TY  - JOUR
AU  - de Carvalho, Jozélio Freire
AU  - de Jesus, Rosangela Passos
PY  - 2026
DA  - 2026/06/16
TI  - Vegan and Plant-Based Diets in Rheumatic Diseases: A Review of Current Evidence, Mechanisms, and Perspectives
JO  - Recent Progress in Nutrition
SP  - 009
VL  - 06
IS  - 02
AB  - Plant-based diets have attracted increasing interest in the context of rheumatic diseases due to their potential anti-inflammatory, antioxidant, and immunomodulatory effects. However, there is an important conceptual distinction between a vegan diet, which completely excludes animal-derived products, and a plant-based diet, which prioritizes plant foods but may include small amounts of animal-derived foods. This differentiation is essential to understand the variability in clinical outcomes reported across studies. To critically and comparatively evaluate the available evidence regarding the effects of vegan and plant-based diets on major rheumatic diseases: rheumatoid arthritis (RA), psoriatic arthritis (PsA), axial spondyloarthritis (axSpA), gout, and fibromyalgia—with an emphasis on clinical, laboratory, and metabolic outcomes. A structured narrative review with systematic elements was conducted, with searches performed in PubMed/MEDLINE, Embase, Scopus, and Web of Science databases up to October 6, 2025. Meta-analyses, systematic reviews, randomized clinical trials, and prospective cohort studies investigating vegan, vegetarian, or plant-based diets in adults with rheumatic diseases were included. Methodological quality was assessed using the AMSTAR-2, RoB 2, and Newcastle–Ottawa Scale tools, and the certainty of evidence was graded according to GRADE criteria. A total of 21 relevant studies were identified, including seven clinical trials, four systematic reviews, and ten observational studies. In RA, vegan diets—particularly gluten-free and low-fat patterns—demonstrated significant reductions in pain, CRP, and DAS28, along with improvements in lipid profile and gut microbiota. In PsA and axSpA, data are limited but suggest a modest benefit with whole-food plant-based patterns, possibly mediated by modulation of the gut-immunity axis. Cohort studies indicated up to a 40% reduction in gout risk among vegetarians. In fibromyalgia, plant-based dietary patterns were associated with improvements in pain, fatigue, and quality of life. Overall evidence quality ranged from low to moderate depending on study design and dietary control. Vegan and plant-based diets may have potentially beneficial effects as adjunctive strategies in the management of rheumatic diseases, supporting inflammatory and metabolic control. Distinguishing between a strict vegan diet and a healthy plant-based pattern is essential, as the quality of plant foods appears to determine the magnitude of benefit. Despite methodological limitations in the existing literature, the evidence is biologically plausible. It supports the need for longer and more rigorously designed clinical trials to strengthen evidence-based dietary recommendations in rheumatology.
SN  - 2771-9871
UR  - https://doi.org/10.21926/rpn.2602009
DO  - 10.21926/rpn.2602009
ID  - de Carvalho2026
ER  -