Thromb Haemost 1999; 81(06): 913-917
DOI: 10.1055/s-0037-1614598
Letters to the Editor
Schattauer GmbH

Vegetarians and Cardiovascular Risk Factors: Hemostasis, Inflammatory Markers and Plasma Homocysteine

Diego Mezzano
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Ximena Muñoz
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Carlos Martínez
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Ada Cuevas
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Olga Panes
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Eduardo Aranda
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Viviana Guasch
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Pablo Strobel
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Blanca Muñoz
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Soledad Rodríguez
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Jaime Pereira
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
,
Federico Leighton
1   From the Departments of Hematology-Oncology and Nutrition, Diabetes and Metabolism, School of Medicine, and Department of Cell and Molecular Biology, Faculty of Biological Sciences, Catholic University of Chile, Santiago de Chile, Chile
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Received 26. Oktober 1998

Accepted after resubmission 11. März 1999

Publikationsdatum:
09. Dezember 2017 (online)

Summary

We studied hemostatic and inflammatory cardiovascular risk factors (CVRF), and total plasma homocysteine (tHcy) in 26 vegetarians (23 lacto- or ovolactovegetarians and 3 vegans), matched by age, sex and socioeconomic status with omnivorous controls. Vegetarians had significantly lower proportion of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids in plasma lipids, significantly shortened bleeding time, and increased blood platelet count and in vitro platelet function (aggregation and secretion). Plasma levels of all coagulation or fibrinolytic factors and natural inhibitors synthesized in the liver were lower in vegetarians than in controls. Whereas for some factors this decrease was statistically significant (fibrinogen, factor VIIc, anti-thrombin III, protein S, plasminogen) for the remaining (factors VIIIc, Vc, prothrombin, protein C) a trend in the same direction was found. For hemostatic proteins of predominantly extrahepatic origin (von Willebrand factor, tPA, PAI-1) this tendency was not present. No significant differences in inflammatory proteins (C-reactive protein and α1-protease inhibitor) were detected in both groups. tHcy was significantly increased in vegetarians, and correlated only with cobalamin levels. The increased platelet function and tHcy found in vegetarians may counteract the known cardiovascular health benefits of vegetarian diet (VD).

