Abstract

Introduction: Dietary modification that reflects healthy eating is a notable strategy for CVD prevention on a population level. The cardioprotective role diet plays in hemostasis and thrombosis, particularly in respect to platelet function remains unclear. Hypothesis: Healthier Alternative Healthy Eating Index (AHEI) scores associate with attenuated platelet reactivity in a large-scale population cohort. Methods: Cross-sectional data was obtained from Framingham Heart Study participants (N=3,429). AHEI scores were derived from self-reported Harvard semi-quantitative food frequency questionnaires. Ranging from 0 to 110, higher AHEI scores reflect healthier overall diet quality. Five bioassays measured platelet reactivity traits across several agonists in whole blood and platelet-rich plasma samples. Linear mixed effects models adjusted for age, sex, aspirin use, family relatedness, daily energy intake, and BMI evaluated associations between platelet reactivity and AHEI scores and components. Results: Higher AHEI scores associated with attenuated platelet reactivity among 16 different traits (P<0.01), with notable decreased platelet aggregation to collagen, TRAP6 (PAR1 agonist), ADP, and ristocetin. Of the 11 AHEI components, higher EPA & DHA intake was most strongly associated to decreased platelet function with the greatest number of significant associations to platelet traits (18 traits, P<0.01) and moderate negative effect sizes (Figure 1). Conclusions: We report that higher AHEI scores associate with decreased platelet reactivity. Effects appear strongest for EPA & DHA intake consistent with several small randomized controlled trials. However, we found that a holistic AHEI score reflects a better interpretation of diet as a modulator of platelet function compared to individual components. Our results conclude that the impact of a healthier diet in preventing thrombosis may be partially mediated through a decline in platelet reactivity through multiple independent activation pathways.

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