Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-19T20:45:03.311Z Has data issue: false hasContentIssue false

Dietary monounsaturated fatty acids and haemostasis

Published online by Cambridge University Press:  28 February 2007

Colette N. M. Kelly*
Affiliation:
Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, University of Reading, Reading RG6 6AP, UK
Ruth D. Smith
Affiliation:
Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, University of Reading, Reading RG6 6AP, UK
Christine M. Williams
Affiliation:
Hugh Sinclair Unit of Human Nutrition, School of Food Biosciences, University of Reading, Reading RG6 6AP, UK
*
*Corresponding Author: Dr Colette Kelly, present address British Nutrition Foundation, High Holborn House, 52–54 High Holborn, London WC1V 6RQ, UK, fax +44 (0) 20 7404 6747, email [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Diets high in monounsaturated fatty acids (MUFA) are increasingly being recommended as a highly-effective cholesterol-lowering strategy in populations at risk of CHD. However, the need for a re-appraisal of the benefits of diets rich in MUFA became apparent as a result of recent studies showing that meals high in olive oil cause greater postprandial activation of blood coagulation factor VII than meals rich in saturated fatty acids. The present review evaluates the evidence for the effects of MUFA-rich diets on fasting and postprandial measurements of haemostasis, and describes data from a recently-completed long-term controlled dietary intervention study. The data show that a background diet high in MUFA has no adverse effect on fasting haemostatic variables and decreases the postprandial activation of factor VII in response to a standard fat-containing meal. Since the same study also showed a significant reduction in the ex vivo activation of platelets in subjects on the high-MUFA diet, the overall findings suggest that there is no reason for concern regarding adverse haemostatic consequences of high-MUFA diets.

Type
Postgraduate Symposium
Copyright
Copyright © The Nutrition Society 2001

References

Avellone, G, Di Garbo, V, Cordova, R, Scaffidi, L & Bompiani, GD (1998) Effects of Mediterranean diet on lipid, coagulative and fibrinolytic parameters in two randomly selected population samples in Western Sicily. Nutrition Metabolism and Cardiovascular Disease 8, 287296.Google Scholar
Babior, BM & Stossel, TP (editors) (1990 a) Platelets. In Hematology: A Pathophysiological Approach, pp. 203220. New York: Churchill Livingston.Google Scholar
Babior, BM & Stossel, TP (editors) (1990 b) The coagulation cascade and its regulation: Congenital and acquired clotting factor disorders. In Hematology: A Pathophysiological Approach, pp. 181201. New York: Churchill Livingston.Google Scholar
Berry, EM, Eisenberg, S, Haratz, D, Friedlander, Y, Norman, Y, Kaufmann, NA & Stein, Y (1991) Effects of diets rich in monounsaturated fatty acids on plasma lipoproteins – the Jerusalem Nutrition Study: high MUFAs vs high PUFAs. American Journal of Clinical Nutrition 53, 899907.CrossRefGoogle Scholar
British Nutrition Foundation (1992) Unsaturated fatty acids, thrombogenesis and fibrinolysis. Unsaturated Fatty Acids: Nutritional and Physiological Significance. The Report of the British Nutrition Foundation's Task force, pp. 92113. London: Chapman and Hall.CrossRefGoogle Scholar
Cardinal, DC & Flower, RJ (1980) The electronic aggregometer: A novel device for assessing platelet behavior in blood. Journal of Pharmacological Methods 3, 135158.CrossRefGoogle ScholarPubMed