 
  • References

  • 1 Thorogood M, Roe L, McPherson K, Mann JI. Dietary intake and plasma lipid levels: lessons from a study of the diet of health conscious groups. BMJ 1990; 300: 1271-301.
  • 2 Margetts BM, Armstrong BK, Bekin LJ, Vandongen R. Vegetarian diet in mild hypertension: a randomised controlled trial. BMJ 1986; 293: 1468-71.
  • 3 Thorogood M, Carter R, Benfield L, McPherson K, Mann JI. Plasma lipids and lipoprotein cholesterol concentration in people with different diets in Britain. BMJ 1987; 295: 351-3.
  • 4 Hostmark AT, Lystad E, Vellar OD, Hovi K, Berg JE. Reduced plasma fibrinogen, serum peroxides, lipids and apolipoproteins after a three week vegetarian diet. Plant Food Hum Nutr 1993; 43: 55-61.
  • 5 Mann JI, Appleby PN, Key TJ, Thorogood M. Dietary determinants of ischaemic heart disease in health conscious individuals. Heart 1997; 78: 450-5.
  • 6 Fraser GE, Shavlik DJ. Risk factors for all-cause and coronary heart disease mortality in the oldest-old. The Adventist Health Study. Arch Int Med 1997; 157: 2249-58.
  • 7 Key TJA, Thorogood M, Appleby PN, Burr ML. Dietary habits and mortality in 11,000 vegetarians and health conscious people: results of a 17-year follow up. BMJ 1996; 313: 775-9.
  • 8 Arntzenius AC, Kromhout D, Barth JD, Reiber JH, Bruschke AV, Buis B, van Gent CM, Kempen-Voogd N, Strikwerda S, van der Velde EA. Diet, lipoproteins, and the progression of coronary atherosclerosis. The Leiden Intervention Trial. N Eng J Med 1985; 312: 805-11.
  • 9 Ornish D, Brown SE, Scherwitz LW, Billings JH, Armstrong WT, Ports TA, McLanahan SM, Kirkeeide RL, Brand RJ, Gould KL. Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial. Lancet 1990; 336: 129-33.
  • 10 Ness AR, Powles JW. Fruit and vegetables, and cardiovascular disease: a review. Int J Epidemiol 1997; 26: 1-13.
  • 11 Ravnskov U. The questionable role of saturated and polyunsaturated fatty acids in cardiovascular disease. J Clin Epidemiol 1998; 51: 443-60.
  • 12 Ridker PM. Fibrinolytic and inflammatory markers for arterial occlusion: the evolving epidemiology of thrombosis and hemostasis. Thromb Haemost 1997; 78: 53-9.
  • 13 Haines AP, Chakrabarti R, Fisher D, Meade TW, North WRS, Stirling Y. Hemostatic variables in vegetarians and non-vegetarians. Thromb Res 1980; 19: 139-48.
  • 14 Schmidt T, Wijga A, von zur Muhlen A, Bravant G, Wagner TO. Changes in cardiovascular risk factors and hormones during a comprehensive three month kriya yoga training and vegetarian nutrition. Acta Physiol Scand Suppl 1997; 640: 158-62.
  • 15 Pan W-H, Chin C-J, Sheu C-T, Lee M-H.. Hemostatic factors and blood lipids in young Buddhist vegetarians and omnivores. Am J Clin Nutr 1993; 58:: 354-9.
  • 16 Ho CH, Chwang LC. Influence of vegetarianism on fibrinolytic activity. Proc Natl Sci Counc Repub China B 1993; 17: 35-9.
  • 17 Fisher M, Levine PH, Weiner B, Ockene IS, Johnson B, Johnson MH, Natale AM, Vaudreuil CH, Hoogasian J. The effect of vegetarian diets on plasma lipid and platelet levels. Arch Int Med 1986; 146: 1193-7.
  • 18 Butcher LA, O´Dea K, Sinclair AJ, Parkin JD, Smith IL, Blombery P. The effect of very low fat diets enriched with fish or kangaroo meat on cold-induced vasoconstriction and platelet function. Prostaglandins Leukot Essent Fatty Acids 1990; 39: 221-6.
  • 19 Sanders TA, Roshanai F. Platelet phospholipid fatty acid composition and function in vegans compared with age- and sex-matched omnivore controls. Eur J Clin Nutr 1992; 46: 823-31.
  • 20 Agren J, Törmälä M-L, Nenonen M, Hänninen OO. Fatty acid composition of erythrocyte, platelet, and lipids in strict vegans. Lipids 1995; 30: 365-9.
  • 21 Chetty N, Bradlow BA. The effects of a vegetarian diet on platelet function and fatty acids. Thromb Res 1983; 30: 619-24.
  • 22 Thompson SG, Kienast J, Pyke SDM, Haverkate F, van de Loo JCW. for the European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. Hemostatic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. N Eng J Med 1995; 332:: 635-41.
