Abstract
There is little information on the dietary modulation of thrombosis-related risk factors such as platelet count. We aimed to assess the effects of Mediterranean diet (MedDiet) on platelet count and related outcomes in an older population at high cardiovascular risk. In participants of the PREDIMED (PREvención con DIeta MEDiterránea) study, we assessed whether an intervention with a MedDiet enriched with extra-virgin olive oil or nuts, relative to a low-fat control diet, modulated platelet count (n = 4189), the risk of developing thrombocytosis and thrombocytopenia (n = 3086), and the association between these alterations and all-cause mortality (median follow-up time: 3.0 years). Although platelet count increased over time (+0.98·109 units/L·year [95% confidence interval: 0.12; 1.84]), MedDiet interventions moderated this increase, particularly in individuals with near-high baseline count (both MedDiets combined: −3.20·109 units/L·year [−5.81; −0.59]). Thrombocytopenia incidence was lower in the MedDiet interventions (incidence rates: 2.23% in control diet, 0.91% in MedDiets combined; hazard ratio: 0.44 [0.23; 0.83]). Finally, thrombocytopenia was associated with a higher risk of all-cause mortality (hazard ratio: 4.71 [2.69; 8.24]), but this relationship was attenuated in those allocated to MedDiet (p-interaction = 0.018). In brief, MedDiet maintained platelet counts within a healthy range and attenuated platelet-related mortality in older adults at high cardiovascular risk.
Highlights
Accruing evidence from observational studies and randomized controlled trials such as the PREDIMED (PREvención con DIeta MEDiterránea) study indicates that following a Mediterranean diet (MedDiet) reduces the risk of developing cardiovascular outcomes [1,2]
MedDiet interventions decreased the risk of developing thrombocytopenia and attenuated the interventions decreased the risk of developing thrombocytopenia and attenuated the association association of of this this platelet platelet count-related count-related alteration alteration with with all-cause all-cause mortality
Following a MedDiet intervention contributed to maintaining platelet counts within normal ranges, a surrogate risk factor for several chronic diseases that tended to increase over time
Summary
Accruing evidence from observational studies and randomized controlled trials such as the PREDIMED (PREvención con DIeta MEDiterránea) study indicates that following a Mediterranean diet (MedDiet) reduces the risk of developing cardiovascular outcomes [1,2]. There is little information on the effects of this dietary pattern on other markers related to thrombosis of a more clinical nature, such as platelet count. Defective and excessive platelet count has been associated with increased mortality and cardiovascular disease incidence in the general population and high cardiovascular risk individuals [9,10,11]. Finding preventive strategies to avoid the appearance of these alterations seems essential Following another plant-based dietary pattern (vegan diet) for 4 weeks decreased platelet counts in a small population relative to a meat-rich eating plan (n = 53) [12]. No study has assessed the effects of this dietary pattern on thrombocytosis in the long term and in larger populations, or on other platelet count-related alterations, such as thrombocytopenia, likely to appear in individuals with poor nutritional status [15]. We do not know whether a possible improvement in platelet count could partially mediate the beneficial effects of MedDiet on chronic diseases and their associated mortality [16]
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