**Background:** The Patrak Valley in the eastern Hindukush, North Pakistan, is home to three ethnolinguistic groups—Pathans, Kohistanis, and Gujjars—whose traditional foraging practices are threatened by globalization and socioeconomic change. This study aimed to document wild food plant and mushroom (WFP) knowledge among these communities, cross-culturally compare plant use, and assess the potential of these practices for ecological transition and food sovereignty.
**Methods:** A field survey was conducted from July to August 2022. Data were collected through 120 semi-structured interviews (40 participants per group) with elderly community members selected via pseudo-random sampling. Participants were asked about WFP uses, including botanical names, local names, parts used, culinary preparations, and gathering locations. Voucher specimens were collected and identified using the Flora of Pakistan and verified against World Flora Online and Index Fungorum. Data were analyzed using use report counts, Venn diagrams for cross-cultural comparison, and the Jaccard similarity index (JI). The study followed the International Society of Ethnobiology code of ethics.
**Key Results:** A total of 68 WFP taxa were documented. The majority were consumed as raw snacks (37 taxa, 49%) and as cooked vegetables (28 taxa, 37%), with a few used in seasonings and herbal teas (1%). Seven distinct food preparation types were recorded: cooked vegetables, chutneys, herbal drinks, herbal teas, salads, raw snacks, and seasonings/spices. Fruits (28 taxa) and aerial parts (25 taxa) were the most utilized plant parts. Plants reported as raw snacks by >50% of participants included Berberis lycium, Morus alba, Celtis tetrandra, Morella esculenta, Pyrus pashia, Olea ferruginea, Diospyros lotus, Morus nigra, Ziziphus oxyphylla, and Ziziphus jujuba. Wild vegetables reported by >50% of participants included Apteranthes tuberculata, Rubus fruticosus, Chenopodium murale, Nasturtium officinale, Chenopodium album, Sophora mollis, and Malva neglecta. Cross-cultural analysis revealed that 37% of plant uses were common to all three groups. Jaccard indices showed the greatest similarity between Kohistanis and Gujjars (JI = 0.38), followed by Pathans and Kohistanis (JI = 0.35), and Pathans and Gujjars (JI = 0.30). Pathans reported the highest number of use reports (1051), followed by Gujjars (626) and Kohistanis (588). Pathans also showed the highest number of idiosyncratic plant uses. Novel or little-known food ingredients within Pakistani food ethnobotany included Aesculus indica, Agaricus campestris, Apteranthes tuberculata, Duchesnea indica, Equisetum arvense, Eremurus himalaicus, Isodon rugosus, Morella esculenta, Sophora mollis, and Drimia indica.
**Clinical Implications:** While not a clinical study, the findings have significant public health and nutritional implications for marginalized mountain communities. The documented WFPs represent a diverse, locally available source of nutrition that could enhance food sovereignty and food security in a region highly vulnerable to food insecurity and climate change. The study highlights that traditional foraging practices align with environmental and social sustainability standards and could be integrated into future development programs. The authors recommend promoting food tourism, sustainable harvesting practices, and educational initiatives to revitalize local ecological knowledge among youth. They also emphasize the need for policy revisions to protect biodiversity and support WFP-centered approaches to food security, particularly in the context of ongoing ecological transition and the threat of biodiversity loss.