Clauss, A (1957) Gerinnungsphysiologische Schnellmethode zur Bestimmung des Fibrinogens (Coagulation physiological fast method for determination of fibrinogens). Acta Haematologica 17, 237246.CrossRefGoogle Scholar
Davie, EW & Ratnoff, OD (1964) Waterfall sequence for intrinsic blood clotting. Science 145, 13101312.CrossRefGoogle ScholarPubMed
Elwood, PC, Renaud, S & Sharp, DS (1991) Ischaemic heart disease and platelet aggregation. The Caerphilly Collaborative Heart Disease Study. Circulation 83, 3844.CrossRefGoogle ScholarPubMed
Ernst, E & Resch, KL (1993) Fibrinogen as a cardiovascular risk factor: a meta-analysis and review of the literature. Annals of Internal Medicine 118, 956963.CrossRefGoogle ScholarPubMed
Fielding, BA, Callow, J, Owen, RM, Samra, JS, Matthews, DR & Frayn, KN (1996) Postprandial lipemia: the origin of an early peak studied by specific dietary fatty acid intake during sequential meals. American Journal of Clinical Nutrition 63, 3641.CrossRefGoogle ScholarPubMed
Fitzgerald, GA & Barry, P (1997) Dietary factors in thrombosis and hemostasis: summary and conclusions. American Journal of Clinical Nutrition 65, 1699S1701S.CrossRefGoogle Scholar
Foley, M, Ball, M, Chisholm, A, Duncan, A, Spears, G & Mann, J (1992) Should mono- or polyunsaturated fats replace saturated fat in the diet? European Journal of Clinical Nutrition 46, 429436.Google ScholarPubMed
Freese, R & Mutanen, M (1995) Postprandial changes in platelet function and coagulation factors after high-fat meals with different fatty acid compositions. European Journal of Clinical Nutrition 49, 658664.Google ScholarPubMed
Freese, R, Mutanen, M, Valsta, LM & Salminen, I (1994) Comparison of the effects of two diets rich in monounsaturated fatty acids differing in their linoleic/α-linolenic acid ratio on platelet aggregation. Thrombosis and Haemostasis 71, 7377.Google Scholar
Green, D, Ruth, K, Folsom, A & Liu, K (1994) Haemostatic factors in the coronary artery risk development in young adults (CARDIA) study. Arteriosclerosis and Thrombosis 14, 686693.CrossRefGoogle ScholarPubMed
Hamsten, A, Wallidius, G, Szamos, A, Blomback, M, de Faire, U, Dahlen, G, Landou, C & Wiman, B (1987) Plasminogen activator inhibitor in plasma: risk factor for recurrent myocardial infarction. Lancet ii, 38.CrossRefGoogle Scholar
Heinrich, J, Balleisen, L, Schulte, H, Assman, G & van de Loo, J (1994) Fibrinogen and factor VII in the prediction of coronary risk: Results from the PROCAM study. Arteriosclerosis and Thrombosis 14, 5459.CrossRefGoogle ScholarPubMed
Howard, BV, Hannah, JS, Heiser, CC, Jablonski, KA, Paidi, MC, Alarif, L, Robbins, DC & Howard, WJ (1995) Polyunsaturated fatty acids results in greater cholesterol lowering and less triacylglycerol elevation than do monounsaturated fatty acids in a dose-response comparison in a multiracial study group. American Journal of Clinical Nutrition 62, 392402.CrossRefGoogle Scholar
Humphries, SE, Lane, A, Green, FR, Cooper, J & Miller, GJ (1994) Factor VII coagulant activity and antigen levels in healthy men are determined by interaction between factor VII genotype and plasma triglyceride concentration. Arteriosclerosis and Thrombosis 14, 193198.CrossRefGoogle ScholarPubMed
Institute of Brain Chemistry and Human Nutrition (1993) Foodbase. London: Institute of Brain Chemistry and Human Nutrition.Google Scholar
Junker, R, Heinrich, J, Schulte, H, van de Loo, J & Assmann, G (1997) Coagulation factor VII and the risk of coronary heart disease in healthy men. Arteriosclerosis Thrombosis and Vascular Biology 17, 15391544.CrossRefGoogle ScholarPubMed