  • 23 Kuller LH, Tracy RP, Shaten J, Meilahn EN. for the MRFIT Research Group. Relationship of C-reactive protein and coronary heart disease in the MRFIT nested case-control study. Am J Epidem 1996; 144:: 537-47.
  • 24 Ridker PM, Cushman M, Stampfer M, Tracy R, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Eng J Med 1997; 336: 973-9.
  • 25 Ridker PM, Cushman M, Stampfer M, Tracy R, Hennekens CH. Plasma concentration of C-reactive protein and risk of developing peripheral vascular disease. Circulation 1998; 97: 425-8.
  • 26 Alexander D, Ball MJ, Mann J. Nutrient intake and haematological status of vegetarians and age-sex matched omnivores. Eur J Clin Nutr 1994; 48: 538-46.
  • 27 Rauma AL, Törrönen R, Hänninen O, Mykkänen H. Vitamin B12 status of long-term adherents of a strict uncooked vegan diet (“living food diet”) is compromised. J Nutr 1995; 125: 2511-5.
  • 28 Schneede J, Dagnelie PC, van Staveren WA, Vollset SE, Refsum H, Ueland PM. Methylmalonic acid and homocysteine in plasma as indicators of functional cobalamin deficiency in infants on macrobiotic diets. Pediat Res 1994; 36: 194-201.
  • 29 Graffar M. Une méthode de classification sociale d´échantillons de population. Courrier 1956; 6: 445-59.
  • 30 Christie WW. The analysis of fatty acids. In Gas Chromatography and Lipids. A Practical Guide. Christie WW, ed. Scotland: The Oily Press Ltd.; 1989. Part 2 64-183.
  • 31 Motchnik PA, Frei B, Ames BN. Measurement of antioxidants in human blood plasma. Methods Enzymol 1994; 234: 269-79.
  • 32 Mezzano D, Tagle R, Panes O, Pérez M, Downey P, Muñoz B, Aranda E, Barja P, Thambo S, González F, Mezzano S, Pereira J. Hemostatic disorder of uremia: the platelet defect, main determinant of the prolonged bleeding time, is correlated with indices of activation of coagulation and fibrinolysis. Thromb Haemost 1996; 76: 312-21.
  • 33 Macy EM, Hayes TE, Tracy RP. Variability in the measurement of C-reactive protein in healthy subjects: implications for reference intervals and epidemiological applications. Clin Chem 1997; 43: 52-8.
  • 34 Pronczuk A, Kipervarg Y, Hayes KC. Vegetarians have higher plasma alpha-tocopherol relative to cholesterol than do nonvegetarians. J Am Coll Nutr 1992; 11: 50-5.
  • 35 Harker LA, Gent M. Antiplatelet agents in the management of thrombotic disorders. In Hemostasis and Thrombosis. Basic Principles and Clinical Practice. Colman RW, Hirsh J, Marder VJ, Salzman EW. eds Philadelphia: J.B.: Lippincott; 1994: 1506-13.
  • 36 Dyerberg J, Bang HO. Haemostatic function and platelet polyunsaturated fatty acids in Eskimos. Lancet 1979; 2 (8140) 433-5.
  • 37 Kromhout D, Bosschieter EB, De Lezenne Coulander C. The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Eng J Med 1985; 312: 1205-9.
  • 38 Shekelle R, Missell L, Paul O, MacMillan-Schryock A, Stamler J. Fish consumption and mortality from coronary heart disease. N Eng J Med 1985; 313: 820.
  • 39 Mead TW, Brozovic M, Chakrabarti RR, Haines AP, Imeson JD, Mellows S, Miller GJ, North WRS, Stirling Y, Thompson SG. Haemostatic function and ischaemic heart disease: principal results of the Northwick Park Heart Study. Lancet 1986; 2: 533-7.
  • 40 Mead TW, Ruddock V, Chakrabarti RR, Miller GJ. Fibrinolytic activity, clotting factors, and longterm incidence of ischaemic heart disease in the Northwick Park Heart Study. Lancet 1993; 342: 1076-9.
  • 41 Mann KG, Butenas S, van’t Veer C. “Normal” hemostasis?. Blood 1998; 92 (Suppl. 01) 38a.
  • 42 Boers GHJ. Hyperhomocysteinemia as a risk factor for arterial and venous disease. A review of evidence and relevance. Thromb Haemost 1997; 78: 520-2.
  • 43 D’Angelo A, Selhub J. Homocysteine and thrombotic disease. Blood 1997; 90: 1-11.
  • 44 Nygard O, Nordrehaug JE, Refsum H, Ueland PM, Farstad M, Vollset SE. Plasma homocysteine levels and mortality in patients with coronary artery disease. N Eng J Med 1997; 337: 230-6.
  • 45 Herbert V. Staging vitamin B-12 (cobalamin) status in vegetarians. Am J Clin Nutr 1994; 59 (Suppl. 05) (Suppl) 1213s-22s.