Mediterranean Diet and White Blood Cell Count-A Randomized Controlled Trial.

Álvaro Hernáez,Xavier Pintó,Andrés Díaz-López,Montserrat Cofán,José Lapetra,Dolores Corella,Miquel Fiol,Ramón Estruch,José V Sorlí,Olga Castañer,Emilio Sacanella,Emilio Ros,Camille Lassale,Lluís Serra‐Majem ,Enrique Gómez‐Gracia ,Ángel M Alonso‐Gómez ,Ana García‐Arellano ,Sara Castro‐Barquero ,Anna Tresserra‐Rimbau ,Nancy Babió ,Miguel Ángel Martínez‐González ,Jordi Salas‐Salvadó

doi:10.3390/foods10061268

Abstract

We aimed to assess the effects of the antioxidant-rich Mediterranean diet (MedDiet) on white blood cell count. Our study population included participants in the PREvención con DIeta MEDiterránea study (average age 67 years old, 58% women, high cardiovascular risk). We assessed whether a MedDiet intervention enriched in extra-virgin olive oil or nuts, versus a low-fat control diet, modified the incidence of leukocytosis (>11 × 109 leukocytes/L), mild leukopenia (<4.5 × 109 leukocytes/L), or severe leukopenia (<3.5 × 109 leukocytes/L) in individuals without the condition at baseline (n = 3190, n = 2925, and n = 3190, respectively). We also examined whether MedDiet modified the association between leukocyte count alterations and all-cause mortality. Both MedDiet interventions were associated with a lower risk of developing leukopenia (incidence rates: 5.06% in control diet, 3.29% in MedDiet groups combined; hazard ratio [95% confidence interval]: 0.54 [0.36–0.80]) and severe leukopenia (incidence rates: 1.26% in control diet, 0.46% in MedDiet groups combined; hazard ratio: 0.25 [0.10–0.60]). High cumulative adherence to a MedDiet was linked to lower risk of leukocytosis (incidence rates: 2.08% in quartile 1, 0.65% in quartile 4; HRQ4-Q1: 0.29 [0.085–0.99]) and attenuated the association between leukopenia and all-cause mortality (P-interaction = 0.032). In brief, MedDiet decreased the incidence of white blood cell count-related alterations in high cardiovascular risk individuals.

Highlights

There is growing evidence that diet can modulate the response of the immune system [1,2]
Our results show that a Mediterranean diet (MedDiet) intervention was associated with a lower risk of developing mild and severe leukopenia in middle-aged and older adults at high cardiovascular risk
High adherence to a MedDiet—regardless of the intervention—was associated with decreased incidence of any white blood cell (WBC) count alteration and attenuated all-cause mortality risk linked to leukopenia

Summary

Introduction

There is growing evidence that diet can modulate the response of the immune system [1,2]. Immunomodulatory effects of some of these nutrients are yet to be proven beyond low-grade inflammation ( in the case of vitamin E and phenolic antioxidants) [3,4,9,10]. Combining these functionally diverse bioactive compounds in a healthy dietary pattern such as the Mediterranean diet (MedDiet) may be a sound strategy to promote the overall function of the immune system. No intervention study has assessed the effects of MedDiet on other immune-related responses such as white blood cell (WBC) count. An improvement in WBC counts and their related conditions after following a MedDiet is plausible

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