Kelly, CNM, Smith, RD, Nydahl, MC & Williams, CM (2000) Use of habitual diet records to estimate the fats required to achieve target fatty acid intakes in an intervention study of subjects living in a residential setting. Proceedings of the Nutrition Society 59, 26A.Google Scholar
Kelly, CNM, Smith, RD, Silva, KDRR, Nydahl, MC & Williams, CM (2001) Effects of substituting dietary saturated fatty acids with monounsaturated fatty acids on whole blood platelet aggregation in young healthy volunteers. Proceedings of the Nutrition Society 60 (In the Press).Google Scholar
Keys, A, Menotti, A, Karvonen, MJ, Aravanis, C, Blackburn, H, Buzina, R, Djordjevic, BS, Dontas, AS, Fidanza, F, Keys, MH, Kromhout, D, Nedeljkovic, S, Punsar, S, Seccareccia, F & Toshima, H (1986) The diet and 15-year death rate in the Seven Countries Study. American Journal of Epidemiology 124, 903915.CrossRefGoogle ScholarPubMed
Kris-Etherton, P, Pearson, TA, Wan, Y, Hargrove, RL, Moriarty, K, Fishell, V & Etherton, TD (1999) High-monounsaturated fatty acid diets lower both plasma cholesterol and triacyglycerol concentrations. American Journal of Clinical Nutrition 70, 10091015.CrossRefGoogle Scholar
Larsen, LF, Bladbjerg, E-M, Jespersen, J & Marckmann, P (1997) Effects of dietary fat quality and quantity on postprandial activation of blood coagulation factor VII. Arteriosclerosis Thrombosis and Vascular Biology 17, 29042909.CrossRefGoogle ScholarPubMed
Larsen, LF, Jespersen, J & Marckmann, P (1999) Are olive oil diets antithrombotic? Diets enriched with olive, rapeseed or sunflower oil affect postprandial factor VII differently. American Journal of Clinical Nutrition 70, 976982.CrossRefGoogle ScholarPubMed
Lichtenstein, AH, Ausman, LM, Carrasco, W, Jenner, JL, Gualtieri, LJ, Goldin, BR, Ordovas, JM & Schaefer, EJ (1993) Effects of canola, corn and olive oils on fasting and postprandial plasma lipoproteins in humans as part of a national cholesterol education program step 2 diet. Arteriosclerosis and Thrombosis 13, 15331542.CrossRefGoogle ScholarPubMed
Lopez-Segura, F, Velasco, F, Lopez-Miranda, J, Castro, P, Lopez-Pedrera, R, Blanco, A, Jimenez-Pereperez, J, Torres, A, Trujillo, J, Ordovas, JM & Perez-Jimenez, F (1996) Monounsaturated fatty acid-enriched diet decreases plasma plasminogen activator inhibitor type 1. Arteriosclerosis Thrombosis and Vascular Biology 16, 8288.CrossRefGoogle ScholarPubMed
McDonald, BE, Gerrard, JM, Bruce, VM & Corner, EJ (1989) Comparison of the effect of canola oil and sunflower oil on plasma lipids and lipoproteins and on in vivo thromboxane A2 and prostacyclin production in healthy young men. American Journal of Clinical Nutrition 50, 13821388.CrossRefGoogle ScholarPubMed
Macfarlane, RG (1964) An enzyme cascade in the blood clotting mechanism, and its function as a biochemical amplifier. Nature 202, 498499.CrossRefGoogle ScholarPubMed
Mann, KG (1997) Thrombosis: theoretical considerations. American Journal of Clinical Nutrition 65, 1657S1664S.CrossRefGoogle ScholarPubMed
Marckmann, P, Bladbjerg, EM & Jespersen, J (1998) Diet and blood coagulation factor VII – a key protein in arterial thrombosis. European Journal of Clinical Nutrition 52, 7584.CrossRefGoogle ScholarPubMed
Marckmann, P, Sandstrom, B & Jespersen, J (1990) Effects of total fat content and fatty acid composition in diet on factor VII coagulant activity and blood lipids. Atherosclerosis 80, 227233.CrossRefGoogle ScholarPubMed
