Diabetes Mortality Study. Diabetes Care. 25, 43–48. First citation in articleCrossref MedlineGoogle Scholar

  • 136 Brindisi, M.C., Bouillet, B., Vergès, B., & Halimi, S. (2010) Cardiovascular complications in type 1 diabetes mellitus. Diabetes Metab. 36, 341–344. First citation in articleCrossref MedlineGoogle Scholar

  • 137 de Oliveira, E.P., & Burini, R.C. (2012) High plasma uric acid concentration: causes and consequences. Diabetol Metab Syndr. 4, 12. First citation in articleCrossref MedlineGoogle Scholar

  • 138 Giammarioli, S., Filesi, C., Vitale, B., Cantagallo, A., Dragoni, F., & Sanzini, E. (2004) Effect of high intakes of fruit and vegetables on redox status in type 2 onset diabetes: a pilot study. Int J Vitam Nutr Res. 74, 313–320. First citation in articleLinkGoogle Scholar

  • 139 Birketvedt, G.S., Aaseth, J., Florholmen, J.R., & Ryttig, K. (2000) Long term effect of fibre supplement and reduced energy intake on body weight and blood lipids in overweight subjects. Acta Medica (Hradec Králové). 43, 129–132. First citation in articleCrossref MedlineGoogle Scholar

  • 140 Sierra, M., García, J.J., Fernández, N., Diez, M.J., Calle, A.P., & Farmafibra Group. (2002) Therapeutic effects of psyllium in type 2 diabetic patients. Eur J Clin Nutr. 56, 830–842. First citation in articleCrossref MedlineGoogle Scholar

  • 141 Wolfram, R.M., Kritz, H., Efthimiou, Y., Stomatopoulos, J., & Sinzinger, H. (2002) Effect of prickly pear (Opuntia robusta) on glucose- and lipid-metabolism in non-diabetics with hyperlipidemia – a pilot study. Wien Klin Wochenschr. 114, 840–846. First citation in articleMedlineGoogle Scholar

  • 142 Aoe, S., Fujita, T., Kinoshita, S., Uchida, T., Suguri, N., Toba, Y., Tsuji, S., Hirakata, M., & Ohya, K. (2006) Effect of oatmeal supplementation on the serum cholesterol levels in adults with boundary and mild hypercholesterolemia. Jpn J Nutr Diet. 64, 77–86 (in Japanese). First citation in articleCrossrefGoogle Scholar

  • 143 Sánchez-Moreno, C., Cano, M.P., de Ancos, B., Plaza, L., Olmedilla, B., Granado, F., & Martín, A. (2004) Consumption of high-pressurized vegetable soup increases plasma vitamin C and decreases oxidative stress and inflammatory biomarkers in healthy humans. J Nutr. 134, 3021–3025. First citation in articleCrossref MedlineGoogle Scholar

  • 144 Chatzipavlou, M., Magiorkinis, G., Koutsogeorgopoulou, L., & Kassimos, D. (2014) Mediterranean diet intervention for patients with hyperuricemia: a pilot study. Rheumatol Int. 34, 759–762. First citation in articleCrossref MedlineGoogle Scholar

  • 145 Saura-Calixto, F., & Goñi, I. (2009) Definition of the Mediterranean diet based on bioactive compounds. Crit Rev Food Sci Nutr. 49, 145–152. First citation in articleCrossref MedlineGoogle Scholar

  • 146 Chrysohoou, C., Skoumas, J., Pitsavos, C., Masoura, C., Siasos, G., Galiatsatos, N., Psaltopoulou, T., Mylonakis, C., Margazas, A., Kyvelou, S., Mamatas, S., Panagiotakos, D.B., & Stefanadis, C. (2011) Long-term adherence to the Mediterranean diet reduces the prevalence of hyperuricemia in elderly individuals, without known cardiovascular disease: the Ikaria study. Maturitas. 70, 58–64. First citation in articleCrossref MedlineGoogle Scholar

  • 147 Kontogianni, M.D., Chrysohoou, C., Panagiotakos, D.B., Tsetsekou, E., Zeimbekis, A., Pitsavos, C., & Stefanadis, C. (2012) Adherence to the Mediterranean diet and serum uric acid: the ATTICA study. Scand J Rheumatol. 41, 442–449. First citation in articleCrossref MedlineGoogle Scholar

  • 148 Guasch-Ferré, M., Bulló, M., Babio, N., Martínez-González, M.A., Estruch, R., Covas, M.-I., Wärnberg, J., Arós, F., Lapetra, J., Serra-Majem, L., Basora, J., & Salas-Salvadó, J. (2013) Mediterranean diet and risk of hyperuricemia in elderly participants at high cardiovascular risk. J Gerontol A Biol Sci Med Sci. 68, 1263–1270. First citation in articleCrossref MedlineGoogle Scholar

