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Influence of dietary fat type on arterial thrombosis tendency
1Professor of Experimental Nutrition Maastricht University, Scientific Director NutriScience, PO Box 616, 6200 MD Maastricht, The Netherlands.
Insights
Replacing saturated fats with unsaturated fats, like those in fish oil and vegetable oils, generally lowers cardiovascular risk. Studies suggest these dietary changes can reduce arterial thrombosis and improve outcomes, though more research is needed for specific conditions.
Area of Science:
- Cardiovascular Science
- Nutritional Science
- Thrombosis Research
Background:
- Cardiovascular disease (CVD) has multiple causes, with dietary fat type influencing many risk indicators.
- Modifying risk factors, like dietary lipids, can impact CVD morbidity and mortality once a causal link is established.
Purpose of the Study:
- To review the effects of dietary lipids on cardiovascular risk.
- To emphasize the impact of dietary fats on arterial thrombosis, platelet function, coagulation, and fibrinolysis.
Main Methods:
- Review of epidemiological studies and secondary prevention trials.
- Analysis of animal thrombosis models and human models (PTCA, CABG).
- Examination of effects on endothelial integrity, platelet aggregation, coagulation factors, and fibrinolysis.
Main Results:
- Replacing saturated with unsaturated fatty acids generally reduces CVD morbidity and mortality.
- Fish oil and certain vegetable oils show potential for secondary prevention and reducing arterial thrombosis.
- Dietary fat impacts endothelial integrity, platelet aggregation, coagulation, and fibrinolysis, but results are often inconsistent and require novel validation methods.
Conclusions:
- Dietary unsaturated fatty acids appear beneficial for cardiovascular health, primarily by reducing thrombotic tendencies.
- While promising, the anti-thrombotic effects of specific dietary fats require further investigation and validation in human models.
- Trans unsaturated fatty acids may increase cardiovascular risk, but likely not through direct effects on arterial thrombosis.
Abstract:
Cardiovascular disease has a multifactorial aetiology, as is illustrated by the existence of numerous risk indicators, many of which can be influenced by the dietary fat type. It should be recalled, however, that only after a cause-and-effect relationship has been established between the disease and a given risk indicator (called a risk factor in that case), modifying this factor can be expected to affect disease morbidity and mortality. In this review, effects of dietary lipids on cardiovascular risk are considered, with special emphasis on modification of arterial thrombosis and platelet thrombotic processes, coagulation and fibrinolysis. Although epidemiological studies do not give entirely consistent results, replacement of dietary saturated by unsaturated fatty acids generally lowers cardiovascular morbidity and mortality. The few (secondary) prevention studies reported so far confirmed this for fish oil or fish oil concentrates, as well as for vegetable oils rich in oleic-, linoleic- or a-linolenic acids. Animal thrombosis models demonstrated that dietary unsaturated fatty acids reduce arterial thrombosis tendency as compared to saturated fatty acids. Using restenosis after percutaneous transluminal coronary angioplasty (PTCA) and occlusion of coronary artery bypass grafts (CABG) as human models of arterial thrombosis, fish oil treatment has been shown to have an anti-thrombotic effect, but results are inconsistent (PTCA) or need confirmation (CABG). Major thrombotic and anti-thrombotic conditions and processes include endothelial integrity, thrombotic functions of blood platelet, coagulation, and fibrinolysis. The dietary fat type can affect endothelial integrity, but results are inconsistent and often difficult to interpret in terms of arterial thrombosis tendency. The same can be concluded for platelet aggregation, especially because results of dietary interventions often depend on the aggregation measuring technique. Novel well-validated methods are required to solve this problem. Dietary fats can affect certain factors involved in blood coagulation and fibrinolysis. Thus, Factor VII activity is increased by the fat content of the diet. However, the dietary fat type seems of less importance. Studies addressing the effect of specific fatty acids on extrinsic clotting and thrombin formation in vivo did not produce consistent results. The same holds for the dietary fatty acid effects on promoters and inhibitors of the plasma fibrinolytic potential. Although trans unsaturated fatty acids may increase cardiovascular risk, this is probably not mediated by effects on arterial thrombosis.