Marckmann, P, Sandstrom, B & Jespersen, J (1992) Fasting blood coagulation and fibrinolysis of young healthy adults unchanged by reduction in dietary fat content. Arteriosclerosis and Thrombosis 12, 201205.CrossRefGoogle ScholarPubMed
Marckmann, P, Sandstrom, B & Jespersen, J (1993) Favorable long-term effect of a low-fat/high-fibre diet on human blood coagulation and fibrinolysis. Arteriosclerosis and Thrombosis 13, 505511.CrossRefGoogle Scholar
Marckmann, P, Sandstrom, B & Jespersen, J (1994) Low-fat, high-fiber diet favorably affects several independent risk markers of ischemic heart disease: observations on blood lipids, coagulation and fibrinolysis from a trial of middle-aged Danes. American Journal of Clinical Nutrition 59, 935939.CrossRefGoogle ScholarPubMed
Mata, P, Garrido, JA, Ordovas, JM, Blazquez, E, Alvarez-Sala, LA, Rubio, MJ, Alonso, R & de Oya, M (1992) Effect of dietary monounsaturated fatty acids on plasma lipoproteins and apolipoproteins in women. American Journal of Clinical Nutrition 56, 7783.CrossRefGoogle ScholarPubMed
Meade, TW, Brozovic, M, Chakrabarti, RP, Haines, AP, Imeson, JD, Mellows, S, Miller, GJ, North, WRS, Stirling, Y & Thompson, SG (1986) Haemostatic function and ischaemic heart disease: Principal results of the Northwick Park Heart Study. Lancet ii, 533537.CrossRefGoogle Scholar
Meade, TW, Vickers, MV, Thompson, SG, Stirling, Y, Haines, AP & Miller, GJ (1985) Epidemiological characteristics of platelet aggregability. British Medical Journal 290, 428432.CrossRefGoogle ScholarPubMed
Mensink, RP & Katan, MB (1989) Effect of a diet enriched with monounsaturated or polyunsaturated fatty acids on levels of low-density and high-density lipoprotein cholesterol in healthy women and men. New England Journal of Medicine 321, 436441.CrossRefGoogle ScholarPubMed
Mensink, RP & Katan, MB (1987) Effect of monounsaturated fatty acids versus complex carbohydrates on high-density lipoproteins in healthy men and women. Lancet i, 122125.CrossRefGoogle Scholar
Miller, GJ (1993) Hyperlipidaemia and hypercoagulability. Progress in Lipid Research 32, 6169.CrossRefGoogle ScholarPubMed
Miller, GJ, Cruickshank, JK, Ellis, LJ, Thompson, RL, Wilkes, HC, Stirling, Y, Mitropoulos, KA, Allison, JV, Fox, TE & Walker, AO (1989) Fat consumption and factor VII coagulant activity in middle-aged men. An association between a dietary and thrombogenic coronary risk factor. Atherosclerosis 78, 1924.CrossRefGoogle ScholarPubMed
Miller, GJ, Martin, JC, Mitropoulos, KA, Esnouf, MP, Cooper, JA, Morrissey, JH, Howarth, DJ & Tuddenham, EGD (1996) Activation of factor VII during alimentary lipemia occurs in healthy adults and patients with congenital factor XII or factor XI deficiency, but not in patients with factor IX deficiency. Blood 87, 41874196.CrossRefGoogle Scholar
Miller, GJ, Martin, JC, Webster, J, Wilkes, H, Miller, NE, Wilkinson, WH & Meade, TW (1986) Association between dietary fat intake and plasma factor VII coagulant activity – A predictor of cardiovascular mortality. Atherosclerosis 60, 269277.CrossRefGoogle ScholarPubMed
Miller, GJ, Stirling, Y, Esnouf, AP, Heinrich, J, van de Loo, J, Kienast, J, Wu, KK, Morrissey, JH, Meade, TW, Martin, JC, Imeson, JD, Cooper, JA & Finch, A (1994) Factor VII-deficient substrate plasmas depleted of protein C raise the sensitivity of the factor VII bio-assay to activated factor VII: an international study. Thrombosis and Haemostasis 71, 3848.Google ScholarPubMed
Mitropoulos, KA, Miller, GJ, Watts, GF & Durrington, PN (1992) Lipolysis of triglyceride-rich lipoproteins activates coagulant factor XII: a study in familial lipoprotein-lipase deficiency. Atherosclerosis 95, 119125.CrossRefGoogle ScholarPubMed