  • 149 Zgaga, L., Theodoratou, E., Kyle, J., Farrington, S.M., Agakov, F., Tenesa, A., Walker, M., McNeill, G., Wright, A.F., Rudan, I., Dunlop, M.G., & Campbell, H. (2012) The association of dietary intake of purine-rich vegetables, sugar-sweetened beverages and dairy with plasma urate, in a cross-sectional study. PLoS One. 7, e38123. First citation in articleCrossref MedlineGoogle Scholar

  • 150 Loenen, H.M., Eshuis, H., Löwik, M.R., Schouten, E.G., Hulshof, K.F., Odink, J., & Kok, F.J. (1990) Serum uric acid correlates in elderly men and women with special reference to body composition and dietary intake (Dutch Nutrition Surveillance System). J Clin Epidemiol. 43, 1297–1303. First citation in articleCrossref MedlineGoogle Scholar

  • 151 Williams, P.T. (2008) Effects of diet, physical activity and performance, and body weight on incident gout in ostensibly healthy, vigorously active men. Am J Clin Nutr. 87, 1480–1487. First citation in articleCrossref MedlineGoogle Scholar

  • 152 Haldar, S., Rowland, I.R., Barnett, Y.A., Bradbury, I., Robson, P.J., Powell, J., & Fletcher, J. (2007) Influence of habitual diet on antioxidant status: a study in a population of vegetarians and omnivores. Eur J Clin Nutr. 61, 1011–1022. First citation in articleCrossref MedlineGoogle Scholar

  • 153 Shadick, N.A., Kim, R., Weiss, S., Liang, M.H., Sparrow, D., & Hu, H. (2000) Effect of low level lead exposure on hyperuricemia and gout among middle aged and elderly men: the normative aging study. J Rheumatol. 27, 1708–1712. First citation in articleMedlineGoogle Scholar

  • 154 Choi, H.K., & Curhan, G. (2004) Beer, liquor, and wine consumption and serum uric acid level; the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 51, 1023–1029. First citation in articleCrossref MedlineGoogle Scholar

  • 155 Choi, J.W.J., Ford, E.S., Gao, X., & Choi, H.K. (2008) Sugar-sweetened soft drinks, diet soft drinks, and serum uric acid level: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 59, 109–116. First citation in articleCrossref MedlineGoogle Scholar

  • 156 Nguyen, S., Choi, H.K., Lustig, R.H., & Hsu, C.Y. (2009) Sugar-sweetened beverages, serum uric acid, and blood pressure in adolescents. J Pediatr. 154, 807–813. First citation in articleCrossref MedlineGoogle Scholar

  • 157 Pham, N.M., Yoshida, D., Morita, M., Yin, G., Toyomura, K., Ohnaka, K., Takayanagi, R., & Kono, S. (2010) The relation of coffee consumption to serum uric acid in Japanese men and women aged 49–76 years. J Nutr Metab. pii. 930757. doi: 10.1155/2010/930757 First citation in articleCrossrefGoogle Scholar

  • 158 Choi, H.K., & Curhan, G. (2007) Coffee, tea, and caffeine consumption and serum uric acid level: the third national health and nutrition examination survey. Arthritis Rheum. 57, 816–821. First citation in articleCrossref MedlineGoogle Scholar

  • 159 Gao, X., Curhan, G., Forman, J.P., Ascherio, A., & Choi, H.K. (2008) Vitamin C intake and serum uric acid concentration in men. J Rheumatol. 35, 1853–1858. First citation in articleMedlineGoogle Scholar

  • 160 Stein, H.B., Hasan, A., & Fox, I.H. (1976) Ascorbic acid-induced uricosuria. A consequency of megavitamin therapy. Ann Intern Med. 84, 385–388. First citation in articleCrossref MedlineGoogle Scholar

  • 161 Berger, L., Gerson, C.D., & Yü, T.F. (1977) The effect of ascorbic acid on uric acid excretion with a commentary on the renal handling of ascorbic acid. Am J Med. 62, 71–76. First citation in articleCrossref MedlineGoogle Scholar

  • 162 Juraschek, S.P., Miller, E.R. 3rd., & Gelber, A.C. (2011) Effect of oral vitamin C supplementation on serum uric acid: a meta-analysis of randomized controlled trials. Arthritis Rheum. 63, 1295–1306. First citation in articleCrossrefGoogle Scholar

  • 163 Hayden, M.R., & Tyagi, S.C. (2004) Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle. Nutr. Metab (Lond). 1, 10. First citation in articleCrossref MedlineGoogle Scholar

  • 164 Wang, Y., Zhu, J.X., Kong, L.D., Yang, C., Cheng, C.H., & Zhang, X. (2004) Adminstration of procyanidins from grape seeds reduces serum uric acid levels and decreases hepatic xanthine dehydrogenase/oxidase activities in oxonate-treated mice. Basic Clin Pharmacol Toxicol. 94, 232–237. First citation in articleCrossref MedlineGoogle Scholar

  • 165 Mo, S.F., Zhou, F., Lv, Y.Z., Hu, Q.H., Zhang, D.M., & Kong, L.D. (2007) Hypouricemic action of selected flavonoids in mice: structure-activity relationships. Biol Pharm Bull. 30, 1551–1556. First citation in articleCrossref MedlineGoogle Scholar

  • 166 Chan, W.S., Wen, P.C., & Chiang, H.C. (1995) Structure-activity relationship of caffeic acid analogues on xanthine inhibition. Anticancer Res. 15, 703–705. First citation in articleMedlineGoogle Scholar

  • 167 Ajani, U.A., Ford, E.S., & Mokdad, A.H. (2004) Dietary fiber and C-reactive protein: findings from national health and nutrition examination survey data. J Nutr. 134, 1181–1185. First citation in articleCrossref MedlineGoogle Scholar

  • 168 Ma, Y.S., Griffith, J.A., Chasan-Taber, L., Olendzki, B.C., Jackson, E., Stanek, E.J., Li, W.J., Pagoto, S.L., Hafner, A.R., & Ockene, I.S. (2006) Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr. 83, 760–766. First citation in articleCrossref MedlineGoogle Scholar

  • 169 Estruch, R., Martínez-González, M.A., Corella, D., Salas-Salvadó, J., Ruiz-Gutiérrez, V., Covas, M.I., Fiol, M., Gómez-Gracia, E., López-Sabater, M.C., Vinyoles, E., Arós, F., Conde, M., Lahoz, C., Lapetra, J., Sáez, G., Ros, E., & PREDIMED Study Investigators. (2006) Effects of a Mediterranean-style diet on cardiovascular risk factors: a randomized trial. Ann Intern Med. 145, 1–11. First citation in articleCrossref MedlineGoogle Scholar

  • 170 Alkerwi, A., Vernier, C., Crichton, G.E., Sauvageot, N., Shivappa, N., & Hébert, J.R. (2015) Cross-comparison of diet quality indices for predicting chronic disease risk: findings from the Observation of Cardiovascular Risk Factors in Luxembourg (ORISCAV-LUX) study. Br J Nutr. 113, 259–269. First citation in articleCrossref MedlineGoogle Scholar

  • 171 Huang, X., Jiménez-Moleón, J.J., Lindholm, B., Cederholm, T., Arnlöv, J., Risérus, U., Sjögren, O., & Carrero, J.J. (2013) Mediterranean diet, kidney function, and mortality in men with CKD. Clin J Am Soc Nephrol. 8, 1548–1555. First citation in articleCrossref MedlineGoogle Scholar

  • 172 Tyrovolas, S., Bountziouka, V., Papairakleous, N., Zeimbekis, A., Anastassiou, F., Gotsis, E., Metallinos, G., Polychronopoulos, E., Lionis, C., & Panagiotakos, D. (2009) Adherence to the Mediterranean diet is associated with lower prevalence of obesity among elderly people living in Mediterranean islands: the MEDIS study. Int J Food Sci Nutr. 60(Suppl 6), 137–150. First citation in articleCrossref MedlineGoogle Scholar

  • 173 Kagan, A., Harris, B.R., Winkelstein, W. Jr., Johnson, K.G., Kato, H., Syme, S.L., Rhoads, G.G., Gay, M.L., Nichaman, M.Z., Hamilton, H.B., & Tillotson, J. (1974) Epidemiologic studies on coronary heart disease and stroke in Japanese men living in Japan, Hawaii and California: demographic, physical, dietary and biochemical characteristics. J Chronic Dis. 27, 345–364. First citation in articleCrossref MedlineGoogle Scholar

  • 174 Tsuji, K. (1990) Dietary fiber. Gendai iryo. 23, 33–37. (in Japanese). First citation in articleGoogle Scholar

  • 175 National Institute of Health and Nutrition. (2015) The National Health and Nutrition Survey Japan, 2011. Tokyo: Daiichi-shuppan, 276 (in Japanese). First citation in articleGoogle Scholar

  • 176 Dietary Guidelines Advisory Committee. (2005) Nutrition and your health: Dietary guidelines for Americans. 2005 Dietary Guidelines Advisory Committee Report. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC First citation in articleGoogle Scholar

  • 177 Institute of Medicine of the National Academies (IOM). (2005) Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (Macronutrients). In Dietary, functional, and total fiber (Institute of Medicine of the National Academiesed., pp. 339, The National Academies Press, Washington, DC. First citation in articleGoogle Scholar

  • 178 Wallström, P., Sonestedt, E., Hlebowicz, J., Ericson, U., Drake, I., Persson, M., Gullberg, B., Hedblad, B., & Wirfält, E. (2012) Dietary fiber and saturated fat intake associations with cardiovascular disease differ by sex in the Malmö Diet and Cancer Cohort: a prospective study. PLoS One. 7, e31637. First citation in articleCrossref MedlineGoogle Scholar