Morrissey, JH, Macik, BG, Neuenschwander, PF & Comp, PC (1993) Quantitation of activated factor VII levels in plasma using a tissue factor mutant selectively deficient in promoting factor VII activation. Blood 81, 734744.CrossRefGoogle ScholarPubMed
Mutanen, M, Freese, R, Valsta, LM, Ahola, I & Ahlström, A (1992) Rapeseed oil and sunflower oil diets enhance platelet in vitro aggregation and thromboxane production in healthy men when compared with milk fat or habitual diets. Thrombosis and Haemostasis 67, 352356.Google ScholarPubMed
Needleman, P, Wyche, A & Rat, A (1979) Platelets and blood vessel arachidonate metabolism interactions. Journal of Clinical Investigation 63, 345349.CrossRefGoogle Scholar
Nydahl, MC, Smith, RD, Kelly, CNM & Williams, CM (2000) Detailed analysis of fat sources in diets eaten in a residential hall: basis for planning a dietary intervention. Proceedings of the Nutrition Society 59, 29A.Google Scholar
Oakley, FR, Sanders, TAB & Miller, GJ (1998) Postprandial effects of an oleic acid-rich oil compared with butter on clotting factor VII and fibrinolysis in healthy men. American Journal of Clinical Nutrition 68, 12021207.CrossRefGoogle ScholarPubMed
Pearson, TA, LaCava, J & Weil, HFC (1997) Epidemiology of thrombotic-hemostatic factors and their associations with cardiovascular disease. American Journal of Clinical Nutrition 65, 1764S1782S.CrossRefGoogle ScholarPubMed
Pekkanen, J, Mutanen, M, Räsänen, L, Rauramaa, R & Nissinen, A (1995) Association of factor VIIc activity with dietary fat and blood lipids among elderly men – Finnish cohorts of the Seven Countries Study. Nutrition Metabolism and Cardiovascular Disease 5, 149154.Google Scholar
Prydz, H (1987) Triggering of the extrinsic blood coagulation system. In Blood Coagulation and Haemostasis, pp. 121 [Thomson, JA, editor\. London: Churchill Livingstone.Google Scholar
Rao, LVM & Rapaport, SI (1987) Studies of a mechanism inhibiting the initiation of the extrinsic pathway of coagulation. Blood 69, 645651.CrossRefGoogle ScholarPubMed
Roche, HM & Gibney, M (1997) Postprandial coagulation factor VII activity: the effect of monounsaturated fatty acids. British Journal of Nutrition 77, 537549.CrossRefGoogle ScholarPubMed
Roche, HM, Zampelas, A, Knapper, JME, Webb, D, Brooks, C, Jackson, KG, Wright, JW, Gould, BJ, Kafatos, A, Gibney, MJ & Williams, CM (1998) Effect of long-term olive oil dietary intervention on postprandial triacylglycerol and factor VII metabolism. American Journal of Clinical Nutrition 68, 552560.CrossRefGoogle ScholarPubMed
Ruddock, V & Meade, TW (1994) Factor VII activity and ischaemic heart disease: fatal and non-fatal events. Quarterly Journal of Medicine 87, 403406.Google ScholarPubMed
Sanders, TAB, de Grassi, T, Miller, GJ & Humphries, SE (1999) Dietary oleic and palmitic acids and postprandial factor VII in middle-aged men heterozygous and homozygous for factor VII R353Q polymorphism. American Journal of Clinical Nutrition 69, 220225.CrossRefGoogle ScholarPubMed
Sirtori, CR, Gatti, E, Tremoli, E, Galli, C, Gianfranceschi, G, Franceschini, G, Colli, S, Maderna, P, Marangoni, F, Perego, P & Stragliotto, E (1992) Olive oil, corn oil, and n-3 fatty acids differently affect lipids, lipoproteins, platelets, and superoxide formation in type II hypercholesterolemia. American Journal of Clinical Nutrition 56, 113122.CrossRefGoogle ScholarPubMed
Sirtori, CR, Tremoli, E, Gatti, E, Montanari, G, Sirtori, M, Colli, S, Gianfranceschi, G, Maderna, P, Dentone, CZ, Testolin, G & Galli, C (1986) Controlled evaluation of fat intake in the Mediterranean diet: comparative activities of olive oil and corn oil on plasma lipids and platelets in high-risk patients. American Journal of Clinical Nutrition 44, 635642.CrossRefGoogle ScholarPubMed
Smith, RD, Kelly, CNM, Silva, KDRR, Nydahl, MC & Williams, CM (2001) Effects of substituting dietary saturated fatty acids with monounsaturated fatty acids on blood lipids in young healthy volunteers. Proceedings of the Nutrition Society 60 (In the Press).Google Scholar
Temme, EHM, Mensink, RP & Hornstra, G (1999) Effects of diets enriched in lauric, palmitic or oleic acids on blood coagulation and fibrinolysis. Thrombosis and Haemostasis 81, 259263.CrossRefGoogle ScholarPubMed
Tholstrup, T, Marckmann, P, Hermansen, J, Hølmer, G & Sandström (1999) Effect of modified dairy fat on fasting and postprandial haemostatic variables in healthy young men. British Journal of Nutrition 82, 105113.CrossRefGoogle ScholarPubMed
Tholstrup, T, Marckmann, P, Jespersen, J & Sandström, B (1994) A fat high in stearic acid favorably affects blood lipids and factor VII coagulant activity in comparison to fats high in palmitic acid and high in myristic and lauric acid. American Journal of Clinical Nutrition 59, 371377.CrossRefGoogle Scholar
Thompson, SG, Kienast, J, Pyke, SDM, Haverkate, F & van de Loo, JCW (1995) Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. New England Journal of Medicine 332, 635641.CrossRefGoogle ScholarPubMed
Trip, MD, Cats, VM, van Capelle, FJL & Vreeken, J (1990) Platelet hyperreactivity and prognosis in survivors of myocardial infarction. New England Journal of Medicine 322, 15491554.CrossRefGoogle ScholarPubMed
Turpeinen, AM, Pajari, A-M, Freese, R, Sauer, R & Mutanen, M (1998) Replacement of dietary saturated by unsaturated fatty acids: effects on platelet protein kinase C activity, urinary content of 2,3-dinor-TxB2 and in vitro platelet aggregation in healthy man. Thrombosis and Haemostasis 80, 649655.Google ScholarPubMed
Vicario, IM, Malkova, D, Lund, EK & Johnson, IT (1998) Olive oil supplementation in healthy adults: effects in cell membrane fatty acid composition and platelet function. Annals of Nutrition Metabolism 42, 160169.CrossRefGoogle ScholarPubMed
Wahrburg, U, Martin, H, Sandkamp, M, Schulte, H & Assmann, G (1992) Comparative effects of a recommended lipid-lowering diet vs a diet rich in monounsaturated fatty acids on serum lipid profiles in healthy young adults. American Journal of Clinical Nutrition 56, 678683.CrossRefGoogle Scholar
Wessler, S & Gitel, SN (1984) Warfarin. From bedside to bench. New England Journal of Medicine 311, 645652.Google ScholarPubMed
Williams, CM, Francis-Knapper, JA, Webb, D, Brookes, CA, Zampelas, A, Tredger, JA, Wright, J, Meijer, G, Calder, PC, Yaqoob, P, Roche, H & Gibney, MJ (1999) Cholesterol reduction using manufactured foods high in monounsaturated fatty acids: a randomized crossover study. British Journal of Nutrition 81, 439446.CrossRefGoogle ScholarPubMed
Zampelas, A, Roche, H, Knapper, JME, Jackson, KG, Tornaritis, M, Hatzis, C, Gibney, MJ, Kafatos, A, Gould, BJ, Wright, J & Williams, CM (1998) Differences in postprandial lipaemic response between Northern and Southern Europeans. Atherosclerosis 139, 8393.CrossRefGoogle ScholarPubMed
Zur, M & Nemerson, Y (1987) Tissue factor pathways of blood coagulation. In Haemostasis and Thrombosis, pp. 148164 [Bloom, AL and Thomas, DP, editors]. New York: Churchill Livingstone.Google Scholar